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Journal of Recent Advances in Medicine
Number of Followers: 2  Open Access journalISSN (Print) 2636-252X - ISSN (Online) 2636-2538 Published by Al-Azhar University  [6 journals]
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- Sonomammograhy versus MRI diffusion in evaluation of suspicious breast
lesions
Abstract: Background: Breast cancer is the most frequent cancer in women and the second leading cause of death among them. Breast lesions were first categorized as benign or cancerous. Objective: was to highlight the role of noninvasive diagnostic breast modalities including mammography, ultrasound, conventional MRI and MRI diffusion imaging in detection and characterization of suspicious breast lesions. Methodology: It was a hospital based cross sectional study done on total number of 50 female patients presented by breast lump or nipple discharge, some of them were referred from surgical department and others from out-patient clinic to the radiology department at Met Ghamr oncology center, after receiving clearance from the institute's ethical council, the study was carried out for two years, from June 2019 to August 2021. Before being included in the trial, all patients provided informed permission. They were subjected for imaging by digital mammography, ultrasonography and MRI mammography. Results: The study revealed that in the evaluation and description of worrisome breast lesions, MRI mammography plays a leading role over digital mammography and ultrasonography. Conclusion: MRI mammography outperformed digital mammography and ultrasonography regarding of sensitivity, specificity, and diagnostic performance.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Effect of vaginal pH on the efficacy of vaginal misoprostol for induction
of mid trimester abortion
Abstract: Background: Missed abortion occurs when the deceased result of conception remains in the uterus beyond 20 weeks of gestation. Misoprostol, a prostaglandin analogue, is often employed for medical purposes.Objective: The aim of this study is to investigate whether change in the acidity of the vagina affects the pharmacokinetics of the misoprostol and, therefore, its efficacy for mid-trimester abortion inductionMethodology: The study is a prospective study conducted on a cohort of 81 pregnant women (gestational age 14-26 weeks and failed abortion) at the obstetric department of Al-Zahra university hospitals in the interval from August2021 till February 2022 they were followed up for 24 hours.Results: Induction abortion intervals were substantially longer in group with pH ≥ (5) than in group with pH < (5) (22.33± 2.29 hrs. vs. 11.80± 1.63 hrs. p < 0.001). Group pH ≥ (5) showed an increased prevalence of fever and intense abdominal pain compared to group < (5) (p < 0.001 & 0.007 respectively).Conclusion: Misoprostol used vaginally for inducing of mid-trimester abortion is more effective when vaginal acidity is increased as it was more effective in group pH < (5).
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Mean platelet volume and neutrophil to lymphocyte ratio in lupus nephritis
patients
Abstract: Background: Systemic lupus erythematosus (SLE) is an autoimmune illness with uncertain cause that manifests itself clinically and laboratory as organ involvement with remission and return. Lupus nephritis (LN) is an immune complex glomerulonephritis that arises because of SLE in around 50% of patients. The neutrophil lymphocyte ratio (NLR) has been identified as an inflammatory marker. Also Mean platelet volume (MPV) has also been studied in chronic inflammatory disorders, implying that MPV and NLR might be employed as inflammatory indicators in LN.Objective: to investigate the role of mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) as inflammatory markers for occurrence of lupus nephritis.Methodology: This was a case control study conducted in Al-Zahraa University hospital on 60 patients diagnosed as SLE, 30 with lupus nephritis and 30 were controls. All patients were subjected to detailed history taking, physical examination, laboratory investigations for CBC, MPV, NLR, ESR, CRP, Serum creatinine, Serum urea, Serum uric acid, Serum albumin and the GFR was calculated.Results: The mean age of the LN group was 27.4 ± 4.9 and 27.6 ± 4.7 for patients without lupus nephritis. The mean MPV was 10.3 ± 1.2 in cases with LN and 8.1 ± 0.5 in cases without LN. The NLR was 5.9 and ranged between 3.04 and 18.9 in cases with LN while in cases without NL, the mean NLR was 1.6 and ranged between 1.05 and 2.9 indicating that there was high significant difference between the 2 groups regarding MPV and NLR. NLR is positively correlated to platelet lymphocyte ratio (PLR). Both MPV and NLR values fail to correlate with any inflammatory markers in LN patients.Conclusion: MPV and NLR could be used to predict LN but not as inflammatory markers in those patients.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Level of decorin as a small leucin rich proteoglycan in knee
osteoarthritis patients
Abstract: Background: Knee osteoarthritis is a chronic joint illness distinguished by the gradual cartilage loss of extracellular matrix and subsequent disturbance in chondrocyte biology. Decorin is a small leucin-rich proteoglycan that provides physical linkage among both molecules of aggrecan and collagen II fibrils. It is an important structural component of matrix integrity and cartilage biomechanical function. Its level helps to determine OA grading and subsequently management. Objective: to measure the serum decorin levels in knee OA patients and to explore their association with clinical manifestations and disease severity. Methodology: In this case-control study, 50 patients with varying grades of knee OA were compared to 50 age-and sex-matched seemingly healthy people as controls. The serum decorin level in both groups has been measured using the enzyme linked immunosorbent assay (ELISA) technique. Results: There had been a highly statistically significant elevation in serum decorin in the OA patient group, with a median of 52.4 (9.8-66.8)compared to 8.6 (6.6-9.13)in the control group, and there was a significant positive correlation (p < 0.05) between decorin level and Western Ontario and McMaster Universities (WOMAC). Conclusion: Serum decorin has been significantly elevated in the patient group and its level correlates positively with WOMAC
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Cognitive behavioral therapy for management of tinnitus
Abstract: Background: Severe tinnitus causes many, often psychological symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). Tinnitus sufferers may benefit from cognitive behavioural therapy (CBT), which has been shown useful.Objective: to assess whether cognitive behavioural therapy is effective in management of patients suffering from tinnitus.Methodology: It was Randomized controlled clinical trial (RCT) that was conducted in Audio-vestibular units and psychiatric departments at Al-Zahraa university Hospital and Banha Educational Hospital. The study consisted of 60 participants, were divided into 2 groups: Group (1): study group: 30 tinnitus cases receiving CBT over 8 weeks, only 22 patients had complete sessions and the other refused completing sessions because they were not interested. Their mean age was (46.23 ± 13.98). They were 10 males (45.5%) and 12 females were (40.0%). Group (2): waitlist control group: 30 control subjects , their mean age (48.43 ± 13.64). They were 12 male (54.5%) and 18 female 60.0%). Basic audiological evaluation by using Pure tone audiometry(PTA) , tympanometry, speech audiometry and Psychophysical parameters (Tinnitus pitch • tinnitus loudness), Questionnaires (Tinnitus handicap inventory (Arabic version)General health questionnaire (GHQ). Beck depression inventory. PCASEE Quality of life questionnaire ).Results: Study group showed significant improvement of tinnitus related symptoms after intervention when compared to control group evidenced by improvement in GHQ, BDI, PCASEE scores when compared to control group. Otherwise, no significant difference was found regarding THI score between the two groups.Conclusion: Cognitive behavioural therapy (CBT) could be effective in reducing the impact of tinnitus on quality of life evidenced by improvement in PCASEE Quality of life scores. Nevertheless, we are fully aware that the sample size is too small to draw a definitive conclusion out of our study.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Clinical importance of C1q antibodies in systemic lupus patients with and
without nephritis
Abstract: Background: Serological markers for lupus nephritis (LN) have recently been established in Systemic Lupus Erythematosus (SLE) cases with high levels of anti-C1q antibodies (SLE). We investigated serum level ofanti-C1q antibodies in Egyptian female SLE cases less than 25 years to detect if they could serve as a biomarker for nephritis activity.Methodology: This hospital based case control study was conducted on 180 female subjects from Sept 2021 to March 2022. Patients were collected from rheumatology, nephrology and pediatrics departments of Alhusien and Bab Alsharia University hospitals, all female cases underwent follow-up. Their ages were less than 25 years old. They were divided into three groups. Group 1 included 60 female cases of SLE and active lupus nephritis. Group 2 included 60 female cases of SLE without active lupus nephritis. Group 3included 60age matched apparently healthy females as a control group.Results: There was significant elevation in ESR and anti C1q in group 1 more than other two groups with decrease in C3,4. In group 1 Anti-C1q was significantly correlated with 24 h Protein, C3&4 and SLEDAI Score. In group 2 Anti C1q was significantly correlated with C3 only. ESR, C3, C4, Anti-C1q, ANA Titer and Anti dsDNA were considerable sensitive as positive markers for lupus nephritis in SLE cases.Conclusion: Proteinuria, complement levels, and renal SLEDAI all correlate with renal disease activity and flare-ups, as do anti-Clq auto antibodies. Anti-C1q antibodies, instead of other validated disease activity markers, may be utilized to diagnose nephritis flare in pediatric and adolescent Egyptian females with SLE.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Cerebroplacental doppler ratio in prediction of adverse perinatal outcome
in term normal pregnancy
Abstract: Background: The cerebroplacental ratio (CPR) may be able to detect fetus that do not develops fully at term and predict poor pregnancy outcomes. In third-trimester studies of high-risk pregnancies, low CRP due to increased umbilical artery (UA) or fetus middle cerebral artery pulsatility index (MCA-PI) has been linked to poor pregnancy outcomes. .Objective: To assess the predictive utility of doppler CPR for screening of full-term (37 week - 40 week) normal un-complicated pregnancies with a bad outcome.Methodology: This observational hospital based cross sectional study was conducted on 500 women normal uncomplicated full-term pregnancy (37- 40 weeks), giving birth at Al-Zahraa university hospital and Elsinbelaween general hospital from June 2021 to June 2022. All women were subjected to measurement of abdominal ultrasound, femur length (FL), abdominal circumference (AC), gestational age, complete, cardiotocography (CTG) to assess fetal, and umbilical and placental doppler for middle cerebral artery (MCA) and umbilical artery (UA).Results: MCA systolic / diastolic (S/D) ratio was inversely correlated with pCO2, while UA-S/D ratio was positively correlated with pCO2 and negatively correlated with all other parameters except neonatal death and neonatal intensive care unit admission.Conclusion: In full-term normal pregnancy, the CPR is an excellent predictor of unfavorable perinatal outcome
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Intervention effect on breastfeeding knowledge, attitude and practice
barriers and COVID-19 ...
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Effects of preservative-free and preservative prostaglandin analogs on
ocular surface by ...
Abstract: Background: Glaucoma represents a significant health problem and is an important cause of blindness worldwide. In order to delay the onset of advanced irreversible optic nerve injury and visual field abnormalities, topical medication treatment is typically used as first-line therapy.Objectives: To compare the effects of preservative-free and preservative-containing prostaglandin analogs on ocular surface by using impression cytology (IC) in newly diagnosed primary open angle glaucoma (POAG) patients.Methodology: A prospective randomized controlled clinical trial was done on 60 eyes of 30 patients with POAG and randomly divided into group A (n = 30) received preservative- free prostaglandin analogs and group B (n = 30) received preservative-containing prostaglandin analogs.Results: Clinical assessment of ocular surface features showed a significant difference between two study groups after 3 months of treatment. Schirmer test, tear film break up time (TBUT) and Fluorescein corneal staining (P<0.001). IC was significantly different between the two groups (P < 0.001). Also, the ocular surface disease index (OSDI) questionnaire score was significantly different between the two groups (P < 0.001). There was a significant difference in intra ocular pressure ( IOP) between the two study groups (P=0.018).Conclusion: Our study concluded that glaucoma patients treated with preservative-free prostaglandin analogs have less ocular surface side effects than those treated with preservative-containing prostaglandin analogs. This finding suggests improving the tolerability of the topical medications that reflected on the patient compliance, efficacy of treatment, and control of glaucoma.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
- Impact of chronic cigarette smoking on blood count indices, erythrocyte
sedimentation rate and ...
Abstract: Background: Cigarette smoking is awell-known significant contributor to the development of many illnesses that having an inflammatory component. Smoking has both acute and chronic effects on haematological parameters.Objective: to assess the impact of cigarette smoking on complete blood count (CBC) indices and some inflammatory markers erythrocytic sedemitation rate (ESR) and C-reactive protein(CRP).Methodology: this case-control study was conducted on 30 healthy active smokers and 30 healthy passive smokers and 30 age and sex-matched healthy non-smokers subjects. Data regarding age, sex, smoking index, and smoking duration were recorded. CBC, differential leucocytic count, platelets/lymphocytes ratio (PLR), neutrophils/lymphocytes ratio (NLR), CRP and ESR were measured.Results: A statistically significant differences were identified between active and passive smokers groups regarding CBC and inflammatory markers parameters except for neutrophil %. ESR and CRP had no statistically significant difference. Statistically, significant differences have been identified between active smokers group and control group regarding all CBC indices and inflammatory markers e.g PLR, NLR, ESR and CRP, while no statistical difference has been identified between passive smokers group and control group regarding CBC and inflammatory markers parameters except monocyte % and ESR, which had statistically significant difference.Conclusion:Passive smoking affects hematological indices and inflammatory markers as well as active smoking. Accordingy, it is important to keep in mind that cigarette smoking either active or passive is one of differential diagnoses of change in blood indices.
PubDate: Sat, 31 Dec 2022 22:00:00 +010
