APIGENIN RESTORES NORMAL VASCULAR REACTIVITY IN DIABETIC RATS VIA PROTEIN KINASE C INHIBITION
Nora
Desoky
Department of Pharmacology, Faculty of Pharmacy, Zagazig University, Egypt
author
Hany
El-Bassossy
Department of Pharmacology, Faculty of Pharmacy, Zagazig University, Egypt
,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
Ahmad
Azhar
Department of Pediatric Cardiology, Faculty of Medicine, King Abdulaziz University, kingdom of Saudi Arabia
author
text
article
2014
eng
Deterioration of vascular reactivity has pivotal role in diabetic vascular complications. Apigenin is a natural flavonoid with protein kinase C inhibiting activity and antioxidant effect.Objective: In the present study, the effect of the flavonoid apigenin on diabetes-induced deteriorated vascular reactivity was investigated.Materials and methods:Insulin deficiency was induced by streptozotocin while, insulin resistance (IR) by fructose. Rats were left tenor twelve weeks after STZ or fructose administration respectively, isolated thoracic aorta reactivity to phenylephrine (PE), KCl, acetylcholine (ACh) and sodium nitroprusside (SNP) was studied.Results: Insulin deficiency increased responses to PE and KCl, decreased response to ACh but not affect response to SNP, while incubation with apigenin (7μM, 20min) normalized responses to PE, KCl andACh. In addition, insulin resistance (IR) increased responses to PE and KCl, decreased response to ACh but not affect the response to SNP, while in vitro incubation with apigenin normalized responses to PE, KCl and ACh. Furthermore, , protein kinase C stimulation by incubation with phorbol 12-myristate 13-acetate (PMA, 800nM, 1h) led to a similar impairment in isolated normal aorta to that seen in case of insulin deficiency and insulin resistance while co-incubation with apigenin restored normal vascular reactivity.Discussion and conclusion: Apigenin, a natural protein kinase C inhibitor, restores normal vascular reactivity in diabetes via a mechanism involving PKC inhibition.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
5
https://zumj.journals.ekb.eg/article_4336_8e6e93716b7a49d8bbe5aa2b11c32bb1.pdf
dx.doi.org/10.21608/zumj.2014.4336
EARLY POSTOPERATIVE MEASUREMENT OF CALCIUM AND PARATHRMONE LEVELS AS PREDICTORS OF EARLY PARATHYROID INSUFFICIENCY AFTER TOTAL THYROIDECTOMY
Ahmed
Awad
General Surgery departments, Faculty of Medicine, Zagazig University.
author
Mohamed
Hassan
General Surgery departments, Faculty of Medicine, Zagazig University.
author
Mohamed
Aboud
General Surgery departments, Faculty of Medicine, Zagazig University.
author
Ahmed
Abd-Elftaah
General Surgery departments, Faculty of Medicine, Zagazig University.
author
Nermin
Raafat
Biochemistry departments, Faculty of Medicine, Zagazig University
author
text
article
2014
eng
Background: Declines in serum calcium or intact parathyroid hormone (iPTH) levels after surgery have been suggested as being reliable predictors of postoperative hypocalcemia. Although measurements of serum calcium or iPTH allow the identification of patients who have no risk of hypocalcemia after total thyroidectomy, it is not always easy to predict which patients can be discharged early from the hospital or to identify those requiring close monitoring of serum calcium levels or those that should receive calcium and vitamin D supplements. Aim of the work To evaluate early postoperative parathyroid insufficiency following total thyroidectomy by estimating parathyroid hormone and calcium level in the early postoperative period, and whether we can rely on to start Ca supplement or not. Patients and methods: This study was done in General Surgery department, Zagazig University on 50 patients; 10 males (20%)) 40 females (80%) who underwent total thyroidectomy. Serum total Calcium and Parathormone levels were evaluated in all patients 6 h and 24 h in early postoperative period. Results: Our results showed highly significant VALUE OF relative decline of serum calcium and parathyroid hormone 6 h and 24 h after total thyroidectomy. The results showed also highly significant positive correlation between serum calcium and parathyroid hormone both preoperative and postoperative and highly significant positive correlation between relative decline in serum calcium and relative decline of serum parathyroid hormone at both 6h and 24 h after total thyroidectomy IN HYPO CALCEMIC PATIENTS. There was no significant relationship between hypocalcemia and any of demographic, clinical, ultrasonographic and pathological data. There is significant relationship between both relative decline of serum calcium and relative decline parathyroid hormone and postoperative hypocalcemia. Conclusion: Relative decline of parathyroid hormone 6 h and 24 h after total thyroidecomy is a good predictor of postoperative hypocalcemia and is reliable for allowing safety discharge of patients 24 h after total thyroidectomy.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
6
https://zumj.journals.ekb.eg/article_4337_479ae2b7c030a81909b2ec3588866f5b.pdf
dx.doi.org/10.21608/zumj.2014.4337
STUDY OF ENDOGENOUS SEX HORMONES AND INFLAMMATION IN ELDERLY WOMEN WITH DIABETES MELLITUS
Hamed
Draz
Internal Medicine Department and Biochemistry department, faculty of medicine, zagazig university
author
Emam
Esmayel
Internal Medicine Department and Biochemistry department, faculty of medicine, zagazig university
author
Mayada
Mousa
Internal Medicine Department and Biochemistry department, faculty of medicine, zagazig university
author
Azeem
Gomaa
Internal Medicine Department and Biochemistry department, faculty of medicine, zagazig university
author
Amira
Mahmoud
Internal Medicine Department and Biochemistry department, faculty of medicine, zagazig university
author
text
article
2014
eng
Background .C-Reactive Protein (CRP), an acute phase reactant has long been considered as a classic marker of inflammation. Ageing is characterized by a chronic, low-grade inflammatory status, the so-called “inflame-ageing”. Diabetes is known to be also associated with low-grade inflammation .The normal process of reproductive ageing is characterized by marked hormonal changes, during menopause, estradiol (E2) level decreases dramatically, whereas testosterone level presents a small decline or remain unchanged. A large body of clinical data suggests the important roles of endogenous sex hormones in the pathogenesis of type 2 diabetes. In many studies in women, plasma estradiol and testosterone have been positively associated with glucose intolerance and insulin resistance, independently of adiposity. Objective .The aim of this study was to assess serum levels of endogenous sex hormones (estrogen and testosterone) as well as high sensitive C -Reactive protein ( hs-CRP) in elderly women with and without type 2 diabetes.Research Design. This study was done in the period between august 2009 to august 2011, The study population included a total number of 60 post menopausal elderly females, 20 healthy non diabetic elderly females as control group and 40 diabetic females. The diabetic females were further divided into two groups according to presence or absence of complications cardiovascular diseaes complicated group and non complicated group. They were also divided into two groups according to glycosylated hemoglobin level (HbA1c) to controlled group and non controlled group.Methods. Total testosterone, total estradiol, hs-CRP and HbA1c were measured in diabetic and non diabetic elderly women.Results. As regard hs-CRP there was a high significant difference between patients(2,2±,56 mg/L) and control group(1.60 0.39 mg/L) and also there was a significant difference between complicated(2.160.51 mg/L) and non complicated group(2.080.76 mg/L) and no significant difference among diabetics whether controlled or non controlled . As regard the serum estradiol, there was a high significant difference between patients (22.513.9 pg/ml) and control group (12.92.71 pg/ml). While there was no significant difference as regard presence or absence of complication and diabetes control. As regard the serum testosterone, there was no significant difference between patients and control group, presence or absence of complication and control of diabetes.Conclusion. In type 2 diabetic postmenopausal elderly women there was significant association between inflammation and serum estradiol while there was no association between inflammation and serum testosterone. As regarding presence or absence of cardiovascular complication and diabetes control neither of two hormones were associated with inflammation.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
14
https://zumj.journals.ekb.eg/article_4338_6cfafaaafb6999f31e50f2b8fc9e723d.pdf
dx.doi.org/10.21608/zumj.2014.4338
SEX HORMONE BINDING GLOBULIN GENE POLYMORPHISM AND RISK OF TYPE2 DIABETES MELLITUS IN EGYPTIAN MEN
Shereen
El Tarhouny
Medical Biochemistry Department, FOM, Zagazig University, Egypt & Taibah University, KSA
author
Soha
Zakaria
Medical Biochemistry Department, FOM, Tanta University, Egypt & Taibah University, KSA
author
Khaled
Hadhoud
Internal Medicine Department FOM, Zagazig University, Egypt
author
Manal
Hanafi
Community Medicine Department FOM, Alexandria University, Egypt & Taibah University, KSA
author
Azza
Kamel
Medical Biochemistry Department, FOM, Menofia University, Egypt & Taibah University, KSA
author
Omar
Al Nozha
Medicine Department FOM, Taibah University, Al Madina, KSA
author
text
article
2014
eng
Conditions of hypoandrogenism in men have been linked to insulin resistance, suggesting that alterations in normal sex steroid physiology could play a role in the pathogenesis of type 2 diabetes (T2DM). Sex hormone binding globulin gene polymorphisms may be the cause of sex steroid alteration The aim of this work to study effect of sex hormone binding globulin (SHBG) gene polymorphisms on type 2 diabetes mellitus risk through its impact on testosterone and estradiol level in Egyptian men. In 185 diabetic men and 120 matched healthy controls, two polymorphisms (rs6257 and rs6259) of the gene encoding sex hormone–binding globulin were genotyped and serum levels of sex hormone–binding globulin, testosterone and estradiol were measured by ELISA; Our results showed significant decrease in sex hormone binding globulins in type 2 diabetic patients compared with the control group. Carrier of variant allele of SHBG single nucleotide polymorphism (SNP) rs6259 had a higher level of SHBG in serum (p=0.000) While carrier of SHBG rs6257 SNP had a lower level of SHBG level in serum SHBG gene polymorphisms are associated with risk of type 2 diabetes in Egyptian men, through lowering circulating levels of sex hormone–binding globulin and consequently lowering testosterone and elevating estradiol level. SHBG rs6257 genotype may have a predictive value of developing type II diabetes mellitus
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
7
https://zumj.journals.ekb.eg/article_4339_b75ecec62ce3df95517d0674b701f995.pdf
dx.doi.org/10.21608/zumj.2014.4339
GENE POLYMORPHISM OF TRANSFORMING GROWTH FACTOR BETA-1 (TGF-Β1) AND ITS LEVEL IN RHEUMATOID ARTHRITIS PATIENTS ASSOCIATED WITH OSTEOPOROSIS DISEASE
Gina
Said
Biochemistry Department, Faculty of Pharmacy, Zagazig University, Egypt
,Biochemistry Department, Faculty of Pharmacy, MSA University, Egypt
author
Youssri
Hussein
Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Egypt
author
Hoda
El-Sayed
Biochemistry Department, Faculty of Pharmacy, Zagazig University, Egypt
author
Mervat
Askar
Biochemistry Department, Faculty of Pharmacy, Zagazig University, Egypt
author
text
article
2014
eng
Objective: The imbalance between pro-inflammatory and anti-inflammatory cytokines is a feature of rheumatoid arthritis (RA). The role of transforming growth factor beta-1 (TGF- β1) and its receptor in the pathogenesis of RA is conflicting. We aim to investigate the role of polymorphisms in the gene in susceptibility and severity of RA and osteoporosis.Methods: Eighty-six RA patients and eighty-four control were enrolled in the study.Genotyping of TGF- β1 T/C869 and TGF- β1 G/A800 was determined by restriction fragment length polymorphism-polymerase chain reaction (PCR-RFLP).Results: Subjects carrying T allele of TGF- β1 T/C869 genotype were significantly more likely to have osteoporosis than subjects carrying C allele (OR:6.95, 95% CI: 2.7-15.7, P: 0.001).Also, Subjects with A allele of TGF- β1 G/A800 genotype were significantly more likely to have osteoporosis (OR: 1.13, 95% CI: 1.05-1.2, P: 0.001).Conclusion: T/C869 genotype and G/A800 genotype of TGF-β1 gene affecting on severity of RA and have the ability to develop the risk to osteoporosis in patients carrying T allele and A allele of T/C869 and G/A800 gene polymorphism respectively
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
8
https://zumj.journals.ekb.eg/article_4340_5c44aabf1a2bfd72670985f49ab2de7d.pdf
dx.doi.org/10.21608/zumj.2014.4340
18F-FDG SYNTHESIS AND QUALITY CONTROL AND COST EFFECTIVENESS IN NUCLEAR MEDICINE CENTER IN KHMC*
Ala
Khwaj
NM unit KHMC,King Hussien Medical Center
author
Faisal
Al Obied
King Hussien Medical Center
author
Samer
Ofeshat
King Hussien Medical Center
author
Amjad
Yazjeen
King Hussien Medical Center
author
Farah
rehab
King Hussien Medical Center
author
Qusai
Migdadi
King Hussien Medical Center
author
Noorhan
Al Mahasees
NM unit KHMC
King Hussien Medical Center
author
text
article
2014
eng
The most widely used radiopharmaceutical in the expanding medical imaging technology of Positron Emission Tomography (PET) is 2-[18F]fluoro-2-deoxy-D-glucose (18FDG). The increasing demand for 18FDG requires reliable production in large amountsIn this article we will covers the fludeoxyglucose (18F-FDG) synthesis and quality control procedures and the cost effectiveness in KHMC with emphasis on practical synthesis currently; 18F-FDG is the most successful PET radiopharmaceutical so far.It's started in Royal Medical Services in 2003 the advancement in synthesis and quality control of 18F-FDG, together with its approval by the US FDA and the availability of reimbursement, are probably the main reasons for the florin of clinical PET over the last 20 years. 18F-FDG can be synthesized by either electrophonic fluorination or nucleophilic fluorination reaction. Nucleophilic fluorination using mannose triflate as precursor and Kryptofix or tetrabutylammonium salts (TBA) is widely used because of higher yield and shorter reaction time.The quality control requirements of 18F-FDG can be found in United States Pharmacopeia (USP), British Pharmacopeia (BP), European Pharmacopeia (EP) and the Chemistry, Manufacturing, and Controls (CMC) section from United States Food and Drug Administration (US FDA) PET draft guidance documents. Basic requirements include radionuclide identity, radiochemical purity, chemical purity, pH, residual solvent, sterility, and bacterial endotoxin level. Some of these tests (sterility, endotoxins and radionuclide purity) can be accomplished after the 18F-FDG has been released..
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
8
https://zumj.journals.ekb.eg/article_4341_a99739d8fbf54e44d6ca87a75a5aac18.pdf
dx.doi.org/10.21608/zumj.2014.4341
MALARIA TREATMENT VS. MALARIA PROPHYLAXIS : A COST COMPARISON.
Mutazbellah
Alzubi
author
Alaa
Alabbadi
author
Mahdi
Alfarhan
author
Wafaa
Abujamaah
author
Amal
Aljariri
author
Samerv
A lefeshat
author
Ola
Aldhmoor
author
text
article
2014
eng
Aim This research aims to evaluate the cost of using drugs to combat an established infection as compared with drugs used for prophylactic purposes. And this aim was achieved by using the following objective which was: (i) To estimate the cost of using anti-malarial drugs as treatment compared to using them as prophylaxis.Methods The study used 142 subjects (n=142) who had travelled to Liberia for six months to work among the Jordanian Level III Hospital within the United Nations Mission in Liberia (UNMIL). This is a malarious area, so the participants have to take prophylactic medicine, or they will be at risk of acquiring malaria. The prophylactic medicines that have been taken by the participants cost the RMS a particular value (Cost 1), In contrast those who acquired malaria will need treatment and hospitalization and this will incur on the RMS another different set of costs (Cost 2). A questionnaire was distributed among the participants to collect the data needed. In addition, data was collected from the records of the financial offices in the hospitals of Royal Medical Services (RMS) where the malarious patients were treated.Results From the 142 participants, 52.1% used Mefloquine for prophylaxis in comparison with Doxycycline which was used by 29.6% of them, and the rest, 18.3%, used more than one prophylactic method. One case of malaria infection occurred during the study period and it was diagnosed as Severe Falciparum Malaria (SFM). The patient answered that he didn’t use any prophylactic medication, Cost 1 and Cost 2 evaluated and found to be £10189.00 and £1220.00 respectively.Conclusion The study showed much less cost when using these drugs for prophylaxis by 94% per capita comparing with the cost of treating one case of Severe Falciparum Malaria (SFM).
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
11
https://zumj.journals.ekb.eg/article_4342_b53611b850f30d07e795986760ad3da2.pdf
dx.doi.org/10.21608/zumj.2014.4342
PREDICTION OF CORONARY ARTERY DISEASE BY DETECTION OF POSITIVE ISOVOLUMIC RELAXATION VELOCITY IN PATIENTS WITH NORMAL RESTING WALL MOTIONS "A Tissue Doppler Echocardiographic Study"
Abdelfattah
Frer
Cardiology Department, Faculty of Medicine, Zagazig University.
author
Magdy
Abdelsamie
Cardiology Department, Faculty of Medicine, Zagazig University.
author
Maha
Elsebaie
Cardiology Department, Faculty of Medicine, Zagazig University
author
Ahmed
Eldamanhory
Cardiology Department, Faculty of Medicine, Zagazig University
author
text
article
2014
eng
Background: Diagnosis of coronary artery disease (CAD) is of importance in the contemporary society of ever-increasing CAD (1,2). Isovolumic relaxation velocity (VIR), Postsystolic motion or postsystolic shortening (PSS) is a delayed ejection motion of the myocardium occurring after the aortic valve closure during a generally prolonged isovolumic relaxation time, which is related with myocardial ischemia in human(3,4) and in experimental studies(5). Spectral tissue Doppler imaging (TDI) is a simple echocardiographic technique that can provide velocity measurement of the myocardial segments(6). A positive myocardial velocity during isovolumic relaxation phase (VIR) detected by TDI, which corresponds to postsystolic motion or PSS, has been shown to indicate severely ischemic myocardium(8). So, detection of positive VIR by spectral TDI may be used as a noninvasive, nonprovocative method to predict possible CAD; specially for those with coexisting morbidities, such as peripheral artery disease in the lower limb, orthopedic diseases. Aim of the work: Diagnostic value of positive myocardial velocity during isovolumic relaxation phase (VIR) by spectral TDI in prediction of CAD in patients with typical ischemic chest pain and normal resting wall motions. Patients and methods: This study was done in Cardiology department, Zagazig University on 80 patients; 41 females (51%) & 39 males (49%)) with typical ischemic chest pain and no regional wall motion abnormalities detected by resting echocardiography. Patients were divided into 2 groups according to presence of significant coronary artery lesion by coronary angiography; group A (patients with CAD) and group B (patients without CAD). All the following parameters were measured by TDI; 5 peak velocities during; Isovolumic contraction phase (VIC), Systolic ejection phase (S'), Early diastolic relaxation phase (Em), Atrial contraction phase (Am) and Isovolumic relaxation phase (VIR) if present and VIR time. Then coronary angiography was done for all patients. Results: As regard to presence of VIR velocity, there was significant difference (<0.05) between group A and group B at mid septal and anterior walls, highly significant difference (<0.001) at basal septal and anterior walls. There was highly significant difference between group A and B at mid and basal lateral and inferior walls. There was highly significant correlation between coronary angiography and VIR velocity regarding detection of positive and negative cases and also there was highly significant correlation between previous 2 tests by Kappa test p value (<0.001). Conclusion: Positive VIR detected by spectral tissue Doppler imaging is a useful indicator of CAD in patients with apparently normal left ventricular contraction and chest pain.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
8
https://zumj.journals.ekb.eg/article_4346_81528b07f9229900c3a95dd3df435950.pdf
dx.doi.org/10.21608/zumj.2014.4346
CORONARY ARTERY DISEASE AND SEGMENTAL ISOVOLUMIC RELAXATION PATTERNS- WHAT IS THE RELATION?
Tarek
Abd El-Aziz
Cardiology Departments. Zagazig university hospitals. Faculty of Medicine, Zagazig. Egypt.
author
Ibtesam
El-Dosouky
Cardiology Departments. Zagazig university hospitals. Faculty of Medicine, Zagazig. Egypt.
author
Mohammad
Al-Daydamony,
Cardiology Departments. Zagazig university hospitals. Faculty of Medicine, Zagazig. Egypt
author
text
article
2014
eng
Background: Some segments relax with the early diastolic peak velocity lying in the isovolumic relaxation period. Its significance for prediction of coronary artery disease has not been fully elucidated. So we aimed to elucidate if the presence of abnormal isovolumic relaxation velocities can add a value to predict presence of significant coronary artery disease.Methods: This study included 100consecutive subjects; 60 subjects with coronary artery disease (CAD), 40 normal subjects as a control group. Echocardiographic evaluation of: wall motion abnormalities, transmitral; E and A-velocities & E/A ratio. Tissue-Doppler study of the isovolumic relaxation velocities detected in the four basal segments. Patients with CAD were divided into; group I with significant CAD, group II with non significant CAD, the control group represents group III. Collected data underwent statistical analysis.Result: post systolic shortening (PSS) was more frequent in the ischemic myocardium; with high specificity (92.5%) and good positive predictive value (86.6%) in detecting segments with significant coronary stenosis. The incidence of occurrence of peak early diastolic velocity (PVIVR) is more in patients with non significant CAD; it has good specificity (86.2%) for detection of any degree of coronary stenosis.Conclusion: The presence of abnormal isovolumic relaxation velocities could be considered as a good positive test for prediction of CAD.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
6
https://zumj.journals.ekb.eg/article_4347_422843ea166c027507f5b1d8911120e1.pdf
dx.doi.org/10.21608/zumj.2014.4347
SERUM LEVELS OF ADIPOCYTE FATTY ACID BINDING PROTEIN 4 AND RETINOL BINDING PROTEIN 4 AS BIOMARKERS FOR EARLY DETECTION OF DIABETIC NEPHROPATHY IN TYPE 2 DIABETES
Essam
Amin
Internal Medicine and Clinical Pathology* Departments, Faculty of Medicine,
Zagazig University Hospital
author
Ezzat
Saad
Internal Medicine and Clinical Pathology* Departments, Faculty of Medicine,
Zagazig University Hospital
author
Hala
Allam
Internal Medicine and Clinical Pathology* Departments, Faculty of Medicine,
Zagazig University Hospital
author
Amal
Zidan
Internal Medicine and Clinical Pathology* Departments, Faculty of Medicine,
Zagazig University Hospital
author
text
article
2014
eng
Background: Adipocyte fatty acid binding protein 4(A-FABP4) and retinol binding protein 4(RBP4) are recently discovered adipokines, which are members of lipocalin family. Both adipokines have been proposed to be important markers for metabolic syndrome and diabetes mellitus . Diabetic nephropathy is a leading cause of chronic kidney disease in patient starting renal replacement therapy and is associated with increased cardiovascular mortality . Objective: To study serum A-FABP4 and RBP4 levels in patients with type 2 DM with different stages of diabetic nephropathy and to investigate whether serum A-FABP4 and RBP4 could be used as biomarkers-in single or combination-for early detection of diabetic nephropathy.Subjects and methods: 60 subjects were included in this study ,they were divided into six groups according urinary albumin excretion(UAE) and glomerular filtration rate (GFR) Group 1 (Control group) consists of 10 patients who are normo-albuminuric with normal GFR . Group 2 consists of 10 patients who are normoalbuminuric with increased GFR>120 Group 3 consists of 10 patients who are microalbuminuric i.e. UAE 30-300 mg/day. Group 4 consists of 10 patients who are macroalbuminuric i.e. UAE ≥ 300 mg/day without renal impairment (normal creatinine and GFR > 90 ml/min/1.73m²). Group 5 consists of 10 patients who are macroalbuminuric with renal impairment and declining GFR <90 ml/min/1.73m². Group 6 consists of 10 patients who are end-stage renal disease (GFR <15 ml/min/1.73m²). Measurement of serum AFABP4 , serum RBP4 , UAE, GFR were done for every subjectResults: There was significant increase in the serum level of AFABP4 and RBP4 among different stages of diabetic nephropathy and there was significant difference between microalbuminuric group and normoalbuminuric group so both biomarkers can be used for early detection of diabetic nephropathy. Both AFABP4 and RBP4 correlated positively with UAE and negatively with GFR. Conclusion: High circulating AFABP4 and RBP4 concentrations were demonstrated in early diabetic nephropathy in type 2 DM. AFABP4 and RBP4 increased significantly with the progression of diabetic nephropathy. Large scale multicenter and prospective studies are necessary to gather a definitive support that these adipokines might be directly involved in early detection of diabetic nephropathy and in impairment of kidney function in type 2 DM.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
12
https://zumj.journals.ekb.eg/article_4348_075109452619e0ecd424dc526214745a.pdf
dx.doi.org/10.21608/zumj.2014.4348
INCIDENCE OF DEEP VENOUS THROMBOSIS IN STROKE PATIENTS IN MEDICAL INTENSIVE CARE UNIT ZAGAZIG UNIVERSITY HOSPITALS, EGYPT.
Abdulla
Abdel-Aziz
Internal Medicine and Radiology Departments, Zagazig University Hospitals
author
Magdy
Elfawwal
Internal Medicine and Radiology Departments, Zagazig University Hospitals
author
text
article
2014
eng
Background and Purpose: Venous thromboembolism(VTE) is a leading cause of morbidity and mortality during the acute recovery period after stroke. This study was designed to study the incidence of deep venous thrombosis (DVT) in acute stroke patients & determine the risk factors contributing to development of DVT in these patients.Patients &Methods: 280 patients, admitted because of acute stroke, were enrolled in this study. All patients were examined by Doppler ultrasonography (DUS) of the four limbs at one and two weeks after admission for possibility of DVT . If the patients was suspected to have DVT before or after this time (limb swelling, local pain or tenderness) DUS of the affected limb was done. We performed D-dimer assay level and considered it as an important marker for DVT suspicion. Other co-morbidities, type of stroke and their relation to DVT development were investigated. Data were collected, entered and checked using SPSS software version 17. Univariate and multivariate analysis of data were done to determine important predictor risk factors for DVT development in stroke patientResults: 25 out of 280 patients(8.93%) developed DVT during their stay in intensive care unit (ICU) as a complication of acute stroke. DVT affected mainly the paralyzed limb and was mainly distal and occurred mostly after 2 weeks of admission. Patients complicated with DVT were characterized by being older and having higher percentage of smokers with no impact of gender. Multivariate regression analysis identified atrial fibrillation (AF) and intracerebral hemorrhage (ICH) as independent risk factors for early stroke related DVT (p=0.002 & p=0.025 respectively).Conclusions: Incidence of DVT as a complication of stroke was 8.93 %. AF and ICH were determined as predictors and independent risk factors for development of DVT poststroke.We recommend to follow the international guidelines for DVT prophylaxis .
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
9
https://zumj.journals.ekb.eg/article_4349_5855d1034c50f928ccadc9384e6d656c.pdf
dx.doi.org/10.21608/zumj.2014.4349
NON-INVASIVE POSITIVE PRESSURE VENTILATION VERSUS CONVENTIONAL OXYGEN THERAPY AFTER EXTUBATION IN PATIENTS WITH HYPERCAPNIC RESPIRATORY INSUFFICIENCY
Rabieh
Hussein
Chest Department, Faculty of Medicine, Zagazig University, Egypt
author
Mohammed
M
Chest Department, Faculty of Medicine, Zagazig University, Egypt
author
Mohammed
El-Gammal
Chest Department, Faculty of Medicine, Zagazig University, Egypt.
author
Niveen
Zayed
Chest Department, Faculty of Medicine, Zagazig University, Egypt.
author
text
article
2014
eng
The need of reintubation after extubation and discontinuation of mechanical ventilation (MV) is not uncommon and is associated with increased morbidity and mortality. Non invasive positive pressure ventilation (NIPPV) has been suggested as promising therapy to avoid respiratory failure after extubation. The aim of this work is to study the effectiveness of NIPPV compared to conventional oxygen therapy after planned extubation on the rate of reintubation as well as weaning outcome in patients with hypercapnic respiratory insufficiency. Patients and methods: This study was carried out at Chest Department, Zagazig University Hospitals during the period from September 2011 to August 2013. The study included 100 invasively mechanically ventilated patients with hypercapnic respiratory failure (69 males and 31 females). According to the applied therapy after extubation, the patients were randomly classified into two equal groups, Group I received NIPPV and GroupII received conventional oxygen therapy after extubation.Results: The rate of reintubation in group I (18%) was significantly lower than in group II (38%). The mortality rate in group I (8%) was significantly lower than in group II (24%). After extubation, the duration of ICU stay in group I (3.48 ± 1.4 days) was significantly shorter than in group II (4.4 ± 1.32 days) but no significant difference between the stay duration in general medical floor of both groups. The rate of occurrence of the various therapy related complications (tracheotomy, postextubation stridor, VAP, arrhythmias and heamodynamic affection) was significantly lower in group I than in group II. Gastric distention (22%) and mask related complications (20%) occurred only in group I patients.Conclusions: The use of NIPPV immediately after extubation in patients with hypercapnic respiratory insufficiency can decrease reintubation and mortality rate, duration of ICU stay and the rate of occurrence of the various therapy related complications especially tracheostomy and VAP.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
8
https://zumj.journals.ekb.eg/article_4350_5d116f2aa51ec9e02d0e6495253c60e5.pdf
dx.doi.org/10.21608/zumj.2014.4350
ENDOVASCULAR EMBOLIZATION OF CEREBRAL ARTERIOVENOUS MALFORMATIONS
Sarhan
AA
Neurology Department, Faculty of Medicine, Zagazig and Al-Azhar* Universities
author
Aidaros
MA
Neurology Department, Faculty of Medicine, Zagazig and Al-Azhar* Universities
author
Sobh
KM
Neurology Department, Faculty of Medicine, Zagazig and Al-Azhar* Universities
author
El-Serafy
TSS
Neurology Department, Faculty of Medicine, Zagazig and Al-Azhar* Universities
author
text
article
2014
eng
Background: An arteriovenous malformation is a collection of dysplsatic plexiform vessels that is supplied by one or more arterial feeders and drained by one or more venous channels. Arteriovenous malformations may have a pure plexiform nidus or contain a mixed plexiform fistulous nidus. Objective: This work was carried out to evaluate the clinical outcome and effectiveness of the endovascular treatment of cerebral arteriovenous malformations with ethylene vinyl alcohol copolymer (Onyx). Methods: Twenty five patients (14 males and 11 females) with cerebral arteriovenous malformations were treated by embolization with Onyx at the Neurointervention Unit in Al-Azhar University. All patients with intracranial AVMs were subjected to preprocedural, procedural and postprocedural assessments. Result(s): There was significant difference in nidus diameter in all patients after embolization in comparison to before embolization. There was significant difference in Spetzler and Martin grading system before and after embolization. Conclusion(s): Onyx as a new embolic material, with its non-adherent properties has significantly facilitated this development.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
7
https://zumj.journals.ekb.eg/article_4351_4511429965eee0c24a8994388e9c5459.pdf
dx.doi.org/10.21608/zumj.2014.4351
DETERMINATION OF THE CORRELATION BETWEEN THE SEVERITY OF OBSTRUCTIVE SLEEP APNEA AND PRIMARY HYPERTENSION BY USING ACOUSTIC PHARYNGOMETRY
Samer
Badee
Department of otorhinolaryngology, Faculty of medicine ,
Benha University, Egypt
author
Naslshah
Kazem
Department of otorhinolaryngology, Faculty of medicine ,Benha University, Egypt
author
Hesham
Khalid
Department of Cardiology, Faculty of medicine , Benha University, Egypt
author
text
article
2014
eng
Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive partial and total collapse of the upper airway that induces stressful arousals throughout sleep to reestablish breathing. Hypertension was more frequently seen in patients with OSAS than in patients without OSAS and hypertension frequency increased in parallel to the severity of OSAS .The goal of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea syndrome is to reduce obstruction by eliminating redundant tissue in three areas: soft palate, tonsils and pharynx . Objective: The aim of this prospective study was to determine the relationship between the severity of OSA and primary hypertension by using acoustic pharyngometry pre and post uvulopalatopharyngoplasty.Study design: A prospective comparative study.Subjects and methods: 50 patients with both OSA and primary hypertension examined and investigated with acoustic pharyngometer, then operated up on with UPPP and reassessed for their blood pressure and acoustic pharyngometer after 3 months from the operation in comparson with 10 normal individuals.Results: The results 3 months after UPPP showed that the total number of cured and improved cases by acoustic pharyngometery were 9 & 23 cases (18% & 46%) & cases of pimary hypertension cured & improved were 8 & 40 cases that represented 16% & 40% respectively Conclusion:The severity of OSA can be determined objectively by using acoustic pharyngometry and blood pressure in the sleep apnea patients might gradually decreased after UPPP surgery
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
7
https://zumj.journals.ekb.eg/article_4352_ef1b34d3d690f8d5f175b88b4b7f64c5.pdf
dx.doi.org/10.21608/zumj.2014.4352
STUDYING THE EVIDENCE OF COMPLEXITY OF INTERACTION BETWEEN ENVIRONMENTAL, OCCUPATIONAL AND HOST CANCER RISK FACTORS IN AN AREA WITH SUSPECTED CANCER CLUSTER IN EGYPT
Mona
Abou El khair
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Egypt
author
Marwa
zalat
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Egypt
author
Ghada
Salem
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Egypt
author
Marwa
Awad Allah
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2014
eng
Background: Cancer is a generic term for a large group of diseases that can affect any part of the body with rapid creation of abnormal cells that grow beyond their usual boundaries, and can metastasize. The aim of this study was to explore the feature of the problem of cancer among Wady El Mollak citizens to add to research a new study in the field; to determine possible risk factors which may be responsible for horrible problem and the objectives were to assess the magnitude of the problem; to identifying the possible risk factors through comparing with comparable area. Subjects and Methods: Multi method research including case control study and ecological study were conducted at El-Mollak village in Sharkia Governorate, in November 2012. Cases of cancer were sixteen (N=16) at El Mollak village, their features were studied and matched, control group (N=16) selected randomly from a nearby village where no symptoms of cancer. A pre-coded pre-constructed questionnaire was used to collect the relevant data from cases and their controls. The ecological part of this study was done through searching the environmental risk factors and linking them to the cases and through reviewing the results of samples taken from water canal, tap water and soil of El Mollak village. Results: It was found that farming occupational exposure and pesticides exposure are statistically significant in the case group. Eating fish is statistically higher among cases than among controls. Environmental factors including; trench waste disposal, living near electrical fields and military croups are highly statistically significant among cases than among controls (P< 0.01). Presence of relatives with similar cancer or other cancers are statistically significant in the cases group. Conclusions and Recommendations: Cancer risk results from different complex interaction of host factors with environmental and occupational exposure. So need exists to revitalize comprehensive global cancer control policies by incorporating primary interventions against the modifiable cancer risk factors.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
9
https://zumj.journals.ekb.eg/article_4353_bcbdcdd1b17c2633cf33bd4f97fe9f79.pdf
dx.doi.org/10.21608/zumj.2014.4353
SYMPTOMATIC NONUNION AFTER FRACTURE CLAVICLE, WHAT IS THE FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION WITH A CURVED RECONSTRUCTION PLATE?
Mohamed
Elzohairy
Lecturer of Orthopaedic Surgery,Faculty of medicine, Zagazig University.Egypt
author
text
article
2014
eng
Background: Although fracture mid shaft clavicle always united with a good functional outcome, nonunion of fracture clavicle always leads to impaired shoulder joint functions with a significant disability that can cause poor functional outcome and limitations of shoulder joint activities due to pain and stiffness. Materials and Methods: From July 2005 through October 2011, twenty (20) patients (13 males and 7 females) were suffering from symptomatic nonunion of the mid-shaft clavicle (no union for more than three months). They had treated operatively in 14 patients who had suffered from the atrophic nonunion by using a curved reconstruction plate and autologous iliac bone grafting and in six patients with hypertrophic nonunion of mid-shaft clavicle fracture by using a curved reconstruction plate and “local bone grafting” from local callus, bone chips. The American Academy of Orthopedic Surgeons (AAOS) disabilities of the arm, shoulder and hand (DASH) questionnaire was used for the outcome results evaluation. Results: The patients were followed-up for an average of 15 months (range from one year to four years). All fractures were united within three months. The preoperative DASH score was varied from 80 to 70, mean (75). The postoperative DASH score was varied from, 10 to 25, mean (12.7) in our series. Functionally, this was very much acceptable. Conclusion: Based on the results of our and other studies, we recommended open reduction and internal fixation with using a curved reconstruction plate and autologous iliac bone grafting in patients whom suffering from the atrophic nonunion. For treating patients whom suffering from hypertrophic nonunion of mid-shaft clavicle fracture we recommended using a curved reconstruction plate and local bone graft as a sufficient procedure to achieve necessary union, and autologous bone graft from other sites of the body appears to be unnecessary. This successful procedure had a good functional outcome and most of the patients had promising results, as regard to return to a near normal level of function.
Zagazig University Medical Journal
Zagazig University, Faculty of Medicine
1110-1431
20
v.
1
no.
2014
1
7
https://zumj.journals.ekb.eg/article_4354_e3af6196432d89e0be871e8c08741ab7.pdf
dx.doi.org/10.21608/zumj.2014.4354