Publications by authors named "Attia Ashraf"

6 Publications

  • Page 1 of 1

Prospective nonrandomized study with early steroid withdrawal (Day 5) postrenal transplant in low immunological risk patients: A singlecenter experience at prince sultan military medical city Riyadh.

Saudi J Kidney Dis Transpl 2019 Nov-Dec;30(6):1398-1406

Department of Nephrology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Steroids remain an essential part of immunosuppressive therapy for renal transplant patients since the start of transplant era. Different immunosuppressive regimens are prescribed so as to minimize the side effects. The purpose of our study is to compare the outcome of early steroid withdrawal with steroid maintenance protocol. It is a prospective nonrandomized study. All patients that received renal transplants from January 2011 to December 2013 were included in the study. Early steroid withdrawal at day 5 was done in low immunological risk patients, and the results were compared with the steroid maintenance group, at one-year, posttransplant. Outcome measures included acute rejection (AR), slow graft function and delayed graft function (SGF and DGF), patient and graft survival, and new-onset diabetes after transplant (NODAT), dyslipidemia, hypertension, and obesity. A total of 249 patients were divided into two groups - 105 patients had early steroid withdrawal and 144 patients were maintained on steroid therapy. Outcome measures were compared one-year posttransplant. There was no significant difference in AR, patient and graft survival, creatinine level, and weight gain. However, a significant difference in systolic and diastolic blood pressure, lipid profile, NODAT, SGF, and DGF was found in the steroid group. Our study shows that early steroid withdrawal is a safe standard of care in low immunological risk patients.
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http://dx.doi.org/10.4103/1319-2442.275484DOI Listing
August 2020

Treatment of cardiac nocardiosis in a post-renal transplant patient of systemic nocardiosis.

J Cardiovasc Thorac Res 2019 28;11(2):161-163. Epub 2019 May 28.

Tulane University, New Orleans, USA.

In general, nocardia infects immunosuppressed patients, however, sometimes it can also infect immunocompetent individuals. Nocardia infection can disseminate to any organ system of the body but the pulmonary system is the most commonly involved system. In some rare cases, the heart can also be involved and the resulting cardiac mycetoma can be treated successfully with antimicrobials without the need of surgery, unlike fungal cardiac mycetomas wherein surgery may be required in addition to antimicrobial therapy. We present an interesting case of post-renal transplant cardiac nocardiosis, which was treated successfully with a course of antibiotics.
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http://dx.doi.org/10.15171/jcvtr.2019.27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669421PMC
May 2019

Brucellosis in renal transplant recipients: a comparative review of 5 cases.

BMJ Case Rep 2018 Jul 30;2018. Epub 2018 Jul 30.

Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Although brucellosis in renal transplant recipients is rare, we studied the clinical characteristics of this infection in this patient population due to the significantly increased number of renal transplantations performed over the past few decades. We report one case from our experience and undertake a review of the previously reported cases retrieved from the PubMed. A total of 5 cases of brucellosis in renal transplant recipients were found to date. The mean time from transplantation to diagnosis of brucellosis was 4.7 years (range, 4 months to 13 years). Blood culture and detection of anti- antibodies were frequently used diagnostic investigations. Treatment with appropriate antibiotic regimen led to a clinical cure and marked improvement in titre in all the patients. This review illustrates that clinicians should remain vigilant for this infectious aetiology following renal transplantation. Further studies are required to delineate the magnitude and scope of this association.
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http://dx.doi.org/10.1136/bcr-2018-225865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069935PMC
July 2018

Hyperinfection Syndrome Combined with Cytomegalovirus Infection.

Case Rep Transplant 2016 15;2016:1786265. Epub 2016 Sep 15.

Department of Nephrology, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.

The mortality in hyperinfection syndrome (SHS) is alarmingly high. This is particularly common in bone marrow, renal, and other solid organ transplant (SOT) patients, where figures may reach up to 50-85%. Immunosuppressives, principally corticosteroids, are the primary triggering factor. In general, the clinical features of hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and starting appropriate therapy. Although recurrent Gram-negative sepsis and meningitis have been previously reported, the combination of both cytomegalovirus (CMV) and strongyloidiasis had rarely been associated. We here describe a patient who survived SHS with recurrent () urosepsis and CMV infection.
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http://dx.doi.org/10.1155/2016/1786265DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040796PMC
September 2016

The transgenic expression of LARGE exacerbates the muscle phenotype of dystroglycanopathy mice.

Hum Mol Genet 2014 Apr 13;23(7):1842-55. Epub 2013 Nov 13.

Comparative Biomedical Sciences, Royal Veterinary College, University of London, London NW1 0TU, UK.

Mutations in fukutin-related protein (FKRP) underlie a group of muscular dystrophies associated with the hypoglycosylation of α-dystroglycan (α-DG), a proportion of which show central nervous system involvement. Our original FKRP knock-down mouse (FKRP(KD)) replicated many of the characteristics seen in patients at the severe end of the dystroglycanopathy spectrum but died perinatally precluding its full phenotyping and use in testing potential therapies. We have now overcome this by crossing FKRP(KD) mice with those expressing Cre recombinase under the Sox1 promoter. Owing to our original targeting strategy, this has resulted in the restoration of Fkrp levels in the central nervous system but not the muscle, thereby generating a new model (FKRP(MD)) which develops a progressive muscular dystrophy resembling what is observed in limb girdle muscular dystrophy. Like-acetylglucosaminyltransferase (LARGE) is a bifunctional glycosyltransferase previously shown to hyperglycosylate α-DG. To investigate the therapeutic potential of LARGE up-regulation, we have now crossed the FKRP(MD) line with one overexpressing LARGE and show that, contrary to expectation, this results in a worsening of the muscle pathology implying that any future strategies based upon LARGE up-regulation require careful management.
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http://dx.doi.org/10.1093/hmg/ddt577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944840PMC
April 2014

Predictors of psychological well-being of nurses in Alexandria, Egypt.

Int J Nurs Pract 2003 Oct;9(5):313-20

High Institute of Public Health, Alexandria University, Alexandria, Egypt.

As nursing has been previously identified as a stressful occupation, sources of job stress and levels of job satisfaction were extensively investigated. However, studies addressing issues of nurses' mental health are scarce. This work aims to assess psychological well-being of nurses in different job settings in Alexandria and to identify sociodemographic, psychosocial and workplace predictors. A total sample of 412 nurses represented nurses working in five different health organizations in Alexandria. A self-administered questionnaire was used to collect sociodemographic, occupational and health data, and the Standardized Arabic Version of General Health questionnaire (GHQ-30 items), Job Descriptive Index (JDI), and Social Support Scale (SSS) were also used. Results revealed that 21.67% of nurses recorded moderate to severe psychological symptoms on GHQ. Fewer years of experience, negative family and friend support, and negative total work satisfaction were found to be significant predictors of psychological ill health among nurses in a descending rank order. Implications for nursing intervention will be discussed.
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http://dx.doi.org/10.1046/j.1440-172x.2003.00437.xDOI Listing
October 2003