# Internationally Published Papers 2016

Authors:
Simis M1, Di Lazzaro V2, Kirton A3, Pennisi G4, Bella R4, Kim YH5, Takeuchi N6, Khedr EM7, Rogers LM8, Harvey R8, Koganemaru S9, Turman B10, Tarlacı S11, Gagliardi RJ12, Fregni F13.

Title:
Neurophysiological Measurements Of Affected And Unaffected Motor Cortex From A Cross-Sectional, Multi-Center Individual Stroke Patient Data Analysis Study.

Abstract:
OBJECTIVES:
Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers.

METHODS:
Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter "resting Motor Threshold (rMT)" was the main outcome and the demographic, anatomic and clinical characteristics were included as independent variables.

RESULTS:
The variable "severity of motor deficit" consistently remained significant in predicting rMT in the affected hemisphere, with a positive β coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between "age" or "time since stroke" and the rMT in the affected hemisphere were significant, as well as the interaction between "time since stroke" and "severity of motor deficit".

CONCLUSIONS:
We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation.

Author Info:
1
Harvard Medical School, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Laboratory of Neuromodulation, Boston, USA; Santa Casa Medical School, Division of Neurology, Sao Paulo, Brazil; University of Sao Paulo Medical School General Hospital, Physical and Rehabilitation Medicine Institute, Sao Paulo, Brazil.
2
Università Campus Biomedico, Institute of Neurology, Rome, Italy.
3
University of Calgary, Alberta Children's Hospital Research Institute, Calgary Pediatric Stroke Program, Calgary, Alberta, Canada.
4
University of Catania, Section of Neurosciences, Department GF Ingrassia, Catania, Italy.
5
Sungkyunkwan University, School of Medicine, Samsung Medical Center, Heart Vascular Stroke Institute, Department of Physical and Rehabilitation Medicine, Seoul, Republic of Korea.
6
Tohoku University Graduates School of Medicine, Department of Physical Medicine and Rehabilitation, Sendai, Japan.
7
Assiut University Hospital, Faculty of Medicine, Department of Neurology, Assiut, Egypt.
8
Rehabilitation Institute of Chicago, Sensory Motor Performance Program, Chicago, USA; Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Chicago, USA.
9
Kyoto University Graduate School of Medicine, Human Brain Research Center, Kyoto, Japan.
10
Bond University, School of Medicine, Robina, Australia.
11
Sifa University, Izmir, Turkey.
12
Santa Casa Medical School, Division of Neurology, Sao Paulo, Brazil.
13
Harvard Medical School, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Laboratory of Neuromodulation, Boston, USA. Electronic address: Fregni.Felipe@mgh.harvard.edu.


Authors:
Soliman MK1,2, Sarwar S1, Sadiq MA1, Jack L3, Jouvenat N4, Zabad RK4, Kedar S3,4, Nguyen QD1,3.

Title:
Acute Onset Of Fingolimod-Associated Macular Edema.

Abstract:
PURPOSE:
Fingolimod is among the first oral disease-modifying agents for the treatment of relapsing-remitting multiple sclerosis (MS). Despite its favorable safety profile, fingolimod may cause macular edema, a significant adverse event, which occurs within the first 4 months of therapy. Macular edema usually resolves upon discontinuation of fingolimod; however, the time required for resolution of this condition is unknown.

OBSERVATIONS:
A 42-year-old white male with a history of relapsing-remitting MS presented with blurring of vision in his left eye 24 h after the first dose of fingolimod. Dilated fundus examination of the left eye revealed an increased retinal thickness and mild optic disc pallor. Spectral domain optical coherence tomography (SD-OCT) confirmed the diagnosis of cystoid macular edema. Topical nonsteroidal anti-inflammatory drug (NSAID) was initiated immediately after the diagnosis, and fingolimod therapy was discontinued shortly thereafter. Seven weeks after the initial presentation, intermediate uveitis was noted in the inferior periphery of the left eye, and SD-OCT revealed worsening of macular edema. Acetazolamide therapy was added to the topical NSAID to control the edema. Three weeks after initiation of acetazolamide, macular thickness reduced significantly. The patient then stopped all medications, and 3 weeks later macular edema rebounded. Systemic steroid was employed to control both the intermediate uveitis and macular edema.

CONCLUSIONS AND IMPORTANCE:
We report a case of acute and very rapid onset of fingolimod-associated macular edema (FAME). Acetazolamide may have a beneficial effect on macular edema secondary to fingolimod. It is unclear if intermediate uveitis is associated with the rapid development of FAME.

Author Info:
1
Ocular Imaging Research and Reading Center, Omaha, NE, 68131, USA.
2
Department of Ophthalmology, Assiut University Hospital, Assiut University, Assuit, Egypt.
3
Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, 168198-5540, USA.
4
Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 168198, USA.


Authors:
Sur YJ1, Morsy M2, Mohan AT3, Zhu L4, Lachman N5, Saint-Cyr M6.

Title:
The First Perforating Branch Of The Deep Femoral Artery: A Reliable Recipient Vessel For Vascularized Fibular Grafts: An Anatomical Study.

Abstract:
INTRODUCTION:
Although the perforating branches of the deep femoral artery have been introduced as recipient vessels for vascularized fibular grafts in the treatment of osteonecrosis of the femoral head, comprehensive knowledge of the related anatomy is deficient. The aims of this study were to provide detailed anatomical data for the perforating branches of the deep femoral artery and validate their usefulness as recipient vessels for vascularized fibular grafts.

MATERIALS AND METHODS:
Anatomical dissection was performed on 11 fresh human cadaveric lower extremities. The number, locations, and diameters of the perforating branches were documented. The topographic relationships with the vastus ridge and the tendinous insertion of the gluteus maximus were clarified. The diameters of the perforating branches were compared with those of the ascending branch of the lateral circumflex femoral and the peroneal arteries.

RESULTS:
The mean number of perforating branches was 3.5. The mean distances from the vastus ridge to the first, second, and third perforating branches were 8.1, 13.7, and 20.4 cm, respectively. The first perforating branch was always located medial to the tendinous insertion of the gluteus maximus, whereas the second perforating branch was always located distal to the gluteus maximus. The mean diameters of the first, second, third, and fourth perforating branches were 3.1, 2.3, 1.6, and 1.2 mm, respectively. The mean diameters of the ascending branch of the lateral circumflex femoral and the peroneal arteries were 2.0 and 3.6 mm, respectively.

CONCLUSION:
The first perforating branch of the deep femoral artery is an appropriate alternative recipient vessel for vascularized fibular grafts in the treatment of osteonecrosis of the femoral head. It has a very consistent anatomy with a suitable location and diameter for anastomosis of the peroneal artery.

Author Info:
1
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea.
2
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Assiut University Hospital, Assiut, Egypt.
3
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Restoration of Appearance and Function Charitable Trust (RAFT), UK.
4
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital, Beijing, People's Republic of China.
5
Department of Anatomy, Mayo Clinic, Rochester, MN, USA.
6
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address: msaint-cyr@sw.org.


Authors:
Sur YJ1, Morsy M, Mohan AT, Zhu L, Michalak GJ, Lachman N, Laungani AT, van Alphen N, Saint-Cyr M.

Title:
Three-Dimensional Computed Tomographic Angiography Study of the Interperforator Flow of the Lower Leg.

Abstract:
BACKGROUND:
The area perfused by a single perforator depends on its perforasome and its unique interperforator flow pattern. The purpose of this study was to clarify the interperforator flow patterns of the peroneal and posterior tibial artery perforators using three-dimensional computed tomographic angiography.

METHODS:
Thirteen whole-leg skin flaps were harvested in the subfascial plane from fresh cadavers. Peroneal, posterior tibial, anterior tibial, and sural artery perforators with a diameter greater than 0.5 mm were documented. Three-dimensional computed tomographic angiography with an injection of iodinated contrast medium into the peroneal or posterior tibial artery perforator was used to investigate the percentages of the area and the perforators that were perfused.

RESULTS:
The mean percentage of the total area perfused was as follows: peroneal artery perforator, 42.0 percent; posterior tibial artery perforator, 38.0 percent (p = 0.084). The mean percentage of the total perforators perfused was as follows: peroneal artery perforator, 55.0 percent; posterior tibial artery perforator, 44.2 percent (p = 0.004). Although the mean percentages of same-source artery perforators perfused by a peroneal artery perforator (73.6 percent) and by a posterior tibial artery perforator (77.2 percent) did not differ (p = 0.513), the mean percentages of other-source artery perforators perfused by a peroneal artery perforator (49.9 percent) and by a posterior tibial artery perforator (32.3 percent) were significantly different (p < 0.001).

CONCLUSIONS:
This study demonstrated that a single peroneal or posterior tibial artery perforator perfused approximately 40 percent of the whole leg surface and that peroneal and posterior tibial artery perforators had different interperforator flow patterns. The results of this study may improve preoperative planning for pedicled perforator flap surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.

Author Info:
1
Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of ChinaFrom the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.


Authors:
Taha EA1, Sayed SK2, Gaber HD1, Abdel Hafez HK1, Ghandour N3, Zahran A4, Mostafa T5.
Author information

Title:
Does Being Overweight Affect Seminal Variables In Fertile Men?

Abstract:
The effect of being overweight on seminal variables was assesed in 165 fertile men. Participants were divided into three groups: fertile men with normal body mass index (BMI) (18.5-24.9 kg/m2), fertile overweight men (BMI 25-29.9 kg/m2) and fertile obese men (BMI >30 kg/m2). Medical history was taken, a clinical examination conducted. Semen analysis was undertaken and BMI measured. Seminal reactive oxygen species (ROS) was estimated by chemiluminescent assay, sperm vitality by the hypo-osmotic swelling test and sperm DNA fragmentation by propidium iodide staining with flowcytometry. Fertile obese men had significantly lower sperm concentration, progressive sperm motility and sperm normal morphology, with significantly higher seminal ROS and sperm DNA fragmentation compared with fertile normal-weight men and overweight men (all P < 0.05). BMI was negatively correlated with sperm concentration (r = -0.091; P = 0.014), progressive sperm motility (r = -0.697; P = 0.001), normal sperm morphology (r = -0.510; P = 0.001), sperm vitality (r = -0.586; P = 0.001), but positively correlated with sperm DNA fragmentation percentage (r = 0.799; P = 0.001) and seminal ROS (r = 0.673; P = 0.001). Increased BMI was found to affect semen parameters negatively even in fertile men.

Author Info:
1
Dermatology, Venereology and Andrology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
2
Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
3
Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
4
Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut 71515, Egypt.
5
Andrology and Sexology Department, Cairo University, Cairo 11562, Egypt. Electronic address: taymour1155@link.net.


Authors:
Tawfeek MS1, Raafat DM1, Saad K2, Idriss NK3, Sayed S4, Fouad DA5, El-Houfey AA6.

Title:
Plasma Levels Of Neutrophil Gelatinase-Associated Lipocalin In Children With Heart Failure.

Abstract:
INTRODUCTION:
Data about plasma levels of neutrophil gelatinase-associated lipocalin (NGAL) in children with heart failure (HF) are very limited. NGAL is used widely as a biomarker for the diagnosis of renal injury in numerous clinical studies. The aim of this study is to investigate the plasma NGAL in children with HF caused by idiopathic dilated cardiomyopathy (IDCM) and its relation to the severity of HF.

MATERIAL AND METHODS:
In a case-control study, 30 nondiabetic children, aged -16 years (all have IDCM) recruited from the pediatric department of our institute together with 30 healthy children were prospectively enrolled in this study. Patients underwent a detailed history taking, clinical examination, New York Heart Association (NYHA) class assessment and echocardiographic evaluation. Plasma levels of NGAL were measured by enzyme-linked immunosorbent assay.

RESULTS:
Plasma levels of NGAL were significantly higher in children with HF compared with healthy controls (mean: 290.97 versus 144.33, p < 0.0001). The relationship between NGAL and the severity of HF was investigated. However, we did not find any statistically significant relationship between plasma NGAL levels and indices of myocardial function.

CONCLUSIONS:
NGAL levels were significantly increased in children with HF caused by IDCM. However, there was no significant relationship between plasma NGAL levels and indices of myocardial function. Future multicenter clinical studies in a large population addressing the natural course of NGAL in HF and its potential as a treatment target are needed in the near future.

Author Info:
1
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
2
Associate Professor of Pediatrics, Faculty of Medicine, University of Assiut, Assiut 71516, Egypt khaled.ali@med.au.edu.eg ksaad8@yahoo.com.
3
Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.
4
Department of Anesthesiology, Faculty of Medicine, Assiut University, Assiut, Egypt.
5
Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt.
6
Department of Community Health Nursing, Assiut University, Assiut, Egypt.


Authors:
Tolba ME1,2, Huseein EA1, Farrag HM1,3, Mohamed Hel D1, Kobayashi S4, Suzuki J5, Ali TA6, Sugano S2.

Title:
Allovahlkampfia Spelaea Causing Keratitis In Humans.

Abstract:
BACKGROUND:
Free-living amoebae are present worldwide. They can survive in different environment causing human diseases in some instances. Acanthamoeba sp. is known for causing sight-threatening keratitis in humans. Free-living amoeba keratitis is more common in developing countries. Amoebae of family Vahlkampfiidae are rarely reported to cause such affections. A new genus, Allovahlkampfia spelaea was recently identified from caves with no data about pathogenicity in humans. We tried to identify the causative free-living amoeba in a case of keratitis in an Egyptian patient using morphological and molecular techniques.

METHODS:
Pathogenic amoebae were culture using monoxenic culture system. Identification through morphological features and 18S ribosomal RNA subunit DNA amplification and sequencing was done. Pathogenicity to laboratory rabbits and ability to produce keratitis were assessed experimentally.

RESULTS:
Allovahlkampfia spelaea was identified as a cause of human keratitis. Whole sequence of 18S ribosomal subunit DNA was sequenced and assembled. The Egyptian strain was closely related to SK1 strain isolated in Slovenia. The ability to induce keratitis was confirmed using animal model.

CONCLUSIONS:
This the first time to report Allovahlkampfia spelaea as a human pathogen. Combining both molecular and morphological identification is critical to correctly diagnose amoebae causing keratitis in humans. Use of different pairs of primers and sequencing amplified DNA is needed to prevent misdiagnosis.

Author Info:
1
Department of Parasitology, Faculty of Medicine, Assiut University, Assiut, Egypt.
2
Department of Medical Genomics, Graduate School of Frontier Sciences, The University of Tokyo, Minato-ku, Tokyo, Japan.
3
Faculty of Applied Medical Science, Shaqra University, Shaqra, Saudi Arabia.
4
Department of Infectious Diseases, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
5
Division of Clinical Microbiology, Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan.
6
Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.


Authors:
van Alphen NA1, Morsy M, Laungani AT, Kadar A, Vercnocke AJ, Lachman N, Ritman EL, Moran SL.

Title:
A Three-Dimensional Micro-Computed Tomographic Study of the Intraosseous Lunate Vasculature: Implications for Surgical Intervention and the Development of Avascular Necrosis.

Abstract:
BACKGROUND:
The purpose of this study was to use micro-computed tomography to demonstrate the intraosseous vascularity of the lunate within a three-dimensional orientation to identify areas of greatest perfusion and define vascular "safe zones" for surgical intervention.

METHODS:
Fourteen upper extremities were injected with a lead-based contrast agent. The lunates were harvested and scanned using a micro-computed tomography scanner. The intraosseous vascularity was incorporated into a three-dimensional image. Vessel number, diameter, distribution, and pattern were evaluated and analyzed. Vascularity of all specimens was projected onto one representative lunate to identity areas of higher and lower vascularity.

RESULTS:
Twelve specimens had nutrient vessels entering the bone from volar and dorsal; two specimens had no dorsal vessels. The intraosseous vascularity could be classified according to the Y, I, and X patterns described by Gelberman et al. Average number and diameter of vessels were 2.3 and 118.1 μm, respectively, for volar; and 1.4 and 135.8 μm, respectively, for dorsal. The long axis of the lunate showed the highest vascularity on both axial and lateral views. Lower vascularity was observed in the dorsoradial and volar-ulnar quadrants on the axial view, and in the proximal part on the lateral view. Lunate shape was not associated with an increase or decrease in nutrient vessels or vascular pattern.

CONCLUSIONS:
Vascular safe zones were identified, allowing for potentially safer surgical interventions to the lunate. Volar approaches to the lunate may result in localized ischemia in a subset of patients with absent dorsal nutrient vessels. This study may help to better define patients at risk for Kienböck disease.

Author Info:
1
Rochester, Minn.; and Assiut, Egypt From the Division of Plastic Surgery, Department of Surgery, the Departments of Physiology and Biomedical Engineering and Anatomy, Mayo Clinic; and the Department of Orthopedic Surgery, Assiut University Hospital, Assiut University.


Authors:
Widmer M1, Piaggio G2, Abdel-Aleem H3, Carroli G4, Chong YS5, Coomarasamy A6, Fawole B7, Goudar S8, Hofmeyr GJ9, Lumbiganon P10, Mugerwa K11, Nguyen TM12, Qureshi Z13, Souza JP14, Gülmezoglu AM12.

Title:
Room Temperature Stable Carbetocin For The Prevention Of Postpartum Haemorrhage During The Third Stage Of Labour In Women Delivering Vaginally: Study Protocol For A Randomized Controlled Trial.

Abstract:
BACKGROUND:
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality. We describe a randomized, double-blind non-inferiority trial comparing a newly developed room temperature stable formulation of carbetocin to the standard intervention (oxytocin) for the prevention of PPH after vaginal birth.

METHODS/DESIGN:
Approximately 30,000 women delivering vaginally will be recruited across 22 centres in 10 countries. The primary objectives are to evaluate the non-inferiority of room temperature stable carbetocin (100 μg intramuscular) versus oxytocin (10 IU intramuscular) in the prevention of PPH and severe PPH after vaginal birth. The primary endpoints are blood loss ≥500 mL or the use of additional uterotonics (composite endpoint required by drug regulatory authorities) and blood loss ≥1,000 mL (WHO requirement). Non-inferiority will be assessed using a two-sided 95 % confidence interval for the relative risk of the above endpoints for room temperature stable carbetocin versus oxytocin. The upper limit of the two-sided 95 % confidence interval for the relative risk for the composite endpoint of blood loss ≥500 mL or the use of additional uterotonics, and for the endpoint of blood loss ≥1,000 mL, will be compared to a non-inferiority margin of 1.16 and 1.23, respectively. If the upper limit is below the corresponding margin, non-inferiority will have been demonstrated. The safety analysis will include all women receiving treatment. Safety and tolerability will be assessed by a review of adverse events, by conducting inferential testing with significance levels for between-group comparisons.

DISCUSSION:
If the results of the study show that room temperature stable carbetocin is a safe and effective alternative to oxytocin, this could have a substantial impact on the prevention of postpartum haemorrhage and maternal survival worldwide.

TRIAL REGISTRATION:
ACTRN12614000870651 (14 August 2014).

Author Info:
1
Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Avenue Appia 20, Geneva, 1201, Switzerland. widmerm@who.int.
2
Medical Statistics deparment, London School of Hygiene and Tropical Medicine, London, UK.
3
Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.
4
Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
5
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Hospital Singapore, Singapore, Singapore.
6
Birmingham Women's NHS Foundation Trust, Birmingham, UK.
7
Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
8
Department of Medical Education, K L E Society's J N Medical College, Belgaum, India.
9
Effective Research Care Unit, University of Witwatersrand, University of Fort Hare, East London, South Africa.
10
Department of Obstetrics and Gynaecology, Khon Kaen University, Khon Kaen, Thailand.
11
Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
12
Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Avenue Appia 20, Geneva, 1201, Switzerland.
13
Department of Obstetrics and Gynaecology, Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya.
14
Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.


Authors:
Woodworth TG1, Suliman YA1,2, Li W1, Furst DE1, Clements P1.

Title:
Scleroderma Renal Crisis And Renal Involvement In Systemic Sclerosis.

Abstract:
Scleroderma renal crisis (SRC) is a rare, potentially life-threatening complication that affects 2-15% of patients with systemic sclerosis (SSc, also known as scleroderma). SRC typically presents in patients with early, rapidly progressive, diffuse cutaneous SSc within the first 3-5 years after the onset of a non-Raynaud sign or symptom. SRC is characterized by an acute, usually symptomatic increase in blood pressure, a rise in serum creatinine levels, oliguria and thrombotic microangiopathy in about 50% of patients. The prognosis of SRC substantially improved in the 1980s with the introduction of angiotensin-converting-enzyme inhibitors for rapid blood pressure control, with additional antihypertensive agents as required. However, the survival of patients with SRC can still be improved. Current patient survival is 70-82% at 1 year, but decreases to 50-60% at 5 years despite dialysis support. Patients with SRC who show no signs of renal functional recovery despite timely blood pressure control are candidates for transplantation. In this Review, we discuss progress made in the identification and proactive management of patients at risk of SRC and make recommendations aimed at optimizing management for those who progress to chronic kidney failure.

Author Info:
1
Division of Rheumatology, David Geffen School of Medicine, University of California, 100 Veterans Avenue, Los Angeles, California 90025, USA.
2
Rheumatology and Rehabilitation Department, Assiut University Hospital, Assiut, Egypt.


Title:
Chemical Composition And Efficacy Of Some Selected Plant Oils Against Pediculus Humanus Capitis In Vitro.

Abstract:
Natural compounds have been suggested as alternative sources for pediculosis capitis control. We aimed to investigate the chemical composition and evaluate the pediculicidal activity of spearmint, clove, cassia, thyme, eucalyptus, and anise essential oils in addition to sesame oil against human head lice in vitro. A filter paper contact bioassay method was used by applying 0.25 and 0.5 mg/cm(2) of each tested oil to filter paper in Petri dishes with 15 females head lice and another with ten nits. The lice mortalities were reported every 5 min for 180 min. The percentage of inhibition of hatch (PIH) was used to calculate ovicidal activity by daily microscopic inspections 5 days after the hatching of controls. Comparison with the widely used pediculicide (malathion) was performed. The most effective essential oil was spearmint followed by cassia and clove with KT50 values of 4.06, 7.62, and 12.12 at 0.5 mg/cm(2) and 8.84, 11.38, and 19.73 at 0.25 mg/cm(2), respectively. Thyme, eucalyptus, and anise were also effective adulticides with KT50 values of 18.61, 32.65, and 37.34 at 0.5 mg/cm(2) and 29.92, 43.16, and 45.37 at 0.25 mg/cm(2), respectively. Essential oils were also successful in inhibiting nymph emergence. Spearmint oil was the most effective, with a complete inhibition of emergence at 0.5 mg/cm(2). Sesame fixed oil did not show any adulticidal or ovicidal activity against head lice in vitro. The observed insecticidal activity was comparable to malathion. The results herein described the effectiveness of these essential oils as potential pediculicides for head lice control. Incorporation of essential oils in pediculicide formulations needs proper formulation and clinical trials.

Author Info:
1
Parasitology Department, Faculty of Medicine, Assiut University, Assiut, 71526, Egypt. doaayones@gmail.com.
2
Parasitology Department, Faculty of Medicine, Assiut University, Assiut, 71526, Egypt.
3
Pharmacognosy Department, Faculty of Pharmacy, Assiut University, Assiut, 71526, Egypt.


Authors:
Yones DA1, Badary DM2, Sayed HM3, Bayoumi SA3, Khalifa AA3, El-Moghazy AM3.

Title:
Comparative Evaluation of Anthelmintic Activity of Edible and Ornamental Pomegranate Ethanolic Extracts against Schistosoma mansoni.

Abstract:
Due to the development of praziquantel (PZQ) schistosomes resistant strains, the discovery of new antischistosomal agents is of high priority in research. This work reported the in vitro and in vivo effects of the edible and ornamental pomegranate extracts against Schistosoma mansoni. Leaves and stem bark ethanolic extracts of both dried pomegranates were prepared at 100, 300, and 500 μg/mL for in vitro and 600 and 800 mg/kg for in vivo. Adult worms Schistosoma mansoni in RPMI-1640 medium for in vitro and S. mansoni infected mice for in vivo tests were obtained from Theodor Bilharz Research Institute, Cairo, Egypt. In vitro activity was manifested by significant coupled worms separation, reduction of motor activity, lethality, and ultrastructural tegumental alterations in adult worms. In vivo activity was manifested revealed by significant reduction of hepatic granulomas number and diameter, decreased number of bilharzial eggs in liver tissues, lowered liver inflammatory infiltration, decreased hepatic fibrosis, and inducible nitric oxide synthase (iNOS) expression. Ethanolic stem bark extract of edible pomegranate exhibited highest antischistosomal activities both in vitro and in vivo. Therefore, pomegranate showed a good potential to be used as a promising new candidate for the development of new schistosomicidal agents.

Author Info:
1
Parasitology Department, Faculty of Medicine, Assiut University, Assiut 71526, Egypt.
2
Pathology Department, Faculty of Medicine, Assiut University, Assiut 71526, Egypt.
3
Pharmacognosy Department, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt.


Authors:
Yosef A1, Allaire C2, Williams C2, Ahmed AG3, Al-Hussaini T3, Abdellah MS3, Wong F2, Lisonkova S2, Yong PJ4.

Title:
Multifactorial Contributors To The Severity Of Chronic Pelvic Pain In Women.

Abstract:
BACKGROUND:
Chronic pelvic pain affects ∼15% of women, and is associated with significant societal cost and impact on women's health. Identifying factors involved in chronic pelvic pain is challenging due to its multifactorial nature and confounding between potential factors. For example, while some women with endometriosis have chronic pelvic pain, there may be comorbid conditions that are implicated in the chronic pelvic pain rather than the endometriosis itself.

OBJECTIVE:
We sought to explore multifactorial variables independently associated with the severity of chronic pelvic pain in women.

STUDY DESIGN:
We used baseline cross-sectional data from an ongoing prospective cohort, collected from patient online questionnaires, physical examination, and physician review of medical records. Participants were recruited from a tertiary referral center for endometriosis and chronic pelvic pain in Vancouver, British Columbia, Canada, from December 2013 through April 2015. Exclusion criteria included menopausal status or age >50 years. Primary outcome was self-reported severity of chronic pelvic pain in the last 3 months (0-10 numeric rating scale). Potential associated factors ranged from known pain conditions assessed by standard diagnostic criteria, validated psychological questionnaires, musculoskeletal physical exam findings, as well as pain-related, reproductive, medical/surgical, familial, demographic, and behavioral characteristics. Mann-Whitney, Kruskal-Wallis, or Spearman test were used to identify variables with an association with the primary outcome (P < .05), followed by multivariable linear regression to control for confounding and to identify independent associations with the primary outcome (P < .05).

RESULTS:
Overall, 656 women were included (87% consent rate), of whom 55% were diagnosed with endometriosis. The following factors were independently associated with higher severity of chronic pelvic pain: abdominal wall pain (P = .005), pelvic floor tenderness (P = .004), painful bladder syndrome (P = .019), higher score on Pain Catastrophizing Scale (P < .001), adult sexual assault (P = .043), higher body mass index (P = .023), current smoking (P = .049), and family history of chronic pain (P = .038). Severity of chronic pelvic pain was similar between women with and without endometriosis.

CONCLUSION:
Multifactorial variables independently associated with severity of chronic pelvic pain were identified, ranging from myofascial/musculoskeletal, urological, family history, and psycho-social factors. Continued research is required to validate these factors and to determine whether any are potentially modifiable for the management of chronic pelvic pain.

Author Info:
1
Department of Obstetrics and Gynecology, University of British Columbia, Women's Health Research Institute, BC Women's Hospital and Health Center, Vancouver, British Columbia, Canada; Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
2
Department of Obstetrics and Gynecology, University of British Columbia, Women's Health Research Institute, BC Women's Hospital and Health Center, Vancouver, British Columbia, Canada.
3
Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
4
Department of Obstetrics and Gynecology, University of British Columbia, Women's Health Research Institute, BC Women's Hospital and Health Center, Vancouver, British Columbia, Canada. Electronic address: paul.yong@vch.ca.


Authors:
Yousef SA1, AbdelRahim KA2,3, Ahmed AO4, Almaary KS5, Mohamed AM1.

Title:
Diagnosis of Pulmonary Tuberculosis and Detection of Resistance to Rifampin and Isoniazid through Direct Molecular Methods in Stool Samples.

Abstract:
BACKGROUND:
Tuberculosis (TB) is an infectious disease that is caused by Mycobacterium tuberculosis (M.tb). TB has high morbidity and mortality around the world.

OBJECTIVE:
To evaluate molecular-based methods performed directly on stool samples for the diagnosis of pulmonary tuberculosis (PTB) and to determine the susceptibility to Rifampicin (RMP) and Isoniazid (INH).

STUDY DESIGN:
This is a descriptive study evaluating the performance of the PCR-based method for direct PTB diagnosis and to determine the susceptibility of RMP and INH using stool samples from PTB patients. The study was conducted between March 2011 and March 2014.

METHODS:
Three stool samples and three sputum samples (n=300 stool and 300 sputum) were collected from 100 PTB patients (75 pretreatment and 25 follow up). Stool samples (n=60) were also collected from 20 healthy individuals to serve as controls. DNA was extracted from stool samples using Chelex®-100. PTB was diagnosed using a Genekam® kit. RMP and INH susceptibility testing was performed using the Genotype MTBDRplus® assay. The sputum Lowenstein Jensen (LJ) culture and agar proportion method (PM) of drug susceptibility testing for INH and RMP were considered to be the gold standard methods for comparing the results of the molecular methods.

RESULTS:
The Genekam kit showed 100% sensitivity and 95.24% specificity for diagnosing new patients and showed 100% sensitivity and 80% specificity for follow-up patients. The Genotype MTBDR-plus assay showed 86.4% and 100% sensitivity and 98.1% and 97.8% specificity for determining INH and RMP sensitivity, respectively, in newly diagnosed patients and 85.7% and 94.4% sensitivity and specificity, respectively, for both INH and RMP in follow-up patients.

CONCLUSION:
Molecular-based methods are promising techniques for the diagnosis and susceptibility testing of PTB when the ease of sample collection and the speed of diagnosis are taken into consideration. However, they are not as useful for assessing follow-up patients.

Author Info:
1
Department of Medical Laboratory Technology, College of Applied Medical Science, University of Hafr Albatin, Hafr Al Batin, Saudi Arabia.
2
Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia kabdelraheem@ksu.edu.sa khalidfp7@gmail.com.
3
Botany Department, Faculty of Science, Sohag University, Sohag, Egypt.
4
Department of Clinical Pathology, Clinical Microbiology Unit, Faculty of Medicine, Assiut University Hospital, Egypt.
5
Botany and Microbiology Department, College of Science, King Saud University, Riyadh, Saudi Arabia.


Authors:
Zahran AM1, Elsayh KI, Mohamad IL, Hassan GM, Abdou MA.

Title:
Circulating Endothelial Cells and Endothelial Progenitor Cells in Pediatric Sepsis.

Abstract:
OBJECTIVES:
The aim of the study was to measure the number of circulating endothelial cells (CECs) and circulating endothelial progenitor cells (CEPs) in pediatric patients with sepsis and correlating it with the severity of the disease and its outcome.

METHODS:
The study included 19 children with sepsis, 26 with complicated sepsis, and 30 healthy controls. The patients were investigated within 48 hours of pediatric intensive care unit admission together with flow cytometric detection of CECs and CEPs.

RESULTS:
The levels of both CECs and CEPs were significantly higher in patient with sepsis and complicated sepsis than the controls. The levels of CECs were higher in patients with complicated sepsis, whereas the levels of CEPs were lower in patients with complicated sepsis. Comparing the survival and nonsurvival septic patients, the levels of CEPs were significantly higher in the survival than in nonsurvival patients, whereas the levels of CECs were significantly lower in the survival than in nonsurvival patients. Serum albumin was higher in survival than in nonsurvival patients.

CONCLUSIONS:
Estimation of CECs and CEPs and their correlation with other parameters such as serum albumen could add important information regarding prognosis in septic pediatric patients.

Author Info:
1
From the *Oncological Clinical Pathology Department, South Egypt Cancer Institute, Assiut University; †Pediatric Department, Assiut University Children Hospital, Assiut, Egypt; ‡King Saud University, Riyadh, Saudi Arabia; and §Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.


Authors:
Zahran AM1, Elsayh KI2, Saad K3, Eloseily EM2, Osman NS2, Alblihed MA4, Badr G5, Mahmoud MH6,7.

Title:
Effects Of Royal Jelly Supplementation On Regulatory T Cells In Children With SLE.

Abstract:
BACKGROUND AND OBJECTIVE:
To our knowledge, no previous studies have focused on the immunomodulatory effects of fresh royal jelly (RJ) administration on systemic lupus erythematosus (SLE) in humans. Our aim was to study the effect of fresh RJ administration on the disease course in children with SLE with some immunological markers (CD4+ and CD8+ regulatory T cells and T lymphocytes apoptosis).

METHODS:
This was an open-label study in which 20 SLE children received 2 g of freshly prepared RJ daily, for 12 weeks.

RESULTS:
The percentages of CD4+ CD25+high FOXP3+cells (CD4+ regulatory T cells) and CD8+CD25+high FOXP3+cells (CD8+ regulatory T cells) were significantly increased after RJ treatment when compared with baseline values. Apoptotic CD4 T lymphocytes were significantly decreased after RJ therapy when compared with baseline values and the control group.

CONCLUSION:
This is the first human study on the effect of RJ supplementation in children with SLE. Our results showed improvements with 3-month RJ treatment with regard to the clinical severity score and laboratory markers for the disease. At this stage, it is a single study with a small number of patients, and a great deal of additional wide-scale randomized controlled studies are needed to critically validate the efficacy of RJ in SLE.

Author Info:
1
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
2
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
3
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt; ksaad8@yahoo.com; khaled.ali@med.au.edu.eg.
4
Medical Biochemistry Department, College of Medicine, Taif University, Taif, Kingdom of Saudi Arabia.
5
Zoology Department, Laboratory of Immunology & Molecular Physiology, Faculty of Science, Assiut University, Assiut, Egypt.
6
Deanship of Scientific Research, King Saud University, Riyadh, Kingdom of Saudi Arabia.
7
Food Science and Nutrition Department, National Research Center, Dokki, Cairo, Egypt.


Authors:
Zahran AM1, Elsayh KI2, Saad K3, Embaby M2, Ali AM2.

Title:
Regulatory B Cells (CD19(+)CD38(hi)CD24(hi)) in Alloimmunized And Non-Alloimmunized Children With β-Thalassemia Major.

Abstract:
BACKGROUND:
β-Thalassemia major (BTM) is considered the most common hemoglobinopathy in Egypt and is one of the major health problems in our locality.

MATERIALS & METHODS:
We investigated the frequency of B-regulatory cells (CD19(+)CD38(hi)CD24(hi)); (Bregs) among polytransfused alloimmunized and non-alloimmunized children with BTM. The study included 110 polytransfused pediatric patients with β-thalassemia major. Clinical and transfusion records of all studied patients were reviewed. Indirect antiglobulin test was performed to detect the presence of alloantibodies. We used flow cytometry for detection of CD19(+)CD38(hi)CD24(hi) regulatory B cells.

RESULTS:
Alloimmunization was detected in 35.5% of thalassemic patients (39/110). The analysis of our data showed a significantly higher frequency of Bregs (CD19(+)CD38(hi)CD24(hi)) in the peripheral blood of both alloimmunized and non-alloimmunized patients as compared to healthy controls.

CONCLUSIONS:
Our data showed that the frequencies of CD19(+)CD24(hi)CD38(hi) Bregs cells were significantly increased in children with BTM. Our data suggested that Bregs cells could play a role in the clinical course of BTM. The relationship of Bregs to immune disorders in BTM children remains to be determined. Further longitudinal study with a larger sample size is warranted to explore the mechanisms of Breg cells in the disease process in BTM patients.

Author Info:
1
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Egypt.
2
Pediatric Department, Faculty of Medicine, Assiut University, Egypt.
3
Pediatric Department, Faculty of Medicine, Assiut University, Egypt. Electronic address: ksaad8@yahoo.com.


Authors:
Abdel Azeem, N.E.a,  Attallah, D.A.aEmail Author,  Hussein, A.A.b,  Alzzubidi, N.A.S.a

Date of Publishing:
Volume 13, Issue 3, 1 September 2016, Pages 129-132

Title:
The Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism of ‎Vitiligo in a Population in Upper Egypt: A Hospital-Based Study‎

Abstract:
Background Vitiligo is an acquired depigmentary disorder resulting from the loss of functional melanocytes and melanin from the skin. The causes of the nonfunctional effects on melanocytes remain unclear. There is considerable evidence that genes play a significant role in the pathogenesis of vitiligo. A few genes have been reported to contribute toward susceptibility to vitiligo. One of these is the angiotensin-converting enzyme (ACE) gene. Objective To investigate the distribution of the ACE genotype in vitiligo patients in upper Egypt to examine whether the insertion (I) and deletion (D) of the ACE polymorphism confers susceptibility to vitiligo. Patients and methods A total of 100 Egyptian vitiligo patients (36 men and 64 women, age range 10-70 years), and 100 age-matched and sex-matched healthy control participants were enrolled in this study; they were subjected to an ACE gene polymorphism analysis. Results There was a significant difference in the percentage of D/D, I/D, and I/I genotypes between the control group and the vitiligo patients, with P less than 0.001 for each. The frequencies of both D and I alleles for the ACE genetic marker were significantly different between the control and patient populations (P<0.001). Genotype distribution and frequencies of D and I alleles did not show significant differences between vitiligo patients with and without other autoimmune diseases (P=0.755, 0.860, 0.299, respectively). Conclusion The ACE gene can be a susceptible gene in Egyptian vitiligo patients and the increased risk of developing vitiligo is associated with the D/D genotype. © 2016 Egyptian Women's Dermatologic Society.

Author Info:
aDepartment of Dermatology, Faculty of Medicine, Assiut University Hospital, Assiut, 71526, Egypt
bDepartment of Animal Hygiene, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt


Authors:
Abdel-Wahab, B.A.aEmail Author,  Abdel-Wahab, M.M.b

Title:
Protective Effect of Resveratrol against Chronic Intermittent Hypoxia-‎Induced Spatial Memory Deficits, Hippocampal Oxidative Dna Damage and ‎Increased P47phox Nadph Oxidase Expression in Young Rats‎

Abstract:
Long-term intermittent hypoxia (IH) is a characteristic hallmark of obstructive sleep apnea (OSA) and causes most of the neurological aspects of OSA, such as spatial memory and learning deficits. These deficits are accompanied by an increase in oxidative stress and inflammation in brain areas involved in cognition, such as the hippocampus, particularly in children. Resveratrol is a natural polyphenolic compound with potent antioxidant, anti-inflammatory and neuroprotective properties. Aim: The aim of this work is to study the possible protective effect of resveratrol against IH-induced neurobehavioral deficits and to investigate the possible mechanism of this protective effect in the young rat model of OSA. Methods: The effect of resveratrol (5 and 10 mg/kg, orally) on anxiety, spatial memory and learning deficits in young rats exposed to IH for 6 weeks and the corresponding biochemical changes were studied. Results: Resveratrol attenuated IH-induced anxiety and spatial memory deficits, as indicated by the elevated plus maze and Morris water maze tests, respectively, in a dose-dependent manner. In addition, resveratrol antagonized IH-induced increases in hippocampal glutamate, TBARS and 8-OHdG levels and p47Phox expression and decreases in GSH levels and GSH-Px activity in the hippocampus of IH-exposed young rats. Conclusion: Resveratrol ameliorates IH-induced anxiety and spatial learning deficits through multiple beneficial effects on hippocampal oxidative pathways that involve decreased expression of the p47Phox subunit of NADPH oxidase. Hence, the potential therapeutic role of resveratrol in OSA may be utilized in the near future and deserves further exploration. © 2016 Elsevier B.V..

Author Info:
Department of Pharmacology, College of Medicine, Assiut University, Assiut, Egypt
bDepartment of Biochemistry and Molecular Biology, Fayoum University, Fayoum, Egypt


Authors:
Abdelhafez, M.A.H.a,cEmail Author,  El-Chilali, K.a,  Plicht, B.a,  Lind, A.a,  Abd Al Rahman, H.c,  Youssef, A.c,  Demitry, S.R.c,  Nensa, F.b,  Schlosser, T.b,  Kahlert, P.a,  Erbel, R.a

Date of Publishing:
Volume 68, Issue 3, 1 September 2016, Pages 153-158

Title:
Infarct Size Assessment by Cardiac Magnetic Resonance and Peak ‎Troponin I after Aspiration Thrombectomy and Intracoronary Abciximab ‎Assisted Primary Percutaneous Coronary Intervention in a Real-World ‎Cohort of Patients with St-Segment Elevation Myocardial Infarction: A ‎Single-Center Study‎

Abstract:
Objectives To assess the effect of manual thrombectomy on infarct size by cardiac magnetic resonance (CMR) and peak troponin I (TnI) levels. Background Use of manual thrombectomy during primary percutaneous coronary intervention (primary PCI) and its effect on infarct size is still debatable. Methods 70 patients (30 patients with thrombectomy and 40 without) who underwent primary PCI for ST-elevation myocardial infarction (STEMI) with adjunct intracoronary abciximab between January 2007 and August 2013 and had CMR afterwards were included. Results No significant difference in the baseline characteristics except for a higher baseline TnI (11.6 ± 16.7 vs. 2.4 ± 7.9, P = 0.009) and more visible thrombus and or TIMI 0 flow (P = 0.04) in the thrombectomy group. No significant difference was found in infarct size assessed by CMR (18.1 ± 13.2 vs. 16.45 ± 11.7, P = 0.6) or peak TnI (75.9 ± 126 vs. 51.3 ± 50.4, P = 0.26) between the two groups. A moderate positive correlation was found between Peak as well as TnI at 24 hours (TnI-24 h) and CMR-determined infarct size (r = 0.5 and r = 0.7 respectively, P < 0.001). TnI-24 h (B = 0.152, 95.0% Confidence Interval (CI) 0.116–0.187, P < 0.001) as well as final TIMI grade (B = −10,848, 95.0% CI −15.109 to −6.587, P < 0.001) predicts infarct size. Conclusions In a retrospective real world cohort of patients with STEMI, no difference was found in infarct size assessed by CMR or peak TnI between the groups with and without thrombectomy. TnI-24 h as well as final TIMI flow predicts infarct size. © 2016 Egyptian Society of Cardiology

Author Info:
aWest German Heart and Vessels Center Essen, Department of Cardiology, Germany
bDepartment of Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital, University Duisburg-Essen, Germany
cDepartment of Cardiology, Assiut University, Assiut, Egypt


Authors:
bubeih, H.M.A.Email Author,  Badran, M.,  El-Assal, M.

Title:
Fallen End Cap of Retrograde Femoral Nail inside the Knee Joint: A Case ‎Report‎

Author Info:
Orthopaedic Department, Assiut University Hospitals, Assiut, 71515, Egypt


Authors:
Abubeih, H.M.A.Email Author,  Saleh, W.R.,  Thabet, M.A.,  Ibrahim, A.-K.H.

Title:
Extensor Tendon Splitting Versus Extensor Tendon Sparing Approach for ‎Miniplate Fixation of Extraarticular Proximal Phalangeal Fractures‎

Abstract:
Background: Unstable phalangeal fractures constitute a challenge for surgeons with many options for operative treatment. Miniplate fixation of these fractures has the advantages of stability and neutralization of bending, rotational, and shear forces. To our knowledge, this is the first study to compare the functional results of an extensor tendon splitting approach with an extensor tendon sparing approach in extraarticular proximal phalangeal fractures fixed with a miniplate and screws. Methods: In a randomized prospective study we compared two groups of patients: group A, patients treated with an extensor tendon splitting approach (24 fractures in 21 patients with average age 31.9 yr) and group B, patients treated with an extensor tendon sparing approach (26 fractures in 19 patients with average age 30.8 yr). The final results were assessed with total active range of motion (TAM), grade of TAM, grip strength and Quick Disability of the Arm, Shoulder, and Hand (DASH) Score. Results: A TAM of 220 degrees or more was achieved in 79.2% (19/24) and 84.6% (22/26) of fractures in group A and B, respectively. There was a significant reduction in grip strength in group A compared to group B (45.9 ± 8.4 kg vs. 51.7 ± 7.3 kg; P<0.025). Other parameters showed slightly better results in group B compared with group A but the differences were statistically insignificant in regard to time to union (5.3+1wk vs. 5.6+1.1wk), TAM (226.8+18.4 degrees vs. 233.2+17.5 degrees), grading of TAM(excellent score 75% vs. 80.8%) and QuickDASH score (12 ± 9.2 vs. 11.5 ± 8.3). Conclusions: Meticulous surgical dissection, anatomical closure of layers, and early active mobilization are the keys to success in fixation of phalangeal fractures, regardless of the approach chosen. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Author Info:
Orthopaedic Department, Assiut University Hospitals, PO Box 71526, Assiut, Egypt


Authors:
Ahmed, S.S.a,b,  Wang, X.N.a,b,  Norden, J.a,  Pearce, K.a,  El-Gezawy, E.a,c,  Atarod, S.a,  Hromadnikova, I.d,  Collin, M.a,  Holler, E.e,  Dickinson, A.M.a,b

Date of Publishing:
Volume 51, Issue 6, 1 June 2016, Page 890

Title:
Erratum: Identification and Validation of Biomarkers Associated with Acute ‎and Chronic Graft Versus Host Disease ‎

Author Info:
aHaematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
bAlcyomics Ltd, Newcastle-upon-Tyne, United Kingdom
cClinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
dThird Faculty of Medicine, Charles University, Prague, Czech Republic
eRegensburg University Hospital, Department of Hematology and Oncology, Regensburg, Germany


Authors:
Ahmed, T.A.N.aEmail Author,  Hassan, A.K.M.a,  Othman, M.H.M.b,  Hasan-Ali, H.a,  Dimitry, S.R.a,  Kishk, Y.T.a

Date of Publishing:
Volume 68, Issue 4, 1 December 2016, Pages 261-269

Title:
Novel Strategy in Endovascular Treatment of Coronary Steal Using ‎Histoacryl®‎

Abstract:
Background Coronary steal is an often encountered clinical condition attributable to multiple etiologies. Diverse treatment modalities have been previously elucidated. Aim To elucidate the potential role of interventional approach using N-butyl Cyanoacrylate (Histoacryl®) to treat coronary steal. Material and methods We present four patients with coronary steal due to different causes. Three patients had coronary arterial fistulas, and the fourth patient underwent prior Coronary Artery Bypass Graft (CABG) surgery with a patent unligated Left Internal Mammary Artery (LIMA) side-branch. We report the attempted trans-catheter closure of the fistulas and LIMA side-branch using n-butyl cyanoacrylate as an embolic agent. Results In our series, Coronary angiography was the imaging modality used for diagnosing and guiding the treatment of all cases. Multi-detector CT was used to track the pathway and termination of the fistula in one case only. From the three fistula cases, two originated from the left anterior descending (LAD) coronary artery and one from the left circumflex (LCX) coronary artery. We accomplished successful occlusion in two of the three fistula cases and in the LIMA side-branch case as well. Conclusion N-butyl Cyanoacrylate (Histoacryl®) is a useful interventional embolic agent that could be used to treat coronary steal of diverse etiology. © 2016 Egyptian Society of Cardiology

Author Info:
aDepartment of Cardiovascular Medicine, Assiut University Hospital, Assiut, Egypt
bDepartment of Radiology, Assiut University Hospital, Assiut, Egypt


Authors:
Al Azhary, N.M.a,bEmail Author,  Kamel, M.M.b,  Ismail, Y.M.c,  Mahmoud, A.A.d,  Radwan, E.M.b

Journal:
Asian Pacific Journal of Cancer Prevention

Date of Publishing:
Volume 17, Issue 11, November 2016, Pages 4945-4949

Title:
The Role of Genetic Polymorphisms in Nrf2 and P73 in Egyptian Women ‎with Breast Cancer‎

Abstract:
Background: Breast cancer is the commonest cancer in Egyptian females. Nrf2 is involved in oxidative stress while P73 functions in response to DNA damage. This study aimed to assess the role of Nrf2 promoter and P73 G4C14 to A4T14 SNPs in breast cancer in Egypt. Patients: Eighty-five female patients with breast tumours (41 malignant, 44 benign) were included. Nrf2 (rs6721961) and p73 (G4A) SNPs were determined by PCR- CTPP assay. Results: Genotype frequencies of the Nrf2 promoter SNP were 34.2% and 37.9% for AA in benign and malignant groups respectively, and 43.9% and 40.5% for CC and, 21.9 % and 21.6% for CA. Genotype frequencies for the P73 G4A SNP were 52.9% and 44.7% for GA in benign and malignant groups respectively, and 47.1% and 55.3% for GG. Discussion: Nrf2 genotypes in pre - and post-menopausal patients, showed significantly different distributions in the 2 patient groups, the AA genotype being significantly more common in pre-menopausal patients. The P73 G4A SNP showed no relation to age of disease onset. Conclusion: The Nrf2 (rs6721961) AA genotype might be related to early breast cancer onset. In contrast the P73 G4A polymorphism showed no relation to either disease risk or age at presentation. © Asian Pacific Organization for Cancer Prevention.

Author Info:
aBiochemistry and Molecular Medicine Department, College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
bDepartment of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
cDepartment of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
dClinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Al-Shamsi, H.O.a,b,cEmail Author,  Jones, J.d,  Fahmawi, Y.a,  Dahbour, I.a,  Tabash, A.a,  Abdel-Wahab, R.a,e,  Abousamra, A.O.S.a,  Shaw, K.R.c, Xiao, L.a,  Hassan, M.M.a,  Kipp, B.R.f,  Kopetz, S.a,  Soliman, A.S.g,  McWilliams, R.R.d,  Wolff, R.A.a

Title:
Molecular Spectrum of Kras, Nras, Braf, Pik3ca, Tp53, and Apc Somatic ‎Gene Mutations in Arab Patients with Colorectal Cancer: Determination of ‎Frequency and Distribution Pattern‎

Abstract:
Background: The frequency rates of mutations such as KRAS, NRAS, BRAF, and PIK3CA in colorectal cancer (CRC) differ among populations. The aim of this study was to assess mutation frequencies in the Arab population and determine their correlations with certain clinicopathological features. Methods: Arab patients from the Arab Gulf region and a population of age- and sex-matched Western patients with CRC whose tumors were evaluated with next-generation sequencing (NGS) were identified and retrospectively reviewed. The mutation rates of KRAS, NRAS, BRAF, PIK3CA, TP53, and APC were recorded, along with clinicopathological features. Other somatic mutation and their rates were also identified. Fisher's exact test was used to determine the association between mutation status and clinical features. Results: A total of 198 cases were identified; 99 Arab patients and 99 Western patients. Fifty-two point seven percent of Arab patients had stage IV disease at initial presentation, 74.2% had left-sided tumors. Eighty-nine point two percent had tubular adenocarcinoma and 10.8% had mucinous adenocarcinoma. The prevalence rates of KRAS, NRAS, BRAF, PIK3CA, TP53, APC, SMAD, FBXW7 mutations in Arab population were 44.4%, 4%, 4%, 13.1%, 52.5%, 27.3%, 2% and 3% respectively. Compared to 48.4%, 4%, 4%, 12.1%, 47.5%, 24.2%, 11.1% and 0% respectively in matched Western population. Associations between these mutations and patient clinicopathological features were not statistically significant. Conclusions: This is the first study to report comprehensive hotspot mutations using NGS in Arab patients with CRC. The frequency of KRAS, NRAS, BRAF, TP53, APC and PIK3CA mutations were similar to reported frequencies in Western population except SMAD4 that had a lower frequency and higher frequency of FBXW7 mutation. © Journal of Gastrointestinal Oncology.

Author Info:
aDepartment of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
bKhalifa Bin Zayed Al Nahyan Foundation, Abu Dhabi, United Arab Emirates
cSheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
dDepartment of Oncology, Mayo Clinic, Rochester, MN, United States
eClinical Oncology Department, Assiut University, Assiut, Egypt
fDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
gDepartment of Epidemiology, The University of Nebraska Medical Center, Omaha, NE, United States


Authors:
Asahi, H.aEmail Author,  Kobayashi, F.a,  Inoue, S.-I.a,  Niikura, M.a,  Yagita, K.b,  Marghany Tolba, M.E.c,d

Date of Publishing:
Volume 16, Issue 27, 1 November 2016, Pages 3048-3057

Title:
Copper Homeostasis for the Developmental Progression of ‎Intraerythrocytic Malarial Parasite‎

Abstract:
Malaria is one of the world’s most devastating diseases, particularly in the tropics. In humans, Plasmodium falciparum lives mainly within red blood cells, and malaria pathogenesis depends on the red blood cells being infected with the parasite. Nonesterified fatty acids (NEFAs), including cis-9-octadecenoic acid, and phospholipids have been critical for complete parasite growth in serum-free culture, although the efficacy of NEFAs in sustaining the growth of P. falciparum has varied markedly. Hexadecanoic acid and trans-9-octadecenoic acid have arrested development of the parasite, in association with down-regulation of genes encoding copper-binding proteins. Selective removal of Cu+ ions has blockaded completely the ring-trophozoite-schizont progression of the parasite. The importance of copper homeostasis for the developmental progression of P. falciparum has been confirmed by inhibition of copper-binding proteins that regulate copper physiology and function by associating with copper ions. These data have provided strong evidence for a link between healthy copper homeostasis and successive developmental progression of P. falciparum. Perturbation of copper homeostasis may be, thus, instrumental in drug and vaccine development for the malaria medication. We review the importance of copper homeostasis in the asexual growth of P. falciparum in relation to NEFAs, copperbinding proteins, apoptosis, mitochondria, and gene expression. © 2016 Bentham Science Publishers.

Author Info:
aDivision of Tropical Diseases and Parasitology, Department of Infectious Diseases, Kyorin University School of Medicine, Tokyo, Japan
bDepartment of Parasitology, The National Institute of Infectious Diseases, Tokyo, Japan
cDepartment of Medical Genomics, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
dDepartment of Parasitology, Faculty of Medicine, The Assiut University, Assiut, Egypt


Authors:
Atta, H.aEmail Author,  Abdel-Gawad, E.A.bEmail Author,  ElAzab, A.cEmail Author,  Saleh, M.dEmail Author,  Abbas, W.A.eEmail Author,  Soliman, R.fEmail Author,  Imam, H.fEmail Author

Date of Publishing:
Volume 47, Issue 3, 1 September 2016, Pages 1103-1110

Title:
Whole Ureteric Course Delineation Assessment Using Non Contrast Curved ‎Sagittal Oblique Reformatted Ct‎

Abstract:
Purpose To develop a standardized technique to assess delineation of the whole ureter for the evaluation of symptomatizing urologic patients. Method and materials 2500 patients are examined using 64-MDCT. Examinations were performed with oral hydration Group I (n = 834), Group II which received IV diuretics (n = 847), or Group III which received nothing (n = 819). Curved planar reformatted images were obtained manually to obtain the entire ureter in a single coronal oblique image. The ureter was divided into 3 anatomic segments for estimating the degree of its delineation where if the segment is assessed along its whole length it is graded as satisfactory delineation, otherwise it is graded as non-proper delineation. Delineation degrees for each ureteric segment were compared. Results Satisfactory delineation obtained with group II (51.3%) was statistically higher than other groups with p value < 0.001, with a statistical significant result (p < 0.001) as regards the delineation of ureteric segments and patients’ sex; the middle and lower third segments show satisfactory delineation in group II with 86%, while the non-proper delineation is higher in females with percentage 66.1%, and the percentage of non-proper delineation among females is least recorded in group II. Conclusion Curved sagittal oblique reformatted image with IV diuretics allows better tracing of the whole ureteric course. © 2016 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aRadiology Department, South Egypt Cancer Institute, Assiut University, Egypt
bRadiology Department, Faculty of Medicine, Elminia University, Egypt
cUrology Department Faculty of Medicine, Assiut University, Egypt
dPublic Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt
eInternal Medicine Department, Faculty of Medicine, Assiut University, Egypt
fRadiology Department, Faculty of Medicine, Assiut University, Egypt


Authors:
Attallah, D.A.aEmail Author,  Awad, S.M.a,  Salama, R.H.M.b,  Mahran, A.M.a,  Ahmed, A.O.c  View Correspondence (jump link)

Title:
Serum Levels of IL-12 and Il-23 in Psoriatic Patients with or without ‎Concomitant Hepatitis C: A Comparative Study‎

Abstract:
Background A role for hepatitis C virus (HCV) infection in psoriasis has been proposed, but the underlying pathogenic mechanisms are still undetermined. Interleukin (IL)-12 and IL-23 dysregulation may be involved. Objective To compare the serum levels of IL-12 and IL-23 in psoriatic patients with and without concomitant hepatitis C and investigate their relationship with both disease processes. Patients and methods Forty-nine psoriatic patients attending the Dermatology Outpatient Clinic in our hospital from January to December 2013 were included in the study. Psoriasis area and severity index scores were calculated. Serum levels of IL-12 (IL-12p70) and IL-23 were assessed and compared with 49 age-matched and sex-matched healthy individuals. All participants were tested for HCV infection. Results Serum IL-12 and IL-23 were significantly increased in psoriatic patients compared with controls (P=0.004 and 0.001, respectively). Only IL-23 was significantly higher in HCV-positive than in HCV-negative psoriatic patients (P=0.026) and positively correlated with psoriasis severity (psoriasis area and severity index) and alanine aminotransferase levels (P=0.01 for both). Conclusion IL-23 overproduction in psoriasis appears to be accentuated by concomitant HCV infection. © 2016 Egyptian Women's Dermatologic Society.

Author Info:
aDepartment of Dermatology and Venereology, Assiut University Hospital, Assiut, 71526, Egypt
bDepartment of Biochemistry, Egypt
cDepartment of Clinical Pathology, Clinical Microbiology Unit, Assiut University Hospital, Assiut, Egypt


Authors:
Hassan, M.a,  Afridi, R.a,  Sadiq, M.A.a,  Soliman, M.K.a,b,  Agarwal, A.a,  Sepah, Y.J.a,  Do, D.V.a,  Nguyen, Q.D.aEmail Author

Date of Publishing:
Volume 16, Issue 5, 3 May 2016, Pages 699-709

Title:
The Role of Aflibercept in the Management of Age-Related Macular ‎Degeneration‎

Abstract:
Introduction: During the past decade, significant advances have occurred in the management of neovascular age-related macular degeneration (NV-AMD). The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has shifted the treatment goal of NV-AMD from merely salvaging vision to improving visual acuity and maintaining a good quality of life. Aflibercept (AFL) is a significant addition to the arsenal of anti-VEGF therapies against the NV-AMD. In the index review, pharmacology and efficacy of AFL has been reviewed.Areas Covered: An extensive literature search was performed to identify preclinical and clinical studies performed to illustrate the role of AFL in NV-AMD. Randomized clinical trials evaluating other anti-VEGF agents were also included for comparison. Additionally, studies where AFL was employed to treat anti-VEGF-resistant cases agents have been reviewed.Expert Opinion: AFL is an effective agent in the management of NV-AMD and its efficacy has been found to be comparable to ranibizumab (RBZ). Additionally, AFL is a good alternative agent in patients with NV-AMD resistant to RBZ and bevacizumab (BVZ), and can potentially lessen the treatment burden. As more research is conducted, the role of AFL in varying dosing regimens, as monotherapy and in combination with other agents, will become further defined. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Author Info:
aOcular Imaging Research and Reading Center (OIRRC), Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, United States
bDepartment of Ophthalmology, Assiut University, Assiut, Egypt


Authors:
Heller, S.a,  Cable, C.a,  Penrose, H.a,  Makboul, R.a,c,  Biswas, D.a,  Cabe, M.a,  Crawford, S.E.b,  Savkovic, S.D.aEmail Author

Journal:
American Journal of Physiology - Gastrointestinal and Liver Physiology

Date of Publishing:
Volume 310, Issue 10, May 2016, Pages G844-G854

Title:
Intestinal Inflammation Requires Foxo3 and Prostaglandin E2-Dependent ‎Lipogenesis and Elevated Lipid Droplets‎

Abstract:
Intestinal inflammation has been recently characterized by the dysregulation of lipids as metabolic and energy sources, revealing a novel feature of its pathophysiology. Because intracellular lipids, stored in dynamic lipid droplets (LDs), provide energy for cellular needs, we investigated whether they play a role in intestinal inflammation. In the inflamed intestine of mice, elevated LDs were found in colonic and infiltrating immune cells as shown by staining for the LD coat protein PLIN2 and for lipids with BODIPY. In colonic cells, TNF stimulated LD increases by receptor signaling rely on phosphatidylinositol 3-kinase activation. Downstream, TNF triggered a negative regulatory loop between LDs and the transcription factor FOXO3. This was shown in the colon of Foxo3-deficient mice, where elevation in PLIN2 and lipids were further facilitated by inflammation and were more prominent relative to wild-type, whereas, in colonic cells, inhibition of lipogenesis blocked the TNF-mediated loss of FOXO3. Furthermore, blockade of PGE2 synthesis abrogated TNF-stimulated increases in LDs and FOXO3 inactivation. We found in colonic tissue of Foxo3- deficient mice higher levels of cyclooxygenase-2, a mediator of prostaglandin E2 (PGE2) synthesis, supporting involvement of PGE2 in the LD-FOXO3 regulatory loop. Ultimately, TNF-stimulated lipogenesis leading to elevated LDs facilitated NF-κB-mediated increases in IL-8 protein, which is associated with the surface of LDs found in the lumina of the endoplasmic reticulum and Golgi apparatus. This novel immunometabolic mechanism of colonic inflammation involving elevated LDs could provide opportunities for new treatment options. © 2016 the American Physiological Society.

Author Info:
Department of Pathology and Laboratory Medicine, Tulane University, New Orleans, LA, United States
bDepartment of Pathology, St. Louis University, St Louis, MO, United States
cPathology Department, Assiut University, Assiut, Egypt


Authors:
Kaf, W.A.aEmail Author,  Mohamed, E.S.b,  Elshafiey, H.b

Date of Publishing:
Volume 25, Issue 1, March 2016, Pages 41-53

Title:
‎40-Hz Sinusoidal Auditory Steady-State Response and Tone Burst Auditory ‎Brainstem Response Using a Kalman Filter to Determine Thresholds Pre- ‎and Post-Myringotomy with Grommet Tube in Children with Mild, Low-‎Frequency Conductive Hearing Loss‎

Abstract:
Purpose: Accurate estimation of mild, low-frequency hearing loss is difficult in young children. This study aimed to determine the accuracy of 40-Hz sinusoidal auditory steady-state response (sASSR) compared with tone burst auditory brainstem response (TB-ABR) to detect mild, low-frequency hearing loss in children with otitis media with effusion and to measure postoperative thresholds. Methods: Thresholds at 500 and 4000 Hz were measured behaviorally and electrophysiologically using TB-ABR and 40-Hz sASSR with a Kalman filter in 26 children with otitis media with effusion. Recording was conducted preoperatively and postoperatively while children were actively awake. Repeated measures mixed analyses of variance were conducted to determine effects among measures and the two test frequencies. Results: Both 40-Hz sASSR and TB-ABR accurately detected preoperative and postoperative thresholds and were within 5–10 dB of the behavioral thresholds at 4000 Hz. At 500 Hz, the mean 40-Hz sASSR threshold was only 5 dB above the behavioral thresholds and 18 dB better than the 500-Hz ABR threshold. Positive correlations were found but not between 40-sASSR and TB-ABR at 500 Hz. Also, the interrater judgment of the response was better for sASSR (89%) than TB-ABR (83%). Conclusion: The 40-Hz sASSR is more accurate than TB-ABR in determining a mild, low-frequency threshold. © 2016 American Speech-Language-Hearing Association.

Author Info:
aMissouri State University, Springfield, United States
bAssiut University, Egypt


Authors:
Mahmoud, H.A.a,  Atta, H.bEmail Author,  Diab, W.A.a,  Eloteify, L.M.a,  Mourad, A.E.c,  Gabr, A.d,  Mekkawy, M.A.a,  Omar, W.M.e

Date of Publishing:
Volume 7, Issue 2, April 2016, Pages 85-91

Title:
The Debate on Pelvic Lymphadenopathy Size Significance in Ovarian ‎Cancer Patients‎

Abstract:
Background: This study attempts to ascertain a reliable cutoff size to determine whether pelvic lymph nodes are metastatic or not in ovarian cancer patients. Methods: We retrospectively reviewed 73 PET/CT scans of 52 female patients with ovarian carcinoma who underwent surgery followed by chemotherapy. The findings of contrast enhanced MDCT were interpreted by two experienced radiologists unaware of the PET/CT findings. At least two experienced nuclear medicine physicians unaware of the contrast enhanced-MDCT findings examined the PET scans in order to localize, characterize and compare these scans to co-registered PET/CT images. A comparative study was done. Lymph node sizes were recorded in short axis diameter with a significant cut off estimated at 7.5 mm. Metabolic activities of different lymph node groups were assessed and the semi-quantitative SUV was calculated. The level of SUV significance was 2.5. Significant metastatic lymph nodes were judged by the assessment of integrated PET/CT results. Results: Of the 73 scans, 47 showed significant lymph node metastases, with the following sensitivities: 75% (external iliac), 77.8% (internal iliac), and 75% (inguinal). The specificities were 84% (external iliac), 86% (internal iliac), and 54% (inguinal) with a P-value of 0.000 for the external an internal iliac groups and 0.079 for the inguinal group. Conclusion: To improve detection of malignant pelvic lymph nodes, the size threshold should be decreased to 7.5 mm. © 2016, All rights reserved.

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


Authors:
Moeen, A.M.Email Author,  Hameed, D.A.Email Author,  Gadelkareem, R.A.Email Author,  Abdelsalam, Y.M.Email Author,  Abdel-Hafez, S.E.S.Email Author,  Ahmed, A.I.Email Author

Date of Publishing:
Volume 22, Issue 3, 1 September 2016, Pages 153-161

Title:
Functional Evaluation of a Modified Studer Ileal Neobladder‎

Abstract:
Objectives To evaluate the results of using a shorter ileal segment (40 cm only) in reconstructing Studer ileal neobladder after radical cystectomy. Subjects and methods Radical cystectomy and modified Studer ileal neobladder was performed in 60 patients for invasive bladder cancer. Only 40 cm of the ileum was used; 32 cm segment for constructing the body of the neobladder, while the remaining 8 cm as an isoperistaltic intact limb for ureteral reimplantation. After one year, evaluation included clinical, laboratory, radiographic and urodynamic studies to determine the functional and oncological outcomes. Results Early complications occurred in 5 patients (8.6%). According to the modified Clavien system, two patients had grade I complications, IIIb occurred in one patient and two patients had grade V complications. Late complications (8.6%) included incisional hernia in 2 patients, deep venous thrombosis, bilateral uretero-ileal anastomotic stricture and intestinal obstruction each occurred in one patient. At one year, daytime and nighttime continence was 93.1% and 89.7%, respectively. Reflux was observed in 6 patients (10.3%) which was unilateral in 3 patients and bilateral in 3 without affecting the renal functions. Neobladder pressure was 7–18 cmH2O at half capacity and 13–38 cmH2O at full capacity with no uninhibited contractions. Conclusion Minimizing the length of the ileum for Studer neobladder reconstruction is feasible and with acceptable results. © 2016 Pan African Urological Surgeons’ Association

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


Title:
The Effect of N-Acetylcysteine on the Liver Following Aluminium Chloride ‎Exposure in Adult Male Albino Rat: A Histological and Immunohistochemical ‎Study‎

Abstract:
Background: There is considerable interest in the role of N-acetylcysteine (NAC) in attenuating aluminium chloride-induced hepatic damage. Aim: This study was undertaken to evaluate the effect of NAC on the liver following aluminium chloride exposure. Materials and methods: Sixty adult male rats were divided into three groups: The first group was the control group; the second group was treated with aluminium chloride (50 mg/kg/day) orally for 21 days; and the third group was treated with aluminium chloride (50 mg/kg/ day)+NAC (50 mg/kg/day) orally for 21 days. Liver specimens were processed for light, electron and immunohistochemical studies. Results: In the aluminium chloride-treated group, light microscopic examination showed degenerative changes in hepatocytes. The hepatocytes had vacuolated cytoplasm and apparent dilatation of the portal vessels. An extensive amount of collagen fibres were noted in the periportal zone, as well as an intense immune reaction for caspase. The ultrastructural study showed hepatocytes with condensation of the nuclear chromatin. The cytoplasm of the hepatocytes contained damaged mitochondria with disrupted cristae. The aluminium chloride+NAC-treated group showed significant attenuation of the histological alteration of the aluminium chloride-induced liver injury. Conclusion: NAC attenuates the damaging effect of aluminium chloride in the liver. © 2016 The Egyptian Journal of Histology.

Author Info:
Department of Human Anatomy and Embryology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Mohamed, H.Z.E.a,  Ragab, I.K.cEmail Author,  Ghafeer, H.H.b

Date of Publishing:
Volume 39, Issue 1, 1 March 2016, Pages 1-11

Title:
A Histological Study on the Possible Protective Effect of Selenium against ‎Chromium-Induced Thyrotoxicity in Adult Male Albino Rats‎

Abstract:
Background Chromium is hazardous for animals and human beings. Hexavalent chromium is highly toxic to life forms because of its carcinogenic, neurotoxic, nephrotoxic, genotoxic, and immunotoxic effects. Selenium is known for its antioxidant role in living systems, and therefore it is considered an essential element for humans and animals. Aim The present work aims at investigating the possible protective effect of selenium against chromium-induced thyrotoxicity in adult male albino rats. Materials and methods A total of 120 adult male albino rats were divided into three equal groups. The control group was given a single dose of sterile PBS daily for five consecutive days; the chromium-treated group was given a single dose of potassium dichromate daily for five consecutive days; and the selenium-chromium-treated group was given a single dose of nanoselenium and a single dose of potassium dichromate daily for five consecutive days. The animals of all groups were sacrificed at the same time and their thyroid glands were rapidly dissected out. The specimens of each group were processed for light and electron microscopic, and immunohistochemical studies. They were stained with hematoxylin and eosin, toluidine blue, and inducible nitric oxide synthase for evaluating follicular epithelial cells. Quantitative morphometric, and statistical studies were performed. Results Manifestations of cytotoxicity were visible on light and electron microscopic studies in chromium-treated thyroid sections in the form of disorganized follicles of varying diameters, with a preponderance of smaller over larger follicles. The follicular epithelial cells appeared to be enlarged and had a vacuolated cytoplasm. In addition, irregular shrunken nuclei were noticed. The thyroid gland of selenium-chromium-treated animals showed a near-normal follicular structure. Conclusion Administration of selenium in response to an increased risk of exposure to chromium compounds may protect the human body against their harmful effects. © 2016 Wolters Kluwer Health Lippincott Williams & Wilkins.

Author Info:
aDepartment of Human Anatomy and Embryology, Faculty of Medicine, Assiut University, Egypt
bDepartment of Histology, Faculty of Medicine, Assiut University, Egypt
cDepartment of Histology, Faculty of Medicine, Al-Azhar Faculty of Medicine in Assiut, Assiut, Egypt


Authors:
Moubasher, A.E.A.a,  Hassan, O.M.a,  Youssef, E.M.K.aEmail Author,  Sabek, M.M.A.b

Date of Publishing:
Volume 13, Issue 3, 1 September 2016, Pages 151-158

Title:
Intralesional Injection of Purified Protein Derivatives Versus Zinc Sulfate ‎‎2% in Recalcitrant Palmar and/or Plantar Warts‎

Abstract:
Background The immune system plays an essential role in the clearance of warts, and thus recently there is a trend to use immunotherapy in wart treatment. Tuberculin-purified protein derivatives (PPDs) and zinc sulfate 2% were not previously compared regarding their efficacy in the treatment of warts. Objective The aim of this study was to determine the efficacy and safety of intralesional (IL) immunotherapy with tuberculin PPD versus zinc sulfate 2% in multiple recalcitrant palmar and/or plantar warts. Patients and methods Forty-five patients who presented with resistant palmar and/or plantar warts were divided randomly into two groups: the first group included 23 patients treated with IL tuberculin PPD, and the second group included 22 patients treated with IL zinc sulfate 2%. Results The target wart in the tuberculin-PPD-treated group showed a statistically nonsignificant higher rate of complete clearance compared with the zinc sulfate 2%-treated group (87 vs. 72.7%, respectively). Partial response was seen in 13 versus 13.6% and no response was seen in 0 versus 13.6%. In untreated distant warts, the tuberculin-PPD-treated group showed statistically significant higher rates of complete response compared with the zinc sulfate 2%-treated group (73.9 vs. 40.9%, respectively); the partial response was 13 versus 36.4% and no response was 13 versus 22.7%, respectively. Conclusion IL immunotherapy with tuberculin PPD was more effective than zinc sulfate 2% in the treatment of cutaneous warts. It is a simple, effective, safe procedure, with tolerable pain, and it may represent an alternative treatment for multiple resistant palmar and/or plantar warts. © 2016 Egyptian Women's Dermatologic Society.

Author Info:
aDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
bAssiut Dermatology and Venereology Hospital, Assiut, Egypt


Authors:
Mubashar, H.a,  Almushait, M.A.aEmail Author,  Sukit, B.a,  Shaamash, A.b,  Handady, S.c,  Almutawa, N.d

Title:
Knowledge, Attitude and Practice of Contraceptives among Saudi Women ‎in Aseer Region, Saudi Arabia‎

Abstract:
Objective: The study was carried out to assess the knowledge, attitude towards, and practice of contraception and the factors that could affect its use among Saudi women in Aseer region of Saudi Arabia. Methods: This cross-sectional and hospital-based study was conducted in Aseer Region, Saudi Arabia, during one year (January, 2014 – December, 2014). Five-hundred women of reproductive age (18–45 year) were interviewed regarding their knowledge, attitude and practices of contraception. The inquiries were recorded by a predesigned questionnaire. Questions on methods of contraception known and source of knowledge and their practices were recorded. Results: The mean ± SD of age was 32.7 + 7.2 years. (99.2%) of women heard and had knowledge of contraception, while (0.8%) said they did not know anything about contraception. (377 subjects, 75.4%) used contraception, while 123 subjects (24.6%) did not. Oral pill method of contraception was the most popular method known and practiced (87.0%, 32.2% respectively). The media seemed to be the major source of information (40.8%). In response to the reason for non-use, the majority said they wanted more children (10.2%). The major reason for the use of contraception was to limit family size (32.0%). The majority (79.6%) of women had good attitude towards contraception. Conclusion: The present study concludes that a significant proportion of respondents have good knowledge about contraception. But practice of contraception and compliance is low. Desire of more children is one of the major factors among reasons of the non-use of contraception. © 2016, Ibn Sina Trust. All rights reserved.

Author Info:
aDepartment of Obstetrics & Gynecology, College of Medicine, King Khalid University, Abha, Saudi Arabia
bDepartment of Obstetrics & Gynecology, College of Medicine, Assiut University, Assiut, Egypt
cDepartment of Obstetrics & Gynecology, Empreal Hospital, Khartoum, Sudan
dDepartment of Obstetrics & Gynecology, King Faisal Medical City, Aseer Region, Saudi Arabia


Authors:
Naser, R.K.A.a,  Hassan, A.A.K.a,  Shabana, A.M.b,  Omar, N.N.a

Date of Publishing:
Volume 47, Issue 2, 1 June 2016, Pages 577-584

Title:
Role of Magnetic Resonance Spectroscopy in Grading of Primary Brain ‎Tumors‎

Abstract:
Objective To assess the usefulness of MR spectroscopy (MRS) in grading of primary brain tumors. Methods MRS was performed in 22 patients with primary brain tumors. Metabolite ratios of Choline (Cho)/N-acetylaspartate (NAA), Cho/Creatine (Cr), Cho+Cr/NAA as well as lipids and lactate (LL)/Cr were calculated at short and intermediate echo times (TEs). Additionally, myo-inositol (mI)/Cr was calculated at short TE. Tumors were subdivided into low grades and high grade on the basis of histopathology. Receiver operating characteristic analysis of metabolite ratios was performed to find cutoff values between high and low grade tumors. The resulting sensitivity, specificity and accuracy were calculated. Results At intermediate TE, Cho/NAA, Cho+Cr/NAA and Cho/Cr were significantly higher in high grade tumors than in low grade tumor. At short TE, Cho/Cr and LL/Cr ratios were significantly higher in high grade tumors than in low grade tumor. The diagnostic accuracy of metabolite ratios at intermediate TE was 86% whereas at short TE, the diagnostic accuracy was 75%. Combination of both TEs revealed a diagnostic accuracy of 88%. Conclusion Cho/NAA, Cho+Cr/NAA and Cho/Cr are reliable in determining the tumor grade. LL/Cr is highly related to high grade tumors. Combination of both short and intermediate TEs provides better accuracy, in grading of brain neoplasm, compared to that when using each TE separately. © 2016 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, Egypt
bDepartment of Diagnostic Radiology, National Cancer Institute, Cairo University, Egypt


Authors:
Nassr, A.A.a,bEmail Author,  Abdelmagied, A.M.a,b,  Shazly, S.A.M.a,b

Date of Publishing:
Volume 44, Issue 2, 1 March 2016, Pages 249-256

Title:
Fetal Cerebro-Placental Ratio and Adverse Perinatal Outcome: Systematic ‎Review and Meta-Analysis of the Association and Diagnostic ‎Performance‎

Abstract:
Objective: The objective of this meta-analysis is to assess the value of fetal cerebro-placental Doppler ratio (CPR) in predicting adverse perinatal outcome in pregnancies with fetal growth restriction (FGR). Methods: Three databases were used: MEDLINE, EMBASE (with online Ovid interface) and SCOPUS and studies from inception to April 2015 were included. Studies that reported perinatal outcomes of fetuses at risk of FGR or sonographically diagnosed FGR that were evaluated with CPR were considered eligible. Perinatal outcomes include cesarean section (CS) for fetal distress, APGAR scores at 5 min, neonatal complications and admission to neonatal intensive care unit (NICU). Pooled data were expressed as odds ratio (OR) and confidence intervals (CI), and the summary receiver operating characteristic (SROC) curve was used to illustrate the diagnostic accuracy of CPR. Results: Seven studies were eligible (1428 fetuses). Fetuses with abnormal CPR were at higher risk of CS for fetal distress (OR=4.49, 95% CI [1.63, 12.42]), lower APGAR scores (OR=4.01, 95% CI [2.65, 6.08]), admission to NICU (OR=9.65, 95% CI [3.02, 30.85]), and neonatal complications (OR=11.00, 95% [3.64, 15.37]) than fetuses who had normal CPR. These risks were higher among studies that included fetuses diagnosed with FGR than fetuses at risk of FGR. Abnormal CPR had higher diagnostic accuracy for adverse perinatal outcomes among "sonographically diagnosed FGR" studies than "at risk of FGR" studies. Conclusion: Abnormal CPR is associated with substantial risk of adverse perinatal outcomes. The test seems to be particularly useful for follow up of fetuses with sonographically diagnosed FGR. © 2016 by De Gruyter.

Author Info:
aDepartment of Obstetrics and Gynecology, Mayo Clinic, College of Medicine, Rochester, MN, United States
bWomen's Health Hospital, Assiut University Hospitals, Assiut, Egypt


Date of Publishing:
Volume 44, Issue 3, 1 April 2016, Page 357

Title:
Reply To: Fetal Cerebroplacental Ratio and Adverse Perinatal ‎Outcome‎

Author Info:
aDepartment of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, United States
bWomen's Health Hospital, Assiut University Hospitals, Assiut, Egypt


Authors:
Osama, A.a,  Sabry, D.b,  Hassany, S.M.c,  Abdelmoneim, S.S.c,  Sabry, A.dEmail Author  View Correspondence (jump link)

Title:
Sirt-1expression Is Associated with Expression of Nanog in Patients with ‎Colorectal Adenocarcinoma‎

Abstract:
AIMS: The study aimed to investigate the quantitative expression of NANOG, p38 a, NCF2, ELF and TGF-β genes in patients with colorectal adenocarcinoma, adenoma and normal colonic tissue and their correlation with SIRT-1 protein level expression. METHOD: This study enrolled one hundred sixty seven patients; group A: 87 patients with colonoscopic findings of no adenoma or adenocarcinoma and group B: 80 patients with colorectal mass. Consecutive colonoscopic examinations were conducted, and tissue samples were taken from the colonic lesions/masses. Total RNA was isolated and mRNA expression level of NANOG, mitogen activated p38a, Neutrophil Cytosol Factor 2 (NCF2), Embryonic Liver Fodrin (ELF) and Transforming Growth Factor Beta (TGF-β) genes were quantified by qRT-PCR. Sirt-1 protein expression level was assessed by quantitative western blot. RESULTS: There were significantly high level of mRNA transcripts expression of the genes studied in patients with adenocarcinoma and adenoma compared with normal tissue (P value < 0.01), NANOG, NCF2, ELF and TGF-β at a cut of > 0.314, > 0.392, 0.349 and 0.333 respectively showed sensitivity (96.5%, 98.8%, 95.3%, 98.8%) and specificity of (95.3%, 92.6%, 89.5%, 93.8%) respectively in diagnosing colonic adenocarcinoma. Sirt-1 protein level was significantly highly expressed in colorectal adenocarcinoma compared to normal and adenoma colonic tissue and positively correlated with NANOG. CONCLUSION: Over expression of NANOG, p38a, NCF2, ELF and TGF-β genes in both cases of adenocarcinoma and adenoma could have a diagnostic value. SIRT-1 and NANOG are high correlated biological markers for diagnosis and prognosis follow up in patients with adenocarcinoma.

Author Info:
aBiochemistry Department, Assiut University, Assiut, Egypt
bMedical Biochemistry and Molecular Biology Department, Cairo University, Cairo, Egypt
cTropical Medicine and Gastroenterology Department, Assiut University, Assiut, Egypt
dInternal Medicine Department, Assiut University, Assiut, Egypt


Authors:
Othman, E.R.a,bEmail Author,  Al-Adly, D.M.M.c,  Elgamal, D.A.d,  Ghandour, N.c,  El-Sharkawy, S.c

Date of Publishing:
Volume 23, Issue 4, 1 April 2016, Pages 508-514

Title:
Bisphenol a Concentrates Preferentially in Human Uterine Leiomyoma and ‎Induces Proliferation in Rat Myometrium‎

Abstract:
Objectives: To measure tissue levels of bisphenol A (BPA) in uterine leiomyoma (ULM), adjacent myometrium (Myo-F), and normal myometrium (Myo-N). Also, we tested the effect of BPA treatment on rat myometrium. Methods: Uterine leiomyomas and Myo-F tissues were isolated from hysterectomy specimens done to treat symptomatic ULMs (N = 30). Normal myometrium is isolated from hysterectomies done on ULM-free uteri for other benign indications (N = 25). Bisphenol A was measured in 1 g of tissue using solid-phase extraction and high-performance liquid chromatography, with fluorescence detectors. Experimentally, adult female rats were fed BPA orally at a dose of 50 mg/kg/d for 90 days. Animals were killed, and their myometrial thickness and proliferating cell nuclear antigen (PCNA) immunostaining were evaluated. Results: Tissue concentration of BPA in each of ULM (12.3 ± 2.8 μg/g) and Myo-F (10.1 ± 0.2 μg/g) was significantly higher than that of Myo-N (0.58 ± 0.2 μg/g). There was no statistically significant difference in BPA level between ULM and Myo-F within submucous or interstitial/subserous fibroid groups. Compared to control rats, BPA-treated animals showed significantly higher myometrial thickness (168.67 ± 5.7 μm and 281.6 ± 20.32 μm, respectively, P =.003) and increased myometrial PCNA immunoscores (1.5 ± 0.37 and 10.38 ± 0.67, respectively, P ≤.001). Conclusion: Bisphenol A concentrates in human ULM tissue and its adjacent Myo-F compared to Myo-N. No significant difference is detected in BPA content of ULM tissue of different subtypes. Bisphenol A increases thickness and induces cellular proliferation in rat myometrium. Taken together, our results support a role of BPA in ULM development/growth. © The Author(s) 2015.

Author Info:
aDepartment of Obstetrics and Gynecology, Assiut University, Womens Health Hospital, Assiut University Campus, Assiut, 71111, Egypt
bCenter of Excellence of Stem Cells and Regenerative Medicine CESCRM, Assiut University, Assiut, Egypt
cDepartment of Forensic Medicine and Toxicology, Assiut University, Assiut, Egypt
dDepartment of Histology, Assiut University, Assiut, Egyp


Authors:
Othman, E.R.a,bEmail Author,  Hornung, D.c,d,  Hussein, M.a,  Abdelaal, I.I.a,  Sayed, A.A.b,e,  Fetih, A.N.a,  Al-Hendy, A.f

Journal:
European Journal of Obstetrics Gynecology and Reproductive Biology

Title:
Soluble Tumor Necrosis Factor-Alpha Receptors in the Serum of ‎Endometriosis Patients‎

Abstract:
Introduction We examine serum levels sTNFR-I and sTNFR-II in endometriosis patients, and their role as biomarkers of endometriosis. Material and methods Women were diagnosed with endometriosis during laparoscopy to investigate pelvic pain and/or infertility (N = 62). Control group included women with pelvic pain and/or infertility, whose laparoscopy showed no abnormalities (N = 55). Serum concentrations of sTNFR-I and sTNFR-II were measured using Bioplex Protein Array system. Non-parametric statistics were used. Results Endometriosis patients had significantly higher levels of sTNFR-I than controls (257.46 pg/ml, IQR = 2.37-1048.92 versus 130.39 pg/ml, IQR = 0.99-361.1 respectively, P value = 0.01). For TNFR-II, difference between women with (232 pg/ml, IQR = 0.0-624.4), and women without (132.93 pg/ml, IQR = 0.0-312.81) endometriosis was not significant (P value = 0.05). Early stage endometriosis patients had significantly higher level of sTNFR-I (559.13, IQR = 1.82-1289.86) and sTNFR-II (248.8, IQR = 0-644.65) than control women (P value is 0.01 for TNFR-I and 0.04 for TNFR-II). Levels of sTNFR-I and sTNFR-II were comparable for advanced endometriosis and controls, and between early and advanced endometriosis. As a biomarker for all- stage endometriosis, sTNFR-I produces AUC of 0.62, sensitivity of 61%, and specificity of 47.3%, at a cutoff of 81.87 pg/ml. For early stage disease, sTNFR-I yields AUC of 0.68, sensitivity of 60.7%, specificity of 75%, at a cutoff of 351.22 pg/ml. Conclusion sTNFR-I is significantly higher in serum of endometriosis patients than controls. As an endometriosis biomarker, sTNFR-I achieves better performance for early stage disease. © 2016 Elsevier Ireland Ltd. All rights reserved.

Author Info:
aOB-GYN Department, Assiut University, Egypt
bCenter of Excellence of Stem Cells and Regenerative Medicine (CESCRM), Assiut University, Egypt
cOB-GYN Department, University of Lübeck, Lübeck, Germany
dOB-GYN Department, Diakonissenkrankenhaus Karlsruhe Rüppurr, Karlsruhe, Germany
eBiochemistry Department, Assiut University, Egypt
fOB-GYN Department, Medical College of Georgia, Georgia Regents University (GRU), GA, United States


Authors:
Plaza-Puche, A.B.a,  Aswad, A.E.a,b,  Arba-Mosquera, S.c,  Wróbel-Dudzinska, D.a,  Abdou, A.A.d,  Alió, J.L.a,eEmail Author

Date of Publishing:
Volume 32, Issue 1, January 2016, Pages 6-13

Title:
Optical Profile Following High Hyperopia Correction with a 500-Hz Excimer ‎Laser System‎

Abstract:
PURPOSE: To evaluate corneal higher order aberrations after LASIK for the correction of high hyperopia using a 500-Hz excimer laser and optimized ablation profile. METHODS: Retrospective consecutive study including 51 eyes of 28 patients (age range: 21 to 54 years) with high hyperopia or hyperopic astigmatism (sphere ≥ 5.00 diopters). All cases underwent LASIK using the sixth generation Amaris excimer laser (SCHWIND eyetech- solutions, Kleinostheim, Germany) and a femtosecond laser platform for flap creation. Postoperative changes in corneal higher order aberrations for the 4-, 5-, and 6-mm pupil diameters and corneal asphericity for 4.5 and 8 mm were represented at the end of the 6-month follow-up. RESULTS: A significant increase in corneal root mean square higher order, spherical, and coma aberrations was observed 6 months after surgery (P < .01). Corneal asphericity for the 4.5-mm (Q45) and 8-mm (Q8) corneal diameter also changed significantly during the postoperative period (P < .01). Strehl ratio change was not statistically significant (P = .77). CONCLUSIONS: Correction of high hyperopia with LASIK significantly induces corneal higher order aberrations regardless of the physiologic level of photopic and mesopic pupil conditions. Copyright © SLACK Incorporated.

Author Info:
Vissum Corporation, Avenida de Denia s/n, Edificio Vissum, Alicante, 03016, Spain
bResearch Institute of Ophthalmology, Giza, Egypt
cR and D Department, SCHWIND Eye-tech-solutions, Kleinostheim, Germany
dOphthalmology Department, Assiut University, Egypt
eDivision of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain


Authors:
Radwan, M.E.M.a,cEmail Author,  Aboshaera, K.O.b

Date of Publishing:
Volume 47, Issue 3, 1 September 2016, Pages 903-908

Title:
Magnetic Resonance Angiography in Evaluation of Acute Intracranial Steno-‎Occlusive Arterial Disease‎

Abstract:
Objectives Assessment of the diagnostic usefulness of MRA in evaluation of patients with acute intra cranial steno-occlusive arterial disease. Patients and methods 84 patients with acute intracranial steno-occlusive arterial disease were subjected to the following brain MRI protocol: Axials DWI, T1WI, T2WI, FLAIR, T2∗ Gradient Echo Imaging and 3D TOF MRA. Results Eighty four patients (M/F = 49/35) aged between 28 and 86 years. MRA findings of arterial segments correlated with location of the ischemic lesions described by different MRI sequences including the DWI in all cases (100%). MRA of the intracranial vessels revealed 60 arterial segments with occlusions/absent flow. Occlusions were most common in MCAs (n = 45) followed by PCAs (n = 9). 31 arterial segments with stenosis were seen, and they were mainly affecting arterial territories of PCAs (n = 16). Atheromatous plaques were identified at the Lt. ICA in 3 cases and in Rt. ICA in 2 cases, absent A1 segment of Rt. ACA (n = 12), absent A1 segment of Lt. ACA (n = 2), dominant Rt. VA (n = 6), dominant Lt. VA (n = 4) and Dolichoectasia of BA (n = 4). Conclusions MRA provides early detailed diagnosis of occlusive intracranial arterial disease through detection of exact site of arterial affection. © 2016 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aDepartment of Radiodiagnosis, Assiut University, Egypt
bDepartments of Neurology and Psychiatry, Assiut University, Egypt
cDepartment of Radiodiagnosis, Taibah University, Al-Madinah Al Munwarah, Saudi Arabia


Authors:
aDepartment of Radiodiagnosis, Assiut University, Egypt
bDepartment of Neurology and Psychiatry, Assiut University, Egypt
cDepartment of Radiodiagnosis, Taibah University, Al-Madinah Al Munwarah, Saudi Arabia

Date of Publishing:
Volume 47, Issue 4, 1 December 2016, Pages 1557-1563

Title:
One Step Diagnosis of Multiple Sclerosis Disease Activity, Dissemination in ‎Time and Space Using Diffusion Weighted MRI

Abstract:
Objectives To assess the value of DWI with its two components (DWI-b1000 and DWI b0) images in assessment of active MS and in defining dissemination in time (DIT) and dissemination in space (DIS) in those patients. Methods Brain MRI studies were performed using T1WI, T2WI, FLAIR and DWI and CE T1WI. Results Twenty-one patients (Males/Females = 6/15)of age range 18–50 years were included. Forty lesions were hyperintense on DWI-b1000 that had significant link to enhancement seen on contrast-enhanced T1WI (100%) indicating disease activity. Using the 2010 revised McDonald criteria: In 9 patients (42.85%), there were [Asymptomatic active lesions (n = 17)]. Those lesions were simultaneously present along with [Non-active demyelinating lesions]; DIT could be diagnosed in these cases based alone on MRI findings. In 12 patients (57.14%), there was simultaneous presence of [Symptomatic active lesions (n = 23)]. Those lesions were present along with [Non-active demyelinating lesions]; DIT could be diagnosed in these cases based on both clinical and MRI findings. Conclusion DWI-b1000 is of the same sensitivity as CE T1WI in detection of MS active lesions and in detection of DIT and DIS. DWI-b0 can substitute the T2WI in detection of demyelinating lesions and in confirmation of the MS disease beyond the active stage. © 2016 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aDepartment of Radiodiagnosis, Assiut University, Egypt
bDepartment of Neurology and Psychiatry, Assiut University, Egypt
cDepartment of Radiodiagnosis, Taibah University, Al-Madinah Al Munwarah, Saudi Arabia


Authors:
Rahman, H.A.Email Author,  Ghany, M.A.Email Author,  Youssef, A.A.A.Email Author

Date of Publishing:
Volume 68, Issue 2, 1 June 2016, Pages 125-129

Title:
Correlation of Fragmented Qrs Complexes with the Severity of Cad (Using ‎Syntax Score) in Patients with Non-St Elevation Acute Coronary ‎Syndromes‎

Abstract:
Background: Fragmented QRS (f-QRS) complexes are novel electrocardiographic signals, which reflect myocardial conduction delays in patients with coronary artery disease (CAD). The significance of f-QRS complexes in non-ST elevation ACS patients for detection of the severity of CAD (correlation with Syntax score) was evaluated in this prospective study. Methods: A total of 104 patients with non-ST-elevation ACS who underwent invasive coronary angiography for detection of coronary artery disease were recruited prospectively in this study, ECG was done to all patients, which showed f-QRS in 50 patients (f-QRS group) and inverted T wave or depressed ST in 54 patients (non f-QRS group). The significance of f-QRS complexes on 12-lead ECG for detection of the severity of the CAD (correlated with Syntax score) was assessed in this cohort of patients. Results: Among the patients studied, elderly patients (age ≥ 65 years), males, diabetics, smokers and those with dyslipidemia had a significantly higher frequency of fQRS complexes (with P value = 0.02, 0.01, 0.019, 0.005, 0.02 respectively). Also, the present study found a higher frequency of f-QRS in patients with multi-vessel disease, in those with more severe degree of coronary artery stenosis, in those with positive Troponin I level and in those with high Syntax score (with P value = 0.009, 0.000, 0.000 respectively). Conclusions: The frequency of f-QRS complexes was found to be higher in elderly, diabetic, dyslipidemic, and male patients with NSTE-ACS. The higher frequency of (f-QRS) was correlated with the extent and severity of coronary lesions in patients with NSTE-ACS. © 2016 The Authors.

Author Info:
Department of Cardiology, Assiut University, Egypt


Authors:
Razik, N.A.Email Author,  Taha, S.,  Elmaghraby, K.,  Demitry, S.

Date of Publishing:
Volume 4, Issue 4, April 01, 2016, Pages 406-408

Title:
Seventy-Year-Old Patient Survives a Giant Apical Lv Pseudoaneurysm for 8 ‎Years

Abstract:
Key clinical message The risk of rupture of LV pseudaneurysm is still not well understood, and ischemic cardiomyopathy with heart failure is a common consequence. Simple investigations like chest X-ray can give clue to such a serious diagnosis. © 2016 The Authors.

Author Info:
Cardiovascular Medicine, Assiut University, Assiut, Egypt


Authors:
Sadiq, M.A.a,,  Soliman, M.K.a,e,  Sarwar, S.a,  Agarwal, A.a,  Hanout, M.a,  Demirel, S.b,  Rentiya, Z.S.c,  Khan, W.c,d,  Do, D.V.a,  Nguyen, Q.D.a,  Sepah, Y.J.aEmail Author

Title:
Effect of Vitreomacular Adhesion on Treatment Outcomes in the ‎Ranibizumab for Edema of the Macula in Diabetes (Read-3) ‎Study‎

Abstract:
Purpose To assess the role of vitreomacular adhesion (VMA) in visual and anatomic outcomes in patients with diabetic macular edema (DME). Design Retrospective cohort study. Participants Data from patients enrolled in the Ranibizumab for Edema of the Macula in Diabetes: Protocol 3 with High Dose (READ-3) study were analyzed. Methods In the READ-3 study, patients with DME received monthly intravitreal injections of either 0.5 or 2.0 mg ranibizumab. Optical coherence tomography images from patients who completed the month 6 visit of the study were analyzed at the baseline visit to identify the presence (VMA+) or absence (VMA-) of VMA. Patients with any degree of vitreomacular traction were excluded from the analysis. Two independent graders graded all images. Vitreomacular adhesion was classified by size of adhesion into either focal (<1500 μm) or broad (≥1500 μm). Main Outcome Measures Mean changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at month 6 and incidence of posterior vitreous detachment (PVD). Results One hundred fifty-two eyes (152 patients) were randomized in the READ-3 study. One hundred twenty-four eyes (124 patients) were eligible for the study based on study criteria. Twenty-eight eyes did not meet study criteria and were excluded from the study. At baseline, 26 patients were classified as VMA+ and 98 patients were classified as VMA-. The distribution of the 2 doses of ranibizumab (0.5 and 2.0 mg) in the 2 groups was similar. At month 6, the mean improvement in BCVA was 11.31±6.67 and 6.86±7.58 letters in the VMA+ and VMA- groups, respectively (P = 0.007). Mean improvement in CRT was -173.81±132.31 and -161.84±131.34 μm in the VMA+ and VMA- groups, respectively (P = 0.681). At month 6, among the 26 VMA+ eyes (at baseline), 7 eyes demonstrated PVD, 17 eyes showed no change in VMA status, and 2 eyes were not gradable and were excluded. Conclusions Diabetic macular edema patients with VMA have a greater potential for improvement in visual outcomes with anti-vascular endothelial growth factor therapy. Therefore, the presence of VMA should not preclude patients with DME from receiving treatment. © 2016 American Academy of Ophthalmology.

Author Info:
aOcular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE 68198-5540, United States
bDepartment of Ophthalmology, Ankara University, Ankara, Turkey
cWilmer Eye Institute, Johns Hopkins University, Baltimore, MD, United States
dUniversity of Maryland, Baltimore County, Baltimore, MD, United States
eDepartment of Ophthalmology, Assiut University, Assiut, Egypt


Authors:
Sayed, M.M.aEmail Author,  El-Sayed, M.I.a,  Abdel-Wanis, M.E.a,  Abdel-Fatah, O.N.b

Date of Publishing:
Volume 102, Issue 5, September-October 2016, Pages 496-500

Title:
Definitive Chemoradiation for Non-Small-Cell Lung Cancer: Could a ‎Consensus Be Reached?‎

Abstract:
Aims and background: There is currently no consensus as to which chemotherapy to combine with thoracic radiotherapy (TRT) in the setting of definitive chemoradiation for non-small-cell lung cancer (NSCLC). We aimed to retrospectively evaluate the efficacy and report outcome measures of cisplatin/etoposide with conventionally fractionated TRT over a 9-year period. Methods: Cisplatin 50 mg/m2 on days 1, 8, 29, and 36 and etoposide 50 mg/m2 on days 1-5 and 29-33 with conventionally fractionated conformal radiation therapy starting on day 1 was given to 201 eligible patients. Patient records were reviewed for overall survival (OS) and progression-free survival (PFS). Results: The 2-year OS and PFS were 53% and 47%, respectively, while the 3-year OS and PFS were 18% and 17%, respectively. No grade 4 or treatment-related deaths were recorded, and grade 3 hematologic toxicity occurred in only 22 patients (11%) in the form of granulocytopenia and thrombocytopenia. Multivariable analysis showed clinical stage and Eastern Cooperative Oncology Group performance status to statistically significantly affect PFS and OS. Conclusions: Cisplatin and etoposide in these doses with conventionally fractionated TRT is a well-tolerated, effective treatment schedule in the definitive treatment of unresectable or inoperable NSCLC.

Author Info:
aRadiation Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
bClinical Oncology Department, Assiut University, Assiut, Egypt


Authors:
Seif, H.M.A.H.aEmail Author,  Abu Rahma, M.Z.b,  Zaky, S.b,  Swifee, Y.M.b

Date of Publishing:
Volume 47, Issue 3, 1 September 2016, Pages 825-832

Title:
Transjugular Intrahepatic Porto-Systemic Shunt in Bleeding Esophageal ‎Varices and Refractory Ascites. The First 4 years Experience in Assiut ‎University Hospital‎

Abstract:
Aim: To evaluate our first four years experience with 71 cases of TIPSS procedures performed in Assiut University Hospital. Patients and methods: Between February 2011 and April 2015, seventy-one patients who underwent TIPSS procedure in Assiut University Hospital were included in this study. The patients were selected among those suffering from refractory hepatic ascites and/or recurrent hematemesis due to variceal bleeding. Follow-up duration of our patients ranged from 3 to 34 months (mean 15.8). Results: The mean age of the patients was 47 ± 10.7 years. The technical success rate was 83%. Seventy-five percent of patients with refractory ascites improved after TIPSS. Reduction of variceal size occurred in 84.6% of patients. The 3 months mortality rate was 8%. Conclusion: Proper pre-procedural investigations and patients selection are mandatory for practicing TIPSS. BCS is a common cause of technical and clinical failure of TIPSS, so practicing TIPSS in BCS should be reserved for experts. © 2016 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aDepartment of Radiology, Assiut University Hospital, Faculty of Medicine, Assiut, 71517, Egypt
bDepartment of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egyp


Authors:
Seifeldein, G.S.aEmail Author,  Omar, N.N.a,  Faddan, N.H.A.b,  Elraheem, O.A.c

Date of Publishing:
Volume 47, Issue 4, 1 December 2016, Pages 1585-1590

Title:
Low Dose Multidetector Computed Tomography in Localizing the Transition ‎Zone of Hirschsprung's Disease: A Novel Study‎

Abstract:
Objectives The objectives of this study were the evaluation of low dose multidetector computed tomography (MDCT) in localizing the site of the transition zone (TZ) of Hirschsprung's Disease (HD) for preoperative planning. Patients and methods Twenty-two infants were recruited from pediatric and surgical clinics in Assiut University Hospital and Sohag University Hospital. The recruited patients were sedated before examination. Examinations were done using 64-rows MDCT. Each MDCT examination was reviewed to determine the location and length of the TZ and compared with operative and pathological results. Results were analyzed by chi square test and interobserver agreement using Kappa test. P < 0.05 was considered statistically significant. Results According to operative and pathological data, the site of the TZ: 17 (77.27%) were of short-segment disease (rectosigmoid HD), 2 (9%) were of long segment (above sigmoid colon), and 3 (13.63%) were of ultrashort segment. A correct diagnosis of TZ by MDCT was made in 19 out of 22 with 82.4% sensitivity and 80% specificity. The site of TZ was concordant in 17. Results yielded a moderate strength of inter-observer agreement in localizing the site of TZ (k = 0.546) and ( P= 0.009). Conclusion Low-dose MDCT has a good role in localizing the site of TZ of HD in infants. © 2016

Author Info:
aDepartment of Diagnostic Radiology, Assiut University, Egypt
bDepartment of Pediatrics, Assiut University, Egypt
cDepartment of General Surgery, Sohag University, Egypt


Authors:
Shazly, S.A.M.a,b,  Famuyide, A.O.aEmail Author,  El-Nashar, S.A.a,  Breitkopf, D.M.a,  Hopkins, M.R.a,  Laughlin-Tommaso, S.K.a

Journal:
Journal of Minimally Invasive Gynecology

Date of Publishing:
Volume 23, Issue 4, 1 May 2016, Pages 582-589

Title:
Intraoperative Predictors of Long-Term Outcomes after Radiofrequency ‎Endometrial Ablation‎

Abstract:
Study Objective: To identify intraoperative predictors of radiofrequency ablation (RFA) failure after adjusting for clinical risk factors. Design: A cohort study (Canadian Task Force II-2). Setting: An academic institution in the Upper Midwest. Patients: Data were retrospectively collected from medical records of women who underwent RFA and who had a postprocedure gynecologic assessment between April 1998 and December 2011. Interventions: RFA. Measurements and Main Results: The primary outcome was RFA failure, which was defined as hysterectomy, repeat ablation, synechiolysis, or treatment with gonadotropin-releasing hormone analogue for postablation pain or bleeding. Cox proportional hazards regression was used to test the predictability of intraoperative variables on RFA failure with adjustment for baseline predictors. We created an RFA index to capture the procedure duration divided by the uterine surface area. One thousand one hundred seventy-eight women were eligible. The median age at ablation was 44 years (interquartile range, 40-48 years), and the median parity was 2 (interquartile range, 2-3). Dysmenorrhea and prior tubal ligation were reported in 37.1% and 37.2% of women, respectively. After adjustment for baseline characteristics, intraoperative predictors of failure were uterine sounding length >10.5 cm (adjusted hazard ratio [HR] = 2.58; 95% confidence interval [CI], 1.31-5.05), uterine cavity length >6 cm (adjusted HR = 2.06; 95% CI, 1.30-3.27), uterine width >4.5 cm (adjusted HR = 2.06; 95% CI, 1.29-3.28), surface area >25 cm2 (adjusted HR = 2.02; 95% CI, 1.26-3.23), procedure time <93 seconds (adjusted HR = 2.61; 95% CI, 1.25-5.47), and RFA index <3.6 (adjusted HR = 3.14; 95% CI, 1.70-5.77). Conclusion: Intraoperative parameters are predictive of long-term adverse outcomes of RFA independent of patient clinical characteristics. Uterine length, procedure duration, and RFA index are associated with unfavorable outcomes and thus could be used to optimize postprocedure patient counseling. © 2016 AAGL.

Author Info:
aDepartment of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, United States
bDepartment of Obstetrics and Gynecology, Assiut University, Assiut, Egypt


Authors:
Shazly, S.A.M.a,b,  Laughlin-Tommaso, S.K.a,  Breitkopf, D.M.a,  Hopkins, M.R.a,  Burnett, T.L.a,  Green, I.C.a,  Farrell, A.M.c,  Murad, M.H.d,  Famuyide, A.O.aEmail Author

Date of Publishing:
Volume 23, Issue 6, 1 September 2016, Pages 867-877

Title:
Hysteroscopic Morcellation Versus Resection for the Treatment of Uterine ‎Cavitary Lesions: A Systematic Review and Meta-Analysis‎

Abstract:
This systematic review and meta-analysis compares hysteroscopic morcellation with electrosurgical resection to treat uterine cavitary lesions. A search of Ovid MEDLINE, Ovid Embase, Scopus, and Web of Science was conducted through August 18, 2015, for randomized controlled trials (RCTs) and prospective and retrospective studies, regardless of surgical indication and study language or sample size. Seven studies were eventually included (4 RCTs and 3 retrospective observational studies), enrolling 650 women. The meta-analysis showed that the total procedure time was significantly shorter for morcellation than for resection (weighted mean difference = 9.36 minutes; 95% confidence interval [CI], −15.08 to −3.64). When reviewing RCTs only, intrauterine morcellation was associated with a smaller fluid deficit and lower odds of incomplete lesion removal. This difference was not statistically significant in observational studies. There was no significant difference in the odds of surgical complications (odds ratio = 0.72; 95% CI, 0.20–2.57) or the number of insertions (weighted mean difference = −3.04; 95% CI, −7.86–1.78). In conclusion, compared with hysteroscopic resection, hysteroscopic morcellation is associated with a shorter operative time and possibly lower odds of incomplete lesion removal. The certainty in evidence was limited by heterogeneity and the small sample size. © 2016 AAGL

Author Info:
aDepartment of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, United States
bDepartment of Obstetrics and Gynecology, Assiut University, Assiut, Egypt
cMayo Clinic Library, Mayo Clinic, Rochester, Minnesota, United States
dEvidence-based Practice Center, Center for Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, United States


Authors:
Soliman, M.K.a,b,  Agarwal, A.a,  Sarwar, S.a,  Hanout, M.a,  Sadiq, M.A.a,  Do, D.V.a,  Nguyen, Q.D.a

Journal:
Ophthalmic Surgery Lasers and Imaging Retina

Date of Publishing:
Volume 47, Issue 1, January 2016, Pages 60-68

Title:
Pharmacologic Vitreolysis in Vascular Diseases of the Retina‎

Abstract:
Vascular diseases of the retina such as diabetic retinopathy and vascular occlusions account for a large proportion of visual morbidity and blindness worldwide. The role of vitreous in the pathogenesis of these conditions has been increasingly recognized. Despite advances in the surgical technique of pars plana vitrectomy, the use of intravitreal agents for the lysis of vitreous has received attention, guided largely by promising results from the trials involving patients with non-vascular retinal diseases such as vitreomacular traction. The purpose of this review is to provide a comprehensive summary of the present knowledge on pathophysiologic basis of pharmacologic vitreolysis and its efficacy in vascular diseases of the retina. A review of completed and ongoing clinical trials will be presented, along with insights into future directions of this therapy.

Author Info:
aOcular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska, Medical Center, 985540 Nebraska Medical Center, Omaha, NE 68198-5540, United States
bDepartment of Ophthalmology, Assiut University Hospital, Assiut University, Assiut, Egypt


Authors:
Suliman, Y.A.aEmail Author,  Agrawal, H.b,  Furst, D.E.c

Journal:
Scleroderma: From Pathogenesis to Comprehensive Management

Title:
Clinical Trial Design in Systemic Sclerosis‎

Abstract:
Clinical trial methodology in SSc is evolving and has been improving. This chapter reviews updated aspects of clinical trials such as epidemiology, phases of trial design, outcome measures, surrogate measures, patient selection, analysis, and updated guidelines for trial design. © Springer Science+Business Media New York 2017.

Author Info:
aDepartment of Rheumatology and Rehabilitation, Assiut University Hospital, Assiut, Egypt
bDepartment of Internal Medicine, Division of Cardiology, Paul. L. Foster School of Medicine, Texas Tech University, El Paso, TX, United States
cDepartment of Rheumatology, University of California, Los Angeles, Los Angeles, CA, United States


Authors:
Wagdy, W.M.aEmail Author,  Othman, M.H.M.c,  Saluzzo, C.M.b,  Abdallah, A.E.H.c

Date of Publishing:
Volume 47, Issue 3, 1 September 2016, Pages 853-858

Title:
Role of Infrapopliteal Angioplasty in Diabetic and Non-Diabetic ‎Patients‎

Abstract:
Objective To compare the outcomes of infrapopliteal angioplasty between diabetic patients and non-diabetic patients with critical limb ischemia. Patients and methods From March 2014 to December 2014, infrapopliteal angioplasty was performed on 60 limbs (43 men and 17 women with mean age 70.13 years) with the CLI (Fontaine's grade III or IV). The number of diabetic patients was 40 (66.66%). Follow-up included clinical examination for rest pain improvement and ischemic ulcer healing, and duplex-documented target vessel patency or re-stenosis at discharge and at 3 months. Results The technical success rate was 100% in diabetic and non-diabetic groups. The ulcer healing rate was 33/37 (89.18%) in diabetic patients vs. 14/15 (93.3%) in non-diabetic patients. And the re-stenosis and re-occlusion rates of treated vessels after 3 months were 10.0% in diabetic vs. 5.0% in non-diabetic groups. Conclusion There were no significant differences between the 2 groups in the technical success rate, but the 3 months clinical success rate and the primary patency rate were better in non-diabetic than in diabetic patients with no significant differences. © 2016 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aRadiodiagnosis Department, Qena University Hospital, Egypt
bInterventional unit, Istituto di Cura Citta‘ di Pavia, Italy
cRadiodiagnosis Department, Faculty of Medicine, Assiut University, Egypt


Authors:
Yosef, A.a,bEmail Author,  Ahmed, A.G.bEmail Author,  Al-Hussaini, T.bEmail Author,  Abdellah, M.S.bEmail Author,  Cua, G.aEmail Author,  Bedaiwy, M.A.aEmail Author

Date of Publishing:
Volume 21, Issue 4, 1 December 2016, Pages 205-221

Title:
Chronic Pelvic Pain: Pathogenesis and Validated Assessment‎

Abstract:
Chronic pelvic pain (CPP) is a disabling disease that causes distress as the quality of life of CPP patients is vastly diminished. In addition, CPP is a public health crisis and is a burden on healthcare expenditure. In the United States, the annual costs for the diagnosis and treatment of CPP are 2.8 billion US $. Moreover, to the indirect cost resulting from the absence from work and CPP associated family problems add 550 million US $ more making the economic burden more than 3.4 billion US $ (Mathias et al., 1996). Yet, the diagnosis of CPP is usually complicated as there are no gold standard guidelines that clearly define this syndrome. Although we have a limited understanding of its etiology, CPP has been found to be correlated with central sensitization, painful bladder syndrome, irritable bowel syndrome, endometriosis and adhesions. As such, in the evaluation of patients, it is imperative to take a comprehensive patient history. Performing physical examinations and ultrasound imaging is of particular value to elucidate the etiology of pain. As CPP patients are at risk for psychological disorders, psychological assessments are critical to diagnose associated psychological disorders and to take these into account in planning a holistic treatment plan for patients. By such evaluation techniques, we can provide better diagnostic service and patient care to people with CPP. © 2016 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, University of British Columbia, Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, V6H3N1, Canada
bDepartment of Obstetrics and Gynecology, Assiut University, Egypt


Title:
Diagnosis of Pulmonary Tuberculosis and Detection of Resistance to ‎Rifampin and Isoniazid through Direct Molecular Methods in Stool ‎Samples‎

Abstract:
BACKGROUND:
Tuberculosis (TB) is an infectious disease that is caused by Mycobacterium tuberculosis (M.tb). TB has high morbidity and mortality around the world.

OBJECTIVE:
To evaluate molecular-based methods performed directly on stool samples for the diagnosis of pulmonary tuberculosis (PTB) and to determine the susceptibility to Rifampicin (RMP) and Isoniazid (INH).

STUDY DESIGN:
This is a descriptive study evaluating the performance of the PCR-based method for direct PTB diagnosis and to determine the susceptibility of RMP and INH using stool samples from PTB patients. The study was conducted between March 2011 and March 2014.

METHODS:
Three stool samples and three sputum samples (n=300 stool and 300 sputum) were collected from 100 PTB patients (75 pretreatment and 25 follow up). Stool samples (n=60) were also collected from 20 healthy individuals to serve as controls. DNA was extracted from stool samples using Chelex®-100. PTB was diagnosed using a Genekam® kit. RMP and INH susceptibility testing was performed using the Genotype MTBDRplus® assay. The sputum Lowenstein Jensen (LJ) culture and agar proportion method (PM) of drug susceptibility testing for INH and RMP were considered to be the gold standard methods for comparing the results of the molecular methods.

RESULTS:
The Genekam kit showed 100% sensitivity and 95.24% specificity for diagnosing new patients and showed 100% sensitivity and 80% specificity for follow-up patients. The Genotype MTBDR-plus assay showed 86.4% and 100% sensitivity and 98.1% and 97.8% specificity for determining INH and RMP sensitivity, respectively, in newly diagnosed patients and 85.7% and 94.4% sensitivity and specificity, respectively, for both INH and RMP in follow-up patients.

CONCLUSION:
Molecular-based methods are promising techniques for the diagnosis and susceptibility testing of PTB when the ease of sample collection and the speed of diagnosis are taken into consideration. However, they are not as useful for assessing follow-up patients


Authors:
Zahran, K.M.Email Author,  Abd Elaal, D.E.M.Email Author,  Kamel, H.S.Email Author,  Samy, E.I.Email Author,  Ismail, A.M.Email Author,  Abbas, A.M.

Date of Publishing:
Volume 21, Issue 1, 1 March 2016, Pages 22-26

Title:
A Combination Treatment of Folic Acid, Aspirin, Doxycycline and ‎Progesterone for Women with Recurrent Early Pregnancy Loss; Hospital ‎Based Study‎

Abstract:
Objective: The study aims to state the effectiveness of a new combination treatment composed of folic acid, doxycycline, low dose aspirin and natural progesterone in cases of recurrent early pregnancy loss. Study design: A clinical comparative hospital-based study. Setting: Women Health Hospital - Assiut University - Egypt. Materials and methods: All patients with recurrent early pregnancy loss at 10 weeks or less attending our antenatal care unit were included. The patients were recruited over a period of 16 months and allocated into two groups. The study group received a regimen of folic acid, doxycycline, aspirin, and progesterone. The control group did not receive the previous regimen in the proposed way. The main outcome measures the live birth rate and complications of pregnancy in both groups. Results: Three hundred patients were recruited, with 150 women in each group. A high rate of live births was found in the study group (76.0%) more than the control group (59.3%). Women in the Control Group reported more complications (76.0% vs. 51.3%). These were mainly abortion (40.0% vs. 23.3%), pre-eclampsia (16.0% vs. 10.7%) and oligohydramnios (10.0% vs. 6.7%). Conclusion: The implementation of combination treatment of folic acid, doxycycline, low dose aspirin and natural progesterone resulted in a significant increase in the live birth rate, a significant reduction in miscarriages, and lower incidence of complications in patients with recurrent early pregnancy loss. © 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of Middle East Fertility Society.

Author Info:
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Women Health Hospital, Assiut, 71111, Egypt


Authors:
Zaky, S.a,  Makhlouf, N.A.a,  Abdel-Malek, M.O.a,  Bakheet, A.A.a,  Seif, H.M.A.b,  Hamza, H.M.c,  Sabry, A.M.M.d

Date of Publishing:
Volume 27, Issue 2, March 2016, Page 204

Title:
‎"Authors' Reply: Good Selection of Hepatocellular Carcinoma Cases for ‎Radiofrequency Ablation Yield Better Outcome."‎

Author Info:
aDepartment of Tropical Medicine and Gastroenterology, Assiut University, Faculty of Medicine, Assiut, Egypt
bDepartment of Radiology, Assiut University Faculty of Medicine, Assiut, Egypt
cDepartment of Oncology Surgery, Assiut University South Egypt Cancer Institute, Assiut, Egypt
dDepartment of Internal Medicine, Assiut University Faculty of Medicine, Assiut, Egypt


Authors:
Zedan, H.M.a,  Gaber, H.D.aEmail Author,  Ibrahim, A.K.b,  Refaa, E.Z.a

Date of Publishing:
Volume 13, Issue 3, 1 September 2016, Pages 143-150

Title:
Reliability and Validity of the Arabic Version of the Psoriasis Disability Index ‎Questionnaire‎

Abstract:
Background Psoriasis has a significant negative impact on patients' quality of life. Psoriasis Disability Index (PDI) is a psoriasis-specific questionnaire that was developed by Finlay and Coles, which concerns the functional lifestyle disabilities caused by psoriasis. It has been used internationally for almost 20 years and has been translated into at least 26 languages. Objective The objective of this study was to evaluate the reliability and validity of the Arabic version of the PDI questionnaire for Egyptian psoriasis patients. Patients and methods One hundred adult Egyptian patients with chronic plaque-type psoriasis aged 16 years or older with no other systemic disease were enrolled in this study. The patients were examined to determine the clinical type of psoriasis and to measure the severity of psoriasis by calculating Psoriasis Area Severity Index score. The impact of psoriasis on quality of life was assessed using the Arabic version of the PDI after translation and cultural adaptation according to WHO guidelines. Results The internal consistency for the 15 items of the Arabic version of the PDI questionnaire was significant; intraclass correlation coefficient was 0.853 and Cronbach's α coefficient was 0.860, indicating reliability of the developed Arabic version. Conclusion The Arabic version of the PDI questionnaire was found to be a reliable and valid measure for evaluating the quality of life for Egyptian patients with psoriasis. © 2016 Egyptian Women's Dermatologic Society.

Author Info:
aDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, 17515, Egypt
bDepartment of Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt


