Publisher: Al-Azhar University   (Total: 6 journals)   [Sort by number of followers]

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Al-Azhar Intl. Medical J.     Open Access   (Followers: 8)
AL-Azhar J. of Pediatrics     Open Access   (Followers: 17)
Al-Azhar J. of Pharmaceutical Sciences     Open Access   (Followers: 6)
Al-Azhar Medical J.     Open Access   (Followers: 8)
J. of Recent Advances in Medicine     Open Access   (Followers: 16)
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Al-Azhar Medical Journal
Number of Followers: 8  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1110-0400
Published by Al-Azhar University Homepage  [6 journals]
  • IS HYPERSENSITIVITY/ALLERGY CLASSIFICATION VALID TODAY '

    •  
  • MRI ASSESSMENT OF CSF FLOW AND DIAGNOSIS OF NORMAL PRESSURE HYDROCEPHALUS

    • Abstract: Background: Normal-pressure Hydrocephalus is a clinical triad of gait disturbance, subcortical dementia, and urinary incontinence in a patient who has communicating hydrocephalus.Objective: To reveal the role of phase-contrast MR imaging in the detection of normal pressure hydrocephalus among patients with ventriculomegaly.Patient and Methods: The study group included 40 patients with ventriculomegaly. Patients were referred to the multiple MRI centers (including Nile Scan Radiology Center and Watani Scan Radiology Center), Radiology Department of AL Mokatam Hospital. The consensus about final diagnosis in the ventriculomegaly group was reached on the light of the typical clinical findings and typical conventional MRI findings. The study was done between January 2018 and June 2020. The study was performed on 1.5 Tesla imager, using pulse -gated, cine-phase-contrast MRI technique and CSF quantification software.Results: This study revealed that the surest phase contrast MRI parameters in predicting normal pressure hydrocephalus was a CSF aqueductal stroke volume greater than 42 μL having a positive predictive value100%.Conclusion: The study yielded considerable information on the physiology of the normal CSF circulation, and in the evaluation of pathological CSF flow dynamics in normal pressure hydrocephalus that provided a better method of selecting those patients with hydrocephalus who gain benefit most from shunt operation.
       
  • ULTRASONOGRAPHY AND MR ARTHROGRAM IN DETECTION OF SHOULDER JOINT DISORDERS

    • Abstract: Background: Ultrasonography and Magnetic Resonance Imaging (MRI) are widely used to detect a lot of the shoulder joint pathologies as rotator cuff, labral, and capsular abnormalities. Objective: to detect role of ultrasonography and MR Arthrogram in detection of shoulder joint disorders in comparison to conventional MRI. Patients and methods: Thirty patients underwent ultrasound examination, conventional MR imaging of the shoulder and MR shoulder arthrography for clinically suspected labral or rotator cuff abnormalities. This study was done at the Radiodiagnosis Department, Al-Azhar University Hospitals during the period between October 2019 and October 2020. Results: MR arthrography was found superior over conventional MRI in its sensitivity regarding specifically labral tears Whereas 0% of patients were found positive by conventional MRI, 10% of patients were detected by magnetic resonance arthrography (MRA), followed by bankert lesion being positive in 7% by conventional MRI, whereas 27% were proved positive by MRA, anterior labrum periosteal sleeve avulsion (ALPSA) was negative in 100% of patients who underwent conventional MRI, 3% positive result was detected by Magnetic Resonance Angiogram (MRA), and finally compared to 3% positive superior labral anterior posterior (SLAP) cases detected by conventional MRI, 7% positive cases were proved by MRA. Conclusion: Ultrasound together with MR arthrography enhanced the accuracy of MR in the evaluation of the glenoid labrum and rotator cuff tendon.
       
  • PREVALENCE OF ESINOPHILIC ESOPHAGITIS AMONG ATOPIC EGYPTIAN POPULATION

    • Abstract: Background: Esinophilic esophagitis (EoE) is an atopic inflammatory disease of the esophagus that has become increasingly recognized in children and adults during the last decade. EoE is an atopic inflammatory disease of the esophagus that has become increasingly. Esinophils are typically present throughout the gastrointestinal tract since it is continuously exposed to foods, environmental allergens, toxins, and pathogens. Objective: To evaluate the prevalence of esinophilic esophagitis in atopic patients. Patients and Methods: This was a retrospective single center non randomized, observational study, 120 patients with age ranged from 18-60 years were recruited for this study. They were evaluated for esophageal symptoms using the frequency scale for the symptoms of gastro-esophageal reflux disease (GERD). It was conducted at Dermatology, Ear, Nose, and Throat (ENT), Ophthalmology and allergy clinic of Internal Medicine Departments, Al-Husein University Hospital. The study was done during the periods between July 2017 and September 2018. Results: The mean total immunoglobulin E (IgE) of group II was higher than group I with significant statistical difference between both groups. As regards the mean blood esinophils of group II was higher than group I with significant statistical difference between both groups. Heartburn documented the higher presentations (83%), followed by regurgitation (58.5%), and a combination of other symptoms in patients. Only 6 cases out of 53 examined, endoscopic biopsies have histological features of EoE. The remaining 47 biopsies featured different histological diagnosis which included mild reflux esophagitis in 12 cases, moderate reflux esophagitis in 20 cases, and severe reflux esophagitis in 15 cases. Conclusion: Atopic patients who suffered from esophagitis symptoms were assessed for EoE by endoscopic and histopathological examination especially if there was a high IgE level or increased blood esinophils.
       
  • THE POSSIBLE PROTECTIVE ROLE OF N-ACETYLCYSTEINE AGAINST TRAMADOL- INDUCED
           NEPHROTOXICITY IN THE ADULT ALBINO RATS (LIGHT AND ELECTRON MICROSCOPIC
           STUDY)

    • Abstract: Background: Tramadol is nephrotoxic in over doses N-acetylcysteine is effective against inflammatory processes and oxidative stress. Objective: Study of tramadol- induced nephrotoxicity on the rats and assess the possible protection of N-acetylcysteine. Material and Methods: Forty adult albino rats were obtained from the breading animal house of Faculty of Pharmacy, Al-Azhar University. The rats were housed in the animal house at Faculty of Pharmacy, Al-Azhar University under the suitable and standard conditions of temperature and feeding from January, 2021 till February, 2021. The rats were divided  into four groups Group I (control group): the rats of this group was given 30 ml /kg saline daily for thirty days orally; group II (treated with tramadol): the rats of this group were given l5.5 mg /kg tramadol orally daily for thirty days; Group III (Toxic dose tramadol): The rats of this group were given 30 mg /kg tramadol orally daily for thirty days; Group IV (treated with toxic dose of tramadol and N-acetyl cysteine): The rats of this group were given 30 mg /kg tramadol and N-acetylcysteine 100 mg/kg orally daily for thirty days. The rats at the last day of the experiment were killed and their kidneys were collected for histological evaluation using hematoxylin and eosin and Masson trichrome, and examined under light and transmission electron microscope. Also, Blood samples were taken for measurement of urea and creatinine. The data obtained from biochemical results for all groups were expressed as means and subjected to statistical analysis. Results: Treatment of rats with toxic dose of tramadol (group III) showed marked damage in the renal tissues, The damage in the renal tissues was improved in rats that were given N- acetylcysteine together with tramadol (group IV). However, tramadol that was given in a therapeutic dose (Group II) did not cause any damage in the kidney. Conclusion: N-acetylcysteine partially improves the tramadol –induced nephrotoxicity.
       
  • EFFECT OF PREOPERATIVE PREGABALIN ON STRESS RESPONE DURING LARYNGOSCOPY
           AND INTUBATION ON POSTOPERATIVE ANALGESIA IN NORMOTENSIVE NORMOGLYCEMIC
           PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY

    • Abstract: Background: Laryngoscopy and intubation is a noxious stimulus, which can provoke many untoward responses, particularly in the cardiovascular system in the form of hypertension, tachycardia, and dysrhythmia, which can be detrimental in cardiovascular compromised patients. For decreasing anxiety and the intubation response, use of nonopioid drugs has become a part of the multimodal regimen. Many recent studies show that drugs such as gabapentin and pregabalin are known to decrease stress response due to laryngoscopy and intubation. Objective: To evaluate the effect of different doses of pregabalin as oral premedication to attenuate cardiovascular response during laryngoscopy and endotracheal intubation. Patients and methods: The study included 120 normotensive normoglycemic patients undergoing abdominal hysterectomy who were randomly divided into 4 equal groups: group A received a placebo drug, groups B, C and D received different doses of oral pregabalin (75 mg, 150 mg and 300 mg respectively). The patients were unaware of their group distribution. Patients were carefully selected regarding the demographic data and the medical status. The anesthetic technique included preoperative assessment and preparation, during which the patients were informed about the details of the study, gave their consent, learned how to use VAS, and received the drug of the study. This study was done at Al-Azhar University Hospitals after approval of the medical ethical committee, from December 2019 till July 2021. Results: There was no significant difference between groups as regards demographic data, duration of intubation or duration of surgery. There were increase in hemodynamic values during intubation compared to the baseline values in all groups. However, the increase in both groups C and D was less than that of groups A and B. Afterwards, there was a gradual decrease in the hemodynamic parameters at 1, 3 and 5 minutes after intubation in all groups. Intraoperative fentanyl consumption decreased in the current study on using pregabalin in doses of 150 mg and 300 mg. A dose of 75 mg did not show such effect. Blood cortisol level decreased in the current study on using pregabalin in doses of 150 mg and 300 mg. Conclusion: Pregabalin in doses of 150 and 300 mg attenuated the hemodynamic response to laryngoscopy and endotracheal intubation, and decreased the requirement of post-operative analgesia.
       
  • ASSESSMENT OF SERUM AUTOTAXIN AS NOVEL BIOMARKER OF LIVER CIRRHOSIS

    • Abstract: Background: Autotaxin and its product lysophosphatidic acid are considered to be involved in the development of liver cirrhosis and elevated levels of serum autotaxin have been found in patients with hepatitis C virus associated liver disease. Objective: The clinical role of systemic autotaxin in the stages of liver cirrhosis was unknown. So, in our study we investigated the utility of serum autotaxin level as a marker of liver cirrhosis. Methods: Patients with liver cirrhosis were prospectively enrolled. Blood samples drawn at the day of inclusion in the study were assessed for autotaxin content by an enzyme-linked immunosorbent assay. Autotaxin levels were correlated with liver cirrhosis. The diagnostic value of autotaxin was investigated by analyses. Results: 60 subjects were enrolled.  Cirrhotic group had highest level of serum Autotaxin (105.86 ± 14.85 mg/l, p1<0.001) compared to hepatitis C virus non cirrhotic group (81.98 ± 11.31 mg/l, p2<0.001) and to control group (42.52 ± 4.95 mg/l, p3<0.001) with statistically significant difference and also hepatitis c non cirrhotic group had higher level compared to Control group by using of one-way ANOVA test. Conclusion: Our findings supported that serum Autotaxin level is a valuable test for detection of cirrhosis and associated with the severity of liver cirrhosis.
       
  • ROLE OF RENAL ULTRASONOGRAPHY AND DOPPLER IN DETECTION OF COMPLICATIONS OF
           POST-TRANSPLANTED KIDNEY

    • Abstract: Background: The increasing number of renal transplantations and the increased survival rate of renal transplantation patients lead to an increase of the number of complications. Complications of renal transplant can be diagnosed and managed with minimally invasive techniques. Radiologists must know about post-renal transplant complications, since it is essential to respond with early treatment, which improves the prognosis of the transplanted kidney. Most complications can be detected by Doppler and ultrasound, although on other occasions it is necessary to resort to other diagnostic techniques such as the CT Angiogram or arteriography. Objective: The aim of work was to highlight the role of ultrasound and duplex study in evaluation of early complications of the transplanted kidney. Patients and methods: This study included 30 renal transplant patients who were referred either for routine assessment of the renal allograft or for investigation of the cause of elevated serum creatinine levels. Patients selected from Ahmed Maher Teaching Hospital and Urology and Nephrology Center Mansoura University, in the period from November 2016 to August 2017. The patients were divided into two major groups: Group I: 20 patients with early complicated renal allografts, and Group II (Control Group): 10 patients with normal renal transplant grafts. Results: The perinephric complications have specific findings on the grey scale ultrasound while the Doppler may not reveal any significant findings. This study revealed that parenchymal complications were the most common early complications to occur after the kidney transplant surgery. The relation between the PSV of either the renal artery or the external iliac artery and the detection of early renal transplant complications in this study was insignificant. Ultrasound and Doppler showed different responses in relation to their specificity and sensitivity in the detection of early renal transplant complications. While Ultrasound was more accurate in detecting urological and perinephric complications showing sensitivity of 100%, Doppler appeared to have the upper hand in the detection of early vascular and parenchymal complications showing sensitivity ranging from 80-100 %. Conclusion: Doppler indices differ in their specificity and sensitivity in detecting the early renal transplant complications. Doppler indices in different arteries differ in the detection of early parenchymal renal transplant complications. In our study, Resistive index of the interlobar artery proved to be more specific in the detection of early cases of parenchymal complications in a renal transplant patient.
       
  • A COMPARISON BETWEEN BRACHIOBASILIC FISTULA AND SUPERFICIALIZATION IN ONE
           STAGE OR TWO STAGES

    • Abstract: Background: Hemodialysis continues to be the single most prevalent modality of kidney replacement therapy. Longevity on dialysis is directly proportional to the quality of dialysis, and that quality in turn depends on the reliability and integrity of the access to the patient’s vascular system. This crucial connection is known as the hemodialysis vascular access. Objective: To compare between brachiobasilic fistula and superficialization in one stage (basilic v. transposition) or two stages (basilic v. elevation) according to primary failure rate, primary patency rate, complication rate. Patients and Methods: This prospective present study was carried out at Al Azhar university hospitals, El Mokattam health insurance hospital and El Mattaria teaching hospital on 30 patients with ESRD needing vascular access in the period from January 2020 to January 2021. Results: Twelve fistulae were on the right side while eighteen patients had their fistulae on the left side. No significant difference was found. There were no significant differences between both groups in terms of the diameters of basilic vein and brachial artery among the patients. What really differs was the time to cannulate the fistula in both groups. It was earlier in Group A (p 0.007). Seroma had occurred in one patient (6.7%) in each group. Hematoma had occurred in one patient (6.7%) in Group A and two patients (13.3%) in Group B. Wound infection had occurred in one patient (6.7%) in each group. They all responded to conservative treatment. Thrombosis occurred in three patients (20%) in Group A; two patients had early thrombosis ( in the first 30 days) while one patient had thrombosis lately while two patients (13.3%) had thrombosis in Group B; one early and one late. Pseudoaneurysm occurred in only one patient in Group B (6.67%) which was impending rupture. So, it was ligated Mild steal syndrome occurred in one patient (6.67%) in each group which respond to medical treatment with no intervention. Regarding the fate of AVF, primary failure had occurred in four patients in Group A (26.7%) and in two patients in Group B (13.3%). In Group A, eleven patients (73.3%) had patent AVF after 3 months while ten patients (66.7%) had patent AVF after 6 months. In Group B, thirteen patients (86.7%) had patent AVF after 3 months while eleven patients (73.33%) had patent AVF after 6 months Conclusion: The brachiobasilic arteriovenous fistula was a good option as a native access for regular hemodialysis in chronic renal failure patients either done in one stage or in two stages with favoring two stages procedure due to higher primary patency rate and less primary failure rate.
       
  • STUDYING THE ASSOCIATION BETWEEN NON-ALCOHOLIC FATTY LIVER DISEASE AND
           NON-ALCOHOLIC FATTY PANCREAS DISEASE USING TRANSABDOMINAL ULTRASOUND AND
           ENDOSCOPIC ULTRASOUND

    • Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic triglyceride accumulation not due to alcohol consumption (<20 g ethanol per day), resulting in steatosis and hepatic inflammation. NAFLD is currently the most common liver disorder, particularly in Western countries. Worldwide, the prevalence of NAFLD is about 25%. Nonalcoholic fatty pancreas disease (NAFPD) is an excessive lipid accumulation in the pancreas in the absence of significant alcohol intake. Endoscopic ultrasound (EUS) can provide detailed images of the entire pancreas. The use of high-frequency US waves and the ability to simultaneously image adjacent organs like the liver and spleen in real-time. Objective: To determine the possible association between non- alcoholic fatty pancreatic disease (NAFPD) and non-alcoholic fatty liver disease (NAFLD). Patients and methods: This study was conducted on 100 subjects divided into two equal groups: Group I Included individuals with sonographically proven NAFLD, and Group II (control group): Included healthy individuals with no sonographic evidence of NAFLD. All cases were selected from Internal Medicine Department at Al-Hussein Hospital, Al-Azhar University, during the period from April 2019 to April 2020. Results: Based on the severity of fatty pancrease, moderate and severe fatty pancrease was significantly associated with older age with p value 0.0001. Fasting-blood-sugar (FBS), erythrocyte sedimentation rate (ESR), and aspartate-aminotransferase (AST) significantly higher in moderate and severe fatty pancreases too with p value 0.0001, 0.001 and 0.0001 respectively. Serum albumin level was the lowest in severe fatty pancreases with p value 0.001. In addition, low-density lipoprotein (LDL), TG and cholesterol was significantly higher in severe fatty pancreases with p value 0.0001, 0.0001 and 0.0001 respectively. High-density lipoprotein (HDL) was the highest in absent fatty pancreases with p value 0.0001. Patient with severe fatty pancrease was only present in fatty liver group with 24%. Conclusion: Degree of pancreatic steatosis was significantly related to old age, high erythrocyte sedimentation rate, low albumin level, high cholesterol, high triglycerides, and low high-density lipoprotein. Pancreatic steatosis was significantly correlated to presence of fatty liver.
       
  • COMPARATIVE STUDY BETWEEN MICROSCOPIC SURGICAL EXCISION OF
           CEREBELLOPONTINE ANGLE MASS VERSUS ENDOSCOPIC ASSISTED EXCISION

    • Abstract: Background: The combination of microscopic and endoscopic technique has showning significant advantages in the management of various cerebellopontine angle (CPA) lesions through different approaches. Endoscopic-assisted techniques have frequently been applied to cerebellopontine angle (CPA) surgery in the context of minimally invasive craniotomies, which increase the extent of tumor resection, minimize complications, and preserve the function of the delicate CPA structures. Objective: To assess the outcome of microscopic and combined microscopic with endoscopic technique as minimally invasive approach in Al Azhar experience. Patients and Method: twenty-two consecutive patients proved to have CPA masses were treated with microscopic and combined microscopic with endoscopic technique between September 2016 and December 2019 at the Neurosurgery Department, Al-Azhar University Hospitals. All patients included in this study have CPA masses. The reliability of the extent of microscopic removal was evaluated with endoscopic exploration. Additional resection was performed with both microscopic and the combined microscopic-endoscopic technique. Endoscopically verified total resection was validated by postoperative MRI. The function of the cranial nerves was evaluated to assess the impact of the combined technique on their function. Results: The mean age of patients in this study was ~ 43 years. All cases are clinically elevated by Glasgow Outcome Score (GOS) early after wakeup of anesthesia and late after 24 hrs. The favorable outcome achieved early in 18 patients (81.82%) and late in 19 patients (86.36%), while unfavorable outcome achieved early in 4 patients (18.18%) with improvement of one case later on and the achieved unfavorable outcome became 3 patients (13.64%). In correlation of pathology to GOS; schwannoma cases show 9 favorable outcome and only one unfavorably outcome, all 8 epidermoid cases were favorably outcome, while meningioma cases show 1 favorably and 2 unfavorably outcome. Regarding 7th cranial nerve injury; inadvertent injury occurred in one meningioma patient. Three patients experienced transient deterioration of their facial nerve functions in the postoperative period and improved by the end of the first month postoperative. Conclusion: This method provides simultaneous microscopic and endoscopic visualization and dissection techniques through skull-base approaches to CPA tumors. It overcomes some of the shortcomings of endoscopic-assisted surgery, further extends the surgical field, and increases the radicality of tumor resection with good functional outcomes.
       
  • COMPARISON BETWEEN ULTRASOUND GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP)
           BLOCK AND LOCAL ANESTHETIC INFILTRATION IN PATIENTS UNDERGOING
           LAPAROSCOPIC CHOLECYSTECTOMY

    • Abstract: Background: Post-laparoscopy analgesia of laparoscopic cholecystectomy is still a challenge. Many studies have been carried out to find the effect of different analgesic techniques in patients undergoing laparoscopic cholecystectomy including ultrasonic guided TAP block &wound infiltration of local anesthetic. Objective: To assess degree of pain control, duration of action, duration of postoperative analgesia, the effect on postoperative analgesic requirements in patients undergoing laparoscopic cholecystectomy and compare between Transversus abdominis plane block and local wound infiltration. Methods: 60 cases were enrolled for laparoscopic cholecystectomy and were divided randomly into two groups: TAP group: (n=30) patients of this group received TAP block performed by ultrasound guidance and LWI group (n=30) patients of this group received local anesthetic (ropivacaine).After surgery, Visual Analogue Score (VAS) was recorded at 1, 2,4,6,12,18 &24 hours. Requirement of rescue analgesia when VAS score ≥4, total dose of morphine received in 24 h were noted in both groups postoperatively. Results: The overall VAS during the first postoperative 24 hours was significantly lower in TAP group (P <0.001at 6, 12, 18 and 24 hours after surgery) and total analgesic consumption (morphine in mg) was lower in TAP group (8.2 mg) compared to LWI (12.2 mg). Conclusion: TAP block provides better postoperative pain control & reduce postoperative opioid requirement in comparison with local wound infiltration in patients undergoing laparoscopic cholecystectomy.
       
  • COMPARATIVE STUDY BETWEEN RADIAL AND FEMORAL ARTERY APPROACHES IN ACUTE ST
           SEGMENT ELEVATION MYOCARDIAL INFARCTION; IMMEDIATE AND SHORT-TERM FOLLOW
           UP

    • Abstract: Background: Trans-radial approach (TRA) gained sound acceptance as an alternative to trans-femoral approach (TFA), however, still having numerous pitfalls as hematoma, spasm and radial artery occlusion. Objectives: To evaluate the feasibility and safety of TRA for coronary angiography (CAG) and percutaneous coronary intervention (PCI) compared with the TFA in ST segment elevation myocardial infarction (STEMI) patients. Methods: Our study was a prospective analysis enrolled 100 consecutive patients presented with acute STEMI. The patients were randomly assigned to get vascular access either from TFA (Group I, 50 patients) or from TRA (Group II, 50 patients). The clinical, technical, procedural and post-procedural data collected. Results: Group I was younger than Group II (53.0±8.4) versus (55.8±10.9 years), however didn’t reach a statistical significance (p= 0.156). History of prior STEMI was significantly more in group II (6% versus 16%, p=0.032). There was no difference between the two groups regarding the procedural success (98% versus 96%) and number of attempts to fix the femoral or radial sheath. However, the total procedure time, amount of contrast usage and fluoroscopic time were significantly higher in radial group (42.2 ± 16.8 versus 77.4 ± 27.1 minutes), (157.4 ± 10.8 versus 181.2 ± 16.7 milliliter) and 8.74 ± 3.8 versus 18.64 ± 7.1 minute) with p=0.001 respectively. The frequency of acute complications was similar in both groups despite hematoma was less in group II, however, it didn’t reach statistical significance. Conclusions: Our study demonstrated the radial access is a safe and practical approach for coronary angiography or angioplasty in ST segment elevation myocardial infarction patients compared to femoral access, without major complications, however, the procedure time was significantly longer with higher usage of contrast media and fluoroscopic time.
       
  • COMPARATIVE STUDY BETWEEN PANCREATICOJEJUNOSTOMY AND
           PANCREATICOGASTROSTOMY FOLLOWING PANCREATICODUODENECTOMY

    • Abstract: Background: Pancreaticojejunostomy and pancreaticogastrostomy are the two techniques for pancreatic anastomosis that are widely established for the reconstruction after pancreaticoduodenectomy. Aim: To study the effect of the type of pancreaticoenteric reconstruction pancreaticojejunostomy versus pancreaticogastrostomy (PJ versus PG) after pancreaticoduodenectomy regarding the post-operative mortality and morbidity particularly pancreatic fistula (PF). Patients and Methods: A prospective cohort study included 40 patients with pancreatic or periampullary cancer who undergone pancreaticoduodenectomy. The patients divided randomizly into two groups; Group (A)included 20 patients who had undergone pancreaticojejunostomy reconstruction while group (B) included 20 patients who had undergone pancreaticogastrostomy reconstruction. Results: Mean operative time in group A and B was 7.6 ± 2.2 and 7.2 ± 2.7, mean blood loss 984.7 ± 253.2 and 852.5 ± 152.6, in most of the cases there was a Drains in contact with anastomosis was 85% and 70%, respectively. Also, there is no significant difference between both groups regarding intraoperative data. Considering postoperative complications, there was significant difference between both groups regarding pancreatic fistula, bile leak, postoperative pancreatitis andpeptic ulcer. Conclusion: This study observed that PG is associated with a lower risk for PF compared with PJ.
       
  • ACCURACY OF DOPPLER ULTRASOUND IN PREDICTION AND DIAGNOSIS OF PLACENTA
           ACCRETE

    • Abstract: Background: The worldwide incidence of placenta accreta spectrum (PAS) is rapidly increasing, following the trend of rising cesarean delivery. PAS is an heterogeneous condition associated with a high maternal morbidity and mortality rate, presenting unique challenges in its diagnosis and management. Objective: This study aims to compare between the role of Transabdominal ultrasound vs Transvaginal ultrasound in assessment of placental invasion in cases of placenta previa anterior wall with previous uterine scar applying the unified descriptors of the "EW-AIP" and also to evaluate the sensitivity and specificity of each criterion by comparing them with the final outcome of pregnancy. Patients and methods: This study was conducted on (50) pregnant women diagnosed as placenta previa by ultrasonography and were candidates for repeated elective CS or elective hysterectomy (if the diagnosis of placenta accreta is confirmed). All of those patients presented during the period of December 2018 till August 2020 to El-sheikh Zayed Specialized Hospital Obstetrics outpatient clinic during their follow up visits in the 3rd trimester. Results: Combined gray-scale ultrasonography and color Doppler increased   the accuracy for diagnosis of placenta accreta to 100% as approved intra-operatively and by the histopathological examination. In our study: As regards the analysis of gray-scale ultrasonographic criteria, loss of the hypo-echoic retroplacental sonolucent zone has the highest percentage among the studied group (87.5%), followed by presence of abnormal placental lacunae (79.2%) then thinning or disruption of hyperechoic serosa – bladder interface and the presence of focal exophytic masses invading the urinary bladder (41.7%), (25%) respectively. Conclusion: Combined gray-scale ultrasonography and color Doppler ultrasound are suggested for all patients with placenta previa and pervious CS to find out the features which suggest presence of placenta accreta, and this allows the surgical team to plan ahead of each case individually according to the variable morphological and vascular patterns.
       
  • ESTIMATION LEVELS OF SERUM CALCIUM, MAGNESIUM, URIC ACID AND C-REACTIVE
           PROTEIN IN MILD PREECLAMPSIA COMPARED TO LEVEL NORMAL PREGNANT WOMEN TO
           EARLY PREDICT SEVER PREECLAMPSIA

    • Abstract: Background: Preeclampsia is a common medical disorder affecting about 2–7% of pregnant women worldwide and can lead to unfavorable pregnancy outcomes such as increased maternal as well as perinatal morbidity and morbidity. The etiology of preeclampsia remains ambiguous, albeit, reports that implicated placental defects and oxidative stress early during pregnancy in affected pregnancies. Micronutrients and trace elements play a pivotal role in metabolism and in the preservation of tissue function. Trace elements are important constituents of a number of antioxidants. Therefore, they are integral part of a robust antioxidant that protects the cell from damage. Objective: To assess association serum levels of calcium, magnesium, uric acid and C-reactive protein in mild preeclampsia ladies and normal pregnant ladies to predict sever preeclampsia. Patients and methods: This was a case control study was conducted at Al-Azhar university hospitals included 100 patients in their third trimester of gestation divided into two groups; The 1st group consisted of 50 pregnant ladies with preeclampsia in the third trimester of pregnancy that was determined by last menstrual period (LMP) or first trimester ultrasound, and the 2nd group consisted of 50 normotensive pregnant ladies in the third trimester of pregnancy that was determined by last menstrual period (LMP) or first trimester ultrasound. Duration of research was one year starting from May2020 to May 2021. Results: Calcium and magnesium were significantly lower in preeclampsia group compared to normotensive group. Meanwhile, uric acid and CRP levels were significantly higher in preeclampsia group compared to normotensive group. There a significant positive correlation between DBP with uric acid, CRP and proteinuria while there a significant negative correlation between DBP with calcium and magnesium. Receiver operating characteristic (ROC) curve of UA to predict women with preeclampsia. Best cutoff value for UA is >5.9 mg/dl, which gives a sensitivity of 78% and specificity of 84%. The study revealed that CRP with value > 12 mg/L, has a sensitivity of 85% and specificity of 94%, furthermore, cutoff value for calcium is < 8.9 mg/dl and has a sensitivity of 73% and specificity of 88%, while as regard Magnesium with cutoff value < 1.8 mg/dl has a sensitivity of 70% and specificity of 82%. Calcium, uric acid and CRP were found to be significant predictors for preeclampsia. Conclusion: Serum C-reactive protein, magnesium and uric acid levels along with blood cell count cumulatively can be measured and may be used as markers for early diagnosis of preeclampsia and can be reduced maternal as well as fetal morbidity and mortality.
       
 
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Publisher: Al-Azhar University   (Total: 6 journals)   [Sort by number of followers]

Showing 1 - 5 of 5 Journals sorted alphabetically
Al-Azhar Intl. Medical J.     Open Access   (Followers: 8)
AL-Azhar J. of Pediatrics     Open Access   (Followers: 17)
Al-Azhar J. of Pharmaceutical Sciences     Open Access   (Followers: 6)
Al-Azhar Medical J.     Open Access   (Followers: 8)
J. of Recent Advances in Medicine     Open Access   (Followers: 16)
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