Pub Date : 2021-07-01DOI: 10.4103/azmj.azmj_179_20
M. El-kholy, F. Mustafa, Mahmoud A. Badawy
Background and aim Bleeding is considered one of the most common problems in perimenopausal women. The menopausal transition is an imprecise period and can be established from the moment of appearance of menstrual disturbances and elevation of the serum follicle-stimulating hormone (FSH) level. The objective of this study was to evaluate the efficacy of tactile electrosurgical ablation of endometrium under rectal ultrasound guidance versus modified tactile versapoint hysteroscopic ablation in the management of perimenopausal abnormal uterine bleeding. Patients and methods This study was conducted in the Department of Obstetrics and Gynecology of Al-Azhar University Hospital (Assuit), Egypt on 50 perimenopausal patients with abnormal uterine bleeding. Patients were divided into two groups according to the method used. Group 1 included 25 participants, and ablation was done using tactile ablation guided by rectal ultrasound. Group 2 included 25 participants, who underwent hysteroscopic ablation using versapoint hysteroscope. Results Regarding sociodemographic study data, age in both groups ranged from 38 to 45 years, with P value of 0.903. Parity also showed no statistically significant difference between both groups. The incidence of complication was more in group 1 but less dangerous. Thermal injury of genital tract was seen in two cases in group 1 but no cases in group 2, with P value of 0.245. Cervical injury was seen in two cases in group 1 and one case in group 2, with P value of 0.500. Perforation occurred in two cases in group 1 and one case in group 2, with P value of 0.500. Regarding specific complication of endometrial ablation by versapoint hysteroscopic ablation, which occurred in group 2 only, by distension media, four cases had complications such as hyponatremia (decrease in serum sodium of 10 mmol/l). Postoperative complication such as hematometra occurred in one case only in group 1, with P value 0.500. The cost range in group 1 was from $14 to 20 and in group 2 it was from $40 to 50, with P value less than 0.001FNx08. The time of surgery ranged from 10 to −15 min in group 1 and from 20 to 30 min in group 2, with P value less than 0.001FNx08. After 6 months, two cases came back with recurrent Hge in group 1 and six cases in group 2, with P value 0.123. Conclusion Tactile ablation is easier, effective, and less costly.
{"title":"Comparative study between tactile electrosurgical ablation guided by rectal ultrasound and versapoint hysteroscopic ablation in cases of perimenopausal uterine bleeding","authors":"M. El-kholy, F. Mustafa, Mahmoud A. Badawy","doi":"10.4103/azmj.azmj_179_20","DOIUrl":"https://doi.org/10.4103/azmj.azmj_179_20","url":null,"abstract":"Background and aim Bleeding is considered one of the most common problems in perimenopausal women. The menopausal transition is an imprecise period and can be established from the moment of appearance of menstrual disturbances and elevation of the serum follicle-stimulating hormone (FSH) level. The objective of this study was to evaluate the efficacy of tactile electrosurgical ablation of endometrium under rectal ultrasound guidance versus modified tactile versapoint hysteroscopic ablation in the management of perimenopausal abnormal uterine bleeding. Patients and methods This study was conducted in the Department of Obstetrics and Gynecology of Al-Azhar University Hospital (Assuit), Egypt on 50 perimenopausal patients with abnormal uterine bleeding. Patients were divided into two groups according to the method used. Group 1 included 25 participants, and ablation was done using tactile ablation guided by rectal ultrasound. Group 2 included 25 participants, who underwent hysteroscopic ablation using versapoint hysteroscope. Results Regarding sociodemographic study data, age in both groups ranged from 38 to 45 years, with P value of 0.903. Parity also showed no statistically significant difference between both groups. The incidence of complication was more in group 1 but less dangerous. Thermal injury of genital tract was seen in two cases in group 1 but no cases in group 2, with P value of 0.245. Cervical injury was seen in two cases in group 1 and one case in group 2, with P value of 0.500. Perforation occurred in two cases in group 1 and one case in group 2, with P value of 0.500. Regarding specific complication of endometrial ablation by versapoint hysteroscopic ablation, which occurred in group 2 only, by distension media, four cases had complications such as hyponatremia (decrease in serum sodium of 10 mmol/l). Postoperative complication such as hematometra occurred in one case only in group 1, with P value 0.500. The cost range in group 1 was from $14 to 20 and in group 2 it was from $40 to 50, with P value less than 0.001FNx08. The time of surgery ranged from 10 to −15 min in group 1 and from 20 to 30 min in group 2, with P value less than 0.001FNx08. After 6 months, two cases came back with recurrent Hge in group 1 and six cases in group 2, with P value 0.123. Conclusion Tactile ablation is easier, effective, and less costly.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"366 - 372"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49191756","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}
Adel Elrakeeb, Sawsan Eltayyeb, A. Elgazzar, A. Elgendy, M. Alboraie
Background and aims Tailored (culture and sensitivity) therapy has gained attention over recent years as an effective option for eradication of Helicobacter pylori infection. The authors aimed to assess the efficacy of antibiotics sensitivity-guided therapy versus clarithromycin or levofloxacin triple therapies as the first-line therapy for H. pylori. Patients and methods Dyspeptic patients who underwent esophagogastroduodenoscopy were prospectively enrolled. Patients with positive H. pylori results by the rapid urease test were randomized to receive either antibiotics sensitivity-guided therapy or empirical clarithromycin or levofloxacin-based triple therapy for 14 days. Antimicrobial sensitivity tests for seven antibiotics (clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline, nitrofurantoin, and rifampicin) were performed using the disk-diffusion method. Group A received antibiotics sensitivity-guided therapies that included esomeprazole plus two antibiotics for which the isolates were sensitive and group B received conventional therapies that included esomeprazole, amoxicillin plus clarithromycin or levofloxacin for 2 weeks. Eradication of H. pylori was checked using stool antigen 4 weeks after therapy. Results A total of 25 patients completed the study in each group. Both studied groups were matched for baseline characteristics. The most commonly used regimen in the antimicrobial sensitivity-based therapy was clarithromycin-based triple therapy (46.5%), followed by levofloxacin-based triple therapy and levofloxacin and nitrofurantoin plus esomeprazole. The association analysis demonstrated that, in the intention-to-treat populations, the H. pylori eradication rate was significantly higher in the antibiotic sensitivity-guided therapy group [85.7% (24/28) vs. 53.3% (16/30) in the conventional therapy group (P=0.035). In the per-protocol populations, the eradication rate was 96% for the sensitivity-guided therapy group and 64% for the conventional therapy group (P=0.005). The rates of adverse events were similar in both sensitivity-guided and conventional therapies, with no significant differences (P=0.527). Conclusions Culture-based eradication therapy demonstrated superior eradication rates than empirical therapy as a first-line therapy for H. pylori in a region with high rates of antimicrobial resistance.
{"title":"Tailored Helicobacter pylori therapy is more effective than conventional therapy: a randomized-controlled trial","authors":"Adel Elrakeeb, Sawsan Eltayyeb, A. Elgazzar, A. Elgendy, M. Alboraie","doi":"10.4103/azmj.azmj_51_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_51_21","url":null,"abstract":"Background and aims Tailored (culture and sensitivity) therapy has gained attention over recent years as an effective option for eradication of Helicobacter pylori infection. The authors aimed to assess the efficacy of antibiotics sensitivity-guided therapy versus clarithromycin or levofloxacin triple therapies as the first-line therapy for H. pylori. Patients and methods Dyspeptic patients who underwent esophagogastroduodenoscopy were prospectively enrolled. Patients with positive H. pylori results by the rapid urease test were randomized to receive either antibiotics sensitivity-guided therapy or empirical clarithromycin or levofloxacin-based triple therapy for 14 days. Antimicrobial sensitivity tests for seven antibiotics (clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline, nitrofurantoin, and rifampicin) were performed using the disk-diffusion method. Group A received antibiotics sensitivity-guided therapies that included esomeprazole plus two antibiotics for which the isolates were sensitive and group B received conventional therapies that included esomeprazole, amoxicillin plus clarithromycin or levofloxacin for 2 weeks. Eradication of H. pylori was checked using stool antigen 4 weeks after therapy. Results A total of 25 patients completed the study in each group. Both studied groups were matched for baseline characteristics. The most commonly used regimen in the antimicrobial sensitivity-based therapy was clarithromycin-based triple therapy (46.5%), followed by levofloxacin-based triple therapy and levofloxacin and nitrofurantoin plus esomeprazole. The association analysis demonstrated that, in the intention-to-treat populations, the H. pylori eradication rate was significantly higher in the antibiotic sensitivity-guided therapy group [85.7% (24/28) vs. 53.3% (16/30) in the conventional therapy group (P=0.035). In the per-protocol populations, the eradication rate was 96% for the sensitivity-guided therapy group and 64% for the conventional therapy group (P=0.005). The rates of adverse events were similar in both sensitivity-guided and conventional therapies, with no significant differences (P=0.527). Conclusions Culture-based eradication therapy demonstrated superior eradication rates than empirical therapy as a first-line therapy for H. pylori in a region with high rates of antimicrobial resistance.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"379 - 385"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45940291","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 and aim This case–control study was conducted to evaluate serum ferritin, vitamin D, and thyroid functions in patients with telogen effluvium (TE) in comparison with controls and to find if they can be used as diagnostic biomarkers of TE. Patients and methods A retrospective matched case–control study was performed using data from Hera Hospital database, Makkah, Saudi Arabia. The case records of 100 women diagnosed with TE and treated in the dermatology outpatient clinic were analyzed retrospectively. To obtain appropriate controls, records were searched for age-matched and sex-matched women who came to the hospital for a condition other than TE during the same period. Results The mean levels of patients’ serum ferritin and vitamin D were significantly lower than those of the controls. With respect to thyroid function tests, the mean levels of thyroid-stimulating hormone, thyroxine, and triiodothyronine showed no statistically significant differences between patients and controls. Although nonsignificant, 7% of patients with TE had laboratory evidence of hypothyroidism compared with 2% of controls, and 16% had subclinical hypothyroidism compared with 10% of controls, suggesting a role of thyroid dysfunction in TE. Conclusions Low serum ferritin, vitamin D deficiency, and thyroid dysfunction could be the risk factors for TE and can be used as diagnostic biomarkers of TE; hence, treating such patients with iron, vitamin D, and correction of thyroid dysfunction would be valuable. Prospective clinical studies with a larger number of participants are required to further address the risk factors for TE.
{"title":"Role of ferritin, vitamin D, and thyroid dysfunction in telogen effluvium among the hospital population in Western Saudi Arabia: a case–control study","authors":"S. Mohammed, M. Fatani, Abdulmajeed S. Khan","doi":"10.4103/azmj.azmj_9_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_9_21","url":null,"abstract":"Background and aim This case–control study was conducted to evaluate serum ferritin, vitamin D, and thyroid functions in patients with telogen effluvium (TE) in comparison with controls and to find if they can be used as diagnostic biomarkers of TE. Patients and methods A retrospective matched case–control study was performed using data from Hera Hospital database, Makkah, Saudi Arabia. The case records of 100 women diagnosed with TE and treated in the dermatology outpatient clinic were analyzed retrospectively. To obtain appropriate controls, records were searched for age-matched and sex-matched women who came to the hospital for a condition other than TE during the same period. Results The mean levels of patients’ serum ferritin and vitamin D were significantly lower than those of the controls. With respect to thyroid function tests, the mean levels of thyroid-stimulating hormone, thyroxine, and triiodothyronine showed no statistically significant differences between patients and controls. Although nonsignificant, 7% of patients with TE had laboratory evidence of hypothyroidism compared with 2% of controls, and 16% had subclinical hypothyroidism compared with 10% of controls, suggesting a role of thyroid dysfunction in TE. Conclusions Low serum ferritin, vitamin D deficiency, and thyroid dysfunction could be the risk factors for TE and can be used as diagnostic biomarkers of TE; hence, treating such patients with iron, vitamin D, and correction of thyroid dysfunction would be valuable. Prospective clinical studies with a larger number of participants are required to further address the risk factors for TE.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"452 - 458"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48450615","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: 10.4103/1687-1693.326365
{"title":"Erratum: Interest in research among female medical students at Al-Azhar University in Cairo, Egypt","authors":"","doi":"10.4103/1687-1693.326365","DOIUrl":"https://doi.org/10.4103/1687-1693.326365","url":null,"abstract":"","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"480 - 480"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41894405","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}
Maisa A Abdel Wahab, Shayma Mohammed, I. Ahmad, Salwa I Elshennawy, Sadek Mostafa
Background and aim Diabetes mellitus (DM) is a major risk factor for atherosclerosis that increases platelet activation and aggregation. Aim This study aimed to investigate the different types of platelet activation markers in diabetic patients with peripheral arterial disease (PAD). Patients and methods Using flow cytometry on forty noninsulin-dependent diabetic type II patients with PAD receiving antiplatelet therapy, participants were divided into two groups: those with controlled, uncontrolled DM and 20 control samples. Results There was a highly significant increase in mean platelet volume, CD62P%, CD62 mean fluorescence intensity, and CD63% in the uncontrolled DM group compared with the control group, in addition to a highly significant correlation between CD62P% and glycated hemoglobin in all cases, with a P value of 0.015. Conclusion The CD62P% is a more selective platelet marker that is activated in uncontrolled DM, causing atherosclerosis and leading to PAD. Glycemic control is the most important factor in the prevention of atherothrombotic progress than antiplatelet treatment.
{"title":"A study of activated platelet by flow cytometry in diabetic patients with peripheral arterial disease","authors":"Maisa A Abdel Wahab, Shayma Mohammed, I. Ahmad, Salwa I Elshennawy, Sadek Mostafa","doi":"10.4103/azmj.azmj_15_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_15_21","url":null,"abstract":"Background and aim Diabetes mellitus (DM) is a major risk factor for atherosclerosis that increases platelet activation and aggregation. Aim This study aimed to investigate the different types of platelet activation markers in diabetic patients with peripheral arterial disease (PAD). Patients and methods Using flow cytometry on forty noninsulin-dependent diabetic type II patients with PAD receiving antiplatelet therapy, participants were divided into two groups: those with controlled, uncontrolled DM and 20 control samples. Results There was a highly significant increase in mean platelet volume, CD62P%, CD62 mean fluorescence intensity, and CD63% in the uncontrolled DM group compared with the control group, in addition to a highly significant correlation between CD62P% and glycated hemoglobin in all cases, with a P value of 0.015. Conclusion The CD62P% is a more selective platelet marker that is activated in uncontrolled DM, causing atherosclerosis and leading to PAD. Glycemic control is the most important factor in the prevention of atherothrombotic progress than antiplatelet treatment.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"395 - 400"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47989153","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 and aim Renal failure is usually treated by hemodialysis forever. Renal transplantation is the only curative intervention. However, regenerative therapies are expected to exert a beneficial role in such situations. The aim of this study was to study the role of mesenchymal stem cells (MSCs) in the treatment of acute renal failure (ARF) in an animal model. Materials and methods ARF was induced by cisplatin injection in 20 male rats weighing 200–225 g. Rats were allocated into one of two equal groups: group A included 10 rats with ARF and umbilical cord-derived stem cell treatment, and group B included 10 rats with saline treatment. In addition, 10 healthy rats were included as a healthy control group (group C). Both serum urea and creatinine were measured after induction of renal failure and on the 7th and 15th day after MSC treatment. Kidney sections were obtained, stained with hematoxylin and eosin, and examined histologically. Results Serum urea and creatinine showed marked elevation after cisplatin injection. These values progressively decreased with MSC treatment significantly. At the end of the second week, the values were near normal. In addition, histological examination of renal section confirms the results obtained by laboratory analysis. Conclusion Umbilical cord-derived MSCs could play a regenerative action in ARF.
{"title":"Role of stem cells in the management of acute kidney disease","authors":"Fawzi Galala, S. Mohammed","doi":"10.4103/AZMJ.AZMJ_42_18","DOIUrl":"https://doi.org/10.4103/AZMJ.AZMJ_42_18","url":null,"abstract":"Background and aim Renal failure is usually treated by hemodialysis forever. Renal transplantation is the only curative intervention. However, regenerative therapies are expected to exert a beneficial role in such situations. The aim of this study was to study the role of mesenchymal stem cells (MSCs) in the treatment of acute renal failure (ARF) in an animal model. Materials and methods ARF was induced by cisplatin injection in 20 male rats weighing 200–225 g. Rats were allocated into one of two equal groups: group A included 10 rats with ARF and umbilical cord-derived stem cell treatment, and group B included 10 rats with saline treatment. In addition, 10 healthy rats were included as a healthy control group (group C). Both serum urea and creatinine were measured after induction of renal failure and on the 7th and 15th day after MSC treatment. Kidney sections were obtained, stained with hematoxylin and eosin, and examined histologically. Results Serum urea and creatinine showed marked elevation after cisplatin injection. These values progressively decreased with MSC treatment significantly. At the end of the second week, the values were near normal. In addition, histological examination of renal section confirms the results obtained by laboratory analysis. Conclusion Umbilical cord-derived MSCs could play a regenerative action in ARF.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"351 - 356"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44397781","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 and aim Chronic total occlusion is a common condition in patients with coronary artery disease and represents one of the most challenging targets of lesion recanalization with successful percutaneous coronary intervention (PCI). Different echo-Doppler modalities can be used for the assessment of right ventricular (RV) performance in patients undergoing PCI with reported superiority of the newer modalities. The aim was to assess the effect of successful PCI for chronic totally occluded vessel on the RV performance by different echo-Doppler modalities. Patients and methods The present study enrolled 25 patients with chronic total occlusion for whom PCI was performed. Patients were subjected to history taking, clinical assessment, 12-lead surface ECG, and evaluation of RV functions before, within 48 h after successful PCI, and 1 month later, using conventional and new echo-Doppler modalities. Echo-Doppler parameters included RV dimensions, Doppler flow velocities (E, A, and E/A) across tricuspid valves, RV fractional area change (RV-FAC), tricuspid annular plane systolic excursion, tissue Doppler systolic, and diastolic velocities (Sa, Ea, and Aa) at the lateral tricuspid annulus, in addition to evaluation of RV global longitudinal strain (RV-GLS). Results There was no significant improvement of parameters reflecting RV function comparing the pre-PCI and 48-h post-PCI values. On the contrary, significant improvement was detected comparing the echo-Doppler measures of either the pre- or 48-h PCI value with those of 1 month later. There was a significant increase of RV-FAC, tricuspid Sa and Ea, and RV-GLS (P<0.05). The E/A ratio of tricuspid flow and tricuspid annular plane systolic excursion showed no significant difference from pre- to 48 hr or 1-month PCI value. Conclusion RV performance improves after successful PCI of chronic totally occluded vessels. Newer echo-Doppler modalities appear to be better tools for assessment of RV performance.
{"title":"Assessment of right ventricular function after successful percutaneous coronary intervention to chronic total occlusion using different echo-Doppler modalities","authors":"E. Zaki","doi":"10.4103/azmj.azmj_34_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_34_21","url":null,"abstract":"Background and aim Chronic total occlusion is a common condition in patients with coronary artery disease and represents one of the most challenging targets of lesion recanalization with successful percutaneous coronary intervention (PCI). Different echo-Doppler modalities can be used for the assessment of right ventricular (RV) performance in patients undergoing PCI with reported superiority of the newer modalities. The aim was to assess the effect of successful PCI for chronic totally occluded vessel on the RV performance by different echo-Doppler modalities. Patients and methods The present study enrolled 25 patients with chronic total occlusion for whom PCI was performed. Patients were subjected to history taking, clinical assessment, 12-lead surface ECG, and evaluation of RV functions before, within 48 h after successful PCI, and 1 month later, using conventional and new echo-Doppler modalities. Echo-Doppler parameters included RV dimensions, Doppler flow velocities (E, A, and E/A) across tricuspid valves, RV fractional area change (RV-FAC), tricuspid annular plane systolic excursion, tissue Doppler systolic, and diastolic velocities (Sa, Ea, and Aa) at the lateral tricuspid annulus, in addition to evaluation of RV global longitudinal strain (RV-GLS). Results There was no significant improvement of parameters reflecting RV function comparing the pre-PCI and 48-h post-PCI values. On the contrary, significant improvement was detected comparing the echo-Doppler measures of either the pre- or 48-h PCI value with those of 1 month later. There was a significant increase of RV-FAC, tricuspid Sa and Ea, and RV-GLS (P<0.05). The E/A ratio of tricuspid flow and tricuspid annular plane systolic excursion showed no significant difference from pre- to 48 hr or 1-month PCI value. Conclusion RV performance improves after successful PCI of chronic totally occluded vessels. Newer echo-Doppler modalities appear to be better tools for assessment of RV performance.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"373 - 378"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43354144","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}
Md Musleh Uddin Hasan, A. Shokry, Sara Mohamad, Ali El
Background and Aim Diabetic peripheral neuropathy is one of the most challenging complications of diabetes mellitus. A large number of patients have subclinical neuropathy at the time of detection of diabetes. Proper detection of subclinical diabetic neuropathy is important to prevent more complications. When the symptoms start, there are not many effective therapeutic treatments. Nerve conduction studies (NCS) are known to be sensitive, reliable, noninvasive, and easy to perform to study diabetic neuropathy. Study of the medial plantar and sural nerves can test the most distal parts of the nerves and can be considered an alternative method for the diagnosis of polyneuropathy in the early stages. The aim of this work is to study the utility of both medial plantar and sural nerve conduction in the early diagnosis of diabetic polyneuropathy. Patients and methods Twenty diabetic asymptomatic patients and 20 healthy volunteers of both sexes were included. Their ages ranged between 26 and 44 years and 24 and 46 years, respectively. NCS of the medial plantar and sural nerves for all the patients and control groups is performed using the antidromic method of stimulation for sural nerve and orthodromic stimulation for the medial plantar nerve. Results There were significant changes in the sensory study of both medial plantar and sural nerves of neurologically asymptomatic diabetic patients compared with the control. Conclusion NCS of both medial plantar and sural nerves aids in the detection of subclinical diabetic polyneuropathy.
{"title":"Sural and medial plantar nerve conduction study in the diagnosis of subclinical diabetic neuropathy","authors":"Md Musleh Uddin Hasan, A. Shokry, Sara Mohamad, Ali El","doi":"10.4103/azmj.azmj_5_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_5_21","url":null,"abstract":"Background and Aim Diabetic peripheral neuropathy is one of the most challenging complications of diabetes mellitus. A large number of patients have subclinical neuropathy at the time of detection of diabetes. Proper detection of subclinical diabetic neuropathy is important to prevent more complications. When the symptoms start, there are not many effective therapeutic treatments. Nerve conduction studies (NCS) are known to be sensitive, reliable, noninvasive, and easy to perform to study diabetic neuropathy. Study of the medial plantar and sural nerves can test the most distal parts of the nerves and can be considered an alternative method for the diagnosis of polyneuropathy in the early stages. The aim of this work is to study the utility of both medial plantar and sural nerve conduction in the early diagnosis of diabetic polyneuropathy. Patients and methods Twenty diabetic asymptomatic patients and 20 healthy volunteers of both sexes were included. Their ages ranged between 26 and 44 years and 24 and 46 years, respectively. NCS of the medial plantar and sural nerves for all the patients and control groups is performed using the antidromic method of stimulation for sural nerve and orthodromic stimulation for the medial plantar nerve. Results There were significant changes in the sensory study of both medial plantar and sural nerves of neurologically asymptomatic diabetic patients compared with the control. Conclusion NCS of both medial plantar and sural nerves aids in the detection of subclinical diabetic polyneuropathy.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"446 - 451"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49184203","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 and aim The aim of this study was to investigate the advantages of the extended pterional approach and compare it with more invasive and less-invasive similar approaches. Patients and method s This study is an observational retrospective case-series study and descriptive statistics was used. Twelve patients with suprasellar and parasellar lesions were managed in the period between January 2016 and January 2019. Preoperative and postoperative clinical and radiological assessment were done for each patient. Results Twelve cases were done via this approach. There were nine females and three males. Age ranges from 2 to 55 years with a mean of 31.7 years. Regarding pathology, eight (67%) cases were meningiomas, three (25%) cases were craniopharyngiomas, while one (8.3%) case was pituitary adenoma. Most of the cases (91.7%) were presented with visual affection. The lesion was excised totally (gross total resection) in seven (58.3%) out of the 12 cases. Visual affection improved in seven (63.6%) out of 11 cases. Regarding complications, one case experienced permanent hemiparesis. One patient had deep-vein thrombosis that had been treated. One case had seizures. Approach-related complications: two cases had periorbital edema that disappeared within 1 week. One case had a rim of subdural hematoma. Frontalis nerve injury occurred in two cases, one of them improved within 6 months. We do not have a permanent cosmetic deformity with this approach. Conclusion The extended pterional approach has less functional and cosmetic complications and it can be done in lesser time than frontotemporal–orbitozygomatic approach. The exposure is much larger than conventional pterional approach.
{"title":"Extended pterional approach with orbital flattening for suprasellar and parasellar lesions","authors":"Gasser Al-Shyal","doi":"10.4103/azmj.azmj_37_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_37_21","url":null,"abstract":"Background and aim The aim of this study was to investigate the advantages of the extended pterional approach and compare it with more invasive and less-invasive similar approaches. Patients and method s This study is an observational retrospective case-series study and descriptive statistics was used. Twelve patients with suprasellar and parasellar lesions were managed in the period between January 2016 and January 2019. Preoperative and postoperative clinical and radiological assessment were done for each patient. Results Twelve cases were done via this approach. There were nine females and three males. Age ranges from 2 to 55 years with a mean of 31.7 years. Regarding pathology, eight (67%) cases were meningiomas, three (25%) cases were craniopharyngiomas, while one (8.3%) case was pituitary adenoma. Most of the cases (91.7%) were presented with visual affection. The lesion was excised totally (gross total resection) in seven (58.3%) out of the 12 cases. Visual affection improved in seven (63.6%) out of 11 cases. Regarding complications, one case experienced permanent hemiparesis. One patient had deep-vein thrombosis that had been treated. One case had seizures. Approach-related complications: two cases had periorbital edema that disappeared within 1 week. One case had a rim of subdural hematoma. Frontalis nerve injury occurred in two cases, one of them improved within 6 months. We do not have a permanent cosmetic deformity with this approach. Conclusion The extended pterional approach has less functional and cosmetic complications and it can be done in lesser time than frontotemporal–orbitozygomatic approach. The exposure is much larger than conventional pterional approach.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"439 - 445"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43667609","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 and Aim Acetabular bone defects are one of the most difficult problems in both primary and revision total hip replacements. Many techniques have been described to deal with acetabular bone defects in total hip replacement, including the use of cement with or without cages and rings, structural bone grafting, and impaction bone grafts with cementless or cemented cups. The aim of this study was to asses short-term to midterm clinical and radiological outcomes of acetabular reconstruction by impaction bone grafts and cemented cups in both primary and revision cases indicated for total hip arthroplasty (THA) with acetabular bone deficiency. Patients and methods This is a retrospective study that included 26 patients with total hip arthroplasty (THA) who underwent acetabular bone defect reconstructions with grafting and cemented cups between December 2014 and January 2019. The mean age at operation was 45.3 years. Among the procedures, 12 were primary THAs, whereas 14 procedures were revision THAs. The morselized grafts were used in eight cases only, along with combined strut graft and morselized grafts in five cases, acetabular rim mesh and morselized grafts in 12 cases, and Kerboul cross-ring with morselized grafts in one case. All cases were clinically evaluated by Harris hip score in addition to radiological evaluation. Results All the patients except one showed clinical improvement, where the mean postoperative Harris hip score became 84. Radiograph follow-up for all the cases showed graft incorporation without loosening or any significant cup migration, except one case, which was revised owing to loosening around the cup. Conclusion The use of impaction graft and cemented cups is safe and reproductive even in young patients. Moreover, this technique reconstitutes bone and gives a stable platform of bone stock for further revision, especially in young population.
{"title":"Functional and radiological outcomes of impaction grafts and cemented cup for the treatment of acetabular bone deficiency in total hip arthroplasty","authors":"M. Bayoumy, M. Mohamed","doi":"10.4103/azmj.azmj_57_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_57_21","url":null,"abstract":"Background and Aim Acetabular bone defects are one of the most difficult problems in both primary and revision total hip replacements. Many techniques have been described to deal with acetabular bone defects in total hip replacement, including the use of cement with or without cages and rings, structural bone grafting, and impaction bone grafts with cementless or cemented cups. The aim of this study was to asses short-term to midterm clinical and radiological outcomes of acetabular reconstruction by impaction bone grafts and cemented cups in both primary and revision cases indicated for total hip arthroplasty (THA) with acetabular bone deficiency. Patients and methods This is a retrospective study that included 26 patients with total hip arthroplasty (THA) who underwent acetabular bone defect reconstructions with grafting and cemented cups between December 2014 and January 2019. The mean age at operation was 45.3 years. Among the procedures, 12 were primary THAs, whereas 14 procedures were revision THAs. The morselized grafts were used in eight cases only, along with combined strut graft and morselized grafts in five cases, acetabular rim mesh and morselized grafts in 12 cases, and Kerboul cross-ring with morselized grafts in one case. All cases were clinically evaluated by Harris hip score in addition to radiological evaluation. Results All the patients except one showed clinical improvement, where the mean postoperative Harris hip score became 84. Radiograph follow-up for all the cases showed graft incorporation without loosening or any significant cup migration, except one case, which was revised owing to loosening around the cup. Conclusion The use of impaction graft and cemented cups is safe and reproductive even in young patients. Moreover, this technique reconstitutes bone and gives a stable platform of bone stock for further revision, especially in young population.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"432 - 438"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44509483","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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