@article { author = {Abdel Shafi, Mohamed}, title = {EVALUATION THE EFFICACY OF PULSED RADIOFREQUENCY ( PULSED DOSE MODE) FOR THORACIC POST HERPETIC NEURALGIA TREATMENT}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-7}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4514}, abstract = {Neuralgia is a sharp, shocking pain that follows the pathway of a nerve and is due to irritation or damage to the nerve. Post-herpetic neuralgia (PHN) is one of the most common forms of neuralgia . It is characterized by persisting pain in the affected dermatome after rash healing which last for years. PHN is often resistant to the traditional methods of treatment. Pulsed Radiofrequency (PRF) is known as an effective treatment for neuropathic pain. The aim of this study was to evaluate the efficacy of PRF ( pulsed dose response second generation of pulsed radiofrequency) for the management of PHN .This study included 20 patients who have post herpetic neuralgia in thoracic dermatomes, the patients were selected according to inclusion and exclusion criteria, A 10 cm length cannula with 10 mm active tip was introduced in the thoracic transforaminal opening of the affected dermatomes under fluoroscopic guidance to become adjacent to dorsal root ganglia (DRG) , this position was confirmed by sensory and motor stimulation, after obtaining the appropriate stimulation , PRF was applied to the corresponding level( temperature 42 degree, pulse number 900, voltage 65 ) , after finishing the procedure the patients were evaluated at one, three and six months using McGill questionnaire.The result of this study demonstrated that there are highly statistically significant decreases in Pain Rating Index (PRI) and Pain Persistent Intensity (PPI) in all patients of McGill pain questionnaire at one, three or six months after radiofrequency application , when compared with before radiofrequency application. In conclusion , the use of PRF for treatment of PHN is a safe therapeutic alternative method . Benefits include that the procedure is minimally invasive, provides short-term pain relief and improves quality of life.}, keywords = {Postherpatic neuralgia,Pulsed radiofrequency}, url = {https://zumj.journals.ekb.eg/article_4514.html}, eprint = {https://zumj.journals.ekb.eg/article_4514_0b9c2b2901b2ec827df839994dc57272.pdf} } @article { author = {Omar, Hesham and El-Seikh, Amira and Fathy, Ayman and El-Helaly, Amira}, title = {THE POTENTIAL CONTRIBUTION OF FLOW CYTOMETRIC ANALYSIS IN DIAGNOSIS AND SCORING OF MYELODYSPLASTIC SYNDROME PATIENTS}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-6}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4515}, abstract = {Background: Myelodysplastic syndromes (MDSs) are a heterogeneous group of bone marrow disorders. Morphology may be difficult to evaluate in some patients, either due to hypocellularity or fibrosis of bone marrow.Objective: To define immunophenotypic pattern in MDS patients, quantify and score complex flow cytometric abnormalities, and to correlate flow cytometry scores with conventional and established parameters used in MDS diagnosis.Methods: Using flow cytometry, we studied 40 bone marrow specimens 30 patients with MDS and 10 cytopenic patients with non-clonal hematologic disorders as control group. A panel of monoclonal antibodies including: CD45, CD13, CD33, CD34, CD7, CD11b, CD16, CD56 and HLA-DR were used. Immunophenotyping using 2 gates were done: Forward (FSC) and right angle light scatter SSC and a second gate were done on the basis of CD45 staining and SSC to confirm identification of the selected cells. These combinations of Moab were used to measure the degree of maturation of their corresponding antigen by expressing their intensity.Results: For MDS diagnosis, FCM had a sensitivity and specificity of 86.7% and 80% with score 1.5:9, 80% and 100% with score 3.5:9, 53.3% and 100% with score 5:9 and 30% and 100% with score 6.5:9 respectively, and a significant positive correlation between IPSS and FCM score.Conclusion: This study defines immunophenotypic pattern in MDS patients and allow for a simple numerical display of results as score which is positively correlated with IPSS.}, keywords = {Myelodysplastic syndromes,Flowcytometry score,Immunophenotypin}, url = {https://zumj.journals.ekb.eg/article_4515.html}, eprint = {https://zumj.journals.ekb.eg/article_4515_3f17ddbae1fc66829d314f22ad3e8967.pdf} } @article { author = {Emara, Mahmoud and Omar, Masood and Mostafa, Kamal and Abdel Fatah, Abdel Fatah}, title = {DIAGNOSTIC AND PREDICTIVE VALUE OF SURVIVIN, P63 ANDCD15 IN NON HODGKIN'S LYMPHOMAS}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-14}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4516}, abstract = {Background: Lymphoid proliferations are thought to be either benign reactive conditions, atypical lymphoid proliferations or malignant lymphomas. NHL's are a diverse group of malignant neoplasms that affect lymphoid tissue, their incidence has risen twofold over the past 10 years. IHC, is now routinely used to confirm the diagnosis of lymphoma.The aim: Is to evaluate the expression of Survivin, P63 and CD15 in different types of reactive lymphoid hyperplasia and lymphoma and their ability to differentiate between some types of them. Also, correlate expression of the above markers as indicators of aggressiveness in NHL's.Methods: A total of selected 80 cases of patients which were previously diagnosed as: 30 cases of Non Hodgkin's lymphoma, 20 cases of Hodgkin's lymphoma, and 30 cases of reactive lymphoid hyperplasia. The sections were stained with H&E and immunohistochemical markers of Survivin, p63 and CD15 separately.Results: Expression of survivin & P63 immunostains in cases of aggressive lymphomas was (61.9%)&(71.4%) which are higher than their expression in cases of indolent lymphomas (38.1%)&(28.6%) respectively. Also, expression of survivin &P63 immunostains in cases of follicular lymphoma was (50%)&(33.3%) which are higher than their expression in cases of atypical lymphoid hyperplasia(40%)&(20%) respectively. P63 was frequently expressed in large cell lymphoma cases (64.2%). None of the cases of CHL demonstrated any P63 expression. CD15 is a specific marker of reed Sternberg cells of CHL and showed no expression in cases of lymphocytic predominance HL. CD15 was also occasionally expressed in cases of large cell lymphomas.Conclusion: survivin and P63markers can be used as immunohistochemical tools in distinguishing follicular lymphoma from lymphoid hyperplasia especially atypical cases. Also, survivin and P63markers can be used as indicator of aggressiveness in NHL cases. CD15 is a specific marker of RS cells of CHL. Also, CD15 is occasionally expressed in cases of large cell lymphomas, so not used alone in differentiation between large cell lymphoma and CHL where morphological distinction is difficult. When adding a P63 immunostaining, the accuracy of distinction between these lesions was increased. so,P63 can be used as a potential tool in the differential diagnosis between these lesions.}, keywords = {IHC,CHL,RS cells,NLPHL,survivin,P63,Immunohistochemistry}, url = {https://zumj.journals.ekb.eg/article_4516.html}, eprint = {https://zumj.journals.ekb.eg/article_4516_19ea99552e80518868f8199c4cf30163.pdf} } @article { author = {Elsayed, Ayman and Mohammed, Esam and Ali, Naglaa and Ibrahim, Amani}, title = {ROLE OF INTERLEUKIN-17 IN THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA IN HEPATITIS C VIRUS LIVER CIRRHOSIS}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-9}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4517}, abstract = {Background: The level of Interleukin-17 (IL-17) have been found in increased frequencies within certain tumors. However, their role in cancer biology remains controversial. This study aimed to clarify the role of IL-17 in hepatocellular carcinoma (HCC).Subjects& Methods: It included a total number of 81 subjects. They were divided into three groups: 27 subjects as control group, Group I (27 subjects HCV cirrhotic patients without HCC), Group II (27 subjects HCV cirrhotic patients with HCC) . All patients included in this study were subjected to the following: Full clinical assessment, Complete blood picture, Liver function tests, Renal function tests, Coagulation profile , HCV Antibodies, HBs Ag ,α fetoprotein and IL-17.Results: our study reported statistical significance differences (p<0.001) between the three studied group in interleukin 17 level. The highest mean of IL 17 level were found in group 2 followed by group 1 and the control group had the lowest mean level.Conclusion: IL-17 levels were increased with increasing liver disease progression and chronicity, IL-17 may play an important role in HCC immunopathogenesis in HCV cirrhotic patients. Also, its therapeutic application needs to be evaluated by in vivo studies in experimental animals aiming at future immunotherapy..}, keywords = {Interleukin (IL)-17,HCV,Cirrhosis,HCC}, url = {https://zumj.journals.ekb.eg/article_4517.html}, eprint = {https://zumj.journals.ekb.eg/article_4517_57da79377a23177f8ecaf4160eec74d2.pdf} } @article { author = {Ismail, Anwar and Azzam, Mohamed and Al-Sayed, Gamal and Salem, Mostafa}, title = {OVARIAN STROMAL BLOOD FLOW AFTER LAPAROSCOPIC OVARIAN DRILLING IN WOMEN WITH POLYCYSTIC OVARY SYNDROME}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-14}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4518}, abstract = {Background: Women with polycystic ovary syndrome have significant difference in their ovarian stromal blood flow indices when compared to women with normal ovaries. The intra-ovarian blood flow is assessed by studying small arteries in the ovarian stroma not close to the surface of the ovary or near the wall of the follicles.Aim: To assess the value of changes in Doppler indices of ovarian stromal blood flow and hormonal profile in women with PCOS and previously described as being clomiphene citrate resistant in predicting the clinical outcome of laparoscopic ovarian drilling as regard ovulation.Study design: This study is interventional study.Setting: Department of Obstetrics and Gynecology (Ultrasound and Gynecologic endoscopy units), Faculty of Medicine, Zagazig University.Patients' criteria: Women with PCOS according to Rotterdam criteria, 2003, aged 18-35 years. All women in the study were free of any medical illness and had not received any medications in the last 6 months before the study apart from incremental doses of clomiphene citrate with its failure to induce ovulation in them (clomiphene citrate resistant). Hysterosalpingography and husband semen analysis were normal in all subjects.Sample size: 59 PCOS patients.Procedures: After measuring peak systolic blood flow velocity (PSV), pulsatility index (PI) and resistance index (RI) within the ovarian stroma using two dimensional colour Doppler transvaginal sonography and measuring the serum concentrations of FSH, LH and total testosterone of 59 PCOS patients, laparoscopic ovarian drilling was done (4 punctures in each ovary using 40 watts monopolar electrocautery for 4 seconds). Ovulation was evaluated by serial ultrasound and mid luteal serum progesterone level in the first post-operative menstruation.Results: Within 10 weeks of laparoscopic ovarian drilling (LOD), LH decreased significantly from (13.1 + 1.9) before LOD to (6 + 0.6) after LOD and total testosterone decreased significantly from (1.04+0.23) to (0.51 + 0.2). As regard FSH, it increased significantly from (6.16+ 0.34) before LOD to (7.6 + 0.8) after LOD. PSV decreased significantly from (11.9 + 1.8) before LOD to (7.44 + 1.5) after LOD. Also, PI increased significantly from (2.02 + 0.56) before LOD to (2.98 + 0.5) after LOD. As regard RI, it increased significantly from (0.75 + 0.06) before LOD to (0.86 + 0.05) after LOD. There was significant negative correlation between total testosterone and PI (r = 0.49, p. value < 0.01), highly significant negative correlation between total testosterone and RI (r = 0.41, p. value < 0.001) and significant positive correlation between total testosterone and PSV (r = o.32, p. value< 0.05). Conclusion(s): PCOS patients to whom Laparoscopic ovarian drilling was done usually experienced reduction in their blood flow within the ovarian stroma. There was statistically significant correlation between hormonal profile and changes in the blood flow within the ovarian stroma in those patients. This may be valuable in predicting the clinical outcome of LOD as regard ovulation and pregnancy.}, keywords = {ovarian stromal blood flow,laparoscopic ovarian drilling,Doppler,polycystic ovary syndrome}, url = {https://zumj.journals.ekb.eg/article_4518.html}, eprint = {https://zumj.journals.ekb.eg/article_4518_b8862b0345db587250b16bd88036fd5d.pdf} } @article { author = {Alghamdi, Mushabab}, title = {DIGITAL GANGRENE AS THE INITIAL PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS WITHOUT SECONDARY ANTIPHOSPHOLIPID SYNDROME: CASE REPORT}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-4}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4519}, abstract = {This is a case of a 28-year-old female presented with an extensive cutaneous gangrene of her fingers and toes with history of a livedo reticularis rash in both lower limbs. Her work-up showed positive serology for Systemic Lupus Erythematosus (SLE). There were no other symptoms suggestive of SLE. Interestingly, the patient adequately responded to rituximab therapy. Such a case of digital gangrene as the initial presentation of SLE without secondary antiphospholipid syndrome has rarely been reported in the literature.}, keywords = {missed}, url = {https://zumj.journals.ekb.eg/article_4519.html}, eprint = {https://zumj.journals.ekb.eg/article_4519_645ab97a03e32a56597f4625978d725f.pdf} } @article { author = {Abdelhafez, Sayed and Abu Shehata, Mohammad and Mostafa, Fatma and Mostafa, Amal and Essa, Heba}, title = {BLEOMYCIN INDUCED –INTERSTITIAL PULMONARY FIBROSIS IN MICE}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-4}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4522}, abstract = {Background and objectives: The uses of animal models in researches of pulmonary fibrosis depend on the presence of structural, biochemical, and molecular similarity between fibrotic reaction in humans and animals. The aim of this study was to evaluate the ability of bleomycin to induce interstitial pulmonary fibrosis in mice.Material and methods: This study was conducted on C57BL/6 mice (14). Normal C57BL/6 mice (6) received 0.25 ml normal saline intraperotineal twice weekly for 8 weeks and sacrificed two days after last saline dose injection.8 mice received intraperotineal injection of 0.5mg bleomycin twice weekly for 8 weeks only 6 mice completed the study and sacrificed two days after last bleomycin dose. Weight recorded once weekly.Results: bleomycin induced fibrosis in the animal model after eight weeks with p<0.001Conclusion: bleomycin in a dose of 0.5mg for 8weeks induce pulmonary fibrosis in C57BL/6 MICE}, keywords = {Bleomycin,intraperotineal injection,interstitial pulmonary fibrosis}, url = {https://zumj.journals.ekb.eg/article_4522.html}, eprint = {https://zumj.journals.ekb.eg/article_4522_6aa75423599c1fb5ca872b0cc2c9224f.pdf} } @article { author = {El-Sabakawy, Karima and Assaf, Raymonde and Arafa, Lamiaa and Shiha, Osama and El-Beeh, Shymaa}, title = {EVALUATION OF HYPERMETHYLATION OF RAS ASSOCIATION DOMAIN FAMILY-1 A AND GLUTATHIONE S-TRANSFERASE PROTEIN-1 GENES AS DIAGNOSTIC MARKER FOR HEPATOCELLULAR CARCINOMA}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-13}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4524}, abstract = {Background and study aims: The molecular pathogenesis of HCC involves well-defined genetic and epigenetic alterations. The Ras association domain family 1A (RASSF1A) and the Glutathione S-transferase P 1 (GSTP1) genes are two tumour suppressor genes that are reported to be silenced by CpG island promoter hypermethylation which is a key to the tumourigenic process in HCC. The aim of this study was to analyze the methylation frequency of RASSF1A and GSTP1 genes in early stages of HCC , chronic hepatitis C and healthy subjects to evaluate its value as a diagnostic marker for early HCC. Patients and methods: Methylation-specific polymerase chain reaction (MSP) was used to detect RASSF1A and GSTP1 promotor methylation in DNA extracted from plasma samples of 25 patients with HCC, 25 patients with chronic hepatitis C and 25 healthy controls. Assessment of alpha fetoprotein (AFP) was performed in all groups by ELISA using commercially available kits. Results: Methylated RASSF1A was detected in 76 % of the HCC group (19/25), in 20% of the chronic hepatitis C patients (5/25) and in 16% of the healthy controls(4/25). The methylation frequencies were significantly higher in patients with HCC compared to the controls (P ≤ 0.001) and chronic hepatitis C patients ( P ≤ 0.001). While methylated GSTP1 was detected in 44% of the HCC group(11/25) ,in 12% of the chronic hepatitis C group (3/25) and in 8% of the controls (2/25). Although the sensitivity and specificity, for each gene as an epigenetic biomarker was moderate (76% and 44% for RASSF1A and GSTP1 respectively), the combination analysis of both genes resulted in an increased sensitivity and specificity to 88%,and 76% respectively) in discriminating HCC from normal control and chronic hepatitis C pateints. As regard AFP, Receiver operating characteristic curves were plotted and showed an optimal cutoff value of 9.5 ng/ml with sensitivity of 88 % and specificity of 58% when the area under the receiver operator characteristic (AUROC) curve was 0.87 with 95% Confidence Interval .Conclusion: The epigenetic changes observed in this study indicate that examination of methylation status of RASSF1A and GSTP1 could be of value for early diagnosis of HCC especially when using a combination of more than one epigenetic marker .}, keywords = {}, url = {https://zumj.journals.ekb.eg/article_4524.html}, eprint = {https://zumj.journals.ekb.eg/article_4524_d270a1819d0b2da1c5e232078ea21d54.pdf} } @article { author = {Saad, Aly and Abd El-Salam, Khalid and Elzaki, Manar and Al-Ashry, Rehab}, title = {ASSESSMENT OF INTERATRIAL DYSSYNCHRONY BY TISSUE DOPPLER IMAGING IN MITRAL STENOSIS: EFFECT OF AFTERLOAD REDUCTION AFTER BALLOON MITRAL VALVULOPLASTY.}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-10}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4525}, abstract = {Background: Atrial fibrillation (AF) predisposition in mitral stenosis (MS) has been studied using many electrocardiographic (increased P-wave dispersion) and echocardiographic parameters (interatrial electromechanical delay). There are scarce data on the effect of percutaneous balloon mitral valvuloplasty (PBMV) on the interatrial electromechanical coupling in patients with MS. We aimed to assess the interatrial electromechanical coupling in MS before and after PBMV by tissue Doppler imaging (TDI) echocardiography. Patients and methods: This study included 45 patients suffered from moderate to severe MS who underwent PBMV successfully without complication and 20 healthy volunteers as a control group. We compared between both groups in the clinical, electrocardiographic and echocardiographic parameters. The patients with MS were re-evaluated one week after PBMV. Interatrial electromechanical delay (EMD) was estimated by TDI before and after PBMV and we compared the results.Results: The interatrial EMD (56.4  15.8 vs. 34.6  7.2 ms, p < 0.001) was higher in patients with MS as compared to healthy individuals. The maximum P-wave duration (P-max) and P-wave dispersion (PWD) showed highly significant positive correlation with the interatrial EMD (r = 0.37, p < 0.001 and r = 0.41, p < 0.001 respectively). There was a highly significant decrease in the interatrial EMD (56.4  15.8 vs. 38.3  10.4 ms, p < 0.001) one week after PBMV.Conclusion: The current study showed significant increase in the interatrial EMD in patients with moderate to severe MS. These changes improved significantly after PBMV.}, keywords = {Mitral Stenosis,Atrial Fibrillation,Tissue Doppler imaging,Interatrial electromechanical delay,Percutaneous Balloon Mitral Valvuloplasty}, url = {https://zumj.journals.ekb.eg/article_4525.html}, eprint = {https://zumj.journals.ekb.eg/article_4525_8a9e9e28109f13b2b7797db89fefe987.pdf} } @article { author = {Abdul-Rahman, Mohamed and El Ashmawy, Abdul and Kheiry, Mamdouh and Abdul-Maguid, Yosri and Abdul Hakeem, Samy and Yaseen, Husain n}, title = {ULTRASONOGRAPHY OF DISABLED SHOULDER DUE TO ROTATOR CUFF DISORDERS IN ADULT EGYPTIANS}, journal = {Zagazig University Medical Journal}, volume = {21}, number = {3}, pages = {1-9}, year = {2015}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2015.4526}, abstract = {This study aims at assessment of role of ultrasonography as an available, cheap, easy and valuable diagnostic aid in detecting soft tissue disorders, especially of the small parts of the body including the shoulder. The four tendons of the rotator cuff (Supraspinatus, Infraspinatus, Teres minor & Subscapularis) are vulnerable for injury with frequent use of the shoulder especially in thrower athletes and with advancing age.In this work, 36 patients (20 males & 16 females) were chosen being suffering from pain in the shoulder (either interrupted or continuous) with or without limitation of movement of the affected shoulder. Plain X-ray and ultrasonography were made to affected shoulders of all cases.X-ray revealed calcification of some shoulder tendons in some cases, while ultrasonography displayed some labral and tendon disorders (e.g. focal tendon non-visualization, labral and tendon tear, abnormal echogenicity and other disorders).Ultrasonography is proved as a preliminary diagnostic tool for assessment of rotator cuff disorders. This methodology is considered the easiest, fastest, cheapest, most available, most tolerable and least invasive method than MRI. Its biggest limitations are low experience, long duration of learning, less acceptance by orthopedic surgeons and lack of detailed information about different lesions that may be associated with or mimics RC lesions (such as muscle changes following nerve injuries).}, keywords = {missed}, url = {https://zumj.journals.ekb.eg/article_4526.html}, eprint = {https://zumj.journals.ekb.eg/article_4526_2525c63bda7dcbde8b2df7a09d354256.pdf} }