Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
OXIDATIVE STRESS INDICES OF ORGANOPHOSPHATES PESTICIDES AMONG AGRICULTURAL WORKERS AT MIT-GHAMR DISTRICT, EGYPT
187
197
EN
Raghda
Ali
Elshamy
mr_forever08@yahoo.com
Aida
Abdel Hamid
Hassan
Safaa
Abd El-Moez
El-Naggar
Mahmoud
Abd elghany
Nomier
Dalia
Abdallah
El-Shafei
10.21608/ZUMJ.1999.25525
Background: Organophosphates pesticides (OPs) exert their toxicity on the body through inhibition of Cholinesterase Enzyme (ChE) in the nerve and muscle tissues. Inhibition of cholinesterase itself cannot account for the wide range of disorders that have been reported following OPs exposure as oxidative stress has been implicated as one of the mechanisms for the adverse health effects of OPs exposure. <br />Aim of the study: To study oxidative stress among agricultural workers through assessment of blood level of Butyl Choline Esterase enzyme (BuChE), as an indicator of exposure to OPs, assessment of blood level of Malondialdehyde (MDA), as an indicator of oxidative stress, and erythrocyte activity of Superoxide Dismutase (SOD), as an indicator of antioxidant activity and identification of occupational and personal risk factors that may be associated with oxidative stress among agricultural workers.<br />Subjects and methods: A comparative cross sectional study was conducted among 48 agricultural workers exposed to OPs and 48 subjects non-exposed to OPs. Both two groups were subjected to a structured questionnaire included questions about Socio-demographic and Occupational history, followed by laboratory investigations to measure BuChE, MDA and SOD. <br />Results: This study showed that the median level of MDA was significantly higher among exposed group compared to non-exposed group, while the median levels of BuChE and SOD were significantly lower among exposed group compared to non-exposed group. The level of BuChE, MDA and SOD were significantly correlated with each other and with work duration (years), number of worked hours/day, hours of spraying pesticides/day. Non-usage of personal protective equipment (PPE) and lack of washing facilities increased the risk of abnormal MDA and SOD. Duration of work (years) and number of worked hours / day were the significant predictors for abnormal oxidative indices.<br />Conclusion: The study concluded that exposure to OPs can induce abnormal oxidative stress indices among agricultural workers. So, it is recommended to do regular screening of agricultural workers, design strategies that can reduce pesticide exposure, provide PPE all time and encourage workers to take antioxidants regularly.
Oxidative Stress Indices,Organophosphate Pesticides,Agricultural workers,Egypt
https://zumj.journals.ekb.eg/article_28188.html
https://zumj.journals.ekb.eg/article_28188_3241298661cc3c2de5ac78a3abc639bd.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
THE ROLE OF MONOCYTE CHEMOATTRACTANT PROTEIN-1 IN DIAGNOSIS OF ISCHEMIC HEART DISEASE WITH NEGATIVE EXERCISE
198
206
EN
Adel
Atia
Ahmed Algdar
Aly
Mohammed
Abdorahman Saad
Islam
Abdel Moneim
El-Sherbiny
Ahmed
Saied
Eldamanhory
10.21608/ZUMJ.2019.26921
<strong>Objective:</strong> The aim of the present study was to find new simple non-invasive test can be used in early prediction of the presence of coronary artery disease.<br /> <strong>Methods:</strong> This comparative cross-sectional study was conducted at Cardiology Department, Zagazig University Hospital, and Al-Ahrar Hospital during the year period 2018. <br /> <strong>Results:</strong> The present study was carried out among 39 patients diagnosed with ischemic heart disease (IHD) admitted at Cardiology Department, Zagazig University Hospital, and Al-Ahrar Hospital during the year period 2018. Out of total 39 patients, 51.3% were males and 48.7% were females.<br /> <strong>Conclusion:</strong> Our Study concluded that MCP-1 at cut off value 113.5ng/l can predict the presence of significant coronary artery lesion need intervention in patient with chest pain and negative exercise test. Also We found that MCP-1 at cut off value 406 ng/l is correlated to heigh syntax score,that guide the decision for CABG against PCI . <br /><br />
Monocyte Chemoattractant,Protein-1,MCP-1,Ischemic heart disease,Negative Exercise ECG
https://zumj.journals.ekb.eg/article_28189.html
https://zumj.journals.ekb.eg/article_28189_7e297b0a161e7395a49804747b94aef6.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
ROLE OF MULTIDETECTOR COMPUTED TOMOGRAPHY IN BILIARY OBSTRUCTION.
207
215
EN
Ahmed
Mohamed
Samy
Hazim
Ibrahim
Tantawy
hazimtantawy@yahoo.com
Hamed
Abdalhakim
Gobran
hamed_gobran@yahoo.com
Ahmed
Mohamed
Alsowey
10.21608/ZUMJ.2019.6906.1008
<strong>Background</strong>: Obstructive Jaundice is a common surgical problem, MultiDetector Computed Tomography in diagnosis of biliary tract obstruction has a vital role as post processing techniques can be utilized to identify variant biliary anatomy to guide preoperative biliary surgery planning, determine level and cause of obstruction, early tumor detection and staging of biliary cancer are the key factors for possible cure by surgical resection, our aim is to evaluate the role of MDCT in diagnosing level and cause of biliary obstruction.
<strong>Patients and Methods:</strong> Sixty nine patients with clinically suspected biliary obstruction were encountered in the study and subjected to clinical assessment including full history taking, clinical examination and imaging assessment by MDCT, our findings were correlated to standard reference examinations including: Operative/ERCP/Biopsy and histopathology findings.
<strong>Results:</strong> Our results showed that the most affected age group was group between 60: <70 years old, males were affected more than females. The most common clinical presentation in our patients was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination in our study. Our patients were categorized according to the cause of biliary obstruction into seven groups: Malignant stricture group 52.2% (36patients), Calcular group 24.6% (17patients), Iatrogenic group 5.8% (4patients), Porta hepatis lesions group 5.8% (4patients), Benign stricture group 4.3% (3patients), Inflammatory group 4.3% (3patients), Congenital group 1.4% (1patient).
<strong>Conclusions:</strong> MultiDetector computed tomography provides a modality with high diagnostic performance for differentiating benign from malignant lesions and in detecting biliary calculi.<strong> </strong>
Multidetector Computed Tomography,Biliary obstruction,Obstructive jaundice
https://zumj.journals.ekb.eg/article_28190.html
https://zumj.journals.ekb.eg/article_28190_a647cf02d86d0ab461e138ca8c4f322e.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
PREVALENCE AND ASSOCIATED FACTORS OF SUICIDE AMONG PREGNANT WOMEN AT ZAGAZIG UNIVERSITY HOSPITALS
216
226
EN
Mohamed
Abdelghani
Moustafa
Usama
Mahmoud
Youssef
Nagy
Fawzy
Sleem
Reham
Hassan
Mohamed El- Hanafy
10.21608/ZUMJ.2019.26922
<strong>Background</strong><strong>:</strong> Pregnant women are at increased risk for suicidal ideation and behaviors (SIB) compared to the general population. To our knowledge, this is the first study in Egypt discussing the prevalence and risk factors of suicide among pregnant women. The study aimed to estimate the frequency of suicide and suicidal ideation and identify the socio-demographic and clinical determinants of suicide and suicidal ideation among pregnant women at Zagagzig University Hospitals.
<strong>Methods:</strong> A sample of 167 pregnant women received prenatal care at Obstetrics and Gynecology Outpatient clinic, Zagazig University hospitals. A simple questionnaire was structured for all participants to collect data on socio-demographic data, clinical and obstetric history & exposure interpersonal violence. The psychometric assessment was done which included: Beck Suicidal Ideation Scale (BSS), Zagazig Depression Scale (ZDS), and Hamilton Anxiety Rating Scale (HAM-A).
<strong>Results</strong><strong>:</strong> The prevalence of current suicidal risk (CSR) among pregnant women was 22.2%, this value could be subdivided into suicidal ideation of 20.4% and suicidal attempt of 1.8 %.Women who had anxiety/ depression or had exposed to current partner aggressiveness were significantly more likely to have had current suicide risk (CSR).
<strong>Conclusion: </strong>Pregnant women at the greatest risk for current suicide risk (CSR) were those who were depressed/anxious or had experienced some form of current partner aggressiveness. With the high prevalence of these conditions, attention should be given to the establishment of adequate mental health treatment programs for pregnant women.
Pregnancy,current suicide risk (CSR),anxiety/ depression,current partner aggressiveness
https://zumj.journals.ekb.eg/article_28191.html
https://zumj.journals.ekb.eg/article_28191_14eb5a256a4b637669bede06b097849b.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
LATERAL SPHINCTEROTOMY UP TO THE FISSURE APEX VERSUS TO LESS-THAN 1CM FROM ANAL VERGE IN CHRONIC ANAL-FISSURE IN FEMALES
227
233
EN
Beshoy
Tharwat
Eskander
tharwat_beshoy@yahoo.com
Abd El-Rahman
Hassan
Sadik
Abd El-Wahab
Saleh
Hassan
Awad
Saad
12341234123512341234
ebramos_2010@yahoo.com
10.21608/ZUMJ.2019.26923
<strong>Background:</strong> Lateral internal sphincterotomy is the ideal and gold standard surgical management of chronic anal fissure. The extent of lateral internal sphincterotomy is still a subject of discussion. Excess division of the internal sphincter leading to incontinence either to stool or flatus, so we must determine the extent of sphincterotomy.
<strong>Subjects and methods:</strong> Between the period from February 2018 and October 2018 in the General Surgery Department of Zagazig University and El – Ahrar teaching Hospitals, 62 female patients with chronic anal fissure with mean ages of (34.1 + 8.2) and (41.8 + 9.05) of group A and B respectively complaining of chronic anal fissure. Group A of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy up to the fissure apex. Group B of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy to less than 1 cm from anal verge.
<strong>Results:</strong> Group A showed complete fissure healing in 4 weeks (25) patients (80.6%) with (6 )patients cases comprising (19.35%) with delayed wound healing in 6 weeks .( 9 ) patients ( 29 % ) had transient incontinence to flatus .
Group B showed complete fissure healing in 5 weeks (20) patients (64.5%) with (11 )patients cases comprising (35.5%) with delayed wound healing in 6 weeks .( 2) patients ( 6 % ) had transient incontinence to flatus
<strong>Conclusions: </strong>In females with chronic anal fissure, division of internal sphincter must not exceed 1 cm from anal verge and not reach apex of the fissure to preserve the internal sphincter function and prevent incontinence either to stool or to flatus.
chronicanal fissure,lateral internal sphincterotomy,stool incontinence,fissure healing
https://zumj.journals.ekb.eg/article_28192.html
https://zumj.journals.ekb.eg/article_28192_9062a38e83ed2857b9d1c285e3114681.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
IMPACT OF INFARCT RELATED ARTERY AND ITS PATENCY ON THE OUTCOMES OF PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
234
241
EN
Mohammad
Ibrahim
Alameddin
0000-0002-3465-7508
m3alamdien@gmail.com
Mesbah
Taha
Hasanin
mesbahhasanein1@gmail.com
Tamer
Mohamed
Mostaf
Wael
Ali
Khalil
drwael123456@yahoo.com
10.21608/ZUMJ.2019.27409
<strong>Background: </strong>Primary percutaneous coronary intervention (PCI) for acute myocardial infarction might be associated with suboptimal coronary flow with consequent poor functional recovery and higher rate of complications. Identification of the predictors of reperfusion failure can increase the rate of procedural success, preserve ventricular function and lessen mortality. We aimed to find the association between baseline coronary patency & culprit site with PCI outcome and the incidence of major adverse cardiac events (MACE).
<strong>Methods: </strong>46 STEMI patients treated by primary angioplasty were enrolled, then grouped according to the infarction related artery patency graded by TIMI flow. Over the next 3 months, patients were followed for the incidence of stent thrombosis, re-infarction, acute decompensated HF & death.
<strong>Results: </strong>27 patients had initial TIMI 0 flow and 19 patients had initial TIMI ≥1 flow.The proportion of satisfactory PCI outcome was 44.4% and 78.9% respectively (p=0.019). The later incidence of MACE was 66.7% and 21.1% respectively (p=0.002). The culprit vessel was LAD, LCX and RCA in 54.3%, 10.9% and 34.8% of the cases. When grouped based on the culprit, incidence of MACE was 68%, 20% and 25% (p=0.011). Multivariate logistic regression analysis found that initial TIMI 0 flow (p=0.013) and LAD as the infarction related vessel (p=0.032) were independent predictors for MACE.
<strong>Conclusion: </strong>Initial infarction related artery patency at angiography has a direct impact on PCI outcome. Baseline TIMI 0 flow and LAD as a culprit site are independent predictors for major adverse cardiac events in STEMI patients undergoing primary angioplasty.
STEMI,Primary PCI,TIMI flow,LAD,MACE
https://zumj.journals.ekb.eg/article_28193.html
https://zumj.journals.ekb.eg/article_28193_dcd3bfc559183328cafa133b91d4d490.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
EFFECTS OF DOXORUBICIN ON LEFT VENTRICLE OF ADULT MALE ALBINO RATS: HISTOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY
242
249
EN
Khaled
F
Ahmed
F.E
Shaheen
M.A
10.21608/ZUMJ.2019.25882
<strong>Background/Aim</strong>:Doxorubicin (Dox) is one of the anthracyclines which are a group of antibiotics that are among the most active chemotherapeutic agents. It has a cardiotoxic effect. The objective of the study was to evaluate Dox as chemotherapeutic agent with cardiotoxic effect.
<strong>Methods</strong>: forty male wistar rats (200 ± 50 g) were divided in to two groups: control and doxorubicin. Doxorubicin group was injected at a dose of 3 mg/kg BW of doxorubicin at days 1, 3, 5, 7, 9 and 11. At 12<sup>th</sup> dayof the study, blood was collected by retro-orbital puncture and serum LDH and CK-MB were estimated. The animals were then sacrificed and their hearts were dissected and specimens were prepared and stained for histological examination by light microscope.
<strong>Results</strong>: Examination of H&E sections of the left ventricular myocardium of Dox-treated group showed irregular separated cardiomyocytes with pyknotic nuclei and hemorrhage in-between. Sections of the same group revealed weak positive cytoplasmic immunoreactions for desmin protein in numerous cardiomyocytes. Intercalated discs and cytoplasmic striations also disappeared in several cardiomyocytes. Ultrathin sections of left ventricle of the Dox-treated group exhibited cardiomyocytes with irregular fragmented shaped nucleiand peripheral condensed chromatin with disorganized intercalated discs.Variable sized mitochondria with ruptured cristae were observed in between the fragmented myofibrils.
<strong>Conclusion</strong>: Dox showed evident harmful effects on left ventricular cardiocytes of adult male albino rats. Therefore, searches are required to find an alternative drug with the same efficacy or exploring protective methods against Dox hazardous impact on the heart.
Doxorubicin,Cardiomyocytes,intercalated discs
https://zumj.journals.ekb.eg/article_28194.html
https://zumj.journals.ekb.eg/article_28194_e1f0eac82b5604f4bd542295d7e6161a.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
EFFECT OF MONOSODIUM GLUTAMATE ON THE CEREBELLAR CORTEX OF MALE ALBINO RAT AND PROTECTIVE ROLE OF VITAMIN C
250
260
EN
Abd El-mawla
El sayed
Aidaros
Amal
Al-Shahat
Ibrahim
Heba
Osama
Mohammed
0000-0002-0944-6186
yassin_mekkawy@yahoo.com
Nancy
Husseiny
Hassan
0000-0002-8497-0412
nancyhusseiny@gmail.com
10.21608/ZUMJ.2019.27410
<strong>Background:</strong> Monosodium Glutamate (MSG) is one of the most widely used food-additives in commercial foods that had effect on various tissues including cerebellum. It acts via creating an oxidative stress. The central nervous system is a target organ for MSG especially cerebellar cortex. The health benefits of vitamin C were derived from its role in the key reactions within immune function, metabolism, and other enzymatic reactions. <strong>Aim:</strong> To evaluate the effect of MSG on rat’s cerebellar cortex with the possible protective role of Vitamin C. <strong>Methods: </strong>Twenty one adult male albino rats have been used in this work. The animals were randomly divided into three groups with seven animals in each group. Group 1 (Control): Animals were kept without addition of any chemicals. Group 2 (MSG-treated): Animals were subjected to administration of MSG 4g/kg body weight dissolved in 1 ml normal saline. Group 3 (MSG and Vitamin C treated): Animals were subjected to administration of both MSG 4g/kg body weight dissolved in 1 ml normal saline and 500 mg/kg vitamin C, orally. By the end of the experiment which was 10 days. Animals were anaesthetized and sacrificed. Cerebellar hemispheres were obtained and specimens were processed for both light and electron microscopic examination. <strong>Results: </strong>MSG caused histopathological and morphometric changes in rat’s cerebellar cortex. Vitamin C protected the cerebellar cortex specimens against such changes. <strong>Conclusion:</strong> MSG could result in hazards to the structure of cerebellar cortex. Fortunately co-administration of vitamin C is suggested to reduce such hazards.
adult rats,cerebellar cortex,Monosodium glutamate,vitamin c
https://zumj.journals.ekb.eg/article_28195.html
https://zumj.journals.ekb.eg/article_28195_21cbe49ae3788948996842d4601ee0e3.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
ASSESSMENT OF DIFFERENT NON-INVASIVE SCORE MODALITIES IN PREDICTION OF ESOPHAGEAL VARICES IN PATIENTS WITH LIVER CIRRHOSIS
261
268
EN
Kamel
A. Ahmed
Ibrahim
H. Mohammed
Farag
A.
Alaa
Gomaa
F.
Ahmed
10.21608/ZUMJ.2019.27411
<strong>Background: </strong>Varices are a serious consequence of portal hypertension, and variceal bleeding is a life-threatening complication occurring in up to 30% of patients with cirrhosis. Despite the great improvement in diagnosis and the available therapeutic modalities, mortality from acute variceal bleeding may still reach up to 20%. Therefore, our aim was to assess the role of non-invasive score modalities in the prediction of the presence of EVs & to predict EVs severity. <strong>Methods: </strong>This Comparative cross-sectional study was conducted on a cohort of 90 cirrhotic patients. All patients were subjected to investigations include complete blood count, liver and kidney function tests, bleeding profile, random blood sugar, and serum sodium.The following scores were estimated: Child-Pugh score, MELD -Na<sup>+</sup> score, AAR, APRI, FIB-4, and King's score. Upper GI endoscopy was done for evaluation of presence or absence of EVs. <strong>Results: </strong>Our results revealed that Kings Score is the most sensitive and specific score in predicting the presence of EVs, followed by APRI score while AAR score has the least sensitivity and specificity.FIB-4 score is the most sensitive scoring system in predicting severe EVs, followed by APRI, Kings, and AAR scores. Regarding specificity, King’s Score is the most specific one followed by FIB-4, APRI and AAR. <strong>Conclusions: </strong>King’s score has the highest sensitivity and specificity in EVs prediction followed by APRI. Regarding severe EVs, FIB-4 score is the most sensitive scoring system in the prediction of severe EVs. However, King’s score is the most specific one.
Esophageal varices,GIT Endoscopy,Cirrhosis,Non-Invasive modalities
https://zumj.journals.ekb.eg/article_28196.html
https://zumj.journals.ekb.eg/article_28196_bbcbdf0ea5264078906f6b4ad479a853.pdf
Zagazig University, Faculty of Medicine
Zagazig University Medical Journal
1110-1431
2357-0717
25
2
2019
03
01
EFFECTS OF TAMOXIFEN AND AROMATASE INHIBITORS ON ENDOMETRIUM IN BREAST CANCER PATIENTS AT ZAGAZIG UNIVERSITY HOSPITALS.
269
277
EN
Ahmed
A.
Amer
amrawd75@yahoo.com
Nashwa
E.
Nawar
nashwa.near22@gmail.com
Amr
A.
Elnemr
amrabmohsen@yahoo.com
Manal
A.
Abd Elmageed
10.21608/ZUMJ.2019.26413
<strong>Objective</strong>: To investigate the effect of endometrial abnormalities in breast cancer patients treated with Tamoxifen (group I), Aromatase inhibitors (group II) or No treatment (group III) .To determine the best approach for screening these patients for endometrial pathology. <strong>Methods</strong>:117 patients at outpatient clinic, Departments of Clinical Oncology& Nuclear medecine and of Obstetrics & Gynecology, Zagazig University Hospitals .Conventional transvaginal ultrasonography for detection of the uterine size, endometrial thickness as basal ultrasound and followed up every six months. Diagnostic hysteroscopy and endometrial biopsy were done only for patients with abnormal uterine bleeding and asymptomatic patients with increasd endometrial thickness >5mm in postmenopausal or >8mm in premenopausl cases . <strong>Results</strong>: At the end of 48 months follow up period, the most common endometrial lesions of group I were endometrial hyperplasia in 5 patients (31.3%),endometrial polyp in 4 patients (25 %) and endometrial atrophy in two patient (12.5%). This gave impression that endometrial poylp & endometrial hyperplasia were the most common endometrial lesion of group I. In group II the most common endometrial lesions detected by hysteroscopy and histopathological examination were endometrial atrophy in 3 patients (30%), endometrial polyp in one patient (10%) and endometrial hyprplasia in one patient (10%) . <strong>Conclusions:</strong> Tamoxifen was associated with development of various endometrial changes, including endometrial hyperplasia, cystic atrophy, leiomyoma, endometrial carcinoma and other types of uterine malignancy especially in postmenopausal patients. Even if they are asymptomatic, these patients must be evaluated carefully
https://zumj.journals.ekb.eg/article_28197.html
https://zumj.journals.ekb.eg/article_28197_49ff7c19fdbcf1a7d5d92562d2537c8a.pdf