ABSTRACT
Egypt’s medical insurance is mainly covered by government and commercial insurance. The low coverage of commercial insurance and the quality of medical services needs more improvement in Egypt. Recently, the incidence rate of diabetes, chronic kidney disease, hypertensive heart disease, COPD and liver cancer is rising. Traditional Egyptian medicine is similar to Traditional Chinese Medicine (TCM), and its modern traditional medicine is mainly Arabian medicine. Acupuncture, as the main form of TCM, was introduced into Egypt in the 1970s, but it has not been covered by the medical insurance system. The development of TCM in Egypt needs improvement. It is suggested that further explorated fields should be focused on the acupuncture therapy, TCM education and TCM treatment of keeping health in Egypt.
ABSTRACT
Background: Pulmonary arterial hypertension is a newly recognized disease in patients with renal disease. In a recent review, the prevalence of PHT in ESRD patients was reported to be around 40-50%
Aim of the work: To evaluate the prevalence of primary pulmonary hypertension among CKD patients on and without dialysis and to compare clinical, hemodynamic, and metabolic variables among patients with and without PH to search for possible etiologic factors
Patients and methods: Our study included 99 CKD patients; 65 patients on hemodialysis, 12 on peritoneal dialysis and 22 on conservative management. Detailed medical history, examination, and complete laboratory investigations were obtained. Systolic PAP, EF% and cardiac output were evaluated by Doppler echocardiography and AVF flow by Doppler ultrasound
Results: A high prevalence of pulmonary hypertension was demonstrated among 27 patients [41.53%] receiving long-term hemodialysis with a mean systolic PAP of 49.33 +/- 9.18 mmHg; as well as in two patients [16.66%] receiving peritoneal dialysis 43 +/- 1.41 mmHg, and in five patients [[22.72%] receiving conservative management 44.8 +/- 5.89 mmHg
Conclusion: This study demonstrated a high prevalence of pulmonary hypertension among patients with CKD on and without dialysis. The prevalence was highest among patients with ESRD receiving long-term hemodialysis [41.53%] especially in patients with older age, longer duration of dialysis treatment, higher AV fistula flow, cardiac output
Subject(s)
Humans , Male , Female , Hypertension, Pulmonary , Prevalence , Renal Dialysis , Chronic DiseaseABSTRACT
In spite of different modifications to decrease pain after haemorrhoidectomy were applied such as lateral internal sphinectrotomy, closed haemorrhoidectomy, anal dilatation and sphincter relaxants, all of these techinques failed to decrease pain to gain universal acceptance [Seow- Choen, 2001]. Stapled haemorrhoidectomy dramatically decreases the postoperative pain and stay in hospital [longo, 1998]. The purpose of this article is to compare between different techniques of haemorrhoidectomy [open, closed and stapled] types