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Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access  
3D Printing in Medicine     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 5)
ABCS Health Sciences     Open Access   (Followers: 3)
Abia State University Medical Students' Association Journal     Full-text available via subscription  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Full-text available via subscription   (Followers: 41)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Facultatis Medicae Naissensis     Open Access  
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta Medica International     Open Access  
Acta medica Lituanica     Open Access  
Acta Medica Marisiensis     Open Access  
Acta Medica Martiniana     Open Access  
Acta Medica Nagasakiensia     Open Access  
Acta Medica Peruana     Open Access   (Followers: 2)
Acta Médica Portuguesa     Open Access  
Acta Medica Saliniana     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 4)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 6)
Addictive Behaviors Reports     Open Access   (Followers: 8)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access  
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 7)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 5)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28)
Advances in Life Course Research     Hybrid Journal   (Followers: 8)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Medical Education and Practice     Open Access   (Followers: 25)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Medicine     Open Access   (Followers: 2)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access  
Advances in Phytomedicine     Full-text available via subscription  
Advances in Preventive Medicine     Open Access   (Followers: 5)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5)
Advances in Wound Care     Hybrid Journal   (Followers: 10)
African Health Sciences     Open Access   (Followers: 2)
African Journal of Biomedical Research     Open Access  
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 1)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 2)
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 8)
AJOB Primary Research     Partially Free   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 2)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3)
American Journal of Biomedical Engineering     Open Access   (Followers: 12)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 6)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 11)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 11)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 3)
American Journal of Medicine     Hybrid Journal   (Followers: 43)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access  
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 7)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 5)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 2)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy     Open Access  
Anatomy Research International     Open Access   (Followers: 2)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 1)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 2)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 3)
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 10)
Annals of Family Medicine     Open Access   (Followers: 12)
Annals of Fundeni Hospital     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Microbiology     Hybrid Journal   (Followers: 10)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 4)
Annual Review of Medicine     Full-text available via subscription   (Followers: 17)
Anthropological Review     Open Access   (Followers: 23)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal  
Applied Medical Informatics     Open Access   (Followers: 10)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arak Medical University Journal     Open Access  
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Trauma Research     Open Access   (Followers: 3)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Full-text available via subscription   (Followers: 12)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 12)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access  
Asia Pacific Family Medicine     Open Access   (Followers: 1)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 10)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 3)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 1)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 9)
Auris Nasus Larynx     Full-text available via subscription  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)
Autopsy and Case Reports     Open Access  
Aviation, Space, and Environmental Medicine     Full-text available via subscription   (Followers: 10)
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 1)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 3)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 3)
Bangladesh Journal of Medical Physics     Open Access  
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  

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Journal Cover
Alexandria Journal of Medicine
Journal Prestige (SJR): 0.191
Citation Impact (citeScore): 1
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2090-5068
Published by Elsevier Homepage  [3163 journals]
  • 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
      Pages: 103 - 109
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.01.005
  • Health-related quality of life and associated factors among patients with
           diabetes mellitus in Botswana

    • Authors: Godfrey Mutashambara Rwegerera; Thato Moshomo; Marea Gaenamong; Taibat Aderonke Oyewo; Sivasomnath Gollakota; Yordanka Piña Rivera; Anthony Masaka; Brian Godman; Meshack Shimwela; Dereje Habte
      Pages: 111 - 118
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Godfrey Mutashambara Rwegerera, Thato Moshomo, Marea Gaenamong, Taibat Aderonke Oyewo, Sivasomnath Gollakota, Yordanka Piña Rivera, Anthony Masaka, Brian Godman, Meshack Shimwela, Dereje Habte
      Background: Health-related quality of life (HRQOL) is an important aspect of diabetes mellitus care. The objective of the study was to determine theHRQOL of diabetes mellitus (DM) patients in Botswana as little known in Africa. Materials and methods: A cross-sectional study of 380 randomly selected DM patients in a tertiary clinic in Gaborone, Botswana was conducted to obtain Data on HRQOL and structured questionnaire was used to collect information on sociodemographic and clinical characteristics. Multivariate logistic regression to determine sociodemographic and clinical characteristics associated. Results: Majority of patients were female with no formal education or primary level of education. Mean HbA1c was 7.97% (SD: 2.02) and most patients had poor glycemic control. The majority had both worse physical composite score (PCS-12) and mental composite score (MCS-12), with worse proportions of the two. Female gender, older age ≥65years, and the presence of three or more documented diabetic complications were associated with significant worse PCS-12. Presence of two diabetic complications, three or more diabetic complications, and musculoskeletal disease were associated with significant MCS-12. Conclusions: Diabetic patients in Botswana have relatively poor HRQOL. The fact that most patients present late with complications calls for policy attention to diagnose diabetes mellitus early and prevent associated complications, ultimately improving health-related quality of life among diabetes mellitus patients.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.010
  • Ameliorative effect of apelin on streptozotocin-induced diabetes and its
           associated cardiac hypertrophy

    • Authors: Islam Ibrahim Hegab
      Pages: 119 - 127
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Islam Ibrahim Hegab
      Aim Apelin, an adipocyte-derived factor, exhibited a number of cardioprotective properties; however, its effect in diabetes which is a major risk factor for cardiovascular disease (CVD) needs to be further studied. So this work was designed to evaluate the effect of apelin on diabetes and its associated cardiac hypertrophy with its possible underlying protective mechanisms. Experimental protocol Thirty male adult Wistar rats were categorized into three groups, 10 rats each, normal control group: received standard food and water regime. Diabetic control group: received streptozotocin (STZ) at a dose of (55mg/kg, i.p., once) dissolved in citrate buffer (pH 4.5). Apelin-13 treated diabetic group: STZ diabetic rats received an intra peritoneal injection of apelin-13 at a dose of (100nmol/kg/day), and given daily for 8weeks. at the end of the experiment, oral glucose tolerance test (OGTT) was assayed, then rats were sacrificed and serum glucose, insulin, triglyceride (TG), total cholesterol, high density lipoprotein (HDL) cholesterol, serum lactate dehydrogenase (LDH) and serum creatine kinase – MB (CK-MB) were measured, together with cardiac hypertrophy index (CHI), left ventricular hypertrophy index (LVHI) and left ventricular protein and collagen content levels. Myocardial superoxide dismutase (SOD), catalase, reduced glutathione (GSH) and malondialdehyde (MDA) were determined in the myocardial tissue of experimental rats. Results Treatment with apelin-13 improved hyperglycemia and hyperlipidemia, and significantly protected against STZ-induced structural alterations in cardiac tissue, it also produced a significant reduction in MDA while it elevated the level of antioxidant enzymes in hearts of diabetic rats. Conclusion This study suggested that apelin can ameliorate diabetes and its associated myocardial hypertrophy through mainly its anti diabetic, anti hyperlipidemic and anti oxidative stress properities.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.006
  • Superimposed effect of ovariectomy on type 2 diabetes mellitus in Wistar

    • Authors: Minerva K. Fahmy; Hayam G. Sayyed; Eman A. Abd Elrahim; Rana T.A. Farag
      Pages: 129 - 137
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Minerva K. Fahmy, Hayam G. Sayyed, Eman A. Abd Elrahim, Rana T.A. Farag
      Background Estrogen deprivation in the postmenopausal women plays a critical role in progression of type 2 diabetes mellitus (T2DM). Aim The present study investigated the overlaid effect of ovariectomy on T2DM and the possible underlying mechanism. Materials Forty female Wistar rats were divided into four groups (10 rats each): sham control, ovariectomized control, sham diabetic and diabetic ovariectomized groups. At the end of experiment, estimation of body weight gain percentage, food intake, fasting blood glucose concentration, and insulin tolerance test were done. Then, rats were euthanized and blood samples were taken for measurement of serum concentration of insulin, HOMA-IR, lipid parameters, tumor necrosis factor-α, interleukin 1 beta, interleukin 4, interleukin 10, malondialdehyde and total thiol. Also, histopathological and immunohistochemical examination of the pancreas were done. Results The present study revealed that ovariectomy aggravated the diabetic induced glucose metabolic disturbance as implied by impaired insulin tolerance test, increased insulin resistance alongside lipid dyshomeostasis. These metabolic disturbances might claim to exacerbation of oxidative stress and inflammatory response along with apparent histopathological and immunohistochemical changes on the pancreas. Conclusion We concluded that metabolic disturbances induced by diabetes might be getting worse after ovariectomy via intensification of oxidative stress and inflammatory state.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.011
  • Unmet need for postpartum family planning in Alexandria, Egypt

    • Authors: Heba Mahmoud Taha Elweshahi; Gihan Ismail Gewaifel; Sameh Saad EL-Din Sadek; Omnia Galal El-Sharkawy
      Pages: 143 - 147
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Heba Mahmoud Taha Elweshahi, Gihan Ismail Gewaifel, Sameh Saad EL-Din Sadek, Omnia Galal El-Sharkawy
      Background Postpartum women are a priority group to target on trying to solve the problem of closely spaced pregnancies as well as population explosion. Aim To estimate the level of unmet need for postpartum family planning one year after birth as well as identify factors associated with having unmet need in Alexandria, Egypt. Methods A cross sectional survey was adopted. A sample of 1500 women one year post-partum was selected. A predesigned interviewing questionnaire was used to collect data. Data include their socio-demographic characteristics and current use of family planning method. Those with unmet need for postpartum family planning (PPFP) were asked about the reasons for non-use, their intention to use in the future and their knowledge about contraceptives. Setting Public settings delivering routine immunization for infants in Alexandria. Results Out of 1500 postpartum women, 1370 (91.33%) have a real demand for family planning. Out of those with a real demand for family planning (n=1370), 1106 (80.72%) were using a modern contraceptive method and only 41 (3%) were using a traditional method for birth control while the remaining 223 (16.28%) were having unmet need for postpartum family planning. Amenorrhea, breast feeding, fear of side effects, discontinuation due to health concerns and pressure from the surroundings were the most common cited reasons for non-use. Conclusion Integration of family planning education during antenatal, natal and postnatal care services in Egypt should be actively initiated. Women with unmet need for PPFP in general and those with intention to use a contraceptive in particular should be targeted for recruitment efforts and services in any program tackle the problem of family planning and rising fertility in Egypt.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.03.003
  • Sleep restriction progress to cardiac autonomic imbalance

    • Authors: Arbind Kumar Choudhary; Tanwir Alam; Anup Kumar Dadarao Dhanvijay; Sadawarte Sahebrao Kishanrao
      Pages: 149 - 153
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Arbind Kumar Choudhary, Tanwir Alam, Anup Kumar Dadarao Dhanvijay, Sadawarte Sahebrao Kishanrao
      Previous studies have shown that night shift work is thought to be a risk factor for cardiovascular disease and inadequate sleep is a common feature of night shift work. Since it’s more difficult to maintain adequate sleep duration among night watchmen during their working schedule, hence the purpose of our present study was to investigate whether mental stress or fatigue over restricted sleep period in night shift, affects HRV, in order to elucidate on cardiac autonomic modulation among nigh watchmen. With the purpose of this, autonomic activity determined from the levels of the heart rate variability (HRV), and also measured, body mass index (BMI), body fat percentage from skin fold thickness (biceps, triceps, and sub-scapular, supra-iliac) among normal sleep watchmen) (n=28) and restricted sleep watchmen (n=28) at first (1st) day, fourth (4th) day and seventh (7th) day of restricted sleep period. We observed that among restricted sleep individuals, sleepiness was significant increase at 4th day and 7th day when compare to normal sleep individuals, and, there was significant increase in, mean NN, VLF, LF, LF(nu), LF/HF AND significant decrease in SDNN, RMSSD, TSP, HF, and HF(nu) at 4th and 7th day of restricted sleep period. In addition to, this variable was more significant increase on 7th day, when compare with 4th day. As well as there was significant negative correlation between LF(nu) and HF(nu) at subsequent 4th day [r (48)=−0.84; P=0.01] and 7th day[r (48)=−0.95; P=0.01] of restricted sleep period. However we didn’t observe any significant variation in BMI, and body fat percentage among restricted sleep individuals when compare to normal sleep individuals with in this restricted sleep periods. Hence we concluded that partial sleep loss may cause autonomic imbalance represented by increased sympathetic and decreased parasympathetic activity; as revealed by altered HRV indices observed in this study.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.003
  • Screening for psychological distress among High School Graduates Accepted

    • Authors: Iman Hassan Diab; Heba Mahmoud Taha Elweshahi; Hesham Adel Sheshtawy; Ayat Nabil Youssef Salem Eltayar; Abd Elrahman Mohammed Sharaf
      Pages: 155 - 159
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Iman Hassan Diab, Heba Mahmoud Taha Elweshahi, Hesham Adel Sheshtawy, Ayat Nabil Youssef Salem Eltayar, Abd Elrahman Mohammed Sharaf
      Background Mental and psychological health of adolescents in general and prospective medical students in particular is a priority area to investigate as it affects wellbeing of the future doctors. Objectives The current research was conducted to screen first year medical students accepted for enrollment at Alexandria Faculty of Medicine to identify those with a high probability of having psychological distress before the start of academic courses as well as explore the sources of stress among them. Methods. A cross sectional survey of 779 high school graduates accepted for admission to Alexandria Faculty of medicine was conducted. Participants were approached on the days of obligatory pre-enrollment medical examination. The translated Arabic version of DASS 21 questionnaire was used to screen students for three negative emotional symptoms namely depression, anxiety and stress. Inquiry about age, sex, residency and type of high school was added. Results More than a tenth of studied medical students (12.6%) suffered from severe or profound stress and 29.1% of them had mild to moderate stress. Moreover, one fifth (20%) of studied students were severely anxious and less than one third (29.3%) had mild to moderate anxiety. Severe and profound depression was diagnosed among 14.3% of students whereas, 18.7% them were moderately depressed. No association was found between any of studied negative emotional symptoms and the students' educational background or their residency. Conclusion Nearly half of the prospective medical students might have some sort of psychological distress before starting their study in the Faculty of Medicine. They should be investigated to verify diagnosis and start intervention to minimize its adverse effects on academic performance and advancement at the faculty. Stress management courses should be considered for all medical students.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.005
  • Verification of brain ring enhancing lesions by advanced MR techniques

    • Authors: Momena Essam Elsadway; Heba Ibrahim Ali
      Pages: 167 - 171
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Momena Essam Elsadway, Heba Ibrahim Ali
      Purpose To evaluate the role of MR Spectroscopy in verification and differentiation of different brain ring enhancing lesions, for better diagnostic purpose and management outcome. Patients and methods 25 patients were included in this study, 15 of them were males and 10 were females, with age ranging between 21 and 75 (mean 46±14). All patients were presented with variable symptoms, some of them have known primary disease entity and others presented with headache, visual disorders or disturbed level of consciousness. MRI was done to all the patients including conventional and contrast sequences, as well as MR Spectroscopy. Some did MR perfusion and DTI in order to further characterize their nature. Histopathological findings and results of clinical follow up were our reference standard. Results Among the 25 patients, MR Spectroscopy was able to specify 22 lesions (88%), DTI was performed in 13 out of 25 lesions and MR perfusion was performed in 8 out of 25 lesions. Conclusions Characterization of ring enhancing lesions of the brain has increased accuracy by applying advanced MRI techniques. In this study, MR Spectroscopy combined with DTI and MR perfusion sequences in some cases improved verification of different ring enhancing brain lesions.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.001
  • Role of static fluid MR urography in detecting post urinary diversion

    • Authors: Amr Farouk Ibrahim Moustafa; Tamer M. Abd el Rahman; Amr Abd Elfattah Hassan Gadalla; Karam Gaber Mohamed; Ahmed Morsi Moustafa Fahmy; Sameh Abd AlAziz Zaki Hanna
      Pages: 173 - 179
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Amr Farouk Ibrahim Moustafa, Tamer M. Abd el Rahman, Amr Abd Elfattah Hassan Gadalla, Karam Gaber Mohamed, Ahmed Morsi Moustafa Fahmy, Sameh Abd AlAziz Zaki Hanna
      Aim of work The aim of the study was to assess the diagnostic performance of static MR urography in detection of post cystectomy complications & the ability of static fluid MR urography in visualization of urinary tract segments. Material & methods We prospectively reviewed 21 MR urograms with urinary diversion. The most common surgical procedures included Ileal conduit & Ileocecal neobladder diversion. Magnetic resonance urography examinations were performed with 1.5-T MR scanners. T2 weighted (static fluid) MR urography techniques were done, in addition to conventional T1- and T2-weighted axial and coronal sequences. Urinary tract was divided in different parts: pelvicalyceal systems, upper, mid and lower ureteric segments & the reservoir or conduit Imaging features of the urinary collecting systems were evaluated for their visualization and complications detection. Results T2-weighted MR urography could demonstrate 95% of urinary tract segments & together with conventional MR sequences all urinary tract segments can be visualized. Urinary diversion related complications were encountered included in 15 patients (71.4%) & no urological complications were seen in 6 patients (28.6%). Conclusion Comprehensive T2-weighted MR urography is an effective imaging method for the visualization of the urinary system and detection of early and late postoperative complications in patients with urinary diversion.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.04.001
  • Tracheotomy as a surgical access for removal of bullet in the trachea: A
           case report

    • Authors: Shankar Ramasundram; Baharudin Abdullah; Sivakumar Kumarasamy; Nurul Syamiza Shamsudin
      Pages: 181 - 183
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Shankar Ramasundram, Baharudin Abdullah, Sivakumar Kumarasamy, Nurul Syamiza Shamsudin
      Gunshot tracheal injury with retained bullet fragment inside the trachea presents a challenge for removal. The treatment of the tracheal injury depends on the magnitude of the tracheal wound and the presence of injury to adjacent organs. The surgical removal may require both bronchoscopy and an open trachea exploration. We report a case of a gunshot injury to the trachea which requires a tracheotomy for a successful bullet removal.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.007
  • Sharp foreign body ingestion by a young girl

    • Authors: Riyadh Mohamad Hasan
      Pages: 185 - 187
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      Author(s): Riyadh Mohamad Hasan
      A 16year old patient had ingested two sewing needles about 4.5cm long accidentally that eventually resided in extra intestinal tract position, and being asymptomatic, she ignored the problem for a long period about 2years. She only consulted the hospital after having symptoms. The needles were located by X-ray imaging and retrieved with the aid of C-arm fluoroscope at a laparotomy. Her postoperative period was uneventful.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.009
  • 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
      Pages: 1 - 9
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2016.12.008
  • 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
      Pages: 11 - 15
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.02.001
  • The effects of valproic acid on the mRNA expression of Natriuretic Peptide
           Receptor A and KQT-like subfamily Q-1 in human colon cancer cell lines

    • Authors: Mona Hajikazemi; Hoda Sohrabi; Ahad Yamchi; Mohsen Saeedi
      Pages: 17 - 22
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      Author(s): Mona Hajikazemi, Hoda Sohrabi, Ahad Yamchi, Mohsen Saeedi
      Aim and objectives The histone deacetylase (HDAC) inhibitor, Valproic Acid (VPA), causes growth inhibition and apoptosis in colorectal cancer cells. HDAC inhibition is associated with the transcriptional regulation of Natriuretic Peptide Receptor-A (NPR-A). NPR-A regulates voltage-gated potassium channel, KQT-like subfamily Q, member 1 (KCNQ1). NPR-A and KCNQ1 are also involved in the initiation and propagation of cancer cells. In this study, we investigated the simultaneous expressional changes of NPR-A and KCNQ1 among VPA-treated colon cancer cells. Materials and methods Human colorectal cancer cells were cultured and treated with increasing concentrations of VPA at different time points. MTT viability test was conducted to evaluate the growth inhibition. Real Time RT-PCR was used to quantify differential mRNA expression of NPR-A and KCNQ1 genes. Two-way ANOVA and bonferroni post-tests were used to analyze data statistically. Results We showed that VPA treatment inhibits the growth of SW-480 cells more efficiently compared to HT-29. NPR-A and KCNQ1 genes were significantly upregulated upon VPA treatment in both cell lines (P<0.0001). Conclusion The alteration of NPR-A and KCNQ1 genes were more ordered among SW-480 cancer cells. The expressional changes of KCNQ1 and NPR-A among VPA treated human colon cancer cells follow the same pattern in similar combinations. VPA could regulate the expression of KCNQ1 through altering the mRNA expression of NPR-A.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.04.002
  • 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
      Pages: 23 - 26
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.02.002
  • 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
      Pages: 27 - 39
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2016.08.001
  • The effect of the essential oils of lavender and rosemary on the human
           short-term memory

    • Authors: O.V. Filiptsova; L.V. Gazzavi-Rogozina; I.A. Timoshyna; O.I. Naboka; Ye.V. Dyomina; A.V. Ochkur
      Pages: 41 - 44
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      Author(s): O.V. Filiptsova, L.V. Gazzavi-Rogozina, I.A. Timoshyna, O.I. Naboka, Ye.V. Dyomina, A.V. Ochkur
      The research results of the effect of essential oils on the human short-term image and numerical memory have been described. The study involved 79 secondary school students (34 boys and 45 girls) aged 13 to 17years, residents of the Ukrainian metropolis. Participants were divided into three groups: the control group, “Lavender” group, in which the lavender essential oil was sprayed, and “Rosemary” group, in which the rosemary essential oil was sprayed. The statistically significant differences in productivity of the short-term memory of the participants of different groups have been found. Therefore, the essential oils of rosemary and lavender have significantly increased the image memory compared to the control. Inhalation of the rosemary essential oil increased the memorization of numbers, and inhalation of the lavender essential oil weakened this process.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.004
  • 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
      Pages: 45 - 48
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.03.005
  • 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; T.W. Rennie
      Pages: 49 - 56
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      Author(s): P.A. Mataranyika, D. Kibuule, F. Kalemeera, H. Kaura, B. Godman, T.W. 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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.03.002
  • Is canscore a good indicator of fetal malnutrition in preterm newborn

    • Authors: B.N. Ezenwa; V.C. Ezeaka
      Pages: 57 - 61
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.01.004
  • 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
      Pages: 69 - 76
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.01.003
  • Spontaneous de novo vaginal adenosis resembling Bartholin’s cyst: A
           case report

    • Authors: Adebayo Alade Adewole; Osadolor Augustine Ugiagbe; Temitope Gabriel Onile; Olatunji Oluwaseyi Fadahunsi; Daniel Ike Awelimobor; Toba Ajagun; Obioma Jude Nnorom
      Pages: 77 - 80
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      Author(s): Adebayo Alade Adewole, Osadolor Augustine Ugiagbe, Temitope Gabriel Onile, Olatunji Oluwaseyi Fadahunsi, Daniel Ike Awelimobor, Toba Ajagun, Obioma Jude Nnorom
      Background Vaginal adenosis is a rare benign condition with a small percentage of patients at risk of vaginal adenocarcinoma. Case A 34year old woman presented with paravaginal swelling resembling Bartholin’s cyst. Vaginal examination revealed a cystic, fluctuant and non-tender mass on the right lateral vaginal wall measuring 6 by 5 cm. The cervix, uterus, adnexa and Pouch of Douglas (POD) were normal. She had paravaginal cyst excision and histology showed stratified cuboidal epithelial cells with proliferation of numerous glands of small caliber within its wall that are separated by scanty stroma and consistent with vaginal adenosis. No other lesion was found on the genital tract. Conclusion Excision and histology is required in suspicious cases of paravaginal cyst to rule out vaginal adenosis, a potential precursor of vaginal adenocarcinoma. Counseling and follow up will help detect early occurrence of adenocarcinoma.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.05.002
  • 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
      Pages: 81 - 84
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      Author(s): Abdullahi Hassan, Gobir Abdulrazaq Abdullahi, Abubakar Aisha Ahmed, Adamu Sabiu, Uwaya John, Gwamna Ezekeil, Yahaya Aliyu Ibrahim

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.03.006
  • 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
      Pages: 85 - 92
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2016.11.002
  • Broken Heart Syndrome – An intra operative complication

    • Authors: Zara Wani; Meenaxi Sharma
      Pages: 93 - 95
      Abstract: Publication date: March 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 1
      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: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.02.003
  • The possible protective effect of lactoferrin on
           lipopolysaccharide-induced memory impairment in albino rats

    • Abstract: Publication date: Available online 28 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): Nermin M. Madi, Mervat H. El-Saka

      PubDate: 2018-06-01T01:30:20Z
  • Results of arthroscopic treatment of femroacetabular impingement (FAI)

    • Abstract: Publication date: Available online 24 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): Raafat Ragab, Tarek Elkhadrawe, Philip Housden, Ahmed Abotaleb
      Introduction Femoroacetabular impingement (FAI) has been suggested as an important etiology of pain in the groin region in young adults especially athletes and there are theories connecting it to early onset osteoarthritis. Aim To assess the results of arthroscopic treatment of FAI. Patients Forty patients had been managed arthroscopically for their FAI in both El-Hadra university hospital and William Harvey Hospital. Methods Results of arthroscopic treatment of FAI in 40 consecutive patients had been evaluated using patients reported outcomes (modified Harris Hip Score and international Hip Outcome Tool-12) and clinical measures of improvement of range of motion in both flexion and internal rotation in 90° of hip flexion. Results The average of the outcome scores showed statistically significant improvement following the arthroscopic intervention. Conclusion Femroacetabular impingement is an important etiology of groin pain in young adults, nevertheless the athletes. Diagnosis of this condition is primarily a clinical one to be supported with relevant imaging. Hip arthroscopy is an effective approach to treat and correct the underlying bony abnormalities of FAI. Younger age of patients predicts better improvement in i-HOT-12 score.

      PubDate: 2018-06-01T01:30:20Z
  • Toxicities of selected medicinal plants and floras of lower phyla

    • Abstract: Publication date: Available online 24 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): P.U. Amadi, E.N. Agomuo, A.I. Bob-Chile Agada, U.C. Njoku, M.O. Ifeanacho, J.C. Okereke, C.U. Iheka, J.O. Osuoha
      The aim of this study was to evaluate the toxic effects associated with the administration of aqueous extracts (AE) of Calliandra portoricensis (CP), Dracaena arborea (DA), Duranta repens (DR), Polytrichum juniperinum (PJ), Parmelia caperata (PC), and Nostartium officinale (NO) on Wistar rats. LD50 for each plant was obtained prior to administration. Seven groups of six rats each were orally gavaged for 28 days as follows; group 1–7 received normal rat pellets and saline, in addition, group 2 received 20 mg/kg b.w CP, group 3 & 4 respectively received 8 mg/kg b.w DA and DR, group 5 & 6 respectively received 4 mg/kg b.w PJ and PC, and group 7 received 100 mg/kg b.w NO. Liver enzymes; ALP, ALT, AST and GGT were significantly (p < 0.05) elevated by CP, DR, PJ and PC extracts. All the extracts caused significant alterations of the total protein, albumin and globulin levels. The urea levels were deranged by all the extracts while CP, PJ, PC, and NO extracts caused no significant effects on the creatinine levels. Both DR and NO deranged the serum electrolytes; Na, K, Cl, and HCO3. Results for the lipid profile showed that all extracts significantly altered the phosphatidate phosphohydrolase and LDL levels while no significant effects were observed in the VLDL, TG, TC, HDL, cardiac risk ratio, arterogenic coefficients, and arterogenic index of plasma, of NO treated rats. For hematological parameters DR, PJ, and PC significantly deranged the RBC, HGB, MCHC, MCV, and MCH concentrations while the neutrophils, eosinophils and basophils were significantly altered on administration of all the extracts. No significant effects were observed on the platelets and plateletcrit level in rats gavaged with CP, whereas the MPV, PDW, and PCT concentrations were deranged by DR extracts. CP and NO caused no alterations in the MDA, GSH, and GST levels whereas the SOD, GPx, and xanthine oxidase levels were significantly deranged by all the plant extracts. Only NO treatment produced catalase, glutathione reductase, and xanthine dehydrogenase levels equivalent to the control group. This study has shown various degrees of deleterious effects on biochemical parameters associated with the consumption of these plants, thus raising serious concerns over their continuous applications as local medicaments.

      PubDate: 2018-06-01T01:30:20Z
  • Microbiological monitoring of ultrapure dialysis fluid in a hemodialysis
           center in Alexandria, Egypt

    • Abstract: Publication date: Available online 18 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): Aleya A. Abbass, Ahmed F. El-Koraie, Walaa A. Hazzah, Eman A. Omran, Mohammed A. Mahgoub

      PubDate: 2018-06-01T01:30:20Z
  • Comparative study between multi-detector computed tomography and
           echocardiography in evaluation of congenital vascular rings

    • Abstract: Publication date: Available online 8 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): Manal Hamisa, Fatma Elsharawy, Wafaa Elsherbeny, Suzan Bayoumy
      Vascular rings are unusual anomalies represent less than 1% of all cardiac anomalies, it is abnormal development of aortic arch complex leading to formation of a ring formed by vessels that encircle both the trachea and esophagus, echocardiography had limited acoustic window which leads to inadequate evaluation of great vessels, Multi-detector computed tomography (MDCT) is one of the most important non invasive diagnostic tool for detection the vascular ring anomalies. The Aim To evaluate role of MDCT Scanning for diagnosis of congenital vascular rings anomalies compared to echocardiography. Methods This is a prospective study of 21 children suspected to have vascular ring anomalies. All patients underwent chest radiography, echocardiography examinations and MDCT Scanning using a 128-row CT scanner with 3D reconstruction. Results Twenty-one patients (11 male and 10 female), mean age (14 months) were diagnosed as vascular ring anomalies by MDCT then confirmed by surgical results MDCT diagnosed 14 patients with (double aortic arch), 4 patients (right sided aortic arch with aberrant left subclavian), 2 patients (left sided aortic arch with aberrant right subclavian artery) and one patient with pulmonary sling. MDCT also diagnosed seven patients with tracheobronchial stenosis. Echocardiography succeeded only in nine patients with DAA and failed in five and succeeded in diagnosis of two cases of (right aortic arch with aberrant left subclavian). Conclusion MDCT is an excellent diagnostic tool for optimum detection of vascular ring anomalies and other extra cardiac lesions compared to echocardiography.

      PubDate: 2018-06-01T01:30:20Z
  • Nodular hidradenoma of the breast: A case report

    • Abstract: Publication date: Available online 4 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): G.H. Ano-Edward, I.O. Amole, S.A. Adesina, O.A. Ajiboye, M.E. lasisi, R.K. Jooda
      Nodular hidradenoma is a rare benign skin adnexial lesion of the breast. It is often located in the nipple areolar region and presents as a slow growing painless lesion. We report a case in a 62 yr old male who had a slowly growing left breast lesion of 10 yrs duration. Physical examination revealed an 8 cm superficial, spherical, mobile non tender lump in the nipple areolar region. Excision biopsy with clear margins was performed and histologic examination was nodular hidradenoma after wide consultations. Nodular hidradenoma of the breast is a differential diagnosis of sub areolar masses that must be considered by both pathologist and surgeons to avoid misdiagnosis and overtreatment.

      PubDate: 2018-06-01T01:30:20Z
  • Omentin-1 and diabetic retinopathy in type 2 diabetic patients

    • Abstract: Publication date: Available online 3 May 2018
      Source:Alexandria Journal of Medicine
      Author(s): Mohamed Abdelraouf Korany, Ahmed Sonbol, Sameh Mohamed Elgouhary
      Background Diabetic retinopathy (DR) is one of the most common and serious micro vascular complication affecting type 2 diabetic patients. The literature on adipokines as a possible mechanism in the pathogenesis of DR is contradictory. We are in need for more explanation about the pathogenesis of DR and also in need for reliable biomarker for early diagnosis of such complication. The aim of this work was to study the serum level of omentin-1 and its relation to diabetic retinopathy in type 2 diabetes mellitus (type 2 DM). Patients and methods This study was conducted on 75 type 2 DM patients; 20 healthy subjects served as a control group. All participants were classified into 4 groups: • Group1: Included 25 type 2 diabetics without retinopathy. • Group2: Included 25 type 2 diabetics with non proliferative diabetic retinopathy (NDPR). • Group 3: Included 25 type 2 diabetics with proliferative diabetic retinopathy (PDR). • Group 4: Included 20 healthy subjects as a control group. Thorough history taking and physical examination with calculation of body mass index (BMI), investigations were done including serum creatinine, lipid profile, glycosylated haemoglobin (HbAIc), C-reactive protein (CRP), urine albumin creatinine ratio (UACR) and serum omentin-1. Fundus examination was carried out by an expert ophthalmologist. Results Serum omentin-1 level was significantly lower in diabetic patients compared with the control, and in DR compared with diabetics without DR and in PDR compared with NPDR. There was a negative significant correlation between serum omentin-1 level and BMI, HbA1c, CRP, total cholesterol, low density lipoprotein (LDL) and Serum triglycerides (TG) and positive significant correlation with high density lipoprotein (HDL). Conclusions From this study we can conclude that serum omentin-1 is significantly lower in patients with DR compared with diabetics without retinopathy and in PDR patients compared with NPDR patients. Also, there is a negative significant correlation between serum omentin-1 and HbAIc, BMI, CRP and some lipid parameters.

      PubDate: 2018-06-01T01:30:20Z
  • Sexual function of pregnant women in the third trimester

    • Authors: Erbil
      Abstract: Publication date: June 2018
      Source:Alexandria Journal of Medicine, Volume 54, Issue 2
      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: 2018-04-25T11:37:39Z
  • Lateral ankle anatomical variants predisposing to peroneal tendon

    • Authors: Mahmoud Agha; Mohamed Saied Abdelgawad; Nasser Gamal Aldeen
      Abstract: Publication date: Available online 21 March 2018
      Source:Alexandria Journal of Medicine
      Author(s): Mahmoud Agha, Mohamed Saied Abdelgawad, Nasser Gamal Aldeen
      Purpose To delineate the significant association between the peroneal tendons injury and the lateral ankle joint anatomical variants. Subjects Retrospective revision of the last 600 ankle MRI examinations, with dividing such candidates into: Group A: Inclusion group including patients with pure Peroneal tendon injury & lateral ankle anatomical variants. Group B: Control group including patients with Peroneal Tendonsinjury & no anatomical variants. Group C: Exclusion group including patients with other different types of ankle injuries. Technique Standard MRI ankle joint protocols. Results Group A: 73 patients (40.3%) had PTT including: straight/convex RMG in 48 (26.5%) patients; 19 of them (39.6%) had PTT, PT hypertrophy in 39 (21.6%) patients; 14 (35.9%) of them had PTT. RCE hypertrophy in 33 (18.3%) patients; 12 of them (36.4%) had PTT. PQ muscle was seen in 15 (8.3%) patients; 7 (46.7%) of them had PTT. Low PB muscle belly was found in 29 (16%) patients; 13 (44.9%) of them had PTT. OP was found in 17 (9.3%) patients; 8 (47%) of them had PTT. Group B: 26 of them (18%) had PTT. Fisher exact test 0 P value. Conclusion The lateral ankle joint anatomical variants facilitate peroneal tendons injury, ending in chronic lateral joint instability.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2018.03.001
  • Prevalence of pre-hypertension and hypertension and its related risk
           factors among undergraduate students in a Tertiary institution, Ghana

    • Authors: Daniel Gyamfi; Christian Obirikorang; Emmanuel Acheampong; Kwabena Owusu Danquah; Evans Adu Asamoah; Fatima Zarah Liman; Emmanuella Nsenbah Batu
      Abstract: Publication date: Available online 12 March 2018
      Source:Alexandria Journal of Medicine
      Author(s): Daniel Gyamfi, Christian Obirikorang, Emmanuel Acheampong, Kwabena Owusu Danquah, Evans Adu Asamoah, Fatima Zarah Liman, Emmanuella Nsenbah Batu
      Objectives This study sought to provide information about pre-hypertension and hypertension status among undergraduate students at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Methods This cross-sectional study was conducted among a total of 540 students. Participants were interviewed using questionnaires and their blood pressures (BP), height, weight were measured and Body Mass Index ‘BMI’ and Waist-to-Height Ratio (WHtR) were calculated. Repeated measurements were obtained on two successive times in students with persistently elevated BP. Data obtained was entered and analyzed using SPSS version 23. Final prevalence was adjusted for loss-to- follow up on participants with first elevated BP from the reading and logistic regression used to evaluate risk factors. P-value less than .05 was considered statistically significant. Results Twelve (2.2%) of the students were hypertensive, whilst pre-hypertension was prevalent in 26.1% of the student. Family history of hypertension [OR = 1.68(0.73–1.68)], kidney failure [OR = 1.38(0.34–5.60)], stroke [OR = 1.10(0.64–1.91)] and heart failure [OR = 1.03(0.27–3.94)] were associated with increased risk of developing pre-hypertension; however no significant association was observed (p > .05). WHtR and BMI were independent positively correlated with blood pressure status after controlling for gender and age (p < .05). Further analysis revealed that, obesity detected by WHtR [OR = 3.67(1.13–11.94), p = .031] and BMI [OR = 6.89(0.71–66.48), p = .0005] were significant predictors of hypertension using logistic regression analysis. Conclusion The study revealed considerable prevalence rates of pre-hypertension and hypertension among undergraduate students, with significant risk factors such as obesity detected by BMI and WHtR. Gender as male was also significant for pre-hypertension and hypertension. Sound prevention and control programmes of hypertension should be devised among students, to improve their knowledge and lifestyle practices early in life.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2018.02.002
  • Impact of methylenetetrahydrofolate reductase (MTHFR) A1298C gene
           polymorphism on the outcome of methotrexate treatment in a sample of
           Egyptian rheumatoid arthritis patients

    • Authors: Ola Atef Sharaki; Amira Hasan Elgerby; Eman Saad Nassar; Sara Salah Eldin Khalil
      Abstract: Publication date: Available online 7 March 2018
      Source:Alexandria Journal of Medicine
      Author(s): Ola Atef Sharaki, Amira Hasan Elgerby, Eman Saad Nassar, Sara Salah Eldin Khalil
      Background: Methotrexate is the most commonly used disease-modifying anti-rheumatic drug (DMARD) and it is considered the first-line treatment in the management of rheumatoid arthritis (RA). MTX treatment outcome regarding response to the drug and adverse effects in RA patients are not universal. Therefore, it would be beneficial if we could predict the response of patients to MTX before starting MTX treatment in order to determine the patient’s drug-treatment plan. Objectives: The present study aimed to evaluate the impact of MTHFR A1298C SNP (rs1801131) on the clinical outcome of MTX treatment as regards treatment efficacy and toxicity in a cohort of Egyptian rheumatoid arthritis patients. Patients and methods: Fifty rheumatoid arthritis patients were included in the present study. Data about patient related variables such as age and sex, disease related variables such as disease duration as well as treatment related variables such as treatment duration, dose of MTX, its route of administration and concomitant use of other drugs (NSAIDs) were obtained. DAS28 was calculated to all patients to assess drug response. MTHFR A1298C polymorphism was investigated using real time 5′ nuclease allelic discrimination assay. Results: Multivariate regression analysis for factors predicting MTX drug response showed that MTHFR A1298C SNP and MTX dose were the most significant independent predictors for MTX treatment response (p = .016, OR = 39.113, 95% C.I = 1.970–776.558, p = .003, OR = 1.667, C.I = 1.184–2.348, respectively). Considering clinicopathological variables; longer disease duration, positive anti-CCP, NSAIDs users, higher MTX doses and longer treatment durations were significantly associated with non-response to MTX. Regarding MTX drug toxicity, MTHFR 1298 CC genotype, MTX dose and concomitant use of NSAIDs were significantly associated with MTX drug toxicity (MCp = .003, p = .031, p = .029, respectively). Conclusion: Our study proved that MTHFR A1298C SNP can predict clinical outcome of MTX treatment as regards treatment efficacy and toxicity in Egyptian rheumatoid arthritis patients.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.11.008
  • Neuronal and glial regeneration after focal cerebral ischemia in rat, an
           immunohistochemical and electron microscopical study

    • Authors: Abeer E. Dief; Passainte S. Hassan; Oehring Hartmut; Gustav F. Jirikowski
      Abstract: Publication date: Available online 6 March 2018
      Source:Alexandria Journal of Medicine
      Author(s): Abeer E. Dief, Passainte S. Hassan, Oehring Hartmut, Gustav F. Jirikowski
      Objectives Unilateral middle cerebral artery occlusion (MCAO) is an established rat model for stoke studies. It induces focal cerebral ischemia, prior to necrotic and apoptotic loss of tissue in a circumscribed cortical area, paralleled by temporary motor impairment. Methods Here we examined tissue samples from the peri-infarct zone of rats that had survived unilateral MCAO for up to 90 min. With immunohistochemistry we stained sections for proliferation markers Ki 67 and PCNA and for intermediate filament protein nestin. Electron microscopy was employed to assess ultrastructural changes. Results All MCAO animals developed pronounced lesions in the motor cortex. Numerous cells in the immediate peri-infarct area and scattered cells which seem to have migrated into the infarcted lesion stained positively for Ki 67 and PCNA. Electron microscopy revealed that cells in the lesion site proliferate along the blood vessels. Most of these cells had the ultrastructural features of fibrillary astrocytes while some of the cells were clearly neurons. Endothelia were in part fenestrated. Some of the surrounding cells showed immunostaining for PCNA, indicating proliferation. Oligodendroglia and myelination could not be seen in the lesion site. Single neuronal contacts exhibited the ultrastructural features of synapses. Reformation of cortical layers could not be observed. Conclusions We concluded that in spite of extensive proliferation; neuronal and glial regeneration occurs after MCAO only to a small extent. Revascularization seems to be an important initial step. The observed functional recovery of experimental animals may be due to neuronal plasticity in young rats rather than structural regeneration.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2018.02.001
  • Plasma soluble CD 163 level as a marker of oesophageal varices in
           cirrhotic patients

    • Authors: Alaa El Din Mohamed Abdo; Khaled Mahmoud Mohy El Din; Essam El Din Saeed Bedewy; Reham Abdel Haleem Abo Elwafa; Mohamed Adel Abdel Aziz
      Abstract: Publication date: Available online 23 February 2018
      Source:Alexandria Journal of Medicine
      Author(s): Alaa El Din Mohamed Abdo, Khaled Mahmoud Mohy El Din, Essam El Din Saeed Bedewy, Reham Abdel Haleem Abo Elwafa, Mohamed Adel Abdel Aziz
      Background Variceal bleeding (VB), the most common lethal complication of cirrhosis, associated with high mortality. Timely prediction of esophageal varices (EV) represents a real challenge for the medical team. This study evaluated the level of plasma soluble CD 163 as a marker of the presence of EVs and to compare it with other noninvasive clinical, laboratory and ultrasonographic parameters as well as endoscopy. Methods This prospective controlled study was conducted on 80 adults. Gp I had no oesophageal varices, gp II had small varices, gp IIIa had large varices, gp IIIb are the same patients of gp IIIa but after eradication of varices and gp IV as healthy controls. Serum samples were assayed for soluble CD 163. Results soluble CD163 was statistically significant different between controls and all liver cirrhosis. it showed a statistically significant difference between group I and II (p=0.009) and between group I and IIIa (p<0.001) and between group II and IIIa (p<0.001) but, no difference between group IIIa and IIIb (p=0.179). Conclusion Serum soluble CD163 is a good noninvasive predictor for the presence of EVs and it may be used for grading of EVs. Its level does not change after esophageal varices eradication. Trial registration: IRB No: 00007589 FWA No: 00015712 The Ethics Committee of the faculty of medicine Alexandria University.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.08.003
  • Study of risk factors for erectile dysfunction in patients with type 2
           diabetes mellitus: Correlation to serum testosterone level

    • Authors: Mohamed Abdelraouf Korani; Ahmed Sonbol
      Abstract: Publication date: Available online 13 February 2018
      Source:Alexandria Journal of Medicine
      Author(s): Mohamed Abdelraouf Korani, Ahmed Sonbol
      Background Diabetes mellitus (DM) is one of the most frequent etiologies of erectile dysfunction (ED). Risk factors of ED in type 2 diabetes mellitus (T2 DM) include patient age, disease duration, sedentary life and glycemic control. Subnormal testosterone concentrations contribute to ED as testosterone regulates nearly every component of erectile function. The aim of the work was to study the age of the patient, duration of diabetes mellitus, body mass index (BMI), glycosylated hemoglobin (HbAIc) and urinary albumin creatinine ratio (uACR) in type 2 male diabetic patients as risk factors for erectile dysfunction and their relation to serum testosterone level. Patients and methods This study was conducted on 100 male type 2 diabetics selected from inpatient department and out patient clinics of the Internal Medicine Department in Menoufia University Hospital. The patients were divided into two groups: Group 1: 50 patients with type 2 DM with erectile dysfunction and Group 2: 50 patientswith type 2 DM without erectile dysfunction. The study groups were subjected to thorough history with special emphasis on age of the patients, disease duration and investigations including testosterone level, glycosylated hemoglobin, and uACR. The patients answered the abridged 5-item version of the International Index of Eectile Function (IIEF-5) questionnaire. Results Total serum testosterone was significantly lower in diabetics with ED compared to those without ED. HbAIc, diabetes duration and uACR were independently negatively correlated with testosterone level. Conclusion The diabetes duration, glycemic control and uACR contribute to erectile dysfunction in type 2 diabetics, and they were independently and negatively correlated with total serum testosterone level.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2018.01.002
  • Osteocalcin, Azan and Toluidine blue staining in fibrous dysplasia and
           ossifying fibroma of the jaws

    • Authors: Samuel Ebele Udeabor; Akinyele Olumuyiwa Adisa; Anna Orlowska; Poju Chia; Robert A. Sader; Shahram Ghanaati
      Abstract: Publication date: Available online 13 February 2018
      Source:Alexandria Journal of Medicine
      Author(s): Samuel Ebele Udeabor, Akinyele Olumuyiwa Adisa, Anna Orlowska, Poju Chia, Robert A. Sader, Shahram Ghanaati
      Background Fibrous dysplasia (FD) and ossifying fibroma (OF) are fibro-osseous lesions (FOLs) having several overlaps that may make final diagnosis difficult by hematoxylin and eosin (H/E) alone. Aim This study seeks to detect any association between Azan and Toluidine blue staining as compared with osteocalcin in FD and OF diagnosis. Methods Forty formalin fixed paraffin embedded (FFPE) blocks of FD and OF were prepared for Azan, Toluidine blue and osteocalcin staining. Brown staining of calcified structures was considered as positive for osteocalcin. Scoring for Azan and Toluidine blue was evaluated based on intensity and localization. Level of agreement of original and revised diagnosis was determined. Results Six (40%) of 15 FD were corroborated by osteocalcin. Eight cases initially diagnosed as OF were revised to FD. There were 25 OF according to H/E, and 17 (68%) were validated by osteocalcin. Measure of agreement between histology and immunohistochemistry was 0.081; p = .608. Eleven (42.3%) OF expressed strong toluidine blue staining of the intervening fibrous connective tissue stroma while only 2 (14.2%) FD showed similar staining, this difference was statistically significant [p = .001]. Conclusions Histomorphometric analysis with Toluidine blue may reduce diagnostic errors of OF and FD.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2018.01.001
  • Upgrading patients with pacemakers to resynchronization pacing: Predictors
           of success

    • Authors: Samir Rafla; Aly Aboelhoda; Mostafa Nawar; J.Ch. Geller; Mohamed Lotfi
      Abstract: Publication date: Available online 11 January 2018
      Source:Alexandria Journal of Medicine
      Author(s): Samir Rafla, Aly Aboelhoda, Mostafa Nawar, J.Ch. Geller, Mohamed Lotfi
      Background The investigations of predictors of success or failure of cardiac resynchronization therapy were studied previously. Assessment of success in patients already on dual or single pacemakers and upgraded to cardiac resynchronization therapy (CRT) were not extensively studied before. How to select patients in whom this may be the most optimal strategy is unclear. We sought to determine factors associated with success or failure in this group of patients who were already paced for heart block. Methods 81 pts were subjected to upgrade to CRT implantation after being on pacemaker. The study was conducted in Germany. Data was presented as Median (Min.–Max.) for abnormally distributed data or Mean ± SD. for normally distributed data. Parameters that revealed no statistical significance in response: Age, sex, EF, diabetes, renal disease, GFR, MR, QRS duration (all above 150 ms), history of ablation, AF recurrence, previous pacemaker, optimization. The following parameters revealed significant influence on response to CRT: Less responders with: Higher C reactive protein (CRP), presence of tricuspid incompetence (TR), presence of pulmonary hypertension (PHN), presence of previous MI, being ischemic vs nonischemic cardiomyopathy (CM) (less responders with ischemic CM). Conclusions The findings through light on specific parameters that predict response to upgrade to CRT after usual pacemaker.

      PubDate: 2018-04-25T11:37:39Z
      DOI: 10.1016/j.ajme.2017.11.006
  • Assessment of the onset of radiation-induced cardiac damage after
           radiotherapy of breast cancer patients

    • Authors: Ebtsam Zaher; Enayat Fahmy; Kamal Mahmoud; Yasser El Kerm; Mohammad Auf
      Abstract: Publication date: Available online 10 January 2018
      Source:Alexandria Journal of Medicine
      Author(s): Ebtsam Zaher, Enayat Fahmy, Kamal Mahmoud, Yasser El Kerm, Mohammad Auf
      Objectives The study aimed to evaluate the dose delivered to the heart during radiotherapy of left-sided and right-sided breast cancer (BC) patients, correlate the dose and laterality of radiotherapy to the possible cardiac damage and evaluate whether Left-ventricular Ejection Fraction (LVEF), Troponin-I (TnI), Creatinine Kinase (CK), Creatine Kinase-MB Relative Index (CK-MBRI) or Lactic Dehydrogenase (LDH) could be used to detect the possible onset of radiotherapy-related cardiotoxicity. Subjects and methods 80 females were assigned as; 30 left-sided BC patients, 30 right-sided BC patients and 20 healthy females. Patients were treated by radical mastectomy followed by FAC-based chemotherapy and radiotherapy. CT-based 3D-planning was used to generate cardiac dose-volume histograms to assess mean dose received by the heart. Echocardiography was done to all patients before and 1 year after completing radiotherapy. In serum, TnI and CK-MB concentration and CK and LDH activities were determined before and 1 year after radiotherapy. Results In left-sided patients, mean dose delivered to the heart was significantly higher in left-sided patients with significant association with total radiotherapy dose in left- but not right-sided patients. LVEF before and after radiotherapy were statistically different only in left-sided patients. LVEF one year after radiotherapy dropped 20% or more (ΔLVEF) in 6 patients, all were left-sided. Using cut-off values 0.08 ng/mL for TnI and 1.4 for CK-MBRI; 11 left-sided patients had abnormal TnI and CK-MBRI vs 5 right-sided patients, the 6 patients identified with ΔLVEF ≥ 20 were all among them. Conclusion the mean dose delivered to the heart is significantly higher in left-sided patients, and it was correlated to the total radiotherapy dose. One year after radiotherapy, ΔLVEF is possibly good marker of cardiotoxicity onset, however, the persistent elevation of both TnI and CK-MBRI could identify both patients with cardiotoxicity and patients that are thought to be in subclinical phase of cardiac damage.

      PubDate: 2018-01-10T03:37:43Z
      DOI: 10.1016/j.ajme.2017.12.001
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