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Elbarbary H, Abdelmohsen A, Zein AB, Arafa A, Hegazy M, Yaseen A, Afifi A. Is it possible to achieve multiplanar correction of complex deformities around the knee in children and adolescents using a monolateral external fixator? Int Orthop 2024; 48:1427-1438. [PMID: 38558191 DOI: 10.1007/s00264-024-06149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To present the technique of correction of multiplanar deformities around the knee in children and adolescents using the monolateral external fixator. Also, to evaluate the results of the technique regarding radiological correction, time to union, and possible complications. METHODS A total of 29 patients (47 limbs) were prospectively included in the study (14 males and 15 females). Their median age was 13 years (range, 7-17). All patients had at least a 2-plane deformity around the knee which was corrected using a monolateral external fixator. The primary outcome measure was deformity correction (correction of mechanical axis deviation (MAD) in both the coronal and sagittal planes with correction of rotational deformities). The secondary outcome measures included bony union, radiographic, and functional results (assessed by using the Association for the Study and Application of the Method of Ilizarov (ASAMI) score). RESULTS The median pre-operative MAD improved from 6.3 to 0.4 cm post-operatively. According to the ASAMI scoring system, the radiographic scoring was excellent in all cases (100%), and the functional scoring was excellent in 22 cases (89.7%) and good in three cases (10.3%). CONCLUSION The simple monolateral fixator can be an effective tool for multiplanar correction of complex deformities around the knee without limb length discrepancy.
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Affiliation(s)
- Hassan Elbarbary
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Abdelmohsen
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abo-Bakr Zein
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amr Arafa
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Hegazy
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Yaseen
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Safoury Y, Afifi A, Farghaly A, Khalid O. Outcomes after radioscapholunate arthrodesis for intra-articular malunion of distal radius fractures. Eur J Orthop Surg Traumatol 2024:10.1007/s00590-024-03934-6. [PMID: 38652314 DOI: 10.1007/s00590-024-03934-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To study the clinical, radiological, and functional outcomes after of radioscapholunate (RSL) fusion for intra-articular malunion of the distal radius. METHODS This retrospective study included 26 patients (17 males and 9 females) with intra-articular malunion of distal radius fractures who underwent RSL arthrodesis using locked miniplates (without distal scaphoid excision) between 2012 and 2020. Their mean age was 43 years (range, 32-56). Patients were assessed radiographically for union and clinically for range of motion, grip strength, and pain (assessed by Visual Analogue Scale (VAS) for pain). Functional evaluation was performed by using the Mayo modified wrist score (MMWS) and the Disabilities for the Arm, Shoulder, and Hand (DASH) questionnaire. RESULTS All patients showed complete healing at the fusion site after a mean of 8.7 weeks (range, 8-12). The mean follow-up period was 72 months (range, 60-84). The pinch strength improved from a mean of 6.2 kg (range, 3-12) to a mean of 9.8 kg (range, 5-18) which represents 80% of the contralateral side. The mean pinch strength was 7 kg (range, 5-18) which presents 80% of the other side. VAS for pain showed a mean improvement of 72.6%. The DASH score improved to a mean of 19.2 (range, 14-24). The MMWS improved to a mean of 68 (range, 45-86). At the final follow-up period, no degenerative changes were detected in the midcarpal joint. CONCLUSION RSL arthrodesis (using locked miniplates without distal scaphoid excision) is a reliable surgical procedure to manage cases of radiocarpal OA after intra-articular malunion of distal radius fractures with good clinical and radiological outcomes. LEVEL OF EVIDENCE Level IV- therapeutic.
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Affiliation(s)
- Yasser Safoury
- Hand, Upper Limb, and Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Hand, Upper Limb, and Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Ahmed Farghaly
- Hand, Upper Limb, and Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Omar Khalid
- Hand, Upper Limb, and Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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3
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Afifi A, Mahgoub A, Yacoub M. Toward Excellence in Managing Transposition of the Great Arteries in the Community. Ann Thorac Surg 2024; 117:549-550. [PMID: 37804912 DOI: 10.1016/j.athoracsur.2023.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Ahmed Afifi
- Department of Cardiothoracic Surgery, The Magdi Yacoub Institute, Harefield Hospital, Hill End Rd, Harefield, Middlesex UB9 6JH, United Kingdom
| | - Ahmed Mahgoub
- Department of Cardiothoracic Surgery, The Magdi Yacoub Institute, Harefield Hospital, Hill End Rd, Harefield, Middlesex UB9 6JH, United Kingdom
| | - Magdi Yacoub
- Department of Cardiothoracic Surgery, The Magdi Yacoub Institute, Harefield Hospital, Hill End Rd, Harefield, Middlesex UB9 6JH, United Kingdom.
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Ors DM, Ramadan M, Maree AMF, Zaher AH, Afifi A, Ebid AM. Machine learning base models to predict the punching shear capacity of posttensioned UHPC flat slabs. Sci Rep 2024; 14:3969. [PMID: 38368475 PMCID: PMC10874378 DOI: 10.1038/s41598-024-54358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
The aim of this research is to present correction factors for the punching shear formulas of ACI-318 and EC2 design codes to adopt the punching capacity of post tensioned ultra-high-performance concrete (PT-UHPC) flat slabs. To achieve that goal, the results of previously tested PT-UHPC flat slabs were used to validate the developed finite element method (FEM) model in terms of punching shear capacity. Then, a parametric study was conducted using the validated FEM to generate two databases, each database included concrete compressive strength, strands layout, shear reinforcement capacity and the aspect ratio of the column besides the correction factor (the ratio between the FEM punching capacity and the design code punching capacity). The first considered design code in the first database was ACI-318 and in the second database was EC2. Finally, there different "Machine Learning" (ML) techniques manly "Genetic programming" (GP), "Artificial Neural Network" (ANN) and "Evolutionary Polynomial Regression" (EPR) were applied on the two generated databases to predict the correction factors as functions of the considered parameters. The results of the study indicated that all the developed (ML) models showed almost the same level of accuracy in terms of the punching ultimate load (about 96%) and the ACI-318 correction factor depends mainly on the concrete compressive strength and aspect ratio of the column, while the EC2 correction factor depends mainly on the concrete compressive strength and the shear reinforcement capacity.
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Affiliation(s)
- Dina M Ors
- Faculty of Engineering and Technology, Future University, New Cairo, Egypt.
| | - Mohamed Ramadan
- Faculty of Engineering, 6Th of October University, Giza, Egypt
- Faculty of Engineering, Ain Shams University, Cairo, Egypt
| | | | - Amr H Zaher
- Faculty of Engineering, Ain Shams University, Cairo, Egypt
| | - Ahmed Afifi
- Faculty of Engineering, 6Th of October University, Giza, Egypt
| | - Ahmed M Ebid
- Faculty of Engineering and Technology, Future University, New Cairo, Egypt
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Yacoub MH, Afifi A, Hosny H, Mahgoub A, Nagy M, Vaz S, Sarathchandra P, Latif N. Structural aortic wall abnormalities following the Nikaidoh operation, which could be reversible and include a healing process. Glob Cardiol Sci Pract 2024; 2024:e202403. [PMID: 38404663 PMCID: PMC10886688 DOI: 10.21542/gcsp.2024.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/11/2023] [Indexed: 02/27/2024] Open
Abstract
The Nikaidoh operation continues to be used for patients with transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction. We recently reported structural and functional changes in the aortic root during the follow-up of a patient who underwent the Nikaidoh operation. These changes necessitated re-operation. The pathophysiology of these changes and their potential for reversibility have not yet been studied. In this communication, we describe the extensive structural changes in the aortic wall of the same patient.
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Affiliation(s)
- Magdi H. Yacoub
- Magdi Yacoub Institute, National Heart and lung Institute, Imperial College London, London, UK
| | - Ahmed Afifi
- Cardiac surgery department, Aswan Heart Centre, Aswan, Egypt
| | - Hatem Hosny
- Cardiac surgery department, Aswan Heart Centre, Aswan, Egypt
| | - Ahmed Mahgoub
- Cardiac surgery department, Aswan Heart Centre, Aswan, Egypt
| | - Mohamed Nagy
- Cardiac surgery department, Aswan Heart Centre, Aswan, Egypt
| | - Sanida Vaz
- Magdi Yacoub Institute, National Heart and lung Institute, Imperial College London, London, UK
| | - Padmini Sarathchandra
- Magdi Yacoub Institute, National Heart and lung Institute, Imperial College London, London, UK
| | - Najma Latif
- Magdi Yacoub Institute, National Heart and lung Institute, Imperial College London, London, UK
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Tabassum S, Kalsoom T, Zaheer Z, Naeem A, Afifi A, Ohadi L. Reflections on the surge in malaria cases after unprecedented flooding in Pakistan-A commentary. Health Sci Rep 2023; 6:e1620. [PMID: 37822844 PMCID: PMC10563404 DOI: 10.1002/hsr2.1620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
Background Malaria is a parasitic infection primarily caused by four main species of the genus Plasmodium, that is, Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, and Plasmodium malariae. It is transmitted through the bite of the female Anopheles mosquito. It holds the status of one of the leading causes of death in the developing world. Malaria is endemic to Pakistan, and the country experienced the worst floods in its history from April to October 2022. The stagnant flood water served as a breeding ground for mosquitoes, culminating in an alarming spike in malaria cases. According to the World Health Organization (WHO), the number of cases reported till August 2022 was more than in the whole year of 2021. There was more than a twofold rise in cumulative cases in 62 high-burden Pakistani Districts in August 2022 as compared to August 2021. Aims This commentary aims to bring this emerging issue to notice and highlight the most effective probable measures to help eliminate and prevent the hazards the current outbreak poses. Results Rapid planning and execution are needed to ensure the most efficient and rapid elimination of malaria. To educate the general public, the national government must start public awareness efforts in electronic, print, and social media and deploy solar-powered mobile healthcare units to far-flung areas. Prophylactic and postexposure treatments should be planned because larvicidal preventive measures are less practical in flood-affected vicinities. Conclusion The most effective preventive strategy is drug prophylaxis, followed by insecticide-treated nets, indoor residual spraying, and untreated nets. Scientists should intensify their investigations for effective medications to alleviate the malaria burden in Pakistan.
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Affiliation(s)
| | | | | | - Aroma Naeem
- King Edward Medical UniversityLahorePakistan
| | - Ahmed Afifi
- Benha University Faculty of MedicineBanhaEgypt
| | - Laya Ohadi
- Shahid Beheshti University of Medical SciencesTehranIran
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Fouad HM, Yousef A, Afifi A, Ghandour AA, Elshahawy A, Elkhawass A, Hawees H, Shaheen E, Alaaeldin M, Kamal M, Bastawy S, Rabie S, Wissa F, Shalaby S. Prevalence of malnutrition & anemia in preschool children; a single center study. Ital J Pediatr 2023; 49:75. [PMID: 37322509 DOI: 10.1186/s13052-023-01476-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Malnutrition including undernutrition, overnutrition, and micronutrient deficiencies are considerable problems worldwide, with variable burdens among different communities. Its complications include physical and cognitive impairment, with the probability of irreversible lifelong consequences. We aimed to assess the prevalence of undernutrition, overweight, obesity, and anemia in preschoolers, being a risk group for developmental adverse events. METHODS We recruited 505 healthy preschool children, with a male: female ratio of 1.05:1. Children with chronic diseases were excluded. We used anthropometry and complete blood count to screen for malnutrition and anemia. RESULTS The mean age of the study group was 3.8 ± 1.4 years (1.02-7). The screening results were average in 228 (45.1%) children, while 277 (54.9%) children had either abnormal anthropometry, anemia, or both. We observed undernutrition in 48 (9.5%) children; among them, 33 (6.6%) were underweight, 33 (6.6%) wasted, and 15 (3%) were stunted, with no significant difference between children aged below or above five. We identified overnutrition in 125 (24.8%); 43 (8.5%) were overweight, 12 (2.4%) were obese, and 70 (13.9%) had a high body mass index Z score, not qualifying the definition of overweight. Anemia was diagnosed in 141 (27.9%) children and was significantly more frequent among older children without gender discrimination. About 10% (50 children) had both anemia and abnormal anthropometry. The frequency of abnormal anthropometry was comparable between children with anemia and those with normal hemoglobin. CONCLUSION Malnutrition and anemia in preschoolers are still a heavy burden affecting about half of our study group, with an upward trend towards the overnutrition side. Anemia is still a moderate public health problem in preschoolers.
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Affiliation(s)
- Hanan Mina Fouad
- Pediatrics Department, Helwan University, Cairo, Egypt.
- National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
| | - Aly Yousef
- Pediatrics Department, Helwan University, Cairo, Egypt
| | - Ahmed Afifi
- Pediatrics Department, Helwan University, Cairo, Egypt
| | - Ahmed A Ghandour
- Community, Environmental and Occupational Medicine Department, Helwan University, Cairo, Egypt
| | - Amira Elshahawy
- Pediatric Department, the National Nutrition Institute, General Organization of Teaching Hospitals, Ministry of Health, Cairo, Egypt
| | | | - Hazem Hawees
- Intern in Helwan University Hospital, Cairo, Egypt
| | - Eman Shaheen
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | | | - Mostafa Kamal
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | - Samah Bastawy
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | - Samah Rabie
- Psychiatry Department, Helwan University, Cairo, Egypt
| | - Farah Wissa
- Intern in Helwan University Hospital, Cairo, Egypt
| | - Sherine Shalaby
- Pediatrics Department, Helwan University, Cairo, Egypt
- Pediatrics Department, Suez Canal University, Ismailia, Egypt
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8
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Naeem A, Tabassum S, Gill S, Khan MZ, Mumtaz N, Qaiser Q, Karamat M, Arif M, Naeem F, Afifi A, Basit J, Nashwan AJ. COVID-19 and Cardiovascular Diseases: A Literature Review From Pathogenesis to Diagnosis. Cureus 2023; 15:e35658. [PMID: 37009373 PMCID: PMC10065369 DOI: 10.7759/cureus.35658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) took the world by storm after the first case of COVID-19 emerged in China on December 8, 2019. The disease is generally considered as an infection of the respiratory system, but serious life-threatening myocardial injuries have been reported with this infection. Coronavirus can damage cardiac myocytes by entering the cell through angiotensin-converting enzyme 2 (ACE-2) receptor binding. Myocardial infarction, myocarditis, heart failure, cardiac arrhythmias, and Takotsubo cardiomyopathy are cardiac clinical manifestations commonly seen among patients affected by COVID-19. These cardiac pathologies are seen both during ongoing infection and post-infection. Elevated levels of myoglobin, troponin, creatine kinase-MB, plasma interleukin-6, lactate dehydrogenase (LDH), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) have been found in COVID-19-associated myocardial injuries. The diagnostic modalities used in myocardial injuries due to COVID-19 include electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), endomyocardial biopsy, echocardiography (Echo), and computerized tomography (CT-Scan). This literature review will discuss, in detail, the pathogenesis, clinical manifestations, and diagnosis of myocardial injuries due to COVID-19.
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9
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Moharram AN, Afifi A, Abdel-Wahed M, Ezzat M. Latissimus dorsi tendon transfer to restore shoulder abduction in patients with deltoid paralysis: A novel technique. Shoulder Elbow 2023; 15:37-44. [PMID: 36895600 PMCID: PMC9990102 DOI: 10.1177/17585732211053297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
Background Shoulder abduction is an essential movement for placement of the hand in space and thus for upper limb function. The objective of this study was to introduce and test the effectiveness of a new technique of latissimus dorsi tendon transfer to deltoid insertion to restore shoulder abduction. Methods We prospectively included 10 male patients with a lost deltoid function. Their mean age was 34.6 years (range, 25-46). We describe a new technique to compensate for the loss of the deltoid function using a latissimus dorsi tendon transfer augmented with a semitendinosus tendon graft. The tendon graft is passed over the acromion and attached to the anatomical deltoid insertion. Postoperatively, a shoulder spica in 90° abduction was used for six weeks followed by physiotherapy. Results Patients were followed up for a mean of 25.4 months (range, 12-48). The mean range of active shoulder abduction rose to 110° (range, 90-140°) with a mean gain of 83° of abduction. Conclusions This procedure can be a useful technique for restoration of a significant range and strength of active shoulder abduction.
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Affiliation(s)
- Ashraf N Moharram
- Hand and Microsurgery Unit, Department of
Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Hand and Microsurgery Unit, Department of
Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Abdel-Wahed
- Hand and Microsurgery Unit, Department of
Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Ezzat
- Hand and Microsurgery Unit, Department of
Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Afifi A, Azzam EZ, Farghaly Y, Abd-elghany A. ADDED VALUE OF DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN DIAGNOSING MALIGNANT THYROID NODULES. ALEXMED ePosters 2022; 4:51-52. [DOI: 10.21608/alexpo.2022.183414.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Afifi A, Mansour A. Is it necessary to fix basal fractures of the ulnar styloid after anterior plate fixation of distal radius fractures? A randomized controlled trial. J Hand Surg Eur Vol 2022; 48:544-550. [PMID: 36448506 DOI: 10.1177/17531934221140730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The purpose of this study was to investigate the necessity for surgical fixation of basal fractures of the ulnar styloid without distal radioulnar joint (DRUJ) instability, after stabilization of associated distal radial fractures using an anterior plate. This single-centre, prospective, randomized controlled trial, conducted between 2015 to 2021, included 43 patients in each study arm who were randomized to either fixation (Group A) or non-operative treatment (Group B) of the ulnar styloid. The mean follow-up period was 24 months (SD 5.2) in Group A and 23.9 months (SD 5.5) in Group B. At the final follow-up, patients were evaluated by the Disabilities of the Shoulder, Arm, and Hand (DASH) score, the Modified Mayo Wrist Score (MMWS), the visual analogue scale (VAS) for pain, the grip strength, wrist range of motion. The DASH score was 6 (SD 2.6) in Group A and 6 (SD 2.4) in Group B; the MMWS was 87 (SD 5.6) in Group A and 87 (SD 5.6) in Group B; and the grip strength was 88% (SD 9.4) in Group A and 87% (SD 7.7) in Group B. In conclusion, fixation of basal ulnar styloid fractures is not mandatory if the DRUJ is stable after rigid fixation of the associated fracture of the distal radius.Level of evidence: II.
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Affiliation(s)
- Ahmed Afifi
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Mansour
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Ibrahim AM, Roshdy M, Latif N, Sarathchandra P, Hosny M, Haikal S, Desouky A, Elsawy A, Elmozy W, Elaithy A, Khedr H, Afifi A, Aguib Y, Yacoub M. Structural, molecular and functional characterization of the aorta in HCM. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Changes in the Extracellular Matrix (ECM) in Hypertrophic Cardiomyopathy (HCM) is thought to involve the myocardium as well as extracardiac tissues. The extent and significance of extra-myocardial changes has not been adequately studied.
Purpose
To describe the structural, molecular, and functional changes in the aorta of HOCM patients.
Methods
The structural and molecular changes in the aortic wall were studied in a cohort of 102 consecutive patients with hypertrophic obstructive cardiomyopathy undergoing myectomy. The biopsies were examined histologically, immunohistochemically and by Electron microscopy. The findings were compared to 10 normal controls obtained from the homograft bank of the Harefield hospital, following IRB guidelines. Changes in expression were quantified using morphometry and western blotting. For aortic stiffness, pulse wave velocity [PWV] was measured using Cardiac Magnetic Resonance (CMR), in the 102 HCM patients as well as age-matched 166 normal controls.
Results
Specimens from HCM aortas showed a misalignment in collagen and elastin fibres. There was a significant reduction in smooth muscle cells [SMCs] markers; integrin beta1 and smooth muscle actin, and an increase in an apoptosis marker, Caspase3. In addition, there was a significant decrease in the number of lamellae and an increase in the interlamellar distance in HCM aortas. FBLNs 1, 2 and 5 showed a reduction in expression in tunica intima and tunica media of HCM biopsies. PWV was significantly higher in HCM patients compared to healthy controls with the highest levels in patients with LV fibrosis.
Conclusion
This study illustrates the link between functional abnormalities in the aorta of HCM patients with structural and molecular changes. These findings can have a potential value in risk stratification and identify new therapeutic targets in HCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): STDF-EgyptMagdi Yacoub Foundation
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Affiliation(s)
| | - M Roshdy
- Aswan Heart Centre , Aswan , Egypt
| | - N Latif
- Imperial College London , London , United Kingdom
| | | | - M Hosny
- Aswan Heart Centre , Aswan , Egypt
| | - S Haikal
- Aswan Heart Centre , Aswan , Egypt
| | | | - A Elsawy
- Aswan Heart Centre , Aswan , Egypt
| | - W Elmozy
- Aswan Heart Centre , Aswan , Egypt
| | | | - H Khedr
- Aswan Heart Centre , Aswan , Egypt
| | - A Afifi
- Aswan Heart Centre , Aswan , Egypt
| | - Y Aguib
- Aswan Heart Centre , Aswan , Egypt
| | - M Yacoub
- Imperial College London , London , United Kingdom
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Yacoub MH, Nagy M, Hosny H, Afifi A, Shehata N, Mahgoub A, El Sawy A, Sabry M, Abdullah H, Romeih S, Elafifi A. Right ventricular structure and function after novel repair of common arterial trunk. International Journal of Cardiology Congenital Heart Disease 2022. [DOI: 10.1016/j.ijcchd.2022.100416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Afifi A, Ali AM, Abdelaziz A, Abuomira IE, Saleh WR, Yehya M. Arthroscopic Wafer Procedure Versus Ulnar Shortening Osteotomy for Treatment of Idiopathic Ulnar Impaction Syndrome: A Randomized Controlled Trial. J Hand Surg Am 2022; 47:745-751. [PMID: 35753828 DOI: 10.1016/j.jhsa.2022.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 02/15/2022] [Accepted: 04/06/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE We compared the arthroscopic wafer procedure (AWP) and ulnar shortening osteotomy (USO) for treatment of idiopathic ulnar impaction syndrome in terms of clinical, functional improvement and time of return to work. METHODS This single-center study was conducted at an academic level 1 referral center between 2014 and 2020. Sixty patients with idiopathic ulnar impaction syndrome were prospectively randomized to treatment with either AWP or USO. At the final follow-up, patients were evaluated by the Disabilities of the Arm, Shoulder, and Hand; the Modified Mayo Wrist Score; the visual analog scale for pain; wrist range of motion; and grip strength. Also, the time of return to work and complications were reported. RESULTS The mean follow-up periods were 22 ± 5.7 months in the AWP group and 21.1 ± 5.3 months in the USO group. All patients in the USO group achieved union by 12 weeks. At the final follow-up, there were no statistically significant differences in the outcome measures (Disabilities of the Arm, Shoulder, and Hand score; Modified Mayo Wrist Score; visual analog scale score; range of motion; and grip strength) in either group. Fewer complications and an earlier return to work were observed in the AWP group. CONCLUSIONS Both techniques yielded comparable outcomes, with earlier return to work, a lower incidence of complications, and fewer secondary procedures in the AWP group. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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Affiliation(s)
- Ahmed Afifi
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Abdelaziz Monsef Ali
- Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Ashraf Abdelaziz
- Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
| | - Ibrahim E Abuomira
- Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Waleed Riad Saleh
- Department of Orthopedic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed Yehya
- Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
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15
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AbouZeid E, Hussein R, Afifi A, Salama A, Youssef F, El-Ahmady S, Ammar N. Phytochemical Profile of Phoenix rupicola T. Anderson Seeds and In Vitro Evaluation of their Estrogenic Activity using MCF-7 Cell Lines. Egypt J Chem 2022. [DOI: 10.21608/ejchem.2022.129433.5731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Khattab AS, Abdel Aziz AH, Afifi A. Estimates of direct and maternal genetic effects on birth and weaning weights in Egyptian buffalo calves. Buffalo Bull 2022. [DOI: 10.56825/bufbu.2022.4122935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A total of 1173 first calves of Egyptian buffalo kept at Mehalet Mousa Farm, belonging to Animal Production Research, Ministry of Agriculture, Dokki, Cairo, Egypt during the period from 2000 to 2015 were used to estimate variances of direct and maternal genetic effects for birth weight (BW) and weaning weight (WW). Two animal models are used. Model 1 (full model) includes month and year of birth and sex as fixed effects and direct genetic, maternal genetic, covariance between direct and maternal genetic and residual as random effects. Model 2 is similar to model 1 while additive maternal genetic and covariance between direct and maternal effects were omitted from the analysis. Year of birth and sex had highly significant effects on BW and WW, while month of birth had no significant effects on both traits studied. Bulls of the buffalo had highly significant effects on BW and WW. Direct heritability estimates for BW are 0.30 and 0.33, for Model 1 and Model 2, respectively. Direct heritability estimates for WW are 0.34 and 0.39 for Model 1 and Model 2, respectively. Maternal heritability estimates are 0.10 and 0.03 for BW and WW, respectively. Phenotypic and genetic correlations among BW and WW are positive and highly significant. These results indicate the important of maternal genetic effect on birth weight.
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17
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Afifi A, Abdel-Ati EA, Abdel-Wahed M, Moharram AN. Arthroscopic-Assisted Foveal Reattachment of Triangular Fibrocartilage Complex Tears With Distal Radioulnar Joint Instability: A Comparison of Suture Anchors and Transosseous Sutures. J Hand Surg Am 2022; 47:507-516. [PMID: 35341629 DOI: 10.1016/j.jhsa.2022.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/30/2021] [Accepted: 01/21/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the clinical outcomes of arthroscopically-assisted suture anchor repair and transosseous sutures for repair of foveal triangular fibrocartilage complex tears in patients with distal radioulnar joint (DRUJ) instability. METHODS Sixty patients with triangular fibrocartilage complex foveal detachment associated with DRUJ instability were prospectively recruited and randomized into 2 equal groups-the anchor repair group and the transosseous repair group. The primary outcome was DRUJ function after 2 years, which was assessed by the DRUJ evaluating system. The secondary outcomes were grip strength, visual analog scale for pain, Mayo Modified Wrist ScorePatient-Rated Wrist Evaluation score, and the Disabilities of the Arm, Shoulder, and Hand score. RESULTS There were no significant differences between the groups for any of the outcome measures. Good-to-excellent outcomes (according to the DRUJ evaluation system) were achieved in 27 (90%) patients in the anchor repair group and 26 (86.7%) patients in the transosseous repair group. Fewer complications were observed in the anchor repair group. CONCLUSIONS Both techniques yielded good and comparable outcomes with a lesser incidence of early complications in the anchor repair group. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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Affiliation(s)
- Ahmed Afifi
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Emad A Abdel-Ati
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Abdel-Wahed
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf N Moharram
- Hand and Microsurgery Unit, Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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18
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Abdellaoui H, Tazi M, Benmassoud Z, Balde F, Atarraf K, Afifi A. Séquelles Grave De Brûlure Des Deux Pieds : Un Cas Pédiatrique De Déformation Extrême Des Orteils. Ann Burns Fire Disasters 2022; 35:74-78. [PMID: 35582095 PMCID: PMC9020850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/26/2021] [Indexed: 06/15/2023]
Abstract
Les brides rétractiles post-brûlure au niveau du pied sont considérées comme graves en raison de leurs retentissement fonctionnel et esthétique potentiellement importants. Nous rapportons un cas pédiatrique âgé de 13 ans présentant des brides rétractiles au niveau des deux pieds, négligées depuis 10 ans et responsables d'une déformation très importante, avec désaxation marquée des orteils. Le patient souffrait d'une importante limitation des activités et d'une impossibilité de chaussage. La libération chirurgicale des brides par plusieurs plasties en Z associées à la réaxation des orteils luxés a permis d'obtenir un bon résultat avec un retour à une fonction quasi normale. La prévention des brides rétractiles et leur prise en charge précoce restent le meilleur moyen d'éviter des déformations grave et leurs conséquences chez un patient en croissance.
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Affiliation(s)
- H. Abdellaoui
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
| | - M. Tazi
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
- Université Sidi Mohamed Ben Abdellah Faculté de Médecine et de Pharmacie, Fès, M
| | - Z. Benmassoud
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
| | - F.B. Balde
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
| | - K. Atarraf
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
- Université Sidi Mohamed Ben Abdellah Faculté de Médecine et de Pharmacie, Fès, M
| | - A. Afifi
- Centre Hospitalier Universitaire Hassan II, Fès, Maroc
- Université Sidi Mohamed Ben Abdellah Faculté de Médecine et de Pharmacie, Fès, M
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19
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Salah N, Sobieh W, Afifi A, Kamel R, Abd El-Hady F. Anti-candida effect of Saudi Propolis: GC/MS analysis, in-silico study and nanoencapsulation. Egypt J Chem 2022. [DOI: 10.21608/ejchem.2022.117158.5395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Afifi A, Shehata N, Nagi M, Sultan AR, Yacoub M. Expanding Valve Repair in Rheumatic Heart Disease. Front Cardiovasc Med 2022; 8:799652. [PMID: 35187111 PMCID: PMC8854295 DOI: 10.3389/fcvm.2021.799652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Rheumatic heart disease is a serious ailment with significant morbidity and mortality in endemic areas; yet, there is no agreement on indication, timing, and surgical modality for treating rheumatic valve affection. There is mounting evidence that rheumatic mitral valve repair is possible with good long-term results, less is the case with rheumatic aortic valve disease. We discuss the surgical approach for both valves emphasizing the role of multimodality imaging.
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Affiliation(s)
- Ahmed Afifi
- Magdi Yacoub Heart Foundation-Aswan Heart Centre, Cairo, Egypt
- *Correspondence: Ahmed Afifi
| | - Nairouz Shehata
- Magdi Yacoub Heart Foundation-Aswan Heart Centre, Cairo, Egypt
| | - Mohamed Nagi
- Magdi Yacoub Heart Foundation-Aswan Heart Centre, Cairo, Egypt
| | | | - Magdi Yacoub
- Magdi Yacoub Heart Foundation-Aswan Heart Centre, Cairo, Egypt
- Department of Biomedical Engineering, Imperial College London, London, United Kingdom
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21
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Weigt J, Repici A, Antonelli G, Afifi A, Kliegis L, Correale L, Hassan C, Neumann H. Performance of a new integrated computer-assisted system (CADe/CADx) for detection and characterization of colorectal neoplasia. Endoscopy 2022; 54:180-184. [PMID: 33494106 DOI: 10.1055/a-1372-0419] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Use of artificial intelligence may increase detection of colorectal neoplasia at colonoscopy by improving lesion recognition (CADe) and reduce pathology costs by improving optical diagnosis (CADx). METHODS A multicenter library of ≥ 200 000 images from 1572 polyps was used to train a combined CADe/CADx system. System testing was performed on two independent image sets (CADe: 446 with polyps, 234 without; CADx: 267) from 234 polyps, which were also evaluated by six endoscopists (three experts, three non-experts). RESULTS CADe showed sensitivity, specificity, and accuracy of 92.9 %, 90.6 %, and 91.7 %, respectively. Experts showed significantly higher accuracy and specificity, and similar sensitivity, while non-experts + CADe showed comparable sensitivity but lower specificity and accuracy than CADe and experts. CADx showed sensitivity, specificity, and accuracy of 85.0 %, 79.4 %, and 83.6 %, respectively. Experts showed comparable performance, whereas non-experts + CADx showed comparable accuracy but lower specificity than CADx and experts. CONCLUSIONS The high accuracy shown by CADe and CADx was similar to that of experts, supporting further evaluation in a clinical setting. When using CAD, non-experts achieved a similar performance to experts, with suboptimal specificity.
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Affiliation(s)
- Jochen Weigt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v. Guericke University, Magdeburg, Germany
| | - Alessandro Repici
- Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giulio Antonelli
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Ahmed Afifi
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v. Guericke University, Magdeburg, Germany
| | - Leon Kliegis
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-v. Guericke University, Magdeburg, Germany
| | - Loredana Correale
- Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Cesare Hassan
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Helmut Neumann
- Department of Interdisciplinary Endoscopy, University Hospital Mainz, Mainz, Germany.,GastroZentrum Lippe, Interventional Endoscopy, Bad Salzuflen, Germany
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22
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Badawy MY, Afifi A, Shaker ES, Elbarbary H, Hegazy M, Mohamed MT, Arafa A. Is capsulorrhaphy a necessary step during open reduction of developmental dysplasia of the hip? A randomized controlled trial. Int Orthop 2021; 46:589-596. [PMID: 34817631 DOI: 10.1007/s00264-021-05267-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the necessity of performing capsulorrhaphy during open reduction of DDH. METHODS A single-centre, prospective, randomized controlled trial was conducted between 2015 and 2020. The study included 82 hips in 67 patients with developmental dysplasia of the hip (DDH) who were treated with open reduction via the anterior approach. Patients were randomized into two equal groups (41 hips in each group); group A (capsulorrhaphy was done) and group B (capsulorrhaphy was not done). Dega osteotomy was performed in all cases, while femoral derotation shortening osteotomy was performed only in four hips in group A and four hips in group B. The mean age at the time of surgery was 33 ± 22.3 months. The follow-up period was 24 months for all patients. At the final follow-up, maintenance of reduction was chosen as the primary outcome and was assessed radiologically by the Severin's grading system. Secondary outcome measures were functional evaluation (by using the modified McKay's criteria), Shenton line assessment, acetabular index measurement, and complications. RESULTS According to the Severin's grading system, concentric reduction was achieved in 36 hips in group A and 37 hips in group B, subluxation occurred in three hips in each group, and redislocation was encountered in two hips in group A and one hip in group B. There was no statistically significant difference between both groups (p-value = 0.239). According to the modified McKay's criteria, the results were satisfactory (excellent and good) in 34 hips (82.9%) in group A and 36 hips (87.8%) in group B. The difference was statistically insignificant (p-value = 0.352). The rate of complications was higher in group A (17.1%) than group B (12.2%) (p-value = 0.532). CONCLUSION The stability of the hip joint after open reduction depends mainly on adequate removal of soft tissue obstacles that impede reduction and proper correction of the bony configuration of the hip using pelvic and/or femoral osteotomy. So, the authors believe that capsulorrhaphy is not necessary in the surgical management of DDH, provided that adequate soft tissue and bony gestures are combined.
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Affiliation(s)
| | - Ahmed Afifi
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Ezzat Samir Shaker
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hassan Elbarbary
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Hegazy
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Amr Arafa
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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23
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Youssef AI, Afifi A, Abbadi S, Hamed A, Enany M. PCR-based detection of Helicobacter pylori and non-Helicobacter pylori species among humans and animals with potential for zoonotic infections. Pol J Vet Sci 2021; 24:445-450. [PMID: 34730306 DOI: 10.24425/pjvs.2021.138737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Helicobacter species have been reported in animals, some of which are of zoonotic importance. This study aimed to detect Helicobacter species among human and animal samples using conventional PCR assays and to identify their zoonotic potentials. Helicobacter species was identified in human and animal samples by genus-specific PCR assays and phylogenetic analysis of partial sequencing of the 16S ribosomal RNA gene. The results revealed that Helicobacter species DNA was detected in 13 of 29 (44.83%) of the human samples. H. pylori was identified in 2 (15.38%), and H. bovis was detected in 4 (30.77%), whereas 7 (53.85%) were unidentified. H. bovis and H. heilmannii were prevalent among the animal samples. Phylogenetic analysis revealed bootstrapping of sequences with H. cinaedi in camel, H. rappini in sheep and humans, and Wollinella succinogenes in humans. In conclusion, the occurrence of non-H. pylori infections among human and animal samples suggested zoonotic potentials.
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Affiliation(s)
- A I Youssef
- Animal Hygiene and Zoonoses, Faculty of Veterinary Medicine, Suez Canal University, 41522, 4.5 Km Ring Road, Ismailia, Egypt
| | - A Afifi
- Microbiology and Immunology Department, Faculty of Veterinary Medicine, Suez Canal University, Egypt
| | - S Abbadi
- Microbiology and Immunology Department, Faculty of Medicine, Suez University, 43512, Alsalam City, Suez, Egypt
| | - A Hamed
- Biotechnology Department, Animal Health Research Institute, P.O. Box 264, Dokki, Giza 12618, Egypt
| | - M Enany
- Microbiology and Immunology Department, Faculty of Veterinary Medicine, Suez Canal University, Egypt
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24
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Moharram AN, Mahmoud M, Lymona A, Afifi A, Ezzat M, Abdel-Wahed M. Temporary spanning plate across the elbow for complex fractures of the distal humerus. BMC Musculoskelet Disord 2021; 22:875. [PMID: 34645437 PMCID: PMC8515665 DOI: 10.1186/s12891-021-04764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Open reduction internal fixation (ORIF) is the gold standard management of fractures of the distal humerus. Stable fixation to allow early mobilization is not always possible in cases with comminuted fracture patterns and bone loss, with a high failure rate. We propose augmentation of internal fixation in these unstable situations with a spanning plate across the elbow to protect the fixation construct temporarily until bone union. METHODS Eighteen patients with complex distal humeral fractures were managed with standard ORIF technique augmented with a temporary plate spanning across the elbow as an internal fixator. Cases included were either very distal, comminuted (6 cases) or insufficiency fractures (4 cases) or revision fixation cases (8 cases). The temporary spanning plate was removed as soon as signs of early radiographic union were detected. RESULTS Seventeen patients were available for final follow up at a mean 28.3 months. The spanning plate was removed after 3.4 months on average. At the final follow-up, the mean elbow total arc of motion was 86.3°. The mean Mayo Elbow Performance Score (MEPS) was 80, and the mean Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score was 27. CONCLUSION Spanning the elbow temporarily with a plate in adjunct to standard ORIF technique is both simple and effective in achieving fracture stability and union and minimizes failure rates after fixation of comminuted, very distal fractures, osteoporotic cases, or revision fixation cases with bone loss. LEVEL OF EVIDENCE Level IV, Therapeutic study.
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Affiliation(s)
| | - Mostafa Mahmoud
- Kasr El-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Lymona
- Kasr El-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Kasr El-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Ezzat
- Kasr El-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
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25
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Afifi A, Hosny H, Mahgoub A, Yacoub M. The Ross procedure-the loose jacket technique. Ann Cardiothorac Surg 2021; 10:544-545. [PMID: 34422572 DOI: 10.21037/acs-2020-rp-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/27/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Ahmed Afifi
- Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.,Cardiac Surgery Department, National Heart Institute, Giza, Egypt
| | - Hatem Hosny
- Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Ahmed Mahgoub
- Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Magdi Yacoub
- Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.,National Heart and Lung Institute, Imperial College London, London, UK
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26
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Barakat AS, Arafa A, Mohamed MT, Zein AB, Afifi A, Wanas JSF, El Barbary H, Hanna A, Hegazy M, Khalifa AH. Treatment of genu valgum by a novel percutaneous transverse metaphyseal osteotomy of the distal femur in children and adolescents. Eur J Orthop Surg Traumatol 2021; 32:1179-1186. [PMID: 34392444 DOI: 10.1007/s00590-021-03093-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the outcomes of a novel percutaneous medial supracondylar femoral osteotomy and above-knee cast technique in children and adolescents as a minimally invasive surgical intervention for treatment of genu valgum. METHODS In this prospective study, 60 patients (70 knees) with a tibiofemoral angle more than 15° were treated with a novel medial percutaneous supracondylar femoral osteotomy and above-knee cast and followed up for an average of 29 months. The radiological outcome was measured with MAD, TFA, and mLDFA. The functional outcome was evaluated by a modified Böstman score. RESULTS The preoperative mean MAD, TFA, and mLDFA were 2.9 cm, 16.3°, and 79.2° respectively. The Böstman score averaged preoperatively 23.1. There was a significant improvement of all radiological and clinical outcome measures (P < 0.001). Per Böstman score, 2 knees in one patient (3%) showed an unsatisfactory result, while 14 (20%) and 54 (77%) knees had a good or excellent result, respectively. Two patients (three limbs) needed early re-casting. Other complications were not encountered. CONCLUSION In experienced hands, percutaneous transverse metaphyseal femoral osteotomy and above-knee casting appear to be a safe, supracondylar cost-effective, and reliable minimally invasive acute correction technique in genu valgum in children and adolescents. LEVEL OF EVIDENCE Level IV-therapeutic.
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Affiliation(s)
| | - Amr Arafa
- Orthopaedic Surgery Department, Cairo University, Cairo, Egypt
| | | | - Abo Bakr Zein
- Orthopaedic Surgery Department, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Orthopaedic Surgery Department, Cairo University, Cairo, Egypt.
| | | | | | - Atef Hanna
- Orthopaedic Surgery Department, Cairo University, Cairo, Egypt
| | - Mohamed Hegazy
- Orthopaedic Surgery Department, Cairo University, Cairo, Egypt
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27
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Ortigão R, Weigt J, Afifi A, Libânio D. Cold versus hot polypectomy/endoscopic mucosal resection-A review of current evidence. United European Gastroenterol J 2021; 9:938-946. [PMID: 34355525 PMCID: PMC8498395 DOI: 10.1002/ueg2.12130] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022] Open
Abstract
Background Colonoscopy with polypectomy substantially reduces the risk of colorectal cancer (CRC) but interval cancers still account for 9% of all CRCs, some of which are due to incomplete resection. Aim The aim of this review is to compare the outcomes of cold and hot endoscopic resection and provide technical tips and tricks for optimizing cold snare polypectomy. Results Cold snare polypectomy (CSP) is the standard technique for small (≤10 mm) colorectal polyps. For large colonic polyps (>10 mm), hot resection techniques with use of electrocautery (polypectomy or endoscopic mucosal resection) were recommended until recently. However, the use of electrocoagulation brings serious adverse effects in up to 9% of the patients, such as delayed bleeding, post‐polypectomy syndrome and perforation. In recent years, efforts have been made to improve the polypectomy with cold snare in order to avoid these adverse effects of electrocoagulation without compromising the efficacy of the resection. Several authors have recently shown that the complication rates of CSP of polyps >10 mm is close to zero and recurrence rates varies between 5‐18%. Lower recurrence rates are found in serrated lesions (<8%).
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Affiliation(s)
- Raquel Ortigão
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
| | - Jochen Weigt
- Gastroenterology Department, Hepatology and Infectious Diseases, Otto-v.-Guericke University, Magdeburg, Germany
| | - Ahmed Afifi
- Gastroenterology Department, Hepatology and Infectious Diseases, Otto-v.-Guericke University, Magdeburg, Germany
| | - Diogo Libânio
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal.,MEDCIDS-Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal
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Yacoub MH, Hosny H, Afifi A, Nagy M, Mahgoub A, Simry W, AbouZeina MG, Doss R, El Sawy A, Shehata N, Elafifi A, Abdullah H, Romeih S. Novel concepts and early results of repairing common arterial trunk. Eur J Cardiothorac Surg 2021; 61:562-571. [PMID: 34347066 PMCID: PMC8922708 DOI: 10.1093/ejcts/ezab336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Common Arterial Trunk (CAT) continues to have a very poor prognosis globally. To address that, we have developed a novel technique targeting key concepts for the correction of all components of the anomaly, using autologous arterial tissue. This aims to enhance results, availability worldwide, and importantly to avoid the need for repeated reoperations. METHODS From January 2019 to 4 January 2021, all patients with isolated CAT had repair of the defect using autologous arterial trunk tissue with direct right ventricle (RV) to pulmonary artery (PA) connection. Clinical outcomes, follow-up which included multi-slice computed tomography 3D segmentation and 4D cardiovascular magnetic resonance flow, are presented. RESULTS Twenty patients were included in the study (median age 4.5 months). There were 2 hospital deaths due to systemic infection and pulmonary hypertensive crisis, respectively. Following discharge all patients remained asymptomatic with no signs of heart failure and improved pattern of growth (median follow-up: 8 months). Early postoperative 3D segmentation showed a conical shaped neo-right ventricular outflow chamber connecting the body of the RV to the main PA through a valveless ostium, and normal crossing of PA and neo-aorta. 4D cardiovascular magnetic resonance pattern of flow showed normal rapid laminar flow through the atrioventricular valves followed by a vortex towards the outflow tracts. There was laminar flow through the neo-aorta and neo-PA with velocity not exceeding 2.5 m/s. The PA regurgitant fraction was 25 ± 5% and was limited to early diastole. CONCLUSIONS The initial results of utilizing the key concepts, using autologous arterial tissue for the repair of CAT, are encouraging, both clinically and by multimodality imaging.
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Affiliation(s)
- Magdi H Yacoub
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Hatem Hosny
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt
| | - Ahmed Afifi
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt.,Cardiac Surgery Department, National Heart Institute, Giza, Egypt
| | - Mohamed Nagy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Ahmed Mahgoub
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt
| | - Walid Simry
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt.,Cardiac Surgery Department, National Heart Institute, Giza, Egypt
| | | | - Ramy Doss
- Internal Medicine Department, Baylor University Medical Center, Dallas, TX, USA
| | - Amr El Sawy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Nairouz Shehata
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | | | - Hedaia Abdullah
- Pediatric Intensive Care unit, Aswan Heart Centre, Aswan, Egypt
| | - Soha Romeih
- Radiology Department, Aswan Heart Centre, Aswan, Egypt.,Cardiology Department, Tanta University, Tanta, Egypt
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Kotit S, Phillips DIW, Afifi A, Yacoub M. The "Cairo Accord"- Towards the Eradication of RHD: An Update. Front Cardiovasc Med 2021; 8:690227. [PMID: 34277735 PMCID: PMC8282907 DOI: 10.3389/fcvm.2021.690227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/07/2021] [Indexed: 01/18/2023] Open
Abstract
Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference "Rheumatic Heart Disease: from Molecules to the Global Community," experts from 21 countries formulated an approach for addressing the problem of RHD: "The Cairo Accord on Rheumatic Heart Disease." The Accord attempts to set policy priorities for the eradication of acute rheumatic fever (ARF) and RHD and builds on a recent series of policy initiatives and calls to action. We present an update on the recommendations of the Cairo Accord and discuss recent progress toward the eradication of RHD, including contributions from our own Aswan Rheumatic Heart Disease Registry (ARGI).
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Affiliation(s)
| | - David I. W. Phillips
- Developmental Origins of Health and Disease Division, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | | | - Magdi Yacoub
- Aswan Heart Centre, Aswan, Egypt
- Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Simry W, Afifi A. Radial artery as a second conduit gains momentum: The RAPCO trial. Glob Cardiol Sci Pract 2021; 2021:e202110. [PMID: 34285901 PMCID: PMC8272406 DOI: 10.21542/gcsp.2021.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/31/2021] [Indexed: 11/05/2022] Open
Abstract
In coronary artery bypass grafting (CABG), the use of an internal mammary artery (IMA) to graft the left anterior descending coronary artery (LAD) improves survival and reduces the need for repeat revascularization. The other IMA, radial artery (RA), and saphenous vein (SV) have contested to complete the surgical revascularization. For that purpose, SV remains the most commonly used conduit despite current evidence in favor of arterial grafts. To determine which conduit is best for grafting the second most important coronary artery, Buxton and colleagues have recently published the long term results of their "Radial Artery Patency and Clinical Outcomes (RAPCO)" trial.
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Affiliation(s)
- Walid Simry
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt
| | - Ahmed Afifi
- Cardiac Surgery Department, Aswan Heart Centre, Aswan, Egypt
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Hegazy M, El Barbary H, Hammoud M, Arafa A, Mohamed MT, Barakat AS, Afifi A. The foot external rotation above-knee (FERAK) brace versus the Denis Browne brace for management of idiopathic clubfoot following Ponseti casting: a randomized controlled trial. Int Orthop 2021; 46:313-319. [PMID: 34120232 DOI: 10.1007/s00264-021-05107-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the foot external rotation above-knee (FERAK) brace and the Denis Browne boot (DBB) brace in terms of relapse prevention and parents' compliance after successful correction with Ponseti casting. METHODS A single-centre, randomized controlled study was conducted between 2016 and 2020. A total of 60 feet in 38 patients with idiopathic clubfoot initially corrected with the Ponseti method were included. They were randomized into two equal groups: the FERAK group and the DBB group. The primary outcome was the efficacy in maintaining correction measured by the Pirani score. The secondary outcomes were parents' compliance and complications (e.g., relapses, skin complications). RESULTS The follow-up period was 24 months for each patient. The mean final Pirani score was 0.42 ± 0.76 in the FERAK group and 0.57 ± 0.82 in the DBB group. This difference was statistically insignificant (p-value = 0.411). Regarding parents' compliance in the FERAK group, 86.7% of parents had good and intermediate compliance while 13.3% had bad compliance. In the DBB group, 66.7% had good and intermediate compliance while 33.3% had bad compliance. This difference was also statistically insignificant (p-value = 0.118). CONCLUSION Both braces achieved good comparable outcomes after Ponseti casting. However, the FERAK brace yielded slightly better parents' compliance with a less recurrence rate.
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Affiliation(s)
- Mohamed Hegazy
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hassan El Barbary
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Hammoud
- Department of Orthopaedic Surgery, Nasr City Health Insurance Hospital, Cairo, Egypt
| | - Amr Arafa
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Ahmed Samir Barakat
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
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32
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Hosney M, Badr AM, Fahmy SR, Afifi A, Baumans V, Gaafar KM. Culture of Care Enhancement in Egypt: The Impact of Laboratory Animal Science Training on Participants' Attitudes. Altern Lab Anim 2021; 49:49-55. [PMID: 33985357 DOI: 10.1177/02611929211016851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cairo University was the first academic institution in Egypt to establish an Institutional Animal Care and Use Committee (IACUC), as mandated by the World Organisation for Animal Health (OIE). Animal-based research should be performed in accordance with international regulations to monitor the humane care and use of the laboratory animals. Until 2018, the formal training of researchers in the appropriate and correct methods of animal handling during sampling and administration, as well as their husbandry demands, was an uncommon practice in Egypt. In 2018, the Egyptian Association for Animal Research Advancement (EAARA) organised the first international course in laboratory animal science (LAS), in collaboration with Utrecht University (The Netherlands) and the Faculty of Science, Cairo University, to raise researchers' awareness and increase their knowledge of the principles that govern the humane use and care of laboratory animals. A total of 26 researchers from a number of fields (veterinary medicine, dentistry, science, medicine, pharmacy and agriculture) enrolled in the course. In the responses to the post-course questionnaire, 24 (92.3%) participants stated that the principles of animal welfare (Three Rs) were well explained. In addition, 18 (69%) participants found that the course improved their skills in animal sampling and handling. Of the 26 participants, 22 (84.6%) became aware of their responsibility towards their experimental animals and agreed that the different methods of euthanasia were well explained. In conclusion, the general assessment of the course revealed a positive outcome regarding the culture of animal care; the course was repeated a year later, and several participants were enlisted as trainers in this second course.
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Affiliation(s)
- Mohamed Hosney
- Department of Zoology, Faculty of Science, 63526Cairo University, Giza, Egypt
| | - Abeer M Badr
- Department of Zoology, Faculty of Science, 63526Cairo University, Giza, Egypt
| | - Sohair R Fahmy
- Department of Zoology, Faculty of Science, 63526Cairo University, Giza, Egypt
| | - Ahmed Afifi
- Department of Zoology, Faculty of Science, 63526Cairo University, Giza, Egypt
| | - Vera Baumans
- Department of Animals, Science and Society, Faculty of Veterinary, 8125Utrecht University, Utrecht, The Netherlands
| | - Khadiga M Gaafar
- Department of Zoology, Faculty of Science, 63526Cairo University, Giza, Egypt
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33
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Nagy M, Hosny H, Afifi A, Elafifi A, Yacoub MH. Three-dimensional images of a pulmonary dominant truncus arteriosus before and after a novel repair. Glob Cardiol Sci Pract 2021; 2021:e202109. [PMID: 34036095 PMCID: PMC8133784 DOI: 10.21542/gcsp.2021.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This paper documents, for the first time, the in vivo size, geometry, and function of the different components of this important subtype of truncus arteriosus (pulmonary dominant). Previous descriptions were based on examining formalin-fixed (collapsed) specimens, or descriptions during operations. It is hoped that this information can be of value in designing operative treatment as well as interpreting future sequential imaging, with the aim of optimizing the results of comprehensive repair.
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Affiliation(s)
| | | | - Ahmed Afifi
- Aswan Heart Centre, Aswan, Egypt.,National Heart Institute, Giza, Egypt
| | | | - Magdi H Yacoub
- Aswan Heart Centre, Aswan, Egypt.,Imperial College London, London, United Kingdom
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Afifi A, Takada C, Yoshimura Y, Nakaguchi T. Real-Time Expanded Field-of-View for Minimally Invasive Surgery Using Multi-Camera Visual Simultaneous Localization and Mapping. Sensors (Basel) 2021; 21:s21062106. [PMID: 33802766 PMCID: PMC8002421 DOI: 10.3390/s21062106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 01/23/2023]
Abstract
Minimally invasive surgery is widely used because of its tremendous benefits to the patient. However, there are some challenges that surgeons face in this type of surgery, the most important of which is the narrow field of view. Therefore, we propose an approach to expand the field of view for minimally invasive surgery to enhance surgeons’ experience. It combines multiple views in real-time to produce a dynamic expanded view. The proposed approach extends the monocular Oriented features from an accelerated segment test and Rotated Binary robust independent elementary features—Simultaneous Localization And Mapping (ORB-SLAM) to work with a multi-camera setup. The ORB-SLAM’s three parallel threads, namely tracking, mapping and loop closing, are performed for each camera and new threads are added to calculate the relative cameras’ pose and to construct the expanded view. A new algorithm for estimating the optimal inter-camera correspondence matrix from a set of corresponding 3D map points is presented. This optimal transformation is then used to produce the final view. The proposed approach was evaluated using both human models and in vivo data. The evaluation results of the proposed correspondence matrix estimation algorithm prove its ability to reduce the error and to produce an accurate transformation. The results also show that when other approaches fail, the proposed approach can produce an expanded view. In this work, a real-time dynamic field-of-view expansion approach that can work in all situations regardless of images’ overlap is proposed. It outperforms the previous approaches and can also work at 21 fps.
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Affiliation(s)
- Ahmed Afifi
- Department of Computer Science, College of Computer Science and Information Technology, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia
- Faculty of Computers and Information, Menoufia University, Menoufia 32511, Egypt
- Correspondence: (A.A.); (T.N.)
| | - Chisato Takada
- Graduate School of Science and Engineering, Chiba University, Chiba 263-8522, Japan;
| | - Yuichiro Yoshimura
- Center for Frontier Medical Engineering, Chiba University, Chiba 263-8522, Japan;
| | - Toshiya Nakaguchi
- Center for Frontier Medical Engineering, Chiba University, Chiba 263-8522, Japan;
- Correspondence: (A.A.); (T.N.)
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35
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Hosny H, Said F, Afifi A, Hassan W, Nagy M, Romeih S, Yacoub M. Pulmonary artery banding in a modified Mustard operation improves biventricular geometry and function. Glob Cardiol Sci Pract 2020; 2020:e202036. [PMID: 33598496 PMCID: PMC7868099 DOI: 10.21542/gcsp.2020.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/20/2020] [Indexed: 11/20/2022] Open
Abstract
Patients with transposition of great arteries, with intact interventricular septum (TGA-IVS) and deconditioned left ventricle, represent a considerable challenge in developing countries. The modified Mustard operation was shown to provide a significant improvement for these patients, particularly by enhancing atrial functions and left ventricular filling. Yet, the problems of the systemic right ventricular dysfunction and the resulting secondary tricuspid regurgitation (TR) remain to be of major concern. In addition, the deviation of the interventricular septum towards the left side markedly impairs ventriculo-ventricular interaction and predisposes to dynamic left ventricular outflow tract obstruction (LVOTO). We report that adding a moderately loose pulmonary artery banding to the modified Mustard operation in a case of TGA-IVS results in improvement of biventricular geometry and function, tricuspid and mitral valve functions and disappearance of dynamic LVOTO.
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Afifi A, Alhumam A, Abdelwahab A. Convolutional Neural Network for Automatic Identification of Plant Diseases with Limited Data. Plants (Basel) 2020; 10:plants10010028. [PMID: 33374398 PMCID: PMC7823428 DOI: 10.3390/plants10010028] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022]
Abstract
Automated identification of plant diseases is very important for crop protection. Most automated approaches aim to build classification models based on leaf or fruit images. These approaches usually require the collection and annotation of many images, which is difficult and costly process especially in the case of new or rare diseases. Therefore, in this study, we developed and evaluated several methods for identifying plant diseases with little data. Convolutional Neural Networks (CNNs) are used due to their superior ability to transfer learning. Three CNN architectures (ResNet18, ResNet34, and ResNet50) were used to build two baseline models, a Triplet network and a deep adversarial Metric Learning (DAML) approach. These approaches were trained from a large source domain dataset and then tuned to identify new diseases from few images, ranging from 5 to 50 images per disease. The proposed approaches were also evaluated in the case of identifying the disease and plant species together or only if the disease was identified, regardless of the affected plant. The evaluation results demonstrated that a baseline model trained with a large set of source field images can be adapted to classify new diseases from a small number of images. It can also take advantage of the availability of a larger number of images. In addition, by comparing it with metric learning methods, we found that baseline model has better transferability when the source domain images differ from the target domain images significantly or are captured in different conditions. It achieved an accuracy of 99% when the shift from source domain to target domain was small and 81% when that shift was large and outperformed all other competitive approaches.
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Affiliation(s)
- Ahmed Afifi
- Department of Computer Science, College of Computer Science and Information Technology, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (A.A.); (A.A.)
- Faculty of Computers and Information, Menoufia University, Shibin Al Kawm 32511, Menoufia, Egypt
- Correspondence:
| | - Abdulaziz Alhumam
- Department of Computer Science, College of Computer Science and Information Technology, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (A.A.); (A.A.)
| | - Amira Abdelwahab
- Department of Computer Science, College of Computer Science and Information Technology, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (A.A.); (A.A.)
- Faculty of Computers and Information, Menoufia University, Shibin Al Kawm 32511, Menoufia, Egypt
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Yacoub MH, Afifi A, Hosny H, Nagy M, Shehata N, Gamrah MA, El Sawy A, Simry W, Mahgoub A, Francis N, El Nashar H, Tseng YT, Romeih S, Aguib H. A New Technique for Shaping the Aortic Sinuses and Conserving Dynamism in the Remodeling Operation. Ann Thorac Surg 2020; 112:1218-1226. [PMID: 33253669 DOI: 10.1016/j.athoracsur.2020.10.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/02/2020] [Accepted: 10/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Preserving dynamism and recreating the sinuses in the Dacron graft are thought to be important for optimizing results of aortic valve-conserving operations. METHODS We describe a novel technique that preserves dynamism and recreates the sinotubular junction. In addition, it tailors 3 sinuses of defined longitudinal and transverse curvatures in a straight Dacron tube during the operation. The technique has been used in 6 patients with varied aortic root pathology. We performed preoperative and postoperative multimodality imaging using computerized image analysis as well as 3-dimensional models. RESULTS There was no early or midterm death. Upon discharge, patients were clinically well, with echocardiographic evidence of minimal (3 patients) or mild (3 patients) aortic regurgitation. Computed tomography and cardiac magnetic resonance imaging with extensive image analysis of the aortic root size, shape, and function showed partial or complete normalization of these parameters. This included the shape and dynamism of the aortic annulus and the size and shape of the geometric (effective) orifice. The 4-dimensional magnetic resonance imaging pattern of flow in the sinuses and ascending aorta showed favorable vortices in the sinuses, right-handed helical flow, and marked diminution of energy loss in the ascending aorta. CONCLUSIONS The novel technique described here is simple, practical, and cost-effective because it uses a widely available straight Dacron tube. The technique does not use rigid internal or external support. The early results are encouraging. Larger series with longer follow-up are required.
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Affiliation(s)
- Magdi H Yacoub
- Cardiac Surgery Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt; National Heart and Lung Institute, Imperial College London, London, United Kingdom; Harefield Heart Science Centre, Harefield, Middelsex, United Kingdom.
| | - Ahmed Afifi
- Cardiac Surgery Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt; Cardiac Surgery Department, National Heart Institute, Giza, Egypt
| | - Hatem Hosny
- Cardiac Surgery Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Mohamed Nagy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Nairouz Shehata
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Mazen Abou Gamrah
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Amr El Sawy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Walid Simry
- Cardiac Surgery Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Ahmed Mahgoub
- Cardiac Surgery Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Nadine Francis
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Hussam El Nashar
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Yuan-Tsan Tseng
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Soha Romeih
- Radiology Department, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Heba Aguib
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
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Youssef A, Afifi A, Hamed A, Enany M. First report of PCR-based detection of Helicobacter species DNA in Camelus dromedarius in Egypt. Vet World 2020; 13:1898-1901. [PMID: 33132603 PMCID: PMC7566247 DOI: 10.14202/vetworld.2020.1898-1901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
Background and Aim: Helicobacter species infections have epidemiological and zoonotic impacts, and different species of Helicobacter have been implicated in infecting humans and animals. The aim of this study was to investigate Helicobacter species infections in Camelus dromedarius. Materials and Methods: Fecal samples were collected from 32 camels from 9 camel farms located at Ismailia Governorate, Egypt. The collected samples were investigated by bacteriological isolation and conventional polymerase chain reaction (PCR) assays targeting the 16S ribosomal RNA gene. Results: Although Helicobacter species could not be isolated from all the examined samples, Helicobacter DNA was detected in 2 (22.22%) of the 9 camel farms. Of the 32 camel fecal samples examined, 4 (12.5%) were positive for Helicobacter species as analyzed by the PCR assay. Conclusion: To the best of our knowledge, this is the first report of PCR-based detection of Helicobacter species infections in C. dromedarius. Further epidemiological studies are required to clarify Helicobacter species infections in camels.
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Affiliation(s)
- Ahmed Youssef
- Department of Animal Hygiene and Zoonoses, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ahmed Afifi
- Department of Microbiology (Bacteriology), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ayman Hamed
- Department of Biotechnology, Animal Health Research Institute, 7 Nady El Seid St., Dokki, Giza, Egypt
| | - Mohamed Enany
- Department of Biotechnology, Animal Health Research Institute, 7 Nady El Seid St., Dokki, Giza, Egypt
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Saad AM, Afifi A, Gad M, Al-Husseini MJ, Baidoun F, Hilal T. Causes of death in nodular lymphocyte predominant Hodgkin's lymphoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e20016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20016 Background: Nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) accounts for 5% of all cases of HL. The outcomes of patients with NLPHL is generally regarded as better than those with classical HL. However, causes of death (COD) of patients with NLPHL have not been previously described. Methods: The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program was used to identify all patients with NLPHL diagnosed between 1990 and 2015. Patient characteristics and disease stage, using the Ann-Arbor system, was extracted and tabulated. COD were identified and proportions were calculated for deaths within 5 years and after 5 years of diagnosis for patients with early and late stage NLPHL. Results: We identified 1,937 cases of NLPHL. The majority were younger than 65 years (86%), white (70%), male (67%), and diagnosed between 2001-2015 (85%), when rituximab was introduced. Of all cases, 1336 (69%) were classified as early stage. At a median follow-up of 91 months (IQR 41, 152) for early stage disease, and 73 months (IQR 30-123) for late stage disease, the median cancer-specific or overall survival were not reached. The estimated 5-year survival was 92% and 81% for early stage and late stage disease, respectively. Of all patients with early stage NLPHL, 186 (14%) died by the end of 2015, and 87 (46%) deaths occurred within 5 years of diagnosis. During the first 5 years after diagnosis, COD was NLPHL in 30 (35%). Beyond 5 years from diagnosis, NLPHL was the COD in 27% followed by other cancers (23%), and cardiovascular disease (18%). Of all patients with late stage NLPHL, 107 (21%) died, and 75 (70%) of deaths occurred within 5 years of diagnosis. During the first 5 years after diagnosis, COD was NLPHL in 44 (59%). Beyond 5 years from diagnosis, cardiovascular disease was the COD in 25%, followed by NLPHL (22%). Conclusions: The prognosis of NLPHL is excellent. Of all patients with NLPHL, those with advanced stage disease are more likely to die of their disease within 5 years of diagnosis. Patients with early and advanced stage disease beyond 5 years of diagnosis are more likely to die of causes other than NLPHL.
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Affiliation(s)
| | | | | | | | | | - Talal Hilal
- University of Mississippi Medical Center, Jackson, MS
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Afifi A, Lymona AM, Galal S. Radial Head Fixation vs Replacement in Terrible Triad: Preliminary Results of a Prospective Cohort Study with Patient Reported Outcome. Indian J Orthop 2020; 54:254-259. [PMID: 33194099 PMCID: PMC7609740 DOI: 10.1007/s43465-020-00090-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/07/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The combination of posterior elbow dislocation, radial head fracture, and coronoid fracture has been named "terrible triad" as this injury is difficult to treat and yield poor outcomes. Some studies compared the results of radial head fixation to replacement in isolated radial head fractures, very few reports have tried to compare both treatment modalities in the setting of a terrible triad injury.The aim of this study was to compare the functional outcome of radial head fixation vs replacement in terrible triad injuries of the elbow. METHODS A single-center, prospective cohort study was conducted at an academic Level 1 Trauma Center from April 2016 to April 2019.A total of 30 patients with terrible triad injury of the elbow were enrolled. The primary outcome was the Quick Disability of Arm, Shoulder and Hand (Quick-DASH) at 1 year. The secondary outcomes were to report the Mayo Elbow Performance Score (MEPS) at 1 year and elbow range of motion. RESULTS At final follow up for each patient (13.4 ± 1.2 months) The Quick-DASH score at 1 year for fixation group was 5 ± 2.3, for the replacement group it was 7.1 ± 7.1. The MEPS at 1 year for fixation group was 93.6 ± 8.4, for the replacement group it was 90.9 ± 9.4.Loss of elbow extension at 1 year for fixation group was 17.1° ± 10.7°, for replacement group it was 18.75° ± 11.5°. CONCLUSION A systematic approach to address the bony and soft tissue components of terrible triad elbow injury is crucial to obtain satisfactory outcome. Our study shows that radial head repair and replacement, in the setting of terrible triad injury, yields comparable results. LEVEL OF EVIDENCE Level II, Therapeutic study.
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Affiliation(s)
- Ahmed Afifi
- grid.7776.10000 0004 0639 9286Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, 11559 Egypt
| | - Ahmed M. Lymona
- grid.7776.10000 0004 0639 9286Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, 11559 Egypt
| | - Sherif Galal
- grid.7776.10000 0004 0639 9286Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, 11559 Egypt ,grid.239915.50000 0001 2285 8823Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY USA
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Yacoub M, Nagy M, Hosny H, Doss R, Afifi A, El Guindy A, Romeih S, Aguib H. Right ventricular crypts in a myocardial bridge: Relevance to surgical relief. Glob Cardiol Sci Pract 2020. [DOI: 10.21542/gcsp.2019.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Crypts are very thin walled invaginations from the cavity of the left ventricle into the compact myocardium. With the advent and increased application of multimodality imaging, crypts are being increasingly identified in both normal individuals and patients, with various conditions including HCM, before and after the development of LV hypertrophy, LV non-compaction and hypertensive heart disease. to date crypts have not been described in the right ventricle. We here describe for the first time, RV crypts which were extending into a myocardial bridge, in a patient with HCM and dynamic obstruction of the LAD coronary artery. We also document and discuss the serious complications which can arise from crypts, and highlight the importance of preoperative identification of crypts. Further studies are required to determine the fetal origin of crypts and their clinical significance
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Elhalawany AS, Afifi A, Anbar A, Galal S. Hybrid fixation for adolescent both-bones diaphyseal forearm fractures: Preliminary results of a prospective cohort study. J Clin Orthop Trauma 2020; 11:S46-S50. [PMID: 31992916 PMCID: PMC6976989 DOI: 10.1016/j.jcot.2019.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/30/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Both-bone forearm fractures account for 3.4% of all pediatric fractures and 26% of all pediatric upper extremity fractures. Although non-operative management remains a feasible treatment option for children older than 10 years, they have a higher incidence for malunion due to their limited bone remodelling potential. Therefore, surgical intervention could be advocated for this age group, however the optimal method of surgical fixation in this age group remains controversial.Authors wanted to evaluate hybrid fixation (plating of ulna & elastic nail for radius) of adolescent both-bone forearm fractures in a large single-institution cohort of patients. METHODS A single-center, prospective cohort study was conducted at an academic Level 1 Trauma Center from February 2016 to February 2019.A total of 60 patients (age 10-16 years) with both-bones forearm fracture were enrolled. Patients were assessed radiographically for union as well as clinically using the "Outcome Grading System" developed by Martus et al. for functional assessment of surgical management of pediatric forearm fractures using forearm rotation range of motion & complications rate. RESULTS At final follow up for each patient (24 months) Union was achieved in all cases. Delayed union occurred in 4 patients (2 radii & 2 ulnae) with no case of combined radius & ulnar delayed union. At final follow up, the mean supination range was 81.27° ± 4.1°, while the mean pronation range was 68.17° ± 3.03°. The "Outcome Grading System" results were: 48 cases (80%) scored excellent, 10 cases (16.7%) scored good & 2 cases (3.3%) scored fair. CONCLUSION Hybrid fixation method in adolescent both-bones forearm fracture could be a viable option in managing these injuries & may reduce the problem of ulnar non-union encountered when using elastic stable intramedullary nail (ESIN) in that age group. LEVEL OF EVIDENCE Level II, Therapeutic study.
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Affiliation(s)
- Ahmed S. Elhalawany
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Afifi
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf Anbar
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sherif Galal
- Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt,Department of Orthopaedic Surgery, Johns Hopkins Children's Center, Baltimore, MD, USA,Corresponding author. Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, P.O 11559, Egypt.
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Abdel-Latif M, Afifi A, Soliman R, Elkhouly A, Abdelmotaal A, Youness R. A new quercetin glycoside enhances TNBC immunological profile through TP53/miR-155/MICA/ULBP2. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Afifi A, Nagy M, Hosny H, Shehata N, Simry W, Raef Y, El Mozy W, Abou Gamrah M, Aguib H, Yacoub M. P2789A new technique to restore shape and pattern of flow in hypoplastic aortic arch. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There is no agreement about the best method for correcting hypoplastic aortic arch in infancy. Residual abnormalities in shape can cause late complications.
Patients and methods
We have developed and applied a new method of direct anastomosis of the descending to the ascending aorta to allow for restoration of shape, function and growth. 12 infants undergoing this technique at the age of 61±3months (range 6–28 months) underwent repeat CT 4–15 months after operation.
Pre- and post-operative arch width, height and height to width ratio were recorded for all cases. Computerized shape analysis using an in-house tool (developed in MATLAB) was used for processing the 3D segmented shapes of the aortic arch, and assessing changes in the cross-sectional area at different levels. Computational Fluid Dynamics (CFD) was used to simulate aortic flow propagation and pattern after surgery, using patient specific geometry and flow boundary conditions.
Results
The pre- and post-operative cross-sectional area along the centerline of the aorta and arch was almost normalized, Figure 1.
The pattern of flow during the cardiac cycle with a retrograde helix in the aortic arch, similar to normal, was observed in all cases with peak velocities of 1.1±0.2m/s.
Aortic Shape and flow after surgery
Conclusion
We here describe a new technique, which at least in the short term appears to normalize the size, shape and pattern of flow in the arch. Long term studies are required to establish the value of this technique.
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Affiliation(s)
- A Afifi
- Aswan Heart Centre, Department of Surgery, Aswan, Egypt
| | - M Nagy
- Aswan Heart Centre, Biomedical Engineering and Innovation Laboratory, Aswan, Egypt
| | - H Hosny
- Aswan Heart Centre, Department of Surgery, Aswan, Egypt
| | - N Shehata
- Aswan Heart Centre, Biomedical Engineering and Innovation Laboratory, Aswan, Egypt
| | - W Simry
- Aswan Heart Centre, Department of Surgery, Aswan, Egypt
| | - Y Raef
- Aswan Heart Centre, Biomedical Engineering and Innovation Laboratory, Aswan, Egypt
| | - W El Mozy
- Aswan Heart Centre, Department of Radiology, Aswan, Egypt
| | - M Abou Gamrah
- Aswan Heart Centre, Biomedical Engineering and Innovation Laboratory, Aswan, Egypt
| | - H Aguib
- Aswan Heart Centre, Biomedical Engineering and Innovation Laboratory, Aswan, Egypt
| | - M Yacoub
- Imperial College London, National Heart and Lung Institute, London, United Kingdom
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Sawy AE, Nagy M, Afifi A, Hosny H, Romeih S, Aguib H, Yacoub M. Characterization of size, shape and pattern of flow in the neo-aorta and pulmonary artery in a patient following an innovative technique of repair for truncus arteriosus. Glob Cardiol Sci Pract 2019; 2019:e201918. [PMID: 31799292 PMCID: PMC6865202 DOI: 10.21542/gcsp.2019.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background. Truncus arteriosus (TA) caries a very poor prognosis. In the absence of early correction, only 12 percent of patients born with this anomaly survive beyond one year. There is no agreement about the best method of surgical correction of this anomaly. We have devised an innovative valveless technique using autologous arterial tissue to repair TA. Objectives. Characterizing the size, shape and pattern of flow in the neo-aorta and pulmonary artery, in a patient following the new technique. Patient and Methods. Cardiac MRI and multislice CT imaging, followed by offline computerized image analysis was used in a patient aged 3 months, within 3 weeks of operating. Results. The size, shape and topology of the neo-aorta and pulmonary artery, approximated that present in normal hearts. The pattern of flow in the reconstructed vessels was laminar, throughout the cardiac cycle with minor acceleration during systole. The pulmonary regurgitation resulting from the absence of a valve occurred during late diastole, and was well tolerated. The size of the right ventricle diminished considerably following operation, and the right ventricular ejection fraction was supernormal. Conclusion. This early study in one patient provides new unique data of the size, shape, topology and pattern of flow in the neo-aorta and pulmonary artery, which appear to approximate normality. The long-term results of this promising operation need to be studied.
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Affiliation(s)
- Amr El Sawy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Mohamed Nagy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Ahmed Afifi
- Department of Surgery, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Hatem Hosny
- Department of Surgery, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Soha Romeih
- Department of Radiology, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Heba Aguib
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt
| | - Magdi Yacoub
- Department of Surgery, Aswan Heart Centre, Magdi Yacoub Heart Foundation, Egypt.,National Heart and Lung Institute, Imperial College London, UK
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Najmi E, Bahbah EI, Negida A, Afifi A, Baratloo A. Diagnostic Value of Serum Neuron-Specific Enolase Level in Patients With Acute Ischemic Stroke; A Systematic Review and Meta-Analysis. Int Clin Neurosci J 2019. [DOI: 10.15171/icnj.2019.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: We aim to assess the predictive value of serum neuron-specific enolase (NSE) level in patients with acute ischemic stroke referring to the emergency department. Methods: This systematic review and meta-analysis performed, considering the PRISMA and MOOSE statement guidelines. A computerized literature search of the known medical database conducted by using the relevant keywords. We included studies published before November 2016 in which stroke patients compared with non-stroke controls and also studies evaluating the serum levels of NSE in the study groups. Statistical analysis was pooled in a random effect model analysis using the Comprehensive Meta-Analysis software. Results: We included 12 articles in the qualitative and quantitative analysis, that their quality acceptable based on the Newcastle Ottawa Scale (NOS scale). The pooled effect estimates showed that NSE is significantly higher in ischemic stroke patients in comparison with their controls with a high effect estimate [OR 9.68, 95% CI (3.06 to 30.6)]. The effect estimate remained statistically significant under the fixed and random effects model. Conclusion: Our results show higher levels of NSE in patients with stroke than in the control group, indicating that NSE plays a role in the diagnosis of stroke. In terms of prognosis, there is evidence regarding the direct and indirect relationship; and it founded that serum levels of NSE is higher in larger stroke volume, which needs further research.
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Affiliation(s)
- Elham Najmi
- Department of Emergency Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ahmed Negida
- Faculty of Medicine, Zagazig University, EL-Sharkia, Egypt
| | - Ahmed Afifi
- Medical Research Center, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aireza Baratloo
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Saleh ME, Gadalla R, Hassan H, Afifi A, Götte M, El-Shinawi M, Mohamed MM, Ibrahim SA. The immunomodulatory role of tumor Syndecan-1 (CD138) on ex vivo tumor microenvironmental CD4+ T cell polarization in inflammatory and non-inflammatory breast cancer patients. PLoS One 2019; 14:e0217550. [PMID: 31145753 PMCID: PMC6542534 DOI: 10.1371/journal.pone.0217550] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/14/2019] [Indexed: 12/24/2022] Open
Abstract
Herein, we aimed to identify the immunomodulatory role of tumor Syndecan-1 (CD138) in the polarization of CD4+ T helper (Th) subsets isolated from the tumor microenvironment of inflammatory breast cancer (IBC) and non-IBC patients. Lymphocytes and mononuclear cells isolated from the axillary tributaries of non-IBC and IBC patients during modified radical mastectomy were either stimulated with the secretome as indirect co-culture or directly co-cultured with control and Syndecan-1-silenced SUM-149 IBC cells. In addition, peripheral blood mononuclear cells (PBMCs) of normal subjects were used for the direct co-culture. Employing flow cytometry, we analyzed the expression of the intracellular IFN-γ, IL-4, IL-17, and Foxp3 markers as readout for basal and co-cultured Th1, Th2, Th17, and Treg CD4+ subsets, respectively. Our data revealed that IBC displayed a lower basal frequency of Th1 and Th2 subsets than non-IBC. Syndecan-1-silenced SUM-149 cells significantly upregulated only Treg subset polarization of normal subjects relative to controls. However, Syndecan-1 silencing significantly enhanced the polarization of Th17 and Treg subsets of non-IBC under both direct and indirect conditions and induced only Th1 subset polarization under indirect conditions compared to control. Interestingly, qPCR revealed that there was a negative correlation between Syndecan-1 and each of IL-4, IL-17, and Foxp3 mRNA expression in carcinoma tissues of IBC and that the correlation was reversed in non-IBC. Mechanistically, Syndecan-1 knockdown in SUM-149 cells promoted Th17 cell expansion via upregulation of IL-23 and the Notch ligand DLL4. Overall, this study indicates a low frequency of the circulating antitumor Th1 subset in IBC and suggests that tumor Syndecan-1 silencing enhances ex vivo polarization of CD4+ Th17 and Treg cells of non-IBC, whereby Th17 polarization is possibly mediated via upregulation of IL-23 and DLL4. These findings suggest the immunoregulatory role of tumor Syndecan-1 expression in Th cell polarization that may have therapeutic implications for breast cancer.
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Affiliation(s)
| | - Ramy Gadalla
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
| | - Hebatallah Hassan
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
| | - Ahmed Afifi
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
| | - Martin Götte
- Department of Gynecology and Obstetrics, Münster University Hospital, Münster, Germany
| | - Mohamed El-Shinawi
- Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Abstract
Rheumatic valve disease is an endemic problem that is responsible for substantial morbidity and mortality in many countries. Unlike the rheumatic mitral valve, aortic repair continues to be challenging. A thorough understanding of the underlying mechanisms; structural and functional, is essential for repair. We here describe various methods of repair and outline our favoured techniques.
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Mokhtar G, Ragab I, Bakr S, Afifi A. Cytomegalovirus Has No Impact on Immune Thrombocytopenia Bleeding Scale or Prognostic Outcomes in Egyptian Pediatric Immune Thrombocytopenia. J PEDIAT INF DIS-GER 2019. [DOI: 10.1055/s-0039-1679883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background Cytomegalovirus (CMV) has been implicated as one of the etiological factors of immune thrombocytopenia (ITP) in many reports.
Objectives We aimed to estimate the frequency of CMV positivity among childhood ITP patients, and to assess its impact on severity of bleeding, chronicity of the disease, and response to therapy.
Methods A cross-sectional study was performed including 40 Egyptian pediatric patients with ITP. CMV infection was detected by serological testing and polymerase chain reaction (PCR). Clinical assessment for bleeding severity using ITP bleeding scale (IBLS) and initial response to therapy were included in the study.
Results The prevalence of CMV DNAemia among the ITP patients was 72.5%. The virus DNAemia was higher among newly diagnosed ITP cases compared with chronic ones (85 and 60% respectively, p = 0.07). There were no significant differences in age, gender, bleeding severity, or initial clinical presentation in patients who were CMV-PCR positive or negative (p > 0.05). Refractory cases were found in 17.2% of CMV-positive cases compared with 36.4% in CMV-negative ones (p = 0.29). Specificity and sensitivity of serological assay in comparison to PCR were 72.4% and 20.69%, respectively, with a negative predictive value of 25.8%, and a positive predictive value of 66.7%.
Conclusion Cytomegalovirus appears to have a high frequency among both newly diagnosed and chronic ITP patients in Egypt. CMV serological assay for IgM was not a good indicator of the presence of viral infection. CMV DNAemia seems to have no significant effect on severity of bleeding, clinical presentation, or outcomes of childhood ITP.
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Affiliation(s)
- Galila Mokhtar
- Department of Pediatrics, Hematology-Oncology Unit, Children Hospital, Ain Shams University, Cairo, Egypt
| | - Iman Ragab
- Department of Pediatrics, Hematology-Oncology Unit, Children Hospital, Ain Shams University, Cairo, Egypt
| | - Salwa Bakr
- Department of Clinical Pathology/Hematology, College of Medicine, Fayoum University, Fayoum, Egypt
| | - Ahmed Afifi
- Department of Pediatrics, Hematology-Oncology Unit, Children Hospital, Ain Shams University, Cairo, Egypt
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Maher S, Kamel M, Salah F, Demerdash Z, Atta S, Badr A, Afifi A, El Baz H. Development of new lateral-flow immunochromatographic strip using colloidal gold and mesoporous silica nanoparticles for rapid diagnosis of active schistosomiasis. Asian Pac J Trop Biomed 2019. [DOI: 10.4103/2221-1691.262083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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