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CASE REPORTS
'Humming bird sign', 'Mickey Mouse sign', and 'morning glory sign' in progressive supranuclear palsy
Muhammed Jasim A Jalal, Murali K Menon
January-March 2017, 30(1):325-326
DOI
:10.4103/mmj.mmj_204_16
Progressive supranuclear palsy (PSP), also known as the Steele–Richardson–Olszewski syndrome, is a form of Parkinson-plus syndrome. Patients with PSP show interesting radiological signs such as the 'Humming bird sign' and the 'Mickey mouse sign'. Here, we report a patient with PSP, in whom the MRI brain demonstrated the 'Humming bird sign', the 'Mickey mouse sign', and the 'Morning glory sign'.
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3
REVIEW ARTICLES
Obsessive-compulsive disorder, an Islamic view
Nabil R Mohamed, Morsey Sh Elsweedy, Somaia M Elsayed, Afaf Z Rajab, Said T Elzahar
April-June 2015, 28(2):289-294
DOI
:10.4103/1110-2098.163869
Objective
The aim of this work was to study obsessive-compulsive disorder (OCD) from the Islamic viewpoint and programs of Islamic cognitive behavioral therapy (CBT) in OCD.
Background
OCD in Arab and Islamic populations is mostly viewed and managed from a religious perspective, and these individuals are often more religious and more likely to seek out religious counseling and less likely to receive medical treatment. Most early Islamic scholars associated most cases of OCD to the devil and related it to religion; they established Islamic legislations on the basis of this concept. Research from the Islamic viewpoint on issues linked to these disorders can prevent exploitation of patients by swindlers and imposters on the basis of religion.
Methods
The authors performed a systematic review and a narrative synthesis of studies; relevant publications were identified, reference lists were examined, and citation searches were performed. No restrictions on date or type of study were applied.
Recent findings
Religious patients receiving religious psychotherapy showed significantly more rapid improvement, and required lower dosage of medications and for periods less than others. The role of religion as CBT could be significant in the Islamic culture.
Conclusion
OCD is quite different from the whispers of Satan or self-talk by the Islamic understanding. Islamic legislation for patients with OCDs has to be revised in accordance with changes in the concept of obsessions in Islamic considerate. The religious component in CBT can be effective for religion-oriented OCD patients in Islamic culture. Education on OCD and specialized treatment trainings in religious settings could be beneficial to providing therapies. The correct teachings of Islam provide adequate support for individuals with scrupulous obsessions.
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1
DERMATOLOGY - ORIGINAL ARTICLES
Role of melatonin in constitutional delayed puberty in boys
Abdallah M Attia, Belal A Montaser, Nehal K Abdallah
January-March 2020, 33(1):283-287
DOI
:10.4103/mmj.mmj_300_18
Objective
The aim of this work to assess melatonin level in boys with constitutional delayed puberty (CDP) and study its correlation to follicle-stimulating hormone (FSH), total testosterone, and prolactin hormones.
Background
CDP is a common cause of pubertal delay. These boys have no underlying pathology and will progress normally. Melatonin hormone has an important role in pubertal onset. Before puberty, it is too high for hypothalamic activation. However, at puberty, it drop below threshold value, after which pubertal changes start occurring.
Patients and methods
This study was carried out on 50 boys aged 14–18 years who were divided into two groups: 25 boys with CDP as a patient group and another 25 age-matched boys with full pubertal development as a control group. All boys were subjected to full history taking, clinical examination, bone age determination, and laboratory investigations (testosterone, FSH, prolactin, and melatonin).
Results
Our results showed that in CDP, bone age is significantly delayed compared with their chronological age as well as the bone age of control group. Weight and height are significantly less in CDP than control. Both serum total testosterone and FSH are significantly lower in CDP compared with controls, whereas there were insignificant differences in serum prolactin. Melatonin is significantly higher in CDP compared with control. Melatonin is inversely correlated with both testosterone and FSH and has no correlation with prolactin.
Conclusion
Melatonin is significantly elevated in CDP boys, and it is negatively correlated with hormones of sexual maturation (testosterone) and reproduction (FSH).
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4
DERMATOLOGY - ORIGINAL ARTICLES
Effect of vaginal pH in preconceptional fetal sex determination
Mohamed A Gaber, Saeed A Saleh, Nashwa H Allam
July-September 2020, 33(3):1063-1066
DOI
:10.4103/mmj.mmj_338_18
Objective
To assess the effect of vaginal pH on fetal sex determination.
Background
Sex determination is a very important topic. Changing of the normal vaginal pH (3.8–4.5) can affect the activity of different types of spermatozoa and therefore affect the fetal sex.
Patients and methods
This prospective study was carried on 20 patients coming to clinic of gynecology and obstetrics, with variable ages ranging from 21 to 37 years and free of any gynecological or obstetric disorders; vaginal swab from each case was taken on a litmus paper on preovulatory time to assess the acidity and alkalinity of vagina and define its effect on fetal sex.
Results
Overall, 20 patients were from different gravidity and parity. Regarding the comparison between acidic and alkaline vaginal pH and fetal sex, there were significant associations between fetal male sex and alkaline vaginal pH, and significant association between fetal female sex and acidic vaginal pH.
Conclusion
Vaginal pH could be used as a natural method to determine the fetal sex.
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ORIGINAL ARTICLES
Sexual and reproductive functions in men with Down's syndrome
Abdalla M Attia, Naglaa M Ghanayem, Heba H El Naqeeb
April-June 2015, 28(2):471-476
DOI
:10.4103/1110-2098.163904
Objective
The aim of this study was to evaluate sexual and reproductive functions in men with Down's syndrome.
Background
Down's syndrome is a genetic condition that occurs due to an extra copy of chromosome 21. Affected children show characteristic features and associated diseases in different body systems. All of these diseases have received much interest of researchers and can be managed. However, sexually transmitted infections (STIs), the sexual development, associated congenital anomalies of the genital organs, sexuality, and reproductive disorders of these people have not gained much attention.
Patients and methods
A case-control study was carried out on 21 Down's syndrome male patients (patient group), aged 21-28 years. Another 21 healthy, age-matched volunteers were included as the control group. Full sexual history was obtained from all participants , including the age at puberty, desire of marriage and parenting children, practice of masturbation, and attraction to the other sex. Follicle-stimulating hormone, luteinizing hormone, prolactin, total testosterone, and estradiol levels were measured and the BMI was evaluated.
Results
Patients included in the study entered puberty and became fully sexually mature, but later than their healthy peers. More than half (57.1%) of Down's syndrome patients were sexually active, masturbated, were attracted to the other sex, and had the desire to marry. Down's syndrome patients showed a higher BMI. Follicle-stimulating hormone, luteinizing hormone and prolactin levels were significantly higher in Down's syndrome patients compared with the controls. They showed a lower serum total testosterone. The serum estradiol was normal.
Conclusion
According to our results, some men with Down's syndrome have normal sexual development. They can marry and father children.
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The effect of prophylactic laser barrage treatment before phacoemulsification in high myopia
Moustafa Kamal Nassar, Hatem Mohammed Marey, Kareem Mohamed Abdelreheem
January-March 2015, 28(1):203-206
DOI
:10.4103/1110-2098.155995
Objective
The aim of this work was to study the effect of prophylactic laser barrage treatment before phacoemulsification in high myopia.
Background
High myopia is considered as an important risk factor for the development of peripheral retinal degeneration and the subsequent development of retinal detachment, and hence, prophylactic laser barrage treatment is used for such uses.
Patients and methods
Thirty eyes of 20 patients with high myopia were divided into the following two groups: group I, high myopia with peripheral retinal degeneration subjected to laser retinopexy, and group II, high myopia with peripheral retinal degeneration not subjected to laser retinopexy. The two groups after undergoing phacoemulsification had been followed for the development of retinal detachment.
Results
Prophylactic laser barrage treatment significantly reduces the incidence of retinal detachment after phacoemulsification in high myopia.
Conclusion
Prophylactic laser barrage treatment decreases the incidence of retinal detachment after phacoemulsification in high myopia.
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Nutritional knowledge, attitude, and practice of parents and its impact on growth of their children
Fathea El-Nmer, Aml A Salama, Dalia Elhawary
July-September 2014, 27(3):612-616
DOI
:10.4103/1110-2098.145529
Objective
The aim of the study was to assess the effect of parental nutritional knowledge, attitude, and practice (KAP) on their children nutritional behavior and growth.
Background
Good nutrition is cornerstone for growing children during early childhood and school-age years; children begin to establish habits for eating and exercise that stick with them for their entire lives. If children establish healthy habits, their risk for developing many chronic diseases will be greatly decreased.
Participants and methods
This was a cross-sectional study through multistage stratified random sampling technique. Bialla district of Kafr-Elsheikh governorate was selected randomly from 10 district of Kafr-Elsheikh governorate. Predesigned questionnaires that assess parents and children (KAP) were then given to parents and children and 120 pairs of completed questionnaires were returned.
Results
There was no significant correlation between nutritional knowledge (KAP) of parents and nutritional practice of their children (
P
>0.05), whereas there was a significant correlation between parent's knowledge score and healthy food intake in general by children (
r
= 0.222;
P
< 0.05). There was no significant correlation between nutritional practice of children and their BMI and height, whereas there was significant correlation between nutritional practice of children and their weight. There was a highly significant correlation between social class of parents and their children nutritional behavior; in addition, there is significant correlation between father's education and mother's education and their children nutritional practice (χ
2
= 15.3 and 14.6;
P
= 0.018 and 0.023, respectively).
Conclusion
There is no relationship between parents knowledge, attitude, and healthy food intake by their children. Parents education and socioeconomic status constituted important determinants of healthy food intake by their children.
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How to avoid the false diagnosis of venous leakage by pharmaco-penile duplex ultrasonography?
Abd Allah M. Attia, Hossam A Yasien, Mohamed S Abdullah, Mohamed S Abo Hola
July-September 2017, 30(3):928-934
DOI
:10.4103/1110-2098.218292
Objectives
The aim of the present study to carefully reassess the erectile hemodynamic status in men previously diagnosed with venous leak on penile duplex ultrasonography (DUS) under the guidelines of the Australasian Society for Ultrasound in Medicine (ASUM).
Background
Erectile dysfunction (ED) is a widespread problem affecting men across all age groups (about 50% in 40–70-year age group) and disturbing the quality of life of sexually active men. Vascular insufficiency is one of the major causes of ED. DUS is a useful, minimally invasive method for evaluating penile hemodynamics in patients with ED, but has a propensity to inaccurately assign a diagnosis of venous leak.
Patients and methods
Fifty patients from 18 to 50 years olds selected from the Andrology Unit, Dermatology and Andrology Department, Faculty of Medicine, Menoufia University, Egypt were included in the study. All cases were subjected to the following: detailed history, thorough clinical examination, routine and hormonal investigations, and imaging studies including re-evaluation through DUS under the guidelines of ASUM.
Results
Overall, 50% of the patients previously diagnosed with venous leak were shown to be normal when re-evaluated under the guidelines of ASUM. The other 50% demonstrated a significant improvement in the value of end diastolic velocity (EDV). The study demonstrated a significant increase in the value of peak systolic velocity in repeated DUS with a mean difference of 10.29, and a significant decrease in the value of EDV with a mean difference of 4.19 compared with the original DUS. Our results indicated a significant negative correlation between age and value of peak systolic velocity, and an insignificant positive correlation between age and value of EDV for all participants, in both original and repeated DUS.
Conclusion
Careful assessment should be carried out when performing DUS, especially in younger men without a significant vascular risk factor in history for ED, to avoid misdiagnosis of venous leak.
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The role of fibroscan in assessment of liver cirrhosis in patients with chronic liver disease
Mohamed S Elzawawy, Shaimaa A Hassanein, Rasha M El Nomrosy
April-June 2018, 31(2):520-524
DOI
:10.4103/mmj.mmj_26_17
Objective
The aim of this study is to evaluate the accuracy of fibroscan in the assessment of liver cirrhosis in chronic liver disease.
Background
Fibroscan is a noninvasive imaging study for measuring liver stiffness by transducer probe-induced elastic share wave that propagates through liver tissue to measure its velocity.
Patient and methods
The present study was conducted on 50 patients with chronic liver disease. There were 32 males and 18 females, and their ages ranged from 34 to 75 years, with mean age of 51 years. The study was conducted in the hepatology units of Menoufiya University Hospitals, and the disease was confirmed by standard diagnostic criteria. All cases were subjected to the following protocol: full history, clinical examination, laboratory investigation, and ultrasound examination. The patients were subjected to fibroscan examination. The elasticity is directly correlated with the degree of hepatic fibrosis, and 7 kPa has been proposed as a cut-off for fibrosis equal to or greater than F2, and 12.5 kPa for cirrhosis.
Results
Liver stiffness was significantly correlated with liver cirrhosis. The fibroscan technique has high sensitivity and high specificity of 100%, with the area under the receiver operating characteristic curve (95% confidence interval) of 1.00, at the cut-off level of 14.5 kPa.
Conclusion
Transient elastography is a promising noninvasive method for detection of cirrhosis in patients with chronic liver disease. Therefore, fibroscan can be used regarding the decision of treatment and follow-up of patients with cirrhosis for screening and detection of the complications.
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Prevalence of urinary tract infection among pregnant women and possible risk factors
Hala M Shaheen, Taghreed M Farahat, Nesreen A El-Hakeem Hammad
October-December 2016, 29(4):1055-1059
DOI
:10.4103/1110-2098.202505
Objectives
The aim of this study was to estimate the frequency of urinary tract infection (UTI) during pregnancy and the possible risk factors.
Background
UTIs during pregnancy are among the most common health problems worldwide, especially in developing countries. It has several adverse outcomes not only on the mother but also on the fetus.
Patients and methods
A case–control study nested in a cross-sectional investigation was carried out on 250 pregnant women who were attending Berket El Sabae Family Health Center in Menoufia Governorate. Data were collected from the first of September to the end of November 2014. Each participant was assessed using a predesigned questionnaire, which included age, personal history, occupation, present history, past history, obstetric history, and personal hygiene. Urine sample was collected from the studied women for analysis. According to history and urine analysis women were divided into two groups: group I had UTI and group II did not have UTI.
Results
The result of this study revealed that the frequency of UTIs during pregnancy was 32%, with 63.3% of them having moderate infection. UTIs were more significant among women with an intermediate socioeconomic score (37.9%). The most important risk factors associated with UTI in the studied group were unsatisfied personal hygiene, positive history of diabetes mellitus, anemia, and past history of UTI.
Conclusion
This study concluded that about one-third of pregnant women had UTI with different degrees of severity. The most important risk factors associated with UTI during pregnancy were unsatisfactory personal hygiene, history of UTI, diabetes mellitus, and anemia. Therefore, the study recommends health education on personal sanitary hygiene and frequent complete urine analysis during pregnancy.
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Fistulectomy versus fistulotomy in the management of simple perianal fistula
Olfat I Elsebai, Alaa A Elsesy, Mohammed S Ammar, Ahmed M Khatan
July-September 2016, 29(3):564-569
DOI
:10.4103/1110-2098.198710
Objective
The objective of this research was to study the functional and clinical outcomes of fistulectomy versus fistulotomy in the treatment of simple perianal fistula.
Background
Anal fistula has been known as a common surgical ailment for over two and a half millennia. Current management remains dependent on surgeon preference between options such as fistulotomy and fistulectomy.
Patients and methods
This is a prospective clinical study that included 30 patients suffering from simple perianal fistula; patients were divided into two groups each containing 15 patients: group A was managed by fistulectomy and group B was managed by fistulotomy. Both groups were evaluated according to the operative time, postoperative pain, time of wound healing, postoperative complication, incontinence, and recurrence.
Results
There was a significant decrease in the operative time in group B compared with group A (
P
< 0.05), there was a significant decrease in postoperative pain in group B compared with group A (
P
< 0.05), and there was a significant decrease in the time needed for wound healing in group B compared with group A (
P
< 0.05). There was no significant difference in postoperative complications, incontinence, and recurrence between the two groups (
P
> 0.05).
Conclusion
Fistulotomy is a simple and effective method for the treatment of simple perianal fistula, as it has shorter operating time with less postoperative pain and less time needed for wound healing compared with fistulectomy, with the same incidence of postoperative complications, incontinence, and recurrence as fistulectomy.
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4
Comparison between fasting and nonfasting lipid profile in patients receiving treatment with statin therapy
Walaa F Abdel-Aziza, Ghada M Soltana, Ahmed M Ahmed Amer
April-June 2017, 30(2):614-618
DOI
:10.4103/1110-2098.215443
Objectives
The aim of this study was to assess the effect of ordinary meal on the lipid profile of patients receiving statin therapy.
Background
The lipid profile is an essential investigation for the patient who comes to cardiology outpatient clinic. Numerous guidelines recommend sampling in the fasting state for cardiovascular risk assessment. Fasting for 12–14 h is not only cumbersome and unpleasant for patients, but may result in limited compliance to disease monitoring and treatment.
Patients and methods
This study was performed on 100 patients with dyslipidemia receiving statin therapy whose doses had not changed for 2 or more months (group I), and 100 patients with dyslipidemia not receiving statin therapy (group II). Lipid profile was determined for fasting and postprandial statuses.
Results
The lipid profile parameters in both groups in fasting and postprandial statuses were compared. In group I, the mean fasting serum triglyceride level was 176.21 mg/dl and mean postprandial serum triglyceride level was 213.49 mg/dl (
P
= 0.0001); the mean fasting low-density lipoprotein (LDL) level was 161.19 mg/dl and mean postprandial LDL was 159.25 mg/dl (
P
= 0.184). In group II, the mean fasting serum triglyceride level was 231.06 mg/dl and mean postprandial triglyceride level was 284.60 mg/dl (
P
= 0.005); the mean fasting LDL was 185.18 mg/dl and mean postprandial LDL was 181.32 mg/dl (
P
= 0.871).
Conclusion
Finally, from this study we found that there is no significant clinical difference between fasting and nonfasting levels of total cholesterol, high-density lipoprotein, and LDL. Thus, we can use the nonfasting tests to follow-up the dyslipidemic patients.
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1
Effect of pornography on married couples
Mohamed A Gaber, Hesham N Khaled, Manal M. A. Nassar
July-September 2019, 32(3):1025-1029
DOI
:10.4103/mmj.mmj_905_17
Objective
The objective of this study was to study the effects of pornography on married couples in their sexual and social live.
Background
Pornography has long been a major problem in our society, but since the arrival of the internet it has grown to proportions no one could have imagined.
Participants and methods
The study included 300 married men and women selected randomly with age ranging from 20 to 50 years having regular sexual intercourse. They were asked to fill a self-report questionnaire. The study was carried out in the outpatient clinics of Obstetrics/Gynecology and Dermatology of Menoufia Faculty of Medicine, Sirs Elyan and El-Bagour General Hospital. Internal validity and item domain of the questionnaire were assessed using Cronbach's
α
statistical analysis to assess the six main domains of the questionnaire: sociodemographic characters, source of pornography, partner watching pornography, sexual relationship, satisfaction with sexual life, and social life. The results showed high internal consistency and reliability of the questionnaire of Cronbach's
α
of 0.93 and high item domain and domain total correlation (
r
= 0.86–0.97).
Results
The prevalence of positive watchers among participants was 43.3%. The main source of watching was internet (47.6%). Male participants watching pornography were higher than female participants (69.2 vs. 30.8%) and 46.2% of pornography watchers said that coital frequency after watching increases only on the watching day. Watching pornography increases with increase in the years of marriage was the opinion of watchers (70%). Sexual desire increase with watching pornography in 53.1% of watchers. Also, lubrication always increase with watching was the opinion of 56.2% of watchers. Pornography increases masturbation among 74.6% of watchers, but it could not help to reach orgasm among 61.5% of them. Pornography watching increases the incidence of divorce (33.8%) (
P
= 0.001).
Conclusion
Pornography has a negative effect on marital relation.
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3
Genetic evaluation of children with ambiguous genitalia
Soheir S Abou El-Ella, Maha A Tawfik, Wafaa M Abo El-Fotoh, Ahmed Sh Abo Howla
January-March 2016, 29(1):79-88
DOI
:10.4103/1110-2098.178991
Objectives
The aim of the study was to conduct a clinical assessment of pediatric patients with ambiguous genitalia, perform molecular genetic studies for
SRY
and
SOX9
genes, and provide genetic counseling for patients and their families.
Background
Ambiguous genitalia, currently known as disorders of sex development (DSDs), are associated with atypical development of chromosomal, gonadal, or anatomical sexual characteristics, with an incidence of one in 4500 live births. Their early management is crucial for preventing complications, especially psychiatric impacts on the patient and the family, and should be decided after careful consideration of the child's welfare.
Materials and methods
Sixteen patients aged 1 day to 6 years were selected from the Genetic and Endocrinology Unit, Pediatric Department, Faculty of Medicine, Menoufia University, Egypt. All patients were subjected to detailed history taking, a thorough clinical examination, routine and hormonal investigations, imaging studies, and cytogenetic and molecular studies for
SRY
and
SOX9
genes.
Results
History revealed seven patients (43.75%) with positive consanguinity and five patients with similar conditions in their families. Hormonal study revealed five patients (31.25%) above normal ranges for serum 17-OH progesterone levels and two patients (12.5%) below normal ranges. Karyotyping revealed six patients with 46, XX DSD, eight with 46, XY DSD, one with 45, X, and another with 45, X/46, XY. On the basis of molecular studies, the
SRY
gene was positive for six patients with a normal male 46, XY karyotype and for one patient with 45, X karyotype (translocated
SRY
).
SRY
was negative for five patients with a normal female 46, XX karyotype and for one patient with 45, X/46, XY karyotype (deleted
SRY
). All patients were positive for the
SOX9
gene and no deletions were detected.
Conclusion
Early identification of the genetic cause of DSD will in many cases streamline and direct clinical management of the patient with more focused endocrine and imaging studies and better surgical decision.
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1
Respiratory and auditory health disorders among workers in a plastic factory (industrial zone, Queisna City, Menoufia Governorate)
Gaafar M Abdel-Rasoul, Mahmoud E Abu-Salem, Hewaida M El Shazly, Heba K Allam, Eman A Salem, Asmaa A Ahmed
July-September 2016, 29(3):757-761
DOI
:10.4103/1110-2098.198804
Objective
The aim of the study was to investigate auditory and respiratory health disorders among Egyptian workers in a plastic industry as well as assess the workplace environment in the same factory.
Background
The common health hazards associated with plastic manufacturing processes include noise, and exposure to respirable airborne particulates, especially polyvinyl chloride (PVC) and styrene, that lead to occupationally induced hearing loss and chronic effects such as decreased pulmonary function and lung disease.
Participants and methods
A cross-sectional comparative study was carried out in 180 workers in a plastic factory in Queisna City, Menoufia Governorate, Egypt, and in 60 nonoccupationally exposed individuals, who served as the control group. An environmental study of dust, fumes, and noise levels was carried out. Spirometric measurements were taken and air conduction audiometric examination was performed.
Results
The mean values of PVC, styrene concentrations, and noise levels are higher than the national and international permissible levels. Plastic factory workers had a highly significant prevalence of chest and auditory manifestations as well as deteriorated spirometric measurements and abnormal audiometric findings.
Conclusion
Exposure to a high level of PVC, styrene, and noise is implicated in the increase in frequency of chest manifestations, early spirometric changes, and occupationally induced hearing loss. Use of an automated plastic grinding machine to decrease the exposure to dust as well as use of good-quality personal protective equipment, especially masks and ear mufflers, is recommended.
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Knowledge, attitude and practice of rural mothers towards home injuries among children under 5 years of age in Menouf District- Menoufia Governorate, Egypt
Mohamed A Megahed, Nora A Khalil, Reda A Ibrahem, Reham S El Disoki
October-December 2016, 29(4):1033-1039
DOI
:10.4103/1110-2098.202506
Objective
The aim of this study was to assess rural mothers' knowledge, attitudes, and practices as regards first aid for home-related injuries among children under 5 years of age before and after implementation of educational program and to measure the prevalence of these injuries. This study was conducted to assess rural mothers' knowledge, attitudes, and practices toward home-related injuries and their first aids among children under 5 years of age before and after implementation of educational program.
Background
Accidental injuries are a major health problem in children. They are the most common cause of death in children under 5 years of age. Every year they leave many thousands permanently disabled. Most of the children at risk from a home accident are in the 0–5 years' age group. Most of these accidents are preventable through increased awareness, improvements in the home environment, and greater product safety.
Materials and methods
This cross-sectional interventional study included 270 mothers from Bijirim village, Queisna district, Menoufia, Egypt. A predesigned questionnaire was administered to them before and after application of educational program. The first part of the questionnaire included sociodemographic and economic characteristics of the mothers. The second part included mothers' knowledge about the causes, prevention, and first aid of home injuries. The third part included mothers' practice followed toward their children in case of exposure to any type of home injuries and its occurrence.
Results
The study result revealed that mass media were the main source of knowledge for 43.3% of the participants. There was a statistically significantly higher percent of satisfactory knowledge among highly educated mothers and those with middle and high socioeconomic level. There was a significant positive correlation between mothers' practice and either their education or their socioeconomic level. There was a significant correlation between socioeconomic level and either knowledge or attitude of mothers toward home injuries. There was a significant improvement in mothers' knowledge after intervention.
Conclusion
The study revealed that there was a significant improvement in mothers' knowledge and practice as regards home injuries after intervention.
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The role of sildenafil citrate (viagra) suppositories on endometrial response (thickness and mean resistance index of endometrial spiral artery) in cases of unexplained infertility
Shahinaz El-Shourbagy, Ahmed M. E. Ossman, Ashraf El-Mohamady
April-June 2017, 30(2):343-349
DOI
:10.4103/1110-2098.215451
Objective
The oblective of this study was to evaluate the endometrial response of women with unexplained infertility after treatment with sildenafil citrate (viagra) suppositories.
Background
Unexplained infertility refers to failure to conceive in a couple with no definitive cause. Endometrial thickness (ED TH) and perfusion may have an important contribution to etiopathogenesis of unexplained infertility.
Patients and methods
A total of 50 women with unexplained primary infertility were treated with 25 mg of sildenafil citrate suppositories four times per day for 7 days starting from the fifth day of the menstrual cycle for three cycles. Ultrasonographic measurement of ED TH and the mean resistance index (RI) values of endometrial spiral artery (SA) assessed by transvaginal color-pulsed Doppler ultrasound were measured in women with unexplained infertility before and after sildenafil citrate treatment and compared with an equal number of a fertile control group receiving no treatment. The conception rate and pregnancy outcome were recorded in the two groups.
Results
Women with unexplained infertility in the present study had a significantly thinner endometrium and a higher SA-RI (6.52 + 0.77; 1.00 + 0.23 mm, respectively), meaning lower peri-implantation blood flow compared with fertile controls (11.98 + 1.23; 0.58 + 0.06 mm, respectively). Sildenafil citrate-treated women showed a statistically significant increase in ED TH (8.87 + 0.56 mm;
P
< 0.001) and a significant decrease in the mean SA-RI (0.61 + 0.07;
P
< 0.001), yielding a better conception rate.
Conclusion
Treatment with viagra suppositories enhances endometrial blood flow by decreasing the SA-RI and consequently improves endometrial growth and receptivity in cases of unexplained infertility, thus yielding a better conception rate.
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Role of triphasic MRI in the diagnosis of hepatic focal lesions
Zeinab A Ali, Tarek F Abd Ella, Mostafa M Adel
July-September 2017, 30(3):870-875
DOI
:10.4103/1110-2098.218261
Objective
The aim of this study was to highlight the role of triphasic (dynamic) MRI in the diagnosis of hepatic focal lesions.
Background
MR of liver depends on the signal characteristics (T1-weighted and T2-weighted signal intensities) and post-Gd imaging. The combination of these imaging techniques provides anatomic and functional imaging information to best detect and diagnose liver pathology. Liver lesions were classified as malignant or benign on the basis of a combination of imaging features such as enhancement pattern/presence of fat, necrosis, and clinical features such as the presence of new/growing liver lesions and uncontrolled systemic disease.
Patients and methods
The study was conducted in the Hepatic Oncology Unit of the National Liver Institute, Menoufia University on 40 patients with focal hepatic lesions. The study was performed between January 2015 and February 2016.
Results
Out of the 40 patients studied (28 male and 12 female), 39 were found to have hepatic focal lesions and one had a well-defined hyperechoic area by ultrasound and revealed focal fatty infiltration when examined with dynamic MRI. Their ages ranged from 30 to 71 years, with a mean age of 52 years. Dynamic MRI was successfully performed in all patients, revealing 18 focal lesions to be benign, 21 malignant lesions, and one area of focal fatty infiltration.
Conclusion
MRI was found to be of considerable value in diagnosing and differentiating between the different cirrhotic hypervascular nodules. This technique can be implemented simply and reliably. It offers the advantages of significantly shorter acquisition times, retrospective thin-section or thick-section reconstruction from the same raw data, improved three-dimensional rendering, and high-quality liver imaging with high intrinsic soft-tissue contrast. It also provides a global overview of the abdomen. Its relative contraindications include renal impairment and sensitivity to IV contrast.
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17,331
409
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Improving esthetic outcome of facial scars by fat grafting
Fouad Ghareeb, Dalia M Elsakka, Yahia Alkhateep, Hossam M Zayed
April-June 2017, 30(2):412-419
DOI
:10.4103/mmj.mmj_718_16
Objective
The aim of this study was to evaluate the effects of different techniques of fat grafting on improving the esthetic outcome of facial scars.
Background
Control of facial scarring is one of the most difficult challenges in surgical practice, and represents a difficult therapeutic problem facing plastic surgeons to achieve good results. To date, no gold standard exists for the treatment of scar tissue. Autologous fat grafting has been introduced as a promising treatment option for scar tissue-related symptoms. However, the scientific evidence for its effectiveness remains unclear.
Patients and methods
This study was conducted on 30 patients with obvious facial scars. Patients' age ranged from 8 to 48 years. Patients were selected randomly to be treated with fat grafting. The abdomen and thigh were the most commonly chosen donor sites. Fat was processed to be injected at the dermohypodermal junction (microfat grafting) or intradermal injection (nanofat grafting) was used.
Results
Fat grafting proved to have a significant role in scar remodeling. This was measured clinically by the Vancouver Scar Scale. Regarding patient satisfaction with cosmetic appearance, 15 cases were evaluated as excellent, eight cases were evaluated as good, and five cases were evaluated as fair.
Conclusion
Autologous fat grafting has a significant role in facial scar remodeling and provides a beneficial effect on facial scar tissue and scar-related conditions with not only esthetic results but also functional results. Significant improvement in scar appearance, skin characteristics, and restoration of volume and three-dimensional contour is reported.
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7
Effect of ondansetron on hypotension and bradycardia associated with spinal anesthesia during cesarean section
Ayman A Shabana, Nabih I Elkholy, Ashraf M Mohamed, Mai I Abdel Hamid
January-March 2018, 31(1):12-17
DOI
:10.4103/1110-2098.234215
Objective
The aim of the study was to evaluate the efficacy of ondansetron during spinal anesthesia for cesarean section in overcoming the associated nausea, vomiting, bradycardia, and hypotension.
Background
Ondansetron, a widely used antiemetic and serotonin antagonist, has been safely used to blunt the Bezold–Jarisch reflex, resulting in less bradycardia and hypotension in humans undergoing spinal anesthesia.
Patients and methods
One hundred parturients scheduled for elective cesarean section were randomly allocated into two groups. Before induction of spinal anesthesia group I (
n
= 50) received intravenous ondansetron 4 mg and group II (
n
= 50) received normal saline. Blood pressure, heart rate (HR), nausea and vomiting, shivering, vasopressor requirements, and Apgar score at 1 and 5 min were assessed.
Results
Decreases in systolic arterial pressure were significantly lower in group I than in group II. Patients in group I had significantly less requirement for vasopressor (
P
= 0.005), needed lower dose of vasopressor (
P
= 0.01), and had significantly lower incidences of nausea and vomiting (
P
= 0.03). Decreases in HR were significantly lower in group I than in group II just after spinal anesthesia (
P
= 0.02), at 20 min (
P
= 0.01), and 50 min (
P
= 0.02). Decreases in mean blood pressure were significantly lower in group I than in group II just after spinal anesthesia (
P
= 0.007).
Conclusion
In parturient women undergoing elective cesarean section, intravenous 4 mg ondansetron significantly decreased the hypotension, HR fluctuation, and vasopressor doses used.
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16,064
1,008
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Draw-a-person test as a tool for intelligence screening in primary school children
Ali M El-Shafie, Dalia M El Lahony, Zein O Abd El Latif, Mohamed O. A. Khalil
January-March 2019, 32(1):329-334
DOI
:10.4103/mmj.mmj_603_17
Objective
The aim was to conduct a study for screening intelligence of primary school children using draw-a-person (DAP) test in Meit Ghamr District, Al-Dakahlia Governorate.
Background
The significance of children's drawings has been thought to provide indications of visual motor development, levels of cognitive functioning, and intellectual maturity. One of the earliest drawing tests was the DAP test devised by Goodenough to assess children's creativity, mental age, and visual motor intellectual maturity by coding features of their drawing of a man.
Participants and methods
This study was carried out in 1000 apparently healthy primary school children aged from 6 to 12 years old in Meit Ghamr District, Al-Dakahlia Governorate. All students were subjected to an adequate assessment of history, full clinical examination, socioeconomic level, school achievement, and also DAP test.
Results
The study showed that children with superior intelligence, with high average, with average, with low average, and with below average were 1.5, 9.9, 64.6, 21.1, and 2.9%, respectively. Moreover, positive correlations were found between intelligence quotient (IQ) levels and socioeconomic standards, school achievement, and residence. There was no correlation between IQ levels and children's sex.
Conclusion
There were a positive correlation between IQ levels obtained by DAP test and socioeconomic standards, residence, and school achievement. Moreover, no correlation was found between IQ levels and sex.
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Effect of phototherapy on serum calcium level in neonatal jaundice
Mohammed Hamed Bahbah, Fathia Mohamed ElNemr, Rania Salah ElZayat, Elham Aziz Khalid Aziz
April-June 2015, 28(2):426-430
DOI
:10.4103/1110-2098.163896
Objectives
The aim of the study was to determine the effect of phototherapy on serum calcium level in neonatal jaundice.
Background
Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia in neonates. However, this treatment modality may result in the development of some complications such as induction of hypocalcemia.
Patients and methods
This study included 50 full-term neonates with jaundice (25 males and 25 females) who received phototherapy for treatment of neonatal indirect hyperbilirubinemia and 25 neonates (13 males and 12 females) complaining of exaggerated physiological hyperbilirubinemia taken as control not exposed to phototherapy. Serum calcium was checked before and 48 h after starting phototherapy. A comparative study was conducted between these groups to determine the effect of phototherapy on serum calcium level.
Results
In the neonates of the study group, the serum bilirubin level before phototherapy was 15.48 ± 1.94 mg/dl. However, the serum bilirubin level after phototherapy was 12.41 ± 2.10 mg/dl. There was highly statistically significant decrease of the serum bilirubin levels after phototherapy as compared with serum bilirubin levels before phototherapy in the study group (
P
< 0.001). With respect to the calcium level, the total serum calcium level before phototherapy was 9.36 ± 0.29 mg/dl, whereas the serum calcium level after phototherapy was 8.58 ± 0.76 mg/dl. There was highly statistically significant decrease of the serum calcium levels after phototherapy as compared with serum calcium levels before phototherapy in the study group.
Conclusion
Hypocalcemia is a common complication of phototherapy.
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OBSTETRICS AND GYNECOLOGY - ORIGINAL ARTICLES
Comparing the efficacy of cefixime versus amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women
Emad Eldeen Soliman, Mohamed A Emara, Abdelhamid E Shahin, Mahmoud A M Nafie
October-December 2019, 32(4):1382-1387
DOI
:10.4103/mmj.mmj_304_18
Objective
To evaluate efficacy of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria (ASB) in pregnant women.
Background
ASB can cause progressive and severe infections and endanger maternal as well as fetal health. Bacteriuria is usually associated with low birth weight, high blood pressure during pregnancy, maternal anemia, and fetal death.
Patients and methods
A prospective randomized study was conducted on 100 pregnant women having ASB in the first and early second trimester attending the pregnancy follow-up clinic in Galaa Teaching Hospital. Detailed history, laboratory investigations, obstetric, and ultrasound follow-up study were done.
Results
Maternal age (year) of patients ranged from 20 to 35 years, with a mean of 26.06 ± 4.91 years. The presence of pus and serial assessments of fetal growth were significant differences among the studied patients. Overall, 25% of patients had Intrauterine growth retardation (IUGR), 13% had premature rupture of membranes, and 13% had preterm labor. Adverse effects of drug such as presence of Gastrointestinal (GIT) upset, diarrhea, and vaginal candida infection were significantly increased in group 1 (18, 22, and 22%, respectively) than group 2 (4, 6, and 6%, respectively).
Conclusion
The use of amoxicillin/clavulanate is significantly more often accompanied by the development of adverse reactions compared with cefixime. Amoxicillin/clavulanate shows higher incidence of GIT manifestation, diarrhea, and vaginal candida infection. So, further larger studies could provide cost-benefit data necessary to inform a national screening program.
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REVIEW ARTICLES
Maternal anemia with pregnancy and its adverse effects
Medhat E Helmy, Nabih I Elkhouly, Rania A Ghalab
January-March 2018, 31(1):7-11
DOI
:10.4103/1110-2098.234258
Objectives
This article reviews the different types of anemia with pregnancy and its adverse outcome for mother and fetus.
Data summary
Data sources
: Data were obtained from Medline databases (PubMed, Medscape,) and literatures from 2008 until 2014.
Study selection
: Studies that enabled the investigation of the advancement of early diagnosis and management of different types of anemia were selected.
Data extraction
: In this review, data from published studies were manually extracted and summarized.
Data synthesis
: In this review, the data revealed that different types of anemia affect the mother, causing headache, fatigue, weakness, and depression. Outcomes of pregnancy included intrauterine growth restriction, low Apgar scores with a high risk of birth asphyxia, and low birth weight.
Conclusion
Anemia during pregnancy and its management remains an important issue in perinatal medication. Correct diagnosis and treatment lead to effective management of fetal and maternal risks and improved perinatal outcome.
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ORIGINAL ARTICLES
Letrozole with dexamethasone versus clomiphene citrate with dexamethasone for induction of ovulation in polycystic ovary
Ayman A Shabana, Alaa El-Deen F. Al-Halby, Abd Hamid E. Shaheen, Ahmed M El-Naggar
January-March 2018, 31(1):38-45
DOI
:10.4103/mmj.mmj_703_16
Objective
The objective of this study was to compare the effect of letrozole with dexamethasone (DEX) versus clomiphene citrate (CC) with DEX in ovulation induction in polycystic ovarian syndrome (PCOS).
Background
PCOS is a common endocrinologic disorder in women characterized by chronic anovulation, hyperandrogenemia, and infertility.
Patients and methods
Sixty women with PCOS were included in this study and subdivided randomly into two groups. Group I included 30 women who took letrozole 2.5 mg tablet times daily starting from day 2 to day 6 of menstrual cycle and DEX 2 mg/day orally in two divided doses starting from day 3 to day 12 of the cycle. Group II includes 30 women who took the same protocol of DEX combined with CC 50 mg two times daily starting from day 2 to day 6 of the menstrual cycle. Treatment was continued for three consecutive cycles. Main outcome measures are number and diameter of follicles, endometrial thickness, ovulation rate, and pregnancy outcome.
Results
In group I, the number of mature follicles was less than three follicles/cycle with monofollicular stimulation, whereas in group II it was more than three follicles/cycle with multifollicular stimulation. The mean diameter of follicles was 18.73 in group I and 16.23 in group II. Difference in endometrial thickness was highly statistically significant (
P
< 0.001), where the mean endometrial thickness was 10.60 in group I and 6.97 in group II. Ovulation was more significantly detected after using letrozole than CC – in 20 (62.5%) women in group I and 12 (37.5%) women in group II (
P
< 0.05). Pregnancy was achieved in 11 (68.8%) women in group I, which is significantly higher than that in group II – five (31.2%) women (
P
= 0.05).
Conclusion
Letrozole and DEX have more success rates in ovulation induction and pregnancy outcome than CC and DEX.
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357
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© Menoufia Medical Journal | Published by
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Online since 31 Jan, 2014