Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.368096
Mustafa Kamal
Background: There are several pre-, intra-, and post-operative therapies and management options available for minimizing and controlling postoperative pain. Postoperative pain following total hip arthroplasty (THA) is frequently categorized as moderate to severe. This can have an impact on the recovery process after surgery, leading to a delay in the ability to move and an extended stay in the hospital. A very efficient approach for pain relief is required. Historically, the management of this has been accomplished by the utilization of epidural analgesia, peripheral nerve blocks, and the administration of opioids through injection or directly into the spinal cord. Combining multimodal analgesia with nerve block methods is frequently employed to alleviate pain throughout the surgical phase of hip fractures. This approach has been demonstrated to effectively prevent complications and enhance postoperative function by ensuring proper pain control. Objective: This review aimed to assess spinal anesthesia in management of postoperative pain. Methods: We searched PubMed and Google Scholar for information on Postoperative pain management, Hip surgeries and Spinal anesthesia. Although only the most current or comprehensive study from October 2009 to November 2023 was included, the writers additionally assessed references from pertinent literature. Papers written in languages other than English have been disqualified due to lack of translation sources. Conclusion: Peripheral nerve blocks offer efficient pain relief, but to adequately manage pain, it may be required to block the femoral nerve (FN), obturator nerve (ON), and lateral cutaneous nerves (LCN). However, this procedure can be challenging, time-consuming, and may lead to lingering motor impairment. Spinal and parenteral opioids have a connection with modest but unpleasant adverse effects.
{"title":"Postoperative Pain Management in Patients Undergoing Hip Surgeries with Spinal Anesthesia: Review Article","authors":"Mustafa Kamal","doi":"10.21608/ejhm.2024.368096","DOIUrl":"https://doi.org/10.21608/ejhm.2024.368096","url":null,"abstract":"Background: There are several pre-, intra-, and post-operative therapies and management options available for minimizing and controlling postoperative pain. Postoperative pain following total hip arthroplasty (THA) is frequently categorized as moderate to severe. This can have an impact on the recovery process after surgery, leading to a delay in the ability to move and an extended stay in the hospital. A very efficient approach for pain relief is required. Historically, the management of this has been accomplished by the utilization of epidural analgesia, peripheral nerve blocks, and the administration of opioids through injection or directly into the spinal cord. Combining multimodal analgesia with nerve block methods is frequently employed to alleviate pain throughout the surgical phase of hip fractures. This approach has been demonstrated to effectively prevent complications and enhance postoperative function by ensuring proper pain control. Objective: This review aimed to assess spinal anesthesia in management of postoperative pain. Methods: We searched PubMed and Google Scholar for information on Postoperative pain management, Hip surgeries and Spinal anesthesia. Although only the most current or comprehensive study from October 2009 to November 2023 was included, the writers additionally assessed references from pertinent literature. Papers written in languages other than English have been disqualified due to lack of translation sources. Conclusion: Peripheral nerve blocks offer efficient pain relief, but to adequately manage pain, it may be required to block the femoral nerve (FN), obturator nerve (ON), and lateral cutaneous nerves (LCN). However, this procedure can be challenging, time-consuming, and may lead to lingering motor impairment. Spinal and parenteral opioids have a connection with modest but unpleasant adverse effects.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.363742
Abdullah S. Alhazmi, Meshal Y. Altowairqi, Majd Saemaldahar, Abdulaziz A. Abdulaziz, Dhafer Almuffarh
Background: Giant cell tumors (GCTs) are benign bone tumors that can be locally aggressive, leading to joint destruction or pathologic fractures. In rare cases, they can progress to lung metastasis and death. The management modalities of GCTs include medical treatment, curettage, cryotherapy, and resection and reconstruction, including arthroplasty. Objective: The current case report aimed to discuss alternative treatment options to the reported case of GCT. Case report: The reported case showed a healthy 25-years-old man with left hip joint pain progressing over six months. The pain was resistant to lifestyle modifications and medications. Investigations resulted in the diagnosis of a GCT in the left femur head. The management included a preoperative course of denosumab, surgical dislocation of the left hip, lesion curettage, irrigation, and bone graft and cementation. Our plan was a good alternative because it is a low-cost surgery that resulted in regaining the same previous level of activities without limitations. The plan showed excellent outcomes, but more cases and long-term follow-up are needed in further studies. The aim of the case report was to discuss alternative treatment options for the reported case of GCT. Conclusion: A criterion standard treatment option for GCT in the femur is lacking. In the current case, a GCT of the femoral head was treated with an initial course of denosumab for six months, followed by curettage, bone grafting and cementing packing. The outcome showed that this alternative modality yielded functionally and radiologically acceptable results. In addition, the treatment plan was simple and cost-effective.
{"title":"Preserving Approach in Management of Femur Giant Cell Tumor with Curettage and Bone Grafting in an Adult Patient: Case Report","authors":"Abdullah S. Alhazmi, Meshal Y. Altowairqi, Majd Saemaldahar, Abdulaziz A. Abdulaziz, Dhafer Almuffarh","doi":"10.21608/ejhm.2024.363742","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363742","url":null,"abstract":"Background: Giant cell tumors (GCTs) are benign bone tumors that can be locally aggressive, leading to joint destruction or pathologic fractures. In rare cases, they can progress to lung metastasis and death. The management modalities of GCTs include medical treatment, curettage, cryotherapy, and resection and reconstruction, including arthroplasty. Objective: The current case report aimed to discuss alternative treatment options to the reported case of GCT. Case report: The reported case showed a healthy 25-years-old man with left hip joint pain progressing over six months. The pain was resistant to lifestyle modifications and medications. Investigations resulted in the diagnosis of a GCT in the left femur head. The management included a preoperative course of denosumab, surgical dislocation of the left hip, lesion curettage, irrigation, and bone graft and cementation. Our plan was a good alternative because it is a low-cost surgery that resulted in regaining the same previous level of activities without limitations. The plan showed excellent outcomes, but more cases and long-term follow-up are needed in further studies. The aim of the case report was to discuss alternative treatment options for the reported case of GCT. Conclusion: A criterion standard treatment option for GCT in the femur is lacking. In the current case, a GCT of the femoral head was treated with an initial course of denosumab for six months, followed by curettage, bone grafting and cementing packing. The outcome showed that this alternative modality yielded functionally and radiologically acceptable results. In addition, the treatment plan was simple and cost-effective.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.363743
M. Elgohary, Ezzat Mostafa, Heba Shafeak, Abd El, Khalik Hussein, Ibrahim Mohamed Salem, Mostafa Mahmoud Salah, Mai Mohamed Abdelwahab
Background: People with end-stage kidney disease have an unusually high risk of upper gastrointestinal bleeding (UGIB), but no one knows why. Researchers have looked into the causes and frequency of these lesions using upper GI endoscopy. Objective: To investigate how often different UGI symptoms and abnormalities detected by endoscopy are in individuals with chronic kidney disease (CKD). Patients and methods : This cross-sectional study was conducted on a total 116 CKD patients with GIT symptoms. The Clinical Pathology Department and laboratories of Zagazig University Hospitals followed a specific protocol for the laboratory investigations, which comprised a full blood count, liver and kidney functions, PT, PTT, and INR. Following an overnight fast, a fiberoptic endoscopic examination of the upper gastrointestinal tract was carried out. Results : We found that 65.5% of the patients were G5, 23.3% were G4, and 11.2% were G3. 43.1% of the patients presented with anorexia, 36.2% presented with nausea, 38.8% presented with vomiting, 23.3% presented with heart burn, 20.7% presented with epigastric pain, 7.8% presented with hiccup, and 14.7% presented with GI bleeding. 39.7% of the patients showed esophagitis, 51.7% showed gastritis, 14.7% showed duodenitis, 20.7% showed gastric ulcer, 3.7% showed duodenal ulcer, and 7.8% showed hiatus hernia. There were 15 patients who showed positive H. pylori by biopsy. significant differences were found between the groups regarding anorexia, vomiting, esophagitis and gastritis (p=0.001, 0.003, 0.044, 0.004 respectively). Conclusion : Endoscopy on patients with end-stage renal disease (ESRD) can help in early detection of commonly occurring GI lesions and proper management for prevention of serious complications.
{"title":"Study of Upper Gastrointestinal Endoscopic Findings in Chronic Kidney Disease and Dialysis Patients at Zagazig University Hospitals","authors":"M. Elgohary, Ezzat Mostafa, Heba Shafeak, Abd El, Khalik Hussein, Ibrahim Mohamed Salem, Mostafa Mahmoud Salah, Mai Mohamed Abdelwahab","doi":"10.21608/ejhm.2024.363743","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363743","url":null,"abstract":"Background: People with end-stage kidney disease have an unusually high risk of upper gastrointestinal bleeding (UGIB), but no one knows why. Researchers have looked into the causes and frequency of these lesions using upper GI endoscopy. Objective: To investigate how often different UGI symptoms and abnormalities detected by endoscopy are in individuals with chronic kidney disease (CKD). Patients and methods : This cross-sectional study was conducted on a total 116 CKD patients with GIT symptoms. The Clinical Pathology Department and laboratories of Zagazig University Hospitals followed a specific protocol for the laboratory investigations, which comprised a full blood count, liver and kidney functions, PT, PTT, and INR. Following an overnight fast, a fiberoptic endoscopic examination of the upper gastrointestinal tract was carried out. Results : We found that 65.5% of the patients were G5, 23.3% were G4, and 11.2% were G3. 43.1% of the patients presented with anorexia, 36.2% presented with nausea, 38.8% presented with vomiting, 23.3% presented with heart burn, 20.7% presented with epigastric pain, 7.8% presented with hiccup, and 14.7% presented with GI bleeding. 39.7% of the patients showed esophagitis, 51.7% showed gastritis, 14.7% showed duodenitis, 20.7% showed gastric ulcer, 3.7% showed duodenal ulcer, and 7.8% showed hiatus hernia. There were 15 patients who showed positive H. pylori by biopsy. significant differences were found between the groups regarding anorexia, vomiting, esophagitis and gastritis (p=0.001, 0.003, 0.044, 0.004 respectively). Conclusion : Endoscopy on patients with end-stage renal disease (ESRD) can help in early detection of commonly occurring GI lesions and proper management for prevention of serious complications.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.363734
Bassiony Dabian, Eman Ahmed, Maha Mosaad, Mohammed Reda, Dalia Farouk
Background: One of the most crucial steps taken to stop postpartum hemorrhage (PPH) is to take a uterotonic medication as soon after delivery. Objective: Our main objective was to determine which method was better for controlling intraoperative and early postoperative bleeding after an elective Cesarean section (CS) whether intravenous (IV) oxytocin bolus or oxytocin bolus with infusion. Patients and methods: Randomized controlled study that included 214 women who were scheduled for an elective Cesarean section after 38 weeks were divided into two equal groups and given an IV slow bolus oxytocin 5 IU and a placebo infusion (500 ml of normal saline over 4 hours) (Control group) or an IV slow bolus oxytocin 5 IU and an oxytocin infusion (40 IU in 500 ml of normal saline over 4 hours) (Study group). Following fetal delivery, all patients were administered the study medication. Results: The need for additional uterotonics was statistically higher in group A than in group B 26 (24.3%) versus 14 (13.1%). While the estimated blood loss was statistically insignificant between both groups (691.9 ± 233.6 ml in group A versus 543.1 ±179.4 ml in group B. Conclusion: Following IV oxytocin slow bolus during an elective Cesarean section, an additional oxytocin infusion was not superior to IV oxytocin slow bolus alone in reducing the operative blood loss but it may reduce the postoperative need for additional uterotonics
{"title":"A Comparative Study between Oxytocin Intravenous Bolus versus Oxytocin Intravenous Bolus and Infusion for Control of Blood Loss at Elective Cesarean Section","authors":"Bassiony Dabian, Eman Ahmed, Maha Mosaad, Mohammed Reda, Dalia Farouk","doi":"10.21608/ejhm.2024.363734","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363734","url":null,"abstract":"Background: One of the most crucial steps taken to stop postpartum hemorrhage (PPH) is to take a uterotonic medication as soon after delivery. Objective: Our main objective was to determine which method was better for controlling intraoperative and early postoperative bleeding after an elective Cesarean section (CS) whether intravenous (IV) oxytocin bolus or oxytocin bolus with infusion. Patients and methods: Randomized controlled study that included 214 women who were scheduled for an elective Cesarean section after 38 weeks were divided into two equal groups and given an IV slow bolus oxytocin 5 IU and a placebo infusion (500 ml of normal saline over 4 hours) (Control group) or an IV slow bolus oxytocin 5 IU and an oxytocin infusion (40 IU in 500 ml of normal saline over 4 hours) (Study group). Following fetal delivery, all patients were administered the study medication. Results: The need for additional uterotonics was statistically higher in group A than in group B 26 (24.3%) versus 14 (13.1%). While the estimated blood loss was statistically insignificant between both groups (691.9 ± 233.6 ml in group A versus 543.1 ±179.4 ml in group B. Conclusion: Following IV oxytocin slow bolus during an elective Cesarean section, an additional oxytocin infusion was not superior to IV oxytocin slow bolus alone in reducing the operative blood loss but it may reduce the postoperative need for additional uterotonics","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.363737
Eman Abdelrazek, Hagar AbdelMagied, Reham Alagizy, Ahmed Abd, Elaziz Heba, Amira Abdelaziz Mahmoud, Hegazy, Amira Hegazy
Background: Immunonutrition controls the response of the body to disease and damage . Glutamine acts to maintain the intestinal tract, immune cells and muscle, thus it is important to attack against infections and mucositis, also modifies the inflammatory response. Arginine plays a significant role in cell proliferation, synthesis of protein, endocrine, and immune control. So they help to reduce the degree of toxicities induced by treatment. Objective: This study aimed to evaluate the effects of immunonutrition formula administration on the incidence of acute radiotherapy (RT) related toxicities, treatment interruption, overall treatment time and response to treatment. Patients and methods: This prospective study included 120 patients who met the inclusion criteria (adults > 18 years old, pelvic malignancy; bladder, prostate, cervix, uterus and rectum who received radical dose radiotherapy; adjuvant, neoadjuvant, or definitive, either alone or with chemotherapy or hormonal treatment, and PS 0-2). Patients were randomized into 2 groups: Group 1 received immunonutrition with planned calculated diet and standard treatment, and group 2 that received standard treatment only with standard nutrition. difference regarding percentage of body weight loss, development of toxicity, time to recovery from toxicity, incidence of hospital admission, and treatment interruption, which were lower in group 1 (P value < 0.0001, 0.022, 0.001, 0.021, and 0.022 respectively). By multivariate logistic regression, group 1, diagnosis of bladder and rectal cancer were independent predictors of toxicity (P value 0.045, 0.026, and 0.001 respectively). Conclusion: Arginine, glutamine, fish oil immunonutrition formula administration could reduce the incidence of radiotherapy-related toxicities, hospital admission, treatment gap and prevent weight loss.
{"title":"Effects of Early Immunonutrition on Patients with Pelvic Malignancies Receiving Radiotherapy","authors":"Eman Abdelrazek, Hagar AbdelMagied, Reham Alagizy, Ahmed Abd, Elaziz Heba, Amira Abdelaziz Mahmoud, Hegazy, Amira Hegazy","doi":"10.21608/ejhm.2024.363737","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363737","url":null,"abstract":"Background: Immunonutrition controls the response of the body to disease and damage . Glutamine acts to maintain the intestinal tract, immune cells and muscle, thus it is important to attack against infections and mucositis, also modifies the inflammatory response. Arginine plays a significant role in cell proliferation, synthesis of protein, endocrine, and immune control. So they help to reduce the degree of toxicities induced by treatment. Objective: This study aimed to evaluate the effects of immunonutrition formula administration on the incidence of acute radiotherapy (RT) related toxicities, treatment interruption, overall treatment time and response to treatment. Patients and methods: This prospective study included 120 patients who met the inclusion criteria (adults > 18 years old, pelvic malignancy; bladder, prostate, cervix, uterus and rectum who received radical dose radiotherapy; adjuvant, neoadjuvant, or definitive, either alone or with chemotherapy or hormonal treatment, and PS 0-2). Patients were randomized into 2 groups: Group 1 received immunonutrition with planned calculated diet and standard treatment, and group 2 that received standard treatment only with standard nutrition. difference regarding percentage of body weight loss, development of toxicity, time to recovery from toxicity, incidence of hospital admission, and treatment interruption, which were lower in group 1 (P value < 0.0001, 0.022, 0.001, 0.021, and 0.022 respectively). By multivariate logistic regression, group 1, diagnosis of bladder and rectal cancer were independent predictors of toxicity (P value 0.045, 0.026, and 0.001 respectively). Conclusion: Arginine, glutamine, fish oil immunonutrition formula administration could reduce the incidence of radiotherapy-related toxicities, hospital admission, treatment gap and prevent weight loss.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.363702
H. F. Salama, Said Abd, Elatti Saleh, Sara Sami, Mohamed Abo Shanab, Mohamed Zakaria, Sayer Dayer
Background: Clomiphene citrate (CC)-induced ovarian stimulation has been linked to detrimental endometrial consequences that are anti-estrogenic. Objectives: To assess the effects of sildenafil vaginal tablet combined to CC on the endometrial thickness (ET) during ovulation induction. Patients and Methods: This randomized controlled study was conducted at Departments of Obstetrics and Gynecology of Menoufia University Hospital and Alshohadaa Central Hospital. A total of 124 women were recruited. The patients were blinded to group allocation. Group I: (Clomiphene citrate (CC) alone): received clomiphene citrate (50 mg oral tablet twice daily from day 3 to day 7 of the menstrual cycle). Group II: (Clomiphene and sildenafil): received clomiphene citrate (50 mg oral tablet twice daily from day 3 to day 7 of the menstrual cycle) plus vaginal sildenafil tablets (25 mg/12h daily from day 7 up to ovulation trigger) . Mean endometrial stripe thickness measured on day 13 of the cycle and pregnancy rates were the primary endpoints. Results: There were no significant differences between both groups regarding demographic, clinical and basal hormonal profiles. The mean ET measured on day 13 of menstrual cycle was statistically significantly higher among patients received clomiphene and sildenafil than those received clomiphene alone (11.09± 3.83 mm versus 9.22± 3.90 mm, p value 0.021). Also, pregnancy rates were 32.3% and 48.4% in group 1 and 2 respectively with significant differences. Conclusion: Incorporation of sildenafil to CC regimen of ovulation induction has a positive impact on endometrial stripe thickness and so pregnancy outcomes.
{"title":"The Impact of Usage of Sildenafil Citrate with Clomiphene Citrate on The Endometrial Thickness during Ovulation Induction","authors":"H. F. Salama, Said Abd, Elatti Saleh, Sara Sami, Mohamed Abo Shanab, Mohamed Zakaria, Sayer Dayer","doi":"10.21608/ejhm.2024.363702","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363702","url":null,"abstract":"Background: Clomiphene citrate (CC)-induced ovarian stimulation has been linked to detrimental endometrial consequences that are anti-estrogenic. Objectives: To assess the effects of sildenafil vaginal tablet combined to CC on the endometrial thickness (ET) during ovulation induction. Patients and Methods: This randomized controlled study was conducted at Departments of Obstetrics and Gynecology of Menoufia University Hospital and Alshohadaa Central Hospital. A total of 124 women were recruited. The patients were blinded to group allocation. Group I: (Clomiphene citrate (CC) alone): received clomiphene citrate (50 mg oral tablet twice daily from day 3 to day 7 of the menstrual cycle). Group II: (Clomiphene and sildenafil): received clomiphene citrate (50 mg oral tablet twice daily from day 3 to day 7 of the menstrual cycle) plus vaginal sildenafil tablets (25 mg/12h daily from day 7 up to ovulation trigger) . Mean endometrial stripe thickness measured on day 13 of the cycle and pregnancy rates were the primary endpoints. Results: There were no significant differences between both groups regarding demographic, clinical and basal hormonal profiles. The mean ET measured on day 13 of menstrual cycle was statistically significantly higher among patients received clomiphene and sildenafil than those received clomiphene alone (11.09± 3.83 mm versus 9.22± 3.90 mm, p value 0.021). Also, pregnancy rates were 32.3% and 48.4% in group 1 and 2 respectively with significant differences. Conclusion: Incorporation of sildenafil to CC regimen of ovulation induction has a positive impact on endometrial stripe thickness and so pregnancy outcomes.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejhm.2024.368100
T. Bakheet, Nagah Abo, El-Fetoh, Ayat Ahmed, Magda Ali
Background: Cardiovascular diseases (CVD) account for 31% of global mortality, with major contributors including heart attacks and strokes. The development of CVD is influenced by a combination of dietary, lifestyle, and genetic factors. Objective: The review aimed to clarify the benefits and potential risks associated with micronutrient supplementation, including vitamins and minerals, in the context of CVD prevention and management and modulating risk factors associated with CVD. Methods: We searched Google Scholar, Science Direct, PubMed and other online databases for vitamins and minerals supplementation and their impact on cardiovascular health. The authors also reviewed references from pertinent literature, however only the most recent or comprehensive studies from 2010 to February 2023 were included. Documents in languages other than English were disqualified due to lack of translation-related sources. Papers such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations that were not part of larger scientific studies were excluded. Conclusion: Micronutrients play significant roles in cardiovascular health through mechanisms involving inflammation, oxidative stress, and endothelial function. While certain micronutrients, such as calcium, zinc, vitamin D, and selenium, show promise in supporting cardiovascular health, excessive levels may pose risks. Supplementation with folic acid and B vitamins has been associated with reduced stroke risk, whereas niacin and antioxidants may increase all-cause mortality risk. The evidence does not support the routine use of vitamin supplements for reducing cardiovascular risk, highlighting the need for balanced micronutrient intake through diet rather than supplementation.
背景：心血管疾病（CVD）占全球死亡率的 31%，其主要诱因包括心脏病发作和中风。心血管疾病的发生受饮食、生活方式和遗传因素的综合影响。研究目的本综述旨在阐明在心血管疾病预防和管理以及调节心血管疾病相关风险因素的背景下，补充微量营养素（包括维生素和矿物质）的益处和潜在风险。研究方法我们在 Google Scholar、Science Direct、PubMed 和其他在线数据库中搜索了维生素和矿物质的补充及其对心血管健康的影响。作者还查阅了相关文献的参考文献，但只收录了 2010 年至 2023 年 2 月期间最新或最全面的研究。英语以外语言的文献因缺乏翻译相关资料而被取消资格。未发表的手稿、口头报告、会议摘要和论文等不属于大型科学研究的论文也被排除在外。结论微量营养素通过涉及炎症、氧化应激和内皮功能的机制在心血管健康中发挥着重要作用。虽然某些微量营养素，如钙、锌、维生素 D 和硒，有望支持心血管健康，但过量摄入可能会带来风险。补充叶酸和 B 族维生素与降低中风风险有关，而烟酸和抗氧化剂可能会增加全因死亡风险。证据并不支持常规使用维生素补充剂来降低心血管风险，这突出表明需要通过饮食而不是补充剂来平衡微量营养素的摄入。
{"title":"Impact of Micronutrients on Cardiovascular Health: A Review Article","authors":"T. Bakheet, Nagah Abo, El-Fetoh, Ayat Ahmed, Magda Ali","doi":"10.21608/ejhm.2024.368100","DOIUrl":"https://doi.org/10.21608/ejhm.2024.368100","url":null,"abstract":"Background: Cardiovascular diseases (CVD) account for 31% of global mortality, with major contributors including heart attacks and strokes. The development of CVD is influenced by a combination of dietary, lifestyle, and genetic factors. Objective: The review aimed to clarify the benefits and potential risks associated with micronutrient supplementation, including vitamins and minerals, in the context of CVD prevention and management and modulating risk factors associated with CVD. Methods: We searched Google Scholar, Science Direct, PubMed and other online databases for vitamins and minerals supplementation and their impact on cardiovascular health. The authors also reviewed references from pertinent literature, however only the most recent or comprehensive studies from 2010 to February 2023 were included. Documents in languages other than English were disqualified due to lack of translation-related sources. Papers such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations that were not part of larger scientific studies were excluded. Conclusion: Micronutrients play significant roles in cardiovascular health through mechanisms involving inflammation, oxidative stress, and endothelial function. While certain micronutrients, such as calcium, zinc, vitamin D, and selenium, show promise in supporting cardiovascular health, excessive levels may pose risks. Supplementation with folic acid and B vitamins has been associated with reduced stroke risk, whereas niacin and antioxidants may increase all-cause mortality risk. The evidence does not support the routine use of vitamin supplements for reducing cardiovascular risk, highlighting the need for balanced micronutrient intake through diet rather than supplementation.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Plantar fasciitis (PF) is a condition characterized by the plantar fascia's deterioration, which is brought on by constant strain at the calcaneus, where it attaches. This leads to heel pain and functional impairment. Purpose: to compare between integrated neuromuscular inhibition technique (INIT) as well as instrument assisted soft tissue mobilization (IASTM) in treatment patient with chronic PF. Patients and Methods: A total of 54 participants, comprising both genders aged between 40 and 60 years, were randomly divided into three groups. Group (A): got conventional treatment of PF. Group (B): got conventional treatment in addition INIT. Group (C): got conventional treatment in addition IASTM. Each group received 4 weeks’ treatment; 3 sessions per week. Pain intensity level, pain pressure threshold (PPT), active ankle dorsiflexion ROM (range of motion) and foot functional disability level were measured using visual analogue scale, electrogoniometer, pressure algometer, and foot disability index in Arabic. Results : There was a significant difference decrease in mean value of pain and foot function index (FFI), increase in mean value of pressure pain threshold (PPT) and ankle dorsiflexion ROM within three groups. Post hoc test conducted between groups reveled a favor of INIT group program (Group B) followed by IASTM group program (Group C) in all variables.
{"title":"Integrated Neuromuscular Inhibition Technique versus Instrument Assisted Soft Tissue Mobilization in Patients with Chronic Plantar Fasciitis","authors":"Esraa Khairy, Afify Esmail, Fatma Sedik, Amin, Mohamed Abdelalim Qudahh, M. Zahran","doi":"10.21608/ejhm.2024.368099","DOIUrl":"https://doi.org/10.21608/ejhm.2024.368099","url":null,"abstract":"Background: Plantar fasciitis (PF) is a condition characterized by the plantar fascia's deterioration, which is brought on by constant strain at the calcaneus, where it attaches. This leads to heel pain and functional impairment. Purpose: to compare between integrated neuromuscular inhibition technique (INIT) as well as instrument assisted soft tissue mobilization (IASTM) in treatment patient with chronic PF. Patients and Methods: A total of 54 participants, comprising both genders aged between 40 and 60 years, were randomly divided into three groups. Group (A): got conventional treatment of PF. Group (B): got conventional treatment in addition INIT. Group (C): got conventional treatment in addition IASTM. Each group received 4 weeks’ treatment; 3 sessions per week. Pain intensity level, pain pressure threshold (PPT), active ankle dorsiflexion ROM (range of motion) and foot functional disability level were measured using visual analogue scale, electrogoniometer, pressure algometer, and foot disability index in Arabic. Results : There was a significant difference decrease in mean value of pain and foot function index (FFI), increase in mean value of pressure pain threshold (PPT) and ankle dorsiflexion ROM within three groups. Post hoc test conducted between groups reveled a favor of INIT group program (Group B) followed by IASTM group program (Group C) in all variables.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.21608/ejhm.2024.349393
N. Zaher, Emad M. Abdelrahman, Ola Seif, Mohamed F. Abdelfattah, Refaat S. Salama
Background: Mastectomy leads to moderate to severe degrees of depression and anxiety. Objectives: This study aimed to evaluate the outcome of breast conservative surgery with breast reconstruction on the quality of life (QOL). Patients & methods: The current retrospective study included 62 patients with T1, and T2 breast cancer who underwent modified radical mastectomy (MRM) or breast conservative surgery (BCS) with reconstruction. Evaluation of the quality of life, depression as well as post-operative complications was reported and compared. Results: The current study included 62 female patients with mean age of 43.20 ± 4.49 and 44.36 ± 5.16 in groups A and B respectively. There was a significantly lower mean operative time (P value =0.001) in patients who underwent MRM. There was statistically significant beck depression inventory (BDI) scores in both groups with more improvement in BCS group. Both groups reported statistically significant improvement of psychological well-being, social well-being, and spiritual well-being after 6 months with significant improvement in group A. Conclusion: Conservative breast surgery with reconstruction offers an oncologically safe alternative for modified radical mastectomy with less impact on the QOL and associated with less depression
背景：乳房切除术会导致中度至重度抑郁和焦虑。研究目的本研究旨在评估乳房保守手术和乳房重建对生活质量（QOL）的影响。患者和方法本次回顾性研究纳入了 62 名接受改良根治性乳房切除术（MRM）或乳房保守手术（BCS）加乳房重建的 T1 和 T2 乳腺癌患者。研究对患者的生活质量、抑郁以及术后并发症进行了评估和比较。研究结果本次研究共纳入 62 名女性患者，A 组和 B 组患者的平均年龄分别为（43.20±4.49）岁和（44.36±5.16）岁。接受 MRM 的患者平均手术时间明显更短（P 值 =0.001）。两组患者的贝氏抑郁量表（BDI）评分均有统计学意义，BCS 组的改善幅度更大。6 个月后，两组患者的心理健康、社交健康和精神健康均有明显改善，其中 A 组改善明显：保守乳房手术加重建为改良根治性乳房切除术提供了一种肿瘤学上安全的替代方案，对 QOL 的影响较小，相关的抑郁也较少。
{"title":"The Effect of Concomitant Conservative Breast Surgery with Reconstruction on Quality of Life of and Depression in Breast Cancer Patients","authors":"N. Zaher, Emad M. Abdelrahman, Ola Seif, Mohamed F. Abdelfattah, Refaat S. Salama","doi":"10.21608/ejhm.2024.349393","DOIUrl":"https://doi.org/10.21608/ejhm.2024.349393","url":null,"abstract":"Background: Mastectomy leads to moderate to severe degrees of depression and anxiety. Objectives: This study aimed to evaluate the outcome of breast conservative surgery with breast reconstruction on the quality of life (QOL). Patients & methods: The current retrospective study included 62 patients with T1, and T2 breast cancer who underwent modified radical mastectomy (MRM) or breast conservative surgery (BCS) with reconstruction. Evaluation of the quality of life, depression as well as post-operative complications was reported and compared. Results: The current study included 62 female patients with mean age of 43.20 ± 4.49 and 44.36 ± 5.16 in groups A and B respectively. There was a significantly lower mean operative time (P value =0.001) in patients who underwent MRM. There was statistically significant beck depression inventory (BDI) scores in both groups with more improvement in BCS group. Both groups reported statistically significant improvement of psychological well-being, social well-being, and spiritual well-being after 6 months with significant improvement in group A. Conclusion: Conservative breast surgery with reconstruction offers an oncologically safe alternative for modified radical mastectomy with less impact on the QOL and associated with less depression","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.21608/ejhm.2024.348715
Ayman El, Sayed Solyman, Hamed Elsayed Ellakwa, Adel Gaber Allam, Hasnaa Samir, Aboumosalam Mousa, Eman Said Badr
Background: According to estimates, between 30% and 40% of implanted pregnancies end in spontaneous abortion in the first trimester, with the majority happening fairly early on. Objectives: To evaluate gestational sac (GS) diameter and shape, yolk sac (YS) diameter and shape, embryonic heart rate (EHR) and crown rump length (CRL) during the first trimester as prognostic factors of first trimester pregnancy outcome. Patients and Methods: This prospective observational cohort study was carried out on 118 patients in Shebin Elkom Teaching Hospital and Menoufia University Hospital in uncomplicated singleton pregnancy from (20-35) years old women. Results : 109 cases (92.4%) resulted in an ongoing pregnancy and entered the 2 nd trimester successfully, while 9 cases (7.6%) resulted in miscarriage. There was a highly statistically significant decrease in GS diameter, CRL, fetal heart rate but increase in YS diameter in fetal loss group more than ongoing pregnancy at 6, 9 and 12 weeks. Conclusion: The best indicator of the prognosis for first trimester pregnancy outcomes was YS diameter measurement. Fetal heart rate, GS diameter, and CRL diameter were the next best predictors, and an increase in YS diameter beyond what is expected for any gestational age (GA) and a decrease in any of these factors are indicators of poor pregnancy outcomes during the first 12 weeks of pregnancy.
{"title":"Ultrasonographic Evaluation of Gestational Sac, Yolk Sac, Embryonic Heart Rate and Crown Rump Length as Prognostic Factors for First Trimester Pregnancy Outcomes","authors":"Ayman El, Sayed Solyman, Hamed Elsayed Ellakwa, Adel Gaber Allam, Hasnaa Samir, Aboumosalam Mousa, Eman Said Badr","doi":"10.21608/ejhm.2024.348715","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348715","url":null,"abstract":"Background: According to estimates, between 30% and 40% of implanted pregnancies end in spontaneous abortion in the first trimester, with the majority happening fairly early on. Objectives: To evaluate gestational sac (GS) diameter and shape, yolk sac (YS) diameter and shape, embryonic heart rate (EHR) and crown rump length (CRL) during the first trimester as prognostic factors of first trimester pregnancy outcome. Patients and Methods: This prospective observational cohort study was carried out on 118 patients in Shebin Elkom Teaching Hospital and Menoufia University Hospital in uncomplicated singleton pregnancy from (20-35) years old women. Results : 109 cases (92.4%) resulted in an ongoing pregnancy and entered the 2 nd trimester successfully, while 9 cases (7.6%) resulted in miscarriage. There was a highly statistically significant decrease in GS diameter, CRL, fetal heart rate but increase in YS diameter in fetal loss group more than ongoing pregnancy at 6, 9 and 12 weeks. Conclusion: The best indicator of the prognosis for first trimester pregnancy outcomes was YS diameter measurement. Fetal heart rate, GS diameter, and CRL diameter were the next best predictors, and an increase in YS diameter beyond what is expected for any gestational age (GA) and a decrease in any of these factors are indicators of poor pregnancy outcomes during the first 12 weeks of pregnancy.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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