Zagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501STUDY ON PROTECTION OF CARDIOVASCULAR SYSTEM AND KIDNEY BY DIFFERENT ANGIOTENSIN RECEPTOR BLOCKERS IN EXPERIMENTALLY INDUCED HYPERTENSIVE ADULT MALE ALBINO RATS111468910.21608/zumj.2017.4689ENZakiAbdel KaderClinical Pharmacology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptEl SayedKamelClinical Pharmacology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptFatmaAliClinical Pharmacology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptSaharAliClinical Pharmacology Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptJournal Article20171218Background: In treatment of hypertension, care should be taken for preventing hypertensive organ injuries as well as lowering blood pressure to the adequate level in order to decrease the risk of cardiovascular and renal diseases. Objectives: To assess and compare the possible protective effect of various angiotensin receptor blockers namely candesartan, olmesartan, telmisartan ,and valsaratn on cardiovascular and renal tissues in renal hypertensive rats Methods: In this study 72 adult male albino rats were used and divided into six equal groups (each of 12 rats): Group 1,<br />control normal received the vehicle; Group 2, control renal hypertensive induced by left renal artery ligation received the vehicle and Group 3 treated renal hypertensive rats which is divided into four subgroups: subgroup (A) received candesartan ( 0.1 mg/kg/day); subgroup (B) received olmesartan ( 3mg/kg/day ); subgroup (C) received telmisartan ( 0.5 mg/kg/day),and subgroup (D) received valsartan (0.5 mg/kg/day). Rats received drugs orally by gavage once daily for 2 weeks. Results: The present study revealed that left renal artery ligation induced significant increases in mean arterial blood pressure (MABP), heart rate (HR), heart weight, cardiac fibrosis and glomerulosclerosis. Also, there were significant increases in serum level of tumor necrosis factor alpha (TNF-α), cardiac level of inteleukin1β (IL1β), and cardiac and renal levels of malondialdehyde (MDA) concomitant with significant reduction in cardiac and renal level of reduced glutathione (GSH). MABP was similarly reduced in candesartan, olmesartan, telmisartan and valsartan groups compared to control renal hypertensive group. Heart rate, cardiac weight, and cardiac fibrosis were significantly reduced in telmisartan and candesartan group. Telmisartan and candesartan suppressed serum level of TNFα and the cardiac level of IL-1β. Meanwhile, olmesartan and valsartan significantly decreased glomerulosclerosis index and renal level of MDA with significant increase in renal level of GSH. Conclusion: Telmisartan and candesartan exerted better cardioprotective effect via prevention of inflammatory cascade, and olmesartan and valsartan exerted better renoprotective effect via enhancement of antioxidant capacity. https://zumj.journals.ekb.eg/article_4689_11dab24c24a988d3d0dbcf3b5c11741b.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501ASSESSMENT OF BRONCHOALVEOLAR LAVAGE PEPSIN LEVEL IN IDIOPATHIC PULMONARY FIBROSIS19469110.21608/zumj.2017.4691ENAhmedSaidChest depatment, Zagazig University, EgyptAhmedAlsoweyRadiodiagnosis department, , Zagazig University, EgyptHodaIbraheemClinical pathology department, , Zagazig University, EgyptJournal Article20171218Background: Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause.Recently, there is increasing evidence supporting a relationship between gastroesophageal<br />reflux, microaspiration, and IPF, since the diagnostic gold-standard for microaspiration remains unknown. So, the aim of this study is to assess the presence of chronic microaspirates by bronchoalveolar lavage pepsin level in these patients.<br />Patients and method: A case -control study was conducted at Chest Department and outpatient clinics Faculty of Medicine, Zagazig University hospitals in the period from (February 2013 till January 2016) on thirty patients with stable interstitial lung diseases (ILD).they were divided into two groups: 15 patients (group I) with stable idiopathic pulmonary fibrosis (IPF), another 15 patients (group II) stable ILD other than IPF. Both groups underwent pulmonary function tests (PFTs), Pulmonary HRCT and Bronchoscopy. Measurement of bronchoalveolar lavage pepsin level was done for all patients. Results: 80% of IPF patients complained from gastroesophageal reflux with a statistically significant decrease in PaO2, FEV1 and FVC than in non IPF patients.Bronchoalveolar lavage pepsin level was (43.711.4ng/ml) in IPF group, which was significantly higher than non IPF group (32.710.5 ng/ml).Also total cell count in IPF patients were increased significantly including neutrophils, alveolar macrophages and red blood. Increased reticulation on HRCT for IPF patients group were associated with higher BAL pepsin levels (p <0.01). Regression coefficient revealed the most powerful predictor of IPF severity were; HRCT findings: reticulation score,honeycombing score[(Odds ratio(95%CI)=5.3 (1.9 to14.9), 7.8 (2.7 to 22.3)respectively],pepsin level[(Odds ratio(95%CI)=4.6 (1.9–11.4)],FEV1 and FVC[(Odds ratio(95%CI)=3.7<br />(1.6 to 8.9), 3.2 (1.4 to 7.5)respectively].while gastroesophageal reflux symptom [(Odds ratio(95%CI)=1.04(0.94-1.14)] was the least powerful predictor. Conclusion: Gastroesophageal reflux or microaspiration is common in patients<br />with IPF, associated with elevated levels of pepsin in BAL fluid. https://zumj.journals.ekb.eg/article_4691_e8c7a12aaa279ab78a1040108996bba9.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF BONE MARROW BIOPSY IN NON HODGKINS LYMPHOMA110469210.21608/zumj.2017.4692ENAhmadAhmadClinical Pathology Department, Zagazig University, Zagazig, EgyptSaad AL DeenEshClinical Pathology Department, NCI, Cairo University, EgyptAmiraKhorshedClinical Pathology Department, Zagazig University, Zagazig, EgyptMohamadMouradClinical Pathology Department, Zagazig University, Zagazig, EgyptJournal Article20171218Background: Trephine bone marrow biopsy is the standard method for the diagnosis of neoplasia. In the last few years its role has been defined further by the widespread introduction of immunohistochemistry (IHC), the method that<br />increased the diagnostic power of the trephine bone marrow biopsy by detecting specific antigens in the tumor tissue using nonflourescent chromogens that can be seen by conventional microscopy. Objective: to evaluate the diagnostic and prognostic significance of bone marrow biopsy in non-Hodgkin's lymphomas. Correlation of bone marrow biopsy finding with other prognostic markers in non-Hodgkin’s lymphomas is another aim. Methods: The study was performed on 50 patients of NHL diagnosed by LN histopathology. All patients were subjected to: clinical examination and laboratory investigations including complete blood picture, liver function tests, kidney function tests, Erythrocyte sedimentation rate, serum lactate dehydrogenase, B2 microglobulin, bone marrow aspiration, immunophenotyping of bone marrow aspiration of the disseminated cases, bone marrow trephine biopsy for: histological classification according to WHO, staging of NHL and Immunohistochemical staining for CD3 and CD20. Results: Twenty patients (40%) positive for infiltration on examination of marrow biopsy and 30 patients (60%) were negative. The results of fifty NHL cases showed only in six cases, both bone marrow biopsy and aspiration were positive (12%; 95% CI, 4.0: 22.0), and in 30 out of 50, the two parameters were negative (60%, 95%CI, 46: 54). Thus, the agreement level between BMB and BMA in the diagnosis of NHL was 27% and discrepancies between bone marrow biopsy and aspirate were found in the remainder. In 14 of 50<br />specimens, BMB alone was positive (28%; 95% CI, 16 : 42). Conclusion: Bone marrow biopsy morphology and immunohistochemical staining remain the cornerstone for proper staging in NHL patients to increase the diagnostic<br />and prognostic accuracy, for appropriate treatment protocols. https://zumj.journals.ekb.eg/article_4692_8cbe4aba712b38c8a8370138b1f8087a.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501SYSTEMATIC REVIEW FOR MANAGEMENT OF POSTEROLATERAL CORNER INJURIES OF THE KNEE19469310.21608/zumj.2017.4693ENAhmedElsaeedDepartment of Orthopedic Surgery, Faculty of Medicine, Ain Shams University.AmrAbdelrahmanDepartment of Orthopedic Surgery, Faculty of Medicine, Ain Shams University.AhmedMeselhyDepartment of Orthopedic Surgery, Faculty of Medicine, Ain Shams UniversityJournal Article20171218Background: There is a paucity of outcome data to guide the surgical treatment of posterolateral corner knee injuries.<br />Purpose: To systematically review the literature to compare clinical outcomes of the treatment PLC injuries.<br />Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature including PubMed<br />was performed. The following search terms were used: “posterolateral corner”, “chronic PLC injuries” “acute PLC injuries” and “repair of PLC injuries”, “reconstruction of PLC”. Inclusion criteria were: Human examinations and treatment, measures of functional and clinical outcome included, exclusion criteria were: Non English papers, Non-human trials, Articles with no clinical data. Results: Eighteen studies with a total of 559 patients were included.<br />When time to surgery was performed within 6 weeks it is considered acute injury while on the other hand more than that was considered chronic injury. Surgical treatment varied between repair and reconstruction there was an overall success rate of repair 75% and failure rate of 25% and overall success rate of reconstruction was 91%<br />and 9% failure rate. Surgical techniques: 83 patients underwent repair for the PLC while 476 patients underwent reconstruction for the PLC, surgical techniques varied among studies, between repair and reconstruction<br />techniques which was different between studies, including fibular sling using one femoral tunnel or two femoral tunnels, posterolateral capsular shift trying to increase rotational stability, anatomic PLC reconstruction, biceps tenodesis and isometric reconstruction of the FCL and the popliteus with a single graft. Conclusion: The repair of acute PLC injuries and staged treatment of combined cruciate injuries were associated with a substantially higher postoperative PLC failure rate than reconstruction. Further research is required to identify the reconstruction technique that provides optimal<br />subjective and objective outcomes. https://zumj.journals.ekb.eg/article_4693_88d59dc05015e4236d5be8e42db78bd0.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501IMPACT OF LAPAROSCOPIC OVARIAN CYSTECTOMY VERSUS LAPAROSCOPIC COAGULATION ON OVARIAN RESERVE IN CASES OF OVARIAN ENDOMETRIOMA110469410.21608/zumj.2017.4694ENYousryShalalObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityYoussefElSayedObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityMohamedMahdyObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityMohamedZaitounObstetrics and Gynecology Department, Faculty of Medicine, Zagazig UniversityJournal Article20171218Objectives: To compare between laparoscopic ovarian cystectomy and laparoscopic ovarian coagulation on ovarian reserve in cases of ovarian endometrioma. Cases, methods: Prospective randomized cohort study had been conducted<br />form January 2014 to January 2016 at Laparoscopic, Cytogenetic Unit of Obstetrics, Gynecology at Faculty of Medicine, Zagazig University Hospitals. Fifty cases had included in the study. They had put in two groups; one for laparoscopic cystectomy for ovarian endometrioma (group I), the other for laparoscopic coagulation for ovarian endometrioma (group II). Antimullerian Hormone (AMH) had been measured preoperatively, on day 3 of the first, third, six menstrual cycle after surgery. Transvaginal U/S had been performed for assessment of Antenatal Follicle Count (AFC), ovarian volume, stromal blood flow of the ovary preoperatively, on first ,third, six menstrual cycle after surgery.<br />Results: Results showed a highly significant reduction of AMH, AFC, ovarian volume, stromal blood flow for both groups.<br />Conclusion: Laparoscopic surgery for endometrioma was associated with impaired ovarian reserve. The decrease in ovarian reserve was more pronounced in the cystectomy group when compared to the coagulation group. https://zumj.journals.ekb.eg/article_4694_d508affea939daab8e8dd1d54451e036.pdfZagazig University, Faculty of MedicineZagazig University Medical Journal1110-143123320170501EFFECT OF BISPHENOL A ON CORPUS EPIDIDYMIS AND CHROMOSOMAL PATTERN OF ADULT RATS111469510.21608/zumj.2017.4695ENAbdelmonemHegazyAnatomy and Embryology DepartmentAhmedOmarForensic Medicine and Clinical Toxicology DepartmentYoussefHusseinAnatomy and Embryology DepartmentMahaAbdul RahmanAnatomy and Embryology DepartmentEmtethalEl-BestawyAnatomy and Embryology Department,Faculty of Medicine, Zagazig University, Zagazig, EgyptJournal Article20171218Introduction: The epididymis is a male accessory organ essential for male fertility. The biochemical and physiological consequences of genotoxicity which are of most concern are the effects on the reproductive health.<br />Bisphenol A (BPA) is a chemical used in the production of polycarbonate plastics and epoxy resins. It is present in food and drink packages. It is considered an endocrine disrupting factor due to is estrogenic properties.<br />Aim of the Work: The study aimed to demonstrate the possible changes in the corpus epididymis structure and chromosomal pattern following administration of BPA. Materials and Methods: Thirty-six adult male albino rats were used; and divided into three groups: Group Ι (control); each rat received 1mL corn oil once daily. Group ΙІ (BPA treated); each rat was given BPA in corn oil in a dose of 50 mg/kg orally once daily for 8 weeks. Group ΙΙІ (follow-up); the<br />rats of this group were given the same dose for the same duration as group ΙІ then held for another 4 weeks without BPA administration. At the end of experimental period, blood was collected for serum testosterone assessment. Histological and immunohistochemical investigations were done on epididymis; and the femoral bone was used for cytogenetic<br />studies. Results: Light microscopic examination of corpus epididymis in treated group revealed wide intercellular and intertubular spaces with inflammatory infiltration and blood vessels congestion. The tubules were empty or filled with cellular debris. The epithelial lining showed vaculation, darkly stained nuclei and stratification. The abnormal sperm<br />forms and both the structural and numerical chromosomal aberrations were significantly increased. These parameters were improved in follow-up group but not reached the levels of control one. Conclusion: BPA administration could induce histopathological changes in corpus epididymis associated with genotoxic effects. These changes were partially reversible after stoppage of administration. https://zumj.journals.ekb.eg/article_4695_262d9a8d0306650e5179872140f2b81b.pdf