Tishreen University Journal -Medical Sciences Series

Repairing an inguinal hernia under local anesthesia and sedation

jamal suleiman — 2024-11-10

introduction: Hernias are one of the most common conditions seen in inpatients and outpatients, but the exact incidence is still unknown, estimated at approximately 5% of the population during their lifetime. Inguinal hernias are the most common hernias seen in patients, accounting for about 75% of all hernias, and about two-thirds of them are of the indirect type. Inguinal hernia repair constitutes an important percentage of the total number of elective and emergency surgeries performed in hospitals around the world. Surgery is usually performed under general anesthesia, but it may be difficult or not possible in some cases, especially in elderly patients or those with comorbidities that raise the proportion of anesthetic complications, which precludes the possibility of the procedure.

The importance and purpose of the research: The possibility of performing inguinal hernia repair under local anesthesia and sedation when general anesthesia is not available or difficult to perform in patients who suffer from intubation difficulties or wish to perform surgery under local anesthesia due to their fear of general anesthesia.

Research method: A retrospective study was conducted that included 90 patients who attended the Department of General Surgery at Tishreen University Hospital between April 2022 and March 2023 with an inguinal hernia that needed surgical repair. The surgical procedure was performed under local anesthesia and sedation with ketofol (2 ml ketamine + 10 ml propofol).

Alpha amylase and angiotensin-converting enzyme-1 inhibitory effects of home-made pomegranate molasses

wesam zam — 2024-11-10

Pomegranate fruit and its products are rich sources of bioactive compounds, the most important of which are polyphenols. Pomegranate molasses is traditionally prepared in Syria and is considered to have a high nutritional value, which makes it of great importance. This study aims to evaluate the total polyphenols content and the antioxidant, anti-diabetic and anti-hypertensive properties in a number of home-made pomegranate molasses samples (10 samples). The average total content of polyphenols in the ten samples was 140.76±19.41 mg of gallic acid/g of sample. The samples also showed high antioxidant activity through the DDPH-scavenging activity assay, with IC50 values ranging between 0.05-0.13 mg/ml. As for anti-diabetic activity, the IC50 values for inhibiting the alpha-amylase enzyme for pomegranate molasses samples ranged between 0.83 and 3.67 mg/ml, which are values very close to the activity of the reference drug (acarbose). Finally, the rates of ACE inhibition for pomegranate molasses samples ranged between 32-41%, which indicates good antihypertensive effectiveness. As a result, it is recommended to use pomegranate molasses in the diets of diabetics and hypertensive patients in order to maintain blood sugar levels and blood pressure levels within their normal limits, through a synergistic mechanism and not an alternative to drug treatments.

Evaluation of the accuracy of 2D cephalometric analysis in the measurement of bucculingual incisors inclination

abdalkareem hasan — 2024-11-10

Aim: To study the accuracy of angular measurements of incisors in the sagittal plane when measured using lateral cephalometric radiographs and comparing them with measurements made on CBCT images.

Materials and Methods This study was designed as a retrospective radiographic study and the study sample included 30 CBCT images of patients with skeletal class I. Three-dimensional cephalometric analysis was used to measure the bucculingual inclination of the incisors from which lateral cephalometric radiographs were derived and the same measurements were repeated.

Results: There were no statistically significant differences in the bucculingual inclination values of the incisors measured using 2D analysis on derived cephalometric radiographs when compared with those measured using 3D cephalometric analysis on CBCT radiographs.

Conclusions: The study concluded that the accuracy of 2D cephalometric analysis and conventional cephalometric measurements derived from CBCT images were sufficient for measuring the bucculingual inclination of the incisors.

Preparation of a gel from rosemary extract and zinc oxide nanoparticles and determination of its antibacterial effectiveness for acne

Samer Housheh — 2024-11-10

Phytotherapy has been used over the centuries, and interest in it has increased recently. Rosemary extracts contain many active substances of various medical importance, including antibacterial activity. Additionally, zinc oxide nanoparticles have great antibacterial capabilities due to their small size, which can stimulate various mechanisms to eliminate germs. On the other hand, acne affects a large number of teenagers and adults, and both Propionibacterium acnes and Staphylocoocus aureus are among the most common bacterial strains affecting people with acne.

During this study, essential oils were extracted from rosemary leaves and analyzed using GC/MS. It was found that the essential oil of rosemary leaves contains a high content of triterpenoids, monoterpenoids, and phenolic diterpenes, including 32 compounds. Zinc oxide nanoparticles were also prepared chemically and their specifications were verified using a scanning electron microscope to confirm the formation of the nanoparticles. Essential oil and zinc oxide nanoparticles were used to prepare a gel that was uniform, easy to apply, and had a pH suitable for application on the skin. The bacteriological study confirmed the effectiveness of the gel in inhibiting the growth of both P. acnes and S. aureus, as the diameter of the inhibition zone was 17.32±0.92 mm and 23.56±0.67 mm for P. acnes spores and S. aureus spores, respectively. As a result, the prepared gel using the essential oil of rosemary leaves and zinc oxide nanoparticles can be considered an alternative natural formula to combat acne.

In vitro study of the anticoagulant efficacy of lemon verbena and lemongrass extracts

noma hasan — 2024-11-10

Aloysia citrodora or Lemon verbena is a plant rich in phenolic compounds, and exhibits lots of medical properties, such as antioxidant, antimicrobial, sedative, narcotic and anxiolytic properties. Andropogon citrates or Lemongrass is used as a traditional remedy in folk medicine to treat many diseases such as digestive disorders, cough, and others. It is known for its antioxidant, anti-inflammatory, antibacterial and antifungal effects, due to its content of phenolic compounds. The anticoagulant effect of the two mentioned plants has not yet been studied, although phenols have a known anticoagulant activity.

This study aimed to investigate the in vitro anticoagulant activity of aqueous extracts of Lemon verbena and Lemongrass by testing their effect on prothrombin time using plasma from healthy individuals and comparing the efficacy of both plants.

Aqueous extracts of the two plants were prepared and the total phenolic content TPC was determined. The TPC in lemon verbena extract was 10.825 g _GAE /L and 8.235 g _GAE /L in lemongrass extract. Different concentrations were prepared to investigate their effect on prothrombin time. The studied concentrations of lemon verbena showed a significant increase in prothrombin time compared to distilled water and the effect was concentration dependent. Also, the increasing concentrations of lemongrass showed an increase in PT but the difference was not significant at all studied points. The results indicate that the two extracts have anticoagulant activity in vitro due to their content of phenolic compounds with a superior effect of lemon verbena.

Determination of Acetaldehyde levels in some dairy products

dima aldyab — 2024-11-10

Acetaldehyde is naturally found in many foods such as dairy products and coffee. It is also used as a flavoring agent in milk products, sweets and juices including soft drinks. Acetaldehyde is classified as carcinogen to humans (group B2) additionally it affects yogurt flavor. Yogurt is a widely consumed milk product in the local market and it is one of the important exposure sources to acetaldehyde. Yogurt is obtained by fermenting milk using specific bacterial strains of lactic acid bacteria that metabolize lactose and turn it into many products such as acetaldehyde. This study aims to determine the levels of acetaldehyde in some yogurt samples using the titration method. Acetaldehyde was not detected in samples of cow milk, both full fat or low fat. The amount of acetaldehyde in cow milk ranged between 1.34 and 41.26 mg/kg, in (Ayran) samples it ranged between 5.32 and 11.2 mg/kg, while (Labneh) samples contained 2.57 to 5.5 mg/kg, and finally sheep milk samples contained between 20.81and 40.53 mg/kg. The storage of Yogurt for a week resulted in a gradual decrease of acetaldehyde.

Aortic Root Replacement with conservation of the Aortic Valve using the Technique of Aortic Root Reimplantation in Large Aneuryms And High Grade Aortic Regurgitation

mudar abdullatif — 2024-11-10

Aortic root reimplantation is an ideal choice in the treatment of aortic root aneurysms with or without aortic regurgitation. However, some surgeons may consider large aneurysms as a contraindication to this procedure referring to the technical complexity and the possible need to additional interventions to repair the regurgitating valve

In this article we represent a clinical case of a patient with severe dilatation of the aortic root reaching 72 mm, and severe aortic regurgitation, where we performed a conservative procedure using the technique of reimplantation as described by Tirone David; with an excellent outcome following the patient for one year with regression of the AR and amelioration of the patient’s clinical classification from NYHA IV to NYHA I

Management of acute Arterial ischemia of the upper extremity experience in Tishreen university hospital in latakia (2022-2024)

souliman ali — 2024-11-10

Acute arterial ischemia of the upper extremity is an emergency condition during which the patient must be quickly transferred to the hospital and urgent consultation from a vascular surgeon is required, due to the seriousness of complications that may lead to death.

It is considered one of the most common and dangerous emergency cases in vascular surgery, as this disease is a group of serious complications resulting from the sudden interruption of blood flow due to an obstruction in one of the arteries (the cause is often an embolism emanating from the heart).

In the cause of emboli originating from the heart, 60% of them are usually directed to the brain, and of the remaining 40%, 80% of them go to the lower extremities, about 15% of them go to the upper extremities, and the rest goes to other destinations.

Our study included 22 patients who visited the ambulance at Tishreen university hospital in Latakia between 01.01.2022 and 01.01.2024 with a complaint of acute arterial ischemia in the upper extremity. Our study dealt with the causes and management and was compared with international studies.

In our study, we did not address acute traumatic obstruction resulting from accidents or errors medical or small thrombotic conditions in the fingers caused by peripheral vascular diseases.

Evaluation of Diabetic Child’s Mother Stressors

Abtesam Jbyly — 2024-11-10

Today, psychological stress is considered one of the most widespread psychological and social phenomena in societies. Therefore, the moment in which a child’s illness is discovered in the family is a decisive stage that leads to a radical change for the family in general and for the mother in particular. However, regardless of the information available about diabetes, she must experience some surprise, fear, disbelief, sadness, anger, and guilt, and this Which leads to being in psychologically stressful situations. Therefore, the study aimed to identify her level of psychological stress, using the psychological stress perception index regarding the quality of life and strategies for dealing with psychological stress for the mother of a child with diabetes. The study population included all mothers of children with type 1 diabetes using the descriptive approach. A non-random, purposive sample was selected from mothers who accompanied their children during visits to the Diabetes Center of the Health Directorate in Lattakia. Their number reached 25 during the data collection period. The results of our study showed that mothers of children have an average level of not feeling comfortable, unable to do the things they love, do not feel as calm as they should, are not full of vitality, do not feel protected and safe, do not enjoy themselves with what they want, and are not a free person. Of worries. Our study also showed that mothers have a high level of psychological stress due to fear for their children about the future. Our study did not show any statistically significant differences in the level of stress according to the variable of age and work, with there being differences attributed to the variable of educational level in favor of university women who had a lower level of psychological stress.

Comparative study of Molar Distalization with Coil Spring Anchored by Mini Implants and Carrier Device in Patients of Class II Malocclusion

Mohammad Ammar Baroudi — 2024-11-10

The Aim: The aim of the current study was to compare Overbite and Overjet variables between a group of Springs Anchored by mini implants, a group of Carrier appliance, and a group of Distal jet appliance in patients with Class II malocclusion.

Materials and Methods: 51 patients aged 12-14 with Class II malocclusion were selected for the current study. They were randomly divided into three groups of 17 patients each. The first group received Springs anchored by mini implants, the second group received Carrier appliances from the upper canine to the first upper molar on both sides, and the third group received Distal jet appliances. Overbite and Overjet were evaluated in all three groups from the start of orthodontic treatment until completion of correction and achieving a Class I relationship.

Results: The mean value of Overbite between the groups G1 (Springs), G2 (Carrier), and G3 (Distal jet) was 2.50, with the mean value in group G2 being 0.03, without a significant difference compared to group G1, while for group G3 it was -1.42, with a significant difference. The mean value of Overjet in group G2 was 0.25 compared to group G1, without a significant difference, and 0.75 compared to group G3, with a significant difference.
Conclusions: Treatment with the Carrier appliance resulted in values Overbite and Overjet close to those of the group Springs anchored by mini implants, while the lack of Overbite and Overjet in the Distal jet group was greater than in groups G1 and G2.

Effect of physical rehabilitation on insomnia among cancer patients undergoing chemotherapy

laila assaf — 2024-11-10

Insomnia is widely spread among cancer patients undergoing chemotherapy, which may exacerbate their pre-existing health issues. The study sheds light on the role of physical therapy programs in managing insomnia. The current quasi-experimental study aimed to determine the impact of physical rehabilitation on insomnia of cancer patients undergoing chemotherapy. The study included 60 patients at the chemotherapy and radiation treatment center at Tishreen University Hospital in Latakia. They were selected using appropriate sampling methods and non-randomly divided into two groups: an experimental group of 30 patients receiving physical rehabilitation and a control group of 30 patients following the hospital's routine care. Data was collected using the Athena Insomnia Scale AIS. The study found that the majority of cancer patients undergoing chemotherapy suffer from moderate to severe levels of insomnia. Physical therapy was shown to effectively alleviate their insomnia levels. The study recommended including insomnia assessment as a routine part of the nursing care plan for cancer patients, along with implementing the physical therapy outlined in this study to reduce insomnia in chemotherapy-treated cancer patients.

Evaluation of the Effect of Treatment with Clear Aligners Orthodontic Appliances on The health of Periodontal Tissues

osamah almashaal — 2024-11-10

Background &Aims :This study aims to evaluate the effect of treatment with clear aligners orthodontic appliances the health of periodontal tissues and bacterial plaque accumulation.

Materials and methods: the study sample consisted of 15 patients with class 1 type1 malocclusion and moderate crowding .Plaque index (PI) Gingival Index (GI) were evaluated at 4-time points: Before treatment (T0), 1 month later (T1),3 month later(T2),6 month later(T3).

Results: there was increase of gingival after 1 month of treatment in comparison with T0 (P=0.000).Plaque index degree also increased at all periods of assessment and peaked on the first month following appliance placement (P=0.000),while after 6 month there were no significant differences in comparison with (P=0.905)

Conclusions: These results suggest that using Clear aligners orthodontic appliances is associated with increase gingival during the first month of treatment because of the attachments ,and caused a moderate to mild increase in plaque accumulation during treatment

The Reality of Practicing Transformational Leadership Methods Among Leaders in the Management of Physical Preparation and Sports in Syria

Zainab Alshamaq — 2024-11-10

This study aims to know the reality of practicing transformational leadership methods among leaders in the Physical Preparation and Sports Department in Syria. To achieve the study objectives, the descriptive approach was adopted by distributing a research questionnaire to an appropriate sample of leaders and workers in the Physical Preparation and Sports Department in Syria, numbering (181) individuals, (157) questionnaires were retrieved, of which valid for analysis, with a recovery rate of (86.7%). In light of this, data was collected and analyzed and hypotheses tested using SPSS statistical package for social sciences. The study reached a number of results, the most important of which are: There is a high level of application of the transformational leadership style by leaders in the Department of Physical Preparation and Sports in Syria, and social communication among the respondents. The results of the study also showed that there is a high level of application of all dimensions of transformational leadership in the organization under study, as the features of idealized influence were the most evident among the dimensions of transformational leadership, followed by empowerment, then motivation and intellectual stimulation at the same level, and finally individualized consideration.

The study concluded with a set of recommendations, the most important of which is strengthening the leadership skills of administrative leaders in the physical preparation and sports Department , and focusing on transformational leadership that contributes to enhancing positive behaviors of employees and raising their performance.

Evaluation Of The Role Of CT Scan In The Investigation Of Lymph Node Enlargement In Cervical Cancer Patients

Mohammad Mohammad — 2024-11-10

Objective: to assess the sensitivity and quality of preoperative CTscan in determining the presence of enlarged lymph nodes in patients with cervical cancer.

Methods: the study included data of 43 patientsdiagnosed with cervical cancer, CTscan was performed before surgery for all patients after histologically determining the type of cancer.

Results: the age of the patients ranged from28-75 years, the majority of them were smokers and multiple birth , squamous cell cancer was the most common histological type in the affected women. The sensitivity, specificity, and both the positive and negative predictive value of CTscan were high.

Conclusion: preoperative CT scan is an accurate diagnostic method for determining the presence of enlarged lymph nodes in cervical cancer patients, especially in poor countries and resource-limited communities, which helps in choosing the right treatment.

A study to evaluate the condition of the periodontal tissues around titanium implants supporting zirconia restorations compared with zirconia restorations with a PEEK base on the opposite side after functional loading

Batool suliman — 2024-11-10

This study aims to compare the gingival response around titanium implants supporting zirconium restorations on the one hand and to compare it with zirconium restorations with a polyetheretherketone base manufactured by CAD/CAM on the other hand after one year of functional loading. The research sample consisted of 30 titanium implants distributed among 15 patients with a single posterior tooth loss on each side according to the type of abutment: the posterior loss was compensated by a single titanium implant on each side of the same jaw and after complete healing, i.e. after about three months from surgery, titanium abutments were used in each patient and replaced with zirconium crowns manufactured by CAD/CAM on the one hand and zirconium crowns with a PEEK base manufactured by CAD/CAM on the other hand. Clinical examinations were conducted on the patients during the observation period (4-8-12) months of functional loading. The soft tissue condition around the implants was examined by recording the values of the following periodontal indices: modified plaque index, modified bleeding index, and modified probing depth index.

The results showed that the effect of the type of abutment used on the mean gingival bleeding index at probing was not statistically significant, especially after eight or twelve months, and the type of abutment did not show a significant association with the mean probing depth, while the mean plaque index values showed a significant association with the mean probing bleeding.

The gingival reactions around zirconium restorations with a PEEK base manufactured by CAD/CAM were almost similar to the gingival reactions around conventional zirconium restorations during the one-year follow-up period.

A Laboratory Study of Blood Fibrinogen in Patients with Laryngeal Cancer Before and After Surgery

Moayad Kheirbek — 2024-11-10

Laryngeal cancer accounts for 2% of all diagnosed cancers, with approximately 151,000 new cases occurring annually. The aim of this research was to study the laboratory parameters of fibrinogen by investigating the difference in fibrinogen values in patients before and after surgery, and then comparing these values with a control group. The study included all patients diagnosed with laryngeal cancer who visited the Department of Otolaryngology and Head and Neck Surgery at Tishreen University Hospital in Latakia, and who underwent surgery for this tumor, after obtaining informed consent. A prospective study was conducted, and the number of patients was 30. A special research form was prepared for the patients.
The results of the study showed that fibrinogen levels in patients with laryngeal cancer increase after surgery compared to their levels before surgery. There was a statistically significant difference in fibrinogen levels in patients with laryngeal cancer before and after surgery compared to the control group.
The study recommends further studies to understand the mechanisms of change in fibrinogen levels after surgery. These studies may include: Analyzing the interactions between surgery, inflammation, and coagulation. Evaluating the effect of different factors on fibrinogen levels, such as cancer stage, type of treatment, and the presence of surgical complications on fibrinogen levels and patient outcomes.

Study of the AGT M235T polymorphism as a potential genetic marker for the development of cardiac complications in hypertensive patients

Mais yousif — 2024-11-10

Background: Cardiovascular diseases caused by hypertension constitute a major burden on the health care system around the world, and efforts have recently focused on searching for the genetic factors that cause them. The M235T polymorphism of the angiotensinogen gene (AGT) has received much attention due to its association with hypertension and cardiac damage in many countries. Therefore, we aimed in this study to investigate the prevalence and importance of this polymorphism in the development of heart disease in a segment of Syrian hypertensive patients.

Materials and methods: This study included 40 participants of both sexes (25 of hypertensive patients with a cardiac complications and 15 healthy controls). Data were collected and the safety of the participants’ cardiovascular system was examined. DNA was extracted from blood samples using the column method. The genotyping of AGT M235T polymorphism based on PCR-RFLP. STATA was used for the statistical study.

Results: After amplifying the required sequence of the AGT gene using PCR technology, we obtained a single fragment with a length of 98 bp, and after digestion using the restriction enzyme BstFNI (RFLP technology), the genotypes of the AGT M235T polymorphism were distinguished based on the length of the fragments formed as follows: MM (98 bp) , TT (77 bp), MT (98 bp and 77 bp), and the frequencies of the genotypes (TT, MT, MM) were respectively in the patient group (56%, 32%, 12%), and in the controls group (20%, 13.33%, 66.6%), and the frequency of the TT genotype in patients was five times higher than in controls, with significant statistical significance, and the frequency of the T allele in the patient group was higher than in the controls.

Conclusion: The presence of the M235T polymorphism was associated with cardiac complications in patients with hypertension, and the TT genotype was the most frequent in these patients, and it can be considered as a potential genetic marker for the development of cardiovascular diseases in them.

Genetic detection of mecA and mecC genes in MRSA among nasal carries from the medical staff at Tishreen University Hospital, Lattakia.

Lama Doya — 2024-11-10

Introduction: Staphylococcus aureus has emerged as one of the most important human pathogens and has been leading cause of hospital- and community-acquired infections. MRSA strains pose a major threat to hospital patients because these bacteria may be transmitted by asymptomatic carriers of medical staff working in the hospital. MRSA carrying mecA gene is resistant to most beta-lactam antibiotics. In 2007, a new strain of Staphylococcus aureus containing a gene similar to mecA( mecC) was found in England, leading to diagnostic problems. Accurate and rapid detection of MRSA among health personnel is necessary for prevention and determining effective treatment.Objective: To detect the mecA and mecC genes among methicillin-resistant isolates of Staphylococcus aureus taken from the nasal carriers of medical staff working in the intensive care unit at Tishreen University Hospital to determine prevalence of MRSA in our hospital and limit it to reduce the material and moral burden of infection borne by health authorities and patients.Research materials and methods: A cross-sectional descriptive study was conducted in the microbiology laboratory at Tishreen University Hospital - Latakia - Syria and the laboratory of Department of Molecular Biology and Biotechnology at the Syrian Atomic Energy Commission - Damascus. 60 nasal swabs were collected from health personnel working in the intensive care unit at Tishreen Hospital. University. Characterization of bacterial strains for detection of Staphylococcus aureus and detection of MRSA was performed using Cefoxitin by disk diffusion method. The presence of mecA gene and the absence of mecC was confirmed by performing a mutiplexPCR assay Results: Among 60 nasal swabs taken from health staff working in the intensive care unit at Tishreen University Hospital, there were 24 samples diagnosed as Staphylococcus aureus (40%), and among them there were 20 samples MRSA (83.3%) based on resistance to cefoxitin. 20 mecA positive MRSA samples were 100%, while all samples were mecC negative.

Prevalence and Asscociated Factors of Ovarian Cyst Malignancy: A Cros-sectional Based Study in TSHRIEN UNIVERSITY HOSPITAL in LATAKIA

Nehad Salloum — 2024-11-10

Ovarian cyst is the sac-like formation filled with brownish fluid and sebum in the ovarium.

Most ovarian cysts are benign, and the potential to develop malignancy is only 2%. The malignant cyst is considered as cancer type. This study aimed to analyze the prevalence and associated factors of ovarian cyst malignancy. Methods: This crossectional based study used252 samples of women with an ovarian cyst in TSHIREN UNIVERSITY HOSPITAL . The detection of ovarian cyst is conducted by ultrasound and histopathological examination to

determine the level of malignancy. Results: From 252 cases, there were9 cases of ovarian cyst malignancy (3.6%). There was a significant difference in the level of malignancy based on age (p= 0.000). The ovarian cyst in patients over 50 years old was more likely to develop into a malignant cyst. The majority of ovarian cysts subtype were bilateral cyst and endometriosis cysts, consist of 93 patients (36.9%) and 66 patient (26.2%) respectively. Analysis for the cyst location, majority of ovarian cysts was located bilaterally consist of 141 patients (56.0%). All patients with malignant cyst were not experience bleeding. There were no significant differences on category of cyst (p= 0,674), location of cyst (p= 0.294) and the presence of bleeding (p= 0.541) . Conclusion: The prevalence rate of

ovarian cyst malignancy was 3.6% with age as a significantly associated factor

Evaluation of total cholesterol levels and neutrophils to lymphocytes ratio (NLR) in breast cancer patients and their relationship with tumor development

Razan Hasan — 2024-11-10

Objective: Breast cancer is considered one of the most prevalent cancers among women worldwide with increasing number of new cases diagnosed globally. There are many factors can affect tumor development ; therefore, it is useful to study some of these factors especially the simple and affordable ones ,such as neutrophils to lymphocytes ratio (NLR) and total serum cholesterol, in order to use them as indicators for breast cancer progression.

Methods: our study included 151 participants divided into two groups: 101 newly diagnosed breast cancer patients and 50 healthy controls. Complete blood count(CBC) was conducted using auto hematology analyser Urit5160, while serum levels of total cholesterol were measured according to enzymatic method using Mindray analyser.

Results: White blood cells( WBCs), neutrophils, NLR and serum levels of total cholesterol were significantly higher in breast cancer patients than controls. There was significant satistically correlation between NLR and tumor pathological characteristics(tumor size and lymph node metastasis).Also, there was significant correlation between total cholesterol and tumor size, lymph node metastasis and tumor grade. There was also correlation between elevated serum levels of total cholesterol and elevated NLR in patients group.

Conclusions: Elevated serum cholesterol and NLR may be useful indicators for breast cancer progression and tumor aggressiveness.

Respiratory Distress Progress in Neonates Admitted to Neonatal Intensive Care Unit of Tishreen University Hospital

rand slaiman — 2024-11-10

Background: Respiratory distress is one of the most common causes of admission in neonatal intensive care units, it has multiple morbidities and depletes human and medical resources and it is an important cause of mortality and long term sequelea.

Objective: Studying clinical progress of respiratory distress in neonates in neonatal intensive care unit in Tishreen university hospital.

Materials and Methods: An analytic prospective study, we studied clinical progress of all neonates admitted with respiratory distress when admitted or happened during hospitalisation in neonatal intensive care unit in Tishreen university hospital between June 2022 and June 2023.

We categorized the neonates by number of distress days, number of admission days, we studied the final diagnosis and the maternal history, we studied the complications and the final prognosis. We studied the relation between complications and final diagnosis and with prognosis.

We used IBM SPSS Statistics (Version 25) program to do

Statistics and analysis of results.

Results: The study included 268 neonates admitted to neonatal intensive care unit in Tishreen university hospital, respiratory distress prevalance was 45.7%, the most common cause of respiratory distress was neonatal sepsis 44%, complications occurred 34.2%, mortality rate was 22.4%.

Conclusion: Respiratory distress is an important cause of admission in neonatal intensive care unit and an important cause of complications and mortality so we have to study the clinical progress to limit morbidity and mortality.

Role of superdisintegrants in enhancing dissolution rate of valsartan

Narjess Baabaa — 2024-11-10

Drug solubility and dissolution rate vitally affects its oral bioavailability. Unfortunately, most marketed drugs exhibit low solubility. Valsartan, an angiotensin II receptor blocker, and one of the most effective and commonly used anti-hypertension agents, suffers from low solubility and dissolution rate, and therefore low oral bioavailability. As such, enhancing its dissolution rate could prove very beneficial for the management of hypertension. This study made use of the superdisintegrants crospovidone and croscarmellose, which exhibit ameliorating properties such as wicking and swelling, in order to enhance the disintegration profile of valsartan capsule formulations, and in turn improve its dissolution rate. Seven formulations were prepared and subjected to various quality assessment tests, concluding with an in-vitro dissolution test to identify the optimal formulations.

A clinical study of the relationship between Triglyceride/Glucose index (TyG index) and Glycated hemoglobin(HbA1c )in patients with Diabetes Mellitus Type 2

Hadeel Nasser — 2024-11-10

Introduction: Diabetes Mellitus is a global health issue due to the huge number of patients worldwide and its devastating complications. ADA recommended achieving a good glycemic control to avoid that by reaching HbA1c ˂ 7%. Insulin resistance is one of the pathophysiology of T2DM many ways have been used to evaluate it including HOMA-IR & HEC and lately TYG index.

Materials and Methods: a total of 83 patients T2DM were included in this prospective cross sectional study and divided into 3 groups according to their HbA1c, a group with good control diabetes HbA1c˂7%, a group of intermediate control HbA1c 7-9% ,a group of bad control HbA1c˃ 9%. Anthropometric and biochemical parameters were measured, TYG index was calculated using formula TYG index = ln [fasting glucose(mg/dl) ͯ fasting triglyceride(mg/dl)] / 2

Results: fasting blood glucose and fasting triglyceride and HDL were higher in patients with HbA1c˃7%, TYG index correlates with HbA1c also TYG-BMI & TYG-WC, the receiver area under curve analyze ROC showed TYG index had a maximum area under curve of 0.852 with a cut-off value 4.9 for identifying glycemic control in T2DM sensitivity 85.5% and specificity 63.2%.

Conclusion: TYG index is a useful tool for assessing glycemic control in T2DM and positively correlate with HbA1c, it can be used as a simple, available, and inexpensive alternative to asses glycemic control in T2DM.

Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia

Marah Ali — 2024-11-13

Objective: To identify antecedent risk factors for predicting vocal cord leukoplakia recurrence and malignant transformation.
Materials and methods:

The sample included 58 patients attending the Ear, Nose, and Throat Surgery Clinic at Tishreen University Hospital during the time period 2022-2023 with white lesions on the vocal cord and who met the inclusion criteria in the research. Their ages ranged from 35 to 77 years, with an average of 64.27 ± 6.8 years. All patients participating in the study were interviewed and the following information was recorded for each patient: name; Age, gender, habits and instincts (smoker, alcoholic); Then he took a comprehensive medical history from the patients, A comprehensive clinical examination of the head and neck was performed and the larynx was carefully examined with a laryngoscope. The morphological features of the lesion and its extension on the vocal cord were recorded. An initial clinical diagnosis was made. Then a tissue biopsy of the white lesion on the vocal cord was performed and sent to the pathological autopsy. After the results appeared, appropriate treatment), patients were monitored for 18 months, during which factors leading to leukoplakia recurrence and transformation into malignancy were identified.

Results:The study showed that the smoking and the degree of dysplasia and the extent of the lesion extending over the vocal cord have a significant statistical significance in the recurrence of vocal cord leukoplakia and its transformation into malignancy.
Conclusions:The patient should be informed of the possibility of leukoplakia reoccurring and becoming malignant if the patient is a smoker, and/or has vocal cord leukoplakia with a lesion of more than half of the vocal cord and/or moderate or severe dysplasia on histological biopsy result.

Prevalence of Prediabetes and Undiagnosed Diabetes Mellitus among Medical Staff in Tishreen University Hospital

nora khalil — 2024-11-13

Background : Pre-diabetes is a real warning sign of developing diabetes. The basic strategy to avoid the transition from pre-diabetes to type 2 diabetes lies in early detection of pre-diabetes to reduce the prevalence of diabetes and its huge economic burden

Aim: The aim of this study was to determine the prevalence of pre-diabetes and undiagnosed diabetes among medical staff working at Tishreen University Hospital.

Methods: A hospital-based cross-sectional study including 450 participants (230 female and 220 male), age 24 - 65 years surveyed.

Type 2 diabetes and pre-diabetes were diagnosed by glycated hemoglobin A1c (HbA1c) levels(diabetes: HbA1c ≥6.5%; pre-diabetes: HbA1c ≥ 5.7% to <6.5%).

Results and discussion: The results indicated that a vast majority of the evaluated healthcare personnel (360 people; 80%) had normal glycated hemoglobin levels. The remainder of the study group showed carbohydrate metabolism disturbances. Pre-diabetes was found in 85 people (18.9%) suggested an increased risk for diabetes. As a result of the study 5 people (1.1%) were diagnosed with diabetes (initial diagnosis).

Conclusion: Screening of health care workers especially doctors having high risk of getting type 2 diabetes is reliable,effective and appropriate enough to be included in every hospital.

Comparison of antiurolithic effect of some medicinal plants (Paronychia argentea and Adiantum capillus veneris) with locally marketed herbal medicines

Sara Zaher — 2024-11-13

Urolithiasis is a polygenic disorder with complex etiology and complicated treatment outcomes. Adiantum capillus veneris and Paronychia argentea are widely spread crops with traditional claims for its antiurolithiatic potential. The present study was an attempt to investigate the antilithic potential of aqueous extract of Adiantum capillus veneris and Paronychia argentea and locally marketed medication against calcium oxalate (CaOx) urolithiasis by employing in vitro methods. Nucleation, growth and aggregation assay of CaOx crystallization were used. In the Nucleation and aggregation stage, the aqueous extract of Adiantum capillus veneris showed the highest inhibition, followed by the medication extract, then the extract of Paronychia argentea. During the growth phase, the aqueous extract of medication demonstrated the highest inhibition, followed by the Adiantum capillus veneris extract, then the Paronychia argentea extract. Aqueous extract of Adiantum capillus veneris and Paronychia argentea possess significant antiurolithiatic activity against CaOx urolithiasis in vitro which could be attributed to its active components like saponins, tannins, flavonoids and phenolic content.

Investigating the relationship between serum magnesium levels and the degree of tumor in breast cancer patients

reem hammodey — 2024-11-13

Background: Breast cancer is a deadly disease caused by the accumulation of mutations that lead to the uncontrolled growth of cells in breast tissue ,the relationship between magnesium and cancer formation is intricate ,some researches have shown that an imbalance in magnesium levels is often found in tumor cells ,and both magnesium deficiency and supplementation can impact the development of tumors.

Numerous studies have explored the effect of magnesium deficiency on tumor incidence and the progression of existing tumors.

Aim: To determine serum levels of magnesium in newly diagnosed female breast cancer patients and to assess their association with some prognostic factors in breast cancer pateints.

Design and methods: This study is done on 79 newly diagnosed female breast cancer patients and 29 age matched apparently healthy female volunteers as controls. Serum samples from all patients and controls were subjected to magnesium measurement

Results: In the breast cancer group, the median serum levels of magnesium were1.99 mg/dl , while it was 2.48 mg/dl in the control group. Deficient Mg levels were detected in 26/79 (33%) of the breast cancer patients and 0/29 (0%) of the control group. the tumor characteristics of the breast cancer patients (histology, grade, stage, and receptor status) did not show any significant associations with serum levels of magnesium

Conclusion: deficient levels of magnesium might contribute to the development of cancer. Further studies with larger number of patient are needed.

Studying predisposing factors for urinary tract infection incidence after lower urinary endoscopy .

Tayseer Alsamsam — 2024-11-13

Introduction: Cystoscopy is a fundamental procedure in the diagnosis and management of a wide range of urinary tract diseases. It involves the use of instruments through the urethra, which is considered the most common route for urinary tract infections.

Aim: To study the risk factors that contribute to the incidene of infection after performing cystoscopy, in order to reduce them.

Materials and Methods: This was a prospectiveanalytic cohort study involved 150 patients who underwent lower urinary endoscopy for various indications at Tishreen University Hospital- Lattakia-Syria during the period between May 2023 and May 2024. Patients were divided into two groups according to the occurrence of urinary tract infection after procedure: group 1 with urinary tract infection (12 patients), and group 2 without infection(138 patients), in which demographic and endoscopic characteristics were compared between groups.

Results: A total of 150 patients, 98 males (65.3%) and 52 females (34.7%) with a mean age of 59.87±17.6 years were included in the study.There were no significant differences between two groups regarding of gender, smoking, hypertension, number of endoscopic procedures, indication of procedure and endoscopic findings(p>0.05). Urinary tract infection was significantly more frequent in age group older than 50 years(75% versus 25% in other groups,p:0.04), presence of diabetes mellitus(41.7% versus 20.3%,p:0.002), cystoscope Storz Fr 20( 66.7% versus 33.3% in Fr 17,p:0.02), duration of procedure longer than 5 minutes(83.3% versus 16.7%,p:0.0001), hospitalization cases(58.3% versus 41.7%,p:0.0001) and presence of urinary catheter(66.7% versus 33.3%,p:0.0001). Diabetes mellitus(OR: 2.3[1.1-8.4], p:0.001), presence of urinary catheter (OR: 5.8[1.4-11.8], p:0.0001) and longer duration of procedure(OR: 3.3[1.7-12.4], p:0.007) represented an independent risk factors for development of urinary infection.

Conclusion: : The current study demonstrated the importance of presence high index of suspicion for urinary tract infection after lower urinary endoscopy especially in presence of risk factors for early diagnosis and treatment to improve final outcome of patients.

Study effectiveness of tamsulosin in the management of lower third ureteral stones with size 1cm or less

Magdi Awkan — 2024-11-13

Background: Ureteral stones are a common problem in daily emergency department practice, and medical therapy may be offered to facilitate stone expulsion in patients with distal ureteral calculi.

Aim: The purpose of this study was to evaluate the effectiveness of tamsulosin in management of lower ureteric stones with size 1 cm or less.

Materials and Methods: This was an analytical comparative study (prospective) included 142 patients with stones in the lower third of ureter at Tishreen University Hospital- Lattakia-Syria during one year period (2023- 2024). Patients were divided into two groups according to the method of management: group 1 included 71 patients who received treatment with tamsulosin and group 2 included 71 patients who didn't receive any therapy, in which final outcome were compared between two groups.

Results: A total of 142 patients, 101 males (71.1%) and 41 females (28.9%) with a mean age of 37.66±14.6 years were included in the study. The stones were solitary in in 95.8%, multiple in 4.2% with stone sizes less than 5 mm in 63 cases(44.4%). There were no significant differences between two groups regarding of age(p:0.6), sex(p:0.3), number of stones(p:0.6), and its size(p:0.2). The success rate of stone expulsion was higher in tamsulosin group but without significant difference(87.3% versus 78.9%,p:.0.09). There were no significant correlation between size of stones and the rate of success in the two groups(p:0.07). In addition to, mean duration of stones passage was significantly shorter in tamsulosin group(7.66±2.4 days versus 10.6±3.3 in placebo,p:0.01).

Conclusion: The current study demonstrated that tamsulosin provides better stone expulsion in the cases of distal ureterolithiasis without significant difference compared with placebo, but with minimum amount of time.

Syndrome Of Inappropriate Antidiuretic Hormone Secretion (SIADH) In Inflammatory Diseases And Its Effect On Heart

wiaam sahyouni — 2024-11-13

Although Hyponatremia is a well-known complication of many inflammatory diseases, However, the pathophysiology in this context remained poorly understood until recently. There is now considerable evidence indicating the important role played by inflammatory cytokines, especially IL-6, in the non-osmolar secretion of Vasopressin, which is the primary cause of syndromic formation during systemic inflammatory diseases. The seriousness of serum sodium deficiency occurring in the context of SIADH is not limited to its neurological symptoms, but also to its effects on cardiac action potential and conductive pathways in the heart

Prevalence and Progression of Newly Diagnosed Diabetes Mellitus in COVID-19 patients at Tishreen University Hospital

Doaa Fayood — 2024-11-13

Background: During the follow-up of Covid-19 patients during the Corona pandemic, an increase in the numbers of people with newly diagnosed diabetes mellitus (NDDM) and its severe course was observed in a number of patients. It was assumed that there is a relationship between infection with Covid-19 and development of diabetes in those not previously known to have diabetes. It was suggested that they should be followed up to understand the course of diabetes following Covid-19 infection

Objectives: Study the incidence of newly discovered diabetes among Covid-19 patients. Then study the development and progression of the disease by following them for 3 months after diagnosis. And the study of the prognostic factors that accompanied the newly discovered diabetes.

Materials and Methods: A prospective cohort study conducted in the isolation department of Tishreen University Hospital in Latakia between May 2022 and May 2023. The study included 209 COVID-19 patients diagnosed with a positive PCR and not previously known to have diabetes. Glycated hemoglobin was measured on those who developed hyperglycemia in order to study the prevalence of newly diagnosed diabetes in the study group.

Results: The incidence of newly diagnosed post-COVID-19 diabetes was (16.3%), while the incidence of new-onset post-COVID-19 diabetes was (11.5%). The recovery rate after a 3-month follow-up in patients with new-onset diabetes was (27.3%). Mean BMI was higher in the NDDM group compared to non-diabetics. The lymphocyte count and WBC were lower with a statistically significant difference in the NDDM group compared to the non-diabetic group. The severity of infection on chest CT, body mass index, family history, need for oxygen, and duration of hospitalization were higher in patients with new-onset diabetes who have continued on the treatment of diabetes.

Conclusions: COVID-19 infection can cause new-onset diabetes mellitus and ketoacidosis in some cases and without a history of diabetes. Upon follow-up for three months, one-third of the cases recoverd without the need for treatment. Mean body mass index, the severity of the infecton on chest CT scan, and decreased lymphocyte count were an important prognostic factor in the development of new-onset diabetes.

Effectiveness evaluation of using posterior tonsillar pillars in management of velopharyngeal insufficiency in cleft palate patients (Clinical study)

Jafar Hamdy — 2024-11-13

Aim:

This study was designed to examine the efficacy of utilizing the Posterior tonsillar pillar in management of velopharyngeal insufficiency symptoms.

Material and methods:

The research sample consisted of 10 patients who had an operation to correct velopharyngeal insufficiency using the posterior tonsillar pillar. The study variables were the improvement of patient intelligibility speech, the elimination of snoring and nasopharyngeal regurgitation, the patient’s satisfaction and the condition of the middle ear before surgery and after 12 months post-operatively.

Results:

The patients' speech improvement reached 61.91%. No snoring or nasopharyngeal regurgitation occurred postoperatively. The condition of the middle ear 12 months after surgery with a tympanometry test type A (normal) in 40% of patients, while type B (inflammation and fluid in the ear) in 60% of patients. Patient satisfaction scored 8 out of ten for 80% and 7 for 20% of patients.

Conclusion:

The use of the posterior tonsillar pillar showed effectiveness in improving subsequent speech, eliminating nasopharyngeal regurgitation and snoring, and an asymptomatic middle ear condition in all patients, and very good patient satisfaction postoperatively.

The Prognostic Value of Serum CRP in Acute Leukemia

Hala Alhasan — 2024-11-13

Objective: Acute Leukemia is one of the malignant hematological disorders with an increasing incidence rate worldwide. As tumor cells stimulate liver to produce inflammatory cytokines, serum CRP levels are elevated. The prognostic significance of serum CRP as sensitive, easily analyzable, and cost-effective tumor marker in acute leukemia has been questioned. Methods: The study included 54 newly diagnosed patients with acute leukemia (30 with acute lymphoblastic leukemia and 24 with acute myeloid leukemia). CRP levels were measured by Immunoturbidemetry with using a Mindray analyser. Patients were divided into two groups based on their to serum CRP levels: Group (1) CRP ≤ 7.5 mg/L, Group (2) CRP > 7.5 mg/L. Results: Overall Survival (OS) rate was statistically higher in the Group CRP ≤ 7.5 mg/L. 84.8 % Conclusions: Pre-treatment serum CRP levels is an important prognostic marker in acute leukemia patients, with high CRP levels indicating poor prognosis and lower survival rates. CRP can be used as a routine, cost-effective, and easily analyzable test.

In vitro efficacy of Rosmarinus officinalis L. leaves ethanolic extract and essential oil against head lice

Abeer qassem — 2024-11-13

Introduction: Head lice infestation is one of the most important public health proplems among children worldwide, its treatment is challenging because of the toxicity and the increased resistance to the existing treatments. Therefore, it’s important to find alternative non-toxic anti-lice agents to overcome this problem.

Objective: This study aims to test the efficacy of essential oil and ethanolic extract from Rosmarinus officinalis L. leaves and compare their activity with benzyl benzoate in vitro.

Materials and methods: The leaves of Rosmarinus officinalis L. were collected from Banias City, Syria. Essential oil was extracted from dried and powdered leaves by hydrodistillation using a modified Clevenger apparatus. Ethanolic extract was prepared from leaves powder using Soxhelt. A filter paper diffusion bioassay was carried out to determine the pediculicidal activity of ethanolic extract and essential oil from Rosmarinus officinalis L. leaves and comparing their activity with benzyl benzoate lotion, 4µl/cm² was an appropriate starting dose for screening.

Results: In a filter paper contact bioassay with P. humanus capitis females at 4 µl/cm ², the results showed that Rosemary essential oil ethanolic solution 800 µl/ml with LT50= 0.17h was more toxic than Rosemary ethanolic extract 25 mg/ml with LT50= 1.99h, but both were less effective than benzyl benzoate lotion with LT50= 0.03h.

Conclusion: The results demonstrate Rosemary essential oil in our study was more toxic than Rosemary essential oil in other studies and Rosemary ethanolic extract has good mortality against head lice, both of them can use in preparation the pediculicdal commercial product .

Effect of passive smoking on haematological parameters in children

Mahmoud Harba — 2024-11-13

Background: Passive smoking (PS) exposure is a major risk for children’s health, passive smoking contains more than 4000 chemical compounds, and which exposure or inhalation of these compounds leads to pathological changes on the haematological parameters, and these alterations might be associated with a greater risk for developing many diseases.

Objective: The purpose of this study was to assess the effects of exposure to passive smoking on haematological parameters in children.

Materials and Methods: An observational study (case study and reference) was conducted for the period one year (October 2022–October 2023) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of children aged between (8-12) years and were compared: group I consisted of 66 children who had a history of exposure to passive smoking by their parents inside the house, whereas group II consisted of 58 children without a history of exposure to passive smoking. Complete blood count (CBC) and Lipid profile were performed and comparison values between two groups.

Results: group with Chronic exposure to passive smoking had a significant increase (p=0,042) in hemoglobin, white blood cells (p<0,001), Cholesterol (p=0,04), Low-density lipoprotein (LDL) (p=0,05), and a significant decrease in High-density lipoprotein (HDL) (p=0,04) in comparison with non-exposure group. All other measured parameters did not differ significantly. We found an important relationship between exposure to passive smoking and pathological changes in the values of some blood parameters WBC>10,5 (×10e⁹/L) (ORs=3,3), HDL<45(mg/dL) (ORs=2,6).

Conclusion: In conclusion, our study showed that children with exposure to passive smoking has adverse effects on haematological parameters (e.g., hemoglobin, white blood cells count, low density lipoprotein(LDL), High density lipoprotein(HDL) , Cholesterol ) and these alterations might be associated with a greater risk for developing atherosclerosis, chronic obstructive pulmonary disease and/or cardiovascular diseases at an early age.

Comparison of the Efficiency of Using Papain Gel (Brix 3000) and Carbide Bur in Dentin Caries Removal in deciduous teeth: an in vitro study

salam ghabra — 2024-11-13

Introduction: Due to the expansion of the use of chemomechanical caries removal as an alternative to traditional methods that are more preserving of dental tissues and more acceptable to patients, especially those who are anxious, the importance of having a study that show the advantages and consequences of this use have emerged.

Aim of study: The study aimed to evaluate the efficiency and effectiveness of two methods of removing caries, Brix 3000 and traditional excavation burs.

Materials and methods: The sample included 40 extracted deciduous molars randomly distributed into two groups, Brix 3000 and traditional excavation burs. Efficiency was evaluated by calculating the time required to remove caries and the effectiveness of both methods.

Results: The average of time taken to completely remove the caries in the Brix 3000 group was higher with a statistically significant difference than the traditional excavation burs group (P=0.000), while both methods were effective in removing the caries completely.

Conclusions: Brix 3000 is effective in removing caries similar to traditional excavation burs, but it required a longer time.

Prevalenc of Acquired cyctic kidney disease and its relation with anemia in ESRD patients at Hemodialysis center

Muhammad Yahya Husami — 2024-11-13

Background. Acquired renal cystic disease is an important complication of end-stage chronic kidney disease (ESRD) that is not widely studied and has a poorly defined clinical course.

The development of AKI is often asymptomatic, and the most serious complications are retroperitoneal hemorrhage and renal cell carcinoma.

The aim of this study was to investigate the prevalence of acquired CKD in these patients and its relationship with anemia, duration of hemodialysis therapy, and arterial hypertension.

Methods: : The study included 150 patients who underwent kidney ultrasound with end-stage chronic kidney disease at the hemodialysis department at Tishreen University Hospital from 2022-2024

Results: The incidence of Acquired renal cystic disease was 21.3% during the first year of evaluation and increased to 36% a year later at re-evaluation.

Arterial hypertension was the most common comorbidity in the study sample (72%), followed by diabetes mellitus (29.3%).

The most common reason for the need for hemodialysis treatment was hypertension (66.7%), followed by diabetes mellitus (28.7%).

The category of patients treated with hemodialysis less than 3 years old was the highest in the studied research sample with 60.7%.

50.7% of patients in the study sample had at least one cyst in at least one kidney.

59.3% of patients in the study sample had moderate anemia (7-10 g/dL).

The age group older than 40 years was the highest percentage of the research sample, amounting to 73.3%.

Conclusion: Acquired renal cystic disease is a common complication in patients with end-stage chronic kidney disease treated with hemodialysis.

The relationship between serum levels of (1-25 dehydroxy colicalcifirole) vitamin D3 and Parathormone (PTH) and hip fractures in older people

Nasab Abdullah — 2024-11-13

Introduction:The incidence of hip fractures and associated deaths among the elderly has increased in recent years, with 1.3 million cases reported worldwide in 1990, and this number is expected to reach 21-7 million in 2050. Due to the functional disability and financial burden these fractures cause on the individual and society, their prediction is of great importance.
Objective: The study was conducted to evaluate vitamin D and parathyroid hormone levels in predicting the occurrence of hip fractures among the elderly at Tishreen University Hospital in Lattakia during the period between February 2022 and January 2024.
Materials and methods: The research sample included 58 patients admitted to the Orthopedic Surgery Department at Tishreen University Hospital in Lattakia, aged 50-90 years, and diagnosed with a hip fracture during the period between February 2022 and January 2024. The control sample included 30 patients who visited the emergency department or were admitted to the Orthopedic Surgery Department for reasons other than hip fractures.All study patients were subjected to a medical history, patient information, clinical examination and laboratory evaluation upon admission to the orthopedic department, which included biochemical parameters including calcium and phosphate, in addition to other blood tests. Patients were divided into groups according to the type of hip fracture. The study sample consisted of 31 patients with femoral neck fracture, 27 patients with intertrochanteric fracture, and 30 controls. Vitamin D and parathyroid hormone levels were measured, in addition to all biochemical parameters including calcium and phosphate, for patients upon admission to the department.
Results: The mean values of vitamin D were lower in the hip fracture group with p-value=0.0001, and the mean values of parathyroid hormone were higher in the hip fracture group with p-value=0.0001, while blood calcium was lower in the hip fracture group with p-value=0.001. We also found a relationship between age and vitamin D, which was lower in the older age group (70-90 years), in addition to a statistical relationship with parathyroid hormone, which was higher in that group. Finally, a relationship was observed between the type of hip fracture and both vitamin D and parathyroid hormone levels, as we found that in patients diagnosed with femoral neck fractures, vitamin D values were lower with a decrease in parathyroid hormone values, while in patients diagnosed with intertrochanteric fractures, vitamin D values were lower with an increase in parathyroid hormone values.
Conclusions: Vitamin D and parathyroid hormone levels in elderly people over 50 years of age are considered the most important parameters for predicting the risk of hip fractures.

The prevalence of elevated liver enzymes level(ALT/AST) in epileptic children treated with valproic acid(VPA)

Nermeen Alaneed — 2024-11-13

Background: Epilepsy is considered the most common neurological disorder affecting children. Valproic acid is the most commonly prescribed antiepileptic drug, and although it is a safe drug, it may cause some side effects, such as elevated transaminase levels.

Objective: The research aims to study the prevalence of elevated liver enzymes (ALT, AST) in epileptic children treated with valproic acid.

Materials and Methods: An observational descriptive study (cross-sectional) was conducted for the period one year (May 2023–May 2024) at Tishreen University Hospital in Lattakia-Syria. The study included 240 children. ALT, AST were performed on a peripheral venous blood sample .The study included two groups of patients: group I patients with normal AST values, whereas group II patients with high AST values.

Results: The results showed that 1.3% of the study population had elevated AST values, while ALT values were normal in all children. No statistically significant difference was observed with regard to age group, gender, and drug dose and the incidence of clinical side effects between the two research groups (Pv > 0.05), while the duration of treatment was longer in the second group, Pv = 0.0001.

Conclusion: Valproic acid can be used as a liver-safe treatment in the management of epilepsy.

Evaluation of Surgical Duration When Preparing the Implant Bed Using the Single Drilling Protocol (Clinical Study)

oday bisher — 2024-11-13

Research objectives: The study aims to assess the efficacy of the single drilling protocol in the success of dental implants, comparing them with the gradual drilling protocol (traditional method). And it will evaluate the duration of surgical procedures.

Materials and Methods: A comparative study was conducted on 24 patients visiting the Department of Oral and Maxillofacial Surgery at Tishreen University Hospital and the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry at Tishreen University.

The sample was divided into two groups:

12 Treated using the gradual drilling protocol
12 Treated using the gradual drilling protocol

The study utilized a split-mouth method, with patients who had lost a minimum of two teeth being selected for the research. This involved applying the conventional drilling protocol to one implant and the gradual drilling protocol to another to control variables as much as possible.

The Results: The success rate of the implants was 100%. The average working time in the single drilling protocol was 21.33±4.03 compared to 43.25±4.2 in the gradual drilling protocol.

Conclusions: Within the limits of this study, we determined that the single drilling protocol is a safe and effective method for achieving successful dental implants when compared to the gradual drilling protocol. Additionally, it plays a crucial role in decreasing surgical time.

A Chemical and Morphological study of some Crataegus L. spieces in the Syrian Coast

Batoul Ghanem — 2024-11-13

This study was conducted on a medicinal plant known as the "food of the heart" from the Rosaceae family، specifically hawthorn (Crataegus L.)، which is widely distributed along the Syrian coast. Plant samples of various species (flowers، leaves، fruits) from the genus Crataegus L. were collected from different areas along the Syrian coast، specifically in Tartus Governorate، during the year 2022. These samples differed morphologically at the time of collection. The study involved identifying the collected species by comparing them with specialized botanical floras and consulting experts. Additionally، total phenolic compounds and flavonoid compounds were extracted from the flowers، leaves، and fruits in their dried state and quantitatively assessed using a spectrophotometer according to the Folin-Ciocalteu method and the aluminum chloride colorimetric method، which are standard procedures for total phenolics and flavonoids، respectively.

The results indicated the presence of two main species of the genus Crataegus in the studied area: Crataegus monogyna Jacq and Crataegus azarolus L. It was found that the species Crataegus azarolus L. with yellow fruits (Mouterde) is the same as Crataegus aronia L. (Zohary)، which has been classified as a variety in modern taxonomy (KEW)، specifically Azarolus var. Aronia Crataegus. The total phenolic content in the flower extracts was found to be 22.76 and 17.34 mg Gallic acid/g dry weight (d.w)، in the leaf extracts 8.198 and 4.425 mg Gallic acid/g d.w، and in the fruit extracts 0.412 and 1.81 mg Gallic acid/g d.w for the species Crataegus monogyna Jacq and Crataegus azarolus L.، respectively. Additionally، the flavonoid content in the flower extracts was 0.46 and 1.047 mg Rutin equivalents (R.E)/g d.w، in the leaf extracts 2.37 and 1.65 mg R.E/g d.w، and in the fruit extracts 0.099 and 0.096 mg R.E/g d.w for the species Crataegus monogyna Jacq and Crataegus azarolus L.، respectively.

Study of pleural fluid cholesterol compared with Light’s criteria to differentiate exudative and transudative pleural effusion in patients admitted at Tishreen University Hospital

anas ghosainah — 2024-11-13

Background: Pleural effusion is a manifestation of several diseases, both pulmonary and extra pulmonary, and may be an exudate or a transudate. In recent years, pleural fluid cholesterol has been proposed for separation of exudates from transudates.
Objective: To study levels of pleural fluid cholesterol compared with Light’s criteria to differentiate between exudates and transudates.
Materials and Methods: This was a Cross-Sectional study, conducted in the Department of Respiratory Diseases at Tishreen University Hospital in Lattakia during the period September 2022 to September 2023, 84 patients were included by adhering strictly to certain inclusion and exclusion criteria. Pleural fluid and serum protein, lactate dehydrogenase (LDH) and cholesterol were studied.
Results: According to Light’s criteria 68 (%81) patients had exudate pleural effusion and 16 (%19) had transudate effusion. Pleural fluid cholesterol ˃ 45 mg/dl was considered as exudative pleural fluid, 67 (%79.8) patients had exudate pleural effusion and 17 (%20.2) patients had transudate. We compared between transudates and exudates based on disease diagnosis and Light’s criteria plus pleural fluid cholesterol, we noted highly significant difference between them (p value = 0.0001). The cut-off value of pleural fluid cholesterol 48 mg/dl was determined with sensitivity of %97.1 and specificity of %100 and p value = 0.0001.
Conclusion: Pleural fluid cholesterol is a simple, cost effective and useful parameter in differentiating pleural exudates from transudates, with the advantage of requiring only one laboratory determination and no simultaneous blood sample, as compared to the use of Light’s criteria, which require four parameters.

Study of the diagnostic yield of cytology in pleural fluid in malignant pleural effusions in Tishreen University Hospital.

Leen Adrah — 2024-11-13

Background: Malignant pleural effusion (MPE) is a common global issue, resulting from direct invasion of the pleura by adjacent tumors or secondary to pleural metastases. Not all pleural effusions in patients with cancer are malignant, thus accurate diagnosis is crucial as it influences prognosis and treatment. Various methods are employed to diagnose effusions, with cytology being an initial investigation due to its relatively non-invasive nature. The diagnostic accuracy of cytology for MPE ranges between 40-87%.

Objective: To evaluate the diagnostic value of cytology of pleural fluid in malignant pleural effusions at Tishreen University Hospital, and to classify the most common tumors causing malignant pleural effusion as diagnosed by cytology.

Methods: The study included 85 patients: those with previously diagnosed tumors who developed pleural effusion for the first time, and patients who presented with pleural effusion for the first time with clinical or radiological suspicion of a tumor and were subsequently diagnosed. Pleural fluid samples were obtained via thoracentesis and sent for cytological examination. If the initial thoracentesis was negative, a second thoracentesis was performed in some patients.

Results: The diagnostic value of cytology was 50.6%. The diagnostic yield was 40% on the first thoracentesis, and repeating the procedure improved the diagnostic value by 10.6%. The most frequently diagnosed type was adenocarcinoma, accounting for 74.4%.

Conclusion: Cytology is an important and useful initial investigation for diagnosing malignant pleural effusion. The diagnostic value improves with repeated thoracentesis, and the type of tumor plays a significant role in the cytological diagnosis.

Evaluation of the efficacy of inhaled peppermint oil versus ginger syrup on nausea and vomiting in cancer patients undergoing chemotherapy

Bakr Touqaj Turkmen — 2024-11-13

Cancer is a public health problem and the second leading cause of death worldwide. Despite the progress and development achieved in the field of cancer treatment, chemotherapy has led to a high rate of side effects such as anemia, neutropenia, nausea, vomiting, diarrhea, and mucositis. However, some other side effects can persist and cause permanent damage to certain organs such as the heart, lungs, and kidneys, which severely affects the quality of life of cancer patients. Nausea and vomiting caused by chemotherapy are among the most annoying symptoms for patients receiving chemotherapy, and have been shown to affect the quality of life and the ability to perform daily life activities. Moreover, patients suffering from nausea and vomiting may require emergency care or hospitalization, which increases the economic burden of cancer care. Ginger is a perennial herbaceous plant that has been used since ancient times as a spice and herbal medicine to treat a variety of gastrointestinal diseases such as nausea, vomiting, diarrhea, and indigestion. It has been used as a complementary treatment to control nausea and vomiting caused by chemotherapy. Ginger oil has also been used Peppermint, which is an aromatic herb with a distinctive scent and great medicinal value, is used in the food, pharmaceutical, perfume and flavouring industries, in addition to being used as a treatment for cramps, headaches, indigestion, flatulence, diarrhea, nausea and vomiting caused by chemotherapy. This study aimed to evaluate the effectiveness of inhaling peppermint oil versus ginger syrup on nausea and vomiting in cancer patients undergoing chemotherapy. The study adopted a quasi-experimental approach and used a questionnaire as a tool for collecting data. It included a sample of (60) patients admitted to the inpatient department of the Oncology Treatment Center. The results of the study showed a decrease in the degree of nausea and vomiting in each group of the ginger syrup group and the peppermint oil inhalation group, as the degree of nausea and vomiting in all sample members in both groups was within the mild degree compared to the control group. The study recommended adding ginger and peppermint syrup with routine medications to the treatment plan to treat nausea and vomiting caused by chemotherapy, and conducting educational courses for healthcare professionals and cancer patients regarding the prevention and management of nausea and vomiting during chemotherapy.

A chemical study of Ostrya carpinifolia scop widespread in Syria

Afraa Mansour — 2024-11-13

phytochemical screening was achieved on its’ parts (leaves, fruiting cones) to evaluate the presence of some secondary metabolites, total phenol and flavonoid content assays. Phenol content was quantified according to Folin-Ciocaltu method using Gallic acid (Ga) as standard, and flavonoids content was quantified according to Aluminium trichloride method using Rutin (R) as standard. Phytochemical tests revealed the presence of tannins, flavonoids, and cardiac glycosides, while alkaloids and saponins were absent in the studied parts of the plant. Methanol extracts of leaves contained the highest level of total phenols and flavonoids (35.29 mg Ga E/g _DW and 1.13 mg R E/g _DW, respectively), while the contents of phenoles and flavonoids in fruiting cones were (5.67 mg Ga E/g _DW, 0.3 mg R E/g _DW, respectively).