Publications by authors named "Ahmed A Hassan"

22 Publications

  • Page 1 of 1

Towards FAIR protocols and workflows: the OpenPREDICT use case.

PeerJ Comput Sci 2020 21;6:e281. Epub 2020 Sep 21.

Institute of Data Science, Maastricht University, Maastricht, Netherlands.

It is essential for the advancement of science that researchers share, reuse and reproduce each other's workflows and protocols. The FAIR principles are a set of guidelines that aim to maximize the value and usefulness of research data, and emphasize the importance of making digital objects findable and reusable by others. The question of how to apply these principles not just to data but also to the workflows and protocols that consume and produce them is still under debate and poses a number of challenges. In this paper we describe a two-fold approach of simultaneously applying the FAIR principles to scientific workflows as well as the involved data. We apply and evaluate our approach on the case of the PREDICT workflow, a highly cited drug repurposing workflow. This includes FAIRification of the involved datasets, as well as applying semantic technologies to represent and store data about the detailed versions of the general protocol, of the concrete workflow instructions, and of their execution traces. We propose a semantic model to address these specific requirements and was evaluated by answering competency questions. This semantic model consists of classes and relations from a number of existing ontologies, including Workflow4ever, PROV, EDAM, and BPMN. This allowed us then to formulate and answer new kinds of competency questions. Our evaluation shows the high degree to which our FAIRified OpenPREDICT workflow now adheres to the FAIR principles and the practicality and usefulness of being able to answer our new competency questions.
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http://dx.doi.org/10.7717/peerj-cs.281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924452PMC
September 2020

A new convenient methodology based on dihydropyridine derivative for selective fluorimetric analysis of baclofen: Application to spiked urine and content uniformity evaluation.

Spectrochim Acta A Mol Biomol Spectrosc 2021 Mar 12;248:119165. Epub 2020 Nov 12.

Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt.

Baclofen belongs to skeletal muscle relaxant and is used for the treatment of muscle spasticity that originated from multiple sclerosis or a spinal cord injury and other cases as hiccups. In the current analytical study, a new, convenient and selective fluorimetric method for baclofen analysis has been developed and validated. The analytical methodology depends on Hantzsch reaction that leads to formation of dihydropyridine fluorescent derivative. The primary amino moiety in baclofen condensed with two equivalents of acetylacetone in the presence of formaldehyde and acetate buffer solutions. Spectrofluorimetric monitoring of the product was accomplished at emission wavelength of 477.3 nm after excitation at 419.9 nm. The method exhibited linearity when baclofen concentration plotted against the fourescence response in the range of 0.3-6.0 µg/mL. Adjustment of the reaction variables and studying validation parameters according to directives of ICH were performed perfectly. Ultimately, the proposed approach was applied successfully for baclofen analysis in raw material, dosage form and spiked urine and it was also extended to test content uniformity.
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http://dx.doi.org/10.1016/j.saa.2020.119165DOI Listing
March 2021

NOX5-induced uncoupling of endothelial NO synthase is a causal mechanism and theragnostic target of an age-related hypertension endotype.

PLoS Biol 2020 11 10;18(11):e3000885. Epub 2020 Nov 10.

Department of Pharmacology and Personalised Medicine, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.

Hypertension is the most important cause of death and disability in the elderly. In 9 out of 10 cases, the molecular cause, however, is unknown. One mechanistic hypothesis involves impaired endothelium-dependent vasodilation through reactive oxygen species (ROS) formation. Indeed, ROS forming NADPH oxidase (Nox) genes associate with hypertension, yet target validation has been negative. We re-investigate this association by molecular network analysis and identify NOX5, not present in rodents, as a sole neighbor to human vasodilatory endothelial nitric oxide (NO) signaling. In hypertensive patients, endothelial microparticles indeed contained higher levels of NOX5-but not NOX1, NOX2, or NOX4-with a bimodal distribution correlating with disease severity. Mechanistically, mice expressing human Nox5 in endothelial cells developed-upon aging-severe systolic hypertension and impaired endothelium-dependent vasodilation due to uncoupled NO synthase (NOS). We conclude that NOX5-induced uncoupling of endothelial NOS is a causal mechanism and theragnostic target of an age-related hypertension endotype. Nox5 knock-in (KI) mice represent the first mechanism-based animal model of hypertension.
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http://dx.doi.org/10.1371/journal.pbio.3000885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654809PMC
November 2020

A new feasible approach based on utility of ninhydrin for selective fluorimetric analysis of baclofen. Application to content uniformity evaluation.

Luminescence 2021 May 24;36(3):588-594. Epub 2020 Nov 24.

Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia, 61519, Egypt.

In the current proposed analysis, a new, feasible, and selective fluorimetric approach was designed for baclofen assay. Baclofen is a medication prescribed as a therapy for muscle spasticity that originated from multiple sclerosis or a spinal cord injury, and other cases such as hiccups. The analytical approach relies on the use of ninhydrin to form a fluorescent derivative that was monitored at λ 386 nm or λ 480 nm. Under suitable reaction conditions, the primary amino moiety in baclofen was condensed with ninhydrin and phenylacetaldehyde in the presence of Teorel buffer as a buffered medium. The method exhibited linearity when baclofen concentration was plotted against response in the range 1-10 μg ml . Adjustment of the reaction variables and study of validation parameters according to ICH directives were performed correctly. An interference study was implemented to ensure that no discrepancy from the excipient had occurred. Finally, the proposed method was applied successfully for baclofen assay in dosage form and extended to test Mylobac content uniformity.
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http://dx.doi.org/10.1002/bio.3976DOI Listing
May 2021

Use of acetylacetone for nano-level assay of fluvoxamine maleate in pure form and pharmaceutical formulation.

Luminescence 2020 Dec 23;35(8):1360-1365. Epub 2020 Jun 23.

Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia, Egypt.

The present study developed and validated a selective spectrofluorimetric method designed to assay fluvoxamine maleate (FLX). The validated method relied on the condensation reaction between FLX and acetylacetone/formaldehyde using acetate buffer (pH 4.2). The formed fluorescent product was measured at an emission wavelength of 479 nm after excitation at 419 nm. Parameters that influenced the reaction were studied and adjusted accurately. The constructed calibration graph was rectilinear over the range 200-2000 ng ml and the estimated limit of detection was 60 ng ml . Two products from an Egyptian market were assayed using the suggested method and the final results agreed with the measurements of the reported method. The selectivity of the proposed approach was evaluated using the standard addition method and results were acceptable and confirmed the reliability of this approach. Finally, directives from the International Council for Harmonisation guidelines were applied to establish the validity of the study.
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http://dx.doi.org/10.1002/bio.3898DOI Listing
December 2020

Optic nerve sheath diameter by ultrasound is a good screening tool for high intracranial pressure in traumatic brain injury.

Ir J Med Sci 2021 Feb 30;190(1):387-393. Epub 2020 May 30.

King Fahd Military Medical Complex, Dahran, Kingdom of Saudi Arabia.

Objectives: This study aimed to determine the role of ONSD measurement by US for diagnosis of high ICP in TBI patients.

Methods: ONSD measurement by US was performed in adult TBI patients within 1 h of planned CT brain, while CT signs of high ICP were determined. Invasive ICP measurement was performed simultaneously in patients who had intraventricular device in situ. High ICP was determined as ICP > 22 mmHg.

Results: A total of 48 patients were enrolled. Twenty-eight patients had positive CT criteria for high ICP, while 20 patients were negative. The mean value of ONSD was 0.63 ± 0.06 cm in positive group compared with 0.55 ± 0.07 cm in negative one with significant difference (p < 0.001). A total of 22 patients had intraventricular device. Thirteen patients had high ICP, while 9 patients had normal ICP. The mean value of ONSD was 0.66 ± 0.05 cm in high ICP group compared with 0.58 ± 0.08 cm in normal one with significant difference (p = 0.004). ONSD with cut-off value > 0.61 cm predicted high ICP with sensitivity of 84.62% and specificity of 66.67% with significant AUC of 0.85 (p = 0.006).

Conclusion: ONSD measurement by ultrasound is a good screening tool for high ICP in traumatic brain injury patients.
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http://dx.doi.org/10.1007/s11845-020-02242-2DOI Listing
February 2021

Optic nerve sheath diameter by ultrasound is a good screening tool for high intracranial pressure in traumatic brain injury.

Ir J Med Sci 2021 Feb 30;190(1):387-393. Epub 2020 May 30.

King Fahd Military Medical Complex, Dahran, Kingdom of Saudi Arabia.

Objectives: This study aimed to determine the role of ONSD measurement by US for diagnosis of high ICP in TBI patients.

Methods: ONSD measurement by US was performed in adult TBI patients within 1 h of planned CT brain, while CT signs of high ICP were determined. Invasive ICP measurement was performed simultaneously in patients who had intraventricular device in situ. High ICP was determined as ICP > 22 mmHg.

Results: A total of 48 patients were enrolled. Twenty-eight patients had positive CT criteria for high ICP, while 20 patients were negative. The mean value of ONSD was 0.63 ± 0.06 cm in positive group compared with 0.55 ± 0.07 cm in negative one with significant difference (p < 0.001). A total of 22 patients had intraventricular device. Thirteen patients had high ICP, while 9 patients had normal ICP. The mean value of ONSD was 0.66 ± 0.05 cm in high ICP group compared with 0.58 ± 0.08 cm in normal one with significant difference (p = 0.004). ONSD with cut-off value > 0.61 cm predicted high ICP with sensitivity of 84.62% and specificity of 66.67% with significant AUC of 0.85 (p = 0.006).

Conclusion: ONSD measurement by ultrasound is a good screening tool for high ICP in traumatic brain injury patients.
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http://dx.doi.org/10.1007/s11845-020-02242-2DOI Listing
February 2021

One-pot reaction for determination of Asenapine maleate through facile complex formation with xanthine based dye: Application to content uniformity test.

Spectrochim Acta A Mol Biomol Spectrosc 2020 Oct 14;239:118474. Epub 2020 May 14.

Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt.

Asenapine maleate was approved by the FDA for the treatment of schizophrenia and mania or mixed episodes with bipolar I disorder. In the present article, two spectroscopic methods were developed and validated for the determination of asenapine. Both methods depend on association complex formation between xanthine based dye (eosin Y) and the cited drug in acetate buffer pH = 3.8. In the spectrophotometric method (method I), the absorbance of the formed complex was estimated at maximum wavelength of 545 nm and Beer's law was obeyed in the range of 1-12 μg mL. The spectrofluorimetric method (method II) depends on measuring the quenching effect of the drug on the native fluorescence of eosin Y at 545 nm after excitation at 303 nm. The linearity range of method II was 0.4-3.2 μg mL. The limits of detection were 0.24 and 0.08 μg mL for method I and II, respectively. The instructions of ICH were followed to fully validate the developed analytical procedures. The formation constant of the reaction was 3.93 × 10 while its Gibb's free energy was -2.6 × 10 J mol. Finally, the methods were applied for the analysis of pharmaceutical tablets and for evaluation of their content uniformity.
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http://dx.doi.org/10.1016/j.saa.2020.118474DOI Listing
October 2020

New approach for stability study and determination of fluvoxamine in raw materials and pharmaceuticals through condensation with 2,2-dihydroxyindane-1,3-dione.

Luminescence 2020 Sep 21;35(6):934-940. Epub 2020 Apr 21.

Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia, Egypt.

The present study describes the validation of a selective spectroscopic method for assay of fluvoxamine maleate (FXM). The validated method relies on condensation of FXM with 2,2-dihydroxyindane-1,3-dione and phenylacetaldehyde using Teorell-Stenhagen buffer (pH 6.6) to give coloured fluorescent product measured at 482 nm using 386 nm as the excitation wavelength. The parameters influencing the reaction were studied precisely and adjusted accurately. The constructed calibration graph appeared rectilinear over the following range (0.8-14 μg ml ) and the estimated limit of detection was 0.25 μg ml . Two pharmaceutical products from the Egyptian market were assayed using the suggested method and the final results agreed with measurements from other reported methods. Moreover, the drug was subjected to diverse stress conditions including acidic, alkaline, thermal, and photolytic degradation to examine the FXM stability. Directives from the International Conference on Harmonisation guidelines were applied to establish the validity of the work.
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http://dx.doi.org/10.1002/bio.3807DOI Listing
September 2020

Assessment of Bottle-Feeding Practices in Kassala, Eastern Sudan: A Community-Based Study.

Open Access Maced J Med Sci 2019 Feb 25;7(4):651-656. Epub 2019 Feb 25.

Unaizah College of Medicine, Qassim University, Unaizah, Kingdom of Saudi Arabia.

Background: The World Health Organization encourages exclusive breastfeeding up to six months and avoidance of bottle-feeding. There are few published research articles on the practice of bottle-feeding and associated factors in Sudan.

Aim: The study aimed to assess the usage and factors associated with bottle-feeding practices during the first six months of life among mothers with children aged between 6 and 24 months in Kassala, Eastern Sudan.

Methods: A community-based cross-sectional study was conducted from July to September 2017. A structured questionnaire was used to collect relevant data from interviewed mothers.

Results: A total of 242 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children's age was 27.13 (5.73) years and 12.2 (6.7) months, respectively. From the total, 96/242 (39.7%) used bottle-feeding for their children in the first six months of life. In multivariable analysis, urban residence (Adjusted Odds Ratio [AOR] 1.96, 95% Confidence Interval [CI] (1.06, 3.63), not receiving breastfeeding education (AOR 1.92, 95% CI 1.07, 3.45) and child hospitalization (AOR 1.83, 95% CI 1.02, 3.28) were significantly associated with bottle-feeding.

Conclusion: There was a high usage of bottle-feeding and it was found to be associated with child hospitalisation. To avoid bottle-feeding, urgent actions are required to support and educate mothers regarding breastfeeding with special attention to urban-residence ones.
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http://dx.doi.org/10.3889/oamjms.2019.132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420941PMC
February 2019

From single drug targets to synergistic network pharmacology in ischemic stroke.

Proc Natl Acad Sci U S A 2019 04 20;116(14):7129-7136. Epub 2019 Mar 20.

Department of Pharmacology and Personalised Medicine, Maastricht Center for Systems Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands;

Drug discovery faces an efficacy crisis to which ineffective mainly single-target and symptom-based rather than mechanistic approaches have contributed. We here explore a mechanism-based disease definition for network pharmacology. Beginning with a primary causal target, we extend this to a second using guilt-by-association analysis. We then validate our prediction and explore synergy using both cellular in vitro and mouse in vivo models. As a disease model we chose ischemic stroke, one of the highest unmet medical need indications in medicine, and reactive oxygen species forming NADPH oxidase type 4 () as a primary causal therapeutic target. For network analysis, we use classical protein-protein interactions but also metabolite-dependent interactions. Based on this protein-metabolite network, we conduct a gene ontology-based semantic similarity ranking to find suitable synergistic cotargets for network pharmacology. We identify the nitric oxide synthase ( to ) gene family as the closest target to Indeed, when combining a NOS and a NOX inhibitor at subthreshold concentrations, we observe pharmacological synergy as evidenced by reduced cell death, reduced infarct size, stabilized blood-brain barrier, reduced reoxygenation-induced leakage, and preserved neuromotor function, all in a supraadditive manner. Thus, protein-metabolite network analysis, for example guilt by association, can predict and pair synergistic mechanistic disease targets for systems medicine-driven network pharmacology. Such approaches may in the future reduce the risk of failure in single-target and symptom-based drug discovery and therapy.
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http://dx.doi.org/10.1073/pnas.1820799116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452748PMC
April 2019

Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study.

Int Breastfeed J 2018 25;13:34. Epub 2018 Jul 25.

1Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Background: The World Health Organization (WHO) encourages early initiation of breastfeeding within the first hour after birth with the objective of saving children's lives. There are few published research papers about factors associated with the initiation of breastfeeding in Sudan.The aim of this study was to investigate the prevalence of and factors associated with the timely initiation of breastfeeding among mothers with children two years and under in Kassala, Eastern Sudan.

Methods: A community-based cross-sectional study was conducted from December 2016 to March 2017. Mothers were interviewed using a structured questionnaire.

Results: A total of 250 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children's age was 27.1 (5.68) years and 11.9 (6.9) months, respectively.Of the 250 mothers, 218 (87.2%) initiated breastfeeding within the first hour. In multivariable logistic regression analysis, factors associated with the delay of breastfeeding initiation were having a male baby (Adjusted Odds Ratio [AOR] 3.90, 95% Confidence Interval [CI]1.33, 11.47), and mothers with medical disorders (AOR 5.07, 95% CI 1.22, 21.16).

Conclusion: There was a high prevalence of early initiation of breastfeeding. An association with delayed initiation of breastfeeding was found amongst mothers who had medical disorders and those who had a male infant. Wherever possible, early initiation of breastfeeding should be promoted for all infants, regardless of gender.
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http://dx.doi.org/10.1186/s13006-018-0177-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060461PMC
July 2018

Who's a-Gonna Hold Your Hard Luck Hand and Who's a-Gonna Be Your Man: Bob Dylan, "Kingsport Town".

JACC Cardiovasc Interv 2018 06 16;11(11):1034-1035. Epub 2018 May 16.

Department of Cardiology, MC Zuiderzee Hospital, Lelystad, the Netherlands.

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http://dx.doi.org/10.1016/j.jcin.2018.01.264DOI Listing
June 2018

Studying the association complex formation of atomoxetine and fluvoxamine with eosin Y and its application in their fluorimetric determination.

R Soc Open Sci 2018 Mar 14;5(3):170943. Epub 2018 Mar 14.

Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Al-Azhar University, Assiut branch, Assiut, Egypt.

A simple, sensitive and non-extractive spectrofluorimetric method has been developed and validated for the determination of two psychoanaleptic drugs, atomoxetine and fluvoxamine, in pure forms and pharmaceutical dosage forms. The proposed method is based on the formation of binary complexes between eosin Y and the studied drugs in the presence of a Teorell-Stenhagen buffer. The quenching of the native fluorescence of eosin Y due to complex formation with the studied drugs was measured spectrofluorimetrically at 545 nm after excitation at 302 nm. At the optimum reaction conditions, the fluorescence quenching values (Δ) and concentrations were rectilinear over the concentration ranges of 0.2-2.2 and 0.3-2.2 µg ml for atomoxetine and fluvoxamine, respectively. The developed method was successfully applied for the determination of the studied drugs in their pharmaceutical formulations with average percentage recoveries of 100.13 ± 0.66 and 99.69 ± 0.44 for atomoxetine and fluvoxamine, respectively ( = 5), without interference from common excipients.
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http://dx.doi.org/10.1098/rsos.170943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882668PMC
March 2018

Intraoperative magnesium sulphate decreases agitation and pain in patients undergoing functional endoscopic surgery: A randomised double-blind study.

Eur J Anaesthesiol 2017 10;34(10):658-664

From the Faculty of Medicine, Menoufia University, Shibin El Kom, Menofia (HEE); Faculty of Medicine, Ain Shams University, Cairo (MCM); Faculty of Medicine, Menoufia University, Shibin El Kom (HAA); and Faculty of Medicine Al-Azhar University, Cairo, Egypt (AAH).

Background: Postoperative agitation is harmful for the patient as it may be associated with removal of catheters, nasal packs, oxygen masks and self-injury, and pose a danger to operating theatre staff.

Objective: The current study investigated the potential role of magnesium sulphate in treatment of postoperative agitation following functional endoscopic sinus surgery.

Design: A randomised, double-blinded, placebo-controlled trial.

Setting: ENT operating room, Menofia University Hospitals, Egypt.

Patients: A total of 312 adult patients (171 men and 141 women) were enrolled in the study. Eighteen patients (10 men and eight women) were excluded; data from 294 patients were analysed. Inclusion criteria were age between 20 and 60 years, American Society of Anesthesiologists' physical status 1 or 2 scheduled for functional endoscopic sinus surgery. Exclusion criteria were hypertension, cardiac ischaemia, cerebrovascular insufficiency, neuromuscular diseases, pregnancy, prolonged treatment with calcium-channel blockers, diabetic neuropathy or a known allergy to magnesium compounds.

Interventions: Patients were allocated randomly to either the magnesium group (a magnesium infusion of 30 mg kg in the first hour followed by 9 mg kg h until the end of the surgical procedure) or the control group (0.9% saline at the same volume and rate). Hypotensive anaesthesia was induced by nitroglycerine 5 to 20 μg kg min. In the postanaesthetic care unit (PACU), patients were assessed for agitation and pain using the Richmond agitation-sedation scale and numerical rating scale, respectively.

Primary Outcome: The incidence and severity of agitation measured 5 min after admission to the PACU.

Results: Magnesium reduced postoperative agitation at time 0 (P = 0.009) and 5, 10, 15 and 30 min after PACU admission (P < 0.0001) as well as total agitation score [3 (0 to 6) versus 9 (0 to 12), P < 0.0001]. Magnesium also reduced pain [4.5 (4 to 5) versus 6 (5 to 6.25), P < 0.0001] and length of PACU stay (88 ± 23 versus 111 ± 31 min, P < 0.0001). The magnesium group consumed less pethidine in PACU compared with the control group (43 ± 15 and 59 ± 19 mg, respectively, P < 0.0001). The intraoperative end-tidal CO2 tension was comparable between groups (4.7 ± 0.7 versus 4.8 ± 1.2 kPa).

Conclusion: Intraoperative infusion of magnesium in patients undergoing endoscopic sinus surgery reduced postoperative agitation, pethidine consumption and pain assessed in the PACU. It also decreased the length of stay in PACU compared with the control group.

Trial Registration: The current study was registered according to WHO and ICMJE standards on 7 January 2014, under registration number PACTR 201402000737691.
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http://dx.doi.org/10.1097/EJA.0000000000000642DOI Listing
October 2017

Uremic pruritus pathogenesis, revisited.

Arab J Nephrol Transplant 2014 May;7(2):91-6

Department of Nephrology, Internal Medicine, Zagazig University Hospital, Zagazig, Egypt.

Introduction: Uremia is the most important systemic cause of pruritus. Uremic pruritus (UP) was found to affect 50-90% of patients undergoing dialysis and about 25% of patients with chronic kidney disease (CKD). Despite its high prevalence, morbidity and the marked influence on quality of life, UP remains poorly characterized.

Review: Triggering factors for UP may include cutaneous xerosis, uremic toxins, systemic inflammation and associated common co-morbidities such as diabetes mellitus, endocrinopathies,viral hepatitis and somatic neuropathy. Moreover, high pre-dialysis levels of blood urea nitrogen (BUN), β2-microglobulin, calcium and phosphate, as well as parathyroid hormone (PTH) were found to be related to UP. A new hypothesis of glycation, with advanced glycation end products (AGEs) accumulation in stratum corneum has been proposed as a possible underlying cause of UP. Common treatments used for UP include antihistamines, steroids, emollients, charcoal, erythropoietin and phototherapy (UVB). Other treatments with some reported efficacy are serotonin antagonists, selective serotonin reuptake inhibitors (SSRI), mast cell stabilizers, leukotriene receptor antagonists, κ-opioid agonists and nicotinamide. Many non-pharmacological treatments, including acupressure, are also used. In addition, improvement of dialysis modalities could relieve patients of UP. The future use of anti-glycation preparations for treatment of UP is supported by recent researches.

Conclusion: Recent researches on the process of glycation as a possible cause of UP may open the way for treatment with anti-glycation preparations. Nevertheless, associated co-morbidities with possible role should be concurrently treated.
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May 2014

Congenital Neurofibromatosis in a Saudi Neonate who Presented with Neck Mass, Esophageal and Airway Obstruction.

J Clin Neonatol 2012 Oct;1(4):214-6

Department of Pediatrics, Neonatology Section, Jeddah, Saudi Arabia.

We are presenting a case of a neonate presented with a neck mass, airway and esophageal obstruction, the tumor has a brain extension; treated with partial surgical excision; the pathological studies revealed plexiform Neurofibromatosis. The patient also has café au lait spots.
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http://dx.doi.org/10.4103/2249-4847.106004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762044PMC
October 2012

Comparison between two phenylephrine infusion rates with moderate co-loading for the prevention of spinal anaeshtesia-induced hypotension during elective caesarean section.

Middle East J Anaesthesiol 2011 Oct;21(3):361-6

Department of Anaesthesia, Corniche Hospital, Abu Dhabi, United Arab Emirates.

Background: Phenylephrine induces maternal bradycardia in 50% of mothers when used for prevention and treatment of spinal anaesthesia-induced hypotension during caesarean delivery. Rapid fluid administration immediately after initiation of the spinal block (co-loading) may have a vasopressor sparing effect. The aim of this study was to evaluate the hypothesis that when using rapid crystalloid co-loading, an infusion of 50 mcg/minute of PE could be as effective as 100 mcg/minute in preventing maternal hypotension but with minimal maternal bradycardia and an acceptable fetal outcome.

Methods: 117 mothers scheduled for elective caesarean section were recruited in this randomized controlled trial. Co-loading with 10 ml/kg of Hartmann's solution started immediately after a standard spinal anaesthesia. Parturients were then randomly allocated into two groups. Group 50 (n = 54) received phenylephrine infusion at 50 microg/min, and group 100 (n=63) 100 microg/min. Rescue phenylephrine boluses (50 mcg) were administered if needed to maintain systolic blood pressure between 80-100% of its baseline values.

Results: Systolic blood pressure was not different between mothers in both groups during the study period. All neonatal Apgar scores at 1 minute were > or =7 and at 5 minutes were > or =9. No mother had umbilical arterial pH <7.2. Umbilical arterial and venous blood gas and acid base values were not different between both groups except the umbilical arterial PCO2 that was significantly higher in group 100. There were more frequent episodes of maternal bradycardia in Group 100 than in Group 50 (eleven and one parturients respectively). There was no difference in the incidence of nausea and vomiting in both groups.

Conclusion: In combination with rapid co-loading, an infusion rate of 50 microg/min of PE is as adequate as 100 microg/min in prevention of spinal anaesthesia-induced hypotension during elective caesarean section. Both infusions are associated with a similar neonatal outcome. PE infusion of 50 microg/min is associated with significantly less maternal bradycardia than 100 microg/min.
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October 2011

Evaluation of hand function after early excision and skin grafting of burns versus delayed skin grafting: a randomized clinical trial.

Burns 2011 Jun 26;37(4):707-13. Epub 2011 Jan 26.

Faculty of Physical Therapy, Cairo University, Cairo, Egypt.

Introduction: Thermal injury of the hand is characterized by disfigurement and deformity with marked problems because the patient is no longer able to perform the daily living activities and function at school or work. Early excision and grafting (E&G) were introduced to decrease hospital stay, hospital cost, and septic complications and to eliminate burn toxins. In this study, E&G was compared with delayed skin grafting in deep hand burns.

Materials And Method: 40 patients with deep second- and third- degree hand burns with average burn size less than 30% total body surface area (TBSA) were randomly divided into E&G group and delayed grafting group. All hands in both groups were subjected to pre and post operative program of physiotherapy. Measurement of total active motion (TAM) of each digit and grip strength was recorded pre and post operative. Hand function using Jebsen-Taylor hand function test (JTHFT) was recorded three months after operation in both groups.

Results: There were statistically significant differences in both groups regarding to TAM, hand grip strength and Jebsen-Taylor hand function test favoring the E&G group.

Conclusion: The study concluded that early excision and skin grafting with physiotherapy gave better results than delayed grafting in terms of preservation of hand function and shortened hospital stay.
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http://dx.doi.org/10.1016/j.burns.2010.12.012DOI Listing
June 2011

Education, prenatal care, and poor perinatal outcome in Khartoum, Sudan.

Int J Gynaecol Obstet 2009 Apr 5;105(1):66-7. Epub 2008 Dec 5.

Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

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http://dx.doi.org/10.1016/j.ijgo.2008.10.026DOI Listing
April 2009

Prolonged hemiplegic migraine.

Neurosciences (Riyadh) 2008 Jul;13(3):302-4

Department of Neurosciences, King Faisal Specialist Hospital and Research Center, PO Box 40047, Jeddah 21499, Kingdom of Saudi Arabia.

Hemiplegic migraine is a rare form of migraine variant. It is characterized by recurrent attacks of headache associated with temporary neurological deficit, usually unilateral hemiparesis or hemiplegia. It can be difficult to distinguish from migrainous stroke clinically, and a full neurological work-up and careful review of medical history and symptoms are necessary for the diagnosis. Two forms of hemiplegic migraine are known: familial and sporadic, phenotypically similar, differentiated by the absence of family history of similar attacks in the sporadic form. We report a case of sporadic hemiplegic migraine with unusually prolonged deficit and progression to quadriplegia with complete return to baseline 7 days after onset. Diffusion weighted images helped in excluding infarction.
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July 2008

Hepatic dysfunction in kidney transplant recipients: prevalence and impact on graft and patient survival.

Clin Exp Nephrol 2007 Dec 21;11(4):309-315. Epub 2007 Dec 21.

Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Background: Liver disease has emerged as an important cause of morbidity and mortality in renal transplant recipients. Liver insufficiency is the cause of death in up to 28% of long-term survivors after renal transplantation. The aim of this work was to evaluate the prevalence and causes of hepatic dysfunction in renal transplant recipients in Egypt, and its impact on both renal graft function and patient survival.

Methods: This study comprised 447 kidney transplant recipients who received their grafts between January 1999 and December 2003 at Mansoura Urology and Nephrology Center. Among these recipients, 104 patients showed persistent hepatic dysfunction, while the remaining 343 had normal liver function or transient hepatic dysfunction of less than 6 months' duration.

Results: We found that the prevalence of persistent hepatic dysfunction in our recipients was 23.3%. Infections such as hepatitis C virus (HCV;, with longer dialysis duration and blood transfusion as risk factors), HBV, and cytomegalovirus (CMV), were the main causes of persistent hepatic dysfunction. Drugs (e.g., the sirolimus and tacrolimus; cyclosporine; and azathioprine) were also associated with hepatic dysfunction. We did not find a significant impact of hepatic dysfunction on either patient or graft survival.

Conclusions: Viral infections-especially HCV and CMV-were more prevalent in the group of patients with persistent hepatic dysfunction, with duration of dialysis as an important risk factor for HCV infection. Dose-dependent cyclosporine-induced hepatic dysfunction was observed early post-transplant. Neither tacrolimus- nor sirolimus-associated hepatic dysfunction was dose-dependent. Hepatic dysfunction had no significant impact on either patient or graft survival; however, this finding may be due to the relatively short duration of follow up.
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http://dx.doi.org/10.1007/s10157-007-0490-7DOI Listing
December 2007