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Biomedical subjects

M El-Shazly

Publications and source records attributed to M El-Shazly.

10 recordsLinked to original sources

Impact of psoriasis on quality of life in Kuwait.

BACKGROUND: Psoriasis can seriously affect the quality of life (QOL) of patients and has a strong impact on social relations, psychological status and daily activities. OBJECTIVE: The aim of this study was to describe the impact of different grades of severity in psoriasis on QOL in patients in Kuwait. PATIENTS/METHODS: We used the Dermatology Quality Of Life scale (DQOLS) developed by Morgan and then validated for use in Kuwait to study a sample of 330 out-patients with psoriasis. RESULTS: Overall, physical activities were affected in greater than 50% of cases. This figure increased significantly with increased severity of psoriasis. Also, social relationships were disrupted in more than half of the patients but with no significant difference between different grades of severity. All psychological feeling items were affected by psoriasis to variable degrees. However, significant differences related to the severity of psoriasis were detected: feeling embarrassed, feeling short tempered, feeling depressed, and feeling a lack of hope. One third of cases declared their sexual activities were affected by psoriasis. CONCLUSION: Data provided should improve the physicians' awareness of the importance of patients' QOL and enhance psychological evaluation of the psoriatic patient which will promote his/her positive outcome and compliance with treatment.

Adult↗

Endoscopic-assisted microsurgery: microsurgery in the new millennium? A comparative experimental study.

Endoscopes are already present in almost all plastic surgery departments. The operating microscope is currently an essential piece of equipment for performing microsurgical anastomoses; however, microsurgery could be conducted using other equipment, including the endoscope. By performing 60 vessel and nerve repairs in rats under the operating microscope and the same number using the endoscope as a visual aid, we investigated the technical and clinical differences between the two instruments. We recorded significantly shorter operative, vascular preparation and anastomotic times in the endoscopically assisted group. Based on the data collected during this study, we conclude that microsurgery is possible with the aid of an endoscope. Using the endoscope may make prolonged microvascular procedures shorter and less physically demanding and may increase the comfort level of both the surgeon and the assistant.

Anastomosis, Surgical↗

Displacement of the common peroneal nerve associated with upper tibial fracture: implications for fine wire fixation.

The constant anatomic position of the common peroneal nerve is relied on when performing fine wire external fixation in the upper tibia. We report the case of a sixty-two-year-old woman with a Schatzker Type V fracture of her right tibial plateau and upper-third diaphyseal fracture associated with displacement and shortening of the upper tibia. She was treated by minimal internal fixation of the intraarticular fracture and application of a Sheffield Hybrid External Fixator. During percutaneous insertion of the reference wire in the fibular head, a distal muscle twitch alerted the surgeon, and the common peroneal nerve was duly explored and found displaced forward over the fibular head, dangerously close to the wire. It is postulated that at the time of injury, the common peroneal nerve was displaced anteriorly and that despite reduction of the tibial fractures, it had failed to return to its original position. The mechanism of this was confirmed by an anatomic study on an above-the-knee amputation specimen in which the metaphyseal-diaphyseal element of the fracture was reproduced. We recommend insertion of the reference fibular wire with the knee in flexion. Open insertion of this wire, with an incision down to bone and exposure of the fibular head, is recommended in cases in which severe trauma with shortening of the upper tibia, with possible disruption of the tibiofibular joint, puts the nerve in danger of injury.

Bone Wires↗

The use of trans-articular and extra-articular external fixation for management of distal tibial intra-articular fractures.

Twenty-nine consecutive cases of distal tibial intra-articular fractures treated by trans-articular or extra-articular external fixation techniques have been reviewed. Eleven cases were treated initially with a trans-articular dynamic axial fixator. Of these seven were converted to an extra-articular SHF, for a combination of poor ankle motion and delayed healing of the metaphyseo-diaphyseal dissociation (MDD). Three of these cases (two patients) required bone grafting for delayed healing of the diaphyseal component of the fracture. Apart from one refracture through the MDD, no major complications were seen. No deep infections and no angular malalignments were noted. There were 11 pin track infections. Subjective assessment using short form-36 (SF-36) questionnaires, however, revealed significant differences compared to a normal population particularly in physical function and pain at a mean follow-up of 21 months. Using Bone's criteria for assessment of range of motion there were 62% excellent and good results, which dropped to 53% when fractures with a metaphyseo-diaphyseal extension were included. The use of minimally invasive techniques of internal fixation and stabilisation with a Sheffield hybrid frame in the management of distal tibial intra-articular fractures has minimal complications. Trans-articular external fixation is a good primary treatment for badly comminuted articular fractures with poor soft tissue condition. Conversion to extra-articular external fixation is recommended for slower healing fractures allowing ankle movement and early weight-bearing. The presence of a MDD dissociation lengthens the treatment time significantly, adds to the morbidity and affects final outcome.

Adult↗

Health care for diabetic patients in developing countries: a case from Egypt.

The aim of this was to evaluate the pattern of care for diabetic patients in Alexandria as a model from a developing country. It is a cross-sectional multi-centric. One thousand diabetic patients who had diabetes for no less than one year were randomly selected from 14 out-patient clinics and diabetic centres. Results showed that monitoring of the glycaemic state was based, almost entirely upon fasting blood glucose levels, with only a small minority (4%) having HbA measurements. During the previous 12 months, an electrocardiogram had not been performed in 26% of the subjects studies and the fundus was not examined in 38%. Twenty nine percent did not receive neurological examination, and feet were not inspected in 24%. Testing for albuminuria, serum creatinine, blood cholesterol, and triglycerides was performed only in 34%, 37%, 36% and 32% respectively. Patient's habits in seeking care revealed that 78% regularly attended the medical centre for follow up, 64% followed dietetic instructions, and 89% were compliant with prescribed therapy. Only 8% did self examination of blood glucose and 26% checked glucose in urine by themselves. Generally, the pattern of care provided for health insured diabetic patients is better than that received by non-health-insured cases. It is concluded that in Egypt the quality of diabetes care differs in many aspects from the recommended standards and that structural as well as organisational improvements are urgently needed, particularly to guarantee adequate care to non-health insured patients.

Adult↗

Profile of familial breast cancer in Alexandria, Egypt.

Nearly two thirds of the cancers which will appear in the next 25 years will occur due to unawareness of the public. In a population genetic study in Alexandria, Egypt, we found that the parents of 20% of the population are first degree cousins. Out of 9,587 female cancer cases registered in the last 10 years by the Alexandria Cancer Registry, 3250 (33%) were breast cancer. Twelve percent of breast cancer patients had a positive first-degree relative family history of cancer. Familial breast cancer (FBC) occurred at a younger age, ranging from 23-74 years, with a median equal to 46.5 years compared to 35-76 years, with a median of 54.5 years, in non-familial cases. The aim of this work was to show how familial cancer registries can produce useful data, helping to develop a data base of familial cancer, for the primary care program to control the morbidity of breast cancer in females by identification of those with a positive family history of cancer who are at a high risk of developing breast cancer.

Adult↗

Life expectancy and cause of death in the Kuwaiti population 1987-2000.

Census and health data were analysed to determine changes in life expectancy at birth during 1987-2000 in the Kuwaiti population and to correlate these with cause-specific annual mortality rates. Life expectancy at birth rose from 73.3 to 75.5 years with a gap between females and males, which increased from 2.2 to 4.5 years. For all causes of death except hypertension and ill-defined conditions, males had higher mortality than females. The leading causes of death in males were ischaemic heart diseases, traffic accidents and cancer, while in females they were cancer, ischaemic heart diseases and hypertension. The problems of an ageing population will need to be considered in planning the health policies of Kuwait.

Accidents, Traffic↗