2024-03-29T13:23:40Z
https://zumj.journals.ekb.eg/?_action=export&rf=summon&issue=2566
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
INSUKINE LIKE GROWTH FACTOR IN RELATION TO MACROSOMIA IN DIABETIC MOTHERS’ BLOOD
Hesham
AbdElhamied
Ehab
Rashied
Esraa
Mohamed
Purpose: The study aim was to assess the relation between maternal blood levels of insulin like growth factor 1& its relation to neonatal macrosomia.
Methods: 68 pregnant women was included in the study, divided into two groups as 34 women was diabetic ( TIDM, TIIDM or GDM) the other 34 was healthy women as control group. We obtain a venous blood sample ante-natally from each mother after consent, IGFI estimated on each sample.
Results: Between the two mother groups the significant difference was noted regarding the laboratory testing for both random blood sugar and for insulin like growth factor1. Mean random blood sugar in diabetic group was 241 mg/dl ranging from 130 to 400 mg/dl. While; mean random blood sugar in control group was 109 mg/dl ranging from 78 to 200 mg/dl. With student T test 11.9 and P < 0.001** . Mean value of serum level of IGF1 in diabetic group founded to be 11.3ng/ml with a range of 8.8 to 13 ng/ml. In control group mean value of IGF1 8.1 ng/ml ranging from 4.2 to 12.6 ng/ml. with the student T test 7.1 and P value <0.001**
Conclusions: insulin like growth factor 1 was significantly higher in diabetic mothers blood which all give birth to macrosomic babies, IGF1 can be used as a predictive factor of fetal macrosomia
2018
07
01
283
288
https://zumj.journals.ekb.eg/article_13206_130361c65d834f690525b2580c7dd559.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
THE PREDICTIVE VALUE OF NEWLY DEFINED CHA2DS2-VASC-HSF SCORE FOR SEVERITY OF CORONARY ARTERY DISEASE IN NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION
Alaa
Al-shorbagy
Montaser
Al-Cekelly
Ashraf
Dwedar
Mohamed
Soliman
Background: CHADS2 and CHA2DS2-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that factors comprising the newly defined CHA2DS2-VASC-HSF score promote atherosclerosis and are associated with severity of CAD [1].
Aim: To investigate the association of CHA2DS2-VASc-HSF score with severity of Coronary Artery Disease as assessed by Syntax Score (SxS) in patients with Non ST Segment Elevation Myocardial Infarction.
Subjects and methods: A total of 50 patients with NSTEMI (37 males and 13 females, their age ranged from 35 to 77 years old with a mean age of 57.8 years old) who underwent coronary angiography were included in our study. The patients were divided into 2 groups according to SxS score (SxS ≤22 and SxS < 22(.
Results: This study showed a statistically significant positive correlation between CHA2DS2-VASC-HSF score and Syntax score I of patients. There is a statistically significant positive correlation between CHA2DS2-VASC-HSF score and serum cholesterol levels of patients. A statistically significant positive correlation was found between CHA2DS2-VASC-HSF score and serum LDL levels of patients. Our study also showed a statistically significant negative correlation between CHA2DS2-VASC-HSF score and ejection fraction (EF%) of patients.
Conclusions: A newly defined CHA2DS2-VASC-HSF score predicts the severity of atherosclerosis in patients with NSTEMI.
2018
07
01
289
296
https://zumj.journals.ekb.eg/article_13209_206cc0cd8621993287d69bf78b3ec1e5.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
FEASIBILITY AND FUNCTIONAL OUTCOME OF LAPAROSCOPIC NERVE SPARING RADICAL HYSTERECTOMY.
Khaled
Ahmed Gaballa
Adel
Denewer
Ashraf
Khater
Fayez
Shahatto
Valerio
Gallotta
Giovanni
Scambia
Aim: Evaluation of the feasibility of laparoscopic nerve sparing radical hysterectomy in comparison to the non-nerve sparing type.
Methodology:Patient recruitment started from November 2014 to November 2016, patients who underwent laparoscopic type C1 hysterectomy and laparoscopic type C2 hysterectomy according to Querleu-Morrow classification(1) at our departments were prospectively evaluated. The inclusion criteria included: Patients with cervical carcinoma Stage IA2 to stage IIB cervical cancer according to FIGO staging and Stage II-III endometrial cancer with cervical involvement according to FIGO staging. Postoperative drainage of the bladder through a Foley catheter was maintained for 2 days and removed on the third day and the patients were asked to perform spontaneous voiding every 3 hours followed immediately by drainage of the bladder by urinary catheter to assess the post void residual (PVR) urine volume. The procedure was repeated until the PVR is less than 100 ml. The voiding function was considered normal when the patient had 2 consecutive measurements of PVR urine less than 100 ml and abnormal if the patient had a PVR urine more than 100 ml with need of self- catheterization after 4 weeks from the date of surgery.
Results:46 patients were included in the study, 30 patients underwent type C1 LNSRH (Group A) and 16 patients underwent type C2 LRH (Group B). The mean age was 49.1±13.1 and 51.2±11.8, median BMI was 26.2(22.9-28.5) and 23.8(21-26.6) respectively for the 2 groups. The mean operative time was 240.1±65.5 in group A and 308.1±83 in group B (P value=0.004). The rate of intraoperative complications was 10% in group A and 12.5% in group B. The median duration of postoperative catheterization until the PVR urine volume was less than 100 ml was 3.5(3-5) days in group A and 6(4-8.5) days in group B (P value=0.002), The rate of late postoperative complications including bladder dysfunction was 3.3% (Group A) and 31.25% (Group B) (P value 0.002).
Conclusion:Our study results supported the feasibility of LNSRH technique with better functional outcome without compromising the oncologic safety of the procedure
2018
07
01
297
306
https://zumj.journals.ekb.eg/article_13213_75ca390745b5c13d0857e2ebdd6560e0.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
OUTCOMES WITH INTRA-AORTIC BALLOON PUMP IN HIGH RISK CARDIAC SURGERY PATIENTS
Ihab
Moursi
Karim
Al Fakharany
Introduction:In high-risk cardiac surgical patients the intra-aortic balloon pump (IABP) is the most frequent used tool for temporary mechanical circulatory support during the perioperative phase. The effects of IABP are an increase in diastolic blood pressure, an improvement in coronary perfusion and a reduction of ventricular afterload, so it increases the stroke volume and cardiac output.
Objective:To study the effect of preoperative use of intra-aortic balloon pump (IABP) on the outcome of high-risk patients that were subjected to coronary artery bypass graft (CABG) surgery.
Methods: From June 2009 to June 2011. Group of 100 patients considered as high-risk patients were subjected to elective bypass cardiac surgery at our center.
Forty patients subjected to preoperative IABP as a prophylactic measure and 60 patients were not subjected to IABP. This is retrospective study of prospectively collected data .The definition of High risk was the presence of two or more known risk factors. The patient’s outcome is compared regarding the predicted mortality of the Euro SCORE. The preoperative effect of IABP on the outcome, mortality and 30 days follow-up was statistically analyzed.
Results:Forty patients subjected to preoperative IABP as prophylactic measure due to higher Euro SCORE-predicted mortality than other 60 patients did not subject to IABP(60% vs 40 %,
P = ˂0.05). Seventy patients (70%) were male while (30%) were female with a mean age of 58.62 ± 9.65 years. Patients subjected to preoperative IABP had increased a percentage of hospital mortality (P = ˂0.05) but this percentage is relatively lower than predicted by Euro SCORE. Patients subjected to preoperative IABP had lower rate of postoperative complication (acute kidney insult (P = 0.045), cardiac surgical intensive care unit (CSICU) stay (P = 0.032) and decrease the need for postoperative inotrope (P = 0.046)) compared to patients without preoperative IABP use. Other complications postoperative were low and similar in both groups.
Conclusions:
We conclude that patients have high-risk CABG, the preoperative IABP in this group with higher predicted mortality was associated with a relative reduction than predicted by Euro score.
The preoperative IABP in this group has a reliable and acceptable outcome on postoperative complications.
intra-aortic balloon pump
high risk
cardiac surgery
2018
07
01
307
3014
https://zumj.journals.ekb.eg/article_13215_be8ccea7d43d1b97658068820cad0627.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
CARDIAC BIOMARKER PROFILING IN EVALUATION OF RISK IN ACUTE CORONARY SYNDROME
May
Sami Ibrahim
Ahmed
Gab-Allah
Ola
Hussein
Montaser
Alcekelly
Background: The significance of the contribution of laboratory medicine to clinical cardiology has grown in importance over the years. This is witnessed by the recent incorporations of biomarkers into new international guidelines and in the re-definition of myocardial infarction (MI).
Aim of the work: The aim of this study is to evaluate the most important cardiac biomarker in risk evaluation in patients presenting by symptoms of cardiac ischemia. cTnT, HsCRP, pro-BNP and GDF-15 will be assayed to correlate their levels with known clinical and angiographic risk factors.
Subjects & Methods: The study subjects included 80 adult subjects. They were divided into the following groups: Group (I) STEMI: 30 subjects, group (II) Non STEMI: 30 subjects and group (III) controls:20 healthy volunteers age and sex matched.
Results: cTnT showed statistically significant difference between the three studied groups. As regard hsCRP and pro-BNP, there was a statistically significant difference between group (I&III) and group (II&III). As regard GDF-15, there was a non-statistically significant difference between the three studied groups. When both patient groups were compared regarding angiographic findings, patients of NSTEMI group showed higher percent of having multi-vessel disease than those of STEMI group.
Conclusion: All studied biochemical markers except GDF-15 showed a statistically significant difference between cases and controls, while only troponin T showed a statistically significant difference between both patient groups.
Acute Coronary Syndrome
STEMI
NSTEMI
biomarkers
GDF-15
2018
07
01
315
321
https://zumj.journals.ekb.eg/article_13217_462e2ca593a12e8c69867d6ce20b631d.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
URINE AND SERUM SOLUBLE INTERLEUKIN 7 RECEPTOR LEVELS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AT ZAGAZIG UNIVERSITY HOSPITALS
Mazen
El-Sheikh
Fadya
Abd-El-Ghany
Yousry
Abo Elmagd
Rofaida
Hafeez Mohamed
Background: Soluble interleukin 7 receptor (sIL7R) is secreted by fibroblasts after stimulation with proinflammatory cytokines. SIL7R has been implicated in many autoimmune diseases such as rheumatoid arthritis (RA) , inflammatory bowel diseases (IBD) and graft-versus-host disease (GVHD).
Objectives: we aimed to evaluate urine and serum sIL7R levels in patients with systemic lupus erythematosus and their association with the disease activity.
Subjects and methods: For a case control study, 54 patients with systemic lupus erythematosus and 27 age and sex matched healthy controls were involved. Serum and urine sIL7R levels (ng/mL) were determined by a sandwich ELISA kit. Disease activity was measured by SLE disease activity index (SLEDAI) score, complement C3, C4 levels and anti-dsDNA titre.
Results: Serum sIL7R levels were significantly higher in SLE patients (p<0.0001) than in control group . Patients with lupus nephritis had significantly higher serum levels of sIL7R than those without nephritis . There was significant correlation between sIL7R levels and SLE disease activity including SLEDAI, C3,C4, anti dsDNA. Urine levels of sIL7R showed non-significant difference between SLE patients and control group and did not correlate with disease activity.
Conclusions: Serum sIL7R is a valuable marker of SLE disease activity, especially in patients with lupus nephritis.
Systemic lupus erythematosus
soluble interleukin 7 receptors
SLEDAI
2018
07
01
322
328
https://zumj.journals.ekb.eg/article_13222_5bc63f2663b1acf1efc24e22dba92938.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
PREVALENCE, PATTERN AND CLINICAL OUTCOME OF CIRCULATORY SHOCK IN CRITICALLY ILL PATIENTS IN MEDICAL ICU
Osama
Khalil
Mohamed
Sakr
Fayrouz
Selim
Islam
Mohammed Salem
Background: To study the epidemiology of circulatory shock secondly to assess different pattern of circulatory shock among adult critically ill patients admitted to medical ICU of internal medicine department Zagazig University during the study period and finally to study the clinical outcome (morbidity and mortality) of different pattern of circulatory shock.
Methods and subjects: The current Cross-sectional cohort study had been carried out on 694 patients with circulatory shock who were admitted in medical ICU with criteria of peripheral circulatory failure. The included patients were subdivided into three groups according to the provisional and definitive diagnosis of type of circulatory shock depending on CVP, echocardiography, cardiac output and laboratory investigations as follow: Group1: hypovolemic shock group ,Group 2: cardiogenic shock group and Group 3: septic shock group. All patients were subjected to thorough medical and clinical history taking and full clinical assessment. Blood samples were withdrawn for routine investigations (Complete blood count, Kidney function tests, Liver function tests, CRP, INR, Arterial blood gases (ABG), Mean saturation of central venous oxygen (ScvO2) and serum lactate. Shock severity was assessed by using APACHE IV score and SOFA score.
Results: The frequency of circulatory shock patients is 13.9% per year. Hypovolemic shock was the major cause of circulatory failure in the studied population followed by septic shock and finally cardiogenic shock. The severity assessment parameters including APPACHE IV score , SOFA score, length of hospital stay and GCS were statically significant difference among the three studied groups, with significant increase in APPACHE IV score and SOFA score in cardiogenic group. APPACHE IV score and SOFA score were significant independent predictor of survival. The outcome measures of our populations during their ICU stay and after discharge to the medical words shows that mortality increase progressively with increase the length of ICU stay, there was significant difference in survival among the three groups, the most favorable outcome is hypovolemic group, and the worst was observed in the cardiogenic shock group.
Conclusions: Circulatory shock is a life threatening condition associated with high mortality so early recognition and early intervention will decrease morbidity and mortality in critically ill patients. CVP, echocardiography and laboratory investigations especially serum lactate and SCVO2 are easy, reliable and available in all emergency departments. All can help in early diagnosis of type of circulatory shock. Calculation of APPACHE IV score and SOFA score were easy and reliable which potentially allow one to diagnose life-threatening condition and treat them before laboratory results are back.
Circulatory Shock
medical ICU
2018
07
01
329
337
https://zumj.journals.ekb.eg/article_13226_6e678a4537069a5de052f28fb8491241.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
STUDY OF MATERNAL RISK FACTORS CONTRIBUTING IN THE DEVELOPMENT OF CONGENITAL HYPOTHYROIDISM
Eman
El Shorbagy
Ihab
A. Salem
Seham
Zaki
Islam
Wahid El Din
Background: The study was conducted to assess maternal factors contributing in the development of congenital hypothyroidism (CH) in their neonates whom were diagnosed by public health insurance newborn screening program during study period from January to December 2017 in Sharkia governorate.
Methods: The study had been conducted on selected sample of 50 mothers; they are selected according to their neonates' thyroid profile and divided into two groups: Group 1 (cases): selected 25 mothers having neonates diagnosed with CH. Group 2 (control): selected 25 healthy neonates and their mothers. All mothers in our study were subjected to full history assessment, physical exam and specific laboratory testing including (TSH, Free T4, Free T3, Anti TPO and Anti TG). On other hand, baseline characteristics and screening laboratory results of neonates diagnosed with CH were obtained from their registered profiles in public health insurance organization in Sharkia governorate.
Results: Clinical parameters of mothers included revealed that mothers having previous history of thyroid disorders as well as maternal abortion rates were higher in case group compared to control group and this difference was statistically significant. Clinical and demographic results of neonates diagnosed with CH, showed that neonatal birth weight was lower in case group compared to control group and this difference was statistically significant. The presence of maternal thyroid dysfunction (mainly hypothyroidism) was higher in case group compared to control group and this difference was statistically significant. Maternal auto-thyroid antibodies (Anti TPO and Anti TG) were higher in case group compared to control group and this difference was statistically significant.
Conclusions: Maternal risk factors in our study contributing in the development of CH were highly related to the presence of maternal thyroid disorders either controlled on treatment or not. As well as, thyroid laboratory dysfunction (mainly sub/hypothyroidism) in mothers induced mostly by autoimmune thyroid state confirmed by presence of higher levels of auto-thyroid antibodies (Anti TPO and Anti TG) which proved to be significant and these autoimmune antibodies in its turn increase the rates of maternal miscarriage, neonatal prematurity and low birth weight as reported in our study.
Abbreviations: CH= congenital hypothyroidism, TSH= Thyroid Stimulating Hormone, Anti TPO= anti thyroid peroxidase antibodies, Anti TG= anti thyroglobulin antibodies.
Background: The study was conducted to assess maternal factors contributing in the development of congenital hypothyroidism (CH) in their neonates whom were diagnosed by public health insurance newborn screening program during study period from Janua
they are selected according to their neonates' thyroid profile and divided into two groups: Group 1 (cases): selected 25 mothers having neonates diagnosed with CH. Group 2 (control): selected 25 healthy neonates and their mothers. All mothers in our
2018
07
01
338
346
https://zumj.journals.ekb.eg/article_13230_56906a539a54606a0b5ad7fc8fffffa3.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
DOUBLE ANTERIOR TEMPORALIS FASCIA MYRINGOPLASTY IN LARGE CENTRAL TYMPANIC PERFORATION
Ezzeddin
Elsheikh
Magdy
Abdel fatah
Ibrahim
Ibrahim
Objective: This study aimed to study double anterior temporalis fascia myringoplasty in primary safe large central tympanic perforation regarding graft uptake and hearing gain.
Methods: The present work included the study of fourteen (14) patients who presented with symptoms suggestive of chronic suppurative otitis media (CSOM) to E.N.T. outpatient clinic, Zagazig university hospitals. All patients were suffering from mucosal type of CSOM and the tympanic membrane perforations are of large size; subtotal perforation. Temporalis Fascia Tympanoplasty type I operation was performed for all patients with double anterior layer technique.
Results: This study included Fourteen (14) patients suffering from mucosal type of CSOM. They included 5 males (35%) and 9 female (65%). The age of patients at the time of presentation was maximum of 37 years and minimum of 12 years with a mean of 23.71 years. The main presenting symptom was hearing impairment in all the fourteen (100%) patients. Ear discharge was the second common presenting symptom. The rate of success in our fourteen cases was 100% in our study, the audiometric tests performed at the 3rd postoperative month revealed that the mean air-bone gap decreased by 20±1dB.
Underlay tympanoplasty
Over-underlay tympanoplasty
Large perforation
2018
07
01
347
353
https://zumj.journals.ekb.eg/article_13234_f41e20835dd2f60e7c5eb3b4891562b6.pdf
Zagazig University Medical Journal
1110-1431
1110-1431
2018
24
4
MEDICAL TREATMENT OF BENIGN PROSTATIC HYPERPLASIA AFTER CYSTOLITHOTRIPSY
Mohammed
Mohammed
Ahmed
Ali
Mohammed
Seleem
Abraheem
Ali
Background: Benign prostatic hyperplasia (BPH) is a noncancerous increase of the size of the prostate gland. The two main medication classes for BPH management are alpha blockers and 5α -reductase inhibitors .Urinary bladder stones account for 5% of all urinary stone disease. Lithotripsy with the holmium: YAG laser started with making small perforations on the stone surface. the laser fiber should be moved over the surface of the stone vaporizing the stone rather than fragmenting it till fragments become small enough to pass spontaneously or can be safely retrieved.
The aim: This study was conducted to investigate the outcomes of Cystolithotripsy with medical Treatment for Benign Prostatic Hyperplasia as an option for treatment of Patients with Bladder Stone and Benign Prostatic Hyperplasia.
Methods: prospective short term cohort study. 44 Patients with urinary bladder stone and benign prostatic hyperplasia BPH who are programmed for endoscopic removal of bladder stone with subsequent medical management of BPH, including alpha-blocker (Silodosin 8mg).from January 2017 – June 2017. All laboratory investigation within normal level no renal Hydronephrosis detected by radiological imaging and no malignancy in urinary bladder.
Results: In our study shows significant improvement in IPSS which started 17.89±2.35 preoperative to 8.48±0.84 after six months, also significant improvement in PVR which started 90.62±.13.30 Before operation to become 27.27±14.3 After operation and lastly significant improvement in Q-max which started 11.93±1.64 Before operation to become 16.46±0.77 after six month.
Conclusion: Medical treatment of benign prostatic hyperplasia after endoscopic removal of bladder stone is an appropriate option for managing patients with bladder stone and benign prostatic hyperplasia. Lithotripsy with Holmium: YAG laser is an appropriate line in management of bladder stone associated with Benign prostatic hyperplasia.
Background: Benign prostatic hyperplasia (BPH) is a noncancerous increase of the size of the prostate gland. The two main medication classes for BPH management are alpha blockers and 5α -reductase inhibitors .Urinary bladder stones account for 5% of
including alpha-blocker (Silodosin 8mg).from January 2017 – June 2017. All laboratory investigation within normal level no renal Hydronephrosis detected by radiological imaging and no malignancy in urinary bladder. Results: In our study shows signi
also significant improvement in PVR which started 90.62±.13.30 Before operation to become 27.27±14.3 After operation and lastly significant improvement in Q-max which started 11.93±1.64 Before operation to become 16.46±0.77 after six month. Concl
2018
07
01
354
358
https://zumj.journals.ekb.eg/article_13237_47e6ac1267a87330760fd27607df9675.pdf