Sohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Variations of The Coronary Arteries in The Population of Sohag Governorate178079410.21608/smj.2020.80794ENJournal Article20200102<span>Background: The coronary arteries differ greatly in their number, origin and its course. According to that the dominance of the coronaries were found to be either “right dominance” in case of the posterior interventricular artery arising from right coronary artery, Whereas “left dominance” if the posterior interventricular artery comes from the left coronary artery. “Co-dominance” occurs when both the right coronary artery and the left circumflex artery gives a posterior interventicular artery. Many other variations are widely studied and their importance varies greatly according to their clinical consequences especially when they become manifested. Also, a well-known study of each case differs greatly in the decisions taken by cardiologists before any invasive procedure. The</span><br /><span>aim of this research is to study some variations of the coronary arteries and some other anatomic variants in the population of Sohag governorate.</span><br /><span>Variations in coronary arteries may be due to : sex, age, conducting system of the heart, gene, race, geography, climate, nutrition.</span>Sohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Behavioral Evaluation of rotenone model of Parkinson’s disease in male Wistar rats8148101210.21608/smj.2020.21596.1089ENDina MonirHegabMedical Physiology department, Sohag Faculty of Medicine, Sohag universityOmyma GalalAhmedDepartment of physiology, Faculty of medicine, Assuit University, Assuit, EgyptMotamedMahmoudDepartment of Animal Behavior and Husbandry, Faculty of Veterinary Medicine, Sohag, University, Sohag, EgyptAmany AbderahmanAbdelhamidphysiology department, faculty of medicine, Sohag universityJournal Article20200115Introduction: Parkinson’s disease (PD) is a prevalent neurodegenerative disorder in elderly people. The condition is associated with damage to the dopaminergic neurons in the substantia nigra pars compacta, a great decrement of dopamine neurotransmitter in the striatum, and a deficiency of tyrosine hydroxylase; the rate-determining enzyme during dopamine formation. In rats, rotenone has been administered to induce a syndrome that mimics the behavioral and pathophysiological finding of Parkinson's disease.<br />Aim of the work: To evaluate the behavioral aspects of PD in rotenone-treated Wistar rats.<br />Materials and Methods: Rotenone at 2 mg/kg was injected subcutaneously to male adult Wistar rats in the rotenone-treated group once a day for 4 weeks for induction of PD. Open Field test, object recognition test, Rota-rod test, footprint test and forced swim test were performed at the end of induction. Tyrosine hydroxylase levels in the brain were measured.<br />Results: Our data showed deteriorated behavioral aspects after rotenone treatment, with a decrease in exploration and locomotion, impaired motor coordination, asymmetrical impaired gait, increased depressive-like behaviors, reduction in short-term memory and reduction in tyrosine hydroxylase levels. <br />Conclusion: in this study, rotenone subcutaneously at a dose of 2 mg/kg daily for 4 weeks, in adult male Wistar rats, caused the appearance of the motor and the non-motor features of PD with a marked drop-off tyrosine hydroxylase levels in the striatum.https://smj.journals.ekb.eg/article_81012_8fcc77de2875b5ac1f308eb6aba2ac75.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Liver Involvement in COVID-19 infected patients15199483410.21608/smj.2020.27882.1142ENMona MohammedAbd El Rhmantropical medicine and gastroentrology, faculty of medicine, sohag universityNoha SaberShafikMedical microbiology , Faculty of Medicine, Sohag University, EgyptAmiraMaherTropical medicine and gastroenterology, faculty of medicine, sohag university, sohag, egyptShimaa BadawyHemdanLecturer at Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityReem MahmoudAbd ElhamidDepartment of Tropical Medicine & Gastroenterology, Sohag Faculty of Medicine, Sohag UniversityJournal Article20200413Coronavirus outbreak in December 2019 was reported in the city of Wuhan, China firstly named 2019 novel coronavirus (2019-nCoV). Later on, the World Health Organization (WHO) declared another name for this disease which is Corona Virus Disease (COVID-19). On the eleventh of March, 2020, WHO considered the disease as a pandemic. Person-to-person transmission has been reported either through droplet transmission or direct contact. The affected individuals complain from mild symptoms to severe acute respiratory syndrome (ARDS). <br />With the increasing number of COVID-19 infected patients, several studies reported that the liver is the most frequently affected organ after lung damage. Elevation of transaminases was frequently reported in patients with severe disease and patients admitted to ICU. The mechanism of hepatic injury in COVID-19 not completely understood. Multiple factors have been accused including direct invasion of the hepatocyte by SARS-CoV-2, high level of inflammatory mediators, drug-induced hepatic injury, and or concomitant chronic liver diseases. So, evaluation of the mechanism of hepatic injuries in COVID-19 infection is needed.https://smj.journals.ekb.eg/article_94834_5d4fe62488824dc48c309dd420d21f37.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Immune Checkpoint Inhibitors in Hepatocellular Carcinoma: A New Era in Treatment of Advanced Disease202610307610.21608/smj.2020.21206.1084ENAhmedAbudeifDepartment of Tropical Medicine and Gastroenterology0000-0001-8732-3520Journal Article20200103Hepatocellular carcinoma (HCC) is the most prevalent primary hepatic cancer with high fatality and recurrence rates. The prognosis of advanced HCC is dismal, and treatment was limited for a decade to sorafenib with limited effectiveness and miserable overall survival. The advent of immune checkpoint inhibitors (ICPIs) provides a considerable step in the treatment of several advanced malignancies including HCC and opens new horizons for this group of patients. Two drugs belonging to ICPIs, namely nivolumab and pembrolizumab, have now been licensed by the US FDA as a second-line treatment of patients who have progressed or have not responded to sorafenib, both are inhibitors of programmed cell death protein 1 (PD-1). Possible synergism of ICPIs, when used in conjunction with drugs active against other checkpoint molecules, targeted drugs, and locoregional modalities, is now investigated in several clinical trials. The current challenge is to evolve predictive biomarkers of tumor response to appropriately select patients who may respond well to ICPIs.https://smj.journals.ekb.eg/article_103076_caa598707121869bc3c788879e553e1e.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Robotic in the field of kidney Transplant Surgery273210308010.21608/smj.2020.21878.1092ENAhmed Mahmoud MohammedAhmed ElsheriefUrology department, faculty of medicine, Sohag University,Sohag, EgyptAtef JalalAbdelwahabdepartment of urology,
Faculty of medicine,
Sohage University,
Sohag,
EgyptAhmed RashedHammadyUrology department, faculty of medicine, Sohag University,Sohag, EgyptAhmed MamdouhSharkawyurology department,sohag faculty of medicine ,sohag,egyptNasreldin AbdelaalMohammedUrology Department, Faculty of Medicine, Assuit University,Assuit , EgyptJournal Article20200117Currently, minimally invasive surgical treatment has ended up the usual approach in an extensive style of interventions.<br />Robotic surgical treatment is an emerging field specifically, in a laparoscopic surgical operation. Many agencies have manufactured robotic structures with different skills and fee tags.<br />With robotic systems as the da Vinci Surgical System (daVSS), the power of organ transplantation is carried out with minimally invasive fashion.<br />Da Vinci device received its recognition from its advantages, within the factor of the most effective ergonomic surroundings for the operator, and a 3D vision that restores the hand-eye coordination misplaced in the laparoscopic approach.<br />Within the kidney transplant area, the robotic-assisted surgery applied in donor nephrectomy and recipient kidney transplants.<br />Every other use for the robotic within the field of kidney transplantation, that it's been described in recipients for the remedy of complications related to surgery, and radical prostatectomy in kidney transplant recipients with higher effectshttps://smj.journals.ekb.eg/article_103080_e61eee3bdbabb90420bd7648b288754a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Prognostic value of central venous oxygen saturation during anesthesia for cardiac surgery.333910944010.21608/smj.2020.21279.1086ENMarwa AhmadMahrousanesthesia and intensive care department, sohag faculty of medicine, sohag university, sohag, EgyptKhaled MohamedHassananesthesia and intensive care department, sohag faculty of medicine, sohag universityAbdelrahman HassanAbdelrahmanDepartment, of Anesthesia &amp; Intensive Care, Fuculty of Medicine, Sohag University.Abd El Hady AhmedHelmyDepartment, of Anesthesia and intensive care, Fuclty of Medicine, Sohag University.Journal Article20200113Background:<br />During cardiac surgery, CPB machine pumps blood instead of the heart affecting blood flow and hence blood perfusion of all tissues. One important marker of blood perfusion is central venous oxygen saturation. Relationship between central venous oxygen saturation and patient morbidity and mortality is an indicator for the reliability of blood lactate as a perfusion marker.<br />Methods:<br />In a prospective observational study, 66 patients admitted to Sohag university hospital and Sohag Heart Institute in the period between October 2017 and April 2019 for open cardiac surgery were enrolled. Immediately after induction of anesthesia, the first sample of venous blood gas was obtained from central venous catheter. For measuring of central venous oxygen saturation, the next samples were obtained just before CPB weaning, the next after 24 hours of staying ICU and the last sample were obtained after 48 hours of staying ICU.<br />Results:<br />Central venous oxygen saturation in correlation to ICU length of stay showed significant change in central venous oxygen saturation in patients with favorable outcome. Central venous oxygen saturation in correlation to postoperative duration of mechanical ventilation showed significant change in central venous oxygen saturation in patients with favorable outcome. Central venous oxygen saturation in correlation to postoperative complications showed significant change in central venous oxygen saturation in patients with favorable outcome.<br />Conclusion: Measuring ScvO2 at 4 points during and after open-heart surgery showed their prognostic value, regarding results for ScvO2: ICU length of stay, duration of mechanical ventilation and complications.https://smj.journals.ekb.eg/article_109440_971d84c3ad399665bfdc4b8e2bf5a523.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Coronavirus disease (COVID-19) in hepatic patients40459483910.21608/smj.2020.28077.1145ENReem MahmoudAbd El Hamedtropical medicine, faculty of medicine, sohag university, sohag, egyptGhada MoustafaGalalDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Nagwa SayedAhmedMedical Biochemistry, Faculty of Medicine, Sohag UniversityMahmoud Saif-Al-IslamAbd-El-FatahDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University0000-0003-3311-3354Mona MohammedAbd El Rhmantropical medicine and gastroentrology, faculty of medicine, sohag universityJournal Article20200416Abstract<br />A new coronavirus (severe acute respiratory syndrome) (SARS-CoV-2) epidemic initially began in Wuhan, China, in December 2019, which became an international harm to public life. Globally the count of reported patients of COVID-19 (SARS-CoV-2) from 31st December 2019 to 14th April 2020 has achieved 1 873 265 cases, which include 118 854 fatalities. Many of the COVID-19 cases seem to be mild and rapidly improved, however, the infection can be terminal, with an incidence of deaths about 3 percent. Pulmonary disease was found to be the main injury done via the coronavirus two disease (SARS-CoV-2). Furthermore, hepatic damage was documented to exist in extremely ill patients. Likewise, multiple pieces of research found that hepatic injury became widespread in cases diagnosed with another two more serious coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) and correlated to the intensity and poor outcome of the infection.https://smj.journals.ekb.eg/article_94839_2946d3d0aa416a683589bba3310cdaa5.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401New corona virus and pregnancy; What should obstetricians know?46519482610.21608/smj.2020.29130.1158ENAhmed AbdelrahemAhmed Tahaobstetric and gynecology departement,
sohag faculty of medicineHatem AboelftoohAwagaDepartment of Obstetrics and Gynecology, Faculty of medicine, Sohag University, Egypt.0000-0001-5700-4385Marwa ZanatyElsayedInternal medicine department haematology unit Sohag university hospital EgyptSara KasemAbdelaalinternal medicine department.faculty of medicine.sohag university hospitalSalah RoshdyR.AhmedDepartment of Obstetrics and Gynecology.Sohag Faculty of medicine.Sohag University0000-0002-3762-8665Journal Article20200502COVID-19, the disease caused by a new coronavirus, has quickly raised the world concern by spreading globally at an accelerated rate and is now a pandemic, according to the World Health Organization. But limited data are available for pregnant women with COVID-19 infection. <br />The pregnant women present a unique challenge during the COVID-19 pandemic and several questions remain about pregnant women and their newborns. whether they will develop distinct symptoms from non-pregnant adults and whether COVID-19 could spread vertically pose risks to the fetus and neonate. Information on adverse pregnancy outcomes in pregnant women with COVID-19 is lacking. Previous reports on pregnant women with SARS and MERS show higher case fatality rate, while, COVID-19 appears less-lethal Compared with SARS and MERS,<br />In this study we aim to highlight COVID-19 infection during pregnancy, bringing together the various factors integral to the understanding of clinical manifestations, diagnostic challenge and susceptibleness with the virus, intrauterine infection and maternal-fetal complications, therapeutic controversies,https://smj.journals.ekb.eg/article_94826_b713d34e5e7173637e0b45528d0d2106.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Histological Differences in Naiive Chronic Hepatitis B Patients with Normal and Elevated ALT525710944810.21608/smj.2020.19197.1070ENEl-Zahraa MohammedMeghezelTropical Medicine and Gastroenterology, Faculty of Medicine, Sohag UniversityAmiraMaherTropical medicine and gastroenterology, faculty of medicine, sohag university, sohag, egyptNagwa SayedAhmedMedical Biochemistry, Faculty of Medicine, Sohag UniversityGhada MoustafaGalalDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Journal Article20191109Abstract<br />Background and aims: HBV infection is a significant public health issue all over the world. Egypt shows marked variations of HBV prevalence by age, gender, and geographical distribution. Treatment guidelines for CHB are based on serum ALT, together with HBV viral load and liver inflammation or fibrosis. Our study aimed to compare histological findings between CHB patients with ALT levels >ULN and patients with normal levels.<br />Methods: Twenty-nine CHB adult Egyptian patients were included in our cross-sectional study. Liver biopsy was performed for all patients to detect fibrosis stage and inflammation grade using the METAVIR score, which was used to divide patients into two groups: patients with mild to moderate fibrosis (F0-1-2) and patients with advanced fibrosis (F3-4). Patients were also categorized into patients with ALT normal ALT; and Patients with ALT values > ULN.<br />Results: We found that moderate to severe inflammation was detected in 56.7% of cases with normal ALT compared to 28% of cases with raised ALT (P = 0.015). Advanced fibrosis was detected in 10.44% of cases with normal ALT and 20% of cases with raised ALT without a statistically significant difference between both groups.<br />Conclusions: Liver injury is present in a considerable proportion of patients with normal and those with mild ALT rise, so, these cases need careful evaluation in order not to miss a treatment indication.https://smj.journals.ekb.eg/article_109448_ba0d4cf43952eb04afb2c4a513be8ab1.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Effect of Calcium Supplementation in Glucocorticoid-Induced Osteoporosis586210308410.21608/smj.2020.25201.1112ENRasha AbdeenRefaiePhysiology department, Faculty of medicine, Sohag University, Sohag EgyptHoda MostafaAhmedDepartment of Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt.Aida AbdeenMahmoudDepartment of Biochemistry, Faculty of Medicine, Sohag UniversityMahmoud RaafatAbdel FadeelDepartment of Physiology, Faculty of Medicine, Assiut UniversityJournal Article20200304The commonest secondary cause of osteoporosis is Glucocorticoid-induced osteoporosis (GIO) which is also the commonest cause of iatrogenic osteoporosis. Chronic glucocorticoids (GCs) treatment may cause fractures in 30-50% of patients. Fracture risk is increased among those using oral glucocorticoids. On long-term glucocorticoids therapy, deterioration of cortical bone progressively detected and long bones became increasingly fragile. Any patient with chronic glucocorticoids therapy should be expected as suffering from GIO. Patients on glucocorticoids should receive supplementation with calcium. These deleterious influences are the result of suppression of bone formation that occurs with an early but temporal rise in the process of bone resorption. Numbers of osteoclast also rapidly rise, and accompanied by inactivation of osteoblast and decline of bone formation, these changes cause the fastest bone loss during the initial phase disease. Glucocorticoids cause inhibition of osteoblasts replication and function and accelerate their apoptosis. Calcium is fundamental for bone, and assuring sufficient calcium intake is important. It is said that when children and adolescents ingest large amount of calcium could result in a decrease in the danger of developing osteoporosis when they got old, however, some researches propose that solitary use of calcium supplementation might not be enough for lowering the danger for fracture. Conflicting results were reported about the effects of the use of supplemental calcium on the bone mineral content in those taking glucocorticoids therapy. Whereas, calcium supplementations were used in most bone protective treatment trials and therefore should be used as an adjunct to GIO therapy.https://smj.journals.ekb.eg/article_103084_753270af44468909e944a521e3e0b23d.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200616Recommendations for oncological surgical practice in COVID-19 pandemics: a review of literature636810289510.21608/smj.2020.32022.1164ENEmad AliAhmedSurgery department, Faculty of Medicine, Sohag University, Egypt0000-0003-4384-0934Journal Article20200607While the whole world is gaining more and more achievements and progression in several fields, a corona pandemic comes to brake this progress and find us lacking many crucial points. One of these points is to have an emergency protocol for performing different types of surgery in such pandemic states. This led to floundering in surgical decisions for many patients. This review summarizes some recommendations for performing surgeries, especially oncological surgery in the corona pandemic. As a general protection measure, all surgical patients and medical staff must complete preoperative screening whatever symptomatic or not. The medical staff should comply with the regulations of the health facilities to decrease the viral transmission between the medical staff themselves and their patients. Moreover, correct protective apparel (goggles, visor, mask, and protective bodysuit) must be routine. When dealing with a suspected case or a diagnosed patient, tertiary dress code, increasing the operative room ventilation, and installing air purification equipment should be applied. In conclusion, elective surgeries are recommended to be discontinued to avoid patients' and health professionals' morbidity and mortality. Emergency and oncological surgeries to be performed with extreme precautions.https://smj.journals.ekb.eg/article_102895_583bcace899f7441fbe05fa6a1fa62d1.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401An overview of Immunopathogenesis towards COVID-19 infection697510309110.21608/smj.2020.28056.1144ENNoha SaberShafikMedical microbiology , Faculty of Medicine, Sohag University, EgyptMona MohammedAbd El Rhmantropical medicine and gastroentrology, faculty of medicine, sohag universityJournal Article20200420Patients complaining from cough, fever, dyspnea, and severe pneumonia were recorded in Wuhan, China in late December 2019 due to an unkown microbial agent. Virus genome sequencing of the examined patients during this period confirmed the presence of β- CoV strain. This extracted new β-CoV exhibits 88 percent similarity to the series of 2 severe bat-derived acute respiratory syndromes (SARS)-like corona viruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, and about 50 percent identical to the MERS-CoV series. Later, the International Commission for Virus Classification called the novel β-CoV "SARS-CoV-2." On the eleventh of February 2020, the World Health Organization (WHO) reported another name for the disease caused by the 2019-n CoV: which is Corona Virus Disease (COVID-19). Several complex immune system mechanisms exist against the newly discovered COVID-19. Communication has undergone between different branches of the immune system, but the exact mechanism remained unclear until now. This study helps to clarify COVID-19 molecular immune pathogenesis.https://smj.journals.ekb.eg/article_103091_3f81fda73c8b149aa0eb51a810357ff7.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Hepatocellular carcinoma care during The Coronavirus disease (COVID-19) era768110306810.21608/smj.2020.28553.1150ENAliAbdel AzizTropical medicine and Gastroenterology department, Sohag Faculty of MedicineHammam Abo ElalaminEl SaidDepartment of Tropical Medicine and Gastroenterology, Faculty of
Medicine, Sohag UniversityKhairy HammamMorsyDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Ghada MoustafaGalalDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Journal Article20200429The coronavirus pandemic (COVID-19) is now a great universal health problem and the biggest threat we have compete since World War Two. Since its emergence in china late last year, this virus has reached to all world continents except Antarctica. Cases in Europe, the Americas and Africa are growing regularly. COVID-19 pandemic is spreading like a wave-one that may yet crash on those least able to face. although COVID-19 is much more than just a health issue. All medical communities are facing a lot of challenges either in the prevention or in the treatment of this infection.COVID-19 is a hazardous infection especially in cancer patients that need a more immediate priority in obtaining medical care. Hepatocellular carcinoma (HCC) is the world's sixth most common malignant tumor and the fourth common malignant tumor in Egypt, also, Egypt is the third and fifteenth most crowded region in Africa and globally. This review aims to highlight the best measures that reduce the risk of deterioration in liver cancer patients leading to the best outcome in facing the COVID-19 pandemic.https://smj.journals.ekb.eg/article_103068_585b58277a7d6f4997680ce4ba8e582a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401The Outcome of supine versus prone percutaneous nephrolithotomy in multiple renal stones Author: - Emad Abdellah. prof Dr Abd Elmoneim Abou zeid. prof Dr Ahmed Hammadi. Assit prof Hazem Elmoghazy828910307010.21608/smj.2020.30670.1160ENEmad AbdellahMostafaUrology , faculty of medicine ,sohag university,egyptAbdelmoneem MohamedAbouzeidUrology department,Sohag faculty of medicine,Sohag university ,Sohag,EgyptAhmed RashedHammadyUrology department, faculty of medicine, Sohag University,Sohag, EgyptHazem MohamedElmoghazyUrology department,Sohag faculty of medicine,Sohag university,Sohag,EgyptJournal Article20200625ABSTRACT:- <br />Purpose: <br />To differentiate the outcomes of percutaneous nephrolithotomy (PCNL) discharged in the prone posture versus the supine posture in multiple renal stones.<br />Materials and Methods:-<br />Comparative prospective randomized study of 30 cases divided into two sectors sector A included 15 cases in the supine posture and sector B included 15 cases in the prone posture. The outcomes of a period of exposure to radiation, renal stone-free rate, body mass index (BMI), size of the stone, period of operation, hold up in the hospital, and complications were compared.<br />Results:-<br />There were no differences in age, gender, site of stone, body mass index, size of the stone, and the presence of hydronephrosis between the two sectors. The supine sector had a little mean surgical period (93 minutes vs. 123 minutes, phttps://smj.journals.ekb.eg/article_103070_001e4938658bce60f6717d345551ee73.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Effect of pre and postnatal administration of pregabalin on the granule cells of the cerebellar cortex of albino rats (An Electron microscopic study)909510307310.21608/smj.2020.25308.1113ENZahra MohamedIsmaelAnatomy department faculty of medicin sohag university sohag egyptMostafa Abd_ElkhalikAbdellahGyna and obestetric,sohag university,sohag,sohagSalwa M.OuiesAnatomy department,sohag university,sohag,sohagJournal Article20200314ABSTRACT<br />Introduction: the cerebellum organogenesis in the mammals takes place along period of the development from the embryogenesis to the postnatal time to reach the mature form morphologically and physiologically, therefore these stages are very critical to the growth of the cerebellum. <br />Pregabalin is an oral medication that used to treat neuropathic pain, fibromyalgia and partial seizures <br />Aim of the work: The present study was carried out to study the effect of low and high therapeutic dose of pregabalin administration in pre and postnatal periods on granule cells of the cerebellar cortex of albino rats. <br />Subjects and methods: Atotal of 15 offspring's 15 pregnant female albino rats were subdivided into three groups: Group A: Includes offspring's of 5 control mothers received distelled water, Group B: Includes offspring's of 5 mothers treated with pregabalin at dose of 150mg/kg, Group C: includes offspring of 5 mothers treated with pregabalin at dose of 600mg/kg, the offsprings are scarified at 2.5 months, Cerebellar specimen were processed for transmission electron microscopic assessment.<br />Results: ultrastructure studies of granule cells in group B were altered than control group, the cytoplasmic membrane was ill-defined , vacuoles were presented, the nucleus showed disturbed chromatin. <br />Ultra structural studies of granule cells in group C showed shrunken granule cells, ill-defined cytoplasmic membrane, destructed and organelles, marked cytoplasmic vacuoles, the nucleus showed heterochromatic chromatin.<br />Conclusion: pre and postnatal administration of pregabalin in low and high doses proved distortions of cerebellar cortical cells that may effect on the physiological functions of the cerebellum.https://smj.journals.ekb.eg/article_103073_9d9178082e1c581008057dcbafef5c76.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Ankle Joint in Active Rheumatoid Arthritis961018724310.21608/smj.2020.16564.1059ENDoaaMohammedRheumatology and rehabilitation dept.faculty of medicine.sohag.egyptZeinab MMahmoudDepartment of clinical and chemical pathology, Sohag Faculty of Medicine, Sohag University.AhmedElsamanRheumatology and rehabilitation dept.faculty of medicine.sohag.egyptJournal Article20200218Background: Ultrasonography (US) is a useful tool for imaging, which can be used for assessment of joints and per articular structures in all rheumatologic disorders. Ankle and foot sonography requires a linear high-frequency transducer; a 7.5 to 15 MHz probe is commonly used. The aim of this study was to evaluate ankle joint affection in active Rheumatoid arthritis and its value in assessment of disease activity by using US, and its correlation to disease duration, sex and age.<br /><br />Methods: A total of 63 patients with Rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria. 20 age and sex matched control volunteers were included. Evaluation of disease activirty by DAS-28. US examination of both ankles were done for patients and controls. High frequency US with 12 MHZ linear probe was used.<br /><br />Results: Our results show that ankle synovitis was found significantly higher among RA patients (18.3%) compared to controls (2.5%); p value = 0.013. although tenosynovitis and erosions were higher among cases (27% and 8.7%; respectively) than controls (15% and 0%; respectively); the differences were non-significant. We found that ankle affection as seen by US was significantly related to the activity of RA. Patients with higher DAS-28 score were more like to have ankle affection and also to have bilateral ankle affection; both with significant differences.<br /><br />Conclusion: It can be stated that ankle evaluation by US should be considered more in RA assessment, and further studies should be done to uncover the under-etsimation of ankle involvement in RA patients.<br /><br /><br /><br /><br /> https://smj.journals.ekb.eg/article_87243_3c27017f6bba84377430a5287614ea5a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Have the malaria eradication measures been behind the COVID-19 pandemic?10210610287710.21608/smj.2020.26898.1121ENHassan MohammedElnadyDepartment of Neurology and Psychological medicine, Faculty of medicine, Sohage University, Sohag, Egypt0000-0002-1904-9248Journal Article20200330The world is now facing a pandemic of the novel Corona virus (COVID-19), medical experts are puzzled and searching for some explanation. It is the responsibility of all of us working in the medical field to observe, think, and ask to inspire those who are more specialized in dealing with this disaster. The story started on 31 December 2019, the World Health Organization (WHO) was alerted to the emergence of cases of pneumonia of unknown etiology detected in Wuhan city, China. Within days, Chinese health authorities identified 44 more cases. A novel coronavirus was subsequently isolated from patients. On 12 January 2020, the World Health Organization (WHO) temporarily named this new virus as the 2019 novel coronavirus (2019‐nCoV). On 30 January 2020, WHO announced the 2019‐nCoV epidemic a public health emergency of international concern. On 11 February 2020, the WHO formally named the disease triggered by 2019‐nCoV as coronavirus disease 2019 (COVID‐19).https://smj.journals.ekb.eg/article_102877_9102c2647435f3357231821580c04764.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Predictive Factors of Complications of PNL in Solitary Kidney: A Prospective Study.10711710310910.21608/smj.2020.33654.1169ENAhmed SabriMahmoudUrology department, Faculty of medicine, Sohag university, Sohag, Egypt0000-0002-8820-095XMohammed DyaaS.saleemurology department ,Sohag faculty of medicine,Sohag University,Sohag,EgyptMohammed SaberKhalafurology department,Sohag faculty of medicine,Sohag university,Sohag,EgyptElnisr RashidMohamedurology department,Sohag faculty of medicine,Sohag university,Sohag,EgyptJournal Article20200626Objectives: To analyze factors that can impact the intraoperative and postoperative complications and bleeding after percutaneous nephrolithotomy (PNL) in patients with a solitary kidney. <br />Material and Methods: A prospective hospital-based study that was carried out at the Urology Department, Sohag University Hospital from June 2017 to June 2019. All patients with renal calculi in a solitary kidney were recruited and underwent PNL. <br />Results: 150 patients were enrolled in this study. 93 (62%) patients were males while 57 (38%) patients were females. Initial SFR was achieved in 129 (86%) patients while residual fragments were reported in 21 (14%) patients. 39 (26%) patients had postoperative complications. On univariate analysis, the rate of complications was associated with the complexity of the stones, acute dilatation of the tract, and operative time (P-value = 0.048, 0.004 & 0.023 respectively). On the other hand; there was an association between the number of the accessed tracts and the rate of bleeding and blood transfusion (P-value = 0.008).<br />Conclusion: PNL in solitary kidneys is a challenging procedure; however high SFRs can be achieved with a low rate of significant complications. The complexity of the stones, acute dilatation of the tract, and prolonged operative time are associated with more complications. Multiple tracts have a significant effect on intraoperative bleeding. PNL should be considered by urologists as an effective therapeutic choice for patients presenting with large burden stone disease in a solitary kidney.https://smj.journals.ekb.eg/article_103109_7d54ee13e7c62842a550f11b906d0564.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Neuroprotective Effect of Combined Therapy of Liraglutide with Vitamin D on Streptozotocin-Induced Diabetic Neuropathy in Rats.11813610311710.21608/smj.2020.28543.1149ENHala MostafaElBadreMedical Biochemistry, Faculty of Medicine, Assuit UniversityMohamed MostafaElBadreDepartment of Medical Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt.Mohamed AhmedMostafaAnaesthesia, ICU and Pain Relief Department, South Egypt Cancer Institute, Assuit University, Egypt.Mona HassanSedeekDepartment of Physiology, Faculty of Medicine, Aswan University, Aswan, Egypt.Journal Article20200501ABSTRACT<br /><br />Background:<br />Liraglutide is an incretin mimetic agent that approved recently in type-2 diabetes. The use of vitamin D is associated with an improvement in diabetic neuropathy. <br />The aim of the study: <br />Evaluation of the effect of liraglutide and vitamin D each alone and in combination with each other on diabetic neuropathy induced by streptozotocin in rats. <br />Materials and Methods:<br />Five groups ofWistar rats were used in the experiment. Diabetic neuropathy was induced in groups 2, 3, 4, and 5 using a single intraperitoneal(i.p.) injection of streptozotocin(STZ) in a dose of 60 mg/kg. The third, fourth, and fifth groups were treated for 4 weeks with liraglutide (0.8 mg/kg), vitamin D3 (12 µg/kg), and combination of the 2 drugs, respectively. Then the behavioral tests were done (hot plate, tail-flick, paw withdrawal pressure, and the rotarod tests). Blood samples were used for assessment of blood glucose, tumor necrosis factor -α (TNF-α) and interleukin-Iβ(IL-Iβ). Malondialdehyde(MDA) and glutathione (GSH)were measured in the sciatic nerve homogenate. <br />Results:<br />Liraglutide caused significant improvement in the behavioral tests of the diabetic rats with a significant reduction in blood glucose, TNF-α, IL-1β, and malondialdehyde. Vitamin D caused mild improvement in the behavioral tests, inflammatory and oxidative stress markers. The combined use of liraglutide with vitamin D caused more improvement in diabetic neuropathy tests, inflammatory and oxidative stress markers. <br />Conclusion: <br />Liraglutide has a moderate neuroprotective, anti-inflammatory, and antioxidant effects in cases of streptozotocin-induced diabetic neuropathy which are enhanced by the addition of vitamin D.https://smj.journals.ekb.eg/article_103117_bd10384a8a8aa40131bdbedf06c52a23.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Study of the relation of Anti-Ro and Anti-La Antibodies with cardiac arrhythmia and other ECG abnormalities in Systemic Lupus Erythematosus13714610518810.21608/smj.2020.21905.1093ENMaha Salah El DINMohammedRheumatology and rehablitation department faculty of medicine , sohag universityHananAbozaidRheumatology and rehablitation department faculty of medicine sohag universitySaharEl SayedRheumatology and rehablitation department
faculty of medicine, sohag university0000-0001-8755-1750Journal Article20200123Introduction: Arrhythmias and conductive system disorders are among the cardiovascular aggravations brought about by Systemic lupus erythematosus. Anti-Ro/SSA and LA antibodies are often recognized in connective tissue disease patients as well as in apparently healthy people. <br />Aim of the work: Assess the role of Anti-Ro and Anti-La antibodies as hazard factors for arrhythmia in grown-up SLE patients.<br />Patients and Methods: Cross_ sectional clinical investigation. A sum of 70 SLE cases going to the outpatient and inpatient divisions of rheumatology, Sohag University Hospitals; remembered for investigations. All members will be exposed to the accompanying: Full history, General and local assessment, Routine examinations: complete blood picture, erythrocyte sedimentation rate, liver capacities, kidney capacities, ANA IF, Anti Ro and Anti La appraisal by Immunoblot measure and Electrocardiogram<br />Results: 13 (41.9%) of our patients who had positive anti_ RO and LA had strange ECG findings, while 18 (58.1%) of them had typical ECG, just oral/nasal ulcers and Anti _RO/LA were an independent risk factor for abnormal ECG. Disease duration was nonsignificant and positive corresponded with disease activity by SLEDAI score <br />Conclusion: This study exhibited that the grown-up heart may represent a goal for the anti_ Ro⁄SSA antibodies 'arrhythmogenicity. Notwithstanding, the particular rhythm changes happened appear to be, correlated with age, as shown by the way that while ventricular repolarization variations from the norm (specifically QTc prolongation) are the transcendent finding in the adults, the inclusion of conduction system is limited to the fetal heart only.https://smj.journals.ekb.eg/article_105188_eb7cab44617863fb6a4a37f0e5375a52.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Lung Ultrasound in Corona Pandemics: How Can Lung US Assist Early Diagnosis of COVID-19 Pneumonia? An Overview14715210495110.21608/smj.2020.27399.1127ENEnas KhalifaAbuzieddepartment of Chest diseases and Tuberculosis,Faculty of medicine,Sohag University Hospital,SohagAshrafEl AbidienDepartment of Chest diseases and Tuberculosis, Faculty of medicine, Assuit UniversityKhaledAlkhayatDepartment of Chest diseases and Tuberculosis, Faculty of medicine, Sohag UniversityHishamAbdelghanyRadiology department,faculty of medicine,Sohag universityHamdy AliMohammadienDepartments of Chest, Faculty of Medicine, Sohag UniversityJournal Article20200410Up-to-date review of the role of lung ultrasound (US) in early diagnosis of COVID-19 disease associated pneumonia, based on the recent publications at the 2019/2020 pandemic of nCoV-19. Further, highlighting the advantages of lung US over the other imaging modalities as regard early diagnosis, cost and potency of its use as a screening tool in pandemics. The COVID-19 tends to be bilateral with patchy pattern. More frequent in the posterior and inferior fields of the lung. This infiltration is usually irregular and extends to the pleural line. Diffuse B-lines are noticed with air bronchogram sign. Sometimes localized pleural thickening is seen or localized pleural effusion. Occasionally, impaired blood flow in the consolidation patch was detected.<br />In novel COVID-19 era lung US is a bedside, practical, safe and useful emergency tool for diagnosis. It is operator dependent and this drawback can be avoided by providing proper training.<br /><br />Keyword: Lung ultrasonography, COVID-19 Pneumonia and Corona virushttps://smj.journals.ekb.eg/article_104951_7e3f8e8a7fc09eb95ebd4c99053c3b69.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Thyroid function in children with nephrotic syndrome: A prospective hospital-based study15315710520610.21608/smj.2020.22976.1102ENMohamedAbd El-Aaldepartment of Pediatric , Faculty of Medicine, Sohag University, Sohag, Egypt.Ahmed MonirHegabpediatric department,faculty of medicine,sohag university ,sohagEman ElsayedMasoudpediatric departement, faculty of medicine ,sohag university,sohagJournal Article20200213Abstract<br /><br />Background. Nephrotic syndrome is a common kidney disease among children which is characterized by proteinuria, hypercholesterolemia, hypoproteinemia, and edema. The urinary losses of proteins including albumin and thyroid-binding globulin might affect the thyroid hormone levels in those children. <br />Objective. To assess the thyroid function in children with nephrotic syndrome during the nephrotic attack and after remission.<br />Methods. This was a prospective study conducted at the Pediatrics department, Sohag University Hospital, Sohag, Egypt over a one-year period (from January to December 2017). Data were collected from 51 children with nephrotic syndrome aged between 1 and 12 years old. The study participants were subjected to investigations including thyroid-stimulating hormone (TSH), thyroxin (T4), triiodothyronine (T3), serum urea, creatinine, cholesterol, triglycerides, albumin, total proteins, urinary albumin-to-creatinine ratio and 24 hours urinary proteins during the nephrotic attack and after remission.<br />Results. The mean age for the study participants was 6.1 ± 2.9 years. Thirty-one participants were males (60.8%). The study found that serum TSH levels were elevated while serum Total T3 and Total T4 were reduced during the nephrotic attack. As regards the thyroid hormone status, we found true hypothyroidism in 12 patients (23.52%) and subclinical hypothyroidism in 24 patients (47.06%) during the nephrotic attack. However, only one patient (1.96%) had true hypothyroidism and 14 patients (27.45%) had subclinical hypothyroidism after remission. Conclusion. A large proportion of children with nephrotic syndrome had thyroid dysfunction in the form of either true (overt) or subclinical hypothyroidism. Therefore, monitoring the thyroid function in those children is important.https://smj.journals.ekb.eg/article_105206_7e0fc75f8aef5b4f8fbbfc8d52df5e9a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Mastoid abscess as a Presenting Complaint of Kostmann syndrome in childhood.1581627242010.21608/smj.2020.20958.1081ENRamadanSayedotorhinolaryngology faculty of medicine sohag university egyptAhmedIsmailotorhinolaryngology faculty of medicine sohag university egyptKhaled GamalDahyotorhinolaryngology faculty of medicine sohag university egyptArafatMohamedotorhinolaryngology faculty of medicine sohag university egypt0000-0003-2390-7943FarghaliMekkiotorhinolaryngology faculty of medicine sohag University EgyptJournal Article20200110Kostmann syndrome is a rare congenital disorder characterized by severe neutropenia due to impairment of myeloid differentiation in the bone marrow, with the neutrophil count being characteristically less than 500_103 cells/l<br />Male child 4.5-year old complains from a bilateral aural discharge of 2years duration. examination there is multiple skin scars, gapped postauricular wound with necrosis in parts and inflamed lower part of mastoid and upper part of neck, and bilateral pinhole central perforation with pulsating discharge. Normal cranial nerve examinations. Hematological investigations were done that reveal severe neutropenia (kostmann syndrome).<br />canal wall down (CWD) mastoidectomy with wide meatoconchoplasty for exteriorization of the cavity was done Removal of infected and necrosed tissues in the postauricular region, undermining of skin and primary repair was done in two layers . after that, ear discharge and postauricular swelling improved and patient with good general condition with an excellent outcome.so mastoid abscess can be a presenting symptom of Kostmann syndrome.https://smj.journals.ekb.eg/article_72420_d00115faa0a6292abf47c6a317db54df.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Prognostic value of serum lactate during anesthesia for cardiac surgery.16317110944310.21608/smj.2020.21163.1085ENMarwa AhmadMahrousanesthesia and intensive care department, sohag faculty of medicine, sohag university, sohag, EgyptKhaled MohamedHassananesthesia and intensive care department, sohag faculty of medicine, sohag universityAbdelrahman HassanAbdelrahmanDepartment, of Anesthesia &amp; Intensive Care, Fuculty of Medicine, Sohag University.Abd El Hady AhmedHelmyDepartment, of Anesthesia and intensive care, Fuclty of Medicine, Sohag University.Journal Article20200111Abstract <br />Background:<br />During cardiac surgery, CPB machine affecting blood perfusion of all tissues. important marker of blood perfusion is blood lactate. blood lactate in relation to patient morbidity is an indicator for the reliability of blood lactate as a perfusion marker.<br /><br />Patients and Methods:<br />In a prospective observational study, 66 patients admitted to Sohag university hospital and Sohag Heart Institute in period between October 2017 and April 2019 for cardiac surgery were enrolled. Immediately after induction of anesthesia, the first sample of arterial blood gas (ABG) was obtained. For measuring of lactate levels, the next samples were obtained just before CPB weaning, the next after 24 hours of staying ICU and the last sample were obtained after 48 hours of staying ICU.<br /><br />Results:<br />Blood lactate levels in correlation to ICU length of stay showed both patient groups stayed in the ICU less than 48 hours and more than 48 hours both had significant p-valuehttps://smj.journals.ekb.eg/article_109443_10237e7d6c5d64cd59adcff1a7307f45.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Drawbacks of conservative treatment of proximal humerus fractures in elderly1721767242410.21608/smj.2020.19419.1071ENBahgatTharwatOrthopaedic Department faculty of medicine Sohag University EgyptMohamedWanisDepartment faculty of medicine sohag universityMoustafaElsayedDepartment faculty of medicine Sohag University EgyptJournal Article20191207Abstract<br />Background<br />Fractures of proximal humerus are popular in older people . About ¾ of proximal humerus fractures occur in patients older than sixty. Several methods of internal fixation and arthroplasty are used. However conservative treatment continues to be used in this age group, although some complications of conservative management limit its indications.<br />Objective<br />To assess the outcomes of conservative treatment of proximal humerus fractures in elderly patients.<br />Methods<br />It is a retrospective study of 30 elderly patients (over 50 ys) suffered from proximal humerus fractures and received conservative treatment using broad arm sling. All patients were subjected to regular clinical and radiological examination to evaluate time of union, range of motion, residual pain and complications.<br />Results<br />The average follow up time was 6 months. Nine cases(30%) showed nonunion while 11 cases(37%) showed delayed union after 3 months. The results showed8 cases (27%) with poor range of motion and 13 cases(43%) with acceptable range of motion while 9 cases (30%)showed good range of motion. As regard Pain evaluation,8 cases (27%) with moderate pain while 13 cases (43%) with mild pain and 9 cases (30%) showed no pain. There were 4 cases (13%) of malunion, 3 cases (10%) of avascular necrosis of humeral head, 4 cases (13%) of inferior subluxation of the humeral head and 2 cases (7%) of posttraumatic arthritis.<br />Conclusion <br />Conservative treatment of proximal humerus fractures in elderly patients is associated with significant incidence of unsatisfactory outcomes and should be limited only to patients unfit for surgery.https://smj.journals.ekb.eg/article_72424_a9cebbf98fc06593128cedfc173e4b7c.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Carbapenem Resistance In Enterobacteriaceae17718610495310.21608/smj.2020.24472.1105ENRadwaFaragClinical and chemical pathology department, faculty of medicine, Sohag universityHadirElmahllawyclinical and chemical pathology department, national cancer institute, Cairo universityLaila MohamedYousefDepartment of Clinical Pathology, Faculty of Medicine, Sohag University.HasnaaAbo-ElwafaClinical Pathology, Faculty of medicine
Sohag University0000-0001-7688-4314Journal Article20200224Carbapenem resistance is now a public health concern worldwide. Carbapenem is considered the last resort antimicrobial drug used for treatment of hospital care associated infection and community acquired infection that resistant to all other β-lactam drugs. There are a different mechanisms by which bacteria become resistant to carbapenem drug including efflux pump, porin mutation and production of carbapenemase enzyme that hydrolyze the drug. Carbapenemase enzymes were identified largely in different members of Enterobacteriaceae family which is a gram negative bacteria responsible for a variety of infectious diseases and this was associated with increased morbidity and mortality rate worldwide. Many Risk factors were found to be associated with increased susceptibility to develop carbapenem resiatance that should be searched for to prevent further spread of resistance.Various phenotypic and genotypic tests are used to detect carbapenemase production with different sensitivity and specificity. The current state of carbapenem resistance is well identified in many parts of the world while in other places such as sub-Saharan Africa, this is not well known.https://smj.journals.ekb.eg/article_104953_1ab32cf47ef8e8e7a05bce096ebba452.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Alpha feto protein in obstetrics18719110953410.21608/smj.2020.24854.1109ENMohamed MortadaAbd ElraheimObstetric and Gynecology department faculty of Medicine Sohag unevirstyIbrahim MohamedAbd ElraheimDepartment of obstetric and GynecologyMagdy AbdelrahmanMohamedDepartment of obstetric and GynecologyAhmed HussienMohamedDepartment of obstetric and GynecologyJournal Article20200229Alpha-feto protein in obstetrics<br />Abstract<br />All obstetricians have the primary objective of obtaining an optimum obstetric and perinatal result. Diagnosis of many obstetric complications, such as restriction of intrauterine development, preeclampsia; placental necrosis or early pregnancy abruption may be conducted through several safe tests to minimize maternal and fetal morbidity or mortality. Biochemical markers were used for the earl during the 1980s and 90s .Early detection of fetal genetic disorders was performed using biochemical markers. Soon after the establishment of maternal serum screening tests for early detection of fetal abnormalities, poor pregnancy results started to be reported after unexplained isolated alpha-fetoprotein (AFP) elevation was identified. This correlation was recorded between high AFP and poor obstetric outcomes Recorded over the last 20 years. In this paper, we attempt to investigate recently updated data on the relationship between high levels of maternal serum alpha-fetoprotein (MS-AFP) with various obstetric and fetal outcomes and to assess its significance as effective markers in predicting poor outcomes for pregnancies<br />The aim of the study: <br />The aim of our study was to detect the significance of AFP in obstetric medicine.<br />Conclusion: <br />As a result of our research, unexplained AFP rates have been discovered with unfavorable perinatal results. Pregnancies in which AFP rates increasing rapidly were complicated with adverse perinatal outcomes in a more serious manner.https://smj.journals.ekb.eg/article_109534_6d800759936ea51b04a43a2559ed43cf.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Role of medical thoracoscopy in diagnosis of pleuropulmonary lesions192203110399ENShimaaMoursichest department, faculty of medicine, Sohag universityHamdy AliMohammadienDepartments of Chest, Faculty of Medicine, Sohag UniversityOla Abdel RehimALKADYDepartments of Chest, Faculty of Medicine, Sohag UniversitySabah AhmedHusseinDepartments of Chest, Faculty of Medicine, Cairo UniversityHideoSakaDepartments of Chest, National Hospital Organization, Nagoya Medical Center, Nagoya, JapanJournal Article20200229Objectives: To assess the analytic utility and wellbeing of pleuroscopy in patients with pleuropulmonary diseases.<br />Patients and Methods: A retrospective and prospective observational clinical study including 179 patients divided into 2 groups; group 1 included 139 patients in Nagoya medical center and Toyota Kosei hospital, Japan with undiagnosed pleural effusions. Group 2 included 40 patients with diffuse parenchymal lung diseases (DPLD) of unknown etiology admitted in Kasr Alainy Hospital, Cairo University. All patients were exposed to clinical assesment, routine laboratory investigation, coagulation profile, arterial blood gases, collagen profile, chest X-ray and CT, pleural fluid analysis in cases with pleural effusion and Spirometry in cases with DPLD.<br /><br />Results: The Final histopathological diagnosis in G1 revealed malignancy in 53.2% and benign diagnosis in 46.8% and in G2, hypersensitivity pneumonitis in 20%, UIP in 17.5%, NSIP in 15%, DIP in 10%, LAM in 10%, COP in 7.5%, alveolar proteinosis in 5%, sarcoidosis in 5%, invasive mucoid adenocarcinoma in 5%, Metastatic adenocarcinoma (gastric) in 2.5% and silicosis in 2.5%. Thoracoscopic complications; in G1, bronchopleural fistula in 10.8%, fever in 3.6%, HAI in 1.44%, lung laceration in 2.2% and Subcutaneous emphysema in 0.72% and in G 2; Pneumomediastinum in 2.5%, Surgical emphysema in 7.5%, bronchopleural fistula in 10%, Pneumothorax in 10% and Pulmonary embolism in 2.5%.<br />Conclusions: VAMT is a valuable tool for the diagnosis of undiagnosed pleural diseases, management of empyema and malignant pleural effusion. It is a promising, inexpensive and safe technique in DPLDhttps://smj.journals.ekb.eg/article_110399_f570be12aef00ab3f4e9f19df728c09a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324220200401Management of premature rupture of membranes at Sohag University Hospital: A clinical audit20421211368410.21608/smj.2020.24955.1111ENAhmed MohamedFahmyObstetrics and Gynaecology, Faculty of Medicine, Sohag University, EgyptMagdy AbdelrahmanMohamedDepartment of obstetric and GynecologyMohamedNour El-dienObstetrics and Gynecology faculty of medicine Sohag universitySalahRasheedObstetrics and Gynaecolog department,faculty of medicine.sohag universityJournal Article20200302Background: Premature Rupture of membranes is not unusual yet the management is contentious, even at term. When it happens in a pregnancy that approaches full term, labor is expected to start naturally, without surgical or medical support. Expectant management was used where the rate of surgical intervention was greater, without rising in the perinatal and maternal complications. Clinical audit is a process of quality improvement which aims to improve patient care and outcomes by systematically reviewing care against specific standards and reviewing change.<br />Objectives: All cases of PROM at Sohag University Hospital were recruitted for auidt management.<br />Patients and methods: 73 cases were enrolled over a period of 6 months from February 2019 to August 2019.<br />Results: The main results of the study were identifying areas with nearly optimal care and areas with substandard care in the management of cases with PROM at Sohag University Hospital. They enabled the assessment of the practice at the Sohag University Hospital to see if this meets the recommended clinical practice guidelines (CPG).<br />Conclusion: Rupture of fetal membranes once has occurred, the debate lies regarding whether or not to deliver the baby according to the gestational age. Careful identification of present or possible complications, and each case should be dealt with separately based on gestational age and the presence or likelihood of these complications currently holds best hopes for optimizing fetal and maternal outcome in PROM patients.https://smj.journals.ekb.eg/article_113684_63da7802905355dd2dcde16557809c43.pdf