Ain Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301VITAMIN D3 ADMINISTRATION BEFORE AND AFTER DETORSION COULD SALVAGE THE TESTICULAR ENDOCRINE FUNCTION IN AN EXPERIMENTAL MODEL OF TESTICULAR TORSION/DETORTION11410639710.21608/asmj.2020.106397ENDoaa A.Abou-BakrMedical Physiology Department,
Faculty of Medicine, Ain Shams
University, Cairo , Egypt.Journal Article20200806Background: Testicular torsion is one of the emergencies affecting mostly adolescent males, resulting in sub-fertility if not<br />rapidly and efficiently managed. Oxidative stress, inflammatory response as well as immunological reactions were implicated in its pathogenesis. Recently interest in studying the non-skeletal effects of vitamin D is growing, many researches indicates its antioxidant, antiinflammatory and immuno-modulatory effects. Aim of the Work: Investigating the possible conservative effect of vitamin D3 treatment on testicular endocrinal function in testicular torsion/detorsion rat model, and elucidating its possible underlying mechanism. Materials and Methods: 24 young adult male albino rats,<br />weighing 120-160 g., were randomly allocated into 3 groups, 8 in each group, Sham operated (SHAM), Testicular torsion/detorsion (T/D) and Testicular torsion/detorsion; vitamin D3 treated (T/D; D3) groups. All rats were subjected to measurement of absolute and relative testicular weight (ATW and RTW, respectively), assessment of testicular endocrinal function by serum total testosterone and inhibin B levels. In addition to determination of serum antisperm antibody<br />(AsAb). Testicular tissue was examined for oxidative stress markers; malondialdeyde (T. MDA) and glutathione peroxidase (T, GPx), as well as inflammatory marker; myeloperoxidase (T. MPO). Results: Testicular T/D resulted in significant reduction in ATW, RTW, serum testosterone and inhibin B levels with significant elevation in serum AsAb, T. MDA and T. MPO when compared with SHAM group. On treatment with vitamin D3, RTW was significantly increased as compared with T/D group but still significantly less than SHAM group. Serum testosterone level was significantly increased when compared with both SHAM and T/D groups. Inhibin B was significantly increased as compared with T/D group but still not<br />normalized as being significantly less than SHAM group. Serum AsAb, T. MDA and T. MPO were significantly decreased when compared with T/D group, being normalized for T. MDA but still significantly higher for serum AsAb and T. MPO when compared with SHAM group, however, T. GPx was significantly increased as compared with both SHAM and T/D groups.<br />Conclusion: Vitamin D3 could retrieve the testicular endocrinal dysfunction induced by Torsion/Detorsion by its antioxidant, antiinflammatory and immuno-modulatory effects.https://asmj.journals.ekb.eg/article_106397_04b84cfafc5b70a2af736a5ddf4bfaf2.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301NEUROTOXIC EFFECT OF ASPARTAME ON THE SCIATIC NERVE OF ADULT MALE ALBINO RAT AND THE POSSIBILITY OF SPONTANEOUS RECOVERY: LIGHT AND ELECTRON MICROSCOPIC STUDY153010639810.21608/asmj.2020.106398ENEnas AnwarBekheetAnatomy Department, Faculty of
Medicine, Ain Shams University,
Cairo , Egypt.Hagar YousryRadyAnatomy Department, Faculty of
Medicine, Ain Shams University,
Cairo , Egypt.Journal Article20200806Background: Aspartame is considered the most widely used nocaloric artificial sweetener. It is used in a variety of food products and beverages. However, the consumption of aspartame has been controversial as several studies have reported an association between its use and many serious diseases. Aim of the work: The aim of the present study was to evaluate<br />the potential neurotoxic effect of long duration aspartame consumption on the sciatic nerve of the adult male albino rats and the possibility of spontaneous recovery following cessation of its administration. Material and methods: Thirty adult male albino rats were used in this study, aged from 6-8 months, weighting 180 -200 gm. Rats were randomly divided into three groups: Group I: ten rats that received nothing except food and water, Group II: ten rats that received aspartame (250 mg/kg/d) for 12 weeks and Group III: ten rats that received aspartame as in group II then left for four weeks to recover. Results: The present work revealed that aspartame induced histological changes of rats’ sciatic nerves in the form of irregular nerve structure with wide separation of myelinated nerve fibers and dark elongated Schwann cells. Ultrastructural examination of group II showed separated myelin lamellae and excessive in folding with myelin loops formation. The recovery group showed histological improvement when compared to group II, yet it didn’t reach completely to the histological picture of the control group. Conclusion: The results supported the neurotoxic effect of aspartame on rats’ sciatic nerves when consumed regularly for a long period and proved that the spontaneous recovery wasn’t complete.https://asmj.journals.ekb.eg/article_106398_d905409fd46a1970d02d9c5cfcb34f4f.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301MRI ROLE IN CHEMOTHERAPEUTIC INDUCED PRES314510640010.21608/asmj.2020.106400ENSamar RamzyRaghebDepartment of radiodiagnosis,
Faculty of medicine, Ain Shams
university, Cairo , Egypt.Sherine MohamedShararaDepartment of radiodiagnosis,
Faculty of medicine, Ain Shams
university, Cairo , Egypt.Journal Article20200806Background: Posterior reversible encephalopathy syndrome is a very common neurotoxic side effect of chemotherapeutics. Aim of the work: To display the importance of Magnetic resonance imaging in early detection of the chemotherapeutic induced neurotoxicity. Patients & Methods: Fifty cancer patients (12 females and 38 males), their age ranged from 2 to 61 years on chemotherapy having neurological manifestations. Magnetic resonance imaging was<br />performed to evaluate the radiological findings of neurological manifestations. Results: 31 cases were found to have Posterior reversible encephalopathy syndrome, while the others 19 cases showed other complications. Conclusion: MRI showed an important role in detecting PRES in cancer patients due to chemotherapeutics.https://asmj.journals.ekb.eg/article_106400_141c0055c7d4a8c099a2d62e6687c294.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301ROLE OF 128-SLICE, DUAL-SOURCE CT CORONARY ANGIOGRAPHY AS A NOVEL IMAGING TECHNIQUE IN ASSESSMENT OF IN-STENT RESTENOSIS475810640110.21608/asmj.2020.106401ENHesham MahmoudMansourDepartment of Radiodiagnosis,
Faculty of medicine, Ain Shams
university, and Radiodiagnosis
Specialist in Manshiet El Bakry –
General Hospital Cairo , Egypt.Eman Ahmed ShawkyGeneidiDepartment of radiodiagnosis,
Faculty of medicine, Ain Shams
university, and Radiodiagnosis
Specialist in Manshiet El Bakry –
General Hospital Cairo , Egypt.Amal IbrahimAhmedDepartment of radiodiagnosis,
Faculty of medicine, Ain Shams
university, and Radiodiagnosis
Specialist in Manshiet El Bakry –
General Hospital Cairo , Egypt.Wasila Moustafa MohammedEldolifyDepartment of radiodiagnosis,
Faculty of medicine, Ain Shams
university, and Radiodiagnosis
Specialist in Manshiet El Bakry –
General Hospital Cairo , Egypt.Journal Article20200806Background: Over the past 35 years, catheter-based intervention has become the dominant form of coronary revascularization. Percutaneous coronary interventions are increasingly performed. The most important advance in the field of percutaneous coronary interventions was the introduction of coronary stent implantation in the 1990s, which led to reductions in incidence of restenosis. The use of multi–slice CT is gaining increasing acceptance for noninvasive cardiac imaging. Recent years with the new emerging machines have demonstrated successful application of multi–slice CT angiography for the noninvasive assessment of coronary artery disease and the evaluation of coronary artery stents.<br />Aim of the Work: To evaluate the role of 128-slice, dual-source CT coronary angiography as a novel technique in assessment of coronary artery in-stent restenosis. Patients and Methods: This study included forty patients with<br />prior coronary artery stent implantation. The mean age of the included patients was 58 with an age range between 40 and 73 years. A total of 42 coronary artery stents deployed within 40 patients were included in this study; and assessed by MSCT angiography and they underwent invasive coronary angiography as a gold standard for evaluation of the coronary artery stents. Results: In an overall view, MSCT angiography compared to the invasive coronary angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 83.8 %, an accuracy of about 87.1%, positive predective value (PPV) is 61.5% and negative predective value (NPV) is 100% in the assessment of the patency of<br />the coronary artery stents, taking into consideration proper standard CT angiography techniques in all cases.<br />Conclusion: Our study helps to identify factors that influence the assessability of coronary artery stents by 128-slice dual source CT scanner, namely, stent type and diameter. It shows that under certain conditions, the detection of in-stent restenosis might be possible with an accuracy that could permit clinical applications, but the nonassessable stents do not allow the use of MSCT coronary angiography in unselected patients with implanted stents in coronary arteries. So that MSCT angiography as a noninvasive technique can be used for assessment of in-stent restenosis but patients must be<br />carefully selected.https://asmj.journals.ekb.eg/article_106401_a7febb952dddf9c886fa44a75f34ff3f.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301DOES ORAL CHLOROQUINE AFFECT THE HIPPOCAMPUS IN RATS? A CLUE TO CHLOROQUINE INDUCED NEUROPSYCHIATRIC ADVERSE EFFECTS597910640210.21608/asmj.2020.106402ENAhmed FaridAl-NeklawyDepartment of Anatomy and
Embryology, Ain Shams Faculty
of Medicine, Cairo, Egypt
Department of Physiological
Sciences, Fakeeh College for
Medical Sciences, Jeddah, KSA.Journal Article20200806Background: Chloroquine is widely used in medicine. The main indication for its usage is treatment of malaria. Reports<br />about psychiatric side effects of chloroquine are rare. However, the list of recorded chloroquine induced neuropsychiatric<br />disorders shows wide range of symptoms. Aim of the work: In this study, the effect of oral chloroquine on the hippocampus of rats was assessed. Material and methods: Twenty seven male adult albino rats were randomly divided into four groups. Group I (control group): nine rats were divided into I-a and I-b subgroups. Group II (chloroquine for two weeks): six rats received 4ml of distilled water solution/day containing chloroquine in a dose of 80 mg/kg bwvia oral gavage for two weeks. Group III (chloroquine for three weeks): six rats received chloroquine as in group II for three weeks. Group IV (chloroquine for four weeks): six rats received chloroquine as in group II for four weeks. After sacrifice, the hippocampi were retrieved, fixed, and processed for paraffin sections. H&E and Bielschowsky silver stains were applied and immunehistochemical staining for GFAP was performed to examine the distribution of astrocytes. Results: Examination of different regions of the hippocampal formation revealed dark, shrunken cells, with pyknotic nuclei and pericellular spaces in all treated groups. Neurofibrillary tangles were also seen in some stained sections. Moreover, an increase in the density of astrocytes was also observed. Morphometrically, there was a decrease in the thickness of both pyramidal and granular layers of cornu ammonis and dentate gyrus respectively in all treated groups as compared with control group. All these changes appeared in group II, and were clearer in both groups III and IV. Conclusion: It was concluded that oral administration of chloroquine caused duration dependent neuronal damage in the hippocampus of rats giving a possible explanation for chloroquine induced neuropsychiatric adverse effects.https://asmj.journals.ekb.eg/article_106402_9a8711407211ea0515534be8b5aeeadc.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301ASSESSMENT OAF -243A>G POLYMORPHISM OF GLUTAMATE DECARBOXYLASE 2 GENE IN OBESE PATIENTS818810640310.21608/asmj.2020.106403ENKarim YehiaShaheenDepartment of Clinical
Pathology, Faculty of Medicine,
Ain Shams University
Cairo , Egypt.Hala AbdelAl AhmedDepartment of Clinical
Pathology, Faculty of Medicine,
Ain Shams University
Cairo , Egypt.Walaa AhmedYousryDepartment of Clinical
Pathology, Faculty of Medicine,
Ain Shams University
Cairo , Egypt.Nouran Mahmoud Bahig MustafaEl MihiDepartment of Clinical
Pathology, Faculty of Medicine,
Ain Shams University
Cairo , Egypt.Journal Article20200806Background: Obesity is one of the most common noncommunicable diseases and public health issues in the world at every<br />stage of development. The World Health Organization (WHO) estimates that 13% of adults worldwide are obese.<br />Aim of the Work: To investigate the relationship between - 243A>G polymorphism of GAD2 gene and the presence of obesity. Subjects and Methods: The present case-control study included thirty (30) obese patients with BMI ≥30 kg/m². In addition, twenty (20) age- and sex- matched healthy subjects served as a healthy control group with BMI <25 kg/m². All subjects were genotyped for the GAD2 gene SNP -243 A>G (rs2236418) using PCR-RFLP technique. The study was approved by the Research Ethics Committee of Ain Shams University. Results: The present study revealed that the (AA) genotype and the (A) allele frequencies were significantly higher in healthy controls when compared to obese patients. Meanwhile, the frequencies of the (AG) and (GG) genotypes as well as the (G) allele were significantly higher among obese patients as compared to healthy controls. Conclusion: The present study demonstrated the presence of a<br />significant association between the -243A>G polymorphism and obesity.https://asmj.journals.ekb.eg/article_106403_1de5a43ef47cf430f5429f124351ec05.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301ACROMIOCLAVICULAR AND CORACOCLAVICULAR RECONSTRUCTIONBY NYLON TAPE VERSUS CORACOCLAVICULAR SCREW IN MANAGEMENT OF ACUTE ACROMIOCLAVICULAR DISLOCATION899910640410.21608/asmj.2020.106404ENTarek MohammedKhalilDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Maged Mohamed SamyAbou ElsoudDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Wael Ahmed MohammedNassarDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Mohamed HassanSobhyDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Ashraf MohammedEl SeddawyDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Ahmed Eid MorsyKhaledDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Journal Article20200806Background & Purpose: A number of different surgical techniques were described to treat acute acromioclavicular (AC) joint dislocations which aim to restore joint congruity and mechanical stability. The purpose of this study was to compare functional, radiological outcomes and fixation related complications of acromioclavicular and coracoclavicular (CC) reconstruction by nylon tape versus coracoclavicular screw in management of acute acromioclavicular dislocation.<br />Patients &Methods: In the periodfrom September 2017 to December 2019, a prospectiverandomized controlled clinical trial was conducted in Ain Shams University hospitals including 30 cases with types III and V AC injuries. They were divided into two groups, 15 patients underwent AC and C Creconstruction by nylon tape (Group A) and the other 15 patients underwent coracoclavicular screw (Group B).The patients were evaluated forpain, range of motion (ROM), radiologic findings (CC distance difference between both sides was measured), American Shoulder and Elbow Surgeons<br />(ASES), and Constant scores. Postoperative complications were recorded and assessment of time of returning to the work was done. The evaluation was done preoperatively and each time of follow up with a minimum period of one year.<br />Results: After a mean follow up period of 15±2.7 months for group A and 14.37±4.74 months for group B, patients of both groups showed highly significant improvement between mean preoperative and postoperative pain, ROM, Constant, ASES scores and CC distance difference. Group A showed better results as regard mean postoperative ROM, Constant score and ASES score than group B, while group B showed better results as regard mean postoperative pain score and CC distance difference. However, there was no statistically significant difference between the 2 groups. In group A the mean post-operative pain and ROM scores (both as a part of constant score) was 12.67 (±3.2) and 33.53 (±2.9) respectively while in group B was 12.92 (±3.34) and 32.83 (±2.98) respectively. The mean post-operative Constant and ASES scores was 86.93 (±7.22) and 89.93 (±7.5) respectively for group A and 86.17 (±8.33) and 87.58 (±6.08) respectively for group B. Radiographic CC distance difference (mm) between both shoulders at one year postoperatively was 2.27 in group A and 2.13 in group B. There was a statistically significant difference between the mean time to return to work for patients in group A (3.2 months) and patients in group B (4.2 months). Complete loss of reduction occurred in three patients in group B, two cases of subluxation (50 % of the preoperative CC distance difference) in group A, one case of wound infection in each group and one case of fracture clavicle in group B. Conclusion: Both AC and CC reconstruction by nylon tape and CC screw procedures are valid surgical options and have adequate outcome in treatment of patients with acute AC dislocation. However there are some concerns about the failure rate and the need of another operation for screw removal that was present in CC screw group which affects patient satisfaction in that group.https://asmj.journals.ekb.eg/article_106404_d1ff1fc86f5248c90ab61e057c155e3e.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301SUPRA CONDYLAR FEMORAL EXTENSION OSTEOTOMY WITH PATELLAR TENDON ADVANCEMENT TO TREAT FIXED KNEE FLEXION DEFORMITY IN CROUCHING AMBULATORY ADOLESCENTS WITH CEREBRAL PALSY10111810640510.21608/asmj.2020.106405ENHany MamdouhHefnyDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Mahmoud AliMahranDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Tamer Abd El MeguidFayyadDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Mohammed Hazem Abd El-WahabAhmedDepartment of Orthopedic
Surgery, Faculty of medicine,
Ain Shams University.
Cairo , Egypt.Journal Article20200806Background: Ambulatory cerebral palsy (CP) patients present with different gait patterns because of muscular spasticity and contractures and subsequent limited range of motion leading to loss of their functional abilities. Crouch gait is one of the most common gait pattern in ambulatory children with CP. Aim of the work: The purpose of this study is to evaluate the results of supra condylar femoral extension osteotomy (SCFEO) and patellar tendon advancement (PTA) in the treatment of fixed knee flexion deformity (FKFD) in patients with spastic ambulatory cerebral palsy (CP) to achieve full knee extension and restore an appropriate relationship between quadriceps length and tension in order to maintain knee extension during the stance phase of gait to correct the crouch gait. Patient and Methods: This prospective case series study was done on 20 patients (37 knees); 12 males and 8 females, who had spastic or mixed (mainly spastic) CP and walked with a crouch gait, and who underwent combined SCFEO and PTA along with the context of single event multi-level surgery. Results: The mean Fixed Knee Flexion Angle (FKFA) improved from 24.25o ±11.86o to be 2.25o± 2.25o. The mean knee extension lag improved from 15.8o±5.68o to be 4.2o±1.31o. The mean Gross Motor Function Measurement (GMFM) improved from 53.3 to be 69.1. The mean Koshino Index (KI) improved from 1.54±0.29 to be 1.14±0.12.<br />Conclusion: For crouching adolescents there are 4 questions must be answered: Frist, differentiate between isolated myogenic flexion deformity and combined myogenic-arthrogenic knee flexion deformity. Second, assess isolated myogenic flexion deformity due to hamstring shortening by unilateral popliteal angle test. Third, differentiate between apparent and true hamstring shortening by popliteal shift test; apparent functional hamstring shortening and hamstring lengthening is not indicated. Forth, if the unilateral popliteal angle is positive with negative popliteal shift test, true hamstring shortening is found.https://asmj.journals.ekb.eg/article_106405_44c99862dde8815b83292cc9b832a56d.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301HYPO PERFUSION MARKERS AS THERAPEUTIC AND PROGNOSTIC TOOLS FOR SEPTIC PATIENTS11912810640610.21608/asmj.2020.106406ENMohammed Abd EL-khalek MohammedAliDepartment of Anesthesiology,
General Intensive Care and Pain
Management, Faculty of
Medicine – Ain Shams
University, Cairo , Egypt.Noha MohammedElsharnoubyDepartment of Anesthesiology,
General Intensive Care and Pain
Management, Faculty of
Medicine – Ain Shams
University, Cairo , Egypt.Ibrahim MamdouhEsmatDepartment of Anesthesiology,
General Intensive Care and Pain
Management, Faculty of
Medicine – Ain Shams
University, Cairo , Egypt.Milad RagaeyZekryDepartment of Anesthesiology,
General Intensive Care and Pain
Management, Faculty of
Medicine – Ain Shams
University, Cairo , Egypt.Shirin Fekry Abd ElAzimEmaraIntensive Care Medicine,
MISR University for Science and
Technology
Cairo , Egypt.Journal Article20200806Background: Venous-to-arterial carbon dioxide difference (PvaCO2) and central venous oxygen saturation (ScvO2) may reflect the adequacy of blood flow during septic shock states. We sought to test whether the development of Pv-aCO2 and ScvO2 during the early phases of resuscitation is related to multi-organ dysfunction and outcomes in a population of septic shock patients resuscitated targeting the usual oxygen-derived and hemodynamic parameters. Aim of the Work: To assess the central venous-arterial carbon dioxide difference (Pv-aCO2) as a goal in goal directed therapy of sepsis resuscitation in comparison to central venous oxygen saturation (ScvO2) and to test for their prognostic values. Patients and Methods: This prospective observational study was performed in a 24-bed mixed ICU in a university-affiliated hospital. We examined all septic patients with a new episode admitted to the emergency room or proceeding from clinical wards during a 24-month period. After approval by Ethical Medical Committee and obtaining informed consent, simultaneous blood samples were collected from the central venous line and the arterial catheter for obtaining venous and arterial gases respectively at (T0), and 6 hours (T6), 12 hours (T12) and 24 hours (T24) later. Patients were classified into four groups; two group (30patients) (A1 and A2) according to PcvO2 gap and another two groups (30patients) (B1 and<br />B2) according to Central venous oxygen saturation. Group (A1) Decreasing Pcv-aCO2 (high at T0, declining at T6), Group (A2) Persistently high Pcv-aCO2 (high at T0 and T6), Group (B1) Increasing Central venous oxygen saturation (less than 70% at T0, increasing at T6), Group (B2) Decreasing Central venous oxygen saturation (less than 70%at T0 and decreasing T6). Results: Sixty-eight septic critically ill patients were included in this study. However; 8 patients were excluded from the study. Among the included patients in the study, 3 patients were excluded as they developed acute coronary syndrome, 4 patients refused to complete the treatment and discharged against medical advice, and 1 patient<br />developed an ischemic cerebral vascular stroke. The final sample was therefore 60 patients. In this study, Central veno-arterial PCO2 gap and ScvO2 are considered as surrogate markers of the payment of the oxygen debt and early predictors of clinical outcome and organ dysfunction in the ICU. As regard the study, Central veno-arterial PCO2 gap is predictors for resuscitation in septic patients. As regard A Group, there was significant statistical difference between mortality and survival at T6, T12 and T24. However; regarding B Group, there was significant statistical difference between mortality and survival at T12 and T24. Also, this study shows that patients with persistently low ScvO2 are considered a good hypo perfusion marker for septic patients. Conclusion: Data support the hypothesis that persistence of high PCO2 Gap and low ScvO2 during the resuscitation of septic patients is associated with significant higher multi-organ dysfunction and poor outcomes in critically-ill patients. Recommendations: Future studies on a larger number of patients are needed and should test PCO2 Gap and ScvO2 as perfusion goals during early phases of the resuscitation of patients in septic shock to confirm its reliability.https://asmj.journals.ekb.eg/article_106406_c488e948ca6fd5b2d676c9f186d2932e.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301ROLE OF CONTRAST ENHANCED DIGITAL MAMMOGRAPHY IN BREAST LESIONS12913610640810.21608/asmj.2020.106408ENRababAbdelmoniemDepartment of Radiodiagnosis,
Ain Shams University
Cairo , Egypt.Fatma S.EMohamedDepartment of Radiodiagnosis,
Ain Shams University
Cairo , Egypt.Samer M.BotrosDepartment of Radiodiagnosis,
Ain Shams University
Cairo , Egypt.Amr M.Abd ElsamadDepartment of Radiodiagnosis,
Ain Shams University
Cairo , Egypt.Journal Article20200806Back ground: Breast cancer in women is major public health problem throughout the world, Mammography is basic breast imaging modality for early detection and diagnosis of breast cancer, mammography has its own limitations so contrast enhanced digital mammography is new advanced application using intravenous injection of contrast under development of subtraction and dual energy technique to improve detection of breast cancer. Aim of the Work: To investigate the potential of using intravenous contrast material with full field digital mammography to facilitate the detection and characterization of lesions in the breast. Patients and Methods: This study was conducted on 40 patients with mammographic clinical findings that warranted biopsy recruited from department of Radio-Diagnosis, Ain Shams University hospitals. A technique for demonstrating breast cancers, dualenergy contrast agent–enhanced digital subtraction mammography, was performed<br />for the 40female patients. The technique consists of high energy and low-energy digital mammography after administration of iodinated contrast agent. Weighted subtraction of the logarithmic transform of these images is then performed to obtain an image that preferentially shows iodine. Results: Of the40 subjects, twenty eight of these tumors enhanced strongly, proved carcinoma, in the other 12 patients, benign tissue enhanced diffusely in two and weakly ocally in two. These results indicate that the technique is feasible and worthy of further study. Conclusion: Contrast-enhanced digital mammography is a new breast imaging technique using full-field digital mammography in conjunction with the injection of an iodinated contrast medium. Dualenergy CEDM also allows shorter acquisition duration and does not<br />require prolonged breast compression. This could result in better acceptance from patients and fewer technical problems, such as misregistration of subtracted images.https://asmj.journals.ekb.eg/article_106408_97a9d249b0b710ca3031fe3d6189c2f9.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301CONSERVATIVE TREATMENT VERSUS FIXATION OF TYPE I CORONOID FRACTURE IN TERRIBLE TRIAD INJURIES OF THE ELBOW JOINT13714610640910.21608/asmj.2020.106409ENMohammed MostafaEl-MahyOrthopaedic Department,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Ahmed NaeemAtiyyaOrthopaedic Department,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Ramy AhmedDiabOrthopaedic Department,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Amr MostafaAlyOrthopaedic Department,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Mohamed Ahmed Abas MounirElbishbishiOrthopaedic Department,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Journal Article20200806Background: The coronoid process is considered the keystone of bony elbow stability, in addition to its soft tissue attachment. Aim of the work: To compare conservative treatment versus fixation of type I coronoid fracture in terrible triad injuries as regard elbow stability, functional outcome, and possible complications. Patients and methods: We performed a prospective randomized control study on 20 patients with terrible triad injuries and were divided into two equal groups. Randomization was done using Microsoft Excel. Group (1) including 10 patients where the coronoid<br />fracture was not repaired, and Group (2) including 10 patients where the coronoid fracture was repaired. All patients were operated using the lateral approach. In the second group, the coronoid fracture was fixed using pull-out sutures. In both groups, internal fixation was done for the radial head or neck fracture with reattachment of the lateral ulnar collateral ligament (LUCL) to its humeral origin by transosseous sutures. Postoperative patient assessment was done according to the Disabilities of the Arm, Shoulder and Hand (DASH) Score, and the Broberg-Morrey rating system. Results: In the first group, the mean Broberg-Morrey score was 91.2 (range, 85–98) with four excellent results and six good results. The average DASH score was 13 (range, 2.5–30). In the second group, the mean Broberg-Morrey score was 94.4 (range, 89–98) with seven excellent results and three good result. The average DASH score was 9.6 (range, 0–23.3).Two patients experienced postoperative complications in the first group, one implant failure of the radial neck fracture after 3 weeks follow up and the other did not reach complete union of his radial neck. Both patients refused a second operation.<br />Conclusion: We conclude that fixation of type I coronoid fractures in terrible triad injuries did not show significant difference regarding elbow stability and clinical outcome at short-term follow up.https://asmj.journals.ekb.eg/article_106409_b388c0edb2e7ac1fac177c520cdf56e0.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301DETERMINANTS OF RECURRENCE RATE DURING MIDTERM FOLLOW-UP OF PATIENTS AFTER ENDOVENOUS LASER ABLATION OF PRIMARY LOWER LIMB VARICOSE VEINS14716010641010.21608/asmj.2020.106410ENMohammedHatemDepartment of vascular surgery, Faculty
of medicine, Ain Shams University. Cairo , Egypt.MahmoudSobhyDepartment of vascular surgery, Faculty
of medicine, Ain Shams University. Cairo , Egypt.WagehFawzyDepartment of vascular surgery, Faculty
of medicine, Ain Shams University. Cairo , Egypt.KaremSabryDepartment of vascular surgery, Faculty
of medicine, Ain Shams University. Cairo , Egypt.AhmedAl-TaherDepartment of diagnostic and
interventional radiology, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Journal Article20200806Background: The goal of this prospective cohort study was to study the different determinants impacting primary varicose vein recurrence rates and patterns after endo venous laser ablation (EVLA) for primary lower limb varicose veins.<br />Patients and Methods: 127 symptomatic patients (127 limbs) with great saphenous vein reflux (>0.5 seconds), GSV diameter> 3mm and pre-operative incompetent perforators were followed up within two years for recurrence after EVLA.<br />Outcomes: Recurrence was defined clinically by venous clinical severity score (VCSS) and CEAP classification and radiologically by patterns of reflux on duplex ultrasound examination. Assessment was done at 1, 6, 12 and 24 months after the procedure. Results: Two-year life table analysis showed varicose vein recurrence in 9 (7.1%) of limbs. Varicose vein recurrence was mostly seen owed to due to BMI more than 30.5 kg/m2 in 77.8 % (p <0.001, 95% CI 1.105 to 1.590) of recurrence patients, refluxing anterior accessory saphenous vein in 77.8% of patients (p <0.001, 95% CI 3.2 to 1669.1) and postoperative incompetent perforators in 77.8% of patients (p <0.001, 95% CI 2.7 to 69.3). Age, gender and pre-operative GSV diameter ≥ 5.5 mm were statistically insignificant in determination of recurrence. Conclusion: BMI, refluxing anterior accessory saphenous vein and postoperative incompetent perforators are the most important<br />determinants of recurrence after EVLA with a statistically significant impact in comparison with age, gender and preoperative dilated GSV diameter ≥5.5 mm.https://asmj.journals.ekb.eg/article_106410_a7eb718608e58830b1c8ba4a31f72df8.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301MEMBRANE INDUCED OSTEOGENESIS (MASQUELET TECHNIQUE) VERSUS BONE TRANSPORT IN MANAGEMENT OF LARGE BONE DEFECTS OF THE LOWER LIMB16117010641110.21608/asmj.2020.106411ENSalah AbdelgawadAbou-SeifOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Mootaz FouadThakebOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Ahmed HassanYousryOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Mahmoud AliMahranOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Tamer Abd El Meguid MohamedFayyadOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Mohamed Ismail Abdel Hakim MohamedKotbOrthopaedic Department, Faculty
of medicine, Ain Shams
University. Cairo , Egypt.Journal Article20200806Background: Management of bone defects is controversial, between grafting, acute shortening, and up to amputation and<br />disarticulation in extensive defects. This study is a comparative study between 2 modalities for management of bone defects to reveal advantages and disadvantages of each modality. Aim of the work: The aim of this work is to assess and compare results of membrane induced osteogenesis and bone transport in extensive bone defects of the lower limb .<br />Patients and methods: We prospectively studied 40 patients (29 males and 11 females) with lower limb bony defects. They were divided into two groups according to the method of reconstruction using either Masquelet technique in 20 patients (group A) or bone transport in the other 20 patients (group B). The mean age of the patients was 35.٢ years in group A and was 35.2 years in group B. diagnosis was infected non union (20 cases: 10 in group A &10 in group B) and posttraumatic and non infective defects (20 cases: 10 in group A &10 in group B) .The most common anatomical site was the tibia (24 cases:9 in group A &15 in group B).. Patients were reviewed every 3 monthly for a minimum period of 1 year. Regular outpatient follow-up was done with a mean period of 18.35±5.58 months in group A and 18.25±3.95 months in group B. Results: In cases of group A (Masquelet group) 12 cases showed complete union, and the other 8 cases showed no evidence of union (all from infected group). While in case of group B (bone transport group) all cases showed complete union Conclusion: bone transport technique is more reliable method with more expectable results for healing and infection eradication. Up to our study, Masquelet technique can be used in the following indications: small, metaphyseal and posttraumatic or non infective defectshttps://asmj.journals.ekb.eg/article_106411_eadf80a13e60c654196ddbb3609b0c14.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301MODIFIED DOUGHNUT TECHNIQUE IN REDUCTION MAMMOPLASTY FOR BREAST CANCER17118010641210.21608/asmj.2020.106412ENSamy A.Abdl RhamanDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.SherifMouradDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.HossamEl SadekDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Hoda E.GergesDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Journal Article20200806Background: Breast cancer is the commonest malignancy in women and comprises 18% of all female cancers. The goal of modern breast surgery is to cure patients with preservation and reconstruction of breast tissue leading to satisfactory physical and psychological outcome. Aim of the Work: to evaluate modification of Dougnut technique in reduction mamoplasty as part of oncoplastic breast surgery for breast cancer. Patients and Methods: This prospective study included 20 female patients diagnosed with breast cancer suitable for management with the modified doughnut breast oncoplastic reduction mammoplasty surgery the age of the patients varied from 22 and 60 years old. The mean age for our study was 46.5. Results: From the 20 patients, the most common were of cup size C and D with the later being the mean and accounting for more than half (55%). The mean tumor size was 3.37 1.01 with a mean distance from NAC of 2.86 0.85. The location was 60% paraaereolar and 40% in the lower half of the breast. 13 (65%) patients underwent operation unilateral and 7 (35%) patients underwent bilaterally. The most common tumor pathology was IDC (70%). Regarding our patients' cosmetic satisfaction, the overall mean score of our study was 4.35 which falls between very good and excellent Conclusion: The modification of oncoplastic surgical techniques allows combining of several benefits, as here the modified doughnut technique benefiting from combining the round block and superior medial techniques giving better access of tumors and oncological control around the breast and reduction mammoplasty in large breast of cup C, D and more, with safe NAC and good aesthetic outcome. That technique showed good adoption bilaterally which is a key for<br />symmetrization in oncoplastic surgeries.https://asmj.journals.ekb.eg/article_106412_3193174374b1c6a2ec5b69cf3eebe70f.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301OUTCOME OF LAPAROSCOPIC SLEEVE GASTRECTOMY AND LAPAROSCOPIC MINI GASTRIC BYPASS ON EGYPTIAN MORBID OBESE PATIENTS18119610641310.21608/asmj.2020.106413ENOsama AliElAtrashDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Walid IbrahimAbdel HamidDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Mohamed Abdel MonemMarzoukDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Mohamed Abdel SatarAbdel HamidDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Ahmed FaroukAbdel HafeezDepartment of General Surgery,
Faculty of medicine, Ain Shams
University. Cairo , Egypt.Journal Article20200806Background: Chronic diseases are well established as the predominant death cause, and obesity, being one of the factors<br />strongly contributive to chronic diseases, has been consistently threatening the global health. Aim of the Work: To compare between laparoscopic mini gastric bypass and laparoscopic sleeve gastrectomy on morbid obese patients in Egypt as regard weight loss, outcome of associated co-morbiditis and with 1 year follow up after operation. Patients and Methods: This study included 200 patients, 100 patients in each group. The group age ranged between 22 -55 years with a mean ± SD of 37.88 ± 9.52 years. Female patients represented the main population of this study (60.5%). It is a common finding in the literature that women are undergoing bariatric surgery more than men. We included in this study patients with BMI ≥ 40 or BMI = 35–39 with one or more obesity-related co morbidities. It is a sample study which was done between December 2016 – December 2018 at Ain Shams University Hospitals, Cairo, Egypt. Results: Finally our study suggests that bariatric surgery (mainly LSG and LMGB which are the most common bariatric operations nowadays) are considered the best treatment of diabetes type 2 in obese patients and LMGB is superior to LSG in diabetes remission. Both procedures are also associated with improvement of the blood pressure and the sleep apnea owing to weight loss.<br />Conclusion: It is reasonable to say that both LSG and LMGB achieve similar weight loss mean and resolution of co-morbidities at 1 year.https://asmj.journals.ekb.eg/article_106413_f005f7b31847ce173a846ce7eb37fa08.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301THE ROLE OF DIFFUSION TENSOR IMAGING (DTI) IN SPINAL CORD PATHOLOGY19720510641410.21608/asmj.2020.106414ENHend Galal Eldeen Mohamed AliHassanDepartment of Radiodiagnosis,
Faculty of medicine, Ain Shams
University, Cairo , Egypt.Rania AliMaaroufDepartment of Radiodiagnosis,
Faculty of medicine, Ain Shams
University, Cairo , Egypt.Mohamed Amr FaroukAbo-ElelaDepartment of Radiodiagnosis,
Air force hospital, Egypt.Norhan RamzyMohamadyDepartment of Radio
diagnosis, Elsheikh Zayed Al-
Nahian hospital.
Cairo , Egypt.Journal Article20200806Background: Many patients complain from sensory deficient secondary to different causes, although the magnetic resonance (MR) shows the mass effect or changes of spinal cord yet it is still limited in predicting symptoms everity as patients may have a varying tolerance of spinal cord compression. Diffusion tensor imaging (DTI) shows could predict degree of spinal cord affection even with mild lesions. Aim of the work: is to show the role of Diffusion tensor imaging(DTI) in proved different cervical or dorsal spinal lesions by conventional MRI. Patients and Method: The study included 16 patients divided into 6 patients complaining from compressive disc lesions with sensory deficient,2 patients with neoplasm complain from newly developed sensory deficient patients with and 8 patients complaining from<br />internal spinal cord lesions in the form of single spinal multiple sclerosis (MS) plaque. All cases are considered as self control by measuring two controls above and below lesion. Results: High statistically significant difference of fractional<br />anisotropy (FA) between lesion and control with statistically significant difference of apparent diffusion coefficient (ADC) between lesion and control (Mann-Whiteny Test p value < 0.05), resultant cut off value is 0.333 which gives higher specificity and sensitivity with efficacy 87.5%. Conclusion: the resulted values of newly designed protocol give<br />functional and numerical marker by which the diagnosis and prognosis will be more suitable.https://asmj.journals.ekb.eg/article_106414_b749f66fafe13039243571e348e525d6.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301COMPARATIVE STUDY BETWEEN CONSERVATIVE BREAST SURGERY AND SKIN SPARING MASTECTOMY IN PATIENTS WITH MULTIFOCAL BREAST CANCER20721910641510.21608/asmj.2020.106415ENOsama AliEl AtrashDepartment General Surgery,
Faculty of Medicine, Ain Shams
University , Cairo , Egypt.Rania El AhmadyElshekhDepartment General Surgery,
Faculty of Medicine, Ain Shams
University , Cairo , Egypt.Ahmed GamalOsmanDepartment General Surgery,
Faculty of Medicine, Ain Shams
University , Cairo , Egypt.Amr AhmedHassanDepartment General Surgery,
Faculty of Medicine, Ain Shams
University , Cairo , Egypt.Journal Article20200806Background: Breast cancer is by far the most common cancer among women of both developed and developing countries and the leading cause of cancer death in females. The incidence of multifocal breast cancer has increased due to the improvement in imaging studies and the use of MRI. Multifocal breast cancer was previously considered a contraindication for breast conservative surgery. However, with the recent progress in the neoadjuvant systemic therapy Together with development of oncoplastic surgeries breast conservation is being increasingly performed for multifocal cases. Skin sparing mastectomy can also be used for multifocal cases with superior aesthetic results without compromising the oncological safety. Aim of the work: This study aims to compare conservative breast surgery and skin sparing mastectomy in multifocal breast cancer regarding local recurrence. Patients and methods: This is a prospective randomized clinical<br />trial study conducted in Ain-Shams University Hospitals Breast surgery unit over 30 patients with minimal follow-up of 18 months.2 groups of patients; Group A: composed of 15 patients that undergoing conservative breast surgery for multifocal breast cancer. Group B: composed of 15 patients that undergoing skin sparing mastectomy for multifocal breast cancer. An informed consent will be taken from all patients who will accept to participate. Results: The percentage of local recurrence were found to be comparable in both groups. Also the aesthetic results and patients’ satisfaction were similar in both groups. However, postoperative wound complications were higher in the skin sapring mastectomy group.<br />Conclusion: This study suggests that any of the two procedures can safely be done to cases with multifocal breast cancer however the cosmetic results in skin sparing mastectomy group was more superior than in the conservative breast surgery group.https://asmj.journals.ekb.eg/article_106415_6b87fc59d67dc29c671efaa9c26b78f4.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301LAPAROSCOPIC MINI GASTRIC BYPASS AS A REVISIONAL PROCEDURE AFTER FAILED PRIMARY RESTRICTIVE BARIATRIC SURGERY22123510641610.21608/asmj.2020.106416ENAlaa AbbasSabryDepartment General Surgery,
Faculty of Medicine, Ain Shams
University, Cairo, Egypt.Hytham MostafaMohamedDepartment General Surgery,
Faculty of Medicine, Ain Shams
University, Cairo, Egypt.Medhat MohamedHelmyDepartment General Surgery,
Faculty of Medicine, Ain Shams
University, Cairo, Egypt.Mohamed Ahmed FouadElshimyDepartment General Surgery,
Faculty of Medicine, Ain Shams
University, Cairo, Egypt.Journal Article20200806Background: Restrictive bariatric procedures are commonly performed to induce weight reduction, however, some patients may require a second surgery due to inadequate weight loss, weight regain or late complications. Laparoscopic mini gastric bypass (LMGB) is a promising bariatric procedure, which provides an effective long-term weight loss and resolution of primary procedure related complications. Aim of the Work: To assess laparoscopic Mini Gastric Bypass as a bariatric surgical technique for revision after failed primary restrictive bariatric procedure. Cause of revision, weight loss, resolution of primary procedure related co-morbidities and complication rates will be assessed. Patients and Methods: This study included 60 patients with failed primary restrictive bariatric procedures (20 patients with failed sleeve gastrectomy, 20 patients with failed vertical banded gastroplasty and 20 patients with failed adjustable gastric banding) that were converted to laparoscopic MGB with minimal follow-up of 1 year. Results: Among all patient samples (60 patients) , there was significant decrease in mean body mass index after conversion to MGB. The mean BMI before revision was 42.80 ± 3.43 kg/m2 (range, 36-48.9) that decreased to 32.51 ± 3.31 kg/m2 one year after revision. A significant improvement of obesity related co-morbidities was observed after one year, the incidence of remission of diabetes mellitus was 91.6%, while it was 64.7% for hypertension and it was 70.5% for dyslipidemia. Reflux symptoms improved in about 80% of<br />affected cases. Complications occurred only in 5% of cases and they were successfully managed. Conclusion: Mini gastric bypass is a safe and effective revisional procedure after failed primary restrictive bariatric surgery that adequate weight loss and satisfactory improvement of the primary procedure related complications.https://asmj.journals.ekb.eg/article_106416_79848bff08a316119e251bff0ab84cc1.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301BIPOLAR PLASMA VAPORIZATION VERSUS QUARTZ HEAD LASER ABLATION OF THE PROSTATE FOR THE TREATMENT OF BENIGN PROSTATEHYPERPLASIA: A COMPARATIVE STUDY OF OUTCOME AND COMPLICATIONS23724810641710.21608/asmj.2020.106417ENHassan S.ShakerDepartment of Urology, Faculty of
Medicine, Ain shams University, Cairo, Egypt.Hisham M.El ShawafDepartment of Urology, Faculty of
Medicine, Ain shams University, Cairo, Egypt.MohamedAbu El NagaDepartment of Urology, Faculty of
Medicine, Ain shams University, Cairo, Egypt.Mohamed A.Abd El HamidUrologist at Shoubra General
Hospital, Egypt.Journal Article20200806Background: Benign prostatic hyperplasia (BPH) is considered one of the most common causes of lower urinary tract symptoms (LUTS), urinary obstruction and urinary retention which usually occurs above age of 40 years. Aim of the Work: to compare the short term effectiveness and complications of bipolar plasma versus laser vaporization of prostate<br />over 6 months duration of follow up post-operative. Patients and Methods: This prospective comparative clinical study (double armed) included 128 patients with prostates less than 80 gm operated upon and followed up in the Urology Department of Ain shams University hospitals in the period from September 2015 to January 2018. The patients were divided into 2 groups: Group A 64 patients who underwent Plasma vaporization. Group B 64 Patients who underwent Quartz Laser Ablation of prostate (QLAP). Results: There were statistically significant differences between both groups as regards prostate volume reduction, PSA reduction and decrease in postvoiding residual urine more in the laser group. While IPSS and QOL reduction and uroflowmetry improvement showed higher improvement in the plasma group.<br />Conclusion: both techniques whether laser vaporization or plasma vaporization are considered safe, effective minimally invasive procedure in managing prostatic enlargement indicated for surgery. Both techniques are similar in the outcome and both lead to improvement of all parameters of prostatic symptoms. Laser vaporization looks to be faster, has stronger power to vaporize more tissues than plasma. No serious complications occurred in both groups. Nevertheless complications are more frequent in the plasma group.https://asmj.journals.ekb.eg/article_106417_5ee823cd14c72e34e15d95b62fbd1e80.pdfAin Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific SocietyAin Shams Medical Journal0002-214471120200301USE OF PCR-RFLP FOR GENETIC CHARACTERIZATION OF ECHINOCOCCUS GRANULOSUSISOLATES FROM EGYPT24925710641810.21608/asmj.2020.106418ENDoaa AshrafNassarParasitology Department, Faculty of
Medicine, Ain Shams University,
Abbassia, 115891, Cairo, Egypt.Hala SalahElwakilParasitology Department, Faculty of
Medicine, Ain Shams University,
Abbassia, 115891, Cairo, Egypt.Hayam MohammedEzz EldinParasitology Department, Faculty of
Medicine, Ain Shams University,
Abbassia, 115891, Cairo, Egypt.Hanan MahmoudAbou-SeriParasitology Department, Faculty of
Medicine, Ain Shams University,
Abbassia, 115891, Cairo, Egypt.Khalifa El SayedKhalifaParasitology Department, Faculty of
Medicine, Ain Shams University,
Abbassia, 115891, Cairo, Egypt.Journal Article20200806Background: Cystic Echinococcosis (CE) is a widespread neglected zoonotic disease caused by the larval stage of the dog<br />tapeworm Echinococcus granulosus sensu lato (E. granulosus s. l) that occurs in most parts of the world. Egypt is considered one of the countries where CE represents a public health concern and so far, few studies were done for molecular characterization of E. granulosus. Aim of the work: The aim of the present work was to use polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) targeting mitochondrial NADH dehydrogenase subunit 1<br />(nad1) for genetic characterization of Egyptian isolates of E. granulosus to infer the most probable transmission patterns.<br />Subjects and methods: Fifty Hydatid Cyst Fluid (HCF) and/or germinal layer samples (19 human, 23 camels, and 8 pigs) were collected from hydatid cysts. DNA was extracted from protoscolices and/or germinal layers from each individual cyst and used as template to amplify nad1 gene (1071-1078 bp). The amplification products were then digested with the restriction endonuclease Haemophilus influenza (HinfI) enzyme. Results: Two RFLP patterns were obtained, pattern I in 95.2 % of samples (12 human, 21 camel and 7 pig samples) with three fragments of 115, 218, and 738 bp and pattern II in 4.8 % (2 human samples) with two fragments of 1035 and 36 bp. In total, 85.7 % of human and 100 % of camel and pig samples shared the same digestion pattern I, while pattern II appeared exclusively in two human cases out of the 14 typed (14.3 %). Conclusion: These results indicate that camels and pigs are crucial in the life cycle of E. granulosus in Egypt, although other animals may play a role.https://asmj.journals.ekb.eg/article_106418_c8cba21c726f0ce2783f2585b509ff54.pdf