Open Access Original Research Article

3D CT Volumetry of Varient Gastric Reservoir after Sleeve Gastrectomy and Its Relation to Clinical Outcome

Dina Mostafa Hammad, Rania Sobhy Abou Khadrah, Rasha Lotfy Younes, Mohamad Fouad Sherif

Journal of Advances in Medicine and Medical Research, Page 1-6
DOI: 10.9734/jammr/2022/v34i1231365

Background: The role of radiology in gastric bariatric surgery is no longer limited for detection of postoperative complications, but also it extends to evaluate the role of surgical reduction of gastric size in body weight changes after surgery. The aim of this work was to assess the ability of 3D CT volumetry of variant gastric reservoir after sleeve gastrectomy and its relation to clinical outcome.

Methods: This prospective study that was carried out on 30 obese patients who was candidates for gastric sleeve surgery for the first time. All patients were subjected to clinical examinations [blood pressure, pulse rate and respiratory rate], pre-operative preparation: Blood testing, liver function, electrolytes and hormonal tests, an upper gastrointestinal (GI) endoscopy, abdominal ultrasound (US), echocardiography and CT volumetry

Results: There was no statistically significant correlation between body weight and gastric volume preoperative but a significant relation postoperative. Body weight, Body mass index (BMI) and gastric volume were significantly lower post-operative compared to pre-operative (P<0.001).

Conclusions: Computed tomography scan plays a significant role being a comprehensive imaging tool sensitive for accurate diagnosis of any suspected complication. Also, 3D CT volumetry adds more value in the evaluation of the new gastric pouch volume. In the setting of bariatric sleeve gastric surgery, MSCT volumetric assessment of the stomach is the gold standard imaging tool for evaluating gastric size in the postoperative phases.

Open Access Original Research Article

Cerebroplacental Doppler Ratio and Cerebrouterine Doppler Ratio in Predicting Neonatal Outcome in Preeclamptic Pregnant Women

Reem Taha Elsharkawy, Ahmed Mahmoud El Khyat, Raghda Ahmed El Dakhakhni, Mona Khaled Omar, Mahmoud Salah El Deen Hamoda

Journal of Advances in Medicine and Medical Research, Page 7-15
DOI: 10.9734/jammr/2022/v34i1231366

Background: Umbilical artery and middle cerebral artery Doppler ultrasound clearly depict the information about placental resistance and the changes in the fetal hemodynamics in response to it. The aim of this work was to assess the role of cerebroplacental ratio and cerebrouterine ratio in prediction of neonatal outcome in preeclamptic women.

Methods: This prospective observational study was carried out on 110 pre eclamptic women. Patients were divided into two groups: Preeclampsia with severe features (n=58) and preeclampsia (n=52). All patients were subjected to laboratory testing (complete blood count (CBC), coagulation profile, liver and kidney function tests, 24 hours urine sample collection) and ultrasonographic scanning trans - abdominal sonographic examinations.

Results: The cut off value of CP ratio was 1.09 with sensitivity 84%, specificity 89%, PPV (positive predictive value) 94%, NPV (negative predictive value) 73% and accuracy 85% while the study cut off value of CU ratio was 1.3 with sensitivity 97%, specificity 93%, PPV 95%, NPV 95% and accuracy 95%. UTA, UMBA, MCA, CP and CU were significantly higher in Preeclampsia with severe features than Preeclampsia (P value <0.05).

Conclusions: Most of unfavourable neonatal outcome associated with abnormal cerebroplacental and cerebrouterine ratio so cerebroplacental and cerebrouterine ratio were complementary to each other in predicting the adverse neonatal outcomes.

Open Access Original Research Article

Correlation of CT Severity Index with Clinical Severity of COVID-19 Pneumonia and it’s Relation to Disease Outcome

K. Sandhya Hemraj, M. J. Jacob, Vidyashree Kotian, D. K. Sachin, R. G. Geetha, Lilly Boney Veliath

Journal of Advances in Medicine and Medical Research, Page 16-26
DOI: 10.9734/jammr/2022/v34i1231369

Background and Objectives: Since the first case of Covid – 19 infection in Kerala, it has spread rapidly throughout the country. The COVID-19 infection is caused by SARS-CoV-2 virus. Fever, cough and breathlessness are the most common symptoms of infected individuals. An in-depth understanding of the modes of spread, clinical features, triage of infected patients at presentation, immediate appropriate treatment and containment measures to minimize transmission of infection are cornerstones of pandemic control. The present study attempts to correlate chest CT Severity Index with clinical severity of Covid-19 infection and its outcome in infected individuals. 

Materials and Methods: This was a retrospective, cross – sectional, descriptive study. Study group consisted of 97 adults who tested Covid positive with RT-PCR and had positive findings on chest CT scan at our Hospital.

Results: There was a statistically significant association between CT Severity Index and clinical severity of Covid – 19 Pneumonia in the study patients; as well as between CTSI and outcome of Covid – 19 Pneumonia in terms of favourable and adverse outcomes.

Interpretation and Conclusion: Since the CTSI correlates significantly with clinical severity of Covid - 19 infection and it’s outcome, its inclusion in the CT report is invaluable in rapidly triaging the patient, initiating early appropriate treatment and providing a reasonably accurate prediction of future course and outcome of the infection. By significantly cutting down time spent in triaging a patient in the ER, it saves time and minimizes need for large skilled workforce of medical personnel in limited resource settings.

Open Access Original Research Article

The Effect of Endometrial Scratching before Embryo Transfer in Woman with History of Implantation Failure in Previous Intracytoplasmic Sperm Injection Cycle, Clinical and Biological Study

Fatma Ali Mohamed Ebied, Aml Abd El-Sameia El-Sokary, Ahmed El-Sayed El-Halwagy, Mahmoud Salah El-Din Hamouda

Journal of Advances in Medicine and Medical Research, Page 27-32
DOI: 10.9734/jammr/2022/v34i1231370

Background: The gain of endometrial scratching in people has been offered with the aid of clinicians as a potential of growing endometrial receptivity was once at the beginning stated as a serendipitous discovering because a high pregnancy price was once located in IVF female who had undergone repeated endometrial biopsies at some stage in their preceding herbal menstrual cycle. The goal of this work used to be to consider the impact of endometrial scratching earlier than fresh or frozen embryo switch on clinical pregnancy fee in girls with records of implantation failure after one or more Intracytoplasmic sperm injection cycle(s) and to predict its cost based on measuring the level of peripheral Natural Killer Cells (cd56).

Methods: This potential randomized learn about was carried out on 60 ladies with records of one or more implantation failure of ICSI cycle, and regular uterine cavity. Patients were divided into two equal groups: an experimental group A and a manage group B. All sufferers were subjected to history taking, clinical examination, investigations for infertility, serum Natural killer cells CD56 measure and hormonal profile.

Results: There was once giant difference in CD56 size between girls who obtained pregnant (decreased CD56) and those who now not got pregnant (increased CD56) in team A .Clinical Pregnancy rate was higher in group A after endometrial scratching was done.

Conclusions: Performing harm profiling at the time of implantation window (CD56 measurement) ought to assist in deciding on sub-groups of infertile patients who would gain from a targeted intervention.

Open Access Original Research Article

Impact of using Low Dose versus High Dose Antithymocyte Globulin Based Conditioning Regimen on the Outcome of Peripheral Blood Stem Cell Transplantation in Children with βeta-thalassemia Major

Hend M. Shamhout, Amira Y. Ahmed, Gamal A. Fathy, Ibrahim M. Badraia, Shebl Saeed Shebl

Journal of Advances in Medicine and Medical Research, Page 33-41
DOI: 10.9734/jammr/2022/v34i1231371

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only commonly available curative treatment for people with thalassemia major (TM).This work aimed to study the impact of using low dose versus high dose anti thymocyte globulin (ATG (based conditioning regimen on the results of peripheral blood stem cell transplantation in children with βeta- TM.

Methods: This comparative study was established on 40 patients with βeta-thalassemia major (Pesaro class II and/or III) who subjected to (HSCT)   from donor who is related. Our patients received the same myeloablative regimen. They were then categorized according to dose of ATG into two groups: group I (Busulfan/Cyclophosphamide/Low dose ATG-30 mg) and group II (Busulfan/Cyclophosphamide/High dose ATG-110 mg).

Results: There was no association between both groups according to the clinical features, transplant related complications in both groups. There was a higher risk of mucositis and infections in high dose group. (P = 0.024 & P = 0.046; respectively). Patients in low dose group achieved faster neutrophil engraftment with median value of (14 days). No difference was found in the incidence of post-transplant viral reactivation, graft versus host disease in both groups.

Conclusions: Pesaro II, III thalassemia patients can safely receive hematopoietic stem cell transplantation (HSCT) with low dose ATG-30 mg regimen and attain the same result.

Open Access Original Research Article

Evaluation of the Efficacy of Topical Minoxidil in Treatment of Male Androgenetic Alopecia

Nehal Mohamed Elshebiny, Ghada Fawzy Rezk Hassan, Eiman Adel Hasby, Abeer Abd El-hakam Hodeib

Journal of Advances in Medicine and Medical Research, Page 42-51
DOI: 10.9734/jammr/2022/v34i1231372

Aims: This study was conducted to evaluate the efficacy of topical minoxidil 5% in treating male androgenetic alopecia.

Study Design: A prospective, randomized study

Place and Duration of study: Outpatient clinic of Dermatology and Venereology Department, Tanta University Hospitals between January 2020 and March 2021.

Methodology: 15 male patients with androgenetic alopecia (age range 23 – 31 years) were included and received topical minoxidil 5% (twice daily) for 24 weeks. Efficacy of treatment was assessed clinically, trichoscopically, and by histopathology (H&E stain).

Results: Patients were classified between grades Ⅲ- Ⅵ at baseline, after 24 weeks of treatment: patients were classified between grades Ⅱ- Ⅴ A. There was an improvement in 60% of patients with no statistically significant difference in the clinical grading before and after treatment. The statistical significance was apparent in the percentage of the terminal and vellus hair and hair density and width after treatment. There were 31.7% and 42.56% increases in hair density and width, respectively. There was a decrease in the miniaturized hair follicles and perifollicular inflammatory infiltrate by H&E stain.

Conclusions: Topical minoxidil 5% was found to be an effective method of treatment of male androgenetic alopecia, which affects both hair density and width.

Open Access Original Research Article

Revisiting Male Sterilization for Contraception in Port Harcourt, Nigeria: Where do the Women Stand

Emmanuel Okwudili Oranu, Esther Nonye-Enyindah

Journal of Advances in Medicine and Medical Research, Page 52-58
DOI: 10.9734/jammr/2022/v34i1231375

Background: The various advancements in the armamentarium of modern contraceptive service are many, yet the methods available for men are few; worse still, their effective participation is embarrassingly low. Considering the high failure rate of the male condom as a contraceptive method and the numerous unwanted effects of the varied female methods, vasectomy remains a promising way to go in contraception; hence the periodic monitoring of its acceptance/practice trend, especially by women, in this part of the globe. 

Objective: To assess the knowledge and willingness to support the practice of vasectomy by women in Port Harcourt, Nigeria.

Method: It was a cross-sectional descriptive questionnaire based prospective study of consenting 249 parous women attending the family planning clinic in the 2 University Teaching Hospitals in Port Harcourt. The pre-tested validated questionnaire was administered on the participants by two trained assistants. Data on their socio-demographic characteristics, awareness and willingness to support the practice of vasectomy were obtained and entered into excel sheet and analyzed using SPSS version 20, taking p value of 0.05 at 95 percent confidence interval as significant. The result was expressed in tables of percentages and frequencies.

Results: Of the two hundred and forty nine women who were involved in the study, 224(89.96%) were within the reproductive age grouping 15 – 45 and 25(10.04%) were above 45 years. Most of them, 234 (93.98%) had at least a secondary education. A high percentage of the respondents, 212(83.14%) knows vasectomy does not reduce potency, they could not say for sure if it affects male fertility (51.81%); but 164(65.86%) knows it mechanism of action, 191(76.71%) said it is very effective means of contraception while 184(73.90%) knows it is safe. One hundred and forty one (56.63%) of the women will not give consent for their spouse to have vasectomy done. However, if they are reassured on their worries on vasectomy, 135 (54. 22%) will give their support for the procedure. Reasons for not wanting vasectomy include being a permanent method (30.53%), it surgical method (20.60%) and against their faith (20.22%).

Conclusion: The knowledge of vasectomy of women in Port Harcourt is high but their willingness to support this practice is low. Reassurance on their concerns improved their support for the procedure. Sustained adequate counseling is needed to surmount this obstacle to the much desired practice of vasectomy in this part of the world.

Open Access Original Research Article

Evaluation of Unilateral Sinonasal Lesions

Manar Emad Marzouk, Kamal Abd Elmonem Ebeid, Mohamed Nasser El-Sheikh, Hasan Mustafa Hegazy

Journal of Advances in Medicine and Medical Research, Page 59-69
DOI: 10.9734/jammr/2022/v34i1231376

Background: Sinonasal lesions are a common occurrence in people of all ages. Nasal and paranasal sinus lesions are quite deceiving; Thus, the presenting characteristics, nasal endoscopy, clinical examination, histopathology, and radiographic findings are all used in conjunction to provide a diagnosis. The aim of this research was to observe a much of higher percentage of unilateral sinus pathology. Comprehensive evaluation of patient age, presenting symptoms, sex, nasoendoscopic examination and computed tomography (CT) or magnetic resonance imaging (MRI) results help in the diagnosis of unilateral sinus disease with finding the same result in patient who had endoscopic sinus surgery performed in ear, nose, and throat (ENT) department of Tanta University Hospital.

Methods: This prospective randomized controlled study was conducted on 100 adult and pediatric patients who were suffering from nasal obstruction, epistaxis, proptosis, headache, and space occupying lesions in one side of nose including inflammatory, benign and malignant lesions. All cases underwent complete taking of history, endoscopic assessment, otorhinogological examination, CT, MRI for evaluation of unilateral opacification of paranasal sinuses and other routine preoperative laboratory investigation.

Results: Of all affected sinuses, right maxillary sinus and nasal cavity were the most significantly affected sinuses in malignant tumor group than both inflammatory disease group and benign tumor group (P = 0.002, 0.001 respectively) while left maxillary, right ethmoid, left ethmoid, right sphenoid, left sphenoid, right frontal and left frontal showed insignificant differences in affection among the three groups. All performed radiology to the patients was insignificantly different among the three groups (P = 0.211). The main symptoms were significantly different among the three groups (P <0.001). Preoperative biopsy taking was significantly increased in malignant tumor group than both inflammatory disease and benign tumor group (P = 0.001). Diseases in the patients were significantly different among the three groups (P <0.001). Patients with excellent results of the operation was significantly decreased in malignant tumor group than benign tumor group (P = 0.001). The type of surgery was significantly different among the three groups (P <0.001).

Conclusions: Unilateral nasal polyps are associated with a high rate of malignancy and should be carefully examined using endoscopy and histology.