Pub Date : 2024-01-01DOI: 10.21608/ejhm.2024.345180
Nada Elsayed, Ahmed Mohamed, Salwa Fadl Abdelmegeed, Aya A. Khalil, Dina S. Abd, Mohamed Abdelmegeed
Background: Non-specific chronic low back pain (NSCLBP) is a complex issue that impacts an individual's quality of life and functionality, leading to impairments in somatosensory and proprioception. Errors in proprioception are evaluated using specific tests such as joint reposition sense. Objective: This study aimed to validate and determine the reliability of the iPhone inclinometer application (Clinometer) in measuring the error in lumbar joint repositioning in patients suffering from NSCLBP. Materials and methods: In this cross-sectional study, 55 male and female patients diagnosed with NSCLBP were involved, with an average age of 25.51 ± 6 years. All patients underwent an active lumbar repositioning test using the Clinometer application and an isokinetic dynamometer to calculate the absolute angular error for a target angle of 30° lumbar flexion. This was done over two assessment sessions on different days, with each patient being evaluated by two examiners at each session. The intra-rater and inter-rater reliability were determined using the Intraclass Correlation Coefficient (ICC), and the concurrent validity was tested using Spearman’s correlation. Results: The Clinometer application demonstrated excellent concurrent validity with the isokinetic measurements at the same target angle (r= 0.83, p< 0.01), and exhibited excellent intra and inter-rater reliability (ICC values ranged from 0.88 to 0.93 for intra-rater reliability and from 0.82 to 0.88 for inter-rater reliability). Conclusion: The Clinometer app is a viable and reliable alternative to the isokinetic dynamometer for evaluating active lumbar reposition sensation in persons with NSCLBP at 30˚ of flexion.
{"title":"Validity and Reliability of an iPhone® Clinometer Application for Assessment of Joint Repositioning Error in Patients with Non-Specific Chronic Low Back Pain","authors":"Nada Elsayed, Ahmed Mohamed, Salwa Fadl Abdelmegeed, Aya A. Khalil, Dina S. Abd, Mohamed Abdelmegeed","doi":"10.21608/ejhm.2024.345180","DOIUrl":"https://doi.org/10.21608/ejhm.2024.345180","url":null,"abstract":"Background: Non-specific chronic low back pain (NSCLBP) is a complex issue that impacts an individual's quality of life and functionality, leading to impairments in somatosensory and proprioception. Errors in proprioception are evaluated using specific tests such as joint reposition sense. Objective: This study aimed to validate and determine the reliability of the iPhone inclinometer application (Clinometer) in measuring the error in lumbar joint repositioning in patients suffering from NSCLBP. Materials and methods: In this cross-sectional study, 55 male and female patients diagnosed with NSCLBP were involved, with an average age of 25.51 ± 6 years. All patients underwent an active lumbar repositioning test using the Clinometer application and an isokinetic dynamometer to calculate the absolute angular error for a target angle of 30° lumbar flexion. This was done over two assessment sessions on different days, with each patient being evaluated by two examiners at each session. The intra-rater and inter-rater reliability were determined using the Intraclass Correlation Coefficient (ICC), and the concurrent validity was tested using Spearman’s correlation. Results: The Clinometer application demonstrated excellent concurrent validity with the isokinetic measurements at the same target angle (r= 0.83, p< 0.01), and exhibited excellent intra and inter-rater reliability (ICC values ranged from 0.88 to 0.93 for intra-rater reliability and from 0.82 to 0.88 for inter-rater reliability). Conclusion: The Clinometer app is a viable and reliable alternative to the isokinetic dynamometer for evaluating active lumbar reposition sensation in persons with NSCLBP at 30˚ of flexion.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"15 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140517343","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 : 2024-01-01DOI: 10.21608/ejhm.2024.337174
Khaled M Monib, Mohamed S Hussein, Amira M Abdelrahman, Mohamed S Darwish, Rania M Elhady
Background: Vitiligo is an acquired pigmentary disorder of the skin characterised by patches and circumscribed depigmented macules caused by epidermal melanocyte loss. A vasculoprotective molecule, endocan is an indicator of endothelial function. Objective: We aimed to evaluate carotid intima media thickness (CIMT) and serum endocan level in vitiligo patients and to compare their levels with healthy controls. Methods: This case-control study involved sixty male vitiligo patients aged 18 years or older, in addition to twenty healthy controls of the same age. A comprehensive evaluation of each patient included general and clinical examination, the Vitiligo Extent Tensity Index (VETI) score that was used to quantify the severity of vitiligo, a laboratory analysis to determine the serum endocan level, and Doppler ultrasound imaging of the CIMT. Results: No statistically significant differences were observed between the patient and control groups with respect to the age, gender, and body mass index. Patients had a significantly higher mean CIMT than the control group. Conclusion: Serum endocan and CIMT levels were significantly higher in vitiligo patients than in the control group and were significantly correlated with the severity of the disease, according to the study.
{"title":"Serum Endocan and Carotid Intima Media Thickness Evaluation in Vitiligo Patients","authors":"Khaled M Monib, Mohamed S Hussein, Amira M Abdelrahman, Mohamed S Darwish, Rania M Elhady","doi":"10.21608/ejhm.2024.337174","DOIUrl":"https://doi.org/10.21608/ejhm.2024.337174","url":null,"abstract":"Background: Vitiligo is an acquired pigmentary disorder of the skin characterised by patches and circumscribed depigmented macules caused by epidermal melanocyte loss. A vasculoprotective molecule, endocan is an indicator of endothelial function. Objective: We aimed to evaluate carotid intima media thickness (CIMT) and serum endocan level in vitiligo patients and to compare their levels with healthy controls. Methods: This case-control study involved sixty male vitiligo patients aged 18 years or older, in addition to twenty healthy controls of the same age. A comprehensive evaluation of each patient included general and clinical examination, the Vitiligo Extent Tensity Index (VETI) score that was used to quantify the severity of vitiligo, a laboratory analysis to determine the serum endocan level, and Doppler ultrasound imaging of the CIMT. Results: No statistically significant differences were observed between the patient and control groups with respect to the age, gender, and body mass index. Patients had a significantly higher mean CIMT than the control group. Conclusion: Serum endocan and CIMT levels were significantly higher in vitiligo patients than in the control group and were significantly correlated with the severity of the disease, according to the study.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"14 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140525580","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 : 2024-01-01DOI: 10.21608/ejhm.2024.344174
Bothaina Mahrous, Laila Ahmed Ghanem, Mai Sharaf, Shams El-din Attwa, Sara Hamdy Fouad
Background : Keloids are benign fibroproliferative lesions characterized by abnormal collagen deposition within a skin injury. Keloid occurs as a result of an exaggerated tissue response to skin injury in a genetically-predisposed individual. Bleomycin is an anti-cancer agent that has been utilized for treating keloids and hypertrophic scars. It inhibits collagen synthesis and activates apoptosis of fibroblasts. Objective : To assess the effectiveness and the safety of bleomycin for treating keloids and hypertrophic scar. Patients and Methods : This was a prospective randomized experimental study, carried out on forty patients with keloid or hypertrophic scars. Dermatological examination included c omplete clinical assessment of lesions to determine the distribution, clinical variants and the extent of lesions. Assessment of keloid was done by Vancouver scar scale (VSS). The Patient and Observer Scar Assessment Scale (POSAS) were utilized to evaluate the efficacy of treatments. No recurrence was observed after six months follow up. Results : Sixty% of the patients were females. The commonest cause for lesions was surgery, there was a significant improvement in POSAS and VSS after treatment, 52.5% of the patients showed improvement percentage >75% and other 40% showed improvement percentage 50-75%, 50% of the patients had excellent satisfaction while 42.5% had good satisfaction, the most frequently reported adverse effect was hyperpigmentation. Conclusion : Bleomycin is a safe and effective method for treating keloids and hypertrophic scars.
{"title":"The Efficacy of Bleomycin for Treating Keloid and Hypertrophic Scar","authors":"Bothaina Mahrous, Laila Ahmed Ghanem, Mai Sharaf, Shams El-din Attwa, Sara Hamdy Fouad","doi":"10.21608/ejhm.2024.344174","DOIUrl":"https://doi.org/10.21608/ejhm.2024.344174","url":null,"abstract":"Background : Keloids are benign fibroproliferative lesions characterized by abnormal collagen deposition within a skin injury. Keloid occurs as a result of an exaggerated tissue response to skin injury in a genetically-predisposed individual. Bleomycin is an anti-cancer agent that has been utilized for treating keloids and hypertrophic scars. It inhibits collagen synthesis and activates apoptosis of fibroblasts. Objective : To assess the effectiveness and the safety of bleomycin for treating keloids and hypertrophic scar. Patients and Methods : This was a prospective randomized experimental study, carried out on forty patients with keloid or hypertrophic scars. Dermatological examination included c omplete clinical assessment of lesions to determine the distribution, clinical variants and the extent of lesions. Assessment of keloid was done by Vancouver scar scale (VSS). The Patient and Observer Scar Assessment Scale (POSAS) were utilized to evaluate the efficacy of treatments. No recurrence was observed after six months follow up. Results : Sixty% of the patients were females. The commonest cause for lesions was surgery, there was a significant improvement in POSAS and VSS after treatment, 52.5% of the patients showed improvement percentage >75% and other 40% showed improvement percentage 50-75%, 50% of the patients had excellent satisfaction while 42.5% had good satisfaction, the most frequently reported adverse effect was hyperpigmentation. Conclusion : Bleomycin is a safe and effective method for treating keloids and hypertrophic scars.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"26 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140519615","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 : 2024-01-01DOI: 10.21608/ejhm.2024.343130
Fatma Ahmed Abdelfatah, Mohamed Soliman Gaber, Ali Mohamed Ali, M. Abdelhakem
Background: In the treatment of locally advanced cervical cancer (LACC), brachytherapy (BT) is a pivotal treatment modality, used in conjunction with external beam radiotherapy (EBRT). However, even with advancements in EBRT and BT techniques, the occurrence of local relapse continues to pose significant challenges. Objective: This research aimed to examine the recurrence patterns following the administration of concomitant chemoradiotherapy (CCRT) and subsequent enhancement with image-guided brachytherapy (IGBT). Subjects and methods: The research involved 40 patients diagnosed with locally advanced cervical cancer. These individuals underwent CCRT, subsequently enhanced by IGBT, as part of a phase 2 prospective study. Results: Among the 40 patients studied, 4 (10%) experienced local recurrence, and among these, 2 also had simultaneous distant relapses. Node recurrence was identified in 2 patients (5%), and 4 patients (10%) had distant failures. Local recurrence within the radiation treatment area was noted in 2 patients (5%), while 2 others experienced recurrence outside the treatment area. Treatments administered included stereotactic body radiotherapy (SBRT) for one patient, salvage surgery for another, and palliative care for the two patients with concurrent distant metastases. The median survival time after recurrence was 12.1 months, with an interquartile range (IQR) of 10 to 14.1 months. Conclusion: Although the application of IGBT in the treatment of cervical cancer led to commendable local control and disease-free survival rates, the most common failure mode observed was distant relapse.
{"title":"Patterns of Relapse in Patients with Locally Advanced Cervical Cancer after Image Guided Brachytherapy","authors":"Fatma Ahmed Abdelfatah, Mohamed Soliman Gaber, Ali Mohamed Ali, M. Abdelhakem","doi":"10.21608/ejhm.2024.343130","DOIUrl":"https://doi.org/10.21608/ejhm.2024.343130","url":null,"abstract":"Background: In the treatment of locally advanced cervical cancer (LACC), brachytherapy (BT) is a pivotal treatment modality, used in conjunction with external beam radiotherapy (EBRT). However, even with advancements in EBRT and BT techniques, the occurrence of local relapse continues to pose significant challenges. Objective: This research aimed to examine the recurrence patterns following the administration of concomitant chemoradiotherapy (CCRT) and subsequent enhancement with image-guided brachytherapy (IGBT). Subjects and methods: The research involved 40 patients diagnosed with locally advanced cervical cancer. These individuals underwent CCRT, subsequently enhanced by IGBT, as part of a phase 2 prospective study. Results: Among the 40 patients studied, 4 (10%) experienced local recurrence, and among these, 2 also had simultaneous distant relapses. Node recurrence was identified in 2 patients (5%), and 4 patients (10%) had distant failures. Local recurrence within the radiation treatment area was noted in 2 patients (5%), while 2 others experienced recurrence outside the treatment area. Treatments administered included stereotactic body radiotherapy (SBRT) for one patient, salvage surgery for another, and palliative care for the two patients with concurrent distant metastases. The median survival time after recurrence was 12.1 months, with an interquartile range (IQR) of 10 to 14.1 months. Conclusion: Although the application of IGBT in the treatment of cervical cancer led to commendable local control and disease-free survival rates, the most common failure mode observed was distant relapse.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140524225","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 : 2024-01-01DOI: 10.21608/ejhm.2024.346635
Ahmad AbdelNasser Abdallah, Gamal Ahmed, Ahmad Sobhy Hosny, Allam Abdelsalam, AbdelAleem
Background: Congenital pseudarthrosis of the tibia (CPT) presents significant treatment challenges due to its complex pathology and high complication risk. The Ilizarov technique, based on the principles of distraction osteogenesis, offers a promising approach to manage this condition. Objective: To assess the effectiveness of Ilizarov technique in resecting congenital pseudarthrosis and lengthening the tibia, with evaluations of union rates, mechanical axis deviation, range of motion in ankle and knee joints, and complications. Patients and Methods: In a prospective, retrospective cohort study at Benha University Hospitals, 30 patients with CPT underwent treatment using the Ilizarov technique. Clinical and radiological evaluations were conducted to assess union, while mechanical axis deviation and joint range of motion were measured. Results: The mean age of the participants was 11.3 ± 3.65 years, with a male predominance (60%). The Ilizarov technique, involving corticotomy and bone transport in 83.33% of patients, showed union in 93.33% of cases, with treatment duration averaging 9.9 ± 4.06 months. Radiological outcomes were rated as excellent in 20%, good in 46.67%, fair in 26.67%, and poor in 6.67% of patients. Complications included pin tract infections in all patients, pain in 13.33%, non-union in 6.67%, refracture in 20%, ankle stiffness in 10%, and valgus deformity at the ankle in 16.67%. The final leg-length discrepancy was corrected to a mean of 2.7 ± 1.04 cm. Conclusion: The Ilizarov technique demonstrates a high efficacy in treating CPT, with significant improvements in bone lengthening, union rates, and mechanical alignment.
{"title":"Treatment of Congenital Pseudarthrosis Tibia by Ilizarov Principle","authors":"Ahmad AbdelNasser Abdallah, Gamal Ahmed, Ahmad Sobhy Hosny, Allam Abdelsalam, AbdelAleem","doi":"10.21608/ejhm.2024.346635","DOIUrl":"https://doi.org/10.21608/ejhm.2024.346635","url":null,"abstract":"Background: Congenital pseudarthrosis of the tibia (CPT) presents significant treatment challenges due to its complex pathology and high complication risk. The Ilizarov technique, based on the principles of distraction osteogenesis, offers a promising approach to manage this condition. Objective: To assess the effectiveness of Ilizarov technique in resecting congenital pseudarthrosis and lengthening the tibia, with evaluations of union rates, mechanical axis deviation, range of motion in ankle and knee joints, and complications. Patients and Methods: In a prospective, retrospective cohort study at Benha University Hospitals, 30 patients with CPT underwent treatment using the Ilizarov technique. Clinical and radiological evaluations were conducted to assess union, while mechanical axis deviation and joint range of motion were measured. Results: The mean age of the participants was 11.3 ± 3.65 years, with a male predominance (60%). The Ilizarov technique, involving corticotomy and bone transport in 83.33% of patients, showed union in 93.33% of cases, with treatment duration averaging 9.9 ± 4.06 months. Radiological outcomes were rated as excellent in 20%, good in 46.67%, fair in 26.67%, and poor in 6.67% of patients. Complications included pin tract infections in all patients, pain in 13.33%, non-union in 6.67%, refracture in 20%, ankle stiffness in 10%, and valgus deformity at the ankle in 16.67%. The final leg-length discrepancy was corrected to a mean of 2.7 ± 1.04 cm. Conclusion: The Ilizarov technique demonstrates a high efficacy in treating CPT, with significant improvements in bone lengthening, union rates, and mechanical alignment.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"11 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516909","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 : 2024-01-01DOI: 10.21608/ejhm.2024.344771
Holy Shaker Iskander, Naroz, Nadia Abd El, Azeem Fayaz, S. Fadl, Dina Mohamed, Ali Al Hamaky
Introduction: Anterior translation, also recognized as Forward Head Posture (FHP), is a pathology that happens when the head moves forward from the vertical line of gravity. FHP can cause significant problems, such as fascial stretching at the lower cervical level, shortening of the upper cervical segment, hamstring tightness, and back fascial limitation at the hamstring and calf muscles levels. Aim of this study: This study aimed to determine the correlation between forward head posture and hamstring, calf muscles tightness. Methods: The study involved 84 university students of both sexes, with a mean age of 21.96 ± 2.25 years for males and a mean age of 22.05 ± 2 years for females, and a mean BMI of 22.32 ± 1.68 kg/m 2 for males and a mean of 22 ± 1.7 kg/m 2 for females. The sample size included only those with a craniovertebral angle (CVA) measurement of less than 49 0 , which was determined using the photogrammetry method. The study was conducted to establish the degree of correlation among FHP and hamstring-calf muscles by using the active knee extension test (AKE test), as well as the passive straight leg raise test (PSLR) for hamstring muscles tightness using the ankle dorsiflexion with the knee extended (ADFKE), in addition to ankle dorsiflexion with the knee flexed (ADFKF) for calf muscles tightness. Results: There was a weak significant direct correlation (r=0.300, p=0.034) between CVA and right hamstring tightness as measured by PSLR in males with a normal BMI. Conclusion: Forward head posture (FHP) weakly correlates with hamstring tightness in males with normal BMI, therefore treatment program should include hamstring muscles stretching.
{"title":"Correlation between the Degree of Forward Head Posture and Hamstring Muscles Tightness in Non-Specific Neck Pain","authors":"Holy Shaker Iskander, Naroz, Nadia Abd El, Azeem Fayaz, S. Fadl, Dina Mohamed, Ali Al Hamaky","doi":"10.21608/ejhm.2024.344771","DOIUrl":"https://doi.org/10.21608/ejhm.2024.344771","url":null,"abstract":"Introduction: Anterior translation, also recognized as Forward Head Posture (FHP), is a pathology that happens when the head moves forward from the vertical line of gravity. FHP can cause significant problems, such as fascial stretching at the lower cervical level, shortening of the upper cervical segment, hamstring tightness, and back fascial limitation at the hamstring and calf muscles levels. Aim of this study: This study aimed to determine the correlation between forward head posture and hamstring, calf muscles tightness. Methods: The study involved 84 university students of both sexes, with a mean age of 21.96 ± 2.25 years for males and a mean age of 22.05 ± 2 years for females, and a mean BMI of 22.32 ± 1.68 kg/m 2 for males and a mean of 22 ± 1.7 kg/m 2 for females. The sample size included only those with a craniovertebral angle (CVA) measurement of less than 49 0 , which was determined using the photogrammetry method. The study was conducted to establish the degree of correlation among FHP and hamstring-calf muscles by using the active knee extension test (AKE test), as well as the passive straight leg raise test (PSLR) for hamstring muscles tightness using the ankle dorsiflexion with the knee extended (ADFKE), in addition to ankle dorsiflexion with the knee flexed (ADFKF) for calf muscles tightness. Results: There was a weak significant direct correlation (r=0.300, p=0.034) between CVA and right hamstring tightness as measured by PSLR in males with a normal BMI. Conclusion: Forward head posture (FHP) weakly correlates with hamstring tightness in males with normal BMI, therefore treatment program should include hamstring muscles stretching.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522363","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: Diabetic retinopathy is a great ocular diabetic disorder and may cause blindness. It is linked with hyperglycemia, inflammation and oxidative stress. Adiponectin is an adipokine that has antioxidant, anti-inflammatory and anti-angiogenic effects. Objective: to detect possible role of adiponectin as a therapy in experimentally induced diabetic retinopathy in male adult rats. Material and Methods: Thirty male adult rats were divided into 2 groups: group Ι (control 10 rats) and group II (diabetic type 1 induced by streptozotocin, 20 rats). Diabetic rats were divided four weeks later into 2 subgroups: Subgroup IIA (diabetic retinopathy), Subgroup IIB (adiponectin-treated diabetic retinopathy), in all groups, serum glucose, insulin, lipid profile, superoxide dismutase (SOD), malonaldehyde (MDA), interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) and aquaporin-4 (AQP4) gene expression were estimated. Retinal histopathology and immunohistochemistry of retinal VEGF and tumor necrosis factor (TNF) alpha were also estimated. Results: Subgroup IIB showed significant decrease in serum levels of glucose, cholesterol, triglyceride, low density lipoprotein (LDL), MDA, VEGF and IL-6, and AQP4 gene expression, with significant increase in insulin, SOD and high-density lipoprotein (HDL) levels. Retinal histopathology showed partial restoration of retinal layers organization and immunohistochemistry showed downregulation of TNF-α and VEGF. Conclusion: Adiponectin may improve diabetic retinopathy via antioxidant, anti-inflammatory, antidiabetic and anti-angiogenic effect.
{"title":"Adiponectin Decreased Aquaporin 4 MRNA Expression in Rat Model of Type 1 Diabetic Retinopathy, Can It Prevent Retinal Edema?","authors":"Mohamed Hussein Mohamed, Huda Galal, Reham Mohamed, Hassan Ebrahim","doi":"10.21608/ejhm.2024.341827","DOIUrl":"https://doi.org/10.21608/ejhm.2024.341827","url":null,"abstract":"Background: Diabetic retinopathy is a great ocular diabetic disorder and may cause blindness. It is linked with hyperglycemia, inflammation and oxidative stress. Adiponectin is an adipokine that has antioxidant, anti-inflammatory and anti-angiogenic effects. Objective: to detect possible role of adiponectin as a therapy in experimentally induced diabetic retinopathy in male adult rats. Material and Methods: Thirty male adult rats were divided into 2 groups: group Ι (control 10 rats) and group II (diabetic type 1 induced by streptozotocin, 20 rats). Diabetic rats were divided four weeks later into 2 subgroups: Subgroup IIA (diabetic retinopathy), Subgroup IIB (adiponectin-treated diabetic retinopathy), in all groups, serum glucose, insulin, lipid profile, superoxide dismutase (SOD), malonaldehyde (MDA), interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) and aquaporin-4 (AQP4) gene expression were estimated. Retinal histopathology and immunohistochemistry of retinal VEGF and tumor necrosis factor (TNF) alpha were also estimated. Results: Subgroup IIB showed significant decrease in serum levels of glucose, cholesterol, triglyceride, low density lipoprotein (LDL), MDA, VEGF and IL-6, and AQP4 gene expression, with significant increase in insulin, SOD and high-density lipoprotein (HDL) levels. Retinal histopathology showed partial restoration of retinal layers organization and immunohistochemistry showed downregulation of TNF-α and VEGF. Conclusion: Adiponectin may improve diabetic retinopathy via antioxidant, anti-inflammatory, antidiabetic and anti-angiogenic effect.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522435","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 : 2024-01-01DOI: 10.21608/ejhm.2024.343365
Hossam Eldin, Mohammed Abdelazeem, Khaled Elhusseiny, Mohammed Khdr, Mohammed Goda Elnems
Background: Children's hearing impairment is primarily caused by otitis media with effusion (OME). OME may be linked to developmental delays, thus early and appropriate therapy of OME avoids hearing and speech impairment in children. Treatment is still a contentious topic, though. Objectives: We aimed to assess the efficacy of Intratympanic (IT) steroids for the management of OME resistant to traditional medical Therapy. Patients and methods: The study was conducted on 40 patients who had complaints of hearing loss and bilateral OME that resisted medical treatment lasting at least three months. Under general anesthesia, we performed myringotomy and ventilation tube (VT) was inserted bilaterally on each patient Then we injected steroid (.5 ml methylprednisolone 40 mg/mL) into the right middle ear. During the operation and in follow-up visits, once a week for three weeks in a row. Results: Resolved OME was 32 (80%) ears with ventilation tube (VT) alone and 38 (95%) ears with ventilation tube (VT) and steroid injection. This difference was significant (p = 0.043). As regard postoperative complication, tympanosclerosis was noted in 6 (15%) non-injected ears and one injected ear (2.5%) and the difference was statistically significant (p<0.05). Also, permanent perforation occurred in two (5%) non-injected ears and one (2.5%) injected ears, with statistically non-significant difference (p =1.000). While Otorrhea occurred in 4 (10%) non-injected ears and 5 (12.5%) injected ears, with statistically non-significant difference (p =1.000). Conclusion: IT steroid injections have been shown to be effective in treating OME resistant to pharmaceutical and surgical interventions, with a little risk of recurrence and surgical side effects. The best well-known therapeutic method combines IT steroid injection with ventilation tubes.
{"title":"Intratympanic Steroid Treatment in Otitis Media with Effusion Resistant to Conventional Therapy in Children","authors":"Hossam Eldin, Mohammed Abdelazeem, Khaled Elhusseiny, Mohammed Khdr, Mohammed Goda Elnems","doi":"10.21608/ejhm.2024.343365","DOIUrl":"https://doi.org/10.21608/ejhm.2024.343365","url":null,"abstract":"Background: Children's hearing impairment is primarily caused by otitis media with effusion (OME). OME may be linked to developmental delays, thus early and appropriate therapy of OME avoids hearing and speech impairment in children. Treatment is still a contentious topic, though. Objectives: We aimed to assess the efficacy of Intratympanic (IT) steroids for the management of OME resistant to traditional medical Therapy. Patients and methods: The study was conducted on 40 patients who had complaints of hearing loss and bilateral OME that resisted medical treatment lasting at least three months. Under general anesthesia, we performed myringotomy and ventilation tube (VT) was inserted bilaterally on each patient Then we injected steroid (.5 ml methylprednisolone 40 mg/mL) into the right middle ear. During the operation and in follow-up visits, once a week for three weeks in a row. Results: Resolved OME was 32 (80%) ears with ventilation tube (VT) alone and 38 (95%) ears with ventilation tube (VT) and steroid injection. This difference was significant (p = 0.043). As regard postoperative complication, tympanosclerosis was noted in 6 (15%) non-injected ears and one injected ear (2.5%) and the difference was statistically significant (p<0.05). Also, permanent perforation occurred in two (5%) non-injected ears and one (2.5%) injected ears, with statistically non-significant difference (p =1.000). While Otorrhea occurred in 4 (10%) non-injected ears and 5 (12.5%) injected ears, with statistically non-significant difference (p =1.000). Conclusion: IT steroid injections have been shown to be effective in treating OME resistant to pharmaceutical and surgical interventions, with a little risk of recurrence and surgical side effects. The best well-known therapeutic method combines IT steroid injection with ventilation tubes.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"16 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140524064","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 : 2024-01-01DOI: 10.21608/ejhm.2024.341344
Mostafa Gamal, El Helbawy, Amany Wasef, Abdel Salam, El-Sayed Shaaban Tharwa, El-Sayed Ibraheem, Ahmed Salah, Abd El Gawad, Hassan Ahmed Elshenawy
Background: Spontaneous bacterial peritonitis (SBP) is a severe worldwide liver condition. Objective: The aim of this study was investigating the association between serum 25(OH)D deficiency and the complications of hepatitis c virus (HCV) related cirrhosis, notably, SBP. Patients and Methods: This prospective case control study was carried out on 100 patients, with cirrhosis and ascites. The patients were divided into two groups: Group I cirrhotic patients with ascites and SBP, which were divided into two equal subgroups according to addition of 25(OH)D to treatment of SBP: group Ia did not receive vitamin D and group Ib received vitamin D. Group II: cirrhotic patients with simple ascites and without SBP. Group Ib of patients were receiving a dose of 2.000 I. U of 25 hydroxycholecalciferol per day for at least 1 week. Results: There was a significant correlation between serum vitamin D and end-stage liver disease (MELD) score (r = - 0.51, P= 0.012; r = -0.37, P= 0.016, respectively) in subgroup (GI a) not receiving vitamin D and control group. Serum level of vitamin D was also significantly correlated with ascitic polymorphonuclear neutrophils (PMN) count (cell/µL) in both SBP subgroups (GI a and b) (r = -0.61, P= 0.002; r = -0.61, P= 0.002, respectively). The receiver operating characteristic (ROC) curve analysis estimated a sensitivity of 78.3%, a specificity of 69.0%, a positive predictive value (PPV) of 58%, a negative predictive value (NPV) of 85.3% and an accuracy of 73.7% at the best cutoff value of ≤13.96 (ng/mL). The AUC was 0.76 with a highly significant P-value < 0.001. A positive highly significant correlation between serum vitamin D and serum albumin was observed in both subgroups and control (r = 0.67, P = 0.001 and r =0.50, P=0.014, r = 0.44, P=0.004, respectively). Conclusions: MELD scores >15 were related with an increased risk of SBP. It was also shown that Escherichia coli and Staph aureus were the most frequent bacteria among SBP patients.
背景：自发性细菌性腹膜炎（SBP自发性细菌性腹膜炎（SBP）是一种严重的世界性肝病。研究目的本研究旨在探讨血清 25(OH)D 缺乏症与丙型肝炎病毒（HCV）相关肝硬化并发症（尤其是 SBP）之间的关系。患者和方法：这项前瞻性病例对照研究的对象是 100 名肝硬化和腹水患者。患者分为两组：第一组：有腹水和 SBP 的肝硬化患者，根据在治疗 SBP 的过程中添加 25（OH）D 的情况分为两个相同的亚组：Ia 组不服用维生素 D，Ib 组服用维生素 D。Ib 组患者每天服用 2.000 I. U 的 25 羟基胆钙化醇，至少持续一周。结果显示在未接受维生素 D 的亚组（GI a）和对照组中，血清维生素 D 与终末期肝病（MELD）评分之间存在明显的相关性（分别为 r = - 0.51，P= 0.012；r = -0.37，P= 0.016）。在两个 SBP 亚组（GI a 和 b）中，血清维生素 D 水平与腹水多形核中性粒细胞（PMN）计数（细胞/μL）也有显著相关性（分别为 r = -0.61，P= 0.002；r = -0.61，P= 0.002）。根据接收器操作特征曲线（ROC）分析，在最佳临界值≤13.96（纳克/毫升）时，灵敏度为 78.3%，特异度为 69.0%，阳性预测值为 58%，阴性预测值为 85.3%，准确度为 73.7%。AUC为0.76，P值高度显著<0.001。在两个亚组和对照组中均观察到血清维生素 D 与血清白蛋白之间存在高度显著的正相关（分别为 r = 0.67，P = 0.001 和 r =0.50，P = 0.014，r =0.44，P =0.004）。结论MELD 评分 >15 与 SBP 风险增加有关。研究还表明，大肠杆菌和金黄色葡萄球菌是 SBP 患者中最常见的细菌。
{"title":"Is Vitamin D Deficiency a Risk Factor for Spontaneous Bacterial Peritonitis?","authors":"Mostafa Gamal, El Helbawy, Amany Wasef, Abdel Salam, El-Sayed Shaaban Tharwa, El-Sayed Ibraheem, Ahmed Salah, Abd El Gawad, Hassan Ahmed Elshenawy","doi":"10.21608/ejhm.2024.341344","DOIUrl":"https://doi.org/10.21608/ejhm.2024.341344","url":null,"abstract":"Background: Spontaneous bacterial peritonitis (SBP) is a severe worldwide liver condition. Objective: The aim of this study was investigating the association between serum 25(OH)D deficiency and the complications of hepatitis c virus (HCV) related cirrhosis, notably, SBP. Patients and Methods: This prospective case control study was carried out on 100 patients, with cirrhosis and ascites. The patients were divided into two groups: Group I cirrhotic patients with ascites and SBP, which were divided into two equal subgroups according to addition of 25(OH)D to treatment of SBP: group Ia did not receive vitamin D and group Ib received vitamin D. Group II: cirrhotic patients with simple ascites and without SBP. Group Ib of patients were receiving a dose of 2.000 I. U of 25 hydroxycholecalciferol per day for at least 1 week. Results: There was a significant correlation between serum vitamin D and end-stage liver disease (MELD) score (r = - 0.51, P= 0.012; r = -0.37, P= 0.016, respectively) in subgroup (GI a) not receiving vitamin D and control group. Serum level of vitamin D was also significantly correlated with ascitic polymorphonuclear neutrophils (PMN) count (cell/µL) in both SBP subgroups (GI a and b) (r = -0.61, P= 0.002; r = -0.61, P= 0.002, respectively). The receiver operating characteristic (ROC) curve analysis estimated a sensitivity of 78.3%, a specificity of 69.0%, a positive predictive value (PPV) of 58%, a negative predictive value (NPV) of 85.3% and an accuracy of 73.7% at the best cutoff value of ≤13.96 (ng/mL). The AUC was 0.76 with a highly significant P-value < 0.001. A positive highly significant correlation between serum vitamin D and serum albumin was observed in both subgroups and control (r = 0.67, P = 0.001 and r =0.50, P=0.014, r = 0.44, P=0.004, respectively). Conclusions: MELD scores >15 were related with an increased risk of SBP. It was also shown that Escherichia coli and Staph aureus were the most frequent bacteria among SBP patients.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140527181","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: Nephrotic syndrome (NS) is characterised by a loss of albumin, proteins, and other plasma components with comparable bulk. Symptoms include decreasing serum albumin levels, increased blood lipid levels, lipids in urine, and edema. Objective: To estimate serum levels of IgG, IgM, in nephrotic syndrome cases in addition to detect the relationship between IgG/IgM ratio and response to treatment with steroids. Patients and Methods: The present study was carried out in Benha University Hospital, it comprised 60 children admitted to Nephrology Unit of Pediatric Department of Benha University Hospitals. The cases were divided into four groups: Group A included 15 cases of frequent relapse N.S. (FRNS), Group B comprised 15 cases of steroid-resistant nephrotic syndrome (SRNS), and Group C consisted of 15 cases with infrequent relapses. Additionally, a control group of 15 cases. Results: In our study, serum IgM showed a significant difference between the studied groups (P < 0.001). Pairwise analysis revealed that it was significantly lower in the control group (median = 0.71 mg/ml) than in groups A (median = 1.48 mg/ml), B (median = 1.27 mg/ml), and C (median = 1.62 mg/ml). ROC analyses were conducted to assess the discriminatory potential of serum IgG and IgM levels among the different study groups (Group A, Group B, and Group C) compared to controls. For serum IgG, the analysis for all groups demonstrated significant AUC values, ranging from 0.938 to 0.958, with confidence intervals indicating excellent discrimination. Conclusion: Our findings highlight the potential of serum IgG and IgM levels as diagnostic markers for differentiating nephrotic syndrome cases and provide valuable insights into the pathophysiology and treatment response in these patients.
{"title":"Serum Immunoglobulin G and M as Predictors for Outcome of Childhood Nephrotic Syndrome","authors":"Abdelhamed Salah El-Hamshary, Alaa Tarek Abdelwahab, Asmaa Adel El-Fallah, Hanaa Ramadan","doi":"10.21608/ejhm.2024.343129","DOIUrl":"https://doi.org/10.21608/ejhm.2024.343129","url":null,"abstract":"Background: Nephrotic syndrome (NS) is characterised by a loss of albumin, proteins, and other plasma components with comparable bulk. Symptoms include decreasing serum albumin levels, increased blood lipid levels, lipids in urine, and edema. Objective: To estimate serum levels of IgG, IgM, in nephrotic syndrome cases in addition to detect the relationship between IgG/IgM ratio and response to treatment with steroids. Patients and Methods: The present study was carried out in Benha University Hospital, it comprised 60 children admitted to Nephrology Unit of Pediatric Department of Benha University Hospitals. The cases were divided into four groups: Group A included 15 cases of frequent relapse N.S. (FRNS), Group B comprised 15 cases of steroid-resistant nephrotic syndrome (SRNS), and Group C consisted of 15 cases with infrequent relapses. Additionally, a control group of 15 cases. Results: In our study, serum IgM showed a significant difference between the studied groups (P < 0.001). Pairwise analysis revealed that it was significantly lower in the control group (median = 0.71 mg/ml) than in groups A (median = 1.48 mg/ml), B (median = 1.27 mg/ml), and C (median = 1.62 mg/ml). ROC analyses were conducted to assess the discriminatory potential of serum IgG and IgM levels among the different study groups (Group A, Group B, and Group C) compared to controls. For serum IgG, the analysis for all groups demonstrated significant AUC values, ranging from 0.938 to 0.958, with confidence intervals indicating excellent discrimination. Conclusion: Our findings highlight the potential of serum IgG and IgM levels as diagnostic markers for differentiating nephrotic syndrome cases and provide valuable insights into the pathophysiology and treatment response in these patients.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522675","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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