Medical Specialties Commons^™

The Impact Of Recipient And Donor Characteristics On Kidney Transplant Graft Survival, Ashraf Donia, Azza A. I. Elmenyawia, Tarek T. Ahmed

Journal of Medicine in Scientific Research

Introduction Many factors determine the outcomes of renal transplant, including characteristics of both donors and recipients. Antihuman leukocyte antigen donor-specific antibodies are strongly linked to antibody-mediated rejection and late allograft loss. Aim The aim was to determine the effect of recipient and donor characteristics on kidney transplant graft survival, with special stress on panel-reactive antibodies. Participants and methods This study included 168 adult recipient and donor couples. The authors analyzed data of kidney transplants performed between the years of 2008 and 2018 at National Institute of Urology and Nephrology. Results The authors found a significant increase in renal failure in …

Importance Of Pgc-1Α Gene Expression In Egyptian Hemodialysis Patients, Ashraf Donia, Azza A. I. Elmenyawi

Journal of Medicine in Scientific Research

Introduction The peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) is an upstream transcriptional regulator of mitochondrial biogenesis and function. Its function is immediate elimination of reactive oxygen species to get rid of their cellular destruction sequelae. Decreased PGC-1α count and less mitochondrial function take part in renal failure. COX6C gene encodes mitochondrial oxidative phosphorylation proteins. Reaction of excessive reactive oxygen species with linolenic acid results in malondialdehyde (MDA) as a breakdown product. It is an important marker for evaluating oxidative damage. Patients and methods A total of 58 hemodialysis (HD) patients in the National Institute of Urology and Nephrology and 20 …

Comparing The Effect Of Volume Preload Versus Ephedrine Infusion For The Prevention Of Hypotension Due To Spinal Anesthesia For Lower Abdominal And Lower Limb Vascular Surgery, Ashraf A. H. Mahmoud Soliman

Journal of Medicine in Scientific Research

Objective To evaluate the efficacy of ephedrine infusion without preblock crystalloid administration in reducing the incidence of hypotension during spinal anesthesia. Patients and methods Fifty patients presented for lower abdominal and lower limb surgery under spinal anesthesia who were divided into equal groups (group F and group E), each group had 25 patients each. Results As regards demographic data there was no statistical significance between both groups. As regards blood pressure there is statistical significance between both groups except at 4 and 22 min postspinal; regarding heart rate there was no statistical significance between both groups; and regarding the incidence …

The Use Of Ultrasound Indices To Evaluate Volume Status And Fluid Responsiveness In Patients With Septic Shock, Ashraf A. H. Mahmoud, Wael A. E. El Hakeem

Journal of Medicine in Scientific Research

Objective The purpose of this study is to assess the use of ultrasound indices to evaluate volume status and fluid responsiveness in patients with septic shock. Patients and methods A total of 40 successive patients aged above 40 years, with septic shock on admission to the ICU, were enrolled in the study, comprising 26 fluid responders and 14 fluid nonresponders. Results Regarding demographic data and other patient characteristics, no statistically significant difference between both the study groups was seen. Regard baseline hemodynamics data, there was no statistically significant difference between both groups. but after fluid bolus, there was a statistically …

Initial Experience Of Thoracoscopic Video-Assisted Minimally Invasive Mitral Valve Surgery At National Heart Institute, Ahmed M. E. Abdelgawad, Ahmed Zayed, Tamer Elbanna

Journal of Medicine in Scientific Research

Background Advancements in instruments and thoracoscopes and the evolution of cannulation techniques and cannulae types for cardiopulmonary bypass as well as cardiopulmonary bypass machines during the past decade have encouraged many surgeons to adopt minimally invasive mitral valve surgery (MIMVS). Today, MIMVS has become the standard approach for many surgeons and institutions. Patients and methods This is a nonrandomized prospective study in which 150 patients of mitral valve pathology scheduled for mitral valve surgery over a period of 3 years from March 2014 to May 2017 at National Heart Institute were allocated to two groups after fulfilling the inclusion criteria. …

Invasive Versus Noninvasive Assessment Of Functional Significance Of Intermediate Coronary Artery Lesions, Ahmed Zayed

Journal of Medicine in Scientific Research

Background Myocardial perfusion imaging (MPI) is noninvasive test used for evaluation of functional significance of borderline coronary artery lesions. Moreover, instantaneous wave-free ratio (IFR) is a well-validated invasive method used for the same purpose. Objectives To compare the results of MPI and IFR in detection of ischemia in patients with single intermediate coronary artery lesion. Patients and methods A total of 60 patients with single intermediate coronary artery stenosis, visually judged as angiographic stenosis more than or equal to 50% and less than 70% during coronary angiography, were included. After coronary angiography, all patients were subjected to MPI and IFR …

Peribulbar Injection Of Triamcinolone Acetonide As An Outpatient Clinic Procedure In The Management Of Mild To Moderate Macular Edema, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Background Diabetic retinopathy is a microvascular complication of diabetes mellitus and is the most common and most blinding ophthalmic complication. Diabetic macular edema (DME) is an essential manifestation of diabetic retinopathy that occurs across all its severity levels. Several intraocular treatment modalities for diabetic eye disease exist, including per-bulbar steroid injections. This study was conducted aiming to study the clinical effect and central macular thickness decrease following an outpatient clinic simple procedure of peribulbar injection of prepared triamcinolone acetonide (TAA) as a single procedure. Patients and methods This study was performed on 100 eligible eyes in 70 consecutive patients. The …

Intravitreal Injection Of Ranibizumab (Lucentis) Versus Pan-Retinal Photocoagulation As A Preoperative Adjuvant Before Vitrectomy In Management Of Proliferative Diabetic Retinopathy, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Background Diabetic retinopathy is a microvascular complication of diabetes mellitus, and it is the most common ophthalmic complication. Pan-retinal photocoagulation (PRP) has been the standard treatment for proliferative diabetic retinopathy (PDR) and can be used as an adjuvant before vitrectomy but has adverse effects. The use of intravitreal ranibizumab has been suggested as an alternative treatment or an alternative adjuvant before vitrectomy. Aim This study was conducted to study the effect of intravitreal injection of ranibizumab 10 mg/ml (Lucentis) versus PRP as an adjuvant before vitrectomy in the management of PDR. Patients and methods This study was performed on 40 …

Relaxing Retinotomies And Retinectomies In Case Of Proliferative Diabetic Vitreoretinopathies And Tractional Retinal Detachment, Alaa Atteya, Hussam E. O. Elrashidy, Maged Adly

Journal of Medicine in Scientific Research

Introduction Radical anterior vitreous base dissection and lensectomy in combination with inferior 180° retinectomy will improve the anatomic success of complex proliferative diabetic vitreoretinopathies (PVR)-related retinal detachment. Our study aims to describe the anatomical and functional results of pars plana vitrectomy with retinotomies and relaxing retinectomies in patients with tractional retinal detachment in advanced PVR. Patients and methods A case series study was conducted on 28 eyes of patients with tractional retinal detachment with severe PVR. Preoperative and postoperative complications and final visual outcomes were recorded. The follow-up period was 12 months. Results Full reattachment rate was reached intraoperatively in …

Effect Of Repeated Peribulbar Triamcinolone Injection On Corneal Topography In Patients With Thyroid Eye Disease, Hussam E. O. Elrashidy, Laila A. Abulnasr, Nehal O. Elfarouk

Journal of Medicine in Scientific Research

Introduction Studies have shown that repeated peribulbar triamcinolone injections reduce the inflammatory signs of moderate to severe thyroid eye disease (TED). Other studies found that TED was associated with greater with-the-rule corneal astigmatism owing to fibrosis of the soft tissue in the superolateral orbital region. This study aimed to detect the effect of repeated peribulbar triamcinolone injections in patients with moderate to severe TED on corneal topography and astigmatism. Patients and methods A prospective, controlled, and randomized study was conducted that included 30 eyes with moderate to severe TED who underwent repeated peribulbar triamcinolone injections in addition to pretreatment and …

Evaluation Of Posterior Decompressive Lumbar Surgery For Multilevel Lumbar Spinal Canal Stenosis With And Without Fusion, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background There is no consensus regarding the best treatment of patients with multilevel lumbar stenosis. Surgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. Aim and objective The aim was to study and evaluate the outcome of surgery for degenerative lumbar canal stenosis (LCS) on a clinical, radiological, and functional basis and to identify whether spinal decompression with fusion has a better effect than decompression alone for patients with degenerative lumbar spinal stenosis or not. Patients and methods …

Tibial Angioplasty In Diabetics, Ihab N. A. Hanna

Journal of Medicine in Scientific Research

Background Diabetics are pron e to develop serious complications such as nephropathy, retinal detachment, and others, and among such complications lies the devastating serious complication of diabetic foot, whether ulceration or diabetic foot infections up till gangrene. This could be attributed to either one or all of the following etiological factors: peripheral vascular disease, peripheral neuropathy, and/or infection owing to impaired immunity. Patients and methods We enrolled 88 diabetic ischemic patients with tibial artery disease confirmed by Duplex. Their mean age was 67 years (54 males and 34 females). Patients were subjected to ipsilateral antegrade transluminal or subintimal tibial angioplasty. …

Great Saphenous Vein Diameter At Different Regions And Its Relation To Reflux, Kareem Hady, Said I. El Mallah, Yahia M. Al-Khateep

Journal of Medicine in Scientific Research

Background Great saphenous vein (GSV) incompetence is involved in most cases of varicose disease. Standard preinterventional assessment is required to decide the treatment modalities. GSV diameter was measured at saphenofemoral junction, proximal thigh, distal thigh, knee, proximal leg, and distal leg. Analysis was done to find at which diameter size the reflux is expected to occur. Patient and methods The study involved 100 limbs from outpatient vascular clinic. GSV diameter was measured at the saphenofemoral junction, the proximal thigh, the distal thigh, below the knee, and mid-leg and correlated with reflux. Results Reflux in the sapheno-femoral junction (SFJ) (group I) …

Predictors Of Mortality In The Neonatal Intensive Care Unit Of El-Galaa Teaching Hospital, Michael W. G. Hany

Journal of Medicine in Scientific Research

Aim Neonatal mortality accounts for most infant mortality. Various factors influence the risk of neonatal mortality. Available estimates of survival and mortality in neonatal intensive care units (NICUs) are needed to provide antenatal counseling and guide management decisions. This study aimed to determine the predictors of admitted neonatal mortality. Patients and methods A retrospective study was done between June 2016 and May 2018 in the NICU of El-Galaa Teaching Hospital to determine the predictors of admitted neonatal mortality. Data were collected as follows: premature rupture of membranes, mode of delivery, multiple or single pregnancy, sex, weight, gestational age (GA), Apgar …

Continuous Chain Of Exporting Wuhan Novel Coronavirus Infection: A Comparison Of Primary And Secondary Step Rates, Rujittika Mungmungpuntipantip, Viroj Wiwanitkit

Journal of Medicine in Scientific Research

No abstract provided.

Redo-Mitral Valve Replacement And Predictors Of Operative Mortality: A Single-Institute Experience, Ahmed M. E. Abdelgawad, Ahmed Abdelaziz

Journal of Medicine in Scientific Research

Background In spite of improved survival of first-time mitral valve replacement (MVR), operative mortality associated with redo-mitral valve surgery is still higher than that of the primary operation. Consequently, more patients require redo-MVR, and studies investigating the operative outcome with current techniques and prostheses are thus needed. Patients and methods This is a nonrandomized prospective study that included 83 patients who underwent redo-MVR with either bioprosthetic or mechanical valves between March 2014 and December 2017 at National Heart Institute. Recorded data were analyzed using the statistical package for social sciences, version 23.0 (IBM SPSS). All preoperative and operative data were …

Dietary Intake Of A Sample Of Stunted Egyptian Preschool Children, Amina S. Soliman, Hoda A. Abdel Salam, Saher A. Khairy, Salwa M. Saleh

Journal of Medicine in Scientific Research

Background Growth retardation is highly prevalent among children. Infections and inadequate food intake are well-established causes of growth retardation. Nutrition plays a key role in the control of linear growth. Objective The aim was to assess dietary intake of stunted Egyptian preschool children. Participants and methods The study was designed as a case–control study that included 100 Egyptian children aged 2 to less than 6 years old with delayed linear growth, proportionate stunting, who were randomly selected from the stunted outpatient clinic of National Nutrition Institute. Their results were compared with age-matching and sex-matching controls. All participants were subjected to …

Assessment Of The Nutritional Status Of Malnourished School-Age Egyptian Children, Hoda A. Abed-El Salam, Sally R. Eid, Salwa M. Saleh

Journal of Medicine in Scientific Research

Background The nutritional status of school-age children is a primary determinant of children's health, as it influences their physical and mental development. The aim of this study was to assess the nutritional status and dietary intake of macronutrients and micronutrients in a sample of malnourished school-age children (5–12 years) in Egypt. Patients and methods This was a cross-sectional study that included school-age children (5–12 years) recruited from the outpatient clinic of the National Nutrition Institute, Cairo, Egypt. Participants sampling was performed during the period from June to August 2019. In this study, 85 children of both sexes were enr?olled. Results …

Comparison Of Aims65, Glasgow-Blatchford, And Pre-Endoscopy Rockall Scoring Systems For Risk Stratification In Egyptian Patients With Upper Gastrointestinal Bleeding, El Saied E. Shabaan, Tarek A. Fouad

Journal of Medicine in Scientific Research

Background Upper gastrointestinal bleeding (UGIB) is a serious medical emergency. Many scoring systems have been developed to predict bleeding outcomes for patients with UGIB. Recently, the guidelines recommend use of risk scores in UGIB to facilitate accurate triage and assist in clinical decisions. The aim of this study was to compare the AIMS65 with the Glasgow–Blatchford score (GBS) and the pre-endoscopy Rockall score (PRS) for risk stratification among Egyptian patients with UGIB. Patients and methods This prospective study involved 74 adult patients with UGIB. Clinical data, biochemical data, transfusion requirements, endoscopic interventions, and duration of hospitalization were collected. AIMS65, GBS, …

Comparison Between Short And Long Letrozole Therapy For Ovulation Induction In Clomiphene.Resistant Women With Polycystic Ovarian Syndrome, Mohamed A. El-Naggar

Journal of Medicine in Scientific Research

Objective

The aim of this study is to compare the effect of the short and long letrozole therapy for ovulation induction in clomiphene‑resistant women with polycystic ovary syndrome. Design

This was a prospective study. Patients and methods

Sixty infertile women were selected from the patients attending the outpatient clinic of Benha Teaching Hospital. All patients were diagnosed as having anovulation due to polycystic ovary syndrome. Intervention

Patients were randomly allocated to treatment with either long letrozole therapy (\[n=30;\] three cycles) or short letrozole therapy (\[n=30;\] three cycles). Main outcome measure

Number of growing, mature follicles and the occurrence of pregnancy. …

Radiofrequency Endogenous Ablation And Concomitant Sclerotherapy, Ihab N. A. Hanna, Khaled Elkafas

Journal of Medicine in Scientific Research

Background Varicose veins are a widespread disease with various treatment modalities ranging from classic saphenofemoral crossectomy and ligation and stripping to various minimally invasive interventional procedures. The era of endovenous interventions has now stabilized head to head in results with surgical procedures, hence the shift to minimally invasive procedures. All minimal invasive endovenous procedures have excellent results, particularly when correctly selected according to the varicose vein case and the treated vein. Thermal ablation techniques are now established and have reliable and satisfactory outcomes, yet nonthermal techniques have offered further options. This article provides a novel approach combining the usage of …

Right Anterolateral Thoracotomy As An Alternative Approach To Resternotomy For High-Risk Cardiac Surgery Patients, Maged M. A. Kisho

Journal of Medicine in Scientific Research

Introduction Redocardiac valve surgery through median sternotomy is associated with a potential increased risk of morbidity and mortality. The study was done at the National Heart Institute of Egypt from June 2016 to June 2018 to evaluate the right anterolateral thoracotomy for high-risk patients undergoing mitral and tricuspid valve redo procedures. Patients and methods This study includes 26 patients operated through right anterolateral thoracotomy which include high-risk group on the basis of the proximity of sternum to the right ventricle or great vessels, mainly ascending aorta. Moreover, the presence and location of patent grafts were assessed. Results In right submammary …

Successful Surgical Management Of Intracerebral Hydatid Cyst In Children: Timing, Procedure, And Adjuvant Treatment, Sameh M. Saleh

Journal of Medicine in Scientific Research

Background Cerebral hydatid cysts are very rare, and surgery, with its inherent risk of rupture and spillage of cyst contents, has been the traditional treatment. The goal of surgery is to remove the cysts without rupture. Aim The aim of this review was to investigate the surgical technique of removing cerebral hydatid cysts in children, to show the possible pitfalls of surgery and to assess the effect of adjuvant preoperative and postoperative medical treatment. Patients and methods This retrospective analysis included four patients who underwent surgery for an intracranial hydatid cyst at the Department of Neurosurgery, Matarya Teaching Hospital. The …

Complications Of Decompressive Lumbar Spine Procedures Without Instrumentations – An Institutional Experience, Ayman Wageh, Ihap Bedier, Mohamed Mousa, Ramadan Shamseldein

Journal of Medicine in Scientific Research

Background Till now, there is insufficient documentation of operative complications in spine surgery, and the expected results are far less predictable if the actual indication for surgical intervention is not clear. Complication could be defined as 'a condition that directly or indirectly results from surgical intervention and disrupts the planned outcome of the surgery.' So, spine surgeons should be aware of these events and know how to deal with them. Aim To detect the number and percentage of moderate and/or major operation-related complications associated with the relatively repeated and popularized neurosurgical procedures performed at the Neurosurgical Department, Shebin Elkom Teaching …

Study Of Motor And Sensory Nerve Conduction Of Wrist Palm And Palm-Finger Segments Of Median Nerve And Studying Their Contribution In Diagnosis Of Carpal Tunnel Syndrome, Abeer H. Ismaiel

Journal of Medicine in Scientific Research

Objectives Our objective is to report a modified and simplified technique of sensory and motor segmental conduction studies to improve diagnostic sensitivity, especially in cases with mild carpal tunnel syndrome (CTS). Patients and methods Patients with suspected CTS referred to our electrophysiology laboratory and a control group were included. The data were collected prospectively. The following measurements made: median sensory conduction velocity wrist digit 1(W-1), median sensory conduction velocity wrist digit 3 (W-3), median wrist palm sensory conduction velocity (W-Ps), distoproximal ratio of velocity (D/P), median distal motor latency wrist (MDML) -APB (Abductor pollicis brevis), and median wrist -palm segment …

Novel Technique Of Vein Harvesting For Reversed Saphenous Vein Bypass Graft, Ihab N. A. Hanna

Journal of Medicine in Scientific Research

Background The technique of harvesting the great saphenous vein for bypass procedures may affect the results of the procedure. We describe a simple modification of the vein harvesting technique, which consists of leaving the saphenofemoral junction intact after completion of the proximal anastomosis. This modification allows blood to flow into the vein as soon as the proximal anastomosis is completed, thereby shortening the vein warm ischemia time and allowing the vein to distend with blood rather than saline, under physiologic pressure. This modification aims at improved vein integrity during harvesting and therefore improved graft patency. Patients and methods In this …

Tracheostomy In Covid-19-Infected Patients, Mohammad M. Gaballah, Wael M. H Eldin Eldrandaly

Journal of Medicine in Scientific Research

Purpose To evaluate the modifications in the indications and technique of tracheostomy for prolonged-intubated COVID-19-infected patients. Methodology Commissioned by the Ministry of Health in Egypt, different guidelines for tracheostomy for COVID-19 patients were revised. A guideline was adopted and modified to meet the equipment provided by facilities assigned to contain the current pandemic. The understanding of staff and the applicability of the new guidelines were evaluated using a mini-summative quiz answered by 117 tracheostomy team members in facilities around Grand Cairo, Egypt. Results The percentages of consistent answers for questions 1–6 were 94, 90.60, 89.70, 95.70, 61.50, and 93.20%, respectively. …

Effect Of Thyme (Thymus Vulgaris L.) Essential Oil On The Quality Parameters Of Stirred Yoghurt, Emad A. H. Guirguis, Mary G. B. Meleka

Journal of Medicine in Scientific Research

Aim Stirred yoghurt was supplemented with thyme essential oil in an attempt to enhance its quality. Materials and methods Thyme (Thymus vulgaris L.) essential oil concentrations (0, 2, 4, 6, 8, and 10 μl/ml) were added to the prepared stirred yoghurt and then examined for microbiological count and mycotoxin quality during storage intervals following the Egyptian standards. Results Samples contained ≥ 6 μl/ml oil showed significant increase (p<0.05) of total viable bacterial count and lactic acid bacteria, whereas mold and yeast count was decreased. Pathogenic bacteria including Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes, Salmonella spp., Escherichia coli, and coliform group were not detected in any of the samples, which complied with the standards. Moreover, …

Profile Of Patients Visiting The Pediatric Emergency Service In El-Behera Hospitals, Hamouda E. El Gazzar, Kareem A.E Awad, Mahmoud T. Elmougi, Mohamed F. Alsoda, Tahseen S.M Yousef

Journal of Medicine in Scientific Research

Background The emergency department (ED) is an essential component of the medical service offered in any hospital. However, the published information about patients' profile and utilization of emergency services in both developing and developed countries is scarce. Visits caused by nonserious diseases remain a burden on the ED, preventing efficient and effective use of health services and compromising quality. Aim This study aimed to characterize the profile of patients visiting the emergency service in El-Behera Hospitals (Damanhour Teaching Hospital, Central Abohommos Hospital, and General Kafr Eldawar Hospital), describing the epidemiology of patient presentations and outcome in the ED. Patients and …

Trabeculectomy Outcomes For Patients With Advanced Glaucoma, Ahmed S. Dewedar, Hanan M. Elghonemy, Mettias Nader, Nagla H. Shaban

Journal of Medicine in Scientific Research

Context Safety and cost-effectiveness of trabeculectomy in advanced glaucoma is essential. Aim The aim was to evaluate the visual outcome and visual field (VF) changes in patients with advanced glaucoma who underwent trabeculectomy. Settings and design The study was done on 36 eyes clinically diagnosed with advanced primary open-angle glaucoma (POAG) who were uncontrolled on medical treatment and had cup-to-disc ratio (CDR) of more than 0.85 along with severe glaucomatous VF defects. The visual outcome changes were evaluated after 1 week, 1 month, and 3 months following trabeculectomy, whereas VF changes were evaluated at 3 months after trabeculectomy. Participants and …