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Publisher: Elsevier   (Total: 3030 journals)

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Showing 1 - 200 of 3030 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 303, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 196, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 120, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 304, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 390, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 174, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 154, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 143, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Alexandria Journal of Medicine
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2090-5068
   Published by Elsevier Homepage  [3030 journals]
  • Can mesenchymal stem cells be used as a future weapon against breast
           cancer?

    • Authors: Hend AbdelGawad Shakshouk; Hayssam Rashwan
      Pages: 1 - 5
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Hend AbdelGawad Shakshouk, Hayssam Rashwan
      Background Mesenchymal stem cells (MSCs) are recruited to the stroma of cancers. They interact with cancer cells to promote invasion and metastasis or to suppress tumor growth. The unique tumor-homing capacity of MSCs makes them a promising vehicle to deliver various anticancer agents. Aim The aim of this study was to detect the possibility of using mesenchymal stem cells as a future weapon against breast cancer. Methods PubMed, PubMed central, Springer and Cochrane databases were searched using specified terms. Results Literature search yielded 17 manuscripts: seven of which suggested the use of MSCs in breast cancer therapy, while six studies raised the possibility that MSCs may promote tumor growth and four other studies assumed a dual role for MSCs. Conclusions The role of MSCs in breast cancer therapy is still debatable. We recommend future research in the field of MSCs in Alexandria University as it is our hope in the fight against breast cancer.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.003
       
  • Current status of multi-detector row helical CT in imaging of adult
           acquired pancreatic diseases and assessing surgical neoplastic
           resectability

    • Authors: Mary Y. Tadros; Remon Zaher Elia
      Pages: 7 - 14
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Mary Y. Tadros, Remon Zaher Elia
      Background It is usually hard to detect pancreatic lesions early as the pancreas lays retro peritoneum so it cannot be assessed during a routine physical exam. By the time a person has symptoms, the disease has already established morphological imaging CT changes. Objective The objective of our study was to clarify the role of multidetector computerized tomography (MDCT) in different adult acquired pancreatic diseases and assess the efficacy of surgical pancreatic tumors resectability preoperative. Materials & methods The study included thirty adult patients suspected to have pancreatic diseases (18 males and 12 females); their age range was 45–90years with a mean age of 68years. All patients underwent triple-phase multi-detector row CT using a 16-slice machine. The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, histopathology or follow-up. Results Of 30 patients, 15 had pancreatic malignancies (14 adenocarcinoma of which 6 were resectable and 8 were irresectable, 1 distant metastasis) proven at biopsy and/or surgery, 11 patients had pancreatitis (acute and chronic), three patients had cystic benign tumors (2 mucinous cystadenoma, 1 serous cystadenoma), and one patient had neuroendocrine tumor (insulinoma). Conclusion Contrast enhanced multiphase pancreatic imaging by MDCT with its post processing techniques represents the imaging modality of choice for the diagnosis of different adult acquired pancreatic diseases.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.004
       
  • Clinical outcome of ovarian vein embolization in pelvic congestion
           syndrome

    • Authors: Hassan Abdelsalam
      Pages: 15 - 20
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Hassan Abdelsalam
      Introduction Pelvic congestion syndrome (PCS), is a condition associated with ovarian vein (OV) incompetence among other causes. It is manifested by chronic pelvic pain with associated dyspareunia and dysmenorrhea. The diagnosis of PCS is often overlooked and the management can be difficult. Traditional therapy for PCS has included both medical and surgical approaches and more recently endovascular therapy. The aim of this work The aim of this work was to assess the clinical efficacy of ovarian vein embolization in treatment of PCS associated with OV incompetence and in the management of pelvic varices via catheter directed coil embolization. Conclusion From our and previous results, we can conclude that catheter directed OV coil embolization is a feasible procedure for treatment of pelvic congestion syndrome associated with OV incompetence. Presence of bilateral OV incompetence should always be investigated prior this therapy. Further prospective trials are required to assess the full benefits and efficacy of this technique, and to assess which may be the best embolic agent.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.006
       
  • Diagnostic accuracy of the combined use of conventional sonography and
           sonoelastography in differentiating benign and malignant solitary thyroid
           nodules

    • Authors: Ahmad Hafez Afifi; Walid Abdel Halim Abo Alwafa; Wael Mohamad Aly; Habashy Abdel Baset Alhammadi
      Pages: 21 - 30
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Ahmad Hafez Afifi, Walid Abdel Halim Abo Alwafa, Wael Mohamad Aly, Habashy Abdel Baset Alhammadi
      Objective To assess the diagnostic accuracy of combined use of conventional grayscale US and sono-elastography in differentiating benign and malignant solitary thyroid nodules. Materials and methods This prospective study included 50 patients with solitary thyroid nodules being evaluated using grayscale US followed with sono-elastography (USE). Suspicious conventional sonographic data for malignancy then evaluated using USE were classified according to Rago criteria with calculation of strain ratio. The diagnostic performances of grayscale US, elastography with Rago criteria, for predicting thyroid malignancy were compared and cutoff value for strain ration was statistically analyzed. Finally all patients with solitary nodule were subjected to US-guided FNAC and 35 patients recommended for surgery in the form of 12 patients underwent total thyroidectomy and 23 patients underwent thyroidectomy with neck dissection. Results 30 females (60%), and 20 males (40%) were included (Mean age 38) with final diagnosis comprised 29 (58%) pathologically proved benign thyroid nodules and 21 (42%) pathologically proved malignant nodules. US showed significant relation between markedly hypo-echogenicity, oval than tall, margin irregularity, presence of micro-calcification with diagnosis of thyroid malignancies with p value <0.001. Regarding sonoelastography, there was significant relation between elastography scores 4 and 5 and thyroid malignancies showing sensitivity of 80%, a specificity of 100%, and p value <0.001. The most accurate strain ratio cutoff value among studied cases was 2.52. Combination of grayscale US and sono-elastography yielded better results with sensitivity of 92%, specificity of 95%, PPV of 89%, NPV of 92% and diagnostic accuracy or efficacy of 96%. Conclusion Combined use of USE and grayscale US, showed superior performance in the differentiation of malignant and benign thyroid nodules compared with each technique alone. Suspicious US criteria with elasticity Rago scores 4 and 5 and strain ratio more than 2.52 are the most predictive signs of malignancy.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.007
       
  • Gold in semen: Level in seminal plasma and spermatozoa of normal and
           infertile patients

    • Authors: K.P. Skandhan; J. Valsa; B. Sumangala; V. Jaya
      Pages: 31 - 33
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): K.P. Skandhan, J. Valsa, B. Sumangala, V. Jaya
      The study was conducted to understand the amount of gold in semen of normal and different infertile conditions. Gold was estimated in normal (n38) and pathological conditions (n86) by employing Atomic Absorption Spectrophotometer. Gold level observed in seminal plasma was as follows: in normozoospermia (n38) – 17.0μg%±9.63; oligozoospermia (n23) – 13.0μg%±0.73; oligoasthenozoospermia (n44) – 20.5μg%5±.58 and in azoospermia (n19) 21.5μg%±7.52. Gold level in sediment (spermatozoa) of normal was almost same as observed in its seminal plasma whereas in oligozoospermia and oligoasthenozoospermia the level was low.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.003
       
  • Serum IL 6 and umbilical artery Doppler indices in pre-eclamptic patients

    • Authors: Medhat Y. Anwer; Tark A. Karkor; Sally S. El-Tawab; Akram A. Deghady; Ihab M. El Tayeb
      Pages: 35 - 40
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Medhat Y. Anwer, Tark A. Karkor, Sally S. El-Tawab, Akram A. Deghady, Ihab M. El Tayeb
      Objectives To study the changes in serum IL 6 levels in pre-eclamptic patients and to detect any correlation between these changes and changes in the umbilical artery Doppler velocimetry. Methods In Shatby Hospital, 100 pregnant women, at or beyond 32weeks were selected and divided into three groups: group A with severe pre-eclampsia, group B with mild pre-eclampsia, and group C with normal pregnancy as control. Measurement of maternal serum IL 6 using ELISA and umbilical artery Doppler velocimetry was done. Kruskal–Wallis, Mann–Whitney U tests, and Spearman’s rank correlation tests were used. Results A statistical significant difference (p <0.001) was found regarding serum IL-6 level. Using ROC curve for IL 6 levels, it is suggested that IL 6 of 0.82ng/dl is a cutoff level to early diagnose mild pre-eclampsia (with sensitivity 87.5% and specificity 100%). A statistical significant correlation was found between maternal serum IL 6 levels and S/D ratio and RI in severe pre-eclamptic group (p <0.05). Conclusion Maternal serum IL 6>0.82ng/dl can be implicated as an early laboratory diagnosis of mild pre-eclampsia. The significant correlation between maternal serum IL 6 levels and Doppler velocimetry supports both the immunologic and the systemic endothelial dysfunction theories of pre-eclampsia.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.004
       
  • Serum CYFRA 21-1 in Egyptian women with breast cancer

    • Authors: Samia A. Ebied; Wafaa M.E. Abdel-Rehim; Sanaa A. El-Benhawy; Mona A. El-Gawish; Mohamed A.A. Hassan; Islam I. El-Settawy
      Pages: 41 - 47
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Samia A. Ebied, Wafaa M.E. Abdel-Rehim, Sanaa A. El-Benhawy, Mona A. El-Gawish, Mohamed A.A. Hassan, Islam I. El-Settawy
      Introduction: Cytokeratin fragment 21.1 (CYFRA 21.1) assay detects a serum fragment of cytokeratin 19 (CK19) and is employed in the diagnosis and management of lung cancer, particularly of squamous cell histotype. Breast carcinoma has been demonstrated to express CK19 fragments in the primary and metastatic lesions and CK19 mRNA is detectable in peripheral blood from patients affected by breast cancer. Aim of the work: The aim of the present study was to evaluate the clinical significance of serum CYFRA21-1 in patients with breast cancer by analyzing the correlation between serum CYFRA21-1 titers, clinicopathological factors and prognosis in comparison with serum CA15.3 and CEA tested in the same samples. Subjects and methods: This study included 60 breast cancer patients and 25 healthy females as control group. Three blood samples were drawn from each patient, before surgery, two weeks after surgery and after 6 cycles of chemotherapy. One blood sample was drawn from each subject of control group. Serum was separated and kept frozen till used for estimation of CYFRA21-1 by enzyme linked immunosorbent assay (ELISA) and serum CA15.3 and CEA by immunoradiometric assay (IRMA). Results: Serum CYFRA21-1 was highly elevated in breast cancer patients than in controls and was significantly associated with tumor size, clinical stage and axillary lymph node involvement. Serum CYFRA21-1 was superior to CA15.3 and CEA as a diagnostic marker for breast cancer using ROC curve analysis. Higher levels of serum CYFRA21-1 and CA15.3 were significantly associated with poor prognosis in primary breast cancer patients. Conclusions: The measurement of serum CYFRA 21-1 in breast cancer patients may be useful for detecting disease relapse and for assessing surgical and chemotherapeutic efficacy. Further prospective studies using greater number of patients are required to confirm our findings.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.006
       
  • Total ear reconstruction: The role of bilateral triangular post-auricular
           flaps for creation of the cephaloauricular sulcus

    • Authors: Saad Mohamed Saad Ibrahiem; Adham Farouk
      Pages: 49 - 53
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Saad Mohamed Saad Ibrahiem, Adham Farouk
      Introduction Auricular reconstruction of congenital or acquired ear defects can provide a realistic good-looking ear and functional cephaloauricular sulcus especially for those who wear eyeglasses. Over the past few years, refinements in the techniques of elevating the buried ear framework in the second stage of ear reconstruction have shifted from simple skin grafting to the use of flaps and cartilage blocks for creation of the cephaloauricular sulcus. Objective The aim of the study was to describe useful simple modification using bilateral triangular flaps and full thickness skin graft to create adequately functional cephalo-auricular sulcus especially for patients wearing eyeglasses during the second stage ear reconstruction. The study design The described technique was carried out between June 2010 and January 2014, for 37 patients (24 patients with congenital microtia grade III, 7 patients with post-burn ear deformity, and 6 patients with post-traumatic ear defects). During the second stage of total ear reconstruction, the ear framework is separated substantially from the side of the head and positioned at the desired angle by means of a block of cartilage covered with a fascial flap. Then, two local triangular flaps from the adjacent non-hairy skin are created (one is superiorly based and the other is inferiorly based) and inset into the created cephaloauricular sulcus. The rest of the post-auricular defect is covered with a full thickness graft. Results The technique was simple and effective with no post-operative complication regarding flaps viability. Patients requiring glasses have worn frames soon after the tie-over was removed and no sulcus problems have resulted.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.008
       
  • Effects of l-carnitine on oxidative stress parameters in oophorectomized
           rats

    • Authors: Emel Peri Canbolat; Nevin Sağsöz; Volkan Noyan; Aykan Yücel; Üçler Kısa
      Pages: 55 - 60
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Emel Peri Canbolat, Nevin Sağsöz, Volkan Noyan, Aykan Yücel, Üçler Kısa
      Aims The aim of this study was to investigate the antioxidant effects of l-carnitine on the oxidative stress parameters in oophorectomized rats. Methods Twenty-four female albino Wistar rats were used. Rats were divided into four groups: laparotomy-only (LOSALINE) group, oophorectomy plus l-carnitine 100mg/kg/day (OXL100) group, oophorectomy plus l-carnitine 500mg/kg/day (OXL500) group, and oophorectomy-only (OXSALINE) group. Experimental protocol was started on day 21 post-castration. Various dosage forms of l-carnitine or isotonic saline were administered intraperitoneally for 14 consecutive days. Nitric oxide (NO), malondialdehyde (MDA), total antioxidant status (TAS), total oxidative stress (TOS) and oxidative stress index (OSI) were evaluated in the tissues including kidney, liver and heart, and sera. Result(s) In the heart tissue samples, there was no difference in the levels of NO, OSI and TOS between the groups. However, MDA levels in OXSALINE group were significantly higher than OXL500 group. On the other hand, there was no statistically significant differences between the groups in terms of levels of NO, MDA, TAS, TOS and OSI in liver, kidney and sera samples. Conclusion(s) Levels of MDA in the heart tissue were significantly higher in OXSALINE group compared to OXL500 group. Thus, it may be suggested that l-carnitine reduces oxidative stress at least in the heart of oophorectomized rats.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.002
       
  • l-Carnitine ameliorates knee lesions in mono-iodoacetate induced
           osteoarthritis in rats

    • Authors: Samia Mohamed Ali; Amr Abdel Kader Okda; Iman Samy Dessouky; Wafaa Ahmed Hewedy; Noha Mahmoud Zahran; Butheina Abdul-wally Alamrani
      Pages: 61 - 66
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Samia Mohamed Ali, Amr Abdel Kader Okda, Iman Samy Dessouky, Wafaa Ahmed Hewedy, Noha Mahmoud Zahran, Butheina Abdul-wally Alamrani
      Objective To evaluate the chondroprotective effect of l-carnitine in relation to glucosamine sulfate and in an experimental model of osteoarthritis (OA). Materials and methods Thirty-two adult male Wister albino rats weighing 150–210g were assigned randomly into 4 groups: 8 rats in each group, group I (control group), group II (MIA induced OA group), group III (MIA induced OA+glucosamine sulfate treated group), and group IV (MIA induced OA+ l-carnitine treated group). Weight, knee diameter, and knee bend score were recorded on days 0, 1, 7, 14 and 28. On day 28 all animals were sacrificed. Synovial fluid of left knee was collected, and the interleukin-1β (IL-1β), Cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-13 (MMP-13) levels were measured by ELISA. The knee joints were removed and stained with H&E for histological evaluation. Results The pathological abnormalities attributed to MIA induced arthritis was dramatically lowered in rats treated with glucosamine or l-carnitine. Synovial fluid levels of IL-1β, COMP and MMP-13 were increased in OA group, and significantly reduced with glucosamine or l-carnitine treated groups. Conclusion l-Carnitine has a potential chondroprotective effect in this animal model of OA.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.03.002
       
  • Mean platelet volume and mean platelet volume/platelet count ratio as a
           risk stratification tool in the assessment of severity of acute ischemic
           stroke

    • Authors: Amira M. Elsayed; Ghada A. Mohamed
      Pages: 67 - 70
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Amira M. Elsayed, Ghada A. Mohamed
      The mean platelet volume (MPV) is a laboratory marker associated with platelet function and activity. Increased MPV in thromboembolic disease is reflected as an important risk factor. The aim of this study was to compare the MPV and mean platelet volume/platelet count (MPV/PC) ratio between ischemic cerebrovascular stroke and control subjects and furthermore, to find out their diagnostic value in an acute setting to help risk stratification in patients with ischemic stroke. Methods: The cross-sectional study was conducted in Kuwait city Medical Hospitals, the state of Kuwait from April 2015 to October 2015. It comprised 50 consecutive patients with acute ischemic stroke, and 20 healthy volunteers. Blood samples were taken to measure MPV and MPV/PC ratio. The Severity of ischemic stroke was assessed by the Modified Rankin scale. Result: The ischemic stroke patients had significantly higher MPV and MPV/PC ratio compared to the control group (p =0.001 and p =0.017) respectively. The MPV value was higher and more significant (p =0.011) in patients group with high Rankin scale (⩾3) in comparison with those with lower scores. Receiver operator characteristic analysis revealed that an MPV cutoff value of >8.1 femtoliters provided 68.0% sensitivity and 80.0% specificity. An MPV/PC cutoff value of >0.031 fl10−4 μL−1 showed 70% sensitivity and 75% specificity. The area under the ROC curve for MPV and MPV/PC ratio was 0.789 and 0.701 respectively, which indicates the high discriminative value of MPV and MPV/PC ratio for predicting severe ischemic stroke based on Rankin score ⩾3 from a mild stroke. Conclusion: MPV and MPV/PC ratio could be considered meaningful laboratory markers for the risk of acute ischemic stroke.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.03.003
       
  • Interest of the therapeutic education in patients with type 2 diabetes
           observing the fast of Ramadan

    • Authors: Henda Jamoussi; Rym Ben Othman; Salma Chaabouni; Amel Gamoudi; Olfa Berriche; Feten Mahjoub; Imen Sebai; Chiraz Amrouche
      Pages: 71 - 75
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Henda Jamoussi, Rym Ben Othman, Salma Chaabouni, Amel Gamoudi, Olfa Berriche, Feten Mahjoub, Imen Sebai, Chiraz Amrouche
      The fast of Ramadan is a dilemma for diabetic patients due to the complexity of the management of diabetes during this holy month and the multiple risks they face (hypoglycemia, etc.). Objectives Evaluate the impact of a structured protocol of therapeutic education in a sample of type 2 diabetes, who were authorized by their doctors to fast, on metabolic and anthropometric profiles. Methods This prospective study was conducted among 54 type 2 diabetic patients (28 men and 26 women) aged 36–65years, recruited from National Nutrition Institute. Patients were divided into two groups: the first group (n =26) received an education session one to two weeks before the month of Ramadan; the second group (n =28) did not have appropriate therapeutic education except therapeutic adjustments. All our diabetic patients benefited from anthropometric measurements, determination of body composition and metabolic assessment (HbA1c, cholesterol, triglycerides, etc.) before and after the month of Ramadan. Results The fast was completed without complications in 25 diabetic patients educated group and 22 control patients. We found that weight loss was greater among educated diabetic patients (−1.05kg) than in controls (−0.58kg), but without statistical significance. Body composition has not undergone significant changes in both diabetic groups. Therapeutic education has led to a decline of 0.27% in HbA1c in the educated group while glycemic control in diabetic patients uneducated remained stable. Furthermore, we observed a better lipid profile in diabetic patients educated than those who did not have education. Conclusion Our results justify the interest of patient education centered on the month of Ramadan in all type 2 diabetic patients observing the fast of the holy month. This education should be continued during Ramadan in order to fulfill this religious rite safely.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.002
       
  • Prevalence and associated factors of stress, anxiety and depression among
           medical Fayoum University students

    • Authors: Wafaa Yousif Abdel Wahed; Safaa Khamis Hassan
      Pages: 77 - 84
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Wafaa Yousif Abdel Wahed, Safaa Khamis Hassan
      Background Mental health issues are increasing in severity and number on college campuses. Improving adolescent mental well-being remains a challenge for most societies. Objectives The objectives of this study was to study the prevalence of psychological mood disorders and its association with some factors. Methods A cross-sectional-questionnaire based study was conducted among medical students in Fayoum University. Propensity to Psychological mood disorders was assessed by using a short version Depression, Anxiety and Stress Scale-21 (DASS-21), along with a pretested Sociodemographic questionnaire. Results A total of 442 students participated in the study with the mean age of 20.15±1.9years. Overall, the prevalence of stress, anxiety and depression with various degrees was 62.4%, 64.3%, and 60.8% among studied sample respectively. Higher stress and anxiety scores were significantly associated with female sex, older age, and BMI⩾25kg/m2. Higher depression score was associated with increasing age, low socioeconomic standard and among students from other governorates. Conclusion A substantial proportion of medical students are suffering from depression, stress, and anxiety. Female sex, increasing age, overweight and obesity are significant associated factors. Further studies need to be carried to identify other associated factors related to academic medical education.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.01.005
       
  • A cross-sectional survey of parental care-seeking behavior for febrile
           illness among under-five children in Nigeria

    • Authors: Mohammed Baba Abdulkadir; Zainab Ajoke Abdulkadir
      Pages: 85 - 91
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Mohammed Baba Abdulkadir, Zainab Ajoke Abdulkadir
      Background Infections are a common cause of childhood morbidity and mortality in developing countries. Proper management of these conditions in appropriate health facilities provides the best opportunity for survival and reducing disability. Aims To evaluate the care-seeking behavior by parents of under-five children with fever in Nigeria and determine household characteristics associated with appropriate care-seeking. Material and methods The study is a secondary analysis of 2013 Demographic and Health Survey data for Nigeria, which was a cross-sectional survey conducted nationwide to obtain demographic and health characteristics of the population among 40,680 households selected using a multistage cluster sampling method. Under-five children with fever in the preceding two weeks were selected alongside their mothers. Selected sociodemographic parameters were related to parents seeking care from appropriate health facilities or otherwise. Logistic regression analysis was employed to evaluate the association of these parameters with appropriate care-seeking. Results There were 3632 (12.6%) under-five children with fever in the preceding two weeks. Of these, 1142 (31.4%) had been taken to an appropriate health facility for care. Factors associated with appropriate care-seeking were paternal secondary (OR, 95% CI; 1.49, 1.16–1.90), paternal tertiary education (OR, 95% CI; 2.03, 1.49–2.76) and belonging to the Muslim faith (OR, 95% CI; 2.31, 1.86–2.87). Others were age of child <36months, being married and working mother. Conclusion There is poor care-seeking for fever in under-five children by parents in Nigeria. Improved literacy, women empowerment and health education are strategies that may improve care-seeking behavior. Highlighted regional differences are additional considerations for such interventions.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.005
       
  • Spatial distribution and epidemiological features of cutaneous
           leishmaniasis in southwest of Iran

    • Authors: S. Khademvatan; S. Salmanzadeh; M. Foroutan-Rad; S. Bigdeli; F. Hedayati-Rad; J. Saki; E. Heydari-Gorji
      Pages: 93 - 98
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): S. Khademvatan, S. Salmanzadeh, M. Foroutan-Rad, S. Bigdeli, F. Hedayati-Rad, J. Saki, E. Heydari-Gorji
      Introduction Leishmaniasis, as a major health concern exists in 14 out of 22 countries of the Eastern Mediterranean Region (EMR). Therefore, the aim of present investigation was to evaluate the epidemiological features and spatial distribution of cutaneous leishmaniasis (CL) during six consecutive years (2009–2014). Material and methods In current retrospective cross-sectional study among 2009–2014, simple direct smear was taken from all suspicious CL subjects who referred to health centers affiliated to Ahvaz Jundishapur University of Medical Sciences. For each patient a questionnaire including some demographic details was filled. Eventually data analysis was done by SPSS.16. Results Trend of CL in the region was unstable. Spatial distribution of CL in central and west cities was higher than in others. During the years, a total of 4137 smear positive individuals were diagnosed. Of these 55.7% lived in urban and 44.3% lived in rural districts. Frequency of CL was higher in men (60.1%) than in women (39.9%). Also based on age range, 11–30 was the most afflicted group (45.7%). Anatomic location of ulcers was as follows: hands 45.7%, feet 27.4%, face 19.1% and other places 7.8%. Conclusions Regarding high incidence of CL in southwest of Iran, special programs related to vector and reservoir control should be adopted and implemented. Traffic control of immigrants and travelers from neighboring endemic countries, also can be helpful.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.03.001
       
  • Ethanol, flavonoid and prevention

    • Authors: Gianni Testino; Patrizia Balbinot
      Pages: 99 - 100
      Abstract: Publication date: March 2017
      Source:Alexandria Journal of Medicine, Volume 53, Issue 1
      Author(s): Gianni Testino, Patrizia Balbinot


      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2016.02.001
       
  • Right ventricular function assessment in single LAD lesion patients using
           strain and strain rate imaging

    • Authors: Rania Gaber
      Pages: 299 - 302
      Abstract: Publication date: December 2016
      Source:Alexandria Journal of Medicine, Volume 52, Issue 4
      Author(s): Rania Gaber
      Background Strain and strain rate imaging is currently the most popular echocardiographic technique that reveals subclinical myocardial damage, and data are not available on this imaging method with regard to assessing right ventricular involvement in single LAD lesion. Aim To evaluate right ventricular regional functions using strain and strain rate imaging tissue Doppler method in patients with single LAD lesion. Methods The patient group was composed of 60 patients who had experienced first anterior myocardial infarction and had undergone successful percutaneous coronary intervention for LAD lesion. Twenty patients were selected for the control group. The right ventricular myocardial samplings were performed in three regions: the basal, mid, and apical segments of the lateral wall. The individual myocardial velocity, strain, and strain rate values of each basal, mid, and apical segment were obtained. Results The right ventricular tissue Doppler parameters (Sm, E, A, E/A ratio, IVA, E/E″) of the patients group were significantly decreased than controls. In addition, changes in the right ventricular mean strain and strain rate values were significantly lower in patient group than controls. Conclusion Right ventricular involvement in LAD lesion patient is significant even after PCI and recanalization of LAD. TDI, strain and strain rate are new, useful imaging techniques for detection of subclinical RV dysfunction in patients with LAD lesion.

      PubDate: 2017-01-01T20:25:04Z
      DOI: 10.1016/j.ajme.2015.09.004
       
  • A study of serum magnesium, calcium and phosphorus level, and cognition in
           the elderly population of South India

    • Authors: M.P. Basheer; K.M. Pradeep Kumar; E. Sreekumaran; T. Ramakrishna
      Pages: 303 - 308
      Abstract: Publication date: December 2016
      Source:Alexandria Journal of Medicine, Volume 52, Issue 4
      Author(s): M.P. Basheer, K.M. Pradeep Kumar, E. Sreekumaran, T. Ramakrishna
      Introduction Different studies have shown the role of micro and macronutrients on cognitive function. Macronutrients have been involved in many metabolic activities of the body including oxidation and reduction reactions in the central nervous system. This involvement of macronutrients in the activities of central nervous system indicates its role in cognition. The present study is designed to know the role of macronutrients and its relation with cognition by using biological samples. Materials and methods A total of 337 subjects with a mean age of 49 participated in the cross sectional study from different parts of Kerala state in India. Individuals participating in this study were administered a series of neuropsychological test batteries with major emphasis on 7-min screen test. All test procedures were administered by standard protocol after a written consent was obtained from the participating subjects. Analysis of macronutrients level of magnesium, calcium and phosphorus was done by using serum samples and the data obtained were then statistically analyzed using SPSS software version 17. Results The macronutrients magnesium, calcium and phosphorus were found to be significantly related to the cognitive score. Increasing magnesium and calcium level was associated with higher cognitive score (P <0.0031 and 0.001 respectively), while lower phosphorus level was significantly associated with lower composite score (P <0.001). Conclusion The results of our study give us an expression that macronutrients such as calcium, magnesium and phosphorus may be associated with cognitive function in elderly population of our state. But further studies on a larger population are required to come out with a definite conclusion.

      PubDate: 2017-01-01T20:25:04Z
      DOI: 10.1016/j.ajme.2015.11.001
       
  • Promoting effect of adipocytokine, apelin, on hepatic injury in
           caerulein-induced acute pancreatitis in rats

    • Authors: Marwa N. Emam; Rehab E. Abo El gheit
      Pages: 309 - 315
      Abstract: Publication date: December 2016
      Source:Alexandria Journal of Medicine, Volume 52, Issue 4
      Author(s): Marwa N. Emam, Rehab E. Abo El gheit
      Objective To evaluate the potential apelin effect on hepatic injury in caerulein (Cn) -induced AP in rats. Experimental protocol Thirty male albino rats were divided into three groups, 10 rats each: control group: received 0.9% NaCl solution. AP group: received (Cn, 50μg/kg/h, i.p.) for 6h. Apelin-13 treated AP group: received apelin 13, 50nmol/kg/h, i.p, immediately after each Cn injection, starting after the second Cn dose. 12h after the last Cn injection, the rats were sacrificed, and serum amylase, lipase, phospholipase A2 (PLA2), interleukin (IL)-6, IL-1β, IL-10, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactic dehydrogenase activity (LDH) were assayed. The hepatic malondialdehyde (MDA), reduced glutathione (GSH) and catalase (CAT) levels, caspase-3 activity and tumor necrosis factor-alpha (TNF-α) were assessed, while myeloperoxidase (MPO) was determined in pancreatic and hepatic tissues. Results Cn injection caused severe AP, with marked hepatic damage. The exogenous apelin reduced Cn-induced pancreatic and hepatic injury with reduction in hepatic oxidative, apoptotic and inflammatory markers, pancreatic and hepatic MPO activity with modulation of inflammatory cytokines. Conclusion Apelin could be protective in AP associated liver damage, possibly through anti-oxidant, anti-apoptotic mechanisms with modulating the inflammatory mediators.

      PubDate: 2017-01-01T20:25:04Z
      DOI: 10.1016/j.ajme.2015.11.003
       
  • Assessing prescriber’s awareness of essential medicine list, hospital
           drug formulary and utilization of standard treatment guidelines in a
           tertiary healthcare facility in North-Central Nigeria

    • Authors: Abdullahi Hassan; Gobir Abdulrazaq Abdullahi; Abubakar Aisha Ahmed; Adamu Sabiu; Uwaya John; Gwamna Ezekeil; Yahaya Aliyu Ibrahim
      Abstract: Publication date: Available online 26 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Abdullahi Hassan, Gobir Abdulrazaq Abdullahi, Abubakar Aisha Ahmed, Adamu Sabiu, Uwaya John, Gwamna Ezekeil, Yahaya Aliyu Ibrahim


      PubDate: 2017-04-26T18:50:27Z
      DOI: 10.1016/j.ajme.2017.03.006
       
  • Liver enzyme elevations in a cohort of HIV/AIDS patients on first-line
           antiretroviral therapy in Namibia: Findings and implications

    • Authors: P.A. Mataranyika; D. Kibuule; F. Kalemeera; H. Kaura; B. Godman; W.T. Rennie
      Abstract: Publication date: Available online 13 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): P.A. Mataranyika, D. Kibuule, F. Kalemeera, H. Kaura, B. Godman, W.T. Rennie
      Introduction All antiretroviral therapies (ARTs) are potentially toxic to the liver. In sub-Saharan Africa, the rising incidence of ART induced adverse events has complicated treatment leading to recent revisions of Namibian ART guidelines. Unfortunately there have been limited studies to date evaluating ART induced liver injury in Namibia to guide further revisions if needed. Objective Determine the current patterns and grades of ALT elevation in Namibia’s HIV/AIDS. Methods Retrospective cohort analysis. Patterns of alanine amino transferase (ALT) liver enzyme elevation were determined in a cohort of ART naïve HIV patients on firstline ART regimen in a referral hospital in Namibia over a 1year treatment period. Patterns of ALT changes at baseline, 3months and 6months were analyzed using ANOVA and Bonferroni test for pairwise comparisons. Results Of 79 eligible patients, 72 developed significant ALT elevation within 3months of ART initiation (F (3, 76)=6.4, p =0.002, η2 =0.193). Four 4 (5.6%) and 1 (1.38%) patient respectively developed grade 2 and grade 3 ALT elevation by month 3. There was no significant difference between mean ALT levels at baseline and month 6. A CD4 count of <350cells/mm3; female gender and age over 40years were the main factors associated with moderate or severe ALT elevation. Conclusions First line ART commonly induces mild self-limiting liver enzyme elevation in Namibian HIV patients especially in the first 3months. Consequently, there is a need to monitor ALT levels for at least 3months after initiation mainly in high risk patients to reduce side-effect concerns. This is already happening.

      PubDate: 2017-04-19T17:17:02Z
      DOI: 10.1016/j.ajme.2017.03.002
       
  • Sexual function of pregnant women in the third trimester

    • Authors: Erbil
      Abstract: Publication date: Available online 7 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Nülüfer Erbil
      Introduction Physical, hormonal and psychological changes during pregnancy can affect a woman’s sexuality as well as a couple’s sexual relationship. The aim of this study was to examine sexual function of pregnant women in the third trimester of pregnancy. Methods The data of descriptive and cross-sectional study was collected via a questionnaire form and Female Sexual Function Index. A score≤26.55 is classified as female sexual dysfunction. A total of 125 volunteer healthy and married pregnant women in third trimester of pregnancy who admitted to the antenatal policlinics were included in this study. Results The determined that 92% of participants had sexual dysfunction. The Female Sexual Function Index and domains scores in the 28th-31st, 32nd-35th and 36th and higher gestational weeks of pregnancy were as follows: sexual desire scores, 2.50, 2.77 and 2.40; sexual arousal scores, 2.26, 2.72 and 1.69; lubrication scores, 2.61, 3.42 and 1.97; orgasm scores, 2.51, 2.85 and 1.78; sexual satisfaction scores, 3.17, 3.77 and 2.66; pain scores, 2.44, 2.72 and 1.66, and total Female Sexual Function Index scores were 15.51, 18.29, 12.26, respectively. Sexual arousal (p=0.008), lubrication (p=0.001), orgasm (p=0.031), sexual satisfaction (p=0.005), pain (p=0.049) and total Female Sexual Function Index score (p=0.004) were the lowest in 36th and higher gestational weeks, and only sexual desire did not differ (p=0.191). Conclusions Sexual function of pregnant women in the third trimester were negatively effected. Health professionals should be trained to evaluate sexual difficulties in pregnant women and to recommend possible solutions.

      PubDate: 2017-04-11T19:41:53Z
       
  • Natural pomegranate juice reduces inflammation, muscle damage and increase
           platelets blood levels in active healthy Tunisian aged men

    • Authors: Ammar Achraf; Chtourou Hamdi; Mouna Turki; Osama Abdelkarim; Fatma Ayadi; Anita Hoekelmann; Sourou Yaich; Nizar Souissi
      Abstract: Publication date: Available online 7 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Ammar Achraf, Chtourou Hamdi, Mouna Turki, Osama Abdelkarim, Fatma Ayadi, Anita Hoekelmann, Sourou Yaich, Nizar Souissi
      Currently, it’s well established that aging is associated with various health problems that may interfere with the maintenance of a good nutritional status. Otherwise, pomegranate (POM) was shown to prevent or treat various disease risk factors in adults. However, its efficacy is still not well widespread in elderly population. Therefore, the purpose of the present study is to investigate the effect of natural pomegranate juice (POMj) rich in polyphenols on the blood levels of selected biochemical parameters using older adults. Twelve active healthy aged men (age: 60±5years) volunteered to participate in this randomized study. Before and after the supplementation period fasting blood samples were collected, heart rate (HR) and systolic arterial pressure (SAP) were recorded. Supplements of placebo (PLA) or POMj were taken twice daily (250ml×2) for 15days. Paired simple t-test showed a significant difference between PLA and POMj supplementation effects on systolic blood pressure (SAP), creatinine (CRE), hematological and muscle damage parameters and C-reactive protein (CRP) (p<0.01) with lower values using POMj. Similarly, a significant differences were shown for platelets PLT (p<0.01) with higher values using POMj supplementation. POMj rich in polyphenols seems to have a power anti-inflammatory effect and to be an effective treatment for patients who suffer from the thrombocyto-penia disease. Therefore, aged populations are advised to add natural POMj to their daily nutrition behavior.

      PubDate: 2017-04-11T19:41:53Z
      DOI: 10.1016/j.ajme.2017.03.005
       
  • Protective role of Spondias mombin leaf and Cola acuminata seed extracts
           against scopolamine-induced cognitive dysfunction

    • Authors: Ismail O. Ishola; Bukola O. Ikuomola; Olufunmilayo O. Adeyemi
      Abstract: Publication date: Available online 6 April 2017
      Source:Alexandria Journal of Medicine
      Author(s): Ismail O. Ishola, Bukola O. Ikuomola, Olufunmilayo O. Adeyemi
      The leaves of Spondias mombin L. (Anacardiaceae) when chewed with Cola acuminata (P. Beauv.) Schott & Endl. (Sterculiaceae) seeds have memory enhancing and anti-ageing properties. This study sought to investigate the protective effect of hydroethanolic leaf extract of Spondias mombin (SM) and Cola acuminata seed extract (CA) against scopolamine-induced cognitive dysfunction. SM or CA (50, 100 or 200mg/kg, p.o.) or SM+CA (50mg/kg, p.o.) was administered to rats for 3 consecutive days. One hour post-treatment on day 3, scopolamine (3mg/kg i.p) was administered and 5min later, the Y-maze test or Morris water maze test (MWM; days 3–7) was conducted. The rat’s brains were isolated for the estimation of oxidative-nitritive stress status following the MWM task. The antioxidant capacity of SM and CA was also evaluated in vitro using the 1,1-diphenyl-2-picrylhydrazyl (DPPH), nitric oxide (NO) and ferric ion reducing power (FRAP) assays. Pretreatment of rats with SM, CA or SM+CA significantly ameliorated the learning and memory impairment induced with scopolamine as evidenced in Y-maze and MWM paradigms. Moreover, SM, CA or SM+CA significantly attenuated the oxidative-nitritive stress induced by scopolamine, evidenced in the decrease in malondialdehyde and nitrite levels and restoration of glutathione, catalase and superoxide dismutase levels. Furthermore, SM and CA showed promising free radical scavenging effect against DPPH and moderate antioxidant activity in NO and FRAP tests. This study showed that Spondias mombin and Cola acuminata have significant protective effect against scopolamine-induced memory deficit that could be attributed to their antioxidant properties.

      PubDate: 2017-04-11T19:41:53Z
      DOI: 10.1016/j.ajme.2016.08.001
       
  • Broken Heart Syndrome – An intra operative complication

    • Authors: Zara Wani; Meenaxi Sharma
      Abstract: Publication date: Available online 9 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Zara Wani, Meenaxi Sharma
      We report a case of Broken Heart Syndrome in a 56year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case.

      PubDate: 2017-03-13T03:33:09Z
      DOI: 10.1016/j.ajme.2017.02.003
       
  • IGF-I and IGFBP-3 levels and their correlations with carcinoembryonic
           antigen in colorectal cancer patients

    • Authors: Çiğdem Yağcıoğlu Yücel; Gönül Erden; Fatma Meriç Yılmaz; Sevilay Sezer; Esin Çalcı
      Abstract: Publication date: Available online 7 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Çiğdem Yağcıoğlu Yücel, Gönül Erden, Fatma Meriç Yılmaz, Sevilay Sezer, Esin Çalcı
      Background Colorectal cancer is one of the most frequently seen cancers worldwide. Currently, CEA is the most commonly used tumor marker in colorectal cancer. The changes in IGF/IGFBP equilibrium is also known to cause carcinogenesis. In this study, we aimed to monitor IGF-I/IGFBP-3 levels, the changes in IGF-I/IGFBP-3 ratio and correlations of these peptides with the common tumor marker CEA. Materials and methods 55 colorectal cancer patients and 35 control group patients were included in this study. Serum CEA, IGF-I and IGFBP-3 levels of all specimens were measured with chemiluminescence method. Results In colorectal cancer patients, IGF-I levels was found to be increased, IGFBP-3 levels decreased and IGF-I/IGFBP-3 ratio was increased; when compared to control group (p<0.05). A moderately significant correlation was found between the conventional tumor marker CEA and IGF-I and IGF-BP3 (p=0.001, r=0.533 and p=0.001, r=−0.573 respectively). Conclusions IGF-I/IGFBP-3 ratio seems to be increased in the colorectal cancer patients. When considered with the moderate correlation levels of these peptides with CEA, this increase in IGF-I/IGF-BP3 ratio may be useful in monitoring carcinogenesis in colorectal cancer patients among with CEA but more detailed and extensive studies in larger study groups needed to be carried out.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.02.001
       
  • Antidiabetic medication adherence and associated factors among patients in
           Botswana; implications for the future

    • Authors: Godfrey Mutashambara Rwegerera; Thato Moshomo; Marea Gaenamong; Taibat Aderonke Oyewo; Sivasomnath Gollakota; Francis Apolinary Mhimbira; Joseph Fadare; Brian Godman; Johanna C. Meyer; Yordanka Piña Rivera
      Abstract: Publication date: Available online 6 March 2017
      Source:Alexandria Journal of Medicine
      Author(s): Godfrey Mutashambara Rwegerera, Thato Moshomo, Marea Gaenamong, Taibat Aderonke Oyewo, Sivasomnath Gollakota, Francis Apolinary Mhimbira, Joseph Fadare, Brian Godman, Johanna C. Meyer, Yordanka Piña Rivera
      Background Diabetes mellitus (DM) is a major global public health problem. Lack of adherence to medication causes suboptimal glycemic control increasing complication rates, costs and mortality. The objective of the study was to determine current antidiabetic medication adherence in Botswana and assess associated factors so as to direct potential future interventions. Materials and methods A cross-sectional study among 376 randomly selected diabetic patients attending a leading clinic in Gaborone, Botswana. Eight item Morisky Medication adherence questionnaire was used to assess antidiabetic medication adherence. A structured questionnaire was also used to collect information on factors influencing adherence including age, gender, education, type and duration of diabetes, treatment, complications and HIV status. Data were entered and analyzed using STATA Version 14, and logistic regression performed. Results Over forty percent (41.8%) of patients were non-adherent to antidiabetic medications. Studied sociodemographic characteristics and clinical variables did not affect adherence. HIV positive status was associated with a statistically significant better adherence at multivariate analysis. Conclusion Adherence to antidiabetic medication was found to be suboptimal in a setting where medicines are provided free of charge. Only HIV positivity was found to be significantly associated with better adherence, probably due to effect of greater psychosocial support and counselling as part of HIV treatment. There is a need to carry out studies to further improve understanding of factors associated with medication adherence that are pertinent to Botswana and similar settings given the growing prevalence of diabetes.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.01.005
       
  • Is sdLDL a valuable screening tool for cardiovascular disease in patients
           with metabolic syndrome?

    • Authors: Radwa Momtaz Abdelsamie Zaki Khalil; Dalia Ahmed Mohamed Al-Azab; Ola Abdelmoneim Akl
      Abstract: Publication date: Available online 27 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): Radwa Momtaz Abdelsamie Zaki Khalil, Dalia Ahmed Mohamed Al-Azab, Ola Abdelmoneim Akl
      Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardiovascular disease. Among high risk patients, those with metabolic syndrome represent an important target population. Different methods of small dense low density lipoprotein measurement were developed. Accordingly, two phenotypes of low density lipoprotein are recognized: Phenotype A (predominance of large buoyant low density lipoprotein) & phenotype B (predominance of small dense low density lipoprotein). However, none of the methods has been yet considered as a gold standard one. A lot of studies confirmed the role of small dense low density lipoprotein in the development of cardiovascular disease through atherogenic properties & clinical trials. However, others failed to do so. These discrepancies may be due to different sample sizes, different populations, different age groups, different methods of measurement & other possible confounding factors. The aim of this review is to discuss the role of small dense low density lipoprotein as a valuable screening/preventive tool of cardiovascular disease in patients with metabolic syndrome.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.01.002
       
  • A comprehensive in vitro biological investigation of metal complexes of
           tolfenamic acid

    • Authors: Md. Mahabob Ullah Mazumder; Abhijit Sukul; Sajal Kumar Saha; Asif Alam Chowdhury; Yasir Mamun
      Abstract: Publication date: Available online 24 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): Md. Mahabob Ullah Mazumder, Abhijit Sukul, Sajal Kumar Saha, Asif Alam Chowdhury, Yasir Mamun
      Objective The inquisitive objective of the study was to observe the antimicrobial, cytotoxicity, and antioxidant activities of some newly synthesized metal complexes of tolfenamic acid. Methods While antimicrobial activity was studied by disk diffusion method, cytotoxicity was studied by performing brine shrimp lethality bioassay. Moreover, DPPH radical scavenging potential was observed to determine the antioxidant property of the complexes. Results From the disk diffusion antimicrobial screening of tolfenamic acid and its metal complexes, it was found out that considerable antimicrobial activity in terms of zone of inhibition against the tested organisms had been demonstrated by Cu and Zn complex of tolfenamic acid. In addition, the brine shrimp lethality bioassay corroborated that tolfenamic acid and Cu, Co, Zn complexes of the parent NSAID exhibited cytotoxicity with LC50 values 1.23±0.91μg/ml, 1.12±0.12μg/ml, 1.17±0.56μg/ml, 1.35±0.24μg/ml respectively, compared to the vincristine sulfate had LC50 value of 0.82±0.09μg/ml. Furthermore, 1,1-diphenyl-2-picrylhydrazyl assay revealed that in comparison with standard BHT had IC50 of 11.84±0.65, Cu and Co complex of tolfenamic acid exhibited significant antioxidant or radical-scavenging properties with IC50 values 13.61±0.58μg/ml and 15.38±0.09μg/ml, respectively. Conclusion It can be postulated that metal complexes of tolfenamic acid have auspicious pharmacological effects: antimicrobial, cytotoxicity, and antioxidant potency. Hence, these complexes might have better therapeutic responses in future; notwithstanding, it needs further detailed analysis in other pharmacological perspectives.

      PubDate: 2017-03-08T02:40:08Z
      DOI: 10.1016/j.ajme.2017.02.002
       
  • Group B streptococcal carriage, antimicrobial susceptibility, and
           virulence related genes among pregnant women in Alexandria, Egypt

    • Authors: Salama Mohamed Sadaka; Hala Abdelsalam Aly; Marwa Ahmed Meheissen; Yasser Ibrahim Orief; Basma Mohamed Arafa
      Abstract: Publication date: Available online 21 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): Salama Mohamed Sadaka, Hala Abdelsalam Aly, Marwa Ahmed Meheissen, Yasser Ibrahim Orief, Basma Mohamed Arafa
      Background and aim Group B Streptococcus (GBS) has emerged as a leading cause of illness and death among neonates. The study was conducted to estimate the prevalence of recto-vaginal carriage of GBS among pregnant women at 35–37weeks, gestation, to describe GBS antimicrobial susceptibility profile and to investigate selected virulence genes by PCR. Subjects and methods Two-hundred pregnant women at 35–37weeks of gestation attending antenatal clinic at Al-Shatby University Hospital were enrolled in the study. Both vaginal and rectal swabs were collected from each subject. Swabs were inoculated onto CHROMagar™ StrepB and sheep blood agar plates. All GBS isolates were subjected to antimicrobial susceptibility testing using disc diffusion. Disc approximation test was performed to detect erythromycin resistance phenotype (MLSB). GBS virulence genes scpB, bac, bca, and rib were identified by PCR. Results Among the 200 pregnant women, 53 (26.5%) were identified as GBS carriers. All carriers had vaginal colonization (100%), four (7.5%) had combined recto-vaginal colonization. None of the carriers had rectal colonization alone. All isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid. On the other hand, 43.4%, 28.3%, 22.6%, and 15% of isolates were resistant to levofloxacin, azithromycin, erythromycin, and clindamycin respectively. Out of 12 erythromycin resistant isolates, six isolates had constitutive while two had inducible MLSB resistance. scpB was identified in 100%, rib in 79.2%, and bac in 35.8% of GBS isolates. None of the isolates possessed the bca gene. Conclusion Introduction of GBS screening in Egyptian pregnant women is recommended. Penicillin or ampicillin is still the antibiotic of choice for intrapartum prophylaxis.

      PubDate: 2017-02-23T06:01:27Z
      DOI: 10.1016/j.ajme.2017.01.003
       
  • Is canscore a good indicator of fetal malnutrition in preterm newborn

    • Authors: B.N. Ezenwa; V.C. Ezeaka
      Abstract: Publication date: Available online 16 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): B.N. Ezenwa, V.C. Ezeaka
      Background Fetal malnutrition is a risk factor for increased neonatal morbidities and mortalities worldwide. BMI and CANScore had been used for determining fetal malnutrition in term newborns. Objective To assess the nutritional status of preterm newborns at birth using BMI, PI and CANscore and determine the better indicator for FM. Methods The study was carried out on consecutive, live-born babies between 28 completed weeks through 36weeks gestation. Birth weights and lengths were recorded as per protocol. BMI was calculated and BMI <10th centile using Brock’s chart is considered as FM and a PI <2.2 was considered as malnutrition. Using Metcoff’s CANscore, score <25 is FM. Data was analyzed using the SPSS version 22.0. Results One hundred and forty preterm newborns were assessed and 108 (77%) were of LBW. BMI, CANscore and PI identified 40.0%, 34.3% and 30.0% of the preterm newborns as FM. Using BMI as standard for detecting FM, CANscore and PI identified 33.9% and 51.8% of the babies as FM. PI had a better sensitivity for detecting FM in preterm infants compared to CANScore and this was statistically significant, p<0.00. Conclusion FM is common in preterm babies. BMI and PI are simple and easy tools to use in assessing FM in preterm babies. They are also better identifiers of FM in preterm newborns compared to CANScore.

      PubDate: 2017-02-23T06:01:27Z
      DOI: 10.1016/j.ajme.2017.01.004
       
  • Role of MRI in differentiating benign from malignant breast lesions using
           dynamic contrast enhanced MRI and diffusion weighted MRI

    • Authors: Mohamed Ahmed Youssef; Hanan Mohamed Saleh Elahwal; Mohamed Morsi Alwageeh; Sally Elbially Attya
      Abstract: Publication date: Available online 15 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mohamed Ahmed Youssef, Hanan Mohamed Saleh Elahwal, Mohamed Morsi Alwageeh, Sally Elbially Attya
      Objective To evaluate the role of MRI in differentiation of benign from malignant breast lesions using dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted MRI (DW-MRI). Patients and methods The study included 33 female patients with clinically suspicious breast lesions detected by mammography and/or breast ultrasound. Cases were referred from general surgery departments in Tanta university hospital. The patients underwent full history taking and clinical examination, full field digital mammography and US, for those patients cases diagnosed on sonomammography as BI-RADS 3 & 4 were selected for MRI examination. Results Quantitative analysis of DWI was done for the 33 breast lesions and their ADC values are recorded at 3 different b-values (250, 600, and 1000). Seventeen lesions showed facilitated diffusion, proved to be benign and 10 lesions showed restricted diffusion, 9 lesions of them proved to be malignant and one proved to be benign. There are 6 lesions showed mixed restricted and facilitated diffusion proved to be malignant. Conclusion DWI improves the diagnostic ability of the DCE-MRI of the breast. It is a better method for detecting breast lesions than either T1- or T2-weighted imaging, but it is better to be performed in conjunction with contrast enhanced MRI.

      PubDate: 2017-02-16T04:04:51Z
      DOI: 10.1016/j.ajme.2016.12.008
       
  • Maternal morbidity and mortality in ElShatby and Dar Ismail maternity
           hospitals in Alexandria: A comparative study

    • Authors: Sahar khashab; Nermeen S. El Beltagy; Dina Badie
      Abstract: Publication date: Available online 10 February 2017
      Source:Alexandria Journal of Medicine
      Author(s): Sahar khashab, Nermeen S. El Beltagy, Dina Badie
      Objective To compare ElShatby University Maternity Hospital and Dar Ismail Public Hospital in regard to antenatal, natal, and postnatal morbidity and the causes of maternal mortality. Methods A cross-sectional survey was conducted to study females who gave birth in each of the hospitals. Then, a prospective survey of the women was conducted until the 42nd day after delivery. Data were gathered from women who delivered in addition to their caring obstetricians as well as reviewing their medical records. Additionally, records of maternal mortality were reviewed. All females who gave birth between January and April 2014 (3months) were included in the study. Results Two hundred and eighty females participated in the study (130 from ElShatby University Maternity Hospital and 150 from Dar Ismail Public Hospital). Significantly more rural women (29.2%) gave birth at ElShatby University Hospital than at Dar Ismail Public Hospital (16.7%), p=0.012. More than half of all the study participants (51.8%) suffered from anemia during pregnancy. A minority (5%) of the women were diagnosed with preeclampsia, all of whom gave birth at ElShatby Hospital. Caesarean section rate was significantly higher among women delivered at ElShatby University Hospital compared to Dar Ismail Hospital (61.5% versus 41.3%, p<001). Only 8.2% of all women needed ICU admission at ElShatby Hospital. The most common cause of maternal mortality was eclampsia, which accounted for 75% of deceased women. Conclusion Future studies are needed to identify and understand better the avoidable factors contributing to the relatively high rates of maternal morbidity and mortality in public hospitals. Such information will be of significant use in the processes related to providing quality services, ensuring accessibility of those services, and allocating corresponding resources aimed at reducing maternal morbidity and mortality.

      PubDate: 2017-02-16T04:04:51Z
      DOI: 10.1016/j.ajme.2016.12.003
       
  • Ultrastructural changes in peripheral arteries and nerves in diabetic
           ischemic lower limbs, by electron microscope

    • Authors: Mohamed E. Salem; Abdel-Azzem A. Ismael; Amr Salem; Tarek Salem
      Abstract: Publication date: Available online 30 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Mohamed E. Salem, Abdel-Azzem A. Ismael, Amr Salem, Tarek Salem
      Background The results of “light and electron microscopic study” of the peripheral arteries and nerves biopsies in diabetic neuropathy comparing with biopsies of normal arteries and nerves of traumatic amputation as a control group. Aim of the work To evaluate the “electron microscopic changes” in the peripheral small arteries and nerves in the diabetic ischemic lower limbs. Patients and methods From January 2015 to June 2016 a total number of 20 patients with diabetic ischemic lower limbs (Diabetic patients group) compared with 20 non diabetic non ischemic persons as (Control group) who undergone traumatic lower limb amputation. All cases were subjected to complete history taking, complete clinical examination, and routine laboratory investigations. “Light and electron microscopic studies” of biopsies from the peripheral small arteries and nerves e.g. digital or posterior tibial arteries and nerves during amputation of diabetic gangrene of the toes, below knee, above knee amputation and from traumatic amputation of the control group. Results The results of an “electron microscopic study” of diabetic peripheral arteries and nerves biopsies, 12 out of 20 cases showed thrombi in small vessels. In some small vessels, masses of fibrin were seen within the lumen. In other vessels, older thrombi were present. 17 out of 20 cases showed endothelial cells hyperplasia in some vessels. The degree of hyperplasia was sufficient to occlude the lumen of the vessels. Some vessels showed degenerate pericytes and endothelial cells which contained large lipid droplets. The peripheral nerves showed patchy demyelination, areas of degeneration and regeneration, areas of infarction and necrosis and collagen fibers deposition. Among the control group, no cases contained thrombi, degenerated vessels, degenerate pericytes or lipid droplets within the endothelial cells. Conclusion The present study found that the diabetic microangiopathy is the main cause of diabetic neuropathy and diabetic foot lesions.

      PubDate: 2017-02-02T23:05:25Z
      DOI: 10.1016/j.ajme.2016.11.005
       
  • Prospective comparative study between un-enhanced multidetector computed
           tomography and ultrasonography in evaluation of acute renal colic

    • Authors: Rehab Abdel Rahman El Bakry
      Abstract: Publication date: Available online 21 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Rehab Abdel Rahman El Bakry


      PubDate: 2017-01-27T22:15:17Z
      DOI: 10.1016/j.ajme.2017.01.001
       
  • The possible role of cerium oxide (CeO2) nanoparticles in prevention of
           neurobehavioral and neurochemical changes in 6-hydroxydopamine-induced
           parkinsonian disease

    • Authors: Maha Abd Elkader Hegazy; Hala Mohamed Maklad; Doaa A. Abd Elmonsif; Fatma Yosry Elnozhy; Malik Ahmad Alqubiea; Fisal Aliwi Alenezi; Obaid Mahdi Al abbas; Mahdi Mana Al abbas
      Abstract: Publication date: Available online 20 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Maha Abd Elkader Hegazy, Hala Mohamed Maklad, Doaa A. Abd Elmonsif, Fatma Yosry Elnozhy, Malik Ahmad Alqubiea, Fisal Aliwi Alenezi, Obaid Mahdi Al abbas, Mahdi Mana Al abbas
      Cerium oxide nanoparticles (CeO2NPs) is an efficient neuroprotective agent and showed promising effects in some neurodegenerative diseases such as Alzheimer’s disease and multiple sclerosis. However, the implication of CeO2NPs in Parkinsonism remains to be investigated. The aim of this study was to assess the possible role of CeO2NPs as a neuroprotective agent against the development of behavioral and biochemical changes in rat model of Parkinson’s disease. Thirty rats were included and received left intrastriatal injection of either saline (controls, n=10) or 6-hydroxy dopamine (6-OHDA) in untreated group (n=10) and 10 rats were received intraperitoneal injection of low dose CeO2NPs two hours before surgery, and continued once daily for 6 weeks (preventive group). At the end of experimental period, rats were subjected to behavioral assessment and then killed for biochemical analysis of striatal dopamine levels, oxidative stress markers and caspase-3 activity. Results showed that CeO2NPs resulted in partial neuroprotection against disturbances in motor performance. It also partially decreased apoptosis and oxidative stress in preventive group, while it failed to increase striatal dopamine level as compared to untreated rats. The present study verified some neuroprotective effects of CeO2NPs in 6-OHDA-induced Parkinsonian rats through their antioxidant and anti apoptotic effects. Some of these effects persisted till the end of six weeks whereas others declined after three weeks. A larger dose may be needed to produce more valuable effects and to maintain protection for a longer period.

      PubDate: 2017-01-27T22:15:17Z
      DOI: 10.1016/j.ajme.2016.12.006
       
  • Sub-chronic toxicological studies of transition metal complexes of
           naproxen on sprague-dawley rats

    • Authors: Md. Sharif Hasan; Narhari Das; Farida Begum; S M Abdur Rahman
      Abstract: Publication date: Available online 18 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Md. Sharif Hasan, Narhari Das, Farida Begum, S M Abdur Rahman
      Objective The purpose of this research was to investigate sub-chronic toxicity in animal model. Methods A detailed study was done on the physical, hematological, biochemical and hormonal parameters of both male and female Sprague-Dawley rats after 28days administration of naproxen and its metal complexes. Results There were no significant changes found in physical parameters on observation for both male and female rats without some minor differences. However, Naproxen metal complexes showed comparatively lower side effects than naproxen. Hematological report suggested that naproxen was in process of initiating inflammation which was justified by decreasing the mean value hemoglobin and hematocrit level and increasing the white blood cells level. There were no significant changes in biochemical parameters, however, the mean value of blood glucose level and cholesterol seemed to be higher and triglyceride was lower. Thyroid hormone levels were found lower, that was another indication inflammatory process. However, this might have the ability to lower the insulin secretion resulting in increasing blood glucose level. Conclusion In the present investigation, there were no significant alterations in histopathological studies and physical parameters though some signs of abnormalities had been found but hematological and hormonal data did not suggest any inflammatory or toxicological activity. However, we observed that naproxen showed more side effects than metal complexes which indicated that carboxylic group (COOH) of naproxen may be responsible for showing those most of the side effects.

      PubDate: 2017-01-19T19:40:06Z
      DOI: 10.1016/j.ajme.2016.12.005
       
  • The hemodynamic repercussions of the autonomic modulations in
           growth-restricted fetuses

    • Authors: Victorovich Lakhno Igor
      Abstract: Publication date: Available online 16 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Victorovich Lakhno Igor
      Objectives Idiopathic fetal growth restriction is considered to be associated with hemodynamic abnormalities. The study was aimed to the investigation of the relationship between fetal and maternal autonomic balance, arterial and venous hemodynamic Doppler indices and CTG variables in case of normal fetal development and fetal growth restriction. Methods 106 patients at 32–40weeks of gestation were enrolled in the study. 30 of them had healthy pregnancy and were involved in Group I. In Group II, 44 pregnant women with fetal growth restriction and normal umbilical hemodynamic Doppler indices were observed. 32 patients with fetal growth restriction and an absent or reversed end-diastolic umbilical flow were monitored in Group III. The curves of maximum blood flow velocity were isolated and their spectral components were determined from the umbilical Doppler spectrograms. The maternal and fetal heart rate variability, conventional CTG patterns were obtained from RR-interval time series registered from maternal abdominal wall electrocardiographically. Results The increased adrenergic regulation has modulated parasympathetic impact on fetal cardiovascular system. The decreased reactivity was mirrored in low LTV, lack of accelerations and an increased score of decelerations. The CTG findings were also featured by the revealed correlations demonstrated an obvious relationship between fetal and maternal hemodynamics in healthy pregnancy. It was possible to speculate that a controlling signal of 0.5Hzhas played a significant role in the umbilical venous blood flow. The decreased fetal autonomic tone and the fetal and maternal hemodynamic decoupling were found in growth-retarded fetuses. Conclusion Fetal heart rate pattern was influenced by maternal and fetal autonomic tone. Maternal cardiovascular oscillations were reflected in the umbilical circulation in healthy pregnancy Fetal distress was featured by sympathetic overactivity and the reduction of vagal tone. Such autonomic modulations was manifested by the decelerative pattern of CTG and deteriorated umbilical hemodynamics.
      Graphical abstract image

      PubDate: 2017-01-19T19:40:06Z
      DOI: 10.1016/j.ajme.2016.12.007
       
  • Relationship between motor and cognitive learning abilities among primary
           school-aged children

    • Authors: Osama Abdelkarim; Achraf Ammar; Hamdi Chtourou; Matthias Wagner; Elke Knisel; Anita Hökelmann; Klaus Bös
      Abstract: Publication date: Available online 11 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Osama Abdelkarim, Achraf Ammar, Hamdi Chtourou, Matthias Wagner, Elke Knisel, Anita Hökelmann, Klaus Bös
      Background The relationship between motor and cognitive development has already been proven in young children. However, in relation to the academic achievement the association between motor and cognitive performance still not well established. Therefore, the aim of this study was to examine the levels of motor and cognitive learning abilities and their independent and combined associations among German primary school-children. Methods Participants were (n=197) between the ages of six to eight. The German motor test (DMT), the cognitive abilities test (KFT), height, weight, and body mass index (BMI) were measured. Results ANOVA testing found that boys perform better in long jumping and in the six minutes running test while girls perform better in balancing backwards and in deductive thinking test (p<0.05). With maturation from ages six to eight the achievement level of both populations showed a higher performance in motor and cognitive learning abilities (p<0.001). Concerning the combined and independent associations between the tested abilities, a significant correlation was shown between total motor and total cognitive learning abilities (p<0.001, r=0.60) with higher contribution of balancing backwards, six minutes running and push-up levels (r=0.63, r=0.62, r=0.60, respectively) in the performance of the cognitive learning abilities (i.e. mathematical thinking, r=0.62 and language understanding, r=0.59). Conclusions In conclusion, fostering the childrens’ physical fitness during the primary school age could enhance both motor and cognitive learning abilities related to the academic achievement.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.12.004
       
  • Safe injection procedures, injection practices, and needlestick injuries
           among health care workers in operating rooms

    • Authors: Nermine Mohamed Tawfik Foda; Noha Selim Mohamed Elshaer; Yasmine Hussein Mohamed Sultan
      Abstract: Publication date: Available online 10 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Nermine Mohamed Tawfik Foda, Noha Selim Mohamed Elshaer, Yasmine Hussein Mohamed Sultan
      Background Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms. Methods A descriptive cross sectional approach was adopted. Modified observational checklists based on World Health Organization (WHO) definitions were used in operating rooms (n=34) and interview questionnaire was administered to HCWs (n=318) at the Alexandria Main University Hospital. Results Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of injection equipment (100%), overflowing of sharps containers and presence of infectious waste outside containers (50%), HCWs not cleaning their hands with soap and water or alcohol-based hand rub (58.1%), and HCWs not wearing gloves during IV cannula insertion (58.1%), were all findings during observations. High prevalence of NSSIs was reported (61.3%), mostly during handling suture needles (50.8%). In addition, 66.2% of the injured HCWs were the original user of the sharp item which was contaminated in 80% of injuries. At time of NSSI, 79% HCWs were wearing gloves. The most common injured sites were left fingers (39.5%), and 55.4% of injuries were superficial. After exposure, 97.9% did not report their exposure. The source patient was not tested for HBV, HCV and HIV infection in more than 70% of injuries and 96.9% of injured HCWs did not receive post exposure prophylaxis. Conclusion The study highlighted that inadequately adopted safe injection procedures and insufficient injection practices lead to high prevalence of NSSIs in operating rooms.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.11.002
       
  • Significant reductions in heart and lung doses using semi lateral
           decubitus techniques for left sided breast cancer patients: A comparative
           dosimetric study with supine techniques

    • Authors: Amr Abdul Aziz; Lila Mosa; Mohamed Farouk; Azza Helal; Mahran Abdo
      Abstract: Publication date: Available online 9 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Amr Abdul Aziz, Lila Mosa, Mohamed Farouk, Azza Helal, Mahran Abdo
      Introduction Various treatment techniques as breath hold techniques have been developed to spare the heart and lung in breast cancer patients receiving adjuvant radiotherapy. Purpose to compare the heart and lung dosimetric parameters of semi lateral decubitus technique with and without deep inspiration breath hold with standard supine techniques for left-sided breast cancer patients undergoing breast conservative surgery and adjuvant radiotherapy. Methods Fifty patients with left-sided breast cancer were simulated using standard supine, semi lateral decubitus and semi lateral decubitus and deep inspiration breath hold. The three plans carried out using two tangential opposed photon beams were compared. Results There was a significant reduction in heart V5Gy, V10Gy, V25Gy, V30Gy, mean dose & max dose with semi-lateral decubitus and breath hold technique compared to supine technique & semi-lateral decubitus technique (P<0.001). There was also a significant reduction in the above mentioned heart DVPs with semi-lateral decubitus (P<0.001) compared to supine technique. There was a significant reduction in ipsilateral lung V20Gy and mean dose with semi-lateral decubitus and breath hold technique compared to supine technique (P<0.001) & semi-lateral decubitus technique (P=0.003 & 0.006) respectively. There was also a significant reduction in ipsilateral lung V20Gy and mean dose with semi-lateral decubitus (P<0.001 & 0.007) compared to supine technique. Conclusion Semi-lateral decubitus techniques with and without breath hold for left sided breast cancer patients significantly reduce the dosimetric parameters of the heart and ipsilateral lung compared to supine technique with comparable target dose coverage.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.12.002
       
  • Antihyperglycemic activity of the bark methanolic extract of Syzygium
           mundagam in diabetic rats

    • Authors: Rahul Chandran; Thangaraj Parimelazhagan; Blassan P. George
      Abstract: Publication date: Available online 3 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Rahul Chandran, Thangaraj Parimelazhagan, Blassan P. George
      The present study was designed to investigate the free radical defence and antihyperglycemic property of S. mundagam. Petroleum ether, ethyl acetate, methanol and hot water extracts of bark were determined for the total phenolic, tannin, flavonoid content and antioxidant property using DPPH, ABTS+, phosphomolybdenum, FRAP, superoxide, nitric oxide and metal chelating assays. The antioxidant response was best observed in ABTS+ (109686.87μM TE/g extract), phosphomolybdenum (268.54g AAE/100g extract) and superoxide radical scavenging assays (84.30%). Bark methanol extract was found highly efficient in scavenging the free radicals than other extracts. The higher phenolic content (54.44g GAE/100 extract) could be attributed to this effect. The glucose homeostasis was observed till 180th min in glucose loaded rats treated with the bark methanol extract. The extract could also induce potent hypoglycaemia in STZ induced diabetic rats. The antioxidant defence system could be one of the prime mechanisms of S. mundagam leaf and bark extracts that needs to be studied further for the exact molecular action leading to antidiabetic effect.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.12.001
       
  • Toxic effects of formalin-treated cadaver on medical students, staff
           members, and workers in the Alexandria Faculty of Medicine

    • Authors: Noha Selim Mohamed Elshaer; Madiha Awad Elsayed Mahmoud
      Abstract: Publication date: Available online 2 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Noha Selim Mohamed Elshaer, Madiha Awad Elsayed Mahmoud
      Background Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff members, and workers at the Anatomy department in the Alexandria Faculty of Medicine (AFM). Methods A cross sectional approach was adopted to investigate medical students (n=454). Staff members and workers at the Anatomy department (n=16), and unexposed staff members and workers in the AFM (n=19) were included in the study. Medical students filled self-administered predesigned questionnaire. Formalin-exposed and unexposed staff members filled a questionnaire and a Complete Blood Count was done for them. Results The most frequently reported symptoms by medical students were unpleasant smell (91.2%), itching in the eyes (81.3%), and excessive lacrimation (76.1%). Majority of them reported duration of relief within one hour (>80%), and more than two thirds reported wearing laboratory coats and hand gloves. Formalin-exposed staff reported symptoms of skin disorders as drying (75%), eczema (68.8%), and allergic contact dermatitis (87.5%), besides, eye irritation (68.8%), respiratory tract irritation (93.8%), and work-related bronchial asthma (53.3%). The mean RBCs and platelets counts were significantly lower among formalin-exposed staff (4.08±0.65×106/ul and 237,375±71745.73/ul respectively) compared with unexposed staff (4.95±0.50×106/ul and 280473.68±54456.27/ul respectively). WBCs count was abnormal (low or high) among formalin-exposed staff members (6.2%, and 18.8% respectively), while all unexposed staff had normal WBCs counts. Conclusion The research highlighted the irritating action of formalin on medical students, and chronic toxic effects on staff members. This necessitates re-evaluation of the concentration of formalin, proper ventilation and assessment of working practices in the dissecting rooms at the Anatomy department.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.11.006
       
  • Effect of Prosthechea karwinskii (Orchidaceae) on obesity and dyslipidemia
           in Wistar rats

    • Authors: Alejandra Rojas-Olivos; Rodolfo Solano-Gómez; Alfonso Alexander-Aguilera; Manuel Jiménez-Estrada; Stefan Zilli-Hernández; Luicita Lagunez-Rivera
      Abstract: Publication date: Available online 2 January 2017
      Source:Alexandria Journal of Medicine
      Author(s): Alejandra Rojas-Olivos, Rodolfo Solano-Gómez, Alfonso Alexander-Aguilera, Manuel Jiménez-Estrada, Stefan Zilli-Hernández, Luicita Lagunez-Rivera
      Background Prosthechea karwinskii is an endemic Mexican orchid, it’s currently used as decorative element and in the traditional medicine to treat diabetes and some problems related to inflammatory processes. Aim To determine antioxidant activity index (AAI) and to validate by the first time and through an rat model the hydroalcoholic extract obtained from Prosthechea karwinskii, a plant used in traditional medicine for treat conditions relate to the metabolic syndrome. Methods For in vivo assays 25 weaned male Wistar rats were divided into a control group (CG; n=5) and a Metabolic Syndrome group (MS; n=20). The rats of the latter were induced to MS with 40% sucrose in the drink water during 13weeks. After MS induction this group was subdivided into 4 groups: MS group (n=5) received sucrose, and three groups receiving 200mg/kg of body weight of each extract pseudobulb (P, n=5), leaf (L, n=5), and flower (F, n=5). All treatments were followed for 13days. Blood was collected at the end of the study to measure glucose, cholesterol and triglycerides. AAI were measured in the extracts by the method of DPPH. The results were analyzed using MINITAB 16.1.0, and the statistical significance was determined by ANOVA and a Tukey’s test (P <0.05). Results Leaves (L) extract had highest values in AAI, followed by flowers (F) and pseudobulb (P) extracts. Leaves extract had highest reducing effect on glucose level, while flower extract had highest reducing effect on the cholesterol and triglycerides levels. Conclusions The P. karwinskii extracts evaluated here reduces the glycemic and lipidemic parameters in Wistar rats with MS induced. These effects may be attributed to the high antioxidant capacity of the extracts.

      PubDate: 2017-01-12T16:20:42Z
      DOI: 10.1016/j.ajme.2016.11.004
       
  • Subclinical hypothyroidism ups the risk of vascular complications in type
           2 diabetes

    • Authors: Ghada A. Mohamed; Amira M Elsayed
      Abstract: Publication date: Available online 31 December 2016
      Source:Alexandria Journal of Medicine
      Author(s): Ghada A. Mohamed, Amira M Elsayed
      The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical hypothyroidism (SCH) and vascular complications of type 2 diabetes. Objectives: To find out the relationship between SCH and vascular complications in patients with Type 2 diabetes. Subjects and Methods: Our cross sectional study included 110 patients with type 2DM (45 males and 65 females) who were followed at the Diabetes outpatient Clinics in the state of Kuwait during 6months period. All patients subjected to complete clinical and laboratory data, including thyroid function tests, total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, urinary albumin, fundus examination, ECG, and Glycosylated hemoglobin. Results: Among 110 patients, 21 (19.1%) Patients had SCH. Patients with SCH were more significantly older, with longer duration of diabetes, higher HbA1c, total cholesterol and LDL-C than euthyroid group. However, gender (p=0.076), BMI (p=0.092), and smoking (P=0.715) were not significantly different between the SCH and euthyroid groups. The SCH group had a higher prevalence of dyslipidemia (p=0.017), diabetic nephropathy (p=0.003) diabetic retinopathy (p=0.004) and IHD (p=0.011) than the euthyroid group while no significant difference in the prevalence of diabetic neuropathy (p=0.420). Conclusions: SCH is a common endocrine disorder in patients with Type 2 diabetes. It could be associated with a higher prevalence of vascular complications in type 2 diabetes. We could not prove a relation between SCH and diabetic neuropathy.

      PubDate: 2017-01-01T20:25:04Z
      DOI: 10.1016/j.ajme.2016.10.003
       
  • Carotid artery aneurysm associated with Marfan Syndrome: A case report

    • Authors: Paolo Simone; Collura Cristiano Saronni Giacomo Pata Andrea Battistella Federico
      Abstract: Publication date: Available online 31 December 2016
      Source:Alexandria Journal of Medicine
      Author(s): Paolo Re, Simone Collura, Cristiano Saronni, Giacomo Pata, Andrea Battistella, Federico Ghidinelli, Gianluca Abrami, Maurizio Giovanetti


      PubDate: 2017-01-01T20:25:04Z
       
  • Caudal Regression Syndrome/neurogenic bladder presented as recurrent
           urinary tract infection

    • Authors: Burhan Edrees
      Abstract: Publication date: Available online 31 December 2016
      Source:Alexandria Journal of Medicine
      Author(s): Burhan M. Edrees


      PubDate: 2017-01-01T20:25:04Z
       
  • Proliferaton index in pituitary adenomas from a black African population

    • Authors: Ayodeji Salami; Mustapha Ajani Augustine Adeolu Olufunmi Ogun Amos Adeleye
      Abstract: Publication date: Available online 31 December 2016
      Source:Alexandria Journal of Medicine
      Author(s): Ayodeji Salami, Mustapha Ajani, Augustine Adeolu, Olufunmi Ogun, Amos Adeleye, Olabiyi Ogun, Clement Okolo, Adefolarin Malomo, Effiong Akang
      Background The WHO has recognized a variant of pituitary adenomas with potential aggressive behaviour which have been termed atypical pituitary adenomas. This group of tumours are recognized by their mitotic rate of more than >3%, p53 expression and invasion of surrounding structures. There has however been no study of the occurrence of these tumours in a black African population. This study is a preliminary attempt to examine this group of tumours in blacks. Methods This study retrospectively reviewed fifty-seven histologically diagnosed and immunohistochemically characterized pituitary adenomas received in our department over a twenty-one year period. Specimens were stained with ki67, a nuclear marker of cell proliferation which has been identified as the single best predictor of atypical pituitary adenoma. Results Twelve of the tumours showed atypical features with eight (67%) of these tumours being prolactinomas. Two of the tumours were gonadotrophs and two were null cell adenomas. There was no correlation with age or gender. Two of the tumours required neurosurgical re-exploration with one of these showing a higher mitotic index in the second biopsy. Conclusion The study suggests similarity in the rate of occurrence of pituitary adenomas with atypical features in a black African population with what is seen in Caucasians. Prolactinomas constitute a significant percentage of the tumours with this feature.

      PubDate: 2017-01-01T20:25:04Z
       
 
 
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