@article { author = {El-baz, Farida and Mohamed, Mohamed and Sadek, Abdelrahim and Othman, Amr}, title = {Study Of The C677T and 1298AC Polymorphic Genotypes Of MTHFR Gene And Phenotype Genotype Correlation In Autism Spectrum Disorder}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {1-10}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.38891}, abstract = {Background:  Autism is currently known as "a behaviorally defined syndrome” manifested as impairment in social communication, repetitive routines and restricted interests .Overall, there is an increased risk of ASDs associated with common mutations affecting the folate/methylation cycle. Aim of the study: This study aimed at identification of the C677T and 1298AC polymorphic genotypes of MTHFR gene among a sample of Egyptian children with autism and to make a phenotype-genotype correlation for the autistic patients. Subjects and methods: This case-control study included 31 children with autism and 39 children in a normal control group , the  mean  age of patients and control  was comparable ( 4.5 years± 2) with more males predominance in both groups. Assessments by DSM-V-TR criteria, Stanford-Binet intelligence scale V and childhood autism rating scale (CARS) were done. Genotyping for MTHFR gene polymorphic loci C677T and 1298AC was performed on amplified DNA by PCR with subsequent reverse hybridization and restriction fragment length polymorphisms analysis.    Results The relation between low birth weight and occurrence of autism was highly significant (P < 0.01). The delayed motor and social milestones showed a statistically highly significant difference in cases of autism compared to controls (P < 0.01). Heterozygosity for A1298C polymorphism was highest among patients (41.9%) followed by 35.5% mutant genotype CC  and 22.6% normal AA(wild ) type and  .Allele Cwas detected in patients more than in control (56.45% vs. 11.54%)(P <0.001). For C667T polymorphism, heterozygosity was also highest among patients (48,4% ) followed by wild type genotypes C677 (38.7%) and 12,9%  for mutant genotypes 667T. Allele T appeared more in patients than control (31.10 %vs. 5.13%) (P < 0.00). Heterozygosity for CT and A-C genotypes were detected equally (46.2%) among patients with severe autism (according to CARS). Conclusion       There is a significant association between severity and occurrence of autism with MTHFR gene polymorphisms C677T and A1298C. Further studies are needed on larger scale to explore other genes polymorphisms that may be associated with autism to correlate the genetic basis of autism.}, keywords = {autism,MTHFR gene,Polymorphism,Genotype–phenotype,Egyptian children}, url = {https://smj.journals.ekb.eg/article_38891.html}, eprint = {https://smj.journals.ekb.eg/article_38891_ebcb2f7c73f9636879c5940c8d7a7c1a.pdf} } @article { author = {Kassem, Ahmed and Yamamoto, Norio and Hayashi, Katsuhiro and Takeuchi, Akihiko and Miwa, Shinji and Morsy, Ahmad and Assaghir, Yasser and Alameldeen, Mohammed and Tsuchiya, Hiroyuki and Shiha, Anis}, title = {Long term results of using frozen bone autograft for reconstruction after resection of osteosarcoma around the knee in children}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {13-21}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.38896}, abstract = {Introduction:    Limb salvage has become the standard practice in the management of osteosarcoma.  Limb salvage surgery represents a challenge in skeletally immature patients in whom further growth is anticipated. Several options are available for limb reconstruction in children, we report the long term results of using the freezing technique by liquid nitrogen for treatment of lower limb osteosarcoma in children using different reconstruction techniques.  Method:  This study includes 24 children with lower limb osteosarcoma, average age was13±3.2 y (6-18 y), ten boys. The mean follow-up period was 87.3±44.7 m (28-224 m). In 14 cases the lesion was in the femur, in ten patients it was in the tibia. Joint sparing and intercalary freezing was carried in out in 15 cases, while in five cases, osteoarticular freezing was performed, and a composite technique with a tumor prosthesis was performed in four cases. Results: Ten patients remained disease-free, eleven patients lived with no evidence of disease, one was alive with the disease, and two patients died of the disease. Five- and ten -year rates of survival were 91.76%. Graft five and ten years survival rates were 91.48% and 83.3 % respectively. Function on the Enneking scale was excellent in 19 patients (79.1%), and good in three patient (12.5%), fair in one (4.1%), and poor in two patients (8.3%), mean MSTS score was 25±5.4 (6-30). Mean union time was 8.7 m±2.1m (6-12m). Mean MSTS score was higher among children who receive a joint sparing rather than a joint sacrificing resection; 27.2 versus 21.3. Complications were recurrence in three cases (12.5%), all recurrences were from soft tissue, collapse of the osteoarticular graft occurred in two cases (8.3%). Fracture of the graft occurred in two cases (8.3%), nonunion occurred in three cases (12.5%). Leg length discrepancy occurred in seven cases, mean difference was 21.8mm±8.3mm (7-31mm), lengthening was carried out in four cases and finally got had equal leg length, in three cases, shoe lefts were enough. Conclusion:    Reconstruction by frozen bone autograft for osteosarcoma around knee in children is easy, effective, biological, low-cost, immediate mobilization of joints, possible cryo-immune effects, with excellent long term functional outcome and with less complication.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_38896.html}, eprint = {https://smj.journals.ekb.eg/article_38896_1b895ed1736d67cd03e5f07df4440218.pdf} } @article { author = {Sadek, Abdelrahim and Ahmed, Ramadan and Gamal, Nahla}, title = {Evaluation of Risk Factors and Outcome of Haemorrhagic Stroke in Neonates}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {21-26}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.38919}, abstract = {Back ground: Few data regarding causes and outcomes of hemorrhagic stroke in late preterm and term neonates are available so we were trying to identify them in this study. Methodes:This prospective case control study was carried out at Sohag University Hospitals, during the period from 1/1/2015 to 31/12/2015 at the department of pediatrics and neonatal care unit at Sohag University. A total of 50 neonates term and late preterm neonates (≥34 weeks gestation) and ≤28 days of life had met the inclusion criteria were 23 males and 27 females. Results: As regard outcome in our study, 8% had grade I, 14 % had grade II, 32% had grade III, 12%had grade IV, 14.5% had subdural hemorrhage and 20% had subarachnoid hemorrhage. So most patients have grade III intracranial hemorrhage and subarachnoid hemorrhage. According to the severity, in our study patients who had mild intracranial hemorrhage represented 48% and patients with moderate intracranial hemorrhage represented 30% and patients with severe intracranial hemorrhage represented 22%. Conclusion: IVH is very rarely reported in full-term and late preterms neonates and may occur in these children with a variety of risk factors, in our study we tried to identify these risk factors and also the outcome and we found that the most frequent associated risk factors were absence of vitamin K administration followed by prolonged labour then neonatal sepsis.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_38919.html}, eprint = {https://smj.journals.ekb.eg/article_38919_5fb57689b81d3b26f0f53dfd01af96cd.pdf} } @article { author = {El-Nadi, Nada and Ahmed, Noha and Fadel, Eman and K. Omran, Eman}, title = {Epidemiology of Intestinal Polyparasitism among Schoolchildren In Sohag, Egypt}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {29-39}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.38927}, abstract = {Introduction: Intestinal parasitic infections (IPI) are still public health problems in many communities, particularly among children in developing countries.This cross-sectional study aimed to investigate the current prevalence and risk factors associated with intestinal polyparasitism (the concurrent infection with multiple intestinal parasite species) among schoolchildren in Sohag governorate, Egypt. Methodology / Principal findings: Fecal samples were collected from 200 schoolchildren (51.5% boys and 48.5% girls), preserved and examined by using formalin-ethyl acetate concentration technique and modified Kinyoun acid fast stain. Demographic information was collected by using a standardized questionnaire. Overall, 63.5% of the children were found to be positive for at least one parasite species. Of these, 23.5% were polyparasitized. The overall prevalence of Cryptosporidium, Giardia duodenalis, Entamebahistolytica/ dispar, Blastocystisinfections were 34%, 14.5% and 13%, respectively. Univariate and multivariable logistic regression models showed that  none of the age, gender, residence or family size were risk factors for polyparasitism. Conclusions/Significance: Intestinal polyparasitism is prevalent among children in Sohag, Egypt.  Hence, effective and sustainable control measures, including school-based periodic chemotherapy, providing adequate health education focused on good personal hygiene practices and proper sanitation, as well as safe drinking water supply should be implemented to reduce the prevalence and consequences of these infections in this population}, keywords = {intestinal parasitic infections,polyparasitism,schoolchildren}, url = {https://smj.journals.ekb.eg/article_38927.html}, eprint = {https://smj.journals.ekb.eg/article_38927_76ba061e792689cf8cfdf250468755af.pdf} } @article { author = {Saro, Adham and Radwan, Gamal and Ismail, Ali and Abozaid, Mortada}, title = {Prevalence of Keratoconus in Refractive Surgery Population in Sohag Governorate}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {41-44}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.38956}, abstract = {IntroductionKeratoconus (KC) is a developmental anomaly in which the inferior or central portion of the cornea becomes thinner and bulges forward in a cone-shaped fashion as a result of non-inflammatory thinning of the corneal stroma[1, 2].                                                                                       The disease has its usual onset at puberty and, in many cases, progresses until the third to fourth decade of life, when it usually arrests[1]. Although a large proportion of keratoconic patients can be managed with contact lenses, an average of about 20% of all keratoconic corneas require keratoplasty; some authors report markedly different surgical indication rates of 6.5 and 12 to 45%.[3-5]                          Aim of the work: to study the prevalence of keratoconus in patients seeking refractive surgery to correct their refractive errors and to study common risk factors. Patients and Methods: Two thousand eyes to 1202 patients (623 males and 579 females) coming for investigations for refractive surgery were randomly chosen in the period from April to October 2015. Screening –by Pentacam- was bilateral in 798 patients and unilateral in 404 patients. Results: the resulting cases of keratoconus were 293 eyes (14.65%) of 210 patients. Of those patients, males were 117 (165 eyes) (56.25%) and females were 93 (128 eyes) (43.75%).}, keywords = {Keratoconus- Pentacam,prevalence- pachymetry- Keratometry}, url = {https://smj.journals.ekb.eg/article_38956.html}, eprint = {https://smj.journals.ekb.eg/article_38956_a819431c94f3f77beb9006f19ed9bfd1.pdf} } @article { author = {khalaf, Asmaa and Abouelella, Azza and Mohammadien, Hamdy}, title = {Non Invasive Mechanical Ventilation in Acute Respiratory Failure}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {47-62}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.39011}, abstract = {Objectives : Acute respiratory failure is a common clinical condition encountered in emergency department and intensive care units (ICU). The use of NIV during acute respiratory failure (ARF) has increased since the late 1990s for all diagnoses, including patients with and without chronic obstructive pulmonary disease (COPD). The use of NIV is associated with reduced tracheal intubation, duration of hospitalization, and mortality. Aim of the work: To evaluates the effectiveness of Non invasive ventilation in the management of acute hypercapnic respiratory failure of different aetiologies as acute exacerbation of COPD, and acute hypoxemic respiratory failure. Design of study:  Prospective, Observational, Single-center study. Patients  and Methods: 103 patients with acute respiratory failure (ARF) were admitted to Respiratory Intensive Care Unit (RICU) of Chest Department at Assuit University Hospital and received non invasive ventilation, in all patients demographic , clinical and functional parameters were recorded including the cause of acute respiratory failure . NIV success was defined as clinical and gasometric improvement and discharge to regular ward, while need of endotrachial intubation was considered NIV failure.  Results:  one hundred and three patients with mean age 59.1 years were included in the study,62 (60%) were males and 41(40%) were females, Baseline pH, PaCO2 and PaO2 were 7.51±0.09, 72±21.63and 59.41±20.34 mmHg respectively. The success rate with NIPPV was 69%, with 71of 103 patients weaned successfully. Significant improvements were observed at 2 hour,24-48hrs following institution of NIPPV in pH (7.34±0.08, P < 0.02), PaCO2 (62.87±17.94, P < 0.002) and PaO2(74.30±14.45 P < 0.001).These improvements maintained (within 24 hrs) postweaning from the ventilator, pH 7.39±0.04, PaCO2 56.76±10.18, PaO2 73.28±10.04 ( P < 0.001). Duration of mechanical ventilation , length of ICU stay were significantly longer in NIV failure group (p<0.0001). , the complications and death were significantly higher in NIV failure group (p<0.00001),(p<0.0001). Serum albumin level was significantly lower in the NIV failure group (p<0.01). Conclusion: The use of NIV in patients presenting with ARF of diverse etiology has shown to be effective in the improvement of clinical and gasometric parameters, in preventing endotracheal intubation, and improving overall survival}, keywords = {Acute Respiratory Failure,Noninvasive ventilation,COPD}, url = {https://smj.journals.ekb.eg/article_39011.html}, eprint = {https://smj.journals.ekb.eg/article_39011_eadb6e4bc2850a1b3f4d53d1a644750e.pdf} } @article { author = {Sabet, Eman}, title = {Correlation Between Serum Apoptotic Markers and Hepatitis C viral load In Chronic Hepatitis C Virus-Related Liver Disease}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {65-76}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40006}, abstract = {Hepatitis C virus (HCV) is considered the most common etiology of chronic liver disease in Egypt. Developing non invasive tests that can predict liver injury represents a growing medical need.  Considering that hepatocyte apoptosis plays a role in chronic hepatitis C pathogenesis; evaluation of  the presence of different apoptotic markers that correlate with liver injury in HCV- related liver diseases could be a way for this achievement. The aim of the present study was to identify the correlation between serum apoptotic markers Bcl-2 and Bax with hepatitis C viral load in the chronic hepatitis C virus related liver diseases. The study included three groups ; group 1: 35 compensated  chronic HCV patients without any suspected evidence of liver cirrhosis and with Child - Pugh score of 5-6 (class A), Group 2: 35 decompensated chronic HCV patients with Child - Pugh score of 10-15 (class C) and group 3: 15  healthy volunteers as a control group. The results collectively suggest that statistically significant correlations were noticed between serum Bcl-2, Bax, Bcl-2/Bax ratio and HCV PCR in chronic hepatitis C virus-related liver disease.}, keywords = {Chronic HCV,Hepatitis,Bcl-2,Bax}, url = {https://smj.journals.ekb.eg/article_40006.html}, eprint = {https://smj.journals.ekb.eg/article_40006_0d4796b1ec154920355057b27c9ea4e9.pdf} } @article { author = {Ahmad, Nagwa and Abdelmoaty, Mohamed and Saleem, Tahia and Galal, Ghada and Morad, Amira}, title = {Non-invasive tests and markers for liver fibrosis}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {77-93}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40017}, abstract = {Chronic liver disease is characterized by liver fibrosis, which may lead to cirrhosis. Conventional serum-based liver function tests do not give information on either the presence or the rate of progress of liver fibrosis. The reference diagnostic test to detect fibrosis is liver biopsy, a procedure subject to various limitations, including risk of patient injury and sampling error. Serum markers have been evaluated for the determination of fibrosis either singly or combined as a panel of markers, however diagnostic accuracy is greatest in studies using a panel together with an algorithm, which generates a predictive score. Serum marker models, especially those targeted at hepatitis C, have multiplied in spectacular fashion over the last five years, with most models regularly achieving a median area under the receiver operating characteristic curve (ROCC) of 0.80 versus liver biopsy. Five years after publication of the first major serum marker model, the first study to document clinical outcomes reported that applying the model to hepatitis C patients improved prediction of decompensated cirrhosis and survival compared to liver biopsy. An obstacle to widespread adoption of serum marker models has been the lack of uniform performance indicators, such as diagnostic odds ratios and likelihood ratios. This review highlights the most well-established noninvasive biomarkers to-date, with a particular emphasis on serum}, keywords = {}, url = {https://smj.journals.ekb.eg/article_40017.html}, eprint = {https://smj.journals.ekb.eg/article_40017_7070c78420f0fbae1deb624882217dc9.pdf} } @article { author = {Arafa, Abd ellatif and Youssef, Gamal Youssef and Tharwat, Ahmed}, title = {POSTERIOR TIBIAL ARTERY FLAPS FOR LEG AND ANKLE RECONSTRUCTION}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {105-112}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40026}, abstract = {Defects of the leg, ankle, and Achilles tendon regions still represent a tricky issue in lower limb surgery. Among the several reconstructive possibilities, local propeller perforator flaps have gained popularity in the last decades. The posterior tibial artery perforator flap is one of the most versatile flaps for reconstruction in these regions. Objectives: To explore the feasibility and therapeutic effect of the posterior tibial artery perforator flaps for coverage of defects around the ankle, heel and lower third of leg Methods: From June 2013 to March 2016 a total number of 15 cases of soft tissue defect on the leg, achilles tendon and ankle area in 13 patients managed by posterior tibial artery perforator flap inShebinElkom Teaching Hospital, SohagUniversity hospital and Menofia University Hospital Follow up was done for at least 6 months with good results. Results: A total number of 15 cases of soft tissue defect on the leg, achilles tendon and ankle area in 13 patients managed by posterior tibial artery perforator flap. All flaps healed well with good functional results and acceptable donor site morbidity  Conclusions It was concluded that the distally based pedicled posterior tibial artery perforator flap was a reliable, easy, less time consuming, and versatile procedure for covering the defects around the ankle, heel, and lower third a leg. KEYWORDS: Lower limb reconstruction; achilis and calcaneal regions; Adipofascial flaps; posterior tibial perforators}, keywords = {}, url = {https://smj.journals.ekb.eg/article_40026.html}, eprint = {https://smj.journals.ekb.eg/article_40026_184e6712fd680604f5a0d7afae57263e.pdf} } @article { author = {ALI, Hossam and Mahmoud, Shaimaa and Ahmed, Alzahraa}, title = {Characterization and outcome of packed red blood cells transfusion in critically ill children in PICU in Sohag University hospita}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {115-122}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40030}, abstract = {Red blood cell transfusions are a common therapy in critically ill anemic children ,a packed cell product is the component of choice for replacement therapy during RBC loss  and sporadic transfusion therapy. The decision to transfuse must be based on an assessment of the risks of anemia versus the risks of transfusion. In addition to the individual assessment of any symptomatic anemic child, the duration of anemia must be taken into consideration as well as the extent of trauma or surgery and the probability of blood loss and coexisting conditions such as impaired pulmonary function and inadequate cardiac output. (1-3) This study was a prospective observational study conducted for one year in Pediatric Intensive Care Unit (PICU) of SohagUniversity Hospital ,a tertiary health center which provide specialized care to critically ill  infants and children with about 400 admissions yearly.Patients was divided to two groups according to arterial blood pressure.                  Stable critically ill: not hypotensive (mean arterial pressure not less than 2 standard deviations below the mean for age), or no cardiovascular support for at least two hours prior to enrollment.                                                                                                                 Unstable critically ill: hypotensive (mean arterial pressure less than 2 standard deviations below the mean for age), or there is cardiovascular support for at least two hours prior to enrollment, this includes patients with heart failure.                                     Packed RBCS transfusion following  arestrictive blood transfusion strategywas used. Stable critically ill patients: received blood transfusion only if hemoglobin concentration falls below 7 gm/dl.                                                                                        Unstable critically ill patients: received blood transfusion according to clinical judgment.(1,4)                                                                                                                                                              Short term outcome till discharge including (mortality or improvement) and duration of ICU stay was observed and recorded.                                                                                  Our study showed that respiratory diseases were the main risk factor that increase the duration of PICU stay (p value 0.001),while suffering from hemodynamic unstablity was the main risk factor for death in our PICU (P value 0.02) .a restrictive blood transfusion strategy was safe in pediatric patients whose  condition was stable in PICU, with no effect on mortality or duration of admission in PICU andthe studywas not able to highlight a cause-effect relationship between RBC transfusions and outcomes in critically ill children.                                                                                                                             }, keywords = {Packed RBCs,transfusion,Critically Ill,Pediatric ICU}, url = {https://smj.journals.ekb.eg/article_40030.html}, eprint = {https://smj.journals.ekb.eg/article_40030_5654c868c59b27bd537a6219eff77c17.pdf} } @article { author = {Galal, Ghada and Ahmad, Nagwa and Mohammad, Asmaa and Bakrey, Rahma}, title = {Serum Selenium Level in Patients with Chronic Liver Disease}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {125-133}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40037}, abstract = {Background: Selenium has been shown to protect against liver necrosis. Selenium deficiency has been involved in the pathogenesis of chronic hepatitis B and C related hepatocellular damage.Serum selenium concentration in cirrhotics was found tobe low, supportive selenium administration may be beneficial for them.Reduced selenium levels result in accumulation of lipid peroxides which accelerate the growth of hepatocellular carcinoma (HCC). Aim: To study serum selenium level in patients with chronic liver diseases and its relation with severity of theliver diseases. Patients and Methods: This case–control study was conducted on 100 subjects. The cases were 80 adult patients including chronic hepatitis C and B, liver cirrhosis and HCC.The study also included 20 healthy age and sex-matched subjects served as a control group. Clinical, laboratory and radiological data and blood samples were collected from all participants. Serum selenium concentration was measured and statistical analysis was done. Results: Selenium concentration was significantly lower in patients compared to healthy controls.Selenium levelwas found low in Chronic HBV, chronic HCV patients and lower incirrhotic group and the lowest in HCC group. Patients with advanced liver cirrhosis (Child B, C) had significantly lower selenium level compared to those with Child A. Conclusion: Selenium was lower in patients with chronic liver disease and its leveldecreases with the progression of liver disease. Patients with HCC had the lowest Selenium concentration that might correlate with the pathophysiology of HCC. Chronic hepatitis C and B, liver cirrhosis and HCC were independent predictors forSelenium deficiency.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_40037.html}, eprint = {https://smj.journals.ekb.eg/article_40037_4a434c9a458e54155785c6a239631053.pdf} } @article { author = {ASKAR, GHADA and SAFE EL DEEN, FATMA EL ZAHRAA and Salah ElDeen, Eman and ABD EL GAFFAR, HAZEM}, title = {Cell Abnormality in Pap Smear in Women with Postmenopausal Bleeding}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {135-142}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40058}, abstract = {Cancer cervix is a preventable and curable disease due to effective screening methods. Uterine cervix is ideal for screening due to easy accessibility for inspection, palpation and exfoliative cytology. The Pap smear is a screening test for cervical cancer, and with appropriate follow-up it can reduce cervical cancer incidence by up to 80%. This study includes fifty peri and postmenopausal women, cervical smears were taken in the Out-patient Clinic of Gynecology and Obestetrics Department and Pap stain was used for each sample, and the criteria of Bethesda (2014) was used for the diagnosis of each case. Bleeding was the main complaint in 92% patient and the remaining 8% complained from vaginal discharge and itching. Thirty nine patients were negative for intraepithelial lesion or malignancy (non-neoplastic), eight showed neoplastic changes, and 3 samples were insufficient for cytological interpretation. Two out of the 8 cases showed neoplastic lesions were atypical squamous cells of undetermined significance (ASCUS), two diagnosed as atypical squamous cells cannot exclude HSIL (ASC-H), 3 were high grade squamous intraepithelial lesions (HSIL) and one cases had features of squamous cell carcinoma (SCC). Six out of 39 samples showed only pure atrophy, three showed follicular cervicitis, three had features suggestive of Tichomonas vaginalis infection, one diagnosed as HSV infection, one showed bacterial vaginosis and eleven cases showed nonspecific inflammation. Non-neoplastic cases included also six cases showed metaplastic changes and eight had normal cytological findings. Conclusion: cervical smears is important in early detection of cervical carcinoma and its precursors in Sohag community as an easy, costless, accessible, and reliable manner and Bethesda system (2014) is beneficial for accurate diagnosis.          }, keywords = {}, url = {https://smj.journals.ekb.eg/article_40058.html}, eprint = {https://smj.journals.ekb.eg/article_40058_e85ddd15d617582e904475197a85b521.pdf} } @article { author = {abdelreheam, Ghada and Ahmed, Ali and Ali, Safaa and Ahmed, Naglaa}, title = {Changes in Steroid Response pattern in Childhood Idiopathic Nephrotic Syndrome in Sohag}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {145-151}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40092}, abstract = {Background and aim of work: Nephrotic syndrome (NS) is a common chronic kidney disease in childhood and it is mostly idiopathic. Steroid response pattern remains the most important issue in prognosis of NS. Increase in steroid resistant nephrotic syndrome (SRNS) frequency over years was documented in some studies. This work aimed to demonstrate the change in steroid response pattern of idiopathic nephrotic syndrome (INS) over years in our locality at Sohag in Upper Egypt. Patients and Methods: Combined retrospective and prospective studies were done; including 280 children with INS, aged from 1 to 15 years, diagnosed and followed in our pediatric renal unit in Sohag University Hospital, Egypt in the period from January 2000 to December 2014. The patients' demographic features, steroid response pattern in both groups were studied. Results: A total of 280 patients (203 in the retrospective group and 77 in the prospective group) with INS were included with mean age at disease onset 4.60±2.58 (range 1-15) years and male/female ratio 1.8/1. Mean follow up duration was 4.44±3.24 (range 1-15) years. Steroid was given to all patients. 94.1% and 79.2% of patients in the retrospective and the prospective groups respectively were steroid sensitive, and the rest of patients were steroid resistant. Renal biopsy was done in 36 and 26 patients in the retrospective and prospective studies respectively. Biopsy results revealed minimal change disease (MCD) in 55.6% and 38.5%, focal segmental glomerulosclerosis (FSGS) in 22.2% and 42.3%, mesangioproliferative glomerulonephritis (MesPGN) in 22.2% and 19.2% of biopsied patients in the retrospective and prospective groups respectively. End stage renal disease (ESRD) was developed in 4 patients all of them were steroid and other immunosuppressive therapies resistant and with FSGS histopathology. Death occurred in 5 patients. Conclusion: Steroid sensitive NS is the most common form of INS in children but there is increase in the frequency of SRNS over years in our locality.}, keywords = {Idiopathic nephrotic syndrome,steroid resistant,focal segmental glomerulosclerosis}, url = {https://smj.journals.ekb.eg/article_40092.html}, eprint = {https://smj.journals.ekb.eg/article_40092_f7bb0bc3f2981fa985494f90f0e3c959.pdf} } @article { author = {abdelreheam, Ghada and Ahmed, Ali and Fadda, Swsan and Ali, Safaa and Ahmed, Naglaa}, title = {Patterns of idiopathic nephrotic syndrome in Upper Egyptian children}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {135-160}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40106}, abstract = {Background and aim of work: Idiopathic nephrotic syndrome (INS) is a common and important chronic kidney disease in childhood. Steroid response pattern and the underlying histopathological spectrum of INS show variabilities in the different geographical regions. This work aimed to highlight the clinical profile, steroid response pattern and histopathological spectrum of INS in our locality in Sohag, Upper Egypt. Patients and Methods: A prospective study included 77 children with INS aged from 1-15 years followed for at least one year, diagnosed and treated at our pediatric nephrology unit in the period from January 2010 to December 2014 was done.The patients' demographic features, clinical profile, steroid response pattern and the underlying histopathological spectrum were studied. Results: Total included patients were 77 children. The mean age at disease onset was 4.87±2.94 (range 1.5-15) years. Male/female ratio was 1.6/1. Steroid was given to all patients, 79.2% of patients had steroid sensitive nephrotic syndrome (SSNS), while 20.8% had steroid resistant nephrotic syndrome (SRNS). Out of 61 steroid sensitive patients, about 54% developed either steroid dependent nephrotic syndrome (SDNS) or frequently relapsing nephrotic syndrome (FRNS). Biopsy was done in 33.8% of patients and revealed focal segmental glomerulosclerosis (FSGS) in 42%, minimal change disease (MCD) in 39% and mesangio-proliferative glomerulonephritis (MesPGN) in 19% of patients. End stage renal disease (ESRD) developed in 1 patient with SRNS and FSGS. Conclusion: About eighty percent of our patients were steroid sensitive but more than half of them had SDNS or FRNS. The main histopathological pattern seen in renal biopsies was FSGS}, keywords = {Idiopathic nephrotic syndrome,steroid response and focal segmental glomerulosclerosis}, url = {https://smj.journals.ekb.eg/article_40106.html}, eprint = {https://smj.journals.ekb.eg/article_40106_159692d8612860a586b2d981631ab172.pdf} } @article { author = {El-Bawab, El-Saeid and Ahmad, Nagwa and Abo Dahab, Lotfy and El-Sayed, Mahmoud and Mostafa, Kenawy}, title = {STUDY THE RELATIONSHIP BETWEEN INTERCELLULAR ADHESION MOLECULES (ICAM), OXIDATIVE STRESS AND INSULIN RESISTANCE AMONG TYPE 2 DIABETIC PATIENTS WITH NEPHROPATHY}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {162-173}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40502}, abstract = {BACKGROUND: Diabetes mellitus (DM), especially type 2, represents one of the most important health problems worldwide and, according to recent estimations, it is likely to worsen to critical levels in the next decades, with the great concern that this disease is rising rapidly in younger population groups, including children and adolescents. Oxidative stress is an important factor in the etiology and pathogenesis of diabetes mellitus. Intercellular adhesion molecule-1: Intercellular adhesion molecule-1 (ICAM-1), also known as CD54, is an endothelial and leukocyte associated transmembrane protein with relevance in stabilizing cell-cell interactions and facilitating leukocyte endothelial transmigration. It is constitutively present in the membranes of leukocytes and endothelial cells; upon cytokine stimulation, the concentrations greatly increase. ICAM-1 ligation produces pro-inflammatory effects such as inflammatory leukocyte recruitment by signaling through cascades involving a number of kinases. AIM OF THE WORK: In this study, we attempt torelationship between sICAM-1 (intercellular adhesion molecule-1) and diabetic nephropathy as an important marker in inflammation, immune responses and in intracellular signaling events. we determined plasma concentration of ICAM-l, serum malondialdehyde (MDA), superoxide dismutase (SOD), Serum nitric oxide (NO) as a marker for endothelial activation among   type- 2 diabetic patients with or without nephropathy and oxidative stress as a marker (as tool in early diagnosis of nephropathy as major diabetic complications) also to explore the relationship between plasma level of ICAM-l and insulin resistance in the studied patients. PATIENTS AND METHODS: This study carried out on 100 male individuals. Their age ranged from 25- 60 years. They were classified as follows:Control group: 30 apparently healthy adult males. Patients groups: 70 patients suffering from type 2 diabetes mellitus, Patients were subdivided into two groups. Group I:35 patients with type 2 diabetes mellitus with normal albuminuria without complications.Group II:35 patients with type 2 diabetes mellitus with nephropathy. RESULTS: This study has found a strong relationship between sICAM-1     (intercellular adhesion molecule-1) and diabetic nephropathy. It has been shown that inflammation has a role in the development of diabetic nephropathy, so sICAM-1 may play a role in the development of diabetic nephropathy. Our results also, show strong direct correlation between ICAM-1 and insulin resistance which supports the conclusion that insulin resistance may be a factor contributing to the increase plasma levels of adhesion molecules. In accordance to our results the metabolic syndrome and type 2 diabetes are associated with endothelial activation, but the mechanisms that underlie these associations are not fully understood.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_40502.html}, eprint = {https://smj.journals.ekb.eg/article_40502_4850c977dd87bb50a72b4330bf86b97c.pdf} } @article { author = {Abd Allah, Ahmad and Ammar, Hatem and Tamam, Kariman and Shimada, Yoshiaki}, title = {Multifocal Electroretinogram in normal subjects}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {181-175}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40534}, abstract = {Background: Multifocal electroretinogram (mfERG) is a device for recording the physiological response of multiple retinal areas in short time. Using this technique enables us to detect the spatial extent and severity of the retinal damage. Objectives: In this study,we aimed to assess the topographic properties of mfERG in normal subjects to use it as a basic data to evaluate eye disease. Methods: We recorded mfERG from 20 eyes of 20 normal subjects. We measured amplitude and latency of recorded waves. We compared between amplitude of these waves between different retinal areas and the same for latency. Results: We found mfERG responses in the form of waves, every wave consists of negative wave (N1) followed by positive wave (P1). The amplitude of N1 wave and amplitude of P1 were largest at the fovea and decreased toward periphery. The latency of N1 and P1 were shorter in upper retina than lower retina. The N1 amplitude and P1 amplitude was larger in upper retina than lower retina, which reflex functional superiority of upper retina. There was no statistical difference between nasal and temporal retina in the amplitude and latency.Conclusion: Multi-focal ERG would be useful for objective examination of the retinal function.}, keywords = {retina,Topography,functional superiority of upper retina}, url = {https://smj.journals.ekb.eg/article_40534.html}, eprint = {https://smj.journals.ekb.eg/article_40534_3a768b42840a928ed48306958564250d.pdf} } @article { author = {Abd El Rahman, Ahemed and Hassan, Khaled and Mohamed, Mohamed}, title = {Comparative Study Between Dexmedetomidine And Magnesium sulfate Added to Bupivacaine In Spinal Anesthesia For Postoperative Analgesia In Patients Undergoing Perianal Surgeries}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {183-189}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40543}, abstract = {Spinal anesthesia is the most commonly used technique for lower abdominal surgeries as it is very economical and easy to administer.  A number of adjutants, such as Opioids , Clonidine, and Midazolam have been studied to prolong the effect of spinal anesthesia (ELIA , et al 2008).      Dexmedetomidine a new highly selective a2- agonist is under evaluation as a neuraxial adjuvant as it provides stable hemodynamic conditions, good quality of intraoperative and postoperative analgesia with minimal side effects(Kanazi and Al-Ghanem 2009).     Magnesium sulfate (Mg)  is an antagonist of N-methyl D Aspartate receptor (NMDA) improves postoperative analgesia after intrathecal administration as an effective adjuvant to bupivacaine (Soave  and  Arcangeli  2009).Aim of the work      To compare the postoperative analgesic effects and any side effects ofdexmedetomidine and magnesium sulfate (Mg) when added to bupivacaine in spinal anesthesia in patientsundergoing perianal surgeries.Patients and methods     Ninty ASA physical status I and II patients aged 18-70 years, of either sex, scheduled for perianal surgeries under spinal anesthesia in this prospective randomized, double-blinded study.Results       All the Mg cases needed analgesia within 4 hours postoperative, while for all the Dex cases needed analgesia within5 hours postoperative. The difference between the two groups was highly significant.}, keywords = {Spinal anesthesia,Postoperative Analgesia,Dexmedetomidine,magnesium sulfate,Perianal Surgeries}, url = {https://smj.journals.ekb.eg/article_40543.html}, eprint = {https://smj.journals.ekb.eg/article_40543_6bf0b76bf262c6f2a0f03158ac69ccff.pdf} } @article { author = {Ahmed, Mohamed and Ahmed, Ashraf and abdelrahman_khalifa@med.sohag.edu.eg, abdelrahman_khalifa@med.sohag.edu.eg}, title = {Fixation of adolescent diaphyseal tibial fractures with flexible intramedullary nailing}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {191-194}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40563}, abstract = {to evaluate the results of fixation of diaphysealtibial fractures with flexible intramedullary nail in adolescent.Methods: 20 patients complaining of diaphyseal fracture tibia were managed by flexible intramedullary nail in our department between Jule 2015 to April 2016 .Mean age of patients is 14 years old ranging between (10 – 17) years old .They are fourteen males and six females. Twelve cases were simple fractures and eight cases were compound fractures.Results : All patients of our study were followed up in our outpatient clinic with mean time of follow up was 36 weeks .All fractures achieved full union at a mean of 12.7 weeks with range from 10 to 18 weeks .Only one case suffered from nonunion and it was followed up. One patient had postoperative fracture angulation that was less than 5 degrees in the coronal and sagittal planes and postoperative valgus angulation of about 5 degrees. Conclusion:The use of elastic intramedullary nails in treatment of diaphyseal tibial whether simple fractures or open fractures (Gustillo and Anderson Type 1 and Type 2) in adolescents provide satisfactory results for the patient and his family and for surgeon. }, keywords = {diaphysealfracture,tibia,Adolescent,flexible nails}, url = {https://smj.journals.ekb.eg/article_40563.html}, eprint = {https://smj.journals.ekb.eg/article_40563_ae81f880db2ffe2a436720ab71ad17fc.pdf} } @article { author = {Khalifa, Mostafa and Musa, Shazly and Abdel Rahman, Hassan and Shiha, Anis}, title = {Management of aseptic non union tibia using plating or interlocking nail with or without bone grafting}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {197-203}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40579}, abstract = {Background : 'The purpose of this study is to compare results of usage of reamed interlocking nail versus plating in management of aseptic non- union  fracture shaft tibia .Methods :20 patients with aseptic non union tibia were managed in our department between June 2015 and June 2016.Patients were divided randomlyin this retrospective study into two groups : plating group ( 10 patients ) and nailing group (10 patients ). Mean age of patients ( plating group ) was 40.3 years old, while in ( nailing group) was 30.3 years old. Illac bone graft was used in 4 patients (plating group ) and 3 patients (nailing group).Initial fracture was simple in 8 cases ( 4  in plating group and  4 in nailing group )and compound in 12 cases ( 6 in plating group and 6 in  nailing group).Results :All patients were followed up in our patient clinic,  with a mean period of follow up was 36.9 weeks. 19 cases healed and one case lost from( plating group). Mean period  of healing was 6.7 months (plating group) while 4.7 months in (nailing group).According to Olerud and Molander score ,2 patients excellent , 2 good and 5 fair (plating group) ,while 1 patients excellent , 7 good and 2 fair (nailing group).No significant complications  rate difference was found  between the two groups . Conclusion:Reamed interlocking nail can obtain higher union rate , shorter time to union incidence and less complications rate than plating in the treatment of aseptic non union fracture shaft tibia.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_40579.html}, eprint = {https://smj.journals.ekb.eg/article_40579_cd2e352d766ead0a93327a6bfa0badbc.pdf} } @article { author = {Hilal, Maha and Radwan, Rania and M. Mohamed, Khaled and Aref, Hend}, title = {Chemistry, Pharmacology and Toxicology of New Designer Drugs - A Comprehensive Review}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {205-214}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40735}, abstract = {Drugs have been used for recreational purposes since time immemorial. Addicting potential and the propensity to harm has led to a ban on many of these drugs. New compounds are being developed to circumvent the ban. They are similar in effect to the banned drugs but are slightly different in their chemical structure so that they can escape detection in the standard drug tests. These drugs are commonly known as designer drugs or new psychoactive substances (NPS).This work aimed to do a comprehensive review on chemistry, pharmacology and toxicology of new designer drugs for establishing the basic knowledge about them, focusing on their assessment and management and recent methods for their detection.According to the United Nations Office on Drugs and Crime (UNODC) classification, NPS include the following groups: Synthetic cannabinoids, synthetic cathinones, piperazine, phenethylamines, ketamine analogues, plant-based substances(Kratom, Salvia Divinorum) and miscellaneous substances (aminoindanes and tryptamines). NPS have become a global phenomenon with over 100 countries and territories from all regions of the world having reported one or more NPS. Up to December 2015, more than 600 substances have been reported to the UNODC Early Warning Advisory (EWA) on NPS by Governments, laboratories and partner organizations.NPS represent a challenge both in forensic analytical toxicology as well as in clinical toxicology as they may cause serious toxicity and can escape detection in the standard drug tests.Clinicians should keep designer drugs in mind when evaluating substance use in young adults or in anyone presenting with acute neuropsychiatric complaintsCoordination among emergency medical personnel, forensic toxicologists, scientific researchers, law enforcement and policymakers is essential to foster more effective responses in dealing with this evolving drug-abuse phenomenon}, keywords = {Designer drugs,New Psychoactive Substances and Legal high}, url = {https://smj.journals.ekb.eg/article_40735.html}, eprint = {https://smj.journals.ekb.eg/article_40735_5142520286bfaea31ebd1a08c7db78c2.pdf} } @article { author = {Ahmed, Tarek and Sadek, Mohamed}, title = {Comorbidity with Depression and Anxiety among Patients with Epilepsy inQena Governorate}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {215-220}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40736}, abstract = {INTRODUCTION & AIM OF THE WORK : Depression and anxiety are common psychiatric comorbidities of epilepsy. This work aimed to assess the relationship between psychological disorders (depression and anxiety) and epilepsy and to explore the different factors involved in such relationship.   SUBJECTS AND METHODS: We studied 100 patients with epilepsy in the neuropsychiatry department in Qena South Valley University Hospital for comorbid depression and anxiety. Hamilton questionnaire for depression and anxiety (HAMD and HAMA), EEG and  brain Imaging were carried out..   RESULTS: Demographic data of the studied population show that the mean ± SD of age is 25.08±13.81, male (64%), age of onset of epilepsy (19.18± 12.597), duration  of  treatment (4.82± 4.546). HAMD score (9.31±5.74), HAMA score (13.80±7.16). Depression was diagnosed in 48% and anxiety in 36% of patients. Among epileptic patients with depression or anxiety, no significant relation was detected regarding age, sex, educational level, age of onset nor duration of illness Depression was more in those with postictal drowsiness and GTC type of seizures.  }, keywords = {Depression and anxiety are common but underestimated epilepsy comorbidities}, url = {https://smj.journals.ekb.eg/article_40736.html}, eprint = {https://smj.journals.ekb.eg/article_40736_6a3901e4cd8956f386882922d7c7272b.pdf} } @article { author = {Mousa, Mohammad and Ismail, Ali and Elhawwary, Ashraf and Shawky, Seham}, title = {Macular thickness in healthy subjects and diabetics without diabetic macular edema}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {231-235}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40747}, abstract = {Purpose: To compare macular thickness values in normal subjects and diabetic patients without diabetic macular edema (DME) using optical coherence tomography (OCT).   Methods :comparative  prospective case control study was conducted on 150 eyes with varying stages of diabetic retinopathy compared with 50 normal control. We  used the Topcon,3D OCT-2000 machine to perform the fast macular scan which gives 3 concentric circles : 1 , 3 and 5 mm. centered on the fovea . The mean ± standard deviation of macular thickness by area in these eyes were analyzed and compared.    Results: OCT findings demonstrated that the macula in the diabetic patients with no diabetic retinopathy group was significantly thinner than that of the control group with mean (233.34±29.15) and (221.38±24.26) respectively. In addition, our findings showed that the macular thickness with mean (221.38±24.26) ,(231.30±29.34) and (256.48 ±39.62)gradually increased with the duration of DM with mean (5.48±4.39) ,(13.96±4.93) and (14.70±4.17) respectively probably because of an increase in vascular permeability in the diabetic retinas .   Conclusion: OCT will allow the detection of early changes and designing a personalized, noninvasive treatment .the role of neurodegeneration in the pathogenesis of DR is a solid basis for proposing neuroprotection as an effective strategy for preventing or arresting DR.}, keywords = {OCT,diabetic retinopathy,Macular Thickness}, url = {https://smj.journals.ekb.eg/article_40747.html}, eprint = {https://smj.journals.ekb.eg/article_40747_3a414eea054d97217c233f3335c86620.pdf} } @article { author = {Elnashar, Afaf and El-Naby, Noha ED and Abd El Wahab, Atef. and Nageeb, Ola}, title = {IMMUNOHISTOCHEMICAL EXPRESSION OF P63 IN UROTHELIAL CARCINOMA}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {237-246}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40748}, abstract = {Introduction: Urothelial carcinoma is the most common histologic type of urinary bladder cancer in Egypt. Detection of high-grade urothelial carcinoma is important for modification of therapy and improving the prognosis. P63 is expressed at high levels in the basal layers of different epithelial tissues, including the urothelium. Aim of the work: to study the diagnostic and prognostic value of p63 expression in urothelial carcinoma (UC).   Materials and Methods: Fifty cases of bladder urothelial carcinoma were involved in the study; 12 cases of non-invasive UC, (3 HG & 9 LG), and 38 cases of invasive UC, (30 HG & 8 LG). Sixteen cases of UC showed Bilharziasis. All the specimens were stained with p63 using immunohistochemical technique.  Results:  P63 was expressed in 28/38 cases (73.7%) of invasive UC and in all cases of non-invasive UC, and also in 16/17 (94%) low-Grade and in 24/33 (72.7%) of high-grade UC, with a statistically significant relation between p63 expression and both invasion (p > 0.001) and the tumor grade (p> 0.034). Conclusion: P63 can be used as a diagnostic and a prognostic factor for high grade invasive UC}, keywords = {P63,urothelial carcinoma (UC),High Grade (HG),Low Grade (LG)}, url = {https://smj.journals.ekb.eg/article_40748.html}, eprint = {https://smj.journals.ekb.eg/article_40748_f050a8a425856b5e5042b3dbbf4f2abc.pdf} } @article { author = {mahmod, MOHAMMED and A. GALHOM, RANIA and NASR EL-DIN, , WAEL and ALI, MONA H. and ABDEL-HAMID, SAAD}, title = {The effect of rotenone on the dopaminergic cells of the substantia nigra of the midbrain in the adult male albino rats}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {247-257}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40762}, abstract = {Background aims.  Rotenone is a widely used insecticide has a neurodegenerative effect on the dopaminergic cells of substantia nigra (SN) of midbrain producing Parkinsonism. The aim of this study is to study the effects of rotenone when injected subcutaneously on the dopaminergic cells of the substantia nigra of the midbrain.Methods. The effects of rotenone on the SN of midbrain and the were determinedhistopathologically, immunohistochemically, and by transmission electron microscopy. Results. Subcutaneous rotenone produced Parkinsonism through producing degeneration of the dopaminergic cells of SN of the midbrain. Conclusion. These results indicate that, rotenone has a neurodegenerative effect on the dopaminergic cells of the substantia nigra of the midbrain producing parkinsonism}, keywords = {Dopaminergic neurons,Neurodegeneration,parkinsonism,Rotenone,Substantia nigra}, url = {https://smj.journals.ekb.eg/article_40762.html}, eprint = {https://smj.journals.ekb.eg/article_40762_d52bb1d9732dd4cb3cb8365afe2fd260.pdf} } @article { author = {Ahmed, Mohamed and Ahmed, Ashraf and Khalifa, Abdelrahman and Shiha, Anis}, title = {Comparative study between interference screw fixation and implant free technique in anterior cruciate ligament reconstruction using semitendinosus and gracilis auto graft}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {247-257}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40773}, abstract = {Introduction to compare between interference screw fixation and implant free technique in anterior cruciate ligament reconstruction using semitendinosus and gracilis auto graft. Patients and methods this prospective study included 60young active patients. There were 56 males and 4 females. The mean age was27 years (range20-35). The meanfollow-up was 24 months (range 12–48). Patients were evaluated using subjective as well as objective International KneeDocumentation Committee (IKDC) assessment forms, ResultsAssessment using IKDC scoring revealed that 90 %of the patients had normal or nearly normal knee (IKDC score of A/B). Postoperative level of activity was excellent in 85 %of patients. ConclusionThis study showed that implant free technique in anterior cruciate ligament reconstruction using semitendinosus and gracilis auto graft ACL reconstruction is comparable to interference screw fixation in clinical out come}, keywords = {Arthroscopic .ACL.Implantfree.Interferencescrew. Reconstruction.Press.Fit}, url = {https://smj.journals.ekb.eg/article_40773.html}, eprint = {https://smj.journals.ekb.eg/article_40773_64057dbe59275a98337454bb941e2b38.pdf} } @article { author = {Hadhoud, Somaya and El-Adawy, Ahlam and Ahmed, Abeer and Mahmoud, Mona}, title = {Effect of Intrathecal Methotrexate Injectionon Neurocognitive Functions in Children with Non Hodgkin Lymphoma after Treatment}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {265-272}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40777}, abstract = {Introduction and aim of work: Neurocognitive late effects are common sequelae of cancer in children, especially in those who have undergone treatment for brain tumors or in those receiving prophylactic cranial radiation or intrathecal chemotherapy therapy to treat leukemia and non Hodgkin lymphoma (NHL). As NHL represents 8–10% of all malignancies in children between 5–19 years of age (Cairo, 2009)  and all NHL children receive intrathecal methotrexate as therapy or prophylaxis so we studied effect of intrathecal methotrexate in NHL treated children in their cognitive function and compare it with normal children, also we studied effect of some risk factors (age at disease onset and number of intrathecal injections) on the affected intelligence subscales and lastly a suitable and applicable model to evaluate neurocognitive function was done. Patients and methods: The study included 25 NHL treated children and 10 children as controls, all children are subjected to some specific neurocognitive tests and sheet for assessment of neurocognitive function as complementary study. Result: It showed that total IQ score, verbal and quantitative subscales are significantly affected in NHL patients and verbal subscale is more affected in children who began treatment at younger age}, keywords = {}, url = {https://smj.journals.ekb.eg/article_40777.html}, eprint = {https://smj.journals.ekb.eg/article_40777_de86d30ae94e899daa2265d4e7c35392.pdf} } @article { author = {Sadek, Abdelrahim and Mahmoud, Shaimaa and Abd alhalim, Walaa}, title = {Cardiac function of children with Duchenne muscular dystrophy}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {273-280}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40782}, abstract = {Background:Duchenne muscular dystrophy (DMD) is the most common childhood form of muscular dystrophy. Clinical guidelines recommend that evaluations for cardiomyopathy, arrhythmia, and heart failure be performed upon diagnosisThe incidence of cardiomyopathy in DMD increases with age Early detection of muscular dystrophy associated cardiomyopathy is important, because institution of cardioprotective medical therapies may slow adverse remodeling and attenuate heart failure symptoms in these patients. Aim: evaluation of cardiac function in children clinically suspected to have Duchenne muscular dystrophy. Methods:28 male children who met criteria for diagnosis of Duchenne muscular dystrophy aged from 3 to 18 years compared to 47 healthy control children were approached to participate in the study and, after consent, were submitted to full clinical examination, blood samples were collected to determinate CPK (creatinine phosphokinase), Troponin I enzyme, Myoglobin and LDH (lactate dehydrogenase) enzyme level,echocardiography and 12-lead electrocardiogram were done. Results: 28 Duchenne muscular dystrophy children and 47 age matched healthy male control children were included in the study. The mean age of study group was 7.29±3.24 years, and the mean age of the control group was 8.06±2. 86 years (p value 0 .28). 25% of cases had Positive family history of DMD. 35.7% of cases had positive consanguinity.all our  cases had elevated CPK  level (creatine phosphokinase)   .The mean  CPK level of cases  was 2495.79 ± 3457.02  While CPK level in controls was normal, (p value<0.0001). LDH level was elevated in 19 cases 67.86% of cases. The mean serum LDH level in DMD cases was 1232.07 ± 617.72. All control children have normal LDH level with mean 163.02 ± 109.62, (P value : <0.0001).The mean serum myoglobin level of (DMD) patients was higher relative to that of healthy controls   (but still within normal limits) 39.39  ± 7.25 versus 33.68 ±12.38 (ng/ml) respectively with statistically significant difference (P value: 0.01).There was no statistically significant difference between mean serum troponin I   level of DMD patients and that of controls 0 .03 ± 0.05 versus 0.01 ±0 .02  (U/L) respectively (p value: 0.37). Echocardiography of our patients revealed that one patient (3.57%)   had mild dilation of the left ventricular cavity which was statistically not significant, (P value: 0.37).7 cases (25%) of patients had low Ejection fraction (EF) and fraction shortening (FS) with mean (EF) 59.86 ± 10.20. All control children have normal EF with mean 73.30 ± 5.08 (P value : <0.0001). The mean FS was 20.29±5.59. All control children had normal (FS) with mean ±SD 36.17± 2.58 (P value : <0.0001). Electrocardiogram showed 28.57% of cases had sinus tachycardia with average heart rate (HR) 107 ±12.32 136. While 6.88% of controls had sinus tachycardia; (P value: 0.0001). Prolonged QTc interval was present  in39.29% of cases with a  mean of 431.39 ± 43.60 and that of controls was 415.17±25.2 (p value : <0.0001).  QTc duration of controls were normal for age. Other parameters of ECG were normal for age; no type of arrhythmia could be detected apart from sinus tachycardia. Conclusion:ECG manifestations in children with DMD in the form of sinus tachycardia and prolonged QTC interval are an early alarm for developing cardiomyopathy before overt echocardiographic findings appear}, keywords = {Duchenne muscular dystrophy,Echocardiography,electrocardiography,Cardiac}, url = {https://smj.journals.ekb.eg/article_40782.html}, eprint = {https://smj.journals.ekb.eg/article_40782_d5db8583a41cc0f9d8dad4af16c923ed.pdf} } @article { author = {Sayed, Sayed and Ouies, Salwa and Elsamman, Walaa}, title = {Values of Head circumference and Body Height in Sohag children from birth to six years}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {281-287}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.40790}, abstract = {population; for determining growth velocity, longitudinal data are required.The growth supervision of children usinggrowth curves is a widespread and usefultool in general pediatric practice.Head circumference (HC) is one of the anthropometric parameters included in the physical examination of the infant and toddler.Due to the differences in the international and interracial standard charts of anthropometric indices, several researchers around the world have attempted to provide alternative standard charts for measuring the HC at different ages. Aim of the work:The present study was carried out to obtain head circumference and body height values for children from birth to six years.Subjects and methods:The study included1300 child (boys and girls) in different ages from birth to six years and 20 years of sohag governorate in Upper Egypt.The children divided into different ages (at birth, 2 months, 4 months, 6 months, 9 months, 12 months, 18 months, 24 months, 3 years, 4years, 5years and 6years) and in each age there is 50 boy and 50 girl. Head circumference and Body Height were measured andcompared between boys and girls. Results:The mean values of head circumference and body height increase with increase in age and the values were higher in boys than girls in all ages. Conclusion: the growth velocity is higher in boys than in girls in all ages.}, keywords = {Head circumference,Height,Sohag,children}, url = {https://smj.journals.ekb.eg/article_40790.html}, eprint = {https://smj.journals.ekb.eg/article_40790_d87cb54c77b4dc42d56e493b2ec8dbd9.pdf} } @article { author = {Mohhmed, Nasma and Ismail, Mohamed and DeifAllah, Osama}, title = {Comparitive Study Between Early Menopause and Premenopausal Rheumatoid Arthritis patients}, journal = {Sohag Medical Journal}, volume = {21}, number = {1}, pages = {288-295}, year = {2017}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2017.110403}, abstract = {Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory disease marked by symmetric, peripheral polyarthritis. It is the most common form of inflammatory arthritis and often results in joint damage and physical disability. Exposure to estrogen may be protective against the onset of disease, yet earlier age at menopause may be associated with a greater proportion of patients presenting with a milder disease course Aim of the work: Assess the effect of early menopause on the activity and severity of rheumatoid arthritis. Patients and Methods: Cross sectional clinical study, included 50 patient divided on 2 groups (premenopausal and early menopausal), diagnosed as RA based on ACR/EULAR  classification criteria 2010. Results: Disease activity was higher in earlymenopause group than premenopause group. Conclusion: Early menopause is associated with a mild type of RA among women with disease onset after 45 years of age.}, keywords = {RA,early menopause,premenopause}, url = {https://smj.journals.ekb.eg/article_110403.html}, eprint = {https://smj.journals.ekb.eg/article_110403_8050d4e6adffaf49900d13a1d564b54b.pdf} }