Papers by Adel Hamed Elbaih
Posterior Uterine Wall Rupture in a Multiparous Female Presenting Post-Cesarean Deliveries: A Case Report
International Journal of Surgery and Medicine
Uterine rupture is a rare and one of the most dreaded complications of pregnancy. It carries pote... more Uterine rupture is a rare and one of the most dreaded complications of pregnancy. It carries potentially disastrous consequences for both the mother and the fetus. It occurs frequently during the antepartum or peripartum period. In the majority of cases, the rupture occurs at the lower anterior uterine segment. However, the rupture can rarely occur atypically at the posterior wall and away from the surgical scar. The recognized major risk factors for uterine rupture include previous cesarean deliveries, uterine surgeries, advanced maternal age, and induction of labor with prostaglandins. Our center experienced an unusual case of posterior uterine rupture in a 40-year-old gravid woman, G8P6A1, presenting four hours after cesarean delivery with non-specific clinical presentation of hypotension and paleness. Physical examination revealed no abdominal distension, pain, or tenderness. Blood per-vaginum was not remarkable. The diagnosis was initially made by ultrasonographic findings and ...
Evaluate the incidence, topography, management, and outcomes in patients with polytrauma in the Suez Canal and Sinai areas
African Journal of Emergency Medicine
Frequency of major causes of coma patients presented to emergency room of tertiary care hospitals with impaired conscious level, in Qassim region of Saudi Arabia
International Journal of Surgery and Medicine
Background: Disorders of consciousness including coma can be caused by a wide variety of etiologi... more Background: Disorders of consciousness including coma can be caused by a wide variety of etiologies affecting the central nervous system. Severity of coma may vary according to the causes of coma and patient’s characteristics. Objective: To determine frequency of major causes of coma patients presented to Emergency Department (ED) of tertiary care hospitals in Qassim region of Saudi Arabia. Methods: This retrospective audit study consisting of cases of coma, presented with impaired conscious level of any age and either gender admitted through ED of tertiary care hospitals in X region of Saudi Arabia over past 2 years. Patients with transient impairment of conscious level, pregnant women, referred cases of multiple organ failure and no clear etiological diagnosis on discharge were excluded from the study. After ethical approval, the data of the patients were collected retrospectively from the medical records on structured Proforma (Annexure-1). Results: Out of 422 patients of coma, 9...
Mini review on approach, teaching aspects, and common pitfalls in dealing with bradyarrhythmia
Medicine Science | International Medical Journal, 2022
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2021
Background Biological markers of acute nerve cell damage can assist in the outcome of acute ische... more Background Biological markers of acute nerve cell damage can assist in the outcome of acute ischemic stroke, such as neuron-specific enolase (NSE) that have been tested for association with initial severity of stroke, extent of infarction, and functional outcome. Objective To determine short-term prognostic value of the biochemical marker neuron-specific enolase (NSE) in acute ischemic stroke. Methods A cohort study carried out on 37 patients with acute ischemic stroke. Data were gathered in a prepared data sheet. Initial serum NSE level was measured to the patients in the Emergency department within 6 h of the onset of stroke and another measurement after 48 h. National Institute of Health Stroke Scale (NIHSS) was held to the patients at presentation and after 28 days of stroke to determine short-term morbidity and mortality. Results Out of the 37 patients, 31 patients survived (no-death group) and 6 patients died (death group). The mean serum level of neuron-specific enolase at pr...
Arşiv Kaynak Tarama Dergisi Archives Medical Review Journal 274 DNA Metilasyonu DNA Methylation
Methylation is a chemical reaction in biological systems for normal genome regulation and develop... more Methylation is a chemical reaction in biological systems for normal genome regulation and development. It is a well known type of epigenetic mechanism. Methylation which regulates gene expression via epigenetic events like gene activation, repression, and chromatin remodelling, consists of two methylation systems. One of these systems is DNA methylation whereas the other is protein (histone) methylation. These systems are associated with some fundamental abnormalities and diseases. This review highlights the role of methylation in normal genome function, how it can be arranged and which diseases it cause. Furthermore, the role of methylation in some diseases and its functions in epigenetic mechanism has been reviewed.
Teaching Approach for Emergency Traumatic Airway Management
International Journal of Surgery and Medicine
Background: - Traumatic Brain Injuries (TBI) among trauma patients with chest and neck injuries, ... more Background: - Traumatic Brain Injuries (TBI) among trauma patients with chest and neck injuries, including those that died immediately, is estimated at 0.5-2%. An anticipated incidence of airway injury in patients with penetrating chest trauma ranges from <1% to 2%. Therefore, we aim to investigate the common pitfalls that both medical students and new physicians face in the recognition, diagnosis, and Emergency Airway Management. Targeted Population: Airway injuries patients who are requiring urgent management in the ED, with Emergency Physicians for teaching approach protocol. Aim of the study: Appropriate for assessment and priorities for Airway injuries patients by training protocol to Emergency Physicians. Based on patients’ causes of Airway injuries. Methods: Collection of all possible available data about the TBI with airway injuries in the Emergency department. By many research questions to achieve these aims so a midline literature search was performed with the keywords ...
African Journal of Emergency Medicine
Introduction: Chest imaging plays a prominent role in the assessment of patients with blunt traum... more Introduction: Chest imaging plays a prominent role in the assessment of patients with blunt trauma. Selection of the right approach at the right time is fundamental in the management of patients with blunt chest trauma. [1] A reliable, economic, bedside, and rapidly accomplished screening test can be pivotal. [2] Objective: The aim of this study was to compare the accuracy of extended-focused assessment with sonography for trauma (E-FAST) to that of the National Emergency X-Radiography Utilisation Study (NEXUS) chest algorithm in detecting blunt chest injuries. Methods: This descriptive cross-sectional study included 50 polytrauma patients with blunt chest trauma from the emergency centre of Suez Canal University Hospital. E-FAST and computed tomography (CT) were conducted, followed by reporting of NEXUS criteria for all patients. Blinding of the E-FAST performer and CT reporter were confirmed. The results of both the NEXUS algorithm and E-FAST were compared with CT chest results. Results: The NEXUS algorithm had 100% sensitivity and 15.3% specificity, and E-FAST had 70% sensitivity and 96.7% specificity, in the detection of pneumothorax. In the detection of hemothorax, the sensitivity and specificity of the NEXUS algorithm were 90% and 7.5%, respectively, whereas E-FAST had a lower sensitivity of 80% and a higher specificity of 97.5%. Conclusion: E-FAST is highly specific for the detection of hemothorax, pneumothorax, and chest injuries compared with the NEXUS chest algorithm, which demonstrated the lowest specificity. However, the NEXUS chest algorithm showed a higher sensitivity than E-FAST and hence can be used effectively to rule out thoracic injury.
Teaching Approach of Cardiac Arrest in Pregnancy
International Journal of Internal and Emergency Medicine, Nov 27, 2020
ARC Journal of Surgery, 2021
Background: Traumatic brain injuries are the leading cause of death or severe disability in child... more Background: Traumatic brain injuries are the leading cause of death or severe disability in children older than 1 year, and the incidence is continuing to increase accounts for approximately 50% of accidental deaths. It is not recommended that all children presenting with head trauma obtain a head computed tomographic scan. Rather, this decision should be based on the mechanism of injury and the signs and symptoms of the patient. Therefore, we aim to look into Pediatric Trauma for both medical students and new physicians face in the recognition, diagnosis and management of these problems. Targeted Population: Pediatrics Trauma is requiring urgent management in the ER and operative room, So Emergency Physicians need teaching approach protocol. Aim of the study: Appropriate approach of Pediatric Trauma and management by training protocol to Emergency Physicians. Based to Practice Gap prevent pediatric death and adverse long-term complications. Methods: Collection of all possible available data about pediatric trauma at the emergency department. By many research questions to achieve these aims so a midline literature search was performed with the keywords "critical care", "emergency medicine", "Pediatric Trauma principals in emergencies", "Pediatric Trauma and management". Literature search included an overview of recent definition, causes and recent therapeutic interventions strategies. Results: All studies introduced that the initial diagnosis of different emergencies situations of Pediatric Trauma and their interventions are serious conditions that face patients at the emergency departments especially traumatic brain injuries. Conclusion: Pediatric Trauma guidelines will help resolve much of the guesswork that many primary care providers have to consider when evaluating children who have sustained some form of head trauma. And clinicians should be aware of the most recent guidelines for the management of Pediatric Trauma, including the need for imaging, and should be able to differentiate mild from moderate and severe traumatic brain injury
Teaching approach of ACLS in cardiac arrest with pregnancy
Cardiac arrest is the abrupt loss of heart function in a person. Cardiac arrest can be lifesaving... more Cardiac arrest is the abrupt loss of heart function in a person. Cardiac arrest can be lifesaving and it is important to understand the causes of maternal mortality to have an understanding of the unique pathogenic factors that may have precipitated the maternal cardiac arrest. Therefore, we aim to look into the common pitfalls that both medical students and new physicians face in the recognition, diagnosis, and management of these conditions. All Cardiac arrest pregnant patients who are requiring urgent management in the ED, with Emergency Physicians for teaching approach protocol. Appropriate for assessment and priorities for Cardiac arrest pregnant patients by training protocol to Emergency Physicians. Based on patients’ causes of Cardiac arrest pregnant women. Collection of all possible available data about the Pregnancy with cardiac arrest in the Emergency department. By many research questions to achieve these aims so a midline literature search was performed with the keywords...
Background: Maternal collapse occurs any time during pregnancy, up to 42 days following delivery ... more Background: Maternal collapse occurs any time during pregnancy, up to 42 days following delivery and is an acute event involving cardiorespiratory systems and/or brain, resulting in impaired consciousness or death. Therefore, we aim to look into the common pitfalls that both medical students and new physicians face in the recognition, diagnosis, and management of these conditions. Targeted Population: Maternal collapse patients who are requiring urgent management in the ED, with Emergency Physicians for teaching approach protocol. Aim of the study: Appropriate for identifi cation of women at risk and review of maternal collapse with neonatal outcomes by training protocol to Emergency Physicians. Based on patients’ causes of maternal collapse pregnant women. Methods: Collection of all possible available data about the Pregnancy in Maternal Collapse in the Emergency department. By many research questions to achieve these aims so a midline literature search was performed with the keywo...
Introduction: The hospital ED is one of the most important components of the health care system. ... more Introduction: The hospital ED is one of the most important components of the health care system. There is an increase in numbers of hypovolemic patients visiting EDs leading to overcrowding, long waiting time, missed diagnostic cases and negative impact on patient satisfaction. Hypovolemia is one of the most common reasons people call for emergency medical help. Fortunately, Fluid is about half of healthy adult body weight. Total body fluid in adult male is about 60% of lean body weight, and about 50% of lean body weight in female. Blood is about 11 12% of total body fluid. But even if the hypovolemic patients experience has nothing to do, the problem may still be important and worth the time spent in an emergency room for evaluation and intravenous fluids administration So we aimed to update knowledge and review researches in the field of fluids therapy and reduction in waiting time and Overcome Crowdness Patients in emergency department. Methods: Collection of all possible availab...
Validity of S100B protein as a prognostic tool in isolated severe head injuries in emergency patients
The Egyptian Journal of Surgery, 2020
Introduction Trauma results in 10% of all deaths or five million died annually. In spite of the p... more Introduction Trauma results in 10% of all deaths or five million died annually. In spite of the progress in monitoring and imaging studies, definite, correct prediction of brain death after brain trauma is not possible until now, and brain injury is the third most common cause of mortality in the world. Aim The aim of the study is to identify the validity of S100B protein as a predictor of mortality in isolated severe head trauma patients. Patients and methods Th study was a cross-sectional one that was carried out among 44 patients who presented with isolated severe head trauma to the emergency room. All the patients fulfilled our inclusion and exclusion criteria of this study. The initial level of S100B protein was obtained from each patient on admission, 48 h later, and every patient was followed up for 28 days. Results This study demonstrates that the mean of S100B dimer levels within the first 2 h was 0.12 mg/l, while after 48 h the mean was elevated to 1.09 mg/l. In addition, ...
Accuracy of Shock Index as A Predictor Tool for Differentiating Major from Minor Injuries in Adult Trauma Patients Attending to Emergency Department at Suez Canal University Hospital
Background: The importance of early recognition of hemorrhagic shock and its effects on outcome h... more Background: The importance of early recognition of hemorrhagic shock and its effects on outcome have long been recognized. Traditional vital signs are relatively insensitive as early diagnostic markers of hemorrhage. The Shock Index (SI); Heart Rate (HR) divided by Systolic Blood Pressure (SBP), has been suggested as such a marker. We tested the accuracy of the SI in differentiating major from minor injury in trauma patients. Aim: To assess accuracy of shock index as a simple and early predictor marker in differentiating major from minor injuries in trauma patients in Emergency Department at Suez Canal University Hospital. Patients and Methods: This cross sectional study was conducted on 106 trauma patients, both genders and all age groups above 18 years old, admitted to Emergency Department at Suez Canal University Hospital. Demographics, injury mechanism, HR, SBP, base deficit and lactate were recorded and Injury Severity Score were calculated. Major injury was defined as either d...
Salivary cortisol level as a marker of adrenal function in children with systemic inflammatory response syndrome in Egypt
Annals of Paediatric Rheumatology, 2017
Introduction: Pediatric systemic inflammatory response syndrome (SIRS) criteria is widely used to... more Introduction: Pediatric systemic inflammatory response syndrome (SIRS) criteria is widely used to identify patients who need specialized, advanced therapies. Cortisol plays an important anti-inflammatory in SIRS. Adrenal status and use of corticosteroid in children with SIRS still controversial. Objective: to assess salivary in children with SIRS and its relation to outcome in PICU of Suez Canal University hospital. Methods: prospective case control study was carried out. We analyzed 45 patients with SIRS and45 healthy control children for morning salivary and total serum cortisol level Results: children with SIRS have significantly higher morning salivary and total serum cortisol level than control group (p=.00). Mortality was associated with higher levels of both salivary and total cortisol. Conclusions: Salivary cortisol can be used to estimate cortisol levels in pediatric with SIRS and can foretell outcome. Keywords: systemic inflammatory response syndrome, children, salivary, c...
The Journal of medical research, 2016
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure pe... more Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure performed with a side view scope that can be either diagnostic or therapeutic. Endoscopic procedure as with other medical procedures has both minor and major complications. The most common major complication of ERCP is pancreatitis, with a prevalence of 1% to 40%. Aim: to assess the efficacy of diclofenac sodium versus somatostatin for prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Methods: the present study was carried out as an interventional study on 75 patients with evidence of biliary obstruction accepted for ERCP, divided into 3 groups. Group I included 25 patients as control group, group II included 25 patients who were administered 100 mg of diclofenac sodium administered rectally 30 minutes before ERCP and group III included 25 patients who were administered a single bolus injection of 250 mcg somatostatin 30 minutes before ERCP and these gr...
ARC Journal of Surgery, 2020
TPT may be said to occur when a one-way valve communicates with the pleural space. Air is forced ... more TPT may be said to occur when a one-way valve communicates with the pleural space. Air is forced into the plural space with no way to escape, eventually collapsing the affected lung. Ultimately, pushesthe mediastinum to the opposite side, decreasing venous return and comprising the opposite lung (Figure 4-1).Tension pneumothorax is considered a lifethreatening emergency condition and requires rapid recognition and treatment.
Correlation between diabetes mellitus and the clinical outcome of acute variceal bleeding in cirrhotic patients in Suez Canal University Hospital, Ismailia, Egypt
Medicine Science | International Medical Journal, 2017
Variceal bleeding is one of the major complications of portal hypertension. Gastro-esophageal var... more Variceal bleeding is one of the major complications of portal hypertension. Gastro-esophageal varices are present 40-60% of patients with cirrhosis; bleeding occurs in 25-35% of patients and account for 80-90% of bleeding episodes in these patients. Hepatic venous pressure gradient (HVPG) > 20 mmHg is associated with early re-bleed and failure to control bleeding (83%) with high mortality (64%) In the last two decades variceal re-bleeding has decreased from 47% to 13% with the use of pharmacological, endoscopic, and radiological intervention.DM co-existing with cirrhosis is considered to be one of the factors in the genesis of variceal bleeding. This may be due to an increase in portal blood flow. is to determine the correlation between DM as a risk factor and failure to control variceal bleeding and re-bleeding in cirrhotic patients. This study is a case-control study, sixty cirrhotic patients with variceal bleeding with or without DM were included in the study. The patients were divided into two groups: Group 1 (diabetic group): this group included 30 cirrhotic patients with variceal bleeding and had a history of DM. Group 2 (control group): this group included 30 cirrhotic patients with variceal bleeding and had no history of DM. All Patients were subjected to the following:-Complete clinical evaluation (history and physical examination) with Laboratory and imaging investigations. Tthere were significantly higher frequency of unstable course and mean times of previous admission in diabetic patients than control patients (73.3% and 1.6 times versus 36.6% and 1.3 times, respectively). Other variables showed insignificant differences between both groups (p>0.05). There were significantly higher mean numbers of attacks of hematemesis and melena and times of previous admission with these attacks in diabetic patients than control patients.
International Surgery Journal, 2016
Patients presenting with haematemesis have a higher mortality than those presenting with melena a... more Patients presenting with haematemesis have a higher mortality than those presenting with melena alone. 3 Risk factors associated with poor outcome There is a lack of good quality studies on the initial assessment of patients with acute upper GI bleeding. 5
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Papers by Adel Hamed Elbaih