Seham K Khirala, Omnia A. El-dydamoni, Soad Abdel Rehim, Mervat El missiry
Background and Aim Helicobacter pylori (H. pylori) is a common etiology for infection-related cancers and represents 5.5% of global cancer burden that increases the need for more sensitive noninvasive diagnostic techniques. The aim was to evaluate the role of saliva and stool samples in the diagnosis of H. pylori infection to replace invasive techniques and to compare between three noninvasive diagnostic tests: salivary culture, PCR, and rapid stool antigen test (RSAT). Patients and methods The study was conducted on 45 patients with dyspepsia and 45 healthy participants as a control. Saliva and stool samples were taken from all groups and subjected to culture, PCR for detection of 16SrRNA gene of H. pylori, and RSAT to detect H. pylori. Gastric biopsy samples were taken for H. pylori culture, rapid urea test, and histopathology from 20 patients. Results A total of 15.6% specimens were positive by salivary culture in patients’ group and 2.2% specimens were positive in the control group. About 31% were positive by salivary PCR in patients’ group and 6.7% were positive by salivary PCR in the control group. About 71% were positive by RSAT in patients and 49% were positive by RSAT in controls. From 20 patients, gastric biopsy samples were taken, 11 patients were positive for H. pylori infection by gastric biopsy culture, 20 were positive by histopathological examination, and 13 were positive by rapid urea test. The salivary culture showed (100%) specificity, (38.5%) sensitivity, and (60%) accuracy. While PCR on saliva showed specificity (100%), (61.5%) sensitivity, and (75%) accuracy. RSAT showed (71.4%) specificity, 92.3% sensitivity, and 85% accuracy. Conclusion The oral cavity is an important extragastric reservoir of H. pylori; salivary PCR technique shows a much higher specificity and sensitivity than salivary culture. RSAT shows high sensitivity but with lower specificity.
{"title":"Comparative study between noninvasive techniques for diagnosis of helicobacter pylori in patients with dyspepsia","authors":"Seham K Khirala, Omnia A. El-dydamoni, Soad Abdel Rehim, Mervat El missiry","doi":"10.4103/azmj.azmj_18_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_18_21","url":null,"abstract":"Background and Aim Helicobacter pylori (H. pylori) is a common etiology for infection-related cancers and represents 5.5% of global cancer burden that increases the need for more sensitive noninvasive diagnostic techniques. The aim was to evaluate the role of saliva and stool samples in the diagnosis of H. pylori infection to replace invasive techniques and to compare between three noninvasive diagnostic tests: salivary culture, PCR, and rapid stool antigen test (RSAT). Patients and methods The study was conducted on 45 patients with dyspepsia and 45 healthy participants as a control. Saliva and stool samples were taken from all groups and subjected to culture, PCR for detection of 16SrRNA gene of H. pylori, and RSAT to detect H. pylori. Gastric biopsy samples were taken for H. pylori culture, rapid urea test, and histopathology from 20 patients. Results A total of 15.6% specimens were positive by salivary culture in patients’ group and 2.2% specimens were positive in the control group. About 31% were positive by salivary PCR in patients’ group and 6.7% were positive by salivary PCR in the control group. About 71% were positive by RSAT in patients and 49% were positive by RSAT in controls. From 20 patients, gastric biopsy samples were taken, 11 patients were positive for H. pylori infection by gastric biopsy culture, 20 were positive by histopathological examination, and 13 were positive by rapid urea test. The salivary culture showed (100%) specificity, (38.5%) sensitivity, and (60%) accuracy. While PCR on saliva showed specificity (100%), (61.5%) sensitivity, and (75%) accuracy. RSAT showed (71.4%) specificity, 92.3% sensitivity, and 85% accuracy. Conclusion The oral cavity is an important extragastric reservoir of H. pylori; salivary PCR technique shows a much higher specificity and sensitivity than salivary culture. RSAT shows high sensitivity but with lower specificity.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"548 - 555"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41774984","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}
Ghada Mohammed, R. Rashed, Asmaa Elsayed, S. Mostafa
Background and aim Otitis media with effusion (OME) is characterized by retention of fluid behind an intact tympanic membrane. The association of vitamin D deficiency, upper respiratory tract infections, and otitis media has been reported by several studies. Aim: The aim was to investigate the relationship between OME and vitamin D level in children. Patients and methods This study is a case–control study that was carried out at Otorhinolaryngology and Pediatric Clinics at Al-Azhar University for Girls and Al Mataria General Hospital. In this study, 40 children were included, 20 children were controls and 20 children were diagnosed with OME (cases). Patients were subjected to history, otoscopic examination, and audiological evaluation (pure-tone audiometry and tympanometry). Blood samples (5 cm) were taken from case and control groups in the laboratory to measure serum 25-hydroxy vitamin D level. Results In the case group, mean vitamin D level was 17.02 ng/ml, SD±8.49, and the median was 14.90 (8.7–35.0) ng/ml. In the control group, mean vitamin D level was 25.85 ng/ml, SD±8.94, and the median was 30.20 (9.8–36.1) ng/ml with P significance equal to 0.007. Sixteen children (80%) out of 20 children of the case group and eight children (40%) out of 20 children of the control group had an abnormal value of vitamin D. An abnormal value of vitamin D was statistically significant in children with OME than the control group with P significance equal to 0.03. Conclusion It was found that vitamin D plays an important role in OME in our children and can share in the regimen of treatment of OME when it was found abnormal. Measuring vitamin D level in the case group is necessary and must be treated if abnormal.
{"title":"Role of vitamin D in children with otitis media with effusion","authors":"Ghada Mohammed, R. Rashed, Asmaa Elsayed, S. Mostafa","doi":"10.4103/azmj.azmj_39_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_39_21","url":null,"abstract":"Background and aim Otitis media with effusion (OME) is characterized by retention of fluid behind an intact tympanic membrane. The association of vitamin D deficiency, upper respiratory tract infections, and otitis media has been reported by several studies. Aim: The aim was to investigate the relationship between OME and vitamin D level in children. Patients and methods This study is a case–control study that was carried out at Otorhinolaryngology and Pediatric Clinics at Al-Azhar University for Girls and Al Mataria General Hospital. In this study, 40 children were included, 20 children were controls and 20 children were diagnosed with OME (cases). Patients were subjected to history, otoscopic examination, and audiological evaluation (pure-tone audiometry and tympanometry). Blood samples (5 cm) were taken from case and control groups in the laboratory to measure serum 25-hydroxy vitamin D level. Results In the case group, mean vitamin D level was 17.02 ng/ml, SD±8.49, and the median was 14.90 (8.7–35.0) ng/ml. In the control group, mean vitamin D level was 25.85 ng/ml, SD±8.94, and the median was 30.20 (9.8–36.1) ng/ml with P significance equal to 0.007. Sixteen children (80%) out of 20 children of the case group and eight children (40%) out of 20 children of the control group had an abnormal value of vitamin D. An abnormal value of vitamin D was statistically significant in children with OME than the control group with P significance equal to 0.03. Conclusion It was found that vitamin D plays an important role in OME in our children and can share in the regimen of treatment of OME when it was found abnormal. Measuring vitamin D level in the case group is necessary and must be treated if abnormal.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"569 - 574"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44076146","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 : 2021-10-01DOI: 10.4103/azmj.azmj_108_21
Eman Abd El-Gaber, Eglal M. Kenawy, Waleed S El-Nasser, E. Hassanin
Background and aim Several previous studies on coronavirus disease 2019 (COVID-19) cases reported that impairment of organs, that is, the liver, heart, and the kidneys, other than the lung can occur. This study aimed to evaluate the impact of COVID-19 infection on the kidneys. Patients and methods The current study was conducted as a retrospective and prospective study, where two samples of adult inpatients (aged >18 years) were recruited. The study was carried out in the period from April to June 2020 (the first wave) and from December 2020 to February 2021 (the second wave). Results A total of 1065 COVID-19 confirmed patients were admitted to the two Asyut governorate quarantine hospitals by the end of the study period (first wave n=525 and second wave n=540 patients). According to renal function parameter results, kidney injury was reported in 57.5% (n=302) of the patients in the first wave and in 58.7% (n=317) of cases in the second wave. On follow-up, only a small proportion (<10%) of patients had improvement in the kidney function parameters. Conclusion About half of the confirmed COVID-19 patients admitted to the quarantine hospitals at Asyut Governorate had kidney injury, which persisted after treatment and less than 10% showed improvement on treatment with no significant effect on the mortality rate of the patients.
{"title":"Impact of coronavirus 2019 infection on the kidneys in Assiut governorate","authors":"Eman Abd El-Gaber, Eglal M. Kenawy, Waleed S El-Nasser, E. Hassanin","doi":"10.4103/azmj.azmj_108_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_108_21","url":null,"abstract":"Background and aim Several previous studies on coronavirus disease 2019 (COVID-19) cases reported that impairment of organs, that is, the liver, heart, and the kidneys, other than the lung can occur. This study aimed to evaluate the impact of COVID-19 infection on the kidneys. Patients and methods The current study was conducted as a retrospective and prospective study, where two samples of adult inpatients (aged >18 years) were recruited. The study was carried out in the period from April to June 2020 (the first wave) and from December 2020 to February 2021 (the second wave). Results A total of 1065 COVID-19 confirmed patients were admitted to the two Asyut governorate quarantine hospitals by the end of the study period (first wave n=525 and second wave n=540 patients). According to renal function parameter results, kidney injury was reported in 57.5% (n=302) of the patients in the first wave and in 58.7% (n=317) of cases in the second wave. On follow-up, only a small proportion (<10%) of patients had improvement in the kidney function parameters. Conclusion About half of the confirmed COVID-19 patients admitted to the quarantine hospitals at Asyut Governorate had kidney injury, which persisted after treatment and less than 10% showed improvement on treatment with no significant effect on the mortality rate of the patients.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"575 - 579"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41962600","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 : 2021-10-01DOI: 10.4103/azmj.azmj_166_20
Khalid El Khateeb, A. Abonar, M. Ibrahim, M. Shalamesh
Background and Aim Carbohydrate antigen 15.3 (CA 15.3) is the most frequently used tumor marker in breast cancer (BC). MicroRNAs (miRs) can be used to screen, diagnose, evaluate, and follow-up on some cancers. Our research aimed to explore the value of circulating miR-155 and miR-21 for diagnosis and monitoring therapy of BC compared with CA 15.3. Patients and Methods Our study included four groups: 25 women who were completely healthy, 20 women suffering from benign breast diseases, 20 patients suffering from BC after complete therapy, and 25 patients with BC before undergoing any therapy. CA 15.3, MiR-155, and miR-21 were measured for all participants. Results MiR-155, miR-21, and CA 15.3 levels in the four groups showed significant differences. MiR-21 is the most sensitive, followed by miR-155 and CA 15.3. Conclusion Serum miR-155 and Serum miR-21 could be useful tests like CA 15.3 for differentiation between women suffering from BC, women suffering from benign breast diseases, and completely healthy women.
{"title":"Serum miR-155, miR-21, and CA 15.3 for diagnosis and monitoring therapy of breast cancer in females","authors":"Khalid El Khateeb, A. Abonar, M. Ibrahim, M. Shalamesh","doi":"10.4103/azmj.azmj_166_20","DOIUrl":"https://doi.org/10.4103/azmj.azmj_166_20","url":null,"abstract":"Background and Aim Carbohydrate antigen 15.3 (CA 15.3) is the most frequently used tumor marker in breast cancer (BC). MicroRNAs (miRs) can be used to screen, diagnose, evaluate, and follow-up on some cancers. Our research aimed to explore the value of circulating miR-155 and miR-21 for diagnosis and monitoring therapy of BC compared with CA 15.3. Patients and Methods Our study included four groups: 25 women who were completely healthy, 20 women suffering from benign breast diseases, 20 patients suffering from BC after complete therapy, and 25 patients with BC before undergoing any therapy. CA 15.3, MiR-155, and miR-21 were measured for all participants. Results MiR-155, miR-21, and CA 15.3 levels in the four groups showed significant differences. MiR-21 is the most sensitive, followed by miR-155 and CA 15.3. Conclusion Serum miR-155 and Serum miR-21 could be useful tests like CA 15.3 for differentiation between women suffering from BC, women suffering from benign breast diseases, and completely healthy women.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"496 - 501"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48185287","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 Thalassemia is a chronic illness that has a range of serious clinical and psychological effects, it does not only affect the physical functioning of patients but also their emotional and social functioning and school functionings, leading to impairment of health-related quality of life of the patients due to the effects of the disease and its treatment. The aim of this study was to assess the effect of treatment with hydroxyurea on calcium homeostasis in β-thalassemia-major patients. Patients and methods This study is a prospective, case–control one, it was done on 50 patients with β-thalassemia major who received regular blood transfusion at Luxor International Hospital [25 patients received hydroxyurea (group II) and 25 patients did not receive hydroxyurea (group I)] and 25 apparently healthy children as controls. Results Group II (received hydroxyurea) had better results than group I (not received hydroxyurea) regarding the frequency of blood transfusion, manifestations of hypocalcemia (tetany, convulsions, and carpopedal spasm), and the occurrence of the boneache and bone fractures. Group II (received hydroxyurea) had better hemoglobin levels as well as other complete blood count parameters than group I (not received hydroxyurea). Group II (received hydroxyurea) had better results regarding serum-ionized calcium as well as serum ferritin, serum alkaline phosphatase, and serum phosphorus levels than group I (not received hydroxyurea). Conclusion Disturbed calcium homeostasis is one of these iron-overload hazards; it has different clinical and laboratory manifestations that can be improved by using the hydroxyurea therapy in the management of β-thalassemia patients.
{"title":"Effect of treatment with hydroxyurea on calcium homeostasis in β-thalassemia-major patients","authors":"K. Hassan","doi":"10.4103/azmj.azmj_52_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_52_21","url":null,"abstract":"Background and aim Thalassemia is a chronic illness that has a range of serious clinical and psychological effects, it does not only affect the physical functioning of patients but also their emotional and social functioning and school functionings, leading to impairment of health-related quality of life of the patients due to the effects of the disease and its treatment. The aim of this study was to assess the effect of treatment with hydroxyurea on calcium homeostasis in β-thalassemia-major patients. Patients and methods This study is a prospective, case–control one, it was done on 50 patients with β-thalassemia major who received regular blood transfusion at Luxor International Hospital [25 patients received hydroxyurea (group II) and 25 patients did not receive hydroxyurea (group I)] and 25 apparently healthy children as controls. Results Group II (received hydroxyurea) had better results than group I (not received hydroxyurea) regarding the frequency of blood transfusion, manifestations of hypocalcemia (tetany, convulsions, and carpopedal spasm), and the occurrence of the boneache and bone fractures. Group II (received hydroxyurea) had better hemoglobin levels as well as other complete blood count parameters than group I (not received hydroxyurea). Group II (received hydroxyurea) had better results regarding serum-ionized calcium as well as serum ferritin, serum alkaline phosphatase, and serum phosphorus levels than group I (not received hydroxyurea). Conclusion Disturbed calcium homeostasis is one of these iron-overload hazards; it has different clinical and laboratory manifestations that can be improved by using the hydroxyurea therapy in the management of β-thalassemia patients.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"517 - 525"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49078380","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 trapeziometacarpal arthritis is one of the most common joint problems affecting women after the age of 50 years. Surgery is indicated after failure of conservative treatment with continuation of pain and functional disabilities. One of the most reported and well-known surgical procedure for management of basal thumb arthritis is the ligament reconstruction and tendon interposition arthroplasty. The aim of the study was to evaluate patients who underwent modified Zancolli arthroplasty for basal thumb arthritis. Patients and methods The study included 15 patients with basal thumb arthritis (three males and 12 females). Full clinical examination and scoring of the hand was done using Quick DASH, visual analog scale, measuring range of motion, and grip strength. All patients underwent full radiological and laboratory investigations. Results Overall pain intensity was measured with a visual analog scale, which ranged from 5–10 preoperatively and ranged from 0 to 1 6 months postoperatively. Regarding the DASH score, there was improvement from a mean of 64.48±16.61 points preoperatively to a mean of 1.37±1.67 points postoperatively. The mean postoperative abduction was 75% to the normal side, opposition was 80% to the normal side, and power grip was 90% to the normal hand. Conclusion Modified Zancolli arthroplasty is an effective means of treating symptomatic patients with trapeziometacarpal arthritis who failed to improve with nonsurgical measures. This technique ensures a dynamic fixation of the apical ligament and provides better stability. The procedure is simple both technically and regarding postoperative care.
{"title":"Assessment of modified Zancolli arthroplasty for basal thumb arthritis","authors":"B. Kornah, Maysra Bayuomy, A. Ibrahim","doi":"10.4103/azmj.azmj_8_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_8_21","url":null,"abstract":"Background and aim The trapeziometacarpal arthritis is one of the most common joint problems affecting women after the age of 50 years. Surgery is indicated after failure of conservative treatment with continuation of pain and functional disabilities. One of the most reported and well-known surgical procedure for management of basal thumb arthritis is the ligament reconstruction and tendon interposition arthroplasty. The aim of the study was to evaluate patients who underwent modified Zancolli arthroplasty for basal thumb arthritis. Patients and methods The study included 15 patients with basal thumb arthritis (three males and 12 females). Full clinical examination and scoring of the hand was done using Quick DASH, visual analog scale, measuring range of motion, and grip strength. All patients underwent full radiological and laboratory investigations. Results Overall pain intensity was measured with a visual analog scale, which ranged from 5–10 preoperatively and ranged from 0 to 1 6 months postoperatively. Regarding the DASH score, there was improvement from a mean of 64.48±16.61 points preoperatively to a mean of 1.37±1.67 points postoperatively. The mean postoperative abduction was 75% to the normal side, opposition was 80% to the normal side, and power grip was 90% to the normal hand. Conclusion Modified Zancolli arthroplasty is an effective means of treating symptomatic patients with trapeziometacarpal arthritis who failed to improve with nonsurgical measures. This technique ensures a dynamic fixation of the apical ligament and provides better stability. The procedure is simple both technically and regarding postoperative care.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"357 - 365"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45588514","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 Nystagmus is an ocular motility disorder in which the eyes make uncontrollable, repeated movements. These movements can cause vision and depth perception problems, as well as affect balance and coordination. The aim was to study electrophysiological changes that occur in patients with nystagmus and pattern of changes in each disease. Patients and methods A prospective, institutional, clinical trial was conducted on 60 eyes with nystagmus. The age of the patients ranged between 5 and 50 years, and the patients were chosen from Al-Hassan Eye Center, Giza and Al-Azhar University Hospital outpatient clinic. Results The study revealed the relation between photopic electroretinogram (ERG), scotopic ERG, and flash visual-evoked potential (VEP) and each of fundus examination and final diagnosis of the studied group, and it shows highly statistically significant differences between groups according to fundus examination and final diagnosis. Conclusions Electrophysiological examination is an essential step in the assessment of patients with early-onset nystagmus especially when the eyes are apparently normal on routine examination and should be enrolled within their medical records. This study clarified the need to investigate cases with nystagmus by ERG and suggested that the ERG was useful where the diagnosis was uncertain. Visual-evoked potential is complementary to ERG and can be tested simultaneously.
{"title":"Electroretinography and visual-evoked potential changes in patients with nystagmus","authors":"N. Hassan, Abdelsalam Elaskary, Mahmoud Wahdan","doi":"10.4103/azmj.azmj_53_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_53_21","url":null,"abstract":"Background and aim Nystagmus is an ocular motility disorder in which the eyes make uncontrollable, repeated movements. These movements can cause vision and depth perception problems, as well as affect balance and coordination. The aim was to study electrophysiological changes that occur in patients with nystagmus and pattern of changes in each disease. Patients and methods A prospective, institutional, clinical trial was conducted on 60 eyes with nystagmus. The age of the patients ranged between 5 and 50 years, and the patients were chosen from Al-Hassan Eye Center, Giza and Al-Azhar University Hospital outpatient clinic. Results The study revealed the relation between photopic electroretinogram (ERG), scotopic ERG, and flash visual-evoked potential (VEP) and each of fundus examination and final diagnosis of the studied group, and it shows highly statistically significant differences between groups according to fundus examination and final diagnosis. Conclusions Electrophysiological examination is an essential step in the assessment of patients with early-onset nystagmus especially when the eyes are apparently normal on routine examination and should be enrolled within their medical records. This study clarified the need to investigate cases with nystagmus by ERG and suggested that the ERG was useful where the diagnosis was uncertain. Visual-evoked potential is complementary to ERG and can be tested simultaneously.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"386 - 394"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45486291","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/AZMJ.AZMJ_108_18
Hussein El-Ghait, A. Akar, Abdelazim Hegazy, Mahmoud El-Maadawy
Background and aim Low back pain and radiculopathy are the main annoying complaints in patients with degenerative disc diseases. Epidural steroid injection (ESI) has a role to reduce pain and improve disability by decreasing inflammatory process at the nerve root caused by herniated disc. This study was done to evaluate the efficacy of lumbar ESI regarding the improvement of pain and functional outcome. Patients and methods This study was a prospective randomized study on 30 patients, aged between 30 and 65 years with low back pain and lumbar radiculopathy secondary to lumbar disc prolapse with no absolute indication for surgery. The patients were treated by lumbar epidural injection of steroids. Patients were divided randomly into two groups: group 1 included 15 patients subjected to lumbar interlaminar ESI, and group 2 included 15 patients subjected to lumbar transforaminal ESI. Patients were evaluated using visual analog scale (VAS) score for pain and the Oswestry Disability Index (ODI) for functional capacity. They were followed up after 4 weeks, and clinical and functional outcomes were assessed using the same tools for evaluation. Results The mean VAS for the 30 patients improved by 58.33% (P<0.001), and the mean ODI for the 30 patients improved by 35.4% after 4 weeks following injection (P<0.001). In group 1, the mean VAS improved by 52% and the mean ODI improved by 31.13% after 4 weeks following injection (P<0.001). In group 2, the mean VAS improved by 64.66% and the mean ODI improved by 39.66% after 4 weeks following injection (P<0.001). We found that the mean improvement of VAS and ODI was more in group 2 than in group 1(P<0.026). Conclusion We found by the end of the study that the ESI is a safe and effective procedure in alleviating radicular pain and improvement of functional outcome, but the transforaminal approach gives better results than the interlaminar approach.
{"title":"Efficacy of epidural steroid injection in management of lumbar disc lesion","authors":"Hussein El-Ghait, A. Akar, Abdelazim Hegazy, Mahmoud El-Maadawy","doi":"10.4103/AZMJ.AZMJ_108_18","DOIUrl":"https://doi.org/10.4103/AZMJ.AZMJ_108_18","url":null,"abstract":"Background and aim Low back pain and radiculopathy are the main annoying complaints in patients with degenerative disc diseases. Epidural steroid injection (ESI) has a role to reduce pain and improve disability by decreasing inflammatory process at the nerve root caused by herniated disc. This study was done to evaluate the efficacy of lumbar ESI regarding the improvement of pain and functional outcome. Patients and methods This study was a prospective randomized study on 30 patients, aged between 30 and 65 years with low back pain and lumbar radiculopathy secondary to lumbar disc prolapse with no absolute indication for surgery. The patients were treated by lumbar epidural injection of steroids. Patients were divided randomly into two groups: group 1 included 15 patients subjected to lumbar interlaminar ESI, and group 2 included 15 patients subjected to lumbar transforaminal ESI. Patients were evaluated using visual analog scale (VAS) score for pain and the Oswestry Disability Index (ODI) for functional capacity. They were followed up after 4 weeks, and clinical and functional outcomes were assessed using the same tools for evaluation. Results The mean VAS for the 30 patients improved by 58.33% (P<0.001), and the mean ODI for the 30 patients improved by 35.4% after 4 weeks following injection (P<0.001). In group 1, the mean VAS improved by 52% and the mean ODI improved by 31.13% after 4 weeks following injection (P<0.001). In group 2, the mean VAS improved by 64.66% and the mean ODI improved by 39.66% after 4 weeks following injection (P<0.001). We found that the mean improvement of VAS and ODI was more in group 2 than in group 1(P<0.026). Conclusion We found by the end of the study that the ESI is a safe and effective procedure in alleviating radicular pain and improvement of functional outcome, but the transforaminal approach gives better results than the interlaminar approach.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"343 - 350"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70687491","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 All platelet indices may be useful biomarkers for follow-up in inflammatory bowel disease patients as they show a strong correlation with disease activity. In this work, we aimed to investigate the relation between mean platelet volume (MPV) and ulcerative colitis (UC) activity by comparing the MPV values between cases with active UC, mild cases and normal individuals. Patients and methods This observational study was carried out on 90 individuals aged >18 years. They were divided equally into the following groups: group A: active UC, group B: remitting UC and group C: healthy controls free of any systemic diseases as a reference. UC was confirmed based on colonoscopy and biopsy. Results Patients with active UC have significantly smaller MPV in comparison with patients with disease remission or healthy controls (P value <0.001), without a difference between patients in remission and healthy controls. MPV was directly proportional to the Hemoglobin level among study populations (r=0.64, P<0.001). MPV was negatively correlated with erythrocyte sedimentation rate (r=−0.74, P<0.001), total leukocytic count (r=−0.49, P<0.001) and platelet count (r=−0.24, P=0.023) in all the study populations. Conclusion MPV decreases in the active phase of UC compared with the remission phase or healthy individuals. There is a relationship between the degree of disease activity and MPV in UC. Hence, MPV can be a useful biomarker for assessing disease activity for UC.
{"title":"Mean platelet volume (MPV) as a biomarker of disease activity in ulcerative colitis","authors":"Nasha Mohammed, K. Eid, A. Mohammad","doi":"10.4103/azmj.azmj_25_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_25_21","url":null,"abstract":"Background and aim All platelet indices may be useful biomarkers for follow-up in inflammatory bowel disease patients as they show a strong correlation with disease activity. In this work, we aimed to investigate the relation between mean platelet volume (MPV) and ulcerative colitis (UC) activity by comparing the MPV values between cases with active UC, mild cases and normal individuals. Patients and methods This observational study was carried out on 90 individuals aged >18 years. They were divided equally into the following groups: group A: active UC, group B: remitting UC and group C: healthy controls free of any systemic diseases as a reference. UC was confirmed based on colonoscopy and biopsy. Results Patients with active UC have significantly smaller MPV in comparison with patients with disease remission or healthy controls (P value <0.001), without a difference between patients in remission and healthy controls. MPV was directly proportional to the Hemoglobin level among study populations (r=0.64, P<0.001). MPV was negatively correlated with erythrocyte sedimentation rate (r=−0.74, P<0.001), total leukocytic count (r=−0.49, P<0.001) and platelet count (r=−0.24, P=0.023) in all the study populations. Conclusion MPV decreases in the active phase of UC compared with the remission phase or healthy individuals. There is a relationship between the degree of disease activity and MPV in UC. Hence, MPV can be a useful biomarker for assessing disease activity for UC.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"401 - 407"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42508802","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 Systemic hypertension (SH) causes a gradual increase in the mass of the left ventricle, resulting in left ventricular hypertrophy (LVH). Derangement of LV function is caused by morphologic changes in the left ventricular (LV) walls, which result in hypertrophy. According to a recent meta-analysis, LVH raises the risk of cardiovascular morbidity and mortality. The aim was to compare between hypertensive patients with LVH and hypertensive patients without LVH regarding LV function (by Simpson’s method) and myocardial performance index (by Tissue Doppler echocardiography). Patients and methods The study included 40 selected hypertensive patients and 20 healthy participants undergoing echocardiographic assessment at the echocardiography unit. The patients were classified into two groups: group I included 20 normotensive healthy control, and group II included 40 hypertensive patients. Group II was further divided into two subgroups according to the absence or presence of echocardiographic signs of LVH: group IIa included 20 hypertensive patients without echocardiographic signs of LVH, and group IIb included 20 hypertensive patients with echocardiographic signs of LVH. Results Regarding systolic and diastolic blood pressures, there was an extremely statistically significant difference between the two groups. Regarding LV mass index, there was a highly statistically significant difference. However, LVMI in subgroup IIa was normal in comparison with subgroup IIb, with an extremely statistically significant difference. Regarding ejection fraction (EF%), there was an extremely statistically significant difference between the two groups. Regarding EF%, there was an extremely statistically significant difference between group I and group IIa. Regarding EF%, there was an extremely statistically significant difference between subgroup IIa and subgroup IIb. Regarding myocardial performance index, there was an extremely statistically significant difference between the two groups (0.36±3.2 in group I vs. 0.51±4.8 in group II). Conclusion First, SH causes a cascade of LV hemodynamic changes that can range from maladaptive hypertrophy to heart failure. Second, Tissue Doppler echocardiography appears to be able to differentiate between the many types and degrees of LV dysfunction in SH, as well as the various stages of the hypertensive disease process. Third, Myocyte apoptosis and collagen deposition in the interstitial space appear to be factors that favor the transition from LVH to heart failure.
{"title":"Comparison of hypertensive patients with left ventricular hypertrophy versus hypertensive patients without left ventricular hypertrophy using echocardiography and tissue doppler imaging","authors":"Waleed Yousof, M. Abdelghafar, A. El-Tayeb","doi":"10.4103/azmj.azmj_48_21","DOIUrl":"https://doi.org/10.4103/azmj.azmj_48_21","url":null,"abstract":"Background and aim Systemic hypertension (SH) causes a gradual increase in the mass of the left ventricle, resulting in left ventricular hypertrophy (LVH). Derangement of LV function is caused by morphologic changes in the left ventricular (LV) walls, which result in hypertrophy. According to a recent meta-analysis, LVH raises the risk of cardiovascular morbidity and mortality. The aim was to compare between hypertensive patients with LVH and hypertensive patients without LVH regarding LV function (by Simpson’s method) and myocardial performance index (by Tissue Doppler echocardiography). Patients and methods The study included 40 selected hypertensive patients and 20 healthy participants undergoing echocardiographic assessment at the echocardiography unit. The patients were classified into two groups: group I included 20 normotensive healthy control, and group II included 40 hypertensive patients. Group II was further divided into two subgroups according to the absence or presence of echocardiographic signs of LVH: group IIa included 20 hypertensive patients without echocardiographic signs of LVH, and group IIb included 20 hypertensive patients with echocardiographic signs of LVH. Results Regarding systolic and diastolic blood pressures, there was an extremely statistically significant difference between the two groups. Regarding LV mass index, there was a highly statistically significant difference. However, LVMI in subgroup IIa was normal in comparison with subgroup IIb, with an extremely statistically significant difference. Regarding ejection fraction (EF%), there was an extremely statistically significant difference between the two groups. Regarding EF%, there was an extremely statistically significant difference between group I and group IIa. Regarding EF%, there was an extremely statistically significant difference between subgroup IIa and subgroup IIb. Regarding myocardial performance index, there was an extremely statistically significant difference between the two groups (0.36±3.2 in group I vs. 0.51±4.8 in group II). Conclusion First, SH causes a cascade of LV hemodynamic changes that can range from maladaptive hypertrophy to heart failure. Second, Tissue Doppler echocardiography appears to be able to differentiate between the many types and degrees of LV dysfunction in SH, as well as the various stages of the hypertensive disease process. Third, Myocyte apoptosis and collagen deposition in the interstitial space appear to be factors that favor the transition from LVH to heart failure.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"19 1","pages":"408 - 419"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46445362","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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