Benha University Research Articles

Evaluation of foveal avascular zone changes in patients with type 1 diabetes using optical coherence topography angiography

Aim To evaluate vascular changes in the foveal avascular zone in pediatric patients with type 1 diabetes by using optical coherence tomography angiography (OCTA). Patients and methods This cross-sectional study was performed in Benha University Hospital at Department of Ophthalmology. The patients were obtained from the Pediatric Endocrinology Clinic in Benha University Hospital. The study was conducted on 48 patients (96 eyes) divided into two groups: group A, 24 diabetic children with type 1 diabetes, group B, 24 healthy children of the same age and sex who met the inclusion criteria. The patients were collected from April 2022 to April 2023. The patients were photographed using the Optovue AngioVue OCTA System. Results Our results show that according to the foveal avascular zone it was slightly wider in type 1 diabetic cases with no clinically evident diabetes retinopathy (DR) than control. There were insignificant differences between the two groups as regards foveal density, but as regards foveal thickness, it was significantly lower in diabetic cases than in the control group. Conclusion We discovered that OCTA could consistently identify microvascular changes in the Deep and Superficial Capillary Plexus prior to the clinical indications’ onset of DR. In order to assess the OCTA potential for the screening of DR in children with T1DM, it is necessary to conduct numerous prospective studies.

Response of pathogenic bacteria isolated from wound infections to Antibiotics and some Essential oils from surgery department at Benha university hospital

Response of pathogenic bacteria isolated from wound infections to Antibiotics and some Essential oils from surgery department at Benha university hospital

Outcome of PICU in Benha University in Last 2 Years

Outcome of PICU in Benha University in Last 2 Years

C-reactive protein compared to procalcitonin in guiding of anti-microbial stoppage in patients with septic shock

BackgroundOne of the greatest and most effective strategies to decrease the likelihood of discovering antibiotic-resistant bacteria in patients receiving critical care is to shorten the duration of antibiotic therapy.ObjectivesTo assess the utility of procalcitonin compared to traditional inflammation markers like C-reactive protein in an antimicrobial stoppage in patients with septic shock.MethodsThis was a comparative, prospective, randomized, observer-blind clinical experiment conducted on 60 septic patients hospitalized in intensive care units at Benha University hospitals between May 2021 and May 2022. Groups for PCT and CRP patients were separated. The full clinical history, co-morbidities that were related, and patient history were recorded. The baseline PCT and CRP values were determined on days 4, 7, 10, and 14. They were contrasted with sepsis ratings obtained from the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sepsis-related Organ Failure Assessment (SOFA). Days 4, 7, and 10 were used to evaluate the antibiotic's efficacy.ResultsThere was no correlation between CRP levels and APACHE II and SOFA scores on days 1, 4, and 7, but on days 7 and 10, PCT levels were strongly linked with both (P < 0.05). PCT was linked to lower antibacterial exposure (23.3% of PCT participants ceased taking antibiotics on day 4, compared to 6.6% of CRP participants; P = 0.07). After 10 days, 30% of the PCT group and 70% of the CRP group kept up their antimicrobial regimen (P = 0.0001).ConclusionProcalcitonin dramatically reduced the duration of antimicrobial treatment. Procalcitonin use has reduced hospital expenses, complications of extended hospital stay, side effects of excessive antibiotic use, and hence, the mortality rate in septic patients.

Relationship between Peripheral Blood Cytopenia and Type 2 Diabetic Patients in Benha University Hospital

Relationship between Peripheral Blood Cytopenia and Type 2 Diabetic Patients in Benha University Hospital

The effects of laser acupuncture on metabolic syndrome in obese postmenopausal women: a randomized controlled study

To study the laser acupuncture (LA) effects on postmenopausal obese women’s metabolic syndrome. Randomized controlled trial. Benha university hospital. Thirty postmenopausal women were randomized into two equal groups. Group A received a diet regimen and Group B received LA treatment for 30 min three times a week for two months beside the diet regimen. Included weight (W), body mass index (BMI), waist (WC), hip (HC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum level of total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), fasting blood insulin (FBI), homeostatic model assessment-insulin resistance (HOMA-IR) before and after the end of treatment. The study’s findings showed that both groups experienced a highly statistically significant decrease in the post-testing mean value of W, BMI, WC, HC, WHR, SBP, DBP, TC, TG, LDL, FBG, FBI, and HOMA-IR, while both groups experienced a significant increase in the post-treatment mean value of HDL (p 0.0001). The posttreatment SBP, DBP, TC, TG, LDL, FBS, FBI and insulin resistance were significantly lower while HDL was significantly higher in women who received combined LA and diet regimen compared to those who received dietary regimen only. LA beside the nutritional intervention is a physical therapy technique that may be used safely, easily, and effectively to minimize metabolic syndrome features during menopause.

Significance of Runt-related transcription factor 1 and Notch1 expression in non-small-cell lung cancer: involvement in epithelial-mesenchymal transition and epidermal growth factor receptor-tyrosine kinase inhibitor therapy resistance

Objective One of the main obstacles to treating patients with non-small-cell lung cancers (NSCLC) is the emergence of drug resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy. Aim To investigate the prognostic relevance of Runt-related transcription factor 1 (RUNX1) and Notch1 in NSCLC and to evaluate their potential involvement in induction of epithelial-mesenchymal transition and resistance to EGFR-TKI therapy. Materials and methods Immunohistochemical study of RUNX1, Notch1, E-cadherin, and hypoxia-inducible factor 1α (HIF-1α) was conducted upon 83 cases diagnosed as NSCLC. The research was conducted in the departments of pathology, chest, and medical oncology of the Faculty of Medicine, Benha University. Results A significant relation was found between RUNX1 and sex (P=0.001), smoking history (P=0.002), and tumor grade (P=0.002). High RUNX1 expression was associated with poor OS and DFS (P=0.003 and 0.005), respectively. Cases with positive Notch1 expression were significantly associated with tumor grade (P=0.005) and tumor stage (P=0.024). A significant association was detected between Notch1 expression and poor OS and DFS (P=0.025 and 0.011), respectively. A statistically significant correlation was found between RUNX1 and Notch1 expressions (P=0.040). Moreover, high RUNX1 and positive Notch1 expressions were significantly associated with negative E-cadherin and positive HIF-1α expressions. Resistance against EGFR–TKI therapy was significantly associated with high RUNX1, positive Notch1, negative E-cadherin, and positive HIF-1α expressions, in EGFR-mutated cases. Conclusions RUNX1 and Notch1 may be involved in therapy resistance through the induction of epithelial–mesenchymal transition and may serve as prognostic markers in patients with NSCLC.

Effect of Educational Guidelines on Diabetic Patients' Knowledge, Attitude, and Self-Efficacy Regarding Use of Artificial Pancreas

Context: Artificial pancreas has a beneficial effect on controlling blood glucose levels. Nurses play a crucial role in helping diabetic patients through educational guidelines that increase their knowledge and improve their attitude and self-efficacy regarding the use of artificial pancreas as a new technology to help continuously control blood glucose levels. Aim: to evaluate the effect of educational guidelines on diabetic patients' knowledge, attitude, and self-efficacy regarding using artificial pancreas. Methods: A quasi-experimental study design (pre/post-test) was used to achieve the aim of this study. The study was conducted in the medical department and outpatient medical clinic at Benha University Hospital. A purposive sample of 100 adult patients with type 1 diabetes mellitus were admitted to the mentioned setting during the study period. Three tools were used. Patients' Assessment Questionnaire comprises two parts: Patients' personal data and health history of the disease and patients' knowledge assessment. Patients' attitude Rating Scale regarding the use of the artificial pancreas, and Self-Efficacy Scale. Results: The result reported a significant difference in the satisfactory knowledge level of patients from 15% pre-educational guidelines to 57% post-educational guidelines. Significant differences in the total level of positive attitude increased from 22.0% pre-educational guidelines to 63.0% post-guidelines, and significant differences between the mean self-efficacy scores of the studied patients regarding their perception and confidence in the ability to use the artificial pancreas as it increased from 1.8±0.7 pre to 3.1±0.4 post the educational guidelines implementation. Conclusion: Educational guidelines have a positive effect on improving diabetic patients' knowledge, attitude, and self-efficacy regarding the use of artificial pancreas. The study recommends implementing ongoing educational programs and workshops for diabetic patients on artificial pancreas.

Trabecular Metal Augments for Reconstruction of Acetabular Bone Defects in Revision Total Hip Replacement: Short-Term Outcomes

Abstract Background: Revision hip surgeries are increasing dramatically nowadays, and achieving hip center of rotation is challenging. Obtaining a press-fit implant and restoring the hip’s center of rotation might be difficult during the restoration of acetabular deformities during revision total hip arthroplasty (THA). Aim: The aim of the study was to evaluate the outcomes of using trabecular metal augments for reconstruction of the acetabulum in patients undergoing revision THA with short-term follow-up. Patients and Methods: This study was conducted in Benha University Hospital between April 2019 and March 2023. It is a prospective cohort study including 20 patients who are undergoing revision THA with acetabular defects. Results: The mean age of patients in this study was 59 years old. According to Paprosky classification: 45% of type 2B. The postoperative Oxford Hip Score showed marked improvement in the outcomes, the score was excellent in 55% (11 patients), good in 40% (8 patients), and fair in only 5% (1 patient) over 16 months’ mean follow-up period. Conclusion: Due to its modularity, tantalum augments are considered a valuable method in the reconstruction of acetabular defects.

The Impact of Obesity on Total Laparoscopic Hysterectomy Outcomes: A retrospective Analysis Comparing class I, II Obese Women versus Nonobese in Benha University Hospital

The Impact of Obesity on Total Laparoscopic Hysterectomy Outcomes: A retrospective Analysis Comparing class I, II Obese Women versus Nonobese in Benha University Hospital

Efflux pumps encoding genes (adeA and adeS) in relation to antibiotic resistance pattern in Acinetobacter baumannii strains isolated from Benha university hospital

Background Acinetobacter baumannii become a growing problem in hospitals as a predominant multidrug-resistant (MDR). This resistance capacity is generated by various mechanisms including efflux pumps that can direct antibiotics outwards and prevent antibiotics from affecting the bacteria. Methods Clinical samples were cultured on blood agar and MacConkey agar medium, identified by Gram stain and biochemical reactions, and then identified to the species level by Vitek2 automated system. The adeA and adeS genes among isolated strains were detected by conventional PCR. This study included 50 A. baumannii strains to assess the antibiotic resistance pattern of A. baumannii. Results A. baumannii strains were fully resistant to Piperacillin (100%) and lowest resistance to Imipenem (54%) was observed. Out of 50 isolates, 41 (82%) of A. baumanii isolates had adeA gene and 32 (64%) had adeS gene. The clinical strains that had adeA gene and adeS gene showed significantly higher resistance to Ciprofloxacin (92.7%) and (100%), respectively. Additionally, borderline significant differences were reported regarding Gentamycin (P = 0.065), Ceftazidime (P = 0.08), and Meropenem (P = 0.08), with the resistance being higher in the adeA positive group. Conclusion Efflux pumps genes (adeA, adeS) played a key role in antibiotic resistance of A. baumanii.

Effect of Guidelines regarding Patients' Safety on Nurses' Performance in Hemodialysis Unit at Benha University Hospital.

Effect of Guidelines regarding Patients' Safety on Nurses' Performance in Hemodialysis Unit at Benha University Hospital.

Pattern of eye trauma among pediatric ophthalmic patients in upper and lower Egypt: A prospective two-center medicolegal study.

Ocular trauma is the leading cause of monocular blindness in children. This study aimed to identify and compare pediatric ocular injuries at two national university hospitals: Benha University Hospital (BUH) and South Valley University Hospital (SVUH) while evaluating the predictive utility of the Ocular Trauma Score (OTS) for post-traumatic permanent visual infirmity. This multicenter observational study enrolled children under 18 years at BUH and SVUH Ophthalmology Departments from May 31 to December 31, 2022. Comprehensive medical histories and detailed data on eye trauma were obtained, with each undergoing thorough eye examinations at the initial presentation and during the 6-month follow-up period. The final visual outcome was permanent visual infirmity that was defined as the Best Corrected Visual Acuity in the better eye worse than 3/60 or near vision worse than N6 according to the International Classification of Diseases 11. The study included 120 cases evenly distributed between the two hospitals, with a mean age of 10.03 (±3.30) years, 74.17% male and 51.67% urban residents. Blunt, sharp, and foreign objects were the most common causes (39.17%, 33.33%, and 11.67%, respectively). Closed-globe injuries prevailed at BUH (83.33%) than SVUH (40.0%). Most injuries were accidental and outdoors, with an average interval of 9.93 (±23.57) hours to seek medical care. Lack of education, open-globe injuries, poor initial visual acuity, longer intervals from admission to intervention, and lower OTS were associated with visual impairment.

Comparative study between retrograde intrarenal surgery and ultrasound- guided shock wave lithotripsy for treatment of 1 to 2 cm radiolucent lower calyceal stones.

The objective is to compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and ultrasound-guided (US-guided) shock wave lithotripsy (SWL) for the treatment of radiolucent lower pole calculi of 1-2 cm. This prospective randomized study was performed at our tertiary care urology institute of Benha University Hospitals; cases were randomized either to undergo RIRS (Group A) or US-guided SWL with a triple focus system (Group B). The safety and effectiveness of both therapies were compared using new criteria for stone-free rate (SFR): Grade A (absolutely stone free), Grade B (≤2 mm fragments), and Grade C (>2 mm up to 4 mm fragments), fluoroscopy time, operative time, auxiliary procedures, retreatment, and complications. Out of 100 patients, 92 were eligible for this study. RIRS had a higher SFR of 88.9% compared to SWL, 72.3% (P = 0.045). Furthermore, stone-free classification significantly differed between the studied groups (P < 0.001), with Grade A being significantly higher in Group A. Conversely, Grades B and C were lower in Group A. On the other hand, operative and fluoroscopy times were significantly reduced with SWL (P = 0.004 and < 0.001, respectively). While complications did not significantly differ between the two groups (P = 0.340), a significant distinction was observed in terms of the Clavien-Dindo classification. RIRS is an effective and safe option for treating radiolucent lower calyceal stones of ≤2 cm, with a greater SFR and lower need for auxiliary operations. However, Sono SWL is a cost-effective alternative that can achieve a comparable success rate after retreatment sessions.

Prevalence of irritable bowel syndrome among Egyptian undergraduate physiotherapy students of Benha University

Prevalence of irritable bowel syndrome among Egyptian undergraduate physiotherapy students of Benha University

Effect of combined versus individual intranasal dexmedetomidine and ketamine on intraocular pressure in pediatric patients

ABSTRACT Purpose To compare impact of intranasal infusion of dexmedetomidine, ketamine, or combination of both on IOP in children. Patient & methods This prospective, randomized, observational study was conducted at Benha University Hospital, Egypt and included ASA I or II children aged 1–6 years who underwent examination under sedation. They were randomly divided into three groups: Group D (dexmedetomidine 3 μg/kg); Group DK (dexmedetomidine 1 μg/kg with ketamine 2 mg/kg) & Group K (ketamine 4 mg/kg). We assessed IOP difference before and after sedation. Secondary outcomes were sedation scale assessment (Ramsay Sedation Score), emergency agitation and medication side effects. Results We studied 118 children divided into Group D (36 patients), Group DK (42 patients) & Group K (40 patients). IOP was significantly lower in group D (13 ± 3 mmHg) than in groups DK (16 ± 4 mmHg) and K (17 ± 3 mmHg), with no significant difference between groups DK and K. Ramsay 3 was higher in group K (65%) compared to groups D and DK (22.2% and 9.5%, respectively), while Ramsay 4 was higher in group D and DK (52.8% and 52.4%, respectively) compared to group K (35%). Post-sedation nausea and vomiting were higher in group K (25%) compared to groups D and DK (0% for each). Agitation was higher in group K (62.5%) than in groups D and DK (0% for each) (p < 0.001). Conclusion Intranasal dexmedetomidine and ketamine combination are viable for achieving optimal sedation in pediatric patients undergoing surgeries or medical procedures with no significant change in the IOP.

Role of speckle tracking echocardiography in assessing right ventricle function after percutaneous closure of atrial septal defect

Background; Atrial septal defect (ASD) is one of the most common congenital heart diseases. Right ventricular (RV) dysfunction is closely related to patient outcome in open and closed ASD closure. Aim of work; to quantify RV function in patients with chronic RV volume overload due to an ASD before and after its percutaneous closure. Subjects &amp; methods; In this prospective study which included 40 patients with secundum type ASD and normal sinus rhythm who underwent successful percutaneous ASD closure procedure at Cardiology Department, Faculty of Medicine, Benha University; and Cardiology Department, national-heart-institute. All patients underwent full history taking, clinical examination, ecg &amp; echocardiography including assessment of LA, LV, RA &amp; RV functions &amp; dimensions with special emphasis on TAPSE, RV MPI &amp; 2D speckle tracking. Result: LA diameters (mm) were decreased significantly after ASD closure; Antero-posterior, Medio-lateral, and Apico-basal. RA diameters (mm) were decreased significantly after ASD closure; PASP was decreased significantly after ASD closure. LVEF% was increased significantly after ASD closure. TAPSE was increased significantly after ASD closure. RV end diastolic diameters were decreased significantly after ASD closure. Pulsed Doppler RV MPI was decreased significantly after ASD closure. RV longitudinal strain (%) was increased significantly after ASD closure. there was a positive correlation among delta RVSTE and delta LVEF and TAPSE. Also, there was a negative correlation among delta RVSTE and delta RV MPI, RV end diastolic diameter, RA diameters, and PASP. Conclusion; Our study demonstrated significant improvements in multiple echocardiographic measures of cardiac structure and function including reduced LA/RA diameters, decreased PASP, increased LVEF, higher TAPSE, reduced RVEDD, lower RV MPI, and increased RV longitudinal strain at one month post-procedure. These changes indicate reversal of the chronic volume and pressure overload on the right heart caused by the left-to-right shunt, resulting in measurable reverse remodeling and improved mechanics of the right ventricle.

Evaluation of functional significance of intermediate coronary artery lesions noninvasively by tissue doppler echocardiography and single photon emission computed tomography versus invasively by IFR

Background: Myocardial perfusion imaging by single photon emission computed tomography (MPI–SPECT) is noninvasive test that can give an important information for the diagnosis of coronary artery disease (CAD), detect reversible ischemia, quantify defect sizes and help in clinical decisions of interventions as well as assessment of disease prognosis. Tissue Doppler imaging (TDI) emerged as a potential modality for assessing systolic and diastolic LV performance. Strain doppler echocardiography (SDE) is a new tool for measuring regional myocardial deformation excluding the effect of adjacent myocardial tissue. The development of Instantaneous wave-free Ratio (IFR) as a relatively new invasive method for physiological assessment of coronary lesions without the use of pharmacologic hyperemic agents is the golden standard test for assessment of intermediate coronary lesions and guiding the revascularization decision. Methods: This Cross-sectional study was done was conducted on 50 cases with intermediate coronary artery lesions admitted at the Cardiology departments in Benha University, Kobry Elkobba Military Hospital and Air Force Specialized Hospital. All groups were subjected to history and clinical examination, cardiac examination, 12 lead ECG, 2D echocardiography, routine laboratory investigations, coronary angiography with evaluation of intermediate lesion by IFR then TDI and SDE for evaluation the regional myocardial deformation of the segments supplied by the same coronary artery, after that 99mTc-sestamibi (MIBI) SPECT imaging was done to quantify defect size and finally correlation was done between results of IFR, TDI and SPECT to guide the revascularization decision. Results: Pearson’s correlation analysis showed that; Gated single-photon emission computed moderate and severe Ischemia, Sm-velocity, WMSI, DT, had a highly significant positive correlation with IFR value (p &lt; 0.001). E/A ratio, Mean E/e’ velocity ratio, FS, LVEF and LV GLS had a highly significant negative correlation with IFR value (p &lt; 0.001). Conclusions: Instantaneous wave-free Ratio (IFR) modality is a reliable measure to guide functional significance of the intermediate coronary artery lesions for decision making and guiding plan of management. But it is an expensive and invasive modality. On the other hand, SPECT and tissue doppler modalities showed high sensitivity and specificity in the same group of patients with less expensive, non-invasive and no contrast use advantages.

Sonographic assessment of the diaphragm in COVID 19 and non-COVID ICU patients

BackgroundSonographic evaluation of the diaphragm has gained popularity in the ICU due to the necessity of assessing diaphragmatic function in a variety of clinical situations. The sonographic examination of diaphragmatic dynamics in ICU patients by measuring diaphragmatic thickness and excursion in connection to various modalities of mechanical ventilation (MV) and patient outcomes was the objective of this study.MethodsThis prospective observational study was carried out on 50 patients in respiratory ICU in Kafr Elsheikh and Benha University Hospitals. Patients were classified into 2 equal groups: COVID-19 group and non-COVID group. All patients underwent ultrasound assessment included the diaphragm thickness fraction and excursion in ICU patients on admission and on weaning.ResultsSuccessful weaning (SW) was higher in group I compared to group II. In group I (COVID), diaphragm excursion, thickness at end inspiration and at end expiration in NIV at weaning were significantly higher in patients with SW but thickness at end expiration on admission was significantly lower. In group II (non-COVID) MV patients, excursion at weaning was significantly higher in patients with SW, also were thickness at end inspiration and end expiration on admission, thickness at end inspiration and end expiration at weaning in NIV patients but thickness at end inspiration in MV on admission was significantly lower.ConclusionWeaning success and mortality were significantly predicted by excursion in NIV at weaning, thickness at end inspiration in MV at weaning, thickness at end inspiration in NIV at weaning, and thickness at end expiration in MV at weaning.

Facilitators and Barriers of Employing Electronic Exams as Perceived by Nursing Students and the Relation to their Satisfaction

Context: Nowadays, during the COVID-19 pandemic, electronic exams are perceived as a fast-evolving assessment tool because of their accuracy and reliability. It provides relatively more accurate results and immediate feedback for students and instructors. Aim: To assess facilitators and barriers of employing electronic exams as perceived by nursing students and the relation to their satisfaction. Methods: A descriptive correlational research design was used to achieve the aim of this study. The study was conducted at the Faculty of Nursing at Benha University on 970 nursing students from the four academic years (2020/2021). They were selected using a stratified random sampling technique. Data was collected using three tools. The student perception of electronic-exams facilitators questionnaire, the student perception of electronic-exams barriers questionnaire, and the nursing students’ satisfaction assessment scale. Results: More than half of nursing students (59.9%) had a high perception level about facilitators of electronic exams, whereas nearly two-thirds of nursing students (60.9%) had a moderate perception level about barriers to electronic exams, and 75.5% had a high satisfaction level regarding electronic exams. Conclusion: This study concluded that more than three-quarters of students had high satisfaction. There was a positive, statistically significant correlation between total students' satisfaction with facilitators of the electronic exam and a statistically significant negative correlation with barriers to the electronic exam. The study recommends that students must receive regular, periodic in-service computer skills courses and study the factors that influence university students to embrace and use electronic exams with an online test system.