Benha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Assessment the Association of Fatty Acid Binding Protein 1 with Hepatocellular Carcinoma.11312460310.21608/bmfj.2020.124603ENReda AlbadawyDepartment of Hepatology, Gastroentrology and Infectious Diseases, Benha faculty of medicine, Benha University, EgyptBadawy Abd El-AzizDepartment of Hepatology, Gastroentrology and Infectious Diseases, Benha faculty of medicine, Benha University, EgyptMaha AzzamDepartment of Hepatology, Gastroentrology and Infectious Diseases, Benha faculty of medicine, Benha University, EgyptEman BehiryDepartment Clinical and Chemical Pathology, Benha Faculty Of Medicine ,Benha University, EgyptJournal Article20201120<strong>Background & Objectives</strong>: Hepatocellular carcinoma and its complications with the multiplicity is crucial worldwide health problem especially in the presence of heterogeneous liver. We aimed to assess the value of fatty acid binding protein-1in the diagnosis of hepatocellular carcinoma in comparison to alpha-fetoprotein. <strong>Methodology: </strong>One hundred subjects were enrolled in this observational case-control study who attended the Hepatology, Gastroenterology and Infectious Diseases Department in Benha University Hospitals between January 2018 and January 2019 and divided into 80 patients (40 HCC &40 LC and 20 healthy subjects). Serum level of fatty acid binding protein-1 was determined by enzyme-linked immunosorbent assay. <strong>Results: </strong>Hepatocellular carcinoma patients were slightly older than healthy subjects as mean age in group І was (56.1±9 yrs) while in group III was (52.9±17.1 yrs). There was a marked increase in hepatocellular carcinoma in males with male to female ratio 4:1. There was a high prevalence of hepatocellular carcinoma in the rural population. Fatty acid binding protein-1 was higher in hepatocellular carcinoma compared to liver cirrhosis and the control group, ranged from (107-1224 ng/L, 48-981 ng/L and 34-460 ng/L) respectively. Analysis of ROC curve revealed that at a level 214 ng/L sensitivity, specificity, PPV, NPV and accuracy were 60%, 77.5%, 72.7%, 66% respectively with AUC 0.715 <strong>Conclusion</strong>: The use of fatty acid binding protein-1especially in multicentric hepatocellular carcinoma will be valuable because the difficulty in most cases to prove the multiplicity of hepatocellular carcinoma.<br /> <strong> </strong>https://bmfj.journals.ekb.eg/article_124603_abe203e398f1ff877c1dce1be2b717bc.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Uterine Artery Doppler and Placental Morphological Features as Predictors of Peripartum Complications in Placenta Previa and Placenta Previa Accreta142613862110.21608/bmfj.2021.138621ENShimaa EliwaDepartment of Obstetrics and Gynecology , Benha faculty of medicine, Banha University, EgyptMahmoud Abdel FatahDepartment of Obstetrics and Gynecology , Benha faculty of medicine, Banha University, EgyptMohamed El NouryDepartment of Obstetrics and Gynecology , Benha faculty of medicine, Banha University, EgyptMostafa El SayedDepartment of Obstetrics and Gynecology , Benha faculty of medicine, Banha University, EgyptJournal Article20210112<strong>Background:</strong> Placenta accreta is becoming an increasingly common complication of pregnancy. Placenta accreta originates from abnormal trophoblast invasion. <strong> Objective: </strong>to assess if uterine artery Doppler and Placental Morphological Features could be predictors of maternal and fetal outcome in pregnancies complicated with placenta previa and placenta previa accreta.<strong> Subjects and methods:</strong> This study included 80 pregnant women of which they were divided into 3 groups. The first group included 40 pregnant women of normal pregnancies, 2<sup>nd</sup> one included 20 pregnant women with placenta previa and the 3<sup>rd</sup> one included 20 pregnant women with suspected placenta previa accreta by ultrasound. Abdominal ultrasound and uterine artery Doppler were done in a week before delivery. <strong> Results:</strong> There was a direct relationship between presence of lacunae especially high grade, placental vascularity (abnormal) and the mean values of uterine artery PI, RI and presence of peripartum maternal and fetal complications. <strong> Conclusion: </strong>the gray scale and color Doppler ultrasound have a high diagnostic value in the diagnosis by certain placental morphological features, Including loss of retro-placetal clear zone, thinning of myometrial thickness, Intraplacental lacunae, Intraplacental vascularity and exophytic mass into bladder space. Ultrasound is helpful and non-invasive tool in prediction of maternal and fetal outcome. High grade of placental lacunae and abnormal placental vascularity were highly associated with maternal and fetal complications. Uterine artery Doppler PI and RI is also useful in prediction of maternal complications and fetal complications of placenta previa and placenta previa accreta.https://bmfj.journals.ekb.eg/article_138621_8ccf66fe2126f56d3ebbe519ca86339c.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Impact of body mass index and leptin on response of non-Hodgkin's lymphomas to chemotherapy274013764810.21608/bmfj.2021.137648ENAli E. AliDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.Nabil E. KhattabDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.Hanan NassarDepartment of medical Oncology, National Cancer Institute, Cairo University, EgyptAbd Elmonem A. Abd ElmonemDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.Hiam AbdallahDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.Mohamed AhmedDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.0000-0003-4235-0220Journal Article20210109<strong>Background</strong>: Obesity is a positive chronic imbalance between energy intake and expenditure mediated through leptin signaling pathway. Obesity is associated with increased incidence and mortality of cancer, including non-Hodgkin's lymphoma (NHL). Associations between polymorphisms in leptin and leptin receptor genes and non-Hodgkin's lymphomas have been reported. <strong>Aim of study</strong>: evaluate the impact of body mass index and serum leptin level on response of NHL patients to chemotherapy. <strong>Subjects and methods</strong>: 100 NHL adult patients were included. For each patient, body mass index was determined. Investigations performed include laboratory (complete blood count, serum levels of lactate dehydrogenase, liver enzymes, bilirubin, albumin, creatinine, uric acid, and lipid profiles, and serum leptin level), imaging (pelvi-abdominal ultrasonography, computerized tomography scans and positron-emission tomography), and pathologic examination of biopsy samples. Appropriate chemotherapy regimens were given for 6 cycles, and then the patients were re-assessed to determine their response to chemotherapy. <strong>Results</strong>: Positive correlation was observed between body mass index and serum leptin level. Serum leptin level was higher in non-Hodgkin's lymphoma patients presented with B symptoms compared to those without B symptoms. Body mass index and serum leptin levels were significantly higher in patients with stage-4 disease compared to those with stage-1. Also, body mass index and leptin levels were significantly higher in patients who did not respond to chemotherapy and showed progressive disease compared to those who showed regressive response. <strong>Conclusion</strong>: Increased body mass index and elevated serum leptin level had a worse impact on response of non-Hodgkin's lymphoma patients to chemotherapy.https://bmfj.journals.ekb.eg/article_137648_b42333ca7745149124f326abe8b0f708.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Transthoracic Echocardiographic Hemodynamic Assessment in Patients under Spinal Anesthesia in Lower Limb Surgery415411990210.21608/bmfj.2020.119902ENSameh MEl-Sherbinydepartment of anesthesia, ICU and Pain-faculty of medicine, Mansoura University, EgyptAhmed Elaidydepartment of anesthesia, ICU and Pain-faculty of medicine, Mansoura University, EgyptAboelnour Badrandepartment of anesthesia, ICU and Pain-faculty of medicine, Mansoura University, EgyptOla AbdeldayemDepartment of anesthesia, ICU and pain management, faculty of medicine, Mansoura University, Egypt.Journal Article20201021<strong>Background: </strong>Spinal anesthesia is often associated with significant hypotension due to a sympathetic blockand can increase the risk of perioperative cardiac complications. Transthoracic echocardiography (TTE) is widely used throughout medicine as a clinical, diagnostic and research tool. Portability, accuracy, ease of use and a variety of training courses have encouraged its use. <strong>Aim: </strong>The present study was designed to evaluate the hemodynamic changes of spinal anesthesia by Transthoracic Echocardiography and test its efficacy as a monitoring tool in lower limb surgery.<strong> Methods: </strong>The study included50 patients, who were scheduled for lower limb surgery under spinal anesthesia. Two serial TTE studies were performed. One immediately before spinal anesthesia after giving the preload, then at 10 mins after spinal anesthesia. Changes of heart rate (HR), mean arterial blood pressure (MAP), the total doses of ephedrine and atropine, and data regarding highest sensory level and bromage scale were recorded.<strong> Results: </strong>Echocardiographic monitoring the heart variables have showed marked decrease when MAP was < 70% of basal values. <strong>Conclusion:</strong> Transthoracic echocardiography has proved its efficacy as a monitoring tool in assessment and guiding the management of hemodynamic changes after spinal anesthesia.https://bmfj.journals.ekb.eg/article_119902_a3525def0e8f0c800907c76c42b62af2.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Comparative Study between Endoscopic Dacryocystorhinostomy and Balloon Catheter Dilatation in Treatment of Chronic Nasolacrimal Duct Obstruction556413831510.21608/bmfj.2021.138315ENMosaad ElsisiDepartment of Otorhinolaryngology, Benha faculty of medicine, Banha University, Egypt.Ismail ElmoftyDepartment of Otorhinolaryngology, Benha faculty of medicine, Banha University, Egypt.Ahmed AbdelghanyDepartment of Otorhinolaryngology, Benha faculty of medicine, Banha University, Egypt.Alaa AbdelsamieDepartment of Otorhinolaryngology, Benha faculty of medicine, Banha University, Egypt.https://orcid.org/00Journal Article20210111Background: Epiphora is defined as watering of the eye due to imperfect drainage of tears through lacrimal passages.It may result from a wide variety of causes, the commonest cause is nasolacrimal duct obstruction (NLDO), which may be congenital or acquired. Acquired NLDO may be primary or secondary.Dacryocystorhinostomy (DCR) is an operation that creates a lacrimal drainage pathway into the nasal cavity to facilitate drainage of the previously obstructed excreting system.Aim of the work: The aim of this study is to compare endoscopic DCR and balloon catheter dilation in treatment of nasolacrimal duct obstruction.Patients and methods; A Prospective randomized comparative Study was conducted on 30 patients .15 cases underwent endoscopic DCR while the other cases underwent balloon catheter dilation. Data were analyzed and compared using Z, Chi-square and Fisher exact test. Results: The balloon catheter dilatation is a safe and minimally invasive technique but the endoscopic DCR has a high success rate.Conclusion:The two techniques are acceptable alternatives. The choice of surgery should depend upon patient's preference and availability of resources.https://bmfj.journals.ekb.eg/article_138315_0e03a7110ec5f56622b2e66b7e25c5ef.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Study of Common Infections among Children with Sickle Cell Anaemia In Saudi Arabia657812086910.21608/bmfj.2020.120869ENSidieg Sheikheldin ElobiedDepartment of pediatrics, Benha faculty of medicine, Banha University, EgyptIsmail N RamadanDepartment of pediatrics, Benha faculty of medicine, Banha University, EgyptGhada AbdelmotalebDepartment of pediatrics, Benha faculty of medicine, Banha University, EgyptAbd Elmoniem YounisDepartment of Puplic Health and Community Medicine, Benha Faculty of Medicine- Benha UniversityJournal Article20201031Sickle cell disease (SCD) is a collective term for a number of genetic disorders in which hemoglobin is structurally abnormal, resulting in the episodic formation of sickle-shaped red blood cells (RBCs) and a wide range of clinical manifestations.<strong>Aims</strong>: To identify the common infections in children with sickle cell disease in Kingdom of Saudi Arabia regarding its prevalence, infection sites, as well as type of pathogens.<strong>Methods and Material:</strong> This was cross-sectional study conducted on 100 sickle cell disease patients who attended emergency department, King Abdulla Hospital, KSA. <em> </em>All children with SCD presenting with symptoms and signs suggestive of infections or acute complications of sickle cell anaemia were included e.g. fever, cough, pain, burning micturition, swelling, bonny tenderness. The identification of the infecting organism was done by culture studies.<strong>Results</strong>: Patients' age ranged from 2 to 18 years old with a mean of 13.12±4.85 (SD); 68 patients were females and 32 were males while, 95% of patients had positive family history of consanguinity. Nine (9%) and 12 (12%) cases had positive blood and urine cultures. Out of the 21 positive microbial infection cases, 12 cases were diagnosed as Urinary Tract Infection, 4 cases as Osteomyelitis, 2 cases as Fever for investigation and 3 cases as Sepsis. All cases of pneumonia were diagnosed clinically (no positive microbial blood culture cases). Two of the Osteomyelitis cases were Staphylococcus species and the other 2 were Salmonella. In all cases diagnosed as Fever for investigation and Sepsis, the organism was Staphylococcus species. In cases diagnosed as Urinary Tract Infection; 7 of them were <em>E. coli</em> and 5 were <em>Klebsiella pneumonia</em>. <em> </em><strong>Conclusions</strong><strong>: </strong>Urinary tract infection was the most common infection in our study. E. Coli was the most common organism isolated followed by Staphylococcus species, <em>Klebsiella pneumonia</em> and Salmonella spcshttps://bmfj.journals.ekb.eg/article_120869_0213ab1f830b2729e22072e3fd1f6232.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Evaluation of MicroRNA-210(miR-210) as a Diagnostic and Prognostic Biomarker in Pre-eclampsia Pregnancies799312028710.21608/bmfj.2020.120287ENFetnat TolbaDepartment of clinical and chemical pathology, Faculty of Medicine, Benha university, Egypt.Adel AghaDepartment of clinical and chemical pathology, Faculty of Medicine, Benha university, Egypt.Maha RachwanDepartment of clinical and chemical pathology, Faculty of Medicine, Benha university, Egypt.Basma SakrDepartment of Gynecology and Obstetric, Faculty of Medicine, Benha university , EgyptMaha AbdellaDepartment of clinical and chemical pathology, Faculty of Medicine, Benha university, Egypt.Amira AbdelrahmanDepartment of clinical and chemical pathology, Faculty of Medicine, Benha university, Egypt.Journal Article20201024<strong>Objective: </strong>This study aims to assess the level of miR-210 in Egyptian women with pre-eclampsia (PE) and to evaluate its role in diagnosis and prognosis of the disease.<br /> <strong>Subjects & Methods: </strong>The study was conducted on 30 pregnant women with PE divided into two groups: group (I): included 15 cases with mild PE and group (II): included 15 cases of severe PE and, 20 healthy pregnant women with matched age and sex were included as control group.<br /> All women included in the study were subjected to, history taking full clinical examination, laboratory investigations included (CBC), (PT), (ALT, AST), (urea, creatinine), detection of protein in urine, as well as miRNA-210 gene expression by RT-PCR.<br /> <strong>Results: </strong>Patients with PE showed a highly significantly increase in serum miR-210 (P value <0.001) compared to control as well as, it was higher in severe PE than in mild PE (P value <0.001). MiR 210 have highly significant positive correlation with (systolic, diastolic, MABP), (Proteinuria) and (PT) a significant positive correlation with (AST), (ALT),.However no significant correlation was found with (Hb%) ,platelet count, PTT and INR, serum urea and creatinine. PTT was statistically significant (P value 0.002).The best cutoff value of PE (2.03) with sensitivity and specificity of 90.0% and 85.0% respectively.<br /> <strong>Conclusion: </strong>Expression of mir-210 is upregulated in pre-eclampsia and was higher in severe than in mild. Hence, the serum miR-210 can be used as a diagnostic, prognostic biomarker in PE patients and understanding pathophysiology.https://bmfj.journals.ekb.eg/article_120287_7ad27b04a3d34fe2d4a4c03221627b2b.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Evaluation of Interleukin-17 in Viral Warts9410112889410.21608/bmfj.2020.128894ENOsama AlkadyDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, Egypt0000000299105990Soha AbduulahDepartment of Dermatology, Venereology and Andrology 6th October University , EgyptYasser IsmailDepartment of clinical pathology, Faculty of Medicine, Benha University, Egypt.Shymaa RezkDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Benha University, EgyptJournal Article20201210<strong>Background:</strong> Warts are common benign epithelial keratinocytes proliferations caused by human papillomavirus (HPV) infection that may involve the skin and the mucous membranes Interleukin-17A (IL-17A), is a prototypic member of cytokines<strong>.</strong> It is recognized as an inflammatory cytokine and exerts its function mainly on myeloid cells and mesenchymal cells to induce the expression of certain kinds of chemokines, which in turn increase granulopoiesis and recruit neutrophils to the infectious site. <strong>Aim and objectives: </strong>The aim of the work was to evaluate the serum level of interleukin 17 in patients with viral warts and its correlation with the disease severity.<strong> Subjects and methods:</strong> this was a case control study, in which participants were selected from the outpatient clinic of Dermatology, Venereology & Andrology department of Benha University Hospitals, carried on sixty patients of wart and thirty healthy subjects serving as a matched control subjects group. Serum IL17 was detected by ELISA <strong>Results: </strong>The results of the study revealed that there was high statistically significant difference between groups regarding IL 17 serum level where it was higher in wart patients’ group. <strong>Conclusion: </strong>This study reported increased IL17 in sera of patients with warts irrespective of their clinical type (plane, plantar or common).This finding may denote that IL17 may have a role in pathogenesis of viral warts.https://bmfj.journals.ekb.eg/article_128894_f43c0d7aacbf16f7985c5ff68dc530c2.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Correlation between Vascular Endothelial Cell Growth Factor (VEGF) and Muscular Ultrasonography Finding in Knee Osteoarthritis10211212517010.21608/bmfj.2020.125170ENMayada KhalilDepartment of Rheumatology , Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Mounir Serag EldeenDepartment of Rheumatology , Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Samy E. EgelaDepartment of Rheumatology , Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Yasmine HadhoudDepartment of Rheumatology , Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Al-Shaimaa Al TabbakhDepartment of Medical Microbiology and Immunology department, Benha Faculty of medicine, Benha University, Egypt.Journal Article20201124<strong>Background:</strong> Osteoarthritis (OA) is a degenerative joint disorder affecting articular cartilage that may be associated with synovial inflammation. The vascular endothelial growth factor is implicated in the pathogenesis of OA. This study aimed to assess man serum vascular endothelial growth factor (VEGF) levels in patients with primary knee osteoarthritis (KOA) and to evaluate their correlation with clinical manifestations, physical function and musculoskeletal-ultrasonography findings. <strong>Results:</strong> This is a case control study conducted on 50 subjects, thirty patients with primary Knee OA recruited from the outpatients’ clinic of the Rheumatology, Rehabilitation and Physical Medicine Department Benha University Hospitals, from November 2018 to November 2019. Twenty age and sex matched apparently healthy adult individuals were also included as a control group. The present study showed a highly statically significant difference (p < 0.0001) between the mean serum levels of VEGF in the patients’ and the control groups being higher in the patients group compared to the control group (<strong><0.001</strong>). The current study revealed a strong significant positive correlations of VEGF levels with the presence of Baker’s cysts, cartilage thickness index and color Doppler US grading <strong>(p < 0.0001). </strong>Significant positive correlations were also reported between VEGA levels (p=<0.001) and WOMAC total and WOMAC sub scores<strong>.</strong><br /> <strong>Conclusions: </strong>VEGF serum levels are highly correlated with clinical, functional and musculoskeletal ultrasound severity of KOA. Thus it could be used as a potential biomarker for estimating Knee OA disease statushttps://bmfj.journals.ekb.eg/article_125170_00ec9995f55924a37abb039dad5a6cb2.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Visfatin in Association with Severity and Activity of Primary Osteoarthritis and Rheumatoid Arthritis11312413040810.21608/bmfj.2020.130408ENDalia AllamDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, EgyptAbd El Wahab Shams El DinDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, EgyptAhmed El ShambakyDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, EgyptMarwa YehiaDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, EgyptJournal Article20201217<strong>Background</strong>: Visfatin is a one of the recently discovered adipokine that has important pro-inflammatory and catabolic roles in rheumatoid arthritis (RA). Pro-inflammatory cytokines initiate a number of physiological changes that result in the characteristic signs of inflammation. Visfatin may play a role in OA by activating chondrocytes. Along with its cytokine effect, visfatin has an enzymatic activity called nicotinamide-phosphoribosyl-transferase (NAMPT). <strong>Objectives</strong>: To study the level of Visfatin in RA and OA sera and correlate its levels with activity and severity scores of both diseases. <strong>Subjects and methods</strong>: A case control study was conducted to assess Visfatin serum level in 20 patients of osteoarthritis and 25 patients rheumatoid arthritis and 20 apparently healthy individuals. Lequesne’s algo-functional Index used for assessment of OA functional impairment , Kellgren and Lawrence for radiological severity and KOFUS for activity , while Larsen's scoring system used for assessment of RA severity and DAS 28 score for activity. Visfatin concentrations in serum measured using a commercially available ELISA kit. <strong>Results</strong>: Mean Lequesne’s index was 11.2 ± 3.6. According to Kellgren and Lawrence we had one patient G1 , 9 patients GII , 7 patients GIII and 3 patients GIV .Median KOFUS was 5 and it ranged from 3 to 13,. Mean DAS 28 was 4.96± 1.27. As regards Larsen score, mean was 24± 22. There was an overall significance in visfatin between three groups. P value was Conclusion: Visfatin may have a role in the pathogenesis of OA and RA. Furthermore it acts as a potential marker for disease activity and severity of RA as well as severity of OA.https://bmfj.journals.ekb.eg/article_130408_a0641eea7183e9601ccec44ab37be92c.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Procalcitonin, C-reactive Protein and White Blood Cells Count in Children With Community Acquired Pneumonia12513614218710.21608/bmfj.2021.142187ENMohamed RashadDepartment of pediatrics, Benha faculty of medicine, Benha University, Egypt.Yasser IsmailDepartment of clinical and chemical pathology, Benha faculty of medicine, Benha University, Egypt.Ahmad Ata SobeihDepartment of pediatrics, Benha faculty of medicine, Benha University, Egypt.Omar Abdel AzizDepartment of pediatrics, Benha faculty of medicine, Benha University, EgyptJournal Article20210122v<br /> <strong><em>Background: </em></strong>community-acquired pneumonia (CAP) is one of the most common pediatric diseases. Early and accurate diagnosis of CAP in children has a great value in avoiding pneumonia complications and decreasing rates of pneumonia related mortality. <strong><em>Aim of the work:</em></strong>this study aims to investigate the role of procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBCs) count in diagnosis of childhood CAP.<strong> <em>Patients and Methods:</em></strong> 90 infants and children aged from 2 months to 5 years (60 months) were included in this study. They were divided into two groups group I: 60 patients hospitalized for CAP and group II: 30, age and sex matched, healthy controls attending the outpatient clinics of the same hospitals for routine care. Chest x-ray was performed to the patients group only, while WBCs count, serum CRP, serum procalcitonin were applied to both patients and controls.<strong> <em>Results:</em> </strong>WBCs count, neutrophil percentage, CRP level, procalcitonin concentration were higher in the patients group than the controls with high statistically significant difference (13.4±3.4 vs 8.3±1.7) (54.5±15.4 vs 37.2±6.7) (57.5±30.1 vs 5.7±5.6) (0.5±0.47 vs 0.07±0.04) respectively. Using the AUROC test WBCs count at cut-off value >10.5 x10<sup>3</sup> cell/mm<sup>3</sup>, CRP at cut-off value >20 mg/L, procalcitonin at cut-off value >0.17 ng/ml could predict presence of CAP in the patients with 83.3%, 85%, 86.7% sensitivity and 76.6%, 100%, 96.7% specificity respectively. <strong><em>Conclusion:</em></strong> evaluation of WBCs count, serum CRP and serum procalcitonin concentration has an important role in diagnosis of CAP in infants and children.https://bmfj.journals.ekb.eg/article_142187_80f58fdb7cb5f22cf7bff404b7f2cce7.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Vitamin D Deficiency in Subclinical Hypothyroid Dysfunction Patients: A Case Control Study13714514352810.21608/bmfj.2021.143528ENMedhat ElamawyDepartment of internal medicine, Benha faculty of medicine, Benha University, Egypt.Seham Gouda AmeenDepartment of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Egypt.Journal Article20210126<strong>Background</strong>: the prevalence of subclinical hypothyroidism worldwide is commoner than the overt disease. Limited studies discussed the vitamin D levels in subclinical hypothyroid patients. Giving vitamin D supplements may prevent form developing overt hypothyroidism. In this cross-sectional case-control study, we described the differences in the vitamin D of adult Saudis with and without subclinical hypothyroid dysfunction. <strong>Methods:</strong> This is an observational single-center, retrospective, age, and sex matched, case-control study. A total of 60 subjects [41 healthy controls, 19 subclinical hypothyroid case] were included. 25(OH) vitamin D, TSH, free T4 and free T3 are measured in both groups. <strong>Results:</strong> Subjects with subclinical hypothyroid dysfunction had a significantly lower serum Vitamin D than controls (p value 0.016) although both groups fall below vitamin D sufficiency levels. Correlation is found between both vitamin D and TSH, p value 0.036. but it was found to be less statistically significant positive relation, r value is 0.279, (R square = .078, beta regression coefficient = -.055 and p value <0.0005) <strong>Conclusion:</strong> Patients with hypothyroid dysfunction showed much lower serum vitamin D compared to controls but it has not that big role in early hypothyroid disorders as shown in less significant relation. <br /> <strong> </strong>https://bmfj.journals.ekb.eg/article_143528_6b6f5e04fc5425a8b35c16ad4031f91d.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Cranioplasty using Titanium Mesh Versus Acrylic Bone Cement: Short-term Outcomes and Complications14615414480410.21608/bmfj.2021.144804ENMohab DarwishDepartment of Neurosurgery, Minia University Hospital, Minia, Egypt.0000-0002-7225-104XWaleed Zidan NanousDepartment of Neurosurgery, Minia University Hospital, Minia, Egypt.Journal Article20210130<strong>Background: </strong>Cranioplasty is a reconstructive procedure to restore bone anatomy and repair skull defects. Optimum reconstruction could be a challenge for neurosurgeons, and therefore the strategy to attain the ideal result remains a subject of discussion. <strong>Aim: </strong>we aimed at comparing two completely different prostheses in reconstructing calvarial bone defects, titanium mesh and polymethyl methacrylate (PMMA) bone cement. We looked for the differences in the cosmetic and functional outcomes as well as the prosthesis-related complications.<strong> Patients and Methods: </strong>This was a randomized prospective study on the first forty successive adult patients with calvarial skull defects of different etiologies, sites and sizes admitted and operated upon at neurosurgery department, Minia University hospital between January 2017 and December 2018. We divided patients into 2 groups, <strong><em>Group1</em></strong><em>:</em> 20 patients were operated upon using Titanium mesh and <strong><em>Group 2</em></strong><em>:</em> 20 patients were operated upon using (PMMA) acrylic bone cement implants. <strong>Results: </strong>Regarding cosmetic appearance, functional outcome, and improvement of the clinical symptoms (syndrome of trephined), Cranioplasty using titanium mesh and acrylic bone cement proved to have non-significant differences in the reconstruction of calvarial skull defects of different etiologies. However, there is a statistically significant difference between both materials regarding complications especially with large skull defects (≥25 cm<sup>2</sup>). <strong>Conclusion: </strong>there is no statistical difference between both materials regarding cosmetic and functional outcomes. However, large bone defects (≥25 cm<sup>2</sup>)are better treated with titanium mesh due to lower incidence of complications. https://bmfj.journals.ekb.eg/article_144804_34fd3b00e996713b2ad68406cfadd8b0.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Shockwave Therapy versus Local Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A comparative study.15516813515710.21608/bmfj.2021.135157ENAbd El-Wahab Shams El-DinDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine, Benha University, Egypt.Amal SolimanDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine, Benha University, Egypt.Nagwa HaroonDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine, Benha University, Egypt.Rasha FawzyDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine, Benha University, Egypt.Journal Article20210103<strong>Objectives: </strong>This study aimed to assess the reliability and safety of extracorporeal shockwave therapy (ESWT) versus local corticosteroid injection on pain intensity and functional disability, as treatment modalities of patients suffering from chronic plantar fasciitis (PF). <strong>Patients and methods: </strong>This study was conducted on 45 patients suffering from chronic PF who failed to respond to conservative treatments. Patients were divided into 3 groups: 15 patients treated with ESWT once per week for 6 successive sessions (Group I), 15 patients treated with a local corticosteroid injection (Group II) and 15 patients taking acetaminophen 500mg/6 hrs for 7 days and exercises, as controls (Group III). All patients were subjected to history taking, clinical examination and assessment of foot pain, disability and activity limitations using the Foot Function Index (FFI) at the beginning of the study and after 6 weeks. <strong>Results</strong>: At the beginning of the study, no significant differences were reported between the studied groups regarding the FFI (p value = 0.23). However, at the end of the study, a highly statistically significant difference was reported between the three groups regarding the outcome variables (p value =0.001). Improvement occurred in group I and II but it was superior among group I patients. Skin reddening occurred in 11 patients (73.3%) of group I and 2 patients (13%) of group II with a statistically significant difference (p < 0.001) between the 2 groups. Pain was reported in 4 patients (26.7%) and 15 patients (100%) in group I and group II respectively with a highly significant difference (p < 0.001). None of the cases reported allergy or fat bad atrophy. <strong>Conclusion:</strong> Both ESWT and local corticosteroid injection treatments improved pain and functional ability in patients with chronic PF. Improvement of the FFI total scores was superior with the ESWT therapy that seems to be an unconventional but a safe method for the management of chronic PF.https://bmfj.journals.ekb.eg/article_135157_d68c997087823ccc2d173e8395f565ee.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Serum Neutrophil Gelatinase- Associated Lipocalin as a Marker of Malnutrition in Maintenance Hemodialyzed Patients16918412049210.21608/bmfj.2020.120492ENAnas Abd AlRahmanDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Hesham EsaaDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Enas AhmadDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Seham MohammedDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Journal Article20201027<strong>Background</strong>: Neutrophil Gelatinase<em>-</em> Associated Lipocalin (NGAL) is a useful clinical biomarker for early diagnosis, predicting disease severity, therapeutic monitoring, and for predicting clinical outcomes. <strong>Aim</strong>: The current study aimed to investigate serum Neutrophil gelatinase-associated lipocalin ( NGAL ) levels as a marker of malnutrition in maintenance hemodialysis patients. <strong>Subjects and methods</strong>: This study was conducted on 50 subjects. Subjects were divided into three groups .Group (1): Hemodialyzed patients : Included <strong>30 </strong>patients before starting hemodialysis (HD). Group (2): The same 30 patients after hemodialysis. Group (3): Included control group. Serum levels of NGAL was measured by enzyme-linked immunosorbent assay (ELISA ). <strong>Results: </strong>There is high statistically significant decrease in NGAL in dialyzed patients after dialysis when compared to the same patients before dialysis (p < 0.001). There is statistically significant positive correlation between NGAL after dialysis and albumin, pre-albumin, serum iron, serum ferritin, TLC and neutrophils %. There is a statistically significant decrease in the serum level of NGAL (before and after) in dialysis patients with malnutrition when compared to ( before and after ) dialysis patients without malnutrition. <strong>Conclusion</strong>: Serum level of NGAL seems to be a reliable marker of malnutrition appearance, allowing early diagnosis and preventive therapy.https://bmfj.journals.ekb.eg/article_120492_3ea5c070fdb49fb25197bec6fbeb7ac0.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Impact of Hepatitis C virus Infection and direct-acting Oral Antiviral Drugs on glycaemic state in Type 2 Diabetic Patients18519515056410.21608/bmfj.2021.58139.1371ENAyman ElBadawyInternal Medicine
Faculty of Medicine, Banha UniversityMohamed ElSayedProfessor Professor of Internal Medicine
Head of Internal Medicine Department and Endocrinology unit
Faculty of Medicine, Banha UniversityIslam AbdullatifMBBCHRasha AbdelMoneimInternal Medicine
Faculty of Medicine, Banha UniversityJournal Article20210114Background: Diabetes mellitus (DM) is strongly associated with chronic hepatitis C virus (HCV) infection. This work aimed to estimate the impact of Hepatitis C virus infection on glycaemic state and insulin resistance in type 2 Diabetic patients, and evaluate the effect of direct-acting oral antiviral treatment on the glycaemic state and insulin resistance in type 2 Diabetic patients. Methods: The study was performed on (40 patients) with Type 2 Diabetes who were infected by Hepatitis C Virus and took Direct-acting Oral Antiviral Drugs. The study also included (10 patients) who had Type 2 Diabetes and HCV infection serving as control group. All patients and control were subjected to thorough history taking, clinical examination, and lab. investigations as FBG, PP and HBA1c , Serum fasting Insulin level, And HOMA-IR, HCVab – HBsAg – HIVab, CBC, SGOT, SGPT, Serum Albumin and Bilirubin, PCR for HCV RNA, and Abdominal US. Results: DAAs-based eradication of HCV is associated with improved glycemic control in patients with type 2 diabetes as evidenced by a significant reduction of mean FBG, Fasting insulin, HbA1c, and HOMA IR. There was a positive correlation between the treatment of HCV infection and the reduction of anti-diabetic drugs used in the studied patients. Conclusion: DAAs-based eradication of HCV is associated with improved glycemic control in patients with type 2 diabetes.https://bmfj.journals.ekb.eg/article_150564_f63946cc5d2e01d8f02aab1b0b8ddd58.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Investigation of the Influences on Decision-Making Algorithms in Allogeneic Stem Cell Transplantation in Different Groups of Pediatric Nonmalignant Diseases19620913236310.21608/bmfj.2020.132363ENSamar ElbahyDepartment of pediatrics, Benha faculty of medicine, Banha University, Egypt.0000-0001-8465-3794Mohamed ElBakryDepartment of pediatrics, Benha faculty of medicine, Banha University, Egypt.Sameh AbdulsameaDepartment of pediatrics, Benha faculty of medicine, Banha University, Egypt.0000-0002-7478-5037Robert WynnBone Marrow transplant unit Royal Manchester Children's Hospital, Manchester, United KingdomJournal Article20201226<strong>Background:</strong> Haematopoietic stem cell transplantation (HSCT) represents the definitive treatment for many non-malignant diseases. Treosulfan is considered a safe and effective conditioning drug compared to other conventional myeloablative conditioning (MAC) regimens, especially in patients with comorbidities. <strong>Aim of the work</strong>: To evaluate the safety and efficacy of Fludarabine-Treosulfan-Thiotepa reduced toxicity conditioning in different paediatric nonmalignant disease. <strong>Patients and methods</strong>: 54 patients (55 transplants) were reviewed retrospectively, they had metabolic, immunodeficiency, BM failure, hemoglobinopathy and other nonmalignant diseases. All had the same conditioning. 96% received serotherapy (Alemtuzumab/ATG). post-transplant Graft-versus-Host disease (GVHD) prophylaxis was given in all patients, based mostly on ciclosporin. 90% of the patients were fully HLA-matched. <strong>Results: </strong>Median age at transplant was six years. No primary graft failure, 4%(n=2) had secondary graft failure. Overall survival at a median follow-up of 15months was 90.9%. Neutrophil engraftment occurred at a median of 12 days, Platelet engraftment occurred at a median of 19 days. immune reconstitution was achieved at a median time of nine Chimerism was full donor in 64%(n=35), high donor in 18%(n=10), and mixed donor in 6%(n=3). 60%(n=33) developed GVHD but only 4%(n=2) had acute severe GVHD, another 4%(n=2) had severe chronic GVHD. One patient had severe VOD.<br /> <strong>Conclusion:</strong> This study demonstrates that Fludarabine-Treosulfan-Thiotepa regimen is a safe and effective conditioning that can achieve engraftment, with very low rates of graft failure, transplant-related mortality and morbidity, even if it is used twice in the same patient.https://bmfj.journals.ekb.eg/article_132363_5d969e73f78382b4683f9f16cc26448f.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Molecular Quantification of Pseudomonas Aeruginosa from Respiratory Samples in Patients with Suspected Ventilator Associated Pneumonia21022013114210.21608/bmfj.2020.131142ENSahar FayedDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Shahen DabourDepartment of Paediatrics, Faculty of Medicine Benha University.Heba SallamDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.Neveen SolimanDepartment of clinical and chemical pathology, Faculty of Medicine, Benha University, Egypt.0000-0002-3925-912xJournal Article20201220<strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a frequent issue in intensive care units (ICU), with a major impact on morbidity, mortality and cost of care. VAP diagnosis remains challenging: traditional culture-based microbiological techniques are still the gold-standard, but are too slow to enable clinicians to improve prognosis with timely antimicrobial therapy adjustment.<strong> Aim: </strong>to compare the performance of the real time quantitative molecular based method versus conventional culture in diagnosis of ventilator associated pneumonia caused by P. aeruginosa in pediatric patients.<strong> Methods: </strong>this study included forty paediatric patients aged from one month to 18 years attending Paediatric Intensive Care Unit (PICU) and developed VAP during mechanical ventilation, All patients were subjected to full history taking, full clinical examination, chest X-ray, semiquantitative culture of BAL and ETA on different routine bacteriological media for isolation of the causative organisms and molecular quantification for detection and quantification of P. aeruginosa in BAL and ETA samples by real -time PCR.<strong> Results: </strong>The mean age in patients' group was 40.7±31.6 months with male predominance (60%). PCR ETA can diagnose Pseudomonas aeruginosa in VAP, with 88.9% sensitivity, 90.3% specificity, 72.7% PPV and 96.5% NPV. AUC (95%CI) = 0.896 (0.76-1.0) and ROC curve analysis showed that PCR BAL can diagnose Pseudomonas aeruginosa in VAP, with 100% sensitivity, 96.7% specificity, 90.9% PPV and 100% NPV. AUC (95%CI) = 0.983(0.94-1.0).<strong> Conclusion:</strong> Molecular biology makes it possible to obtain in the future quick and reliable microbiological results in patients with VAP. qPCR can provide reliable quantitative microbiological data, highly specific and with a good sensitivity for common pathogens involved in VAP.https://bmfj.journals.ekb.eg/article_131142_91f4981f96faf411a17f8093179267b4.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Pulmonary Involvement in Patients with Systemic Sclerosis22123312557410.21608/bmfj.2020.125574ENAli FoudaDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Abdel-Wahab Shams EldinDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Noha IbrahimDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Mona MostafaDepartment of Rheumatology, Rehabilitation and physical medicine, Benha faculty of medicine , Benha University, Egypt.Journal Article20201126<strong>Background:</strong> Systemic sclerosis is a multisystem autoimmune disease of unknown etiology. The pulmonary system is involved in Systemic sclerosis and causes a significant increase in morbidity and mortality. This study aimed to assess the extent of pulmonary system involvement in patient with systemic sclerosis.<strong> Methods:</strong> This study was a case control study, done on thirty patients with systemic sclerosis and twenty age and sex matched as a control group < strong><em>.</em> All patients included in the study were subjected to the following: Full history, evaluation of skin involvement using modified Rodnan skin thickness score. Investigations including: Pulmonary function test, radiological examination (plain chest X-ray and high-resolution computed tomograghy. <strong>Results:</strong> predominance of females among patients. 53.33% had limited scleroderma. Modified Rodnen Score ranged from 12 to 35 with mean of 21.03 ± 7.04. Regarding skin changes of systemic sclerosis patients, skin thickness (60%), hyper or hypopigmentation (100%), ischemic ulcers (30%) and subcutaneous calcinosis (20%). A higher frequency of ILD was observed among SSc patients included in this study. The most common patterns in the HRCT in the current study were ground-glass appearance, followed by, honeycombing. Pulmonary hypertension occurred in 30% patients There were highly statistically significant differences (p < 0.001) between cases and the control group regarding PFTs and the severity of restrictive pattern.<strong> Conclusion:</strong> Pulmonary manifestations are very common in SSc in the form of ILD and PH. PFTs are cornerstone in the evaluation of dyspnea and for detection of pulmonary involvement in SSc patients.<br /> <strong> </strong>https://bmfj.journals.ekb.eg/article_125574_9d92df4e61859965508e27129e2f16ef.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Sedation and anesthesia of pediatric patient for External beam radiotherapy (XRT)23424615837210.21608/bmfj.2021.33194.1281ENPeter MiladSaiedAnesthesia department-Matarya Teaching Hospital-CairoIhab ElshahatAfifiAnesthesia and ICU department, faculty of Medicine , Benha UniversityIbrahim EzzatMostafaAnesthesia and ICU department, faculty of Medicine , Benha UniversityJournal Article20200627BACKGROUND: External beam radiation delivers a beam of high-energy x-rays to a patient's tumor site, Ιn order to destroy the cancer cells. External beam radiation gets its name from the fact that the beams come from an external source (a machine called a linear accelerator) and are aimed at the site of the tumor.AIM: was to obtain the most recent guideline in sedation and anesthesia of pediatric patient for External beam radiotherapy (XRT). Providing sedation anesthesia techniques during the performance of diagnostic and therapeutic procedures οn children decreases anxiety, discomfort, and pain and may improve child wellbeing. Immobilization is a pre-requisite for accurate radiotherapy. SUBJECTS and METHODS: This is a review article, the search was performed in MEDLINE , Embase , Pubmed, and CINHAL. RESULTS: Anesthetic drugs can be used in sub-anesthetic doses to cause sedation but, because they are potent, the difference between sedative and anesthetic doses is too small and airway skills are required too often for non-anesthetists to use them.C0NCLUSION: Sedation and anesthesia of pediatric patients have serious associated risks, as hypoventilation, apnea airway obstruction and cardiopulmonary impairment or depression. These risks should be avoided, diagnosed rapidly and treated appropriately. Medical practitioners responsible for the sedation process should know the nature of the sedatives and their side-effects. They should be able to detect and manage complications.This study was approved by the institutional ethical committee.https://bmfj.journals.ekb.eg/article_158372_2022201e0ef7eee83a73f04485266b4c.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Role of MRCP in Assessment of Biliary Anatomy in Potential Living Liver Transplant Donors24725315898910.21608/bmfj.2021.36939.1296ENMedhat MohammedRefaatHead of Radiology Department, Professor of Radiodiagnoosis, Faculty of Medicine, Benha UniversityAhmed El-SayedShalanRadiology Department, Faculty of Medicine, Benha universityIbrahim ShiblShehab El-DinRadiology Department, Ahmed Maher Teaching Hospital, Cairo, Egypt0000-0002-1761-4880Journal Article20200723Aim: to assess biliary anatomical variants in potential living liver transplant donors using Yoshida classification.<br />Patients and methods: the study was carried out on 54 potential living liver transplantation donors. The donors were randomly selected and evaluated with preoperative MRCP. All candidates’ pattern of biliary tree was classified according to Yoshida classification.<br />Results: The most common biliary tree arborizing pattern was bifurcation of the right and left ducts (RL) with 40 candidates (74.04%). The second most common pattern was A-PL where right posterior intrahepatic duct joins the left hepatic duct, then they both join the right hepatic duct to form the common hepatic duct, this pattern was seen in 9 candidates (16.66%). Least common was the trifurcation pattern (APL), seen in 5 candidates (9.25%).<br />Conclusion: Preoperative MRCP is an essential step in evaluating potential living liver transplant donors. As a non-invasive technique, MRCP can safely and accurately delineate the branching pattern of biliary tree, guiding the surgical team and reducing post-operative complications.https://bmfj.journals.ekb.eg/article_158989_0f8907eb7419c2ed0bb79819192bd221.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Magnetic Resonance Imaging Role in Evaluation and characterization of Hand and Finger Lesions25426515837310.21608/bmfj.2021.37316.1297ENMedhat MohammedRefaatHead of radiology departement , Faculty of medicine , Benha universityAhmed El-SayedMohamed ShaalanRadiology department, Faculty of medicine, Banha university, Banha, EgyptAhmed MosaadMontasrRadiology Department, Faculty of Medicine, Benha University, Benha, EgyptJournal Article20200726Background: MRI describes the main features of the encountered different pathological lesions of the hand and fingers, as well as specifies the signal characteristics and location, which help to differentiate them. In general, a specific diagnosis may be achieved by taking into account the location of the lesion within the hand or wrist and its signal characteristics. Aim: The aim of the study is to evaluate the role of MRI in diagnosis of various hand and finger pathologies using different sequences. Methods This is a prospective observational study of patients who suffers from hand or fingers swelling or trauma. The patients were investigated by MRI. Results: The study included 30 patients with hand or finger lesions who were evaluated by MRI and enrolled from Benha University hospitals. Conclusion: Magnetic resonance imaging is the preferable method of choice for evaluating various hand and finger lesions in traumatic and non-traumatic condition if conventional radiography isn’t enoughhttps://bmfj.journals.ekb.eg/article_158373_3fae0cd10439ad240e81636d09a8b9d3.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Indications and Outcome of Admission of Patients with Diabetes Into Benha University Hospitals, Egypt: A Prospective Study.26627915837110.21608/bmfj.2021.49219.1341ENAmira MohamadyElsayeddepartment of internal medicine,faculty of medicine,Benha univeristyAyman MohamadElbadawydepartment of internal medicine,faculty of medicine,benha univerisityWalaa MohamadIbrahiminternal medicine department, faculty of medicine, benha univeisityMarwa Sallamainterenal medicine department,faculty of medicine,benha univeristyRasha OmarAbd El Monieminternal medicine department, faculty of medicine, benha univerisityJournal Article20201109Background:<br />Patients with diabetes have a 3-fold greater chance of hospitalization compared to those without diabetes. The risk factors for hospitalizations in diabetic patients constitute poor glycemic control, longer diabetes duration, and coexisting morbidity. Other factors include, old age groups, insulin use, hypoglycemia, presence of chronic renal insufficiency and diabetes-related hospitalizations in the preceding year are other important risk factors. Aim: Our aim of the study is to report the causes, patient characteristics, and outcome of admissions of diabetic patients to the wards and emergency unit of Benha university hospital Methods: The study included 260 patients with known history of type 1 or 2 DM who were admitted from the emergency department, outpatient clinic ,and other departments of the hospital.Demographic data and laboratory investigations were collected. Results: The study constituted mainly type 2DM (90.4%). The mean age of the study population was 57± 14 years, most of them were females (55.8%).The median duration of diabetes was 10 years.The most common reason for diabetes related hospitalizations were chronic complications of DM, whereas sepsis is the most common reason of non diabetes related .The mortality rate was 26.9%, of overall deaths, cardiovascular disease was the most frequent( 47.7%).Conclusion: The most frequent reason for hospitalization in diabetic related admissions was chronic complications of diabetes. Whereas, sepsis is the most common cause in diabetic non related admissions.Cardiovascular disease is still the main cause of death among diabetics.https://bmfj.journals.ekb.eg/article_158371_e99f725200ee9143aa81a76262e269d3.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401The Added Value of B-Flow Technique in Assessment of Lower Limb Arterial Lesions with Densely Calcified Atheromatous Plaques28029316116510.21608/bmfj.2021.38713.1304ENMahmoud ElShenawyRadiology Department, ElAgouza hospitalIslam MahmoudElshazlyRadiodiagnosis department , faculty of medicine , Benha university.Hesham El SayedEl SheikhRadiology department, faculty of medicine, Benha universityJournal Article20200810Aim: assess the added value of B-flow technique in assessment of lower limb arterial lesions in presence of densely calcified atheromatous plaques.<br /><br />Patients and methods: Our study included 30 cases, all have densely calcified arterial atheromatous plaques. All subjects were examined by CDU with spectral analysis and BFI; and the results were compared to the gold standard CTA.<br /><br />Results: BFI has higher discrimination than CDU in presence of densely calcified plaques at the femoral segments. It is also better in detecting sites of collaterals take-off at the infra-popliteal segments. However, extensively calcified plaques, depth and edema represent major limitations.<br /><br />Conclusion: B-flow has the potential to improve US imaging in patients with PAD. However, it is not free of limitations. As such, we do not encourage the use of B-Flow as a sole ultrasound imaging mode, but as a complementary technique to use in situations where CDU findings are inconclusive or unclear.https://bmfj.journals.ekb.eg/article_161165_5b838a3299d40d6a4ea5f355e4aae423.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401The possible therapeutic Effect of Mesenchymal Stem Cells and Vitamin E on Experimentally Induced Ulcerative Colitis in Adult Male Albino Rats: Histological and immunohistochemical study29432116336310.21608/bmfj.2021.24068.1215ENOmayma HelalDepartment of Histology and Cell Biology, faculty of medicine, Benha University, Egypt.Hala MetwalyDepartment of Clinical Pathology, Faculty of Medicine, Cairo University, Egypt.Maha Abo GaziaDepartment of Histology and Cell Biology, Faculty of Medicine- Kafr El Sheikh University. Egypt.Rania El DesokiDepartment of Histology and Cell Biology, faculty of medicine, Benha University, Egypt.Naira AshrafEl Ashmounyassistant lecturer of Histology and Cell Biology, Faculty of Medicine, Kafr El Sheikh University, EgyptJournal Article20200215Background:<br />Ulcerative colitis (UC) is one of the inflammatory bowel diseases (IBD) that results in recurrent inflammation and ulcers of the colon and rectum. <br />Aim:<br />The aim of the study was to explore the possible therapeutic effect of bone marrow-derived mesenchymal stem cells (BM-MSCs) and vitamin E on experimentally induced UC in rats.<br />Materials and methods:<br />Sixty rats were divided into four main groups: group I (control group); group II (UC) consisted of 10 rats that received a single intrarectal injection of 2 ml of 3% acetic acid; group ΙIΙ (10 rats) consisted of rats that received vitamin E three times in a week orally after induction of ulcerative colitis; group ΙV consisted of 10 rats that received a single injection of BM-MSCs after induction of ulcerative colitis ; and group V comprised 10 rats that received both vitamin E orally and BM-MSCs after induction of colitis. Colonic samples were examined using light and fluorescent microscopy. <br />Results:<br /><br />Group ΙI showed ulceration, loss of surface columnar epithelium, disturbed crypts architecture with few goblet cells and many cellular infiltrations. Group III showed a picture that was nearly similar to UC group. Group IV showed improvement in colitis. Group V showed a histological picture that was nearly similar to the control group. <br />Conclusions: <br />BM-MSCs represent future therapeutic hopes for chronic intestinal inflammatory states through their regenerative and anti-inflammatory effects. The combination of vitamin E and BM-MSCs was more effective and produced an additive effect than using bone marrow derived MSCs alone.https://bmfj.journals.ekb.eg/article_163363_cb9ef68bae2e4f0d4811b9781ce9b26c.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Comparison between induction of labor and expectant management in postdate pregnancy32233316139510.21608/bmfj.2021.67314.1399ENMahmoud DoniaDepartment of Obstetrics and Gynecology,
Shebin El-Kom Teaching Hospital, Menofuia,
EgyptJournal Article20210315Background: Post-date pregnancy is associated with increased perinatal morbidity and mortality. Therefore post-date pregnancy is considered as a high-risk condition which requires specialist surveillance and induction of labor at some stage<br />Purpose: to evaluate if a policy of induction of labor at 41 GW is superior, in terms of neonatal and maternal outcomes, as compared to expectant management in healthy women with a low risk singleton pregnancy.<br />Materials and Methods: a case control study. The study included 2 groups: group 1 (n = 50) including women who awaited for spontaneous labor till 42 weeks (expectant management); group 2 (n=50) including women who had induction of labor at 41+0 to 41+6 weeks. <br />Results: This study shows that MAS occurred in significantly more neonates in the expectant group as compared to the induction group. There were no significant differences between the two groups regarding APGAR score and other perinatal outcomes. Also, This study shows that the rate of CS was significantly higher in the induction group than in expectant group, also the need for analgesia was significantly higher in the induction group as compared to the expectant group.<br />Conclusion: it can be concluded that induction of labor at 41 completed weeks carries no increased risk of perinatal mortality or morbidity when compared to expectant management until 42 completed weeks. The policy of labor induction may be associated with an increase rate of CS and the need for analgesia.<br />Keywords: Post-date pregnancy – Induction of labor – post-Term pregnancyhttps://bmfj.journals.ekb.eg/article_161395_0e5a70466b0aee6f557c7fdbe6cb2060.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401The Relation between Serum Progranulin and Platelet Count in Immune Thrombocytopenia Patients.33434316131910.21608/bmfj.2021.60711.1376ENNoha MoustafaAttiamedical universityAdel MAghaclinical &amp; chemical pathology dep., Faculty of Medicine, Benha university , EgyptSafaa EbrahimAbasclinical & chemical pathology department,faculty of medicine , Benha university , Egypt.Ola SamirEl Shimiclinical & chemical pathology department,faculty of medicine, Benha university, Egypt.0000-0001-8276-8352Journal Article20210131Background: Immune thrombocytopenia (ITP) is an autoimmune disease with excessive platelet destruction and reduced platelet production. Progranulin (PGRN) has a protective effect against autoimmune diseases by competitive binding tumor necrosis factor-α receptors. Thus, we assessed the serum progranulin level in relation to platelet count in ITP patients, pre-and post-induction of corticosteroid therapy.<br />Methods: A case – control study was conducted on 30 ITP patients and 30 apparently healthy subjects serving as acontrol group. Platelet count and serum progranulin levels were measured in newly diagnosed ITP patients before and 3−7 days after starting corticosteroid treatment.<br />Results: The mean serum level of PGRN was significantly higher in ITP patients pre-treatment compared to healthy control subjects (Phttps://bmfj.journals.ekb.eg/article_161319_a0c7fd1db2859fb3ad38292fa1c0a087.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401The Role of Dynamic Subtraction MRI in assessment of reactivity of HFLs post TACE by 3 tesla MRI machine34435216628010.21608/bmfj.2021.50243.1345ENMedhat RefaatRadiodiagnosis and head of the department of Radiology, Faculty of medicine Banha UniversityWael ElshawafRadiodiagnosis and head of the department of Radiology, Faculty of medicine Banha UniversityShorouk ZakyAbdel Azizradiology departement,faculty of medicine, benha university, Egypt0000-0001-8283-2553Khalid ElsaiedDiagnostic &amp; interventional Radiology
Faculty of medicine Banha UniversityJournal Article20201118Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and has a poor prognosis unless treated. The aim of this work was to assess HCC cases after trans-arterial chemoembolization by subtraction dynamic contrast enhanced MRI to detect its accuracy, sensitivity and specifity in detecting residual tumor and assess the need for further treatment. Methods: 35 patients with 42 HCC lesions underwent transarterial chemoembolization were included in this study. Those patients underwent MRI after 3 months where dynamic MRI and subtraction dynamic MRI were obtained. The interpretation of dynamic MRI and the subtraction dynamic MRI was done by two different readers experienced in hepatic imaging blinded to each other. Patients were classified according to reactivity rate into 2 independent groups: Reactive group (30 patients), Not reactive group (5 patients). Results: Comparative study between D-MRI and DS-MRI assessments revealed; highly significant increase in reactivity rate in DS-MRI in HCC patients during 1st and 2nd readings; with highly significant difference (p = 0.0078 respectively). By using ROC-curve analysis, DS-MRI assessment discriminated patients with reactivity from patients without, with perfect accuracy, sensitivity= 100% and specificity= 100% (p < 0.0001). Conclusion: Dynamic MRI is valuable in detecting recurrent lesions however, this value is augmented by the addition of subtraction technique especially in lesions having high signal before administration of contrast medium.https://bmfj.journals.ekb.eg/article_166280_df6912c688a8123c9b5935d5ebccdd00.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Ultrasound Assessment of Diaphragmatic Thickness in Chronic Obstructive Pulmonary Disease Patients as a predictor for Disease Severity35336716336810.21608/bmfj.2021.62994.1384ENTarek SamyEssawychest department, faculty of medicine, Benha universityAbdelsadek HamedAl-AragChest department , faculty of medicine ,Benha universityHany Mousachest department, faculty of medicine , Kafrelsheikh universityMona ElsayedAbdelsattarchest department, faculty of medicine ,Kafrelsheikh universityRehab Elsawychest department, faculty of medicine , Benha universityJournal Article20210213Background and objectives: COPD patients usually had an imbalance in the load/capacity ratio of the respiratory muscles. This study aimed to use of ultra-sonographic (U/S) techniques for the assessment of diaphragmatic thickness of the diaphragm (TD) at different lung volumes in COPD patients, and its relation with severity of the disease.<br />Methods A Case control study conducted on 100 subjects at outpatient clinics of Benha University Hospitals and Kafrelsheikh University Hospitals during the period from (March, 2020) to (January, 2010); 80 patients with clinically stable chronic obstructive pulmonary disease (COPD), were diagnosed and classified into four groups according to GOLD 2020: Group A COPD): 20 cases, Group B COPD): 20 cases, Group C COPD): 20 cases, Group D COPD): 20 cases. U/S was used for assessment of diaphragmatic thickness (TD) and diaphragmatic thickness fraction (TF) at different lung volumes in COPD subgroups, and correlated with severity of the disease and 20 apparent healthy control group.<br />Results: In total 4 potentially relevant publications were included, the studies showed decrease in diaphragmatic thickness, thickness fraction and excursion in copd patients in comparison with normal subjects specially groups B and D COPD.<br />CONCLUSION<br /> Ultrasound is anon invasive, simple and available bedside diagnostic tool for outpatient clinic examination of COPD patients for severity detectionhttps://bmfj.journals.ekb.eg/article_163368_8b7789362c650da7e33302f7e8396955.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Pre-operative Assessment of the Size of the Herniated Lumbar Disc on MRI as Apredictor of Surgical Outcome36837916627810.21608/bmfj.2021.66486.1390ENHesham El Sayed El SheikhDepartment of Radiodiagnosis- Faculty of Medicine-Benha University.Ahmed DeabesNeurosurgery, Faculty of Medicine, Banha UniversityNour ZaghlolRadiodiagnosis, Faculty of Medicine, Banha UniversityEnas SweedRadiodiagnosis, Faculty of Medicine, Banha University0000-0001-9503-5318Journal Article20210306Background: Lumbar intervertebral disc herniation (LDH) are the most common source of lumbar radiculopathy. Magnetic Resonance Imaging (MRI) is considered the diagnostic imaging procedure of choice for LDH as it can provide exquisite morphologic detail of the disc abnormality. The aim of this study was to determine if baseline MRI findings including disc herniation size is associated with differential surgical treatment effect. Method: This study was conducted on Benha university hospitals on 36 patients who underwent lumbar discectomy to estimate the role of MRI as a predictor of surgical outcome (by comparison between Preoperative and postoperative leg and back pain scores, as well as functional status measured using the modified oswestry disability index (MODI). Results: The age of patients was (21-51) years, mean 36 and 22 patients (61.1 %) were males and 14 patients (38.9 %) were female, all patients suffered from Back and leg pain, 69.44% of them with lower extremity pain , Sciatica with 77.78% of them hypoesthesia and/or leg weakness was reported in 36.11% of cases. Conclusion: It can be concluded that MRI finding espicially disc size and disc height can predict the surgcail outcome. Patients with larger disc herniations, on average, may have a higher likelihood of experiencing superior clinical outcomes following discectomy. Additional findings seem to support that a patient’s preoperative functional score has the strongest influence on postoperative clinical outcome.https://bmfj.journals.ekb.eg/article_166278_bade8f29747fe6045c9c379936222e27.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401The value of urine Soluble Triggering Receptor expressed on Myloid cell-1 in early diagnosis of Sepsis associated Acute Kidney Injury38039415570610.21608/bmfj.2021.56361.1367ENMohamed AhmedElbazPediatric department;faculty of medicine;Benha University;QalyubiaEffat HusseinAssarPediatric department;faculty of medicine;Benha University;QalyubiaHeba MohamedSarhanPediatric department;faculty of medicine;Benha University;QalyubiaAyat HashimPediatric department;faculty of medicine;Benha University;QalyubiaJournal Article20210105Introduction<br />We explored the diagnostic value of a urine soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for early sepsis identification, severity and prognosis assessment, and for secondary acute kidney injury (AKI). We compared this with white blood cell (WBC) counts, serum C-reactive protein (CRP), urine output, creatinine clearance (CCr), serum creatinine (SCr), and blood urea nitrogen (BUN).<br />Methods<br />This case control study will be conducted on 50 critically ill children with sepsis admitted to PICU and 20 healthy children as control group.<br />Study group will be classified as follows :<br />I. Patients : <br />- group (A) : Septic patients with AKI<br />- group (B) : Septic patients without AKI<br />II. Control group (20) with the same age&sex<br />Results for urine Strem-1,CBC,CRB and S.Creatinine were recorded on day 1<br />Results<br />There were no significant differences between all groups as regard age & gender. P values were 0.43 & 0.709 respectively<br />sTREM-1 showed overall significant difference between all groups (P valuehttps://bmfj.journals.ekb.eg/article_155706_0a85f3f6bda36ee387389adf7746e38a.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Prevalence and Risk Factors of Occult Hepatitis C Virus infection in One Tertiary Egyptian Centre39540616773310.21608/bmfj.2021.167733ENMaha HabeebDepartment of internal medicine (Hepatology and Gastroenterology), Mansoura UniversityAbd-Elmohsen EldesokyDepartment of internal medicine (Hepatology and Gastroenterology), Mansoura UniversityMysaa ZakiDepartment of clinical pathology, Mansoura University Faculty of Medicine, EgyptMona ArfaDepartment of Tropical medicine , Mansoura University Faculty of Medicine, EgyptDina ElhamadyDepartment of Tropical medicine , Mansoura University Faculty of Medicine, EgyptMohamed ElegezyDepartment of Tropical medicine , Mansoura University Faculty of Medicine, EgyptJournal Article20210430<strong>Background: </strong>Occult hepatitis C infection (OCI)is a new form of hepatitis C virus (HCV) in which HCV-RNA is present in hepatocytes or peripheral blood mononuclear cells(PBMCs)with undetectable plasma HCV-RNA , regardless of hepatic transaminase elevation. <strong>Aim: </strong>To find out prevalence of OCI infection in patients with anti HCV antibodies positive regardless to their transaminases and to study possible risk factors for OCI <strong>Patients and Methods: </strong>The current study included 100 patients in which HCV antibodies were detected by ELISA and HVC-RNA were examined in serum and PBMCs by real time polymerase chain reaction (PCR). <strong>Results: </strong>OCI was detected in 14 % of enrolled patients. Having BMI ≥35.5kg/m<sup>2 </sup>demonstrating 5-times higher odds of exhibiting OCI in females while male sex had 10-times higher odds. <strong>Conclusions and Recommendations :</strong>Prevalence of OCI was 14% in anti HCV positive patients regardless hepatic transaminases level among them, obesity and male sex considered the main risk factors in this study, more studies on bigger number of patients are required.https://bmfj.journals.ekb.eg/article_167733_00a6a80d7ed31adacdd5b9893e81931d.pdfBenha University, Faculty of MedicineBenha Medical Journal1110-208X38120210401Role of NBI and WLE in diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux disease40741816103510.21608/bmfj.2021.51085.1348ENEnass AMEBarakatMansoura University Faculty of Medicine Internal Medicine Department Gastroenterology and Hepatology UnitMaha HabeebMansoura University Faculty of Medicine Internal Medicine Department Gastroenterology and Hepatology UnitNeven FaroukAbbasMansoura University Faculty of Medicine Internal Medicine Department Gastroenterology and Hepatology UnitJournal Article20201125Abstract:<br />Background: Recent data have emerged that a targeted biopsy technique using Narrow-Band Imaging (NBI) could be considered in patients undergoing surveillance for Barrett’s esophagus (BE).<br />Aim of the study: to determine the role of NBI versus conventional- white light endoscopy (WLE) in diagnosis of Barrett’s esophagus<br />Subjects and methods: the study included 274 patients with chronic reflux symptoms, conventional- white light endoscopy (WLE) was done in all cases for diagnosis of BE, 4-random biopsies were taken and examined by histopathology for detection of columnar-lined intestinal metaplasia, patients tested negative were re-examined by NBI and targeted biopsy were taken in patients for confirmation of presence of intestinal metaplasia.<br />Results: 90 patients had columnar-lined epithelium (CLE) by WLE (32.8%); Seventy- three patients with 4 quadrant biopsy technique confirmed to have intestinal metaplasia (81.1% of cases with endoscopic BE, and 26.6% of all screened patients), 17 patients with negative histopathology for BE were re-examined endoscopically and NBI - targeted biopsies were taken, 7 patients of them showed intestinal metaplasia, so total patients confirmed to have BE has risen to 80 patients (88.9%).<br />Conclusion: NBI- targeted biopsies could diagnose BE in patients tested negative by WLE taken biopsieshttps://bmfj.journals.ekb.eg/article_161035_7ad8541c227035004c51199c20f9f77b.pdf