Thyroid dysfunction and thyroid autoantibodies in Egyptian patients with systemic lupus erythematosus [SLE]

Background: Systemic lupus erythematosus [SLE] is a systemic autoimmune disease with many clinical manifestations and immunological abnormalities. SLE and autoimmune thyroid disease are at the two endpoints of a shared immunogenetic mechanism

Aim of the study: To evaluate the link between SLE and thyroid disorders

Patients and Methods: Thirty patients known to have SLE were recruited in this study, with age ranged from 17 to 35 years. All patients were submitted to history taking, clinical examination, and relevant laboratory investigation

Results: Thyroid disorders were common [33.3%] in lupus patients. Hypothyroidism was the commonest [16.6%] abnormality in SLE patients then euthyroid [10.0%], and lastly hyperthyroidism [6.6%]. The mean age of SLE patients was 26.1 +/- 1.5 year. Eighty percent of the patients were females. The most common SLEcharacteristics were malar flush [90.0%], photosenstivity [80.0%], fever [70.0%], and arthritis [50.0%]. Mean Hb level was 9.2 +/- 0.59 g/dL. While, mean values of acute phase reactants were erythrocyte sedmentaion rate [ESR] at 1[st] and 2[nd] hour [74.3 +/- 6.6 and 121.4 +/- 5.26 mm/h, respectively] and C-reactive protein [20 +/- 6.7 mg/L]. The means of FT[3], FT[4], TSH, TG Ab, and anti thyroperoxidase [TPO] Abin SLE patients were 136.6 +/- 14.1 ng/dL, 8.83 +/- 1.2 ng/dL, 4.15 +/- 1.27ng/dL, 15.12 +/- 11.15ng/dL, and 121 +/- 65.4 IU/mL, respectively. Meanwhile, 30.0% and 76.7% of SLE patients were +ve for rheumatoid factor [RF] and antineuclearAb, respectively. There were 6.7% and 16.7% of the patients +ve for thyroglobulin Ab and anti TPO Ab, respectively. The statistically significant differences parameters in SLE patients with normal and abnormal thyroid function were ESR at 1 and 2 hours, RF, and antiTPO Ab [P=0.00, 0.00, 0.03, and 0.03, respectively]. The statistically significant differences parameters of demographic, clinical, and laboratory data in SLE patients with normal and subgroups of abnormal thyroid function were age, SLE duration, Hb level, RBC, WBC, PLT, and ESR at 1 and 2 hours [P=0.00, 0.00, 0.00, 0.001, 0.0001, 0.00, 0.00, and 0.00, respectively]

Conclusion and Recommendation: Thyroid disorders are common in SLE patients. The most common form is hypothyrodism. Patients with SLE should be evaluated for thyroid disorders by testing FT[3], FT[4], TSH, TG Ab, and anti PO Ab for early detection of thyroid abnormalities. Further studies are needed to support and clarify the association between SLE and thyroid disorders

Trends and determinants of contraceptive use among young [15-24 year] married women: a secondary analysis based on the 2008 and 2014 Egypt demographic and health surveys

Background: young females in Egypt still face a number of challenges regarding their reproductive health [RH] despite efforts to enhance it. Importance of young women?s reproductive choices arises from the concept that early childbearing can impair their health and their productive participation in community

Aim: the paper aimed to explore the key determinant of the contraceptive [CC] use amongst young married females in Egypt using the 2008 and 2014 Egypt Demographic and Health Survey [EDHS] with a comprehensive look at the CC use changes occurred in the study period 2008-2014

Subjects and Methods: data from the 2008 and 2014 EDHS were secondary analyzed. Variables were selected to assess their effect on CC use. Multivariable regression analyses were performed. Odds ratio was computed

Results: overall contraceptive prevalence [CP] decreased from 53.7% in 2008 to 51.2% in 2014. Traditional methods were responsible for this decrease. Younger age, being from rural Upper Egypt, husband desire for more children, no visit to health facility were the most important risk factors for not using any CC method among Egyptian young married females in 2008. Added to these factors; low women autonomy, no exposure to family planning message, in the poster and women justifying husband violence in 2014. However, region lost its significance as a determinant in 2014

Conclusions: our results discovered the determinants that modulate the CC use behavior among Egyptian young married females

Psychosocial impact and quality of life among adult Egyptian patients with psoriatic arthritis

Background: psoriatic arthritis [PsA] is a chronic, inflammatory, progressive joint disease. It has much psychosocial impact and affects quality of life [QOL] of the patients

Aim of the study: to determine the psychosocial impact of PsA on the patients and to define QOL of them

Patients and Methods: the study was conducted on 50 PsA patients, 68 psoriasis [Ps] patients, and 100 controls. A case-control, clinic-based study design was used in this research. An interviewing form and Middle Sex Hospital Questionnaire were used to survey the characteristics of the patients and controls. Severity of PsA was determined clinically. Also, the medical outcomes study 36-item short form [SF-36] was used to assess impact of the disease on the patient's QOL

Results: most [92.0%] of PsA patients had psychiatric symptoms. The disease had interfered with most of patients' personal feelings and relationships, daily activities, school/work, and leisure/sport. Majority [88.0%] of the patients had stigma feeling. Also, 40.0% and 60.0% of PsA patients had severe and mild forms, respectively. The differences between two forms of PsA regarding interference with school/work and presence of suicidal ideation were significant. The difference regarding presence of familial psychological stress was significant. The highly affected SF-36 domain scores were general health and physical limitation. The eight mean domain scores were significantly lower among PsA patients than controls. The mean domain scores of physical functioning, physical limitation, social functioning, emotional limitation, and mental health were significantly lower among patients with severe PsA than those with mild PsA. The eight mean domain scores were significantly lower among PsA patients than those with only Ps

Conclusions: the physical and psychosocial aspects of PsA may interact and influence one another. So, PsA has a great effect on the patients' QOL; disrupting physical and psychosocial aspects, and interfering with daily activities, school/work, and leisure/sport. QOL scores were significantly lower among PsA than only Ps patients

association between hypoalbuminemia and intradialytic hypotension in heamodialysis patients

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

Low birth weights: I- maternal risk factors a hospital- based study in Cairo city, Egypt

Low birth weight [LBW] is an important public health problem. The problem is prevalent world-wide and has negative impacts. So, its prevention is a major challenge. To determine maternal risk factors of LBW in Cairo city. A case-control, hospital-based, study design. Mothers of 270 LBW neonates were recruited in this study. A control group of mothers of an equal number of normal birth weight [NBW] neonates was chosen. The mothers of LBW and NBW neonates were interviewed using a specially designed questionnaire. All mothers had been subjected to full examinations. The neonates were weighted and examined after labor. Low education, unskilled occupation, and husband unavailability are significant sociodemographic risk factors of LBW; OR=1.75, 1.62, and 2.21, respectively. Mother's height [

Psoriasis and psoriatic arthritis: characteristics and risk factors among adult patients in Egypt

Psoriasis and psoriatic arthritis are common, chronic, immune mediated disease of the skin and joints. Interaction between genes and environment are important in disease causation. The aim of the present study was to determine the socioemographic and clinical characters of adult patients with psoriasis and those with psoriatic arthritis, to define psoriasis and psoriatic arthritis etiological risk factors, and to define the relationship between psoriasis severity and these items. This study was conducted at Dermatology Clinic, Al-Hussein University Hospital. A case-control study design was chosen to perform this research. The study was conducted on 100 adult patients with psoriasis and an equal number of free adults as controls. Criteria for diagnosis of psoriasis and psoriatic arthritis were used. A comprehensive questionnaire was used to survey the studied groups. Body surface area of the affected patients was used as a marker of disease severity. The study showed that 44.0% of the cases had psoriasis age of onset; 22-45 years. Stress was the most common etiological risk factor, 67.0%. While, the most important risk factors were family history of psoriasis, recurrent pharyngitis, smoking >/=20 cigarettes/ day and higher level of education, odds ratio [OR]=7.58, 5.94, 2.78 and 2.69, respectively. Also, 32.0% of the patients had psoriatic arthritis. Psoriatic arthritis comes after psoriasis and had mild severity in 65.6% and 68.7% of the cases, respectively. The most important etiological risk factors were severe psoriasis, smoking >/= 20 cigarettes/day and early onset of psoriasis, OR=9.64, 3.06 and 2.72, respectively. The epidemiology of psoriasis is not well defined in Egypt. The heredity and environmental factors are the most important risk factors. Also, psoriatic arthritis is an important associated disease. The fact that it has no cure has important implications for how it should be viewed, prevented and treated. We recommend that more research should be carried out to understand the true epidemiological features of the disease in Egypt and its impacts on quality of life of the patients

Invasive and noninvasive mechanical ventilation for acute exacerbations of chronic obstructive pulmonary disease: a comparative study

Acute exacerbation of chronic obstructive pulmonary disease [COPD] is a frequent cause of hospitalization and intensive care unit admission. Respiratory failure from airflow obstruction is a direct consequence of acute airway narrowing. It was to compare the efficacy of noninvasive mechanical ventilation [NIMV] against conventional mechanical ventilation [CMV] in patients with acute exacerbation of COPD. Forty patients with acute exacerbation of COPD were recruited in the present study. A comparative, hospital based study design was used. All the cases were examined; clinically and laboratory. The patients were divided into two groups each include 20 patients. Group A received NIMV in the form of continuous positive airway pressure [CPAP] and group B with CMV. There were statistically significant decreases in respiratory rate, heart rate and diastolic blood pressure after 6 hours of CPAP in comparison to baseline parameters in group A. While, there were statistically significant increases in PaO2 and SaO2 after 6 hours of CPAP in comparison to baseline parameters. In group B there were statistically significant decreases in respiratory rate, heart rate, systolic blood pressure and diastolic blood pressure after 6 hours of CMV in comparison to baseline parameters. While, there were statistically significant increases in pH, PaO2, and SaO2 and a statistically significant decrease in PaCO2 after 6 hours of CMV in comparison to baseline parameters. Further, comparison of respiratory rate and hemodynamic parameters in both groups showed statistically significant decreases in respiratory rate, heart rate, systolic blood pressure and diastolic blood pressure in group A in comparison to group B. Finally, failure rate was 35.0% in group A [NIMV] compared to 5.0% in group B [CMV] with statistically significant difference. Noninvasive mechanical ventilation is a safe and effective means of improving gas exchange in patients with acute exacerbations of CPPD. If patient not respond to NIMV, CMV should be used. Further studies are needed to evaluate the appropriate selection of patients and to find the best level and schedule of ventilation

Maternal serum calcium and trace elments; copper and zinc among pre-eclamptic women in Cairo, Egypt

Low levels of blood calcium [Ca] and trace elements are observed in patients with pre-eclampsia [PE]. Among these patients low serum Ca, copper [Cu] and zinc [Zn] may be one of the disease causes. The aim of this study was to find out the serum biochemical profile of these elements in the studied pre-eclamptic women. A case-control, hospital based study design was used. All the cases and controls were examined laboratory. Maternal mean serum Ca, Cu and Zn were lower among pre-eclamptic cases compared to normal pregnant controls with statistically significant differences [P= 0.000 for each of them]. Further, maternal mean serum Ca, Cu and Zn were lower among the severe PE cases compared to the mild cases with statistically significant differences [P-0.002, 0.000 and 0.000, respectively]. Also, these low elements; Ca, Cu and Zn were significantly correlated factors with severe PE [P=0.01, 0.03 and 0.01, respectively]. Early ante-natal care and treatment for pre-eclamptic women are recommended. Ca, Cu and Zn supplementation may be a cost effective method to prevent PE. Prospective population based studies are needed in different areas in Egypt and on large number of pregnant women to determine possible PE risk factors