Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701AUDIOLOGICAL HAZARDS OF PROLONGED TELEVISION WATCHING AT YOUNGER AGES111440410.21608/zumj.2014.4404ENEbtessamNadaAudiology Unit, ENT Department, Zagazig UniversityJournal Article20171205Introduction: Frequent complaints of poor attention, delayed language development, abnormal behaviors and even diminished hearing were encountered lately among parents of young children presented to Audiology and Phonology units. Careful history taking revealed long periods of TV watching as yong as , in some cases, 3 months old. What exactly did this do to their brains and if it is reversible is what we are seeking for.<br />Methods: 50 children with age range from 2 to 3 years presented to the audiology unit complaining of hearing problems or referred from phonology unit for hearing assessment as a an investigation necessary for DLD complaining of language problems and/ or abnormal communication behavior.<br />All parents were subjected to<br /> Full history taking.<br /> Questionnaire.<br />All children were subjected to:<br /> Full audiological assessment (Tympanometry, ABR).<br /> MMN.<br /> Remediation for three months.<br />Counseling of the parents was performed then retesting was done after 3 months using the same questionnaire and children were subjected to MMN and ABR.<br />Results: Both study and control groups were age matched. IQ assessment revealed average intelligence in both study and control groups. A statistically significant difference was found between study and control groups as regards scale of auditory behaviors questionnaire. A statistically significant difference was found also between tham as regards Modified checklist for Autism in toddlers.<br />Study group showed also, statistically significant prolonged latency and significantly lower amplitude.<br />Conclusion: Learning through electronic media is not suitable for children before preschool age. In fact it has many adverse effects on socialization, cognitive function, attention and memory butting the child in different categories of auditory processing disorders and even autism and has adverse effects on language skills. So learning through real life situation is more important at earlier ages.https://zumj.journals.ekb.eg/article_4404_7ab6eb047ccc598a15a5416bdbddbe71.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701ASSESSMENT OF THE SERUM INTERLEUKIN-6, INTERCELLULAR ADHESION MOLECULE-1, NITRIC OXIDE AND C-REACTIVE PROTEIN IN ACUTE ISCHEMIC STROKE19440510.21608/zumj.2014.4405ENEl-ShazlySMANeurology departments, Faculty of Medicine, Zagazig UniversityAbdel-GawadEANeurology departments, Faculty of Medicine, Zagazig UniversityOmarHMclinical pathology departments, Faculty of Medicine, Zagazig UniversityEl-KhatibTHNeurology departments, Faculty of Medicine, Zagazig UniversityJournal Article20171205Background: Cerebral ischemia initiates an inflammatory response in the brain which is a composite process that involves many inflammatory mediators.The investigation of inflammatory response in the acute stage may contribute to improve the treatment of ischemic stroke. Objective: We assessed the relationship between peak values of serum interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1),erythrocyte sedimentation rate (ESR), c-reactive protein (CRP)and nitric oxide (NO)in the first week after ischemic stroke, with measures of stroke severity and outcome.Methods:forty-five patients (22 males and 23 females) with ischemic stroke were prospectively recruited. Serum IL-6, and other markers of peripheral inflammation, was measured at time points 24 h, as well 7 days after symptom onset.Twenty-five age-matched volunteers were used as controls. We correlated levels with stroke severity assessed by the NIH Stroke Scale; stroke outcome at 1 month assessed by BI and computed tomography (CT) brain infarct volume. Result(s): Peak serum IL-6 and CRP concentrations correlated significantly (p < 0.001) with CT brain infarct volume (r = 0.75) and NIHSS at 1 week (r = 0.72). They correlated similarly with clinical outcome at 1 month. Strong associations were also noted between either peak serum ICAM-1 or NO concentrations and short-term stroke outcome. Conclusion(s):These data provide evidence that the peripheral inflammatory response may be related to the severity of acute ischemic stroke, and may be used as predictors for clinical outcome.https://zumj.journals.ekb.eg/article_4405_f027dd73fd1884077a538bffe5b5d909.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701ANTI- ANNEXIN 1 ANTIBODIES CORRELATION BETWEEN ANTIBODIES LEVEL AND DISEASE ACTIVITY IN SOME AUTOIMMUNE CONNECTIVE TISSUE DISEASES15440610.21608/zumj.2014.4406ENKhashabaADermatology and Venereology Department, Faculty of Medicine, Zagazig UniversityMetwalliIDermatology and Venereology Department, Faculty of Medicine, Zagazig UniversityGhanemHDermatology and Venereology Department, Faculty of Medicine, Zagazig UniversityZedanAClinical Pathology Department, Faculty of Medicine, Zagazig UniversityJournal Article20171205Introduction: Annexin 1 is an anti-inflammatory protein, exerts a regulatory effect in both innate and adaptive immune responses. Autoantibodies against annexin 1 have been recognized in some patients with autoimmune connective tissue diseases. Aim: to detect presence of anti-annexin 1 antibodies in patients with rheumatoid arthritis, scleroderma, systemic and discoid lupus erythematosus and to evaluate whether there is a correlation between the antibodies levels and disease activity. Methods: determining the levels of IgM antibodies in serum samples by ELISA and correlating them with the disease activity, which is evaluated using specific activity index for each disease. Results: levels of anti- annexin 1 antibodies were found to be significantly higher in diseased groups when compared to normal healthy controls. When correlating antibodies levels with disease activity, rheumatoid arthritis and discoid lupus patients showed no significant correlation, however systemic lupus and scleroderma patients showed significant correlation between antibodies levels and disease activity. Conclusion: anti- annexin 1 antibodies might be a promising aid in diagnosis of these diseases and could have a prognostic capacity in some autoimmune connective tissue diseases.https://zumj.journals.ekb.eg/article_4406_7ef16dab6bca1521fb251d55cd24b353.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701EVALUATION OF THE RESULTS OF DIFFERENT PROCEDURES IN COCHLEAR IMPLANTATION19440710.21608/zumj.2014.4407ENAlaaEl-FekyOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityEzz El-DinM El ShiekhOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityHassanWahbaOtorhinolaryngology Department, Faculty of Medicine, Ain-Shams UniversityAhmedEl AassarOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityJournal Article20171205Background: The cochlear implantation has radically changed the outlook for profoundly deaf adults and children. The cochlear implant can provide sufficient hearing sensations to enable most severely or profoundly deafened persons to continue communicating using speech as their primary means of communication .In Classic cochlear implantation; mastoidectomy is done to help retain the electrode leads within the confines of the mastoid cavity. Then the facial recess should be widely opened followed by cochleostomy which is followed by insertion of the electrode array. Minimally invasive cochlear implant surgery has become the mainstay of most experienced centers. Aim of work: to evaluate the results of using different procedures in cochlear implantation. Patients and methods: The study carried out on 41 patients underwent cochlear implantation, starting from April 2011 till April 2014. Patients were 27 males and 14 females, their age ranged from 2 years to 18 years and all complained of profound sensori-neural hearing loss.<br />We excluded postlingual adults (n=2) and children with congenital anomalies (n=3), post-meningitis cochlear ossification (n=1) and children with chronic suppurative otitis media (n=1). Total number of excluded cases is 7 patients and remains 34 patients. The patients were divided into two groups: the 1st group of patients were implanted by classic approach (n=28) the 2nd group of patients were implanted by the SMA (n =6) and another comparison in which, the patients were divided into patients was implanted by PULSAR ci100 device (5 cases) and the patients were implanted by HI-RES 90K device (29cases); all patients were subjected to full preoperative assessment, and full postoperative assessment of complications (major and minor complications). Results: there is significant relation between the two groups regarding major complications in favor to classic approach but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, there is no significant difference between the ways of insertion regarding the major complications and there is significant difference between the 2 groups as regard to device migration, electrode extrusion and device malfunction in favor to Hi-res 90k device. Conclusion: classic approach has fewer incidences of major and minor complications than SMA, but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, Hi-res 90k device is better than PULSAR ci100 device as regard to device migration, electrode extrusion and device malfunction, We still need more assessment for surgical approaches, way of electrode insertion, type of devices.https://zumj.journals.ekb.eg/article_4407_d8eab83275a6732147335ef5736bf9e8.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701STUDY ON EFFECT OF OMENTIN IN GLUCOSE AND LIPID METABOLISM IN NORMAL AND DIABETIC RATS.16440810.21608/zumj.2014.4408ENAhmadAbd-AllahPhysiology department, Faculty of medicine, Zagazig University.MohammedZamzamPhysiology department, Faculty of medicine, Zagazig UniversityAzzaMegahedPhysiology department, Faculty of medicine, Zagazig University.SafyaEsmaeelPhysiology department, Faculty of medicine, Zagazig University.Journal Article20171205Background and study aim: Previous works have revealed that adipose tissue functions as an endocrine organ, producing a variety of adipokines. These so-called adipokines play important roles in metabolic homeostasis, and when their production is not properly regulated, they can contribute to metabolic diseases. Omentin is a novel adipokine secreted from visceral omental fatand others. Evidence suggests that omentin is one of the factors involved in the complex network that controls insulin resistance, obesity and diabetes. We aimed to evaluate the effects of in vivo administration of omentinon glucose and lipid metabolism in normal conditions and in experimentally induced type 2 diabetes mellitus.<br />Material and Methods: In this work, 60 adult male white albino rats were divided into 6 equal groups each group contains 10 animals. These groups are control, omentin injected, obese/diabetic, obese/diabetic omentin injected, obese/diabetic insulin injected and obese/diabetic insulin and omentin injected groups. The effect of omentin on metabolic parameters was reflected by analysis of fasting serum glucose, insulin and HOMA IR and HOMA β. Also, full analysis for lipid profile including total cholesterol, LDL-cholesterol, triglycerides and HDL-cholesterol was performed. Parallel to analytic studies, anthropometric measures were obtained in the form of body mass index (BMI) and waist circumference.<br />Results: There were significant decreases in serum levels of glucose in obese/diabetic omentin injected and obese/diabetic insulin and omentin injected group (P< 0.001, P< 0.001 respectively). But, this effect was insignificant in omentin injected animals when compared with control. Likewise, there were significant decreases in HOMA IR in obese/diabetic omentin injected and obese/diabetic insulin and omentin injected group (P< 0.001, P< 0.001 respectively). In addition, there were significant increases in HOMA βin obese/diabetic omentin injected and obese/diabetic insulin and omentin injected group (P< 0.001, P< 0.001 respectively).<br />In obese/diabetic animals, injection of omentin resulted in a significant decrease in total cholesterol, LDL and triglycerides, together with a significant increase in HDL.<br />Conclusion: We can conclude that, the insulin sensitizer effect of omentin improves both glucose tolerance and dyslipidemia in cases of type 2 diabetes but not in the normal conditions.https://zumj.journals.ekb.eg/article_4408_d4bdef66da694618d16990a06255c07a.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701OUTCOME OF ACUTE RESPIRATORY DISTRESS SYNDROME NETWORK PROTOCOL IMPLEMENTATION IN PATIENTS WITH ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME.111440910.21608/zumj.2014.4409ENRamadanNafaeChest Diseases Department, Faculty of Medicine, Zagazig University, Egypt.MohamedIsmailChest Diseases Department, Faculty of Medicine, Zagazig University, Egypt.RedaElghamryChest Diseases Department, Faculty of Medicine, Zagazig University, Egypt.AdelHamadaChest Diseases Department, Faculty of Medicine, Zagazig University, Egypt.Journal Article20171205Background: There is under-use of ARDS Network ventilatory protocol in managing ARDS patients. Hence the objective of this study was to assess the impact of implementing ARDS network protocol, as a ventilatory strategy in management of ALI/ARDS patients.<br />Design: retrospective-prospective comparative study.<br />Patients and Methods: This study was conducted on 40 mechanically ventilated patients with ARDS admitted at ICUs of Zagazig University Hospitals. Twenty newly admitted cases of ALI/ARDS (group I)(prospective group) that have been managed by ARDS Network protocol of mechanical ventilation were compared with another 20 patients who have not been managed by ARDS Network protocol of mechanical ventilation (group II) (retrospective group).<br />Results: Both groups were matched as regards age, sex,smoking habits, oxygenation ratio and SAPS II on admission .There were a significant statistical difference between both groups as regards tidal volume and plateau pressure on days 1,3 &7 with mortality ( 60% vs. 90% p= 0.028) , duration of MV(18.6 vs. 25.5 days p = 0.001), LOS in ICU among survivors (22.6 vs. 30.5 days p=0.001)and barotraumas ( 1 vs. 6 patients p= 0.037) in group I and group II respectively.<br />Conclusions: Application of ARDS Network ventilatory protocol as a ventilatory strategy in ARDS patients decreases the overall mortality, days on mechanical ventilation, the length of stay in ICU and the incidence of barotrauma.https://zumj.journals.ekb.eg/article_4409_62fc27a210c8eef0946a38de509fc440.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701EFFECT OF DIAZEPAM ON BLOOD AND BRAIN OXIDATIVE STRESS AND PLASMA ACTH OF ANXIOGENIC MALE ALBINO RATS111441010.21608/zumj.2014.4410ENAzizaEl-ShafeyZoology Department, Faculty of science, Benha University, Egypt.MagdaEl-EzabyZoology Department, Faculty of science, Benha University, Egypt.MoshiraSeliemZoology Department, Faculty of science, Benha University, Egypt.EmanShaheenZoology Department, Faculty of science, Benha University, Egypt.HanemAbdel-MaksoudZoology Department, Faculty of science, Benha University, Egypt.Journal Article20171205The present study was designed to investigate the effect of diazepam on the physiological changes of anxiogenic male rats. 120 male albino rats weighing 120±10g were divided into 6 groups. Control -ve (Untreated), control +ve (Treated with saline), drug (0.9mg diazepam/kg body weight), anxiety (Sleep deprived), drug+ anxiety, anxiety+ drug groups (exposed to the same conditions of drug and anxiety groups). Blood and brain samples were taken from all groups after 48 and 72 hours of anxiety. Blood was collected into two tubes, the first containing EDTA and the second without anticoagulant. Erythrocyte lysate, plasma and serum were separated and frozen at -20cº for biochemical and hormonal analysis. The results revealed that 48 and 72 hours of sleep deprivation caused depletion of SOD, CAT and GSH activities and increase of MDA levels in blood and brain of anxiogenic rats compared with control ones. The increment of plasma ACTH was also reported in anxiety group. Anxiogenic rats treated with diazepam revealed an improvement in SOD, CAT and GSH activities and depletion of MDA level in blood and brain compared with anxiety group. Plasma ACTH concentrations was decreased also in anxiogenic rats treatmed with diazepam. It might be referred that treatment with diazepam minimizing deleterious effects of sleep-deprivation induced oxidative damage suggesting its anti oxidative effect, and its inhibitory effect on the hypothalamic pituitary adrenal axis (HPA) activity.https://zumj.journals.ekb.eg/article_4410_b06d4601ac1034428395e2f66c2944b5.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701THE ANALGESIC EFFECT OF PREGABALIN, A COMPARATIVE STUDY WITH MORPHINE18441110.21608/zumj.2014.4411ENHassan.ShabayekClinical Pharmacology Department, Faculty of Medicine, Zagazig UniversityAlyMustafaClinical Pharmacology Department, Faculty of Medicine, Zagazig UniversNadiaKhorshidClinical Pharmacology Department, Faculty of Medicine, Zagazig UniversHosamMohammedClinical Pharmacology Department, Faculty of Medicine, Zagazig UniversityJournal Article20171205Objectives: this study was designed to assess and compare the effects of pregabalin and morphine on acute thermal pain and on nerve injury associated pain (chronic neuropathic pain). Methods: 72 male albino rats were divided into two major groups: group I (acute pain group) 30 rats divided into 5 equal subgroups (1)control, (2) pregabalin 30 mg/kg, (3)morphine 0.5 mg/kg, (4) pregabalin 60 mg/kg, (5)morphine 1mg/kg, and group II(chronic pain group) 42 rats were divided into 7 equal subgroups (1)sham operated, (2)control normal, (3) control postoperative, (4) pregabalin 30mg/kg, (5) morphine 0.5 mg/kg, (6) pregabalin 60 mg/kg, (7) morphine 1mg/kg. For acute pain the reaction times, which indicate the tolerability of the animals to acute thermal pain, was measured using analgesia meter. However chronic neuropathic pain was induced in experimental animals by unilateral ligation of the sciatic nerve in the thigh. Results: The result of the present study revealed that neither 30 nor 60 mg/kg pregabalin produced any significant effects on the tolerability of rats to acute thermal pain. On the other hand, pregabalin (30 and 60 mg/kg) markedly reversed allodynia and hyperalgesia in rats subjected to sciatic nerve ligation. The effect of pregabalin 30 mg/kg was noticed after 60 minutes and persist for 90 minutes but the higher dose (60 mg/kg) produced analgesic effect all over the experiment. On the other hand morphine 0.5 and 1 mg/kg significantly increased the tolerability of normal and sciatic nerve ligated rats to thermal nociception. The analgesic effect of morphine was more significant than that of pregabalin all over the experiments.<br />Conclusion: in contradiction to morphine, pregabalin was not effective for treatment of acute pain. Both pregabalin and morphine produced significant analgesic effect in neuropathic pain. The effect of morphine was more significant than that of pregabalin.https://zumj.journals.ekb.eg/article_4411_66ffb4331047be6e7233c7db16d0c8d7.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701THE PREDICTIVE VALUE OF ULTRASONOGRAPHIC ASSESSMENT OF LOWER SEGMENT SCAR INTEGRITY IN PATIENT WITH PREVIOUS CAESAREAN SECTION NEAR TERM18441210.21608/zumj.2014.4412ENAhmedAzeemDiagnostic radiology Departments, Zagazig University.DoaaIbrahimDiagnostic radiology Departments, Zagazig University.SheenShazelyobstetrics & gynecology Departments, Zagazig University.Journal Article20171205Purpose: to determine the predictive value of trans-abdominal (TA) US in assessing thickness of lower uterine segment by measuring lower uterine segment (LUS) scar thickness at term in patient with previous CS. Patient and methods: This study was carried out as tool- assessment cross-sectional case study on pregnant females, who had previous cesarean section at 36-40W of gestation and planning for elective CS. LUS thickness measured by TAUS and measured by the surgeon after labour using a sterile vernier caliper. The sensitivity, specificity, positive and negative predicted values of the TAUS measurement was determined. Results: eighty nine women were studied at a mean gestational age of 38.5±0.59weeks. With cut-off value equal to or less than 2.4 mm , the sensitivity, specificity, positive and negative predicted values were 90%, 100%, 100%, and 98.7%, respectively. Conclusion: LUS measurement is a useful clinical tool in the prediction of scar integrity. It should be performed routinely in women who had a previous cesarean before labour.https://zumj.journals.ekb.eg/article_4412_56661d46f74547fe5a1c1faf807a50ea.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701LAPAROSCOPIC ASSISTED ANORECTOPLASTY: A NEW DEFINITIVE REPAIR OF HIGH IMPERFORATE ANUS17441410.21608/zumj.2014.4414ENTarekGobranUnit of Pediatric Surgery, Zagazig UniversityAmeenSalehUnit of Pediatric Surgery, Zagazig UniversityOmarElEkiabiUnit of Pediatric Surgery, Zagazig UniversityJournal Article20171205Background/ Purpose : The classic treatment of the the high anorectal anomalies over the last 3 decade is the posterior sagittal anorectoplasty. . Laparoscopic assisted anorectoplasty is a minimally invasive technique that aims at preserving the sphincters, placing sensate skin within the control of the sphincters, and shortening recovery. The objective of this work is to evaluate the effectiveness of the laproscopic assisted anorectoplasty for the infants suffering from high imperforate anus.<br />Materials & Methods: Twenty eight patients with high anorectal anomalies were included in this study. All patients had laparoscopically assisted anorectal pull-through (LAARP) for high imperforate anus. Hospital charts and surgical notes were reviewed and clinical characteristics tabulated.<br />Results: Postoperative complications included rectal mucosal prolapsed (n=3), intestinal obstruction (n=1),anal stricture(n=1) ,and development of blind ended posterior urethral fistula(n=1 ). There were no complications related to the urinary system, also there was no wound infection, no hernia through<br />the port sites, or anal retraction. Six cases developed constipation. The overall clinical assessment for continence of the cases showed that 50% had good outcome, 36% had moderate, and 14% had poor functional outcome<br />Conclusion: LAARP for treatment of high anorectal anomalies is a feasible technique with encouraging functional results . Before recommendation of its use as a treatment of choice ,we recommend more studies for further evaluation of this technique, as the studies done for this subject are still few.https://zumj.journals.ekb.eg/article_4414_477ba95edbcaf925fbb7c77f4efd5586.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701MULTIDETECTOR COMPUTED TOMOGRAPHY OF RENAL VASCULATURE. ANATOMY AND NORMAL VARIANTS.113441510.21608/zumj.2014.4415ENAhmadHassanRadiology department. Associate Professor of Radiodiagnosis, Suez Canal University.TarekElKammashRadiology department. Associate Professor of Radiodiagnosis, Suez Canal University.Adel AlamAdel AlamDepartment of Urology, Farwania Hospital, Kuwait. Professor of Urology, Banha University.Journal Article20171205Multi Detector Computed Tomography Angiography (MDCTA) provides a fast, non-invasive modality for the evaluation of the renal vascular pedicle. CTA can reliably and accurately depict the renal arteries and veins and approaches conventional angiography in the assessment of most vascular abnormalities. Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm.<br />Objective: To illustrate the diagnostic accuracy of MDCT for evaluation of renal vasculature anatomy.<br />Design: An analytic, comparative study.<br />Subjects: fifty six patients including 43 living renal donors, 13 hypertension and abdominal pain (27 men and 29 women, mean age 39.5 years) were examined from January 2008 to September 2010 in Radiology department, Farwania hospital Kuwait. Gold standard was the operative data, conventional angiography or DSA.<br />Main outcome: The value of MDCT in assessment of renal vascular anomalies.<br />Results: Renal vascular anatomical variants included multiple arteries (21.4%), multiple veins (7.1%), early arterial bifurcation (8.9%), late venous confluence (7.1%), circum-aortic renal veins (7.1%) and retro-aortic vein (3.6%). The sensitivity and specificity of multiple arterial anomalies were 91.7% and 97.7%, respectively. The sensitivity and specificity of multiple venous anomalies were 85.7% and 97.6%, respectively.<br />Conclusion: MDCT is valuable for detection of renal vascular anomalies.https://zumj.journals.ekb.eg/article_4415_25e9d149000c5f2faf1a4423b6a5c411.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701DUCTUS VENOSUS FLOW, DIASTOLIC DYSFUNCTION AND MYOCARDIAL HYPERTROPHY IN FETUSES OF DIABETIC MOTHERS17441610.21608/zumj.2014.4416ENMohamedAbdel RahmanAssistant Lecturer of Obstetrics and Gynecology Faculty of medicine, Zagazig UniversityAbdel HamedHarounProfessor of Obstetrics and Gynecology Faculty of medicine, Zagazig UniversityRashaKamelProfessor of Obstetrics and Gynecology Faculty of medicine, Cairo UniversityJournal Article20171205Infants of diabetic mothers have an established risk of developing myocardial hypertrophy even with adequate maternal metabolic control. The pulsatility index of ductus venosus flow may be a useful parameter for assessing the role of myocardial hypertrophy due to maternal diabetes in fetal diastolic ventricular function.<br />Aim of the work: To test the hypothesis that the pulsatility index of ductus venosus (PIDV) is higher and the mitral & tricuspid early diastolic/atrial systole velocity ratios (E/A ratios) are lower in the fetuses of diabetic mothers (FDM) with myocardial hypertrophy (MH) than in the FDM with no MH and in the control fetuses of non-diabetic mothers (FNDM).<br />Subjects and methods: Cross-sectional study included fetuses with gestational ages ranging from 20 to 36 weeks, divided into the following 3 groups: 10 FDM with MH (group I), 20 FDM with no MH (group II), and 30 FNDM (group III, control). The Doppler echocardiogram assessed the PIDV through the ratio (systolic velocity – pre-systolic velocity)/mean velocity. The mitral and tricuspid E/A ratios were also assessed.<br />Results: The mean PIDV in groups I, II, and III were 1.28 ± 0.5, 0.73 ± 0.09, and 0.59±0.09, respectively. Using ANOVA test, the mean pulsatility index was significantly higher in group I than in group II and III (P 0.001). Comparing the pulsatility index of ductus venosus in group II with that in group III, a statistically significant difference (P=0.02) was observed. The mean mitral E/A ratios in groups I, II and III were 0.68 ± 0.04, 0.73 ± 0.06 and 0.68 ± 0.1, respectively. When applying the ANOVA, the mitral E/A ratios were non significant between the three groups (P = 0.17). The mean tricuspid E/A ratios in groups I, II and III were 0.69 ± 0.05, 0.71 ± 0.03 and 0.68 ± 0.07, respectively. When applying the ANOVA, the tricuspid E/A ratios were non significant between the three groups (P = 0.19).<br />Conclusion: DV PI is significantly greater in FDM with MH than in FDM with no MH and in FNDM. It is a useful parameter than E/A ratios of the mitral and the tricuspid valves for assessing fetal diastolic function.https://zumj.journals.ekb.eg/article_4416_8074a84bf1ec6f7eed2d3811116f0d16.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701NON INVASIVE PREDICTORS OF CORONARY SLOW FLOW111441710.21608/zumj.2014.4417ENRagabMahfouzCardiology Department, Faculty of Medicine, Zagazig University.MesbahHasaneinCardiology Department, Faculty of Medicine, Zagazig University.ElsayedFaragCardiology Department, Faculty of Medicine, Zagazig University.RadwaAbdullahCardiology Department, Faculty of Medicine, Zagazig University.Journal Article20171205Background:The coronary slow flow phenomenon (CSFP) is an angiographic clinical entity, characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. The pathogenic mechanisms are incompletely understood. It has direct clinical implications, being linked to clinical manifestations of myocardial ischemia, life-threatening arrhythmias, sudden cardiac death, and recurrent acute coronary syndrome.<br />Aim of the work: To evaluate the role of non-invasive measures in predicting Primary coronary slow flow patients.<br />Patients and methods: Our study was a case control study, taking patients referred for cardiac catheterization for suspected coronary artery disease. We took two groups 50 patients each.Group I: primary coronary slow flow phenomenon. Group II: normal coronary angiography. All patients were subjected to thorough clinical examination and full lab including lipid panel, hsCRP and Troponin, ECG where PWD and QTc dispersion were measured, TTE including coronary flow velocities (Diastolic and systolic) and DSPVR (Diastolic and systolic peak velocity ratio) as well as assessment of TIMI frame counts.<br />Results: The independent factors predicting PCSF among the examined groups, included diabetes, P wave dispersion ≥ 60 msec, QT dispersion ≥ 60 msec, HCT (hemataocrit) level ≥ 40 % and hs CRP ≥ 4 mg/L and DSPVR ≤ 1.6. A score was done for the independent variables using the prediction equation for multiple regression. Patients with scores > 12 are more likely to have PCSF (P=0.000).<br />Conclusion: PCSF is associated with diabetes, greater PWD and QTc dispersion, higher HCT and hsCRP levels.https://zumj.journals.ekb.eg/article_4417_d53f6c8a6d276ac428ded6fea9caaa00.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701COMPARATIVE STUDY BETWEEN SUPRAMEATAL APPROACH AND POSTERIOR TYMPANOTOMY APPROACH IN COCHLEAR IMPLANTATION110441810.21608/zumj.2014.4418ENAlaa El-DinEl-FekyOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityMohamedMubashirOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityBadr EldinMostafaOtorhinolaryngology Department, Faculty of Medicine, Ain-Shams UniversityYasserFouadOtorhinolaryngology Department, Faculty of Medicine, Zagazig UniversityJournal Article20171205Background: Cochlear implant is established as an effective and safe method of rehabilitation for profoundly deaf patients. There are two common surgical approaches for cochlear implantation. The first surgical approach, with mastoidectomy and posterior tympanotomy, is known as the classic approach or posterior tympanotomy approach. The second surgical approach, without mastoidectomy or posterior tympanotomy, is known as the suprameatal approach. Using the suprameatal approach, the active electrode is inserted and posterior tympanotomy. Aim of the work: To compare between suprameatal approach and posterior tympanotomy approach in cochlear implantation. Patients and methods: This study was conducted on 30 patients that underwent cochlear implantation surgery in Zagazig University Hospital, in the period from October 2010 to April 2014. The patients were 19 males and 11 females, their age ranged from 2 to 7 years. Patients were divided to 2 groups: one group was implanted by the supra meatal approach (6 patients) and the other one was implanted by posterior tympanotomy approach (24 patients). Results: There was a significant difference between the 2 groups as regard the total duration of surgery in favor of 1st group A (SMA). There was no significant difference between the 2 groups as regard the total number of major or minor complications. But there was one case of facial nerve paralysis in a child implanted by the classic approach. Conclusion: SMA may be clearly a good alternative to the classical surgery technique for CI in terms of reducing the duration of surgery and reducing the incidence of facial and chorda tympani nerve injury.https://zumj.journals.ekb.eg/article_4418_21817435e3454b68cd6da576c6e5607a.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701IMPACT OF CHRONIC KIDNEY DISEASE ON OUTCOME OF PERCUTANEOUS CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME113441910.21608/zumj.2014.4419ENHananRadwanLecturer of Cardiology, Faculty of Medicine, Zagazig University, Egypt. And Consultant of Cardiology, King Faisal Specialist Hospital, KSA.AbdelhakemSelemAssistant Professor of Cardiology, Faculty of Medicine, Zagazig University, Egypt. And Consultant of Cardiology, Ibn Sina National Medical College Hospital, KSA.YaserAmmarAssistant Professor of Internal Medicine, Medical Research Institute, Alexandria University, Egypt. And Consultant of nephrology, New Jeddah Clinic Hospital, KSA.NaserMahdiConsultant of Cardiology, Interventional Cardiology Department, King Faisal Specialist Hospital, KSA.Journal Article20171205OBJECTIVES: 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.https://zumj.journals.ekb.eg/article_4419_e669083bf4ccef8bf6f9feaecfc3305f.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143120420140701EOSINOPHILIC GASTROENTERITIS PRESENTING WITH ASCITES; CASE REPORT AND REVIEW OF LITERATURE15442010.21608/zumj.2014.4420ENHanyElsadekLecturer of internal medicine, gastroenterology unit, internal medicine department, faculty of medicine, Zagazig University, EgyptJournal Article20171205Eosinophilic gastroenteritis (EGE) is an uncommon disorder affecting both children and adults, that is characterized by eosinophilic infiltration of the stomach and intestine with or without peripheral blood eosinophilia, in the absence of other known causes of eosinophilia. Presentation may vary depending on the location as well as on the depth and extent of involvement and usually runs a chronic relapsing course. Eosinophilic ascites (EA) is probably the most unusual and rare presentation of EGE. Almost all reported cases of EA are idiopathic. One case of EGE presenting with EA, that was successfully diagnosed and treated, is reported here. The subsequent review describes the main features and management of EGE and EA.https://zumj.journals.ekb.eg/article_4420_597495b1ccf1d4144227179acada1829.pdf