Medicine and Health Sciences Commons^™

Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien

HCA Healthcare Journal of Medicine

Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient’s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks after …

A Case Of Simpson-Golabi-Behmel Syndrome Presenting With Cutaneous Findings, Tessa Mullins, Abigail Russell, Chad Johnston

HCA Healthcare Journal of Medicine

Simpson-Golabi-Behmel syndrome is a rare, X-linked recessive syndrome associated with mutations in the genes encoding glypican 3 (GPC3). The majority of cases have been described in pediatric males, with those affected showing manifestations of overgrowth, congenital heart defects, and increased incidence of neoplasia. Due to the X-linked nature of this disorder, penetrance is not well understood in female cases. Very few cases of female presentations of Simpson-Golabi-Behmel syndrome have been described, and this case highlights that there may be an association between mutated GPC3 carrier status and other cancers. We present a case of GPC3 gene mutation suggestive …

Tumor Necrosis Factor Alpha Snp Variant In Promoter Region G308a, Cause Preeclampsia During Pregnancy In Pakistani Women, A Case Control Study, Azizah Ziauddin, Sadia Ahmad, Asad Iqbal, Abdul Majid Khan, Shahid Mahmood Baig

Journal of Bioresource Management

Preeclampsia (PE) is a very common critical condition during pregnancy. As PE is a high-risk condition during pregnancy, occurring in 25% of all pregnancies, worldwide. In women with PE there is an increase in hypertension and albuminuria. Elevated blood pressure can be life-threatening after 20^th week of pregnancy. Single nucleotide variation in gene sequence can be disease causing, among these pathogenic SNPs, a variant in TNF-α, G308A is analyzed in many studies as a causative variant to cause preeclampsia. In this case control study fifty patients and fifty healthy individuals were enrolled for analysis of TNF-α promoter region …

Specimens, Sara Kapadia

The STEAM Journal

A short rumination on specimens

The Aboriginal Gap In Online Active Vaccine Safety Surveillance, Patrick Cashman, Sally-Anne Munnoch, Katrina Clark, Natalie Allan, Stephen Clarke, Kristine Macartney, David Durrheim

Australian Indigenous HealthBulletin

Objectives: To investigate if Aboriginal people are equally included in new forms of vaccine safety post-marketing surveillance that support safety signal detection and confidence in the vaccine program by comparing the use of Vaxtracker active adverse events following immunisation (AEFI) surveillance between Aboriginal and non-Aboriginal parents of vaccinated children.

Methods: In 2016, automated AEFI surveillance was conducted to monitor seasonal influenza vaccine in children aged 18 months to less than 5 years and for DTPa vaccine after the inclusion of a new dose at 18 months of age. To explore reasons for non-response, Aboriginal Immunisation Officers contacted the …

Evaluation Of Superior Rectal Artery Preservation In Sigmoidectomy For Sigmiod Colon Cancer, Abd El Rahman El Kady, Mohammed Asar

Al-Azhar International Medical Journal

Background: In the conventional radical treatment of sigmoid colonic cancer, the ligation of root of inferior mesenteric artery is performed to verify harvesting of D2 and D3 lymph nodes (I.e. intermediate and central lymph node groups) and improve the surgical prognosis. IMA ligation may compromise the blood supply at site of anastomosis and risk injury of autonomic nerve plexus, so preservation of superior rectal artery (SRA) may lead to increase blood flow and decrease postoperative bowel complications. Aim of the study: evaluation of SRA preservation in open sigmoidectomy for sigmoid colon cancer as regard impact on both radicality and vascularization …

Incidence Of Placenta Accrete And Its Complications In Cases Of Previous Cesarean With Placenta Previa Anterior, Gamal Abd El Khabeer

Al-Azhar International Medical Journal

Background: Placenta accreta is regarded to be a massive complication in pregnancy that can be correlated with intrapartum and postpartum hemorrhage, which is severe and potentially life-threatening. Aim of the Work: Determination of the occurrence and complications of placenta accreta in instances of prior cesarean sections with placenta previa and outcome of management of these complications. Patients and Methods: A prospective randomized analysis was performed on 100 cases of placenta previa centralis anterior with previous history of placenta previa centralis anterior and delivered by CS to show the incidence of placenta accreta in this pregnancy whom attended at Al Hussein …

Study Of The Effect Of The Opioid Antagonist "Naltrexone" On Acetic Acid-Induced Enteritis In Rats, Mahmoud Zaffan, Ahmed Labib, Adel Abd Alaziz

Al-Azhar International Medical Journal

Background: Crohn's diseaseis a transmural, relapsing inflammatory condition affecting the digestive tract.Opioid signaling was known to affect secretion and motility in the gut and may be implicated(involved in)in the inflammatory cascade of Crohn's disease.Endogenous Opioid peptides modulate inflammatory cytokine production.Opioid antagonists have been shown to play a role in healing and repair of tissues. This work was designed to detect the possible beneficial effects of opioid antagonist naltrexone in acetic acid -induced enteritis in rats. Experimental approach:Mature rats are allocated in to 9 groups (6 rats each). Enteritis was induced by2trans-rectal injection of acetic acid 4%(2 mg/kg). Salfasalazine (500mg/kg/day), naltrexone …

Correlation Between Endometrial Histopathology In Postmenopausal Uterine Bleeding And Transvaginal Colour Doppler, Shawkat El Kady, Emad Eltemamy, Ahmed Abd El Fatah, Ibrahim Mohamed, Sondos Salem

Al-Azhar International Medical Journal

Background: Correlation between Endometrial Histopathology in Postmenopausal Uterine Bleeding and Transvaginal colour Doppler. Aim of the Work: To evaluation of transvaginal ultrasound and transvaginal color doppler of uterine arteries compared to endometrial histopathology in Postmenopausal uterine bleeding. Patients and methods: Prospective comparative observational cohort study. This study involving 90 patients complaining postmenopausal bleeding recruited from those attending in the Gynecology clinic in Obstetrics & Gynecology Department at “ Mansheat El-Bakery Hospital”. Results: The result found patients with endometrial carcinoma significantly in older age (P =0.009), with higher body mass index (BMI) (P <0.001). There was no statistically significant difference as regard parity and, medical disorders (DM and HTN) (P >0.05). 5 mm endometrial thickness (ET) used the …

Endoscopic Sinus Surgery Decision And Timing For Endodontic Origin Sinusitis After Failure Of Primary Medical Treatment, Ibrahim Eldsoky, Wael Ismaiel Essa, Ahmed Mahmoud, Nashwa Elsayed

Al-Azhar International Medical Journal

Background: Odontogenic sinus disease require optimal management that involves definitive treatment of the underlying dental pathology. Further endodontic management with root canal, dental extraction, or apicoectomy. So, endoscopic sinus surgery (ESS) is recommended for patients who fail initial medical and/or dental treatment. However, the optimal timing for ESS is still unclear in literatures. Objective: The aim of this study is to find the optimal time for ESS in odontogenic sinusitis (ODS) patients after the failure of the primary medical treatment. Patients and Methods: This study was conducted on 25 patients with ODS: 14 males and 11 females. After the failure …

Comparative Study Between Interlocking Nail And Locked Plate In Distal Tibial Fractures Fixation, Ahmed Elmezian, Ahmed Mohammed, Ismael Yassin

Al-Azhar International Medical Journal

ABSTRACT Background: Distal tibial fractures accounts for approximately 37.8% of all tibial injuries affecting all ages. Treatment of distal tibial fractures in skeletally mature patients is challenging because of its unique anatomical characteristics of subcutaneous location with weak blood supply and proximity to the ankle joint. Objective: To compare the results of fixation of extra-articular distal tibial fractures in adults by ILN vs. distal tibial locked plate with MIPPO. Patients and methods: This study was done at Al-Azhar University Hospital, during the period of January 2020 to December 2020. 20 patients were recruited for this study to compare ILN vs. …

Possible Protective Role Of Aphanizomenon Flos-Aquae (Afa) Food Supplement Against Cerebellum Neuronal Injury Induced By Gamma Radiation (Histological, Histochemical And Immunohistochemical Study), Mohamed Nasr, Wagih Mansour, Ahmed Elbana

Al-Azhar International Medical Journal

Background: Exposure to radiation alters the equilibrium of the protection mechanism by producing of free radicals, resulting in an imbalance in prooxidant, antioxidant status inside the cells. Oxidative stress has been shown to affect our nervous system. Natural dietary supplements have been shown to have antioxidant properties which can protect our bodies against free radicals. For example, Aphanizomenon flos-aquae (AFA) is a specific dietary supplement that has clinically proven health-promoting effects especially on the nervous system. Objectives: to study the radio-protective impact of AFA as a natural antioxidant on the cerebellar neuronal cells of adult albino rats against the gamma …

Transcerebellar Diameter To Abdominal Circumference Ratio In Assessment Of Normal Fetal Growth, Ahmed Hamid Shaaban, Ismael El Garhy, Ehab Hasanin

Al-Azhar International Medical Journal

Background: Intrauterine growth restriction (IUGR) and its early detection were correlated with a high risk of perinatal mortality and morbidity and management are helpful in decreasing the neonatal risks. Transcerebellar diameter to abdominal circumference ratio becomes a gestational age independent parameter, which may be helpful for early detection of IUGR. Objectives: Study the accuracy of transcerebellar diameter/abdominal circumference ratio (TCD/AC ratio) for the evaluation of normal fetal development. Patients and methods: Our Prospective observatory research included 500 women with uncomplicated pregnancy attending the outpatient clinic of Al Azhar university hospitals for routine antenatal care. Routine ultrasound parameters were measured as …

Assessment Of The Effectiveness Of Toxoplasma Surface Antigen Grade I For Diagnosis Of Human Toxoplasma Gondii, Abdelrahman Elmowafy, Adham Sadek, Alaa Samn, Hanan Hamza, Ibrahim Aly

Al-Azhar International Medical Journal

ABSTRACT Background: Toxoplasmosis represents a neglected equatorial poverty disorder triggered by an intracellular mandatory protozoan parasite, known as Toxoplasma gondii. Aim of the work: Purpose of this study was to assess the Effectiveness of Toxoplasma Surface Antigen Grade I for Diagnosis of Human Toxoplasma gondii in Egypt by Sandwich ELISA Technique. Subjects and Methods: This study was conducted on 94 individuals, divided to 3 categories, category I: Toxoplasma gondii, category II: Other parasites, It encompassed 10 infected patients that have E. histolytica and 14 infected with G. lamblia and category III: Healthy control group. Result: The cutoff value was 0.233 …

Howard's "Showing: What Pregnancy Tells Us About Being Human" (Book Review), Kyle D. Diroberts

The Christian Librarian

No abstract provided.

Sonographic Evaluation Of Hindfoot Pain, Ibrahim Fawzy Ezz Mohammed, Safwat Sayed El-Araby, Ehab Abdul-Azeim Ahmed, Hany Aly

Al-Azhar International Medical Journal

ABSTRAC. Background : Hindfoot is frequently injured either duo to trauma, overuse or inflammatory processes. Different diagnoses unfortunately tend to have overlapping clinical signs and symptoms. So, clinicians tend to rely on imaging. Ultrasonography (US) has many benefits for evaluating hindfoot pain. Aim of the study: To review the prevalence of etiologies in patients with hindfoot pain by musculoskeletal ultrasound. Patient and methods: This study included one hundred (100) patients complaining of unilateral or bilateral hindfoot pain ranging in age from 16 to 65 years with no sex specification, excluding patients with chronic rheumatological inflammatory diseases, diabetes mellitus, major ankle …

Comparative Study Between Intramedullary K Wires Versus Mini-Plates And Screws In Fixation Of Metacarpal Shaft Fractures In Adults, Mahmoud Abdel-Hamid, Mohamed Abulsoud, Mohamed Bissar

Al-Azhar International Medical Journal

Abstract Background: Percutaneous intramedullary K. wires fixation and mini-plates fixation are reasonable options for treating unstable metacarpal fractures as they provide anatomical reduction and rigid fixation, which is adequate to permit early mobilization. Objective: To compare between mini-plates and Kirschner wires in management of unstable metacarpal shaft fractures in adults. Patients and Methods: All patients (n=30) included in this prospective comparative study were managed and followed up at Al-Azhar University Hospital from January 2019 to February 2020. Thirty patients with fracture of shaft metacarpal were divided into 2 groups: group A (n=15) were managed by percutaneous intramedullary K-wires and group …

Correlation Between Ultrasound And Magnetic Resonance Imaging In Diagnosis Of Ovarian Tumors, Tarek Mansour, Mohamad Tawfik, Mohamed El-Barody, Sileem Sileem, Ahmed Okasha

Al-Azhar International Medical Journal

ABSTRAC. Background and objective: To discuss the value of ultrasound (US) and magnetic resonance imaging (MRI) in the evaluation of female patients with ovarian tumors. Methods: This study was performed on 250 patients at University hospital and the National Cancer Institute who were referred to radiodiagnosis department from the Obstetric and Gynecology department during the period from March 2017 to March 2018. All patients were subjected to pathology assessment, transvaginal ultrasonography (TVUS) and MRI with diffusion-weighted imaging (MRI-DWI). Results: The study group of 250 patients had a mean age of 38.85 ± 17.1 years. Lesions were classified according to histo-pathological …

Effect Of Ultrasound-Guided Injection Of Local Ozone Or Platelet Rich Plasma Versus Corticosteroid In Plantar Fasciitis, Ahmed Elsawy, Hesham Abdelraouf

Al-Azhar International Medical Journal

ABSTRAC. Background : Plantar fasciitis or recently called plantar fasciopathy, generally observed with heel spurs because of the deposition of calcium, although the definite pathology is still unknown. Ultrasound-guided injection of conventional corticosteroids was the primary treatment modality, with other emerging substances (e.g. Ozone or Platelet Rich Plasma PRP). Aim of the study: This study was conducted to evaluate the effect of ultrasound-guided injection of local Ozone or Platelet Rich Plasma (PRP) versus conventional corticosteroid in the management of plantar fasciitis. Patient and methods: this a randomized Prospective comparative study has done Al-Azhar university hospitals (Al-Hussein and Sayed Galal), where …

Prevention Of Postpartum Haemorrhage In Patients With Severe Preeclampsia Using Carbetocin Versus Misoprostol, Hossameldeen Mostafa, Mohamed Mostafa, Hasan Abdrabou, Emad Ibrahim

Al-Azhar International Medical Journal

ABSTRACT Background: A significant reason of maternal deaths is postpartum hemorrhage (PPH) that accounted for one-quarter of all maternal mortality globally. Primary postpartum hemorrhage (PPH) is conventionally described as a loss of blood of ≥ 500 ml within the first 24 hours following childbirth. AIM OF THE WORK using carbetocin versus misoprostol in postpartum hemorrhage prevention in sufferers with intense preeclampsia. Patients and Methods: A randomized prospective study is done to compare use carbetocin vs misoprostol in postpartum hemorrhage prevention with severe preeclampsia. In the present research a total of 100 patients who attended Sohag general Hospital included. First group …

Neurological Manifestations In Egyptian Covid-19 Patients, Ahmed Essmat

Al-Azhar International Medical Journal

Background and aim: The current Covid-19 pandemic massively overwhelmed the health scene in almost all world countries including Egypt. Neurological manifestations are commonly reported among Covid-19 patients. The aim of the present study is to describe the neurological manifestations in a group of Egyptian patients diagnosed with Covid-19. Patients and methods: The present retrospective study was conducted at Al-Azhar University Hospitals. Patients included in the study comprised 50 patients with variable new-onset neurological manifestations in addition to other 50 patients without neurological manifestations recruited from other departments. All participants were subjected to careful history taking, thorough clinical examination and routine …

Surgical Treatment Of Middle Third Fracture Clavicle In Adults By Pre-Contoured Locked Plate, Al-Hussein Adham, Mahmoud Hassan, Mohamed Abulsoud

Al-Azhar International Medical Journal

Background: The clavicle is one of the bones that are most commonly fractured in the body. In adults, clavicle fractures represent 5–10 % of all fractures and 35 % of shoulder girdle fractures. Although most clavicular fractures may be treated nonoperatively, there is still a debate about the best therapy option for displaced mid-shaft clavicle fracture. Aim of the Study: To investigate the results of surgical fixation of displaced middle-third fracture clavicle by the anatomical pre-contoured locked plate in young adults. Materials and methods: This research involved 20 adult patients with a recent middle-third clavicle fracture. Results were assessed after …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Covid-19 And Arrhythmias: A Review Of Cardiac Electrophysiology Associated With Sars-Cov-2, Kashmala Khan, Francis Dimtri, Carlos Vargas, Thomas Alexander

HCA Healthcare Journal of Medicine

Coronavirus infectious disease 2019 (COVID-19) has become one of the most recognized viral illnesses to date. Most people infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a benign clinical course, but there have also been catastrophic outcomes. Although, notoriously known to affect the respiratory system, extra-pulmonary manifestations have also been established. An increasing number of people have been reported to present with cardiac manifestations, which include but are not limited to arrhythmias. The cardiac conduction system can be damaged by various mechanisms in patients infected with SARS-CoV-2. In this review, we will attempt to briefly describe the arrhythmogenic …

Research Amidst The Pandemic, Howard Burris

HCA Healthcare Journal of Medicine

Cancer patients need access to promising investigational therapies, available only through clinical trials, and the emergence of COVID-19 and the resulting pandemic became an emerging threat to fulfilling that need. Many academic medical centers were pausing their clinical research programs, diverting their resources and sheltering their teams. Sarah Cannon, the Cancer Institute of HCA Healthcare, made the decision to stay safe, but stay the course.

Mycobacterium Fortuitum And Mycobacterium Abscessus Infections In The Foot And Ankle In Two Immunocompetent Patients, Khai Phang Wong, Zhi Hao Tang, Gek Meng Tan

BioMedicine

Nontuberculous mycobacteria (NTM) infections of the musculoskeletal system are commonly missed due to its rarity and the absence of systemic symptoms. A high clinical index of suspicion is required to recognize such infections as they may occur in immunocompetent hosts. We present two cases of foot and ankle NTM infections involving Mycobacterium fortuitum and Mycobacterium abscessus in two such patients. The first case involves an 83-year old lady who presented with a two-month history of multiple foot abscesses initially treated at a rural hospital. She underwent drainage and debridement of her foot, with eventual cultures growing Pseudomonas aeruginosa and Mycobacterium …

Persistent Palatal Hypertrophy Associated With Rapid Maxillary Expansion Procedure: Report Of A Rare Case, Mehmet Melih Omezli, Damla Torul, Tolunay Avci

BioMedicine

Maxillary transversal deficiency (MTD) is a common skeletal problem. If not treated on time, MTD evolve to a more complex malocclusion. This problem can affect facial growth and development. Rapid maxillary expansion (RME) procedure frequently used for the management. This technique is usually successful in young individuals but as the age advances and the articulations of the maxilla with surrounding facial bones get more rigid, it becomes ineffective. Undesirable side effects or results have been reported after use of RME in skeletally mature patients such as buccal tipping of posterior teeth, extrusion, periodontal tissue recession, fenestration of buccal cortex, necrosis …

Investigation The Effect Of Jujube Capsule On Sleep Quality Of Postmenopausal Women: A Double-Blind Randomized Clinical Trial, Razieh Mahmoudi, Somayeh Ansari, Mohammad Hosein Haghighizadeh, Nader Shakiba Maram, Simin Montazeri

BioMedicine

Abstract

Bakground and objective: Sleep disorder is among the most common problems in the life of postmenopausal women. Because of the complications of chemical drugs, many women prefer to use herbal supplements for relieving sleep problems. So, the main objective of this study was to determine the effect of the jujube capsule on sleep quality in postmenopausal women.

Materials and methods: This study was a double-blind clinical trial conducted on 106 postmenopausal women in Khuzestan province, southwest of Iran. All participants were selected by a simple non-probability sampling method. Data were collected through a demographic data form and the Pittsburgh …

Three-Dimensional Reconstruction Of Renal Vascular Tumor Anatomy To Facilitate Accurate Preoperative Planning Of Partial Nephrectomy, Chien-Heng Lin

BioMedicine

Objectives: To evaluate the role of three-dimensional (3D) reconstruction tumors and vessels of the kidneys in aiding the preoperative planning of partial nephrectomy.

Materials and Methods: Patients with renal tumors to be treated with partial nephrectomy were included. Each patient underwent a preoperative computed tomography (CT) survey, and the reconstruction of each patient’s 3D arteriography and 3D surface-rendered tumor was performed based on the CT images for preoperative surgical planning.

Results: A total of 6 patients, three with tumors of the right kidney and three with tumors of the left kidney, were enrolled in the study. The patients’ mean age …

Evaluation Of Subacute Subarachnoid Haemorrhage Detection Using A Magnetic Resonance Imaging Sequence: Double Inversion Recovery, Zahra Mardanshahi, Maryam Tayebi, Sajad Shafiee, Maryam Barzin, Misagh Shafizad, Reza Alizadeh-Navaei, Abdolmajid Gholinataj

BioMedicine

Background and Objectives: The diagnosis of subarachnoid hemorrhage (SAH) especially at the subacute stage is still a challenging issue using the conventional imaging modalities. Here we evaluated the role of double inversion recovery (DIR) sequence of MRI compared with the conventional gradient-recalled echo (GRE)-T2*-W and susceptibility-weighted imaging (SWI) sequences in the diagnosis of subacute SAH.

Materials and Methods: This prospective study was conducted on 21 patients with SAH, which were diagnosed using CT scan at the initial step. In the third week after the injury (14-20 days), all patients underwent a brain MRI exam that included T2*-W, SWI, and …