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Minia Journal of Medical Research
Number of Followers: 14  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2682-4558
Published by Minia University Homepage  [2 journals]
  • Maternal And Perinatal Outcome In cases of placenta previa A Study in
           Minia Maternity University Hospital

    • Abstract: ; Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide, Aim and objectives; to study maternal and perinatal outcome in patients of APH at a tertiary care referral hospital, Subjects and methods; This study was retrospective study, was conducted on 74 women admitted to our hospital with antepartum hemorrhage at the Minia Maternity University Hospital from March 2020 to March 2021, Result; Among the studied patients, the most frequent outcome was antenatal bleeding by 70.3% followed by hysterectomy (41.9%) and the less frequent outcome was bladder injury (4.1%). Maternal death presented 5.4%, Conclusion; Placenta previa is a major cause of maternal and perinatal morbidity and mortality which could be prevented by early registration, regular antenatal care, early detection of high-risk cases, and early referral to higher center. In our study, the major morbidities found were antenatal bleeding (70.3%), hysterectomy (41.9%), PPH (39.2%) and prolonged hospital stay >14 days (35.1%). Regarding neonatal complications, the majority was prematurity (45.9%). Regarding mortality, maternal death was 5.4% and fetal death was 1.4%
       
  • Relationship between level of serum vitamin D and pneumonia and sepsis in
           Minia pediatric university hospital at period between 2019 and 2021

    • Abstract: BACKGROUND AND OBJECTIVE:Low serum 25-hydroxyvitamin D (25[OH] D) levels have been associated with increased susceptibility to and severity of respiratory infections and sepsis. Hypovitaminosis D may be a modifiable risk factor in the severity of respiratory illnesses and sepsis. The hypothesis for this study was that children hospitalized for respiratory illnesses and sepsis would have lower serum 25(OH)D levels than controls and that 25(OH)D levels would be associated with illness severity among cases.METHODS:A study of a sample of patients aged 6 months through 12 years hospitalized at Minia paediatric university hospital was performed. Cases were children hospitalized for acute respiratory illnesses, sepsis and controls were children hospitalized for nonrespiratory illnesses. Illness severity among cases was assessed according to hospital length of stay, ICU admission, peripheral oxygen saturation, and paediatric risk of admission II score. Associations between serum 25(OH)D levels and dependent variables were tested for by using binary logistic and multivariable linear regression while controlling for admission diagnosis, age, gender, and race/ ethnicity.RESULTS:There was significant difference (p=0.0001*) between groups regarding vit D, its mean was higher in controls (63.7±23.1) than other groups (13.4±4.1 and 9.3±5.09 for pneumonia and sepsis respectively), also they show that there is non-significant difference (p3=0.2) between pneumonia group and sepsis group, its mean was higher in pneumonia (13.4±4.1) than in sepsis (9.3±5.09). CONCLUSIONS:Hypovitaminosis D was common among pneumonia and sepsis cases and it was normal among controls, moreover it was significantly associated with the presence or severity of respiratory illnesses.
       
  • Assessment of Serum Magnesium In Children With Type 1 Diabetes Mellitus

    • Abstract: Introduction:Type-1 Diabetes Mellitus (T1DM) is the most common metabolic disease of childhood characterized by chronic hyperglycemia accompanied by disturbances in carbohydrate, fat and protein metabolism resulting from a relative or absolute insufficiency of insulin secretion. Magnesium and some trace elements known to act as antioxidants or related directly to glucose metabolism which may be altered in diabetes mellitus.Aim of the Study: was to assess levels of serum Mg in T1DM children and to correlate their levels with different parameters.Subjects and methods: This study was conducted upon 120 child who were randomly selected; 80 with T1DM from the Pediatric Diabetes outpatients’ Clinic, Maternity and Children Minia University Hospital, Egypt. Another 40 children apparently healthy were taken as a control group. The study was conducted during the period from December 2020 to December 2021.All children were subjected to the following: history taking, general and systematic examination and laboratory investigations including; serum Magnesium, Potassium, Calcium levels,.Results: Diabetic groups had significant lower levels of Mg than the control and serum magnesium was insignificantly lower in cases with longer duration of disease (>5years) than those with short duration. Serum magnesium level was negatively correlated with the duration of diabetes. Conclusion: we found that serum Mg levels were lower in newly diagnosed and much more lower in the long standing diabetic children. Serum Mg had significant correlations with duration of diabetes and HA1C%,TC,TG and LDL which suggest that hypomagnesaemia may increase the risk for chronic cardiovascular for complications.
       
  • The ventilatory effect of High Velocity Nasal Insufflation versus
           Non-invasive Positive Pressure Ventilation in the treatment of acute
           hypercapnic respiratory failure in patients with AECOPD

    • Abstract: Background:High-Velocity Nasal Insufflation (Hi-VNI) is a type of non-invasive ventilation (NIV) that doesn't require a face mask and is used to help oxygenate patients experiencing respiratory distress.At flow rates of 35 liters per minute,it can completely clear extrathoracic dead space,besides oxygenation support.It may also be able to provide ventilatory assistance in patients suffering from acute type II respiratory failure.This study evaluated the ventilatory support capabilities of Hi-VNI.Patients and methods:Seventy-four AECOPD patients presented to Cardiothoracic Minia University Hospital during the period from November 2022 to January 2024 by acute hypercapnic respiratory failure were enrolled in this study.Cases were divided into two categories based on the first line of ventilatory support used,including NIPPV group (40 patients) and Hi-VNI group (34 patients).Results:34 of the 74 included patients were randomized to Hi-VNI and 40 patients to NIPPV and both groups were compared regarding the ventilatory effect of the used regimen.The therapeutic impact on Respiratory Rate (RR),hydrogen ion concentration (pH),partial pressure of carbon dioxide in arterial blood (PaCO2) and partial pressure of arterial oxygen (PaO2) over time in every group were similar.The intubation rate was17.6% in the Hi-VNI group and 25% in the NIPPV group (p value = 0.244).The percentage of patients who do not improve after treatment was 35.3% in the Hi-VNI group and 32.5% in the NIPPV group (p value = 1.0).Conclusion:Hi-VNI may provide ventilatory support similar to NIPPV in COPD patients presenting with acute type II respiratory failure. More research is required to confirm these results.
       
  • Assessment of Neonatal Hyperbilirubenemia Outcome ,and its Relationship to
           Neonatal and Maternal Factors in Minia Governate.

    • Abstract: Introduction : Neonatal hyperbilirubinemia (NH) is a common problem which occurs in about 60% of fullterm newborns and 80% of premature newborns during the first week of life. Actually, accumulation of bilirubin in the brain may result in temporary or permanent brain injury. So, early diagnosis and proper treatment of jaundice is of great significance. Several risk factors had been known as the determinants of jaundice including ; maternal and neonatal risk factors.Aim of the study: was to assess neonatal hyperbilirubenemia outcome, and its relationship to neonatal and maternal risk factors in Minia Governate.Subjects and Methods:It was a prospective study included one hundred sixty nine neonates with clinical jaundice. All of them had total serum bilirubin level> 2mg/dl and were admitted in different Neonatal Intensive Care Units (NICUs) in Minia Governorate during the period from August 2021 to May 2022.All the involved newborns were subjected to a structured questioner, clinical examination and laboratory investigations. They were followed up to detect their outcomes (survival , mortality or discharged with complications. Finally ,we study the relationships between these risk factors ant different outcomes. Results: Eighty seven (51.5%) of neonates were full term and eighty two(48.5%)were preterm. Neonates.As regard the outcomes neonataes with exaggerated physiological jaundice were statically significantly recovered more than those with other causes.Furtherly , neonates with sepsis were more significantly died or developed complications than the neonates with other etiology of hyperbilirubinemia. Prematurity.low weight ,previuos history of jaundiced neonates, low APGAR score wer associated with poor outcomes.
       
  • The effect of leflunomide on B-cell lymphocytes in vitiligo

    • Abstract: Abstract:Background: Vitiligo is a long-lasting pigmentary skin disease. It is distinguished by the demise of melanocytes in the skin. It significantly affects the quality of life of patients. Its source remains unknown. B lymphocytes have a significant role in autoimmune process by producing autoantibodies. Leflunomide (LF) is an immunomodulator and a member of the disease-modifying antirheumatic family of drugs (DMARDs). Aims: Immunohistochemical expression of CD20 in lesional skin of vitiligo patients before and after leflunomide treatment. Methods: Skin biopsies were taken from 16 active vitiligo patients before and after treatment with leflunomide for immunohistochemichal examinations of CD 20. Results: No CD20+ cells in skin biopsies either before or after treatment. Conclusions: Despite the known role of B lymphocyte in vitiligo, and the role of leflunomide in halting vitiligo activity, skin biopsies of active vitiligo lesions showed no B cells (CD 20+ cells) either before or after treatment with leflunomide.Keywords: Vitiligo; leflunomide; B-lymphocyte; skin biopsy; CD20.
       
  • The role of maximum intensity projection and volume rendering of
           multidetector computed tomography in detecting small metastatic pulmonary
           nodules .

    • Abstract: The inability of computed tomography (CT) to identify lung nodules is an established clinical issue in radiology.It is common knowledge that radiologist and traditional CT scans fail to identify tiny lesions, and that this is especially true when the lump is near to another nodule in the lung.When it comes to imaging modalities,CT chest has the best sensitivity for pulmonary identification.Work Objective:Using Maximum Intensity Projection (MIP) images and Volume Rendering (VR), our study aims to investigate the accuracy of Computed Tomography (CT) in detecting tiny pulmonary nodules in suspected metastatic lesions in cancer patients. Procedures : After receiving clearance from the hospital ethics committee/review board,a prospective observational research was carried out on 60 patients with lung metastases. The research took place at the radiology departments of El Minia University Hospital and the El Minia Oncology Center. Sixty patients, ranging in age from eighteen to sixty, were enrolled in the present study after being referred from the chest department for the presence of pulmonary nodules.The number and size of nodules were assessed using both MIP and VR methods. There was a statistically significant difference in 4,7,and 10 mm slip thickness when comparing the number of pulmonary nodules smaller than 6 mm between MIP and VR, with P‐values of 0.001,0.001,and 0.001,respectively.The number of discovered nodules varied dramatically according to the slip thickness, with 10 mm being much greater than 4 mm and 7 mm, according to a statistical analysis of the lung nodules.The following terms are associated with pulmonary nodules:MDCT,MIP,VR.
       
  • ‎ Patent Foramen Ovale in patients with Aortic Root
           Dilatation‎

    • Abstract: Background: Aortic root dilatation and patent foramen ovale (PFO) are two separate medical conditions; altered geometry due to aortic root dilatation may lead to hinder the complete closure of the foramen ovale.However, the relationship between both is not well-established and requires further research.Aim: was to explore the relation between PFO & aortic root dilatation. Methods: This case-control study was carried out in the Department of Cardiology, Minia University Hospital, during the period from May 2022 to May 2024; the study including 210 participants they were classified into two groups: Group I including 120 participants who had dilated aortic root and Group II including 90 participants as a control group. All the participants were subjected to: Transthoracic echocardiography and Transesophageal echocardiography. Multiplane TEE was used to identify PFO shunt either spontaneously, under valsalva or agitated saline injection. PFO shunt degree was classified as small, moderate or large.Results: This study showed non statistically significant increase number of PFO 12 (10%) in group I compared to 6 (6.7 %) in group II (p=0.694). PFO was clearly visualized in 3 participants, using valsalva maneuver in 6 participants and using contrast study in 9 participants. 12 PFO shunt were small and 6 were moderate in degree.Conclusion: Based on the results of this study, we observed increased number and percentage of PFO in patients with aortic root dilatation. This may support the possibility of changing the anatomical conformation of inter atrial septum by aortic root dilatation.Keywords: patent foramen ovale, aortic root dilatation
       
  • Safety and Efficacy of Mini percutaneous nephrolithotripsy in supine
           position versus prone position for treatment of pediatric renal stones, a
           prospective randomised study

    • Abstract: Introduction: PCNL has been established as a gold standard minimally invasive procedure for treatment of paediatric nephrolithiasis more than 20 mm. The aim of our study to compare the safety and efficacy of mini-percutaneous nephrolithotomy with laser lithotripsy in supine position vs prone position in treatment of paediatric renal stones.Patient and methods:At our outpatient clinic of Urology department at Minia university, Nephrology and Urology hospital ,There were 60 children attended , diagnosed as renal stone disease, fulfilled our criteria and included to our thesis .Patients were randomized by single blind technique into two groups: (Group 1) underwent mini PCNL in supine position (30) and (Group 2) underwent mini PCNL in prone position (30) .All patients were evaluated 1 month postoperatively by: plain X-ray KUB or CT KUB (if radiolucent stones ) for assessment of stone clearance .ResultsThere were no statistically significant differences in access time, number of punctures, or stent type between the two groups. However, positioning time was significantly shorter for the supine group compared to the prone group. Additionally, the supine group had notably shorter operative and fluoroscopy times than the prone group.ConclusionBoth mini PCNL in supine and prone positions are safe and effective in treatment of paediatric renal stones However, supine position relatively shorter operative time and fluoroscopy consumption.
       
  • Role of diffusion tensor imaging biomarkers and tractography to predict
           motor outcomes in patients with cerebral ischemic infarctions.

    • Abstract: Background: Acute ischemic stroke is one of the main causes of death globally. Conventional magnetic resonance techniques cannot provide reliable information regarding the integrity of the white matter tracts limiting its ability to predict the clinical outcome. Prediction of the motor outcome becomes very important to determine a specific rehabilitation strategy and the final clinical outcomes. The purpose of this study was to assess the value of diffusion tensor imaging (DTI) in patients with acute ischemic stroke as a prognostic modality to predict the motor outcome.Results: A significant statistical association was found between the 3D tractography findings and the NIHSS score on admission and the NIHSS score on recovery after 3 months. Residual neurological deficits were found in patients with disrupted tracts. However, near-complete clinical recovery was found in patients with intact non-disrupted tracts. Also, significant statistical association was found between the degree of FA reduction in the affected tracts and the NIHSS score on admission and the NIHSS score on recovery after 3 months.Conclusion: DTI is a technique that can detect the microstructural changes in the white matter tracts affected by ischemic lesions, as a result, it can be used as a tool to predict motor outcomes in patients with acute stroke and help in determining the best rehabilitation strategy.
       
  • Comparison between modified RECIST and WHO criteria for assessment of
           hepatocellular carcinoma

    • Abstract: In 2010, modified RECIST (mRECIST) criteria were presented to address the unique characteristics of hepatocellular carcinoma (HCC). Our goal was to compare mRECIST and WHO criteria in the treatment response after local and systemic therapies. Additionally, we aimed to improve the assessment of progression, which could be misinterpreted by conventional RECIST 1.1 and WHO criteria due to clinical events associated with chronic liver disease progression (e.g., ascites, lymph node enlargement). mRECIST has been used in clinical practice guidelines for managing HCC in Europe, America, and Asia. Today, mRECIST is the standard tool for assessing responses in the early and middle stages of HCC. We used both methods ( mRECIST and WHO criteria) in assessment of the same patients with hepatocellular carcinoma and then compared the results with post treatment level of alpha fetoprotein (AFP). We concluded that mRECIST is a reliable, applicable and preferable in tumor response assessment of HCC.
       
  • Intra-ocular pressure changes after pars plana vitrectomy with silicone
           oil tamponade in rehgmatogenous retinal detachmentn

    • Abstract: AbstractIntroduction Ocular hypertension and secondary glaucoma are relatively common and serious complications in silicone filled eyes which may end in blindness. Reports have described the percentage of incidence to be within 3 - 30 % of silicon filled eye which are complicated with secondary glaucoma. Aim of study Evaluation of intra-ocular pressure (IOP) in patients with rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV) with silicone oil (SO) 1000cs tamponade and after silicone oil evacuation. Patients and methods The study was a prospective interventional study. The study included 30 eyes from 30 patients with rhegmatogenous retinal detachment (RRD). The study was conducted at Ophthalmology department, Minia University Hospital in Egypt between April 2023 and April 2024.Results Patients with RRD who underwent PPV with SO 1000cs endotamponade experienced significant increase in IOP post-operatively, and then IOP values decreased post-evacuation of silicone oil.Conclusion Ocular hypertension is a common finding after PPV with SO endotamponade which improves after oil evacuation.Key words: IOP, silicone oil and vitrectomy
       
  • Growth Hormone Receptor Expression In HCV-Related Hepatocellular Carcinoma

    • Abstract: ABSTRACT:Background: Hepatocellular carcinoma (HCC) is unquestionably a major obstacle in the way of health progress in Egypt, considering its high incidence and extreme fatality. In Egypt most of HCC cases occur on top of advanced liver cirrhosis where it was believed to represent a growth hormone (GH) resistance state. Meanwhile, one of the major molecular pathways in many solid tumors is that of the GH and its downstream pathways.Aim of the study: To assess the state of expression of growth hormone receptor (GHR) in cases of HCC as compared to those with liver cirrhosis and healthy controlsSubjects & Methods: sixty patients were enrolled in this study. They were arranged into three equal groups: the first contained 20 HCC patients, while the second consisted of 20 cirrhotic patients, and the third represented 20 healthy controls. We compared the immunohistochemistry results of liver tissue biopsies for GHR expression to patients' demographic data, clinical and laboratory findings, as well as the tumor's clinicopathological characteristics.Results: It was found that HCC patients levels of GHR expression were lower than cirrhotic and control groups which were also correlated with features of tumor aggressiveness.Conclusion: The down-regulation of GHR was associated with the development and aggressiveness of Hepatitis C-related HCC, regardless of the functional condition of the liver.
       
  • Predictive Value of Bishop Score, Cervical Length and Head–Perineal
           Distance for the Success of Vaginal Delivery in Primigravida with
           Premature Rupture of Membrane

    • Abstract: Background: Induction of labor is indicated when benefits to the mother or the fetus outweigh those of continuing the pregnancy including cases of post-term pregnancy, preeclampsia or fetal growth restriction. The aim of this study: was to analyze the efficacy of ultrasonography evaluation of the Head-Perineum Distance in predicting the likelihood of a successful vaginal birth before inducing labor.Methods: This prospective observational study was carried out on 120 pregnant patients aged from18 to 32 years old, singleton pregnancy, primigravida, 36–41 weeks gestation, living fetus, cephalic presentation, preinduction reassuring non stress test and premature rupture of membranes (PROM). Foetal Head-Perineum Distance (FHPD) was measured by a transpernial ultrasound.Results: An ultrasound measurement of the Foetal Head-Perineum Distance showed a strong positive connection with both effective induction and the likelihood of a cesarean section. The Bishop score and head perineal distance exhibited significant differences between the two groups. The cervical length did not show a statistically significant difference between the two groups. The predictability of FHPD was superior in all respects when compared to Bishop's score and cervical length.Conclusions: The foetal head - perineum distance is reliable method in predicting successful vagina delivery. Ultrasound examination is simple, non-invasive, and tolerated by women than pelvic examination.
       
  • R1/ Assessment of Risk Factors in Patients Presented With symptomatic
           Intracranial Arterial Stenosis In Minia University Hospital

    • Abstract: Background: Cerebrovascular stroke is the 1st leading cause of death and the third leading cause of disability.It's been reported that intracranial Stenosis (ICAS) accounted for 10% of all cerebral ischemic events worldwide. Finding out what variables put individuals with intracranial artery stenosis at risk was the driving force behind this study. Methods: This cross-sectional study was carried out on all patients referred to Minia University hospital presented with symptomatic intracranial stenosis either presented with stroke or transient ischemic attack aged from 18 to 80 years old, both sexes, for one year duration.Results: Total number of patients was 168 .Patients with no ICAS represented 89 cases while 79 of cases had ICAS .The mean age of patients with ICAS was 62±12.9 years, Male gender represented in 52(65.8%) of cases with ICAS. Smokers with ICAS were 28(35.4%). According to comorbidities, hypertension and dyslipidemia were found in 52(65.8%) & 51(64.6%) of cases with ICAS respectively, diabetes found in 29(36.7%) of cases with ICAS , obesity found in 18(22.8%) and IHD found in 13(16.5%) of cases with ICAS. History of previous stroke presented in 27(34.2%) of cases. Median Glasgow Coma Scale (GCS) was 15(14-15). Previous history of stroke were significantly higher among cases with ICAS than among cases without ICAS (p value <0.05).Conclusions: the most common risk factors associated with patient with ICAS were being male, Hypertension,dyslipidemia , diabetes and smoking respectively ,and previous history of cerebrovascular stroke is significantly found in patients presented with symptomatic ICAS than patients without ICAS
       
  • Role of magnetic resonance spectroscopy in Multiple sclerosis patients

    • Abstract: background:Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system , it causes physical disability as well as cognitive dysfunction.  the use of MRI in diagnosis and monitoring of multiple sclerosis made an important step towards appropriate use of MRI in routine clinical practice. MRS is considered as better indicator of metabolic dysfunction & disability more clearly than conventional MRI methods.Aim of the workTo asses the role of magnetic resonance spectroscopy in multiple sclerosis patients.Methods:A cross sectional study was conducted on MRI unit Department of Radiology on 30 patients diagnosed with MS according to the 2017 McDonald diagnostic criteria and 20 healthy patients. A written informed consent was obtained from each patient prior to participating in the study. ResultsMRS studies on multiple sclerosis patients enabled in vivo assessment of metabolites reflecting tissue alteration , it also enabled to evaluate neurotransmitters probably involved in MS pathogenesis. MRS has revealed increased level of metabolites such as lipids, lactates, myoinositol & glutamic gluatamte As well as, there was different levels of Cho/ Cr & Cho/ NAA in multiple sclerosis patients according to activity of lesions.ConclusionMRI has revolutionized the diagnosis and surveillance of patients with MS. Not only can an MRI confirm the diagnosis, but follow-up scans can assess the response to treatment and help determine the disease pattern. Adding MR spectroscopy to conventional MRI increases the specificity and accuracy of MRI study in the diagnosis of MS
       
  • IMMUNOPHENOTYPING IN COVID 19

    • Abstract: Background:Newly recognized acute respiratory disorder caused by coronavirus 2 (SARS-CoV-2) infected more than 13 million individuals around the world. Some studies handled the immune response toward COVID-19. However, the lucid picture of immune cells that impact this disease is not fully understoodAim of the work:To measure the frequency of CD3⁺, CD8⁺ for T-cytotoxic, CD3⁺ CD4⁺, CD25⁺ for T-regulatory cells and CD19⁺ B lymphocytes in COVID-19 patients Methods: A total of 20 patients and 20 healthy controls of the same age were included in the study. Patients were recruited at the Clinical Pathology Department and the chest department in Minia university hospital in a one-year durationResults: There was a statistically significant difference between cases and controls in phenotyping. In case group CD3, CD4 and CD25 ranged from 1.8 to 2.8%, CD3 and CD8 ranged from 11.3 to 21.5% and CD19 ranged from 8.3 to 12.8%.Conclusion: COVID-19 infection reduces the percentage of CD3, CD4, CD25, CD8 and CD19 T cells
       
  • Exploring the Multifactorial Pathophysiology of Vitiligo: Genetic,
           Immunological, and Oxidative Stress Interactions

    • Abstract: Vitiligo is a prevalent pigmentary disorder. Numerous studies conducted over many years and across various countries have attempted to elucidate the pathophysiology of vitiligo, yet it remains incompletely understood. This review article presents recent research supporting the most widely accepted theories regarding this disfiguring illness. Emphasis is placed on the genetic predisposition theory, the neurological theory proposed in the 1950s, and other significant theories including the autoimmune hypothesis, the reactive oxygen species model, zinc-α2-glycoprotein deficiency, viral infection, intrinsic theory, and biochemical, molecular, and cellular mechanisms that lead to the loss of functional melanocytes in vitiligo. The formation and maintenance of disease are predisposed by the discovery of several genes implicated in these processes. However, the integration of hypotheses related to the pathogenesis of vitiligo is challenged by the interaction between vitiligo and psychological stress, comorbidities, environmental variables, and the characteristics that characterize individual vulnerability to the disease. The condition's complexity arises from multiple interacting factors. Further research is needed to understand these interactions better and improve vitiligo treatment.
       
  • Study of Immunohistochemical Expression of NUSAP1 in Clear Cell Renal Cell
           Carcinoma

    • Abstract: Introduction: Globally, renal cell carcinoma (RCC) is among the most prevalent malignancies. A mixture of genetic mutations and environmental influences are the main causes. NUSAP1 is an anti-apoptotic marker which enhances cellular invasion and migration via a variety of pathways, including PI3K/AKT/mTOR pathway. NUSAP1 has been shown to be significantly expressed in variety of tumours, but little is known about its implications in ccRCC.Aim of work: to assess the IHC expressions of NUSAP1 and investigate the relationship between NUSAP1 expression and various clinical and pathological characteristics of cases of ccRCC.Methods: Fifty tissue specimens of ccRCC were subjected to IHC staining procedure of NUSAP1 utilizing the avidin biotin-peroxidase method in conjunction with chromagen detection in order to look into how clinicopathological data and NUSAP1 expression relate to one another.Results: In 60% of instances, there was evidence of prominent NUSAP1 expression. A statistically positive correlation was observed between the expression of NUSAP1 and tumor stage (p=0.003), Fuhrman grade (p=0.022), and distant metastases (p=0.007). Conclusion: In ccRCC, NUSAP1 expression may be regarded as a negative predictive factor.Keywords: Renal cell carcinoma, NUSAP1, IHC.There is no conflict of interest among authors.
       
  • Outcomes of Amniotic Membrane Use as an Allograft in Flexor Tendon Repair

    • Abstract: Introduction Flexor tendon injuries of the hand are challenging problem for surgeons because of the following reasons.Firstly,such injuries cannot heal without surgical intervention.Secondly postoperative protocol should be done cautiously as mobilization was found to be crucial in preventing adhesions and improving gliding but there is a risk of rupture. Finally because the flexor tendons have unique anatomy within their sheaths.Many ideas were recently introduced to decrease the rate of adhesions, one of them is the use of Amniotic membrane (AM). Aim of the workThe aim of this study is to evaluate using the amniotic membrane as an allograft around tendon repair site for prevention of peritendinous adhesions in cases of flexor tendon injuries in zones II,III of the hand in Minia University Hospital,Plastic&Reconstructive surgery department. Patients and MethodsThis is a prospective clinical study that was performed on 30 fingers at Minia University Hospital,Plastic Surgery department,with acute flexor tendon injury in zone II&III of the hand. ResultsThe study included 30 fingers,males were 23 and 7 were females with age range 11-51 years.There was significant relation between application of the AM around tendon repair site and decreased rate of adhesions (P value < 0.05).Also there is improvement in the results range of motion.ConclusionIn comparison with other techniques,the use of AM allograft seems to result in clinically meaningful improvement.This is proven from the results of our study.However,it is yet unknown if the undesirable results are related to technical issues,irregular distribution of complications or the amniotic membrane allograft itself.
       
  • Vestibular Evoked Myogenic Potentials (VEMPS) in Children

    • Abstract: ABSTRACTBackground: The normative data of vestibular evoked myogenic potentials (VEMPS) in normal children.Aim of the work: To investigate the normative VEMP results in normal children because there is currently little information available regarding normal VEMP results in children. This will aid in the future in identifying any abnormalities, which will enable us to identify any vestibular and balance dysfunctions in children. Methods: 10 participants were included in this study and all of them were examined with both types of VEMP (cVEMP and oVEMP) tests.Results: For every child, VEMP was tested. Latencies and amplitudes of children were different than that of adults.Conclusion: The function of the otolith in normal children could be assessed using VEMP testing. Furthermore, it is reasonable to anticipate lower amplitude and shorter latencies in the normal youngsters compared to adult levels.Keywords: VEMP parameters in normal children, vestibular and balance dysfunctions in children.
       
  • Correlation of Best Corrected Visual Acuity and Vessel density quantified
           with optical coherence tomography angiography in diabetic macular edema

    • Abstract: Background: Diabetic macular edema (DME) is a pathology that can result in blindness in individuals who are of working age and is considered a serious health risk. Approximately 7 million people with diabetic retinopathy (DR) are impacted. The aim of this research is to use optical coherence tomography angiography to examine the linkage between macular microvascular indices and visual acuity. Methods: Hospital-based cross-sectional study conducted on 70 patients of type II diabetes with macular edema at Minia University Hospital ophthalmology investigation clinic and El-Minia Eye Center during the period from May 2020 to February 2023. The study included 100 eyes investigated for Best corrected visual acuity (BCVA) and retinal vascular density analysis using optical coherence tomography angiography (OCTA) for measurmet of superficial and DCPdensity (SCP and DCP).Results: Significant negative correlation was present between BCVA and Fovea of DCP (r=-0.23, p=0.01*) which mean that increasing fovea significantly associated with decreasing visual acuity), and significant positive correlation with deep capillary plexus (DCP) para fovea (r=0.23, p=0.01*), superior hemisphere (r=0.23, p=0.01*) and inferior hemisphere (r=0.20, p=0.03*) by mean of decreasing theses parameters significantly associated with decreasing visual acuity.Conclusion: The results of current study conclude that capillary dropout specially DCP has principle corporation in the disturbance visual function in patients with DME.
       
  • Role Of Transcutaneous Perianal Ultrasonography In Grading Of Patients
           With Perianal Fistula According To Garg (2017) & St James Grading
           Systems In Correlation With Magnetic Resonance Imaging

    • Abstract: Background: Trans-perineal ultrasound (TPUS) is a dynamic diagnostic technique for assessment of the perianal region for evaluating fistulas and abscesses. Magnetic resonance imaging (MRI) is considered the modality of choice in evaluation of perianal fistula, especially in cases of perianal fistulae. The aim of this work was to assess the role of TPUS in grading perianal fistula according to St James & Garg grading system and to correlate the findings with MRI as gold standard. Methods:This prospective clinical study was carried out on 25 patients, aged from 17 to 68 years, both sexes, with clinical criteria of clinical suspicion of perianal fistula, primary and recurrent cases.All patients underwent TPUS and then MRI. The time interval between TPUS and MRI examinations was less than fourteen days.Results: The different values of Garg grades detected by TPUS plotted against those detected by MRI, we found that TPUS had moderate agreement with MRI (kappa = 0.61 and P value <0.001). There is higher agreement between TPUS and MRI using this system (kappa = 0.67and P value < 0.001). Conclusions:TPUS had moderate agreement with MRI (kappa agreement about 0.61) and high statistical significance. There was higher agreement between TPUS and MRI using this system where kappa agreement was 0.67 with high statistical significance. Speaking about the new classification that was approved in 2017 by Garg, the most common fistula type was grade I by both TPUS and MRI happened in 11 patients 44% by TPUS and 9 patients 36% by MRI.
       
  • Subcutaneous injection of local anesthetic at port site versus bilateral
           sonar guided TAP block for pain control after laparoscopic
           cholecystectomy.

    • Abstract: Background: One well-known technique for postoperative analgesia in laparoscopic abdominal surgery is the transversus abdominal plane (TAP) block. TAP block is risk-free; it lessens or does away with the requirement for analgesics and has less adverse effects, like postoperative vomiting and nausea. Objectives: Examining the relative merits of TAP block and LA infiltration for the alleviation of postoperative pain following laparoscopic cholecystectomy. Study design: Eighty adults will participate in the prospective, randomized, double-blind controlled trial. Method: This study involved 80 patients who are undergoing general anesthesia for elective laparoscopic cholecystectomy; the patient will be allocated into 2 groups (40 patients in each group). Group A: Transverse abdominis plane (TAP) block. Group B: Port sites local infiltration. Results: There is significant decrease in 24-hour fentanyl consumption in group A than group B. Also, there is significant difference in rescue analgesia as it more in group B than group A. Conclusion: Tap block was more effective in pain management postoperative in laparoscopic cholecystectomy.
       
  • Prognostic Significance of L1CAM Expression in Endometrial Carcinoma

    • Abstract: Background: Endometrial carcinoma (EC) is predominantly having a favorable prognosis. However, there is still need to identify prognostic biomarkers for improved categorization into high- or low-risk EC. There is ongoing debate about the predictive significance of L1CAM expression in EC. Aim of the study: to investigate the prognostic role of L1CAM in EC. Methods: This is a retrospective study included 52 randomly selected formalin fixed, paraffin embedded tissue blocks of endometrial carcinoma. Cases included 50 cases of endometroid EC and two cases of non-endometroid EC. Tissue sections were stained immunohistochemically with L1CAM antibody. Results: Regarding endometroid subtype cases, positive L1CAM expression was detected in 19 /50 (38%) cases. A significant positive association was found between positive L1CAM expression and higher tumor grade (p = 0.01), advanced tumor stage (p = 0.02), presence of LVI (p <0.04), post-menopausal state (p=0.02) and cervical stromal invasion ( p=0.002). Additionally, positive significant association was found between L1CAM expression and higher risk groups (p = 0.003). No significant associations were found between L1CAM expression and patients’ age, tumor necrosis, tumor site and tumor size (p = 0.7, p = 0.4, p = 0.4 and p = 0.2 respectively). Regarding both serous and clear cell types cases, high positive expression for L1CAM was detected. Conclusion. Our results suggest that L1CAM expression may help to detect EC patient group with poor prognostic features. L1CAM can be an additional tool of a considerable value for risk stratification in EC with potential therapeutic utility.
       
  • Diabetic Cardiovascular Auto-nomic Dysfunction

    • Abstract: Abstract: Diabetes poses a significant worldwide public health threat, impacting a vast number of individuals. Cardiovascular autonomic neuropathy is a common outcome among those who have diabetes. Research has established a correlation between CAN and an increased likelihood of illness and mortality in individuals with diabetes. Furthermore, CAN has the ability to independently forecast cardiovascular illness and mortality. It shows how autonomic dysfunction can have an impact on a diabetic's day-to-day activities and can have potentially fatal consequences. A bad prognosis is linked to the advancement of CAN. One important strategy to reduce the morbidity and death linked to this chronic illness may be the early detection and treatment of CAN. The introduction, pathogenesis, and diagnosis of cardiac autonomic neuropathy (CAN) are covered in this article. This study has some limitations such as those related to clinical work and laboratory investigations. So, further studies with larger sample sizes and different settings are recommended to confirm our findings.
       
  • Reproducibility of Multi-detector CT in assessment and characterization of
           pancreatic ductal adenocarcinoma according to American pancreatic
           association consensus reporting template.

    • Abstract: ABSTRACT.Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal solid tumors. PDAC has a poor prognosis in spite of recent advances in different imaging modalities mainly due to difficulty in early diagnosis and aggressive biological behavior.Aim of the work: to assess the value of the pre-operative assessment of PDAC using Multi-detector (MDCT) according to the American pancreatic association (APA) consensus reporting guidelines in comparison with intra operative findings and to assess possible short term post-operative whipple complications. Methods: Prospective, cohort study included fifteen consecutive patients with clinical suspicious of PDAC, all of the patients had MDCT assessment using GE Revolution EVO 128 multi slice thickness. Results: Each of the lesion site, lesion size, biliary tree, superior mesenteric artery (SMA), common hepatic artery (CHA), main portal vein (MPV), superior mesenteric vein (SMV), and anatomical variation with the preoperative CT findings using APA consensus. Post Whipple’s operation, the majority of cases have no complications; meanwhile, 18.2% had fluid collection. The comparison between APA consensus and the old report documentation of PDAC cases by CT indicated a statistically significant lack in mentioning lesion appearance, pancreatic duct, biliary tree, SMA, celiac artery, CHA, MPV, SMV, and anatomical variation among old report documentation compared with APA consensus reports.Conclusion: The application of multi-detector MDCT according to the American pancreatic association reporting template was highly reproducible and provides accurate assessment of pancreatic ductal adenocarcinoma (PDAC) thus improving the patients selection for whipple operation and provides a clear guide for the surgical approach
       
  • R1 Title: Prognostic Significance of L1CAM Expression in Endometrial
           Carcinoma

    • Abstract: Background: Endometrial carcinoma (EC) is predominantly having a favorable prognosis. However, there is still need to identify prognostic biomarkers for improved categorization into high- or low-risk EC. There is ongoing debate about the predictive significance of L1CAM expression in EC. Aim of the study: to investigate the prognostic role of L1CAM in EC. Methods: This is a retrospective study included 52 randomly selected formalin fixed, paraffin embedded tissue blocks of endometrial carcinoma. Cases included 50 cases of endometroid EC and two cases of non-endometroid EC. Tissue sections were stained immunohistochemically with L1CAM antibody. Results: Regarding endometroid subtype cases, positive L1CAM expression was detected in 19 /50 (38%) cases. A significant positive association was found between positive L1CAM expression and higher tumor grade (p = 0.01), advanced tumor stage (p = 0.02), presence of LVI (p <0.04), post-menopausal state (p=0.02) and cervical stromal invasion ( p=0.002). Additionally, positive significant association was found between L1CAM expression and higher risk groups (p = 0.003). No significant associations were found between L1CAM expression and patients’ age, tumor necrosis, tumor site and tumor size (p = 0.7, p = 0.4, p = 0.4 and p = 0.2 respectively). Regarding both serous and clear cell types cases, high positive expression for L1CAM was detected. Conclusion. Our results suggest that L1CAM expression may help to detect EC patient group with poor prognostic features. L1CAM can be an additional tool of a considerable value for risk stratification in EC with potential therapeutic utility.
       
  • Different Factors Predicting Diabetic Foot Ulcer Development

    • Abstract: Background: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus (DM) that has spread over recent decades. DFU is considered as a major source of morbidity and a leading cause of hospitalization in diabetic patients, so identifying the contributing factors in DFU development is crucial. Objective: we aim to identify the factors predicting the risk of DFU occurrence and its risk stratification in patients with type 2 diabetes mellitus in Minia university hospital. Methods: 200 patients with type 2 diabetes mellites were assigned to a questionnaire of sociodemographic characteristics, diabetes treatment and smoking, and a foot risk classification system after a foot examination. Results: The highest proportion of patients, (35%) were categorized as having a high risk. Results showed a statistically significant association between the IWGDF score and age (p = 0.001), income (p = 0.006), education (p < 0.001), smoking (p < 0.001), and DM duration (p < 0.001). A higher proportion of patients aged 60 years or above, illiterate, current smokers, having low income, and having DM for >10 years are being classified as having a high risk. Conclusion: DFU development is associated with old age, low income, low education, smoking, and long duration of DM.
       
  • Surgical Outcomes of Various Subtypes of Primary Congenital Glaucoma

    • Abstract: Abstract: Primary congenital glaucoma is considered the most common subtype of pediatric glaucoma which accounts for 50%-70% of the cases and for 0.01%–0.04% of the global blindness. According to the Childhood Glaucoma Research Network (CGRN) classification, PCG is further classified as neonatal subtype (0–1 month), infantile subtype (>1month-2years), and late onset (>2years).Aim to assess and compare the surgical consequences of the various subtypes of PCG.Methods The nature of the study was a prospective comparative interventional clinical study. Sixty eyes of patients diagnosed as primary congenital glaucoma were included in the study and subdivided into three groups as regarding the onset of the disease. Group 1 (neonatal onset) comprised of 11 eyes; group 2 (infantile onset) included 46 eyes & group 3 (late- onset) included 3 eyes. Results There was a difference between the neonatal group & the other 2 groups which was statistically significant as regarding pre-operative IOP (P-value= 0.005, 0.05) while there was no significant difference between infantile & late onset groups (P-value= 0.69). Similarly to the pre-operative ocular data, there was a considerable difference between neonatal group & the other 2 groups as regarding post-operative IOP (P-value= 0.002, 0.05) while there was no significant variation between infantile & late onset groups (P-value= 0.82). In addition, there was a considerable difference between infantile and late onset groups regarding C/D ratio (P-value= 0.05). Conclusion It can be concluded that a young age at presentation represents a significant prognostic factor that adversely affects the effectiveness of standard angle surgery.
       
  • Immunohistochemical Expression of PDL1 in Colorectal Carcinoma

    • Abstract: AbstractBackground: Colorectal Cancer (CRC) accounts for a widely occurring malignant neoplasm originating from the colon or rectum. It is considered the second most common contributor to cancer-related death. PDL1 plays an important function in the immune response, serving as a vital component bolstering the body's immune system against tumor cells. The utilization of medications in inhibiting the PD1/PDL1 pathway strengthens the immune system and induce the of lysis tumor cells, therefore presenting a novel avenue for the treatment of cancer.Aim of the work: This study was undertaken to investigate the immunohistochemical expression of PDL1 in cases of CRC, with the aim of assessing its pattern of expression and exploring its correlation with different clinicopathological characteristics. The present study also aimed to study the possible change in the PDL1 expression between the adenocarcinoma cases and their corresponding Lymph node metastasis and investigate the disease-free survival for the studied cases.Materials and methods: A total of 50 tissue blocks from primary colorectal adenocarcinoma and 10 corresponding lymph node blocks, demonstrating metastasis, were randomly selected for immunohistochemical staining of PDL1 expression. Results: PDL1 expression was detected as positive membranous immunostaining ranging between –ve/ low and high expression. Eleven cases (22%) showed high expression while 39 (78%) showed -ve/ low expression. Ten pairs of primary tumor and respective lymph node metastasis were compared, Univariate and multivariate regression analysis were employed to examine disease-free survival. Conclusion: PDL1 elevated expression can be regarded as an unfavorable prognostic indicator in the assessment of CRC patients.
       
  • Effect of Human Amniotic Membrane Application on Microskin Graft

    • Abstract: Abstract:Background; Severe full-thickness burns and significant injuries that cause extensive skin damage hinder natural regeneration and jeopardize patient survival. Immediate coverage is essential to restore normal skin function. When a donor site is available, using an autograft is always the preferred and most effective option.Aim and objectives; To assess the impact of applying human amniotic membrane at the recipient site of micro-autogenous split-thickness skin grafts for covering post-burn raw areas, this study focuses on several factors: the graft take percentage, infection rates, time required for complete wound healing, the expansion ratio of the recipient site to the graft donor site, and the scar evaluation of the graft.Subjects and methods; This prospective controlled clinical study was conducted on 20 patients at the Plastic Surgery Department of Minia University Hospitals. The study involved applying human amniotic membrane to the recipient site of micro-autogenous split-thickness skin grafts on only one half of the raw area, with the other half serving as a control.Results; The mean time for complete healing in study side which is covered by amniotic membrane is (25.5±4.2), and it is significantly lower than the control side which is not covered by amniotic membrane which is (30.8±5). No need for another session of grafting at both sides.
       
  • Chest Ultrasound versus High Resolution Chest CT in the diagnosis of
           pleuropulmonary lesions

    • Abstract: Aim of the work:to detect sensitivity of chest ultrasound versus high-resolution computed tomography (HRCT) chest in the diagnosis of peripheral lung lesions.Background:Peripheral pleuropulmonary lesions vary from peripheral lung nodules,masses,effusion,consolidations and cavities,in addition to pleural nodules,pleural thickening and even lesions arise from chest wall.There were different imaging modalities to detect these lesions,so we aim to detect similarity and difference in detection of these lesions by both transthoracic ultrasound and high-resolution computed tomography (HRCT)chest. Patients and methods:our study was done at our outpatient clinics,internal medicine department or department of chest diseases,Minia cardiothoracic university hospital,during the period from November 2022 to February 2024.The study included 60 patients subjected to have peripheral pleuro-pulmonary lesions in their chest x-ray,the lesions vary from pleural nodules,pleural thickening, peripheral soft tissue mass,peripheral pulmonary nodules, peripheral suspicious cavitary lesions and others. chest x-ray,HRCT chest and transthoracic ultrasonography were done to confirm lesions,we consider HRCT chest is the gold standard in our study,Results: our results revealed that HRCT chest detected 27(45%) patients had mass lesion while transthoracic ultrasound detected 43% of studied patients with mass lesion with sensitivity of chest ultrasound of 85.2% and specificity of 90.9%. In comparison between HRCT chest and transthoracic ultrasound findings, there were no statistically significant between both of them as P was 0.76 Conclusion:there was no statistically difference between both of HRCT chest and transthoracic ultrasound in diagnosis of peripheral pleuropulmonary lesions with higher sensitivity of ultrasound in diagnosis of peripheral mass lesion in comparison with HRCT chest as a gold standard.
       
  • Role of intranasal insulin in the management of post- COVID -19 Oldactory
           dysfunction

    • Abstract: Background: Olfactory dysfunction associated with COVID-19 is a significant issue that impairs quality of life. We address the potential of intranasal insulin as a therapeutic agent considering the limitation of viable medicines for this issue.Aim of the study: Assessment of intranasal insulin's therapeutic impact on post-COVID-19 Olfactory Dysfunction.Methodology: This study included 40 patients suffering from post-COVID-19 olfactory dysfunction at the ENT outpatient clinic of Minia University Hospital. They were divided into two groups: group 1 included 20 patients who received intranasal insulin fast-dissolving films while group 2 included 20 patients who received plain intranasal films (placebo).Results: The mean score of the Butanol threshold test for the intervention group was 3.4 while for the placebo group was 2.4 after the fourth session and the mean scores reached 5.7 for the intervention group and 2.6 for the placebo group after the eighth session reflecting a statistically significant improvement in olfactory function for the intervention group than the placebo group.Conclusion: Finally, our results showed that administering intranasal insulin to patients greatly shortened their anosmia duration. Notably, a highly statistically significant rise in Butanol Threshold test scores compared to pre-treatment scores highlights the potential advantages of intranasal insulin in treating olfactory impairment in patients who have recovered from COVID-19.
       
  • The impact of vitamin k2 supplementation on inhibition of vascular
           calcification in chronic kidney disease patients

    • Abstract: Patients with chronic kidney disease (CKD) often have vascular calcification, which is defined by calcium deposition in the intimal and medial layers of the artery wall. Vascular calcification increases the risk of unfavorable cardiovascular (CV) outcomes. But our understanding of the intricate pathophysiology at play is still lacking. Vitamin K insufficiency is quite common in chronic kidney disease (CKD), and supplementing with this vitamin shows tremendous promise in slowing the onset of arterial calcification. The pathophysiology connecting vitamin K insufficiency and vascular calcification is covered in this article along with the functional vitamin K status in various stages of chronic kidney disease (CKD) and a review of recent research using animal models, observational studies, and clinical trials. The abnormal ectopic mineralization of the heart valves and artery walls is sometimes referred to as "cardiovascular calcification." However, a variety of pathophysiological pathways can contribute to the deposition of calcium across different cardiac and arterial beds, and the diverse manifestations of calcification result in distinct clinical problems. There are currently no authorized medicinal approaches for treating or preventing cardiovascular calcification. Clinical trials to examine the effectiveness of treatments may be complicated by the long-term development of calcification in cardiac and vascular tissues in the general population. People with chronic kidney disease (CKD) are a population in need of anticalcification treatments that might potentially finish clinical trials because of how quickly calcification develops in response to renal insufficiency.
       
  • Reversed proximal humeral internal locking system (PHILOS) plate for
           distal humeral shaft fractures through an Anterolateral Approach

    • Abstract: Background: We described the application of a PHILOS plate in a reversed manner for the treatment of extra-articular distal third humeral fractures through an anterolateral approach.Methods: For the treatment of distal humerus fractures, sixteen patients underwent internal fixation procedures using the reversed (PHILOS) plate between August 2022 and August 2023. Data was collected regarding clinical results, radiological results, and surgical complications. The Mayo and Oxford elbow scores, as well as the elbow's range of motion, were all part of the clinical evaluation.Results: The mean follow-up time was 8 months(range, 6 to 12 months).The average Mayo elbow and Oxford elbow scores were 95.31 (of a total of 100) and 45.31 (of a total of 48), respectively. The mean range of elbow motion was 134.37° (range 130–140). Fracture union was noted in all patients, with an average period of 15.13 weeks. One patient had a superficial wound infection, and another patient post operatively developed radial nerve palsy which completely recovered within 3 months. Conclusion: In extra-articular distal third diaphyseal humeral fractures, a modified anterior application of the PHILOS plate could be a practical choice in fractures within 3 cm from coronoid fossa.
       
  • Role of Multi Detector CT Liver Volumetry in Surgical Assessment of
           Hepatic Lesions.

    • Abstract: Background: Liver diseases account for approximately 2 million deaths per year worldwide, so various imaging modalities as computed tomography (CT) imaging is useful for detection, characterization of liver tumors and for estimation liver volume and liver remnant volume preoperative in patients undergoing liver surgery.Aim: This study aims to evaluate the accuracy of CT volumetry in assessment of the total liver volume, the residual liver volume as well as the volume of diseased liver segment.Patient and methods: This prospective study was conducted on 20 patients with hepatic focal lesion referred from liver surgery department at Minia university hospital during the period from January 2023 to November 2023.Results: The mean age of studied patients was 60 ±11.68 & 70% of patients were males, 30% were females. There were 55% of patients have RT HCC, 30% have LT HCC, 10% hepatic cyst, 5% caudate lobe HCC. The mean total volume of the liver in the studied patients was 2388.78± 813.53, the mean volume of the tumor was 508.1±653.12, the mean liver remnant % was 81.02±21.25 and 55% of patients were operable. Conclusion: The findings of the present study indicate that automated CT liver volumetry is an accurate and quick method for determination the total liver volume, tumor volume and future liver remnant in patients with hepatic focal lesion who undergo hepatic resection.
       
  • Dermoscopy in Facial Post-Acne Erythema patients

    • Abstract: Background: Post-Acne Erythema (PAE) is delineated as an erythematous macule persisting subsequent to the resolution of inflamed acne lesions. PAE can significantly impact the quality of life of affected individuals. No previous studies found addressing the dermoscopic features of PAE. Aim: The primary objective of this study was to assess the use of dermoscopy to evaluate features of facial erythema in patients complaining from PAE. Material and methods: This study was conducted on 43 patients with PAE and assessed clinically according to clinician erythema assessment (CEA) scale followed by further dermoscopic evaluation. Results: The dermoscopy assessment revealed two components of erythema: diffuse erythema and telangiectatic vessels. This study unveiled differences in the dermoscopic erythema between the different clinical erythema groups according to CEA (p value = 0.042). In contrast, this study unveiled no differences in the severity of the dermoscopic telangiectasia between the different clinical erythema groups according to CEA (p value = 0.926) Moreover, this research illustrated a significant disparity in the severity of dermoscopic telangiectasia between the different dermoscopic erythema groups according to 4-point grades of erythema scale (p value = 0.017). Conclusion: Dermoscopy, a non-invasive handheld device, proves invaluable and essential in the evaluation of PAE. PAE includes not only erythematous macules but also telangiectatic vessels against a background of diffuse redness, each of them needs to be addressed as a separate matter.
       
  • A Review of Optical Coherence Tomography Angiography (OCTA) as a Novel
           Diagnostic Tool in pediatrics

    • Abstract: Advanced non-invasive imaging, such as optical coherence tomography angiography, allows one to visualize the retinal and choroidal vasculature with exquisite detail. OCTA will provide enhancement in axial and lateral resolution, excelling routine imaging technologies like ultrasound and MRI. This technology can be particularly useful in pediatric ophthalmology, where it helps to detect and track disorders such as retinopathy of prematurity, choroidal neovascularization, and retinal vascular occlusions. OCTA's ability to assess retinal vessel density and the foveal avascular zone provides critical insights into various retinal diseases and developmental abnormalities. This technology has shown exceptional utility in evaluating vascular layers of the retina, aiding in the diagnosis and management of various pediatric ocular conditions such as retinopathy of prematurity, cataracts, and retinoblastoma. Moreover, OCTA's application extends beyond ophthalmology, offering insights into systemic conditions like beta-thalassemia and type 1 diabetes. By capturing high-resolution images and offering real-time analysis, OCTA stands out as an essential tool in both clinical and research settings, advancing the understanding and treatment of pediatric ocular diseases.
       
  • Effect of hepatic ischemia reperfusion on testicular tissue in rats

    • Abstract: Background: Hepatic ischemia reperfusion (HIR) injury is a major cause of liver damage occurring in many surgical circumstances such as liver transplantation resulting in tissue injury and remote organ affection which are dangerous medical conditions that carry poor prognosis to the patients and need to be managed and prevented efficiently. There are no clear data addressing the effect of HIR injury on testicular tissue in rats. This study aimed to evaluate the effect of HIR injury on testicular tissue with the explanation of possible underlying causes.Methods: Rats were allocated into 2 groups; group 1: Sham (received carboxymethyl cellulose) for 5 days, groups 2: HIR group. Rats were sacrificed after 30 minutes of ischemia and 60 minutes of reperfusion. The effect of HIR on rat testes was evaluated by serum testosterone and histopathological assessment. Results: No significant differences were revealed in HIR group in comparison to the sham group. Conclusion: There is no significant affection of testes after HIR.
       
  • Short-term effect of Dapagliflozin, a sodium-glucose cotransporter 2
           inhibitor, on patients with rheumatic mitral regurgitation and preserved
           left ventricular systolic function.

    • Abstract: Background: SGLT2 inhibitors have been demonstrated to lower cardiovascular mortality risk and HF worsening in patients of HF with reduced, mildly reduced and preserved ejection fraction regardless of diabetes status (1) However, its effect on patients with mitral regurgitation and preserved LV systolic function is unclear (2).Aims: Study the short-term effects of Dapagliflozin on functional capacity, symptoms and LV systolic function in patient with rheumatic mitral regurgitation and preserved LV systolic function.Patients and Methods: A prospective cohort study, that included 150 patients with severe rheumatic mitral regurgitation and preserved left ventricular function (LV EF > 60%), 75 patients received dapagliflozin and 75 patients did not receive dapagliflozin served as a control group were studied and followed up after 3-month using 2D speckle tracking echocardiography and the Kansas City Cardiomyopathy Questionnaire (KCCQ).Results: After three months of follow-up, there was significant improvement in KCCQ score in patients who received dapagliflozin compared to those who didn’t, (p value< 0.001) However, no statistically significant difference in GLS between cases and control regarding basal GLS and GLS.Conclusions: Dapagliflozin relieves symptoms in patients with severe rheumatic mitral regurgitation and preserved LV function during a short-term follow-up in spite that no improvement in LV systolic function.
       
  • ultrasound guided clips insertion within breast masses

    • Abstract: Introduction: Neoadjuvant chemotherapy is widely used in different types of breast cancer resulting in reduction of the size of the breast mass changing the scenario of management from being inoperable to operable cases and changing the surgical management in operable cases from radical mastectomy to conservative mastectomy. There is a need for radiopaque markers as clips for localization of these tumor bed.Objectives: assessment of the safety of clips and their accuracy in detecting the location of the primary breast tumor during exposure to neoadjuvant chemotherapy (NAC).Patients and methods: The study will include 20 patients with locally advanced breast carcinoma, with or without nodal involvement, planned for neoadjuvant chemotherapy (NAC). All patients will have clip inserted before neoadjuvant chemotherapy (NAC) in small lesions or after 2-3 cycles of chemotherapy in relatively large lesions. Follow up will be done for the patients as regard the location of inserted clips and occurrence of clip migration. Also follow up for complications as pain, infection and hemorrhage.Results: the clips were accurate in localization of breast mass as in all our patients, only two of them showed subtle migration of the clips which was due to reduction in the size of the mass. Those clips cause no complications to our patients. Conclusion: The clips can be used efficiently as markers for localization of breast cancer in patients candidate for neo-adjuvant chemotherapy as it showed no migration. The clips are safe to the patients and caused no significant harm to them.
       
  • Sequelae of Adjuvant Irradiation of Breast Cancer on the Shoulder Region
           (Influence of Different Doses and Techniques)

    • Abstract: Introduction :Globally, breast cancer (BC) is the most frequently diagnosed cancer; about 2.2 million new cases are expected to be diagnosed with BC in 2020. Furthermore, with over 680,000 deaths, it is the primary cause of cancer-related mortality among women. (Sung and others, 2021). Multim odalities have been described in treatment of breast cancer ; surgery , chemotherapy , hormonal therapy , targeted therapy and radiotherapy . In addition, adverse effects from breast cancer treatment could include fibrosis, shoulder and arm pain, limited movement, and breast cancer-related lymphedema (BCRL). Breast cancer patients' arm pain has been linked mostly to radiation therapy (RT) (Hopwood et al.,2010)Subjects and Methods: The female patients over the age of eighteen who had primary breast cancer and metastasized to the axillary lymph nodes underwent adjuvant regional nodal irradiation (RNI) in this retrospective longitudinal research. Minia University Hospital (MUH) provided the data, which were gathered between 2017 and 2022. The American Joint Committee on Cancer (AJCC 2018) TNM staging approach was utilized to stage the patients, and immunohistochemistry was employed for molecular categorization. Results: Relation between shoulder affection and weight , age , median dose of radiation to the shoulders and number of lymph nodes dissected. Conclusion :There was a correlation between the mean radiation dose and the volume of the shoulder receiving doses of 10 Gy, 20 Gy, and 30 Gy, as well as shoulder affection following radiotherapy, in addition to the patient's age, weight, and surgical dissection of the axillary lymph nodes.
       
  • Assessment of Brain Natriuretic Peptide Serum Levels in Children with
           Chronic Kidney Disease

    • Abstract: Chronic kidney disease (CKD) is a significant global public health issue,with a growing number of cases that could potentially approach epidemic proportions.(CKD) in both children and adults is linked to severe outcomes,such as higher chances of death,renal failure,cardiovascular disease,mineral bone problem,and inadequate nutrition.In patients with chronic kidney disease (CKD),both B-type natriuretic peptide (BNP) and its amino-terminal cleavage product,N-terminal pro-B-type natriuretic peptide (NT-pro-BNP),are widely recognized as biomarkers for diagnosing,predicting outcomes,and monitoring treatment in patients with heart-related conditions, particularly heart failure (HF).As the glomerular filtration rate (GFR) decreases,the levels of natriuretic peptides (NPs) tend to increase.Measuring blood BNP (or NT-pro-BNP) in children has become widely accepted as a valuable and dependable biomarker for diagnosing,managing, and perhaps predicting the outcome of major structural and functional cardiovascular disease (CVD).Subjects and Methods:This study is across-sectional case control study was conducted upon 60 children with chronic kidney disease collected from the Pediatric Department and Pediatric Outpatient Nephrology Clinic and Pediatric Unit of Dialysis–Minia University Children Hospital in a period from April 2020 to June and 30 apparently healthy children with age and sex matched with the CKD children 2022. All children were subjected to:detailed medical history,through examination,evaluation of serum BNP level, estimated GFR calculated from Schwartz formula.Results:Shows significantly increased the B-type natriuretic peptide (BNP) levels in both CKD groups compared with control. It also showed significant decrease after the dialysis effect in dialyzed CKD children.Conclusion:CKD children especially those on hemodialysis have higher levels of BNP,thus they at higher risk of cardiovascular disease.
       
  • Mineral Trioxide Aggregate as a Direct Pulp Capping Material in Dog Teeth:
           An Experimental Study

    • Abstract: Introduction: The current study aimed to discuss the efficacy of mineral trioxide aggregate (MTA) in direct pulp capping (DPC) in terms of the histological effect after mechanical pulp exposure of immature premolars of Mongrel dogs Methods: For histological analysis, a spilt-mouth design was used in which 24 immaturepremolars of three healthy 2-3 years-old Mongrel dogs were mechanically exposed andcapped with MTA. After 3 months, animals were sacrificed, and stained specimens (hematoxylin and eosin) were examined for inflammatory cell reactions and hard tissue formation Chisquareand Fisher’s exact tests were used to compare the histological success rates Results: Histologically, MTA material showed no inflammatory cells after 3 months, while hardtissue was significantly superior in the MTA. Conclusions: MTA is a biocompatible material with a favorable pulp tissue response interms of the absence of an inflammatory cell reaction a small amount of calcified tissueformation after 3 months. MTA is an effective treatment option in the DPC of carious, immature permanent teeth.
       
  • The ventilatory effect of High Velocity Nasal Insufflation versus
           Non-invasive Positive Pressure Ventilation in the treatment of acute
           hypercapnic respiratory failure in patients with AECOPD.

    • Abstract: Background:High-Velocity Nasal Insufflation (Hi-VNI) is a type of non-invasive ventilation (NIV) that doesn't require a face mask and is used to help oxygenate patients experiencing respiratory distress.At flow rates of 35 liters per minute,it can completely clear extrathoracic dead space,besides oxygenation support.It may also be able to provide ventilatory assistance in patients suffering from acute type II respiratory failure.This study evaluated the ventilatory support capabilities of Hi-VNI.Patients and methods:Seventy-four AECOPD patients presented to Cardiothoracic Minia University Hospital during the period from November 2022 to January 2024 by acute hypercapnic respiratory failure were enrolled in this study.Cases were divided into two categories based on the first line of ventilatory support used,including NIPPV group (40 patients) and Hi-VNI group (34 patients).Results:34 of the 74 included patients were randomized to Hi-VNI and 40 patients to NIPPV and both groups were compared regarding the ventilatory effect of the used regimen.The therapeutic impact on Respiratory Rate (RR),hydrogen ion concentration (pH),partial pressure of carbon dioxide in arterial blood (PaCO2) and partial pressure of arterial oxygen (PaO2) over time in every group were similar.The intubation rate was17.6% in the Hi-VNI group and 25% in the NIPPV group (p value = 0.244).The percentage of patients who do not improve after treatment was 35.3% in the Hi-VNI group and 32.5% in the NIPPV group (p value = 1.0).Conclusion:Hi-VNI may provide ventilatory support similar to NIPPV in COPD patients presenting with acute type II respiratory failure. More research is required to confirm these results.
       
  • Relation between systemic immune inflammatory index and coronary
           

    • Abstract: Background: Atherosclerosis is known to be the most common underlying pathology of coronary artery disease (CAD). Leukocyte recruitment and proinflammatory cytokines were found to participate essentially in the process of atherogenesis. Systemic immune inflammatory index (SII) is derived by calculating both platelet counts and neutrophil/lymphocyte ratio (NLR) [ SII = platelets count *NLR]. SII is suggested to have prognostic value regarding mortality in patients with CAD, myocardial infarction (MI) and acute coronary syndromes (ACS).Aim of the Work: to investigate the relation between the systemic inflammatory and immune state of the patient using SII and the extent of atherosclerosis of coronaries assessed by SYNTAX score in patients undergoing elective coronary angiography.Patients and Methods: This cross-sectional study was conducted on 113 patients undergoing elective coronary angiography divided into three groups according to SII; Lower SII group (n=64), intermediate SII group (n=30), and High SII group (n=19). Results: Our results showed statistically significant difference among the three groups regarding SYNTAX score being higher in intermediate SII group and high SII group compared to lower SII group with moderate positive correlation between SYNTAX score and SII. Moreover, SII was the most independent predictors for both low and high SYNTAX score.Conclusion: SII is correlated with extent of CAD assessed by SYNTAX score among patients with chronic coronary syndrome (CCS) undergoing elective coronary angiography.
       
  • Evaluation of Feasibility and Safety of the posterior approach of
           laparoscopic cholecystectomy in patients with symptomatic gallstones

    • Abstract: Introduction:Laparoscopic Cholecystectomy (LC) which is the gold standard in the treatment of gallbladder diseases.However,this method carries risks of serious complications,including biliary duct injury and bleeding during and after surgery.Although various dissection techniques have been described by different authors to make laparoscopic cholecystectomy safer,there is no consensus on a new,standardised method for dissecting Calot's triangle that is said to prevent biliary injuries (BI).However,all aim to reduce the incidence of such injuries.Aim and Objective:Our study is prospective analysis aiming at assessment of the safety and feasibility of dissection of the triangle of calot from the posterior portion of Cystic duct toward the cystic artery along lateral to the medial Surface few above the sulcus of ROUVIERE with clear identification of parts of critical view of safety which is useful in difficult laparoscopic cholecystectomies.Patient and Methods:Our study was done at the Laparoscopic unit of Minia University Hospital.It was a prospective analysis that was performed on more than 50 patients with symptomatic gall bladder stones.Result:starting the dissection from the posterior aspect of gallbladder Therefore,the probability of injury to any arterial or biliary structure at this level is reduced.It also appears to be a safe decision technique and in patients with vascular and biliary abnormalities.Conclusion:Dissection using posterior approach is one more step towards safer laparoscopic cholecystectomy.Less blood loss and less operative time appear to be the main advantages of using the posterior approach.However,more studies with larger sized samples are needed to substantiate these results.so we recommend that approach for laparoscopic Cholecystectomy
       
  • Estimating level of serum PLGF and sFLT-1 in Egyptian pregnant women with
           and without preeclampsia

    • Abstract: Pre-eclampsia is considered one of the leading causes of maternal and foetal mortality and morbidity worldwide, pre-eclampsia is a prevalent pregnancy condition. As a result, we must immediately begin working on practical and inexpensive diagnostic tools that will allow for the early detection of high-risk women, which will pave the way for more precise preventative measures and treatment. The main object is to reduce the number of maternal fatalities caused by preeclampsia. The increased circulating antiangiogenic substances that originated from a hypoxic placenta is associated with pre-eclampsia (PE).Objective : the aim of this study To estimate the values of serum sFlt-1 and PLGF in the diagnosis and prediction of pre-eclampsia in the Egyptian pregnant womenPatients and methods: 160 pregnant women with pre-eclampsia and 64 pregnant women with normal pregnancy were included in our study. Patients with Pre-eclampsia were subdivided into mild and severe as well as early-onset and late-onset. serum PLGF and sFlts were measured. Results:serum PlGF was statistically significant lower in pregnant patients with preeclampsia (74.5 ± 22 vs. 236.1 ± 108.6, p <0.001), while serum sFlt-1 and sFlt-1/PlGF ratio were statistically significant higher in pregnant patients with preeclampsia (4264.2± 804.5 vs. 373.4 ± 62.7, p <0.001; 73.1 ± 66.5 vs. 1.8 ± 0.6, p <0.001 respectively) as compared to control groupConclusionWe concluded that PlGF and sFlts-1 are useful in diagnostic and prediction of pre-eclampsia
       
  • Sepsis-Related Mortality Among Patients with Pulmonary Disorders

    • Abstract: Background: Sepsis is a one cause of increased morbidity and mortality in intensive care units (ICUs). Most studies on sepsis are performed on patients admitted in general or surgical ICU, with limited evaluation on patients admitted at the Respiratory Intensive care unit (RICU) with underlying pulmonary illness . The objective was to determine the mortality rate and the possible risk factors of sepsis in patients admitted at RICU. Methods: A cross-section observational study was performed on 100 patients admitted at RICU during a 6 months duration. Patients were devided into two groups : Sepsis and non sepsis groups. The two groups were compared in predictors of mortality by demographics, clinical and laboratory data. Fifty patients had sepsis based on systemic inflammatory response (SIRS) score ≥ 2 with the mean age of 60.5 years. Results: Twenty- seven patients out of 50 cases of sepsis (54%) died. Univariate regression analysis identified that detection of micro-organisms in sputum and or blood culture, low oxygen saturation< 90% upon admission and elevated serum lactate > 2 mmol/L were associated with mortality. In addition, variables significantly associated with mortality on multivariate regression analysis were age > 60 years, increase length of ICU stay, onset of symptoms of sepsis more than 1 week, presence of microbes on laboratory assay and elevated serum lactate. Conclusion: The prevalence of death in sepsis is high.Old age,presence of Gram-negative bacteria, elevated serum lactate,oxygen desaturation,use of vasopressor agents, use of invasive mechanical ventilation and renal failure were possible risk factors of mortality.
       
  • transfer of maternal antibodies risk for preterm delivery

    • Abstract: Background: One of the most significant challenges in obstetrics is the persistence of preterm birth. Having a baby before the 37th week of gestation is considered preterm birth.Another prevalent reason for anti-fetal rejection is antibodies produced by mothers.Aim of the work: To detect Maternal antibodies ( anti-Human leucocyte antigen class I and class II Panel reactive antibodies) in women with preterm labour in Minia University hospitals.Methods: From October 2023 to June 2024 , venous blood was withdrawn from every subject (pregnant woman) selected from the obstetrics and gynecology department, Minia University Hospital for determination of panel reactive antibodies (PRA) by Luminex.Results: (i) HLA class I PRA positivity was more common in patients with spontaneous preterm delivery (P = 0.011) and class II PRA positivity (P = 0.038) compared to patients who delivered at full term; (ii) HLA class I PRA positivity was higher in patients with spontaneous preterm delivery between 28 and 34 weeks (P < 0.001) than in patients with full-term deliveries; (iii) primigravida women had a higher risk of HLA class I PRA positivity than multigravida women; and (iv) the rate of HLA class I PRA positivity in primigravida women increased with each passing week of gestation. Conclusion: Due to antibody-mediated maternal anti-fetal rejection, pregnant women who test positive for HLA class I or class II PRA during the second trimester are more likely to have spontaneous premature birth.
       
  • Histological Study Of The Toxic Effect Of Methotrexate On The Cornu
           Ammonis Pyramidal Cells Of Adult Male Albino Rat Hippocampus and The
           Possible Protective Role Of Moringa Leaves Extract.

    • Abstract: Abstract:Purpose: We aimed to detect the ameliorating effects of Moringa leaves extract (MLE) against Methotrexate (MTX) induced hippocampus damage. Methods: 50 male Albino rats weighing 150-170 g were divided into equal five groups; Group I: served as a control group, Group II: received MLE orally (300 mg/kg b w) twice a week for four weeks, Group III: injected intraperitoneal with MTX (0.5mg/kg b w) twice a week for four weeks, Group IV: rats received MTX and MLE at the same timeline for four weeks with the same dose and route of administration, Group V: received MTX firstly followed by MLE for four weeks with the same dose and route of administration.Results: the histological examination showed that in the control group, and group II there was a normal hippocampal features. Conversely, Group III revealed pronounced alterations, including a contracted CA size and a C-shaped DG with a lost angle, accompanied by pyramidal cell degeneration. In the group IV, the DG angle partially restored. In group V, showed persistent challenges in mitigating MTX induced alterations, with the contracted CA size and C-shaped DG configuration persisting. The immunohistochemical study of P53 immunoreactivity showed that the contrasting findings in P53 expression between the control and MLE-treated groups suggest that MLE may modulate the expression of this tumor suppressor gene in the hippocampus.Conclusions: MLE has a therapeutic effect against MTX induced hippocampus damage as evidenced by the stimulation of the pro-apoptotic effect via increasing the P53 expression in the brain tissues.
       
  • Primary Anterior Cruciate Ligament reconstruction by Peroneus Longus
           tendon Autograft versus Hamstring Tendon Autograft

    • Abstract: Background: The utilization of the peroneus longus tendon (PLT) as a viable alternative auto-graft for anterior cruciate ligament repair (ACLR) has been seen. The present study aimed to compare the functional outcomes of ACLR using PLT auto-graft versus hamstring tendon (HT) auto-graft. Material and Methods: We recruited a total of forty patients who had experienced an anterior cruciate ligament (ACL) tear. These patients were then separated into two groups based on the type of auto-graft used in the anterior cruciate ligament reconstruction (ACLR). Group A had ACLR with PLT auto-graft prospectively, and group B had ACLR with HT auto-graft retrospectively. Results: At the final follow-up, the mean post-operative IKDC score for groups A and B was 96±1 and 90.5±2.75, respectively. The mean post-operative AOFAS score for group A was 98±2. Conclusion: In our series, PLT auto-graft for ACLR produced excellent functional results. PLT auto-graft can be a safe and efficient substitute for other auto-grafts for ACLR without causing appreciable donor site morbidity.
       
  • Effect of Arteriovenous fistula patency on blood pressure in patients of
           renal transplantation

    • Abstract: Background: Hemodialysis and peritoneal dialysis have evolved into bridging therapies that individual undergo while they await a suitable kidney donor, thanks to the rapid expansion of numerous national and international transplantation programs.Aim and objectives: Assessment of the impact of arteriovenous fistula patency on blood pressure in patients of kidney transplantation.Patients and methods: This trial was performed on 98 kidney transplant recipients who were divided into 2 groups: the closed AVF group (N= 46), the patent AVF group (N = 52). This study was conducted at El Minia University outpatient nephrology clinic and ensurance hospital nephrology clinic in Minia governorate.Results: There was statistically significant variance among two studied groups regarding Systolic blood pressure was significantly higher in patent AVF group than closed AVF group but there was no difference in diastolic blood pressure in the two studied groups. Key words: Arteriovenous fistula, blood pressure, renal transplantation.Conclusion: In this study we found that systolic BP higher in patient with patent AVF than patients with closed AVF also we found that patients patent AVF have significant increase in LVH and diastolic dysfunction more than patients with closed so it is advisable to close AVF in patients of renal transplantation will protect them from hypertension and destructive changes in the heart as LVH and Lt vent diastolic dysfunction.
       
  • Language development in sensorineural hearing loss children using hearing
           aids .

    • Abstract: Abstract: Due to deficiencies in spoken language skills, a child with hearing loss faces specific challenges. Poor language frequently causes reading difficulties and hinders academic achievement. Conventional hearing aids can potentially provide children with hearing loss with enough auditory information to learn age-appropriate spoken language.Aim of the work: to evaluate language development in sensorineural hearing loss children using hearing aids and describe the effect of hearing aid in language and speech development. Patients and method: This study included 50 children with sensorineural hearing loss children using bilateral hearing aids, age ranging from 5years to 10years. All children assessed with Preliminary Diagnostic Procedures (Parents interview and history taking), IQ assessment, Audiological evaluation, language assessment.Results: All language parameters are affected by duration of deafness, age of fitting, and duration of rehabilitation.Conclusion: Short period of deafness, early age of fitting, and regular rehabilitation improve language ability in children with bilateral hearing aids.
       
  • Vitamin b12 deficiency in metformin and non-metformin diabetics and
           relation to renal functions

    • Abstract: Background: Individuals diagnosed with type 2 diabetes mellitus frequently suffer from signs of vitamin B12 insufficiency. (T2D). Objectives: To study occurrence of Vitamin B12 shortage in metformin utilizers.Patients and methods: This observational prospective investigation was participated in through the Department's ambulatory clinic. of Internal Medicine at Minia University hospital between August 2022 to November 2023 and included 100 patients with type 2 DM divided into two collections metformin (70 patients) & non-metformin users (30 patients as a control group). The metformin group was divided into sub groups according to GFR into three groups. First group (30 patients) with GFR more than 90 ml/min/1.73m. Second collection (20 individuals) with GFR 60-90ml/min/1.73m. Third group (20 patients) with GFR 45-60 ml/min/1.73m. Results: There are statistically significant difference between different types of MUI regarding vitamin B12 level (p value<0.05). As when MUI=0, the majority of cases (66.7%) had normal vitamin B12 while the reverse is true when MUI>15, the majority of cases (90%) had deficient vitamin B12. The maximum & minimum incidence rates of VIT B12 deficiency was among MUI>15 & MUI <5 respectively (90% & 4%). There is statistically significant variance amongst the different categories of GFR regarding vitamin B12 (p value<0.05). As in normal GFR level of Vit B12 was higher (298) than when GFR = (60-90) OR when GFR <60. Conclusion: We can conclude that vit B12 deficiency in metformin elderly utilizers have risk to renal disease.
       
  • Cerebral oxygenation monitoring in critically congenital heart neonates
           during cardiac catheterization

    • Abstract: IntroductionNIRS and cerebral oximetry are only two terms for the same technology. The reason they rely on it is that oxyhemoglobin, deoxyhemoglobin, and cytochrome aa3 all have distinct absorption patterns in the 700 to 900 nm region of near infrared light, and biological tissue is rather transparent to this light. The redox status of cytochrome aa3, amounts of oxy- and deoxyhemoglobin, and ScO2 can be determined by analysing light signals at many wavelengths Aim of the work• The goal is to assess brain oxygenation in cases of severe congenital heart defects undergoing cardiac catheterization using near-infrared spectroscopy (NIRS).• Reduced brain injury, including alterations in neurocognitive function and blood biomarkers, is a result of using NIRS cerebral oximetry. Transfusion rates, mortality, and resource utilisation are all decreased, and injuries to other organs, such as the brain and heart, are also decreased.Patients and methods• The catheterization laboratory of the paediatric cardiology section at Cairo University Hospital was the site of. beginning on November 1, 2021, and continuing until November 30, 2023, the research will be conducted.• Fifty individuals in direct need of an invasive cardiac catheterization due to critical congenital heart disease were enrolled in this trial..• Conclusions• We may conclude from this study that INVOS has been beneficial when used within 6 months of cardiac catheterization procedures in critically ill youngsters.• Recommendations• Therefore, to compare our results, we propose further studies on the same infant cohorts.
       
  • Arthroscopic Repair of radial meniscal tear by Double Vertical cross
           sutures through Inside-Out technique

    • Abstract: AbstractBackground: The knee meniscus is essential for lubricating the joint, absorbing shocks, and distributing loads & weight-bearing. Aim and objectives: To develop a novel suture technique in repairing radial meniscal tear for better healing of the meniscus and better functional outcome. Patients & methods: This was Prospective controlled study on 20 individuals with radial meniscal tear were underwent repair with a combination of inside-out sutures & secondary reinforcement to the tibia utilizing all-suture knotless anchors in Minia University Hospital. Results: About one half of cases had marching cleft sign on MRI before operation, 30% had ghost meniscus sign and only 20% had fluid cleft sign. Regarding time to operation, it ranged from 5 weeks to 20 weeks from time of trauma with mean 10.6 ±3.2. For time of arthroscopic repair, it ranged from 40:90 minutes with mean 57 min. also mean time of hospital stay after operation was 1.6 days ranged from 1:3 days. There was highly significant reduction in mean score of VAS after 3 months and 6 months of operation compared to baseline before operation (p value <0.001). There was high significant increase in mean knee society score and function score after 3 months and 6 months of operation compared to baseline before operation (p value<0.001). Conclusion: This novel suture technique in repairing radial meniscal tear by double vertical cross sutures through inside-out technique had better healing of the meniscus and better functional outcome.
       
  • Risk Factors of Diabetic Foot Ulcers in Diabetes and endocrinology Unit in
           Minia University Hospital

    • Abstract: AbstractBackground: Diabetes mellitus is a multifaceted, long-lasting medical condition that requires comprehensive risk-reduction methods that go beyond managing glucose levels. Continuous diabetes self-management education and assistance play a crucial role in empowering individuals, minimizing immediate difficulties, and mitigating the likelihood of long-term complications. Substantial data exists that substantiates several interventions aimed at enhancing diabetes outcomes. The aim of the work is to evaluate risk factors associated with Diabetic foot ulcer patients at the Diabetes and Endocrinology unit at Minia University Hospital. Methods: The current study is a cross-sectional prospective case-control study was conducted on 66 persons 22 males and 44 females of the same age group (28:65years) were selected from outpatient clinic of Diabetes and Endocrinology unit, Department of internal medicine in Minia University Hospital from february 2020 to May 2022. Results Our results showed that there was a statistical significant difference as regard WBCs, neutrophil, A/C ratio, FBG, 2-hr PPBG, HbA1c, fasting insulin, HOMAIR, HOMAB, CH, LDL, TG and HDL between the two groups Healthy control group and Diabetic foot ulcer group with p value (p=0.0001 for all except 0.04 for HOMA-B and0.002 for TG). Conclusion FBG, 2-hr PPBG, HbA1c, fasting insulin, HOMA IR, CH, LDL, TG and HDL are important risk factors for DFU
       
  • Prediction of neonatal respiratory distress syndrome by Quantitative
           ultrasound texture analysis of fetal lung Observational cross section
           study

    • Abstract: Aim and objectives; to predict respiratory distress syndrome using a noninvasive method called quantitative ultrasonography study of fetal lung texture. Subjects and methods; a cohort of 304 cases and was conducted in the feto maternity unit of Minia Maternity and Children University Hospital over 3 years. fetal lung images were used to develop a computerizedmethod based on texture analysis and machine learning algorithms, trained to predict neonatal respiratory morbidity risk on fetal lung ultrasound images.Result; RI in Control group ranged from 0.58 to 1.04 with mean ± SD = 0.82 ± 0.1 while in RD group the RI ranged from 0.53 to 1.06 with mean ± SD = 0.77 ± 0.13 with statistical significant difference (p= 0.002 ) between the two groups. Regarding texture lung analysis using computerized programs there was no significant difference between the two groups .Conclusion: The research showed a significant and meaningful difference between the groups regarding Doppler indicesThere was no significant difference regarding texture lung analysis .
       
  • Diagnostic Role and Prognostic Significance of miRNA-133a in Acute
           Myocardial Infarction

    • Abstract: Background: Despite improvement in acute ST elevation myocardial infarction (STEMI)) therapy, 30% of patients have LV remodeling after myocardial infarction (MI) . It was discovered that miRNA-133a, plays a role in the initial pathophysiology of MI . Objectives: to evaluate diagnostic and prognostic role of miRNA-133a in STEMI.Methods: a prospective study that was conducted during 1.5 years. It had two groups: Group I which consisted of 100 patients with acute STEMI, all managed by 1ry PCI , and Group II (n=50) as controls .They underwent comprehensive clinical evaluation, laboratory testing for miRNA-133a , serum high sensitivity cardiac troponin and 2D echocardiographic examination. after 6 months follow up , Group I was divided into subgroup I with LV remodeling based on  20 increase in LVED volume after 6 months and IB without LV remodeling and again was subdivided according to the occurrence of the major adverse cardiovascular events (MACE) during 6-months follow-up.Results: Group I showed significantly higher levels of miRNA-133a expression (44.22 ± 10.98 vs. 4.31 ± 1.58, p 0.001) than group II. The level of miRNA-133a was not significantly different in patients with LV remodeling and patients with early and late complications. According to a multivariate analysis, LVED was the best predictor of LV remodeling.Conclusions: miRNA-133 a was found to be a better diagnostic biomarker for Acute STEMI .It could neither predict myocardial remodeling, nor early or late complications as well as fate of the patients after acute STEMI.
       
  • Effect of Diabetes Mellitus on Oxidative Stress and Inflammatory Markers
           in Parkinson's Adult Male Albino Rats

    • Abstract: Background : Diabetes mellitus (DM) is a chronic metabolic condition defined by persistent hyperglycemia . Parkinsonism is a clinical syndrome with bradykinesia, static tremors, rigidity, and postural instability. Parkinson's disease is a neurological condition that progresses progressively over time. As people age, it becomes more common. Clinical symptoms remain the primary determinant of PD diagnosis. Aim and Objectives: This study aims to detect the effect of diabetes mellitus on model of Parkinson's disease (PD) in adult albino rats.Material and Methods: This study was a prospective controlled experiment done in the laboratory of the Medical Physiology department, under the college of Medicine at Minia University. The experiment involved a collective of 30 rats. Results: The diabetic Parkinson's group exhibited a statistically significant deterioration in Malondialdehyde (MDA) , Total antioxidant capacity (TAC), and Tumor necrosis factor-alpha (TNF-α) compared to the control group (C group), Parkinson's group (P group), and Diabetes Parkinson's group (DP group). Conclusion: Diabetes mellitus has a worsening effect on Parkinson’s disease.
       
  • Is there a relationship between parasitosis and urticaria'

    • Abstract: Little research has been done to explore the connection between parasitosis and urticaria. Therefore, this study was to evaluate how parasitosis and urticaria are related. The study involved 150 healthy subjects and 150 urticarial patients; three stool samples were collected, examined by direct and staining methods. Immunoglobulin E (IgE) levels were measured. Out of 150 patients, 38.0% had acute urticaria and 62.0% had chronic urticaria, 78.0% were women, and 22.0% were men. The rate of parasitic infections in the urticarial group was 94%, whereas it was 51.33% in the healthy group. Blastocystis spp. was the most detected parasite (32.67% vs. 22.7%), followed by Entamoeba coli (29.33% vs. 20.0%), Cryptosporidium spp. (13.33% vs. 8.7%), Giardia intestinalis (12.7%. vs. 0.0%) (p value< 0.0001). Also, mixed parasitic infections were detected. Associated diarrhea and colic were 72.0% in urticarial patients vs. 12.7% in control persons. The mean concentration of total serum IgE was 473.44±147.13 in patients with parasitic infections, whereas it was 130.77±11.34 in negative patients. Serum IgE mean concentration levels were 99.88±1.93 in the parasitic infection-positive control group and 30.77±11.34 in the parasitic infection-negative control group. Out of 141 patients who had parasitic infections, 34.75% showed peripheral eosinophilia. Conversely, out of 77 parasitic infection-positive control group, 19.48% showed peripheral eosinophilia. Urticarial remissions occurred in 85.11%. These findings indicate that skin allergy may be associated with certain stages of the parasites’ life cycle or with host tissue location, but not necessarily only with parasites’ presence in the hostile organism.
       
  • Efficacy of Progestin Primed Ovarian Stimulation versus GnRH Antagonist
           Protocols in Clomiphene Resistant PCOS Undergoing ICSI Cycles. Randomized
           Controlled Trial (RCT) aa

    • Abstract: Background: Polycystic ovary syndrome (PCOS) is one of the endocrine disorders and anovulatory cycles of reproductive age women, it represents 70% of anovulation. Recent study has demonstrated that, the continuous administration of progestin showed a comparable pregnancy outcome compared to the conventional protocols such as short and GnRH antagonist protocols in infertile and poor responder patients with normal ovarian reserve.Aims and Objectives: This a Prospective Randomized Control Study Aimed to Evaluate the Efficacy of Progestin - Primed Ovarian Stimulation Versus GnRH - Antagonist in Patients with Clomiphene resistant PCOS Undergoing ICSI Cycles on Clinical Pregnancy Rate and Premature LH Surge. Patients and Methods: This study was conducted at one of the Privide IVF/ICSI center at Minia Govenate. The study was performed on a total of 100 infertile patients complaining of clomiphene-resistant or clomiphene failed PCOS underging ICSI cycles. All Patients were divided randomelly into two groups; group I who recieved (Progestin – Primed ovarian stimulation protocol), group II who recieved (GnRH – antagonist). Results: There was no significant differences between the two studied groups regarding the demographic characteristics basal hormonal levels (FSH,LH, Prolactin, TSH, and AMH), and incidence of multiple pregnancies, however there is statistically significant differences between the two studied groups in the median of MII, Fertilization rate, Pregnancy rate, Premature LH surge, mild and moderate OHSS, abortion rate and Cost effectiveness. Conclusion: Use of Progestin – Primed ovarian stimulation is safe , effective less cost, less complications with better reproductive outcomes compared to GnRH – antagonist Protocol
       
  • Serum Levels of Nitric Oxide in Lichen Planus Patients

    • Abstract: Background: Lichen planus (LP) is an inflammatory condition characterized by the presence of little raised lesions on the skin, mucous membranes, hair, and nails. The overall prevalence is around 1% of the population.Aims and objectives: To evaluate serum nitric oxide (NO) levels in LP and its relation with LP symptoms and duration and the course of the disease.Patient and methods: This case-control research involved 20 Egyptian subjects who were recruited from the Outpatient Clinic of the Dermatology and Venerology department, Minia University Hospital from the first of June 2022 to the end of January 2023. They were divided in 2 equal groups; group I included 10 patients with LP and the other 10 subjects served as age-matched normal volunteers.Results: There was a statistically significant greater levels of NO in cases with LP when compared with the control group. NO serum level correlated with symptoms, severity as well as the duration of the disease.Conclusion: The properties of NO in the stimulation mechanism of lymphocytes and the cellular immune system closely resemble the development of LP. NO may potentially contribute to the development of LP. Consequently, the utilization of antioxidant medications might be regarded as a potential therapy for LP.
       
  • The use of anterior subcutaneous internal fixation (INFIX) for treatment
           of pelvic ring injuries: clinical outcomes.

    • Abstract: Background: Pelvic injuries constitute 2% of all orthopaedic hospitalisations and are linked to elevated death rates. They need a reliable stabilisation rather than an anatomical stabilisation. Therefore, the function of internal fixation (INFIX) becomes relevant, as it offers a secure internal fixation method without the complexities that occurs with reduction and external fixation.patients and methods: The trial will include 40 patients who have injuries in the pelvic ring, classified by Young and Burgess classification and AO/OTA classification . These patients will be treated using the anterior subcutaneous pelvic INFIX technique for the anterior ring and two screws for the posterior ring. The patients were monitored for a duration of six months and assessed based on the Majeed score. Results: Patients who had INFIX surgery for pelvic ring injuries saw a significant improvement in functional outcomes, including the ability to sit, stand, return to work, engage in sexual intercourse, and tolerate discomfort. The majority of patients exhibited an average Majeed score of 78, indicating a stable bone union within six months and a complete range of motion. Furthermore, these patients did not have any difficulties in their daily professional activities.Conclusion: INFIX offers a reliable method of internally stabilising pelvic fractures, resulting in favourable functional outcomes, while avoiding the drawbacks associated with external fixation or open reduction with plates.
       
  • Value of LDH in Lymphoproliferative disorders

    • Abstract: Both the lymphatic tissues (as in lymphoma) & the bone marrow (as in leukaemia & myeloma) may be the site of lymphoproliferative diseases. Depending on the type & other personal circumstances, the course of the disease & its treatment can differ significantly. Subjects & methods the research carried out on60 patients, divided into3 groups, group I: 20 ALL patients, group II: 20 CLL patients and 20 NHL patients. Each patient was subjected to complete history taking, clinical examination, laboratory investigations in the form of routine investigations; CBC, LDH. Bone marrow aspiration, Immunophenotyping on bone marrow samples defined by Flowcytometer for routine panel of B cell lymphoid disorder. Results: significant statistically (p-value = 0.008) Age & LDH have a negative connection (r = - 0.59). Significant statistically high (p-value < 0.001) Correlation among lymph percentage & LDH is negative (r = - 0.74). Positive association (r = 0.58), statistically significant (p-value = 0.008) among lymph & LDH (abs). Positive correlation (r = 0.67), statistically significant (p-value = 0.002) among peripheral blast & LDH. Following therapy, there had been a positive correlation (r = 0.51) among peripheral blast & LDH that had been statistically significant (p-value = 0.024). Conclusion: LDH level act as valuable markers for managing lymphoprolieferative disorder. Its clinical applications can guide treatment strategies for this disease.
       
  • Carbapenem resistant strains of Pseudomonas aeruginosa among patients in
           Minia university hospitals

    • Abstract: Abstract: Background: Pseudomonas aeruginosa is a common cause of hospital-acquired infections. Carbapenems are β-lactam antibiotics with a wide-ranging antibacterial effect. Carbapenems are the most dependable last option for treating infections generated by multidrug-resistant pathogens Carbapenem resistant P. aeruginosa (CRPA) isolates are increasingly observed. has emerged as a prominent global public health issue. Aim of the work: To detect the presence of carbapenem resistant P. aeruginosa in different wards of Minia University hospitals. Methods: From August 2022 to January 2023 carbapenem resistant P. aeruginosa was isolated from different clinical specimen received to clinical microbiology unit, minia university hospital. And the minimal inhibitory concentration of meropenem & imipenem were detected by VITEK-2.Results: 167 P. aeruginosa isolates were recovered. CRPA were 45 isolates (26.9 %). Most of CRPA isolated from patients of ICUs (55.8%) and the urine specimens were the highest specimen from which CRPA isolated. Conclusion: high level of carpabenem resistance among P. aeruginosa in our medical setting.
       
  • Brain MRI in Children with Autism Spectrum Disorder

    • Abstract: Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in early childhood, its key features are deficit in social communication and social interaction accompanied by restricted and repetitive behaviors. Numerous non-invasive imaging techniques have been developed to identify the distinctive brain features of ASD. Some researches revealed high frequency of minor abnormalities/variations on brain MRIs of autistic individuals.Objectives:evaluation of brain MRI abnormalities/variations in relation to ASD symptoms and severity.Patients and methods: This study included 50 children diagnosed with ASD according to DSM-5 diagnostic criteria, they had follow up visit to Pediatric Neuropsychiatric Clinic at Minia University Children Hospital, from January 2023 to January 2024. All patients were subjected to complete medical history, thorough clinical examination, evaluation of autism symptoms severity by The Gilliam Autism Rating Scale–Third Edition (GARS-3), and brain imaging through 3Tesla brain MRI diffusion.Results: Most children with ASD had normal MRI findings. The most common normal MRI finding/variant in these children were benign enlargement of the subarachnoid space and persistent cavum septum pellucidum. Gilliam total score, social interaction and communication scores were significantly higher in autistic children with Mega cisterna magna in MRI brain, while stereotyping score was higher in children with benign enlargement of the subarachnoid space.Conclusions: Brain MRI may be useful in ASD to determine the severity of symptoms. It may be beneficial for future research on determining the etiology/pathogenesis of ASD. Brain MRI may be useful in identifying early presymptomatic ASD children.Keywords:Autism, Children, MRI findings, symptoms, and severity.
       
  • The Role of EMERGENCY CERVICAL CERCLAGE VERSUS CONSERVATIVE MANAGEMENT IN
           PREVENTION OF PRETERM LABOR

    • Abstract: Aim and objectives; to evaluate the outcome of emergency cervical cerclage in preventing pre term labor and second trimestric miscarriage compared with conservative management in MUMH. methods : Clinical and demographic data, gestational age at cerclage, interval between cerclage and delivery, gestational age at delivery, birth weight, and other relevant information were retrieved from medical records. The factors that could impact the outcome were examined.Result: The study included forty pregnant women ranging in gestational age from twelve to twenty-four weeks. Cerclage was performed at an average gestational age of 21 weeks. Intervals between cerclage delivery were 46 days on average. Neonatal weight at birth was 1341 gm, and the average gestational age was 27 weeks. While there was a statistically significant difference in gestational age at delivery and neonatal birth weight, there was no difference in the cerclage-delivery interval regardless of whether the cerclage was performed before or after 20 weeks. A dilated cervix greater than 3 cm, symptoms, membranes passing through the cervix, or an infection are all risk factors for failure.Conclusion: Patients with cervical incompetence can benefit from emergency cervical cerclage in two ways: it can lengthen the pregnancy and it improves the newborn outcome. Nevertheless, it is advised to conduct large-scale randomized controlled trials in the future.
       
  • Visual acuity evaluation of patients of Behcet disease on adalimumab

    • Abstract: AbstractIntruductionBehcet uveitis (BU) is one of major criteria of Behcet disease (BD) that end in macular structural damage.(Yalçındağ, Temel, Şekkeli, & Kar, 2021) Adalimumab (ADA) , which is an anti-TNF alpha biological drug, has proven higher safety in controlling Behcet uveitis over traditional treatment.(van der Houwen et al., 2023)Aim of studyEvaluation of visual acuity (VA) in patients of BD on adalimumab.Patients and methodsThe study was a case control study. The study included 60 eyes from 60 BU patients that divided into 2 groups. The study was conducted at Ophthalmology department, Minia University Hospital in Egypt between february 2023 and August 2023.ResultsPatient on ADA therapy is very effective in recovery of Visual acuity in BU. This makes ADA has higher preference for achieving better visual prognosis in patients of BU rather than traditional therapy.Conclusion ADA is better as a first line of therapy in patients of BD associated with uveitis.
       
  • High caloric carbohydrate diets promote disturbed metabolic milieu and
           induce renal injury in albino rats

    • Abstract: BACKGROUND: Carbohydrates are essential components for a healthy diet; however, they have been found to be harmful if consumed in excess. Type of carbohydrates consumed has an imperative influence on health according to how rapidly they elevate serum glucose level besides its amount as well. Thus, the rationale of the current study is to compare the influence of two different types of high caloric carbohydrate diets, namely: starch and sucrose, on glycemic control and consequently, affection on the metabolic milieu, pancreatic and renal architecture.METHODS: Adult male albino rats were divided into 3groups: Control group, starch group, and sucrose group. Food intake, body mass index (BMI) and visceral fat amount were estimated. Serum lipid profile, total antioxidants (TA), malondialdehyde (MDA), insulin resistance and sensitivity tests (HOMA-IR, HOMA-β), interleukins (IL-6, IL-10), pancreatic amylase, urea, creatinine, and adiponectin/leptin ratio were measured. Histopathological examination of pancreas and kidney with H&E stain, Masson’s trichrome stain, and immune-staining for Nuclear Factor Erythroid-2-Related Factor-2 (Nrf-2) were assessed.RESULTS: Starch and sucrose groups showed significant higher food intake, BMI, visceral fat, pro-inflammatory markers, pancreatic amylase, insulin resistance, disturbed renal function and dyslipidemia, and deficient anti-inflammatory markers and insulin sensitivity compared to control group with disturbed pancreatic and renal integrity. Starch group showed the significantly worst results.CONCLUSION: Though carbohydrates are an essential nutrient in everyday diet, the type and amount of carbohydrates consumed should be considered carefully.KEYWORDS: High carbohydrate diet, sucrose, starch, glycemic index, insulin sensitivity
       
  • Diagnostic utility of serum procalcitonin in ventilator-associated
           pneumonia in the pediatric intensive care unit.

    • Abstract: Abstract: Background: Mechanical ventilation is a respiratory support system that works as a lifesaver for critically sick children in pediatric intensive care units. Ventilator-associated pneumonia (VAP) is a serious infection and one of the most common complications of mechanical ventilation. VAP remains a challenge to pediatricians in diagnosis due to variable clinical criteria and the lack of discriminative diagnostic tests. Delayed VAP diagnosis can lead to increased risk of morbidities and mortality. Objective: To evaluate the diagnostic utility of serum procalcitonin (PCT) in ventilator-associated pneumonia among mechanically ventilated pediatric patients, clinically exhibiting signs of VAP in pediatric intensive care unit. Methods: This is a prospective observational study that was conducted on 165 pediatric patients who were subjected to mechanical ventilation; 80 cases diagnosed with ventilator associated pneumonia (VAP-positive) and 85 cases negative for VAP (VAP-negative). Results: Serum PCT was elevated in VAP-positive group (3.67 ± 2.4 ng/ml) compared to VAP-negative group (1.72 ± 2.43 ng/ml) with statistically significant difference (P<0.001). Conclusion: Serum procalcitonin is a valuable biomarker to be considered in the provisional diagnosis of ventilator-associated pneumonia in pediatric patients on mechanical ventilation that have a suspicion for VAP.
       
  • Clinical Scores can predict mortality in septic patients in icu

    • Abstract: Background: Sepsis was a significant contributor to death in Intensive Care Units globally (1). There was a scarcity of information concerning early indicators that can predict death and morbidity (2). Methodology: A research was done on adult cases who entered to the medical Intensive care unit with severe sepsis. The first outcome was the death between studied cases; scores measured on admission were the secondary outcome. Demographic and clinical data were collected at the beginning of the trial. Results: between the all of 91 patients, the mortality rate was 63%. The analysis revealed that individuals over the age of 60, experiencing high scores on (APACHE) II , sofa and NUTRIC score assessment scales were factors related with increased mortality.In conclusion;The study revealed a death rate of 63% among patients diagnosed with extreme infection. Severely septic individuals having an APACHE II score greater than 25, SOFA score greater than 8.5 and NUTRIC score more than 5 on entrance to intensive care unit were appeared to be with great chance of mortality. Identifying the factors that predict mortality at an early stage should allow us to intervene appropriately in order to increase the chances of surviving severe sepsis.
       
  • comparative study about outcome of posterior cervical laminectomy with and
           without lateral mass fixation

    • Abstract: Background: Cervical spondylotic myelopathy(CSM) is a common disease in neurosurgery.Aim and objectives: To compare multilevel cervical laminectomy with and without lateral mass fixation in patients with CSM and the value of each in post-operative rehabilitation.Patients and methods: This is retrospective study that included 30 patients with cervical spondylotic myelopathy who were admitted to Minia University Hospital between June 2021 and January 2023. Patients were divided into two groups. Group (A)included 15 patients who underwent posterior laminectomy, and group( B) included 15 patients who underwent posterior decompression with lateral mass fixation.Results: The mean age was 55.27 years in posterior laminectomy and 53.67 In posterior laminectomy with lateral mass fixation. There was a statistically significant difference between the studied groups regarding Myelopathy score after 6 months of follow-up (P=0.04). Posterior laminectomy patients with lordotic/straightening/kyphotic sagittal alignment showed no statistically significant difference in Cobb's angle preoperative and postoperative. In posterior laminectomy with lateral mass fixation, patients with lordotic sagittal alignment showed no statistically significant difference in Cobb's angle preoperative and postoperative. Patients with straightening / kyphotic curve showed a statistically significant difference in mean Cobb's angle.Conclusion: Regarding our results, we concluded that in posterior cervical laminectomy with lateral mass fixation group , there was a statistical significance between preoperative and postoperative Cobb's angle for patients with straightening or kyphotic curve, while there was no statistically significant difference between preoperative and postoperative cobb's angle for patients with straightening or kyphotic curve in posterior cervical laminectomy without lateral mass fixation group.
       
  • The effects of mycophenolate mofetil and mycophenolate sodium on kidney
           transplant recipients at the University Hospital for Nephrology and
           Urology in Minia, Egypt

    • Abstract: Aim: The purpose of this research is to examine tacrolimus-based renal transplant patients and compare MMF with MPS..Patients and MethodsThree hundred patients will be enrolled in this case-control research from Minia University Hospital's outpatient clinic.There are two categories of subjects:Group I: Fifty-five individuals undergoing a renal transplant on MPSGroup II: Fifty-five patients undergoing renal transplantation on MFFResults: The p-value (<0.001) indicates that there is a statistically significant difference in BMI and dose between the two groups twice. The p value (<0.001) indicates that there is a statistically significant difference between the two groups in terms of S.Cr and a/c ratio.In conclusion, there was no statistically significant difference in the safety or effectiveness of MMF and MPS. Compared to maintenance MMF dosages, MPS doses were greater. It is possible that immunosuppression will be improved with these greater dosages. There was no discernible difference in the two regimens' efficacies, nevertheless, according to our research. When deciding on a mycophenolic acid derivative, cost should be a major factor.
       
  • Recent Trends in The Management of Meniere's Disease

    • Abstract: Background: Meniere's disease is a chronic illness affecting the quality of life and productivity of patients with minimal diagnostic tools available, limited options of treatment and a lot of follow up difficulties. we discuss old and recent tools helping in the diagnosis and the treatment of Meniere's disease.Aim of the study: Discussing recent modalities in the management of Meniere's disease including diagnosis, treatment and follow up.Methods: A literature review of recent tools in the management of Meniere's disease.Conclusion: Post contrast magnetic resonance imaging of endolymphatic hydrops is a very important diagnostic tool in the definite diagnosis of Meniere’s disease and we should consider intratympanic injection of gadolinium as another tool of contrast delivery in cases with no contraindications to this method. Follow up for Meniere’s disease cases is so substantial in the management of these cases so recent mobile applications helping in that should be put into consideration. Another field that light should be directed to is the regeneration of vestibular hair cells, also this field is still under research but it has a very essential role in the treatment of Meniere’s disease and more researches should be directed to this scope.
       
  • The Prevalence of liver steatosis post liver transplantation

    • Abstract: Introduction: After liver transplantation , non-alcoholic fatty liver disease (NAFLD) may develop as a recurrence or as de novo hepatic steatosis. It is unknown how the recurrence may affect the graft and patient outcomes. There is insufficient evidence to support its lack of effect on patient and graft survival.Aim of the study: Identify prevalence of denovo or recurrent NAFLD in the post-transplant populationMaterials& Methods: This is an observational cross sectional study ,during September 2021 to May 2023.This study included all recipients of living donor liver transplantation (LDLT) at Ain Shams center for Organ transplantation (ASCOT) , Ain shams university. All patients were conducted to detailed history, clinical examination, routine laboratory investigations in addition to abdominal ultrasonography. Transient elastography was done for positive US finding.Results: we depended on imaging abdominal Ultrasonography and transient elastography and we found 36 patients among 150 patient visited outpatient transplant clinic within 18 month have steatosis. Seven of them (19%) underwent to LT because of NASH related cirrhosis and the rest of the patients ( 81%) have de novo steatosis. Conclusion: liver transplant recipients have a significant risk of de novo or recurrent graft steatosis and fibrosis.
       
  • " Management of Surgical Scars by Microneedling "

    • Abstract: Abstract:Background: For unexplained reasons, surgical scars are specific to humans and do not exist in other animals. Excessive collagen synthesis and deposition by fibroblasts results in surgical scars. The current study's objective is to compare the effectiveness of microneedling alone to its use combined with platelet rich plasma (PRP) in the treatment of surgical scars.Methods: The present study included 20 patients suffering from disfiguring surgical scars seeking for better cosmetic appearance. Patients were divided into 2 equal groups: group I (microneedling only) and group II (microneedling plus PRP).Results: Clinical improvement was statistically significantly higher in group II; 42.1 ± 18.0% vs. 31.6 ± 8.3%, p= 0.05. Mild, moderate and good cases among group II were 2 (20.0%), 5 (50.0%) and 3 (30.0%) respectively vs. 4 (40.0%), 6 (60.0%) and 0 (0%) in group I respectively (p= 0.04). Conclusion: For the treatment of surgical scars, microneedling combined with PRP works better than microneedling alone.Keywords: Micro-needling; PRP; Surgical Scars
       
  • Cardiovascular risk in psoriatic patients Relation to disease activity

    • Abstract: Background: Increased cardiovascular risk and subclinical atherosclerosis are linked to psoriatic illness. For the assessment of subclinical atherosclerosis (SA), carotid ultrasonography is helpful. Aim of the work: Determining the carotid intimal thickness (IMT) in individuals with psoriasis (PsO) who do not have cardiac disease. Patients and methods: Thirty healthy sex and age-matched controls and thirty PsO cases were included in this investigation. The carotid IMT was evaluated. SA was characterized by the presence of plaque and/or IMT >0.9 mm. The Psoriasis Area and Severity Index (PASI) was used to measure the disease activity in psoriasis. Body mass index, blood pressure, waist circumference, and lipid profile estimation were performed on all patients and controls. Results: PsO patients were 43.46 ± 13.94 years old on average, with 43.3% of them being female. IMT was 0.47±0.06 mm in control and in PsO (p<0.0001). In PsO, CIMT was substantially correlated with age (p<0.0001), disease duration (p=0.001), and PASI (p=0.001). Conclusions: In psoriatic disease, subclinical atherosclerosis has been connected to both disease activity and severity.
       
  • Assessment of PTH in different treatment strategies for secondary
           hyperparathyroidism in haemodialysis patients

    • Abstract: Background:Chronic kidney disease (CKD) is further compounded by the presence of either one or a combination of biochemical abnormalities, such as inappropriate calcium,phosphate,parathyroid hormone,or vitamin D metabolism.Additionally,CKD is associated with bone abnormalities,including abnormal bone turnover,mineralization,volume, linear growth,or strength.Furthermore,CKD can lead to the development of vascular or other soft tissue calcification. In recent times, there has been an increased understanding of the underlying pathophysiology, which has shown a more intricate nature. It has been discovered that fibroblast growth factor 23 (FGF23),a-Klotho,and the Wnt-b-catenin signaling pathway also have significant involvement in this process.Aim of work:to assess PTH in different treatment strategies for secondary hyperparathyroidism in haemodialysis patients Patients and Methods:We selected our patients from renal dialysis unit at El-Minya and Aswan university hospital.We divided them into 4 groups: Group 1:20 patients undergo parathyroidectomy.Group 2:10 patients who receive calcimimetics. Group 3:10 patients who receive phosphate binders(sevelamer).Group 4:10 patients who receive vit D analogues (Alfacalcidol). Results: there was significant decrease in serum parathormone level in group I in comparison with other groups in all serial measurements as intial level of parathormone was 1755.0 pg/ml,1225.0 pg/ml,820.0 pg/ml,813.5 pg/ml in goup I,II,III and IV respectively.Also there was significant decrease in serum parathormone in all groups in serial measurements.Conclusion:There has been a substantial expansion in the range of treatment options for managing renal hyperparathyroidism,and in most cases,these drugs can effectively regulate PTH levels.Nevertheless,there is currently insufficient evidence to support the notion that these interventions have substantial positive effects on critical clinical outcomes,such as fracture prevention,cardiovascular events,or survival.
       
  • Study of mineral and bone disorders in Minia University Hospital dialysis
           patients

    • Abstract: Background: Chronic renal disease-MBD is characterized by irregularities in the metabolism of calcium, phosphorus, PTH, or vitamin D, and abnormalities in mineralization, bone turnover, and the calcification of soft tissues or blood vessels (1). Serum parathormone or bone-specific alkaline phosphatase measurements can be utilized to evaluate bone disease, as elevated or diminished values indicate underlying bone turnover (2). Methods: The study included ninety patients with end stage renal disease (ESRD) undergoing regular hemodialysis at the hemodialysis unit at El-Minia University Hospital. After obtaining informed consent, laboratory tests conducted, including a complete blood count, blood sugar, lipid profile, CRP, blood urea, serum creatinine, albumin, total calcium, phosphate, bone specific alkaline phosphatase, and PTH level evaluation. Results: Hyper-parathyroid bone disease was prevalent in 23.3% of the studied patients and low parathyroid level in 10% of the studied patients and Serum calcium and bone-specific alkaline phosphate levels show high significant correlation with PTH level. Symptoms of MBD were common in both low and high bone turnover populations. According to the study, 57% of the individuals had hypocalcemia. In 66.7% of the patients, PTH was within the regulated range. Conclusion: Depending on abnormal PTH levels (23.3% of patients with high PTH levels and 10% with low PTH levels), the percentage of MBD among the HD patients under study was 33.3%. The majority of patients with low PTH levels had high serum Ca and low bone specific alkaline phosphatase. Patients with high PTH levels had low serum Ca and high bone specific alkaline phosphatase.
       
  • Effect of Sacubitril/Valsartan on heart rate turbulence in patients with
           heart failure with reduced ejection fraction

    • Abstract: AbstractBackground: HRT is noninvasive tool that predicts sudden cardiac death and arrhythmic events in patients with heart failure with reduced ejection fraction Aim: the current study aimed to know the effect of sacubitril / valsartan drug (Entresto) on the (HRT) in the patients with heart failure with reduced ejection fraction (EF ≤ 35 %).Methods: We included 42 patients with heart failure with reduced ejection fraction (EF ≤35 %). Patients with normal sinus rhythm and at least 5 PVCs fulfilling the criteria for measurement of HRT in Holter.A comparative study was done between HRT parameters before and 3 months after sacubitril / valsartan treatment. Results: We found that HRV index, mean HR, Maximum HR and total number of beats in 24 hrs. were improved after 3 months of sacubitril/ valsartan treatmentHRT score did not improve but it predicted development of complications .Conclusion: Although HRT score did not improve after 3 months of sacubitril/ valsartan, HRT could predict development of complications such as sudden death , VT , Runs of salvos and PVCs more than 10% .
       
  • (APACHE II score, Mortality and length of ICU stay in patients with
           systemic inflammatory response syndrome)

    • Abstract: Background: sepsis is a life-threatening disorder involving disseminated organ injury due to systemic inflammatory response that mediate direct tissue injury.Aim and objectives: The major objective of this research is to identify factors that increase the risk of death for intensive care unit survivors. Finding out what factors influence these patients' length of time spent in the intensive care unit (LOS) is a secondary objective.Patients and methods: This observational study was conducted on 53 patients at Minia University Hospitals, intensive care unit. Results: The positive connection between APACHE II and duration of stay in the intensive care unit was statistically significant.Median of APACHE II was 6 with IQR (3-9). Median of ICU stays was 6.5 with IQR (5-8). Mortality rate was 13%. At cut off point >9.5, Sensitivity was 85.7% and specificity was 87% in APACHE II score for prediction of mortality with highly statistical significance.Conclusion: APACHE II score has a benefit predictive role in detection of mortality in systemic inflammatory response syndrome (SIRS) patients with 85.7 % sensitivity and 87 % specificity with highly statistical significance.Key words: APACHE II score, Mortality, systemic inflammatory response syndrome, ICU stay. 
       
  • Estimation of Gestational Age by Using Fetal Kidney Length and
           Transcerebellar Diameter in Comparison with Other Biometric Indices

    • Abstract: Background and aim of the work:Physicians need precise estimates of gestational age in order to plan for accurate management.Ultrasound measurements,such as(BPD),(HC),(AC),and(FL),throughout the second and third trimesters,lack high reliability.Research on the association between gestational age and the length of(FKL)and(TCD)has shown a strong correlation.We sought to evaluate the precision of FKL and TCD measures in estimating the GA in comparison to other fetal biometric markers.Methods:This study was a prospective observational study carried out at the prenatal and fetomaternal clinics of Minia Maternity University Hospital in Minia,Egypt.The study took place from March to September 2023.The study comprised a sample of 77 women who had normal,uncomplicated pregnancies with a single fetus.The women had measurements of the right and left kidneys,(TCD),and other fetal biometric indices,recorded in millimeters and weeks,and mean values were documented.GA was determined by last menstrual period (LMP).Results:The average age of the women included in the study was 27.13±5.31 years,with a range of 18-40 years.The median number of pregnancies and abortions were 2 and 3,respectively.The range for pregnancies was between 0 and 6 times,while the range for abortions was between 1 and 9 times.The majority of cases(80.5%)had a cephalic presentation. Gestational age(GA)exhibits a strong positive connection with many fetal indices,including(FKL)and(TCD)measurements(p<0.001).Strong positive connection was found between GA and the predicted age determined by MFKL and TCD in millimeters(r= 0.885;p<0.001 and r=0.966,p<0.001)respectively.Conclusion:Based on the current findings,it can be concluded that;MFKL and TCD can serve as reliable new indicators for estimating gestational age, particularly throughout the second and third trimesters (19 to 39 weeks) of pregnancy.
       
  • Thyroid-Stimulating Hormone Levels in Non-Alcoholic Fatty Liver Disease:
           Implications for Type 2 Diabetes Risk and Adiponectin Association in
           Euthyroid Subjects

    • Abstract: Background: The regulation of body weight, lipid metabolism, and insulin resistance is entirely dependent on thyroid hormones. Thyroid hormones are therefore thought to be involved in the pathophysiology of non-alcoholic fatty liver disease (NAFLD). Aim: the aim of this study was biochemical evaluation of serum thyroid stimulating hormone (TSH) and serum Adiponectin levels in non-alcoholic fatty liver disease (NAFLD), euthyroid subjects as a risk for T2DM.Patient and methods: a prospective study was held in Internal medicine department and clinical pathology department. The study lasted from March 2023 to December 2023, 82 subjects were collected from outpatient clinic, divided into three groups, first group 24 fatty liver only patients, second group24 fatty liver and type 2 diabetic patients, 34third control group.Serum TSH, also Adiponectin were assessed in the three groups.Results: TSH levels exhibited significant differences among the groups (p < 0.001). Post-hoc analysis indicated a significant increase in TSH levels in NAFLD and type 2 diabetic group compared to NAFLD only group I (p value < 0.001) and control group (p value< 0.001).Serum Adiponectin level was significantly lower in type2 diabetic and NAFLD patients in comparison with NAFLD only group with (P value <0.003).Conclusion: Prominent increase in thyroid-stimulating hormone concentration and decreased adiponectin level can be additional risk factors for the development of type 2 diabetes in fatty liver euthyroid subjects.Keywords: NAFLD, type 2diabetes, (TSH) Thyroid stimulating hormone.
       
  • Can uterine artery Doppler Be used to Predict Placenta accreta Spectrum
           disorders (PAS-disorders) in patients with placenta Previa'

    • Abstract: AbstractBackground: Placenta accreta is a disorder in which there is adhesion of a portion or the entire placenta to the uterine wall. Massive bleeding after placental separation, which can result in shock, renal failure, adult respiratory distress syndrome, and even death (1). The aim of the study is to evaluate the value of uterine artery Doppler velocimetry in Suspecting placenta accreta spectrum in patients with placenta previa. Methods: Between January 2023 and December 2023, a cross-sectional observational study was conducted at Minia Maternity University Hospital's Department of Obstetrics and Gynecology. 50 pregnant women with placenta previa were included . Patients underwent a thorough history taking, an ultrasound examination, and a color Doppler.Results: The mean age of cases was 31.6 ± 4.3, ranging from 22:41 years and 78% had average BMI.The mean PI of uterine artery Doppler in PAS cases was 0.73±0.16, and the mean RI was 0.52±0.14. The mean PI of the non-morbidly adherent placenta was 0.87 ±0.40, and the mean RI was 0.62±0.30. Conclusion: color Doppler and grayscale ultrasonography are useful tools for diagnosing placenta accreta. The uterine artery Doppler may be able to predict placenta accreta.
       
  • Diagnostic value of Lung Ultrasound for pneumonia in critical care
           Patients

    • Abstract: BACKGROUND: Pneumonia is a significant global health and economic issue that impact on morbidity and mortality. AIM: We conducted this study to estimate the value of lung ultrasound in diagnosing pneumonia in critical care. METHODS: This study was conducted on 60 patients hospitalized to ICU at Minia University hospitals between October 2022 and September 2023. These patients were suspected to have pneumonia based on their medical history and physical examination. written consent was obtained from each patient. All patient underwent assessment of CURB-65 score, chest X-ray (CXR), Lung ultrasound (LUS) and Computerized tomography (CT) chest scan, that was considered as the definitive diagnostic imaging. The patients were subsequently categorized into two groups based on the CT report diagnosis: 50 patients in the positive pneumonia group and 10 patients in the negative pneumonia group. RESULTS: The study sample had a mean age of 57.6 ± 14.7 years, with 46.7% being men and 53.3% being females. Employing a CT chest scan as a benchmark imaging technique to authenticate the diagnosis of pneumonia. The LUS test had a sensitivity of 80%, specificity of 40%. The CXR had a sensitivity of 70%, specificity of 50%for detecting pneumonia. CONCLUSION: Compared to bedside CXR, lung ultrasound was determined to be a superior and more dependable method for identifying pneumonia. Bedside LUS is a beneficial alternative to CT scan in situations where doing a CT scan is challenging. Recommendation: Pneumonia in ICU could be diagnosed and followed-up by LUS.
       
  • Efficacy of uniportal video-assisted thoracoscopic surgery for initial
           treatment of early pleural empyema .

    • Abstract: Background: Pleural empyema is a serious disease. For the majority of patients with advanced empyema, surgery is the standard treatment. Video assisted thoracoscopic surgery (VATS) is a minimally invasive surgical procedure that allows visualization of the pleural cavity through small incisions. Uni-portal VATS (U-VATS) offers many advantages over traditional open thoracotomy and multi-portal VATS.Objective: To evaluate the efficacy of U-VATS for the initial treatment of early pleural empyema.Patients & Methods: This prospective study included adult patients with early stage empyema (stages I and II) who underwent initial drainage and debridement with U-VATS procedure at our institutions.Results: The average age of the 30 patients was 37.73±15.23 years, and there were 1.5 times as many males as females. All of them received U-VATS for stage I and II empyema. Diabetes mellitus and chronic obstructive pulmonary disease were the most prevalent co-morbidities. Eighty percent of patients had a sickness duration of two weeks or less. No one died, and no thoracotomy was necessary. Ten percent of patients needed further procedures (debris removal or drainage) following U-VATS. No problems arose after surgery for the vast majority of individuals (83.3%). On average, patients spent 6.23±2.2 days in the hospital.Conclusion: The first U-VATS is a risk-free and successful treatment for individuals with mild to moderate empyema. Additional comparative research involving multiple centers are advised.
       
  • Lateral versus central approach in dissecting urinary bladder during
           cesarean section in placenta accreta spectrum: case control study

    • Abstract: Injury of the urinary bladder is a prevalent complication associated with cesarean sections. Multiple cesarean sections, placenta previa (PP), and any form of Placenta accreta spectrum (PAS) disorders are recognized as a significant risk factors for urinary tract injuries after cesarean birth.Aim: To compare the urological outcomes of lateral and classical central urinary bladder dissection, in placenta previa and PAS cases.Methods: A case controlled study included patients suspected to be PAS disorders based upon ultrasound findings (2D and color Doppler ultrasound) was conducted.All recruited patients were subjected to caesarian delivery with 2 modalities of bladder dissection; central and lateral approaches.Results: A total of 111 pregnant women suspected with PAS disorders were recruited; 85 females had central and 26 had lateral bladder dissection. Eighty-seven of our patients were placenta previa and 24 were PAS cases; 71-cases with PP were subjected to central bladder dissection and 16 had lateral approach while the placenta accrete cases; 14 had central approach and 10 had the lateral approach of bladder dissection. The urinary system injuries among the PP group was 17% among central group in comparison to 0% among the lateral group with a significant difference between them (P=0.021*). While the urinary system injuries among the placenta accrete group was 21.4% among the central group and 20% among the lateral approach group with no significance between them.Conclusion: Lateral approach of bladder dissection may reduce the incidence of urinary system injuries among PP cases and of lower significance among PAS.
       
  • Visual outcome after YAG posterior capsulotomy in pseudophakic eyes

    • Abstract: AbstractIntroduction :Within the first five years following cataract surgery for uncomplicated senile cataracts, PCO is reported to occur at an incidence of between 3% and 50%. (1) It affects patient satisfaction significantly due to increased light dispersion and decreased visual function.( (2), (3)Aim of study: To evaluate the effect of YAG posterior capsulotomy on visual acuity in pseudophakic eyes with thick posterior capsular opacifications .Patients and methods: Fifty eyes from fifty individuals with substantial posterior capsular opacification (PCO) were included in the study. All cases had YAG posterior capsulotomy; visual acuity was measured before and one month following the procedure, and the results were compared. Results:Preoperative BCVA ranged from (0.10: 0.50) with mean 0.28 ± 0.12SD, while after one month, BCVA ranged from (0.17: 0.67) with mean 0.44 ± 0.16SD. Ther was significant improvement in BCVA (P <0.001) .Conclusion: A safe, non-invasive method for performing a posterior capsulotomy in eyes with pseudophakic defects is the Neodymium-YAG laser . that results in improvement of visual acuity and patient satisfaction.
       
  • Is Metabolic Associated Fatty Liver Disease Common in Chronic Kidney
           Disease Patients'

    • Abstract: Introduction: Metabolic associated fatty liver disease (MAFLD) chosen as a term to encompass fatty liver disease and metabolic issues in patients, this illness was called non-alcoholic fatty liver disease. About 10% to 15% of the world's population lives with chronic kidney disease (CKD). Damage to the kidneys, either structurally or functionally, that lasts longer than three months characterizes this progressive disease. The mechanisms that cause both the buildup of fat in the liver and the impairment of the kidneys are interrelated. However, further research is needed to definitively link MAFLD to chronic kidney disease (CKD).Aim of the study:Our objective was to assess the frequency of MAFLD in CKD patients and examine the variables that contribute to the development of MAFLD in these individuals.Materials& Methods: The study we did is an observational cross-sectional study that took place from January to December 2023. The study encompassed a cohort of 108 individuals diagnosed with chronic kidney disease (CKD), all of them were at least 18 years of age and underwent therapy at the outpatient clinic of Renal and Urology Minia university hospital. The patients had a comprehensive assessment, including clinical examination, anthropometric measurements, biochemical analysis, and ultrasound imaging.
       
  • Study of aggressive behavior in Children on regular hemodialysis

    • Abstract: AbstractBackground: Most of CKD children on hemodialysis have a probable psychiatric disorder and poor quality of life which can easily impact the family members’ psychological health.(Panzarino et al., 2022)Purpose: The aim of this study is to asses aggressive behavior in children with chronic kidney disease on regular dialysis and its correlation with children with chronic kidney disease not on regular dialysis.Methods: This is cross sectional study was conducted upon100 children with CKD on regular dialysis aged 6-18 years old (Group I), and100 children with chronic kidney disease not on regular dialysis (group II) who attended the outpatient nephrology clinic& dialysis unit and pediatric nephrology departmentResults: our results show that there was higher frequency of clinical significance of aggressive behavioral disorders in children with CKD on regular dialysis than children with CKD not on regular dialysis.Conclusions: Higher incidence of aggressive behavior was reported in children with CKD On regular dialysis
       
  • Ultrasound of the Vagus Nerve as an indicator of autonomic nervous
           dysfunction in patients with diabetic neuropathy

    • Abstract: AbstractObjective: The goal is to compare the vagus nerve cross-sectional area (CSA) of diabetic patients with polyneuropathy to that of controls and ascertain whether there is a relationship between the two as well as with clinical and laboratory markers. Methods: People with diabetes who had symptoms or indicators of peripheral nerve damage were identified. They were assessed through examination, lab work, and ultrasonography. Both the left and right vagus nerves were imaged at the level of the thyroid gland and at the common carotid bifurcation. Age, sex, and body mass index matched healthy controls were compared to the results.Results: Two sites were used to examine a total of 40 nerves from 20 patients and 60 nerves from 30 controls. Compared to controls, diabetes patients had a smaller vagus nerve (p < 0.01). Regarding the sonographic right vagus nerve CSA at the common carotid bifurcation and thyroid gland, as well as the left vagus nerve at the common carotid bifurcation and thyroid gland, there was a significant difference between the two (p= 0.006, p= 0.001, p= 0.004, p= 0.002), respectively.In conclusion, diabetic neuropathy patients showed a comparatively reduced CSA of the vagus nerve on ultrasonography compared to control subjects, suggesting autonomic affection in those patients. Keywords; Diabetic neuropathy, ultrasonography, vagus nerve area
       
  • Ophthalmic manifestations of Behçet Disease

    • Abstract: Abstract:Objective: to report ophthalmic manifestations of Behçet disease (BD) in a cohort of Egyptian patients.Methods: 60 BD patients (120 eyes) according to the International Criteria for Behçet's Disease were included and screened for ocular affection. Detailed ophthalmic history and examination with a slit lamp and fundus examination were done on all patients even in the absence of ocular symptoms. Results: Ocular affection was detected in 60% of the patients. 8 patients lost their vision, 3 patients had single seeing eye (5%) and 5 patients were blind (8.3%). 33 of the patients had uveitis (55%). Pan-uveitis was the most common form, being acute in 20% and chronic in 11.7%. Anterior uveitis was the second most common, 8 of BD patients had acute form (13.3%) and 4 had chronic form (6.7%). 2 had isolated acute posterior uveitis (3.3%), and no statistically significant difference was detected between male and female BD.Conclusion: Uveitis is the most common ocular presentation in BD. Routine ophthalmic consultation should be done to detect and preserve vision early.
       
  • primary immunodeficiency disorders in infants attending Minia University
           Hospital

    • Abstract: Introduction: Primary immunodeficiency diseases (PID) are a group of disorders of the immune system. (PIDs) are genetically inherited diseases characterized by an increased susceptibility to infections, autoimmunity, lymphoproliferation, and malignancies. PIDs are under-diagnosed, and the registered cases and prevalence are below the estimated numbers, especially in countries with high consanguinity rates. Early diagnosis leads to better outcomes and lower costs because of earlier initiation of appropriate treatment.Objective: To identify the prevalence of various types of primary immunodeficiency disorders in infants at Minia university hospitalsPatients and methods: This study included 40 cases from age 0-2 years diagnosed as Primary Immunodeficiency attending to the Pediatric Rheumatology and immunology out-patient clinic and admitted to inpatient ward in Minya University Children Results: The median age of onset was 13 months, the median age at diagnosis was 11 months, and the median diagnosis lag was 5 months among 40 cases, including 27 (67.5%) male and 13 (32.5%) women. The male-to-female ratio was 2:1. Results revealed that PIDs is common between consanguineous parents (70%) with positive history of sibling died (40%) and history of sibling diagnosed as PID (8%). The most common type was Predominantly antibody deficiencies (PAD) 17 (42.5%) patients with least dominant Disorder of immune dysregulation 1 (2.5%) patient. The most common presentation was recurrent pneumonia (52.5%). The mortality rate was 12.5%.Conclusion: PID cases are present and under-diagnosed in Minia governorate, due to lack of awareness with these cases, history of sibling death were additional significant warning signs in our community.
       
  • The influence of Hydroxyzine Premedication on Preoperative Hemodynamics in
           Pediatric Patients

    • Abstract: BACKGROUND: Hydroxyzine is an antihistamine that belongs to the first generation of H1 Antihistamines and used in medicine for a variety of purposes. It was introduced into the field of anesthesia for a variety of reasons, including its sedative, antiemetic and anti-allergic properties. Therefore, it's critical to understand how hydroxyzine premedication affects hemodynamic changes in individuals, particularly in younger ones undergoing surgeryOBJECTIVES: The objective of this study was to identify the impact of administering hydroxyzine orally before surgery on hemodynamics prior to induction of anesthesia in pediatric patients undergoing adenotonsillectomy. MATERIALS AND METHODS: In a randomized, double-blinded, prospective trial, a total of 60 children, aged 3-10 years old and of both genders were divided into two equal groups. Group A received oral hydroxyzine at a dosage of 1mg/kg, mixed with 10 ml of apple juice, one hour before to the initiation of anesthesia. Group B was administered a 10 ml dose of apple juice as a placebo. The main outcome focused on the impact of hydroxyzine on pre-operative hemodynamic alterations (heart rate, blood pressure, oxygen saturation, and breathing rate) before the administration of anesthetic agents. RESULTS: There is no statistically significant difference between hydroxyzine and placebo as regard pre-operative measured hemodynamics CONCLUSIONS: Oral hydroxyzine by a dose 1mg/kg does not affect pre-operative hemodynamics in pediatric patients undergoing adenotonsillectomy.
       
  • Ocular manifestations associated with Pre-eclampsia

    • Abstract: 1. PreeclampsiaHypertensive disorders in pregnancy include mild, severe preeclampsia and eclampsia with blood disorders as hemolysis, increased liver enzymes and decreased platelet count (HELLP) syndrome. These disorders have a significant effect on multiple organs as heart, liver, brain and kidneys. Also, the eye may be -to a variable degree -included. (Lambert et al., 2014)Preeclampsia causes multiple organ failure, hypertension, proteinuria, and ultimately, maternal death so it is regarded as a serious pregnancy complication. (Kongwattanakul et al., 2018) It occurs in the third trimester of pregnancy. It is distinguished by an atypical vascular reaction to placentation and linked to heightened systemic vascular resistance, increased platelet aggregation, stimulating the coagulation , and malfunction of endothelial cells.(2000)According to the American College of Obstetricians and Gynecologists (ACOG), it is defined as the presence of SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg, values taken in a previously normotensive female patient at least at two different sessions and at least 4 hours apart.(2013)Hypertension and proteinuria are both necessary for diagnosing preeclampsia, although the International Society for the Study of Hypertension in Pregnancy (ISSHP) and ACOG diagnose preeclampsia in the absence of proteinuria in presence of other specific symptoms. (Obstetricians and Gynecologists, 2013, Basques et al., 2018)
       
  • Striae rubra: Demographic study

    • Abstract: Abstract: Background: Striae rubra are prevalent dermatological problem. They are scars or atrophic depressed lines that develop in the dermis as a result of fast stretching over fragile connective tissue. Although striae rarely cause serious physical issues, it can give people suffering from it a great emotional anguish. Aim: The aim of this study is making demographic study for striae rubra. Patients and methods: The current study included a sample of 60 people with striae rubra, 56 females and 4 males who were between the ages of 18 and 40 years old. Results: Females had a greater impact compared to males. The participants were between the age range of 18-40 years with skin types III and IV. The most prevalent factors contributing to the development of striae were obesity and pregnancy. Conclusion: Striae rubrae are bothersome issue that mostly affects young females with dark skin tones. Obesity and pregnancy are the most common causes.
       
  • STUDY OF THE POTENTIAL ROLE OF SLCO4C1 IN ENDOMETRIAL CARCINOMA

    • Abstract: AbstractEndometrial carcinoma (EC) is the second most frequent malignant tumor of the female reproductive system in Egypt. In recent years, the incidence and deaths of EC have been increased. SLCO4C1 is found to have a role in various tumors such as head and neck, renal, ovarian and prostate cancer. In EC, it controls endometrial cancer cells' migration, apoptosis, proliferation, and other traits. This study's objective was to investigate the expression and prognostic role of SLCO4C1 in endometrial lesions. The immunohistochemical expression of SLCO4C1 was examined in 20 cases of atypical endometrial hyperplasia (AEH) and 100 cases of EC tissues. The association between expression patterns of this marker and clinicopathologic parameters was analyzed separately. SLCO4C1 was highly expressed in endometrial cells' membrane and/or cytoplasm of in (70%) of AEH cases and (48%) of EC cases. High expression of SLCO4C1 in EC was associated with lower tumor grade (P = 0.03). These findings suggest expression of SLCO4C1 could declare the use of this marker as an endometrial cancer patients' prognostic markerKeywords SLCO4C1. endometrial hyperplasia, endometrial carcinoma, immunohistochemistry.
       
  • Evaluation of Mean Retentive Values in Three Different Milled Framework
           Material in Implant Supported Mandibular Overdentures: An In Vitro Study

    • Abstract: Statement of Problem:Implant overdentures are an excellent treatment option as they increase stability, retention, improve masticatory function.Various attachment systems used to improve the retention and stability of implant supported overdentures,The bar system plays great role especially with 4 implants design.However the super structure sleeve material is still a point to be chosen carefully.Material&Methods:The aim of this study was to evaluate mean retentive value in three different milled framework attachments(Zirconia Z,titanium T and Peek P frameworks)in implant supported mandibular overdentures using universal testing machine.The study was conducted invitro using a mandibular acrylic model with 4implants inserted in the canine and second premolar regions.Over these implant titanium bar and 3superstructure(Z, T and P)frame works were constructed.The mean retention of each design was measured after periods of simulated use.Results:Two-way ANOAVA showed that significant differences in retention force(N) exist between groups and simulated periods of use(p<0.001). (N) after simulated cycles of insertion and removal to mimic different usage periods were:For P group, immediate at insertion(73.9±7.3)followed by insignificant decrease after 1year(70.3±3.4)followed by 2years(67.5±2. 5)and a significant decrease at 3years(65.0±7.0)compared to immediate at p=0.02.But for T group,3years(27.3±2.6)resulted in significant lowest (N) followed by 2years(33.6±4.2)followed by 1year(44.2±5.3)compared to immediate(56.4±6.2)at p<0.001.For Z group,1year (17.3±2.8) showed an insignificant decrease in(N)followed by 2years(15.3±3.1)and significant decrease at 3years(6.3±0.9)compared to immediate (30.0±4.8)at p<0.001.Conclusion combining of titanium bar with peek sleeve showed the best retention value,Titanium bar with the titanium sleeve showed satisfactory retention values but less and titanium bar with zircon sleeve showed the least retention values.
       
  • Impact of urinary bladder filling on Maternal outcome during surgeries for
           placenta accreta (randomized controlled trial) at Minia Maternity hospital
           

    • Abstract: Background; Placenta accreta spectrum (PAS) is a serious obstetric complication that can cause life-threatening haemorrhage. Previous caesarean sections (CS) and placenta previa are commonly acknowledged as risk factors for aberrant placentation. Preserving the integrity of the bladder boundary is a crucial aspect of the surgical procedure used to address invasive placental diseases. Supplementary techniques, such as infusing the bladder with saline, delivering intravenous dye, are employed to safeguard the bladder or ascertain bladder damage. The main aim of this study was to evaluate impact of filling the urinary bladder during placenta accreta surgery on maternal outcome. Subjects and methods; This prospective randomized controlled study involved 100 patients who were diagnosed with placenta accreta and underwent cesarean section between 1st of Jan 2023 and end of Jun 2023. And presented to the Minia Maternity hospital, Egypt. Patients were randomly divided into 2 groups first group included 50 patients without filling the urinary bladder during placenta accreta surgery and second group included 50 patients with filling the urinary bladder. Result; There was no significant difference between groups as regard demographic data, maternal data, vital signs, and laboratory finding. There was a significant difference between groups as regard incidence of bladder injury, duration of hospital stay, and blood loss. Conclusion; the current study showed that filling the bladder was effective technique and had significant role on prevention of bladder injury during placenta accreta surgery with lower blood loss and lower need for hospital stay than non-filling group.
       
  • Long Term Outcome of Permanent Hemodialysis Catheter in Minia University
           Hospital

    • Abstract: Background:Tunneled dialysis catheters (TDCs) are commonly employed as a temporary solution for hemodialysis (HD) until permanent arteriovenous (AV) access is established. Nevertheless,certain patients may ultimately require prolonged catheter-based hemodialysis as a result of the absence of alternate options for accessing dialysis.Objective:The objective of this study was to assess the results of TDCs and the potential long-term issues that arise during its usage in our hemodialysis patients.Patients and methods:This study examines 86 patients who had TDC implantation for hemodialysis at the nephrology and urology Minia University Hospital from September 2021 to September 2022. The study recorded patients' age,gender,catheter implantation location,reasons for catheter removal,and total catheter days while monitoring for the occurrence of problems.Complications have been classified into early and late.Results:The average age of the patients was 48.8 years, with men comprising 51.2% of the population.The right internal jugular vein was the predominant location for TDC insertion,accounting for 75.6% of cases.Operational TDCs were effectively extracted in over 60.5% of instances once their permanent access had reached maturity. Approximately 34.9% of the patients in the sample had experienced complications.infection has the largest proportion, accounting for 14%.The others experienced complications such as catheter thrombosis, hematoma, and incorrect cannulation. Catheter-related bloodstream infection (CRBSI) occurred in 12 patients (14%).Eight patients (9.3%) experienced mechanical dysfunction that necessitated catheter removal. No deaths were detected as a result of complications associated to the catheter.Conclusion: TDCs serve as the optimal interim solution for hemodialysis until a permanent dialysis access is established or a kidney transplant is performed.
       
  • A comparative study of three methods (pharmacological, mechanical and
           combined pharmacological and mechanical) for indicated termination of
           pregnancy in 2nd trimester pregnancy in women with previous caesarean
           section scared uterus

    • Abstract: Objective:To evaluate efficacy of three regimens for termination of second trimester pregnancy in women with previous caesarean section.Patients and Methods:Clinical comparative experiment was carried out at the prenatal and fetomaternal clinics in the obstetrics & gynecology department of Minia maternity & children University hospital.102 pregnant women in good health,between 14 and 28 weeks pregnant,who had previously had one or more cesarean births and were diagnosed with missed abortion or intrauterine fetal death.And classified into three Groups Group 1 (G-1) vaginal or sublingual misoprostol,Depending on pregenancy duration.Group 2 (G-2) Foley's catheter Insertion,which was then filled with normal saline.Group 3 (G-3) combined misoprostol and Foley's catheter.The primary outcome was (IAI),together with the (standard deviation) needed for full uterine evacuation.Results:No statistically significant disparity (p > 0.05) in the patients' characteristics and baseline data among the three groups.Notable disparity among the three groups regarding IAl.[G-3] had the shortest length,[G-1] had the greatest duration,and [G-2] had an intermediate duration (32.5 +10.9,43.1 ± 17.5, and 36.7 ± 14.8, respectively) (P< 0.013).The success rate was 100% for Group 3, 97.05% for Group 1,and 88.2% for Group 2 (p < 0.03).A significant discrepancy regarding fever,with the highest number of cases (12) recorded in G-1.Hysterotomy needed among G-1,one cases,G-2cases.Conclusion:The concurrent administration of misoprostol and Foley's catheter for the purpose of medically terminating a pregnancy in the second trimester,specifically in women with a previous caesarean section and a uterus that is prone to scarring,has been determined to be more efficacious and secure compared to other methods.
       
  • Utility of CA125 in acute decompensated heart failure

    • Abstract: AbstractBackground: In acute decompensated Heart Failure (ADHF), Signs and symptoms are explained by congestion. Carbohydrate antigen (CA) 125, a tumor marker, is shown to be a surrogate for congestion and inflammation Aim: evaluating the utility of CA 125 in ADHFMethods: We investigated CA 125 compared to NT-proBNP in 70 participants (35 cases and 35 control) . Relationship of CA 125 to complications (Death or rehospitalization for HF) was assessed with its cost effectiveness compared to NT-ProBNPResults: CA 125 was significantly higher in ADHF cases than in controls (mean ± SD 39 ± 12.7 and 7.4 ± 10.8 respectively, At cut-off value 35 , CA125 predicted diagnosis of ADHF with 80% sensitivity, 88.6% specificity, ( p = 0.001 ). Patients with complications showed a higher level of CA 125 compared to uncomplicated patients (mean ± SD 45.9 ± 10.3 and 33.3 ± 11.8 respectively, At cut-off value 41 , CA125 predicted complications with 87.5% sensitivity, 69% specificity (p value 0.001) There was strong positive significant correlation coefficient between CA125 and NT-proBNP in diagnosis of ADHF (r = 0.81) with significant p value <0.05 and moderate positive correlation coefficient between CA125 and NT-proBNP among complicated cases was found (r=0.56) with significant p value <0.05. We found that CA 125 gives same value as NT-proBNP with less cost. Conclusion: CA125 level is high in patients with acute decompensated heart failure and predicts adverse prognosis. CA125 is a cost-effective test.
       
  • Comparison between dexmedetomidine and neostigmine as an adjuvant to
           bupivacaine and lidocaine in peribulbar block for cataract surgery.

    • Abstract: Abstract:Background: Local anesthetics are often injected into the peribulbar region. However, using just local anesthetics is associated with delayed globe akinesia onset, shorter duration of pain relief, and frequent block reapplication requirements. In comparison to a mix of local anesthetics.This research aimed to evaluate the effects of adding dexmedetomidine and neostigmine to local anesthetic in peribulbar block on hemodynamic of patients and quality of the block.Study design: A study that is prospective, randomized, and double-blinded.Methods: Sixty patients were a part of the present study's cohort at Minia University Hospital. A control group had just a local anaesthetic combination; the other two groups were of similar size. Patients were randomly assigned to these groups. In the group given dexmedetomidine, twenty patients were given a dosage of 25µg of the drug in addition to a mix of local anesthetics. Twenty individuals had a combination of local anesthetics and 0.4 mg of neostigmine as part of the Neostigmine group.Results: The three groups showed negligible disparities in terms of hemodynamic metrics. The Dexmedetomidine group exhibited a much faster onset and longer duration of sensory and motor block in comparison to the other groups. The group that received dexmedetomidine experienced considerably better levels of satisfaction among both patients and surgeons.Conclusion: This research revealed that adding dexmedetomidine or neostigmine to the local anesthetic mixture improved the quality of the block and patients and surgeon satisfaction with minimal hemodynamic effects and without changes in the incidence of side effects.
       
  • Study of patient satisfaction with thyroid hormone replacement therapy in
           patients with hypothyroidism

    • Abstract: Abstract:Background: Dissatisfaction with the treatment is a common health problem among all patients on regular treatment which may lead to incompliance, poor quality of life (QOL), psychological problems, and even failure of treatment. Such problem has been reported frequently with Levothyroxine (L4) treatment of hypothyroid patients and lead to the search for alternatives to the gold standard treatment with L4. Objective: We aim at assessing patient satisfaction among hypothyroid patients on thyroid hormone replacement therapy (THRT) at Diabetes & endocrinology Unit, Internal Medicine Department, Minia University Hospital. Methods: In this cross-sectional study 100 patients were included all of them were confirmed hypothyroid cases on L4 treatment aging from 18 to 60 years of both sex, pregnant females and patients with other comorbidities were excluded, we applied a personal interviewer questionnaire designed and tested by the British Thyroid Foundation (BTF) on outpatient hypothyroid patients. Results: We found a relatively high percent of incompliance to L4 treatment (16%) of our studied sample, most of our patients depended on their doctors as the main source of information. The majority of our studied patients were moderately satisfied with their L4 treatment; subjects were offered a score (from 0 to 6) where 0 meant dissatisfied and 6 meant very satisfied. All of the 11 questions in the main questionnaire had a mean answer above 3, and a median (IQR) of 4(3-5). Conclusion: our study suggests that most of hypothyroid patient are moderately satisfied with their L4 treatment with relative high prevalence of incompliance.
       
  • High Prevalence of Subclinical Hypothyroidism in Chronic Kidney Disease
           patients caused by Diabetes and Hypertension at Nephrology & Urology
           Minia University Hospital

    • Abstract: Abstract:Background: Subclinical hypothyroidism (SCH) is becoming a major issue especially among patients with other chronic diseases like chronic kidney disease (CKD), hypertension (HTN), and diabetes mellitus (DM), but yet we have no solid data about the relationship between such diseases. Objective: our objective is to assess the prevalence of SCH among CKD patients and how it might be affected by the underlying cause of CKD at Nephrology & Urology Minia university hospital. Methods: 180 CKD patients aged between (18 and 60 years) all at stages (1 to 4) of CKD from outpatient clinics at our hospital were included. We investigated their thyroid and renal status by history, clinical examination, and laboratory tests. Results: we found a very high prevalence of SCH among CKD patients 48(26.7%) (P <0.0001). Causes of CKD significantly affected the prevalence of SCH: DM was associated with the highest prevalence of SCH (50%) (P <0.001), HTN was also associated with a rather high prevalence of SCH (40%) (P<0.001). While very low prevalence was found in obstructive uropathy, repeated urinary tract infection, congenital causes, G.N, lupus nephritis and others. Conclusion: SCH is highly prevalent among CKD patients especially when the underlying cause is DM or HTN.
       
  • Physical activity in patients undergoing coronary artery bypass graft
           surgery (CABG)

    • Abstract: Background: Worldwide, cardiovascular diseases are the main cause of death, accounting for 25 to 45 percent of all fatalities. Low levels of physical activity pose a serious risk to cardiovascular health. Aim of the study was to determine the physical activity in patients undergoing coronary artery bypass graft surgery. Methods: A hospital-based cross-sectional study was conducted among 210 patients attending cardiothoracic outpatient clinic or were admitted to the internal ward in Assiut university heart hospital, Egypt. Results: Male patients had significant higher mean levels than females regarding; duration of vigorous/ moderate activity per day, duration of walking and using bicycle, duration of vigorous/moderate sports per day (p < 0.0001).The mean duration of moderate activity per week (day) was significantly higher in less than 60 years than in 60 years or more (P=0.002). Conclusion: More than three quarter (77%) of the study population have insufficient physical activity. To overcome this, national awareness campaigns about physical activity should be increased.
       
  • Evaluation of functional outcomes of Studer ileal orthotopic bladder
           substitutions

    • Abstract: Background: The most frequent cancer of the urinary system and the second leading cause of mortality from genitourinary cancers is urothelial carcinoma. The usual course of treatment for high-risk non-muscle invasive bladder cancer (NMIBC) and localized muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC). Methods: This one-armed hospital-based clinical trial study included 12 patients who were subjected to radical cystectomy and Studer ileal neo-bladder substitution at the urology department, Minia University, and Ain Shams University Hospital in the period from January 2022 to January 2023.Results: The mean age in our study was 63 years, with highest incidence in the age group (61:70 years), the mean blood loss and blood transfusion was 1166.5 ml, the mean operative time was 3.6 hours, total diurnal continence was achieved in 7 patients (58.5%) while 4 patients (33.5%) developed stress incontinence, and total nighttime continence was achieved in 5 patients (41.5%). Conclusion: Based on functional outcomes, we determined that Studer neobladder repair is safe in terms of effectiveness.
       
  • Comparative Study Between The Role Of Two Dimensional And Four Dimensional
           Ultrasound In Assessment Of Fetal Central Nervous System Congenital
           Anomalies. Recent update

    • Abstract: Abstract Background and objective: The central nervous system malformation is one of common congenital anomalies encountered in pregnancy. Prenatal diagnosis uses a variety of noninvasive techniques to provide preliminary information on all fetal abnormalities. Four dimensions ultrasound allows visualization of embryonic movements two weeks earlier than 2D ultrasound and it gives the opportunity to explicit detailed fetal anatomy and fetal activity.The outcomes of fetal examination differ based on the timing and proficiency of the assessor. The primary limitation of ultrasonography (US) is in its inability to effectively image certain viewpoints, such as the sagittal mid-plane. This particular view is crucial for obtaining distinctive information about the corpus callosum and cerebellar vermis Methods: This prospective clinical study included twenty patients with gestational age from 18 weeks to 24 weeks examined by 2D ultrasound then examined by 4D ultrasound. Results: positive agreement was found between 2D ultrasound and 4D ultrasound. Conclusion: 4D ultrasound give more information in diagnosis during fetal malformations evaluation especially in illustration of fetal small cranial anomalies and spina bifida.
       
  • Dietary factors affecting control of hypertension in Minia Cardiothoracic
           University Hospital

    • Abstract: Abstract:Background: Uncontrolled hypertension is a major risk factor for global cardiovascular morbidity and mortality, causing an estimated half of the cardiovascular events. The relationship between blood pressure and obesity, excessive or deficient intake of certain nutrients is a subject of great importance. Aim of the study: Assessment of the nutritional status of hypertensive patients and its effect on the control of their hypertension. Methods: This study was a hospital based cross-sectional study among adult hypertensive patients (older than 18 years old) who attended the outpatient clinic in Minia Cardiothoracic University Hospital, in the period from May 2023 until October 2023. Patients were interviewed and the data was collected through a designed well-structured questionnaire including socio-demographic data and dietary assessment of each patient.Results:Total number of patients included in the study was 322 patients. The mean age was 56.9 ± 12.62 years, with (34.2%) males and (65.8%) females. The percentage of uncontrolled hypertension was 34%. There was a significant effect of consuming grains (P=0.001), proteins (P=0.001), sweets (P=0.004), different types of fats (P=0.038), and amount of salt (P=0.001) on the control of hypertension. Conclusion: Dietary factors decreasing the control of hypertension include consumption of grains, proteins, sweets, ghee, hydrogenated oils, and salt. These factors should be restricted in the diet of hypertensive patients to achieve the best possible control.Keywords: Hypertension, control, diet, nutrition.
       
  • Lessons from Maternal Mortality in Cases of Emergency Peripartum
           Hysterectomy at Tertiary Hospital in Egypt (Retrospective Study)

    • Abstract: AbstractBackgroundEmergency peripartum hysterectomy is one of the life-saving procedure that is essential for reducing postpartum haemorrhage deaths, which are a significant factor in maternal mortality rates (1). EPH is a hysterectomy performed during labour or 6 weeks after delivery (during perperium) in the case of persistent obstetric haemorrhage.Aim and purpose of the study This study aimed to analyse cases of maternal mortality associated with emergency peripartum hysterectomy at Minia Maternity University Hospital.Basic proceduresThis study was conducted at Minia Maternity University Hospital From January 2021 to December 2022.It was conducted on 74 emergency peripartum hysterectomy. Main findings The total number of deliveries during the study period was 21978 cases. incidence of EPH was 74 (3.36/1000) cases. Mortality occurred in 6 (8.11%) patients (8108/100,000). Principle conclusionOur study found that increased number of cs, high parity, high BMI and previous Uterine scar increase the prevalence of EPH and hence it's related maternal mortality.
       
  • The relationship between liver and kidney dysfunction with acute
           myocardial infarction

    • Abstract: Background: In both developed and developing countries, coronary artery disease (CAD) is a major public health concern. One of the main reasons people die on a global scale is acute myocardial infarction (AMI). The narrowing or blocking of the arteries that feed blood to the heart muscle as a result of atherosclerosis and its complications, or any other condition that causes an oxygen supply demand mismatch, is what causes coronary artery disease. There are a number of risk factors that can affect the prognosis of coronary artery disease, including arterial hypertension, dyslipidemia, diabetes mellitus, obesity, smoking, and genetic factors. These factors are associated with the injury of endothelial cells and the advancement of atherosclerosis. Unfortunately, diagnostic techniques for CAD prognosis are lacking in both simplicity and efficacy. Aim of the study; In light of this, the present research set out to use the data we gathered from our retrospective analysis to assess the usefulness of liver and kidney function tests in predicting the prognosis of patients with acute myocardial infarction (AMI). Methods: Minya University Hospital's Critical Care Unit accepted 30 patients with acute myocardial infarction. Samples of peripheral venous blood were drawn when the patient was admitted. Fresh samples were tested for liver and kidney function using (FLEXOR Pro XL, ELI Tech, France). Results: There is a strong link between hepatic and renal dysfunction and AMI. Conclusion: The findings supported that hepatic and renal dysfunction were applicable to the prediction of risk in acute myocardial infarction patients.
       
  • R Effect of STZ- induced Diabetes on Retina of Adult Male Albino Rat.

    • Abstract: Background: Vision loss is a possible consequence of diabetic retinopathy (DR), DR is an eye condition linked to diabetes which affect retinal vas-culture. Oxidative stress is the main mechanism of diabetes which causing diabetic retinopathy.Aim of the work: Investigate the retinal effects of STZ-induced diabetes in albino rats.Methods: Twenty rats were divided equally into two groups: the control group and the DR group. Results: The group with DR exhibited a noteworthy reduction in the overall thickness of the retina, along with a disturbed histological structure charac-terized by a destructed photoreceptor layer, visible vacuolation in the nuclear and plexiform layers, and dilated congested blood vessels in the outer nuclear layer (ONL). Also, DR group showed significant increase in blood glucose level compared to control group.Conclusion: STZ-induced diabetes had an apparent damaging effect on reti-nal tissue through hyperglycemia which cause oxidative stress damage and neovascularization.Keywords: DM, oxidative stress, neovascularization.
       
  • 2D & 3D echocardiography assessment before and after balloon
           mitral valvoplasty

    • Abstract: AbstractBackground: When treating individuals with symptomatic rheumatic mitral stenosis, balloon mitral valvoplasty is secure and efficient procedure.Aim: To assess the changes in mitral valve morphology caused by balloon mitral valvoplasty by 2D & 3D echocardiography.Subjects and methods: Fifty patients with mitral stenosis were planed for balloon mitral valvuloplasty and had their mitral valve morphology evaluated using 2D and 3D echocardiography before and after the procedure.Results: Of the 50 patients in the research, 37 were female (74%), and 13 were male (26%). Their ages between 22 and 45, with the mean age was 33.4 ± 7.5 years. We found that there was significant increase in MVA after BMV measured by 2D ,3D echocardiography (P <0.001) and there was significant decrease in pulmonary arterial pressure and left atrium volumes after BMV (P <0.001). Conclusion: Mitral commissural splitting , enhancement of MVA, enhanced leaflet opening and decrease in pulmonary arterial pressure and LA volume are all significant alterations in how the mitral valve is shaped that are linked to BMV.
       
  • Role of flexible fiberoptic bronchoscopy in foreign body retrieval

    • Abstract: AbstractBackground: Foreign body aspiration is more common in children,it is also a life threatening situation that can occur at any age.Patients may have no symptoms,but others may present with achoking event and sometimes inspiratory stridor.Aim of the work: The aim of the work is to evaluate safety and efficacy of flexible bronchoscopy in foreign body retreival.Patients and methods: The study included 30 patients with foreign body aspiration who recruited from chest, departments from AL Kasr El Einy and Minia university hospitals in the period between october2020 to July 2023. Data collected included baseline demographics (age, sex, history of foreign body aspiration or fits ).Results: included 30 patients who had FB aspiration, their age ranged between 1.5 – 29 years with mean value of 8.417 ± 8.079. 26.7% were females and 73.3% were males. Our results showed that regarding the type of used bronchoscopy, all of FB were removed by flexible fibroptic bronchoscope (100%). Most of FB (70%) were removed by Crocodile forceps while the remaining 30% were removed by Dormia basket.Conclusion:flexible bronchoscopy is an effective and safe treatment modality for foreign inhalation.
       
  • Postoperative lumbar discitis, surgical vs conservative management, a
           retrospective study

    • Abstract: Introduction: Spondylodiscitis is a serious intervertebral disc infection that is uncommon but can have devastating effects. Patients under 20 and between 50 and 70 years old have the highest incidence. The annual incidence is between 0.4 and 2.5 per 100,000. Bloodstream infections (such Staphylococcus aureus) and post-operative complications are the two most common secondary causes of spondylodiscitis. Aim of the work: Comparison between conservative therapy and fixation in post lumbar surgery spondylodiscitis Patients and Methods: a retrospective study done on forty patients admitted in neurosurgery department at our hospital, 20 of them underwent surgical fixation while the remaining patients were treated conservatively. Results: the first group was treated conservatively while the second group was treated by surgical fixation (80 % by pedicular screws and posterolateral fusion , while 20% had done PLIF) , Based on the Kirkaldy–Willis functional outcomes criteria 4 (20%), 6 (30), 2 (10%), 8 (40%) patients had excellent, good, fair and poor outcomes respectively in patients who were treated conservatively.In patients treated surgically 13 (65%), 4 (20%), 2 (10%), 1 (5%) patients had excellent, good, fair and poor outcomes respectively. Conclusion: surgical fixation for cases of postoperative lumbar spondylodiscitis gives better and faster results with better functional outcome than conservative management.
       
  • Assessment of best corrected visual acuity in type 2 diabetic patients
           with meibomian gland dysfunction

    • Abstract: Introduction: Meibomian gland dysfunction (MGD)is considered an inflammatory state and a trigger for evaporative dry eye disease (DED) (1).Aim of the study: Assessment of visual acuity in patients with MGD including type 2 diabetic patients.Patients and methods: This was a case control study; the study was conducted on 90 eyes of 90 patients with meibomian gland dysfunction were randomly classified into 3 groups, and assessment of visual acuity was done in each group. The study was done in Ophthalmology department, Minia University Hospital, Egypt between December 2022 to May 2023.Results: There was a significant difference between the 3 groups in best corrected visual acuity (BCVA) in patients with meibomian gland dysfunction, more pronounced in patients with Diabetes mellitus (DM).Conclusion: In patients with MGD, BCVA was affected especially in type 2 diabetic patients. Presence of hyperglycemia leads to MGD and causes evaporative dry eye disease, which consequently leads to poor vision.
       
  • Effect of quetiapine on arterial oxygen saturation on head trauma patients

    • Abstract: ABSTRACTBackground: Traumatic brain injury (TBI) is considered a major global public health epidemic, economic and social issue as it is the main cause of death and disability in most countries.Aim and objectives: To assess and evaluate the efficacy and safety of Quetiapine in the management of agitated behaviors following traumatic brain injury (TBI) and its effect on arterial oxygen saturationPatient and methods: This prospective randomized controlled study conducted on 40 adult patients (divided into 2 equal groups, 20 cases each) aged 18-60 years old with isolated moderate TBI in trauma ICU of Minia University Hospital (MUH) starting from July 15, 2022.Results: There was a substantial variation between the two studied groups as regard arterial oxygen saturation readings which was significantly higher in group Q compared to group C in the 7th and 8th days.Conclusion: Quetiapine was safe and effective in the management of agitated behaviors following traumatic brain injury (TBI) and improvement of arterial oxygen saturation.
       
  • Immunohistochemical Expression of SIX1 in Papillary Thyroid Carcinoma

    • Abstract: Abstract:Background: Thyroid cancer (TC) is the most common type of malignant endocrine cancer and it's ranked as the 10th most common cancer worldwide, and its incidence increases, due to improvement of diagnostic procedures. Papillary thyroid cancer (PTC) is the most frequent type of differentiated thyroid carcinoma. In Egypt PTC subtype represents 85% of all TC cases. SIX1 is expressed in a wide range of normal and neoplastic tissues and it has different pathways in tumorigenesis in different tissues. SIX1 is upregulated in human thyroid cancer cell and promoted cell proliferation and invasion.Aim of the work: this study was conducted to research the association between SIX1 expression and the clinicopathological features of PTC.Material and Methods: Immunohistochemical staining of SIX1 was conducted on 50 randomly chosen tissue specimens of PTC 34 (68%) were classic PTC and 16 (32%) were follicular subtype, that was done by using the avidin biotin-peroxidase complex method with diaminobenizidine (DAB) chromogen detection system.Results: High SIX1 expression was detected in 36% of cases. SIX1 expression showed statistically significant correlation with tumor focality (P= 0.003), lymph node metastasis (P= 0.002), tumor grade (P= 0.002), advanced tumor stage (P= 0.01) assessed by pT staging system, tumor necrosis (P= 0.002), lymphovascular, perineural invasion, and extra thyroidal extension (P= 0.002), (P= 0.01) and (P= 0.001) respectively.Conclusions: SIX1 expression is significantly associated with poor prognostic factors and thus can be used as a prognostic indicator for PTC patients. Key words: SIX1, PTC, Immunohistochemistry.
       
  • Risk of Paediatric Urolithiasis among Children Attending Minia University
           Hospital for Urology

    • Abstract: Background: Paediatric urolithiasis is a significant health problem with considerable morbidity. Over the past decades, the prevalence of pediatric nephrolithiasis has increased due to increased sodium intake, decreased calcium intake, low water intake, increased use of antimicrobials, poor nutrition, obesity, sedentary life style. Aims of study: Assessment of prevalence of paediatric urolithiasis among children attending Minia University Hospital for Urology and determine different risk factors related to pediatric urolithiasis. Methods: This study is a cross-sectional study conducted among children < 16 years old attending Minia University Hospital for Urology during the period from January 2023 to October 2023.children and their parents were interviewed and the data was collected through a designed well-structured sheet included socio-demographic data and clinical data of children Results: Total number of children aged <16 years attending Minia University Hospital for Urology during the period from January 2023 to October 2023 was 1200 children from which 85 children diagnosed with urolithiasis and the prevalence was estimated to be 7%. The mean age was 8.3 ± 4 years with 57.5% males and 42.5% females. Positive family history was 70% of children. There are significant differences between various age groups regarding the clinical presentations , the recurrence rate was significantly higher in males (49%) than females (16%) Conclusions: prevalence of pediatric urolithiasis is estimated 7% in children attending Minia University hospital with positive family history in 70% and rate of recurrence 35% so children with a positive family history should be followed up cautiously to avoid stone recurrence.
       
  • IMMUNOHISTOCHEMICAL EXPRESSION OF HAX1 IN INVASIVE DUCTAL CARCINOMA OF THE
           BREAST AND CORRESPONDING LYMPH NODE METASTASES.

    • Abstract: Background: HAX1 protein comprises a family of ubiquitously expressed proteins ranging in size from ∼26 to ∼35 kDa that result from complex alternative splicing events of the single HAX-1 gene. Hax1 acts as antiapoptotic protein through different mechanisms. Moreover, HAX1 enhances cellular invasion and migration through different pathways.Aim: This study aimed to evaluate the clinical significance of HAX1 expression in invasive ductal carcinoma of the breast and in corresponding lymph node metastasis. Materials and methods: The expression of HAX1 was examined in 70 tumor tissues plus 54 paraffin blocks of corresponding lymph node metastasis by immunohistochemistry. Results: The association between expression of this marker and clinicopathological parameters was analyzed. HAX1 was highly expressed in 47.1% of the cases. HAX1 was positively correlated with larger tumor size (p=0.004), higher grade tumors (P = 0.029), advanced tumor stage (p=0.001), more lymph node involvement (p= 0.028), poor Nottingham prognostic index (P=0.008), PR negativity (p=0.031), HER2 negativity (p=0.024), high Ki67 index (p=0.029) and distant metastasis (p=0.002). As regard HAX1 expression in primary tumor and corresponding lymph node metastasis, 87% of pairs revealed a concordance between the primary tumor and corresponding lymph node metastasis and only 7 cases (13%) were nonconcordant and the results were statistically significant (p=0.001).Conclusion: These findings suggest that HAX1 expression can be considered as a poor prognostic and therapeutic marker for targeted therapy of breast cancer patients.
       
  • The possible effects of Zinc sulfate on adult rat olfactory mucosa. A
           histological study

    • Abstract: Abstract:Background: Zinc (Zn) is a well-known trace element that helps regulate a variety of physiological activities. Zinc sulfate (ZnS) is an inorganic chemical, commonly used in zinc insufficiency therapy. Previously oral Zinc supplementation was found to help shorten length of the common cold; however, intranasal Zinc use has been linked to anosmia, or loss of smell, in humans.Aims of work: This work aims to assess possible effects of ZnS induced toxicity on adult male albino rat olfactory mucosal histological structure.Methods: Twenty rats were equally allocated into two groups: Control group (C- group) and Zinc sulfate (ZnS) group (given intranasally as 10% ZnS solution).Olfactory mucosa was processed for histological study.Results: ZnS group showed marked structural alterations in olfactory mucosa in the form of thinning, desquamation of olfactory epithelium and degeneration of both nerve bundles Bowmans glands in the lamina propria.Conclusion: Zinc sulfate produced destruction of olfactory mucosa in adult male albino rats. Keywords: Zinc, anosmia, olfactory
       
  • Comparison of hemodynamics changes after infusion of Dexmedetomidine
           versus Midazolam as a premedication in pediatric patients undergoing lower
           abdominal surgery

    • Abstract: Background: The administration of anesthesia and the surgical procedure can potentially have adverse impacts on hemodynamics. Premedication, midazolam and dexmedetomidine, was utilized in this study to mitigate the stress response. The administration of midazolam resulted in hemodynamic effects. This study showed that dexmedetomidine can reduce the requirement for anesthesia and mitigate the body's response to stressful events during surgical procedures.Patients and methods: This study comprised a total of sixty patients who underwent general anesthesia for lower abdomen surgery at Minia University Hospital. The experiment was conducted using a prospective and randomized study design. Group M was administered intravenous midazolam, whereas group D received intravenous dexmedetomidine. The participants were assigned to one of these groups in a random manner. Both groups underwent a conventional anesthetic treatment. We assessed the heart rate and blood pressure at different time intervals. Results: Comparing the baseline parameters of the two groups showed no statistically significant disparity. There was a noticeable change in heart rate between the two groups after the premedication infusion. The heart rates of Group M and Group D exhibited a significant difference (p<0.05). Following administration of the medicine, group M exhibited significantly elevated blood pressures compared to group D, with a p-value of less than 0.05, indicating statistical significance. There was a distinct disparity between the two groups regarding the alteration in the initial measurements of heart rate and blood pressure.Conclusion: The use of dexmedetomidine resulted in a significant enhancement in hemodynamic stability and effectiveness.
       
  • INDOCYANINE GREEN GUIDED LAPAROSCOPIC EXPLORATION OF COMMON BILE
           DUCT;VALUE AND EFFECTIVENESS

    • Abstract: Background: In recent years, the use of laparoscopic CBD exploration in the treatment of CBD stones has become more widespread. The bile duct must be extensively dissected during the transcystic and transductal exploration, which increases the risk of iatrogenic damage. In order to execute a real-time fluorescence cholangiography, indocyanine green (ICG) injection permits accurate identification of the biliary anatomy that may facilitate the process. Aim and Objectives: The purpose of this study is to assess the effectiveness, safety, and results of utilizing indocyanin green during laparascopic exploration of the common bile duct.Subjects and methods: The study is carried out in the department of General surgery, Minia university hospital during the period from 2022 to 2023. Our study will be prospective and retrospective and include 20 patients presented with CBD stones who will undergo laparoscopic CBD exploration using the ICG dye.Result: There was a great success in the difficult cases especially those with previous operations as the ICG dye makes better delineation of the anatomy of the biliary tract and hence safe dissection and short operative duration. The rate of cases converted to open also decreased in our study after usage of the indocyanin green dye.Conclusion: ICG injection results in exceptional biliary structures fluorescence, delineating biliary anatomy especially when there are adhesions or abnormal structure, it may be a useful tool in CBD exploration since it contrasts well with the hepatic parenchyma.
       
  • Comparative split-face research comparing two distinct combined
           microneedling techniques for the therapy of acne scars.

    • Abstract: AbstractBackground: Eighty to 90% of teenagers worldwide suffer from acne. In the afflicted population, the resulting scars may result in psychological issues and facial deformities. Numerous therapeutic approaches, including as resurfacing lasers, dermabrasion, peeling, fillers, and microneedling, have been explored to address this issue. Everybody has displayed inconsistent outcomes.Objectives: In order to treat atrophic post-acne scars, this study compared the effectiveness of two distinct combination microneedling modalities: topical PRP microneedling and topical vitamin C microneedling.Methods: Forty participants (16 men and 24 women) received therapy for post-acne scarring in this research investigation. Over the course of three months, six microneedling procedures were performed, two weeks apart, using PRP on the right side of the face and vitamin C on the left. At the beginning and completion of treatment, scars were evaluated using photography, ASAS, and SQGS, at the beginning and completion of therapy.Results: Both sides of the face showed a statistically significant improvement in the mean ASAS value and SQGS when compared to the baseline, with no discernible difference between them.Keywords: microneedling, acne scars, PRP, vitamin C.
       
  • Electromyographic abnormalities in systemic lupus erythematosus
           correlation with clinical and laboratory .parameters

    • Abstract: Objective: Determine the pattern of muscle involvement clinically, neurophysiology and laboratory in systemic lupus erythematous and Correlating clinical, function, laboratory finding.Methods: We gathered patients with systemic lupus erythematoses who involved or did not involve muscles. Clinical examination, functional testing (such as ALT, AST, CPK, Alkaline phosphatase, and aldolase), nerve conduction studies (NCS), electromyography (EMG), and muscle biopsy were used to evaluate them. The outcomes were contrasted with sex- and age-matched healthy controls.Results: During the study period, thirty patients underwent muscle biopsy, electromyography (EMG), nerve conduction studies (NCS), and laboratory testing. Musculoskeletal symptoms included arthralgia (25 patients), arthritis (16 patients), myalgia (17 patients), mucocutaneous symptoms (malar rash (30), alopecia (6), discoid (3), oral ulcer (11), photosensitivity (9)), chest symptoms (ILD) (11) and central nervous system (CNS) (3). Out of the SLE patients, 1 (3.3%) had clinical muscle weakness. Muscle biopsy affection was 15(50%) and EMG muscle affection was 15% in SLE patients. Clinical, serological, and laboratory differences between patient groups with and without myositis were not statistically significant. Conclusion; The patient's age and sex with hemoglobin and TLC, as well as their age and the length of their illness with increased insertional activity, were the only two variables that showed a statistically significant positive correlation (p=0.055, p=0.020, respectively). Clinical and laboratory characteristics did not significantly differ between patients with and without myositis. Muscle biopsy affection affected 15% of SLE patients, while EMG muscle affection affected 15% of patients. obtained treatment and whether or not myositis is evident.
       
  • Arthroscopic reconstruction of isolated anterior cruciate ligament versus
           anterior cruciate ligament reconstruction and extra articular tenodesis

    • Abstract: Background; Orthopedic physicians worldwide frequently perform anterior cruciate ligament reconstruction (ACLR), a regularly executed surgical surgery. The Anterolateral ligament (ALL) has shifted attention to the primary mechanism that restricts the rotational instability of the knee after an ACL injury. Aim and Objectives; In order to evaluate and contrast the functional outcomes of patients diagnosed with anterior cruciate ligament (ACL) injury in knees that undergo extremely demanding activities, we conducted a study comparing the effectiveness of arthroscopic isolated ACL reconstruction (ACLR) versus with lateral extra-articular tenodesis (LET). Patients and Methods; This study was a prospective randomized controlled experiment conducted at Minya University Hospital between January 2019 and March 2023. It included a total of 60 patients who presented with ACL injury. Results; No statistically significant differences were seen between the studied groups in terms of age and sex. Athletic Endeavor, ASA Physical state, injury mechanism, affected side, dominant side, time elapsed from injury, period of follow-up. The Lachman and pivot shift tests were conducted before surgery and at various intervals of 3, 6, 12, 24, and 36 months after surgery. The range of motion (ROM) was measured both before and after the operation. The Lysholm score was assessed at different follow-up intervals, and the IKDC score and complications were also evaluated. Conclusion: The combination of ACL reconstruction with lateral extra-articular tenodesis (LET) was found to be both safe and successful in treating ACL injuries in knees that are subjected to high demands.
       
  • Evaluation of the impact of an acute single paracetamol overdose on renal
           functions and serum electrolytes

    • Abstract: Abstract:Background: Paracetamol overdose is a common cause of drug-induced acute liver injury worldwide. The easy availability of the drug makes it a common method of suicide especially among young adults. Aim of the work: The study aims to assess the impact of an overdose ingestion of paracetamol over renal functions and electrolytes in patients without a pre-existing renal disease who were admitted in the Poison Control Center of Minia University Hospital after an acute single paracetamol overdose. Methods: The study included patients hospitalized at the Poison Control Center from the start of February 2022 to the end of January 2023. Patients were classified into mild, moderate and severe groups depending on paracetamol plasma level 4-hrs post ingestion. Sociodemographic data were collected from all the patients including age, gender, residence and body weight. Blood samples were drawn from each patient for laboratory investigations on admission and follow up. Results: The patient's age ranged from 18-47 yrs, mostly came from cities. with a female predominance. Statistically significant differences were recorded among groups as regarding the ingested dose of the drug, paracetamol plasma levels and liver transaminases (ALT and AST) especially from 2nd and 3rd days of admission. Renal function tests and serum electrolytes recorded statistically insignificant changes within groups either on admission or during the follow up. All patients improved and discharged after treatment. Conclusion: Despite toxic dose ingestion of paracetamol renal affection or electrolyte imbalance may not occur.
       
  • Immunohistochemical Expression of CD56 in Thyroid Lesions and Its Possible
           Diagnostic Utility

    • Abstract: AbstractIntroduction: Thyroid nodules are very common among general population. Most of them are benign, however thyroid cancer (TC) represents 5% of these nodules. PTC is the most prevalent malignant thyroid neoplasm and its diagnosis is dependent on the presence of specific nuclear features, however diagnostic difficulties may arise in some cases. CD56 is a neural cell adhesion molecule that is expressed in different immune cells and neurons. Previous researches reported that lack of this marker has been linked to the malignant potentiality of tumor cells.Aim of work: Evaluate the diagnostic value of CD56 in distinguishing benign from malignant thyroid lesions.Methods: Seventy tissue blocks representing benign and malignant thyroid lesions were randomly selected for the current study. Among the forty selected malignant cases, 30 cases of papillary thyroid carcinoma and 10 cases of follicular carcinomas were included. Twenty cases of follicular adenomas and ten cases of nodular hyperplasia are included among the thirty benign lesions. Institutional Review Board” IRB”, Minya University has reviewed & approved submitted research proposal” Approval No. 404/04/2021.Results: CD56 positive expression was found in 36 (51.4%) cases. A statistically significant relation was found between CD56 expression and histologic subtype and benign versus malignant lesions (p-value=<0.001 and <0.001 respectively). In PTC, CD56 negative expression was detected in 26 (86.7%) cases. A statistically significant relation was found between CD56 expression and site of lesion lymph node metastasis (p-value=0.029 and 0.009 respectively).Conclusion: CD56 can be a helpful immunohistochemical marker in distinguishing benign from malignant thyroid lesions.
       
  • Apache ІІ score as predictor for outcome of traumatic brain
           injury (TBI).

    • Abstract: Abstract Background :Some scoring systems, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), are used to predict mortality, but they are not specialized for traumatic brain injury. The present study aims to evaluate performances of Acute Physiology and Chronic Health Evaluation II (APACHE II) to predict mortality in traumatic brain injuries.Methods : In this study, 50 patients who were treated in anesthesiology intensive care unit diagnosed as moderate to severe traumatic brain injury were included. Patients under the age of 18, foreigners patients with incomplete data were excluded from this study. APACHE II score in the first 24 hours was counted up. Results: Of the 50 patients, 45 (90%) were males and 5 (10%) were females. The overall mortality was 44% (22/50). The mean APACHE II score was 21.08±14.8. This represents mortality probability 40%Conclusion: APACHE II can predict the mortality of TBI in the ICU.
       
  • Diagnostic value of combining high resolution computed tomography with
           pulmonary artery systolic pressure for assessment of idiopathic pulmonary
           fibrosis

    • Abstract: Abstract Background and objective: Idiopathic interstitial pneumonias (IIPs) are a heterogeneous group of non-neoplastic disorders resulting from the deterioration of lung tissue. High-resolution computed tomography (HRCT) is now a crucial technique for evaluating individuals with idiopathic interstitial pneumonia (IIP). Individuals diagnosed with idiopathic pulmonary fibrosis (IPF) commonly suffer from pulmonary artery hypertension (PAH). When PAH is identified, it is associated with increased mortality rates and could perhaps clarify the decline in health observed in certain patients with intact pulmonary function. Methods: Our study involved a thorough examination of 40 individuals who had been diagnosed with idiopathic pulmonary fibrosis (IPF) using high-resolution computed tomography (HRCT). Subsequently, we performed a correlation study by monitoring the pulmonary artery pressure by transthoracic echocardiography. Results: A direct association was observed between the HRCT findings and the PASP value. Conclusion: Combining HRCT findings with PASP measures offers supplementary information for assessing individuals with idiopathic pulmonary fibrosis.
       
  • Hysteroscopic evaluation of the cervix and uterine cavity after Cervical
           Advancement in cases of placenta accreta spectrum (intrventional study)

    • Abstract: Abstract Background: Placenta accreta spectrum (PAS) diseases are primarily linked to a prior cesarean section (CS) in medical history. The objective of this study was to assess the cervix, uterine cavity for the existence of postoperative sequelae in cases of PAS following cervical advancement using a hysteroscope.Methods: This interventional study was carried out on 43 patients aged from 19 to 39 years old, female, with history of Cervical Advancement of placenta accreta (either symptomatic or not) and females seeks fertility. Ultrasonography and hysteroscopy are assessed to all patients.Results: There was a significant inverse relationship between the development of cervical stenosis and scar thickness, whereas There was a strong inverse relationship between cervical stenosis and the thickness of the endometrium. A strong positive correlation was seen between the development of irregularities in the uterine cavity and the thickness of the endometrium, whereas a negative correlation was found with scar thickness. There was a strong negative correlation seen between the occurrence of scar niche and cervical length, although no significant association was found with other factors.Conclusions: The three most discovered abnormalities cervical stenosis, uterine cavity irregularity, and intrauterine adhesions are linked to cervical advancement. Some factors are correlated with ultrasound (US) findings including scar thickness, endometrial thickness, cervical length with uterine adhesions, uterine cavity irregularities and scar niche.
       
  • Thyroid Nodules: Are There Gender Differences'

    • Abstract: ABSTRACT:Background: Although gender has always been regarded as one of the essential epidemiological factors to take into account when researching thyroid illnesses, the relatively recent field of gender medicine has contributed to providing fresh insights into the topic. The existing research in clinical practice confirms the significance and frequency of both functional and neoplastic thyroid problems. Our goal is not to address every aspect of the topic but rather to provide some guidance to initiate a new and thought-provoking discussion. As a result of a fruitful mindset shift in our practice, further research is required to develop better diagnostic and therapeutic procedures and incorporate them into everyday clinical work-up.Aim of the study: To evaluate how common the thyroid nodules are in females in comparison to males in Minia governorate in the period from December 2020 to June 2023.Patients & Methods: This study included 100 euthyroid patients with thyroid nodules diagnosed with ultrasound;Results: The patients' ages ranged from 18 to 79 years, with a mean age of 39.8 years ± 12.2. 10 of them were males (10%) and 90 were females (90%). The Majority of the patients had thyroid nodules in their right and left lobes, 44% and 31% respectively. Furthermore, most of them were classified as TIRADS III and IV.Conclusion: As people age, thyroid nodular disease becomes more common and is more prevalent in females.
       
  • Comparing the Efficacy of Two-Dimensional Ultrasound and Three-Dimensional
           Power Doppler for Diagnosing Placenta Accreta Spectrum Disorders and
           Predicting Complications: A Prospective Cross-Sectional Study.

    • Abstract: Background: Placenta accreta spectrum (PAS) issue has become a noteworthy dangerous obstetrical issue because of its expanded rate from 0.12 to 0.31% in the last 30 years and the detailed death of roughly 7.0%.Objectives: To compare between the two-dimensional ultrasound and three-dimensional power Doppler for diagnosis of Placenta accrete spectrum disorders and prediction of its complications.Patients and methods: This was a prospective cross sectional single-institute study carried out on 86 patients suspected to have PAS-disorders by Two dimensional ultrasound 2D US and color Doppler during ANC at Obstetrics and Gynecology department, Minia maternity University Hospital from July 2021 to July 2022.Results: There was highly statistically significant difference as regards histopathology findings of 2D US (MAP, Non-MAP and Total) P<0. 001. VI, FI, and VFI were significantly higher among patients with MAP compared to patients without P<0. 001. The 2D US sensitivity was 87.3%, specificity was 90.3%, NPV was 80% and PPV was 94.1% with accuracy of 88.4% in diagnosis of MAP. 70.9% of the patients suffered from hemorrhage, 6.9% suffered from bladder injury, 10.5% reported preterm birth, and 3.5% suffered from bowel injury.Conclusion: 3D power Doppler can be used as a complementary technique to 2D ultrasound for confirmation of the diagnosis of placental invasion owing to its high sensitivity.
       
  • Evaluation of Total leucocytic count and CD8+ T lymphocytes in the
           peripheral blood of COVID-19 patients as primary markers of disease
           severity

    • Abstract: Background: The novel COVID-19 virus has rapidly disseminated globally, posing a significant risk to human lives. Although some individuals may experience a minor infection, the disease can be life-threatening for many others. Thus far, it has been established that alterations in specific parameters of the laboratory immunological profile are correlated with severe instances of COVID-19. T cell-mediated immunity is crucial for the regulation of viral infections. While the natural immune response basically eliminates diseases, its over stimulation may cause significant damage and worsen the prognosis of the disease. Analysing the changes in immune cell expression can enhance our understanding of the course of COVID-19. The objective of this study was to identify the alterations in total lymphocyte count (TLC) and CD8+ T cells in COVID-19 patients across different levels of disease severity and clinical outcomes. Methods: This case-control study included two groups of subjects: positive COVID-19 patients that were confirmed by RT-PCR (n = 15) and a control group (n = 15). Detection of the expression of CD8+ was done by flowcytometry. Then all the data collected were analyzed to compare the investigated parameters in the patient group to the control group.Results: TLC was found to be affected in COVID-19 patients, with 13.3% showing leucopenia and 53.3% showing leukocytosis. However, 33.3% of patients showed normal TLC that was correlated with their clinical classification as mild cases. Lymphopenia represented 100% in cases.Conclusion: Changes in specific immune cells are significant in prediction of the disease severity in COVID-19.
       
  • Evaluating the Analgesic Efficacy of Magnesium Sulfate in Quadratus
           Lumborum Block for Mild Pre-eclampsia during Cesarean Section

    • Abstract: The escalating global rates of cesarean sections underscore the imperative to address postoperative pain management, particularly in the context of pre-eclampsia, a pregnancy-specific complication with inherent risks. This study, conducted at Minya University Hospital from October 2021 to April 2023, investigated the analgesic efficacy of combining magnesium sulfate with bupivacaine in quadratus lumborum block for mild pre-eclampsia during cesarean section.Eighty ASA grade II women participated in this double-blind, controlled study, with random group assignments. The assessment criteria included the Visual Analog Scale (VAS) for pain, hemodynamic monitoring, and observation of adverse effects. The results demonstrated comparable demographics and hemodynamic parameters between groups, emphasizing the safety of the intervention. Importantly, VAS scores at 8, 12, 18, 24, and 48 hours post-surgery favored the magnesium sulfate group (p<0.05), indicating superior analgesic efficacy without observed complications.This study contributes novel insights, suggesting that the combination of magnesium sulfate with bupivacaine in quadratus lumborum block offers a promising opioid-sparing strategy for postoperative pain management in mild pre-eclampsia during cesarean section. The observed benefits are particularly noteworthy, as they align with the global need for alternatives to traditional opioid-based analgesia, especially in populations with unique considerations such as pregnant women. Further research is warranted to validate and expand upon these findings, potentially influencing clinical approaches for enhancing maternal well-being in this specific patient population.
       
  • Revised Carotid Intimal Media Thickness in Type 1 Diabetes Miletus

    • Abstract: Introduction: Type 1 diabetes mellitus (T1DM) is characterised by the autoimmune death of pancreatic beta cells, which play a crucial role in the production of insulin. Insulin is a crucial anabolic hormone that has diverse effects on glucose, lipid, protein, and mineral metabolism, in addition to its role in growth. Insulin assumes a pivotal function in several physiological processes. It facilitates the transfer of glucose into muscle and adipose cells, stimulates the liver to store glucose as glycogen and produce fatty acids, enhances the absorption of amino acids, suppresses the breakdown of fat in adipose tissue, and promotes the uptake of potassium into cells. Individuals who have received a diagnosis of Type 1 Diabetes Mellitus (T1DM) necessitate continuous administration of exogenous insulin throughout their lifetimes. The manifestation of diabetic ketoacidosis (DKA) occurs in the absence of insulin. Patients and methods: The study was conducted on 60 type 1 DM children and 30 nondiabetic children. Random blood sugar, HbA1c, and carotid intimal medial thickness were assessed in all children.Results: There were no differences between the diabetic children and controls regarding age, sex, and weight.Conclusion: Random blood sugar and HbA1c were higher in diabetic patients.
       
  • Effect of Tramadol on offspring's of Pregnant female Albino
           Rats' Cerebellum

    • Abstract: Background: :Cerebellum is a vital component in the human brain as it plays a role in motor movement regulation and balance control. The cerebellum coordinates gait and maintains posture, controls muscle tone and voluntary muscle activity .cerebellum is particularly susceptible to developmental and environmental injury because of its long developmental period tramadol is a synthetic centrally acting analgesic agent used for treating moderate to severe pain including postoperative, gynecologic and obstetric pain. Aim of the work: Toto shed light on the effects of tramadol in the cerebellar cortex of postnatal male albino rat offspring's after Prenatal Exposure to tramadol Methods: 12-rats were equally divided into two groups: Control group and Tramadol group. Histological approach and assessment of serum glutathione (GSH) were done.Results: Tramadol group showed degenerative changes on the cerebellum.Conclusion: Tramadol had an obvious damage on offspring's cerebellum with decreased level of GSH.Keywords: Tramadol, offspring's ,cerebellum and GSH.
       
  • Impact of using Single File System Versus Multiple File System on
           Single-bacterial biofilm in Oval Canals (Comparative in- vitro study)

    • Abstract: Abstract:Aim of Study :The current study aimed to assess and evaluate the effects of a single file system against a multiple file system on the eradication of single-species E. faecalis biofilm in oval canals. Materials and Methods: A total of 100 human Maxillary second premolars were acquired from the outpatient clinic. All collected teeth (n=100) were numbered and randomly assigned to four groups as follows: In Group I, consisting of 40 samples, instrumentation was performed utilizing a single-file method known as Reciproc Blue 40, accompanied by saline irrigation.Group II (n=40): The samples were instrumented using the Hyflex CM multiple file system, with Saline irrigation.Group III (n=10): A positive control group was employed to assess the survivability of bacteria during the entire experiment. In this group, the root canals were intentionally contaminated but not instrumented.Group IV (n=10): A negative control group was included in the study to assess the sterility of the procedures. In this group, the root canals were instrumented but not contaminated. To introduce E. faecalis suspension into each root canal, 20 lL was filled through their orifice using sterile automatic micropipettes.The bacterial colonies were enumerated, and the resulting data was quantified as colony-forming units per milliliter (C.F.U./mL).The results indicate a statistically significant difference seen among the various groups (p<0.001). The positive control exhibited the highest value (12.39±0.16), followed by Reciproc blue (11.90±0.21) and Hyflex CM (10.95±0.36), whereas the negative control had the lowest value (0.00±0.00).
       
  • Right Ventricular Strain Assessment by Speckle Tracking Echocardiography
           before and after treatment of clinical and subclinical hypothyroidism

    • Abstract: Background: Hypothyroidism is prevalent endocrinological disease that raises cardiovascular disorders. Due to the complexity of right ventricular (RV) geometry and its challenging non-invasive testing, speckle tracking echocardiography (STE) emerges as contemporary tool for identifying early changes in RV function.Aim: RV function evaluation in clinical and subclinical hypothyroidism patients before and after treatment using STE. Methods: Total 74 individuals underwent for STE. 24 clinical hypothyroidism subjects (group I), 24 subclinical hypothyroidism subjects (group II), and 26 normal individuals as a control group. RV function evaluated prior to the treatment regimen and three months after reaching euthyroid stage.Results: Prior to therapy, global longitudinal strain (GLS) was significantly lower in patients groups compared with controls. (GLS in group I= -25.2 ± 0.3 Vs. -27.8 ± 0.5 in control group (P value <0.01) and GLS in group II= -25.3 ± 0.2 Vs. -27.8 ± 0.5 in control group (P value <0.01), but no statistically significant difference was found regarding ejection fraction (EF %). After three months at euthyroid stage, the values were not totally reversed but there was significant improvement of GLS, (GLS in group I after treatment= -27.2 ± 0.4 Vs. -25.2 ± 0.3 before treatment (P value <0.05) and GLS in group II after treatment= -27.4 ± 0.2 Vs. -25.3 ± 0.2 before treatment (P value <0.05). Conclusion: Early detection and treatment of both clinical and subclinical hypothyroidism patients partially reverse RV functional abnormality. STE may efficiently detect early contractile changes, before changes in EF occurs.
       
  • Effect of Dexmedotomin on spinal anesthesia in lower limb surgery.

    • Abstract: Background: Spinal anaesthesia is a commonly employed method for lower limb procedures due to its rapid onset, efficient sensory and motor blockage, and extended postoperative analgesic effects. Spinal anaesthesia offers a diverse range of local anaesthetic medications, including bupivacaine, levobupivacaine, and ropivacaine. The primary physical characteristic that significantly influences the degree of analgesia following the Intrathecal administration of a local anaesthetic is its baricity. The utilisation of 0.5% hyperbaric bupivacaine hydrochloride is widespread due to its extended period of motor and sensory blockage.. Patients and methods : The impact of Dexmedotomin on spinal anaesthesia.The study focused on individuals who underwent lower limb surgery at Minia University Hospital and received intrathecal Dexmedotomin. During the time frame spanning from February 2022 to September 2023.The patients were divided into two groups: group C, which received a combination of bupivacaine and normal saline (BS) (n = 20), consisting of 3 mL of 0.5% hyperbaric bupivacaine with 0.5 mL of normal saline; and group D, which received a combination of bupivacaine and dexmedetomidine (BD) (n = 20), consisting of 3 mL of 0.5% hyperbaric bupivacaine with dexmedetomidine 10μg. The variables of interest were the time of first analgesic request and the total analgesic requirement, which was ketolac 30mg. Within a span of 24 hours, a record was documented.
       
  • Effect of doxorubicin on Male Albino Rats' heart:Biochemical and
           Histological study

    • Abstract: Abstract:Background:Drug-induced cardiotoxicity especially the anticancer drugs can be a major cause for limitations of these drugs therapeutic usage. Doxorubicin is one of the most important chemotherapy, it treats many types of cancers but it has toxic effects on heart tissue as it causes oxidative stress ,apoptosis and inflammation and this limits the therapeutic usage of doxorubicin as an anticancer drug.Aim of the work: To study the effect of doxorubicin on Albino Rats' heart.Methods: Thirty male albino rats were divided equally into two groups: C-group (control group) and B-group ( doxorubicin exposure group). Measurement of malondialdehyde (MDA) in the heart tissue, an oxidative stress marker, and histological approaches were done.Results: B-group showed significant increase in MDA levels in cardiomyocytes compared to control group and had degenerative changes in the heart tissue.Conclusion: Doxorubicin had an apparent damaging effect on cardiac tissue structure by different mechanisms as oxidative stress ,apoptosis and inflammationKeywords: Cardiotoxicity, DOX , MDA.
       
  • Endoscopic management of Cushing’s disease caused by pituitary
           adenomas

    • Abstract: Background: Cushing’s syndrome is an endocrinopathy, resulting in distinctive clinical features and associated systemic changes. Cushing’s disease is the name given to the disorder when it is caused by a pituitary source, usually an adrenocorticotrophic hormone (ACTH)-secreting pituitary microadenoma. The hypersecretion of ACTH by the pituitary adenoma, usually a microadenoma, results in bilateral adrenocortical hyperplasia and hypercortisolism. Cushing’s disease is a rare disorder with a reported incidence of between 0.7 and 2.4 cases per million inhabitants.OBJECTIVES: Studying the outcome , remission rates , complications of transsphenoidal endoscopic surgery in treating Cushing’ disease . METHODS: This is a retrospective and prospective study on first successive 20 patients from January 2015 to July 2021 with Cushing’s disease due to pituitary adenoma. Patients were admitted and operated by transnasal transsphenoidal endoscopic approach in Neurosurgery Department, Minia University hospital, Minia University, El-Minia, Egypt.RESULTS: this study included twenty patients of different ages with mean of 37.8 yrs , 16 of them were females and 4 males. The study showed significant reduction of cortisol levels postoperative as the mean cortisol level preoperative was 32.67 ug/dl while the mean cortisol postoperative was equal to 3.60. 90% percentage of patients showed remission after transsphenoidal endoscopic excision of adenoma at the one year follow up. CONCLUSIONS: The endonasal trassphenoidal endoscopic surgical management of the ACTH-secreting pituitary adenomas in those patients succeeded in amelioration of the altered clinical, endocrinological and radiological findings. It achieves high remission and low relapse rates with noticeable low postoperative complications. .
       
  • Androgenic Alopecia In Female

    • Abstract: Abstract Background: Androgenic alopecia is a prevalent hair loss illness, that impacts individuals of both genders. The onset of androgenic alopecia typically occurs in adolescence, resulting in a gradual and patterned hair loss. Females suffering with androgenic alopecia may have substantial deterioration in their quality of life. There are several methods that evaluate FPHL, Sinclair grading one of them. Objective: The objective of the current investigation is to identify pattern of Androgenic alopecia in female. Patients and Methods: A total of 30 randomly selected patients were enrolled in the study from March 2021 to January 2023, all the patients completed the study after the inclusion and exclusion criteria were satisfied. Thirty alopecia female patients were evaluated by Sinclair grading. Results: Age of patients ranged from 28 to 45 years with a mean ± SD of 34.7 ± 5 years. Positive family history represented in 15 cases and 18 cases were married. Grade lll was the most common type. Conclusion: Sinclair grading is a good descriptive method for pattern of female androgenic alopecia, the most common type was Grade III.
       
  • New era of Diffusion weighted imaging as screening tool for breast cancer

    • Abstract: Background: Breast cancer has been recently known as a heterogeneous group of diseases. Early detection of breast cancer plays an important role in the treatment and control of the disease Diffusion-weighted MRI (DW-MRI) is sensitive to characteristics often disrupted in malignant breast tissues, such as cell organization, density, extracellular space, and cell membrane permeability, which may help to better discriminate between different types of breast lesions.Aim of study: The aim of our study was to determine if we can fully relay on DWI with conventional images alone for detection, evaluation of different breast lesions to avoid unneeded biopsy. Subject and Methods: This was a prospective study; it was conducted on 30 female patients at Minya oncology center & Diagnostic Radiology department of Minya University. This studied included patients with equivocal breast lesions detected by either sonograhy or mammography (BIRADS III). Then MRI was conducted. Biopsy was done to confirm diagnosis.Results: There were 30 female patients (mean age, 45; SD, 13.8) with 17 BI-ADS 3 lesions included (56.7% ). The area under the ROC curve was 0.83. Applying the investigated ADC cutoff, sensitivity 100 %, specificity was 66.7%. The potential reduction of unnecessary biopsies was 23.3%.Conclusion: DWI can be great screening tool for breast cancer as well as had been helpful in at assessment of post-operative statutes.
       
  • Evaluation of surgical outcome of giant supratentorial meningiomas

    • Abstract: Background: Giant supratentorial meningiomas are challenging to operate on because of their size, conspicuous vascularity (both facilitating and impeding imaging of various neurovascular systems), and the significant cerebral oedema they cause. In this study, we will use our institution's background in the treatment of large supratentorial meningiomas to assess surgical outcomes for these tumors. Methods: This study presents a 5-year (Jan 2018-Jan 2023) retrospective study of 40 patients with histologically confirmed meningioma ( more than 5 cm in diameter) who had surgical excision at Minia University hospital. Data was gathered about the patient's initial presentation, imaging, surgical approach, complications that arose, and the patient's follow-up status. Results: 32 females and 8 males participated in the study. average age 44. Average time to follow-up was 36 months. The goal of treatment was complete gross removal of the tumor, which was achieved using a variety of approaches depending on site of lesion. In 95% of cases (38 cases), complete excision of the mass was achieve. In four cases, the tumor recurred. There were no intraoperative deaths recorded while 2 cases died postoperatively. Conclusion: Radical surgical excision is the primary and best approach for managing giant intracranial supratentorial meningioma. Although young age, surgical procedures, good localization, attempting to reduce operating duration, and Simpson grade all help, large size can make surgery challenging. In order to reduce the risk of complications during surgery, such as pulmonary embolism (PE) and postoperative hematoma in the tumor bed, interdisciplinary collaboration is crucial.
       
  • (R) Alopecia areata hair pull test and its correlation to
           histopathological findings.

    • Abstract: Background: Alopecia areata (AA) is a common non scarring type of hair loss that affects 2% of the general population with unpredictable course. Aim: Histopathological comparing of perifollicular lymphocytic infiltrate in alopecia areata in both longitudinal and transverse sections and its relation to hair pull test. Methods: The study was conducted on 18 AA patients attending the dermatology outpatient clinic, Minia university hospitals from September 2022 to December 2022. Three millimeters punch biopsy was taken from the edge of the lesion in each patient and was processed routinely for longitudinal sections and was stained with hematoxylin and eosin stain then re-embedded and transverse sectioning was performed. Perifollicular mononuclear inflammatory infiltrate was evaluated either significant or not in each case and in each follicle. Result: Significant higher numbers of the terminal hair follicles with significant existence of perifollicular infiltrate were found in transverse sections when compared to longitudinal sections and that immune infiltrates positively correlated to the positive hair pull test.
       
  • Relative motion splint versus static splint in extensor tendon repair:
           comparative study

    • Abstract: Background; Safe active motion of a repaired extensor tendon has been achieved via regimens that permit limited motion across the MCP and IP joints with support from static and dynamic splints. Two early active regimens have modified early passive protocols and have created an ‘early active regimen’ by including either active MCP joint extension or active wrist extension while preserving the use of a dynamic outrigger, Aim and objective; to evaluate the effect of usage of relative motion splinting in comparison to the static splint at the rehabilitation after extensor tendon injuries regarding Healing time after repair, Joint stiffness, and restoration of normal hand function, Subjects and methods; The study was conducted at Minia University Hospital, faculty of medicine, department of plastic and reconstructive surgery. The study included 20 patients. There were 2 groups each group including 10 cases. Results; there was a statistically significant difference between the studied groups regarding Flexion deficit, pain, Correlations between time needed to regain normal range of motion and different parameters, Conclusion; relative motion splinting technique is better than Static splint technique because the first group had higher flexion deficits in their MCP, PIP, and DIP joints at different time points, with a gradual reduction over time. On the other hand, the second group exhibited lower flexion deficits. The significant differences observed between the two groups suggest that the second group had better flexion capabilities compared to the first group at 3, 6, and 12 weeks for all joint types (MCP, PIP, and DIP).
       
  • The relationship between miRNAs and clinical data of COVID-19 patients

    • Abstract: SARS-CoV-2, the causative agent of the 2019 coronavirus illness (COVID-19) pandemic, has quickly disseminated over the globe. As the number of COVID-19 cases has skyrocketed, numerous nations have implemented emergency measures and set recommendations to stem the spread of the virus. A number of biomarkers for COVID-19 have been established after extensive study; however, there is currently no biomarker that is both specific and accurate for predicting the prognosis of patients with COVID-19 infection. Purpose of the study; Therefore, the purpose of this research was to evaluate the potential of miRNAs as predictive biomarkers for COVID-19 by analyzing the correlation between miRNA-106a expression and clinical data from individuals with this condition. Basic procedures: Fifty patients with COVID-19 were hospitalized to Minia University with symptoms including fever, dyspnea, cough, anosmia, GIT signs, and loss of taste sense; samples of 6 ml of venous blood were taken from each patient. Serum miRNA-106a was measured using real-time PCR, and clinical data was gathered after total RNA with preserved miRNAs was isolated from 200 µL of serum from each patient. Main findings: There is a strong link between the expression level of serum miRNA-106a and the clinical data of COVID-19 patients including fever, cough and congested throat. Principle conclusion: The findings supported the feasibility of miRNAs as potential diagnostic biomarkers and early predictors of COVID-19 infection.
       
  • Study of Serum ferritin Level in case of Premature Rupture of Membrane:
           Cross Sectional Study

    • Abstract: Background: Serum ferritin level and c_reactive protein act as an acute phase reactants may be elevated due to subacute genital tract infection leading to preterm premature rupture of membranes.Aim and objectives: To investigate whether serum ferritin level and crp can be utilized as a predictor of premature membrane rupture and chorioaminitis . Research Design: a case control study.Subjects and methods: case control research was performed in obstetrics and gynecology department, Minia university on 150 pregnant women with intact membrane for measuring the serum ferritin, CBC, CRP levels according to their age, parity, gestational age every 2 weeks (from 30 till 37 weeks)Results: Ferritin in all the 3 assessments was significantly increased in CRP positive cases when compared with CRP negative cases. Regarding comparison between CRP +ve and -ve cases, Age and Hb level were significantly increased in CRP +ve cases when compared with CRP -ve cases. There was significant positive correlation among S. Ferritin & CRP.Conclusion: The current research demonstrated that elevated serum ferritin and CRP levels are predictive of spontaneous preterm premature membrane rupture because they reflect an acute-phase response to subclinical infections. Preterm premature rupture of membranes was associated with substantially elevated serum ferritin levels, estimated by three distinct assessments.
       
  • Risk factors and comorbidities in cerebral palsy patients aged 6 months to
           under 5 years

    • Abstract: Background: Cerebral palsy (CP) is the most widespread childhood motor disability. This study aimed to determine the risk factors and comorbidities associated with CP in children aged 6 months to under 5 years.Patients and Methods: The study included 44 children with CP. A detailed history of antenatal, natal, and postnatal events was taken, a thorough physical, developmental, and neurological examination was performed, and a clinical assessment of comorbidities was carried out. Results: Hypotonic CP is the commonest type of CP. Muscle strength assessed by the MRC scale ranged from 30 to 60 with a mean of 37.43 (SD: ± 11.92). 34.1 % of patients had at least one risk factor, 61.4% had multiple risk factors, and 4.5% had unidentified risk factors. The majority of children had natal and postnatal risks (77.3%, and 47.7% respectively). Admission to the neonatal intensive care unit (NICU) and cesarean section delivery are the most common natal risk factors (56.8% for both), followed by low birth weight (43.2%). Intellectual disability was the commonest comorbidity in 95.5% of patients (43.2% had mild form, and 52.3% had severe form) followed by musculoskeletal disorders and epilepsy in 63.6% and 15.9% respectively.Conclusion: The most common risk factors in children with cerebral palsy include natal and postnatal different factors, while the most common comorbidity is intellectual disability followed by musculoskeletal disorders and epilepsy. There is a need for longitudinal studies that would assess comorbidities over time for patients with CP.Keywords: Cerebral palsy, Risk factors, Comorbidities, Motor impairment
       
  • Depression and COVID 19

    • Abstract: Background: Following recovery from COVID-19, it was found that an increasing number of individuals have reported the persistence and/or presence of new onset symptoms which collectively have been identified as post-COVID-19 syndrome by the National Institute for Health 2020. depressive symptoms in the acute phase of COVID-19 have been well described, the frequency of depression following recovery of the acute phase remains unknown. Objectives: we thought to screen for depression as an important post COVID19 presentation among nurses, who serve as front line care givers.Method: 88 nurses with history of COVID 19 infection were enrolled in this study by using MINIDEP screening tool for depression.Results: 13.6% of the patients had post COVID19 depression according to MINIDEP score. It was found that female sex, duration of COVID illness, post COVID19 sleep disturbance (P=0.03, P=0.004, P=0.001, respectively). were significantly correlated with depression in post COVID patients.Conclusion: COVID 19 infection can trigger depression.Keywords: SARS-CoV-2,coronavirus disease psychological impact
       
  • R1 Role of Conservative Measures in Management of Pediatric Epiphora

    • Abstract: Objective: to evaluate the efficacy of conservative and medical management of pediatric congenital nasolacrimal duct obstruction (CNLDO) associated with nasal allergy.Method: The current research is a prospective study on 28 pediatric cases (40 eyes) visiting ENT and ophthalmology departments of Minia university hospital presented with epiphora due to CNLDO above age of 1 year and below the age of 8 years. The epiphora is associated with nasal allergy. Those cases had been received medical and conservative treatment for 3 months.Results: All 28 cases received conservative measures and medical treatment prescribed by ophthalmology and E.N.T doctors. These measures were successful in cure of epiphora in 11 of 28 patients (16 of 40 eyes). The overall success rate is 39.3% of our patients (40% of eyes).Conclusion: We showed for the first time the impact of E.N.T evaluation and nasal allergy conservative management on the outcome of CNLDO from total number of 28 patients up to 40% showed improvement with medical treatment. So, many pediatric cases will not need invasive or surgical intervention. Lead to minimizing childhood morbidity as regarding hazards of general anesthesia and or surgical complications.
       
  • R( R)Lipopolysaccharide-induced acute lung injury in experimental male
           albino rats.

    • Abstract: Acute lung injury (ALI) is a life-threatening lung disorder marked by rapid development of hypoxemia, severe dyspnea, tachypnea, widespread pulmonary interstitial edema, and alveolar edema, ultimately leading to respiratory failure and death. ALI can be induced both directly and indirectly. Lipopolysaccride (LPS) is the main cause of the toxicity linked to gram-negative bacteria and is frequently used to establish ALI models. Purpose of the study; this study was assigned to investigate the short-term LPS-induced lung injury. Basic procedures; rats were randomly assigned into 2 equal groups: Control group: where rats were allowed to run about in their cages with unrestricted access to food and water, Lipopolysaccharide (LPS) treated group: in which rats were received single intra-tracheal dose of LPS 3mg/kg on the 8th day after the beginning of the experimental study then sacrificed 24 hours after intra-tracheal LPS injection. Main findings; Intra-tracheal administration of LPS produced a significant elevation of plasma level of Ferritin as well as resulted in elevation of the level of pulmonary malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α) as compared to control group.Principle conclusion: LPS was proved to produce extensive lung tissue damage as proved in the present study by inflammatory and oxidative markers. So, LPS can be considered as one model of lung injury.
       
  • (rev.1)(new ) Socio-demographic Characteristics of Patients with Comorbid
           Depression and Non-alcoholic Fatty Liver

    • Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent cause of liver disease across the globe. An increasing number of individuals have recently shown a substantial correlation between this liver condition and various central nervous system (CNS) problems. Cognitive impairment, hippocampal-dependent memory impairment, and mood disorders (in particular, depression and anxiety) are all CNS dysfunctions associated with NAFLD. Objectives: This study aims to evaluate the socio-demographic features and comorbidities of NAFLD patients. Methods: Patients whose diagnosed with NAFLD by clinical history and examination, laboratory investigations and non-invasive techniques (such as abdominal ultrasound) were evaluated for socio-demographic features. Results: The mean age of patients with comorbid depression and NAFLD was 42.2 (SD±13.73), while the NAFLD patients without depression mean age was 42.6 (SD± 13.2) and the control group was 41.7(SD± 14.3). Comorbid depression and NAFLD were common among female patients who live in rural areas. Conclusion: The profile of patients with depression and NAFLD is characterized by sociodemographic factors.
       
  • Effect of blue light on Albino Rat's retina

    • Abstract: Abstract:Background: Blue light has a very dangerous and harmful effect on the retina. Blue light is part of electromagnetic radiation and has wavelength in-between 400: 500 nm. Blue light affect retina through different mechanisms and causes blue light hazard. It affects mainly people having longtime on smartphones and TVs. It also causes eye strain, corneal damage, lense damage, migraine and sleep disorders.Aim of the work: To study the effect of blue light on albino rat’s retina.Methods: Thirty rats were divided equally into two groups: C-group (control group) and B-group (blue light exposure group). Measurement of retinal malondialdehyde (MDA) and histological approaches were done.Results: B-group showed significant increase in MDA levels and had retinal thinning with degenerative changes as loss of some retinal cells and layers and disorganization of normal retinal arrangement.Conclusion: Blue light had an apparent damaging effect on retinal tissue.Keywords: Retina, Blue light and MDA
       
  • Interleukin 26 in patients with systemic lupus erythematosus

    • Abstract: Purpose of study: Systemic lupus erythematosus (SLE) is an autoimmune disease affecting all body organs. Beside genetic, hormonal and environmental variables, unbalance between pro-inflammatory and anti-inflammatory cytokines causes alteration of the immune system and promote tissue damage .Interleukin 26 is a pro inflammatory cytokine that has a function in the pathophysiology of autoimmune diseases like SLE .The aim of this study was to assess the level of interlekin-26 in SLE patients and correlate IL-26 with SLE activity. Basic procedures: The study was conducted on eighty five subjects : 20 seemingly healthy individuals as control group and 65 SLE patients, they were subdivided into 2 subgroups ( SLE patients in active state and SLE patients in inactive state). SLE patients were diagnosed according to The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) 2019 criteria for SLE . Interleukin 26 level was assessed by EIA method. Main findings: results revealed that patients with SLE showed statistically significant higher IL-26 levels than control group and SLE patients in active state had statistically significant higher IL-26 levels than SLE patients in inactive state. Also, significant positive correlation between IL-26 and (SLEADI score, A/C ratio, ESR and Anti –ds DNA) and significant negative correlation between IL-26 and (C3 and C4). Principle conclusion: The findings of this study showed correlation between IL-26 and SLE activity, therefor measurement of IL-26 can help in assessment of SLE activity. Also IL-26 may be useful marker in predicating lupus nephritis because IL-26 serum level correlated positively with A/C ratio.
       
  • (R) Prevalence of Neurological Manifestations in Egyptian Female Patients
           on Hemodialysis

    • Abstract: Background: End-stage renal disease (ESRD) is a significant problem in nearly all countries, and the prevalence has increased in developing countries . Normal kidneys filter and remove excess small proteins from the blood but in patients on dialysis, beta 2-microglobulin builds up in the blood. And may join together forming a few large molecules which can form deposits and eventually damage the surrounding tissues. This condition is called dialysis-related amyloidosis (DRA) .Methods: Thirty eight female patients with CRF and on hemodialysis were enrolled to the study, their ages ranged from 27 to 70 years old. All patients were subjected to complete history taking and both general and local examination to detect any neurological affection. Patients with chronic diseases which can cause neurological manifestations, and patients with history of significant hand trauma were excluded from the study.Results: Regarding to causes of hemodialysis, hypertension was the most common cause of hemodialysis in our patients(52.6%)of cases, followed by NSAIDs (21.1%) of cases, chronic obstructive uropathy was found in (7.9%)of cases also chronic glomerulonephritis was a cause in (7.9%)of cases and polycystic kidney was a cause in (10.5%) of cases. Regarding to diabetic patients, they were excluded from our study Patients complained of hand weakness more frequently than paresthesia and night awakening. And by clinical examination, sensory loss was more frequent than thenar wasting, hypoesthesia, also positive phalen and tinnel signs were common in our patients. Conclusion: neurological manifestations including Carpal tunnel syndrome (CTS) are common in female patients on hemodialysis.
       
  • Estradiol valerate-induced endometrial hyperplasia in rats: A possible
           role for NFκB and caspase-3

    • Abstract: Endometrial hyperplasia is induced by estradiol valerate (EV), however the underline mechanism is not fully understood. The aim of this study is to examine the impact of EV dosing on oxidative stress, inflammation, and apoptosis. The rats were allocated into two groups: Group 1 (Control) was given 1 ml of 0.5% aqueous solution of carboxy methyl celluse (CMC) as the drug's vehicle. Group 2 (EV-treated) received 2 mg/kg/day Estradiol valerate (EV) suspended in CMC orally. The rats were sacrificed 10 days later and utrine tissues were harvested for histopathological and biochemical analysis. Biochemical tests used for assessing oxidative marker malonaldehyde (MDA) and serum total antioxidant capacity (TAC). Interestingly, EV- treated group showed a remarkable histopathological and biochemical changes. It showed a significant increases in uterine MDA levels and decreases in uterine TAC and caspase-3 levels with increases in NFκB expression.In conclusion, EV induced endometrial hyperplasia via oxidative stress damage, induction of NFκB and reduction in apoptotic marker (caspase-3).
       
  • Pulmonary arterial hypertension in patients with systemic lupus
           erythematousus

    • Abstract: Systemic lupus erythematosus (SLE) is a life-threatening multisystem inflammatory condition affecting any organ systemPulmonary arterial hypertension is severe, potentially life-threatening complication of SLE with range of 1.8% -14% Aim of the study: to predict of pulmonary arterial hypertension in SLE patients at early stage to prevent further complicationsMethods: As a cross-sectional study, 47 patients with systemic lupus erythematosus diagnosed according to EULAR/ACR 2019 criteria were enrolled in Minia university Hospital, cardiology department and rheumatology Clinic. Patients were subjected to full clinical evaluation, laboratory investigations and Echocardiography for detection of pulmonary hypertension Results: The mean duration of SLE was13.02±6 years. There was a significant relation between severity of SLE disease and pulmonary artery systolic pressure (P < 0.0001). there was no significant difference between 2 groups regarding duration of the disease while pulmonary hypertension was presented in severe form of SLE cases and absent in mild form Conclusion: There was a significant correlation observed between severity of the SLE disease and pulmonary arterial hypertension
       
  • Large scale ICU data sharing for 1000 critically ill patients with severe
           acute ARDS corona virus 2 “SARS” covid 19 in three distinct
           centers.

    • Abstract: Background:A coronavirus disease pandemic (COVID-19) caused by the SARS-CoV-2 coronavirus has been spreading to China since December 2019 and is now regarded as a global threat. The infection has an average incubation period of 5.2 days and causes fever, coughing, and other flu-like symptoms. Objectives:The statistical analysis included a large group of critically ill patients with severe acute ARDS corona virus 2 "SARS" COVID 19.Study design:Three different health institutions in the MINYA governorate were used to gather data on 1000 people who had their COVID-19 tested in a lab. Methods:All patients who had a positive polymerase chain reaction (PCR) test result on a nasopharyngeal sample and had a verified case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were included. When patients were admitted to MINYA health acute care hospitals, clinical outcomes were monitored.Results:The results showed that 694 patients (69.7%) did not have acute renal impairment whereas 301 individuals (30.3%) did. Additionally, stage I was seen in 155 (51.5%) patients, stage II in 69 (21.9%), and stage III in 77 (25.6%) people, according to the KDIGO classification.Conclusion:Despite the fact that acute renal injury is a common finding in COVID-19 patients, the risk of death is increased in these people. Furthermore, a statistically significant relationship existed between AKI and (Age, DM, CKD, HTN, Non-invasive MV, Invasive MV, Death, O2 saturation on admission, p/f ratio on admission, and Creatinine).
       
  • Comparison Of Two Different Modalities To Reduce Blood Loss During
           Myomectomy: A Randomized Controlled Trial.

    • Abstract: Background: Uterine leiomyomas are the most common benign uterine tumors. Abdominal myomectomy is a common kind of treatment for large, symptomatic uterine fibroids in women who want to preserve their fertility. Severe intraoperative bleeding frequently poses a challenge during transabdominal myomectomy. Aim: this study aimed to compare the effectiveness of preoperative vaginal misoprostol with intraoperative pericervical tourniquet in reducing blood loss during abdominal myomectomy. Patients and Procedures:120 patients with symptomatic uterine leiomyomas who underwent abdominal myomectomy participated in this clinical randomized controlled experiment. Patients were randomly assigned to one of three equal groups. Group II received an intraoperative pericervical hemostatic tourniquet, Group III functioned as the control group and underwent surgery without any further intervention, while Group I received preoperative vaginal misoprostol 400 mcg two hours before the procedure. This study was conducted by the Obstetrics & Gynecology Department at the Minia University Maternity Hospital (MUMH). Results: When Misoprostol, Tourniquet, and Control groups were compared, it was reported that there was a statistically significant reduction in the need for blood transfusions (12.5%, 7.5%, and 30%, respectively), estimated blood loss (462.08 ± 15.43, 375.1 ± 13.98, and 661.82 ± 12.85 ml, respectively), and surgery time (64.77 ± 3.78 minutes, 55.17± 5.48, and 66.75± 6.47 minutes, respectively).conclusion: After abdominal myomectomy , preoperative vaginal misoprostol and intraoperative pericervical hemostatic tourniquet is more effective in reducing blood loss than the non-intervention approach. Preoperative vaginal misoprostol 400mcg is an effective and safe method for reducing blood loss during transabdominal myomectomy.
       
  • Prevalence of neuropsychiatric disorders related to long-term COVID-19
           syndrome following acute SARS CoV-2 infection in pediatric patients

    • Abstract: Background: Coronavirus-2 is the causative agent of acute respiratory distress syndrome (COVID-19), which has led to an alarmingly high number of fatalities and cases of sickness. Children who have acute SARS-CoV-2 infections frequently show no symptoms or just moderate ones, and severe consequences practically never occur as a result of these.Aim of the work: quantify the risks of new-onset neuropsychiatric conditions in pediatrics.Method: a survey-based, cross-sectional, analytical, and descriptive study. Pediatric Department of Minia University, through To direct the interview's content, a semi-structured interviewer guide will be created, which will include broad and targeted questions. We included a history of microbiologically proven (nasopharyngeal swab) infections, children aged 1 month to 18 years with acute COVID-19 phase 1-6 months before study enrollment, and permission to participate from parents or guardians. We omit the patient because his family refused to participate, there was no contact information provided, or it was impossible to reach the family. Additionally, COVID-19 began more than six months ago.Results: Eighty children were included in the study, and Neurological screening  showed that 5(6.25%)had Weakness, 7(8.75%)had Tremors, 4(5%)had 4 (5%) had seizures. Psychiatric screening showed that 6 (7.5%) had experienced little interest or pleasure in doing things, 9(11.25%)had been feeling down, sad, or hopeless, and 1(1.25%)had heard or seen things that others could not or when no one else was present.Conclusions: Neuropsychiatric complications following a severe COVID-19 infection were especially notable in children. This may inform post-discharge support for children who have evidence of COVID-19 infection.
       
  • Accuracy of lung volumetry using three-dimensional computed tomographic
           (3D CT) imaging in chronic obstructive pulmonary disease patients

    • Abstract: Background: Both developed and developing nations are affected by the disorder known as chronic obstructive pulmonary disease (COPD). The use of CT to offer phenotypic classification to assist in the clinical characterization of COPD patients is becoming more and more popular. The purpose of the current study was to examine if pulmonary function tests and quantitative computed tomography lung analyses were significantly correlated in people with chronic obstructive pulmonary disease.Methods: Pulmonary function tests and chest CT scans were performed on fifty COPD patients. For the quantitative evaluation, the low attenuation volume LAV-950 HU (%) of both lungs, the right lung, the left lung, and each lobe were obtained. The forced expiratory volume in 1 second (FEV1) and the ratio of FEV1 to forced vital capacity (FEV1/FVC) were compared to the quantitative CT findings.Results: All quantitative assessment parameters with less than -950 HU showed a moderately negative correlation with pulmonary function tests (FEV1 and FEV1/FVC ratio), and LAV < -950 HU (%) values in both lungs, right lung, left lung, and each lobe were higher in patients with GOLD stages 3 and 4 of COPD compared to GOLD stages 1 and 2 (p 0.001).Conclusion: A further reliable, quick, and simple non-invasive method for determining the severity of emphysema is provided by the strong correlation between the parameters of pulmonary function tests and quantitative CT assessments of the disease.
       
  • (R.) "Efficacy of Intralesional Injection of Vitamin D3 in treatment
           of Alopecia Areata"

    • Abstract: AbstractBackground: People of all ages and genders may be afflicted by the common inflammatory, non-scaring, hair loss illness known as alopecia areata (AA).Aims: The efficacy of intralesional vitamin D3 injection for the treatment of patchy alopecia areata was evaluated in this research.Patients and Methods: Twenty adult patients with localized alopecia areata participated in the clinical study. There were a total of four sessions with one milliliter (1 ml) of intralesional vitamin D3 permitted. Dermoscopy and the 5-point semiquantitative regrowth score (RGS) were used to assess the treatment's effectiveness.Results: With a p-value of 0.001, the 5-point semiquantitative regrowth score( RGS) showed a clinically meaningful improvement after treatment. With dermoscopy , signs of activity were reduced, signs of improvement increased, and by the third month of treatment, improvements were apparent.Conclusion: Patchy alopecia areata may be effectively treated with intralesional vitamin D3 which is safe and not expensive.
       
  • Evaluation of development of cesarean section scar niche in Patients with
           post cesarean section surgical site infection by 2 Dimension saline
           infusion sonohysterography:prospective study at Minia Maternity University
           Hospital

    • Abstract: Purpose of study : the niche as "any indentation representing myometrial discontinuity at the site of the scar that communicates with the uterine or cervical cavity" (1).CSD identification is made easier by the advancement and greater use of diagnostic technologies such as pelvic ultrasonography and MRI. Furthermore, the higher incidence of caesarean delivery may lead to a rise in the number of women complaining of postmenstrual spotting, irregular bleeding, pelvic discomfort, or infertility (2). This study aimed to evaluate development of scar niche in patient with post CS SSI. Basic procedures: this study was conducted on 100 women at the Minia University Hospital's Department of Gynaecology for follow-up following CS SSI. The research was started in June 2022 to June 2023. Using saline infusion sonohysterography. Main findings: results of this study revealed niche prevalence 84% of participants had a niche. 71% had a triangular niche, 26% a semicircular niche, and 3% a droplet niche. Principle conclusion: Our prospective analysis found that surgical site infections , rural domicile, higher BMI and emergency CS all enhance the chance of scar defect formation.
       
  • R2 The acceptability of using levonorgestrel IUD (Mirena) among Egyptian
           women: a cross sectional study

    • Abstract: Abstract:Introduction: Preventing pregnancy is what contraception is all about. This might be a tool, a drug, a technique, or a habit.Aim of work: To determine if levonorgestrel IUD (Mirena) use is acceptable among Egyptian womenPatients and Methods: 500 women who were using levonorgestrel IUDs (Mirena) received contraceptive services at the facilities in Minia and Maghaghuh over the course of this research.Results: This table displays a mean age of 28.56 years and a mean BMI of 26.71 kg/m2. While just 45.8% of the patients were urban and 54.2% were in rural areas.Discussion: Due to their excellent effectiveness, safety, simplicity, and affordability, intrauterine devices (IUDs) are the second most popular reversible contraceptive method used globally.Conclusion: In our setting, there is a low incidence of levonorgestrel IUD (Mirena) use and a high rate of cessation owing to adverse effects. Recommendations: It is advised that larger, comparative observational studies or well planned randomized controlled trials be used in future research.
       
  • Clinical outcomes after conventional penetrating keratoplasty : 12 months
           follow up

    • Abstract: Abstract Background: Using a manual trephination technique, a diseased cornea is replaced with a healthy one in a process referred to as conventional Penetrating Keratoplasty (PKP). Healthy cornea can be obtained from a donated human cornea, which is usually obtained from an eye bank. Keratoplasty is a promising visual rehabilitation for end stage corneal cases. Purpose: to evaluate clinical outcomes after conventional PKP within 12 months postoperatively. Patients and Methods: Prospective study including 12 cases of conventional PKP. Six and twelve months after surgery, patients had slit lamp and fundus examinations, uncorrected and best-corrected visual acuity (BCVA) tests, postoperative refraction and spherical equivalent evaluations.Results: The mean BCVA was 0.05(0.1) at 6 months and 0.3(0.2) at 12 months, with 12 months having a significantly higher value (p = 0.004). Manifest astigmatism is quite higher at 12 m than at 6 m.Conclusion: Clinical results, such as BCVA have significantly improved after conventional PKP.
       
  • Relation of smartphone addiction to sleep quality and social isolation
           among medical students at minia university during Covid era

    • Abstract: Background: the use of smartphones has increased rapidly. Because of the rapid adoption of new technologies, technology-related consequences are of great interest. The usage of new technology is increasing, particularly among young people, but not exclusively. The Internet is used by 50% of the world's population, and more than 3.8 billion people (or about 49% of the world's population) own a smartphone. OBJECTIVES: To estimate the prevalence & evaluate factors of mobile phone and internet addiction among medical students at Minia university. To assess the prevalence of sleep disturbance in medical students and the association between mobile phone use and sleep disturbance.METHODS: an observational cross-sectional study conducted on a random sample of medical students in faculty of medicine Minia universty Minia, Egypt.RESULTS: Three hundred and eighty-five students participated in this study; About 61.7% of medical university students in the current study meet the criteria for smartphone addiction with no significant difference between genders. Smartphone addicts showed significant increase in level of loneliness than non addicts (p=0.024). Regarding sleep quality, the number of bad sleepers was significantly higher(84.6%) (p = 0.003) in smartphone addicts than non addicts.CONCLUSIONS: prevalence of smartphone addiction increased significantly during Covid era due to lockdown. Main Predictors of smartphone addiction were found to be sleep disturbance, social networking, social isolation and poor academic achievement.
       
  • (NEW) Electrocardiographic Changes In Children With Idiopathic Epilepsy
           And Epilepsy Secondary To Structural Brain Lesions

    • Abstract: Background: Epileptic seizures associated with several changes in autonomic functions, which may lead to cardiovascular, respiratory, gastrointestinal, and urinary or sexual manifestations during or soon after the ictal event. This study aimed to assess Electrocardiographic (ECG) changes after an epileptic seizure in children with idiopathic epilepsy and epilepsy secondary to structural brain lesions (SBL). Subject and Methods: This was a case control study, it was conducted on epileptic children admitted to Pediatric Inpatient Department of Minia University Hospital for Obstetrics & Gynecology and Pediatrics. This studied included 60 epileptic children and 30 healthy children as controls. They were divided into three groups, group I: idiopathic epileptic children, group II: epileptic children secondary to structural brain lesions and group III: healthy children.CBC, LFT, electrolytes (Na, K, Ca), ECG, EEG were done for all patients.Results: In this study there were no significant difference in the ECG rhythm, ST segment, T wave, QRS complex among all the studiedgroups.On the other hand there was a significant higher heart rate in group I (idiopathic epilepsy) and group II (epilepsy secondary to SBL) than group III (healthy controls).Conclusion: idiopathic epilepsy and epilepsy secondary due to SBL can cause myocardial strain and significant tachcardia
       
  • Additive role of dynamic MRI in diagnosis of intermediate breast lesions
           (BIRADs 3&4)

    • Abstract: Abstract:Background: Breast cancer is the malignancy with the greatest prevalence among women in many countries, including Egypt, and diagnostic radiology aims to detect it early. Because primary prevention is impossible, screening programs are used to discover breast cancer at an early stage. Clinical examination, mammography, ultrasonography, and magnetic resonance imaging are used to make a diagnosis (1).Method: 32 individuals identified with intermediate breast lesions on ultrasonography received dynamic MRI breast assessment. A confirmatory Tru-cut biopsy was performed.Results: the study involved 32 patients with suspicious breast lesions in ultrasonography examination, the range of the age of our study patients was from 29 to 78 years old with mean age of 56.1 years (40.6 % of the lesions was seen in the right side and 53.13 % of the lesions was seen in the left side with 6.25 % of the cases with bilateral breast lesions). Conclusion: to determine the function of dynamic MRI breast examination in the diagnosis of discovered intermediate lesions in ultrasonography, followed by biopsy to confirm the diagnosis.
       
  • Prognostic Value of Triglyceride Glucose Index in Patients with Type II
           Diabetes Presented with Acute ST Elevation Myocardial Infarction after
           Percutaneous Coronary Intervention.

    • Abstract: AbastractBackground: cardiovascular disease pathogenesis is strongly influenced by insulin resistance (IR), the triglyceride-glucose index (TyG index) acts as a rapid and accurate surrogate diagnostic tool of IR diagnosis. Previous data suggests possible prognostic role for TyG index in coronary artery disease patientsMethods:Patients with diabetes who had STEMI and were treated with primary PCI numbered 175. Patients were divided into two groups based on the presence or absence of major adverse cardiovascular and cerebral events (MACCEs) throughout the follow-up period (30 days, 6 months, and 1 year). The TyG index was determined by taking the logarithm of the ratio of fasting triglycerides to fasting phosphorus.Results:More MACCEs and deaths from any cause occurred in patients with STEMI who had higher TyG index values 30 days, 6 months, and 1 year following PCI. Independent of other risk variables, the TyG index was related with a greater incidence of MACCEs in STEMI patients within a year after initial PCI (p = 0.0001).Conclusion:Patients with type 2 diabetes with STEMI within 1 year following PCI had an elevated risk of MACCEs, and the TyG index may be used as a strong independent predictor of this increased risk.Key words: Insulin resistance (IR), Major adverse cardiac and cerebral events (MACCEs) Triglyceride-glucose index (TyG index), Acute myocardial infarction (AMI), Type 2 diabetes mellitus (T2DM),
       
  • Impact of Sleep and psychological distress on clinical pregnancy rate in
           infertile couples undergoing Assisted Reproductive Technology at Minia
           Infertility special centers Prospective Observational Study

    • Abstract: ABSTRACTBackground: Assisted reproduction technologies (ART) encompass a range of medical interventions aimed at initiating pregnancy. These interventions involve the manipulation of both oocytes and sperm or embryos in a laboratory setting, with the primary techniques being in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI). The presence of sleep impairment has been linked to a range of adverse mental and physical health consequences.Aim and objectives: To establish a correlation between the quality of sleep and the expression of psychological stress in relation to clinical pregnancy.Subjects and methods: The present study was conducted within the Obstetrics and Gynecology department at the Faculty of Medicine, Minia University, specifically in the Minia Infertility Special Centers. Ethical approval was obtained from the local hospital's ethical council. A total of 150 couples were included in the study, and data collection took place from April 2022 to April 2023.Results: There was a notable and statistically significant distinction observed among the groups under investigation in relation to various factors, including the ovarian stimulation protocol's impact on clinical pregnancy, the distribution of the Pittsburgh Sleep Quality Index (PSQI) based on the ovarian stimulation protocol, the distribution of pregnancy rates according to PSQI, the association between anxiety, depression, and psychological stress with clinical pregnancy.Conclusion: There is no significant association between sleep quality, psychological discomfort, and the clinical pregnancy rate in patients undergoing intracytoplasmic sperm injection (ICSI).
       
  • Comparative study between Laparoscopic mini-gastric bypass versus
           laparoscopic single anastomosis sleeve jejunal bypass for treatment of
           morbidly obese patients

    • Abstract: AbstractIntroduction: Bariatric surgery is a long-lasting and efficient method for managing of obesity and curing associated comorbidities. The objective of this study is to compare the short-term results of laparoscopic single anastomosis sleeve jejunal bypass and mini gastric bypass as regard to patient metabolic and nutritional impacts, postoperative weight reduction, and the effects on both.Results Thirty individuals had SASJ and thirty had MGB. For the SASJ and MGB groups, the mean age was 37.23±13.9 and 37.1±8.83 years, the body mass index was 52.1±9.12 and 50.14±8.23, the percentage of total weight reduction was 28.3±6 and 27.8±4.7, and the percentage of excess weight loss was 56.4±12.4 and 53.4±11 respectively. In SASJ patients, type two Diabetes was resolved in 75% of cases, hypertension in was improved in 33.3% of cases, and dyslipidemia was improved in 38.1% of cases, compared to type 2 diabetes resolution in 81.5% of cases, hypertension improvement in 28.6%, and dyslipidemia improvement in 38.5% of cases in the MGB group.Conclusion: Both MGB and SASJ bypass are effective bariatric procedures for weight loss and treating comorbidities. Laparoscopic SASJ bypass is a safe, simple procedure that can cure patients who are morbidly obese while also resolving co-morbidities. It has comparable post-operative outcomes to MGB.
       
  • Epidemiology of traction alopecia among school students in Minia, Upper
           Egypt

    • Abstract: Traction alopecia, as a distinctive disease, was first identified in 1904 but is still a major cause of scarring hair loss in young girls worldwide. Traction alopecia is initially reversible, but if it continues, it can become an irreversible (scarring) form of alopecia. It can be seen across all races due to tightly-pulled hairstyles. The pattern of alopecia depends on the hairstyle causing it, but it most commonly affects the frontotemporal hairline. There are some new clinical features associated with traction alopecia, which are traction folliculitis, the fringe sign, and hair casts (pseudonits) on dermatoscopy. The primary treatment for traction alopecia is to discontinue the contributing excessive hairstyles. Camouflage, anti-inflammatory, or growth-stimulating topical preparations are second-line treatments. In the later stages of permanent scarring form of traction alopecia, hair transplantation may be the only effective treatment. This study was conducted to study the incidence of traction alopecia among school students in Minia, Upper Egypt.
       
  • (R) Cardiac Involvement In Children Impacted By COVID-19.An Observational
           Study

    • Abstract: Background: Corona virus disease 2019 (COVID-19) is a contagious disease caused by (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. Since the disease is still spreading quickly around the world and has already claimed nearly 360,000 lives, the World Health Organization (WHO) has determined that corona virus disease 2019 (COVID-19) can be considered a pandemic in March 2020The sequelae of pediatric COVID-19 can affect organs and systems, as cardiovascular system with emphasis on the development of myocarditis, heart failure, cardiogenic shock.Objective: This study aimed to assess cardiac complications caused by COVID-19 infection in children.Patient and methods: The study is a prospective cross - sectional study included 40 patients admitted to PICU isolation unit in Pediatric Department of Minia University Hospital, during the period from December2021 to December2022 , who were COVID-19 infection with cardiac complications. Results: patient investigated for cardiac complication that was (25%) of participants had tachyarrhythmias, while (75%) did not., (30%) participants experienced myocardial dysfunction, while (70%) did not have. (7.5%) of the participants had BBB, while 37(92.5%) did not have. (2.5%) of participants had pan carditis, (97.5%) did not have. (5%) of the participants experienced heart block, while (95%) did not have. (30%) had a mild condition, (42.5%) had a moderate to severe condition, and (27.5%) had a critical condition. Conclusion: Cardiovascular issues are emerging as one of the most significant complications of SARS-CoV-2 infection in children.Keywords: COVID 19, MIS-C, ECHO.SARS-CoV-2
       
  • Effectiveness of Precooling Versus 20% Benzocaine In Pain Perception
           During Intra oral Local Anesthetic Injections in Children: A Randomized
           Controlled Trial

    • Abstract: ABSTRACTResearchers are always looking for the most effective technique to decrease pain while administering local anesthesia.Aim of the study: This study compared the efficacy of cooling the injection site versus using a topical anesthetic agent to decrease pain associated with local anesthetic injection in children. Patient & Methods: 112 school children were randomly selected from the outpatient clinic of the Pediatric Dentistry Department, Faculty of Dentistry, Minia University. The main inclusion criteria included the administration of local anesthesia before dental procedures. Children were randomly divided into two groups of equal size, each with 56 subjects; Group A: using 20% Benzocaine (control) and Group B: using precooling. Pain was evaluated immediately after intra-oral injections using the Mean arterial blood pressure (MABP).Results: The results demonstrated that there was no statistically significant difference between the two groups on the mean arterial blood pressure (MABP).Conclusion: There is no statistically significant difference between cooling and using 20% Benzocaine during injection of local anesthesia.
       
  • Clinical and laboratory predictors of isolated coronary artery ectasia in
           patients with chronic coronary syndromes

    • Abstract: Background: Coronary artery ectasia (CAE)is a dilatation of coronary arteries that can cause acute coronary syndrome (ACS), its causes and pathophysiology are not cleared yet, however, many postulations existed including; endothelial dysfunction, micro-vascular disease, oxidative stress, inflammation, enhanced platelet activity and exaggerated positive vascular remodelling. Methods: Our study highlights some of the predictors for CAE such as Big Endothelin-1(BigET-1), High sensitive CRP (hs-CRP), Neutrophils to lymphocytic count ratio(NLR), LDL/HDL ratio, and ALT/AST Ratio. Results: 100 patients are included in this study. patients were categorized into four equal-sized groups, 25 patients with isolated CAE, 25 patients with both obstructive CAD and CAE, 25 patients with obstructive CAD only, and 25 patients with normal CA( control group). Our study showed that the Big Endothelin-1(BigET-1)( P=0.001), High sensitive CRP (hs‑CRP)( P=0.001), LDL/HDL ratio(P=0.006) were significant predictors of CAE, Others as Neutrophils to lymphocytic count ratio(NLR)( P=0.09), ALT/AST Ratio (P=0.08)were not significant predictors of CAE. Conclusions: A higher level of BigET-1, hs‑CRP, and LDL/HDL Ratio were predictors independently associated with CAE patients. These markers level may therefore provide diagnostic information for CAE patients
       
  • Comparative study between different modalities of common bile duct closure
           after exploration and choledocho-lithotomy

    • Abstract: AbstractBackground: Recent developments in radiologic, endoscopic, and surgical procedures have increased treatment options and made laparotomy unnecessary for evacuation of bile duct stones. Choledochotomy, stone extraction, confirmation of CBD clearance via passage of a soft catheter or dilator proximally or distally, cholangiography, and choledochoscopy are all part of standard CBD exploration process; choledochoscopy may be preferred; and finally, drainage procedures are recommended but are controversial due to options such as:biliary drainage using a T-shaped tube. A biliary stent is implanted intraoperatively. Aim of study: The purpose of this study is to compare two methods of CBD closure following CBD exploration: T-shaped tube biliary drainage and biliary stent implantation. Patient and methods: Thirty patients were included, all of whom had undergone general surgery at ELMinia University Hospital. CBD stones found in every single one of them. Results: In situations of CBD stone with failure of stone extraction by ERCP, a common bile duct closure after intraoperative biliary stent implantation is safe and possible after choledocolithotomy in appropriate patients. findings demonstrate the efficacy of this method in terms of reduced length of stay in the hospital, decreased risk of complications such biliary leakage and biliary stricture, and reduced financial outlay. Conclusion: In this study we found that intraoperative CBD stenting after choledocholithotomy is better than T-tube drainage with shorter hospital stay, wound infection, good biliary drainage from CBD to the duodenum with less liability for postoperative bile leakage, equivalent operation time and mortality rate. Keywords: CBD exploration; choledocho-lithotomy; CBD stent.
       
  • R: Detection of drug resistance pattern of Pseudomonas aeruginosa clinical
           isolates in Minia University hospitals

    • Abstract: Background: Pseudomonas aeruginosa (P. aeruginosa) infection shows a higher morbidity and mortality rates especially in immunosupperessed individuals. It has a high level of resistance through various mechanisms to most antimicrobials. P. aeruginosa can cause severe nosocomial infections, manifesting as pneumonia, surgical site infections, urinary tract infections (UTI) and It is one of the most common causes of bacteremia Methods: From February 2022 to May 2023, 48 samples collected from various infected surgical wound specimens were used in this work. Then, antimicrobial susceptibility tests were done to the isolates by the disc diffusion method .PCR used for detection of gene responsible for antibiotic resistance. Results: Out of 48 samples, 25 isolates were positive for P. aeruginosa and (18/25) 72% were MDR. Conclusion: P. aeruginosa Infections have become a severe problem that requires a precise diagnosis and effective treatment. To replace the current unsuccessful therapies, new alternative treatment plans should be taken into consideration and researched.
       
  • Stented Versus Non-stented Bilio-Enteric Anastomosis in Hepatobiliary
           Unit, Minia University Hospital

    • Abstract: Background Hepaticojejunostomy (HJ) is a widespread procedure used to establish continuity to bypass an obstructed bile duct, as well as after resection performed due to various diseases and injuries. The complications of HJ including leakage and stricture formation, imposing a challenge in biliary surgery. Objectives The current study aims to evaluate the role of stenting in bilio-enteric anastomosis in reducing morbidity like biliary leakage in comparison with non-stented cases.Subjects and methods A prospective randomized comparative study was conducted on 40 patients undergoing bilio-enteric anastomosis from August 2020 to February 2023, in the Hepato-Pancreato-Biliary Unit, General Surgery Department, Minia University Hospital, Minia, Egypt. Results 20 patients (50%) of the study sample were stented; the size of the stent was chosen according to the intra-operative size of the common bile duct (CBD); the remaining 20 patients (50%) were non-stented. There was no statistically significant difference between stenting/ non-stenting in intra-operative blood loss or operative time (p=0.067, 0.758, respectively). Post-operative follow-up showed a significant difference between stented and non-stented patients in drain bile content (p-value=0.039), post-operative wound complications (P-value= 0.028), as well as postoperative fever (P-value= 0.044). Stented patients also had shorter hospital stay and a lower risk of ICU admission (P-value = 0.0434, and 0.049, respectively. Conclusion By taking into consideration that postoperative complications were higher in non-stented patients with a longer hospital stay as well as a higher risk of ICU admission, stenting is superior to non-stenting in patients undergoing bilio-enteric anastomosis (Hepaticojejunostomy).
       
  • Multidrug resistance in proteus species isolated from outpatients with
           urinary tract infections in Minia university hospitals, Egypt

    • Abstract: Introduction and aim of the work: Proteus species represent an important cause of urinary tract infections (UTIs) both in community and hospital settings. Proteus species are more isolated from inpatients especially in catheter associated UTIs while little information is available among outpatients. The current study aims to access prevalence and antimicrobial susceptibility of proteus species isolated from outpatients with UTIs. Subjects and Methods: 135 outpatients presented with symptoms of UTI from whom midstream urine samples were collected. Urine culture was done on MacConkey agar, colonies more than 105 CFU/ml are further identified for isolation of proteus species and antimicrobial susceptibility testing was performed using disk diffusion method. Results: proteus species were isolated from 11% of outpatients with UTIs. All proteus isolates were sensitive to Gentamicin and resistant to Cefazolin and nitrofurantoin; 75% of proteus isolates showed multidrug resistance. Conclusion: Increased rates of multidrug resistant proteus isolated from community acquired urinary tract infections.
       
  • The Value of Serum Hepciden level in Diagnosis of Anemia in Children with
           Chronic kidney Diseases

    • Abstract: Abstract: stract:Background: Anemia is a common complication in chronic kidney disease (CKD. Hepcidin, an acute phase protein in iron regulation, can provide information regarding iron homeostasis and anemia in chronic disease Aim of the work: to determine the cause of anemia in children with CKD by measuring the serum level of hepcidin.Methods: This study was carried out in Pediatric department in Minia University maternity & children hospital from Augest 2021 to February 2022. The study included 60 patients with clinical and laboratory confirmation Chronic Kidney Disease With anemia and 30 apparently healthy children of matchable age and sexResults: There was a significant difference in cases with CKD regarding weight and height [p value <0.001, when compared to their corresponding values in control healthy group. There is no significant difference in cases with CKD regarding age, gender, residence & BMI when compared to control group., that showed significantly lower growth parameters compared to controls . Hb, MCV, MCH, MCHC were significantly lower in cases, [p value <<0.001] when compared to their corresponding values in control group. Also, renal function tests Urea, creatinine and GFR were significantly higher in cases, [p value <0.001], when compared to values in control group. Elevated urea and creatinine would have independent effects of eGFR on the development of anemia by representing the accumulation of uremic toxins which could inhibit effective erythropoiesis. there was a significant elevation in ferritin and TIBC and significant decrease in iron in cases with CKD.
       
  • A randomized prospective study of the efficacy of ejaculation- preserving
           bipolar transurethral resection of prostate

    • Abstract: Introduction: Bladder outlet blockage is a typical side effect of BPH in elderly men. When conservative therapy fails, surgical intervention [TURP] can produce satisfactory clinical and functional results. We changed the standard TURP approach to prevent resection of bladder neck and supramontanal tissues in order to maintain forward ejaculation. Patients and Methods: Minia Urology Hospital's outpatient clinic conducted a prospective randomized trial to assess the preservation of antegrade ejaculation following bipolar TURP. The research included 40 male patients with normal sexual activity who had BPE and were candidates for surgery. The trial comprised men who had failed normal medical therapy for prolonged urine retention, infection, or hematuria. There was no evidence of prostate cancer, neurogenic bladder, urethral strictures, or sexual or ejaculation difficulties. All surgeries were carried out using a standard resectoscope and an ERBE BISTOURI VIO 300D with bipolar resection box. Results: The present study included 40 males who had normal sexual activity and benign prostatic enlargement. The median age was 63.6 years. When compared to preoperative values, postoperative IPSS, IIEF, and ejaculation preservation are substantial.Conclusion: The epTURP method was created as a successful minimally invasive surgery for patients experiencing severe urinary obstructive symptoms as a result of BPE and the need to sustain ejaculation. Bipolar TURP that preserves bladder neck and supramontanal ejaculation outperforms standard TURP in terms of forward ejaculation preservation, with equivalent effectiveness in micturition parameters.Key Words: TURP, retrograde ejaculation, IPSS, IIEF, ejaculation preservation
       
  • Neuroglobin as a biomarker in children with autism spectrum disorder.

    • Abstract: Neuroglobin as a biomarker in children with autism spectrum disorder.Abstract:Background: Autism spectrum disorder (ASD) is a group of neurodevelopmental conditions diagnosed based on behavioral assessments that reveal deficits in social interactions.Objectives: The aim of this study is to investigate the possible role of neuroglobin as a biomarker in children with ASD.Methods: This cross-sectional study was carried out at Minia University of Children, Obstetrics and Gynecology Hospital over the period from January 2022 to January 2023.It was conducted on 19 children diagnosed with ASD attending to the Pediatric neuropsychiatry out-patient clinic or admitted to the pediatric neurology inpatient ward of Minia University of Children, Obstetrics and Gynecology Hospital during the period of the study.They were subdivided into two groups:Group I (N=19): included autistic children (14 males & 5 females) for fulfillment the criteria of autism.Group II (N=30): included apparently healthy children (21 females & 9 males) whose age and sex were matched with group I. The two groups were subjected to careful detailed history taking, complete clinical examination, and laboratory investigations including: complete blood count, Serum Neuroglobin level.Results:Our results show that there were statistically significant differences as regard serum neuroglobin level between group (I), group (II).Conclusion: In conclusion, higher serum neuroglobin levels among children with ASD than controls.
       
  • R2 Demographic data and its relation to clinical improvement in
           parkinsonian patients subjected to rTMS

    • Abstract: Introduction: Parkinsonism is a group of disorders characterized by bradykinesia, tremors, rigidity, postural instability and other non-motor manifestations. It includes many types, the most common among them is Parkinson's disease (PD) that affects about 9 million people worldwide. Treatment of parkinsonism can be divided into: Medical treatment which is considered the first line and surgical treatment. Transcranial magnetic stimulation (TMS) is a non-invasive safe device that causes stimulation of targeted brain cortical areas. It's used in many neuropsychiatric diseases including trails in parkinsonian disorders. Aim and Objectives: This study aims to investigate the relation between demographic data and clinical improvement after repetitive TMS. Patients and method: our study was held in Minia university hospital on 35 parkinsonian patients with specific inclusion criteria. They underwent 10 successive high frequency rTMS sessions and were assessed by Unified Parkinson's Disease Rating Scale (UPDRS). Results: Mean age of patients was 58.74 and male: female ratio: 24: 11. Four of them are diabetic, 15 are hypertensive, 7 complain of another disease. Four have positive family history. Thirty of them were on levodopa medication. Our study showed that there was no correlation between improvement in UPDRS resulted from TMS and demographic data except for levodopa use and UPDRS part II. Conclusion: Our study concluded that improvement appeared after TMS use, UPDRS score wasn't related to any of demographic data except what mentioned before.
       
  • Coagulation Profile in COVID-19 Patients

    • Abstract: Purpose of study: Coronavirus disease-2019 (COVID-19) is an infectious illness caused by coronavirus-2 (SARS-CoV-2) that results in a severe acute respiratory syndrome. The hallmark of COVID-19 is thromboembolic consequences, which can result in death even in COVID-19 individuals who are asymptomatic Aim and objectives: This study aimed to evaluate activated partial thromboplastin time(aPTT) ,International normalized ratio (INR) and D-dimer in COVID-19 patients and their association in COVID-19 coagulopathy . Basic procedures: The study was conducted on 54 subjects including 16 apparently healthy individuals (group II) with matched age and sex as a control group and 38 patients diagnosed having covid 19 infection by PCR , level of aPTT , INR and D-dimer were measured . Main findings: results of this study revealed that there was statistically significant increase in aPPT , INR and D-dimer in the COVID-19 patients when compared to the control group. Principle conclusion: Overall Coagulopathy is a serious complication . Therefore, markers of coagulation aPTT, INR and D-dimer are useful determinig and predicting fate of COVID-19 .
       
  • Value of flowcytometric determination of circulating endothelial
           progenitor cells in Behcet’s disease patients.

    • Abstract: Background and aim of the study: Behcet's disease (BD) defined as a systemic vasculitis condition with multifactorial immunopathogenesis. Endothelial progenitor cells (EPCs) are essential for vascular repair and hemostasis. Our current study aimed to evaluate role of circulating EPCs in BD and correlate it with lab findings & clinical manifestations /disease activity. Methodology: The study included 30 patients (group I) suffering from BD and 25 apparently healthy subjects group(II) matched with group(I). For BD patients, clinical features and activity assessed by current disease activity form (BDCAF). For All subjects, clinical and laboratory investigations including routine tests and the determination of circulating EPCs using flowcytometry (Identified as live nucleated CD45 negative/CD34 bright/CD309positive events) were recorded. Results: There was statistically significant increase in group I regarding EPCs,TLC,AST CRP and ESR compared to group II.Circulating EPCs showed positive significant correlation with hemoglobin,AST and ALT However there were negative significant correlations with TLC, Monocytes ,Neutrophils, ESR and NLR and negative insignificant correlation with CRP and ANCA and ANCA C& P, There was negative non-significant correlation between EPCs and eye , skin and joint symptoms and BDCAF score .Conclusion:Our study demonstrated increased level of circulating EPCs in BD than controls with negative correlation with inflammatory markers and negative(nonsignificant) correlation with clinical manifestations and BDCAF score. High levels of circulating EPCs could be a good sign of endothelial healing suggesting its potential, after further studies on large cohort of patients, to serve as a maker of repair and recovery of damaged blood vessels in BD patients.
       
  • Evaluation of degloving only in surgical repair of buried penis

    • Abstract: Introduction : Buried penis is a congenital defect described by smaller external genitalia than they actually are yet they are normally sized . This is frequently accompanied by poor external skin of the penis, Dartos fascia fibrosis , poor attachment of the subcutaneous layer to Buck's fascia, and a small prepuce opening. Several symptoms have been noted, including humiliation while unclothed, trouble maintaining cleanliness, gripping the penis when voiding, balanitis, and infection of urinary system . Aim of study : to evaluate the results of buried penis repair using degloving of the penis without fixation of the penis to the skin . Patient and methods : 20 patients with buried penis, not obese ,not associated with other penile disorder like hypospadias , epispadias ,chordae ,penile torsion or previous penile operation with mean age 5 years, underwent surgical repair of buried penis by penile degloving and cut of dartos tissue and tethering bands without stitches to fix penis to skin . Results : .the overall results were satisfactory with no major complication or recurrence of buried penis only one parent was dissatisfied with result due to partial retraction of the penile shaft ,but not completely hidden . Conclusion : penile degloving without suturing it to skin can repair the condition and get good results with few complications.
       
  • Demographic data and its relation to clinical improvement in parkinsonian
           patients subjected to rTMS

    • Abstract: Abstract: Introduction: Parkinsonism is a group of disorders characterized by bradykinesia, tremors, rigidity, postural instability and other non-motor manifestations. It includes many types, the most common among them is Parkinson's disease (PD) that affects about 9 million people worldwide. Treatment of parkinsonism can be divided into: Medical treatment which is considered the first line and surgical treatment. Transcranial magnetic stimulation (TMS) is a non-invasive safe device that causes stimulation of targeted brain cortical area. It's used in many neuropsychiatric diseases including trails in parkinsonian disorder. Aim and Objectives: this study aims to investigate the relation between demographic data and clinical improvement after repetitive TMS. Patients and method: our study was held in Minia university hospital on 35 parkinsonian patients with specific inclusion criteria. They underwent 10 successive high frequency rTMS sessions and were assessed by Unified Parkinson's Disease Rating Scale (UPDRS). Results: Mean age of patients was 58.74 and male: female ratio: 24: 11. Four of them are diabetic, 15 are hypertensive, 7 complain of another disease. Four have positive family history. Duration of illness ranges from 1year: 16 years, half of them complain of rigidity as main feature beside bradykinesia, 30 of them were on levodopa medication. Our study showed that there was no correlation between improvement in UPDRS resulted from TMS and demographic data. Conclusion: Our study concluded that improvement appeared after TMS using UPDRS score wasn't related to any of demographic data mentioned above.
       
  • Role of volumetric computed tomography in the evaluation of the
           therapeutic response of hepatocellular carcinoma treated by trans-arterial
           chemoembolization and radio frequency ablation.

    • Abstract: Background: Hepatocellular carcinoma (HCC) is the second most common cause of death due to cancer and is diagnosed in around half a million individuals each year across the globe. Primary and secondary liver diseases are increasingly being treated utilizing loco-regional minimally invasive interventional therapies as an effective alternative to surgery. Aim: to retrospectively estimate the accuracy of CT volumetry (By comparing the 2D with 3D volumetric CT index of liver tumors) as a more accurate tool for assessment of treatment response after TACE and RF at radiology department of Minia University Hospital. Basic procedures: Thirty patients whom were recruited from Minia UniversityHospital's , and whom had an interventional treatment for HCC with either standard TACE or RF participated in this retrospective cohort study.Inclusion criteria: Radiological and laboratory diagnosis of HCC. All patients were in BCLC class B and had Child-Pugh scores of A or B. Results: `There were a significant difference among Responders and Non-responders in our study, between 3D volumetric CT and 2D CT as regarding lesion response size in our study. Conclusion: 2D and 3D Volumetric CT varied significantly when assessing the treatment response of HCC following TACE or RF, with only moderate agreement among the two diagnostic modalities in identifying partial response (PR), stable disease (SD) & progressing disease (PD).
       
  • R1 Classic and Combined Approaches in Surgical Strategies for Management
           of Synchronous Colorectal Liver Metastasis

    • Abstract: ABSTRACTBackground: Liver is the most common target organ of metastasis from colorectal cancer. Surgery is the best treatment for patient of colorectal liver metastasis to achieve long term survival or even complete cure, 5-year survival rate after surgery is about 30 - 50 %. Aim and objectives: to evaluate short-term outcome for 6 months of surgery in management of colorectal cancer liver metastasis by both classic and combined techniques. Subjects and methods: This study was A prospective study included 20 patients in National Cancer Institute & Minya university hospital with synchronous colorectal liver metastasis who undergo surgery by classic and combined techniques, 6 and 14 patients respectively . Result: There was a significant difference found between the groups regarding operative time and blood loss. Thus, operative time and blood loss were significantly higher among combined group compared to staged group. There was no significant difference between the groups regarding demographic data, liver biopsy, type of liver resection, type of colorectal resection, complications, histopathology, recurrence and mortality. Conclusion: sCRLM patients managed with either a staged or simultaneous approach had similar perioperative and short-term outcomes. Both minor and major hepatectomy can be performed safely with low morbidity and mortality as part of either a simultaneous or a staged operative strategy. Although not statistically different, patients who underwent an extended hepatic resection did seem to have a higher perioperative mortality. Keywords: Synchronous Colorectal Liver Metastasis; Classic and Combined Approaches; Surgical Strategies.
       
  • Clinical assessment of scorpion sting victims in Minia government upper
           Egypt Abstract

    • Abstract: Envenomation by scorpions is frequent in tropical and subtropical areas. It is a serious public health issue in northern Sahara and the Middle East. According to the World Health Organization (WHO), scorpion stings infect 1.2 to 1.5 million individuals each year, resulting in 3000 to 5000 fatalities. The venom alone causes an inflammatory reaction in the heart, lungs, and liver, resulting in inflammatory cell infiltration (eosinophil and neutrophil) and leukocytosis. The scorpion venom also causes changes in the histological architecture of these organs (heart, lungs, and liver).Purpose of study: The goal of this study is to evaluate the most prevalent clinical signs of scorpion bite victims in Minia government that are peculiar to our government's most common species.Basic procedures: Eighty-one volunteers were recruited from two Minia governorate sites for the research. During the period from the 1st of January 2021 to the 30th of January 2022, these centers were the poisoning center at El Minia general hospital in Minia city and El-Minia university hospital in Minia city. They range in age from 13 to 45 years. The research comprised participants of both sexes. The history and clinical examination were documented on standardized report forms, which included age, gender, vital signs, and physical examinations.
       
  • the Impact of glycaemic control in Type 2 Diabetes Mellitus patients on
           left ventricular diastolic function: Two-Dimensional Echocardiography
           Based Study.

    • Abstract: Abstract:Background: Type 2 Diabetes Mellitus affects left ventricle (LV) diastolic function. Aim of the study: This study's primary objective was assessment of the LV diastolic Functioning in asymptomatic diabetic individuals with normal blood pressure and comparing it to control group by the use of 2D echocardiography.Patients and methods: 80 Diabetes Mellitus (DM) type 2 patients were enrolled. We excluded hypertensive patients and Patients with valvular or coronary heart diseases. All patients got thorough clinical and cardiological examination, laboratory work up including (HbA1C, Fasting blood sugar (FBS), post prandial blood sugar (PPS), CBC, Lipid profile, S.Creatinine, albumin and liver enzymes), 12 leads ECG and echocardiographic assessment of both ventricles by tissue Doppler and conventional methods.Results: In the uncontrolled diabetic individuals, ratio (E/A) of peak early to peak late diastolic flow velocities across mitral were significantly lower than those with controlled diabetes.Conclusion: Patients with uncontrolled type II DM were associated with compromised left ventricular diastolic function compared to controlled diabetics.
       
  • Coagulopathy Reversal in HCV Related Cirrhosis Patients

    • Abstract: Background: Cirrhosis is accompanied by haemostasis modifications. Cirrhotic individuals, show complicated coagulation alterations that comprise decreased hepatic synthesis of both pro- and anticoagulant elements as well as elevated concentrations of procoagulant agents synthesized outside the liver. According to current understanding, these modifications lead to a rebalanced but vulnerable coagulation system that can quickly tip into a hypercoagulable condition. Aim of the work: The research aimed to discuss the hypercoagulability in people having HCV related cirrhosis before and post-treatment using traditional worldwide and individual‐factor coagulation techniques. Subjects and Methods: 25 patients (14 male and 11 female) with HCV related cirrhosis, from 22 to 77 years old, subjected to coagulation tests PT, APTT, activity of PT %, INR, TAT, F1+ 2, and Protein C before and after releasing of the HCV with DAA, and 18 healthy individuals (11 male and 7 female) as a control group . Results: as the patients group post-treatment compared to the patients group before treatment there was statistically significant decrease in the PT test P= (0.008*), APTT test, TAT test, and F1+2 test, while there was statistically significant increase of activity of PT % test with P=(0.01*) . Conclusion: This study revealed improvement of hemostatic derangement in HCV related liver cirrhosis patients after 12 weeks of treatment with DAAs in the form of correction of routine coagulation tests (PT level, % of active PT test, APTT test), plus decrease of the markers of hypercoagulability (TAT test and F1+2 test) with no significant change in protein C level.
       
  • Assessment of serum VEGF level in children type 1 diabetes mellitus

    • Abstract: AbstractBackground: Diabetes mellitus is a chronic metabolic disorder that affects numerous body organs and causes a variety of consequences. It is characterized by persistent hyperglycemia brought on by a problem with insulin production or by insulin resistance.Aims: The aim of this study is to assess the level of serum VEGF (Vascular endothelial growth factor) in children with type 1 DM and its correlation with glycemic control.Patient and Methods: This case-control study, was conducted on 50 children with type 1 DM (Group I) who had regular follow up in the Pediatric Endocrinology Outpatient Clinic. And controls are 20 other apparently healthy children (group II) with matched age and sex. Age: between 5 and 18 years, Duration of diabetes mellitus more than 3 years, normal A\C ratio, and normal fundus examination were included in our study. HBA1c and VEGF were done on all of the patients.Results: our results show that there is a significant positive correlation between the duration of the disease, HBA1C (P value= 0.001), duration of disease and VEGF level (p value= 0.001), HBA1C level and VEGF serum level (p value= 0,001)Conclusions: we demonstrated the significant correlation of VEGF and HbA1c and that should be done to all diabetic patients.Key words;:diabetes mellitus, HBA1C, VEGF.
       
  • Role of high resolution T2& diffusion-weighted images in detection of
           muscle invasion of the urinary bladder carcinoma

    • Abstract: Background :Carcinoma of the urinary bladder is a common malignant tumor of the urinary tract. Proper management of the urinary bladder cancer depends on the stage of the lesions. Cases with muscle invasive bladder carcinoma (MIBCs) are treated with neoadjuvant chemotherapy, radical cystectomy, and lymphadenectomy while in non-muscle invasive bladder carcinoma (NMIBCs) transurethral resection + chemo/immunotherapy . The aim of this prospective study was to determine the accuracy of high resolution T2 & diffusion-weighted images in early detection of muscle invasion, local tumor staging of urinary bladder carcinoma and to measure the correlation between the apparent diffusion coefficient (ADC) and histologic grade. Methods:25 cases of urinary bladder cancer were enrolled in this study before undergoing transurethral cystoscopy and biopsy. Results :the study involved 25 pateints with urinary bladder mass lesion. Their age ranged from47 to 74 years with mean (64.08) years ± standard deviation (7.49) years. The study included 21 males (84%) and 4 females (16%), combination of T2WI and DWI provide better assessment of muscle invasion than using T2 alone.
       
  • Prognostic value of complement 4 in covid-19 pediatric patients

    • Abstract: Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-caused pandemic of COVID-19, which has killed 2 million people worldwide and infected over 97 million more, is now the most catastrophic public health disaster in a century. Objectives: to assess the prognostic value of complement 4 with disease severity in covid-19 pediatric patients. Patients and methods: our patients were selected from Pediatrics inpatient department and outpatient pediatric clinic, faculty of medicine, Minia University. It was conducted during the period March 2021 till June 2021. One hundred and fifty patients were included in our study. Result: Out of 300 children were diagnosed as Covid-19, One hundred and fifty patients were included in our study according to the inclusion criteria divided into four groups (mild, moderate, severe and critical). C4 was significantly lower in both severe and critical groups than the other 2 groups (mild &moderate). Conclusion: Complement 4, indicating excessive complement activation and product consumption is significantly associated with presence of severe disease and increased mortality in patients with COVID-19. So, complement 4 can be a prognostic factor for mortality in covid -19 pediatric patients.Keywords: COVID-19, pediatric patients, Complement 4, Prognostic value and severity.
       
  • Protective Effect of Melatonin on Cisplatin Induced Liver Toxicity in
           Albino Rats; Biochemical and Histological Study

    • Abstract: Cisplatin is a potent chemotherapeutic agent, widely used in treatment of cancer. Melatonin, body hormone secreted by the pineal gland, has anti inflammatory and antioxidant characters. This study was done to evaluate the protective role of melatonin on cisplatin-induced hepatotoxicity in rats.Materials and Methods: Forty rats were divided into four groups : group I(control group) in which, the animals received no drug), group II ( melatonin group) receiving melatonin (4mg/kg i.p. for 10 days), group III (cisplatin group) receiving (single dose of 7 mg/kg), and group IV (melatonin/cisplatin group) receiving melatonin for 10 days+ cisplatin with a single dose on the 5th day of experiment. Drugs were given by intraperitoneal injection. At the end of experiment, blood samples were obtained from the tails of animals for biochemical study then all rats were sacrificed and livers were dissected out for histological study.Results: Cisplatin increased liver enzymes (ALT, AST). Cisplatin induced histopathological changes such as vaculation of hepatocytes, sinusoidal dilatation, congestion of central and portal veins, and inflammatory cell infiltration. Cisplatin significantly decreases PAS reaction in hepatocytes and increases collagen fiber deposition. Melatonin administration significantly ameliorated these changes.Conclusion: melatonin with its antioxidant and anti-inflammatory properties can be recommended as a promising medication in treatment of cisplatin induced hepatotoxicity in cancer patients.
       
  • Improving quality of thyroid ultrasound reporting after implementation of
           the ACR thyroid imaging reporting and data system at Minia University
           Hospitals

    • Abstract: Thyroid cancer is a common neck tumor. Although the majority of the thyroid nodules are benign, malignancy has a prevalence of 5-15%. There has a debate whether surgeries for thyroid nodules are unnecessarily performed, so the specialists seek for improvement in preoperative diagnosis. The efficacy of gray scaled ultrasound (US) in differentiation between benign and malignant nodules is low. So researchers promoted the thyroid imaging reporting and data system (TIRADS).In this study we have evaluated the reporting quality on adherence to American college of radiology- TIRADS (ACR-TIRADS) and its effect on reducing the un-necessary fine needle aspiration biopsy (FNAB). Patient and methods: A prospective single center case series study, we evaluated the US reports of 100 patients at Minia university hospitals. After detailed history taking previous US was revised. B mode ultrasonography was done on GE LOGIQ S8 R4 OLED US machine using linear transducer 6-15 megahertez (MHz). Data reported according to ACR TIRADS and compared with the previous US. Evaluate the effect of the new reporting method on decrease number of un necessary FNAB. Results: Our study included 100 Nodules, 68 of them were benign. Patients with no US recommendation to FNAB in the previous US were excluded. 62 patients were recommended to have FNAB based on the previous US, with implementation of ACR-TIRADS, 54 patients (87.1%) were recommended to have FNAB (P value 0.006). So we conclude that adherence to ACR-TIRADS in the US reporting decrease the count of un necessary FNAB. Keywords: ACR-TIRADS, Thyroid nodule, FNAB.
       
  • Effect of Omega3 in rat stomach induced peptic ulcer by ethanol

    • Abstract: Alcohol intake and physiological stress are major causes of gastric ulcer (GU). The pathophysiology of ethanol-induced GU in animals is similar to that of a human ulcer, Aim of the study; to identify the part omega-3 plays in peptic ulcer and cytokines . TNF-α , IL- β.-.Basic procedures; Sixty white male albino rats weighing an average of 160 g were used in this experiment. Six groups of rats with the same number of animals each were created. The rats were separated into six groups with the same number of animals. After fasting for 18 hours and having access to water, rats were administered ethanol to induce stomach ulcers. Absolute ethanol 95% at the dose level of (0.5 ml/100 g rat) caused stomach ulcers when administered orally. Main findings: The ulcerated control group had significantly higher levels of. TNF-α , IL- β. than Omega-3-treated rats. . TNF-α , IL- β.- levels were considerably lower in rats given Omega-3. Principle conclusion: In both the early and late ulcer groups, serum IL-1B and TNF- α levels were considerably greater compared to the control group, In contrast to the group with ulcers, the protected group had a significant reduction.. Furthermore, in models of ethanol-induced gastric ulcers, oral therapy with omega-3 has been shown to have considerable gastroprotective benefits.
       
  • Lipoprotein(a) in patients with coronary atherosclerosis.

    • Abstract: Purpose of study: Cardiovascular diseases (CVDs) are the main cause of death all over the world. Atherosclerotic coronary heart disease is the major cause of mortality associated CVD and represents about 45% of all cases. Despite the therapeutic improvement in treatment of CVD, it stills the main cause of mortality worldwide, representing a higher portion of health cost than any other disease. Lipoprotein (a) (Lp[a]) concentration is considered to be causal in the progression of atherosclerotic cardiovascular disease (ASCVD). The aim of this study is to assess the impact of high lipoprotein (a) on severity of coronary atherosclerosis. Basic procedures: The study was conducted on one hundred subjects including 35 apparently healthy individuals (group II) with matched age and sex as a control group and 65 patients diagnosed having coronary artery atherosclerosis by angiographic imaging. They were selected from the Cardiology Clinic, Faculty of Medicine, Minia University Hospital during the period from November 2021 to June 2022 (group I). The diseased subjects included patients diagnosed as coronary atherosclerosis by angiography and on treatment. Main findings: results of this study revealed that there was no statistically significant difference regarding gender and age distributions between the atherosclerotic subjects and the control groups, however patients with atherosclerosis showed statistically significant higher Lp (a) levels than control group. Principle conclusion: Overall, the findings of this study indicate that lipoprotein (a) elevation was evident in patients with coronary artery atherosclerosis and so it should be targeted in therapy and risk assessment of coronary artery atherosclerosis.
       
  • Diagnostic Value of Diffusion Tensor Imaging Indices in Assessment of
           Cervical Spondylotic Myelopathy

    • Abstract: Background: Cervical spondylotic myelopathy (CSM) develops progressively resulting from spinal cord's long-term segmental compression and it is identified by degenerative alterations to the vertebrae, intervertebral discs, facets, and related ligaments. Imaging is the most important modality to confirm the diagnosis of CSM and Magnetic resonance imaging (MRI) has become the preferred screening method for evaluation of cervical spine myelopathy. Now there is a direction to use advanced MRI techniques for more confirmation of diagnosis and better image quality, Diffusion tensor imaging (DTI) now become the most important advanced technique and diffusion properties can be assessed using the quantitative indices, apparent diffusion coefficient (ADC) and fractional anisotropy (FA), FA and ADC are the most important metrics in assessing the CSM because they are more sensitive and specific than the conventional MRI. Method: This study enrolled 30 patients with cervical spondylotic myelopathy who was diagnosed based on mJOA grading system then MRI was conducted and DTI quantitative and qualitative maps were obtained. Results: We observed a significant difference between FA & ADC metrics at stenotic and non stenotic segments and higher sensitivity and specificity of FA and ADC in diagnosing CSM over the conventional T2 hyper intense signal. Conclusion: DTI metrics are a very effective tool for quantitative evaluation of degenerative CSM.
       
  • Proposed effect of curcumin in type I diabetes mellitus

    • Abstract: People of all ages may develop diabetes mellitus (DM), a chronic condition caused by insufficient insulin production and activity. Damage to the eyes, kidneys, heart, and blood vessels may result from diabetes because of the disease's high glycemic effect and ketosis. Type I diabetes mellitus (T1DM) is an endocrine illness in which pancreas cells cease generating insulin as a consequence of autoimmune destruction, making diabetes a severe disease with numerous probable causes. Hyperglycemia and ketoacidosis are difficult to manage without insulin replacement. Purpose of the study; Therefor, the current study aimed to assess the protective effects of curcumin (Cur) against type I diabetes in rats. Basic procedures; rats were allocated in 4 groups. group1: control (C) received normal saline, group2: diabetic (D) injected intra-peritoneal (IP) with single dose of streptozotocin (STZ) (40 mg/kg), group3: diabetic treated with low dose curcumin (DC) received curcumin 100 mg/kg/day by gavage for 28 days, group4: diabetic treated with high dose curcumin (DC) received curcumin 200 mg/kg/day by gavage for 28 days. Rats were sacrificed after 28 days of treatment. Main findings: The damaging effect of STZ on the pancreatic beta cells resulted in T1DM and protective effect of Cur on beta cells that was evaluated by assessment of glucose and insulin, in the diabetic rats ’serum.Principle conclusion: The results suggested the protective effects of curcumin on TIDM.
       
  • CRP and kidney function tests in patients with Covid-19

    • Abstract: Purpose of study: Coronavirus disease 2019 (COVID-19) is a newly discovered respiratory disorder caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and recently declared as pandemic. Mild to moderate symptoms are the initial presentation in most patients. Kidney damage is a frequent side effect of COVID-19. Acute phase reactants (APRs), are inflammation biomarkers that exhibit marked changes in blood concentrations at the time of inflammation. Important APRs include serum ferritin, C-reactive protein (CRP) and D-dimer. This study aimed to assess the role CRP and kidney function tests in Covid-19 and their impact on disease severity. Basic procedures: This study was conducted on 80 subjects including 20 apparently healthy individuals (group II) as a control group matched for age and sex and 60 Covid-19 patients diagnosed by PCR (group I) and was subdivided into 2 subgroups, G Ia: 30 (Non- ICU) Covid-19 patients and G Ib: ICU (intensive care unit) admitted COVID-19 patients with respiratory complications. This study was conducted at clinical pathology department, faculty of medicine, Minia University during the period from November 2021 to June 2022. Main findings: results of this study revealed a significant difference regarding CRP and kidney function tests as covid-19 patients showed higher levels than control group, but there was no significant difference between both patient groups. Principle conclusion: Overall, this study revealed that elevation of both CRP and kidney function tests indicate a poor prognosis in individuals with covid-19, therefore, they may be involved in prediction of clinical course of the infection.
       
  • Role of 3D gradient echo MRI sequence in early detection of hemosiderin in
           hemophilic joint

    • Abstract: Purpose of study: In hemophilic patients, Blood deposition within the joints is the cause of morbidity, this is because the affection of all joint components, this leads to inflammation and results in synovitis, osteochondral degeneration which leads to hemophilic arthropathy. 3D Gradient echo MRI sequences are available on most scanners including scanners with lower magnetic field strengths so they are commonly used in clinical practice. The purpose of this study is to investigate the role of T1 3D FFE MRI sequence which is one of gradient echo MRI sequences for assessment of hemosiderin deposition in the joints of hemophilic patients.Methods: In this study we recruited 20 Hemophilic patients who admitted to hematology unit by attacks of bleeding or for follow up between august 2022 to April 2023. All patients underwent MRI for asymptomatic joint by conventional MRI sequences and T1 3D FFE sequence (It has the name of SPGR in GE machine and the name of FLASH in siemens machine ) correlation statical analysis was done between results of hemosiderin deposition by conventional sequences and by T1 3D FFE sequence. Results: T13D FFE MRI sequence can detect early hemosiderin deposition in hemophilic joint better than other conventional sequences and there is no significant correlation between hemosiderin deposition by conventional sequences and by 3DT1FFE sequence. Conclusion:3D T1 FFE is one of gradient MRI sequences has high capacity to detect even subtle intra-articular hemosiderin and provides a potential sensitive method for the early diagnosis and prognosis of hemophilic arthropathy.
       
  • Neutrophil CD64 expression in radiographic axial spondyloarthritis
           activity; is it valuable'

    • Abstract: Background: In a number of inflammatory diseases, neutrophils that express CD64 may be utilized as a biomarker of inflammation. This research examined individuals with radiographic axial spondyloarthritis (axial SPA) for neutrophil CD64 expression as a possible indicator of disease activity.Methods: There were 32 patients with radiographic axial SPA who were matched for age and gender with 15 healthy controls. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and neutrophil CD64 expression were evaluated. The patients with radiographic axial SPA were then separated into two groups based on their BASDAI scores: those with active disease (BASDAI> 4) and those with inactive disease (BASDAI< 4). Analysis was done on the expression of neutrophil CD64, ESR, CRP, and disease activity.Results: Active radiographic axial SPA patients, inactive radiographic axial SPA patients, and controls did not significantly vary in neutrophil CD64 expression.Between patients with active and inactive radiographic axial SPA, there is a statistically significant difference in ESR and CRP (P0.0001, 0.001, respectively).Conclusion: neutrophil CD64 expression is not a useful diagnostic for assessing disease activity in radiographic axial SPA, which is a conclusion that can be drawn from the data.
       
  • HCV seropositivity and breast cancer in Egyptian population, is there a
           link'

    • Abstract: Abstract: Background:HCV is a significant contributor to mortality associated with liver-related conditions globally. In addition to its known association with extrahepatic cancers, such as lung and pancreatic cancer, this research aimed to investigate the potential correlation between HCV seropositivity and the occurrence of breast cancer. Furthermore, the study aimed to assess the impact of HCV infection on survival rates within the Egyptian population.Methods:This retrospective case-control study involved of 938 female patients diagnosed with breast cancer, who were categorized into cancer groups. Their HCV seropositivity status was then compared to a control group consisting of 1251 female individuals. HCV seropozitivity was determined by the presence of HCV antibodies in the blood samples of the subjects. The study compared the characteristics of breast cancer patients who tested positive for HCV antibodies with those who tested negative, focusing on factors such as TNM staging, histological grading, and survival outcomes.Results:938 female breast cancer cases (with a mean age of 50.7 years) were compared to 1251 female controls (with a mean age of 52.2 years). HCV seropositivity among breast cancer cases was notably higher than that among controls (8.1% vs. 5.7%) [OR = 1.47, P = 0.031]. Additionally, this study revealed a non-significant increase in survival rates among breast cancer seropositive patients compared to seronegatives [HR = 0.79, P = 0.513].Conclusion:HCV sero-positivity was found to be associated with elevated risk of developing breast cancer; however, it did not demonstrate a significant impact on survival in breast cancer patients.
       
  • Bioinformatic analysis of some RAG mutations contributing to the primary
           immunodeficiencies.

    • Abstract: Recombination activating genes (RAG) encode RAG1/2 proteins which catalyze formation of DNA double strand breaks (DSB) between variability (V), diversity (D) and joining (J) segments of genes encoding immunoglobulins (Ig) and T-cell receptors (TCR) and rejoining of these segments to allow the unlimited production of (Ig)s and (TCR)s and to maintain durable adaptive immunity. RAG1 structure is composed of enzymatically active core and regulatory non-core. Large numbers of RAG1 mutations were reported in primary immunodeficiencies. In this study, we aimed to analyze some of these mutations and compare the results with the clinical significance displayed on the online websites like NCBI and HGMD. For this purpose, a protein remodeling program called Pymol and other online computational tools like Fathmm, Polyphen-2, SVM-1, Provean, SIFT and CADD were used to recognize the special effect of each mutation on the protein 3D structure. Our findings showed that R507W, W522C, R737H, R778Q, R841W, A857V, F974L, R975W RAG1 mutations have damaging effect as displayed by the computational analysis and this result agreed with what mentioned in the websites. Additionally, H612R and R1006V were found to be more tolerable than others which also concurred with the websites. However, M435V RAG1 mutation has been described as pathogenic in NCBI while most computational programs defined it as benign. In conclusion, Pymol and the computational tools are in co-ordination with the clinical significance described by the mentioned websites except in case of M435V mutation.
       
  • Gender variation of Vit. D levels in Hair and Serum

    • Abstract: Background: To put it simply, vitamin D is a prohormone. A healthy plasma vitamin D level is indicative of ‘good’ health. Vit D is necessary for calcium metabolism and bone mineralization due to its anti-inflammatory and immunomodulatory properties, and regulation of keratinocyte differentiation and proliferation. It also affects the hair cycle, and its role in hair loss is under constant research. Aim and objectives: to evaluate serum and hair levels of vitamin D according to Gender. Subjects and methods: In this cross-sectional research; Circulating 25(OH)D levels were recorded in 80 cases from Dermatology Outpatient Clinic of Minia University Hospital using ELISA kits. Results: In males; serum vitamin D levels was 17-31 ng/ml, with a mean ±SD 24.2 ± 3.4. In females; Serum vitamin D levels range between 17-30 ng/ml, with a mean ±SD 23.2 ± 2.8. In males, the hair vitamin D level was 0.1-1.86 ng/ml, with a mean ±SD 0.8 ± 0.4. In females; hair vitamin D levels range between 0.05-1.98 ng/ml, with a mean ±SD 0.8 ± 0.4. There was non-statistical difference between participants regarding hair and serum level vit D. Conclusion: No significant variations in serum and hair vit D among males and females.
       
  • Chemical component separation with botulinum toxin type A in the
           management of complex midline ventral hernia: A prospective randomized
           controlled comparative study

    • Abstract: Introduction: The repair of complex ventral hernia poses a significant challenge, as there is currently no universally accepted evidence-based approach for its treatment. One of the primary issues that arise in such instances is the loss of domain, which leads to a subsequent rise in intra-abdominal pressure following the repair.Patient & Methodology: A prospective, randomized, controlled cohort study was carried out at the General Surgery theater and Section 11(A) of Cairo University Hospitals, as well as the Department of General Surgery, Faculty of Medicine, Minia University, spanning from March 2020 to March 2022. The research encompassed a cohort of 51 patients who underwent elective surgical intervention for Complex Midline Ventral hernia repair, with or without loss of domain. Results: our study comprised a total of 51 participants who were categorized into three distinct cohorts.Each group consisted of 17 patients.The first group was administered Botox exclusively, while the second group received Botox with PPP. The third group was subdivided into two subgroups, with five patients receiving PPP and 12 patients receiving no preoperative intervention. The incidence of intraoperative intestinal injury was 17.6% in the Botox group, 0.0% in the Botox with PPP group, and 29.4% in the control group. Recurrence was observed solely within the control group, with a prevalence of 5.8%. Conclusion: the employment of a combined approach involving Botox and PPP for preoperative preparation represents an efficacious method for complex ventral hernia repair. This technique serves to mitigate the risk of ACS, intraoperative intestinal injury, and postoperative recurrence.
       
  • Neurological effects of COVID-19 in pediatric patients with the
           multisystem inflammatory syndrome in children (MIS-C).

    • Abstract: Background: In December 2019, people residing in the Chinese region of Wuhan were reported to have developed a severe form of pneumonia brought on by a novel coronavirus that is now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since then, cases of COVID-19, have been documented from every nation in the world. Objective: To assess the neurological impact in paediatric patients with COVID-19-associated Multisystem Inflammatory Syndrome in Children (MIS-C). Methods: Patients who were admitted to Minia University Hospital's Pediatric Intensive Care Unit (PICU) isolation unit between December 2020 and July 2022 were included in this cross-sectional study. We investigated at a total of 368 patients, of which 62 had PCR results that were positive for covid. Results: Convulsions was demonstrated among the patients by 20 (31.7%), p-value<0.0001. followed by DCL was 18 (28.2%)p-value<0.0001. Headache was also demonstrated among the patients also by 18 (28.2%)p-value<0.0001. Weakness was also demonstrated among the patients 18 (28.3%)p-value<0.0001. While, drowsiness among patients was (9 (14.52%), p-value<0.0001. Hypertonia, hyperreflexia, hypotonia, hyporeflexia, 4 (3.5%) and2 (1.7%) respectively. The majority of the patients had abnormal ground glass opacities on their chest scans (CO-RADS III). The number of patients who had neurological manifestations show significantly increased mortality. Conclusion: paediatric patients with SARS-CoV-2 infection may have life-threatening neurological disorders, even if only neurologic symptoms are present, patients should be tested for SARS-CoV-2 due to its prevalence in children. In addition, many of these patients arrived at the hospital unaware of COVID-19 exposure and positivity, so testing is necessary.
       
  • Assessment of Sleep Quality In patients With Interstitial Lung disease In
           Minia University Hospital

    • Abstract: It's common for people with interstitial lung diseases to have problems in sleeping. Lack of sleep or poor quality sleep has been associated to an impaired quality of life, an increased risk of death, and even tragedy in children with ILD.Consider the Big Picture: Patients at Minia university Hospital who have been diagnosed with interstitial lung diseases will be surveyed to assess their sleep quality.Research Strategies and Human Subjects With a diagnosis of lung disease, 110 patients were recruited between December 2019 and December 2021 at Minia University Hospital's inpatient sector or intense outpatient plan of such chest department. Data collected included demographic boundaries (age, sex, body mass index [BMI] and occupational history). The pulmonary capacities were evaluated. Patients assessed their own sleep using a quiz (Pittsburgh sleep quality index PSQI, Epworth sleepiness scale ESS, and STOP BANG) to provide feedback on its quality. The subjects were also required to walk during 6 minutes (6-MWT).The average age of our sample of 110 patients with ILD was 51.9 ±14.5, but 81.8% were female. There were sixty-three patients (57.2%) who complained about having poor sleep. Both the Epworth sleepiness scale and the mass index showed significantly different distributions across the groups. When comparing the high-quality sleep group to the low-quality sleep group, the high-quality group had significantly higher rates both of BMI and Epworth sleep scale (p0.0001 and p0.02, respectively).This means that people with ILD have bad sleep patterns regardless of their health.
       
  • Liver abnormalities and clinical outcome of covid -19 infected patients

    • Abstract: Liver harm is discovered in up to half hospitalized COVID19 patients and result either from actions of SARS-CoV2 or from medicine treatment. the current paper introduces Associate describes the pathways by SARS-CoV-2 resulting in liver injury. this will be caused by direct binding of the virus and native actions in cholangiocytes, however might also indirectly result from the final state of drive and general inflammation in COVID-19 patients. Aim of the study: The aim of the current study to evaluate liver abnormalities and the effect of these changes in prognosis of patients infected with Covid-19 in Minia University hospital.Materials& Methods: This study is a a prospective study, during the period from May to December, 2021.This study included 325 patients with covid-19 Minia university hospitals.Results: Significantly increased levels of TB and DB (p<0.0001*) were seen in patients with abnormal liver enzyme levels and liver injury as compared to patients with normal levels and normal liver . Significant increase in the levels of AlT and AST was(p<0.0001*) CRP and ferritin p<0.0001) peaks were observed on 2nd and 3rd day of admission respectively. positive correlation was found between the levels of these inflammatory markers and liver function parameters in covid 19 patient .Conclusion: More than half of patients admitted to the hospital with SARS-CoV-2 infection had an abnormal liver function which was found to be associated with raised levels of inflammatory markers. Significantly higher proportions of patients with liver disease and were at higher risk of progressing to severe disease.
       
  • Impact evaluation of Diabetes Mellitus in postcovid patients in Minia
           university hospitals

    • Abstract: Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19), infected more than 126 million individuals, and caused more than 6 million fatalities globally. Diabetes is chronic endocrine/metabolic disease with heterogeneous etiologies, clinical presentations, and associated complications. caused mainly by insulin deficiency and/or insulin resistance. It remains unknown whether diabetes alone or in conjunction with accompanying illnesses contributes to the poorer prognosis. Patients and Methods: This study is a retrospective observational study, during the period from May 2021 to May 2022. This study included 300 laboratory-confirmed SARS-Cov-2 infections. Attended the isolation wards in our internal medicine department at Minia university hospitals.Results: We found that in individuals with COVID-19. Diabetes and COVID-19 may interact in both directions, as SARS-CoV-2 infection may exacerbate pre-existing diabetes and may predispose non-DM people to develop diabetes. In addition, SARS-CoV-2 pancreatic cell invasion induces -cell autoimmunity in susceptible individuals, resulting in type 1 diabetes and Increased COVID-19 severity.Conclusion: In individuals with COVID-19. Diabetes and COVID-19 may interact in both directions, Also, newly diagnosed diabetes In this study. Diabetes was more prevalent in individuals with severe COVID-19, also as regards the comorbidities, Diabetes patients have a higher rate of complications such as cardiovascular disease, pulmonary disease, cancer, and other chronic conditions .Also, In our study, the individuals with NIDDM had greater inflammatory markers additionally, the complications were obvious to be much more in recently diagnosed diabetics
       
  • Intracorporeal Versus Extracorporeal Anastomosis In Laparoscopic Right
           Hemicolectomy In Right Sided Colonic Cancer

    • Abstract: Introduction: Laparoscopic right hemicolectomy is currently considered the standard of care in benign and malignant right colon disease This chapter describes the technique for laparoscopic right colectomy technique, with a focus on ileo-colic anastomosis, highlighting the differences between intracorporeal and extracorporeal anastomosis fashions in terms of clinical outcome and surgical safety.Patients and methods: prospective and retrospective study study was conducted in Minia university hospital including 10 patients with Right sided colonic cancer who underwent laparoscopic right hemicolectomy,. 5 cases with Extracoropreal type and 5 cases with intracorporeal type of ileocolic anastomosis from Dec. 2019 to june. 2022.ResultsOperative time was The operative time (199 min vs. 183 min; p = 0.109) wasslightly higher in the ICA group than in the ECA group; however, this difference was statisticall not significant. Wound infection (10% of patients ICA group vs. 20% of patients in ECA group) overall intestinal leakage occurred in 2 cases 20% of all cases one case with IC anastomosis and one case with Extracorporeal anastomosisConclusionTheres no big differences between types of anastomosis that held on our cases Slightly good results in intracorporeal type of anastomosis than extracorporeal type
       
  • Ascitic and plasma D-dimer as a prognostic biomarker for predicting
           hospital mortality in cirrhotic patients with spontaneous bacterial
           peritonitis

    • Abstract: Background: D-dimer is a specific test for the presence of fibrinolysis. Its abnormality reflects the activation of coagulation and fibrinolysis systems in vivo . chronic liver disease is associated with disordered hemostasis, it could be associated not only with defects in coagulation but also of clot lysis. Estimation of D –Dimer provide insight into possible derangements in the fibrinolytic pathway.Objective: Aim of this study was, (1) Evaluate serum D-dimer in cirrhotic patients with and without ascites to assess the relationship between ascites and the hyperfibrinolytic state in liver cirrhosis. Additionally, we assessed the effect of SBP on serum and ascitic fluid concentration of D-dimer.(2) Role of D-dimer in predicting the in-hospital mortality in liver cirrhosis. Patients & Methods: This study is a prospective study. It was conducted on 60 patients from the Department of Internal Medicine in Minia University hospital included patients hospitalised with decompensated liver cirrhosis and ascites This study was conducted on four groups, where full history taken, clinical examination, biochemical tests, ultrasonography .Results: There is diagnostic performance of serum and ascitic D dimer in diagnosing of SBP, and there were significant role of serum D dimer in prediction of 3 months mortality based on MELD score.Conclusion: D-dimer good diagnostic performance for SBP among patients with liver cirrhosis.D dimer levels of liver cirrhosis patients were found significantly associated with the degree of liver dysfunction. Furthermore, higher D dimer levels predicted an increased risk of in hospital mortality as a result of liver cirrhosis.
       
  • Prognostic Value of Bioactive Adrenomedullin in Critically Ill Patients

    • Abstract: This study's objective is to assess the prognostic value of the serum level of admission bio-ADM in critically ill patients. In this observational prospective study, patients who were admitted to Minia University Hospitals' medical critical care unit between December 2020 and November 2021 underwent a complete blood count, CRP , renal and liver function tests and blood culture. All patients had their bio-adrenomedullin levels evaluated by ELISA at the time of admission. The work included 114 patients who were subdivided into 3 groups: non-septic group including SIRS patients with negative blood culture (n=44), mild sepsis group including patients with SOFA score ≥2 without organ dysfunction (n=26), and severe sepsis group including sepsis patients with organ dysfunction (n=44). There was a significant difference in distribution of the quartiles of bio-ADM between survivor and non-survivors. Most of the non-survivors in our cohort were in the 4th quartile of bio-ADM (38.9%) while 45% of the survivors were in the 1st quartile of bio-ADM. The levels of Bio-ADM were positively correlated with CRP (r-value: 0.65, p-value < 0.001) and SOFA score (r-value: 0.63, p-value < 0.001). Using receiver operating characteristic (ROC) curve to determine the prognostic accuracy of bio-ADM, CRP, and SOFA score revealed higher area under curve (AUC) for bio-ADM (0.78, 95% CI: 0.69-0.86) followed by CRP (0.66, 95% CI: 0.56-0.76) and SOFA score (0.63, 95% CI: 0.52-0.73). The best cut-off for bio-ADM to predict ICU mortality in our cohort was 121.5 pg/ml with a sensitivity of 85% and a specificity of 61%.
       
  • Study Of Inflammatory Infiltrate in Vitiligo

    • Abstract: Abstract Background Vitiligo is a multifactorial disease which is characterized by apparently healthy milky white macules and patches due to loss of functioning melanocytes from the epidermis, mucous membranes and sometimes hair follicles.Objectives evaluation of the inflammatory cell infiltrate in vitiligo patients. Methods Forty-six nonsegmental vitiligo (NSV) patients had been included in this study. Histological hematoxylin and eosin staining of the mononuclear infiltrate were evaluated by microscopic examination.Results The inflammatory infiltrates in the marginal skin were significantly abundent when compared to the non leisonal skin (p=0.005*). On the other hand, the difference between the marginal skin and the leisonal skin was insignificant (p=0.083). Conclusion The inflammatory infiltrate of non-segmental vitiligo is more abundant in the marginal skin than the non leisonal skin. The active lesion's margin is regarded as a critical site for active melanocyte destruction by the inflammatory infiltrate; thus, marginal infiltrates are abundant in active lesions.
       
  • Vital signs after local anesthesia administration with lidocaine
           two-percent in pulpotomy for children under age of four

    • Abstract: AbstractBackground: The aim of study is to evaluate vital signs after administration of lidocaine 2% for pulpotomy anestheticefficacy pulp therapy in primary molars in young children below four years.Methods: 100 young children under age of four years seeking pulpotomy of primary molars which performed afterbuccal infiltration injection. lidocaine hydrochloride 2% with epinephrine 1:100 000. The intervention was articainehydrochloride 4% with epinephrine 1:100 000 was deposited. Children's blood pressure and heart rate was assessedbefore and after treatment.Results: No statistically significant difference was found before LA injection and after finishing clinical procedures.Regarding the heart rate (HR), no statistically significant difference was detected pre- and postoperatively.Conclusion: lidocaine hydrochloride 2% with epinephrine 1:100 000 for treatment of children between the age of 3and below 4 years old did not significantly increase the vital signs before and after injectionKeywords: buccal infiltration, lidocaine, local anesthesia, blood pressure
       
  • Hair straighteners

    • Abstract: Background: Hair plays an important role in one's personality and builds confidence. Now-a-days, chemical and physical hair relaxers are used very commonly in the society. The adverse effects occurring with the use of the professional hair relaxers are not well documented.Aim of the work: Our study aims to assess the adverse effects caused by chemical hair straighteners.Materials and Methods: The sample was restricted to females. This study was carried out on sixty female subjects who underwent chemical hair relaxers once or more. A questionnaire was given to the volunteers who matched our criteria then the data was documented, tabulated and statistically analyzed using SPSS computer program version 24 for frequency, distribution and significance rates. Results: Adverse effects reported by the sample after undergoing the procedure were found to be high (95.56%). Out of which the followings were the common adverse effects reported; frizzy hair, dandruff, hair loss, thinning and weakening of hair and greying of hair.Conclusions: From our study, it can be stated that most of the samples had adverse effects, which was as high as 95.56%. So, we can conclude that usage of chemical hair relaxers can cause adverse effects to the hair.
       
  • The Effect of Microneedling on Acne Scars

    • Abstract: The Effect of Microneedling on Acne Scars Moataz Bellah M. El-Domyati MD, Rasha T. A. Abdel-Aziz MD, Maha Mohamed-Elsayed MSc. Department of Dermatology, STD’s and Andrology, Faculty of Medicine, Minia University, Minia, EgyptAbstractBackground: Postacne scarring is disfiguring. Multiple modalities for treatment of acne scars have emerged and microneedling with dermaroller is one of them.Objectives: To evaluate the efficacy of microneedling treatment for atrophic facial acne scars.Methods: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Patients were photographed at baseline as well as one and three months from the start of treatment.Results: Compared to the baseline, patients’ evaluations revealed significant clinical improvement in atrophic post-acne scars in response to skin microneedling (p= 0.02).Conclusion: Microneedling is a simple and cheap, means of treatment modality for acne scars remodulation with little downtime, satisfactory results and with the advantage of being a relatively risk-free.Key words: Acne scars, Microneedling.
       
  • Different approaches for pancreaticoduodenectomy rather than the
           conventional Whipple procedure

    • Abstract: Introduction: Pancreatico duodenectomy (PD) is the only potentially curative therapy for malignancies of the pancreatic head and periampullary region. Despite this complicated surgical operation is mature, the low R0 resection rate remains the major obstacle to improving the prognosis of pancreatic cancer [1].Patients and methods: This prospective descriptive study was performed on all patient’s candidate for PD for pancreatic head and duodenal cancers in the NCI, and ELMENIA University Hospital during the period from January 2021 till January 2023.ResultsOur study showed that, the operating time ranged from 220 to 340 minutes (mean 277.70 ± 37.70 minutes), the mean Blood loss (ml) were 725.75 ± 291.68, the PRBC transfusion requirement (units) ranged from 0 to 6 with mean 3.05 ± 1.74, the ICU stays (days) ranged from 4 to 12 with mean 8.95 ± 2.40 and the mean hospital stay (days) were 17.03 ± 6.81. Our study showed that, there were 40 (100.0%) of Patients had Pseudo-aneurysm, 10 (25.0%) of Patients had complication and 4 (10.0%) of Patients were with re-exploration. Our study showed that, there were 3 (7.5%) of Patients had Pulmonary complications, one patient with cardiac complications and 6 (15.0%) patients with Other Complication. ConclusionPancreaticoduodenectomy (PD) is the only potentially curative therapy for malignancies of the pancreatic head and periampullary region. Despite this complicated surgical operation is mature, the low R0 resection rate remains the major obstacle to improving the prognosis of pancreatic cancer
       
  • Corneal crosslinking in keratoconus

    • Abstract: ABSTRACTPurpose: To describe visual and refractive outcomes of conventional versus accelerated corneal cross linking in keratoconus. Methods: A prospective descriptive interventional case series. 20 eyes were evenly allocated into two groups. First group (20 eyes) was treated with conventional corneal collagen crosslinking (CXL) and the second group was treated using was treated with accelerated corneal collagen crosslinking (CXL). Results:Both groups showed statistically improvement in BSCVA, which was insignificantly different between both groups over the follow-up period.oth groups with conventional and accelerated corneal collagen crosslinking (CXL) showed statistically improvement in BSCVA, which was insignificantly different between both groups over the follow-up period.oth groups with conventional and accelerated corneal collagen crosslinking (CXL) showed statistically improvement in BSCVA, which was insignificantly different between both groups over the follow-up period.oth groups with conventional and accelerated corneal collagen crosslinking (CXL) showed statistically improvement in BSCVA, which was insignificantly different between both groups over the follow-up period.Conclusion:Both groups with conventional and accelerated corneal collagen crosslinking (CXL) showed statistically improvement in BSCVA, which was insignificantly different between both groups over the follow-up period.
       
  • Combined general -spinal anesthesia versus combined general - epidural
           anesthesia for Laparoscopic Hysterectomy

    • Abstract: Background and Aim of the work:General anesthesia(GA) is the preferred anesthetic technique for laparoscopic hysterectomy(LH). However, laparoscopic surgery is accompanied with marked stress response, Adding regional techniques,to GA was used to overcome these significant hemodynamic effects .The aim of our study is to compare the effect of combined spinal-general anesthesia with that of combined epidural-general anesthesia on hemodynamic stress ,Requirement of Isoflurane, analgesics and vasodilators,recovery profile ,VAS score at recovery, the time for first analgesic request, surgeon’s satisfaction, and intraoperative and postoperative complications. Methods:This was a prospective randomized controlled study including 105 female patients,aged 45-65 years old,belonging to ASA I or II grade who underwent LH.They were randomly assigned to one of three equal groups.Group S-GA received spinal combined with general anesthesia; group E-GA received epidural along with GA; and group GA received only general anesthesia. Intraoperatively, cardiovascular parameters and SpO2 were recorded.operative field assessed by surgeons ,isoflurane ,nitroglycrine and opoid consumption were recorded also post operative pain, intra and postoperative complication.Results: S-GA and E-GA groups showed stable hemodynamic parameters (MAP and HR) at pneumoperitoneum and during surgical manipulation. However, MAP decreased significantly at postinduction in groups S-GA and E-GA.Intraoperatively, consumption of isoflurane, opioid and nitroglycerine infusion was higher in group GA .groups S-GA and E-GA showed better operative field ,pain scores ,fast recovery and longer postoperative analgesia .Incidence of postoperative complications was low.Conclusion:spinal or epidural anesthesia, combined with general anesthesia was an effective for attenuation of the hemodynamic stress response associated with peumoperitoneum without increasing side effects
       
  • Risk factors of otitis media with effusion

    • Abstract: background: otitis media with effusion is a typeof chronic non-suppurative otitis media that means presence of fluid in the middle ear cavity. which is a common disorder in childhoodAim of the study :is to know the commonest causes and risk factors for secretory otitis media to help us in its prevention and to provide better treatment for it according to etiological factors.patient and methods:143 patients who had otitis media with effusion presented to our clinic confirmed by tympanogram were included in this study , aged from 4-16years .all the patients underwent otoscopic examination,Anterior rhinoscopy and oral cavity examination was done.The children had tympanometry to confirm clinical diagnosis. Imaging in the form of x-ray nasopharynx lateral view was done. results :the age ranged from4 years to16 years There were 71 males and 72females.According to our study, there was a strong relation between adenoid hypertrophy and otitis media with effusion. It is a very important etiological factor 102 children of otitis media had hypertrophied adenoid (71.3%%).there were 97 children of otitis media with effusion who had history of recurrent upper respiratory tract infection. which is an important etiological factor.conclusion :There is a strong relation between adenoid hypertrophy and secrettory otitis media. Adenoid hypertrophy is a very common etiollogical factor. This must be taken into consideration in management of persistent otitis media with effusion. Also recurrent upper respiratory inffection is associated with otitis media with effusion, so protection of the children against it helps in prevention of secretory otitis media.
       
  • Efficacy of try-in paste and resin cement shades in prediction of the
           Final Color of multilayer Zirconia Veneers (An In-Vitro Study).

    • Abstract: Objectives: Aimed to study the efficacy of using try- in paste resin cement shades, in prediction of the final perceived color of Cercon Veneer.Material and Methods: tetragonal zirconia polycrystal stabilized with 5 mol% yttria and 9 wt.% yttria, Variolink Esthetic (LC) System kit for resin cement, and tetric N-ceram composite resin. A total of thirty CAD/CAM Cercon disks (diameter = 10mm), shade A2, and thickness of 0.5mm (n=30) fabricated. The ceramic groups were ordered into three subgroups, n=10 for each, according to the shade of luting cement used, then each subgroup ordered into two equal classes n=5 for each, according to the type of cement (final cement or try in paste). Thirty samples of resin background disks fabricated using a Teflon mold (10 x 3) mm to acquire a uniform background to resemble the prepared tooth substrate. The specimens' color was assessed by fixing them onto a grey background. Color parameters assessment was performed utilizing a spectrophotometer according to the CIE Lab color system. Results were then statistically analyzed using Shapiro-Wilk test to assess the normality of distribution, and two-way Anova. Results: One way ANOVA test used for quantitative data between the 3 groups succeeded by post hoc LSD analysis between each two groups in 0.5 mm thickness, there was significant increase in ΔE in light shade compared with natural shade. there was insignificant difference between others.Conclusion: Caution should be taken when using a try-in paste to determine the final restoration's color and addition test should be done.
       
  • Supine percutaneous nephrolithotomy post operative hospital stay
           assessment

    • Abstract: Background: Since it was first used in 1976, percutaneous nephrolithotomy (PCNL) has become the industry standard treatment for significant renal calculi. Initially, as mentioned sixty years ago, only the prone position was used for percutaneous access to the kidney. Valdivia provided the first account of supine positioning in PCNL. Both positions have since been adopted by PCNL. To enhance the surgical results, modifications to the initial supine position were created. The advantages of each supine position were discussed for five different supine postures (full supine, Valdivia, Galdakao-modified Valdivia, Barts-modified Valdivia, and Barts flank-free modified supine positions). In this study, we evaluated the results of supine PCNL surgery.Methods: All patients were evaluated at baseline to complete diagnosis of renal stones, evaluation of previous line of management if present, confirm indication for surgery and fitness for surgical procedure, where patients selected for operative procedure had been counseled and written consent is obtained for the surgical procedure, then admitted patients will be assigned to certain hospital admission number.Results: This study was conducted on 53 patients (31male & 22 female), age range 18 to 65 years old. there were 58.5% of the studied cases were males and 41.5% were females. The mean age was 36.09 ± 12.14 SD with range (18.0 – 65.0). There were 13.2% of the studied cases had Co-morbidities and 86.8% had no Co-morbidities. The current study showed that mean hospital stay was 2.23 ± 0.64 SD with range (2.0 – 5.0).
       
  • ULTRASOUND AND FLUOROSCOPY GUIDED INTRALESIONAL BLEOMYCIN INJECTION (IBI)
           FOR TREATMENT OF SUPERFICIAL HEMANGIOMAS AND VASCULAR MALFORMATION.revised
           

    • Abstract: Hemangiomas and vascular malformations are benign lesions that can occur at any organ. Currently various medical and surgical options are available for the treatment of hemangiomas including intra lesional bleomycin, laser therapy, cryotherapy, corticosteroids and surgical excision . Recently bleomycin injections is commonly used as a sclerosing agent for the treatment of vascular malformations, compared to the surgery, intra lesional bleomycin injection is a simple, practical non invasive method of treatment. Aim of the work: To evaluate the role of ultrasound and fluoroscopy guided intralesional bleomycin injection (IBI) for treatment of superficial hemangiomas and vascular malformations. This study will be conducted in the interventional radiology unit, department of Radiology, Faculty of Medicine, Minia University. This study is including thirty patients presented with superficial hemangiomas and vascular malformation. There was statistically significant difference in the study regards Relation between response with demographic data, Relation between response and site of lesion, Relation between response with Doppler findings and Relation between response with number of sessions. There was no statistically significant relation between response and size of lesion. Bleomycin appears to be safe, effective and has some antitumor activity and also bleomycin has local sclerosing effect on endothelial cells of hemangiomas and vascular malformation.
       
  • Controlled Evaluation Study of Serum Level of Zinc and Iron in Patients
           with Androgenetic Alopecia (REVISED)

    • Abstract: ABSTRACTBackground: Androgenetic alopecia (AGA) is androgen-dependent alopecia resulting from the conversion of terminal hair into vellus hair. Zinc is one of the most studied trace elements in hair disorders and Iron is one of the trace elements used in the treatment of AGA.Aim of the Work: To evaluate the serum levels of zinc and iron in male and female patients with AGA and to compare the findings with normal controls.Patients and Methods: The study was conducted on 60 AGA patients (30 males and 30 females) and 40 healthy volunteers (20 males and 20 females). We measured serum zinc and iron for all participants.Results: Serum zinc (µg/dL) and iron (µg/dL) levels were statistically significantly lower in female AGA (FAGA) patients compared to controls. There were non-significant differences in serum levels of zinc and iron seen in the male AGA (MAGA) group compared to controls.Conclusions: Serum levels of zinc and iron were lower in FAGA patients than in normal controls and adding zinc and iron to female patients with AGA is recommended.
       
  • COMPARISON BETWEEN UTERINE EXTERIORIZATION AND IN-SITU REPAIR OF UTERUS IN
           CAESARIAN SECTION

    • Abstract: AbstractBackground: During a caesarean section, there is some debate over whether or not to exteriorize the uterus. Routine uterine exteriorization does not seem to be supported by enough evidence. It's still unclear whether this practice ought to be become standard operating procedure. Our goal was to compare the outcomes of Caesarean deliveries in which the uterine incision was repaired externally vs inside.Methods: A prospective Randomized and single-blinded trial spanned from February to December of 2022. Two groups, A and B, with A receiving repairs after exteriorization and B receiving in situ repair. Intraoperative internal bleeding, postpartum anemic, transfusion rate, mean operating time, perioperative wound infection rate, and postoperative nausea and vomiting are be measured. Results: A statistically significant increase in the frequency of nausea and vomiting among some of the women who had exteriorization compared to those whose uteri had repaired in-situ. Average preoperative haematocrit, postoperative haematocrit, estimated blood loss (575 vs 577 ml, p = 0.942), transfusion rate (15.3% vs 17.9%, p = 0.518), postpartum anaemia, operative time, and surgical site infections rate were not significantly different between the exteriorization and in situ groups. Conclusion: Exteriorization and in-situ repair of uterine incisions are equal in terms of intraoperative blood loss, postoperative anaemia, and infections at the surgical site, although the former is linked to significantly more nausea and vomiting than the latter. The results could not definitively prove that one was superior to the other.Keywords: Uterine excision, uterine in situ repair, and caesarean section
       
  • Importance of MRI in Pre-operative evaluation of rectal cancers as regard
           sphincters invasion and adjacent organs infiltration and its effect on
           surgical decision

    • Abstract: In this article, we will discuss how magnetic resonance imaging (MRI), the gold standard for imaging rectal cancer, has improved clinical staging of head and neck cancer malignancy. High-resolution T2-weighted object detection (T2WI) MRI is the gold standard due to its superior tissue contrast precision when imaging tumor tumor in the sagittal, longitudinal, and coronal planes.Both Patients and TechniquesBetween March 2021 and February 2023, 60 patients with endometrial cancer were gathered from the Urology Outpatient Clinics at Minia University Hospital and the National Cancer Institute for this prospective cohort research.The ages of the Cases varied from 23 and 72 years, with 27 men and 33 females participating (mean 50.8 years). Substantial consensus (Kappa 0.721) was found between MRI and surgical findings regarding tumor infiltration of the sphincters and subscapular muscle; MRI's sensitivity for the prediction of body invasion was 95% for both external and internal sphincter infiltration; its specificity was 93.8%; its PPV was 94%; and its NPV was 92%. As for MR's predictive abilities, they were calculated to be 95% sensitive, 83% specific, with a positive predictive value of 70% and a predictive values of 92%, respectively.In conclusion, sphincter complex expansion and penetration to surrounding organs may be accurately assessed by rectal MRI, allowing for more effective therapy of patients with cancer and better outcomes.Rectal cancer, MRI, sphincter invasion, subscapular muscle, neighboring organ infiltration, Low Midline resection, locoregional rectal cancer, and Neoadjuvant chemoradiotherapy are some of the significant terms here.
       
  • Combined Use Of MRI Morphological Criteria And Apparent Diffusion
           Coefficient (ADC value) In Diagnosis Of Probably Benign and Suspicious
           Breast Lesions (BI-RADS3 and 4) in Correlation with Histopathology

    • Abstract: Background: This prospective clinical study is aimed to evaluate the diagnostic value of morphological criteria, the apparent diffusion coefficient (ADC) and diffusion-weighted imaging in differentiating benign from malignant breast lesions in correlation with histopathology.Method: The study includes 25 females with 25 breast lesions. Routine conventional MRI protocol of the breast was conducted including T2WI, T2 SPAIR and DWI. We used contrast administration in only 10 patients of this study group and DCE-MRI was conducted on them. We compared the conventional unenhanced images to the DCE-MRI by radiologists to detect and characterize breast lesions then we compared the results with the final reference diagnoses supplied by the histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy for UE-MRI and DCE-MRI were calculated. Results: The calculated UE-MRI sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 100%, 85.7%, 94.7%, 100%, and 96% respectively. On the other hand, those for the DCE-MRI were 100%, 75%, 85.7%, 100%, and 90% respectively.Conclusion: The unenhanced MRI of the breast can be an available, reliable, and effective alternative for breast DCE-MRI. Also it can be used with comparable accuracy to DCE-MRI when contrast administration is not suitable or contraindicated.
       
  • Immunohistochemical Expression of TRIP13 in Transitional and Squamous cell
           carcinoma of Urinary Bladder Carcinoma

    • Abstract: Background: Urinary bladder carcinoma (UBC) is the 9th most common cancer globally. Thyroid receptor-interacting protein 13 (TRIP13) is a member of the AAA+ ATPase family. The upregulation of TRIP13 has been shown to be involved in the development and progression of different tumors, including UBC. Method: The current study included 50 formalin-fixed, paraffin-embedded tissue specimens of UBC. Tissue sections have been subjected to haematoxylin and eosin staining and immunohistochemical staining for TRIP13 expression. TRIP13 expression was estimated and its associations with clinicopathological factors were evaluated. The prognostic significance of TRIP13 was evaluated using univariate and multivariate COX regression analyses. Results: In the present study, 62% (n=31) of the cases showed ‘negative/low’ TRIP13 expression, whereas 38% (n=19) showed ‘high’ TRIP13 expression. A significant association was found between TRIP13 expression and tumor grade, stage, lymph node metastasis (LNM) and distant metastasis (P=0.012, 0.007, 0.045, <0.001, and 0.004 respectively). In addition, TRIP13 was remarkably correlated with poor prognosis.
       
  • Comparing a vessel sealing system with the conventional technique in
           axillary lymph node dissection for primary breast cancer

    • Abstract: Abstract:Objective: This study aimed to compare the efficacy and safety of the newest bipolar vessel sealing system (BVSS; LigaSure™ Small Jaw) to that of conventional technique in axillary dissection. Patient and Methods: Eighty-nine patients with breast cancer were randomized to a conventional dissection surgical technique (CONV group; n = 45) by scalpel and monopolar cautery or that using a vessel sealing system (BVSS group; n = 44). Results: in conventional group, mean drain volume was 851.1±96.2 ml ml and 370±152 ml in ligasure group with a p-value <0.001, which is statistically significant. In conventional group, mean number of days till drain removal was 10.6 ± 1.9 days and 6.2 ± 0.8 days in ligasure group with a p-value of 0.001 which is statistically significant.Conclusions: Our results suggest that BVSS is a more effective device when compared to the conventional techniques in axillary dissection.Keywords: Breast cancer, Vessel sealing system, Axillary lymph node dissection, Randomized controlled trial
       
  • ultrasonography in prediction of difficult airway intubation in obese
           patients in emergency operations

    • Abstract: Background: Unexpectedly challenging laryngoscopy may still be a significant issue despite the adoption of several clinical index tests for airway evaluation.Patients and method: this a prospective single center, double blind Cohort study, included as many eligible patients over period of 6 months whom were obese patients without clear anatomical abnormalities undergoing urgent surgeries and receiving general anesthesia, 349 patients included and divided to Control group (c) who were non obese patients, Obese group (O) with BMI >30 kg/m2. Aim of the work: evaluate the efficacy of ultrasonography for predicting difficult intubation in patients who need emergency surgical treatment and are obese.Results: a significant difference recorded between the two groups as regard the weight which was higher in obese patients (92.1±6.2), and consequently the BMI was (34.8±4.9). Also, a significant difference in the clinical assessment between two groups, incidence of difficult laryngoscopy DL (20.3%) of obese patients, Conclusion: In obese individuals, ultrasonography might foretell a more challenging laryngoscopy.
       
  • The Added Values Of Duplex Study And Cranial Ultrasonography In Clinically
           Suspected Preterm Brain Injury

    • Abstract: Our study was conducted on 50 premature infants (than 32 weeks) with clinically suspected preterm brain injury. All patients underwent cranial ultrasonography using high-resolution sonography machines at NICU of Minia University Hospitals. Radiological investigations were done for all cases and controls including transcranial sonar, and transcranial Doppler studies of ICA, MCA and ACA for mean velocity, PSV and resistive index. Grading system for germinal matrix haemorrhage/ intra ventricular haemorrhage (GMH/IVH) by Volpe is based on cranial ultrasound scan (CUS). Grade I refers to haemorrhage confined to the subependymal GM, and grade II as haemorrhage within the lateral ventricle without ventricular dilation and/or haemorrhage occupying less than 50% of the ventricle. Grade III haemorrhage is defined by ventricular dilation and/or haemorrhage occupying more than 50% of the ventricle, while grade IV is ventricular haemorrhage with periventricular hemorrhagic infarction. 40 % had GMH/IVH in the US. Among those 35.3% were grade 1, 29.4% were grade 2, 23.5% were grade 3, while 11.8% were grade 4. Associated pathology found among these cases included: 10 % had cerebellar haemorrhage,. 15 % had signs of brain edema by Doppler (an early finding) among them 5 % had progressed to just periventricular echogenicity (PVL – grade I), whereas 10 % progressed to periventricular cystic leukomalacia at TEA (PVL – grade II – IV). The positive cases had a significantly lower age and weight than the negative. Transcranial Doppler findings revealed higher mean velocity and lower PI & RI in preterms.
       
  • ''Placenta accreta spectrum disorders: the management options
           and outcome in one year study (2022) in Minia maternity and children
           University hospital: Observational case series study.''

    • Abstract: Background; PAS is a condition that might endanger life. The occurrence of PAS is projected to rise more over time given the rising frequency of cesarean sections globally , Aim and objectives; to assess the effectiveness of various care strategies for placenta accreta spectrum patients from January 2022 to December 2022 at Minia Maternity & Children University Hospital, Subjects and methods;The current investigation was conducted from January 2022 to December 2022 on all patients at Minia maternity and children University hospital who were either suspected of having or were officially diagnosed with placenta accreta, Result; Among the studied women, 15 (14.7%) were managed by Hysterectomy. While the remaining 87 women were managed by Conservative surgical options. There was a statistically substantialconnection between GA and hysterectomy, women who underwent hysterectomy were with younger GA as compared with those who managed by Conservative surgical options. There were non-statistically significant differences with other studied variables regarding mode of management, Conclusion; PAS can be managed by Conservative surgical options and Hysterectomy. As a result, practitioners need to be aware of the difficulty in making the diagnosis and the difficulties in treating this disorder. key words; GA gestational age, GHTN gestational hypertension, CS cesarean section.
       
  • Visual Acuity Evaluation in Diabetic Macular Oedema with Foveal Hard
           Exudates

    • Abstract: AbstractIntroductionDiabetic retinopathy (DR) is one of the main causes of blindness in the middle-aged individuals. (Yau et al., 2012) The primary cause contributing to loss of vision in diabetic patient is diabetic macular oedema (DME).(Williams et al., 2004) Hard exudates are deposits of lipo-protein that is build up as a result of a disintegration of the inner BRB.(Zhou et al. 2018)Aim of The StudyAssessment of visual acuity (VA) in patient with diabetic macular oedema with foveal hard exudatesPatients and Methods The study was a case control study. The study included 100 eyes from 100 DME patients that divided into 2 groups. The study was conducted at Ophthalmology department, Minia University Hospital in Egypt between february 2022 and August 2022.ResultsPresence of hard exudates in fovea in DME was associated with significant decrease of BCVA so Presence of hard exudates in fovea in DME was a bad prognostic sign for DME.Conclusion Presence of hard exudates in fovea in DME affected macular function determined by BCVA and it was a bad prognostic sign for DME.
       
 
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