@article { author = {elghamry, esraa and seleim, heba and yossef, manal and mortada, mohamed}, title = {Ultrasonography features of salivary gland in patients with rheumatoid arthritis and secondary Sjogren syndrome}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {826-831}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.14698.1331}, abstract = {The aim of this study was to detect the ultrasonographic features of salivary glands in patients with rheumatoid arthritis and secondary Sjogren Methods: This cross sectional study was carried out in Rheumatology and Rehabilitation department, Faculty of Medicine, Zagazig University Hospitals. All paitents included were evaluated by clinical examination and salivary gland ultrasonography. . Results 68 patients were included in our study ,most of them were female 88.3% .Disease duration was 9.31±2.4 . The median value for disease activity (DAS28) was 2.5, ESR median value was 30 .RF median value was 16. CRP median value was 18, Anti CCP median value was 19.5.Ultrasonographic of salivary glands in the included patients shows hypoechoic areas in (67.6%) of right parotid gland(PG), (47%) of left PG , (48.5%)of right submandibular gland(SMG), (44%) left SMG. (88.2%)of PG showed heterogenic areas, (82.3%)of left PG, (41.1%) of right SMG, (73.5%) of left SMG. Hyperechoic bands were detected in (80.8%)of right PG, (85.2%)of left PG, (42.6%)of right SMG, (48.5%)of left SMG. fatty infiltrations were noticed in (10.2%) of right PG, (11.7%)of left PG (20.5%)of right SMG, (39.7%) of left SMG. calcifications were identified in (4.4%) of right PG, and (8.8%)of left PG, (4.4%) of right SMG, (2.9%) of left SMG. The posterior border was visible in (57.3%)of right PG, and (48.5%)of left PG, (89.7%)of right SMG, (88.2%) of left SMG. There is no significant correlation between disease activity and Ultrasonographic features of salivary glands in patients with rheumatoid arthritis and secondary Sjogren.}, keywords = {sjogren’s syndrome,Musculoskeletal ultrasound,Rheumatoid Arthritis}, url = {https://zumj.journals.ekb.eg/article_44854.html}, eprint = {https://zumj.journals.ekb.eg/article_44854_1ac1a59eab60ae11de1be44935d11955.pdf} } @article { author = {EL Saadawy, mohammed and ghoneim, Salwa and gad, marwa and Farid, Omar}, title = {The Short-term Impact of Percutaneous Device Closure of Secundum Atrial Septal Defects on P wave dispersion and Atrial Electromechanical Delay.}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {839-846}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15221.1368}, abstract = {Background: In patients with ASDs There’re significant LA remodeling as result of chronic LA stretch and dilatation which occurs in addition to the longstanding right atrial volume overload. These structural changes result in electromechanical and electrophysiological changes. The prolonged atrial electromechanical delay also the non-hemogenous spread of sinus impulse which represented as dispersion in P wave duration are considered electrophysiological characteristics atrial fibrillation.Aim: to compare atrial electromechanical delay by means of tissue doppler echocardiography and P wave dispersion on surface ECG before and three months after transcatheter ASD closure.Patients and methods: we prospectively evaluated the short-term effect of transcatheter closure of secundum ASD patients on electromechanical delay by tissue doppler echocardiography and on P wave dispersion by surface ECG. Results: There was significant increase in LVEDD and LVESD after device closure (P value}, keywords = {Device closure,P wave dispersion,Tissue Doppler,Electromechanical Delay}, url = {https://zumj.journals.ekb.eg/article_45120.html}, eprint = {} } @article { author = {Seada, Sara and Mansour, Sherif and Asalah, Ali and Hasan, Mai}, title = {Serum Adropin Levels in Isoproterenol-induced Myocardial Infarction in Lean and Obese Male Albino Rats}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {880-894}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15838.1418}, abstract = {Background: Cardiovascular diseases such as acute myocardial infarction(AMI) are major causes of morbidity and mortality all over the world,where obesity is a major risk factor for such diseases. Adropin,which is a peptide synthesized in the heart,is suggested to be released into the bloodstream after ischaemic cardiac injury.Aim: To investigate the effect of the ISO-induced AMI in normal and obese rats on serum adropin level and to define any potential association between its level and other cardiac enzyme markers,oxidative stress markers,proinflammatory and metabolic parameters.Material and methods: Eighty seven adult male albino rats were used.Seventeen animals died and the remaining animals(70) were divided into 5main groups:control group and four ISO-induced AMI groups where blood samples and hearts were taken at 1h.,2h.,6h. and 24 h.post AMI.Each group is subdivided into lean and obese subgroups.In all groups, serum adropin,cTn-I,CK-MB,CRP,TNF-α,oxidative stress markers(MDA,SOD,GSH and catalase),lipid profile,insulin and glucose levels were measured.HOMA-IR was calculated.ECG and blood pressure were recorded. Histopathological examination of the heart was done. Results: Our results showed that serum adropin levels were increased after AMI together with cTn-I,CK-MB,CRP,TNF-α,MDA,TC,TGs and LDL-C. Adropin showed positive correlation with abovementioned parameters in all studied groups. SOD,GSH,catalase and HDL-C were decreased after AMI with negative correlation with adropin in all groups. Histopathological examination revealed edema, inflammatory cell infiltration,congestion,haemorrhage and necrosis in ISO-induced AMI.Conclusions: Serum adropin can be used as an alternative biomarker to other cardiac enzyme markers(cTn-I,CK-MB)for early diagnosis of AMI especially in cases of obesity. Key words:adropin,acute myocardial infarction,oxidative stress markers.}, keywords = {adropin,Acute myocardial infarction,Oxidative stress markers}, url = {https://zumj.journals.ekb.eg/article_45450.html}, eprint = {https://zumj.journals.ekb.eg/article_45450_bbc0f63a23ece7fd251725fcd554be1a.pdf} } @article { author = {hassan, amira and El-Menshawy, Sohair and Sekina, Ameen and Kabil, Soad and Rashed, Hayam}, title = {Protective effects of Gemfibrozil, Silymarin, and their combination on liver ischemic/reperfusion insult in rats}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {865-879}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15612.1394}, abstract = {Background: Hepatic ischemic reperfusion (I/R) injury is an inevitable critical problem occurs during resection of liver tumors, and liver transplantation. Silymarin is a herbal product widely used for its hepatoprotective effect. Gemfibrozil is a FDA-approved fibrate drug, commonly prescribed for management of dyslipidaemia.Objective: The aim of this work is to study the possible hepatoprotective effect of Silymarin, Gemfibrozil, and their combination against hepatic ischemic reperfusion injury in rats. Materials & Methods: Rats were divided into six groups: Group1: normal control; Group2: sham-operated; Group3: I/R (Rats subjected to partial hepatic ischemia for 30 minute followed by 6 h reperfusion), Group4: Silymarin pretreated group (100 mg/kg orally once daily for 14 days); Group5: Gemfibrozil pretreated group (100 mg/kg orally once daily for 14 days), and Group 6: Silymarin and Gemfibrozil- pretreated group. Serum AST and ALT, hepatic tissue MDA, SOD, GSH-Px, TNF-α, MPO, caspase-3 levels, and real-time qPCR for gene expression of IκB-α, and PI3K, and its subunits (P85: p110 α /p110 β) were measured besides liver histopathology and 8-OHdG, NF-κB (p65), and caspase immunohistochemistry. Results: I/R insult deteriorated the liver function and evoked oxidative stress, inflammation, and apoptosis. Pretreatment with Silymarin and /or Gemfibrozil improved the deteriorated liver function and the histopathological changes as well as attenuating oxidation, apoptosis and inflammatory processes. Conclusion: The combination of Gemfibrozil and Silymarin has protective effects against liver I/R in rats better than each of these drugs alone due to antioxidant, anti-inflammatory and anti-apoptotic properties of the used drugs.}, keywords = {Ischemic-reperfusion,Silymarin,Gemfibrozil}, url = {https://zumj.journals.ekb.eg/article_46338.html}, eprint = {https://zumj.journals.ekb.eg/article_46338_25d47af439acb45943cb4a29da67b6f1.pdf} } @article { author = {Hatem, Al Shaimaa and Gab~Allah, Ahmed and Ghonaim, Rania and Haggag, rasha}, title = {Prognostic Impact of microRNAs (miR-155, miR-10a, let-7a) on the Outcome of Adult Patients with Acute Myeloid Leukemia.}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {810-825}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.14277.1302}, abstract = {Background: Acute myeloid leukemia is a heterogeneous disease caused by clonal proliferation and disrupted differentiation of malignant myeloid precursors. AML can be classified based on chromosomal abnormalities, acquired somatic mutations, gene expression. Significant changes in gene transcription may lead to relapse after chemotherapy. So, assessment of the prognosis in AML is very crucial. Aim: To assess prognostic impact of miRNAs (miR-155, miR-10a, let-7a) levels using in AML patients. Method: 55 subjects were included in this work. They were classified into 2 groups: patient and control group. Patient group is further classified according to cytogenetic analysis into 3 groups: bad, intermediate & good prognosis. miRNAs (mir155, miR-10a, let7a) was assessed using real time PCR [QIAGEN, miScript, Quanti Tect and Rotor-isc (QIAGEN Group) PAXgene (pre Analytix Gmbh)]. Results: There was significant increase in miRNAs (miR-155, miR-10a, let-7a) level among cases compared to control group. There was significant increase in miR-155 level and significant decrease in miR-10 and Let-7a among bad prognosis cases compared to intermediate and good subgroups. There was significant +ve correlation between miR-155 & blast % B.M and significant -ve correlation between (miR-10a, let-7a) and blast % BM among the cases group. There was significant increase in DFS and OS among intermediate & good compared to bad subgroups. ROC curve detected the validity of (miR-155, mir10a & let7a respectively) in diagnosis of AML. Conclusion: miRNAs (miR-155, miR-10a, let-7a) expression levels were significantly higher in AML patients compared to control group and have prognostic significance in adult patients with AML.}, keywords = {miR-155,miR-10a,let-7a,miRNA & AML}, url = {https://zumj.journals.ekb.eg/article_46503.html}, eprint = {https://zumj.journals.ekb.eg/article_46503_b33f9396920be96c836eaee732a88ea4.pdf} } @article { author = {Abdel-Baset Abdel-Badea, Hala and Sherby, Nagwa Ahmed and Salah eldin, Ghada Mohamed and Abd Allah Hammad, Mohamed}, title = {Effects of Sleep Quality on Health –Related Quality of Life in Rheumatoid Arthritis Patients at Zagazig University Hospitals.}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {847-854}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15344.1374}, abstract = {Aim of the work: to study sleep quality in RA patients and its effects on health related quality of life. Subjects and methods: This study was carried out on 30 RA patients and 30 healthy controls. RA disease activity was measured by DAS-28. All patients were subjected to full history taking, clinical examination and laboratory investigations including: CBC, ESR, CRP, RF, anti-CCP antibodies, liver and kidney functions. Quality of life was evaluated by Health Assessment Questionnaire –Disability Index (HAQ-DI). Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression was evaluated by Hospital Anxiety and Depression Scale (HADS). Pain was evaluated by visual analogue scale (VAS). Results: Our study found that PSQI was higher in RA patients compared to controls without statistical significant difference. Depression and Anxiety were significantly higher compared to controls. We also found that RA patients with poor sleep had RF, Anti CCP, DAS28, ESR, CRP, depression, anxiety VAS and HAQ were significantly higher compared to good sleepers. Also, RA with a PSQI score ≥5 (poor sleepers) were significantly having DMARDs more frequently than those with good sleep. HRQoL also associated with sleep quality and its impaired was affected by physical pain or function.Conclusion: We observed that 73% of RA patients had poor sleep quality compared with healthy controls affecting their HRQoL. We found essential need for systemic psychiatric screening and management to help RA patients get rid of their sleep problems and improve their HRQoL.}, keywords = {Sleep quality,HRQoL,Rheumatoid Arthritis}, url = {https://zumj.journals.ekb.eg/article_46885.html}, eprint = {https://zumj.journals.ekb.eg/article_46885_b93108c84153de9ea8a00ba752d8827b.pdf} } @article { author = {Mahmoud Gaafer, Manar and Fahmy, Howaida and Raya, Yasser and Bahaa El Din, Rasha}, title = {Frequency and Risk Factors of Depression among Elderly at Geriatric Clubs in Zagazig City}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {992-1005}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15731.1410}, abstract = {Background: Depression is one of most prevalent disabling health problems among elderly. Aim of the study: To improve quality of life of elderly. Objectives: To assess frequency of depression among elderly (≥60) and identify its risk factors. Subjects and methods: A cross sectional study included 280 persons attending geriatric clubs in Zagazig city. Participants were asked about socio-demographic data, presence of chronic diseases, and participation in physical and social activities. Depression was measured by Geriatric Depression Scale short form (GDS-SF). Results: Prevalence of depression among the studied group was 66.1%, while 33.9% had no depression. According to severity, 61% of the depressed elderly had mild depression and 10% had severe depression. Results revealed that elderly belonging to the age group 70-75 years (63.9%), female sex (44.7%), urban residents (42.7), widowed (48.0%), and those with middle education (63.0%) were more exposed to depression than others. Also, elderly without past occupation (50.5%), those without current occupation (42.9%), and those of low social class (66.6%) had depression more than others. Lastly, elderly with minimal participation in physical activities (60.0%) and moderate participation in social (53.2%) activities, and those having chronic conditions were more prone to depression than others. Conclusion: Depression is an undiagnosed public health problem. It significantly increases with age, female sex, widowhood, urban residence, middle education, low socioeconomic level, past unemployment, and absence of current occupation. It is recommended to increase the awareness about the geriatric depression to allow early detection thus preventing its progression.}, keywords = {Key words: Depression,geriatric,Assessment,frequency}, url = {https://zumj.journals.ekb.eg/article_47319.html}, eprint = {https://zumj.journals.ekb.eg/article_47319_8eeffea92c588c35cc4c320ffd8ff3ef.pdf} } @article { author = {omar, mahmoud and Idris, Khaled and Megahed, Riad and Mohammed, Mohammed}, title = {Guided Growth for Genu Valgum Deformity in Children}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {801-809}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.14025.1280}, abstract = {Introduction: Genu valgum that develops during the childhood years may contribute to anterior knee pain, patellofemoral instability, circumduction gait, and difficulty running. Lateralization of the mechanical axis places pathologic stresses on the anterior and lateral compartments of the knee, posing the risk of accelerated degenerative changesObjective: To evaluate results of correction of genu valgum deformity in children by guided growth.Methods: The prospective study was carried out in Orthopedic Surgery Department, Beni Suef General Hospital and Orthopedic Surgery Department at Zagazig University Hospital on 12 children with genu valgum attending for guided growth using a flexible two-hole titanium plate.Results: In our study we evaluate 12 patients 3-14years old mean age 7±2.6 years old, 41.7%, 58.3% female, 58.3% unilateral, 44.7% bilateral. These 12 patients prospectively followed up for 12-32 months with average 18.3 months.Conclusion: This study has confirmed the reversible nature of growth inhibition on the physis produced by a bridging flexible titanium plate and has demonstrated its value in correcting deformities around the knee. The procedure is technically simple and has significant potential for treating genu valgum for many children without the need for osteotomy. The simplicity and cost-effectiveness of this minimally invasive technique make it an attractive alternative to more complex methods of limb deformity correction.}, keywords = {Guided growth,Genu Valgum Deformity,proximal femur,Computed tomography,Knee Ankle Foot Orthosis}, url = {https://zumj.journals.ekb.eg/article_47321.html}, eprint = {https://zumj.journals.ekb.eg/article_47321_d5285a0ca2abc7eb8788a0ea0bd0237b.pdf} } @article { author = {Ragab, Salma and Sarhan, AbdAllah and El Sayed, Dorriya and Lotfy, Sabah and Zidan, Amal}, title = {SERUM LACTATE AS A BIOMARKER IN MULTIPLE SCLEROSIS}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {832-838}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.14966.1352}, abstract = {Abstract Background: Multiple sclerosis (MS) is an inflammatory demyelinating disease of central nervous system with secondary progressive neurodegenerative changes lead to accumulation of disability. The important role of mitochondrial dysfunction has been reported in the pathogenesis of MS.Objective: To investigate the serum lactate level in MS and to explore the prognostic value of lactate regarding disability and progression Methods: This case-control study was conducted on 80 Egyptian subjects; 40 MS patients and 40 normal healthy individuals. Patients were subjected to detailed history taking, thorough neurological examination and clinical assessment of the disability using Expanded Disability Status Scale (EDSS(.Serum level of lactate was measured in both groups. Results: In comparison to control, serum lactate level was significantly higher among MS patients. There was no significant correlation between serum lactate level and any clinical variants apart from age and age of onset of MS. Conclusion: Measurement of serum lactate may be helpful in MS and this support the hypothesis of the critical role of mitochondrial dysfunction and axonal damage in MS. Our study recommend future researches on large cohort of MS patients to assess long term prognosis in patients with elevated lactate levels .In addition , we recommend measurement of lactate in cerebrospinal fluid of MS patients to evaluate its clinical significance as a biomarker in MS..}, keywords = {Multiple sclerosis,Lactate,EDSS,Mitochondrial dysfunction}, url = {https://zumj.journals.ekb.eg/article_47701.html}, eprint = {https://zumj.journals.ekb.eg/article_47701_7aaa603ff89beeee36e57e308d90a0ae.pdf} } @article { author = {salem, Ibrahim and Ghoniem, Salwa and kandil, nader and soliman, mohammed}, title = {Tissue Doppler Echocardiographic Evaluation of Myocardial Function after Uncomplicated Coronary Artery By pass Grafting Operation.}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {895-902}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.16098.1437}, abstract = {ABSTRACTBackground: CABG operation may affect myocardial function by inducing stunning.Objective: evaluation whether myocardial function is affected by CABG in patients with preserved function.Methods: : LV function evaluated by LVEF ,LV dimensions ,LA and Aortic root dimension ,Doppler mitral inflow velocities E and A waves and pulsed wave tissue Doppler of mitral annulus.RV function evaluated by tricuspid annular plane systolic excursion, tricuspid valve inflow E and A waves, tissue Doppler echocardiography at the lateral side of the tricuspid annulus and myocardial Performance Index of RVResults: Forty patients underwent CABG were included. 18 underwent conventional CABG , while 22 underwent off-pump surgery . Systolic LV function was not statistically significantly affected by CABG . LV diastolic function improved post CABG. Regarding RV function, IMP improved (i.e. values decreased) significantly when comparing the values from before CABG to after CABG. RV systolic function measured via TAPSE was significantly reduced 5 days after CABG and remained so three months postoperatively, and by using TDI systolic and diastolic RV function deteriorated post CABG.reduced TAPSE&RV S՝ with improved RIMP may indicate reduced regional RV function rather than reduced global function..Conclusion: LV function did not deteriorate after CABG in patients with preserved preoperative systolic function. LV diastolic function improved after CABG. RV function reduced post CABG using TAPSE &TDI and improved using RIMPKeywords: : Coronary artery bypass grafting ; Tissue Doppler echocardiography; Cardiopulmonary bypass; off-pump surgery.}, keywords = {Coronary artery bypass grafting,Tissue Doppler echocardiography,Cardiopulmonary bypass}, url = {https://zumj.journals.ekb.eg/article_48143.html}, eprint = {https://zumj.journals.ekb.eg/article_48143_87a913d1330f718b44a7938b1d329cd9.pdf} } @article { author = {EL-sayed, Yassmen and Fahmy, Nabila and Khattab, Monira and Kabil, Soad and ElKashishy, Kamal}, title = {Beneficial effects of sitagliptin ,metformin and their combination on myocardial ischemic and vascular changes in type-two diabetic rats}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {909-923}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.16166.1448}, abstract = {Background: Myocardial infarction is a critical complication frequently occurs with type2diabetes mellitus. Sitagliptin is antidiabetic drug inhibits DPP-4,which augments endogenous levels of GLP-1.Metformin is an FDA-approved antidiabetic drug, which commonly prescribed for management ofT2DM.Objectives: Is to investigate the possible beneficial effects of sitagliptin, metformin, and their combination on myocardial ischemic and vascular changes in T2Drats and possible mechanisms underlying this effects Methods: Adult male albino rats were used in this study and randomly divided into control normal group, control diabetic group , sham diabetic group and diabetic with induction of MI group. Diabetic rats with MI were divided into the following treated subgroups: Oral Sitagliptin (300 mg/kg/day),Metformin(120mg/kg/day)and Combined metformin sitagliptin treated subgroups for6weeks. bl gl level, serum TG and LDL levels, markers of oxidative stress(vascular MDA and cardiac SOD levels),inflammation marker(plasmaIL6),and plasma CK-MB were measured. Hematoxylin and Eosin stained sections of cardiac tissue were examined. vascular reactivity of thoracic aortas were measured. Results:DMT2with induction of MI evoked oxidative stress, inflammation, as well as histopathological derangements in cardiac tissue and decrease vascular reactivity. Treatment with sitagliptin , metformin and their combination improved the cardiac histopathological changes and vascular reactivity. as well as attenuating the oxidative stress and inflammatory processes Conclusion: Sitagliptin has beneficial protective effects against myocardial ischemic changes induced in T2Drats but combined administration of metformin sitagliptin was superior to each drug alone in cardiovascular protection effects. This protective effects of sitagliptin may be due to its anti-inflammatory and antioxidant potentials.}, keywords = {Metformin,Sitagliptin,Diabetes mellitus}, url = {https://zumj.journals.ekb.eg/article_48901.html}, eprint = {https://zumj.journals.ekb.eg/article_48901_c519b2ad89208d1694c085b797a57d16.pdf} } @article { author = {Zayed, Amany and kamel, elsayed and abdelsamee, ahmed and abdullah, doaa}, title = {Comparison between the analgesic effect of Tizanidine, Diclofenac and Gabapbentin on experimentally induced acute and chronic pain in male albino rats}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {855-864}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.15421.1381}, abstract = {AbstractBackground: Pain is an unpleasant sensation experienced when tissues are damaged. Therapeutic management of pain requires consideration of many factors due multiplicity of etiopathogenesis. Objectives: The present study was designed to assess and compare the analgesic effects of gabapentin, diclofenac and tizanidine as well as their combinations in acute and chronic pain. Methods: 128 rats were randomly allocated into two main equal categories; one for acute inflammatory and other for chronic neuropathic pain study. The acute category was divided into 8 equal groups; control, carrageenan, diclofenac, gabapentin, tizanidine, gabapentin-diclofenac, gabapentin-tizanidine and tizanidine-diclofenac groups. Acute inflammatory pain was induced by carrageenan injection in the animals paw. In the chronic category neuropathic pain was induced by right sciatic nerve ligation except for control and sham groups. This category was divided into; control, sham, gabapentin, tizanidine, gabapentin-diclofenac, gabapentin-tizanidine and tizanidine-diclofenac groups. The mean reaction time was assessed in all groups. Results: In acute pain the three drugs and their combinations had significant analgesic effects. Tizanidine potentiated the analgesic effects of diclofenac and gabapentin. In chronic neuropathic pain diclofenac and gabapentin had significant analgesic action while, tizanidine had no analgesic effect. Conclusion: Tizanidine didn’t show analgesic effect on chronic pain but potentiated the analgesic effect of gabapentin and diclofenac in acute pain model.}, keywords = {Acute pain,Neuropathic pain,Diclofenac,Gabapentin,Tizanidine}, url = {https://zumj.journals.ekb.eg/article_48902.html}, eprint = {https://zumj.journals.ekb.eg/article_48902_31aa8a1d2f3c0aac81750803c347e457.pdf} } @article { author = {Elsayed, Elsayed and Mahfouz, Ragab and mahmoud, kamal and Mostafa, Tamar}, title = {Correlation of the coronary flow reserve, the angiographic TIMI flow and the contractile reserve in patients with cardiac syndrome x}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {924-931}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.16709.1501}, abstract = {ABSTRACT Background: The cardiovascular syndrome X includes chest pain with positive stress test, and coronary arteries that appear normal in angiography with possible extra cardiac causes of chest pain, ruled out. The aim of the study is to evaluate the correlation between TIMI flow, contractile reserve and the coronary flow reserve in patients with cardiac syndrome X using TTDE. Methods: 60 patients with cardiac syndrome X, and 30 individuals as a control. All studied individuals were subjected to full history taking, full clinical examination, routine laboratory examination, resting ECG, treadmill stress ECG, Dobutamine stress echocardiogram and Transthoracic Doppler Echocardiogram .Results: all individuals were referred to TTDE and DSE in cardiac unit of Zagazig University Hospital from January 2017 to March 2019. The patients group showed a significant decrease in contractile reserve, a highly significant lower value of a percentage change of MAPSE with p value}, keywords = {Transthoracic Echocardiogram,coronary flow reserve,contractile reserve,cardiac syndrome x}, url = {https://zumj.journals.ekb.eg/article_49551.html}, eprint = {https://zumj.journals.ekb.eg/article_49551_a374ef1371912a4da6da75dc5293f2aa.pdf} } @article { author = {qwader, mohamed and sherief, laila and Sherif, Adel and Baraka, Ahmed}, title = {Evaluation of osteopathy and vitamin D status in patients with beta-thalassemia major}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {776-781}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10819.1127}, abstract = {Background: The survival of patients with thalassemia major has progressively improved with advances in therapy; however, osteoporosis and cardiac dysfunction remain frequent complications. Adequate circulating levels of vitamin D are essential for optimal skeletal health and reducing fracture risk this study aimed to evaluate the density of bone mineral (BMD) and vitamin D status in patients with β-thalassemia major (β-TM). Methods: The current study was carried on thirty three β-thalassemic childrens who attend the Pediatric Hematology Clinic at Zagazig University Hospitals during the period from April 2018 to October 2018 (21 male and 12 female). Dual-energy X-ray absorptiometry scan was used to evaluate bone density and interpreted as Z-score which compared to the BMD of age, sex and ethnicity-matched reference population. Biochemical parameters such as calcium, serum ferritin (SF) and 25-OH Vitamin D have been evaluated. Results: there were significant increase in serum ferritine level, AST, ALT, ALP, total bilirubin and urea and decrease in total protien , serum albumin and criatinine in the thalassaemic patients than controls. There was significant low level of vitamin k2 in the thalassaemic patients than controls Conclusion: Osteopathy has a high prevalence in patients with β-TM and should receive an optimal transfusion and chelation therapy to prevent bone expansion. Calcium and Vitamin D should be routinely determined to prevent deficiency.}, keywords = {Beta-thalassemia major,Osteoporosis,Osteopenia,25 (OH) cholecalciferol}, url = {https://zumj.journals.ekb.eg/article_52214.html}, eprint = {https://zumj.journals.ekb.eg/article_52214_01ad95ef29ecb2f942cb579e847ff549.pdf} } @article { author = {Zamzam, Samir and El-Hindawy, Eman and Atteya, Mostafa}, title = {Assessment of Different Presentations of Myocarditis in Pediatric Intensive Care Units: (A Multi-Center study in Al-Sharqia Governorate).}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {791-800}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.12862.1228}, abstract = {AbstractBackground: Myocarditis can be presented with various clinical manifestations that may be wrongfully diagnosed and managed as other illness. Early suspicion and detection would specify the management and improve outcome of such disease. Objectives: To determine the different clinical presentation and findings of acute myocarditis in pediatric patients admitted to PICU and clinical, radiological and laboratory factors that may affect the diagnosis and the outcome. Methods: This cross sectional study included twenty four cases taken as a comprehensive sample due to the relatively rare presentation, all of them are Egyptian children aged between: 1.2 month to 9 years (108 months) old, diagnosed as acute myocarditis during the period from November 2017 till November 2018. Results In our study, the patients were 13 males (54.2%) and 11 females (45.8%). Their age mean was 27.82 ± 30.47 months. Acute heart failure, respiratory distress, cerebral hypoperfusion and epigastric pain were the main clinical presentations of myocarditis. Conclusion: In this study, it was concluded that myocarditis has wide range of clinical presentations that might be missed for other system affection than the heart, and high clinical suspicion is mandatory for early diagnosis and management, and hence, better prognosis would be achieved.}, keywords = {Acute heart failure,myocarditis,hypoperfusion,respiratory distress}, url = {https://zumj.journals.ekb.eg/article_52215.html}, eprint = {https://zumj.journals.ekb.eg/article_52215_37c30dbbb8d4814468869e3806502720.pdf} } @article { author = {Emteres, Khaled and Sharawy, Sahar and sami, mona and ahmed, shaimaa}, title = {Assessment of Quality of Life in Congenital Heart Disease among Egyptian and Libyan Children}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {782-790}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.11164.1161}, abstract = {Abstract:Background: Congenital heart diseases (CHD) is defined as a structural abnormality of the heart or intra thoracic vessels present at birth that is actually or potentially of functional significance .CHD is a lifelong disease that results from a heart defect or structural anomaly at birth.As CHD impacts the physical, nutritional, and developmental status of children health, it also may change many aspects of patients and their families' life, as social, psychological dimensions, there by impacting their quality of life. Aim of the study:This study aims to verify a possible effect of CHD on the quality of life of Egyptian and Libyan children and their families.Subjects and methods: Across sectional study was conductedamong279 children, distributed into 2 groups; 186 Egyptians, and 93Libyans, and were subjected to complete history, socioeconomic evaluation,assessment of Quality of life(QoL) of patient by pediatric cardiac quality of life inventory,and evaluation of quality of life of family by WHOQOL BREF.Results:Regarding QoL assessment in CHD patients, results showed that QoL of diseased children was affected in both groups.Bad parents’ QoLwas higher among Egyptian CHD families than Libyan families, while bad child’s QoL and bad siblings’ QoL were higher among Libyan CHD children than Egyptian CHD children. Children's bad QoLwas positively correlated to parents and siblings'QoL. Also, cyanotic CHD was associated with bad QoL.Conclusion:CHD can affect QoL. So, it is recommended to concentrate on social and psychological aspects in CHD patient through health education and group therapy.}, keywords = {quality of life,Congenital heart disease,Egyptian,Libyan}, url = {https://zumj.journals.ekb.eg/article_52597.html}, eprint = {https://zumj.journals.ekb.eg/article_52597_b0f1e56ad79561ccb8b3b0ae46e01f95.pdf} } @article { author = {Badawy, mohamed and Hasanin, Mesbah and Al-Daydammony, Mohammad and Gad, Marwa}, title = {Non-invasive predictors & clinical outcomes of Non ST Elevation myocardial infarction (NSTEMI) with completely occluded coronary artery (OCA)}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {903-908}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.16133.1441}, abstract = {Background: TIMI score has been used to predict outcomes in patients presenting with NSTEMI with occluded coronary artery . Objective: To assess the independent predictors & clinical outcomes of patient with – NSTEMI with occluded coronary artery .Methods: A prospective cohort of 100 patients presented with NSTEMI with occluded coronary artery from December 2018 to May 2019 in Cardiology Department, Zagazig University Hospitals and Gamal Abdel-Naser Health Insurance Hospital were recruited. Patients were divided into two groups: group (A): patients with NSTEMI with non-occluded artery and group (B): patients with NSTEMI with occluded artery. Patients underwent PCI during admission. We analyzed the demographic, angiographic data and potential risk predictors for major adverse cardiac events (MACE) and death during in hospital follow up.Results: Patients with totally occluded lesion were statistically significant younger in age (mean age in years 56.9 ± 8.6) versus (mean age in years 62.4 ± 11.1) in patients with patent vessel, more smoking (seventeen patients, 77.3%) versus (thirty-five patients, 44.9%) in patients with patent culprit vessel. Patients with totally occluded culprit vessel had higher incidence of MACE during hospital stay (six patients, 27.3%) versus (seven patients, 9%) in patients with patent culprit vessel and higher Recurrent ischemic symptoms and decompensated HF. Conclusion: A quarter of NSTEMI patients had an occluded coronary artery. They were more likely to be affected by smoking with high troponin and CK-MB. were more prone to MACE.}, keywords = {Non-St-Segment Elevation Myocardial Infarction,Oral anti-coagulant,Acute Coronary Syndrome,Congestive Heart Failure,Clinical Outcome}, url = {https://zumj.journals.ekb.eg/article_52602.html}, eprint = {https://zumj.journals.ekb.eg/article_52602_4402af41c54481fc0772123e6ff7619b.pdf} } @article { author = {Mohammed Soliman, Ebtehal and ElKashishy, Kamal and Metwally, Mohammed and Hassan, Abeer}, title = {The diagnostic roles of C4D expression in SOME AUTOIMMUNE BULLOUS DERMATOSES IN ZAGAZIG UNIVERSITY HOSPITALS; an immunohistochemical study}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {767-775}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.7305.1032}, abstract = {Background: Autoimmune bullous skin dermatoses (AIBD) diagnosis relies on direct immunofluorescence examination performed on frozen tissue sections. However, this is not always available for DIF; therefore, alternative techniques needed for diagnosis. We tested the usefulness of C4d immunohistochemistry on formalin-fixed, paraffin-embedded tissue (FFPE) sections for the diagnosis of AIBD.Objective: to evaluate the role of C4d expression using immunohistochemistry in diagnosis of some autoimmune bullous skin diseases.Methods: This study included FFPE tissue blocks of 35 cases from archives of pathology department, Faculty of medicine, Zagazig University in the period from January 2017 to December 2017. These 35 cases were diagnosed histopathologically as: 30 cases autoimmune bullous dermatoses (18 pemphigus vulgaris, 6 bullous pemphigoid, 3 pemphigus foliaceus and 3 drug induced pemphigus) and 5 cases erythema multiforme. Specimens were obtained as punch biopsy from the edge of a recent bullous lesion. C4d immunostaining was performed and correlated with clinicopathology.Results: C4d immunohistochemistry was a reliable method for detecting AIBD in 29 of 30 cases diagnosed by histopathology, with 96.7% sensitivity. Also it was efficient in ruling out of the all 5 negative cases ruled out by histopathology with 100% specificity. Conclusion: When correlated with the light microscopic and clinical findings, the C4d assay defines an important diagnostic adjunct in the evaluation of some autoimmune vesiculobullous dermatoses. It may prompt further DIF testing or, in some instances, may even define a reasonable substitute for DIF and/or add to the morphologic assessment of a biopsy specimen submitted for routine light microscopic assessment.}, keywords = {C4d,Immunohistochemistry,Autoimmune Bullous Dermatoses}, url = {https://zumj.journals.ekb.eg/article_53297.html}, eprint = {https://zumj.journals.ekb.eg/article_53297_34c66c8cf0f140d07c25d7640c1c8df3.pdf} } @article { author = {Alzobir, Mohamed and Ramadan, Ahmed and Elnashar, Ismail and Alshawadfy, Mohamed}, title = {Assessment of Surgical Turbinoplasty Versus Bipolar Cauterization in Management of Inferior Turbinate Hypertrophy.}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {932-937}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2020.20666.1642}, abstract = {Background: Several techniques for management of inferior turbinate hypertrophy have been described to date, but the turbinoplasty, outfracture, and bipolar cautery methods have been used frequently for the last three decades. This study aimed to study the effect of the turbinoplasty versus surface bipolar cauterization in management of inferior turbinate hypertrophy. Patients and Methods: This prospective cohort study included 20 patients with nasal obstruction due to hypertrophied inferior turbinates resistant to medical treatment for a period not less than six week. The study included 6 males and 14 females with a mean age of 22 (range 18-26 years). The study work was done in Otorhiriolaryngology Department in Zagazig University Hospitals in the period from Aug 2018 to Aug 2019. The first group include 10 patients underwent surface bipolar cauterization and second group include 10 patients underwent Surgical turbinoplasty for inferior turbinate. Results: The results of nasal symptoms score of the study showed that nasal obstruction and headache showed significant improvement in both groups post operatively with higher improvement in the turbinoplasty group. In addition, there was statistically significant difference in post-operative crusting between the two studied groups with better results in the turbinoplasy group. Conclusions: Inferior turbinate hypertrophy failing medical treatment can be improved by surface bipolar cauterization or endoscopic surgical turbinoplasty technique. Both techniques have many advantages and disadvantages. However, the turbinoplasty technique has favour of less crusting and earlier improvement in nasal obstruction than the surface bipolar cauterization technique.}, keywords = {inferior turbinate hypertrophy,turbinoplasty,surface bipolar cauterization,obstruction,headache}, url = {https://zumj.journals.ekb.eg/article_69409.html}, eprint = {https://zumj.journals.ekb.eg/article_69409_3d52c0ec8a7ae7437f210f3a0e074117.pdf} } @article { author = {Omar, Marwa and Abaza, Beessa Abaza and Mousa, Esraa and Rashed, Hayam and Farag, Tahani}, title = {EFFECT OF NITRIC OXIDE IN CHRONIC EXPERIMENTAL TOXOPLASMA GONDII INFECTION: HISTOPATHOLOGICAL AND HISTOCHEMICAL STUDY}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {938-947}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2020.29297.1839}, abstract = {Aim of the work: To evaluate the histopathological alterations and immuno-histochemical pattern in chronic Toxoplasma gondii infection, and to evaluate the role aminoguanidine in experimental toxoplasmosis. Subjects and methods: This study was carried out on 48 laboratory-bred male Swiss albino mice which were divided into 4 groups (non-infected control; infected control; infected and treated with spiramycin; infected and treated with aminoguanidine). The effect of the used drugs was assessed using parasitological, histopathological and immunohistochemical approaches. Results: There was highly significant (P}, keywords = {Toxoplasmosis,Aminoguanidine,Immunohistochemical,Spiramycin,iNOS}, url = {https://zumj.journals.ekb.eg/article_103249.html}, eprint = {https://zumj.journals.ekb.eg/article_103249_7b85e19bb2fe05b6866e61ef1c5eb7cd.pdf} } @article { author = {Laskar, Shyamalendu and Majumder, Prasanta and Suman, Anshika and Koul, Manisha}, title = {Clinically mimicking Dentigerous cyst in maxillary left cuspid region diagnosed as Mural Unicystic plexiform ameloblastoma in a 17 year old female: A rare variant - a case report}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {951-961}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2020.49034.2007}, abstract = {Ameloblastoma is a benign odontogenic tumor most commonly occuring in the jaw bones. It develops fromthe residual epithelium of the tooth germ, epithelium of odontogenic cysts stratified squamousepithelium and epithelium of the enamel organ. About 80% of ameloblastomas occur in themandible mainly the molar - ramus region and the rest 20% in the maxilla. Ameloblastomaclinically appears as an aggressive odontogenic tumor, often asymptomatic and slow-growing,with no evidence of swelling which affects the treatment outcome. Since ameloblastoma isalso associated with a high rate of recurrence when treated inadequately, might results inaggressive recurrence. The rate of recurrence accounted for 60.3% of all odontogenic tumorsin Indian population which is significantly high. This case report aims to add to the existingliterature a variation of a clinically appearing dentigerous cyst in a 17 year old female inmaxillary as a case of Mural Unicystic ameloblastoma diagnosed histopathologically.}, keywords = {dentigerous cyst,Ameloblastoma,maxillary,odontogenic tumour}, url = {https://zumj.journals.ekb.eg/article_132556.html}, eprint = {https://zumj.journals.ekb.eg/article_132556_746d98894819e72a23dd83215844f11e.pdf} } @article { author = {El Sammak, Dena Abd El Aziz and Allam, Hala and M. Abdelhay, Rabab}, title = {Can partial splenic embolization be a promising treatment for hypersplenism–related thrombocytopenia in oncological patients requiring systemic chemotherapy: a retrospective analysis}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {962-972}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2021.50403.2020}, abstract = {Background: PSE has been safely used to improve hypersplenism–related thrombocytopenia by reducing the splenic volume using conventional transarterial superselective embolization technique. PSE provides an increase in hematologic indices to facilitate initiation and continuation of SC in oncological patients who are not surgical candidates and for whom splenectomy is contraindicated.OBJECTIVE: The aim of this study is to evaluate 1ry, 2ry end points, technical parameters, outcomes and complications of PSE in oncological patients with hypersplenism-related thrombocytopenia requiring SC.METHODS: This retrospective study comprised 24 oncological patients (18 males and 6 females; their ages ranged 35–70 years old), they underwent PSE for correcting thrombocytopenia in order to initiate (n=6) or continue (n=18) their optimally dosed SC. The 1ry endpoint was the achievement of a platelet count >130×〖10〗^9/L and the 2ry endpoint was the initiation or continuation of SC. RESULTS: Mean platelet count prior to PSE was 69.08 ± 3.54 ×109/L (range 62–75×109/L).The percentage of splenic necrosis was estimated by angiography, mean post-PSE splenic infarction percentage was 58.33 ± 8.16 %. Mean platelet counts at days 10, 20 and 30 post-PSE were 273.58±77.30×109/L, 218.54±60.06×109/L and 157.16±44.90×109/L, respectively (P}, keywords = {Partial Splenic Embolization,Hypersplenism,thrombocytopenia,Systemic chemotherapy}, url = {https://zumj.journals.ekb.eg/article_150033.html}, eprint = {https://zumj.journals.ekb.eg/article_150033_7057f33491d0e46eed915082a6737ddc.pdf} } @article { author = {Sarhan, Walaa and Ismail, Nagwan and Zidan, Nahla and Elhawary, Abeer and Makani, Vishruti and Abd elnour, Hanim}, title = {Association of Fat mass and obesity gene (FTO) polymorphism with COVID-19 severity in Egyptian obese patients}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {984-991}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2021.80189.2260}, abstract = {Background: Fat mass and obesity gene (FTO) polymorphism had linked with risks and health problems related to obesity in many studies and different population. Our study was designed to investigate association of FTO rs9939609 with COVID-19 severity and biochemical parameters such as serum triacylglycerol, cholesterol, transaminases and plasma glucose in obese Egyptian population.Methods: TaqMan SNP Genotyping Assay of FTO gene rs9939609 (A < T) in a sum of 253 obese cases infected with COVID-19. Fasting samples of serum insulin, plasma glucose, lipid profile, as well as ALT and AST were measured. Evaluation of the association between COVID-19 severity and genotype distribution was done via logistic regression tests and Chi-square.Results: The association of COVID-19 severity with genotype distribution was significant (χ2 = 8.6/P = 0.014) and odds ratio under dominant model (OR = 1.86, P = 0.029 and 95%C.I = 1.08-3.4) and recessive model (OR = 2.95,P = 0.017 and 95%C.I = 1.23-6.42) was increased. HDL-C levels in (AA) subjects (P = 0.009) were significantly lower in comparison to (TT). Moreover, ALT levels in (AA) genotype subjects (P = 0.02) were significantly higher and persisted in accordance with correction of major confusing parameters as TAG and BMI, while aborted with conservative Bonferroni adjustment.Conclusions: The current study displayed that Fat mass and obesity gene (FTO) rs9939609 is a risk factor for COVID-19 severity in obese individuals that may aid to understand the pathophysiology of the disease progression and highlighted that lipid metabolism may play a role in this association.}, keywords = {FTO,Obesity,COVID-19,SNP,serum lipid}, url = {https://zumj.journals.ekb.eg/article_178090.html}, eprint = {https://zumj.journals.ekb.eg/article_178090_847010f790a4a3407ffbe969531a7b6f.pdf} } @article { author = {Ali Abo El-Asbaa, Ola and Sarhan, Abdel-Mageed and seliem Soliman, Badeaa and Ali, Mohamed}, title = {Effect of Vaginal Sildenafil versus Oral Estradiol Valerate on Endometrial Thickness and Pregnancy Rate in infertile Women Undergoing Induction of Ovulation by Clomiphen Citrate}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {948-956}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2021.48959.2004}, abstract = {Background: Endometrial thickness (ET) is one of the best predictors of implantation rate and continued success rate for pregnancy. There were possible beneficial effects of sildenafil citrate or estradiol on endometrial receptivity. The aim of this study was to compare the effect of Vaginal Sildenafil versus Oral Estradiol Valerate on Endometrial Thickness and Pregnancy Rate in infertile women undergoing induction of ovulation by clomiphen citrate. Patients and Methods: This Randomized control study was conducted on 44 infertile women undergoing induction by Clomiphen Citrate attending infertility and U/S unit, Obstetrics & Gynecology Department, Zagazig University Hospital, during the period from December 2018 to August 2019. Patients were randomized into 2 groups (22 in each group); group (1) received Sildenafil and group (2) received oral Estradiol Valerate. Results: The results of present study showed that there was no statistically significant difference between the studied groups regarding age, Type of infertility, body mass index (BMI), follicle stimulating hormone (FSH), luteinizing hormone (LH), Thyroid stimulating hormone (TSH), prolactin, ovulation rate, follicles number and size, results of pregnancy test and fetal pulse detection between studied group. But there was a statistically significant difference between them in endometrial thickness on the day of triggering. Conclusion: It could be concluded from this study that vaginal use of vaginal sildenafil citrate 20 mg or oral Ethinyl Estradiol in infertile females increase endometrial thickness and support embryo growth but Ethinyl Estradiol has better results on endometrial thickness than sildenafil. But both treatments have the same effect on pregnancy rate.}, keywords = {Infertility,sildenafil,Estradiol Valerate,Endometrial Thickness}, url = {https://zumj.journals.ekb.eg/article_182617.html}, eprint = {https://zumj.journals.ekb.eg/article_182617_e9cb1159cd37b6e8e878371bf241352d.pdf} } @article { author = {Ashour, Walid and el-serafy, Tamer and AbdElghaffar, Adel and Selim, Karam and Mohamed, Eman}, title = {Sex Differences in Clinical Presentation, Severity and Outcome in patients with acute ischemic stroke; a prospective cohort study}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {973-983}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2021.74507.2212}, abstract = {Background: Many differences between men and women are seen in the epidemiology, risk factors, clinical presentation, severity and outcome of stroke. Aim: To assess sex differences in clinical presentation, severity and outcome of stroke. Subjects: This prospective cohort study included 70 stroke patients (34 males and 35 females with age ranged from 30 to 90 years) during a period (from April 2017 to Septembre 2017). Written informed consent was obtained from all patients or written assent from a relative. Methods: All patients were assessed according to detailed medical history and complete general and neurological examination. Glascow Coma Scale was used to assess level of consciousness. Evaluation of stroke severity was assessed by using National Institute of Health Stroke Scale (NIHSS). Modified Rankin Scale (mRS) was used for assessing the extent of disability. Laboratory investigations included full routine laboratory investigations at admission and radiological investigations included brain computed tomography and magnetic resonance imaging. Twelve-Leads electrocardiogram was done to all patients. Results: There was highly significant difference regarding smoking, men were more smokers. There was significant difference regarding presence of atrial fibrillation (AF), females had more AF. There was significant difference regarding obesity as females were more obese. Women had more severe strokes and worse functional outcome. We found significant difference between males and females regarding stroke severity using NIHSS and stroke outcome using mRS. Females had more severe strokes and worse outcome. Conclusion: Sex is one of the fundamental factors regarding stroke severity and outcome.Key Words: stroke, sex, NIHSS, mRS}, keywords = {stroke,sex,NIHSS,Outcome,severity}, url = {https://zumj.journals.ekb.eg/article_185610.html}, eprint = {https://zumj.journals.ekb.eg/article_185610_b6727a96885126899a949c054e599da9.pdf} } @article { author = {mubarak, asmaa and Abdel-Hai, Ayman and Morad, Emad and Elsayed, Ayman}, title = {Study Of Bacterial Translocation Markers In Hepatitis C Infection Patients And In Liver Cirrhosis}, journal = {Zagazig University Medical Journal}, volume = {27}, number = {5}, pages = {1006-1016}, year = {2021}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2021.79724.2258}, abstract = {AbstractBackground: Hepatitis c infection are an Increasing problem in Egypt. Bacterial translocation is defined as the migration of live microorganisms or bacterial endotoxins from the intestinal lumen to the mesenteric lymph nodes and extraintestinal sites. The aim was to measure bacterial translocation markers namely bacterial DNA and endotoxin in HCV status and cirrhotic patients with correlation of the presence of bacterial markers of translocation and the viral status. Methods: This study was conducted on 81 inpatients clinically suffering from liver cirrhosis. Patients were divided into three groups each group included 27 patients. First group patients with hepatitis c virus infection causing liver cirrhosis particulary child A and B groups. The second group included patients with HCV infection who treated with direct antiviral agents (DAA).The last group included patients with compensated liver cirrhosis with negative viral markers. All patients were subjected to laboratory investigations included: Hepatitis markers, CBC, Liver function tests, Kidney function tests. Bacterial DNA and Bacterial Endotoxin Results: 67.9% of cases were positive DNA for bacterial translocation. Endotoxin level and DNA results showed significant difference between the three groups as active hepatitis c had highest level of serum endotoxin and all were positive DNA. There was statistically significant difference between DNA positive and DNA negative patients with positive patients had higher median serum endotoxin level 43 Vs 2 in negative patients. Conclusion: Bacterial translocation markers (bacterial DNA and endotoxin) are high in cirrhotic and hepatitis c virus infected patients.Key words: bacterial translocation- bacterial DNA- endotoxin- Hepatitis c-cirrhosis.}, keywords = {bacterial translocation,bacterial DNA,Endotoxin,hepatitis C,Cirrhosis}, url = {https://zumj.journals.ekb.eg/article_188798.html}, eprint = {https://zumj.journals.ekb.eg/article_188798_f4ac9fee4e5edc5a6648ec5d19c668fb.pdf} }