Sohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Inhalational versus intravenous magnesium sulfate in management of pulmonary hypertension in neonates1136381810.21608/smj.2019.16602.1053ENAmany AhmadAbdalsalampediatric department, faculty of medicine, sohag university, Sohag. EgyptSomiaHadhoodDepartments of Pediatrics, Faculty of Medicine, Sohag UniversityMohamedAbd El-Aaldepartment of Pediatric , Faculty of Medicine, Sohag University, Sohag, Egypt.RamadanMahmoudpediatric department, Faculty of medicine, sohag university, Sohag, EgyptJournal Article20190911Background: persistent pulmonary hypertension of the newborn (PPHN) is a serious medical emergency in the neonatal period which occurs because of failure of transition of the fetal circulation into the normal circulation. The condition is characterized by persistently elevated pulmonary vascular pressures and carries with it a high rate of mortality and morbidity.<br />Objective: to evaluate the effect of inhaled versus intravenous magnesium sulfate (MgSO4) as a treatment of pulmonary hypertension in neonates.<br />Methodology: this is an observational prospective study done in Sohag university hospital in the neonatal intensive care unit during the period from January 2016 to December 2017 on 50 neonates who were diagnosed to have PPHN by echocardiography. In this study, we compared the effect of intravenous versus the inhalational MgSO4 on reducing the PHN and SILDENAFIL was used as an adjuvant treatment.<br />Results: there was a statistically significant difference between the three studied groups as regard: age, sex, the degree of respiratory distress, the pulmonary artery pressure before treatment, side effects of treatment, duration of treatment and the SpO2 after treatment. Also there was a great difference in SpO2 in the right hand before and after treatment. Pulmonary artery pressure as well differs greatly before and after treatment in the three groups.<br />Conclusion: based on this study we don't recommend the use of nebulized MgSO4 alone as a treatment of PPHN in neonates.https://smj.journals.ekb.eg/article_63818_332fab3e440906e5db253c29c5d87472.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Radiofrequency ablation, A new paradigm for the treatment of adenomyosis: Case series14176381910.21608/smj.2019.16618.1052ENMamdouh ElsemaryAyedOb/Gyn. department,Faculty of medicine, Sohag university,Sohag,Egypt.SabryMahmoudobesterics and gynacology faculty of medicine sohag universityAllamMohamedobesterics and gynacology faculty of medicine sohag universityMedhatIbrahimRadiology deprtment, Faculty of medicine, Sohag universityHishamAbdelghanyRadiology department,faculty of medicine,Sohag universityJournal Article20190905Adenomyosis is a challenging clinical condition that is commonly being diagnosed in women of reproductive age. To date, many aspects of the disease have not been fully understood, making management increasingly difficult. Heavy menstrual bleeding and dysmenorrhea are the typical symptoms of adenomyosis, occurring in approximately 60 and 25 percent of women, respectively. The diagnosis of adenomyosis is based mainly on transvaginal ultrasonography and magnetic resonance imaging (MRI).A thickness of the junctional zone of at least 12 mm is the most frequent MRI criterion in establishing the presence of adenomyosis. Adenomyosis can appear as a diffuse or focal form. Although hysterectomy is a definitive treatment option, minimally invasive treatment methods have been developed as more women desire uterine preservation for future fertility or to avoid major surgery. Several uterine-sparing treatment options are now available, including medication, hysteroscopic resection or ablation, conservative surgical methods, high-intensity focused ultrasound, uterine artery embolization and radiofrequency ablation each with its own risks and benefits.https://smj.journals.ekb.eg/article_63819_2c6bc367a057e3673ba1643c8d3bb672.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Impact of Radiofrequency Ablation in the management of symptomatic uterine myoma18256382010.21608/smj.2019.16684.1055ENMamdouh ElsemaryAyedOb/Gyn. department,Faculty of medicine, Sohag university,Sohag,Egypt.SabriMahmoudobesterics and gynacology department, faculty of medicine, sohag university, EgyptAllamMohamedobesterics and gynacology department, faculty of medicine, sohag university, Egypt.MedhatIbrahimRadiology deprtment, Faculty of medicine, Sohag university, Egypt.HishamAbdelghanyRadiology department,faculty of medicine,Sohag university, EgypytJournal Article20190907OBJECTIVES:<br />To evaluate the feasibility and safety of Ultrasound-guided radiofrequency ablation in the treatment of women with symptomatic uterine fibroids.<br />DESIGN: <br />Prospective interventional clinical trial study. <br />METHODS:<br />Forty women with symptomatic uterine fibroids underwent Ultrasound-guided radiofrequency ablation. Primary Outcome measures are changes in fibroid-related symptoms and tumor size after the procedure measured at baseline, 3 and 6 months after the intervention. Secondary Outcome measures are recurrence of fibroid symptoms following the procedure ( Time Frame: Baseline to 6 months ) and operative complications ( Time Frame: Baseline to 6 weeks ).<br />RESULTS:<br />The 40 patients, fulfilled the follow-up evaluations post-ablation. The mean uterine fibroid volume reduction rate was 40% at 3 months and 60% at 6 months post-ablation. symptoms, especially bleeding were statistically significantly declined. No severe complications such as penetration or burn injuries of the nearby organs were detected.<br />CONCLUSION:<br />Ultrasound-guided radiofrequency ablation is effective in reducing fibroid symptoms and size. Ultrasound-guided radiofrequency ablation ablation is a promising new treatment option for Leiomyomas and should be further evaluated.https://smj.journals.ekb.eg/article_63820_b99d5e3f02270a29795ba74590ce13f5.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231COMPARISON OF THYROID HORMONES LEVEL IN NORMAL AND PREECLAMPTIC PREGNANCY26326382110.21608/smj.2019.16234.1048ENAhmed Salah EldeenAbdal LatiefObstetrics and gynaecology,Sohag faculty of medicine ,Sohag universitySalahRoshdyobesterics and gynacology faculty of medicine sohag university0000-0002-3762-8665MohamedNour El-dienObstetrics and Gynecology faculty of medicine Sohag universityMohamed YahyaAbdel Hafezobesterics and gynacology faculty of medicine sohag universityWael Abd El-hameidAlyclinical pathology department faculty of medicine sohag universityJournal Article20190918To find a relationship between preeclampsia and thyroid dysfunction by comparing serum levels of Free T3 (fT3), Free T4 (fT4) and TSH in preeclampsia and normal pregnancy. <br /><br />The study was conducted within 6 months from May 2018 to November 2018, on the patients who attended OB/GYN department of Sohag Faculty of Medicine, Institutional review board approval was obtained April 2017. <br />30 of them were diagnosed as preeclamptic [blood pressure after 20 weeks of gestation is raised to 140/90 mm of Hg or more or have mean Blood Pressure. (diastolic+1/3rd pulse pressure) of more than 110 mm of Hg] with presence of proteinuria and/or edema. <br /><br />30 age-matched normotensive pregnant women. Blood pressure was measured (auscultatory and palpatory) in semi sitting position using sphygmomanometer. Both groups had no history of thyroid dysfunction. <br />According to the International Society for the Study of Hypertension Pre-eclampsia is defined as blood pressure ≥140/90 mmHg on two separate occasions 6 hours apart or a single recording of a diastolic blood pressure of 110 mmHg, in association with proteinuria ≥1+ on dipstick urine testing (Dawn C. Scantlebury, et al., 2013)https://smj.journals.ekb.eg/article_63821_88282af6384aef763a7ec44d7df881c8.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Outcomes of Non-Invasive laser Therapy for Treatment of Female Stress Urinary Incontinence33406382210.21608/smj.2019.16202.1046ENHassan AliAbdelhaleemUrology Department,Sohag faculty of medicine,Sohag university,Sohag ,EgyptMohammed SaberKhalafurology department,Sohag faculty of medicine,Sohag university,Sohag,EgyptElnisr RashedMohamedurology department,Sohag faculty of medicine,Sohag university,Sohag,EgyptMohammed DyaaS.saleemurology department ,Sohag faculty of medicine,Sohag University,Sohag,EgyptJournal Article20190825Objective: Female stress urinary incontinence (SUI) is common lower urinary tract symptom. It affects the patient's quality of life. This study aimed to evaluate the therapeutic outcomes of non-ablative Er: YAG laser therapy SUI. <br />Study design: This was a prospective non-randomized study for female patients with SUI who were referred to the Urology Department, Sohag University Hospital from March 2017 to June 2018. The study was approved from Sohag University ethics committee. Patients were treated by the clinical protocol for SUI with non-ablative 2940 nm Er: YAG laser. Patients were evaluated at the baseline and every 3 months for 1 year by Validated International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) Arabic version and the number of daily pads usage .Side effects of the treatment were also reported.<br />Results: Our results included 32female patients. 20 patients (63 %) had SUI while 12 patients (37%) had mixed incontinence. the median duration of symptoms 3 years. with 17 patients (53%) had mild to moderate SUI. There was a significant reduction in the median of daily pads usage from a median of 3to one pad per day at one year with P value (˂ 0.0001). The median (ICIQ-UISF) improved from 12to 5.5at one year (pvaluehttps://smj.journals.ekb.eg/article_63822_42ae122ed2c6d7d606315a42f27a54f0.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120201231PCNL monotherapy for staghorn stones: Sohag faculty of medicine experience.41476449710.21608/smj.2019.19900.1076ENHosny FathallaOmarFaculty of medicine Sohag university Urology department.Atef JalalAbdelwahabdepartment of urology,
Faculty of medicine,
Sohage University,
Sohag,
EgyptEsameldin SalemMorsydepartment of urology,
Faculty of medicine,
Sohage University,
Sohag,
EgyptAhmed MamdohAbdelhamiedUrology department ,Sohag faculty of medicine ,Sohag university ,Sohag ,EgyptJournal Article20191122PCNL monotherapy for staghorn stones: Sohag faculty of medicine experience.<br />Background: PCNL as monotherapy for renal staghorn stones is challenging for urologists to attain complete clearance of all calculi. The purpose of this study is to evaluate the efficacy and safety of PCNL for renal staghorn stones.<br />Methods: Study was initiated on June 2017 - June 2018 by recording the data of 32 patients with staghorn stones to do PCNL as a single or multiple sessions till complete clearance of the stones was achieved (20 males, 12 females), age range of 15-63 years, Right-sided stones were in 18 cases and left-sided stones in 14 cases. Recurrent stones were in 12 patients. Intraoperative and early postoperative complications, blood transfusion and hospital stay were recorded. The data were analyzed SPSS for Windows version 20.<br />Results: Mean age was 39.88 ± 13.5 years. Mean operative time was 58.75 ± 24.8 minutes. The range of hospital stay was 1-10 days. Bleeding was the most common complication( 25%) of cases. The stone clearance status of percutaneous nephrolithotomy monotherapy after only one session was achieved in 22 cases (68.75%). Second session was needed in 6 cases to achieve complete clearance. Other auxiliary measures needed in 4 cases.<br />Conclusions: Percutaneous nephrolithotomy for treatment of renal staghorn stones is a safe and effective choice to achieve a reasonable Stone free rate with minimal morbidity.https://smj.journals.ekb.eg/article_64497_585f86e1f6238877b6fc7a98197dd6f7.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Sleep Disorders and Risk of Ischemic Stroke.48566382810.21608/smj.2019.17822.1065ENMohammed GamalAbdellatifMohammed G. Abdellatif
Neurology and Psychological Medicine department; Sohag Faculty of Medicine; Sohag UniversityOsama Abdel RaoufMoradSohag University0000-0001-6488-5221Ahmed EzzatAminNeurology and Psychological Medicine department, Faculty of Medicine, Sohag UniversityAhmed GamalArafaNeurology and Psychological Medicine department, Faculty of Medicine, Sohag UniversityJournal Article20191007Sleep is a highly coordinated physiologic state, which is essential for functional integrity of the neurons and brain. It is crucial for survival. Non rapid eye movement sleep (NREM) vagal dominance enables neural/cardiovascular axis to regenerate homeostasis after periods of stress or fatigue during wakefulness. Any reasons of sleep interruption or deprivation like periodic limb movements during sleep (PLMS), insomnia, shift work and obstructive sleep apnea have negative effect on cardiovascular homeostasis and restoration. Sleep disorders have a fundamental contribution in cerebrovascular and other cardiovascular diseases. The aim of this review is to highlight the role of sleep disorders in the risk of cerebrovascular ischemic stroke and help both neurologists and our community to realize the great value of diagnosis and management of sleep disorders for effective prevention of ischemic stroke and proper care. Further attention and care should be given to the early identification of sleep disorders in risky patients to avoid major cerebrovascular and cardiovascular events.https://smj.journals.ekb.eg/article_63828_e02ac8be65a00a60c134a1d8fadcf1be.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Cognitive Implications in Epilepsy.57636382710.21608/smj.2019.17819.1064ENMohammed GamalAbdellatifMohammed G. Abdellatif
Neurology and Psychological Medicine department; Sohag Faculty of Medicine; Sohag UniversityOsama Abdel RaoufMoradSohag University0000-0001-6488-5221Ahmed GamalArafaNeurology and Psychological Medicine department, Faculty of Medicine, Sohag UniversityAhmed EzzatAminNeurology and Psychological Medicine department, Faculty of Medicine, Sohag UniversityJournal Article20191007Cognitive dysfunction is one of the major contributors to the burden of epilepsy. It can significantly disrupt intellectual development in children and functional status and quality of life in adults. There is major evidence confirms that cognitive impairment can appear or worsen with early and chronic progressive neurologic changes in epilepsy. It has been increasingly accepted that comorbidity does not indicate causality. Certainly, cognitive impairment in epileptic patients warrant crucial evaluation and mitigation from the time of diagnosis and treatment of epilepsy. The concept of a bidirectional nature of cognitive impairment in epilepsy represents a change in the paradigm of neuropsychology of epilepsy. It has been suggested that both behavioral and cognitive dysfunction associated with epilepsy are not necessarily the consequence of active epilepsy but in fact can dominate and be associated with factors before emergence of epilepsy. This review discusses different etiologies of cognitive and behavioral comorbidities in epilepsy and tries to clarify the nature of relation between epilepsy and cognition.https://smj.journals.ekb.eg/article_63827_bed7294f8710964badb4ac6d8c211f8a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191201Comparative Study Between Dexmedetomidine And Morphine as Adjuvants to Bupivacaine in Spinal Anesthesia.64706382310.21608/smj.2019.16445.1050ENHossam Eldin HassanAhmedfaculty of medicine ,sohag universityEman EbrahimDarweeshDepartment of anesthesia and ICU,Sohag University, sohag,EgyptAhmed Abd-elRhmanIbrahiemdepartment of anesthesia, intensive care, and pain management faculty of medicinem sohag universityJournal Article20190824Aim: Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing lower abdominal surgeries.<br />Methods:<br />This was a prospective, randomised, double blind study involving 30 patients in each group. Group A received 15 mg of 0.5% hyperbaric bupivacaine with 250 μg of morphine while Group B received 15 mg of 0.5% hyperbaric bupivacaine with 5 μg of dexmedetomidine. Characteristics of spinal block, time for first rescue analgesic and total dose of rescue analgesics were noted. Vital parameters and adverse effects were noted perioperatively. Data analysis was done with independent two sample t-test..Results:<br />Time for first rescue analgesic (P = 0.19) and total analgesic demand( p value=0.23) were similar in both groups. Duration of sensory (P = 0.001) and motor (P = 000) block was significantly higher in dexmedetomidine group.Itching was noticed in 43% ,nausea in 27% and vomiting in 44% of patients in the morphine group but no itching in dexametomedine group was recorded ,nausea 20% and vomiting 40% of patients in dexametomedine group.<br />. Conclusion : Intrathecal dexmedetomidine produces prolonged motor and sensory blockade without undesirable side effect.https://smj.journals.ekb.eg/article_63823_d484e6677be08a6889a30ccc57efa462.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Possible effects of erythropoietin on diabetic rats71786540010.21608/smj.2019.16102.1044ENWalaaMohamedphysiology department, faculty of medicine, sohag universityAhmed MostafaMahmoudDepartment of Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt.HassanElalafphysiology department, faculty of medicine, sohag university, sohag, EgyptMotamedMahmoudDepartment of Animal Behavior and Husbandry, Faculty of Veterinary Medicine, Sohag, University, Sohag, EgyptJournal Article20190828Abstract<br /> Background: Blood glucose is controlled by a pancreatic hormone, insulin, so any altered functions of pancreas are associated with disturbances in blood glucose level. Erythropoietin (EPO) is glycoprotein produced mainly by the kidney as a result of reduced intracellular oxygen. This study was designed to investigate the effect of EPO on blood glucose level in normal and streptozocin-induced diabetic rats. <br />Materials and methods: Eighty mature rats were used in this study animals and randomly divided into 4 different isolated groups (n = 20); Group I was administered with normal saline and act as a control group. Animals were injected with streptozocin (STZ; 30 mg/kg, ip) to induce diabetes, and animals were treated with saline (Group II) or EPO (300 iu//kg, ip Group III) or insulin (3 iu//kg, s.c., group IV) respectively, for three successive weeks. STZ-induced diabetes was indicated by hyperglycemia. Further, Results: Three weeks after EPO treatment, there was enhanced blood glucose level associated with enhanced glucose tolerance and insulin sensitivity tests (Phttps://smj.journals.ekb.eg/article_65400_9c44966b18963231603a20a9a1bb5327.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Hepatitis C Virus Treatment Update79856529110.21608/smj.2019.18760.1068ENMona MohammedAbd El Rhmantropical medicine and gastroentrology, faculty of medicine, sohag universityGhada Moustafa MoustafaGalalDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Ramy MamdouhAbd El Hamidtropical medicine and gastroentrology , sohag university hospitalSafaa KhalafAbd Allahtropical medicine and gastroenrology, facultyof medicine, sohag universityJournal Article20191031Hepatitis C virus (HCV) infection is a worldwide public health problem where anti-HCV prevalence had an estimated 2.8% increase over the last decade, corresponding to more than 185 million infections (3% of the world’s population). Treatment of chronic HCV was based on interferon-α for more than 20 years. Over the last years, the treatment of chronic hepatitis C was evolving rapidly with the development of Interferon-free regimens with direct-acting antiviral agents (DAAs). These regimens induce higher rates of sustained virological response (SVR) and show a favorable safety profile compared with IFN-based treatments. The objective of chronic hepatitis C treatment is to achieve SVR which is defined as the absence of viral replication at 12 or 24 weeks after treatment completion. SVR reduces morbidity and mortality and is equivalent in most cases to cure the HCV infection. When considering a patient for HCV therapy, three important pieces of information are needed to guide the treatment plan for all patients: genotype, prior treatment history, and stage of liver diseasehttps://smj.journals.ekb.eg/article_65291_dd71f394ea28f27c1e1e3e9d9f31b9f4.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Direct Markers of Liver Fibrosis86936528510.21608/smj.2019.19160.1069ENAmiraMaherTropical medicine and Gastroenterology, Faculty of medicine, Sohag universityGhada MoustafaGalalTropical medicine and Gastroenterology, Faculty of Medicine, Sohag UniversityNagwa SayedAhmedMedical Biochemistry, Faculty of Medicine, Sohag UniversityEl-Zahraa MohammedMeghezelTropical Medicine and Gastroenterology, Faculty of Medicine, Sohag UniversityJournal Article20191110Abstract<br />Liver fibrosis is a chronic condition that originates as a result of prolonged hepatic injury. Liver fibrosis is caused mainly by Schistosomiasis, chronic hepatitis C and B viral infections, non-alcoholic fatty liver disease, alcoholic liver disease, cholestatic and autoimmune liver diseases. Hepatic stellate cells are the master cells in the fibrosis process regardless of the cause. HSCs activation involves two separate stages: the initiation stage and the perpetuation stage. The activated HSCs up-regulate gene expression of extracellular matrix elements, matrix-degrading enzymes, and their inhibitors. The components of fibrotic ECM or inflammatory mediators implicated in either the process of fibrosis or degradation of scar tissue could be used as direct markers of fibrosis. Direct indices of fibrosis are classified into direct markers associated with matrix deposition such as HA and laminin, direct markers associated with matrix degradation such as MMPs and TIMPs, and Cytokines and chemokines linked to hepatic fibrosis such as TGF-𝛽1 and PDGF. The validation of these markers for use in clinical practice instead of liver biopsy should be balanced against the possibility of misleading results of these markers as they are affected by factors other than fibrosis.https://smj.journals.ekb.eg/article_65285_6429fedb47a8be9401f14254aaac217a.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Foam sclerotherapy for reticular veins and telangiectasias94986383710.21608/smj.2019.17176.1062ENKariem AymanAlsakatyvascular surgery department, faculty of medicine, Sohag university0000-0002-5338-7152Ahmad Saif Al EslamAbd Alfatahvascular surgery department faculty of medicine sohag universityHossam FaroukAbd Alhamidgeneral surgery department faculty of medicine sohag universityJournal Article20191025Abstract<br />Background Injection Sclerotherapy for treatment of varicose veins in general and foam sclerotherapy for telangiectasias and reticular veins, in particular, has been used widely in the last decades. The procedure aims to occlude the lumen of varicose veins or superficial veins.<br />OBJECTIVE aiming to determine the safety profile by mean of a satisfactory complication rate and effectiveness in enhancing symptoms and limb appearance of foam sclerotherapy for the treatment of telangiectasias and reticular veins and to describe rates of procedure failure in terms of symptomatic or cosmetic varicose vein recurrence.<br />Search policy & methods This study is a prospective study included 60 patients with telangiectasia and reticular veins in which assessment of side effect diversity and severity including the presence of cardiovascular or pulmonary events and the degree of injected vein disappearance and patient satisfaction as outcomes.<br />Results 60 patients included in this study between them were 9 males (15%) 51 females (85%), The rate of adverse events was relatively small for all recorded complications including hyperpigmentation (20%), skin ulceration (6.7%), pain after sclerosant injection (5%), and matting and /or new vessel formation (3.3%). The net improvement percentage was 91.7% represent the disappearance of injected veins and success of procedure with 8.3% of cases show no improvement. No major adverse events occurred.<br />Conclusion Foam sclerotherapy is safe, easy and efficient for treatment of leg varicosities, reticular veins, and telangiectasias. major adverse events are rare.https://smj.journals.ekb.eg/article_63837_4efdfd997b839ef7da09439dc8404c15.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Presentation and Echocardiographic Findings In Patients With Coarctation Of Aorta991037241410.21608/smj.2020.17072.1063ENAsmaa AliMohammedpediatrics, faculty of medicine, Sohag university, sohagSomiaHadhoodDepartments of Pediatrics, Faculty of Medicine, Sohag UniversitySafaaHuseinDepartments of Pediatrics, Faculty of Medicine, Sohag UniversityJournal Article20191002Abstract<br />Background: Coarctation of the aorta (CoA) is a partial- or long-segment narrowing of the aorta, usually at the aortic isthmus, between the ductus arteriosus and the left subclavian artery.<br />Patients and methods: This was an observational cohort prospective study conducted at the Pediatric Department at Sohag University Hospital between July 2016 to July 2017. Full history, full clinical examination, Echocardiography were done for all included patients.<br />Results: The age range of presentation of CoA, was found to be 30 cases (60%) presented during infancy, followed by 14 cases (28%) at the age from 1-5 years, then 6 cases (12%) after 5 years.<br />The clinical presentation of the studied cases were (54%) of the patients presented with heart failure, 28 (56%) cases presented with dyspnea, 32 (64%) cases presented with loss of femoral pulse, all patients had a femoral radial delay and 21 (42%) cases presented with hypertension. <br />Echocardiographic findings show that 58% of patients had left ventricular hypertrophy, 12% had hypoplasia of aortic arch, 22% had the bicuspid aortic valve, 18% had aortic stenosis. The associated cardiac congenital anomalies were 58% and 42% had no associated cardiac congenital anomalies.<br />Conclusion: Most cases of Coarctation of the aorta (CoA) presented during infancy, the most frequent symptoms were dyspnea and the most common sign is a femoral radial delay. Echocardiography is a noninvasive method and the one of choice in the diagnosis of Coarctation of the aorta.https://smj.journals.ekb.eg/article_72414_2689ccb0945de541bed846f7f519c553.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Efficacy, Safety, and Biochemical response of Sofosbuvir-Based Combinations in Treatment of Chronic Hepatitis C Patients in Sohag Governorate1041116383610.21608/smj.2019.18730.1067ENMona MohammedAbd El Rhmantropical medicine and gastroentrology, faculty of medicine, sohag universityGhada MoustafaGalalDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.Ramy MamdouhAbd El Hamidtropical medicine and gastroentrology , sohag university hospitalSafaa KhalafAbd Allahtropical medicine and gastroenrology, facultyof medicine, sohag universityJournal Article20191103Background and aims: Worldwide Interferon-free regimens with direct acting antiviral agents (DAAs) are the standard treatment for chronic hepatitis today. Different studies have shown that DAAs have favorable safety profile and high rates of sustained virological response (SVR) compared with IFN-based treatments. Therefore, this study aims to assess the rate SVR in patients treated with sofosbuvir-based regimens in Sohag Governate and to evaluate the adverse events (AEs) and the biochemical response to therapy in the studied patients.<br /><br /> Patients and Methods: Our study was a prospective one conducted on 135 patients eligible for treatment with sofosbuvir-based regimens. Patients were categorized into two groups: Group 1 (easy to treat) which was treated with dual therapy (sofosbuvir plus daclatasvir) and group 2 (difficult to treat) which was treated with triple therapy (sofosbuvir plus daclatasvir with ribavirin). The efficacy and safety of the treatments were evaluated. Liver function tests were assessed at baseline, at 4 weeks, at end of treatment (EOT) and at 12-week post-treatment follow-up.<br /><br />Results: SVR12 was nearly equal in patients who received dual and triple therapy (98.5%). The most common reported AEs were headache and fatigue. There was a significant improvement in liver function parameters at SVR12.<br /><br />Conclusion: Sofosbuvir plus daclatasvir with or without ribavirin (RBV) were highly effective and well-tolerated.https://smj.journals.ekb.eg/article_63836_56855b8fcf9fc7df3c7f2212cd249259.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Effect of regular Exercise and iron injection on iron status of anemic obese male rats.1121196539910.21608/smj.2019.16088.1043ENSeham Abd-AlrahmanAbd-allatifphysiology department.faculty of medicine,sohag university.Hoda MMoghazyDepartment of Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt.Ahmed MostafaMahmoudDepartment of Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt.Ahmed RoshdiHamedDepartment of Pathology ,Faculty of Medicine, Sohag University.Journal Article20190822Many animal studies have reported an association between obesity and reduced iron storage. Systemic chronic inflammation induced by obesity and higher hepcidin levels has been suggested as a reason for the iron deficiency that occurs with obesity. Hepcidin is a master regulator of systemic iron homeostasis. Hepcidin is a peptide hormone, produced mainly from the liver. It inhibits intestinal iron absorption. The hepatic production of hepcidin is up-regulated by pro-inflammatory cytokines. An exercise is an effective approach for controlling obesity. Several studies showed that exercise reduced body weight. So this study hypothesized that regular exercises may be used as an adjuvant line in treating iron deficiency associated with obesity via reducing serum hepcidin. <br />Materials and methods: 75 young male albino rats were categorized into 5 groups. Obesity was induced by high-fat diet(HFD) for 3 months in Group II, III, IV, and V. After 12 weeks, Rats of GIII and GV were injected once every 2 days with iron-III poly-maltose 50 ml/kg for 2 weeks.,treadmill regular exercise was performed for 8 weeks for rats of GIV and GV. Measurement of body weight was done after 3 months of HFD and at the end of the experiment. Biochemical analysis was done for serum iron and serum hepcidin. Results: Measurement of body weight showed that exercise has a decreasing effect on body weight in obese rats. Exercise decreased serum hepcidin levels in obese rats and increased serum iron. <br />Conclusion: Exercise decreases serum hepcidin level also improves the serum iron level in obese rats.https://smj.journals.ekb.eg/article_65399_c8e35437b6b7a593d1581bccc9e57a0b.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Clinico-laboratory profile in children with status epilepticus and correlation to short-term outcomes at Sohag University Hospital1201287241310.21608/smj.2020.16701.1058ENAsmaaMansourDepartments of Pediatrics, Faculty of Medicine, Sohag UniversityAbdelrahim AbdrabouSadekpediatric,medicine,sohag university,egyptAshrafAbou-TalebDepartments of Pediatrics, Faculty of Medicine, Sohag UniversityJournal Article20190911Background: Status Epilepticus is a major neurological and medical emergency. Despite the advance in treatment, it is still associated with mortality and morbidity. It is a common pediatric neurological emergency with an estimated incidence of 18–23 per 100,000 children per year and mortality of 2%–7%.<br />Objective: The objectives of the study were to determine the clinical profile, immediate outcome and possible risk factors of SE in the pediatric age group admitted at Sohag University Hospital. <br />Patients and Methods: In this research, we have studied 100 patients who were admitted to the pediatric department over a period of 1 year 56 were males and 44 were females, Their ages ranged from one month to 15 years with a mean age was 37.8±44.4 months and those patients were subjected to full clinical histories, clinical and laboratory examination.<br />Results: In our study, we found that 38% of patients were improved without any neurological deficits. <br />15.8% of patients who had epileptic seizures were related significantly to improved outcomes, while recurrence outcome represents about 59.3% in those patients who presented with epilepsy. patients presented with hypoxic-ischemic encephalopathy show the highest mortality rate (38.1%) among the deaths(21%). <br />Conclusion: In this study, we found that in the included children, epilepsy is the most common cause of status epilpticus and those epileptic children were significantly related to the improvement and recurrence outcome, patients presented with hypoxic-ischemic encephalopathy were significantly related to death outcome and all patients presented with status epilepticus should have full clinical examination and laboratory investigations.https://smj.journals.ekb.eg/article_72413_d5236e5ab500e7a8b1c5e910fe03be10.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120191231Growth Parameters in Children with Congenital Acyanotic Heart Disease before and after Cardiac Catheterization at Sohag University Hospital1291346382610.21608/smj.2019.17010.1061ENSylvia MagdyTamerpediatric department, faculty of medicine, sohag university,sohagAhmed MonirHegabpediatric Department, Faculty of Medicine, Sohag university, Sohag, Egypt.MohamedAbd El-Aaldepartment of Pediatric , Faculty of Medicine, Sohag University, Sohag, Egypt.Alzahraa AlsayedAhmedpediatric department, faculty of medicine, sohag university,sohag, Egypt.Journal Article20190917Background and objectives: Growth failure is common among children with congenital heart disease (CHD). This study aimed at the assessment of the effect of therapeutic cardiac catheterization on the growth status of children with CHD.<br /><br />Patients and Method: This was a prospective observational study conducted at pediatric cardiac catheterization unit-Sohag university hospital, from October-2016 to September-2017, on children with congenital acyanotic heart diseases who were admitted for therapeutic cardiac catheterization. We assessed the growth parameters as a weight for age Z-score (WAZ), height for age Z-score (HAZ), body mass index and upper arm circumference before catheterization, at one month, three months and six months after catheterization. The growth status was considered normal when WAZ and HAZ were from < +2 SD to > -2 SD, underweight if WAZ was ≤ -2 SD and stunting if HAZ was ≤ -2 SD. <br /><br />Results: One-hundred and two children with congenital acyanotic heart diseases were included. The mean age was 3.95 ±3.11 years. Sixty participants(58.8%) were females. Before catheterization,70 patients (68.6%) had normal growth status, 20 patients (19.6%) had underweight and 19 patients (18.6%) had stunting. The prevalence of underweight significantly diminished to3.92% (p < 0.001) at the 6th month after catheterization. However, no significant differences in the prevalence of stunting were found during the follow-up period.<br /><br />Conclusion: Therapeutic cardiac catheterization had a significantly positive impact on weight gain shortly after catheterization. However, improvement in the height could not be detected in the first 6 months after catheterization and longer follow-up periods are required.https://smj.journals.ekb.eg/article_63826_d05c9b341038dd807b4c958cf122f697.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Gap analysis for health services provided to oncology patients in Sohag Governorate1351396381710.21608/smj.2019.15981.1042ENFouadYousefDepartment of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.TasneemBakheetPublic health and community medicine, Faculty of medicine, Sohag UniversityJournal Article20191204Abstract<br />Purpose: This study was conducted to identify areas where there are big gaps between oncology and nuclear medicine patients perception and expectation for the services provided to them and need to be improved to assure quality care<br />Methodology: A sample of 550 patients of oncology department of Sohag University Hospita (SUH) and Sohag Cancer Center (SCC) participated in the study. Descriptive statistical techniques and gap analysis were employed.<br />Findings : The results showed that the quality of services provided to patients was significantly lower than their expectations and the quality gaps were statistically significant in all studied dimensions of the SERVQUAL tool which was used to assess the quality of health service provided (P < 0.05). Furthermore, the highest and lowest quality gaps were related to assurance and empathy dimensions respectively. <br />Conclusion: Steps toward improving the quality of services in all dimensions should be taken, especially assurance and tangibility, through planning properly, prioritizing services, and reviewing processes with regard to the patients' expectations.<br />Practical implication : Based on the findings of this study, hospital managers are in a position to recognize the patients' perceptions of health care quality and the level of their satisfaction. Consequently, managers can design strategies that improve the quality of services for increasing patients' satisfaction.https://smj.journals.ekb.eg/article_63817_51bc74f5b7d25512bef16b8d271831a0.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Prevalence of Anatomical Abnormalities of Nose & Paranasal Sinuses in Cases of Rhinogenic Headache Among Sohag University Students1401496382510.21608/smj.2019.16715.1056ENYousry OthmanAbdelrahmandepartment of E.N.T ,faculty of medicine, Al-Azhar University, AssuitEslamBakheetENT department, Student Hospital, Sohag UniversityTasneemBakheetPublic health and community medicine, Faculty of medicine, Sohag UniversityMahmoudEl-bahrawydepartment of ENT, Faculty of medicine Al-Azhar University, AssuitJournal Article20200111Abstract<br />Objective: to determine the prevalence of anatomical abnormalities of nose and PNS in cases suffering from rhinogenic headache among Sohag University students seeking health services in the ENT outpatient clinic of the Student Hospital in Sohag University along the period starting Oct. 2017 till June 2019. <br />Study design: Across sectional study<br />Results: 104 students -(59.6 %) females- were enrolled in the study, inhabiting rural and/or slum areas of Sohag (69.2 %). They had a narrow range of ages; 19 – 23 years; X` = 20.13 ± 1.25 years. Frontal site of headache predominated, then the nasal site. These followed by periorbital, tempo parietal, temporal and scalp regions respectively in 32.7, 25, 17.3, 11.5, 7.7 and 5.8 % of the rhinogenic cases. Each attack lasted 3.27± 1.76 days duration with maximum 7 days. Prevalence of rhinogenic headache due to anatomical abnormalities was (26.9 %). over the frontal, glabellar and periorbital regions. A highly significant statistical difference between cases of rhinogenic headache with anatomical abnormalities and those without anatomical abnormalities (p = .004) regarding how the headache was presented; Heaviness (16.2 %), pressure (81 %) and dullness (2.7 %) were the type of such headache. It was found that most of the cases have combined abnormalities.<br />DNS affected 16 cases (43.2 %), a manifestation of concha bellosa in 9 cases(24.3%), bilateral inferior turbinate hypertrophy appeared in 10 cases(27%) . Haller cells was detected in about ( 1.9 % )of the anatomical abnormalities also.https://smj.journals.ekb.eg/article_63825_d477461607ca441c06118d25cc2c3f4e.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200131Prevalence of Macrovascular complications in Diabetic Patients in Sohag Governorate: Sex Differences1501547241810.21608/smj.2020.20427.1079ENMohammadOmranDepartment of internal medicine, sohag university hospitalMohamed AbdelwahabEzzatDepartment of internal medicine, Sohag university hospitalAdel Abdel AzizEl-SayedDepartment of internal medicine, Sohag university hospitalJournal Article20191217Background: Atherosclerotic cardiovascular disease (ASCVD) is the major cause of death and disability in patients with type 2 diabetes. Objective: The aim of the research was to study the differences between male and female diabetic patients as regard the prevalence of macrovascular complications in Sohag Governorate, Upper Egypt. Methods: This Study was a cross sectional study on diabetes mellitus in Upper Egypt. The study included 500 diabetic patients randomly selected from rural and urban areas of Sohag Governorate. all patients were subjected to: history taking, clinical examination, blood pressure and pulse evaluation, ECG, echocardiography and laboratory investigations including blood glucose and HbA1c estimation. Results: 500 diabetics patients included in this study, 44.2% of them were males while 55.8% were females. one third of males were smokers and body mass index was statistically higher in females than males. No difference between male and female diabetics as regard control of diabetes or lipogram. The prevalence of hypertension, heart failure with reduced ejection fraction (HFrEF), and diastolic dysfunction were higher in males with significant difference. Peripheral arterial disease was higher in females while stroke was higher in males but with no significant difference. Conclusion: Macrovascular complications are prevalent among male and female diabetic patients. Hypertension, HFrEF and diastolic dysfunction were higher in males than females with significant difference.Sohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Annexin A1 in Malignancy1551617241610.21608/smj.2020.19887.1075ENMahmoud GaberMahmoudInternal Medicine department,faculty of Medicine, Sohag University0009-0002-4484-4769Mohamed IbrahimElsayedInternal medicine department,Faculty of medicine ,Sohag universityHany AhmedMohammedInternal Medicine department,faculty of Medicine, Sohag UniversityMohammed EzzatAminInternal Medicine department,faculty of Medicine, Sohag UniversityJournal Article20191208Annexin A1 (Anxa1) is an agent of the superfamily of Annexin proteins. Previously, it was known as a mediator in the anti-inflammatory response of glucocorticoids. In several types of research in past decades, it was reported as lipomodulin, lipocortin-1, renocortin, and macrocortin, before it was termed Annexin A1. Anxa1 has complex roles in different essential cellular processes as membrane aggregation, cellular transduction, phagocytosis, inflammation, differentiation, proliferation, and apoptosis. Cumulative evidence has suggested that Anxa1 dysregulations are linked to tumorigenesis, tumor progression, metastasis, invasion, and drug resistance of cancers by contributing to cell proliferation and differentiation, cell apoptosis and signaling. Recently, there is growing evidence indicates that Anxa1 could function either as a tumor promoter or a tumor suppressor candidate for certain cancers relying on the specific type of tumor cells/tissues.<br />In this article, we attempt to clarify the association between Annexin A1 and malignancies, as well as potential action mechanisms. Anxa1 may serve as prognostic predictor of outcome and response to chemotherapy and a potential target for therapy in the future.https://smj.journals.ekb.eg/article_72416_2908bc17ae047e0749b9da14b8156087.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Urban and Rural differences of Macrovascular complications Prevalence among Diabetic Patients in Sohag Governorate1621677241710.21608/smj.2020.20420.1078ENMohammadOmranDepartment of internal medicine, Sohag university hospitalMohamed AbdelwahabEzzatDepartment of internal medicine, Sohag university hospitalAdel Abdel AzizEl-SayedDepartment of internal medicine, Sohag university hospitalJournal Article20191217Background: Diabetes is associated with increased risk of a large number of complications including microvascular and macrovascular diseases, blindness, some cancers, gallstones and all-cause mortality. Objective: The aim of the research is to study the prevalence of macrovascular complications among rural and urban diabetic patients in Sohag Governorate, Upper Egypt. Methods: This Study was conducted in Sohag Governorate as cross sectional study on diabetes mellitus in Upper Egypt. The study included 500 diabetic patients randomly selected from various cities and villages (rural and urban) of Sohag Governorate. all patients were subjected to: history taking, clinical examination, blood pressure and pulse evaluation, ECG, echocardiography and laboratory investigations including blood glucose and HbA1c estimation. Results: 500 diabetics patients included in then study, 239 from rural areas and 261 from urban areas. No statistically significant difference between patients from urban and rural areas as regard age, gender and smoking while body mass index was higher in patients from urban areas. Both groups were badly controlled on anti-diabetic medications. The prevalence of HTN was higher in rural than urban. The prevalence of IHD and diastolic dysfunction were higher in urban than rural areas with significant difference. The prevalence of stroke was nearly equal and the prevalence of PAD was higher in rural with no significant difference. Conclusion: Macrovascular complications are prevalent among diabetic patients either from rural or urban residence. Ischemic heart disease and diastolic dysfunction is significantly prevalent among urban diabetic patients than rural ones.https://smj.journals.ekb.eg/article_72417_70566173c22b3837d3339e256dd5b396.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101A retrospective study of the effect of neoadjuvant chemotherapy as a primary treatment of advanced breast cancer and its effect on surgical modalities.1681756382410.21608/smj.2019.16525.1051ENNahla MohamedEl MahdyOncology department,faculty of medicine,shag university,sohagMohamed GaberSolimanoncology department,assuit univeristyRafat AbdellalBekeetoncology department ,sohag univeristy,facaulty of medicineJournal Article20190909Aim of the work: neoadjuvant chemotherapy in downstaging of each the primary tumour and axillary disease, reach pathological complete response to neo-adjuvant remedy have had a marked effect on loco-regional remedy concerns, boom opportunities facilitating surgical intervention compare its impact on surgical management of breast cancers either mastectomy or BCS.<br />Patients and Method: This retrospective study is carried out on one hundred female patients with documented breast cancer, examined in the medical oncology department & nuclear medicine remedy Sohag university hospitals and sohag cancers institute, at the period from (2013 - 2018).<br />Results: Number of patients identified before receiving neo-adjuvant chemotherapy asT2 become 15 instances (15%),32 cases (32%) become T3,24 cases(24%) was T4a, 24 instances (24%) T4b,3 instances (three%) changed into T4c and 2cases (2% ) became T4d.<br />The number of instances identified before receiving neo-adjuvant chemotherapy as N0 was4 cases (4%), N1 turned into 37 instances (37%), N2 became fifty-two instances (fifty-two %) and N3 turned into (7%).<br />Number of cases that identified postoperative T0 was 10 cases(10%),T1 turned into 10 instances(10%),T2 was 47 instances(forty seven%),T3 was21 cases (21%),T4a turned into 5cases (5%) and T4b turned into 7 instances (7%).<br />Some instances that turned into postoperative N0 turned into 11cases(eleven%), N1 turned into 57cases (fifty-seven %), N2 was29 cases (29%) and N3 turned into 3cases (3%).<br />Conclusion: Neo-adjuvant chemotherapy plays a vital role in downstaging of breast and axillary disease, facilitates surgical resection, takes part in pathological entire response and testing response to chemotherapy.https://smj.journals.ekb.eg/article_63824_9e1e314e0751e8c6956d21d7be0f1162.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835324120200101Pattern of cancer in Sohag Governorate1761806381610.21608/smj.2019.15980.1041ENTasneem MohammedBakheetPublic health and community medicine, Faculty of medicine, Sohag UniversityFouad M.YousefDepartment of public health and community medicine , Faculty of medicine, Sohag University, sohag, egypt.Journal Article20190911Background: Cancer cases are increasing with time evolution in Egypt. There are an increasing number of the attendant cancer patients and the Outpatient Clinic affiliated to the Oncology and Nuclear Medicine department, Sohag University Hospital and Sohag Cancer Centre are facing difficulties with work pressure. As a consequence, the most prevailing types of cancer among patients suffering this entity of diseases must be addressed to ensure continual and improved quality of care<br />Purpose: find out the pattern of cancer among cancer patients in Sohag governorate<br />Methods: The researcher collected data from 550 patients. Clinical observational study “evaluative type” was conducted at Sohag University hospital (SUH), oncology and nuclear medicine department and Sohag Cancer Center (SCC) in Sohag governorate. Descriptive statistical techniques ,percentages and proportions were used<br />Findings: Commonest sites of cancer in Sohag Governorate were cancer breast (29.9%), then came lymphomas(9.7) and cancer bladder about (9%) followed by colorectal cancer (8.2).<br />Conclusion: pattern of cancer indicated the increased burden of Breast cancer, comes after are lymphomas which occupy the second rank. Study of rates of individual sites of cancer might help in giving clues for preventive programs. <br />Implementing value : essential for planning cancer control actions, health care and allocation of resources. Here we project the cancer burden at the National level estimatehttps://smj.journals.ekb.eg/article_63816_f27bd9363105c249471d23cc1e6c8756.pdf