The Medical Journal of Cairo University

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EISSN : 2536-9806
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M.D.; Safaa M. Abdelrahman Abdelrahman A. Abdelrazek, M.D.; Iman E. Abdel Meguid Rania M.H. Elkafase, M.Sc. Zeinab A. El-Sayed
The Medical Journal of Cairo University, Volume 89, pp 1907-1916; https://doi.org/10.21608/mjcu.2021.203302

Abstract:
Background: Congenital anomalies comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. Congenital anomalies defined as structural changes that have significant medical, social or cosmetic consequences for the affected individual, and typically require medical intervention. Three to seven percent is the estimated worldwide incidence of congenital anomalies, with 295000 newborns die within 28 days of birth every year worldwide due to congenital anomalies. Aim of Study: This study aims to detect the incidence of congenital anomalies in neonates admitted in Neonatal Inten-sive Care Units, Cairo University in the year 2014 and the associated risk factors present in their parents. Patients and Methods: We retrospectively reviewed the records of neonates having congenital anomalies admitted in Neonatal Intensive Care Units, Cairo University Children Hospital over one year from January 2014 to January 2015. Our collected data include full history with pedigree, full clinical examination and investigations. Results: 1105 neonatal 's records collected from Neonatal intensive care units, Cairo University for one year, four hundred sixty five (42%) of them having congenital anomalies, with high mortality (30.5%) from congenital anomalies, consanguineous marriage represent with 28.8%. Gastrointes-tinal tract anomalies are the most common congenital anom-alies (48.6%) followed by cardiovascular system (24.3%) respiratory system (4.3%) urinary and genetic causes (1.9%), mothers have chronic illness represent (10.3%) with eight% took drug during pregnancy. Conclusion: We found that there is high incidence of congenital anomalies in our Neonatal Intensive Care Units this is mostly related to that we are tertiary referral center and also most of these cases collected from surgical unit and need surgical interference and related to high incidence of consanguineous marriage. Congenital anomalies can contribute to long-term disabil-ity, which may have significant impacts on individuals, families, health-care systems and societies. The exact causes of congenital anomalies cannot be identified so close follow-up of pregnant women is highly indicated. Some congenital anomalies can be prevented. For example, vaccination, adequate intake of folic acid or iodine during pregnancy and adequate antenatal care are keys for prevention.
M.D.; Yasmin M. Aboul-Ela Ahmed N. Hassan, M.Sc. Mennatallah A.A. Shetaya
The Medical Journal of Cairo University, Volume 89, pp 1961-1966; https://doi.org/10.21608/mjcu.2021.203328

Abstract:
Background: Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2). Aim of Study: Our study was conducted to assess serum zinc level before and after low carbohydrate diet program over 40 days. Patients and Methods: The study included 30 overweight and obese students with age range from (20-26 years) 22 females and 8 males selected randomly from Faculty of medicine Ain Shams University during 2019-2020 after ex-clusion of students with body mass index below 25kg/m2 and students with constipation, fatigue, diarrhea, heartburn, gas, nausea, vomiting, appetite changes or headache. Results: Serum zinc levels in overweight and obese students were low, most of participants have zinc deficiency which improved with the decrease of BMI after low carbohy-drate diet program this ensures that serum zinc levels affected by body weight and body mass index. Our single arm open label clinical trial showed that serum zinc level improved with decrease in body mass index among overweight and obese medical students after applying low carbohydrate diet program over the same period of time. Conclusion: Taken together the benefits of carbohydrate restriction in overweight/obese patients and the altered serum zinc levels in these patients, it was tempting to further serum zinc levels before and after low carbohydrate diet in overweight and obese youth, where to our knowledge, this is the first clinical study targeting this subject in Egypt.
The Medical Journal of Cairo University, Volume 89, pp 2093-2101; https://doi.org/10.21608/mjcu.2021.203432

Abstract:
Background: Although the acute symptoms of COVID-19 have been widely described, the longer-term effects are less well known because of the relatively short history of the pandemic. Theories attributed those symptoms to chronic inflammation (fatigue), sequelae of organ damage (pulmonary fibrosis and chronic kidney disease) and hospitalization and social isolation (muscle wasting and malnutrition). Aim of Study: The study aimed at determining the fre-quency of persistent post-COVID-19 symptoms among sur-vived COVID-19 patients, clarifying the relation between this frequency and the degree of disease severity and spotlighting some of the factors that might influence it. Patients and Methods: This case control study was carried out during the period from March 2021 to June 2021. It included 103 subjects from the medical staff of Bab Al-Sha'reia University Hospital and their relatives, diagnosed 13-16 weeks ago to have COVID-19 infection by positive reverse transcription real-time polymerase chain reaction (rt RT-PCR) test in their respiratory tract swabs. They were communicated either directly or through phone. Forty sex, age and body mass index (BMI) matching individuals, chosen from the medical staff of the hospital, with no history sug-gesting COVID-19 infection, tested negative for COVID-19 IgG and IgM by rapid test, served as a control group. Results: The frequency of persistent post-COVID-19 symptoms among COVID-19 survivors was 41.75%. Fatigue was the most frequently reported symptom (38.83%), followed by dyspnoea and musculoskeletal pain (25.24%). Fatigue, headache, musculoskeletal aches, cough and dyspnoea were significantly more frequent among hospitalized subjects compared with home-managed ones. Dyspnoea was the only symptom to show a significant frequency among ICU individ-uals (p-value=0.015). As well, statistically significant higher BMI and prolonged duration of hospital stay were reported among individuals managed in the ICU when compared with the ward participants. Patients with post-COVID syndrome (PCS) were significantly older than non-symptomatic individ-uals (p-value <0.0001), with higher rates of co-morbidities (p-value=0.001). Hypertension was the only co-morbidity that reported a discrete significant higher frequency among post-COVID-19 patients (p-value=0.003). Hospitalization, length of hospital stay, requiring oxygen therapy and receiving either NIV or MV were all significantly linked to the devel-oping of persistent post-COVID-19 symptoms. Conclusion: Persistent post-COVID-19 symptoms are common among COVID-19 survivors. Older patients and those with co-morbidities (especially hypertension) are more liable to have PCS. Many factors including hospital admission, longer hospital stay, the need for oxygen therapy, NIV or MV are associated with persistent post-COVID-19 symptoms.
M.D.; Ayman M. Mansour Sherief N. Amin, M.Sc. Ahmed S. Moustafa Hamada M. Abdelaal
The Medical Journal of Cairo University, Volume 89, pp 2023-2033; https://doi.org/10.21608/mjcu.2021.203337

Abstract:
Background: Scaphoid nonunion result in a predictable pattern of wrist arthrosis. To minimize the incidence of arthrosis, the goal of treatment should be consolidation of the fracture of the scaphoid in anatomic alignment. Aim of Study: To evaluate different means of treatment of scaphoid nonunion and evaluate its clinical results. Patients and Methods: This study was conducted at EL-Helmya Military Hospital and Kasr El-Ainy Hospital during the period from 2011 to 2016 on fifty patients diagnosed as non-united fracture scaphoid and operated upon by fixation and graft if needed, then followed-up for a period of at least 18 months. Patients were 49 male and one female with an average age of 23 years. All operative management and follow-up. Results: This study proved that operative treatment of scaphoid nonunion can be summarized as follows: Grade I,II,III according to Slade and Geissler`s classification can be treated by percutaneous or open fixation by Herbert screw even if the nonunion in prox. Pole. Grade IV/V/VI we have to open volarly for waist or dorsally for prox. Pole and fixation with bone graft from iliac crest or distal radius. Conclusion: This study proves that the goal of treatment of scaphoid nonunion should be consolidation of the fracture in anatomic alignment. scaphoidnonunions with severe collapse and humpback deformity must be approached volarly with interposition of an intercalary bone graft and internal fixation. A dorsal approach to proximal scaphoid nonunions allows immediate access for removing the necrotic bone from small proximal pole nonunions and internal fixation.
M.D.; Yasir A. Radwan Wesam G. EL Inani, M.Sc.; Hamada M. Abd Elaal Ahmed S. Moustafa
The Medical Journal of Cairo University, Volume 89, pp 2007-2014; https://doi.org/10.21608/mjcu.2021.203335

Abstract:
Background: Acute compartment syndrome of the leg may be a devastating complication of a tibial fracture. Metic-ulous and repeated examinations of the patient who has such a fracture are needed to ensure the diagnosis of acute com-partment syndrome (ACS). A.C.S. remains challenging in many patients although the "5 Ps" of compartment syndrome; pain, pallor, paralysis, pulselessness, and paresthesia. Aim of Study: To measure intra-compartmental pressure in different compartments in the lower leg in tibial fractures and to correlate it with common clinical findings found in acute compartment syndrome in trial to early detect acute compartment syndrome and to decrease its devastating com-plications and rate of fasciotomy. Patients and Methods: This study was conducted on 100 patients referred to the Emergency department having Tibial fracture predisposed to have acute compartment syndrome by measuring intra-compartmental pressure instrumentally using stryker intra-compartmental pressure monitoring system and correlated with clinical picture and detect the percentage of patients need fasciotomy. Results: The Stryker intra compartmental monitoring system (STIC catheter) has accuracy and easy to measure intra-compartmental pressure and helps us to early detect A.C.S. in the lower leg also to decrease rate of fasciotomy and complications but it is expensive and needs proper training to use it. Conclusion: The patient who undergoes fasciotomy re-quires a physical therapy program to regain function. Postop-erative care and rehabilitation are just as important as the procedure itself.
M.D. Mohamed M. Khalifa
The Medical Journal of Cairo University, Volume 89, pp 1929-1933; https://doi.org/10.21608/mjcu.2021.203306

Abstract:
Regular physical exercise is a well-known mechanism for preventing and treating several health conditions, from the general improvement of the overall health condition and the prevention of obesity and increasing the arterial collater-alization and blood flow to the upregulation of antiinflamma-tory and antioxidant signaling cascades. The beneficial effects of regular physical exercise are far-reaching and diverse. Chronic neurological disorders are considered a significant public health concern. Given the fact that the available treat-ment modalities in most neurological conditions are not fully curative and aiming primarily at improving the quality of life and the ability to cope, with a wide side effect profile of the available medications to the high cost of other available methods as electric stimulation devices, this highlight the importance of investigating the beneficial roles of regular physical exercise, both as a preventive and a curative tool, indifferent chronic neurological diseases. This short review of the literature highlights the recent research finding and mechanisms of the beneficial effects of exercise in different chronic neurological diseases.
M.D.; Hedy A. Badary Mohamed B. Hashem, M.D.; Sherif Hamdy Ismail Anwar, M.D.; Iman Hamza Mohammad S. Abdelbary
The Medical Journal of Cairo University, Volume 89, pp 1839-1842; https://doi.org/10.21608/mjcu.2021.203260

Abstract:
Background: The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on the daily practice of gastrointestinal endoscopy all over the world. Most endoscopy units had to undergo major adjustments including reducing the numbers of personnel, trainees and postponing a large proportion of endoscopic procedures. We hereby report the daily experience from 15th of March to 15th of July 2020 of Kasr Al Ainy Cairo University Hospital Endoscopy unit during the COVID-19 pandemic pre-peak and peak phases in Egypt. Aim of Study: To study the implications of COVID-19 on the endoscopy unit daily practice and exhibiting the precautions adopted to minimize the risk of exposure to infection. Patients and Methods: We retrospectively analysed the number of procedures done during the peak of the 1st wave of COVID-19 pandemic in Egypt as well as precautions used in the endoscopy setting and a comparison was made with the number of procedures done over the previous 4 months and during the same period in 2019. Results: During the lockdown, upper endoscopies and colonoscopies accounted for the major differences in number of procedures in comparison to the previous four months prior to the lockdown. On the other hand, the rate of endoscopic biliary drainage did not differ significantly. Conclusion: During the global COVID-19 pandemic, reorganization of the workflow and the service provided by Kasr Al-Ainy Cairo University hospital endoscopy unit was deemed necessary. Through implementation of strategies aiming at proper patient selection and risk assessment, effi-ciently reducing the number of working staff, putting off training programs, and applying strict infection control meas-ures, we were able to safely traverse the peak phase of the pandemic in Egypt.
M.D.; Hanaa A. Ahmed Mona A.M.A. Nagi, M.Sc. Dhurgham Hayder Wali
The Medical Journal of Cairo University, Volume 89, pp 1935-1943; https://doi.org/10.21608/mjcu.2021.203307

Abstract:
Background: Urinary bladder cancer is the fourth com-monest among males and the tenth among females. It has a high recurrence rate necessitating proper initial management. MRI is a very valuable imaging tool with high tissue contrast and multi-planar imaging abilities thus allowing better tissue characterization. Aim of Study: Is to evaluate the value of diffusion weighted magnetic resonance imaging (MRI-DWI) in the diagnosis and staging of urinary bladder carcinoma, with pathological diagnosis taken as the reference. Patients and Methods: In this study, 40 patients with suspected urinary bladder masses performed pelvic MR im-aging. All patients were scheduled for variable MR sequences including T2WIs and DWIs. Results: Regarding the detection of urinary bladder car-cinoma the sensitivity, specificity, and accuracy for differen-tiating superficial from invasive tumors using T2 images alone and combined use of T2 and DW images were 62.5%, 66.7%, 63.2% and 100%, 100%, 100% respectively. Conclusion: DW-MRI is a safe, quick accurate sequence that can accurately detect and local stage urinary bladder carcinoma. In addition, DW images can predict the histological grade of the tumor decreasing the need for biopsy.
M.D.; Tamer EL Banna Mohamed Makram
The Medical Journal of Cairo University, Volume 89, pp 2089-2092; https://doi.org/10.21608/mjcu.2021.203397

Abstract:
Background: Coronary angiography via TRA approach (TRA) has gained growing acceptance and operator preference in recent years, based on a reduction in vascular complications and mortality. Aim of Study: This study was aimed to Compare left radial versus femoral artery approach during coronary angiography in patients post CABG especially in fluoroscopy time and contrast amount. Patients and Methods: Our study was a single center, retrospective cohort study was done on 100 patients to compare procedural variables especially fluoroscopy time and contrast amount of TRA versus TFA catheterization in patients who had previously undergone CABG surgery. In the period be-tween February 2020 and February 2021, 100 patients who had previously undergone CABG surgery and had received diagnostic or interventional cardiac catheterizations at our institute were included in the study population. Results: Our results observed in Table (1) cleared that, the number of male patients in TFA access group was 35 (70%), while, the number of males in TRA group was 37 (74%). Conclusion: Our study concluded that the fluoroscopy time and contrast amount were of lower levels in the TRA access than TFA access.
M.Sc.; Faten Hassan Abdelazeim Nada Elgharieb
The Medical Journal of Cairo University, Volume 89, pp 1973-1977; https://doi.org/10.21608/mjcu.2021.203330

Abstract:
Background: E-learning is the use of electronic devices to conduct teaching synchronously or asynchronously, that allow students to learn from different places especially during pandemic COVID 19. Aim of Study: This study aims to find out which form of e-learning synchronous or asynchronous practical training more effective to acquire knowledge and skills for pediatric physical therapy students. Patients and Methods: Seventy-five undergraduate (5th grade and internship) students selected randomly from different universities, students randomly allocated in two groups, thirty seven students in group A receive synchronous e-learning through zoom life session, thirty eight students in group B receive asynchronous e-learning through recorded video, students knowledge and skills assessed by online quiz designed on Google forms platform, the study carried out from December 2020 to April 2020. Result: There was a significant increase in the quiz total score of group B compared with that of group A (p=0.003) (p < 0.05). Conclusion: The result suggested that asynchronous e-learning is more effective than synchronous e-learning to acquire knowledge and skills for pediatric physical therapy students.
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