Pub Date : 2021-07-01DOI: 10.4103/sjamf.sjamf_112_21
H. Ahmed, M. Mohammed, N. Metwally
Objective This study aims to assess the role of multidetector computed tomography (MDCT) in the diagnosis and assessment of patients with hemoptesis. Patients and Methods This was a prospective study carried out on a total of 20 patients who presented with hemoptysis, all referred from the Chest Department and clinic to the Radiology Department in El-Zahra Hospital for 164 slice MDCT examination; the study was carried out for a period of 1 year from January 2020 to January 2021 after receiving approval from the ethical committee of the institute. Informed consent was obtained from all patients before inclusion in the study. Results The MDCT study showed that bronchogenic carcinoma was found to be the most common cause of hemoptysis in six (30%) patients, pulmonary embolism and bronchiectasis were found in four (20%) patients, in two (10%) patients, metastasis was present due to breast and testicular cancer, and one (5%) patient, lung abscess, pulmonary hypertension, tuberculosis, and alveolar hemorrhage were present. Conclusion MDCT proved to be the imaging modality of choice in the diagnosis of hemoptysis, being superior to chest radiography in demonstrating not only causes of delay but also the extent of lung abnormalities.
{"title":"The role of multidetector computed tomography in the diagnosis and assessment of patients with hemoptesis","authors":"H. Ahmed, M. Mohammed, N. Metwally","doi":"10.4103/sjamf.sjamf_112_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_112_21","url":null,"abstract":"Objective This study aims to assess the role of multidetector computed tomography (MDCT) in the diagnosis and assessment of patients with hemoptesis. Patients and Methods This was a prospective study carried out on a total of 20 patients who presented with hemoptysis, all referred from the Chest Department and clinic to the Radiology Department in El-Zahra Hospital for 164 slice MDCT examination; the study was carried out for a period of 1 year from January 2020 to January 2021 after receiving approval from the ethical committee of the institute. Informed consent was obtained from all patients before inclusion in the study. Results The MDCT study showed that bronchogenic carcinoma was found to be the most common cause of hemoptysis in six (30%) patients, pulmonary embolism and bronchiectasis were found in four (20%) patients, in two (10%) patients, metastasis was present due to breast and testicular cancer, and one (5%) patient, lung abscess, pulmonary hypertension, tuberculosis, and alveolar hemorrhage were present. Conclusion MDCT proved to be the imaging modality of choice in the diagnosis of hemoptysis, being superior to chest radiography in demonstrating not only causes of delay but also the extent of lung abnormalities.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91351331","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_113_21
B. Ibrahim, Alshimaa Mohammad Enayet, N. Metwally
Objective The aim of this study was to evaluate the added value of multidetector computed tomography in the characterization of renal cystic lesions based on the Bosniak classification and compare the old with the new one (version 2019). Patients and methods A prospective study was carried out on 21 patients from the adult group of both sexes; their age ranged from 31 to 83 years. They referred from the Urology Department and clinic to the Radiology Department in Alzahraa University Hospital. The study was carried out from January 2020 to March 2021. Results The mean age of the patients was 56.7±13.76. The incidence of renal cysts was higher in age group greater than 50 years, with a male predominance. There were insignificant differences between old and new classifications by computed tomography. According to the nature of lesion class (I and II) the classification was as follows: there were 15 benign (51.7%), four class (IIF) lesions, probably benign, (13.8%), four class (III) indeterminate lesions (13.8%), and six malignant class (IV) lesions (20.7%). The pathology and diagnosis of the lesions of the studied group revealed that six lesions (20.7%) were renal cell carcinoma, six lesions (20.7%) were complicated cysts, two lesions (6.9%) were multilocular cystic nephroma, two lesions (6.9%) were autosomal dominant polycystic kidney disease, and 13 lesions (44.8%) were benign cortical simple cysts. Conclusion The Bosniak classification applied by multidetector computed tomography is a practical and accurate method to evaluate renal cystic lesions, also limiting the number of patients wrongly diagnosed with complex lesions and subjected to unnecessary surgeries.
{"title":"Bosniak classification of renal cystic lesions based on multidetector computed tomography","authors":"B. Ibrahim, Alshimaa Mohammad Enayet, N. Metwally","doi":"10.4103/sjamf.sjamf_113_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_113_21","url":null,"abstract":"Objective The aim of this study was to evaluate the added value of multidetector computed tomography in the characterization of renal cystic lesions based on the Bosniak classification and compare the old with the new one (version 2019). Patients and methods A prospective study was carried out on 21 patients from the adult group of both sexes; their age ranged from 31 to 83 years. They referred from the Urology Department and clinic to the Radiology Department in Alzahraa University Hospital. The study was carried out from January 2020 to March 2021. Results The mean age of the patients was 56.7±13.76. The incidence of renal cysts was higher in age group greater than 50 years, with a male predominance. There were insignificant differences between old and new classifications by computed tomography. According to the nature of lesion class (I and II) the classification was as follows: there were 15 benign (51.7%), four class (IIF) lesions, probably benign, (13.8%), four class (III) indeterminate lesions (13.8%), and six malignant class (IV) lesions (20.7%). The pathology and diagnosis of the lesions of the studied group revealed that six lesions (20.7%) were renal cell carcinoma, six lesions (20.7%) were complicated cysts, two lesions (6.9%) were multilocular cystic nephroma, two lesions (6.9%) were autosomal dominant polycystic kidney disease, and 13 lesions (44.8%) were benign cortical simple cysts. Conclusion The Bosniak classification applied by multidetector computed tomography is a practical and accurate method to evaluate renal cystic lesions, also limiting the number of patients wrongly diagnosed with complex lesions and subjected to unnecessary surgeries.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87647412","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_123_21
Dina Adam, Madeeha Kamel, Doaa A. Mahmoud
Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.
{"title":"Refractive outcome of combined phacoemulsification and glaucoma surgery in patients of primary \"open-angle glaucoma\"","authors":"Dina Adam, Madeeha Kamel, Doaa A. Mahmoud","doi":"10.4103/sjamf.sjamf_123_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_123_21","url":null,"abstract":"Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81473930","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_133_21
M. Aly, Magda S.Yaqout, Fathy Aly, A. Shoukry, L. Sakr
Background Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG–PET/CT) play an important role in the diagnostic workup of patients with malignant mesothelioma. Applications for FDG–PET/CT at this time help in differentiation between malignant and benign pleural lesions, staging, and the ability for surgical interference. Objectives The objective of this study was to review the role of PET/CT in diagnosis, staging, prognostication, and pre- and post-therapeutic response of malignant mesothelioma. Patients and methods This study was performed on 55 of known patients with malignant mesothelioma at Naser Institute (cancer center) from May 2016 to July 2020 referred for staging, pre-, and post-therapeutic response. Results The study proved that combined PET/CT was superior to CT and PET individually in diagnosis of patients with malignant mesothelioma and improves the sensitivity, specificity, and accuracy of local extent (T), regional lymph nodes (N), and distant metastases (M), also pre- and post-therapeutic response. Conclusion The information provided by PET/CT is likely to obtain the best imaging for the diagnosis and staging in patients with malignant mesothelioma and also for monitoring tumor response to therapy.
{"title":"The role of 18F-FDG-PET/CT in the evaluation of malignant mesothelioma","authors":"M. Aly, Magda S.Yaqout, Fathy Aly, A. Shoukry, L. Sakr","doi":"10.4103/sjamf.sjamf_133_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_133_21","url":null,"abstract":"Background Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG–PET/CT) play an important role in the diagnostic workup of patients with malignant mesothelioma. Applications for FDG–PET/CT at this time help in differentiation between malignant and benign pleural lesions, staging, and the ability for surgical interference. Objectives The objective of this study was to review the role of PET/CT in diagnosis, staging, prognostication, and pre- and post-therapeutic response of malignant mesothelioma. Patients and methods This study was performed on 55 of known patients with malignant mesothelioma at Naser Institute (cancer center) from May 2016 to July 2020 referred for staging, pre-, and post-therapeutic response. Results The study proved that combined PET/CT was superior to CT and PET individually in diagnosis of patients with malignant mesothelioma and improves the sensitivity, specificity, and accuracy of local extent (T), regional lymph nodes (N), and distant metastases (M), also pre- and post-therapeutic response. Conclusion The information provided by PET/CT is likely to obtain the best imaging for the diagnosis and staging in patients with malignant mesothelioma and also for monitoring tumor response to therapy.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89434106","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_100_21
Mariam Saadanya, Fatma Attia, E. Mohamed, Ali El Rahim Ali, S. Sabry
Background Endoscopic retrograde cholangiopancreatography (ERCP) was first described as a diagnostic technique. ERCP is used for management of various biliary and pancreatic diseases. Post-ERCP pancreatitis is defined as new-onset abdominal pain following ERCP, which is associated with amylase levels that are elevated three times the normal range, Pancreatic stenting is widely employed after pancreatic sphincterotomy with goals of reducing both early restenosis and post-ERCP pancreatitis. The risk of pancreatitis is significantly decreased when a pancreatic stent is placed and then left in following a precut sphincterotomy. Aim To evaluate the efficacy of pancreatic stent to decrease the risk of post-ERCP pancreatitis in patients with calcular obstructive jaundice. Patients and methods A prospective randomized study was conducted that included 40 patients with obstructive jaundice with a difficult biliary cannulation who are at risk to develop post-ERCP pancreatitis in patients with calcular obstructive jaundice. Group A included 20 patients with manipulation of pancreatic duct guidewire without pancreatic stent insertion. Group B included 20 patients with manipulation of pancreatic duct guidewire with pancreatic stent insertion. Results There was a highly statistically significant. Pancreatic stent placement decreases the risk of post-ERCP pancreatitis. Conclusion Prophylactic pancreatic duct stenting after difficult cannulation of the pancreatic duct is a safe and feasible procedure and significantly reduces the rate of post-ERCP pancreatitis.
{"title":"Evaluation of pancreatic duct stenting for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis in difficult cannulating patients with calcular obstructive jaundice","authors":"Mariam Saadanya, Fatma Attia, E. Mohamed, Ali El Rahim Ali, S. Sabry","doi":"10.4103/sjamf.sjamf_100_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_100_21","url":null,"abstract":"Background Endoscopic retrograde cholangiopancreatography (ERCP) was first described as a diagnostic technique. ERCP is used for management of various biliary and pancreatic diseases. Post-ERCP pancreatitis is defined as new-onset abdominal pain following ERCP, which is associated with amylase levels that are elevated three times the normal range, Pancreatic stenting is widely employed after pancreatic sphincterotomy with goals of reducing both early restenosis and post-ERCP pancreatitis. The risk of pancreatitis is significantly decreased when a pancreatic stent is placed and then left in following a precut sphincterotomy. Aim To evaluate the efficacy of pancreatic stent to decrease the risk of post-ERCP pancreatitis in patients with calcular obstructive jaundice. Patients and methods A prospective randomized study was conducted that included 40 patients with obstructive jaundice with a difficult biliary cannulation who are at risk to develop post-ERCP pancreatitis in patients with calcular obstructive jaundice. Group A included 20 patients with manipulation of pancreatic duct guidewire without pancreatic stent insertion. Group B included 20 patients with manipulation of pancreatic duct guidewire with pancreatic stent insertion. Results There was a highly statistically significant. Pancreatic stent placement decreases the risk of post-ERCP pancreatitis. Conclusion Prophylactic pancreatic duct stenting after difficult cannulation of the pancreatic duct is a safe and feasible procedure and significantly reduces the rate of post-ERCP pancreatitis.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76307173","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_36_21
Somaya Ahmad, Nahed Mohamad, Boshra Ali, Rania Mahfouz El Wahed
Background Cerebroplacental ratio (CPR) assessment in late third trimester in gestational hypertension (HTN) can be used to predict adverse perinatal outcome. Aim To evaluate whether CPR assessment in late pregnancy can predict suspected fetal compromise or occurrence of adverse perinatal outcomes in singleton term pregnancy with controlled gestational HTN. Patient and methods This prospective study was conducted in El Zahraa University Hospital on 100 pregnant women who were divided equally into control group and gestational HTN group. LOGIC V5 ultrasound equipment was used to measure umbilical artery pulsatility index and middle cerebral artery pulsatility index and CPR. Results There was a statistically significant decrease of the mean CPR in gestational hypertensive group when compared with the control group (P<0.001) and a highly statistically significant decrease in the mean estimated fetal weight (P<0.001) and Apgar score (P=0.012) in gestational hypertensive group when compared with the control group. Conclusion Study of the pulsatility indices of placental and fetal circulation in women with singleton term pregnancy who developed gestational HTN can provide important information about fetal well-being to be an opportunity to improve fetal outcome.
{"title":"Cerebroplacental ratio assessment for the prediction of adverse perinatal outcomes in gestational hypertensive term pregnancy","authors":"Somaya Ahmad, Nahed Mohamad, Boshra Ali, Rania Mahfouz El Wahed","doi":"10.4103/sjamf.sjamf_36_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_36_21","url":null,"abstract":"Background Cerebroplacental ratio (CPR) assessment in late third trimester in gestational hypertension (HTN) can be used to predict adverse perinatal outcome. Aim To evaluate whether CPR assessment in late pregnancy can predict suspected fetal compromise or occurrence of adverse perinatal outcomes in singleton term pregnancy with controlled gestational HTN. Patient and methods This prospective study was conducted in El Zahraa University Hospital on 100 pregnant women who were divided equally into control group and gestational HTN group. LOGIC V5 ultrasound equipment was used to measure umbilical artery pulsatility index and middle cerebral artery pulsatility index and CPR. Results There was a statistically significant decrease of the mean CPR in gestational hypertensive group when compared with the control group (P<0.001) and a highly statistically significant decrease in the mean estimated fetal weight (P<0.001) and Apgar score (P=0.012) in gestational hypertensive group when compared with the control group. Conclusion Study of the pulsatility indices of placental and fetal circulation in women with singleton term pregnancy who developed gestational HTN can provide important information about fetal well-being to be an opportunity to improve fetal outcome.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89502673","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_10_21
Ahmed Aburashed, Mahmoud Elshamy, Ismail Elsokkary
Background Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass graft (CABG) evaluation owing to high temporal and spatial resolution, besides it being noninvasive and highly effective in assessment of extracoronary manifestations. Objective To evaluate the feasibility of high-quality MDCT in assessment of patients with CABG in comparison with conventional coronary angiography. Patients and methods A total of 50 patients were enrolled for ECG-gated CT of CABGs between May 2020 and September 2020. Patients were subjected to conventional coronary angiography within 10 days after MDCT examination at Al Hussein University Hospital. Administration of beta-blocker and nitroglycerin was done before CT examination. Breath-hold training was mandatory. Results A total of 46 grafts were arterial and 74 were venous. Overall, 36 (78.2%) of the arterial grafts were patent, six (13%) were significantly narrowed, and four (8.8%) were completely occluded. Regarding venous grafts, 52 (70.2%) of them were patent, 14 (19%) were significantly narrowed, and eight (10.8%) were completely occluded. CT angiography compared with the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98%, and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion MDCT is considered the imaging modality of choice nowadays to evaluate the patency and stenosis of CABGs than the conventional coronary angiography owing to its multiple drawbacks.
{"title":"Assessment of coronary artery bypass grafts by multidetector computed tomography","authors":"Ahmed Aburashed, Mahmoud Elshamy, Ismail Elsokkary","doi":"10.4103/sjamf.sjamf_10_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_10_21","url":null,"abstract":"Background Multidetector computed tomography (MDCT) had made a revolution in coronary artery bypass graft (CABG) evaluation owing to high temporal and spatial resolution, besides it being noninvasive and highly effective in assessment of extracoronary manifestations. Objective To evaluate the feasibility of high-quality MDCT in assessment of patients with CABG in comparison with conventional coronary angiography. Patients and methods A total of 50 patients were enrolled for ECG-gated CT of CABGs between May 2020 and September 2020. Patients were subjected to conventional coronary angiography within 10 days after MDCT examination at Al Hussein University Hospital. Administration of beta-blocker and nitroglycerin was done before CT examination. Breath-hold training was mandatory. Results A total of 46 grafts were arterial and 74 were venous. Overall, 36 (78.2%) of the arterial grafts were patent, six (13%) were significantly narrowed, and four (8.8%) were completely occluded. Regarding venous grafts, 52 (70.2%) of them were patent, 14 (19%) were significantly narrowed, and eight (10.8%) were completely occluded. CT angiography compared with the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 98%, and an accuracy of about 93.6% in the assessment of any type of coronary artery grafts. Conclusion MDCT is considered the imaging modality of choice nowadays to evaluate the patency and stenosis of CABGs than the conventional coronary angiography owing to its multiple drawbacks.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77645361","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_135_21
Amal Elmesiry, S. Mahmoud, M. Mohamed, H. Hamoud
Introduction Psoriasis and psoriatic arthritis (PSA) are chronic immune-mediated diseases associated with chronic low-grade systemic inflammation, leading to endothelial cells proliferation and vascular insufficiency, which lead to abnormalities in capillaries. Aim To assess the patterns of nailfold capillaroscopy in psoriatic domains and compare these patterns with control groups. Patients and methods A total of 150 patients with psoriasis and PSA were subdivided into five subgroups: group 1 included 30 patients with predominant peripheral PSA; group 2 included 30 patients with predominant peripheral PSA and/or dactylitis, as well as enthesitis; group 3 included 30 patients with predominant axial affection; group 4 included 30 patients with predominant axial affection and/or dactylitis, as well as enthesitis; and group 5 included 30 patients with predominant skin and/or nail affection. In addition, group 6 was the control group, which included 25 patients with rheumatoid arthritis, and group 7 included 25 patients with systemic sclerosis. Results Capillary density was statistically significantly lower among group 7 and higher among group 5. Tortuous capillaries were statistically significantly higher among group 2. However, group 5 had the least tortuous capillaries. Microhemorrhage, angiogenesis, and subpapillary venous plexus were statistically significantly higher among group 7. However, there was no statistically significant difference among the psoriatic groups regarding microhemorrhage, whereas angiogenesis was statistically significantly lower among group 5. Conclusion PSA showed low capillary density, increased tortuous capillaries and capillary hemorrhage, more visibility of subpapillary venous plexus, and dilated capillaries in comparison with patients with rheumatoid arthritis, whereas systemic sclerosis had specific pattern.
{"title":"Nailfold capillaroscopy in psoriatic domains according to Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)","authors":"Amal Elmesiry, S. Mahmoud, M. Mohamed, H. Hamoud","doi":"10.4103/sjamf.sjamf_135_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_135_21","url":null,"abstract":"Introduction Psoriasis and psoriatic arthritis (PSA) are chronic immune-mediated diseases associated with chronic low-grade systemic inflammation, leading to endothelial cells proliferation and vascular insufficiency, which lead to abnormalities in capillaries. Aim To assess the patterns of nailfold capillaroscopy in psoriatic domains and compare these patterns with control groups. Patients and methods A total of 150 patients with psoriasis and PSA were subdivided into five subgroups: group 1 included 30 patients with predominant peripheral PSA; group 2 included 30 patients with predominant peripheral PSA and/or dactylitis, as well as enthesitis; group 3 included 30 patients with predominant axial affection; group 4 included 30 patients with predominant axial affection and/or dactylitis, as well as enthesitis; and group 5 included 30 patients with predominant skin and/or nail affection. In addition, group 6 was the control group, which included 25 patients with rheumatoid arthritis, and group 7 included 25 patients with systemic sclerosis. Results Capillary density was statistically significantly lower among group 7 and higher among group 5. Tortuous capillaries were statistically significantly higher among group 2. However, group 5 had the least tortuous capillaries. Microhemorrhage, angiogenesis, and subpapillary venous plexus were statistically significantly higher among group 7. However, there was no statistically significant difference among the psoriatic groups regarding microhemorrhage, whereas angiogenesis was statistically significantly lower among group 5. Conclusion PSA showed low capillary density, increased tortuous capillaries and capillary hemorrhage, more visibility of subpapillary venous plexus, and dilated capillaries in comparison with patients with rheumatoid arthritis, whereas systemic sclerosis had specific pattern.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91202091","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_40_21
W. Hassan, E. Hafez, E. Zaki, G. Ahmad
Background Cardiac autonomic neuropathy is one of the most insidious complications of diabetes mellitus. It can be detected by abnormality in heart rate recovery, which is defined as decline in heart rate within the first few minutes following a graded exercise stress test. Aim To detect cardiac autonomic neuropathy in type II diabetic patients using heart rate recovery. Patients and methods This study included 45 individuals, 30 diabetic patients in case group and 15 healthy individuals as a control. All participants underwent history taking, clinical examination, laboratory investigations (FBS, PPBS, HbA1c, kidney function test and liver enzymes), comprehensive transthoracic echocardiographic examination, 24 h Holter monitor and exercise ECG test to assess heart rate recovery. Results 30 diabetic patients (7 male and 23 females, with mean age 40±3.5 years) and 15 healthy individuals (4 males and 11 females with mean age 36±5.8 years) participated in this study. Cases group had significant increase in FBS, PPBS, HbA1c and serum creatinine compared to control group. Patients had significant decrease in PNN50, SDNN, LF and HF in the 24 h Holter monitoring as well as significant delay in heart rate recovery at 1st and 2nd minutes compared to control group. Glycemic control and duration of diabetes were the most predictors to abnormal heart rate recovery. Conclusion Heart rate recovery derived from exercise ECG test could be considered as an easy, low cost and widely available tool for detection of cardiac autonomic neuropathy.
{"title":"Detection of cardiac autonomic neuropathy in type II diabetic patients using heart rate recovery","authors":"W. Hassan, E. Hafez, E. Zaki, G. Ahmad","doi":"10.4103/sjamf.sjamf_40_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_40_21","url":null,"abstract":"Background Cardiac autonomic neuropathy is one of the most insidious complications of diabetes mellitus. It can be detected by abnormality in heart rate recovery, which is defined as decline in heart rate within the first few minutes following a graded exercise stress test. Aim To detect cardiac autonomic neuropathy in type II diabetic patients using heart rate recovery. Patients and methods This study included 45 individuals, 30 diabetic patients in case group and 15 healthy individuals as a control. All participants underwent history taking, clinical examination, laboratory investigations (FBS, PPBS, HbA1c, kidney function test and liver enzymes), comprehensive transthoracic echocardiographic examination, 24 h Holter monitor and exercise ECG test to assess heart rate recovery. Results 30 diabetic patients (7 male and 23 females, with mean age 40±3.5 years) and 15 healthy individuals (4 males and 11 females with mean age 36±5.8 years) participated in this study. Cases group had significant increase in FBS, PPBS, HbA1c and serum creatinine compared to control group. Patients had significant decrease in PNN50, SDNN, LF and HF in the 24 h Holter monitoring as well as significant delay in heart rate recovery at 1st and 2nd minutes compared to control group. Glycemic control and duration of diabetes were the most predictors to abnormal heart rate recovery. Conclusion Heart rate recovery derived from exercise ECG test could be considered as an easy, low cost and widely available tool for detection of cardiac autonomic neuropathy.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90272584","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 : 2021-07-01DOI: 10.4103/sjamf.sjamf_98_21
Abd El Kalmoush
Background Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone disease. Laparoscopic cholecystectomy is done worldwide by general surgeons, but difficult cases remain challenging even to experts in laparoscopic surgery. Redo-cholecystectomy is done owing to either interval cholecystectomy after first surgery or stone in cystic duct stump or remnant gall bladder. The most important investigation done for the patients is magnetic resonance cholangiogram. Redo-surgery is applicable to be done laparoscopic. Patients and methods A retrospective study was conducted on 11 patients whom underwent to cholecystectomy either open or laparoscopic, where one case could undergo cholecystostomy by Foley’s catheter and second one could not reach the gall bladder, and nine cases could undergo laparoscopic (four cases postpone from the start and five cases have remnant of gall bladder or retained stone in it). Clinical examination, laboratory, and radiological evaluation was done. All cases of redo-surgery were by laparoscopy. Results One case needed to convert to open surgery. Time of surgery ranged from 1 to 3 h. There is no bile leakage or common bile duct injury. There were two cases of intraoperative bleeding and one case with postoperative bleeding. Postoperative stay in hospital was 1–2 days, except a case that was converted to open, which had 3 days of hospital stay. Conclusion Redo-laparoscopic cholecystectomy is applicable and safe but needs experience in laparoscopic skills.
{"title":"Redo-laparoscopic cholecystectomy: is it applicable","authors":"Abd El Kalmoush","doi":"10.4103/sjamf.sjamf_98_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_98_21","url":null,"abstract":"Background Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone disease. Laparoscopic cholecystectomy is done worldwide by general surgeons, but difficult cases remain challenging even to experts in laparoscopic surgery. Redo-cholecystectomy is done owing to either interval cholecystectomy after first surgery or stone in cystic duct stump or remnant gall bladder. The most important investigation done for the patients is magnetic resonance cholangiogram. Redo-surgery is applicable to be done laparoscopic. Patients and methods A retrospective study was conducted on 11 patients whom underwent to cholecystectomy either open or laparoscopic, where one case could undergo cholecystostomy by Foley’s catheter and second one could not reach the gall bladder, and nine cases could undergo laparoscopic (four cases postpone from the start and five cases have remnant of gall bladder or retained stone in it). Clinical examination, laboratory, and radiological evaluation was done. All cases of redo-surgery were by laparoscopy. Results One case needed to convert to open surgery. Time of surgery ranged from 1 to 3 h. There is no bile leakage or common bile duct injury. There were two cases of intraoperative bleeding and one case with postoperative bleeding. Postoperative stay in hospital was 1–2 days, except a case that was converted to open, which had 3 days of hospital stay. Conclusion Redo-laparoscopic cholecystectomy is applicable and safe but needs experience in laparoscopic skills.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88327114","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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