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Al-Azhar Medical Journal
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1110-0400
Published by Al-Azhar University Homepage  [6 journals]
  • Environmental pollution and the immune system

    • Abstract: Environmental pollution, particularly air pollution, is now a worldwide problem. Pollution represents a challenge not only to human health, but also to animals and plants.  In turn, human health will also be affected. The immune system is also sensitive to any environmental changes. The immune system itself consists of multiple types of immune cells that act together to generate (or fail to generate) immune responses. Understanding the effects of ambient pollutants on the immune system is vital to understanding how pollution causes disease, and how that pathology could be abrogated. It is also aimed to know how to lessen or prevent their effects on human health.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • GENOTYPING STUDY ON HEPATITIS B VIRUS AMONG EGYPTIAN PATIENTS

    • Abstract: Background: Infection of hepatitis B virus (HBV) is foremost communal health disquiet around the world. In this sense, Egypt has a seroprevalence of HBV that is somewhere in the middle. There are ten genotypes of HBV (A–J), each with its own geographical spread. Africa is one of the supreme endemic areas, by five genotypes (A-E) were discovered for HBV. Genotype D is the most dominant in the Middle East. There is a scarcity of information about HBV genotyping in Egyptians.Objective: The goal of this research was to find out the genotypes of HBV that were most prevalent among Egyptian patients.Patients and methods: This study included 190 serum samples from patients at the Hospital of Al-Hussein at Al-Azhar University in Cairo, Egypt, whose hepatitis B surface antigen (HBsAg) test result was positive. Of the 190 serum samples, HBV DNA was detected in only one hundred (100) serum samples, and they were the only ones comprised in the research. Patients were sectioned into two collections: 40 from Upper Egypt governorates and 60 from Lower Egypt governorates. The INNO-LiPA technique, which is predicated on the notion of reverse hybridization, was used to determine HBV genotypes.Results: Genotype C represented for 60% of all infections and was mostly distributed among patients in Lower Egypt's governorates, while genotype D represents for 40% of all infections and was mostly spread among patients in Upper Egypt's governorates.Conclusion: These findings substantiated that the most dominant genotype in Lower Egypt governorates was genotype C, while the most dominant genotype in Upper Egypt governorates was genotype D.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • METABOLIC CHANGES AFTER BARIATRIC SURGERIES (A REVIEW ARTICLE)

    • Abstract: Background: Obese persons may suffer from peripheral obesity with joint disease and venous stasis or central obesity that predisposes to a number of mortality-related problems due to the metabolic syndrome. Obesity is classified into: overweight, obesity class one, moderate obesity class two, morbid obesity, and super morbid obesity according to the body mass index (BMI). Extensive metabolic changes accompany bariatric surgery-based treatment of obesity. Consequently, the term “metabolic” surgery is being increasingly adopted in relation to the beneficial effects these procedures have on chronic diseases like type 2 diabetes.Objectives: Discussing metabolic changes that occur in the body after bariatric surgeries.Conclusion: Metabolic surgery achieves and sustains improvements in metabolic dysfunction secondary to obesity. Further mechanistic studies are essential to assess the true potential of metabolic surgery to treat the myriad other disorders of metabolism and their consequences in terms of cardiovascular disease and cancer.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • THE SHORT-TERM EFFECT OF NIFEDIPINETOCOLYSIS ON PLACENTAL, FETAL CEREBRAL
           AND ATRIOVENTRICULAR ...

    • Abstract: Background: Preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. Nifedipine is characterized by lack of tachyphylaxis and by a reversible effect after discontinuation of the treatment. The vascular relaxation obtained with nifedipine in hypertensive women does not occur significantly in normotensive patients. This explains the absence of severe hypotension induced by high doses of calcium antagonists for tocolysis in normotensive patients.Objective: To assess the acute effects of maternal nifedipine administration on placental and fetal cerebral blood flow resistance as well as on diastolic fetal cardiac function.Patients and methods: This study was an observational prospective study, on 30 healthy pregnant women with singleton fetuses who admitted to labor ward with the diagnosis of preterm labor, gestational ages of 28-34 weeks, intact membranes and received nifedipine maintenance tocolysis for persistent uterine contractions under surveillance of maternal vital signs and Doppler examinations performed prior to nifedipine administration, 3 hours after the first dose and after 48 hours on umbilical artery, middle cerebral artery, mitral valve and tricuspid valve. The study was done at Bab El-Shaaria University Hospital during the time of the study between August 2019 and September 2020.Results: In this study we found that, the P value for both systolic and diastolic blood pressure after 3 hours and after 48 hours was <0.001 which is statistically significant. Also the study found that, as regards the maternal heart rate, the P value was 0.065 which is statistically insignificant. As regards the fetal heart rate, P-value was 0.062 which is statistically insignificant. As regards Umbilical artery PI, P-value was 0.149 which is statistically insignificant. Regarding umbilical artery S/D, P-value was 0.284 which is statistically insignificant. As regards MCA PI, P-value was <0.001 which is statistically significant. Regarding MCA S/D, P-value was 0.562 which is statistically insignificant. Also results found that, the P-value for cerebroplacental ratio was <0.001 which is statistically significant. The mean E/A values, TVIs and TVI x FHR values after 3 hrs and after 48 hrs were unchanged from the baseline values.Conclusion: Nifedipine maintenance tocolysis is associated with significant changes in maternal vital parameters, utero-placental blood-flow resistance and results in fetal redistribution. Fetal cardiac diastolic function is unaffected and the significant redistribution is likely to be attributable to altered cerebral blood flow.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • CORRELATION OF INFERIOR VENA CAVA COLLAPSIBILITY INDEX WITH LUNG
           ULTRASOUND AND STROKE VOLUME ...

    • Abstract: Background: Differentiating fluid responders from non-responders is the primary goal when assessing critical care hypotensive patients for fluid responsiveness.Objectives: To assess the fluid responsiveness in critical care hypotensive patients using inferior vena cave (IVC) collapsibility index and correlating its effectiveness with lung ultrasound (US) and stroke volume variation (SVV) induced by passive leg raising (PLR) in prediction of fluid responsiveness.Patients and Methods: After approval of scientific and ethical committees, One hundred critical care hypotrnsive patients who were admitted to the ICU of El-Hussein University Hospital from November 2018 to March 2021 were included in the study. The following were done: echocardiography on admission, routine hemodynamic monitoring, lung US for assessment for extra volume lung water (EVLW), assessment of IVC variability, assessment of SVV induced by passive leg raising. Patients were classified into fluid responders and non-responders based on SVV. Responders were patients with SVV ≥ 12%.Results: Caval index for assessment of fluid responsiveness is strongly correlated with lung US for assessment of EVLW and SVV with highest sensitivity and specificity in mechanically ventilated patients on muscle relaxant, and lower sensitivity and specificity in spontaneously breathing patients.Conclusion: Caval index can be used to predict fluid responsiveness, but with different values depending on mechanical ventilation status and use of muscle relaxation.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • ROLE OF SONOHYSTEROGRAPHY IN INFERTILITY

    • Abstract: Background: Infertility is estimated to affect between 8-12% of reproductive aged couples worldwide, and is caused by a combination of factors in both parents to prevent conception from occurring. The tubal and uterine factors of infertility are responsible for the main percentage of female infertility, and hence evaluation of tubal patency and intact uterus represent a key step and basic investigation in the assessment of infertile women.Objective: To observe the role of saline infusion sonohysetrography (SIS) to find out endometrial pathology and tubal patency in infertility woman.Patients and Methods: The present study was carried out at Radio-Diagnosis Department of Farafra Hospital during the period between January 2021 and March 2021 on 30 patients in reproductive age who presented with inability to conceive, 16 cases (53.3%) were of primary infertility, while 14 cases (46.7%) were of secondary infertility. All patients underwent the transvaginal scanning to evaluate any potential pathological condition without injection of saline. All patients underwent transvaginal scanning with injection of saline transcervically into uterine cavity.Results: There were 16 (53.3%) as a primary group, and 14 (46.7%) as a secondary group. The mean age 27.23 and SD 4.20 years, and 8(26.7%) with age < 25 and 22(73.3%) with age > 25. There was a statistically significant difference between the two groups regarding age, and non-significant regarding endometrial hyperplasia, submucus fibroid, endometrial polyp, ovarian cyst/mass, hydrpsalphnix, synechiea, congenital, bilateral patencytube, bilateral block tube and unlateral block tube.Conclusion: Saline infusion sonohysetrography can be used as a simple, noninvasive, cost-effective and useful tool in the work up of infertility patient, with better compliance and better results, with no radiation exposure to patients in evaluation of female infertility.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • CORRELATION BETWEEN ULTRASOUND PARAMETERS AND RECURRENT PREGNANCY LOSS IN
           FIRST TRIMESTER

    • Abstract: Background: First trimester recurrent pregnancy loss is three or more consecutive miscarriage which can be due to genetic, anatomical, endocrinological, immunological, microbiological and environmental factors.Objective: To evaluate the correlation between each of the ultrasound parameters that  assessed in the first trimester(the gestational sac size, yolk sac size, crown rump length  and fetal cardiac activity ) to early pregnancy loss.Patients and Methods: This was a prospective study of 100 (1 hundred) pregnant women in their first trimester that were carried out in the outpatient clinic and Emergency Department – Obstetrics and Gynecology Department – Al-Sayed Galal Hospital and Basyoun  Hospital during the period from 1st April 2020 till 1st October 2020.They classified into two equal groups:Group I: Pregnant women with history of first trimester recurrent pregnancy loss as cases.Group II: Pregnant women with history of normal obstetric history as controls. Transvaginal ultrasound scan was used to assess mean gestational sac diameter, yolk sac, crown-rump length and fetal heart rate.Results: The gestational sac diameter grew 6.65 mm per week in ongoing pregnancy group, and it was smaller in the pregnancy loss group. However, the difference was not significant until 8 weeks of pregnancy when the median diameter of the gestational sac was 15 mm in pregnancy losses, and 31 mm in ongoing pregnancy (p < 0.001). The yolk sac grew 0.38 mm per week in ongoing pregnancy group with p wave <0.001 at 10th week.     In pregnancy loss group, the yolk sac was either smaller or larger than in ongoing pregnancy group. The crown-rump length grew 7.54 mm per week, and was significantly larger in the ongoing pregnancy than in the pregnancy loss group from 6th -10th week with p value <0.001. The embryonic heart rate less than 100 b/m was associated with higher risk of pregnancy loss.Conclusion: The diagnosis of miscarriage was made in the presence of fetal pole 10 mm with no fetal heart activity, or the gestational sac diameter was 25 mm but no fetal pole could be demonstrated. In cases of an empty gestational sac 25 mm in diameter, a repeated scan was carried out 1-2 weeks later.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • PREVALENCE AND EVALUATION OF CARDIAC COMPLICATIONS AMONG PATIENTS WITH
           SUBSTANCE ABUSE IN AL ...

    • Abstract: Background: Substance abuse refers to excessive use of a drug in a way that is detrimental to self, society, or both. Substance abuse and its health outcomes has become a major public health issue in Egypt in recent years.Objective: To determine the prevalence of electrocardiographic and echocardiographic abnormalities among substance abusers who have low cardiovascular risk profile and evaluate the relation between these abnormalities and substance abuse.Patients and Methods: This case–control study was conducted at Al-Hussein University Hospital from January 2018 to May 2020. It included 500 males and females cases aged between 18 and 45 years. They were divided into 2 major groups: Group I contained 250 substance abusers with duration of abuse ≥ one year and Group II contained 250 non abusers as controls. All members of both groups had low cardiovascular risk profile. The only major risk factor for heart disease presented in this study was smoking cigarette and its effect was ameliorated by matching with the control group. All cases were subjected to a full history taking, comprehensive clinical examination and laboratory investigations to exclude cases with major risk factors for heart diseases. Cardiac condition was evaluated in all cases using standard 12-lead electrocardiogram and the results were interpreted. Further evaluation using echocardiography examination were done for all patients with abnormal ECG findings in addition to 42 cases selected randomly from control group for statistical purposes, and divided into 2 sub-groups. Sub-group I included 54 patients who had abnormal ECG findings in group I, Sub-group II included 54 cases (12 patients who had abnormal ECG findings + 42 cases selected randomly) from group II.Results: There was significantly higher prevalence of ECG and echocardiographic abnormalities among substance abusers (p < 0.05) in comparison to non-abusers. The most common abnormality detected in substance abusers was QT interval prolongation (6.4%), while the most common echocardiographic abnormality detected was diastolic dysfunction (25.9%). All of abused substances detected in our study (cannabis, tramadol, heroin, alcohol and strox), except benzodiazepines, had significant relation with the abnormal ECG findings. Further analysis for factors related to abnormal ECG findings showed that the increase in duration of abuse, tramadol abuse and heroin abuse were significantly associated with the odds of abnormal ECG findings.Conclusion: ECG and Echocardiographic abnormalities have significant prevalence among substance abusers, especially those with multiple substance abuses, despite of their low cardiovascular risk profile. Long duration of abuse, heroin abuse and tramadol abuse were considered risk factors for abnormal ECG findings.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • COMPARATIVE STUDY BETWEEN BILATERAL SUPRAZYGOMATIC MAXILLARY NERVE BLOCKS
           VERSUS PALATINE ...

    • Abstract: Background: Cleft palate is one of the most common craniofacial malformations which requires early surgical intervention to allow proper feeding and phonation.  Anesthesia for cleft palate surgery in infant and children carries a higher risk with general anesthesia and airway complications. Administration of opioids, often needed for intra- and postoperative analgesia, increases the risk of airway obstruction and ventilator control dysfunction.Objective: To compare the effectiveness of bilateral suprazygomatic maxillary nerve blocks (SMB) versus bilateral blocks of greater palatine, lesser palatine and nasopalatine nerves on the postoperative opioids consumption and time to first need of analgesia.Patients and methods: Three hundred and fifty child older than one year and less than five years who were scheduled for cleft palate surgery, and divided into 2 equal groups: maxillary group received standardized general anesthesia, then bilateral SMB using 0.25% bupivacaine 0.15 ml/kg with maximum dose 3mg/kg, and palatine group received standardized general anesthesia, then greater palatine, lesser palatine, and nasopalatine nerves had been blocked bilaterally using 0.5 ml bupivacaine 0.25% at each point with a total volume of 2.5 ml bupivacaine 0.25%. Postoperative rescue analgesia was administered after patient evaluation and pain assessment in the form of 100 µg/kg of nalbuphine. The two groups were compared as regard time to first analgesia given to the patient and total amount of postoperative nalbuphine consumption over the postoperative 24 hours. Also, they were compared for pain score, hemodynamic changes, block related complications, and parents’ satisfaction. This study was done at Al-Azhar University Hospitals after approval of the medical ethical committee, from March 2019 till May 2021.Results: Maxillary group has less analgesic consumption with no statistically significant difference. However, the time to first rescue analgesia was significantly more in the maxillary group patients.Conclusion: SMB prolonged the duration of post-operative analgesia and decreased rescue analgesic consumption with no statistically significant difference compared to palatal block with no increases in adverse effects.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • PLATELET LEUKOCYTE AGGREGATES AS A PRO-THROMBOTIC RISK FACTOR IN PATIENTS
           WITH INFLAMMATORY ...

    • Abstract: Background: Patients with inflammatory bowel disease (IBD) are at an increased risk for venous thromboembolism (VTE). VTE events carry significant morbidity and mortality, and have been associated with worse outcomes in patients with IBD. Studies have suggested that the hypercoagulable nature of the disease stems from a complex interplay of systems that include the coagulation cascade, endothelium, immune system, and platelets. Additionally, clinical factors that increase the likelihood of a VTE event among IBD patients include pregnancy, active disease, more extensive disease, hospitalization, and IBD-related surgeries.Objective: To assess the platelet-leukocyte aggregation in patients with IBD and its relation to disease activity.Patients and Methods: This was a prospective cohort study conducted on 40 IBD Patients and 20 control cases who were admitted to Al-Hussein University Hospital, and some selected from outpatient clinic, during the period from 15th of April, 2020 to 31st of March, 2021. All participants underwent to clinical examination, laboratory findings, colonoscopy, histopathology and flowcytometric findings were recorded from patients.Results: There was a statistical significant difference (p-value < 0.001) between studied groups as regard hemoglobin level, white blood cells and platelets count. Statistical significant difference (p-value < 0.05) was found between studied groups as regard erythrocytic sedimentation rate and statistical significant difference (p-value < 0.001) between studied groups as regard C reactive protein and Fecal calprotectin. Also, there was a statistical significant difference (p-value < 0.001) between studied groups as regard ulcer, ileitis and edematous mucosa. Statistical significant difference (p-value < 0.001) was found between studied groups as regard platelet leukocyte aggregates.Conclusion: In patients with active inflammatory bowel disease (IBD), there was a significant high level of platelet leukocyte aggregates (PLAs), which might be explanation phenomena of increased risk for thrombosis.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • FETAL TRANSCEREBELLAR DIAMETER COMPARED TO BIPARIETAL DIAMETER FOR PRECISE
           GESTATIONAL AGE ...

    • Abstract: Background: The provision of obstetric and neonatal care and pregnancy outcomes relies upon the precise determination of gestational age. Many patients in our setup due to socio-economic reasons come for their first antenatal visits in third trimester. There is a crucial requisite for programmatically feasible and accurate approaches of gestational age dating in low and middle income countries. Trans cerebellar diameter (TCD) has evolved as a promising indicator for assessing fetal growth and gestational age.Objective: This study aimed to compare between the accuracy of fetal transcerebellar diameter and biparietal diameter in gestational age measurement in the third trimester of pregnancy.Patient and methods: This study comprised 200 pregnant women at third trimester who were chosen from the outpatient clinics at El-Sayed Galal Hospital of Al-Azhar University during the period of research from May 2020 to December 2020. They all had singleton uncomplicated pregnancy at third trimester pregnancy between 28th week of gestation and term (gestational age (GA) evaluation was based on menstrual history (LMP) and early ultrasonographic assessment before 15 weeks of gestation). Additionally, they had sure date of last normal menstrual period (LNMP) and they all had viable fetus in the longitudinal lie, cephalic presentation.Results: The overall accuracy of estimated gestational age based on various fetal biometric parameters within three days from that calculated via last menstrual period (LMP) was: the highest accuracy was reported in GA-TCD in 55.5 % of cases followed by GA- femur length (FL) & GA- head circumference (HC) that were accurate in 42.5% of cases then GA- abdominal circumference (AC) was accurate in 32 %, and the least was GA- Biparietal diameter (BPD) was accurate in 31.5%. While when detecting accuracy within one week, the highest accuracy was reported in GA-TCD in 83 % of cases followed by GA-FL that was accurate in 76% of cases then GA-HC was accurate in 71.5% GA-BPD was accurate in 65.5%, and the least was GA-AC that was accurate in 57 %, and of cases.Conclusion: It is concluded that TCD had shown better correlation and predictive accuracy of gestational age determination in third trimester of pregnancy then femur length they were superior to biparietal diameter and with the femur length, TCD can be utilized as a tool to aid in the assessment of gestational age in third trimester. As this is essential particularly notably in our country as many of our patients attend the hospitals with lacking medical record or prior antenatal care visits especially in low socioeconomic rural areas, not recalling their LMP.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • RETROSPECTIVE STUDY OF TUBERCULOSIS PATTERN IN KAFER EL-SHEIKH CHEST
           HOSPITAL IN THE PERIOD ...

    • Abstract: Background: Tuberculosis, is an infectious mycobacterial disease either by inhalation, or direct contact with Tuberculosis bacilli. With 10.4 million persons, tuberculosis (TB) is a global public health concern. Significant factor in the decline of Tuberculosis is early diagnosis of the disease, efficient chemotherapy and prevention of disease transmission.Objective: To study the pattern of tuberculosis in Kafer El-Sheikh Chest Hospital.Patients and methods: This retrospectively study conducted on the result of patient diagnosed as a tuberculosis cases at Kafer El-Sheikh Chest Hospital during the period from January 2008 to January 2018. One thousand and two hundred and sixty patients were included in this study, and diagnosed according to National Egyptian TB control Programme (NTP) and guidelines of the Egyptian Ministry of Health. The total number of TB cases was 1260: 1034 cases of them (82%) were pulmonary, while 226 cases (18%) were extra pulmonary.Results: the total numbers of TB cases were (1260), 1034 cases of them (82%) were pulmonary, while 226 cases (18%) were extra pulmonary. The total number recorded of T.B cases was 1260, the largest number of them was recorded in 2013(166) cases (13.2%), and the least number was recorded in 2009 (68) cases (5.4 %). In the current study 745 out of 1260 were males (59%),while 515 were females (41%). The mean age of TB cases was 39 years. There was no statistically significant difference as regards age between patients with pulmonary and patients with extra pulmonary TB. The total number of mortality was 41 cases, where the majority of them were recorded in 2010 (7.6%), and in 2013 was 0.6%.Conclusion: TB affects the most productive age groups, and this necessitated more attention in TB control programs targeting those age groups. TB incidence was higher in males especially in pulmonary TB.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • ROLE OF PLATELET MASS INDEX IN PREDICTION OF SEVERITY OF TRANSIENT
           TACHYPNEA OF THE NEWBORN

    • Abstract: Background: Transient tachypnea of the newborn (TTN) is a benign, self-limited condition that can present in full‐term or late preterm infants. TTN is caused by delay in clearance of fetal lung fluid after birth.Objective: To evaluate the role of platelet mass index (PMI) in predicting the severity of transient tachypnea of newborn (TTN).Patient and methods: This was a case control study followed by follow up of cases till remission of TTN. It was carried out on 100 term and near-term neonates with TTN. Platelet mass index (PMI) test was done by CBC which included platelet count, as well as platelets indices such as mean platelets (MPV) in neonatal intensive care unit at Damietta, Al-Azhar University Hospital. PMI was calculated using the following formula: PMI = platelet count x mean platelet volume /103 (fl/nl).Results: Decreased platelet count and PMI were significantly associated with TTN when compared to control group. Increased duration of oxygen therapy was significantly associated with decreasing platelet count and PMI.  MPV did not differ significantly between cases and controls as well as according to duration of oxygen therapy. Platelet count and PMI showed significant increase after remission. PMI showed significant positive correlations with platelet count, and significant negative correlations with duration of oxygen therapy. No significant correlations were found regarding of PMI with other parameters among studied TTN cases.Conclusion: Lower PMI and platelet count were associated with longer duration of oxygen therapy in patient with TTN, which could be used in prediction of severity of TTN.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • MANAGEMENT OF BURST ABDOMEN AND ABDOMINAL WALL RECONSTRUCTION (Review
           Article)

    • Abstract: Background: In many surgical instances (e.g. emergencies), the use of the open abdomen technique becomes an ideal approach to save patient’s life. There are many complications that follow the open abdomen technique in which abdominal wall dehiscence and/or complete burst abdomen is the most serious of them all being dependent on many factors related to patient, surgical technique, materials used, and surgeon’s skills. Objective: To provide the latest advanced information about the causes, prevention of burst abdomen and variable modalities to treat this grave postoperative complications. Data Sources: In this review some of the most popular materials and methods used by surgeons all over the world to treat such serious complication were outlined. Many studies were done comparing 2 or more methods either in techniques of abdominal wall closure or in materials used for this purpose. Conclusion: One of the best methods in closing the abdominal wall wound after operations was the mass closure technique as it carried the lower rate of post-operative complications especially wound dehiscence.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • FOLLICULAR FLUID CONCENTRATION OF VASCULAR ENDOTHELIAL GROWTH FACTOR,
           INHIBIN A AND INHIBIN B ...

    • Abstract: Background: Vascular endothelial growth factor (VEGF) is a protein produced by many different tissues. In the ovary. VEGF is produced both by granulosa and theca cells. The granulosa cells increase production of VEGF in response to FSH, LH-hCG, as well as hypoxia. VEGF concentrations of FF at the time of oocyte retrieval for in vitro fertilization (IVF) are significantly higher in older women.Objective: To measure concentrations of vascular endothelial growth factor (VEGF), inhibin A and inhibin B in follicular fluid (FF) of women undergoing to in-vitro fertilization (IVF) cycles, and to determine their relationship with ovarian response and pregnancy.Patients and methods: This was a prospective randomized comparative study that was carried out at Al-Azhaar University Hospitals from January 2020 till October 2020. The study was conducted at Gynecology outpatient clinic of Al-Hussein Hospital of Al-Azahar University over 58 women were divided into two groups, based on reproductive outcome: Group (A): Women who became pregnant after embryo transfer, and Group (B): Non-pregnant women.Results: Among the studied cases, according to pregnancy, there were 28(48.3%) pregnant, 30(51.7%) non-pregnant, according to single or multiple. There were 18(64.3%) single and 10(35.7%) twins. Among total cases, the fertilized rate was 299/527 (56.7%). According to quality; there were 243/299 (81.3%) grade 1, 56/299 (18.7%) grade 2, the number of embryos transferred were115/299 (38.5%). Among group A, the fertilized rate was 185/307 (60.3%), according to quality; there were 160/185 (86.5%) grade 1, 25/185 (13.5%) grade 2, and the number of embryos transferred were 64/185 (34.6%). Among group B, the fertilized rate was 114/220 (51.8%), according to quality; there were 83/114 (72.8%) grade 1, 31/114 (27.2%) grade 2, and the number of embryos transferred were 51/114 (44.7%). There was a statistically significant difference between studied cases as regard serum VEFG, FF VEGF, serum inhibin A, FF inhibin A, serum inhibin B and FF inhibin B.Conclusion: Lower concentrations of serum and FF VEGF, higher concentrations of FF inhibin A and B may serve as a reliable predictive marker for pregnancy, in women undergoing IVF. All of these parameters allowed the recognition of cycles predetermined to fail, and this information may contribute to the criteria for cryopreservation of embryos to be used in future transfers.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • COMPARATIVE STUDY BETWEEN TRANSABDOMINAL AND TRANSVAGINAL SONOGRAPHY IN
           THE ASSESSMENT OF LOWER ...

    • Abstract: Background: Sonography has proven to be a useful modality to determine abnormalities related to the lower uterine segment (LUS) (such as placenta previa or weak previous cesarean section scar).Objective: To compare the accuracy of transvaginal ultrasound versus transabdominal ultrasound in assessment the lower uterine cesarean scar thickness at term, and compare them with actual intraoperative LUS thickness.Patients and methods: This prospective observational study included one hundred forty seven pregnant women who have history of previous scar. All cases were selected from Obstetrics and Gynecology Department at Al-HusseinHospital, Al-AzharUniversity, during the period from January 2021 to July 2021.Result: LUS thickness detected by TAS (transabdominal sonography) was significantly higher than LUS thickness detected by TVS (transvaginal sonography). LUS thickness detected by TAS was significantly higher than LUS thickness detected intraoperatively, and LUS thickness detected by TVS was significantly higher than LUS thickness detected intraoperatively.Conclusion: The LUS scar thickness measurement was most accurate with TVS in comparison with TAS. Ultrasonography evaluation permited better assessment of the risk of intrapartum complications for patients attempting VBAC (vaginal birth after cesarean section), and could allow for safer management of delivery.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • A PROSPECTIVE OPEN CONTROLLED STUDY ON NON-SEGMENTAL VITILIGO PATIENTS
           FOCUSING ON THE ...

    • Abstract: Background: Vitiligo is an acquired idiopathic skin disease that appears as skin white depigmented patches due to loss of melanocyte cells that are responsible for melanin pigment production which gives color to the skin, hairs, retina and mucous membranes.Objective: To assess the metabolic changes (namely cholesterol) in blood and tissues of patients suffering from non-segmental vitiligo.Patients and Methods: Our study was carried out during the period from September 2020 to March 2021. Patients were selected from the outpatient skin clinic at Al-HusseinHospital, Al-AzharUniversity, Cairo. A total number of 30 patients suffering from non-segmental vitiligo were included in addition to 30 normal persons of the same age group and both sexes, not having any skin disease, not suffering from any systemic morbid disease (diabetes mellitus, dyslipidemia, liver disease, kidney disease or hypertension) or taking any systemic medication for any other disease were introduced in the study as a control group.     A Punch skin biopsy was taken from the vitiliginous patches and another one from the adjacent apparently normal skin of the patients. The specimens were stained with special stains for cholesterol (Sudan III) stain.Results: The results of this study disclosed elevated levels of cholesterol in the blood samples of about 21 patients (70%) among the total number of patients, compared to 9 patients (30%) who showed normal blood cholesterol values.     Tissue biopsy specimens from the vitiliginous patches of the patients, stained with Sudan III stain, disclosed the presence of cholesterol in the dermis in 22 patients (73.3 %), while the rest of the specimens of 8 patients (26.7 %) showed no cholesterol deposition.     Tissue biopsy specimens from the apparently normal skin of the patients did not show any lipids in the dermis of these samples.Conclusion: Increased blood cholesterol levels in addition to the presence of cholesterol (as a secondary metabolic product) deposited in the skin tissue samples of vitiliginous patches could be related to nerve fibers which were undergoing a degenerative process. These nerve fibers were innervating the melanocyte cells in the skin.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EFFECT OF MAGNESIUM SULFATE ON DOPPLER INDICES OF UTERINE, UMBILICAL AND
           FETAL MIDDLE CEREBRAL ...

    • Abstract: Background: Preterm labor is one of the commonest clinical events where traditional pregnancy can turn into a high risk situation for the mother as well as the fetus. Magnesium sulfate (MgSO4), which is a calcium antagonist, has been used for over 30 years as short-term treatment (less than 48 h) for acute preterm labor. It acts by inhibiting voltage independent calcium channels in the myometrial cell surface. Extracellular magnesium suppresses calcium influx across cell membranes, whereas intracellular magnesium competes with calcium, there by inhibiting myosin light-chain kinase activity.Objective: To assess the effect of Mgso4 as a tocolytic agent on Doppler parameters of fetal middle cerebral, umbilical and uterine arteries in women with threatened preterm labor.Patients and methods: A prospective observational study was conducted in Al Shohadaa Central Hospital in the period between September 2018 and September 2020. A total of 300 women with threatened preterm labor were included in the study. The study group underwent a Doppler ultrasound study to evaluate the flow velocity parameters resistibility index (RI), pulsatility index (PI) and systolic/ diastolic ratio (S/D) of fetal middle cerebral artery (MCA), umbilical artery (UA) and uterine artery (UtA) using the abdominal probe of the ultrasound device. Then immediately they were given an intravenous infusion of 4- 6 gm of magnesium sulphate as a loading dose then 1 gm / hour as Mgso4 maintenance dose. The same Doppler Ultrasound parameters were recorded again after 24 hours Mgso4 tocolysis to evaluate the effect of magnesium sulphate administration.Results: There was a no statistically significant reduction in RI, PI, SD ratio of the UA before 32 weeks gestation while a statistically significant reduction in these parameters after 32 weeks gestation following magnesium sulphate infusion. Regarding MCA Doppler parameters in our study, there was a statistically significant reduction in RI, PI, SD ratio after magnesium sulphate infusion. Regarding UtA Doppler parameters in our study, there was no statistically significant differences were found in uterine artery RI and S/D ratio following magnesium sulphate infusion, whereas uterine artery PI showed statistically significant reduction after magnesium sulphate infusion.Conclusion: Although the use of Mgso4 as a tocolytic agent is controversial but it is valuable as neuroprotective agent and for treatment of eclamptic seizures. Its effect on the fetal blood flow has a very beneficial role till now. In this study it was found that it has significant effect on fetal MCA, UA and UtA Doppler parameters (RI, PI and S/D ratio). More studies with larger cohorts are needed to support these results.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EVALUATION OF THE IMPACT OF HLA-G 14BP POLYMORPHISM ON THE SUSCEPTIBILITY
           OF HEPATITIS C VIRUS ...

    • Abstract: Background: Viral hepatitis was estimated to be the 7th leading cause of mortality globally. About half of this mortality is attributed to hepatitis C virus (HCV). Egypt is the most affected nation by HCV. Human Leucocytic Antigen-G (HLA-G) has an immunosupressor function. Many polymorphisms of HLA-G were reported. Most of those polymorphisms increase HLA-G expression, which increase the susceptibility to HCV infection.Objective: To evaluate the HLA-G 14bp deletion polymorphism on the susceptibility to hepatitis C virus infection.Patients and methods: The study was carried out on 90 subjects (30 females and 60 males) at Al Hussein University Hospital. Their age ranged from 27 to 70 years. They were classified into two groups: Group 1 (control group) included 30 normal healthy subjects (10 females and 20 males), aged 28-68 years and Group 2 (patient group) included 60 patients with HCV infection (20 females and 40 males), aged 27-70 years. All subjects of both groups were tested for detection of HLA-G 14bp deletion polymorphism.Results: The HLA-G 14bp polymorphism was detected in 3 subjects of the control group (10%), while it was detected in 33 patients (54.9%) of the patient group. This revealed a significant increase of HLA-G 14bp deletion (P <0.05) in patient group compared to control group. Conclusion: The HLA-G 14bp deletion polymorphism increased the susceptibility for HCV infection.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • OPTICAL COHERENCE TOMOGRAPHY PROGNOSTIC CRITERIA FOR INTRAVITREAL
           INJECTION OF ANTIVEGF IN ...

    • Abstract: Background: Diabetic macular edema (DME) is the most common cause of visual impairment in diabetic patients. Disruption of both components of blood retinal barrier (BRB) leads to increased accumulation of fluid within the intraretinal layers of the macula. Optical coherence tomography (OCT) enables obtaining the high resolution cross-sectional images (tomograms) of the human retina in a noninvasive manner. It can detect the response of the patient to different modalities of treatment upon some factors will be discussed in that issue.Objective: Assessment of different patient’s response to different modalities of treatment in patients with diabetic macular edema using the OCT. Patients and methods: In this study, we tested 50 eyes of 35 patients with diabetic macular edema. They were evaluated using the spectral domain OCT before intravitreal injection of antiVEGF and after 1 and 6 months from 1st injection.Results: The 50 eyes with diabetic macular edema were 22(44%) males and 28(56%) females. The age of patients ranged from 48 to 66 years with a mean of 56.48±4.98, 6(12%) of them had diabetes type one and 44(88%) had diabetes type two. Twelve (24%) were treated by insulin, 9(18%) by tablets, and 29(58%) used both insulin and tablets. As regards other co-morbidities, 12(24%) had hypertension, 6(12%) had nephropathy, and 8(16%) had ischemic heart diseases.     The fifty eyes were 21(42%) right, and 29(58%) left. Eleven (22%) of patients had intraretinal cyst, 11(22%) of patients had subfoveal neuroretina detachment, external limiting membrane (ELM) was disrupted in 10(20%), and inner segment/outer segment (IS/OS) was disrupted in 18(36%).     There was a statistically significant difference between the mean of Logarithim of the Minimum Angle of Resolution best corrected visual acuity (log MAR BCVA) (0.71±0.32) and the central subfoveal thickness mean (470.70±99.14) pre injection, and 1-month post injection log MAR BCVA mean (0.48±0.23), and the central subfoveal thickness mean (386.72±85.92) (𝑃 < 0.001). BCVA and the central subfoveal thickness continued to improve progressively until the end of the 6-month follow-up period where they were 0.42 ± 0.29 and 384.64 ± 97.69 respectively and that was statistically significant (𝑃 < 0.001).Conclusion: OCT characteristics of different DME patterns at baseline can predict morphological features and timing of DME recurrence. OCT characteristics at follow-up can be used in prognosis of DME.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • PRESCENCE OF GASTRIC PEPSINOGEN IN THE MIDDLE EAR FLUID OF PATIENTS WITH
           OTITIS MEDIA WITH EFFUSION

    • Abstract: Background: Gastroesophageal reflux (GERD), in particular extra-esophageal reflux, has been associated with a variety of upper aerodigestive tract symptoms or diseases such as sinusitis and otitis. Many studies showed the role of reflux in chronic otitis media with effusion in children.Objective: To investigate the relationship between gastro-esophageal reflux diseases (GERD) and otitis media with effusion (OME) by evaluation of the presence of gastric pepsinogen in middle ear fluid of patients with OME.Patients and methods: Prospective study was conducted on 24 patients. Those patients suffered from recurrent otitis media with effusion, undergoing bilateral myringotomy with ventilation tube insertion and middle ear effusions, as well as blood samples were collected. All cases were subjected to history taking and ENT examination. Total pepsinogen concentrations of effusions and serum samples were measured with an enzyme-linked immuno sorbent assay (ELISA) using Human Pepsinogen I ELISA Kit (CUSABIO, USA).Results: The mean age of the included cases were 32.7 years. Patients were 25 females (62.5%) and 15 males (37.5%). The mean value of GERD score was 11.18 (range, 10 – 12). The four tympanogram types did not differ in age and gender. All the cases with type B and C tympanometry in the right ear was with GERD score of 11 and 12.Conclusion: GERD is considered as one of the contributing factors in the etiopathogenesis of middle ear effusion.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EVALUATION OF THE EFFECT OF ARGON LASER IN TREATMENT OF RESISTANT
           INFECTIVE CORNEAL ULCER

    • Abstract: Background: Resistant infective corneal ulcer is an ocular emergency which needs an early and aggressive management to avoid its serious complications. Despite the availability of a wide range of newer antimicrobials, new diagnostic techniques and recent treatment modalities, infective keratitis continues to pose a diagnostic and therapeutic challenge.Objective: To evaluate the effectiveness and safety of the use of the argon laser in treatment of cases with resistant infective corneal ulcers.Patients and methods: Thirty patients with different forms of resistant infected corneal ulcers included in this study attended the cornea unit in the Ophthalmology Department at Al-Azhar University Hospitals. The cases were treated with argon laser, during the period from May 2019 to August 2020. We followed up the cases to detect the response to the argon laser until complete healing was achieved. Each case was followed up for 3 months to detect any relapse or recurrence.Results: We found that 86.6 % of cases healed without relapse (56.6 % of cases healed after about 2 weeks from laser therapy, 13.3 % healed after about 3 weeks, and 16.6 % healed after about 4 weeks), while 13.3 % of cases healed with relapse. Amniotic membrane grafting was needed in 13.3 % of cases.Conclusion: Argon laser, in most of cases, led to complete healing with small corneal opacity.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • COMPARATIVE STUDY BETWEEN MEASUREMENT OF SUBGLOTTIC TRANSVERSE TRACHEAL
           DIAMETER BY ...

    • Abstract: Background: Choosing the correct endotracheal tube (ETT) size is important in pediatrics patients as an inappropriately large sized tube may cause damage to the airway and subglottic stenosis. On the other hand, a smaller tube will increase the resistance to gas flow, risk of aspiration, insufficient ventilation, and the need to re-intubate with a different size of tracheal tube.Objective: To compare the accuracy of measurement of subglottic transverse tracheal diameter using ultrasonography and aged based formula for prediction of uncuffed endotracheal tube size in children aged 2-12 years submitted to general anesthesia.Patients and Methods: After approval of scientific and ethical committees, 88 children aged 2- 12 years submitted to general anesthesias in Al-Azhar University Hospitals were enrolled in this study from May 2019 to May 2021. Children were allocated in two groups: Group I where subglottic transvers tracheal diameter, outer diameter of ETT, inner diameter of ETT, inspiratory tidal volume, expiratory tidal volume, leak volume and leak % were measured and calculated after induction of general anesthesia and Group II where inner diameter of uncuffed ETT was calculated according to cole formula (0.25 (age in years) + 4.Results: Ultrasonography (USG) was more accurate in prediction of uncuffed ETT size with sensitivity 86.4%, while the sensitivity of the age based formula was 68.2%.Conclusion: The sensitivity of ultrasonography in prediction of ETT size was superior to age based formula Ultrasonography was more sensitive in yonger children than in older children.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • CHEST ULTRASOUND VERSUS CHEST COMPUTED TOMOGRAPHY FOR ASSESSMENT OF
           UNDIAGNOSED PLEURAL ...

    • Abstract: Background: The definitive diagnosis of pleural malignancy depends upon histological confirmation by pleural biopsy.Objective: To compare chest U/S and chest CT findings of undiagnosed pleural effusion before medical thoracoscopy to examine the concordance and discordance between them.Patients and Methods: This study was conducted on 30 patients admitted at the Department of Chest Diseases, Al-HusseinUniversityHospital during the period between January 2021 and June 2021.Results:Chest CT was superior to chest ultrasound in the detection of pulmonary nodules, mediastinal lymphadenopathy and mediastinal shift. However, CT findings missed by U/S did not affect the procedure conductance, technique or outcome. Chest U/S was superior to CT chest in the detection of multiloculations, septations, diaphragmatic pleural nodules and visceral pleural nodules. These findings, detected by ultrasound, were consistent with the operative findings. The most common complications of medical thoracoscopy in the study were subcutaneous emphysema in 16.7%, failure of full lung expansion in 10 %, and intractable cough in 3.3% of patients.Conclusion: Sonography overcame the shortcomings of CT, as it used no ionizing radiation, being portable and could be performed while the patient was in the supine, sitting and lateral decubitus positions. U/S has the capacity to clarify the nature of pleural effusions and underlying abnormalities.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EVALUATION OF THE RESULTS OF DIFFERENT MODALITIES OF TREATMENT OF
           INTRACRANIAL ANEURYSMS

    • Abstract: Background: Intracranial aneurysm is a common medical problem affecting people of both sexes. Diagnosis of intracranial aneurysm is critical and the management differs according to many factors to be either surgical clipping or endovascular coiling.Objective: To evaluate the effectiveness, advantages and risks of different modalities of treatment of different types of intracranial aneurysms.Patients and methods: The study has been conducted on patients presented with intracranial aneurysms in Al-AzharUniversity hospitals and Damanhur Medical National Institute, from July 2019 to June 2021. In this study, there were 48 patients with intracranial aneurysms either ruptured or not: 26 patients have been treated with endovascular coiling, and 22 patients had surgical clipping. All patients in the study have been subjected to complete history and clinical examination. Radiological investigations were done using either Computed Tomography (CT) of the brain, CT Angiography or digital subtracting angiography.Results: The mean admission period for endovascular coiling was 4.5 days, while for clipping was 6.27 days, and 46.2% of endovascular cases had intraoperative complications compared to 50% of clipping cases. The rates of post-operative complications were 42.3% and 45.5% for endovascular coiling and clipping respectively. Complete occlusion was achieved in 76.9% of endovascular cases, and 86.4% of clipping cases. 88.5% of endovascular cases had favorable clinical outcome compared to 90.9% of clipping cases.Conclusion: Surgical clipping has a better occlusion rate, lower rate of recurrence and re-bleeding. It has the advantage of lower direct and total cost of the intervention. Endovascular coiling has a shorter period of hospital stay and fewer symptoms during follow up period. Both techniques were similar regarding the rate of perioperative complications and clinical outcome.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EVALUATION OF THE CAUSE OF CARDIOVASCULAR SYNCOPE IN FEMALES VERSUS
           MALESIN A SAMPLE OF YOUNG ...

    • Abstract: Background: Vasovagal syncope (VVS) occurs in > 40% of individuals at least once in their lifetime. Sex-dependent differences in presentation and outcomes are not understood.Objective: To study the cause of syncope in young Egyptian Population with inconclusive holter monitoring results.Patients and Methods: The present study enrolled 60 patients with unexplained syncope presenting at Cardiology Department, Alexandria Main, UniversityHospital, either as outpatients or during hospitalization. We excluded patients with cardiac or neurologic syncope. All patients were subjected to thorough history taking with special emphasis on important features, physical examination (blood pressure, pulse and complete cardiac examination), standard 12 lead emergency electrocardiography (ECG) for evidence of abnormalities suggestive of arrhythmic syncope, calculations of OESIL (Osservatorio Epidemiologico sulla Sincope nel Lazio) risk score (ORS), conventional transthoracic echocardiography for confirmation of exclusion of definitive structural heart diseases, Holter 24 hours for exclude any arrhythmic syncope, and Head-up tilt- table testing.Results: There was a statistically significant difference between the 2 studied groups regarding true syncope (p-value 0.001), frequency of attacks (p-value 0.001), prodromal symptoms (p-value 0.001), duration (p-value 0.006), resting pulse (p-value 0.013), and resting systolic pressure (p-value 0.001). There was no difference regarding recovery (P value = 1), resting diastolic pressure (p-value 0.317) and mean age(Value =0.264).There were statistically significant differences between the 2 studied groups regarding the negative results of head up tilt testing (HUT) test (p-value 0.001), drug free phase (p-value 0.002), pharmacological provocation(p-value 0.001), and the vasodepressor response III (p-value 0.038). The mixed response I was not statistically significant between the 2 groups (p-value 0.754) as well as the cardio inhibition response with IIb or without IIa a systole ( p-value 0.612).Conclusion: Female patients were experiencing syncopal episodes for longer periods of their lives, and more episodes of syncope than male patients
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • EVALUATION OF SLUG IMMUNOHISTOCHEMICAL EXPRESSION IN ENDOMETRIAL CARCINOMA

    • Abstract: Background: SLUG, which is included in the group of zinc finger type proteins, is regarded as major epithelial-mesenchymal transition (EMT) inducers to inhibit the transcription of cell adhesion molecules, including E-cadherin. Some signaling pathways, such as the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway, upregulate the expression of SLUG, Slug antisense could prevent EMT indicating that the Slug gene could act a treatment target for tumor invasion and metastasis.Objective: To studied SLUG immunohistochemical stain expression among Type I (endometrioid) endometrial carcinoma and Type II (serous) endometrial carcinoma.Patients and methods: Thirty paraffin-embedded endometrial tissue samples were diagnosed as 24 endometrioid endometrial carcinoma (Type I), and 6 serous endometrial carcinoma (Type II) were collected. All endometrial tissue samples of endometrial carcinoma were obtained through hysterectomy. The specimens were collected from archive of surgical pathology files of Pathology Department, Faculty of Medicine, Al-AzharUniversity, during the period from 2018 till December, 2020.Results: There was a statistically significant correlation between SLUG expression and grade of endometrial carcinoma (P value<0.001). No case of endometrial carcinoma showed complete absence of SLUG expression. All of the cases (10 cases) of high-grade endometrial carcinoma (4 cases type I and 6 cases type II), showed expression of SLUG in varying degrees of expression, and (5 cases) 50% showed expression of SLUG in more than 50% tumor cells (strong expression), 2 cases 8.3% of type I (EECA) and three cases 50% of type II (serous endometrial ca.). There was no statistically significant correlation between SLUG expression and the age of cases (P value = 0.206). There was no statistically significant correlation between SLUG expression and the types of the endometrial carcinomas (P value 0.002).Conclusion: SLUG immunohistochemical stain expression was very significantly correlated to the grade and stage of endometrial carcinoma. The correlation between expression of SLUG and high tumor grade, stage are suggesting that SLUG may serve as a prognostic indicator in esophageal carcinoma (EC).
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • SINGLE-INCISION MINI SLING COMPARED WITH TRANSOBTURATOR SLING FOR TREATING
           STRESS URINARY ...

    • Abstract: Background: Stress urinary incontinence (SUI) is a common disorder that affects a large number of women and their quality of life. It is defined as the involuntary leakage of urine on effort or exertion, or on sneezing or coughing according to the standardized terminology of the International Continence Society.Objective: The aim of this study was to compare both the efficacy and safety of the single-incision mini- sling (SIMS) against the traditional trans-obturator (TOT) sling for the surgical management of SUI in women including; objective and subjective cure rates, patient’s satisfaction, and complication rates.Patients and methods: This study was a prospective, double-blind clinical trial conducted on 100 women complaining of symptoms of stress urinary incontinence, with or without urge incontinence, based on patient complaint, cough stress test and ICIQ-SF score. Attended the outpatient clinic of the Obstetrics and Gynecology Department of Al- Hussein hospital, Al-AzharUniversity, Cairo, during from March 2016 to March 2019.Results: Regarding the cough stress test after one year follow up, the number of participants who reported negative results showed continuous progress in group (B) [42 women (89%)] after 38 (79.2%) in 6th month visit. On the other hand, group (A) women showed a little drop [44 women (91.7%)] after 46 (93.9%) in 6th month visit. Yet, the two groups showed insignificant difference at this follow up stage (P= 0.74).Conclusion: The 1-year follow-up results of this prospective trial indicate that both procedures appear to be equally effective for the treatment of SUI as regard the objective cure rates, whereas the SIMS procedure showed higher subjective cure rates than the TOT procedure.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • Evaluation of Cerebral Arteriovenous Malformations (AVMs): Postoperative
           Endovascular ...

    • Abstract: Background: Arteriovenous malformation (AVMs) is a collection of dysplsatic plexiform vessels that is supplied by one or more arterial feeders and drained by one or more venous channels. AVMs may have a pure plexiform nidus or contain a mixed plexiform fistulous nidus. Objective: To evaluate cerebral AVMs postoperative endovascular embolization by intervention, clinical and radiological outcome  in a sample of Egyptian patients. Patients and Methods: This was a  retrospective  study of all consecutive patients who had underwent endovascular embolization for cerebral AVMs between December 2006 up to April 2021.One hundred sixty-nine (169) patients (91 female and 78 males) with cerebral arteriovenous malformations were treated by embolization at the Neurointervention Unit at Al-Hussein Hospital University Results: The mean age in our study was 32.85 years with a range of 6-80 years, and the standard deviation was 14.875 years . The sex distribution showed slight higher incidence in females (53.8%) than in males (46.2%), and twenty eight patients (16.6%) were with family history of cerebral AVMs. The most common presnetation was intracranial hemorrhage (prsented as weakness), seizure came second, and headache came third Other neurological deficits (focal deficits , learning disability  and cognitive impairment) were due to AVM itself. were significant difference in nidus diameter, and the Spetzler and Martin grading of the cerebral AVMs after embolization in comparison to before embolization. Conclusion: The endovascular treatment of the cerebral AVMs was safe, efficient and achieved high rates of total and near total occlusion.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • Possible Protective Effects of Avocado Pear (Persea Americana) Ethanolic
           Extract on the Ovarian ...

    • Abstract: ABSTRACT Background: Histological and physiological studies have increased in evaluating the effects of electromagnetic fields on human health. Several studies focused on investigated the effect of low frequency EMF on follicle development, and ovulation process in ovary. Objective: To study the structural and functional changes in the ovaries of adult female albino rats post- exposure to cellular phone and the possible protective effect of avocado extract. Material and Methods: The present study was carried out on 50 healthy adult female albino rats. divided into 5 main groups: 1) Group I: Control rats left without treatment, 2) Group II: Control rats receive the avocado extract, 3) Group III: Rats exposed to frequency equals 950 MHz of electromagnetic field for one month,4) Group IV: Exposed to EMF and  treated orally with a daily dose of the avocado extract in same day , 5) Group V: Rats left for spontaneous recovery for one month after exposure to EMF. The animals were sacrificed and the ovaries were dissected. The dissected tissues were processed. Using Hematoxylin and Eosin, and Masson's trichromestain. Immunohistochemical stains were used to detect two proteins: Nuclear Factor Kappa B (NF-κB) and Proliferating Cell Nuclear Antigen (PCNA). Results: There was an increase in tunica albugenia (TA) thickness, Blood vessels congestion and collagen deposition in EMF exposed group. Besides, there was an increase in NF-κB expression in Group III. Avocado reversed the structural and functional changes in ovary. In Group V.There was a reduction but did not reach to the Group I as shown in avocado treatment. Conclusions: EMF affected negatively on ovary.Avocado as antioxidant, protected the ovary from structural and functional changes resulting from exposure to EMF
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • ROLE OF ROUTINE COMPREHENSIVE SYSTEMATICPELVIC LYMPHADENECTOMY IN THE
           MANAGEMENT OF ENDOMETRIAL ...

    • Abstract: Background: Endometrial cancer is the fifth most common cancer among women worldwide. Systematic lymphadenectomy of pelvic lymph nodes (LN) and para-aortic are often part of surgical staging. This procedure is not done universally. The therapeutic effects of lymphadenectomy are issues of great debate.Complications of lymphadenectomy including lymphadenoma and lymphatic cysts can affect patients’ quality of life. Objective: To evaluate the use of systematic pelvic lymphadenectomy in the management of endometrial cancer. Patients and Methods:  A descriptive retrospective cohort study was conducted in multi-centric three national cancer institutes (Tripoli, Misurata, and Sabratha) located at Western -Northern Libya, from January 2020 toMay2022. A total number of 180 diagnosedendometrial cancer cases were enrolled in the study.In all cases routine systematic pelvic lymphadenectomy was conducted. Theprimary outcome measure was the rate of lymph node metastases in relation to tumor (size, depth of endometrial invasion, grade, histopathological findings, and lymph-vascular space invasion) and patients’ characteristics (age, parity, co-morbidities including obesity). Results: There was no significant association between lymph nodemetastasis and patients’ characteristics.Patients were divided into two groups: below sixty years old and above sixty,menstrual status into perimenopausal, and postmenstrual,parity, nullipara, and multipara, obesity body mass index (BMI) below 25 and above 25, and presence or absence of comorbidities. There were significant associations with all tumor factors except tumor size.Stage Irepresented nearly 60% of sample (59.44%), stage II 18.9%, stage III 18.3%, and stage IV (3.3%). Low risk patients (FIGO stage I, grade 1-2) had 6.52% lymph node, intermediaterisk (FIGO stage II, any grade) had 17.65% lymph node invasion, and high risk (FIGOIII, and FIGO IV 84.8%, and 100% respectively. (The overall incidence of lymph node metastasis in clinically uterine-confined endometrial cancer was proportionally increasing with the increase in gradings. (About9% in grade 1, 19% in grade 2, and 76% in grade 3).Lymph node metastasis occurred in 11% of cases with less than 50% myometrial invasion,compared with about 38% of patients with more than 50% myometrial invasion.Histopathologicallymore invasion occurred with poorly differentiatedtumors(64%), and the least occurred with endometrioid carcinoma (23%). Lymph-vascular space invasion significantly affected lymph node metastasis, it occurred in 15.2% of low risk group (FIGO stage I) was highest (100%) in high risk group (FIGO stage IV). Conclusion:Use of more precise and less aggressive methods may be useful to predict tumor aggressiveness and lymph node metastasis. Such methods include preoperatively theuse ofmolecular markers, computerized tomogram scan(CT), magnetic resonance images (MRI), ultrasound scanning, and the intra-operatively use of sentinel lymph nodes mapping during surgical procedures. These investigations should be considered to assess ovarian, nodal, peritoneal, and other sites of metastatic disease.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
  • IMPORTANCE OF USING FACIAL NERVE STIMULATOR DURING PAROTID SURGERY

    • Abstract: Background: Parotid gland surgery is a difficult procedure because of the unique pathology of the parotid gland and the intimate relationship with the facial nerve. A devastating complication of a parotidectomy can be postoperative facial paralysis. Proper safe surgical technique is paramount for facial nerve preservation. Objective: To describe the goals and benefits of facial nerve monitoring during parotid surgery. Patient and Methods: This prospective study was conducted on 20 patients of both sexes with count age determination, who attached to the out-patient E.N.T clinic at Bab El Sha’ria (Sayed Galal) Hospital from October of 2019 to January of 2021. All the patients with the complaint of parotid swelling and the study compromised the patients who were submitted to superficial parotidectomy after completing all the clinical examinations and investigations. Results: Mean age of all studied patients was 42.90 ± 17.68 years, with a minimum age of 13 years and maximum age of 75 years. There were 6 males (30%) and 14 females (70%) in the considered patients. Superficial parotidectomy was done in all 20 patients. Histopathological types were pleomorphic adenoma in 14 cases (70%), Warthin's tumor in 5 cases (25%) and chronic nonspecific inflammatory cells in 1 case (5%). Postoperative complication was in 1 case (5%) as facial nerve affection. Conclusion: Facial nerve monitoring during parotid surgery is an adjunctive method to assist the functional preservation of the facial nerve.
      PubDate: Sun, 31 Jul 2022 22:00:00 +010
       
 
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