Biomedical subjects

H Mostafa

Publications and source records attributed to H Mostafa.

13 recordsLinked to original sources

PubMed2003

Symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus: special consideration for renal vein thrombosis.

OBJECTIVE: To evaluate the prevalence of symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus (SLE), and to evaluate the frequency and the risk factors associated with renal vein thrombosis in those patients. METHODS: Fifty-four patients with SLE, 51 (94.4%) females, were involved in this study. All of them were submitted for abdominal sonography, chest X-ray, echocardiography, and Doppler of renal, abdominal and lower limb veins, with examination of data on clinical and laboratory profile. Abdominal CT, brain MRI, MRI both hips, CT chest and pulmonary scintigraphy were used when needed. RESULTS: Sixteen patients (29.6%) were diagnosed with symptomatic thrombotic events. Eight patients had more than one type of thrombosis. Two patients (3.7%) were diagnosed by Doppler as having renal vein thrombosis (RVT). This was confirmed by abdominal CT. One of them presented with nephrotic syndrome, graded by renal biopsy as World Health Organization (WHO) class V, and had positive anticardiolipin antibodies (ACL). The other patient had RVT and inferior vena cava (IVC) thrombosis, nephrotic syndrome, positive ACL, and died before renal biopsy was performed. Both of them were without history of peripheral thrombotic events. One patient was diagnosed with IVC thrombosis, lupus nephritis grade II, positive ACL, and diagnosed by abdominal CT. One patient was diagnosed with portal vein thrombosis and had positive ACL. One patient with retinal vessel thrombosis and positive ACL. Four patients had deep vein thrombosis (DVT). Recurrent miscarriages were reported in 4 patients (7.4%), skin ulcerations in 3 (5.6%), avascular necrosis of the hips in 4 (7.4%), stroke in 1 (1.9%), and pulmonary hypertension in 2 patients (3.7%). CONCLUSION: Sixteen SLE patients (29.6%) were diagnosed with symptomatic thrombotic events. RVT was detected in 2 patients representing 3.7% of all patients, and 12.5% of patients with thrombosis. Both patients with RVT presented with nephrotic syndrome.

Adult↗

PubMed2002

Plasma endothelin-1 concentrations in children with cirrhosis and their relationship to renal function and the severity of portal hypertension.

BACKGROUND: Plasma endothelin-1 (ET-1) is a potent vasoconstrictor peptide involved in the pathogenesis of several disorders. Endothelin-1 concentrations are increased in adult patients with cirrhosis. However, little is known about ET-1 concentrations in children with cirrhosis. METHODS: Radioimmune assay was used to measure plasma ET-1 concentrations in 19 children with cirrhosis (8 patients with ascites, and 11 without ascites), and 11 age- and sex-matched healthy children. The plasma ET-1 concentrations were correlated with the mean blood pressure, creatinine clearance, and severity of portal hypertension, as measured by portal flow volume and portal flow velocity. RESULTS: Patients with cirrhosis and ascites had increased plasma ET-1 concentrations compared with patients who did not have ascites (6.8 pg/mL +/- 0.62 pg/mL vs. 4.6 pg/mL +/- 0.35 pg/mL; mean +/- SEM; < 0.01) and controls (3.6 pg/mL +/- 0.27 pg/mL; mean +/- SEM; < 0.0005). Plasma ET-1 concentrations were higher in patients with cirrhosis who did not have ascites compared with controls ( < 0.005). No significant differences were observed between concentrations of the patients with cholestasis and those without cholestasis (5.4 pg/mL +/- 0.52 pg/mL vs. 5.2 +/- 0.32 pg/mL; mean +/- SEM; = 0.1). Plasma ET-1 concentrations correlated positively with the mean blood pressure ( = 0.58; < 0.05) and negatively with renal function, as measured by creatinine clearance ( = -0.7; <0.005). However, no correlation was detected between ET-1 concentrations and portal flow volume ( = -0.02; = 0.4) or portal flow velocity ( = -0.16; = 0.4). CONCLUSIONS: Plasma ET-1 concentrations are increased in children with cirrhosis, with or without ascites, compared with controls. Patients with cirrhosis and ascites have increased ET-1 concentrations compared with those without ascites. The degree of increase does not relate to the severity of portal hypertension. This increase tends to maintain systemic blood pressure but is associated with a decrease in renal function.

Ascites↗

PubMed2001

Evaluation of the triangular cord sign in the diagnosis of biliary atresia.

BACKGROUND: Infantile cholestasis continues to represent a diagnostic challenge. It is very important to diagnose surgically correctable disorders, such as biliary atresia, in a timely manner to prevent progressive damage to the liver. It has been recently suggested that the triangular cord (TC) sign is a simple and useful tool in the diagnosis of biliary atresia. METHODS: We prospectively studied 65 infants presenting with conjugated hyperbilirubinemia (age range: 32-161 days). All patients underwent ultrasonographic examination with a 7.0-MHz transducer (Acuson, Mountain View, CA). The TC was defined as a triangular, or tubular, echogenic density seen immediately cranial to the portal vein bifurcation. RESULTS: The TC sign was identified in 25 infants, and all of them had histologic features suggestive of biliary atresia; the diagnosis was confirmed at surgery by gross morphology of hepatobiliary system, and liver biopsy, with or without intraoperative cholangiogram. Among the 40 patients who did not have the TC sign, 6 had paucity of the intrahepatic bile ducts. Three had alph-1-antitrypsin deficiency, and 31 had neonatal hepatitis. None of the 40 patients who did not have the TC sign developed acholic stools. Seven patients with biliary atresia were followed by ultrasonographic examination for 6 months after the Kasai procedure. The TC sign disappeared in all patients after the surgery; however, the TC sign reappeared in 3 patients who developed progressive cholestasis after the procedure. CONCLUSION: The TC sign is a simple, timesaving, and reliable diagnostic tool in the evaluation of infants with infantile cholestasis. The TC sign may also prove to be helpful in following patients after hepatoportoenterostomy. We suggest a new diagnostic strategy for patients suspected to have biliary atresia. When the TC sign is visualized, the patient should undergo intraoperative cholangiogram to confirm the diagnosis of biliary atresia, reserving percutaneous liver biopsy for those patients in whom the TC sign could not be detected.

Biliary Atresia↗

PubMed1998

Endoscopic management of ejaculatory duct obstruction.

A total of 191 patients were evaluated at our department for azoospermia, and 11 were found to have azoospermia due to ejaculatory duct obstruction as proved by normal serum hormones, normal testicular biopsy, low ejaculate volume and absence of fructose in semen. Also transrectal ultrasound was performed, revealing distended seminal vesicles and dilated ejaculatory ducts. All these criteria together suggested ejaculatory duct obstruction as a cause of azoospermia. All patients underwent endoscopic management for treatment of their ejaculatory duct obstruction in the form of resection and/or incision of the ejaculatory duct ostium inside the urethra and patency was checked intraoperatively by injection of sterile methylene blue in the vas and visualizing the efflux of the blue dye endoscopically. Intraoperative patency was documented in 10 patients and postoperative patency by follow-up semen analysis in 7 patients (70% patency rate) of which 2 (20% pregnancy rate) were able to conceive within 2 years of endoscopic treatment. Postoperative complications included acute urinary retention in 1 patient, haematuria in 5 and recurrent epididymitis in 2 patients.

Ejaculatory Ducts↗

PubMed1998

Evaluation of the role of corpus cavernosum electromyography as a noninvasive diagnostic tool in male erectile dysfunction.

Corpus cavernosum electromyography (EMG) and its evolution: single potential analysis of cavernous electrical activity (SPACE) seem to be promising diagnostic methods in the evaluation of erectile dysfunction and smooth muscle integrity. Our study concentrates on the role of EMG in the evaluation of corpus cavernosum smooth muscles, using it as a noninvasive technique for demonstrating autonomic erectile dysfunction through their influence on recording SPACE and consequent proper selection of patients for different therapeutic modalities. A total of 80 male patients were examined for the feasibility of transcutaneous registration of cavernous electrical activity with a 2-channel electrophysiological unit (Evamatic 2000, Dantec) with two surface electrodes bilaterally placed on the penile shaft. Ten patients had normal erectile function, but complained of other urological symptoms. They served as the controls for normal electrical activity. Fifty patients with organic impotence of nonvascular (neurogenic) or vascular (venogenic, arteriogenic) aetiologies were subjected to EMG in both the flaccid and the erect state. On the basis of the EMG patterns the patients were divided into the following groups: 34 patients having normal tracing in both the flaccid and the erect state, and 21 patients showing abnormal patterns of waves with evidence of autonomic neurogenic dysfunction and incomplete smooth muscle relaxation. Of the latter 4 had long-standing diabetes mellitus and 4 had spinal injuries.

Adult↗

PubMed1996

Study of the arterial pattern of the rectum and its clinical application.

The purpose of this communication was to study rectal arterial supply in order to characterize its various patterns and use them to help avoid rectal ischemic complications and, in addition, to explain some of the unknown rectal pathologic conditions. Thirty-two cadavers were studied. The pelvic organs were eviscerated. The rectal arteries were examined by direct dissection in 12 specimens and after injecting the inferior mesenteric artery with barium sulfate in 20 specimens. The superior rectal artery (SRA) and vein were found to be enclosed in a fibrous sheath which was connected to the posterior rectal surface by an anterior mesorectum containing the "transverse rectal branches', and to the sacrum by an avascular posterior mesorectum. Small lymph nodes were scattered alongside the anterior mesorectum. The SRA gave rise to 4 branches: transverse rectal, descending rectal, rectosigmoid and terminal. The transverse rectal arteries arose from the SRA in 24 specimens and from the descending rectal artery in 8. They were distributed to the upper half of the rectum. The rectosigmoid artery was distributed to the descending limb of the sigmoid colon and rectosigmoid junction. We found 2 terminal branches in 21/32 cadavers and 3 in 11/32. They communicated in the lower half of the rectum. The inferior rectal arteries were present in all the dissected cadavers while the middle rectal arteries could be identified in only 50% of the cadavers. Two arterial patterns were recognized: annular in the upper rectal half provided by the transverse rectal arteries and plexiform in the lower half supplied by the SRA terminal branches.

Adolescent↗

PubMed1995

Serum levels of tumor necrosis factor in different stages of schistosomal infection.

Schistosomal infections present their hosts with enormous immunological problems. The cytokine tumor necrosis factor, an effector molecule released mainly by stimulated macrophages is involved in various defence mechanisms mounted by the host against schistosome, However, TNF can be dangerous and may contribute to the pathology associated with schistosmal infections. In this study, the authors examined the circulating levels of TNF, IgE and the eosinophilic count in 41 patients and 25 health controls, trying to find an association between TNF concentrations and severity of the disease, IgE levels and eosinophilic count. All cases had significant anaemia, eosinophilia, elevated IgE and TNF concentrations.

Adolescent↗

PubMed1971