No.

Titles / Authors

Full

Text

No.

1

Topical Beta Blockers as a Treatment for Superficial Cutaneous Infantile Haemangiomas

Prof. Dr. Mosaad Mohammed El Behery¹, Dr. Ahmed Ain Shoka², Dr. Mohammed Said El Sherbeny¹, Emad Eldeen Mamdouh El Deghedy²

¹Pediatric Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

²General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

dremadeldeghedy@gmail.com

Abstract: IH is a pediatric vascular tumor that appears as red, raised flesh a few weeks after birth in 5-10 % of neonates, and it is more common in the prematurely-born and in females. Infantile hemangioma (IH) is one of the most common benign tumors of childhood, with an incidence of between 4% and 10%. Topical application of timolol maleate, a non-selective β-blocker, is efficacious for the treatment of IHs, especially small superficial lesions. The use of topical beta blockers for hemangiomas is a relatively new indication for an old drug that has rapidly been accepted by the medical community, particularly those in pediatric specialities. The mechanism of action is being elucidated, but currently is thought to involve multiple pathways. Early reports find efficacy with minimal risk to the child, particularly when compared to the potential side effects of corticosteroids. A consensus on the preparation, dose, and duration of treatment would be beneficial. Similarly, a method of standardizing reporting of treatment success would improve analysis of future publications. In this study the age of initiation of treatment was more than eighteen months in twenty patients while sixteen patients had the onset of their treatment before twenty four months of age, four patients started the treatment after twenty four months of age, twelve patients who are less than twenty four months of age had 50% at least or more improvement of their hemangiomas (Good response) while only four patients had less than 50% improvement in their hemangiomas. On the other hand four patients who started their treatment after twenty four months of age had less than 50% improvement in their hemangiomas (Poor response). We suppose Topical Timolol maleate is a successful line of treatment for small superficial infantile hemangioma.

[Mosaad Mohammed El Behery, Ahmed Ain Shoka, Mohammed Said El Sherbeny, Emad Eldeen Mamdouh El Deghedy. Topical Beta Blockers as a Treatment for Superficial Cutaneous Infantile Haemangiomas. Nat Sci 2019;17(12):1-9]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 1. doi:10.7537/marsnsj171219.01.

Keywords: Topicalp; Beta Blocker; Treatment; Superficial; Cutaneous; Infantile; Haemangiomas

Full Text

1

2

Treatment of Chronic Neck Pain Using Different Injections (Comparative Study)

Nehal Ibrahim El-Sheshtawy; Heba Fawzy El-Shishtawy; Howayda Farouk Zidan; Rania Helmy Ahmed

Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Egypt

raninsedawy90@gmail.com

Abstract: Background: Neck pain is the second most prevalent musculoskeletal dysfunction in the active population. The approach to treatment of neck pain should be conservative and multidisciplinary, and should include education, pharmacological treatment, physical therapy, massage therapy, gentle stretching and exercise. Injections into Trigger point are common and effective treatment in decreasing pain and muscular spasm, increasing ROM and local circulation and cause fibrotic scar formation in trigger points. Objective: Our study was aimed to detect the most effective in pain relief in treatment of chronic neck pain with different injections (mesotherapy, prolotherapy and dry needling). Methods: This study was conducted at the Department of Physical Medicine, Rheumatology and Rehabilitation in Ain Shams University Hospitals as well as Railway Hospital on 45 patients with chronic neck pain. Their age group 30 to 70 years old and the disease duration ranged from 3 to 36 months. All patients were subjected to history taking, clinical examination, neurological examination and investigations as CBC, ESR and cervical plain x ray. Pain and functional assessment using Northwick park neck pain questionnaire (NPQ), the visual analog scale (VAS), Neck Disability Index (NDI) and chronic pain grade scale (CPGS).  All patients were randomly assigned into one of three groups: Group I who received mesotherapy injection, Group II who received prolotherapy injection and Group III who received dry needling injection. Results: As regard age, sex and duration of pain there was no significant difference between the three groups. Group I who received mesotherapy, as regard NPQ, NDI, and VAS, there were highly statistically significant difference between the patients before and after injection (improvement) (p<0.001). Group II who received prolotherapy, as regard NPQ, NDI, and VAS, there were highly statistically significant difference between the patients before and after injection (improvement) (p<0.001). Group III who received dry needling, as regard NPQ, NDI, and VAS, there were highly statistically significant difference between the patients before and after injection (improvement) (p<0.001). As regard the percentage of change there was statistically significant difference among group I than group II in the visual analog scale (VAS) and also among group II than group III in Northwick park neck pain questionnaire (NPQ), and the visual analog scale (VAS), i.e. significant improvement in group I versus group II and significant improvement in group III versus group II. There was significant positive correlation between age and duration of pain of all cases before injection. There was significant positive relation in comparison between duration of pain and CPGS before injection. Conclusion: The present study showed that the three methods of injection were effective from the first session of injection in treatment of chronic neck pain. The most effective method was the mesotherapy and dry needling over prolotherapy. The three methods of injection were easily and quickly carried out with no local or allergic reactions, but the easiest and least cost method was dry needling. Injection therapy seems to represent an alternative therapeutic technique especially in the presence of other diseases or comorbidities where there is a high risk of drug interaction or when conventional therapy of NSAIDs is contraindicated.

[Nehal Ibrahim El-Sheshtawy; Heba Fawzy El-Shishtawy; Howayda Farouk Zidan; Rania Helmy Ahmed. Treatment of Chronic Neck Pain Using Different Injections (Comparative Study). Nat Sci 2019;17(12):10-23]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 2. doi:10.7537/marsnsj171219.02.

Keywords: Treatment; Chronic; Neck; Pain; Different; Injection; Comparative Study

Full Text

2

3

Therapeutic Options in Management of Pediatric Flexible Flatfoot

Shereen Abdelsalam Elwan¹, Mervat Abd Elsatar Elsergany¹, Hamdi Ahmed Khaliaf¹, Hanan Mohamed Elsaadany¹, Mahmoud Abd El-Monem El-Rosasy²

¹ Department Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Egypt

²Department of Orthopedic Surgery, Faculty of Medicine, Tanta University, Egypt

shereenabdelsalam80@yahoo.com, sergany3@hotmail.com, Shereenabdelsalam80@yahoo.com, Hanan0777@hotmail.com, elrosasym@yahoo.com

Abstract: Background: Flatfoot is a common foot deformity affecting mainly children. Flexible and rigid are the two main categories of Flatfoot. Flexible flatfoot is identified by the normal arch with non-weight bearing flattening on stance. In contrast, rigid flatfoot is known as a stiff, flattened arch whether non-weight bearing or standing. Most of flexible flatfeet actually are physiologic, asymptomatic and requiring no therapy. However, symptomatic pes planus usually require either conservative or surgical treatment intervention. Objective: appraisal of complementary role of rehabilitation program in conjugation with either conservative or surgical management of paediatric flexible flat foot. Patients and Methods: This study was performed on 40 cases of idiopathic flexible flatfeet their ages range from 8-18 years at period of about 24 months between May 2015 and May 2017. Patients classified according to the line of treatment into 2 groups. Group 1: Twenty cases with 36 feet (16 cases bilateral and 4 cases unilateral) treated conservative in the form of therapeutic exercises, corrective foot wear and electrical stimulation, Group 2: Twenty cases with 32 feet (12 bilateral and 8 unilateral) were treated surgically by calcaneo-stop procedure after exhausting a total of 6 months of conservative methods. All Patients were selected from the outpatient clinics of physical medicine, Rheumatology and Orthopedic surgery departments in Tanta University Hospitals. Results: There was significant improvement of pain by VAS and activity of daily living by FAAM score after conservative treatment, with significant difference between both groups after treatment and insignificant difference between both groups after 1 year of follow up. There was significant improvement of navicular index after surgical treatment, with significant difference between both groups after treatment and after 1 year of follow up.

[Shereen Abdelsalam Elwan, Mervat Abd Elsatar Elsergany, Hamdi Ahmed Khaliaf, Hanan Mohamed Elsaadany, Mahmoud Abd El-Monem El-Rosas. Therapeutic Options in Management of Pediatric Flexible Flatfoot. Nat Sci 2019;17(12):24-30]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj171219.03.

Keywords: Therapeutic; Option; Management; Pediatric; Flexible Flatfoot

Full Text

3

4

Tympanometric changes in gastro esophageal reflux disease patients

Dr. Mustafa Shams al-Din Khafaji, MD¹, Dr. Ahmed Sobhi Elsayed, MD², Ahmed Mustafa Abdelmoneim, M.B.B.CH³

¹Professor of Otorhinolaryngology Faculty of Medicine, Al-Azhar University, Egypt

²Lecturer of Otorhinolaryngology Faculty of Medicine, Al-Azhar University, Egypt

³Resident of Otorhinolaryngology, Egypt

Abstract: Background: Multiple studies have questioned about the relationship between GERD and eustachian tube dysfunction. This study was conducted to survey tympanometric changes in GERD patients who presented to the Outpatient otorhinolaryngology clinic at Al-Azhar University hospitals. Patient and methods: Forty-eight cases with GERD scores higher than 8 were included. They were subjected to history taking, clinical examination, and complete otorhinolaryngological examination including anterior rhinoscopy, otoscopy, and tympanometry. Results: The mean age of the cases included in the study was 34.51 ± 14.71. The mean GERD score of the cases included in the study was 10.69±16.91. In the right ear, there were 39 cases (81.3%) with type A curve, 3cases (6.3%) with type B curve and 6 cases (12.5%) with type Ad curve. In the left ear, there were 36 cases (75%) with type A curve, 3 cases (6.3%) with type B curve, 6 cases with type C curve (12.5%) and 3 cases (6.3%) with type Adcurve. Conclusion: Based on the results of the study, we concluded that GERD causes tympanometric changes mostly unilateral type c mostly secondary to unilateral Eustachian tube dysfunction.

[Mustafa Shams al-Din Khafaji, Ahmed Sobhi Elsayed, Ahmed Mustafa Abdelmoneim. Tympanometric changes in gastro esophageal reflux disease patients. Nat Sci 2019;17(12):31-38]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 4. doi:10.7537/marsnsj171219.04.

Keywords: Tympanometric; change; gastro; esophageal; reflux; disease; patient

Full Text

4

5

Role of MDCT in diagnosis of pulmonary nodules

Nadia Abdelsater Metwally ¹, Hoda Mahmoud Abdelwahab¹, Amal Rashad Abdelasttar²

¹Professor of Radiodiagnosis Faculty of Medicine for Girls Al-Azhar University, Egypt

² M.B.B.CH Faculty of Medicine for Girls Al-Azhar University, Egypt

pharma_20102002@yahoo.com

Abstract: Objective: This study aims to evaluate role of MDCT in diagnosis of pulmonary nodules. Methods: The prospective study was carried out on 20 patients which presented by pulmonary nodules and some of patients were accidentally discovered pulmonary nodules. The patients were referred from chest, Internal medicine department and out patient clinic of Al Zahraa University hospital to MDCT unit of radiology department. The study will be conducted for a period of one year from October 2018 to October 2019 after getting approval from the ethical committee of the institute. Informed consent from all patients was taken before inclusion in the study. Results: The total number of cases in this study were 20 cases, 12 (60%) cases were male and 8 (40%) cases were female. Multiple pulmonary nodules were the commonest noted in 15 (75%) patients while solitary nodules seen in 5 (25%) patients. The commonest type of pulmonary nodules is secondary from other malignancy presented in 11 (55%) cases while Primary malignancy was presented in 5 (25%) cases. Conclusion: MDCT is more sensitive than single-detector CT in evaluating morphologic characteristics, growth and follow-up of pulmonary nodules.

[Nadia Abdelsater Metwally, Hoda Mahmoud Abdelwahab, Amal Rashad Abdelastta. Role of MDCT in diagnosis of pulmonary nodules. Nat Sci 2019;17(12): 39-43]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 5. doi:10.7537/marsnsj171219.05.

Keywords: MDCT, Pulmonary nodule diagnosis

Full Text

5

6

Estimation of the loss of taro yield during marketing stage and its effect on the price of the Producer

Manal Mahmoud Ibrahim and Wael Abdel Fatah Abdel Gaied

Agricultural Economics Research Institute. ma_halim@hotmail.com

Abstract: Taro is one of the most important crops economically, The research problem is the lack of sufficient studies to determine the extent of losses in the post-harvest period, the absence of accurate data on the economics of production, and the scarcity of scientific research on this crop. The objective of the research was to estimate the percentage of taro in the post-harvest level at the farm, On the economics of taro production and access to economic derivatives of the production functions and costs of the research sample and productivity estimated about the volume of production which reduces costs. The average cultivated area of taro in Egypt during the period (2000-2016) was 7.9 thousand feddan, with 13.72 tons/feddan and a total production of 108.7 thousand tons. The average area cultivated in Menoufia during the same period was 2.15 thousand feddan with a production capacity of 13.82 tons/Feddan with an average production of 31.22 thousand tons, and the average percentage of the production of Menoufia governorate for the total production in Egypt during the same period 28.09%. The time trend for the development of taro area in Menoufia Governorate during the same period showed that it has taken an increasing general trend of 5 feddan per year, as well as the trend of taro production in the governorate of Menoufia during the same period showed that it has taken an increasing trend of 3 tons annually. By accumulating 10 tubers, their weights were calculated daily for one month at room temperature during December 2017. It was found that the percentage of losses in the weights of the tubers was about 15.9% with a minimum of 11.4% and a maximum of 19.6%. The total area cultivated with taro in the sample used in the research was about 32 feddan with an average total cost per feddan of 23.62 thousand pounds and the average production of taro 10.92 tons per feddan. The average price of taro tar was about LE 3648 and the average yield of taro was 39.75 thousand pounds The yield per feddan of taro was about 16 thousand pounds, one in addition to the average yield of the loaded crop, which turned out to be the highest net yield of the crop was the yield of zucchini, where the average net yield of zucchini 8034 pounds/feddan and Malukhia 6548 pounds / fed and finally corn 3059 pounds/feddan. Using the logarithmic form, it was possible to obtain the elasticity of the independent production elements of the taro yield in the research sample. The equation indicated that the increase in the use of the elements (labor, fertilizer, super phosphate and potassium sulphate fertilizer by 10% increased production by 5.7% 9%. The same equation indicates that there is excessive use of seeds as well as municipal fertilizers and that their rates have not been substantiated. For the cost function, the research showed that the civilian size of the costs is 14.8 tons.

[Manal Mahmoud Ibrahim and Wael Abdel Fatah Abdel Gaied. Estimation of the loss of taro yield during marketing stage and its effect on the price of the Producer. Nat Sci 2019;17(12): 44-50]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 6. doi:10.7537/marsnsj171219.06.

Keywords: Estimation; loss; taro; yield; marketing; stage; effect; price; producer

Full Text

6

7

Evaluation of Different Methods for Management of Difficult Cases of Otomycosis

Mostafa M. El said¹, Ahmed S. Abdelgelil¹, Ibrahim H. Bayomy² and Mahmoud M. Abd Elkhalek¹

¹Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

²Department of Medical Microbiology and Immunology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email: emanal95@gmail.com

Abstract: Background: Otomycosis is one of the most common conditions encountered in general ENT practices. Otomycosis is mainly used to describe external fungal infections and also known as fungal otitis externa where fungal infection occurs at the external auditory canal, auricle, eardrum, and rarely middle ear ⁽¹⁾. Objective: This study aims to identify the most common pathogens encountered in difficult cases of otomycosis and evaluation of the most effective protocol for management of such cases. Subjects and methods: This prospective study was conducted at the otolaryngology outpatient clinic of Shubra General Hospital, Ministry of Health between April 2018 and June 2019 after approval of the study protocol by local ethical committee. An informed consent was obtained from all patients enrolled in this work. This study comprised a total of 50 patients clinically diagnosed with otomycosis and were divided into: Group 1: (20) patients without tympanic membrane perforation and Group 2: (30) patients with tympanic membrane perforation. Group 1patients have been divided into 2 groups: Group 1a and group 1b. (Group 1a): 10 patients were treated by topical antifungal cream (Clotrimazole 1%). (Group 1b): 10 patients were treated by topical antifungal ear drops (clotrimazole 1%). Results: -Group 1A (received topical antifungal cream); 9 cases cured within 5 days and only one cured within 10 days. -Group 1B (received topical antifungal drops); 7 cases cured within one month and 3 within 1.5 months. -Group 2: 30 patients group with tympanic membrane perforation (treated with topical antifungal cream); 27 cases cured within 5 days, 2 cured within 10 days and only one cured within 15 days. Conclusion: From this prospective randomized study it can be concluded that application of local antifungal agent in the form of cream is more effective than application of the same agent as drops in treatment of otomycosis.

[Mostafa M. El said, Ahmed S. Abdelgelil, Ibrahim H. Bayomy and Mahmoud M. Abd Elkhalek. Evaluation of Different Methods for Management of Difficult Cases of Otomycosis. Nat Sci 2019;17(12):51-58]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 7. doi:10.7537/marsnsj171219.07.

Key words: Otomycosis, fungal infections, antifungal cream, antifungal drops

Full Text

7

8

Ankyloglossia and Its Effect on Breast Feeding

Hatem Abd El-Kadder Saafan¹; Ali El-Anwar²; Mohamed Saeed El-Sherbiny¹; Mohamed Gamal Abdel Nasser Mohamed¹

¹Paediatric Surgery Department, Faculty of medicine, Ain Shams University, Egypt

²General Surgery Department, Faculty of medicine, Ain Shams University, Egypt

m.g.abdelnasser@gmail.com

Abstract: Background: According to the World Health Organization Global Health Observatory data repository, the rate of exclusive breast feeding in Egypt under 6 month according to the last official study done was 39.4%Review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Ankyloglossia has been controversial among the medical community as a cause affecting the efficacy of breastfeeding. Aim of this Study is to establish the effect of ankyloglossia on breastfeeding. Objective: To evaluate effect of frenulum releases in newborn infants with suspected tongue-tie (ankyloglossia) and its variable degrees and to determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia. Methods: Ethical considerations and study approval were obtained, patients attending Ain Shams University hospitalsin a duration of 6 months. Two self-reported questionnaires were administered to mothers whose infants were undergoing frenotomy to determine the degree of tongue tie and the effectiveness of breastfeeding prior to frenotomy, Telephone contact after procedure by two weeks was done to determine effectiveness of tongue tie release on the breastfeeding of the patients. Results: LATCH score showed improvement in 70% of the cases as the patient attachment during breastfeeding increasing post frenotomy making breastfeeding more efficient. Conclusion: Ankyloglossia is a congenital oral anomaly with variable degrees affects efficient breastfeeding and frenotomy is not an elective surgery in age below 6 months for patient on exclusive breastfeeding.

[Hatem Abd El-Kadder Saafan; Ali El-Anwar; Mohamed Saeed El-Sherbiny; Mohamed Gamal Abdel Nasser Mohame. Ankyloglossia and Its Effect on Breast Feeding. Nat Sci 2019;17(12):59-62]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 8. doi:10.7537/marsnsj171219.08.

Keywords: Breast Feeding; Ankyloglossia

Full Text

8

9

Effect of negative pressure wound therapy on wound healing

Hussein Boshnak¹; Ossama El-Najjarabd El Ella²; Wael Ghanem Radwan²; Mohamed Hisham Soliman²; Yehia Emad Barhouma El-sayed²

¹General Surgery Department, Faculty of Medicine, Ain Shams University, Egypt

²Paediatric Surgery Department, Faculty of Medicine, Ain Shams University, Egypt

Yeka511@hotmail.com

Abstract: Background: A wound may be defined as any disruption of the integrity of skin, mucous membrane or organ tissue. A distinction is made between simple wounds that are confined to the skin, and complicated wounds which are deeper and also involve injury to muscles, nerves, and vessels. Delay in wound healing poses the risk of additional wound complications like infection and disruption. It is a major contributor towards morbidity of surgical patients, adds to the cost of treatment and consumes a lot of hospital resources. The NPWT system (also known as microdeformational wound therapy MDWT or Vacuum assisted closure VAC) is a relatively new technology in wound management. Objective: This study is designed to evaluate NPWT methodology as a technique for management of difficult open wounds in paediatric surgery practice. Giving clinical examples of the usage of NPWT from our university, Ain shams university hospitals, department of pediatric surgery. Methods: This is a case series study was done at paediatric surgery department), Ain Shams University Hospitals study was conducted over a period of 6 months. Results: Advantages of NPWT to be discussed are better and faster wound healing, less discharge, short hospital stay and lower cost than the conventional dressing while it also has some disadvantages and challenges as sponge adherence to the surrounding tissues, possibility or contra-indication of usage with enteric fistula. Conclusion: NPWT showing great results but it needs more time to study and observe its usage to reach the optimum benefit out of it and to avoid its complications as much as possible.

[Hussein Boshnak; Ossama El-Najjarabd El Ella; Wael Ghanem Radwan; Mohamed Hisham Soliman; Yehia Emad Barhouma El-saye. Effect of negative pressure wound therapy on wound healing. Nat Sci 2019;17(12):63-66]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 9. doi:10.7537/marsnsj171219.09.

Keywords: Negative pressure wound; wound healing

Full Text

9

10

Inferior Vena Cava Collapsibility versus Central Venous Pressure as a Guide of Fluid Management in Septic Patients

Naglaa Basiony¹, Simon Metry² and Tamer Harraz³

¹Professor of Critical Care Medicine and Pain Management Ain Shams University, Egypt.

² Lecturer of Critical Care Medicine and Pain Management, Ain Shams University, Egypt.

³M.B.B.CH Faculty of Medicine, Alexandria University, Egypt.

tamerharraz@gmail.com

Abstract: Objective: Fluid infusion, the most critical step in the resuscitation of patients with septic shock, needs preferably continuous invasive hemodynamic monitoring. The study was planned to evaluate the efficacy of ultrasonographically measured inferior vena cava collapsibility index (IVC CI) in comparison to central venous pressure (CVP) in predicting fluid responsiveness in septic shock. Materials and Methods: Thirty-six patients of septic shock requiring ventilatory support (invasive/noninvasive) were included. Patients with congestive heart failure, raised intra-abdominal pressure, and poor echo window were excluded from the study. They were randomly divided into two groups based on mode of fluid resuscitation – Group I (CVP) and Group II (IVC CI). Primary end-points were mean arterial pressure (MAP) of ≥65 mmHg and CVP >12 mmHg or IVC CI <20% in Groups I and II, respectively. Patients were followed till achievement of end-points or maximum of 6 h. Outcome variables (pulse rate, MAP, urine output, pH, base deficit, and ScvO2 ) were serially measured till the end of the study. Survival at 2 and 4 weeks was used as secondary end-point. Results: Primary end-point was reached in 31 patients (15 in Group I and 16 in Group II). Fluid infusion, by either method, had increased CVP and decreased IVC CI with resultant negative correlation between them (Pearson correlation coefficient –0.626). There was no significant difference in the amount of fluid infused and time to reach end-point in two groups. Comparison in outcome variables at baseline and end-point showed no significant difference including mortality. Conclusion: CVP and IVC CI are negatively correlated with fluid resuscitation, and both methods can be used for resuscitation, with IVC CI being noninferior to CVP.

[Naglaa Basiony, Simon Metry and Tamer Harraz. Inferior Vena Cava Collapsibility versus Central Venous Pressure as a Guide of Fluid Management in Septic Patients. Nat Sci 2019;17(12):67-74]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 10. doi:10.7537/marsnsj171219.10.

Key Words: Central venous pressure, fluid responsiveness, hypovolemia, septic shock, sonographic inferior vena cava variability

Full Text

10

11

Fetal hemodynamic changes following maternal betamethasone administration in pregnancies with fetal growth restriction and absent end-diastolic flow of the umbilical artery

Mohammed Ali Mohammed, El-Sayed Ahmed El-Desoky, Sameh Said, Ahmed Hammam Ahmed Hammam

Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Egypt

Ahmedhamam120@gmail.com

Abstract: Objectives: To evaluate the effects of antenatal betamethasone administration on umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV) Doppler flow. Design: Longitudinal prospective study. Setting: Department of Obstetrics and Gynecology, Elsayed Galal University Hospital. Population: 50 singleton pregnancies complicated by fetal growth restriction with absent end-diastolic flow in the UA. Methods: Doppler indices of the UA, MCA and DV were measured from 28 to 34 weeks prior to and within 24 or 48 hours after starting betamethasone treatment course. Analysis of variance for repeated measures was used to determine the changes in the fetal hemodynamic Doppler flow following maternal corticosteroid administration. Main outcome measures: Improvement of UA-PI within 24 hours and DV-PIV (venous pulsatility) within 48 hours from the first betamethasone dose. Results: Mean gestational age at delivery was 31.38 weeks and birth weight was 1137.20 g. A reduction in the UA-PI was observed in 46 (92%) cases, with return of end-diastolic flow in 34/50 (68%). The mean UA-PI were 2.08 before corticosteroid administration, 1.75 within 24 hours and 2.09 after 48 hours, with a significant difference along the evaluations (p<0.001). No significant changes in the MCA Doppler were observed. DV-PIV decreased from 1.07 prior corticosteroids administration to 0.72 within 24 hours and 0.69 after 48 hours (p<0.001). Conclusions: There was reduction in the umbilical artery and in the DV pulsatility indices within 24 hours from betamethasone administration that was maintained up to 48 hours.

[Mohammed Ali Mohammed, El-Sayed Ahmed El-Desoky, Sameh Said, Ahmed Hammam Ahmed Hammam. Fetal hemodynamic changes following maternal betamethasone administration in pregnancies with fetal growth restriction and absent end-diastolic flow of the umbilical artery. Nat Sci 2019;17(12):75-80]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 11. doi:10.7537/marsnsj171219.11.

Key words: Betamethasone, fetal growth restriction, Doppler ultrasound, ductus venosus, middle cerebral artery, umbilical artery, absent end-diastolic flow

Full Text

11

12

A Comparative Study for Lymphedema Following Formal Axillary Lymph Node Dissection versus Lymphnode Sentinel Biopsy for Breast Cancer

Mohamed khalaf¹; Wagih Fawzy²; Sherif Morad¹; Alaa Mohamed Abd Elsalam Khedr¹

¹General Surgery Department, Faculty of medicine, Ain Shams University, Cairo, Egypt

²Vascular Surgery Department, Faculty of medicine, Ain Shams University, Cairo, Egypt

Alaakhdr00@gmail.com

Abstract: Background: Breast cancer treatment related lymphedema (BCRL) is associated with significant morbidities. To reduce the rate of BCRL, surgeons have changed the clinical practice in the surgical treatment of breast cancer, by performing sentinel lymph node biopsy (SLNB) instead of performing axillary lymph node dissection (ALND). Objective: The aim of this study is to compare and describe occurrence of lymphedema after complete axillary dissection versus sentinel lympnode biopsy in management of breast cancer. Methods: The present study is a prospective comparative study. It was conducted in the period from July, 2017 through June, 2018. The present study sought to compare using SLNB versus ALND in breast cancer patients in respect to occurrence of lymphedema. The study recruited 20 women indicated for modified radical mastectomy. They were equally and randomly allocated to one of the treatment groups: group I patients were subjected to ALND while group II patients were subjected to SLNB. Postoperatively, all patients were followed for lymphedema and related symptoms up to 6 months. Results: Comparison between the studied groups at baseline regarding age, BMI and pathological data revealed no statistically significant differences. In addition, there were no statistically significant differences between the studied groups regarding the preoperative arm circumference. Matching of the basic data assures that the study outcome would be probably attributed to the different surgical interventions. In the current study, comparison between the studied groups regarding the postoperative arm circumference higher arm circumference in GI patients which was short of statistical significance. However, the percent of arm circumference increase was significantly higher in GI patients. These differences were reflected in the significantly higher rate of lymphedema in GI patients as compared to GII patients (40.0 % versus 0.0 %, p=0.025). Conclusions: SLNB is associated with significantly lower rate of lymphedema.

[Mohamed khalaf; Wagih Fawzy; Sherif Morad; Alaa Mohamed Abd Elsalam Khed. A Comparative Study for Lymphedema Following Formal Axillary Lymph Node Dissection versus Lymphnode Sentinel Biopsy for Breast Cancer. Nat Sci 2019;17(12):81-86]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 12. doi:10.7537/marsnsj171219.12.

Keywords: Lymphedema; Lymph Node Dissection; Lymphnode Sentinel Biopsy; Breast Cancer

Full Text

12

13

Assessment of Progranulin as an Early Diagnostic Marker of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus 

Fawzy Abdel Fattah Elmessalamy, Hazem Mohamed El Ashmawy, Mohamed Gaber Hamed and Amin Mohamed Amin

Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt

dr.amin.mohmd@gmail.com

Abstract: Aims: We aimed to investigate progranulin as a diagnostic marker of diabetic nephropathy in patients with type 2 diabetes mellitus. Methods: The study included ninety subjects, divided into three groups; 30 patients with type 2 diabetes mellitus with diabetic nephropathy, 30 patients with type 2 diabetes mellitus without diabetic nephropathy and 30 apparently healthy individuals (control group). All personnel were subjected to full history taking, thorough clinical examination, glycated hemoglobin, complete lipid profile, serum creatinine and blood urea and Urinary albumin creatinine ratio. progranulin level was measured for all personals. Results: There are statistically significant differences between the three groups regarding age and body mass index with significant difference between every group in comparison with others. Also, there are significant differences between both groups regarding systolic and diastolic blood pressure. There are statistically significant differences between the three groups regarding kidney function tests, glycated hemoglobin and fasting blood glucose. Also, there are significant differences between both groups regarding ALT, AST and serum albumin. There are significant differences between both groups regarding total cholesterol and triglycerides. There is a significant difference between both groups regarding serum progranulin. There are significant differences between both groups regarding type of therapy used and disease duration. There are highly significant positive correlations between serum PGRN and age, urea, creatinine, urinary albumin-to-creatinine ratio, glycated hemoglobin, fasting blood glucose, duration, total cholesterol, triglycerides, systolic and diastolic blood pressure. There are highly significant negative correlations between serum progranulin and BMI, estimated glomerular filtration rate and serum albumin. Multiple stepwise regression analysis demonstrated that only urinary albumin-to-creatinine ratio, duration and diastolic blood pressure were independently associated with serum progranulin. Conclusion: Serum progranulin concentrations increased in Egyptian patients with nephropathy. The level of progranulin in patients with type 2 diabetes should be paid high attention and it could be a potential therapeutic target for the management of type 2 diabetes and diabetic nephropathy.

[Fawzy Abdel Fattah Elmessalamy, Hazem Mohamed El Ashmawy, Mohamed Gaber Hamed and Amin Mohamed Amin. Assessment of Progranulin as an Early Diagnostic Marker of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus. Nat Sci 2019;17(12):87-95]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 13. doi:10.7537/marsnsj171219.13.

Key Words: type 2 diabetes mellitus, diabetic nephropathy, progranulin

Full Text

13

14

Ultrasound-assisted Transversus Abdominis Plane Block Versus Wound Infiltration for Postoperative Analgesia in Pediatric Patients Undergoing Inguinal Hernia Repair: A Randomized Controlled Trial

Mohamed H. Shokeir, Ibrahim M. Esmat, Thabet A. Nasr, Sara M. El-kfafi

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University

saramagdy333@gmail.com

Abstract: Background: Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimens provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Objectives: to evaluate the analgesic effect of ultrasound guided TAP block compared with wound infiltration during the first 24 h after surgery in children undergoing inguinal hernia repair. Design: prospective, randomized, double-blinded and controlled study. Setting: Pediatric surgery department at Children's Ain Shams University Hospital, Patients and Methods: Sixty Children between 2 and 8 years of age undergoing unilateral inguinal hernia repair at Pediatric surgery department at Children's Ain Shams University Hospital, were randomized between TAP block group and wound infiltration group each of Thirty patients. Measurements: Pain scores, Time to rescue analgesia, Total analgesic drug requirements, and side effects were observed for 24 hours. Results: The duration of adequate analgesia was significantly higher in group A (TAP) compared to group B (Wound infiltration) p-value <0.001. Twenty-Two (78.6%) patients in TAP group did not require any analgesic within the first 24 h compared with only ten patients (37%) in wound infiltration group. Also a statistically significant decreased number of patients of TAP group was found compared to wound infiltration group regarding the need for analgesia and total analgesic dosesp-value <0.05. The side effects were equally insignificant in both groups. Conclusion: US guided TAP block provided significantly prolonged postoperative analgesia, reduced postoperative analgesic requirements compared with wound infiltration and without any clinical side-effects during the first 24 h after surgery in children undergoing inguinal hernia repair. Both analgesic techniques are safe.

[Mohamed H. Shokeir, Ibrahim M. Esmat, Thabet A. Nasr, Sara M. El-kfafi. Ultrasound-assisted Transversus Abdominis Plane Block Versus Wound Infiltration for Postoperative Analgesia in Pediatric Patients Undergoing Inguinal Hernia Repair: A Randomized Controlled Trial. Nat Sci 2019;17(12):96-103]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 14. doi:10.7537/marsnsj171219.14.

Key words: Transversusabdominis Plane Block, wound Infiltration, postoperative Analgesia, children, inguinal hernia repair

Full Text

14

15

Laryngeal ultrasound versus cuff leak test in prediction of post extubation laryngeal edema

Prof. Dr. Sahar Mohamed Kamal Mahmoud Hassanen, Dr. Waleed Abdalla Ibrahim Ahmed, Dr. Mohamed Moien Mohamed El Saed Ellewa, Mostafa Aboelyazeed Kassem

Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt

Kassem2014@gmail.com

Abstract: The Post extubation Laryngeal edema is a common cause of obstruction of the upper air way after extubation in critical care patients and is thought to arise from direct mechanical trauma to the larynx by the endotracheal tube. The severity of airway obstruction due to laryngeal edema varies up to emergency reintubation. Reintubation itself is associated with increased mechanical ventilation days and length of stay in the critical care unit, higher costs, morbidity and mortality. There is a substantial need to identify a test to confirm or exclude the presence of significant laryngeal edema before extubation. The purpose of this study was to determine the accuracy of bedside ultrasound in the ICU in predicting post extubation stridor (PES) versus the cuff leak test. The current study was a prospective observational cohort study enrolled 75 patients admitted to AIN SHAMS Main University Hospital, who were planned for extubation. The air column width difference (ACWD) was measured before planned extubation using portable ultrasound and cuff leak test was measured by the spirometery function of the mechanical ventilation The primary goal was to assess the diagnostic accuracy of ACWD to predict the presence of significant laryngeal edema, enough to cause PES. The results showed that the prevalence of LE was 18.7%. The data collected from patients, with and without, PES showed no definite risk factors for PES. A cut off point of 0.9 mm change in ACWD (air column width difference at vocal cords) was identified (p= 0.0014), below which high probability of developing PES was noticed. The sensitivity and specificity of ACWD below or equal to 0.9 mm were 88% and 82% in predicting PES respectively, with negative predictive value of 0.83 and positive predictive value of 0.86. while the cuff leak test on cutoff point of 110 ml show p value equal 0.0016 with senetivity and specifity of68% and 89% with negative predictive value of 0.87 and positive predictive value of 0.69.

[Sahar Mohamed Kamal Mahmoud Hassanen, Waleed Abdalla Ibrahim Ahmed, Mohamed Moien Mohamed El Saed Ellewa, Mostafa Aboelyazeed Kassem. Laryngeal ultrasound versus cuff leak test in prediction of post extubation laryngeal edema. Nat Sci 2019;17(12):104-112]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 15. doi:10.7537/marsnsj171219.15.

Keywords: Laryngeal; ultrasound; versus; cuff leak; test; prediction; post extubation; laryngeal edema

Full Text

15

16

Comprehensive Study of Vancomycin and Piperacillin/Tazobactam inducedAcute Kidney Injury

Wael A. Mohammed, Gihan S. El-Nasr, Wael A. Abd El-Aal, Amr H. Mohammed

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Ain Shams University, Egypt

3amrhanafy.n9000@gmail.com

Abstract: Background: In people without any acute disease, acute kidney injury is increasingly shown in primary care and awareness of the condition must be increased between primary health care professionals. Aim of the Work: To discuss comparison of the incidence of Vancomycin and Piperacillin/Tazobactam induced Acute Kidney Injury in hospitalized patients, especially critically ill patients with Acute Broncho-Pneumonia. Efficacy of renal replacement therapy will be evaluated. Patients and Methods: The prospective research involved 75 adult patients aged 18 years and older admitted to ICU with broncho-pneumonia and normal kidney functions. All patients were divided into 3 groups; the first group composed of 25 patients who received Vancomycin as monotherapy, the second group consisted of 25 patients who received Piperacillin/Tazobactam as monotherapy, and the third group consisted of 25 patients who received combined Vancomycin/Piperacillin. Results: regarding incidence of AKI there was only 1 case (4%) of Vanc. group who developed AKI, while there were another 4 cases (16%) of Piptazo. group and 6 cases (24%) of comb V/P group who developed AKI (p=0.100). Conclusion:Compared with vancomycin monotherapy and piperacillin / tazobactam monotherapy, there is an increased risk of acute kidney injury correlated with the combination of vancomycin and piperacillin / tazobactam.

[Wael A. Mohammed, Gihan S. El-Nasr, Wael A. Abd El-Aal, Amr H. Mohammed. Comprehensive Study of Vancomycin and Piperacillin / Tazobactam induced Acute Kidney Injury. Nat Sci2019;17(12):113-119].ISSN 1545-0740 (print); ISSN 2375-7167 (online).http://www.sciencepub.net/nature.16. doi:10.7537/marsnsj171219.16.

Keywords: Vancomycin, Piperacillin/Tazobactam, acute Kidney Injury, Broncho-Pneumonia

Full Text

16

17

Relationship between Prostate Volume, Prostate-Specific Antigen, Age, and Weight of Healthy Adults Sudanese Men

Dr. Mohamed Yousef

Radiological Science Program, Batterjee Medical College for Science and Technology, Jeddah, KSA

Mohamed.yousef@bmc.edu.sa

Abstract: Ultrasound is a widely used imaging modality for evaluation of the prostate. This study was carried out to determine the Relationship between Prostate Volume, Prostate-Specific Antigen, Age, and Weight of Healthy Adults Sudanese Men using supra-pubic ultrasonography. This is Cross-sectional descriptive study was carried out at ultrasound department of Ribat University Hospital- Khartoum Sudan, included fifty asymptomatic adult their age ranges from 20 to 40, 52% are single and measurements of the maximum length, height and width of their prostate gland were obtained and the volume calculated using the ellipsoid formula. Subjects were selected, if they had no complaints related to the urinary system or signs of urinary tract disease. The results of this study for the entire study population was revealed that the transverse, AP and Longitudinal diameters mean values are (2.68) cm, (3.56) cm, and ( 3.02) cm respectively. Mean±SD of Weight (Kg), Prostate-Specific Antigen (PSA) and prostatic volume (PV) (cm3)ml, 66.74±7.63, 1.89±0.59,15.24±4.30 respectively, and there is strong positive correlation between prostatic volume and age, (p value = 0.001), and PSA (p value = 0.000) there is no significant correlation between prostate volume and weight (p value = 0. 0.145). The study concluded that prostate gland volume increased gradually by age and PSA, the means prostatic volume 15.24±4.30 cm3, the normal reference ranges for PV for Sudanese was established.

[Yousef M. Relationship between Prostate Volume, Prostate-Specific Antigen, Age, and Weight of Healthy Adults Sudanese Men. Nat Sci 2019;17(12):120-124]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 17. doi:10.7537/marsnsj171219.17.

Keywords: Prostate; Volume; Ultrasound.; Normal; Sudanese

Full Text

17

18

Fibrin Glue versus Sutures for Mesh Fixation in open Repair of Uncomplicated Inguinal Hernia

Prof. Dr. Ahmed Abd Alaziz Abo Zaid, Assist. Prof. Dr. Hanna Habib Hanna, Dr. Mohamed Ibrahim Mohamed Ali, Elsayed Hassan Elsayed Abdalhalem

General Surgery Department, Faculty of Medicine – Ain Shams University, Cairo, Egypt

s_elghozz@yahoo.com

Abstract: Abdominal wall hernias are common, with a prevalence of 1.7% for all ages and 4% for those aged over 45 years. Inguinal hernias account for 75% of abdominal wall hernia. The increasing use of mesh procedures in inguinal hernia surgery has led to a substantial decrease in the incidence of hernia recurrence. The Lichtenstein technique is a standard procedure for open tension-free inguinal hernia repair performed using prosthetic meshes to strengthen the inguinal canal posterior wall. Sutures and staples may strangulate muscle fibers, compress regional nerves, or give rise to a lesion, leading to incapacitating pain or dysesthesia Because of the Complications associated with sutured mesh fixation following open groin hernia repair have prompted surgeons to evaluate methods of atraumatic fixation, such as the use of human fibrin glue. Fibrin glue is a biodegradable adhesive combining human-derived fibrinogen and thrombin that replicates the last step of the coagulation cascade. It has been used in a variety of surgical fields for its effectiveness, excellent local tolerability, and relative lack of adverse effects and contraindications. In this study, forty (40) patients suffering from uncomplicated inguial hernia were repaired by tension free hernioplasty (Lichtenstien), was done in Bolak Aldakror General Hospital, Ahmed Maher teaching hospital and hospital, they randomly assigned into 2groups: group (A): with fibrin glue fixation and group (B): with suture fixation, the main aim of the study was to compare between sutures and fibrin glue for mesh fixation in openinguinal hernioplasty with evaluation of operative time, post-operative pain, hospital stay and return to normal life activity. The presented results show that the mesh fixation with fibrin glue in open, tension free repair by Lichtenstein is simple, safe and effective. This method of fixation show distinct advantages over suture fixation, with slight possibility of chronic pain, and complications. During polypropylene mesh fixation with fibrin glue minimal retraction is required. Greater retraction, as in suture methods, leads to increased tissue contusion and short-term pain. Therefore, consistent with our results, a small contusion of soft tissues associated with minimal postoperative pain is what makes this method more advanced.

[Ahmed Abd Alaziz Abo Zaid, Assist. Hanna Habib Hanna, Mohamed Ibrahim Mohamed Ali, Elsayed Hassan Elsayed Abdalhalem. Fibrin Glue versus Sutures for Mesh Fixation in open Repair of Uncomplicated Inguinal Hernia. Nat Sci 2019;17(12):125-131]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 18. doi:10.7537/marsnsj171219.18.

Keywords: Fibrin; Glue; Suture; Mesh; Fixation; open; Repair; Inguinal Hernia

Full Text

18

19

Assessment of biocompatibility properties of Calcium– Silicate Based pulp capping materials

Roshdy A¹, Farghaly A², Eslam T³.

[1] Endodontist, Police hospital, Cairo, Egypt

2 Professor, Endodontics Department, Faculty of Oral and Dental Medicine, Al-Azhar University (Boys- Cairo), Egypt

3 Professor, Endodontics Department, Faculty of Oral and Dental Medicine, Al-Azhar University (Boys- Cairo). Egypt

Ahmedmrs2003@hotmail.com

Abstract: Purpose: The objective of the study was to evaluate biocompatibility properties of calcium–silicate based pulp capping materials (MTA-Biodentine and Theracal). Materials and Methods: 27 males and females rabbits were selected to be used for the present study. The rabbits were classified into three mains groups. the roof of the pulp was removed and the pulptomy materials were mixed and the exposed pulps were capped with either of the three pulptomy agents ( MTA, Biodentine or Theracal ) "3 rabbits from each main group" at 1month, 2months and 3 months and the pulpotomized teeth evaluate the histopathological changes of the pulpal reactions to the selected materials under the light microscope using a definite scoring system. Results: The early response of pulp tissue to all tested materials was inflammatory reactions, of various degrees, that were subsided by time and Pulp tissue responses more favorably to both MTA and Biodentine compared to Theracal. Conclusion: The responses of pulp tissue to the tested materials are time dependant i.e. it get affected by increasing the duration of capping.

[Roshdy A, Farghaly A, Eslam T. Assessment of biocompatibility properties of Calcium– Silicate Based pulp capping materials. Nat Sci 2019;17(12):132-138]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 19. doi:10.7537/marsnsj171219.19.

Keywords: Assessmen; biocompatibility; Calcium; Silicate Based pulp; capping materials

Full Text

19

20

Arthroscopically Assisted Management for Schatzker Type I & II Tibial Plateau Fractures

Ali Mohamed Elguioshy, Mohamed Ibrahim Abulsoud, Ahmed Essam Ibrahim Saber

Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

enar413@yahoo.com

Abstract: Background: Tibial plateau fractures have always been a challenge for orthopedic surgeons. These fractures may be difficult to manage and, although these lesions are relatively rare representing approximately 1% of all fractures, the consequences of an inadequate treatment can be serious. Objective: To review the arthroscopically assisted management for schatzker type (I – II) tibial plateau fractures and to determine the factors that influence the overall clinical and radiological results. Patients and methods: In the period between August 2018 and August 2019, 20 consecutive patients (12 males & 8 females) with closed tibial plateau fractures who had undergone arthroscopic assisted surgery were enrolled in this prospective study. All of them underwent the same treatment protocol for arthroscopic-assisted surgery with percutaneous screw for closed tibial plateau fractures in Al-Azhar University Hospitals & Naser Institute hospital. Results: Mean Clinical Score was 26 range (21-30) as; 60.0% were excellent, 30.0% were good and 10.0% were fair. Mean Radiographic Score was 17 as; excellent were 12 cases (60.0%), good were 6 cases (30.0%) and fair were 2 cases (10.0%). Conclusion: Standards of Arthroscopic reduction and internal fixation (ARIF) technique have been shown to be widely used all over the world since 1991. From this time researchers are hardly working to modify or develop this technique to achieve better results to reach optimum fixation and alignment for early mobilization and protect against stiff joint or postoperative osteoarthritic changes.

[Ali Mohamed Elguioshy, Mohamed Ibrahim Abulsoud, Ahmed Essam Ibrahim Saber . Arthroscopically Assisted Management for Schatzker Type I & II Tibial Plateau Fractures. Nat Sci 2019;17(12):139-146]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 20. doi:10.7537/marsnsj171219.20.

Keywords: ARIF; Schatzker, Arthroscopy; Tibial plateau fracture, Technique

Full Text

20

21

A Morphometric and Statistical Study for Determination of Sex from Certain Bony Pelvic Parameters in Assiut Governorate by Using Plain X-Ray Films

Sherif F. Mahmoud, Nagy M. Al-Fadaly, Huda A. El Kareem Abdel Samie, Gamal El-Deen I. A. Biomy, Abdel Rahman Z. Abdel Rahman

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Al-Azhar University

zaky.abdelrahman@yahoo.com

Abstract: Background: The identification of sex from human remains is of fundamental importance in forensic medicine and anthropology, especially in criminal investigations as well as in the identification of missing persons and in attempts at reconstructing the lives of ancient populations. Objective: The aim of this study was to assess specific pelvic parameters (Human sacrum and subpubic angle measurements) in Assiut Governorate population by using plain x-ray films. Patients and methods: The study was conducted on 500 plain x-ray films, which were obtained and collected from the Radiology Department- Al-Azhar Faculty of Medicine (Assiut branch), out of which, 250 were males and 250 were females in the age group of 25–70 years belonging to Assiut population to assess the sacral and subpubic angle measurements. Results: Statistically significant increase in the length of sacrum in males compared to females. The sacral length in males varied from 86–120mm with the mean value of 100.06±9.00 mm, while the sacral length in females varied from 78–120mm with the mean value of 93.00±9.46 mm. Conclusion: The present study concluded that the subpubic angle is the best criterion for sex determination of pelvis. It was found that66.4% of males’ bones and 58.4% of females’ bones could be identified by using subpubic angle alone.

[Sherif F. Mahmoud, Nagy M. Al-Fadaly, Huda A. El Kareem Abdel Samie, Gamal El-Deen I. A. Biomy, Abdel Rahman Z. Abdel Rahman. A Morphometric and Statistical Study for Determination of Sex from Certain Bony Pelvic Parameters in Assiut Governorate by Using Plain X-Ray Films. Nat Sci 2019;17(12):147-157]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 21. doi:10.7537/marsnsj171219.21.

Keywords: Sex, Pelvic parameters, Human, Plain x-ray films

Full Text

21

22

Effect of L-Arginine on Intrauterine Growth Restriction Fetuses Measured by Birth weight a Randomised Controlled Trial

Moustafa I. Ibrahim MD, Hayam F. Mohammad MD, Manar L. Younis M.B.B.Ch

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Egypt.

manaryunis88@yahoo.com

Abstract: Background An area of fetal medicine research interest is to determine whether the enhancement of NO productivity could boost fetal growth patterns. There are attempts to the treatment of IUGR pregnancies by L-Arginine but the results are still inadequate. Objective: This study investigate the effect of L-arginine supplementation on fetal growth and pregnancy outcome. Methodology A prospective interventional randomized controlled research trial, conducted at Ain Shams University Maternity Hospital. From 2017till 2018, 260 pregnant females as research study Categorized randomly into two equal numbered research groups, 12 cases were dropped out due to loss of contact with them. Finally249 pregnant women were diagnosed with IUGR and have been categorized into two groups according to the results: Group I:125 pregnant women with IUGR received 3g L_arginine and 75 mg of Acetyle salicylic daily. Group II: 124 pregnant women with IUGR received 75mg Acetylesalicylicic acid daily only. Both research groups were followed up by daily fetal movement counting, day after daycardiotocography (CTG), doppler twice weekly, Pelvic sonographic assessment weekly for: Head Circumference (HC), Abdominal circumference (AC), Femur Length (FL), Estimated fetal weight (EFW), Amniotic fluid index (AFI) or Mean Vertical Pocket. Results The Rate of estimated fetal weight increase, birth weight and Apgar score were statistically significantly higher among L-Arginine research group than among control group (p values<0.001). NICU admission and preterm delivery were statistically significantly less frequent among L-Arginine group than among control group (p value<0.001). Conclusions L-arginine seems to be useful management agent for improving asymmetrical mild IUGR fetuses viaraising nitric oxide levels which enhances the fetomaternal circulatory functional performance.

[Moustafa I. Ibrahim, Hayam F. Mohammad, Manar L. Younis Ch. Effect of L-Arginine on Intrauterine Growth Restriction Fetuses Measured by Birth weight a Randomised Controlled Trial. Nat Sci 2019;17(12):158-166]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 22. doi:10.7537/marsnsj171219.22.

Keywords: L-arginine, IUGR, nitric oxide

Full Text

22

23

Circumferential Abdominoplasty after Massive Weight Loss Following Bariatric Surgery: Indications, Operative Techniques, and Outcomes, A Systematic Review and Meta-Analysis

Prof. Dr. Ahmed Mohamed Ibrahim Khalil, Dr. Moheb Shoraby Eskandaros, Ahmed Marzouk Fathy Abdelkareem

General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Ahmed.abdelkareem1@outlook.com

Abstract: The number of patients demanding plastic surgery correction of contour abnormalities has increased with the advancement in weight loss procedures. Massive weight-loss patients often present a circumferential truncal skin and subcutaneous tissue redundancy, which cannot be optimally corrected by common abdominoplasty techniques. Circumferential abdominoplasty, belt lipectomy, 360° abdominoplasty, and lower body lift are all synonyms of a body contouring procedure with the aim of sculpting the torso, modifying abdominal contour, loins and lower back contours. Despite growing number of published literature that supports the efficacy of circumferential abdominoplasty for post-bariatric body contouring, there is, still, a scarcity in high-level evidence that assesses the safety and efficacy of circumferential abdominoplasty. Thus, we conducted the present systematic review and meta-analysis in order to summarize surgical indications, operative techniques, outcomes, complications of circumferential abdominoplasty procedures following bariatric surgery. In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) from their inception till February 2019. The search retrieved 512 unique records. We then retained 89 potentially eligible records for full-texts screening. Finally, 26 studies (Total No. of patients =1234) were included in the present systematic review and meta-analysis. The present systematic review and meta-analysis showed that the average age of the patients within the included studies ranged from 28-45.2 years old; while the majority of those patients were females. In the present systematic review and meta-analysis, the majority of the included studies (No = 14 studies) utilized lower body lift technique; while six studies utilized belt lipoectomy. In the present systematic review and meta-analysis, we utilized patients’ satisfaction as the primary outcome for abdominoplasty effectiveness. Over all, eight studies reported the satisfaction rates after circumferential abdominoplasty, the overall effect estimates showed that the circumferential abdominoplasty achieved a satisfaction rate of 98% (95% CI [0.95.5 – 0.99.7). The overall effect showed that the average operative time of circumferential abdominoplasty was 278 minutes (95% CI 241 - 315). Similarly, overall effect showed that the hospital stay after circumferential abdominoplasty was 5.5 days (95% CI 1.45 - 9.52). In terms of complications, sixteen studies reported the rates of complications after circumferential abdominoplasty. The overall effect estimates showed that the rates of complications after circumferential abdominoplasty was 35% (95% CI 26 – 44%). In conclusion, circumferential abdominoplasty is safe and effective body-contouring procedure for post-bariatric patients. This procedure can be ethically proposed to patients with body-contour deformities following bariatric surgery, giving excellent results with minor morbidity. The present systematic review and meta-analysis showed that circumferential abdominoplasty achieved a satisfaction rate of 98% and lower hospital stay than classic abdominoplasty. In addition, the rate of serious postoperative complications was very low. However, special attention should be paid for postoperative seroma and wound dehiscence.

[Ahmed Mohamed Ibrahim Khalil, Dr. Moheb Shoraby Eskandaros, Ahmed Marzouk Fathy Abdelkareem. Circumferential Abdominoplasty after Massive Weight Loss Following Bariatric Surgery: Indications, Operative Techniques, and Outcomes, A Systematic Review and Meta-Analysis. Nat Sci 2019;17(12):167-176]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 23. doi:10.7537/marsnsj171219.23.

Keywords: Circumferential; Abdominoplasty; Massive Weight Loss; Bariatric Surgery; Meta-Analysis

Full Text

23

24

Drug Resistance in Salmonella Typhi with special reference to Ciprofloxacin

Dhriti Himanshu Bhavsar¹, Mudit Sharma² and YK Singh²

^1. Jay Shree Periwal International School, Jaipur, Rajasthan, India.

^2. Mudrakshi Histology Centre, New Sanganer Road, Jaipur, Rajasthan, India.

yogeshbhu76@gmail.com

Abstract: A study was conducted to evaluate the resistance pattern and MIC of Salmonella typhi isolated from blood of patients suffering from enteric fever, Approximately 50 isolates were taken for the studies. Which were isolated from collected clinical samples within a time span of 3 month. The isolates were biochemically analyzed for confirmation of their identity. The MIC and sensitivity patterns of all the isolates were studied using fourteen antibiotics that usually represented most of the available antimicrobial groups. Resistance to several drugs, amoxicillin (18%), gentamicin (16%), nalidixic acid (22%), sulfonamides (24%), and tetracycline (24%), has been observed. However among all the antibiotics experimented, it was observed that all the isolates sensitive for ciprofloxacin. MIC of ciprofloxacin was observed to be 4μg/ml and 8μg/ml in Salmonella Typhi isolates collected.

The resistance of ciprofloxacin is chromosomal mediated. When plasmid of resistance ciprofloxacin insert in to the E.coli, the transformed strain could not be show the resistance. This conform that resistance to Ciprofloxacin was chromosomal.

[Bhavsar DH, Sharma M and Singh YK. Drug Resistance in Salmonella Typhi with special reference to Ciprofloxacin. Nat Sci 2019;17(12):177-178]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 24. doi:10.7537/marsnsj171219.24.

Keywords: Salmonella Typhi, Drug resistance, Chromosomal Mediated

Full Text

24

25

Role of Contrast Enhanced Multidetector CT Enterography in Evaluation of Inflammatory Bowel Diseases

Mohammed Taha Abd-Elhak¹; Ahmed Abdelsamie Mahmoud ²; Fadila Mamdouh E Lsayed ³; Zahraa Mahmoud Mohamed ⁴

¹Professor of Radiodiagnosis Radiodiagnosis Department, Alazhar University, Cairo, Egypt

²Assistantprofessor of Radiodiagnosis, Radiodiagnosis Department, Theodor Bilharz Institute, Cairo, Egypt.

³Assistant Professor of Radiodiagnosis Radiodiagnosis Department, Alazhar University, Cairo, Egypt

⁴Assistant Lecturer of Radiodiagnosis, Radiodiagnosis Department, Theodor Bilharz Institute, Cairo, Egypt.

Email: drzahraamahmoud@gmail.com

Abstract: Background: Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It non-invasively determines the extent of involvement, severity of disease, possible disease-related complications and extra-intestinal manifestations. Aim of the work: Was to highlight the role of contrast enhanced CT Enterography in evaluation of patient of patients of inflammatory bowel diseases. Materials and Methods: This study was done between July 2017 and June 2019 at Theodor Bilharz research institute & some private radiology centers in Cairo including 60 patients with inflammatory bowel diseases. Scan was performed on 256 Multislice CT scanners. Results: For Crohn’s patients, 45 patients out of 50 (90%) showed signs of activity, while the other 5 patients (10%) were in the remission state (showed no signs of activity), 18 patients out of 50 (36%) showed complications and 15 patients (30%) showed extra-intestinal manifestations. For Ulcerative colitis, 9 patients out of 10 (90%) had active disease, 4 patients showed mild degree (44.4%), 3 patients with moderate degree (33.3%) and 2 patients showed severe form of the disease (22.2%). Conclusion: CT enterography can accurately assess the activity of inflammatory bowel disease, their activity, severity, possible complications perienteric & extra intestinal manifestations.

[Mohammed Taha Abd-Elhak; Ahmed Abdelsamie Mahmoud; Fadila Mamdouh ELsayed; Zahraa Mahmoud Mohamed. Role of Contrast Enhanced Multidetector CT Enterography in Evaluation of Inflammatory Bowel Diseases. Nat Sci 2019;17(12):179-186]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 25. doi:10.7537/marsnsj171219.25.

Keywords: Computed tomography enterography, inflammatory bowel diseases, Crohn’s disease, ulcerative colitis, activity, severity.

Full Text

25

26

Characterization and bioactivities of Lactobacillus plantarum and Pediococcus acidilactici isolated from meat and meat products

Ashraf, A. Abd El-Tawab¹, Ahmed, A. A. Maarouf², Fatma, I. El Hofy¹, and Zeinab, A. M. Mahdy²

¹Bacteriology, Immunology and Mycology Department, Faculty of Veterinary Medicine, Benha University, Egypt.

²Animal Health Research, Benha Branch, Egypt

mohamedebrahim30901988@gmail.com

Abstract: The present study was conducted on 250 random samples of meat and meat products (minced meat, kofta, beef burger and sausage; 50 for each) collected from small retails and different supermarkets at Kaliobia Governorate, Egypt for inspection of L. plantarum and P. acidilactici strains. The results revealed that, 178 strains from 250 samples (71.2%) of L. plantarum (76=30.4%) and P. acidilactici (102 =40.8%) were isolated from the examined samples. All of them produce bacteriocin and biosurfactant that inhibited the growth of tested pathogenic bacteria. In addition, most isolated strains had the ability to perform biofilm which able to inhibit the biofilm formation of tested pathogenic strains. The amplification for 16S rRNA, sequencing and phylogenetic tree construction of the obtained sequences with the closely related lactobacillus species were performed. Sequences for and are available in the GeneBank and NCBI with the accession numbers MK806485 and MK850564 for L. plantarum and MK871658, MK871674 for P. acidilactici.

[Ashraf, A. Abd El-Tawab, Ahmed, A. A. Maarouf, Fatma, I. El Hofy, and Zeinab, A. M. Mahdy. Characterization and bioactivities of Lactobacillus plantarum and Pediococcus acidilactici isolated from meat and meat products. Nat Sci 2019;17(12):187-193]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 26. doi:10.7537/marsnsj171219.26.

Keywords: Bacteriocin; lactic acid bacteria; pathogenic bacteria

Full Text

26

27

Phenotypic and molecular detection of Aeromonas and pseudomonas species isolated from fish with special reference to their virulence factors

Ashraf, A. Abd El- Tawab¹, Ahmed, A.A. Maarouf², Fatma, I. El Hofy¹, Amany, O. Salim² and Aya, A.M. El-sayed³

Bacteriology, Immunology and Mycology Department, Faculty of Veterinary Medicine, Benha University, Egypt.

2Animal Health Research "Benha branch". Agriculture Research Center, Egypt.

3Veterinarian.

mohamedebrahim30901988@gmail.com

Abstract: The present study was conducted on 250 diseased Nile tilapia (Oreochromis niloticus) fish of various sizes were collected from different fish markets at Kaliobia Governorate, Egypt, during the period from May (2017) to January (2019) for inspection of Aeromonas and Pseudomonas strains. Samples were collected from apparently pathognomic lesions in muscle, liver, kidney, intestine and spleen for bacteriological examination. The results revealed that, 161 Aeromonas and Pseudomonas species; 118 Aeromonas (73.3%) and 43 Pseudomonas species (26.7%) were isolated mostly from 50 muscle lesion samples followed by 41 liver samples then 35 kidney samples; 32 intestine samples and 3 spleen lesion samples. Most isolated Aeromonas and Pseudomonas strains were enterotoxigenic ones, as they had haemolytic; amylase activity; proteolytic; lipolytic; Lecithinase activities and had the ability for biofilm production. PCR results showed that, specific gene of A. hydrophila (16SrRNA) and polar flagella gene (fla) genes were detected in all 8 studied strains; aerolysin (aero); A. hydrophila cytolytic enterotoxin (AHcytoen); cytotonic enterotoxins- heat-stable (ast) virulence genes were detected in 5; 3 and 5 out of 8 A. hydrophila studied strains. In addition, specific gene of Ps. aeruginosa (16SrDNA); outer membrane lipoprotein L (oprL) and flagellin C (fliC) genes were detected in all 8 studied Ps. aeruginosa strains; exotoxin A (toxA) and exotoxin S (exoS) virulence genes were detected in 5 and 6 out of 8 studied ones.

[Ashraf, A. Abd El-Tawab, Ahmed, A.A. Maarouf, Fatma, I. El Hofy, Amany, O. Salim and Aya, A.M. El-sayed. Phenotypic and molecular detection of Aeromonas and pseudomonas species isolated from fish with special reference to their virulence factors. Nat Sci 2019;17(12):194-205]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 27. doi:10.7537/marsnsj171219.27.

Key words: Fish, Aeromonas, Pseudomonas, Lecithinase, virulence genes

Full Text

27

28

Crystallization of calcium sulfate crystals in simulated conditions of drinking water treatment

N. S. Yehia, F.A. Essa and H.A. Hamouda

Department of Chemistry Faculty of Science, Shebin El-Kom, Menofia University, Egypt.

drnaemasalem@yahoo.com

Abstract: Mechanism of crystallization of calcium sulfate dihydrate (CSD) crystals was studied in the absence and presence of some amino acids; threonine (Thr), methionine, (Meth), asparagine (Asp), tyrosine, (Tyr) and alanine (Ala,) at t = 25 °C, ionic strength = 0.3 mol dm^-3, d=1.32 and pH=7.5 from the study, it was obtained that concentrations as low as 10^-5mol dm^-3 for each additive markedly reduce the crystallization rate of CSD crystals. As the concentration of additive increase, the active sites on CSD crystal surface are blocked through adsorption and the rate of crystallization of crystals decreased. This confirmed from the order of reaction (n=1), the value of activation energy, 250 Kcal / mol, and the validity of applying Langmuirisotherm. The values of affinity constants K_L were found 31.1, 25.00, 7.143, 5.00 and 2.19 x10⁵ KJ/mol in case of the presence of Thr, Meth, Asp, Tyr and Ala respectively. The values of affinity constants (K_L) reflect the high adsorption at the same value of relative degree of supersaturation (d = 1.32), and the order of inhibition was: Thr> Met > Asp > Tyr > Ala. The values of ΔG supported this order of inhibition of these additives. From the study, the anionic part of the additive molecule adsorbs onto Ca²⁺ active sites on the surface of CSD crystals through electrostatic attraction. The molecular weight, molecular geometry, hydrophilicty and structure of the amino acid molecules were found to be the important factors affecting on the efficiency of the them.

[N. S. Yehia, F. A. Essa and H. A. Hamouda. Crystallization of calcium sulfate crystals in simulated conditions of drinking water treatment. Nat Sci 2019;17(12):206-219]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 28. doi:10.7537/marsnsj171219.28.

Key words: crystallization, CSD, amino acids, adsorption inhibition.

Full Text

28

29

Histological Study on the Possible Protective Effect of Co-enzyme Q10, Evening Primrose and Esomeprazole on Indomethacin Induced Gastric Ulcer in Adult Male Albino Rats

Prof. Dr. Dina Mohamed Radwan¹, Dr. Noha Abd Ellatif Ebrahim², Dr. Eman Abas Farag¹, Marwa Abd ElAziz Sofi²

¹Histology Department, Faculty of Medicine, Cairo University, Egypt

²Histology Department, Faculty of Medicine, Fayoum University, Egypt

marwaabdelaziz1811@yahoo.com

Abstract: Introduction: The non-steroidal anti-inflammatory drug (NSAID) Indomethacin is widely used especially in treatment of osteoarthritis and rheumatoid arthritis. However, it has many side effects; the most common of them is gastrointestinalin tolerance and ulceration. Coenzyme Q10 (CoQ10) and Evening primrose (EP) were reported to have anti-inflammatory and antioxidant properties. Aim of the Work: To investigate the histopathological effects of Indomethacin on the fundic mucosa of adult male albinorats and the possible protective role of Coenzyme Q10, Evening primrose and esomeprazole. Materials and Methods: Forty eight adult male albino rats were randomized into 5 groups (N=8). Group I (Control). Group II (INDO): received 50 mg/kg of indomethacin dissolved in gum acaciaorally. Group III (CoQ10+INDO): received Coenzyme Q10 10mg/kg for 2 days then INDO on the 2^nd day 1 hour after CoQ10. Group IV (EP+INDO): received evening primrose intraperitoneally 10g/kg for 2 days then INDO on the2^nd day 1 hour after EP. Group V (ESP+INDO (: Subgroup Va (low dose): received 5mg/kg/day esomeprazole orally for 2 days then INDO on the2^nd day 1 hour after ESP. Subgroup Vb (high dose): treated as group Va but received 20mg/kg/dayESP. At the end of the experiment, ulcer index and antioxidant parameters were evaluated. The fundic mucosa was processed and stained with H & E, PAS stains as well as Caspase-3 and PCNA immunostains. Morphometric measurements and statistical analysis were done. Results: Erosions, congestion, extravasated RBCs and inflammatory cell infiltration were detected in fundic mucosa of INDO group. In CoQ10+INDO group, EP+INDO and ESO+INDO high dose the structure of the mucosa was restored. There was marked increase in mucus secretion, significantly increased ulcer index and decreased MDA level. A significant decrease in area % of PAS reaction in INDO group was revealed as compared with the other groups. There was a significant increase in area % of Caspase immunoreaction and a significant decrease in area % of PCNA expression in INDO group as compared with other groups. Conclusion: Coenzyme Q10, Evening primrose and esomeprazole (high dose) can partly protect the fundic mucosa against indomethacin induced damage.

[Dina Mohamed Radwan, Noha Abd Ellatif Ebrahim, Eman Abas Farag, Marwa Abd ElAziz Sofi. Histological Study on the Possible Protective Effect of Co-enzyme Q10, Evening Primrose and Esomeprazole on Indomethacin Induced Gastric Ulcer in Adult Male Albino Rats. Nat Sci 2019;17(12):220-240]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 29. doi:10.7537/marsnsj171219.29.

Key words: Indomethacin, gastritis, CoQ10, evening primerose, esomeprazole, caspase, PCNA and rat.

Full Text

29

30

Hepatoprotective Effect of Carica papaya and Actinidia delicosa against Methotrexate Induced Liver Toxicity

Amina A. Bedawy, Ibrahim A. Ibrahim, Sherif Y. Saleh, Abeir A. Shalaby and Marwa A. El-Beltagy

Department of Biochemistry, College of Veterinary Medicine, University of Suez Canal, Egypt

Email: aminaabdelhay30@gmail.com

Abstract: Methotrexate is an effective drug for rheumatoid artheritis and cancer but has many harmful side effects. C. papaya and Actinidia delicosa (kiwi) fruits are hepatoprotective agents. This study explored the hepatoprotective role of C. papaya and Actinidia delicosa pretreatment against methotrexate (MTX) that induced hepatotoxicity in male rats. We prepared ethanolic extraction of C. papaya and Actinidia delicosa fruits then measured the total phenolics, total flavonoids and antioxidant activity of each extract. Forty rats were divided into four groups (10 rats each); control, MTX, (C. papaya + MTX) and (kiwi + MTX) groups. MTX group injected with ( 20mg/kg/Intra peritoneal twice weekly) at 5^th week, (C. papaya + MTX group) pretreated with C. papaya fruit ethanolic extract (400 mg/kg/orally/day) for 8weeks + MTX ( 20mg/kg/Intra peritonial twice weekly) at 5^th week and (Kiwi + MTX group) pretreated with Actinidia delicosafruit ethanolic extract (400 mg/kg/orally/day) for 8weeks before MTX injection ( 20mg/kg/Intra peritonial twice weekly) at 5^th week. We measured (MDA) level, reduced Glutathione (GSH) and Superoxide Dismutase (SOD) in the liver homogenate. Moreover, Nitric Oxide (NO), Alanine Aminotransferease (ALT) and Aspartate Aminotransferase (AST) levels were measured in the serum. Histopathological examination of liver tissue. Biochemical analysis revealed significant increase in the liver MDA, serum NO and serum transaminases meanwhile liver GSH and SOD were significantly decreased in MTX group. C. papaya and Actinidia delicosa fruit ethanolic extract pretreatment significantly ameliorated histopathological and biochemical changes induced by MTX.

[Amina A. Bedawy, Ibrahim A. Ibrahim, Sherif Y. Saleh, Abeir A. Shalaby and Marwa A. El-Beltagy. Hepatoprotective Effect of Carica papaya and Actinidia delicosa against Methotrexate Induced Liver Toxicity. Nat Sci 2019;17(12):241-250]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 30. doi:10.7537/marsnsj171219.30.

Key words: MTX (methotrexate), Carica papaya fruit ethanolic extract, Actinidia delicosa (kiwi) fruit ethanolic extract

Full Text

30

31

Study of CD305, CD26 Expression in Chronic Lymphocytic Leukemia

Heba M. El-Erian¹, Mohamed K. Zahrah¹, Sahar Hazzaa¹, Atef M. Taha²

¹Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

²Internal Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt

heba.alaryan@yahoo.com

Abstract: Background: B-CLL is a heterogeneous disease with a highly variable clinical course and prognosis. Rai and Binet staging systems have been recognized as standard methods of assessing the survival and the treatment requirements in B-CLL patients. There is a need to seek out other prognostic factors in the early stage of the disease to identify stable or progressive forms of CLL that might facilitate risk-adapted treatment strategies. CD26 is a multifunctional type II cell surface glycoprotein that is widely expressed by many cells. LAIR1 (CD305) is a transmembrane glycoprotein acting as inhibitory receptor has been recently demonstrated in patients with CLL. Aim of the Work: Studying the role of CD305, CD26 expression in chronic lymphocytic leukemia and their correlation with CD38 and ZAP 70 expression. Subjects and Methods: This study was conducted on 50 newly diagnosed CLL cases from Internal Medicine Department, Tanta University Hospital and 20 healthy subjects as a control group. Results: Higher expression of ZAP 70, CD38, CD26, lower expression of CD305 is associated with more advanced staging. A negative correlation between CD305 expression and TLC, ALC, LDH, CD26, CD38 and ZAP 70 expression and a positive correlation with Hb level and platelet count. Where, positive correlation between CD26 expression and previous parameters and a negative correlation with Hb level, platelet count and CD305 expression. There was a significant longer overall survival and disease free survival in patient with high CD 305 expression and also in low CD 26 expression. Conclusions: CD26 and CD305 together with CD38 and ZAP 70 represent an important adverse prognostic markers, their expression should be routinely investigated for a better prognostic assessment of CLL patients and showed be taken in consideration in designing further therapeutic strategies based on patient specific risk factors.

[Heba M. El-Erian, Mohamed K. Zahrah, Sahar Hazzaa, Atef M. Tah. Study of CD305, CD26 Expression in Chronic Lymphocytic Leukemia. Nat Sci 2019;17(12):251-258]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 31. doi:10.7537/marsnsj171219.31.

Key words: CD305 Expression, CD26 Expression, Chronic Lymphocytic Leukemia

Full Text

31

32

The Impact of Neurological Disorders on Cardiac Functions in Non-Cardiac Children

Hebatallah Ahmed Bedair (MSc) ¹* Khaled Talaat Abu-Eala (MD) ¹, Osama Abdrab Elrasol Tolba (MD) ¹, Sahar Abdel-Azeem Abdel-Aziz (MD) ¹, Magdy Abdel-Aziz Elmahallawy (MD) ²

¹ Pediatric Department, Faculty of Medicine, Tanta University, Egypt.

² Neurosurgery Department, Faculty of Medicine, Tanta University, Egypt.

Email: hebabedair86@yahoo. com

Abstract: Background: Cardiac injury frequently complicates neurological disorders, leading to higher morbidity and mortality. Neurological disorders such as hemorrhagic and ischemic stroke, epilepsy, CNS infection and traumatic brain injury, results in dysfunctions of the autonomic nervous system, alteration of systemic circulation homeostasis mediated by neurogenic stimuli, change in serum cardiac enzyme levels, electrocardiographic, and echocardiographic abnormities. Aim of the work: The aim of the present study was to detect the impact of neurological disorders on cardiac functions in pediatric non-cardiac patients. Subjects and methods: This prospective cohort study was carried out on one hundred and fifty children (aged from 2 months to 16 years) equally divided into three groups (n=50); group I: critically ill neurological patients, group II: non critically ill neurological patients, group III: healthy children matched for age and sex as a healthy control group. Echocardiography, electrocardiography and cardiac enzymes (including cardiac troponin I and lactate dehydrogenase) were done within 12 hours of admission. Results: Regarding ECG abnormalities, group Ι showed that there were 41cases (82%) with ECG abnormalities, group ΙI showed that there were 14 cases (28%) with ECG abnormalities. ECG abnormalities include ischemic changes, rhythm and conduction abnormalities. Regarding echocardiographic examination there was significant decrease in both left ventricular systolic and diastolic functions (measured by tissue Doppler and strain echocardiography) in patients with neurological disorders compared with the control group. The mean plasma concentration of cardiac enzymes (lactate dehydrogenase, cardiac troponin I) was statistically higher in patients with neurological disorders compared with the control group. Conclusion: Cardiac injury has to be anticipated as an impact of neurological disorders and cardiac evaluation should be an essential step in the assessment of neurological pediatric patients.

[Hebatallah Ahmed Bedair, Khaled Talaat Abu-Eala, Osama Abdrab Elrasol Tolba, Sahar Abdel-Azeem Abdel-Aziz, Magdy Abdel-Aziz Elmahallawy. The Impact of Neurological Disorders on Cardiac Functions in Non-Cardiac Children. Nat Sci 2019;17(12):259-266]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www. sciencepub. net/nature. 32. doi:10.7537/marsnsj171219.32.

Key words: arrhythmia, cardiac injury, neurological disorders, troponin

Full Text

32

33

Comparative Study of Bone Marrow and Adipose Tissue-Mesenchymal Stem Cells In The Treatment of Cyclophosphamide Induced Ovarian Damage In Adult Female Albino rats.

Talaat M. Mohamed, Gamal Elsayed Abd- Salam, Kamal M. Kamal, Eman El Bana, Mohammed A. Gebba

Anatomy and Embryology Department, Faculty of Medicine, BenhaUniversity, Egypt

kamal01225756395@gmail.com

Abstract: Background: Cyclophosphamide (CLP), used as an anticancer therapy , One of its side effects in women is through inducing  ovarian toxicity and consequently infertility Aim of work: to evaluate the impact of BM-MSCs&AT-MSCs in the overcome of cyclophosphamide-induced ovarian damage in rats. Materials&Methods: Forty female adult Albino rats were randomly divided into four groups. Group I (control group). Group II (cyclophosphamide treated group) were subjected to intra-peritoneal injection of 150 mg/kg- B.W, followed by a dose of 8 mg/kg every week, the rats were scarified after 3 weeks. Group III (BM-MSCs treated group) were treated by cyclophosphamide in the same manner as in group II and after five weeks from the second CLP injection 100 μl of BM-MSCs mixture (2.5x10⁶cells) in 100 µl PBS was injected intra-venous. Group IV(AT-MSCs treated group) were treated by CLP as in group II and after 5 weeks from the second CP injection, 100 μl of AT-MSCs mixture (2.5x10⁶cells) in 100µl PBS was injected intra-venous, Then 30 days after cell therapy the rats were scarified, Ovarian sample sections were stained with different stains, H&E, Masson ́s Trichrome and Immunohistochemical stains for anti-PCNA antibody. The average number of primordial germ follicles, % of collagen fibers, area % of +ve immune-reactivity area for PCNA were determined by histomorphometric tests and analyzed statistically. Results: Histological examination of the ovaries of CLP treated group revealed severe degeneration of ovarian follicles with sloughing of granulosa cells. The ovarian follicles treated with BM-MSCs showed a normal appearance of oogenesis in comparison to the cyclophosphamide-group. The AT-MSCs treated group rats showed relative improvement of oogenesis but no graafian follicle was detected. Conclusion: BM-MSCs and AT-MSCs were impressive in the therapy of ovarian failure in albino rat model where they repair the ovarian structure and protected ovary against CLP-induced toxicity. However BM-MSCs more effective

[Talaat M. Mohamed, Gamal Elsayed Abd-Salam, Kamal M. Kamal, Eman El Bana, Mohammed A. Gebba.Comparative Study of Bone Marrow and Adipose Tissue-Mesenchymal Stem Cells in The Treatment of Cyclophosphamide Induced Ovarian Damage In Adult Female Albino rats. Nat Sci 2019;17(12):267-283]. ISSN 1545-0740 (print); ISSN 2375-7167 (online).http://www.sciencepub.net/nature. 33. doi:10.7537/marsnsj171219.33.

Keywords: Bone marrow, Adipose tissue, Mesenchymal stem cells, Cyclophosphamide, Premature ovarian failure

Full Text

33

34

Role of high resolution CT and MRI in the assessment of painful ankle and foot

Emam Mohamed Abdelaziz, Hoda Mahmoud Abdelwahab, Mohamed Hasan Ateya*

Radiology Department, Faculty of Medicine, Al-Azhar University, Egypt

E-mail:Mohamedhasanzagg@gmail.com

Abstract: Background: Ankle pain is a common condition in adults that may cause significant discomfort and disability. A variety of soft tissue, osseous, and systemic disorders can cause pain. Emphasis in radiology has been directed toward advanced imaging, primarily computed tomography (CT), and magnetic resonance imaging (MRI), to an extent where radiographic findings may be overlooked or ignored. Multidetector CT is commonly used for the assessment of fractures and multiplanar reformation (MPR) has allowed accurate evaluation of fracture lines, dislocation and comminution for the selection of appropriate treatment. Magnetic resonance imaging (MRI) has become a frequently used adjunct in the evaluation of tendinous and ligamentous injures because it provides great detail of soft tissue structures through its multiplanar capability. Aim of the Study: to analyze the value of high resolution CT and MRI in patients with ankle and foot pain. Patients and Methods: this study will be performed on 159 patients presenting with ankle and foot pain There were 108 males and 51 females. The patients age range from 20 years to 69 years (mean age 44.5 years). The right ankle and foot was affected in 113 cases and the left side was affected in 29 cases. All cases were examined with either CT or MRI according to the clinical data obtained. CT examination was done to 52 patients, while MRI was done to 107 patients. Results: CT had high diagnostic accuracy at diagnosing fractures. At our study, 37% of patients had fractures while MRI had high accuracy at ligamentous and tendinous trauma. There were 34% of patients had tendinous injures and 23% of patients had ligamentous injures. Conclusion: CT has high sensitivity at accurate evaluation of fracture lines, dislocation and comminution that was not detected by plain radiography. Magnetic resonance imaging (MRI) has sensitivity and specificity at detection of soft tissue abnormalities including tendon, ligamentous injures, infectious and metabolic causes.

[Emam Mohamed Abdelaziz, Hoda Mahmoud Abdelwahab, Mohamed Hasan Ateya. Role of high resolution CT and MRI in the assessment of painful ankle and foot. Nat Sci 2019;17(12):284-298]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 34. doi:10.7537/marsnsj171219.34.

Keywords: Achilles, fracture, impingement, Lateral Collateral, osteochondral defect, Peroneal, sprain, spur, tear, tenosynovitis, trauma.

Full Text

34

35

Prevalence of Diabetes Mellitus among different phenotypes of Polycystic Ovary Syndrome in Egypt

Emam M, Montaser E, Elmorsi Y and Thabet M.

Department of Obstetrics and Gynecology, Faculty of Medicine. Mansoura University, Mansour, Egypt.

Email: Email:eman_montaser@yahoo.com and mae335@hotmail.com.

Abstract: Objective: To study the prevelance of Diabetes Mellitus in different phenotypes of polycystic ovary syndrome (PCOS) among attendants to Obstetric and Gynecology Clinic at Mansoura University Hospital (MUH) in Egypt utilizing OGTT and HBA1C. Design: Observational Prospective study. Setting: MUH (Tertiary Hospital), Obstetric and Gynecology Clinic. Dakahlia, Egypt. Population: A total of 140 women, among attendants to Obstetric and Gynecology Clinic at MUH which were diagnosed as PCOS based on the 2003 Rotterdam criteria. Methods: PCOS patients were divided into four subgroups: (i) Classic type: oligoand/oranovulation (O), hyperandrogenism (H), and polycysticovay morphology (P); (ii) Non classic type: O + H; (iii) Ovulatory type: H + P; and (iv) Normoandrogenic type: O + P., Then screening for DM using OGTT and HBA1C. Results: No significant difference between the 4 different phenotypes of PCOS regarding fasting blood sugar and the most significant type is classic type (phenotype A) regarding OGTT and HbA1C. The high sensitivity of 2-Hour postprandial blood glucose in detecting diabetic cases. The high specificity of HbA1C specially in detecting prediabetic cases. Conclusions: Classic PCOS phenotype has the highest risk of impaired glucose tolerance. Hyperandrogenism is associated with increasing risk of DM. High sensitivity of 2-Hour postprandial blood glucose in detecting diabetic cases and high specificity of HbA1C specially in detecting prediabetic cases.

[Emam M, Montaser E, Elmorsi Y and Thabet M. Prevalence of Diabetes Mellitus among different phenotypes of Polycystic Ovary Syndrome in Egypt. Nat Sci 2019;17(12):299-304]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 35. doi:10.7537/marsnsj171219.35.

Keywords: Polycystic ovary syndrome, Diabetes Mellitus, Phenotypes of PCOS

Full Text

35

36

Effect of Tramadol and Heroin on Cardiovascular System

Kareem Essam Abd El Halim El shaer^1,2, Wesam Abd El salam Ghareeb^1,2, Hatem Mohammed Fathy El sokkary³, El sayed Abd El hamied Gad^1,2

¹ Neuropsychiatry Department, Faculty of Medicine, Tanta University, Egypt

²The Centre of Psychiatry, Neurology and Neurosurgery, Faculty of Medicine, Tanta University, Egypt

³Cardiology Department, Faculty of Medicine, Tanta University, Egypt

kareemelshaer2015@yahoo.com

Abstract: Background: Drug addiction is a worldwide common disorder, problems of substance abuse lead to dramatic costs for all societies in the term of low productivity, transmission of infectious diseases, family and social troubles as well as crimes Tramadol hydrochloride is a synthetic, centrally acting, opiate-like analgesic that is used to treat acute and chronic pain. Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the opiates. Aim: The aim of this study was to assess the effect of tramadol and heroin on cardiovascular system; namely: clinical, electrocardiogram (ECG) and transthoracic echocardiography study. Patients & Methods: This was a comparative case - control study, it was carried out at Department of Neuropsychiatry, The Centre of Psychiatry, Neurology and Neurosurgery and Department of Cardiology, Tanta University Hospitals. The research was conducted during one year period, started from March 2018 through April 2019. Ninety persons were included in this study Patients' groups (Tramadol group:30 patients with tramadol use disorders diagnosed according to DSM-5 criteria) (Heroin group:30 patients with heroin use disorders diagnosed according to DSM-5 criteria) Control group: 30smokers with no cardiac history. Results: Tramadol induced hypertension and hypotension with hypertension predominance while heroin induced hypotension. Tramadol induced tachycardia and bradycardia with tachycardia predominance while heroin induced bradycardia.13.3% of heroin addicts had elevated temperature.23.3% of heroin addicts had bradyapnea.40% of heroin addicts had vascular changes (thrombosed veins). Tramadol induced mostly sinus tachycardia, QTc interval prolongation and sinus bradycardia while heroin induced sinus bradycardia. Heroin addiction induced valve abnormalities which tricuspid and mitral valves were the most affected valves. There were no significant differences between vital signs, ECG changes and ECHO findings and the severity of tramadol addiction. There were significant differences between the vital signs of the patients abusing heroin in relation to drug severity index except bradyapnea. There were significant differences between vascular, ECG changes and ECHO findings and the severity of drug abuse in the heroin group. But There was no a significant difference between the diameter of cardiac chambers and the severity of drug abuse in the heroin group. Conclusion: There were no significant differences between vital signs, ECG changes and ECHO findings and the severity of tramadol addiction. There were significant differences between the vital signs of the patients abusing heroin in relation to drug severity index except bradyapnea. There were significant differences between vascular, ECG changes and ECHO findings and the severity of drug abuse in the heroin group. But There was no a significant difference between the diameter of cardiac chambers and the severity of drug abuse in the heroin group.

 [Kareem Essam Abd El Halim El shaer, Wesam Abd El salam Ghareeb, Hatem Mohammed Fathy El sokkary, El sayed Abd El hamied Gad. Effect of Tramadol and Heroin on Cardiovascular System. Nat Sci 2019;17(12):305-315]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 36. doi:10.7537/marsnsj171219.36.

Key word: Tramadol, Heroin, Cardiovascular System

Full Text

36

37

Evaluation of the Protective Effect of Rosuvastatinin Attenuating Contrast-Induced Acute Renal Injury in the Adult Albino Rat

Mahmoud H. Baseem (MD), Mohammed A. Mohammed (MD) and Hussein B. Youssef

Anatomy and Embryology Department, Faculty of Medicine, Al-Azhar University, Egypt

husseinabomario@gmail.com

Abstract: Background: Contrast-induced nephropathy (CIN) is one of important causes of hospital-acquired acute renal failure and is responsible for about 10–12% of the cases. Rosuvastatin is a new generation of statins which reduces levels of circulating LDL-C. In addition to its beneficial cholesterol lowering effects, rosuvastatin has been shown to protect against inflammatory, oxidant, and thrombotic effects, and may improve endothelial function. Objective: This study is suggested to explore and evaluate the renoprotective effect of rosuvastatin against contrast-induced acute kidney injury (CI-AKI) in adult albino rat using light microscopy. Methods: Fourty adult albino rats were used in this study each of which weighs about 200 – 250 gm. The rats were acclimatized for 7 days prior to the start of study. Rats were divided randomly into four equal groups each of which was formed of 10 rats. Group I (control group): rats were able to access normal diet and normal amounts of water without any medication. Group II (dehydration group) (dehydration + furosemide, without CM administration): rats were deprived of water for 72 hours and then were given 10 mg/kg furosemide by intramuscular injection. Group III (CI-AKI group): rats will were treated in the same manner as group II, then after 20 minutes they were given a low-osmolar CM, Ultravist 50 ml injectable solution (Iopromide 300mg/mL) by intravenous injection (10 mL/kg) via the tail vein over the course of 5 minutes once then they were sacrificed. Group IV (CI-AKI + rosuvastatin group): rosuvastatin was administered by oral gavage once daily for 5 consecutive days prior to CM injection and once at 4 hours after CM injection. Rats were allowed to recover for 24 hours after the CM injection and then they were sacrificed. By the end of the experiment, kidney specimens were processed for light microscope examination using H & E and PAS stains. Results: group II showed average renal capsule, mildly congested glomeruli with average Bowman’s spaces, proximal tubules showed partial loss of brush borders and markedly edematous and apoptotic epithelial lining with intra-tubular debris, and renal medulla showed collecting tubules with markedly edematous and apoptotic epithelial lining with markedly congested peri-tubular capillaries compared to group I. Group III showed disrupted renal capsule, partially necrotic glomeruli with patent Bowman’s spaces, scattered completely necrotic proximal tubules and others with markedly apoptotic epithelial lining and complete loss of brush borders, and areas of hemorrhage with inflammatory infiltrate, and renal medulla showed collecting tubules with markedly apoptotic and edematous epithelial lining with congested peri-tubular capillaries. While when rosuvaststin was administered before CM in group IV, there was a significant improvement in the histological picture towards the normal. Conclusion: the results of the current study showed that rosuvastatin has some protective role against contrast-induced acute kidney injury.

[Mahmoud H. Baseem, Mohammed A. Mohammed and Hussein B. Youssef. Evaluation of the Protective Effect of Rosuvastatin in Attenuating Contrast-Induced Acute Renal Injury in the Adult Albino Rat. Nat Sci 2019;17(12):316-325]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 37. doi:10.7537/marsnsj171219.37.

Keywords: rosuvastatin, contrast-induced, acute kidney injury.

Full Text

37

38

The Role of Manganese Superoxide Dismutase as a Prognostic Marker in Egyptian Patients with Ulcerative Colitis

Shaimaa Mansour¹, Galal Elkassas¹, Sahar El-Yamany¹, Ayman El Saka², Shaimaa Elsharawy¹, Samah Soliman¹.

¹Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Egypt.

²Department of Pathology, Faculty of Medicine, Tanta University, Egypt.

samah.soliman@med.tanta.edu.eg

Abstract: Background: Ulcerative colitis (UC) is a disease characterized by remitting and relapsing inflammation of the colon. Clinical, endoscopic, radiological and histopathological findings play a major role in the diagnosis and assessment of inflammatory degree and disease severity in UC but it is hard to predict the clinical outcome for a patient. We aimed to evaluate the role of Manganese Superoxide Dismutase as a prognostic marker in Egyptian Patients with Ulcerative Colitis by detection of its relation to severity of illness by colonoscopy findings, inflammatory status and patient outcome. Methods: We analyzed MnSOD expression immunohistochemically in 80 formalin-fixed and paraffin-embedded specimens from 80 patients, including 26 ulcerative colitis patients with chronic continuous (CC)/symptoms remaining (SR) type, 24 ulcerative colitis patients with remission relapse (RR)/exacerbation (E) type and 30 subjects as control, who underwent colonoscopy examinations and biopsy. MnSOD expression was observed in lamina propria. Results: We found the expression pattern of MnSOD in lamina propria showed significant difference among the studied groups (P value <0.001) in which, it is more positive in chronic continuous (CC) patients. It was more frequently found in cases of CC and SR type and showed significant positive correlation with disease severity. Conclusion: Immunohistochemical evaluation for MnSOD expression may be helpful for early detection of the degree of severity, activity and prediction of progression of UC.

[Shaimaa Mansour, Galal Elkassas, Sahar El-Yamany, Ayman El Saka, Shaimaa Elsharawy, Samah Soliman. The Role of Manganese Superoxide Dismutase as a Prognostic Marker in Egyptian Patients with Ulcerative Colitis. Nat Sci 2019;17(12):326-331]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 38. doi:10.7537/marsnsj171219.38.

Keywords: Ulcerative colitis, colonoscopy, Manganese Superoxide Dismutase, Prognosis

Full Text

38

39

Three-dimensional Transvaginal ultrasonography versus hysteroscopy for the detection of intracavitary uterine abnormalities

Hamdi Alaa El-Din Ghorab M.Sc; Ahmed Tawfeeq Morsy Soliman M.D; Hesham Abdel-Aziz Salem, M.D and Dina Gamal El Din El Kholy M.D

Department of Obstetrics and Gynaecology, Faculty of Medicine, Tanta University.

Abstract: Objective: It was aimed at carrying out a comparative study between 3DTVUS and hysteroscopy in the accuracy of diagnosis of intrauterine cavitary lesions. Study design: 3DTVUS was done followed by hysteroscopy for all cases (number=100). Data obtained were compared and analyzed to estimate the accuracy of 3DTVUS. Results: The comparison with using Hysteroscopy, the sensitivity, specificity, positive predictive value, negative predictive values and total overall accuracy of 3DTVUS for total abnormal findings were 95%, 88%, 99, 58% and 94% respectively. Conclusion: The three dimensional transvaginal ultrasound is a sensitive method to evaluate the uterine cavity abnormalities, before resorting to invasive procedures such as diagnostic hysteroscopy. But hysteroscopy allows direct visualization of the uterine cavity so it can detect small intrauterine lesions which could be missed by vaginal ultrasound.

[Hamdi Alaa El-Din Ghorab; Ahmed Tawfeeq Morsy Soliman, Hesham Abdel-Aziz Salem, and Dina Gamal El Din El Kholy. Three-dimensional Transvaginal ultrasonography versus hysteroscopy for the detection of intracavitary uterine abnormalities. Nat Sci 2019;17(12):332-339]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 39. doi:10.7537/marsnsj171219.39.

Keywords: 3DTVUS, hysteroscopy, uterine cavity

Full Text

39

40

The role of tranexamic acid in control of traumatic intracranial hemorrhage

Radwa Ashraf Mohamed Fathi Fouda¹, Ashraf Mohamed Faried ², MagdyAbd-el Aziz El Mahallawy ² and Sameh Mohamed Refaat El-Shehdawy².

¹Emergency Medicine & Traumatology Department, Faculty of Medicine, Tanta University, Tanta 35127, Egypt.

Email: darafouda050@gmail.com

Abstract: Background: Traumatic brain injury (TBI) is a leading cause of death and disability. Intracranial hemorrhage (ICH) secondary to TBI is associated with a high risk of coagulopathy which leads to increasing risk of hemorrhage growth and higher mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid (TA) might reduce traumatic ICH. Aim of the work: To assess the effect of TA on intracranial hemorrhage in patients with TBI.

Patients and methods: This study was conducted on 40 patients with traumatic ICH. Patients were divided into intervention and control groups (20 patients each). All patients received a conservative treatment for ICH, and either intravenous TA or control. The extent of ICH growth as the primary outcome was measured by brain CT scan after 48 h. Results: TA administration was likely to be associated with a reduction in hemorrhage growth (difference 0.445 ml and -1.500 in both groups respectively), significant improvement in GCS (difference -0.900 p value 0.007 and 0.350 in both groups respectively) and fewer deaths (5% and 8% in both groups). Conclusion: Administration of TA might reduce ICH growth and improve clinical outcomes.

[Radwa Ashraf Mohamed Fathi Fouda, Ashraf Mohamed Faried, MagdyAbd-el Aziz El Mahallawy and Sameh Mohamed Refaat El-Shehdawy. The role of tranexamic acid in control of traumatic intracranial hemorrhage. Nat Sci 2019;17(12):340-349]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 40. doi:10.7537/marsnsj171219.40.

Keywords: role; tranexamic acid; control; traumatic; intracranial; hemorrhage

Full Text

40

41

Microsurgical Subinguinal Varicocelectomy for Male Subfertility: A Prospective Study

Haytham A. Alshazly, M.Sc.; Tarek A. Gamil, M.D.; Maged M. Ragab, M.D. and Magdy A. Sabaa.

Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt

E-mail: haytham.elshazly@med.tanta.edu.eg

Abstract: Background: Several surgical approaches for varicocelectomy have been described to reach best postoperative outcomes and least complications. Aim of study: To assess outcome of microscopic subinguinal varicocelectomy in subfertile men with varicocele and affected sperm quality. Materials and Methods: This prospective cohort study was conducted on 100subfertile male with evident varicocele in Tanta Urology Department in 2018 and 2019. We included adult infertile men for more than 1 year with clinical evident varicocele and affected semen parameters. We excluded azospermic males, patients with abnormal hormonal profile or associated factors for male infertility. Patients were followed-up for at least 12 months. Procedure: Microscopic sub-inguinal varicocelectomy. Outcome Measurements and Statistical Analysis: Data were demonstrated as mean ± standard deviation, ranges or percentages. P value was significant if <0.05. The relation between semen parameters was demonstrated using chi-squared test. Results and Limitations: Semen parameters (sperm count, motility, abnormal morphology) changes from the mean baseline are our primary outcomes during the designated 12-months period. All data supported positive impact of varicocelectomy on postoperative semen parameters. Conclusions: Microsurgical subinguinal varicocelectomy is the standard procedure in subfertile male with clinical evident varicocele.

[Haytham A. Alshazly, Tarek A. Gamil, Maged M. Ragab, Magdy A. Sabaa. Microsurgical Subinguinal Varicocelectomy for Male Subfertility: A Prospective Study. Nat Sci 2019;17(12):350-352]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 41. doi:10.7537/marsnsj171219.41.

Key-words: subfertile, varicocelectomy, Microsurgical.

Full Text

41

42

Comparative Ultrastructural Study of the Retina in Three Marine Teleost Fishes (Hippocampus Hippocampus, Solea Solea and Gobius Niger)

Samah T. Darwish¹, Mahmoud E. Mohalal², Menna M. Helal¹

¹Zoology Department, Faculty of Science, Al-Arish University, Egypt

² Zoology Department, Faculty of Science, Suez Canal University, Egypt

Abstract: Despite the fact that the fundamental structure of the retina is comparable over all vertebrates, high changeability in particular highlights of the fish retina mirrors the distinctions in visual microhabitat of these species. The vertebrate retina is the initial phase in the neural coordination of visual data. Three marine teleost fishes inhabiting various marine depths specifically Hippocampus hippocampus, Gobius niger and Solea solea (Linnaeus, 1758) were investigated in a relative investigation of the fine structure of the retina. The ultrastructure and association of the components show in all the retinal layers have been examined. The retina demonstrates every one of the eight layers and two membranes common place of vertebrates. The current results demonstrated different structural components with characteristic photoreceptors mostly of either rods for Hippocampus hippocampus, and Solea solea or duplex type, rods and cones, photoreceptors are identified in Gobius niger. It can be concluded that the retina of the studied teleost fishes exhibited obvious varying structure reflecting the ultrastructural characteristics for stabilizing functional characteristics of visualization affording to the marine habitat depths.

[Samah T. Darwish, Mahmoud E. Mohalal, Menna M. Helal. Comparative Ultrastructural Study of the Retina in Three Marine Teleost Fishes (Hippocampus Hippocampus, Solea Solea and Gobius Niger). Nat Sci 2019;17(12):353-359]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 42. doi:10.7537/marsnsj171219.42.

Key Words: Marine teleosts, Retina, Transmision EM

Full Text

42

43

Evaluation of the Impact of Preoperative Transarterial Particle Embolization of Juvenile Nasopharyngeal Angiofibroma on the Surgical Outcome on 30 Egyptian Patient.

Ayman El Shaikh Ahmed¹, Farouk Hassan², Manal Fathi Hamisa¹, Emad Mohammed Mashaly¹, Abd Elrahman Younes³.

¹Department of Radiology and Medical Imaging, Faculty of Medicine, Tanta University, Egypt

² Department of Diagnostic radiology, Faculty of Medicine, Cairo University, Egypt

³ Department of Otorhinolaryngeology, Faculty of Medicine Faculty of Medicine Cairo University, Egypt

Abstract: Background: Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular benign tumor with potentially fatal intraoperative haemorrhage. The aim of this study was to evaluate the impact of preoperative embolization of JNA on the surgical outcome including intraoperative blood loss, transfusion and endoscopic feasibility. Results: Preoperative embolization used PVA particles in all cases and resulted in lowering the mean intraoperative blood loss and transfusion to 665 and 928.57 ml respectively. Pure endoscopic resection was used in 19/30 (63.3%) patients. There was a significant correlation between blood loss and endoscopic use, residual tumor blush and internal carotid artery supply to the tumor. No major, but only minor post-operative complications were encountered. Conclusions: Preoperative embolization of nasopharyngeal angiofibroma is a safe and effective technique to reduce intraoperative blood loss and facilitate endoscopic use. Angiography enables better surgical planning. Minor complications may be encountered, but major complications are rare if done using the correct technique.

[Ayman ElShaikh Ahmed, Farouk Hassan, Manal Fathi Hamisa, Emad Mohammed Mashaly, Abd Elrahman Younes. Evaluation of the Impact of Preoperative Transarterial Particle Embolization of Juvenile Nasopharyngeal Angiofibroma on the Surgical Outcome on 30 Egyptian Patient. Nat Sci 2019;17(12):360-365]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 43. doi:10.7537/marsnsj171219.43.

Keywords: Evaluation; Impact; Preoperative; Transarterial; Particle; Embolization; Juvenile; Nasopharyngeal; Angiofibroma; Surgical Outcome; Egyptian; Patient

Full Text

43

44

Relation between Mean Platelet Volume and Supraventricular Tachyarrhythmias

Rania Hassaan Elsayed Ebrahim Deif (M.B.B.CH). *Raghda Ghonimy El-sheikh (M.D), and Hatem Mohamed El-Sokary (M.D).

Emergency Medicine and Traumatology Department Faculty of Medicine, Tanta University, Egypt

Email: raniahassan5761@gmail.com

Abstract: Background: Palpitation is considered one of the most common symptoms of patients presenting to the emergency department (ED). The diagnosis of palpitation is very difficult in the ED and the waiting time for first appointment with an arrhythmia clinic can be very long. Aim of the study: This study aimed to investigate the relation between mean platelet volume and supraventricular tachyarrhythmias. Patients and Methods: This study was conducted on two study groups, SVT group which came to the Emergency department with documented Supraventricular tachyarrhythmias (n=60) and healthy group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period. Results: The MPV was significantly higher in SVT Group (Group I) (12.11±1.36) fl than Control Group (Group II) (8.13±1.1) fl (P <0.001). These results were statistically significant between two groups. Conclusions: In our study, mean platelet volume (MPV) was elevated in patients with documented supraventricular tachyarrhythmias (SVT). It was considered as a helpful marker in SVT patients.

[Rania Hassaan Elsayed Ebrahim Deif, Raghda Ghonimy El-sheikh, and Hatem Mohamed El-Sokary. Relation between Mean Platelet Volume and Supraventricular Tachyarrhythmias. Nat Sci 2019;17(12):366-369]. ISSN 1545-0740 (print); ISSN 2375-7167 (online). http://www.sciencepub.net/nature. 44. doi:10.7537/marsnsj171219.44.

Keywords: Relation; Platelet; Volume; Supraventricular; Tachyarrhythmias

Full Text

44