# Internationally Published Papers 2015

Authors:
Hijioka, S.aEmail Author,  Hosoda, W.b,  Mizuno, N.a,  Hara, K.a,  Imaoka, H.a,  Bhatia, V.c,  Mekky, M.A.d,  Tajika, M.e,  Tanaka, T.e,  Ishihara, M.e,  Yogi, T.a,  Tsutumi, H.a,  Fujiyoshi, T.a,  Sato, T.a,  Hieda, N.a,  Yoshida, T.a,  Okuno, N.a,  Shimizu, Y.f,  Yatabe, Y.b,  Niwa, Y.e,  Yamao, K.a

Date of Publishing:
Volume 50, Issue 5, 1 May 2015, Pages 564-572

Title:
Does the Who 2010 Classification of Pancreatic Neuroendocrine Neoplasms ‎Accurately Characterize Pancreatic Neuroendocrine Carcinomas?‎

Abstract:
Background: The WHO classified pancreatic neuroendocrine neoplasms in 2010 as G1, G2, and neuroendocrine carcinoma (NEC), according to the Ki67 labeling index (LI). However, the clinical behavior of NEC is still not fully studied. We aimed to clarify the clinicopathological and molecular characteristics of NECs.Methods: We retrospectively evaluated the clinicopathological characteristics, KRAS mutation status, treatment response, and the overall survival of eleven pNEC patients diagnosed between 2001 and 2014 according to the WHO 2010. We subclassified WHO-NECs into well-differentiated NEC (WDNEC) and poorly differentiated NEC (PDNEC). The latter was further subdivided into large-cell and small-cell subtypes.Results: The median Ki67 LI was 69.1 % (range 40–95 %). Eleven WHO-NECs were subclassified into 4 WDNECs and 7 PDNECs. The latter was further separated into 3 large-cell and 4 small-cell subtypes. Comparisons of WDNEC vs. PDNEC revealed the following traits: hypervascularity on CT, 50 % (2/4) vs. 0 % (0/7) (P = 0.109); median Ki67 LI, 46.3 % (40–53 %) vs. 85 % (54–95 %) (P = 0.001); Rb immunopositivity, 100 % (4/4) vs. 14 % (1/7) (P = 0.015); KRAS mutations, 0 % (0/4) vs. 86 % (6/7) (P = 0.015); response rates to platinum-based chemotherapy, 0 % (0/2) vs. 100 % (4/4) (P = 0.067), and median survival, 227 vs. 186 days (P = 0.227).Conclusions: The WHO-NEC category may be composed of heterogeneous disease entities, namely WDNEC and PDNEC. These subgroups tended to exhibit differing profiles of Ki67 LI, Rb immunopositivity and KRAS mutation, and distinct response to chemotherapy. Further studies for the reevaluation of the current WHO 2010 classification are warranted. © 2014, Springer Japan.

Author Info:
aDepartment of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan
bDepartment of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
cDepartment of Medical Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
dDepartment of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
eDepartment of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
fDepartment of Surgery, Aichi Cancer Center Hospital, Nagoya, Japan


Date of Publishing:
Volume 38, Issue 4, December 2015, Pages 793-803

Title:
Effect of Long-Term Boron Exposure on the Liver Structure of Adult Male ‎Albino Rats and the Possible Role of Vitamin C‎

Abstract:
Background Boron is an essential trace element for humans, animals, and higher plants. It is largely used in the manufacture of glass, detergents, cosmetics, photographic materials, soaps, and cleaners, and is used in agriculture and leather tanning industries. Humans consume a few milligrams of boron in the form of water, fruits, and vegetables. High doses of boron have been recorded to be developmental and reproductive toxin in animals. Vitamin C is water soluble nonenzymatic antioxidant, and acts to overcome the oxidative stress. Aim The present study aimed to shed light on the effects of long-term boron exposure on the histological structural of the liver in adult male albino rats, and to evaluate the possible protective role of vitamin C against these changes. Materials and methods A total of 30 adult male albino rats were divided into three equal groups: group I, which acted as the control group; group II, in which the rats received drinking water containing 55×10-6 g boron/l for 90 days; and group III, in which the rats were given vitamin C (200 mg/kg body weight) orally concomitant with boron for 90 days. Liver specimens were then processed for light and electron microscopic study. Results Examination of the liver sections of group II revealed foci of dilatation and congestion of the central and veins of portal areas with mononuclear cellular infiltration and hepatocellular vacuolation. There was an increased collagen deposition around the central and portal areas. By electron microscopic-marked electron-lucent areas and degenerated cytoplasm, heterochromatic nuclei and decreased lipid content of Ito cells were noted. In group III, the coadministration of vitamin C improved most of the structural changes of the hepatocytes and Ito cells, and decreased collagen fiber deposition. Conclusion Exposure to boron induced changes on the structure of liver. The coadministration of vitamin C improved most of these structural changes. © 2015 The Egyptian Journal of Histology.

Author Info:
Histology and Cell Biology Department, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Khalaf, M.a,  Tammam, A.E.b,  Ibrahem, I.a,  Habib, D.M.a,  Abdellah, M.S.bEmail Author,  Bahlol, M.a,  Khairy, M.a,  El Saman, A.M.a

Date of Publishing:
Volume 20, Issue 1, 1 March 2015, Pages 54-56

Title:
Effect of Ramadan Fasting on Amniotic Fluid Index in Last Month of ‎Pregnancy‎

Abstract:
Objective To assess the effect of fasting in Ramadan on amniotic fluid index (AFI). Design A cross sectional observational study. Methods This study was conducted between July 21, 2012 and August 17, 2012, which corresponded to the 3rd and 27th days of the month of Ramadan 1433 and from July 12, 2013 and August 6, 2013, which corresponded to the 3rd and 27th days of the month of Ramadan 1434. Pregnant women attending the antenatal care clinic at Assiut and Qena University Hospitals were included in this study. The study groups included fasting and non fasting women beyond 36 weeks of gestation. The study took place at the same time of day (i.e., between 9 and 12 AM). Results A total of 221 pregnant women were studied, 97 fasting and 124 non fasting. As regards age, parity and the gestational age no significant differences were reported. The AFI was less affected by fasting, also there was a significant difference in the AFI between fasting and non fasting pregnant women with oligohydramnios (4.00 ± 0.82 and 2.64 ± 1.12 respectively). A positive relationship with gravidity was observed as AFI increased with the increase of gravidity in pregnant fasting women, on the other hand there was variable non significant relation between AFI and gravidity in pregnant non fasting women. Conclusion We conclude that the fasting in Ramadan has no effect on or may improve the AFI in the last month, while gravidity plays a role in the AFI in fasting group. © 2014 Production and hosting by Elsevier B.V. on behalf of Middle East Fertility Society.

Author Info:
aWoman's Health Center, Assiut University, Egypt
bQena University Hospital, South Valley University, Egypt


Authors:
Khater, A.H.a,  Sobhy, M.H.a,  Said, H.G.bEmail Author,  Kandil, A.c,  Reda, W.d,  Seifeldin, A.F.d,  Moustafa, R.e,  Elassal, M.A.b,  Kamel, E.M.a

Title:
Latarjet Procedure for Anterior Shoulder Instability Due to Tramadol-Induced ‎Seizures‎

Abstract:
Background: Seizures, commonly due to epilepsy, are known to cause shoulder instability. Tramadol addiction has recently been found to induce seizures in patients who exceed the recommended dose. Because of the easy accessibility and low cost of tramadol, an increasingly alarming phenomenon of tramadol abuse has been demonstrated in recent years. Purpose/Hypothesis: The purpose of this multicenter study was to investigate shoulder instability resulting from tramadol-induced seizure (TIS) as well as to recommended management for such shoulder instability. The hypothesis was that TIS leads to anterior shoulder dislocations with major bony defects, which favors bony reconstructive procedures as a suitable method of treatment. Study Design: Case series; Level of evidence, 4. Methods: This prospective case series study was conducted on 73 patients (78 shoulders) who presented with anterior shoulder dislocations and a clear history of tramadol abuse. The mean age of the patients was 26.8 years, and the mean number of dislocations was 14. The mean duration of addiction was 17 months, with a mean dose of 752 mg of tramadol hydrochloride per day. Glenoid and humeral bone loss ranged from 15% to 35% and from 15% to 40%, respectively. The mean follow-up period was 28 months. All patients underwent an open Latarjet procedure. Results: Postoperative mean Rowe score and American Shoulder and Elbow Surgeons score at final follow-up (24 months) improved significantly from 20 to 84 and from 44 to 91, respectively (P <.05). The patient satisfaction rate reached 95%, and the mean period of return to work was 12.8 weeks. Five patients (9%) had postoperative seizures due to relapse of the tramadol abuse, but only 3 patients (5%) had redislocations with nonunion or breakage of the graft or hardware. Conclusion: Tramadol addiction has evolved as an important cause of seizures that can result in shoulder dislocation. Anterior shoulder instability with TIS occurs mainly with higher levels of addiction and results in significant humeral and/or glenoid bone defects. The Latarjet procedure is recommended for these patients, after control of addiction, and provides 95% satisfaction at midterm follow-up. © 2016 The Author(s).

Author Info:
aOrthopaedic Department, Ain Shams University, Cairo, Egypt
bOrthopaedic Department, Assiut University, PO Box 110, Assiut, 71111, Egypt
cOrthopaedic Department, Alexandria University, Alexandria, Egypt
dOrthopaedic Department, Cairo University, Cairo, Egypt
eNeurology Department, Ain Shams University, Cairo, Egypt


Authors:
Khedr, E.M.aEmail Author,  Fawi, G.b,  Abd Abbas, M.A.c,  Mohammed, T.A.c,  El-Fetoh, N.A.a,  Al Attar, G.d,  Zaki, A.F.c

Date of Publishing:
Volume 37, Issue 7, 1 July 2015, Pages 607-618

Title:
Prevalence of Parkinsonism and Parkinson’s Disease in Qena ‎Governorate/Egypt: A Cross-Sectional Community-Based Survey‎

Abstract:
Background and purpose: In a previous study we found a high crude prevalence rate (CPR) for Parkinson’s disease (PD) in Assiut governorate/Egypt. We therefore surveyed a second Nile valley governorate (Qena) to provide confirmatory evidence for the high prevalence rate of PD in Egypt. Subjects and methods: 10 areas in Qena governorate were selected by random sampling to recruit 8027 inhabitants. Positive cases were identified using a modified screening questionnaire, the unified Parkinson disease rating scale (UPDRS), mini-mental state examination (MMSE) and the non-motor symptoms scale (NMSS) for PD. Results: Forty-four patients were identified with Parkinsonism, giving a CPR of 548/105 inhabitants. Among them, 35 patients were diagnosed as PD with CPR of 436/105; three cases were diagnosed as drug-induced Parkinsonism with CPR 37/105; two cases had atherosclerotic Parkinsonism with CPR 25/105.Age-specific CPR of PD among population aged ≥50 years old was 2534/105.The highest age-specific CPR was recorded among subjects ≥75 years old. The CPR showed a tendency to be higher in males than females, urban than rural areas and industrial than non-industrial areas (503 vs 363/105, 474 vs 389/105 and 655 vs 312/105, respectively). There was a significantly higher CPR among illiterate than literate persons (1982 vs 299/105 with P=0.00001). About one quarter of patients had cognitive impairment. All cases had positive symptoms in at least one or more NMS Domains. Conclusion: The overall prevalence of PD disease is high in Nile valley governorates of Upper Egypt compared to other Arabic countries. © W. S. Maney and Son Ltd 2015.

Author Info:
aDepartment of Neuropsychiatry, Assiut University, Egypt
bDepartment of Neuropsychiatry, Sohag University, Egypt
cDepartment of Neuropsychiatry, South Valley University, Qena, Egypt
dDepartment of Public Health and Community Medicine, Assiut University, Egypt


Authors:
Khodry, M.M.a,  Abd-Ellah, A.H.b,  Tammam, A.A.E.a,  Shazly, S.A.M.c,dEmail Author,  Salem, H.T.c

Date of Publishing:
Volume 31, Issue 6, 1 December 2015, Pages 357-361

Title:
Uterine Leiomyomas in Adolescents: A Diagnostic and Treatment Dilemma-a ‎Case Series‎

Abstract:
Background: Despite being the most common pelvic tumor in women during the reproductive age, uterine leiomyoma is a rare pathology in adolescents. However, diagnosis and treatment of this benign tumor is more challenging in younger patients because of being unexpected and associated with fertility-related hazards following surgery. Cases: This case series describes 22 adolescents with uterine leiomyomas and their variable clinical presentations; among these patients, uterine size ranged from 14 weeks and 36 weeks of gestation. One of these patients was eventually diagnosed with leiomyosarcoma. Management of these cases was individualized depending on their presentations and operative indications. The patients underwent appropriate surgical procedures. Results: The postoperative course was smooth in these cases, except for 4 women who had transient fever on the first postoperative day; this was resolved quickly. No recurrences were reported at follow-ups. Hysterosalpingography was conducted in 9 women, and 3 showed abnormalities of dye localization or tubal obstruction. Only 1 patient had infertility as a primary complaint. Conclusions: According to this case series, considerations and precautions should be taken when adolescent patients are surgically treated to minimize the risk of fertility impairment or conversion to hysterectomy, which are both catastrophic in this age group. © 2015 Mary Ann Liebert, Inc.

Author Info:
aDepartment of Obstetrics and Gynecology, Qena University Hospital, South Valley University, Qena, Egypt
bSouth Egypt Cancer Insitute, Assiut University, Assiut, Egypt
cWomen's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
dDivision of Gynecology, Mayo Clinic, 229 6th Avenue SW, Rochester, MN 55902, United States


Authors:
Mahmoud, H.A.aEmail Author,  Atta, H.bEmail Author,  Diab, W.A.aEmail Author,  Eloteify, L.M.aEmail Author,  Imam, H.cEmail Author,  Gabr, A.dEmail Author,  Mekkawy, M.A.aEmail Author,  Omar, W.M.eEmail Author

Date of Publishing:
Volume 46, Issue 4, 1 December 2015, Pages 1313-1322

Title:
The Predominant Role of 18f-Fdg Pet/Ct over Mdct in Assessment of Ovarian ‎Cancer Patients‎

Abstract:
Objectives: This article discusses that FDG PET/CT is superior to MDCT in evaluation of ovarian cancer oncological evaluation. Patients and methods: 87 PET/CT scans of 64 women with clinically suspected or pathologically proven ovarian cancer were retrospectively analyzed. The findings of contrast enhanced MDCT (CE-CT) were interpreted by two experienced radiologists unaware of PET/CT findings. At least two experienced nuclear medicine physicians who were unaware of CE-MDCT findings examined PET images, evaluating localization and characterization and comparing them to co-registered PET/CT images. Diagnostic accuracy was determined on a patient level and a region level. Results: PET has significantly higher Sensitivity, specificity, PPV, NPV, and overall accuracy of 94.7%, 86.7%, 93.1%, 89.7%, and 91.9% respectively compared to 89.5%, 30%, 70.8%, 60% and 68.9% for MDCT on patient level. The diagnostic performance of PET was also better at most anatomical sites when results were analyzed on region level. © 2015 The Authors.

Author Info:
aDepartment of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Egypt
bDepartment of Radiology/Oncoradiology, South Egypt Cancer Institute (SECI), Assiut University, Assiut, 71526, Egypt
cDepartment of Radiology, Assiut University Hospital, Egypt
dDepartment of Medical Oncology, South Egypt Cancer Institute, Assiut University, Egypt
eDepartment of Nuclear Medicine, National Cancer Institute, Cairo University, Egypt


Authors:
Megally, H.I.aEmail Author,  Elmalah, H.E.M.a,  Seifeldein, G.S.a,  Abbas, N.A.a,  Elamin, H.A.b

Date of Publishing:
Volume 46, Issue 1, 1 March 2015, Pages 1-8

Title:
The Diagnostic Role of MDCT Enterography in Small Bowel Lesions‎

Abstract:
Purpose To evaluate the role of MDCT enterography in the diagnosis of small bowel diseases. Patient and methods Thirty nine patients suspected to have small bowel diseases were examined with 64 MDCT enterography. Result MDCT enterography easily diagnosed small intestinal diseases which confirmed with histopathological results, operative data and follow up. Conclusions MDCT can be used as a front-line imaging and one stop imaging modality for the detection of small bowel diseases. However, biopsy is still the confirmatory diagnostic method. © 2014 The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V. All rights reserved.

Author Info:
aDepartment of Radiodiagnosis, Assiut University Hospital, Assiut, Egypt
bDepartment of Internal Medicine, Assiut University Hospital, Assiut, Egypt


Authors:
Moeen, A.M.Email Author  View Correspondence (jump link)

Date of Publishing:
Volume 21, Issue 4, 1 December 2015, Pages 214-216

Title:
Recurrence of Isolated Transitional Cell Carcinoma in an Orthotopic Ileal ‎Neobladder: A Case Report‎

Abstract:
Recurrent tumors inside an orthotopic ileal neobladder are rare, and only few cases have been reported in the literature. Herein, we report a case of recurrent transitional cell carcinoma in an orthotopic ileal neobladder discovered one and a half years after the operation. © 2015 Pan African Urological Surgeons' Association.

Author Info:
Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt


Authors:
Mohamad, A.E.-R.E.-S.a,d,  Essa, T.M.b,dEmail Author,  Ata, H.S.c,e

Date of Publishing:
Volume 9, Issue 3, December 2015, Pages 117-127

Title:
Nigella Sativaprotects against Formaldehydeinduced Neurotoxicity in the Rat ‎Frontal Cortex‎

Abstract:
Objectives:Nigella sativa(NS) is well known for its strong antioxidant properties. The aim of this study was to investigate the potential protective effect of NS, as a potent antioxidant and free radical scavenger, on the rat frontal cortex following formaldehyde (FA)-induced neuronal injury and oxidative stress. Methods: Forty albino rats were divided into four groups (n=10, each): control group received 1 ml distilled water, NS treated group crushed seeds of NS at a single daily dose of 180 mg/kg/bw orally for two weeks, FA-treated group 10 mg/kg/bw FA i.p. daily for two weeks, and FA and NS treated group received 10 mg/kg/bw FA i.p. followed by a single dose of NS (180 mg/kg/bw) orally for 2 weeks. The animals then were sacrificed and the frontal lobes were excised. Frontal cortex was stained with hematoxylen-eosin and caspase-3 immunohistochemistry to identify cell morphology and apoptosis. Lipid peroxide, nitric oxide, superoxide dismutase and glutathione levels were measured. Results: Histological examination revealed severe neurodegenerative changes in frontal cortex neurons in the FA-treated group as observed with hematoxylen-eosin and caspase-3 immunohistochemistry. However, these changes were partly prevented in the FA and NS-treated group. Apoptotic cell index in the frontal cortex decreased significantly in FA and NS treated rats compared to FA-treated rats. In the FA-treated group, lipid peroxide levels increased, while nitric oxide and glutathione levels decreased significantly compared with controls. In the FA + NS treated group, nitric oxide, glutathione and superoxide dismutase levels increased and lipid peroxide level decreased significantly when compared with the FA-treated group. Conclusion:NS administration protects frontal cortex neurons against oxidative damage induced by FA. © 2015 Turkish Society of Anatomy and Clinical Anatomy (TSACA).

Author Info:
aDepartment of Anatomy and Embryology, Cairo University, Cairo, Egypt
bDepartment of Anatomy and Embryology, Alexandria University, Alexandria, Egypt
cDepartment of Pathology, Assiut University, Assiut, Egypt
dDepartment of Anatomy and Embryology, Qassim University, Qassim, Saudi Arabia
eDepartment of Pathology, College of Medicine, Qassim University, Qassim, Saudi Arabia


Authors:
Mohamed, E.S.aEmail Author,  Ahmed, M.A.R.bEmail Author,  Said, E.A.F.aEmail Author

Journal:
Egyptian Journal of Ear, Nose, Throat and Allied Sciences

Date of Publishing:
Volume 16, Issue 2, 1 July 2015, Pages 139-144

Title:
Role of Cervical Vestibular-Evoked Myogenic Potentials Testing in Vestibular ‎Migraine‎

Abstract:
Background: Vestibular dysfunction has been long described in patients with migraine; this relation has been addressed as vestibular migraine. The pathophysiology as well as the peripheral or central localization of this deficit is unclear. Cervical vestibular evoked myogenic potential (cVEMP) is a validated method to test saccular function and vestibulocollic pathway. Objectives: The current work was designed to assess the characteristics of cVEMP response in patients with vestibular migraine and compare them with the results of healthy controls, and to find out if the cVEMP could be useful as a complementary tool for testing vestibular function in vestibular migraine. Methods: Twenty five patients with definite vestibular migraine were involved as a study group. Twenty healthy volunteers of comparable age and sex were taken as a control group. The amplitude and latency of cVEMP were measured. Electronystagmography (ENG) test battery including caloric testing was done. Results: Our study demonstrated significant reduction in cVEMP amplitudes, and more frequently absent response in patients with vestibular migraine compared to healthy controls. There was no correlation between cVEMP amplitudes and caloric testing. ENG tests showed peripheral vestibular lesion in 36% of patients, central lesion in 16%, mixed lesion in 4%. Conclusion: cVEMP is a useful complementary tool for testing vestibular function in vestibular migraine. Reduced cVEMP amplitude or absent response were the most frequent features in vestibular migraine. The saccule and or the sacculo-collic pathway are affected in vestibular migraine, with more tendencies for peripheral vestibular dysfunction in our patient group. © 2015.

Author Info:
aAudiology Unit, Assiut University Hospital, Assiut, Egypt
bDepartment of Neuropsychiatry, Assiut University Hospital, Assiut, Egypt


Authors:
Mohamed, M.S.a,  Zahran, K.M.aEmail Author,  Mohamed, H.S.E.a,  Galal, H.b,  Mustafa, A.M.a

Date of Publishing:
Volume 20, Issue 1, 1 March 2015, Pages 43-47

Title:
Pattern of Glucose Intolerance among Pregnant Women with Unexplained ‎IUFD‎

Abstract:
Purpose To determine the possible causes for IUFD and to investigate for the pattern of glucose intolerance as a cause of unexplained IUFD among pregnant women. Methods For one year, 420 pregnant women with IUFD at or after the 28th week of pregnancy and another 200 women carrying normal looking fetuses were recruited as a control group. Random venous samples and HbA1c were tested to assess the glucose control in the studied women. Results Of the studied women, 68.09% had unexplained cause for their IUFD. Other causes for IUFD included Hypertensive disease with pregnancy (6.9%), accidental hemorrhage (5.5%), and small for gestational age (11.4%). Overt DM was diagnosed at 1.7%. Women who had unexplained IUFD showed higher HbA1c and Random Blood Sugar (RBS) than control group. 18% of women carrying unexplained IUFD and had normal RBS showed abnormally high HbA1c level. Conclusions Unexplained IUFD represented the major category of IUFD (68.09%). Laboratory indices of diabetes mellitus are more prevalent in this category of patients. Accordingly, screening for diabetes is recommended for these women. However, the use of RBS alone is not sufficient to exclude poor metabolic control. HbA1c may be a better alternative. © 2014 Production and hosting by Elsevier B.V. on behalf of Middle East Fertility Society.

Author Info:
aDepartment of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
bDepartment of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Mohamed, T.A.Email Author,  Soliman, W.,  Fathalla, A.M.  View Correspondence (jump link)

Date of Publishing:
Volume 26, Issue 2, 26 August 2015, Pages 107-113

Title:
Effect of Intracameral Triamcinolone Acetonide on Postoperative Intraocular ‎Inflammation in Pediatric Traumatic Cataract‎

Abstract:
Purpose: To study the effect of a single intracameral injection of triamcinolone acetonide at the end of pediatric traumatic cataract surgery on postoperative inflammation. Methods: This prospective interventional study comprised 40 eyes of children with unilateral traumatic cataract. Patients were classified into 2 groups: the study group, in which intraoperative intracameral triamcinolone acetonide (2 mg) was used at the end of surgery; and a control group, which did not receive intracameral triamcinolone acetonide. Results: The study group included 20 eyes of patients with an average age of 6 ± 2.8 years. The control group included 20 eyes of patients with an average age of 6 ± 2.1 years. No serious intraoperative complications occurred. In the immediate postoperative period, 3 eyes of the control group (15.0%) developed a fibrinous anterior chamber reaction. None of the study group eyes developed a similar reaction. There were no cases of endophthalmitis. In addition, 3 eyes (15%) in the control group had obscuration of the visual axis at the last follow-up. This complication was not encountered in the study group. Posterior synechiae and cellular deposits were observed in 4 eyes (20%) in the study group and 8 eyes (40%) in the control group at 1 month and at the last follow-up. Conclusions: The use of intracameral triamcinolone decreased anterior segment inflammation postoperatively in children who had surgery for traumatic cataract. © 2015 Wichtig Publishing.

Author Info:
Ophthalmology Department, Assiut University Hospital, Assiut, Egypt


Authors:
Mohammed, R.A.A.a,bEmail Author,  Shaaban, O.M.c,  Mahran, D.G.d,  Attellawy, H.N.e,  Makhlof, A.c,  Albasri, A.a

Journal:
Journal of Taibah University Medical Sciences

Date of Publishing:
Volume 10, Issue 1, 1 March 2015, Pages 6-11

Title:
Plagiarism in Medical Scientific Research‎

Abstract:
Objectives Plagiarism is defined as "the practice of taking someone else's words, work or ideas and passing them off as one's own". It is probably the most common form of scientific dishonesty found in research articles. The aim of this review is to present a comprehensive account about plagiarism to raise awareness of all aspects of plagiarism. Methods The key words "plagiarism", "types", "detection" and "consequences" were used to retrieve articles from the MEDLINE database. Results About five hundred articles were retrieved. Articles were divided into subgroups, with each group covering an aspect of plagiarism. Main findings and updates were summarized for each topic. The main reason behind plagiarism was found to be a lack of knowledge about the subject. When coupled with insufficient time, immature writing skills and the pressure on researchers to get their work published in good journals, authors take unacknowledged pieces of others' work and commit plagiarism. In the past, it was difficult to detect plagiarism; however, in recent years, many plagiarism-detection services and software programs have become available. The present article details how journals use these services and software as a helpful tool to check for plagiarism in submitted manuscripts. Within academia, plagiarism is an offense that can be devastating. Conclusion Plagiarism is the most common problem in research writing. The cornerstone in preventing this problem from getting worse is to raise awareness about how to cope with this growing problem of research misconduct. © 2015 The Authors.

Author Info:
aDepartment of Pathology, Faculty of Medicine, Taibah University, Al-Madinah Almunawwarah, Saudi Arabia
bDepartments of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartments of Gynecology and Obstetrics, Faculty of Medicine, Assiut University, Assiut, Egypt
dDepartments of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
eDepartments of Neuroscience, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Morsy, K.H.a,  Mekky, M.A.b,  Abdel-Malek, M.O.b,  Abbas, W.A.cEmail Author  View Correspondence (jump link)

Date of Publishing:
Volume 26, Issue 6, November 2015, Pages 517-521

Title:
Incidence, Causes, and Outcomes of Renal Failure among Cirrhotic ‎Patients‎

Abstract:
Background/Aims: To evaluate the incidence, risk factors of RF among cirrhotic and its impact on patient's outcome. Materials and Methods: A total of 573 cirrhotic patients were evaluated for renal failure (RF) and its causes, 212 patients (37%) were enrolled. Results: Majority of the patients had post hepatitis C liver disease (n=190, 89.6%) with Child-Pugh score C (88.2%), HCC was in 21.2% of cases baseline characteristics. Infections were observed in 45.8% (n=97) of patients whereas, spontaneous bacterial peritonitis (SBP) was the most type of infection (19.3%) among cirrhotic patients with renal failure, followed by pneumonia (9.9%). Infection-induced represents 30.2% followed by hypovolemia (29.7%), whereas HRS was in 11.3%. Reversibility of the condition was seen in 81 patients (38.2%), whereas mortality was seen in 58 (27.4%) patients of RF. The reversibility was more common in the patients with infection, followed by hypovolemia. Mortality was higher in the patients with HRS followed by parenchymal renal disease. Conclusion: Infection-induced and hypovolemic-induced RF represent the most common and also the most correctable causes and must be considered in management protocols for early detection and treatment that will serve for a better prognosis. © Copyright 2015 by The Turkish Society of Gastroenterology.

Author Info:
aBiology Department, Taibah University, Medina, Saudi Arabia
bBotany and Microbiology Department, Assiut University, Assiut, 71516, Egypt


Authors:
Nassr, A.A.a,bEmail Author,  Youssef, A.A.a,  Zakherah, M.S.a,  Ismail, A.M.a,  Brost, B.C.b

Date of Publishing:
Volume 43, Issue 6, 1 November 2015, Pages 749-754

Title:
Clinical Application of Fetal Left Modified Myocardial Performance Index in the ‎Evaluation of Fetal Growth Restriction‎

Abstract:
Objective: This study aims to evaluate cardiac function in fetuses with intrauterine growth restriction (IUGR) compared with healthy fetuses, using the left modified myocardial performance index (MPI) and the association between MPI and perinatal outcome. Methods: Pregnant women between 34 and 39 weeks of gestation, who met the criteria for IUGR and were scheduled for delivery at an Egyptian tertiary medical center, were prospectively enrolled in the study. Women in the same gestational-Age group with uncomplicated pregnancies were included as a control group. MPI was measured in all fetuses. The IUGR group was analyzed based on normal and abnormal umbilical artery (UA) Doppler. Perinatal outcomes were recorded. Results: The mean left MPI was significantly higher in IUGR fetuses with abnormal UA Doppler (mean 0.58±SD 0.093) compared with healthy fetuses (mean 0.45±SD 0.070) (P<0.001). IUGR fetuses with abnormal left MPI showed significantly worse perinatal outcome and increased morbidity compared with the control group. IUGR fetuses with abnormal left MPI also showed significantly worse perinatal outcome compared with IUGR fetuses with normal MPI (whether the UA Doppler was normal or abnormal). The fetal MPI was associated with the severity of fetal compromise in IUGR fetuses based on the perinatal outcome. Conclusion: MPI is a potentially useful tool in evaluating fetuses with suspected IUGR, which is crucial in classifying IUGR pregnancies into critical and non-critical cases and in predicting neonatal outcome. © 2015 by De Gruyter 2015.

Author Info:
aDepartment of Obstetrics and Gynecology, Women's Health Center, Assiut University Hospitals, Assiut, 71516, Egypt
bDivision of Maternal Fetal Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States


Authors:
Okasha, H.H.aEmail Author,  Amin, H.M.a,  Al-Shazli, M.b,  Nabil, A.b,  Hussein, H.c,  Ezzat, R.d

Title:
A Duodenal Gastrointestinal Stromal Tumor with a Large Central Area of Fluid ‎and Gas Due to Fistulization into the Duodenal Lumen, Mimicking a Large ‎Duodenal Diverticulum‎

Abstract:
Gastrointestinal stromal tumors (GISTs) can occur anywhere along the gastrointestinal tract especially the stomach and upper small bowel. They are usually solid, but cystic degeneration, necrosis, and focal hemorrhage have been described in larger tumors leading to central necrotic cavitation. The most sensitive marker of GIST is CD117 (c-kit). In computed tomography (CT) scan, it is often difficult to decide the origin of the primary tumor, especially in large GISTs. We report an incidental case of a large duodenal GIST fistulizing into the second part of the duodenum with a large amount of fluid and gas inside, mistaken for a cystic pancreatic neoplasm by CT and mistaken for a duodenal diverticulum by endoscopic ultrasound.

Author Info:
aDepartment of Internal Medicine, Cairo University, Egypt
bDepartment of Surgery, Cairo University, Egypt
cDepartment of Pathology, Cairo University, Egypt
dDepartment of Internal Medicine, Assiut University, Assiut, Egypt


Authors:
Okasha, H.H.aEmail Author,  Ashry, M.b,  Imam, H.M.K.b,  Ezzat, R.b,  Nagui, M.a,  Farag, A.H.a,  Gemeie, E.H.c,  Khattab, H.M.d

Title:
Role of Endoscopic Ultrasound-Guided Fine Needle Aspiration and Ultrasound-‎Guided Fine-Needle Aspiration in Diagnosis of Cystic Pancreatic ‎Lesions‎

Abstract:
Background and Objective: The addition of fi ne-needle aspiration (FNA) to different imaging modalities has raised the accuracy for diagnosis of cystic pancreatic lesions. We aim to differentiate benign from neoplastic pancreatic cysts by evaluating cyst fl uid carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9), and amylase levels and cytopathological examination, including mucin stain. Patients and Methods: This prospective study included 77 patients with pancreatic cystic lesions. Ultrasound-FNA (US-FNA) or endoscopic ultrasound-FNA (EUS-FNA) was done according to the accessibility of the lesion. The aspirated specimens were subjected to cytopathological examination (including mucin staining), tumor markers (CEA, CA19-9), and amylase level. Results: Cyst CEA value of 279 or more showed high statistical signifi cance in differentiating mucinous from nonmucinous lesions with sensitivity, specifi city, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 73%, 60%, 50%, 80%, and 65%, respectively. Cyst amylase could differentiate between neoplastic and nonneoplastic cysts at a level of 1043 with sensitivity of 58%, specifi city of 75%, PPV of 73%, NPV of 60%, and accuracy of 66%. CA19-9 could not differentiate between neoplastic and nonneoplastic cysts. Mucin examination showed a sensitivity of 85%, specifi city of 95%, PPV of 92%, NPV of 91%, and accuracy of 91% in differentiating mucinous from non-mucinous lesions. Cytopathological examination showed a sensitivity of 81%, specifi city of 94%, PPV of 94%, NPV of 83%, and accuracy of 88%. Conclusion: US or EUS-FNA with analysis of cyst CEA level, CA19-9, amylase, mucin stain, and cytopathological examination increases the diagnostic accuracy of cystic pancreatic lesions.

Author Info:
aDepartment of Internal Medicine, Cairo University, Oula, Giza, Egypt
bDepartment of Internal Medicine, Assiut University, Assiut, Egypt
cDepartment of Pathology, National Cancer Institute, Cairo University, Oula, Giza, Egypt
dDepartment of Pathology, Cairo University, Oula, Giza, Egypt


Authors:
Omran, O.M.a,cEmail Author,  AlSheeha, M.b

Title:
Human Papilloma Virus Early Proteins E6 (HPV16/18-E6) and the Cell Cycle ‎Marker P16 (INK4a) Are Useful Prognostic Markers in Uterine Cervical ‎Carcinomas in Qassim Region- Saudi Arabia‎

Abstract:
Cervical cancer is a common and an important public health problem for adult women in developing countries. In contrast, cervical cancer incidence is low in Saudi Arabia. High-risk types of human papilloma viruses (HPV16 and HPV18) are the most significant risk factors for cervical cancer. HPV16/18-E6 oncoprotein is associated with HPV etiology, viral persistence and epithelial transformation. Cell cycle protein p16 INK4a (p16) plays an important role in the pathophysiology of cervical carcinomas. The aims of this study were to investigate the expression of HPV16/18-E6 and p16 in uterine cervical carcinomas in Qassim Region - Saudi Arabia, and to relate the results to the established clinicopathological prognostic parameters (age of the patient, educational level, birth control methods, number of pregnancy, smoking status, degree of histological differentiation, clinical stage, and lymph node metastasis) The study included 40 specimens of uterine cervical squamous cell carcinomas diagnosed and confirmed by biopsy. Histopathological classification of cervical tumors cases was performed according to the International Federation of Gynecology and Obstetrics (FIGO). Immunohistochemical analysis for HPV16/18-E6 and p16 were carried out on formalin-fixed paraffin-embedded sections of cervical tissues using avidin-biotin peroxidase method. There was a significant statistical correlation between HPV16/18-E6 expression in cervical carcinoma and nationality, smoking status and size of the tumor. HPV16/18-E6 oncoprotein expression in normal lymphocytes and endothelial cells in the tumor tissues and the adjacent normal cervical tissues suggest the possibility that HPV infection might spread to other organs through blood circulation. P16 expression has been correlated with high grade, stage of cervical SCC and HPV16/18-E6 expression. The current study supports the critical function of p16 and HPV16/18-E6 as specific markers for cervical carcinoma. However the potential for usage of p16 and HPV16/18-E6 as prognostic markers will require detailed follow data for a larger group of patients. © 2014, Arányi Lajos Foundation.

Author Info:
aDepartment of Pathology, College of Medicine, Assiut University, Assiut, Egypt
bDepartment of Obstetrics and Gynacology, College of Medicine, Qassim University, Buridah, Qassim Region, Saudi Arabia
cDepartment of Pathology, College of Medicine, Qassim University, Buridah, Qassim Region, Saudi Arabia


Authors:
Omran, O.M.a,b,dEmail Author,  Omer, O.H.c

Date of Publishing:
Volume 211, Issue 6, 1 June 2015, Pages 462-469

Title:
The Effects of Alpha-Lipoic Acid on Breast of Female Albino Rats Exposed to ‎Malathion: Histopathological and Immunohistochemical Study‎

Abstract:
Background: The wide use of the organophosphate insecticide malathion is accompanied by the risk of human exposure and may be involved in the etiology of breast cancers, especially in developing countries. Alpha (α)-lipoic acid, a natural molecule, present in our diet has antioxidant and protective effects in cases such as aging, diabetes mellitus, and vascular and neurodegenerative diseases all in which free radicals are involved. However, there is only scarce data regarding the efficacy and biological activity of α-lipoic acid on malathion-induced breast histopathological changes. Aims: To investigate whether malathion can induce mammary histopathological changes, to immunohistochemically analyze the modulations in proliferation-apoptosis balance associated with these changes, to assess the associated metabolic parameters, antioxidant stress and hormonal profile changes and to elucidate the possible protective effect of α-lipoic acid on malathion induced alterations in rats. Materials and methods: Forty Wistar female rats weighing 150-170. g were divided into four groups. Group 1: control group were injected intraperitoneally (ip) with saline solution. Group2: animals were injected (ip) with malathion twice a day for five days. Group 3: animals were orally given α-lipoic acid, after three hours of treatment with malathion at the same dose given to group 2. Group 4: animals were treated with α-lipoic acid at the same dose given to group 3. Rats were sacrificed on the 90th day, and breast tissues were analyzed for histopathological and immunohistochemical alterations. Blood samples were collected for biochemical tests. Results: α-Lipoic acid exhibited a striking reduction of malathion-induced mammary tumor incidence, and reversed intra-tumor histopathological alterations. Alpha lipoic acid suppressed proliferating cell nuclear antigen (PCNA) and p53 expression, induced apoptosis, upregulated proapoptotic protein Bax. Conclusions: Our results provide the experimental evidence that α-lipoic acid exerts chemopreventive effect in the breast hyperplastic and malignant changes by suppressing abnormal cell proliferation and inducing apoptosis with an oncostatic effects during an early-stage breast cancer. © 2015 Elsevier GmbH.

Author Info:
aDepartment of Pathology, College of Medicine, Qassim University, Saudi Arabia
bDepartment of Pathology, College of Medicine, Assiut University, Egypt
cDepartment of Pharmaceutics, College of Pharmacy, Qassim University, Saudi Arabia
d4166 Pathology Department, The Ohio State University, Columbus, OH, United States


Authors:
Qenawy, O.K.aEmail Author,  Tantawy, W.H.bEmail Author,  Abdalla, A.K.H.aEmail Author,  Sayed, S.A.A.aEmail Author

Date of Publishing:
Volume 46, Issue 4, 19 March 2015, Pages 1003-1010

Title:
Comparative Study between Multi-Detector Ct Angiography and Digital ‎Subtraction Angiography in Evaluation of Peripheral Arterial Occlusive ‎Disease‎

Abstract:
Objective: The aims of the study were the evaluation of peripheral arterial occlusive disease with multidetector or multi-slice CT angiography (MDCTA) and comparison of the results with the results of digital subtraction angiography (DSA), a standard reference. Patients and method: The written informed consent of the patients and ethics committee approval were obtained. The prospective study group consisted of 10 patients complaining of peripheral arterial disease. Using MDCT-A, the arterial tree of the lower extremity was evaluated for the presence of steno-occlusive lesions that might have led to luminal stenosis. The diagnostic accuracy of MDCTA was calculated and compared with that of DSA. Results: In the segment-based analysis, the sensitivity, specificity, and accuracy of MDCT angiography in determining significant stenoses were 100%, 99.3%, and 99.6.3%, respectively. The compatibility between MDCTA and DSA methods in grading stenosis was calculated as 0.896 (P <0.007) and it was statistically significant. Conclusion: MDCT angiography is significantly compatible with DSA method in the evaluation of peripheral arterial diseases. It is a non-invasive method and can be an alternative to DSA. © 2015 The Authors. The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V.

Author Info:
aDepartment of Diagnostic Radiology, Faculty of Medicine, Assiut University Hospital, Assiut University, Egypt
bDepartment of Diagnostic Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt


Authors:
Ragab, I.K.aEmail Author,  Mohamed, H.Z.E.b

Date of Publishing:
Volume 38, Issue 4, December 2015, Pages 766-777

Title:
The Effect of Chloroacetonitrile on the Liver and Kidney of Adult Male Rats: A ‎Light and Electron Microscopic Study‎

Abstract:
Background Chloroacetonitrile (CAN) is a by-product of chlorination of drinking water. It might present a hazard to human health. It has mutagenic and carcinogenic activity. It is metabolized to cyanide in the body. CAN is ∼10 times more toxic compared with acetonitrile. Occupational exposure to CAN may occur through inhalation or dermal contact at workplaces where CAN is used or produced. There is scanty information on CAN hepatotoxicity and nephrotoxicity. Aim The present study was designed to investigate the effects of CAN on the liver and kidney of adult male rats using light and electron microscopic studies to avoid any hazard to human health. Materials and methods A total of 120 adult male SpraguëCDawley rats were divided into two groups (60 rats/group). The rats of the control group were given corn oil orally through a gastric tube for 21 days. The rats of the treated group were given CAN at a dose of 25 mg/kg/day orally through a gastric tube for 21 days. The animals of both groups were sacrificed. The livers and kidneys were dissected immediately. The specimens of each group were processed for light and transmission electron microscopic studies. The specimens for light microscopic studies were stained with H&E, Masson's trichrome, and toluidine blue. Quantitative morphometric and statistical studies were performed. Results In light and electron microscopic studies on treated liver and kidney sections, cytotoxicity manifested in the form of disorganized architecture of the liver, damaged endothelial lining of the hepatic sinusoids, Von Kupffer cells, and hepatocytes. The kidney showed partial and complete damage of the glomeruli and proximal convoluted tubules, and obliterated space of Bowman's capsule. Conclusion CAN is both hepatotoxic and nephrotoxic in adult male rats. Hence, it may be hazardous to human health. © 2015 The Egyptian Journal of Histology.

Author Info:
aDepartments of Histology, Faculty of Medicine, AL-Azhar University, Assiut, 21624, Egypt
bHuman Anatomy and Embryology Department, Faculty of Medicine, Assiut University, Egypt


Authors:
Refaat, B.aEmail Author,  Ashshi, A.M.a,  El-Shemi, A.G.a,c,  AlZanbagi, A.b

Date of Publishing:
Volume 15, Issue 3, 3 August 2015, Pages 293-302

Title:
Effects of Chronic Hepatitis C Genotype 1 and 4 on Serum Activins and ‎Follistatin in Treatment Naïve Patients and Their Correlations with Interleukin-‎‎6, Tumour Necrosis Factor-Α, Viral Load and Liver Damage‎

Abstract:
The importance of activins and follistatin in liver diseases has recently emerged. The aim of the present study was to measure the influence of chronic infection with viral hepatitis C (CHC) genotype 1 and 4 on serum levels of activin-A, activin-B and follistatin, and to determine their correlations with viral load, liver damage, interleukin-6 (IL-6) and tumour necrosis factor (TNF)-α. Sera samples collected from 20 male and 20 female treatment naïve CHC genotype 1 and 4 Saudi patients (ten males and ten females for each genotype), and 40 gender- and age-matched healthy participants were analysed for activin-A, activin-B and follistatin using enzyme-linked immunosorbent assay and their levels were correlated with IL-6, TNF-α, viral load and AST platelet ratio index (APRI). Serum activin-A, activin-B, IL-6 and TNF-α were significantly increased, while serum follistatin was significantly decreased, in both genders of CHC patients compared with control subjects, In both viral genotypes, activin-A was strongly and positively correlated with the viral load, APRI, IL-6 and TNF-α, and negatively with albumin (P < 0.01). Activin-B showed the same correlations of activin-A only in CHC genotype 1 patients, but it was weaker than activin-A. No correlation was detected with follistatin. Serum activins, particularly activin-A, and follistatin are significantly altered by CHC genotype 1 and 4. This dysregulation of activins/follistatin axis may be associated with viral replication, host immune response and liver injury. Further studies are needed to illustrate the definite role(s) and clinical value of activins and follistatin in CHC. © 2014, Springer-Verlag Italia.

Author Info:
aLaboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, PO Box 7607, Al Abdeyah, Makkah, Saudi Arabia
bGastroenterology Department, King Abdullah Medical City, Makkah, 21955, Saudi Arabia
cDepartment of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Saad, K.aEmail Author,  Abd Aziz, N.H.R.a,  El-Houfey, A.A.b,  El-Asheer, O.a,  Mohamed, S.A.A.c,  Ahmed, A.E.d,  Abdel Baseer, K.A.d,  Darwish, M.M.e  View Correspondence (jump link)

Journal:
Pediatric, Allergy, Immunology, and Pulmonology

Date of Publishing:
Volume 28, Issue 2, 1 June 2015, Pages 102-106

Title:
Trial of Vitamin D Supplementation in Infants with Bronchiolitis: A Randomized, ‎Double-Blind, Placebo-Controlled Study‎

Abstract:
Background: There is interesting growing evidence for a relationship between bronchiolitis and vitamin D. This suggests a possible benefit from vitamin D therapy to children with bronchiolitis. Methods: A double-blind, randomized clinical trial was performed on 89 infants with bronchiolitis. Patients were randomized to receive vitamin D or placebo. Results: The intervention group, which received vitamin D therapy, had significant improvement in three parameters: the mean time taken for resolution of the disease, the mean time taken for the improvement of oral feeding, and the duration of hospitalization. All these outcomes in the intervention group (vitamin D) were significantly better than the control (placebo) group with p<0.001, p<0.05, and p<0.01 respectively. The study supported the efficacy of vitamin D therapy in bronchiolitis. Conclusion: This double-blinded, randomized placebo controlled trial of 100 IU /kg vitamin D supplementation daily in Egyptian children with bronchiolitis found a clinically and statistically significant reduction in hospitalization with rapid recovery of the disease. The study suggests that short-term supplementation with vitamin D given daily during the course of illness, starting from day 1, may help in resolution of bronchiolitis. © Copyright 2015, Mary Ann Liebert, Inc. 2015.

Author Info:
aDepartment of Pediatrics, Assiut University, Assiut City, 71516, Egypt
bDepartment of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt
cDepartment of Chest Diseases, Assiut University, Assiut, Egypt
dDepartment of Pediatrics, Qena Faculty of Medicine, South Valley University, Egypt
eDepartment of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Saad, K.aEmail Author,  Elserogy, Y.b,  Abdel rahman, A.A.b,  Al-Atram, A.A.c,  Mohamad, I.L.a,  ElMelegy, T.T.H.d,  Bjørklund, G.e,  El-Houfy, A.A.f

Date of Publishing:
Volume 115, Issue 4, 1 December 2015, Pages 657-663

Title:
ADHD, Autism and Neuroradiological Complications among Phenylketonuric ‎Children in Upper Egypt‎

Abstract:
The aim of this study is to evaluate the neuropsychological status in a cohort of children with early and continuously treated phenylketonuria in Assiut, Upper Egypt. The study was implemented in seventy-eight phenylketonuria (PKU) children. Only 34 patients met the inclusion criteria. Investigated patients were evaluated according to detailed history, neurological examination, Childhood Autism Rating Scale, full scale Intelligence Quotient, attention deficit hyperactivity disorder, electroencephalography and magnetic resonance imaging (MRI). This study concluded that the prognosis for early diagnosed children with PKU treated from the first weeks of life is generally good. However, they are at increased risk for neurological complications and behavioral problems. So, neonatal screening for PKU is highly recommended in Egypt, for early detection and management. In addition, neuropsychological and MRI assessments in PKU children should be done. © 2015, Belgian Neurological Society.

Author Info:
aDepartment of Pediatrics, Assiut University, Asyût, 71516, Egypt
bDepartment of Neuropsychiatry, Assiut University, Asyût, 71516, Egypt
cDepartment of Psychiatry, College of Medicine, Almajmaah University, Al Majma’ah, Saudi Arabia
dDepartment of Clinical Pathology, Assiut University, Asyût, 71516, Egypt
eCouncil for Nutritional and Environmental Medicine, Mo i Rana, Norway
fDepartment of Community Health Nursing, Assiut University, Asyût, 71516, Egypt


Authors:
Sayed, D.S.aEmail Author,  Youssef, E.K.a,  Mohamed, E.E.-D.M.b,  Darwish, M.M.M.c

Journal:
Journal of the Egyptian Women's Dermatologic Society

Title:
Profile of Vitiligo among the Attendants of Phototherapy Units in Two ‎University Hospitals in Assiut, Upper Egypt‎

Abstract:
Background Vitiligo is a common, acquired, idiopathic skin disorder characterized by one or more patches of depigmented skin. Objective The aim of the study was to investigate the clinical and epidemiological profile of two phototherapy unit attendants in two university hospitals in Assiut governorate (Upper Egypt). Patients and methods The clinical presentation of vitiligo was examined in patients attending Assiut and Al-Azhar University hospitals. Demographic data of all patients were obtained. History taking and clinical examination were performed. Results A total of 283 patients were recruited: 90 were Male (31.8%) and 193 were feMale (68.2%). Their mean age ± SD was 27.71 ±15.84 years. Most of the vitiligo patients were adult feMales, with a positive family history in 22.6% of them. The most common presentation was vitiligo vulgaris; there was no patient with isolated mucosal affection. The most common presentation in children was focal, that in adolescents was acrofacial, and in adults was segmental. Leukotrichia was found in 42%, Koebner phenomenon in 25%, halo nevus in 6%, associated cutaneous disease in 5%, and associated systemic disorder in 22%. Conclusion From this study a hypothesis was generated outlining a profile for vitiligo patients in Assiut. We concluded that vitiligo most commonly occurs in the first two decades of life and more commonly in the feMale population. Vitiligo vulgaris was the most common clinical type observed. The minority had a positive family history, whereas the majority had progressive course of the disease. Leukotrichia was the most commonly associated abnormality. Vitiligo is less often associated with systemic diseases. © 2015 Egyptian Women's Dermatologic Society.

Author Info:
aDermatology, Venereology and Andrology Department, Assiut University Hospital, Assiut, 71111, Egypt
bDermatology, Venereology and Andrology Department, Azhar University Hospital, Egypt
cPublic Health and Community Medicine Department, Assiut Faculty of Medicine, Assiut, Egypt


Authors:
Sayed, M.H.M.a,bEmail Author,  Eltayeb, A.O.c,  Farghaly, H.R.S.a

Date of Publishing:
Volume 46, Issue 3, 1 September 2015, Pages 599-603

Title:
The Impact of Hypertension on Diastolic Left Ventricular Function, Evaluated ‎by Quantitative ECG-Gated Myocardial Perfusion SPECT‎

Abstract:
Background Abnormality of left ventricular (LV) diastolic function is frequently the earliest indicator of LV dysfunction in many diseases, including coronary artery disease (CAD), and hypertension. Electrocardiography (ECG)-gated technetium (Tc)-99 m tetrofosmin single-photon emission computed tomography (SPECT) has been reported to be a useful method for evaluation of LV function. Objectives The purpose of this study was to assess the impact of hypertension on diastolic left ventricular function using ECG-gated Tc-99m tetrofosmin SPECT. Methods Thirty consecutive patients with normal exercise myocardial perfusion and normal LV systolic function, were studied out of 233 patients underwent ECG-gated Tc-99m tetrofosmin SPECT at our institution between January 2012 and December 2013. Patients were divided into two groups according to the presence or absence of systemic hypertension (blood pressure ≥140/90 mm Hg on ≥3 measurements or treatment with antihypertensive medication). Parameters of diastolic LV function were assessed. Results Of the studied 30 patients, 19/30 (63%) had hypertension. There was no difference with respect to age, gender, LV end-diastolic volume (EDV), LV end-systolic volume (ESV), and LV ejection fraction values obtained by quantitative gated SPECT between patients with and without hypertension. The first-third mean filling rate (1/3 MFR), peak filling rate (PFR) of patients with hypertension (1.22 ± 0.38, 2.83 ± 1.10 EDV/s) were lower than those of patients without hypertension (1.54 ± 0.30, 2.90 ± 0.35 EDV/s), and the time to peak filling (TTPF) of patients with hypertension (199.42 ± 68.34 ms) was higher than TTPF of patients without hypertension (164.90 ± 36.39 ms). Conclusions Quantitative ECG-gated Tc-99m tetrofosmin SPECT reveals that hypertensive patients with preserved global LV systolic function may have significant changes in diastolic LV function. Gated myocardial perfusion SPECT reports are always lacking in these changes in diastolic function. We recommend inclusion of such changes in diastolic function in gated myocardial perfusion SPECT reports that can help in proper management of hypertensive patients. © 2015 The Authors.

Author Info:
aDepartment of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
bDepartment of Nuclear Medicine, Almana General Hospital, Dammam, Saudi Arabia
cDepartment of Cardiology, Almana General Hospital, Dammam, Saudi Arabia


Authors:
Sayed, M.H.M.a,bEmail Author,  Farghaly, H.R.S.a,  Fadl, F.A.c

Date of Publishing:
Volume 30, Issue 2, 1 April 2015, Pages 116-121

Title:
Rate of Thyroglossal Duct Remnant Visualization after Total Thyroidectomy for ‎Differentiated Thyroid Carcinoma and Its Impact on Clinical Outcome of ‎Radioactive Iodine (I-131) Ablation‎

Abstract:
Objectives: The rate and impact of thyroglossal duct remnant (TGDR) visualization in patients with hypothyroidism after total thyroidectomy for differentiated thyroid carcinoma (DTC) have not yet been fully determined. The aim of this study was to assess the rate of TGDR visualization in post total thyroidectomy whole body scan (WBS) for DTC and to evaluate its impact on the outcome of I-131 ablation. Methods: A total of 60 consecutive DTC patients (51 papillary thyroid Ca., and 9 Follicular thyroid Ca.), underwent total thyroidectomy, followed by WBS (using I-131 in 28 patients and I-123 in 32 patients), neck ultrasound (US), thyroglobulin (Tg) and Tg anti-bodies (TgAb) assay after 40 days and subsequent I-131 ablation. At 6 months later follow-up I-131 WBS, neck U/S, Tg and TgAb were performed following suspension of L-thyroxine for 1-month (thyroid stimulating hormone [TSH] >30 μIU/ml) in 53 patients and following recombinant human TSH stimulation in seven patients. Results: Of the studied 60 patients, 19/60 (31.7%) had a linear or focal radioactivity at the superior midline of the neck, suggesting TGDR (Group 1), and 41/60 (68.3%) had no uptake to suggest TGDR (Group 2). No significant difference regarding age, gender and histopathology between both groups. Neck US showed no evidence of thyroid tissue in the superior midline of the neck in both groups, and only a small or no residual thyroid tissue in patients of Group 1. There was a significant successful I-131 ablation rate among patients of group 1 compared to group 2 (79% in Group 1 vs. 41.5% in Group 2) (P = 0.007). Conclusions: Thyroglossal duct remnant visualization on WBS of hypothyroid subjects after total thyroidectomy suggests presence of only a small or no residual functioning thyroid tissue at the thyroid bed and can predict a good response to I-131 ablation.

Author Info:
aDepartment of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
bDepartment of Nuclear Medicine, Almana General Hospital, P.O. Box 2366, Dammam, 31451, Saudi Arabia
cDepartment of Radiology and Medical Imaging, Almana General Hospital, Dammam, Saudi Arabia


Authors:
Sayed, S.a,  Idriss, N.K.b,  Sayyed, H.G.c,  Ashry, A.A.d,  Rafatt, D.M.e,  Mohamed, A.O.b,  Blann, A.D.fEmail Author  View Correspondence (jump link)

Title:
Effects of Propofol and Isoflurane on Haemodynamics and the Inflammatory ‎Response in Cardiopulmonary Bypass Surgery‎

Abstract:
Cardiopulmonary bypass (CPB) causes reperfusion injury that when most severe is clinically manifested as a systemic inflammatory response syndrome. The anaesthetic propofol may have anti-inflammatory properties that may reduce such a response. We hypothesised differing effects of propofol and isoflurane on inflammatory markers in patients having CBP. Forty patients undergoing elective CPB were randomised to receive either propofol or isoflurane for maintenance of anaesthesia. CRP, IL-6, IL-8, HIF-1α(ELISA), CD11 and CD18 expression (flow cytometry), and haemoxygenase (HO-1) promoter polymorphisms (PCR/electrophoresis) were measured before anaesthetic induction, 4 hours post-CPB, and 24 hours later. There were no differences in the 4 hours changes in CRP, IL-6, IL-8 or CD18 between the two groups, but those in the propofol group had higher HIF-1α (P=0.016) and lower CD11 expression (P=0.026). After 24 hours, compared to the isoflurane group, the propofol group had significantly lower levels of CRP (P<0.001), IL-6 (P<0.001) and IL-8 (P<0.001), with higher levels CD11 (P=0.009) and CD18 (P=0.002) expression. After 24 hours, patients on propofol had increased expression of shorter HO-1 GT(n) repeats than patients on isoflurane (P=0.001). Use of propofol in CPB is associated with a less adverse inflammatory profile than is isofluorane, and an increased up-regulation of HO-1. This supports the hypothesis that propofol has anti-inflammatory activity.

Author Info:
aDepartment of Anaesthesiology, Faculty of Medicine, Assiut University, Assiut, Egypt
bDepartment of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartment of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
dDepartment of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
eDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
fDepartment of Medicine, University of Birmingham Centre for Cardiovascular Science, City Hospital, Birmingham, B18 7QH, United Kingdom


Authors:
Sayed, T.A.aEmail Author,  Bakrey, M.b,  Elsedfy, G.O.c

Date of Publishing:
Volume 22, Issue 3, 23 July 2015, Pages 164-170

Title:
Psychiatric Sequel of Repeated Pediatric General Anesthesia‎

Abstract:
Background: Repeated anesthesia and surgery in young children are distressing for children and families, leading to anxiety and psychological disturbances in the children. Preclinical and clinical data suggest a high possibility of neurotoxicity after exposure of young children to general anesthetics, with subsequent behavioral and emotional disturbances. Objective: The aim of this study was to determine the overall psychiatric effect of repeated general anesthesia on the cognitive function, the behavior, and emotions of young 11/2-5-year-old children compared with a control group of healthy children attending the vaccination clinic. Patients and methods: Thirty-five children who underwent repeated anesthesia were recruited and matched with the same number of healthy children who attended the vaccination clinic as a control group. Both groups were administrated the Child Behavior Checklist 11/2-5 years and the Diagnostic and Statistical Manual of Mental Disorders (DSM) oriented scale. Behavior data were collected through a semistructured questionnaire. Results: The Child Behavior Checklist score revealed that children with repeated anesthesia were more likely to become anxious or depressed, to have sleep and attention problems, to become aggressive, and to develop internalized and externalized behavioral problems. There were no statistically significant differences between the two groups regarding problems of being emotionally reactive, having somatic complaints or being withdrawn. On the DSM scale, children with repeated anesthesia were more likely to develop affective and anxiety problems and attention-deficit/ hyperactivity problems. There were no statistically significant differences between the two study groups regarding pervasive developmental and oppositional defiant problems. Conclusion: Young pediatric patients undergoing repeated surgical procedures under general anesthesia are more likely to have subsequent behavioral and emotional disturbances. Proper perioperative pain management, psychological counseling, and social support could minimize these untoward consequences. Copyright © 2015 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited.

Author Info:
aDepartment of Neuropsychiatry, Faculty of Medicine, Sohag University, Sohag, 82425, Egypt
bDepartment of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Seif, H.M.A.aEmail Author,  Khalaf, L.M.R.bEmail Author

Title:
Endovascular Management of Postpartum Hemorrhage of Placental ‎Origin‎

Abstract:
Aim To evaluate the potential role, efficacy, and complications of endovascular management of postpartum hemorrhage induced by variable placental abnormalities. Materials and methods Ten patients with placental abnormalities underwent pelvic arterial embolization in Assiut University Hospital, because of postpartum hemorrhage. Placental abnormalities were; retained placenta (n = 4), placenta accrete vera (n = 1), placenta increta (n = 2), placenta percreta (n = 1), and choriocarcinoma (n = 2). Only three patients were embolized on emergency bases, while the other 7 patients were scheduled for embolization. Results The mean hemoglobin level before embolization was 6 g/dL (range: 4.5-8 g/dL). Severe coagulation disorders were present in one patient. Postembolization pelvic angiogram showed total devascularization of the pathological arteries in 7(70%) patients, and subtotal devascularization in 3(30%) patients. The clinical success is 100%. Conclusion Whatever the placental disease, pelvic embolization with long-lasting embolizing agents is very effective and safe treatment of associated postpartum hemorrhage. © 2015 The Authors.

Author Info:
aDepartment of Radiology, Assiut University Hospital, Faculty of Medicine, Assiut, 71517, Egypt
bDepartment of Radiology, South Egypt Cancer Institute, Assiut, Egypt


Authors:
Seif, H.M.A.aEmail Author,  Reyad, H.A.b,  Korany, M.b,  Metwally, M.b,  Ahmed, A.I.c

Date of Publishing:
Volume 46, Issue 4, 28 February 2015, Pages 999-1002

Title:
Immediate Operation Versus Percutaneous Drainage for Treatment of ‎Appendicular Abscess‎

Abstract:
Aim This study aims to compare the outcomes, morbidity and hospital stay in patients who underwent emergency surgery, and those who underwent percutaneous drainage for treatment of appendicular abscess. Patients and methods From April 2013 to October 2014, we recruited 40 patients with appendicular abscesses for this study. These patients were randomized into two groups: group 1 (20 patients) for emergency surgery and group 2 (20 patients) for percutaneous drainage. Preoperative data, hospital stay, functional recovery and postoperative complications were analyzed. Results Functional recovery was 2.2 ± 1 days in group 1 and 1 ± 0 day in group 2. Hospital stay in group 1 was 7.7 ± 3.5 days and in group 2 was 4 ± 1 days. Postoperative complications in group 1 were noted in 8 (40%) patients. No complications were recorded in group 2. Conclusions Appendicular abscesses may be safely and effectively treated by US-guided percutaneous drainage with high technical and clinical success rates, low incidence of complications and shorter hospital stay. © 2015 The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V.

Author Info:
aDepartment of Radiology, Assiut University Hospital, Faculty of Medicine, Assiut, 71517, Egypt
bDepartment of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartment of Radiology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt


Authors:
Selim, Z.I.a,  Hamed, S.A.bEmail Author,  Elattar, A.M.c

Journal:
International Journal of Clinical Rheumatology

Date of Publishing:
Volume 10, Issue 2, 1 April 2015, Pages 85-96

Title:
Peripheral and Central Auditory Pathways Function with Rheumatoid ‎Arthritis‎

Abstract:
Aims: We aimed to determine auditory pathways functions with rheumatoid arthritis (RA). Materials & Methods: Included were 46 adult females. They underwent audiometry, transient evoked otoacoustic emissions (TEOAEs) and brainstem-auditory response (ABR). Results: Hearing losses were reported in 60.87% ears. Compared to controls, TEOAE at 3.0-4.0 kHz were lower in 39.13% ears. ABR showed prolonged waves I and III-V latencies. Prolonged wave I and III-V and I-V latencies were observed in 45.65, 39.13 and 17.39% ears. Significant associations were identified between duration of RA and hearing thresholds, waves I and III and III-V and I-V latencies and TEOAEs amplitudes at 4 kHz. Conclusion: Chronic RA causes pathologies of the auditory nerve, cochlea and auditory pathway within the brainstem. © 2015 Future Medicine Ltd.

Author Info:
aDepartment of Rheumatology and Rehabilitation, Assiut University Hospital, Assiut, Egypt
bDepartment of Neurology and Psychiatry, Hospital of Neurology and Psychiatry, Assiut University Hospital, PO Box 71516, Assiut, Egypt
cAudiology Unit, Assiut University Hospital, Assiut, Egypt


Authors:
Shaamash, A.H.a,bEmail Author,  Alshahrani, M.S.b,  Awadalla, N.J.c,  Hakami, H.W.d

Date of Publishing:
Volume 20, Issue 3, 1 September 2015, Article number 338, Pages 159-164

Title:
Falling in Serum Β Human Chorionic Gonadotropin Levels between Days 1 and ‎‎7 as a New Protocol to Predict Successful Single-Dose of Methotrexate ‎Therapy for Ectopic Pregnancy‎

Abstract:
Abstract Objective To study the patterns of serum βhCG levels on days 1-4 and days 1-7 after single-dose methotrexate injection (MTX) for ectopic pregnancy (EP) and to determine the sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the best cut-off points for the "percentage of fall" in serum βhCG levels for predicting a successful outcome. Patients and methods This is a retrospective cohort study including forty-nine consecutive patients treated with single-dose MTX (50 mg/m2). We analyzed patterns of falling in βhCG levels on D1, D4 and D7 of follow up. Our main outcome measures included the overall success rate, the "percentage of fall" variable of serum βhCG levels on D4 and D7 and the best cut-off point for the "percentage of fall" that predicts a successful outcome. Results The success rate of single-dose MTX treatment in EP was 77.5%. A cut-off "percentage of fall" in βhCG serum levels on D1-D7 of ≥33% has the best sensitivity (96%) and PPV (85%) for predicting a successful outcome. This is out performing any cut-off on days 1-4 and comparable to the standard D4-D7 protocol. Conclusions After single-dose MTX injection for EP, the use of D1 to D7 follow up protocol outperforms that of D1 to D4; with possible elimination of D4 routine βhCG blood draw. A cut-off "percentage of fall" in βhCG serum levels on D1-D7 of ≥33% has the best sensitivity and PPV. © 2014 The Authors.

Author Info:
aDepartment of Obstetrics and Gynecology, College of Medicine, Assiut University, Assiut, Egypt
bDepartment of Obstetrics and Gynecology, College of Medicine, King Khalid University, Abha, Saudi Arabia
cDepartment of Family Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
dDepartment of Obstetrics and Gynecology, Abha Maternity Hospital, Abha, Saudi Arabia


Authors:
Shams-Eddin Taher, H.,  Hassan, A.K.M.Email Author,  Dimitry, S.R.,  Mahfouz, A.K.

Date of Publishing:
Volume 67, Issue 4, December 2015, Pages 337-343

Title:
Predicting Contrast Induced Nephropathy Post Coronary Intervention: A ‎Prospective Cohort Study‎

Abstract:
Objective: The purpose of our study was to assess the incidence and predictors of contrast induced nephropathy (CIN) in unselected patients undergoing coronary intervention either coronary angiography (CA) or percutaneous coronary interventions (PCI), at Assiut university hospitals. Background: CIN is a frequent, potentially lethal complication after coronary intervention. It is the 3rd most common cause of hospital-acquired acute renal failure. Patients and methods: This is an observational prospective cohort study. Two hundred consecutive patients between December 2011 and August 2012 underwent CA and PCI were enrolled in the study. Blood samples were collected at baseline and 3 days after interventions. All patients were followed up for 2 weeks for major adverse events. Results: CIN was observed in 23 (11.5%) patients. According to Mehran risk score, 84.5% of our patients had low risk for CIN, 15.5% had moderate risk for CIN, and no one had high risk score.Multivariate logistic regression analysis of predictors for CIN, showed that the use of high osmolar contrast media (CM) (Telebrix) was associated with 4 times higher incidence of CIN than the use of low osmolar CM (Ultravest) (OR= 4.07; 95% CI= 1.1-15.1). None of our patients had clinical signs or symptoms of acute renal failure, or required haemodialysis at 2 weeks of follow up. Conclusion: Although most of our study population was at low risk, the incidence of CIN was relatively high due to the use of high osmolar CM. Further studies are needed for cost effectiveness in light of negligible clinical impact. © 2015 The Authors.


Authors:
Shehata, G.A.aEmail Author,  El-Lateef, Z.A.b,  Ghanem, H.M.b,  El-Masry, M.A.b

Date of Publishing:
Volume 15, Issue 4, 1 January 2015, Pages 192-198

Title:
Knowledge, Attitude and Practice Regarding People with Epilepsy among ‎Nurses‎

Abstract:
Background: This work handled three aspects: to assess the nurses' knowledge and practice with regard to patients with epilepsy, to study the outcome of training of nurses regarding epilepsy. Material and methods: The study conducted at the Department of Neurology at Assiut University Hospital. Data collected from all nurses (n = 35) working at the Department of Neurology. The following tools were used for data collection; a pre-/post-test questionnaire sheet for the assessment of the nurses' knowledge of epilepsy, an observation checklist sheet for nurses, and the patient's assessment sheet to assess the nurses' practice. The work involved nine sessions, each about 30 minutes long, applied to teach nurses about all data necessary for the patients with epilepsy. Results: A good improvement in the mean knowledge and practice scores observed following the implementation of the designed nursing protocol. A significant decrease in complication rate which resulted from bad practice during fit following the implementation of the designed nursing protocol. A reduction in seizure-related complications reported after the training of nurses with the designed nursing protocol which acts as an additional advantage. Conclusion: Improving the nurses' knowledge and practice with regard to patients with epilepsy will lead to the improvement the health and social conditions of patients with epilepsy. © Aktualn Neurol 2015.

Author Info:
aDepartment of Neurology and Psychiatry, Faculty of Medicine, Assiut University, PO Box 71516, Assiut, Egypt
bAdult Nursing Department, Faculty of Nursing, Assiut University, Assiut, Egypt


Date of Publishing:
Volume 6, Issue 3, 1 June 2015, Pages 181-190

Title:
The Role of Na+/Ca2+ Exchanger Subtypes in Neuronal Ischemic ‎Injury‎

Abstract:
The Na+/Ca2+ exchanger (NCX) plays an important role in the maintenance of Na+ and Ca2+ homeostasis in most cells including neurons under physiological and pathological conditions. It exists in three subtypes (NCX1-3) with different tissue distributions but all of them are present in the brain. NCX transports Na+ and Ca2+ in either Ca2+-efflux (forward) or Ca2+-influx (reverse) mode, depending on membrane potential and transmembrane ion gradients. During neuronal ischemia, Na+ and Ca2+ ionic disturbances favor NCX to work in reverse mode, giving rise to increased intracellular Ca2+ levels, while it may regain its forward mode activity on reperfusion. The exact significance of NCX in neuronal ischemic and reperfusion states remains unclear. The differential role of NCX subtypes in ischemic neuronal injury has been extensively investigated using various pharmacological tools as well as genetic models. This review discusses the mode of action of NCX in ischemic and reperfusion states, the differential roles played by NCX subtypes in these states as well as the role of NCX in pre- and postconditioning. NCX subtypes carry variable roles in ischemic injury. Furthermore, the mode of action of each subtype varies in ischemia and reperfusion states. Thus, therapeutic targeting of NCX in stroke should be based on appropriate timing of the administration of NCX subtype-specific strategies. © 2015, Springer Science+Business Media New York.

Author Info:
aDepartment of Pharmacology and Physiology, Drexel University College of Medicine, 245 North 15th Street, Mail Stop #488, Philadelphia, PA 19102, United States
bDepartment of Pharmacology, Assiut University College of Medicine, Assiut, Egypt


Authors:
Sleem, M.a,  Taye, A.aEmail Author,  El-Moselhy, M.A.a,  Mangoura, S.A.b

Date of Publishing:
Volume 744, 24 February 2015, Pages 10-17

Title:
Combination Therapy with Losartan and L-Carnitine Protects against ‎Endothelial Dysfunction of Streptozotocin-Induced Diabetic Rats‎

Abstract:
Endothelial dysfunction is a critical factor during the initiation of diabetic cardiovascular complications and angiotensin II appears to play a pivotal role in this setting. The present study aimed to investigate whether the combination therapy with losartan and the nutritional supplement, l-carnitine can provide an additional protection against diabetes-associated endothelial dysfunction and elucidate the possible mechanism(s) underlying this effect. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ) (60 mg/kg) in rat. Effects of losartan (20 mg/kg, orally, 3 months) and l-carnitine (200 mg/kg, orally, 3 months) on tumor necrosis factor (TNF)-α, oxidative stress parameters, endothelial nitric oxide synthase expression (eNOS), and vascular function were evaluated. Our results showed a marked increase in aortic superoxide anion (O2 -) production and serum malondialdehyde (MDA) level alongside attenuating antioxidant enzyme capacities in diabetic rats. This was associated with a significant increase in anigiotensin II type 1 receptor gene expression and TNF-α serum level of diabetic rats alongside reducing aortic eNOS gene expression and nitric oxide (NO) bioavailability. The single or combined administration of losartan and l-carnitine significantly inhibited these changes. Additionally, the vascular endothelium-dependent relaxation with acetylcholine (ACh) in aortic diabetic rat was significantly ameliorated by the single and combined administration of losartan or l-carnitine. Noteworthy, the combination therapy exhibited a more profound response over the monotherapy. Collectively, our results demonstrate that the combined therapy of losartan and l-carnitine affords additive beneficial effects against diabetes-associated endothelial dysfunction, possibly via normalizing the dysregulated eNOS and reducing the inflammation and oxidative stress in diabetic rats. © 2014 Elsevier B.V. All rights reserved.

Author Info:
aDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Egypt
bDepartment of Pharmacology, Faculty of Medicine, Assiut University, Egypt


Authors:
Taha AG1, Byrne RM2, Avgerinos ED2, Marone LK2, Makaroun MS2, Chaer RA3.

Title:
Comparative Effectiveness of Endovascular Versus Surgical Revascularization ‎for Acute Lower Extremity Ischemia‎

Abstract:
OBJECTIVE:
Thrombolysis and open surgical revascularization are current options for the treatment of acute limb ischemia (ALI). Despite the several randomized controlled trials comparing the two options, no single treatment can yet be recommended as a universal initial management of ALI. The purpose of this study was to evaluate contemporary endovascular and surgical revascularization for ALI.

METHODS:
Consecutive patients with ALI treated with endovascular revascularization (ER) or open revascularization (OR) between 2005 and 2011 were identified and reviewed. Procedural success and outcomes were compared between the two groups. Limb salvage and survival were assessed by time-to-event methods, including Kaplan-Meier estimation and competing-risks regression models.

RESULTS:
A total of 154 limbs were treated in 147 patients in the ER group, compared with 326 limbs in 296 patients in the OR group. The mean follow-up was 14 ± 18.5 months. The majority of patients presented with Rutherford II ischemia (83% for OR, 90% for ER). In Rutherford II patients, technical success was achieved in 90.7% of the OR group vs 79.9% of the ER group (P = .002), with amputation rates of 10.0% vs 7.2% (P = .35) at 30 days and 16.3% vs 13.0% (P = .37) at 1 year, respectively. In Rutherford II patients with failed bypass graft, technical success rate was 95.0% (OR) vs 75.0% (ER) (P = .001), whereas the amputation rate was 6.3% vs 15.38% (P = .13) at 30 days and 24.1% vs 23.1% (P = .90) at 1 year, respectively. The overall 30-day mortality rate was 13.2% (OR) and 5.4% (ER) (P = .012). Overall amputation rates were 13.5% (OR) vs 6.5% (ER) at 30 days (P = .023) and 19.6% (OR) vs 13.0% (ER) at 1 year (P = .074). The primary patency rate was 57% (OR) and 51% (ER) at 1 year (P = .74). Predictors of limb loss by life-table analysis included coronary artery disease (hazard ratio [HR], 2.0; P = .007) and Rutherford category III (HR, 19.0; P < .001). Predictors of death by life-table analysis included age (HR, 1.03; P < .001), end-stage renal disease (HR, 7.28; P < .001), cancer (HR, 1.65; P = .005), and chronic obstructive pulmonary disease (HR, 1.61; P = .005).

CONCLUSIONS:
In patients presenting with class II ALI, ER or surgical OR resulted in comparable limb salvage rates. Although technical success is higher with OR for patients presenting with failed bypass grafts, the amputation rates are comparable. Overall mortality rates are significantly higher at 30 days and 1 year in the OR group.

Author Info:
1
Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa; Department of Vascular Surgery, Assiut University, Assiut, Egypt.
2
Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
3
Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa. Electronic address: chaerra@upmc.edu.


Title:
Peripheral Pulmonary Artery Stenosis as a Cause of Pulmonary Hypertension ‎in Adults‎


Authors:
Tonelli, A.R.a,  Ahmed, M.K.a,b,  Alkukhun, L.a,  Cikach, F.a,  Aulak, K.a,  Dweik, R.A.a

Journal:
American Journal of Respiratory and Critical Care Medicine

Date of Publishing:
Volume 192, Issue 8, 15 October 2015, Pages 1014-1016

Title:
Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial ‎Hypertension‎

Author Info:
aCleveland Clinic, Cleveland, OH, United States
bAssiut University, Assiut, Egypt


Authors:
Tonelli, A.R.aEmail Author,  Alkukhun, L.a,  Cikach, F.b,  Ahmed, M.c,  Dweik, R.A.a

Date of Publishing:
Volume 22, Issue 4, 1 May 2015, Pages 249-256

Title:
Are Transcutaneous Oxygen and Carbon Dioxide Determinations of Value in ‎Pulmonary Arterial Hypertension?‎

Abstract:
Background: We hypothesized that transcutaneous gas determinations of O2 and CO2 (TcPO2 and TcPCO2) are associated with the severity of PAH. Methods: In this cross-sectional study, we included consecutive patients with PAH (group 1 PH; n = 34). Transcutaneous gas determinations were compared to those of age- and gender-matched healthy controls (n = 14), nongroup 1 PH (n = 19) or patients with high estimated RVSP on echocardiography but without hemodynamic evidence of PH (n = 12). Results: In patients with PAH, TcPO2, and TcPCO2 were significantly associated with PaO2 (R = 0.44, p = 0.03) and PaCO2 (R = 0.77, p < 0.001), respectively. TcPO2/FiO2 (mean difference: -65.0 [95% CI: -121.3, -8.7]) and TcPCO2 (mean difference: -7.4 [95% CI: -11.6, -3.1]) were significantly lower in patients with PAH than healthy controls. TcPCO2 was useful in discriminating PAH patients from other individuals (AUC: 0.74 [95% CI: 0.62, 0.83]). TcPO2/FiO2 ratio was significantly associated with mean PAP, TPG, PVR, CI, SVI, DLCO, six-minute walk distance and components of the CAMPHOR questionnaire. Conclusions: Transcutaneous pressure of CO2 was lower in patients with PAH. Transcutaneous pressure of O2 over inspired fraction of O2 ratio was inversely associated with severity of disease in patients with PAH. © 2015 John Wiley & Sons Ltd.

Author Info:
aDepartment of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
bCleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
cDepartment of Chest Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Wilson, S.J.a,bEmail Author,  Baxendale, S.c,  Barr, W.d,  Hamed, S.e,  Langfitt, J.f,  Samson, S.g,h,  Watanabe, M.i,  Baker, G.A.j,  Helmstaedter, C.k,  Hermann, B.P.l,  Smith, M.-L.m,n

Date of Publishing:
Volume 56, Issue 5, 1 May 2015, Pages 674-681

Title:
Indications and Expectations for Neuropsychological Assessment in Routine ‎Epilepsy Care: Report of the Ilae Neuropsychology Task Force, Diagnostic ‎Methods Commission, 2013-2017‎

Abstract:
The International League Against Epilepsy (ILAE) Diagnostic Methods Commission charged the Neuropsychology Task Force with the job of developing a set of recommendations to address the following questions: (1) What is the role of a neuropsychological assessment? (2) Who should do a neuropsychological assessment? (3) When should people with epilepsy be referred for a neuropsychological assessment? and (4) What should be expected from a neuropsychological assessment? The recommendations have been broadly written for health care clinicians in established epilepsy settings as well as those setting up new services. They are based on a detailed survey of neuropsychological assessment practices across international epilepsy centers, and formal ranking of specific recommendations for advancing clinical epilepsy care generated by specialist epilepsy neuropsychologists from around the world. They also incorporate the latest research findings to establish minimum standards for training and practice, reflecting the many roles of neuropsychological assessment in the routine care of children and adults with epilepsy. The recommendations endorse routine screening of cognition, mood, and behavior in new-onset epilepsy, and describe the range of situations when more detailed, formal neuropsychological assessment is indicated. They identify a core set of cognitive and psychological domains that should be assessed to provide an objective account of an individual's cognitive, emotional, and psychosocial functioning, including factors likely contributing to deficits identified on qualitative and quantitative examination. The recommendations also endorse routine provision of feedback to patients, families, and clinicians about the implications of the assessment results, including specific clinical recommendations of what can be done to improve a patient's cognitive or psychosocial functioning and alleviate the distress of any difficulties identified. By canvassing the breadth and depth of scope of neuropsychological assessment, this report demonstrates the pivotal role played by this noninvasive and minimally resource intensive investigation in the care of people with epilepsy. © Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Author Info:
aMelbourne School of Psychological Sciences, University of Melbourne, Austin Health, Melbourne, Australia
bComprehensive Epilepsy Program, Austin Health, Melbourne, Australia
cDepartment of Clinical and Experimental Epilepsy, UCL Institute of Neurology, NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
dDepartments of Neurology and Psychiatry, NYU School of Medicine, New York, United States
eDepartment of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
fDepartments of Neurology and Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
gEpilepsy Unit, La Pitié-Salpêtrière Hospital, Paris, France
hNeuropsychology and Auditory Cognition, University Lille-Nord de France, France
iDepartment of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
jUniversity Department of Neurosciences, Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
kDepartment of Epileptology, University of Bonn, Bonn, Germany
lDepartment of Neurology, University of Wisconsin, School of Medicine and Public Health, Madison, WI, United States
mDepartment of Psychology, University of Toronto Mississauga, Toronto, Canada
nNeurosciences and Mental Health Program, Hospital for Sick Children, Toronto, Canada


Authors:
Zahran, K.M.Email Author,  Ismail, A.M.,  Ali, M.K.,  Badran, E.Y.,  Khalil, M.M.,  Shazly, S.A.

Date of Publishing:
Volume 31, Issue 1, 1 February 2015, Pages 40-42

Title:
Advanced Abdominal Pregnancy: An Unexpected Late Pregnancy ‎Presentation‎

Abstract:
Background: Abdominal pregnancy is a rare form of ectopic gestation. Early diagnosis of this rare condition is difficult, owing to its atypical presentation and low index of suspicion. The characteristic history is that of abdominal pain, vaginal bleeding, and symptoms related to the gastrointestinal tract. These symptoms are occasionally overlooked, and the diagnosis is often missed. Case: A 20 year-old woman, gravida 2, para 0+1, 30 weeks' pregnant, presented with abdominal pain and absent foetal movements for 7 days. There was no history of pain prior to this episode, and she had no vaginal bleeding during pregnancy. She reported that she had regular antenatal care with 3 ultrasound scans confirming a normal pregnancy. On examination, the fetal position was transverse with easily palpable fetal parts. Fetal heart sounds were audible. Ultrasound examination revealed an unexpectedly empty uterus with a 30 week-old fetus and an extrauterine placenta. Magnetic resonance imaging (MRI) confirmed the previous findings. Laparotomy was performed to extract the fetus and the placenta. Results: The patient's postoperative course was uneventful, and she was discharged after 5 days. The neonate died after 2 weeks because of severe respiratory distress syndrome. Conclusions: Despite being very rare, abdominal pregnancy should be suspected regardless of gestational age. The presence of easily palpable fetal parts and an empty uterus should warrant the diagnosis. Good quality antenatal care is mandatory for early detection of this rare condition, Ultrasound examination remains the "gold standard" for initial diagnosis. However, MRI may be necessary to confirm the diagnosis. © Mary Ann Liebert, Inc. 2015.

Author Info:
Department of Obstetrics and Gynecology, Women's Health Hospital, Assiut University, Assuit University Street, Assiut, 71116, Egypt


