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Updated Thursday, 02 December 2021

QJM ◽  
2021 ◽  
Author(s):  
Isa Khan ◽  
Elizabeth Brookes ◽  
Nima Yaftian ◽  
Andrew Wilson ◽  
Jonathan Darby ◽  
...  

QJM ◽  
2021 ◽  
Author(s):  
A Kono ◽  
R Yoshioka ◽  
P Hawk ◽  
K Iwashina ◽  
D Inoue ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Bassel Mohamed Essam Noureldin ◽  
Eman Mohamed Kamal Abo Seif ◽  
Omar Mohamed Mohamed Eltawansy ◽  
Mohamed Mohamed Abdel Fattah Ghoneim

Abstract Background Inhalation mask induction is a cornerstone of pediatric anesthesia. Because of their natural aversion to needles, healthy children are usually anesthetized by mask prior to intravenous insertion. The early insertion of an intravenous access provides a means for administering fluids and drugs if an untoward event occurs during inhalational induction. Sevoflurane is the inhalation agent most commonly used for mask inductions in pediatric anesthesia, having largely replaced halothane for this purpose. Objectives The aim of the study was to evaluate the optimum end tidal concentration of Sevoflurane at which an intravenous cannulation can be successfully attempted without movement in pediatric patients. Patients and Methods In this clinical trial, pediatric subjects of either sex aged 2-5 years, weighing 10-20 kg were included. Results Showed that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation without movement in children. Conclusion We conclude that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation in un- premedicated children aged between 2 and 5 years.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Lotfy ◽  
Ahmed I Eldesoky ◽  
. Sameh S Thabet

Abstract Background Patients with inferior wall myocardial infarction who have right ventricular (RV) involvement appear to have a worse prognosis than those without RV involvement; infarcted RV tissue fails to offer a sufficient preload which is essential for adequate LV performance. Thus, assessment of RV function is an important step in dealing with patients presenting with inferior wall myocardial infarction that will help in adopting a proper management plan. Objective To assess the correlation between RV function and angiographic findings in patients presenting with inferior wall myocardial infarction associated with RV infarction undergoing primary percutaneous coronary intervention. Patients and Methods Study included 60 patients who presented to Ain shams university hospitals by inferior wall ST segment elevation myocardial infarction associated with RV infarction during the period from February 2019 to August 2019.All patients were subjected to history taking, clinical examination, ECG recording then primary percutaneous coronary intervention. Echocardiographic assessment was done to all patients within 48 hours of admission. Results Study included 60 patients, 43 males (71.7%) and 17 females (28.3%), with mean age of 56.73 ± 9.94 years. Commonest Infarction related Artery (IRA) associated with impaired RV function was proximal RCA (p-value: 0.003). In 23 patients (38.3%) heavy thrombus burden was found while in the other 37 patients (61.7%) there was no evidence of heavy thrombus burden. Regarding post procedural TIMI flow grade: 1 patient (1.7%) had final TIMI I flow, 9 patients (15.0%) had final TIMI II flow and 50 patients (83.3%) had final TIMI III flow. There was statistically significant relationship between RV function assessed through measuring RV free wall strain and both of thrombus burden and final TIMI flow grade. Abnormal RV function was more commonly associated with heavy thrombus burden (p-value:0.023) and less than TIMI III flow after angioplasty (p-value:0.011).RV free wall systolic strain assessment had highest accuracy (75%) in detection of proximal RCA occlusion compared to other parameters including TAPSE, S’ and FAC. Conclusion Impaired RV function in patients presenting with RV infarction can be predicted by different angiographic findings. Proximal RCA total occlusion being commonest IRA associated with impaired RV function. Also, presence of heavy thrombus burden and less than TIMI III flow after angioplasty are associated with increased risk of impaired RV function. RV free wall strain measured by 2D-speckle tracking echocardiography has highest accuracy in detection of proximal RCA occlusion compared to other echocardiographic indices including TAPSE, S’ and FAC.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ashraf Mohamed Farouk Kortam ◽  
Tarek Aly Raafat ◽  
Rehab Mohamed Abd El Rahman ◽  
Amir Hamdy Abd El Hady Mahfouz

Abstract Background Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy. Objective Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University. Methods This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria. Results This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group). Conclusion s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy M Abd Elgawaad ◽  
Amr M El Helaly ◽  
Malames M Faisal ◽  
Asmaa F Kasem

Abstract Background Endometrial carcinoma is the most common gynecological malignancy in the developed countries and the third common gynecological malignancy in Egypt after breast and ovarian cancers. Aim of the Work to evaluate this risk scoring model on Egyptian patients and to study the effect of adding other patient characteristics (DM, BMI and relevant family history) on the sensitivity and specificity of RHEA scoring model. Patients and Methods The current study was conducted in Ain Shams University Maternity Hospital in the period between September 2017 and December 2018. A total of 100 women with postmenopausal bleeding and endometrial thickness > 4mm were included in the study. Results Histological examination revealed that benign pathology (n = 65) (73%) was found to be: most common cause was endometrial hyperplasia without atypia (20.3%) followed by chronic endometritis (13.5%), then endometrial polyp (11.3%), cystic atrophy of endometrium (8.9%), proliferative endometrium (8.9%), endometrial hyperplasia with atypia (6.7%) and lastly mucous polyp (3.4%) while malignant histopathology(n = 24)(27%) which is significantly higher than the international rates showed: Endometriod adenocarcinoma (n = 19)(21.3%), papillary serous carcinoma (n = 4)(4.5%) and undifferentiated carcinoma (n = 1)(1.1%). The current study showed that RHEA score performs in our study population with a comparable validity to that reported by its inventors with sensitivity 79.2% (57.8% - 92.9%) vs. 87.5% and specificity 84.6% (73.5% - 92.4%) vs. 80.1% respectively. In results of the current study it was found that the time since onset of menopause rather than age was associated with endometrial cancer with the optimum cut-off for postmenopausal duration was estimated to be 9 years achieving a sensitivity of 87.5% and a specificity of 60.0%, but it needs multivariate analysis on larger and more representative sample size to confirm this association, A statistically significant regression model was including only postmenopausal duration, recurrent bleeding and endometrial thickness. None of age, BMI, family history or hypertension proved a statistically significant predictive effect after adjustment for other predictive variables. Conclusion Taking in consideration the higher prevalence of endometrial carcinoma in the sample of the current study, the wide 95% confidence intervals for the different validity indices for the RHEA scores derived from this study, it seems that RHEA score performs in this study population with a comparable validity to that reported by its inventors.


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