Hanaa Abd El-Moniem Younis, Reda Tawfik Mohamed, Aliaa Hussein Abd El-Aziz
Background : The accurate difference between normal pregnancy and abnormal pregnancy in early gestation remains a challenge clinically. Different studies have previously described the association between fetal well-being and gestational sac characteristics. Yolk sac fi rst appears at 5 weeks gestation and becomes visible by ultrasound, while the fetal heart rate appears at 6 weeks gestation and these can be used as prognostic parameters for fi rst-trimester outcomes in pregnancy. Study aim : Relation of the ultrasound parameters in early pregnancy (gestational sac size, yolk sac, and embryonic cardiac activity) to early fetal demise. Patients and methods : This was a hospital-based cross-sectional study conducted in the outpatient clinic and Emergency Department e Obstetrics and Gynecology Department e El Monera General Hospital on 100 pregnant women in their fi rst trimester. Patients were subjected to general examination and abdominal and local clinical examination. Result : Gestational sac diameter at different gestational ages was signi fi cantly higher among the ongoing pregnancy group compared with the pregnancy loss group. Conclusion : Based on our fi ndings we concluded that yolk sac diameter, gestational sac diameter, Crown-rump length in different gestational ages, and cardiac activity at sixth and seventh weeks were signi fi cantly higher among the ongoing pregnancy group; yolk sac diameter, gestational sac diameter, and fetal heart rate were signi fi cant predictors for pregnancy loss.
{"title":"Gestational Sac Size, Yolk Sac Size and Embryonic Cardiac Activity as Prognostic Factors of First Trimester Pregnancy Outcome","authors":"Hanaa Abd El-Moniem Younis, Reda Tawfik Mohamed, Aliaa Hussein Abd El-Aziz","doi":"10.58675/2682-339x.1677","DOIUrl":"https://doi.org/10.58675/2682-339x.1677","url":null,"abstract":"Background : The accurate difference between normal pregnancy and abnormal pregnancy in early gestation remains a challenge clinically. Different studies have previously described the association between fetal well-being and gestational sac characteristics. Yolk sac fi rst appears at 5 weeks gestation and becomes visible by ultrasound, while the fetal heart rate appears at 6 weeks gestation and these can be used as prognostic parameters for fi rst-trimester outcomes in pregnancy. Study aim : Relation of the ultrasound parameters in early pregnancy (gestational sac size, yolk sac, and embryonic cardiac activity) to early fetal demise. Patients and methods : This was a hospital-based cross-sectional study conducted in the outpatient clinic and Emergency Department e Obstetrics and Gynecology Department e El Monera General Hospital on 100 pregnant women in their fi rst trimester. Patients were subjected to general examination and abdominal and local clinical examination. Result : Gestational sac diameter at different gestational ages was signi fi cantly higher among the ongoing pregnancy group compared with the pregnancy loss group. Conclusion : Based on our fi ndings we concluded that yolk sac diameter, gestational sac diameter, Crown-rump length in different gestational ages, and cardiac activity at sixth and seventh weeks were signi fi cantly higher among the ongoing pregnancy group; yolk sac diameter, gestational sac diameter, and fetal heart rate were signi fi cant predictors for pregnancy loss.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132110703","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 : 2023-01-08DOI: 10.21608/aimj.2023.147614.2020
Abdullah Abohabib, Sayed Hamdy, Abdel‐Azeim Safwat
{"title":"Prospective study of outcomes of Laparoscopic versus open splenectomy in hematological and benign splenic diseases","authors":"Abdullah Abohabib, Sayed Hamdy, Abdel‐Azeim Safwat","doi":"10.21608/aimj.2023.147614.2020","DOIUrl":"https://doi.org/10.21608/aimj.2023.147614.2020","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127770910","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 : 2023-01-03DOI: 10.21608/aimj.2023.150881.2048
H. Ibrahim, Mohamed Fahmy, Ashraf Seddek
{"title":"Prevalence and Impact of External Genitourinary Anomalies among Children undergoing routine Circumcision","authors":"H. Ibrahim, Mohamed Fahmy, Ashraf Seddek","doi":"10.21608/aimj.2023.150881.2048","DOIUrl":"https://doi.org/10.21608/aimj.2023.150881.2048","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114812429","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}
Ibrahim G. Ewaiss, Mostafa Aboelkhir, Abelgelel Ragab Abdelgelel Atta
{"title":"Outcome of lumbar discectomy by using endoscopic interlaminar approach","authors":"Ibrahim G. Ewaiss, Mostafa Aboelkhir, Abelgelel Ragab Abdelgelel Atta","doi":"10.58675/2682-339x.1834","DOIUrl":"https://doi.org/10.58675/2682-339x.1834","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114583115","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}
Ahmed Hamed Okaz, Abdellah Yassin, A. Zidan, M. Rashad
Background : Although clinical data are still used to suspect multiple sclerosis (MS), MRI is now included in the disease ' s clinical prognosis. Aim : To evaluate the clinical importance of recent MRI techniques in MS. Patients and methods : This study was conducted on 20 patients of both sexes having MS. All patients were evaluated by full history taking,clinical assessment, and MRI examination includingrecent MRI modalities; double inversion recovery (DIR); spectroscopy; fl uid-attenuatedinversionrecovery(FLAIR)inaxial,sagittal,andcoronalplanes;anddiffusiontensorimaging. Results : We found that DIR and T2-weighted turbo spin echo (T2W-TSE) differed signi fi cantly from FLAIR and T2W-TSE regarding white matter (WM)-gray matter (GM). DIR and FLAIR differed signi fi cantly from DIR and T2W-TSE regarding WM-cerebrospinal fl uid (CSF). DIR and FLAIR differed signi fi cantly from DIR and T2W-TSE regarding GM-CSF. Moreover, FLAIR differed signi fi cantly T2W-TSE regarding lesion-WM. DIR and FLAIR, DIR and T2W-TSE, and FLAIR and T2W-TSE differed signi fi cantly regarding lesion-CSF. Conclusion : We can conclude that DIR can add a powerful diagnostic value or act as another option for standardized T2W and FLAIR. Therefore, we intensely recommended adding DIR imaging to imaging protocol of MS.
{"title":"The Role of New MRI Modalities in Diagnosis of Multiple Sclerosis","authors":"Ahmed Hamed Okaz, Abdellah Yassin, A. Zidan, M. Rashad","doi":"10.58675/2682-339x.1631","DOIUrl":"https://doi.org/10.58675/2682-339x.1631","url":null,"abstract":"Background : Although clinical data are still used to suspect multiple sclerosis (MS), MRI is now included in the disease ' s clinical prognosis. Aim : To evaluate the clinical importance of recent MRI techniques in MS. Patients and methods : This study was conducted on 20 patients of both sexes having MS. All patients were evaluated by full history taking,clinical assessment, and MRI examination includingrecent MRI modalities; double inversion recovery (DIR); spectroscopy; fl uid-attenuatedinversionrecovery(FLAIR)inaxial,sagittal,andcoronalplanes;anddiffusiontensorimaging. Results : We found that DIR and T2-weighted turbo spin echo (T2W-TSE) differed signi fi cantly from FLAIR and T2W-TSE regarding white matter (WM)-gray matter (GM). DIR and FLAIR differed signi fi cantly from DIR and T2W-TSE regarding WM-cerebrospinal fl uid (CSF). DIR and FLAIR differed signi fi cantly from DIR and T2W-TSE regarding GM-CSF. Moreover, FLAIR differed signi fi cantly T2W-TSE regarding lesion-WM. DIR and FLAIR, DIR and T2W-TSE, and FLAIR and T2W-TSE differed signi fi cantly regarding lesion-CSF. Conclusion : We can conclude that DIR can add a powerful diagnostic value or act as another option for standardized T2W and FLAIR. Therefore, we intensely recommended adding DIR imaging to imaging protocol of MS.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128983346","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}
Mohammed Mohammed Gebreil, A. El-Sadek, Ahmed Talaat Abd El-Ghaney Abo Elhasan
{"title":"Assessment of Fetal Head–Perineum Distance via Ultrasound as a Predictor of Successful Vaginal Delivery Preceding Labor Induction","authors":"Mohammed Mohammed Gebreil, A. El-Sadek, Ahmed Talaat Abd El-Ghaney Abo Elhasan","doi":"10.58675/2682-339x.1725","DOIUrl":"https://doi.org/10.58675/2682-339x.1725","url":null,"abstract":"","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129345447","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}
Al-Hadidy Salah S, Al-Morsy Mohammad A, Naeem Saad Mohey El-Din Mahmoud Al-Jamal
Background : It might be dangerous and further obstruct the surgical fi eld to have intraoperative bleeding during endoscopic sinus surgery (ESS). Tranexamic acid may be able to reduce bleeding during surgery. Aim : Assess the effect of topical TXA and hydrogen peroxide (H 2 O 2 ) solution on bleeding and improvement of surgical fi eld during functional endoscopic sinus surgeries (FESS) in patients with chronic sinusitis with or without sino nasal polyposis. Patients and methods : 30 patients were included, for all the 30 patients, Pads soaked with TXA 5% was introduced in one side of the nasal cavity for 10 min then irrigation by 3% H 2 O 2 solution which was freshly prepared by a 50% dilution with a physiological saline solution. The other side of the nasal cavity was not receive pads of TXA nor H 2 O 2 and was only on controlled blood pressure during the operation. Result : There was statistically signi fi cant difference between both sides with time reduced in applied side after the application of tranexamic acid and H 2 O 2 wash regarding surgical fi eld by Boezaart grading,but it is non-signi fi cant in control side. There were statistically signi fi cant differences according to blood loss between both sides of the nose after application of tranexamic acid and H 2 O 2 wash either after 15, 30, and 45 min. Conclusion : The application of topical TXA with the irrigation with 3% H 2 O 2 may be a useful method for providing a suitable surgical fi eld.
{"title":"Effect of Tranexamic Acid and H2O2 on Blood Loss during Functional Endoscopic Sinus Surgery","authors":"Al-Hadidy Salah S, Al-Morsy Mohammad A, Naeem Saad Mohey El-Din Mahmoud Al-Jamal","doi":"10.58675/2682-339x.1726","DOIUrl":"https://doi.org/10.58675/2682-339x.1726","url":null,"abstract":"Background : It might be dangerous and further obstruct the surgical fi eld to have intraoperative bleeding during endoscopic sinus surgery (ESS). Tranexamic acid may be able to reduce bleeding during surgery. Aim : Assess the effect of topical TXA and hydrogen peroxide (H 2 O 2 ) solution on bleeding and improvement of surgical fi eld during functional endoscopic sinus surgeries (FESS) in patients with chronic sinusitis with or without sino nasal polyposis. Patients and methods : 30 patients were included, for all the 30 patients, Pads soaked with TXA 5% was introduced in one side of the nasal cavity for 10 min then irrigation by 3% H 2 O 2 solution which was freshly prepared by a 50% dilution with a physiological saline solution. The other side of the nasal cavity was not receive pads of TXA nor H 2 O 2 and was only on controlled blood pressure during the operation. Result : There was statistically signi fi cant difference between both sides with time reduced in applied side after the application of tranexamic acid and H 2 O 2 wash regarding surgical fi eld by Boezaart grading,but it is non-signi fi cant in control side. There were statistically signi fi cant differences according to blood loss between both sides of the nose after application of tranexamic acid and H 2 O 2 wash either after 15, 30, and 45 min. Conclusion : The application of topical TXA with the irrigation with 3% H 2 O 2 may be a useful method for providing a suitable surgical fi eld.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121548174","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}
Hazem Arnous, Mamdouh Eltahhan, T. Ahmad, A. Fahmy, M. Sallam
Background and objectives : The current clinical practice advocates dual antiplatelet therapy (DAPT) for a year after stent thrombosis (ST) segment elevation myocardial infarction (STEMI), primarily owing to persistent thrombotic risk. The novel COBRA PzF coronary stent was developed to reduce ST risk. The primary goal of the current research was to compare the ef fi cacy and safety of the novel nanocoated PzF stenting with one-month DAPT against 12-month DAPT after the current drug-eluting stent (DES) in STEMI patients and single-vessel coronary artery disease (CAD). Patients and methods : A prospective observational study enrolled 100 cases presented with STEMI and single vessel CAD. Eligible patients were allocated into 2 groups; group I consisted of 50 patients managed with the COBRA PzF stent who received one-month DAPT. Group II consisted of 50 patients treated with DES who received one-year DAPT. The occurrence of ST was our primary endpoint. The secondary endpoints were target vessel revascularization and major adverse cerebro-cardiovascular occurrences throughout the year. Results : There were no observed cases of de fi nite ST in group I against three in group II, however, it did not reach statistical signi fi cance ( P ¼ 0.094) The incidence of target vessel revascularization (6% against 10%), death (2% versus 4%), stroke (0 versus 2%) and major bleeding (0% versus 4%) observed in group I and II, respectively, however, it did not reach statistical signi fi cance. Conclusion : The COBRA Polyzene-F stent with one-month DAPT met the performance goals for ST in patients presenting with STEMI with single vessel CAD and compared favorably with the commercially available DES with one-year DAPT.
{"title":"Comparative study between Nano-surface Polyzene F and drug eluting stents in acute coronary syndrome patients with one-month dual antiplatelet therapy: Immediate and one-year clinical outcome.","authors":"Hazem Arnous, Mamdouh Eltahhan, T. Ahmad, A. Fahmy, M. Sallam","doi":"10.58675/2682-339x.1717","DOIUrl":"https://doi.org/10.58675/2682-339x.1717","url":null,"abstract":"Background and objectives : The current clinical practice advocates dual antiplatelet therapy (DAPT) for a year after stent thrombosis (ST) segment elevation myocardial infarction (STEMI), primarily owing to persistent thrombotic risk. The novel COBRA PzF coronary stent was developed to reduce ST risk. The primary goal of the current research was to compare the ef fi cacy and safety of the novel nanocoated PzF stenting with one-month DAPT against 12-month DAPT after the current drug-eluting stent (DES) in STEMI patients and single-vessel coronary artery disease (CAD). Patients and methods : A prospective observational study enrolled 100 cases presented with STEMI and single vessel CAD. Eligible patients were allocated into 2 groups; group I consisted of 50 patients managed with the COBRA PzF stent who received one-month DAPT. Group II consisted of 50 patients treated with DES who received one-year DAPT. The occurrence of ST was our primary endpoint. The secondary endpoints were target vessel revascularization and major adverse cerebro-cardiovascular occurrences throughout the year. Results : There were no observed cases of de fi nite ST in group I against three in group II, however, it did not reach statistical signi fi cance ( P ¼ 0.094) The incidence of target vessel revascularization (6% against 10%), death (2% versus 4%), stroke (0 versus 2%) and major bleeding (0% versus 4%) observed in group I and II, respectively, however, it did not reach statistical signi fi cance. Conclusion : The COBRA Polyzene-F stent with one-month DAPT met the performance goals for ST in patients presenting with STEMI with single vessel CAD and compared favorably with the commercially available DES with one-year DAPT.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131372311","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}
K. Abdallah, Zakaria Moustafa Elmashtoly, Bahaa A. Elkhonezy
Background : Coronary artery bypass grafting (CABG) is often complicated by hemodynamic instability, especially in cases with decreased left ventricular ejection fraction (LVEF). Levosimendan as an inotropic agent can be used in those patients. Objective : The aim was to assess morbidity and mortality rates up to 6 months following CABG surgery in patients with LVEF equals 35%, who were given levosimendan. Patients and methods : A total of 40 patients with preoperative LVEF less than or equal to 35% who underwent elective CABG were retrospectively analyzed between March 2020 and April 2022 at Al-Azhar University Hospitals. Levosi-mendan was u continuously given as a bolus-free infusion at a rate of 0.05 e 0.2 m g/kg/min before surgery. Hemodynamic and outcome parameters were registered and statistically analyzed. Results : A signi fi cant improvement was recorded in ejection fraction percentage from 32.8 to 35.9% and then 39.4% after 1 week and 6 months, respectively; it was associated with signi fi cant increase in cardiac output from 5.22 to 6.3 l/ min and 6.1 l/min after 1 week and 6 months, respectively. Mean arterial pressure was also increased from 63.44 to 80.4 mm Hg and 84.6 mm Hg after 1 week and 6 months, respectively. Overall, 80% of patients showed no complications, whereas 5% of them had low cardiac output syndrome, 5% needed intra-aortic balloon pump (IABP), 5% rapid atrial fi brillation, and 5% needed reoperation due to bleeding. On the contrary, postoperative (later) complications included the following: severe sternal wound infection in two cases (5%) and chronic atrial fi brillation in one case (2.5%). The overall mortality rate was 10%. Conclusion : Levosimendan has a bene fi cial effect in improving hemodynamic state. In addition, it aids the reduction of hospital and ICU stays, along with the ability to reduce the incidence of low cardiac output syndrome and mortality rate.
背景:冠状动脉旁路移植术(CABG)经常并发血流动力学不稳定，特别是在左心室射血分数(LVEF)降低的情况下。左西孟旦可作为一种肌力药物用于这些患者。目的:目的是评估LVEF = 35%且给予左西孟旦的CABG术后6个月的发病率和死亡率。患者和方法:回顾性分析2020年3月至2022年4月在爱资哈尔大学医院接受选择性冠脉搭桥手术的40例术前LVEF小于或等于35%的患者。术前以0.05 ~ 0.2 m g/kg/min的速率连续无丸输注左旋门丹。记录血流动力学和结局参数并进行统计学分析。结果:1周后和6个月后，射血分数分别由32.8%提高到35.9%和39.4%;1周和6个月后，心排血量分别从5.22升/分和6.1升/分显著增加。平均动脉压在1周和6个月后分别由63.44和80.4 mm Hg升高到84.6 mm Hg。总的来说，80%的患者没有出现并发症，而5%的患者有低心输出量综合征，5%的患者需要主动脉内球囊泵(IABP)， 5%的患者需要快速心房颤动，5%的患者因出血需要再次手术。相反，术后(后期)并发症包括:严重胸骨伤口感染2例(5%)，慢性心房颤动1例(2.5%)。总死亡率为10%。结论:左西孟旦有改善血流动力学的作用。此外，它有助于减少住院和ICU的时间，以及降低低心输出量综合征的发生率和死亡率的能力。
{"title":"EFFECT OF LEVOSEMINDAN ON OUTCOME OF CORONARY ARTERY BYPASS GRAFTING SURGERY IN PATIENT WITH IMPAIRED LEFT VENTRICULAR SYSTOLIC FUNCTION","authors":"K. Abdallah, Zakaria Moustafa Elmashtoly, Bahaa A. Elkhonezy","doi":"10.58675/2682-339x.1672","DOIUrl":"https://doi.org/10.58675/2682-339x.1672","url":null,"abstract":"Background : Coronary artery bypass grafting (CABG) is often complicated by hemodynamic instability, especially in cases with decreased left ventricular ejection fraction (LVEF). Levosimendan as an inotropic agent can be used in those patients. Objective : The aim was to assess morbidity and mortality rates up to 6 months following CABG surgery in patients with LVEF equals 35%, who were given levosimendan. Patients and methods : A total of 40 patients with preoperative LVEF less than or equal to 35% who underwent elective CABG were retrospectively analyzed between March 2020 and April 2022 at Al-Azhar University Hospitals. Levosi-mendan was u continuously given as a bolus-free infusion at a rate of 0.05 e 0.2 m g/kg/min before surgery. Hemodynamic and outcome parameters were registered and statistically analyzed. Results : A signi fi cant improvement was recorded in ejection fraction percentage from 32.8 to 35.9% and then 39.4% after 1 week and 6 months, respectively; it was associated with signi fi cant increase in cardiac output from 5.22 to 6.3 l/ min and 6.1 l/min after 1 week and 6 months, respectively. Mean arterial pressure was also increased from 63.44 to 80.4 mm Hg and 84.6 mm Hg after 1 week and 6 months, respectively. Overall, 80% of patients showed no complications, whereas 5% of them had low cardiac output syndrome, 5% needed intra-aortic balloon pump (IABP), 5% rapid atrial fi brillation, and 5% needed reoperation due to bleeding. On the contrary, postoperative (later) complications included the following: severe sternal wound infection in two cases (5%) and chronic atrial fi brillation in one case (2.5%). The overall mortality rate was 10%. Conclusion : Levosimendan has a bene fi cial effect in improving hemodynamic state. In addition, it aids the reduction of hospital and ICU stays, along with the ability to reduce the incidence of low cardiac output syndrome and mortality rate.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134206607","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}
Abdelhaleim Abdelghany Hasabo, Mahmoud Osama Ahmed Abd El Fatah, Mohamed Basiouny Yahia, Gamal Zakaria Ali Morsy
Background : Esophageal Varices (EV) caused by liver cirrhosis is a very common complication where endoscopy is the best screening procedure. Insulin resistance (IR) is a reliable predictor of portal hypertension. Aim of the work : This study aims to compare and evaluate the role of markers of IR and other non-invasive markers in the detection of EVs in patients with liver cirrhosis. Patients and methods : Fifty patients were screened in this cross-sectional study in the gastroenterology unit of the internal medicine department by abdominal ultrasound. ELISA technique was used to estimate fating serum insulin levels. Furthermore, (HOMA-IR) referring to the Homeostasis model assessment of IR was carried out. Results : Cirrhotic patients whether they possessed any grade of EV or not correlated with higher IR with their platelet count/spleen diameter ratio (PC/SD) and spleen diameter showing a statistically signi fi cant difference among the groups. Conclusion : Elevations in IR (as they were assessed by HOMA-IR) were found to be good predictors of the development of EVs noninvasively. The diameter of the Portal vein (PV), the diameter of the spleen, and PC/SD were also found to be good predictors of EVs.
{"title":"The Role of Insulin Resistance in the Prediction of Esophageal Varices in Cirrhotic non-Diabetic patients","authors":"Abdelhaleim Abdelghany Hasabo, Mahmoud Osama Ahmed Abd El Fatah, Mohamed Basiouny Yahia, Gamal Zakaria Ali Morsy","doi":"10.58675/2682-339x.1833","DOIUrl":"https://doi.org/10.58675/2682-339x.1833","url":null,"abstract":"Background : Esophageal Varices (EV) caused by liver cirrhosis is a very common complication where endoscopy is the best screening procedure. Insulin resistance (IR) is a reliable predictor of portal hypertension. Aim of the work : This study aims to compare and evaluate the role of markers of IR and other non-invasive markers in the detection of EVs in patients with liver cirrhosis. Patients and methods : Fifty patients were screened in this cross-sectional study in the gastroenterology unit of the internal medicine department by abdominal ultrasound. ELISA technique was used to estimate fating serum insulin levels. Furthermore, (HOMA-IR) referring to the Homeostasis model assessment of IR was carried out. Results : Cirrhotic patients whether they possessed any grade of EV or not correlated with higher IR with their platelet count/spleen diameter ratio (PC/SD) and spleen diameter showing a statistically signi fi cant difference among the groups. Conclusion : Elevations in IR (as they were assessed by HOMA-IR) were found to be good predictors of the development of EVs noninvasively. The diameter of the Portal vein (PV), the diameter of the spleen, and PC/SD were also found to be good predictors of EVs.","PeriodicalId":256725,"journal":{"name":"Al-Azhar International Medical Journal","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133446157","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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