Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301EVALUATION OF ANGIOPOIETIN-2 AS AN EARLY MARKER FOR DIABETIC NEPHROPATHY INZAGAZIG UNIVERSITY HOSPITALS931011308210.21608/zumj.2018.13082ENMohammad HassanAlyMohammad AbbasArafatOla AlyHusseinHanaaHosnyAyman RiyadAbdel-Hammed El SayedJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1"> </span><span class="fontstyle0">Background: </span><span class="fontstyle3">To assess the validity of measuring plasma </span><span class="fontstyle0">Angiopoietin </span><span class="fontstyle3">as a biomarker for early detection of diabetic<br />nephropathy and todetermine the relation between plasma Ang-2 and inflammation in diabetic nephropathy patients in<br />Zagazig university Hospitals.<br /></span><span class="fontstyle1"> </span><span class="fontstyle0">Subjects and methods:</span><span class="fontstyle3">This study included a total of 76 diabetic patients divided to microalbuminuria and<br />macroalbuminuria groups , each group contained 38 patients in addition to 40 healthy control subjects.<br /></span><span class="fontstyle0">Results</span><span class="fontstyle3">: Plasma levels of Ang-2 was significantly higher in patients with microalbuminuria and macroalbuminuria<br />compared to healthy controls. Indeed, Ang-2 levels steadily increases with the progression of albuminuria . The study<br />showed significant positive correlation between plasma Ang-2 , MAP and creatinine, uric acid, phosphorus, CRP, total<br />cholesterol and triglycrides . We observed also significant negative correlation between plasma Ang-2 and Hb, eGFR,<br />serum calcium and albumin.<br /></span><span class="fontstyle1"> </span><span class="fontstyle0">Conclusion:</span><span class="fontstyle3">Our results indicated that Plasma Angiopoietin-2 levels are elevated in patients with diabetic<br />nephropathy . plasma Ang-2 steadily increase with the progression of albuminuria, suggesting their possible role as early<br />markers of microvascular angiopathy of glomeruli . Plasma Ang-2 is related to CRP, this implies that elevated levels of<br />this biomarker occur as a result of inflammation and vascular dysfunction as a part of atherosclerotic process.<br /></span><span class="fontstyle1"> </span><span class="fontstyle0">Abbreviations: Ang-2 </span><span class="fontstyle0">=</span><span class="fontstyle3">Angiopoietin-2</span><span class="fontstyle0">, CRP </span><span class="fontstyle3">= C-reactive protein, </span><span class="fontstyle0">Hb</span><span class="fontstyle3">= hemoglobin, </span><span class="fontstyle0">ACR </span><span class="fontstyle3">= albumin-creatinine<br />ratio, </span><span class="fontstyle0">ESRD </span><span class="fontstyle3">= end stage renal disease, </span><span class="fontstyle0">MAP</span><span class="fontstyle3">= mean arterial pressure, </span><span class="fontstyle0">FBS </span><span class="fontstyle3">= fasting blood suger.</span>
https://zumj.journals.ekb.eg/article_13082_4e9f8b8f704e92a2b0f3d4e277f0de59.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301FLUID CHALLENGES IN INTENSIVE CARE: MONITORING FLUID RESPONSIVENESS IN CRITICALLY ILL PATIENTS1021141308310.21608/zumj.2018.13083ENMona A.ElharrisiKhalid MElsayedShrief MSMowafyJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of over<br />zealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac<br />output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsive<br />ness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other ―static‖<br />markers of preload has been used for decades, but they are not reliable. Robust evidence suggests that this traditional<br />use should be abandoned. Over the last 15 years, a number of dynamic tests have been developed. These tests are based<br />on the principle of inducing short term changes in cardiac preload, using heart–lung interactions, the passive leg raise or<br />by the infusion of small volumes of fluid, and to observe the resulting effect on cardiac output. Pulse pressure and<br />stroke volume variations were first developed, but they are reliable only under strict conditions. The variations in vena<br />caval diameters share many limitations of pulse pressure variations. The passive legraising test is now supported by<br />solid evi dence and is more frequently used. More recently, the endexpiratory occlusion test has been described, which<br />is easily performed in ventilated patients. Unlike the traditional fluid challenge, these dynamic tests do not lead to fluid<br />overload. The dynamic tests are complementary, and clinicians should choose between them based on the status of the<br />patient and the cardiac output monitoring technique. Several methods and tests are currently available to identify<br />preload responsiveness. All have some limitations, but they are frequently complementary. Along with elements<br />indicating the risk of fluid administration, they should help clinicians to take the decision to administer fluids or not in a<br />reasoned way.<br /></span><span class="fontstyle3">Key words</span><span class="fontstyle1">: Pulse pressure variation, Stroke volume variation, Pulse contour analysis, Heart–lung interactions,<br />Passive leg raising, Fluid responsiveness, Cardiac preload, Stroke volume, Volume expansion, Fluid therapy,<br />Haemodynamic monitoring, Critical care, Echocardiography, ICU, Operating room</span>
https://zumj.journals.ekb.eg/article_13083_cc2aea360ced3faf5250e157efd03871.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301VIDEO-ASSISTED THORACOSCOPIC BILATERAL SYMPATHECTOMY FOR PRIMARY HYPERHIDROSIS IN ZAGAZIG UNIVERSITY HOSPITALS1151221308410.21608/zumj.2018.13084ENYehia ZakariaAtwaaMohamed RashadMohamedEmad MohamedSalahRasha ShaabanAbdel MaksoudJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Background</span><span class="fontstyle0">:</span><span class="fontstyle2">. Hyperhidrosis is the condition characterized by abnormally increased sweating/perspiration in excess of<br />that required for regulation of body temperature. Hyperhydrosis can be primary or secondary. Primary hyperhidrosis is<br />idiopathic in nature and the most affected regions are palms , axillae and feet. Palmar and axillo-palmar hyperhidrosis is<br />a disabling disorder. It usually has negative impact on the patient’s social and professional life.The incidence of primary<br />hyperhydrosis is estimated to be around 0.6 to 1% . Management strategies to hyperhidrosis may be classified as non<br />surgical or surgical Treatment. Thoracoscopic sympathectomy is considered the most effective and durable treatment<br />for patients suffering from moderate to severe hyperhidrosis with good short-term results and minimal postoperative<br />complications </span><span class="fontstyle1">Aim of the work</span><span class="fontstyle0">: </span><span class="fontstyle2">The aim of the work is to evaluate and compare the immediate and long-term<br />outcomes of video-assisted thoracoscopic sympathectomy in the treatment of primary hyperhidrosis.</span><span class="fontstyle1">Patients and<br />Methods</span><span class="fontstyle0">: </span><span class="fontstyle2">From Jul. 2012 to Jun. 2017, a prospective study was conducted on fifty six patients, admitted to surgery<br />Departments, zagazig university hospitals scheduled for bilateral thoracoscopic sympathectomy,for the treatment of<br />primary hyperhydrosis involving the palms of both hands in all patients with or without involvement of the axillae.All<br />the patients were considered in grades 3 or 4 of the HDSS in which their lifestyle and occupation were markedly<br />affected.The sample included38 (67.9%) males and 18 (32.1%) female with mean age of 27.03±4.89.</span><span class="fontstyle1">Statistical<br />analysis: </span><span class="fontstyle2">SPSS version 20. </span><span class="fontstyle1">Results</span><span class="fontstyle0">: </span><span class="fontstyle2">In total number of 56 patients with primary hyperhidrosis who passed bilateral<br />thoracoscopic sympathectomy, it was found that all patients had immediate stoppage of palmar hyperhidrosis. The<br />mean hospital stay was1.08±0.28.Good Satisfaction had occurred in 51 cases(91.1%)The most common postoperative<br />troublesome was pleuritic chest pain in 18 cases(32.1%) .Compensatory sweating had occurred in 4 cases(7.1%). 4cases<br />had developed postoperative pneumothorax. </span><span class="fontstyle1">Conclusion:</span><span class="fontstyle2">Video-assisted thoracoscopic bilateral sympathectomy is a<br />rapid, reliable and safe technique. It presents important advantages over the staged procedures because it can be done in<br />a single surgical procedure, requires placement of only two thoracic ports, avoiding the third port. The transaxillary<br />bilateral approach provides as good if not better results and can certainly be done with similar or perhaps less morbidity.<br />Furthermore, the bilateral approach reduces the time of patient recovery and reduces healthcare costs.</span>https://zumj.journals.ekb.eg/article_13084_86a5c053abbc44bcbed8c6e23e20f760.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301FENTANYL VERSUS MAGNESIUM SULPHATE AS ADJUVANT TO HYPERBARIC BUPIVACAINE IN SPINAL ANESTHESIA FOR ELECTIVE CESAREAN SECTIONS1231281308510.21608/zumj.2018.13085ENAshraf SaidSayed AhmedKamelia AhmedAbazaDina Abdel HameedEl SadekJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background: </span><span class="fontstyle2">Subarachnoid block achieved a wide spread popularity as a simple and effective method of<br />anesthesia for elective cesarean sections.The use of intrathecal adjuvants has gained popularity, with the<br />intention of reducing the dose of local anesthetics, maintaining hemodynamic stability and delaying the onset of<br />pain during the postoperative period </span><span class="fontstyle2">The present study </span><span class="fontstyle2">compared between fentanyl and magnesium sulphate as<br />adjuvant to hyperbaric bupivcaine in subarachnoid block for patients undergoing elective cesarean sections.<br /></span><span class="fontstyle0">Subject and Methods: </span><span class="fontstyle2">A total of 56 consented pregnant females </span><span class="fontstyle2">undergoing elective cesarean section</span><span class="fontstyle2">s, ASA<br />grade I and II, were randomized into two groups of 28 patients<br />each. Group F received </span><span class="fontstyle2">12.5 mg of intrathecal 0.5% hyperbaric bupivacaine ( 2.5 ml ) + 12.5 μg (0.25 mL)<br />fentanyl + .75 ml normal saline</span><span class="fontstyle2">, Group M 12.5 mg of intrathecal 0.5% hyperbaric bupivacaine ( 2.5 ml ) + 100<br />mg (1 ml) magnesium sulfate. The two groups were assessed for character of the block, haemodynamic changes,<br />duration of post operative analgesia, the side effects.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal<br />anesthesia and motor block were significantly longer in the magnesium group. Total analgesic dose<br />requirement was less in Group M. Hemodynamic parameters were comparable in the two groups. Intrathecal<br />magnesium caused minimal side effects.<br /></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">The addition of magnesium sulfate 100 mg to bupivacaine for sub-arachnoid block in patients<br />undergoing elective cesarean section prolongs the duration of analgesia and reduces postoperative analgesic<br />requirements without additional side effects and adverse neonatal outcomes.</span>https://zumj.journals.ekb.eg/article_13085_3939dc84034bebdeb5cac51d37cc400e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301STUDY THE EXPRESSION OF TETRASPANIN (CD81) ON B CELLS IN RESPONSE TO INTERFERON THERAPY IN CHRONIC HCV PATIENTS1291341308610.21608/zumj.2018.13086ENEbtehag HelmyHassanNaglaa AliKhalifaSahar GoudaZaghlolAhmed SallamSolimanJournal Article20180909<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Hepatitis C virus (HCV) infection causes life threatening disease due to its persistence in the liver, over time leading to<br />cirrhosis and hepatocellular carcinoma. Therapeutic intervention with interferon (INF) - alpha combined with ribavirin<br />is aimed at viral clearance, Interferon and ribavirin might discontinue the virus induced hepatocytes damage, thus<br />slowing down the progress to end- stage liver disease. It has been demonstrated that HCV virion, via major structure<br />envelop (E) protein 2 or EIE2 complex could specifically bind to human CD81 molecule, thereby altering the cellular<br />activities in B cells, T cells and natural killer (NK) cells</span><span class="fontstyle0">. </span><span class="fontstyle1">CD81, a surface protein belonging to the tetraspanin family,<br />facilitates B–T cell interaction in the process of antigen presentation Evidence has revealed that CD81 on B and T cells<br />substantially enhanced T helper IL-4 secretion and NK-cell CD81 enabled E2-mediated reduction of the IFN-gamma<br />levels Those data suggest that CD81 might activate the pathway leading to a predominant type-2 immune response, and<br />as such be prone to cause a strong antibody production but weak or insufficient cytotoxic activities to clear the.The aim<br />of this work was to investigate the clinical relevance and the possible mechanism of CD81 down-regulation under IFN<br />alpha treatment to detect possible role of CD 81in response to INF therapy of chronic HCV patients.<br /></span><span class="fontstyle0">Subjects and Methods: </span><span class="fontstyle1">The study included: </span><span class="fontstyle0">Group I: </span><span class="fontstyle1">10 healthy subjects. And 60 HCV patients classified into 3<br />groups: </span><span class="fontstyle0">Group II: </span><span class="fontstyle1">20 chronic HCV patients have not received treatment </span><span class="fontstyle0">Group IIIa: </span><span class="fontstyle1">20 chronic HCV patients have<br />received treatment responsive to treatment </span><span class="fontstyle0">Group IIIb: </span><span class="fontstyle1">20 chronic HCV patients have received treatment not<br />responsive to treatment .the patients were subjected to: (CBC) .liver and kidney function tests and special investigation<br />CD 81, CD19, CD 22.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle1">TLC and PLT higher in group I while ALT and AST were significantly higher in group II, while T. bilirubin<br />was significantly higher in group IIIb, Direct bilirubin was significantly higher in group II ,and Alb was significantly<br />higher in group I ,ASMA and ANA more higher in group IIIb, AFP and TSH were significantly higher in group IIIb ,<br />there was negative correlation between CD81 and TLC positive correlation between ALT, AST and CD81 were<br />positively correlated to T Bilirubin , D Bilirubin and CD81.There was also significant negative correlation between<br />Albumin and CD81. CD81, CD19, CD22 and Lymphocytes were significantly higher in group IIIb.<br /></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle1">In conclusion, CD81 down-regulation is a primary host response to interferon-alpha-based therapy and an<br />immunophenotype associated with anti-HCV sustained virological response (SVR)</span>
https://zumj.journals.ekb.eg/article_13086_4aba419c7c84452889c954a6742b3450.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301RECTAL ADVANCEMENT FLAP TREATMENT COMPARED WITH SETON FOR HIGH TRANSSPHINCTERIC PERIANAL FISTULA1351421308710.21608/zumj.2018.13087ENMohammed KhairyMohammedZaki AbdelgawadAllamNawel El-SayedHusseinNabil Abdel AzimHamrahJournal Article20180910<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Background: </span><span class="fontstyle3">Treatment of anal fistula is a balance between maximizing the chances of successful healing and avoiding<br />complications particularly incontinence from division of the anal sphincters. Many surgical procedures have been used<br />in the treatment of anal fistula, with varying success. Endorectal advancement flap can be a useful tool for the surgeon<br />faced with an anal fistula. This study aims to compare outcomes for rectal flap advancement in comparison to seton<br />placement in treating high transsphincteric perianal fistula.<br /></span><span class="fontstyle1">Subjects & methods: </span><span class="fontstyle3">The study included 54 patients with high transsphincteric perianal fistulas; 27 patients were treated<br />by rectal partial thickness advancement flap and the other 27 patients were treated by seton placement.<br /></span><span class="fontstyle1">Results: </span><span class="fontstyle3">Results proved to be better with rectal advancement flap than seton regarding time to complete healing,<br />postoperative wound infection, postoperative continence and recurrence.<br /></span><span class="fontstyle1">Conclusion: </span><span class="fontstyle3">Rectal Advancement Flap was found to be a promising and a more effective procedure than seton with<br />better healing rates and less liability for postoperative incontinence or recurrence.<br /></span>
https://zumj.journals.ekb.eg/article_13087_1fd268170aecb81ebaf1ca76e3330a51.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301MYRINGOPLASTY OF CENTRAL TYMPANIC MEMBRANE PERFORATION WITH A FAT GRAFT FROM THE EAR LOBULE AND PLATELET RICH PLASMA.1431491308810.21608/zumj.2018.13088ENAhmed RoshdyEbrahimYasser AhmedFouadMagdy BedirAliSaeed Abo El-EzEl-BazJournal Article20180910<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background: </span><span class="fontstyle2">Fat myringoplasty had been described over 50 years to be a safe and simple option for<br />myringoplasty. Platelet rich plasma [PRP] is a simple and minimally invasive method to obtain a high<br />concentrate of autologous growth factors that can facilitate wound healing.<br /></span><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To assess the effectiveness of using fat and PRP in myringoplasty.<br /></span><span class="fontstyle0">Patients and methods: </span><span class="fontstyle2">Twenty patients with small to medium sized tympanic membrane perforations were<br />enrolled in this study. Under local anesthesia, the margin of the perforation was freshened, then a single<br />piece of ear lobule fat graft, approximately double the size of the perforation, was placed through the<br />perforation, then the PRP was applied over the fat graft.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Successful TM perforation repair was achieved in 36 ears [85.7%]. 100% success rate was<br />obtained in small peroration and 79.3%in medium sized perforation. There was significant postoperative<br />improvement in the mean air bone gap [p = 0.0016].<br /></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Adding PRP to fat myringoplasty is a safe, effective, cost saving and minimally invasive<br />procedure. It is suitable to repair small as well as moderate sized TM perforations.</span>
https://zumj.journals.ekb.eg/article_13088_b6855c0c96f10aded70ad682bccacec7.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301EFFECT OF LAPAROSCOPIC OVARIAN CYSTECTOMY FOR ENDOMETRIOMA ON OVARIAN RESERVE1501561308910.21608/zumj.2018.13089ENAzza Abd ElmageidAbd ElhameidAbd Elaziz IbrahimAminAmr Abd AlmohsenAlnemrMaha SabrySelim MohamedJournal Article20180910<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background: </span><span class="fontstyle2">To assess the effect of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve by<br />markers as Anti-Mullerian Hormone and Follicle Stimulating Hormone.<br /></span><span class="fontstyle0">Subjects: </span><span class="fontstyle2">48 Women of reproductive age who had ultrasonographic diagnosis of endometrioma measuring>3cm<br />whether unilateral or bilateral and subjected to laparoscopic excision.<br /></span><span class="fontstyle0">Methods: </span><span class="fontstyle2">From January 2017 to December 2017, Women with endometrioma underwent to laparoscopic<br />excision. Serum AMH and FSH were determined preoperatively and 3months postoperative.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">There was a statistically significant reduction in postoperative mean value of AMH ( 2.04+ 1.69 ) when<br />compared to the preoperative mean value of AMH (2.59+ 1.85 ) and a statistically significant rise in<br />postoperative mean value of serum FSH (7.23+ 1.48 ), when compared to preoperative mean value of FSH<br />(5.50+ 1.85 ). Post-operative AMH decreases were greater in patients with endometriomas > 5cm in diameter<br />compared with smaller ones and in patients with bilateral endometriomas compared with unilateral ones.<br /></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Laparoscopic cystectomy for endometrioma has an adverse impact on ovarian reserve. Bilaterality<br />and size of endometrioma increase the adverse effect of Laparocopic ovarian cystectomy on the ovarian reserve.</span>
https://zumj.journals.ekb.eg/article_13089_583897a86df5b8401b101c4e469a19dd.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301EPICARDIAL FAT VOLUME AS A PREDICTOR OF THE SEVERITY OF CAD BY MSCT1571651309010.21608/zumj.2018.13090ENOsama KhalilMohammedMagdy MohammedAbd-ElsameeHisham SamirRoshdyMohammed HassanSolimanJournal Article20180910<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle0">Background: </span><span class="fontstyle2">Distribution of body fat is known to be more independent and potent predictor of morbidity and<br />mortality than total body adipocity. Each visceral fat storage is anatomically and functionally different and according<br />to its closeness to an organ, it exerts a specific local function for each one. Epicardial adipose tissue (EAT) as a fat<br />depot is further implicated on coronary artery disease (CAD) because of proximity to the adventitia of major epicardial<br />coronary arteries. Epicardial fat volume (EFV) can be evaluated by MSCT even without contrast injection which helps<br />in prediction of the presence and the severity of CAD.<br /></span><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To evaluate the relationship between epicardial fat volume and the severity of coronary artery disease<br />among patients presented by chest pain with low to intermediate pretest probability for CAD using Multi-Slice CT<br />coronary angiography.<br /></span><span class="fontstyle0">Subjects and methods: </span><span class="fontstyle2">The study included 100 patients, 94 males and 6 females with mean age 56.03 ± 10.24 years<br />who were referred to the MSCT coronary angiography unit in Zagazig University Hospital and Kobri Elkobba Military<br />Hospital during the period from January 2017 to August 2017. All patients were subjected to through history taking<br />including age, sex, family history of CAD, DM, HTN, smoking, complete clinical examination including BMI and<br />overweight was defined as ≥ 25 kg/m2, standard ECG, analysis of lipid profile, measurement of serum creatinine and<br />random blood glucose level as well as Multi-slice CT angiography.<br /></span><span class="fontstyle0">Results: </span><span class="fontstyle2">There was significant relationship between EFV and Proximal LAD and D1 lesions (p = 0.020) as regarding<br />segment involvement score (SIS) and segment stenosis score (SSS) by MSCT. Epicardial fat volume (EFV) was<br />125.34 ± 35.37 cm3 (range from 47.4 to 221.3 cm3 and the median value of EFV in our patients was 123.35 cm3) and<br />Coronary artery calcium score (CACS) was 157.69 ± 352.95 (range from 0 to 2212 and the median value was 29.55)<br />with significant relationship between EFV and Ca score (p = 0.009), highly significant relationship between EFV and<br />SIS score and SSS score (p < 0.001). There was significant relationship between EFV and sex (p = 0.002), highly<br />significant relationship between EFV and hypertension and diabetes mellitus (p < 0.001), no significant relationship<br />between EFV and smoking (p = 0.754) and family history of ischemic heart disease (p = 0.082), significant<br />relationship between EFV and age (p = 0.011), highly significant relationship between EFV and serum cholesterol,<br />LDL, serum triglycerides, LDL/HDL ratio, BMI and inversely proportional to HDL (p < 0.001).<br /></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">we concluded in our study that EFV was associated with coronary atherosclerosis and EFV increased<br />steeply in patients with significant coronary artery stenosis and in those with severe coronary artery calcification as<br />revealed by MSCT angiography. Quantitation of EFV may be useful in addition to coronary artery calcium score as a<br />predictor to identify patients at risk for CAD.</span>
https://zumj.journals.ekb.eg/article_13090_5d4c6a8fee79f35ae6c30623bf9b568e.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143124220180301ASSESSMENT OF THE ROLE OF 128 ROW MULTI DETECTOR COMPUTED TOMOGRAPHY IN THE EVALUATION OF CORONARY ARTERY BYPASS GRAFTS PATENCY1661771309110.21608/zumj.2018.13091ENKhaled MohamedEl GerbyMohamed IbrahimAminMohamed IbrahimAmin MousaJournal Article20180910<span class="fontstyle0">ABSTRACT<br /></span><span class="fontstyle1">Background: The recently developed 128 row multidetector CT had made a revolution in coronary artery bypass grafts<br />(CABG) patency evaluation due to high temporal and spatial resolution beside it is being non invasive.<br />Subjects and Methods: 50 patients were enrolled for ECG gated CT of coronary arteries bypass grafts between January 2015<br />and May 2017.<br />Patients underwent conventional coronary angiography within 2 weeks of MDCT exam. Administration of beta blocker and<br />nitroglycerin was done prior to CT exam. Breath hold training was mandatory.<br />Results: 46 grafts were arterial and 74 were venous. 36 of the arterial grafts (78.2 %) were patent, 6 (13 %) were significantly<br />narrowed and 4 (8.8 %) were completely occluded. Regarding venous grafts, 52 (70.2 %) of them were patent, 14 (19 %) were<br />significantly narrowed and 8 (10.8 %) were completely occluded. CT angiography compared to the conventional angiography<br />as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98% and an accuracy of about 93.6% in the<br />assessment of any type of coronary artery grafts.<br />Conclusion: MDCT is considered the imaging modality of choice at the current days to evaluate the patency and stenosis of<br />coronary artery bypass grafts than the conventional coronary angiography due to its multiple drawbacks.</span>https://zumj.journals.ekb.eg/article_13091_be1f97fc47de8d67b63c177254b53096.pdf