eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
11
13
10.21608/smj.2018.34180
34180
Original Article
Cognitive outcome of traumatic brain injury in elderly patients
Momen Almamoun
momenmohamed@med.sohag.edu.eg
1
Magda Ali
magda_ali@med.sohag.edu.eg
2
Ahmed EL Sayed
3
Roshdy Elkhayat
4
Department of Neurosurgery , Faculty of Medicine, Sohag University.
Department of public health and community medicine, Faculty of Medicine, Sohag University.
Department of Neurosurgery , Faculty of Medicine, Sohag University.
Department of Neurosurgery , Faculty of Medicine, Assuit University.
Objective: To assess the cognitive outcome of traumatic brain injury in elderly patients. Design: a prospective study. Methodsthis study was conducted on 50 elderly patients exposed to TBI in sohag university hospital and 50 patients exposed to TBI but less than 65 years used as a control. IntroductionTraumatic brain injury (TBI) is a significant problem in older adults,and is associated with changes in the brain that affect the cognition(Sapoznik et al 2006) ResultsDuring the study period, 50 elderly patients with TBI were followed up for cognitive outcome, 12 patients (24%) were associated with cognitive deficits. Conclusion: TBI in elderly patients is associated with cognitive deficits post injury
https://smj.journals.ekb.eg/article_34180_098e5b4b5fe65a6499ab1d2b135998d6.pdf
Traumatic brain injury
elderly patients
cognitive outcome
geriatric trauma
prognosis
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
15
26
10.21608/smj.2018.34303
34303
Original Article
METABOLIC SYNDROME INPATIENTS WITH RHEUMATOID ARTHRITIS
Hanan Mohammed Abo-Zeid
hanan_abozaid@med.sohag.edu.eg
1
Ebtesam Ali Fayez
ebtsamkhalaf@med.sohag.edu.eg
2
Ali Kasem
3
Esam Abo Al-Fadl
essam_mohamed@med.sohag.edu.eg
4
Department of Rheumatology, Rehabilitation and Physical medicine - Faculty of Medicine- Sohag University.
Department of Rheumatology, Rehabilitation and Physical medicine - Faculty of Medicine- Sohag University.
Department of Internal Medicine- Faculty of Medicine- Sohag University
Department of Rheumatology, Rehabilitation and Physical medicine - Faculty of Medicine- Sohag University.
Objectives:To determine the prevalence of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and to evaluate the relation between parameters of MetS and clinical aspects of RA. Design: Cross-sectional study. Patients:Patients with rheumatoid arthritis (RA) according to 2010 ACR/EULAR classification criteria for RA (n = 150). Methods: Demographic data, arthritis history, medical and therapeutic history were evaluated. Height, weight, BMI, waist circumference (WC) and blood pressure (BP) were recorded. Disease activity was evaluated using DAS28 (ESR). Immunological investigations included RF, ESR, CRP, and anti-CCP. Fasting blood glucose and lipid profile were measured.The patient was diagnosed as having MetS according to 3 definitions; ATPIII (2004), IDF (2005), and JIS (2009). Results:Prevalence of MetS in rheumatoid patients was 48% (ATPIII definition), 52 % (IDF definition), and 46 % (JIS definition with Egyptian cut-off of WC), respectively. The most prevalent component of MetS was central obesity (75.3- 92 % according to the used definition).DAS28 was significantly higher in patients with MetS with higher number of tender joints and VAS (0-100) and most rheumatoid patients with MetS (68 %) had high disease activity. Conclusions:The increased prevalence of MetS components in RA patients, suggests greater attention be given to modifiable risk factors, including improvement of dietary habits, physical activity and blood pressure control.
https://smj.journals.ekb.eg/article_34303_d944f5a7466f79980580bfa5e68b4ef3.pdf
Rheumatoid Arthritis
Metabolic syndrome
DAS28
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
27
29
10.21608/smj.2018.34316
34316
Original Article
Relation Between SF-36, mHAQ Scores and Disease Activity in Rheumatoid Arthritis
Aya Gmal
1
Nagwa Ahmad
nagwa_ahmed@med.sohag.edu.eg
2
Mohammed AI
3
Nihal F
4
Specialist of Rheumatology and Rehabilitation Faculty of Medicine .Assiut University
Debartment of Biochemistry, Faculty of Medicine, Sohag University.
Debartment of Rheumatology and Rehabilitation Faculty of Medicine Sohag.
Debartment Rheumatology and Rehabilitation Faculty of Medicine .Assiut University.
Objective: To investigate the relationship between quality of life (QOL) and disease activity in patients with rheumatoid arthritis (RA). Methods: 200 patients with RA were included in the study. Data were obtained by questionnaires and laboratory investigation. Disease Activity Score (DAS-28) was calculated for assessment of disease activity. Separate dimensions and physical and mental summary scores of the Short form Health survey (SF-36) and Health Assessment Questionnaire (HAQ) were compared to study the relationship between QOL and disease activity in patients with rheumatoid arthritis. Results: There was a significant association between DAS-28 and QOL scores. Conclusions: RA has a significant effect on the health related quality of life of patients, and its activity is ditectly related to worse QOL.
https://smj.journals.ekb.eg/article_34316_9635f867d1a2b276ca954d7462e85c14.pdf
Rheumatoid Arthritis
quality of life
DAS-28
SF-36
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
31
41
10.21608/smj.2018.34658
34658
Original Article
Word Finding Difficulty Test Design and Standardization
OBJECTIVE: The aim of this study is to design a new test for assessment of word finding difficulty in children in order to better assess and manage this problem. SUBJECTS AND METHODS: The test was designed and included pictures of different semantic groups. It was revised by Phoniatric experts. Then it was applied on a group of 50 normal children and a group of 25 DLD children with age range of 5-10 years with average or below average IQ. . RESULTS: The test consists of 7 sections. Validity of the test was examined by content validity, contrasted group validity and internal consistency validity. The results showed significant difference between scores of normal children and DLD children in all sections of the test. . CONCLUSION: Word finding difficulty test is suitable and easy applicable to assess word finding difficulty in children. It will help in accurate assessment of these children and therefore putting suitable plan for
https://smj.journals.ekb.eg/article_34658_c6a36a03f8a5e453d360a1f72657918e.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
45
52
10.21608/smj.2018.34677
34677
Original Article
Virtual CT Colonography: Technique and findings: Single Institute experience.
Hossam saro
hossam.salah@med.sohag.edu.eg
1
khaled Alkhayat
khaled_mohamed@med.sohag.edu.eg
2
Mohammed Al Sayed
alaa_abusedera@med.sohag.edu.eg
3
Mohammed Ali
4
Department of Chest Diseases, Faculty of Medicine, Sohag University
Colorectal cancer is the second leading cause of death due to malignancy in industrialized counties. It is argued that most large bowel malignancies arise from preexisting adenormas. Computed tomographic (CT) colonography is a noninvasive, rapidly evolving technique that has been shown in some studies to be comparable with conventional colonoscopy for the screening of colorectal cancer. However, widespread colorectal screening and preventive efforts aimed at detecting disease in this early stage are opposed by several practical obstacles, including limited resources, and poor patient acceptance and therefore poor compliance (1-2). Patients and methods
https://smj.journals.ekb.eg/article_34677_aaf935fbbdfbfc5d6ec38ea248a8bb24.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
53
64
10.21608/smj.2018.34967
34967
Original Article
Virtual CT Colonography Versus Lower Endoscopy in Detection of Colorectal Lesions.
Hossam saro
hossam.salah@med.sohag.edu.eg
1
khaled Alkhayat
khaled_mohamed@med.sohag.edu.eg
2
Mohammed Al Sayed
alaa_abusedera@med.sohag.edu.eg
3
Mohammed Ali
4
Wael Barakat
5
Faculty of Medicine- Sohag University.
Department of Chest Diseases, Faculty of Medicine, Sohag University
Faculty of Medicine- Sohag University
Faclty of medicine-sohag university
faculty of medicine- sohag university
Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death in Western countries. As with other malignancies, screening and early detection is fundamental for successful management of colorectal cancer. Computed tomographic (CT) colonography is a noninvasive, rapidly evolving technique that has been shown in some studies to be comparable with conventional colonoscopy for the screening of colorectal cancer. CT colonography is being increasingly applied as a routine screening method for the detection of colorectal cancer in last few years as it is more convenient and less invasive than colonoscopy. In addition, it has an upper hand in diagnosis of small lesions less than 10mm (Choi, et al., 2011). Patients and methods:This prospective double blind comparative study will be conducted on 23 patients with colorectal symptoms and signs as altered bowel habits, bleeding per rectum, abdominal pain, weight loss, unexplained fatigue and loss of appetite.An informed written consent was obtained from all patients and approval of the faculty research ethics committee was obtained. Results: Total of 108 colonic lesions were analyzed in 23 patient; Seven colonic masses were diagnosed in 6 patients, 41 polyps in 8 patients and 60 diverticulae in 5 patients. Six patients had incomplete colonoscopy. Of them, 2 patients had a large polypoidal mass that prevents further colonoscopic introduction. Using CT colonography we were able to evaluate those polypoidal masses. Moreover, we could complete the examination and evaluation of the proximal colon and one of them had a polypoidal sigmoid colon mass and showed another proximal annular mass. Four patients presented with colonic obstruction and good preparation to the proximal parts of the colon failed, So completing the colonoscopy was difficult. After undergoing CT colonography, 2 patients were normal and 2 patients had annular masses causing proximal obstruction and marked distension. ConclusionCT Colonography (Virtual Colonoscopy) is a reliable tool and more sensitive for detecting colonic mass lesions larger than 5 mm, polyps larger than 5 mm, strictures and diverticulosis. CTC is of value in evaluating the colonic segment lying proximal to colonic cancers including those with occlusive growths or strictures. Contrast-enhanced CTC is also useful in identifying extra-colonic findings.Virtual Colonoscopy is a good screening tools for malignant or premalignant lesions in patients presented with colorectal symptoms.
https://smj.journals.ekb.eg/article_34967_8d91495b905d0bb331818e509e1daddd.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
65
71
10.21608/smj.2018.34992
34992
Original Article
Role of leptin and visfatin in infertility in obese and non obese women
Hussein Hussein
1
Mahmoud Abdel Fadeil
2
Abdou Saeed Ait-allah
3
Faculty of medicine -sohag university
faculty of medicine -sohag university
faculty of medicine -sohag universty
Infertility considered a big health problem with increasing prevalence, having several causes, some of these causes refer to adipose tissue abnormalities. Many substances secreted from white adipose tissue like leptin ,visfatin may have a role in several cases in infertility in women Objective:to answer questions concerned with the relation between lepin ,visfatin and omen's infertility through analysis of data from previous studies. Thwe strategy of this systematic review will be based on raising some research questions that give an idea about the relationship between leptin and visfatin level and women infertility. لإhe research questions 1-Is there a relationship between obesity and infertility in women? 2-Is there a relationship between obesity and leptin and visfatin level ? 3- Is there a relationship between leptin and visfatin level and infertility in women ? 4-Is there a difference in leptin ,visfatin level between obese and non obese infertile women ? 5-How does leptin ,visfatin affect women's fertility?
https://smj.journals.ekb.eg/article_34992_02ad53dcd8adc2f0df3eee25f0c58c9d.pdf
leptin
Visfatin
Obesity
Infertility
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
73
80
10.21608/smj.2018.35256
35256
Original Article
Updates of Pulmonary Embolism
Mohamed Elsayed
mohamed_elsayed@med.sohag.edu.eg
1
Department of Internal Medicine. faculty of medicine.sohag University
Pulmonary embolism (PE) is the third most common cause of cardiovascular death worldwide, behind myocardial infarction and stroke. Due to pulmonary bed obstruction, PE can result in acute right ventricular (RV) failure which is a life-threatening condition. Because most patients ultimately die within the first hours of presentation, early diagnosis is very important (1). Mortality due to pulmonary embolism varies greatly, depending on various factors including age, comorbid conditions, and stability on presentation. Patients with low-risk PE have a 1-year survival rate over 95%. In contrast, patients presenting with high risk PE and hemodynamic instability have an approximately 40% mortality rate within 90-days. In this review, we will discuss the basic pathophysiology of PE, risk factors for developing PE, and standard diagnostic testing modalities. We will also cover risk stratification of patients presenting with PE and the implications for treatment and disposition. While no exact epidemiological data are available, the incidence of PE is estimated to be approximately 60 to 70 per 100,000, and that of venous thrombosis approximately 124 per 100,000 of the general population (2). The European guidelines for the diagnosis and management of PE report annual incidence rates of venous thrombosis and PE of approximately 0.5 to 1.0 per 1000 inhabitants (3). However, the actual figures are likely to be substantially higher because silent PE can develop in up to 40% to 50% of patients with deep vein thrombosis (DVT) (3)
https://smj.journals.ekb.eg/article_35256_49ecfb347b337193925897adf5f53688.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
83
87
10.21608/smj.2018.35373
35373
Original Article
LIPID PROFILE INPATIENTS WITH RHEUMATOID ARTHRITIS: CORRELATION WITH DISEASE ACTIVITY
Ali Kasem
1
Esam Abo Al-Fadl
essam_mohamed@med.sohag.edu.eg
2
Hanan Mohammed Abo-Zeid
hanan_abozaid@med.sohag.edu.eg
3
Ashraf Abd El-Latif
ashraf_abdelwahab@med.sohag.edu.eg
4
Ebtesam Ali Fayez
ebtsamkhalaf@med.sohag.edu.eg
5
Department of Internal Medicine- Faculty of Medicine- Sohag University
Department of Rheumatology, Rehabilitation and Physical medicine,Faculty of Medicine- Sohag University.
Department of Rheumatology, Rehabilitation and Physical medicine - Faculty of Medicine- Sohag University.
Department of Dermatology, Venereology and Andrology- Faculty of Medicine- Sohag University.
Department ofPhysical medicine,Rheumatology and Rehabilitation- Faculty of Medicine- Sohag University
Objectives:To study changes in lipid profile in patients with rheumatoid arthritis (RA) and to evaluate the relation between lipid profile and disease severity of RA. Design: Cross-sectional study. Patients:Patients with rheumatoid arthritis (RA) according to 2010 ACR/EULAR classification criteria for RA (n = 150). Methods: Demographic data, arthritis history, medical and therapeutic history were evaluated. Disease activity was evaluated using DAS28 (ESR). Immunological investigations included RF, ESR, CRP, and anti-CCP.Lipid profile levels were measured. Results:Raised TG was found in 38 (25.3 %) of patients, raised TC was found in 69 (46 %) of patients and decreased HDL-C was detected in 85 (56.7 %) of the patients
https://smj.journals.ekb.eg/article_35373_d13809ceb776516d2b2ec93de9d7fb62.pdf
Rheumatoid Arthritis
Lipid profile
DAS28
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
89
94
10.21608/smj.2018.36787
36787
Original Article
Radiological Parameters of Calcaneovalgus Deformity of the Foot
Abodoma Shabeb
1
Mohamed Kenawy
2
Ahmed Kassem
3
Ashraf Marzouk
4
Hassan Noamany
5
Department of Orthopaedic and traumatoulogy , Faculty of Medicine, Sohag University.
Department of Orthopaedic and traumatoulogy , Faculty of Medicine, Sohag University.
Department of Orthopaedic and traumatoulogy , Faculty of Medicine, Sohag University.
Department of Orthopaedic and traumatoulogy , Faculty of Medicine, Sohag University.
Department of Orthopaedic and traumatoulogy , Faculty of Medicine, Sohag University.
Background Calcaneo valgus deformity is postural deformity of infancy which is characterized by dramatic hyperdorsiflexion of the foot that appears to be plastered up against the anterior surface of the tibia. Planter flexion of the foot is frequently limited as a result of contracture of the anterior ankle and foot structures. Aim of the work:To asses radiological parameters of calcaenovalgus deformity of the foot in children. Patients and methods:The patients were children up to 5 years old. The participants were 7 males and 13 females. The affected foot were 10 right sided and 10 left sided. Results: The present study was designed to asses radiological parameters of calcaenovalgus deformity of the foot in children. Conclusion The radiological parameters of calcaenovalgus deformity of the foot in children varies widly accodrding it is vevtical talus or oblique talus deformity.
https://smj.journals.ekb.eg/article_36787_8fdfea6731eb2d3a8aaf117ed674c112.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
95
103
10.21608/smj.2018.40569
40569
Original Article
Prognostic Factors Of Extradural Heamatoma Evacuation
Ahmed ELsayed
1
Khaled Fadle
khaled_ahmed@med.sohag.edu.eg
2
Mohammed AbdElaal
mohamed_abdelaal@med.sohag.edu.eg
3
Roshdy Elkhayat
4
Department of Neurosurgery , Faculty of Medicine, Sohag University.
Department of Neurosurgery , Faculty of Medicine, Sohag University.
Department of Neurosurgery , Faculty of Medicine, Sohag University.
Department of Neurosurgery , Faculty of Medicine, Assuit University.
Objective: To assess the Prognostic Factors of Extradural Heamatoma Evacuation Methodology :This study was conducted on 50 patients with extradural heamatoma 14 females and 36males, the oldest was 63 years old and the youngest was 3 years old, with mean age of 38.48 years, the cause of trauma was road traffic accident in 23 patients of them and falling from high in 14 patients of them and assault in 11 patients and animal kick in 2 patients, according to the clinical presentation the most common was manifestation of increase intracranial tension as headache and vomiting in 38 cases, followed by Loss of consciousness in 28 patients and 19 cases have typical lucid interval followed by disturbed conscious level in 12 cases, then weakness of one sideof the body in 8 cases, then unilateral dilated pupil in 5 cases followed by fits in 2 cases, while 2 cases were neurologically free and one case has bilateral dilated fixed pupil,the volume of EDH was between 20-30cc in 27 patients and between30-40cc in 17 patients and between 40 -50cc in 5 patients and more than 50cc in one patient, the EDH located in temperoparietal region in 16 patients and purely in the temporal lobe in 13 patients and in the parietal lobe in 8 patients and frontoparietal in 6 patients and the frontal lobe in 3 patients and in the posterior fossa in 3 patients and biparietal in one patient ,we operate 2patients in the 1st hour and 14 in the 2nd and 14 in the 3rd and 10 in the 4th and 6 in the 5th and 4 cases after 5 hours. RESULT: We operate 50 patients 39 of them show full recovery and 7 patients show neurological deficit and 4 patients died and no one show vegetative state and from the 46 patients who recovered 6 patients develop superficial wound infection and one patients show recollection of EDH and reoperation. Conclusion: The EDH is more common in middle aged males .As regard the site of EDH we found that the site play minimal rule in the outcome of EDH and as the most common sites was temperoparietal and temporal so mostly the middle meningial artery is the most common source of EDH and the posterior fossa is the most dangerous site as one case of the 3 patient presented with posterior fossa EDH died (33.3%) followed by temporal lobe EDH as 2(6.5%) cases from the 15 case died. the size and time from the trauma to evacuation and clinical presentation of EDH thy are the major factors that affect EDH. The clinical presentation especially the conscious level is the main factor affecting theoutcome as all the 4 cases who died the GCS was less than 8 when they arrived.
https://smj.journals.ekb.eg/article_40569_5355d961a2ede642663612b996ec0dca.pdf
Extradural Heamatoma
surgical evacuation
Prognostic factors
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
105
109
10.21608/smj.2018.40591
40591
Original Article
Sohag experience in treatment of Dorsolumbar fractures according to Thoracolumbar injury classification and severity score(TLICS)
Ahmed Abdelrhman
1
Ahmed Shaker
ahmed_saleem@med.sohag.edu.eg
2
Ahmed Kassem
ahmedhamed@med.sohag.edu.eg
3
Ashraf Ahmed
ashraf_marzouk@med.sohag.edu.eg
4
Mohamed Abdel-Wanis
mohamed_abdelwanees@med.sohag.edu.eg
5
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthopedic Surgery,Faculty of Medicine,Sohag University Hospital, Egypt.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Background:.The Thoracolumbar Injury Classification and Severity Score (TLICS) was developed to improve injury classification and guide surgical decision making, yet validation remains necessary. This study evaluates the functional ,clinical and radiological outcome of patients with thoracolumbar spine trauma (TLST) treated according to the TLICS. Aim of the work:To validate the efficacy of Thoracolumbar injury classification and severity score (TLICS) in orthopaedic emergency department at sohag university hospitals. Patients and methods:The TLICS was prospectively applied to a consecutive series of patients (30 cases) treated for TLST between October 2016 and October 2017. Patients with a TLICS score more than 4 points were surgically treated, whereas patients with a TLICS score of less than 4 points were conservatively managed.Those with a score of equal 4 ,group were managed conservatively and the other were operated.The primary outcome was the American Spinal Injury Association Impairment Scale (AIS)(1). Results:The decision taken according to TLICS either conservative if the final score 4. Conservative treatment in the form of rest and dorsolumbosacral brace .Operative in form of posterior fixation with or without decompression .Transpedicular fixation and decompression was needed in 10 cases (33.33%) because they were suffering from neurological insult.The mean age was 34years.There were a marked improvement in angle of kyphosis , vertebral height loss and Oswestry disability index .No patient had neurological worsening during the follow-up. Conclusion:.Thoracolumnar injury and severity score is valid and safe for management of thoracolumbar fractures and has good reliability.
https://smj.journals.ekb.eg/article_40591_03baba957681d134b76112dd944cc068.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
111
119
10.21608/smj.2018.40606
40606
Original Article
Measurement of Knowledge, attitudes and practices of parents on misuse of antibiotics in children with acute upper respiratory tract infections in Sohag district
eman mohamed
eman_mohamed@med.sohag.edu.eg
1
ahmed Hamed
ahmed_hamed@med.sohag.edu.eg
2
Fouad Yousef
fouad_atya@med.sohag.edu.eg
3
Ayat Ahmed
4
Department of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.
Department of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.
Department of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.
Department of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.
Background: Upper respiratory tract infections (URTIs) are considered to be the most common reason for children’s visits to outpatient clinics. The emergence and spread of resistance related to the irrational use of antibiotics is a major global public health problem. Aim of the work: This study aimed to assess parents’ knowledge, attitude, and practice (KAP) regarding the use of antibiotics in URTIs in children. Methodology: A cross-sectional study wascarried out among parents(N=800) of children who were attending the maternal and child health center in Sohag city and the family medicine unit in Elmahamdaelbahria village in the period from 1st July 2016 till 31th May 2017 .Results:Our results revealed that females were about 62.6%, those not sharing in labor force were 55.9 %, and urban parents were about58.8%. The mean age of parents was 33 years old.There is a statistically highly significant difference between mother & father in mean scoresof knowledge, attitude, practice; they were lower in fathers. Also, there is statistically significant difference between parents with different ages in practice score. There are highly statistically significant differences between mothers who were sharing and not sharing in labor force in Attitude, Practice scores. Conclusion:Parents with loweducational level, rural residence, low income and with two children or less have lack of knowledge ,inappropriate beliefs andpractices so they are vulnerable for misusing antibiotics for their children.
https://smj.journals.ekb.eg/article_40606_7abd9f5ecbbf778d357a2fcdaa0d00a2.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
121
136
10.21608/smj.2018.40878
40878
Original Article
Risk Factors of Delayed Milestones Among Children Attending Sohag General Hospital
Ekram Abdel khalek
1
Sabra Ahmed
2
Ramadan Ahmed
ramadan_mahmoud@med.sohag.edu.eg
3
Gamal Soliman
4
Department of Public Health and Community Medicine , Faculty of Medicine, Assiut university.
Department of Public Health and Community Medicine , Faculty of Medicine,Assiut university.
Department of Pediatrics , Faculty of Medicine, Sohag university.
Department of Public Health and Community Medicine , Al-Azhar Faculty of Medicine, Assiut branch.
Developmental delay occurs when a child exhibits a significant delay in the acquisition of milestones or skills, in one or more domains of development (i.e., gross motor, fine motor, speech/language, cognitive, personal/social, or activities of daily living). Objectives: present study aims to investigate the most common risk factors of The delayed development in children under four years attending Sohag GeneralHospital. Subjects and methods: A case control study was conducted in Sohag General Hospital during the period from January 2015 to June 2016 on children attending Pediatric, Physiotherapy and phoniatric clinicsin Sohag General Hospital, Sohag Governorate. The sample size was 150 cases and 150 controls. One hundred and fifty children (aged 1.5 month to 48 months) diagnosed with developmental delay by a specialist or/and a developmental pediatrician were recruited as cases. Results: In the logistic regression model, the odds of developing delayed milestones is significantly higher among children with cyanosis (OR = 16.391), low birth weight (OR = 6.147), parental consanguinity (OR = 5.489), 1st birth order (OR = 4.048), urban residence (OR = 3.702) and history of neonatal jaundice (OR = 2.518). Conclusion: The urban children, first children and from few number of family members were more frequently at risk for developmental delay.
https://smj.journals.ekb.eg/article_40878_26e0dd85a57250661798cbd4b2312544.pdf
developmental delay
risk factors
Sohag General Hospital
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
137
141
10.21608/smj.2018.40889
40889
Original Article
Fixation of pilon Fracture & Comminuted distal tibial fracture with Triangular External fixator
Shazly Musa
shazli_mousa@med.sohag.edu.eg
1
Ahmed Eldosoky
ahmed_eldesouky@med.sohag.edu.eg
2
Mostafa Ibrahim
mostafaismail@med.sohag.edu.eg
3
Mohamed Ahmed
mohamed_mohamed2@med.sohag.edu.eg
4
Hasan Ahmed
5
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Back ground : patients with pilon fractures and distal comminuted fractures, These fractures give the surgeon a great challenge In methods of fixation starting from External fixator up to platting and Illizarov But our method of fixation which Is Triangular External fixator acheive a great success.
https://smj.journals.ekb.eg/article_40889_f6cbd89fc3e596906696d9e9e663b8ed.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
143
153
10.21608/smj.2018.40904
40904
Original Article
The Use of Interleukin-22 as a Novel Marker of Disease Activity in Female Patients with Rheumatoid Arthritis
Laila Yousef
lailamohamed@med.sohag.edu.eg
1
Sahar Aboalftoh
sahr_mahran@med.sohag.edu.eg
2
Tamer Abdel-Latef
tamer_soliman@med.sohag.edu.eg
3
Khalid Ali
4
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical and Chemical pathology, Sohag Faculty of Medicine, Sohag University.
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by progressively destructive joint inflammation and destruction of articular cartilage, bone and synovial hyperplasia. Cytokines play a fundamental role in the processes that cause inflammation, articular destruction and extra-articular manifestations associated with RA.The preferential production of interleukin22 (IL22) by T cells suggests that elevated levels of this cytokine exist in chronic, T cell-mediated diseases, such as psoriasis and RA and that IL-22 plays an important role in the pathogenesis of these disorders. Objective: To study the role of IL-22 in RA. Methods:IL-22 serum levelswere measuredin55 female patients with RA, 28 of them on medical treatment and the other 27 were newly diagnosed patients and in 18 healthy controls. Patients are assessed for clinical and laboratory variables. Correlations of IL-22 serum levels with disease activity markers as disease activity score for 28 joints (DAS28), serological markers, bone erosions were assessed. Results: IL-22 levels were increased in patients with RA compared with controls (mean 34.6 pg/ml and 3.2pg/ml, respectively; P < 0.001). Levels of IL-22 correlated positively with DAS28 score (P <0.001). C-reactive protein (CRP) correlated positivity with high levels of IL-22 in RA patients (mean 53.8 pg/ml; P < 0.001) and rheumatoid factor (RF) correlated positivity with high levels of IL-22 in RA patients (mean 46.1 pg/ml;P < 0.001). The presence of bone erosions was associated with high IL-22 levels (P = 0.008). Conclusion:IL-22 is elevated in the serum of patients with RA.Elevated serum IL-22allows discrimination between patients with different clinical and laboratory measures and indicates thepotential of IL-22 as an additional tool for assessment of activity in RA, particularly in patients with RFantibodies. IL-22 is associated with bone destructive disease.
https://smj.journals.ekb.eg/article_40904_ea5fc0d13248fbc4ea9078a3fa85ecb5.pdf
Interleukin-22
Rheumatoid Arthritis
disease activity
Disease activity score 28
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
155
162
10.21608/smj.2018.40927
40927
Original Article
Efficacy of microneedling in treatment of acne scars
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Ramadan Abdo
ramadan_saleh@med.sohag.edu.eg
2
Rasha Mohhmed
rashaismail@med.sohag.edu.eg
3
Mohammed Mostafa
4
Department of Dermatology , Venereology and Andrology, Faculty of Medicine , sohag university.
Department , of Dermatology, Venereology and Andrology , Faculty of Medicine- , Sohag University.
Department of Dermatology, Faculty of Medicine, Sohag University.
Department of Dermatology, Faculty of Medicine, Sohag University.
Introduction: Microneedling is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles.Traditionally used as a collagen induction therapy for skin rejuvenation and facial scars specially acne scars. Aim of the work: Evaluation of efficacy of microneedling in treatment of acne scars. Patients and Methods: Ten patients with post acne atrophic facial scars attending the outpatient clinic of Dermatology in Sohag University Hospitals between June2014 to September 2017 were offered six sessions of microneedling at an interval of 1 month.They were evaluated monthly and one month after completion of sessions for both efficacy and safety of the procedure. Results: The mean ± SD of the patients' age in the study population were26.900±5.952years old.eight females and two males with mean acne scars duration ± SD 8.500±6.311 years, 60% of patients had psychological distress from their acne scars. At the end of study duration Out of the ten patients 7(70%) achieved one grade reduction in their Goodman and Baron qualitative grading score while 4 patients (40% ) achieved reduction in their quantitative ECCA " Echella d'e valuation Clinique des cicatrices d'acne" score with 8.55% improvement in the ECCA score. The mean ECCA score value of V scar started to decrease earlier than U scar , but M scar was fixed up to end of sessions. 50% of patients had good satisfaction, 30% of them had very good satisfaction and only 10% had excellent satisfaction. All treated patients , had adverse events of temporary erythema, edema, bleeding, or a serous ooze resolving with crusting or scabbing following each session of microneedling but in 1 patient (10%) aggravation of acne occurred, bacterial infection not occurred in any of our patients. Conclusion: Multiple minimally invasive sessions of skin microneedling is an effective treatment for post-acne atrophic scars with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.
https://smj.journals.ekb.eg/article_40927_ee7186859ff97ffb497e2689da1bac36.pdf
Acne
scar
Microneedling
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
163
170
10.21608/smj.2018.40958
40958
Original Article
Efficacy of microneedling with topical vitamin C in treatment of acne scars
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Ramadan Abdo
ramadan_saleh@med.sohag.edu.eg
2
Mohammed Mostafa
3
Rasha Mohhmed
rashaismail@med.sohag.edu.eg
4
DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university
Department , of Dermatology, Venereology and Andrology , Faculty of Medicine- , Sohag University
Department of Dermatology, Faculty of Medicine, Sohag University.
Department of Dermatology, Faculty of Medicine, Sohag University.
Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. There is no single treatment modality that has been shown to be universally effective. Microneedling is a relatively new minimally invasive procedure used as a collagen induction therapy for skin rejuvenation and facial scars. Aim of the work: Evaluation of efficacy of microneedling with topical vitamin C in treatment of acne scars. Patients and Methods: Ten patients with post acne atrophic facial scars attending the outpatient clinic of Dermatology in Sohag University Hospitals between June 2014 to September 2017 were offered six microneedling sessions plus topical vit. C (during the session of microneedling and daily topical application in between sessions) microneedling sessions were four weeks apart. They were evaluated monthly and one month after completion of sessions for both efficacy and safety of the procedure. Results: The mean ± SD of the patients' age in the study population were 28.900 ±5.384yers old nine females and one males with mean acne scars duration ± SD 11.900±5.506 years, 90%% of patients had psychological distress from their acne scars. At the end of study duration Out of the ten patients 6(60%) achieved one grade reduction in their Goodman and Baron qualitative grading score and 2 (20%) achieved two grade reduction. According to the quantitative ECCA " Echella d'e valuation Clinique des cicatrices d'acne" score 80% 0f patients achieved reduction in their score with 27.5% improvement in the ECCA score. The mean ECCA score value of V scar started to decrease earlier than both U scar, and M scar. 40% of patients had excellent satisfaction and 60% had very good satisfaction. All treated patients, had adverse events of temporary erythema, edema, bleeding, or a serous ooze resolving with crusting or scabbing following each session of microneedling, bacterial infection not occurred in any of our patients. Conclusion: Multiple minimally invasive sessions of skin microneedling with topical vitamin C during sessions and daily application is an effective treatment for post-acne atrophic scars with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.
https://smj.journals.ekb.eg/article_40958_c9563750652df58d20d3cf739449999c.pdf
Microneedling
Vitamen C
acne scar
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
173
178
10.21608/smj.2017.40972
40972
Original Article
Association of CA 15-3 and CEA with Clinicopathological Parameters In Patients With Metastatic Breast Cancer
Zeinab Mahmoud
zainbdiab@med.sohag.edu.eg
1
Sahar Abd Elwahed
sahr_mahran@med.sohag.edu.eg
2
Doaa El Badry
3
Ahmed Mohammed
ahmed_ahmed3@med.sohag.edu.eg
4
Department of clinical and chemical pathology, Sohag Faculty of Medicine, Sohag University.
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of medicine, Sohag university.
Department of clinical pathology, Faculty of medicine, Sohag university.
Background. Breast cancer is the most common cancer and the leading cause of cancer death for women, a third of women are diagnosed with breast cancer at a late stage when the disease has a poor prognosis. Serum tumor markers have been widely used as noninvasive tools for measuring treatment response, early diagnosis of recurrence and predicting prognosis. In breast cancer, the most widely used serum tumor markers are cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA). The aim of this study was to investigate the association of serum CA15-3 and CEA levels with clinicopathological parameters in patients diagnosed with metastatic breast cancer (MBC). Patients and methods. This retrospective study was conducted on 50 patients who had used to predict response to chemotherapy in patients with metastatic breast cancer. The concentration of serum CA15-3 and CEA levels were measured using chemiluminescent enzyme immunoassays (ABBOTT ARCHITECT). The upper limits of normal for CA15-3 and CEA were 31.3 U/ml and 5 ng/ml, respectively. Result. Of the 50 patients, elevated CA 15-3 and CEA levels at initial diagnosis of recurrence were identified in 37 (74%) and 32 (64%) patients, respectively. Elevated CA 15-3 and CEA levels were significantly associated with breast cancer molecular subtypes (P=0.005 and P=0.008, respectively). Elevated CA 15-3 level was correlated with bone metastasis (P=0.047). Conclusion. CA 15-3 and CEA level elevation at initial diagnosis of recurrence were found to be associated with breast cancer molecular subtype; these serum tumor markers are frequently increased in the HER2-enriched and triple negative (TN) molecular subtypes of breast cancer.
https://smj.journals.ekb.eg/article_40972_af30ed9a4047aea0926efd346abb54c6.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
181
186
10.21608/smj.2018.40981
40981
Original Article
Comparative Prospective Study Between Platlete Rich Plasma and Steroid Injection in Treatment of Chronic Planter Fasciitis
Wael salama
waeladel@med.sohag.edu.eg
1
Mostafa Ibrahim
mostafaismail@med.sohag.edu.eg
2
Abdel Rahman Abo takia
3
Abdel Rahman El sheikh
4
Department of Orthopedics and Traumatology, Faculty of medicine, Sohag university, Egypt
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthopedics and Traumatology, Faculty of medicine, Sohag university, Egypt
Department of Orthopedics and Traumatology, Faculty of medicine, Sohag university, Egypt.
Purpose:Compare the results of injection of steroid and PRP in cases of chronic plantar fasciitis
INTRODUCTION: plantar fasciitis can be a difficult condition to treat. results of platelet rich plasma (PRP) injection have been promising. We compared PRP to cortisone injection in the treatment of chronic plantar fasciitis resistant to conservative management.
METHODS:38 heels (20 heels in the steroid group and 18heels in the PRP group) with plantar fasciitis failed conservative treatment were included to receive either PRP or Steroid injection. All patients were assessed by Visual Analogue Score (VAS) for pain, at 2 weeks 1 month and 3months post injection .
RESULTS:Our study included 38 patients; 20 in the steroid arm and 18 had PRP injections. The average age of the steroid injection group was 43.1±9.7 years and in the PRP was 43.1±8.4 years (P= 0.698).
The starting average pain scores were 8.6 for both groups (P= 0.712). Then our patients were followed up clinically at 2 weeks, 1 month and 3 months following the injections. There was statistically significant lower VAS scores for the steroid injection group at all follow up visits (P< 0.001 in all follow ups). The average pain scores were 4.9 and 6.7 at 2 weeks follow up for the steroid injection versus the PRP respectively, it was 2 and 4.2 at 1 month and last 0.6 and 1.2 after 3 months respectively.
CONCLUSIONS:PurposThe purpose of this study was to assess the safety and preliminary clinical results of platelet-rich plasma (PRP) injections for treating chronic plantar fasciitisMethods
Fourteen consecutive patients with chronic plantar fasciitis receiving three injections of PRP into the plantar fascia were assessed 12 months after the procedure. The modified Roles and Maudsley score and a visual analogue scale (VAS) for pain were used to evaluate the clinical results.
Results
According to criteria of the Roles and Maudsley score, at 12 months of follow-up, results were rated as excellent in nine (64.3 %), good in two (14.3 %), acceptable in two (14.3 %) and poor in one (7.1 %) patient. VAS for pain was significantly decreased from 7.1 ± 1.1 before treatment to 1.9 ± 1.5 at the last follow-up (p < 0.01).
Conclusions
In this single-centre, uncontrolled, prospective, preliminary study, results indicate that treating chronic plantar fasciitis with PRP injections is safe and has the potential to reduce pain.
This study demonstrates that both steroid and PRP injections are highly effective in treatment of chronic plantar fasciitis but improvement in pain was more rapid with steroid injection. This study recommends for follow up for a longer period than three months to compare long term benefits of steroids and PRP.
https://smj.journals.ekb.eg/article_40981_9510ae00e330c04990a4c523005d975b.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
187
191
10.21608/smj.2018.41088
41088
Original Article
Assessment of Hemodialysis Adequacy in patients with Chronic Kidney Disease in the Hemodialysis Unit at Sohag University Hospital
Lotfy Abo Dahab
loutfy_abodahab@med.sohag.edu.eg
1
Eman Sabet
eman_thabet@med.sohag.edu.eg
2
Emad Mohammed
emad_youssif@med.sohag.edu.eg
3
Abdallah abdel-Naiem
4
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal medicine ; Faculty of medicine; Sohag University.
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal medicine ; Faculty of medicine; Sohag University.
introduction evaluation of HD adequacy in patients with ESRD who were being maintained on regular HD in a trial to identify the prevalence and causes of inadequate HD among the patients and the impact of HD adequacy on other parameters. design and setting:prospective study, at sohag university hospital in egypt. METHODS All patients in this study were subjected to laboratory investigations including blood urea nitrogen (BUN) (before dialysis and after dialysis), serum albumin, and hemoglobin (Hb) level. • URR = (1 - [postdialysis BUN ÷ predialysis BUN]) Kt/V was calculated using the second-generation Daugirdas formula • Single-pool Kt/V = −In (R −0.008 × t) + (4 −3.5 × R)×UF/W, R is the ratio of postdialysis to predialysis BUN; t is the length of a dialysis session in hours; UF is the ultrafiltration volume in liters; and W is the patient’s postdialysis weight in kilograms. RESULTS The results shown that 69,64% of patients had adequate HD (KT\V >1,2),and only 30,36% of patients had indequate HD (KT\V>1,2). CONCLUSION A significant percentage(69,64%) of patients in the HD unit of Sohag University hospital had adequate HD. HD adequacy was influenced by several factors such as duration and frequency of the dialysis session.
https://smj.journals.ekb.eg/article_41088_9147014111f5014f3ad1520416dad7d9.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
192
198
10.21608/smj.2018.41100
41100
Original Article
The Relationship of Serum 25-Hydroxyvitamin D Levels with Disease Activity in Upper Egyptian Patients with Rheumatoid Arthritis
Abdullah Ahmed
abdalah_radwan@med.sohag.edu.eg
1
Ahmed Allam
ahmed_farag@med.sohag.edu.eg
2
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Sohag University, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Sohag University, Egypt.
Aim of the work: To assess the serum 25-hydroxyvitamin D concentrations [25(OH)D] and their relationship with parameters of disease activity in upper Egyptian patients with rheumatoid arthritis (RA). Patients and methods: A case-control study was made on 34 patients with RA and 34 healthy control subjects. The following values were assessed for each patient: erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (Anti-CCP), visual analogue scale of pain (VAS), disease activity score 28 (DAS28), and serum 25-hydroxyvitamin D concentrations. Results: Patients with RA had mild to moderate (DAS28 ˂ 5.1) disease activity. The mean serum level of 25(OH)D in patients with RA (24.35±5.66 ng/ml) was significantly lower (P˂ 0.001) than controls (42.46±11.33 ng/ml). Serum 25(OH)D levels did not show correlation with disease duration, ESR, CRP, VASor DAS28 in patients with RA.Serum 25(OH)D levels were significantly correlated with age in RA patients (P˂ 0.01).Serum 25(OH)D levels had no relation to RF or anti-CCP positivity. Conclusion: Although serum 25(OH)D levels were lower in RA patients of upper Egypt, there was no correlation with disease activity parameters, therefore, serum 25(OH)D concentrations cannot be used to reflect disease activity.
https://smj.journals.ekb.eg/article_41100_b999f141bfb8da4a345af3ed20484e7d.pdf
disease activity
Rheumatoid Arthritis
Vitamin D
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
199
206
10.21608/smj.2018.41306
41306
Original Article
Expansion in Head and Neck at Sohag University Hospital
Gamal Elsayed
gamal_elsayed@med.sohag.edu.eg
1
Esam Bahgat
2
Tarek Abulezz
tabulezz@med.sohag.edu.eg
3
Hossam Abd El Hameed
hossam_abdelhameed@med.sohag.edu.eg
4
Department of Plastic Surgery Faculty of Medicine University of Sohag
Department of plastic surgery, Faculty of medicine, Sohag University.
Department of plastic surgery, Faculty of medicine, Sohag University.
Department of General surgery, Faculty of medicine, Sohag University.
Background: Tissue expansion is widely used in the head and neck, it have many advantages as the expanded tissue have the same color and texture of the treated area of the skin. Objectives:The aim of this work is to evaluate the expander utilization in head and neck reconstruction regarding indications and complications.Patients and methods: This is a prospective study included 30patients (18 female and 12 male), their age ranged from 3 to 36 years with mean value of 16 years,all patients were evaluated and managed in the plastic surgery department at Sohag university hospital. Results: the most cases of tissue expander used for scalp reconstruction followed by neck and nose reconstruction, young aged mostly treated with tissue expander than old aged and female more than male. Conclusion:The use of expanders provides the surgeon with a very reliable, simple method of reconstruction, the most common indications of expander uses were the post burn lesion alopecia of the scalp, post burn scar of the face, congenital melanocytic nevus of the forehead, haemangioma of the nose and congenital lymphatic malformations of the neck. The most common complications were expander exposure, wound dehiscent and serosa.
https://smj.journals.ekb.eg/article_41306_70847c2841d3bd111fb449e3d5d971d5.pdf
tissue expander
Scalp
Reconstruction
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
207
211
10.21608/smj.2018.41313
41313
Original Article
Use of mesenchymal stem cells in an experimental model of metabolic syndrome complicated with cardiomyopathy
Nagwa Ahmad
nagwa_ahmed@med.sohag.edu.eg
1
Esam Abdel Raheem
essam_abdelmawgoud@med.sohag.edu.eg
2
Hanan Fouad
3
Tahia Saleem
4
Department of Biochemistry, Faculty of Medicine, Sohag University.
Department of Biochemistry, Faculty of Medicine, Sohag University.
Department of Biochemistry, Faculty of Medicine, Cairo University.
Department of Biochemistry, Faculty of Medicine, Assuit University.
Obesity is a major global health issue. Most obese patients develop metabolic syndrome, a cluster of clinical features characterized by hypertension, insulin resistance and dyslipidemia this pre-diabetic condition has recognized as an independent risk factor for cardiovascular diseases, particularly hypertension, atherosclerosis and diabetic cardiomyopathy. MSC can differentiate into many mesenchymal cells as cardiomyocytes. The application of MSCs in the treatment of DC in recent years offers promising results. Stem cell therapy has emerged as a promising strategy for the treatment of dead myocardium, directly or indirectly, and seems to offer functional benefits to patients.Recently, a substantial number of clinical trials have proven that stem cell therapy is safe. Infusion of bone marrow-derived stem cells (BMCs) represents the greatest number of clinical studies for MI. This review highlights the use of mesenchymal stem cells in metabolic syndrome and diabetic cardiomyopathy
https://smj.journals.ekb.eg/article_41313_cebb07da3eb655ffea368190944dac04.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
213
221
10.21608/smj.2018.41318
41318
Original Article
Comparing the Performance of Tissue Doppler versus Left Atrial Strain in Predicting Left Ventricular End Diastolic Pressure in Patients with Different Left Ventricular Ejection Fractions
Aliaa Mahfouz
1
Mohammed Salama
2
Ramadan Mohamed
3
Mohamed Saleh
4
Department of Cardiovascular Medicine, Aswan University, Aswan, Egypt.
Department of Cardiovascular Medicine, Aswan University, Aswan, Egypt.
Department of Cardiovascular Medicine, Aswan University, Aswan, Egypt.
Department of Cardiovascular Medicine, Aswan University, Aswan, Egypt.
Background:Early trans-mitral inflow velocity and mitral annular tissue Doppler imaging (E/Em ratio) is widely applied to noninvasively estimate left ventricular (LV) filling pressures. However, E/Em ratio has a significant gray zone among patients with severely impaired ejection fraction. Speckle tracking echocardiography (STE) was recently proposed as an alternative surrogate to estimate LV filling pressures. This study aimed at assessing performance of tissue Doppler parameters and left atrial global longitudinal strain as non-invasive surrogates for LV filling pressures and comparing accuracy of these two parameters across different striae of LVEF. Methods: A total of 96 patients with sinus rhythm and different ejection fraction who divided into four groups of 24 patients each according to their EF(>55%, 45–54%, 30–44%, and <30%), had an invasive measurement of the LV pressure. Both medial and lateral E/Em ratio were measured in all subjects by 2D Tissue Doppler, peak atrial longitudinal strain (PALS) and Peak atrial contraction strain (PACS) were obtained by averaging all segments measured in the 4-chamber. Results: Significant Correlation between global PALS and invasive LVEDP in all groups (r = 0.70 P < 0.000), While Lateral E/E’ shows significant correlation only in two groups; preserved and mildly impaired EF (r=0.42 P=0.023, r=0.439 p-0.032; respectively) Conclusion:In patients with preserved or mildly reduced LV ejection fraction, global PALS and Lateral E/E’ ratio presented good correlations with LVEDP. In patients with moderate or severe reduction of EF, E/E’ ratio correlated poorly with invasively measured LV filling pressures. Global PALS provided an overall better estimation of LV filling pressures.
https://smj.journals.ekb.eg/article_41318_bd5d489f8bde850e7fe8c714b9510ede.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
223
227
10.21608/smj.2018.41657
41657
Original Article
Closed Reduction and Percutaneous Screws Fixation in Tibial Plateau Fractures
Omar Abdelkareem
1
Anis Shiha
anies_sheha@med.sohag.edu.eg
2
Hussam Eldin Elazab
hossameldin_azab@med.sohag.edu.eg
3
Mohamed Ali
4
Department of orthopedics and traumatology, Sohag University, Egypt.
Department of orthopedics and traumatology, Sohag University, Egypt.
Department of orthopedics and traumatology, Sohag University, Egypt.
Department of orthopedics and traumatology, Sohag University, Egypt.
Purpose:To evaluate treatment outcomes of closedreduction and percutaneous screw fixation for tibialplateau fractures. Methods:18 men and 4 women aged 21 to 64 (mean, 38.1) years underwent closed reduction and percutaneous screw fixation for closed tibial plateaufractures. According to theSchatzker classification, patients were classifiedinto type I (n=6), type III (n=10), type IV (n=4), andtype V (n=2). Closed reduction was achieved usingmanual ligamentotaxis with traction in extensionunder image intensifier control. Reduction was fixedpercutaneously with cancellous screws (6.5 mm) andwashers. Functional outcome (pain, walking capacity,extension lag, range of motion, stability and return to daily activity) wasevaluated using the Modified Hospital for Special Surgery Score. A total score of 55 to 60 was considered as excellent, 45 to 54 as good, 35 to 44 as fair, and Results:Patients were followed up for a mean of 8 (range, 6–12) months. The mean length of hospitalstay was 2 (range, 1–3) days. All the fracture unitedradiographically after a mean of 3 (range, 2.5–3.5)months. Respectively in Schatzker types-I, -III, -IV, and-V fractures, outcomes were excellent in 4, 1, 1, and 0 patients, good in 2, 6, 2, and 0 patients, fair in 0, 3, 0, and 1 patients, and poor in 0, 0, 1, and 1 patients. Outcome was satisfactory (good-to-excellent) in 100%, 70%, 75%, and 0% of the respective fracture typesof patients. The mean Modified-HSS score was 46.2 for all patients; it was 53.3 for type I, 40.3 for typeIII, 45 for type IV, and 36 for type V fractures. One patient had metal failure due to early weight bearing at 5 weeks. No patient had infection or wound dehiscence. Conclusion:Closed reduction and percutaneous screw fixation for tibial plateau fractures is minimally invasive. It reduces the length of hospitalstay and costs, enables early mobilization with minimal instrumentation, and achieves satisfactory outcomes.
https://smj.journals.ekb.eg/article_41657_8b3cdab8ef79d2cf47af2099e8f0bf2d.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
229
241
10.21608/smj.2018.41679
41679
Prevalence of gyrA and parE mutations in clinical isolates of Streptococcus pneumoniae with decreased susceptibilities to different Fluoroquinolones
Laila Yousef
lailamohamed@med.sohag.edu.eg
1
Ghada Ismael
2
Ashraf Mohammed
ashraf_abdallah@med.sohag.edu.eg
3
Mohamed Mahmoud
4
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Introduction: Streptococcus pneumoniae is a major Gram-positive pathogen responsible for pneumonia, bactermia, otitis media, and meningitis leading to considerable morbidity and mortality among children and elderly individuals. The primary goals of antibiotic treatment of respiratory tract infections are clinical efficacy of treatment, pathogen eradication, and prevention of resistance development. Resistance to fluoroquinolones in S. pneumoniae arises in a stepwise fashion and results from alterations in the target binding site due to the acquisition of spontaneous mutations in the quinolone resistance-determining regions (QRDRs) of the topoisomerase IV and DNA gyrase genes. Although mutations usually occur in the QRDRs of parC and gyrA, a role for mutations in the parE subunit in low-level resistance has been reported. Aim of the work: The aim of this study was to determine the prevalence of fluoroquinolone resistance Streptococcus pneumoniae (FQRSP) and to examine the genetic relatedness of pneumococcal isolates with parE and gyrA genes mutations in different specimens in Sohag University Hospital. Patients and Methods: This study was prospectively conducted over a period of 24 months between October 2015 and September 2017, at Sohag university hospital. During the study period, 78 patients hospitalized for a syndrome consistent with a diagnosis of community acquired pneumonia (CAP ) included in this study with a mean age of 34.5 years (range, 2 to 67), 60% of whom were males. A CAP syndrome was defined as a newly recognized pulmonary infiltrate together with 2 of the following findings: subjective fever or documented temperature 37.4 °C, increased cough, sputum production, or shortness of breath, pleuritic chest pain, confusion, rales, leukocytosis, (according to age) (1). Patients who had taken antibiotic treatment within 3 days prior to initial visit were excluded from this study. Results: Our study illustrate the role of mutation in the gyrA&parE genes and the effect of mutations in the both genes in fluoroquinolone resistance among S. pneumoniae isolates. Conclusion: The present study provide an opportunity to view the predominant mutations conferring reduced susceptibility to FQs in clinical pneumococcal isolates. There is a strong relationship between these mutations and decrese susceptibility to the most fameous FQs to some extent, although this varies between strains and for each drug.
https://smj.journals.ekb.eg/article_41679_9e04a14890c2922fbe60fb891a0eca5d.pdf
gyrA
ParE
Streptococcus pneumonia
Fluoroquinolones
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
243
250
10.21608/smj.2018.41680
41680
Original Article
Comparative study between Tramadol and Midazolam as an admixture to bupivacaine inUltrasound guided supraclavicular brachial plexus block.
Mostafa Abdelzaher
1
Hamza Mahmoud
hamza_aboalam@med.sohag.edu.eg
2
Ahmed Abd El-Mabood
ahmed_abdelmaboud@med.sohag.edu.eg
3
Khaled Hassan
khaled_hassan@med.sohag.edu.eg
4
Department of Anesthesiology, Sohag University, Egypt.
Department of Anesthesia, Faculty of Medicine,Sohag University.
Department of Anesthesia, Faculty of Medicine,Sohag University.
Department of Anesthesiology, Sohag University, Egypt.
Background:This is a prospective, randomized, double blind study to evaluate the postoperative analgesia following ultrasound guided supraclavicular brachial plexus block with Tramadol or Midazolam as an admixture to bupivacaine in upper extremity surgery. Patientsand methods:Total 60 patients of ASA I and II undergoing upper extremity surgery under ultrasound guided brachial plexus block with Bupivacaine were randomly divided in to two groups; one group received Tramadol (1mg/kg) and the other group received midazolam (0.05mg/kg) as an admixture to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score. Results: The mean duration of postoperative analgesia in the Midazolam group was 650±47.49 minutes while in the tramadol group it was 508±30.44 minutes. Conclusion: We concluded that midazolamwith local anaesthetic prolongs postoperative analgesiasignificantly than Tramadol (P<0.0001) when used as admixture to local anaesthetic inUltrasound guided brachialplexus block in upper extremity surgery.
https://smj.journals.ekb.eg/article_41680_b089ee6a7dfd61843671a085c944b8a8.pdf
Analgesia
brachial plexus
Ultrasound
midazolam
tramadol
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
253
262
10.21608/smj.2018.41769
41769
Original Article
Prevalence of Fluoroquinolone-Resistant Clinical Isolates of Escherichia Coli in Urinary Tract Infection
Laila Yousef
lailamohamed@med.sohag.edu.eg
1
Ashraf Mohammed
ashraf_abdallah@med.sohag.edu.eg
2
Ahmed Mohamed
ahmed_ibrahim@med.sohag.edu.eg
3
Doha Ali
4
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Department of Clinical and chemical pathology, Sohag Faculty of Medicine, Sohag University.
Introduction: The commonest bacterial agent involved in causation of UTIs is Escherichia coli. The emergence of FQ resistant uropathogenic E. coli is of great concern. Aim of the work: to study resistance towards urinary E. coli with various generations of fluoroquinolones. Patients & Methods:: our study was carried out in the Clinical Pathology Department, Sohag University Hospital during the period from June 2016 to May 2017. Our study included 140 participants. Isolates from the specimens were obtained and identified using; Gram staining, colony characteristics on different culture medias. VITEC 2 Compact 15 identification kits were be used to confirm the identification of the isolates Results: E.coli was isolated from 100 patients (71%) of all patients complaining of UTI with positive urinary culture (study or case group). By studying prevalence of Antibiotic resistance of E.coli isolates reveals that fluoroquinolones show sensitivities of 42-46%. Also Nitrofurantoin has the highest sensitivity of 87%. This is followed by meropenem (67%). Ampicillin shows sensitivity in only 6% of cases. Regarding drug sensitivity in out & inpatients, we find that all generations of fluoroquinolones show highly significant resistance ratios among inpatients compared to outpatients. Meropenem show resistance more in inpatients than outpatients, with significant difference, Ampicillin and Nitrofuratoin show non-significant difference. Conclusion: our study show an increased fluoroquinolone resistance among uropathogenic E. coli isolates mainly in hospital admitted patients.
https://smj.journals.ekb.eg/article_41769_57d877911adb22fef942a56f2ac65404.pdf
Urinary tract infection (UTI)
Escherichia coli and fluoroquinolone resistant E.coli
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
265
271
10.21608/smj.2018.41770
41770
Original Article
Comparison of Fixation of supracondylar humeral fractures in children by lateral cross-wiring technique versus traditional lateral pinning
Abdelrahman Sadek
1
Mostafa Elsayed
mostafaismail@med.sohag.edu.eg
2
Hussam Eldin Elazab
hossameldin_azab@med.sohag.edu.eg
3
Hassan Abdel Rahman
hassan_abdelrahman@med.sohag.edu.eg
4
Department of Orthopedic, Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of orthopedics and traumatology, Sohag University, Egypt.
Department of Orthopedic, Faculty of Medicine, Sohag University.
Introduction The currently accepted treatment for displaced supracondylar humeral fractures in children is closed reduction and fixation with percutaneous Kirschner wires. The aim of this study was to study the results of a cross-wiring technique, achieved solely from the lateral side, in an effort to reduce the risk of ulnar nerve injury. Conclusion there was no significant difference between lateral cross-wiring technique and traditional lateral pinning as regard postoperative clinical results and radiological results. Introduction Supracondylar fractures of the humerus in children accounts for 60% of all fractures around the elbow. (1) It represents 4 - 6.5% of all paediatric fractures. In treatment of non-displaced Type I fractures simple immobilization with a posterior splint applied at 60-90o of elbow flexion is preferred. (2) Currently, the treatment of choice for type II fractures is operative reduction and pinning rather than cast. (3) Most cases of type III fractures require operative reduction and pinning. The results of type III fractures treated with closed reduction and cast immobilization are not as good as the results of pinning. (4) There are various options for the pattern of K-wire fixation of displaced supracondylar fractures. Studies found the greatest resistance to rotation occurred with medial-lateral cross pinning. (5) The second most stable pattern was fixation utilizing three lateral diverging pins. The least stable was fixation with two lateral pins, which cross at the fracture site. While medial-lateral cross pinning has the greatest resistance; the disadvantage is the risk of ulnar nerve injury. (6) Lateral pinning is recommended (7) to avoid iatrogenic ulnar nerve injury that can occur with medial lateral cross pinning. Although iatrogenic ulnar nerve injuries usually resolve, several permanent iatrogenic ulnar nerve injuries have been described. (8) Closed reduction and lateral cross-wiring technique with ascending and descending K-wires is an effective method to treat type II and III supracondylar fractures in children. Regardless of stability, this method can be used to avoid iatrogenic ulnar nerve injuries. (9) Aim of the work The aim of this work is to assess clinical results of fixation of supracondylar humeral fractures by lateral cross-pinning versus traditional lateral pinning in children.
https://smj.journals.ekb.eg/article_41770_b98ef9df22483eb1d2ca2e322a6ef06d.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
273
280
10.21608/smj.2018.41790
41790
Original Article
Value of High Sensitive CRP in Hyperglycemic Patients with Acute Coronary Syndrome
Alaa Said
1
Omar Mohammed
omar_salim@med.sohag.edu.eg
2
Yasser Kamal
yasser_kamal@med.sohag.edu.eg
3
Adel El Sayed
adel_elsayed@med.sohag.edu.eg
4
Department of Internal Medicine, Sohag university Hospital.
Department Internal Medicine, Sohag university Hospital.
Department of Internal medicine , Faculty of Medicine, Sohag University.
Department Internal Medicine , Sohag university Hospital.
BACKGROUND: Hyperglycemia on admission in patients with acute coronary syndromes is common, and it is a powerful predicator of increased risk of in hospital complications in patients with and without diabetes mellitus, high sensitivity c- reactive protein (hs- CRP) is a cardiovascular risk marker in patients with acute coronary syndrome. OBJECTIVES: 1. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome with admission hyperglycemia whatever diabetic or not. 2. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome without admission hyperglycemia. 3. To compare the results of the above two groups and assess the prognostic value of admission glucose and hs -CRP levels in hyperglycemic patients with acute coronary syndromes. DESIGN AND SETTING: Prospective study, at Sohag university hospital in Egypt. METHODS: We measured the blood glucose, hs -CRP, cardiac enzymes and HBAIC levels at admission in 100 consecutive patients with ACS. Glucose was categorized as ≤11.1mmol=200 mg/dl. hs -CRP negative 3 mg, HBAIC ≤ 6.5% or ≥ 6.5). RESULTS: In our study reveals a statistically significant relation between levels of admission glucose and left ventricular function (LV failure, pulmonary edema and cardiogenic shock) or arrhythmias in hyperglycemic patients with ACS (P< 0.0001). Also there is a significant relation between level of hs- CRP and LVF and type of myocardial infarction in-hospital complications. Also there is insignificant relation between HBAIC levels and left ventricular function in ACS at admission. CONCLUSION: We conclude that elevated admission glucose appears a more important in predicting in-hospital and short term complications particularly left ventricular failure and cardiogenic shock in patients with acute coronary syndromes. Also the increased levels of hs- CRP are a predictor for severity and extent of myocardial damage and left ventricular function especially in STEMI. The synergistic effect of associated both stress hyperglycaemia and hs- CRP is a strong predictor for poor ACS outcome.
https://smj.journals.ekb.eg/article_41790_531d1e8793f308dadec21157c5eb0775.pdf
High-sensitivity C-reactive protein level
hyperglycemia
Inflammatory marker
Atherosclerosis
Acute Coronary Syndrome
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
281
290
10.21608/smj.2018.41796
41796
Original Article
Ischemic Heart Disease in Patients with Diabetes Mellitus
Alaa Ghaleb
alaa_ahmed@med.sohag.edu.eg
1
Elham Hamed
elhamomar@med.sohag.edu.eg
2
Ahmed Boghdady
ahmed_boghdady@med.sohag.edu.eg
3
Hassan Hassanin
hassan_hassanain@med.sohag.edu.eg
4
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Clinical andChemical pathology, Sohag Faculty of Medicine, Sohag University.
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal Medicine, Faculty of Medicine, Sohag University.
https://smj.journals.ekb.eg/article_41796_4eab2a2fedfff612ec9a39a381d12370.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
291
295
10.21608/smj.2018.41805
41805
Original Article
Comparative study between posterior and modified posterior approaches of humeral diaphyseal fractures in adults
Emad Nagib
1
Ahmed Shaker
ahmed_saleem@med.sohag.edu.eg
2
Wael salama
waeladel@med.sohag.edu.eg
3
Ahmed Eldosoky
ahmed_eldesouky@med.sohag.edu.eg
4
Shazly Musa
shazli_mousa@med.sohag.edu.eg
5
Department of Orthopaedic and Traumatology , Faculty of Medicine , Sohag Univeristy.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthopedics and Traumatology, Faculty of medicine, Sohag university, Egypt.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthopaedic and Traumatology , Faculty of Medicine , Sohag Univeristy.
Introduction The optimal treatment of humeral shaft fractures continues to be debated. In the current investigation, we sought to determine the clinical and radiographic outcomes following the plate fixation of humeral shaft fractures utilizing the modified posterior approach. Materials and methods A retrospective review identified a consecutive series of 30 humeral shaft fractures (OTA20-A, 10-B, or 0-C) treated with plate fixation via a posterior (14 patients), ormodified posterior approach (16 patients) between 2016 and 2017 by a single surgeon. Demographics, operative reports, clinical follow-up, and preoperative radiographs were reviewed. Postoperative radiographs were assessed for angular deformity and time to union. Range of motion and strength testing were also reviewed. Results A total of 30 humeral shaft fractures were reviewed with a mean clinical follow-up of 4 months. The mean time to union was13.1 weeks and there3 patients developed radial nerve palsies in posterior approach group and one case in modified posterior approach postoperatively. Conclusionboth approaches could be used in the management of humeral diaphyseal middle or distal third fractures, And the modified posterior approach confirmed by our results minimizes the complication rate, allow early return of full range of elbow motion and full triceps muscle power and facilitates early return to normal activities of the patient with excellent functional out comes .
https://smj.journals.ekb.eg/article_41805_36ccfc72ec24c1f47cf92151f8aec739.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
297
311
10.21608/smj.2018.41810
41810
Original Article
A Study of Prevalence of Obesity among Female Students in Sohag University
Farida Abdou
1
ahmed elnahhas
ahmed_hamed@med.sohag.edu.eg
2
Eman Mohammed
eman_mahmoud@med.sohag.edu.eg
3
Nesreen Mohammed
nesreen_mohamed@med.sohag.edu.eg
4
Department of Family Medicine, Faculty of Medicine, Sohag University.
public health and community medicine department, faculty of medicine, Sohag University, sohag, egypt.
Department of Family Medicine, Faculty of Medicine, Sohag University.
department, of Public Health and Community Medicine-Sohag University.
Introduction: Obesity is a medical case in which extra body fat has stored to the extent that it may have a harmful effect on health. People are generally measured obese when their body mass index (BMI), ameasurement obtained by dividing aperson's weight by the square of the person's height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight. Some East Asian countries use lower values. Aim of the work: Find out the prevalence of overweight and obesity among female students in Sohag University, and identify important risk factors. Patients and Methods: Cross sectional study, included a sample of female students aged 17-25 in the selected faculties in Sohag University, the study was carried out in Faculty of Medicine, Faculty of Nursery and Faculty of Education in Sohag University, the questionnaire was divided into five parts, the demography, dietary habits, physical activity, perceptions of body weight and beliefs of obesity and the record of self-reported and actual anthropometric body measurements. Results: Overweight and obesity were prevalent among the our study subjects as the prevelance was 38.5%, lack of physical activity, soft drink consumpton and marital status were significantly associated with obesity, our students preferred dairy products and fatty foods over vegetables and fruits. In addition, their “lack of time” was the most frequently mentioned barrier to eating a healthy diet and engaging in regular exercise. Life style modification is important to improve healthy habits earlier in life. Conclusion: Overweight and obesity were prevalent among the our study subjects as the prevelance was 38.5%.
https://smj.journals.ekb.eg/article_41810_716cc8e1f291fee826818527c6594db3.pdf
Obesity
Female
Sohag university
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
313
319
10.21608/smj.2018.41816
41816
Original Article
Study of Ankle-Brachial Index Compared to Carotid Intima-Media Thickness as a Non-Invasive Technique to Predict the Severity of Coronary Atherosclerosis
Mohamed Elsayed
mohamed_elsayed@med.sohag.edu.eg
1
Department of Internal Medicine. faculty of medicine.sohag University.
https://smj.journals.ekb.eg/article_41816_ffa444fcdef546504eec74f2e2723bdf.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
321
334
10.21608/smj.2018.41821
41821
Original Article
Molecular characterization of mutation in the parC and gyrB genes that confer fluoroquinolone resistance in Streptococcus pneumonia isolates
Laila Yousef
lailamohamed@med.sohag.edu.eg
1
Ghada Ismael
2
Ashraf Mohammed
ashraf_abdallah@med.sohag.edu.eg
3
Mohammed Mahmoud
mohamedhamdy@med.sohag.edu.eg
4
Department of Clinical and Chemical pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Department of Clinical Pathology, Faculty of Medicine, Sohag University.
Resistance of Streptococcus pneumoniae to multiple antibacterial agents, including β-lactams, macrolides, tetracyclines, and co-trimoxazole, has emerged worldwide in the 1980s and 1990s and has emphasized the need for new therapeutic alternatives, such as newer fluoroquinolones. Older fluoroquinolones, such as ciprofloxacin and ofloxacin, have been widely used in the last 2 decades, but their activity against gram-positive pathogens is limited. Newer fluoroquinolones, such as levofloxacin, gatifloxacin, moxifloxacin, and gemifloxacin, have enhanced activity against most respiratory pathogens, and some are being more widely used to treat respiratory tract infections. Therefore, the emergence of fluoroquinolone-resistant S. pneumoniae strains, although worldwide prevalence is low, is a concern to clinicians who manage respiratory tract infections. Aim of the work: The aim of this study was to determine the prevalence of fluoroquinolone resistance Streptococcus pneumoniae (FQRSP) and to examine the genetic relatedness of pneumococcal isolates with parC and gyrB genes mutations in different specimens. Patients and Methods: In this study, Biometra Thermal Cyclar-T Gradient Software PCR system version 4 together with DNASIS 2.6 Sequence Analysis Programs were used to investigate the presence of mutations at quinolone resistance-determining regions of topoisomerase IV and DNA gyrase on 78 S. pneumoniae strains, Among 78 isolates 37 (47.4%) of S. pneumonia isolates were Fluroquinolones susceptible, 12 (15.4%) were with variable susceptibility and 29 (37.2%) were Fluroquinolones resistant. Results: Our study illustrate the role of mutation in the parC & gyrB genes and the effect of mutations in the both genes in fluoroquinolone resistance among S. pneumoniae isolates. Conclusion: Results indicated that there is a significant correlation between quinolone resistance development and mutations in the parC gene and in less significance in the gyrB genes .
https://smj.journals.ekb.eg/article_41821_3a91a239a906032e4e7baefa9b4dcb62.pdf
GyrB
ParC
Streptococcus pneumonia
Fluoroquinolones
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
337
341
10.21608/smj.2018.41979
41979
Original Article
MANAGEMENT OF SUPRACONDYLAR FRACTURE HUMERUS WITH Pink Pulseless Hand in Children.
Mohamed Atea
1
Ashraf Ahmed
ashraf_marzouk@med.sohag.edu.eg
2
Ahmed Eldosoky
ahmed_eldesouky@med.sohag.edu.eg
3
Mohamed Abdel-Wanis
mohamed_abdelwanees@med.sohag.edu.eg
4
Department of Orthopedics, Sohag University ,Sohag , Egypt.
Department of Orthopedics, Sohag University ,Sohag , Egypt.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
Department of Orthpaedic and Traumatology , Faculty of Medicine, Sohag University.
The management of children with a pink pulseless hand in severely displaced supracondylar humeral fractures remains controversial regarding immediate exploration of the brachial artery and revascularization during fracture fixation or just closed reduction of the fracture and percutaneous pinning and follow up of limb perfusion.Between 2012 and 2016 we followed 52 children with displaced supracondylar fracture humerus. All patients had absent radial pulse with an otherwise well perfused hand. The radial pulse was returned in all patients, without surgical exploration after closed reduction of the fracture and percutaneous pinning .It takes variable periods from 1week to 2 months . Radial pulse recovery may be due to recanalization of brachial artery or by collaterals. So closed reduction of the fracture, percutaneous pinning and observation is a good option of treatment pediatric supracondylar humeral fractures with a pink pulseless hand without need to do early revascularization procedures.
https://smj.journals.ekb.eg/article_41979_176a8d574753a55a5aeb9423e5124def.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
343
347
10.21608/smj.2018.41980
41980
Original Article
The use of modified humeral intramedullary interlocking nail in adolescent and elder children femoral shaft fracture
Mohamed Derar
1
Mohamed Kenway
mohamed_ahmed8@med.sohag.edu.eg
2
Yasser EL Sagher
3
Shazly Musa
shazli_mousa@med.sohag.edu.eg
4
Department of Orthopedic surgery, Faculty of Medicine, Sohag university.
Department of Orthopedic surgery, Faculty of Medicine, Sohag university.
Department of Orthopedic surgery, Faculty of Medicine, Sohag university.
Department of Orthopedic surgery, Faculty of Medicine, Sohag university.
https://smj.journals.ekb.eg/article_41980_d3e27a641c539e2fd327047415474f33.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
349
355
10.21608/smj.2018.42001
42001
Original Article
Factors Affecting the Outcome in the Management of Cervicofacial Infection
Mohammed Abbas
1
Tarek Ftohy
tarek_elsayed@med.sohag.edu.eg
2
Ahmed Ahmed
ahmed_ahmed2@med.sohag.edu.eg
3
Kamal El-Sharkawy
kamal_mohamed@med.sohag.edu.eg
4
Department of surgery, Faculty of medicine, Sohag university.
General Surgery Faculty of Medicine , Sohag university.
Department, of General Surgery , Faculty of Medicine, Sohag University
Department of General Surgery, Faculty of Medicine, Sohag University.
Introduction Facial cellulitis and abscesses are common in public health problems and early recognition and management is critical, as they are becoming more severe with a noticeable increase in hospitalization. Aim of work detection of factor affecting outcome in the management of cervicofacial infections and complication to reduce associated mortality and morbidity. Patient and method This study was a prospective study which was conducted at Sohag University Hospital, General Surgery Department. It included patients with cervicofacial infection of odontogenic or non-odontogenic origin either localized or diffuse infection attended to at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit from October 2016 to October 2017. Results This study included 35 cases, the submandibular space was the most common single site affected (11-34.29%), followed by bilateral or multi- space involvement presented (13-37.14%) of study patients, Diabetes mellitus was the most common associated co- morbidity among study population (12-34.29%), and other systemic diseases (6-17.14%). Conclusion Diabetes, bad general condition, impaired laboratory parameters including an elevated blood sugar level and metabolic acidosis at time of admission were found to be significant risk factors for development of post intervention complications and/ or delayed recovery.
https://smj.journals.ekb.eg/article_42001_f2e8de17883f0ec8b38a03b1d57eab47.pdf
cervicofacial infection
deep neck space infection
DM
odontogenic infection
Trismus
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
357
365
10.21608/smj.2018.42037
42037
Original Article
Oncoplastic breast surgery:current strategies and outcome
Mahmoud Abd El Baky
1
Ahmed Aldardeer
ahmed_eldardeer@med.sohag.edu.eg
2
Ayman Ali
ayman_ali@med.sohag.edu.eg
3
Alaa Redwan
profalaaredwan@yahoo.com
4
Department of surgery, Faculty of medicine, Sohag university.
Department, of Surgery Faculty of, Medicine University of, Sohag.
Department of surgery, Faculty of medicine, Sohag university.
Department, Faculty, of Medicine General Surgery, Sohag University.
Oncoplastic surgery has emerged as a new approach to allow wide excision for breast conserving surgery without compromising the natural shape of the breast. It is based on integration of plastic surgery techniques for immediate breast reshaping after wide excision for breast cancer. Objective:To study the different methods of oncoplastic surgery for breast reconstruction to achieve better aesthetic outcome and improve quality of life. Patients and Methods: Thirty patients with breast cancer, treated at Sohag University Hospital between July 2016 to May 2017 were included in this study. The oncoplastic techniques performed were Local glandular tissue displacement in (60%), latissimus dorsi flap (LD) in (16.6%), superior pedicle flap in(10%), implant insertion in (6.6%) and Transverse rectus abdominus myocutanous flap (TRAM) in (6.6%). The choice of the oncoplastic techniques depends on the achievement of free safety margins, the breast volume, and its ptotic degree. Results: The number of patients included in the study were thirty. The median age was 43 years (range; 20–60 ys). There were three major complications that require repeating the oncoplastic techniques. Recorded complications included wound infection (5/30, 16.6 %) donor site seroma (10/30, 33.3 %), postoperative haematoma (1/30, 3.3%), flap ischemia and necrosis (1/30, 3.3%). The 12-months subjective patient satisfaction was excellent in 27 (90%) patients, and bad in 3 (10 %) patients. There were two local recurrence, no systemic metastasis after an average follow-up duration of 12 months. Conclusion:Restoring the defect after resection of the breast cancer can be safely achieved using oncoplastic procedures including the previous techniques with immediate breast reconstruction. In our patients, these procedures yield a satisfactory aesthetic outcome with lower morbidity.
https://smj.journals.ekb.eg/article_42037_3492f2c01c5f4ce3e422143fe3a3eee4.pdf
Oncoplastic breast surgery
Breast conservative surgery
LD flap
TRAM flap
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
367
373
10.21608/smj.2018.42045
42045
Original Article
Microneedling as a monotherapy in treatment of male androgenetic alopecia
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Reham El Sharkawy
reham_elsharkawy@med.sohag.edu.eg
2
Wafaa Abd El- Maged
wafaa_mohamed@med.sohag.edu.eg
3
Ashraf Abd El-Latif
ashraf_abdelwahab@med.sohag.edu.eg
4
Marwa Abo Elmagd
marwaaly@med.sohag.edu.eg
5
DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university.
Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology- Faculty of Medicine- Sohag University.
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
https://smj.journals.ekb.eg/article_42045_1077226ee9d5f75e30faa2fa0374d1dd.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
375
379
10.21608/smj.2018.42049
42049
Original Article
Association of osteopontin promoter polymorphism and aggresivness in breast cancer
Madeha Zakhary
1
Aida Mahmoud
aida_mahmoud@med.sohag.edu.eg
2
Wael Ahmed
3
Marwa Hashim
marwa_hashem@med.sohag.edu.eg
4
Department, of Medical Biochemistry, Faculty of Medicine, Assuit university.
Department, of Medical Biochemistry, Faculty of Medicine, Sohag university.
Department of General Surgery, Faculty of Medicine, Sohag university.
Department of Biochemistry and microbiology, Facaulty of Medicine, Sohag University.
Osteopontin (OPN) is an extracellularmatrix protein that is overexpressed in various cancers and promotes oncogenic features including cell proliferation, survival, migration, and angiogenesis, among others. OPN can participate in the regulation of the tumor microenvironment, affecting both cancer and neighboring cells. Here, we review The role of single-nucleotide polymorphism (SNP)-443 of the OPN gene in cancer aggressiveness.
https://smj.journals.ekb.eg/article_42049_6179996784565298af078fddbde59104.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
381
386
10.21608/smj.2018.42078
42078
Original Article
Evaluation of some biomarkers in breast cancer patients
Madeha Zakhary
1
Aida Mahmoud
aida_mahmoud@med.sohag.edu.eg
2
Wael Ahmed
3
Marwa Hashim
marwa_hashem@med.sohag.edu.eg
4
Department OF Medical Biochemistry Faculty of Medicine. Assuit university.
Department, of Medical Biochemistry, Faculty of Medicine, Sohag university.
Department, OF General Surgery, Faculty of Medicine, Sohag university.
Department of Biochemistry and microbiology, Facaulty of Medicine, Sohag University.
Background. Osteopontin (OPN) is an extracellularmatrix protein that is overexpressed in various cancers and promotes onco-genic features including cell proliferation, survival, migration, and angiogenesis. Here, we analyzed the correlation between the expression pattern of (osteopontin and CA15.3) and clinic-pathological status of breast cancer and other standard prognostic factors. Patients and methods. A case control study with 60 female breast cancer patients and 20 controls. All patients were subjected to complete medical history uptake , clinical examination and laboratory investigations include histopathological type of cancer, hormone receptor status ,CA 15-3 serum concentratios and osteopontin plasma level by ELISA. Results. Our study showed that osteopontin plasma level was significantly different among breast cancers and controls (p<0.0001) but no association between osteopontin plasma level and histological type , stage or grade. Also we found significant association between CA 15-3 and cancer stage (p<0.000). Interestingly CA15.3 serum concentrations increased in hormone receptor positive cancer. Conclusion. OPN and CA15.3 are overexpressed in breast cancer. OPN overexpression is associated with poor prognosis. Moreover CA15.3 has minimal prognostic value in non metastatic breast cancer.
https://smj.journals.ekb.eg/article_42078_a27a9b54f154efc5297ab95b75239b5b.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
387
400
10.21608/smj.2018.42083
42083
Original Article
Topical dutasteride with microneedling in treatment of male androgenetic alopecia
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Reham El Sharkawy
reham_elsharkawy@med.sohag.edu.eg
2
Wafaa Abd El- Maged
wafaa_mohamed@med.sohag.edu.eg
3
Marwa Abo Elmagd
marwaaly@med.sohag.edu.eg
4
Department, OF DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university.
Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
https://smj.journals.ekb.eg/article_42083_24b61cbba4be9982db23c318414034c0.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
403
410
10.21608/smj.2018.42251
42251
Original Article
Nerve growth factor (NGF) expression in correlation with severity of pruritus in cirrhotic patients
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Hanan Assaf
hanan_asaf@med.sohag.edu.eg
2
Reham El Sharkawy
reham_elsharkawy@med.sohag.edu.eg
3
Amr Zaghloul
amr_hashem@med.sohag.edu.eg
4
Marwa Abd El Meged
5
Mahmoud Abd El Wahed
6
Asmaa Ahmed
7
DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university.
Department of Dermatology, Venereology and Andrology, Sohag Faculty of Medicine, Sohag University.
Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology, Sohag Faculty of Medicine, Sohag University.
Department of pathology, Assuit Faculty of Medicine, Assuit University.
Department of pathology, Assuit Faculty of Medicine, Assuit University.
Background:Hepatic pruritus is a very common symptom among different chronic liver diseases, particularly in those related to cholestasis. Its prevalence is variable among liver diseases, ranging from 5% in chronic hepatitis C virus infection to 70% in primary biliary cirrhosis. Its etiopathogenesis remains poorly understood.Nerve growth factor (NGF) is a member of neurotrophins. many studies clearly demonstrate their role in pruritus. Nerve growth factor (NGF) is overexpressed in prurigonodularis and its therapeutic administration is pruritogenic. In atopic dermatitis, NGF is released by keratinocytes, mast cells and fibroblasts and plasma levels of NGF are also elevated and correlate with disease activity.This study examines the hypothesis that expression of NGF protein is altered in cirrhotic patients with pruritus. Patients and Methods: To test our hypothesis, we examined the expression patterns of NGF protein in cirrhotic patients with pruritus, cirrhotic patients without pruritus and corresponding healthy (control). skin biopsies (20 specimens each) were evaluated using immunoperoxidase staining techniques. Results: We found variations between the skins of cirrhotic patients with and without pruritus and healthy skin. In healthy skin, the expression of NGF protein was strong (basal cell keratinocytes), moderate (spinouslayer), and weak or abscent (granular cell layer). In contrast, marked expression of NGF protein was observed in all layers of skin (total NGF epidermis and dermis) incirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control and this was statistically significant. NGF protein expression was strong (basal cell keratinocytes), moderate (spinous layer), and weak or abscent (granular cell layer). The expression of NGF protein was strong in the adnexal structures. Conclusions: We report, for the first time, increased expression of NGF protein in the epidermal keratinocytes of cirrhotic patients with pruritus skin. Our findings suggest possible roles for this protienin pathophysiology of hepatic pruritus. The clinical ramifications of these observations mandate further investigations.
https://smj.journals.ekb.eg/article_42251_fe116eb3b70a0cd3c5fe26915e705197.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
415
420
10.21608/smj.2018.42518
42518
Original Article
Gut microbiome in chronic kidney disease
Noher Abass
nahirmohamed@med.sohag.edu.eg
1
Department of Internal Medicine, Sohag Faculty of Medicine, Sohag University.
https://smj.journals.ekb.eg/article_42518_b99dc76e0f8a486f978232d8936a6abe.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
423
429
10.21608/smj.2018.42519
42519
Original Article
Study of Pulmonary Hypertension in Hemodialysis patients in Sohag University Hospital
Lotfy Abo Dahab
loutfy_abodahab@med.sohag.edu.eg
1
Ahmed Boghdady
ahmed_boghdady@med.sohag.edu.eg
2
Nayel Zaki
nail_elsaghier@med.sohag.edu.eg
3
Noher Abass
nahirmohamed@med.sohag.edu.eg
4
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal Medicine, Faculty of Medicine, Sohag University.
Department of Internal Medicine, Sohag Faculty of Medicine, Sohag University.
https://smj.journals.ekb.eg/article_42519_88372dc5ac53e1833f2b20041083daac.pdf
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
431
438
10.21608/smj.2018.42520
42520
Original Article
Review on Collection , Preservation and Fowarding of Biological Samples for Toxicological Analysis
Maha Hilal
maha_abdelaziz@med.sohag.edu.eg
1
Essam Abdullah
essam_abdallah@med.sohag.edu.eg
2
Reda El Sayed
reda_abdelrasowl@med.sohag.edu.eg
3
Hend Salman
hend-mohamed@med.sohag.edu.eg
4
Department of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Sohag, University.
Lecturer of Forensic Medicine & Clinical Toxicoogy, Faculty of Medicine - Sohag University.
Department of, Forensic Medicine & Clinical Toxicology Faculty of Medicine, Sohag University, Egypt.
Demonstrator in the Department of Forensic Medicine & Clinical Toxicoogy, Faculty of Medicine - Sohag University.
Forensic Toxicology is the study and practice of the application of toxicology to the purposes of the law. The relevance of any finding is determined, in the first instance, by the nature and integrity of the specimen(s) submitted for analysis. This means that there are several specific challenges to select and collect specimens for ante-mortem
and post-mortem toxicology investigation. Post-mortem specimens may be numerous and can endow some special difficulties compared to clinical specimens, namely those resulting from autolytic and putrefactive changes. Storage stability is also an important issue to be considered during the pre-analytic phase, since its consideration should facilitate the assessment of sample quality and the analytical result obtained from that sample. The knowledge on degradation mechanisms and methods to increase storage stability may enable the forensic toxicologist to circumvent possible difficulties. Therefore, advantages and limitations of specimen preservation procedures are thoroughly discussed in this review. Presently, harmonized protocols for sampling in suspected intoxications would have obvious utility. In the present review an overview is given on sampling procedures for routinely collected specimens as well as on alternative specimens that may provide additional information on the route and timing of exposure to a specific xenobiotic. Last, but not least, how to forward a correct report and how to interpret a toxicological results is provided. This comprehensive review article is intented as a significant help for forensic toxicologists to accomplish their frequently overwhelming mission.
https://smj.journals.ekb.eg/article_42520_ad2abd4b3401991089c172c5604e19f1.pdf
sampling
collection
Preservation
toxicological analysis
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
439
444
10.21608/smj.2018.42525
42525
Original Article
Evaluation of cardiac function in patients with thalassemia intermedia: A prospective hospital based study
Alzahraa Ahmed
elzahraa_sharaf@med.sohag.edu.eg
1
Safaa Ali
safaa_ahmed@med.sohag.edu.eg
2
Walaa Madkoor
3
Department of Pediatric haematology Unit, Pediatric Department,Faculty of Medicine, Sohag University, Sohag, Egypt.
Department of Pediatric , Faculty of Medicine,Sohag University, Sohag, Egypt.
Department of Pediatric ,Faculty of Medicine, Sohag University, Sohag Egypt.
Background:B-Thalassemia is an inherited hemoglobin disorder caused by impaired synthesis of the b-globin chain and resulting in chronic hemolytic anemia.In the absence of regular treatment of thalassemia intermedia patients the diastolic performance of the left ventricle is maintained stable, while the pressure of pulmonary arteries continues to rise which is the main cause of death in these patients. 2D, M mode echocardiographyand tissueDopplerare method for evaluating the cardiac function in patients with thalassemia intermedia. Objective: Our main objective in this study is to evaluate the cardiac function in patients with thalassemia intermedia by 2D, M mode echocardiography and Doppler methods. Methods: This case-control study was conducted on 46 thalassemic patients (mean age: 9.7 ± 4.6years) and 46 healthy individuals (mean age: 10.3 ± 4.1 years) as a control group from October 2016 toSeptember 2017 in the Pediatric haematology Clinics and inpatients of Pediatric Department.There was no sign of cardiac involvement by physical examination, chest x-ray and ECG in patients. Echocardiographic parameters were measured in groups, and finally data was analyzed by SPSS software. Results:The mean of left ventricular myocardial performance index (LMPI) ((P- value<0.001) and left ventricular mass index (LVMI) ((P- value<0.001) have statistically significant differencebetween two groups. Mean of interventricular septal dimension in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD) and interventricular septal dimension in systole (IVSS) were also statistically significant with a P-value of, <0.001, 0.042, 0.05). Conclusion: the systolic and diastolic performance of thalassemia intermedia patients is affected earlier in comparison with control group in some parameters including LVMPI, EF, FS, IVSD, IVSS, LVPWDD and RVMPI. For more evaluation, more quantitative and comprehensive research suggested by evaluation of specific effective factors to psychosocial health of these patients. Study Limitation * Age group: we conduct only the pediatric age group thalassemia intermedia, and as we know the most of complication appear in older age * Number of patient: we conduct only46 patient in our study. *Lack of material potential: availability of other facilities like T* and MRI as echocardiography is not able to replace them even echocardiographic abnormalities are found.
https://smj.journals.ekb.eg/article_42525_5d882dc5bb636b5dceefbb41cf213bbc.pdf
thalassemia intermedia in children
Complications of TI
cardiac function
echocardiography and Dopplerstudies
eng
Sohag University; Faculty of Medicine
Sohag Medical Journal
1687-8353
2682-4159
2018-01-01
22
1
447
452
10.21608/smj.2018.42529
42529
Original Article
Histopathological evaluation of skin in cirrhotic patients with pruritus
ESSAMELDIN NADA
essameldin_nada@med.sohag.edu.eg
1
Hanan Assaf
hanan_asaf@med.sohag.edu.eg
2
Reham El Sharkawy
reham_elsharkawy@med.sohag.edu.eg
3
Amr Zaghloul
amr_hashem@med.sohag.edu.eg
4
Marwa Abd El Meged
marwamohamed@med.sohag.edu.eg
5
Mahmoud Abd El Wahed
6
Asmaa Ahmed
7
DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university.
Department of Dermatology, Venereology and Andrology, Sohag Faculty of Medicine, Sohag University.
Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.
Department of Dermatology, Venereology and Andrology, Sohag Faculty of Medicine, Sohag University.
Department of pathology, Assuit Faculty of Medicine, Assuit University.
Department of pathology, Assuit Faculty of Medicine, Assuit University.
Background: Cirrhosis often is a silent disease Clinical symptoms at presentation may include jaundice of the eyes or skin, pruritus, gastrointestinal bleeding, coagulopathy, increasing abdominal girth, and mental status changes. Pruritus may be the presenting symptom, arising years before any other classic clinical and laboratory markers of hepatic dysfunction. This study examines the clinical, laboratory and histopathological changes in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control skins . Patients and Methods: To evaluate clinical, laboratory and histopathological changes in cirrhotic patients with pruritus, cirrhotic patients without pruritus and corresponding healthy (control). skin biopsies (20 specimens each) using hematoxylin and eosin stain and to study mast cell density using gimesa stain. Results: In the skin biopsy specimens of the cirrhotic patients with pruritus we found several histological changes including: epidermal hyperplasia (acanthosis) ,vascular ectasia(dilated dermal blood vessels), hypertrophied dermal nerve endings, mixed inflammatory cellular infilterate and lymphocytic vasculopathy (swelling of the endothelial cell lining of the blood vessels without fibrinoid necrosis, leucocytoclasia or extravasation of red blood cells). Evaluation of mast cell count in Gimesa stained skin sections revealed an increased numbers of these cells in the group of cirrhotic patients with pruritus ( N=5-10). The cells noted in perivascular, perineural and interstitial distribution (between collagen bundles). Conclusions: We report, for the first time, some histopathologial changes in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control skins .
https://smj.journals.ekb.eg/article_42529_fa33077822e6f05ca719099bdc318829.pdf