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":"1 1","pages":"667 - 672"},"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":"57 1","pages":"610 - 614"},"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_124_21
L. Azel, H. Kandeel, I. Ahmad, A. Althoqapy
Background Gut microbiota dysbiosis in type 2 diabetes mellitus (T2DM) causes an increase in the metabolite, trimethylamine-N-oxide (TMAO) that contributes to increased cardiovascular disease risk and exacerbates hyperglycemia. Aim The aim of this study was to assess serum TMAO and its relation with insulin resistance (IR) and cardiovascular risk indices in type 2 diabetic patients. Patients and methods This case–control study was conducted on 60 type 2 diabetic patients and 28 healthy age- and sex-matched individuals. Patients were divided into two groups according to the presence of ischemic heart disease (IHD). Fasting and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycosylated hemoglobin, fasting serum insulin, and serum TMAO were measured. Assessment of IR index by using Homeostatic Model Assessment HOMA-IR was done. Neck ultrasound was done to assess carotid intima-media thickness (CIMT). Results All diabetic patients had significantly elevated TMAO values than controls. TMAO levels correlated positively with fasting serum insulin and HOMA-IR in IHD-diabetic patients, and correlated negatively with CIMT in diabetic patients both with and without IHD. Conclusion Serum TMAO levels were significantly higher in type 2 diabetic patients than controls. TMAO showed a positive correlation with fasting insulin and HOMA-IR in the IHD-diabetic patients and a negative correlation with CIMT in diabetics both with and without IHD. Serum TMAO more than 7 ngml may be considered a potential diagnostic biomarker for T2DM with IHD in Egyptians with T2DM. HOMA-IR level of more than 1.25 can be used for the diagnosis of IR.
背景:2型糖尿病(T2DM)的肠道菌群失调导致代谢物三甲胺- n -氧化物(TMAO)增加，从而增加心血管疾病的风险并加剧高血糖。目的探讨2型糖尿病患者血清TMAO水平及其与胰岛素抵抗(IR)和心血管危险指标的关系。患者与方法本研究选取60例2型糖尿病患者和28例年龄、性别匹配的健康人作为研究对象。根据是否存在缺血性心脏病(IHD)将患者分为两组。测定空腹及餐后2小时血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、糖化血红蛋白、空腹血清胰岛素、血清TMAO。用稳态模型评估HOMA-IR对IR指标进行了评价。颈部超声评估颈动脉内膜-中膜厚度(CIMT)。结果所有糖尿病患者TMAO值均明显高于对照组。TMAO水平与IHD-糖尿病患者的空腹血清胰岛素和HOMA-IR呈正相关，与伴有和不伴有IHD的糖尿病患者的CIMT呈负相关。结论2型糖尿病患者血清TMAO水平明显高于对照组。TMAO与IHD-糖尿病患者的空腹胰岛素和HOMA-IR呈正相关，与伴有和不伴有IHD的糖尿病患者的CIMT呈负相关。在埃及T2DM患者中，血清TMAO超过7 ngml可能被认为是T2DM合并IHD的潜在诊断生物标志物。HOMA-IR水平大于1.25可用于诊断IR。
{"title":"Relation of gut microbiota-dependent metabolite trimethylamine-N-oxide with insulin resistance and cardiovascular risk indices in type 2 diabetic patients","authors":"L. Azel, H. Kandeel, I. Ahmad, A. Althoqapy","doi":"10.4103/sjamf.sjamf_124_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_124_21","url":null,"abstract":"Background Gut microbiota dysbiosis in type 2 diabetes mellitus (T2DM) causes an increase in the metabolite, trimethylamine-N-oxide (TMAO) that contributes to increased cardiovascular disease risk and exacerbates hyperglycemia. Aim The aim of this study was to assess serum TMAO and its relation with insulin resistance (IR) and cardiovascular risk indices in type 2 diabetic patients. Patients and methods This case–control study was conducted on 60 type 2 diabetic patients and 28 healthy age- and sex-matched individuals. Patients were divided into two groups according to the presence of ischemic heart disease (IHD). Fasting and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glycosylated hemoglobin, fasting serum insulin, and serum TMAO were measured. Assessment of IR index by using Homeostatic Model Assessment HOMA-IR was done. Neck ultrasound was done to assess carotid intima-media thickness (CIMT). Results All diabetic patients had significantly elevated TMAO values than controls. TMAO levels correlated positively with fasting serum insulin and HOMA-IR in IHD-diabetic patients, and correlated negatively with CIMT in diabetic patients both with and without IHD. Conclusion Serum TMAO levels were significantly higher in type 2 diabetic patients than controls. TMAO showed a positive correlation with fasting insulin and HOMA-IR in the IHD-diabetic patients and a negative correlation with CIMT in diabetics both with and without IHD. Serum TMAO more than 7 ngml may be considered a potential diagnostic biomarker for T2DM with IHD in Egyptians with T2DM. HOMA-IR level of more than 1.25 can be used for the diagnosis of IR.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"13 1","pages":"699 - 704"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76804220","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_106_21
Amr Alamin, Adel Khalil, H. El-Rahman
Introduction Keratoconus is a bilateral, progressive ectasia of the cornea resulting in irregular astigmatism and myopia. We can use spectacles or contact lenses to correct the symptoms of keratoconus, whereas in advanced cases, corneal grafting is the only treatment. Corneal collagen cross-linking (CXL) is a promising treatment to strengthen and stabilize the cornea in cases of keratoconus. Aim To evaluate changes in corneal topography indices after corneal CXL in patients with keratoconus and analyze these changes. Patient and methods CXL was performed in eyes with keratoconus. Quantitative descriptors of corneal topography were measured with the Pentacam topographer and included seven indices: index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, minimum radius of curvature, index of height asymmetry, and index of height decentration. Follow-up was 6 months. Results The study comprised 50 eyes of 35 patients with keratoconus. In the entire patient cohort, there were significant improvements in the index of surface variance, index of vertical asymmetry, keratoconus index, and minimum radius of curvature at 6 months compared with baseline (all P<0.001). Conclusion There were improvements in four of seven topography indices 6 months after CXL, suggesting an overall improvement in corneal shape.
{"title":"Changes of corneal topography indices after corneal collagen crosslinking for treatment of keratoconus assessed by scheimpflug camera","authors":"Amr Alamin, Adel Khalil, H. El-Rahman","doi":"10.4103/sjamf.sjamf_106_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_106_21","url":null,"abstract":"Introduction Keratoconus is a bilateral, progressive ectasia of the cornea resulting in irregular astigmatism and myopia. We can use spectacles or contact lenses to correct the symptoms of keratoconus, whereas in advanced cases, corneal grafting is the only treatment. Corneal collagen cross-linking (CXL) is a promising treatment to strengthen and stabilize the cornea in cases of keratoconus. Aim To evaluate changes in corneal topography indices after corneal CXL in patients with keratoconus and analyze these changes. Patient and methods CXL was performed in eyes with keratoconus. Quantitative descriptors of corneal topography were measured with the Pentacam topographer and included seven indices: index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, minimum radius of curvature, index of height asymmetry, and index of height decentration. Follow-up was 6 months. Results The study comprised 50 eyes of 35 patients with keratoconus. In the entire patient cohort, there were significant improvements in the index of surface variance, index of vertical asymmetry, keratoconus index, and minimum radius of curvature at 6 months compared with baseline (all P<0.001). Conclusion There were improvements in four of seven topography indices 6 months after CXL, suggesting an overall improvement in corneal shape.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"442 1","pages":"567 - 572"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76502113","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_111_21
T. Elkholy, Hoda Ebrahim, Hala K. Maghraby, Maisa A Abdel Wahab
Background A pulsatile tinnitus may be the first and sole manifestation of carotid artery atherosclerosis and stenosis. The objective of this study was to detect the association between pulsatile tinnitus and degree of carotid stenosis by carotid Doppler ultrasound parameters. Patients and methods This prospective cross-sectional analytical study has been conducted on 40 selective cases complaining from pulsatile tinnitus. Carotid duplex ultrasonography scanning was done. Research has been approved by the Research Ethical Committee of Otolaryngology Department, Faculty of Medicine for Girls, AL-Azhar University. Results Carotid artery atherosclerosis and stenosis were diagnosed as a cause of pulsatile tinnitus in five patients (12.5%). The internal carotid artery (peak systolic velocity and end diastolic velocity) values were significantly higher in patients whose intima-media thickness was greater than 1 mm and the lumen diameters were smaller. Conclusion A pulsatile tinnitus may be the first, unusual, and sole manifestation of carotid artery atherosclerosis and stenosis. So, early screening and accurate diagnosis of atherosclerosis will prevent stroke and other central nervous system complications.
{"title":"The association between pulsatile tinnitus and degree of carotid stenosis","authors":"T. Elkholy, Hoda Ebrahim, Hala K. Maghraby, Maisa A Abdel Wahab","doi":"10.4103/sjamf.sjamf_111_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_111_21","url":null,"abstract":"Background A pulsatile tinnitus may be the first and sole manifestation of carotid artery atherosclerosis and stenosis. The objective of this study was to detect the association between pulsatile tinnitus and degree of carotid stenosis by carotid Doppler ultrasound parameters. Patients and methods This prospective cross-sectional analytical study has been conducted on 40 selective cases complaining from pulsatile tinnitus. Carotid duplex ultrasonography scanning was done. Research has been approved by the Research Ethical Committee of Otolaryngology Department, Faculty of Medicine for Girls, AL-Azhar University. Results Carotid artery atherosclerosis and stenosis were diagnosed as a cause of pulsatile tinnitus in five patients (12.5%). The internal carotid artery (peak systolic velocity and end diastolic velocity) values were significantly higher in patients whose intima-media thickness was greater than 1 mm and the lumen diameters were smaller. Conclusion A pulsatile tinnitus may be the first, unusual, and sole manifestation of carotid artery atherosclerosis and stenosis. So, early screening and accurate diagnosis of atherosclerosis will prevent stroke and other central nervous system complications.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"14 1","pages":"591 - 595"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84326425","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 : 2021-04-01DOI: 10.4103/sjamf.sjamf_63_21
Hend Elmenam, M. Farouk
Background Preterm delivery (PTD) that occurs before the 37th week of gestation complicates 10% of all pregnancies. Iron deficiency, iron-deficiency anemia, and inflammatory processes either related to infection or sterile inflammatory response represent risk factors for PTD (Genc and Ford, 2010). Bovine lactoferrin (BLF), an emerging important regulator of iron and inflammatory homeostasis, can represent a new therapeutic approach for PTD, with significant improvement of maternal serum interleukin 6 (IL-6) after oral administration. Aim The goal of the study was to evaluate the role of BLF in preventing PTD associated with sterile inflammation between the gestational age of 28 and 34 weeks. Patients and methods The study was carried out at Al Zahra University Hospital at the Department of Obstetrics and Gynecology, including 50 patients, with single pregnancy, no previous preterm birth, gestational age between 28 and 34 weeks, rhythmic uterine contraction (three to five contraction in 10 min; every one last from 40 to 60 s), cervical dilation of 2–4 cm and cervical effacement of ∼50–80% by local pelvic examination, and cervical length 2–3 cm and/or funneling by ultrasound. On admission, all patients were given 100 mg BLF and subjected to withdrawal of 5-ml blood, and samples were sent to Clinical Pathology Department to detect IL-6 before and after BLF intake. Results Oral BLF administration blocked further shortening of cervical length and prolonged pregnancy. This prospective study provides strong evidence for a role of BLF in PTD treatment, thus extending the therapeutic potential of this multifunctional protein. Conclusion Determination of maternal serum IL-6 may be useful for management of patients with preterm labor, and BLF can represent a new therapeutic approach of PTD.
{"title":"Bovine lactoferrin in preterm labor with sterile inflammation","authors":"Hend Elmenam, M. Farouk","doi":"10.4103/sjamf.sjamf_63_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_63_21","url":null,"abstract":"Background Preterm delivery (PTD) that occurs before the 37th week of gestation complicates 10% of all pregnancies. Iron deficiency, iron-deficiency anemia, and inflammatory processes either related to infection or sterile inflammatory response represent risk factors for PTD (Genc and Ford, 2010). Bovine lactoferrin (BLF), an emerging important regulator of iron and inflammatory homeostasis, can represent a new therapeutic approach for PTD, with significant improvement of maternal serum interleukin 6 (IL-6) after oral administration. Aim The goal of the study was to evaluate the role of BLF in preventing PTD associated with sterile inflammation between the gestational age of 28 and 34 weeks. Patients and methods The study was carried out at Al Zahra University Hospital at the Department of Obstetrics and Gynecology, including 50 patients, with single pregnancy, no previous preterm birth, gestational age between 28 and 34 weeks, rhythmic uterine contraction (three to five contraction in 10 min; every one last from 40 to 60 s), cervical dilation of 2–4 cm and cervical effacement of ∼50–80% by local pelvic examination, and cervical length 2–3 cm and/or funneling by ultrasound. On admission, all patients were given 100 mg BLF and subjected to withdrawal of 5-ml blood, and samples were sent to Clinical Pathology Department to detect IL-6 before and after BLF intake. Results Oral BLF administration blocked further shortening of cervical length and prolonged pregnancy. This prospective study provides strong evidence for a role of BLF in PTD treatment, thus extending the therapeutic potential of this multifunctional protein. Conclusion Determination of maternal serum IL-6 may be useful for management of patients with preterm labor, and BLF can represent a new therapeutic approach of PTD.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"44 1","pages":"299 - 306"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78463872","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 : 2021-04-01DOI: 10.4103/sjamf.sjamf_93_21
S. Hamouda, A. Awad, Ruqaya Elsayed, Tarek M.Elsaid Awdan, Radwa S. Ibrahim
Background Total intravenous anesthesia (TIVA) and volatile inhalation anesthesia are both standardized techniques for lumbar laminectomy and discectomy procedures. Objective To compare TIVA versus desflurane anesthesia in improving postoperative recovery for patients undergoing spinal fixation. Patients and methods This prospective, double-blind, randomized study was carried out on 60 patients undergoing spinal fixation. Patients were randomized into two equal groups: group D received desflurane anesthesia, and group T received TIVA technique. Induction was done by propofol, fentanyl, and rocuronium. Anesthesia was maintained using desflurane in oxygen air mixture in group D. Still, anesthesia was maintained by intravenous infusion of propofol and dexmedetomidine in group T. Intraoperative vital signs, recovery time, postoperative nausea and vomiting, visual analog score, postanesthetic care unit stay time, total first 24 h postoperative analgesic needs, and serum cortisol and interleukin 6 preoperative and postoperative were assessed. Results TIVA group had lower intraoperative heart rates and mean arterial blood pressure. TIVA group also had a faster recovery time, shorter postanesthetic care unit stays, lower postoperative visual analog score for pain assessment, lower total analgesic requirements, and lower incidence of nausea and vomiting. Conclusions TIVA provided better postoperative recovery with fewer postoperative adverse effects and analgesia need.
{"title":"Desflurane versus total intravenous anesthesia in improving the postoperative outcome for the patient undergoing spinal fixation","authors":"S. Hamouda, A. Awad, Ruqaya Elsayed, Tarek M.Elsaid Awdan, Radwa S. Ibrahim","doi":"10.4103/sjamf.sjamf_93_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_93_21","url":null,"abstract":"Background Total intravenous anesthesia (TIVA) and volatile inhalation anesthesia are both standardized techniques for lumbar laminectomy and discectomy procedures. Objective To compare TIVA versus desflurane anesthesia in improving postoperative recovery for patients undergoing spinal fixation. Patients and methods This prospective, double-blind, randomized study was carried out on 60 patients undergoing spinal fixation. Patients were randomized into two equal groups: group D received desflurane anesthesia, and group T received TIVA technique. Induction was done by propofol, fentanyl, and rocuronium. Anesthesia was maintained using desflurane in oxygen air mixture in group D. Still, anesthesia was maintained by intravenous infusion of propofol and dexmedetomidine in group T. Intraoperative vital signs, recovery time, postoperative nausea and vomiting, visual analog score, postanesthetic care unit stay time, total first 24 h postoperative analgesic needs, and serum cortisol and interleukin 6 preoperative and postoperative were assessed. Results TIVA group had lower intraoperative heart rates and mean arterial blood pressure. TIVA group also had a faster recovery time, shorter postanesthetic care unit stays, lower postoperative visual analog score for pain assessment, lower total analgesic requirements, and lower incidence of nausea and vomiting. Conclusions TIVA provided better postoperative recovery with fewer postoperative adverse effects and analgesia need.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"5 1 1","pages":"487 - 493"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88248849","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 : 2021-04-01DOI: 10.4103/sjamf.sjamf_30_21
Doaa A. Younis, Eglal Algohary, Eman Ahmed, H. Elaal
Background Neonatal sepsis is an important cause of morbidity and mortality among newborns. Its diagnosis depends mainly on blood culture that takes at least 48 h to give results. Therefore, searching for biomarkers for early diagnosis is of value. We aimed to assess neutrophil CD64 as an early diagnostic biomarker in early-onset and late-onset neonatal sepsis in full-term and preterm neonates and to compare it with other diagnostic markers, blood culture, and neonatal scores of sepsis. Patients and methods A case–control study was conducted on 60 neonates with clinical sepsis and 30 neonates as control aged from 1 to 28 days of life admitted to NICU in Damanhour Teaching Hospital during the period from 1/8/2018 to 1/4/2019. Studied neonates were evaluated using clinical and laboratory indicators for sepsis, and neutrophil CD64 was measured by flow cytometry. Results There was a statistically significant increase in CD64 of early-onset sepsis and late-onset sepsis groups than control group (P>0.001), either in full-term and preterm neonates, whereas there was no statistically significant difference between early-onset sepsis group and late-onset sepsis group regarding CD64. CD64 at a cutoff point more than 30% had sensitivity of 100%, specificity of 100%, positive predictive value of 100, negative predictive value 100, and area under a curve=1, which means CD64 is the gold standard test. However, C-reactive protein (CRP) at a cutoff point more than 6 mg/l had sensitivity of 71.67%, specificity of 83.33%, and area under a curve=0.78, which means CRP is a good test. Conclusion The level of CD64 was equally increased in neonates with early-onset and late-onset neonatal sepsis and not affected by age or sex and was highly sensitive and specific in diagnosis of neonatal sepsis. There were positive significant correlations between CD64 and both CRP and neonatal score of sepsis, whereas there was an insignificant relation between mean values of CD64 and blood cultures results.
{"title":"A study of leukocyte surface antigen CD64, as a marker of early-onset and late-onset sepsis in preterm and full-term neonates","authors":"Doaa A. Younis, Eglal Algohary, Eman Ahmed, H. Elaal","doi":"10.4103/sjamf.sjamf_30_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_30_21","url":null,"abstract":"Background Neonatal sepsis is an important cause of morbidity and mortality among newborns. Its diagnosis depends mainly on blood culture that takes at least 48 h to give results. Therefore, searching for biomarkers for early diagnosis is of value. We aimed to assess neutrophil CD64 as an early diagnostic biomarker in early-onset and late-onset neonatal sepsis in full-term and preterm neonates and to compare it with other diagnostic markers, blood culture, and neonatal scores of sepsis. Patients and methods A case–control study was conducted on 60 neonates with clinical sepsis and 30 neonates as control aged from 1 to 28 days of life admitted to NICU in Damanhour Teaching Hospital during the period from 1/8/2018 to 1/4/2019. Studied neonates were evaluated using clinical and laboratory indicators for sepsis, and neutrophil CD64 was measured by flow cytometry. Results There was a statistically significant increase in CD64 of early-onset sepsis and late-onset sepsis groups than control group (P>0.001), either in full-term and preterm neonates, whereas there was no statistically significant difference between early-onset sepsis group and late-onset sepsis group regarding CD64. CD64 at a cutoff point more than 30% had sensitivity of 100%, specificity of 100%, positive predictive value of 100, negative predictive value 100, and area under a curve=1, which means CD64 is the gold standard test. However, C-reactive protein (CRP) at a cutoff point more than 6 mg/l had sensitivity of 71.67%, specificity of 83.33%, and area under a curve=0.78, which means CRP is a good test. Conclusion The level of CD64 was equally increased in neonates with early-onset and late-onset neonatal sepsis and not affected by age or sex and was highly sensitive and specific in diagnosis of neonatal sepsis. There were positive significant correlations between CD64 and both CRP and neonatal score of sepsis, whereas there was an insignificant relation between mean values of CD64 and blood cultures results.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"1 ","pages":"292 - 298"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91469134","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 : 2021-04-01DOI: 10.4103/sjamf.sjamf_79_21
Doaa E. A. Salama, Fatma Hammad, Eman Mohamed, I. Ahmad
Background Irisin is an adipo-myokine, which has broad implications for metabolism and energy homeostasis. However, evidence about its association with diabetic nephropathy (DN) is limited. Aim To evaluate serum irisin level and its relation to DN in patients with type 2 diabetes. Patients and methods This case–control study was conducted on 60 patients with type 2 diabetes and 30 healthy age-matched and sex-matched individuals. Patients were divided into three groups according to urinary albumin–creatinine ratio (ACR), namely, normoalbuminuric group, which included 15 patients; microalbuminuric group, which included 30 patients; and macroalbuminuric group, which included 15 patients. Detailed history, clinical examination, and anthropometric measurements were assessed for all participants. Fasting blood glucose and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, urea, creatinine, uric acid, estimated glomerular filtration rate, and irisin were measured for all participants. Glycosylated hemoglobin and urinary ACR were measured for patients only. Results Irisin was significantly lower in diabetic groups compared with controls. Irisin was positively correlated with estimated glomerular filtration rate but negatively correlated with fasting blood glucose, creatinine, and ACR. Multivariable regression analysis revealed that lower irisin level was considered as an independent predictor for DN. Conclusion Serum irisin is significantly related to diabetic kidney disease, and it might be progressively decreasing with development of the different stages of DN.
{"title":"Serum irisin level and its relation to diabetic nephropathy in patients with type 2 diabetes mellitus","authors":"Doaa E. A. Salama, Fatma Hammad, Eman Mohamed, I. Ahmad","doi":"10.4103/sjamf.sjamf_79_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_79_21","url":null,"abstract":"Background Irisin is an adipo-myokine, which has broad implications for metabolism and energy homeostasis. However, evidence about its association with diabetic nephropathy (DN) is limited. Aim To evaluate serum irisin level and its relation to DN in patients with type 2 diabetes. Patients and methods This case–control study was conducted on 60 patients with type 2 diabetes and 30 healthy age-matched and sex-matched individuals. Patients were divided into three groups according to urinary albumin–creatinine ratio (ACR), namely, normoalbuminuric group, which included 15 patients; microalbuminuric group, which included 30 patients; and macroalbuminuric group, which included 15 patients. Detailed history, clinical examination, and anthropometric measurements were assessed for all participants. Fasting blood glucose and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, urea, creatinine, uric acid, estimated glomerular filtration rate, and irisin were measured for all participants. Glycosylated hemoglobin and urinary ACR were measured for patients only. Results Irisin was significantly lower in diabetic groups compared with controls. Irisin was positively correlated with estimated glomerular filtration rate but negatively correlated with fasting blood glucose, creatinine, and ACR. Multivariable regression analysis revealed that lower irisin level was considered as an independent predictor for DN. Conclusion Serum irisin is significantly related to diabetic kidney disease, and it might be progressively decreasing with development of the different stages of DN.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"124 1","pages":"347 - 352"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87920196","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 : 2021-04-01DOI: 10.4103/sjamf.sjamf_27_21
S. Salama, Mona R. Elaziz, Sabry Alfathah, N. Elgendy
Introduction Endoscopic ultrasound (EUS) is a diagnostic procedure that continues to have greater clinical applications. EUS performed before endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice can reduce morbidity and mortality. Aim This study aimed to compare the diagnostic accuracy of both EUS and ERCP as combined or individual procedures in 30 patients diagnosed with biliary obstruction. Patients and methods From January 2017 to December 2019 in Al Azhar University Hospitals in Cairo, we recruited 30 patients with obstructive jaundice. All the patients underwent clinical examination, laboratory investigations, and abdominal US followed by EUS and ERCP procedures at the same session, and EUS findings were compared with that of ERCP. Results The diagnostic accuracy of EUS was as follows: choledocholithiasis in 92%, and malignant lesions in 95%. EUS showed pathology in 47.3% of patients who had an unknown pathology in biliary system at initial investigations. The overall diagnostic performance of EUS shows that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90.9, 89, 91.7, 95, and 93.5%, respectively. Regarding common bile duct stone (s), by ERCP, it was present in 13 (43.3%) cases, whereas by EUS, it was present in 12 (40%) cases. Regarding malignant lesions (ampullary tumor, cholangiocarcinoma, and pancreatic tumor), by ERCP, they were present in four (13.3%), seven (23.3%), three (10%) cases, respectively, whereas by EUS, they were present in five (16.6), six (20%), and five (16.6) cases, respectively. The complication rate was 3.3%. Conclusions EUS established high diagnostic accuracy in diagnosing the causes of obstructive jaundice, with no statistically significant difference between ERCP and EUS findings. This accurately guided ERCP need and avoided needless ERCP. EUS and ERCP in a single session for treatment of obstructive jaundice is scientifically valuable.
{"title":"Comparative study between endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in diagnosis of biliary obstruction","authors":"S. Salama, Mona R. Elaziz, Sabry Alfathah, N. Elgendy","doi":"10.4103/sjamf.sjamf_27_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_27_21","url":null,"abstract":"Introduction Endoscopic ultrasound (EUS) is a diagnostic procedure that continues to have greater clinical applications. EUS performed before endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice can reduce morbidity and mortality. Aim This study aimed to compare the diagnostic accuracy of both EUS and ERCP as combined or individual procedures in 30 patients diagnosed with biliary obstruction. Patients and methods From January 2017 to December 2019 in Al Azhar University Hospitals in Cairo, we recruited 30 patients with obstructive jaundice. All the patients underwent clinical examination, laboratory investigations, and abdominal US followed by EUS and ERCP procedures at the same session, and EUS findings were compared with that of ERCP. Results The diagnostic accuracy of EUS was as follows: choledocholithiasis in 92%, and malignant lesions in 95%. EUS showed pathology in 47.3% of patients who had an unknown pathology in biliary system at initial investigations. The overall diagnostic performance of EUS shows that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90.9, 89, 91.7, 95, and 93.5%, respectively. Regarding common bile duct stone (s), by ERCP, it was present in 13 (43.3%) cases, whereas by EUS, it was present in 12 (40%) cases. Regarding malignant lesions (ampullary tumor, cholangiocarcinoma, and pancreatic tumor), by ERCP, they were present in four (13.3%), seven (23.3%), three (10%) cases, respectively, whereas by EUS, they were present in five (16.6), six (20%), and five (16.6) cases, respectively. The complication rate was 3.3%. Conclusions EUS established high diagnostic accuracy in diagnosing the causes of obstructive jaundice, with no statistically significant difference between ERCP and EUS findings. This accurately guided ERCP need and avoided needless ERCP. EUS and ERCP in a single session for treatment of obstructive jaundice is scientifically valuable.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":"19 1","pages":"282 - 285"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73691852","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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