@article { author = {Kassem, Ali and Sabet, Eman and Ahmed, Mohamed and Ahmed, Ahmed}, title = {Relationship between different normal serum bilirubin concentrations and diabetic nephropathy in patients with type 2 diabetes mellitus}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {1-8}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.30670}, abstract = {Background: One of the major complications of type 2 diabetes is diabetic nephropathy (DN). Nephropathy develops in ~20–40% of patients with diabetes and is the single leading cause of end-stage renal disease (ESRD) around the world.(1) Oxidative stress has been considered to be an important pathogenic factor in the development of diabetic vascular complications, including nephropathy. Bilirubin(BIL) has been recognized as an endogenous antioxidant. Objective: The objective of this study is to detect the relationship between serum bilirubin concentrations and diabetic nephropathy in patients with type 2 diabetes mellitus. PATIENTS & METHODS:The  study  included  92 patient  with  type 2 diabetes mellitus  who visit Sohag  University  Hospital ,All patients in this study were subjected to full history taking, complete physical examination, and laboratory investigations including urine analysis, albumin creatinine ratio, renal and liver function tests. Patients with T2DM were recruited and bilirubin concentrations were compared between patients with or without diabetic nephropathy. DN was diagnosed according to KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease .(7) Patients were classified according to stage of nephropathy(8): 1-stage 1          ------- albumin creatinine ratio less than 30 mg/g creatinin. 2-stage 2          ------- morphologic lesions without signs of clinical disease. 3-stage 3          ------- albumin creatinine ratio more than 30 , less than 300 mg/g creatinin. 4-stage 4          ------- albumin creatinine ratio more than 300 mg/g creatinin. 5- stage 5         ------- end stage renal disease. Results: Multiple stepwise regression analysis was used to examine the relationship between bilirubin concentrations (within normal range) and albumin creatinin ratio. Conclusions Serum bilirubin concentration correlated negatively with stage of diabetic nephropathy, which suggests that bilirubin has a potential role for protection of diabetic nephropathy.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_30670.html}, eprint = {https://smj.journals.ekb.eg/article_30670_54632d4eeb340831245d88ca392e9161.pdf} } @article { author = {Refai, Ahmed and Ismail, Ali and Ammar, Hatem and Mostafa, Engy}, title = {A comparative study between manifest, cycloplegic and wavefront refraction in myopia}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {9-16}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31118}, abstract = {Aim. to compare between manifest, cycloplegic and wavefront refraction in different grades of myopia. Methods. 100 myopic eyes were included. The data collected included: age, sex, manifest refraction, cycloplegic refraction, wavefront refraction and pupil diameter. Manifest refraction was acquired by autorefractometer ( NideK). Cycloplegic refraction was acquired after applying cyclopentolate eye drops 1% for an hour. Wavefront refraction was acquired by the iDesign aberrometer ( Hartmann Shack Aberrometer) (Visx, USA) using a 32 × 32 lenslet array and near infra-red light with a wavelength of 780 nm. Results. The study showed that the wavefront refraction using the iDesign aberrometer (Hartmann-Shack aberrometer) gives higher values for each of sphere, cylinder and spherical equivalent followed by the manifest autorefraction using the Nidek autorefractometer and lastly cycloplegic refraction in all grades of myopia. Conclusions. Regarding the three methods of refraction (manifest, cycloplegic and wavefront), our results showed that the wavefront refraction acquired by the iDesign aberrometer (Hartmann Shack Aberrometer) shows higher values for each of sphere, cylinder and spherical equivalent, followed by manifest refraction acquired by autorefractometer (NideK) and lastly cycloplegic refraction in all grades of myopia.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31118.html}, eprint = {https://smj.journals.ekb.eg/article_31118_0d7d9b9d5b05912934de2d8e2d6890b3.pdf} } @article { author = {Abdel-Moniem, Ahmad and Saied, Samia and Bakri, Sherif}, title = {Primary surgical care of cleft lip and palate patients}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {19-22}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31119}, abstract = {Social factors and gender of patients with cleft lip and palate have a major impact in the medical and surgical care yet this impact is not fully reviewed. The aim of the present study was to investigate if there is any difference between males and females in the primary surgical treatment of cleft lip and palate patients and the delayed presentation of cases with cleft lip and palate. This is a retrospective study of 343 patients with total number of 720 primary surgical procedures, Each procedure categorized into primary lip and primary palate repair. Then the age of first surgical procedure is then analyzed and compared according to gender of patients. The result of our study show that there is no statistically significant differences in the number of primary surgeries or the age of first operation but the mean of the age of first operation is higher than our protocol for primary repair. This study give an alert about the care given to cleft patients with delayed primary repair of cleft patients.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31119.html}, eprint = {https://smj.journals.ekb.eg/article_31119_6e915fefb1f011bf0575cbd22f384612.pdf} } @article { author = {Hassanin, Hassan and Zaki, Nayel and Ghaleb, Alaa and Rabee, Eslam}, title = {Study of acute pulmonary embolism patients in Sohag University Hospital}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {25-31}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31122}, abstract = {Background: Acute pulmonary embolism (PE) is a common and potentially lethal form of venous thromboembolism (VTE) which is commonly encountered in clinical practice. Most patients die of this fatal condition usually within the first 1 h of the event with mortality rate reaching nearly 10% during this period.(1) Objective: The objective of this study was to determine of risk factors and clinical presentation of acute pulmonary embolism at Sohag University Hospitals patients& Methods: All the patients underwent the following: (1)  Detailed history was taken. (2) Examination: Full clinical examination. (3) Investigations: (ABG, D. Dimer, CBC, ECG, Echocardiography, and CT Angiography). Results: As regard risk factors of pulmonary embolism 70% of them have DVT, 42% have dyslipidemia 32% were postoperative, 28% were diabetics, 24% were hypertensive, 22% were smokers and 20% were females taking cocs). Conclusion: The study show that PE more common in females and the mean age of the studied patients was 45years The most common risk factor is DVT.}, keywords = {acute pulmonary embolism}, url = {https://smj.journals.ekb.eg/article_31122.html}, eprint = {https://smj.journals.ekb.eg/article_31122_a654b24c61c84ebaa24cebd66ae611db.pdf} } @article { author = {Elasmay, Asmaa and Radwan, Gamal and Elagouz, Mohamed and Ammar, Hatem}, title = {Pentacam topographic changes after Epithelium-off collagen cross-linking versus Epithelium-on collagen cross-linking in patients with keratoconus}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {33-37}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31200}, abstract = {Keratoconus is a bilateral non-inflammatory disease .One of its characteristics is reduction of biomechanical strength of cornea and stromal thinning , which gradually decreases corneal thickness and induces  irregular astigmatism , myopia , corneal scaring, andreduction of visual acuity.(1)For early stages of keratoconus , one would use spectacles and contact lenses though the progression of the disease can lead to irregular astigmatism or corneal scaring, leaving no other option but corneal transplantation in about 20% of patients.(2)Corneal transplantation is an expensive procedure with many complications such as high astigmatism and graft rejection;  hence, seeking for a way to halt this progressive disease seems to be of crucial importance.(3) For more than a decade, corneal cross-linking  (CXL)   has been considered as the only method for improvingcorneal biomechanical power.(4)Corneal collagen cross-linking (CXL) is a low-invasive treatment aimed to improve biomechanical stability in eyes with keratectasia.(5) The “standard CXL protocol” described by Wollensak and colleagues includes removal of the corneal epithelium in a diameter of 9 mm , followed by saturation of the corneal stroma using 0.1% isotonic riboflavin solution in 20% dextran.(6)This procedure is proved to be effective in increasing corneal stiffness , stabilization of keratoconus , and in some cases in improving the refractive and topographic features.Even so, the epithelial removal may lead to serious complications that include infection(7),stromal haze (8), and corneal melting (9)in addition to severe pain and decrease in vision occurring during the first days after the treatment.To avoid such complications, Boxer Wachler et al. suggested a modification of the technique by keeping the epithelium intact (epithelium-on or transepithelial CXL) (10).In this study, we sought to compare keratoconus indices before and after crosslinking either epi-off or epi-on CXL by Pentacam criteria.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31200.html}, eprint = {https://smj.journals.ekb.eg/article_31200_2b51e54dd9ffb0cf690e81f2cf160691.pdf} } @article { author = {Ali, Ali and Kamal, Yasser and Abd El Aal, Asmaa}, title = {Quality of life after Renal Transplantation}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {41-50}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31209}, abstract = {Objective: This study was carried out with the purpose of assessment  quality of life of patients who have undergone kidney transplants and factors affecting it. Methodology: The study included 50 cases at Nephrology Outpatient Clinic at Sohag University Hospital the research was conducted at the duration from setmper 2017 to march 2018, In this study quality of life for patients after renal transplantation was assessed by two tools: 1-Quality of life questionnaire 2-Lab investigations Results: The average scores for quality of life  after renal transplantation were good ,many facors affect quality of life after renal transplantation ,in this study we discussed gender,residence,marital state,work,age duration of dialysis,duration after renal transplantation and level of serum creatinine,Study findings clarified that gender,marital state,work state and duration of dialysis had no  statistically significant distinction between them and total QOL score while residence,age,duration of transplantation  and level of serum creatinine after renal transplantation had statistically significant distinction between them and total QOL score. Conclusion: t was concluded that: the average scores for quality of life  after renal transplantation were good, residence,age,duration of transplantation  and level of serum creatinine after renal transplantation had impact on quality of life after renal transplantation but gender,marital state,work state and duration of dialysis had no impact on quality of life after renal transplantation.}, keywords = {Kidney transplantation,quality of life,Factors affecting}, url = {https://smj.journals.ekb.eg/article_31209.html}, eprint = {https://smj.journals.ekb.eg/article_31209_a3bf0db436313ea6487d72b04614c101.pdf} } @article { author = {El-Mishad, Mostafa and Mohamed, Abeer and Mahmoud, Tamer and Mahmoud, Ekram}, title = {Antimicrobial Resistance Pattern of Mycobacterium Tuberculosis Complex Isolated from Extrapulmonary Tuberculosis Patientsin Sohag Governorate}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {51-61}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31235}, abstract = {As the number of drug resistant pulmonary TB is increasing around the world, the number of drug resistant TB with extrapulmonary manifestations are also on rise. However, there is surprisingly scant information in medical literatures on prevalence and impact of extrapulmonary drug-resistant TB Aim:This study aimed to detect and isolate Mycobacterium Tuberculosis Complex (MTC or MTBC) strains from extrapulmonary samples then determine the drug resistance pattern of these strains to antituberculus drugs. Materials and Methods: A total of 100 clinical specimens were collected during the study period from September 2016 to January 2018 at Medial Microbiology & Immunology Department, Sohag Faculty of Medicine from patients suspected to have EPTB. All samples subjected to ZN staining &cultures on LJ media then all positive culture were subjected for identification of the type of mycobacteria by two methods, phenotypically by biochemical tests and genotypically by conventional PCR fordetection of MTC.Antimicrobial susceptibility pattern was done for MTC strains. Results:Out of100 collected extrapulmonary samples, 66 samples were positive for mycobacterial culture. By using biochemical tests and PCR for identification of species, 53 isolates were identified as MTC and 13 isolates were identified as NTM. Antimicrobial susceptibility pattern was done for MTCstrains and detected 5 strains were MDR and one strain was XDR. Conclusion:Extrapulmonary TB infection rate in Sohag governorate is high and the problem of drug resistance in extrapulmonary tuberculosis (EPTB) cannot be overlooked.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31235.html}, eprint = {https://smj.journals.ekb.eg/article_31235_19bf9a907454897f6ddf22044822927e.pdf} } @article { author = {El-Mishad, Mostafa and Mohamed, Abeer and Mahmoud, Tamer and Mahmoud, Ekram}, title = {Phenotypic and Genotypic Characters of Mycobacteria Isolated from Extrapulmonary Tuberculosis Patients in Sohag Governorate}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {63-72}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31280}, abstract = {Tuberculosis is a major global health problem. ExtrapulmonaryTB(EPTB) refers to TB involving organs other than the lungs. It shoulddrag more attention after increasing numbers of immunocompromised individualswith higher risk of developing EPTB. Aim: This study aimed to detectEPTB in clinically suspected cases and identificationof mycobacteria species by phenotypic and genotypicmethods. Materials and Methods: A total of 100 clinical specimens were collected during the study period from September 2016 to January 2018 at Sohag University from patients suspected to have EPTB. All samples subjected to ZN staining & culture on LJ media then all positive culture were subjected for identification of mycobacteria  speciesby two methods, phenotypically by biochemical tests and genotypically by conventional PCR for detection of mycobacterium Tuberculosis Complex ( MTC).Immunochromatographic tests were done for all strains with negative PCR in addition to some strains with positive PCR for confirmation and for comparison between immunochromatographic test and both biochemical test and PCR in identification of MTC. Results: Mycobacteria were isolated from 66 samples of which the highest number of isolates were obtained from urine samples followed by stool samples then other extrapulmonary samples. By using different methods of identification, 53 isolates were identified as MTC and 13 isolates were identified as nontuberculus mycobacteria (NTM). Conclusion: Our results suggest that due attention should be given for EPTB and rapid differentiation between MTC and NTM is very important for the proper management of patients with mycobacterial infections.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_31280.html}, eprint = {https://smj.journals.ekb.eg/article_31280_aaae9e803387ff562e393cf9266704bb.pdf} } @article { author = {mossa, Elshimaa and Abd Allah, Ahmad and Ammar, Hatem and Mostafa, Engy}, title = {Comparing efficacy, safety and stability of Femtosecond assisted LASIK and implantable collamer lens implantation in correction of high myopia}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {75-83}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31339}, abstract = {PURPOSE: To compare efficacy, safety and stability of Femtosecond assisted LASIK and implantable collamer lens implantation in correction of high myopia. METHODS: This study was non-randomized comparative prospective consecutive interventional study. It included 74 eyes with high myopia (≥ -6 Ds) of 40 patients attended to the outpatient ophthalmic clinic of Sohag university hospitals from the period from Jan.2016 to Jan.2017. The patients were divided into two groups depending on: Degree of myopia, corneal thickness and corneal tomography. The first group (34 eyes) of 20 patients were subjected to implantable collamer lenses implantation and the second group (40 eyes) of 40 patients were subjected to femtosecond assisted LASIK. RESULTS: Group one (ICL group) showed UCVA preoperative was (1.90±0.29) and UCVA postoperative was (0.27±0.21) with (p-value}, keywords = {High myopia,Femtosecond,Excimer laser,implantable collamer lens,Efficacy,safety,stability}, url = {https://smj.journals.ekb.eg/article_31339.html}, eprint = {https://smj.journals.ekb.eg/article_31339_542200f54711ec9d3e59e85bcd98bafd.pdf} } @article { author = {mossa, Elshimaa and Abd Allah, Ahmad and Ammar, Hatem and Mostafa, Engy}, title = {Efficacy, safety and stability of implantable collamer lens incorrection of high myopia}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {85-90}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31431}, abstract = {PURPOSE: To evaluate efficacy, safety and stability of implantable collamer lens in high myopia. METHODS:This study was non-randomized comparative prospective consecutive interventional study. It included 34 eyes with high myopia (≥ -6 Ds) attended to the outpatient ophthalmic clinic of Sohag university hospitals from the period from Jan.2016 to Jan.2017. RESULTS:UCVA preoperative was (1.90±0.29) and UCVA postoperative was (0.27±0.21) with (p-value<0.000*). BCVA preoperative was (0.526±0.272) and that of BCVA postoperative was (0.217±0.128) with (p-value<0.001*),VA values are improved in 100% of cases which can be up to (0.1 logMAR or more) after 6 months follow up (p<0.000*).Spherical equivalent preoperative was (-15.173±4.079) and that of postoperative was (-0.269±0.787) with (p-value<0.000*), which didn’t change of spherical equivalent of manifest refraction ≥ 1.00 D within 6 months follow up period. CONCLUSIONS:Implantable collamer lenses proved high efficacy, safety and stability for high myopic patients.}, keywords = {High myopia,implantable collamer lens,Efficacy,safety,stability}, url = {https://smj.journals.ekb.eg/article_31431.html}, eprint = {https://smj.journals.ekb.eg/article_31431_684f684be4bed1d46fdb9b7d1560ce28.pdf} } @article { author = {Abdelrahman, Abdelrahman and Abdgalil, Wesam and Taha, Al haitham}, title = {Association between electrocardiographic findings and cardiac dysfunction in adult isolated traumatic brain injury}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {91-94}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31435}, abstract = {Background: Abnormal electrocardiographic (ECG) findings can be seen in traumatic brain injury (TBI) patients. ECG may be an inexpensive tool to identify patients at high risk for developing cardiac dysfunction after TBI. The aim of this study was to examine abnormal ECG findings after isolated TBI and their association with true cardiac dysfunction, based on echocardiogram. Patients and methods: Data from adult patients with isolated TBI between 2015 and 2017 was retrospectively examined. Inclusion criteria included the presence of a 12-lead ECG within 24 h of admission and a formal echocardiographic examination within 72 h of admission after TBI. Patients with preexisting cardiac disease were excluded. Baseline clinical characteristics, 12-lead ECG, and echocardiogram report were abstracted. Logistic regression was used to identify the relationship of specific ECG abnormalities with cardiac dysfunction. Results ECG values showed abnormalities in 11 patients ( 22.4 % ) at the first day of admission in the form of ; two patients ( 18.1 % ) had  ventricular ectopics, three patients  ( 27.2% ) developed supraventricular tachycardia  and nine patients  ( 81.8 % ) had significant ST segment elevation. Conclusion: Repolarization abnormalities (prolonged QTc and MERA), but not ischemic-like ECG changes, are associated with cardiac dysfunction after isolated TBI. 12-lead ECG may be an inexpensive screening tool to evaluate isolated TBI patients for cardiac dysfunction prior to more expensive or invasive studies}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31435.html}, eprint = {https://smj.journals.ekb.eg/article_31435_f2a5e368ea7613986c77762821d38241.pdf} } @article { author = {Abdelrahman, Abdelrahman and Abdgalil, Wesam and Taha, Al haitham}, title = {Cardiac troponin elevation as an evidence of neurogenic myocardial dysfunction in patients with head trauma}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {95-108}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31438}, abstract = {Background: cardiac dysfunction is frequently observed after severe traumatic brain injury (sTBI), however its significance is poorly understood. Our study sought to elucidate the association of cardiac troponin I (cTnI) elevation with all cause in-hospital mortality following isolated sTBI (brain AIS ≥ 3 and admission GCS ≤ 8, no AIS ≥3 to any other bodily regions). Patients and methods: After approval of this study from local ethical committee, and obtaining written informed consent from relatives, head trauma patients will be enrolled in this observational  prospective study. study was conducted in the 10-bed trauma-surgical ICU in Sohag university hospital , Fifty patients with isolated TBI , were consecutively included between January 2015 and February 2017. Results: our study validated cTnI as a novel biomarker and independent predictor of all cause in-hospital mortality in patients with TBI. these findings have several implications. First, cTnI assay should be considered in patients with sTBI even in absence high suspicion of cardiac injury. Second, cTnI is a sufficiently prognostic biomarker of mortality in patients with sTBI. Third, cTnI elevation in patients with sTBI must be treated with caution. Conclusion: cTnI level was a significant indicator for stress cardiomyopathy , severity of trauma calculated by RTS had no relation with incidence of stress cardiomyopath . Our study provided important insights to the heart-brain interactions following TBI and possible schemes for subsequent optimization of management of these patients.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31438.html}, eprint = {https://smj.journals.ekb.eg/article_31438_9c2996c521218eed4842264587897069.pdf} } @article { author = {Muhammad, Eman and Farghali, Omar and El Badawy, Zeinab and Ahmed, Sheren and Ahmed, Amira}, title = {Immunohistochemical Expression of Cancer Stem Cell marker Aldehyde dehydrogenase 1B1 (ALDH1B1) in Colorectal Carcinoma}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {109-115}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31537}, abstract = {Background: Colorectal cancer (CRC) is the third most common cause of cancer-related death in the US. One out of four patients presenting with conventionally staged node negative disease (AJCC Stage I and II), and over 50% of patients with Stage III disease will develop local recurrence and/ or metastases. Across all stages, approximately 30% of patients will develop distant metastases. Once metastases become clinically evident prognosis is often fatal. Biomarkers capable of predicting progression, risk stratification and therapeutic benefit are needed. CRCSC markers will identify a group of patients at high risk for progression. ALDH1 has been reported as a cancer stem cell marker in pancreatic, breast, prostate, and lung cancer, multiple myeloma and leukemia. By IHC analysis, human ALDH1B1 was found to be expressed at high levels in the small intestine, liver, and pancreas, and at lower levels in the lung and colon. This study aims to investigate ALDH1B1 expression in different types of colorectal carcinoma and correlate this expression with different clinicopathological parameters.  Materials and Methods: ALDH1B1 immunostaining was studied in 50 specimens of colorectal carcinoma using avidin-biotin peroxidase method. Results: ALDH1B1 was strongly expressed in 12/50 (58%) of cases of colorectal carcinoma, moderately expressed in 31/50 (36%) of cases and weekly expressed in 7/50 (6%) of cases. ALDH1B1 expression in colorectal carcinoma was significantly positively correlated with tumor size (p= 0.021), tumor grade (p= 0.035) where the highest expression levels were associated with moderately or poorly differentiated tumors and positive regional lymph node status (p= 0.038). Conclusion: The up-regulation of ALDH1B1 with increasing grade of colorectal carcinoma and presence of LN metastases indicates that ALDH1B1 might play a role in carcinogenesis and tumor progression. }, keywords = {colorectal cancer,stem cell marker}, url = {https://smj.journals.ekb.eg/article_31537.html}, eprint = {https://smj.journals.ekb.eg/article_31537_0aa63408047645ae4e5ecd9825e848fa.pdf} } @article { author = {Elsliney, Eman and El Sayed, Adel and Saad, Hamdy and Hussein, Ahmed}, title = {Impact of glycemic state on hospital outcome in patients with acute coronary syndrome in sohag university hospitals}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {117-124}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31559}, abstract = {   Background    Hyperglycemia is common and related to more morbidity and death rates in hospitalized patients with acute coronary syndromes (ACS). We planned to research the relationship between the glycemic state and the hospital outcomes in ACS patients. Methods It was a prospective cohort study in included 150 patients admitted to the coronary care unit (CCU) with ACS at Sohag University hospital and were followed up for one month. We classified the patients into three gatherings regarding their glycemic state, group A (euglycemic), group B (hyperglycemia and not diabetic), and group C (hyperglycemia and known to be diabetic). Results  We found no significant difference in the individual hospital outcomes, including serious arrhythmia, acute pulmonary edema, cardiogenic shock, recurrent ischemia, heart failure, cerebrovascular stroke (CVS), or all-cause deaths in the three groups. There was a significantly higher total outcome in hyperglycemic patients (group B+ C) compared to euglycemic patients (group A) after multivariate regression analysis and confounders adjustment (Adjusted OR was 1.79; 95% CI 1.31-3.12; p-value 0.01). Conclusion:In both diabetic and non-diabetic patients presented with ACS, the admission hyperglycemia has a harmful impact on the hospital outcomes. So, strict monitoring of the blood glucose levels at admission for all ACS patients is required, and tight management of hyperglycemia is mandatory.}, keywords = {ACS,DM,hyperglycemia,hospital outcomes}, url = {https://smj.journals.ekb.eg/article_31559.html}, eprint = {https://smj.journals.ekb.eg/article_31559_d6315e8e05433dccaf1e42d4e184257d.pdf} } @article { author = {Ahmed, Aya and Ismail, Mohammed and Elsayed, Sahar and Ali, Rabab}, title = {Quality of Life in Patients with Systemic Lupus Erythematosus}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {125-131}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31607}, abstract = {Introduction: Systemic lupus erythematosus (SLE) is a chronic disease that results in variable and occasionally life-threatening manifestations. persons with SLE may experience a wide range of physical, psychological and social problems that affect quality of life.Aim of the work: Assess quality of life in the patients suffering from systemic lupus erythromatosus.Patients and Methods:The study was conducted on forty patients, with systemic lupus erythematosus [32 females (80%) and 8 males (20%)] and forty healthy adults of matched age and sex, as control group [30 female (80%) and 10 males (20%)]. The patients selected from the rheumatology outpatient clinic of Sohag University hospital. An informed written consent had been taken from all patients.Results: The increase in the disease activity, as assessed bysystemic lupus erythematosus disease activity index (SLEDAI) was significantly associated with more impaired quality of life as assessed by SF-36 and systemic lupus erythematosus quality of life questionnaire (SLEQOL).Conclusion:SLE patients have more significantly impaired quality of life, as assessed by short form-36(SF-36), and systemic lupus erythematosus quality of life questionnaire (SLEQOL) than the controls. }, keywords = {SLE,quality of life}, url = {https://smj.journals.ekb.eg/article_31607.html}, eprint = {https://smj.journals.ekb.eg/article_31607_46412ef30af8cbd4f0e9fd7290a24d95.pdf} } @article { author = {Hassanin, Bahaa and Almamoun, Momen and Abdalal, Mohamed and Awesh, Mohamed and Elkhyat, Roshdy and Brawanski, Alexander and Schebesch, Karl-Michael}, title = {Cerebral aneurysms: Conflicts and future trends.}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {133-150}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31626}, abstract = {Cerebral aneurysms are pouch-like focal dilatations of intracranial arteries, which usually occurred at their branching points. Most of these aneurysms remain asymptomatic and never ruptures. When an aneurysm ruptures, it may bleed into the brain parenchyma resulting in a parenchymal hemorrhage, or more often, it will bleed into the subarachnoid space, resulting in a subarachnoid hemorrhage (SAH). Cerebral aneurysms are not a disease unique to the modern society and a lot of improvements have been achieved especially in its treatment in the second half of the 20th century, especially after the adoption of microsurgical techniques and FDA approval for detachable coils as Endovascular techniques to treat cerebral aneurysms in 1995. The aim of the current study is to review basic knowledge about the cerebral aneurysms, with brief telescopic view on areas of conflicts, to know the current state of research regarding the cerebral aneurysms to conclude what the future research trends should be.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_31626.html}, eprint = {https://smj.journals.ekb.eg/article_31626_48b9dafc018d0c25418eb72bccc6b968.pdf} } @article { author = {Fadl, Khaled and Kasim, Abdin and Abo Zeid, Waleed}, title = {Neuro-Endoscopic Management of Multiloculated Hydrocephalus}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {151-155}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31720}, abstract = {OBJECTIVE: The aim of this study is to evaluate the role of endoscopy in management of multiloculated hydrocephalus. PATIENTS AND METHODS: We reviewed 30 consecutive patients during the period from January 2012 to December 2015 with multiloculated hydrocephalus who underwent neuroendoscopic approach for treatment, in Sohag university Hospital. The patients’ clinical outcomes, and complications were reported. RESULTS: There were 30patients (12male18 female).endoscopic septum pellucidum fenestration was done in 9 cases and endoscopic ventricular septal fenestration was done in 21 cases; The success rate was achieved in 25 cases (83.3%). The remaining 5 cases (16.7%) needed a re-do the procedure due to the presence of residual compartments not opened and not drained by the existing shunts, no immediate or late postoperative complications and there was no mortality. CONCLUSION:Neuroendoscopic management for multiloculated hydrocephalus can restore communication between isolated intraventricular compartments transforming them into single cavity and one intraventricular catheter can be used , reduce the number of surgical procedures, and improving the quality of life of the patient}, keywords = {Endoscopy,multiloculated hydrocephalus,Fenestrations,Outcome,comlpications}, url = {https://smj.journals.ekb.eg/article_31720.html}, eprint = {https://smj.journals.ekb.eg/article_31720_d1c82b0f352ff28eb980a2698fd9abff.pdf} } @article { author = {Abdelatif, Ismael and Radwan, Gamal and Gaber, Mohammed and Mahmoud, Sara}, title = {Relationship between peripapillary retinal nerve fiber layer and visual field severity indices in primary open angle glaucoma}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {157-162}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.31807}, abstract = {Background: Optical Coherence Tomography (OCT) and visual field (VF) are devices for diagnosis and management of glaucoma. Using both techniques enable us to detect the functional and anatomical changes occur in glaucomatous eyes. Objectives: In this study, we aimed to determine the relationship between optical coherence tomography (OCT) parameters and visual field severity indices computed by standard automated perimetry (SAP) in patients with primary open angle glaucoma and to know the correlation between OCT disc parameter and ganglion cell layer (GCL). Methods: The study included 94 subjects (160 eyes) divided into two groups. Group1 included 54 subjects with primary open angle glaucoma (cases) (92 eyes) Group 2 included 40 healthy non-glaucomatous subjects (controls) (68eyes).OCT disc &macula and VF using standarded automated perimetry were performed for all participants in both groups. Correlations between OCT parameters and VF parameters and between OCT disc parameters and GCL were detected. Area under curve (AUC) was used to detect most important factor to differentiate cases from control. Results: We found strong correlations between MD and each of  total , Inferior , Superior p RNFL respectively , PSD  is moderately correlated with total ,inferior and superior  p RNFL and vertical CDR  respectively ,Inferior p RNFL is strongly correlated to inferior GCLcomplex. Regarding the "area under curve (AUC)" : the most important factors to differentiate cases from control are in order: total GCC, followed by inferior GCC, then total p .RNFL. Conclusion : macular scans may be a good alternative to p. RNFL thickness assessment for the detection of glaucoma, we should perform VF test with both macular and p.RNFL scanning in all subjects suspected or known to have glaucoma for better and earlier diagnosis as they improve the sensitivity of glaucoma detection.}, keywords = {OCT,VF,Glaucoma,macular ganglion cell layer}, url = {https://smj.journals.ekb.eg/article_31807.html}, eprint = {https://smj.journals.ekb.eg/article_31807_354facf439c6be4f92f413d51e9a867e.pdf} } @article { author = {Mohammed, Alaa El Din and Mohamed, Mona and Goda, Asmaa and Mohamed, Samah}, title = {Biofilm Formation of Staphylococcus aureus Isolated from Infected Wound}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {163-177}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.32143}, abstract = {Background: Staphylococcus aureus  has the ability  to form biofilms, and causes significant mortality and morbidity in the patients with wounds. Our aim was to study the in vitro biofilm-forming ability of isolated S. aureus patients and methods: one hundred clinical isolates of S. aureus were isolated from 350 pus samples using standard microbiological techniques. Biofilm formation ability  of  these isolates was detected  phenotypically by tissue culture plate (TCP) method and congo red agar (CRA) and genotypically by detection of ica ABCD genes by PCR. Results: The clinical isolates of S. aureus recovered from infected wounds exhibit a high degree of biofilm formation Biofilm formation was observed in (76 %), (74%) and (70%) isolates of S. aureus via TCP method CRA and genotypically, respectively. Conclusion: This study illustrated that PCR method can be adopted as most suitable an reproducible method for detection of biofilm. CRA is qualitative, simple, inexpensive and easily reproducible method and convenient as screening method. TCP is semiquantitative method and remains a precious tool for in vitro screening of different biomaterial for the adhesive properties. Regular surveillance of biofilm formation by S. aureus leads to the early treatment of the wound infection.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_32143.html}, eprint = {https://smj.journals.ekb.eg/article_32143_c488998fbb2acf21c383138f0cd49f5e.pdf} } @article { author = {Mohammed, Alaa El Din and Mohamed, Mona and Goda, Asmaa and Mohamed, Samah}, title = {Antimicrobial Resistance Pattern of Staphylococcus aureus Isolated from Infected Wounds at Sohag University Hospitals}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {179-187}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.32146}, abstract = {Background:Staphylococcus aureus is an important human pathogen causing varieties of mild to life threatening community and hospital infections. This study was carried out to determine the antibiotic susceptibility profile of Staphylococcus aureus isolated from infected wounds of patients at Sohag University Hospitals. patients and methods: 100 clinical isolates of S. aureus were obtained from 350 pus samples using standard microbiological techniques. Antimicrobial susceptibility test was performed using the modified Kirby–Bauer disk diffusion method and confirmed by VITEK 2 automated microbiology system. methicillin resistant Staphylococcus aureus (MRSA) detection was also confirmed by detection of mec A gene by PCR. Results: S.aureus isolates were totally resistant to Penicillin G and highly  resistant to Cefoxitin and Oxacillin. They were moderately resistant to Gentamycin, Tetracycline, Erythromycin, Clindamycin, Doxycycline and Chloramphenicol.They showed low resistance to Ciprofloxacin, Levofloxacin Trimethoprim/ Sulfamethoxazole, Moxifloxacin and Azithromycin. All isolates were sensitive to Qunipristin/Dalfopristin, Linezolid, Vancomycin ,Tigecycline, Nitrofurantoin, Rifampicin and Teicoplanin.Among the 100 isolated Staphylococcus isolates, 89(89%) were identified as MRSA. Conclusion: The high incidence of S.aureusisolates resistant to the commonly used antibiotics in the hospital calls for urgent need to put in place measures to curtail the spread of MRSA infections in the hospital.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_32146.html}, eprint = {https://smj.journals.ekb.eg/article_32146_f298db1b60dd1500cbdb8889015b10a7.pdf} } @article { author = {Abd EL Naeem, Abeer and Desouky, Mohammed and Ouies, Salwa}, title = {A Morphologic and Morphometric Study of the jugular foramen of the adult human skulls: an osteological study in Upper Egypt}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {189-193}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.32155}, abstract = {Background:Jugular foramen is one of the foramen at the base of skull lies between the occipital bone and the petrosal portion of the temporal bone. It allows passage of important nervous and vascular elements, such as the glossopharyngeal, vagus accessory nerves, and the internal jugular vein. Glomic tumors, schwannomas, metastatic lesions and infiltrating inflammatory processes are associated with this foramen, which can account for injuries of related structures. Variability in anatomical aspect of jugular foramen has been studied by many workers in different part of the world. Aims & Objective:Tostudy the variability in shape and size of jugular foramen which has clear cut relationshipwith size of internal jugular vein and presence or absence of dome. Materials andMethods: Present study has been designed to study on 100 skulls (100×2=200 foramen). Result: In the study Bilateral presence of dome has been found in 98% of cases. Both unilateral and bilateral completeseptation have been observed. The mean diameters on the right side were more than the left. Conclusion:The clinical significance of jugular foramen is very important during surgeries. Therefore, the dimensions of jugular foramen is very much necessary.}, keywords = {Jugular foramen,internal jugular vein,Dome,skull}, url = {https://smj.journals.ekb.eg/article_32155.html}, eprint = {https://smj.journals.ekb.eg/article_32155_2da7311e3a8963e65e426eefc7cd3e71.pdf} } @article { author = {Desouky, Mohammed and Ouies, Salwa and Abd EL Naeem, Abeer}, title = {A Morphologic and Morphometric Study of the greater palatine foramen: An osteological study in Upper Egypt}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {195-200}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.32163}, abstract = {Background:Evidence supports a clear racial variation in the position of the greater palatine foramen. Therefore detailed knowledge of the population specific data on biometric features of the greater palatine foramen will facilitate therapeutic, local anesthetic and surgical manipulations in the maxillo-facial region. Aims &Objective: The goal of this study was to elucidate the morphological features and precise anatomical position of the greater palatine foramen in relation to the molar tooth . Materials andMethods:A total of one hundred adult dry skulls were assessed to determine the position, shape, and straight distance from it to incisive foramen. The position of the greater palatine foramen was determined in relation to the maxillary molars. Result: The results indicated that 47% opposite 3rd molar.27%opposite 2nd molar.26% between 2nd and 3rd molars. Distance from incisive foramen: on the right side it varied between 30.01to 40.94mm. On the left side it varied between 32.1to 41.4 mm. Conclusion:The GPF is most frequently palatal to the third maxillary molar. For an edentulous patientthe distance from incisive foramenwas about 30mm.}, keywords = {greater palatine foramen,3rd molar,incisive foramen}, url = {https://smj.journals.ekb.eg/article_32163.html}, eprint = {https://smj.journals.ekb.eg/article_32163_8f2991c1c2c0903b9f04961e00e9231f.pdf} } @article { author = {Abdelhameed, Hany and Kamel, Ahmed and Mohammed, Usama and Ismail, Ali}, title = {Intraocular pressure reduction in neovascular glaucoma using Ex-PRESS implantation}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {201-208}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.32272}, abstract = {Purpose: evaluation of the role of the Ex-PRESS device implantation in IOP reduction of neovascular glaucoma. Design: non-comparative case series study. Patients and methods: 5 eyes with neovascular glaucoma scheduled to undergo Ex-PRESS glaucoma filtration device. Each study patient underwent a complete ophthalmic examination preoperatively including full clinical history taking, VA measurement, autorefraction examination, slit lamp biomicroscopy of the anterior segment, IOP measurement using Goldmann applanation tonometer, gonioscopic examination to evaluate of the angle of AC, and ophthalmoscopy of the posterior segment using a direct ophthalmoscopy. All patients included were having neovascular OAG (angle grade 3 and 4 on Shaffer classification). Patients were excluded if they were under 18 years old. All eyes underwent Ex-PRESS device implantation performed by the same surgeon for consistency, using the standardized technique for the procedure. A complete ophthalmologic follow-up examination included IOP measurement using Goldmann applanation tonometry, number of drugs required to attain IOP control and any associated complications was carried out postoperatively at the 1st and 3rd days, the end of 1st week, every month till the end of the 6th month and the end of 1st year. Best-corrected visual acuity (BCVA) was tested using Snellen chart, which was converted to LogMAR for statistical analysis. Criteria for success were defined as follows; Absolute success: IOP ≤21 mmHg without any medication, qualified success: IOP ≤21 mmHg with ocular hypotensive medications. Results: all cases (100%) showed qualified success. There is a statistically significant reduction in IOP 1, 3, 6 months and one year postoperatively (P<0.001) with the most reduction in IOP observed at 6 months after surgery due to controlling all cases with IOP >21 mmHg using anti-glaucoma medications by this time. There is a statistically significant improvement of postoperative BCVA (P=0.002). Moreover, there is a statistically significant reduction of number of anti-glaucoma medications used postoperatively (P<0.001). Conclusion: Ex-PRESS is preferable for neovascular glaucoma.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_32272.html}, eprint = {https://smj.journals.ekb.eg/article_32272_7f0de4f6a28d970bd7d9781bec864c3b.pdf} } @article { author = {Abdelhameed, Hany and Kamel, Ahmed and Ismail, Ali and Mohammed, Usama}, title = {The role of the Ex-PRESS device implantation in the management of pseudophakic glaucoma}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {209-217}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.33465}, abstract = {Purpose: evaluation of the role of the Ex-PRESS device implantation in the management of pseudophakic glaucoma. Design: non-comparative case series study. Patients and methods: 6 eyes with pseudophakic glaucoma scheduled to undergo Ex-PRESS glaucoma filtration device. Each study patient underwent a complete ophthalmic examination preoperatively including full clinical history taking, VA measurement, autorefraction examination, slit lamp biomicroscopy of the anterior segment, IOP measurement using Goldmann applanation tonometer, gonioscopic examination to evaluate of the angle of AC, and ophthalmoscopy of the posterior segment using a direct ophthalmoscopy. All the patients were subjected to functional and structural evaluation by SAP (HFA 745i) for central 30-2 threshold test, endothelial cell evaluation by non-contact specular microscopy (Topcon specular microscope; SP-1P Version 1.20) for endothelial cell count and OCT scans (Topcon 3D OCT-2000) for peripapillary RNFL thickness measurements, ONH analysis and GCA. All patients included were having pseudophakic OAG. Patients were excluded if they were under 18 years old. All eyes underwent Ex-PRESS device implantation performed by the same surgeon for consistency, using the standardized technique for the procedure. A complete ophthalmologic follow-up examination included IOP measurement using Goldmann applanation tonometry, number of drugs required to attain IOP control and any associated complications was carried out postoperatively at the 1st and 3rd days, the end of 1st week, every month till the end of the 6th month and the end of 1st year. Best-corrected visual acuity (BCVA) was tested using Snellen chart, which was converted to LogMAR for statistical analysis. Criteria for success were defined as follows; Absolute success: IOP ≤21 mmHg without any medication, qualified success: IOP ≤21 mmHg with ocular hypotensive medications. VF test with SAP, specular microscopy and ONH analysis and GCA assessed with OCT were carried out one year postoperatively. Results: There were 4 eyes (80%) showed complete success (IOP P<0.001) with the most reduction in IOP observed at 6 months after surgery due to controlling all cases with IOP >21 mmHg using anti-glaucoma medications by this time. There is a statistically significant improvement of postoperative BCVA (P=0.002). Moreover, there is a statistically significant reduction of number of anti-glaucoma medications used postoperatively (P<0.001). For VF indices, there is a statistically significant improvement in both MD and PSD postoperatively (MD; P<0.001) (PSD; P=0.002). However; There is no significant improvement in the staging of glaucoma according to GSS2 (P=327). For OCT parameter, there is a statistically significant increase in the thickness of both RNFL and GCC (P<0.001). Furthermore, endothelial CD shows a statistically significant increase postoperatively (P <0.001). Conclusion: Ex-PRESS is preferable for pseudphakic glaucoma.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_33465.html}, eprint = {https://smj.journals.ekb.eg/article_33465_88aa48d49032c7e545719f82cc2bab1a.pdf} } @article { author = {Abdelaal, Mahmoud and mohamed, El niser and sayed, Mohmed}, title = {elation between Benign prostatic hyperplasia and Metabolic syndrom}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {219-222}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.33494}, abstract = {Objectives: Determine the association  between LUTS associated with BPH and metabolic syndrome. Methods: The study was conducted over 100 patient at Sohag university hospital. Results: Regarding the relation between BMI and LUTS we found that the mean of BPH volume&prostatic specific antigen  was significantly higher in obese patients than normal and overweight patients. Regarding  the relation between diabetes mellitus and LUTS we found that the mean flowrate was lower in diabetic patients than non diabetic patients. Regarding the  relation between hypertension and LUTS we found that mean IPSS and PSA was higher in hypertensive patient than non hypertensive patients. Conclusion: BPH volume was significantly correlated with each of age,  body mass index,waste circumference, triglyceride and cholestrol. IPSS was significantly correlated with body mass indx and diabetus mellitus.}, keywords = {Metabolic syndrome,Benign Prostatic Hyperplasia,diabetes mellitus hypertension}, url = {https://smj.journals.ekb.eg/article_33494.html}, eprint = {https://smj.journals.ekb.eg/article_33494_80926049d86cf6fbdf9cd105b8ce0742.pdf} } @article { author = {Galal, Ghada and Zaghloul, Amr and Aref, Rania}, title = {Laboratory and Ultrasonographic predictors of oesophageal varices in cirrhotic patients}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {223-230}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.33804}, abstract = {Portal hypertension in cirrhosis results from progressive fibrotic remodeling of the liver, which increases the resistance to hepatic sinusoidal blood flow. Increased portal venous pressure causes esophageal and gastric varices, which contribute substantially to cirrhosis-related morbidity and mortality. The gold standard in the diagnosis of varices esophagogastroduodenoscopy (EGD) but identification of non –invasive predictors of oesophageal varices (OVs) will allow upper gastrointestinal (GIT) endoscopy to be carried out only in selected group of patients . Different non-invasive parameters including clinical, laboratory and sonographic predictors were suggested an alternative approach to perform selective screening endoscopy only in patients at high risk. Objective: Our objective is to evaluate whether the NIHCED (non-invasive hepatitis C related cirrhosis early detection) score and the right lobe diameter to albumin ratio can predict the presence of esophageal varices in patients with liver cirrhosis. Patients and method: This prospective study included seventy-five patients with liver cirrhosis, all patients were evaluated clinically and ultrasonographically. complete blood count, liver function tests, calculation of NIHCED score and right lobe diameter to albumin ratio. Upper GIT endoscopy were done to all of them for detection of oesophageal varices. Results In total 75 patients were included (51 males and 24 females) with mean age 53.11±9.89. All 75 patients were segregated into two groups those with oesophageal varices and those without oesophageal varices. Roc curve analysis of NIHCED score was applied to both goups with a cut off score of >45.  It had a sensitivity of 70%, specifity of 78%, and diagnostic accurancy of 74% with an AUC of 0.77 (95% CI, 0.66-0.86).  Roc curve analysis of right lobe diameter to albumin ratio was applied to both groups with a cut off score of >2.80. It had a sensitivity of 80%, specifity of 53%, and diagnostic accurancy of 67% with an AUC of 0.67 (95% CI , 0.55-0.77). Conclusions: The NIHCED score and right lobe diameter to albumin ratio were simple non-invasive predictors of presence of varices in patients with liver cirrhosis.}, keywords = {Liver cirrhosis,Oesophageal varices}, url = {https://smj.journals.ekb.eg/article_33804.html}, eprint = {https://smj.journals.ekb.eg/article_33804_77b526d04aa2ac255e27c0621223b013.pdf} } @article { author = {Ali, Ali and Kamal, Yasser and Kerollos, Romany}, title = {Relation between Helicobacter Pylori infection and Irritable Bowel Syndrome}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {231-237}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.33805}, abstract = {Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. The association of Helicobacter pylori(H. pylori) infection with IBS still remains controversial. Objective: The objective of this study is to determine the rate of H. pylori infection among patients with IBS through the detection of H. pyloriStool Antigen Teesttitre (SAT) Materials &Methods :,This study will be performed on 80 patient attended GIT out patient clinic of sohag university hospital from 6/2017to 3/2018 will be classified into: 1-controle group (20patients)who do not fulfill criteria for diagnosis of irritable bowel syndrome 2-Affected group(60patients) who fulfill criteria for diagnosis of irritable bowel syndrome Those groups  will be classified  according to severity Also the affected groups will be classified according to subtypes All patents underlying the following: (1) history will be taken including:  (2)Full clinical examination (3) Laboratory investigations Fasting blood glucose level,HBA1C renal function .liver function, complete blood counting Abdominal ultrasonography H.pylori stool antigen test titr (SAT) Results: Comparison was done among all types of IBS as regard H.Pylori SAT revealed constipation predominant cases have the  highest number(33%) of H.Pylori SAT positive cases while lowest number of cases(4%) were unclassified, Comparison was done among all grades of IBS as regard H. Pylori SAT revealed grade 3 cases the highest number of H. Pylori SAT positive cases, lowest number of cases were grade1 Conclusion: In this study revealed positive relationship between H . Pylori infection and irritable bowel syndrome as regard types of irritable bowel syndrome, the incidence of  H. Pylori infection was more with constipation predominant patients and as regard severity of  irritable bowel syndrome , H . Pylori infection more common in grade 3.}, keywords = {Irritable bowel syndrome,Helicobacter pylori infection}, url = {https://smj.journals.ekb.eg/article_33805.html}, eprint = {https://smj.journals.ekb.eg/article_33805_171026a4e5deb5cfe50b8b2cd92070db.pdf} } @article { author = {El-Hady, Hanaa and Abd-Elmaged, Samir and Abd-Elmawgood, Amal and Ahmed, Salwa}, title = {Parasites in Duodenal Aspirate using Endoscopy in Sohag, Egypt}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {239-244}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34032}, abstract = {Background and study aim:Gastrointestinal parasites cause infectious diseases. Parasitic infection of duodenum is a relevant cause of its inflammation and appearance of upper GIT manifestation, especially in developing countries. Examination of duodenal aspirates can be very helpful in diagnosing intestinal infection because it eliminates some of the problems inherent in stool examination. The aim of this study was to estimate the prevalence of parasites in duodenal aspirate obtained by upper gastrointestinal tract endoscopy. Subjects and methods: This cross-sectional study was conducted from March 2017 to March 2018 in sohag university hospital and Center of the digestive system. It was done on 100 patients who underwent Esophago-gastro-duodenoscopy. A total of 100 duodenal aspirate samples were collected from patients were subjected to Esophagogastroduodenoscopy for diagnostic or therapeutic reason. All cases were reviewed as regard age, sex. Cases with parasitic infestations were characterized regarding the mentioned variables.  Results:  60 % of duodenal aspirate samples were positive. Monoparasitized patients constituted 38% (38/100) of patients while 22% were polyparasitized. There were 44 patients (44%) of Cryptosporidium infection, 21 patients (21%) of Blastocystis hominis infection, 11 patients (11%) of Cyclospora infection, 8 patients (8%) of Giardia lamblia infection. Conclusion:  We concluded that the duodenal aspirate samples obtained during gastrointestinal endoscopic procedures helped in diagnosing the parasites. }, keywords = {Intestinal parasites,duodenal aspirate,Esophagogastroduodenoscopy}, url = {https://smj.journals.ekb.eg/article_34032.html}, eprint = {https://smj.journals.ekb.eg/article_34032_2c25eb145582516933a7007b6dc31716.pdf} } @article { author = {Galal, Ghada and Abd-El-Fatah, Mahmoud and Kamel, Samar}, title = {Non-invasive methods for diagnosis of hepatic fibrosis in chronic hepatitis B patients}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {245-251}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34099}, abstract = {Non-invasive markers for assessing liver fibrosis have been developed, and they are frequently used in clinical practice. They have been validated in different studies, and some were found to be highly accurate compared with liver biopsies which have always been used as the standard reference method for evaluating the accuracy of non-invasive methods1.The performance of a non-invasive diagnostic method is evaluated by calculation of the area under the receiver operator characteristic curve (AUROC)2.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_34099.html}, eprint = {https://smj.journals.ekb.eg/article_34099_d40cb90905a3ca9eec8233e741fe6438.pdf} } @article { author = {Ali, Rasha and Fouad, Seham}, title = {Performance assessment of health care providers}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {252-259}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34231}, abstract = {}, keywords = {}, url = {https://smj.journals.ekb.eg/article_34231.html}, eprint = {https://smj.journals.ekb.eg/article_34231_64340ea1a2bb50d63a503eadc6fe20bd.pdf} } @article { author = {Solyman, Mohamed and Arafa, Osama and Alam Eldeen, Mohamed and Ali, Sherif}, title = {MRI assessment of left ventricular volumetrics and ejection fractions in patients with chronic ischemic heart disease in comparison with 2D echocardiography}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {263-271}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34388}, abstract = {Background: Ischemic heart disease (IHD) is highly prevalent in developed countries and is the leading cause of death. Diagnostic imaging plays an important role in the proper assessment and management of ischemic heart disease. The new criteria incorporating imaging evidence of ischemic heart disease involve not only established modalities such as echocardiography and radionuclide imaging, but also the newer modalities, cardiovascular magnetic resonance (CMR) and cardiac computed tomography especially in presence of pitfalls and limitations in diagnosis by established modalities. Aim:To assess left ventricular volumes; end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and wall motion abnormalities by MRI in patients with chronic ischemic heart disease in comparison with 2D echocardiography. PatientsandMethods: This prospective study include examination of 50 adult patients known to have chronic ischemic heart disease with or without suspected progression of the disease came for follow up by MRI and 2D echocardiography in Cairo university and Aswan heart center (MYF) radiology and cardiology departments. MRI was done by using 1.5T machine, using SENSE (sensitivity encoding) cardiac coil (6 element phased-array coil, receive only), functional cine images, first pass perfusion images and delayed enhancement images were acquired. Echocardiography was done transthoracic (TTE) by using a 2D ultrasound machine. The left ventricle volumes and ejection fractions obtained by MRI were compared to those obtained by echocardiography and correlated with standard tables of left ventricle volumetrics. Wall motion abnormalities were assessed visually by both modalities. Results:By comparison of the diagnostic performance of MRI versus 2D echo in estimation of left ventricle volumes and ejection fraction there was agreement and strong correlation value (0.97) between both modalities however, we found that the left ventricle volumes were of lower values by echocardiography relative to MRI with statistically significant difference with P value (0.004) and we found that the EFs detected by echocardiography were of higher values relative to MRI with statistically significant difference with P value (<0.001). As regard wall motion abnormalities, both CMR and 2D echo detected the hypokinetic and akinetic left ventricle segments with no statisticaly significant difference. Conclusion:  Cardiac MRI can detect the impairment in left ventricle function in patients with ischemic heart disease and is an accurate tool for assessment of left ventricle volumes and ejection fraction and can be considered as a  standard reference for these issues. *= radiodiagnosis department, ^=internal medicine department- faculty of medicine-sohag unevirsity.}, keywords = {left ventricular volumetrics,Cardiac magnetic resonance imaging,Echocardiography,Ischemic heart disease}, url = {https://smj.journals.ekb.eg/article_34388.html}, eprint = {https://smj.journals.ekb.eg/article_34388_a728f461a117967c6fea6befb5e47519.pdf} } @article { author = {Solyman, Mohamed and Arafa, Osama and Alam Eldeen, Mohamed and Ali, Sherif}, title = {MRI assessment of left ventricle myocardial viability in patients with chronic coronary artery disease in comparison with single photon emission computed tomography}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {274-283}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34490}, abstract = {Background: Coronary artery disease (CAD) is highly prevalent in developed countries and is a leading cause of death. Diagnostic imaging plays an important role in the proper assessment and management of CAD. Myocardial perfusion is evaluated by SPECT in most patients today; however, this technique exposes patients to radiation and its diagnostic accuracy is sometimes limited by relatively low spatial resolution and artifacts from photon scatter and tissue attenuation. Scintigraphy defects may not be apparent until 10 g of tissue is infarcted. Thus, because a sizable threshold of damage is required, SPECT may miss small or subendocardial MI. Advances in rapid magnetic resonance imaging technology and its application to cardiac imaging have shown that MR imaging has tremendous potential for evaluation of cardiac disease. Practical advantages of cardiac MRI include the lack of ionizing radiation, a shortened examination time (25 to 40 min), good safety and tolerability profile, and detection of small subendocardial infarcts. Aim: assessment of myocardial viability in patients with chronic coronary artery disease by magnetic resonance imaging in comparison with single photon emission computed tomography (SPECT). Patients and Methods: This prospective study include examination of 10 adult patients (each patient has 3 coronary arteries, so we examined 30 coronary arteries and their myocardial territories) known to have chronic ischemic heart disease in Cairo university by MRI and SPECT with conventional angiography as a standard reference. MRI done by using 1.5T machine, using SENSE (sensitivity encoding) cardiac coil (6 element phased-array coil, receive only), functional cine images, first pass perfusion images and delayed enhancement images were acquired. SPECT study was done by 2-day exercise/rest gated SPECT imaging with Tc–99m sestamibi. Conventional coronary angiography was done using a trans-femoral approach to selectively inject the left and right coronary systems sequentially. The results of cardiac MRI subdivided into three groups: (a) Myocardial ischemia was defined as: either 1- Cardiac segment with motion abnormality or perfusion deficit at first-pass perfusion MR imaging consistent with no hyper-enhancement at delayed-enhancement MR imaging. Or 2- Cardiac segment of subendocardial enhancement (25 % thickness scar) with motion abnormality. (b) Myocardial scarring is defined as: either 1- Cardiac segment with myocardial delayed enhancement having ≥ 75% thickness scar. Or 2- Myocardial thickness less than 6 mm in diastole. (c) Mixed myocardial ischemia and scarring is defined as: Cardiac segment with myocardial delayed enhancement of near 50 % (>25% and <75%) thickness scarring. The results of SPECT were obtained by comparison between resting and exercise images to detect areas with fixed defects (scar) and those with reversible defects (ischemia). A defect was considered to be fixed (scarred) when there was no change between the stress and rest images, partially reversible (mixed ischemia and scar) when there was an improvement in tracer uptake of at least 1 grade between stress and rest images, totally reversible (ischemic) when there was normalization of uptake at rest images. In coronary angiography a reduction of the luminal diameter 70% or more in a major epicardial coronary artery or the major branches was considered to be a relevant stenosis. The angiographic results were classified as one-, two-, or three-vessel disease. Results:Both CMR and SPECT are accurate in detection of diseased coronary arteries with statistically significant P values. The overall patient based sensitivity, specificity, PPV, NPV and accuracy of cardiac MRI for the detection of diseased coronary artery  were 94% (15 of 16 territories), 100% (14 of 14), 100% (15 of 15), 93% (14 of 15) and 97% (29 out of 30) respectively while the overall sensitivity, specificity, PPV, NPV and accuracy of SPECT for the detection of coronary artery stenosis were 88% (14 of 16), 93% (13 of 14), 93% (14 of 15), 87% (13 of 15) and 90% (27 out of 30) respectively. Both modalities CMR and SPECT show no statistically significant difference in detection of ischemic and scarred left ventricle myocardial segments although the sensitivity of MRI was higher than SPECT in detection of transmural scarring. As regard detection of complications CMR detected 1 intraventricular thrombus that was missed by SPECT. Conclusion:  CMR is an accurate tool for assessment of coronary artery disease and myocardial viability as regard ischemia, scarring with great capability for detection of transmural extension of scarring and prediction of recovery. MRI can detect complications like ventricular thrombus that was missed by SPECT. Other advantages of MRI are time saving, lack of ionizing radiation and detection of left ventricular volumetrics and wall motion abnormalities. *= radiodiagnosis department, ^=internal medicine department- faculty of medicine-sohag unevirsity.}, keywords = {myocardial viability,Cardiac magnetic resonance imaging,SPECT,Coronary Artery Disease}, url = {https://smj.journals.ekb.eg/article_34490.html}, eprint = {https://smj.journals.ekb.eg/article_34490_6fe58ba7f38431d01eb01f1e04016938.pdf} } @article { author = {Mahdi, Saber}, title = {Attention and Memory in Tramadol Addiction}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {285-289}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34496}, abstract = {Background and Objective: Impairment in cognitive domains  occurs commonly in substance use disorders. Tramadol abuse is a common problemin Egypt. The objective of this study was to study the effect of tramadol addiction on attention and memory. Methods: This study included 30 patients with tramadol addiction and 30 control subjects (matched for age, sex, and education).The participants were interviewed using attention and memory subscales of Montreal Cognitive Assessmenttest (MoCA) and Trail making test A and B. Results: The average score of memory in the tramadol addiction group was 2.46±1.33, while the average score in the control group was4.47±1.04, there was significant difference between the two groups with P value <0.0001.There was no statistically significant impairment in Trail making tests A and B.Therewas no association between cognitive impairment and sociodemographicor clinical factors. Conclusions: Tramadol addiction causes impairment in memory.There is no effect of tramadol dose or duration of abuse on cognitive impairment.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_34496.html}, eprint = {https://smj.journals.ekb.eg/article_34496_844643116fa25fc7003380cce3b9ffae.pdf} } @article { author = {Arafa, Osama and Ahmed, Amal and Ahmed, Abdellah}, title = {Comparison of risk factors and clinical presentation between men and women with acute coronary syndrome at Sohag University Hospitals}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {291-297}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34537}, abstract = {Background: Comparison of risk factors and clinical presentation  between men and women with acute coronary syndrome at Sohag University Hospitals. presence of relation between sex of the patient and clinical presentation is still controversial  Objective: The objective of this study is to determineof risk factors and clinical presentation  between men and women with acute coronary syndrome at Sohag University Hospitals patients& Methods :All the patients  underwent the following : (1)  Detailed history was taken including: Age,sex, residence, smoking, duration of diabetes and type of treatment used,HTN or other current illness(2)Examination:Full clinical examination(3) Laboratory investigations: Fasting blood glucose level, lipid profile ,cardiac enzymes,  complete blood counting(4)  Electrocardiograph Results:male patients with acute coronary syndrome mainly had risk factors as smoking as (44%) followed by HTN (42%) then DM (37%) , while female patients mainly had risk factors of HTN and DM as (65%) followed by dyslipidemia (39%), old age and obesity are more frequent in females than males. Clinical presentation of typical chest pain is higher in males (87%) than in females(73%). Conclusion:women with acute coronary syndrome had higher rates of traditional risk factors like old age, obesity, hypertension, diabetes while smoking and positive family history are higher in men . typical chest pain is more common in men }, keywords = {Acute Coronary Syndrome}, url = {https://smj.journals.ekb.eg/article_34537.html}, eprint = {https://smj.journals.ekb.eg/article_34537_a45255b8d2ca8542dafb20bd1a82c8bb.pdf} } @article { author = {Abouelella, Azza and Madkour, Hala and Abdelraheem, Mahmoud}, title = {N-acetyl-L-Cysteine ameliorates oxidative stress and reproductive toxicity induced by nicotine in male rats}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {299-305}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34692}, abstract = {Background: The current study assessed the protective role of N-acetyl-L-Cysteine in alleviating the detrimental effect of nicotine on reproductive functions in male rats. Methods: twenty four adult male albino rats were divided into four groups of six rats. Control group was treated orally with 0.5ml/kg normal saline, nicotine treated group received 1.0 mg/kg of nicotine i.p, N-acetyl-L-Cysteine treated group received 100 mg/kg and 200 mg/kg i.p for four weeks. Results: Nicotine caused significant reduction in serum level of total antioxidant, testosterone and luteinizing hormone. It also caused a significant reduction in sperm count. There was impairment in testicular histology of rats treated with nicotine. N-acetyl-L-Cysteine improved the reduction in sperm count, hormone levels and testicular alterations observed in nicotine treated rats. Conclusion: The study shows that nicotine exerts significant deleterious effects on male reproductive system and the concurrent administration of N-acetyl-L-Cysteine ameliorated these detrimental effects.}, keywords = {Nicotine,N-acetyl-L-Cysteine,Sperm count,FSH,LH,Testosterone and Total antioxidant}, url = {https://smj.journals.ekb.eg/article_34692.html}, eprint = {https://smj.journals.ekb.eg/article_34692_5791fdb4f9558d7723242b7c9fe20028.pdf} } @article { author = {Abo Dahab, Lotfy and Boghdady, Ahmed and Ezzat, Mohamed and Alsayed, Kassem}, title = {Correlation between Serum Uric Acid level and Left Ventricular Ejection Fraction in Patients with Congestive Heart Failure}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {307-314}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34708}, abstract = {Background: One of the risk factors of congestive heart failure that still under investigations is hyperuricemia. It's still debatable whether it's an independent risk factor or it's just a consequence of other disorders associated with cardiovascular diseases like hypertension, diabetes and dyslipidemia. Objective: The aim of our study is to elucidate whether in patients with heart failure serum uric acid level correlated with left ventricular ejection fraction supporting the possibility that the detection of progressive hyperuricemia in these patients may be an indicator of deteriorating cardiac function. Methods: We conducted a prospective study that included 124 studied patients and 26 apparently healthy persons at Coronary care unit and Internal Medicine Department at Sohag University Hospitals. All studied populations were classified into four groups; v Group "I" patients being newly diagnosed heart failure, v Group "II" patients decompensated heart failure on regular treatment, v Group "III" patients decompensated heart failure but stopped their treatment from three months, v Group "IV" control group selected to our study healthy and  age-matched subjects from 30 to 70 years old . Then we studied the association between left ventricular ejection fraction, the severity of congestive heart failure and the serum uric acid levels and the well-known conventional risk factor that include age, sex, BMI, positive family history, smoking, hypertension, diabetes and dyslipidemia then through logistic regression analysis we tried to identify the independent predictors of coronary artery diseases. Results: The mean finding in our study is the significant higher mean ± SD serum uric acid levels in patients with congestive heart failure (8.43±2.95) versus apparently healthy persons (5.55±1.48) with "P value = .02". When we adjusted the serum uric acid with others significant factors in the univariate analysis which were age, gender and smoking, serum uric acid was an independent risk factor "P value = .04". Another interesting finding is significant correlation between serum uric acid level and the severity of congestive heart failure "P value<0.001,correlation coefficient=.35", where, that high rates of serum uric acid levels were recorded in patients with severe congestive heart failure. The gold finding is significant correlation between serum uric acid level and left ventricular ejection fraction "P value<0.001, correlation coefficient=.35", where, that high rates of serum uric acid levels were recorded in patients with reduced ejection fraction. According to ROC analysis a uric acid level of 8.45 mg/dl was found to be the most appropriate cut-off point with the sensitivitv 62% and the specificity 75%. Conclusion: Higher serum uric acid levels are significantly correlated with the severity of congestive heart failure and left ventricular ejection fraction, as follows, the mean finding in our study is the significant higher mean ± SD serum uric acid levels in patients with congestive heart failure (8.43±2.95) versus apparently healthy persons (5.55±1.48) with "P value = .02". When we adjusted the serum uric acid with others significant factors in the univariate analysis which were age, gender and smoking, serum uric acid was an independent risk factor "P value = .04".  }, keywords = {Serum uric acid,congestive heart failure and left ventricular ejection fraction}, url = {https://smj.journals.ekb.eg/article_34708.html}, eprint = {https://smj.journals.ekb.eg/article_34708_73303d3557ab9f85f78d23a35b49bba1.pdf} } @article { author = {Hamed, Elham and Abdel-Latef, Tamer and Mahmoud, Ahmed and Fahem, Katren}, title = {Serum Clusterin In Patients With Chronic HCV infection Related Cirrhosis}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {315-319}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.34972}, abstract = {Cirrhosis is a condition in which the liver does not function properly due to long term damage. Typically, the disease comes on slowly over months or years. Cirrhosis is characterized by the replacement of normal liver tissue by scar tissue.  Clusterin (apolipoprotein J) is a 75 - 80 kDa disulfide-linked heterodimeric protein associated with the clearance of cellular debris and apoptosis.   Objective: We aimed to evaluate the diagnostic performance of serum CLU level in diagnosing chronic HCV infection-related cirrhosis, and comparing it to that of alpha fetoprotein (AFP).  Methods: Case control study was carried out in the Clinical Pathology Department, Faculty of medicine, Sohag university hospital.Twenty cases of apparently healthy subjects and  20 cases of chronic HCV infection-related cirrhosis(CHC cases) were included in this study. Serum CLU concentration was determined using a quantitative sandwich enzyme immunoassay technique.  Results: Serum clusterin level showed a significant decrease in the CHC group compared to the control group (88.3 ± 30.7 vs. 110.7 ± 30.1). Conclusion: CLU is decreased in the serum of patients with established CHC.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_34972.html}, eprint = {https://smj.journals.ekb.eg/article_34972_df89198551b449364c33ec32e146cdb4.pdf} } @article { author = {}, title = {A study on the effects of rotenone on the midbrain in the adult male albino rats}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {321-326}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.35037}, 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_35037.html}, eprint = {https://smj.journals.ekb.eg/article_35037_0613d0c08191d467bd3b821fe7b50b66.pdf} } @article { author = {Hashim, Marwa and Mohamed, Nesma and Mahmoud, Ekram}, title = {Role of autophagy in immune regulation}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {329-331}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.36151}, abstract = {Autophagy is a highly conserved protein degradation pathway responsible for removal of damaged organelles, malformed proteins during biosynthesis, and nonfunctional long-lived proteins by lysosome. Autophagy has been divided into three general types depending on the mechanism by which intracellular materials are delivered into lysosome for degradation that is, microautophagy, chaperone mediated autophagy (CMA), and macroautophagy. Numerous studies reveal autophagy and autophagy related proteins also participate in immune regulation. in this review we summarized current understanding of the roles of autophagy and autophagy proteins in immune regulation.}, keywords = {}, url = {https://smj.journals.ekb.eg/article_36151.html}, eprint = {https://smj.journals.ekb.eg/article_36151_52988c58fa4ba311f692a663fcd87ea7.pdf} } @article { author = {Yousef, Laila and Mohammed, Ahmed and Sayed, Sherif and Mohammad, Marwa}, title = {Common Pathogens Associated with Neonatal Sepsis and Their Antibiotic Resistance Pattern in Sohag University Hospital}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {333-340}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.36160}, abstract = {Introduction: Neonatal sepsis is defined as a clinical syndrome in an infant 28 days of life or younger, manifested by systemic signs of infection and isolation of a bacterial pathogen from the bloodstream[EmanShehab El-Din et al, 2015]. Positive blood culture and sensitivity of the isolate is the best guide to antimicrobial therapy and once started should be modified according to the culture sensitivity reports[Aggarwalet al, 2001]. Aim of the work: To determine clinical and microbiological pattern of neonatal sepsis in Sohag university hospital with special focus on causative pathogens and their response to used antimicrobials. Patient and methods: Our study conducted over a period of 18 months between October 2015 and April 2017 at Sohag university  hospital and included 75 neonates with suspected sepsis and positive blood culture using Egyptian neonatal network (EGNN) guidelines, subjected to full clinical examination, septic screen(CBC, ESR and CRP) and blood culture and sensitivity tests. Results: All studied neonates presented with late onset sepsis with higher incidence in infants born via CS especially with low and very low birth weight.The incidence of neonatal sepsis was predominantly due gram negative bacteria mainly Klepseillapneumonae followed by staphylococcus haemolyticusandstaphylococcus epidermidis. Klebseilla isolates showed high sensitivity for aminoglycosides and quinolones antibiotics with resistance to penicillin's group, Staphylococcus isolates showed resistance to penicillin's and aminoglycosides while sensitive to quinolones and nitrofurantions. E.coli and Pseudomonas species showed moderate sensitivity to 3rd generation cephalosporins, aminoglycosides, quinolones and nitrofurantoins with resistance to classic penicillin's. Conclusion: In our study gram negative bacteria mainly Klepseillapneumonae was the most causative agent of neonatal sepsis. Most isolated organisms showed resistance to classic penicillins.Klepseillapneumonaeshowed high sensitivity for aminoglycosides and quinolones, Staphylococcus isolates showed high sensitivity to quinolones and nitrofurantions while E.coli and Pseudomonas species showed moderate sensitivity to 3rd generation cephalosporins, aminoglycosides, quinolones and nitrofurantoins.}, keywords = {Neonatal sepsis,blood culture and sensitivity in neonates,Klebsiella neonatal sepsis,multidrug resistance}, url = {https://smj.journals.ekb.eg/article_36160.html}, eprint = {https://smj.journals.ekb.eg/article_36160_6d635972ea4d08c80a5fa0ad595d7952.pdf} } @article { author = {Abd Allah, Safaa and Galal, Ghada and Nazir, Mariam}, title = {Pathogenesis of Portal Hypertension and Esophageal Varices}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {343-347}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39061}, abstract = {Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients. Portal hypertensionis associated with both increased portal inflow and increased intrahepatic vascular resistance. Intrahepatic vascular resistance is caused by the architectural distortion of the liver resulting from fibrosis and by increased sinusoidal tone. Portal venous inflow results from a combination of ahyperdynamic circulatory state and increased plasma volume. In response to the increased portal pressure, collateral circulation develops by the opening of preexisting vascular channels. Esophagogastric varices are the most important collateral vessels: they tend to increase in size with the increase of portal pressure and rupture when wall tension exceeds a critical value.  }, keywords = {}, url = {https://smj.journals.ekb.eg/article_39061.html}, eprint = {https://smj.journals.ekb.eg/article_39061_6fad95cdaeda0a170c91249344ae1459.pdf} } @article { author = {Rasheed, Salah and Abd El- Monem, Allam and Mohamed, Magdy and Hassan, Mostafa}, title = {Management of preterm labour In Sohag University hospital: A clinical audit}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {349-356}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39239}, abstract = {Objective : Auditing the current management of preterm labor in department of Obstetrics and Gynaecology, Sohag  University hospital against RCOG recommendations ,Identifying the gap between the current practice and ideal practice and Setting recommendations for filling the gap(if present)  to improve neonatal and maternal out comes. Methods : This is an observational study which was conducted at  Sohag University hospital durin the period from 1 march 2017 to 31 December 2017. All patients with preterm birth who admitted to Sohag university hospital during the study period were included into the study and their data were  recorded in a special check list sheet.  IBM-SPSS ( version 24) was used for statistical data analysis. Results : The mean age of our studied group was 26.01±5.15 and 81.1 % of them were rural,48 cases had scarred uterus due to mostly previous caesarean section, while the other 79 cases had non scarred uterus. Also, a little more than half of our cases (66 cases, 52%) .UTI were the only indication for the use of antibiotics .Antibiotics not used for prophylactic in management of preterm birth in our study which is recommended by RCOG .Vaginal swab for oncofetal fibronictine or GBS/vaginal infection were not done  as it is not accepted in our department which is against RCOG recommendation .Tocolysis failed in 12 cases out of the 15 multiple pregnancy cases, with a significant difference from the failure rate among singleton pregnancy women .As regard RCOG recomendatins : There is insufficient evidence for any firm conclusions about whether or not tocolysis leads to any benefit in preterm labour in multiple pregnancy.  Conclusion : The use of Mgso4 as IV tocolytic drug in our hospital play effective role in prevention of preterm labour and giving the  chance for receving the dexamethasone but we need to modyfiy our strategy and using other tocolytic drugs as Ca channel blocker  as recommended }, keywords = {preterm labor,tocolytic drugs,antenatal steroids,RCOG}, url = {https://smj.journals.ekb.eg/article_39239.html}, eprint = {https://smj.journals.ekb.eg/article_39239_2a9c1adfcad1d45f203b77443cb09e53.pdf} } @article { author = {Mahmoud, Zeinab and El-Gawad, AbdElhady and Abdel-Latef, Tamer and Hassan, Myada}, title = {Monoclonal Antibodies Production, Diagnostic and Therapeutic Applications}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {357-363}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39245}, abstract = {Introduction:Monoclonal antibody is an antibody that is specific for one antigen and is produced by a B-cell hybridoma.  Hybridoma technology has been replaced by recombinant DNA technology and transgenic method (mice, plant and chickens). Once monoclonal antibodies for a given substance have been produced, they can be used to detect the presence and quantity of this substance and so monoclonal antibody has many diagnostic applications. Aim of the work:To clarify the new methods for production of monoclonal antibodies and application of monoclonal antibodies in diagnostic and therapeutic approaches. Conclusion:Hybridoma technology has been replaced by recombinant DNA technology and transgenic method (mice, plant and chickens). Once monoclonal antibodies for a given substance have been produced, they can be used to detect the presence and quantity of this substance and so monoclonal antibody has many diagnostic applications as in the analysis of cell surface and secreted molecules like CD molecules identification and identification of transcription factor FOXP3. Also, they have a role in the molecular genomics to identify the susceptible genes that predispose to development of autoimmune thyroid diseases. }, keywords = {Monoclonal Antibodies,hybridoma technology,immune-diagnosis}, url = {https://smj.journals.ekb.eg/article_39245.html}, eprint = {https://smj.journals.ekb.eg/article_39245_c4ec474d53d29cbf83f53535bd5fedf7.pdf} } @article { author = {Desouky, Mohammed and Ouies, Salwa and Fadel, Mohamed and Zakher, Mena}, title = {Study of Normal Egyptian cervical Spinal Canal Using Different Radiological Modalit}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {365-372}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39263}, abstract = {Introduction: Decline in the size of Spinal canal would increase chance of compression of important structures and might lead to many symptoms including neck pain, and radiculopathy. Diagnosis of Spinal stenosis based on clinical findings along with the radiological assessing of the canal size measuring antero-posterior diameter and cross-sectional area which are different for each population. Many factors suggested affecting the spinal canal diameters such as race, sex, height and age which is still a controversial factor. Aim of the work:  The present study carried out to provide normal values of the cervical spinal canal dimensions in male Egyptian population and to evaluate the effect of aging. Subjects and methods: MRI of 24 and CT of 32 male Egyptian subjects in different ages from 20 to 70 years. The population divided into three age groups (20-39 years, 40-59 years and 60 years and older). For each age group; Mid-sagittal antro-posterior diameter and Cross sectional area was measured from C2-C7. Results:Mean values of the cervical canal diameters found to be widely variable fromC2 to C7, and normal diameters defined as antero-posterior (APD) ranged (from 9.60to20mm), and (from 11.2to19.5mm) in CT and MRI respectively. Mid-sagittal antero-posterior canal diameter and Cross sectional area, decreased steadily with age at all levels. Conclusion: Mean values for the cervical canal diameters decreased steadily at all levels with increase in age. }, keywords = {cervical spinal canal,Age,Egyptian males}, url = {https://smj.journals.ekb.eg/article_39263.html}, eprint = {https://smj.journals.ekb.eg/article_39263_e808d9d7f373a26b4bc266896c985cea.pdf} } @article { author = {Arafa, Osama and Ahmed, Amal and Askar, Ashraf and Abo-Elhamd, Naglaa}, title = {Outcome Of Hepatorenal Syndrome in Sohag University Hospital}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {373-378}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39293}, abstract = {Background: Hepatorenal syndrome is a clinical condition that occurs in patients with chronic liver disease, advanced liver cell failure and portal hypertension characterized by impaired renal function Various variables were studied between survivor and non-survivor groups to detect possible predictors of non-survival . Objective: This study aims to assess outcome of hepatorenal syndrome in Sohag University Hospitals and discover possible predictors of non-survival in these patients. Materials & Methods : This study included 50 patient attented Sohag University hospital from 1 / 4 / 2017 till 1 / 10 / 2017 and Who agreed to share in the study and fulfilling the criteria of hepatorenal syndrome were be studied prospectively to observe clinical outcome Various variables were studied between survivor and non-survivor groups to detect possible predictors of non-survival in hepatorenal syndrome. The diagnosis for cirrhosis was based on history, examination, liver function test, and abdominal ultrasound. In all patients history of jaundice, fever, abdominal pain, abdominal distension, deceased urine output and GIT bleeding was  taken. diagnosis of hepatorenal syndrome was according to the International Ascites club criteria (inclusion criteria).Study was divided into 2 groups, survivors and non-survivors. Results: the study shows 14 patients (28%) were survivors, but the remaining 36 patients were non-survivors (72%). the possible predicting factors of mortality  included were male sex,having tense ascites, having SBP,hepatic encephalopathy being child score C, type I HRS,with high level ofserum creatinine and urea,low level of serum albumin. These factors were be subjected to multivariate regression analysis.}, keywords = {Hepatorenal syndrome,Terlipressin}, url = {https://smj.journals.ekb.eg/article_39293.html}, eprint = {https://smj.journals.ekb.eg/article_39293_2d5c5fd5ef7579569a9beb589e076268.pdf} } @article { author = {Ahmad, Heba and El Sharkawy, Reham and Rasheed, Salah}, title = {Cutaneous Changes During Pregnancy}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {381-389}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39336}, abstract = {Background:There are several changes which affect females’ skin that occur during pregnancy. These changes, although considered, physiological are quite distressing to many women.  Discussion with the pregnant woman about the nature of her skin condition and the possible fetal risks associated with it is imperative. Aim of the work: This study aimed to evaluate the pattern of dermatological manifestations which affect pregnant women in our environment with different socio-economic levels. Patients and Methods: This study was a cross- sectional design. It included 600 pregnant women who attended Dermatology, Venereology, Andrology and Antenatal care clinics. Local examination included morphology of skin changes (monomorphic or polymorphic), type of lesion (primary or secondary), distribution of skin disease (localized or generalized, unilateral or bilateral) and site of the lesion. Results: The most common physiological skin changes were pigmentary changes (98%) followed by striae distensae (76%), vascular changes (27.3%), hair changes (20.2%), glandular changes (19%) and nail changes (2%). As regarding pigmentary changes; lineanigra (86.6%), secondary areola (74.3%) and melasma (44%) were most common pigmentary changes in pregnant women.Scabies was the most common associated dermatological disorder (2.7%) of pregnant women followed by acute urticaria (1.3%), polymorphic light eruption (1.3%) and molluscum contagiosum (0.3%) of patients.Pregnancy-induced dermatoses were found in 67 (11.3%) of pregnant women. Atopic eruption of pregnancy (44.8%) was the most common condition [i.e. includes eczema (23.9%), prurigo (14.9%) and pruritis folliculitis (6%)]; polymorphic eruptions (44.8%), intrahepatic cholestasis of pregnancy (6%) and pemphigoid gestationis (4.5%) of pregnant women. Conclusion: Pregnancy is a unique physio-logical state characterized by metabolic, immunologic, and hormonal readjustments. These make a pregnant woman vulnerable to all dermatoses occurring in the non-pregnant state and also to certain eruptions related to the physiologic burden of gestation.}, keywords = {retro peritoneal neuroblastoma,children,Surgery,Chemotherapy,Radiotherapy}, url = {https://smj.journals.ekb.eg/article_39336.html}, eprint = {https://smj.journals.ekb.eg/article_39336_8016e773860818b3662dd380e2eae867.pdf} } @article { author = {Abdelkareem, Osman and Ameen, Magdy and Mohammed, Ahmed and kadry, Haitham}, title = {Multifetal Pregnancy: Facts and Outcomes Prospective cohort study}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {391-394}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39354}, abstract = {Objective :to present an updated overview of multifetal pregnancy as well as to study the problems of multifetal pregnancy in our community via a hospital-based study . Methods :data concerning maternal and neonatal adverse outcomes in multiple pregnancy was collected from feb. 2017 to jan. 2018. IBM-SPSS ( version 24) was used for statistical data analysis. Results :The prevalence of  multifetalprgnancy was 4.5% , Mean maternal age was 27.3 years with SD 5.9 years, and ranged from 17 to 42 years, Mean of gestational age was 31 weeks with SD 6.1 weeks, and ranged from 17 to 40 weeks, risk factors of multiple pregnancy was 17% history of ART and ovulation inducton in 53%. Only 13% had family history of multiple pregnancy and only 4% had previous history of multiple pregnancy, ,  85% of the study group had a twin ,  11% had  a triplet and  4% had a quadriplet., that 21% had inevitable abortion, 2% had Deep venous thrombosis(DVT), 2% had threatened  abortion, also 2% had missed abortion, 3% had polyhydraminos, 3% had Intrauterine fetal death(IUFD) , 27% had premature rupture of membranes(PROM), 12% had Pre_eclampsia, only 1% had eclampsia, 10% had Hyperemesis gravidarum(HEG), 2% had gestational DM, 4% had gestational hypertension , 2% had congenital anomalies and 1% had antepartum hemorrhage , 56% had CS, 23% delivered vaginally  and 21% had abortion, 30% not need neonatal intensive care unit (NICU), 43% need NICU, 4% had neonatal deaths, 23% abortion  and  51 % preterm baby. Conclusion :Multifetal pregnancies are associated with increased maternal and perinatal risks  specially preterm delivery  that increase risk of neonatal morbidity and mortality . There is a need for specialized antenatal care to reduce complications  via wise used of ovulation induction ,  fetal reduction, single embryo transfer in case of ART .}, keywords = {multiple pregnancy,twin,perinatal outcomes,Neonatal outcomes}, url = {https://smj.journals.ekb.eg/article_39354.html}, eprint = {https://smj.journals.ekb.eg/article_39354_c49c1aba3cdf2ad9206184f0a48e40b9.pdf} } @article { author = {Elsamman, Mahmoud and Morsy, Khairy and Mohammad, Asmaa and Ali, Walaa}, title = {Bleeding Gastric Varices: Frequency and Outcome}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {395-401}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39409}, abstract = {Background and aims: Gastric variceal (GV) bleeding is less frequent than esophageal variceal (EV) bleeding but it is still a serious cause of morbidity and mortality.The aim of study was to assess the frequency and identify the patients' outcome after management. Patients and methods: The study was conducted on 500 cirrhotic patients with upper gastrointestinal bleeding the period from June 2016 to June 2017.All patients were subjected to complete history taking, clinical examination, laboratory investigations, abdominal US and esophago-gastro-duodenoscopy (EGD) for detection of the source of bleeding. If bleeding GVs were detected, Cyanoacrylate was injected into them to achieve primary haemostasis. Results: Endoscopic examination revealed bleeding GV in 50 patients (10 %), bleeding EV in 400 patients (80%), while bleeding from other sources was in 50 patients (10%).In the GV group, thirty-five patients (70%) had isolated GV (type I)  and 15 patients (30%) had continuous Gastroesophogeal varices (type 2).Most patients (80%) with GV had red colour signs (Rc+).PHG was seen in 48 patients (96%). After Cyanoacrylate injection of GV, 40% developed eradication, 38% died & 22% developed re-bleeding.Upon studying the predictors of mortality, we found that patients who died had significantly lower albumin & higher ALT & AST levels. Early re-bleeding was more common among Child A patients with moderately sized GV (F2), but the difference was not statisticallysignificant. By multivariate analysis we found no independent predictors of mortality or re-bleeding. Conclusions: Bleeding GVs represents 10% of upper GIT bleeding in cirrhotic patients. No independent factors could predict the mortality or re-bleeding among cirrhotic patients with bleeding GVs by multivariate analysis.}, keywords = {gastric varices,Bleeding,predictors of mortality,predictors of re-bleeding}, url = {https://smj.journals.ekb.eg/article_39409.html}, eprint = {https://smj.journals.ekb.eg/article_39409_d8dedb9374adbabad15f2f8b9ea7d154.pdf} } @article { author = {Hassanin, Hassan and Zaki, Nayel and Elsamman, Mahmoud and Awad, Youhanna}, title = {Pattern of Renal involvement in Systemic Lupus Erythematosus patients in Sohag University Hospitals}, journal = {Sohag Medical Journal}, volume = {22}, number = {3}, pages = {415-420}, year = {2018}, publisher = {Sohag University; Faculty of Medicine}, issn = {1687-8353}, eissn = {2682-4159}, doi = {10.21608/smj.2018.39838}, abstract = {Background: Systemic Lupus Erythematosusis asystemic disease characterized by multiple system affection,each system affected has apathognomonic features for lupus affection,renal involvement have variable patterns in SLE and tretment vary accordingly. Objective: The objective of this study is to study pattern of  renal involvement  in Systemic Lupus Erythematosus  patients  in  Sohag  University Hospitals . Materials &Methods:This study was performed on 100 patients with SLE who fulfiled the clinical and laboratory criteria of (Modified american colleague of rheumatology for SLE diagnosis-1997)admitted to Sohag University Hospital and those of outpatients clinic were studied by means of  a retrospective review of  their records, Patients were analyzed according to their clinical symptoms and laboratory profile which included complete blood counts, serum creatinine and electrolytes, ESR, total proteins, 24 hour urinary proteins, creatinine clearance, anti nuclear factor and anti-DNA. Results of renal biopsy which were  performed by light microscopy study were revised.Results: The study revealed that class( 2) were 46 patients (46%) all of them were females.Class (3) were 36 patients (36%), 33 of them were females, 3 patients were males.Class (4) were 14 patients (14%) all of them were females .Class (5) were 4 patients  ( 4% ) all of them were females .According  to  proteinuria  between classes of renal biopsy , 24 h urinary protein was > .5 g in all patients of class 5 (100%) .Class (3) and class (4)  the same range (about 92%), class 2 about (84%).Conclusion: Our study in Sohag University Hospitals was in 100 patients revealed that roughly number of rural patients equal to urban patients , also revealed that the most common renal biopsy class is the  class (2) in our locality and  that the most common symptoms associated with renal involvement is arthritis followed by oral ulceration. Anaemia affect most of our patients in Sohag and thrombocytopenia very common between them , our study show that proteinuria increased markedly by increasing grades of renal biopsy with low response to treatment, this may explained by non compliance of our patients to treatment .}, keywords = {SLE,Renal involvement}, url = {https://smj.journals.ekb.eg/article_39838.html}, eprint = {https://smj.journals.ekb.eg/article_39838_e9ed95fad8b2980115dc92c378e23a1d.pdf} }