The Scientific Journal of Al-Azhar Medical Faculty, Girls最新文献

{"title":"Middle East Respiratory Syndrome Coronavirus (MERS-CoV) spike protein as a DNA candidate vaccine","authors":"A. Ghamry, E. Abushady, M. Shehata, Mahmoud Shahata, M. Ali","doi":"10.4103/sjamf.sjamf_32_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_32_21","url":null,"abstract":"Background Middle East respiratory syndrome coronavirus (MERS-CoV) has become a global public health threat as it is capable of causing life-threatening disease with lower respiratory tract involvement, with a case fatality rate of ∼37.5%. So, ongoing efforts to develop MERS-CoV vaccines are mandatory, and their immunity profiles against different antigens and correlation with protection should be assessed. Aim The present study aimed to assess the neutralizing capacity of MERS-CoV spike (S) structural protein as a DNA-based candidate vaccine in mice models. Materials and methods The spike structural protein gene of MERS-CoV was amplified and cloned using pcDNA3.1 (negative) mammalian expression vector and competent Escherichia coli, for immunization of BALB/c mice as a DNA candidate vaccine, followed by a booster dose after 2 weeks. Sera of mice were collected within 8 weeks after prime vaccination for evaluation of the neutralizing capacity of DNA vaccine using plaque reduction neutralization test (PRNT) assay compared with the neutralizing capacity of inactivated whole virus vaccine, and also a group of mice was injected with empty vector in phosphate-buffered saline (PBS); PBS-pcDNA3.1 (negative) was used as a negative control. Results PRNT50 showed complete neutralization in mice vaccinated with inactivated MERS-CoV vaccine (PRNT50 titer, ∼1 : 160) 6 and 8 weeks of first immunization (P<0.01). The negative control group of mice injected with PBS-pcDNA3.1 (negative) did not show any neutralizing antibodies against MERS-CoV at 2, 4, 6, and 8 weeks after prime vaccination. The mice vaccinated with S gene-based DNA vaccine (pcDNA3.1-S) showed a significant increase of neutralizing antibodies against MERS-CoV strain NC163/2014 at week 8 after prime vaccination with PRNT50 titer, ∼1 : 80. Conclusion These results reported that the spike gene-expressed protein is a major immunogenic protein in MERS-CoV, so it would be recommended in future vaccine development.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89125554","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":"Evaluation of serum sclerostin level and its correlation with the cardiovascular outcome in patients with chronic kidney disease","authors":"R. Mohamed, Khalida El Refaei El Refaei, E. Mohamed, Ahmed El Thakaby, A. Adaroas, M. Maher","doi":"10.4103/sjamf.sjamf_37_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_37_21","url":null,"abstract":"Background Cardiovascular calcification is a significant insult at all stages of chronic kidney disease (CKD). Vascular/valvular calcification was considered a strong predictor for cardiovascular morbidity and mortality in CKD population. Sclerostin is an inhibitor of the Wnt pathway that has an association with vascular calcification in various vascular beds. Aim To evaluate the serum sclerostin level and its correlation with the cardiovascular outcome in patients with CKD. Patients and methods The study group consisted of 70 patients (30 nondialysis patients with CKD and 40 hemodialysis patients with end-stage renal disease) and 20 healthy controls. The patients were followed up for 30 months for detection of cardiovascular events. Laboratory investigations including serum sclerostin level were calculated, and a standard two-dimensional transthoracic echocardiography was performed for detection of cardiac valve calcification. Results There was a significant increase in the serum sclerostin level in all patients with CKD when compared with the control group (P<0.001), There was a significant decrease in serum sclerostin level in patients with valvular calcification (P=0.016) when compared with patients with noncalcified valves. There was significant decrease in serum sclerostin in patients who developed cardiovascular morbidity (P<0.001), but no significant relation with cardiovascular mortality when compared with patients who did not develop CVD insults. Conclusion Decreased sclerostin level in patients with CKD is associated with increased incidence of valvular calcification, and also, there was a significant decline in serum sclerostin level in patients who developed cardiovascular morbidity, but there was no significant relation with cardiovascular mortality.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85202638","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":"Evaluation of urinary podocyte level as a noninvasive biomarker in lupus nephritis","authors":"S. Mohammed, F. Mourad, H. Elsayed, E. Youness","doi":"10.4103/sjamf.sjamf_89_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_89_21","url":null,"abstract":"Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that predominately affects women. It is characterized by a broad spectrum of immunologic and clinical manifestations. Lupus nephritis (LN) is documented as one of the most severe complication of SLE. Aim To investigate the intensity of podocyturia in LN as a noninvasive biomarker and its relation to grade of disease activity. Patients and methods This is a case–control study. It was carried out on 60 patients and 20 control. All participants were randomly selected from those admitted in the internal medicine and rheumatology departments in Al Zahraa University Hospital, Al Hussein University Hospital, and Sayed Galal University Hospital in the period from March 2019 to March 2020. These patients were divided into three groups: group I included 20 healthy controls, group II included 20 patients SLE without nephritis, and group III included 40 patients with LN, which was subdivided into IIIA, which included 20 highly active LN cases and IIIB, which included 20 inactive LN cases. Results In the current work, there was a highly statistically significant difference among the studied groups regarding hemoglobin, white blood cells, creatinine, urea, albumin/creatinine ratio, estimated glomerular filtration rate, anti-DNA, C3, C4, erythrocyte sedimentation rate, C-reactive protein, and antinuclear antibody. Moreover, there was a highly significant difference among the studied groups regarding urinary podocyte marker. There was a statistically significant positive correlation between podocyte marker and creatinine, urea, albumin/creatinine ratio, and anti-DNA in all patients. There was a positive correlation between immunoglobulin (Ig) Cγ and urea and between Ig Cκ and albumin/creatinine and a negative correlation between Ig Cκ and C4 in group III A (active LN). Conclusion SLE deleteriously affects the fine glomerular structures as reflected by augmented urinary levels of podocyte, so we suggested urinary podocyte as a highly sensitive, early, and noninvasive biomarker of LN.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85070764","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 vagus nerve stimulation during ear wash","authors":"Mai Eldahan, Mohamed Abd El-Hady, H. Ibrahim","doi":"10.4103/sjamf.sjamf_34_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_34_21","url":null,"abstract":"Background Ear wash is the process for removing cerumen from the external auditory canal. Objective To detect the effects of ear wash on pulse, blood pressure, ECG, and saturation percentage of the oxygen in the blood (SPO2) and to know also if it leads to cough, tinnitus, and vertigo. Patients and methods This study was performed on 200 patients divided to two groups: group I included 120 healthy persons and group II included 80 diseased persons. Results In most of the cases, decreased pulse was seen but was within normal limits in the two groups. In group I, most of the cases had decreased systolic and diastolic blood pressures but still within normal, whereas in group II, most of the cases had increased systolic and diastolic blood pressures but within normal limits. Most of the cases had no changes in ECG in the two groups. Most of the cases had decreased SPO2 but within normal limits in the two groups. We found positive ear cough reflex, tinnitus, and vertigo in some cases during the ear wash in the two groups. Conclusion The results of the study showed that the majority of the changes that happened during the ear wash in the pulse, the blood pressure, ECG, and SPO2 in the both groups were within normal range, and we found that the ear wash can lead to cough, tinnitus, and vertigo. These changes were caused by stimulation of the auricular branch of the vagus nerve that supplies the external auditory canal.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76203041","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":"Relation between inflammatory markers and sepsis in critically ill patients","authors":"Amir Hafez, Amani K. Mohamed, D. Zakaria, Asmaa S Hassan","doi":"10.4103/sjamf.sjamf_117_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_117_21","url":null,"abstract":"Background Sepsis and septic shock is a serious complication in ICU patients. Early identification can help to improve the outcome. C-reactive protein (CRP) and neutrophil–lymphocyte ratio (NLR) are suggested markers for diagnosis. The aim of the work is to evaluate the relation between inflammatory markers and sepsis in critically ill patients. Patients and methods The study included 30 patients with different degrees of sepsis and septic shock in addition to age-matched and sex-matched healthy controls. All patients were subjected to full clinical examination. The clinical condition of the patients was further assessed using acute physiology age chronic health evaluation II score and Sequential (sepsis-related) Organ Failure Assessment score. The performed laboratory investigations included complete blood count, coagulation profile, erythrocyte sedimentation rate, CRP, renal function tests (blood urea, serum creatinine, sodium, and potassium), liver function tests (serum albumin and bilirubin), and pan-cultures. Results Among the studied patients, there were 16 (53.3%) patients with sepsis, seven (23.3%) patients with severe sepsis, and seven (23.3%) patients with septic shock. Six (20.0%) patients died at the end of the study. The patients had a significantly higher CRP (46.6±24.3 vs. 6.7±3.3 mg/dl, P<0.001) and NLR (21.6±2.8 vs. 2.8±1.9, P<0.004) levels when compared with controls. Comparison between patients with different degrees of sepsis showed a significant increase of CRP and NLR with increasing the severity of sepsis. There was a significant positive correlation between CRP and NLR and both acute physiology age chronic health evaluation II and Sequential (sepsis-related) Organ Failure Assessment scores. Receiver-operating characteristic curve analysis showed good performance of CRP (cutoff: 40, sensitivity: 80%, and specificity: 84%) and NLR (cutoff: 8.75, sensitivity: 86.7, and specificity: 90.0) for the diagnosis of sepsis. Conclusions Use of CRP and NLR as early predictors of sepsis and septic shock development is reliable and convenient.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77964301","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 direct-acting antiviral drugs for hepatitis C virus on hepatic fibrosis and glycemic control in type 2 diabetes mellitus","authors":"D. Shaaban, A. Gad, H. Kotb","doi":"10.4103/sjamf.sjamf_134_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_134_21","url":null,"abstract":"General background Hepatitis C virus (HCV) is a major cause of chronic liver disease, resulting in end-stage liver disease and hepatocellular carcinoma. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. Not only does HCV increases type 2 diabetes mellitus (T2DM) risk but it also worsens its control and is associated with increased prevalence of diabetes complications. There is interacting relationship between HCV, T2DM, and the degree and severity of liver fibrosis (FIB) and that T2DM is potentially preventable or controllable by curing HCV infection. Our study aimed to evaluate the effect of eradication of HCV by direct-acting antivirals on the glycemic control, indicated by glycated hemoglobin, and liver FIB, indicated by FIB-4 score. Patients and methods We enrolled in our study 200 patients with chronic hepatitis C (with compensated liver function) and T2DM, who were treated with direct-acting antiviral drugs for 12 weeks, and we followed up their fasting blood sugar, glycated hemoglobin %, and FIB-4 score at the beginning of treatment, at the end of treatment, and then after 3 months. Results Overall, 95% of the patients achieved sustained virological response (SVR) and 5% did not (NSVR). Moreover, 80% from SVR achieved improved glycemic control versus only 10% in NSVR. On the contrary, 80.5% of SVR exhibited decrease (improvement) in FIB-4 score versus 70% in NSVR, but the reduction of FIB-4 was more significant in SVR group. Moreover, there was a statistically significant relationship between improved glycemic control and improvement of FIB-4 score. Conclusion Eradication of HCV was significantly associated with improvement of glycemic control and FIB-4 score. Improvement of glycemic control occurred along with improvement of FIB-4 score after eradication of HCV.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86368919","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":"Interleukin-33 in patients with bronchial asthma and its relation to disease severity","authors":"A. Ahmed, N. Ayoub, Reham M. Sabry, Zeinab R. Adawy","doi":"10.4103/sjamf.sjamf_110_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_110_21","url":null,"abstract":"Background Bronchial asthma (BA) is a chronic inflammatory disorder of the airways, characterized by bronchial hyperresponsiveness and variable airflow obstruction. Interleukin (IL)-33 is a member of the IL-1 family that has a role in airway hyperresponsiveness and asthma. Aim The aim was to measure serum level of IL-33 in patients with BA and to assess its relation to disease severity. Patients and methods A total of 20 asthmatic patients and 20 controls were investigated. Serum level of IL-33 was measured by enzyme-linked immunosorbent assay. Results Serum level of IL-33 was increased in asthmatic patients than controls, and its increase was higher in severe BA than mild to moderate BA. There were significant negative correlations between IL-33 and pulmonary function tests and a significant positive correlation between IL-33 and eosinophil count. Conclusion Serum level of IL-33 was increased in patients with BA, and its increase was correlated with the severity of the disease. Further studies are recommended to investigate the possible role of IL-33 as a new therapeutic target in BA.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91509826","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 study between microneedling alone and microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) in treatment of plantar warts","authors":"Abeer Ali, Hanan Darwish, Sara Galal","doi":"10.4103/sjamf.sjamf_127_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_127_21","url":null,"abstract":"Background Verrucae plantaris are benign proliferations that can last for many years. It can cause discomfort. Multiple treatment options are introduced for treatment of Verrucae, but the response is variable and unsatisfactory. Aim The authors aimed to evaluate the efficacy of microneedling alone versus microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) in the treatment of plantar warts. Patients and methods Forty-five patients with plantar warts were included. The patients were randomly divided into three groups: each group comprises 15 patients. The first group was treated with microneedling alone. The second group was treated with microneedling followed by application of topical bleomycin, while the third group was treated with microneedling followed by application of topical polyphenone. Results There is complete clearance in 73.4% of the patients treated with microneedling combined with topical bleomycin versus 20.0% in patients treated with microneedling alone versus 26.0% in patients treated with microneedling combined with polyphenone E. Conclusions From this study, the authors conclude that microneedling alone and microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) are effective and safe in the treatment of plantar warts, but a combination of microneedling with topical bleomycin is a more promising treatment for plantar warts. Topical polyphenone after microneedling did not enhance the effect of microneedling in plantar warts.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80471935","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":"Dermoscopic evaluation of nail changes in alopecia areata","authors":"H. Darwish, Sara Galal, Y. Tawfik","doi":"10.4103/sjamf.sjamf_125_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_125_21","url":null,"abstract":"Background Alopecia areata (AA) is an immune-mediated disease that is characterized by nonscarring hair loss. In the majority of cases, hair falls out in one or more well-circumscribed round or oval patches on the scalp or body (AA focalis), but sometimes it can lead to complete loss of hair on the scalp (AA totalis) or, in extreme cases, the entire body (AA universalis). Hair and nails have a common origin, anatomical structures, and may be involved in many diseases. Nails may also be involved in AA; fragility and pitting can be signs of nail dystrophy in AA patients. Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation and follow-up of many nail disorders. Aim Evaluation of the presence, types, and clinical findings of nail changes in patients with AA by nail dermoscopy. Patients and methods This is a cross-section observational study, including 100 patients with AA. They were subjected to complete history taking, clinical examination (general and dermatological), and the severity of alopecia tool score was calculated for all patients. The finger nail was examined with a dermoscope to clarify the features of nail changes associated with the disease. Results Nail changes were found in (84.0%) of patients of AA, while (16.0%) have not shown nail changes. The most common nail change was scaly cuticle (75%) of the patients. There was a highly significant positive correlation between nail changes in patients having AA with severity of alopecia tool score and duration of the disease. There was no statistical significant correlation regarding sex, age of the patients, and dermoscopic hair features of AA. Conclusions From this study, we have found that scaly cuticle is the most common nail change in AA patients followed by scales in the lateral nail fold. Also, it can be concluded that nail changes in AA related to the disease severity and the duration of disease, but they are not related to the age, sex of patients, and dermoscopic findings of AA.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87548480","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 CT finding and mediastinoscopic biopsy results for diagnosis of mediastinal lymphadenopathy","authors":"Lamiaa Agwa, Hosny El-Sallab, M. Ahmed, Wasiem Mohammad","doi":"10.4103/sjamf.sjamf_119_21","DOIUrl":"https://doi.org/10.4103/sjamf.sjamf_119_21","url":null,"abstract":"Background Mediastinal lesions are difficult to detect on radiograph because these lesions are of soft tissue densities and are surrounded by soft tissue structures. Here is where computed tomography (CT) can provide the answer. It provides information on the anatomical extent of the lesion and the nature of the lesion. Aim The aim of this work is to evaluate the possibility of anticipation of histopathological tissue diagnosis for a mediastinal lymphadenopathy specimen taken by mediastinoscopy on the basis of preoperative CT findings for patients admitted in Al-Zahraa University Hospital in the Cardiothoracic Surgery Department. Patients and methods Thirty patients were included in this study, admitted in the Cardiothoracic Surgery Department of Al-Zahraa University Hospital from December 2019 to May 2020. All patients had received a diagnosis by CT chest and invasive method in the form of mediastinoscopy; then, histopathological results of the mediastinoscopic biopsy were correlated with the CT chest finding to estimate the relationship between both methods of diagnosis in cases with mediastinal lymphadenopathy. Results There is no definitive sign in CT imaging either using the size or shape or distribution to help in reaching the final diagnosis. Therefore, the biopsy is inevitable in all cases. Conclusion The CT remains the most important noninvasive tool for the diagnosis of mediastinal lymphadenopathies with good sensitivity, specificity, and diagnostic accuracy. Despite this, it does not exceed the prediction, and the cause of lymphadenopathy must be diagnosed to be able to start the appropriate treatment.","PeriodicalId":22975,"journal":{"name":"The Scientific Journal of Al-Azhar Medical Faculty, Girls","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84090718","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}