Microsoft Word - 1.DOC The Egyptian Journal of Hospital Medicine Vol., : ­
September
I.S.S.N:

Comparison of hemodynamic responses to dexmedetomidine versus
esmolol in patients undergoing beating heart surgery

Mohamed Abdel Rahman Salem M.D,* Mostafa Elhamamsy M.D,**
Ashraf Darwish M.D***
*Anesthesia department faculty of medicine Menofyia university
**Anesthesia department faculty of medicine Cairo university (Elfayoum Br.)
***Anesthesia department Researsh Institute of Ophthalmology

Abstract
Background:
-adrenergic agonists decrease sympathetic tone with
ensuing attenuation of neuroendocrine and hemodynamic responses to anesthesia and
surgery. Also, administration of beta -adrenergic antagonists contributes to prophylaxis
against hypertension, tachycardia and myocardial ischemia and myocardial protection
during cardiac surgery. The effects of dexmedetomidine (DEX), a highly specific alpha
-adrenergic agonist, on these responses have not yet been fully reported in patients
undergoing cardiac surgery. Esmolol (ESM) is a cardioselective, short-acting -
blocking agent. Previous studies have established the effectiveness of esmolol in the
reduction of hemodynamic responses during anesthetic induction.
Aim: The study of hemodynamic responses of dexmedetomidine and esmolol
and their effects on the anesthetic requirements during anesthesia in beating heart
surgery.
Methods: Forty patients scheduled for elective beating heart surgery received a

!
thereaf
"
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&'
"
end of surgery in the ESM group. Total intravenous anesthesia using fentanyl,
cisatracurium a
"
( )-* )+
of surgery. Hemodynamics measured included heart rate, mean arterial pressure, filling
pressures, cardiac index, systemic and pulmonary vascular resistances. The incidence of
hypotension, hypertension, tachycardia, bradycardia, dysrhythmias, ST segment
changes, total anesthetics requirements, muscle rigidity and postoperative shivering
were recorded.
Results: #$%

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,-
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3
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.&

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( 1 ! +
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sternotomy a
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,-
/40*
3.&
the baseline reading till it reached the baseline recording at the end of surgery. ESM
dropped HR

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/20

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.&
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( 1 ! +! ,-
.&


the end of surgery but HR exceeded the baseline readings and CI did not reach it. DEX
signif "
6 7
8'-&
0 2
, ( 1 ! +
24 0 2
dyn.s.cm .m- ( 1 ! +
2

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40
,
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! 6 7
Refree : Prof ; Dr. Ibrahin Abd El- Gany

www.000webhost.com

Full Paper (vol.4 paper# 1)


Microsoft Word - 2.DOC The Egyptian Journal of Hospital Medicine Vol., 2(­)(
September )
I.S.S.N: )
Study of Helicobacter pylori cag A status and Interleukin -
in patients with dyspepsia

Zeinab N.Said , Magda I.M.El Mahdy*,Mona M.Morsy**
and Hanaa Hassan ***

Microbiology,*Clinical Pathology,**Internal Medicine and***Pathology
Departments, Faculty of Medicine(for girls). AL Azhar University

Abstract:
Helicobacter pylori (H.pylori) is a Gram negative microaerophylic bacterium that
is closely associated with gastroduodenal diseases. The prevalence of H.pylori infection
is high world wild. Cytotoxin ­associated protein (cag A)encoded by cag A gene has
been reported to be a major virulence factor of H.pylori infection. The aim of this study
is to investigate the H.pylori cag A status and its relationship to endoscopic and
histopathological findings as well as serum and local interleukin-
-
H.pylori was confirmed by culture, histopathology and polymerase chain reaction
(PCR),while cag A gene was detected by PCR. Serum and gastric tissue IL-
!
"
#$%
&' &
(
%
"$%

)$%
H.pylori -negative. Serum Il-
&
higher in cag A-positive patients as compared to cagA ­negative H.pylori infected
*
!
- & +
*

-
showed significant increase in cag A-positive patients as compared to cag A-negative
* $
*

significant positive correlation between serum and tissue IL-
, -$ *
'
.
there was significant positive correlation between tissue IL-
!
, #)/*
.
,
/*
$ ,/* $
& '
+ !
concluded that cag A ­positive strains of H.pylori are associated with higher bacterial
density, greater histopathological changes and increased systemic and local IL-
production. This enhanced inflammatory response is thought to have role in disease
pathogenesis, explaining the occurrence of peptic ulcer and sever gastritis with cag A
positive strains.


Introduction



Helicobacter pylori (H.pylori) is a
not result in clinically relevant disease,
pathogenic
microaerophilic
spiral
even though such infections are often
Gram- negative bacterium which plays
persistent and can be life long in many
a significant role in the pathogenesis of
+
0
.--
!
+ .
chronic gastritis, peptic ulcer and gastric
only a small number of infected
0
1
.--
individuals will suffer from clinically
'
%
!

overt gastroduodenal disease and the

Refree : Prof ; Dr. Taghrid El Mekawi
(
(

Full Paper (vol.4 paper# 2)


Microsoft Word - 3.DOC The Egyptian Journal of Hospital Medicine Vol.,
­
September
I.S.S.N:

Comparison between two perineal procedures for
treatment of rectal prolaps

Ahmed Mohamed Abozid, Nabila Mohamed A. Shams, , Yahia Hassan
Zayed, Sayid Mostafa ....
Surgical department, faculty of medicine for girls, Al Azhar university

Abstracts
The optimal surgical procedures for the management of rectal prolapse is still
under debate so comparison between two operations were done in our series. Eighteen
patients with complete rectal prolaps were treated surgically through the perineum they
were divided into two groups. First group were treated by recto-segmoidectomy and
levatroplasty to fortify the pelvic floor, the second group were treated by rectopexy
using prolene mesh and levetroplasty to fortify the pelvic floor, the mesh was inserted
between the rectum and sacrum and fixed through perineal incision. The recurrence rate
!
"
"
#
$
$
!
%
$ &
significant difference in hospital stay among both groups. Also there were no other
cases of postoperative complications such as anastomotic leak or stricture, affection of
the bladder dysfunction in both groups.
Aim of work
The aim of this work was to compare the short-term outcome of two different
perineal operative procedures in patients with full thickness rectal prolaps.

Introduction
Complete full thickness rectal
So fortifying the pelvic floor by
prolapse is a distressing condition for
narrowing it around the rectum is a
the patient. The main objective purposes
mandatory step in the operation. This
of treatment are, first to carry out a
pelvic floor consists of the two levator
procedure that safely correct prolapse
ani muscles including its different parts
with minimal morbidity and no mort -
(i.e. puborectalis, pubococcygeus and
ality, and secondly to improve the
iliococcygeus) ,both coccygeus muscles
associated incontinence and underling
and the external sphincter ani.
defecatory disorders. Continence resto -
Important factors in the produ -
ration is dependent upon restoring a
ction of prolapse: - ! +
positive gradient between sphincter and
abnormally deep rectovaginal and
rectal pressure. Many patients are
rectovesical pouch of peritoneum.
constipated and this play a significant
Those patients are at particular risk.
role in the recurrence of prolapse
However it is not clear whether a deep
'
(()!
pouch associated with rectal prolapse is
It became evident that the receptors
congenital or is due to childbirth (Kaven
of fullness sensation in the rectum are in
$
!$ !
-
the pelvic floor muscle rather than in
eption of the upper rectum. Circular
# *
(
!$
invagination of the proximal rectal wall

Refree : Prof ; Dr. Maha Sudik A. Mukhtor

Full Paper (vol.4 paper# 3)


Microsoft Word - 4.DOC The Egyptian Journal of Hospital Medicine Vol.,
­
September
I.S.S.N:
Electron Microscopic Changes In Esophageal
Epithelium In Reflux Esophagitis

Samia I. El-Naggar*, Suhair A. Abdel Hafeez*, Hany Abdel Karium**
Department of pathology*, and surgery **
Faculty of medicine, Assiut University.



Abestract
Dilated intercellular spaces are a sign of epithelial damage in acid-perfused rabbit
esophagus, a change best identified by transmission electron microscope. The aim of
this work was to study the epithelial changes in reflux esophagitis by transmission
electron microscopy, and to determine if this change is also a feature of acid damage to


!
"
#
had normal appearing mucosa on endoscopy. Ultra-thin section was stained with
toluidine blue and examined with light microscopy and showed feature of epithelial
injury and repair in higher percentage in erosive esophagitis. Transmission electron
microscopy examinatio
#
$ %
specimens irrespective of whether the patients had erosive or non-erosive disease. We
concluded that dilated intercellular spaces are a feature of reflux damage to human
esophageal epithelium.

Key words: reflux esophagitis, TEM

Introduction
Gastro-esophageal reflux is the
diseases GERD. Endoscopy with biopsy
involuntary movement of gastric content
is an important diagnostic procedure in
from the stomach to esophagus (Roy and
patients with gastroesophgeal reflux
&
$$'( )
*
- ./ 0
# +
%
occur in normal individuals, abnormal
of patients with documented symptom -
gastro-esophageal reflux can cause
matic GERD can display normal or only
clinical and pathologic manifestation
minimal abnormal endoscopic findings
(Pace et al + $$ ( *
+

(Knuffte et al + $ (
physiologic reflux becomes pathologic
mucosal biopsy is theoretically useful in
process is incompletely understood, but
patients with symptoms consistent with
numerous complex factors are likely
GERD who have normal appearing
involved including the volume and
esophageal mucosa during endoscopy
potency of the refluxate, the duration of
(Lembo et al + $$$( , histological
esophageal exposure, and the efficiency
abnormalities of GERD encompass a
of esophageal defense mechanisms
range of features denoting epithelial
(Pace et al + $$ ( ,
injury and repair. Collins et al 1$ (+
approach to establishing the diagnosis.
found that vascular dilatation, epithelial
Consequent, there is no completely
hyperplasia, and papillary elongation can
sensitive and specific gold standard for
be detected most reliably, but their
the diagnosis of gastroesophgeal reflux
diagnostic accuracy is limited. Kahrilas
Refree : Prof ; Dr. Samy El-hakeem


Full Paper (vol.4 paper# 4)


Microsoft Word - 5.DOC The Egyptian Journal of Hospital Medicine Vol.,
­
September
I.S.S.N:
Variables affecting outcome of laparoscopic cholecystectomy
in acute cholecystitis

Ahmed M. Abozied, Nabila M. Shams, Yehia H. Zayed, Sahar
B.Alfeki,and Sayed A. Mostafa

Surgical department Azhar Faculty of Medicine for Girls

Abstract
The use of laparoscopic cholecystectomy (LC) for treatment of acute
cholecystectomy (Ac) and timing of this technique are a subject of debate. This study
was undertaken to evaluate our experience with early LC as a safe and effective
treatment of these cases.
Charts for all patients who had undergone LC for the diagnosis of AC were done.

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!
"
# % $&
Comparing both groups, the conversion rate to an open cholecystectomy (OC) was
# &'( )
($
&
*
#"+
,' $
# &'
'
$
-
# &
&
$
&
In conclusion LC is safe and effective technique for treatment of AC. Patents
"
oms has a lower conversion rate to OC, shorter
operative time and reduced total time of hospitalization.

Introduction
At the beginning of LC it was

Studies attempting to identify
introduced for cholecystitis as it
risk factors contribute to conversion,
provides the advantages of decrease
have largely analyzed variables such as
pain and disability as well as improved
patient characteristics and radiographic
cosmoses. However the role of LC in
findings. Although these studies may
the settings of AC has been a subject of
identify patient who have more
some debate. Earlier, AC was
technically challenging cholecystecto -
considered a contra indication to LC.#
mies, they offer little in the way of
'$. Many clinics felt that the inflame -
improving outcome in any given patient
mation, edema and adhesions associated
after presentation. And in a trial to
this process made laparoscopic surgery
improve the success rate of LC for
unsafe. As more experience was gained
treatment of AC, they ignore the patient
in the field of laparoscopy in general,
variables as it is not under there control.
many patients with AC have been succ -
But as they said, we can modify
essfully managed using LC technique
variables under our control, for example
# & &+&"$ .
an operating surgeons experience with

The failure rate of LC for AC
LC for AC, time from emergency
and conversion to OC in the deferent
admission to LC, and equipment avail -
.
"(
ability and familiality have been
' (&
retrospectively identified as variables
Refree : Prof ; Dr. Maha Sudik A. Mukhtor

Full Paper (vol.4 paper# 5)


Microsoft Word - 6.DOC The Egyptian Journal of Hospital Medicine Vol.,
­
September
I.S.S.N:
Valgus rotational -dome shaped -tibial osteotomy in
treatment of tibia vara

Hossam Kandil MD.,

Department of Pediatric Orthopedic Surgery
Institute of Neuromotor System and Rehabilitation


Abstract
The choice of surgical treatment of tibia vara depends upon the age of child, and
!"#$
%
! &
""!"#$
" ''! #$
! &
!

(!' ­
!
years ) .All patients were evaluated clinically . Radiographic measurement of tibio-
)
! *
were treated by dome shaped valgus rotational proximal tibial osteotomy and followed
%
( ­ '
! +
)
)
the varus deformity and improvement of alignment of lower extremities .The mean
%
'! #$
had full correction . No pain or ligamentous laxity of the knee was recorded and the
,
! '
"!"#$
)
)
alignment as positive angle .

Valgus rotational dome shaped tibial osteotomy is a safe, stable and reliable
method to accurately achieve angular and rotational correction of late onset form of
Blount disease. There were no complication, and the healing was rapid.


Introduction



Blount disease is an uncommon growth
proximal tibial epiphysis because of
disorder characterized by disordered
growth disturbances of the subjacent
ossification of the medial aspect of the
physis. The etiology remains controv -
proximal tibial physis, epiphysis, and
ersial, but it is most likely secondary to
metaphysis. This progressive deformity
a combination of hereditary and
is manifested by varus angulation,
)
! '
"$ &
internal rotation of the tibial, and genu
path physiology of Blount disease most
recurvatum in the proximal metaphyseal
likely is due to a combination of
region immediately below the knee. Fig
excessive compressive forces on the
$ &
proximal medial metaphysis of the tibia
irreversible pathologic changes, espec ­
and
altered
endochondral
bone
ially at the medial portion of the
' ( '$!




Refree : Prof ; Dr. Mahamed Osama Hegazy.

Full Paper (vol.4 paper# 6)


Microsoft Word - 7.a doc.doc The Egyptian Journal of Hospital Medicine Vol.,
­
September
I.S.S.N:



The Albino Rat Following Oral Administration
Of A-Chlorohydrin

Fouad A.F.Ali*, Ali A.Abdel Rahman* and Ashraf M.Moustafa**
*Plant protection Dept, faculty of Agriculture, Al-Azhar Univ;
** Histology Dept., Faculty of Medicine, Al-Azher Univ.


Abstract

The antifertility effects of a- chlorohydrin were re-investigated in female albino rats.
a.i/Kg. bw) of and six females were
! "
#
$
The uterine changes were in the form of an increase lumenal folding with areas of
metaplasia, some cellular vaculization and increased the collogen deposition in the
% $ &
!rd
"th day of the drug
intake. The ovarian changes were in the form of decreased number of growing follicles
and absence of both Graafian follicles and corpora lutea. It is clear that, treatment of
female rats with a chlorohydrin caused reversible uterine and ovarian changes. Uterine
changes took longer time to recover compared with that of ovarian changes. These
results support the possibility that this drug could be a functional female sterilant as it
was known as a male sterilant.

Introduction

After the discovery of the
effect a-chlorohydrin against the
rodenticidal and chemosterilant effects
reproductive system of female rats.
of a-
#
!-chloro- - prop -
Material And Methods
anediol, U-
" '() *+,$
A colony of albino rats (Rattus
-
'

, t
norvegicus albinus) has been started
was soon recognized that this was
and built up in Plant Protection Dept.,
unusually interesting functional male
Faculty of Agriculture, Al-Azhar
sterilant. Males with sexual gonads
U
#
-0
,$
external to the body cavity, are
Fifty adult female rats of proven fertility
susceptible to sterility, while, females
were selected for the present study.
from all rodent species tested are
&
) #
-
immune to sterilant property of a-
! - Each female was housed singly in
ch
#
.
/ 0% " 1
metal
cage
under
conventional
' 2

,$ &
(
%
67!89,
investigations had been focused mainly
on ad libitum pellet diet and water. The
on the effect of a-chlorohydrin on male
!
%( ,
( %
#
3
" 14 )
treated with a-chlorohydrin, while, the
5
et al.,
,$ &
%( ,
%
of the present work is to re-examine the
control.

Refree : Prof ; Moustaf Ismail

Full Paper (vol.4 paper# 7)


Microsoft Word - 8.DOC The Egyptian Journal of Hospital Medicine Vol., :
­
September
I.S.S.N:

Quantitative Morphometric And Histochemical Studies Of Hair
Follicles In Alopecia Areata

Wadad Z. Moustafa*, Bassem S. Kotb**, Manal A. Bosseila*, Tarek A. Emara*

*Department of Dermatology, Faculty of Medicine ­ Cairo University and
**Department of Histology, Faculty of Medicine ­ Al Azhar University (Assuit)



Abstract
Alopecia areata (localized hair loss) is a common hair follicle disease with unclear
pathogenesis. The aim of this work is to clarify the changes in the hair follicles that may

!
"!
quantitative histological morphometric measurements and for histochemical analysis of hair
follicles. The study revealed that there was a statistically significant decrease in the mean
percent of anagen hair follicles and statistically significant increase in the mean percent of
!
#

from alopecia patients in comparison to
that of normal volunteer. The study showed that there were statistically significant
decreases in the following; anagenic and telogenic hair follicles areas, telogenic hair
follicles perimeter, anagenic outer sheath thickness, hair follicles irregularity (catagen and
telogen), and telogenic hair (diameter, area and perimeter). Also there were statistically
significant increases in the following; hair follicles irregularities (anagen and telogen),
and anagenic hair perimeter. Regards histochemical studies, there was a statistically
significant decrease in the DNA staining affinity of hair follicles of anagen and catagen.
The study concluded that the morphometric quantitative study of tangential
histological sections of scalp biopsies with the aid of image analyzer is a feasible and easily
technique for differentiation between of alopecia areata and normal hairs and their
subtypes.

Introduction

Alopecia areata is a common
induces alopecia areata (Gupta et al.,
disorder characterized by limited patchy
%% '
!
hair loss which is non-scarring and
cycle of growth, involution and rest.
#
$ #
" %%&'
There are three phases of the hair growth
characteristic
initial
lesion
is
cycle; Anagen (where the kertinocytes of
circumscribed totally bald smooth patch.
bulb proliferate rapidly and penetrates
Genetics constitution, atopic state, non-
deeper into the level of subcutaneous fat),
specific immune and organ specific
Catagen (the hair shows gradual thinning
autoimmune reactions and emotional
and lightening of the pigment at the base
stress may be considered as factor
of hair shaft, the melanocytes undergo
Refree : Prof ; Dr. Hassan S. El-Dawi

Full Paper (vol.4 paper# 8)


Microsoft Word - 9.doc ­

!" #$$%
I.S.S.N: %#$

Transport Processes In A Heavy Eutrophic Marine Bay,
Alexandria (Egypt), Applying Environmental Impact
Assessment (EIA) Model


S.K.Mikhail, W.L.Gergis and E.E.Siam*

National Institute of Oceanography and Fisheries
*Arab Academy for Sscience and Technology and Maritime Transport


Abstract

Autogenous and allogenous control of the phytoplankton standing crop and
biomass was proved in Mex Bay, west of Alexandria (Egypt). Among the clear signs of
eutrophication are the heavy visible blooms, which became regular events, at
intermittent periods during the warm seasons. The causative organisms progressed
differently, the dinoflagellate, Gymnodinium catenatum, is well known toxic species.
The Environmental Impact Assessment model (EIA) was applied to Mex Bay. It is
a three-dimensional water quality and flow model, based on the three interacted
dimensional: longitude, latitude and depth, calculations of time and space variations.
The model deals with processes that affecting the water quality. It was initiated with
measured field data and load input. The model was used to simulate phytoplankton
biomass transport and ambient nutrient concentrations (nitrate, phosphate & ammonia).
The model results and the field measurements are compared in order to fit the model.
Generally, the calculated flow and concentrations corresponded well with observations.
Deviations are attributed to several reasons. A notable influence of the main outfall on
the concentrations, particularly in the near shore area, as well as, on the seawater quality
was detected. The spatial distribution of the phytoplankton standing crop coincided
clearly with the accompanied chlorophyll a concentrations calculated by the model. The
results stressed the need to reduce load input into Mex Bay, in order to counteract
eutrophication in Alexandria waters. Nitrogen reduction is more important for the whole
area, while phosphorous reduction is more effective in the bay.

Introduction


Although coastal marine transiti -
ication. This phenomenon is of wide
onal ecosystems located between land
occurrence in various parts of the world
and open sea represent only small area
&
'
% %( )*
% +,%$
of the world's ocean, they are of great
m+ of partially treated or untreated
ecological and economic importance.
sewage and waste waters are discharged
The land inflow of waste waters
annually into the coast of Alexandria,
and subsequently the excessive input of
but mostly into it's the western part.
nutrients, mainly nitrogen and phosp -
-"
$.
-
horus is underlying cause of eutroph -
nds Alexandri city and as a conseque -
Refree : Prof ; Dr. Abla M . Helmy Afify

Full Paper (vol.4 paper# 9)


Microsoft Word - 10.doc The Egyptian Journal of Hospital Medicine Vol., :
­
September
I.S.S.N:
Evaluation Of Heavy Metals Concenteratioin In Fish From
Alexandria Coast, Egypt

E.E.Siam
Assistant professor in marine environmental protection program.
Arab academy for science and technology and maritime transport


Abstract

Cadmium Cu, Fe, Mn, Pb concentrations were determined in the muscles and
organs (gills, liver, stomach and brain), of five fish species collected from Alexandria
coast (El-

!"Diplodus
sargus, Sparus auratus, Dicentrachus punctatus, and Mugil capito, while the last one
Siganus rivulatus is herbivorous. The results indicated high level of accumulation of
these metals in the different organs of all studied fish, with respect to their
correspondings in the muscle tissues. The accumulation factors for these metals were
higher in the herbivorous fish. The essential metals (Fe, Cu, and Mn) were the more
pronounced ones reflecting increase the trophic level of the fish. Lead concentration
# $
-% & #'(#

$
) !
# $
-
#'(#
in fish muscles. Also, Cd level was generally lower than that of Pb in various organs
while brain gained the highest values. Both of these toxic metals Pb and Cd were of
higher values in the herbivorous fish than in carnivorous ones. Most of the fish
generally showed levels of Cd in the organs which are close to that of the recommended
$ $ *
#'(#
+
!, !
$
$ ! -
!
. ! "
(NHMRC). However, none of them contained Cd concentrat

&
#'(#
their muscle tissues. Comparing the human metal intake due to consumption rate of fish
muscles with the permissible level of a Provisional Tolerable Weekly Intake (PTWI)
demonstrated that, the human consumption of these fish is still safe.

Introduction

Studies of heavy metals in fish are
al
%
"

an important aspect of environmental
elements reaching man by the food
pollution control, because human
chain these trace contaminants may
activities progressively increase the
have effects on the ecosystem greater
concentrations of heavy metals in
than those of the common pollutants.
aquatic system. (El-Nabawi et al

Aquatic organisms require cert -
Also, knowledge of levels of pollutants
ain trace metals to maintain normal
in edible marine organisms is important
metabolism. When present in excess,
from a public health protection view -
however, these essential metals such as
point. In addition, the distribution of
Fe, Cu, and Mn may exert toxic effects.
trace elements, particularly within the
As to the metals, which are known to be
tissues of marine animals, is of interest
harmful like Cd and Pb, their toxicity
in understanding the role they play in
rises with their concentration in an
the biochemical and physiological
accessible form. Many of them are
mechanisms of the organism (Emara et
known to be concentrated by marine
Refree : Prof ; Dr. Abla M . Helmy Afify

Full Paper (vol.4 paper# 10)


Microsoft Word - 11.doc The Egyptian Journal of Hospital Medicine Vol., :
­
September
I.S.S.N:

Radiation-Free Double-Pigtail Stent Insertion Under Local
Anaesthesia For Managing Acute Calcular Ureteral Obstruction
During The Last Trimester Of Pregnancy.

*M. H. El-Shazly, and **Nagwa A. Ghaffar.

*Urology Department; El-Sahel Teaching Hospital;
**Ob/Gyn Department, Al Azhar University (Girls), Cairo, Egypt.

Abstract:
Objective: To evaluate the feasibility, efficacy, and clinical outcome of the
radiation-free endo-insertion of double-pigtail ureteral stents under local anaesthesia for
managing acute calcular ureteral obstruction during the last trimester of pregnancy.
Patients and methods: Radiation-free endo-insertion of double-pigtail ureteral stent
under local anaesthesia was used as an emergency management for managing acute
ureteral obstruction, not responding to conservative measures, in twenty nine pregnant
women during the last trimester. The nature of ureteral obstruction was lower ureteral
per
!"
#
$
%
&
%
#
'
#
improvement occurred in all successful cases. However, the stent had to be removed
(
) *
#
$ "
* %
insertion. Details of the clinical outcome and adverse effects will be presented. No
major complications were recorded. Conclusion: Radiation-free endo-insertion of
double-pigtail ureteral stent under local anaesthesia is a feasible, safe, minimally
invasive, and effective procedure for managing acute calcular ureteral obstruction, not
responding to conservative measures, during the last trimester of pregnancy.

Keywords: ureteral stents, ureteral obstruction, pregnancy.

Introduction:

Acute ureteral colic is not an
are available for managing these clinical
uncommon medical emergency during
situations including insertion of precut -
pregnancy. It is the most common non-
"
* +,
0
obstetric cause of abdominal pain in
double-J or double-pigtail ureteral stents
hospitalized pregnant wom
+, -
+ ,
# #
of the cases are due to small ureteral
+, 1 0
#*
"
* &
calculi
which
spontaneously on
contraindication for extra-corporeal
conservative medical management in
" #($ )
"
* 2/3 4 + ,
-
% #
+
, . $ )
Double-pigtail
stent
(DPS)
further intervention is needed in about
insertion is a minimally invasive option
one third of patients whenever
which has the advantage of being
conservative measures fail to control
feasibl under local anaesthesia without
persistent pain or if complications occur
fluoroscopy avoiding the hazards of
like marked obstruction or acute
general anaesthesia and radiation during
*
"
+
, / )

pregnancy.
Refree : Prof ; Dr. Natlaa EL- Shaprawy

Full Paper (vol.4 paper# 11)


Microsoft Word - 12.doc The Egyptian Journal of Hospital Medicine Vol., :
­
September
I.S.S.N:
Bacterial Number, Heterotrophy and Extra Cellular Enzyme
Activity in the Sea Water of Alexandria Harbour, Egypt

Eman I. Siam
Assistant Professor in Marine Environmental Protection Programme
Arab Academy for Science and Technology and Maritime Transport

Abstract
To study the structure and function of bacterial population in Alexandria harbour
-
-
Eight sampling station were chosen. Samples were collected from surface and bottom
-


!
"
#
"
cells / ml and the total saprophytic bacteria was significantly law with regard to
the total bacterial number. Turnover times of glucose and leucine were extremely
variable depending on the sampling station and the water depth.
In deep sea water the enzyme activity of a $-glycosidase N-acetyl, -
glucosaminidase and amino peptidase of the slow growing bacterial population were
higher then those of the fast growing bacterial population, B- glycosidase activities,
% &
! '
( (
n.

Introduction

Bacterial heterotrophy was consid -
-
(
ered negligible in sea water, but now, it
!
'
&
is starting to appear an important
shallow (water max. dep
!
'
pathway of secondary food chain
m.) and opens to the sea by a narrow
production. Detrital material particu -
canal called "El-,
/0)1
+
larly that are derived from tiny
crustaceans appears to enter the food
chain at different trophic levels
)*
+ ,
exhibit a number of interesting prope -
rties and additionally play an essential
role in the cycling of nutrient (Nessim
+
-
.

of outstanding scientific interest and the
bacterial load in its water varies
according to factors like sewage dispo -
sal and maritime activities.
From this view, this study was
carried out to show the structure and
function of bacterial population in the
Egyptian Mediterranean waters.
Area of Investigation
The western harbour lies between

-
ern harbour of Alexandria
Refree : Prof ; Dr. Kouka S.E. Abd-El- Wahaab

Full Paper (vol.4 paper# 12)


Microsoft Word - 13.doc The Egyptian Journal of Hospital Medicine Vol., :
­
September
I.S.S.N:
Prevalence of Renal Tuberculosis in Patients
With Chronic Renal Failure Prior to
Dialysis, Associated with Constitutional Symptoms

Mona Hosny

General Medicine Department
Ain-Shams University
Abstract


ot yet on dialysis, were included in the
renal failure:
-
:
D.M. is a predispasing fact
!
"# # + $ %

-
­ proliferative
glomerulonephritis as it is the most common cause in Egypt for renal failure. Their
"# $ +
%
ars.

Constitutional and urogenital symptoms were a guide to choose patients included
in the study. For all patients the following was done:
Complete urine analysis, Acid-Fast Bacilli (AFB) in urine; Tuberculin test, chest
X-Ray, Plain urinary tract, CT of (Kidneys ­ ureter ­ bladder) and PCR of
Mycobacterium Tuberculosis in urine using Gen-Probe Amplification test.
&
" '%

(
" %
" '%

(
" %
)*+
tests mentioned above.
)
" %
'
'
" %
with a total
#'
this study.
We conclude that Diabetes Mellitus is a risk factor for renal Tuberculosis, but also
chronic renal insufficiency in itself is another risk factor but to a lesser extent than DM.
There was no significant statistical difference between chronic renal insufficiency
due to diabetic nephropathy and chronic renal insufficiency due to membrano
proliferative glomerulonephritis as regards renal Tuberculosis which was detected
essentially by PCR of TB in urine.
Compared to normal group, there were significant statistical differences in all
parameters that were measured, between normal group and the other two groups
together and separately.

Introduction


Tuberculosis (TB) is an ancient
$
disease that had almost been forgotten
and incidence of the disease showed a
in developed countries since an
dramatic decline during the past several
effective bactericidal chemotherapy was
decades in western countries. However,
Refree : Prof ; Dr. Badowi Labib.

Full Paper (vol.4 paper# 13)