Alasmarya Medical Journal

The Surgical Treatment and Outcome of Blount Disease in a Tertiary Hospital: A 10-years Review

Mohamed Gwila, Abdul Halim Abd Rashid, Sharaf Ibrahim — Wed, 31 Oct 2018 00:00:00 +0000

Blount disease is an uncommon condition in Malaysia. The prevalence has not been documented and to the best of our knowledge, there are no local studies published on this condition. This is a retrospective study carried out in the Department of Orthopedics and Traumatology, Hospital University Kebangsaan Malaysia. Fifteen patients participated in this study, 12 of them had bilateral knee involvement. All patients had an oblique osteotomy of the proximal tibia without an elevating osteotomy of the medial tibial plateau. The objective of this study was to examine the clinical outcome for the surgical treatment of Blount disease in our institution from 1997 to 2008 by measurements of metaphyseal –diaphyseal angles (MDA) and tibio-femoral angles (TFA) preoperative, postoperative and during follow up. The study showed statistically significant reduction in the mean metaphyseal – diaphyseal angles (MDA) and mean tibio-femoral angle (TFA) angles respectively post operatively compared to pre-operatively (p < 0.001).Recurrence of the deformity was noted in 10 knees. All of them underwent further surgery .The mean postoperative follow up is 4.9 years. Half of the cases were Langenskiold stage III. One patient developed gas gangrene post operatively (3.8%) and another patient had wound dehiscence (3.8%). Conclusion: An oblique osteotomy of the proximal tibia without an elevating osteotomy for the improves the clinical and radiological outcome for our patients. However, one patient developed gas gangrene – an extremely rare complication following a clean surgical procedure.

RISK FACTORS AND TYPES OF NON FATAL ACUTE MYOCARDIAL INFARCTION IN ZLITEN TEACHING HOSPITAL

Ali M. Abdelaziz, Salem Kreba, FarajHajjaj, Mohammed F. Fayed — Wed, 31 Oct 2018 00:00:00 +0000

Acute MI is a very significant health problem leading to an important mortality and morbidity and because identification and modification of its risk factors can help to decrease its effects, we had conducted this prospective observational study in the CCU of Zliten Teaching Hospital aiming to determine the risk factors and anatomical distribution of acute non-fatal MI in Zliten area. Zliten area has a population of 481881 according to 2006 census. Cases died on arrival or within 24 hours from admission were excluded from our study. Results:- 30 cases were admitted to the department of medicine in ZlitenTeaching Hospital with acute MI ( 18 males and 12 female) in the period between 1/1/2009 to 31/12/2009. 8 cases were diagnosed as NSTEMI, 22 cases with STEMI, out of which 7cases with inferior MI and the others with anterior or anterolateral MI. The most important risk factor was smoking ,followed by DM and HTN. The striking observation is that the prevalence of hypertriglyceridemia is far more than hypercholesterolemia.

The acute toxicity of diazinonto the freshwater shrimp Gammaruspulex

Salem Elwahaishi, Wesam F A Mohamed, Alan Hargreaves, Chris Lloyd Mills — Wed, 31 Oct 2018 00:00:00 +0000

The wide use of the organothiophosphate insecticide, diazinon, to control insects has led to increased levels of this pesticide in aquatic environments. However, data regarding acute toxicity of diazinon on aquatic biota are limited. The current study aimed to investigate the mortality response of the freshwater amphipod Gammaruspulex to diazinon, its metabolite diazinonoxonanda commercial diazinon in formulation using the LC50 test. Exposure for 24 h to all tested concentrations of the different tested forms of diazinon did not caused significant mortality of G. pulex. The 48 h LC50 were values 923.1 and 87.5 nM for diazinon and diazinonoxon, respectively. The 48 h LC50 value of the commercial formulation of diazinon could not be calculated because mortality did not exceed 50 %. At longer period of exposure, the toxicity of three tested diazinon forms was in the following order: the commercial formulation >diazinonoxon>diazinon. After 72 h of exposure, LC50 values not clear of the tested diazinon forms were 222, 65.3 and 16.1 nM for diazinon, diazinonoxon and the commercial formulation of diazinon, respectively. The toxicity of the tested pesticide increased with increasing exposure time. At the end of the LC50 test (96 h), the LC50 concentrations of diazinon, diazinonoxon and the commercial formulation of diazinon were 140.1, 45.7 and 10.4 nM, respectively. In conclusion, the current study provides data that can be used to examine the sublethal responses of G. pulex to diazinon.

Serological evidence of infection with C. pneumonia and occurrence of abdominal aortic aneurysm and atherosclerosis.

Wojciech Zegarski, Ramadan Elamyal — Wed, 31 Oct 2018 00:00:00 +0000

Seroepidemiological and some experimental evidence relate Chlamydia pneumoniae with the pathogenesis of vascular diseases such atherosclerosis and Abdominal aortic aneurysm. Methods and Materials: Study group: sixty consecutive patients operated on in our department, thirty patients operated for Abdominal Aortic Aneurysm (AAA) and thirty patients for aortoiliac occlusive disease: Leriche's syndrome (LS). Each research group assessed separately, each with various manifestations of ischemic vascular diseases of lower limbs. Control group were 31 patients admitted to our surgery department for treatment of abdominal hernia and gallbladder stones diseases without evidence of atherosclerosis nor aortic aneurysm. The blood samples were sent for serological tests: ELISA to detect IgG and IgA anti- C.pneumonia. So our aim was to study the relationship between serological evidence of infection with C.pneumonia and occurance of AAA and LS. Result: Sixty patients; 30 with abdominal aortic aneurysm (mean age 67.4: 27male, 3female) and 30 with aortoiliac arteriosclerosis (mean age 58.5; 29 male, 1fe male) undergone surgery of the abdominal aorta for atherosclerotic obstructive lesions were the study group. In our study detectable IgG antibodies to C.pneumonia was more common among the study group patients than the control group (85% VS 61% , P<0.02). It was also noted that IgG anti C.pneumonia detected more in patients with AAA((96,6%) than patients with LS (73,3%); P<0.01. Study group patients were roughly have had the same level as the control group regarding IgA antibodies anti-C.pneumonia (58% VS 67%; P value is insignificant).So we conclude that these findings suggest that infection with C. pneumonia may play a role in the pathogenesis of AAA and LS and further studies in this area are needed.

Effects of iron deficiency anemia on the level of glycosylated hemoglobin (HbA1c) in non-diabetic patients

Manal Elhabbash, Zynab Elfurjani — Wed, 31 Oct 2018 00:00:00 +0000

The major form of glycohemoglobin is hemoglobin A1c (HbA1c). The Hb A1c fraction is elevated in chronic hyperglycemic diabetic patients and correlates positively with glycemic control. Previous studies suggest that iron deficiency anemia ( IDA) affects the level of HbA1c. Aim of study: To determine the effect of IDA on HbA1c level in non- diabetic patients before and after treatment with iron. Material and methods: The study included 100 females from Al jmail General Hospital at the west of Tripoli, 50 were with IDA and 50 were not anemic (control group). Age ranged from ( 20-40) years. Fasting blood glucose, HbA1c , complete blood count , serum iron, total iron binding capacity and serum Ferritin were measured in all females before treatment and after treatment. Patients who had glucose tolerance abnormality ( impaired glucose tolerance or diabetes mellitus), hemoglobinopathy ,hemolytic anemia , chronic alcohol ingestion , chronic renal disease , chronic liver disease and rheumatoid arthritis were excluded from study. All patients with IDA were treated with ferrous sulfate as 325mg orally three times a day for 3 months. Results: The mean percentage of the HbA1c in non anemic patients control group was 5.2% . The mean percentage of HbA1c in patients with mild anemia was (6%) , moderate anemia (5.9 %) . In patients with severe anemia HbA1c was (3.2%) which is significantly low in comparison to normal females. After treatment with iron , significant increase in HbA1c was observed in patients with severe anemia (5.2%) p < 0.001 and significant decrease in HbA1c in female with mild and moderate anemia 5.2%,5.3% respectively P<0.001 . Conclusion: In patient with iron deficiency anemia , hemoglobin A1c in not reliable parameter for follow up of patients with diabetes mellitus.