Pub Date : 2024-01-06DOI: 10.21608/bmfj.2023.253437.1971
Hala Elfeky, Rasha Abd Rabh, Mostafa Fouad, Tamer Elazab
Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits. Identifying organic diseases in patients with IBS is crucial, especially when alarming features are present. This study aimed to assess colonoscopic findings in patients fulfilling ROME IV Criteria of Irritable Bowel Syndrome with or without Recently Discovered alarming features. Methods: This cross-sectional study was conducted on sixty consecutive patients with IBS who fulfilled the Rome IV criteria. The patients were divided into two groups: Group A (IBS without alarming features) and Group B (IBS with alarming features). Detailed history, clinical examination, laboratory investigations in the form of complete blood count and full colonoscopy with biopsy were performed. The colonoscopic and histopathological findings were analyzed to determine the presence of organic diseases. Results : Group B exhibited significantly higher occurrences of bleeding per rectum, weight loss, and pallor compared to Group A. Colonoscopic findings revealed a higher prevalence of adenomatous polyps in Group B, whereas Group A showed higher rates of normal findings and lymphocytic colitis. Age above 50 years may have association with organic colonic diseases. Conclusion: Absence of alarming features cannot exclude organic colonic diseases in IBS patients, influencing clinical management.
背景：肠易激综合征（IBS）是一种常见的胃肠道疾病，以反复腹痛和排便习惯改变为特征。鉴别肠易激综合征患者的器质性疾病至关重要，尤其是在出现令人担忧的特征时。本研究旨在评估符合 ROME IV 肠易激综合征标准的患者的结肠镜检查结果，无论其是否具有最近发现的惊人特征。方法：这项横断面研究的对象是连续 60 名符合罗马 IV 标准的肠易激综合征患者。患者被分为两组：A组（无报警特征的肠易激综合征）和B组（有报警特征的肠易激综合征）。他们接受了详细的病史、临床检查、全血细胞计数形式的实验室检查和全结肠镜检查及活检。对结肠镜检查和组织病理学检查结果进行分析，以确定是否存在器质性疾病。结果：与 A 组相比，B 组直肠出血、体重减轻和面色苍白的发生率明显较高。结肠镜检查结果显示，B 组腺瘤性息肉的发生率较高，而 A 组结肠镜检查结果正常和淋巴细胞性结肠炎的发生率较高。年龄超过 50 岁可能与结肠器质性疾病有关。结论如果肠易激综合征患者没有令人担忧的特征，则不能排除器质性结肠疾病，这将影响临床治疗。
{"title":"Colonoscopic Findings in Patients Fulfilling ROME IV Criteria of Irritable Bowel Syndrome with or without Recently Discovered Alarming Features","authors":"Hala Elfeky, Rasha Abd Rabh, Mostafa Fouad, Tamer Elazab","doi":"10.21608/bmfj.2023.253437.1971","DOIUrl":"https://doi.org/10.21608/bmfj.2023.253437.1971","url":null,"abstract":"Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits. Identifying organic diseases in patients with IBS is crucial, especially when alarming features are present. This study aimed to assess colonoscopic findings in patients fulfilling ROME IV Criteria of Irritable Bowel Syndrome with or without Recently Discovered alarming features. Methods: This cross-sectional study was conducted on sixty consecutive patients with IBS who fulfilled the Rome IV criteria. The patients were divided into two groups: Group A (IBS without alarming features) and Group B (IBS with alarming features). Detailed history, clinical examination, laboratory investigations in the form of complete blood count and full colonoscopy with biopsy were performed. The colonoscopic and histopathological findings were analyzed to determine the presence of organic diseases. Results : Group B exhibited significantly higher occurrences of bleeding per rectum, weight loss, and pallor compared to Group A. Colonoscopic findings revealed a higher prevalence of adenomatous polyps in Group B, whereas Group A showed higher rates of normal findings and lymphocytic colitis. Age above 50 years may have association with organic colonic diseases. Conclusion: Absence of alarming features cannot exclude organic colonic diseases in IBS patients, influencing clinical management.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139535820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-06DOI: 10.21608/bmfj.2023.253583.1972
Alrawhaa Abo Amer, Effat Asar, Maha Rashwan, Asmaa Ali
Background: Infants born to diabetic mothers face an increased risk of hypoglycemia, necessitating reliable predictive markers for early intervention. This study aimed to measure C-Peptide in umbilical cord blood, to determine whether it can be used as a predictor of hypoglycemia in infants of diabetic mothers. Methods: A total of 50 infants born to diabetic mothers were studied and they were divided according to blood glucose levels into 25 experiencing hypoglycemia and 25 remaining normoglycemic. Detailed histories, comprehensive examinations, and multi-level investigations were conducted, including C-peptide measurement from umbilical cord blood and monitoring of glucose levels postnatally. Results : In the hypoglycemic group, mean cord C-peptide levels were significantly higher (5.2 ± 0.55 ng/ml) compared to the normoglycemic group (1.71 ± 0.62 ng/ml). A significant negative correlation was found between cord C-peptide levels and the blood glucose levels in the early postnatal period. Additionally, a positive correlation existed between cord C-peptide levels and birth weight. The sensitivity of cord C-peptide in predicting hypoglycemia was 90%, with a specificity of 88% and a cut-off value of 4.2. Conclusion: Cord C-peptide levels in infants of diabetic mothers might be a predictive biomarker for hypoglycemia in infant of diabetic mother.
背景：糖尿病母亲所生的婴儿发生低血糖的风险增加，因此需要可靠的预测指标来进行早期干预。本研究旨在测量脐带血中的 C 肽，以确定它是否可用作糖尿病母亲所生婴儿低血糖症的预测指标。研究方法共研究了 50 名糖尿病母亲所生的婴儿，根据血糖水平将他们分为 25 名低血糖婴儿和 25 名血糖正常婴儿。研究人员对这些婴儿进行了详细的病史询问、全面的检查和多层次的检验，包括脐带血中 C 肽的测定和产后血糖水平的监测。结果：与正常血糖组（1.71 ± 0.62 纳克/毫升）相比，低血糖组的平均脐带 C 肽水平（5.2 ± 0.55 纳克/毫升）明显更高。在产后早期，脐带 C 肽水平与血糖水平呈明显负相关。此外，脐带 C 肽水平与出生体重呈正相关。脐带 C 肽预测低血糖的灵敏度为 90%，特异度为 88%，临界值为 4.2。结论糖尿病母亲婴儿的脐带 C 肽水平可能是预测糖尿病母亲婴儿低血糖的生物标志物。
{"title":"Measurement of C-Peptide Level in The Umbilical Cord of Infants of Diabetic Mothers and Its Relationship to The Risk of Hypoglycemia","authors":"Alrawhaa Abo Amer, Effat Asar, Maha Rashwan, Asmaa Ali","doi":"10.21608/bmfj.2023.253583.1972","DOIUrl":"https://doi.org/10.21608/bmfj.2023.253583.1972","url":null,"abstract":"Background: Infants born to diabetic mothers face an increased risk of hypoglycemia, necessitating reliable predictive markers for early intervention. This study aimed to measure C-Peptide in umbilical cord blood, to determine whether it can be used as a predictor of hypoglycemia in infants of diabetic mothers. Methods: A total of 50 infants born to diabetic mothers were studied and they were divided according to blood glucose levels into 25 experiencing hypoglycemia and 25 remaining normoglycemic. Detailed histories, comprehensive examinations, and multi-level investigations were conducted, including C-peptide measurement from umbilical cord blood and monitoring of glucose levels postnatally. Results : In the hypoglycemic group, mean cord C-peptide levels were significantly higher (5.2 ± 0.55 ng/ml) compared to the normoglycemic group (1.71 ± 0.62 ng/ml). A significant negative correlation was found between cord C-peptide levels and the blood glucose levels in the early postnatal period. Additionally, a positive correlation existed between cord C-peptide levels and birth weight. The sensitivity of cord C-peptide in predicting hypoglycemia was 90%, with a specificity of 88% and a cut-off value of 4.2. Conclusion: Cord C-peptide levels in infants of diabetic mothers might be a predictive biomarker for hypoglycemia in infant of diabetic mother.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"31 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139535941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.21608/bmfj.2023.236981.1900
Hany Ebaid, Kareem Mohamed, Mohamed Hamoda, Marwa Mahmoud
: Background: Myocardial strain analysis by 2D-speckle-tracking echocardiography, which is performed at resting position, offers valuable information about myocardial fiber changes in different types of myocardial diseases. Aim: This study evaluated the role of myocardial strain analysis in assessment of severity of coronary artery stenosis in coronary artery disease patients. Patients and methods: The study was conducted at the Cardiology Department, Benha University Hospitals during the period from January 2023 to July 2023. This study included 100 patients with CAD, patients were divided into two groups: Group A: 50 Patients with Non-ST elevation Acute coronary syndrome. and Group B: 50 Patients with positive or equivocal stress ECG. (Stable coronary artery disease). All patients underwent full history & examination, ECG, conventional & speckle tracking Echocardiography & both Gensini & Syntax scores were calculated for every patient. Results: The study revealed a significant lower GLPSS in Group A compared to Group B (p<0.001). Also as regard the correlation of total longitudinal strain and significant coronary artery disease lesions in each Coronary Artery Territories, a significant higher territorial longitudinal strain correlated with significant lesion in LAD and LCX compared to non-significant lesions in Group A (P value= 0.001) While in Group B a significant higher Territorial longitudinal strain correlated with significant lesion in LAD, LCX and RCA compared to non-significant lesions (P value= 0.001) Conclusion: LVGLS and TLS have an incremental prognostic value and can be used to assess the severity of coronary stenosis in patients with coronary artery disease.
{"title":"Role of Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography in Assessment of Severity of Coronary Artery Stenosis in Coronary Artery Disease Patients","authors":"Hany Ebaid, Kareem Mohamed, Mohamed Hamoda, Marwa Mahmoud","doi":"10.21608/bmfj.2023.236981.1900","DOIUrl":"https://doi.org/10.21608/bmfj.2023.236981.1900","url":null,"abstract":": Background: Myocardial strain analysis by 2D-speckle-tracking echocardiography, which is performed at resting position, offers valuable information about myocardial fiber changes in different types of myocardial diseases. Aim: This study evaluated the role of myocardial strain analysis in assessment of severity of coronary artery stenosis in coronary artery disease patients. Patients and methods: The study was conducted at the Cardiology Department, Benha University Hospitals during the period from January 2023 to July 2023. This study included 100 patients with CAD, patients were divided into two groups: Group A: 50 Patients with Non-ST elevation Acute coronary syndrome. and Group B: 50 Patients with positive or equivocal stress ECG. (Stable coronary artery disease). All patients underwent full history & examination, ECG, conventional & speckle tracking Echocardiography & both Gensini & Syntax scores were calculated for every patient. Results: The study revealed a significant lower GLPSS in Group A compared to Group B (p<0.001). Also as regard the correlation of total longitudinal strain and significant coronary artery disease lesions in each Coronary Artery Territories, a significant higher territorial longitudinal strain correlated with significant lesion in LAD and LCX compared to non-significant lesions in Group A (P value= 0.001) While in Group B a significant higher Territorial longitudinal strain correlated with significant lesion in LAD, LCX and RCA compared to non-significant lesions (P value= 0.001) Conclusion: LVGLS and TLS have an incremental prognostic value and can be used to assess the severity of coronary stenosis in patients with coronary artery disease.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"48 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.21608/bmfj.2023.139168.1595
Shaimaa Kassem, Ola El Shimi, Haytham Abdelkader, Raghdaa Abdelkhaleq Abdelhalem
: Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder. Relapsing-remitting MS (RRMS) is the most common MS pattern characterized by relapses or exacerbations. This study aimed to investigate the status of serum endothelial NOXs (NOX5 and NOX4) and iron metabolism biomarkers in RRMS patients. Methods: The study was carried out on 40 RRMS patients and 40 control subjects. All the participants were subjected to complete history taking, general and full neurological examination, Serum NOX4,5, ferritin, iron, iron binding capacity, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) levels were measured in all the study subjects. Results: MS cases showed significantly lower Nox4, significantly higher Nox5 when compared to control group (median =0.081 versus 0.395, p<0.001; median=3.5 versus 0.225, p<0.001 respectively). High accuracy AUC was found regarding Nox 4 and Nox 5 (AUC=0.928, 0.988 respectively). At best cut off value of Nox-4 (=0.24 Mmol/L), sensitivity was 90%, specificity was 95%, PPV was 95%, NPV was 90% and accuracy was 92.4%. At best cut off value of Nox-5 (=1.67 Mmol/L), sensitivity was 100%, specificity was 97.5%, PPV was 97.6%, NPV was 100% and accuracy was 98.8%. Conclusion: Our data suggests that increased NOX5 expression and decreased levels of NOX4 might be related with oxidative stress related vascular changes and BBB disruption in MS patients.
{"title":"Serum NOXs and Iron Metabolism Biomarkers in RRMS Patients","authors":"Shaimaa Kassem, Ola El Shimi, Haytham Abdelkader, Raghdaa Abdelkhaleq Abdelhalem","doi":"10.21608/bmfj.2023.139168.1595","DOIUrl":"https://doi.org/10.21608/bmfj.2023.139168.1595","url":null,"abstract":": Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disorder. Relapsing-remitting MS (RRMS) is the most common MS pattern characterized by relapses or exacerbations. This study aimed to investigate the status of serum endothelial NOXs (NOX5 and NOX4) and iron metabolism biomarkers in RRMS patients. Methods: The study was carried out on 40 RRMS patients and 40 control subjects. All the participants were subjected to complete history taking, general and full neurological examination, Serum NOX4,5, ferritin, iron, iron binding capacity, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) levels were measured in all the study subjects. Results: MS cases showed significantly lower Nox4, significantly higher Nox5 when compared to control group (median =0.081 versus 0.395, p<0.001; median=3.5 versus 0.225, p<0.001 respectively). High accuracy AUC was found regarding Nox 4 and Nox 5 (AUC=0.928, 0.988 respectively). At best cut off value of Nox-4 (=0.24 Mmol/L), sensitivity was 90%, specificity was 95%, PPV was 95%, NPV was 90% and accuracy was 92.4%. At best cut off value of Nox-5 (=1.67 Mmol/L), sensitivity was 100%, specificity was 97.5%, PPV was 97.6%, NPV was 100% and accuracy was 98.8%. Conclusion: Our data suggests that increased NOX5 expression and decreased levels of NOX4 might be related with oxidative stress related vascular changes and BBB disruption in MS patients.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.21608/bmfj.2023.250015.1959
Naglaa Ramadan, Muhammad Abdel Gaffar, Sarah Atef, Naglaa Abdelrhman, Michael Moris, Tamer El-Azab
: Background: Biliary stent occlusion is a significant clinical concern with potentially severe consequences for patients. This study aimed to evaluate common microorganisms detected by culture from plastic biliary stents, assess their association with stent occlusion, and evaluate their antimicrobial sensitivity. Methods: Forty patients with plastic biliary stents were included in this study. They were divided into two groups: Group (I) 20 patients with clinical signs of stent occlusion and Group (II) 20 patients scheduled for stent extraction within three months after placement. Various clinical, laboratory, and imaging assessments were conducted. The plastic stents were extracted and subjected to microbiological culture to identify aerobic and anaerobic organisms, followed by antimicrobial sensitivity testing. Results: Patients in Group (I) exhibited a higher prevalence of clinical symptoms indicative of stent occlusion, abnormal vital signs, and elevated laboratory parameters (TLC, ESR, CRP, Total Bilirubin., Direct Bilirubin, ALP, ALT, AST, PT, INR and creatinine) compared to Group (II). Microbiological analysis revealed the presence of various organisms, with Klebsiella sp, Proteus, Pseudomonas, and E. coli being the most common. Sensitivity and resistance to antibiotics varied among these microorganisms. Conclusion: Klebsiella was prevalent in stent occlusion (65%), while Proteus dominated non-occlusion (60%). No anaerobic organisms were found. Amikacin, Meropenem, and Imipenem showed the highest sensitivity of microbes in patient with stent occlusion, and Meropenem, Colistin, and Imipenem the highest sensitivity of microbes in patient with non-stent occlusion. Both groups exhibited 100% resistance to various antibiotics.
{"title":"Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents","authors":"Naglaa Ramadan, Muhammad Abdel Gaffar, Sarah Atef, Naglaa Abdelrhman, Michael Moris, Tamer El-Azab","doi":"10.21608/bmfj.2023.250015.1959","DOIUrl":"https://doi.org/10.21608/bmfj.2023.250015.1959","url":null,"abstract":": Background: Biliary stent occlusion is a significant clinical concern with potentially severe consequences for patients. This study aimed to evaluate common microorganisms detected by culture from plastic biliary stents, assess their association with stent occlusion, and evaluate their antimicrobial sensitivity. Methods: Forty patients with plastic biliary stents were included in this study. They were divided into two groups: Group (I) 20 patients with clinical signs of stent occlusion and Group (II) 20 patients scheduled for stent extraction within three months after placement. Various clinical, laboratory, and imaging assessments were conducted. The plastic stents were extracted and subjected to microbiological culture to identify aerobic and anaerobic organisms, followed by antimicrobial sensitivity testing. Results: Patients in Group (I) exhibited a higher prevalence of clinical symptoms indicative of stent occlusion, abnormal vital signs, and elevated laboratory parameters (TLC, ESR, CRP, Total Bilirubin., Direct Bilirubin, ALP, ALT, AST, PT, INR and creatinine) compared to Group (II). Microbiological analysis revealed the presence of various organisms, with Klebsiella sp, Proteus, Pseudomonas, and E. coli being the most common. Sensitivity and resistance to antibiotics varied among these microorganisms. Conclusion: Klebsiella was prevalent in stent occlusion (65%), while Proteus dominated non-occlusion (60%). No anaerobic organisms were found. Amikacin, Meropenem, and Imipenem showed the highest sensitivity of microbes in patient with stent occlusion, and Meropenem, Colistin, and Imipenem the highest sensitivity of microbes in patient with non-stent occlusion. Both groups exhibited 100% resistance to various antibiotics.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536371","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 : 2023-12-23DOI: 10.21608/bmfj.2023.249790.1956
Ali Al Gazzar, ahmed Abdelazim, Ahmed Soliman, Gehad Elsayed
: Background: Pain management after a caesarean section (CS) remains a significant clinical challenge, and alternative strategies for analgesia are continually being explored This study aimed to determine the efficacy of injecting the local anesthetic, Bupivacaine, bilaterally into the rectus sheath incision angles to block the ilioinguinal and ilio-hypogastric nerves, with the aim of reducing postoperative pain in patients undergoing CS under general anesthesia. Methods: A total of 150 female patients scheduled for elective Caesarean section were enrolled in this study. Patients were randomly assigned to one of two groups: Group A received Bupivacaine injections, while Group B received saline injections into the rectus sheath incision angles. Pain assessments, medication usage, and patient satisfaction were evaluated as primary outcome measures. Results: The study revealed that patients in Group A, receiving Bupivacaine injections, experienced significantly lower pain scores at various time intervals, shorter time to the first analgesic request, and a reduced need for meperidine compared to Group B. Additionally, patients in Group A reported higher satisfaction with pain management. Conclusion: Injection of Bupivacaine into both angles of the rectus sheath incision during Caesarean section effectively reduces postoperative pain and improves patient satisfaction.
:背景：本研究旨在确定在直肠鞘切口角度双侧注射局麻药布比卡因以阻断髂腹股沟神经和髂下胃神经的疗效，从而减轻在全身麻醉下接受剖腹产手术的患者的术后疼痛。方法共有 150 名计划进行择期剖腹产的女性患者参与了这项研究。患者被随机分配到两组中的一组：A 组接受布比卡因注射，B 组在直肠鞘切口角注射生理盐水。疼痛评估、用药情况和患者满意度作为主要结果指标进行评估。结果显示研究显示，与 B 组相比，接受布比卡因注射的 A 组患者在不同时间间隔内的疼痛评分明显降低，首次要求镇痛的时间缩短，对甲哌啶的需求减少。结论在剖腹产手术中向直肠鞘切口的两个角度注射布比卡因可有效减轻术后疼痛并提高患者满意度。
{"title":"Evaluation of Analgesic Effect of Bupivacaine Injection into Both Angles of the Rectus Sheath Incision after an Elective Caesarean Section","authors":"Ali Al Gazzar, ahmed Abdelazim, Ahmed Soliman, Gehad Elsayed","doi":"10.21608/bmfj.2023.249790.1956","DOIUrl":"https://doi.org/10.21608/bmfj.2023.249790.1956","url":null,"abstract":": Background: Pain management after a caesarean section (CS) remains a significant clinical challenge, and alternative strategies for analgesia are continually being explored This study aimed to determine the efficacy of injecting the local anesthetic, Bupivacaine, bilaterally into the rectus sheath incision angles to block the ilioinguinal and ilio-hypogastric nerves, with the aim of reducing postoperative pain in patients undergoing CS under general anesthesia. Methods: A total of 150 female patients scheduled for elective Caesarean section were enrolled in this study. Patients were randomly assigned to one of two groups: Group A received Bupivacaine injections, while Group B received saline injections into the rectus sheath incision angles. Pain assessments, medication usage, and patient satisfaction were evaluated as primary outcome measures. Results: The study revealed that patients in Group A, receiving Bupivacaine injections, experienced significantly lower pain scores at various time intervals, shorter time to the first analgesic request, and a reduced need for meperidine compared to Group B. Additionally, patients in Group A reported higher satisfaction with pain management. Conclusion: Injection of Bupivacaine into both angles of the rectus sheath incision during Caesarean section effectively reduces postoperative pain and improves patient satisfaction.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"6 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139161825","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 : 2023-12-23DOI: 10.21608/bmfj.2023.254247.1977
Hamada Khater, Sherif Elrefaey, Gehad Fetouh
: Background: Pediatric spinal anomalies often necessitate accurate and timely diagnosis for effective management. This study aimed to assess the diagnostic value of spinal ultrasound as initial modality for screening of pediatrics spinal anomalies in comparison to MRI. Methods: This cross-sectional study was conducted on pediatric patients suspected of spinal cord disorders. A detailed clinical examination, spinal ultrasound using high-frequency linear array transducers, and MRI scans were performed on all participants. Results: The 23.44 ± 32.02 days, 93.33% were less than 60 days old. Females comprised 68.9%, males 22.2%, and 8.9% had ambiguous genitalia. Common clinical presentations included back swelling (57.78%), hair tuft (31.11%), and sacral dimple (24.44%). Most anomalies involved the lumbosacral region (80%). Ultrasonography exhibited high diagnostic validity, showing perfect agreement with MRI for myelomeningocele, dorsal dermal sinus, tethered cord, myelocele, disyomatomyelia with segmental spinal dysgenesis, dermal sinus, myelocystocele, and retethering of the cord (Kappa > 0.9). However, for caudal regression syndrome, the Kappa value was 0.656, indicating moderate agreement. The overall diagnostic accuracy of ultrasound compared to MRI was above 95.56% across findings. Conclusion: Spinal ultrasound demonstrates substantial diagnostic accuracy comparable to MRI in identifying pediatric spinal anomalies, particularly for various conditions such as myelomeningocele, dorsal dermal sinus, and tethered cord.
{"title":"Diagnostic Value of Spinal Ultrasound in Diagnosis of Spinal Anomalies in Pediatrics in Comparison to MRI","authors":"Hamada Khater, Sherif Elrefaey, Gehad Fetouh","doi":"10.21608/bmfj.2023.254247.1977","DOIUrl":"https://doi.org/10.21608/bmfj.2023.254247.1977","url":null,"abstract":": Background: Pediatric spinal anomalies often necessitate accurate and timely diagnosis for effective management. This study aimed to assess the diagnostic value of spinal ultrasound as initial modality for screening of pediatrics spinal anomalies in comparison to MRI. Methods: This cross-sectional study was conducted on pediatric patients suspected of spinal cord disorders. A detailed clinical examination, spinal ultrasound using high-frequency linear array transducers, and MRI scans were performed on all participants. Results: The 23.44 ± 32.02 days, 93.33% were less than 60 days old. Females comprised 68.9%, males 22.2%, and 8.9% had ambiguous genitalia. Common clinical presentations included back swelling (57.78%), hair tuft (31.11%), and sacral dimple (24.44%). Most anomalies involved the lumbosacral region (80%). Ultrasonography exhibited high diagnostic validity, showing perfect agreement with MRI for myelomeningocele, dorsal dermal sinus, tethered cord, myelocele, disyomatomyelia with segmental spinal dysgenesis, dermal sinus, myelocystocele, and retethering of the cord (Kappa > 0.9). However, for caudal regression syndrome, the Kappa value was 0.656, indicating moderate agreement. The overall diagnostic accuracy of ultrasound compared to MRI was above 95.56% across findings. Conclusion: Spinal ultrasound demonstrates substantial diagnostic accuracy comparable to MRI in identifying pediatric spinal anomalies, particularly for various conditions such as myelomeningocele, dorsal dermal sinus, and tethered cord.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139162302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Meropenem is commonly used in the treatment of critically ill patients with sepsis. However, the optimal dosing regimen remains a subject of debate. This study aimed to compare the pharmacokinetic, clinical, and bacteriological efficacies of continuous infusion of meropenem versus traditional intermittent administration in critically ill patients with sepsis, and to evaluate the safety of both dosing regimens. Methods: This prospective randomized controlled trial was conducted on critically ill patients diagnosed with sepsis and admitted to the ICU. Patients were randomly assigned to either the continuous infusion group (n=30) or the intermittent intravenous group (n=30). Clinical parameters, laboratory data, and clinical outcomes were recorded. Microbiological outcomes, including microbiological eradication and superinfection, were assessed. Pharmacokinetic analysis was performed to evaluate drug concentrations. Results : The superinfection rate (requiring other antibiotics) was lower in the continuous group (3.3%) compared to 16.7% in intermittent group. The mean total fluid infusion in the first 24hr was 4190 ml in the continuous group compared to 4336 ml in the intermittent group. The mean length of ICU stay was 10.10 ± 6.12 days in the continuous group compared to 11.60 ± 5.55 days in the intermittent group. A significantly lower mean duration of meropenem treatment (9.93 days) was associated with continuous group compared to 11.53 days in intermittent group. Mortality rate was lower in the continuous group (26.7%) compared to intermittent group (40%). Conclusion: Continuous infusion of meropenem demonstrated superior clinical and bacteriological outcomes in critically ill septic patients compared to intermittent administration.
{"title":"Continuous versus Intermittent Use of Meropenem in Septic Critically Ill Patients: A Randomized Controlled Trail","authors":"Saad Saad, Bsem Aglan, Eslam Shaboob, Hossam Abdelghany","doi":"10.21608/bmfj.2023.247556.1949","DOIUrl":"https://doi.org/10.21608/bmfj.2023.247556.1949","url":null,"abstract":"Background: Meropenem is commonly used in the treatment of critically ill patients with sepsis. However, the optimal dosing regimen remains a subject of debate. This study aimed to compare the pharmacokinetic, clinical, and bacteriological efficacies of continuous infusion of meropenem versus traditional intermittent administration in critically ill patients with sepsis, and to evaluate the safety of both dosing regimens. Methods: This prospective randomized controlled trial was conducted on critically ill patients diagnosed with sepsis and admitted to the ICU. Patients were randomly assigned to either the continuous infusion group (n=30) or the intermittent intravenous group (n=30). Clinical parameters, laboratory data, and clinical outcomes were recorded. Microbiological outcomes, including microbiological eradication and superinfection, were assessed. Pharmacokinetic analysis was performed to evaluate drug concentrations. Results : The superinfection rate (requiring other antibiotics) was lower in the continuous group (3.3%) compared to 16.7% in intermittent group. The mean total fluid infusion in the first 24hr was 4190 ml in the continuous group compared to 4336 ml in the intermittent group. The mean length of ICU stay was 10.10 ± 6.12 days in the continuous group compared to 11.60 ± 5.55 days in the intermittent group. A significantly lower mean duration of meropenem treatment (9.93 days) was associated with continuous group compared to 11.53 days in intermittent group. Mortality rate was lower in the continuous group (26.7%) compared to intermittent group (40%). Conclusion: Continuous infusion of meropenem demonstrated superior clinical and bacteriological outcomes in critically ill septic patients compared to intermittent administration.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"72 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: ST segment Elevation Myocardial Infarction (STEMI) patients often require reperfusion therapy to restore blood flow to the affected heart muscle. Mean Platelet Volume (MPV) has been proposed as a potential predictor of reperfusion success in STEMI patients. This study aimed to show correlation between MPV on admission and ST segment resolution following reperfusion therapy in STEMI patients. Methods: This observational, single-center study-was conducted on patients with ACS to assess their clinical outcomes and the predictive role of hematological indices, including; MPV-in determining the effectiveness of reperfusion therapy, encompassing fibrinolytics and primary PCI. Our study comprised 100 STEMI patients, with 50 undergoing PCI and the remaining 50 receiving thrombolytic therapy. Among the PCI group, 42 patients achieved successful treatment, while in the fibrinolytic group, only 32 cases were successful. From all study patients there were 74 experienced ST-elevation resolution (Group A), while 26 cases did not exhibit resolution of their ST abnormalities (Group B). Results : ROC curve analysis revealed that MPV-pre at cut-off value of 11.15-could be good predictive test of unsuccessful reperfusion with 76.9% sensitivity and 70.3% specificity (AUC, 0.77 and 95% CI, 0.67-0.87). There is a significant positive correlation between MPV_Pre and MPV_post (r = 0.254, p = 0.011). Conclusion: There is a correlation between MPV on admission and ST segment resolution following reperfusion therapy in STEMI patients. Mean Platelet Volume (MPV) may be utilized as a prognostic predictor of success of thrombolysis following STEMI.
{"title":"Relationship between Mean Platelet Volume and ST Segment Resolution after Reperfusion Therapy in Patients with ST Elevation Myocardial Infarction","authors":"Hesham Rashid, Mohamed Hamoda, Mohamed Elian, Amira Ghonaim","doi":"10.21608/bmfj.2023.243552.1929","DOIUrl":"https://doi.org/10.21608/bmfj.2023.243552.1929","url":null,"abstract":"Background: ST segment Elevation Myocardial Infarction (STEMI) patients often require reperfusion therapy to restore blood flow to the affected heart muscle. Mean Platelet Volume (MPV) has been proposed as a potential predictor of reperfusion success in STEMI patients. This study aimed to show correlation between MPV on admission and ST segment resolution following reperfusion therapy in STEMI patients. Methods: This observational, single-center study-was conducted on patients with ACS to assess their clinical outcomes and the predictive role of hematological indices, including; MPV-in determining the effectiveness of reperfusion therapy, encompassing fibrinolytics and primary PCI. Our study comprised 100 STEMI patients, with 50 undergoing PCI and the remaining 50 receiving thrombolytic therapy. Among the PCI group, 42 patients achieved successful treatment, while in the fibrinolytic group, only 32 cases were successful. From all study patients there were 74 experienced ST-elevation resolution (Group A), while 26 cases did not exhibit resolution of their ST abnormalities (Group B). Results : ROC curve analysis revealed that MPV-pre at cut-off value of 11.15-could be good predictive test of unsuccessful reperfusion with 76.9% sensitivity and 70.3% specificity (AUC, 0.77 and 95% CI, 0.67-0.87). There is a significant positive correlation between MPV_Pre and MPV_post (r = 0.254, p = 0.011). Conclusion: There is a correlation between MPV on admission and ST segment resolution following reperfusion therapy in STEMI patients. Mean Platelet Volume (MPV) may be utilized as a prognostic predictor of success of thrombolysis following STEMI.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"46 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Ramadan fasting presents unique challenges for patients with mechanical prosthetic heart valves on Warfarin therapy. This study aimed to evaluate the potential effects of Ramadan fasting and lifestyle changes during Ramadan on the International Normalized Ratio (INR) level in patients using Vitamin K anticoagulant VKA (Warfarin) for mechanical prosthetic heart valves as anticoagulation. Methods: This prospective study included 150 Muslim patients with mechanical prosthetic heart valves, tracking their INR levels over a period encompassing the month of Ramadan. Patients underwent regular assessments, including clinical examinations, INR measurements, and echocardiography. Data were collected on medication regimens, Warfarin intake timing, and fasting adherence. Results : The mean INR levels increased during Ramadan, with the most significant rise occurring in the last two weeks. Patients exhibited a significantly higher mean INR during Ramadan compared to the pre-Ramadan and post-Ramadan periods. Importantly, more patients reached the supra-therapeutic INR range during Ramadan, while fewer were within the sub-therapeutic range when compared to the post-Ramadan phase. Conclusion: Ramadan fasting can lead to significant fluctuations in INR levels in patients with mechanical prosthetic heart valves using Warfarin. Careful monitoring and adjustment of anticoagulation therapy may be necessary to maintain therapeutic INR ranges during this religious observance.
{"title":"Effect of Ramadan Fasting on the International Normalized Ratio and Prosthetic valve function in Patients with Mechanical Prosthetic Heart Valves","authors":"Yasser Abdelrahman, Saad Ammar, Mohamed El-morshedy, Mahmoud Abdelmoneum","doi":"10.21608/bmfj.2023.245457.1941","DOIUrl":"https://doi.org/10.21608/bmfj.2023.245457.1941","url":null,"abstract":"Background: Ramadan fasting presents unique challenges for patients with mechanical prosthetic heart valves on Warfarin therapy. This study aimed to evaluate the potential effects of Ramadan fasting and lifestyle changes during Ramadan on the International Normalized Ratio (INR) level in patients using Vitamin K anticoagulant VKA (Warfarin) for mechanical prosthetic heart valves as anticoagulation. Methods: This prospective study included 150 Muslim patients with mechanical prosthetic heart valves, tracking their INR levels over a period encompassing the month of Ramadan. Patients underwent regular assessments, including clinical examinations, INR measurements, and echocardiography. Data were collected on medication regimens, Warfarin intake timing, and fasting adherence. Results : The mean INR levels increased during Ramadan, with the most significant rise occurring in the last two weeks. Patients exhibited a significantly higher mean INR during Ramadan compared to the pre-Ramadan and post-Ramadan periods. Importantly, more patients reached the supra-therapeutic INR range during Ramadan, while fewer were within the sub-therapeutic range when compared to the post-Ramadan phase. Conclusion: Ramadan fasting can lead to significant fluctuations in INR levels in patients with mechanical prosthetic heart valves using Warfarin. Careful monitoring and adjustment of anticoagulation therapy may be necessary to maintain therapeutic INR ranges during this religious observance.","PeriodicalId":503219,"journal":{"name":"Benha Medical Journal","volume":"108 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139163686","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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