Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
The Profile of Multi Drug Resistant Bacterial Infections in Long Term Care Facility
1
5
EN
EL Bedewy
R
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
10.21608/ejgg.2017.5345
Aim: To detect the commonest mul tidrug resistant bacteria and i ts antibiotic sensi tivi ty in elderly residents at LTCF<br />Methods: 126 LTCF elderly residents and documented mul ti drug resista nt organisms in thei r samples. Cul ture and<br />sensi tivi ty was done for col lected samples documenting mul tidrug resistant organisms wi th i ts antibiotic susceptibi l i ty<br />to a range of di fferent antibiotic groups. Demographic data was col lected and comorbidi ties were establ ished. Al l<br />samples were processed as per standard techniques and bacteria identi fied by standard biochemical tests. IBM SPSS<br />statistics (version 24, IBM corp., USA, 2016) was used for data analysis.<br />Results: The age range f rom 60 to 98 years wi t h mean 70.5794 +/- SD 10.17years. Males are 79 (~62.27%) , whi le<br />females are 47(~37.37%), The predominant resistant detected organism in these samples is Proteus (49.2 %), then<br />Klebsiela (22.2 %) , then E Col i (11.1%), then Pseudomonas (9.5%), then MRSA (4.8%) and lastly, Mix of [Klebsiela +<br />Pseudomonas ] ~ (3.2%) . Proteus is found to be highly statistical ly signi ficant sensi tive to Meronam (MEM) , Imipenam<br />(IMP), Ciprofloxacin (CP) and highly statistical ly signi ficant resistant to Cefuroxime (CRM) , Ceftazidime (CAZ) ,<br />Gentamycin (GM), Col istin (CT) , Trimethoprim/Sul famethoxazole (TS), Ni t rofurantoin (FD) , Tobramycin (Tobra) whi le<br />Klebsiel la is highly statistical ly signi ficant sensi tive to Ceftazidime (CAZ) , Col istin (CT) and highly statistical ly<br />signi ficant resistant to Imipenam ( IMP) and E Col i is found to be highly statistical ly signi ficant sensi tive to Gentamycin<br />(GM) and Ni t rofurantoin (FD) whi le Pseudomonas is highly statistical ly signi f icant sensi tive to Tobramycin and highly<br />statistical ly signi ficant resistant to CD,MEM, Minocycl in (MN) ,Vancomycin .MRSA is found to be highly statistical ly<br />signi ficant sensi tive to to Trimethoprim/Sul famethoxazole (TS), Cl indamycin (CD) , Minocycl in (MN) , and Vancomycin<br />whi le the mix of Klebsiel la + Pseudomonas is highly statistical ly signi ficant sensi tive to Tobramycin.<br />Conclusions: Gram negative bacteria are the most common mul tidrug resistant bacteria at long term care faci l i ty<br />mostly Proteus, the best antibiotics to use for proteus infections was Minocycl in (MN) then Meronam (MEM) then<br />Imipenam (IMP).
Antibiotic susceptibi l i ty,mul ti drug resistant bacteria,long term car e faci l i ty,elderly residents
https://ejgg.journals.ekb.eg/article_5345.html
https://ejgg.journals.ekb.eg/article_5345_69f5cc641e89c12af0f5f5f77734b560.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
Relation between Blood Pressure Control and Insulin Secretion Markers among Elderly Diabetic Females
6
10
EN
Elsorady
KE
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
,Ain Shams Ageing Research Center
Taha
HM
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
,Ain Shams Ageing Research Center
Aly
WW
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
,Ain Shams Ageing Research Center
Mortagy
AK
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
,Ain Shams Ageing Research Center
Saad
WE
Clinical Pathology Department, Ain Shams University Hospitals
10.21608/ejgg.2017.5346
Background: Hypertension is a common condi tion among elderly individuals, of ten present concur rently wi th<br />diabetes or a part of metabol ic syndrome, and each can accelerate the progression of the other. The importance of<br />identi fying the relation between blood pressure cont rol and i nsul in secretion abi l i ties is of utmost importance to<br />decrease progression of vascular compl ications among diabetics.<br />Aim: To identi fy the prevalence of hypertension and detect the relation between blood pressure cont rol and insul in<br />secretion markers including C-peptide (CP) levels and C-peptide index (CPI ) among elderly diabetic females<br />Methods: A cross sectional study conducted f rom the fi rst of October, 2014 to the end of March, 2016, where 163<br />elderly diabetic females were recrui ted f rom the Inpatient wards of Ain shams universi ty hospi tal at that time. They<br />underwent careful history taking, blood pressure measurement and assessment of insul in secretion including<br />fasting serum C-peptide and CPI measurement in addi tion to assessment of glycemic cont rol b y fasting blood<br />sugar (FBS) estimation.<br />Results: 82.8 % of our participants were hypertensives, 32.5% had uncont rol led systol ic blood pressure and<br />33.7% had uncont rol led diastol ic blood pressure, there was statistical ly signi ficant di fference between uncon t rol led<br />and control led systol ic and diastol ic blood pressure as regard insul in secretion indicators including fasting serum<br />CP level and CPI .<br />Conclusions: Hyper tension is a common heal th problem among diabetic female geriat ric population, and i ts<br />presence and even cont rol could be related to insul in secretion markers such as fasting serum C -peptide level and<br />CPI value.
C-peptide index . insul in secretion in hypertensive elderly
https://ejgg.journals.ekb.eg/article_5346.html
https://ejgg.journals.ekb.eg/article_5346_68b6cdc4937d20c31c06121c3099ec37.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
Thickened Common Femoral Artery Intima Media Thickness: a Surrogate Marker for Subclinical Peripheral Arterial Disease in Patients with Type 2 Diabetes Mellitus
11
14
EN
Amer
MS
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
, Ain Shams Ageing Research Center
Omar
H
3Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mabrouk
R
4Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abdel
T
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
,Ain Shams Ageing Research Center
Rasheedy
D
Geriatrics & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
,Ain Shams Ageing Research Center
10.21608/ejgg.2017.5347
Background: Thickening of ar terial wal l is an early indicator of atherosclerosis which is mostly a poly vascular<br />disease. Thickened carotid intima media thickness is now wel l accepted as a sur rogate marker for cardiovascular ,<br />cerebrovascular , and peripheral vascular a ffection. Some data exists regarding the relationship between intima media<br />thickness of the common femoral artery as a predictor of di fferent vascular beds atherosclerosis.<br />.Aim: To evaluate the abi l i ty of common femoral artery intima media thickness to pr edict subcl inical peripheral<br />ar terial disease in elderly patients wi th type 2 diabetes mel l i tus.<br />Methods: 60 elderly subjects wi th type 2 diabetes were examined for the presence of asymptomatic PAD. Al l were<br />assessed by measuring Common Femoral Artery Intima Media Thickness CFA IMT, ankle brachial index (ABI) .<br />Results: The patients with reduced ABI (N=9) had greater CFA-IMT than those without (N=51). The correlation<br />between CFA-IMT and ABI was highly significant. CFA IMT≥ 8.5 mm had an area under the curve of 0.962 (95% CI;<br />0.917- 1.007, p = 0.000*) for predicting subclinical PAD in patients with type 2 diabetes.<br />Conclusions: This data suggests that thickened CFA IMT is a signi ficant predictor of asymptomatic PAD in patien ts<br />wi th type 2 diabetes
Diabetes mel l i tus Thickened common femoral artery intima media thickness,PAD- elderly
https://ejgg.journals.ekb.eg/article_5347.html
https://ejgg.journals.ekb.eg/article_5347_5b7ed0792cf735785399935e58760825.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
Malnutrition and its Relation to Food System among Elderly Home Male Residents in Cairo, Egypt
15
18
EN
Sweed
HS
Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Ain Shams Ageing Research Center
Mabrouk
RR
Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo
Kamel
HY
Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo,Ain Shams Ageing Research Center
Jamil
MA
Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo,Ain Shams Ageing Research Center
10.21608/ejgg.2017.5348
Background: Malnut ri tion in insti tutional ized elderly is of individual and publ ic co ncern since i t negatively affects<br />heal th outcome and qual i ty of l i fe and is often preventable. Assessing this problem is an impor tant step of the<br />res i den ts ’ assessment to combat morbid sequences .<br />Aim: Assessing the nut ri tional status and i ts association wi th the food system for male residents of elderly homes<br />in Cai ro, Egypt .<br />Methods: 200 male residents were randomly selected f rom 7 elderly homes in Cai ro. Data was col lected via<br />questionnai res, including demographic characteristics, and past medical histor y. The MNA questionnai re was used<br />to gather information regarding nut ri tional risk. Focused dietary assessment and assessing the feeding system in<br />the elderly home using a questionnai re was performed.<br />Results: Among the 200 participants, 17(8.5%) were maln our ished, 96 (48%) were at risk of malnut ri tion and 87<br />(43.5%) were wel l nourished. The presence of ref rigerators and eating in dining room were signi ficantly associated<br />wi th good nut ri tional status.<br />Conclusions: The high prevalence of nut ri tional risk mandates regular screening of elder ly home residents. This<br />wi l l al low early nut ri tional intervention and timely prevent ion of fur ther nut ri tional and functional deterioration. The<br />relation between nutri tional risk and the food system requi res increased awaren ess of proper food system<br />characteristics in a residential care faci l i ty
Malnutrition in Elderly homes,residential care in Egypt
https://ejgg.journals.ekb.eg/article_5348.html
https://ejgg.journals.ekb.eg/article_5348_47996e333815b2d17ecf005697301457.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
Spirometry Screening for Respiratory Obstruction in Asymptomatic Elderly
19
23
EN
Sweed
HS
Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Taha
HM
Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Riad
M
Chest Department; Faculty of Medicine, Ain shams university, Cairo, Egypt
E.
Abdelhamid
Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ejgg.2017.5349
Background: Elderly people are especial ly prone to the adverse heal th ef fects of chronic obst ructive pulmonary<br />disease (COPD) , which is a common disorder in that population. Al though the prevalence and morbidi ty of COPD<br />in the elderly are high, i t is of ten undiagnosed.<br />Aim: To evaluate the prevalence of ai rway obst ruction among asymptomatic elderly.<br />Methods: A cross sectional study was carried over a period of one year where 100 elderly patients aged 60 years<br />and older were recrui ted f rom the outpatiens geriaric cl inic in Ain Shams Universi ty Hospi tal . Each patient<br />underwent detai led history taking including smoking history and medication review, detai led general medical<br />examination and cogni tive assessment by Mini - mental status examination test. Elderly wi th a physician<br />diagnosis of asthma, COPD or another chronic respi rato ry condi tion were excluded. Al l subjects completed<br />spi romet ry testing to diagnose ai rway obst ruction. .<br />Results: The sample included 100 participants wi th a mean age of 64.3±3.1years, 52% male and 48% female,<br />mean body mass index was 29.3 ±1.5 and mean mini mental state examination 24.45± 2.3. As regard smoking<br />61% never smoked. 9% ex -smoker and 30% current smoker . Spi rometery in the cur rent study demonst rated that<br />72% had obst ructed ai rway disease (none of them were diagnosed previously to have chronic bron chi tis) classi fied<br />to mi ld, moderate and severe (35%, 33%, 4%) respectively.<br />Conclusions: Spi romet ry screening of asymptomatic elderly may help detection of individuals wi th ai rway<br />obst ruction, who are at high risk of developing COPD. Addi tional data is n ecessary regarding the cl inical benefi t<br />and cost -effective of screening before spi romet ry can be recommended in general practice.<br /> Background: Elderly people are especial ly prone to the adverse heal th ef fects of chronic obst ructive pulmonary<br />disease (COPD) , which is a common disorder in that population. Al though the prevalence and morbidi ty of COPD<br />in the elderly are high, i t is of ten undiagnosed.<br />Aim: To evaluate the prevalence of ai rway obst ruction among asymptomatic elderly.<br />Methods: A cross sectional study was carried over a period of one year where 100 elderly patients aged 60 years<br />and older were recrui ted f rom the outpatiens geriaric cl inic in Ain Shams Universi ty Hospi tal . Each patient<br />underwent detai led history taking including smoking history and medication review, detai led general medical<br />examination and cogni tive assessment by Mini - mental status examination test. Elderly wi th a physician<br />diagnosis of asthma, COPD or another chronic respi rato ry condi tion were excluded. Al l subjects completed<br />spi romet ry testing to diagnose ai rway obst ruction. .<br />Results: The sample included 100 participants wi th a mean age of 64.3±3.1years, 52% male and 48% female,<br />mean body mass index was 29.3 ±1.5 and mean mini mental state examination 24.45± 2.3. As regard smoking<br />61% never smoked. 9% ex -smoker and 30% current smoker . Spi rometery in the cur rent study demonst rated that<br />72% had obst ructed ai rway disease (none of them were diagnosed previously to have chronic bron chi tis) classi fied<br />to mi ld, moderate and severe (35%, 33%, 4%) respectively.<br />Conclusions: Spi romet ry screening of asymptomatic elderly may help detection of individuals wi th ai rway<br />obst ruction, who are at high risk of developing COPD. Addi tional data is n ecessary regarding the cl inical benefi t<br />and cost -effective of screening before spi romet ry can be recommended in general practice.
Spi rometry,COPD,ai r way obstruction in elder ly
https://ejgg.journals.ekb.eg/article_5349.html
https://ejgg.journals.ekb.eg/article_5349_0212ef4a4a353e212b10f57bcabb5822.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
A case of late Onset Systemic Lupus Erythematosus with severe myalgia
24
26
EN
Mahmoud
HF
Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
10.21608/ejgg.2017.5350
Late onset systemic lupus erythematosus (SLE) after 50 -year -old is rare. We repor t a case of A 60<br />year-old woman referred to our hospi tal because of sever e myalgia and mi ld arthralgia together wi th pancytopenia<br />wi thout other typical symptoms of systemic lupus erythematosus (SLE) . Posi tive di rect Coomb’s test revealed that<br />anemia had autoimmune hemolytic nature and suppression of reticulocyte production was considered a clue of a<br />process of bone marrow suppression which have been involv ed in the etiology of pancytopenia. Posi tivi ty for Anti -<br />dsDNA antibodies led us to the diagnosis of late-onset SLE and there was marked improvement after prednisone<br />administ ration. As late-onset SLE is rare and patients tend to show the typical symptoms le ss f requently, close<br />attention should be focused on latent symptoms and immunological findings.
late-onset SLE,myalgia,pancytopenia,autoimmune disorders in elderly
https://ejgg.journals.ekb.eg/article_5350.html
https://ejgg.journals.ekb.eg/article_5350_5e7d621eb73ccc3b56e169125b7ee1b1.pdf
Ain Shams University, Faculty of Medicine, Geriatrics and Gerontology Department
The Egyptian Journal of Geriatrics and Gerontology
2356-8712
2536-9792
4
1
2017
03
01
Atypical presentation of hypercalcemia in elderly
27
32
EN
Ali
SH
Geriatrics& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
, Ain Shams Ageing Research Center. Cairo, Egypt.
10.21608/ejgg.2017.5351
Background: Hypercalcemia is a common cl inical problem wi th an estimated pr evalence of 0.1% to 0.01% among<br />hospi tal ized patients and this can be ten times more in elder ly. T he a da ge, “s to nes , g r oans , b on es , an d ps y c hi a tri c<br />ov e rto nes ” i s o fte n us e d t o de s c ri b e t he s ym pto ms of hy p er p ar athy r oi di sm . Ho wev e r, 80% of el de rl y wi t h pri ma ry<br />hyperparathyroidism present wi th asymptomatic or atypical hypercalcemia. We are classical ly taught that two most<br />common causes of hypercalcemia are mal ignancy and primary hyperparathyroidism (PHPT). Many case repor ts are<br />publ ished discussing the atypical presentation of hypercalcemia in elderly, meanwhi le, the review article<br />discussing hypercalcemia in elderly is since 1988 (1) which also is the gold standard upon which, symptoms of<br />hypercalcemia in elderly are counted on and we can see that many cases are presented in a di fferent way now.<br />This mini review includes case repor ts of atypical presentation of hypercalcemia in elderly aiming to establ ish a<br />new sight about presentation in this age group.
missed
https://ejgg.journals.ekb.eg/article_5351.html
https://ejgg.journals.ekb.eg/article_5351_3c7f2e8fb30baaadd20082709ca64895.pdf