@article { author = {Bishr, Dalia and El-Fawal, Magdy and El-Gerby, Khaled and El- Maghraby, Ahmed}, title = {Dynamic Ultrasound in Morphological Assessment of Medial Compartment of Knee Joint Osteoarthritis}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {619-629}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.7289.10260}, abstract = {Background: Osteoarthritis is a major joint disease between the elderly with theknee is the most common joint involved. Ultrasound is used for non-invasiveassessment of knee joint status with evaluation of the meniscal position, jointspace narrowing and presence of osteophytic lipping under load-bearing positionfor early detection of osteoarthritis. The aim of the study is to assess the role ofhigh-resolution ultrasonography with dynamic assessment in evaluation of themedial compartment knee joint osteoarthritis.To investigate the correlationbetween the O.A grade determined by radiography and that by ultrasoundevaluation and to investigate the diagnostic accuracy of O.A determined using US.Methods: This study was carried out at Radio diagnosis Department, ZagazigUniversity Hospitals. The present study was carried on 35 patients of kneeosteoarthritis. Diagnostic work up was done including plain radiography & MSUS.Results: Total of 38 of the 40 knees were correctly diagnosed by ultrasonographywith sensitivity of 95 % and specificity of 80 %. The predictive value positive was86.36 % and the predictive value negative was 92.3 % with 88.5% accuracy.Conclusions: Our results indicate that knee ultrasonography provides valuableinformation for the assessment of knee joint osteoarthritis. However, MSUS hasan advantage of dynamic evaluation with qualitative and semi-quantitativeassessment for early detection of knee O.A with good diagnostic accuracy.}, keywords = {Knee joint,osteoarthritis,Dynamic Ultrasound}, url = {https://zumj.journals.ekb.eg/article_46215.html}, eprint = {https://zumj.journals.ekb.eg/article_46215_ea5d03dd25c00bf5d747481e35f091bb.pdf} } @article { author = {Mounir, Mohammed and Ibrahim, Amany and Bayiomy, Sameh and Omar, Hany}, title = {Assessment of Liver Stiffness among Chronic Hepatitis C Patients after Oral Antiviral Drugs in Zagazig University Hospitals}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {630-638}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.11090.11450}, abstract = {Background: The hepatitis C virus (HCV) may be an important explanation for hepatic pathology, cirrhosis, and hepatocellular carcinoma. The aim of the study wasto assess the liver stiffness before and after oral antiviral medication in chronic viral hepatitis c patients attending Zagazig University Hospitals. Methods: This study included forty three Egyptian patients with HCV  infection diagnosed by  HCV RNA  real time quantitative PCR  whose ages  were ranged from 29-71 , All patients took   anti-viral treatment according to the rules of the committee responsible for hepatitis c virus control in Egypt. Treatment regimens included: Sofosbuvir, daclatasvir and ribavirin (RBV). The patients were collected and followed up in the period between April 2017 and August 2018. , radiological tool liver transient elastography (TE) and laboratory tests APRI, FIB4 test were done for all patients.Results: There were  improvements  in liver stiffness measurements,APRI,FIB4 test hemoglobin, fasting blood sugar  , platelets count, and ALT, AST levels  in patients who achieved a 48-week sustained infectious agent response. The failure to achieve improvement within the level of liver stiffness was related to treatment failure. Conclusions:  Treatment with sofosbuvir drug regimen makes significant decrease in liver stiffness measurements and fibrosis indices.}, keywords = {Liver Stiffness,FibroScan,Direct antivirals}, url = {https://zumj.journals.ekb.eg/article_46459.html}, eprint = {https://zumj.journals.ekb.eg/article_46459_aaf714c5f3f25ff3956a32a628596454.pdf} } @article { author = {Aly Tantawy, Hazim and Elfiki, Inas and Bayoumi, Sameh and Sargewa, Essa}, title = {The Role of Multi-Detector Computed Tomography in The Evaluation of Pancreatic Lesions}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {639-647}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.11028.11900}, abstract = {Aim of work: To determine the role of Multi-detector Computed Tomography in the evaluation of various pancreatic lesions. Background:MDCT with its thin collimation allows three-dimensional reformatting and multiplanar reconstruction of pancreatic anatomy which permits good depictions of many pancreatic lesions. Patients and Methods:30 patients with pancreatic lesions suspected on the basis of clinical symptoms, laboratory investigations and USS findings were enrolled in this study. Majority of patients (2 patients were fellow-up patients) were subjected to full clinical history, general and abdominal examination, Laboratory investigations, Ultrasonography examinations with (Siemens, Acuson.X300), and CT examinations; Triphasic contrast-enhanced and monophasic MDCT (with delay of 40-50s) performed on (Philips, Ingenuity core128-multislice CT) in the Zagazig university hospital. Results:This study included 30 patients with suspected pancreatic lesions. They were 19 males (63.4%) and 11 females (34.6%). The most studied patients were above 50 years. 11 patients were diagnosed with acute pancreatitis, one patient with acute on chronic pancreatitis, and 18 patients with pancreatic neoplasms. Hence, pancreatic neoplasms were found to be the most common pancreatic lesions in our study. Conclusion:MDCT with contrast proved to be the imaging modality of choice in identification of various pancreatic lesions. The faster scanning time (with single breath hold) and thin slice thickness, allowed for better resolution and superior scan quality. The ability of MDCT to scan in both arterial and venous phases with its post processing techniques (MIP, MinP, CRP, and VR) allowed for excellent visualization of the pancreas, biliary anatomy and peripancreatic vasculature.}, keywords = {MDCT,Pancreatic cancer,pancreatitis,tumor resectability}, url = {https://zumj.journals.ekb.eg/article_46460.html}, eprint = {https://zumj.journals.ekb.eg/article_46460_7e3fa37b095e4831ce44836e22801ea1.pdf} } @article { author = {Deraz, Hamed and Shawk, Nagwa and Abedlnabi, AL-Shabrawy and Ali El-Feitouri, Ghazala}, title = {Study of Thyroid Profiles in the Elderly}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {648-656}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.7008.10100}, abstract = {Background: Advanced age is associated with changes in the pituitary thyroid axis which lead to changes in the thyroid functions in the absence of thyroid diseases. There is limited data regarding the prevalence of thyroid disease in the elderly Egyptian. It is very important to evaluate the thyroid function in the elderly people. Methods: 126 asymptomatic volunteers (41 males & 85 females) were initially interviewed and examined, and those fulfilling the clinical inclusion criteria were selected.  Serum samples were taken and free T3, free T4 and TSH were measured. Results: Our study showed that the thyroid function abnormalities were present in 20 subjects (15.9%). The prevalence rates of thyroid function abnormalities occurred in 8 males (19.5%) and 12 females (14.1%). Subclinical hypothyroidism was the most common thyroid dysfunction which occurred in in 11 subjects (8.7%) 8 females, with prevalence rate of 9.4% in the females and in 3 males with prevalence rate of 7.3%. Subclinical hyperthyroidism was the second most common thyroid abnormality which occurred in 5 subjects (4%) with 7.3% in males (3 males)) and 2.4% in females (2 females). The prevalence rate of clinical hypothyroidism was (1.6%) (2 females) and in males 0%., and of clinical hyperthyroidism was (1.6%) 2 males and no female. According to the age group, thyroid dysfunction as general occurred in 20 subjects (23.5%) in those people < 70 years, and (0%) in those ≥ 70 years, with significant p-value < 0.05.Conclusions: Thyroid dysfunction is common in elderly subjects.  }, keywords = {THYROID,Elderly,hypothyroidism}, url = {https://zumj.journals.ekb.eg/article_46461.html}, eprint = {https://zumj.journals.ekb.eg/article_46461_8c8668e0f9eab6ae819bc9a113efb6d3.pdf} } @article { author = {Ibrahim, Soad and Labeeb, Zainab and Amer, Amin}, title = {Effect of Dapsone Gel 7.5% Compared to Tazarotene Gel 0.1% for Treatment of Acne Vulgaris}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {657-664}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.7618.10400}, abstract = {Background: Dapsone 7.5% gel was well tolerated, with a low incidence of treatment-related adverse events, with the majority of adverse events being  related to topical application and mild or moderate in severity.Tazarotene helps to normalize the abnormal keratinization in the follicular infundibulum and changes the microenvironment of the follicle to reduce the proliferation of P. acnes. The aim of the study was to compare the efficacy and safety of dapsone gel 7.5% in relation to tazarotene gel 0.1% in the treatment of acne vulgaris. Methods: This study included 38 patients with different grades of AV, of different sexes and their ages ≥ 12 years, the patients were randomly selected from the outpatients clinics. Provided that the patients had not received any topical or systemic treatment for AV during  the previous 2 weeks. A base line evaluation of the severity of acne was done by GAAS and lesional photography for each patient before the start of treatment with topical dapsone and tazarotene,then follow up at 2,4,8,12 weeks of treatment. Results: There is statistically significant difference between dapsone and tazarotene in side effects after treatment as 71.1% of the studied patients didn’t complain of any side effects after dapsone while only 18.4 % of the studied patients had no side effects after tazarotene. The response to treatment with dapsone on the right side and tazarotene on the left side among the studied acne patients showed mild improvement occured in 28.9% after dapsone and occured in 15.8 % after tazarotene treatment, with no significant difference between both drugs. Conclusions:  Dapsone 7.5% gel is a successful, effective and safe alternative in the treatment of acne vulgaris with insignificant side effects.  }, keywords = {Acne vulgaris,Tazarotene,Dapsone,pathogenesis}, url = {https://zumj.journals.ekb.eg/article_46462.html}, eprint = {https://zumj.journals.ekb.eg/article_46462_2a2e2725519862247b4d91c1cc402173.pdf} } @article { author = {Akl, Ragy and El Sadek, Mohamed and Abd el Dayem, Ashraf and Mostafa, Mohamed}, title = {Platelet Rich Plasma versus Corticosteroid Local Injection Results in Treatment of Planter Fasciitis in New-Cairo}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {665-672}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.8086.10460}, abstract = {Background: Chronic plantar fasciitis is a common orthopedic condition that can demonstrate hard to effectively treat. In this study, platelet-rich plasma (PRP), a concentrated bioactive blood segment wealthy in cytokines and growth factors, was compared to cortisone injection in the treatment of Chronic plantar fasciitis resistant to traditional nonoperative management. Methods: Between October 2016 and the end of September 2017; sixty patients exhibited to New Cairo clinic with chronic plantar fasciitis, 30 patients were treated with PRP infusion, and 30 patients were treated with corticosteroid injection. This study compares the efficacy of (PRP) with that of corticosteroid local injection in chronic plantar fasciitis toward the finish of follow up time of 6 months concurring AOFAS score framework out of 100. Results: At the end of follow up, group treated by plasma rich platelets injection demonstrated that mean score was 83.5 of 100. While other treated by corticosteroid injection demonstrated mean score was 61.8 of 100 .No complication detected after the end of follow up period. Conclusions: Both PRP injection and corticosteroid injection are modalities for treatment of chronic plantar fasciitis. PRP preparation is a costly and complicated procedure than corticosteroid injection but PRP is more powerful and strong than cortisone injection for the treatment of chronic plantar fasciitis. Concerning corticosteroid side effects PRP infusion is safer in treatment of Chronic plantar fasciitis.}, keywords = {Chronic plantar fasciitis,Platelet-rich plasma (PRP), Corticosteroid}, url = {https://zumj.journals.ekb.eg/article_46463.html}, eprint = {https://zumj.journals.ekb.eg/article_46463_2ffbe1e5f506fcc2e53da2c29f2a1d90.pdf} } @article { author = {Gharib, Amal and Mohamed, Randa and Abdel-Fatah, Ahmed and Saadawy, Sara}, title = {Association between Serum MicroRNA-21 Gene Expression, Carcinoemberyonic Antigen and Clinicopathological Character for Colorectal Cancer}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {673-681}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.14149.12920}, abstract = {Background: microRNAs (miRNAs) are tiny, noncoding RNAs that regulate gene expression on the posttranscriptional level and this may lead to cancer development. This study aimed to detect the serum levels of microRNA-21 gene expression and to assess their relation to colorectal cancer (CRC) outcome and correlate it with carcinoemberyonic antigen level. Methods:  the collected blood samples from 48 subjects already diagnosed as CRC and 48 healthy controls. A quantitative reverse transcription polymerase chain reaction (qRT-PCR) was using in the measurement of the expression levels of miR-21 .The obtained  data were used to measure the association between serum microRNA-21 levels and clinic pathological and prognostic factors. Results: High serum expression of microRNA-21 have been correlated with greater local recurrence, TNM staging, PT staging, venous invasion, liver metastasis and recurrane (p=0.004), positively correlated with CEA. Conclusions: There was a correlation between the expression level of serum miR-21 and CEA, recurrence and some pathological parameters of patients with CRC. Our results suggest that circulating serum microRNA-21 is a promising tumour marker, can be used in diagnosis and prognosis of CRC.}, keywords = {MicroRNA-21,CEA,colorectal cancer,correlation}, url = {https://zumj.journals.ekb.eg/article_46464.html}, eprint = {https://zumj.journals.ekb.eg/article_46464_5f5a66b8b8839c2d6f6906447a7de5cf.pdf} } @article { author = {Abdel Rahman, Hoda and Hadhoud, Khaled and Bakr, Hoda and Youssef, Khaled}, title = {Assessment of Urinary Podocin Level as an Early Indicator in Diabetic Nephropathy}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {682-688}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10380.10960}, abstract = {Background: Diabetic nephropathy one of the leading causes of end stage renal disease in which podocytes damage play a vital role. It will be interesting to recognize podocyturia as a first noninvasive marker of subclinical early renal damage. The current study was aimed to assess the Urinary podocin level (podocyte-specific protein detected in urine using antipodocin antibody ELISA kit) as an early indicator for the glomerular lesion in patients with type 2 diabetes mellitus. Methods: This study included 45 clinically stable type 2 diabetic patients with glomerular filtration rate (GFR) (>60 ml/min/1.73m2) and excluded patients with fever, urinary tract infection, uncontrolled hypertension, congestive heart failure or malignancy collected from Zagazig University Hospitals and Air force Hospital. In addition to 15 apparently healthy volunteers matched in age and sex as a control group. Patients were classified according to albumin/creatinine (A/C) ratio into three groups 15 patients for each group. Results:There was statistically significant difference between all studied groups as regards urinary podocin levels (P <0.001). urinary podocin levels appeared even in normoalbuminuria group with median 9.2 (7.1 – 12 ng/ml) which was significantly higher compared to control group with median 3.9 (2.2 – 4.8) ng/ml and the higher level was found in macroalbuminuria group with median 41.5 (38.5 – 48.5)ng/ml. Conclusion: Urinary podocin levels were highly sensitive early marker  to predict diabetic nephropathy in patients with type 2 diabetes mellitus for further  studies.}, keywords = {Urinary Podocin Level,diabetic nephropathy}, url = {https://zumj.journals.ekb.eg/article_46465.html}, eprint = {https://zumj.journals.ekb.eg/article_46465_3658a7f328b9b9b8cee82da23646fa71.pdf} } @article { author = {Hussein, Youssef and Elsayed, Lamis and Morsy, Manal and Mohamed, Aboregela}, title = {Prenatal Effect of Methotrexate Exposure on the Fetal Brain of Albino Rats and the Possible Protective Role of Folic Acid}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {689-698}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.8122.10490}, abstract = {Background: Methotrexate is a folate antagonist, used to treat several diseases by interfering with cell growth. The objective of this study was to evaluate the effect of methotrexate on rat fetal telencephalon and the protective role of folic acid. Methods: 20 Pregnant rats weighting 200 – 250 gm were divided into four equal groups; control negative group, control positive group: received 60 mg/kg folic acid daily via gastric gavage from the first gestational day. Methotrexate treated group which treated with a single dose of 30 mg/kg methotrexate at gestation day 16. Methotrexate and folic acid treated group: received combined methotrexate and folic acid by the same manner mentioned before. The pregnant females were sacrificed over 2 gestational days (17thand 19th). The cerebrum was excised from each embryo, gross measurements were taken then processed for hematoxylin and eosin and caspase-3 staining for light microscopic examination. Results: Weight, volume, anteroposterior and transverse diameters of total cerebrum in methotrexate group were decreased in comparison to the control group. Histopathological examination revealed distributed vacuolated cells, hemorrhagic spots and congested blood vessels with in meninges in methotrexate treated group. Caspase-3 was widely expressed in fetal telencephalon in day 19 of methotrexate treated group in when compared with control group. All these findings were considerably improved in the combined methotrexate and folic acid treated group. Conclusions: Methotrexate induces microcephaly and apoptosis in the fetal telencephalon which is partially improved by folic acid supplementation}, keywords = {Methotrexate,Telencephalon,Microcephaly,Folic acid,apoptosis}, url = {https://zumj.journals.ekb.eg/article_46467.html}, eprint = {https://zumj.journals.ekb.eg/article_46467_b1bb68ce11b9c804d277f8f276b611a2.pdf} } @article { author = {Mansour, Sherif and Tawfiq, Mohammed and Khalefa, Abeer and Hadhoud, Shaimaa and El-Shorbgy, Eman}, title = {Effect of Diet Regimen on Serum Vaspin Level in Obese Diabetic Female Patients}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {699-707}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10713.11170}, abstract = {BACKGROUND: High serum vaspin concentrations and increased vaspin mRNA expression in human adipose tissue were associated with obesity, insulin resistance, and type II diabetes. However, the mechanisms how vaspin secretion may be linked to deterioration of glucose metabolism and insulin sensitivity are not understood. OBJECTIVES: The aim of this work is to explore the effect of dietary regimen for 6 months on serum vaspin levels in obese diabetic and non diabetic female patients. PATIENTS AND METHODS: The study was carried out in Zagazig University Hospital and Obesity management and research unit. The sample size was 40 obese female patients. All participants were screened to determine the eligibility for participation in the study according to specific inclusion and exclusion criteria.Control groups didn't follow any diet plan while mediterrnean diet group followed mediterrnean diet for 6 months. The following parameters were assessed at the beginning and after 6months:body mass index(BMI), waist circumference(WC),Homeostatic model assessment (HOMA), Atherogenic index (AI), creatinine clearance  and circulating levels of vaspin, vitamin D ,Low density lipoprotein (LDL), High density lipoprotein (HDL), Triglyecrides (TG), Total cholesterol  (TC), glucose,insulin,HbA1c, Superoxide dismutase (SOD) and Malondialdehyde (MDA). RESULTS: Mediterrnean diet life style for 6 months resulted in a significant decrease in BMI, WC, HOMA, AI, vaspin, LDL, TG, TC,glucose,insulin,HbA1c  and MDA with a significant increase in HDL,SOD and vitamin D. CONCLUSION: Elevated  serum vaspin and low VitD levels  are encountered in obesity.So, vaspin may be used as a novel biomarker for obesity, insulin resistance and TypeII DM management.  }, keywords = {vaspin,Adipokines,Obesity,Type II DM}, url = {https://zumj.journals.ekb.eg/article_46482.html}, eprint = {https://zumj.journals.ekb.eg/article_46482_95e0c94972717d6779d9f4f0d50c749b.pdf} } @article { author = {Abd Elaziz, Laila and Abouzeid, Heba and Abu Fares, Khalifa}, title = {Myocardial Dysfunction in Children with Nephrotic Syndrome: A Tissue Doppler Study}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {708-717}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.9621.10600}, abstract = {Background: The prevalence of chronic kidney disease (CKD) has increased steadily. Mortality and morbidity are seen more frequently in CKD compared to in healthy subjects. Cardiovascular events are the most frequent cause of mortality and morbidity in this patient group. Objectives: To assess the presence of fQRS in children with NS and to evaluate the relationship between fQRS and myocardial functions. Methods: 30 children with nephrotic syndrome and 30 apparently healthy children were enrolled in this study All patients in this study were subjected to: Full history taking and Full clinical examination, Laboratory investigations: (BUN), creatinine, albumin, Calcium, phosphorus, (LDL), (HDL), triglycerides and 24h urine collection for protein in urine, ECG and Echocardiography was performed to detect early pathological problems. and Tissue doppler imaging was used to detect changes occur in the heart with nephrotic Syndrome. Patient group was subdivided in to 2 groups according to presence of FQRS in ECG. Results: fQRS was present in 56.7% of patient group.There was significant increase in systolic and diastolic blood pressure in patient with FQRS in ECG. There were no statistically significantdifferences between tissue doppler parameter and Tie index with fQRS except for Em wave. By univariant analysis for patient with fQRS and all parameter, fQRS was presented with increase in systolic and diastolic blood pressure, and in patient with systolic dysfunction (decrease FS%), and in patient with diastolic dysfunction (E`). Conclusions:  NS children generally have a high risk of cardiovascular complications. The present study revealed that fQRS, determined using ECG, an economic and easily accessible technique, can be used as an early marker of myocardial function impairment in this patient group. }, keywords = {Myocardial dysfunction,A tissue doppler study}, url = {https://zumj.journals.ekb.eg/article_46483.html}, eprint = {https://zumj.journals.ekb.eg/article_46483_96ce621269db2e8f881dc934f844b3b5.pdf} } @article { author = {Ghoneim, Salwa and Farag, Elsayed and El-damanhory, Ahmed and Saleem Kindi, Albasheer}, title = {QRS Fragmentation After Reperfusion in Patients with STEMI}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {718-727}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.9883.10640}, abstract = {Background: Despite advances in the diagnosis, prognosis and treatment with new approaches, STEMI remains the most common cause of cardiovascular mortality and morbidity in developing countries.Aim of the work: The aim of the work was to investigate clinical characteristics of patients with fragmented QRS and QRS distortion to determine if they can help to identify high risk STEMI patients and to determine whether they can be used as non-invasive markers to predict response to reperfusion therapy. Methods: The present study conducted on 150 patients who were admitted to Cardiology Department, Zagazig University, from July 2018 to December 2018, with acute STEMI and treated with thrombolytic and/or primary PCI. University, from July 2018 to December 2018, 150 p.t were selected. Patients were divided into 4 groups; Group 1: included patients with 15 patients, Group 2: included 36 patients with QRS distortion, Group 3: included 84 patients with fQRS and QRS distortion and Group 4: included 15 patients without FQRS or QRS distortion. Results:  The present study showed no statistical significant difference between the four groups as regard to age and sex, hypertension, diabetes mellitus, smoking, dyslipideamia and family history of coronary artery disease and a significant statistical difference between patients with lateral MI, fQRS before and after reperfusion and QRS distortion before and after reperfusion and a highly significant statistical difference between different groups regarding EF and WMSI.. Conclusions: fQRS and QRS distortion can be used for assessment of success of reperfusion therapy.}, keywords = {percutaneous coronary intervention,myocardial infarction,fragmented QRS,Reperfusion therapy}, url = {https://zumj.journals.ekb.eg/article_46484.html}, eprint = {https://zumj.journals.ekb.eg/article_46484_ae3552bcfe5942321a406e7e3c12cba4.pdf} } @article { author = {Fawzi, Mohab and Negm, Mohamed and Abdalla, Ahmed and Abdelgayed, Samar}, title = {Adverse Childhood Experiences and C-Reactive Protein among Adult Patients with Bipolar Disorder at Zagazig University Hospitals}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {728-736}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.9958.10660}, abstract = {Background: Childhood trauma exposure has been associated with increase in the risk of psychiatric disorders and elevated levels of systemic inflammation. Our study will discuss the effect of adverse childhood experiences on Bipolar Disorder (BD) clinical characteristic and high sensitivity C-reactive protein (hs-CRP) level. Our aim is to to estimate the frequency of childhood trauma and its effect on bipolar disorder clinical characteristics and to assess the association between childhood trauma and serum level of hs-CRP in adult patients with bipolar disorder.Methods: The study included 91 bipolar patients who fulfilled the inclusion criteria. The diagnosis of BD was confirmed by Structured Clinical Interview for DSM-IV Axis I Disorders SCID-I. Confirmation of remission was done by Young Mania Rating Scale (YMRS) or Hamilton Depression Rating Scale (HAM-D). Semi-structured Clinical Interview clinical characteristics of the disorder were performed. The World Health Organization (WHO) Adverse Childhood Experiences International Questionnaires (ACE-IQ) was used to estimate the prevalence of childhood trauma among BD subjects and then a blood sample was collected from each participant to measure the hs-CRP. Results: About 93.4% of the studied bipolar patients had at least 1 childhood trauma (CHT). A statistically significant difference between the studied groups is reported in some clinical characteristics, regarding the number of depressive and the total number of mood episode, the type of the first episode, the presence of psychotic features, the noncompliance to medications, the suicidal attempts and Hs-CRP level.Conclusion: Presence of childhood trauma in patients with BD is common. It worsens its clinical course and is associated with higher adult inflammation.  }, keywords = {Bipolar Disorder,Adverse childhood experiences,hs-CRP}, url = {https://zumj.journals.ekb.eg/article_46485.html}, eprint = {https://zumj.journals.ekb.eg/article_46485_1529c9c48f76777bc4ee0c1409bce9bf.pdf} } @article { author = {Al-Mashad,, Gamal and Maaly, AlSadek and Albialy, Hani and Deiaa Al-Din, Yasmine}, title = {Intravitreal Bevacizumab Injection versus Intravitreal Bevacizumab Injection Followed by Macular Grid Laser Photocoagulation for Diabetic Macular Edema}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {738-747}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {}, abstract = {Background: Diabetic macular edema is the commonest cause of visual impairment in diabetic patients. The aim of the study is to evaluate the effectiveness of repeated intravitreal bevacizumab injections alone versus injection with sequential macular grid laser photocoagulation in patients with diabetic macular edema. Methods: This study included 128 eyes of 64 patients with bilateral diabetic macular edema, randomly assigned into two groups. First group was treated with monthly intravitreal bevacizumab injections (IVB group). Second group was treated with 3 monthly IVB injections, followed by macular grid photocoagulation (MGP) 4 weeks later (combined group). All patients received a complete ophthalmic examination including measurement of best corrected visual acuity (BCVA) and measurement of central macular thickness (CMT) by optical coherence tomography at baseline and 3 weeks after each injection. Results: At the end of the follow-up period there was a statistically significant difference between the mean BCVA and the CMT compared to baseline in both groups. In the IVB group at the end of study, the mean BCVA was 0.46±0.11 LogMAR compared to 0.79±0.16 LogMAR preoperatively, and the mean CMT was 248.49±13.40µm compared to 497.25±27.97µm preoperatively. In the combined group the mean BCVA was 0.41±0.12 LogMAR compared to 0.89±0.12 LogMAR preoperatively, and the mean CMT was 239.47±13.53µm compared to 510.86±37.64µm preoperatively. The mean number of injections was significantly lower in combined group. Conclusion: Intravitreal injection of bevacizumab is effective in controlling DME. Performing MGP 4 weeks after the third injection decreased the number of IVB injections needed during the study duration.  }, keywords = {Bevacizumab,Diabetic Macular Edema,laser photocoagulation}, url = {https://zumj.journals.ekb.eg/article_46486.html}, eprint = {https://zumj.journals.ekb.eg/article_46486_8c1f330efa94d19be5561eac0adb2d85.pdf} } @article { author = {Awadain, Waleed and Mohamad, Ezzat and Almessallamy, Fawzy and Gab-Allah, Ahmed and Gheith, Osama}, title = {Prevalence of Hypovitaminosis D among Renal Transplant Recipients and Its Relation to Graft Interstitial Fibrosis}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {748-758}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10093.10750}, abstract = {Background:Vitamin D deficiency is not uncommon among kidney transplant recipients which may lead bone diseases, graft aging and vascular disease. We aimed to evaluate the prevalence of hypovitaminosis D among renal transplant recipients and its relation to graft interstial fibrosis in graft biopsies. Methods:We recruited 99 renal transplant recipients with recent graft biopsies performed during the period between 2016 and 2017 in the nephrology department, organ transplant center of Kuwait. We excluded 2nd transplants, previous rejecters, extremes of ages (<18,>70years), postmenopausal women, and conditions that interfered with vitamin D metabolism as hepatic disease, gastric bypass, cystic fibrosis; extensive burns and chronic diarrhea. Patients were divided the into two groups: recent transplants (1- year post-transplant, n=50). We measured serum 25(OH) vitamin D, iPTH, albumin, creatinine, calcium, phosphorus, cholesterol and uric acid. Graft biopsies were assessed according to Banff classification 2013. Results:Most of patients (81.8%) had hypovitaminosis D with variable degrees’ deficiency (48.5 % had insufficiency, 24.2 % had mild deficiency, and 9.1 % had severe deficiency).  In our study, both groups were comparable regarding their demographic data except longer dialysis duration and higher number of patients receiving tacrolimus-based therapy in group 1. Vitamin D level was lower in group 1 but did not rank to significance (p>0.05), however, it had significant negative correlation with iPTH and the degree of renal graft interstitial fibrosis and vitamin D deficiency. Conclusion: The prevalence of 25-OH vitamin D deficiency is high post-transplant and it might contribute to the graft interstitial fibrosis.  }, keywords = {Vitamin D,renal transplant,fibosis,rejection}, url = {https://zumj.journals.ekb.eg/article_46487.html}, eprint = {https://zumj.journals.ekb.eg/article_46487_ec841f948443bfdbd0ee016336805e19.pdf} } @article { author = {Fahmi, Khaled and Abdo Alaal, Mohamed and Nasr, Mohamed and Mohamed, Mohamed}, title = {Crooked Nose Anatomical Correction and Camouflage}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {659-766}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10012.10840}, abstract = {ABSTRACT Background: The crooked nose is unquestionably the most severe deformity of the nasal septum due to the simultaneous involvement of very important functional and aesthetic element. Subjects and Methods: A prospective study was conducted including twenty four patients, to who suffers crocked nose. Parameters used for evaluation were taken intraoperative, one week and three months postoperatively. Results: combination of both techniques; anatomical repair and camouflage was reliable and gives more satisfactory result, however; Must of morbidity comes from lateral osteotomies in forms of asymmetrical of nasal bone prolonged edema more than three months , excessive narrowing of the nose, hematoma and ecchymosis, residual nasal deviation and residual functional obstruction , inverted v incision deformity, slight lateral depression, late cartilage graft resorbtion , and fat absorption after grafting, lacrimal system injury. Conclusion: This study revealed that the anatomical correction combined with camouflage technique is safe and reliable for management of crooked nose, it is gives good results for patient and solutions to aesthetic problems and functional too , the combination of both techniques gives better results without adding any significant complications, and fat grafting is better to do first to cases who is need revision rhinoplasty.  }, keywords = {Crooked Nose,Anatomical Correction,Camouflage,nasal deviation}, url = {https://zumj.journals.ekb.eg/article_46583.html}, eprint = {https://zumj.journals.ekb.eg/article_46583_9f0a495582dda2a8b51932feb6c3caea.pdf} } @article { author = {Mahmoud, Abd Elrahman and Abd Elsamad, Khaled and Desoky, Esam and forgani, Abdulmonam}, title = {Impact of Using Suprapubic Cystostomy during Monopolar Transurethral Resection of Large Size Prostate: A Prospective Study}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {767-772}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10200.10850}, abstract = {Background: Benign prostatic hyperplasia (BPH), the most common benign neoplasm in men. Despite the development of medical therapy and alternative minimally invasive procedures, the monopolar transurethral resection of the prostate still    the “gold standard” in the operative management of BPH . Purpose:  To evaluate  efficacy and safety of suprapubic cystostomy  during resection of the prostate  > 80 gram. Patients and methods:  In this study patients operated with monopolar TURP between January 2018 and January 2019 were evaluated at zagazig university hospital  . During surgery a catheter (12 Fr) was placed suprapubically. All patients were followed-up for at least 6 months  after surgery. Results: the mean  age (64.95±4.43), IPSS (28.81±2.08), , and post void residual (PVR) 82.75±20.9. Mean prostate volume was (88.87±7.5)g . mean surgical  time was (47.5±7.03 )/min , mean catheter time removed was( 2.37±0.44) day, mean  post  operative  hospital stay was (2.38±0.46)day, mean  bladder pressure was (11.83 ±0.44) cmH2, mean percentage of resection to prostate size(0.60±0.08) and the mean  Resection efficiency was (1.14±0.23)g /mint. Blood transfusion was not necessary and developed TUR syndrome (0.0). At follow-up the mean IPSS (3.55±1.), and PVR (18.79±7.27). regard late complication (16cases) 66.7% were without any complication  29.2% with retrograde ejaculation and 1 case 4.2% was with incontinence. Conclusion: we can conclude the using of suprapubic cystostomy during monopolar transurethral resection of large prostate > 80 gram, is  more safe and more effective method .  }, keywords = {suprapubic cystostomy,Monopolar Transurethral Resection,Large Size Prostate}, url = {https://zumj.journals.ekb.eg/article_46584.html}, eprint = {https://zumj.journals.ekb.eg/article_46584_a42a01d3de93b6ba061e1190ddc4cf7e.pdf} } @article { author = {Naguib, Tarek and Al-Daydammony, Mohammad and Salama, Alaa and Eid, Mohammed}, title = {The Age, Creatinine and Ejection fraction (ACEF_ Score as Predictor of Acute Kidney Injury in Patients Undergoing Primary versus Elective Percutaneous Coronary Intervention}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {773-781}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10231.10870}, abstract = {ABSTRACT Background_ Age, creatinine and ejection fraction (ACEF) score has been established as a predictor of clinical outcomes in patients undergoing primary Percutaneous Coronary Intervention. Its utility in patients undergoing elective percutaneous coronary intervention is yet unexplored. AIM OF WORK__This study aims to investigate the risk factors associated with Acute Kidney Injury development in patients with ST segment Elevation undergoing primary PCI or with Coronary Artery Disease undergoing elective PCI.We investigates the applicability of ACEF score on patients undergoing elective PCI Patients and Methods__ calculating ACEF score for 80 patients divided into two groups: group I will include 40 patients for primary PCI and group II will include 40 patients for elective PCI with fixation of type (meglumine- ioxitalamate) and amount (≤300 ml) of the contrast used . Results__ 8 patients from 80 had AKI; 4 patients from each group .There was no significant difference between both groups regarding smoking, history of diabetes mellitus, hypertension, dyslipidemia and family history of IHD in primary PCI group versus elective PCI group. Conclusion__ A fully pre-procedural risk prediction model would be useful to facilitate precautionary measures for patients at a high risk of Contrast Induced Nephropathy.  ACEF risk score incorporate only 3 variables, which may make it more acceptable for clinical use, because of its simplicity.ACEF score can be used to predict AKI in patients undergoing primary PCI as well as elective PCI.  }, keywords = {ACEF score,Acute kidney injury,percutaneous coronary intervention,Acute myocardial infarction,Chronic Kidney Disease,Ischemic heart disease}, url = {https://zumj.journals.ekb.eg/article_46585.html}, eprint = {https://zumj.journals.ekb.eg/article_46585_f9e9df6ad89db38f0c870f643943744a.pdf} } @article { author = {El-Garf, Ahmed and Salah, Eman and Ahmed, Mohamed}, title = {The Use of Trichoscopy to Assess the Efficacy of Topical Minoxidil 2% Solution in Patients with Female Pattern Hair Loss}, journal = {Zagazig University Medical Journal}, volume = {25}, number = {5}, pages = {782-789}, year = {2019}, publisher = {Zagazig University, Faculty of Medicine}, issn = {1110-1431}, eissn = {2357-0717}, doi = {10.21608/zumj.2019.10297.10920}, abstract = {ABSTRACT Background: Female pattern hair loss is a common cause of alopecia in women that predominately affects postmenopausal women and is characterized by a decrease in hair density over the crown and frontal scalp. The aim of this study was a clinical and trichoscopic evaluation of topical minoxidil 2% solution in treatment of female pattern hair loss. Methods: A clinical trial was done with twenty patients with female pattern hair loss. The studied patients were treated with minoxidil 2% topical solution twice daily for six months. A clinical and trichoscopic examination were done before starting treatment and every two months with photo-documentation, and scoring of disease severity using Ludwig Scale. Results: Regarding hair growth, a significant difference was detected between baseline and both 4 and 6 months. 55% of studied patients reported side effects. Conclusion: Minoxidil stimulates hair growth after 4 months of treatment but with side effects as dermatitis and hypertrichosis.  }, keywords = {Minoxidil,FPHL,Alopecia,Trichoscopy}, url = {https://zumj.journals.ekb.eg/article_46586.html}, eprint = {https://zumj.journals.ekb.eg/article_46586_679a8d0c3b83a6d0fa5ad3a968a5cfe6.pdf} }