Medicine and Health Sciences Commons^™

Expression Levels Of Matrix Metalloproteinase 2 Protein In Preinvasive And Invasive Cervical Lesions And Its Clinicopathological Association: A North Indian Study, Rekha Sachan, Pushp L. Sachan, Ayushi Shukla, Malti Maurya, Munna L. Patel

Journal of Medicine in Scientific Research

Background Matrix metalloproteinase (MMPs) play an important role in development of female genital cancers and metastasis. The aim of this study was to analyze expression levels of MMP2 in various grades of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC) of cervix and its association with clinicopathological variables. Patients and methods This prospective study was carried out in a tertiary care center in Northern India over a period of 1 year. A total of 664 participants with gynecological complaints and unhealthy cervix were recruited for colposcopy. Of these, 70 biopsy samples were obtained from higher grade colposcopy lesions, where …

Standard Median Sternotomy Versus Minimally Invasive Approach For Atrial Septal Defect Closure In Adults, Ahmed S. Ali, Ahmed G. Abd El Fattah Fahmy, Hatem K. Madkour, Reham M. Salah Eldin Ahmed

Journal of Medicine in Scientific Research

Background

Atrial septal defects (ASDs) in adults and adolescents are not uncommon. Surgical ASD closure through a standard median sternotomy (SMS) has become less attractive approach in favor of minimally invasive techniques, especially in young female patients.

Objective

The aim was to compare early postoperative outcomes of surgically closed secundum ASDs through a SMS approach versus minimally invasive right anterolateral thoracotomy (MIRAT) approach in adults.

Patients and methods

The authors prospectively studied 60 adult patients who had their secundum ASD anomalies surgically closed at National Heart Institute between the period of September 2020 and February 2022. A total of 30 …

Molecular Detection Of Entamoeba Histolytica In Diarrheic Fecal Samples From Patients Attending National Hepatology And Tropical Medicine Research Institute, Azza Hasan Abbas, El Shahat Ahmed Elshahat, Heba Mohamed Abdelglil

Journal of Medicine in Scientific Research

Background: Amoebiasis is a worldwide disease caused by Entamoeba histolytica infection. The true prevalence is unknown due to the difficulty in distinguishing Entamoeba histolytica from non-pathogenic amoebas especially when microscopic diagnosis is performed, to overcome microscopy misidentification. Polymerase Chain Reaction (PCR) assay is necessary as a highly sensitive and specific technique. Objective: To determine the value of Real-Time PCR (RT.PCR) in the diagnosis of Entamoeba histolytica in the stool samples of diarrheic patients attending NHTMI versus microscopy, copro- antigen, and serum antibodies detection techniques. Subjects and Methods: A cross-sectional study was conducted on 150 diarrheic patients. Their stool samples were …

The Immune Response To Long Term Administration Of Dipravan Compare To Dormicum In Surgical Care Unit, Ashraf Abd El Hameed Soliman, Wael Abd Elateif El Hakeem, Raghad S. Abdellatif

Journal of Medicine in Scientific Research

Introduction : - Immune response may be affected by anesthesia and sedation. In anesthesia, the immue response is temporary as anesthesia is used for short time. However, the immune response more obvious in critical illness patients because of long time of sedation. Diprivan and dormicum are two commonly used medications for sedation and analgesia in critical care unit patients. Dipravan is a good medication for sedation in the surgical care unit. Dormicum in the surgical care unit, usually producing prolonged time of sedation when used for long time in surgical care unit. Patients and methods: - This article was done …

The Relation Between Heart Rate Response During Exercise And Angiographic Severity In Patients With Chronic Coronary Syndrome, Emmanuel Louka

Journal of Medicine in Scientific Research

Introduction Ellestad and colleagues, in 1975, reached to the conclusion that impaired heart rate response to exercise carries a similar risk for future coronary events such as ischemic ‘ST’ segment changes. Mc Neer and colleagues went beyond these observations to include a survival benefit in patients who achieve a higher peak heart rate (PHR), a more advanced level of exercise, and have a normal exercise electrocardiogram. Aim The aim of this work is to clarify the relation between the chronotropic response to exercise and the severity of coronary artery disease in patients with chronic coronary syndrome. Patients and methods The …

Dental And Oral Manifestations Of Rheumatoid Arthritis: Is It Related To General Disease Activity?, Omnia A. Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: RA is a chronic immune-mediated systemic disorder; its pathogenesis is complex. Genetic, environmental, hormonal, and lifestyle are the main risk factors. The correlation between oral health and RA is rising. Oral manifestations in RA include temporomandibular joint disorder, secondary Sjögren’s syndrome, xerostomia, and periodontal disease. Previous studies suggest a bidirectional relationship between RA and periodontal diseases. This study aims to detect oral mucosal and dental disease in RA patients and its relation to demographic features, disease activity, and extra-articular manifestation. Patients and Methods: This cross-sectional study included 150 patients with RA allocated into two groups, 75 patients in each …

Comparative Study Between Intravenous Anesthesia (Propofol) And Inhalational Anesthesia (Sevoflurane) On The Cytokine’S Response To Abdominal Operation, Ashraf A.H. Mahmoud Soliman, Maisa M. Abdel Khalik, Wael A.E. El Hakeem, Raghad S. Abdellatif

Journal of Medicine in Scientific Research

Introduction These days, the need for more information and familiarity with the inflammatory response to different anesthetic drugs increase. Not only some patients suffering from immune reactions against some anesthetic drugs, but all surgical patients are liable to decrease in immunity postoperatively. This may increase the postoperative morbidity and mortality, affects healing, and spread of tumors postoperatively. This decrease in immunity is due to surgery trauma causing imbalance in cytokine response. Patients and methods This article was written on 40 patients, and patients were randomly classified into four equal classes. Class A: inhalational anesthesia on major operation. Class B: intravenous …

Angiotensin I-Converting Enzyme Insertion/Deletion Gene Polymorphism And Its Association With Diabetic Nephropathy In Type-2 Diabetes Mellitus Patients: An Egyptian Study, Yasmine M. Amrousy, Tamer M. Soliman, Haythem A. Tolba, Aisha Elshimy

Journal of Medicine in Scientific Research

Background Diabetic nephropathy (DN) is one of the most serious complications associated with type-2 diabetes mellitus (T2DM). With variable allele and genotype frequencies, the angiotensin I-converting enzyme (ACE) insertion–deletion (I/D) gene polymorphism has been suggested as a risk factor for DN. Objective The purpose of the study was to find whether ACE I/D polymorphism is associated with DN in Egyptian T2DM patients and its relation to ACE concentration and C-reactive protein quantitative level. Participants and methods A case–control study of 98 T2DM patients was divided into two groups: group 1, T2DM patients without DN, and group 2, T2DM patients with …

Effectiveness Of Management Program Of Chronic Functional Constipation In Children Who Are Attending The Pediatric Gastroenterology Clinic At Elbeheira Specialized Children's Hospital, Hamouda E. El-Gazzar, Sabreen Ahmed Ali Elsaka, Eman Adel Elsaid Elhaddad

Journal of Medicine in Scientific Research

Background: A chronic constipation is one of the most common functional gastrointestinal complaints in pediatric outpatient clinics. The prevalence of childhood constipation in the general population ranges widely from 0.7% to 29.6% internationally. Pediatric Gastroenterology Clinic at Elbeheira specialized children's Hospital is a referral center from the whole governorate. Objectives: To evaluate the current approach to management, risk factors associated, and clinical characteristics, the challenge of functional constipation in the pediatrics who are attending the Pediatric Gastroenterology Clinic at Elbeheira Specialized Children's Hospital. Methods: This retrospective study was conducted in Pediatric Gastroenterology Clinic at Elbeheira Children's Specialized Hospital for 6 …

Endovascular Management Of Vein Of Galen Aneurysmal Malformations: Case Series And Review Of The Literature, Mohammed A. El-Din Habiba, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background Neonates with vein of Galen aneurysmal malformations (VGAMs) who present with heart failure have a high rate of morbidity and mortality, while those who present later in childhood have considerably better outcomes. Aim To determine the factors that have the greatest predictive value in predicting long-term results in children with VGAM. Patients and methods Between June 2015 and June 2020, 15 patients (seven infants, eight children) were diagnosed with symptomatic VGAMs, four of whom were suffering from intractable high-output heart failure and received initial endovascular treatment. All of them were treated by endovascular procedures. Staged transarterial route was the …

Different Modalities Of Tongue Tie Management, Wesam Ibrahem Homouda, Esayed Hussien Elmokadem, Mohamed Amr Hamdy Salem

Journal of Medicine in Scientific Research

Background: Tongue-tie or ‘ankyloglossia’ is a congenital anomaly characterized by presence of an abnormally tight lingual frenulum - a string like membrane – that attaches the tongue to the floor of the mouth. It affects the movement of the tongue. For symptomatizing ankyloglossia surgical treatment with different surgical techniques such as (Frenotomy, frenectomy/frenulectomy, and frenuloplasty) is the treatment of choice that gives satisfactory results. Objectives: We built our study to compare between different surgical techniques used for management of ankyloglossia. Patient and method: in our study 60 patients were included 33 were female and 27 were male with age ranging …

A Case Of Congenital Diaphragmatic Hernia Presenting In The Adult As Gastric Volvulus, Sajal Gupta, Ismail Khan, Indu B. Dubey, Mayank Verma

Journal of Medicine in Scientific Research

We report a case of an adult patient who was referred to the surgical emergency for the evaluation of acute abdominal pain and vomiting. Radiograph chest showed a left-sided cavity, which was misleading to lung pathology. A suspicion of gastric volvulus was kept in mind on seeing the stomach in the radiograph. Computed tomography confirmed the diagnosis of diaphragmatic hernia. The insertion of the Ryle’s tube corrected the gastric volvulus. An immediate laparotomy was done for the closure of the diaphragmatic gap and reduction of the herniated contents. The patient responded well and was discharged in a week.

Complete Dorsal Pancreatic Agenesis: A Case Report, Ritish Gupta, Ashima Mittal, Bhavna Arora, Riya Aggarwal

Journal of Medicine in Scientific Research

Complete agenesis of the dorsal pancreas (ADP), an extremely rare congenital anomaly, is caused as ‘the dorsal pancreatic bud fails in developing the body and tail of the pancreas at the time of embryological development.’ There are nearly 100 cases of dorsal pancreatic agenesis till date. Most of the individuals with ADP are without symptoms; however, few may present with clinical manifestations like pancreatitis, epigastric pain, hyperglycemia, and diabetes mellitus. This is a case report of a 19-year-old female with ADP, who was diagnosed incidentally while undergoing radiological assessment for abdominal pain in left hypochondrium. As complete ADP is very …

Prevalence Of Upper Limb Musculoskeletal Abnormalities In Type 2 Diabetic Patients And Its Relation To Glycemic Control And Associated Factors, Eslam Elsayed Ali Shohda, Amal Emam El-Maghraby, Hadeer Khaled Youssef Elhamid

Journal of Medicine in Scientific Research

Aim of the study: to investigate the prevalence of upper limb musculoskeletal abnormalities and their correlations to glycemic control and associated factors. Methods: A cross-sectional study was conducted at diabetes unit and internal medicine outpatient clinic at Al-ahrar teaching hospital, Zagazig, Egypt. 200 type 2 diabetic patient (T2DM) and 200 non-diabetic control patients of ages > 18 years were enrolled. Rheumatological diseases were excluded. Studied upper limb musculoskeletal abnormalities were Limited joint mobility (LJM), Dupuytren’s contracture (DC), Trigger finger (TF), De Quervain’s tenosynovitis (DQT), Lateral epicondylitis (LE), Medial epicondylitis (ME), Rotator’s cuff tendinitis (RCT) and Carpel tunnel syndrome susceptibility diagnosed by …

Assessment Of Carotid Intima-Media Thickness And Its Relation To Cardiovascular Risk Factors In Obese Children, Faten A.A. Fathi, Somaya M. Abd El Ghany, Ahmed A.H. Taha, Gihan F.A. Hassan, Eman Fouad

Journal of Medicine in Scientific Research

Background Childhood obesity is one of the most critical public health problems today. This study aims to assess the relation between carotid intima-media thickness (CIMT) and cardiovascular risk factors in obese children. Patients and methods This is a case–control study conducted on 80 Egyptian children aged 6–18 years; 40 children with simple obesity as defined by WHO (2011) and 40 healthy children age matched and sex matched were taken as a control group. Cases were selected from the National Nutritional Institute randomly from December 2017 to March 2018. All patients and control groups were subjected to the following: full history …

Outcome Of A Case Of Living Donor Kidney Transplant With High Levels Of Pre-Transplant Donor Specific Antibodies, Ahmed Hassan Elthakaby, Aza Elmenyawi

Journal of Medicine in Scientific Research

For patients with ESRD, kidney transplant offers significant survival and quality-of-life advantages compared with dialysis. Non-sensitized renal transplant recipients when compared to patients with preformed alloantibodies, the latter are at greater risk of cellular, humeral rejection and premature graft failure. In this paper we will present a successful case of young adult who has ESRD and maintained on regular hemodialysis and undergo live related renal transplant with high dose HLA class I and class II antibodies and negative cross match by CDC and flow cytometry.

Oral Mucosal And Dental Affection In Patients With Systemic Lupus Erythematosus: A Clinical Survey, Omnia A Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: SLE is a chronic autoimmune disease predominantly affecting young females. Systemic involvement along with variable clinical presentations characterizes SLE. Various oral and dental manifestations have been described in SLE that include oral ulcerations, candida infection, and periodontal disease. We aimed to detect oral mucosal and dental disease in SLE patients and its relation to demographic features, general disease activity, and the extra-articular manifestation. Patients and Methods: 80 patients with SLE were included in this cross-sectional study. Patients were allocated into 2 groups, 40 patients in each group, according to SLE disease control with immunosuppressive medications: group A included patients …

Repair Vs. Conservative Treatment For Ischemic Patients With A Moderate Degree Of Mitral Incompetence, Ahmed Shafeek Ali, Mohamed Belal Mohamed Abd Elbaki, Haitham Alshahat Ramadan, Reham Mohammed Salah Eldin Ahmed

Journal of Medicine in Scientific Research

Background: Ischemic heart diseases are often associated with a moderate degree of mitral incompetence. The optimal treatment of this condition is still controversial. benefits of repairing moderate mitral incompetence in ischemic patients are uncertain. Objectives: compare outcomes of treating ischemic patients with moderate mitral incompetence either by isolated CABG versus CABG with mitral repair. Patients and methods: We prospectively studied 60 consecutive ischemic patients with a moderate degree of mitral incompetence who were surgically treated at the National Heart Institute between the period of April 2021 to March 2022. 30 patients had isolated CABG surgery while the other 30 patients …

Studying The Therapeutic Effect Of Umbilical Cord Stem Cell In Pneumonia Caused By Covid-19, Salama M. El- Shennawy, Abdalla Abo Hassen, Talal Ibrahim Hagag, Asherf I Zahra, Reham Salama, Mariam A. Fouad

Journal of Medicine in Scientific Research

Context: Coronavirus disease (COVID-19) with severe respiratory morbidity and mortality , rapidly spread all over the world, caused by an sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varying from mild symptoms to pulmonary fibrosis( Li Z et al.,2020). Mesenchymal stem cells (MSCs) can have a critical role, by promoting the pulmonary parenchyma regeneration and subsequently decreasing the symptoms of COVID-19 and help immune system to act against the virus (WHO, 2020).Aim: to evaluate the efficacy and safety of using stem cell in the treatment of COVID-19patients.Setting and design: We performed this case control study during the period from November 2020 …

Assessing Serum Ferritin Together With Some Inflammatory Biomarkers In Overweight And Obese Hospital Care Workers At Elgalaa Teaching Hospital And Its Correlation With Metabolic Syndrome, Sahar Mohamed Said Elbayoumi, Hanan Farouk, Heba Abdelaziz

Journal of Medicine in Scientific Research

Obesity is known to be associated with elevated levels of inflammatory markers. One of the major problems associated with morbidity and mortality. The aim of the study was to assess the posing effect of obesity on the levels of serum ferritin, total cholesterol, HDL and LDL, triglycerides, HBA1C, CRP, and Uric acid with CBC, on random well-being colleague females. Patient and methods: 100 adult female health workers were categorized into three entities according to both BMI and waist circumference, as normal, overweight, and obese. Results: increased serum ferritin as an inflammatory marker might correlate to BMI, in juniors; and might …

Efficacy Of Native T1 Mapping In Differentiation Between Viable And Non-Viable Myocardium In Chronic Ischemia, Diab Mahmoud S, Gad Azza A.H, Abdel Lattif Reda A, Mahrous Mary R

Journal of Medicine in Scientific Research

Background Myocardial ischemia may lead to reversible or irreversible myocardial insult. A precise assessment of myocardial viability (MV) is of clinical relevance to determine the recovery potential of the affected segments. Contrast enhanced cardiac magnetic resonance (CE-CMR) with late gadolinium (Gd) sequences is the gold standard method for MV assessment. Our study tasted the accuracy of segmental native T1 mapping (NT1M) imaging as a non-contrast technique for assessing MV. Methods: Forty-three patients with chronic myocardial ischemia underwent 1.5 T CMR. Imaging protocol includes cine images to assess left ventricular (LV) function, and (LGE) images to detect and estimate the extension …

Considerations In The Management Of Juvenile Absence Epilepsy In Pregnancy And In Females Of Childbearing Age, Casey Brew

Capstone Showcase

JAE is an epilepsy syndrome that typically requires lifelong AED treatment, and valproic acid or lamotrigine is considered first line to manage the spectrum of associated seizures. In females with JAE who become pregnant, there exist risks both from having uncontrolled seizures and from taking AEDs during the pregnancy. Valproic acid carries the highest risks to the fetus but is the most effective in controlling the seizure types seen with JAE. Folic acid supplementation has shown to mitigate some but not all of the fetal risks from valproic acid. Limited guidance from professional organizations exists for management of females of …

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …

Non-Pharmaceutical Symptom Management In Patients With Pcos, Allison Stern

Capstone Showcase

Polycystic Ovarian Syndrome (PCOS) is a relatively common diagnosis among biological females. There are many variations of presentations among patients with PCOS that require an individualized and tailored treatment plan for symptom management. Although there are pharmaceutical medications that can be used for PCOS symptoms, some patients’ symptoms might not be fully managed, or they might prefer to focus on non-pharmaceutical options for their symptoms instead. Therefore, it is important for clinicians to be familiar with alternatives to the mainstay of pharmaceutical treatment.

Acute Otitis Media: Management And Recurrence In The Pediatric Population, Sydney Klaiman

Capstone Showcase

Acute otitis media (AOM) is one the the most common condition that affects the pediatric population. AOM place burden on affected children, caregivers, the healthcare system, and also contributes to antibiotic resistance. In many cases, AOM is not just a one-time occurrence and is the most common reason that kids receive oral antibiotics and undergo surgery. Relative to the number of articles available, there is a large gap in the research that does not thoroughly address recurrent AOM (rAOM) and the importance of its management and prevention. Therefore, the goal of this poster is to discuss different modalities used to …

Inpatient Management Of An Intravenous Drug User With Tetanus, Nina Paris

Capstone Showcase

Tetanus is rare in the United States now due to the tetanus vaccine but there is still the potential too see patients with tetanus. IV drug users, neonates, and geriatric populations are at an increased risk of developing tetanus. Tetanus is caused by Clostridium tetani, a spore forming and exotoxin releasing anaerobic bacteria. The symptoms of tetanus are caused by the exotoxin tetanospasmin which inhibits the release of inhibitory neurotransmitters, leading to sustained neuronal stimulation. The classic symptoms of tetanus are lockjaw (trismus), neck stiffness, back arching, and fever. Patients can be febrile, tachycardic, tachypneic, and hypertensive on exam. …

Managing Neonatal Pain: A Guideline For Non-Neonatal Providers, Kelly Stanton

Capstone Showcase

Neonatal pain, especially in settings outside of the NICU or newborn nursery, is often under-recognized or even unnoticed altogether. Many providers and parents do not know how to recognize when a neonate is in pain and many do not know how to minimize or alleviate this pain effectively. Even when providers know how to assess pain in neonates, they typically assess for acute pain in the presence of chronic pain, or vice-versa. Untreated pain in neonates harms brain development and can lead to behavior defects later in life for these babies. Due to these outcomes, the recognition and effective treatment …

Diagnosis And Management Of Cyclic Vomiting Syndrome, Sara Read

Capstone Showcase

Cyclic vomiting syndrome (CVS) is a chronic and debilitating condition that can be encountered in a multitude of clinical settings. It is classified as a functional gastrointestinal disorder and is often misdiagnosed. Proper identification and management of this condition are crucial to patient care and quality of life. This article reviews the hypothesized etiologies, clinical presentation, and diagnosis of CVS as well as recommendations for management in a variety of settings. As an understudied and underdiagnosed condition, it is important that clinicians have a basic understanding of this disorder.

Choosing The Route Of Delivery: A Discussion Of Vaginal And Cesarean Births, Camille Green

Capstone Showcase

The percentage of cesarean deliveries in the United States has increased to a rate of 32.1%, double what the World Health Organization recommends as an ideal rate for maternal and fetal benefits. The majority of cesarean sections are performed on women who have never had the procedure before and this increases the risk for subsequent cesarean deliveries. Half of the indications for primary cesarean delivery were found to be non-reassuring fetal heart tracings and arrest of labor, both of which are subject to obstetric provider judgment and comfort level. Among these there is also an increasing incidence of elective primary …

Cme: Vitamins, Antidepressants, And The Placebo Effect - How To Help Your Patients, Nicko Inocencio

Capstone Showcase

Depression affects roughly 280 million people globally. The disease puts patients at increased risk for stroke, cardiovascular disease, hypertension, and diabetes. The psychosocial causes of depression are well-known, but the biochemical causes are multifactorial. Theories range from homocysteine excess, calcium modulation at the neuron, inflammation, cortisol elevation, and disruption of the HPA axis. At the center, however, is serotonin, norepinephrine, and dopamine. Pharmacologic treatment directly aims at modulation of serotonin, norepinephrine, and dopamine. First-line treatment is a combination of SSRIs/SNRIs with cognitive behavioral therapy. If patients do not see improvement with the above therapy other agents such as bupropion, mirtazapine, …