Full Physical Examination Research Articles

Determine upper limit of normal range of antistreptolysin-O titer in normal school children from 5 to 15 years old

ObjectiveTo determine upper limit of normal range of antistreptolysin-O (ASO) titer in normal school children from 5 to 15 years old in Menoufia Governorate.BackgroundAlthough ASO titer has provided a useful guideline to physicians this has been shown to vary with age, geographical location, and site of infection.Patients and methodsA cross-sectional study was carried out in Menoufia Governorate and the samples were collected from outpatient clinics of Menoufia university hospital other than infection (by advertising in the outpatient clinics for analysis streptococcus laboratory for free in children aged 5–15 years) in the period from July 2016 to May 2017. Two hundred children aged 5–15 years were participated in this study after consent from their parents. The children were categorized into two groups: group 1: include children aged 5–10 years and group 2: include children aged 11–15 years. Full history, routine, physical examination, and special investigations were taking.ResultsThere was statistically significant difference between residence and social classes in the studied group. Also, there was statistically significant difference between age groups regarding ASO titer among rural patients. There was highly significant correlation between number of attacks of acute follicular tonsillitis with ASO titer level, age groups, and social classes.ConclusionThe upper limit of normal ASO titer in normal Egyptian children is quite high, reaching up to 398.5 IU/ml. Therefore, an isolated high ASO titer is not sufficient to diagnose acute rheumatic fever. Basal levels of ASO titer increase with age but age does not affect the peak level during acute streptococcal infection. Additional studies will be required for establishment of standard values to avoid over diagnosis of acute rheumatic fever and complications of long-acting penicillin.

Mean platelet volume as a prognostic factor in neonatal respiratory distress

ObjectiveTo evaluate mean platelet volume (MPV) as a prognostic factor in neonatal respiratory distress.BackgroundRespiratory distress syndrome (RDS) is a major cause of morbidity and mortality in preterm infants. MPV is an indicator of platelet function. It may be considered a risk factor for the development of RDS.Patients and methodsThis was a case–control study conducted on 50 (21 males and 29 females) Egyptian preterm neonates. Of them, 25 were previously diagnosed as having RDS, as a patient group, and 25 were apparently healthy age-matched and sex-matched neonates as a control group. All of them were subjected to full history and physical examination. Blood samples were taken on first and third day. Blood for complete blood count was obtained by either venipuncture, arterial puncture, or through a central catheter. complete blood count included MPV, platelet count, and white blood cell count.ResultsMPV on the first day (fl) in the study group [10.8 (9.1, 11.2)] was significantly higher than controls [7.9 (7.6, 8.2)], with P value less than 0.001. MPV on third day (fl) in study group [11.5 (10.4, 12.2)] was significantly higher than controls [8.3 (8.1, 8.5)], with P value less than 0.001. However, platelet count on third day (×109/μl) in the study group [146 (103, 170)] was significantly lower than in controls [176 (150, 202)], with P = 0.032.ConclusionMPV is a simple and readily available biomarker, and it is indicated that platelet may have been involved in the physiopathologic process of RDS.

Study of short-term outcome of early and late cord clamping in full-term newborns

ObjectiveThe aim was to assess short-term outcome of both early and late cord clamping in full-term newborns.BackgroundDelaying clamping of the umbilical cord for at least 2 min after birth consistently improved both the short-term and long-term hematologic and iron status of full-term infants.Participants and methodsThis is a case–control study that was conducted on 100 Egyptian full-term neonates (47 males and 53 females), involving 50 newborns with early clamping of the cord less than or equal to 1 min as group I and 50 newborns with late clamping of the cord more than 1 min without milking of the cord, matched for age and sex, as group II. All of them were subjected to full history, physical examination, Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (APGAR) score, and blood samples taking at birth and after 24 h. Complete blood count including hemoglobin (Hb), packed cell volume, hematocrit, mean corpuscular volume, reticulocyte count, and total serum bilirubin (TBS) was done.ResultsHb, hematocrit, packed cell volume, and TBS (P < 0.05) were significantly higher after 24 h of cord clamping in the delayed clamping group than early clamping. APGAR score had no significant difference.ConclusionIn term infants, delayed umbilical cord clamping increases Hb levels at birth. There is a small increase in TBS, requiring follow-up after 24 h, in term infants undergoing delayed umbilical cord clamping.

Clinical Characteristics and main presentation of the COVID19 among Iraqi people

The COVId19 pandemic is a newly emerging infectious disease that needs to be understood thoroughly in order to be controlled. This study aimed to study the clinical and laboratory characteristics of the COVID19 patient . Patient and methods: A cross-sectional study was done in Iraq, at Salahadeen general hospital from the period 1st March to the end of May 2020 on patients diagnosed with COVID 19. A total of 75 COVID19 patients enrolled in the study. a full history was taken, a full physical examination was done, computerized tomography, and laboratory tests. Results: The age distribution of the COVID19 patient were commonly aged (30-50 years) 37(49.3%), and those aged &lt;30 years represented about 6(8%) of the sample. The dominant gender was male 43(57.3%). About 58 (77.3%) of the patient had comorbid disease, coronary vascular disease was 49(65.3%), hypertension was found among 47(62.7%), DM was found among 40(53.3%). Smoking found among 35(46.7%) of the patients . The commonest symptoms were dyspnea 63(84%), fever 51(68%), Myalgia 46(61.3%), loss of smell 8(10.7%), vomiting 8(10.7%), sputum 8(10.7%), loss of taste 6(8%), diarrhea 6(8%), dry mouth found among 6(8%), cough 6(8%), fatigue 5(6.7%)followed by arthralgia 4(5.3%), and chest pain 3(4%). The mean Spo2% was (88±6.6), heart rate was (103±23.3), the mean respiratory rate was (17.7±4.1), the mean temperature value was (38.1±1.1), and the mean C - reactive protein rate was (49.8±41.2). The CBC shows that Lymphopenia was reported among 34(45.3%) of the patient, leukocytosis reported among 19 (25.3%) of the patient. Chest CT revealed that mean lung involvement was (16.6±14.7%). Conclusion: The commonest presentation of the patient was dyspnea, followed by fever. Digestive symptoms and myalgia were common. COVID19 maybe became a stigma in our community and educational programs were needed to overcome this problem.

Ergen Sağlığında Kaçırılmış Fırsatlar: Türkiye’den Genel Bir Bakış

Introduction: Serious health problems and poor health habits persist among adolescents despite access to health information and medical care. The study aimed to determine the status of access to health services, the need for health information, and the preferred source of information among adolescents in Turkey. Method: In this descriptive study, a questionnaire developed by the researchers was applied online to individuals aged 18-25 between September - December 2017. Descriptive statistics were shown with numbers (n) and percentages (%) or mean (m) and standard deviation (± SD). Pearson chi-square and Kruskal Wallis tests were used for data analysis. Results: The mean age of the total 1807 participants was 20.28 (±1.89) and 57% were female. The rate of adolescents whose number of visits to the family physician was accurate to national guidelines was higher among those who had attended public schools and who lived in a nuclear family. This rate was lower among those who continued high school in the lower developed part of Turkey. Only 12% of the adolescents had undergone a full physical examination and few were questioned about psychosocial aspects. The demand for counseling on health topics about risky behaviors differed according to gender. While school was the main ‘past’ source for information, the family physician was the most ‘preferred’ one. Conclusion: Missed opportunities exist in adolescent health. Adolescent health services should be maintained in a multidisciplinary manner. Especially primary care services and school settings should be strengthened to provide accurate health information to young people.

The Physical Examination Experience of Nursing Students: A Qualitative Study

Aim: The aim of this study was to determine the experience of nursing students in physical examination. Materials and Methods: The study was conducted with a total of 10 students studying in a nursing faculty and taking a physical examination course. The data were collected using a semi-structured interview form consisting of 11 questions evaluating students’ experiences in physical examination. Results: In our study, most of the students defined physical examination as “evaluation of lung sounds” and “evaluation of bowel sounds”. They stated that they pay attention to situations such as explaining and introducing the process before the examination, protecting the privacy and they are not sufficient in physical examination skills and they did not perform a full physical examination before. They reported that they were good at edema assessment, bowel and lung sound listening skills, but bad in the ability to know how to contact the patient. All of the students stated that the gender difference increased the shyness of the patients. Most of the students reported that physical examination works. In the feedback about the course, most of the students suggested that they did not feel theoretically incomplete but they could not apply the theory to practice. In order to solve this problem, they suggested “role play” and “practice on model”. Conclusion: It was seen that the majority of the students experienced various problems related to physical examination and they made some suggestions for them.

ECHOCARDIOGRAPHIC VARIABLES IN THE AFRICAN PAINTED DOG (LYCAON PICTUS).

The aim of this study was to screen for cardiac disease and report normal echocardiographic variables from a managed population of the African painted dog (Lycaon pictus; APD). The study included six male adult APDs under managed care with no evidence of significant structural cardiac disease. Echocardiography was performed with APD maintained under anesthesia with a combination of midazolam, butorphanol, and inhaled isoflurane. All animals underwent a full physical examination and two-dimensional (2D), M-mode, and Doppler echocardiography using standard views. Left ventricular volumes were calculated using the Simpson's method of discs. Medians with ranges were reported for the echocardiographic variables. No valvular structural abnormalities were noted. Trace mitral regurgitation was documented in five of six APD, trace tricuspid regurgitation in three of six, and mild pulmonic regurgitation in all APD. No aortic regurgitation was noted. Standard M-mode measurements fell within the normal ranges for allometrically scaled M-mode cardiac measurements for normal adult domestic dogs (Canis familiaris). Two-dimensional measurements were comparable with that of domestic dogs with similar body weight. The study demonstrates a similarity in cardiac size and function compared with normal adult domestic dogs and provides baseline echocardiographic variables for investigation of cardiac health in other populations of APDs in the future.

Role of the Isoform p-53 Protein in Failed Cases of Chronic Lymphocytic Leukemia

Introduction It was discovered in the last few years that the production of some percentage of mutant p-53 proteins, with the increased stability in type B lymphocytes, leads to the carcinogenesis process. This discovery led to the identification and quantification of the p-53 protein by different methods such as immuno-histochemistry (IHC), polymerase chain reaction (PCR), single-stranded peptide microarray, (SSPMa), next-generation sequencing (NGS), and the sandwich enzyme-linked immunosorbent assay (sandwich ELISA). Method Using the ELISA technique, the frequency of p-53 protein expression in 20 representative patients diagnosed with CLL-B was analyzed, in order to investigate the relationship of the p-53 protein at the different stages of the disease and the impact on patient survival. ELISA Kit Component: Coated 96-well, Strip Plate 1, Standard (Lyophilized) 2 vials Assay, Diluent (5x) 1 vial x 15 ml, Biotinylated Detection Antibody 2 vials, HRP-Streptavidin Conjugate (800x) 1 vial x 200 µl, Wash Buffer (20x) 1 vial x 25 ml, TMB Substrate 1 vial x 12 ml, Stop Solution H2SO4 1 vial x 8 ml, Plate Sealers 4. Molecular biology technology used in the method The monoclonal p-53 antibody, PAb 240, used in the ELISA method recognizes both mutant and wild-type p-53 under denaturing conditions. Species reactivity is for human or rhesus monkey in conformity with the prospect. The monoclonal antibody PAb 240 recognizes an epitope that is structurally hidden in the wild-type conformation of p-53 and becomes exposed by denaturing the p-53 protein or the mutant conformations of p-53, where point mutations in the P-53 gene alter the terminal structure of the p-53 protein. This ELISA kit is recommended for use in serum, plasma or tissue homogenates. Using other types of sample is not supported. The sample collection protocols below were adapted from the references. 1. Full physical examination of patients diagnosed with CLL All patients were admitted to hospital with symptoms and clinical features of CLL, such as cough, night sweating, and retrosternal pain. Clinical examination and ultrasounds revealed adenopathy and/or splenomegaly, with spleen enlargement of 3 cm above the normal diameter. 2.Immunophenotyping using monoclonal antibodies (Flow Cytometry) CLL-B diagnosis was confirmed by immunophenotyping: monoclonal antibodies in CD5⁺, CD19⁺, CD20⁺, CD23⁺, CD28⁺ receptors, and with B lymphocytes expressing IgM or IgG heavy chains with kappa or lambda light chains. 3.Laboratory Exams: For each of the cases, a 5 Diff Hematology Analyzer was used to perform a haemogram, and blood smear cytology exams on peripheral blood and medullary bone marrow were carried out by May-Grunwald Giemsa staining. The leukemia cells found in the peripheral blood smear had characteristic microscopic morphology, with the small nuclei having mature lymphocytes with full or partially aggregated chromatin and lacking nucleoli. Results Of the 20 patients studied, 14 men have aged 55-85 years and 6 women aged 39-85 years. Patients were treated at the time of these investigations with cytostatic and immunotherapy specific for CLL. Male results: Protein concentration p-53 / µg / dl: 20, 15, 18, 40, 10, 12, 14, 60, 30, 10, 13, 13, 5, 10, 15, 12. Women's results; Protein concentration p-53 / µg / dl: 140, 30, 13, 10, [Graphic 1]. Statistical interpretations: The probability index (NORMDIST) p, was calculated in the value of p = 0.034. The reference interval was established between the values 10-40µg / dl, (m = 24.5 µg / dl. The pathological values in the 3 cases of highly elevated p-53, reflecting the concentration of p-53 protein mutant, were calculated in 2 men in the amount of 60 µg / dl, respectively in 50 µg / dl, and in the female case, it was calculated in the amount of 140 µg / dl, the frequency of chronic lymphocytic leukemia with mutant p-53 protein being higher in men than in women, in ratio 2/1, in accordance with the data from the specialized literature. Conclusions In the context of a heterogeneous malignant disease, such as CLL-B, a simple and inexpensive ELISA method, such as employed in this study, proves useful for identifying patients to be considered as candidates for personalized therapeutic strategies, based on the mutation of the TP- 53 gene and the presence of p-53 isoform protein. Figure Disclosures No relevant conflicts of interest to declare.

TREATMENT-RESISTANT OBSESSIVE COMPULSIVE DISORDER: AN EVALUATION STUDY OF THE AUGMENTATION EFFECT OF LOW-FREQUENCY REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION

Background: Thelifetime prevalence of obsessive-compulsive disorders (OCD) is estimated to be around 3% in the general population. Selective serotonin reuptake inhibitors (SSRIs) are considered to be the primary treatment strategy of OCD in addition to psychotherapy. Unfortunately, current medications, augmentation strategies, and behavioral therapies fail to provide adequate benefits in many cases. A large percentage of patients (40-60%) do not show satisfactory response to the standard treatments, some of them experiencing a chronically deteriorating course, leading to marked interpersonal and occupational impairments. In recent years, non-invasive neuromodulatory techniques such as repetitive transcranial magnetic stimulation have been increasingly studied as potential adjunct or alternative therapies for a wide range of neurological and psychiatric conditions including pain disorder, depression, and stroke rehabilitation and OCD. Aims: the aim of this work to evaluate rTMS as an augmentation strategy in treatment-resistant OCD, to test the potential value oflow frequency rTMS to SMA,orbitofrontal cortex and right DLPFC in the treatment of resistant OCD and to compare between the therapeutic values of applying the TMS coil to those different areas of the cortex. Patients and Methods: This study was carried out in Psychiatry, Neurology and Neurosurgery Center, Tanta University from September 2017 to November 2019. Eighty patients (52 females and 28 males) aging between 18 and 65 years underwent complete psychiatric evaluation, including full medical history, psychiatric and physical examination and diagnosed as having OCD accordingto DSM-5 with failure of at least two adequate therapeutic trials of SRIs. Results: Before rTMS sessions there was no statistical significant difference between the three active groups and the sham group regarding the scores onYale-Brown obsessive compulsive scale,Hamilton anxiety rating scale, Hamilton depression rating scale and Clinical global impression scale. Results after rTMS sessions revealed the following: Active rTMS on the SMA, the left OFC and right DLPFC was associated with marked improvement in YBOCS, Hamilton anxiety rating scale, Hamilton Depression rating scale and clinical global impression scale. The most significant improvement in Yale Brown Obsessive Compulsive scale was obtained when the brain target was the SMA. The most significant improvement in anxiety rating scale and depression ratingscale was obtained when the brain target was the left OFC. Sham group didnt have significant improvement through the study. Conclusions: We can thus conclude that low frequency rTMS is significantly effective as an adjunctive treatment for resistant OCD and that the SMA is the most effective brain target.

Study of the Level Total Antioxidant Capacity in Urinary Stones Patient

The study was conducted over a hundred patients renal stone and forty apparently were taken as controlgroup. The renal stone comprised one hundred patient aged (10-70 years) with mean ± standard deviationof (46.10+_16.30) years. The Control group includes forty apparently healthy individuals aged (20-65years) with mean± standard deviation (30.22 + 11.36) yea . The study was conducted of the 1th periodfrom February 2019 to the April 2019. Samples collected from outpatient Department AL- Hilla TeachingHospital. All patients underwent full history and physical examination, including (age, sex, medical familyhistory and the presence of stones formation frequently in the patient and other chronic diseases),Venousblood samples was collected from patients with renal stones and control subjects by using disposable (5 ml)of each patient taking (1 ml) of it and put it in tube with coagulation contain EDTA blood and leave the restto coagulate for 10-15 minutes in Temperature of 37 ° C and then enter the rotation speed of 1800 rpm isobtained blood serum and then the serum was stored in -20 degree,

Assessment of Auditory Brainstem response in infants in relation to type of feeding

ABSTRACT Background: Breast milk is important for brain development as it contains high concentration of long chain polyunsaturated fatty acids, also it contains cholesterol, amino acids as taurine and also lactose which broken to glucose and galactose, All are important nutrients for the brain and central nervous system tissues. Auditory Brainstem Response (ABR) is considered to reflect brain function of the infant and is widely used to determine/measure the brain development / maturation of the infant. Objective: to assess auditory brainstem maturation in breast-fed and formula fed infants as part of brain maturation using ABR. Methodology: thiscase-control was study carried out upon 100 apparently healthy infants; 50 infants of them were exclusively breast-fed and 50 infants were exclusively formula-fed, all of them aged 4-6 months. Each infant was subjected to detailed history, a full physical and neurological examination together with estimation of ABR. Results: There was statistically significant prolongation of absolute latencies of wave III and wave V of ABR of right and left ear in bottle feeding infants in comparison to breast feeding infants. Also, there was statistically significant increase of mean wave interpeak latencies I-III, III-V and I-V of right and left ear in bottle feeding infants compared to breast feeding infants. Conclusion: Better brain maturation in breast-fed infants compared to formula-fed infants evidenced by ABR.

Comparison Study between Chest Ultrasonography and High Resolution CT in Diagnosis and Assessment of Interstitial Lung Diseases

Background: Chest high-resolution computed tomography [HRCT] is considered the “gold” standard for radiological diagnosis of interstitial lung disease [ILD]. However, it is not available in all health care facilities and its high cost is a limitation for its wide use. Ultrasound could provide a suitable alternative. Aim of the work: To detect the role of transthoracic lung ultrasonography [LUS] in diagnosis and assessment of ILD and to correlate it with HRCT as a gold-standard diagnostic modality.Methods:This included fifty patients who were admitted with clinical features suggestive of ILD. All were clinically evaluated [by full history and physical examination], submitted to pulmonary functions, arterial blood gases, lung ultrasound and HRCT. Results: The total sum of B-lines was 72.64 ± 39.45 and the total positive chest areas [> 3 B-lines] 6.47 ± 2.35. The most common ultrasound finding was thick pleural line. Finally, there was positive [proportional], moderate, significant correlation between Warrick’s score [HRCT] and B-lines distance [LUS]. However, Warrick score correlated negatively with each of six-minute walk test, partial arterial oxygen tension and forced vital capacity. Conclusions: Lung ultrasound as a diagnostic modality for ILD reveled that, it is a useful tool, as there was good correlation between LUS and HRCT. LUS is cheap, accessible and radiation-free diagnostic tool. It could play a stand alone or a complementary role in the diagnosis and monitoring of ILD.

Molecular Diagnosis of Coronavirus Disease 2019.

To review molecular diagnostics for coronavirus disease 2019. The world is in the midst of a coronavirus disease 2019 pandemic. Containing the spread of the severe acute respiratory distress coronavirus is critical. Instrumental to the future success is the ability to reliably and reproducibly detect this inciting pathogen to inform public health containment policies and treatment decisions. Molecular diagnostics focusing on molecular detection methodologies for detection of the virus and the presence of the disease. Narrative review. Literature, PubMed, Scopus, and official government documents. Diagnosing severe acute respiratory syndrome coronavirus is done through real-time reverse transcriptase-polymerase chain reaction tests, cell culture, and serology. For patients, diagnostics are an integral part of a full medical history, physical examinations, blood tests, and diagnostic imaging. Here, we review current approaches to the molecular diagnosis of coronavirus disease 2019.

Hackensack Meridian School of Medicine at Seton Hall University.

Hackensack Meridian School of Medicine at Seton Hall University.

Assessment of MR-ProADM and N-Terminal B-Type Natriuretic Peptide of Serum Levels in Patients with Heart Failure.

Background: Heart failure timely and effective diagnosis and treatment directly affects the prognosis of patients, so early diagnosis of heart failure treatment is very important. The current diagnosis of heart failure has yet to be further improved. To investigate the relationship between plasma levels of MR-ProADM and NT-proBNP in cardiac structure and function in patients with heart failure (HF) and the early detection of failure. Methods: Patients were recruited from the coronary care unit (CCU) of Al-Yarmouk Teaching Hospital and were admitted and verified as cases of HF by specialist cardiologists. Between the 1st of November 2017 and the 1st of April 2018; 48 patients (29 males and 19 females), were diagnosed to have HF and were included in the study. The total number of HF patients admitted to the CCU of the hospital during the study period was 100 patients but 52 patients were ruled out according to the exclusion criteria of the study such as Acute Myocardial Infarction, active myocarditis, Drug abuse or an alcohol drinker, renal failure .Apparently healthy subjects were recruited from the staff of Al-Mustanseryeah Medicine College. They comprised (40) subjects (30 males and 10 females). Each subject who was recruited in the control group has underwent a full history and physical examination with a recording of : age, gender, smoking, chronic diseases and medications. Any subject in control group in this study must be fasting for 8-14 hours at the time of drawing of blood specimen. Consent was taken from all subjects in the control group after being told about the aim of the study. The plasma MR-ProADM and NT-proBNP levels were compared between the two groups to observe the value of plasma MR-ProADM combined with NT-proBNP in the diagnosis of heart failure. Results: the levels of plasma MR-ProADM and NT-proBNP were significantly higher in patients with heart failure Compared with the healthy control group. The levels of plasma MR-ProADM and NT-proBNP increased significantly (P &lt; 0.01). The area under the ROC curve for the combined detection of plasma MR-ProADM and NT-proBNP was greater than the area under the three alone tests. Conclusion: The combined detection of MR-ProADM and NT-proBNP has high sensitivity and specificity in the diagnosis of heart failure and can be used as a new detection mode.

COVID-19: The Worst Days of Our Careers.

Adapting to this new paradigm during this pandemic has been ever-changing and extraordinarily challenging, both personally and professionally.

The Role of Hyperglycemia and Coexisting Hypertension in The Development of Diabetic Nephropathy in Type II Diabetes Mellitus

Background: diabetic nephropathy (D.N) is an important cause of morbidity and mortality and now the most common cause of end stage renal failure ESRF worldwide but especially in developed countries.Objectives: the aim of the study is to know the role of hyperglycemia and co-existing hypertension HTN in the development of D.N. among patients with type II Diabetes Mellitus(DM).Patients and Method: one hundred and twenty one diabetic patients were enrolled in a prospective observational study. Sixty six patients were females and fifty five were males. Besides full history and physical examination data were collected according to a format. At the end, these data were collected and analyzed statistically.Results: the average age was (54± 2.1) year , female to male ratio 66 to 55 (1.2:1) the number of patients with hyperglycemia was 90. Average random blood sugar R.B.S was 259± 1.6 mg/dL. number of patients with hypertension was 71, the average of systolic blood pressure BP was 158± 6.1mmHg and diastolic was 10.2±1.1, the average duration of D.M. was (10.5± 4.2) year, the average of glycosylated hemoglobin HbA1c was 9.8± 2.1. the number of patients with D.N was 77.Conclusion: the data showed that hyperglycemia and co-existing of hypertension were major risk factors in the development of D.N. among patient with type II D.M.

Comparison between Hypertensive and Non-Hypertensive Individuals in the Value of Response to Salt Administration

Background: consumption of,salt (sodium-chloride) causes,increment of blood pressure (B.P) in both normal and,hypertensive individuals, that is why,the use of diuretics which eliminate salts from the body decreases the B.P. and used as a line of treatment,in hypertension.Objective: the study,aims to know whether there is any,difference in the increment of B.P. both systolic and diastolic between normal people and hypertensive people after giving salt orally.Method: one hundred individuals were involved in the study, 50 patients were hypertensive,individuals (25 males and 25 females) and labelled as group A, and 50 persons (25 males and 25 females) were normal individuals and labelled as group B and played as control. After full physical examination including 3 times B.P. checking before and after giving 6 gm of sodium-chloride (table salt) orally ; after 2 hours the values of B.P. were recorded and statistical,analysis was done to know the difference,between the two groups.Results: in all individuals of both groups, the B.P. increased,after salt consumption. In group A (the hypertensive group) the mean increment,of systolic B.P. (S.B.P.) was (15.98) mmHg and the mean diastolic B.P. increment (D.B.P.) was (9.4) mmHg , while the mean S.B.P. increment,in group B was (8.7) mmHg and mean D.B.P. increment was (8.0) mmHg.Conclusion: the study showed significant difference in the increment of B.P., both systolic and diastolic between the two groups, showing that hypertensive group is more sensitive to salt consumption than normal individuals (the control group).

Topographic corneal changes in children with vernal keratoconjunctivitis

Objectives To determine corneal topographic characteristics of children with vernal keratoconjunctivitis (VKC) and compare the corneal topographic indices between patients with VKC and normal participants. Background Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and ocular allergy is one of them. Patients and methods A cross-sectional prospective study was conducted on children with VKC who attended outpatient clinic of Menoufia University Hospital, Faculty of Medicine, Menoufia University, in the period from February 2018 to February 2019. All study patients were divided in two groups: group I included 50 eyes of children with VKC aged between 7 and 18 years and group II included 30 eyes of normal age-matched and sex-matched participants. Full history, routine and physical examination, general topography, and Pentacam imaging were done. Results Children with VKC had significantly increased keratoconus index, index of surface variance, and index of vertical asymmetry than normal group. However, children with VKC had significantly decreased thinnest location (529.43 ± 34.72) than normal groups (569.30 ± 16.43) (P Conclusions There was a higher prevalence of keratoconus-like topography in patients with VKC. However, owing to small sample size, being hospital-based study, lack of population-based randomized study, and lack of correlation between clinical findings and topographic findings, the data have limited role in extrapolation to the general population. So, patients with VKC should be advised to have corneal topography, especially when presentation of VKC is of long duration, a significant proportion of high refractive error is present, and Best Spectacle-Corrected Visual Acuity (BSCVA) is decreased.

Cystatin C and β2 microglobulin in preeclampsia: a prospective study

Objective To study the plasma levels of β-2-microglobulin (β2M) and cystatin C in patients with preeclampsia. Background The plasma level of cystatin C has been reported to have a better diagnostic performance for diagnosing preeclampsia. Patients and methods A prospective case–control study was carried out on 20 women diagnosed as having preeclampsia as well as 20 pregnant healthy. All patients attended the Obstetrics and Gynecology Department and outpatient clinic of Menoufia University Hospital, Menoufia Governorate, and Suez Insurance Hospital, Suez Governorate, during the study period from December 2016 to November 2017. Full history, routine, physical examination, and other investigations were taken. Results Mean antepartum and postpartum serum cystatin C, mean antepartum and postpartum serum β2M, albuminuria, and creatinine were increased significantly in preeclamptic patient group than the normal pregnancy group. The mean serum level of cystatin C before delivery was 1.78 ± 0.58 and 1.19 ± 0.32, which reduced significantly to 1.31 ± 0.49 and 0.91 ± 0.18 after delivery among preeclamptic patient and normotensive pregnancy groups, respectively. The mean serum level of β2M before delivery was 2.49 ± 0.56 and 1.92 ± 0.64, which reduced significantly to 1.98 ± 0.43 and 1.58 ± 0.49 after delivery among preeclamptic patients and normotensive pregnancy group, respectively. Conclusion Maternal serum cystatin C and β2M concentrations were significantly higher in preeclampsia compared with the normotensives. Cystatin C and β2M can be used as significant and independent predictive factors affecting the occurrence of preeclampsia.