Pub Date : 2023-01-01DOI: 10.21608/amj.2023.273692
Background: Osteomyelitis is a major problem in orthopedic surgery and is usually associated with open fracture surgery, bone reconstruction surgery, or orthopedic implants. Antibiotics alone cannot eradicate chronic osteomyelitis, surgical debridement and sequestrectomy is required to debride all necrotic and infected bone, soft tissue and sinuses. The treatment of broad bone gaps is still a surgical challenge, and there is no consensus about the best reconstruction methods. Objective: To evaluate the results of Masqulete technique in treatment of chronic osteomyelitis. Patients and Methods: This was a prospective study that was conducted on 10 patients with chronic osteomyelitis done at Al-Azhar University and El Minia Health Insurance Hospitals during the period between May 2019 and May 2020. All patients were subjected to Masquelet Procedure, bone ends were debride until bleeding. The bone temporarily stabilized by external fixator, plate or intramedullary nail. The cement spacer was implanted with an overlap to the bone ends to provide a more extensive introduction of the membrane. After several weeks, the resultant then fibrous membrane was incised and the cement spacer removed. The contained void was filled with cancellous autograft. Autograft was obtained from iliac crest. In the Masquelet Procedure, bone ends were debride until bleeding. The bone temporarily stabilized by external fixator, plate or intramedullary nail. The cement spacer was implanted with an overlap to the bone ends to provide a more extensive introduction of the membrane. After several weeks,the resultant then fibrous membrane was incised and the cement spacer removed. The contained void was filled with cancellous autograft. Autograft was obtained from iliac crest. Results: This study comprised 6 men and 4 women. The average age of the included patients was 44.00 ± 2.62, and the average BMI was 25.20 ± 2.70. Among them 4 (40 %) patients did exercise, 3 (30 %) patients had smoking history, and 3 (30 %) patients had hypertension history. The study showed that post Masque let Technique complications are: 60% of patients had no complications, 20% had partial necrosis at edge of the flap, and 20% had superficial infection around the incision. Conclusion: Masquelet technique was a good new challenge in reconstruction treatment of chronic osteomyelitis with simple surgical procedure and low incidence of postoperative complications.
{"title":"TREATMENT OF CHRONIC OSTEOMYELITIS BY MASQUELET TECHNIQUE","authors":"","doi":"10.21608/amj.2023.273692","DOIUrl":"https://doi.org/10.21608/amj.2023.273692","url":null,"abstract":"Background: Osteomyelitis is a major problem in orthopedic surgery and is usually associated with open fracture surgery, bone reconstruction surgery, or orthopedic implants. Antibiotics alone cannot eradicate chronic osteomyelitis, surgical debridement and sequestrectomy is required to debride all necrotic and infected bone, soft tissue and sinuses. The treatment of broad bone gaps is still a surgical challenge, and there is no consensus about the best reconstruction methods. Objective: To evaluate the results of Masqulete technique in treatment of chronic osteomyelitis. Patients and Methods: This was a prospective study that was conducted on 10 patients with chronic osteomyelitis done at Al-Azhar University and El Minia Health Insurance Hospitals during the period between May 2019 and May 2020. All patients were subjected to Masquelet Procedure, bone ends were debride until bleeding. The bone temporarily stabilized by external fixator, plate or intramedullary nail. The cement spacer was implanted with an overlap to the bone ends to provide a more extensive introduction of the membrane. After several weeks, the resultant then fibrous membrane was incised and the cement spacer removed. The contained void was filled with cancellous autograft. Autograft was obtained from iliac crest. In the Masquelet Procedure, bone ends were debride until bleeding. The bone temporarily stabilized by external fixator, plate or intramedullary nail. The cement spacer was implanted with an overlap to the bone ends to provide a more extensive introduction of the membrane. After several weeks,the resultant then fibrous membrane was incised and the cement spacer removed. The contained void was filled with cancellous autograft. Autograft was obtained from iliac crest. Results: This study comprised 6 men and 4 women. The average age of the included patients was 44.00 ± 2.62, and the average BMI was 25.20 ± 2.70. Among them 4 (40 %) patients did exercise, 3 (30 %) patients had smoking history, and 3 (30 %) patients had hypertension history. The study showed that post Masque let Technique complications are: 60% of patients had no complications, 20% had partial necrosis at edge of the flap, and 20% had superficial infection around the incision. Conclusion: Masquelet technique was a good new challenge in reconstruction treatment of chronic osteomyelitis with simple surgical procedure and low incidence of postoperative complications.","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46196226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.276358
The aim of this study was to assess the effect of Sacubitril/Valsartan combination on prevalence of arrhythmias in HFrEF patients and compare it with patients on ACEI or ARBs only in addition to echo parameters follow up. This study was conducted at Ain Shams university and Nasr city insurance hospitals and our target population was heart failure patients with reduced ejection fraction on either SacubitrilValsartan combination therapy (Group A) or on ACEI or ARBs (Group B) for at least 3 months, it was an observational study to follow up the burden of arrhythmia among heart failure patients by 48 hours holter monitoring at 3 and 6 months besides Echo parameters follow up. Our study included 2 groups. Group A (30 patients on Sacubitril/Valsartan combination therapy and mean age was 58.23 ± 4.80 years, 73.3% of patients were males and 26.7% females). Group B (30 patients on ACEIs or ARBs with mean age 56.37 ± 4.49 years, 80.0% of patients were males and 6 % females). There was no significant difference regarding the medical history, risk factors and NYHA classification of heart failure. The patients were classified into ischemic and non-ischemic cardiomyopathy patients and there was no significant difference between both groups. Group A was characterized by significant decrease in QTc values which reached the lowest values after 6 months, in the opposite side; group B was associated with increasing QTc values through the follow up period. As regards echocardiographic parameters we have found that left ventricle ejection fraction was improving to reach the highest values after six months in group A but we did not find significant improvement of left ventricle ejection fraction in group B. Other echocardiography parameters in group A including LA, LVIDd, RVSP and SWMA were improved by the end of the study but we have found that LA diameter was increasing in group B. In group A, burden of ventricular ectopics was found to be decreasing through the follow up period but there was no significant change of ventricular ectopics incidence in group B by the end of the study. Sacubitril/Valsartan combination therapy was superior to ACEIs in reducing ventricular ectopics which means that this drug plays a role in preventing SCD. Ejection fraction in Sacubitril/Valsartan combination group was improving through the follow up period. Echocardiographic parameters were improving in Sacubitril/Valsartan group as regard LA, LVIDd and RVSP. Functional capacity in Sacubitril/Valsartan combinations group was improving through follow up period which means this drug reduces hospitalization.
{"title":"IMPACT OF SACUBITRIL/VALSARTAN COMBINATION ON PREVALENCE OF ARRHYTHMIA IN HEART FAILURE PATIENTS WITH REDUCED EJECTION FRACTION","authors":"","doi":"10.21608/amj.2023.276358","DOIUrl":"https://doi.org/10.21608/amj.2023.276358","url":null,"abstract":"The aim of this study was to assess the effect of Sacubitril/Valsartan combination on prevalence of arrhythmias in HFrEF patients and compare it with patients on ACEI or ARBs only in addition to echo parameters follow up.\u0000 \u0000 \u0000 \u0000 This study was conducted at Ain Shams university and Nasr city insurance hospitals and our target population was heart failure patients with reduced ejection fraction on either SacubitrilValsartan combination therapy (Group A) or on ACEI or ARBs (Group B) for at least 3 months, it was an observational study to follow up the burden of arrhythmia among heart failure patients by 48 hours holter monitoring at 3 and 6 months besides Echo parameters follow up.\u0000 \u0000 \u0000 \u0000 Our study included 2 groups. Group A (30 patients on Sacubitril/Valsartan combination therapy and mean age was 58.23 ± 4.80 years, 73.3% of patients were males and 26.7% females). Group B (30 patients on ACEIs or ARBs with mean age 56.37 ± 4.49 years, 80.0% of patients were males and 6 % females). There was no significant difference regarding the medical history, risk factors and NYHA classification of heart failure. The patients were classified into ischemic and non-ischemic cardiomyopathy patients and there was no significant difference between both groups. Group A was characterized by significant decrease in QTc values which reached the lowest values after 6 months, in the opposite side; group B was associated with increasing QTc values through the follow up period. As regards echocardiographic parameters we have found that left ventricle ejection fraction was improving to reach the highest values after six months in group A but we did not find significant improvement of left ventricle ejection fraction in group B. Other echocardiography parameters in group A including LA, LVIDd, RVSP and SWMA were improved by the end of the study but we have found that LA diameter was increasing in group B. In group A, burden of ventricular ectopics was found to be decreasing through the follow up period but there was no significant change of ventricular ectopics incidence in group B by the end of the study.\u0000 \u0000 \u0000 \u0000 Sacubitril/Valsartan combination therapy was superior to ACEIs in reducing ventricular ectopics which means that this drug plays a role in preventing SCD. Ejection fraction in Sacubitril/Valsartan combination group was improving through the follow up period. Echocardiographic parameters were improving in Sacubitril/Valsartan group as regard LA, LVIDd and RVSP. Functional capacity in Sacubitril/Valsartan combinations group was improving through follow up period which means this drug reduces hospitalization.","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42010662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.273696
{"title":"EFFECT OF QUERCETIN ON INFLAMMATORY PATHWAYS IN ANIMAL MODEL OF OSTEOARTHRITIS","authors":"","doi":"10.21608/amj.2023.273696","DOIUrl":"https://doi.org/10.21608/amj.2023.273696","url":null,"abstract":"","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42736555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.274295
{"title":"PROSPECTIVE STUDY OF ALLEGED CHILD SEXUAL ABUSE CASES DURING A PERIOD OF ONE YEAR EXTENDING FROM THE BEGINNING OF JANUARY TO THE END OF DECEMBER, 2020 IN AL- SHARQIA GOVERNORATE IN EGYPT","authors":"","doi":"10.21608/amj.2023.274295","DOIUrl":"https://doi.org/10.21608/amj.2023.274295","url":null,"abstract":"","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41941554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.274298
{"title":"COMPARATIVE STUDY OF INTRAVENOUS VERSUS INTRAPERITONEAL MAGNESIUM SULPHATE IN POST OPERATIVE PAIN MANAGEMENT AFTER LAPROSCOPIC CHOLECYSTECTOMY","authors":"","doi":"10.21608/amj.2023.274298","DOIUrl":"https://doi.org/10.21608/amj.2023.274298","url":null,"abstract":"","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49294368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.280509
{"title":"EFFECT OF VITAMIN D AND/OR ATORVASTATIN ON HIGH FAT DIET INDUCED HYPERLIPIDEMIC ADULTMALE ALBINO RATS","authors":"","doi":"10.21608/amj.2023.280509","DOIUrl":"https://doi.org/10.21608/amj.2023.280509","url":null,"abstract":"","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47335498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.273689
Background: Non-Hodgkin lymphoma (NHL) is a neoplasm of the lymphoid tissues arising from B cell precursors, T cell precursors, mature B cells, and mature T cells. NHL accounts for one of the most common malignant diseases in the general population. Objective: To assess the importance of positron emission tomography/computed tomography (PET/CT) in the initial staging and evaluation of therapeutic response in patients with NHL. Patients and methods: Thirty cases, confirmed by histopathology to be NHL, were examined by PET/CT for initial staging and evaluation of therapeutic response. Results: PET/CT detected 94 total involved sites with sensitivity 100 %, specificity 97.6 %, and accuracy 98.2 % which was larger than sites detected by CT; 80 total involved sites with sensitivity 84.04 %, specificity 91.5%, and accuracy 89.7 %. Regarding to treatment response assessment, PET/CT detected complete regression (60%), partial regression (30 %) stationary course (0%) and progression (10 %) while CT detected complete regression (70%), partial regression (20 %) stationary course (10%) progression (0%). Conclusion: PET/CT provides more accurate results regarding the staging and treatment response of patients with NHL in comparison with CT declaring a greater sensitivity, specificity, and accuracy.
{"title":"ROLE OF PET/CT IN THE INITIAL STAGING AND EVALUATION OF THE THERAPEUTIC RESPONSE IN PATIENTS WITH NON-HODGKIN LYMPHOMA","authors":"","doi":"10.21608/amj.2023.273689","DOIUrl":"https://doi.org/10.21608/amj.2023.273689","url":null,"abstract":"Background: Non-Hodgkin lymphoma (NHL) is a neoplasm of the lymphoid tissues arising from B cell precursors, T cell precursors, mature B cells, and mature T cells. NHL accounts for one of the most common malignant diseases in the general population. Objective: To assess the importance of positron emission tomography/computed tomography (PET/CT) in the initial staging and evaluation of therapeutic response in patients with NHL. Patients and methods: Thirty cases, confirmed by histopathology to be NHL, were examined by PET/CT for initial staging and evaluation of therapeutic response. Results: PET/CT detected 94 total involved sites with sensitivity 100 %, specificity 97.6 %, and accuracy 98.2 % which was larger than sites detected by CT; 80 total involved sites with sensitivity 84.04 %, specificity 91.5%, and accuracy 89.7 %. Regarding to treatment response assessment, PET/CT detected complete regression (60%), partial regression (30 %) stationary course (0%) and progression (10 %) while CT detected complete regression (70%), partial regression (20 %) stationary course (10%) progression (0%). Conclusion: PET/CT provides more accurate results regarding the staging and treatment response of patients with NHL in comparison with CT declaring a greater sensitivity, specificity, and accuracy.","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47184606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.21608/amj.2023.280511
{"title":"STUDY OF DILATED CARDIOMYOPATHY AMONG PNEUMONIA IN INFANTS NOT RESPONDING TO STANDARD TREATMENT","authors":"","doi":"10.21608/amj.2023.280511","DOIUrl":"https://doi.org/10.21608/amj.2023.280511","url":null,"abstract":"","PeriodicalId":84126,"journal":{"name":"Al Azhar medical journal = Majallat al-Tibb al-Azhar","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43769453","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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