Objective: This is a retrospective study comparing between Furlow and Pharyngeal Flap techniques in treatment of velopharyngeal insufficiency regarding complications and resonance outcomes (including hypernasality, articulation errors, air emission, speech intelligibility). Patients and Methods: Twenty eight patients were operated for correction of velopharyngeal insufficiency between April 2010 and July 2012. Patients fulfilled two criteria; velopharyngeal dysfunction unresponsive to speech therapy and a moderate (40-50 percent) coronal gap on nasopharyngoscopy. Sixteen patients were subjected to Furlow technique and twelve patients to pharyngeal flap technique. All patients were evaluated preoperatively and 7 to 10 days post-operatively to evaluate the organic aspect then 2 to 6 months postoperatively with perceptual speech analysis and flexible fiber-optic nasopharyngoscopy. The patients were assessed for resonance rating to be compared with preoperative one. Results: Both Furlow and pharyngeal flap have a significant effect on treatment of hypernasality. Pharyngeal flap has a significant effect on management of pharyngalization of fricatives and facial grimace. Furlow has a significant effect on treatment of regurgitation. No significant difference was observed between Furlow and Pharyngeal flap techniques regarding complications and resonance outcomes. Conclusion: Pharyngeal flap technique and Furlow double opposing Z plasty technique, both are effective in treatment of hypernasality and have no significant difference in the postoperative resonance outcome and rate of development of postoperative complications when used for management of velopharyngeal insufficiency.
Surgical outcomes for rhinogenic contact point headache. /
قطاع الدراسات الطبية / أنف وأذن
تخصص البحث : أنف وأذن
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 12
د/ ياسر عبدالوهاب محمد خليل( 106580804 )
Headache- Rhinogenic headache- Contact Headache Patients and methods: This study included 30 patients with rhinogenic headache for more than one year and diagnosed to have sinonasal anatomical variations as deviated nasal septum and concha bullosa. 5 cases were excluded from the study, these patients refused surgery. 25 patients (83%) who their ages ranged from 19 to 43 years were included in this study. 14 patients were males (46%) and 11 were females (36%) were included in this study. Results: multiple anatomical variations were noted by endoscopy and CT scans in thirty patients. These variations included septum deviation in 22 patients (88%) followed by concha bullosa in 11 patients (44%) then hypertrophied inferior turbinate in 5 patients (20%). In these 25 patients, 21 cases (84%) showed complete cure, while 4 cases (16%) showed improvement only. Conclusion: Minor intranasal anatomical variations may be the cause of primary headache misdiagnosed as a headache of unknown etiology. The nasal surgeries in our study has succeeded in eliminating or significantly reducing such headache attacks.
Objective: this study aimed to investigate the role of some anatomical variations in rhinogenic headache and to evaluate the role of surgery in management of this headache. Patients and methods: This study included 30 patients with rhinogenic headache for more than one year and diagnosed to have sinonasal anatomical variations as deviated nasal septum and concha bullosa. 5 cases were excluded from the study, these patients refused surgery. 25 patients (83%) who their ages ranged from 19 to 43 years were included in this study. 14 patients were males (46%) and 11 were females (36%) were included in this study. Results: multiple anatomical variations were noted by endoscopy and CT scans in thirty patients. These variations included septum deviation in 22 patients (88%) followed by concha bullosa in 11 patients (44%) then hypertrophied inferior turbinate in 5 patients (20%). In these 25 patients, 21 cases (84%) showed complete cure, while 4 cases (16%) showed improvement only. Conclusion: Minor intranasal anatomical variations may be the cause of primary headache misdiagnosed as a headache of unknown etiology. The nasal surgeries in our study has succeeded in eliminating or significantly reducing such headache attacks.
HISTOLOGICAL, IMMUNOHISTOCHEMICAL AND BIOCHEMICAL /
قطاع الدراسات الطبية / الصيدليه السريريه
تخصص البحث : الصيدليه السريريه
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 14
محمـد أحمد عبد الفتاح عطية المهدى
Clinical Pharmacology, Biochemistry and Histology
Background: Diabetes mellitus and its complication have reached epidemic proportions worldwide. Exenatide is one of glucagon -like peptide-1 (GLP-1) receptor agonists. It is the synthetically derived peptide of exendin-4. It has been shown to improve glycemic state in patients with type 2 diabetes. The aim of the work was to study the effect of exenatide on islets of Langerhans of diabetic adult male rats based on histological, immunohistochemical and biochemical study.Materials and Methods: 30 adult male albino rats were divided into four groups; the 1st group was –ve control, the 2nd group was given exenatide at a dose of 2 ,g/ kg twice daily by S.C route and served as +ve control. The 3rd group was given streptozotocin (STZ) as a single dose of 60mg/ kg I.P to induce diabetes. The 4th group was given exenatide, 4 days after administration of STZ. Blood glucose level was estimated daily and after one week, serum glucagon- like peptide (GLP-1) and insulin levels were also measured. Sections of pancreas were prepared and stained with H&E, Masson trichrome and immunohistochemical staining of B- cells by anti-insulin antibody. The density (area %) of anti-insulin antibody reaction and number of B- cells were studied. Results of diabetic group (GIII) showed marked degenerative and apoptotic changes of cells mostly in the centers of islets with insulinitis. Also deposition of connective tissue around and in between islets cells was seen. Moreover, there was reduction in area % of anti-insulin antibody reaction and number of B- cells. Biochemical results showed elevation of blood glucose level, reduction of insulin level and non significant change of GLP-1 level compared to control group (G1). Administration of exenatide resulted in improvement of morphological picture of islets cells mainly of Bcells. Moreover, the previously mentioned morphometric parameters detected significant increase. There was lowering of blood glucose level, elevation of insulin level and non significant change of GLP-1 Level. Conclusion: It is concluded that exenatide is effective drug in reducing the degenerative changes of B- cells associated with diabetes mellitus. This could be explained by the agonistic activity of exenatide on GLP-1 receptor producing GLP-1 mimetic effects. Such effect makes this drug a beneficial drug to be used in diabetic patients. .
HARMONIC SCALPEL TONSILLECTOMY VERSUS COBLATION TONSILLECTOMY /
قطاع الدراسات الطبية / أنف وأذن
تخصص البحث : أنف وأذن
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 8
Magdy A. Salama
tonsillectomy; Harmonic scalpel, Coblation
OBJECTIVES: To determine if there was a difference between harmonic scalpel tonsillectomy and coblation tonsillectomy in terms of morbidity and operative time in children. STUDY DESIGN AND SETTING: A prospective single-blind randomized controlled trial comparing harmonic scalpel and coblation tonsillectomy in children aged between 5 and 15 years who underwent tonsillectomy for recurrent acute tonsillitis. RESULTS: One hundred and fifty children were included in this study. Patients completed the pain and dietary scales. The average operative time was less in harmonic scalpel tonsillectomy (P<0.05). The post-operative pain was lower in harmonic scalpel group in the 1st, 2nd and 3rd post-operative days and it was found statistically significant (P < 0.001, 002 and 0.012, respectively). The intra-operative blood loss was 2.40 ± 3.42 ml for Harmonic scalpel and was 3.43± 3.42 ml (P>0.05, not significant). Similar rates of nausea and vomiting were detected among our patients. CONCLUSION: We can conclude that the harmonic scalpel instrument is safe, very effective, with minimal intra-operative blood loss and with less post-operative pain. So, the use of the harmonic scalpel for tonsillectomy may have several advantages over standard methods and coblation tonsillectomy.
SENTINEL LYMPH NODE IDENTIFICATIONS IN PAPILLARY THYROID CANCER. /
قطاع الدراسات الطبية / أنف وأذن
تخصص البحث : أنف وأذن
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 12
د/ عصام عبدالونيس بحيرى( 122160184 )
CLND, Otolaryngology
Background:- Cervical lymph node metastases are very common in patients with papillary thyroid cancer (PTC). The sentinel lymph node (SLN) is defined as the first draining lymph node in the lymphatic basin into which the primary tumor drains. The pathological status of SLN actually reflects the histology of the remaining regional lymphatic and extension of the primary tumor and so presence or absence of the SLN determines whether neck dissection of the regional lymphatic is indicated or not. Also neck dissection in patients with papillary thyroid carcinoma (PTC) is a matter of controversy because it depends mainly on expectation not actual lymphatic spread of the tumor. although PTC has an excellent prognosis, lymphatic spread is associated with increased risk of loco-regional recurrence, which significantly impairs quality-of-life and can alter prognosis of the patient. Therefore, the identification of lymph node metastases preoperatively is very important for the surgeon to plan the optimal surgical therapy for the individual patient. also study of SLN in patients with PTC is true and recent advance in the management of PTC. Our aim is to study the feasibility of sentinel lymph node identifications in patients with PTC and its influence in modifying the surgical management of lymph node metastases. Patients & methods - Over the period from May 2010 to March 2013, 12 patients had PTC by FNAC were enrolled in this study .Metheline blue dye was injected in the primary site of the thyroid tumor via thyroidectomy approach with special precautions. After SLN identification ,histopathological analysis were done included microscopic examination and histological grading. Results-from the 12 patient enrolled in the study, we were able to identify sentinel lymph node in 10/12 cases (83.3%).with true + VE 7/12 and true – VE1/12 the mean number of sentinel lymph nodes were 2 (range 1-3).The histopathological study reveals 7/12 true positive patients with cancer cells in the SLN obtained and only 1/12 true negative patients with no cancer cells in in the SLN obtained ,there is 3/12 false +ve and 1/12 false negative patients. micrometastases was detected in 7/12 patients and occult micrometastases was detected in3/12 patients. Conclusions- This study showed that SLN was feasible, repeatable and accurate and reduced false negative rates and increased detection rates of lateral neck sentinel lymph nodes. The main value of sentinel lymph node identification is to avoid unnecessary neck dissection It helps to select patients for compartment neck dissection to avoid unnecessary neck dissection and possible morbidity. also it helps to select patients indicated or not indicated for ablative I 131 with accuracy. it helps to identify lymph node drainage outside the central compartment with appropriate approach and extent of surgery. Also it is cheap, easy ,safe, and can be performed in the same site and time of the procedures planned. Further well designed randomized studies are necessary to validate and further optimize the SLN identification in patients with PTC.
Usual ocular presentations as unusual paranasal Sinus presentations /
قطاع الدراسات الطبية / أنف وأذن
تخصص البحث : أنف وأذن
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 8
د/ عصام عبدالونيس بحيرى( 122160184 )
Background:- Ocular manifestations without sinonasal symptoms can cause perplexity and delayed presentations in patients with paranasal sinus pathology. So the aim of this study was to study the value of ordinary ocular complains in patients without typical paranasal sinus symptoms and to discuss the possible mechanisms and prognosis of such patients. Methods:- Retrospective study on 476 patient complaining from usual ocular symptoms but ophthalmic examination were free referred for otorhinolaryngology consultations, 31 patients (6.5%) selected had an ophthalmic complains without ordinary sinonasal symptoms but with pathology involving the paranasal sinuses discovered accidentally after diagnostic nasal endoscopy and C.A.T to exclude paranasal sinus disorders.Patients underwent symptoms anamnesis, ophthalmic and otolaryngological examination including diagnostic nasal endoscopy and computed tomography (CT) scan. Effect of treatment on patient symptoms was also analyzed. RESULTS: Ocular symptoms and signs presentations were orbital pain in all patients (100%); proptosis (n=8; 25.8%), blurred vision (n=16;51.6%); impairment of ocular mobility (n=3, 9.6%); ptosis(n=1;3.2%) and epiphoria (n=2;6.4%). Paranasal sinus pathology was observed on the anterior group of sinuses (maxillary and or frontal and anterior ethmoids (n =16; 51.6%), posterior group(sphenoid and /or posterior ethmoids (n=10, 32.2%), and both sides (n=5, 16.1%). Endoscopic sinus surgery were done for all patients Ophthalmic complaints disappeared in (67.7%), improved in (22.6%) with total success of (90%). Conclusion: with absence of usual paranasal sinus symptoms, patients with orbital pain, proptosis and visual acuity changes must be referred early for otorhinolaryngology consultations. Visual acuity changes and direction of proptosis can direct attention to paranasal sinuses involved (i.e. anterior or posterior).
Otorhinolaryngology, (i.e. anterior or posterior).
The most known risk factor for nonalcoholic fatty liver disease (NAFLD) is the metabolic syndrome. In this study, we characterized changes in liver pathology, hepatic lipid composition, and plasma biochemistry occurring in rats given fructose-enriched diet 10% (FED). Rats were given FED or standard rat chow for 5 weeks. Rats on FED were divided into 2 groups: One group of rats was fed FED only for 5 weeks and another group of rats was received metformin 50 mg/kg for the last 2 weeks (2 weeks FED + 3 weeks FED and metformin). FED rats had developed hepatic macrovesicular and microvesicular fat deposits, with increase in hepatic triglycerides (+198%) and hepatic cholesterol (+89%), but a decrease in hepatic phospholipids (-36%), hypertriglyceridemia (+223%), and hypertension (+15%) . Also, in FED rats there was significant increase in serum cholesterol and serum glucose (100.6±2.5 , 9.0±0.4 respectively) , and signifcant increase in hepatic MDA and TNF-? (209.9± 43.9 , <12.5 respectively). Metformin reduced blood pressure (-24%), serum triglycerides (-36%), hepatic triglycerides (-51%), hepatic macrovesicular fat (-51%) and increased Hepatic phospholipids (+37%). Also, signifcant decrease in hepatic MDA and TNF-? (150.1± 27.0 , <10.5 respectively). In conclusion: Metformin could reduce most of biochemical and tissue parameters and also improve the histopathological features of liver asscociated with non alcoholic steatohepatitis in rats.
Objective To detect the expression of the PASD1 gene in acute myeloid leukemia (AML) patients and its relation to clinical features and complete remission of AML. Background AML is a heterogeneous disease with variable clinical outcomes. PASD1 [Per ARNT Sim (PAS) Domain containing protein 1] can stimulate autologous T-cell responses, and it is therefore considered to be a potential immunotherapeutic target for the treatment of various malignancies, including AML. Materials and methods The study was carried out on 60 AML patients (group I) and 30 healthy controls (group II). Reverse transcriptase PCR analysis of the PASD1 gene was carried out for all patients and controls. Results PASD1 was expressed in 12 (20%) AML patients, but was not expressed in any of the 30 controls. PASD1 expression was associated more with patients below 45 years (66.7% of the PASD1-positive patients were <45 years old compared with 29.2% of the PASD1-negative patients). No significant correlation was found between PASD1 gene positivity and any of the clinical and hematological variables of AML, except for less incidence of fever at presentation. PASD1-positive patients achieved more complete remission (66.7%) compared with PASD1-negative patients (35.4%) (Po0.05). Conclusion PASD1 is an attractive leukemia-associated antigen. Its expression was associated with young age and favorable outcome. However, further studies are required, with standardization of the age, clinical, and cytogenetic and molecular genetic prognostic markers, to confirm the prognostic value of PASD1 gene expression in AML, to assess its correlation with clinical features of AML patients, and to investigate its role in minimal residual disease detection and immunotherapy of AML.
Fibroblast growth factor 23 as a risk factor of left ventricular hypertrophy and vascular calcification in predialysis chronic kidney disease patients /
قطاع الدراسات الطبية / الباطنه العامه
تخصص البحث : الباطنه العامه
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 04/12/2013
عدد صفحات البحث 11
أ/ حسن عبدالهادى أحمد عطية( 105245473 )
abdominal aortic calcification, chronic kidney disease, fibroblast growth factor 23, left ventricular hypertrophy, left ventricular mass index
Objective The objective of this study was to evaluate the possible role of fibroblast growth factor 23 (FGF23) in the occurrence of left ventricular hypertrophy and vascular calcification in predialysis chronic kidney disease (CKD) patients. Background FGF23 is a suggested risk factor for poor outcome of CKD. This raises the possibility that FGF23 is a hormone that controls calcium–phosphorus metabolism and is a real risk factor for cardiovascular mortality and morbidity in predialysis CKD patients. Materials and methods Thirty predialysis CKD patients with estimated glomerular filtration rate (90ZeGFR415 ml/min/1.73m2) by the modification of diet in renal diseases formula were included in this study. Patients were recruited from the Internal Medicine Department, Menoufia University (Egypt). Our controls were 10 individuals with preserved kidney function of more than 90 ml/min/1.73m2 with normal BUN and creatinine matched by age and sex. Routine and specific investigations (serum FGF23 measurement using ELISA immunoassay, serum intact parathyroid hormone, conventional echocardiography, and lateral abdominal aortic radiograph for calcification) were performed. Results The mean logFGF23 level in CKD patients was 2.3 ± 0.6 Ru/ml and was significantly higher than that of control participants, 1.7 ± 0.1 Ru/ml (Po0.001). There was a significant difference between CKD2–3 stage and CKD4 stage in the FGF23 (Po0.05) level but not in serum phosphorus (P40.05). Left ventricular mass index was correlated positively with logFGF23 (r= 0.44, Po0.05) and negatively with eGFR (r= – 0.4, Po0.05). Abdominal aortic calcification was correlated positively with age (r =0.55, Po0.001), but had no correlation with FGF23 (r= 0.36, P40.05). Conclusion FGF23 could be an early risk factor for the occurrence of left ventricular hypertrophy even before an increase in serum phosphorus in predialysis CKD patients.
Objectives The study aimed at determining the prevalence of and risk factors for chronic kidney disease (CKD) using microalbuminuria (MA) as a screening test in a rural area in Gharbia Governorate. Background CKD is being increasingly recognized as a public health problem. There is still paucity of data on the prevalence of and risk factors for CKD by using MA as a screening test in the Middle East. Methods A randomly chosen sample of 320 apparently healthy individuals were interviewed in Shennera village in Gharbia Governorate using a structured questionnaire including information about risk factors for MA. They were also subjected to laboratory investigations including analyses of microalbumin, creatinine, and random blood sugar levels and lipid profile. Results The mean age of the studied sample was 35.7± 13.7 years; 50.9% were male. Only 85% of the sample had sufficient income. The prevalence of MA was 14.4%. The prevalence of CKD (estimated glomerular filtration rateo60 ml/min/1.73m2+ MA) was 15.6%, but those with elevated creatinine levels comprised 2.8% of the studied group. MA showed an increasing trend with age. The prevalence of MA was significantly higher among diabetic patients, hypertensive patients, obese individuals, cardiovascular disease patients, and smokers. The independent predictor variables associated with the presence of MA in a mutually adjusted logistic regression model were diabetes (odds ratio = 8.62, 95% confidence interval: 2.62–28.31) and hypertension (odds ratio= 4.92, 95% confidence interval: 1.63–14.86). Conclusion Screening of MA seemed to be an easy, equally, or even more efficient method for early identification of significant numbers of individuals with CKD compared with other conventional methods, particularly among those with uncontrolled or undetected diseases such as diabetes or hypertension.
Prevalence of depression, anxiety, and obsessive–compulsive disorders among secondary school students in Menoufia Governorate, Egypt /
قطاع الدراسات الطبية / صحه المجتمع والصحه العامه
تخصص البحث : صحه المجتمع والصحه العامه
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 17/12/2013
عدد صفحات البحث 5
ربيع الدسوقى البهنســى
anxiety, depression, epidemiology, obsessive–compulsive disorder, secondary school students
Objectives The aim of this study was to estimate the prevalence of depression, anxiety, and obsessive–compulsive disorders among secondary school students and to assess the comorbidities of these disorders. Background Any type of mental illness can have a negative impact on cognitive development and learning and involves a very high cost to both the individual and society. Anxiety and depression can be considered reliable indicators for the assessment of mental illness in a community. Participants and methods from a total of 83 635 secondary school students in Menoufia Governorate during the academic year 2010–2011, using a multistage random sampling technique, a sample of 1373 students was selected and surveyed from March 2011 to April 2012 by means of the Beck Depression Inventory, 2nd ed., the Costello–Comrey Anxiety Scale, and the Obsessive–Compulsive Disorder Scale, all of which were answered by the participants. Those with scores higher than the cutoff values were interviewed by a psychiatrist for the final clinical diagnosis on the basis of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria. Results The prevalence of depressive symptoms was 21.5% for mild, 7.1% for moderate, and 0% for severe depression in this study group. The total prevalence of depressive symptoms was 28.6%, and the prevalence of depressive disorders was 11.3%. The prevalence of anxiety symptoms was 41.2% and that for anxiety disorders was 21%. The prevalence of obsessive–compulsive symptoms was 15.8% and that of obsessive–compulsive disorder was 2.7%. Comorbidities of mental disorders were common. Conclusion According to these findings, the high rate of mental disorders among adolescents in our community calls for more attention from the family and educational and health institutes. Comorbidities associated with mental disorders are common. In addition, assessment using screening is recommended.
Objective The aim of this work was to study the effect of garlic on the lipid profile of hypercholesterolemic rats and investigate the vascular reactivity to norepinephrine and acetylcholine in hypercholesterolemic rats treated with garlic in-vitro experiments. Background Hypercholesterolemia is considered an important risk factor for the development of atherosclerosis; currently, there is a major trend to use herbal remedies for the treatment and prevention of hypercholesterolemia and garlic is used for this purpose. Methods Forty male rats were divided into the following four groups of 10 animals each: (i) normal diet-fed animals (control), (ii) hypercholesterolemic animals, (iii) hypercholesterolemic garlic-treated animals, and (iv) hypercholesterolemic garlic-prophylactic animals. The animals were fed a standard food preparation enriched with 2% cholesterol for 2 months and soya bean oil. Thirty days after beginning the experiment, garlic was administered in the hypercholesterolemic garlic-treated group whereas in the hypercholesterolemic garlic-prophylactic group garlic was administered from the start till the end of the experiment. At the end of the experiment, a blood sample was drawn from each rat to determine total cholesterol and to separate the lipoproteins; also, a segment of the thoracic aorta was removed to study endothelial function (vascular reactivity). Results Garlic reduced the total serum cholesterol levels and low-density lipoprotein-cholesterol levels significantly. Endothelium-dependent relaxation was significantly greater in the treated and prophylactic group compared with that in the hypercholesterolemic group. Conclusion Garlic played a significant role in prophylaxis and treatment of hypercholesterolemia and improvement of endothelial dysfunction.
Objectives The present study was carried out to determine the prevalence of aerobic and anaerobic pathogens in diabetic foot infections (DFIs), detect their susceptibility to different antimicrobial agents, investigate the microbiological profiles of DFIs in relation to different grades of Wagner classification, and assess the risk factors for DFIs. Background DFI is the most frequent reason for diabetes-related hospitalization. It develops because of several diabetes-related factors including arterial insufficiency, neuropathy, foot deformities, previous ulcers, previous amputation, and local trauma. Materials and methods The study was carried out on clinical specimens taken from 100 diabetic patients (50 patients had type I insulin-dependent diabetes mellitus (IDDM) and 50 patients had type II noninsulin-dependent diabetes mellitus (NIDDM) and 50 nondiabetic patients with foot infection during the period from May 2011 to July 2012. The specimens were cultured using aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Multidrug-resistant organisms were detected including oxacillin-resistant and vancomycin-resistant staphylococci and gram-negative bacilli extended-spectrum beta-lactamase producers. Results DFIs were polymicrobial in 76% of cases. Staphylococcus aureus was the most common aerobic isolate (17.6%) (including 74.4% methicillin resistant and 23.1% vancomycin resistant). Peptostreptococcus spp. were the most common anaerobic isolate (39.4%). Extended-spectrum b-lactamase production was detected in 53.4% of Gram-negative bacilli. About 62% of diabetic patients were infected with multidrugresistant organisms. The risk factors for DFIs were duration of diabetes more than 1 year, random blood sugar of at least 200 mg/dl, trauma, previous ulcer and amputation, and comorbidities related to diabetes. Conclusion Imipenem was the most effective drug against all isolates. Effective glycemic control and educating patients on the prophylactic foot care are of key importance for decreasing DFIs.
Compliance of diabetic patients with the prescribed clinical regimen /
قطاع الدراسات الطبية / صحه المجتمع والصحه العامه
تخصص البحث : صحه المجتمع والصحه العامه
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 17/12/2013
عدد صفحات البحث 4
إيمان أحمد عطيه
clinical regimen, compliance, diabetes mellitus
Objectives This study aimed at studying the prevalence of noncompliance among diabetic patients in Gharbia governorate in Egypt as well its causes, its effect on glycemic control, and factors affecting it. Background There is growing evidence suggesting that because of the alarmingly low rates of compliance, increasing the effectiveness of compliance interventions may have a great impact on the health of the population. Promotion of therapeutic compliance is considered an integral component of patient care. It has been shown that despite effective methods of treatment, many diabetic patients fail to achieve satisfactory glycemic control, which leads to accelerated development of complications and increased mortality. Patients and methods A total of 339 diabetic patients who fulfilled the inclusion criteria were recruited in the present study. Compliance to treatment was evaluated during patients’ visits to health units in Gharbia governorate. Medication compliance was assessed during a personal interview with each patient using a multiple-choice questionnaire. Blood samples were obtained for measurement of glycated hemoglobin (HbA1c). Results In the study population, the compliance rates were observed to be suboptimal. The most important social factors that significantly affected compliance rates included age, income, and educational level. Among the factors that significantly affected compliance rates were duration of treatment, presence of diseases other than diabetes, and the number of prescribed drugs. Another factor that played an important role was diabetes care costs. The most common reasons for low rates of compliance were forgetfulness and high cost of treatment. Conclusion An improvement in the compliance level may be achieved through improvement of patients’ economic levels as well as reduction in the cost of medication. The number of drugs and doses should be reduced as much as possible through continuous research involving doctors and pharmaceutical companies.
Neurobehavioral, respiratory, and auditory disorders among mercury-exposed fluorescent lamp workers /
قطاع الدراسات الطبية / صحه المجتمع والصحه العامه
تخصص البحث : صحه المجتمع والصحه العامه
Menoufia Medical Journal / / Vol. 25, No. 2 - July 2012
تاريخ تقديم البحث 04/12/2013
تاريخ قبول البحث 17/12/2013
عدد صفحات البحث 5
جعفر محمد عبدالرسول
audiometry, neurobehavioral test battery, occupational mercury exposure, spirometry
Objective The aim of this work was to study some of the health disorders resulting from occupational exposure to mercury among workers in a fluorescent lamp factory. Background With the fast market growth of fluorescent lamps, the associated emissions and risk of mercury, which is an essential component in all types of fluorescent lamps, have received increasing public attention worldwide. Low doses of mercury exert toxicity on various human organs, including the central nervous, renal, respiratory, reproduction, immune, cardiovascular, skin, and motor systems. Methods A cross-sectional study was carried out on 138 workers in a fluorescent lamp factory and a nonoccupationally exposed group of 151 individuals. An environmental study of mercury and noise levels was carried out. Neurobehavioral tests, spirometric measurements, and audiometric examination were performed. Urinary mercury level was also measured for all participants. Results In the exposed group, the mean value of urinary mercury level (mg/g creatinine) was significantly increased among those who showed behavioral changes and hearing loss or had other manifestations related to mercury toxicity. With increasing duration of employment in years or with increasing urinary mercury level, the performance of neurobehavioral test battery and spirometric measurements deteriorated. Prominent symptoms among mercury-exposed workers included tremors, emotional lability, memory changes, neuromuscular changes, and performance deficits in tests of cognitive and/or motor functions. Conclusion The neurobehavioral test battery must be used to study subclinical central nervous system dysfunction because of mercury toxicity, especially to evaluate the severity of the effects of mercury in epidemiological studies. This study also reinforces the need for effective preventive programs at fluorescent lamp industry workplaces, especially in developing countries with the most unhygienic ill-ventilated conditions.
جميع البيانات التي يتم تسجيلها على النظام هي ملك للجهة صاحبة هذه البيانات
لا يتم الاطلاع على هذه البيانات من قبل مهندسي المركز إلا للضرورة القصوى ولغرض الدعم الفني وبالاتفاق مع الجهة صاحبة البيانات شفوياً أو كتابياً
لا يتم إعطاء أي بيان من بيانات النظام لأي فرد او جهة فرعية تنتمي للجهة صاحبة البيانات او لأي جهة أخرى إلا بموافقة كتابية من الجهة صاحبة البيانات
يمكن استخدام البيانات المسجلة على النظام بهدف عمل إحصائيات يستفاد منها فى قياس اداء النظام وكفاءة استخدامه من قبل مستخدميه
يتم تأمين جميع البيانات الخاصة بالنظام من خلال تأمين الحاسب الخادم الذي يستضيف البيانات ومن خلال تأمين انتقال البيانات بين جهاز المستخدم والحاسب الخادم وكذلك تأمين واجهة النظام التي يستخدمها المستخدم
كل مستخدم للنظام مسئول مسئولية كاملة عن كلمة المرور الخاصة به وعليه اتخاذ كافة الاحتياطات الممكنة حتى لا يستطيع أى شخص آخر الحصول عليها
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