Alexandria Journal of Medicine最新文献

{"title":"The impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings","authors":"Nadia Mohamed Ahmed Abdel Fattah, M. Zahran, R. K. Fawzy, Alaa Abdel Hamid, Hala K. Maghraby","doi":"10.1080/20905068.2021.1916244","DOIUrl":"https://doi.org/10.1080/20905068.2021.1916244","url":null,"abstract":"ABSTRACT Introduction: Mammography is the most used breast screening tool and was proven to reduce breast-cancer-associated mortality. The estimated sensitivity of mammography varies between 77% and 95%; however, sensitivity could be 26% lower in dense breasts than in entirely fatty breasts. The ability to represent the complex 3D breast architecture and early changes in anatomical structures in a 2D view is the biggest challenge for mammography. In Digital Breast Tomosynthesis (DBT), tomographic images are reconstructed from multiple projections acquired from different angles. This technique allows the generation of 3D data, reduction of tissue overlap and allows better evaluation of masses, architectural distortion, and asymmetries compared with conventional two-dimensional mammographic images. Objective: To evaluate the impact of Digital Breast Tomosynthesis on BIRADS categorization of mammographic non-mass findings. Methods: Prospective cohort for 180 women with mammographic non-mass findings who presented to Alexandria University Radio diagnosis Department either for screening or diagnostic purposes between July 2019 and August 2020 with mean age 51.44 ± 10.67 . Digital breast tomosynthesis and ultrasound was done for all patients. Lesions were evaluated on DM; DBT alone then combined DBT & DM. Comparison of results according to changes in BIRADS, diagnostic performance using histopathology as gold standard. Results: 208 non-mass findings were detected by conventional mammography (104 asymmetry, 35 architectural distortion, 69 micro calcifications), Tomosynthesis reduced the BIRADS 3 count by 32%, upgraded the count of BIRADS 4 lesions by 11.4% while upgraded the BIRADS 2 by 18.9% with consequent improvement of sensitivity and specificity, PPV, NPV and accuracy to 96%, 95%, 94%,97%, and 95.6%. Conclusion: Combined FFDM and DBT improved the diagnostic performance in evaluation of non-mass findings and proper BIRADS categorization.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"139 - 148"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1916244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45619171","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":"Molecular characterization and distribution of cephalosporin resistance determinants in Escherichia coli and Klebsiella pneumoniae isolated from patients attending Kampala International University Teaching Hospital in Bushenyi, Western Uganda","authors":"Herbert Mbyemeire, Kenneth Ssekatawa, C. Kato, E. Wampande","doi":"10.1080/20905068.2021.1952821","DOIUrl":"https://doi.org/10.1080/20905068.2021.1952821","url":null,"abstract":"ABSTRACT Cephalosporins are the first-line therapy antibiotics used in the treatment of gram-negative bacterial infections. However, high prevalence of cephalosporins resistance in Klebsiella pneumoniae and Escherichia coli has been reported worldwide. Studies conducted in Uganda reported high incidences of cephalosporin resistance (CR). Successive studies at Mulago National Referral Hospital indicated a decline in the resistance levels pointing to the need for regular antibiotic resistance surveillance. Therefore, this study carried out molecular characterization of CR determinants in E. coli and K. pneumoniae isolated from patients attending Kampala International University Teaching Hospital (KIU-TH). A retrospective study using E. coli and K. pnuemoniae samples previously obtained from surgical wounds and urinary tract infections among patients treated at KIU-TH between September 2016 and August 2018 was conducted. Biochemical assays were used to confirm the identity of the samples. Combined disc and boronic acid assays were used to determine the cephalosporine resistance profile of the isolates. Multiplex PCR amplification was used to characterize the extended spectrum beta-lactmase (ESBL) encoding genes. The study revealed that E. coli (130/81.2%) isolates were more predominant than K. pneumoniae (30/18.8%) among the archived samples. K. pneumoniae showed the highest phenotypic resistance with a mean prevalence of 90.6% but comparable to that of E. coli (89.3%). Of the 160 isolates screened, 105 (65.6%) were ESBL producers. Multiplex PCR revealed that the most predominant ESBL encoding gene was bla SHV at a prevalence of 42.0%, followed by bla TEM at 27.3%, bla CTX-M at 22.4% and bla CTX-M-15 at 8.4%. The incidence of phenotypic resistance and distribution of ESBL genes were significantly higher in patients of Ishaka division. Our study reports a high prevalence of cephalosporin-resistant E. coli and K. pnuemoniae isolated from patients attending KIU-TH and highlights the need for routine screening of antimicrobial resistance in health-care facilities so as to guide clinicians on the rational prescription of antibiotics. List of abbreviations: ATCC: American Type Culture Collection; ESBL: extended spectrum beta-lactmases; AmpC: aminopenicillin cephalosporinase; CTX-M: cephotaxime (M-first detected in Munich) hydrolyzing capabilities; CTX-M-U: cephotaxime hydrolyzing capabilities gene Universal primer; SHV: sulfhydryl variables (variant-2); CMY-2: cephamycins (variant-2); TEM: temoneira; ACT-1: AmpC type (variant-1); Bla: Beta lactam; DNA: deoxyribonucleic acid; PCR: Polymerase chain reaction; MNRH: Mulago National Referral Hospital; MRRH: Mbarara Regional Referral Hospital; KRRH: Kabale Regional Referral Hospital (KRRH); KIU-TH: Kampala International University Teaching Hospital; CDL: Central Diagnostic Laboratory; CoVAB: College of Veterinary Medicine, Animal Resources and Biosecurity; CR: cephalosporin resistance","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"205 - 214"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42027234","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":"Removal Statement","authors":"Ahmed H. Hashish, Noha S. Elshaer, Dorria E. Meleis","doi":"10.1080/20905068.2021.1959259","DOIUrl":"https://doi.org/10.1080/20905068.2021.1959259","url":null,"abstract":"The production of carbon black (CB) has been considered as one of the top 50 industrial chemicals manufactured worldwide. Working in CB manufacturing process might pose a cardiovascular risk. This ...","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"224 - 224"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60071314","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 Effectiveness Of Non Invasive Hemodynamic Parameters In Detection Of Spinal Anesthesia Induced Hypotension During Cesarean Section","authors":"Yasser Essam Elfeil, Ahmed Mohammed Alattar, T. Ghoneim, A. Abd Elaziz, E. Deghidy","doi":"10.1080/20905068.2021.1885953","DOIUrl":"https://doi.org/10.1080/20905068.2021.1885953","url":null,"abstract":"ABSTRACT Introduction: Hypotension is the most frequent consequence of spinal anesthesia in cesarean section. It results in harmful effects on mother and newborn. Aim: This study aim was to evaluate the correlation of positional changes in hemodynamic (heart rate and blood pressure) measured before spinal anesthesia in anticipation of occurrence of hypotension throughout cesarean delivery. Methods: 100 ASA grade I parturient were selected for this prospective observational study. Preoperative sociodemographic data, parity, and hemodynamic parameters were recorded including changes in systolic, diastolic, mean arterial blood pressure, and heart rate after positional shift from supine to lateral and sitting positions. Intraoperative, occurrence of hypotension was noted. Results: With hypotension as the dependent variable, the age, parity, heart rate at supine position, and changes in (heart rate, systolic, diastolic and mean arterial blood pressure) from supine to lateral position, and from supine to sitting position had high statistical significant negative correlation with blood pressure as P value <.05. Multivariate logistic analysis to assess predictors of hypotension concluded that changes in hemodynamic variable from supine to lateral position only significant predictor were (∆ heart rate, ∆ diastolic and ∆ mean blood pressure), and changes in hemodynamic variable from supine to sitting position only significant predictor were (∆heart rate and ∆ diastolic blood pressure). Discussion: Elevated sympathetic activity before neuraxial anesthesia was associated with higher risk for post-spinal hypotension. The great variability in hemodynamic after positional change indicates higher sympathetic activity to blood vessels. The high rise in the autonomic activity, the higher the risk for post-spinal hypotension Conclusion: Age, parity, and positional changes in hemodynamic were correlated with blood pressure reading after spinal anesthesia during cesarean delivery.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"121 - 129"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1885953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42957986","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 the relationship between burnout, depression, anxiety, and stress levels of primary health-care workers (Center Anatolia)","authors":"Irem Akova, Öznur Hasdemir, Esma Kiliç","doi":"10.1080/20905068.2021.1874632","DOIUrl":"https://doi.org/10.1080/20905068.2021.1874632","url":null,"abstract":"ABSTRACT Background The aim of this study was to evaluate the relationship between burnout, depression, anxiety, and stress levels of primary health-care workers. Methods This cross-sectional study included 338 health-care workers. The sociodemographic data form, the Maslach Burnout Inventory (MBI), and the Depression Anxiety Stress Scale-21 (DASS-21) were applied. Mann Whitney U test, Kruskal Wallis test, Chi square test, and Logistic regression analysis were used. The error level was taken as 0.05. Results The burnout levels of the health workers were lower level in Emotional Exhaustion (EE) (79.0%), Depersonalization (D) (81.1%), and Personal Accomplishment (PA) (54.1%). The level of the depression, anxiety, and stress were found to be 10.9%, 14.8%, and 5.0%, respectively. The rates of low-moderate-high EE and D, low-moderate PA were higher in physicians than midwives and nurses. There were significant differences between the mean of burnout levels and gender, marital status, occupation, and total working times. Mean depression was higher among physicians while mean stress was lower among who worked 5 years and under. EE and PA were the factors associated with depression and anxiety, while EE was the factor associated with stress. Discussion Considering that burnout, depression, anxiety, and stress are intertwined concepts, it is thought that's needed to develop strategies for health workers to regain working energy.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"52 - 60"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1874632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41885159","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":"Invited commentary on: comparative study between Fisher anatomical subunit approximation technique and Millard rotation-advancement technique in unilateral cleft lip repair","authors":"A. Davies, Sherif M Wilson","doi":"10.1080/20905068.2021.1911111","DOIUrl":"https://doi.org/10.1080/20905068.2021.1911111","url":null,"abstract":"To quote Thompson: “all cleft lip surgeons have their favorite surgical technique for repairing the unilateral cleft lip. It is usually a hybrid of training experience and imagination.” [1] Of the ...","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"137 - 138"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1911111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49419507","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 impact of intra gastric balloon as a treatment of obesity on pre-diabetes in obese persons","authors":"Ahmed A. Elhadidy, S. Mashal","doi":"10.1080/20905068.2021.1904547","DOIUrl":"https://doi.org/10.1080/20905068.2021.1904547","url":null,"abstract":"ABSTRACT Introduction: Obesity is arising health problem that is linked to many pathological conditions. Treatment of obesity has a beneficial effect on many health problems. Little data available about effect of weight loss on prediabetes. Object: To evaluate the effect of intra gastric balloon (IGB) as obesity treatment on prediabetes. Method: In a prospective study we have followed 42 obese prediabetic patients who used IGB as obesity treatment. All patients were evaluated for anthropometric measures, lipid profile, fasting blood glucose (FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin HbA1c before and 6 months after IGB insertion. Results: There was a significant reduction in body weight, waist–hip ratio and also body mass index (BMI), as by time of balloon removal mean body weight was 86.62 ± 7.84 Kg, and mean BMI at time of removal was 29.48 ± 2.31 kg/m2 compared to 99.10 ± 7.34 Kg and 33.61 ± 2.18 Kg/m2 before balloon insertion (p < 0.05). Also, significant improvement of FBG and PPBG with mean value of FBG 93.00 ± 9.12 mg% and mean level of PPBG 133.31 ± 11.68 mg% compared to FBG 110.71 ± 12.10 mg% and PPBG 166.81 ± 18.82 mg% before balloon insertion (p < 0.05), likewise there was a significant reduction in HbA1c as its mean value has become 5.48 ± 0.35 compared to 6.01 ± 0.21 before balloon insertion (p < 0.05). Conclusions: six months treatment with IGB for obesity improved the prediabetic condition that may prevent or at least delay type II diabetes mellitus, which needs longer follow-up.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"110 - 112"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1904547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44245527","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":"Role of expression of atrial natriuretic peptide gene in essential hypertension among Egyptian patients","authors":"M. Gamaleldin, Y. Naga, A. I. Ellakany, E. Nassar","doi":"10.1080/20905068.2021.1995284","DOIUrl":"https://doi.org/10.1080/20905068.2021.1995284","url":null,"abstract":"ABSTRACT Introduction Essential Hypertension has been a great burden on public health services for a long time, with many life-threatening complications. Therefore, we decided to study Atrial Natriuretic peptide (ANP) gene expression as one of the most important blood pressure controlling genes, in order to use ANP gene as a potential diagnostic or therapeutic marker in the near future. Methods One hundred essential hypertensive patients and 100 normotensive controls were included. Study Subjects were subjected to ANP gene expression analysis, together with blood pressure measurement, Lab investigations, and BMI analysis. Results There was a statistical difference between ANP gene expression and blood pressure, with lower ANP gene expression level (median of 0.3) being present among hypertensive patients and higher ANP gene expression level (median of 1.6) among normotensive controls (p < 0.001). Discussion We proved that ANP gene expression to be low in essential hypertension patients compared with normotensive individuals.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"240 - 246"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42759504","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":"Perception of Biostatistics by Lebanese Medical Students: A Cross-Sectional Study","authors":"Nivine Abou Dargham, Youssef Sultan, O. Mourad, Mariam Baidoun, Omar Aboul Hosn, Azza Abou El Naga, H. Bahmad, Bilal Azakir","doi":"10.1080/20905068.2021.1892306","DOIUrl":"https://doi.org/10.1080/20905068.2021.1892306","url":null,"abstract":"ABSTRACT Background Inadequate use of statistics in biomedical research might not only affect science but also harm human beings if applied in medical practice. Biostatistics is fundamental to improve understanding and appraising of evidence-based medicine (EBM); yet, it is still not well understood and appreciated by medical students. Therefore, early exposure of medical students and physicians-in-training to research tools including Biostatistics is of utmost importance. Objective The aim of this study is to determine the perception of Biostatistics by medical students at a private medical school in Beirut, Lebanon, and to identify its best implementation time in the medical curriculum. Methods This is a cross-sectional study based on a self-administered questionnaire distributed among medical students in their pre-clerkship years (first three years of a 6-year program) who undertook Biostatistics. The assessment of perception was based on the 5-point Likert scale anchored by Strongly disagree = 1 and Strongly agree = 5 including 36 questions distributed into four domains to assess the course value, difficulty, behavioral, and expectations. Results 186 of 269 students responded to the questionnaire, yielding a response rate of 69.14%. Around 60% of students declared that the knowledge gained from biostatistics courses is useful to their future career, and almost 70% understood the main concepts of biostatistics. 57.7% of students perceived that lack of practicing exercises might contribute to making the course more difficult. The mean score of domains was higher in females but did not significantly differ within the three academic years. Only 35.1% of the students positively perceived the importance of biostatistics modules, mostly third-year students. Conclusion Although the majority of medical students perceived biostatistics modules negatively, they were aware of the relevance of biostatistics to their medical career and real-life health issues.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"103 - 109"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1892306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037221","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":"Pattern of inguinal hernia in Al- Basra teaching hospital: a prospective clinical study","authors":"A. Khalaf","doi":"10.1080/20905068.2021.1880042","DOIUrl":"https://doi.org/10.1080/20905068.2021.1880042","url":null,"abstract":"ABSTRACT Introduction:Inguinal hernia is the most commonly hernia in both men and women but occurs more common in men. Although there are two basic types of inguinal hernia with differences in anatomy, the etiology, complications, and surgical repair technique of both are very similar. The aim of this study was to evaluate the demographic and clinical characteristics of patients with inguinal hernia who underwent either elective or emergency surgical hernia repair at Al-Basra Teaching Hospital. Methods: This was a prospective clinical study involving patients with inguinal hernia admitted to Al-Basra Teaching Hospital from February 2017to November 2019. Patient’s demographic data, smoking habit, body mass index, history of chronic diseases, family history of inguinal hernia, and post-operative complications were evaluated. The patients were divided into seven groups according to age. All data were recorded and analyzed. Results: A total of 250 patients age 16 to 82 years were included (men, 88.4%, women, 11.6%) in this study. Most of the patients were above the age of 40, nearly half of the patients were smokers and had a positive family history of inguinal hernia. Most patients had normal body weight, and 12% of patients developed postoperative complications. Conclusion: We concluded that a large proportion of patients with inguinal hernia were men and they underwent elective hernia repair. All of patients with recurrent hernia were found to be smokers. Patient who underwent elective hernia repair had minimal postoperative complications with short hospitalization.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":"57 1","pages":"70 - 74"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2021.1880042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42189642","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}