• Users Online: 182
  • Print this page
  • Email this page
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 4 | Issue 2
Page Nos. 85-306

Online since Monday, June 29, 2020

Accessed 11,798 times.
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
ORIGINAL ARTICLES  

Effect of thymoquinone and allicin on some antioxidant parameters in cancer prostate (PC3) and colon cancer (Caco2) cell lines Highly accessed article p. 85
Elsayed M Mahdy, Sara M Abdu, Mohamed A.A El Baseer, Waleed A Mohamed
DOI:10.4103/sjamf.sjamf_69_19  
Background Thymoquinone (TQ) and allicin are two natural compounds separated from the seeds of Nigella sativa (black seeds) and garlic, respectively. These two compounds are known to have antioxidant properties. Aim The aim of this study was to investigate the antioxidant properties of both TQ and allicin in cancer prostate (PC3) and colon cancer (Caco2) cell lines using four cellular parameters, namely, reduced glutathione (GSH), lipid peroxide [malondialdehyde (MDA], catalase enzyme (CAT) and nitric oxide (NO). Materials and methods Two types of cancer cell lines, PC3 cells and Caco2 cells, were used for the investigation of four aforementioned antioxidant parameters before and after treatment with the two natural compounds (TQ and allicin). Viability assay was done first to determine the concentrations used. Results It was found that the concentration of reduced glutathione was highly significantly and significantly decreased in both PC3 cells and Caco2 cells, respectively, after treatment with TQ compared with control, whereas the change in the concentration of reduced glutathione was not significant after allicin treatment for both cell lines compared with control cells. Regarding the concentration of lipid peroxide (MDA), its concentration was highly significantly reduced in PC3 cells in both treatments, whereas it was significantly increased in Caco2 cells treated with TQ compared with control cells. Catalase activity was significantly reduced in PC3 cells after treatment with TQ, and highly significantly increased after treatment with allicin, whereas in Caco2 cells, catalase activity was highly significantly increased after treatment with TQ and allicin compared with control cells. NO concentration was not affected in PC3 cells after treatment with TQ, and highly significantly increased after treatment with allicin, while it was highly significantly increased in Caco2 cells in both treatments, compared to control cells.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Arthroscopic treatment of chondral lesions in varus knee in adults combined with corrective high tibial osteotomy p. 97
Wael Shaban, Eslam Hussein, Hassan El Behairy, Mohammed Yehia
DOI:10.4103/sjamf.sjamf_1_20  
Objectives To document whether cartilage regeneration occurs in the degenerated medial compartment of arthritic knees in patients with varus malalignment after medial opening wedge high tibial osteotomy (MOWHTO) with concomitant cartilage procedures and to assess which predictive factors influence the clinical outcome. Patients and methods A total of 28 patients underwent MOWHTO between December 2016 and December 2018 in Al-Zahraa University Hospital for varus malalignment and medial osteoarthritis. Preoperative and postoperative assessments were done using American Knee Society’s Knee and Functional Scoring System. All patients were evaluated by arthroscopy before and ∼12 months after HTO. The International Cartilage Repair Society grading system was used for arthroscopic grading. Results At initial arthroscopy, two (7.1%) knees had grade II medial femoral condyle articular cartilage finding, seven (25%) knees had grade III findings, and 19 (67.9%) knees had grade IV findings. Only 20 cases had second-look arthroscopy, no regenerative change was found in 40% of knees, white scattering fibrocartilage was found in 55% of knees, and deterioration of the cartilage was observed in one (5%) case. Conclusion The degenerated cartilage could be partially or entirely covered by newly regenerated cartilage at 1 years after adequate correction of varus deformity by MOWHTO.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Retinol-binding protein 4 as a biomarker of cardiometabolic risk in rheumatoid arthritis p. 106
Radwa M Fath Allah, Khalida E El-Refaei, Enayat E Osman, Seham Sabry, Iman M Elbagoury
DOI:10.4103/sjamf.sjamf_3_20  
Background Retinol-binding protein 4 (RBP4) has been implicated in the pathogenesis of cardiovascular disease. Higher circulating RBP4 concentrations have been observed in patients with previous clinical arteriosclerosis. RBP4 concentrations are positively related to the early endothelial dysfunction measured using marker flow-mediated dilation in patients with rheumatoid arthritis (RA). Aim This study was done to measure the serum RBP4 level in patients with RA and to assess its clinical relevance to cardiometabolic risk and carotid atherosclerosis in RA. Patients and methods The current study enrolled 50 patients with RA, fulfilling the American College of Rheumatology criteria for the diagnosis of RA, who were divided into three groups: group Ia (severe disease activity), group Ib (moderate disease activity), and group Ic (mild disease activity), together with 40 apparently healthy participants as a control group (group II). Clinical symptoms, disease activity using disease activity score 28, BMI, and blood pressure were assessed. RBP4 levels were measured by enzyme-linked immunosorbent assay technique. Complete blood count; C-reactive protein; fasting blood glucose; lipid profile including total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides; fasting plasma insulin level; calculation of insulin resistance by homeostatic model assessment of insulin resistance; autoantibody profiles; ECG; and carotid artery ultrasound were done. Results RBP4 levels were highly significantly increased in all patients with RA when compared with the control group (P<0.01). There was a statistically significant positive correlation between the level of RBP4 and BMI, carotid intima media thickness (CIMT) RT, CIMT LT, and mean CIMT (r=0.319, 0.292, 0.315, and 0.323 and P<0.05, 0.05, 0.05, and 0.05, respectively). Conclusion Our data suggest that the level of RBP4 was increased in patients with RA compared with control, and increased level of RBP4 is associated with presence of atherosclerosis in patients with RA as demonstrated by CIMT. RBP4 could be used as a marker for early prediction of premature atherosclerosis in patients with RA.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Intra-articular ultra-low-dose naloxone for postoperative analgesia after knee arthroscopy p. 113
Usama I Abotaleb, Ahmad S Abdelrahman, Ismail M Abdelgawad Ahmed
DOI:10.4103/sjamf.sjamf_5_20  
Background Naloxone has been used at low doses to enhance the analgesic effect; however, this application remains less well defined. It was added to local anesthetics for intrapleural, axillary brachial plexus block, and peribulbar anesthesia with good results but was not used before as an adjuvant in intra-articular injection. The aim of this prospective double-blinded randomized controlled study is to assess the effect of intra-articular ultra-low-dose naloxone when added to bupivacaine on postoperative pain after knee arthroscopy, with time to first analgesic request as the primary outcome and total analgesic requirement, severity of pain, and side effects as secondary outcomes. Patients and methods In all, 80 patients who underwent knee arthroscopic meniscectomy under general anesthesia were randomly allocated into two groups (40 patients each): the naloxone group received 100 ng naloxone added to 20 ml 0.25% bupivacaine, and the control group received 20 ml 0.25% bupivacaine. General anesthesia was standardized for all patients. At the end of surgery, the study solution was injected intra-articularly through the arthroscope. Visual analog scale was recorded at 1, 2, 4, 6, 8, 12, 18, and 24 h. An intravenous dose of 20 mg pethidine was given if visual analog scale greater than or equal to 3 or on patient request. The time to first analgesic request, total analgesic consumption, and side effects were recorded. Results The time to first analgesic request was significantly longer, and the total analgesic consumption was significantly lower in the naloxone group compared with the control group. Pain score was significantly higher after 6 and 8 h in the control group compared with the naloxone group. No side effects were reported. Conclusion Intra-articular ultra-low-dose naloxone enhanced postoperative analgesic effect of bupivacaine after knee arthroscopy without adverse effects.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison between ultrasound-guided sciatic–femoral nerve block and unilateral spinal anesthesia in below-knee amputation surgery p. 118
Ayman Esmail Hussien, Mohamed Abd Elgawad Abd Elhalim, Mohamed Shehata Zarad
DOI:10.4103/sjamf.sjamf_6_20  
Objectives To compare unilateral spinal anesthesia and ultrasound-guided combined sciatic–femoral nerve block (SFB) regarding hemodynamic stability, quality of nerve block, bladder function, and time-to-readiness for discharge (TRD) in below-knee amputation surgery. Patients and methods A total of 80 patients who underwent knee amputation surgery (40 per group) were enrolled in the study. They were randomly assigned to one of two groups. Group A received 2 ml (10 mg) of 0.5% levobupivacaine, and group B (SFB) received 25 ml contains 10 ml of 2.0% lidocaine, 10 ml of 0.5% levobupivacaine, and 5 ml of saline (15 ml of femoral and 10 ml of sciatic nerve block). Surgical anesthesia time, time of operation, total time of anesthesia, time-to-first spontaneous urination, time-to-first analgesia, TRD, and patient satisfaction were recorded. Results Onset of sensory and motor blocks was significantly shorter in group A compared with group B, whereas the recovery time for sensory and motor blocks was longer in group B compared with group A. In the group A, time-to-first analgesia was significantly shorter than the SFB group B; time-to-first spontaneous urination and TRD in the group A were significantly longer than the SFB group B. Pain score was highly significant lower in group B compared with group A after surgery. Conclusion SFB provided sufficient sensory blockage, duration, patient satisfaction, and postoperative analgesia than the unilateral spinal anesthesia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Surgical management of closed-head injury p. 123
Ahmed Swailam Mohamed, Mahmoud Mahmoud El Hendawy, Shymaa Adel Ismail
DOI:10.4103/sjamf.sjamf_8_20  
Purpose To evaluate cases of closed-head injury regarding clinical picture, investigations, surgical management, outcome, and prognosis. Patients and methods A prospective study was conducted on 22 surgical cases of the 62 patients with closed-head injury. Many preoperative factors were studied to evaluate the prognosis of such cases. Results Among 62 cases, 22 cases were subjected to surgery. Overall, 17 cases of extradural hematoma were subjected to surgery, whereas rest were associated with subarachnoid hemorrhage and acute subdural hematoma. Conclusion Early diagnosis and management of primary lesion of closed-head injury is very important to prevent secondary brain injury.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Auditory brainstem response to a chirp stimulus in infants with normal hearing p. 131
Madiha M El-Mously, Abir Omara, Naglaa G Mohamed
DOI:10.4103/sjamf.sjamf_10_20  
Background The CE-chirp stimulus shows promising results in auditory brainstem recording. The response to broad-band CE-chirp in normal infants and comparing it with the gold standard click stimulus is needed. Objective The purposes of this study were to (a) standardize auditory brainstem responses (ABR) in infant using chirp stimuli in normal hearing infants, (b) compare them with those evoked by click stimuli, (c) determine whether chirp-evoked response is easier to detect at near threshold values, and (d) analyze the amplitude growth function of chirp-evoked ABR as a function of stimulus intensity in infants. Patients and methods A total of 50 normal infants, with age ranging from 2 to 24 months, with normal hearing were included. The following procedures were done: a medical history, otologic examinations, behavioral observation audiometry, acoustic impedance, and ABR by click and CE-chirp. Results The chirp stimulus shows higher amplitude at all intensities and shorter latencies in comparison with click at high intensity and longer at low and threshold levels. The early waves are less frequent in chirp at high intensities. Conclusion The present study provides reference CE-chirp ABR values for infants. CE-chirp evokes lower threshold than click and easier peak identification at threshold, which is particularly helpful in infants.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Treatment of distal femur fractures with metaphyseal comminution by minimal internal fixation combined with Ilizarov external fixator p. 137
Wael Sh Mahmoud, Mohamed A Omar
DOI:10.4103/sjamf.sjamf_11_20  
Objectives To evaluate the minimal internal fixation combined with Ilizarov external fixator in treatment of distal fractures of the femur, its effectiveness, complications, and ability to return to work. Patients and methods Fifteen patients (11 males and four females) with comminuted distal femur fractures (12 patients closed and three open) were treated at our hospital. All patients were admitted to the same treatment procedure, which is open reduction, minimal internal fixation by two cannulated screws, and preplanned Ilizarov frame fixation. Olive wires fixation of the reduced condyles to the distal Ilizarov ring was done, which is just above the knee joint. There is no ring distal to the knee joint. Results According to ASAMI protocol, we have nine cases of good results, five excellent, and one case of fair result. Operative time for the procedure averaged 70 min (range, 50–140 min). The mean time in fixation was 26.4 weeks (24–32 weeks). The mean follow-up period after removal of Ilizarov frame was 48.6 weeks (36–67 weeks). Conclusion With short-term follow-up, the Ilizarov external fixator associated with minimal internal fixation is effective in treatment of comminuted distal femur fractures.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Serum galectin-9 level in patients with atopic dermatitis before and after phototherapy p. 146
Noha M Nebar, Naglaa A Ahmed, Noha M Hamdy, Marwa Said
DOI:10.4103/sjamf.sjamf_14_20  
Background Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Galectin-9 (Gal-9) is a member of galectin family, which is widely distributed in epithelial tissues and binds to various receptors expressed on the cell surface, such as T-cell Ig and Tim −3, CD4, and IgE. Phototherapy is the use of ultraviolet light to treat skin conditions, including AD. It plays important roles in immune suppression. Aim The aim of the present study was to evaluate the serum level of Gal-9 in patients with AD before and after treatment with phototherapy. Patients and methods The present study included 20 patients with AD and 20 healthy controls. Blood sample collection was done, and Gal-9 level in sera of patients and controls was measured using ELISA. Patients were subjected to complete history taking, clinical examination, and six area, six sign atopic dermatitis score calculation and received treatment by phototherapy ultravilot B (UVB) sessions for 6–8 weeks. After the end of phototherapy sessions, the authors measured the serum Gal-9 again. Results Serum level of Gal-9 in patients with AD was significantly higher than control group, with significant increase with severity of the disease. There was a decrease in serum Gal-9 level after treatment with phototherapy. Conclusion Serum Gal-9 level was significantly elevated in patients with AD, correlated with disease severity, and decreased after treatment with phototherapy. This suggests a possible role of Gal-9 in the pathogenesis of AD. New treatment strategies directed to lower Gal-9 level may be a hope for future perspectives in the treatment of AD.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Nalbuphine versus neostigmine as an adjuvant to intrathecal hyperbaric bupivacaine-induced postoperative analgesia p. 153
Enas M Ashrey, Bosat E Bosat
DOI:10.4103/sjamf.sjamf_16_20  
Introduction Pain remains one of the most important patient complaints after hemorrhoid surgery; most anal surgical procedures are done as a day-case procedure, so medication to relieve or stop pain and provide analgesia should be administered preoperatively to provide postoperative analgesia. Aim The aim of the study is to evaluate the effect of nalbuphine versus neostigmine as an adjuvant to intrathecal hyperbaric bupivacaine on duration of motor block and postoperative analgesia. Patients and methods A total of 40 adult patients of both sexes, with American Society of Anesthetists status I–II, aged between 21 and 60 years, enlisted to undergo hemorrhoidectomy under spinal anesthesia were included. Patients were randomly divided into two groups. Group I was the nalbuphine group (n=20), which received 15 mg (3 ml) of 0.5% hyperbaric bupivacaine+2 mg (0.1 ml) of nalbuphine HCl. Group II was the neostigmine group (n=20), which received 15 mg (3 ml) of 0.5% hyperbaric bupivacaine+50 μg (0.1 ml) of neostigmine. The total volume administered in each group was 3.1 ml. Results The onset of sensory block was significantly faster in nalbuphine group than neostigmine group, whereas onset of motor block was significant faster in neostigmine group than in nalbuphine group (P=0.0001). The time to two-segment sensory regression was significantly longer in nalbuphine group than in neostigmine group (P<0.0001). Duration of motor block was significantly prolonged in nalbuphine group compared with neostigmine group (P<0.0001). Postoperative visual analog scale was significantly less in nalbuphine group than in neostigmine group. Duration of postoperative analgesia was highly significantly longer in nalbuphine group than neostigmine group (P<0.0001). Postoperative total analgesic consumption in 24 h was less in nalbuphine group than in neostigmine group (P≤0.0001), with no significant adverse effect. Conclusion Addition of either nalbuphine or neostigmine to intrathecal hyperbaric bupivacaine induces postoperative analgesia with no significant adverse effect. However, nalbuphine was superior to neostigmine in prolongation of duration of motor block and postoperative analgesia, with decreased postoperative analgesic requirement.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Effect of dexamethasone versus propranolol on surgically induced endometriosis in an experimental animal model p. 159
Naglaa M.S Emsalem, Samia Fahmy, Doaa M Effat, Ahmed M Abdellah
DOI:10.4103/sjamf.sjamf_17_20  
Background Endometriosis is a disease of adolescents and reproductive-aged women characterized by the presence of endometrial tissue outside the uterine cavity and commonly associated with chronic pelvic pain and infertility. The mechanisms responsible for its pathogenesis and progression remain poorly understood. It is well established that endometriosis grows and regresses in estrogen-dependent fashion, and the diseases can be effectively cured by definitive surgery. However, prolonged medical therapy may be needed in most of the cases. Objective The objective of this study is to evaluate the effects of dexamethasone versus propranolol in rats with surgically induced endometriosis on vascular endothelial growth factor (VEGF) as a marker in the implanted tissue. Materials and methods The study was conducted in the Animal Research Unit of Medical Research Center of Ain Shams University. All procedures were performed from May 2018 to September 2018, in compliance with the international guidelines for care and use of experimental animals, on 100 female Wistar albino rats 90 days old, which were randomly divided into three groups: first group was treated with dexamethasone (n=40), and second group was treated with propranolol (n=40), and third group was a control group (n=20). They were used to create a model for the experimental induction of endometriosis and evaluation of therapeutic effect of dexamethasone versus propranolol. Results In the first group after treatment with dexamethasone, there was a highly statistically significant decrease in size of implant tissue (P<0.001). Moreover, it was found regarding the histopathological finding that there was massive necrosis associated with hyalinization of stroma and complete absence of the vascularity. In addition, it was found regarding immunochemical assay (VEGF) that there was mild amount of VEGF (25–50) in the peritoneal tissue of the endometriotic implant. In the second group after treatment with propranolol, there was higher statistical decrease in implant size (P<0.001). It was found there was diffuse necrosis of the glandular structure and hyalinization of the stroma with absence of vascularity and mild amount of VEGF (25–50) in the peritoneal tissue of the endometriotic implant and absence inflammatory cells. However, in the control group, there was a higher statistical increase in implant size (P<0.001). It was found there was no change in endometrial gland and stroma, with severe amount of VEGF (75–100) and inflammatory cells. Conclusion Both propranolol and dexamethasone efficiently reduced the size of endometriotic implant in conditions of surgical-induced endometriosis in rats. This is through restriction of angiogenesis through VEGF, which was utilized as a marker. So, it can be deemed that the drugs could be promoted in conditions of endometriosis in humans, but they require more research studies for assessment in humans.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of parasagittal meningiomas invading superior sagittal sinus p. 166
Mohammad F Eissa, Rasha A El Hamed Zaki, Noha Z.A.E El Noty
DOI:10.4103/sjamf.sjamf_18_20  
Introduction Meningioma in parasagittal location represents between 20 and 30% of meningioma cases in the cranial cavity. The close relation of it with superior sagittal sinus makes its surgical resection a great challenge to the surgeon to get a good result. Aim A retrospective and prospective study of management of 15 cases of parasagittal meningiomas invading superior sagittal sinus was conducted, including clinical assessment, diagnosis, and surgical management done in Al Azhar University Hospitals. Patients and methods The authors recruited 15 patients with parasagittal meningioma who were admitted to the Neurosurgery Department, Al Azhar University Hospitals. These cases had been assessed according to clinical picture, radiological evaluation, operative details, and postoperative complications. Surgical resection was achieved for these cases in the period between October 2015 and February 2019. Results The patients’ age varied between 20 and 60 years. Patients comprised eight males and seven females. The presenting symptoms were headache (15 patients), seizures (10 patients), motor weakness (12 cases), papilledema (four patients), and frontal manifestation (four cases). A total of 11 cases had gross total tumor excision, whereas four cases showed partial tumor removal. Moreover, there were two mortality cases. Conclusion Several factors contribute to the success of parasagittal meningioma surgery. The authors consider the preservation of the cortical veins to be important, and when possible should be done. The experience has led to believe that until now, surgery is a winning choice if practiced by expert hands.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Effects of intrathecal midazolam-bupivacaine combination on postoperative analgesia p. 174
Rabab S.H El-Seddawy, Rasheda El Sayed Azzam, Thoraya A.-E Mohamed, Mohamed Abd-Allah Amin
DOI:10.4103/sjamf.sjamf_19_20  
Background and aim Subarachnoid injection of local anesthetic with midazolam potentiates spinal blockade. Midazolam is known to produce antinociception and to potentiate the effect of local anesthetic when given in the neuraxial block without significant side effects. This study was designed to assess the effects of adding midazolam to intrathecal bupivacaine in patients undergoing subumbilical surgery. Patients and methods Sixty adult patients were randomly divided into two groups: Group I was administered 3 ml of 0.5% hyperbaric bupivacaine+0.4 ml of normal saline and Group II was administered 3 ml of 0.5% hyperbaric bupivacaine+2 mg (0.4 ml) of preservative-free midazolam. Time of onset of sensory analgesia, level of sensory blockade, time for maximum cephalic spread, and motor blockade as well as vital parameters and intraoperative complications were assessed and recorded. Postoperative pain scores were assessed using the visual analog scale immediately postoperatively. Results The level of sensory blockade is higher in group II while the time of maximum cephalic spread was longer in group I. Concerning the postoperative visual analog scale, there were lower scores in group II than in group I. There was significant difference between groups I and II regarding total diclofenac sodium consumption in the postoperative 24 h with total consumption of 146.83±53.25 and 112.33±25.18 mg, respectively. The P value was found to be 0.002. Conclusion Subarachnoid injection of preservative-free midazolam as an adjuvant to intrathecal bupivacaine potentiates its effect in terms of prolonged motor and sensory blockade without any significant hemodynamic compromise or sedation and with a significant decrease of postoperative analgesic requirements.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Onlay vs retrorectus mesh placement for uncomplicated ventral hernia repair p. 180
Hamed A Elbadawy, Hazem A Badr, Mohamed O Mohamed, Eslam E Elkhateeb
DOI:10.4103/sjamf.sjamf_20_20  
Background Ventral hernia such as paraumbilical and epigastric hernias are among the most common surgical problems as well as the most common surgical operations performed worldwide. The two operative techniques most frequently used in the case of ventral hernia are the onlay and sublay repairs. However, it remains unclear which technique of repair is superior. Objective The aim was to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) vs sublay (mesh in the retromuscular space). The patients included were evaluated for operating time, postoperative seroma formation, wound infection, drain duration, and postoperative hospital stay. Patients and methods Fifty adult patients with uncomplicated ventral hernia were included in this study and were managed at the Al-Azhar University Hospitals. The patients were divided randomly into two groups according to the surgical technique used for the repair, without any specific criteria used in selection for any technique as follows: Group A underwent onlay mesh repair and group B had sublay mesh repair. Results The mean operative time in patients treated with onlay mesh repair was 84.537±12.472 min (75–90) and in patients treated with sublay mesh repair was 93.438±15.536 min (80–100). As regards the drainage time, the mean total time in days was 7.532±2.472 days in onlay repair while in sublay group it was 4.153±1.251 days. Seroma formation after suction drain removal was observed in 12% patients in group A and in 4% in group B. Purulent wound infection was observed in 16 and 4% patients in group A and group B, respectively, and treated with dressing and proper antibiotic according to culture tests. Conclusion Sublay (retromuscular) mesh repair is a good alternative to onlay mesh repairs, and the authors suggest carrying out more trials on the retromuscular mesh repair technique to include a bigger number of cases and a longer period of follow-up.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Safe total thyroidectomy by using intraoperative methylene blue spray p. 187
Fatma El-Hussieny
DOI:10.4103/sjamf.sjamf_34_20  
Background Intraoperative localization and preservation of recurrent laryngeal nerve (RLN) and parathyroid glands improve outcomes following thyroid surgery. This can be facilitated by methylene blue. Aim the aim was to evaluate the value of spraying methylene blue dye during thyroidectomy for the help of the identification and dissection of RLN. Patients and methods A total of 34 patients with benign goiter disorders were included in this prospective observational study. During the surgery, after ligation of the superior pole of the thyroid and before ligation of inferior pole, 1 ml (10 mg) of 1% methylene blue solution was sprayed over the thyroid bed and perithyroidal tissue. Identification and safe dissection of the thyroid gland from the RLN and parathyroid glands were done without injuring these structures. Results RLN remained white, whereas thyroid and parathyroid glands were stained blue. The parathyroid glands washed out the stain within 5 min and were visible in its normal yellow color in all cases. Conclusion Spraying of methylene blue dye during thyroidectomy is a safe and effective method for identification and avoiding injury to RLN and parathyroid glands during thyroid surgeries.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Role of CTLA4-49A polymorphism in the pathogenesis of acute leukemia p. 192
Mahmoud A Hawass, Essam A Afifi, Ibrahim H.M Hazaa, Gamal T.A Ebid
DOI:10.4103/sjamf.sjamf_105_19  
Background Acute leukemia is a clonal disorder of both myeloid and lymphoid progenitors with distinctive morphologic, immunophenotypic, and genotypic features and represents the most frequent malignancy of childhood. Acute leukemia is associated with several humoral and cellular immune abnormalities that could lead to an inadequate antitumor response. One of the co-stimulators that regulates immune response is CTLA-4 which has been well established as a negative regulator of T-cell function. Objective The aim of this study was to investigate the association of an Single-Nucleotide Polymorphism (SNP) in CTLA4 49-A with genetic susceptibility to acute leukemia. Participants and methods This is a case–control study that included 65 Egyptian patients with acute lymphoblastic leukemia (ALL) and 25 patients with acute myeloid leukemia (AML). The control group comprised 60 healthy unrelated participants with no family history of leukemia or autoimmune disease. Using the PCR-restriction fragment length polymorphism methodology, CTLA4 49 A/G was analyzed in 150 samples representing 90 patients (65 patients with ALL, and 25 patients with AML) and 60 controls. Results There was no significant differences that were encountered between the different groups with regard to CTLA4 +49 A/G genotype or allele frequencies in ALL and AML cases. Neither was there a relation between the various genotypes and age of onset or the mode of presentation. Conclusions CTLA4 49 A/G polymorphism was not recognized as a risk susceptibility factor in our case–control study. To our knowledge, this is the first study involving acute leukemia. The authors recommend that additional studies with larger sample sizes and different populations are required to confirm the findings of the present study
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison between the efficacy of injection vs topical platelet-rich plasma as an adjuvant treatment of chronic venous ulcers p. 196
Ayat I Ahmed Ibraheem, Abeer M Kamel, Radwa O Mohamed Kamel, Maisa A Abdel Wahab
DOI:10.4103/sjamf.sjamf_107_19  
Background Chronic venous ulcers are the most common type of leg ulcers and have a major influence on the quality of life and work productivity. Chronic nonhealing ulcers lack the needed growth factors and do not heal later. The use of platelet-rich plasma (PRP) is based on the fact that platelets contain many growth factors that have a well-known role in the course of ulcer repair. Aim and objective The aim was to evaluate and compare the efficacy of autologous PRP injection or topical application in the treatment of chronic venous ulcers. Patients and methods This study was conducted from April 2016 to January 2017 on 30 patients with chronic venous ulcer, who were divided into two equal groups: group A was treated by PRP injections in perilesional tissue, and group B was managed by topical application of PRP on the surface of the ulcer. Thereafter, the ulcers of both groups were covered with Vaseline gauze and then covered by thin elastic sheet without compression for six sessions with a 1-week interval between sessions. Results The study showed marked improvement in patients treated with injection and topical application of PRP after six sessions, with no statistically significant difference between the two groups regarding pressure ulcer scale for healing (PUSH) tool. Moreover, there was no statistically significant difference in healing ratio between both the groups. Conclusion PRP shows promise as an effective treatment in chronic venous ulcers by different methods of application. It is a safe, simple, and inexpensive without any adverse events.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

The effect of nitric oxide to improve the ovulation and pregnancy rates in women with polycystic ovary syndrome treated with clomiphene citrate p. 203
Mai M Farrag, Ayda A Hassan, Mona A El Kafrawy
DOI:10.4103/sjamf.sjamf_22_20  
Background Polycystic ovary syndrome (PCOS), or also called anovulation, hyperandrogenic Stein–Leventhal syndrome, is one of the most common endocrinal disorders affecting ∼5–15% of women in the reproductive age. Aim The aim was to monitor the effect of nitric oxide (NO) on patients with PCOS treated with clomiphen citrate (CC) and to find out the effect on pregnancy and ovulation rates. Patients and methods The study was done on 90 patients divided into three groups: group A included 30 patients treated with CC only, group B included 30 patients treated with CC+10 mg NO, and group C included 30 patients treated with CC+20 mg NO. Results The ovulation and pregnancy rates increased significantly in patients treated with CC+NO compared with patients treated with CC alone. Conclusion The role of NO in induction of ovulation with CC in cases with PCOS increased the ovulation and pregnancy rates as a result of enhancement of follicular maturation and endometrial thickness and improvement of cervical mucus scoring.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Evaluation of fractional carbon dioxide laser-assisted drug delivery of calcipotriol plus betamethasone versus bimatoprost in the treatment of vitiligo p. 210
Ahmed M.M Abdelrazik, Mohammed A El-Khalawany, Shady M.A Ibrahim
DOI:10.4103/sjamf.sjamf_23_20  
Introduction Vitiligo is a disease in which melanocytes (pigment-producing cells) are damaged or destroyed resulting in a patchy loss of pigment from areas of skin. Vitiligo patches can appear anywhere on the skin, but commonly affected sites include the areas around the orifices, the genitals, or any sun-exposed areas such as the face and the hands. The hair and, rarely, the eyes may also be affected. Aim The aim of the work is to evaluate the efficacy of transepidermal drug delivery by CO2 fractional laser of calcipotriol plus betamethasone versus bimatoprost in the treatment of vitiligo. Patients and methods This study included 20 patients with vitiligo. The patients were selected from the Outpatient Clink of Dermatology and Venereology Department in Al-Hussien University Hospital from March 2019 to September 2019. Results Comparison between the first and the second patches was done. In each patient, two patches were selected and classified as follows: side A is the right side, and it was treated with fractional CO2 laser followed by topical bimatoprost (0.03%) drops, and side B is the left side, and it was treated with fractional CO2 laser followed by topical calcipotriol (0.05 mg/g) plus betamethasone (0.5 mg) ointment. The repigmentation grade showed a statistically significant increase in the second patch: regarding the right side, there were five (25%) patients of grade 0, 10 (50%) patients of grade I, three (15%) patients of grade II, one (5%) patient of grade III, and one (5%) patient of grade IV (the mean response was 21±23.7, with minimum response of 0 and maximum response of 80). Regarding the left side, there were three (15%) patients of grade 0, nine (45%) patients of grade I, three (15%) patients of grade II, one (5%) patient of grade III, and four (20%) patients of grade IV (the mean response was 34.8±30.1, with minimum response of 0 and maximum response of 90). Conclusion From the result of this study, we can conclude that fractional CO2 laser followed by topical calcipotriol (0.05 mg/g) plus betamethasone (0.5 mg) ointment gives better results than fractional CO2 laser followed by topical bimatoprost (0.03%) drops in the treatment of vitiligo.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Relationship between neutrophil-to-lymphocyte ratio and diabetic neuropathy in type 2 diabetes mellitus p. 217
Wagida M.F Abou Raya, Sally S Abd Elhamed, Noha H El Salanty
DOI:10.4103/sjamf.sjamf_26_20  
Background Diabetic peripheral neuropathy (DPN) is one of the microvascular complications of diabetes mellitus (DM). Several epidemiological studies have shown that inflammation has a central role in the pathogenesis of diabetic complications. Recently, neutrophil-to-lymphocyte ratio (NLR) is considered as a novel marker for inflammation in systemic disease. Aim To investigate the relationship between the NLR and DPN in type 2 DM, and to estimate whether NLR can be used as a predictive and reliable marker for DPN. Patients and methods This is a case–control study conducted on 90 individuals; 60 patients with type 2 DM were divided into a group with peripheral neuropathy (DPN) (group 1) and into a group without peripheral neuropathy (group 2) and 30 healthy individuals with age and sex matched served as the control (group 3). All were subjected to full history and clinical examination; laboratory tests included fasting blood glucose, 2 h postprandial, glycated hemoglobin, and renal function tests, estimated glomerular filtration rate. Complete blood count with assessment of NLR, and nerve conduction study. Results There was highly statistically significant increase in NLR in diabetic patients with peripheral neuropathy in comparison to group without peripheral neuropathy and control group. Conclusion NLR might be a predictor marker for DPN.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Association between hepatocellular carcinoma and type 2 diabetes in a sample of Egyptian patients p. 225
Mervat E El-Wakeel, Zeinab A Hassan, Aliaa A El-Naggar, Marwa F El-Sayed
DOI:10.4103/sjamf.sjamf_31_20  
Background Studies have reported association between type 2 diabetes mellitus (T2DM) and hepatocellular carcinoma (HCC). T2DM may cause nonalcoholic fatty liver disease-related HCC, suggesting a role of T2DM in hepatocarcinogenesis. Aim The aim was to study the association between HCC and some metabolic factors including insulin resistance and BMI in a sample of Egyptian patients with T2DM. Patients and methods The present work is a case–control study, conducted on 50 patients recently diagnosed as having HCC, and 30 participants as control. Patients and control were classified into diabetic and nondiabetic subgroups. Patients with other primary malignancies, organ failure, ascites, and autoimmune hepatitis were excluded. Results The study revealed that weight, BMI, waist circumference, fasting blood sugar, C peptide, homeostasis model assessment-insulin resistance, and glycosylated hemoglobin (HbA1c) were significantly higher in patients than control, and in diabetic and nondiabetic patients, than their controls. DM percent and duration were significantly higher in patients than control. In all patients, diabetic and nondiabetic, homeostasis model assessment-insulin resistance was significantly positively correlated with weight, BMI, waist circumference, fasting blood sugar, C peptide, and HbA1c. In diabetic patients, tumor size did not show significant correlation with the studied metabolic factors. Conclusion The most predictive factors in diabetic patients with HCC were C peptide, BMI, and HbA1c %.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Genetic variation of pentraxin-3 in Egyptian patients with chronic hepatitis C virus and hepatocellular carcinoma p. 231
Soheir A.R Saleh, Nariman M Zahran, Wafaa M El-Zefzafy, Zakaia A.Z Mohamed, Ola Mahmoud, Amira R Harb
DOI:10.4103/sjamf.sjamf_39_20  
Background Hepatocellular carcinoma (HCC) is one of the most common aggressive solid malignancies worldwide, particularly in Egypt. There is evidence of the contribution of single nucleotide polymorphisms (SNPs) in increasing cancer risk by influencing individual susceptibility to develop HCC. Pentraxin-3 (PTX3) has several functions in controlling cancer-related inflammation through regulation of the complement cascade, so acting as an extrinsic oncosuppressor gene. Several studies have discussed the association between PTX3 genetic polymorphism and cancer risk. Aim To study PTX3-(rs2305619)-SNP and the associated risk to develop HCC in patients with chronic hepatitis C virus (HCV), in addition to its possible correlation with HCV-RNA viral load and fibrosis degree in Egyptian patients with chronic HCV and HCC. Patients and methods A total of 40 patients with HCC on top of chronic HCV infection, 40 patients with chronic HCV, and 40 healthy participants were enrolled in the study. DNA was extracted from the peripheral blood, and PTX3-(rs2305619) genotyping was performed using real-time PCR. Results PTX3-(rs2305619) A/A polymorphic genotype was statistically significantly higher in both HCC and chronic HCV cases with advanced fibrosis than controls. The A/A genotype showed nine-fold increased risk of HCC when compared with healthy control (odds ratio=9.1, 95% confidence interval=2.304–35.94, P=0.002). A positive correlation was detected between A/A genotype and the higher HCV-RNA viral load in both HCV and HCC patients groups. Conclusion A allele of PTX3-(rs2305619) SNP could be considered as an independent molecular detector for HCC in Egyptian patients with chronic HCV.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison between topical cyclosporine A 0.05% and oral antioxidant in the treatment of dry eye disease p. 236
Madeha Abd El-Fatah Kamel, Nermien Salah El-Dien Mohammed EL-Haddad, Shimaa Shafik Abu Seadah, Maha Mohammed Hussein Sahaly
DOI:10.4103/sjamf.sjamf_40_20  
Background Dry eye disease is a multifactorial ocular pathology characterized by corneal epithelial lesions, inflammation of ocular surface, and symptoms of discomfort, including irritation, itching, and burning eyes. Aim The aim of this work is to compare the effect of both topical cyclosporine A 0.05% and oral antioxidant with the preservative-free artificial tears in the treatment of dry eye. Patients and methods This is a prospective randomized comparative cross-sectional study that included 180 eyes. Schirmer I test, break-up time test (BUT), corneal fluorescein staining score, and impression cytology grade were done. Results The results showed that there was no significant difference between the cyclosporine and the antioxidant groups after 3 months of treatment in terms of BUT (P=0.245), corneal fluorescein staining score (P=0.9052), and impression cytology grade (P=0.526), and they were significantly different in terms of (P=0.012). In the preservative-free group, although there were highly significant improvements in schirmer I test, BUT, corneal fluorescein staining, and impression cytology grade after 3 months of treatment, the cyclosporine and the antioxidant groups showed highly significant improvement than the preservative-free group. Conclusion Both topical cyclosporine A 0.05% and oral antioxidant treatments are effective for the treatment of dry eye disorder. However, cyclosporine has better results.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

The effect of deviated nasal septum on aesthetic appearance of the nose p. 244
Mohamed Abdelzaher M Rashad Abdel-Hady, Hoda A Ibrahim, Ramadan Hat-hout
DOI:10.4103/sjamf.sjamf_42_20  
Background The deviated nasal septum affects the aesthetic appearance of the nose, as a well-known phrase projects ‘As the septum goes, so goes the nose.’ The nasal septum is the central structure supporting the framework of the nose. Aim To evaluate the relationship between nasal septum deformities and its effects on aesthetic appearance of the nose, and the management of each effect. Patients and methods A total of 30 patients who underwent septorhinoplasty between April 2016 and December 2019 were evaluated prospectively. This was done in Al-Zahraa University Hospital. Patients who had nasal deformities owing to septal deformities were included. Results Regarding interference with nasal septum in rhinoplasty operation, only two (6.7%) cases were done without septoplasty, whereas 28 (93.3%) cases were done with septoplasty. In 93.33% of the cases, nasal septum affected the shape of the nose, and in only 6.67% of the cases, the nasal septum did not affect the shape of the nose. Conclusion The deviated nasal septum affects the aesthetic appearance of the nose, but not all parts of septum affect it. Bony part does not affect the shape of the nose and not all types of deviations of the septum. However, deviations that reach the dorsum of the nose or columella surely affect the shape of the nose.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Assessment of M-mode index of obstruction in patients with chronic obstructive pulmonary disease p. 251
Sanaa F Qutb, Sawsan B Elsawy, Eman Sobh, Sabah S Oraby
DOI:10.4103/sjamf.sjamf_27_20  
Background Diaphragm motion during forced expiration can be analyzed using M-mode ultrasound in an anterior subcostal approach. Maximal expiratory diaphragmatic excursion and forced expiratory diaphragmatic excursion in the first second physiologically mimic forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), respectively, and may be used as a marker of obstruction. Aim The aim of the work was to assess the role of the M-mode index of obstruction (MIO) as a screening test (tool) for chronic obstructive pulmonary disease (COPD). Patients and methods This case–control study involved 200 participants (100 patients with COPD and 100 age-matched and sex-matched healthy controls). The authors performed spirometry and the diaphragm ultrasonography, during forced expiration. MIO was calculated as the slope of diaphragmatic excursion in first second/slope of diaphragmatic excursion at end of expiration. Results Diaphragmatic excursion was significantly lower in COPD group than control group (4.27±1.49 vs 5.36±1.67 for slope in the first second of expiration, 4.82±1.55 vs 5.72±1.57 for maximum slope at the end of expiration, 4.42±1.53 vs 5.44±1.69 for velocity of diaphragm contraction in first second, and 2.40±1.04 vs 3.52±1.26 for velocity of diaphragm contraction at the end of expiration; P=<0.001) with delayed relaxation time (2.34±0.73 vs 2.08±0.65 for COPD and control groups, respectively). MIO was significantly lower in COPD than the control group (88.46±9.92 vs 93.37±11.15 respectively, P=0.001) and showed a significant positive correlation with FEV1/FVC (P=0.007). Conclusion Diaphragmatic excursion during forced expiration is significantly decreased in COPD in comparison with the control group. MIO is significantly lower in COPD in comparison with control and significantly correlated with FEV1/FVC.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Evaluating the role of nondermatophyte fungi as a causative agent of tinea pedis and its relation to diabetes p. 256
Mervat Hamdino, Sawsan Elsayed, Mohammed Taha, Eman Elkady
DOI:10.4103/sjamf.sjamf_30_20  
Background Nondermatophyte fungi are highly suspected as a pathogen in tinea pedis cases with culture negative results for dermatophytes. The study of antifungal susceptibility restricts the resistance and provides the efficacy of an antifungal drug, especially in diabetic patients. Aim To evaluate the presence of nondermatophyte fungi (yeast and mold) as a causative agent in tinea pedis, in diabetic versus nondiabetic patients, with reference to antifungal sensitivity test through the available antifungal drugs. Patients and methods A total of 60 adult patients were enrolled in this study (30 diabetics and 30 nondiabetics) having tinea pedis. Skin scrapings from all patients were collected, and complete mycological diagnosis was done. Yeast and mold isolates were subjected to disc diffusion antifungal susceptibility testing using Mueller–Hinton agar. Results Yeasts were the most common isolates in 26 (43.3%) cases, followed by dermatophytes nine (15%), nondermatophyte mold eight (13.3%), and mixed infection two (3.3%). There was no statically significant relation between diabetes and causative organisms, with P value more than 0.05. Yeast and mold isolates showed high sensitivity against itraconazole followed by fluconazole. Conclusion Nondermatophyte fungi are becoming increasingly prevalent in tinea pedis. There is a nonsignificant relation between causative agent and diabetes, and the best choice of antifungal treatment of nondermatophyte fungi in our work is itraconazole.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Effect of topical application of mitomycin-c as an adjuvant treatment of laryngotracheal stenosis p. 262
Mohamed K Al Awady, Mohamed A El-Morsy, Osama Mohamed Refaat, Mohamed H Tawfik
DOI:10.4103/sjamf.sjamf_32_20  
Background Laryngotracheal stenosis (LTS) has become more frequent because of prolonged endotracheal intubation (PEI). The endoscopic treatment of LTS is often associated with high recurrence rate owing to excessive fibrosis. Mitomycin-c (MMC) inhibits fibroblast proliferation, so it is used at the time of endoscopic dilation to improve outcomes. Objective The aim was to assess the effect of application of topical MMC in the treatment of LTS to prevent recurrence of stenosis. Patients and methods A prospective study was carried out on 20 patients with LTS subjected to endoscopic dilatation. All patients were divided to two groups: group A (case group) included 10 patients with LTS who were subjected to endoscopic dilatation with topical application of MMC (0.5 mg/ml), and group B (control group) included 10 patients with LTS who were subjected to endoscopic dilatation without topical application of MMC. A neck computed tomography scan was done for all patients to detect the site and length of stenotic area. Results In group A, LTS was due to PEI in six (30%) patients, due to laryngoscleroma in three (30%) patients, and due to Wegener’s granulomatosis in one (10%) patients, whereas in group B, it was due to PEI in four (40%) patients, due to rhinoscleroma in four (40%) patients, and due to Wegener’s granulomatosis in two (2%) patients. The most common site of stenosis was subglottic and trachea in both groups. Most of the patients in case group ended up with grade 2 dyspnea (mild dyspnea with no limitation to daily activities), whereas three patients in control group achieved this outcome, with a statistically significant difference (P=0.043). None of the patients in the case group developed postoperative stridor 6 months after surgery, compared with four patients in the control group. Conclusion Topical application of MMC as an adjuvant treatment for endoscopic management of LTS has shown good results, low recurrence rate, and high success rate.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Histopathological study of compensated inferior turbinate hypertrophy and its hypertrophy in allergic rhinitis p. 269
Mohamed A El-Morsy, Mohamed K Al Awady, Osama M Mostafa
DOI:10.4103/sjamf.sjamf_35_20  
Background Nasal obstruction resulting from inferior turbinate hypertrophy (ITH) is a common complaint in otorhinolaryngology. Objective Differentiation between compensatory ITH due to deviated nasal septum (DNS) and ITH due to allergic rhinitis in order for the surgeon to choose the proper surgical techniques. Patients and methods This study included 60 patients aged between 18 and 50 years (18 men and 12 women). They suffered from ITH as proven by history and endoscopic examination. Patients were subdivided into two groups. Group A: included 30 patients who were presented by compensated ITH due to DNS. Skin prick test was done for all patients of this group to exclude allergic patients. Group B: included 30 patients who were presented by bilateral ITH due to allergic rhinitis. All patients underwent endoscopic partial inferior turbinectomy under general anesthesia with or without septoplasty, taking care to include all three layers of the turbinate. The turbinate specimens were processed in a standard manner in the Department of Pathology, and slides were prepared, and examined histopathologically and micrometrically. Results The mean thickness of the bony layer of ITH patients in group A was 6.50±1.75 mm, whereas its thickness in group B was 2.25±±1.25 mm with a statistically significant P value=0.001, while the mean thickness of the medial mucosal layer of ITH patients of group A was 2.25±0.5 mm, whereas its thickness (group B) was 4.25±0.75 mm with statistically nonsignificant P value (0.06). Conclusion The bony layer contributes to the main thickness of compensatory ITH due to DNS because of the significant bony expansion; so, it should be a target of surgery, while surgical techniques that aim to remove the mucosa, leaving the bony part of the turbinate in allergic rhinitis are suitable for such patients.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Effect of thyroid dysfunction on left ventricular performance using different echo-Doppler modalities p. 276
Azza Almetwally Hatab, Eman Rashed Zaki, Abeer Ahmed Elmalah, Inass Hassan Ahmad
DOI:10.4103/sjamf.sjamf_45_20  
Background Thyroid dysfunction (Thy.D) is one of the commonest endocrinological disorders that increase cardiovascular morbidity and mortality. Echocardiography is a useful, noninvasive, easily accessible, and affordable tool for detection of early cardiovascular changes in patients with thyroid disorders. Aim To assess the effect of Thy.D on left ventricular (LV) performance using different echo-Doppler modalities. Patients and methods This study included 60 individuals, divided into three groups: GI: 20 patients (hypothyroidism), GII: 20 patients (hyperthyroidism), and 20 healthy individuals as controls (GIII). All participants underwent history taking, clinical examination, thyroid profile (free triiodothyronine, free tetraiodothyronine, and thyroid-stimulating hormone), conventional echocardiography, tissue Doppler imaging (TDI) velocities averaged from four annular sites (Av-Sa, Av-Ea, and Av-Aa), TDI-derived strain, and two-dimensional-global longitudinal strain (2D-GLS). Results Despite LV systolic function being preserved in all studied groups, there was a statistically significant reduction in GI and GII compared with GIII (CL), with more reduction in GI (P<0.05). There was a significantly higher Tei-index in patients with Thy.D (P<0.05) by conventional Doppler, with more increase in GI by TDI (P=0.0001). There is a significant lower TDI-strain parameters in both patient groups compared with CL (P<0.01), and regarding 2D-GLS of the LV, there was significant lower LV-GLS in GI and GII, with more significant reduction in GI (P<0.01 and <0.05 respectively). There was a significant increase in E/Ea in both patient groups in comparison with CL, with more increase in GI (P=0.0003 in GI and 0.01 in GII). Conclusion Thyroid disorders have a significant effect on LV systolic and diastolic functions. TDI (velocities and strain) and 2D-GLS are useful indices for detection of LV functions in patients with Thy.D.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Postexercise stunning in type II diabetes mellitus assessed by 2D speckle tracking echocardiography and gated-SPECT myocardial perfusion imaging p. 282
Taghreed A Ahmed, Mona N Ali, Fatma M Attia
DOI:10.4103/sjamf.sjamf_46_20  
Background Type II diabetes mellitus (DM) is usually associated with a number of myocardial structural and functional changes. Noninvasive imaging techniques play a key role in the identification of these changes. Objective Detection of postexercise myocardium stunning in type II DM patients by 2 dimensional speckle tracking Echo (2D STE) and single photon emission computed tomography (SPECT) imaging. Patients and methods The authors enrolled 60 symptomatic patients with type II DM who were classified into different groups: Group I included 17 patients with normal left ventricular global longitudinal strain (LVGLS) and negative SPECT; group II included 43 patients with impaired LVGLS and negative SPECT; and group III included 10 patients with impaired LVGLS and positive SPECT. The authors evaluate LV functions and dimensions before and early after exercise by conventional, tissue Doppler, 2D STE, and gated-SPECT perfusion imaging. Coronary angiography for group III. Results This study shows statistically significant difference between early and late gated SPECT regarding left ventricular end diastolic volume (LVEDV) and EF% between the three different groups. There were significant decrease in average LVGLS from (−20.79±1.04 pre-exercise) vs (−16.15±1.28 postexercise) in group I from (−15.98±1.75 pre-exercise) vs (−14±2.47 postexercise) in group II and from (−15.82±3.44 pre-exercise) vs (−13.48±2.75 postexercise) in group III. Eight out of 10 patientﹶs had coronary artery disease in group III. Conclusion Transient ischemic stunning and dilatation remained a robust marker for high-risk scan especially in type II DM. LVGLS correlated well with gated SPECT in the detection of postexercise LV stunning. LVGLS is a very sensitive parameter and paramount for early detection of LV subclinical systolic dysfunction in diabetic patients.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multislice computed tomography multiplanar reconstruction chest and three-dimensional reconstruction imaging of the airway remodeling in evaluation of asthma and chronic obstructive lung disease p. 289
Suzan A F Swelum, Abdullah H Ahmed, Eman R Abdullah
DOI:10.4103/sjamf.sjamf_48_20  
Objective This study aims to estimate the role of multislice computed tomography multiplanar reconstruction and three dimensional in evaluation of the airway remodeling and lung parenchyma in patients with asthma and those with chronic obstructive lung disease. Patients and methods Asthmatic patients (n=19) and patients with chronic obstructive pulmonary disease (COPD) (n=31) underwent chest high-resolution computed tomography. We selected the apical bronchus (B1) and the posterior basal bronchus (B10) of the right lung. A segmental bronchus was defined as the third-generation bronchus. Wall area (WA) was calculated as Ao−Ai. The percentage wall area (WA%) was calculated as (WA/Ao)×100 and then assessed for each generation from two bronchi. Results Total WA% in patients ranged between 74.6 and 95.2, with a mean±SD of 84.9±5.5. Although the total WA% in patients with asthma was higher than in those with COPD (86.1±5.8 vs. 84.1±5.3), it was not statistically significant (P=0.231). Regarding the parenchymatous lung changes, these changes were detected in patients with both disease groups; Hounsfield unit ranged between −1042 and −855, with a mean±SD of −944.0±56.1. We demonstrated that COPD group had statistically significantly lower Hounsfield unit (mean±SD=−959.8±57.8) compared with bronchial asthma group (mean±SD=−919.1±34.1), with P=0.006. Conclusion Quantitative computed tomography has been widely used as an imaging tool in patients with COPD and those with bronchial asthma. Now it is possible to analyze the lung parenchyma and airways quantitatively using digital data from computed tomography.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Role of matrix metalloproteinase-2, matrix metalloproteinase-9, and tissue inhibitors of metalloproteinase-1 in recurrent depression p. 295
Rania A Hamed, Heba A Elmalt, Abeer A.A Salama, Sarah Y Abozaid, Shaimaa Y Abd Elaziz
DOI:10.4103/sjamf.sjamf_51_20  
Objectives Matrix metalloproteinases (MMPs) play a major role in inflammatory processes, and their effect in depression has been examined. This study evaluates MMP-2, MMP-9, and tissue inhibitors of metalloproteinase-1 (TIMP-1) in patients with major depressive disorder and in a control group of healthy individuals, as well as correlation between their levels and the risk of recurrence of depression. Patients and methods The study included 50 patients with depression (22 in their first episode and 28 had recurrent episodes), of both sexes, aged between 18 and 65 years, diagnosed with major depressive disorder, from psychiatric outpatient clinic in Al-Zahraa Hospital, Cairo, Egypt, as well as 50 matched healthy individuals as a control group. Serum MMP-2, MMP-9, and TIMP-1 levels were determined. Results MMP-2 and MMP-9 showed a statistically significant difference in depressed patients compared with the control group. Moreover, recurrent depression group was significantly different from first episode depression group regarding MMP-2 and MMP-9 with higher levels, whereas TIMP-1 was higher in the control group. Conclusion Changes in the serum levels of MMPs and TIMP in patients with depression are common and can be used to predict recurrence.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Assessment of lactose intolerance in adult Egyptian patients with dyspeptic symptoms using lactase enzyme assay in duodenal biopsy p. 300
Mona Ramadan, Alshimaa M. M Eid, Nora M.A Seliem, Heba A.A Shokr
DOI:10.4103/sjamf.sjamf_53_20  
Objective To assess the role of endoscopic duodenal biopsies in diagnosing lactose intolerance of adult Egyptian patients with dyspeptic symptoms. Patients and methods A validated self-administered questionnaire was applied on 200 patients for symptom assessment after ingestion of lactose or lactose products. They are referred to the Hepatogastro-enterology and Infectious Diseases Department of Al-Zahraa University Hospital during the period from December 2018 to December 2019. Forty adult patients out of 200 were selected and subjected to history taking, clinical, laboratory evaluation, stool analysis, and abdominal ultrasound. They underwent upper gastrointestinal (GI) endoscopy and two postbulbar duodenal biopsies were taken for histopathology and biochemical assay of the lactase enzyme. Results The symptom questionnaire of 200 patients after ingestion of lactose-containing products showed that the mean and SD score of flatulence was the highest score (5.69±0.24); abdominal cramping was 3.29±0.16 while diarrhea was 0.84±0.09 and vomiting was the lowest score (0.30±0.05). Forty patients were selected for upper GI endoscopy with a mean age of 35.15±12.14 years; of the patients, 70.0% were women and 30.0% were men There was no statistically significant results as regards laboratory data or abdominal ultrasound. According to the values of lactase enzyme level in duodenal biopsies; 65% of patients had mild hypolactasia compared with 35% who were constant with normo lactasia and no patients with severe hypolactasia. Conclusion Adult patients with lactose intolerance mainly complain of abdominal cramps and flatulence more than other GI tract symptoms. Biochemical assay of lactase enzyme 35% who were constant with normolactasia and no patients with severe hypolactasia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta