STUDY OF THE IMPACT OF MICROALBUMINURIA ON THE MORBIDITY AND MORTALITY OF THE ACUTE CORONARY SYNDROME IN DIABETIC PATIENTS DURING ICU ADDMISSION
M.
Kamar
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
author
M.
Assy
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
author
Hatem
Salem
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
author
Mohamed S.S. Saad
Saad
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
author
Nermin
Raafat
Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2013
eng
Background: Microalbuminuria (MA) is a well- known risk factor for coronary artery disease (CAD) in diabetics and non diabetics. It is associated with higher cardiovascular mortality. However, the impact of MA on the morbidity and mortality of the acute coronary syndrome (ACS) in diabetic patients is not definitively known and the relationship between the degree of albuminuria and outcome of ACS is unclear. Aim of the Work: To Study the morbidity and mortality of diabetic patients presenting with acute coronary symptoms in relation to presence of MA during ICU admission. Patient and Methods: This study was planned to evaluate the impact of MA on outcome of ACS in diabetics patients admitted to ICU in internal medicine department Zagazig University. The study included 80 patients with acute coronary syndrome 60 diabetics and 20 non diabetics. Patients were classified into four groups: Group (A): 20 ACS non diabetic patients with no albuminuria. Group (B): 20 ACS type 2 diabetic patients without albuminuria. Group (C): 20 ACS type 2 diabetic patients with MA. Group (D): 20 ACS type 2 diabetic patients with macroalbuminuria. Urinary albumin excretion rate was performed to all patients with ACS. They were followed up during their staying in the ICU for the occurrence of heart failure, pulmonary embolism, shock, arrithymia or death. Serum lipid profile and HbA1c were performed also for all patients. Results: Complications occurred more significantly in albuminuric patients with MA (70%) and with macroalbuminuria (65%) than non albuminuric patients (20%);(P<0.001). Complications also occurred more significantly in patients with HbA1c>7%(69.7%) than those with HbA1c<7%(30.3%);(P<0.001). Also complications occurred more significantly in patients with serum triglyceride>150 mg/dl(78.4%) than those with serum triglyceride<150 mg/dl(14%);(P<0.001) and LDL>100mg/dl(82.4) than those with LDL<100mg/dl(15.3%);(P<0.001). Conclusions: There is a significant prevalence of albuminuria in diabetic patients in comparison with non diabetic patients. Complications including life threatening disorder as arrhythmia, heart failure, shock and cardiac arrest occurred more significantly in diabetic albuminuric patients with ACS during admission to ICU. Complications occurred more significantly in patients with abnormal lipid profile especially patients with hypertriglyceridemia or LDL > 100mg/dl
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
11
https://zumj.journals.ekb.eg/article_4273_fa4048dabd91bfa05ae4cdeb86370b4d.pdf
dx.doi.org/10.21608/zumj.2013.4273
STUDY OF SOME BIOMARKERS IN FRAIL ELDERLY
Abdallah
Abdel-Rahman
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Nabila
Hussein
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Hamed
Deraz
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Emam
Esmayel
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Waseem
Seleem
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Marawan
Atiyah
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Emad
Hamed
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Ayman
N.
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
Reda
Salem
Internal Medicine Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Frailty recognized as a common clinical syndrome associated wih a high rate of morbidity and mortality.Aim of the Study: This study aimed at assessing the value of determination of some biomarkers in identification and recruitment of frail elderly. The association between these biomarkers and stages of frailty were also assessedSubjects and Methods : A total number of 100 elderly subjects (above 65 years old) were included in the work divided into three groups : Group 1 (non-frail) included 34 subjects (19 males and 15 females), their ages ranged from 66.3 to 72.9 with mean 67.6 + 3.3 year; Group 2 (pre-frail) included 26 subjects (1 males and 15 females), their ages ranged from 65.5 to 73.1 with mean age of 69.3 + 3.8 year and Group 3 (frail) included 40 subjects (25 males and 15 females), their ages ranged from 67.9+ to 78.3 with mean age of 73.1+5.2 year.All subjects of this study were subjected to : thorough clinical examination, Anthropometric measures (including mid upper arm circumference, mid calf circumference, body mass index), Timed get-up-and-go test, hand grip strengh test and laboratory investigations (including complete blood picture, serum albumin, serum alanine transferase, INR. Prothrombin time and partial thromboplastin time, Cholesterol and C-reactive protein.Results: In our study; frailty recorded higher prevalence than most of epidemiological studies. Regarding CRP, there was significant increase in CRP level in frail group (27.4 + 8.1 mg/l) compared to both pre-frail (14.3 + 4.5 pg/ml) and non-frail groups (7.5 + 5.5 pg/ml). Regarding cholesterol, there was significant decrease in cholesterol level in frail group (125.7 + 54.9) compared to both pre-frail (168.1 + 17.2) and non-frail (165.3 + 29.7) groups. Regarding TGUGT, it was prolonged in frail group compared to both pre-frail and non-frail groups.Conclusions: There is high prevalence of frailty among studied elderly population, the causes of which need further studies to unravel. The changes in biomarkers noticed in our frail elderly may suggest its use in diagnosis and follow up of frailty, a suggestion that still in its infancy and needs further more studies to verify.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
11
https://zumj.journals.ekb.eg/article_4274_2b0c4d2329c8c923c734a50bf3986a1f.pdf
dx.doi.org/10.21608/zumj.2013.4274
EFFECT OF PREGNANCY ON THE LIPID PROFILE IN EGYPTIAN WOMEN
Ghada
Ibrahim
Cardiology Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background:Blood lipid concentration increase significantly during pregnancy. The increased progesterone in the 2nd half of pregnancy may act to reset the lipostat in the hypothalamus. There is conflicting evidence for an association between parity and the risk of cardiovascular disease in women. Previous studies have reported a decline in HDL cholesterol up to 10 years after the first pregnancy.Objective: To detect the effect of pregnancy on the lipid profile during normal pregnancy in the different trimesters.Patients andMethods: This study included 100 cases; 80 pregnant women and 20 healthy non-pregnant women matched for age as control. All patients subjected to: Compete history taking and clinical examination, twelve leads resting surface ECG, echocardiography and total Lipid Profile (at the middle of each trimester and 6-12 weeks post-partum) In general, the test performed following 12 hours overnight fast.Results:The total cholesterol and triglycerides were significantly increased from the 1stto the 2ndtrimester with further significant increase in the 3rdtrimesterand after delivery there were highly significant decrease in both. (TC changed from 196+18 mg/dl to 216 +19.3 mg /dl to 243+13.5 mg/dl with P<0.05 then to 187.1+19.3 mg/dl with P<0.001, respectively). The LDL cholesterol, HDL cholesterol and VLDL cholesterol were non-significantly changed from the 1sttrimester to the 2ndtrimester with significant increase in the 3rd trimester and after delivery it was highly significant decreased to the below or near the 1sttrimester level(LDLchanged from 119+ 9 mg/dl to 111.9+11.5 mg /dl to 123.5+11.9 mg/dl with P>0.05 then to 112.6+13.8 mg/dl with P<0.001, respectively) (HDL changed from 41.9+ 14 mg/dl to 42.8+15.4 mg /dl, with P<0.05 then to 57.9+23.1 mg/dl to 48.6+25 mg/dl with P<0.001, respectively) Conclusions:We have demonstrated that normal pregnancy is associated with raised triglycerides and cholesterol. By the third trimester most women have a lipid profile which would be considered highly atherogenic in the non-pregnant state. However this represents a transient disturbance which reverts to normal after delivery. Further studies are needed to determine the risk and cardiovascular effects of disturbed lipid profile during pregnancy especially in multipara women with repeated pregnancy.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
6
https://zumj.journals.ekb.eg/article_4275_08e2ce360d8020d61e6d9ece872ac754.pdf
dx.doi.org/10.21608/zumj.2013.4275
THYROTOXIC PERIODIC PARALYSIS: DIAGNOSIS, MANAGEMENT AND ROLE OF PROPRANOLOL IN TREATMENT
Jehan
Saeed
Department of Internal Medicine, Zagazig University
author
Ayman
Fathy
Department of Internal Medicine, Zagazig University
author
Ayman
N.
Department of Internal Medicine, Zagazig University
author
Osama
Al Azoni
Department of Department of Neurology, Zagazig University
author
text
article
2013
eng
Background: Hypokalemia is commonly encountered during paralysis in patients with thyrotoxic periodic paralysis (TPP) and may contribute to neuromuscular manifestations. This condition mainly affects male patients of Asian descent. With increasing population mobility and admixture, TPP as the presenting feature of hyperthyroidism is more common in Western countries and Gulf area. TPP is an alarming and potentially lethal complication of hyperthyroidism characterized by muscle paralysis and hypokalemia due to a massive intracellular shift of potassium. A potassium supplement has been recommended to hasten recovery and prevent cardiopulmonary complications. However, this recommendation has not yet proven efficacious. Hyperadrenergic activity has been implicated in the pathogenesis of TPP. We tested whether nonselective β-blockers could terminate neuromuscular symptoms rapidly while reducing an intracellular shift of potassium. Methods: We describe 7 patients who had an acute attack of TPP with characteristic hypokalemia. Results: After oral propranolol, 3 mg/kg, serum potassium concentrations increased promptly in all patients, and there was complete amelioration of paralysis. Only 3 patient needed short term K supplement for their sever hypokalemia and sever symptoms. No rebound hyperkalemia was detected. Conclusion: Given propranolol efficacy in this study, propranolol should be considered as a first-line therapy for TPP.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
6
https://zumj.journals.ekb.eg/article_4276_f76b95dec215d6df0d42a69f97244105.pdf
dx.doi.org/10.21608/zumj.2013.4276
AN INTERVENTIONAL STUDY TO DECREASE CENTRAL VENOUS CATHETER RELATED BLOOD STREAM INFECTION IN INTENSIVE CARE UNITS AT ZAGAZIG UNIVERSITY HOSPITAL
Wafaa
El Nemr
Departments of Public Health and Ansethiology,Faculty of Medicine, Zagazig
University
author
Hoida
Fahmy
Departments of Public Health and Ansethiology , Faculty of Medicine, Zagazig
University
author
Ghada
Abed El Razek
Departments of Intensive Care , Faculty of Medicine, Zagazig University
author
Noha
Abed El Salam
Departments of Public Health and Ansethiology, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Catheter related blood stream infection (CRBSI) is a complication of central venous catheter (CVC) use. This Infection particularly in the ICU population results in higher levels of morbidity and mortality coupled with greater costs in terms of care and increased duration of hospital stay. Aim & Objectives: The aim of this study is to improve the safety of patients with CVC via decreasing the incidence of CRBSI in ICUs patients at Zagazig University Hospital through the following objectives: 1- Calculation the incidences of CRBSI in ICUs patients over six months before and after intervention through active surveillance. 2- Assessment the level of the knowledge and adherence of health care providers in ICUs to evidence based guidelines recommended by CDC to decrease the incidences of CRBSI in ICUs patients before and after intervention. 3- Implementation of health education program on ICUs health care providers i.e. providing them by information about evidence based guidelines recommended by CDC to decrease the incidence of CRBSI in ICUs patients.Subjects & Methods: An interventional study was conducted in surgical and emergency ICUs at Zagazig University Hospital during the academic year between 2011 and 2012. All patients with CVC in the studied ICUs were consecutively enrolled in the study and all health care providers working in the studied units and involved in insertion, maintenance and care of CVC during the period of study were included in the study. The study was carried out through 3 phases. Results: Statistically, there is a significant improvement in physician practice in both ICUs after intervention. The incidence of CRBSI decreased after intervention in surgical ICU but in comparison with that before intervention it was found no significant difference. In emergency ICU, the incidence of CRBSI after intervention is 0% and in comparison with that before intervention it was found a significant difference. Incidence of CRBSI decreased from 6.01/1000 catheter-days to 3.9/1000 catheter-days after intervention in surgical ICU. In emergency ICU, the incidence of CRBSI was 0% after intervention. Conclusion: This study revealed that, implementation of simple education program increased adequacy of knowledge, improved the practice of healthcare providers and reduced CVC blood stream infection rates in ICUs by almost 50%, during the intervention period.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
16
https://zumj.journals.ekb.eg/article_4277_8afd75fca763bce36789215e22c46ed3.pdf
dx.doi.org/10.21608/zumj.2013.4277
ANTIBIOTIC RESISTANCE PATTERNS OF MULTIDRUG RESISTANT AND EXTENDED-SPECTRUM Β-LACTAMASE PRODUCING ESHCHERICHIA COLI URINARY ISOLATES AT QUEEN RANIA AL-ABDULLAH HOSPITALFOR CHILDREN, JORDAN
Adel
Batarseh
Department of Pediatric Nephrology, Queen Rania Al-Abdullah Hospital for children, Amman, Jordan
author
Suhaa
Soneah
Department of Microbiology of Princess Iman Center for Research and Laboratory Sciences, King Hussein Medical Center, Amman, Jordan
author
Reham
Mardeni
Department of Pediatric Nephrology, Queen Rania Al-Abdullah Hospital for children, Amman, Jordan
author
Khaled
Elmadni
clinical pharmacy department , King Hussein Medical Center, Amman, Jordan
author
Mohammad
noor
Department of Pediatric Nephrology, Queen Rania Al-Abdullah Hospital for children, Amman, Jordan
author
Nibal
Abu Ashour
clinical pharmacy department , King Hussein Medical Center, Amman, Jordan
author
text
article
2013
eng
To determine the prevalence and the antibiotic resistant patterns of the multi-drug resistant Extended-Spectrum Β-Lactamase(ESBL) producing E. coli isolates from children urine samples, in Queen Rania Al-Abdullah Hospital for children.A total of 61 non-repetitive urine samples from various outpatient clinics and inpatient wards were collected retrospectively over a period of 5 months (May 2012 to September 2012). The resistant patterns, screening and confirmatory tests for phenotypic detection of ESBL-producers were studied using the VITEK 2 system against a set of antibiotics found on the antimicrobial susceptibility extend card AST-EXN8.Children were nearly equally infected by both types of E. coli isolates, ESBL-producers 31 (50.8%) and non ESBL-producers 30 (49.2%). ESBL-producing E. coli showed maximum rate resistance to Cefuroxime and Piperacillin (100%), Aztreonam, Cefixime, Ceftriaxone plus Levofloxacin (96.8%), Ampicillin/Sulbactam and Cefepime (93.5%), and Moxifloxacin (90.3%), while minimum resistance rate was seen with Tigecycline (12.9%), Colistin (3.2%) and meropenem (0%). ESBL-producing isolates were significantly more resistant than Non-ESBL-producers (p < 0.05) to the following antimicrobials (Ampicillin/Sulbactam, Aztreonam, Cefepime, Cefixime, Ceftriaxone, Levofloxacin, Moxifloxacin, Piperacillin and Tetracycline). Multi-drug resistance was found to be higher in ESBL-producing isolates, which were resistant to at least 9 antibiotics. To limit the spread of the multi-drug resistant ESBL-producers E. coli isolates, we should perform screening test for these isolates on daily basis, isolate the infected patients and choose the best therapeutic option.According to the resistant pattern and safety issue, Morepenem can be considered as first line treatment and colistin as last resort therapy
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4278_a7e47b054f53b7f105878bbdefe944e2.pdf
dx.doi.org/10.21608/zumj.2013.4278
SUSCEPTIBILITY OF CANDIDA ALBICANS CLINICAL ISOLATES TO SOME PLANT EXTRACTS IN SAUDI ARABIA
Khalil
Abdullah
Department of Medical Lab Science, Faculty of Applied Medical Science King Khalid University, Saudi Arabia
author
Mohamed
Soliman
Department of Medical Lab Science, Faculty of Applied Medical Science King Khalid University, Saudi Arabia
author
Mohamed
Mohamed
Department of Medical Lab Science, Faculty of Applied Medical Science King Khalid University, Saudi Arabia
author
text
article
2013
eng
The aim of this study is to determine the occurrence of Candida albicans in clinical specimens and studying its susceptibility to some plant extracts in Saudi Arabia.One hundred twenty eight human clinical specimens from 98 cases suffering from oral thrush and 30 cases suffering from vulvovaginitis were examined by mycological examination. C. albicans was identified by standard methods. The susceptibility of C. albicans to nine medicinal plants extract (alcoholic) marketed in Saudi Arabia was examined.The frequency of C. albicans in the examined urine samples and oral swabs was 82.65 and 86.7%, respectively. Zone of inhibition (mm) of C. albicans against different plant extracts in different concentrations (500-32000 μg/ml) ranged from zero to 10±0.1. The minimum inhibitory concentration ranged from 4000 to 32000 μg/ml.C. albicans is common in ICU cases either those with indwelling urinary catheter or those with oral thrush. The anti-candidal activity of the examined plants extracts (alcoholic) may help in treatment and prevention of candidiasis
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
6
https://zumj.journals.ekb.eg/article_4279_b22bc60d4995b94d2013214cd624d647.pdf
dx.doi.org/10.21608/zumj.2013.4279
COMPARISON OF THE EFFICACY AND SAFETY OF EACH OF LEVITAN AND SHIKANI OPTICAL STYLETS EITHER USED ALONE OR WITH DIRECT LARYNGOSCOPY FOR TRACHEAL INTUBATION
Islam
Eliwa
Department of Anesthesiology
Faculty of Medicine, Zagazig university
author
Akmal
Abd Elsamad
Department of Anesthesiology
Faculty of Medicine, Zagazig university
author
Khalid
Mustafa
Faculty of Medicine, Zagazig university
author
text
article
2013
eng
Background: New intubating optical stylets that facilitate visualization have been developed to overcome obstacles faced with management of the difficult airway. Objective: The aim of the study was a comparison of the efficacy and safety of each of Levitan and Shikani optical stylets either used alone or with direct laryngoscopy for tracheal intubation.Methods: This study was carried out on two hundred ASA physical status I & II of both sex adult patients who were scheduled for elective surgery under general anesthesia with tracheal intubation. Patients were randomly classified according the used aid for endotracheal intubation into four equal groups (each one consisted of fifty patients). In group I (L/A), Levitan optical stylet was used alone for tracheal intubation with manual chin lift and in group II (L/L), Levitan optical stylet was used with a Macintosh laryngoscope aid to retract the base of the tongue. In group III (S/A), Shikani optical stylet was used alone and in group IV (S/L), Shikani optical stylet was used with the aid of Macintosh laryngoscope. Intubation success rate, intubation time and intubation related complications were recorded in each group.Results: Statistically, the patients of the four groups were similar in demographic data (age, sex, weight, height, mallampati grade, thyromental distance and interincisor gap). The overall intubation success rates of the four groups were statistically similar. The intubation time and the degree of difficulty in group I (L/A) were significantly lesser than in group III (S/A) and in group II (L/L) were significantly lesser than in group IV (S/L). Also the intubation time and the degree of difficulty in group II (L/L) were significantly lesser than in group I (L/A) and in group IV (S/L) were significantly lesser than in group III (S/A) (Table – 2).The incidence of the various intubation related complications are statistically similar in the four groups. In conclusion: Levitan optical stylet with or without the aid of direct laryngoscopy is more effective than Shikani optical stylet with or without the aid of direct laryngoscopy for tracheal intubation with similar incidence of intubation related complications
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
6
https://zumj.journals.ekb.eg/article_4280_ccbbb6285afb0ba9769aa6ed64b053fa.pdf
dx.doi.org/10.21608/zumj.2013.4280
CONCEPTS AND TECHNIQUES OF NASAL TIP SURGERY
John
Hodges
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
Abd El-Zaher
Tantawy
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
Tarek
Omran
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
Atef
El-Bahrawy
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
Ahmed
Anany
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt.
author
Said
Abd El Moneem
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
Ahmed
Ali
Otolaryngology Department, Medical School, Tennessee University, USA - Otolaryngology Department, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2013
eng
Background: Rhinoplasty is one of the most challenging procedures in plastic surgery. It is technically demanding, and tip surgery is an art form. It requires an in-depth knowledge of the complex three-dimensional anatomy of the nose, a complete understanding of its physiology, familiarity with the described techniques of nasal tip surgery, and a well-developed sense of aesthetics.Aim of the work: This article will describe different techniques used to create a refined, aesthetically pleasing nasal tip.Patients and methods: The patients in this study were selected from of Dr John Hodges, M.D’ Office, Veterans Hospital, and Methodist hospital, USA, and Zagazig University hospital, Egypt. The study was carried out on 50 patients with different nasal tip deformities, who underwent rhinoplasty, they were 15 males and 35 females, their age ranging from 20 to 60 years old. Two approaches had been selected; an open approach had been done for 30% of our patients, and a closed approach had been done for 70% of our patients with different nasal tip techniques.Results: The results of this study for nasal tip refinement techniques demonstrated a decrease in reductive and irreversible techniques as cartilage transection, domal truncation , morselization, and scoring that had been done in 8% of our patients for each, with a concurrent increase in stabilizing, strengthening, and reorientation techniques as sutures and grafts techniques that had been done in 60% of our patients for each; so cartilage-dividing techniques and the vertical dome division are rarely necessary to reduce projection, broadness, and/or rotation of nasal tips, they have been used if suture and graft techniques do not achieve the adequate nasal tip definition.Conclusion: The simplest approach for refinement of nasal tip deformity that allows the planned surgical techniques to be performed without difficulty and cause the least disturbance to the tip’s support, should be selected. Thus, we recommend the reversible, non destructive techniques as sutures and tip grafts for remodeling the tip deformities, with closed approach once indicated
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
10
https://zumj.journals.ekb.eg/article_4281_83df5a8374b22b1b437b6c0da0bfcf67.pdf
dx.doi.org/10.21608/zumj.2013.4281
THE ROLE OF RELAXIN HORMONE IN INTERNAL DERANGEMENT OF TEMPROMANDIBULAR JOINT
Ahmed
Shahin
Professor of general anasethesiology Faculty of Dentistry Suez Canal University
author
Eman
EL Sharrawy
Professor of general anasethesiology Faculty of Dentistry Suez Canal University
author
Alaa El-Din
Abd El Hamid
Professor of Clinical Pathology Faculty of Medicine Suez Canal University
author
Tamer
Hamed
Assistant Professor of Oral and Maxillofacial Surgery Faculty of Dentistry Suez Canal University
author
text
article
2013
eng
To assess the level of relaxin -2 hormone in the serum and synovial fluid in female patient who have anterior disc displacement and detect the effect the wash and lavage on it’s level .Forty patients were included with age ranged between 20-40 age, old selected from outpatient clinic of oral and maxillofacial department faculty of dentistry, suez canal university. Patients were devided into two groups : group I(control group included 20 patients with normal tmj and group II included 20 patients with tmj internal derangement for patients preoperative assessment was done including standard pain scoring , maximal mouth opening and radiological examination also arthrocentesis with collecting of synovial fluid was performed .serum relaxin -2 hormone & synovial fluid relaxin -2 hormone were estimated using Elisa. results showed a significant increase in serum relaxin -2 hormone level in group II compared to control .this level was significantly decrease after 1 week after arthrocentesis. As regard to synovial fluid relaxin -2 hormone level,there was insignificant decrement in the hormone level after arthrocentesis . Clinical evaluation for the studied patients showed a high significant decreased in pain score after one week ,one month and at six months post-operative while, there was a high significant increased interincisal distance during follw up.we concluded that serum relaxin-2 hormone was elevated significantly in patients with TMJ internal deranegement. Also this hormone is detected locally in TMJ joint this may explain its role in the pathogenesis of TMJ internal deranegement.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
6
https://zumj.journals.ekb.eg/article_4282_b98787f058503be97dce2c0a97cd8dc1.pdf
dx.doi.org/10.21608/zumj.2013.4282
MANAGEMENT OPTIONS FOR CEREBRAL GLIOMAS
Wael
El-Mesallamy
Neurosurgery Department, Faculty of Medicine, Zagazig University
author
Hamdy M. Farahat
Farahat
Neurosurgery Department, Faculty of Medicine, Zagazig University
author
Tarek
Abdel Bary
Neurosurgery Department, Faculty of Medicine, Zagazig University
author
Magdy
Rashed
Neurosurgery Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Cerebral gliomas are the most prevalent primary brain tumors in adult patients. Objectives: The purpose of this prospective study was evaluation of various management strategies including surgery facilitated by intraoperative ultrasonography, radiotherapy and chemotherapy with addressing impact of various factors on the outcome. Patients and methods: In a prospective evaluation, we studied 55 adult patients with primary cerebral gliomas who were operated upon at our department between January 2009 and January 2011 with follow up at least one year for survived patients. Radiotherapy was received postoperatively by 48 patients of whom 34 patients received chemotherapies. All clinical, radiological, imaging, pathological and management modality records were evaluated as prognostic factors. Results: The mean survival time was 13.7 months. We confirmed that the patient age, preoperative functional status (by Karnofesky scale), location of cerebral gliomas, size of gliomas, extent of resection, intraoperative ultrasonography use, grades of glioma and postoperative functional status as decisive prognostic factors and had an impact on outcome. Conclusion: We could show that young ages (≥ 16-40 years), high preoperative Karnofesky scores (≥ 80%), single-lobe involvement by glioma, small tumor size (≤ 5 cm), gross total resection, intraoperative ultrasonography use, low-grade gliomas and high postoperative Karnofesky scores (≥ 80%) were predictors for better outcome
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
11
https://zumj.journals.ekb.eg/article_4283_8f0233d4515a57985de3675b7b3ab84d.pdf
dx.doi.org/10.21608/zumj.2013.4283
ROLE OF DIFFUSION – WEIGHTED MAGNETIC RESONANCE IMAGING IN CHARACTERIZATION OF VERTEBRAL BONE MARROW PATHOLOGICAL LESIONS
Khaled
Lakouz
Radiodiagnosis departments, Faculty of Medicine, ZagazigUniversity
author
Hesham
Radwan
Radiodiagnosis departments, Faculty of Medicine, ZagazigUniversity
author
A.AllahAlmaamoon
Sarhan
Neurology departments, Faculty of Medicine, ZagazigUniversity
author
Rania
Elmolla
(Radiodiagnosis departments, Faculty of Medicine, ZagazigUniversity
author
text
article
2013
eng
AIM: To evaluate the role of diffusion weighted magnetic resonance imaging in characterization of vertebral bone marrow pathological lesions.MATERIALS AND METHODS: Forty patients with bone marrow abnormal MRI signal intensity were enrolled in the study and upon MRI finding they wear grouped into four groups. DWI was performed with b values of 0and 500 s/ mm2. Results of the histo-pathological evaluation or MRI follow up or isotope were compared with the DWI results. Apparent diffusion coefficient (ADC) values were calculated.RESULTS: All cases of malignant collapse (4 cases 10%) were hyper intense on DWIs and hypo intense on ADC map with mean ADC (0.8 ± 0.33 x 10−3 mm2/s). All benign osteoporotic collapse cases (7 cases 17.5%) were hypo intense (3 cases) or iso to hypo intense (4 cases) on DWIs and all wear hyper intense on ADC with mean ADC (1.64 ± 0.33 x 10−3 mm2/s). Twelve cases with endplate changes, the eight infectious spondylitis recorded mean ADC value (1.03 ±0.33× 10−3mm2/s). The remaining, 4 cases (10 %) with degenerative Modic I end plate changes recorded ADC value (1.76 ±0.33× 10−3mm2/s). Also (3 cases) malignant bone marrow infiltration without collapse were hyperintense on DWIs and hypointense on ADC map with mean ADC (0.8 ± 0.33 x 10−3 mm2/s). The mean ADC in hemangioma was (1.9 ± 0.33 x 10−3 mm2/s) and in ABC (1.93 ± 0.33 x 10−3 mm2/s). DW study of 4 cases respond to therapy recorded mean ADC value (1.64 ±0.33× 10−3mm2/s), however, the 2 cases with residual viable tumor tissue record (0.79 ±0.33× 10−3mm2/s). DWI and ADC values have high sensitivity and specificity in differentiating benign from malignant lesions and in post therapy follow up.CONCLUSIONS: DWI with quantitative ADC measurements Using b value (b=500 s / mm2) can be useful in differentiating benign from malignant bone marrow lesions, differentiated between causes of end plate changes and be used in post therapy follow up.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
12
https://zumj.journals.ekb.eg/article_4284_03cb603dddc5c2f7e4e11f2514040d16.pdf
dx.doi.org/10.21608/zumj.2013.4284
MANAGEMENT AND REHABILITATION OF TRAUMATIC BRAIN INJURY IN CHILDREN
Khaled
Abd El-Twab
Professor of Pediatrics, Faculty of Medicine Cairo University
author
Hala
Foaud
Professor of Pediatrics, Faculty of Medicine Cairo University
author
John
youssef
Lecturer of Pediatrics, Faculty of Medicine Cairo University
author
Hala
Metwally
Professor of Clinical Pathology, Faculty of Medicine Cairo University.
author
text
article
2013
eng
Traumatic brain injury is described as a blow to the head or a penetrating head damage which disturb the normal function of the brain. Traumatic brain injuries, in children are common and sometimes are powerful in threatening the life and are leading causes of acquired disability and death. Traumatic brain injury is responsible for nearly 1.4 million injuries and 52 000 deaths annually in the United States. Therefore, in this paper we reviewed the new and recent advances about the management and neuromonitoring in pediatric traumatic brain injury. And to provide a summary of the empirical research on management and rehabilitation in pediatric traumatic brain injury (TBI). Studies of the effectiveness of interventions with children with TBI are hampered by difficulty with combining subjects with various levels of TBI, problems with random assignment to treatment groups, and varying age levels at injury. While these are areas of concern, there are emerging studies that indicate both applied behavioral analysis (ABA) and positive behavioral interventions are helpful to many children. For some children, ABA is not successful, and a shift to positive behavioral interventions has been found to be helpful. Transitions to home and school can be difficult particularly if there are family issues that predated the injury. This review provides additional information for the pediatric neuropsychologist to assist with transition to school and home. Studies utilizing the Internet for family interventions have revealed promising results.Conclusion: Neuromonitoring technology is still at an early stage in pediatric TBI. These improvements have provided the possibility of true multimodal monitoring for useful treatments. But, using clinical functional neuromonitoring would help clinicians to evaluate the managements in hospitals. Studies have indicated that children with severe TBI show significant difficulties with emotional and behavioral adjustment that pose more challenges for intervention and reentry to home and school compared with cognitive and physical issues.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
13
https://zumj.journals.ekb.eg/article_4285_6db36ed29132d5d146d207095c7c0d6b.pdf
dx.doi.org/10.21608/zumj.2013.4285
THE ROLE OF PLASMA D – DIMER AS PROGNOSTIC MARKER IN CHILDREN WITH TRAUMATIC BRAIN INJURY
Khaled
Abd El-Twab
Professor of Pediatrics, Faculty of Medicine Cairo University
author
Hala
Foaud
Professor of Pediatrics, Faculty of Medicine Cairo University
author
John
youssef
Lecturer of Pediatrics, Faculty of Medicine Cairo University
author
Hala
Metwally
Professor of Clinical Pathology, Faculty of Medicine Cairo Univer.
author
text
article
2013
eng
Objectives: To investigate the value of plasma D-dimer as a prognostic marker in severe traumatic brain injury in children and to compare the results of plasma D- dimer level in plasma and the clinical condition of the case and the results of its routine laboratory investigations.Methods: The study was carried out on 64 head trauma children 46 cases and 20 controls of both sexes, who admitted to pediatric intensive care unit in Alharam hospital in Giza.All children patients had full history, vital sign, general examination, complete neurological examination, GCS or PGCS, cranial CT scan, abdominal ultrasonography, full radiological studies, plasma D-dimer on admission, the 3rd day and at 14th day, INR, PT, APTT. on admission, the 3rd day and at 14th day, routine laboratory investigations on admission as CBC, CRP, Liver function test, Urea, Creatinine, Blood glucose, Na, K and Arterial blood gas analysis.Results: GCS improved significantly in the favorable group but not in the unfavorable group. D-dimer mean values were significantly higher in the unfavorable group more than the favorable group. D-dimer is correlated with mortality and can predict poor patient outcome. D-dimer have inverse relation with GCS and. PT, aPTT, INR, and Concentration mean values were significantly higher in the unfavorable group than in the favorable group.Conclusion: GCS or PGCS has evident role in evaluation and assessment of TBI especially in acute stage and gives excellent idea about the prognoses of TBI. D-dimer is a good marker to predict outcome in TBI & it has an inverse correlation with GCS or PGCS. PT, aPTT, INR and Concentration have some role in TBI and their values increase in the acute stage of TBI.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
12
https://zumj.journals.ekb.eg/article_4286_f3a3d72e35805bd301d89aa43b2ddcc6.pdf
dx.doi.org/10.21608/zumj.2013.4286
DETECTION OF HUMAN INTESTINAL PROTOZOA BY USING MULTIPLEX ALLELE SPECIFIC POLYMERASE CHAIN REACTION (MAS-PCR) In New Damietta City
Khaled
Mohammad
Department of Parasitology, Faculty of medicine (Damietta), Al-Azhar University, New Damietta City, Egypt.
author
text
article
2013
eng
Enteric protozoa continue to be the most commonly encountered parasitic diseases causing significant morbidity and mortality in developing regions of the world affecting millions of people. This study assessed the use of Multiplex Allele Specific Polymerase Chain Reaction (MAS-PCR) assay and microscopy for detection and identification of common pathogenic protozoan parasites in New Damietta city of North Delta region, Egypt. During Jun 2013 until Sept 2013, fresh stool samples were obtained from 249 patients up to 65 years of age attending the internal clinic of the Damietta University Hospital and those visiting their general practitioner (GP) of outpatient clinics because of gastrointestinal symptoms. Stool samples collected was preserved at -200C for DNA extraction whilst the remaining was preserved in sodium acetate-acetic acid formalin and concentrated using the formol-ether technique for microscopic examination. DNA extracts were analyzed with the multiplex allele specific Polymerase Chain Reaction (MAS-PCR) for pathogenic protozoan parasites. The diagnostic results obtained using a multiplex allele specific PCR for the detection of E. histolytica/dispar, G. lamblia and C. parvum/C. hominis were compared with these obtained by routine microscopy of faecal samples from patients. 69 samples were positive by MAS-PCR assays, 9 cases of G. intestinalis infection, 34 cases of D. fragilis infection, 3 cases of E. histolytica infection, 17 cases E.dispar and 6 cases of Cryptosporidium infection in the clinical samples. By microscopy, only 32 samples were positive for one or more of the enteric protozoa, 5cases of G. intestinalis infection, 9cases of D. fragilis infection, 13 cases of E. histolytica infection, and 1 cases of Cryptosporidium infection in the clinical samples. However, there are no cases of E.dispar observed. Mixed infections were detected in 4 samples. The sensitivities varied from 58% for D. fragilis to 47% for E. histolytica, 35% for Giardia, and 30% for Cryptosporidium, while the specificities also varied from 97% for E. histolytica to 99% for D. fragilis and 100% for E.dispar . No cross-reactivity was detected in stools samples containing various bacterial, viral, and other protozoan species. This present study showed relatively high rates of protozoa infections in the study patients. The study has also demonstrated that the multiplex real time PCR assay was more sensitive compared to microscopy in the diagnosis of the intestinal protozoa parasites and thus, molecular methods must be considered the diagnostic methods of choice for enteric protozoan parasites.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
13
https://zumj.journals.ekb.eg/article_4287_5cb05968c9b6ced562b06021983ccd4f.pdf
dx.doi.org/10.21608/zumj.2013.4287
CHARACTERIZATION OF A RAT MODEL OF INSULIN DEFICIENCY INDUCED VASCULAR COMPLICATION
Nora
Desoky
Department of Pharmacology, Faculty of Pharmacy, King Abdulaziz University, Kingdom of Saudi Arabia
author
Hany
El-Bassossy
Department of Pharmacology, Faculty of Pharmacy, King Abdulaziz University, Kingdom of Saudi Arabia
author
Ahmed
Fahmy
Department of Pharmacology, Faculty of Pharmacy, Zagazig University, Egypt
author
text
article
2013
eng
Vascular dysfunction is one of the important diabetic complications. Here we fully characterized a rat model of streptozotocin (STZ) induced vascular complication.Diabetes was induced by single intraperitoneally injection of STZ (50 mg.kg-1, ip).Blood pressure (BP) and isolated aorta responses phenylephrine (PE), KCl, acetylcholine (ACh), sodium nitroprusside (SNP) were recorded after 6, 8 and 10 weeks of STZ injection.In addition, serum levels of glucose, tumor necrosis factor α (TNFα), lipids, advancedglycation end products (AGEs), and arginase activity were determined. Furthermore, aortic reactive oxygen species(ROS) generation, hemeoxygenase-1 expression and collagen deposition were examined.Streptozotocin injection resulted in a significant hyperglycemia after 3 days of injection which was stable for 10 weeks. Diabetes was associated with a significant increasein BP after 6 weeks which was stable at 8 weeks. Aorta isolated from diabetic animals showed exaggerated contractility to PE and KCland impaired relaxation to ACh compared to control after 6 weeks which were clearer at 8 weeks of STZ injection. In addition, diabetic animals showed significant increases in serum levels of lipids, AGEs, TNFα and arginase enzyme activity after 8 weeks of STZ compared to control. Furthermore, aortae isolated from diabetic animals were characterized by increased ROS generation and collagen deposition.In conclusion, injecting rats with STZ at dose 50 mg.kg-1 produces a model of diabetic vascular complication after 8 weeks that are characterized by hypertension, disturbed vascular reactivity, elevated serum lipids, inflammatory cytokines and enzymes and enhanced aortic ROS generation and collagen deposition.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
7
https://zumj.journals.ekb.eg/article_4288_f46d4ab17657da89bc9148faf4fc9e69.pdf
dx.doi.org/10.21608/zumj.2013.4288
DETECTION AND DIFFERENTIATION OF HUMAN PROTOZOAN PARASITES IN STOOL SPECIMENS BY USING MULTIPLEX ALLELE SPECIFIC POLYMERASE CHAIN REACTION (MAS-PCR) In New Damietta City, Egypt
Khaled
Mohammad
Department of Parasitology, Faculty of medicine (Damietta), Al-Azhar University, New Damietta City, Egypt
author
text
article
2013
eng
Enteric protozoa continue to be the most commonly encountered parasitic diseases causing significant morbidity and mortality in developing regions of the world affecting millions of people. This study assessed the use of Multiplex Allele Specific Polymerase Chain Reaction (MAS-PCR) assay and microscopy for detection and identification of common pathogenic protozoan parasites in New Damietta city of North Delta region, Egypt. Between Jun 2013 until Sept 2013, fresh stool samples were obtained from 249 patients up to 65 years of age attending the internal clinic of the Damietta University Hospital and those visiting their general practitioner (GP) of outpatient clinics because of gastrointestinal symptoms. Stool samples collected was preserved at -200C for DNA extraction whilst the remaining was preserved in sodium acetate-acetic acid formalin and concentrated using the formol-ether technique for microscopic examination. DNA extracts were analyzed with the multiplex allele specific Polymerase Chain Reaction (MAS-PCR) for pathogenic protozoan parasites. The diagnostic results obtained using a multiplex allele specific PCR for the detection of E. histolytica/dispar, G. lamblia and C. parvum/C. hominis were compared with these obtained by routine microscopy of faecal samples from patients. 69 samples were positive by MAS-PCR assays , 9 cases of G. intestinalis infection, 34 cases of D. fragilis infection, 3 cases of E. histolytica infection, 17 cases E.dispar and 6 cases of Cryptosporidium infection in the clinical samples. By microscopy, only 32 samples were positive for one or more of the enteric protozoa, 5cases of G. intestinalis infection, 9cases of D. fragilis infection, 13 cases of E. histolytica infection, and 1 cases of Cryptosporidium infection in the clinical samples. However, there are no cases of E.dispar observed. Mixed infections were detected in 4 samples. The sensitivities varied from 58% for D. fragilis to 47% for E. histolytica, 35% for Giardia, and 30% for Cryptosporidium, while the specificities also varied from 97% for E. histolytica to 99% for D. fragilis and 100% for E.dispar . No cross-reactivity was detected in stool samples containing various other bacterial, viral, and protozoan species. This present study showed relatively high rates of protozoa infections in the study patients. The study has also demonstrated that the multiplex real time PCR assay was more sensitive compared to microscopy in the diagnosis of the intestinal protozoa parasites and thus, molecular methods must be considered the diagnostic methods of choice for enteric protozoan parasites.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
14
https://zumj.journals.ekb.eg/article_4289_3896ae2812ab744b05e59af77394d14a.pdf
dx.doi.org/10.21608/zumj.2013.4289
BED UTILIZATION PATTERN AT ZAGAZIG UNIVERSITY HOSPITALS
Wassif
M.
Community Medicine Department, Faculty of Medicine, Zagazig University
author
Ali
AS
Community Medicine Department, Faculty of Medicine, Zagazig University
author
Elsharkawy
GF
Community Medicine Department, Faculty of Medicine, Zagazig University
author
Elwan
A
Community Medicine Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Hospital beds are an important and costly resource for all health systems. Objectives: to assess the appropriateness of hospitalization days and identify risk factors associated with extra length of hospital stay. Methods: Record analysis and indepth interview with hospital managers were conducted to review hospital rates and bed management policy for different departments of Zagazig university hospitals in 2012. Then, non emergency settings in 4 selected departments were studied in a cross sectional study involved 200 patients and 108 physicians. Patients were interviewed and their bed days were assessed by using appropriateness evaluation protocol(AEP). Physicians were asked to complete a questionnaire on bed cycle and their recommendations were recorded. Results: Record analysis and indepth interview revealed considerable variability in bed occupancy pattern among various departments with overall bed occupancy rate of 67.9%. In the 4 detailed studied departments, percentages of inappropriate hospital admission and stay were 19% and 59 % respectively. Elective admission and being admitted for first time were the significant predictors of inappropriate admission on logistic regression. The main causes of inappropriate stay were waiting for operating room diagnostic or therapeutic procedures in patients in medical departments and persistence of symptoms or occurrence of complications in surgical departments . Poor records and lack of application of clinical guidelines are the main causes of extra length of stay from physicians, prospective. Conclusion: Optimal use of hospital beds remains a challenge at Zagazig university hospitals .So, application of standardized electronic patients records, proper inter departmental communications, proper discharge planning, in addition to planning for rehabilitative and social services are recommended.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
14
https://zumj.journals.ekb.eg/article_4290_26229f8af1ff6efc7b1122c952117909.pdf
dx.doi.org/10.21608/zumj.2013.4290
PREVALENCE AND PSYCHIATRIC COMORBIDITIESOF NOCTURNAL ENURESIS IN A SAMPLE OF BASIC EDUCATION STUDENTS IN SHARKIA GOVERNORATE
Hayam
Elgohary
Psychiatry Department, Zagzazig University, Zagazig, Egypt
author
Asaad
Shalanda
Psychiatry Department, Zagzazig University, Zagazig, Egypt
author
Saed
El lethy
Psychiatry Department, Zagzazig University, Zagazig, Egypt
author
text
article
2013
eng
Background: Nocturnal enuresis and its psychiatric comorbidities are important psychosocial problem. Aim of the work: The aim is to study the prevalence and psychiatric comorbidities of nocturnal enuresis in 11 to13 years’ old children in Sharkia governorate.Subject and Method:A random sample of school students aged 11 to 13 years old in Sharkia Governorate (N. 603) applied a strucured questionair searching for nocturnal enuresis. The cases having nocturnal enuresis (N.50) and non enuretic control group (51) applied Children's Manifest Anxiety Scale, Children Depression Inventory, Abuse and neglect scale for children. Results: The overall prevalence was 8.29% (50/603), depression, anxiety and child abuse are significantly associated with nocturnal enuresis. Conclusion: Our results with enuresis prevalence was comparable to other epidemiologic studies from various countries. Depression, anxiety and child abuse are more prevalent in enurtic child.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
9
https://zumj.journals.ekb.eg/article_4291_6fcb908f04119553bfb11ca8dfbe0fa4.pdf
dx.doi.org/10.21608/zumj.2013.4291
PSYCHOSOCIAL BURDEN AMONG CAREGIVERS OF PATIENTS WITH SCHIZOPHRENIA IN EGYPT
Amira
Fouad
Department of Psychiatry, Faculty of Medicine, Zagazig University, Sharkia, Egypt
author
Mohab
Fawzi
Department of Psychiatry, Faculty of Medicine, Zagazig University, Sharkia, Egypt
author
El Masry
N.
Department of Psychiatry, Faculty of Medicine, Zagazig University, Sharkia, Egypt
author
text
article
2013
eng
Most studies of family burden have been conducted in developed countries, thus it is important to conduct studies in developing countries, namely Egypt.Aim of the study: To evaluate the psychosocial burden among caregivers of schizophrenic patients.Subjects and Methods: A total of 120 schizophrenic patients attending the outpatient Clinic of Zagazig University Hospital with their primary caregivers, using Caregiver Strain Index (CSI), Caregiver Self Assessment Questionnaire (CSAQ), Hamilton Anxiety Scale, Hamilton Scale of Depression.Results: High level of burden was found mainly among caregivers of disorganized type followed by catatonic type, also high levels of anxiety and depression in disorganized type followed by catatonic type.Conclusion: Schizophrenia is associated with high level of burden on caregiver. So effort should be made to alleviate the burden for better outcome in both patients and caregivers.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4292_ae9b5c06be9d7b58e7181835c238eedb.pdf
dx.doi.org/10.21608/zumj.2013.4292
EFFECT OF DIABETES AND SCHIZOPHRENIA ON COGNITIVE FUNCTION IN EGYPTIANS
Khaled
Hadhoud
Departments of Internal Medicine ,Faculty of Medicine, Zagazig University
author
Amira
Fouad
Departments Psychiatry ,Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Cognitive impairment occurs in both schizophrenia (SZ) and diabetes mellitus, in addition, people with SZ are more likely to develop diabetes than those without SZ. Objective: This study was planned to determine whether SZ patients with diabetes have an increased risk of cognitive impairment than SZ without diabetes or diabetes only. Subjects & Methods: The study included 120 subjects, 30 of them were known patients with SZ (Group I), 30 with type 2 diabetes mellitus (T2DM) (group II), 30 of them had SZ with diabetes (Group III) as well as 30 healthy subjects served as control group (Group IV). All subjects were subjected to complete clinical examination, including body mass index [BMI] and waist circumference, in addition to investigations including fasting blood glucose, lipid profile and routine laboratory investigations and assessment of cognitive functions using RBANS [Repeatable Battery for the Assessment of Neuropsychological Status]. Results: SZ with diabetes showed higher fasting blood glucose and triglyceride levels than SZ without diabetes (both P < 0.05). No significant differences between SZ with and without diabetes in duration of illness, antipsychotic types, duration of current antipsychotic treatment (all P > 0.05). Compared to healthy controls, all patients groups had significantly decreased total and five index RBANS scores [the repeatable pattery for assessment of neuropsychological status] (all P < 0.01 – P < 0.001), except for the visuospatial/ constructional index. SZ with diabetes performed worse than SZ without diabetes in immediate memory (P > 0.01) and total RBANS scores (P < 0.05) and showed a trend for decreased attention (P = 0.052) and visuospatial/constructional capacity (P = 0.63). SZ with diabetes performed worse than diabetes only in immediate memory (P < 0.001) and attention (P < 0.05) and showed a trend for decreased total RBANS scores (P = 0.069). Conclusion and Recommendations: SZ with Co-morbid diabetes showed more impairment than SZ without diabetes or diabetes only especially in immediate memory & attention. Thus, diabetes prevention and control should be targeted in patients with SZ.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
9
https://zumj.journals.ekb.eg/article_4293_38eddcd70538c501ce2d7f7cb5d8647b.pdf
dx.doi.org/10.21608/zumj.2013.4293
SIGNIFICANCE OF FLAT EPITHELIAL LESIONS OF THE URINARY BLADDER IN EARLY DETECTION OF BLADDER CANCER: HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY
Mohamed
Ramadan
Pathology Department, Faculty of Medicine, Zagazig University
author
Masoud
Omar
Pathology Department, Faculty of Medicine, Zagazig University
author
Mona
Abdel-Wahed
Pathology Department, Faculty of Medicine, Zagazig University
author
Shimaa
Ahmed
Pathology Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Urothelial carcinoma of the urinary bladder is the second most common malignancy of the genitourinary system, after prostate cancer. The flat lesions are classified into flat lesions without cytological atypia (Flat hyperplasia) and flat lesions with cytological atypia; reactive atypia, atypia of unknown significance, urothelial dysplasia and urothelial carcinoma in situ). The immunohistochemical markers such as cytokeratin 20,CD 44 and Ki 67 may be useful in differentiating CIS from reactive changes in difficult biopsy cases.Aim: This study was conducted to determine the role of cytokeratin 20, CD 44 and Ki 67 in the diagnosis of dysplasia and other flat lesions of the urinary bladder.Methods: Sixty representative cases for flat urothelial lesions of urinary bladder were examined immunohistochemically using antibodies against CD44, cytokeratin 20 and Ki-67.Results: CD 44 were positive in 100%of cases of reactive urothelial atypia, but flat Hyperplasia and CIS cases were negative. However CD 44 were positive in 42.9% of atypia of unknown significance and 14.3% of Dysplasia. CK 20 were positive in (95.5%) of Dysplasia. Non of Flat Hyperplasia were positive for CK 20. However CK 20 was positive in 88.2% of CIS, 57.1 % of atypia of unknown significance and 7.1% of reactive urothelial atypia. ki 67 index were high in 82.4% of cases of CIS, non of flat hyperplasia expressed high ki 67 index. However ki 67 index were high in 57.1% of atypia of unknown significance, 52.4% of dysplasia and 14.3% of reactive urothelial atypia.Conclusion. CD 44 is the most constant marker in the reactive urothelium. CK20 is the most commonly detected marker in the dysplastic urothelium. Nevertheless, the most accurate is application of an immunohistochemical panel composed of the three antibodies (standard CD 44, CK20 and Ki-67) together with correlation with morphology. This is very useful for confirming the presence of dysplastic changes in the urothelium and differentiating reactive urothelium from dysplastic urothelium (dysplasia/CIS).
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
14
https://zumj.journals.ekb.eg/article_4294_62e30f4e78331fc5bbe83ffe18747a0b.pdf
dx.doi.org/10.21608/zumj.2013.4294
WHAT ARE THE RESULTS OF ANATOMIC RECONSTRUCTION FOR UNSTABLE ACROMIOCLAVICULAR JOINT BY USING AN AUTOGENOUS SEMITENDINOSUS GRAFT?
Mohamed
Elzohairy
Lecturer of orthopedic surgery, faculty of medicine Zagazig University
author
text
article
2013
eng
Acromioclavicular injury is considered as a common athletic shoulder injury. Many of these injuries can be treated nonoperatively but high-grade injuries can result in pain and loss of shoulder function. A numerous operative techniques have been proposed with recent renewed focus on the anatomy of the coracoclavicular ligaments which has led to anatomic reconstructive techniques that show promised results in biomechanical comparisons. These techniques involve reconstruction of the conoid and trapezoid ligaments through anatomically-based tunnels in the clavicle, with preservation of the distal clavicle that improves the biomechanical stability of this construct. The purpose of this study was to evaluate the results of anatomic reconstruction of unstable acromioclavicular joint by using an autogenous semitendinosus graft. All the patients gave the informed consent prior to being included into this study; the study was authorized by the local ethical committee and was performed in accordance with the Ethical standards of the 1964 Declaration of Helsinki as revised in 2000
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
7
https://zumj.journals.ekb.eg/article_4295_61f4fc24d06966091ed8cc4d10bb9638.pdf
dx.doi.org/10.21608/zumj.2013.4295
DIFFERENT MODALITIES OF RECONSTRUCTION IN FOURNIER GANGRENE
Moustafa
El Saady
General Surgery department, Faculty of Medicine, Zagazig University
author
Samy
Ahmed
General Surgery department, Faculty of Medicine, Zagazig University
author
Raafat
Mansour
General Surgery department, Faculty of Medicine, Zagazig University
author
Fady
Salamh
General Surgery department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Fournier gangrene is an acute and potentially lethal necrotising fasciitis that involves the scrotum and perineum. This disease can result in the loss of skin and soft tissue. Multiple options for reconstruction of the scrotum are available. To repair the scrotal and perineal defects remains a surgical challenge. Objective: The aim of this work is to compare different modalities of reconstruction in Fournier gangrene and to verify the indications of efficacy of each modality. Patients and methods: The present study includes 20 patients with diagnosis of Fournier gangrene from the General Surgery Departments, Faculty of Medicine, Zagazig University Hospitals from 2010 to 2012. Following admission, correction of the fluid and electrolyte imbalance, and estimation of the extension and depth of the gangrenous area were done. After stabilization of the patients, all patients underwent surgical debridement with frequent dressing, and then the patients were divided randomally into four groups according to the reconstructive procedure. Results: A total of 20 cases with Fournier gangrene were included in this study. All patients included in this study were males. Their age ranged from 20–70 years old with a mean age of 50 years. The most common comorbid condition was diabetes mellitus in 50% of cases. The infection was polymicrobial in 70% of cases. Wound healing with secondary repair was performed in 5 patients. Wound healing with primary closure was performed in 5 patients. Wound healing with split-thickness skin graft was performed in 5 patients. Wound healing with gracilis muscle flap followed by split-thickness skin graft was performed in 5 patients. No surgical mortality was recorded. Conclusion: Gracilis muscle flap plus split-thickness skin graft covered the deep perineal defects very well. It is a reliable procedure, which provides excellent cover for the exposed testes and gives satisfactory protection and aesthetic outcome.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4296_2af67d5c081c491d3024106953186489.pdf
dx.doi.org/10.21608/zumj.2013.4296
EFFECT OF APELIN-13 ADMINISTRATION ON GASTRIC SECRETION IN NORMAL AND DIABETIC RATS
Akmal
Diab
Physiology Department, faculty of medicine, Zagazig University
author
Soad
Ahmed
Physiology Department, faculty of medicine, Zagazig University
author
Abeer
Khalefa
Physiology Department, faculty of medicine, Zagazig University
author
Reham
Ibrahim
Physiology Department, faculty of medicine, Zagazig University
author
text
article
2013
eng
Background: Apelin is a recently discovered peptide, identified as an endogenous ligand of receptor APJ, apelin has beneficial effect in diabetic conditions as it increase glucose uptake and improve insulin sensitivity, diabetic patients have impaired gastric secretion and apelin is expressed in parietal, chief and mucous cells and this raise the possibility of involvement of apelin in gastric physiology. Objective: The present study was carried out to demonstrate the effect of acute and chronic administration of apelin 13 on gastric secretion in normal and diabetic rats. Design: 98 adult wistar male albino rats were used, animals were divided into three main groups group A (normal rats), group B (high fat diet induced diabetic rats) and group C (streptozotocin induced diabetic rats), each group is subdivided into control subgroup (1), acute apelin-13 injected subgroup (2), chronic apelin-13 injected subgroup for 21 days (3): In all studied groups, different parameters of gastric secretion, gastric mucosal pH and mucin content were measured. Results: acute administration of apelin-13 decreased gastric acid secretion in all groups proved by significant increase in pH accompanied by significant decrease in total and free acidity, the percentage in decrease of gastric acid secretion in normal rats is more than that of high fat diet induced diabetic rats and streptozotocin induced diabetic rats. Ghrelin level, volume of gastric secretion, blood glucose and HOMA- IR significantly decreased in all groups. pepsin, mucin content of gastric mucosa and insulin level had no significant change in all groups, while, pH of gastric mucosal surface significantly increased .In addition, there was negative correlation between ghrelin level and pH, positive correlation between ghrelin and both total and free acidity in normal rats, positive correlation between ghrelin and volume of gastric secretion in all studied groups. Chronic administration of apelin-13 caused no change in gastric acidity in normal rats. and increase gastric acidity in high fat diet induced diabetic rats and streptozotocin induced diabetic rats, proved by significant decrease in pH accompanied by significant increase in total and free acidity, the percentage of increase in gastric acid secretion in high fat diet induced diabetic rats is more than that of streptozotocin induced diabetic rats, moreover, chronic administration of apelin-13decreased ghrelin level, pepsin level, volume of gastric secretion, blood glucose, insulin level and HOMA- IR and increase pH of gastric mucosal surface and mucin level in all studied groups. In addition, there is positive correlation between ghrelin and volume of gastric secretion in all studied groups. Conclusion: While apelin-13 injection on chronic run caused no change in gastric acidity in normal rats, it improved gastric acidity in diabetic rats and can act as a promising target for type 2 diabetes treatment. In addition apelin-13 can be considered as gastro protective agent as it increased pH of gastric mucosal surface and mucin level in normal and diabetic rats.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
13
https://zumj.journals.ekb.eg/article_4297_dd3a2f2ea22a53fd5804af81dd087904.pdf
dx.doi.org/10.21608/zumj.2013.4297
TOTAL VERSUS COMPLETION THYROIDECTOMY IN MANAGEMENT OF SUSPECTED THYROID CARCINOMA
Hatem
Gaafar
General Surgery department, Faculty of Medicine, Zagazig University
author
Mohamed
Hefny
General Surgery department, Faculty of Medicine, Zagazig University
author
Doaa
Refaat
General Surgery department, Faculty of Medicine, Zagazig University
author
Abd Elrahman
Metwalli
General Surgery department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: When results of the FNA are reported as indeterminate, a hemi- or total thyroidectomy may be performed, depending on the suspicion of cancer. Objective: This work was designed is to compare the incidence of complications and surgical outcome of total and completion thyroidectomy in management of suspected thyroid carcinoma Patients and methods: The study included 50 patients with STN and results of the FNA are reported as (indeterminate or a follicular lesion). They divided into 2 groups. (Group I) include 20 patients (40%) were subjected to Completion thyroidectomy and (Group II) include 30 patients (60 %) were subjected to total thyroidectomy. All cases were operated upon in the department of General Surgery department, Zagazig University Hospitals during the period of the research from May 2010 to July 2013.Statistical analysis: SPSS version 19.Results: In the present study there was 38 (76%) were males and 12 (24%) were female and the pathology of residual tissue in (Group I) showed 8 case (40%) had residual malignancy and 12 cases (60.0%) are free from malignancy. From this study the hospital stay in (Group I) ranges from 5 to 8 days with The mean stay was ( 5.9 ± 1.0 days ) which is longer than (group II) ranges from 3 to 5 days with The mean stay was(3.7 ± 0.75 days).From this study the development of hypoparathyroidism was greater in (Group I) (20%) than (group II) (10%) and recurrent laryngeal nerve injury was greater in (Group I) (4%) than (Group II) (2%).Conclusion: The frequency of complications was greater in (Group I) than (Group II) so total thyroidectomy is considered as the treatment of choice for both malignant and benign thyroid disease requiring surgical treatment when performed by experienced surgeons Moreover, it eliminates the requirement of completion thyroidectomy for incidentally diagnosed thyroid carcinoma.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4298_eb614a3f3f99fa2cd5483d395be9ba17.pdf
dx.doi.org/10.21608/zumj.2013.4298
PREVELANC OF HYPONATREMIA AND ITS ASSOCIATION WITH DEVELOPMENT AND SEVERITY OF COMPLICATIONS IN CIRRHOTIC PATIENTS
Osama
Khalil
Internal medicine department,Faculty of medicine ,zagazig university
author
Abdallah
Abdel-aziz
Internal medicine department,Faculty of medicine ,zagazig university
author
Amir
el-okely
Internal medicine department,Faculty of medicine ,zagazig university
author
Nevein
Mikheil
Internal medicine department,Faculty of medicine ,zagazig university
author
Sayed
Al-nahal
Internal medicine department,Faculty of medicine ,zagazig university
author
text
article
2013
eng
Hyponatremia is common in advanced liver cirrhosis. Recently it has attracted an interest as a possible prognostic factor for liver cirrhosis complications. This study was conducted to assess the prevalence of hyponatremia in complicated cirrhotic patients admitted to medical ICU and to identify its relationship to development and severity of these complications. 200 patients with liver cirrhosis were included in this study. According to serum sodium, they were classified into three groups: group 1 with serum sodium ≤130 meq/L (severe hyponatremia), group 2 with serum sodium from 131 to 135 meq/L (mild hyponatremia) and group 3 with serum sodium ≥136 meq/L (normo-natremia). Demographic, clinical, and laboratory variables were prospectively recorded for analysis.In our studyThe prevalence of total hyponatremia was 131/200 patients (65.5%) and those with severe hyponatremia were 91/200 (45.5%) .There was a statistically significant increase in frequency of occurance (p>0.01) and relative risk each of ascites (1.3fold),intractable ascites (9.5fold), spontaneous bacterial peritonitis (2.6fold), hepatic hydrothorax (1.5fold) and hepatic encephalopathy (2.8fold), in hyponatremic groups compared to normonatremic one while there was no significant difference regarding hepatorenal syndrome, esophageal varices and variceal bleeding between different groups. Also there was a statistically significant negative correlation betwee serum sodium level and the two scoring systems: Child-Pugh score (r =-0.690, p<0.001) and Model for End – stage Liver Disease (MELD) score(r =-0.586, p<0.001 ).We can conclude that In critically ill patients with liver cirrhosis, the prevalence of total hyponatremia(Na ≤ 135 meq/L) was 65.5% while those with severe hyponatremia (Na ≤130) was 45.5%. Low serum sodium level was associated with high complications of liver cirrhosis. The relative risk of occurance, frequencies and severity of ascitis, intractable ascitis, hepatic hydrothorax, hepatic encephalopathy and spontineous bacterial peritonitis were increased in cirrhotic patients especially those with serum sodium levels ≤ 130 meq/L.So the Management of hyponatremia may decrease the incidence and severity of the liver cirrhosis complications with better quality of their life. Thus more interest should be tried towards the use of vasopressin receptor antagonists as a line of treatment of complicated cirrhotic patients with hyponatremia without salt overload
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4299_9c94ac81541164f2a8378b5fa10088cf.pdf
dx.doi.org/10.21608/zumj.2013.4299
URINARY LIVER TYPE-FATTY ACID BINDING PROTEIN AND PLASMA CYSTATIN C AS EARLY PREDICTORS OF CONTRAST INDUCED ACUTE KIDNEY INJURY
Essam
Lotfy
Internal medicine department
author
Mabrouk
Ismail
Internal medicine department
author
Aly
Shindy
Internal medicine department
author
Lamiaa
Mohamed
clinical pathology department
author
text
article
2013
eng
Background: Contrast-induced acute kidney injury (CI-AKI) continues to have an increasing incidence, representing the third most common cause of hospital acquired acute kidney injury. It is a syndrome in which an acute renal dysfunction is diagnosed after the intravascular injection of contrast media. Acute renal injury is typically diagnosed by measuring serum creatinine that is an unreliable indicator during acute changes in kidney function; thus, the need for early sensitive biomarkers to detect acute kidney injury before the rise of creatinine has emerged. Urinary Liver type fatty acid binding protein is a newly emerging biomarker that might represent an early, sensitive and non-invasive biomarker for acute renal injury. Cystatin C is a cysteine protease inhibitor that demonstrated a high diagnostic value to detect AKI on the two days before creatinine elevation. Objective: The aim of our study was to elucidate if urinary L-FABP and plasma Cystatin C can be early predictors of AKI after contrast adminstration. Subject and methods: thirty three patients were included in this study, they were divided into two main groups; Group (I): 16 patients underwent coronary angiography for dioagnostic and therapeutic purposes, Group (II): 17 patients underwent computerized tomography using IV (high-osmolar) contrast media; then classified after the procedure to AKI group and Non AKI group according to the change in serum creatinine after 24 hours. Results: the basal value of both plasma cystatin c and urinary L-FABP is significantly higher in AKI vs non AKI groups indicating predictive value of both biomarkers before contrast exposure (AUC of urinary L-FABP = 0.837 (95%CI; 0.673 – 1.001); AUC of plasma Cystatin C = 0.742 (95%CI; 0.600 – 0.925)). After contrast exposure, both both plasma cystatin c and urinary L-FABP showed a highly statistically significiant elevation at 6 hours in the AKI group compared to the non AKI group, while there was no statistically significiant difference in serum creatinine (mg/dl) that showed significant elevation only after 24 hours; thus, both plasma cystatin c and urinary L-FABP may serve as early predictors of AKI after contrast adminstration before any significant change in serum creatinine (AUC of urinary L-FABP =1 (95%CI; 1 – 1); AUC of plasma Cystatin C =1 (95%CI; 1 – 1)). Conclusion: urinary L-FABP and plasma Cystatin C can be considered as predictive biomarkers of contrast induced nephropathy before contrast exposure and as early biomarkers after contrast exposure instead of serum creatinine, as their levels start to rise about 24 hours before any significant change in serum creatinine. Further studies are recommended using large number of patient.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
12
https://zumj.journals.ekb.eg/article_4300_1d90120b9c52bbfcd7705a83c99eddbb.pdf
dx.doi.org/10.21608/zumj.2013.4300
PORTAL VEIN THROMBOSIS IN PATIENTS WITH LIVER CIRRHOSIS ;RISK FACTORS,CLINICAL PRESENTATION AND OUTCOME
Afifi
Afifi
Internal medicine department , Radiology department and Microbiology department
author
Osama
Basha
Internal medicine department , Radiology department and Microbiology department
author
Ahmed
Gomaa
Internal medicine department , Radiology department and Microbiology department
author
Abdelaziz
samack
Internal medicine department , Radiology department and Microbiology department
author
Raghda
Elsherbini
Internal medicine department , Radiology department and Microbiology department
author
text
article
2013
eng
Introduction: The liver has many haemostatic functions, including the synthesis of most coagulation factors and inhibitors as well as fibrinolytic factors . The balance between procoagulant and anticoagulant factors is essential to avoid excessive thrombin generation under physiological conditions. Therefore, advanced liver disease results in a complex pattern of defects in haemostatic functions in the form of reduced synthesis of coagulation factors, inhibitors, and abnormal clotting factors, abnormalities of fibrinolytic activity, disseminated intravascular coagulation and platelet function defects.Development of portal vein thrombosis (PVT) is asignificant milestone in the natural history of cirrhosis. It is associated with worsening liver function, ascites, and the occurrence of gastroesophageal variceal bleeding. It is clear that PVT increases morbidity and mortality associated with liver transplant and may even contraindicate it and. Thus, taken together, these data suggest that PVT is a major index of poor prognosis in patients with cirrhosis.Although spontaneous resolution of PVT has been reported in the literature specific therapeutic management is mandatory to resolve portal vein obstruction and avoid serious complications. The goal of treatment is similar correction of causal factors, prevention of thrombosis extension, and achievement of portal vein patencyObjective: the aim of the work was to clarify the risk factors , clinical presentation and complications of portal vein thrombosis in patients with liver cirrhosis and to study the out come after short term follow up.Subject and methods :- A total number of 80 patients with cirrhosis were included and were classified into two main groups. Group I ( 50 ) cirrhotic patients with portal vein thrombosis. Group II ( 30 ) cirrhotic patients without portal vein thrombosis. Each group was divided in two sub groups A and B a ccording to prescence or absence of HCC respectively.The 2 groups were compared as regard risk factors and clinical presentation and out come.Result:PVT developed as result of combination of both local and systemic risk factors. HCC and abdominal infection specially spontaneous bacterial peritonitis and intervention to the portal system ,were the most important local risk factors . Protein C and S defficincy were amog systemic risk factors. Most of cases were asymptomatic and accidentally discovered , other patients presented with upper GIT bleeding or other complications of liver cell failure .Anticoagulant administration was associated with increased incidence of partial or complete recanalization without increased risk of bleeding.Conclusion and Recommendations:- Portal vein thrombosis occurs mostly in a cirrhotic patient with advanced liver disease. Patients with advanced liver cirrhosis and not so prolonged coagulation parameters might be at particular risk of developing PVT. So regular monitoring using Doppler-ultrasound should be carried out in these patients. Development of varices is a time dependent phenomenon, so it is advisable to screen all PVT patients endoscopically.Early administration of anticoagulation was associated with increased incidence of partial or complete recanalization.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
12
https://zumj.journals.ekb.eg/article_4301_8cc55753c9abc01f9f0eb5d1aa706e7f.pdf
dx.doi.org/10.21608/zumj.2013.4301
VALUE OF MATRIX METALLOPROTEINASE AS A PREDICTOR OF OUTCOME OF ACUTE MYOCARDIAL INFARCTION
El Shaeer
H
cardiology Departments Faculty of Medicine Zagazig University
author
Abd El Aziz
A.
cardiology Departments Faculty of Medicine Zagazig University
author
Hussein
M.
Biochemistry* Departments Faculty of Medicine Zagazig University
author
Shimaa
M.
Biochemistry* Departments Faculty of Medicine Zagazig University
author
text
article
2013
eng
Background: Following acute myocardial infarction (AMI) many cytokines and proteolytic enzymes are released. Among these, matrix metalloproteinases (MMPs) are important proteolytic enzymes that lead to degradation of the extracellular matrix and to change in cardiomyocytes in both infracted and noninfarcted myocardium. This process is known as cardiac remodelling. It has been demonstrated that more than one type of MMP is present in the circulation after cardiomyocye injury. A number of studies have demonstrated the correlation between these MMP levels and the severity of coronary lesion, the prognosis of left ventricular dimension and the survival rate following AMI.Aim of the work To assess the usefulness of matrix metalloproteinase and other factors as predictors of outcome of patients with acute myocardial infarction.Patients and methods: This study was done in Cardiology department and biochemistry department, Zagazig University on 92 patients; 75 males (81.5%)) 17 females (18.5%) with acute myocardial infarction. Patients were divided into 4 groups ; group I(Revascularization),group II (Morbidity),group III(Mortality),group IV(Control) All patients were subjected to full laboratory examination and Plasma MMP-3 was measured , wall motion score index(WMSI) ,systolic and diastolic function were assessed by echocardiography pre-discharge and after 6 months .Results: MMP-3 peaked prior to discharge. MMP-3 was associated with patient cholesterol (p<0.001), triglyceride (p<0.05) ,WMSI (p<0.05) and Gensini score (p<0.001). MMP-3 inversely correlated with fractional shortening at follow-up (p=0.019), Ejection fraction and Isovolumic relaxation time In the 37 patients who had complications or died, MMP-3 was higher (p<0.001). And subjects with levels above optimum cut off identified via ROC curve were more likely to suffer a clinical event (p=0.000).Conclusion: MMP-3 is associated with left ventricular dysfunction, adverse left ventricular remodelling and prognosis after AMI.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
10
https://zumj.journals.ekb.eg/article_4302_8f84a0f3a49a87876d489ff90904b71b.pdf
dx.doi.org/10.21608/zumj.2013.4302
PERIPROCEDURAL MYOCARDIAL NECROSIS PREDICTION BY SYNATX SCORE DURING PERCUTANOUS CORONARY INTERVENTION IN DIABETIC PATIENTS
Mahmoud
El-Menshawy
Cardiology Department, Faculty of Medicine, Zagazig University.
author
Tarek
Naguib
Cardiology Department, Faculty of Medicine, Zagazig University.
author
Ghada
Mohammed Ibrahiem
Cardiology Department, Faculty of Medicine, Zagazig University
author
El-Sayed
El-Shafey
Cardiology Department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Peri-procedural myocardial injury (PPI) during percutaneous coronary intervention (PCI) is common and associated with a poor outcome. No reliable angiographic or clinical predictors of PPI exist. We evaluated the ability of the SYNTAX score (SXscore), Gensini score and American Heart Association/American College of Cardiology (AHA/ACC) classification to predict PPI. Methods: 60 patients with chronic stable angina not controlled by medical treatment were included from the day case PCI. Inclusion criteria; patients undergoing insertion of < 30 mm of stent to a single vessel and/or bifurcation PCI involving a side branch > 2.0 mm in diameter, and/or patients undergoing double vessel PCI. Exclusion criteria; Patients with heart failure and lesions > 30 mm in length, patients with high syntax high syntax score, Patients with coronary bypass grafts, previous PCI and patients with instent restenosis. PPI was defined as troponin T elevation (N 0.1 ng/mL) at 6–24 h post-PCI. Results: Patients were classified according to presence or absence of diabetes mellitus (DM) into two groups; group I (non-diabetic patients DM; 33 patients, 23 males, 10 females, their age ranged from 42- 62 years with mean 50.2±5.3 years), group II (diabetic patients; 27 patients, 16 males, 11 females, their age ranged from 45 -65 years with mean age of 54.4±5.4 years). Patients were reclassified according to syntax score into two groups; group A (with low score (0-22); 48 patients) & group B (with intermediate score (22-32); 12 patients).The mean patient SXscore was higher in diabetic patients and non diabetic patients (22.6 vs. 12.4, p = 0.0001), Gensini score was significantly higher in diabetic patients (52.4 vs. 25.3, p = 0.15). Also mean PCI vessel SXscore was higher in vessels associated with PPI (12.1 vs. 7.6, p = 0.002), but not different for PCI vessel Gensini score (16.2 vs. 13.6, p = 0.42). No vessels with AHA type A lesions were associated with PPI. Higher AHA classification (B and C) were associated with PPI. In total, 60 patients undergoing PCI to 77 vessels were included in the analysis, There were 43/60 (71.6%) patients who had myocardial injury. The incidence of PPI among diabetic patients was higher than non diabetic patients (24/27, 88.9% vs 19/33, 57.6% respectively) reflecting procedural complexity, (long lesion and total occlusion) more in diabetic patients. Indeed, the procedural complexity reflected by the mean patient SXscore was higher in the diabetic patients group than non diabetic patients undergoing day case PCI. By ROC analysis, we found that a patient with high SXscore of ≥ 15 can be considered as predictor of PPI with a sensitivity of 95.3% and specificity of 88.2%.Conclusion: Higher SXscores are predictive of myocardial injury, whilst AHA type A lesions have a high negative predictive value for PPI.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
11
https://zumj.journals.ekb.eg/article_4303_3a5147f58ecc696f2d358c19e2eec3ec.pdf
dx.doi.org/10.21608/zumj.2013.4303
ROLE OF LAPAROSCOPY IN BLUNTABDOMINAL TRAUMA
Mohamed
Yehia
General Surgery department, Faculty of Medicine, Zagazig University
author
Sami
Khalifa
General Surgery department, Faculty of Medicine, Zagazig University
author
Mohamed
Atia
General Surgery department, Faculty of Medicine, Zagazig University
author
Wael
M
General Surgery department, Faculty of Medicine, Zagazig University
author
AbdAlla
AbdAlla
General Surgery department, Faculty of Medicine, Zagazig University
author
Ramadan
Ali
General Surgery department, Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: Treatment of blunt abdominal trauma requires a precise diagnosis that is not always possible with imaging techniques. The introduction of laparoscopic technique is increasingly used alternative to open surgery. Diagnostic laparoscopy with therapeutic option in stable patients is an emerging technique. Objective: To assess the efficacy of laparoscopy and its role in patients with blunt abdominal trauma. Patients and methods: 40 hemodynamically stable patients with suspicious abdominal injuries underwent diagnostic or therapeutic laparoscopy at the trauma service of Zagazig University Hospital. Inclusion criteria: hemodynamically stable patients with suspicious abdominal injuries. Exclusion criteria: penetrating abdominal trauma, marked hemodynamic instability, Patients with increased intracranial tension and Patients with general or local contra-indications for laparoscopy. Operative technique: creation of Pneumoperitonium with placement of three ports, one 10-mm for the telescope and two 5-mm trocars. If necessary, accessory trocars were inserted. A thorough exploration of the abdominal cavity was carried out. The hemoperitoneum or bowel contents were aspirated, and the lesion causing the injury was located and manged, If possible. Conversion to laparotomy was decided in cases of nonsatisfactory or incomplete abdominal examination Statistical analysis: SPSS version 15. Results: laparoscopic mangement showed results better than that of open exploration as regard postoperative pain, operative time, hospital stay and most of complications. Conclusion: Laparoscopic mangemant of haemodynamically stable blunt trauma is a promising solution which needs increasing its learning curve for optimum results.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
7
https://zumj.journals.ekb.eg/article_4304_c8fa249c01b59205d30b62ce32ed1c2b.pdf
dx.doi.org/10.21608/zumj.2013.4304
SURGICAL MANAGEMENT OF THE MOST COMMON BENIGN CRANIOFACIAL FIBROOSSEOUS LESIONS
Mohammed
Mobashir
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt.
author
Ezzat
Merwad
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt.
author
Ahmed
Anany
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt.
author
Abd
Said
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt.
author
Mostafa
Hassan
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt
author
Sameh
hosny
Department Of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2013
eng
Background: fibro-osseous lesions of craniofacial bones are a challenging group of pathological conditions that aredifficult to classify and treat. Unfortunately, there are no universally accepted clinical, radiological, or histopathologicalcriteria that distinguish these lesions from one another. It is often quite challenge to establish their biologic behavior andtreatment. Objective: To outline the the different surgical modalities for management of the most common symptomatic craniofacial fibro-osseous lesions and to evaluate the appropriate surgical management with follow up results.Patients and methods: Sixteen patients with biopsy confirmed craniofacial fibro-osseous lesions were enrolled in our studyfrom Mars 2009 to Mars 2012 in otorhinolaryngology department zagazig university hospital. They were operated usingendoscopic and open surgery. All patients were submitted in thorough history taking, clinical, radiological, andhistopathological examinations, with a follow up period from six months to two years. Results: The most common cases were osteoma 10 cases (62.5%), the fibrous dysplasia was the second most common 6 case (37.5%). Ethmoid and frontal sinus were the most common sinuses involved with osteoma, the maxillary sinus was the most common sinus involved with fibrous dysplasia. There were 3 complications the first was CSF leak, the second was incomplete removal of fibrous dysplasia, and the third was diminution of vision in the epsilateral eye of the huge ethmoidal osteoma due to optic nerve oedema resolved by medical treatment. Conclusion: management of craniofacial fibro-osseous lesions is highly individualized and it is the task of the surgeon to tailor the surgical procedure according to the clinical and radiological data.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
7
https://zumj.journals.ekb.eg/article_4305_02a722b45d15ad0bd5ced9b08c757b60.pdf
dx.doi.org/10.21608/zumj.2013.4305
STUDY OF THE POSSIBLE HEPATOPROTECTIVE EFFECT OF PROPOLIS AGAINST THE HEPATOTOXIC EFFECT OF ATORVASTATIN IN ALBINO RATS
Ahmed
Abdelsameea
Departments of Pharmacology and Pathology* Faculty of Medicine-Zagazig University
author
Laila
Mahgoub
Departments of Pharmacology and Pathology* Faculty of Medicine-Zagazig University
author
Samar
Abdel Raouf
Departments of Pharmacology and Pathology* Faculty of Medicine-Zagazig University
author
text
article
2013
eng
Background: Liver injuries induced by various hepatotoxins have been recognized as a major toxicological problem for years. 3-Hydroxy-3-methyglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used drugs to reduce cholesterol levels and prevent coronary heart disease. One of the adverse effects of statins is affection of the liver functions with increased transaminases levels. Propolis is collected by honeybees from various plant sources. It was found to have hepatoprotective activity. Aim: The present study evaluated the possible hepatoprotective effect of propolis against hepatotoxic effect of atorvastatin in albino rats. Methods: Propolis in doses of 50 and 100mg/kg were administered one hour before atorvastatin in doses of 20 and 80mg/kg daily, orally for one month. Hepatoprotective effect of propolis was evaluated by measuring levels of ALT and AST in the serum and SOD and CAT in the liver homogenate. The histopathological studies were also studied to support the biochemical parameters. Results: Atorvastatin in a dose of 20 and 80mg/kg produced dose-dependent, significant elevation of ALT, AST, SOD, CAT and hepatocyte degeneration. Administration of propolis 50 and 100mg/kg produced dose-dependent, significant reduction of the previous biochemical parameters and also prevented atorvastatin induced alterations in histoarcheticture of liver in a dose dependent manner.Conclusion: Propolis protected the liver from the toxic effect of atorvastatin. The hepatoprotective effect of propolis may be due to its strong antioxidant activity.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
9
https://zumj.journals.ekb.eg/article_4306_99e703740c143d507c2d015fd450eeb3.pdf
dx.doi.org/10.21608/zumj.2013.4306
SOME POSSIBLE INTERACTIONS BETWEEN GLICLAZIDE AND NEBIVOLOL IN EXPERIMENTALLY INDUCED DIABETIC HYPERTENSIVE ALBINO RATS
Nabila H.F. El-Baroudy
El-Baroudy
Clinical Pharmacology Department, Faculty of Medicine ,Zagzig University
author
Fawkia
Fayed
Clinical Pharmacology Department, Faculty of Medicine ,Zagzig University
author
Ameen
Sekinah
Clinical Pharmacology Department, Faculty of Medicine ,Zagzig University
author
Amal
Salim
Clinical Pharmacology Department, Faculty of Medicine ,Zagzig University
author
text
article
2013
eng
Background: Diabetes mellitus is common in patients with hypertension ,also, hypertension is more frequent in the diabetics than in the non-diabetic individuals. Genetics, environment, hormones, and other pathophysiologic factors contribute to this relationship. Drug therapy of hypertension with diabetes has been surrounded by a controversy because concurrent administration of antihypertensive and anti-diabetic agents is a common trend. Objectives: This work was designed to study some interactions between gliclazide(anti-diabetic) and nebivolol (anti-hypertensive) in experimentally induced diabetic hypertensive albino rats Methods: 50 adult male albino rats were used. They were divided into the following groups: G1: Non diabetic normotensive control (CN), Other 40 rats were subjected to induction of type 2 DM and hypertension by streptozotocin (STZ), the diabetic -hypertensive rats were selected and divided into 4 groups: G2: diabetic-hypertensive (DH) control ,G3: DH gliclazide treated (5mg/kg/day) ,G4: nebivolol treated (10 mg/kg/day) , G 5: DH gliclazide & nebivolol treated . After 8 weeks treatment, the following parameters were estimated: fasting blood glucose (FBG), mean arterial blood pressure (MABP) , Serum insulin, nitric oxide (NO), superoxide dismutase (SOD), malondialdehyde (MDA) , lipid profile in addition to the response of isolated aortic strips to noradrenaline before and after acetylcholine Results: Nebivolol, significantly (p<0.05) decreased the elevated FBG,MABP,MDA and increased serum NO and SOD activity and improved NO dependent vasorelaxation response of aorta when compared with G2 group. Also, it significantly decreased LDL, TC. Furthermore nebivolol improved these parameters when administrated with gliclazide more than nebivolol alone. Conclusion: concurrent administration of nebivolol and gliclazide, improved many metabolic parameters, oxidative stress and vascular reactivity more than when each drug was administrated alone in experimentally induced diabetic hypertensive rats.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
13
https://zumj.journals.ekb.eg/article_4307_85d69e7c9e64aabb3bc37f884c561c76.pdf
dx.doi.org/10.21608/zumj.2013.4307
IS APELIN A PROMISING TARGET IN DIABETES MELLITUS OF RATS: TYPE I VS. TYPE II?
Doaa
Attya
Physiology Department, Faculty of medicine, Zagazig University, Egypt
author
Hany
El kattawy
Physiology Department, Faculty of medicine, Zagazig University, Egypt
author
text
article
2013
eng
Background: Apelin is a novel adipokine identified as an endogenous ligand of receptor APJ. Apelin and its receptor APJ are expressed in a wide variety of tissues including heart, brain, kidneys and lungs. Apelin in human physiology acts as a regulating peptide of cardiovascular, hypothalamus-hypophysis, metabolic, gastrointestinal and immune systems.Objective: The present study was carried out to assess the value of apelin in management of type II vs. type I diabetes mellitus in rats. Design: A total number of 60 healthy adult male albino rats were used. Rats were divided into 2 groups: group I (n=40) Streptozotocin induced diabetic group; model of type I diabetes and group II (n=20) high fat diet induced obesity and diabetic group; model of type II diabetes. Group I was subdivided into 4 equal subgroups (saline treated control, an insulin treated, an apelin treated and an apelin and insulin treated subgroups), while group II was further subdivided into 2 equal subgroups (a saline treated control and an apelin treated groups). In all groups the body weight, nose to anus length were measured, and these data were used to calculate the body mass index (BMI). In addition, serum glucose, insulin, triglycerides, total cholesterol, LDL and HDL cholesterol were estimated and used to calculate the homeostasis model assessment as a measure of insulin resistance (HOMA-IR) and the homeostasis model assessment as a measure of β cell function (HOMA-β). Results: This study revealed that an intraperitoneal injection of apelin induced insignificant changes in most of parameters measured in animals of group I when compared with insulin treated subgroup. On the other hand, animals of group II showed a significant decrease in serum levels of glucose and insulin when compared with saline treated controls with resulting a significant decrease in HOMA-IR and a significant increase in HOMA- β. Furthermore, apelin injection induced a significant increase in serum triglyceride, total cholesterol and LDL cholesterol levels and insignificant changes in HDL cholesterol levels in group II rats. Conclusion: In models of type II diabetes, apelin significantly induced amelioration of serum glucose level and enhance insulin sensitivity that was denoted by a significant reduction in HOMA-IR, this was not the case in rats of type I diabetes, so it is promising therapeutic target in anagement of obesity induced type II diabetes rather than type I.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
9
https://zumj.journals.ekb.eg/article_4308_5b16b0f9cd5136fa5f20dc4833ed943c.pdf
dx.doi.org/10.21608/zumj.2013.4308
PERCUTANEOUS FIXATION OF UNSTABLE FRACTURE MEDIAL FOUR METACARPALS
Ahmed M Elsersawy
Elsersawy
Department of orthopedic surgery Elsahil teaching hospital. Egypt Cairo
author
Ahmed
Mostafa
Department of orthopedic surgery Elsahil teaching hospital. Egypt Cairo
author
text
article
2013
eng
Objectives : The objective of this study was to evaluate the clinical outcome of percutaneous fixation of unstable fracture of medial four metacarpls by kirschner wires. Materials and Methods: In our prospective study we documented twenty cases of unstable fracture medial four metacarpals which we fixed percutaneously by k-wires and evaluated radiographic and functional outcome, with follow up for minimum 4 to 6 months in Elsahil teaching hospital during a 2 year period from january 2011 to january 2013, all patients were men with age from 16 to 58 years old. Results: Fracture union was achieved in19 cases (95%) at a mean of 7 weeks (6 to 8 weeks). One case was malunited and that case required revision through open reduction and internal fixation and united in 6 weeks after revision.Conclusion: This study suggests that fixation of medial unstable four metacarpal fractures result in predictable satisfactory radiographic and functional outcome. Also, it suggests that percutaneous fixation carries no risk of damage to soft tissues.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
10
https://zumj.journals.ekb.eg/article_4309_23b3dc2a9dd8922d2a4eaaad5f0b82e0.pdf
dx.doi.org/10.21608/zumj.2013.4309
REVISION TOTAL HIP ARTHROPLASTY
Ahmed
Elsersawy
Department of orthopaedic surgery,Elsahil teaching hospital,Cairo,Egypt
author
Hatem
Ahmed
Department of orthopaedic surgery,Elsahil teaching hospital,Cairo,Egypt
author
Hisham
Elsedeeq
Department of orthopaedic surgery,Elsahil teaching hospital,Cairo,Egypt
author
text
article
2013
eng
Introduction: In revision total hip surgery the surgeon can encounter problems much more difficult and the results definitely not as satisfactory as after a primary total hip arthroplasty(1). The main reason for failure is loss of bone stock, which leads to mechanical problems and instability, also, dislocation, deep sepsis and fracture of the femoral shaft(2). The aim of this study is to evaluate and analyse the causes of failure of total hip arthroplasty which require revision surgery and the proper planning for the revision procedure. Material and Methods:We reviewed a combined prospective and retrospective 20 patients who underwent revision hip arthroplasty in El-Sahel teaching hospital,during the period between Januray, 2008 and December 2012.The average age of the patients was54 years. There were 12 males and 8 females. . In this study the Harris hip score was used for clinical evaluation of the patients both preoperatively and postoperatively which had a score for pain, function, absence of deformity and range of motion out of a hundred point().Also,radiographic analyses was performed when follow up was made at 6 weeks, 12 weeks, 6 months, 1 yearand2 years.Results: Because of variation in general health, and tolerance for discomfort, the clinical picture and radiographic findings did not always coincide. The mean pre-revision harris hip score (3) was 34.18 points [minimum 1 point, maximum 69 points, SD 17.17], while, the mean hip score initial post revision was 80.82 points [minimum 43.00 points, maximum 97.00 points, SD 12.16]. The mean score difference was 46.64 points. The final overall evaluation results were (66%) of patients had excellent or good clinical results and (34%) of patients had either fair or poor clinical results. ( MEAN , ± SD ) Conclusion: The revision total hip arthroplasty is a complicated operation, expensive to perform, and does not give esults as good as a primary joint replacement. Of all causes of failure of total hip arthroplasty perhaps careful evaluation and selection of each patients, definite indication and careful proper surgical technique are the most important aspects in preventing failure.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
8
https://zumj.journals.ekb.eg/article_4310_7e41c8d21e232ede8be1deee49ca063d.pdf
dx.doi.org/10.21608/zumj.2013.4310
PRESCRIBING WRITING ERRORS IN FAMILY HEALTH UNITS IN ZAGAZIG CITY: A COMPARATIVE STUDY BETWEEN ACCREDITED AND NON-ACCREDITED HEALTH UNITS
Shereen
Bahgat
Family Medicine Department, Kasr El-ini, Cairo University and Community Medicine Department
author
Marwa
Saed
Faculty of Medicine, Zagazig University
author
Nagwa E. Sobhy
Nagwa E. Sobhy
Faculty of Medicine, Zagazig University
author
Mohamed A.Fouda
Mohamed A.Fouda
Family Medicine Department, Kasr El-ini, Cairo University and Community Medicine Department
author
text
article
2013
eng
Objective:In this study, the main objective was to determine prescription errors in family health units in Zagazig city accredited versus non accredited and its relation to the organizational climate. Patients &Method:10 accredited family health units were included in the study. Comparing the prescription of these unit to the standard of the ministry of health and WHO. Results:. It was found that the frequency of errors in accredited unit were fewer. The accreditation affects both the frequency of errors and the organizational climate, as the accredited units showed fewer errors and higher organizational climate score than the non-accredited units. There was a negative correlation between the organizational climate and the frequency of missing errors. Conclusions: Prescribers could be helped by designing systems to reduce the risk of these errors like that of a continuous education training programs and use of computerized prescription. The prescriptions need more effort and support from all the related to it; from the doctors, senior managers to the accreditation committee and ministry of health.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
9
https://zumj.journals.ekb.eg/article_4311_c9fb09de4a8b7e9dbef1509149e312e5.pdf
dx.doi.org/10.21608/zumj.2013.4311
ASSESSMENT OF OXIDATIVE STRESS AND ANTIOXIDANT STATUS AMONG PETROL STATIONS’ WORKERS EXPOSED TO BENZENE IN ZAGAZIG CITY
Aida
Hassan
Faculty of Medicine, Zagazig University
author
Sahar
Abou El-Magd
Faculty of Medicine, Zagazig University
author
Amal
Ghareeb
Departments of Public Health and Biochemistry
author
Sarah
Bolbol
Faculty of Medicine, Zagazig University
author
text
article
2013
eng
Background: The main environmental source of benzene exposure is vehicle exhaust emissions and evaporation losses of petrol at petrol filling stations. Activation of benzene and its reactive metabolites leads to continuous production of reactive oxygen species (ROS), which damages DNA, RNA, and proteins by chemical reactions. Aim & Objectives: This study aims to promote health of petrol stations’ workers occupationally exposed to benzene in their daily work with the following objectives: (1)Assess trans,trans-muconic acid (ttMA) level in urine as a biological marker for benzene exposure (2) Estimate the extent of oxidative stress by measuring the Malondialdehyde (MDA) level in blood (3) Assess the activity of erythrocytes superoxide dismutase (SOD) enzyme (4) Identify the personal and occupational risk factors that may be associated with level of (MDA) detected, activity of (SOD) enzyme and level of (ttMA) in studied groups. Subjects & Methods: A cross sectional study was conducted among 43 male workers exposed to Benzene in 6 petrol stations present in Zagazig City. A control group of 40 male service workers, not exposed to Benzene were selected from the Faculty of Medicine in Zagazig University. All workers were subjected to a structured questionnaire included questions about (Personal and socio-demographic data- Occupational history- Oxidative stress questionnaire) and laboratory investigations to measure Trans,trans-muconic acid, Malondialdehyde and Superoxide Dismutase. Results: Results of this study showed that there is a high statistically significant difference regarding the level of (ttMA) & (MDA) which is higher among exposed compared to control group, while the level of (SOD) is statistically lower among exposed group. There is a high statistical significant difference concerning the level of (MDA) among smokers and non-smokers in exposed group as it is higher among smokers compared to non-smokers. Results also showed that there is statistically significant difference regarding the effect of work duration on the level of (ttMA), (MDA) and (SOD) among exposed group, as levels of (ttMA) & (MDA) increased with increased work duration while (SOD) level decreased with increased work duration. There is also a high statistically significant difference between level of (MDA) and chronic emotional stress among exposed group as (MDA) level increased with the increase of emotional stress. Conclusion: It was clear from this study that refueling procedure is an important source of exposure to benzene for the filling station workers who had higher level of benzene metabolites than control and the study also supports the hypothesis that Benzene and its metabolites induce oxidative stress which may plays a role in benzene-initiated toxicity.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
12
https://zumj.journals.ekb.eg/article_4312_c7d552947f8b7d4826719e1a407ffeba.pdf
dx.doi.org/10.21608/zumj.2013.4312
PULMONARY FUNCTION CHANGES AFTER BRONCHOSCOPIC BIOLOGICAL LUNG VOLUME REDUCTION THERAPY USING AUTOULOGOUS BLOOD
Mostafa
Bakeer
Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Taha
Abd El-Gawad
Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Raed
Ali
Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Ahmed
El-Morsi
Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Mohammad
El-Badrawy
Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
Solafa
El-Sharawy
Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura
author
text
article
2013
eng
Background: Bronchoscopic lung volume reduction (BLVR) using biological agents is one of the new alternatives to lung volume reduction surgery.Objectives: To evaluate the potential efficacy of bronchoscopic biological lung volume reduction using autologous blood injection in pulmonary emphysema patients.Methods: 7 male patients were enrolled in the study. After determining the targeted emphysematous segment by high resolution computerized tomography (HRCT), 30 ml autologous blood was injected via balloon catheter over 10 to15 seconds into the targeted segment and left in position for 3-6 minutes allowing time for blood to coagulate. The bronchoscope was then repositioned at the following targeted segment. Changes in residual volume (RV), residual volume to total lung capacity ratio (RV/TLC), forced expiratory volume in one second (FEV1) and forced expiratory volume to forced vital capacity ratio (FEV1/FVC) were evaluated at 12-week post procedure as well as for complications.Results: At 12-week post procedure there was statistically significant reduction in RV/TLC (p = 0.038). FEV1 significantly increased (p = 0.018). In addition, there was significant improvement in FEV1/FVC % (p = 0.003). All cases tolerated the procedure with no mortality. There was one case that developed pneumonia at the same side of intervention, and two cases developed mild haemoptysis (blood streaked sputum). There was no life threatening complications e.g (pneumothorax, pulmonary embolism, cardiac ischaemia or myocardial infarction) occurred htoughout the study.Conclusion: Bronchoscopic lung volume reduction using autologous blood injection could be an effective, cheap and relatively safe method to treat advanced emphysema in comparison to other agents used in the clinical trials.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
4
https://zumj.journals.ekb.eg/article_4313_18e65cd81f4d0c9315544b09f2bf4eff.pdf
dx.doi.org/10.21608/zumj.2013.4313
PROGNOSTIC VALUE OF COMBINED IMMUNOHISTOCHEMICAL EXPRESSION OF BMI1 AND EZH2 IN ASTROCYTOMA
Lobna
Abdelsalam
Department of Pathology, Faculty of Medicine, Zagazig University, Egypt
author
Yehia
Ali
Department of Pathology, Faculty of Medicine, Zagazig University, Egypt
author
Kamal
Elkashishy
Department of Pathology, Faculty of Medicine, Zagazig University, Egypt
author
Eman
Nour Eldeen
Department of Pathology, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2013
eng
Background: Although current improvements in surgery, chemotherapy and radiotherapy, the still survival of astrocytoma’s patient is poor. It is assumed that the combined expression of BMI1 and EZH2 may be associated with malignant transformation of astrocytomas and also it may reveal the biological aggressiveness of this disease.Aim of work: assessment the value of the combined immunohistochemical expression of BMI1 and EZH2 and their correlation with the clinicopathological characters and prognosis in astrocytoma patient.Subjects & Methods: BMI1 and EZH2 expressions were evaluated using immunohistochemical staining in 70 patients 40 cases with astrocytomas and 30 cases of non-neoplastic brain tissue. The relationship between their expressions and clinicopathological factors were analyzed.Results: A significant difference (P<0.002) between expression of BMI1 and EZH2 in astrocytoma compared to corresponding non-neoplastic brain tissue. A significant association was found between high expression of BMI1 and EZH2 and WHO high grades in astrocytomas. No statistically significant association was found between BMI1 or EZH2 with gender of patients, age at diagnosis, site and size of tumor (P > 0.05). The spearman correlation analysis revealed a significant positive association between BMI1 and EZH2 expressions (r = 0.311; P=0.05) revealing direct relationship between BMI1 and EZH2.Conclusions: BMI1 and EZH2 were involved in astrocytoma malignant transformation and poor prognosis in astrocytoma particularly glioblastoma.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
19
v.
5
no.
2013
1
11
https://zumj.journals.ekb.eg/article_4314_bd56385528b06c36c1b1aeaa284b6de3.pdf
dx.doi.org/10.21608/zumj.2013.4314