Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
PROGNOSTIC VALUE OF CIRCUMFLEX ARTERY MOTION AS A MEASUREMENT OF LEFT VENTRICULAR LONG-AXIS SYSTOLIC FUNCTION IN PATIENTS TREATED WITH PERCUTANEOUS CORONARY INTERVENTION
1
11
EN
Ahmad
Ammar
Cardiology Department, Faculty of Medicine-Zagazig University, Egypt
Mohamed
Al-Daydamony
Cardiology Department, Faculty of Medicine-Zagazig University, Egypt
Mohammad
tahlawi
Cardiology Department, Faculty of Medicine-Zagazig University, Egypt
Ismail
Mohamed
Cardiology Department, Faculty of Medicine-Zagazig University, Egypt
10.21608/zumj.2015.4505
Background: Accurate assessment of LV systolic function during primary PCI can help to optimize reperfusion strategies and has many prognostic implications. Circumflex artery motion (CAM) can be measured during primary PCI to reflect LV long-axis function which is an accurate indicator of LV systolic function.<br />Aim of the work: to test the validity of CAM as a measurement of LV long-axis systolic function in anterior STEMI patients treated with primary PCI and to determine its prognostic value.<br />Patients and Methods: CAM was measured using coronary angiography during primary PCI in 50 STEMI patients. Echocardioghraphic (M-mode, tissue Doppler and speckle-tracking) assessment of LV long-axis systolic function was performed within 24 hours after primary PCI. Follow-up echocardiography was scheduled after 6 months. Reverse remodeling was defined as a reduction >10% in LV end-systolic volume by the end of follow-up period.<br />Results: Strong correlation was found between CAM and echocardiographic parameters of LV long-axis systolic function (p for each < 0.001) as well as LVEF (r= 0.845, p< 0.001) 24 hours after successful primary PCI. Patients were dichotomized according to the median value of CAM (median CAM: 13.9 mm). Supra-median CAM was associated with higher LVEF (56.0±7.4 vs. 42.6±3.6, p<0.001), lower peak troponin (6.43±2.6 vs. 11.13±2.78 ug/L, p<0.001) and lower incidence of composite major adverse cardiac events (3.8% vs. 45.8%, p=0.001). A CAM cutoff value of 10.8 mm (sensitivity 96% and specificity 100%) accurately predicted reverse remodeling at 6 months.<br />Conclusion: CAM measured at the time of primary PCI can predict LV systolic function loss, adverse clinical outcome and reverse remodeling in STEMI patients. Thus it can gauge the choice of reperfusion strategy and adjunctive therapy.
CAM (circumflex artery motion),LV long-axis systolic function,Primary PCI
https://zumj.journals.ekb.eg/article_4505.html
https://zumj.journals.ekb.eg/article_4505_4c1da5c35743483b4b26ec5b2faa200f.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
HAIR FOLLICLE STEM CELLS IN THE PATHOGENESIS OF PRIMARY CICATRICIAL ALOPECIA
1
12
EN
Enas
Al-Makhzangy
Dermatology & Venereology and Pathology Departments, Faculty of medicine, Zagazig University
Manal
Elsayed
Dermatology & Venereology and Pathology Departments, Faculty of medicine, Zagazig University
Magda
Assaf
Dermatology & Venereology and Pathology Departments, Faculty of medicine, Zagazig University
Abdulla
Esawy
Dermatology & Venereology and Pathology Departments, Faculty of medicine, Zagazig University
10.21608/zumj.2015.4506
Background: Primary cicatricial alopecia )PCA) is a scarring disease. Although the scarring and deformity may affect any part of the body, such changes have been reported to be most obvious on the face and scalp. The pathogenesis behind this scarring process is not well understood. Once lesions have scarred, recurrent disease tends to occur at the edge of the scarred lesions but not within them. The fact that inflammation in PCA generally involves the bulge area of the hair follicles raises the possibility that damage to the stem cells of the bulge region may be one process leading to the permanent loss of hair follicles. Objective : The aim of this study was to investigate the role of the epithelial hair follicle stem cells which reside in the bulge region in the scarring process in PCA. Methods : We studied the reactivity to Mouse monoclonal antibody, Keratin 15 Ab-1 (LHK15), which recognizes cytokeratin (CK 15) and preferentially immunostains epithelial hair follicle stem cells without staining the remaining hair follicle, on skin biopsies (scalp lesions) from 40 patients with PCA (8 lichen planopilaris, 10 discoid lupus erythematosus, 7 folliculitis decalvans, 5 keratosis follicularis spinulosa decalvans, 10 acne keloid). Reactivity to Mouse monoclonal anti CD8 antibody (cd8-sp16) in cases of prominent inflammatory infiltrate( 16 cases) was studied. Ten normal scalp biopsy specimens served as controls. The correlation between the extent of the cytotoxic inflammatory cell infiltrate(CD8+) and the presence of stem cells was investigated. Results were analyzed semiquantitatively. Results : The expression of CK15 in epithelial hair follicle stem cells was absent at scarred PCA, and in cases of severe inflammation, it was weak or absent. There was normal to moderate CK15 expression at the bulge region of hair follicles when surrounded by mild or moderate inflammatory infiltrate (CD8+). Conclusion : The bulge region appears to be involved in these diseases as a part of a broader involvement of the hair follicles; it is secondarily affected by the surrounding inflammatory cell infiltrate. Expression of CK15 immunostain was diminished and was then absent, indicating either damage to stem cells or differentiation to help in the repair process. Damage to follicular stem cells may help to explain the irreversible alopecia and the scarring process which characterize these diseases.
cytokeratin 15,primary cicatricial alopecia,hair follicle,scar,Stem cell,hair bulge
https://zumj.journals.ekb.eg/article_4506.html
https://zumj.journals.ekb.eg/article_4506_63854588ce471974e6b5f5c6f22ec88f.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
RELATIONSHIP BETWEEN THYROID FUNCTION AND INTENSIVE CARE UNIT MORTALITY IN CRITICALLY ILL PATIENTS AT ZAGAZIG UNIVERSITY HOSPITAL
1
10
EN
Abd Elmonem
Zaid
Internal Medicine Departement,Faculty of Medicine, Zagazig University, Egypt
Mohamed
Assy
Internal Medicine Departement,Faculty of Medicine, Zagazig University, Egypt
Hatem
Salem
Internal Medicine Departement,Faculty of Medicine, Zagazig University, Egypt
Mohamed
Saad
Internal Medicine Departement,Faculty of Medicine, Zagazig University, Egypt
Mohamed
Herzalla
Internal Medicine Departement,Faculty of Medicine, Zagazig University, Egypt
10.21608/zumj.2015.4507
Introduction: Thyroid hormones play a key role in the maintenance of body growthby modulating metabolism and the immune system. In the 20th century,researchers found that thyroid dysfunction is associated with theincreased mortality of patients admitted to the intensive care units (ICU).This study was conducted to evaluate the prognostic value of the thyroid functions; free triiodothyronine(FT3), total triiodothyronine (TT3), free thyroxin (FT4), total thyroxine (TT4) and thyroid-stimulating hormone (TSH) in unselected ICU patients.<br />Methods: A total of 183 unselected critically ill patients without known thyroid diseases were screened for eligibility and followed up during their ICU stay. Patient’s baseline characteristics, the Acute Physiology and Chronic Health Evaluation II (APACHE II), thyroid hormones and C-reactive protein (CRP) levels were determined. The primary outcome was ICU mortality. The patients were divided into two groups; group (1) survivors and group (2) non-survivors. Potential predictors were analysed for possible association with outcomes. We also evaluated the ability of thyroid hormones together with APACHE II score to predict ICU.<br />Results:Among thyroid hormone functions, FT3had the greatest power to predict ICU mortality, as suggested by the largest area under the curve (AUC) of 0.838. The AUC for FT3 was nearly the same for APACHE II score (0.822) but greater than that for CRP (0.722). Multiple regression analysis revealed that FT3 and TSH levels, APACHE II score and CRP level could independently predict primary outcome. The addition of FT3 and TSH levels to APACHE II score gave an NRI of 55.80%. The level of FT3 showed a significant negative correlation with APACHE II score (r = - 0.382, p = 0.000) and with CRP (r = - 0.244, p = 0.001).The level of TSH showed a significant negative correlation with APACHE II score (r = - 0.194, p = 0.008).<br />Conclusion: Among thyroid functions, the serum levels of both FT3 and TSH are the most powerful and independent predictors of ICU mortality. Moreover, the addition of FT3 and TSH to APACHE II score could significantly improve the ability to predict ICU outcome.
thyroid function,ICU,APACHE,mortality
https://zumj.journals.ekb.eg/article_4507.html
https://zumj.journals.ekb.eg/article_4507_23220b2616bb02793170ffe77fde1962.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
PLASMA LEVELS OF ASYMMETRIC DI METHYL ARGININE IN DIABETIC PATIENTS WITH NEUROPATHIC FOOT ULCERATION
1
7
EN
Kyrillos
A.
Departments of Internal Medicine, Faculty of Medicine, Mansoura University.
El-Nahas
R.
Departments of Internal Medicine, Faculty of Medicine, Mansoura University.
Amer
Y.
Departments of Diagnostic radiology Faculty of Medicine, Mansoura University.
Albayoumy
A.
Departments of Clinical Pathology ,Faculty of Medicine, Mansoura University.
Abdulaziz
Y.
Departments of Internal Medicine, Faculty of Medicine, Mansoura University.
10.21608/zumj.2015.4509
Background. Increased cardiovascular mortality had been reported in diabetic subjects with neuropathic foot ulceration (NFU). Endothelial dysfunction (ED) was found to be more remarkable in diabetic subjects with NFU than those without peripheral nerve dysfunction (PND) which could explain the excess cardiovascular morbidity and mortality. By inhibiting nitric oxide (NO) formation, Asymmetric dimethylarginine (ADMA) was found to cause ED.<br />Aim of the work. To evaluate plasma ADMA level as a marker of ED in diabetic subjects with NFU, and to study the possible relations of plasma ADMA level with ED and atherosclerosis in diabetic subjects.<br />Subjects and methods. The study included forty diabetic subjects with NFU (Gr.1), twenty diabetic subjects with PND (Gr.2) and twenty without PND (Gr.3), and ten age and sex matched healthy subjects (Gr.4). Subjects with renal impairment, peripheral arterial disease, ischemic heart disease, smoking or using lipid lowering drugs were excluded. ED was evaluated by measuring the flow mediated dilatation (FMD) of brachial artery using high-resolution ultrasound (Toshiba Power vision 6000 with a 7.5 MHz transducer). Carotid intima media thickness (CIMT) was also used to evaluate atherosclerosis. Fasting blood samples were obtained from all subjects to measure plasma ADMA levels by ELISA kit supplied by EAGLE BIOSCIENCES, INC (Germany).<br />Results. Gr.1 and Gr.2 were having a significantly lower FMD and higher CIMT in comparison to Gr.3 and Gr.4 (both P< 0.001). However, there was no significant difference between Gr.1 and other study groups as regard plasma ADMA levels (P= 0.126). FMD was inversely and strongly related to CIMT (r= -0.520, P< 0.001). Plasma ADMA was found to be positively correlated with CIMT (r= 0.330, P= 0.003) with no significant correlation with FMD (r = -0.176, P =0.118).<br />Conclusion. Plasma ADMA levels are not increased in diabetic subjects with NFU, and are not associated with the remarkable ED in these patients. In diabetic subjects, plasma ADMA levels are positively correlated with atherosclerosis.
missed
https://zumj.journals.ekb.eg/article_4509.html
https://zumj.journals.ekb.eg/article_4509_265b59aca19525bed76a4c91d35750a8.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
EFFICACY OF INTERFERON-INDUCIBLE PROTEIN-10 FOR MONITORING STANDARD TUBERCULOSIS TREATMENT
1
11
EN
Alaa
Refaat
Chest Departments, Faculty of Medicine, Zagazig University, Egypt.
Nasr
Affara
Chest Departments, Faculty of Medicine, Zagazig University, Egypt.
Abeer
Alhawari
Clinical Pathology Departments, Faculty of Medicine, Zagazig University, Egypt.
Mohamed
Fathi
Clinical Pathology Departments, Faculty of Medicine, Zagazig University, Egypt.
10.21608/zumj.2015.4510
Introduction: Tuberculosis (TB) remains a major global health problem. Interferon-inducible Protein-10 (IP-10) has been proposed as a promising biomarker for monitoring the efficacy of standard therapy in patients with active pulmonary TB. Objective: The propose of this study was to assess the efficacy of IP-10 in patients with active pulmonary TB as a sign of a response to TB standard therapy. Patients and methods: A total of 136 newly diagnosed pulmonary tuberculosis patients were recruited in this study. The patients were classified into 2 groups according to the presence of the risk factors of relapse. Group (1) included 30 patients with low risk of relapse and group (2) included 25 patients with moderate and high risk of relapse. In this study, we assessed the IP-10 levels in both serum and in response to QuantiFeron-TB Gold In-Tube test (QFT-GIT) antigens at time of diagnosis, at month 2 and after completing treatment. Results: IP-10 median levels in both serum and in response to QFT-GIT antigens were not significantly different between both patient groups at baseline, at month 2 and after completion of TB treatment. However, in each patient group, medians of IP-10 levels before treatment decreased significantly with time at 2 months and after the completion of anti-TB treatment (all P < 0.05). Conclusion: Interferon-inducible Protein-10 (IP-10) in serum or in response to QFT-GIT antigens was a useful biomarker for monitoring the efficacy of the standard regimen in patients with active pulmonary TB.
Interferon-inducible Protein-10,Monitoring,tuberculosis
https://zumj.journals.ekb.eg/article_4510.html
https://zumj.journals.ekb.eg/article_4510_eefaa23c50f9ab5060640ba98694ff4d.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
IMPACT OF CHRONIC KIDNEY DISEASE ON OUTCOME OF PERCUTANEOUS CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME
1
13
EN
Hanan
Radwan
Lecturer of Cardiology, Faculty of Medicine, Zagazig University, Egypt. And Consultant of Cardiology, King Faisal Specialist Hospital, KSA.
Abdelhakem
Selem
Assistant Professor of Cardiology, Faculty of Medicine, Zagazig University, Egypt. And Consultant of Cardiology, Ibn Sina National Medical College Hospital, KSA
Yaser
Ammar
Assistant Professor of Internal Medicine, Medical Research Institute, Alexandria University, Egypt. And Consultant of nephrology, New Jeddah Clinic Hospital, KSA
Naser
Mahdi
Consultant of Cardiology, Interventional Cardiology Department, King Faisal Specialist Hospital, KSA
10.21608/zumj.2015.4511
Objectives: We aim to study the impact of chronic kidney disease (CKD) on short and long term outcome of percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).<br />BACKGROUND: Renal impairment (RI), even if mild, is a known independent predictor of cardiovascular events, but the effects of various grades of RI on PCI outcomes is not well established.<br />Methods: 427 patients with ACS treated within 24 hours with PCI were subjected to ECG, echocardiography, repeated measurements of cardiac troponin I (cTNI), cardiac isoenzyme of creatine kinase (CK-MB), serum creatinine and estimation of creatinine clearance (eCrCl) by Cockcroft, Gault equation which classified patients into 4 groups as per K/DOQI guidelines. Major adverse cardiovascular events (MACE) comprising death, new myocardial infarction (MI) and target vessel revascularization (TVR) were recorded during early (30 days) and late (up to 5 years) follow up period.<br />RESULTS: Advanced RI was associated with a significant increase in number of affected vessels, percentage of C type lesions and a significant decrease in culprit artery TIMI flow. eCrCl correlated positively with EF and negatively with number of vessels affected and number of late MACE. Patients with advanced RI had an increased risk of TVR in first month after PCI and an increased risk of death, MI and total MACE on long-term follow up.<br />Conclusion: CKD is associated with an increased need for TVR during the first 30 days, and increased death, MI and total MACE during later follow up in PCI treated ACS patients.
Acute myocardial infarction,Acute Coronary Syndrome,Coronary angioplasty,Contrast agents,Chronic Kidney Disease
https://zumj.journals.ekb.eg/article_4511.html
https://zumj.journals.ekb.eg/article_4511_0241799209df07512a7968fd2005d0c5.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
PREDICTORS OF DEPRESSED LEFT VENTRICULAR FUNCTION IN PATIENTS PRESENTING WITH ST-ELEVATION MYOCARDIAL INFARCTION
1
18
EN
Tarek
Naguib
Cardiology Department, Faculty of Medicine, Zagazig University
Eslam
Elsherbeiny
Cardiology Department, Faculty of Medicine, Zagazig University
Ahmad
Elzayyat
Cardiology Department, Faculty of Medicine, Zagazig University
Ayman
Tantawy
Cardiology Department, Faculty of Medicine, Zagazig University
10.21608/zumj.2015.4512
Background: Left ventricular dysfunction after ST segment elevation myocardial infarction (STEMI) is the most important factor affecting morbidity and mortality. The primary objective of reperfusion therapy is to restore epicardial flow and to reperfuse the myocardial tissue. However, in some cases lack of microvascular reperfusion and, consequently, significant left ventricular (LV) dysfunction persist despite the rapid and sustained restoration of blood flow. Early in the course of STEMI, therapies that may harm patients who develop LV dysfunction, such as beta-blockers, are often administered.<br />Aim of the work: construct a predictive score of the risk of developing left ventricular dysfunction in patients with STEMI.<br />Patient and methods: This study was done in Cardiology department, Zagazig University on 100 patients; 78 males (78%) & 22 females (22%) with first acute STEMI underwent successful primary percutaneous intervention (pPCI). Within 72 hours of admission, all of the following parameters were reported: risk factors, blood pressure, heart rate, KILLIP class, need for mechanical ventilation (MV), cardiac enzymes, admission blood sugar, kidney function, lipid profile, electrocardiographic data (ST elevation in millimeters (mm), location of infarction, ST resolution, QRS width in milliseconds (ms), Selvester score), echocardiography (ejection fraction by Simpson's method, wall motion score index) and angiographic data (culprit artery, Total number of diseased vessels, severity of coronary artery disease, Gensini score and door to balloon time).<br />Results: LV dysfunction was associated with decreased renal function (creatinine >1.1 mg/dl, p= 0.029), number of diseased vessels >2 (p=0.034), absence of complete ST segment resolution (p< 0.001), wall motion score index > 2.05 (p=0.008), sum of ST segment elevation >13.5 mm (p<0.001), QRS width >98.5 ms (p<0.001), Selvester score >3.5 (p<0.001) Gensini score >95 (p<0.001), anterior location of infarction (p =0.002) and KILLIP class >1 (p=0.003). A prediction score using these variables stratified patients into low, intermediate and high-risk groups for LV dysfunction; positive likelihood ratios for LV dysfunction in these groups were 2.9, 2.1, and 2.4, respectively.<br />Conclusions: 10 key predictors of in-hospital LV dysfunction after STEMI were identified; a risk score based on these predictors helps to quickly identify patients presenting with STEMI who are at the highest risk for developing significant LV dysfunction and could guide optimal therapeutic choices.
ST-elevation myocardial infarction,left ventricular dysfunction,predictors,Score,primary angioplasty
https://zumj.journals.ekb.eg/article_4512.html
https://zumj.journals.ekb.eg/article_4512_4d908570fbdfd062a47e83b16c6163e0.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
21
2
2015
03
01
EFFECTS OF BOTH GARLIC AND ROSEMARY EXTRACTS ON RATS LIVER FIBROSIS : A HISTOCHEMICAL AND IMMUNOHISTOCHEMICAL STUDY
1
11
EN
Emaraa
W.
Pathology Department, Faculty of Medicine, Zagazig University
Ahmed
I.
Pathology Department, Faculty of Medicine, Zagazig University
Refaat
M.
Pathology Department, Faculty of Medicine, Zagazig University
Mohammed
L.
Pathology Department, Faculty of Medicine, Zagazig University
10.21608/zumj.2015.4513
Background: Liver fibrosis is a reversible scarring response that occurs in almost all patients with chronic liver injury.Liver fibrosis may progress to liver cirrhosis, the end-stage liver disease, which has been a globally increasing major health problem with high mortality and morbidity rates in the past twenty years.<br />Aim: This study aimed at detection of the effects of both Garlic and Rosemary extracts as natural sources on carbon tetrachloride (CCL4) induced rat liver fibrosis.<br />Materials and methods: This experimental study was carried out on 48 adult male albino rats that were classified into five groups(A-B-C-D-E) each group contain ten rats except group (B)contained eight rats.Group (A) is a control group did not receive any medication, group (B) received Carbon tetrachloride (CCL4) only,group (C) received (CCL4) and Garlic extract,group (D) received (CCL4) and Rosemary extract and group (E) received (CCL4) with both Garlic and Rosemary extracts. This work was carried out during the period from July 2013 to July 2014.<br />Results: Livers harvested from rats treated with Garlic extract and rats treated with Rosemary extract revealed marked reduction in both the inflammatory reactions and degenerative changes,as well as, reduction of fibrosis.Rats treated with both Garlic and Rosemary extracts revealed mild or niether reduction of inflammation nor fibrosis. microvesicular steatosis was noticed in Rosemary treated group (D).<br />Conclusion:Both Garlic and rosemary extracts administration with CCL4 significantly ameliorate all necroinflammatory and fibrotic changes in liver tissues when used individually.Thier protective effect was reduced when they were combined together
Liver,Garlic,rosemary,Cirrhosis,fibrosis
https://zumj.journals.ekb.eg/article_4513.html
https://zumj.journals.ekb.eg/article_4513_c5f92cdbc46e408674f614eb57bb102c.pdf