eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
9
10.21608/zumj.2016.4643
4643
Original Article
COMORBIDITY ASSESSMENT AND THYROID HORMONES IN INDEPENDENTLY-LIVING ELDERLY
Ayman Abdelhai
1
Ibrahim Salem
2
Heba Gawish
3
Department of Internal medicine; Faculty of Medicine, Zagazig University, Zagazig, Egypt
Department of Internal medicine; Faculty of Medicine, Zagazig University, Zagazig, Egypt
Department of Clinical Pathology; Faculty of Medicine, Zagazig University, Zagazig, Egypt
Background: the study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate comorbidity with abnormal thyroid function.Methods: a total of 246 subjects aged more than 60 years, admitted to General Medicine or attended the out-patient clinic who were presented with vague symptoms like easy fatigability and lethargy, were subjected to detailed clinical examination and thyroid function testing by biochemical means.Results: a total of 246 patients were included in the study. Thyroid disorders were present in 51.2%. Clinical hypothyroidism in 8.13%, subclinical hypothyroidism in 4.88% cases, hyperthyroidism in 3.3% and Low tri-iodothyronine (T3) syndrome in about one third of our patients were noted. There were no correlation between the thyroid hormones and most of clinical and laboratory parametes. The prevalence of abnormal thyroid patterns were significantly high in patients with comorbidities in comparison to those without.Conclusions: Elderly patients especially those with comorbidity have high prevalence of thyroid dysfunction. Clinical diagnosis is difficult to make because of vague symptomology and comorbid diseases. So, high clinical suspicion and thyroid function tests always helps in diagnosing the disease.
https://zumj.journals.ekb.eg/article_4643_696908b78f9a02f9a4d89413846e21a5.pdf
comorbidity
thyroid hormones
Elderly
No conflict of interest
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
8
10.21608/zumj.2016.4644
4644
Original Article
ESTIMATION OF HOMOCYSTEINE LEVELS IN TYPE 2 NON HYPERTENSIVE AND HYPERTENSIVE DIABETIC PATIENTS
Amal El-Maghraby
1
Eman Aissa
2
Lobna Ibrahim
3
Departments of General Medicine , Benha Teaching Hospital;Benha, Egypt
Departments of Clinical Pathology, Benha Teaching Hospital;Benha, Egypt
Clinical Pathology, Benha Teaching Hospital;Benha, Egypt
Background: Hyperhomocysteinemia increases risk of morbidity and mortality secondary to cardiovascular diseases such as increased risk of atherosclerosis, ischemic heart disease and peripheral vascular disease and has been associated with microalbuminuria in type II diabetes mellitus. Subjects and Methods: 100 patients, 50 hypertensive diabetic patients, 50 normotensive diabetic patients, and 20 patients as control group matched for age, gender and body mass index (BMI) and were clinically assessed and laboratory investigations were done through estimation of plasma homocysteine, lipid profile, fasting and two hours post prandial blood glucose, and serum creatinine. Results: Homocysteine was elevated more in hypertensive diabetic group than diabetic group with high significant correlation (P=0.001), moreover homocysteine was highly significant correlated to BMI fasting blood glucose, cholesterol, serum triglyceride (P=0.001), and insignificant correlation to serum creatinine in both goups. Conclusion: Homocysteine is a significant risk factor in hypertensive diabetic patients. Using folic acid supplement 0.4mg daily is essential to reduce level of serum homocysteine especially in hypertensive, diabetic patients to decrease risk of cardiovascular events in addition of controling blood pressure, blood sugar and obesity.
https://zumj.journals.ekb.eg/article_4644_1d6f452f17761db6666e3106ce1036d9.pdf
Homocysteine
Hypertension
Type II DM
Cardiovascular disease
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
7
10.21608/zumj.2016.4645
4645
Original Article
INDICATION AND THE EFFICACY OF ADENOIDECTOMY IN INFANCY
Wael Alzamil
1
Essam Mohamed
2
Ear nose and throat deparment, hearing and speech institute general organization for teaching hospitals and institutes, egypt, Sameer Attya
general organization for teaching hospitals and institutes, egypt, Said Abdelmonem, faculty of medicine zagazig university.
Objective; this study is carried out to assess the efficacy of adenoidectomy in infants less than 1 year with OSA provided that no craniofacial anomalies or neuromuscular disease. Background; Pediatric obstructive sleep apnea is most commonly caused by adenoid hypertrophy. Although adenoidectomy is the only effective treatment for adenoid hypertrophy, it is rarely performed in infants less than 1 year old. Materials and methods; Twenty infants less than 1 year old with a triad of upper airway obstruction symptoms, findings of obstructing adenoids, and obstructive sleep apnea undergo adenoidectomy will be included in our study. This is a retrospective study reviewing each infant's clinical data, including presenting symptoms, physical examination findings, and results of the investigations such as polysomnography, endoscopy, and echocardiography. With careful preoperative and postoperative monitoring, the 20 infants underwent adenoidectomy. Results: The infants' ages ranged from 8 to 12 months, with a mean of 10 months. There were 13 boys and 7Girls. The length of follow-up ranged from 6 to 16 months, with a mean of 10 months (median, 10.5 months).The most common presenting symptoms were noisy breathing, usually snoring in19 infants (95 %), apnea in 18 infants (90%) After the adenoidectomy all infants showed dramatic improvement with disappearance of symptoms of upper airway obstruction, failure to thrive, and pulmonary hypertension. Conclusions; Adenoidectomy was found to be sufficient and curative for such infants.
https://zumj.journals.ekb.eg/article_4645_d0ef9f91a74bc38fe4cdc77f3c2a74b4.pdf
adenoid hypertrophy
Adenoidectomy
Obstructive sleep apnea
upper airway obstruction
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
9
10.21608/zumj.2016.4646
4646
Original Article
RECONSTRUCTION OF POSTBURN CONTRACTURE OF FIRST WEB SPACE OF THE HAND
Ahmed Ahmed
1
Reconstructive and Plastic surgery Department, Faculty of Medicine, Al-Azhar University Hospital, Damietta, Egypt
Background: Soft tissue reconstruction of the first web space remained a challenge for plastic and reconstructive surgeons. First web space adduction contractures are a common consequence of hand burns. Many reconstructive techniques are used and investigation for more effective methods continues.Objective: assess the range of movement as regard opposition, palmar abduction and thumb extension. Also assessed the depth of web space after reconstruction of post burn contracted first web space to ass the method of covering the defect after release..Materials and Methods: 35 patients’ ages ranged from 12 to 59 years (with mean 31.7), years; 23 males and 12 females admitted to our Hospital during the period from June 2008 to May 2012. All patients were suffering from post-burn first web contractures. The patients underwent a variety of surgical procedures. The follow-up period ranged from one to three years.Results: Full range of motion achieved in most patients, but not those with joint affections.Conclusions: In our experience, surgical correction of first web space contractures- in the form of flaps good results followed by skin grafts- results in meaningful functional enhancement. The outcomes depend primarily on the severity of contracture. Functionally limiting recontracture is rare in our experience and its best prevented by appropriate therapy
https://zumj.journals.ekb.eg/article_4646_61969cc5664be2e2496cccf813b58a51.pdf
Contracture
burns
First web space reconstru
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
10
10.21608/zumj.2016.4647
4647
Original Article
ROLE OF DAIGNOSTIC ULTRASONOGRAPHY IN EVALUATION OF HAND ANDWRIST LESIONS
Osama AllaDawoud
1
Ibraheem Lebida
2
Dalia Khalel
3
Mahmoud Gabal
4
(Radiodiagnosisdepartments, Faculty of Medicine, ZagazigUniversity)
(Radiodiagnosisdepartments, Faculty of Medicine, ZagazigUniversity).
Radiodiagnosisdepartments, Faculty of Medicine, ZagazigUniversity).
Radiodiagnosisdepartments, Faculty of Medicine, ZagazigUniversity).
Objective: To highlight the role of high resolution US (ultra sound) in diagnosis of hand and wrist lesions.Materials And Methods: This study was performed at Radiology department, Zagazig university hospitals during the period from January 2011 to December 2015 .one hundred patients complaining of wrist or hand problem and fifteen normal volunteers subjects as control group were enrolled in the study and uponsuspected clinical diagnosisthey wear grouped into five groups. High resolution US was done for all cases and control subjects. Results following surgical evaluation or clinical and radiological follow up were compared with the US results. Sensitivity, specificity, PPV, NPV and accuracy were calculated.Results:Group A included 40 cases:Carpal tunnel syndrome (CTS) was detected in 20 patient, traumatic or post-operative nerve injury was presented in 20 cases, Majority of cases 10 cases (50%) showed complete chronic nerve cut with neuroma in continuity. Group B included 35 cases40% of the patients had complete tendon cut, 17.2 % had partial thickness tendon cut, 14.3% isolated tenosynovitis and 28.6 % had tendon entrapment. Group C included 10 cases with arthritis; Group D included 8 cases with hand or wrist mass, and group E included 7 cases with foreign body impaction. The sensitivity, specificity, PPV, NPV and accuracy of US examination in diagnosing different wrist and hand pathology in those groups were high reaching up to 100% in most of these pathologies exceptfor complete traumatic tendon cut the sensitivity, specificity, PPV, NPV and accuracy of ultrasound were 87.5%, 100%, 100%, 75% , 90%,for partial tendon cut were 100%, 87.5%, 66.7%, 100%, 90% , for the complete nerve injury were 100%,90.9%, 90% 100% , 95% and for partial nerve injury were 77.8 %, 100%, 100%, 84.6%, 90% respectively.Conclusions:Us has high sensitivity and specificity in detecting most of the hand and wrist pathology. It can be used for pre-operative planning.It is low cost and Lacking of ionizing radiation made it the first imaging modality for hand and wrist lesions.
https://zumj.journals.ekb.eg/article_4647_7e134cd70599919ccd1820cff1f5e5a1.pdf
High Resolution US
hand and wrist lesions
CTS
nerve njury
eng
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
2016-05-01
22
3
1
10
10.21608/zumj.2016.4648
4648
Original Article
MICROALBUMINURIA AS A PROGNOSTIC VALUE FOR POST-OPERATIVE PATIENTS WITH RISK OF SEPSIS AFTER MAJOR ABDOMINAL SURGERY
Sameh Seyam
1
Mostafa Sabra
2
Mohsen Eissa
3
Mofeed Abdelmaboud
4
Tawfik Nooreldin
5
Anesthesia and ICU Department; Faculty of Medicine; Al-Azhar University; Egypt.
Anesthesia and ICU Department; Faculty of Medicine; Al-Azhar University; Egypt.
Anesthesia and ICU Department; Faculty of Medicine; Al-Azhar University; Egypt.
Anesthesia and ICU Department; Faculty of Medicine; Al-Azhar University; Egypt.
Anesthesia and ICU Department; Faculty of Medicine; Al-Azhar University; Egypt.
Background:- Microalbuminuria is one of the early indicators of sepsis. It is caused by diffused endothelial dysfunction in critically ill septic patients. The degree of microalbuminuria corresponds with the intensity of the inflammatory contempt.Purpose:- To investigate whether microalbuminuria has a prognostic value in surgical sepsis or not, with particular regard to its role in anticipating illness intensity, clinical course and mortality.Methods:- The study was applied in the critical care unit, Sayed Galal hospital, Faculty of medicine, Al-Azhar university. A sum of 80 patients were included in a prospective, non-interventional study following major abdominal surgery, and divided into two groups each group containing 40 patients. Albumin/Creatinine ratio (ACR, mg/g) was measured in urinary samples collected preoperatively (tp), upon ICU admission (t0), after 6 hours (t6) and at 24 hours (t24). Acute physiology and chronic health evaluation II (APACHE II) score was calculated 24, 48 and 72 hours, and Sequential Organ Failure assessment (SOFA) score was calculated daily for 3 days. Clinical outcome (length of ICU stay), and final outcome (survival or mortality rates) were recorded and documented for all patients.Results:- There was statistically significant difference between groups according to ACR t0 to t24 specially at t6 which was highly significant in group II in relation to group I with p-value <0.001.There was highly statistically significant difference between groups according to APACHE score in group II in relation to group I for APACHE 24, 48, and 72, p-value <0.001. There was highly statistically significant difference between groups according to SOFA score in group II in relation to group I for SOFA1,2 and 3, p-value <0.001. There was statistically significant difference between groups according to outcome (death was 12.5% in group I in relation to 37.5% in group II) p-value 0.020.Conclusion:- Microalbuminuria an easy, rapid and simple tool has a prognostic value in surgical sepsis, with precise regard to its role in anticipating illness severity, clinical course and mortality.
https://zumj.journals.ekb.eg/article_4648_a919798b0d5116af42cf5a60b207b7e9.pdf
Microalbuminuria
APACHE score
SOFA score
mortality
major abdominal surgery