Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Ultrasound in Suspected Pneumonic COVID-19: Our Experience
682
689
EN
Atef
Alrifai
Department of Chest Diseases and Allergy, Damietta Faculty of Medicine, Al-Azhar University, Egypt
atefchest@gmail.com
Fathiya Mostafa
El-Raey
Department of Hepatology, Gastroenterology and Infectious Diseases, Damietta Faculty of Medicine, Al-Azhar University, Egypt
faresmd76@yahoo.com
Ahmed M.
Yousef
0000-0003-2226-8684
Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt
ahmed.mayousef@domazhermedicine.edu.eg
Samy
Zaky
0000-0003-4123-9221
Department of Hepatology, Gastroenterology, and Infectious Diseases, Faculty of Medicine for Girls, Al-Azhar University, Egypt
samyzs55@yahoo.com
10.21608/ijma.2020.43493.1176
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> Coronavirus disease-19 [COVID-19] is a pandemic spreading all over the world. The novel corona virus has a specific tropism for the low respiratory airways causing viral pneumonia. Early diagnosis of suspicious COVID-19 pneumonia represents a pillar for immediate management. Computed tomography [CT] scan is considered the gold-standard screening tool, but it has several limitations. A chest ultrasound could play a role in COVID-19</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">To evaluate the role of lung ultrasound [LUS] in diagnosis of suspicious COVID-19 pneumonia.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Sixty patients with suspected COVID-19 pneumonia were included. They were initially evaluated in triage and initial diagnosis [Al-Azhar University Hospital; Damietta] and followed up by the surveillance and infection control team till the final diagnosis or discharge from isolation hospitals. All were evaluated clinically, by imaging modalities [LUS, chest computed tomography [CT]] and diagnosis confirmed by polymerase chain reaction. Data of LUS and chest CT compared to results of PC</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">R.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> LUS had sensitivity of 88.2%, specificity of 11.5%, PPV of 56.6%, NPV of 42.8% and overall diagnostic accuracy of 55.0%. on the other side, CT scan had 94.1%, 3.85, 56.14%, 33.33% and 57.0% for sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy, successively. Results of LUS are slightly lower than CT.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">US is a useful screening and monitoring tool in suspected COVID-19. It is feasible, portable with an accepted rate of sensitivity. However, it is advisable to be used as an integrated diagnostic too<span style="font-size: xx-small;">l.</span></span>
COVID-19,lung ultrasound,pneumonia,Screening,Diagnosis
https://ijma.journals.ekb.eg/article_117961.html
https://ijma.journals.ekb.eg/article_117961_748ed8ec20d5786e04e0103923196acb.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Mini-transverse Incision using Swivel Knife for Treatment of Carpal Tunnel Syndrome: An innovative Idea and Preliminary Report "Amin’s technique"
690
697
EN
Mahmoud
Ahmed
Amin
Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
mahmoudplastic1968@gmail.com
Sherief M.
Al shazly
Department of Neurology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
sheriefshazly15@domazhermedicine.edu.eg
10.21608/ijma.2020.36429.1149
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> Carpal tunnel syndrome [CTS] is the commonest entrapment neuropathy of the upper limb. Different treatment modalities [conservative and surgical] are present. Each has its advantages and disadvantages. No consensus is found about the ideal surgical treatment modality. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> To introduce an innovative use of swivel knife with mini-transverse incision in median nerve release. Also to compare the study results' to the conventional approach. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and methods: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Seventy patients included in the study. All had confirmed diagnosis of CTS and scheduled for surgical treatment. The new technique using the</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Swivel Knife has operated on 35 patients [study group] and the traditional technique was done for 35 patients [control group]. All patients have been assessed clinically and by neuro-physiological studies [preoperatively, and at 3 months postoperatively]. Both groups were compared regarding patient demographics and all preoperative data.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> Significant postoperative findings were superior in the study group. Results in the study group showed a reduction of operative time, incision length, Levine score and pain score at 3 months [0.23±0.43 vs 0.89±1.21 respectively, p < 0.05]. In addition, study group was associated with higher safety and patient satisfaction. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Introduction of swivel knife with mini-transverse incision just proximal to distal wrist crease is an effective and safe. This technique could be promising alternative option for surgical treatment of CTS.</span>
Swivel Knife,Mini-transverse,Median nerve,Carpal tunnel syndrome,Neurophysiological
https://ijma.journals.ekb.eg/article_112806.html
https://ijma.journals.ekb.eg/article_112806_4677844322e92453dfb5d262362d8096.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Comparative Study of Electrosurgical Bipolar Vessel Sealing Using Ligasure versus Conventional Suturing for Total Abdominal Hysterectomy
698
704
EN
Mohamed
Anwar
Mohamed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mohaanwar348@gmail.com
Samia
Mohamed
Eid
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
samiamohamad11@gmail.com
Waleed
Ahmed
Ayad
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
waled.ayad@domazhermedicine.edu.eg
Abdelrahman
Ali Hassan
Emam
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
abdelrahmanali83@domazhermedicine.edu.eg
10.21608/ijma.2020.22113.1079
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Hysterectomy is a common gynecological surgical intervention, which could be associated with increased female morbidity and mortality. Bleeding and pain represent two main complications associated with hysterectomy. Hemostatic measures are in a continuous development, and LigaSure could represent one of the most important milestones in this field</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">To compare LigaSure use versus conventional suturing in total abdominal hysterectomy.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Seventy patients who were scheduled for elective hysterectomy were included. They were assigned to equal groups [Ligasure [A] and Conventional suturing [B]]. All were screened preoperatively, prepared and both intra-and post-operative outcome were registered and compared between both groups [mainly blood loss and postoperative pain]</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> Both groups were comparable as regard to patient age, body mass index, parity, and indications for hysterectomy. Operative time was significantly reduced among vessel sealing when compared to conventional group [54.9±6.7 vs 63.1±6.6 minutes respectively]. In addition, vessels sealing group was associated with significantly low blood loss [142.7±23.1 vs 285.7±28.4 ml], high postoperative hemoglobin [11.3±1.0 vs 11.0±0.9], low hemoglobin reduction, and significant reduction of postoperative pain at evening, first and second postoperative days and low need for analgesia.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Electrosurgical bipolar vessel sealing is an effective alternative to sutures in abdominal hysterectomy. It is associated with significant operative time shortening, low blood loss and low postoperative pain<span style="font-size: xx-small;">. </span></span>
Hysterectomy,Bleeding,Ligasure,Sutures,Complications
https://ijma.journals.ekb.eg/article_101120.html
https://ijma.journals.ekb.eg/article_101120_a95cefcba61c4db4f9eef02b751f8311.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Spinal Versus Caudal Anesthesia in Lower Abdominal Surgeries in Pediatrics
705
711
EN
Ahmed
Atya
Al-Kershawy
Departments of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, Damietta
ahmedatya1192@gmail.com
Tawfik
Mohamed
Noor El-Din
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo.
tawfeeknoor59@gmail.com
Mahmoud
Ahmed
Abd-Elsalam
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Asiut.
dr_mahmoud_278@yahoo.com
Hany
Said
Ismail
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo.
hanysaid.icu@gmail.com
10.21608/ijma.2020.23762.1099
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Regional anesthesia in pediatric surgery alone or combination with light general anesthesia provides several advantages, the most significant is intra- and post-operative pain relief</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> This study aimed to compare spinal to caudal anesthesia in children undergoing lower abdominal surgeries regarding [sensory and motor block as a primary outcome], hemodynamics and postoperative pain as a secondary outcome<strong>.</strong></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="color: #2b3942; font-family: 'Arial Narrow'; font-size: xx-small;">T</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">his study was a prospective randomized comparative clinical single-blind study. It included 40 children [ASA I or II] of both sexes, aged [3-9 years] undergoing lower abdominal surgeries. Patients were randomly assigned into one of two groups [20 patients in each group]. group [S] undergo spinal anesthesia, group [C] undergoes caudal anesthesia. To assess the following parameters; sensory and motor block, heart rate, mean arterial blood pressure and postoperative pain.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> Spinal anesthesia has a rapid onset of sensory block, more intensity than caudal anesthesia, but of shorter duration. Caudal anesthesia provides more time of motor block than spinal anesthesia. There was no statistically significant difference between groups regarding mean arterial pressure, but caudal anesthesia has more tachycardia than spinal anesthesia, and caudal anesthesia provides better postoperative analgesia more than spinal anesthesia</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Regional anesthesia in pediatrics is an effective and safe option. Caudal and spinal are both effective, however caudal have relatively more duration of postoperative analgesia and motor block than spinal anesthesia<span style="font-size: xx-small;">.</span></span>
Anesthesia,caudal,spinal,Pediatrics,Surgery
https://ijma.journals.ekb.eg/article_103310.html
https://ijma.journals.ekb.eg/article_103310_9aca7deb8f03cc26adaba099c59f35ce.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Hearing Screening in Neonates of Pre-eclamptic Mother
712
717
EN
Hend
Abdelfattah
Amer
Resident of Audiovestibular Medicine, Department of Otorhinolaryngology, Audiovestibular unit, Kafrelsheikh General Hospital, Ministry of Health, Egypt
dr.hendabdelfattah@gmail.com
Amal
Elsebaie
Beshr
Department of Otorhinolaryngology, Audiovestibular Unit, Faculty of Medicine for Girls, Al-Azhar University, Egypt
beshramal2002@yahoo.com
Takwa
Gaber
Department of Otorhinolaryngology, Audiovestibular Unit, Faculty of Medicine, Kafrelsheikh University, Egypt
takwagabr@gmail.com
Iman
Eladawy
0000-0003-1108-1013
Department of Otorhinolaryngology, Audiovestibular Unit, Faculty of Medicine for Girls, Al-Azhar University, Egypt
loay_sameh@yahoo.com
10.21608/ijma.2020.32175.1136
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">The incidence of congenital sensorineural hearing loss in the new-born is higher than the combined incidence of all the metabolic conditions that we currently screen for with blood tests, the tool we are using, and the timing of screening are very important</span><span style="font-family: 'Arial Narrow'; font-size: small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">To evaluate the possible effects of pre-eclampsia on the neonate’s hearing and determine the best timing to perform the screening.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Seventy neonates were included, they were divided into two groups: control group included 40 neonates born to healthy mothers and study group included 30 neonates born to pre-eclamptic mothers. All neonates in this study subjected to the following: screening with handheld transient evoked otoacoustic emission [TEOAEs] within the first 48 hours after delivery. Infants who failed the first TEOAEs, were re-examined two weeks later. If failed, they were re-examined for the third time with TEOAEs two weeks later.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> There were statistically significant difference between the study and the control group as regards the TEOAES results (p-value = 0.001) in the first and second screening tests. In the control group, 73.8% passed from the first time, versus 41.7% of the study group. In the second TEOAEs, 17.5% control versus 41.7% of the study group.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Preeclampsia has some temporary effect on hearing in the newborns of pre-eclamptic mothers. So, it’s better to postpone the first neonatal hearing screening of these babies, to be performed 2 weeks after delivery<span style="font-size: small;">. </span></span>
Auditory Brain-stem Response,Otoacoustic emissions,Transient Evoked Otoacoustic Emission,preeclampsia,New-born,Hearing Screening
https://ijma.journals.ekb.eg/article_104412.html
https://ijma.journals.ekb.eg/article_104412_3582f7d3974344e656e651e2ab9a9b8a.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
718
721
EN
Nabeel
Joda
Kuwaijo
00353864559955
Department of Urology, Galway Clinic, Royal College of Surgeons, Ireland
dr_kwaijo@yahoo.com
Mohammed
Sayed
AbiElmagd
Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland
mohammedaboelmagd@mater.ie
Nicholas
Hegarty
Department of Urology, Mater Misericordiae University Hospital, Dublin, Irel
nick.hegarty@gstt.nhs.uk
Kiaran
O'Malley
Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland
kiaranomalley@mater.ie
Thomas
Lynch
Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland
lynchsec@joycelynch.ie
10.21608/ijma.2020.27024.1116
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Anatomical abnormalities in kyphoscoliosis [KS] is a huge challenge in patient positioning for robotic prostatectomy. The narrow pelvis limits the range of movement of the robotic instruments’ and port placing could be an issue. Second, carful preoperative assessment prior to administration of anesthesia and pneumoperitoneum in robot-assisted radical prostatectomy [RRP] is crucial to reduce peri-operative cardio-pulmonary complications. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">The Case:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> We report a successful use of robot in a patient with sever kyphoscoliosis for radical prostatectomy. He was a 58 years old male, overweight, with KS and </span><span style="font-family: 'Arial Narrow'; font-size: small;">history of cardiac stenting, bilateral total hip replacement. He had </span><span style="font-family: 'Arial Narrow'; font-size: small;">prostatic carcinoma. He is on antihypertensive medications, statins and bronchodilator inhalers. Auscultation revealed bronchovascular breathing with left base inspiratory crepitation. He was </span><span style="font-family: 'Arial Narrow'; font-size: small;">Mallampati </span><span style="font-family: 'Arial Narrow'; font-size: small;">score III [difficult intubation], recurrent chest infection, and severe restriction of respiratory function. The management had been performed under general anesthesia, in the</span><span style="font-family: 'Arial Narrow'; font-size: small;"> supine-Trendelenburg-Lithotomy position before engaging the robot. The operative intervention showed stability of the patient except an episode of hypertension [an hour after starting surgery]. The total operative time [3 hours, 50 minutes]; the patient then transferred to intensive treatment unit for the next 12 hours. Postoperatively, backache is absent, d</span><span style="font-family: 'Arial Narrow'; font-size: small;">rain removed 24 hours later; patient discharged after 48 hours, and catheter removed 10 days later. Histological examination showed adenocarcinoma of prostate, 35% of the gland with negative surgical margin.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">We confirmed that, robotic assisted radical prostatectomy could be handled in <span style="font-size: small;">Kyphoscoliosis,</span><span style="font-size: small;">Ankylosing Spondylitis with satisfactory outcome, irrespective of both technical and anaesthetic difficulties</span></span>
Robotic,Radical Prostatectomy,Kyphoscoliosis,Ankylosing spondylitis,Case Report
https://ijma.journals.ekb.eg/article_100628.html
https://ijma.journals.ekb.eg/article_100628_e80ebeadcbff06f40d16a1f29386f8b4.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Prevalence and Manifestation of Ototoxic Medications Among the Adult Attendees of The Audiovestibular unit at Al-Zahraa University Hospital, Cairo, Egypt
722
729
EN
Iman
Ibrahim Mohamed
Eladawy
0000-0003-1108-1013
Department of Otorhinolaryngology, Audiovestibular Unit, Faculty of Medicine for Girls, Al-Azhar University, Egypt
loay_sameh@yahoo.com
Amal
Abdel Majid
Ahmed
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University, Egypt
amal.mohamed53@yahoo.com
Samia
Barghash
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University, Egypt
samiasolom@yahoo.com
Hanaa
Abu Elhassan
Department of Community Medicine, Faculty of Medicine for Girls, Al-Azhar University, Egypt
hanaaabouelyazid@azhar.edu.eg
10.21608/ijma.2020.33846.1140
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Hearing loss is considered to be one of the most common factors of moderate to severe disability specially in the developing countries. Ototoxicity is inner ear damage due to usage of chemical substances, which can lead to either reversable or permanent hearing loss and/or vestibular loss. Ototoxic hearing impairment can impact the quality of life by many ways; therefore, we should be very careful when it comes to choose drug therapy to minimize the risk</span><span style="font-family: 'Arial Narrow'; font-size: small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">To identify the commonly implicated ototoxic medications among the adult Egyptian population and to study its presenting features.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> This is a retrospective study, that involved review for the medical notes of all adult patients, who attended the Audio-Vestibular Unit with otological problems between January 2014 and December 2018. A total of 1110 medical folders were reviewed, and data were manually extracted.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> The prevalence of ototoxic medication among the adult attendees was 26.6%. The most common manifestation was hearing impairment, as it was reported in 83.2% of the cases. Tinnitus came second by 70% followed by vertigo in 31%. Aspirin was the most common drug used [44.7%] of the patients, followed by aminoglycoside in 15% of our study sample, then the non-steroidal anti-inflammatory drugs (NSAIDS) in 14.3%.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Audiometric screening is critical to capture the true prevalence of hearing loss. Baseline audiometric and vestibular function test should be performed before prescribing any ototoxic medication especially in patients with other associated risk factors</span>
Ototoxicity,Hearing Impairment,Tinnitus,Vertigo,Hearing Screening
https://ijma.journals.ekb.eg/article_104413.html
https://ijma.journals.ekb.eg/article_104413_9abdd5d976d38ebafdc678a0f0162244.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Simultaneous Open Radical Bilateral Nephroureterectomy and Cystoprostatectomy
730
735
EN
Nabeel
Kuwaijo
00353864559955
Consultant Urologist, The Galway Clinic - Royal College of Surgeons in Ireland
dr_kwaijo@yahoo.com
Megan
Ramsey
Trainee of Histopathology, The Mater Misericordiae University Hospital Dublin Ireland
meganramsey@rcsi.ie
Kiaran
O'Malley
Consultant Urologist, The Mater Misericordiae University Hospital Dublin Ireland
kiaranomalley@mater.ie
Georgina
Flood
Chair– Division of Anesthesia, Mater Misericordiae University Hospital, Ireland
gflood@mater.ie
10.21608/ijma.2020.27025.1117
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> </span><span style="font-family: 'Arial Narrow'; font-size: small;">Synchronous bilateral urothelial tumours of the upper urinary tract are extremely rare. However, their treatment is a real challenge for urologists. Patient with low grade superficial urinary bladder tumour can be treated by endoscopic procedures. But they need to be put onto a surveillance programme for superficial bladder cancer. In the case of high grade, invasive or large volume or multifocal tumours, radical bilateral nephroureterectomy with cystoprostatectomy is considered the standard of care. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Here, </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">We present a case of multifoci high grade tumour of bilateral renal pelvis and ureters in a patient with history of high grade superficial bladder cancer who was treated endoscopically for thirteen years. Most recently, bladder growth recurred aggressively and widely over the last six months and this was treated by single-stage Simultaneous Open Radical Bilateral Nephroureterectomy and Cystoprostatectomy. <strong><span style="font-size: small;">Our aim</span></strong><span style="font-size: small;"> was not only to present the operative technique but also to show that the procedure is safe and effective modality of treatment<span style="font-size: small;">. The open approach was preferred due to its advantage of shorter operative time. In addition, the decision was based on team consultation [Patients, Surgeon and Anesthetist]. The outcome was satisfactory and safe. Thus, the one setting [simultaneous] open approach is considered safe and effective. However, we do not against laparoscopic approach, but we encourage individualization [case by case] of the procedure for each patient according his clinical situation and after counselling of all members of the team. </span></span></span>
Simultaneous,Radical,Nephroureterectomy,Prostatectomy,Cystoprostatectomy
https://ijma.journals.ekb.eg/article_101121.html
https://ijma.journals.ekb.eg/article_101121_7fe6f3db792af0b06d8884a82d256396.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Effect of Zinc Supplementation on Serum Bilirubin Level in Term Neonates Undergoing Phototherapy
736
740
EN
Mahmoud Eldesoky
Ibrahim Eldesoky
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
mahmoudeldesoky707@gmail.com
Mohamed Ibrahim
El-Samannody
27801011202238
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mohamed_elsamanody@yahoo.com
Magdy
Zaky
Elghannam
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mzm.alghannam@domazhermedicine.edu.eg
Mohamed Mohamed
Elmazahy
Department of Pediatrics, Damietta Faculty of Medicine, Al-Azhar University, Egypt
m_mazahi@hotmail.com
10.21608/ijma.2020.31551.1131
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Neonatal jaundice is considered a major health problem in neonates owing to bilirubin deposition. Recently, zinc demonstrated a high efficiency in reduction of low bilirubin level when administrated in association with phototherapy.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To </span><span style="font-family: 'Arial Narrow'; font-size: small;">assess efficiency and safety of oral zinc as a therapy in treatment of indirect hyperbilirubinemia in term neonates during phototherapy.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">A total of 100 term neonates with indirect hyperbilirubinemia were divided into two equal groups: Intervention Group (n=50) received oral zinc sulphate preparation, in a dose of 5 mg twice daily in combination with phototherapy. Control group (n=50) received phototherapy without oral zinc supplementation. In both groups, the total serum bilirubin levels were measured at admission, 12 hours, 24 hours and at discharge.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Treatment of full-term neonates with hyperbilirubinemia by oral zinc sulfate at a dose of 5 mg given twice-daily induce a significant reduction of total serum bilirubin [TSB] after 12 hours, 24 hours and at discharge when compared to the control group. The duration of phototherapy in intervention group was markedly decreased with statistically significant difference in comparison to the control group. However, there was no significant differences between groups regarding adverse effects of phototherapy and zinc therapy.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Oral zinc could play a major role in the management of neonatal jaundice when administrated at dose of ten mg/day as it can decrease the neonatal TSB with subsequent reduction of phototherapy duration.</span>
Neonatal Jaundice,Hyperbilirubinemia,zinc,phototherapy,Total serum bilirubin
https://ijma.journals.ekb.eg/article_103311.html
https://ijma.journals.ekb.eg/article_103311_713340e70ef4d7bf125a179a9c7b2e22.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Incidence of Nasal Polyps Recurrence Rate in Patients with Eosinophilic Esophagitis after Endoscopic Endonasal Surgery
741
748
EN
Nabil Abdelghany
Sarhan
Department of Otorhinolaryngology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
nabelent@yahoo.com
Mohamed Abdelkawi
Fathallah
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Egypt
mnegeib@yahoo.com
Ashraf Abdalla
Wahba
Department of Otorhinolaryngology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
drashrafwahba70@yahoo.com
Ahmed Mohamed
Rabie
Department of Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr.ahmed_rabie@azhar.edu.eg
Sherief Abdelmohsen
Mousa
Department of Hepatology and Gastroenterology, Asuit Faculty of Medicine, Al-Azhar University, Egypt
sherief.mohsen@yahoo.com
Ahmed Alboraey
Kabeel
Department of Hepatology and Gastroenterology, Faculty of Medicine, Al-Azhar University, Egypt
doctorkabil@gmail.com
10.21608/ijma.2020.31129.1128
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Nasal polys [NPs] are frequently encountered inotorhinolaryngology practice. It had been proposed to share etiological origin with eosinophilic esophagitis [EOE]. However, there is not yet adequate estimations of this association and incidence of NPs recurrence after endonasal surgery in patients with EOE. <strong> </strong></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To evaluate incidence of recurrence of NPs after endoscopic endonasal surgery for patients with EOE.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> 150 patients were included and divided into three groups: the control [CG] [50 patients indicated for gastroscopy]. The nasal polyp’s subgroups consisted of 100 patients and further subdivided into two groups according to result of nasal biopsy into two subgroups, eosinophilic nasal polyps [ENP] group IIA; non-eosinophilic nasal polyps [NENP] group IIB. In NPs subgroups, sinonasal outcome test [SNOT22] had been performed to </span><span style="font-family: 'Arial Narrow'; font-size: small;">measure</span><span style="font-family: 'Arial Narrow'; font-size: small;"> the health status and quality of life in patients with NPs through questions relating to their symptoms. The recurrence of nasal polyps were investigated after endoscopic sinus surgery and during follow up and outcome had been compared between groups.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> 22% suffered polyp recurrence after surgery during the follow-up period. Patients with EOE had a significantly higher recurrence rate of nasal polyps [100%] in comparison to 16.4% in EOE patients. These results indicate that, </span><span style="font-family: 'Arial Narrow'; font-size: small;">mucosal</span><span style="font-family: 'Arial Narrow'; font-size: small;"> eosinophilia is a determinant factor in the recurrence of nasal polyps. Hence in patients with EOE [had mucosal eosinophilia] who underwent endonasal surgery, the recurrence of nasal polyps should be highly expected.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Mucosal eosinophilia in patients with EOE, and ENP are a more important prognostic factor in recurrence of nasal <span style="font-size: small;">polyps<span style="font-size: small;">.</span></span></span>
Nasal polyps,Eosinophilic esophagitis,Allergic Rhinitis,Eosinophilia,Sinonasal Outcome Test
https://ijma.journals.ekb.eg/article_104654.html
https://ijma.journals.ekb.eg/article_104654_517c4e2e6ebb0a53e1196e45e42d672e.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Impact of Ischemic Cardiomyopathy on Right Ventricular Function using Speckle Tracking Echocardiography
749
756
EN
Abdelmohsen Mostafa
Aboualia
0000-0001-6618-6918
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
abdelmohsen1@hotmail.com
Eman Rashed
Zaky
Department of Cardiology, Faculty of Medicine for Girls, Al-Azhar University, Egypt
emanrashed791@yahoo.com
10.21608/ijma.2020.31638.1132
Background: Ischemic cardiomyopathy [ICM] refers to the reduced pumping ability of the heart due to damage of myocardium as a result of ischemia. Thus, early detection of coronary artery disease could save the myocardium. Speckle tracking emerged as a new diagnostic tool, but its role in ischemic cardiomyopathy is not well addressed. Aim of the work: To assess right ventricle [RV] function by two-dimensional [2D] speckle tracking imaging in patients with ICM. Patients and Methods: This study included 38 patients with ICM and 30 healthy subjects as a control group. Conventional echo-Doppler parameters of right ventricular function together with tissue Doppler imaging derived RV strain and speckle-tracking echo-derived RV global strain [STE-RVGST] were addressed. Results: The two groups were matched in age and sex. ICM had significantly higher values of LV Tei index [0.90±0.28] versus control group [0.51±0.13] with p value
cardiomyopathy,speckle tracking,Right Ventricle,ischemia,Coronary Artery Disease
https://ijma.journals.ekb.eg/article_104655.html
https://ijma.journals.ekb.eg/article_104655_1e9cf062f186ce0e2824950fa9f49471.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Serum 25-hydroxyvitamin D concentration in Children with Lower Respiratory Tract Infection
757
762
EN
Asmaa Salah
Barania
Department of Pediatrics, Damanhour Teaching Hospital, Ministry of Health, Egypt
asmaabarania2@gmail.com
Elbakry Mohammed
Tharwat Elbakry
Department of Pediatrics, Damietta Faculty of Medicine Al-Azhar University, Egypt
drbakry1@gmail.com
Hany Abdel-Hady
El-khaleegy
Department of Pediatrics, Damietta Faculty of Medicine Al-Azhar University, Egypt
hanykhaleegy@yahoo.com
Sabah
Ibrahim
Abdel-Raheem
Department of Clinical Pathology, Damietta Faculty of Medicine Al-Azhar University, Egypt
drsabahibrahim@yahoo.com
10.21608/ijma.2020.21996.1074
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Vitamin D plays a critical role in the human body. Its deficiency had been proposed to play a role in lower respiratory tract infections [LRTIs], which responsible for 18% of deaths in young children.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> The purpose of this study was to assess vitamin D concentrations in children with lower respiratory tract infections.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">After obtaining approval of the ethics committee, a prospective case control study was conducted in pediatric department, Damietta Faculty of Medicine, Al-Azhar University Hospital on children with lower respiratory tract infections and comparing 25-hydroxyvitamin D level between them and normal matched control from December 2018 to September 2019 include 140 children, Group A: 70 cases children had lower respiratory tract infections [LRTIs] either isolated pneumonia or associated with sepsis. Group B: matched with 70 healthy subjects.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> There was significant reduction of vitamin D among study group children when compared to control group [13.68±5.50 s 40.64±4.76 ng/dl respectively]. There was no significant association between type of infection and vitamin D levels. However, all children with bronchitis had sufficient vitamin D levels. There were vitamin D-deficiency in 64.3% while No one was deficient vitamin D among control group.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Children with acute lower respiratory tract infection had significant reduction in vitamin D levels. The reduction had no significant association with the type of infection.</span>
25-Hydroxyvitamin D,Lower Respiratory Tract Infection,pneumonia,bronchiolitis,bronchitis
https://ijma.journals.ekb.eg/article_105776.html
https://ijma.journals.ekb.eg/article_105776_c9bc007cc2cb113c32dc816ba06998b7.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Evaluation of The Efficacy of Argon Laser in Treatment of Xanthelasma Palpebrarum using Ultrasound Biomicroscopy
763
769
EN
Essam
Khalaf
Mohamed
Ophthalmology Department, Police Hospital, Ministry of Interior, Egypt
ekhalaf@gmail.com
Ahmed
Mahmoud
Amin
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Egypt
ophth.ahmedamin@gmail.com
Mohamed
Abdel Hamid
Abou El-Enin
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Egypt
m.aboelnin@gmail.com
10.21608/ijma.2020.106840
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Xanthelasma palpebrarum [XP] is the most common of the xanthomas with asymptomatic, symmetrical, bilateral, soft, yellow, polygonal papules around the eyelids. The surgical laser offers an extremely elegant and powerful solution to this problem</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">To evaluate the efficacy of Argon Laser in treatment of xanthelasma palpebrarum, based on ultrasound biomicroscopy [UBM]. </span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Preoperatively, full history and clinical examination had been carried out.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">The study included 45 eyelids of 27 patients [13 males and 14 females] presenting with xanthelasma lesion. They underwent single session treatment of XP by Argon Laser, which had been performed on an outpatient basis. Postoperative UBM had been used to ensure eradication of the lesion. Follow up of the patient every 2 weeks in the first month then after 6 months]. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> The UBM was successfully used preoperatively to determine the maximal lesion thickness that can be effectively safely eradicated in only single session. The therapy was well tolerated, and all lesions responded to the therapy in only single session. There were no functional or relevant aesthetic complications. The cosmetic outcome was considered to be excellent in 80% and good in 6.7%of the cases. The study included 45 eyelids, 36 [80.0%] of them had excellent, 3 [6.7%] had good, 2 [4.4%] had satisfactory and only 4[8.9%] patients had poor cosmetic outcome. There were no recorded recurrent cases [0.0%] in the present study.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Argon laser photocoagulation [single session] represents an alternative treatment in selected cases. It is easy to be performed well tolerated by the patients. In addition, UBM was important to determine the maximal lesion thickness that can be eradicated safely in only one session<span style="font-size: xx-small;">.</span></span>
Xanthelasma Palpebrarum,argon laser,Ultrasound Biomicrscopy,Xanthomas,Eyelid
https://ijma.journals.ekb.eg/article_106840.html
https://ijma.journals.ekb.eg/article_106840_7469ba4d85092ea6a31125c777a05cbb.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Ovarian Reserve after Laparoscopic Ovarian Cystectomy in Infertile Patients
770
778
EN
Eslam
Fathy Mahmoud
Awad
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Egypt.
eslam.f486@gmail.com
Mahmoud
Farouk Midan
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
dr-midan@hotmail.com
Waleed
Ahmed
Ayad
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
waled.ayad@yahoo.com
10.21608/ijma.2020.34932.1143
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Ovarian reserve is the key target of infertility treatment; its accurate evaluation is extremely important for outcomes prediction of in-vitro fertilization [IVF].</span><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Ovarian cysts act as a common gynecological site that occurred in 6.6% of patients between twenty-five and forty years old. When its surgical removal is indicated, stripping the ovarian cyst wall by laparoscopic approach is the technique of choice. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the Work: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">The present study was designed to evaluate ovarian reserve after laparoscopic ovarian cystectomy by using basal Follicular Stimulating hormone [FSH], Anti-Mullerian hormone [AMH], and Antral follicle count [AFC] as a marker for evaluation</span><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span></strong><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">This was an observational study which was conducted on infertile patients after laparoscopic ovarian cystectomy from the Obstetrics and Gynecology department Al-Azhar University hospital [New Damietta] from October 2018 to last of November 2019. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">AFC had been increased significantly post-cystectomy when compared to corresponding preoperative values [17.8±2.24 vs 5.57±3.16 respectively]. On the other side, both FSH and AMH significantly decreased after cystectomy when compared to preoperative values. These results are constant regardless of the type of the cyst, the surgical procedure, or its polarity. <strong> </strong></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> <span style="font-size: xx-small;">The FSH and AFC levels increased after laparoscopic cystectomy for benign ovarian cysts, indicating significant ovarian damage post operatively<strong><span style="font-size: xx-small;">.</span></strong></span></span>
Follicle Stimulating Hormone,luteinizing hormone,Antral Follicle Count,ovarian cystectomy,ovarian reserve
https://ijma.journals.ekb.eg/article_107022.html
https://ijma.journals.ekb.eg/article_107022_080adaa0e18af7a9580ff296e6636655.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Prevalence of Acne among Preadolescent School Students in Damietta Governorate
779
785
EN
Mohamed Samir Hassan
Elawady
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
m.samirelawady@gmail.com
Hassan Abou Khodair
Mohamed
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
drhassankhodair@gmail.com
Ramadan Mohamed
El-Dahshan
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
ramadandahshan@gmail.com
Ayman Ahmed
Mahmmoud
Department of Public Health, Damietta Faculty of Medicine, Al-Azhar University, Egypt
draymanahmed@gmail.com
10.21608/ijma.2020.35569.1147
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Acne is one of the commonest chronic inflammatory dermatological disease among adolescents. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the Work: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">The aim of the study was to detect the prevalence of acne among pre adolescents in primary and preparatory schools in Damietta governorate Egypt</span><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">. </span></strong><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">This was a cross sectional study, that was conducted on 1624 pre adolescents in primary and preparatory schools in Damietta governorate. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Age ranged from 8-13 years with mean value 11.44±1.680 years. Male cases were 781 [48.1%] while female cases were 843 [51.9%] and 251[65.8%] had mild acne grade, 122[31.9%] had moderate acne grade and 9[2.4%] had severe acne grade. <strong> </strong></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> <span style="font-size: xx-small;">Acne is one amongst the most common skin disease and includes a great effect on quality of life among pre adolescents attending primary and preparatory schools in Damietta governorate, the prevalence of acne vulgaris among pre adolescents in primary and preparatory schools in Damietta governorate Egypt was 23.5%.</span></span>
Acne,prevalence,Preadolescents,Pediatrics,Female
https://ijma.journals.ekb.eg/article_107181.html
https://ijma.journals.ekb.eg/article_107181_da110b5ca8f9f36e29ea22b31320611c.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Comparison between a Bare–Metal Stents and Drug Eluting Stents in patients undergoing Percutaneous Coronary Intervention.
786
792
EN
Khaled
Ramadan
Alsayed
Cardiology, faculty of medecin, Al azhar University, Assiut branch
dr.khaledramadan85@gmail.com
10.21608/ijma.2020.35338.1145
<strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Background: </span></strong><span style="color: black; font-family: 'Arial Narrow'; font-size: xx-small;">little researches have directly compared second-generation drug-eluting stents with each other or with bare-metal stents.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> To compare between outcomes after implantation of bare-metal stents [BMS] and two kinds of 2<sup>nd</sup> generation drug eluting stents [DES] [Zotarolimus-Eluting Stents [ZES], and A Everolimus-Eluting Stents [EES]] in patients undergoing percutaneous coronary intervention.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;"> 160 Ischemic Heart Disease [IHD] patients undergoing PCI with 2<sup>nd</sup> generation DES implantation [80 ZES and 80 EES] were analyzed against 50 IHD patients undergoing PCI with BMS implantation.<span style="color: black;"> Each patients group received up to 6 </span>[in BMS group] <span style="color: black;">or 24 months </span>[in ZES and EES groups] <span style="color: black;">of clopidogrel therapy. The key efficacy endpoint was the 24 months major adverse cardiac event [MACE] [death, myocardial infarction, or target lesion revascularization], whereas stent thrombosis [ST] was the safety endpoint.</span></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Results: </span></strong><span style="color: black; font-family: 'Arial Narrow'; font-size: xx-small;">The MACE rate was lowest in EES [19%; χ2= 7.661], highest in BMS [41.7%; χ2 =7.661], and intermediate in ZES [28.2%; χ2= 7.661] group with significant P Value =0.002.The 2-year incidence of ST in the EES group [1.3%] was similar to that in the ZES-S group [2.2%], whereas it was lower in contrast with BMS [7.5%] groups, with significant P value= 0.004].</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: xx-small;">DES have more efficacy and safety than BMS as EES have lowest MACE and ST rate while BMS have the highest rate and ZES have <span style="color: black;">intermediate</span> rate while the three stent groups have similar rate of mortality at 2 years follow up.</span>
Bare Metal,Zotarolimus,Eluting Stents,Major adverse cardiac events,In Stent Restenosis,Stent Thrombosis
https://ijma.journals.ekb.eg/article_107606.html
https://ijma.journals.ekb.eg/article_107606_8b9c1c1c3d00af5de46963c710e86f87.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Evaluation of The Role of Topical Cetirizine 1% in Treatment of Male Androgenetic Alopecia
793
797
EN
Hebat-Allah
Elsherbeny
Department of Dermatology, Elsarou General Hospital, Ministry of Health, Egypt
hebaelsherbeny.he@gmail.com
Hassan Abo Khodier
Mohamed
Department of Dermatology and Venereology, Faculty of Medicine (Damietta), Al-Azhar University, Egypt
pharmaismail@yahoo.com
Mohamed Shokry
Zaky
Department of Dermatology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr_m_shoukry@yahoo.com
10.21608/ijma.2020.34317.1142
<strong>Background</strong>: Androgenetic alopecia [AGA] one of the common scalp hair loss disorders affecting males. Androgenetic alopecia is characterized by progressive miniaturization of hair follicles in the scalp and gradual transformation of terminal hairs into vellus hairs leading to progressive decrease in hair density. The pattern of loss follows the scale developed by Hamilton and later extended by Norwood.<br /><strong>Aim of Work</strong>: Evaluation of the efficacy of topical cetirizine 1% for the treatment of androgenetic alopecia in male patients.<br /><strong>Patients and methods:</strong> This case-controlled study included 30 male patients treated by topical cetirizine1%and 30 male patients as a control group treated by placebo for 6 months recruited from dermatology outpatient clinic of Damietta Hospital and Al-Sarou hospital during the period from September 2018 to August 2019. For each patient, the trichoscopic evaluation was performed before the beginning of treatment and after 6 months of treatment.<br /><strong>Results</strong>: Treatment with topical cetirizine 1% in male patients with AGA showed that according to number of new up growing hairs, the majority [56.7%] of cases had no new growing hair, 20.0%, 16.7% &6.7% had one, two and three new hair respectively. On the other hands, all control had no new hair after 6 months of treatment.<br /><strong>Conclusion:</strong> Topical cetirizine is effective in the treatment of Androgenetic alopecia in men.
Alopecia,Androgenetic,Cetirizine,male,Prostaglandins
https://ijma.journals.ekb.eg/article_107623.html
https://ijma.journals.ekb.eg/article_107623_5f3378871b69b82ae166531224159fd8.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
The Value of Serum Progesterone Level at The Day of Triggering in Prediction of Intracytoplasmic Sperm Injection [ICSI] Outcome
798
804
EN
Mohamed
Ahmed
Abo khalil
0000-0002-6464-6260
Department of Obstetrics and Gynecology, El Mahalla General Hospital, Ministry of Health, Egypt
moody_310@yahoo.com
Mahmoud Farouk
Midan
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr-midan@hotmail.com
Abdel Aal Mohamed
EL-Ghandour
International Islamic Center for Population Studies and Research, Al-Azhar University, Egypt
dr.elghandour@hotmail.com
Rashed Moahmed
Rashed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
rmrashed70@yahoo.com
10.21608/ijma.2020.25117.1107
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">The potential association of serum progesterone on the day of human chorionic gonadotropin administration with the outcome of intracytoplasmic sperm injection [ICSI] cycles has been one of the major controversies in the endocrinology of ovarian stimulation. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> This study was conducted to estimate the net effect of progesterone elevation on the day of human chorionic gonadotrophin [hCG] on pregnancy outcome in women undergoing fresh embryo transfer in control ovarian stimulation using long agonist and antagonist protocols. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">This is a prospective study included a total of 177 patients who were indicated for ICSI. The included cases were divided into three groups according to progesterone level at the day of hCG. Both progesterone and E2 were estimated at the day of triggering.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Serum progesterone levels did not differ between cases who got pregnancy and who did not (p=0.435). Estrogen/Progesterone ratio was not significantly different between pregnant and non-pregnant females (p= 0.842). <strong> </strong></span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> <span style="font-size: small;">Progesterone level on the day of hCG administration does not have any effect on ICSI outcome.</span></span>
progesterone,ICSI,Estrogen/progesterone ratio,Triggering,Outcome
https://ijma.journals.ekb.eg/article_108747.html
https://ijma.journals.ekb.eg/article_108747_1330248d3eba350c57490a85fbf67886.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Surgical Treatment of Lumbar Spinal Canal Stenosis by Laminectomy and Posterolateral Fusion
805
810
EN
Mahmoud Gamal
Mahmoud
Ebrahim
Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mgs00360@gmail.com
Samir
Ahmed
Alshura
Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
samirahmed1920@yahoo.com
Mohamed
Abdallah
Hassan
0000-0001-7674-0345
Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr.mohamadabdallh@domazhermedicine.edu.eg
10.21608/ijma.2020.21393.1062
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Lumbar spinal stenosis is a common spinal disease, which lead to neural compression leading to pain, limitation of individuals function and reduced the quality of life</span><span style="font-family: 'Arial Narrow'; font-size: small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">To evaluate the results of surgical treatment of lumbar spinal canal stenosis [LCS] by laminectomy and instrumented posterolateral Fusion.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> A prospective study had been conducted at Orthopedic Surgery Department [Al-Azhar University Hospital, Damietta] to evaluate the outcomes of treatment of lumbar canal stenosis by laminectomy and posterolateral fusion. This study included 15 patients, and the average follow up was 6 months from December 2018 to May 2019. Pain, clinical and radiological outcomes had been assessed. Preoperatively, all patients had been evaluated clinical and radiologically. In addition, lab investigations had been performed to assess the patient.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> The study included 15 patients [10 females and 5 males], their age ranged between 30-55 years [mean age 42.8 years]. The surgical outcome [according to Odom Criteria] revealed that, excellent outcome reported among 26.7%, and 40% had good outcome, fair outcome among 26.7% and poor outcome among 6.7%.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Laminectomy with instrumented posterolateral fusion is a good surgery to treat degenerative lumbar canal stenosis, with reasonable outcome<span style="font-size: small;">. </span></span>
degenerative,Lumbar,Spinal Canal,Stenosis,Laminectomy,Posterolateral Fusion
https://ijma.journals.ekb.eg/article_108748.html
https://ijma.journals.ekb.eg/article_108748_2ac04cf80da8e02ce19cb3171d44e56c.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Selected Trace Elements in Egyptian Females with Preeclampsia
811
819
EN
Abdelrahman
Ali Hassan
Emam
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar Universtiy
abdelrahmanali183@domazhermedicine.edu.eg
Attia
Moahmmed
Attia
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
attia.ma.attia@gmail.com
10.21608/ijma.2020.32767.1137
Background: Evidence exist indicating that, trace elements could play a role in preeclampsia (PE). However, controversy exist regarding the role of the value of trace elements supplementation on the pregnancy outcome. <br />Aim of the work: To estimate serum levels of some trace elements (selenium, calcium, magnesium, iron and zinc) in females developed preeclampsia and compare them to healthy pregnant females and correlate it with pregnancy outcome.<br />Patients and Methods: 140 females were included in each group (preeclampsia and controls). All had been assessed clinically, and by laboratory and ultrasound investigations. In addition, serum levels of selenium, calcium, magnesium, iron and zinc, had been determined and correlated with pregnancy outcome. <br />Results: There was statistically significant increase of all trace elements in preeclamptic when compared to control groups. There was significant increase of females with deficient zinc, iron, calcium, magnesium and selenium in PE when compared to control group (83.6%, 19.3%, 30.7%, 27.9% and 40.0% vs 22.9%, 5.7%, 4.3%, 2.9% and 5.0% respectively). The odds ratio where higher for zinc, followed by selenium, magnesium, calcium and finally iron deficiency. In addition, zinc, iron, calcium, magnesium and selenium were inversely and significantly correlated with systolic blood pressure. Preeclampsia was associated with worse maternal-fetal outcome when compared to controls. <br />Conclusion: Lower levels of studied trace elements are associated with development of preeclampsia and we assume that, supplementation by such elements could reduce the risk of preeclampsia. However, this assumption needs to confirmed in future trials.
preeclampsia,iron,zinc,selenium,calcium
https://ijma.journals.ekb.eg/article_109293.html
https://ijma.journals.ekb.eg/article_109293_de071215ebab2188443213231c547849.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Outcome of Semi-Rigid Ureteroscopy with LASER Lithotripsy for Management of Upper Ureteric Calculi
820
827
EN
El-Sayed Zaky
Moahmed Taha
Department of Urology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
ezm.taha@domazhermedicine.edu.eg
Mohamed Ramadan
Rehan
Department of Urology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mrehan4040@domazhermedicine.edu.eg
Esam Abdelmohsen
Elnady
Department of Urology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
esammohsen78@domazhermedicine.edu.eg
Elsayed
Salih
Department of Urology, Faculty of Medicine, Al-Azhar University, Egypt
elsayedsalih@gmail.com
Hamdy Abdelhamid
Abozeed
Department of Urology, Faculty of Medicine, Al-Azhar University, Egypt
abozeed_ush@hotmail.com
10.21608/ijma.2020.35041.1144
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Proximal ureteral calculi are common with multi-modalities of treatment, with continuous invention of new modalities.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To present the early experience with LASER lithotripsy using semi-rigid ureteroscopy for treatment of upper ureteral calculi, regarding safety and efficacy.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Eighty patients with upper ureteral stones managed by LASER lithotripsy using semi-rigid ureteroscopy were included [30 prospective and 50 retrospective]. Patient evaluation included medical history, clinical examination with preoperative laboratory and radiological investigations. The outcome measure was stone free rate, Intra operative and Postoperative complications, operative time, hospitalization time, and post-operative analgesia.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> During the period from January 2018 through February 2020 in 30 prospective cases but retrospectively in 50 cases done in the last two years, 68.8% of patients were males and 31.2% of them were females, mean of age was 43.70 with range from 20 to 66 years, and mean of BMI was 19.75 with range from 18 to 23 with laterality of 60% of patients was right but of 40% was left and stone opacity of 96.25% of patients was radio opaque, while, 3.75% was radio lucent stones the mean operative time was 50.78 minutes and mean duration of hospital stay was 1.3 days. In addition, 66.2% of patient needed JJ, 32.5% required ureteric catheter and 15% failed ESWL. The mean ureteral stone diameter was 10.81. The clearance rate 97.5%; two cases had migrated stone.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Semirigid ureteroscope with LASER lithotripsy is an effective and safe procedure for management of large proximal ureteral stones with a lesser rate of stone migration needs use of flexible ureterorenoscopy.</span>
Ureterorenoscopy,stone,Ureteral,Laser,Semi-rigid
https://ijma.journals.ekb.eg/article_109294.html
https://ijma.journals.ekb.eg/article_109294_106a01859d9d1284b1c7eb08a259417a.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Value of Middle Cerebral/Umbilical Artery Resistance Index Ratio in Neonatal Outcome in Patients with Intrauterine Growth Restriction (A Prospective Study)
828
834
EN
Fatima Al-Zahraa El-Hawary
Abdel Aziz
Resident at Obstetrics and Gynecology Department at Kafr Saad Central Hospital, Ministry of Health, Egypt
f.alzahraa.ob@domazhermedicine.edu.eg
Mahmoud
Salah Mahmoud
Rady
0000-0002-5858-9263
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr.m.s.rady@domazhermedicine.edu.eg
Ahmed
Mohamed
Abd-Eltawab
0000-0002-7579-0049
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
drelwan850@domazhermedicine.edu.eg
10.21608/ijma.2020.35616.1146
Background: Fetal growth disorders are usually associated with perinatal morbidity and mortality. Accurate assessment of intrauterine fetal growth is difficult, but recent advances have improved with positive implications for antenatal care.<br />Aim of the work: The aim of this study was to assess the accuracy of the umbilical and middle cerebral artery resistance index in prediction of fetal outcome in pregnancies with intra-uterine growth restriction (IUGR).<br />Patients and Methods: Forty-five pregnant females had been included in a prospective study. All had a confirmed diagnosis of intra-uterine growth restriction (IUGR). Doppler ultrasound had been performed to record fetal umbilical and middle cerebral artery (MCA) resistance indices every one week (from 32 weeks onwards). Post-delivery birth weight of the baby, Apgar score at 0 and 5 minutes had been documented and correlated with doppler indices. <br />Results: One-fifth of the mothers participating in the study (20%) had pre-term birth and 6.7% missed the follow-up. Umbilical artery resistance index (RI) at a cut off value of (0.79) had a diagnostic accuracy of 93%. MCA RI best cut off value was 0.63 with diagnostic accuracy of 73.9%. Also, for C/U ratio had diagnostic accuracy of 92.9%. Finally, there was significant, proportional correlation between MCA RA and C/U ratio from one side and APGAR score at 0 and 5 minutes from the other side. However, the correlation between UARI and Apgar score was inverse and statistically significant. <br />Conclusion: Doppler velocimetry of fetal circulation can provide important information regarding fetal well-being, with subsequent impact on fetal outcome.
intrauterine growth restriction,Doppler,Neonatal Outcome,Resistance index,Mean cerebral artery
https://ijma.journals.ekb.eg/article_109295.html
https://ijma.journals.ekb.eg/article_109295_95ed59afc8d7bba57cd86f04a07a87c1.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
835
843
EN
Sabri A.
Soltan
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Egypt
sabrysoltan77@yahoo.com
Nawal M.
Alhulaimi
Department of Otorhinolaryngology, Aljaber Hospital for Ear, Nose, And Throat, Alahsa, 31982, Kingdom of Saudi Arabia
nawal.ent1@gmail.com
Mohsen M.
Eissa
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Egypt
meissa1970@yahoo.com
10.21608/ijma.2020.33699.1139
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Post-surgical pain is a challenging problem. Different modifications of surgical procedures and use of different analgesics had been reported. However, no consensus had been reached for post-surgical pain control. Tonsillectomy is one of the most commonly performed surgical procedure and pain control still controversial</span><span style="font-family: 'Arial Narrow'; font-size: small;">. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">To investigation safety and efficacy of intravenous paracetamol, ibuprofen, or both for post-tonsillectomy pain control.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">The study had been carried at Otorhinolaryngology and Eye, Al-Jabr hospital,</span><span style="font-family: 'Arial Narrow'; font-size: small;">Anesthesia and Intensive Care Department in collaboration with Otorhinolaryngology department and the day care surgery unit], Al-Ahasa directorate, Kingdom of Saudi Arabia [KSA]. It included children aged 2 to 10 years. Patients had been randomly allocated into 3 equal groups [each 30 patients]. Group A [intravenous paracetamol 15mg/kg], Group B [intravenous ibuprofen 10mg/kg], and Group C [intravenous paracetamol 7.5 mg/kg and ibuprofen 5mg/kg]. The examined drug had been administrated 20 minutes after induction of general anesthesia. The analgesic effects and hemodynamics had been assessed on regular postoperative intervals till patient discharge, and patient satisfaction had been addressed. Any side effects and need for postoperative analgesia had been documented</span><span style="font-family: 'Arial Narrow'; font-size: small;">.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Studied groups were comparable regarding patient demographics, recovery time, hospital stay duration and need for additional analgesia. However, pain was significantly variable between studied groups till 3 hours postoperatively. Pain was significantly reduced at groups B [IV ibuprofen] and C [IV paracetamol and Ibuprofen with reduced dose] when compared to group A [IV paracetamol] at all times. In addition, hemodynamic variability was observed for mean arterial pressure and heart rate. At five minutes, blood pressure was significantly higher in group B when compared to group C, and at 5 minutes to 2.5 hours, it was significantly increased among group A when compared to group C.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion: </span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">Drug combination with reduced [half the dose] of both intravenous paracetamol and ibuprofen is more effective and safer than single drug with higher dose. The studied drugs avoid the well-known side effects of opioids<span style="font-size: small;">. </span></span>
acetaminophen,Ibuprofen,Opioid-free,Drug combination,Post-tonsillectomy pain
https://ijma.journals.ekb.eg/article_109297.html
https://ijma.journals.ekb.eg/article_109297_d9a3db7830a95a960108cce37be4a692.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Ultrasound Guided Foam Sclerotherapy for the Treatment of Primary Varicose Vein of Lower Limb
844
853
EN
Ahmed
Abd Elsalam
Department of General Surgery, Dameitta Faculty of Medicine, Al-Azhar University, Egypt
khalid1234@domazhermedicine.edu.eg
Abdo
Arnous
Department of General Surgery, Dameitta Faculty of Medicine, Al-Azhar University, Egypt
abdoarnous@domazhermedicine.edu.eg
Osama
Moeen
Abdelfattah
Department of Vascular Surgery, Dameitta Faculty of Medicine, Al-Azhar University, Egypt.
dr.moeen@domazhermedicine.edu.eg
10.21608/ijma.2020.35938.1148
Background: Veins have one-way valves that prevent blood from backing up into the legs when we stand or sit. When the valves become incompetent (or begin to have reflux), blood pools and causes an increase in pressure in the leg veins. Leg veins become enlarged and twisted.<br />Aim of the work: The aim of the current study was to evaluate safety and efficacy of ultrasound guided foam sclerotherapy for the treatment of primary varicose vein.<br />Patients and methods: The current trial is a prospective observational cohort study. It had been carried out at Al-Azhar University Hospital (New Damietta), Egypt. It included Fifty patients who had great saphenous vein (GSV) reflux associated with saphenofemoral junction (SFJ) incompetence. They had been offered foam sclerotherapy as an alternative to standard surgical treatment or conservative management. The duration of the study extended between November 2019 to January 2020. <br />Results: results revealed that post intervention; duplex assessment revealed a radiologic success with complete obliteration of GSV and collaterals in 40 patients (80%). six patients (12%) underwent direct re-injection for further one or two injection sessions over the following two weeks until complete occlusion of GSV and collaterals was obtained. <br />Conclusion: Foam Slcerotherapy is effective & safe in treatment of primary varicose veins.
varicose veins,foam,sclerotherapy,Ultrasound-guided,Lower limbs
https://ijma.journals.ekb.eg/article_109401.html
https://ijma.journals.ekb.eg/article_109401_a57ae9f3a77c06a9428a8017b5cff322.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Effect of Successful Direct Acting Antivirals Therapy on Liver Stiffness in Patients with Chronic HCV Infection
854
859
EN
Ibrahim Anam
Ezzelregal
Department of Hepatology, Gastroenterology and Infectious Disease, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
dochima7@gmail.com
Fathya Mostafa
Elraie
Department of Hepatology, Gastroenterology and Infectious Disease, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
faresmed76@yahoo.com
Khalid
Elmola
Department of Hepatology, Gastroenterology and Infectious Disease, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
Mostafa Mohamed
Shaqueer
2974077209316470
Department of Radiology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
mshakweer1@domazhermedicine.edu.eg
10.21608/ijma.2020.23053.1138
Background: Achievement of sustained virological response [SVR] and improvement of hepatic fibrosis are the essential goals for therapy of chronic hepatitis C [CHC] with direct acting antivirals [DAAs] therapy. Early detection and management of hepatic fibrosis can significantly improve the prognosis of CHC in clinical practice. <br />Aim of the work: To assess the effect of successful DAAs therapy on liver stiffness in patients with CHC. <br />Methods: This study included 100 patients with chronic HCV-related liver disease. All were treated with Sofosbuvir-based regimen for 12 weeks on outpatient base. HCV treatment applied according to the protocol designed by the Egyptian National Committee for Control of Viral Hepatitis. Follow up continued for 12 weeks [after the end of treatment [EOT]] to estimate effect of successful DAAS therapy on liver stiffness using Shear Wave Elastography [SWE], aminotransferase-to platelet ratio index [APRI] and Fib-4 score before initiation of antiviral therapy, at end of treatment [EOT] and 12 weeks after EOT [SVR12]. <br />Results: Platelets significantly increased, ALT and AST decreased and mean values of APRI, Fib-4 score and Liver stiffness assessment were significantly reduced in all patients at SVR12. Hemoglobin levels significantly reduced in patients receiving ribavirin 12 weeks after EOT. <br />Conclusions: Elimination of HCV after successful DAAS treatment was associated with a significant improvement of the liver stiffness at both EOT and 12 weeks afterwards EOT as evidenced by SWE, Fib-4 score and APRI index
Direct acting antivirals,Elastography,Hepatitis C virus,Liver fibrosis,sustained virological response
https://ijma.journals.ekb.eg/article_112847.html
https://ijma.journals.ekb.eg/article_112847_4cb0572fa072b3af238564cbc8a8b198.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Comparison Study between Chest Ultrasonography and High Resolution CT in Diagnosis and Assessment of Interstitial Lung Diseases
860
865
EN
Mohamed Gamal
Mohamed Elmansy
Department of Chest Diseases, Damietta Faculty of Medicine, Al-Azhar University, Egypt
yoyo.sila2510@gmail.com
Ramadan Shawky
Abdelaziz
Department of Chest diseases, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
ramadan_shawki@yahoo.com
Mostafa Mohamed Mostafa
Shaqueer
2974077209316470
Department of Radiology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
mshakweer1@domazhermedicine.edu.eg
Eisa Ibrahim
Afify
Department of Chest diseases, Faculty of Medicine, Al-Azhar University, Egypt
eisaafify61@gmail.com
10.21608/ijma.2020.116073
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Chest high-resolution computed tomography [HRCT] is considered the “gold” standard for radiological diagnosis of interstitial lung disease [ILD]<strong>. </strong>However, it is not available in all health care facilities and its high cost is a limitation for its wide use. Ultrasound could provide a suitable alternative. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To detect the role of transthoracic lung ultrasonography [LUS] in diagnosis and assessment of ILD and to correlate it with HRCT as a gold-standard diagnostic modality.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">This included fifty patients who were admitted with clinical features suggestive of ILD. All were clinically evaluated [by full history and physical examination], submitted to pulmonary functions, arterial blood gases, lung ultrasound and HRCT. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> The total sum of B-lines was 72.64 ± 39.45 and the total positive chest areas [> 3 B-lines] 6.47 ± 2.35. The most common ultrasound finding was thick pleural line. Finally, there was positive [proportional], moderate, significant correlation between Warrick’s score [HRCT] and B-lines distance [LUS]. However, Warrick score correlated negatively with each of six-minute walk test, partial arterial oxygen tension and forced vital capacity. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusions:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Lung ultrasound as a diagnostic modality for ILD reveled that, it is a useful tool, as there was good correlation between LUS and HRCT. LUS is cheap, accessible and radiation-free diagnostic tool. It could play a stand alone or a complementary role in the diagnosis and monitoring of ILD<span style="font-size: small;">.</span></span>
lung ultrasound,High-Resolution,Computed tomography,Interstitial Lung Disease,B-line
https://ijma.journals.ekb.eg/article_116073.html
https://ijma.journals.ekb.eg/article_116073_861a88adcbf3d5c0f4798edb6c3e8f06.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Audio-Vestibular Findings in Patients with Hyperuricemia
866
872
EN
Mohamed Mahmoud
Al-Sobki
Audiovestibular Unit, Department of Otorhinolaryngology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
mm.sobki@domazhermedicine.edu.eg
Gehan Abd-Al-Rahman
El-Zarea
Audiovestibular Unit, Depart of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Egypt
dinagege@yahoo.com
Ahmed Mohamed
Ahmed Mahmoud
Audiovestibular Unit, Depart of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Egypt
mam.aduio@domazhermedicine.edu.eg
Ahmed Abd El Moez Ali
Saad
Department of Clinical pathology, Faculty of Medicine-Al-Azhar University, Egypt
a.moez@domazhermedicine.edu.eg
10.21608/ijma.2020.38516.1153
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Hyperuricemiais a common biochemical disturbance in which serum concentration of uric acid exceeds the normal values which is 7.0 mg/dl in men and more than 6.0 mg/dl in women leading to deposition of monosodium urate [MSU] crystals in joints and soft tissues resulting in inner ear functions affection. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To elaborate the effect of hyperuricemia on the peripheral hearing as well as peripheral vestibular functions.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Subjects and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> This study included 40 subjects with hyperuricemia and 40 healthy controls. Participants underwent serum uric acid assay, full history taking, basic audiological evaluation and vestibular evaluation. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> 37[92.5%] hyperuricemic subjects had normal peripheral hearing sensitivity, only 3[7.5%] had mild high frequencies sensori-neural hearing loss [SNHL] at 8 kHz. 31[77.5%] Hyperuricemic patients had normal peripheral vestibular functions, only 9[22.5%] subjects had BPPV; They also had higher serum uric acid [SUA] level. No correlation between duration of hyperuricemia and occurrence of BPPV. </span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusions:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> The hyperuricemic subjects had a significant higher incidence of BPPV. Other investigations to detect early and subtle changes in cochlear function of hyperuricemic subjects were recommended<span style="font-size: small;">.</span></span>
Audio-vestibular,Sensorineural hearing loss,Vertigo,Hyperuricemia, Uric acid
https://ijma.journals.ekb.eg/article_117260.html
https://ijma.journals.ekb.eg/article_117260_4f5326519dc4aef1ae32d96d12bf60a6.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Anterior Cervical Discectomy fusion: Cervical PEEK Cage vs Dynamic Cervical Implant
873
879
EN
Mohammed
Ahmed Alhady
Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
m.gebali@domazhermedicine.edu.eg
Mohamed
Hassan
Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt
youssef200877@yahoo.com
10.21608/ijma.2020.45403.1189
Background: There are wide treatment modalities for degenerative disc diseases of cervical spines. However, surgery is indicated when conservative treatment fails, and each procedure had its limitation. <br />Aim of the work: to compare the outcome between cervical peek cage and dynamic cervical implant for anterior cervical discectomy fusion (ACDF) for patients with degenerated cervical disc disease. <br />Patients and methods: Fifty patients with degenerative disk disease (DDD) were treated by cervical poly- etherether-ketone (PEEK) cage (25 patients) and another 25 with dynamic cervical implant (DCI). All patients assessed pre- and post-operatively by clinical and radiological examinations, with pain assessment by visual analogue scale and calculation of the range of motion. Any neurological deficits were documented in both pre-and post-operative periods. <br />Results: Both groups were comparable regarding patient characteristics, preoperative pain and preoperative range of motion. The mean percentage of pain reduction was significantly higher among PEEK when compared to DCI group (81.93±7.07 vs 66.23±11.48 respectively). In DCI group, preoperative mean range of motion at the operated level was 7.56, changed to 6.64 postoperatively, which is statistically significant. Similarly, in PEEK cage group, preoperative mean range of motion at operated level was 7.60 Changed to 7.52 which is statistically non-significant. Complications were mild and treated conservatively. <br />Conclusion: PEEK cage is associated with better alleviation of pain either at the neck or arm pain. On the other side, DCI is associated with slightly better range of motion. However, global range of motion is comparable between both groups.
Cervical,Degenerative Disk Disease,Discectomy,Dynamic Cervical Implant,Polyetherether-ketone Cage
https://ijma.journals.ekb.eg/article_119896.html
https://ijma.journals.ekb.eg/article_119896_754f71909888e53c23f75d89da91ec66.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
Combined Uterine Artery Ligation, Segmental Myometrial Resection and Intrauterine Balloon to Control Bleeding from Placenta Previa Accreta during Caesarean Section
880
885
EN
Asmaa
Ibrahim
Mohamed
Department of Obstetrics and Gynecology, Moutobes Central hospital, Ministry of Health, Egypt
asmaagabr100@gmail.com
Rashed Mohamed
Rashed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
rmrashed70@yahoo.com
Mohammed
Galal
Nasr
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt.
mohammed.30028@yahoo.com
Alaa Eldin
Mahmoud
Megahed
Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr.alaamegahed@domazhermedicine.edu.eg
10.21608/ijma.2020.21455.1066
Background: Morbidity attached placenta (MAP) remain a major surgical problem for obstetricians due to severe hemorrhage and its incidence had been continually increased due to increased rate of cesarean deliveries. <br />Aim of the work: To evaluate the safety and efficacy of a conservative intervention for management of placenta accreta.<br />Patients and methods: Forty-eight, pregnant females with a confirmed diagnosis of placenta previa accreta had been scheduled for elective cesarean delivery had been included. All females had been screened by full history taking, clinical examination, ultrasound and lab investigations. Blood loss, operative time, need for transfusion and need for other surgical interventions represented the main outcome and other complications were documented.<br />RESULTS: The blood loss (ml) ranged between 850 to 1300 ml; the mean values were 1082.29±105.89 ml. The operative time ranged between 60 to 130 minutes; the mean values were 87.92±19.35 minutes. There was significant decrease of post-partum hemoglobin when compared to corresponding pre-partum values (9.29±0.76 vs 10.71±0.54 mg/dl respectively). Four patients [8.3%] need ICU admission, and nine patients [18.75%] need blood transfusion. However, no patients need further surgical intervention or developed DIC. In addition, no mortality had been reported in the current work. <br />Conclusion: Combined uterine artery ligation, partial segmental myometrial resection and intrauterine balloon as a conservative treatment modality or placenta previa accreta is safe and effective
placenta,Caesarean,accreta,Previa,hemorrhage
https://ijma.journals.ekb.eg/article_111018.html
https://ijma.journals.ekb.eg/article_111018_7742eaf3ef2a381e2df209629b6e5f16.pdf
Al-Azhar University (Damietta), Faculty of Medicine
International Journal of Medical Arts
2636-4174
2682-3780
2
4
2020
10
01
The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus
886
897
EN
Muhamed Ahmed
Al Bellehy
Department of Obstetrics and Gynecology, Nabrouh General Hospital, Ministry of Health, Egypt
muhaalbellehy@gmail.com
Khattab Abdelhaleem
Omar
Department of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, Egypt
dr.khattababdelhalim@hotmail.com
Samia
Eid
Department of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, Egypt
samiamohamad11@gmail.com
Abdelrahman
Emam
Department of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, Egypt
abdelrahmanali183@domazhermedicine.edu.eg
10.21608/ijma.2020.37083.1151
<strong><span style="font-family: 'Arial Narrow'; font-size: small;">Background</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;">: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Aim of the work:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Patients and Methods:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome.</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Results:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission].</span><br /><strong><span style="font-family: 'Arial Narrow'; font-size: small;">Conclusion:</span></strong><span style="font-family: 'Arial Narrow'; font-size: small;"> AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.</span><span style="font-family: Arial; font-size: small;"></span>
Doppler Ultrasound,intrauterine growth restriction,Myocardial performance index,Isthmic flow index,Aortic isthmus
https://ijma.journals.ekb.eg/article_111019.html
https://ijma.journals.ekb.eg/article_111019_019f7b73104de21488f2f127cdfba0bf.pdf