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   Table of Contents - Current issue
Coverpage
October-December 2016
Volume 44 | Issue 4
Page Nos. 135-175

Online since Wednesday, March 8, 2017

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ORIGINAL ARTICLES  

Receptor for advanced glycation endproducts in pediatric sepsis: A pilot study p. 135
Ahmed A Abo-Elezz, Samir M Hasan, Shimaa A Mashaly, Mohamed A Saad, Maaly M Mabrouk
DOI:10.4103/1110-1415.201722  
Background Sepsis in pediatric patients is still a leading cause of morbidity and mortality. Aim The aim of the study was to determine whether the serum level of receptor for advanced glycation endproducts (RAGEs) can be used as a potential diagnostic and prognostic marker in septic children. Patients and methods A pilot study was conducted on pediatric intensive care unit patients who had clinical evidence of sepsis over a 1-year period. Forty patients were enrolled in the study within the first 24 h after onset of sepsis; they were classified according to 28-day mortality into survivors and nonsurvivors. Complete blood count, erythrocyte sedimentation rate, C-reactive protein, and soluble form of RAGE (sRAGE) were measured. Bacterial cultures from suitable body fluids were prepared. Results There was a significantly higher mean serum sRAGE level among septic patients compared with controls (P=0.001); the level was higher in nonsurvivors compared with survivors (P=0.001). A cutoff value of 1325 pg/ml for serum sRAGE showed a sensitivity of 89.2% and a specificity of 78.3%. There were positive correlations with C-reactive protein and Pediatric Risk of Mortality III, and no correlation with bacterial culture. Multivariate logistic regression analysis showed that sRAGE level and leukocytic count were significant markers in the diagnosis of sepsis (P=0.047 and 0.001, respectively). sRAGE level and Pediatric Risk of Mortality III score were significant parameters in sepsis prognosis (P=0.019 and 0.043, respectively). Conclusion Serum sRAGE can be used as a diagnostic and prognostic marker in pediatric sepsis, especially in those with a negative blood culture.
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Current status of Schistosoma mansoni infection and its snail host in three rural areas in Gharbia governorate, Egypt p. 141
Basma M El Sharazly, Dina M Abou Rayia, Sanaa N Antonios, Samia Hanim H Eissa
DOI:10.4103/1110-1415.201724  
Background Human schistosomiasis is one of the most important neglected tropical diseases. Ongoing control measures have markedly decreased the incidence of the disease. There are currently no data on newly acquired infections. Aim The aim of the study was to determine the prevalence of Schistosoma mansoni infection among school children in Gharbia governorate and carry out a malacological survey on common snail hosts. Materials and methods A cross-sectional study was carried out in three rural areas of Gharbia governorate: Tanta, Kafr El-Zayat, and El-Mahala El-Kobra. Parasitological examination of 110 stool samples was performed using direct wet smear, formol–ether concentration technique, and the Kato–Katz method. An immunological test was also performed to detect S. mansoni antigen in urine. Snail vectors were collected from different water streams, identified morphologically, and examined for infection using shedding and crushing methods. Statistical analysis was conducted using SPSS, version 16. Results The prevalence of S. mansoni infection was found to be 1.8% among school children of the studied areas. Risk factors were age and previous exposure to canal water. In the malacological survey, six species of freshwater snails were found and morphologically identified. Biomphalaria alexandrina was widely distributed but did not show any cercarial shedding. Conclusion Although the rate of S. mansoni infection among school children is low, they can be a potential infective pool for the rest of the community.
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Study of musculoskeletal disorders in a cohort of Egyptian diabetic patients and its relation to glycemic control p. 151
Amir A Youssef, Adel A Shabana, Mohammed K Senna, Alaa M Wafa, Manar M Elshewehy
DOI:10.4103/tmj.tmj_36_16  
Background Diabetes mellitus (DM) affects the musculoskeletal (MSK) system, resulting in significant morbidity. These manifestations are unrecognized, though they are found in daily practice. Aim To study the effect of DM on the MSK system and the prevalence of these MSK disorders among Egyptians. Patients and methods In total, 100 patients with type 1 DM, 100 patients with type 2 DM, and 100 normal controls were examined for different types of MSK disorders. Fasting and postprandial blood glucose, glycosylated hemoglobin, and lipid profile testings were done for patients and controls. Plain radiography of the dorsolumbar region and ankle joint and nerve conduction study of the median nerve were done in some selected cases. Results These MSK manifestations were found in patients with types 1 and 2 DM, and their prevalence rates are as follows: carpal tunnel syndrome (14 and 5%, respectively), sclerodactyly (9 and 3%, respectively), Charcot joint (2 and 4%, respectively), limited joint mobility (2 and 6%, respectively), stenosing tenosynovitis (1 and 5%, respectively), shoulder capsulitis (1 and 10%, respectively), diffuse idiopathic skeletal hyperostosis (0 and 3%, respectively) and Dupuytren’s contracture (0 and 1%, respectively). MSK manifestations were more prevalent in patients with longer disease duration, poor glycemic control, and higher levels of lipid profile. Conclusion The result of this study emphasizes the importance of glycemic control and its relation to MSK manifestations, in addition to the new finding that elevated levels of low-density lipoprotein are significantly related to MSK manifestations.
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Locus of control among university students with urban and rural background Highly accessed article p. 157
Noha A Sabry, Mohamed L Salem, Eman M El-Baiomy, Azza El-Amir, Nehal El-Mashad
DOI:10.4103/1110-1415.201721  
Background Locus of control (LOC), a psychological theory developed by Julian Rotter (1966), refers to the extent to which an individual believes in controlling the events affecting them. The effect of environment and sex on LOC belief differs from country to country. Aim The aim of the present study was to evaluate LOC belief in a population of university students and the impact of urban versus rural background and sex. Participants and methods Data were collected from a cross-sectional study among university students in Egypt. Two scales were used to measure LOC belief. The first is the Rotter Internal–External Locus of Control (I–E LOC) to measure belief in LOC according to general life. The second is the Multidimensional Health Locus of Control scale with five dimensions: Internal Health Locus of Control, Doctor Health Locus of Control, Powerful Other Health Locus of Control, Chance Health Locus of Control, and God Health Locus of Control to measure belief in LOC according to health. Results Urban population had a significantly higher Doctor Health Locus of Control (mean±SD=15.61±1.91) compared with rural population (mean±SD=14.16±3.38). Rural population had a higher I–E LOC score (mean±SD=8.37±3.24) compared with urban population (mean±SD=6.75±4.14). Women had a significantly higher Powerful Other Health Locus of Control (mean±SD=12.8±3.55) compared with men (mean±SD=10.27±2.84). Women had a significantly higher I–E LOC (high external LOC) (mean±SD=9.6±3.09) compared with men (mean±SD=10.6.33±4.42). Conclusion The findings show that urban population has higher belief in doctor as a controller of health compared with the rural one. Rural population has more external LOC belief in general life compared with the urban population. Women have more external LOC in general life compared with men. Women have higher belief in powerful others as a controller of their life compared with men.
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The impact of ghrelin on oxidative stress and inflammatory markers on the liver of diabetic rats p. 163
Mahmoud Elsawy, Elsayed Emara
DOI:10.4103/1110-1415.201723  
Background On the basis of the antioxidant and anti-inflammatory effects of ghrelin on the liver of diabetic rats. Aim This research was designed to investigate its supposed improving role against histochemical alterations induced in the liver by diabetes. Materials and methods This study was carried out on 21 male albino rats that were divided into three equal groups. Group I included seven male rats and was used as a control group. In the remaining 14 rats, diabetes was induced through an intraperitoneal injection of streptozotocin. The diabetic rats were chosen and randomly divided into two groups. Group II included untreated diabetic rats, and group III included diabetic rats treated with subcutaneous administration of unacylated ghrelin (UAG). At the end of the experimental period, the blood samples were collected and liver tissues were excised for chemical and histopathological investigations. Results The results showed that the plasma level of glucose and inflammatory cytokines were increased and that of insulin and total ghrelin were significantly decreased in diabetic rats. Moreover, serum levels of aspartate aminotransferase and alanine aminotransferase were significantly elevated, whereas there was a significant decrease in lactate dehydrogenase. Furthermore, hepatic tissue malondialdehyde was significantly increased, and the levels of serum superoxide dismutase and glutathione peroxidase were significantly decreased in the diabetic group. However, their treatment with UAG significantly opposed the levels of the previously mentioned parameters toward the normal levels. Finally, liver histopathology of the diabetic animals showed several alterations, which were ameliorated through the administration of UAG. Conclusion It could be concluded that ghrelin administration has an improving effect against histochemical alterations induced in the diabetic liver.
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Relation between intact parathyroid hormone and hemoglobin level in chronic kidney disease patients on hemodialysis p. 170
Rabab A Keshk, Noha E Esheba, Wesam Salah, Nelly El shall
DOI:10.4103/tmj.tmj_37_16  
Background Chronic kidney disease (CKD) is associated with many kinds of metabolic changes caused by the kidney disease itself and by dialysis treatment. Secondary hyperparathyroidism is a major complication of CKD; it describes a complex alteration in bone and mineral metabolism that occurs as a direct result of CKD. In addition, anemia is a common complication of CKD. Aim The aim of this work was to assess the relation between level of intact parathyroid hormone (IPTH) and hemoglobin (Hb) level in CKD patients on hemodialysis with the difference between patients under erythropoietin (EPO) and without EPO. Patients and methods The present study was carried out on 40 patients and 10 healthy individuals as controls. Patients were classified into the following groups − group I included 30 patients with CKD on hemodialysis, which was further divided into the following: group Ia − 10 patients with anemia and under EPO hormone; group Ib − 10 patients with anemia and not receiving EPO hormone; and group Ic − 10 patients on hemodialysis without anemia. Group II included 10 patients with iorn deficiency anemia and without renal impairment. Group III included 10 healthy individuals as a control group matched for age and sex. Laboratory investigations such as IPTH, serum phosphorus, serum calcium, serum creatinine, blood urea, complete blood count, serum ferritin, and transferrin saturation were performed for all participants. Results There was a statistically significant negative correlation between IPTH and serum Hb in group I and the other two groups. Conclusion Increased level of IPTH level in chronic hemodialysis patients may cause resistant anemia to EPO therapy in spite of iron load in their blood.
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