# Internationally Published Papers 2017

Authors:
Thabet AF1, Moeen SM1, Labiqe MO1, Saleh MA2.

Title:
Could Intradialytic Nutrition Improve Refractory Anaemia In Patients Undergoing Haemodialysis?

Abstract:
BACKGROUND:
This prospective randomised study was designed to evaluate the efficacy of intradialytic parenteral nutrition (IDPN) therapy in malnourished patients with refractory anaemia.

METHODS:
Forty patients who were malnourished with a BMI not greater than 23 (17-23) kg/m2 , undergoing regular HD were included. Of those, 20 patients received 500-1000 ml of IDPN at a rate of 250-300 ml/h at each HD session three days per week for six consecutive months. The other 20 patients did not receive IDPN infusion. The malnutrition inflammation score (MIS) and haematological parameters were recorded at baseline and after three and six months.

RESULTS:
Mean haemoglobin levels, BMI and serum albumin were significantly increased while MIS was significantly decreased after the 3rd and 6th months of IDPN.

CONCLUSION:
IDPN has a good role in improving refractory anaemia by significantly increasing haemoglobin levels, body weight, and serum albumin levels. The intervention also significantly decreases the MIS of patients.

Author Info:
1
Faculty of Medicine Assiut University, Department of Internal Medicine, Assiut, Egypt.
2
Faculty of Medicine, Public Health and Community Medicine, Assiut University, Assiut, Egypt.


Authors:
Taha O1,2, Abdelaal M3, Abozeid M4, Askalany A1, Alaa M2.

Title:
Outcomes of One Anastomosis Gastric Bypass in 472 Diabetic Patients

Abstract:
BACKGROUND:
The positive impact of Roux-en-Y gastric bypass (RYGB) on metabolic syndrome and glycemic control has been proven in obese patients. One anastomosis gastric bypass (OAGB) is a simple, effective and easy to learn procedure. OAGB provides encouraging results for the treatment of diabetes obese patients, but does it have the ability to be an alternative procedure to RYGB in the treatment of these patients? The aim of this study is to evaluate the outcomes of OAGB on diabetic obese patients at the bariatric centre of our university hospital. By extension, we evaluated the possibility of BMI and the preoperative antidiabetic medication usage to be predictive factors for postoperative diabetes resolution.

METHODS:
This is a retrospective single-centre study of 472 diabetic patients who underwent OAGB from November 2009 to December 2015. All patients were followed-up for at least 1 year, and up to 3 years, where available. Weight, HbA1c, and anti-diabetic medications were recorded at baseline, 3, 6, 12, 24 and 36 months.

RESULTS:
A total of 472 patients have been followed-up for 1 year and 361 for 3 years. The mean BMI decreased from 46.8 ± 7.2 to 29.5 ± 2.8 kg/m2 and HbA1c from 9.6 ± 1.3 to 5.7 ± 1.5% at the 12-month follow-up. At the 3-year follow-up, the mean BMI was 32.1 ± 3.3 and HbA1c mean was 5.8 ± 0.9%. Diabetes remission was achieved by 84.1% of patients.

CONCLUSIONS:
OAGB can be an excellent alternative to RYGB for the treatment of diabetes and obesity. Pre-operative medications may be used to predict postoperative diabetes remission, but not BMI.

Author Info:
1
Plastic and Obesity Surgery Department, Assiut University Hospital, Assiut, Egypt.
2
Overweight Clinics, Cairo, Egypt.
3
Plastic and Obesity Surgery Department, Assiut University Hospital, Assiut, Egypt. Mahmoud.abdel-aal@ucdconnect.ie.
4
General Surgery Department, Ain Shams University hospital, Cairo, Egypt.


Authors:
Thabit AG1, Hassan MA2, Agban MN2, Makhlouf NA2, Khalil NK3, Hassan HM1, El-Mokhtar MA1.

Title:
Prevalence of Occult HBV Infection Among Chronic Hepatitis C Patients in Upper Egypt

Abstract:
Occult hepatitis B virusinfection (OBI) is defined as the presence of HBV DNA in liver or serum of individuals who test negative for hepatitis B surface antigen (HBsAg).We aimed at determining the prevalence of OBI in patients chronically infected with HCV in Upper Egypt and to evaluate the possible impact of OBI on the progression of the liver disease. This study included 200 chronic HCV infected patients. HBV DNA was detected in the serum of 21 patients (10.5%) by nested PCR. 13 of them were positive for anti-HBc. HBV viral load ranged from 4.2-60.1 IU/ml. The percentage of cirrhotics was higher among OBI/HCV dual infection (52.4%) versus HCV mono infection (34.1%). Our study concluded that the prevalence of OBI among chronic HCV patients in Upper Egypt was 10.5%. OBI correlated with the severity of liver disease. Total anti-HBc cannot be used as a surrogate marker for detection of OBI.

Author Info:
1
Department of Microbiology & Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
2
Department of Tropical Medicine & Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
3
Assiut Liver Center for Treatment of Hepatitis C, Assiut, Egypt.


Authors:
Tohamy A1,2, Klomp M1, Putter H3, Youssef A2, Shams-Eddin H2, Abdelsabour M2, Schalij MJ1, Jukema JW1.

Title:
Very Long-Term Follow-Up After Coronary Rotational Atherectomy: A Single-Center Experience

Abstract:
We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57.9% (standard error [SE]: 5.0%). When comparing patients who received a drug-eluting stent (DES; n = 68) versus patients who did not (balloon only, bare-metal stent, or none of the aforementioned; n = 75), the RA + DES demonstrated very long-term MACE of 49.2% (SE: 7.5%) versus 62.7% (SE: 6.1%), P = .160 with TVR as the most discriminating factor, 10.7% (SE: 4.0%) versus 29.2% (SE: 6.0%), P = .016. Our results point to RA having reasonable long-term clinical results, especially in combined treatment with DES. To date, our study has the longest follow-up after RA.

Author Info:
1
1 Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
2
2 Department of Cardiology, Assiut University Hospital, Assiut, Egypt.
3
3 Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands.


Authors:
Trojan K1, Zhu L1,2, Aly M1,3, Weimer R4, Bulut N4, Morath C5, Opelz G1, Daniel V1.

Title:
Association Of Peripheral NK Cell Counts With Helios+ IFN-γ- Tregs In Patients With Good Long-Term Renal Allograft Function.

Abstract:
Little is known about a possible interaction of natural killer (NK) cells with regulatory T cells (Treg ) in long-term stable kidney transplant recipients. Absolute counts of lymphocyte and Treg subsets were studied in whole blood samples of 136 long-term stable renal transplant recipients and 52 healthy controls using eight-colour fluorescence flow cytometry. Patients were 1946 ± 2201 days (153-10 268 days) post-transplant and showed a serum creatinine of 1·7 ± 0·7 mg/dl. Renal transplant recipients investigated > 1·5 years post-transplant showed higher total NK cell counts than recipients studied < 1·5 years after transplantation (P = 0·006). High NK cells were associated with high glomerular filtration rate (P = 0·002) and low serum creatinine (P = 0·005). Interestingly, high NK cells were associated with high CD4+ CD25+ CD127- forkhead box protein 3 (FoxP3+ ) Treg that co-express the phenotype Helios+ interferon (IFN)-γ- and appear to have stable FoxP3 expression and originate from the thymus. Furthermore, high total NK cells were associated with Treg that co-express the phenotypes interleukin (IL)-10- transforming growth factor (TGF)-β+ (P = 0·013), CD183+ CD62L- (P = 0·003), CD183+ CD62+ (P = 0·001), CD183- CD62L+ (P = 0·002), CD252- CD152+ (P < 0·001), CD28+ human leucocyte antigen D-related (HLA-DR- ) (P = 0·002), CD28+ HLA-DR+ (P < 0·001), CD95+ CD178- (P < 0·001) and CD279- CD152+ (P < 0·001), suggesting that these activated Treg home in peripheral tissues and suppress effector cells via TGF-β and cytotoxic T lymphocyte-associated protein 4 (CTLA-4). The higher numbers of NK and Treg cell counts in patients with long-term good allograft function and the statistical association of these two lymphocyte subsets with each other suggest a direct or indirect (via DC) interaction of these cell subpopulations that contributes to good long-term allograft acceptance. Moreover, we speculate that regulatory NK cells are formed late post-transplant that are able to inhibit graft-reactive effector cells.

Author Info:
1
Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.
2
Department of Hematology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
3
Nephrology Unit, Internal Medicine Department, Assiut University, Egypt.
4
Department of Internal Medicine, University of Giessen, Giessen, Germany.
5
Department of Nephrology, University of Heidelberg, Heidelberg, Germany.


Authors:
Trojan K1, Unterrainer C1, Weimer R2, Bulut N2, Morath C3, Aly M1,4, Zhu L1,5, Opelz G1, Daniel V1.

Title:
Helios Expression And Foxp3 TSDR Methylation Of IFNy+ and IFNy- Treg From Kidney Transplant Recipients With Good Long-Term Graft Function.

Abstract:
BACKGROUND:
There is circumstantial evidence that IFNy+ Treg might have clinical relevance in transplantation. IFNy+ Treg express IFNy receptors and are induced by IFNy. In the present study we investigated in kidney transplant recipients with good long-term stable graft function the absolute cell counts of IFNy+ Treg subsets and whether their expression of Foxp3 is stable or transient.

METHOD:
Helios expression determined by eight-color-fluorescence flow cytometry and methylation status of the Foxp3 Treg specific demethylation region (TSDR) served as indicators for stability of Foxp3 expression. Methylation status was investigated in enriched IFNy+ and IFNy- Treg preparations originating from peripheral blood using high resolution melt analysis. A total of 136 transplant recipients and 52 healthy controls were studied.

RESULTS:
Proportions of IFNy+ Treg were similar in patients and healthy controls (0.05% and 0.04% of all CD4+ lymphocytes; p = n.s.). Patients also had similar absolute counts of IFNy producing Helios+ and Helios- Treg (p = n.s.). Most of the IFNy+ and IFNy- Treg in transplant recipients had a methylated Foxp3 TSDR, however, there was a sizeable proportion of IFNy+ and IFNy- Treg with demethylated Foxp3 TSDR. Male and female patients showed more frequently methylated IFNy+ and IFNy- Treg than male and female controls (all p<0.05).

CONCLUSIONS:
Kidney transplant recipients with good long-term stable graft function have similar levels of IFNy+ Treg as healthy controls. IFNy+ and IFNy- Treg subsets in patients consist of cells with stable and cells with transient Foxp3 expression; however, patients showed more frequently methylated IFNy+ and IFNy- Treg than controls. The data show increased levels of Treg sub

Author Info:
1
Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany.
2
Department of Internal Medicine, University of Giessen, Giessen, Germany.
3
Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
4
Nephrology unit, Internal Medicine Department, Assiut University, Assiut, Egypt.
5
Department of Hematology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.


Title:
IL-10 and TGF-β: Roles In Chondroprotective Effects Of Glucosamine In Experimental Osteoarthritis?

Abstract:
OBJECTIVE:
Osteoarthritis (OA) is a complex disease of the whole joint. Glucosamine (GlcN) treatment may have a chondroprotective effect on OA. We investigated the mechanism of action of glucosamine treatment through interleukin-10 (Il-10) and transforming growth factor β-1 (TGF β-1).

METHODS:
Thirty male albino rats were used. A single intraarticular (i.a.) injection of 2mg of Monosodium Iodoacetate (MIA) was injected into the knee joint of anesthetized rats. GlcN (50 or 100mg/kg/day, p.o. for 2 month) was administered orally. Serum levels of Il-10 and TGF-β1 were determined by ELISA. Histopathological changes in treated and control joints were examined using hematoxylin-eosin (H & E) staining.

RESULTS:
The mean serum level of IL-10 significantly decreased in the OA group compared to control group (P value<0.0001). On the other hand, mean serum level of IL-10 significantly increased in GlcN treated groups when compared to the OA group (P value<0.0001). Serum level of TGF β-1 was significantly elevated in OA group compared to control group (P value<0.0001). On the other hand, the mean serum level of TGF β-1 was significantly decreased in the GlcN treated groups when compared to the OA group (P value<0.0001). Histopathological evaluation of GlcN treated groups showed different grades of healing, according to Osteoarthritis Research Society International (OARSI) grading system.

CONCLUSION:
Our results showed that IL-10 and TGF-β1 possibly mediate GlcN chondroprotective effects in OA. Both serum biomarkers can be useful in the follow-up of articular cartilage damage in clinical settings.

Author Info:
1
Department of Physiology, Faculty of Medicine, Helwan University, Cairo, 11795, Egypt. Electronic address: nwaly@icloud.com.
2
Department of Pathology Faculty of Medicine, Assiut University, Assiut, 71515, Egypt. Electronic address: abeer_refaiy@yahoo.com.
3
Department of Biochemistry, Faculty of Pharmacy, MSA University, Giza, 11787, Egypt. Electronic address: naborehab@msa.eun.eg.


Title:
Folic Acid Improve Developmental Toxicity Induced By Aluminum Sulphates

Abstract:
Aluminum sulphate has a significant toxic effects for humans. Aluminum is one of the most abundant metal on the Earth crust. The purpose of this study is to evaluate the effects of short term exposure to aluminum sulphate on the bone development of the fetuses in rats, and if folic acid has a protective role upon that effects or not. Forty female rats were used, ten per group, GI served as negative control (receive nothing except normal feeding and water), GII served as positive control (receive water by gastric gavage), GIII treated with aluminum sulphate orally by gastric gavage and GIV treated with aluminum sulphate with folic acid. Mating occurred and known by presence of vaginal plug in the female rats. Rats were killed on day 18 of gestation.

RESULTS:
The female rats weight were significantly reduced in the treated group if compared with the control group (p>0.001), all parameters of the fetuses, fetal weight, malformation and the crown rump length reduced significantly p value were <0.000, <0.001, and <0.000 respectively. In histopathological results the aluminum treated group showed severe limited area of preossfication in fetuses vertebrae. Folic acid gave a protective role for all the hazardous effects of aluminum sulphate and prove the diameters measured and also the histopathological effects.

CONCLUSION:
Aluminum sulphate can produce hazardous effects on bone of the fetuses, which may affect the life

Author Info:
1
Assiut University, Faculty of Medicine, Forensic and Clinical Toxicology Department, Egypt. Electronic address: heba612@hotmail.com.
2
Assiut University, Faculty of Medicine, Forensic and Clinical Toxicology Department, Egypt.
3
Assiut University, Faculty of Medicine, Anatomy and Embryology Department, Egypt.


Authors:
Zahran AM1, Eltayeb AA2, Elsayh KI2, Saad K3, Ahmad FA2, Ibrahim AIM2.

Title:
Activated and Memory T Lymphocytes in Children with Gaucher Disease

Abstract:
Gaucher disease (GD) is the most prevalent lysosomal storage disorder. Gaucher disease is associated with remarkable alterations in the immune system, and GD patients are more susceptible to infections and are at a higher risk of developing autoimmune disorders and malignancies. In a case-control study, we used three-color flow cytometric immunophenotyping for determination of the frequency of lymphocyte subpopulations and activated T lymphocytes among 18 children with GD1 under enzyme replacement therapy managed in Assiut University Hospitals. We found significant increases in the frequencies of total lymphocytes, CD19+, CD3+, CD4+, and CD8+ in children with GD1 when compared to healthy control. The frequencies of activated T lymphocytes (CD3+HLA-DR+), activated T-helper cells (CD4+HLA-DR+), and activated T-suppressor/cytotoxic cells (CD8+HLA-DR+) were significantly higher in GD1 as compared to healthy children. Our data show that the increased proportion of activated T lymphocytes in children with GD1 raises the issue of their possible involvement in the pathogenesis of the immune dysfunction seen in these patients. Our data suggested that the activated T lymphocytes could play a role in the clinical course of GD1. The relationship of these cells to immune disorders in GD1 children remains to be determined.

Author Info:
1
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
2
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.


Authors:
Zahran AM1, Saad K2, Elsayh KI3, Alblihed MA4.

Title:
Characterization Of Circulating CD4+ CD8+ Double Positive And CD4- CD8- Double Negative T-Lymphocyte In Children With Β-Thalassemia Major

Abstract:
Infectious complications represent the second most common cause of mortality and a major cause of morbidity in β-thalassemia major (BTM), with a prevalence of 12-13%. The data on unconventional T-lymphocyte subsets in BTM children are limited. The aim of the present study was to investigate and evaluate phenotypic alterations in CD4+CD8+ double positive (DP), CD4- CD8- double negative (DN), and natural killer T-lymphocytes (NKT) in BTM children in comparison to healthy controls. Our case control study included 80 children with BTM and 40 healthy children as controls. Assessment of unconventional T-lymphocyte populations was done using sensitive four-color flow cytometry (FACSCalibur). Our analysis of the data showed a significantly higher frequency CD4+ CD8+ (double-positive) T cells, CD4- CD8- (double negative) T cells, and natural killer T cells in the peripheral blood of both BTM groups (splenectomized and non-splenectomized) as compared to healthy controls, suggesting that these cells may play a role in the clinical course of BTM. The relationship of the unconventional T-lymphocytes to immune disorders in BTM children remains to be determined. Further longitudinal study with a larger sample size is warranted to elucidate the role these cells in BTM.

Author Info:
1
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
2
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt. ksaad8@yahoo.com.
3
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
4
Medical Biochemistry Department, School of Medicine, Taif University, Taif, Saudi Arabia.


Authors:
Yang JD1, Mohamed EA1, Aziz AO2, Shousha HI2, Hashem MB2, Nabeel MM2, Abdelmaksoud AH3, Elbaz TM2, Afihene MY4, Duduyemi BM5, Ayawin JP4, Gyedu A6, Lohouès-Kouacou MJ7, Ndam AW7, Moustafa EF8, Hassany SM8, Moussa AM8, Ugiagbe RA9, Omuemu CE9, Anthony R10, Palmer D11, Nyanga AF11, Malu AO12, Obekpa S12, Abdo AE13, Siddig AI13, Mudawi HM14, Okonkwo U15, Kooffreh-Ada M15, Awuku YA16, Nartey YA16, Abbew ET16, Awuku NA16, Otegbayo JA17, Akande KO17, Desalegn HM18, Omonisi AE19, Ajayi AO19, Okeke EN20, Duguru MJ20, Davwar PM20, Okorie MC20, Mustapha S21, Debes JD22, Ocama P23, Lesi OA24, Odeghe E24, Bello R25, Onyekwere C26, Ekere F26, Igetei R26, Mah'moud MA27, Addissie B1, Ali HM1, Gores GJ1, Topazian MD1, Roberts LR28; Africa Network for Gastrointestinal and Liver Diseases.

Title:
Characteristics, Management, And Outcomes Of Patients With Hepatocellular Carcinoma In Africa: A Multicountry Observational Study From The Africa Liver Cancer Consortium

Abstract:
BACKGROUND:
Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa.

METHODS:
We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories. Participating institutions were from Cameroon, Egypt, Ethiopia, Ghana, Ivory Coast, Nigeria, Sudan, Tanzania, and Uganda. Clinical information-demographic characteristics, cause of disease, liver-related blood tests, tumour characteristics, treatments, last follow-up date, and survival status-for patients diagnosed with hepatocellular carcinoma between Aug 1, 2006, and April 1, 2016, were extracted from medical records by participating investigators. Because patients from Egypt showed differences in characteristics compared with patients from the other countries, we divided patients into two groups for analysis; Egypt versus other African countries. We undertook a multifactorial analysis using the Cox proportional hazards model to identify factors affecting survival (assessed from the time of diagnosis to last known follow-up or death).

FINDINGS:
We obtained information for 2566 patients at 21 tertiary referral centres (two in Egypt, nine in Nigeria, four in Ghana, and one each in the Ivory Coast, Cameroon, Sudan, Ethiopia, Tanzania, and Uganda). 1251 patients were from Egypt and 1315 were from the other African countries (491 from Ghana, 363 from Nigeria, 277 from Ivory Coast, 59 from Cameroon, 51 from Sudan, 33 from Ethiopia, 21 from Tanzania, and 20 from Uganda). The median age at which hepatocellular carcinoma was diagnosed significantly later in Egypt than the other African countries (58 years [IQR 53-63] vs 46 years [36-58]; p<0·0001). Hepatitis C virus was the leading cause of hepatocellular carcinoma in Egypt (1054 [84%] of 1251 patients), and hepatitis B virus was the leading cause in the other African countries (597 [55%] of 1082 patients). Substantially fewer patients received treatment specifically for hepatocellular carcinoma in the other African countries than in Egypt (43 [3%] of 1315 vs 956 [76%] of 1251; p<0·0001). Among patients with survival information (605 [48%] of 1251 in Egypt and 583 [44%] of 1315 in other African countries), median survival was shorter in the other African countries than in Egypt (2·5 months [95% CI 2·0-3·1] vs 10·9 months [9·6-12·0]; p<0·0001). Factors independently associated with poor survival were: being from an African countries other than Egypt (hazard ratio [HR] 1·59 [95% CI 1·13-2·20]; p=0·01), hepatic encephalopathy (2·81 [1·72-4·42]; p=0·0004), diameter of the largest tumour (1·07 per cm increase [1·04-1·11]; p<0·0001), log α-fetoprotein (1·10 per unit increase [1·02-1·20]; p=0·0188), Eastern Cooperative Oncology Group performance status 3-4 (2·92 [2·13-3·93]; p<0·0001) and no treatment (1·79 [1·44-2·22]; p<0·0001).

INTERPRETATION:
Characteristics of hepatocellular carcinoma differ between Egypt and other African countries. The proportion of patients receiving specific treatment in other African countries was low and their outcomes were extremely poor. Urgent efforts are needed to develop health policy strategies to decrease the burden of hepatocellular carcinoma in Africa.

FUNDING:
None.

Author Info:
1
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
2
Endemic Medicine and Hepatogastroenterology Department, University of Cairo, Cairo, Egypt.
3
Department of Diagnostic and Interventional Radiology, University of Cairo, Cairo, Egypt.
4
Department of Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
5
Department of Pathology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
6
Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
7
Department of Hepatology and Gastroenterology, Centre Hospitalier Universitaire de Cocody, Abidjan, Côte d'Ivoire.
8
Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut Governorate, Egypt.
9
Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.
10
Department of Internal Medicine, Effia Nkwanta Regional Hospital, Sekondi, Ghana.
11
Department of Internal Medicine, Mbingo Baptist Hospital, Bamenda, Cameroon.
12
Department of Medicine, Benue State University Teaching Hospital, Benue, Nigeria.
13
Department of Gastroenterology, Ibnsina, Khartoum, Sudan.
14
Department of Internal Medicine, University of Khartoum, Khartoum, Sudan.
15
Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
16
Department of Internal Medicine, School of Medical Sciences, Cape Coast, Ghana.
17
Department of Medicine, University of Ibadan, Ibadan, Nigeria.
18
Department of Internal Medicine, St. Paul's Hospital Millenium Medical College, Addis Ababa, Ethiopia.
19
Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.
20
Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.
21
Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
22
Department of Medicine, University of Minnesota, MN, USA; Department of Medicine, Arusha Lutheran Medical Center, Arusha, Tanzania.
23
Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
24
Division of Gastroenterology and Hepatology, Lagos University Teaching Hospital, Lagos, Nigeria.
25
Department of Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria.
26
Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria.
27
Division of Gastroenterology, Duke University, Durham, NC, USA.
28
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Electronic address: roberts.lewis@mayo.edu.


Authors:
Zahran AM1, Saad K2, Elsayh KI3, Alblihed MA4, Embaby M3.

Title:
Identification of Clinicopathological Spectrum, Platelet Glycoprotein IIb/IIIa complex and Platelet Antibodies in Egyptian Children with Glanzmann's Thrombasthenia

Abstract:
Glanzmann's thrombasthenia (GT) is a rare genetic bleeding disorder. The aim of our study was to evaluate the clinicopathological spectrum of this syndrome and to study the platelet glycoprotein IIb/IIIa complex and platelet antibodies by flow cytometry in a cohort of children with GT in a tertiary care center in Upper Egypt. Forty children with GT were assessed for the expression of GPIIb-IIIa on the platelet surface and platelet antibodies by using flow cytometry, to determine the most common GT subtypes among Egyptian children. By analysis of platelet GP IIb-IIIa by flow cytometry the classification of patients with GT in our study was type I GT (47.5%), type II GT (32.5%) and type III GT (20%). In this study, we have delineated that type I is the most common type of GT in Upper Egypt. Our data suggested that there is a good correlation between quantitative changes in the surface expression of platelet membrane glycoproteins detected by flow cytometry and the clinical severity of bleeding. Therefore, classifying of severity of bleeding in patients with GT could possibly aid the pediatricians and hematologists in the implementation of ideal prophylactic measures.

Author Info:
1
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
2
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt. ksaad8@yahoo.com.
3
Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
4
Department of Medical Biochemistry, School of Medicine, Taif University, Taif, Saudi Arabia.


Authors:
Zahran KM1, Fadel KA2, Ahmed SM2, El-Gazzar AF2.

Title:
Maternal Mortality In An Academic Institution In Upper Egypt

Abstract:
Maternal mortality is a worldwide problem. Measuring maternal mortality and identifying its causes is essential, and should be assessed regularly for the purpose of planning, monitoring and evaluation of provided maternal health care. Quality of care indicators such as case fatality rate is used to measure the facility performance, in particular, quality and promptness of care. This descriptive study aimed to calculate maternal mortality ratio, quality of care indicators such as maternal mortality index, case fatality and direct obstetric case fatality rate for the Women's Health Hospital and identify causes of maternal mortality, and the main deficits in medical records. The Maternal mortality ratio was alarmingly high in Women's Health Hospital, Assiut University, Egypt reaching 225/100,000, however, those who delivered in the hospital, the MMR was 100.5/100,000. The leading causes of maternal death were obstetric haemorrhage (38.3%), complications of caesarean sections (27.7%) and pre-eclampsia/eclampsia (23.4%). Nearly half (42%) of the deaths occurred during vacations. Quality indicators revealed poor quality of health care.

Author Info:
1
a Obstetrics and Gynecology Department, Faculty of Medicine , Assiut University , Assiut , Egypt.
2
b Public Health and Community Medicine Department, Faculty of Medicine , Assiut University , Assiut , Egypt.


Authors:
Zhu L1,2, Aly M1,3, Wang H4, Karakizlis H5, Weimer R5, Morath C6, Kuon RJ7, Toth B8, Opelz G1, Daniel V1.

Title:
Decreased NK Cell Immunity In Kidney Transplant Recipients Late Post-Transplant And Increased NK-Cell Immunity In Patients With Recurrent Miscarriage

Abstract:
BACKGROUND:
There is evidence that NK-cell reactivity might affect graft outcome in transplant recipients and pregnancy in women.

METHOD:
NK-cell subsets were determined in whole blood using eight-colour-fluorescence flow cytometry in patients before and after renal transplantation, patients with recurrent miscarriage (RM) and healthy controls (HC).

RESULTS:
Patients late post-transplant (late-Tx) with functioning renal transplants showed abnormally low CD56dimCD16+ NK-cells containing both perforin and granzyme (vs HC p = 0.021) whereas RM patients exhibited abnormally high numbers of these cells (vs HC p = 0.043). CD56dimCD16+perforin+granzyme+ NK-cell counts were strikingly different between the two patient groups (p<0.001). In addition, recipients late-Tx showed abnormally low CD8+ NK-cells (vs HC p<0.001) in contrast to RM patients who showed an abnormal increase (vs HC p = 0.008). CD8+ NK-cell counts were strongly different between the two patient groups (p<0.001). Higher perforin+granzyme+CD56dimCD16+ and CD8+ NK-cells were associated with impaired graft function (p = 0.044, p = 0.032). After in-vitro stimulation, CD56dimCD16+ and CD56brightCD16dim/- NK-cells showed strong upregulation of CD107a and IFNy, whereas the content of perforin decreased dramatically as a consequence of perforin release. Recipients late post-Tx showed less in-vitro perforin release (= less cytotoxicity) than HC (p = 0.037) and lower perforin release was associated with good graft function (r = 0.738, p = 0.037). Notably, we observed strong in-vitro perforin release in 2 of 6 investigated RM patients. When circulating IL10+CD56bright NK-cells were analyzed, female recipients late post-Tx (n = 9) showed significantly higher relative and absolute cell numbers than RM patients (p = 0.002 and p = 0.018, respectively); and high relative and absolute IL10+CD56bright NK-cell numbers in transplant recipients were associated with low serum creatinine (p = 0.004 and p = 0.012) and high glomerular filtration rate (p = 0.011 and p = 0.002, respectively). Female recipients late post-Tx exhibited similar absolute but higher relative numbers of IL10+IFNy- NK-cells than RM patients (p>0.05 and p = 0.016, respectively).

CONCLUSION:
NK-cells with lower cytotoxicity and immunoregulatory function might contribute to good long-term graft outcome, whereas circulating NK-cells with normal or even increased cytotoxicity and less immunoregulatory capacity are observed in patients with RM.

Author Info:
1
Transplantation-Immunology, Institute of Immunology, University Hospital Heidelberg, Im Neuenheimer Feld 305, Heidelberg, Germany.
2
Department of Hematology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
3
Nephrology unit, Internal Medicine Department, Assiut University, Âssiut, Egypt.
4
Department of Cardiovascular Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
5
Department of Internal Medicine, University of Giessen, Klinikstraße 33, Giessen, Germany.
6
Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
7
Department of Obstetrics and Gynecology, University Hospital Heidelberg, Im Neuenheimer Feld 440, Heidelberg, Germany.
8
Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstraße 35, Innsbruck, Austria.


Authors:
Abdel-Zaher AO1, Farghaly HSM2, Farrag MMY2, Abdel-Rahman MS2, Abdel-Wahab BA2.

Title:
A Potential Mechanism For The Ameliorative Effect Of ‎Thymoquinone On Pentylenetetrazole-Induced Kindling ‎And Cognitive Impairments In Mice

Abstract:
Cognitive dysfunction is commonly observed in epileptic patients. Pentylenetetrazole (PTZ) kindling is a well established animal model which simulates clinical epilepsy. This study evaluated the potential role of glutamate, oxidative stress and nitric oxide (NO) overproduction in pentylenetetrazole (PTZ)-induced kindling and associated cognitive impairments in mice and effect of thymoquinone on these parameters. Repeated treatment of mice with a subconvulsive dose of PTZ (35mg/kg i.p.) once every alternate-day for 12 injections induced kindling. PTZ-kindled mice showed learning and memory impairments as assessed by acquisition and probe trials of Morris water maze and step-through latency of passive avoidance tests. Concurrently, the brain glutamate, malondialdehyde and nitrite levels were increased while the brain intracellular reduced glutathione level and glutathione peroxidase activity were decreased in PTZ-kindled mice. Also, the brain inducible but not neuronal NO synthase mRNA and protein expressions were increased in PTZ-kindled mice. Treatment of mice with thymoquinonne (5, 10 and 20mg/kg i.p.) along with alternate-day subconvulsive dose of PTZ produced dose-dependent protection against PTZ-induced kindling and learning and memory impairments. Moreover, treatment of mice with thymoquinonne (20mg/kg) inhibited the biochemical alterations induced by PTZ in the brain except the elevation of brain glutamate level. The associated increase in brain inducible NO synthase mRNA and protein expressions were also inhibited. These results suggest that glutamate, and subsequent oxidative stress and NO overproduction, via inducible NO synthase, play an important role in the pathophysiology of PTZ-induced kindling and cognitive impairments in mice. Thymoquinone dose-dependently protects against PTZ-induced kindling and cognitive impairments. Inhibition of PTZ-induced brain oxidative stress and NO overproduction, via increase the expression and activity of inducible NO synthase, may play an important role in thymoquinone action.

Author Info:
1
Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt. Electronic address: ahmedosmanaz@hotmail.com.
2
Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt.


Authors:
Abdel-Zaher AO1, Hamdy MM1, Abdel-Rahman MS1, Abd El-Hamid DH1.

Title:
Protective Effect Of Citicoline Against Aluminum-‎Induced Cognitive Impairments In Rats

Abstract:
The potential protective effect of citicoline on aluminum chloride-induced cognitive deficits was investigated in rats. In a Morris water maze, administration of aluminum chloride to rats for 90 days resulted in increased escape latency to reach the platform and decreased swimming speed in acquisition trials. Similarly, in probe trials, the time required to reach the hidden platform was increased and the time spent in the target quadrant was reduced. Also, administration of aluminum chloride to rats for 90 days increased the reference and working memory errors and time required to end the task in the radial arm maze. In addition, this treatment decreased the step-through latency in the passive avoidance test. Concurrently, treatment of rats with aluminum chloride for 90 days increased hippocampal glutamate, malondialdehyde, and nitrite levels and decreased intracellular reduced glutathione level. In the citicoline-treated group, aluminum chloride-induced learning and memory impairments as assessed by the Morris water maze, radial arm maze, and passive avoidance tests were inhibited. At the same time, treatment of rats with citicoline prevented the biochemical alterations induced by aluminum chloride in the hippocampus. It can be concluded that elevation of hippocampal glutamate level with consequent oxidative stress and nitric oxide (NO) overproduction may play an important role in aluminum-induced cognitive impairments. Also, our results suggest, for the first time, that citicoline can protect against the development of these cognitive deficits through inhibition of aluminum-induced elevation of glutamate level, oxidative stress, and NO overproduction in the hippocampus.

Author Info:
1
Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt.


Authors:
Abdel-Zaher AO1, Farghaly HSM2, El-Refaiy AEM3, Abd-Eldayem AM2.

Title:
Protective Effect Of The Standardized Extract Of Ginkgo ‎Biloba (Egb761) Against Hypertension With ‎Hypercholesterolemia-Induced Renal Injury In Rats: ‎Insights In The Underlying Mechanisms.

Abstract:
The potential protective role of the standardized leaf extract of ginkgo biloba (EGb761) on hypertension with hypercholesterolemia-induced renal injury was investigated in rats. Hypertension was induced by L-N(G)-nitroarginine methyl ester (L-NAME) and hypercholesterolemia was induced by feeding rats with a diet containing 1% cholesterol. In these animals repeated treatment with EGb761 produced a progressive reduction in the systolic, diastolic and mean arterial blood pressure (BP). EGb761 increased the progressive reduction in the systolic, diastolic and mean arterial BP induced by repeated administration of losartan with simvastatin. EGb761 corrected the compromised serum lipid profile and enhanced the effect of losartan with simvastatin on lipid profile. EGb761 protected against hypertension with hypercholesterolemia-induced renal injury as assessed by measurement of serum renal function markers and by histopathological examination. EGb761 enhanced the renoprotective effect of losartan with simvastatin in these rats. Concomitantly, hypertension with hypercholesterolemia-induced elevation of renal tissue malondialdehyde (MDA) and nitrite levels and reduction of intracellular reduced glutathione (GSH) level were inhibited by repeated treatment with EGb761. In addition, hypertension with hypercholesterolemia-induced increases in tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) levels in renal tissues were inhibited by treatment with EGb761. Also, EGb761 inhibited hypertension with hypercholesterolemia-induced decrease in endothelial nitric oxide synthase (eNOS) protein expression and increase in the protein expressions of inducible NO synthase (iNOS), TNF-α, IL-6 and IL-1β in the kidney tissues. Losartan with simvastatin produced similar effects on renal tissues oxidative stress, nitrite and inflammatory markers levels and on protein expressions of eNOS, iNOS, TNF-α, IL-6 and IL-1β. EGb761 enhanced losartan with simvastatin effects. These results indicate that EGb761 has the ability to protect against hypertension with hypercholesterolemia-induced renal injury. The ability of EGb761 to provide this renoprotective effect may positively correlate, besides its antihypertensive and antihypercholesterolemic effects, to its ability to suppress renal oxidative stress, nitrosative stress and inflammation.

Author Info:
1
Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt. Electronic address: ahmedosmanaz@hotmail.com.
2
Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt.
3
Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.


Authors:
Abdelhafez M1,2, Bastian A1, Rausch S1, Stenzl A1, Bedke J3, Kruck S1.

Title:
Laparoscopic versus Open Partial Nephrectomy: Comparison of Overall and Subgroup Outcomes.

Abstract:
BACKGROUND:
At experienced centers, laparoscopic partial nephrectomy (LPN) can achieve similar results to those of open surgery (OPN). However, the role of LPN for complex tumors and imperative indications is under debate.

PATIENTS AND METHODS:
A total of 356 cases (186 LPN and 170 OPN) between 2005-2012 were reviewed. Clinical, surgical, pathological and radiological data, including PADUA classification were analyzed.

RESULTS:
In overall analysis, OPN was associated with higher tumor complexity (p≤0.03). Subgroup analysis of PADUA >8 tumors (n=85) showed no significant difference between LPN and OPN. In patients with unfavorable treatment characteristics (imperative indication/multifocal tumors, n=71) LPN was beneficial. In this subgroup, LPN led to better perioperative (p≤0.02) and postoperative (p≤0.04) outcome.

CONCLUSION:
Use of LPN is associated with favorable tumor characteristics. Although no advantage was shown for LPN for tumors with higher complexity (PADUA>8), this large series confirmed the superiority of LPN for imperative indication or multifocal tumors.

Author Info:
1
Department of Urology, Eberhard Karls University, Tuebingen, Germany.
2
Department of Urology, Assiut University, Assiut, Egypt.
3
Department of Urology, Eberhard Karls University, Tuebingen, Germany jens.bedke@med.uni-tuebingen.de.


Authors:
Abdullraheem YF1, Alzolibani AA2, Mahmoud KH1, Korsni AH1, Al-Harbi MH3, Hassanin KM4, Al-Dhubaibi MS2.

Title:
Clinical Study And Assessment Of Leukocyte Phagocytic ‎Function In Children With Atopic Dermatitis In Qassim ‎Region Of Saudi Arabia.‎

Abstract:
OBJECTIVE:
Atopic dermatitis (AD) is a skin disorder clinically seen in the pediatric population. It is well recognized that patients with AD have an increased susceptibility to cutaneous colonization and infection with bacteria, fungi, and viruses. This study was undertaken to investigate the phagocytic activity and chemotactic response of mononuclear and polymorphonuclear leukocytes in severe AD patients.

METHODS:
A total of 50 children with severe AD were selected according to severity scoring of AD (the SCORAD index) and 30 healthy children of same age and sex were also selected as controls. The mononuclear and neutrophilic leukocytes were separated and the phagocytic ingestion of zymosan particles was determined. Migration distance in response tobacterial lipopolysaccharide chemotactic factor was also determined. Immunological disturbance in AD patients was determined by sandwich enzyme-liked immunosorbent assays for total serum immunoglobulin E (IgE), complement 3 (C3) C4.

RESULTS:
Of 50 AD patients with severe disease activity, 36 patients (72%) showed reduction in mononuclear and neutrophilic phagocytic activity. Children with AD had higher levels of total serum IgE, C3, and C4 compared to healthy children (P < 0.01).

CONCLUSIONS:
The study results demonstrated an inhibition in the chemotactic response and phagocytic activity by mononuclear and/or neutrophilic leukocytes in severe AD patients. We further observed an involvement of perturb complement system in patients with AD. Hence, we clearly showed that AD is exacerbated with compromised immunological response, especially the innate immune response

Author Info:
1
Department of Pediatric, College of Medicine, Qassim University, Saudi Arabia.
2
Department of Dermatology, College of Medicine, Qassim University, Saudi Arabia.
3
Intern, College of Medicine, Qassim University, Saudi Arabia.
4
Department of Microbiology, College of Medicine, Assiut University, Egypt.


Authors:
Badary DM1, Rahma MZAA2, Ashmawy AM3, Hafez MZ4.

Title:
H. Pylori Infection Increases Gastric Mucosal Cox2 And ‎Mtor Expression In Chronic Gastritis: Implications For ‎Cancer Progression?‎

Abstract:
BACKGROUND:
Helicobacter Pylori is a Gram-negative bacterium that infects the human stomach and plays an important role in the pathogenesis of chronic gastritis. H. pylori associated chronic gastritis affects various molecular markers related to gastric cancer development. The aim of this study to assess the effect of H. pylori infection on gastric mucosa and to explore its role in gastric carcinogenesis via COX2 and mTOR mucosal expression.

MATERIALS AND METHODS:
This study comprised archival blocks from 60 dyspeptic patients who underwent gastric endoscopic biopsies for histopathological examination. The blocks were cut at 4 μm thicknesses, stained with hematoxylin and eosin to score, using updated Sydney system, and subjected to Giemsa stain to assess H. pylori infection. Then, immunohistochemical method was carried out to determine the expression of COX2 and mTOR.

RESULTS:
Increased H. pylori colonization was significantly correlated with increased severity of inflammation, activity, atrophy, intestinal metaplasia, and the presence of high-grade dysplasia. Also, studied molecular markers were significantly associated with increased H. pylori colonization and presence of severe metaplasia, atrophy, and dysplasia.

CONCLUSION:
These findings suggest that there is a positive feedback loop between H. pylori infection and the pathogenesis of gastric mucosal changes. Also, mTOR and COX2 over expression cause premalignant changes and subsequent tumor occurrence. This may help in providing innovative approaches for the detection of patients-with a higher chance of cancer development, and in trying to introduce effective therapy preventing tumor occurrence, or even using these molecular markers as potential targets for tumors treatment strategies.

Author Info:
1
Pathology department, Assuit University, Al-Gamaa street, Assiut, Egypt. Electronic address: hamasat82@yahoo.com.
2
Tropical medicine and gastroentrology Department, Assuit University, Assuit, Egypt. Electronic address: mzaburahma@yahoo.com.
3
Internal Medicine Department, Assuit University, Assuit, Egypt. Electronic address: dr.ashmawy82@gmail.com.
4
Internal Medicine Department, Aswan University, Aswan, Egypt. Electronic address: m.zain2014@gmail.com.


Authors:
Elnady B1, El-Morshidy E1, El-Meshtawi M1, Shawky A2.

Title:
Pediatric Cervical Spine Injuries With Neurological ‎Deficits, Treatment Options, And Potential For Recovery

Abstract:
PURPOSE:
The purpose of the present study was to highlight the challenges in managing cervical spine injuries in children with neurological deficits.

INTRODUCTION:
Cervical spine injuries in children are relatively rare. Pattern, severity, and level of these injuries are age dependent. Neurological deficits in young children are uncommon and usually have a good potential for recovery.

PATIENTS AND METHODS:
This report includes four cases with pediatric cervical spine injuries with variable degrees of spinal cord injuries and neurological deficits. All the four patients were five years old or younger at the time of injury. Those patients were presented with different patterns of injuries and the treatment was customized for every patient. Marked neurological improvement occurred in all patients at the last follow-up.

CONCLUSION:
The treatment of pediatric cervical spine injuries should be individualized. Children with stable injuries should do well with non-operative treatment while operative treatment is recommended when the indication is appropriate and the expertise is available. Neurological deficits due to spinal cord injuries in pediatric patients have a high potential for recovery, provided that adequate management is considered.

Author Info:
1
Department of Orthopedic and Trauma Surgery, Assiut University Medical School, 71111 Assiut, Egypt.
2
Department of Orthopedic and Trauma Surgery, Assiut University Medical School, 71111 Assiut, Egypt - Department of Spine Surgery, HELIOS Klinikum Erfurt, 99089 Erfurt, Germany.


Authors:
Elnady B1, Shawky A2,3, Abdelrahman H2,4, Elmorshidy E2, El-Meshtawy M2, Said GZ2.

Title:
Posterior Only Approach For Fifth Lumbar Corpectomy: ‎Indications And Technical Notes

Abstract:
PURPOSE:
To evaluate the efficacy and safety of a posterior-only approach for L5 corpectomy, with lumbopelvic fixation for treatment of secondaries, infections, or burst fractures.

METHODS:
Between 2010 and 2013, 17 patients with L5 pathology had corpectomy through a posterior-only approach, with reconstruction of the anterior column using titanium cages filled with bone graft. The indication for surgery was presence of secondaries in nine patients, spondylitis and spondylodiscitis in five patients and burst fractures due to high energy trauma in three patients. All patients underwent detailed neurological examination as well as plain radiography, computed tomography, and magnetic resonance imaging studies.

RESULTS:
This study included 17 patients (8 males and 9 females) with a mean age of 48.3 years. The mean operative time was 186.1 minutes with mean blood loss of 744 ml. No intra-operative or immediate post-operative complications were encountered. Three patients died during follow-up due to advanced malignancy. The remaining 14 patients were followed-up for a mean of 24.9 months. One patient had cut through of L3 screws two years after surgery requiring metal removal. One patient had asymptomatic broken screw, with no need for further intervention.

CONCLUSIONS:
L5 corpectomy is a challenging procedure indicated for treatment of various cases of metastasis, infections, or comminuted fractures. The posterior approach is safe, efficient, and allows both rigid posterior stabilization and anterior reconstruction after L5 corpectomy without the need for an anterior approach and its possible related morbidity.

Author Info:
1
Department of Orthopedic and Trauma Surgery, Assiut University Medical School, Assiut, 71111, Egypt. belalelnady83@gmail.com.
2
Department of Orthopedic and Trauma Surgery, Assiut University Medical School, Assiut, 71111, Egypt.
3
Department of Spine Surgery, Helios Klinikum Erfurt, 99089, Erfurt, Germany.
4
Department of Spine Surgery, Zentralklinik Bad Berka, 99438, Bad Berka, Germany.


Authors:
Elnady B1, El-Sharkawi MM1, El-Meshtawy M1, Adam FF1, Said GZ1.

Title:
Posterior-Only Surgical Correction Of Adolescent ‎Idiopathic Scoliosis: An Egyptian Experience.

Abstract:
INTRODUCTION:
The aim of this prospective case series study is to document safety and effectiveness of high density pedicle screws through posterior only approach with intraoperative wake-up test in correction of adolescent idiopathic scoliosis (AIS).

METHODS:
Between 2011 and 2015, all surgically treated patients for AIS were followed up for a minimum of 2 years. Clinical outcomes were evaluated using scoliosis research society-22 (SRS) questionnaire. All patients were classified according to Lenke classification. Major and minor curves Cobb angle as well as sagittal parameters were measured on whole spine X-rays. All patients underwent an intra-operative wake-up test after deformity correction and a minimum of 80% metal density of implants was used.

RESULTS:
This study included 50 patients. The mean age at time of surgery was 16.8 years. The mean follow-up period was 38.1 months. The mean correction rate for the coronal Cobb angle of the major curve was 79.12%, while that of the minor curve was 68.9%. The mean thoracic kyphosis angle was 38.4° preoperatively, 29.76° postoperatively and 30.36° at the last follow-up. The mean SRS-22 questionnaire scores improved significantly at the last follow-up (P > 0.001). There were no neurological deficits at the wake-up test. No cases of pseudarthrosis or metal failure were encountered.

CONCLUSION:
This is a prospective study of at least 80% metal density pedicle screws technique and intra-operative wake-up test in Egyptian patients with AIS. It proved to be an effective and safe technique in correction of radiological parameters, with no neurological or implant related complications. It allowed excellent scoliotic and kyphotic curves correction with minimal loss of correction. On the whole it led to better quality of life.

Author Info:
1
Department of Orthopedic and Trauma Surgery, Assiut University Medical School, 71111 Assiut, Egypt


Title:
Re: A Paradigm Shift In The Origin Of Ovarian Cancer: ‎The Ovary Is No Longer To Blame: Is The Ovary To ‎Blame For Tubal Carcinoma?‎

Author Info:
1
Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt.


Title:
Neuroprotective Effects Of Melatonin Administration ‎Against Chronic Immobilization Stress In Rats

Abstract:
Chronic stress can impair brain functions and play a well-known role in the development of stress-related disorders such as anxiety. Melatonin (Mel) is a neurohormone which regulate several physiological processes including mood and behavior. This experimental study was designed to evaluate the effect of Mel on chronic immobilization stress (CIS) for 6 weeks in rats and to elucidate its possible underlying mechanisms. Twenty-eight adult male Wistar albino rats were divided into four equal groups: the control group, the Mel-treated group which was injected daily with Mel (10 mg/kg/day; IP) for 6 weeks, the stressed group which was subjected to CIS protocol daily for 6 weeks, and the Mel-treated stressed group which was injected with Mel and concurrently exposed to CIS protocol for 6 weeks. The Mel-treated stressed group showed reduction of both relative adrenal weight and the serum corticosterone levels, suppression of the anxiety-like behavior, increased levels of serotonin, noradrenaline and oxytocin in the frontal cortex, and improved histopathological structure and decreased chromogranin A (CgA) protein expression in the frontal cortex when compared with the chronically stressed group. We concluded that Mel is anxiolytic and this effect was mediated in part by its ability to increase the central release of oxytocin and monoamines and to downregulate CgA protein expression in the frontal cortex.

Author Info:
1
Department of Medical Physiology, Faculty of Medicine, Assiut UniversityAssiut, Egypt.
2
Department of Histology, Faculty of Medicine, Assiut UniversityAssiut, Egypt.


Authors:
Hassan EA1, Ramadan HK1, Ismael AA2, Mohamed KF3, El-Attar MM1, Alhelali I4.

Title:
Noninvasive Biomarkers As Surrogate Predictors Of ‎Clinical And Endoscopic Remission After Infliximab ‎Induction In Patients With Refractory Ulcerative Colitis

Abstract:
BACKGROUND/AIMS:
Treatment of refractory ulcerative colitis (UC) is a clinical challenge, and after biological therapy, monitoring clinical and endoscopic responses is fundamental. We aimed to investigate and compare the predictive power of different noninvasive parameters for clinical remission and mucosal healing after infliximab induction therapy in refractory UC patients.

PATIENTS AND METHODS:
Serum and fecal biomarkers, including hemoglobin, white blood cells, erythrocyte sedimentation rate, C-reactive protein (CRP), and fecal calprotectin (FC), and colonoscopy were assessed in 44 patients with refractory UC before and after (week 12) infliximab induction. Clinical and endoscopic responses were measured by clinical Mayo score and endoscopic Mayo subscore, respectively.

RESULTS:
After infliximab induction, 54.5% and 65.9% had clinical remission and mucosal healing, respectively. Post-induction CRP and FC were significantly lower in clinical responders versus nonresponders (P = 0.01 and 0.001, respectively) and in patients with mucosal healing than without (P < 0.001). Among all the parameters tested, FC had the best predictive value of clinical remission [Area under the curve (AUC = 0.826)] and mucosal healing (AUC = 0.949). Post-induction FC had 87.5% sensitivity and 89% specificity (cut-off <100 μg/g) for predicting clinical remission and 89.7% sensitivity and 93.3% specificity (cut-off <58 μg/g) for predicting mucosal healing.

CONCLUSIONS:
Post-infliximab induction FC can be used as a surrogate marker for predicting clinical remission and mucosal healing in refractory UC patients.

Author Info:
1
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
2
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Sharqia, Egypt; Gastroenterology Unit, Farwaniya Hospital, Kuwait.
3
Gastroenterology Unit, Farwaniya Hospital, Kuwait.
4
Department of Clinical Biochemistry, Ministry of Health, Kuwait.


Authors:
Karim AA1,2,3, Lützenkirchen B1, Khedr E4, Khalil R5.

Title:
Why Is 10 Past 10 the Default Setting for Clocks and Watches in Advertisements? A Psychological Experiment

Abstract:
Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10) would enhance emotional valence and intention to buy compared to a neutral time setting (11:30), whereas a time setting resembling a sad face (8:20) would have the opposite effect. Moreover, we investigated a possible interaction effect with the gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10) can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed.

Author Info:
1
Department of Prevention and Health Psychology, SRH Fernhochschule - The Mobile UniversityRiedlingen, Germany.
2
Department of Psychiatry and Psychotherapy, University of TübingenTübingen, Germany.
3
Department of Neuropsychology, Jacobs UniversityBremen, Germany.
4
Department of Neuropsychiatry, Assiut University HospitalAssiut, Egypt.
5
Center for Molecular and Behavioral Neuroscience, Behavioral and Neural Sciences Graduate Program, Rutgers University, NewarkNJ, United States.


Authors:
Mohamed Mohamed EE1, Younes AK1, Osmand A2, Mohamed R1, Makki M1, Younis M3.

Title:
Punch Graft Versus Follicular Hair Transplantation In ‎The Treatment Of Stable Vitiligo

Abstract:
OBJECTIVE:
To compare the efficacy of follicular hair transplantation and mini punch graft in the treatment of stable vitiligo.

METHODS:
Thirty-two patients with stable vitiligo were included in this comparative study. A single patch from each patient was divided into two halves: one half was treated by punch graft, while the other half was treated by follicular hair transplantation followed by excimer light twice weekly, and the outcome was assessed at 0, 1, 3 and 6 months post operatively by photography and quartile scale.

RESULTS:
At the final visit, the percentage of improvement of vitiligo in punch graft-treated side was significantly higher than that in follicular hair transplantation-treated side (p < 0.05). Also, repigmentation after punch grafting occurred after a mean period of 2.5 ± 0.5 weeks (range, 2-3 weeks), while after follicular hair transplantation, repigmentation occurred after 5.2 ± 1.9 weeks (range, 5-8 weeks) (p < 0.05). Cobblestone appearance was the most common complication after punch graft; it occurred in 29 patients (90%), while no reported side effects occurred after follicular graft technique.

CONCLUSION:
Punch grafting is more effective than follicular grafting in the treatment of stable vitiligo; however, follicular hair transplantation is cosmetically better, so we recommend it in exposed areas as face.

Author Info:
Mohamed Mohamed EE1, Younes AK1, Osmand A2, Mohamed R1, Makki M1, Younis M3.


Authors:
Mohamed KS1, Abd-Elshafy SK1, El Saman AM2.

Title:
The Impact Of Magnesium Sulfate As Adjuvant To ‎Intrathecal Bupivacaine On Intra-Operative Surgeon ‎Satisfaction And Postoperative Analgesia During ‎Laparoscopic Gynecological Surgery: Randomized ‎Clinical Study

Abstract:
BACKGROUND:
Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia.

METHODS:
Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit.

RESULTS:
Surgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups.

CONCLUSIONS:
Magnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

Author Info:
1
Department of Anesthesia, College of Medicine, Assiut University, Assiut, Egypt.
2
Department of Gynecology and Obstetric, College of Medicine, Assiut University, Assiut, Egypt.


Authors:
Moustafa EF1, Makhlouf N2, Hassany SM2, Helmy A2, Nasr A2, Othman M3, Seif H3, Darwish M4, Hassan H5, Hessen M2.

Title:
Non-Invasive Assessment Of Liver Fibrosis In Patients ‎With Hepatitis C: Shear Wave Elastography And Colour ‎Doppler Velocity Profile Technique Versus Liver Biopsy

Abstract:
BACKGROUND AND STUDY AIMS:
Determination of the presence and degree of liver fibrosis is essential for the prognosis and treatment of patients with chronic hepatitis C. Non-invasive methods of assessing fibrosis have been developed to reduce the need for biopsy. We determined the efficacy of shear wave elastography (SWE) and colour Doppler velocity as non-invasive methods for the assessment of liver fibrosis compared to liver biopsy among patients with chronic hepatitis C virus (HCV) infection.

PATIENTS AND METHODS:
In total, 117 patients with chronic HCV infection and 50 healthy age- and sex-matched control subjects were included. For each patient and control, abdominal ultrasonography, Doppler ultrasonography of the right portal vein (PV), and SWE were performed, whereas liver biopsy was performed for patients.

RESULTS:
The mean value of the right PV maximum velocity was lower in patients with different stages of fibrosis than in controls (p<0.001). The mean value of liver stiffness determined by SWE was significantly higher in patients with different stages of fibrosis than in controls. Cutoff values for liver stiffness determined by SWE for assessing fibrosis stages were F2⩾4.815, F3⩾6.335, and F4=7.540 with a sensitivity of 84.6%, 96.2%, and 100.0%; specificity of 88.5%, 93.8%, and 100.0%; positive predictive value (PPV) of 93.6%, 98.0%, and 100.0%; negative predictive value (NPV) of 74.2%, 88.2%, and 100.0%; and overall accuracy of 85.9%, 95.6%, and 100.0% [area under the ROC curve (AUC): 0.89, 0.96, and 1.0], respectively. Cutoff values for the right PV maximum velocity for assessing fibrosis stages were F2<23.4, F3<21, and F4<20 with a sensitivity of 65.0%, 57.4%, and 57.1%; specificity of 59.8%, 76.4%, and 75.5%; PPV of 33.8%, 58.3%, and 32.0%; NPV of 84.4%, 75.7%, and 89.7%; and overall accuracy of 61.1%, 69.5%, and 72.5% (AUC: 0.614, 0.696, and 0.625), respectively.

CONCLUSION:
SWE is effective for the non-invasive assessment of liver fibrosis in patients with HCV infection. SWE provides a more accurate correlation with liver fibrosis stage than colour Doppler velocity profile for the assessment of liver fibrosis, especially in advanced stages (F3 and F4).

Author Info:
1
Assuit University, Tropical Medicine & Gastroenterology Department, Assiut, Egypt. Electronic address: ehab_mostafa99@yahoo.com.
2
Assuit University, Tropical Medicine & Gastroenterology Department, Assiut, Egypt.
3
Assuit University, Radiology Department, Assiut, Egypt.
4
Assuit University, Public Health and Community Medicine Department, Assiut, Egypt.
5
Assuit University, Pathology Department, Assiut, Egypt.


Authors:
Okasha HH1, Naguib M1, El Nady M1, Ezzat R2, Al-Gemeie E3, Al-Nabawy W4, Aref W1, Abdel-Moaty A1, Essam K1, Hamdy A1.

Title:
Role Of Endoscopic Ultrasound And Endoscopic-‎Ultrasound-Guided Fine-Needle ‎Aspiration In Endoscopic Biopsy Negative Gastrointestinal Lesions

Abstract:
BACKGROUND AND OBJECTIVES:
Many cases of gastrointestinal (GI) tumors as lymphoma, adenocarcinoma, and most of submucosal tumors (SMT) such as gastrointestinal stromal tumor (GIST) and leiomyoma are difficult to diagnose as they frequently yield negative endoscopic biopsies. We evaluated the accuracy of endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of endoscopic biopsy negative GI tumors.

PATIENTS AND METHODS:
One hundred and nine patients with biopsy negative GI tumors were included in this prospective study. EUS and EUS-FNA were performed to all patients with cytopathologic examination.

RESULTS:
There were 109 patients with endoscopic biopsy negative GI lesions, including 61 males (56%) and 48 females (44%), with the mean age of 54 years. Sixty-three cases (57.8%) were proved to have malignant lesions, among them there were 15 cases with high-risk GIST as proved by FNA and excision biopsy. Forty-six cases (42.2%) were proved to be benign; among them there were 21 cases presented with non-high-risk GIST. Endoscopic ultrasound had a sensitivity of 96.8%, specificity of 89.1%, positive predictive value (PPV) of 92.4%, negative predictive value (NPV) of 95.3%, and accuracy of 93.6%. EUS-FNA had a sensitivity of 87.3%, specificity of 100%, PPV of 100%, NPV of 85.2%, and accuracy of 92.7%.

CONCLUSION:
EUS with EUS-FNA is an accurate procedure in the diagnosis of GI tumors with negative endoscopic biopsies.

Author Info:
1
Department of Internal Medicine and Gastroenterology, Cairo University, Cairo, Egypt.
2
Department of Internal Medicine, Assiut University, Assiut, Egypt.
3
Department of Pathology, National Cancer Institute (NCI), Cairo, Egypt.
4
Department of Internal Medicine, Beni-Suef University, Beni-Suef, Egypt.


Authors:
Orabi H1, Saba I2, Rousseau A2, Bolduc S3.

Title:
Novel Three-Dimensional Autologous Tissue-Engineered ‎Vaginal Tissues Using The Self-Assembly Technique

Abstract:
Many diseases necessitate the substitution of vaginal tissues. Current replacement therapies are associated with many complications. In this study, we aimed to create bioengineered neovaginas with the self-assembly technique using autologous vaginal epithelial (VE) and vaginal stromal (VS) cells without the use of exogenous materials and to document the survival and incorporation of these grafts into the tissues of nude female mice. Epithelial and stromal cells were isolated from vaginal biopsies. Stromal cells were driven to form collagen sheets, 3 of which were superimposed to form vaginal stromas. VE cells were seeded on top of these stromas and allowed to mature in an air-liquid interface. The vaginal equivalents were implanted subcutaneously in female nude mice, which were sacrificed after 1 and 2 weeks after surgery. The in vitro and animal-retrieved equivalents were assessed using histologic, functional, and mechanical evaluations. Vaginal equivalents could be handled easily. VE cells formed a well-differentiated epithelial layer with a continuous basement membrane. The equivalent matrix was composed of collagen I and III and elastin. The epithelium, basement membrane, and stroma were comparable to those of native vaginal tissues. The implanted equivalents formed mature vaginal epithelium and matrix that were integrated into the mice tissues. Using the self-assembly technique, in vitro vaginal tissues were created with many functional and biological similarities to native vagina without any foreign material. They formed functional vaginal tissues after in vivo animal implantation. It is appropriate for vaginal substitution and disease modeling for infectious studies, vaginal applicants, and drug testing.

Author Info:
1
Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX, Faculté de médecine, Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada; Department of Surgery, Université Laval, Québec, Canada; Department of Urology, Assiut University, Assiut, Egypt. Electronic address: hazem.osman.orabi@gmail.com.
2
Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX, Faculté de médecine, Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada; Department of Surgery, Université Laval, Québec, Canada.
3
Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX, Faculté de médecine, Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada; Department of Surgery, Université Laval, Québec, Canada. Electronic address: stephane.bolduc@fmed.ulaval.ca.


Authors:
Pang T1, Fathalla M2, Whitworth J3, Cuervo LG4.

Title:
Time For WHO To Renew Its Commitment To Health ‎Research

Author Info:
1
Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259772. Electronic address: spptep@nus.edu.sg.
2
Assiut University, Assiut, Egypt.
3
Australian National University, Canberra, ACT, Australia.
4
Pan American Health Organization, Washington, DC, USA.


Authors:
Sayed IM1, Foquet L2, Verhoye L3, Abravanel F4, Farhoudi A5, Leroux-Roels G6, Izopet J7, Meuleman P8.

Title:
Transmission Of Hepatitis E Virus Infection To Human-‎Liver Chimeric FRG Mice Using Patient Plasma

Abstract:
Hepatitis E virus (HEV) is considered as an important pathogen in developing countries but there is growing evidence of its increasing significance and prevalence in the Western world. Although most acute HEV infections resolve spontaneously, chronicity has been observed in immunocompromised patients. The study of HEV has been hampered by the absence of practical animal models. Because the in vivo study of HEV was essentially limited to primates and pigs we recently established the human-liver chimeric uPA-SCID mouse model as a useful tool to study HEV infection. Because the humanized FRG mouse model, another type of mouse with humanized liver, is more easily accessible to the scientific community, we investigated its susceptibility to HEV infection. FRG mice were transplanted with human hepatocytes and challenged with different HEV genotypes using different routes of exposure. Our data clearly shows that the humanized FRG mouse is an alternative animal model for the study HEV infection. As observed in the uPA-SCID model, controlled oral inoculation did not lead to active infection. However, intrasplenic injection of genotype 3-infected patient plasma did result into persistent infection. Although the efficiency of transmission was low, this observation corroborates previously published case reports of blood transfusion-associated HEV transmission.

Author Info:
1
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt. Electronic address: ibrahim.ibrahim@ugent.be.
2
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: lander.foquet@gmail.com.
3
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: lieven.verhoye@ugent.be.
4
INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France; Université Paul-Sabatier, Toulouse, France; Laboratory of Virology, CHU Purpan, Toulouse, France. Electronic address: abravanel.f@chu-toulouse.fr.
5
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: ali.farhoudi@ugent.be.
6
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: geert.lerouxroels@ugent.be.
7
INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France; Université Paul-Sabatier, Toulouse, France; Laboratory of Virology, CHU Purpan, Toulouse, France. Electronic address: izopet.j@chu-toulouse.fr.
8
Dept. Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: philip.meuleman@ugent.be.


Authors:
Sayed S1,2, Schimmer C3, Shade I3, Leyh R3, Aleksic I3.

Title:
Combined Pulmonary And Left Ventricular Support With ‎Veno-Pulmonary ECMO And Impella 5.0 For Cardiogenic ‎Shock After Coronary Surgery‎

Abstract:
BACKGROUND:
Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery.

CASE PRESENTATION:
We describe the combined use of Impella 5.0 and veno- pulmonary extra corporeal membrane oxygenation (VP-ECMO) for biventricular failure in a 52 years-old man. He presented with cardiogenic shock after inferior wall ST-elevation myocardial infarction. After emergency coronary artery bypass surgery and failure to wean from extracorporeal circulation we employed V-P ECMO and consecutively Impella 5.0 to manage the primarily failing right and secondarily failing left ventricles. He remained hemodynamically stable on both Impella 5.0 and VP-ECMO until Heart Mate II left ventricular assist device implantation on the 14th postoperative day. Right sided support was weaned on 66th postoperative day. The patient remained in the intensive care unit for 77 days. During his prolonged stay, he underwent renal replacement therapy and tracheostomy with complete recovery. Six months later, he was successfully heart transplanted and has completed three and half years of unremarkable follow up.

CONCLUSIONS:
The combined use of VP ECMO and Impella 5.0 is effective in the management of postcardiotomy biventricular failure as a bridge for further mechanical support or heart transplantation.

Author Info:
1
Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany. samsayed06@gmail.com.
2
Department of Cardiothoracic Surgery, Assiut University, Assiut, Egypt. samsayed06@gmail.com.
3
Department of Cardiothoracic Surgery, Zentrum Operative Medizine, University of Würzburg, Oberdürrbacher Str.6, 97080, Würzburg, Germany.


Title:
An Overview of the Mechanisms of Abnormal GABAergic Interneuronal Cortical Migration Associated with Prenatal Ethanol Exposure

Abstract:
GABAergic Interneuronal migration constitutes an essential process during corticogenesis. Derived from progenitor cells located in the proliferative zones of the ventral telencephalon, newly generated GABAergic Interneuron migrate to their cortical destinations. Cortical dysfunction associated with defects in neuronal migration results in severe developmental consequences. There is growing evidence linking prenatal ethanol exposure to abnormal GABAergic interneuronal migration and subsequent cortical dysfunction. Investigating the pathophysiological mechanisms behind disrupted GABAergic interneuronal migration encountered with prenatal alcohol exposure is crucial for understanding and managing fetal alcohol spectrum disorders. This review explores the molecular pathways regulating GABAergic interneuronal cortical migration that might be altered by prenatal ethanol exposure thus opening new avenues for further research in this topic.

Author Info:
1
Pharmacology and Physiology, Drexel University College of Medicine, 245 North 15th Street, Mail Stop 488, Philadelphia, PA, 19102, USA. bbs39@drexel.edu.
2
Department of Pharmacology, Assiut University College of Medicine, Assiut, Egypt. bbs39@drexel.edu.


Authors:
Abbas, A.M.a,  Abdallah, M.a,  Michael, A.b

Date of Publishing:
Volume 22, Issue 4, December 2017, Pages 340-342

Title:
Recurrent Rupture Uterus after Hysteroscopic Resection of Uterine ‎Septum: A Case Report‎

Abstract:
Uterine rupture is a catastrophic obstetrical emergency with unpleasant maternal and fetal outcomes. Operative hysteroscopic procedures can add more risk factor for occurrence of this tragedy. Here, we report a case of spontaneous recurrent rupture uterus at 32 weeks of gestation in a 28-year-old woman with previous history of hysteroscopic resection of uterine septum after development of acute abdomen. Repair of anterior uterine wall longitudinal tear was performed through emergency laparotomy. Surgeons should explain to their patients the hazards of probable risk of recurrent UR in the future pregnancy and to document this discussion in the medical records before proceeding to operative hysteroscopic procedures

Author Info:
Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Abbas, A.M.,  Ali, S.S.,  Michael, A.,  Badran, S.A.

Date of Publishing:
Volume 33, Issue 6, December 2017, Pages 261-263

Title:
Caesarean Scar Ectopic Pregnancy Complicated by Uterine Rupture at 10 Weeks Gestation

Abstract:
Background: Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy that becomes implanted at the site of a previous cesarean section scar. It may lead to horrible consequences, such as uncontrolled bleeding and uterine rupture (UR), which might require hysterectomy and result in subsequent loss of fertility. Case: This report covers a case of a CSP complicated by UR at 10 weeks gestation in a 25-year-old woman after development of an acute abdomen. Conservative management of the uterus was used, with removal of the sac and repair of the uterine scar. Results: The patient's postoperative period was uneventful, and she was discharged 5 days after her surgery had occurred. Conclusions: CSP should be detected early to prevent its catastrophic sequences. Although it is a rare complication of cesarean section, CSP must be kept in the minds of obstetricians facing emergency cases.

Author Info:
Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Al-Azhar Street, Assiut, 71511, Egypt


Authors:
Abbas, A.M.a,  Ali, S.S.a,  Sheha, A.M.b,  Talaat, E.b,  Gamal, E.b

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 77-79

Title:
A near Miss Case of Ruptured Non-Communicating Rudimentary Horn ‎Pregnancy in Primigravida‎

Abstract:
Rudimentary horn pregnancy is a rare site of ectopic pregnancy. Diagnosis of rudimentary horn pregnancy requires a high index of suspicion as it can be easily missed during routine ultrasound scan. Rupture of rudimentary horn pregnancy can lead to catastrophic intraperitoneal hemorrhage with consequent maternal morbidity and mortality. Here, we report a case of ruptured non-communicating rudimentary horn pregnancy at 21 weeks of gestation in a 19 years old nulliparous woman which was initially missed during ultrasound scan and misdiagnosed as a case of anemia with pregnancy. The patient was managed immediately with excision of the horn through urgent exploratory laparotomy. High index of suspicion and early referral from the discrete hospitals is needed before exact time is lost; thus reducing the morbidity and mortality of the pregnant women. © 2016 Middle East Fertility Society

Author Info:
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
bAssiut University Hospital, Faculty of Medicine, Assiut University, Egypt


Authors:
Abbas, A.M.,  Gamal, E.b,  Talaat, E.b,  Sheha, A.M.b

Date of Publishing:
Volume 22, Issue 3, September 2017, Pages 236-239

Title:
Torsion of Huge Dermoid Cyst in Adolescent Girl: A Case ‎Report‎

Abstract:
Huge ovarian mass is an uncommon finding in a female adolescent. Dermoid cysts are usually having very slow rate of growth about 1.8 mm per year, so giant dermoid cysts have been rarely reported in the literature. Here we present a case of huge cyst in a 15-year old girl having severe abdominal pain. Abdominal examination revealed regular cystic tender pelvi-abdominal mass corresponding to the size of 28 weeks pregnant uterus by palpation. Abdominal ultrasonography revealed the presence of right ovarian cyst measured 20 × 20 × 18 cm. Colour Doppler evaluation revealed no blood flow in the periphery of the mass. All investigations were normal. Immediate laparotomy revealed right gangrenous huge ovarian mass. Salpingo-oophorectomy was done and histopathological examination revealed twisted gangrenous dermoid cyst. She stayed at hospital for 3 days and then discharged in a healthy condition. © 2017 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
bWoman's Health Hospital, Assiut University, Egypt


Authors:
Abbas, A.M.,  Sheha, A.M.b,  Ali, M.K.a,  Ali, S.S.a,  Salem, N.Z.a,  Talaat, E.b,  Hassan, A.b

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 73-76

Title:
Second-Trimester Spontaneous Uterine Rupture after Laparoscopic ‎Electromyolysis in Nulligravida: A Case Report‎

Abstract:
Spontaneous rupture of gravid uterus is a rare catastrophic obstetrical emergency that puts the life of both mother and fetus at stake. Laparoscopic uterine surgery is one factor sharing increasingly in occurrence of such deadly condition. Treatment of uterine myoma using laparoscopic electromyolysis is one of the conservative surgical techniques reported and used successfully since last decade. However, there is conflicting evidence about pregnancy outcome after its usage. Here, we report a case of rupture gravid uterus at 22 weeks of gestation in a 23 years old nulliparous woman after previous history of laparoscopic myolysis. The patient was managed immediately with repair of the defect through urgent exploratory laparotomy. Laparoscopic myomectomy is the preferred management option for uterine myoma especially in fertility desired patients. Electromyolysis is a procedure that is not frequently performed nowadays and should be cautiously used if at all due to its serious consequences on the fertility potential. © 2016 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
bAssiut University Hospital, Faculty of Medicine, Assiut University, Egypt


Authors:
Abbas, A.M.a,  Sheha, A.M.b,  Ali, M.K.a,  Khalaf, M.a,  Gamal, E.b

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 87-90

Title:
Successful Term Delivery after Khairy's Modified B-Lynch Suture ‎Technique: First Case Report‎

Abstract:
Postpartum hemorrhage (PPH) is a life-threatening obstetric complication. Uterine atony is the most common cause presenting in approximately 80% of cases. As regards management options, B-lynch brace suture, and its modifications have been used for more than a decade with a great success as a substitution for hysterectomy. Their efficiency in preserving future fertility is not well-established. This case reports the first successful pregnancy and delivery after one of the recent B-lynch suture modifications “Khairy's modification” for control of atonic PPH during cesarean delivery. The patient got pregnant two months after the surgery. The course of pregnancy was smooth and she was delivered by Repeat cesarean section with no deformities of uterine cavity or contour. Khairy's modified B-lynch suture is an effective technique that has no reported complications of the classic B-lynch suture or affection of subsequent fertility. © 2016 Middle East Fertility Society


Authors:
Abbas, A.M.a,  Sheha, A.M.b,  Ali, S.S.a,  Maghraby, A.M.a,  Talaat, E.b

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 80-83

Title:
A Rare Presentation of Ruptured Interstitial Ectopic Pregnancy with ‎Broad Ligament Hematoma: A Case Report‎

Abstract:
Ectopic pregnancy is a major cause of maternal morbidity and mortality in the first trimester. Interstitial type is the most dangerous variety with a high risk of life-threatening internal hemorrhage. Obstetricians need a high index of suspicion to diagnose such rare type. We are reporting a rare case of ruptured interstitial ectopic pregnancy presented with a large broad ligament hematoma early in the first trimester. A 25-year-old woman was presented with gradual onset of increasing abdominal pain after 6 weeks of amenorrhea. She had a positive urinary pregnancy test. Abdominal ultrasound revealed bulky empty uterus and ill-defined mass at the right side of the uterus. On exploration, incision and drainage of broad ligament hematoma were performed in addition to right salpingectomy. Interstitial ectopic pregnancy represents a diagnostic and therapeutic challenge and frequently constitutes an obstetrical emergency. Its rupture early in the first trimester should be expected. Early diagnosis and proper management are the most important issues to avoid its catastrophic consequences. © 2016 Middle East Fertility Society


Authors:
Abbas, A.M.a,  Sheha, A.M.b,  Salem, M.N.c,  Altraigey, A.d

Date of Publishing:
Volume 22, Issue 4, December 2017, Pages 241-245

Title:
Three-Dimensional Power Doppler Ultrasonography in Evaluation of ‎Adnexal Masses‎

Abstract:
The differential diagnosis of adnexal masses still represents a challenge in spite of the marvelous efforts that have been made to improve the sonographically based diagnosis. There were rapid technological advances in diagnostic ultrasonography in the last decade, with the recent development of three-dimensional power Doppler ultrasonography (3DPD). The introduction of 3DPD has opened the possibility to characterize microvasculature of the adnexal masses and objectively assess tumor vascularization. 3DPD allows also an objective measurement of vascularity of a given region of interest by estimating 3 vascular indices (vascularization index [VI], flow index [FI], and vascularization-flow index [VFI]) within such region. The aim of this review article is to evaluate the role of 3DPD in the assessment of adnexal masses vascularity, its ability to discriminate benign masses from malignant ones. © 2017 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
bAssiut University Hospital, Faculty of Medicine, Assiut University, Egypt
cDepartment of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Egypt


Authors:
Abbas, A.M.a,  Talaat, E.b,  Gamal, E.b,  Michael, A.b,  Hanna, S.b,  Ali, M.N.a

Date of Publishing:
Volume 22, Issue 2, June 2017, Pages 160-162

Title:
An Unusual Case of Asymptomatic Hyperreactio Luteinalis Present at ‎Cesarean Section of a Spontaneous Singleton Pregnancy‎

Abstract:
Hyperreactio Luteinalis (HL) is a benign self-limited pregnancy-related condition characterized by bilateral ovarian enlargement with multiple theca lutein cysts. It is commonly associated with gestational trophoblastic diseases and multiple pregnancy. We report a rare case of HL discovered accidentally during cesarean section (CS) of a spontaneously conceived normal singleton pregnancy. CS was performed due to fetal malpresentation and previously scarred uterus, and delivered a healthy male neonate. Expectant management was performed to permit conservation of both ovaries without unnecessary surgical intervention. The condition resolved within 6 weeks postpartum without adding morbidity to the patient. © 2017 Middle East Fertility Society


Authors:
Abdel-Motaleb, A.A.a,  Sayed, D.S.a,  Morsy, H.a,  Refaiy, A.E.M.b,  Abo El-Hagag, N.A.b,  Gamal, Y.b,  Hussein, M.R.A.b

Journal:
Journal of the Egyptian Women's Dermatologic Society

Title:
Increased Density of Cd1a + Langerhans Cells and Cd86 + Cells in ‎Perilesional and Lesional Psoriatic Skin: An Immunohistochemical ‎Study‎

Abstract:
Background Psoriasis is a long-lasting autoimmune disease mediated by T-lymphocytes and dendritic cells (DC). CD1a + is a DC marker. CD86 + is a well-known activation marker of the DC (costimulatory molecule). It is hypothesized that the development of chronic plaque psoriasis is associated with alterations of DC. Objective To characterize CD1a + and CD86 + cells in chronic plaque psoriasis. Patients and methods Monoclonal antibodies against CD1a + and CD86 + were used for immunohistochemical evaluation of these molecules in the lesional and perilesional skin obtained from 30 psoriatic cases. Five cases represented the control group (healthy skin). Results We found significant variations in the density of CD1a + and CD86 + cells among the control skin compared with the perilesional and lesional psoriatic skin. There was an increased density of CD1a + Langerhans and CD86 + DC in the perilesional and lesional psoriatic skin compared with healthy skin. Higher counts of CD1a + Langerhans cells in the epidermis and CD86 + cells in both epidermis and dermis of the perilesional psoriatic skin were observed compared with lesional ones. Conclusion The prominent density of CD1a + and CD86 + DC in the perilesional skin compared with the lesional psoriatic skin suggests the pathogenetic role of these cells in the initiation of plaque psoriasis. The simultaneous presence and close localization of CD1a + and CD86 + cells in the psoriatic dermal and epidermal compartments suggests that their interaction potentially contributes to the development of psoriasis. © 2017 Egyptian Women's Dermatologic Society.

Author Info:
aDepartments of A Dermatology, Venereology and Andrology, Assiut University, Assiut, 71515, Egypt
bPathology, Assiut University Hospitals, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Abdelaal, M.a,b,  Le Roux, C.W.a,c,d,  Docherty, N.G.a,c

Journal:
Bariatric Surgical Practice and Patient Care

Date of Publishing:
Volume 12, Issue 4, December 2017, Pages 153-161

Title:
Validated Scoring Systems for Predicting Diabetes Remission after ‎Bariatric Surgery‎

Abstract:
Background: Metabolic surgery is a new term used to emphasize the metabolic benefits of a variety of bariatric surgery procedures, particularly with relationship to the treatment of type 2 diabetes and its complications. Means by which the likely impact of metabolic surgery on diabetes could be assessed in individual patients would be of clinical value. Methods: Two main scoring systems (ABCD and DiaRem) have been proposed to predict remission of diabetes after metabolic surgery. We present a description of these systems, discuss the sources of differences in their predictive power, and suggest means by which to improve predictive power. Results: ABCD is more predictive in patients with intermediate and poorer scores. Neither score is validated as a means of predicting, which patients will benefit most from the repercussions of improved glycemic control in terms of complications. Conclusion: A composite scoring system derived from ABCD and DiaRem may improve prediction of postoperative remission rates. Such a system should be considered principally as an aid to decision-making. Excessive focus on prediction of long-term remission of type 2 diabetes mellitus should be avoided in favor of identifying which patients may stand to benefit most, even if full clinical remission is not achieved. © 2017 Mary Ann Liebert, Inc.

Author Info:
aConway Institute, Diabetes Complications Research Centre, School of Medicine and Medical Sciences, University College Dublin, Dublin 4, Ireland
bPlastic Surgery Department, Assiut University Hospital, Assiut, Egypt
cDepartment of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
dDepartment of Medicine, Investigative Science, Imperial College London, London, United Kingdom


Authors:
Adel, M.a,  Abdo Elgamal, D.b,  Bakry, R.c,  Abdelkader, M.d,  Elshazly, M.a,  Kamel, A.a

Title:
Suture Versus Fibrin Glue Microneural Anastomosis of the Femoral ‎Nerve in Sprague Dewly Rat Model. A Comparative Experimental ‎Assessment of the Clinical, Histological and Statistical Features

Abstract:
Introduction. Peripheral nerve injury is a frequently encountered clinical problem that leads to functional losses at the long--term. Although microsurgical repair has been introduced to clinical practice in peripheral nerve injuries, unsatisfactory outcomes regarding functional recovery in target organ cause an increasing interest on studies about nerve injury and biology of the recovery in nerve injuries1. Material and Methods. Sciatic nerves of seventy adult Sprague Dewly rats were transected and primary anastomosis was performed. Rats were then divided into three groups: Control group, while 30 rats were repaired with sutures, and the remaining 30 were repaired with fibrin glue. After 30 days the rats were sacrified and the sciatic nerves were investigated histologically with morphometrical and statistical analyses. Results. In microsurgical nerve repair, suture placement has been thought to cause hindrance to the sprouting axons and compress the blood supply to the fascicles, thereby impairing the regeneration of the transected nerve ends after repair, with possible neuroma formation. On the other hand, fibrin glue is a simple, effective technique, less time consuming than suturing. Another advantage of this suture-free technique is that it avoids injuring the axon with needles, and the lack of foreign bodies minimizes the inflammatory reaction. Conclusion. We recommend using fibrin glue as it demonstrates less inflammatory reaction, less scar tissue formation, it is less time consuming and provides better outcomes. © 2017 Czech Medical Association J.E. Purkyne. All Rights Reserved.

Author Info:
aDepartment of Plastic Surgery, Assiut University Hospital, Assiut, 71526, Egypt
bDepartment of Histology, Faculty of Medicine, Assiut University, Egypt
cDepartment of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Egypt
dDepartment of General Surgery, Assiut University Hospital, Egypt


Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 70-72

Title:
Two Successful Pregnancies Using Split Embryo Transfer in a Woman ‎with Uterus Didelphys: A Case Report‎

Abstract:
This is a case report of a woman with uterus didelphys who conceived twice following split embryo transfer in both uterine horns after previous four failed ICSI trials. © 2016 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, Assiut University, Assiut, Egypt
bEl-Salama IVF/ICSI Center Assiut, Egypt


Authors:
Al-Shamsi, H.O.a,k,l,  Abdel-Wahab, R.a,i,  Hassan, M.M.a,  Shalaby, A.S.a,  Dahbour, I.b,  Lacin, S.a,j,  Mahvash, A.c,  Odisio, B.C.c,  Murthy, R.c,  Avritscher, R.c,  Abdelsalam, M.E.c,  Rashid, A.d,  Vauthey, J.-N.e,  Aloia, T.A.e,  Conrad, C.e,  Chun, Y.S.e,  Krishnan, S.f, Das, P.f,  Koay, E.J.f,  Amin, H.M.g,h,  Yao, J.C.a,  Kaseb, A.O.a

Date of Publishing:
Volume 93, Issue 4, 1 September 2017, Pages 233-242

Title:
Natural History of T1n0m0 Hepatocellular Carcinoma: Large-Scale ‎Study in the United States‎

Abstract:
Background: Hepatocellular carcinoma (HCC) prognosis depends on clinicopathological features in addition to the treatment provided. We aimed to assess the natural history of TNM stage I HCC tumors which received different treatment over a period of 20 years. Methods: Between 1992 and 2011, a total of 397 stage I HCC patients were included. Detailed information was retrieved from MD Anderson Cancer Center patients' medical records. The Kaplan-Meier method was used to calculate patients' overall survival (OS). Cox regression analysis was used to calculate the estimated hazard ratio and 95% confidence interval of different prognostic factors. Results: Out of 397 patients, 67.5% were males, 42.8% had hepatitis-related HCC, and 59.7% had underlying cirrhosis. After adjustment for confounding factors, we found that all therapeutic modalities were associated with a significant mortality rate reduction with an OS of 63, 42.03, 34.3, and 22.1 months among patients treated with surgery, ablation, local, and systemic therapy, respectively. A restricted analysis of cirrhotic and noncirrhotic patients showed that ablative and local therapy were significantly associated with a longer OS compared to systemic therapy. Conclusion: TNM stage I HCC patients have a favorable prognosis regardless of the type of treatment. Notably, ablative and local therapy significantly improved OS compared to systemic therapy. © 2017 S. Karger AG, Basel.

Author Info:
aDepartments of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States
bInternal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
cIntervention Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
dPatholgy, University of Texas MD Anderson Cancer Center, Houston, TX, United States
eSurgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
fRadiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
gHematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
hUniversity of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, United States
iDepartment of Clinical Oncology, Assiut University, Assiut, Egypt
jDepartment of Medical Oncology, Hacettepe University, Medical Faculty, Ankara, Turkey
kDepartment of Medical Oncology, University Hospital Sharjah, Sharjah, United Arab Emirates
lDepartment of Medical Oncology, Sheikh Khalifa Specialty Hospital, Ras al-Khaimah, United Arab Emirates


Authors:
Amer, S.A.a,  El Shamy, T.T.b,  James, C.b,  Yosef, A.H.c,d,  Mohamed, A.A.a,d

Date of Publishing:
Volume 154, Issue 1, 2017, Pages R13-R21

Title:
The Impact of Laparoscopic Ovarian Drilling on Amh and Ovarian ‎Reserve: A Meta-Analysis‎

Abstract:
Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials (RCTs) investigating serum AMH concentrations and other ovarian reserve markers in women with PCOS undergoing LOD. Various databases were searched including MEDLINE, EMBASE, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and Cochrane Library from January 2000 to December 2016. Sixty studies were identified, of which seven were deemed eligible for this review. AMH data were extracted from each study and entered into the RevMan software to calculate the weighted mean difference (WMD) between pre- and post-operative values. Pooled analysis of all studies (n = 442) revealed a statistically significant decline in serum AMH concentration after LOD (WMD -2.13 ng/mL; 95% confidence interval (CI) -2.97 to -1.30). Subgroup analysis based on duration of follow-up, AMH kit, laterality of surgery and amount of energy applied during LOD consistently showed a statistically significant fall in serum AMH concentration. In conclusion, although LOD seems to markedly reduce circulating AMH, it remains uncertain whether this reflects a real damage to ovarian reserve or normalisation of the high pre-operative serum AMH levels. Further long-term studies on ovarian reserve after LOD are required to address this uncertainty. © 2017 Society for Reproduction and Fertility.

Author Info:
aDepartment of Obstetrics and Gynaecology, University of Nottingham, Royal Derby Hospital, Derby, United Kingdom
bDerby Teaching Hospitals NHS Foundation Trust, Royal Derby Hospital, Derby, United Kingdom
cDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
dDepartment of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt


Authors:
Atta, H.a,  Elsaba, T.M.b,  Hassan, H.M.c,  Hafez, M.M.c,  Aboellela, H.A.d,  Imam, H.e

Journal:
Egyptian Journal of Radiology and Nuclear Medicine

Date of Publishing:
Volume 48, Issue 3, September 2017, Pages 733-739

Title:
Reliability of Multiparametric Prostatic MRI Quantitative Data in the ‎Evaluation of Prostate Cancer Aggressiveness Quantitative ‎Multiparametric Prostatic MRI in Prostate Cancer Diagnosis‎

Abstract:
Purpose To compare the quantitative data of multiparametric prostatic MRI with Gleason scores of histopathological analysis. Materials and methods One hundred twenty-two patients performed Multiparametric MRI of the prostate. Functional MRI quantitative data (including diffusion with mean ADC value and spectroscopic metabolic ratio) where the DWI is employing b 50, 400, 800, 1000 and 2000 sec/mm2 and multivoxel MR spectroscopy compared with of Gleason scores of histopathological results. Malignant cases are classified into three groups according to their Gleason score as group I with Gleason score ≤6, group II Gleason score 7, while Gleason score 8–10 stratified as Group III. Results The histopathological analysis reveals 78 malignant cases and 44 benign Cases. The significant statistical difference between group I and the other two groups (p < 0.001) regarding the quantitative mean ADC value and metabolic spectroscopic ratio. No significant statistical difference between group II and III with p = 0.2 for mean ADC difference and p = 0.8 for the metabolic spectroscopic ratio with a weak negative correlation between ADCand Gleason score [rs = −0.26] and significant positive correlation (p = 0.02) for MRSI metabolic ratio [rs = 0.2]. Conclusion The quantitative data of functional imaging of the prostate is reliable in evaluating prostatic cancer aggressiveness and proper construction of therapeutic plan. © 2017 Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aRadiology Department, South Egypt Cancer Institute, Assiut University, Egypt
bPathology Department, South Egypt Cancer Institute, Assiut University, Egypt
cPathology Department, Faculty of Medicine, Assiut University, Egypt
dUrology Department, Faculty of Medicine, Assiut University, Egypt
eRadiology Department, Faculty of Medicine, Assiut University, Egypt


Authors:
Atta, H.a,  Seifeldein, G.S.b,  AlMamoun, M.c,  Imam, H.b

Date of Publishing:
Volume 48, Issue 1, 1 March 2017, Pages 107-113

Title:
Reliability of Multidetector Ct in the Diagnosis of Cerebrospinal Fluid ‎Rhinorrhea with Operative Correlation‎

Abstract:
Purpose To evaluate the role of non-contrast multidetector CT (MDCT) reliability in localizing CSF leaks and skull base defects in correlation to operative findings. Materials and methods Twenty patients clinically diagnosed to have CSF rhinorrhea; 8 spontaneous and 12 post-traumatic patients were evaluated using 64-rows MDCT with slice section 0.6 mm. CT is considered accurate if correctly determine the site and size of bony defect as matched with operative findings. Results MDCT accurately detected the site of presumed CSF leak in 19 out of 20 cases with sensitivity 95%. Cribriform plate defect is the most common site of defect in 40% of cases with 75% of cases categorized as Keros type II. The consensus image with fair agreement (K = 0.38) shows that coronal reformat has the highest diagnostic performance in 75% of cases while the least diagnostic value is encountered with the axial plane in 15% of cases (p = 0.095). There is almost a perfect agreement (K = 0.810) between the MDCT measurements and operative size of bony defect with minimal difference in 10% of patients (P < 0.001). Conclusion Non-contrast MDCT is an accurate reliable non-invasive imaging modality for preoperative evaluation of CSF rhinorrhea. © 2016 Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aRadiology Department, South Egypt Cancer Institute, Assiut University, Egypt
bRadiology Department, Faculty of Medicine, Assiut University, Egypt
cNeurosurgery Department, Faculty of Medicine, Sohag University, Egypt


Authors:
Bawahab, M.a,  Alshumrani, G.b,  Al-Shraim, M.c,  Eskandar, M.d,  Shaamash, A.d,e

Journal:
Clinical and Experimental Obstetrics and Gynecology

Title:
Isolated Left Descended Inguinal Ovary with Ipsilateral Ectopic Pelvic ‎Kidney: A Case Report and Review of Literature‎

Abstract:
Isolated descended inguinal ovary is a rarity, but it should be considered as a differential diagnosis of an inguinal mass at any age; in particular during female infancy and up to adulthood. Herein the authors report a case of asymptomatic isolated left descended inguinal ovary, with ipsilateral left ectopic pelvic kidney that was accidentally discovered a few years after menarche.

Author Info:
aDepartments of Surgery, Saudi Arabia
bDepartments of Radiology, Saudi Arabia
cDepartments of Pathology, Saudi Arabia
dObstetrics and Gynecology, College of Medicine, King Khalid University, PO Box 641, Abha, Saudi Arabia
eDepartment of Obstetrics and Gynecology, College of Medicine, Assiut University, Egypt


Authors:
Bluth, T.a,,  Teichmann, R.aEmail Author,  Kiss, T.aEmail Author,  Bobek, I.bEmail Author,  Canet, J.cEmail Author,  Cinnella, G.dEmail Author,  De Baerdemaeker, L.eEmail Author,  Gregoretti, C.fEmail Author,  Hedenstierna, G.gEmail Author,  Hemmes, S.N.h,iEmail Author,  Hiesmayr, M.j,k,l,mEmail Author,  Hollmann, M.W.h,iEmail Author,  Jaber, S.nEmail Author,  Laffey, J.G.o,p,q,rEmail Author,  Licker, M.J.sEmail Author,  Markstaller, K.tEmail Author,  Matot, I.uEmail Author,  Müller, G.vEmail Author,  Mills, G.H.wEmail Author,  Mulier, J.P.xEmail Author,  Putensen, C.yEmail Author,  Rossaint, R.zEmail Author,  Schmitt, J.vEmail Author,  Senturk, M.aaEmail Author,  Serpa Neto, A.ab,acEmail Author,  Severgnini, P.adEmail Author,  Sprung, J.aeEmail Author,  Vidal Melo, M.F.afEmail Author,  Wrigge, H.agEmail Author,  Schultz, M.J.i,ahEmail Author,  Pelosi, P.aiEmail Author,  Gama de Abreu, M.aEmail Author,  Güldner, A.ajEmail Author,  Huhle, R.ajEmail Author,  Uhlig, C.ajEmail Author,  Vivona, L.ajEmail Author,  Bergamaschi, A.ajEmail Author,  Rossaint, R.akEmail Author,  Stevanovic, A.akEmail Author,  Treschan, T.alEmail Author,  Schaefer, M.alEmail Author,  Kienbaum, P.alEmail Author,  Laufenberg-Feldmann, R.amEmail Author,  Bergmann, L.anEmail Author,  Ebner, F.anEmail Author,  Robitzky, L.anEmail Author,  Mölders, P.anEmail Author,  Unterberg, M.anEmail Author,  Busch, C.aoEmail Author,  Achilles, M.dgEmail Author,  Menzen, A.apEmail Author,  Freesemann, H.apEmail Author,  Putensen, C.aqEmail Author,  Machado, H.arEmail Author,  Cavaleiro, C.arEmail Author,  Ferreira, C.P.arEmail Author,  Pinho, D.arEmail Author,  Carvalho, M.arEmail Author,  Pinho, S.arEmail Author,  Soares, M.arEmail Author,  Castro, D.S.asEmail Author,  Abelha, F.atEmail Author,  Rabico, R.auEmail Author,  Delphin, E.avEmail Author,  Sprung, J.awEmail Author,  Weingarten, T.N.awEmail Author,  Kellogg, T.A.awEmail Author,  Martin, Y.N.awEmail Author,  McKenzie, T.J.awEmail Author,  Brull, S.J.axEmail Author,  Renew, J.R.axEmail Author,  Ramakrishna, H.ayEmail Author,  Fernandez-Bustamante, A.azEmail Author,  Balonov, K.baEmail Author,  Baig, H.R.bbEmail Author,  Kacha, A.bcEmail Author,  Pedemonte, J.C.bdEmail Author,  Altermatt, F.bdEmail Author,  Corvetto, M.A.bdEmail Author,  Paredes, S.bdEmail Author,  Carmona, J.bdEmail Author,  Rolle, A.bdEmail Author,  Bos, E.beEmail Author,  Beurskens, C.beEmail Author,  Veering, B.bfEmail Author,  Zonneveldt, H.bgEmail Author,  Boer, C.bhEmail Author,  Godfried, M.biEmail Author,  Thiel, B.biEmail Author,  Kabon, B.bjEmail Author,  Reiterer, C.bjEmail Author,  Canet, J.bkEmail Author,  Tolós, R.bkEmail Author,  Sendra, M.bkEmail Author,  González, M.bkEmail Author,  Gómez, N.bkEmail Author,  Ferrando, C.blEmail Author,  Socorro, T.blEmail Author,  Izquierdo, A.blEmail Author,  Soro, M.blEmail Author,  Granell Gil, M.bmEmail Author,  Hernández Cádiz, M.J.bmEmail Author,  Biosca Pérez, E.bmEmail Author,  Suarez-de-la-Rica, A.bnEmail Author,  Lopez-Martinez, M.bnEmail Author,  Huercio, I.bnEmail Author,  Maseda, E.bnEmail Author,  Yagüe, J.bnEmail Author,  Cebrian Moreno, A.boEmail Author,  Rivas, E.bpEmail Author,  Lopez-Baamonde, M.bpEmail Author,  Elgendy, H.bq,dhEmail Author,  Sayedalahl, M.bq,diEmail Author,  Sibai, A.R.brEmail Author,  Yavru, A.bsEmail Author,  Sivrikoz, N.bsEmail Author,  Karadeniz, M.bsEmail Author,  Corman Dincer, P.btEmail Author,  Ayanoglu, H.btEmail Author,  Tore Altun, G.btEmail Author,  Kavas, A.D.btEmail Author,  Dinc, B.buEmail Author,  Kuvaki, B.bvEmail Author,  Ozbilgin, S.bvEmail Author,  Erdogan, D.bwEmail Author,  Koksal, C.bwEmail Author,  Abitagaglu, S.bwEmail Author,  Aurilio, C.bxEmail Author,  Sansone, P.bxEmail Author,  Pace, C.M.bxEmail Author,  Donatiello, V.bxEmail Author,  Mattera, S.bxEmail Author,  Palange, N.bxEmail Author,  Di Colandrea, S.bxEmail Author,  Spadaro, S.byEmail Author,  Volta, C.A.byEmail Author,  Ragazzi, R.byEmail Author,  Ciardo, S.byEmail Author,  Gobbi, L.byEmail Author,  Severgnini, P.bzEmail Author,  Bacuzzi, A.bzEmail Author,  Brugnoni, E.bzEmail Author,  Gratarola, A.caEmail Author,  Micalizzi, C.caEmail Author,  Simonassi, F.caEmail Author,  Malerbi, P.caEmail Author,  Carboni, A.cbEmail Author,  Licker, M.-J.ccEmail Author,  Dullenkopf, A.cdEmail Author,  Goettel, N.ceEmail Author,  Nesek Adam, V.cfEmail Author,  Karaman Ilic, M.cfEmail Author,  Klaric, V.cgEmail Author,  Vitkovic, B.cgEmail Author,  Milic, M.cgEmail Author,  Miro, Z.cgEmail Author,  De Baerdemaeker, L.chEmail Author,  De Hert, S.chEmail Author,  Heyse, B.chEmail Author,  Van Limmen, J.chEmail Author,  Van Nieuwenhove, Y.chEmail Author,  Mertens, E.ciEmail Author,  Neyrinck, A.djEmail Author,  Mulier, J.cjEmail Author,  Kahn, D.ckEmail Author,  Godoroja, D.clEmail Author,  Martin-Loeches, M.cmEmail Author,  Vorotyntsev, S.cnEmail Author,  Fronchko, V.coEmail Author,  Matot, I.cpEmail Author,  Goren, O.cpEmail Author,  Zac, L.cpEmail Author,  Gaszynski, T.cqEmail Author,  Laffey, J.crEmail Author,  Mills, G.csEmail Author,  Nalwaya, P.ctEmail Author,  Mac Gregor, M.cuEmail Author,  Paddle, J.cvEmail Author,  Balaji, P.cwEmail Author,  Rubulotta, F.cxEmail Author,  Adebesin, A.cxEmail Author,  Margarson, M.cyEmail Author,  Davies, S.czEmail Author,  Rangarajan, D.daEmail Author,  Newell, C.dbEmail Author,  Shosholcheva, M.dcEmail Author,  Papaspyros, F.ddEmail Author,  Skandalou, V.deEmail Author,  Dzurnáková, P.dfEmail Author

Date of Publishing:
Volume 18, Issue 1, 28 April 2017, Article number 202

Title:
Protective Intraoperative Ventilation with Higher Versus Lower Levels ‎of Positive End-Expiratory Pressure in Obese Patients (Probese): ‎Study Protocol for a Randomized Controlled Trial‎

Abstract:
Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design: The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion: To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration: ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. © 2017 The Author(s).

Author Info:
aUniversity Hospital Carl Gustav Carus, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, Dresden, Germany
bAneszteziológiai és Intenzív Terápiás Klinika, Semmelweis Egyetem, Budapest, Hungary
cHospital Universitari Germans Trias i Pujol, Department of Anesthesiology, Badalona, Spain
dUniversity of Foggia, Department of Anesthesiology and Intensive Care Medicine, Foggia, Italy
eGhent University Hospital, Department of Anesthesiology, Ghent, Belgium
fPoliclinico P. Giaccone, Department of Biopathology and Medical Biotechnologies, Palermo, Italy
gUniversity Hospital, Section of Clinical Physiology, Department of Medical Sciences, Uppsala, Sweden
hUniversity of Amsterdam, Department of Anesthesiology, Academic Medical Center, Amsterdam, Netherlands
iUniversity of Amsterdam, Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A), Academic Medical Center, Amsterdam, Netherlands
jMedical University of Vienna, Division of Cardiac Surgery, Vienna, Austria
kMedical University of Vienna, Division of Thoracic Surgery, Vienna, Austria
lMedical University of Vienna, Division of Vascular Surgery, Vienna, Austria
mMedical University of Vienna, Department of Anesthesia, Intensive Care and Pain Medicine, Vienna, Austria
nSaint Eloi University Hospital, Department of Critical Care Medicine and Anesthesiology (SAR B), Montpellier, France
oSaint Michael's Hospital, Critical Care Medicine Program, Department of Anesthesia, Toronto, ON, Canada
pUniversity of Toronto, Department of Anesthesia, Toronto, ON, Canada
qUniversity of Toronto, Department of Physiology, Toronto, ON, Canada
rUniversity of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, ON, Canada
sUniversity Hospital Geneva, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva, Switzerland
tMedical University of Vienna, Department of Anesthesia, Intensive Care and Pain Medicine, Vienna, Austria
uTel Aviv University, Department of Anesthesiology and Critical Care, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv, Israel
vTechnical University Dresden, Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Dresden, Germany
wSheffield Teaching Hospitals and University of Sheffield, Operating Services, Critical Care and Anaesthesia (OSCCA), Sheffield, United Kingdom
xAZ Sint Jan Brugge-Oostende AV, Department of Anesthesiology, Brugge, Belgium
yUniversity of Bonn, Department of Anesthesiology and Intensive Care Medicine, Bonn, Germany
zUniversity of Aachen, Department of Anesthesiology, Aachen, Germany
aaUniversity of Istanbul, Department of Anesthesiology and Intensive Care Medicine, Istanbul Medical Faculty, Istanbul, Turkey
abDepartment of Critical Care Medicine, Hospital Israelita Albert Einstein, Faculdade de Medicina do ABC, São Paulo, Brazil
acProgram of Post-Graduation, Research and Innovation, Faculdade de Medicina do ABC, São Paulo, Brazil
adUniversity of Insubria, ASST dei Sette Laghi, Ospedale di Cricolo e Fondazione Macchi, Department of Biotechnology and Sciences of Life, Varese, Italy
aeDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States
afHarvard Medical School, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States
agUniversity of Leipzig, Department of Anesthesiology and Intensive Care Medicine, Leipzig, Germany
ahUniversity of Amsterdam, Department of Intensive Care, Academic Medical Center, Amsterdam, Netherlands
aiUniversity of Genoa, Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino - IST, Genoa, Italy
ajDepartment of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Dresden, Germany
akDepartment of Anesthesiology, University of Aachen, Germany
alDepartment of Anesthesiology CLIPS Clinical Trials-Patient-centered Studies, University Hospital Düsseldorf, Germany
amDepartment of Anesthesiology, University Medical Center Mainz, Germany
anDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Clinic Knappschaftskrankenhaus Bochum, Germany
aoDepartment of Anesthesiology, University Hospital Heidelberg, Germany
apDepartment of Anesthesiology, Marienhospital Wesel, Germany
aqDepartment of Anesthesiology and Intensive Care Medicine, Marienstift Friesoythe, Germany
arDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany
asServiço de Anestesiologia, Centro Hospitalar do Porto, Portugal
atServiço de Anestesiologia, Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
auServiço de Anestesiologia, Centro Hospitalar São João, Porto, Portugal
avServiço de Anestesiologia, Hospital Pedro Hispano, Matosinhos, Portugal
awDepartment of Anesthesiology, Montefiore Medical Center Bronx, New York, NY, United States
axDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States
ayDepartment of Anesthesiology, Mayo Clinic, Jacksonville, FL, United States
azDepartment of Anesthesiology, Mayo Clinic, Phoenix, AZ, United States
baDepartment of Anesthesiology, University of Colorado SOM, Aurora, CO, United States
bbDepartment of Anesthesiology, Tufts Medical Center, Boston, MA, United States
bcDepartment of Anesthesiology, University of Mississippi, Jackson, MS, United States
bdDepartment of Anesthesiology, University of Chicago, Chicago, IL, United States
beDepartment of Anesthesiology, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
bfDepartment of Intensive Care, Academic Medical Center, University of Amsterdam, Netherlands
bgDepartment of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
bhDepartment of Anesthesiology, Westfriesgasthuis, Hoorn, Netherlands
biDepartment of Anesthesiology, VU Medical Center, Amsterdam, Netherlands
bjDepartment of Anesthesiology, Onze Lieve Vrouwen Gasthuis (OLVG), Amsterdam, Netherlands
bkDepartment of Anesthesiology and General Intensive Care, Medical University of Vienna, Austria
blDepartment of Anesthesiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
bmDepartment of Anesthesiology and Critical Care, Hospital Clinico Universitario de Valencia, Spain
bnDepartment of Anesthesiology, Critical Care and Pain Relief, Consorcio Hospital General Universitario de Valencia, Spain
boDepartment of Anesthesiology and Surgical Critical Care, Hospital Universitario La Paz, Madrid, Spain
bpDepartment of Anesthesiology, Hospital Universitari Mútua de Terrassa, Spain
bqDepartment of Anesthesiology, Hospital Clinic de Barcelona, Spain
brDept. of Anesthesiology, King Abdullah Medical City, Makkah, Saudi Arabia
bsDept. of Anesthesiology, Assiut University, Egypt
btDept. of Anesthesiology, Mansoura University, Egypt
buDepartment of Anesthesiology, King Abdulaziz National Guard Medical City, Riyadh, Saudi Arabia
bvDepartment of Anaesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
bwDepartment of Anesthesiology and Reanimation, Marmara University School of Medicine, Istanbul, Turkey
bxDepartment of Anesthesiology and Reanimation, Akdeniz University Hospital, Antalya, Turkey
byDepartment of Anesthesiology and Reanimation, Dokuz Eylül University of Medicine, Izmir, Turkey
bzDepartment of Anesthesiology and Reanimation, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey
caDepartment of Anaesthesiological, Surgical and Emergency Sciences, Second University of Naples, Italy
cbDepartment of Morphology, Surgery and Experimental Medicine, Ospedale Sant' Anna, Ferrara, Italy
ccDepartment of Environment, Health and Safety, University of Insubria, Varese, Italy
cdDept. of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino, IST, University of Genoa, Italy
ceDepartment of Anesthesiology and Reanimation, Ospedale U. Parini, AUSL della Valle d' Aosta, Italy
cfDepartment of Anesthesiology, Pharmacology and Intensive Care, University Hospital Geneva, Switzerland
cgInstitute for Anesthesia and Intensive Care Medicine, Kantonsspital Frauenfeld, Switzerland
chDepartment of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Switzerland
ciUniversity Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Sveti Duh, Zagreb, Croatia
cjDepartment of Anesthesiology, Resuscitation and Intensive Care, Clinical Hospital Dubrava, Zagreb, Croatia
ckDepartment of Anesthesiology, Ghent University Hospital, Belgium
clDepartment of Anesthesiology, UH Antwerpen, Belgium
cmDepartment of Anesthesiology, UZ Leuven, Belgium
cnDepartment of Anaesthesiology, Intensive care and Emergency, AZ Sint Jan Brugge, Bruges, Belgium
coDepartment of Anesthesiology, Cliniques Universitaires St Luc, Belgium
cpDepartment of Anesthesiology, Ponderas Hospital, Bucharest, Romania
cqDepartment of Intensive Care, St James's University Hospital, Dublin, Ireland
crDepartment of Anaesthesiology and Intensive Care, Zaporozhye State Medical University, Zaporozhye, Ukraine
csDepartment of Anaesthesiology and Intensive Care, Lutsk Clinical Hospital, Lutsk, Ukraine
ctDivision of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv, Israel
cuDepartment of Anaesthesiology and Intensive Therapy, Barlicki University Hospital, Medical University of Lodz, Poland
cvDepartment of Anesthesiology and Critical Care, Saint Michael's Hospital, University of Toronto, Canada
cwOperating Services Critical Care and Anaesthesia (OSCCA), Sheffield Teaching Hospitals, United Kingdom
cxDepartment of Anaesthesia and Critical Care Medicine, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom
cyResearch Divisional Lead-Surgery and Oncology, Research and Development Department, Ashford and St Peter Hospitals NHS Trust, Chertsey, United Kingdom
czDepartment of Anaesthesia, Royal Cornwall Hospital, Truro, United Kingdom
daDepartment of Anaesthesia, Hull and East Yorkshire NHS Trust, Hull, United Kingdom
dbDepartment of Critical Care Medicine, Imperial College Healthcare NHS Trust, London, United Kingdom
dcDepartment of Anaesthesia, Western Sussex Hospitals NHS Foundation Trust, Chichester, United Kingdom
ddDepartment of Anaesthesia, York Teaching Hospitals, York, United Kingdom
deDepartment of Anaesthesia, Homerton University Hospitals NHS Foundation Trust, Homerton, United Kingdom
dfDepartment of Anesthesia, Southmead Hospital, Bristol, United Kingdom
dgDepartment of Anaesthesia and Critical Care Medicine, University Clinic of Surgery St. Naum Ohridski, Skopje, Macedonia
dhDepartment of Anaesthesia, Polyclinique Montier La Celle, St. Andre les Vergers, France
diDepartment of Anaesthesia, Alexandra General Hospital, Athens, Greece
djDepartment of Anaesthesiology and Intensive Medicine, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic


Title:
Psychological Assessment and Quality of Life among Patients with ‎Nonmetastatic Colorectal Cancer at Assiut University Hospital and ‎South Egypt Cancer Institute‎

Abstract:
Introduction Depression, anxiety, stress, and poor quality of life (QoL) are often consequences of living with cancer. Cancer patients face the double challenge of learning to manage the physical as well as psychological effects of cancer. This study aimed to assess psychological symptoms and QoL among patients with colorectal cancer (CRC). The study included a convenience sample of 151 patients who attended the outpatient clinic of the Oncology Department at Assiut University Hospital and South Egypt Cancer Institute (Assiut, Egypt). Patients were evaluated through demographic data sheet, socioeconomic status scale, QoL scale, and symptoms check list-90-revised. Results Females represented 64.2% of the patients. Most of the patients (76.16%) were living in rural areas. Somatization was found in 32.45%, hostility in 27.8%, anxiety in 9.27%, and depression in 8.6%. Overall, 65.56% of the patients had a moderate level of QoL. A high percentage of those who had moderate QoL had somatization, depression, anxiety, hostility, and phobia. Conclusion and recommendations These findings of high prevalence of different psychiatric symptoms and moderate level of QoL among CRC patients give the impression that, some of the patients with CRC might get benefit from psychiatric liaison to help them to deal with these challenges. © 2017 Institute of Psychiatry, Ain Shams University.

Author Info:
Department of Psychiatry, Assiut University, Assiut, Egypt


Authors:
Derar, D.R.a,bEmail Author,  Ali, A.a,b,  Osman, S.A.a,c,  Al-Sobayil, F.A.a,  Saeed, E.M.a,  Hassanein, K.d,  Al-Hawas, A.-A.a

Date of Publishing:
Volume 26, Issue 4, 1 July 2017, Pages 965-970

Title:
Potential Pathogens in Infertile Male Dromedary Camels and Their ‎Association with the Spermiogram and Clinical Findings‎

Abstract:
The role of five pathogens potentially implicated in the reproductive failure of 141 male dromedary camels was investigated. Breeding soundness examinations, which included semen analysis and testicular histopathology of the infertile male camels, were compared with seven camels of normal fertility. Antibodies against Chlamydia abortus (C. abortus) and Toxoplasma gondii (T. gondii) were detected using the ELISA assay. Antibodies against Trypanosoma evansi (T. evansi) were identified using the card agglutination test. The Rose Bengal plate agglutination test was used to detect Brucella species. Preputial swabs were cultured for the presence of Campylobacter fetus (C. fetus). The incidence of positive titers of C. abortus and T. evansi, and the incidence of positive culture of C. fetus was found to be 13.5, 10.6, and 7.8%, respectively. T. evansi was more prevalent in younger (5–7 years) than older (more than 7 years) camels (p = 0.02). Most of the semen characteristics were negatively affected in the camels exposed to C. abortus and T. evansi (p = 0.05). T. evansi, C. fetus, and C. abortus may have a role in lowering the reproductive efficiency of male dromedaries. However, further diagnostic techniques are recommended to confirm their association with lowered fertility in this species. © 2017, Springer-Verlag London.

Author Info:
aDepartment of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim, Saudi Arabia
bDepartment of Theriogenology, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt
cDepartment of Animal Medicine, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
dDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
El-saman, A.M.a,  Abbas, A.M.aEmail Author,  Amin, A.F.a,  Fetih, A.N.a,  Bahloul, M.a,  Salem, M.N.b,  Salem, H.T.a

Date of Publishing:
Volume 10, Issue 5, 1 September 2017, Pages 416-422

Title:
Laparoscopic Cervicopexy: A Novel Minimally Invasive Fertility ‎Conservative Procedure for Stages III and Iv Uterine Prolapse – ‎Case Series‎

Abstract:
Objective: To evaluate the safety and efficacy of laparoscopic anterior abdominal wall cervicopexy (LAWC), a novel minimally invasive procedure for management of stages III and IV uterine prolapse. Subjects and methods: The procedure was performed on 39 cases with symptomatic uterine prolapse during the period from June 2012 to January 2015. The procedure was started with obliteration of the pouch of Douglas through the approximation of the uterosacral ligaments with non-absorbable suture. Then, the procedure completed through anchoring the supravaginal cervix to the anterior abdominal wall by two non-absorbable sutures taken in good bites in the dense stroma of the supravaginal cervix. Results: Uterine prolapse was diagnosed as stage III in 36 (92.3%) women and stage IV in three cases. The procedure was conducted safely without any intraoperative complications. At 3 month follow-up, there was a statistically significant reduction in the extent of prolapse at all pelvic organ prolapse quantification (POP-Q) points as compared with preoperative assessment (p = 0.000). Only five cases (12.8%) were found to have stage I uterine prolapse on evaluation by the POP-Q system after one year. Conclusion: LAWC is a minimally invasive, simple, and highly effective procedure to treat marked uterine prolapse and seems not to compromise fertility. © 2017, © British Association of Urological Surgeons 2017.

Author Info:
aDepartment of Obstetrics and Gynecology, Assiut University, Egypt
bDepartment of Obstetrics and Gynecology, Sohag University, Egypt


Authors:
El-Shemi, A.G.a,dEmail Author,  Kensara, O.A.b,  Alsaegh, A.a,  Mukhtar, M.H.c  View Correspondence (jump link)

Date of Publishing:
Volume 101, Issue 1-2, 1 December 2017, Pages 9-21

Title:
Pharmacotherapy with Thymoquinone Improved Pancreatic Β-Cell ‎Integrity and Functional Activity, Enhanced Islets Revascularization, ‎and Alleviated Metabolic and Hepato-Renal Disturbances in ‎Streptozotocin-Induced Diabetes in Rats‎

Abstract:
Aims: This study is aimed at evaluating the antidiabetic effects of thymoquinone (TQ) on streptozotocin (STZ)-induced diabetes in rats, and exploring the possible underlying mechanisms. Methods: Diabetes was induced in adult male Wistar rats by intraperitoneal injection of freshly prepared STZ (65 mg/kg). After disease induction, 42 rats were equally assigned to: Controls, STZ-diabetic group, and STZ-diabetic group treated with oral TQ (35 mg/kg/day) for 5 weeks. Fasting blood glucose levels were determined weekly, and the animals were euthanized at day 38 post-STZ injection. Blood samples were assessed for glucose-insulin homeostasis parameters (plasma glucose, glycated hemoglobin, serum insulin, homeostatic model assessment of insulin resistance, and insulin sensitivity index) and lipid profile. Resected pancreases were subjected to histological examination and immunohistochemical or enzyme-linked immunosorbent assay assessment to determine the pancreatic expression of insulin sensitizing β-cells, anti-apoptotic protein "survivin," apoptosis-inducer "caspase-3," prototypic angiogenic factors (vascular endothelial growth factor [VEGF] and endothelial cluster of differentiation 31 [CD31]), pro- and anti-inflammatory cytokines (interleukin-1beta [IL-1β] and interleukin-10 [IL-10], respectively), thiobarbituric acid reactive substances (TBARS), total glutathione (GSH), and superoxide dismutase (SOD). The hepato-renal statuses were assessed biochemically and histologically. Results: Therapy with TQ markedly improved the integrity of pancreatic islets, glucose-insulin homeostasis-related parameters, lipid profile parameters, and hepato-renal functional and histomorphological statuses that collectively were severely deteriorated in untreated diabetic group. Mechanistically, TQ therapy efficiently increased insulin producing β-cells, upregulated survivin, VEGF, CD31, IL-10, GSH and SOD, and downregulated caspase-3, IL-1β, and TBARSs in the pancreatic tissues of STZ-diabetic rats. Conclusions: These findings prove the anti-diabetic potential of TQ and its efficacy in regenerating pancreatic β-cells and ameliorating pancreatic inflammation and oxidative stress, and highlight its novelty in repressing apoptosis of β-cells and enhancing islet revascularization in STZ-diabetic rats. Further studies are required to support these findings and realize their possible clinical significance. © 2017 S. Karger AG, Basel.

Author Info:
aDepartment of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, PO Box 7607, Holy Makkah, Saudi Arabia
bDepartment of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
cDepartment of Medical Biochemistry, Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
dDepartment of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Elgamal, D.A.aEmail Author,  Ghafeer, H.H.a,  Abdel-Maksoud, S.A.a,  Mahran, A.M.b,  Farag, A.A.a

Title:
Histological, Immunohistochemical, and Morphometric Study of ‎Peritubular Cells and Mast Cells in the Testicular Interstitium of ‎Azoospermic Men‎

Abstract:
Background Infertility continues to be a highly prevalent condition. Although assisted reproduction technology has been significantly effective, it is relatively costly and may yield disappointing clinical outcomes. There is still an unexplained correlation between the substantial contribution of the testicular somatic cells such as the peritubular cells and interstitial immune cells such as mast cells. Aim The aim of this work was to study the histological, immunohistochemical, and morphometric profiles of peritubular cells and mast cells in azoospermic men that might be a clue for male infertility therapy. Patients and methods This study was carried out on 39 infertile azoospermic men attending the Andrology Outpatient Clinic in Assiut University Hospital. Patients were divided into two groups. Group I (GI), which included patients with obstructive azoospermia (n=9), and group II (GII), which included patients with nonobstructive azoospermia. GII was subdivided as follows: Subgroup A, which included patients with Sertoli cell-only syndrome (n=9); subgroup B, which included patients with germ cell arrest (n=10); and subgroup C, which included patients with hypospermatogenesis (n=11). Testicular biopsies were obtained and processed for light, immunohistochemical, morphometric analysis, and electron microscopic examinations. Results The testicular interstitium of GI showed an apparently normal pattern of organization as regards cellular and fibrous components. GIIA showed the highest mast cell number, which established cytoplasmic projections toward peritubular cells. The mean count of tumor necrosis factor α-positive cells showed a significant increase in GIIA compared with GI. The mean area% of collagen fibers increased significantly in GIIA, GIIB, and GIIC compared with GI. In GIIB, bundles of microfibrils were most evident between the basement membrane and the first layer of peritubular cells. In GIIC, they appeared flattened with slender interlacing processes forming bridges. Mast cells bore long cytoplasmic projections, which extended toward the neighboring fibroblasts. Conclusion The present data signify complex cell interactions in cases of testicular dysfunction within the interstitial compartment. © 2017 The Egyptian Journal of Histology.

Author Info:
aDepartments of Histology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
bDepartments of Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Elgayar, S.A.M.Email Author,  Eltony, S.A.,  Sayed, A.A.,  Abbas, A.Y.A.

Date of Publishing:
Volume 21, Issue 3, 1 July 2017, Pages 173-187

Title:
Protective Effect of Vitamin B Com-Plex in Diabetic Peripheral ‎Neuropa-Thy-Histopathological Study‎

Abstract:
Vitamin B complex has been used for peripheral neuropathy for a long time and continues to be part of current practice despite lack of strong evi-dence for its use and its non-inclusion in treatment guidelines. So this study was carried out to verify the neuroprotective effect of vitamin B complex from morphological changes of the diabetic rat sci-atic nerve. A total number of 30 adult male albino rats were used and divided into three groups. Group I: normal vehicle control (N=10). Group II: streptozotocin-induced diabetic rats (N=20), which is equally divided into two subgroups; IIa (diabetic vehicle control) and IIb (diabetic vitamin B complex -treated, at a dose of 1mg/kg/day for 6 weeks). Diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ) at a dose of 80mg/kg. Specimens from sciatic nerve were pro-cessed for light, electron microscopy and immuno-histochemistry investigations. Morphological indi-ces including the average myelin sheath thickness, the average myelinated nerve fiber area, endoneu-rial capillary density and perineurial index were measured and statistically analysed. Vitamin B complex treatment for six weeks markedly protect-ed the sciatic nerve from the deleterious effect of hyperglycemia and preserved normal structural features of the perineurium, Schwann cells and their myelin sheath, nerve fibers, blood capillaries and the interstitium. The results were verified by immunohistochemistry (using CD 31, CD 68 and anti caspase-3 antibodies) and the morphological indices including the myelin sheath thickness, peri-neurial index and endoneurial capillary density. In conclusion, vitamin B complex supplementa-tion might provide a long-term, drug approach for protection from diabetic peripheral neuropathy.

Author Info:
Department of Histology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt


Authors:
Elserogy, Y.,  Abdelrahman, A.A.Email Author,  Noaman, M.M.,  Shehata, G.A.,  Khalifa, H.

Title:
Assessment of Cognitive Functions and Cerebral Blood Flow in ‎Patients with Schizophrenia‎

Abstract:
Introduction Although recent efforts have been undertaken to investigate the aspects of short-term cerebral hemodynamics during cognitive challenge in schizophrenia, there are, to the best of our knowledge, no reports on cerebral hemodynamics during prefrontal function. Objective This aim of this study was to assess cognitive functions and measure cerebral blood flow (CBF) in patients with schizophrenia. Patients and methods Fifty adult inpatients (33 male and 17 female) participated in the study. They were referred from the outpatient clinic of psychiatry at Assiut University Hospital. All patients' guardians provided written consent for their patients to participate in the study after full explanation of the study procedures was provided. All patients met the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision, diagnostic criteria for schizophrenia. The control group comprised 25 adults (aged 20-40 years; 14 male and 11 female) who volunteered to participate in the study. They were selected from general population and matched with the patient group for age, sex, and socioeconomic state, and were relatives of other patients in the outpatient clinic in Assiut University Hospital rather than the neuropsychiatric clinic. All patients and controls were subjected to the following after written informed consent was obtained from each first-degree relative for his or her patient: (a) psychiatric interview, (b) Positive and Negative Syndrome Scale, (c) soft neurological sign assessment using Cambridge Neurology Inventory, (d) transcranial Doppler sonography, and (e) Cognitive Ability Screening Instrument. Results There was an increased frequency of each of the neurological soft sign scores measured using Cambridge Neurological Inventory part II among schizophrenic patients, especially motor coordination and motor sequencing and their correlation with predominance of negative symptoms. The evaluation of mean velocity of CBF in the middle cerebral artery, anterior cerebral artery, and basilar artery using transcranial Doppler revealed no significant difference between the patient and control groups, except for basilar artery, which had a statistical minimal significance. However, there was a correlation between positive symptoms and increased CBF as well as between negative symptoms and decreased CBF. Cognitive functions that were highly affected in schizophrenic patients were short term memory, orientation, mental manipulation, concentration, abstract thinking, judgment, drawing, and fluency, whereas long term memory and attention were affected to a lesser extent in schizophrenic patients. There was no effect on language function; it was affected by predominance of negative symptoms. Conclusion We found that most patients with schizophrenia have moderate-to-marked cognitive dysfunctions. We also found a positive correlation between positive symptoms and increased CBF and between negative symptoms and decreased CBF. © 2017 Institute of Psychiatry, Ain Shams University.

Author Info:
Department of Neuropsychiatry, Assiut Hospital University, Assiut University Street, Assiut, Egypt


Authors:
Elserogy, Y.M.a,  Saad, K.bEmail Author,  Al-Atram, A.A.c,  Othman, H.A.K.d,  Abd El-Baseer, K.A.e,  Ahmed, A.E.e

Title:
Chromosomal Aberrations in Children with Autism Spectrum Disorders ‎in Upper Egypt‎

Abstract:
Objective: The pathogenesis of autism spectrum disorders (ASD) is complex and still not clear. Genetic factors contribute to the occurrence of ASD. However, the genetics of ASD is highly heterogeneous. Chromosomal aberrations have a key role to the genetic abnormalities of both syndromic and non-syndromic ASD. Methods: In our study, we conducted karyotyping analysis in a sample of 231 Egyptian children with ASD aged 3-13 years (132 males and 99 females) from five Governorates in Upper Egypt. Results: Eleven patients (4.7%) were found to have chromosomal abnormalities in this study. We found five patients having sex chromosome aneuploidy, including two patients with Turner syndrome, two with 47,XYY and one with 47,XXY. In addition, we detected three patients have Down syndrome, one patient has monosomy 1p36, one patient has Williams-Beuren syn-drome and one patient has a deletion of the long arm of chromosome 13. Conclusions: The present study rein-forces the findings of the association between some chromosomal aberrations and ASD. Further investigations into these regions may lead to discovery of new genes involved in ASD. The present study directs the attention of the clinicians about the importance of karyotyping in the evaluation of ASD patients. © 2017, Cukurova University, Faculty of Medicine. All rights reserved.

Author Info:
aDepartment of Psychiatry, Assiut, Egypt
bDepartment of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartment of Psychiatry, College of Medicine, Majmaah University, Saudi Arabia
dDepartment of Clinical Pathology, Aswan University, Aswan, Egypt
eDepartment of Pediatrics, Qena Faculty of Medicine, South Valley University, Egypt


Authors:
Elsnosy, E.,  Shaaban, O.M.,  Abbas, A.M.Email Author,  Gaber, H.H.,  Darwish, A.

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 13-17

Title:
Effects of Antenatal Dexamethasone Administration on Fetal and ‎Uteroplacental Doppler Waveforms in Women at Risk for ‎Spontaneous Preterm Birth‎

Abstract:
Objective Maternal administration of synthetic corticosteroids is essential to improve fetal lung surfactant production and hasten the fetal lung maturity in women at risk for preterm birth. The current study aimed to investigate the effects of dexamethasone exerted on fetal and uteroplacental circulation as measured by Doppler in pregnancies at risk for preterm birth after 24 h of its administration. Materials and methods A prospectively registered study at www.ClinicalTrials.gov (NCT02662790) was conducted in Women Health Hospital, Assiut, Egypt, included 50 pregnant women with singleton pregnancies. Doppler studies were performed on the umbilical artery, fetal middle cerebral artery (MCA), fetal descending aorta and maternal uterine arteries just before dexamethasone administration and repeated 24 h after completion of the dexamethasone course. Results The mean age of the study group was 27.7 ± 4.5 years. There was a statistically significant difference between all Doppler indices in umbilical artery, fetal MCA and aorta in comparison before and 24 h after maternal dexamethasone administration. Also uterine artery Pulsatility index was significantly different (p = 0.001). Conclusion Maternal dexamethasone administration to pregnant women at risk of preterm labor improves the blood flow of the maternal uterine artery, fetal MCA, descending aorta and umbilical artery 24 h after its administration. © 2016 Middle East Fertility Society


Authors:
Erdem, H.a,h,  Ozturk-Engin, D.b,  Cag, Y.c,  Senbayrak, S.b,  Inan, A.b,  Kazak, E.d,  Savasci, U.a,  Elaldi, N.e,  Vahaboglu, H.f,  Hasbun, R.gEmail Author,  Nechifor, M.r,  Tireli, H.j,s,  Kilicoglu, G.k,t,  Defres, S.l,m,u,  Gulsun, S.n,v,  Ceran, N.i,o,  Crisan, A.p,w,  Johansen, I.S.q,x,  Namiduru, M.y,  Dayan, S.z,  Kayabas, U.aa,  Parlak, E.ab,  Khalifa, A.ac,  Kursun, E.ad,  Sipahi, O.R.ae,bs,  Yemisen, M.af,  Akbulut, A.u,  Bitirgen, M.ag,  Popovic, N.ah,  Kandemir, B.ag,  Luca, C.ai,  Parlak, M.ab,  Stahl, J.P.aj,  Pehlivanoglu, F.o,  Simeon, S.ak,  Ulu-Kilic, A.al,  Yasar, K.am,  Yilmaz, G.an,  Yilmaz, E.ao,  Beovic, B.ap,  Catroux, M.aq,  Lakatos, B.ar, Sunbul, M.as,  Oncul, O.h,  Alabay, S.al,  Sahin-Horasan, E.at,  Kose, S.au,  Shehata, G.av,  Andre, K.aw,  Dragovac, G.ax,  Gul, H.C.ay,  Karakas, A.ay,  Chadapaud, S.az,  Hansmann, Y.ba,  Harxhi, A.bb,  Kirova, V.bc,  Masse-Chabredier, I.bd,  Oncu, S.be,  Sener, A.bf,  Tekin, R.z,  Deveci, O.z,  Ozkaya, H.D.bg,  Karabay, O.bh,  Agalar, C.bi,  Gencer, S.c,  Karahocagil, M.K.bk,  Karsen, H.bl,  Kaya, S.bm,  Pekok, A.U.bn,  Celen, M.K.bo,  Deniz, S.b,  Ulug, M.bp,  Demirdal, T.bq,  Guven, T.br,  Bolukcu, S.b,bs,  Avci, M.bt,  Nayman-Alpat, S.bu,  Yaşar, K.bv,  Pehlivanoʇlu, F.o,  Ates-Guler, S.bw,  Mutlu-Yilmaz, E.bx,  Tosun, S.bt,  Sirmatel, F.by,  Batirel, A.c,  Öztoprak, N.ca,  Kadanali, A.cb,  Turgut, H.cc,  Baran, A.I.bk,  Karaahmetoglu, G.bj,  Sunnetcioglu, M.bk,  Haykir-Solay, A.cd,  Denk, A.bz,  Ayaz, C.bo,  Gorenek, L.bj,  Larsen, L.ce,  Poljak, M.cf,  Barsic, B.cg,  Argemi, X.ch,  Sørensen, S.M.ci,  Bohr, A.L.cj,  Tattevin, P.ck,  Gunst, J.D.cl,  Baštáková, L.cm,  Jereb, M.cn,  Johansen, I.S.ce,  Chehri, M.co,  Beraud, G.cp,  Del Vecchio, R.F.cq,  Maresca, M.cq,  Yilmaz, H.cr,  Sharif-Yakan, A.cs,  Kanj, S.S.cs,  Korkmaz, F.ct,  Komur, S.cu,  Coskuner, S.A.cv,  Ince, N.cw,  Akkoyunlu, Y.cx,  Halac, G.cy,  Nemli, S.A.cz,  Ak, O.dd,  Kaya, S.de,  Gunduz, A.df,  Gozel, M.G.db,  Hatipoglu, M.da,  Cicek-Senturk, G.dh,  Akcam, F.Z.di,  Inkaya, A.C.dj,  Sagmak-Tartar, A.dk,  Ersoy, Y.dl,  Tuncer-Ertem, G.dm,  Balkan, I.I.dn,  Cetin, B.do,  Ersoz, G.dp,  Ozgunes, N.f,  Yesilkaya, A.dr,  Erturk, A.ds,  Gundes, S.dt,  Turhan, V.da,  Yalci, A.du,  Aydin, E.dv,  Diktas, H.dw,  Ulcay, A.da,  Seyman, D.dc,  Leblebicioglu, H.cr  View Correspondence (jump link)

Journal:
International Journal of Infectious Diseases

Date of Publishing:
Volume 65, 1 December 2017, Pages 107-109

Title:
Central Nervous System Infections in the Absence of Cerebrospinal ‎Fluid Pleocytosis‎

Abstract:
Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated. © 2017 The Author(s)

Author Info:
aDepartment of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
bDepartment of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
cDepartment of Infectious Diseases and Clinical Microbiology, Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
dDepartment of Infectious Diseases and Clinical Microbiology, Uludag University School of Medicine, Bursa, Turkey
eDepartment of Infectious Diseases and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
fDepartment of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
gDepartment of Infectious Diseases, UT Health McGovern Medical School, Houston, TXs, United States
hDepartment of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
iDepartment of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
jDepartment of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
kDepartment of Radiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
lInstitute of Infection & Global Health, University of Liverpool, Liverpool, United Kingdom
mTropical Infections Diseases Unit in Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
nDepartment of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
oDepartment of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
pDepartment of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
qDepartment of Infectious Diseases Q, Odense University Hospital, Odense, Denmark
rDepartment of Pharmacology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
sDepartment of Neurology, Baghdad Teaching Hospital, Baghdad, Iraq
tDepartment of Infectious Diseases, Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
uDepartment of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
vInstitute of Microbiology and Immunology, National Reference Laboratory for Tuberculosis, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
wSection of Infectious Diseases, Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
xDepartment of Infectious Diseases and Clinical Microbiology, Cukurova University School of Medicine, Adana, Turkey
yDepartment of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
zDepartment of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
aaDepartment of Infectious Diseases and Clinical Microbiology, Inonu University School of Medicine, Malatya, Turkey
abDepartment of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
acDepartment of Neurology, Damascus Hospital, Damascus, Syrian Arab Republic
adDepartment of Infectious Diseases and Clinical Microbiology, Baskent University School of Medicine, Adana, Turkey
aeDepartment of Infectious Diseases and Clinical Microbiology, Ege University School of Medicine, Izmir, Turkey
afDepartment of Infectious Diseases and Clinical Microbiology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
agDepartment of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University School of Medicine, Konya, Turkey
ahClinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
aiDepartment of Infectious Diseases, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
ajDepartment of Infectious Diseases, Joseph Fourier University and University Hospital of Grenoble, Grenoble, France
akDepartment of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
alDepartment of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
amDepartment of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
anDepartment of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
aoDepartment of Infectious Diseases and Clinical Microbiology, Uludag University School of Medicine, Bursa, Turkey
apDepartment of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia
aqDepartment of Infectious Diseases, Poitiers University Hospital, Poitiers, France
arDepartment of Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary
asDepartment of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
atDepartment of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Istanbul, Turkey
auDepartment of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
avDepartment of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
awDepartment of Infectious Diseases, Dax Hospital, Dax, France
axDepartment of Prevention and Control of Diseases, Medical Faculty, IPH of Vojvodina, University of Novi Sad, Novi Sad, Serbia
ayDepartment of Infectious Diseases and Clinical Microbiology, Gulhane Medical Academy, Ankara, Turkey
azDepartment of Infectious Diseases, Marie José Treffot Hospital, Hyeres, France
baDepartment of Infectious Diseases, University Hospital, Strasbourg, France
bbService of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania
bcUniversity Clinic for Infectious Diseases and Febrile Conditions, Skopje, Macedonia
bdDepartment of Infectious Diseases, Aurillac Hospital, Aurillac, France
beDepartment of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
bfDepartment of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
bgDepartment of Infectious Diseases and Clinical Microbiology, Karsiyaka State Hospital, Izmir, Turkey
bhDepartment of Infectious Diseases and Clinical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
biDepartment of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
bjGATA Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
bkYuzuncuyil University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Van, Turkey
blHarran University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sanliurfa, Turkey
bmKaradeniz Technical University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey
bnPrivate Erzurum Sifa Hospital, Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey
boDicle University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Diyarbakir, Turkey
bpPrivate Umit Hospital, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
bqKatip Celebi University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
brAnkara Atatürk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
bsBezmi Alem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
btIzmir Bozyaka Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
buOsmangazi University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Eskisehir, Turkey
bvBakIrkoy Dr. Sadi Konuk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
bwSutcu Imam University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kahramanmaras, Turkey
bxSamsun Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
byIzzet Baysal University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bolu, Turkey
bzFirat University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Elazig, Turkey
caAntalya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
cbUmraniye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
ccPamukkale University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Denizli, Turkey
cdIgdir State Hospital, Department of Infectious Diseases and Clinical Microbiology, Igdir, Turkey
ceOdense University Hospital, Department of Infectious Diseases Q, Odense, Denmark
cfInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
cgDr. Fran Mihaljevic University Hospital for Infectious Diseases, Department of Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
chNouvel Hôpital Civil, Department of Infectious Diseases, Strasbourg, France
ciAalborg University Hospital, Department of Infectious Diseases, Aalborg, Denmark
cjInstitute of Inflammation Research, Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen, Denmark
ckInfectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
clAarhus University Hospital, Department of Infectious Diseases, Aarhus, Denmark
cmFaculty Hospital Brno, Department of Infectious Diseases, Masaryk University Faculty of Medicine, Brno, Czech Republic
cnUniversity Medical Centre, Department of Infectious Diseases, Ljubljana, Slovenia
coHvidovre Hospital, Department of Infectious Diseases, Copenhagen, Denmark
cpPoitiers University Hospital, Department of Infectious Diseases, Poitiers, France
cqUniversity of Catania, Section of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Catania, Italy
crOndokuz Mayis University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
csAmerican University, Beirut Medical Center, Beirut, Lebanon
ctKonya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Konya, Turkey
cuCukurova University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey
cvIzmir Bozyaka Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
cwDüzce University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Konuralp, Düzce, Turkey
cxBezmi Alem Vakif University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
cyBezmi Alem Vakif University, School of Medicine, Department of Neurology, Istanbul, Turkey
czKatip Celebi University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey
daGATA Haydarpasa Training Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
dbCumhuriyet University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas, Turkey
dcAntalya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
ddLutfi Kirdar Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
deKaradeniz Technical University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey
dfSisli Etfal Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
dgOndokuz Mayis University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Turkey
dhDiskapi Yildirim Beyazit Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
diSuleyman Demirel University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey
djHacettepe University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
dkFirat University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Elazig, Turkey
dlInonu University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
dmAnkara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
dnIstanbul University Cerrahpasa School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
doKoc University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
dpMersin University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey
dqMedeniyet University, Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
drBaskent University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
dsRecep Tayyip Erdoǧan University, School of Medicine, Department of Department of Infectious Diseases and Clinical Microbiology, Rize, Turkey
dtKocaeli University School of Medicine, Department of Department of Infectious Diseases and Clinical Microbiology, Izmit, Turkey
duAnkara University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
dvKafkas University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kars, Turkey
dwMilitary Hospital, Department of Infectious Diseases and Clinical Microbiology, Tatvan, Turkey


Authors:
Gadelkareem, R.A.a,  Hameed, D.A.aEmail Author,  Moeen, A.M.a,  El-Araby, A.M.b,  Mahmoud, M.A.b,  El-Taher, A.M.a,  El-Haggagy, A.A.a,  Ramzy, M.F.c  View Correspondence (jump link)

Date of Publishing:
Volume 23, Issue 1, 1 March 2017, Pages 56-61

Title:
Living Donor Kidney Transplantation in the Hemodialysis-Naive and ‎the Hemodialysis-Exposed: A Short Term Prospective Comparative ‎Study‎

Abstract:
Introduction Preemptive (P) living donor kidney transplantation (LDKT) provides better survival rates, quality of life and economic saving. However, the extent of these advantages over those with a short period of pre-LDKT dialysis is not known. Objectives Evaluation of the patients’ characteristics and short-term outcomes of PLDKT and LDKT after a pre-transplant period of hemodialysis (HD) not >6 months. Patient and methods This study was conducted between June 2010 and June 2012 and included two groups. Group-I included recipients without HD before operation. Group-II included those who had a period of HD ≤6 months. Recipients and donors were evaluated according to the classic work up. Follow-up for 12 months was scheduled. Results Group-I included 30 recipients and group-II included 15 recipients. Demographic and clinical characteristics were similar except for mean recipient age (44 versus 34.3 years; p = 0.024), recipient donor age difference (p = 0.03), job categories (p = 0.047) and ABO distribution (p = 0.01). Cumulative graft (0.88 versus 0.93) and recipient (0.92 versus 0.100) survival rates were non-significantly different. Graft function and mean serum creatinine level were within normal up to 12 months. Acute graft rejection (AGR) was significantly higher in group-II (16.7% versus 46.7%; p = 0.03). However, lymphoceles were significantly more common in group-I (40% versus 6.7%; p = 0.02). There was no delayed graft function (DGF), major urinary or vascular complications. Conclusion PLDKT has a lower rate of AGR. Despite it has a higher rate of lymphoceles, it saves the patient the morbidities of vascular access and inconveniences of HD. Hence, PLDKT is recommended as the first choice for each KT-candidate. © 2016 Pan African Urological Surgeons’ Association

Author Info:
aUrology University Hospital, Assiut University, Assiut, Egypt
bNational Institute of Nephrology and Urology, Egypt
cDepartment of Internal Medicine, Faculty of Medicine, Cairo University, Egypt


Authors:
Goma, S.H.a,  Abdelaziz, M.M.a,  El-Hakeim, E.H.a,  El Zohri, M.H.b,  Sayed, S.K.c  View Correspondence (jump link)

Title:
Progranulin and Insulin-Like Growth Factor Binding Protein-2 as ‎Biomarkers of Disease Activity and Pathological Changes in Lupus ‎Nephritis: Progranulin Und Insulin-Ähnliches Wachstumsfaktor-‎Bindendes Protein-2 Als Biomarker Für Krankheitsaktivität Und ‎Pathologische Veränderungen Bei Lupusnephritis

Abstract:
Background Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease, characterised by the production of auto-antibodies and the formation of immune complexes due to the polyclonal activation of T and B lymphocytes, which results in tissue and organ damage. During inflammation, neutrophils and macrophages release serine proteases to cleave progranulin (PGRN) into granulin, which exerts its pro-inflammatory effects that counteract the anti-inflammatory effects of intact PGRN. It is suggested that insulin-like growth factor binding protein-2 (IGFBP-2) is a dependable biomarker of renal deterioration but it is still unclear if it has high sensitivity and specificity for discriminating SLE-caused kidney disease from other-cause kidney disease. This study aimed to investigate the diagnostic value of PGRN and ILGFBP-2 in patients with lupus nephritis (LN) and the correlation of these biomarkers with disease activity and renal biopsy pathology. Patients and methods Patients with SLE (n=25) and chronic kidney disease (CKD) (n=25), and age- and sex-matched controls (n=25) were enrolled in the study. Serum PGRN and ILGFBP-2 levels were measured for each group. Results Disease duration was 4.78±4.26 years in the SLE patients. The mean SLE Disease Activity Index score was 15.04±7.54. All renal biopsy results were class 2, 3, and 5 with a percentage of 32, 24, and 44% respectively. PGRN and ILGFBP-2 were significantly higher in SLE patients (p<0.001 all) than in the CKD and control groups. All patients with high levels of biomarkers showed higher values of SLE disease activity. No significant difference was noted between active and inactive LN or classes of renal biopsy with PGRN and ILGFBP-2. Conclusion PGRN and ILGFBP-2 are significantly elevated in SLE compared to CKD and the general population and were associated with the SLE Disease Activity Index but not with active LN or classes of renal biopsy. Copyright ©, Georg Thieme Verlag KG. All rights reserved.

Author Info:
aDepartment of Rheumatology, Rehabilitation, and Physical Medicine, Assiut University Hospital, Assiut, Egypt
bDepartment of Internal Medicine, Rheumatology Unit, Assiut University Hospital, Assiut, Egypt
cDepartment of Clinical Pathology, Assiut University Hospital, Assiut, Egypt


Authors:
Goma, S.H.a,  Selim, Z.I.a,  Shehata, G.A.b,  Sayed, D.S.c,  Ahmed, D.a

Title:
Neuro-Behcet: The Value of Transcranial Doppler‎

Author Info:
aDepartment of Physical Medicine, Rheumatology and Rehabilitation, Assiut University Hospitals, Assiut, Egypt
bDepartment of Neuropsychiatry of the Upper Egypt, Assiut University Hospitals, Assiut, Egypt
cDepartment of Dermatology and Venereology, Assiut University Hospitals, Assiut, Egypt


Authors:
Hameed, D.A.Email Author,  Safwat, A.S.Email Author,  Osman, M.M.Email Author,  Gadelmoula, M.M.Email Author,  Kurkar, A.Email Author,  Elgammal, M.A.

Date of Publishing:
Volume 23, Issue 1, 1 March 2017, Pages 33-37

Title:
Outcome of Ureteral Distensibility on the Success of Ureteroscopy: A ‎Prospective Hospital-Based Descriptive Study‎

Abstract:
Introduction “Difficult ureter” is a known problem that increases the complications during ureteroscopy. Objective To categorize ureters according to their distensibility, and to determine whether ureteric distensibility is associated with the success of ureteroscopy and its complications. Subjects and methods Between January 2010 and September 2012, we tested ureteral distensibility in 306 patients who had a unilateral single radiopaque ureteral stone, 6–20 mm in diameter. Ureteral distensibility was classified into two categories according to the maximum size of a ureteral dilator that could be introduced before ureteroscopy: non-distensible ureters, which admitted a dilator up to 10 Fr and distensible ureters, which admitted a dilator >10 Fr. Correlations between distensibility and the success rate and complications of ureteroscopy were determined. Results Overall, 102 patients (33.3%) had non-distensible ureters and 204 (66.7%) had distensible ureters. Distensibility was correlated with the success of ureteroscopy because initial ureteroscopy failed in 38.2% of non-distensible ureters. Ureteroscopy was successful in all distensible ureters. The incidence of ureteric injury was higher in non-distensible ureters than in distensible ureters. Conclusions Our results suggest that ureteric distensibility should be tested before ureteroscopy. Primary ureteroscopy is recommended in distensible ureters because of its low complication rates and favorable outcome. Pre-stenting may be necessary before ureteroscopy in non-distensible ureters; secondary ureteroscopy may be safer and more feasible in these settings. © 2016 Pan African Urological Surgeons’ Association

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


Authors:
Hassan, W.A.Email Author,  Elserogy, Y.M.,  Abdelrahman, A.A.,  Khalifa, H.,  Badry, R.,  Hussein, H.B.

Abstract:
Background Epilepsy is a common and chronic brain disorder that affects about 50 million people worldwide. The majority of the affected population lives in the low-income regions of the world. Stigma and social marginalization are common to persons with epilepsy. Purpose The aim of the present study was to evaluate the factors, including personality and psychological illnesses, likely to be influential in enhancing the social stigma of epilepsy. Methods Data were collected from 102 epileptic adults recruited from the Epilepsy Clinic of Assiut University Hospital in Egypt, with 52 healthy adults included as controls. Clinical information about seizures was obtained from neurologists, and other information was collected from self-completed questionnaires, including those measuring stigma scales. Results Overall, 65.7% of the people with epilepsy felt stigmatized by their condition and in 17.6% of these the stigma was severe. Multivariate analysis identified experiences of actual discrimination from society; more introverted personalities had a higher degree of depression and anxiety with a low self-esteem, and all dimensions of Quality of Life-36 questionnaire short form were negatively correlated with the social stigma of epilepsy. Conclusion Factors suggested to have an impact on stigma of epilepsy include seizure-related aspects such as seizure type, frequency, duration of illness, type and number of medications, and EEG changes, and individual-related aspects such as age, sex, residence, occupational status, marital status, educational level, age at seizure onset, and the affection of the quality of life. © 2017 Institute of Psychiatry, Ain Shams University.

Author Info:
Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Hofny, E.R.M.a,  Morsy, H.aEmail Author,  Hasaballa, A.b,  Twisy, H.a,  Sayed, S.K.b

Title:
Relationship between microRNA-369-3p, SIRT1, and IL-22 in Psoriasis Vulgaris

Abstract:
Background Several psoriasis-associated microRNAs have been identified. IL-22 plays a pathogenic role in psoriasis. STAT3-dependent IL-22 signaling and its effects on keratinocytes are negatively regulated by SIRT1. Objective To explore the relationship between microRNA-369-3p, SIRT1, and IL-22 in patients with psoriasis. Patients and methods Twenty-five patients with plaque psoriasis and 25 age and sex matched healthy controls were recruited from the Dermatology Department of Assuit University Hospital in Egypt. Each patient was assessed using the Psoriasis Area and Severity Index score. Serum samples and skin biopsies were obtained from each patient and healthy control to determine relative skin expression levels of microRNA-369-3p and SIRT1 using real-time PCR, and serum levels of IL-22 using enzyme-linked immunosorbent assay. Results MicroRNA-369-3p demonstrated increased expression in skin samples collected from patients with psoriasis. There were significantly higher serum levels of IL-22 in patients with psoriasis vulgaris than in controls. There was no significant correlation between microRNA-369-3p, SIRT1 expression, and IL-22 levels. Conclusion MicroRNA-369-3p may play a role in the pathogenesis of psoriasis by regulating the expression of other predicted target genes, but not that of SIRT1.

Author Info:
aDepartment of Dermatology and Venereology, Assiut University, Assiut, 71511, Egypt
bDepartments of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt


Authors:
Ismail, A.M.a,  Abbas, A.M.aEmail Author,  Bakry, A.K.a,  Abu-Elhassan, A.M.a,  Mohamed, A.O.b,  Badr, G.c,  Youssef, M.A.a

Date of Publishing:
Volume 22, Issue 1, 1 March 2017, Pages 33-38

Title:
Expression of Erk and Akt Proteins in Women with Unexplained First-‎Trimester Recurrent Miscarriage‎

Abstract:
Objective: Recurrent miscarriage (RM) is one of the most common clinical problems in reproduction. The aims of the current study were to evaluate the expression of ERK and Akt proteins in human trophoblastic tissue and to assess the significance of MAPK and PI3K-Akt signal pathways in the progression of unexplained recurrent miscarriage. Study design: A case-control study. Setting: Women Health Hospital, Assiut, Egypt. Materials and methods: All pregnant women presented with first-trimester inevitable miscarriage with a history of RM, defined as three or more spontaneous consecutive first-trimester miscarriages before 12 weeks’ gestation, were included in the study (RM group). Age-matched healthy women who had at least one normal pregnancy with no history of miscarriage were included as a control group at the time of delivery. A sample of trophoblastic tissue was taken for Western blot test to evaluate the level of phospho-ERK and Akt (active forms) proteins in trophoblastic tissue. Results: The study included 20 women in each group. There were non-significant differences between both groups as regards maternal age, BMI, passive smoking and family residence. There were significantly lower levels of p-ERK and p-Akt in the RM group as compared to the control group (p = 0.001). Conclusion: The activation of ERK and Akt pathway plays a significant role in RM. The data suggest that decreased expression of p-ERK and p-Akt occurs less frequently during RM may play a role in this process. This suggests that p-ERK and p-Akt may be markers of RM. © 2016 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
bDepartment of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
cDepartment of Zoology, Faculty of Science, Assiut University, Assiut, Egypt


Authors:
Ismail, A.M.a,  Agban, M.N.b,  Hasanein, A.S.b,  Rayan, A.A.b,  Abbas, A.M.a

Date of Publishing:
Volume 22, Issue 4, December 2017, Pages 300-304

Title:
Role of Th-1 Cell Cytokines, Leukemia Inhibitory Factor and Hoxa ‎Genes in Women with Recurrent Pregnancy Loss‎

Abstract:
Objective Immunological problems have been identified as a potential cause of recurrent pregnancy loss (RPL). The aim of this study was to investigate the effect of Th-1 cell cytokines, leukemia inhibitory factor and hoxA genes in women with RPL. Materials & methods A prospective, case-control study conducted in Assiut Women Health Hospital, Egypt included 37 women presented with a history of RPL. Samples of uterine flush and endometrial biopsy were taken during the implantation window from those confirmed as not pregnant. Cytokine (LIF and Th1 induced) levels were measured by ELISA, while hoxA10 and hoxA11 gene expression was evaluated by Taq-man Real Time PCR. Results Higher cytokine mean levels were seen in the RPL group when compared to the control group (TNF-α and LIF cytokines, p ≤ 0.001; INF-γ and IL2 cytokines, p ≤ 0.01). The opposite was true with regards to gene expression, with lower means in both sets found in the RPL group (hoxA11, p ≤ 0.000). A statistically significant positive correlation between INF-γ and TNF-α, hoxA10 and hoxA11, as well as between LIF and hoxA11 was demonstrated. Conclusion This study suggests that women with a history of RPL can have abnormal cytokine and gene expression even when not pregnant. Our findings can be a basis for providing of future successful immunological therapy for women with RPL. © 2017 Middle East Fertility Society

Author Info:
aDepartment of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
bDepartment of Microbiology and Immunology, Faculty of Medicine, Assiut University, Egypt


Authors:
Khalaf, M.,  Amin, A.F.,  Sayed, Z.,  El-Nashar, I.M.,  Abbas, A.M.

Date of Publishing:
Volume 22, Issue 4, December 2017, Pages 264-268

Title:
A Randomized Double-Blind Controlled Trial of Two Different Doses of ‎Self-Administered Vaginal Misoprostol for Successful Copper ‎Intrauterine Device Insertion‎

Abstract:
Objective The current study aims to compare the efficacy and safety of 200 mcg versus 400 mcg vaginal misoprostol administered 3 h prior to intrauterine device (IUD) insertion in parous women. Study design A randomized double-blind controlled trial. Setting Women's Health Hospital, Assiut, Egypt. Materials and methods Two-hundred twelve women were randomized into two groups; group I received 2 misoprostol 400 mcg tablets and group II received one misoprostol 200 mcg and one placebo tablet vaginally three hours before a copper IUD insertion. The primary outcome was the rate of successful IUD insertion in both groups. The secondary outcomes include the rate of adverse effects. Results There was no statistical difference between both groups as regard successful IUD insertion (p = 0.17). Additionally, the satisfaction score reported by the women was not statistically different (p = 0.11). Failure of IUD insertion was present in three cases in the misoprostol 400 mcg group versus four cases in the misoprostol 200 mcg group (p = 0.45). Both groups were similar regarding the duration of insertion (p = 0.85). Abdominal cramping and shivering were the main side effects in both groups, however the rate of their occurrence was significantly higher in the misoprostol 400 mcg group than the other group (30.2% versus 10.4% and 7.5% versus 1.9%, respectively; p = 0.0001). Conclusion Vaginal misoprostol 200 mcg prior to IUD insertion appears to be similar to 400 mcg as regard the success of IUD insertion and procedure duration with significantly lower side effects. © 2017 Middle East Fertility Society


Authors:
Khojah, H.M.aEmail Author,  Ahmed, S.b,  Abdel-Rahman, M.S.c,d,  Alkhalil, K.M.e,  Hamza, A.-B.e

Date of Publishing:
Volume 35, Issue 5, 1 September 2017, Pages 529-535

Title:
Vitamin K Homologs as Potential Biomarkers for Disease Activity in ‎Patients with Rheumatoid Arthritis‎

Abstract:
The aim of this study was to evaluate the possible role of vitamin K homologs as potential biomarkers for disease activity in patients with rheumatoid arthritis (RA). In this study, 42 patients with RA and 40 healthy controls were enrolled. Serum levels of vitamin K homologs were measured using a high-performance liquid chromatography-fluorescence method. Different biochemical and clinical markers for disease activity were measured and correlated with serum levels of vitamin K homologs. There were no significant differences between RA patients and healthy subjects in demographic data. Patients with RA showed significantly higher levels of biochemical markers compared with healthy subjects (p < 0.001). These markers included rheumatoid factor (RF), anticyclic citrullinated polypeptide (anti-CCP), undercarboxylated osteocalcin (ucOC), matrix metalloproteinase (MMP-3), C-reactive protein (CRP), and disease activity score assessing 28 joints with erythrocyte sedimentation rate (DAS28-ESR). In addition, serum levels of vitamin K homologs were reduced in RA patients, and the levels of menaquinone-4 (MK-4) and menaquinone-7 (MK-7) were moderately to strongly inversely correlated with the clinical articular features in RA patients, whereas phylloquinone (PK) levels were weakly correlated. Serum levels of MK-4, MK-7 and PK were strongly inversely correlated with ucOC, MMP-3 and DAS28-ESR in RA patients. In contrast, serum levels of MK-4, MK-7 and PK were weakly correlated with CRP, RF and anti-CCP. These results suggest that serum levels of vitamin K homologs may be considered as potential biomarkers for disease activity. In addition, the results confirm the role of vitamin K deficiency in the etiology of RA. © 2016, The Japanese Society for Bone and Mineral Research and Springer Japan.

Author Info:
aDepartment of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al Madinah AlMunawarah, Saudi Arabia
bDepartment of Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, Taibah University, Al Madinah AlMunawarah, Saudi Arabia
cDepartment of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al Madinah AlMunawarah, Saudi Arabia
dDepartment of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
eDepartment of Rheumatology, King Fahd Hospital, Al Madinah AlMunawarah, Saudi Arabia


Authors:
Kowal-Bielecka, O.aEmail Author,  Fransen, J.b,  Avouac, J.c,  Becker, M.d,e,  Kulak, A.a,  Allanore, Y.c,  Distler, O.e,  Clements, P.f,  Cutolo, M.g, Czirjak, L.h,  Damjanov, N.i,  Del Galdo, F.j,  Denton, C.P.k,  Distler, J.H.W.l,  Foeldvari, I.m,  Figelstone, K.n,  Frerix, M.o,  Furst, D.E.f,  Guiducci, S.p,  Hunzelmann, N.q,  Khanna, D.r,  Matucci-Cerinic, M.p,  Herrick, A.L.s,t,  Van Den Hoogen, F.b,  Van Laar, J.M.u,  Riemekasten, G.v,  Silver, R.w,  Smith, V.x,  Sulli, A.g,  Tarner, I.o,  Tyndall, A.y,  Welling, J.z,  Wigley, F.aa,  Valentini, G.ab,  Walker, U.A.y,  Zulian, F.ac,  Müller-Ladner, U.o,  EUSTAR Coauthors,  Daikeler, T.ae,  Lanciano, E.af,  Becvár, R.ag,  Tomcik, M.ag,  Gińdzieńska-Sieskiewicz, E.ah,  Cuomo, G.ai,  Iudici, M.ai,  Rednic, S.aj,  Vlachoyiannopoulos, P.G.ak,  Caporali, R.al,  Carreira, P.E.am,  Novak, S.an,  Minier, T.ao,  Kucharz, E.J.ap,  Gabrielli, A.aq,  Moroncini, G.aq,  Airo', P.ar,  Hesselstrand, R.as,  Martinovic, D.at,  Radic, M.at,  Marasovic-Krstulovic, D.at,  Braun-Moscovici, Y.au,  Balbir-Gurman, A.au,  Lo Monaco, A.av,  Caramaschi, P.aw,  Morovic-Vergles, J.ax,  Henes, J.ay,  Ortiz Santamaria, V.az,  Heitmann, S.ba,  Krasowska, D.bb,  Seidel, M.F.bc,  Hasler, P.bd,  Pereira Da Silva, J.A.be,  Salvador, M.J.be,  Stamenkovic, B.bf,  Stankovic, A.bf,  Tikly, M.bg,  Ananieva, L.P.bh,  Beretta, L.bi,  Szucs, G.bj,  Szamosi, S.bj,  de la Puente Bujidos, C.bk,  Midtvedt, Ø.bl,  Hoffmann-Vold, A.-M.bl,  Launay, D.bm,  Hachulla, E.bn,  Riccieri, V.bo,  Ionescu, R.bp,  Opris, D.bp,  Mihai, C.bq,  Herrgott, I.br,  Beyer, C.bs,  Ingegnoli, F.bt,  von Mühlen, C.A.bu,  Alegre-Sancho, J.J.bv,  Beltrán-Catalán, E.bv,  Aringer, M.bw,  Fantana, J.bw,  Leuchten, N.bw,  Tausche, A.-K.bw,  De Langhe, E.bx,  Vanthuyne, M.by,  Anic, B.bz,  Barešic, M.bz,  Mayer, M.bz,  Üprus, M.ca,  Otsa, K.ca,  Yavuz, S.cb,  Granel, B.cc,  Azevedo, V.F.cd,  Muller, C.cd,  Jimenez, S.A.ce,  Popa, S.cf,  Agachi, S.cf,  Zenone, T.cg,  Stebbings, S.ch,  Dockerty, J.ch,  Vacca, A.ci,  Schollum, J.cj,  Veale, D.J.ck,  Toloza, S.cl,  Xu, D.cm,  Olas, J.cn,  Rosato, E.co,  Foti, R.cp,  Adler, S.cq,  Dan, D.cq,  Wiesik-Szewczyk, E.cr,  Olesińska, M.cr,  Kayser, C.cs,  Fathi, N.ct,  de la Peña Lefebvre, P.G.cu,  Imbert, B.cv

Date of Publishing:
Volume 76, Issue 8, 1 August 2017, Pages 1327-1339

Title:
Update of Eular Recommendations for the Treatment of Systemic ‎Sclerosis‎

Abstract:
The aim was to update the 2009 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc), with attention to new therapeutic questions. Update of the previous treatment recommendations was performed according to EULAR standard operating procedures. The task force consisted of 32 SSc clinical experts from Europe and the USA, 2 patients nominated by the pan-European patient association for SSc (Federation of European Scleroderma Associations (FESCA)), a clinical epidemiologist and 2 research fellows. All centres from the EULAR Scleroderma Trials and Research group were invited to submit and select clinical questions concerning SSc treatment using a Delphi approach. Accordingly, 46 clinical questions addressing 26 different interventions were selected for systematic literature review. The new recommendations were based on the available evidence and developed in a consensus meeting with clinical experts and patients. The procedure resulted in 16 recommendations being developed (instead of 14 in 2009) that address treatment of several SSc-related organ complications: Raynaud's phenomenon (RP), digital ulcers (DUs), pulmonary arterial hypertension (PAH), skin and lung disease, scleroderma renal crisis and gastrointestinal involvement. Compared with the 2009 recommendations, the 2016 recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for the treatment of SSc-related RP and DUs, riociguat, new aspects for endothelin receptor antagonists, prostacyclin analogues and PDE-5 inhibitors for SSc-related PAH. New recommendations regarding the use of fluoxetine for SSc-related RP and haematopoietic stem cell transplantation for selected patients with rapidly progressive SSc were also added. In addition, several comments regarding other treatments addressed in clinical questions and suggestions for the SSc research agenda were formulated. These updated data-derived and consensus-derived recommendations will help rheumatologists to manage patients with SSc in an evidence-based way. These recommendations also give directions for future clinical research in SSc. © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Author Info:
aDepartment of Rheumatology and Internal Medicine, Medical University of Bialystok, Ul. M. Sklodowskiej-Curie 24A, Bialystok, 15-276, Poland
bRadboud University Medical Center, Nijmegen, Netherlands
cRheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France
dUniversity Hospital Charité, Berlin, Germany
eUniversity Hospital Zurich, Zurich, Switzerland
fUniversity of California at Los Angeles, Los Angeles, CA, United States
gResearch Laboratories and Clinical Division of Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino, Genova, Italy
hDepartment of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary
iUniversity of Belgrade, Belgrade, Serbia
jUniversity of Leeds, Leeds, United Kingdom
kUniversity College London, London, United Kingdom
lUniversity of Erlangen-Nuremberg, Erlangen, Germany
mHamburg Centre for Pediatric and Adolescence Rheumatology, Hamburg, Germany
nFESCA, London, United Kingdom
oUniversity of Giessen, Bad Nauheim, Germany
pUniversity of Florence, Florence, Italy
qUniversity of Cologne, Cologne, Germany
rUniversity of Michigan, School of Medicine, Ann Arbor, MI, United States
sUniversity of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
tNIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester, United Kingdom
uDepartment of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
vUniversity of Lübeck, Lübeck, Germany
wMedical University of South Carolina, Charleston, SC, United States
xGhent University Hospital, Ghent University, Ghent, Belgium
yBasel University, Basel, Switzerland
zFESCA Patient Research Partner, Netherlands
aaJohns Hopkins University, Baltimore, MD, United States
abSecond University of Naples, Naples, Italy
acUniversity of Padua, Padua, Italy
aeRheumatology, University Hospital Basel, Switzerland
afRheumatology Unit-DiMIMP School of Medicine University of Bari, Bari, Italy
agInstitute of Rheumatology, 1st Medical School, Charles University, Praha, Czech Republic
ahDepartment of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
aiDipartimento Medicina Clinica e Sperimentale 'F-Magrassi' II Policlinico U.O. Reumatologia, Napoli, Italy
ajClinica Reumatologie, University of Medicine & Pharmacy 'Iuliu Hatieganu' Cluj, Cluj-Napoca, Romania
akDepartment of Pathopysiology Medical School, National University of Athens, Athens, Greece
alUnita' Operativa e Cattedra di Reumatologia, IRCCS Policlinico S Matteo, Pavia, Italy
amServicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain
anDepartment of Rheumatology and Clinical Immunology, Internal Medicine, KBC Rijeka, Rijeka, Croatia
aoDepartment of Rheumatology and Immunology, Medical Center, University of Pécs, Pécs, Hungary
apDepartment of Internal Medicine and Rheumatology, Medical University of Silesia, Katowice, Poland
aqDipartimento di Scienze Cliniche e Molecolari, Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
arU.O. Reumatologia ed Immunologia Clinica, Spedali Civili, Brescia, Italy
asDepartment of Rheumatology, Lund University Hospital, Lund, Sweden
atDepartment of Internal Medicine, Clinical Hospital of Split, Split, Croatia
auB Shine Department of Rheumatology, Rambam Health Care Campus, Haifa, Israel
avDepartment of Clinical and Experimental Medicine, Rheumatology Unit, University of Ferrara, Ferrara, Italy
awRheumatology Unit, AOUI, Verona, Italy
axMelanie I. Culo, Division of Clinical Immunology and Rheumatology Department of Internal Medicine, School of Medicine University of Zagreb, Dubrava University Hospital, Zagreb, Croatia
ayMedizinische Universitätsklinik, Abt. II (Onkologie, Hämatologie, Rheumatologie, Immunologie, Pulmonologie), Tübingen, Germany
azRheumatology Granollers General Hospital, Barcelona, Spain
baDepartment of Rheumatology, Marienhospital Stuttgart, Germany
bbMalgorzata Michalska-Jakubus, Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
bcMedizinische Klinik III, Oncology, Hematology and Rheumatology, Bonn, Germany
bdKlinik für Rheumatologie, Kantonsspital Aarau, Aarau, Switzerland
beRheumatology Department, Hospitais da Universidade Coimbra, Coimbra, Portugal
bfInstitute for treatment and rehabilitation Niska Banja, Medical School, University of Nis, Serbia
bgRheumatology Unit, Department of Medicine Chris Hani Baragwanath, Hospital and University of the Witwatersrand, Johannesburg, South Africa
bhVA Nasonova Institute of Rheumatology, Moscow, Russian Federation
biScleroderma Unit, Referral Center for Systemic Autoimmune Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
bjDivision of Rheumatology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
bkServicio de Reumatología, Hospital Ramon Y Cajal, Madrid, Spain
blDepartment of Rheumatology, Rikshospitalet University Hospital, Oslo, Norway
bmUniversity Lille, Inserm, CHU Lille, U995, Centre national de référence maladies systémiques et auto-immunes rares (sclérodermie systémique), Lille, France
bnDepartment of Internal Medicine, Hôpital Claude Huriez, Lille, France
boDipartimento di Medicina Interna e Specialita' Mediche, Universita' Sapienza, Roma, Italy
bpDepartment of Rheumatology-St. Maria Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
bqDepartment of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
brDepartment of Dermatology University of Münster, Münster, Germany
bsDepartment of Internal Medicine 3, University Hospital Erlangen, Erlangen, Germany
btDivision of Rheumatology, Istituto Gaetano Pini, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
buRheuma Clinic, Porto Alegre, Brazil
bvHospital Universitario Dr Peset, Valencia, Spain
bwDivision of Rheumatology, Department of Medicine III, University Medical Center Carl Gustav Carus TU Dresden, Dresden, Germany
bxSkeletal Biology and Engineering Research Center, Department of Development and Regeneration KU Leuven; Rheumatology, University Hospitals Leuven, Belgium
byCliniques Universitaires Saint-Luc, Rheumatology Department, Université Catholique de Louvain, Brussels, Belgium
bzUniversity Hospital Centre Zagreb Division of Clinical Immunology and Rheumatology Department of Medicine, Zagreb, Croatia
caEast-Tallin Central Hospital, Department of Rheumatology, Tallin, Estonia
cbUniversity of Marmara, Department of Rheumatology, Istanbul Bilim University, Altunizade-Istanbul, Turkey
ccService de Médecine Interne, Hôpital Nord de Marseille, Marseille, France
cdHospital de Clínicas da Universidade Federal do Paraná, Curitiba—Paraná, Brazil
ceScleroderma Center, Thomas Jefferson University, Philadelphia, United States
cfDepartment of Rheumatology, State University of Medicine and Pharmacy 'Nicolae Testemitanu', Chisinau, Moldova
cgDepartment of Medicine, Unit of Internal Medicine, Valence, France
chDunedin School of Medicine, University of Otago, Dunedin, New Zealand
ciII Chair of Rheumatology, University of Cagliari-Policlinico Universitario, Monserrato, Italy
cjWaikato University Hospital Rheumatology Unit, Hamilton, New Zealand
ckDepartment of Rheumatology, St. Vincent's University Hospital and University College Dublin, Ireland
clHospital San Juan Batista, Catamarca, Argentina
cmDepartment of Rheumatology, Peking Union Medical College Hospital (West Campus), Chinese Academy of Medical Sciences, Beijing, China
cnMalopolskie Centrum Reumatologii, Immunologii i Rehabilitacji, Cracow, Poland
coCentro per la Sclerosi Sistemica-Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy
cpU.O. di Reumatologia, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy
cqDepartment of Rheumatology and Clinical Immunology/Allergology Inselspital, University of Bern, Bern, Switzerland
crDepartment of Connective Tissue Disease, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
csUniversidade Federal de São Paulo-Disciplina de Reumatologia, São Paulo, Brazil
ctAssiut and Sohage University Hospital, Rheumatology Department Assiut University Hospital, Assiut, Egypt
cuHospital Universitario Madrid Norte Sanchinarro, Madrid, Spain
cvVascular Medicine Unit-Department of Medicine, Centre Hospitalier Universitaire de Grenoble, Grenoble, France


Authors:
Mehta KS1, Lee JJ1, Taha AG2, Avgerinos E3, Chaer RA4.

Title:
Vascular Applications of Contrast-Enhanced Ultrasound Imaging‎

Abstract:
OBJECTIVE:
Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications.

METHODS:
The PubMed, MEDLINE, and Embase databases were searched until July 2016 using the PubMed and Ovid Web-based search engines. The search terms used included contrast-enhanced, microbubble, ultrasound, carotid, aneurysm, and arterial.

RESULTS:
The diagnostic and therapeutic utility of CEUS imaging has grown exponentially, particularly in the realms of extracranial carotid arterial disease, aortic disease, and peripheral arterial disease. Studies have demonstrated that CEUS imaging is diagnostically superior to conventional ultrasound imaging in identifying vessel irregularities and measuring neovascularization to assess plaque vulnerability and end-muscle perfusion. Groups have begun to use microbubbles as agents in therapeutic applications for targeted drug and gene therapy delivery as well as for the enhancement of sonothrombolysis.

CONCLUSIONS:
The emerging technology of microbubbles and CEUS imaging holds considerable promise for cardiovascular medicine and cancer therapy given its diagnostic and therapeutic utility. Overall, with proper training and credentialing of technicians, the clinical implications are innumerable as microbubble technology is rapidly bursting onto the scene of cardiovascular medicine.

Author Info:
1
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa; University of Pittsburgh School of Medicine, Pittsburgh, Pa.
2
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa; Department of Vascular Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt.
3
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
4
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa. Electronic address: chaerra@upmc.edu.


Authors:
Mmari, K.aEmail Author,  Moreau, C.a,  Gibbs, S.E.a,  De Meyer, S.b,  Michielsen, K.b,  Kabiru, C.W.c,  Bello, B.d,  Fatusi, A.d,  Lou, C.e,  Zuo, X.e,  Yu, C.e,  Al-Attar, G.S.T.f,  El-Gibaly, O.f

Date of Publishing:
Volume 20, Issue 7, 3 July 2018, Pages 787-798

Title:
Yeah, I’ve Grown; I Can’t Go out Anymore’: Differences in Perceived ‎Risks between Girls and Boys Entering Adolescence‎

Abstract:
This analysis is based on data from the Global Early Adolescent Study, which aims to understand the factors that predispose young people aged 10–14 years to positive or negative health trajectories. Specifically, interview transcripts from 202 adolescents and 191 parents across six diverse urban sites (Baltimore, Ghent, Nairobi, Ile Ife, Assuit and Shanghai) were analysed to compare the perceived risks associated with entering adolescence and how these risks differed by gender. Findings reveal that in all sites except Ghent, both young people and their parents perceived that girls face greater risks related to their sexual and reproductive health, and because of their sexual development, were perceived to require more protection. In contrast, when boys grow up, they and their parents recognised that their independence broadened, and parents felt that boys were strong enough to protect themselves. This has negative consequences as well, as boys were perceived to be more prone to risks associated with street violence and peer pressure. These differences in perceptions of vulnerability and related mobility are markers of a gender system that separates young women and men’s roles, responsibilities and behaviours in ways that widen gender power imbalance with lifelong social and health consequences for people of both sexes. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.

Author Info:
aPopulation, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
bInternational Centre for Reproductive Health (ICRH), Faculty of Medicine and Health Sciences, Ghent, Belgium
cAfrican Population and Health Research Center, APHRC Campus, Nairobi, Kenya
dPopulation and Reproductive Health Programme, College of Health Sciences, Obafemi Awolowo University, Osun State, Nigeria
eKey Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China
fPublic Health and Community Medicine Department, Assiut University, Assiut, Egypt


Authors:
Mohamed, E.S.aEmail Author,  Said, E.A.a

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

Date of Publishing:
Volume 18, Issue 2, July 2017, Pages 115-120

Title:
Effect of Glycerol Test on Audiovestibular Tests in Patients with ‎Meniere's Disease‎

Abstract:
This stud to explore the effect of glycerol on audiovestibular tests in patients with Meniere's disease (MD) and to reflect different pathologic states of endolymphatic hydrops (EH) in the inner ear and compare the results of glycerol on these results. Subjects Thirty patients and 15 normal volunteers. Methods Each subject of this study underwent pure tone audiometry testing, evoked vestibular evoked myogenic potential (VEMP) and Vidionystagmography (VNG) before G1 and 2 h after glycerol G2 administration (1.3 g/kg). Results Affected ears were 32 and unaffected ears were 28. The affected ears had higher hearing and SRT thresholds when compared to the unaffected ears and control group. VEMPs of the affected ears were normal in six ears (18.75%), absent in four ears (12.5%) and augmented amplitude in 22 (68.75%), their VNG results showed peripheral vestibular disorder. After oral administration of glycerol, the previous test battery was repeated and it's result on PTA showed that 53.13% (17/32) of affected ears had positive glycerol test mainly in stage II and III. Ten of the 32 affected ears (31.26%) showed improvement of VEMPs after glycerol administration. Also, two (7.8%) of the unaffected ears showed positive glycerol. Latency of the VEMP had no significant changes after glycerol administration and there was no statistical correlation between the results of G-PTA and G-VEMP. There was statistical significant improvement of the slow peak velocity of caloric test in patient's affected ears and insignificant improvement in control group and in unaffected ears after glycerol administration. © 2017

Author Info:
aDepartment of Otolaryngology, Faculty of Medicine, Assiut University, Egypt
bFaculty of Medicine, Assiut University Audiology Unit, Department of Otolaryngology, Assiut College of Medicine, Assiut, Egypt


Authors:
Mourad, A.F.a,  Mohammad, H.E.-D.G.b,  Sayed, M.M.cEmail Author,  Ragae, M.A.d

Date of Publishing:
Volume 48, Issue 3, September 2017, Pages 661-669

Title:
What's the Clinical Significance of Adding Diffusion and Perfusion MRI ‎in the Differentiation of Glioblastoma Multiforme and Solitary Brain ‎Metastasis?‎

Abstract:
Objective To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis. Patients and methods This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions. Results After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%. There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P < 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P < 0.001). Conclusion The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely. © 2017 The Egyptian Society of Radiology and Nuclear Medicine

Author Info:
aDiagnostic Radiology Department, South Egypt Cancer Institute, Egypt
bRadiology Department, Assiut University, Egypt
cRadiation Oncology Department, South Egypt Cancer Institute, Egypt
dNeurosurgery Department, Assiut University, Egypt


Authors:
Okasha, H.H.aEmail Author,  Elkholy, S.a,  Sayed, M.a,  Mahdy, R.E.b,  Elsherif, Y.c,  El-Gemeie, E.d,  El-Magd, A.A.e

Date of Publishing:
Volume 28, Issue 5, September 2017, Pages 370-376

Title:
Endoscopic Ultrasound and Endoscopic Ultrasound-Guided Fine ‎Needle Aspiration in the Diagnosis of Diffuse Gastrointestinal Lesions ‎with Inconclusive Endoscopic Biopsies‎

Abstract:
Background/Aims: Many gastrointestinal tumors appearing as diffuse circumferential malignancies, for example, diffuse signet ring adenocarcinoma and lymphoma, might primarily involve the submucosal layer and hence are difficult to diagnose because they frequently yield negative endoscopic biopsies. This main aim of this study was to evaluate the accuracy of endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of diffuse gastrointestinal lesions with inconclusive endoscopic biopsies. Materials and Methods: This prospective study included 92 patients with diffuse or circumferential gastrointestinal lesions with non-conclusive biopsies that were taken during upper or lower endoscopy. EUS and EUS-FNA were performed on all patients with cytopathological examination. Results: This study included 58 males (63%) and 34 females (37%) with a mean age of 54.2 years. Seventy-two cases (78.3%) were shown to have malignant lesions, and 20 cases (21.7%) were shown to be benign. EUS had a sensitivity of 94.4%, a specificity of 65%, a positive predictive value (PPV) of 90.7%, and a negative predictive value (NPV) of 45.1% with a p<0.0001 in diagnosing malignant lesions. EUS-FNA had a sensitivity of 83%, specificity of 100%, PPV of 100%, and NPV of 61.9% with a p<0.0001. Conclusion: Endoscopic ultrasound with EUS-FNA is an accurate procedure in the diagnosis of endoscopic biopsy-negative diffuse or circumferential gastrointestinal lesions. © Copyright 2017 by The Turkish Society of Gastroenterology.

Author Info:
aDepartment of Internal Medicine, Cairo University, Faculty of Medicine, Cairo, Egypt
bDepartment of Internal Medicine, Assiut University, Faculty of Medicine, Assiut, Egypt
cDepartment of Tropical Medicine, Cairo University, Faculty of Medicine, Cairo, Egypt
dDepartment of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
eMilitary Medical Academy, Cairo, Egypt


Authors:
Omran, E.A.H.a,  El-Hakeim, E.H.a,  Galal, M.A.A.aEmail Author,  Nasr, N.M.M.b,  Mosaad, E.c

Title:
B-Cell-Attracting Chemokine Cxcl13 as a Marker of Disease Activity in ‎Systemic Lupus Erythematosus (Sle)‎

Abstract:
Background A correlation was detected between the chemokine CXC ligand 13 (CXCL13) and lupus nephritis, but there is no data recorded in the literature about a relationship with other disease manifestations in systemic lupus erythematosus (SLE). Therefore, we sought to investigate the relationship between CXCL13 and overall disease activity and other disease manifestations in SLE. Patients and Methods Fifty-seven SLE patients (51 female, 6 male) aged 18–60 years, fulfilling≥4 SLICC classification criteria for the classification of SLE, were enrolled in a cross-sectional study. Disease activity was scored using the SLE Disease Activity Index (SLEDAI) scoring system. The serological workup included routine lab investigations (full blood count, liver and kidney function tests, and urinalysis) as well as ESR, CRP, anti-ds DNA, C3, C4, 24-h urine protein, and creatinine clearance. Plasma CXCL13 levels were detected by ELISA. Results CXCL13 levels were elevated in active SLE patients. A significant positive correlation was found between the total score of SLEDAI and CXCL13 levels (r=0.547, p-value <0.0001). A statistically significant difference was found regarding the mean CXCL13 levels between the patient groups (classified according to SLEDAI score) (inactive <3, mild/moderate ≥3–12, severe ˃12) (p-value<0.001). The anti-ds DNA antibody titre showed a significant positive correlation with CXCL13 levels (r=0.335, p-value<0.05). The complement levels (C3, C4) showed a significant negative correlation with CXCL13 levels (p-value<0.001). Also there was a significant positive correlation between 24-h urine protein and urinary casts and CXCL13 levels (p-value<0.05). Conclusion Our study revealed elevated levels of serum CXCL13 in active SLE patients. We demonstrated a highly significant positive correlation between serum CXCL13 levels in active SLE patients and SLE disease activity, which supports the role of CXCL13 in the pathogenesis of SLE disease and its activity. Among the variants used in calculating the SLEDAI score, we detected significant relations between level of serum CXCL13 and each of total and extra-renal SLEDAI score. Copyright ©, Georg Thieme Verlag KG. All rights reserved.

Author Info:
aRheumatology, Rehabilitation, and Physical Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
bRheumatology, Om El Qusour Hospital, Rehabilitation, Assiut, Egypt
cSouth Egypt Cancer Institute, Clinical Pathology, Assiut, Egypt


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

Date of Publishing:
Volume 18, Issue 3, November 2017, Pages 271-279

Title:
Health-Related Quality of Life in Elderly Hearing Aid Users Vs. Non-‎Users‎

Abstract:
Background and aim Presbycusis, is usually a harbinger of aging. The negative consequences are not limited to an auditory impairment but influences a range of psychosocial and physical health concerns. The cornerstone of audiologic intervention is the use hearing aids. Optimal management should include an evaluation of quality of life (QoL) status and its assessment. Aim of this work: To quantify the quality of life of hearing impaired elderly individuals (HIEI) and to assess hearing aids impact on QoL. Subjects Elderly patients (1 2 7) above 60 years had sensorineural hearing loss ranged from mild to severe degree of hearing loss, only 24 of them (21.1%) were fitted with monaural hearing aid. Methods Each subject of this study underwent basic audiologic evaluation, speech perception in noise, aided tonal sound field threshold and aided speech tests. Generic WHOQOL-BREF and hearing handicap inventory for the elderly (HHIE). Results There were significant lower aided tonal sound field thresholds (ATSFTs) at 0.5, 1, 2 and 4 kHz of hearing aid users when compared with values of non-users at all tested frequencies. Hearing aid users perform better in all domains of WHO QOL-BREF with significant reductions in emotional, social and total scores of HHIE in users group compared with non-users indicated improvement in their QOL. There were no significant differences between scores of males and scores of females. The severity of the hearing loss had statistically significant effects on these scores for non-users but not in users group. © 2017

Author Info:
Audiology Unit, Department of Otolaryngology, Faculty of Medicine – Assiut University, Egypt


Date of Publishing:
Volume 18, Issue 3, November 2017, Pages 207-216

Title:
Factors Impacting Hearing Aid Performance Outcomes for Egyptian ‎Hearing Impaired Children‎

Abstract:
Despite recent technological advances in the audiologic assessment of children, their hearing aid fitting remains a daunting task. Aims of study To assess effectiveness of amplification in children using aided sound field tests and Auditory Behavior in Everyday Life (ABEL) questionnaire and to elucidate factors contributing to poor outcomes. Methods Detailed medical history, otoscopic examination, basic audiological evaluation, aided sound field tests and ABEL questionnaire for 114 hearing impaired children aged 4–16 years. Results Congenital HL considered the commonest cause of HL (55.3%), 36% had unknown cause and 8.8% of HI had acquired cause. Profound loss in 67.5%, severe in 17% and 54.4% of them (54.4%) were fitted around the age of 3 years. Binaural HA in 88.6% and digital type for 61.4%. There were statistically significant differences between unaided and aided values in sound field tests for HI children. Poor performance in direct measures and ABEl in children with congenital and profound degree of hearing loss, better response when they were fitted earlier with digital aids. ABEL scores showed negative correlations with aided tonal sound field test and positive with aided speech discrimination score. Conclusions Inappropriate amplification, late age of fitting with no speech therapy were clinical red flags for poor outcomes. ABEL questionnaire was a valid procedure to assess the hearing aids appropriateness. © 2017

Author Info:
Department of Otolaryngology, Faculty of Medicine, Assiut University, Egypt


Authors:
Saleem, T.H.a,  Hassan, M.H.bEmail Author,  Ahmed, A.E.-A.c,  Sayed, A.A.a,  Mohamed, N.A.a,  Elsayh, K.I.d,  El-Ebidi, A.M.A.A.e,  Mohammed, N.B.B.b

Journal:
Egyptian Journal of Medical Human Genetics

Date of Publishing:
Volume 18, Issue 3, July 2017, Pages 249-255

Title:
Clinical and Genetic Assessment of Pediatric Patients with Gaucher's ‎Disease in Upper Egypt‎

Abstract:
Background Gaucher's disease (GD) is an autosomal recessive genetic disorder that results from pathogenic mutations of GBA gene encoding the enzyme glucocerebrosidase (acid β-glucosidase). Of the approximately 300 mutations associated with GD, 4 accounts for the majority of mutations seen in GD patients: N370S, L444P, 84 GG and IVS2+1. Aim Establishing and providing, clinical and molecular backgrounds of pediatric patients with GD in Upper Egypt. Subjects and methods The present study is a cross sectional study, carried out on 26 pediatric patients with GD. They were recruited from the pediatric outpatient clinics and inpatients Pediatric departments of Assiut and Qena University hospitals, Upper Egypt. Clinical evaluation and mutation analysis using commercially available strip assay kit after PCR amplification of the target gene were done for all included GD patients. Results Consanguinity between patients’ parents was present in 73.1% of the included patients. 76.9% of included patients were of type 1 GD, while 23.1% were of type 3 GD and none of our patients was classified as type 2 GD. The main frequent clinical presentations of GD in this study were hepatosplenomegaly (88.5%); pallor (76.9%); abdominal distension (61.5%) and musculoskeletal involvement (37.1%). Neurological abnormalities of type 3 GD included in this study were squint, seizures and delayed mental development. Five different genotypes were detected, homozygous for the mutation L444P, homozygous for the mutation N370S, heterozygous for the mutations N370S and rec Ncil, heterozygous for IVS2 +1 and rec NciI, heterozygous for L444P and IVS2 +1. Conclusions Non-neuropathic type 1 and type 3 GD were the only clinical types found in the present study. The most common mutant alleles found in this study were L444P and N370S. © 2016 Ain Shams University

Author Info:
aDepartment of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, P.O. Box 71515, Assiut, Egypt
bDepartment of Medical Biochemistry and Molecular Biology, Qena Faculty of Medicine, South Valley University, P.O. Box No. 83523, Qena, Egypt
cDepartment of Pediatrics, Qena Faculty of Medicine, South Valley University, P.O. Box No. 83523, Qena, Egypt
dDepartment of Pediatrics, Faculty of Medicine, Assiut University, P.O. Box 71515, Assiut, Egypt
eDepartment of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Aswan University, P.O. Box No. 8152, Aswan, Egypt


Authors:
Saleh, M.G.A.a,b,  Campbell, J.P.a,  Yang, P.a,  Lin, P.a

Journal:
Ophthalmic Surgery Lasers and Imaging Retina

Date of Publishing:
Volume 48, Issue 3, March 2017, Pages 208-215

Title:
Ultra-Wide-Field Fundus Autofluorescence and Spectral-Domain ‎Optical Coherence Tomography Findings in Syphilitic Outer ‎Retinitis‎

Abstract:
BACKGROUND AND OBJECTIVE: To determine the ultra-wide-field fundus autofluorescence (UWF-FAF) and optical coherence tomography (OCT) features of syphilitic outer retinopathy (SOR). PATIENTS AND METHODS: Retrospective chart review. RESULTS: Three patients with SOR were investigated. Treatment with parenteral penicillin led to improvement of outer retinopathy, visual acuity, and symptoms. UWFFAF showed speckled hyperautofluorescence, hypoautofluorescence, and normal autofluorescence, similar to what has been described as a trizonal pattern in acute zonal occult outer retinopathy (AZOOR) in the chronic case of SOR, but with hyperautofluorescent areas in the two acute cases. OCT showed disruption of the photoreceptor outer segment ellipsoid zone and external limiting membrane, which improved after penicillin treatment, and corresponded to normalization of the hyperautofluorescent areas on UWF-FAF. There was irregularity and nodular thickening of retinal pigment epithelium on OCT in areas of mottled hyperautofluorescence. CONCLUSION: SOR can present similarly to AZOOR on UWFFAF and should be highly suspected in cases presenting like AZOOR.

Author Info:
aCasey Eye Institute, Oregon Health and Science University, Department of Ophthalmology, 3375 SW Terwilliger Blvd., Portland, OR 97239, United States
bAssiut University, Assiut, Egypt


Authors:
Savant, C.B.aEmail Author,  Kulkarni, A.R.a,  Abdel-Wahab, B.A.b,c,  Al-Qahtani, A.M.c,  Mannasaheb, B.A.d,  Shaikh, I.A.e

Journal:
Journal of Applied Pharmaceutical Science

Date of Publishing:
Volume 7, Issue 4, 1 April 2017, Pages 138-141

Title:
Phytochemical Characterization and Antibacterial Potentials of ‎Mangifera Indica L. Bark Oil‎

Abstract:
There has been a ruthless increase in antimicrobial resistance in most of the pathogenic microorganisms all over the world due to irrational use of antimicrobial agents. Although number of novel antimicrobial drugs are being brought to the market has shown steady decline in the past decades. This gives widespread opportunities to researchers for the discovery of new antimicrobial agent. Objective of the study was to evaluate antimicrobial activity of petroleum ether extract of Mangifera indica Linn. bark by disk diffusion and broth microdilution method to determine inhibition zone diameters and minimum inhibitory concentration (MIC). The organisms exhibited different degree of susceptibility to the inhibitory activity of the crude extract. Amongst the selected pathogenic bacteria P. Aeruginosa has shown maximum zone of inhibition of 20 mm at 75 μl of extract. Whereas E. coli, S. aureus, and B. subtilis has MIC of 0.2 μg/ml. Extract consists of various volatile oil, fatty acids, which has significant lipophilicity this may contribute to the inhibition microbial growth. © 2017 Chetan B. Savant et al.

Author Info:
aDepartment of Pharmacology, Soniya College of Pharmacy, Karnataka, Dharwad, 580002, India
bDepartment of Pharmacology, College of Medicine, Assiut University, Assiut, Egypt
cDepartment of Family Medicine, Faculty of Medicine, Najran University, Najran, Saudi Arabia
dDepartment of Pharmacology, Al-Maarefa Colleges for Science and Technology, Riyadh, Saudi Arabia
eDepartment of Pharmacology, College of Pharmacy, Najran University, Najran, Saudi Arabia


Title:
Effect of Prenatal Exposure to Nicotine/Thiocyanate on the Pituitary-‎Adrenal Axis of 1-Month-Old Rat Offspring‎

Abstract:
Background The adverse effects of prenatal cigarette smoke exposure on humans are a major scientific and public health concern. Maternal cigarette smoking may affect the intrauterine hormonal environment, and this early fetal exposure may have unfavorable effects on the future offspring. Nicotine from cigarette smoke has been linked to several deleterious side effects in the offspring of smoking mothers, including impaired development of the sympathoadrenal system. It seems that thiocyanate, which is present in cigarettes, crosses the placenta. Aim This study aimed to evaluate the toxic effects of nicotine versus thiocyanate in both the pituitary and adrenal glands of developing rats. Materials and methods A total of 15 pregnant female albino rats were divided into three groups (five rats each): Group I, group II, and group III. Group I was the control group; group II was the nicotine-treated group, in which the rats were treated with nicotine at 6 mg/kg/day subcutaneously from gestation day (4-20); and group III was the thiocyanate-treated group, in which the rats were treated with potassium thiocyanate orally at 25 mg/ kg/day from gestation day (4-20). The offspring of each group were sacrificed after 1 month. Specimens from the adrenal and pituitary glands were taken for light and electron microscopic examination. Results In comparison with the thiocyanate-treated group, in the nicotine-treated group the cells of the three cortical zones of the adrenal gland, in particular the zona fasciculata, revealed increased cytoplasmic vacuolation, more lipid droplets, and mitochondrial degeneration. The nuclei showed abnormalities in the form of shrinkage and pyknosis. The mean arbitrary area of both the nicotine-treated group and the thiocyanate- treated group was significantly reduced when compared with that of control. The pituitary corticotrophs showed a reduction in the number of cytoplasmic secretory granules, particularly in the nicotine-treated group. Conclusion The present study demonstrated that among substances found in cigarettes, prenatal nicotine administration could be responsible for degenerative changes in the pituitary and adrenal glands more than thiocyanate. © 2017 The Egyptian Journal of Histology.


Authors:
Sioulas, A.D.a,  El-Masry, M.A.b,  Groth, S.a,  Schachschal, G.a,  Anders, M.a,  Rösch, T.a,  Denzer, U.a

Journal:
Hepatobiliary and Pancreatic Diseases International

Date of Publishing:
Volume 16, Issue 1, 15 February 2017, Pages 96-103

Title:
Prospective Evaluation of the Short Access Cholangioscopy for Stone ‎Clearance and Evaluation of Indeterminate Strictures

Abstract:
Background Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. Methods Consecutive patients were included as follows: difficult stones (group 1) underwent cholangioscopy with electrohydraulic lithotripsy and indeterminate biliary strictures (group 2) were evaluated with macroscopic assessment and cholangioscopy guided biopsy sampling. We evaluated the complete stone clearance rate (group 1) and diagnostic accuracy (group 2). Follow-up was performed over a median of 13 and 16 months, respectively. Results Group 1 (n=21): complete stone clearance defined as lack of stones in cholangiography and stone removal during cholangioscopy was achieved in 15 (71.4%) patients. Clinical stone clearance defined as lack of symptoms, laboratory abnormalities and hospital visits during follow-up, irrespective of stone clearance was evident in 17 (81.0%) patients. One serious adverse event occurred (bile duct perforation). Group 2 (n=28): malignancy was confirmed in 15 patients. Sensitivity, specificity and diagnostic accuracy of cholangioscopy were 85.7%, 75.0% and 80.7%, respectively. Sensitivity, specificity and diagnostic accuracy of biopsies were 54.5%, 100.0% and 72.2%, respectively. No serious adverse events occurred, and one patient was lost to follow-up. Conclusions The novel system enabled complex stone treatment and biliary stricture diagnosis. Cholangioscopy outperformed direct biopsy regarding characterization of indeterminate strictures. © 2017 The Editorial Board of Hepatobiliary & Pancreatic Diseases International

Author Info:
aDepartment of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
bDivision of Gastroenterology, Department of Internal Medicine, Assiut University Hospital, Al Walideyah Al Qebleyah, Qesm Than Asyut, Assiut Governorate, Egypt


