PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 1-12

Assessment of Proinflammatory Th1 Cytokines (IL18-IFN ) and Th2
Cytokine (IL13) Concentrations in patients with Autoimmune Rheumatic
Diseases (Systemic Lupus Erythematosus, Rheumatoid Artharitis and
Systemic Sclerosis)


Maha M. Sultan*, Fatma M. Abd Al Salam* Doaa A Hassan*, Hodaa S. Abdulla**
,Marwa M. Abd El-Rahim** ,Hyam H. Mansour***, Neama R. Hussein****
*
Department of Dermatology and Venereology.
**
Department of Physical Medicine, Rheumatology and Rehabilitation Medicine.
*** Department of General Medicine.
**** Department of Clinical Pathology.
Faculty of Medicine for Girls ­ Al-Azhar Univesity

Abstract

Objective:
Several cytokines play a role in the production of autoantibodies and the
pathogenesis of rheumatic diseases including systemic lupus erythematosus (SLE), rheumatoid
arthritis (RA) and systemic sclerosis (SS). This study investigated serum concentration of the
proinflammatory Th1 cytokine; IL18 and its inducer IFN, the study also investigated serum
concentration of proinflammatory Th2 cytokine; IL13, to explain the role of Th1 and Th2 in the
pathogenesis of autoimmune rheumatic diseases (SLE, RA and SS)
Patients and methods: IL18, IFN and IL13 levels were evaluated by enzyme linked
immunosorbent assay (ELISA). Four groups were included in this study.
Group I: Comprised (15) patients of SLE. Group II: Comprised (15) patients of RA. Group III:
Comprised (15) patients with SS. Group IV: Control group consisted of (15) sex and age
matched healthy controls.
Results: Serum levels of IL18 was significantly higher in SLE (3138.200 1413.096 pg/ml)&
RA(3336.667 921.839 pg/ml) than control group(86.647 35.370 pg/ml ), while IL18 in SS had
no statistically significant difference between patients (103.634 50.593 pg/ml) and control
group (86.647 35.370 pg/ml).The cut off level was 257.75 pg/ml .



IFN was significantly higher in SLE patients (5.4391.430 IU/ml) and RA patients (2.973
0.598 IU/ml ) than control group(0.580 0.234 IU/ml) ,while IFN in SS had no statistically
significant difference (0.592 0.245IU/ml) than control group (0.580 0.234 IU/ml) .The cut
off level was1.2 IU/ml .
As regard IL13 it was significantly higher in SLE patients (55.6736.892 pg/ml) ,RA patients
(59.58712.183 pg/ml) and SS (61.550 12.047 pg/ml) than control group (21.427 7.274
pg/ml ) .The cut off level was 44.4 pg/ml .There was significant positive correlation of IL18/
IL13 and IFN / IL13 ratio in SLE and RA , while significant negative correlation of IL18/ IL13
and IFN / IL13 ratio in SS.
Conclusion: There was a significant increase of both Th1 cytokines (IL18 and IFN) and Th2
cytokine (IL13) in SLE and RA with Th1 predominance,while predominance of Th2 cytokine
(IL13) in SS than Th1 cytokine (IL18 and IFN). This result suggests that IL18, INF and IL13
could be involved in the pathogenesis of autoimmune rheumatic diseases.
Key words: SLE, RA ,SS, IL18, IFN and IL13
1

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Full Paper (vol.38 paper# 1)


PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 13-20

Evaluation of Hoffer Q formula in Short and long axial lengths

Ahmed I Galhoom, MD; Mostafa M Mostafa,
MD;Mohamed I Elkasaby,MD;and Ali A Ghali MD.
Department of ophthalmology, Faculty of medicine Al Azhar University.

Abstract

Purpose
: Evaluation of The accuracy of Hoffer Q formula for intraocular lens (IOL)
power calculation in short and long axial lengths of the eye.

Methods: 100 eyes divided equally into 2 groups: group I (50 eyes) with axial length more than
24.5 and group II( 50 eyes) with axial length more less than 22. Comparison between both
groups was done as regards post operative residual refractive error after IOL implantation using
Hoffer Q formula.

Results: Insignificant difference between the 2 groups as regard post operative residual
refractive error. In short length eyes, the mean postoperative refractive error with Hoffer Q
formula was 0.80 +0.33D. In long eyes, the mean postoperative refractive error was 1.23
+0.70D. The results show that the best performing formula was in short eyes (P = 0.012).

Conclusion: Insignificant difference as regards postoperative residual refractive error between
both groups but Hoffer Q formula best performed in short eyes.

Introduction:


(A) Theoretical IOL formulas
Today, cataract surgery with intraocular
Theoretical
formulas
represented
a
lens IOL implantation is a successful
significant advance over other methods of
procedure. It is minimally invasive,
estimating implant power, but a formula
rehabilitation is quick, and the complication
based on theoretical optics cannot take into
rate is low. In addition, the refractive
account the complex function of the eye.
outcome is excellent and vision can be
Moreover, the values required for the
improved to a level better than before
formula are derived through A- scan and
cataract formation .12
keratometry measurements, and these
There is increasing evidence of the value of
devices are not precise enough to ensure the
preoperative biometry to calculate the power
reliable data being used in the formulas.
of an intraocular implant used during
Thus theoretical formulas help the surgeon
cataract surgery to avoid the large range of
to anticipate what should result, not what
postoperative refractive error associated
will result from implantation.15
with use of a standard power lens .4
Although in practice the theoretical
Postoperative
refractive
errors
after
formulas are generally reliable for eyes
intraocular lens implantation can be a result
with axial lengths between 22 and 24.5 mm,
of different reasons. The most likely is
they tend to predict too large an
incorrect IOL calculation due to incorrect
emmetropic value in short eyes and too
measurements of the
small value in long eyes.
eye .10


13


Full Paper (vol.38 paper# 2)


Protective Effect of Urtica Diocia, Natural Honey and Their Mixture Against Oxidative Stress Caused by Chronic Ethanol Consumption The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 21-37

LARYNGEAL CANCER: SOCIODEMOGRAPHIC, LIFE STYLE AND
CLINICAL RISK FACTORS AMONG PATIENTS UNDERWENT
TOTAL LARYNGECTOMY

E. A. EL-MOSELHY, Y. M. SALEH, M. M. EL-SAWY*,
E. S. ABD-ALLAH** Y. A. BARKA, and T. M. FARGHALY*
Departments of Community Medicine;
Ear, Nose and Throat* and Community Health Nursing**
Faculty of Medicine and Nursing, Al-Azhar and Zagazig University


Abstract

Introduction: Laryngeal cancer (LC) is an important health problem. It is one of the most
common respiratory cancers. The prevalence of this cancer is increasing all over the world.

Objectives
: The aim of the present study is to determine the clinical features of the laryngeal
cancer patients underwent total laryngectomty (TL); to define the characteristic features of
surgery in these patients; and to define the life style, health behavioral, sociodemographic and
clinical risk factors of the patients.

Subjects and methods
: A total of 90 laryngeal cancer patients and a control group of the same
number were enrolled in the study. A case-control, hospital based study design was used.
Results: The most important clinical features of the studied laryngeal cancer cases underwent
TL were; most lesions site was glottis (56.7%), presented with hoarseness of voice (85.6%) and
most of the patients were in stage III (63.3%). Also, the most important characteristics of the
surgery in these cases were 64.4% had TL and primary tracheoesophageal puncture, 88.9%
underwent thyroidectomy and 25.6% had preoperative tracheostomy. The +ve reflux symptoms
index was significant clinical risk factor (OR=6.77). Factory worker occupation was significant
risk factor (OR=4.65). The most important sociodemographic risk factors for laryngeal cancer
were male sex, urban residence, old age, low social level and low occupational level (ORs=
52.59, 2.43, 2.43, 1.99 and 1.97; respectively). Further, the most important significant health
behavioral risk factors were cigarette smoking, goza smoking and no healthy food intake (ORs=
4.44, 4.25 and 2.74; respectively).

Recommendations
: Population based studies are needed in different areas in Egypt and on
large numbers of patients to understand the full epidemiology of the laryngeal cancer and
quality of life of these patients.

Introduction



Laryngeal cancer (LC) is the
1993 and an estimated 3,800 deaths were
second most common respiratory cancer
due to this cancer (Boring et al., 1993).
after lung cancer. Moreover, the prevalence

of LC is increasing over time in much of
Also, in the US the highest
the world (Cattaruzza, 1996). It is
incidence was recorded for black men aged
estimated that 12,600 new cases of LC were
65-69, while the highest incidence among
diagnosed in the United States (US) during
white men occurred for those in age group

70-74 years. Incidence rate was also higher
21

Full Paper (vol.38 paper# 3)


PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 38-50

Influence Of Acacia nilotica On Arsenic Induced Genotoxicity
In Male and Female Mice

INAS S. Ghaly AND ZEINAB E. HANAFY *
National Research Centre, Cell Biology Department And
Department of Zoology, Faculty of Science (Girls), Al-Azhar University*

Abstract

For centuries, plants have been used in traditional medicine and there has been recent
interest in the chemopreventive properties of compounds derived from plants. In the present
study, we investigated the effects of extracts of Acacia nilotica leaves on the genotoxicity of
arsinic .

Arsenic contamination in groundwater a global human health hazard .There is no
effective remedial action of chronic arsenicsis. However, a well-nourished diet can modulate the
onset of adverse health effects and delayed the effect of arsenic in drinking water. In the present
work, genotoxic effects were induced by sodium arsenate through oral administration,and the
protective effect of Acacia nilotica was studied. Chromosomal aberrations were more
pronounced in sodium arsenate treated mice, while supplementation of Acacia nilotica with
sodium arsenate reduced the incidence of the aberrations. The mean of DNA fragmentation
induced by sodium arsenate was highly significant increase. However, the administration of
Acacia nilotica significantly decreased DNA fragmentation induced by sodium arsenate.
The mean number of sperms, were decreased significantly after treatment with sodium arsenate,
while administration of Acacia nilotica increased the number of sperm in mice treated with
sodium arsenate, and also decreased the percentage of sperm abnormalities induced by sodium
arsenate.

The outcome of study showed that Acacia nilotica has the efficiency to encounter the
genotoxic effects induced by arsenic.

Introduction:


For centuries, arsenic has played an
2000 and Gradecka et al., 2001). Other
important role in science and medicine.
studies have found that exposure to
Arsenic
for
its
environmental
inorganic arsenic increases the frequency of
perversiveness has gained unexpected
micronuclei, chromosome aberrations and
entrance to the human body through food,
sister chromatid exchanges both in humans
water and air, thereby poising a great threat
and experimental animals. (Mahata et al.,
to public health due to its toxic effect and
2003; Mahata et al., 2004 and
carcinogenicity. Thus, in modern scenario
Avani&Rao 2007 ). De Chaudhuri et al.,
arsenic is synonymous with "toxic" and is
(2008) showed that health effects (i.e.
documented as a paradoxical human
peripheral neuropathy, conjunctivitis and
carcinogen, although its mechanism of
respiratory illness) and chromosomal
induction of neoplasia remains elusive
aberrations were significantly higher in the
(Mahata et al., 2004).
keratotic group compared to individuals

with no skin lesions.
Arsenic has been found to be

genotoxic. It induced sister chromatid
Arsenic has also been shown to
exchanges and is clastogenic in a range of
enhance
the
clastogenicity
and
in vitro systems using both human and
mutagenicity of other DNA damaging
animal derived cells ( Bernstam&Nriagu
agents. Other change in vitro, are related
38

Full Paper (vol.38 paper# 4)


Protective Effect of Urtica Diocia, Natural Honey and Their Mixture Against Oxidative Stress Caused by Chronic Ethanol Consumption The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 51-58

Analgesic effects of gabapentine in tonsillectomy


Waleed Abdelmageed*, Salah Abdelrazik**, Ahmad Nassar**
And Mohamed Abdelkawi**
*Department of Anesthesia and Intensive Care,
**Department of E.N.T. King Abdulaziz Naval Base Hospital, Jubail, KSA.


Abstract

Objectives: To evaluate the preemptive effects of gabapentin on postoperative pain relief and
its effect on meperidine consumption in patients undergoing tonsillectomy.

Methods: This study took place in King Abdulaziz Naval Base Hospital in the year 2009. Sixty
patients ASA I and II were randomly assigned in a prospective randomized double- blind
placebo-control clinical trial. Gabapentine 1200 mg or placebo was given orally two hours
before induction of anesthesia to patients undergoing tonsillectomy under general anesthesia.
Postoperative pain score was recorded on a visual analogue scale at 1, 3, 6, 12, 18 and 24
postoperative hours. Patients received meperidine 1 mg/ kg i.m once every 4 h if pain score 3
or if requested by the patient. Total dose of meperidine consumption was recorded.

Results: Thirty patients in the gabapentine group and 30 patients in the placebo group
completed the study. Patients in gabapentine group had significantly lower pain score in
comparison to placebo group. Total postoperative meperidine consumption in the gabapentin
group was (48.8±33.9 VS 93.8 ± 54.6) in the placebo group (P< 0.001). There was higher
incidence of nausea, vomiting, and use of antiemetic drugs in the placebo group.

Conclusion: Preemptive use of gabapentine decreased pain score and post operative meperidine
consumption and reduced meperidine ­related adverse effects in patients undergoing
tonsillectomy under general anesthesia.

Introduction

Postoperative pain is a major factor that affect recovery from anesthesia and surgery.
The treatment of postoperative pain after tonsillectomy presents a challenge. Tonsillectomy is
associated with unacceptable intense pain during the first 24 hours after surgery1. Consistent
delivery of first class postoperative pain control is still a major challenge. Opioids are inevitably
associated with emesis and the risk of respiratory depression2. Local anesthetic techniques are
often short lived and required interventional procedures, and the use of non steroidal anti-
inflammatory drugs ( NSAIDs) is limited by the well known complications and concerns. A
combination of opioid and non opioid analgesic drugs improve the quality of postoperative
analgesia and reduce opioid consumption as well as their related side effects3.

Gabapentine, an anticonvulsant drug with structural analogue of gamma amino butyric
acid which was introduced in the year 1994 particularly for partial seizures4. It alleviates pain
and prevents acute nociceptive and inflammatory pain both in animals and volunteers ,especially
when given before trauma5,6.
Despite its name , gabapentine does not bind at the GABAa or GABAb receptors, however , it
has a high binding affinity for the 2 subunit of the presynaptic voltage
gated calcium channels which inhibit calcium influx and subsequent release of
51

Full Paper (vol.38 paper# 5)


Assessment of Nutrition of Obese Primary Schools Children in Urban and Rural Area in El Bihera Governorate The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 59-81

Assessment of Nutrition of Obese Primary Schools Children in Urban and
Rural Area in El Bihera Governorate- Egypt.

Hanaa H. Elsayed, Sahar Khairy, Mohamed K Abd El- Rahman and Effat A. Afifi
National Nutrition Nnstitute

Abstract

Background:
The prevalence of obesity is increasing in both developed and developing
countries. Obesity is associated with increased risks of many diseases. Obesity significantly
affects the quality of life and reduces the average life expectancy.

Objective: Investigate effect of different environment urban and rural areas in El Bihera
governorate on blood glucose level and obesity of children aged 6-12 years to know possible
associated risk factors.

Study design: This study of a representative sample of children 6-12 y of age performed during
1 July 2004 till 20 June 2005.

Methods: Anthropometric data were taken using standard methods, from 188 children. Certain
diet and physical activities as well as other socioeconomic family parameters were assessed with
the aid of a questionnaire. Obesity and overweight were defined using both the National Health
and Nutrition Examination Survey (NHANES)I definition and the new International Obesity
Task Force (IOTF) definition. Logistic regression analyses were performed to estimate the
influence of various parameters.

Results: obesity was prevalent among girls13.8 and 11.7% than boys12.7 and 13.8% in urban
and ruler areas respectively. The high percentage of boys and girls in both urban and rural
(78.0% and 84.2% respectively and 83.3% and 89.8% respectively), who take snacks in between
meals. Also the results show that about three-quarter of the urban boys (70.7%) and more than
half of rural boys (65.8 %) eating during T.V watching. The results show that about two-third
(58.3%) of the urban girls and about three-quarter (67.3%) of the rural girls eating during T.V
watching with significant differences only among the urban groups (P 0.020). on the other hand,
the plasma glucose values of all cases (normal and obese) in urban and rural areas were
significantly different. In boys and girls subjects in rural and urban areas there were no
significant differences between the mean values of plasma TSH. However, a significant
difference between the plasma TC of urban areas than that of rural areas at the same age group
was detected. There was a significant difference for the mean values of plasma TC level
between normal and obese groups in the rural site.

Conclusion: The good news is that schools can help students and staff adopts healthy eating
and physical activity behaviors that are the keys to preventing obesity.

Key words:
Obesity ­ children ­ diabetes.

59

Full Paper (vol.38 paper# 6)


PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 82-93

Endothelial nitric oxide synthase gene polymorphisms (G894T)
in diabetes mellitus in Egypt

El-baz1 ; Farouk2; Tag Eldin2; Ezat2
1Genetics Unit, Mansoura University
2Research Institute (GEBRI),Sadat City

Abstract

Objective:
Diabetic nephropathy (DN) is one of the major microvascular complications of
diabetes. Genetic predisposition has been implicated in DN. The eNOS protein synthesizes
nitric oxide constitutively via a reaction including the conversion of L-arginine to L-citrulline,
which involves the transfer of five electrons provided by nicotinamide adenine dinucleotide
phosphate The aim of this study is to evaluate the association of G894T polymorphisms of
endothelial nitric oxide synthase(eNOS) gene with the development of diabetic nephropathy
(DN) among Egyptian patients with type 1,2 diabetes mellitus in Egypt. Methods: Study
subjects comprised 86 patients of type 2 diabetes with nephropathy,23 patients of type 1
diabetes with nephropathy and 46 patients of type 2 diabetes without nephropathy. G894T
genotypes was determined by SSP- PCR analysis. Results: Mutant T allele, GT and TT
genotypes of G894TSNP had no significant frequencies in type 1,2 diabetic patients with
nephropathy compared to those without nephropathy.. Conclusion: These findings indicate that
G894T polymorphism of eNOS gene may be not considered as genetic risk factors for DN
among Egyptian type1, 2 diabetic patients.
Abbreviations: T2DM: type 2 diabetes mellitus ­ DN: diabetic nephropathy eNOS : Endothelial
nitric oxide synthase:­ SNP: single nucleotide polymorphism- SSP-PCR: sequence specific
primer- polymerase chain reaction.
Key words: eNOS gene ­ Type1, 2 diabetes - diabetic nephropathy.

Introduction:


Diabetic nephropathy (DN) is one
genetic predisposition, based on familial
of the major microvascular complications
clustering of DN, has been implicated in the
of diabetes and one of the leading causes of
pathogenesis of nephropathy in type 2
death among patients with diabetes
diabetes mellitus (Sun J et al., 2004).
(Chiarelli et al., 2009). Clinically, diabetic
Nitric
oxide (NO) synthesized by
nephropathy is manifest as a progressive
endothelial nitric oxide synthase (eNOS)
disease process that advances through
plays an important role in regulation of
characteristic stages. It begins with
endothelial function and in the control of
microalbuminuria
(leakage
of
small
blood pressure.
amounts of albumin into the urine) and
A healthy endothelium plays a core role in
progresses to overt proteinuria. In a large
cardiovascular control (Drexler H,&
proportion of these patients with diabetic
Horning B..2009).
nephropathy, renal function declines and
Besides its regulatory functions on
continues to deteriorate until end stage renal
vasomotor tone and blood flow, endothelial
disease (ESRD) is reached, and replacement
NO is known to inhibit the platelet
therapy is indicated (Perkins et al., 2003;
activation and modulate migration and
Brenner et al., 2004 and Perkins et al.,
growth of the vascular smooth m uscle
2007).
(Marsden PA.et al.2007).
The
etiology
of
DN
is
a point mutation of guanine to thymine at
multifactorial
and
involves
both
nucleotide
position
G894T
in
the
environmental and genetic factors. A
endothelial nitric oxide synthase (eNOS)
82

Full Paper (vol.38 paper# 7)


PLATELET DERIVED GROWTH FACTOR AND THE EXTENT OF SKIN THICKENING AS POTENTIAL INDICATORS OF PULMONARY AFFECTION IN SYSTEMIC SCLEROSIS The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 94-

Stress at Work Place

Mohammad A. Shahrour
Consultant Psychiatry
King Abd ulaziz Naval Base Hospital in Jubail


Introduction:


One of hardest forms of stresses to avoid is that work place or job stress
Job stress refers to stress experienced by an individual at or because of issues at their
work place
The term work related stress has many meanings and it causes different levels of
anxiety.
Not all challenges at work can be called stress as some of these challenges drive
employees upward, and empower them to learn new skills or push them to work harder
to achieve a certain goal.
So, this type of challenges cannot be considered as true stress
True job stress is a condition that not only destroys employee desire to work, but also
his or her energy, getting them to suffer both emotionally and physically.
Warning signs of stress at work when people feel overwhelmed they feel lacking
confidence, become irritated or withdrawn, less productive, less effective and their work
less rewarding if these warning passed unnoticed then signs and symptoms of stress will
appear.


Signs and Symptoms of Excessive
4. Personal conflicts with supervisors
Workplace Stress
or other employees

5. Feeling insecure at work (
1. Feeling
anxious,
agitated,
constantly threatened with criticism
depressed or apathetic
or job loss)
2. Loss of interest at work
6. Discrimination ( race, sex or age)
3. Difficulty
in
attention
and
7. Discouragement
(to
feel
concentration
incompetent and worthless)
4. Insomnia and sleep problems
8. Sexual harassment
5. Feeling fatigue
9. Lack of flexibility in work hours
6. Muscle tension and headaches
10. Poor work environment
7. Stomach problems or different
11. Developments in technology
body aches

8. Social withdrawal
How to Deal with Work Place Stress
9. Loss of sex drive

10. Using alcohol or drugs to cope
Fortunately, there is a lot that you can

do to manage and reduce stress at work.
Different Causes of Job Stress


General Guidelines:
1. Poor work conditions and having

no say over such conditions
A. Taking
responsibility
for
2. Unreasonable
demands
from
improving your physical and emotional
employers ( to do perfect job all the
well being.
time)
B. Avoiding pitfalls: by identifying
3. Long hours of stressful work
knee jerks habits and negative attitudes
93

Full Paper (vol.38 paper# 8)


Assessment of Nutrition of Obese Primary Schools Children in Urban and Rural Area in El Bihera Governorate The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 100-114

Mosquito species diversity and abundance in relation to riceland
agroecosystem and filarial infection in Kafr El-Sheikh Governorate, Egypt.

*TAREK M.Y. EL-SHEIKH , *KOTB M. HAMMAD AND **WALAA A. MOSELHI
*Department of Zoology, Faculty of Science, Al-Azhar University,
**Department of Zoology, Faculty of Science (girls), Al-Azhar University.

Abstract

The present work studied the mosquitoes abundance, identification, distribution and
density in three villages (rural area) and one city (urban area) in Kafr El-Sheikh Governorate
namely; Kebreet, Minyat Al-Ashraaf, El-Salmia and Fowa city, respectively during the rice
cultivation season in relation to filaria from June to Oct. 2009. A total of 11381 mosquitoes
larvae belonging to four genera and 8 species were collected. Of which 3525 (31.0%) in Minyat
Al-Ashraaf followed by 3339 (29.3%) in Kebreet, 3331 (29.3%) in El-Salmia villages compared
with 1186 (10.4%) in Fowa city. The five most common species collected during this study
were Culex pipiens (39.2%), Cx. antennatus (27.3%), Cx. univittatus (15.8%), Anopheles
pharoensis
(10.4%), and An. coustani (3.8%). The mosquito species diversity (H) and evenness
(EH) in the (rice cultivated areas) Minyat Al-Ashraf, Kebreet and El-Salmia villages (H =
1.286, EH = 0.829; H = 1.227, EH = 0.742; H = 1.110, EH = 0.882; respectively) were much
higher than in the Fowa city (non rice cultivated area) (H = 0.718, EH = 0.608). On the other
hand, the highest diversity and density of adult mosquitoes species obtained from Minyat Al-
Ashraaf were 5 species and (33.8%), followed by Kebreet 5 species and (31.6%), El-Salmia 4
species and (24.5%), respectively compared with 3 species and (10.1%) in Fowa city. C. pipiens
adults were the predominant species, in all filarial indicator areas (68.1, 53.4, 40.8 and 20.8
mosquitoes/room) in Minyat Al-Ashraaf, Kebreet, El-Salmia villages and Fowa city,
respectively. Cx. pipiens was the only species to carry infective larvae as well as other stages,
while Cx. antennatus carried immature stages only (not infective). Filarial larvae in Cx. pipiens
and Cx. antennatus were found only in Minyat Al-Ashraaf and Kebreet villages. It is inferred
from the data that different levels of habitat with regard to rice cultivation have different effects
on mosquito diversity and abundance. Also, our study revealed that filarial vectors Cx. pipiens
and Cx. antennatus had a wide distribution and high relative density especially in irrigated rice
regions and hence its role in disease transmission in Kafr El-Sheikh region needs further
investigation .

Keywords: Mosquito, Abundance, Diversity, Density, Filaria, Kebreet, Minyat Al-Ashraaf,
El-Salmia villages and Fowa city.

Introduction:
(Stone, 1975). Most of these species act as

vectors of different pathogens that cause
In general, mosquitoes stand out most
dengue fever, yellow fever, malaria,
among the numerous species of blood
lymphatic filariasis, Japanese encephalitis
sucking arthropods that annoy human. But
or other serious disease of humans (Service
what is more important, is their role in
1996). In Egypt, Culex spp. have a wide
transmission of many serious diseases
distribution and are the main vector of Rift
(Morsy et al, 1990). At least 3500 species
valley
fever
virus
(Darwish
and
of mosquitoes are known all over the world
Hoogastraal, 1981), Wuchereria bancrofti
and being found in almost every country
(Gad et al., 1996) and Western Nile virus
100

Full Paper (vol.38 paper# 9)


Assessment of Nutrition of Obese Primary Schools Children in Urban and Rural Area in El Bihera Governorate The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 115-123

Incidence, Treatment and Visual Outcomes of Non-Infectious Keratitis as a
Postoperative Complication of Laser-Assisted in-Situ Keratomileusis
(LASIK).

Mahmoud M Saleh, MD; Ahmed I Galhoom,MD; Abdallah E Shelil,MD ; Hasan
M Hegazi,MD; and Mohamed A Wahdan,MD.
Department of ophthalmology, Faculty of medicine Al Azhar University.

Abstract

Purpose:
To study the incidence, treatment, and visual outcomes of Non-Infectious Keratitis as
a Postoperative Complication of Laser in-Situ Keratomileusis (LASIK) at Elite Medical &
Surgical Center. K S A

Methods: The files of 3500 post-LASIK patients (6326 eyes) were reviewed for the
development of Non-Infectious Keratitis. Incidence, management regimens, and final best
spectacle corrected visual acuity (BSCVA) were reported.

Results: Post-LASIK Non-Infectious Keratitis was diagnosed in 149 eyes (2.35%). The
Keratitis was classified as diffuse lamellar keratitis (DLK) in 89 eyes (1.4%) and 60 eyes
(0.94%) as localized debris-related Keratitis (LDK).

Conclusion: The occurrence of post-LASIK Non-Infectious Keratitis was 2.35%, with DLK
being the common diagnosis overall, with 92.6% of patients achieving 20/20 BSCVA. The
best way for prevention of DLK is to eliminate defined predisposing factors for DLK. Close
follow-up during the early postoperative period.

Introduction:

Non-Infectious Keratitis can occur
multifactorial.6 Contributing factors
shortly after LASIK and lead to
include meibomian gland secretions,
irreversible visual loss in severe cases.
povidone-iodine, talc powder from
It is a non-infectious inflammatory
surgical gloves, remnants of antiseptics
reaction in the flap-corneal bed
used for cleaning surgical instruments,
interface which usually occurs one
remnants of bacteria, endotoxins and
week after LASIK. Other names given
exotoxins on surgical instruments,
to this syndrome include Sterile
balanced salt solution (BSS), epithelial
interface
inflammation
has
been
cells and red blood cells beneath the
referred to as "sands of the Sahara,"1
flap, polluted autoclave reservoirs and
diffuse lamellar keratitis (DLK),2 or,
contaminations and deposits on the
perhaps most appropriately, diffuse
microkeratome.7
interface keratitis (DIK). But the term

DLK appears more appropriate and is
DLK can range from asymptomatic
more commonly used.3
interface haze near the edge of the flap

to marked diffuse haze with diminished
DLK has been reported by
best
corrected
vision.
Such
excimer laser centers all over the world,
inflammation generally resolves by its
however the exact etiology still remains
own without sequelae but severe cases
unknown.4,5
but
seems
to
be
can lead to scarring or flap melting.
115

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Assessment of Nutrition of Obese Primary Schools Children in Urban and Rural Area in El Bihera Governorate The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 124-130

Inferior oblique inclusion, Incidence Early detection and Prevention

Mahmoud M Saleh MD
Department of ophthalmology, Faculty of medicine Al Azhar University.

Abstract

Purpose: To evaluate the incidence of inferior oblique inclusion during hooking of the lateral
rectus muscle and how to detect and prevent.

Methods
: 50 patients (80) eyes operated upon lateral rectus muscles(recession 55 eyes
resection 25 eyes ) for correction of horizontal deviation (esotropia and exotropia) the incidence
of inferior oblique inclusion during hooking of the lateral rectus muscle throw fornix
conjunctival incision was evaluated and managed.

Results:
the incidence of inferior oblique inclusion was found in 17 eyes 21.25%(12 eyes 15%
Partial inclusion and 5 eyes 6.25% total inclusion) the inclusion was detected and managed
early. Post operatively no element of vertical deviation due to inferior oblique inclusion.

Conclusion
: inferior oblique inclusion is a preventable complication if taken in consideration
during hooking of the lateral rectus muscle.

Introduction:


After operation for horizontal comitant
oblique muscle are inadvertently caught in
strabismus
a
vertical
deviation
or
the lateral rectus muscle insertion 1.
deficiencies of vertical rotation are

significant predictors of inferior oblique
Re-operation to free the inferior oblique
inclusion into the lateral rectus insertion.
fibres often fails to reduce the vertical
In repeat surgery involving the horizontal
deviation, and hence there is a need for
extra ocular muscles, it is frequently noted
careful dissection of the inferior oblique
that the anterior fibers of the inferior
during the primary surgery 4.









A
B
C
A

FIGURE1.
A- Inferior oblique muscle is inadvertently caught in the lateral rectus muscle insertion.
B- Preplaced suture for lateral rectus muscle before separation from inferior oblique. C-
Lateral rectus muscle after freeing the inferior border from inferior oblique.

It is concluded that the simple release of the IO muscle fibers included in the attachment of the
lateral rectus muscle will have a significant impact on reducing the vertical deviation and may
avoid the need for additional vertical muscle surgery 2.
124

Full Paper (vol.38 paper# 11)


Assessment of Nutrition of Obese Primary Schools Children in Urban and Rural Area in El Bihera Governorate The Egyptian Journal of Hospital Medicine (2010) Vol., 38: 131-139

Cytogenetic studies of Acute Myeloid Leukemia

Tarek Abd -Alla Atia
Histology Dept. Faculty of Medicine, Al-Azhar University, Cairo

Abstract

Acute myeloid leukemia (AML) describes as a group of hematopoietic stem cell disorders
characterized by expansion of undifferentiated myeloid progenitors. Acquired chromosomal
anomaly particularly reciprocal translocations constitute one of the major events contribute to
leukemogenesis.

Patient and Methods:
45 untreated, newly diagnosed patients with de novo AML were enrolled in the present study
and subjected to cytogenetic analysis. Four ml of heparinized peripheral blood were collected
for 72 hours synchronized culture, and then chromosome G- banding analysis was performed
using standard methods. The karyotypes were designated according to the International System
for Human Cytogenetic Nomenclature (ISCN). The collected data were analyzed statistically.

Result:
Cytogenetic analysis and karyotype results were obtained in 45 patients with de novo AML.
Males constituted 33.3%, and females constituted 66.7% of this group. The patients' age ranged
from 17-60 years. Chromosomal anomalies have been detected in 21 out of 45 patients (46.7%).
However five different types of chromosome anomalies have been detected; where seven cases
(33.3%) carrying t(15;17)( q22;q21); six cases (28.5%) carrying t(8;21)(q22;q22); three cases
(14.3%) had trisomy 8; three cases (14.3%) had monosomy 7; and lastly two cases (9.5%)
carrying inv(3)(q21q26).

Conclusion:
Conventional cytogenetic analysis reliability detects chromosomal abnormalities in AML
patients at the time of diagnosis. Chromosomal anomalies detected in Egyptian AML patients,
are similar to some extent to those recorded in other areas of the world.
Key words: cytogenetic, myeloid leukemia, karyotypes , trisomy, monosomy

Introduction:


Acute myeloid leukemia (AML) represents
FAB classification has limited prognostic
a hematopoietic malignancy characterized
value,
whereas
certain
recurrent
by abnormal cell proliferation and stalled
chromosomal abnormalities, prior to drug
differentiation leading to the accumulation
exposure and a history of a myelodysplastic
of immature cells in bone marrow, in
syndrome are predictive of outcome
peripheral blood and eventually in other
(Kumar et al., 2007). One the other hand,
tissues (Schlenk, et al., 2008). AML are
the world health organization (WHO)
greatly variable in clinical course and
classification of AML incorporates clinical,
response to therapy as well as in the genetic
morphologic,
immunophenotypic
and
and molecular basis of their pathology
genetic features in an attempt to define
(Mrozek & Bloomfield, 2006).
entities that are biologically homogeneous

and
have
clinical
relevance.
The
The
FAB
(French-American-British)
classification encompasses four major
doctors have classified AML into subtypes
categories; AML with recurrent genetic
(M0 through M7) based on the predominant
abnormalities, AML with multilineage
line of differentiation, and the cell maturity.
dysplasia, AML that is therapy related and
131

Full Paper (vol.38 paper# 12)