c:\work\Jor\vol63_1The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 127 - 132
Is Suturless and GluelessLimbal Conjunctival Autograft for Primary Pterygium Surgery Efficient and Safe? Hoda Saeed Mohamed Hassan Arab
Ophthalmology Department, Faculty of Medicine for Girls, Al-Azhar University ABSTRACT Aim of the study:evaluate the safety and efficacy of sutureless glue free limbal conjunctival autograft for the management of primary pterygium surgery. Material and method:This prospective,interventional randomized,non comparative study was held at AlZahraaUniversity Hospital between May, 2013 and June, 2015. It included 20 eyes of 17 patients, 12 males(70.6%), and 5 females(29.4%). Their mean age±SD was 52.50±18.31 years (Range:30-75 years). They were presented to the outpatient clinic of Al Zahraa University Hospital with primary pterygium. Inclusion criteria included primary pterygium,non atrophic, with healthy conjunctiva. Exclusion criteria included atrophic pterygium, pseudopterygium, ocular surface pathology, infection, previous limbal surgery or double head pterygium. Surgeries were done under local anesthesia. Simple pterygium excision was done leaving a bare sclera. The size of bare sclera was measured. A conjunctival graft 2 mm larger in width and length than the recipient bed was created from the superior temporal quadrantand was extended to the limbus to include limbal stem cells. The graft was gently moved to the recipient bed with the epithelial side up and keeping the limbal edge toward the limbus.Hemostasis was allowed to occur spontaneously without use of cautery to provide autologous fibrin to glue the conjunctival autograft naturally in position without tension.All patients were followed up after 48 hours, weekly for one month then monthly for 12 months. Results:Pterygia were located nasally in all cases. Pterygia were presented right eye in10(50%) and left eye 10(50%). Mean graft size±SD was 5.5±1.5 millimeter (Range: 5-7 mm). Mean duration of graft fixation ±SD was 10±2.82 minutes (Range:1012minutes).Mean operative time±SD was 25±1.41 minutes(Range: 24-26 minutes) with good cosmetic outcome in all cases. There was minimal postoperative pain and discomfort, without graft dislocation or dehiscence and without recurrence of pterygia during the follow up period. Conclusion:Sutureless and gluelessconjunctivallimbalautograft following primary pterygium excision is safe,easy,effective and economic technique in primary pterygium surgery. Keywords:Pterygium,Fibringlue,Limbalautograft,graft retraction, conjunctival edema.
INTRODUCTION
Pterygium (derived from pterygion, ancient
reduce the recurrence rate to an acceptable level
Greek for wing) is a common ocular disease seen
with minimal complications and without the use
mostly in tropical and subtropical areas. It is an
of potentially toxic drugs or radiotherapy would
abnormal overgrowth of fibrovascular tissue
be ideal for the management of pterygium. Some
arising from the subconjunctiva toward the
reports favor the use of fibrin glue above
cornea, almostalways in the palpebral fissure and
sutures.[7-8]The use of fibrin gluehas been
thought to be caused by increased light exposure,
reported to improve comfort, decrease surgical
dust, dryness, heat and wind.[1] Although it can be
time, reduce complications and recurrence
easily excised, it has a high rate of recurrence
rates.[9-10] Suture-related complications include
ranging between 24% and 89%.[2]With the
infection, prolonged operating time, postoperative
popularity of conjunctivalautograft and use of
discomfort, suture abscesses, buttonholes, and
antimetabolites such as mitomycin C and 5-
pyogenic granuloma which usually require a
Fluorouracil the incidence of recurrence has been
second surgery for removal[11]. Plasma-derived
greatly reduced up to 12%.[35] The role of carbon
fibrin glue has the potential risk ofdisease
dioxide and excimer lasers in pterygium surgery
transmission and anaphylaxis in susceptible
remains uncertain. Additionally, the relative
individuals.[12,13]
benefits
and
risks
are
debatable
of
Sutureless grafting has been used successfully in
physiochemical methods to prevent recurrence.
gingival graftsand represents a similar mucosal
For
example
possible
complications
of
membrane tissue environment to the conjunctiva
mitomycin C and beta-irradiation include aseptic
of the eye.[14]
necrosis of the sclera and cornea, cataract,
In this study, weevaluate the safety and efficacy
persistent epithelial defects and visual loss.[6]
of
sutureless
glue
free
Therefore, a simple surgical procedure that can
721
Received: 1/1/2016
Accepted: 25/1/2016 DOI: 10.128
c:\work\Jor\vol63_2The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 133- 137 Incremental Value of 2-Dimensional Longitudinal Radial and Circumferential Speckle Tracking Strain Imaging to Wall Motion Analysis for Detection of Coronary Artery Disease in Patients Undergoing Dobutamine Stress Echocardiography Adel Etriby, Alaa Roshdy, Bassem Wadeaa, Mohamed Abdel Rahman, Zeinab Abdel Salam, Yomna Omar.
Ain Shams University, Cardiology department Cairo, Egypt
ABSTRACT Background: DSE is considered one of the good options in clinical practice but due to some limitations new promising modalities like speckle tracking echocardiography (STE) was introduced. STE is a new imaging technique that allows evaluation of global and regional myocardial function independently from the angle of acquisition and from cardiac translational movements. Objectives: Determine optimal cutoff values for longitudinal, radial and circumferential strains at peak DSE for detection of significant stenosis on CA. Also investigate incremental value of combining strain measurements to wall motion analysis. Methods: The study population comprised 100 patients (age 50 ±9 years) underwent high dose DSE, STE followed by CA. DSE and STE results were compared and added to each other and finally compared to CA result. Results: GLS cutoff points (-16.75%) showed significantly higher accuracy when compared to GCS and GRS, with highest balanced sensitivity and specificity to predict CAD. GLS, GRS and GCS reduced the DSE false positivity by 83%, 72.2% and 66.6% respectively. STE also showed better Agreement with CA than DSE in detecting coronary territorial affection especially LAD (Kappa= 0.775). Conclusions: STE is feasible during DSE, it helps increasing the diagnostic accuracy of DSE and decreasing its false positivity. Both global and segmental longitudinal strain can offer accurate, feasible and non invasive assessment of CAD. Keywords: Coronary angiography (CA), Coronary artery disease (CAD), Dobutamine stress echocardiography (DSE), Global circumferential strain (GCS), Global longitudinal strain (GLS), Global radial strain (GRS), Left anterior descending (LAD), Left circumflex artery (LCX), Left ventricle (LV), Speckle tracking echocardiography (STE), Right coronary artery (RCA), Wall motion score index (WMSI)
INTRODUCTION
STE is considered one of the good
independent.4 Although the use of WMSI during
options assessing the presence, localization and
DSE relies on visual assessment of myocardial
extent of CAD.1 But wall motion analysis during
radial thickening, 2D speckle tracking not only
DSE is subjective, and an expert observer is
allows quantification of LV radial strain but also
required to achieve the published levels of
LV circumferential and longitudinal strains that
accuracy.2 STE is a new technique based on pure
are not visually apparent. However, the
2D grayscale ultrasound acquisition allowing
comparative diagnostic accuracies of these 3
calculation of segmental strains markers that can
orthogonal myocardial strains during DSE for
be tracked from frame to frame throughout the
the detection of CAD have not been previously
cardiac cycle.3 It has been integrated into the
reported.5
most recent echocardiographic systems for OBJECTIVES
quick, automated or manual evaluation of LV
Determine
optimal
cutoff
values
for
function. It is commercially available software
longitudinal, radial and circumferential strains at
that automatically or manually tracks myocardial
peak DSE for detection of significant stenosis on
motion throughout the cardiac cycle and allows
CA. Also investigate incremental value of
rapid generation of regional myocardial strain
combining strain measurements to wall motion
curves that are site specific and angle
analysis.
133
received:15/12/2015 accepted:30/12/2015
DOI: 10.12816/0023839
c:\work\Jor\vol63_3The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 138- 142
Electronic Prescribing with a Quick Look for Its Application in Al-Husein Hospital/ Jordanian Royal Medical Services (Jrms) Rehab.K Salah 1, Jelnar .Z Alkalaldeh 2, Nadia Ahmad AL-Omari 3 Sahar AL-Niemat 4, Rasha Baninasur 5,Toleen.I Bisharat 3 Supply Pharmacy, Queen Alia Heart Institute1, Supply Pharmacy, King Hussein Medical Center2
Clinical Pharmacy, Queen Alia Heart Institute3, Supply Pharmacy, Dirocterate of Royal Medical
Services4, Clinical Pharmacy, King Hussein Medical Center5
Correspondaning author: Rehab.K Salah .E-mail:[email protected] Number: 00962795178447.
ABSTRACT Aim of the study : electronic prescribing is the computerbased electronic generation; it allows a physician to electronically transmit a new prescription to the community or health facility pharmacy. The aim of this study was to evaluate an electronic prescribing patient and physician satisfaction at AL- Hussein Hospital/(JRMS). Patients and Methods:An electronic prescribing patient satisfaction survey was conducted a sample of 100 patient were randomly chosen.An electronic prescribing physician satisfaction survey was conducted a sample of 50 physician in the specialty clinics of AL- Hussein Hospital were randomly chosen . Results:Around 77% of patient was satisfied that the clinic had adopted electronic prescribing, and around 80% of physician were satisfied that the clinic had adopted electronic prescribing. The feedbacks of patients and physicians were great. Conclusion:This study approved that electronic medical record system improve the quality of patient care and decrease medical errors. Periodic assessment is needed to evaluate many aspect and consequences of e-prescribing and to measure the enhancement in patients and community in addition to achieve a good resource management . Keywords: Electronic prescribing, patient, physician, pharmacist, satisfaction, computer, medication. INTRODUCTION
Hippocrates, the father of medicine, already
drug therapy. However, there is quite little co-
realized that "the physician must not only be
operation between the partners. The physician
prepared to do what is right himself, but also
prescribes the drug, the pharmacist delivers the
make the patient cooperate".(1) On a worldwide
drug, and medication compliance depends on
basis, the World Health Organization (WHO)
quite many things, e.g. the drug information the
projects that only about 50 percent of patients
patient has received.
typically take their medicines as prescribed.(2)
The implementation of a well-designed
Inadequate
medication
compliance
and
computerized prescription system is a viable
persistence are old age problems.(3)
policy option that can be done at a relatively
Medical compliance is commonly defined as
small cost, and can bring substantial long-range
the extent to which a patient conforms to
benefits for monitoring and improving quality
medical advice about lifestyle and dietary
of care for public-sector clients.
changes as well as taking medication as
For the hospital budget, the quality
prescribed.(1,4) It remains a challenge more than
management of drugs, in terms of checking
twenty
centuries
after
Hippocrates.(1)
expirations of drugs in stock, is essential. The
Furthermore, lack of medication adherence
presence of professional and technological
leads to unnecessary disease progression,
resources means that pharmacists are expected
disease complications, reduced functional
to do things ``better, faster and cheaper' , as
abilities, a lower quality of life, and even
well as ``smarter.'' Technology would help and
premature death. (2,3)
enable a pharmacist to be a healthy care
Three partners, the patient, the physician
provider under limited professional personnel
and the pharmacist are needed for carrying out
size.(8)
138
Received:25/2/2016 Accepted:8/3/2016 DOI: 10.12816/0023841
c:\work\Jor\vol63_4The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 143- 156
Early Detection of Left Atrial Dysfunction by Speckle Tracking Echocardiography in Hypertensive Patients with Normal Left Atrial Size Bassam Sobhy Kamal ,Osama Mohamed Hassan, Wael Mahmoud El Kilany, Haitham Galal Mohamed, Ahmed Mohamed Mamdouh
Department of Cardiology, Faculty of Medicine, Ain shams University
Corresponding author: Bassam Sobhy Kamal e-mail: [email protected], Phone: 01227141744 ABSTRACT Background: Arterial hypertension adversely affects LA size and function, effect on function may precede effect on size. This effect is reflected on patient's morbidity and mortality risks. Many techniques were used to assess LA function but with many pitfalls. The objectives: early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size. Patients And Methods: The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls , all with normal LA size and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study, both the conventional measures and speckle tracking then both groups were compared regarding LA strain representing LA function. Results: Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value < 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP. Conclusion: Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs. Keywords: hypertension, left atrium, speckle tracking. INTRODUCTION
Arterial hypertension is associated with
limitations of Doppler-derived strain measures. (4)
morphologic and functional left atrial (LA)
The assessment of LA strain dynamics by STE in
abnormalities. An increase in LA size in patients
hypertensive patients may be of particular interest
with hypertension is a common finding in clinical
in those with no evidence of LA enlargement,
practice, and the mechanisms underlying this
because it may provide additional information for
enlargement have been extensively analyzed. (1)
the early detection of LA abnormalities. (5)
Most of studies included patients regardless of
LA size. This raises the question of whether LA PATIENTS AND METHODS
dysfunction in patients with hypertension may be Study subjects: This study included 50 patients
detected in the absence of LA enlargement. This
with arterial hypertension and 50 age matched
question may be of clinical interest, because LA
non hypertensive control subjects.
size is often used as a surrogate marker of LA
function in clinical practice. (2) Inclusion criteria for patients group:
Also, LA enlargement and dysfunction are 1- Patients with systemic arterial hypertension
considered risk factors for development of atrial
;defined
as
:
fibrillation and cerebrovascular strokes in
Systolic BP 140 mmHg and/or diastolic BP
hypertensive patients. (3)
90 mmHg or Antihypertensive treatment with a
Speckle-tracking echocardiography (STE) allows
documented history of hypertension.
direct and angle-independent analysis of 2- All patients should have an echocardiographic
myocardial deformation, thus providing sensitive
evidence of normal LA size; defined as: LA
and reproducible indices of myocardial fiber
volume index < 28 ml / m2.
dysfunction that overcome most of the
143
Received:15/12/2015 Accepted:30/12/2015 DOI: 10.12816/0023841
c:\work\Jor\vol63_5The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 157- 171 Assessment of the Role of Speckle Tracking Echocardiography in Targeting the Left Ventricular Lead Position in Patients Undergoing Cardiac Resynchronization Therapy Azza Abdallah El Fiky, Hayam El Damanhoury, Walaa Adel Abdel Halim, Sameh Samir Raafat Naguib, Ahmed Mohamed Abou Bakr El Missiri, *Ahmed Yehia Ramadan Salama
Department of Cardiology, Faculty of Medicine, Ain shams University
*Corresponding author: Ahmed Yehia Ramadan Salama;
e-mail:[email protected] Phone: 01005643801 ABSTRACT Background: Cardiac Resynchronization Therapy (CRT) is now a well-established treatment for patients with advanced heart failure through biventricular pacing. Optimizing the left ventricular (LV) lead position via echocardiographic speckle tracking guidance could reduce the rate of non-responders to CRT. Objectives: to assess the role of speckle tracking echocardiography in determining the proper position of the left ventricular lead in patients undergoing CRT. Methods: the study population comprised 50 patients who were indicated for CRT according to the ESC 2012 guidelines. Speckle tracking echocardiography was done to all patients before CRT implantation or shortly after implantation while switching off pacing to determine the latest activated myocardial wall of the LV. The patients were classified after CRT implantation into two groups; the first group (group A) included 20 patients and represented those with concordance between the most mechanically delayed myocardial wall derived from speckle tracking echocardiography and the coronary sinus lead position, and the second group (group B) included 30 patients that showed discordance between them. Both groups were recruited for follow-up after a period of 6 months to assess clinical response, echocardiographic response and mortality Results: Significant correlation was observed between echocardiographic response and the LV lead concordance (p value=0.041), and between combined clinical and echocardiographic response and LV lead concordance. There was a nearly significant difference between clinical response and the LV lead concordance (p value=0.057), and there was a trend towards less mortality in the group with concordant LV lead (10.5% in the concordant group versus 24.1% in the discordant group) with no statistical significance (p value=0.286). Conclusions: we demonstrated an increased benefit with an echocardiographically optimized LV lead position targeting the most delayed myocardial wall by 2D speckle tracking echocardiography. Key words: resynchronization, speckle tracking, strain, dyssynchrony
INTRODUCTION
Heart failure is a complex clinical
syndrome characterized by impaired myocardial
the most important causes of morbidity and
performance and progressive activation of
mortality in the industrialized world.(2)
neuroendocrine system leading to circulatory
Cardiac resynchronization therapy (CRT)
insufficiency and congestion. With the increasing
is now an established therapy for patients with
age of the population, improved survival of
advanced heart failure with prolonged QRS
patients with myocardial infarction and reduced
duration.
Apart
from
clinical
benefits,
mortality from other diseases, incidence of heart
improvement of left ventricular (LV) systolic
failure and the cost of managing patients with
function and associated LV reverse remodeling
heart failure continue to increase. Data suggest
has been reported. (3) Recently, improvement of
that the lifetime risk of developing heart failure is
right ventricular function also has been reported.
about 20%.(1) (4)
Heart failure is an urgent public health need
So far, better characterization of patients
with national and global implications. It is one of
who will respond to CRT has been the main focus
157
Received:14/12/2015 Accepted:28/12/2015 DOI: 10.12816/0023842
c:\work\Jor\vol63_6The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 172- 184
Effect of Stiffness of Single Implant Supported Crowns on the Resultant Stresses. A Finite Element Analysis Sara Ahmed Sayed Ahmed 1, Mohamed A. A. Eldosoky1, Mohamed Tarek El- Wakad1, Emad MTM Agamy2
1Department of Biomedical Engineering, Faculty of Engineering, Helwan University, 2Department of
Prosthetic Dentistry, Faculty of Oral and Dental Medicine, Minia University, Egypt ABSTRACT Objective: In the present study, the 3D finite element method was used to investigate the effect of crown material on stress distribution in the bone surrounding immediately loaded single dental. Materials & Methods: A 3D Finite Element model of mandibular first premolar was constructed to evaluate the performance of seven crown materials with different degree of stiffness (Porcelain, zirconium, Porcelain fused to gold, pure titanium, titanium alloy, Poly methyl methacrylate, and Polyether ether ketone PEEK). The model was constructed using Solid Works version 2010 software. The model simulated also a cement layer between the implant abutment and the crown (Virolink II, Vivadent). An axial static occlusal force of 200 N was applied to eight points in each functional cusp. The three-dimensional (3D) FE model was analyzed by ABAQUS/CAE version 6.10 software. Results: The results of this study indicated that among all crown materials the maximum von Mises stress values was observed in porcelain crown design (345.390 MPa).The highest von Mises stresses were found in the abutments for all models. In implants, the greatest stress was concentrated on the cervical region. PMMA and PEEK crown designs transferred less stress to abutment and screw. In all models, von Mises stresses increased in the coronal third of cortical bone in which the maximum von Mises stresses observed in the implant cortical interface. Conclusions: Using more rigid material for the superstructure of an implant supports prosthesis did not have any effect on the stress values and stress distribution at the bone tissue surrounding implant. However, in the abutment, cement and crown structure, stress distributions and localizations were affected by the material's rigidity. More clinical studies are needed to evaluate the survival rate of these materials. Keywords: Dental implant, finite element analysis, prosthetic materials, immediate loading.
INTRODUCTION
Dental implants have become a significant aspect
affects morphology of the surrounding bone is the
of prosthodontic treatment. Despite of high
type of prosthetic material.
success rates; complications and failures still
In this regard, however, the results of various in
occur. One factor that is increasingly being
vitro and in vivo studies appear to be somewhat
implicated with dental implant failure is occlusal
controversial. Skalak proposed that the use of
overloading as the support of teeth and implants
acrylic resin for construction of the prostheses
is inherently different. The natural teeth are
would contribute to dissipate a significant portion
visco- elastically supported in the bone by the
of the impact forces during mastication, due to
periodontal ligament which acts as a shock
the low stiffness of this material.3 However, the
absorber between a root and surrounding bone.
results of an in vivo study by Bassit et al. showed
In contrast to natural teeth; there is no periodontal
that the resilience of an acrylic resin veneer is
ligament between dental implants and their
insufficient to cause significant change in the
surrounding bone. The occlusal loads are
force transmission through the prosthesis as
transmitted directly to surrounding bone which
compared to a ceramic veneer.4 Also
could cause micro fracture in the interface
Eskitascioglu et al investigated the influence of
between bone and implant, fracture of implant.1, 2
porcelain- and acrylic based material on stress
One of the factors that affect load transfer at
distribution when dynamic forces were applied in
the bone implant interface, influences stress
vertical and lateral directions on metal-supported
distribution in dental implants and consequently
crowns over implants. Porcelains were found to
absorb and distribute the stress in itself and
172
Received: 01/01/2016 DOI : 10.12816/0023843
Accepted: 15/01/2016
þÿ(1H*HCHD The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 185- 194
The Association between Hypoalbuminemia and Intradialytic Hypotension in Heamodialysis Patients Ezzat A. Al-Etreby, Ayaman Abd El-Aziz,Osama El-Waseef, and Essam A. El-Moselhy1
Internal Medicine & Nephrology and Community Medicine1
Faculty of Medicine, Al-Azhar University, Egypt
ABSTRACT Background: hypoalbuminemia is an important risk factor of hypotension during hemodialysis and progressive left ventricular hypertrophy in patients with chronic kidney disease (CKD). Aim of the study: this study was done to evaluate the relationship between serum albumin and intradialytic hypotension (IDH) and cardiac functions. Patients and Methods: forty patients on regular hemodialysis (HD) were included in the present study. They have been divided into two groups; Group 1: Patients of this group developed recurrent attacks of IDH and Group 2: Patients of this group not developed IDH. The patients have been classified again according to serum albumin level into two groups; Group A: Hypoalbuminemic patients and Group B: Non-hypoalbuminemic patients. Data collected from each patient included: (1) Demographic features (age, gender) and clinical features (blood pressure changes during session, ultrafiltration rate, cardiothoracic ratio, duration of dialysis and Kt/V); (2) Blood chemistry (creatinine, urea, hemoglobin, hematocrit value, total proteins, albumin, triglycerides, cholesterol, AST, ALT, Kt/V, and fasting blood sugar); and (3) Echocardiographic assessment of left ventricular geometry. Results: there was a significant negative correlation between serum albumin and Delta BP in HD patients. Also we found no significant changes in cardiac functions among different studied groups. Conclusion: We concluded that there was a relationship between low serum albumin and intradialytic hypotention and cardiac functions in CKD patients undergoing HD. Recommendations: Regular assessment of serum albumin is mandatory for all HD patients. Key words: Heamodialysis, Hypoalbuminemia, Risk factor, Intradialytic hypotension.
INTRODUCTION
relationship between serum albumin and
The association between blood pressure
intradialytic hypotention and cardiac functions
changes and death rate is higher in hemodialysis
in patients with chronic kidney disease (CKD)
patients than in general population.(1) Intra-
on regular hemodialysis.
dialytic hypotension (IDH) was found to be an
independent and negative predictor of long-term PATIENTS AND METHODS
fistula outcome.(2) Study groups:
Intradialytic hypotension continues to
This study was done in the nephrology
be a leading problem, especially in elderly and
and dialysis unit at Bab-Eshearea University
cardiovascular compromised patients.(3) The
Hospital on 40 patients with CKD on regular
sensitivity of patients for IDH may not be a
hemodialysis (HD). They were divided into 2
stable condition. Many patients were found to
groups according to BP changes during HD:
have large differences in the incidence of IDH Group 1: This group included 20
over a 24-month period.(4)
patients with CKD on regular HD for at least 6
Rapid ultrafiltration especially in elderly
months, 3 times /week, duration of each session
patients may cause a premature drop in blood
was 4 hours, 11 of them were males, 9 were
pressure during hemodialysis before they reach
females, their age ranged between 17 and 63
dry weight.(3) Hypoalbuminemia is an important
years with a mean of 47.1±2.72. Also, their
risk factor of hypotension during hemo-
serum albumin ranged between 2.4 and 4.7 g/dl
dialysis.(5) Also, hypoalbuminemia was an
with a mean of 3.55±0.15. Blood access was
important risk factor for progressive left
through arteriovenous fistula. The duration of
ventricular hypertrophy in patients with end
HD ranged between 1 and 12 years with a mean
stage renal disease (ESRD).(6)
of 5.8±0.89. The criteria for inclusion in the
study were that patients had recurrent episodes AIM OF THE STUDY
of intradialytic hypotension (IDH) and
The aim of the study is to identify the
interdialytic normal BP. Among these twenty
581
Received: 01/51/2016 DOI : 10.12816/0023844
Accepted: 15/51/2016
c:\work\Jor\vol63_8The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 195- 205
Relation of Body Mass Index and Waist Circumference to Some Fertility Markers among Male Partner of Infertile Couples Hodeeb Y. M.*; Amal M. Al Dinary**; Ibrahim H. S.***; Heba M. Abd El-galil** Zeinab El-sayed Hammour**
Departments of Dermatology & Veneriology*; Community Medicine** Al-Azhar Faculty of Medicine;
International Islamic Centre for Population Studies and Researches*** ABSTRACT Background: Global estimates of infertility range between 8% and 12% of couples with women of childbearing age, affecting 5080 million people. Excess weight is not only linked to increasedrisk of chronic disease but has also been shown to increase risk of reproductive problems. The consequences of obesity in female fertility have been widely studied, but studies in the male population are less frequent. Aim of the study: The aim of this study to clarify the role of body mass Index and waist circumference on some male-fertility laboratory markers among Egyptian males of infertile couples. Subjects and methods: A descriptive cross sectional studywas carried out on a total sample of 59 males of infertile couples for at least one year after regular unprotected reproductive activity. BMI and WC were assessed, and a morning blood sample was taken assessing serum levels of testosterone, sex hormone-binding globulin, prolactin, luteinizing hormone (LH), follicle-stimulating hormone, and estradiol. Semen-analysis parameters were also measured. Results: In the present study, it was found that there was no statistical significant difference in relation of BMI or WC and sperm count. The likelihood of athenospermia was increased at higher BMI and WC values. BMI was not found to be associated with mean numeric values of the semen-analysis parameters, including sperm count, sperm morphology, and sperm motility. BMI was not significantly correlated with some hormone levels, such as LH and prolactin. However, a statistically significant inverse correlations was observed between WC and testosterone (r=-0.3&p=0.04). A different pattern of associations in this study was observed when the associations between BMI &WC and sexual hormone levels were compared between (fertile and subfertile) from infertile men. Conclusion: The association explored between WC and testosterone as well as different patterns of this association between (fertile and subfertile) from infertile men. Keywords: Male infertility, body mass index, waist circumference, sperm analysis, sexual hormones INTRODUCTION
A person's weight can have a profound impact
Involved in the decreased semen quality in men
on fertility, men who are either under or over
with BMI < 20 kg/m² or > 25 kg/m², although
their ideal weight have a higher risk of
the mechanisms behind the decreased semen
experiencing infertility. (1) WHO defined
quality in the slim and overweight men may not
infertility as the failure of a couple to conceive
be the same. (4)
after regular unprotected intercourse for at least
The distribution of body fat specifically in the
one full year. It has a high worldwide
central abdominal region has also been used to
psychosocial burden. Male infertility has a
diagnose a patient as obese and currently waist
substantial share of the total infertility burden. (2)
circumference is believed to be a more accurate
Body Mass Index (BMI) is a simple and widely
marker of obesity. (5) The interaction between
used method for estimating body fat. (3)The
obesity and fertility has received increased
pattern in reproductive hormones differed
attention owing to the rapid increase in the
between the different BMI groups, and it could
prevalence of obesity. (6) Indeed, the American
be speculated that hormonal imbalance may be
Medical Association recently classified obesity
as a disease. (7)
195
Received: 01/01/2016 DOI : 10.12816/0023845
Accepted: 15/01/2016
c:\work\Jor\vol63_9 The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 206- 209
Prognostic Roles of Endostatin, Matrix Metalloproteinase-2 & 9 and Tissue Inhibitors of Metalloproteinase-1in Advanced Non-Small Cell Lung Cancer Majed Al Mourgi, Nesriene El Margoushy, Hala El Nashar, Manal El Nashar, Nihad El Nashar, Mohamed Hatem
College of Medicine, Taif University PO Box 888, Taif 21947, Kingdom of Saudi Arabia
Corresponding author: Dr Majed Al Mourgi, Telephone: 00966559956781, email: [email protected] ABSTRACT Background and aim of the work: Previous studies verified that Endostatin, matrix metalloproteinase (MMP) -2 and -9, in addition to tissue inhibitors of metalloproteinase (TIMP) -1 may play a crucial role in prognosis of non-small cell lung cancer (NSCLC). In this study we will investigate the changes in the pretreatment serum levels of these factors and to evaluate their clinical implication in patients with advanced non-small cell lung cancer (NSCLC). Patients and methods: Pretreatment serum samples were collected from 25 patients and 10 control healthy individuals. The levels of Endostatin, MMP-2, MMP-9, and TIMP-1 were measured using a sandwich enzyme immunoassay kit. Results: The pretreatment serum levels of Endostatin and TIMP1 were significantly elevated and correlated with their stages and survival (P< 0.05), where, the serum level of Endostatin in healthy subjects was 81.20±23.99 ng/ml and in patients with NSCLC was 354.40 ± 164.01 ng/ml. The serum level of TIMP1 in healthy subjects was 1.49±0.29 ng/ml and in patients with NSCLC was 2.96±0.58 ng/ml. The serum level of MMP2 and 9 were non-significantly decreased in serum of NSCLC patients (P > 0.05), where the serum activity of MMP2 in healthy subjects was 0.14±0.03 ng/ml and in patients with NSCLC was 0.09±0.03 % and the serum activity of MMP9 in healthy subjects was 0.13±0.019 ng/ml and in patients with NSCLC was 0.10±0.03 %. Conclusions: Our results indicated that the circulating levels of Endostatin, and TIMP-1 in patients with NSCLC may be valuable future tools for treatment planning and monitoring of treatment, however, these blood tests need to be standardized and validated in large-scale prospective clinical trials. Keywords: Endostatin, matrix metalloproteinase, tissue inhibitors of metalloproteinase, non small cell lung cancer.
INTRODUCTION
The incidence of lung cancer in Saudi Arabia is
normal physiological processes such as
dramatically increasing and it is expected to
embryogenesis and tissue remodeling and may
become the leading cause of cancer deaths in the
be implicated in creating an environment that
near future. (1) Tumor angiogenesis is essential
supports the initiation and maintenance of tumor
for primary tumor growth, spread, and growth of
growth.(5) They are believed to play a crucial role
tumor cell metastasis.(2)Endostatin is an
in tumor invasion and metastasis, and they
angiogenesis inhibitor that is an endogenously
correlate with advanced clinical stage and
produced proteolytic fragment of type XVIII
considered by some investigators as a negative
collagen. It is a specific inhibitor of endothelial
prognostic factor for survival.(6)
cell proliferation, migration, and angiogenesis.(3)
The Tissue Inhibitors of Metalloproteinase
Administration
of
recombinant
mouse
(TIMP) family is a natural inhibitor of several
Endostatin to tumor-bearing animals increases
matrix metalloproteinase (MMPS) enzymes and
the apoptotic index of the tumor cells without
are known to inhibit invasion and metastasis in
affecting their proliferation index.(4)Biologically
animal models.(7) Binding of the TIMPS to their
active Endostatin was able to inhibit systemic
specific MMPS result in an efficient inhibition
angiogenesis, inhibit primary tumor growth, and
of enzymatic activity of MMPS and it was
prevent the development of primary metastatic
suggested by some researchers that a broad
lesions.(4)
spectrum MMP inhibitor might be considered as
Matrix
metalloproteinases
(MMPs)
are
therapeutic method of reducing tumor invasion
proteolytic enzymes which are involved in
and metastasis in NSCLC.(8)
Received:2/2/2016 Accepted:18/2/2016
206 DOI: 10.12816/0023846
c:\work\Jor\vol63_10The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 210-212
Uniportal Therapeutic Video-Assisted Thoracoscopic Surgery: A Single Hospital Experience, Taif Saudi Arabia Majed Al Mourgi1, Ahmad Haj Hussein2, Tamer Abdel-Rahman1, 3, Samir Badr1, 4 Reem Alsayali5, Samah Al-Sawat5, Rana Alsayali5
1Department of Surgery, Taif University, Saudi Arabia, 2 King Abdul-Aziz Specialist Hospital Taif Saudi
Arabia,3Banha Teaching Hospital, Banha, Egypt ,4GOTHI, Egypt,5College of Medicine, Taif, University
Corresponding author: Dr. Majed Al Mourgi, FRCS, FCCP, FACS, Email: [email protected] ABSTRACT Background and aim of the work: Therapeutic uniportal video-assisted thoracic surgery (VATS) has less postoperative pain, shorter hospital stay, and less operative time. In this study we will present our experience in therapeutic VATS at King Abdul Aziz Specialist Hospital, Taif Saudi Arabia. Patients and methods: This retrospective study was conducted in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, from July 2012 to January 2016 and included 162 patients who were admitted to the hospital in this period and therapeutic uniportal VATS was conducted for them. Results: The 162 patients were 102 males (63%) and 60 females with mean age of 45.1±6.8years. Bilateral sympathectomy was performed for palmar hyperhidrosis in 36% of cases, VATS stapled blebectomy with apical pleurectomy were performed for primary spontaneous pneumothorax in 32% of cases, wedge resections in 23.5%, adhesiolysis was performed in 5%, and in3.7% anatomical segment resections was done. Mean operative time was 25.5±5.5 minutes. The mean hospital stay was 5.3±1.2 days. No operative or early postoperative mortality was recorded. Conclusion: Uniportal VATS was proved to be safe and effective and can replace the multiportal approach in the management of various disorders which require thoracic surgery. Keywords: Video-assisted thoracic surgery (VATS), uniportal VATS, uniportal sympathectomy, uniportal blebectomy, uniportal pleurodesis, Taif, Saudi Arabia
INTRODUCTION
Specialist Hospital, Taif, Saudi Arabia, from Over the past two decades, video-assisted
July 2012 to January 2016 and therapeutic
thoracic surgery (VATS) has revolutionized the
uniportal VATS was conducted for them. After
management of intrathoracic disorders. (1-3)
approval of ethical board of the hospital and
VATS is associated with less pain, decreased
taking informed consents we revised the patients
general complications and shorter hospital stay
records. Records which could not be properly
which in turn decreases the hospital cost.(4) The
evaluated were excluded from the study.
technique has the same principles of tumor
Outcomes were; the surgical indications,
management if compared with traditional open
operative findings, mean operative duration, rate
procedures. (5-7) VATS leads to a fast
of conversion to open procedure, postoperative
postoperative recovery which allows the earlier
pain, and mean hospital stay. Statistical
administration of adjuvant therapy when analysis was done using SPSS program version
necessary. (7) The implementation of uniportal
18.0. Qualitative data were expressed as number,
technique into the clinical practice is spreading
percentage and mean ± standard deviation. Mc
globally and the initial clinical outcomes and
Nemar test was used to compare paired
short-term results are encouraging, and more
categorical data.
long term data are awaited.(1-7) In this study we
will present our experience in therapeutic VATS RESULTS
at King Abdul Aziz Specialist Hospital, Taif
The 162 patients were 102 males (63%) and 60
Saudi Arabia.
females with mean age of 45.1±6.8 years. The cases included 58 (36%) where sympathectomy PATIENTS AND METHODS
was performed for palmar hyperhidrosis, 52 In this retrospective study which involved 162
cases (32%), where VATS stapled blebectomy
patients, we revised the records of all patient
with apical pleurectomy were performed for
who were admitted to King Abdul Aziz
primary spontaneous pneumothorax, wedge
210
Received: 01/04/2016 DOI : 10.12816/0023847
Accepted: 07/04/2016
c:\work\Jor\vol63_11 The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 213- 2
16
Routine Early Coronary Angioplasty versus Ischaemia-Guided Coronary Angioplasty after Successful Thrombolysis in Patients with Acute Anterior STEMI *Ahmed Ibrahim Nassar, *Hany Fouad Hanna, *Haytham Galal Mohamed,**Hany Ibrahim Ragy,*Amir Wadie Andrawes. Author's affiliation:*Cardiology department, Ain Shams university.**National heart institute. Corresponding Author:Amir W. Andrawes.Email: [email protected]: 01008880048 ABSTRACT Background: the potential benefits of routine early intervention after thrombolysis include prevention of re-infarction, recurrent ischemia, and reduction of the infarct size and mortality. Aim of the work: the purpose of this study is to compare routine early coronary angioplasty in patients with acute anterior STEMI after successful thrombolysis versus ischaemia-guided coronary angioplastyas regards the occurrence of MACCE. Study design: a total number of 100 patients with acute anterior STEMI received thrombolytic therapy and then were randomly assigned to either routine invasive strategy or ischemia based strategy based on risk stratification by stress myocardial perfusion scan done within 30 days of the onset of AMI with subsequent CA after demonstration of residual myocardial ischemia and or good viability. Results: the cumulative incidence of MACCE including recurrent ischemia, stroke, MI, HF or mortality was significantly lower in theroutine early invasive strategy. Conclusion: STEMI patients who cannot undergo timely primary PCI should receive prompt fibrinolysis followed by early routine invasive strategy. Keywords: Pharmaco-invasive PCI.
c:\work\Jor\vol63_12The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 217- 228
Role of Astaxanthin in Improving the Physiological and Teratolgical Changes of Aspartame in the Pregnant Albino rats and Their Fetuses Abu Gabal, H*and Al Waely, M**
* College of Science and Humanities, Prince Sattam Bin Abdul Aziz University, KSA.
**College of Science, Princess Nora Bent Abdul Rahman University, KSA. ABSTRACT Aim of the work: the present work was done to investigate the role of astaxanthin in ameliorating the physiological and teratological effects of aspartame on the pregnant rats and their fetuses. Materials and methods: in this study 70 virgin mature female albino rats (Wistar wistar) were used and 35 males (for mating); pregnancy was ascertained by vaginal smearing. The pregnant rats were injected on days7, 9, 11 and 13 of gestation (organogenesis period). The animals were divided into the following groups: animals of the first group which were intraperitoneally injected with 0.5ml saline (solvent of aspartame); animals of the second were intraperitoneally injected with 0.5 ml olive oil (solvent of astaxanthin). The third group was divided into 2 subgroups, the pregnant rats of the first subgroup were intraperitoneally injected with aspartame (20mg./kg. body weight), the pregnant rats of the second subgroup were intraperitoneally injected with aspartame (40 mg./kg. body weight). Pregnant rats of the 4th group were intraperitoneally injected with astaxanthin (50mg.\kg. body weight) 2 hours after aspartame injection by its 2 doses. Results: aspartame at the dose of 40 mg./kg.body weight induced pre- term ( early delivery); however the 2 doses of aspartame resulted in very highly significant decrease in the mean maternal body weight , unequal horns of the uteri and unequal distribution of the fetuses between them , abnormal amount of fats surrounding the 2 horns of the uterus, regions of hemorrhage were present on the external membrane of the uteri ,very highly significant uterine weight decrease , cases of abortion were noticed as well as highly significant increased resorption of the fetuses. Intraperitoneal injection with aspartame at the 2 doses resulted in fetal mortality, very highly significant fetal body weight and length decrease with a significant decrease in fetal tail length. Moreover, aspartame induced fetal morphological changes such as body diminution, exencephaly, cognition of the blood vessels in the head region and cleft lips. The skin seemed thin and fragile in the head region as well as the fore and hind regions; hematoma was obvious beside edema, clubbed fore and hind limbs, kyphosis was obvious beside hernias on some regions of the skin with hypertrophy of some fetuses and protrusion of the viscera outside the body. Aspartame exposure at the 2 doses induced highly significant increase in mean of maternal serum AST activity, very highly significant increase in mean serum GGT and serum creatinine activity. Conclusion-Treatment with astaxanthin induced obvious improvement in all of the physiological and morphological changes caused by aspartame in the pregnant rats and their fetuses. Key words: Aspartame- Astaxanthin - Pregnant albino rats - Fetuses -Physiology -Teratology. INTRODUCTION
Canderel).The
sweetener
was
accidentally
Aspartame (APM) is an artificial sweetener
discovered by James Schlatter during his attempts
widespread in the world; its brand name is
to obtain a gastric ulcer drug in 1965.[3]This white,
NutraSweet. Millions of people use aspartame;
crystalline and odorless powder is 180-200 times
which is used in many food products like chewing
sweeter than sucrose. The intense sensation of
gum, desserts, yoghurts, vitamins, medicines and
sweetness allows the use of such small doses so
particularly in diet beverages as well as people
that the product is almost non-caloric although its
trying to lose weight or patients with diabetes,
energy value is 4 kcal/g of aspartame. The
including children, frequently use these products.
sweetener is a chemical agent, N-L-Alpha- [1]It was found that aspartame is present in 68% of
Aspartyl-L-phenylalanine
methyl
ester
comestible assortment among sugar-free products
(C14H18N2O5).[4] This substance is hydrolyzed
in Poland.[2] It is applied by diabetics as tablets
completely in the intestinal lumen during
instead of sugar (NutraSweet, Equal, Sugar Free,
metabolism of the body to the three main breakdown products: phenylalanine (50%),
217
Received: 04/02/2016 DOI : 10.12816/0023850 Accepted: 22/02/2016
c:\work\Jor\vol63_14The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 238- 247
Effects of Recovery Period and Stem Cell Enhancer on Bisphenol A Treated Female Albino Rats Eman G. E. Helal1, Nora Abdulaziz Al Jalaud2, Gamal M. Elnemr 3,4, Doaa I. Gewily1
1Department of Zoology, Faculty of Science (Girls), Al-Azhar University, Cairo, Egypt, 2Department of
Biology, Faculty of Science, University of Dammam, Saudi Arabia, 3Department of Medical and
Radiological Researches, Nuclear Materials Authority, Egypt, and 4Department of Internal Medicine,
Faculty of Medicine, Taif University, Saudi Arabia. ABSTRACT: Background: Bisphenol A (BPA) is a worldwide used endocrine disruptor that is incorporated in many plastic industries. Exposure of humans to such substance starts early during the fetal life, postnatal life, and extends throughout the life of the individual. Many agencies raised warnings against excessive use of such substance. Aim of the work: This study aimed to investigate effects of the recovery period (RP) and stem cell enhancer (SCE) on the female albino rats which received BPA. Materials and Methods: This study was performed on forty female albino rats with an average body weight of 140-160 grams. Animals were divided into four groups (10 rats per cage); group I (control untreated for 30 days), group II (BPA treated for 15 days, and then sacrificed), group III (BPA treated first for 15 days, then left for another 15 days without any treatment "RP"), and group IV (BPA treated first for 15 days, then treated with SCE for another 15 days). The following biochemical analyses were done to all groups; ALT (alanine amino-transferase), AST (aspartate amino-transferase), GGT (gamma glutamyl-transferase), total proteins, albumin, globulins, A/G ratio [i.e., liver function tests], creatinine, A/C (albumin/creatinine) ratio, uric acid [i.e., renal function tests], total lipids, total cholesterol, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), and triglycerides [i.e., lipids profile]. Results: In the BPA treated rats (group II) the biochemical results showed highly significant increases (P<0.01) in the enzymatic activities of ALT, AST, GGT, creatinine, uric acid, total lipids, total cholesterol, LDL-C, and triglycerides levels, with only a significant increase (P<0.05) in globulins levels when compared to the control group. On the other hand, there was highly significant decreases (P<0.01) in total proteins, albumin, A/G ratio, A/C ratio, and HDL-C levels when compared to the control group. These results turned back to about the normal control values after stopping the use of BPA and either taking a RP (group III) or receiving the SCE (group IV). Conclusions and Recommendations: It could be concluded that BPA has dangerous toxic effects on the liver and kidney functions as well as on the lipids profile. So, we recommend minimizing utilization of this compound (BPA) as possible to protect people from these hazardous effects. Moreover, the RP (i.e., 15 days without treatment) is better than the use of SCE which has no more benefit against the antitoxic effects of BPA. Keywords: BPA; bisphenol A, RP; recovery period, SCE; stem cell enhancer. INTRODUCTION
release, and oxidative stress. When first
Bisphenol A (BPA, 2,2-bis 4-hydroxy
discovered, BPA was investigated for its
phenyl propane) is one of the environmental
estrogenic properties, as it is thought to alter the
contaminants widely used in the manufacture of
synthesis of estradiol and testosterone and
polycarbonate plastic (e.g., water and baby
interfere with receptor binding.(5) There is a
bottles), epoxy resin (e.g., inside coating in
significant
relationship
between
urinary
metallic food cans), and is a non-polymer
concentration of BPA and cardiovascular
additive to other plastics.(1, 2) Hence, it became
disorders, type 2 diabetes, and liver enzyme
an integrated part of the food chain.(3) There is a
abnormalities in a representative sample of US
global concern for human health as BPA binds
population.(6) Moreover, two studies on the
to estrogen receptors (ERs),(4) and can interfere
laboratory animals have shown adverse effects
with normal sex hormone balance. BPA is
of BPA on brain, reproductive system, and
thought to wield its effects through endocrine
metabolic processes, including alterations in
disruption, epigenetic modification, cytokine
insulin homeostasis and liver enzymes.(7)
238
Received: 01/04/2016 DOI : 10.12816/0023852
Accepted: 15/04/2016
c:\work\Jor\vol63_15The Egyptian Journal of Hospital Medicine (Apr. 2016) Vol. 63, Page 248- 257
The Potential Protective Effect of Stem Cell Enhancer on Chronic Bisphenol- A Treated Female Albino Rats Eman G. E. Helal1, Rasha A. A. El sayed1, Hoda M.Abu-Taleb2
1Department of Zoology, Faculty of Science, Al-Azhar University (Girls), Cairo, Egypt.
2 Department of Environmental Research, Theodor Bilharz Research Institute, Cairo, Egypt.
*Corresponding authors: Eman G.E. Helal - Rasha A. A. El sayed,
E-mail: [email protected] - [email protected] ABSTRACT Background: The xenoestrogen, bisphenol-A (BPA), is a worldwide food contaminant with
endocrine disruptor activity that is incorporated in many plastic industries. The exposure of humans to such substances starts early during the fetal life, postnatal life and extends throughout the life of the individual. Many agencies raised warnings against the excessive use of these substances. Aim of the work: The present study was designed to determine if the usage of stem cell enhancer (SE) moderates the physiological changes occasioned by exposure to BPA in the female albino rats. Materials and Methods: This study was performed on thirty female albino rats with an average 100-120 g body weight. The animals were divided into three groups; Group I (Control untreated-group), Group II (bisphenolA treated group) and Group III (treated group orally supplied with bisphenol A then treated with stem cell Enhancer (SE)). Serum was separated and used for estimation of hormonal levels [estradiol, progesterone, prolactin (PRL), follicle-stimulating hormone (FSH) and luteinizing hormone (LH)], some biochemical parameters (liver enzymes, kidney function, glucose and lipid profile) and CA-125 and CA 15-3 tumor markers. Results: The biochemical results showed marked significant increase (P<0.01) in the enzyme activities [aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and alkaline phosphatase (ALP)],urea and creatinine in bisphenolA treated group when compared to the control group. These parameters were significantly reduced in the group treated with stem cell enhancer as compared to bisphenol A treated group . Decline in the concentration of lipid profile with increase in high density lipoprotein cholesterol (HDL- C) levels in the stem cell treated group as compared to bisphenol-A group were observed. There was a significant elevation in prolactin, FSH and tumor marker levels concomitant with a significant reduction in LH levels in bisphenol-A treated group compared to the control group. These results were changed to values very close to control by using the stem cell enhancer. Conclusion: It could be concluded that bisphenol-A has dangerous effects on liver and kidney functions as well as on lipid profile, female hormones and tumor markers level. So, we recommended minimizing the utililizing of this compound and the use of some protective materials as stem cell enhancer to protect people from its hazardous effects. Keywords: BPA ( bisphenol- A), stem cell enhancer, tumor markers, kidney and liver function tests. INTRODUCTION
Xenoestrogens are nonsteroidal, man-made
monomer used to manufacture polycarbonate
chemicals that can enter the body by ingestion or
plastics including baby bottles, infant feeding
adsorption.(1)
Health
concerns
regarding
containers or tableware, and a constituent of
exposure to xenoestrogens stem from their
epoxy and polystyrene resin that are extensively
potential actions as endocrine disruptors. These
used in the food-packaging industry and in
chemicals share no structural homology with
dentistry, lining food and beverage cans.(3)
estradiol and include substances such as
BisphenolA has adverse effects on humans
pesticides and industrial by-products. Phenols
because of its ubiquitous presence in the
are one of the most common classes of
environment, resistance to degradation, and
xenoestrogens found in foods and consumer
potential for accumulation in fat tissues.(4)
products that made of polycarbonate plastics.(2)
BPA binds to estrogen receptors (ERs), and
Bisphenol-A (BPA), a food contaminant
can interfere with normal sex hormone balance.
with endocrine disruptor activity, is the widely
Bisphenol-A is thought to wield its effects
248
Received: 02/04/2016 DOI : 10.12816/0023853
Accepted: 17/04/2016