The Egyptian Journal of Hospital Medicine最新文献

{"title":"Allicin Mitigates Immobilization Stress Induced Gastric Ulcer in Rats by Upregulation of Nrf2/HO-1 Pathway","authors":"","doi":"10.21608/ejhm.2025.411716","DOIUrl":"https://doi.org/10.21608/ejhm.2025.411716","url":null,"abstract":"Background: Gastric ulcers brought on by stress offer an intriguing area of study. The persistent challenges in properly controlling and treating these ulcers have attracted a lot of research interest. The primary biologically active ingredient in freshly crushed garlic extract is thought to be allicin. Research has demonstrated that allicin possesses antibacterial, antioxidant, and anti-inflammatory qualities. Objective: To determine any potential underlying processes and assesses the gastroprotective impact of allicin on immobilization stress-induced stomach ulcers. Material and Methods: Three groups of thirty male rats were created: control, ulcer, and ulcer+allicin (10/group). The following factors were assessed: gastric ulcer index values, stomach pH, serum corticosterone, body weight change, stomach PGE2, stomach MDA, stomach GSH, stomach TNF-α, stomach IL-10, and the expression of Nrf2 and HO-1 genes in the stomach. Additionally, stomach tissue was evaluated by histopathology and COX2 immunohistochemistry. Results: Compared to control the ulcer group exhibited dramatically lower change in BW, gastric pH values, gastric GSH, gastric PGE2, gastric IL-10 and gastric gene expression of Nrf2 and HO-1, while also exhibiting significantly higher serum corticosterone, gastric ulcer index values, gastric MDA and gastric TNF-α together with upregulation of COX2 immunoreaction compared to control. Allicin dramatically improved stress-induced changes in gastric tissue. Conclusion: Through the upregulation of the Nrf2/HO-1 signaling pathway, as well as its anti-inflammatory and antioxidant properties, allicin provides gastroprotective effects to rats with stress-induced stomach ulcers.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"98 1","pages":"833-839"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147916789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumothorax in Non-ventilated Patients with COVID-19 Pneumonia: Management and Outcome of a Rare Entity","authors":"","doi":"10.21608/ejhm.2025.406034","DOIUrl":"https://doi.org/10.21608/ejhm.2025.406034","url":null,"abstract":"Background: Rapid clinical deterioration of patients with COVID-19 pneumonia has three potential causes including: Disease progression, pulmonary embolism, and pneumothorax. Pneumothorax is a serious complication in patients with parenchymal lung disease, which may require rapid intervention. Objective: This study aimed to review management and outcome of spontaneous pneumothorax in our hospitalized non-ventilated patients with COVID-19 pneumonia, and to evaluate the relation of pneumothorax with in-hospital outcome. Patients and methods: This retrospective study included non-ventilated patients who had spontaneous pneumothorax associated with moderate or severe COVID-19 pneumonia. Pneumothorax was managed considering hemodynamics and size of pneumothorax. When indicated, tube thoracostomy was performed under strict protective measures. Results: There were 12 cases of spontaneous pneumothorax out of 136 initially non-ventilated COVID-19 patients (8.82%), with median age of 62.5 years. The imaging features included unilateral pneumothorax (91.7%), bilateral pneumothorax (8.3%), subcutaneous emphysema (41.7%), tension pneumothorax (16.7%), pneumomediastinum (16.7%), and hydropneumothorax (8.3%). After median hospital stay of 13 days, the recovery rate was 41.7%, while death was reported in 58.3%. Treatment of pneumothorax was conservative in 58.3% and tube thoracostomy in 41.7% with median chest tube duration of 4 days. Pneumothorax resolved in all patients with no need for further surgical intervention. In comparison with survivors, died patients had higher frequency of severe pneumonia (P= 0.02) and higher ferritin levels (P= 0.04). Severe pneumonia at presentation and the need for invasive ventilation later on had significant impacts on survival after presentation of pneumothorax (P-values of Log Rank test = 0.011 and 0.027 respectively). Conclusion: Pneumothorax is a rare but serious complication of COVID-19, which requires early diagnosis and treatment. Presentation with severe pneumonia and later on deterioration affected prognosis of initially non-ventilated COVID-19 patients with spontaneous pneumothorax.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"98 1","pages":"412-421"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147896723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Transcutaneous Electrical Co-Activation of Diaphragm and Abdominal Muscles on Weaning Time in Mechanically Ventilated Patients","authors":"Shaimaa Elsayed Ahmad, H. Obaya, Ahmad Tarek, Abd Algawad, Gehad Ali Abdelhaseeb, Donia M. Elmasry","doi":"10.21608/ejhm.2024.366543","DOIUrl":"https://doi.org/10.21608/ejhm.2024.366543","url":null,"abstract":"Background : In intensive care units (ICUs), around one-third of severely sick patients need mechanical ventilation (MV) to maintain their breathing; some require it for just hours, while others need it for months. The diaphragm, abdominal, and intercostal muscles—the three main breathing muscles—may experience atrophy due to lack of usage during this period. Objective: We aimed to determine the effect of transcutaneous electrical co-activation of diaphragm and abdominal muscles on weaning time in MV patients. Patients and Methods : A total of 52 mechanically ventilated patients of both sexes participated in the study with age range from 40 to 55 years old. They were recruited from ICU Department in New Cairo Generalized Hospital; referred by physicians. They were assigned randomly into 2 Groups. Group A consisted of 26 patients; received co-activation of both diaphragmatic electrical stimulation and abdominal functional stimulation in addition to conventional physical program for one session per day for 7 days a week till discharge, 60 minutes per session. Group B consisted of 26 patients; received conventional physical therapy program for 30 minutes per session for one session a day for 7 sessions a week till discharge. Outcome measure weaning time was assessed. Results : Both groups showed significant improvements in the weaning time. However, Group A demonstrated greater improvements compared to Group B. Conclusion: Application of transcutaneous diaphragmatic stimulation and abdominal functional electrical stimulation is safe way for critically ill patients for decreasing length of duration in ICU for mechanically ventilated patient thus improve weaning.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"36 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716084","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":"Knowledge and Attitude Towards Postpartum Depression among Nurses Working at Family Health Care Centers in Giza Governorate: Impact of Educational Intervention Program","authors":"Hend Samy, H. Sabry","doi":"10.21608/ejhm.2024.363741","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363741","url":null,"abstract":"Background: postpartum depression (PPD) is a serious issue having severe consequences on both the mother and child. Nurses working in family health care centers, play a crucial role in identifying and managing PPD, but they may have inadequate knowledge. Objective: This study aimed to assess the knowledge and attitude of nurses towards PPD, to assess perceived barriers to diagnose and manage PPD, to provide PPD education sessions, then reassess their knowledge and attitude. Materials and method : A pre-and post-test intervention study that was conducted at four family health centers and included 83 nurses. Knowledge and attitude questionnaires were used. Results: after the educational sessions the mean percent knowledge score increased significantly from 13.2 ± 10 to 56.6 ± 11.4, the percentage of agreements in aspects related to nurses’ role in identification and management of PPD increased significantly and the percentage of nurses who perceived barriers decreased significantly. Conclusion: This study highlighted the importance of provision educational programs to maternal health care, which play a vital role in the early detection, treatment, and referral for professional management.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706126","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":"Long-Term Outcome of Desarda Technique in Elective Inguinal Hernia Repair. A 10 Year Multicenter Experience","authors":"Mohamed A. Shaban, Hisham E. Elareaf, Amr G. Mohamed","doi":"10.21608/ejhm.2024.363591","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363591","url":null,"abstract":"Background: One of the most often performed operations and a pillar of a general surgery practice is inguinal hernia repair. Objective: The study aimed to report our experience in tension-free repair of inguinal hernia using Desarda technique. Patients and methods: 179 out of 216 patients with 1ry inguinal hernia repaired with Desarda and who completed at least five years of follow-up and underwent analysis were included. The current retrospective analysis was conducted between December 2013 and December 2023 . Recurrence, chronic pain, abdominal wall stiffness was the main follow up corners. Results: The mean age of the included patients was 44.76 ± 7.88 years. There was a statistically significant decrease in the testicular edema, hematoma, seroma, and surgical site infection after 1-month follow-up when compared to the incidence by the 1 st week (P < 0.001). There was a statistically significant decrease in the incidence of loss of sensation, abdominal wall stiffness and FB sensation by time. The recurrence rate was 1.7% after 5 years follow. Conclusion: Desarda technique is an easy, effective and reliable method in treatment of inguinal hernia repair with favorable long-term outcome.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695500","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":"Limits and Prognostic Factors for Surgical Decompression in The Management of Massive Hemispheric Infarction","authors":"Hany Elkholy, Mohamed Ahmed Elnaggar, Osama Saber Shereef","doi":"10.21608/ejhm.2024.363733","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363733","url":null,"abstract":"Background: A severe kind of ischemic stroke known as massive hemispheric infarction affects either the entire or most of the middle cerebral artery (MCA) and is distinguished by the emergence of potentially fatal cerebral edema. A death rate of up to 80% has been linked to this type of space-occupying edema. In acute ischemic stroke patients, decompressive craniectomy (DC) is a surgery used to treat brain herniation and deadly progressive edema. Objectives: This work aimed to study the limits and prognostic factors for surgical decompression in managing patients with massive hemispheric infarction. Patients and methods: This prospective study included 17 patients with massive hemispheric infarction who were admitted and treated at the Neurosurgical Departments of Menoufia University Hospital from February 2022 to February 2024. Results: There were no significant differences in the relation between death after treatment and Glasgow Coma Scale (GCS) (Before treatment, after one day and 6 M), MRS (before treatment), and time of surgery after the onset of symptoms/H (P>0.05). Also, NIHSS Score, mRS after 1 M and 6 M were significantly increased among death patients after treatment (P<0.05). Conclusions: Decompressive craniotomy can reduce the mortality rate in patients with massive hemispheric infarction, provided that it is done as early as possible from the onset of symptoms. The higher the GCS the better is the outcome.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"89 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708667","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":"Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage in Twin Pregnancies Delivered by Cesarean Section: A Randomized Controlled Trial","authors":"Mostafa Abdelgalil, Esraa Elmarasy, Ayman Taher, Akmal Elmazny, Ahmed Elzyat","doi":"10.21608/ejhm.2024.363736","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363736","url":null,"abstract":"Background: Research from the literature indicates that the likelihood of postpartum hemorrhage (PPH) is one of the most harmful aspects to take into account when preparing for a twin delivery. Objective : Our foremost objective was to compare the effectiveness and adverse effects of carbetocin with oxytocin in preventing postpartum hemorrhage (PPH) in twin pregnant women following elective cesarean section (CS). Study design : In this randomized controlled study, 118 pregnant women with twin pregnancies who were admitted for an elective cesarean section in two equal groups, were given intravenous slow IV boluses of carbetocin (group A) and slow intravenous oxytocin boluses (10 IU) (group B) . Following the delivery of the second fetus, all patients were given the study medications. Results : The need for additional uterotonics was statistically higher in group B than in group A; 5 (24.3%) versus 15 (13.1%) with P-value 0.025. While the estimated blood loss was statistically insignificant between both groups (928.5 ± 146.4 ml in (group A) versus 941.2 ±277.2 ml in (group B), with P-value 0.311. As such, incidence of PPH was statistically insignificantly different between study groups (p value 0.239). Conclusion: The use of carbetocin at elective cesarean section for twin pregnancy is not superior to slow IV oxytocin bolus in reducing the operative blood loss or prevention of PPH but it may reduce the postoperative need for additional uterotonics, especially in IVF twin gestation.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"101 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697371","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":"Correlation Between Baseline Troponin Level and The Severity of Pulmonary Hypertension 3 Months After COVID-19 Infection in Subjects without Previous Significant Cardiovascular Pathology","authors":"Mohamed Sabry, F. Maklady, Ahmed Tageldein, Fathy A. Nada","doi":"10.21608/ejhm.2024.368090","DOIUrl":"https://doi.org/10.21608/ejhm.2024.368090","url":null,"abstract":"Background: A serious medical condition linked to pulmonary hypertension (PH), right ventricular dysfunction (RVD), and cardiovascular consequences is coronavirus (Covid-19) infection. Objective: This study aimed to assess the relation between the rise of cardiac troponin at base line investigation of COVID patients and the development of pulmonary hypertension 3 months after recovery from the infection. Subjects and methods: The study was conducted as a cross-sectional descriptive study and included 104 non-critically ill patients 3 months after recovery from Covid-19 pneumonia. They were divided into 2 groups; mild cases and moderate/severe non-critically ill cases based on the WHO criteria at the time of admission. Troponin at the time of admission was measured. A full echocardiographic assessment of the right ventricle was done, and the pulmonary artery systolic pressure was calculated for every patient. Results: In COVID-19, PH is a common complication encountered after recovery, especially in moderate/severe (non-critically ill) cases. We observed increased incidence of PH in the moderate/severe group 3 months’ post-recovery, significantly correlated with the initial levels of the cardiac troponin at admission ( p ˂ 0.001). Conclusions: There was a statistically significant positive correlation between troponin I levels at baseline admission and the development of pulmonary hypertension (r2 = 0.696, p = < 0.001) 3 months after recovery from the infection.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"9 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847092","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 Maternal Obesity on Operative and Post-Operative Complications of Elective Cesarean Section: An Observational Cross-Sectional Study","authors":"Bassiony Dabian, Sameh Elmahdy, Akmal Elmazny, Bassem Mohammed, Ahmed Elzyat","doi":"10.21608/ejhm.2024.363732","DOIUrl":"https://doi.org/10.21608/ejhm.2024.363732","url":null,"abstract":"Background: Numerous studies indicate that difficulties during and after cesarean section may be linked to maternal obesity. Objective: This study aimed to assess the consequences of maternal obesity on intra-operative and post-operative sequelae of elective Cesarean delivery. Patients and methods: Based on maternal BMI at time of delivery, patients were categorized into 3 groups: Normal weight, overweight and obese women. Operative data were documented including operative time, estimated blood loss during CS, etc. Post-operative data included post-operative care timing of catheter removal, return of intestinal sounds, mobilization, initiation of oral feeding, etc. Post-operative complications included postpartum hemorrhage, surgical site infection, DVT, blood transfusion, ICU admission and pulmonary embolism. Fetal outcome was documented including 1 & 5 minute Apgar score, RDS, birth injuries, NICU admission. Results: Operative time was statistically significant longer 40.30 ± 3.28 vs. 33.19 ± 4.42 vs. 27.80 ± 5.16 mins, need insertion of intra-peritoneal drain was higher (7.3%) vs. 0 (0.0%) vs. 0 (0.0%), timing of catheter removal was more delayed 5.48 ± 1.19 vs. 4.06 ± 0.82 vs. 3.00 ± 0.88 hours among obese. Incidence of postpartum hemorrhage was statistically significant higher 16 (14.5%) vs. 12 (10.9%) vs. 6 (5.5%) among obese compared to overweight and normal weight women. Conclusion: Adverse consequences for either mother or baby have been linked to maternal obesity. BMI > 30 kg/m 2 was linked to a higher risk of postpartum hemorrhage, a longer length of stay in the operating room, and delayed urinary catheter removal as maternal outcomes. In terms of fetal outcomes, a greater risk of fetal macrosomia and the newborn's transient tachypnea were linked to higher BMI. [","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"5 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715689","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":"Vaspin Levels and Diabetic Nephropathy in Elderly Patients with Type 2 Diabetes Mellitus","authors":"M. Mousa, Samia Hussein, Reda M. Khodry, Atef G. Hussain, A. I. Elagrody, A. A. Elfatah","doi":"10.21608/ejhm.2024.366545","DOIUrl":"https://doi.org/10.21608/ejhm.2024.366545","url":null,"abstract":"Background: Diabetic nephropathy (DN) is a highly prevalent major chronic complications of DM. DN is diagnosed depending on clinical background with existence of albuminuria and/or declined eGFR and hypertension without any other primary renal disease. Vaspin is an adipokine, which acts as anti-atherogenic. Objective: This study aimed to correlate vaspin levels to the biochemical findings in DM and DN, and to investigate the significance of vaspin in predicting the development of DN among type 2 diabetic patients. Subjects and methods: Our research involved 90 subjects (above 65 years old) who were divided into 3 groups. Group I with 30 elderly healthy individuals, group II with 30 elderly uncomplicated type 2 diabetic patients and group III included 30 elderly type 2 diabetic patients with DN. Results: Statistically significant decreases in vaspin levels among group III compared to groups I and II were detected. Also, group II had a statistically significant rise compared to group I. Statistically significant positive correlations were detected between vaspin levels and each of fasting insulin (r=0.909, P<0.001), HOMA-IR (r=0.902, P<0.001), C-peptide (r=0.721, P<0.001), and GFR (r=0.892, P<0.001). However, statistically significant negative correlations were detected between vaspin levels and each of albumin/creatinine ratio (ACR) (r=-0.600, P=0.002), creatinine (r=-0.551, P=0.002), and blood urea nitrogen (BUN) (r=-0.451, P=0.031) among group III. Receiver operating curve (ROC) showed that vaspin had a significant validity in the prediction of DN among DM cases with sensitivity of 87%, specificity of 78.3% and accuracy of 82.6%. Conclusion: Vaspin could be a potential marker in the prediction of DN development among DM cases. Keyboards","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713630","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}