Publications by authors named "M S Mohy Eldin"

38 Publications

Does renal transplant in children with LUTD improve their bladder function?

Pediatr Transplant 2020 09 30;24(6):e13735. Epub 2020 May 30.

Pediatric Urology Division, Urology Department, Cairo Children's Hospital, Cairo University, Cairo, Egypt.

Much is still unknown about LUT function after receiving renal graft. Graft function was the main focus of different studies discussing the same issue. However, these studies ignored the effects of the graft on lower tract function and more demand for bladder cycling and growth of the child. Therefore, we aimed at evaluating the LUT function after RT into patients with LUTD. We enrolled a retrospective cohort of 83 live renal transplant children with LUTD. The 44 patients in Group (A) had a defunctionalized bladder, and the 39 patients in Group (B) had underlying LUT pathology. All patients had clinical and urodynamic evaluation of LUT functions at least 1 year after RT. We found that the improvement in patients with impaired bladder compliance was 73% in Group (A) and 60% in Group (B), with no statistically significant difference between the study groups. In Group (B), there was statistically significant worsening of MFP (8.4%) and mean PVR (79.9%) after RT. In Group (A), mild but stable significant improvement of all clinical and urodynamic parameters was observed. Serum creatinine was significantly worse in patients with pathological LUTD compared with those with defunctionalized bladder but without significant effect on graft survival. All LUT variables seemed to have no adverse effect on graft survival except for use of CIC and augmented bladder. Incident UTI independent of LUT variables accounted for 20% of graft creatinine change.
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http://dx.doi.org/10.1111/petr.13735DOI Listing
September 2020

Effective Elimination of Contaminant Antibiotics Using High-Surface-Area Magnetic-Functionalized Graphene Nanocomposites Developed from Plastic Waste.

Materials (Basel) 2020 Mar 26;13(7). Epub 2020 Mar 26.

Polymer Materials Research Department, Advanced Technology and New Materials Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, Alexandria 21934, Egypt.

The presence of pharmaceutical residues in aquatic environments represents a risk for the equilibrium of the ecosystem and may seriously affect human safety itself in the long term. To address this issue, we have synthesized functional materials based on highly-reduced graphene oxide (HRGO), sulfonated graphene (SG), and magnetic sulfonated graphene (MSG). The method of synthesis adopted is simple and inexpensive and makes use of plastic bottle waste as the raw material. We have tested the fabricated materials for their adsorption efficiency against two model antibiotics in aqueous solutions, namely Garamycin and Ampicillin. Our tests involved the optimization of different experimental parameters of the adsorption process, such as starting antibiotic concentration, amount of adsorbent, and time. Finally, we characterized the effect of the antibiotic adsorption process on common living organisms, namely DH5α ( DH5α) bacteria. The results obtained demonstrate the efficiency of the method in addressing the issue of the emergence of antibiotic-resistant bacteria, which will help in preventing changes in the ecosystem.
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http://dx.doi.org/10.3390/ma13071517DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177265PMC
March 2020

Comparative Application of Different Substaging Techniques for Non-Muscle Invasive Urothelial Carcinoma.

Pathol Oncol Res 2020 Jul 21;26(3):1823-1831. Epub 2019 Nov 21.

Urology and Nephrology Hospital, Assiut University, Asyut, Egypt.

To evaluate the diagnostic performance and clinical significance of 4 systems of substaging cases with non-muscle invasive urothelial bladder carcinoma. In addition 4 cutoff measures were evaluated for prediction of muscularis-mucosa invasion. Four substaging systems were applied to 57 NMIBC cases to assess which of these reported methods correlates best with recurrence and progression. On univariate regression analysis patients having tumor size more than 3 cm, solid tumor architecture, high grade, substage B, substage T1e, substage ROL 2 and Tumor depth more than 1 mm were associated with higher recurrence. On multivariate analysis all the four substaging systems, tumor size, grade and tumor type had significant prognostic value for recurrence. Regarding progression only the metric substaging method was associated with tumor progression (p = 0.04). However, on univariate and multivariate regression analysis none of the substaging systems showed prognostic significance and only solid tumor architecture and CIS had significant prognostic value for tumor progression. The ROC curve analysis showed that 1 mm depth of invasion had the best accuracy for detection of muscularis-mucosa invasion (80.2%). Using 1 mm cutoff in measuring the depth and 0.5 mm for the diameter of infiltration may provide clinically relevant information to guide a more personalized therapy for NMIBC. Inclusion of both measures in addition to other histopathologic variables may aid in the development of a scoring system.
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http://dx.doi.org/10.1007/s12253-019-00767-1DOI Listing
July 2020

NLoS underwater VLC system performance: static and dynamic channel modeling.

Appl Opt 2019 Oct;58(30):8272-8281

In this paper, the impact of water channels under different communication link parameters is studied for underwater visible light communication (UVLC). The objective is to highlight the best results for non-line of sight (NLoS) communication links. In addition, NLoS links are studied under different parameters: LED colors, viewing angle, receiving angle, and data rates. The results are obtained and plotted using MATLAB simulation. The performance of the received power is first measured at different wavelengths and data rates. Then, the best results are further investigated at different viewing angles and receiving angles. The obtained results show that using cyan color provides more depth for the NLoS case, as well as a low bit error rate compared to the other colors. Most of the literature is concerned with unpractical configurations in underwater scenarios, such as an empty sea or assuming no human-object or blockage environment. We use the practical setup in Zemax Optics Studio to allow a precise description of ray tracing and high order of reflections inside a sea water environment. The channel impulse response (CIR) is obtained for static channel modeling, including a blockage environment to evaluate the best transmitters in sea water. Also, we are able to compare the average delay and the average delay spread of the source colors. The reflection characteristics of the sea water are considered as wavelength dependent. The CIR obtained by Zemax Solver and MATLAB indicates that cyan is the best source in sea water for different LED chips. Moreover, other previous studies assume perfect alignment scenarios between divers, which is not practical and not suitable for real channel gain results. Accordingly, we present a comprehensive dynamic channel modeling and characterization study for UVLC. Our study is based on Zemax programming language (ZPL) combined with Zemax Optics Studio. Using ZPL enables us to apply a mobility algorithm for divers and measure the channel gain variations due to random motion. We introduce a dynamic motion in a single-input single-output scenario and a single-input multiple-output scenario in the presence of blockage divers. Statistical analyses are studied for the appropriate distributions that can fit the data with various transmitter and receiver specifications. All dynamic scenarios are performed using cyan color in sea water, as it is proven to have satisfactory performance. The statistical results are beneficial for further analysis. As case studies, we consider various underwater scenarios, and the resulting parameters of statistical distributions can be used for future analysis in UVLC dynamic environments.
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http://dx.doi.org/10.1364/AO.58.008272DOI Listing
October 2019

Fabrication of a novel low-cost superoleophilic nonanyl chitosan-poly (butyl acrylate) grafted copolymer for the adsorptive removal of crude oil spills.

Int J Biol Macromol 2019 Nov 20;140:588-599. Epub 2019 Aug 20.

Polymer Materials Research Department, Advanced Technologies and New Materials Research Institute (ATNMRI), City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, P.O. Box: 21934, Alexandria, Egypt. Electronic address:

A novel superoleophilic-hydrophobic nonanyl chitosan-poly (butyl acrylate) grafted copolymer was fabricated as a low-cost oil-adsorbent. Chitosan (CS) was coupled with a hydrophobic nonanal (N) to form nonanyl chitosan (NCS) schiff base, and followed by grafting with butyl acrylate monomers (ButA). The grafted copolymer was characterized by FTIR, TGA and SEM tools. The grafting percent was augmented and reached 88.5% with increasing ButA concentration up to 156 mM. Moreover, measurements of contact angle proved the superoleophilic character of NCS-g-poly (ButA) copolymer with an oil-contact angle 31°. Factors affecting the removal process such as contact time, oil type, oil dose, adsorbent dose, temperature and agitation speed were optimized. An increment in the oil removal (%) was observed with increasing the oil viscosity in the order of gasoil < mobil-1 oil < light crude oil < heavy crude oil. Besides, the adsorption process followed the pseudo-second order model and the equilibrium data were sufficiently fitted with the Langmuir model with a maximum adsorption capacity 108.79 g/g at 25 °C. Thermodynamic parameters computed from Van't Hoff plot confirmed the process to be exothermic, favorable and spontaneous. The results nominate the superoleophilic adsorbent as a potential oil- adsorbent for petroleum oil spills removal.
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http://dx.doi.org/10.1016/j.ijbiomac.2019.08.169DOI Listing
November 2019

Fabrication of biodegradable gelatin/chitosan/cinnamaldehyde crosslinked membranes for antibacterial wound dressing applications.

Int J Biol Macromol 2019 Oct 29;139:440-448. Epub 2019 Jul 29.

Polymeric Materials Research Department, Advanced Technology and New Materials Research Institute (ATNMRI), City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, P.O. Box, 21934, Alexandria, Egypt.

This study intends to fabricate new biodegradable and antimicrobial membranes based on crosslinked gelatin/chitosan biopolymers. Cinnamaldehyde was incorporated into membranes for boosting their antimicrobial activities. FTIR spectroscopy and electronic spectrum analysis were used to prove their chemical structures, while SEM and TGA analysis were applied to investigate the morphological changes and the thermal properties of the crosslinked membranes. Moreover, ion exchange capacity, wettability and mechanical analysis were also conducted to get more information about the physicochemical properties for the developed membranes. Four different types of bacteria have been used for studying the antibacterial activities of the crosslinked membranes (one gram-positive and three gram-negative bacteria). The results showed a significant augmentation in the inhibition percent with increasing cinnamaldehyde content in the membrane matrix. Besides, hemocompatibility, biodegradability, and cytotoxicity studies were performed and the findings emphasized that the as-fabricated biodegradable gelatin/chitosan/cinnamaldehyde membranes could be efficiently used as antibacterial dressers for ameliorating the wound healing.
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http://dx.doi.org/10.1016/j.ijbiomac.2019.07.191DOI Listing
October 2019

Access to care for non-communicable diseases in Mosul, Iraq between 2014 and 2017: a rapid qualitative study.

Confl Health 2018 29;12:48. Epub 2018 Dec 29.

1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

During June 2014 to April 2017, the population of Mosul, Iraq lived in a state of increasing isolation from the rest of Iraq due to the city's occupation by the Islamic State group. As part of a study to develop a generalisable method for estimating the excess burden of non-communicable diseases (NCDs) in conflict-affected settings, in April-May 2017 we conducted a brief qualitative study of self-reported care for NCDs among 15 adult patients who had fled Mosul and presented to Médecins Sans Frontières clinics in the Kurdistan region with hypertension and/or diabetes. Participants reported consistent barriers to NCD care during the so-called Islamic State period, including drug shortages, insecurity and inability to afford privately sold medication. Coping strategies included drug rationing. By 2016, all patients had completely or partially lost access to care. Though limited, this study suggests a profound effect of the conflict on NCD burden.
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http://dx.doi.org/10.1186/s13031-018-0183-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311030PMC
December 2018

Computed Tomography Assessment of Hepatic Metastases of Breast Cancer with Revised Response Evaluation Criteria in Solid Tumors (RECIST) Criteria (Version 1.1): Inter-Observer Agreement.

Pol J Radiol 2017 20;82:593-597. Epub 2017 Oct 20.

Department of Internal Medicine (Medical Oncology), Faculty of Medicine, Oncology Center Mansoura University, Mansoura, Egypt.

Background: To assess inter-observer agreement of revised RECIST criteria (version 1.1) for computed tomography assessment of hepatic metastases of breast cancer.

Material/methods: A prospective study was conducted in 28 female patients with breast cancer and with at least one measurable metastatic lesion in the liver that was treated with 3 cycles of anthracycline-based chemotherapy. All patients underwent computed tomography of the abdomen with 64-row multi- detector CT at baseline and after 3 cycles of chemotherapy for response assessment. Image analysis was performed by 2 observers, based on the RECIST criteria (version 1.1).

Results: Computed tomography revealed partial response of hepatic metastases in 7 patients (25%) by one observer and in 10 patients (35.7%) by the other observer, with good inter-observer agreement (k=0.75, percent agreement of 89.29%). Stable disease was detected in 19 patients (67.8%) by one observer and in 16 patients (57.1%) by the other observer, with good agreement (k=0.774, percent agreement of 89.29%). Progressive disease was detected in 2 patients (7.2%) by both observers, with perfect agreement (k=1, percent agreement of 100%). The overall inter-observer agreement in the CT-based response assessment of hepatic metastasis between the two observers was good (=0.793, percent agreement of 89.29%).

Conclusions: We concluded that computed tomography is a reliable and reproducible imaging modality for response assessment of hepatic metastases of breast cancer according to the RECIST criteria (version 1.1).
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http://dx.doi.org/10.12659/PJR.902930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894063PMC
October 2017

Correction to: Laser-assisted surgery of the upper aero-digestive tract: a clarification of nomenclature. A consensus statement of the European Laryngological Society.

Eur Arch Otorhinolaryngol 2018 02;275(2):657-658

Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

The article 'Laser-assisted surgery of the upper aero-digestive tract: a clarification of nomenclature. A consensus statement of the European Laryngological Society,' written by Marc Remacle, Christoph Arens, Mostafa Badr Eldin, Guillermo Campos, Carlos Chiesa Estomba, Pavel Dulguerov, Ivana Fiz, Anastasios Hantzakos, Jerôme Keghian, Francesco Mora, Nayla Matar, Giorgio Peretti, Cesare Piazza, Gregory N. Postma, Vyas Prasad, Elisabeth Sjogren, Frederik G. Dikkers, was originally published Online First without open access. After publication in volume 274 issue 10, page 3723-3727 the authors decided to opt for Open Choice and to make the article an open access publication. Therefore, the copyright of the article has been changed to
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http://dx.doi.org/10.1007/s00405-017-4851-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828136PMC
February 2018

Laser-assisted surgery of the upper aero-digestive tract: a clarification of nomenclature. A consensus statement of the European Laryngological Society.

Eur Arch Otorhinolaryngol 2017 Oct 17;274(10):3723-3727. Epub 2017 Aug 17.

Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Acronyms and abbreviations are frequently used in otorhinolaryngology and other medical specialties. CO laser-assisted transoral surgery of the pharynx, the larynx and the upper airway is a family of commonly performed surgical procedures termed transoral laser microsurgery (TLM). The abbreviation TLM can be confusing because of alternative modes of delivery. Classification and definition of the different types of procedures, performed transorally or transnasally, are proposed by the Working Committee for Nomenclature of the European Laryngological Society, emphasizing the type of laser used and the way this laser is transmitted. What is usually called TLM, would more clearly be defined as CO laser transoral microsurgery or CO TOLMS or CO laser transoral surgery only (with a handpiece) would be defined as CO TOLS. KTP transnasal flexible laser surgery would be KTP TNFLS. Transoral use of the flexible CO wave-guide with a handpiece would be a CO TOFLS. One can argue that these clarifications are not necessary and that the abbreviation TLM for transoral laser microsurgery is more than sufficient. But this is not the case. Laser surgery, office-based laser surgery and microsurgery are frequently and erroneously interchanged for one another. These classifications allow for a clear understanding of what was performed and what the results meant.
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http://dx.doi.org/10.1007/s00405-017-4708-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758682PMC
October 2017

Free hand technique of cervical lateral mass screw fixation.

J Craniovertebr Junction Spine 2017 Apr-Jun;8(2):113-118

Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Study Design: We introduce a simple free hand technique with great ease of application, without angles, measures or degrees, and without any fluoroscopic guidance. It is a safe and reproducible technique. We present our preliminary experience with the use this technique, with inimitable simplicity.

Purpose: The primary aim of the procedure was to achieve adequate screw trajectory in an apparent challenging ease which is reproducible with a good outcome.

Overview Of Literature: Lateral mass screw fixation is used for posterior subaxial cervical fixation. It was described by Louis and Magerl, then by Anderson, An, and Ebraheim . Each one described the procedure with a unique screw entrance point and trajectory.

Technical Note: This study is a prospective case study of 45 patients who underwent subaxial cervical lateral mass screw fixation. The screws were inserted using a free hand method. The described free hand technique was found to minimize the morbidity associated with other techniques without compromising the quality of fixation.

Conclusions: Surgical experiences with this technique found it equally safe, rapid, easy, and reproducible.
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http://dx.doi.org/10.4103/jcvjs.JCVJS_43_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490344PMC
July 2017

Antibacterial and antioxidative activity of O-amine functionalized chitosan.

Carbohydr Polym 2017 Aug 21;169:441-450. Epub 2017 Apr 21.

Laboratory of Bioorganic Chemistry of Drugs, Institute of Experimental Pharmacology and Toxicology, Bratislava, Slovakia.

Cinnamaldehyde was immobilized to O-amine functionalized chitosan via a coupling reaction. Fourier transform infrared spectroscopy confirmed N-cinnamyl substitution. Wetting analyses demonstrate more hydrophobicity in the N-cinnamyl substituted O-amine functionalized chitosan compared to chitosan or unsubstituted O-amine functionalized chitosan. Thermal gravimetric analysis and differential scanning calorimetry demonstrates that the prepared N-cinnamyl substituted O-amine functionalized chitosan exhibits higher thermostability than unmodified chitosan at temperatures in which polysaccharides are commonly stored and utilised. The N-cinnamyl substituted O-amine functionalized chitosan, against four different bacteria strains [two gram-positive (Staphylococcus aureus and Bacillus cereus) and two gram-negative (Escherichia coli and Pseudomonas aeruginosa)], displays promotion of inhibition activity against these bacterial strains. Finally, the antioxidative activity of the N-cinnamyl substituted O-amine functionalized chitosan was compared with those activities of chitosan and O-amine functionalized chitosan. This was evaluated by uninhibited and inhibited hyaluronan degradation and ABTS assay. The N-cinnamyl substituted O-amine functionalized chitosan shows a lower activity towards donating a hydrogen radical compared to chitosan or O-amine functionalized chitosan. On the other hand, the N-cinnamyl substituted O-amine functionalized chitosan exhibited a higher ability to scavenge the ABTS cation radical compared to chitosan and O-amine functionalized chitosan.
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http://dx.doi.org/10.1016/j.carbpol.2017.04.027DOI Listing
August 2017

Odontoidectomy through posterior midline approach followed by same sitting occipitocervical fixation: A cadaveric study.

J Craniovertebr Junction Spine 2017 Jan-Mar;8(1):58-63

Department of Neurosurgery, Cairo University, Cairo, Egypt.

Object: Atlantoaxial instability with irreducible odontoid process is one of the challenges in spine surgery. These lesions are commonly treated through anterior transoral approach which is followed by posterior atlantoaxial fusion. However, there are still many limitations, especially cerebrospinal fluid fistula with subsequent life-threatening infection, difficulty in cases with limited opening of mouth due to temporomandibular arthritis or anomalies of naso-oropharynx. Türe . used the extreme lateral transatlas approach for the removal of odontoid. In this study, we applied the transatlas approach but through posterior midline incision aiming to evaluate its safety and feasibility.

Methods: In four silicon injected, formalin-fixed cadaver heads, posterior removal of the odontoid was done through the familiar midline incision and subperiosteal muscle separation and elevation of muscles as on unit followed by microscopic exposure and mobilization of the vertebral artery after opening of the foramen transversarium of atlas followed by drilling of lateral mass and odontoidectomy. Occipitocervical stabilization was done between the occiput and C2, C3 (C1 lateral mass screw can be added in the contralateral side for better stabilization).

Results: Unilateral excision of the lateral mass of atlas after mobilization of the vertebral artery provided safe and excellent exposure of the odontoid process in the four cadaver heads without injury to vertebral artery or retraction of the dura.

Conclusion: Posterior removal of the odontoid can be done safely through wide and sterile operative field, and occipitocervical fixation performed at the same sitting without need for another operation and hence avoids the risk of cord injury from repositioning.
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http://dx.doi.org/10.4103/0974-8237.199879DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324362PMC
March 2017

RNF168 and USP10 regulate topoisomerase IIα function via opposing effects on its ubiquitylation.

Nat Commun 2016 08 25;7:12638. Epub 2016 Aug 25.

Department of Medical Biophysics, Princess Margaret Cancer Centre, Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada M5G 1L7.

Topoisomerase IIα (TOP2α) is essential for chromosomal condensation and segregation, as well as genomic integrity. Here we report that RNF168, an E3 ligase mutated in the human RIDDLE syndrome, interacts with TOP2α and mediates its ubiquitylation. RNF168 deficiency impairs decatenation activity of TOP2α and promotes mitotic abnormalities and defective chromosomal segregation. Our data also indicate that RNF168 deficiency, including in human breast cancer cell lines, confers resistance to the anti-cancer drug and TOP2 inhibitor etoposide. We also identify USP10 as a deubiquitylase that negatively regulates TOP2α ubiquitylation and restrains its chromatin association. These findings provide a mechanistic link between the RNF168/USP10 axis and TOP2α ubiquitylation and function, and suggest a role for RNF168 in the response to anti-cancer chemotherapeutics that target TOP2.
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http://dx.doi.org/10.1038/ncomms12638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007378PMC
August 2016

Convergence of a diabetes mellitus, protein energy malnutrition, and TB epidemic: the neglected elderly population.

BMC Infect Dis 2016 07 26;16:361. Epub 2016 Jul 26.

Médecins Sans Frontières, Paris, France.

Background: On a global scale, nearly two billion persons are infected with Mycobacterium tuberculosis. From this vast reservoir of latent tuberculosis (TB) infection, a substantial number will develop active TB during their lifetime, with some being able to transmit TB or Multi-drug- resistant (MDR) TB to others. There is clinical evidence pointing to a higher prevalence of infectious diseases including TB among individuals with Diabetes Mellitus (DM). Furthermore, ageing and diabetes mellitus may further aggravate protein-energy malnutrition (PEM), which in turn impairs T-lymphocyte mediated immunologic defenses, thereby increasing the risk of developing active TB and compromising TB treatment. This article aims to a) highlight synergistic mechanisms associated with immunosenescence, DM and PEM in relation to the development of active TB and b) identify nutritional, clinical and epidemiological research gaps.

Methods: To explore the synergistic relationship between ageing, DM, tuberculosis and PEM, a comprehensive review was undertaken. The MEDLINE and the Google Scholar databases were searched for articles published from 1990 to March 2015, using different MESH keywords in various combinations.

Results: Ageing and DM act synergistically to reduce levels of interferon gamma (IFN- γ), thereby increasing susceptibility to TB, for which cell mediated immunity (CMI) plays an instrumental role. These processes can set in motion a vicious nutritional cycle which can predispose to PEM, further impairing the CMI and consequently limiting host defenses. This ultimately transforms the latent TB infection into active disease. A clinical diagnostic algorithm and clinical guidelines need to be established for this population.

Conclusion: Given the increase in ageing population with DM and PEM, especially in resource-poor settings, these synergistic tripartite interactions must be examined if a burgeoning TB epidemic is to be averted. Implementation of a comprehensive, all-encompassing approach to curb transmission is clearly indicated. To this end, clinical, nutritional and epidemiological research gaps must be addressed without a delay.
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http://dx.doi.org/10.1186/s12879-016-1718-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960905PMC
July 2016

Serum C3 and uterine artery Doppler indices at 14-20 weeks gestation for preeclampsia screening in low-risk primigravidas: A prospective observational study.

J Reprod Immunol 2016 09 18;117:4-9. Epub 2016 Jun 18.

Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt.

Problem: Preeclampsia affects 2-10% of human pregnancies with poor screening tests. In order to intervene preventively, high risk population should be identified before the 20th week of pregnancy and by a method not subjected to operator efficiency.

Methodology: Prospective observational study recruiting 825 low risk primigravidas. Serum C3 and uterine artery Doppler indices were measured at 14-20 weeks.

Results: Serum C3 levels at 14-20 weeks of gestation had a sensitivity 83.3%, specificity 100%, PPV 100% and NPV 98.3% when the cut-off value was 53.1mg/. For the mean RI, the best cut off value found was 0.72 with 100% sensitivity, 99.1% specificity, 92.3% PPV and 100% NPV. For the mean PI the best cut off value was 1.35 with 100% sensitivity, 94.1% specificity, 63.2% PPV and 100% NPV. The combination of serum C3 level and mean uterine artery PI showed 100% sensitivity, 97.4% specificity, 80% PPV and 100% NPV in prediction of PE.

Conclusion: Serum C3 levels at 14-20 weeks can be used for prediction of PE with comparable results to uterine artery Doppler indices but has the superiority of being operator independent.
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http://dx.doi.org/10.1016/j.jri.2016.06.005DOI Listing
September 2016

Bariatric Bypass Surgery to Resolve Complicated Childhood Morbid Obesity: Case Report Study.

Medicine (Baltimore) 2015 Dec;94(49):e2221

From the Laparoscopic and Bariatric Surgery Department, Al Azhar School of Medicine, Al Hussein University Hospital (AE, M Amer, OO, MF, MTE, AY); Pediatric Department, Misr International School of Medicine, Cairo (MAE); Biochemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia (SB); Internal Medicine Department, Al Azhar school of Medicine, Asuit, Egypt (KS); Cardiovascular Medicine and Pharmacology Departments, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates (AAE, AS); Pulmonology and ICU Departments, Aswan School of Medicine, Aswan University, Aswan (SB); Hepatology Department, National Liver Institute, Minoufiya University, Minoufiya (M Amer); Internal Medicine Department, Al Azhar school of Medicine, Cairo, Egypt (M Alboraie); General and Laparoscopic Surgery Department, Al Azhar School of Medicine, Al Hussein University Hospital, Cairo (AR); and GIT & Hepatology Department, Al Azhar School of Medicine, Asuit Branch, Asuit, Egypt (AEAE).

Children obesity has become one of the most important public health problems in many countries worldwide. Although the awareness of childhood obesity as a modifiable health risk is high, but many societies do not prioritize this issue as a health care problem, which may lead to comorbidities and even premature death. Despite the rising interest in bariatric surgery for children, only laparoscopic sleeve gastrectomy (LSG) is being considered in resolving childhood obesity who failed other dietary or drug therapies; however many of LSG procedures failed to reduce the weight in children or resulted in complications postsurgery.Here, we present a novel bariatric procedure to clue out a female child 13 years old presented with Legg-Calvé-Perthes disease-associated morbid obesity. The surgical bariatric technique applied both fundal resection and surgical bypass in pediatric obesity using the Elbanna novel bariatric technique.Bariatric surgical bypass may be considered in complicated-childhood cases who failed all other options.
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http://dx.doi.org/10.1097/MD.0000000000002221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008506PMC
December 2015

A Description for Rock Joint Roughness Based on Terrestrial Laser Scanner and Image Analysis.

Sci Rep 2015 Nov 20;5:16999. Epub 2015 Nov 20.

Three Gorges Research Center for Geo-hazard, Ministry of Education, China University of Geosciences, Wuhan 430074, China.

Shear behavior of rock mass greatly depends upon the rock joint roughness which is generally characterized by anisotropy, scale effect and interval effect. A new index enabling to capture all the three features, namely brightness area percentage (BAP), is presented to express the roughness based on synthetic illumination of a digital terrain model derived from terrestrial laser scanner (TLS). Since only tiny planes facing opposite to shear direction make contribution to resistance during shear failure, therefore these planes are recognized through the image processing technique by taking advantage of the fact that they appear brighter than other ones under the same light source. Comparison with existing roughness indexes and two case studies were illustrated to test the performance of BAP description. The results reveal that the rock joint roughness estimated by the presented description has a good match with existing roughness methods and displays a wider applicability.
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http://dx.doi.org/10.1038/srep16999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653810PMC
November 2015

Predictive prognostic role of with discrepancy in the liver and serum of genotype 4 hepatitis C virus patients.

Biomed Rep 2014 Nov 13;2(6):843-848. Epub 2014 Aug 13.

The Molecular Pathology Research Group, Department of Pharmacology and Toxicology, German University in Cairo, New Cairo 11835, Egypt.

microRNA (miRNA) expression in organs does not always represent their quantity in serum. A disparity in the expression of has been reported in the tissues and serum of hepatocellular carcinoma (HCC) patients. Since hepatitis C virus (HCV) is a major cause of HCC and has never been studied in HCV, the present study aimed to investigate the expression profile in genotype 4 (GT4)-HCV patients to evaluate whether this pattern is also apparent in HCV. RNA was extracted from liver tissues, peripheral mononuclear cells (PBMCs) and serum samples from GT4-HCV-infected patients and healthy donors to evaluate the relative expression using quantitative reverse transcription-polymerase chain reaction. was significantly higher in the serum of naïve patients compared to controls, and an inverse correlation with the viral load and liver enzymes was apparent. By contrast, no difference in expression was observed in the liver tissues and PBMCs of patients compared to controls. This expression observed in HCV is conflicting to that previously reported in HCC. The study also demonstrates a significant upregulation of post-interferon/ribavirin treatment in the serum of sustained virological responders (SVRs) compared to non-responders and treatment-naïve SVRs. In conclusion, may be considered to be a possible prognostic marker in GT4-HCV infection.
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http://dx.doi.org/10.3892/br.2014.343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179737PMC
November 2014

Deep sternal wound infection after coronary artery bypass: How to manage?

Asian Cardiovasc Thorac Ann 2014 Jul 14;22(6):649-54. Epub 2014 May 14.

Department of Cardiothoracic Surgery, Chest Diseases Hospital, Kuwait.

Mediastinitis is a devastating sternal wound complication. The aim of this study was to identify the incidence, risk factors, mortality, and different treatment modalities of mediastinitis after isolated coronary artery bypass grafting. From January 2007 to May 2010, 1424 patients who underwent isolated coronary artery bypass grafting were studied retrospectively; 1398 (group 1) had no mediastinitis, and 26 (group 2) developed mediastinitis. The diagnosis and classification of mediastinitis were based on the criteria of the Center for Disease Control and Prevention and the Emory classification, respectively. Multivariate analysis showed only 4 risk factors: diabetes mellitus, obesity, prolonged postoperative intensive care unit stay, and prolonged intubation time. On univariate analysis, female sex, renal failure, and reexploration for bleeding were also significant risk factors. The incidence of mediastinitis (1.83%) and the subsequent mortality rate (7.69%) were comparable to those of previous reports. Early detection and aggressive management of mediastinitis play major roles in decreasing the related mortality and morbidity. The Emory classification with some modification is very helpful in choosing the proper treatment modality.
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http://dx.doi.org/10.1177/0218492314536106DOI Listing
July 2014

New genetic markers for diagnosis of hepatitis C related hepatocellular carcinoma in Egyptian patients.

J Gastrointestin Liver Dis 2013 Dec;22(4):419-25

Endemic Medicine and Hepatogastroenterology, Cairo University, Cairo, Egypt;

Background And Aim: Early detection of hepatocellular carcinoma (HCC) enhances effective and curative management. New genetic markers with distinct diagnostic ability are required.

Aim: determine the expression of GPC3, PEG10, SERPINI1, MK and QP-C in the peripheral blood of HCC patients.

Methods: 74 HCV patients were recruited and divided into three groups; chronic hepatitis (I), liver cirrhosis (II) and HCC (III). Demographics, laboratory and imaging data were collected. Child score and metastatic work up were completed. The expression of the five candidate genes in the peripheral blood was performed by qRT-PCR assay.

Results: Groups were gender matched, age in group I was significantly lower than in groups II and III (37.7 vs 50.4 and 55.6, p value <0.005). CHILD score; group II and III A/B/C = (7/5/6) and (20/6/3). AFP was significantly higher in group III than I and II (204 vs 3.9 and 6.9, p < 0.01). In HCC group 69% of the lesions were < 5 cm, and had 1-2 nodules; 14% had metastases. GPC3, PEG10, SERPINI1 and MK mRNA were significantly higher in the HCC group compared to the other groups while QP-C mRNA was higher in chronic hepatitis C group compared to other groups. The gene expression values in HCC patients were independent of the tumor size, AFP levels or extrahepatic metastasis. Combined measurement of the five gene markers showed 100% sensitivity and 33% specificity, 48% PPV and 100% NPV.

Conclusion: GPC3, PEG10, SERPINI1 and MK are genetic markers that can represent a useful tool for detection of HCC.
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December 2013

Prevalence of iron overload complications among patients with b-thalassemia major treated at Dubai Thalassemia Centre.

Ann Saudi Med 2013 Jan-Feb;33(1):18-21

Dubai Health Authority Thalassemia Center, Dubai, United Arab Emirates.

Background And Objectives: Authors and team members of the Dubai Thalassemia Centre obtained data on the prevalence of iron overload complications among patients with b-thalassemia major (b-TM) and compared it to international data to improve patient care and evaluate the effectiveness of earlier used treatment modalities. The information obtained is also expected to be useful in genetic counseling.

Design And Setting: Cross-sectional study of all living transfusion-dependent b-TM patients registered at the Thalassemia Centre in Dubai, United Arab Emirates, until the end of 2007 (n=382).

Patients And Methods: Diagnosis of TM was based on clinical history and laboratory confirmation by hemoglobin electrophoresis and DNA testing. All were uniformly treated with desferrioxamine and monitored by serial serum ferritin. results: The mean (SD) age of patients was 15.4 (7.6) years, with 50.5% males. Mean (SD) serum ferritin was 2597.2 (1976.8) micro g/L. The frequency of iron overload complications were as follows: hypogonadism (n=99, 52.7%), hypoparathyroidism (n=40, 10.5%), diabetes mellitus (n=40, 10.5%), hypothyroidism (n=24, 6.5%) and cardiomyopathies (n=7, 1.8%). Hypogonadism was the most common endocrine abnormality in our study and other reported series. However, cardiomyopathies were less prevalent among our patients with higher rates of diabetes and hypoparathyroidism compared to rates reported internationally. Females had statistically significant lower serum ferritin (2530.8 (1931.2), P < .05) with a lower cardiomyopathies rate.

Conclusion: Iron overload related complications among our patients with thalassemia major were different from those reported internationally. Studying the genetic status of patients from our area may uncover the underlying genetic modifiers of iron overload mediated organs injury.
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http://dx.doi.org/10.5144/0256-4947.2013.18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078582PMC
September 2013

A new class of antimetabolites: pyridine thioglycosides as potential anticancer agents.

Z Naturforsch C J Biosci 2010 Sep-Oct;65(9-10):577-87

Faculty of Science, Chemistry Department, Helwan University, Helwan, Cairo, Egypt.

The present study was designed for highlighting and focusing on the cytotoxic activity of a new class of antimetabolites both on human cell lines, namely liver carcinoma cell line (Hepg2), lung carcinoma cell line (H460), breast carcinoma cell line (MCF7), brain carcinoma cell line (U251), and animal cell line EAC (Ehrlich ascites carcinoma cells). The results revealed that some of these modified deazapyrimidine thioglycosides have significant cytotoxic activity against EAC cells with growth inhibition percentage ranged between 80% to 90%. The possible inhibitory mechanism of the pyridine thioglycosides was explored by studying the cell cycle perturbation of thioglycosides against human cell lines (in vitro) as well as the most suitable time for maximum compound cytotoxic activity after 6, 18, and 24 h of incubation. To confirm the cytotoxic activity of these compounds, they have been tested for their apoptotic and antiproliferative activity in vivo against solid Ehrlich tumours using five groups of Swiss albino mice for 37 days from inoculation and three treatments, 250, 500 and 1000 microg/kg body weight. There was significant reduction in Ehrlich tumour size in case of the 500 and 1000 microg/kg body weight group but mild significant tumour reduction in the 250 microg/kg body weight group. Histograms of DNA per cell for each treatment group indicated that there was a dose-dependent increase in the preG1 phase with a corresponding complete arrest of cells from entering the G2/M phase compared to the untreated EAC group. In conclusion, pyridine thioglycosides have proven good cytotoxic effects against EAC cells and also significant cytotoxic activity against the four tested human cell lines. Flow cytometric DNA ploidy analysis of pyridine thioglcyosides against the Hepg2 and U251 cell lines revealed that the postulated mechanism of action of pyridine thioglcyosides is cell cycle arrest in the S phase. This is similar to antimetabolites and cell cycle arrest in the G2/M phase (M phase) in the same way as microtubule inhibitors like pyridine thioglycosides are cell-cycle-specific in the S phase and the M phase (in case of human cell lines) and have apoptotic effects (in case of animal cell line).
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http://dx.doi.org/10.1515/znc-2010-9-1008DOI Listing
March 2011

Affinity covalent immobilization of glucoamylase onto ρ-benzoquinone-activated alginate beads: II. Enzyme immobilization and characterization.

Appl Biochem Biotechnol 2011 May 10;164(1):45-57. Epub 2010 Nov 10.

Polymer Materials Research Department, Advanced Technologies and New Material Research Institute, Mubarak City for Scientific Research and Technology Applications, New Borg El-Arab City, Alexandria, Egypt.

A novel affinity covalent immobilization technique of glucoamylase enzyme onto ρ-benzoquinone-activated alginate beads was presented and compared with traditional entrapment one. Factors affecting the immobilization process such as enzyme concentration, alginate concentration, calcium chloride concentration, cross-linking time, and temperature were studied. No shift in the optimum temperature and pH of immobilized enzymes was observed. In addition, K (m) values of free and entrapped glucoamylase were found to be almost identical, while the covalently immobilized enzyme shows the lowest affinity for substrate. In accordance, V (m) value of covalently immobilized enzyme was found lowest among free and immobilized counter parts. On the other hand, the retained activity of covalently immobilized glucoamylase has been improved and was found higher than that of entrapped one. Finally, the industrial applicability of covalently immobilized glucoamylase has been investigated through monitoring both shelf and operational stability characters. The covalently immobilized enzyme kept its activity over 36 days of shelf storage and after 30 repeated use runs. Drying the catalytic beads greatly reduced its activity in the beginning but recovered its lost part during use. In general, the newly developed affinity covalent immobilization technique of glucoamylase onto ρ-benzoquinone-activated alginate carrier is simple yet effective and could be used for the immobilization of some other enzymes especially amylases.
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http://dx.doi.org/10.1007/s12010-010-9113-yDOI Listing
May 2011

Interferon therapy shifts natural killer subsets among Egyptian patients with chronic hepatitis C.

Braz J Infect Dis 2010 Jul-Aug;14(4):398-405

Department of Clinical Pathology, Suez Canal University, Egypt.

Natural killer cells can be divided into five subpopulations based on the relative expression of CD16 and CD56 markers. The majority of natural killer cells are CD56(dim), which are considered to be the main cytotoxic effectors. A minority of the natural killer cells are CD56(bright), and function as an important source of immune-regulatory cytokines. Shifts of these subsets have been reported in patients with chronic hepatitis C virus infection. We sought to investigate the shift of natural killer subsets among Egyptian patients with chronic HCV and to analyze the influence of interferon therapy on this shift. We applied a flow cytometric analysis of peripheral blood natural killer subsets for 12 interferon-untreated and 12 interferon-treated patients with chronic HCV, in comparison to 10 control subjects. Among interferon-untreated patients, there was a significant reduction of CD56⁻16(+) (immature natural killer) cells. Among interferon-treated patients, the absolute count of natural killer cells was reduced, with expansion of the CD56(bright) subset and reduction of the CD56(dim)16(+) subset. Natural killer subset counts were not significantly correlated to HCV viral load and were not significantly different among interferon responders and non-responders. In conclusion, HCV infection in Egyptian patients has been observed to be statistically and significantly associated with reduction of the CD56⁻16(+)NK subset, while a statistically significant expansion of CD56(bright) and reduction of CD56(dim)16(+) subsets were observed after interferon therapy. Further studies are required to delineate the molecular basis of interferon-induced shift of natural killer subsets among patients with HCV.
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March 2011

Hepcidin levels and iron status in beta-thalassemia major patients with hepatitis C virus infection.

Egypt J Immunol 2010 ;17(2):33-44

Clinical Pathology Department, National Liver Institute-Menoufyia University, Egypt.

Beta-thalassemia is an inherited anemia in which synthesis of the hemoglobin beta-chain is decreased. Clinical features of beta-thalassemia include variably severe anemia and iron overload due to increased intestinal iron absorption, which may result in damage to vital organs. The hepatic peptide; hepcidin is a key regulator of iron metabolism in mammals. The present study aimed to determine the relationship between hepcidin expression and iron status in beta-thalassemia patients with hepatitis C virus infection. The study included 50 patients diagnosed as beta-thalassemia major (21 of them were HCV infected and 29 were HCV negative), in addition, 20 healthy subjects were enrolled in the study. The hepatic iron and hepcidin mRNA concentration in liver biopsy samples were measured, as well as serum ferritin, serum iron, hemoglobin and levels and serum hepcidin. Result showed remarkable decrease of serum and liver hepcidin mRNA expression in thalassemic patients as compared to controls, and showed a positive correlation with hemoglobin concentration, but negatively correlated with serum ferritin level and hepatic iron index (HII). In HCV infected patients, serum and liver hepcidin mRNA were markedly depressed in HCV positive beta-thalassemia cases, and positively correlated serum albumin and prothrombin concentrations, but inversely correlated with HII and fibrosis score. In HCV positive beta-thalassemia major patients, the hepcidin mRNA level was positively correlated with the synthetic function of the liver (namely serum albumin and prothrombin concentration) and with serum hepcidin level. While, both serum and hepcidin mRNA level was inversely correlated with HII and fibrosis score in these patients. These results suggest a possible role of hepcidin expression in iron overload in beta-thalassemia major, consequent disease progression and development of liver fibrosis.
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January 2013

Safety and efficacy of combined ezetimibe/simvastatin treatment and simvastatin monotherapy in patients with non-alcoholic fatty liver disease.

Med Sci Monit 2009 Dec;15(12):MS6-11

Outpatient Department, National Health Centre, Budapest, Hungary.

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases all over the world. In patients with a high cardiovascular risk the decrease of cholesterol level is especially important. The primary goal of this study is to observe the safety and efficacy of combined ezetimibe / simvastatin treatment and simvastatin monotherapy in patients with NAFLD and high cardiovascular risk disease. The secondary goal of this investigation was to compare the safety and efficacy of combined ezetimibe / simvastatin treatment with simvastatin monotherapy.

Material/methods: The data of 45 patients with NAFLD associated with type2 diabetes and metabolic syndrome were examined. They were diagnosed and treated in Budaörs Health Centre between 2005 and 2008. Twenty-six of the patients were treated with simvastatin (20 mg/day) and 19 individuals were given ezetimibe / simvastatin therapy (10/10 mg). The safety (aspartate-aminotransferase-AST-, alanine-aminotransferase-ALT- and creatine kinase-CK-values) and efficacy (cholesterol, low density lipoprotein-LDL- cholesterol, high density lipoprotein-HDL- cholesterol and triglyceride) of the treatments had been studied for six months of the treatment period.

Results: Ezetimibe/simvastatin treatment resulted in a significant decrease in ALT (63.78+/-5.12 vs 32.57+/-3.92 U/L; p<0.0001) and AST (50.79+/-3.66 vs 23.68+/-3.42 U/L; p<0.0001). Simvastatin monotherapy also yielded significant decrease in ALT (66.58+/-6.13 vs 29.46+/-4.07 U/L; p<0.0001) and AST (59.61+/-5.97 vs 24.00+/-3.87 U/L; p<0.0001). Comparing the two treatment groups, simvastatin monotherapy reduced ALT (37.11+/-8.01 vs 31.21+/-7.08 U/L; p<0.0112) and AST (35.61+/-7.20 vs 27.10+/-5.22 U/L; p
Conclusions: These results showed that both the combined ezetimibe/simvastatin treatment and the simvastatin monotherapy proved to be effective and safe in patients with NAFLD and in cases of high cardiovascular risk.
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December 2009

Diminished absolute counts of CD56dim and CD56bright natural killer cells in peripheral blood from Egyptian patients with hepatocellular carcinoma.

Egypt J Immunol 2009 ;16(2):17-25

Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Egypt.

Natural killer cells (NK) as components of the innate immunity substantially contribute to anti-tumor immune responses, NK cell subpopulations can be defined on the basis of the relative expression of CD16 and CD56 markers. Earlier research demonstrated a dramatic reduction in the frequency of peripheral blood CD56dimCD16+ NK subsets in hepatocellular carcinoma (HCC) patients compared with healthy subjects. We aim to assess the relative and absolute counts of natural killer cells subsets in hepatitis C-related HCC among Egyptian patients. Flowcytometric analysis of peripheral blood NK subsets was performed for HCV with HCC patients (n=20) and HCV without HCC patients (n=14) as compared to healthy control subjects (n=152). We found that HCC patients displayed a marked reduction in the relative frequency of peripheral CD56im subsets compared with healthy subjects. Moreover, there was a significant reduction in the absolute counts of CD56dim16+, CD56dim16- and CD56bright. In conclusion, this study demonstrated that the absolute counts of dim and bright NK cell subsets were decreased in different proportions in patients with HCV-related HCC that refers to a possible role for these cells, particularly CD 56 bright cells, in the immune response to HCC. This might aid in developing new therapeutic strategies targeting both NK subsets for HCC.
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January 2012

Age-related alteration of risk profile, inflammatory response, and angiographic findings in patients with acute coronary syndrome.

Clin Med Cardiol 2009 Feb 18;3:15-28. Epub 2009 Feb 18.

Cardiology Department, Faculty of Medicine, Menoufiya University, Shebin El Kom, Egypt.

Background: Coronary artery disease (CAD) is a major public health problem which in turn imposes a significant burden on health care systems because of high morbidity and mortality. Although the multifactorial etiology of CAD increases with age, but in recent years, the incidence is increasing among younger age groups.

Objectives: In this study we aimed to evaluate the effect of age on risk profile, inflammatory response and the angiographic findings in patients with ACS.

Patients And Methods: The study comprised 253 ACS patients. Seventy six (30%) with UA, 56 (22%) with NSTEMI and 121(48%) with STEMI diagnosis. The value of Hs-CRP, lipid profile, cardiac enzymes, risk factors, EF% and angiographic score were analyzed and compared in different age groups.

Results: Group 1 (n = 68) with age <45 years, group II (n = 110) with age >/=45-<65 years and group III (n = 75) >/=65 years. Group I had more prevalence of male sex, smoking, family history, hypertriglyceridemia and low levels of HDL (P < 0.01), higher incidence of STEMI (P < 0.01) and lower prevalence of UA (P < 0.01). Diabetes mellitus, hypertension, and female gender were more common in older groups. Hs-CRP was significantly lower in the young age (group I). Group I showed a preponderance of single-vessel disease, lower coronary atherosclerotic score and prevalent left anterior descending artery (LAD) involvement compared with older age groups. Hs-CRP was positively correlated to severity of CAD only in older groups. Stepwise multiple regression analysis showed that age, male gender, cardiac enzymes and EF% were common predictors of multivessel disease. Smoking was independent predictor in young patients <45 years while diabetes and Hs-CRP was the key predictor in older patient groups.

Conclusion: Young patients with ACS had different clinical, angiographic and biochemical profile. Hs-CRP peak concentration did not correlate with angiographic findings in young patients that could be attributed to different risk profile and discrete underlying mechanism.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872585PMC
http://dx.doi.org/10.4137/cmc.s2118DOI Listing
February 2009