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Aswan University Medical Journal
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2735-3117 - ISSN (Online) 2735-3109
Published by Aswan University Homepage  [1 journal]
  • Reproducibility and Diagnostic Value of Elastography in Evaluation of
           Breast Masses

    • Abstract: Background; SWE is highly reproducible for assessing elastographic features of breast masses within and across observers. SWE interpretation is at least as consistent as that of BI-RADS ultrasound B-mode features. Aim and objectives; was to assess the role of elastography in diagnosis and differentiation of breast masses. Subjects and methods; this was a Cross sectional study, was carried on all patients admitted to Radiology department, ultrasound unit at Aswan university hospitals, from March 2019 till September 2020. Result; There was a significant difference between the benign and malignant groups in regard to the side and size of the breast masses, while no significant difference was recorded regarding other ultrasonic characteristics as site, surface, surroundings, calcification, and LN. In addition, there was significant difference between the two groups as regard Elastography score (strain ratio). Conclusion; The qualitative and quantitative SWE provided good diagnostic performance in evaluating of malignant and benign masses. The maximum elasticity of the quantitative SWE parameters had the best diagnostic performance._____________________________________________________________________Keywords; Shear wave elastography, Breast, Reproducibility, Diagnostic performance, Solid masses, Ultrasound
       
  • N-Terminal pro-brain natriuretic peptide as a diagnostic and prognostic
           marker in patients with heart failure

    • Abstract: Background: Heart failure is a common medical condition with a poor prognosis. Echocardiography is the gold standard for diagnosis, but it is not always available, especially in emergency situations. NT-pro-brain natriuretic peptide (NT-proBNP) is a novel marker for the diagnosis of heart failure that is being used to detect and predict presence of heart failure. Objective: The purpose of this study was to investigate the diagnostic and prognostic role of NT-proBNP in patients with congestive heart failure and correlate its levels with the clinical manifestations and echocardiographic findings. Patients and methods: This study was performed on 100 heart failure patients who were divided in two groups and subjected to history taking, medical examination, echocardiography and other related laboratory investigations (S.urea, creatinine, ALT, AST, GGT, Alkaline phosphatase). Results: There was a significant proportional relationship between NT-proBNP versus age and inverse versus ejection fraction. ROC curve analysis showed the ability of NT-proBNP to identify patients with HF Also, comparison between different Predictors of developing heart failure, showed that NT-proBNP and Ejection fraction are the most significant. Conclusion: Measurement of NT-proBNP can be used as a useful biochemical marker for detection of heart failure and is superior to other natriuretic peptides.
       
  • Applied Effectiveness of Platelet Rich Plasma on Second-degree Facial Burn
           Healing in Comparison to Conventional facial burn care

    • Abstract: Background: The standard treatment of burn has slow healing time and bad outcomes and applying external blood platelet on the burn wound had shown to accelerate the healing process and prevent the infection.Objective: To evaluate clinical usefulness and wound healing progress after applying Platelet Rich Plasma on second degree facial burn patients. Patients and Methods: we included patients with second degree recent facial burn, not exceeding 20 % of TBSA. Patients were randomly allocated to receive topical PRP application (Group A), PRP intradermal injection (Group B), and conventional facial burn care (Control group).Results: We recruited 60 patients aged ranged from 19 to 37 years. the time needed for complete healing for group A, B and control group were 8.7, 7 and 11 days, respectively. Group A and B showed the best satisfaction rate (90% and 80% respectively). Group A showed less rate of early complications while group B showed the less rate of late complicationsConclusion: Platelet rich plasma either topical or intradermal injection is safe and effective option for wound healing process on second degree facial burn patients.Keywords: Platelet-rich plasma, second degree burn, facial burn, wound healing.
       
  • Serum selenium level among critically ill child in Aswan university
           hospital .

    • Abstract: Background:Selenium plays important role in the protection against lipid peroxidation, mediating inflammatory response. This study aimed to assess the effects of changes in plasma selenium on critically ill children Material and Methods: A cross-sectional study was conducted on 40 critically ill children admitted to the pediatric intensive care unit in Aswan university hospital. All children were subjected to full history taking, clinical examination, and laboratory investigations: (CBC, CRP, Blood culture, and plasma selenium, estimated on 5 days after admission.Results: median age were 27 months, 55 % of cases were males. 15 % had a history of pre-natal complication, 17.5% had a history of post-natal complication and 20% were developmentally delayed. 30 % of cases had respiratory disorders, 20% had gastrointestinal disorders, and 15% had neurological disorders. 15 % of cases positive for Streptococcus pneumoniae, 5% positive for Staph aureus, 2.5 % positive for E. Coli and, 2.5 % positive for Pseudomonas Aeruginosa. 30 % had pneumonic patches in chest X-ray. Median of selenium level was 0.52 μmol/L with range between 0.13 and 1.50. low selenium level was more among children with post-natal complication, p value =0.031Conclusion: low plasma selenium among critical ill children admitted to intensive care unit.
       
  • AIMS 65 score versus Glasgow Blatchford score to predict outcomes of upper
           GI bleeding in Aswan university hospital

    • Abstract: Background: Upper gastrointestinal bleeding (UGIB) is common cause of emergency GI admission. UGIB could accompany with adverse events if not treated timely. Different scoring systems have been suggested for diagnosing these patients, Aim and objectives; to compare the predictive value of the AIMS65 with the Glasgow Blatchford Scale (GBS) score for UGIB patients, Subjects and methods; A cross sectional study, carried out on patients presented with UGIB in Aswan University Hospital, from July 2020 to December 2020. Seventy-three patients were enrolled. Result: Mean age was 43.45 years. Majority (69.6%) of patients was males. Forty-seven (64.4%) patients presented with melena. It was found that AIMS65 and GBS score were significantly higher among patients admitted to intensive care unit (ICU) and died. AIMS65 had 60% sensitivity and 64.15% specificity for prediction of ICU’s and 55.56% sensitivity and 59.38% specificity for prediction of mortality while GBS had 55% sensitivity and 90.57% specificity for prediction of ICU’s and 77.78% sensitivity and 93.75% specificity for prediction of mortality Conclusion; GBS was superior to AIMS65 score in prediction of ICU admission and mortality.
       
  • Imaging of peri-anal sepsis

    • Abstract: Background: Anal fistula is one of the most frequently reported anorectal disorders that has a propensity to recur, particularly in complex cases usually because of un-detected sepsis at operation time. The aim of our review was to assess the diagnostic validity of pelvic MRI with MR Fistulogram in the diagnosis, assessment and classification of Peri-anal fistula.Main text: A broad literature review has been done, searching the electronic databases including Google Scholar and PubMed using keywords like perianal fistula, MRI, and anorectal sepsis, in addition to the standard text-books of colorectal diseases.Contrast X-rays, CT scans, anal endo-sonography, and MRI are the methods utilized for pre-operative scanning of fistula in ano(1). Because of its low accuracy, X-ray fistulo-graphy seldomly utilized for imaging of peri-anal fistula(2). CT fistula-graphy may be more precise in patients presented with acute inflammation, abscess or the fistulae connected with inflammatory bowel diseases(3).Anal endo-sonography and MR-imaging are commonly utilized and dependable imaging methods for fistula in ano(2). The usage of 3D technologies has upgraded the precision of anal endo-sonography. MR-Imaging is now considered the favorite option(4). But, several researches have showed similar accuracies for both MR-Imaging and anal endo-sonography with similar sensitivity. However, with more MRI specificity(5).Conclusion: MRI is extremely effective in preoperative classification of Peri-anal fistulae, thus enabling selection of correct surgical procedure and preventing recurrence.
       
  • The role of serum and placental vascular cell adhesion molecule-1 levels
           in placenta accreta

    • Abstract: Background: Vascular cell adhesion molecule-1 (VCAM-1) is one of the cell adhesion molecules which is expressed in endothelial cells. In pregnancy, VCAM-1 is involved in placentation by promotion of angiogenesis and trophoblastic invasion. Placenta accreta (PA) is a term that refers to abnormal adherence of the placenta to the uterine myometrium. The incidence of PA rises as the number of elective cesarean sections and pregnancies with placenta previa increases.Objectives: This study discusses the role of VCAM-1 in normal pregnancy, the pathogenesis of PA, and its predictive value for PA occurrence.Methods: Our longitudinal study included 62 pregnant women. Then they were divided into Group N: 31 pregnant women with normal placenta and Group P: 31 pregnant women with placenta accreta.Result: Serum VCAM-1 levels were higher in case of PA than those of normal pregnancy and it had a significant predictive value for PA with markedly high sensitivity and specificity.Conclusion: Detection of a high serum level of VCAM-1 in the 2nd trimester can predict the occurrence of PA in healthy women. Moreover, placental VCAM-1 may be implicated in the pathogenesis of PA through enhancing trophoblastic invasion.
       
  • Role of Radiofrequency in Management of Chronic Low Back Pain

    • Abstract: Background: Chronic low back pain (LBP) affects about 45% of the population, it is treated conservatively, and if failed, we use invasive methods, as radiofrequency neurotomy (RF).Objective: to evaluate the efficacy, safety, and outcome of RF in patients with chronic LBP. Patients and Methods: This prospective study included patients with chronic LBP lasting ≥3 months. We performed RF to the included participant, moreover, we assessed the chronic LBP by visual analogue score, the improvement of the daily activities, and the safety immediately after the procedure, after one week, after one month and after three months. Results: We included 40 patients with chronic LBP not responding to medical treatment. The average age was 58.28 ±7.2, 13 of them were male. The L4-L5-S1 levels were the most affected (67.5%). The pain score reduced from 8 before the operation to 3 after three months follow up p-value < 0.001. Regarding to Daily living activities, after 3 months the number of patients with normal daily activities was 50 %, and the number of supported patients still only 3 patients p-value < 0.001. Conclusion: RF showed promising results in the management of chronic LBP, it has advantages regarding the long term follow up.
       
  • Serum fetuin-A as a perdictive biomarker of chronic kidney disease

    • Abstract: Background: Chronic kidney disease (CKD) is a worldwide public health problem. Fetuin A is a natural calcium antagonist. Both human and animal studies have shown that low circulating fetuin A level are associated with vascular calcification and may be an independent risk factor for premature death in CKD patients. Objective: The aim of this study was to evaluate the effect of serum fetuin-A in the pathogenesis of chronic kidney disease and its correlation with routine renal biomarkers.Patients and methods: The study population was divided into 3 groups. Group I: Pre-dialysis group: on conservative treatment. Group II (CKD): on regular hemodialysis, 3 sessions/week for more than 9 months. Group III (Control group).Results: There was significant negative correlation between blood urea, serum creatinine versus serum fetuin-A in conservative group with arterial stiffness. There was significant positive correlation between eGFR and serum fetuin-A in conservative group with arterial stiffness, while there was no significant correlation between serum fetuin-A and Hb, HcT, platelets, WBCS, FBS, Na+, K+, PO4-2, serum uric acid, total bilirubin, ALT, AST, ALP, serum albumin and prothrombin time. There was significant negative correlation between serum Ca+2 and serum fetuin-A. There was significant negative correlation between total cholesterol as well as triglycerides versus serum fetuin A.Conclusion: serum fetuin-A level significantly reduced in hemodialysis patients, significantly correlated with the disease duration, and negatively correlated with serum Ca, T. cholesterol, and T.G.
       
  • EFFECT OF HELMET WEARING ON MOTORCYCLE AND BICYCLE ACCIDENTS (PROSPECTIVE
           STUDY)

    • Abstract: AbstractBackground: Helmet use is one of the most crucial factors that influence the degree of severity of injuries in motorcyclists and pedal cyclists. Purpose: This study aims to determine incidence of Road Traffic Injuries (RTIs) among a sample of motorcyclists and pedal cyclists and giving insight on the negligence of helmet use as a predisposing factor for disagreeable injuries.Patients and Methods: This study is descriptive one, the participants were motorcyclists and pedal cyclists involved in RTIs in two governorates of Upper Egypt, Aswan and Sohag were admitted to the emergency department in university hospitals from 1st of January, 2020 to 1st of January, 2021. Demographic information and types of injuries were recorded.Results: In this study there were 66 victims of motorcycles and 15 victims of pedal cycles involved, all of them were males (100.0%), mostly in the age group (26-35 years). only half of motor cyclists (50.0%) used helmet whereas no one of pedal cyclists used it.Conclusion and recommendations: The present study showed that negligence of helmet use represents risk for traffic safety and there is a need for interventional programs to reduce the burden of motorcycle fatalities.
       
  • Role of High-resolution Ultrasound Examination in Assessment of Early
           Undiagnosed Hand Pain

    • Abstract: ABSTRACTBackground: Ultrasound (US) is a non-invasive method that enables differentiation between different causes of hand and wrist pain and evaluation of several joints during early disease and in mild symptoms. Aim: To assess the role of High-Resolution Musculoskeletal Ultrasound (MSUS) in diagnosis of early undiagnosed hand and wrist pain and their causes. Patients and Methods: A cross sectional study involved 100 patients with non-traumatic painful wrist. Appropriate clinical history and relevant laboratory findings (RA factor, ESR, CRP, anti CCP) were recorded. Musculoskeletal ultrasound (MSUS) of wrists and hands was performed. Results We found that synovitis was found in 69 (69%) patients, erosions in 28 (28%) patients, double contour sign in 6 (6%) patients, osteophytes in 33 (33%) patients, synovial hypertrophy in 5 (5%) patients, subcutaneous fat thickness was found in 2 (2%) patients at wrist dorsal view only, extensor tenosynovitis in 70 (70%) patients and flexor tenosynovitis 36 (36%) patients. Conclusion: Ultrasound is considered an effective tool for diagnosis of early undiagnosed hand and wrist pain and evaluation of several pathologic conditions of the hand and wrist.
       
  • Different modalities of fixation of Acromio-Clavicular joint dislocation:
           joint stability outcome

    • Abstract: Background: Severe acromioclavicular (AC) joint injuries Rockwood types III, IV, V and VI always need surgical management. Achievement of postoperative AC joint stability is a mandatory for satisfactory shoulder joint functional outcome. Aim of the work: The aim of this study was to evaluate for how long the AC joint is stable with different surgical methods.Patients and methods: twenty patients were conducted in this cohort prospective study with AC joint dislocation. Rockwood types III, IV, V and VI treated surgically by 3 different techniques Group 1 by mersilene tape with AC k wires, Group 2 by percutaneous AC joint screw and Group 3 by tension band wire. All Surgeries were performed at Orthopedic Department of Aswan University Hospital between May 2019 and August 2021and follow up time between 6 to 15 months. Patients age ranged from 20 to 57 (mean; 34.95±11.57) years, 17 male and 3 female. Constant score of the shoulder joint was used for final functional outcome. Results: AC joint was stable with the different techniques. Constant score of the shoulder joint showed no significant difference between the 3 groups; however the mersilene tape was the best. Operative time was highest with Group 1. Bleeding time is the least with Group 2.Conclusion: AC joint stability was achieved with using either mersilene tape, percutaneous AC joint screw, or tension band with no significant difference, however after 6 months of follow up mersilene tape achieve the highest stability.
       
  • Management of Open Tibial Diaphyseal Fractures Utilizing Ilizarov External
           Fixator

    • Abstract: Background: open fractures of the tibia are serious injuries that could be associated with catastrophic complications. Management of these fractures is challenging for orthopedic Surgeons to achieve optimum soft tissue coverage, stability, and functional outcome. Purpose: Our study aims to assess the results of using IEF as a definitive method of fixation of these types of fractures. Material and method: cohort study of 30 patients with open diaphyseal tibial fracture treated at the orthopedic department, Aswan University hospital in the period between (March 2019 to May 2021). Patients aged Between 14 and 70 years of age. Closed fractures, Bedridden or neglected patients complaining of Osteoporotic bone were excluded. We performed delayed primary wound closure in all the patients.Results: The patients' median age was 32.7 years (18-50Y).The bone repair took an average of 4.3 months. Of an average 12-month follow-up. 122 minutes were spent operating on average (SD = 16.9). 90% of the patients experienced bone union which is comparable with the average (73.7-100%) of the data from the literatures. patients' average period with the IEF was 4.43± 1.47 months, with a range of 3 to 8 months, which is consistently a better outcome than those often reported in the literatures. Conclusion: using an IEF as an adjunctive method for the fixation of open diaphyseal fractures has many advantages, including being a minimally invasive maneuver, bloodless operation, minimal post-operative pain, stable fixation with fewer risks of neurological and vascular injury than other maneuvers with a skilled hand and early rehabilitation.
       
  • Validity of Various Severity Scoring System in the Surgical Intensive Care
           Unit

    • Abstract: Severity scoring systems are the most important adjuncts of treatment used in the intensive care unit to predict outcome, characterize disease severity and degree of organ dysfunction, and assess resource use. Even though disease severity scores are not the key elements of treatment, however, they are an essential part of improvement in clinical decisions and in identifying patients with unexpected outcomes. In fact, they have become a necessary tool to describe ICU populations and to explain differences in mortality. However, it is also important to note that the choice of the severity score scale, index, or model should accurately match the event, setting or application; as mis-application, of such systems can lead to wastage of time, increased cost, unwarranted extrapolations and poor science. Importantly, the different types of scores should be seen as complementary, rather than competitive and mutually exclusive, proper application of severity scores helps in decision making at the right time and in decreasing hospital cost. This review article provides a brief overview of intensive care unit severity scoring systems along with the prediction of death or survival rate calculations, although the article focused on acute physiology and chronic health evaluation (APCHE), simplified acute physiology score(SAPS) and sequential organ failure assessment (SOFA).
       
  • Validity of Various Severity Scoring System in the Surgical Intensive Care
           Unit

    • Abstract: Severity scoring systems are the most important adjuncts of treatment used in the intensive care unit to predict outcome, characterize disease severity, degree of organ dysfunction, and assess resource use. Even though disease severity scores are not the key elements of treatment, however, they are an essential part of improvement in clinical decisions and in identifying patients with unexpected outcomes. In fact, they have become a necessary tool to describe ICU populations and to explain differences in mortality. However, it is also important to note that the choice of the severity score scale, index, or model should accurately match the event, setting or application of such systems can lead to wastage of time, increased cost and poor science. Importantly, the different types of scores should be seen as complementary, rather than competitive and mutually exclusive, proper application of severity scores helps in decision making at the right time and in decreasing hospital cost. This review article provides a brief overview of intensive care unit severity scoring systems along with the prediction of death or survival rate calculations, although the article focused on Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS) and Sequential Organ Failure Assessment (SOFA).
       
  • Hepatic disorders associated with covid 19

    • Abstract: Background; By the end of December 2019, a single- stranded ribonucleic acid (RNA) virus, Coronavirus, was said to be responsible for an outbreak of respiratory infections of unknown origin in Wuhan . Some studies revealed that patients who were affected with this virus had hepatic affection in form of raised transaminases.Aim and objectives; to study the hepatic disorders in COVID-19 patients in Aswan and its relationship to covid-19 severity and impact on prognosis.Subjects and methods; A cross sectional study, was carried out on patients presented with COVID-19 in Aswan University Hospital, through a period between 2020 to 2022. Up to 152 patients were enrolled. Detailed history and examination was performed to all patients. Laboratory data was done especially liver function test.Result; median age of the patients was 60 years old with range between 54-70 years. Majority of patients were males. Majority of patients were critically ill representing 44% . Up to 61% of the patients (N=92) had hepatic affection. Patients with hepatic affection had higher age, male predominance and severe form of COVID-19 . Also, diabetes mellitus, hypertension, cardiac disease, and asthma were more frequent among those with hepatic affection. Based on the current study, the predictors for hepatic affection in those patients were severe or critical disease.Conclusion; patients with COVID-19 could be liable to hepatic affection especially in case of severe disease .Hepatic affection in those patients may lead to poor outcomes, so future studies with large number of participants are warranted about this point.
       
  • Prevalence of Dry Eye in Type II Diabetic Patients in Upper Egypt

    • Abstract: ABSTRACTBackground: Diabetes mellitus with hyperglycemia is due to impaired insulin secretion or action o both . Dry eye syndrome in diabetes 2 is due to affecting tear film layers and itsstability.Objective: To determine the prevalence of dry eye in type II diabetic patients in Upper Egypt.Methods: In this prospective randomized study included 150 eyes of 75 persons were recruited in the current study, where 100 eyes of 50 diabetic patients were considered as group I (cases), while 50 eyes of 25 non-diabetic persons were considered as group II (control). All patients in the study were undergone comprehensive ophthalmic examination.Results: Among group 1, males 27 (54%) while 23 (46%) were females, meanwhile, among controls, males 15 (60%) and 10 (40%) were females with no statistically significant difference as regards gender between groups. While the age, despite the relatively small difference in mean age, controls were found to be significantly younger than cases (p<0.0001). As regards to severity of dry eye measured by Schiermer's test, there was a statistically significant difference between cases and controls where the p value was 0.021,and severity of dry eye measured by BUT, there was a statistically significant difference between cases and controls where the p value 0.046.Testing the correlation between both tests were strong statistically.Conclusion: The findings of the recent study and similar studies support that diabetic patients have an elevated prevalence of dry eye syndrome than normal individuals.
       
  • Safety and Feasibility of Sutureless Total Thyroidectomy

    • Abstract: Background: Thyroid gland is highly vascular tissue in the body. Total thyroidectomy (TT) is the gold standard for the surgical treatment of many thyroid disorders. There is no change occurred in the technique of total thyroidectomy, but using Harmonic Scalpel, LigaSure, or cutting and hemostasis are new approaches to vessel ligation and division.sutureless thyroidectomy becomes a competitor for the conventional technique. Aim and objectives: to compare the use of the sutureless technique by LigaSure versus Conventional Suture Ligation in thyroid surgery in terms of operative time, drainage volume, complications, and duration of hospital stay. Subjects and methods; This was a Prospective comparative study, on 60 patients divided into 2 groups: (Group 1); patients had sutureless thyroidectomy (S group), (Group 2); patients had conventional thyroidectomy (C group). Result: There was an insignificant difference between both groups as regards Surgical complications. Conclusion: Sutureless thyroidectomy is a safe and efficient way of performing total thyroidectomy. LigaSure was significantly advantageous over conventional techniques in reducing operation time as well as perioperative and postoperative blood loss and parathyroid injury. The reduction of operative times resulted in decreased operating room occupancy costs but the overall cost of surgery was significantly higher in the LigaSure group.
       
  • Outcome of Management of Splenic Injury In Aswan University Hospital

    • Abstract: Background: Spleen is one of the most injured organs among blunt abdominal trauma. spleen injuries were representing 45% of the total blunt abdominal injuries that threaten life. Non-operative management (NOM) proved to be one of the most secure techniques in the management of spleen injuries.Objectives: To evaluate the outcome of operative and non-operative management of blunt abdominal trauma with splenic injury at Aswan University Hospital.Patients and methods: In this prospective non-randomized controlled study, 42 patients with blunt splenic injury were admitted to the emergency unit during the period from December 2020 to December 2021.Result: Our findings revealed that there was a non-significant difference between study groups regarding gender , age, mode of trauma and Total leukocyte count (TLC) (P >/= 0.05). but There was a statistically significant difference between study groups regarding imaging investigations in ultrasound (U/S) and complete blood count in hematocrit and hemoglobin (P <0.05) and CT with a contrast among Grades 1, 2,3, and 4 of spleen injuries, systolic and diastolic blood pressure, and Pulse rate (P < 0.001).Conclusion: For spleen injuries, non-surgical management is the most secure because of fewer complications, preserving spleen functions, and reducing blood transfusion compared to surgical management.
       
  • Development of lipid nanoparticles mRNA vaccine against viral Influenza
           infection

    • Abstract: Background:Influenza is regarded as an over-serious evoke infection present. Infection is typically constricted to the mucosal cells of the respiratory tract. Immunity is abbreviated and reinfection falls out due to the high mutation rate of the influenza virus. The aim of the study: Development of RNA vaccine against Influenza virus by bioinformatics and genetic engineering.Type of Study: Screening experimental study.Methodology:In our study, we designed an RNA vaccine of haemagglutinin (HA) and neuraminidase (NA) of the Influenza virus by bioinformatics and genetic engineering. The particle size of the lipid nanoparticles vaccine delivery system was approximately 100 nm.Results:The vaccine showed 86% efficacy during preclinical trials while 78% during human clinical trials phases 1/2. It showed superior biological activity and fewer side effects than other vaccines such as the Influvac vaccine. The efficacy lasted for 12-14 months. The molecular mass of Haemagglutonin was approximately 66 KDa as determined by a mass spectrometer. As well the molecular mass of neuraminidase was found to be about 70 KDa. The protective neutralizing antibodies were produced against haemagglutinin.Conclusion:The vaccine, in our study, was effective as prophylaxis against viral infection with Influenza and mutant forms of this virus. It needs to be updated periodically to overcome the problem of the high mutation rate of the influenza virus.
       
  • The value of vaginal wash urea and creatinine concentration for diagnosis
           of premature rupture of membranes

    • Abstract: AbstractBackground: Preterm PROM (PPROM), which occurs when the pregnancy is less than 37 weeks ,PROM is referred to as foetal membrane rupture occurring before to the commencement of uterine contractions (PROM).Purpose: This study intends to evaluate the efficacy of vaginal fluid urea and creatinine for the diagnosis of preterm premature rupture of membranes and premature rupture of membranesPatients and Methods: In the current study, 90 pregnant women between completed 28 and completed 40 weeks of gestation were included. They were divided into two equal groups: 45 pregnant women with PPROM or PROM diagnosed by pooling of fluid in the posterior fornix and 45 pregnant women attending the outpatient clinic for routine antenatal care. The posterior vaginal fornix of each group was irrigated with 5ml saline, aspirated, and then tested for urea and creatinine concentrationResults: This study demonstrated a very statistically significant difference between the groups in the vaginal fluid urea and creatinine levels between the diagnosed PPROM and PROM group compared to the control group.Conclusion: Vaginal fluid urea and creatinine testing is a quick, easy, and non-invasive procedure that has higher sensitivity and specificity to provide an accurate diagnosis for PPROM and PROM.
       
  • Attention Functions and Deficits in Children

    • Abstract: Attention is essential for most, if not all, information processing pathway that transforms stimulus input into response output. Attention is comprised of multiple components and is not a unitary construct. Attention disorders are among the most prevalent varieties of childhood disorders and result in adverse long-term outcomes such as antisocial behavior and poor academic performance. Attention Deficit Hyperactive Disorder (ADHD) was the most common cause of attention deficit in children. ADHD may be one of the most common childhood mental health conditions in the world. The cause of most ADHD cases is unknown; however, it is believed to involve interactions between genetic, environmental and psychosocial factors. The purpose of the current review paper was to review the literature about the attention functions and its deficits in children to provide a rational basis for the implementation of appropriate assessment and therapeutic intervention.
       
  • Analgesic Efficacy of Sonar-guided Erector Spinae Plane Block versus
           Thoracic Paravertebral Block after open cholecystectomy: A Double-Blind
           Randomized Trial

    • Abstract: Background and Aims: Erector spinae plane block (ESB) and Paravertebral block (PVB) are formats for post-operative analgesia. This study compares the analgesic effects of both after open cholecystectomy. Methods: fifty patients with ASA physical status I or II and ages 18 - 65 years who had open cholecystectomy surgery were randomly assigned to one of two groups: sonar guided ESB (Group 1, n = 25) or sonar guided PVB (Group 2, n = 25). After induction of general anesthesia all patients received 20 mL 0.5% bupivacaine in each technique of the study. Patients were estimated for post-operative analgesia using Visual analogue scale (VAS) at 0, 2, 4, 6, 12 and 24 h after surgery. Results: Post-operative VAS scores were lower in ESB at 4, 6, 12 and 24 h (P < 0.05). The time for first rescue analgesic requirement was significantly longer in ESB group (416 ± 68 min) than PVB group (371 ± 67 min). Regarding complications there were no significant adverse effects noted in two groups. Conclusion: Sonar-guided ESB reduced post-operative pain scores and prolonged the duration of analgesia compared to PVB after open cholecystectomy
       
  • Hepatic affection associated with COVID-19

    • Abstract: Background; By the end of December 2019, a single- stranded ribonucleic acid (RNA) virus, Coronavirus, was said to be responsible for an outbreak of respiratory infections of unknown origin in Wuhan, China. Some of the reported studies revealed that those patients who were affected with this virus had hepatic affection in form of raised transaminases. Aim and objectives; to study the hepatic disorders in coronavirus-19 (COVID-19) patients in Aswan and its relationship to covid-19 severity and impact on prognosis. Subjects and methods; A cross sectional study, was carried out on patients presented with COVID-19 infection in Aswan University Hospital, through a period between 2020 to 2022. Up to 152 patients were enrolled. Detailed history and examination was performed to all patients. Laboratory data was done in patients especially liver function test. Result; median age of the patients was 60 years old with range between 54-70 years. Majority of those patients were males. Majority of patients were critically ill representing 44% ,while only 31% were mild or moderate. Up to 61% of the patients (N=92) had hepatic affection. Patients with hepatic affection had higher age, male predominance and severe form of COVID-19 disease. Also, diabetes mellitus, hypertension, cardiac disease, asthma and dyspnea were more frequent among those with hepatic affection. Based on the current study, the predictors for hepatic affection in those patients were severe or critical disease. Conclusion; patients with COVID-19 could be liable to hepatic affection especially in case of severe form of the disease. Hepatic affection in those patients may lead to poor outcomes, so future studies with large number of participants are warranted about this point.
       
 
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