Publications by authors named "Mahmoud Nassar"

63 Publications

Diabetes Mellitus and COVID-19: Review Article.

Diabetes Metab Syndr 2021 Sep 4;15(6):102268. Epub 2021 Sep 4.

Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, Chairman, National Diabetes, Obesity, And Cholesterol Foundation (N-DOC), President, Diabetes Foundation (India) (DFI), USA. Electronic address:

Background And Aims: We aim to cover most of the current evidence on the mutual effect of diabetes & COVID-19 infection on each other and the management of the COVID-19 patients with diabetes.

Methods: We utilized databases to review the current evidence related to diabetes mellitus and COVID-19.

Results: We discussed the most recent evidence of diabetes milieus and COVID-19 regarding risk factors, management, complications, and telemedicine.

Conclusion: Diabetes mellitus is associated with a significant risk of complications, extended hospital stays, and mortality in COVID-19 infected patients.
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http://dx.doi.org/10.1016/j.dsx.2021.102268DOI Listing
September 2021

Brown Tumor With Spine Involvement at Multiple Levels in a Hemodialysis Patient.

Cureus 2021 Aug 8;13(8):e17000. Epub 2021 Aug 8.

Medicine, Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals Queens, New York, USA.

Brown tumor of the bone or osteitis fibrosa cystica is a rare manifestation of hyperparathyroidism, most seen nowadays in association with secondary and tertiary hyperparathyroidism. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are the major culprits of secondary hyperparathyroidism (sHPTH). CKD is known to cause phosphate retention and a decrease in 1,25-dihydroxyvitamin D and ionized calcium levels, which in turn trigger the PTH secretion. Brown tumor can affect the jawbones, femur, sternum, ribs, and rarely the spine. We present the case of a 60-year-old male with ESRD on hemodialysis who was found to have lytic bone lesions in the thoracic and lumbar spine. Initially, malignancy was suspected. Blood work revealed markedly elevated PTH at 3,563 pg/mL, hypocalcemia, and hyperphosphatemia. Biopsy of the L5-S1 lesion was consistent with reactive changes due to sHPTH. Once a diagnosis of the brown tumor was confirmed, the patient was started on cinacalcet and was referred for parathyroidectomy.
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http://dx.doi.org/10.7759/cureus.17000DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423116PMC
August 2021

Combined endophthalmitis and orbital cellulitis in patients with corona virus disease (COVID-19).

J Ophthalmic Inflamm Infect 2021 Sep 15;11(1):27. Epub 2021 Sep 15.

Ophthalmology Department, Faculty of Medicine, Minia University, El-Minia, 61519, Egypt.

Purpose: To document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis.

Patients And Methods: This interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease.

Results: The patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss.

Conclusion: Combined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis.

Trial Registration: Clinical registration: clinicaltrials.gov identifier: NCT04456556 .
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http://dx.doi.org/10.1186/s12348-021-00258-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440116PMC
September 2021

Induction Therapy, HLA Mismatching, and Standard-Risk Kidney Transplantation.

Am J Nephrol 2021 Aug 18:604. Epub 2021 Aug 18.

Renal Department, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom.

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http://dx.doi.org/10.1159/000517908DOI Listing
August 2021

Chemical Treatment of Bio-Derived Industrial Waste Filled Recycled Low-Density Polyethylene: A Comparative Evaluation.

Polymers (Basel) 2021 Aug 11;13(16). Epub 2021 Aug 11.

College of Applied Professions, Palestine Polytechnic University, Wadi Alhareya, Hebron P.O. Box 198, Palestine.

The search for renewable alternatives for petroleum products that can be used in industrial applications is increasing. Each year, several tons of bio-derived industrial waste is produced and most of it is burned or placed in landfills. Olive pits (OP) have unique characteristics such as abundance, renewability, and biodegradability, which can be utilized to develop new types of biocomposites. One of the most promising uses of OP is that they can reinforce the mechanical properties of polymeric biocomposites. This study describes the preparation of recycled low-density polyethylene (rLDPE) that is filled with OP flour (10, 20, 30, and 40 wt.%) using a twin-screw extruder. The effects of the chemical treatment of the OP surface (sodium hydroxide (NaOH) and dimethyl sulfoxide (DMSO)) on the bio-filler/polymer compatibility along with the produced composite's chemical, physical, mechanical, and thermal properties have been explored. Overall, the reinforced composites that were obtained with alkali-treated OP have better biocomposite properties. This indicates an improved compatibility between the bio-filler and matrix. The results are promising in terms of using OP flour in developing green composites.
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http://dx.doi.org/10.3390/polym13162682DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398065PMC
August 2021

Liver transplantation during global COVID-19 pandemic.

World J Clin Cases 2021 Aug;9(23):6608-6623

Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States.

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory disease respiratory syndrome coronavirus-2 has significantly impacted the health care systems globally. Liver transplantation (LT) has faced an unequivocal challenge during this unprecedented time. This targeted review aims to cover most of the clinical issues, challenges and concerns about LT during the COVID-19 pandemic and discuss the most updated literature on this rapidly emerging subject.
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http://dx.doi.org/10.12998/wjcc.v9.i23.6608DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362541PMC
August 2021

The impact of structured diabetes education on glycemic control during Ramadan fasting in diabetic patients in Beni Suef, Egypt.

Diabetes Metab Syndr 2021 Sep-Oct;15(5):102249. Epub 2021 Aug 13.

Medicine Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. Electronic address:

Aims: Ramadan is a holy month for the Muslim community. Fasting Ramadan is directed by a systematic alteration in eating habits, sleeping times, and daily physical activities that optimize blood glucose levels. This study aims to evaluate the effects of structured education on safe fasting among diabetic patients.

Methods: This study included diabetic patients with eligibility for the Ramadan fast. The control group included 494 patients who received standard diabetes education, while the intervention group included 407 patients who attained structured diabetes education. The patients were required to register their responses following the written, structured questionnaires before and after Ramadan fasts. In addition, patients were advised to keep a log of their hypoglycemic episodes.

Result: This study showed that structured diabetes education improved the blood glucose levels/glycemic control and outcomes of patients during their Ramadan fasting. The structured diabetes education helped reduce the incidence of hypoglycemic events and hyperglycemic crises. It also increased the acceptance and frequency of blood sugar level measurements among patients during Ramadan.

Conclusion: The standard diabetes management plan should include structured diabetes education measures to improve outcomes effectively. The providers should screen the patients with diabetes before Ramadan and educate them to improve their safe fasting practices.
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http://dx.doi.org/10.1016/j.dsx.2021.102249DOI Listing
August 2021

New-onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis and Pancreatitis in a Patient with COVID-19.

Sci Afr 2021 Sep 3;13:e00915. Epub 2021 Aug 3.

Internal medicine, Faculty of medicine, Cairo university, Cairo, Egypt.

Coronavirus Disease 2019 (COVID-19) had struck the world with health and economic catastrophes and recently with unusual autoimmune presentations, including new-onset Type 1 Diabetes. Herein we present a 17-year-old male patient who presented to the outptient clinic with fever, palpitation, and cough of four-week duration; he was referred to the emergency room and was found to have DKA. CT of the chest showed ground-glass opacities suggestive of COVID-19 pneumonia, and abdominal cuts showed dilated intrahepatic biliary radicles with pancreatic loculations suggestive of pancreatitis. The patient was admitted to the ICU, started on intravenous fluids and insulin infusion then COVID-19 PCR returned positive. We hypothesize that SARS-CoV-2 has a vital role in eliciting an autoimmune response triggering type 1 diabetes, and further studies are needed to confirm this hypothesis. SARS-CoV-2 may cause pancreatitis, and the first presentation could be high blood sugar or DKA.
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http://dx.doi.org/10.1016/j.sciaf.2021.e00915DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329435PMC
September 2021

Current systematic reviews and meta-analyses of COVID-19.

World J Virol 2021 Jul;10(4):182-208

Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC H&H Queens, New York, NY 11432, United States.

Background: Coronavirus disease 2019 (COVID-19) has left a significant impact on the world's health, economic and political systems; as of November 20, 2020, more than 57 million people have been infected worldwide, with over 1.3 million deaths. While the global spotlight is currently focused on combating this pandemic through means ranging from finding a treatment among existing therapeutic agents to inventing a vaccine that can aid in halting the further loss of life.

Aim: To collect all systematic reviews and meta-analyses published related to COVID-19 to better identify available evidence, highlight gaps in knowledge, and elucidate further meta-analyses and umbrella reviews that are yet to be performed.

Methods: We explored studies based on systematic reviews and meta-analyses with the key-terms, including severe acute respiratory syndrome (SARS), SARS virus, coronavirus disease, COVID-19, and SARS coronavirus-2. The included studies were extracted from Embase, Medline, and Cochrane databases. The publication timeframe of included studies ranged between January 01, 2020, to October 30, 2020. Studies that were published in languages other than English were not considered for this systematic review. The finalized full-text articles are freely accessible in the public domain.

Results: Searching Embase, Medline, and Cochrane databases resulted in 1906, 669, and 19 results, respectively, that comprised 2594 studies. 515 duplicates were subsequently removed, leaving 2079 studies. The inclusion criteria were systematic reviews or meta-analyses. 860 results were excluded for being a review article, scope review, rapid review, panel review, or guideline that produced a total of 1219 studies. After screening articles were categorized, the included articles were put into main groups of clinical presentation, epidemiology, screening and diagnosis, severity assessment, special populations, and treatment. Subsequently, there was a second subclassification into the following groups: gastrointestinal, cardiovascular, neurological, stroke, thrombosis, anosmia and dysgeusia, ocular manifestations, nephrology, cutaneous manifestations, D-dimer, lymphocyte, anticoagulation, antivirals, convalescent plasma, immunosuppressants, corticosteroids, hydroxychloroquine, renin-angiotensin-aldosterone system, technology, diabetes mellitus, obesity, pregnancy, children, mental health smoking, cancer, and transplant.

Conclusion: Among the included articles, it is clear that further research is needed regarding treatment options and vaccines. With more studies, data will be less heterogeneous, and statistical analysis can be better applied to provide more robust clinical evidence. This study was not designed to give recommendations regarding the management of COVID-19.
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http://dx.doi.org/10.5501/wjv.v10.i4.182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316876PMC
July 2021

Prognostic Value of Cardiovascular Testing in Asymptomatic Patients With a History of Cardiovascular Disease: A Review of Contemporary Medical Literature.

Cureus 2021 Aug 4;13(8):e16892. Epub 2021 Aug 4.

Internal Medicine, Icahn School of Medicine at Mount Sinai/New York City (NYC) Health+Hospitals, New York, USA.

The cardiac stress testing, carotid duplex, coronary artery calcium (CAC) scoring, myocardial perfusion imaging, coronary angiography, C-reactive protein (CRP), glycated hemoglobin (HbA1C), total serum cholesterol, duplex ultrasonography, digital subtraction angiography, magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography, and ankle-brachial index (ABI) independently predict the risks and prognostic outcomes in asymptomatic cardiovascular disease (CVD) patients. The peripheral artery disease (PAD) screening guides the diagnosis, management, and prognosis of hemodynamically significant arterial stenosis, calcification, and malignant hypertension in patients with CVD without symptoms. The 79% sensitivity and 96% specificity of ABI screening, 90% sensitivity and 97% specificity of MRA, and 95% sensitivity and 50% specificity of CTA for tracking arterial occlusion indicate the high prognostic value of these tests in the setting of CVD. The 85% specificity and 60-70% sensitivity of cardiac stress testing substantiate its suitability to determine asymptomatic CVD prognosis related to myocardial ischemia, heart failure, multivessel disease, and unstable angina. The carotid duplex ultrasound potentially identifies long-term mortality, stroke, atherosclerosis, plaque instability, and angiographic stenosis among asymptomatic CVD patients with 94% specificity and 90% sensitivity. The CAC scoring has a positive predictive value (PPV) of 45.7% for identifying aortic valve calcium and PPV of 79.3% for tracking thoracic artery calcium. The medical literature provides substantial evidence concerning the validity, reliability, and prognostic value of cardiovascular testing for asymptomatic patients. Future studies are needed to undertake detailed assessments of benefits versus adverse outcomes associated with the prospective scaling (of cardiovascular testing) across asymptomatic CVD patients.
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http://dx.doi.org/10.7759/cureus.16892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8338770PMC
August 2021

Coronavirus Disease 2019 (COVID-19)-Induced Takotsubo Cardiomyopathy Prognosis in Geriatric Setting.

Cureus 2021 Jul 6;13(7):e16211. Epub 2021 Jul 6.

Cardiology, Icahn School of Medicine at Mount Sinai/New York City (NYC) Health+Hospitals Queens, Jamaica, USA.

An 86-year-old female with a past medical history of hypertension, vertebral fractures with chronic lumbar pain, hip fracture, osteoporosis, deafness, and microcytic anemia underwent hospital admission for emergency medical management of her respiratory distress. The (overall) diagnostic workup confirmed COVID-19, the patient presented with 50% SPO2 (oxygen saturation), sinus tachycardia, diffuse bilateral pulmonary crackles, mild jugular venous distention (JVD), minimal bilateral pitting edema, elevated cardiac enzymes, bilateral pulmonary opacities, and ST-segment elevation. The cardiovascular assessment indicated stress-induced cardiomyopathy/Takotsubo cardiomyopathy (TCM) determined by 35%-40% LVEF (left ventricular ejection fraction), mid to apical left ventricular (LV) akinesia with preserved function in the proximal segment, aortic valve sclerosis, reduced excursion of Trileaflet valve (without stenosis), and mild-to-moderate tricuspid regurgitation with moderate pulmonary artery systolic pressure (PASP). The treatment protocol relied on 81 mg aspirin, 75 mg plavix, 20 mg lipitor, remdesivir, dexamethasone, ceftriaxone, azithromycin, red blood cells transfusion (pRBCs), endotracheal intubation for respiratory support, and systemic hemodynamic support. The patient's condition did not improve despite all treatment, and she passed away after seven days following her hospital admission.
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http://dx.doi.org/10.7759/cureus.16211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341288PMC
July 2021

Transplant Risk Assessment: It Is Not about the Panel Reactive Antibodies.

Am J Nephrol 2021 29;52(7):602-603. Epub 2021 Jul 29.

Department of Medicine, Icahn School of Medicine at Mount Sinai/NYC Health+Hospitals, Queens, New York, USA,

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http://dx.doi.org/10.1159/000517814DOI Listing
July 2021

Bullous drug eruption after second dose of mRNA-1273 (Moderna) COVID-19 vaccine: Case report.

J Infect Public Health 2021 Jul 8. Epub 2021 Jul 8.

Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, NY, USA. Electronic address:

Background: In December 2020, Moderna released the mRNA-1273 vaccine. The most common side effects are headache, muscle pain, redness, swelling, and tenderness at the injection site. In addition, there have been dermatological adverse events, such as hypersensitivity reactions. Although rare, various bullous eruptions have been described following vaccination. Bullous pemphigoid has been reported to occur most often after receipt of influenza and the diphtheria-tetanus-pertussis vaccine. To the best of our knowledge, there have been no reports of bullous drug eruptions resulting from mRNA vaccines.

Case Summary: A 66-years-old obese Guyanese male presented with a bullous rash following receipt of a commercial COVID-19 mRNA vaccine. He received the first dose uneventfully. However, within 24 h of receiving the second dose, he developed fever, myalgias, and malaise accompanied by a painful blistering rash of his torso, arms, and legs. His fever and myalgias improved after 24 h, but his painful rash did not, and five days after the initial symptoms, he presented to the hospital. There were many violaceous, poorly demarcated patches on his trunk, arms, and thighs on examination, many of which had large flaccid bullae within, and a few areas on his buttocks, posterior shoulder, and scrotum were eroded. The exam was also significant for lower extremity muscle tenderness, stiffness with preserved strength. A skin biopsy showed epidermal necrosis and sparse perivascular dermatitis concerning Stevens-Johnson syndrome or erythema multiforme. However, in the absence of mucous membrane involvement or targetoid lesions, the diagnosis of an extensive bullous fixed drug eruption was made.

Conclusion: This case illustrates that the bullae eruption occurred as a result of receiving the Moderna vaccination.
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http://dx.doi.org/10.1016/j.jiph.2021.06.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264280PMC
July 2021

COVID-19 vaccine-induced myocarditis: Case report with literature review.

Diabetes Metab Syndr 2021 Sep-Oct;15(5):102205. Epub 2021 Jul 10.

Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA. Electronic address:

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http://dx.doi.org/10.1016/j.dsx.2021.102205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270733PMC
July 2021

Isolation and characterization of flavonoid compounds from (L.) Vahl and its role as anti-gastro ulcerative agent in rats.

Biomarkers 2021 Jul 19:1-11. Epub 2021 Jul 19.

Department of Therapeutic Chemistry, National Research Centre, Giza, Egypt.

Context: Stomach ulcer is one of the most common gastrointestinal problems in the world.

Objective: This study aimed to isolate flavonoid compounds from methanol extract of the aerial parts of (L.) Vahl. and evaluate its protective and therapeutic effects against gastric ulcer.

Materials And Methods: Chromatographic techniques were used for the identification of the isolated compounds. To explore the effects of the plant extract, it was administrated by oral gavage for one week either before or post-ethanol ulcer induction. Ranitidine was also evaluated as a reference drug. Stomach pH, gastric juice volume, lesions number, glutathione, superoxide dismutase, malondialdehyde, succinate dehydrogenase, lactate dehydrogenase, acid phosphatase, Interleukin-10, intracellular adhesion molecule-1, prostaglandin E2, and total protein levels were estimated in gastric tissue. Stomach histopathological features were also monitored.

Results: Six flavonoid compounds were isolated, where five of them were isolated for the first time (vitexin, isovitexin, apigenin 7,4'-dimethyl ether, 5,7,2'-trimethoxyflavone, and scutellarein), while apigenin was previously reported. Treatment with plant extract recorded amelioration in all the biochemical parameters.

Conclusion: The methanol extract of plant aerial parts had prophylactic and treatment effects against gastric ulcer in rats, where its treatment effect exceeded its protective role. The extract recorded anti-inflammatory, and antioxidant effects due to the presence of flavonoid compounds.
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http://dx.doi.org/10.1080/1354750X.2021.1950210DOI Listing
July 2021

COVID-19 vaccine induced rhabdomyolysis: Case report with literature review.

Diabetes Metab Syndr 2021 Jul-Aug;15(4):102170. Epub 2021 Jun 15.

Medicine Department, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA. Electronic address:

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http://dx.doi.org/10.1016/j.dsx.2021.06.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205294PMC
August 2021

Massive gastrointestinal bleeding in a patient with COVID-19.

Arab J Gastroenterol 2021 Jun 14;22(2):177-179. Epub 2021 May 14.

Infectious Disease Consultants and Academic Researchers of Egypt (IDCARE), Egypt.

Despite the emerging data about the thrombophilic effect of the novel coronavirus [1] , the relation between coagulation disorders and the COVID-19 pandemic is still not well understood. Various studies pointed to the significant role of the COVID-19 induced cytokine storm in development of the hypercoagulable state which leads to serious thromboembolic complications [2,3] . Some studies report the development of severe immune thrombocytopenia induced by the novel coronavirus [4] . Other studies found a correlation between COVID-19 disease and the development of disseminated intravascular coagulation (DIC) [5]. Patients with severe COVID-19 disease have an increased risk for development of gastrointestinal bleeding (GI) which may be related to stress [6] , critical illness or mechanical ventilation [7] . Further studies showed the ability of the novel coronavirus to infect the epithelial cells of the GI tract [8] . Moreover, some data pointed to the ability of the virus even to infect the endothelium of blood vessels [9]. The relation between the COVID-19 pandemic and GI bleeding deserves more studies [10]. We present a case of GI bleeding in a patient with severe COVID-19 disease. We assume that COVID-19 disease can be a predominant factor for the development of DIC and GI bleeding.
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http://dx.doi.org/10.1016/j.ajg.2021.05.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118668PMC
June 2021

The safety aspects of accepting living kidney donors with pelvi-ureteric junction dysfunction.

Int Urol Nephrol 2021 May 24. Epub 2021 May 24.

Nephrology Division, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA.

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http://dx.doi.org/10.1007/s11255-021-02893-9DOI Listing
May 2021

HPLC-ESI/MS profiling, phytoconstituent isolation and evaluation of renal function, oxidative stress and inflammation in gentamicin-induced nephrotoxicity in rats of Ficus spragueana Mildbr. & Burret.

Biomed Chromatogr 2021 Sep 22;35(9):e5135. Epub 2021 Apr 22.

Medicinal and Pharmaceutical Chemistry Department (Pharmacology Group), Pharmaceutical and Drug Industries Research Division, National Research Centre (ID 60014618), Giza, Egypt.

Ficus spragueana Mildbr. & Burret (family Moraceae) was reported to have various biological activities. However, its activity in treatment of renal injury has not been investigated yet. The current study aimed to evaluate the effects of F. spragueana leaf extract on nephrotoxicity caused by gentamicin. Gentamicin is an important broad-spectrum antibiotic; nevertheless, it exhibits serious nephrotoxic adverse effects. HPLC-ESI/MS spectrometric analysis of the extract revealed the presence of 37 phenolic compounds. Moreover, five compounds were isolated from the leaf extract, and identified on the basis of spectroscopic analysis. The isolated compounds were syringic acid (1), p-coumaric acid (2), 3',5' O-dicaffeoylquinic acid (3), luteolin-8-C-β-D glucopyranoside (orientin) (4) and 8-methoxy kaempferol-3-O-[α-L-rhamnopyranosyl (1→2) β-D-glucopyranoside] (5). The gentamicin-induced nephrotoxicity model was used to evaluate the protective effect of F. spragueana on renal toxicity biomarkers throughout the development of acute kidney injury. Administration of extract led to improvement in kidney function through inhibition of kidney injury molecule-1, creatinine, blood urea nitrogen and total bilirubin, as well as decreasing the inflammatory markers interlukin1-beta and myeloperoxidase. Furthermore, it reduced the oxidative stress by increasing reduced glutathione and total antioxidant capacity levels while decreasing malondialdehyde and nitric oxide content, and improved renal histopathological injuries.
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http://dx.doi.org/10.1002/bmc.5135DOI Listing
September 2021

Chemical Profiles, Anticancer, and Anti-Aging Activities of Essential Oils of (L.) DC. and L.

Plants (Basel) 2021 Mar 31;10(4). Epub 2021 Mar 31.

Chemistry of Natural Compounds Department, National Research Center, 33 El Bohouth St., Dokki, Giza 12622, Egypt.

Plants belonging to the Asteraceae family are widely used as traditional medicinal herbs around the world for the treatment of numerous diseases. In this work, the chemical profiles of essential oils (EOs) of the above-ground parts of (L.) DC. and (L.) were studied in addition to their cytotoxic and anti-aging activities. The extracted EOs from the two plants via hydrodistillation were analyzed by gas chromatography-mass spectroscopy (GC-MS). GC-MS of EO of revealed the identification of 29 compounds representing 96.91% of the total oil. While 35 compounds were characterized from EO of representing 98.21%. The terpenoids were found the main constituents of both plants with a relative concentration of 93.59% and 97.66%, respectively, including mainly sesquiterpenes (93.40% and 81.06%). -Maaliene (18.84%), berkheyaradulen (13.99%), dehydro-cyclolongifolene oxide (10.35%), aromadendrene oxide-2 (8.81%), -muurolene (8.09%), and -eudesmol (6.79%), represented the preponderance compounds of EO of . While, trans-α-farnesene (25.03%), -ocimene (12.58%), isolongifolene-5-ol (5.53%), α-maaliene (6.64%), berkheyaradulen (4.82%), and -muurolene (3.99%), represented the major compounds EO of . A comparative study of our results with the previously described data was constructed based upon principal component analysis (PCA) and agglomerative hierarchical clustering (AHC), where the results revealed a substantial variation of the present studied species than other reported ecospecies. EO of exhibited significant cytotoxicity against the two cancer cells, MCF-7 and A-549 with IC of 37.3 and 22.3 μM, respectively. While the EO of the showed strong cytotoxicity against HepG2 with IC of 25.6 μM. The EOs of , , and their mixture (1:1) exhibited significant inhibitory activity of the collagenase, elastase, hyaluronidase, and tyrosinase comparing with epigallocatechin gallate (EGCG) as a reference. The results of anti-aging showed that the activity of mixture (1:1) > > against the four enzymes.
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http://dx.doi.org/10.3390/plants10040667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066341PMC
March 2021

The association between COVID-19 and type 1 diabetes mellitus: A systematic review.

Diabetes Metab Syndr 2021 Jan-Feb;15(1):447-454. Epub 2021 Feb 10.

Division of Endocrinology, Department of Medicine, Mount Sinai Services, Queens Hospital, Center, NY, USA. Electronic address:

Background: /Aim: Various reports of the occurrence of type 1 diabetes mellitus (T1DM) in patients with COVID-19 have been published, denoting an association between both diseases. Therefore, we conducted this systematic review to summarize the prevalence of T1DM in COVID-19 patients and to identify the clinical presentations and outcomes in this patient population.

Materials And Methods: Up to 10/27/2020, Medline, Embase, cochrane and google scholar databases were searched for original studies investigating the association between COVID-19 and T1DM. A manual search was conducted to identify missing studies. The quality of included studies was analyzed by the National Institute of Health (NIH) risk of bias tool. Outcomes included length of hospital stay, hospitalization, intensive care unit (ICU) admission, diabetic ketoacidosis (DKA), severe hypoglycemia, and death.

Results: Fifteen studies were included in the qualitative analysis. Included studies reported data of both adult and pediatric patients. The prevalence of T1DM in COVID-19 patients ranged from 0.15% to 28.98%, while the rate of COVID-19 in patients with T1DM ranged from 0% to 16.67%. Dry cough, nausea, vomiting, fever and elevated blood glucose levels were the most commonly reported presentations. The investigated outcomes varied widely among studied populations.

Conclusions: The prevalence of T1DM in patients with COVID-19 ranged from 0.15% to 28.98%. The most common presentation of COVID-19 in patients with T1DM included fever, dry cough, nausea and vomiting, elevated blood glucose and diabetic ketoacidosis. The outcomes of COVID-19 in terms of length of hospital stay, hospitalization, ICU admission, DKA rate, and severe hypoglycemia were reported variably in included studies. Due to the heterogeneous study populations and the presence of many limitations, more studies are still warranted to reach a definitive conclusion.
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http://dx.doi.org/10.1016/j.dsx.2021.02.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872855PMC
March 2021

Phytotoxic Effects of Plant Essential Oils: A Systematic Review and Structure-Activity Relationship Based on Chemometric Analyses.

Plants (Basel) 2020 Dec 25;10(1). Epub 2020 Dec 25.

Chemistry of Natural Compounds Department, National Research Centre, 33 El Bohouth St., Dokki, Giza 12622, Egypt.

Herbicides are natural or synthetic chemicals used to control unwanted plants (weeds). To avoid the harmful effects of synthetic herbicides, considerable effort has been devoted to finding alternative products derived from natural sources. Essential oils (EOs) from aromatic plants are auspicious source of bioherbicides. This review discusses phytotoxic EOs and their chemical compositions as reported from 1972 to 2020. Using chemometric analysis, we attempt to build a structure-activity relationship between phytotoxicity and EO chemical composition. Data analysis reveals that oxygenated terpenes, and mono- and sesquiterpenes, in particular, play principal roles in the phytotoxicity of EOs. Pinene, 1,8 cineole, linalool, and carvacrol are the most effective monoterpenes, with significant phytotoxicity evident in the EOs of many plants. Caryophyllene and its derivatives, including germacrene, spathulenol, and hexahydrofarnesyl acetone, are the most effective sesquiterpenes. EOs rich in iridoids (non-terpene compounds) also exhibit allelopathic activity. Further studies are recommended to evaluate the phytotoxic activity of these compounds in pure forms, determine their activity in the field, evaluate their safety, and assess their modes of action.
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http://dx.doi.org/10.3390/plants10010036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823517PMC
December 2020

A Generalized Spatial Modulation System Using Massive MIMO Space Time Coding Antenna Grouping.

Entropy (Basel) 2020 Nov 30;22(12). Epub 2020 Nov 30.

College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria 1029, Egypt.

Massive multiple input multiple output (MIMO), also known as a very large-scale MIMO, is an emerging technology in wireless communications that increases capacity compared to MIMO systems. The massive MIMO communication technique is currently forming a major part of ongoing research. The main issue for massive MIMO improvements depends on the number of transmitting antennas to increase the data rate and minimize bit error rate (BER). To enhance the data rate and BER, new coding and modulation techniques are required. In this paper, a generalized spatial modulation (GSM) with antenna grouping space time coding technique (STC) is proposed. The proposed GSM-STC technique is based on space time coding of two successive GSM-modulated data symbols on two subgroups of antennas to improve data rate and to minimize BER. Moreover, the proposed GSM-STC system can offer spatial diversity gains and can also increase the reliability of the wireless channel by providing replicas of the received signal. The simulation results show that GSM-STC achieves better performance compared to conventional GSM techniques in terms of data rate and BER, leading to good potential for massive MIMO by using subgroups of antennas.
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http://dx.doi.org/10.3390/e22121350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760861PMC
November 2020

Detection of Simulated Tactile Gratings by Electro-Static Friction Show a Dependency on Bar Width for Blind and Sighted Observers, and Preliminary Neural Correlates in Sighted Observers.

Front Neurosci 2020 14;14:548030. Epub 2020 Oct 14.

Biomedical Engineering Department, Faculty of Engineering, Helwan University, Helwan, Egypt.

The three-dimensional micro-structure of physical surfaces produces frictional forces that provide sensory cues about properties of felt surfaces such as roughness. This tactile information activates somatosensory cortices, and frontal and temporal brain regions. Recent advances in haptic-feedback technologies allow the simulation of surface micro-structures via electro-static friction to produce touch sensations on otherwise flat screens. These sensations may benefit those with visual impairment or blindness. The primary aim of the current study was to test blind and sighted participants' perceptual sensitivity to simulated tactile gratings. A secondary aim was to explore which brain regions were involved in simulated touch to further understand the somatosensory brain network for touch. We used a haptic-feedback touchscreen which simulated tactile gratings using digitally manipulated electro-static friction. In Experiment 1, we compared blind and sighted participants' ability to detect the gratings by touch alone as a function of their spatial frequency (bar width) and intensity. Both blind and sighted participants showed high sensitivity to detect simulated tactile gratings, and their tactile sensitivity functions showed both linear and quadratic dependency on spatial frequency. In Experiment 2, using functional magnetic resonance imaging, we conducted a preliminary investigation to explore whether brain activation to physical vibrations correlated with blindfolded (but sighted) participants' performance with simulated tactile gratings outside the scanner. At the neural level, blindfolded (but sighted) participants' detection performance correlated with brain activation in bi-lateral supplementary motor cortex, left frontal cortex and right occipital cortex. Taken together with previous studies, these results suggest that there are similar perceptual and neural mechanisms for real and simulated touch sensations.
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http://dx.doi.org/10.3389/fnins.2020.548030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591789PMC
October 2020

COVID-19 and Autoimmune Diseases: A Systematic Review of Reported Cases.

Curr Rheumatol Rev 2021 ;17(2):193-204

Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations.

Methods: We searched PubMed database using all available keywords for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstracts. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected.

Results: Among the 10006 articles, searches yielded thirty-two relevant articles for full-text assessment. Twenty studies has met the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain-Barré syndrome (48.5%).

Conclusion: COVID-19 has been implicated in the development of a range of autoimmune diseases, which may shed light on the association between autoimmune diseases and infections.
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http://dx.doi.org/10.2174/1573397116666201029155856DOI Listing
June 2021

Triple Procedure for Dense Cataractous Neovascular Glaucoma Patients.

J Ophthalmol 2020 21;2020:1251203. Epub 2020 Jun 21.

Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt.

Purpose: One of the most difficult refractory glaucomas is the neovascular type (NVG), and its association with dense cataract adds to this difficulty. This study aimed to provide results of the triple surgical procedure for such conditions.

Methods: 12 eyes of 12 patients with NVG and dense cataract were included in this case series study. The mean age of patients was 57.25 ± 5.9 years. The mean preoperative intraocular pressure (IOP) was 47.25 ± 4.04 mmHg with maximum antiglaucoma therapy. The mean best corrected distant visual acuity (BCDVA) in LogMAR was 2.13 ± 0.38. All patients received intravitreal injection of 1.25 mg (0.05 ml) bevacizumab followed by phacoemulsification, pars plana vitrectomy (PPV) including panretinal photocoagulation (PRP), and trabeculectomy with mitomycin C (MMC). Mean IOP and BCDVA changes were the main outcome results of this study.

Results: The follow-up period was 2 years. The mean BCDVA was improved to 1.22 ± 0.35, 1.13 ± 0.34, 1.12 ± 0.37, 1.06 ± 0.38, and 1.01 ± 0.37 at 1, 3, 6, 12, and 24 months, respectively, after this procedure. This improvement was statistically significant when compared with preoperative BCDVA ( < 0.0001). The mean postoperative IOP was dropped to 20.08 ± 4.1, 17.08 ± 2.1, 17.17 ± 5, 15.75 ± 4.7, and 16.17 ± 6.1 mmHg, respectively. At the last follow-up, the mean IOP was statistically significantly lower than preoperative IOP ( < 0.0001) at the previously mentioned time points. The success rate was complete in 90.9% of eyes and qualified in 100% of eyes. Iris and angle neovascularization had regressed significantly in all patients, and no serious complications occurred during the follow-up period.

Conclusions: This triple surgery can safely improve patients with NVG and dense cataract regarding BCDVA and IOP control. This trial is registered with NCT04143620.
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http://dx.doi.org/10.1155/2020/1251203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327584PMC
June 2020

One-session laparoscopic management of Mirizzi syndrome: feasible and safe in specialist units.

Surg Endosc 2021 07 6;35(7):3286-3295. Epub 2020 Jul 6.

Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background: To evaluate the laparoscopic management of Mirizzi syndrome, seldom diagnosed preoperatively causing difficulty when performing cholecystectomy and increasing complication risks.

Methods: Analysis of a prospective single-surgeon database of 5700 laparoscopic cholecystectomies found 58 Mirizzi syndrome cases. They were managed with an intention to treat during the index admission according to protocol of single-session management of bile duct stones.

Results: 38/58 patients were females (65.5%). The median age was 55 years. 53 cases were emergency admissions. 34 cases (58.6%) only had ultrasound scanning. Operative difficulty was Grade IV in 34 cases (58.6%) and Grade V in 20 (34.5%) (Nassar Scale). There were 33 Mirizzi Type IA, 7 Type IB, 16 Type II and one each of Type III and Type IV. Bile duct exploration was performed in 94.8% through choledochotomy/ transfistula in 58.6% or transcystic in 36.2%. Four cases required conversion to open. Postoperative morbidity occurred in 29%. Two 30-day mortalities occurred from pneumonia in two elderly patients who were late referrals.

Conclusion: Although the utilization of the laparoscopic approach in managing bile duct stones is not currently widely practiced it was safer in this series than in reported series of open surgery in Mirizzi Syndrome. The optimal approach to Mirizzi Type II is via cholecystocholedochal fistula to explore the bile duct then drain with T-tube through the fistula. It is unnecessary to perform bilioenteric bypass in majority of cases, reducing the morbidity and mortality.
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http://dx.doi.org/10.1007/s00464-020-07765-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195921PMC
July 2021

Prognostic Value of c-Myc Immunohistochemical Expression in Muscle Invasive Urothelial Carcinoma of the Urinary Bladder: A Retrospective Study.

Asian Pac J Cancer Prev 2019 Dec 1;20(12):3735-3746. Epub 2019 Dec 1.

Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Objective: This study aimed to investigate the immunohistochemical expression of c-Myc in muscle invasive urothelial carcinoma (MIUC) of the urinary bladder and to evaluate the correlation of c-Myc expression with different clinicopathological parameters and outcome, including a relatively new histopathological tumor characteristic that is the growth pattern of tumor invasion.

Methods: A total of 66 formalin-fixed and paraffin-embedded sections of MIUC obtained from radical cystectomy specimens were enrolled. The sections were stained with c-Myc antibody using immunohistochemistry technique.

Results: Tumor cells showed variability in nuclear c-Myc expression according to the growth pattern of invasion. The median H-score of nuclear expression of infiltrative pattern was significantly higher than that of non-infiltrative pattern (p<0.001). Nuclear expression of c-Myc in tumor tissue had a significant association with poor prognostic factors (sarcomatoid variant (p<0.001), perineural invasion (p=0.037), lymphovascular invasion (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.042) and advanced stage grouping (p=0.001). Kaplan Meier survival analysis demonstrated that c-Myc expression could not be significantly correlated with overall survival or disease free survival rates.

Conclusion: Nuclear c-Myc seems to have a prominent role in epithelial to mesenchymal transition with consequential in tumor progression and metastasis, while it is not as much useful to predict the clinical behavior of patients with MIUC.
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http://dx.doi.org/10.31557/APJCP.2019.20.12.3735DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173398PMC
December 2019
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