Kasr El-Aini Research Articles

Potential use of Oncostatin M in Critically ill Patients with acute Kidney Injury

BACKGROUND: Acute kidney injury (AKI) is one of the most common complications affecting patients admitted to intensive care unit (ICU) worldwide. In response to injury, both kidneys and liver secrete acute phase reactants as a mechanism of protection. Oncostatin M (OSM) is a member of the interleukin-6 family of cytokines which was found to be elevated during renal injury as in diabetic nephropathy, glomerulonephritis, and obstructive nephropathy. AIM: The study aimed to assess the role of OSM as an early biomarker of AKI in critically ill patients. PATIENTS AND METHODS: We conducted a prospective case–control study that included 202 patients admitted to ICU within Kasr El-Aini University hospitals during the period between January 2022 and August 2022. Eligible patients were divided into two groups according to the occurrence of AKI, and Oncostatin was assessed in the sera of the included patients. RESULTS: Our findings showed that the AKI group had statistically significant lower OSM levels compared to the control group, especially among those patients who had poor clinical outcomes and non-survivors. We also found that OSM is a good predictive tool for the prediction of mortality among patients admitted to ICU with sepsis complicated with AKI (Area under the curve = 0.673, 95% confidence interval: 0.532–0.814) with a sensitivity of 83.8% and specificity of 61.4%. CONCLUSION: OSM plays an important role among critically ill patients who are admitted to the ICU with sepsis, it can significantly predict AKI development and subsequent mortality.

Predictive accuracy of years score in diagnosis of pulmonary embolism

BackgroundPulmonary embolism (PE) is a sudden obstruction of pulmonary arteries usually associated with a high rate of mortality due to acute right ventricular failure. Early diagnosis is of much importance because most patients die within the first hours of presentation. Emergency management is usually highly valuable and right heart failure is potentially reversible. Multidetector computed tomography pulmonary angiography (CTPA) is the best diagnostic imaging modality to document acute pulmonary embolism. Overuse of CTPA increases the unrequired risk of radiation exposure, increasing the risk of malignancy, contrast-related anaphylaxis, and acute kidney injury. To abolish these issues, the simplified score for suspected acute pulmonary embolism using variable D dimer cut-off value in combination with clinical signs can exclude pulmonary embolism safely.Aim of the studyTo evaluate the predictive accuracy of YEARS score in the diagnosis of pulmonary embolism compared to CTPA that might lead to a decrease in the overuse of CTPA.MethodsThe study was held at the chest unit in Kasr ElAini hospitals. It included 50 patients, for which full history, examination, calculation of wells score, D-dimer, YEARS score, and CTPA were done.ResultsThe results showed that the YEARS score succeeded in predicting the presence or the absence of PE in 80% of the 50 enrolled patients in our study. YEARS score has a sensitivity of 90% and specificity of 65%.ConclusionPatients with zero YEARS score and D-dimer ≥ 1000 ng/ml as well as those with ≥ 1 YEARS score and D-dimer ≥ 500 ng/ml are rendered PE likely by the YEARS algorithm with a sensitivity of 90%. Using years score, we can exclude pulmonary embolism in patients with zero YEARS score and a D-dimer ˂ 1000 ng/ml as well as in patients with ≥ 1 YEARS score and D-dimer ˂ 500 ng/ml with 65% specificity, thus decreasing overuse of CTPA in the diagnosis of PE.

Factors that Influence the Need to Start Adaptive Radiotherapy.

Adaptive radiotherapy (ART) is an essential approach to account for anatomical and biological uncertainties. Adaptive radiotherapy is, however, time-consuming, and it is unclear which patients are eligible or when is the best time to start ART. This prospective study was conducted at Kasr El-Aini Center of Clinical Oncology and Nuclear Medicine, Cairo, Egypt from January 2019 to December 2020. Thirty patients with pathologically proven, limited-stage small cell or stage I-II non-small cell lung cancer who were either not fit for or refused surgery or had stage III disease were recruited and underwent treatment planning to receive 60 Gy on a conventional 3D conformal radiation schedule with platinum-based chemotherapy. All patients underwent computed tomography (CT) planning within 2 and 4 weeks of starting radiation therapy to assess the need for adaptation. Pulmonary function test and echocardiography findings were assessed at the end of treatment and at 3 and 6 months after treatment, and were compared to the baseline. We found a significant reduction in mean value of the planning target volume (PTV) in the CT scans at the second (331 cm3) and fourth (257 cm3) weeks of treatment as compared to baseline (342 cm3) (p-value < 0.0001). Adaptation decreased the dose to the organ at risk with statistical significance and with improvement of the target coverage. At week 2 of radiotherapy, the need for adaptation was correlated to the conformity index (p = 0.0473), esophageal V35 (p = 0.0488), esophageal V50 (p = 0.0295), and its mean dose (p = 0.0087). At week 4 it was correlated to forced expiratory volume in 1 second (FEV1) (p = 0.0303), ratio between the forced expiratory volume in 1 second and the forced vital capacity (FEV1/FVC) (p = 0.0024), and echocardiography (p = 0.0183). Conformity index and esophageal dose constraints can predict the need for adaptation at week 2, whereas baseline pulmonary function parameters and echocardiography can predict the need for adaptation at week 4 of radiotherapy.

The relationship between coping self-efficacy and B cells in breast cancer patients

BackgroundBreast cancer is the most common tumor among women throughout the world. Diagnosis and treatment of breast cancer are associated with stress and depression. Self-efficacy is one of the most important personal characteristics, studied in cancer, and is correlated with depression and immunity. The aim of the study is as follows:1. Examining the correlation between coping self-efficacy with depression, DHEA levels, and immunity2. Examining the correlation between depression and DHEA levels3. Studying the effect of depression and DHEA levels on immunity4. Examining the intermediate effect of DHEA levels on the correlation between coping self-efficacy and immunityMethodsThirty newly diagnosed breast cancer patients recruited from the Oncology Department, Kasr EL-Aini, Cairo University (ages 51.40 + 8.24 years) responded to two questionnaires: Coping Self-Efficacy Scale (CSES) and Patient Health Questionnaire-9 (PHQ-9); blood samples were collected to measure the phenotype of patients’ cellular immunity and DHEA levels by flowcytometry and ELISA technique.ResultsThere was a significant negative correlation between CSES and PHQ-9, a significant positive correlation between PHQ-9 and B-cell count, and there is a significant negative correlation between CSES and B-cell count. The presence of DHEA has no mediatory role on correlation between CSES and B-cell count.ConclusionThis paper presents a new model of psychoneuroimmunology by suggesting an effect of coping self-efficacy on immunity against breast cancer patients.

Relationship between authentic leadership style and staff nurse’s loyalty

Background Nowadays, achievement of staff nurse’s loyalty is a critical problem that worries health organization and head nurses. Several ways are proposed to solve this problem, through improving leadership styles, especially authentic style. Aim To assess the relationship between authentic leadership style and staff nurse’s loyalty. Design A descriptive correlational design was used. Setting The study was conducted at New Kasr El-Aini University Hospital, Cairo University, Egypt. Patients A convenient sample of 200 staff nurses was selected to participate in the study. Tools Two tools were used: (a) staff nurses’ loyalty questionnaire and (b) authentic leadership style questionnaire. Results The current study revealed that staff nurses’ perception of the authentic leadership style levels showed low level (48%) among their leaders, and nearly half (49.05%) of staff nurses had low loyalty level. In addition, the current study revealed that there was a statistically significance correlation between authentic leadership styles and loyalty (P&lt;0.05). Conclusion The study concluded that there was a statistically significant correlation between head nurses’ authentic leadership styles and staff nurse’s loyalty. Recommendations A strategic plan should be created by hospital management to increase nurses’ loyalty. Hospital administrators should select head nurses based on pre-requisite criteria not only based on their years of experience, on their capabilities as a leaders to lead others in their job, and on their level of goal achievement as a leader.

Effect of Pilates exercises on fatigue in post-menopausal women

BackgroundA lot of changes occur in women’s post-menopausal period: one of these symptoms is fatigue or a lack of energy which is a potential symptom of menopause, and it can be one of the most difficult symptoms to manage. Few studies are concerned with post-menopausal fatigue treatment. Pilates is a mind-body exercise focusing on muscle strength, core stability, endurance, muscle control, posture, and respiration which seems to improve both the physical and psychological components in post-menopausal women. The purpose was to determine the effect of Pilates exercises on fatigue in post-menopausal women.MethodsFifty-two post-menopausal women are suffering from fatigue, their ages ranged from 50 to 55 years, their body mass index (BMI) is below 30 kg/m2, and they all became menopause at least 1 year ago. The patients were selected randomly from the out clinic of El Kasr EL-Aini Hospital and randomly divided into two equal groups: group A composed of twenty-six patients who received Pilates exercises and medical standard care for fatigue, and group B is composed of twenty-six patients who received medical standard care for fatigue only. It was a randomized controlled trial for 8 weeks, and the outcome measures were fatigue assessment scale (FAS) and interleukin-6 test (IL-6).ResultsThere was a significant decrease in FAS (P < 0.00001) and IL-6 (P < 0.00001) after treatment for group A while there was no significant reduction for group B.ConclusionsPilates exercises are considered an effective modality to reduce fatigue in post-menopausal women.

3D Volume Assessment as an Objective Tool in Breast Asymmetry Management.

This study was conducted between November 2017 and September 2021 on 20 female patients seeking breast asymmetry correction at Kasr El-Ainy Hospital. All patients had volumetric breast assessment using a three-dimensional (3D) imaging system (3D LifeViz, Quantificare system), and MRI breast volumetry was done preoperatively in all patients. The patients were managed with different single-stage surgical procedures depending on the objective assessment of the volume differences between their breasts. Breast volume assessment using the 3D camera was done preoperatively and postoperatively. The preoperative mean volume difference was 159.45 cm3, and the postoperative mean difference was 16.75 cm3 with an overall reduction in mean volume difference of 89.5%. Comparing the 3D camera and MRI in assessing breast volume difference showed no statistical significance. The 3D technology is a useful objective tool to augment the surgeon's experience. It helped achieve an 84.57% reduction in volume difference in managing breast asymmetry with a single-stage procedure.

Prevalence of pelvic floor dysfunction among women with polycystic ovarian syndrome: a case-control study

BackgroundPelvic floor dysfunction (PFD) is a wide term, involving a large array of conditions that negatively impact many women around the world. Polycystic ovarian syndrome (PCOS) is another disorder with long-term serious consequences. Being a disease of hormonal imbalances, PCOS may possibly affect the function of the pelvic floor muscles leading to PFD. Thus, the current study aimed to explore the prevalence of PFD among women with PCOS.MethodsThis is an observational, case-control study. A total of 368 women, aged from 20 to 35 years, with a body mass index (BMI) range of 20 to 30 kg/m2 recruited from Kasr El-Ainy teaching hospital shared in the study. They were classified into case group (PCOS patients; n=184) and control group (non-PCOS participants; n=184), with matched age and BMI for comparison. All case-group women were diagnosed with PCOS, based on Rotterdam diagnostic criteria, while the control group women had regular menstrual cycles. Pelvic Floor Distress Inventory-20 (PFDI-20) was used to identify PFD in the tested groups. The demographic features of the two groups were compared using the unpaired t test, while the chi-squared test was used to determine the prevalence of PFD among women with PCOS. Also, multiple linear regression was done to asses other PFD risk factors in both groups.ResultsOut of 380 women, 368 were involved in the study with mean ± standard deviation (SD) for the age and BMI of 28.48±4.87 years and 25.9±5.8 kg/m2, respectively, for the control group, and 28.76±5.33 years and 27±6.1 kg/m2, respectively, for the PCOS group, without a significant difference in either of the age and BMI between groups (P > 0.05). The frequency distribution of women with and without PFD in both groups revealed that the PCOS group included 68 (37%) women with PFD. While the control group included 12 (6%) women with PFD, with a significant difference (P=0. 03) in the prevalence between both groups. Also, multiple regression revealed that PCOS condition significantly affected PFD.ConclusionPFD was prevalent among women with PCOS, compared to the control group, suggesting a possible link between both conditions.

The association of TRAP1 gene and TNFSF4 gene polymorphisms with susceptibility of rheumatoid arthritis in a sample of Egyptian patients

Background/aim The disclosure of new gene polymorphisms and their association with rheumatoid arthritis (RA) susceptibility open new windows for better clarification of disease pathogenesis, leading to discovering new therapeutic targets. The present study aimed to explore the association of tumor necrosis factor receptor-associated protein 1 (TRAP1) gene rs8055172 and tumor necrosis factor superfamily number 4 (TNFSF4) gene rs1234315 with susceptibility of RA in a sample of Egyptian patients. Patients and methods This study included 200 RA patients from the Rheumatology Department Outpatients’ Clinic of Kasr El Ainy Teaching Hospital and Centre of Medical Excellence of National Research Centre, Cairo, Egypt. The study also included 200 healthy participants with no family history of autoimmunity serving as a control group. Genotyping of the studied polymorphisms was done using real-time PCR technique. Results The control group showed no significant deviations from Hardy–Weinberg equilibrium regarding rs8055172 and rs1234315 (P=0.6 and 0.2, respectively). Regarding genotypes of rs8055172, the CC homozygous genotype was more observed among patients. Therefore, the frequency of C allele is higher among RA patients compared with healthy controls (P=0.001). Logistic regression analysis of rs8055172 genotypes with susceptibility of RA was only significant under the recessive model, where patients carrying CC allele have higher susceptibility to develop RA (P=0.001, odds ratio=3.1) compared with patients carrying TT and CT allele. On the other hand, distribution of TNFSF4 (rs1234315) genotypes showed no significant difference between controls and RA group (P=0.7). Conclusions Our results indicate that the TRAP1 gene rs8055172 associates with RA in a population of Egyptians from Cairo, while TNFSF4 gene rs1234315 plays no role in disease susceptibility. A large-scale study to assess the association between TRAP1 gene polymorphism, TRAP1 mRNA expression, and TRAP1 protein level, is needed to clarify the role of TRAP1 gene polymorphism in RA pathogenesis.

Neutrophil-lymphocyte ratio and its relation to microvascular complication in geriatric patients with diabetes: a case-controlled study

BackgroundDiabetes mellitus is a complex chronic disease characterized by chronic hyperglycemia resulting from defective insulin secretion, defective insulin action, or both. Chronic hyperglycemia related to diabetes can lead to end-organ dysfunction or failure, and changes related to diabetes involving arterioles and capillaries are responsible for long-term microvascular complications in diabetic patients. The neutrophil-to-lymphocyte ratio (NLR) is a novel, simple, and inexpensive marker of subclinical inflammation.Aim of workTo evaluate the possibility that neutrophil-lymphocyte ratio (NLR) could be used as a predictor of microvascular complications during follow-up of elderly patients with type 2 diabetes.Patients and methodsSixty elderly diabetes patients ≥ 65 years old, diagnosed 16 according to ADA criteria, were collected from the endocrine clinic in Kasr El-Ainy Hospital. For every patient, full history and examination were done (including 18 neurological and fundus examinations). Labs (CBC with a differential in blood and 19 albumin/creatinine ratio in urine) were done and the neutrophil/lymphocyte ratio.ResultsWe found that NLR has a statistically significant difference in the detection of nephropathy and retinopathy. There is a significant correlation between nephropathy and NL ratio in all patients (r = 0.44, P < 0.001). Elderly diabetic patients (with or without hypertension) with microvascular complications had a higher NLR value than those without complications.ConclusionNLR value can be used as a non-invasive simple marker for predicting microvascular complications in elderly diabetics with/without hypertension.

Impact of an endometrial cancer prevention program based on health belief model on elderly women's awareness and quality of life

Endometrial cancer is the most common type of gynecologic cancer worldwide affecting elderly women. This study aims to evaluate the impact of an endometrial cancer prevention program based on health belief (HBM-based) model on elderly women's awareness and quality of life. Design: A Quasi-experimental pre- post nonequivalent control group design was utilized. Sample: A purposive sample of 60 elderly women with postmenopausal bleeding and not diagnosed with endometrial cancer. Setting: the study was conducted at El-Galaa' teaching hospital, and El kasr El Ainy teaching hospital outpatient clinics. Study tools: 1- A structured demographic data and medical history questionnaire, 2-An endometrial cancer prevention awareness questionnaire (beliefs, knowledge&amp; practices), 3- (WHOQOL-BREF) questionnaire to assess elderly women's QOL. Results: the mean age of elderly was 65.87±3. 15. All elderly women had unsatisfactory knowledge and practice level related to endometrial cancer prevention during pretest evaluation which was improved to satisfactory in the study group after program implementation, a highly statistically significant difference between total beliefs (perceived severity, perceived susceptibility, perceived barriers, perceived benefits, cues to action) and the total QOL mean score of elderly women in the study group in the pre, post, follow up test (P= 0.00).

Comparative Study between Operative and Conservative Management of Penetrating Anterior Abdominal Stab Injuries

Background: Presently, non-operative management of penetrating abdominal stab injuries has been standardized in several trauma centers. This strategy has appromising outcome conserving decreasing morbidity.&#x0D; Aim of the work: This study aimed to assess the safety and feasibility of SNOM of patients having penetrating abdominal stab injuries not indicating emergent laparotomy and to identify a protocol for selection of patient candidates for non-operative management in a tertiary care hospital in Egypt.&#x0D; Patients &amp; Methods: This is a prospective study that involved patients who presented to the casualty department of Kasr Elainy teaching Hospital, in the period from August 2018 to August 2020, for management of a penetrating abdominal Stab injuries. Fully conscious, haemodynimacally stable patients were included. Eligible patients were allocated to either SNOM group or immediate operative management (IOM) group.&#x0D; Results: SNOM group included64 patients and IOM group included 40 patients. The age of the patients ranged from 16 to 49 years with a mean of 33±6.8 years, and the majority were males (99%). SNOM failed in 4/69 patients (5.7%) who required delayed laparotomy for peritonitis (2 cases) and HB drop and haemodynamic instability (2 cases). In IOM group, only 3 cases had therapeutic laparotomies (7.3%). The remaining cases had unnecessary laparotomies (92.7%). Statistically significant higher LOS was seen in SNOM group (p&lt;0.05). However, less unnecessary laparotomies and lower incidences of complications were noted (p&lt;0.01).&#x0D; Conclusion: vital signs together with abdominal examination are the most important clinical criteria in decision making in penetrating abdominal stab injury patients When surgery is not absolutely indicated, SNOM is a safe and feasible approach in management of penetrating abdominal stab injury by following proper management algorithm and selection criteria.

Assessing the spectrum of pulmonary hypertension identified at an Egyptian expert referral center

Background and objectivePulmonary hypertension is an assorted state that encompasses a spectrum of diseases and is categorized into five groups. The registries are necessary for the identification of risk factors, progression of the disease, outcomes, and effect of treatment strategies on the progression of the disease. The aim of this work was to identify different groups of PH identified at an Egyptian referral center and to compare the demographic and clinical characteristics of each group.Patients and methodsThis study included 132 patients who were diagnosed with a right heart catheter in the Chest Department, Kasr El-Aini Hospital, Faculty of Medicine, Cairo University, in the period from January 2017 to January 2019. Patients were classified into different groups, then received medical treatment accordingly. Demographic and clinical data were documented. Arterial blood gases, spirometry, and 6-minute walk test (6MWT) were performed.ResultsThe mean age of cases was (43.9±13.69) years; the majority of them were females (72.7%). More than half of the patients (57.5%) had pulmonary artery hypertension (PAH), while 22.7% and 18.3% had pulmonary hypertension due to chronic thrombo-embolic cause and lung cause respectively. The 1-year survival rate was 81.8%.ConclusionsThe results of the study showed female predominance, the PAH type was the commonest, and the overall 1-year survival rate was 81.8%.

Operative Treatment of Scaphoid Nonunion

Abstract Background: Scaphoid nonunion result in a predictable pattern of wrist arthrosis. To minimize the incidence of arthrosis, the goal of treatment should be consolidation of the fracture of the scaphoid in anatomic alignment. Aim of Study: To evaluate different means of treatment of scaphoid nonunion and evaluate its clinical results. Patients and Methods: This study was conducted at EL-Helmya Military Hospital and Kasr El-Ainy Hospital during the period from 2011 to 2016 on fifty patients diagnosed as non-united fracture scaphoid and operated upon by fixation and graft if needed, then followed-up for a period of at least 18 months. Patients were 49 male and one female with an average age of 23 years. All operative management and follow-up. Results: This study proved that operative treatment of scaphoid nonunion can be summarized as follows: Grade I,II,III according to Slade and Geissler`s classification can be treated by percutaneous or open fixation by Herbert screw even if the nonunion in prox. Pole. Grade IV/V/VI we have to open volarly for waist or dorsally for prox. Pole and fixation with bone graft from iliac crest or distal radius. Conclusion: This study proves that the goal of treatment of scaphoid nonunion should be consolidation of the fracture in anatomic alignment. scaphoidnonunions with severe collapse and humpback deformity must be approached volarly with interposition of an intercalary bone graft and internal fixation. A dorsal approach to proximal scaphoid nonunions allows immediate access for removing the necrotic bone from small proximal pole nonunions and internal fixation.

MO921PROGNOSTIC OUTCOMES OF TRANSPLANTED KIDNEY USING SOLUBLE CD30 AND Β2- MICROGLOBULIN

Abstract Background and Aims Transplantation is the first successful modality of renal replacement therapy (RRT) for irreversible chronic kidney disease (CKD; stage 5). Identifying additional factors associated with poor long-term prognosis after transplantation may provide clues regarding the pathophysiological mechanisms involved in allograft failure and identify high-risk patients who may benefit from additional monitoring or interventions. Successful kidney transplantation results in a substantial decrease in β2M levels, but a delayed decrease or increasing levels after transplantation may serve as a marker of acute rejection or inflammation. Several reports show that elevated sCD30 levels, pre and post transplantation are associated with a poor prognosis for long term kidney graft survival. These studies found higher CD30 levels in allograft recipients and a good predictor of impending acute rejection. The aim of the work is to study the prognostic outcomes of transplanted kidney using CD30 and β2-Microglobulin Method prospective study was conducted in nephrology unit –internal medicine department at Tanta and Kasr El Ainy university ,over 1 year.20 patients subjected to primary Tx.participated in this study.Cd30 and β2M.at day -1,2weeks and 3 months,with clinical follow up after 1 year to detect graft survival Results At day -1,level of cd30 was higher in rejection group than the other patient group.2 weeks post transplantation ,level of cd30 was higher in rejection group than the other patient group and at 3 monthes post transplantation level of cd30 was higher in rejection group than the other patient group,and these differences are statistically highly significant.(p values :0.003 ,0.005 and 0.002 respectively) Successful transplantation leads to significant decrease in serum cd30 at 2 weeks post tx.(P1 &amp;lt;0.005) and at 3 monthes post tx. (P1&amp;lt;0.001) although in rejection group, significant decrease in cd30 was at 2 weeks post tx.only(P1&amp;lt;0.005) and at 3 monthes serum cd30 began to rise again with( P1 0.157). At day -1,level of β2microglobulin was higher in rejection group than the other patient groupwith statistically significant difference (p. 0.01).2 weeks post transplantation ,level of β2microglobulin was higher in rejection group than the other patient groupbut statistically not significant(p. 0.18 ) and at 3 monthes post transplantation level of β2microglobulin was higher in rejection group than the other patient group but statistically non significant(p. 0.18 ). Successful transplantation leads to significant decrease in serum β2microglobulin at 2 weeks post tx.(P1 &amp;lt;0.002) and at 3 monthes post tx. (P1&amp;lt;0.001) although in rejection group ,significant decrease in β2microglobulin was at 3 monthes post tx.only(P1&amp;lt;0.005) and at 2 weeks no significant decrease(p1 0.15) Conclusion pre transplantation high Cd30 and β2M is associated with poor outcome.failure of decrease of cd30 and β2M post Tx. also associated with poor outcome or infection. Successful transplantation leads to significant decrease in serum cd30 and β2M. which can be used as predictors of graft survival with better sensitivity and specificity than serum creatinin.

Isosorbide mononitrate for cervical ripening in induction of labor for pregnant women with PROM at or post term.

To evaluate the efficacy of isosorbide mononitrate (IMN) for stimulating cervical ripening among pregnant women with premature rupture of membranes (PROM) at or post term. A prospective randomized double-blind, placebo-controlled trial at Kasr El-Ainy Hospital, Cairo, Egypt, from October 2018 to May 2019. Pregnant women at or post term with PROM and unfavorable cervix (Bishop score ≤6) were randomly assigned to receive intra-vaginal IMN (n=70) or placebo (n=70) before admission for induction of labor. The main outcome was induction to the delivery interval. Data were compared between groups by t test. The mean±SD duration from the initial dose of IMN/placebo to the beginning of the active phase of labor was significantly shorter in the IMN group than in the control group (9.7±5.6h vs. 12.9±5.3h). The IMN group also had a shorter time interval from induction to delivery (P<0.01). There was no difference in adverse effects between the groups. Intra-vaginal IMN for cervical ripening in the induction of labor among pregnant with PROM at or post term was found to be effective and safe with minimal adverse effects, and good neonatal and maternal outcomes. ClinicalTrials.gov: NCT03665779.

STUDY THE ANTIBACTERIAL EFFECT OF SOME ESSENTIAL OILS POTENTIATED WITH SELENIUM COMPOUNDS AGAINST SOME GASTROINTESTINAL-TRACT BACTERIA

In this study we aimed to assess the antibacterial activity of some essential oils potentiated with selenium compounds against some multi drug resistant gastrointestinal tract bacteria. A bacterial isolates of E.coli, Klebsiella spp, Proteus spp, Citrobacter spp, Salmonella spp and S.aureus were selected from Thirty three pure stool cultures on the basis of antibiotic resistance activity. Study performed in the laboratory of microbiology, Kasr El-Ainy, Faculty of medicine, Cairo University. Thirteen essential oils were tested for antibacterial effect against the selected isolates alone and in combination with antibiotics, Sod selenite compound (1% w/v). Results revealed that Cinnamomum verum had the greatest effect upon all isolates selected. The efficacy of used antibiotics increased when combined with effective essential oils. Sodium selenite had no any bacterial effect against all bacterial isolated individually or in combination with essential oils except for S.aureus isolate that was inhibited. Sodium selenite posses an additive effect towards essential oils of Cinnamomum verum, Syzygium aromaticum and Carum carviin combination against S.aureus. TEM scanning showed the disintegration of cell wall and plasma membrane lysis when treated with Cinnamomum verum.

Gastropexy after sleeve gastrectomy

Background As the gastrocolic, gastrophrenic, gastrosplenic, and posterior gastric attachments are cut during laparoscopic sleeve gastrectomy (LSG), it increases the possibility of turning, twisting, or folding. In some cases, the fixation of the stomach will keep it in the correct position. Gastric twist can be suspected after surgery in those complaining of any degree of obstructive symptoms in the postoperative course. The objective of our study was to evaluate the value of gastropexy after LSG to the pancreatic fascia and its effect on intraoperative and postoperative morbidities. Patients and methods This prospective randomized study was conducted in Kasr El Ainy Hospital from May 2018 to November 2018. A total of 40 patients were subdivided into two groups. Group A included cases with LSG, whereas group B included cases with LSG with sleeve reattachment to the pancreatic fascia. Assessments of intraoperative twisting, bleeding, time consumed, postoperative vomiting, epigastric pain, gastrografin meal, and upper gastrointestinal endoscopy were done. Results A statistically significant difference regarding vomiting (P=0.003), epigastric pain (P=0.035), and operative time (P Conclusion Adding pancreatic attachment to the procedure posed no harm and did not increase any surgical morbidity. It reduced postoperative gastric pain and vomiting.

Comparison between the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy and Normal Retina

Background: Diabetic retinopathy (DR) is mostly a vascular disease where the development of macular oedema and proliferative retinopathy are major causes of visual impairment. Enlargement of the foveal avascular zone (FAZ) is associated with visual deterioration in patients with diabetic retinopathy. Objective: To evaluate the foveal avascular zone (FAZ) and perifoveal capillary network density in the superficial retinal layer (SRL) and deep retinal layer (DRL) in patients with varying severities of diabetic retinopathy (DR). Patients and methods: This is a prospective comparative randomized case-control study consisting of 77 eyes divided into two groups, each group underwent imaging using OCT-A device. Group one: 37 healthy control eyes, and group two: 40 eyes with DM of different degrees of diabetic retinopathy. Subjects were imaged between September 2019 and February 2020 at Kasr El-Ainy Teaching Hospital. Results: The FAZ area at the levels of the superficial and deep vascular networks of eyes with DR were found to be larger compared with those of age-matched healthy controls, and as would be expected, control eyes had higher vascular density in both networks compared with the diabetic eyes. Furthermore, eyes with worse DR stage showed larger FAZ area and lower vascular density values. This study also showed that angiographic parameters, namely FAZ area and vessel density (VD) correlated with best corrected visual acuity. Conclusion: Our study revealed that vascular density and FAZ area can be quantified in DR eyes in a rapid, automated, and noninvasive manner with OCTA. Also foveal avascular zone area and vascular density as measures of DMI correlate with visual acuity in patients with DR.

Comparison between the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy and Normal Retina

Background: Diabetic retinopathy (DR) is mostly a vascular disease where the development of macular oedema and proliferative retinopathy are major causes of visual impairment. Enlargement of the foveal avascular zone (FAZ) is associated with visual deterioration in patients with diabetic retinopathy. Objective: To evaluate the foveal avascular zone (FAZ) and perifoveal capillary network density in the superficial retinal layer (SRL) and deep retinal layer (DRL) in patients with varying severities of diabetic retinopathy (DR). Patients and methods: This is a prospective comparative randomized case-control study consisting of 77 eyes divided into two groups, each group underwent imaging using OCT-A device. Group one: 37 healthy control eyes, and group two: 40 eyes with DM of different degrees of diabetic retinopathy. Subjects were imaged between September 2019 and February 2020 at Kasr El-Ainy Teaching Hospital. Results: The FAZ area at the levels of the superficial and deep vascular networks of eyes with DR were found to be larger compared with those of age-matched healthy controls, and as would be expected, control eyes had higher vascular density in both networks compared with the diabetic eyes. Furthermore, eyes with worse DR stage showed larger FAZ area and lower vascular density values. This study also showed that angiographic parameters, namely FAZ area and vessel density (VD) correlated with best corrected visual acuity. Conclusion: Our study revealed that vascular density and FAZ area can be quantified in DR eyes in a rapid, automated, and noninvasive manner with OCTA. Also foveal avascular zone area and vascular density as measures of DMI correlate with visual acuity in patients with DR.