Medicine and Health Sciences Commons^™

48 Hours Holter Monitoring In Detecting Occult Atrial Fibrillation In Young Patients With Possible Cardioembolic Stroke, Bushra Khalid, Soban Khan, Muhammad Tariq, Sajid Ali, Ijaz Ali, Zaid Waqar

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and objective: Atrial fibrillation (AF) is a common cause of ischemic stroke. AF is usually paroxysmal and could escape detection via single lead electrocardiogram ECG recorder. Holter monitoring is useful in this scenario. The objective of this study was to assess the role of 48 hours Holter monitoring in identifying clinically inapparent AF in young patients with ischemic stroke

Methods: A retrospective cross-sectional study was conducted with patient data from November 2019 to February 2021. It was conducted in Neurology department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Study contained medical records of 60 patients which were …

Neurological Manifestations Of Cerebral Venous Thrombosis: Experience From A Tertiary Care Center, Anum Irfan, Soban Khan, Zaid Waqar, Sumaira Nabi, Bushra Khalid, Muhammad Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Cerebral venous thrombosis (CVT) is a common cause of cerebrovascular accident (stroke). CVT is caused due to blockage in blood flow either in cerebral veins or in dural sinuses. The objective of this study was to determine prevalence of various clinical and imaging characteristics in patients with cerebral venous thrombosis.

Methods: A descriptive retrospective cross-sectional patient data was collected from November 2019 to February 2021. This study was conducted in Neurology Department in Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. This study contains patient medical histories of 60 patients who were admitted in two and a …

Short, Medium And Long Term Neurological Manifestations And Outcome In Covid-19 Patients, Sajid Hameed, Bashir Soomro, Samar Iltaf, Abdul Malik, Anjum Farooq, Alam Ibrahim Siddiqi, Safia Awan, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: There is a need to improve the understanding of Covid-19 neurological complications in a temporal manner. The objective of our study was to find out temporal relationship of neurological manifestations and outcome in Covid-19 Patients.

Methods: This was a multi-center observational study from six centers in Pakistan. Data of covid patients with six months follow up was retrospectively collected from the hospital records. Time periods were divided into short-term (< 1 month), medium-term (2-3 months) and long-term (>4 months). SPSS version 26.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the data.

Results: Neurological manifestations were reported in 208 out of 905 covid …

Decompressive Hemicraniectomy For Patients With Malignant Cerebral Venous Sinus Thrombosis, Sadaf Majid, Waseem Tariq Malik, Asfandyar Khan Niazi, Ehsan Ul Haq, Hina Yusuf, Raja Farhat Shoaib, Maimoona Siddiqui Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and may lead to the development of raised intracranial pressure due to edema, infarct or bleed. These patients may require decompressive hemicraniectomy to reduce the raised intracranial pressure. However, the evidence for hemicraniectomy in these patients is scanty. Our objective was to perform a retrospective chart review to describe the clinical characteristics of patients who underwent decompressive hemicraniectomy for malignant CVST and their outcomes.

Methods: We retrospectively analyzed the medical records of patients with CVST who underwent decompressive hemicraniectomy between 2013 and 2020 at Shifa International …

Hurdles Of Intravenous Thrombolysis In Acute Ischemic Stroke At Balochistan, Anjum Farooq, Muhammad Essa, Nimra Shafique, Sakina Gull

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Intravenous thrombolysis (IVT) with alteplase tPA (tissue plasminogen Activator) is the FDA approved treatment for acute ischemic stroke. The objective of this study was to determine the hurdles of intravenous thrombolysis in acute ischemic stroke in Balochistan.

Methods: A prospective cross-sectional observational study was carried out from June 2021 to December 2021 at Neurology department of Bolan Medical Complex Hospital Quetta on 272 patients of acute ischemic stroke who fulfilled the criteria. Proforma was filled by relative or patient after informed consent. Proforma included sex, age, diagnosis, time of presentation after stroke and reason of delay. Data …

Multiple Sclerosis And Parkinson’S Disease: Poles Apart Or Cut From The Same Cloth?, Wajid Jawaid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Functional Outcome Of Double And Four Strand Techniques In Hand Flexor Tendon Repair, Mohamed Said Abo Elsayed, Wael Ayad, Mohamed Ouf

Al-Azhar International Medical Journal

Background: 14% to 30% of all treated patients examined in emergency rooms have hand injuries. Tendon injuries rank 2nd (29%) of all patients treated for hand injuries. Objective: To demonstrate the functional outcomes of double-strand and four-strand procedures for the repair of hand flexor tendons and the benefits of early rehabilitation. Patients and methods: We carried out this prospective study on 40 patients who had completely cut flexor tendons of the hand at the plastic and burn surgery department of Al-Hussein & Bab Elsheria University Hospital, Al-Azhar University (Cairo). Results data suggest that, when it comes to hand flexor tendon …

Efficacy Of Immediate Insertion Of An Intrauterine Contraceptive Device During Cesarean Section In Comparison With Late Insertion After The Puerperium, Ahmed Al Safty, Abdel Monem Zakaria, Ahmed Saeed

Al-Azhar International Medical Journal

Background: Postpartum period is one of the critical times when a woman needs special optimal health services as complication rates are quite high during this period and also the women are vulnerable to unintended pregnancy. Aim of the work: To evaluate and compare between intrauterine device (IUD) (pregna T Cu 380A) insertion at the cesarean section and after puerperium in terms of expulsion rate, pain, and amount of bleeding. Patients and methods: This was prospective study, conducted at the Department of Obstetrics and Gynecology of El Hussein University hospital and El Sayed Galal hospital, on 200 women who were scheduled …

Evaluation Of Water Tolerance After Laparoscopic Sleeve Gastrectomy, Ibrahim Aljazzar, Mohammed Taema, Abd-Elfattah Morsy

Al-Azhar International Medical Journal

Background: Obesity is a leading cause of death, luckily it is preventable. Surgical Intervention e.g. laparoscopic sleeve gastrectomy (LSG) is a successful method of obesity management. Patients underwent LSG experience post-operative difficulty of water and fluids intake. Aim of the work: To determine water and juice tolerance following LSG with incidence calculation and comparing this with short-term outcome of LSG regarding excess weight loss and complications. Patients and methods: This Study includes 20 patients with ages ranges from 18 to 45 years and their Pre-operative BMI ranges from 38 to 65. Patients underwent LSG and were followed up for 3 …

Role Of Pigtail Catheter In Patients With Encysted Empyema And In Pleurodesis Of Patients With Malignant Pleural Effusion, Emad Ahmed, Nabil Awad, Ahmed Wahba, Mohammed Abboud

Al-Azhar International Medical Journal

Background: The use of pigtail catheter has developed as a viable choice for thoracostomy tube being less invasive, less painful and fewer procedure-associated complications. Aim of the work: to assess the role of pigtail catheter in encysted empyema and compare the use of it versus the chest tube in pleurodesis in candidates with malignant pleural effusion. Patients and Methods: There were 60 patients in this study, divided into two groups: Group I included 20 patients with encysted empyema and a pigtail catheter was placed using chest ultrasonography guidance. Group II included 40 patients with malignant pleural effusion who were subdivided …

Spheno-Orbital Enplaque Meningioma; Surgical Strategy And Proptosis Result, Mostafa Aboelkhir, Mohammad, Albialy, Mansor Hendawey

Al-Azhar International Medical Journal

Background: Spheno-orbital enplaque meningioma (SOEMs) are complex lesions that primarily originate in the sphenoid wing with extensive hyperostosis and may involve the orbit and cavernous sinus, making a gross total resection difficult and posing a high risk of postsurgical morbidity and recurrence. Method: a series of 13 consecutive patients with SOEM presented by proptosis and hyperostosis who underwent surgical excision by frontotemporal craniotomy, clinical, radiological, surgical technique and follow up was reviewed and analyzed. Result: In this series of 13 consecutive patients, 11 were women and 2 were men. The age range was from 35-63 years with a mean of …

Relation Between Endothelial Protein C Receptor Gene Polymorphism 6936a/G And The Risk Of Vascular Access Thrombosis In Patients With End Stage Renal Disease On Hemodialysis, Mohammed El Emam, Yousri Zoheri, Nora Ibrahim, Mohamed Khedr, Alsayed Rashed

Al-Azhar International Medical Journal

Background: The most significant complication of chronic kidney disease (CKD) is end-stage renal disease (ESRD). Hemodialysis (HD) necessitates a well-functioning vascular access with enough blood flow for clearance and blood dialysis. Thrombosis of the veins can be caused by both acquired and inherited factors. Aim of the study: We aim to assess EPCR levels in patients with ESRD on hemodialysis & study relationship between the presence of EPCR gene polymorphisms (6936A/G) and incidence of vascular access thrombosis. Patients and methods: This research was carried out on 50 studied cases admitted to the Theodor Bilharz Research Institute (TBRI), Imbaba, Giza, Hemodialysis …

Role Of Rouviere's Sulcus In Identification And Dissection Of Calot's Triangle During Laparoscopic Cholecystectomy, Baha El-Dein El-Saman, Adel Abdulhalim Lasheen, Waleed Abdelaty

Al-Azhar International Medical Journal

Background - One of most common surgical technique applied overall the world is laparoscopic cholecystectomy due to the high features instead of another surgical techniques. Furthermore; it is represents as the main technique for gallstones treatment; however the incidence of bile-duct injury still higher than that of open cholecystectomy. Various surgical procedures and principles have been proposed to reduces bile duct injury. Aim - to determine the frequency and the type of Rouviere’s sulcus and its importance as landmark during laparoscopic cholecystectomy. Patients and Methods - This prospective study included hundred-patients who had symptomatic gallstone disease and underwent laparoscopic cholecystectomy …

Effectiveness Of Surgery For Degenerative Lumbar Spinal Stenosis: A Systematic Review, Moataz Labib, Hesham Farhoud, Abd El Aleem Sultan

Al-Azhar International Medical Journal

Background: Lumbar spinal stenosis is common condition. Many similar treatment procedures have been described. In managing spinal stenosis surgery has expanded dramatically in the last two decades. Aim of the study: Assess the safety and efficacy of operative and invasive therapies for people experiencing degenerative LSS. Patient and methods: PubMed, Embase, Web of Science, and the Cochrane library were used to find relevant clinical research. Participants in such studies were 60 years old or older and had degenerative lumbar spinal stenosis. Results: All studies were randomized controlled trials. There were 974 patients. As regard Outcomes measures after surgical treatment, significant …

Incidence Of Placenta Accreta And Its Complications In Cases Of Previous Cesarean Sections With Placenta Previa Anterior, Abdel Ghany Diab, Samir Ali, Mohamed Farahat

Al-Azhar International Medical Journal

Background: The prevalence of placenta previa has been recently estimated to be approximately 0.5% of all pregnancies, and this increase correlates to the elevated cesarean section rate. Placenta previa is a major cause of maternal morbidity and mortality because of the associated massive antepartum and intrapartum hemorrhage. Placenta previa is associated with preterm delivery, with the neonatal mortality increasing threefold. Aim of the study: The aim of this study was to determine the relationship between placenta accreta and its complications in cases of previous cesarean section with placenta previa anterior. Patients and Methods : This study conducted in Department of …

Evaluation Of Role Of Ultrasound In Assessment Of Successful Weaning From Mechanical Ventilation In Critically Ill Patients, Hosam Erfan, Mohammed Sharaf, Mostafa Abo El Enin, Mostafa Shakweer, Othman Mossa, Essam Abdelwahab, Sara Gadwal

Al-Azhar International Medical Journal

Background: Mechanical ventilation waning failure is a common problem, and bedside ultrasonography could be helpful in prediction of the weaning process and its results. Aim of The Work: To ssess by means of ultrasound how diaphragmatic parameters are important in predicting weaning outcome by assessing diaphragmatic thickness, diaphragmatic mobility and variation. Patients and Methods: This study included 62 mechanically ventilated patients who were subjected to transthoracic ultrasonography of the diaphragm throughout a spontaneous breathing experiment and had been divided into two groups: successful extubation and unsuccessful extubation. Results: With a p-value of <0.001, a high DE after extubation was linked to extubation success. Extubation failure was linked to lower DTF before and after extubation, with a p-value of 15 had 100% sensitivity, 85.06% specificity, 70.5 PPV and 100% NPV with p-value 20.4 had 93.55% sensitivity, 93.55% specificity, 93.5% PPV, and 93.5% NPV with p-value Conclusion: Diaphragm ultrasound evaluation of DTF and DE is a simple new weaning index which can be used as a bedside technique in clinical practice and has promising predictors of weaning success or failure before and after extubation.

Early Versus Delayed Umbilical Cord Clamping During Cesarean Section Of Pregnant Women With Preeclampsia: Maternal And Neonatal Outcome, Ahmed Korkor, Mofeed Mohamed, Mohamed Abdelmoaty

Al-Azhar International Medical Journal

Background: umbilical cord serves like a conduit for fetus's gas exchange, nourishment, & endocrinal homeostasis. Clamping of umbilical cord marks watershed moment in development of foetus into independent entity. Aim of the work: To compare effects of early versus delayed cord clamping on intraoperative blood loss during caesarean delivery in cases with severe preeclampsia. As well as to compare neonatal benefit of delayed cord clamping versus early cord clamping. Patients and methods: This randomized prospective control study was conducted, including 60 near term pregnant women with severe preeclampsia candidate for termination by cesarean delivery and the surgery was performed by …

Prediction Of Fetal Hypoxia By Ductus Venosus Doppler Pattern In High-Risk Pregnancies, Waleed Orwa, Abdelrahman Anbar, Ahmed Mohamed

Al-Azhar International Medical Journal

Background: Ductus venosus doppler has effective role in treatment of disorders that put the fetus at risk of cardiovascular diseases. In antenatal assessment, Doppler ultrasonography is increasingly being used to evaluate the blood flow volume rate in vessels during the cardiac cycle in the fetoplacental, uteroplacental circulation. Aim of the work: To discover if ductus venosus Doppler velocimetry may give earlier prediction of fetal hypoxemia than umbilical and middle cerebral artery blood doppler velocity in high-risk pregnancy or not. Patients and methods: According to the inclusion criteria, 60 pregnant women after the age of fetal viability (28 weeks of pregnancy) …

Study Of Sacroiliac Fixation In Patients With Sacroiliitis Associated With L5 Lythesis, Ahmed Gabal, Hany Zahy, Ibrahim Ewis

Al-Azhar International Medical Journal

Background: Chronic low back discomfort is frequently brought on by the sacroiliac joint. The SIJ may be involved in 15–30% of patients who attend for examination of low back pain. Aim of the work: This study evaluates sacroiliac fixation in patients with sacroiliitis associated with L5 lythesis. Patients and methods: In this prospective and retrospective study, 10 individuals with spinal disorders were examined. Ten patients with mechanical sacroiliac joint discomfort underwent sacroiliac joint fixation. Results: Overall, this series' results showed that 7 patients (or 70%) had fully resolved their problems, 2 patients (or 20%), partially improved, and 1 patient (or …

Efficacy And Safety Of Yag Laser Vitreolysis For Symptomatic Vitreous Floaters, Mohamed Mannaa, Adel Osman, Ehab Elsheikh

Al-Azhar International Medical Journal

Background: The symptoms of patients with vitreous floaters are frequently underestimated, leading to no intervention. The majority of patients who have floaters receive conservative therapy that includes patient education and reassurance. On the other hand, more severe instances can necessitate pars plana vitrectomy or YAG laser vitreolysis. The potential for conducting vitreolysis using an Nd: YAG laser has arisen as an alternate therapy to avoid the complications of vitrectomy. Aim of the study: the study aimed to evaluate the safety and effectiveness profile of YAG laser vitreolysis as a modality of therapy for symptomatic vitreous floaters. Patients and methods: A …

The Correlation Of The Placental Thickness, Umbilical Artery Doppler And Fetal Growth, Hanaa Salman, Faisal Mustafa, Sileem Sileem

Al-Azhar International Medical Journal

Background: A healthy foetus requires the normal growth of the placenta during the pregnancy. On the other hand,, any disturbance related to its maturation may have a major effect on the fetal growth and the pregnancy outcome.. Aim and objectives: to detect the relation between the umbilical artery Doppler, placental thickness, and foetal growing. Subjects and methods: This cross-sectional study conducted at the outpatient clinic of the obstetrics and gynecology department, Al-Azhar University hospitals (assuit) and AL_Eman General Hospital Results: At the first visit, there was a strong positive connection between placental thickness and AC, BPD, and HC (r=1.00, p < 0.001). At the second visit, There were a notable positivity correlation between placental thickening and estimated foetal weight and umbilical flow by the Doppler (r=1.00, p < 0.001). Conclusion: Estimating the fetal weight is essential in our daily obstetric practice, especially at the third trimester. It helps the obstetricians in making decisions about delivery time and mode of delivery, to protect against the complications of low birth weight and macrosomic babies during labor and puerperium. From the findings of this study we can conclude that, there is measurably critical positive relationship between placental thickness and EFW, BPD, FL, AC and umbilical flow by the Doppler. Estimation of the placental thickness by Ultrasound is a good predictor for foetal growth and birth weight.

Who Leads The Emergency Department Debrief?, Allison D. Lane, Ethan Bryce, Marcy R. Milbrandt, Lisa R. Stoneking

Journal of Wellness

No abstract provided.

A Cross-Sectional Analysis Of The Relationship Between Tinnitus Functional Index And Anxiety And Depression Disorders In Tinnitus Patients With Normal Hearing, Heba Ghannoum, Reham El Shafei, Eman Basiouny

Al-Azhar International Medical Journal

Background: There is a substantial prevalence of psychopathology of anxiety or depression, and several mental problems in many tinnitus groups. Aim of The Work: To use the Tinnitus Functional Index (TFI) as a valid scale for assessing the overall severity of tinnitus and detailed analysis of multiple severity domains, and correlating it to The Hospital Anxiety and Depression Scale (HADS) scores , This to establish a potential correlation between tinnitus and anxiety and depressive disorders to improve tinnitus clinical implications and rehabilitation. Subjects and Methods: A cross-sectional study design was designed to explore the prevalence of psychological disorders among patients …

Effect Of Manufactured Fat Emulsion Infusion On Protein Loss In Burn Patients (Randomized Controlled Study), Ahmed Elsodany, Ahmed Salim, Yasser Helmy

Al-Azhar International Medical Journal

Background: Burn injury management requires a lot of time and resources. Most patients need lengthy hospital stays. Aim of the study: To determine the impact of manufactured fat emulsion on protein loss in burn patients. Patients and Methods: This Randomized controlled study included 20 patients of 20% up to 40% of TBSA that were hospitalized to department of plastic and reconstructive surgery, Al-Azhar University hospital, which was prospectively be simple into two groups. Group (A) were subjected manufactured fat emulsion IV infusion. Group (B) controlled. The study duration ranged from 6-12 months. The patient administrates 1-1.5g /per kg of intralipid …

Study Of Laparoscopic Nissen Versus Anterior Partial Fundoplication In Management Of Gastro Esophageal Reflux Disease In Children, Mahmoud Ghaly, Mohammed Ellithy, Ibrahim Gamaan

Al-Azhar International Medical Journal

Background: GERD is the most common upper gastroesophageal disorder in the Western population. A number of strategies have been recommended to prevent this problem. Aim of the Work: to compare the Nissen fundoplication with partial anterior fundoplication. Patients and Methods: The present comparative study included thirty patients who had symptomatic GERD admitted in pediatric surgery department ,Al-Azhar University hospitals and all patients submitted to preoperative clinical evaluation and investigations. Patients were randomly allocated to undergo either laparoscopic Nissen fundoplication (group I) or laparoscopic partial anterior fundoplication (group II). All patients in our study signed a consent form. Results: there was …

Total Arterial Revascularization Versus Conventional Coronary Artery Bypass Grafting; A Comparative Study, Mosaad Elgharabawi, Elhusseiny Gamil, Mohamed Mahmoud, Bahaa El Khonizy

Al-Azhar International Medical Journal

Background: The superiority of total arterial revascularization over the conventional method is a matter of continuous debate. Therefore, we aimed to compare early surgical and hospital outcomes of the total artery and conventional revascularization strategies in patients undergoing coronary artery bypass grafting (CABG). Methods: The study included 60 patients who underwent primary elective CABG from 2018 to 2020. Patients were grouped according to the revascularization strategy into two groups. Group 1 included patients who had conventional revascularization using left internal mammary artery (LIMA) and vein grafts (n= 30), and group 2 included patients who had total arterial coronary revascularization (TACR) …

Prevalence And Severity Of Mineral Bone Disorders In Chronic Kidney Disease Patients, Mohamed Eid Mohamed, Ahmed Alaa-Eldin Saad, Alsayed Rashed, Hatem Abdallah, Mohamed Abo-Ghabha

Al-Azhar International Medical Journal

Background Bone abnormalities are frequently developed in hemodialysis patients and people with chronic kidney disease (CKD). It results from aberrant bone turnover and a decline in bone mineral density (BMD). Aim and objectives: With the help of dual energy X-ray absorptiometry in this study, poor bone mineral density in CKD patients at Al-Hussein University Hospital will be analysed for prevalence and severity. Subjects and methods: This Cross-Sectional research included 120 Patients (2 groups) 60 CKD Patients and 60 Hemodialysis Patients. The study has been conducted in Nephrology Unit Al-Hussien University Hospital. Results: In ESRD group there was Significant statistically (p-value …

Prevalence And Impact Of External Genitourinary Anomalies Among Children Undergoing Routine Circumcision, Hend Ibrahim, Mohamed Fahmy, Ashraf Seddek

Al-Azhar International Medical Journal

Background: The knowledge of the incidence of congenital anomalies is important for planning health services in our country. It helps in planning the budget as well as measures for the management and the prevention of the disorders. It also helps to establish a program raising awareness of urogenital anomalies and their management. Objective: The aim of this study is to evaluate the normal anthropometric value of the normal penis and to detect the prevalence and impact of external genitourinary anomalies among 3000 Egyptian children attending for nonmedical circumcision. Patients and Methods: The prospective multi centric study was done on 3000 …

Cervical Cytologic And Colposcopic Changes In Cases Using Intrauterine Devices For Along Time, Eslam Farg, Samir Ali, Abd-Elmonsef Mostafa

Al-Azhar International Medical Journal

Background: Intrauterine Contraceptive Device (IUD) is a safe, convenient and inexpensive method of contraception involving neither repetition nor interference with sexual activity. Aim of the work: To to examine cytologic and colposcopic changes in individuals utilising IUCDs in the cervical region.for long periods of time and to create awareness among the IUCD users for regular follow up. Patients and methods: The Obstetrics and Gynecology Department of Al-Hussein University Hospital conducted this cross-sectional study. 200 monogamous individuals with IUCD who have been free of STIs for three to five years made up the study group (Group 1). On the other hand, …

Intravenous Iron Sucrose Versus Intramuscular Iron Sorbitol In Management Of Iron Deficiency Anemia During Pregnancy, Mohamed Hamed, Abd Allah Ahmed, Islam Sultan

Al-Azhar International Medical Journal

Background: The greatest prevalent nutrient shortage in pregnant women across the globe is iron deficiency anemia (IDA). Maternal anemia continues to significantly increase neonatal morbidity and death, and there is worry over the elevated incidence of iron and other micronutrient deficiencies among pregnant women in poor nations. Aim of the work: To examine the effectiveness and safety of intramuscular iron sorbitol citric acid complex and intravenous iron sucrose in the treating of iron deficiency anemia (IDA) in gestation. Patients and methods: At the Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, 100 pregnant women were separated into two …