Journal of Current Medical Research and Practice最新文献

{"title":"Predictive value of microRNA-210 in preeclampsia: a prospective cohort study","authors":"Yousra M. Mammdoh, H. Omar, O. Mohamed, A. Abbas, Lubna El-din","doi":"10.4103/jcmrp.jcmrp_53_21","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_53_21","url":null,"abstract":"Aim To assess the usefulness of circulating miR-210 as a non-invasive molecular biomarker for early prediction of preeclampsia (PE) in high-risk pregnant women. Methods A total of 40 pregnant women between 14 and 26 weeks of gestation associated with any risk factors for PE were enrolled in the study. MicroRNA-210 was detected using real-time polymerase chain reaction (Q-PCR) in the plasma sample. Follow-up of the pregnant women in antenatal clinic was done. The prediction of PE among the study group was evaluated, and also the level of microRNA-210 at which PE occurred was detected. Results Of 40 cases of high-risk pregnant women, 8 cases developed PE, where 2 had pregestational diabetes mellitus (DM), 1 was primigravida with pregestational DM, 1 had chronic hypertension with pregestational DM, and 4 were primigravida alone. The plasma miR-210 was significantly higher in high-risk pregnant women with PE (n = 8), with a mean ± SE of 19.23 ± 6.95 and median of 15.48 compared with those who did not develop PE (n = 32), with mean ± SE of 4.29 ± 1.36 and median of 1.51 (P = 0.001). At a cutoff value of 2.28-fold change, plasma miR-210 was 87.5% sensitive and 68.8% specific for prediction of PE in risk factor pregnant women, with area under the curve of 0.852. Conclusion Plasma miR-210 levels were significantly elevated in preeclamptic women compared with those without PE in high-risk pregnant women, so miR-210 may have possible pathophysiological role in PE.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130022454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climatotherapy at Red Sea, Hurghada, versus topical combination of corticosteroids with salicylic acid in treatment of psoriasis","authors":"Eman Kamal Youssef, A. Abdel-Mageed, A. Mohamed, Mai M Elkabsh, Esraa E. Ahmed","doi":"10.4103/jcmrp.jcmrp_106_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_106_22","url":null,"abstract":"Background The comparison between the efficacy of climatotherapy and the combination of topical steroids with salicylic acid has not been done before. Climatotherapy treatment includes balneotherapy and sun exposure. Objective To compare the effectiveness and safeness of climate therapy at Red Sea, Hurghada, with topical corticosteroid and salicylic acid combination therapy for treating chronic plaque psoriasis. Patients and methods The work included 30 cases with chronic plaque psoriasis. Patients' age ranged between 9 and 60 years. Cases were classified randomly into two groups, with 15 cases each. Group I was treated with Red Sea climatotherapy (sand bath, bathing in Red Sea water, and sunlight exposure). Group II was treated with topical mix of salicylic acid (3.00%) and corticosteroids (betamethasone dipropionate 0.05%). Psoriasis area and severity index (PASI score), Skindex 16 questionnaire, and histopathological examination of skin biopsies of psoriatic lesions were performed for each patient before and after 3 weeks of treatment. Results A marked decrease in PASI score (P = 0.001) and of Skindex 16 (P = 0.009) and a significant difference between histopathological changes were found in cases treated with climatotherapy and in cases treated with topical combination of steroids and salicylic acid but with much more decrease in patients treated with climatotherapy. After treatment, PASI score improved by 80% in 75% of cases in group I and by 50% in 75% of patients in group II. Conclusion Climatotherapy is a safe, alternative treatment of psoriasis with low risk, high therapeutic effect, and no adverse effects.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134299727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic urinary tract injuries during obstetric and gynecological operations in Assiut University Women Health Hospital","authors":"Abdel-Rahman M. Abdel-Kader, Elwany El Snosy, Mohammad S. Abdellah, Ibrahim Mohammad, Aladin Kamel, Mansour M. Khalifa","doi":"10.4103/jcmrp.jcmrp_104_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_104_22","url":null,"abstract":"Background and aim The close proximity of the urinary tract to the female genital system makes it vulnerable to damage during pelvic surgical procedures. The objective of the current study was to evaluate iatrogenic urinary tract injuries (UTIs) caused by obstetrical and gynecological procedures. Patients and methods The current study was conducted at Department of Obstetrics and Gynecology, Assiut University Hospitals, in the period between March 2018 and March 2021. All women with UTIs secondary to obstetrical or gynecological surgeries during the study period were recruited in the study. Results A total of 20 636 women were scheduled for different obstetric or gynecological surgeries, and 170 (0.82%) of them experienced iatrogenic UTIs, 161 (94.7%) women had injury during obstetric surgeries, whereas the other nine (5.3%) had gynecological surgeries. Operations were repeated cesarean section (34.2%) and placenta previa (54.1%) in obstetric surgeries and repeated section in gynecological surgeries (33.3%). Iatrogenic UTIs were detected intraoperatively in 167 (98.2%) women, whereas in only three patients, detection was delayed. Overall, eight (4.7%) patients had both bladder and ureteric injuries, whereas bladder injury alone occurred in 154 (90.6%) patients and another eight (4.7%) patients had ureteric injuries alone. ICU admission was needed in 43 (25.3%) patients. Conclusion Although frequencies of UTIs in obstetric and gynecological surgeries were found to be relatively low, yet it may lead serious morbidity and outcome. Proper antenatal care and good knowledge of pelvic anatomy may help in decreasing its frequency.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"548 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127659368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to handle hypotension following spinal anesthesia for a cesarean section","authors":"Mohamed Mostafa, S. Hassan, M. Abdelatef","doi":"10.4103/jcmrp.jcmrp_3_23","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_3_23","url":null,"abstract":"Spinal block is the chosen anesthetic technique for cesarean sections because it poses less hazards to the mother and fetus than general anesthesia. The most frequent adverse effect of spinal block is hypotension owing to sympatholysis, which can reduce preload and afterload and cause arterial and venous vasodilation. This leads to maternal hypotension, which can affect uterine blood flow and fetal circulation and result in fetal hypoxia, acidosis, and bradycardia. Since then, a number of research studies on various medications, techniques, and regimens have been published, and neuraxial anesthesia methods in obstetrics are becoming more and more common. Clinical practice employs a variety of strategies for the prevention and management of spinal block-induced hypotension, including intravenous colloid preloading or crystalloid coloading, compression bandages or stockings for the lower limbs, left tilt positioning, administering the ideal local anesthetic dose and attaining the ideal spinal block level, as well as the administration of inotropes and vasopressors as constriction of the arterial vessels is currently emerging as the ideal strategy. The most recent algorithms advocate giving vasopressor infusions as a preventative measure rather than when hypotension has already occurred.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123188025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility of pentraxin 3 for the early diagnosis of infection in mechanically ventilated patients","authors":"Mona T Fadel, D. Magdy, R. Ahmed, Amal Hosni","doi":"10.4103/jcmrp.jcmrp_4_23","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_4_23","url":null,"abstract":"Background Ventilator-associated pneumonia (VAP) is one of the most common ICU-acquired infections; however, its diagnosis is still a challenge. Objectives To evaluate the diagnostic performance of pentraxin 3 (PTX3) in early detection of patients with VAP. Patients and methods In the period from the first of January 2019 up to December 2021, 45 adult patients who underwent mechanical ventilation more than 48 h and developed VAP were enrolled in this longitudinal descriptive hospital-based study, Assiut University Hospital, Assiut, Egypt. Diagnosis of VAP depends on positive culture, in addition to a clinical pulmonary infection score more than or equal to 7. To measure the level of PTX3, the first sample was taken on the first day of the endotracheal intubation, and the second sample was taken on the third day from the patients who developed VAP. Results The study showed that the mean age of enrolled patients was 55.98 ± 14.54 years (range, 30–80 years). Overall, 60% were males and 40% were females. The most common causative pathogen was Pseudomonas aeruginosa, followed by Staphylococcus aureus. Only PTX3 showed significant increase during follow-up, whereas no significant difference was observed in either erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) during the follow-up period. Moreover, it was observed that PTX3 had a significant positive correlation with CRP; however, it did not show correlation with ESR, whereas CRP had a significant positive correlation with ESR. Conclusions PTX3 was superior to both ESR and CRP as a biomarker to diagnose patients with VAP and also for follow-up of disease progression.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128332645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and outcomes of mechanical ventilation in the pediatric ICU of Assiut University Children Hospital","authors":"Kotb Abbass Metwalley, Ismail L. Mohamad, Nora Ramzy, M. Thabet","doi":"10.4103/jcmrp.jcmrp_74_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_74_22","url":null,"abstract":"Background and aim Mechanical ventilation (MV) is one of the most often carried out procedures in pediatric ICU. There are multiple indications of MV. The diseased state, infrastructure, and hospital protocols all influence different management options. Although there is no question that MV has many advantages, it can also be harmful when used. To enhance management procedures and outcomes, this study evaluated the frequency, indications, complications, and immediate outcomes of children receiving MV. Patients and methods A prospective study of children (1 month to 18 years) needing invasive MV in pediatric ICU was conducted. MV was performed after evaluation of its indication. Complications and outcome were monitored. Results Of 561 patients admitted to the pediatric ICU, 283 (50.4%) required MV. The most common cause of admission to pediatric ICU was respiratory system diseases (46.3%). The most frequent indication of MV was respiratory failure (38.2%). Of the 283 patients who required MV, 60 (21.2%) had complications. The commonest complication was ventilator-associated pneumonia (5.3%). The mortality rate of mechanically ventilated children was 53.7%. There was higher mortality in patients admitted with gastrointestinal tract system diseases (65.9%). Conclusion The commonest cause of admission to pediatric ICU was respiratory system diseases. The commonest indication of connection to MV was respiratory failure. The most common complication of MV was ventilator-associated pneumonia. Several factors affect the outcomes of mechanical ventilation. These factors were age, sex, and etiology of admission to pediatric ICU.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126489378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of the causes of symptomatizing hypocalcemia in infants and children","authors":"Asmaa A. Fathy, S. Eldeeb, Yasser Abd-Elrheem","doi":"10.4103/jcmrp.jcmrp_69_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_69_22","url":null,"abstract":"Background Symptomatizing hypocalcemia is defined as reduction in the level of ionized calcium in the blood to less than 0.95 mmol/l, associated with obvious manifestations such as neuromuscular impairment in the form of convulsion, carpopedal spasm, paresthesia or stridor, etc. Calcium hemostasis, to keep the level of calcium maintained at normal level, is controlled by normal nutritional intake of vitamin D and calcium-containing foods, by normal calcium and vitamin D absorption from the intestine, by normal-synthesis of vitamin D by the liver and kidneys, and by the effect of the normal-parathyroid gland. The main aim of the work was to give a profile of the causes of symptomatizing hypocalcemia in infants and children presenting to Assiut University Children Hospital. Patients and methods The study included 50 patients aged 2 months to 17 years (IRB#17100552). Besides full clinical assessment, all cases had the following investigations done: CBC, kidney and liver function test, serum calcium, alkaline phosphatase, vitamin D, and parathyroid hormone level measured. The chest radiography and wrist radiography were done in all cases. Intestinal biopsy was performed where indicated. Results Nutritional vitamin D-deficiency rickets was present in 62% of the cases, hepatic rickets was encountered in 6% of the cases, celiac disease was encountered in 8% of the cases, hypoparathyroidism was present in 4% of the cases, cow's milk allergy was present in 2% of the cases, and hypocalcemia secondary to antiepileptic drugs was present in 4% of the cases. Conclusion Vitamin D supplementation should be recommended during infancy and adolescence, where periods of rapid growth of bone occur. Good advice must be given to parents about foods rich in vitamin D and calcium.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126648664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of carbon dioxide laser and cryotherapy by dermoscopy in treatment of warts","authors":"Nagwa A. Elazim, H. Morsy, Khadija B. Youssef","doi":"10.4103/jcmrp.jcmrp_96_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_96_22","url":null,"abstract":"Background Viral warts are common pores and skin manifestations visible in each youngster and adults owing to the human papillomavirus. Human papillomavirus is transmitted at once with the aid of touch or in a roundabout way via the surroundings. AIM and Objective The aim of our study was to compare the results of two therapeutic modalities, carbon dioxide (CO2) laser and cryotherapy, in the treatment of warts collectively with the dermoscopic assessment of viral warts before and after applying treatment. Methods A total of 50 patients were clinically recognized as having common warts and were recruited from the Dermatology Outpatient Clinics of Assiut University and Luxor preferred Hospitals. All patients were subjected to history taking and scientific and dermoscopic evaluations. In our study, we examined the efficacy of treatment of common warts using cryotherapy and CO2 laser according to improvement in size and width of warts, using dermoscopy, which helped us in our observation to attain a medical diagnosis of warts easily and correctly. Results and Conclusion CO2 laser can be an effective and time-saving modality for warts and is a better modality than cryotherapy. However, studies with larger sample sizes and longer follow-up durations are suggested, which will verify the veracity of these results.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"254 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116880501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of multiple instrumentation changing in transportal and transtibial techniques for anterior cruciate ligament reconstruction regarding bacterial contamination: a randomized controlled study","authors":"Mohamed -E. Abd-Elsalam, H. Elkady, Mohamed Abokrisha, Kerolos T. Matta","doi":"10.4103/jcmrp.jcmrp_86_22","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_86_22","url":null,"abstract":"Background In transtibial technique (TT) for anterior cruciate ligament reconstruction (ACL-R) few instruments pass through the anteromedial portal track (probe, basket, diathermy), but in transportal (Anteromedial portal [AMP]) technique a lot of instruments pass through the anteromedial portal track (probe, basket, diathermy, wire, drill, and screw). Purpose To detect the instrumentation changing effect regarding bacterial contamination in transportal technique and TT for ACL-R. Type of study Randomized controlled study. Patients and methods A total of 80 patients who preceded arthroscopic ACL-R in Assiut Arthroscopy and Sport Injuries Unit in Assiut University Hospital between March 2021 and September 2021 were included in the study. The mean age of the patients was 26 years. Of the patients, 68 cases were males and 12 cases were females. Thirty-five patients underwent the procedure using the TT technique and 45 patients by the AMP technique, through computed randomization. Cotton swabs had been taken of the subcutaneous tissue at the anteromedial portal track in transportal technique and TT before and after instrumentation and femoral tunnel drilling; a control sample was taken from anterolateral track in both techniques. Results There were no positive swabs in both TT and transportal technique in all patients included in the study. Conclusion There is no effect of changing multiple instrumentation on bacterial contamination in transportal technique and TT for ACL reconstruction.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129870065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study on pattern of pulmonary embolism in chestdepartment-Assiut University","authors":"M. El-kholy, S. Sadek, Reham Elmorshedy, Adel El-labody","doi":"10.4103/jcmrp.jcmrp_123_21","DOIUrl":"https://doi.org/10.4103/jcmrp.jcmrp_123_21","url":null,"abstract":"Background Pulmonary embolism (PE) is a severe and fatal disease, and its incidence varies widely between countries. Aim To determine the frequency of PE in the Chest Department of Assiut University Hospital, to determine the risk factors and effective treatment, and to study the outcome of the disease in this locality. Patients and methods In this retrospective study, 222 patients suspected to have PE were screened for PE and underwent computed tomography-pulmonary angiogram to confirm or exclude a clinical suspicion of PE. All of the following were collected from patient data sheets: history, clinical examination data, ECG abnormalities, chest radiograph, Doppler ultrasound, echocardiography, chest ultrasound, laboratory reports, treatment lines, and the outcome in the form of mortality, ICU admission, length of hospital stay, and discharge to home. Results Of the included PE cases, all of them received heparin followed by warfarin, except for 10 patients who received rivaroxaban without any toxicity. Warfarin dose needed to reach therapeutic international normalized ratio (between 2 and 3) was 3–9 mg in –85% of the patients. A total of 71 patients needed admission to ICUs, and of them, 24 patients died, but there were no recorded deaths in the ward. Housewives represented 43.7%. The most common symptoms were dyspnea (84%) and chest pain (62%). Tachypnea was the most frequent sign (72%), and hypotension was observed in 13.5%. PE was common in patients with diabetes mellitus, patients with chronic obstructive pulmonary disease (COPD), patients with deep-vein thrombosis, and those who use oral contraceptive pills (18.5, 17.5, 17.1, and 14.4%, respectively). Regarding echocardiography findings, 16.4% of our patients were cardiomyopathic, 74.4% had mild to moderate pulmonary hypertension, with severe pulmonary hypertension detected in only 7% of patients. Computed tomography-pulmonary angiogram revealed main pulmonary artery embolism in 49.09% of the patients, and in 60 (27%) patients, it was bilateral. Conclusion PE is frequent in Upper Egypt. Diabetes and COPD are the most important risk factors of PE. Death owing to PE is markedly associated with OHS and COPD morbidity.","PeriodicalId":110854,"journal":{"name":"Journal of Current Medical Research and Practice","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115250205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}