Pub Date : 2024-04-01DOI: 10.21608/ejhm.2024.349084
K. Kenawy, Amr M. Tayel, A. Abdelhameid
Background: The subaxial cervical spine trauma associated with spinal cord injury carries high rate of morbidity, mortality, with significant socioeconomic impact. There are different modalities for treatment of such cases. Objective: To evaluate the early outcome of standalone anterior reconstruction cervical spine surgery with cage and plate system in management of displaced subaxial cervical spine injuries with cord compression. Patients and Methods: The study included 14 patients during the period from January 2020 to January 2024 with displaced subaxial cervical spine injuries associated with cord compression. Preoperative symptoms and postoperative results for those patients who underwent standalone anterior reconstruction of cervical spine by surgery with cage and plate system for treatment of their lesions, were all recorded. Results: Patients were 9 males and 5 females with mean age 28 years. The most common cervical level affected was C5-C6 accounting for (71.5%) 10 cases, followed by C4-C5 3 cases (21.5%) then C6-C7 (7 case). The average blood loss intraoperatively was 150 ml ± 50. The most common complication was the C5 palsy occurred in 4 cases who improved with medical treatment and follow up. No CSF leak, hardware failure, vascular injury or soft tissue injuries were reported in this series. Conclusion: Performing immediate intraoperative closed reduction under general anesthesia for subaxial cervical spine dislocations, along with anterior cervical stabilization using a cage and plate system, has been shown to be the preferred treatment option due to its high safety and efficacy rates, with fewer complications.
{"title":"Standalone Anterior Reconstruction Approach in Traumatic Cervical Spine Instability Lesions","authors":"K. Kenawy, Amr M. Tayel, A. Abdelhameid","doi":"10.21608/ejhm.2024.349084","DOIUrl":"https://doi.org/10.21608/ejhm.2024.349084","url":null,"abstract":"Background: The subaxial cervical spine trauma associated with spinal cord injury carries high rate of morbidity, mortality, with significant socioeconomic impact. There are different modalities for treatment of such cases. Objective: To evaluate the early outcome of standalone anterior reconstruction cervical spine surgery with cage and plate system in management of displaced subaxial cervical spine injuries with cord compression. Patients and Methods: The study included 14 patients during the period from January 2020 to January 2024 with displaced subaxial cervical spine injuries associated with cord compression. Preoperative symptoms and postoperative results for those patients who underwent standalone anterior reconstruction of cervical spine by surgery with cage and plate system for treatment of their lesions, were all recorded. Results: Patients were 9 males and 5 females with mean age 28 years. The most common cervical level affected was C5-C6 accounting for (71.5%) 10 cases, followed by C4-C5 3 cases (21.5%) then C6-C7 (7 case). The average blood loss intraoperatively was 150 ml ± 50. The most common complication was the C5 palsy occurred in 4 cases who improved with medical treatment and follow up. No CSF leak, hardware failure, vascular injury or soft tissue injuries were reported in this series. Conclusion: Performing immediate intraoperative closed reduction under general anesthesia for subaxial cervical spine dislocations, along with anterior cervical stabilization using a cage and plate system, has been shown to be the preferred treatment option due to its high safety and efficacy rates, with fewer complications.","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":"140791646","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.2024.349388
AbdelMaguid I. Ramzy
Background: Vaginismus, a prevalent genito-pelvic pain/penetration disorder in the Middle East, often leads to unconsummated marriages, with a significant impact on marital and social well-being. Traditional treatments have shown limited success in refractory cases. Objective: To evaluate the effectiveness of an integrated treatment program, including Botulinum Toxin A (BTXA) injections, gradual vaginal introitus dilation, and psychological support, in treating refractory vaginismus in Egyptian women. Patients and Methods: This retrospective case series analyzed 1,400 women with refractory vaginismus, treated between January 2013 and 2023. The program comprised BTXA injections in the perineal muscles, followed by guided physiotherapy for muscle dilation and psychological counseling. Success was defined as painless vaginal penetration. Results: Of the initial 1,512 cases, 1,400 completed the program. The average age of participants was 28 years. Most patients (93%) had tried conventional treatments without success. Post-treatment, 92.6% (1,288/1,400) achieved painless penetration. The majority required 3 to 5 dilatation treatment sessions for success. Mild adverse effects were reported in 28% of cases. Conclusion: The integrated treatment program, combining BTXA injections, gradual dilation, and psychological support, is highly effective in managing refractory vaginismus in Egyptian women, with a success rate of over 90%. This approach offers a promising solution for couples facing unconsummated marriages due to vaginismus.
{"title":"Vaginismus as a Cause of Unconsummated Marriage: An Egyptian Case Series","authors":"AbdelMaguid I. Ramzy","doi":"10.21608/ejhm.2024.349388","DOIUrl":"https://doi.org/10.21608/ejhm.2024.349388","url":null,"abstract":"Background: Vaginismus, a prevalent genito-pelvic pain/penetration disorder in the Middle East, often leads to unconsummated marriages, with a significant impact on marital and social well-being. Traditional treatments have shown limited success in refractory cases. Objective: To evaluate the effectiveness of an integrated treatment program, including Botulinum Toxin A (BTXA) injections, gradual vaginal introitus dilation, and psychological support, in treating refractory vaginismus in Egyptian women. Patients and Methods: This retrospective case series analyzed 1,400 women with refractory vaginismus, treated between January 2013 and 2023. The program comprised BTXA injections in the perineal muscles, followed by guided physiotherapy for muscle dilation and psychological counseling. Success was defined as painless vaginal penetration. Results: Of the initial 1,512 cases, 1,400 completed the program. The average age of participants was 28 years. Most patients (93%) had tried conventional treatments without success. Post-treatment, 92.6% (1,288/1,400) achieved painless penetration. The majority required 3 to 5 dilatation treatment sessions for success. Mild adverse effects were reported in 28% of cases. Conclusion: The integrated treatment program, combining BTXA injections, gradual dilation, and psychological support, is highly effective in managing refractory vaginismus in Egyptian women, with a success rate of over 90%. This approach offers a promising solution for couples facing unconsummated marriages due to vaginismus.","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":"140787675","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.2024.349086
Mohammed Abd, Elhady Mohammed, Amr Ali, Sharaf Eldeen, Amira Emam Ahmed, Mai Abd, Elgelil Abd, Elmoneem Boshnak
Background: The development of the fetal membranes “amnion and chorion” begins with embryogenesis, although they do not have a direct role in the formation of the embryo or fetus. Objective: This study aimed to decrease the morbidities and mortalities resulting from premature rupture of membranes (PROM.). Patients and methods: This was a cohort study conducted on 90 patients at Department of Obstetrics and Gynecology in Benha University Hospital and Zagazig General Hospital through the period from November 2022 to November 2023. Results: A notable divergence was observed concerning the cervical length, with the first measurement yielding a p-value of 0.005 and the second measurement yielding a p-value of 0.01. Furthermore, a significant disparity was noted in the gestational age at the time of termination, as evidenced by a p-value of 0.029. When evaluating the effectiveness of lactoferrin (LF) in averting membrane rupture, lactoferrin demonstrated a sensitivity of 75.6%, a specificity of 57.8%, and predictive values for positive and negative outcomes of 64.2% and 70.3% respectively, albeit with a non-significant p-value of 0.163. In terms of neonatal vital signs (including pulse rate and respiratory rate) and neonatal weight, no significant differences were discerned, as indicated by p-values of 0.69, 0.545, 0.013, and 0.091, respectively. Conclusion: Augmentation through lactoferrin supplementation presents a conceivable strategy to diminish the incidence of PROM. Additional research is imperative to substantiate the preliminary evidence, which offers a significant conceptual foundation for the prospective utilization of lactoferrin in thwarting preterm childbirth.
{"title":"Role of Lactoferrin in Prevention of Premature Rupture of Membranes","authors":"Mohammed Abd, Elhady Mohammed, Amr Ali, Sharaf Eldeen, Amira Emam Ahmed, Mai Abd, Elgelil Abd, Elmoneem Boshnak","doi":"10.21608/ejhm.2024.349086","DOIUrl":"https://doi.org/10.21608/ejhm.2024.349086","url":null,"abstract":"Background: The development of the fetal membranes “amnion and chorion” begins with embryogenesis, although they do not have a direct role in the formation of the embryo or fetus. Objective: This study aimed to decrease the morbidities and mortalities resulting from premature rupture of membranes (PROM.). Patients and methods: This was a cohort study conducted on 90 patients at Department of Obstetrics and Gynecology in Benha University Hospital and Zagazig General Hospital through the period from November 2022 to November 2023. Results: A notable divergence was observed concerning the cervical length, with the first measurement yielding a p-value of 0.005 and the second measurement yielding a p-value of 0.01. Furthermore, a significant disparity was noted in the gestational age at the time of termination, as evidenced by a p-value of 0.029. When evaluating the effectiveness of lactoferrin (LF) in averting membrane rupture, lactoferrin demonstrated a sensitivity of 75.6%, a specificity of 57.8%, and predictive values for positive and negative outcomes of 64.2% and 70.3% respectively, albeit with a non-significant p-value of 0.163. In terms of neonatal vital signs (including pulse rate and respiratory rate) and neonatal weight, no significant differences were discerned, as indicated by p-values of 0.69, 0.545, 0.013, and 0.091, respectively. Conclusion: Augmentation through lactoferrin supplementation presents a conceivable strategy to diminish the incidence of PROM. Additional research is imperative to substantiate the preliminary evidence, which offers a significant conceptual foundation for the prospective utilization of lactoferrin in thwarting preterm childbirth.","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":"140794774","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.2024.348716
Mohamed Magdy Ezzat, Mohamed El-Said, S. Attia, Mohamed Abd-ElSalam Mohamed
Background: Several epileptic patients give no response to the usual line of treatment, which represents 1/5 of epileptic patients and is known as drug-resistant epilepsy (DRE). DRE is often accompanied by impaired intellectual functions, psychiatric co-morbidities, physical damage, and low quality of life (QoL). Objective: This study aimed to assess the predictive factors for early identification of refractory seizures. Patients and Methods: This was a cross-section study conducted during a period of one year at Emergency Department (ED), Faculty of Medicine, Mansoura University. We comprised cases with diagnosis of refractory epilepsy on a total of 80 patients with refractory seizures [at least 2 potentially effective anti-epileptic drugs (AEDs) whatever mono or combined in maximally tolerated dose]. Results: Of the studied cases, 62.5% were females. There was a significant difference in cases with refractory epilepsy as regard seizures types with higher frequency of mixed and focal seizures. There was no statistically significant difference recorded regarding the previous history of status epilepticus (SE). Mixed seizures were significantly increased among cases with refractory epilepsy. The presence of positive family history, positive history of febrile seizures, associated psychiatric disorders and younger age at disease onset increase risk of refractory epilepsy. Conclusion: The main predictors of development of DRE were high initial seizures frequency, positive family history, febrile seizures, associated psychiatric disorders and younger age at disease onset.
{"title":"Predictive Factors of Refractory Epilepsy","authors":"Mohamed Magdy Ezzat, Mohamed El-Said, S. Attia, Mohamed Abd-ElSalam Mohamed","doi":"10.21608/ejhm.2024.348716","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348716","url":null,"abstract":"Background: Several epileptic patients give no response to the usual line of treatment, which represents 1/5 of epileptic patients and is known as drug-resistant epilepsy (DRE). DRE is often accompanied by impaired intellectual functions, psychiatric co-morbidities, physical damage, and low quality of life (QoL). Objective: This study aimed to assess the predictive factors for early identification of refractory seizures. Patients and Methods: This was a cross-section study conducted during a period of one year at Emergency Department (ED), Faculty of Medicine, Mansoura University. We comprised cases with diagnosis of refractory epilepsy on a total of 80 patients with refractory seizures [at least 2 potentially effective anti-epileptic drugs (AEDs) whatever mono or combined in maximally tolerated dose]. Results: Of the studied cases, 62.5% were females. There was a significant difference in cases with refractory epilepsy as regard seizures types with higher frequency of mixed and focal seizures. There was no statistically significant difference recorded regarding the previous history of status epilepticus (SE). Mixed seizures were significantly increased among cases with refractory epilepsy. The presence of positive family history, positive history of febrile seizures, associated psychiatric disorders and younger age at disease onset increase risk of refractory epilepsy. Conclusion: The main predictors of development of DRE were high initial seizures frequency, positive family history, febrile seizures, associated psychiatric disorders and younger age at disease onset.","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":"140779579","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.2024.348392
Samar G. Soliman, Alaa A. Labeeb, Saga F. El-Gazzar, Aya M. Allam
Background: Carpal tunnel syndrome (CTS) is one of the most diagnosed disabling conditions of the upper extremities. Corticosteroid local injection is one of the traditional treatments. Platelet-Rich Plasma (PRP) local injection has emerged as a new treatment, promoting nerve regeneration. Objectives: Comparison of the effectiveness of a single PRP local injection to a single corticosteroid local injection for treating idiopathic CTS using nerve conduction studies and Visual Analog Scale. Patients and method: 40 patients with mild idiopathic CTS were diagnosed clinically and selected according to Padua's Neurophysiologic Severity Scale (PNSS) started the study. They were divided into 2 equal groups; the first group of patients received a single local corticosteroid injection, and the second group received a single local PRP injection. Nerve conduction studies (NCS) in the form of median nerve sensory conduction velocity and the Visual Analogue Scale (VAS) were compared in both groups before and three months after injection. Results: Our study included 40 patients randomly grouped into two equal main categories. Group I (corticosteroid group) included 20 patients with a mean age of 41.50±11.26 years, while Group II (PRP group) included 20 patients with a mean age of 39.10±11.24 years. VAS and median nerve sensory conduction velocity were significantly reduced in group II compared to group I. Conclusions: PRP single local injection in the wrist proved to be better than corticosteroids single local injection for managing mild idiopathic CTS.
{"title":"Study of Platelet-Rich Plasma Local Injection in Idiopathic Carpal Tunnel Syndrome","authors":"Samar G. Soliman, Alaa A. Labeeb, Saga F. El-Gazzar, Aya M. Allam","doi":"10.21608/ejhm.2024.348392","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348392","url":null,"abstract":"Background: Carpal tunnel syndrome (CTS) is one of the most diagnosed disabling conditions of the upper extremities. Corticosteroid local injection is one of the traditional treatments. Platelet-Rich Plasma (PRP) local injection has emerged as a new treatment, promoting nerve regeneration. Objectives: Comparison of the effectiveness of a single PRP local injection to a single corticosteroid local injection for treating idiopathic CTS using nerve conduction studies and Visual Analog Scale. Patients and method: 40 patients with mild idiopathic CTS were diagnosed clinically and selected according to Padua's Neurophysiologic Severity Scale (PNSS) started the study. They were divided into 2 equal groups; the first group of patients received a single local corticosteroid injection, and the second group received a single local PRP injection. Nerve conduction studies (NCS) in the form of median nerve sensory conduction velocity and the Visual Analogue Scale (VAS) were compared in both groups before and three months after injection. Results: Our study included 40 patients randomly grouped into two equal main categories. Group I (corticosteroid group) included 20 patients with a mean age of 41.50±11.26 years, while Group II (PRP group) included 20 patients with a mean age of 39.10±11.24 years. VAS and median nerve sensory conduction velocity were significantly reduced in group II compared to group I. Conclusions: PRP single local injection in the wrist proved to be better than corticosteroids single local injection for managing mild idiopathic CTS.","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":"140757458","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.2024.348713
Eman Elshahat, Elsayed Orabi
Background: Burnout is recognized as a prevalent problem in contemporary society, particularly in the realm of occupational stress, and it is garnering global attention. It is identified by a sense of depleted energy, cynicism towards one's job, and diminished professional effectiveness. The level of career satisfaction serves as a crucial indicator of the quality of the healthcare system. Objective: To evaluate the correlation between clinician burnout and career satisfaction in Zagazig University Hospitals, aiming to contribute insights for the enhancement of their overall well-being in future endeavors. Subjects and Methods: A cross-sectional study was conducted on 246 clinicians representing various major specialties at Zagazig University Hospitals from July to November 2023. The used structured questionnaire comprised three parts: 1) Personal and professional characteristics, 2) Maslach Burnout Inventory (MBI) questionnaire, and 3) Career Satisfaction assessment questionnaire. Results: Clinicians exhibited moderate levels of emotional exhaustion (EE), depersonalization (DP), personal accomplishment (PA), and average career satisfaction with percentages of 45.6%, 54.1%, 40.7%, and 43.5%, respectively. Pediatricians demonstrated a significantly higher risk of EE (30.02±7.1), whereas internists were notably at a higher risk of low PA (34.3±10). A significant weak negative correlation was observed between emotional exhaustion and career satisfaction (r= -0.133). Conclusions: A moderate level of burnout syndrome was identified among clinicians in Zagazig University Hospitals. Pediatricians faced a higher risk of emotional exhaustion (EE), while internists were more susceptible to low personal accomplishment (PA). Additionally, an overall average level of career satisfaction and a negative correlation between EE and career satisfaction were observed.
背景：职业倦怠被认为是当代社会的一个普遍问题，尤其是在职业压力领域，它正引起全球的关注。倦怠感表现为精力耗尽、对工作愤世嫉俗以及专业效率降低。职业满意度是衡量医疗保健系统质量的重要指标。目的评估扎加齐格大学医院临床医生职业倦怠与职业满意度之间的相关性，旨在为提高他们在未来工作中的整体福祉提供见解。研究对象和方法：2023 年 7 月至 11 月期间，对代表扎加齐格大学医院各主要专科的 246 名临床医生进行了横断面研究。所使用的结构化问卷包括三个部分：1）个人和职业特征；2）马斯拉奇职业倦怠量表（MBI）问卷；3）职业满意度评估问卷。结果显示临床医生表现出中等程度的情感衰竭（EE）、人格解体（DP）、个人成就感（PA）和平均职业满意度，百分比分别为 45.6%、54.1%、40.7% 和 43.5%。儿科医生的 EE 风险明显更高（30.02±7.1），而内科医生的低 PA 风险明显更高（34.3±10）。情绪衰竭与职业满意度之间存在明显的弱负相关（r= -0.133）。结论是在扎加齐格大学医院的临床医生中发现了中等程度的职业倦怠综合征。儿科医生面临情绪衰竭（EE）的风险较高，而内科医生则更容易出现个人成就感低（PA）的情况。此外，还观察到职业满意度总体处于平均水平，EE 与职业满意度之间呈负相关。
{"title":"Clinicians Burnout and Career Satisfaction across The Major Specialties in Zagazig University Hospitals","authors":"Eman Elshahat, Elsayed Orabi","doi":"10.21608/ejhm.2024.348713","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348713","url":null,"abstract":"Background: Burnout is recognized as a prevalent problem in contemporary society, particularly in the realm of occupational stress, and it is garnering global attention. It is identified by a sense of depleted energy, cynicism towards one's job, and diminished professional effectiveness. The level of career satisfaction serves as a crucial indicator of the quality of the healthcare system. Objective: To evaluate the correlation between clinician burnout and career satisfaction in Zagazig University Hospitals, aiming to contribute insights for the enhancement of their overall well-being in future endeavors. Subjects and Methods: A cross-sectional study was conducted on 246 clinicians representing various major specialties at Zagazig University Hospitals from July to November 2023. The used structured questionnaire comprised three parts: 1) Personal and professional characteristics, 2) Maslach Burnout Inventory (MBI) questionnaire, and 3) Career Satisfaction assessment questionnaire. Results: Clinicians exhibited moderate levels of emotional exhaustion (EE), depersonalization (DP), personal accomplishment (PA), and average career satisfaction with percentages of 45.6%, 54.1%, 40.7%, and 43.5%, respectively. Pediatricians demonstrated a significantly higher risk of EE (30.02±7.1), whereas internists were notably at a higher risk of low PA (34.3±10). A significant weak negative correlation was observed between emotional exhaustion and career satisfaction (r= -0.133). Conclusions: A moderate level of burnout syndrome was identified among clinicians in Zagazig University Hospitals. Pediatricians faced a higher risk of emotional exhaustion (EE), while internists were more susceptible to low personal accomplishment (PA). Additionally, an overall average level of career satisfaction and a negative correlation between EE and career satisfaction were observed.","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":"140764789","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.2024.349392
Naser A. Zaher, Emad M. Abdelrahman, Atef A. Salem, Mohamed M. Debes, Marwa M. Yosry, Mohamed E. Zayed
Background: Due to its prevalence and the absence of well-established preoperative indicators, hypoparathyroidism poses a significant problem. Objective: This study aimed to find characteristics that predict hypocalcemia after total thyroidectomy was the primary goal of this investigation. Patients and methods: In this prospective analysis, 123 patients who were candidates for a thyroidectomy were enrolled. Early hypocalcemia symptoms and potential risk factors were monitored in these individuals. Results: The mean age of the studied patients was 47.22 ± 12.2 years. Hypocalcemia was significantly evident in the age group between 40-50 years. Results showed that recurring goiter, Grave's disease, malignant goiter and block neck dissection were significantly correlated with postoperative hypocalcemia. Conclusion: Malignant goiter, Grave’s disease (GD) and recurrent goiter are independent risk factors for post total thyroidectomy hypocalcemia.
{"title":"Incidence and Outcome of Hypocalcaemia after Total Thyroidectomy","authors":"Naser A. Zaher, Emad M. Abdelrahman, Atef A. Salem, Mohamed M. Debes, Marwa M. Yosry, Mohamed E. Zayed","doi":"10.21608/ejhm.2024.349392","DOIUrl":"https://doi.org/10.21608/ejhm.2024.349392","url":null,"abstract":"Background: Due to its prevalence and the absence of well-established preoperative indicators, hypoparathyroidism poses a significant problem. Objective: This study aimed to find characteristics that predict hypocalcemia after total thyroidectomy was the primary goal of this investigation. Patients and methods: In this prospective analysis, 123 patients who were candidates for a thyroidectomy were enrolled. Early hypocalcemia symptoms and potential risk factors were monitored in these individuals. Results: The mean age of the studied patients was 47.22 ± 12.2 years. Hypocalcemia was significantly evident in the age group between 40-50 years. Results showed that recurring goiter, Grave's disease, malignant goiter and block neck dissection were significantly correlated with postoperative hypocalcemia. Conclusion: Malignant goiter, Grave’s disease (GD) and recurrent goiter are independent risk factors for post total thyroidectomy hypocalcemia.","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":"140771131","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.2024.348928
Ahmed M. A. Ismail, Mariam A. Naom, B. M. Refaie, Nesma Magdy, Sahar A. Allam, Ahmed M. Elhalwagy
Background: Acute kidney injury (AKI) is a frequently occurring complication in patients with cancer that can arise from cancer, its treatment, or other complications. Objective: This study aimed to evaluate the epidemiological and clinical characteristics and outcomes of AKI among cancer patients in Egypt. Patients and Methods: This study was conducted at the Intermediate Care Unit (ICU) of Sohag Oncology Center, Sohag, Egypt. This was a retrospective study of 80 cancer patients diagnosed with AKI and admitted to the ICU with AKI between September 2022 and June 2023. Results: The median age of the participants was 58 years. Approximately 52% were females, 95% were diagnosed with solid tumors, and 57% received chemotherapy. According to the RIFLE criteria, 59% of the participants were classified as "Failure", 36% as "Injury", and 5% as "Risk". Approximately 66% of the patients presented with normal consciousness, 82% with repeated vomiting, 99% with fatigue and anorexia, and 88% with hypovolemia. The serum creatinine (SCr) concentration, urea concentration, and international normalized ratio (INR) significantly decreased from presentation to discharge (Pvalue <0.001, <0.001, and 0.031, respectively). However, sodium, potassium, and calcium levels and the glomerular filtration rate (GFR) significantly increased (P=0.004, 0.011, <0.001, and <0.001, respectively). Here, 68% of patients were discharged without the need for dialysis, 18% needed dialysis, and 14% died. Disturbed consciousness (OR=0.14; p = 0.003) and hypovolemia (OR=0.49; p = 0.001) were found to be independent predictors of participant improvement. Conclusion : AKI was more prevalent among elderly females with solid tumors. Common symptoms at presentation were vomiting, fatigue, anorexia, electrolyte imbalances, and hypovolemia. However, additional research is needed to determine the impact of AKI on cancer outcomes.
{"title":"Clinical Characteristics, Outcomes, and Prognosis among Cancer Patients with Acute Kidney Injury: A Single-Center Study at Sohag Cancer Center","authors":"Ahmed M. A. Ismail, Mariam A. Naom, B. M. Refaie, Nesma Magdy, Sahar A. Allam, Ahmed M. Elhalwagy","doi":"10.21608/ejhm.2024.348928","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348928","url":null,"abstract":"Background: Acute kidney injury (AKI) is a frequently occurring complication in patients with cancer that can arise from cancer, its treatment, or other complications. Objective: This study aimed to evaluate the epidemiological and clinical characteristics and outcomes of AKI among cancer patients in Egypt. Patients and Methods: This study was conducted at the Intermediate Care Unit (ICU) of Sohag Oncology Center, Sohag, Egypt. This was a retrospective study of 80 cancer patients diagnosed with AKI and admitted to the ICU with AKI between September 2022 and June 2023. Results: The median age of the participants was 58 years. Approximately 52% were females, 95% were diagnosed with solid tumors, and 57% received chemotherapy. According to the RIFLE criteria, 59% of the participants were classified as \"Failure\", 36% as \"Injury\", and 5% as \"Risk\". Approximately 66% of the patients presented with normal consciousness, 82% with repeated vomiting, 99% with fatigue and anorexia, and 88% with hypovolemia. The serum creatinine (SCr) concentration, urea concentration, and international normalized ratio (INR) significantly decreased from presentation to discharge (Pvalue <0.001, <0.001, and 0.031, respectively). However, sodium, potassium, and calcium levels and the glomerular filtration rate (GFR) significantly increased (P=0.004, 0.011, <0.001, and <0.001, respectively). Here, 68% of patients were discharged without the need for dialysis, 18% needed dialysis, and 14% died. Disturbed consciousness (OR=0.14; p = 0.003) and hypovolemia (OR=0.49; p = 0.001) were found to be independent predictors of participant improvement. Conclusion : AKI was more prevalent among elderly females with solid tumors. Common symptoms at presentation were vomiting, fatigue, anorexia, electrolyte imbalances, and hypovolemia. However, additional research is needed to determine the impact of AKI on cancer outcomes.","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":"140784698","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.2024.348718
Mahmoud Sobhy Allam, Samir Ahmed Abdelmaged, Mamdouh M. Aboulhassan, Kamal A. Hassa Hassaneinen, Islam A. Amer
Background: One of the most common congenital defects of the face is cleft palate (CP). A middle ear issue nearly always affects children who have cleft palates. The way that palatoplasty is performed has a significant impact on how well middle ear function is restored after CP correction. Objective: This study aimed to assess the significance of modified Furlow vs two-flaps technique on Eustachian tube (ET) dysfunction. Patients and methods: Seventy two cleft palate patients were divided into 2 groups: Group1 included 42 patients done by modified Furlow Z-plasty operation. Group 2 included 30 patients done by two flaps palatoplasty. Pre-and post-operative ear evaluation done at 1, 3,6,12 months. Results: Repair of cleft palate leading to direct improvement of ET dysfunction improvement ear function. Modified Furlow showed early improvement at 3 months post-operative of middle ear function (p value 0.004), but had no superiority after one year over two flaps Palato-plasty. Conclusion: The two procedures showed significant effect as regards decreasing severity of ET function and middle ear affection. Thus, supporting conservative management of middle ear effusion instead of prophylactic tube insertion.
背景：腭裂（CP）是面部最常见的先天性缺陷之一。患有腭裂的儿童几乎都会出现中耳问题。腭成形术的方式对 CP 矫正后中耳功能的恢复有很大影响。研究目的本研究旨在评估改良 Furlow 与双瓣技术对咽鼓管（ET）功能障碍的影响。患者和方法：72名腭裂患者分为两组：第一组包括 42 名采用改良 Furlow Z 形成形术的患者。第二组包括 30 名采用双瓣腭成形术的患者。术前和术后 1、3、6、12 个月进行耳部评估。结果腭裂修复术可直接改善 ET 功能障碍，改善耳功能。改良 Furlow 显示，术后 3 个月中耳功能得到早期改善（P 值为 0.004），但一年后与双瓣腭成形术相比没有优势。结论：这两种手术在降低 ET 功能和中耳炎的严重程度方面效果明显。因此，支持保守治疗中耳积液，而不是预防性插管。
{"title":"Effect of Modified Furlow Vs Two-Flap Technique on Eustachian Tube Function","authors":"Mahmoud Sobhy Allam, Samir Ahmed Abdelmaged, Mamdouh M. Aboulhassan, Kamal A. Hassa Hassaneinen, Islam A. Amer","doi":"10.21608/ejhm.2024.348718","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348718","url":null,"abstract":"Background: One of the most common congenital defects of the face is cleft palate (CP). A middle ear issue nearly always affects children who have cleft palates. The way that palatoplasty is performed has a significant impact on how well middle ear function is restored after CP correction. Objective: This study aimed to assess the significance of modified Furlow vs two-flaps technique on Eustachian tube (ET) dysfunction. Patients and methods: Seventy two cleft palate patients were divided into 2 groups: Group1 included 42 patients done by modified Furlow Z-plasty operation. Group 2 included 30 patients done by two flaps palatoplasty. Pre-and post-operative ear evaluation done at 1, 3,6,12 months. Results: Repair of cleft palate leading to direct improvement of ET dysfunction improvement ear function. Modified Furlow showed early improvement at 3 months post-operative of middle ear function (p value 0.004), but had no superiority after one year over two flaps Palato-plasty. Conclusion: The two procedures showed significant effect as regards decreasing severity of ET function and middle ear affection. Thus, supporting conservative management of middle ear effusion instead of prophylactic tube insertion.","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":"140789012","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.2024.348396
Hossam El Din, M. Azim, M. A. Mahmoud, M. G. Sobhy
Background: Otitis media with effusion, a typical condition characterized by fluid in the middle ear area, has a significant negative influence on both the health and economy of the entire world. In children, hearing loss brought on by otitis media with effusion can hinder the development of language and conduct. This study aimed to assess how local dexamethasone affects human tympanic membranes' ability to resist myringosclerosis brought on by ventilation tubes. Patients and Methods: This prospective case-control study was conducted at Benha University Hospital, on 50 patients of both sexes and different ages complained of hearing loss due to persistent otitis media with effusion that has been resistant to therapy for nearly three months. The patients were subdivided into two equal groups: 25 patients were participants in group (A), which underwent myringotomy with breathing tube insertion only. 25 patients were participants in group (B), who had myringotomy, breathing tube insertion, and local dexamethasone instillation. Results : As far as myringosclerosis was concerned, there was no statistically significant variation between the two groups (P-value > 0.05). As determined by the quadrants under otomicroscopic examination, there was a significant variation between the two groups (P-value < 0.01) in relation to myringosclerosis findings. The histopathological assessment of myringosclerosis revealed a significant variation between the two groups with regard to the condition's symptoms (P-value < 0.01). Conclusion:
{"title":"Effect of Local Dexamethasone on Prevention of Myringosclerosis after Tympanostomy Tube","authors":"Hossam El Din, M. Azim, M. A. Mahmoud, M. G. Sobhy","doi":"10.21608/ejhm.2024.348396","DOIUrl":"https://doi.org/10.21608/ejhm.2024.348396","url":null,"abstract":"Background: Otitis media with effusion, a typical condition characterized by fluid in the middle ear area, has a significant negative influence on both the health and economy of the entire world. In children, hearing loss brought on by otitis media with effusion can hinder the development of language and conduct. This study aimed to assess how local dexamethasone affects human tympanic membranes' ability to resist myringosclerosis brought on by ventilation tubes. Patients and Methods: This prospective case-control study was conducted at Benha University Hospital, on 50 patients of both sexes and different ages complained of hearing loss due to persistent otitis media with effusion that has been resistant to therapy for nearly three months. The patients were subdivided into two equal groups: 25 patients were participants in group (A), which underwent myringotomy with breathing tube insertion only. 25 patients were participants in group (B), who had myringotomy, breathing tube insertion, and local dexamethasone instillation. Results : As far as myringosclerosis was concerned, there was no statistically significant variation between the two groups (P-value > 0.05). As determined by the quadrants under otomicroscopic examination, there was a significant variation between the two groups (P-value < 0.01) in relation to myringosclerosis findings. The histopathological assessment of myringosclerosis revealed a significant variation between the two groups with regard to the condition's symptoms (P-value < 0.01). Conclusion:","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":"140763916","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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