Spinal versus General Anesthesia for Elective Cesarean Section: Immediate outcome
Tarik
Sarhan
Department of Anesthesia and Intensive Care, Damietta Faculty of Medicine, Al-Azhar University, Egypt; Emergency Medical Service and Critical Care, Inaya Medical College, Saudi Arabia.
author
Adel
Diab
Department of Anesthesia and Intensive Care, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Abdel-aal
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Recent interest has focused on the influence of obstetric anesthesia types on the immediate neonatal and maternal outcome. Aim of the work: The study was intended to assess the immediate neonatal and maternal outcome in relation to the maternal anesthesia type during cesarean section.Patients and methods: the present study included 200 full term neonates whose mothers underwent elective cesarean section (CS). They were grouped according to type of anesthesia given to mothers into group 1: included 100 newborns whose mothers had general anesthesia and group 2: included 100 newborns whose mothers had spinal anesthesia. Each newborn evaluated for short-term outcome including Apgar score, need for NICU admission and blood gas analysis. Mothers assessed for postoperative outcome. Results: No significant differences were discovered between the types of anesthesia used in regard to the general maternal characteristics. Neonatal outcomes on the other hand showed no significant differences as regard Apgar score (P=0.33) and NICU admission (P= 0.57), PaCO2, HCO3, Na and K; while PH and PaO2 were significantly lower with spinal anesthesia (P= 0.02 and 0.008 respectively). Additionally, spinal anesthesia was associated with rapid recovery of bowel and less need for postoperative analgesia. Conclusion: The type of anesthesia used in mothers undergoing full term elective cesarean deliveries does not seem to affect the immediate neonatal outcome. Both may be safely used in full term elective cesarean deliveries. However, spinal anesthesia had the advantage of lower need for postoperative analgesia with rapid recovery of bowel
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
487
492
https://ijma.journals.ekb.eg/article_91684_c826e991cac9f302cacbff483f46edc9.pdf
dx.doi.org/10.21608/ijma.2020.16397.1026
Incidence of Esophageal Reflux after Laparoscopic Sleeve Gastrectomy for Morbid Obesity
Ahmed
Orouk
Department of General Surgery
author
Ahmed
Sayyouh
Professor and Head Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Nagah
Salem
Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Obesity is considered as an epidemic globally, which associated with gastroesophageal reflux disease (GERD). Bariatrics surgery tends to reduce GERD manifestations. However, some reports noticed development of GERD after bariatric surgery; the problem which not addressed well in our community. Aim of the work: To estimate incidence of postoperative GERD after laparoscopic sleeve gastrectomy (SG) in patients with no history of GERD symptoms prior to surgery. Patients and Methods: Fifty morbidly obese patients who were scheduled for laparoscopic SG with no history of preoperative symptoms suggesting GERD and normal upper gastrointestinal endoscopy were included. All were assessed clinically and radiologically and followed-up for clinical or endoscopic GERD manifestations. Results: Females were predominant (76.0%). Weight, body mass index and waist/hip ratio were significantly reduced after SG. Postoperative complications were leak (2.0%), wound infection (2.0%), bleeding (2.0%), stricture (4.0%) with overall rate of 8.0%. Incidence of GERD was 22.0% (11 patients; 4 grade A, 5 grade B and 2 grade C). There was significant increase of Waist/hip ratio (both pre-and postoperatively) in patients who developed GERD when compared to those who did not develop GERD. In addition, there was significant increase of sleep related problems and stricture in patients who developed GERD when compared to those did not develop GERD (63.6%, 18.2% vs 17.9%, 0.0% respectively).Conclusion: the incidence of GERD after SG was 22.0%. It was of mild or moderate nature, which denotes safety of SG. The procedure is also associated with marked weight reduction.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
493
502
https://ijma.journals.ekb.eg/article_92423_0e4ced9dbbec6891526c3927b8bd1cdb.pdf
dx.doi.org/10.21608/ijma.2020.26707.1112
Urolithiasis in Post Renal Transplant Recipients: Case series
Nabeel
Kuwaijo
The Galway Clinic - Royal College of Surgeons in Ireland
author
Ponnusamy
Mohan
Transplant Unit, Beaumont Rd, Beaumont, Dublin Ireland
author
Mohammed
Mohammed
Mater University Hospital, Urology Department
author
sadiq
Lala
Urology and Transplant
The royal hospital
Oman
author
text
article
2020
eng
Renal transplantation represents the optimal management option for end-stage renal disease. it is associated with favourable outcome. Urolithiasis after renal transplant is an extremely rare condition, with an incidence less than 1% after renal transplantation.We reported six post renal transplant patients who had renal stones. The stones located in the transplanted kidney, its ureter or both. Transplanted kidney and ureteric stones had been reported 2 – 3 years after transplantation, while the urinary bladder calculi reported 8 – 10 years after transplantation, at the site of ureteral implantation to the bladder over the site of sutures and in the absence of any post-transplant complications. A written consent has been signed by the patient to release information for this study. The treatment was individualized for each patient. Interestingly, one patient with asymptomatic post-transplant renal stone needs no intervention “we watched and see” and he passed the stone within shortest follow up period that confirmed by ultrasound examination. Others, underwent extracorporeal wave lithotripsy or percutaneous nephrostomy and antegrade double-J stent insertion.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
503
507
https://ijma.journals.ekb.eg/article_93375_8ad277be8d025ff42b38c4c2febc21d1.pdf
dx.doi.org/10.21608/ijma.2020.27026.1118
Comparative Study between Mathieu Repair and Snodgrass Repair in Distal Hypospadias
Ahmad
Hassouna
Department of General Surgery, Damietta General Hospital, Ministry of Health, Egypt
author
Abdo
Arnous
Department of Pediatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Esam
Taman
Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Ibrahim
Elsayaad
Department of Peidatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Hypospadias is a congenital condition characterized by tissue hypoplasia of the ventral aspect of the penis, with incidence of one in 300 males [0.3%]. There is an increase incidence in those with first-degree relatives having hypospadias to about 13 times more than those without family history. Aim of the work: To compare between the meatal-based flap "Mathieu" technique and tubularized incised plate [TIP] "Snodgrass urethroplasty in treatment of distal hypospadias.Patients and Methods:This study was carried out at the Department of Surgery, Al-Azhar university hospital [Damietta], Egypt., The study consists of forty male children, suffering from distal penile hypospadias. Patients were blindly assigned into two groups;20 patients underwent Mathieu technique and another 20 patients underwent "Snodgrass urethroplasty”.Results: Both groups were comparable regarding patient age, consanguinity, maternal drug intake, urethral plate characteristics and duration of hospital study. However, Snodgrass urethroplasty is associated with significant increase of operative time [80.0±16.1 vs 60.0±9.6 minutes], significant lower complication rate [10% vs 30.0%], significantly good cosmetic appearance of the penis [100% excellent versus 40% excellent, 40% good, and 20% torsion of the shaft] and 100% slit like and vertically oriented meatus.Conclusion: Snodgrass and modified Mathieu repair are safe, and the choice of one of the techniques will depend on the surgeon's decision. Its procedure had its own advantages and disadvantages and final decision should be attributed to surgeon preferences.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
508
518
https://ijma.journals.ekb.eg/article_93050_76026fa108efcbee464c11fa0433d815.pdf
dx.doi.org/10.21608/ijma.2020.26016.1109
Incidence of Endometriosis among Women Prepared for Laparoscopy in Unexplained Infertility and Chronic Pelvic Pain
Mohammed
El-flahgy
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Walaa
El-Bassioune
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Waleed
Ayad
Department of Obstetrics and Gynecology
Faculty of Medicine, Al-Azhar University (Damietta)
Egypt
author
text
article
2020
eng
Background: Unexplained infertility continues to be a health challenge irrespective of revolution in medical care. Endometriosis could be associated with infertility. However, its prevalence is underestimated, as it need laparoscopy for definite diagnosis. Aim of the work: To estimate the incidence of typical and atypical (subtle) pelvic endometriosis among women with unexplained infertility and chronic pelvic pain.Patients and Methods:A total of 100 patients with unexplained infertility [50 patients] and chronic pelvic pain [50 patients] who underwent diagnostic laparoscopy had been included in the current study. All were assessed clinically after full history taking and underwent ultrasound, then prepared for laparoscopy. The main outcome was laparoscopic and histopathologic diagnosis of pelvic endometriosis, and the association between endometriosis and different patient characteristics and other risk factors had been analyzed.Results: Endometriosis was diagnosed by laparoscopy in nearly 33 of patients included in this study of which 29 cases [12 with unexplained infertility and 17 with chronic pelvic pain] were confirmed by histopathologic examination. Thus, the final incidence of endometriosis was 29%. Development of endometriosis was significantly associated with positive family history, dysmenorrhea and higher CA125.Conclusion: Pelvic endometriosis is a frequent association with unexplained infertility and chronic pelvic pain. It should be considered in those women particularly when there was positive family history, dysmenorrhea or higher CA125.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
519
527
https://ijma.journals.ekb.eg/article_93427_48d040ca006fe95f072295174b995434.pdf
dx.doi.org/10.21608/ijma.2020.22163.1080
Predictive Value of both Serum Placental Protein-13 Level and Uterine Artery Doppler for Prediction of Pre-Eclampsia
Marwa
El-hassab
Department of Obstetrics and Gynecology, Sammanoud General Hospital, Ministry of Health, Egypt.
author
Rashed Mohamed
Rashed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Magdy
Elghannam
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Alaa Eldin
Megahed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Preeclampsia [PE] is one of the commonest medical emergencies. It had high morbidity for the mother and her infant. Early diagnosis could reduce such morbidity. Aim of the work: To evaluate the role of maternal serum placental protein [PP13] levels and uterine artery Doppler in early prediction and prognosis of preeclampsia.Patients and Methods: The study included 60 pregnant women in their first and early second trimester with high risk for preeclampsia. Patients were divided into three groups: control, mild and sever preeclampsia. All were subjected to proper history taking, clinical and obstetrical examination, laboratory investigations and ultrasound examination.Results: Cesarean delivery was significantly increased in preeclampsia compared to controls [55% of mild and 20% of severe disease compared to 15% of controls]. Both uterine artery resistance index [RI] and pulsatility index [PI] were significantly increased in PE when compared to control and in severe when compared to mild PE groups. Finally, PP13 was significantly decreased in patients with severe PE [171.7±35.9] when compared to mild PE [213.1±41.8] or control group [254.8±51.1]. In addition, there was significant decrease in cases with mild PE when compared to control group. Finally, there was inverse [negative], moderate and statistically significant correlation between PP-13 from one side and each of systolic BP, diastolic BP, uterine artery RI and PI. In addition, both RI and PI were proportionally correlated with PI and RI.Conclusion: The present study showed that PP13 combined with PI or RI can predict PE with a good sensitivity and specificity.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
528
534
https://ijma.journals.ekb.eg/article_93181_5acfbe9a427fed54eefaa61668ca0fcb.pdf
dx.doi.org/10.21608/ijma.2020.22342.1081
Factors Affecting Nodal Status in Breast Cancer
Diaa
Aboelata
Department of General Surgery, Tanta Cancer Center, Ministry of Health, Egypt.
author
Amr
Sarhan
Department of General surgery, Damietta
Faculty of Medicine, Al-Azhar University, Egypt
author
Mohammed
Abo Mira
Department of General Surgery, Damietta
Faculty of Medicine, Al-Azhar University, Egypt
author
Sami
Mohammed
Department of Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Nodal status in breast cancer [BC] is the most prognostic factor for survival and prognosis, and affects treatment decisions. Nodal status had reciprocal relation with pre- and post-operative factors. All these reflect the crucial importance of nodal status in BC. Aim of the work: Evaluation of pre- and post-operative factors related to nodal status in breast cancer.Patients and Methods: The current work included 40 patients with confirmed BC, who had been scheduled for modified radical mastectomy or conservative breast surgery with axillary evacuation. All were assessed in a systematic manner preoperatively. In addition, an intraoperative and post-operative evaluation had been carried out. Postoperative histopathological examination of excised tissues had been done for all specimens. Both intra- and post-surgical complications and factors associated with positive nodal status were documented. Results: The most significant factors associated with high positive nodal status were age (patient ≤ 45 years was significantly associated with increased positive nodes when compared to > 45 years (37.68±35.23 vs 17.66±19.45 respectively), obesity (30.66±27.33 vs 18.49±25.07 nodes for obese and lean individuals respectively)., tumors greater than 2 cm, positivity of the human-epidermal-growth-factor receptor 2 [Her2]/neu, positive lymphovasular invasion, tumors of the upper quadrant, and the type of histopathology.Conclusion: Nodal status affected by pre- and post-surgery factors (e.g., age, obesity, tumor site, tumor size, Her2/neu, lymphovascular invasion and histopathological type of the tumor). Thus, these factors help in planning of the treatment such as the type of surgery, endocrine therapy, radiation therapy and the adjuvant chemotherapy.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
535
541
https://ijma.journals.ekb.eg/article_92262_04c2f90ab42fd684e7610c88af8e6fc3.pdf
dx.doi.org/10.21608/ijma.2020.24500.1105
Office Hysteroscopy Versus Three-Dimensional Ultrasound in Assessment of Uterine Cavity in Recurrent Pregnancy Loss
Mohamed
Farag
Department of Obstetrics and Gynecology
El-Mahalla General Hospital, Ministry of Health, Egypt.
author
Mahmoud
Mahmoud
Department of Obstetrics and Gynecology;
Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Rashed Mohamed
Rashed
Department of Obstetrics and Gynecology; Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Recurrent pregnancy loss [RPL] is one of the most frustrating and difficult areas in reproductive medicine.Aim of the work: This prospective study aims to evaluate the roles of ultrasound and hysteroscopy in recurrent pregnancy loss.Patients and Methods: A total of 100 patients who had a history of two or more RPL had been included. All patients had been subjected to complete history taking, thorough clinical and gynecological examination, three-dimensional [3D] ultrasound and hysteroscopy. Results: The mean age was 27.43 years. In addition, 45% of the included females had two previous RPL while 55% of them had three or more RPL. Hysteroscopy revealed normal findings in 80 cases [80%], endometrial polyp in 7%, submucous myoma in 3%, uterine septum in 6%, and uterine synechiae in 4%. On the other side, three-dimensional ultrasound [3D US], normal findings had been detected in 83 cases [83%], endometrial polyp in 6%, submucous myoma in 3%, uterine septum in 5%, bicornuate uterus in 1%, and uterine synechiae in 2%. There was a statistically significant correlation between the two techniques in detection of the uterine findings in cases of RPL [p =0.001].Conclusion: Three-dimensional ultrasonography is the best tool for diagnosis of different types of Mullerian duct anomalies whereas hysteroscopy is better in diagnosis of intracavitary lesions.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
542
546
https://ijma.journals.ekb.eg/article_92260_253f6179d04bc6958f9814afab6764f4.pdf
dx.doi.org/10.21608/ijma.2020.25674.1110
Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)
Alaa Ameen
Hamed
Resident at Department of Otorhinolaryngology [Audiovestibular Unit], Faculty of Medicine for Girls, Al-Azhar University, Egypt
author
Amal Elsebaie
Beshr
Department of Otorhinolaryngology, Faculty of Medicine for Girls [Cairo], Al-Azhar University, Egypt
author
Reda Mohamed
Behairy
Department of Otorhinolaryngology, Faculty of Medicine for Girls [Cairo], Al-Azhar University, Egypt
author
Iman Ibrahim
Eladawy
Department of Otorhinolaryngology, Faculty of Medicine for Girls [Cairo], Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Involvement of the brainstem in multiple sclerosis [MS] has significant implications on the disease course and can be presented with different symptoms. There are many tests able to detect brain-stem involvement in MS with various degrees of success.Aim of the work: To study the changes in vestibular evoked myogenic potential [VEMP], in patients with MS, and to detect its sensitivity for detection of the brain-stem lesions previously diagnosed with magnetic resonance imaging [MRI] in MS patients.Patients and Methods: Sixty participants had been enrolled and divided into two groups: 30 healthy subjects [Control group] and 30 MS patients [Study group]. Both groups had been subjected to otological examinations, pure tone audiometry, acoustic impedance, cervical vestibular evoked myogenic potential [cVEMP], ocular vestibular evoked myogenic potential [oVEMP] and MRI. Results: In MS group, oVEMP mean latencies of n1 and p1 and cVEMP mean p13 and n23 latencies were significantly prolonged. In addition, 14 MS patients [46.7%] had brainstem lesions as confirmed by MRI. Finally, oVEMP test had higher sensitivity than the cVEMP in prediction of brainstem lesions.Conclusion: oVEMP seems to be useful and more sensitive than cVEMP as an adjunct test in the evaluation of brain-stem dysfunction in MS patients.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
547
553
https://ijma.journals.ekb.eg/article_94557_2c4b040689225d8a3d1a8a5ed18e1a26.pdf
dx.doi.org/10.21608/ijma.2020.27101.1119
Robotic Assisted Laparoscopic Partial Cystectomy and En Bloc Resection of Urachus and Umbilicus for Rare Case of Mucin Producing Urachal Adenocarcinoma: A Case Report
Nabeel
Kuwaijo
Department of Urology, The Galway Clinic, Royal College of Surgeons, Ireland
author
Stephanie
Curran
Department of Pathology, The Galway Clinic, Royal College of Surgeons, Ireland
author
Paddy
O'Malley
Department of Urology, The Galway Clinic, Royal College of Surgeons, Ireland
author
text
article
2020
eng
Background: Urachal carcinoma accounts for <1% of all bladder cancers, 90% are adenocarcinomas, accounting for 10% of the bladders’ adenocarcinomas. For its rarity, there is no consensus about the nomenclature, staging, diagnosis and treatment. Case report: We described a 42 years old male, who complained of post-voiding mucinous discharge for a long period (10 years). after extensive clinical evaluation and radiologic investigation and cystoscopy, the diagnosis of an early stage urachal adenocarcinoma had been confirmed. It had been completely excised with no metastasis. The surgical resection of the tumour done en-bloc through laparoscopy, robotic-assisted surgery. No chemotherapy nor radiotherapy had been indicated, the patient has been submitted to close follow-up, with our hoping look for recurrence of the disease. Excised specimen had been further submitted to histopathological and immunostaining examination. Histopathological grading had been done according to most recent staging systems (it confirmed the early staging mucinous adenocarcinoma of urachal origin). Conclusion: Here we described our experience with a rare case report of mucinous cystadenoma of urachal origin, robot-assisted laparoscopic surgery and early stage of cancer permits partial cystectomy, good outcome with no need for chemical or radiotherapy.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
554
558
https://ijma.journals.ekb.eg/article_100626_fa1857dc96e7008f1252b85fe710dfc9.pdf
dx.doi.org/10.21608/ijma.2020.25136.1114
Relation between Placental Thickness Measurements and Fetal Outcome in Patients with Intra- Uterine Growth Restriction [IUGR]
Ahmed
Emam
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Walaa
El-Bassioune
obstetrics and gynaecology, Al-Azhar faculty of medecine (damietta)
author
Abdelrahman
Hassan Emam
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Abd Elraouf
Oun
Obstetric and Gynecology Department; Faculty of Medicine (Damietta), Al-Azhar University
author
text
article
2020
eng
Background: Placental thickness appears to be a promising parameter for estimation of gestational age of the fetus due to steady increase in placental thickness with gestational age. Aim of the work: To investigate the relationship between placental thickness and fetal outcome in patients with intrauterine growth restriction [IUGR].Patients and Methods:This study included patients with fetuses diagnosed clinically and by ultrasound as IUGR [estimated fetal weight <10th percentile for gestational age], singleton pregnancy, gestational age between 28 – 40 weeks of gestation, maternal age between 20-40 years old and body mass index between 18-30 kg/m2. The placental thickness was measured at the second and third trimesters and correlated with the fetal outcome.Results: Results revealed that, estimated fetal weight significantly increased in normal placenta when compared to either thin or thick placentae. In addition, thin placentae had significantly low fetal birth weight [1936.4±409.2] when compared to thick placentae [2236.4±410.1] or normal placentae [2636.4±421.4]. Also, Apgar score was significantly higher and need for NICU admission were significantly lower with normal placentae. In addition, there is significant positive correlation between 3rd trimester placental thickness and fetal birth weight, placental weight and APGAR score.Conclusion: Placental thickness could predict deviations from norms of birth weight in late pregnancy. It seems to be promising for estimation of gestational age of the fetus and predicting fetal outcome.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
559
566
https://ijma.journals.ekb.eg/article_101119_95beefa791fcfcbd9e27e3c76d453faa.pdf
dx.doi.org/10.21608/ijma.2020.22101.1078
Our Experience with The Treatment of Hydrocephalus in Infants: Endoscopic Third Ventriculostomy versus Ventriculo-Peritoneal Shunt: A retrospective Comparative Study
Mohammed
Ahmed Alhady
Neurosurgery Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Youssef
Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Hydrocephalus is the commonest pediatric neurological disorder and usually treated by cerebrospinal fluid (CSF) diversion. This diversion accomplished by third ventriculostomy or ventriculo-peritoneal shunt. However, the optimal management is still controversial. Aim of the work: To compare the endoscopic third ventriculostomy (ETV) to ventriculo-peritoneal (VP) shunt in management of Infantile hydrocephalus.Patients and Methods:We conducted a retrospective analysis for 40 infants with hydrocephalus. The treatment used was CSF diversion by ETV or VP shunt.Results: oth treatment groups were comparable regarding age, gender, cause of hydrocephalus, incidence of postoperative re-obstruction, OFC change, hematoma, revision surgery, mortality or success rate. However, the operative time was significantly reduced among ETV when compared to VP shunt group (48.80±9.13 vs 66.75±7.65 minutes, respectively). The rate of postoperative infection was significantly decreased in ETV when compared to VP shunt groups (15.0% vs 45.0% respectively). Finally, the overall mortality during postoperative one year follow up duration was 42.5% with no significant difference between ETV and VP shunt groups (35.0% vs 50.0% respectively). In addition, the overall failure rate was 50.0%, which was lower among ETV when compared to V shunt groups (35.0% vs 65.0% respectively) with no significant difference.Conclusion: Endoscopic third ventriculostomy is effective and safe intervention for treatment of infantile hydrocephalus (for infants between 6 and 3 years of age). It is superior to VP shunt as it is associated with lower postoperative infection and shorter operation time, when compared to shunt.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
567
571
https://ijma.journals.ekb.eg/article_101122_b5d21dc21e2858a43fac4b7c3a8e7beb.pdf
dx.doi.org/10.21608/ijma.2020.28849.1121
Update in Management of Congenital Penile Curvature complex [CPCC]
AbduAllah
Zidan
General surgery department ,pediatric surgery unite, faculty of medicine,Al-Azher university,New Damietta city ,Egypt.
author
Mohammed
shahin
Department of Surgery (pediatric surgery unit) Faculty of Medicine, Al- Azhar University,new Damietta city,Egypt
author
Abdo
Arnous
Department of Pediatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background:Congenital curvature of the penis results from abnormal efflorescence of the tunica albuginea of the corpora cavernosa and not accompanied with urethral anomaly. Complex Congenital curvature of the penis has two abnormal elements : mal-rotation either clockwise or anti clockwise and curvature of the penis either dorsal or ventral. Aim of the work: To present update in management of congenital curvature complex of the penis.Background: Congenital curvature of the penis results from abnormal efflorescence of the tunica albuginea of the corpora cavernosa and not accompanied with urethral anomaly. Complex Congenital curvature of the penis has two abnormal elements: mal-rotation either clockwise or anti clockwise and curvature of the penis either dorsal or ventral. Aim of the work: To present update in management of congenital curvature complex of the penis.Patients and Methods:This prospective study done at Al-Azhar University Hospital in Damietta. Fifteen patients [15] with congenital curvature complex of the penis were evaluated and corrected from June. 2019 to January 2020, their mean age was 5.1 ± 2.34 years [range 2–10 year]. The direction of torsion was anticlockwise in 12 patients and in 3 patients was clockwise. Four patients had dorsal curvature and Eight patients had ventral curvature, while three patients had lateral curvature. All patients treated at first by modified Nesbit's procedure for correction of curvature, then dorsal flap of dartos layer for correction of penile torsion in one stage.Results: All cases with congenital curvature complex of the penis corrected in one-set surgery, which is simple, familiar and safe procedure with high successful rate. There were only a few transient complications, such as edema, mild bleeding, and penile hematoma resolved spontaneously. No recurrence of mal-rotation or curvature reported.Conclusion: Congenital Penile Curvature Complex can be treated in single-stage surgery with excellent functional and cosmetic outcomes by combination of modified Nesbit's procedure with dorsal flap of dartos layer. Patients and Methods:This prospective study done at Al-Azhar University Hospital in Damietta. Fifteen patients (15) with congenital curvature complex of the penis were evaluated and corrected from June. 2019 to January 2020 ,their mean age was 5.1 ± 2.34 years (range 2–10 y). The direction of torsion was anticlockwise in 12 patients and in 3 patients was clockwise. Four patients had dorsal curvature and Eight patients had ventral curvature, while three patients had lateral curvature. All patients treated at first by modified Nesbit's procedure for correction of curvature, then dorsal flap of dartos layer for correction of penile torsion in one stage.Results:All cases with congenital curvature complex of the penis corrected in one-set surgery, which is simple, familiar and safe procedure with high successful rate.There were only a few transient complications, such as oedema, mild bleeding, and penile hematoma resolved spontaneously. No recurrence of mal-rotation or curvature reported.Conclusion: Congenital Penile Curvature Complex can be treated in single-stage surgery with excellent functional and cosmetic outcomes by combination of modified Nesbit's procedure with dorsal flap of dartos layer.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
572
579
https://ijma.journals.ekb.eg/article_101778_ad702a16d141128dab554efa644e0cbf.pdf
dx.doi.org/10.21608/ijma.2020.31699.1133
Comparative Study Between Intramedullary K-wire Fixation Versus Transverse Pinning in Treatment of Fifth Metacarpal Neck Fracture
Ismaeel Shaker
Sallam
Department of Orthopedic Surgery, Nasser General Hospital, Ministry of Health, Egypt
author
ashraf
ezzeldeen
Department of Orthopedics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Samir
El-Shoura
Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Fifth metacarpals and phalangeal fractures are common, and neck fractures of the fifth metacarpal is the commonest. Improper treatment is associated with negative economic impact due to its associated disabilities. Aim of the work: To compare between intra-medullary and transvers K-wires for fifth metacarpal neck fractures.Patients and Methods:Thirty patients with 5th metacarpal neck fracture were included. Fifteen treated by intramedullary k-wire fixation, and fifteen treated by transverse k-wire pinning. Preoperatively, patients were evaluated by clinical, radiological and laboratory studies. Postoperatively, they were assessed clinically and by imaging studies. Objective assessment had been achieved by the total active range of motion [TAM] and hand-grip strength.Results: Both groups were comparable as regard to patient and injury characteristics. Punch was the most common mechanism of injury. The right side was affected in 80%, and the transverse fracture was the most common [reported in 53.3%]. Finally, outcome was slightly better in group 1, except for one patient of non-union. The results based on TAM% were excellent, good, fair and poor among 60.0%, 26.7%, 6.7% and 6.7% in group 1, compared to 83.3%, 40.0%, 0.0% and 6.7% in group 2 with the same order. The time to union ranged between 6 and 14 weeks. Finally, complications were reported in 20% of group 1 and 33.3% of group 2.Conclusion: Intramedullary K-wire Fixation and Transverse Pinning provide an optimal treatment options for Fifth Metacarpal Neck Fracture. Intramedullary K-wire Fixation provide slightly better outcome. However, the superiority is not statistically significant.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
580
589
https://ijma.journals.ekb.eg/article_103729_c255715e0fd5ec9f2099f0f3ef492ce2.pdf
dx.doi.org/10.21608/ijma.2020.32039.1134
Comparative Study between Intranasal Injection of Botulinum Toxin-A and Combined Intranasal Medical Treatment for Allergic Rhinitis
Nabil
Sarhan
Department of Otorhinolaryngology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Fathallah
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University, Egypt.
author
Ashraf
Wahba
Department of Otorhinolaryngology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Ahmed
Alwan
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Allergic rhinitis is one of the most common diseases, with no consensus on its ideal treatment. Botulinum Toxin-A was proposed to be an effective treatment. Aim of the work: To estimate the outcome of intranasal injection of Botulinum Toxin-A [BTX-A] as a sole therapy for allergic rhinitis.Patients and Methods:Ninty patients with classic symptoms of allergic rhinitis were clinically evaluated and asked to complete the score for allergic rhinitis [SFAR] questionnaire using cutoff at >8 as diagnostic AR. Two blood samples [venous] and nasal smears were obtained at the beginning of the study and at the end of 12-weeks after initiation of therapy for estimation of human immunoglobulin E [IgE] and eosinophilia grading. Control group included patients who chose to receive combined medical treatment. BTX-A, 2.5 units were injected intranasally, under 0o rigid telescope guidance. Study outcome was the treatment success rate at the end of 12-w follow-up period.Results: Intranasal BTX-A injection provided significantly maintained relieve of allergic rhinitis manifestations especially for running nose than combination therapy. The treatment success rate of 1.9 versus 0.7 item/patient in study versus control group with significant difference in favor of BTX-A injection. Serum IgE levels and eosinophilia grades were significantly lower in control patients. Patients' satisfaction grading was significantly more with BTX-A injection.Conclusion: Intranasal BTX injection could be a safe and effective sole therapeutic modality for patients with long-lasting AR
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
590
598
https://ijma.journals.ekb.eg/article_97557_49e0d9b4d8de32cf2820631a299a87e0.pdf
dx.doi.org/10.21608/ijma.2020.26878.1113
Mycoplasma Pneumoniae and Bronchial Asthma in Children
Hala
Elzawawy
Damanhoor Medical National Institute, Ministry of Health, Egypt
author
Magdy
Sakr
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohammed
Abdel-Aal
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Hesham
Abd al-samee
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
ABSTRACTBackground: Bronchial asthma is a chronic inflammatory disorder of the airways resulting in recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and early morning. Mycoplasma pneumonia is a frequent cause of acute respiratory infections in children. It can cause pharyngitis, otitis media, tracheobronchitis or community acquired pneumonia, but may also remain totally asymptomatic. Aim of the work: The aim of the study is to find out the relation between Mycoplasma Pneumoniae infection and bronchial asthma in children.Patients and Methods:A cross sectional study carried out at the Al-Azhar University Hospital in Damietta in the period from October 2018 to October 2019. It included 80 asthmatic children in acute attack. Patient demographics, asthma severity and laboratory investigations had been documented. In addition, IgM for Mycoplasma pneumoniae had been determined, and associated with other factors. Results: Mild asthma reported in (76.25%), moderate asthma (17.5%), and severe asthma (6.25%). Eosinophils had significantly increased in severe asthma (5.00±3.24) when compared to moderate (3.57±1.55) or mild asthma (2.33±1.11). Similarly, IgM of M. pneumoniae was significantly increased in severe asthma (1.03±0.69) when compared to moderate (0.67±0.45) or mild asthma (0.61±0.21). None of children with mild asthma had positive IgM while 14.28% of moderate asthma had positive results and 80.0% of severe asthma had positive IgM for M. Pneumoniae. Conclusion: Mycoplasma Pneumoniae infection is common in children with acute attacks of asthma and Mycoplasma Pneumoniae infection is associated with the trigger asthma exacerbation and associated with the severity of asthma.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
599
603
https://ijma.journals.ekb.eg/article_88650_b06482c4f4429c9b01f9a116d3895ae3.pdf
dx.doi.org/10.21608/ijma.2020.24211.1103
Effect of Vitamin-D Supplementation on Recurrence of Acute Otitis Media in Pre-School Children
Osama
Refaat
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar university, Egypt
author
El Bakry
Tharwat
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Ahmed
El-Gamal
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Acute Otitis media (AOM) and its recurrence is a prevalent health problem among pre-school children. Different strategies to prevent recurrent have been established with questionable efficacy. Vitamin D is suspected as a possible preventable risk factor. Aim of the work:To evaluate the effect of vitamin-D supplementation on recurrence rate of acute otitis media among Pre-school children.Patients and Methods:60 pre-school children with a recurrent episode of acute otitis media [by history and otoscopic examination] were included. After diagnosis, all children received standard treatment and after recovery, serum levels of vitamin-D were estimated; those with reduced vitamin D had been included, then divided into: Study group (30 children, received oral vitamin-D supplementation for 4 months; and Control group (30 children; received placebo). New attacks of AOM had been document during the regular visits for the six months. Vitamin D had been re-estimated after 6 months.Results: Both groups were comparable regarding studied variables at the start. Upper respiratory tract infection and ear discharge significantly decreased; vitamin D significantly increased among study group at 6 months. Recurrent AOM after 6 months, had been significantly reduced among study vs control group (1.43±0.62 vs 3.46±0.62 respectively). Also, vitamin-D significantly increased at the end in study vs control group (21.76±5.95 vs 14.53±4.73 ng/ml respectively). The mean percentage of increase of vitamin-D in study group was 135.98% compared to 33.91%. In control group.Conclusion: Vitamin D supplementation to children with a history of rAOM plays a significant role in reduction of attack frequency.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
604
610
https://ijma.journals.ekb.eg/article_104865_fbf06f6461756442ffacf3461d64e5aa.pdf
dx.doi.org/10.21608/ijma.2020.34138.1141
Ondansetron Compared with Doxylamine and Pyridoxine for Treatment of Nausea and Vomiting in Pregnancy
Mohamed
Yahia
Department of Obstetrics and Gynecology, Damietta General Hospital, Ministry of Health, Egypt
author
Khattab
Khattab
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Alaa
Hamed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Nausea and vomiting affects up to 80% of the pregnant women population and are the third leading causes of maternal hospitalization during pregnancy. Many pregnant females, and even some healthcare professionals, dread using antiemetic drugs due to a false beliefof their teratogenicrisk. Aim of the work:This study aimed to evaluate ondansetron to a combination of doxylamine and pyridoxine in controlling pregnancy-related nausea and vomiting.Patients and Methods:This randomized controlled trial included 156 pregnant women, at 16 weeks of gestation, with mild-to-moderate nausea and vomiting. Meanwhile, women with severe symptoms indicating admission, those already on anti-emetics, and those who wouldn’t be able to show up for follow-up visits were excluded. Seventy-eight patients received intravenous injection of ondansetron [Zofran] at a dose of 8 mg once daily for 5 days, whereas the other 78 patients received oral pyridoxine at a dose of 25 mg plus doxylamine at a dose of 12.5 mg [Diclegis] twice daily for 5 days. Each patient was subjected to full history taking, complete clinical examination and investigations.Results: Women on Ondansetron reported better alleviation of nausea compared to those receiving pyridoxine and doxylamine [96.2% vs. 52.6%, P<0.001, respectively]. The most frequently reported side effects were headache, dry mouth, gastrointestinal [GI] disturbances, and abdominal pain, and the differences in their occurrence between the two groups were statistically insignificant.Conclusion: Ondansetron was found superior to the combination of pyridoxine and doxylamine in improving pregnancy-related nausea and vomiting occurring without a significant increase in side effects.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
611
618
https://ijma.journals.ekb.eg/article_98192_7cd2f2a5e8bbc1bcb14e9b27778a0c0d.pdf
dx.doi.org/10.21608/ijma.2020.26371.1111
Comparative study: Transseptal approach versus Transatrial approach in mitral valve replacement in redo patients
Mohamed
Hitawy
Department of Cardiothoracic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Hassan
Department of cardiothoracic surgery, Faculty of Medicine, Al-Azhar University, Egypt
author
Farag
Abdelwahab
Department of cardiothoracic surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Mousa
Department of cardiothoracic surgery, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Previous cardiac operations may complicate mitral valve exposure, as adhesions and loss of mobility in the surrounding tissues may be present. In such cases, the conventional left atrial (LA) incision may not offer satisfactory visualization in the surgical site of the valve. Therefore, several alternative approaches have been proposed for satisfactory visualization of the mitral valve intraoperatively.Aim of the work: to evaluate the outcome of the transseptal and transatrial approaches for mitral valve replacement in patients undergoing redo mitral valve surgery.Patients and Method: This is a prospective study that was conducted at Cardio-thoracic surgery department of Al-Azhar University hospital (Damietta) and other centers during the period from the January 2018 to May 2019. It included 30 patients undergoing redo mitral valve surgery; 15 of them had transseptal approach and 15 with transatrial approach.Results: Age was comparable between studied groups. There was 6 males (40.0%) in group I and 7 males (46.7%) in group II. Smoking was reported in 8 (53.3%) in group I and 7 (46.7%) in group II. Hypertension and pulmonary disease were reported in 6 (40.0%) versus 7 (46.7%) and 2 (13.3%) versus 3 (20.0%) in groups I and II respectively. Diabetes mellitus was reported in 9 (60.0%) in group I versus 4 (26.7%) in group II. Finally, there was no significant difference between both approaches as regard to intraoperative or postoperative data. Conclusion: Transatrial approach has been used in most of previous studies; the transseptal approach appears to be equally effective.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
619
624
https://ijma.journals.ekb.eg/article_92259_bd2560bc85f6df46d37d156be55d26ac.pdf
dx.doi.org/10.21608/ijma.2020.20927.1052
Assessment of Anti-Streptolysin O Titre in Healthy School Age Children in El Behira Governorate
Mona
Kordy
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Mohamed
Zannoun
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Magdy
El Ghanam
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Group-A streptococcal serology is used for post-streptococcal disease diagnoses, such as acute rheumatic fever, and occasionally for diagnosis of streptococcal pharyngitis. The prevalence of rheumatic fever in school children aged 6 to 15 years ranges between 0.2 to 0.75 per 1000 children per year. The prevalence of rheumatic heart disease in 1000 children ranges from 1 to 5.4. Aim of the work: To determine upper limit of the normal range of Antistreptolysin O titre in healthy school children, aged 6-15 years old in El Behira governorate.Patients and Methods:A cross-sectional study had been performed in EL Behira Governorate and the collected sample were tested in clinical pathology Lab [Al-Azhar University Hospital, Damietta]. A total of 3000 [1609 Males, 1391 Females] serum samples had been collected from children aged 6-15 years, had been tested for Anti-streptolysin O titer [ASO] by turbidimetry.Results: Normal value for the ASO titer rose sharply during early childhood and then declined gradually with age. The estimated titer that was 80% of the upper limit or normal at age 10 years was 287 IU/ml for ASO.Conclusion: This study provides the upper limit of normal value for ASO titre of school children. The "more than 400" rating should instruct clinicians in the treatment of post-streptococcal diseases in patients and provide valuable longitudinal evidence for potential intervention trials against streptococcal diseases in group A.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
625
630
https://ijma.journals.ekb.eg/article_91606_7ae14891c03e683689bf5815812e6b0f.pdf
dx.doi.org/10.21608/ijma.2020.23002.1089
Diagnosis of Peripherally Located Bronchogenic Carcinoma: Utility of Non-Guided Flexible Bronchoscopy
Sawsan
Elsawy
Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: The role of flexible bronchoscopy in diagnosis of peripheral pulmonary neoplasia remains controversial. Aim of the work: To assess the diagnostic yield of non-guided flexible bronchoscopy biopsy techniques in diagnosis of peripherally located bronchogenic carcinoma.Patients and Methods:This cross-sectional study was conducted on 49 out of 85 patients with confirmed bronchogenic carcinoma; they were subjected to flexible bronchoscopy forceps biopsy [FB], bronchoalveolar lavage [BAL], transbronchial needle aspiration [TBNA], and bronchial brushing [BB].Results: Diagnostic yield of bronchoscopy was positive in 40.8%. The procedures were; BAL in 26.5% of patients with positive yield in 15.0%, FB in 18.4% of patients with positive yield in 70.0%, TBNA in 26.5% of patients with no positive yield [0.0%] and BB in 18.4% of patients with positive yield in 15.0%. More than ≥6 Biopsy were taken in 79.6% and < 6 biopsies was taken in 20.4%. Lesions in the lower lobes had a high diagnostic yield [60.0%] [P0.007]. Lesions > 3cm had a diagnostic yield of 70% compared to 30 % in lesions ≤ 3 cm [P 0.001]. Cases with CT-Bronchus sign had a higher diagnostic yield [85.0%] [p 0.003]. Also, ≥ 6 Biopsy had higher diagnostic yield than those with lesions ˂ 3cm [100.0% and 34.5% respectively] [P 0.003]. The presence of bronchial lesions and its lobar locations had higher diagnostic yield.Conclusion: The diagnostic yield of bronchoscopy in peripherally locating bronchogenic carcinoma depends on a several factors, including lower lobe location, lesion size≥ 3cm, presence of CT bronchus sign, presence of bronchial lesion, and ≥ 6 biopsies.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
631
638
https://ijma.journals.ekb.eg/article_94569_5242c14323a70d646bdd89a6c615fb42.pdf
dx.doi.org/10.21608/ijma.2020.28841.1120
Study of Sexual Dysfunction among Females with Combined Oral Contraception [COC] versus Intrauterine Hormonal Device
Alaa
Talaat
Department of Obstetrics and Gynecology, Mansura General Hospital, Ministry of Health, Egypt
author
Abdelraouf
Oun
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Waleed
Ayad
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Sexuality in females is a multidimensional issue of psychological, physiological and cultural components. Evaluation of sexual partner, intimate relationships, and past abusive relationships or sexual trauma is crucial in female sexual dysfunction (FSD). Aim of the work: The present study was designed to evaluate the sexual dysfunction among female using combined oral contraception and a hormone releasing intra-uterine device [IUD] as a method of contraception.Patients and Methods:This was observational study which was conducted on 80 women to show the effect of contraception on sexual dysfunctions from February 2019 to last of August 2019. This study includes two groups; Group I: 40 women on combined oral contraceptives [COC] and group II: 40 women on hormonal intrauterine device. All females had been assessed for different domains of sexual function by Female Sexual Function Index [FSFI] questionnaire. Results: Age, parity and body mass index were comparable between both groups; group I [COC] and group II [IDU]. On the other side, females on COC had lower sexual function index (49.4±4.15) than women with hormonal IUD (67.27±6.88). These results confirmed on nearly all domains of FSFI. Thus, sexual dysfunction is significantly higher among COC group. Conclusion: Intrauterine hormonal device contraception is better than combined oral contraception (COC) which has little side effect and has better results on sexual desire, arousal, lubrication and satisfaction in addition to little effect on sexual pain than combined oral contraception.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
639
644
https://ijma.journals.ekb.eg/article_92795_5b47013d51d9c6da1a29db0b5c22a5a2.pdf
dx.doi.org/10.21608/ijma.2020.22039.1077
Effect of Inhaled Corticosteroids on Blood Glucose Homeostasis in Asthmatic Children
Alshaimaa
Essam
Department of Pediatrics, Faculty of Medicine, Mansura University, Egypt
author
Mohamed
Abdel-Aal
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Hesham
Abd Al-samee
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Asthma is a common disease especially in kids. The development of asthma symptoms appears to involve a combination of genetic predisposition and environmental factors. There are many medicines for asthma management, the most important of which is corticosteroid. High doses of inhaled corticosteroids can be associated with hyperglycemia risk increase. Aim of the work: To detect the effect of inhaled corticosteroids on blood glucose homeostasis in asthmatic children.Patients and Methods:This study was conducted at pediatric inpatient and outpatient clinic of New Damietta Al-Azhar University Hospital in the period from September 2018 to September 2019, included 90 asthmatic children chosen randomly, 55 of them were males and 35 of them were females, aged from 2 to 12 years, For each child, the demographic data were collected, divided into three groups according to type of treatment, group I [using ICS only for more than 3 months], group II [using SCS] and group III [using ICS & SCS].Results: Regarding WBCs and its differentiation there was a significant increase in WBCs [7.8±2.1] and eosinophil [2.7±0.83] in [group III] more than [group I]; WBCs [5.8±2.2] and eosinophil [1.4±0.6] and [group II]; WBCs [6.4±2.0] and eosinophil [1.5±0.7]. Regarding blood glucose, [group I] mean value was [89.6±22.8]; [group II] was [91.6±17.3]; [group III] was [104.4±36.1]. There was statistically significant difference between group I with III and group II with III [P2: 0.032 and P3: 0.043].Conclusion: Blood glucose level increased in children using both inhaled and systemic corticosteroids and it was significant statistically.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
645
649
https://ijma.journals.ekb.eg/article_94398_32d6ac199674491ef3be302aecd9a648.pdf
dx.doi.org/10.21608/ijma.2020.22691.1083
Polymerase Chain Reaction versus Slit Skin Smear in Diagnosis of Leprosy; A Cross Sectional Study
Nehal
Mostafa kamel
Department of Dermatology, elsenbellawin General Hospital, Ministry of Health and Populations, Egypt
author
Osama
Hashem
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Hassan
Khodair
Dermatology Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Hesham
Abd El-Samee
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Leprosy is a chronic infectious disease where delay in diagnosis or treatment can lead to deformities and disabilities for the rest of the patient’s life. Definite diagnosis of leprosy has long been based on clinical picture, histopathology and/or the detection of acid-fast bacilli (AFB) from tissue smears or tissue sections stained by Ziehl-Neelsen. Aim of the work: We evaluatedin this study, the usefulness of PCR for detection of M.leprae in the serum, as less invasive technique, in comparison to skin slit smear for the diagnosis of leprosy.Patients and Methods:This study included 30 non-treated patients of leprosy (9 multibacillary, 21 paucibacillary) skin slit smears had been taken. In addition, serum samples had been collected for polymerase chain reaction [PCR] test.Results: Negative Slit Skin Smear for AFB had been obtained in 20 cases with a rate of positivity of 33%. Serum PCR was positive in 20 patients giving an overall rate of positivity of 67% which confirm the diagnosis in 11 out of 20 cases with slit skin smear [SSS] negative.Conclusion: PCR does show to be more sensitive than slit skin smear [SSS] indicating its future use for diagnostic purposes especially in early leprosy cases.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
650
654
https://ijma.journals.ekb.eg/article_95155_df7d2591321b063515d1b1a18de449c3.pdf
dx.doi.org/10.21608/ijma.2020.30181.1126
Comparative Study between Sertraline and Omega-3 Supplementation in The Treatment of Uremic Pruritus in Hemodialysis Patient
Mohamed
Elghareib
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Ibrahim
Fouda
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Hassan
Khodair
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
author
Ahmed
Al-Adl
Department of Internal Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: Pruritus in uremic patients decreases the quality of life because of sleep disturbances, depression and anxiety, thus, pruritus remains an important health issue in ESRD patients. Aim of the work:To evaluate the efficacy and safety of sertraline versus omega 3 supplementation in the treatment of uremic pruritus.Patients and Methods:This randomized case control study was conducted on patients with ESRD patients .All studied subjects had been collected from the Al-Azhar hospital [Damietta] Dialysis Center. This study had been carried out on 50 patients divided into: Group [A] : consists of 25patients had been received 50 mg sertraline twice a day for 8 weeks. Group [B]: consists of 25 patients and had been receive 3 gm omega-3 daily.Results: Although pruritus severity decrease significantly in both groups and both scoring systems [P<0.001], the reduction was significantly more in sertraline group [p Conclusion: Omega-3 fatty acids found to be effective in decreasing of uremic pruritus. So, it seems that Omega-3 fatty acids could be used as an efficient drug for treatment of pruritus in uremic patients. The present study showed that low-dose sertraline was effective for antihistamine-refractory uremic pruritus than omeg3 in renal palliative care patients.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
655
660
https://ijma.journals.ekb.eg/article_95625_aa242e2125c6a95e5a740ceee9c90304.pdf
dx.doi.org/10.21608/ijma.2020.31065.1127
Magnesium Sulfate versus Nitroglycerin in Controlled Hypotensive Anesthesia in Middle Ear Surgeries
Tawfik
Noor El-Din
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo.
author
Mahmoud
Madian
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Assuit
author
Eman
Salem
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo for girls
author
Ahmed
Hamed
Anesthesia and ICU Department, Faculty of medicine, Alazhar university Damietta
author
text
article
2020
eng
Background: Controlled hypotension is required for middle ear surgeries to achieve a bloodless operative field and improve its quality, both magnesium sulfate and nitroglycerine used to produce deliberate hypotension. Aim of the work: This study aimed to compare the efficacy of magnesium sulfate and nitroglycerin in inducing controlled hypotensive anesthesia as a primary outcome and using propranolol if tachycardia occurred as a secondary outcome, in middle ear surgeries.Patients and Methods:The study was carried out on 40 adults’ patients were randomly classified into two equal groups, twenty patients each: Group [M]: Received an intravenous [IV] bolus of magnesium sulfate 30 mg/ kg in 100 ml saline over 10 min followed by infusion of 10 mg/kg/h. Group [N]: Received nitroglycerin IV infusion 0.5-10 mcg/kg/min.Propranolol 1- 2.5 mg IV had been given to both groups if there was tachycardia.Results: Both drugs induced hypotension with statistically significant difference in systolic and mean blood pressure [BP] and there was highly significant increase in heart rate [HR] in nitroglycerin more than magnesium sulfate and high doses of propranolol were administrated in nitroglycerine group. Postoperative pain was significantly increased in nitroglycerin than magnesium sulfate groups which had more analgesic effect.Conclusion: Both drugs induced hypotension. However, magnesium sulfate was better as it provided optimum surgical field, less tachycardia, need less dose of propranolol with less post-operative pain in comparison to nitroglycerin
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
661
667
https://ijma.journals.ekb.eg/article_100625_83faff5cbb13db8ce21f129b16c0e34b.pdf
dx.doi.org/10.21608/ijma.2020.23757.1098
Effect of Sublingual Misoprostol Prior to Insertion of Intrauterine Device in Women with no Previous Vaginal Delivery
Zeinab
Elgharbawy
Department of Obstetrics and Gynecology, Port Fouad General Hospital, Ministry of Health and Populations, Egypt
author
Abd Elraouf
Oun
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
author
Waleed
Ayad
Department of Obstetrics and Gynecology, Dameitta Faculty of Medicine, Al-Azhar University, Egypt.
author
text
article
2020
eng
Background: The intrauterine device [IUD] is a safe and effective method of contraception, fear of pain during insertion discourages some providers to recommend IUDs to women with no previous vaginal delivery. Aim of the work:The aim of the study is to evaluate sublingual misoprostol 200µg on the cervix one hour before IUD insertion; to facilitate IUD insertion in women with tight cervix or in whom did not deliver vaginally.Patients and Methods:The study was a double blinded randomized controlled trial, compared sublingual 200µg misoprostol with placebo. The study included 260 cases attended the Gynecology Clinic [Al-Azhar University Hospital] from December 2018 to November 2019. All females signed an informed written consent, and then have been randomly divided into 2 groups using a closed envelope technique. Every female had been asked to take the drug sublingually then return after one hour to insert her IUD. Group A included 130 females who used sublingual misoprostol 200µg [Misotac] and group B included 130 females who took a placebo one hour before IUD insertion [Control group].Results: IUD and uterine sound insertion was unsuccessful in 8.5% of group A versus 13.8% in group B while it was successful in 91.5% of group A versus 86.2% in Group B. Among the successful cases, 88[73.9] were easy in group A versus 77[68.8] in group B. On the other hand, 31[26.1%] and 35[31.2%] were difficult in group A and B respectively. With no significant difference between both groups either in IUD or uterine sound insertion successful or easiness rate [p=0.17 & 0.38 respectively]Conclusion: Using of misoprostol to facilitate IUD insertion in women with tight cervix, has no role in pain reduction or increase the ease of IUD insertion, although results with misoprostol are superior to placebo, but the different did not reach statistical significance
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
668
673
https://ijma.journals.ekb.eg/article_85217_a43d554a8352744febd5205f0d03a6c4.pdf
dx.doi.org/10.21608/ijma.2020.22013.1075
Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients
Osama
Refaat
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2020
eng
Background: Obstructive sleep apnea (OSA) is a common and challenging health problem, especially in adults, as it is the second most common disease related to sleep. Surgical treatment plays an important role in management of OSA. However, the optimal procedure is not yet determined. Aim of the work: To compare between modified hyoid bone suspension and midline glossectomy in management of OSA due to hypopharyngeal obstruction.Patients and Methods:40 patients with OSA due to hypopharyngeal obstruction were randomly assigned to either modified hyoid bone suspension (group A; 20 patients) or midline glossectomy (group B; 20 patients). All had been assessed by full history, clinical examination and Lab investigations and underwent pre-assigned surgical intervention. Indicators of OSA such as minimal oxygen saturation, Apnea hypopnea Index [AHI] and Epworth Sleepiness Scale [ESS] had been measured preoperatively and 6 months after surgery.Results: The studied groups were comparable as patient characteristics and preoperative data. However, hyoid suspension was associated with significant decrease of AHI [16.67±6.06 vs 20.72±4.41] and ESS [9.10±2.42 vs 11.20±2.33]. Also, minimal oxygen saturation improved significantly in group A than group B. The percentage of responders increased significantly in group A (75.0% vs 40.0% respectively).Conclusion: Modified hyoid suspension is superior than the midline glossectomy, as a safer and more effective procedure for treatment of OSA due to hypopharyngeal obstruction.
International Journal of Medical Arts
Al-Azhar University (Damietta), Faculty of Medicine
2636-4174
2
v.
3
no.
2020
674
681
https://ijma.journals.ekb.eg/article_106003_1fd50e7dfa1f070a5d84bd0869d9acd6.pdf
dx.doi.org/10.21608/ijma.2020.106003