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El-Tallawy SN, Pergolizzi JV, Vasiliu-Feltes I, Ahmed RS, LeQuang JK, El-Tallawy HN, Varrassi G, Nagiub MS. Incorporation of "Artificial Intelligence" for Objective Pain Assessment: A Comprehensive Review. Pain Ther 2024:10.1007/s40122-024-00584-8. [PMID: 38430433 DOI: 10.1007/s40122-024-00584-8] [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] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/08/2024] [Indexed: 03/03/2024] Open
Abstract
Pain is a significant health issue, and pain assessment is essential for proper diagnosis, follow-up, and effective management of pain. The conventional methods of pain assessment often suffer from subjectivity and variability. The main issue is to understand better how people experience pain. In recent years, artificial intelligence (AI) has been playing a growing role in improving clinical diagnosis and decision-making. The application of AI offers promising opportunities to improve the accuracy and efficiency of pain assessment. This review article provides an overview of the current state of AI in pain assessment and explores its potential for improving accuracy, efficiency, and personalized care. By examining the existing literature, research gaps, and future directions, this article aims to guide further advancements in the field of pain management. An online database search was conducted via multiple websites to identify the relevant articles. The inclusion criteria were English articles published between January 2014 and January 2024). Articles that were available as full text clinical trials, observational studies, review articles, systemic reviews, and meta-analyses were included in this review. The exclusion criteria were articles that were not in the English language, not available as free full text, those involving pediatric patients, case reports, and editorials. A total of (47) articles were included in this review. In conclusion, the application of AI in pain management could present promising solutions for pain assessment. AI can potentially increase the accuracy, precision, and efficiency of objective pain assessment.
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Affiliation(s)
- Salah N El-Tallawy
- Anesthesia and Pain Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
- Anesthesia and Pain Department, Faculty of Medicine, Minia University & NCI, Cairo University, Giza, Egypt.
| | | | - Ingrid Vasiliu-Feltes
- Science, Entrepreneurship and Investments Institute, University of Miami, Miami, USA
| | - Rania S Ahmed
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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El-Tallawy HN, Abuhamdah S, Nassar AY, Farghaly WMA, Saleem TH, Atta SA, Sayed AA, Tohamy AM, Hassan MH. Gephyrin and CYP2C9 Genetic Polymorphisms in Patients with Pharmacoresistant Epilepsy. Pharmgenomics Pers Med 2021; 14:1133-1140. [PMID: 34526803 PMCID: PMC8437390 DOI: 10.2147/pgpm.s327808] [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: 07/04/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Gephyrin (GPHN) is an essential protein in the regulation of inhibitory postsynaptic density and polymorphism in the corresponding gene may have a role in the development of pharmacoresistant epilepsy (PRE). For the first time, we aimed to evaluate the association of rs928553T/C variants with PRE susceptibility. Moreover, we have analyzed the genetic polymorphism affecting CYP2C9 “rs12782374G/A” in the same population to detect the effect of SNP on the drug-metabolizing ability of patients with PRE. Patients and Methods This case-control study enrolled 100 patients (group A) and 100 healthy, age and sex-matched controls, unrelated to patients (group B). TaqMan™ assays using real-time PCR were run for genotyping of rs928553T/C and rs12782374G/A in all participants. Results GPHN T>C polymorphism revealed significant risk association with occurrence of PRE using dominant, recessive and codominant models as follows: TT vs (TC+CC): OR 0.23, 95%CI: 0.13–0.43, P<0.001. In addition, (TT+TC vs CC): OR 0.38, 95%CI: 0.18–0.77, P<0.001. Also, T vs C (OR 0.34, 95%CI: 0.22–0.51, P=<0.001). Similarly, CYP2C9 G>A polymorphism showed a significant increased risk of PRE (GG vs (GA+AA): OR 0.11, 95%CI: 0.05–0.23, P<0.001). Furthermore, (GG+GA vs AA): OR 0.18, 95%CI: 0.084–0.39, P<0.001. Also, G vs A (OR 0.24, 95%CI: 0.15–0.366, P=<0.001). Conclusion Mutation of both GPHN (rs928553) and CYP2C9 (rs1278237) genes may be implicated as a genetic mediators of resistance in patients with PRE.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sawsan Abuhamdah
- Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.,Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, University of Jordan, Amman, Jordan
| | - Ahmed Y Nassar
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Wafaa M A Farghaly
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Tahia H Saleem
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sara A Atta
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ayat A Sayed
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Amal M Tohamy
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt
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El-Tallawy HN, Saleem TH, Farghaly WM, Eldien HMS, Khodaery A, Sayed SA, Helaly AA, Elnady HM. Study of cognitive impairment and genetic polymorphism of SLC41A1 (rs11240569 allele) in Parkinson’s disease in Upper Egypt: case-control study. Egypt J Neurol Psychiatry Neurosurg 2021. [DOI: 10.1186/s41983-021-00341-0] [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: 11/10/2022] Open
Abstract
Abstract
Background
Parkinson’s disease is one of the neurodegenerative disorders that is caused by genetic and environmental factors or interaction between them. Solute carrier family 41 member 1 within the PARK16 locus has been reported to be associated with Parkinson’s disease. Cognitive impairment is one of the non-motor symptoms that is considered a challenge in Parkinson’s disease patients. This study aimed to investigate the association of rs11240569 polymorphism; a synonymous coding variant in SLC41A1 in Parkinson’s disease patients in addition to the assessment of cognitive impairment in those patients.
Results
In a case -control study, rs11240569 single nucleotide polymorphisms in SLC41A1, genes were genotyped in 48 Parkinson’s disease patients and 48 controls. Motor and non-motor performance in Parkinson's disease patients were assessed by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The genotype and allele frequencies were compared between the two groups and revealed no significant differences between case and control groups for rs11240569 in SLC41A1 gene with P value .523 and .54, respectively. Cognition was evaluated and showed the mean ± standard deviation (SD) of WAIS score of PD patients 80.4 ± 9.13 and the range was from 61 to 105, in addition to MMSE that showed mean ± SD 21.96 ± 3.8.
Conclusion
Genetic testing of the present study showed that rs11240569 polymorphism of SLC41A1 gene has no significant differences in distributions of alleles and genotypes between cases and control group, in addition to cognitive impairment that is present in a large proportion of PD patients and in addition to the strong correlation between cognitive impairment and motor and non-motor symptoms progression.
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Farghaly WM, Saad Eldien HM, Sayed MA, Elnady HM, Khodeary A, Abdel-Gawad AR, El-Tallawy HN, Abdellatif MG, Alhewaig HK. The relationship of HLA-G 14-bp insertion/deletion genetic polymorphism to the risk of multiple sclerosis and its clinical phenotypes. Egypt J Neurol Psychiatry Neurosurg 2021. [DOI: 10.1186/s41983-021-00312-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abstract
Background
Human leukocyte antigen (HLA)-G molecule has been suggested to have a potential immunomodulatory role in multiple sclerosis (MS). Genetic variant sites of HLA-G molecule have been reported to be associated with autoimmune diseases. Identifying the genetic risk factors of MS may help in preventive strategies and anticipating disease progression. The aim of this work was to investigate the effect of HLA-G 14-base-pair insertion/deletion (14-bp INS/DEL) genetic polymorphism on MS risk and clinical characteristics and to observe the clinical characteristics of the MS patients’ group. The study included 48 MS patients and 50 cross-matched healthy controls, who were recruited from Sohag and Assiut university hospitals. Genetic testing (14-bp Ins/Del gene polymorphism) using polymerase chain reaction (PCR) was performed for patients and control groups. All patients had a detailed clinical assessment and have undergone measurement of disability using the Expanded Disability Status Scale (EDSS).
Results
No statistically significant difference was found between MS patients and healthy controls (HC) in genotypic and allelic frequencies of HLA-G 14-bp INS/DEL polymorphism (P=0.305). No significant association was found between HLA-G 14-bp INS/DEL polymorphism genotypes and clinical characteristics or degree of disability of MS patients. The most frequent presenting symptoms of MS were motor symptoms. Fatigue was the most reported symptom along the course of MS disease.
Conclusion
Although it has been long known that HLA-G represents an important MS susceptibility locus, in this study, no significant relation could be detected between the 14-bp INS/DEL polymorphism genotype and MS susceptibility. MS risk susceptibility may be not linked to a single allele but may depend on the combination of different polymorphic genetic sites. In this study, the lack of genetic susceptibility may be attributed to ethnic factor.
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El-Tallawy HN, Farghaly WM, Abdelhamed MA, Badry R, Rageh TA, Soliman WT, Abdulghani KO, Hassan M, Sobhy S, Shehata GA. Prevalence of migraine in Upper Egypt. Egypt J Neurol Psychiatry Neurosurg 2019. [DOI: 10.1186/s41983-019-0067-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Farghaly WM, Ahmed MA, El-Tallawy HN, Elmestikawy TA, Badry R, Farghaly MS, Omar MS, Hussein ASR, Salamah M, Mohammed AT. Construction of an Arabic computerized battery for cognitive rehabilitation of children with specific learning disabilities. Neuropsychiatr Dis Treat 2018; 14:2123-2131. [PMID: 30174425 PMCID: PMC6110296 DOI: 10.2147/ndt.s155987] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to design an Arabic computerized battery of cognitive skills for training children with specific learning disabilities (SLD). SUBJECTS AND METHODS Nineteen students from fourth grade primary schools in Assiut, Egypt, who were previously diagnosed with SLD, agreed to participate in the rehabilitation program. The study passed through four stages: first stage, detailed analysis of the cognitive profile of students with SLD (n=19), using a previously constructed diagnostic cognitive skill battery, to identify deficits in their cognitive skills; second stage, construction of an Arabic computerized battery for cognitive training of students with SLD; third stage, implementation of the constructed training program for the students, each tailored according to his/her previously diagnosed cognitive skill deficit/deficits; and fourth stage, post-training re-evaluation of academic achievement and cognitive skills' performance. RESULTS Students with SLD have a wide range of cognitive skill deficits, which are more frequent in auditory cognitive skills (68.4%) than in visual cognitive skills (64.1%), particularly in phonological awareness and auditory sequential memory (78.9%). Following implementation of the training program, there was a statistically significant increase (P<0.001) in the mean scores of total auditory and visual cognitive skills, as well as in academic achievement (P<0.001) of the study group. CONCLUSION Remediation-oriented diagnosis of cognitive skills, when tailored according to previously diagnosed cognitive deficits, leads to the improvement in learning abilities and academic achievement of students with SLD.
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Affiliation(s)
- Wafaa Ma Farghaly
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed A Ahmed
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hamdy N El-Tallawy
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Reda Badry
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohammed Sh Farghaly
- Department of Educational Psychology, Faculty of Education, Assiut University, Assiut, Egypt
| | - Montaser S Omar
- Department of Educational Psychology, Faculty of Education, Assiut University, Assiut, Egypt
| | - Amr Sayed Ramadan Hussein
- Department of Hearing Disability, Faculty of Sciences of Special Needs, Beni-Suef University, Beni-Suef, Egypt,
| | - Mohammed Salamah
- Department of Phoniatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Adel T Mohammed
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
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El-Tallawy HN, Saleem TH, El-Ebidi AM, Hassan MH, Gabra RH, Farghaly WM, Abo El-Maali N, Sherkawy HS. Clinical and biochemical study of d-serine metabolism among schizophrenia patients. Neuropsychiatr Dis Treat 2017; 13:1057-1063. [PMID: 28435276 PMCID: PMC5391825 DOI: 10.2147/ndt.s126979] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Schizophrenia is a typical N-methyl-d-aspartate receptor (NMDA-R) hypofunction disorder. Decreased d-serine (d-Ser) levels in the periphery occur in schizophrenia and may reflect decreased availability of d-Ser to activate NMDA-R in the brain. OBJECTIVE The objective of this study was to investigate the role of d-Ser metabolism in the pathogenesis of schizophrenia via biochemical assays and correlates, the serum level of d-Ser, d-serine racemase (SR) (responsible for its formation from l-serine [l-Ser]) and d-amino acid oxidase (DAAO) (responsible for its catabolism), among different clinical types of schizophrenia patients. PATIENTS AND METHODS This cross-sectional case-control study was carried out on 100 patients and 50 controls. They were recruited from the outpatients' psychiatric unit of the Neuropsychiatric Department of Assiut University Hospital, Upper Egypt. The type of schizophrenia was determined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), while the severity of schizophrenia was determined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Serum d-Ser levels were estimated using high-performance liquid chromatography (HPLC), while serum SR and DAAO were measured using commercially available enzyme-linked immunosorbent assay kits. RESULTS There were significantly lower mean serum levels of d-Ser and SR and significantly higher mean serum levels of DAAO (P-value <0.01 for each) among schizophrenia patients when compared with the control group. Paranoid schizophrenia had the highest frequency, with a significantly lower serum levels of d-Ser and SR in the residual type and significantly higher serum levels of DAAO in undifferentiated and catatonic types. Combined receiver-operating characteristic curve for serum d-Ser, SR and DAAO indicated that the best serum level cutoff points at which schizophrenia manifestations started to appear were ≤ 61.4 mg/L for d-Ser, ≤ 15.5 pg/mL for SR and >35.6 pg/mL for DAAO. CONCLUSION The present study confirms that disturbed d-Ser metabolism could be implicated in the pathogenesis of schizophrenia.
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Affiliation(s)
| | - Tahia H Saleem
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, Assiut
| | - Abdallah Maa El-Ebidi
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Aswan University, Aswan
| | - Mohammed H Hassan
- Department of Medical Biochemistry and Molecular Biology, Qena Faculty of Medicine, South Valley University, Qena
| | | | | | - Nagwa Abo El-Maali
- Department of Chemistry, Faculty of Science, Assiut University, Assiut, Egypt
| | - Hoda S Sherkawy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Aswan University, Aswan
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El-Tallawy HN, Farghaly WMA, Badry R, Metwally NA, Shehata GA, Rageh TA, El Hamed MA, Kandil MR. Prevalence of multiple sclerosis in Al Quseir city, Red Sea Governorate, Egypt. Neuropsychiatr Dis Treat 2016; 12:155-8. [PMID: 26834477 PMCID: PMC4716737 DOI: 10.2147/ndt.s87348] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic and disabling disorder with considerable social effects and economic sequelae. It is one of the major causes of disability in young adults. OBJECTIVES This study aimed at detecting the prevalence of MS among the population of Al Quseir city. METHODS This study is a part of door-to-door survey of major neurological disorders that was conducted in Al Quseir city, Red Sea Governorate, Egypt. The sample size was 33,285 persons. The youngest patient was 17 years old. The number of people at and above 17 years of age was 21,827. They were screened by three neurologists. Then, the positive cases were subjected to meticulous clinical evaluation by three staff members of Department of Neurology, Assiut University Hospital, Egypt. Essential investigations were done. RESULTS A total of three cases of MS were diagnosed with an age-specific prevalence ≥17 years of 13.7/100,000.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Wafaa M A Farghaly
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Reda Badry
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Nabil A Metwally
- Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut Branch, Assiut, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mohamed Abd El Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Mahmoud R Kandil
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
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El-Tallawy HN, Farghaly WM, Rageh TA, Shehata GA, Metwally NA, Badry R, Sayed MA, Abdelwarith AM, Kandil MR, Hamed MA, Mohamed KO, Tohamy AM. Spectrum of epilepsy - prevalence, impact, and treatment gap: an epidemiological study from Al-Quseir, Egypt. Neuropsychiatr Dis Treat 2016; 12:1111-8. [PMID: 27257380 PMCID: PMC4874633 DOI: 10.2147/ndt.s87765] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Epidemiology continues to be an important research tool in the study of epilepsy and related disorders, providing a better understanding of the frequency, causes, and natural history of the disorder. OBJECTIVE To estimate the prevalence of epilepsy in Al-Quseir, Red Sea Governorate, Egypt, and its magnitude of treatment gap. METHODS The study was part of a door-to-door study, including every door, to screen all inhabitants in Al-Quseir (33,818 inhabitants) by three specialists of neurology and 15 female social workers (for demographic data collection) using a standardized screening questionnaire. All suspected cases were subjected to detailed history, clinical examination, and electroencephalogram. Neuroimaging studies and estimation of serum drug level were done in select cases if needed. RESULTS The study revealed that the lifetime prevalence rate of epilepsy in Al-Quseir is 5.5/1,000, with the highest peak during early childhood, while that of active epilepsy is 3.3/1,000 population. The annual incidence rate is 48/100,000, and the age-specific incidence rate has a U-shaped pattern with two peaks of incidence in early infancy and elderly life. Localization-related epilepsy is the most frequently encountered type (58.8%). The treatment gap of epilepsy in Al-Quseir is 83.8%. CONCLUSION The lifetime prevalence of epilepsy in Al-Quseir city, Red Sea Governorate, was 5.5/1000.
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Affiliation(s)
| | | | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Nabil A Metwally
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | - Reda Badry
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | - Ahmed M Abdelwarith
- Department of Neurology, Faculty of Medicine, Al-Azhar University - Assiut Branch, Assiut, Egypt
| | | | | | | | - Amal M Tohamy
- Department of Neurology, Assiut University, Assiut, Egypt
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El-Tallawy HN, Farghaly WM, Shehata GA, Rageh TA, Metwally NA, Badry R, Sayed MA, Abd El Hamed M, Abd-Elwarth A, Kandil MR. Cerebral palsy in Al-Quseir City, Egypt: prevalence, subtypes, and risk factors. Neuropsychiatr Dis Treat 2014; 10:1267-72. [PMID: 25045270 PMCID: PMC4099193 DOI: 10.2147/ndt.s59599] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cerebral palsy (CP) is the most frequent cause of motor handicap. The present door-to-door survey was conducted in Al-Quseir City, Egypt, to investigate the epidemiology of CP. All inhabitants were screened by three neurologists. Medical and neurological examinations were performed for all residents and suspected cases of CP were confirmed by meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and testing with the Stanford-Binet Intelligence Scale. Forty-six of 12,788 children aged ≤18 years were found to have CP, yielding a childhood prevalence of 3.6 (95% confidence interval 1.48-2.59) per 1,000 live births. Five adults (aged 19-40 years) among 13,056 inhabitants had CP, giving an adult prevalence of 0.4 (95% confidence interval 0.04-0.72) per 1,000. The risk factors for CP identified in this study were premature birth, low birth weight, neonatal jaundice, neonatal seizures, and recurrent abortion in mothers of children with CP.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Wafaa Ma Farghaly
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Nabil A Metwally
- Department of Neurology, El Azhr University, Assiut Branch, Assuit, Egypt
| | - Reda Badry
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | | | | | - Ahmed Abd-Elwarth
- Department of Neurology, El Azhr University, Assiut Branch, Assuit, Egypt
| | - Mahmoud R Kandil
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
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Abstract
BACKGROUND Cerebral palsy (CP) is the most frequent cause of motor handicap among children. AIM OF THE STUDY We aim to study the relation of epilepsy in children with CP to various risk factors that affect the development of seizures. PATIENTS AND METHODS In a cross-sectional, descriptive, population-based, case-control study, 98 children with CP (48 children with CP with epilepsy, and 50 children with CP without epilepsy) were compared with 180 children without CP or seizures. The children lived in two regions in Egypt: the Al-Kharga District-New Valley and El-Quseir city-Red Sea. These cases were subjected to meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and Stanford-Binet (4th edition) examination. Multinomial logistic regression was used to assess the risk factors. RESULTS Epilepsy was diagnosed in 48.9% of all cases of CP. Mental subnormality was observed more frequently in children with epilepsy than in those without epilepsy (84.6% versus 66.7%). The frequency of epilepsy was highest in patients with the spastic quadriplegic type of illness (58.3%). Multinomial logistic regression revealed that prematurity (<32 weeks of pregnancy), low birth weight (<2.5 kg at birth), neonatal seizures, jaundice, and cyanosis were significantly associated with CP with epilepsy. CONCLUSION CP is associated with a high percentage of seizure disorders. Prematurity, low birth weight, neonatal seizures, cyanosis, and jaundice are significant risk factors among patients with CP with epilepsy compared to patients with CP without epilepsy or a healthy control group.
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Affiliation(s)
| | | | | | - Reda Badry
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University Hospitals, Assiut, Egypt
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El-Tallawy HN, Farghaly WMA, Shehata GA, Abdel-Hakeem NM, Rageh TA, Badry R, Kandil MR. Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt. Clin Interv Aging 2013; 8:1547-51. [PMID: 24293992 PMCID: PMC3839683 DOI: 10.2147/cia.s48785] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and purpose Stroke is a medical emergency that can cause permanent neurological damage, complications, and disability. We aim to determine the epidemiology of non-fatal cerebrovascular stroke (CVS) and transient ischemic attacks (TIAs) in Al Quseir City, Red Sea, Egypt. Methods The total population (n=33,285) was screened through a door to door study by three specialists of neurology and 15 female social workers (for demographic data collection). All suspected stroke patients were subjected to a full clinical examination, computerized tomography (CT) and/or magnetic resonance imaging (MRI) of their brain, blood sugar, lipogram, serum uric acid, complete blood cells, blood urea, and serum creatinine, as well as evaluated by Barthel Index and Scandinavian Stroke Scale. Carotid doppler, echocardiography, and thyroid functions were done for selected cases. Results CVS was recorded among 130 patients out of 19,848 subjects aged 20 years and more, yielding a total prevalence of 6.55/1,000 population. From June 1, 2010 to May 31, 2011, 36 patients were recorded to have stroke within 1-year, yielding an incidence rate of 1.81/1,000. Prevalence and incidence rates were higher among males than females, and both indices increased steadily with advancing age to reach the highest prevalence (37.02/1,000) and incidence rate (9.5/1,000) among aged persons 60 years and more. Conclusion The prevalence of non-fatal stroke in Al Quseir city (6.55/1,000) was at the lower range of that recorded in developing countries (5–10/1,000) and slightly higher than that recorded in industrialized countries (5/1,000 population). Ischemic stroke is the most common type of stroke. The prevalence of TIAs was 0.15/1,000.
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Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assuit, Egypt
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Farghaly WM, El-Tallawy HN, Rageh TA, Mohamed EM, Metwally NA, Shehata GA, Badry R, Abd-Elhamed MA. Epidemiology of uncontrolled epilepsy in the Al-Kharga District, New Valley, Egypt. Seizure 2013; 22:611-6. [DOI: 10.1016/j.seizure.2013.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/29/2022] Open
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El-Tallawy HN, Farghaly WM, Rageh TA, Shehata GA, Abdel Hakeem M N, Badry R, Kandil MR. Prevalence of trigeminal neuralgia in Al-Quseir city (Red sea Governorate), Egypt. Clin Neurol Neurosurg 2013; 115:1792-4. [PMID: 23692870 DOI: 10.1016/j.clineuro.2013.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/15/2013] [Accepted: 04/22/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Trigeminal neuralgia or tic douloureux is sometimes described as the most excruciating pain known to humanity. OBJECTIVES To estimate the prevalence of trigeminal neuralgia among the population of Al-Quseir city. METHODS This study forms a part of door to door survey of major neurological disorders in Al-Quseir city, Red sea governorate, Egypt. The total population (33,285 persons) were screened through door to door (every door) by three specialists of Neurology and fifteen female social workers. Then, positive cases were subjected to clinical and neurological examination by other three staff members of neurology. Cases were identified as suffering from trigeminal neuralgia according to the diagnostic criteria of the International headache society (IHS). RESULTS We identified 4 female patients out of 13,541 persons (aged 30 years and more) suffering from trigeminal neuralgia with age specific prevalence rate of 29.5/100,000. Co-morbid depression and hypertension were observed among the affected persons.
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El-Tallawy HN, Farghaly WM, Shehata GA, Abdel-Hakeem NM, Rageh TA, Abo-Elftoh NA, Hegazy A, Badry R. Epidemiology of epilepsy in New Valley Governorate, Al Kharga District, Egypt. Epilepsy Res 2013; 104:167-74. [DOI: 10.1016/j.eplepsyres.2012.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/20/2012] [Accepted: 08/26/2012] [Indexed: 10/27/2022]
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El-Tallawy HN, Farghaly WM, Shehata GA, Rageh TA, Hakeem NMA, Hamed MAA, Badry R. Prevalence of Parkinson's disease and other types of Parkinsonism in Al Kharga district, Egypt. Neuropsychiatr Dis Treat 2013; 9:1821-6. [PMID: 24379673 PMCID: PMC3843639 DOI: 10.2147/ndt.s48318] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder in older people. The prevalence of PD varies among ethnic and geographic groups around the world. In this study, we aimed to estimate the prevalence of PD and other types of Parkinsonism in persons aged ≥40 years in the Al Kharga district of Egypt. The study was conducted on the total population of Al Kharga district (62,583 persons) between 2005 and 2009 and involved three neurology specialists and 15 female social workers undertaking a door-to-door survey. Suspected cases of Parkinsonism were subjected to meticulous clinical and neurological examination by three neurology staff members from Assiut University hospital who carried out their examinations separately. Of the total population surveyed, 15,482 persons were aged ≥40 years and 49 of these were identified as having Parkinsonism (prevalence: 316.50 per 100,000 people [95% confidence interval {CI} 240.21-404.98]). Of the 49, 33 fulfilled the diagnostic criteria for PD, giving a prevalence rate of 213.15/100,000 (95% CI 150.51-285.80) while 14 fulfilled those for vascular Parkinsonism, with a prevalence rate of 90.43/100,000 (95% CI 49.60-137.78). Postencephalitic and unspecified Parkinsonism each had a prevalence rate of 6.46/100,000. The prevalence of Parkinsonism was found to increase steadily with age, and the prevalence of all types of Parkinsonism was statistically higher in rural compared with urban communities, with no significant difference between men and women.
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Affiliation(s)
| | | | | | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut, Egypt
| | | | | | - Reda Badry
- Department of Neurology, Assiut University, Assiut, Egypt
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Farghaly WM, El-Tallawy HN, Shehata GA, Rageh TA, Abdel-Hakeem NM, Elhamed MAA, Al-Fawal BM, Badry R. Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga District, New Valley, Egypt. Neuropsychiatr Dis Treat 2013; 9:1785-90. [PMID: 24273409 PMCID: PMC3836687 DOI: 10.2147/ndt.s48322] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stroke is a medical emergency. Nonfatal stroke may cause permanent neurologic damage, complications, and disability. The aim of this study was to determine the epidemiology of nonfatal stroke in Al-Kharga District, New Valley, Egypt. METHODS The total population (62,583) was screened via a door-to-door study by three neurology specialists and 15 female social workers for demographic data collection. All subjects with probable stroke were subjected to a full clinical examination, neuroimaging (computed tomography and/or magnetic resonance imaging of the brain), and laboratory investigations including blood sugar, lipid profile, serum uric acid, a complete blood count, blood urea, and serum creatinine. Stroke severity and outcome were assessed using the Scandinavian Stroke Scale and Barthel Index. Carotid Doppler, echocardiography, and thyroid function tests were done in selected cases. RESULTS During the study period (June 1, 2005 to May 31, 2008), 351 subjects were diagnosed as having suffered a cerebrovascular stroke at some point during their lives, yielding a total lifetime prevalence of 5.6 per 1,000 population. Of these, 156 subjects were identified as having suffered a stroke during the year from January 1 to December 31, 2007, with an incidence rate of 2.5 per 1,000. Both prevalence and incidence rates were higher in urban (5.8 per 1,000 and 2.6 per 1,000, respectively) than rural communities (5.2 per 1,000 and 2.3 per 1,000), and were higher in males (6.1 per 1,000 and 2.7 per 1,000, respectively) than in females (5.1 per 1,000 and 2.3 per 1,000). Thrombotic stroke had the highest prevalence and incidence rates (4.2 per 1,000 and 1.7 per 1,000, respectively), whereas subarachnoid hemorrhage had the lowest prevalence and incidence rates (0.03 per 1,000 and 0.02 per 1,000). CONCLUSION The prevalence of cerebrovascular accident in Al-Kharga lies in the lower range of that in developing countries, and is similar to that in industrialized countries.
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Affiliation(s)
- Wafaa Ma Farghaly
- Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt
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El-Tallawy HN, Farghaly WMA, Shehata GA, Metwally NA, Rageh TA, Abo-Elfetoh N. Epidemiology of cerebral palsy in El-Kharga District-New Valley (Egypt). Brain Dev 2011; 33:406-11. [PMID: 20797827 DOI: 10.1016/j.braindev.2010.07.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 06/26/2010] [Accepted: 07/24/2010] [Indexed: 11/19/2022]
Abstract
Cerebral palsy (CP) is the most frequent cause of motor handicap among children. The present door to door (every door) study was conducted in El-Kharga District-New Valley to estimate the epidemiology of CP among children. Each child was subjected to complete medical and neurological examination to detect cases with CP. These diseased children were subjected to meticulous neurological and medical assessment, brain MRI, EEG and Stanford Binet (4th edition). It was found that 52 out of 25,540 children had CP yielding prevalence rate of 2.04/1000 (95% CI: 1.48-2.59) of living births. Mean age of children with CP, was 7.17±4.38years. The order of frequency of different subtypes of CP was as follows, 65.4% had spastic type, 26.9% mixed type and 3.8% for each ataxic and dyskinetic types of CP. The frequency of risk factors of CP in our study is prenatal complications (cyanosis, preterm, jaundice, birth weight and obstructed labor of mothers), first baby, similar condition and recurrent abortions.
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Farghaly WM, El-Tallawy HN, Shehata GA, Rageh TA, Hakeem NA, Abo-Elfetoh NM. Population-based study of acquired cerebellar ataxia in Al-Kharga district, New Valley, Egypt. Neuropsychiatr Dis Treat 2011; 7:183-7. [PMID: 21552320 PMCID: PMC3083991 DOI: 10.2147/ndt.s14497] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this research was to determine the prevalence and etiology of acquired ataxia in Al-Kharga district, New Valley, Egypt. METHODS A population-based study of acquired ataxia was conducted in a defined geographical region with a total population of 62,583. A door-to-door survey was used to identify cases of acquired cerebellar ataxia. Patients with acquired cerebellar ataxia at any age and of both genders were included. Cases of known inherited cerebellar ataxia, acquired neurological disorders with ataxia as a minor feature, or pure acquired sensory ataxia, were excluded. RESULTS We identified 17 cases of acquired ataxia, of which eight were vascular, six were an ataxic cerebral palsy subtype, and three involved postencephalitic ataxia. The crude prevalence rate for acquired ataxia was 27.16/100,000 (95% confidence interval [CI]: 14.3-40.1). The mean age of the patients at interview was 31.8 (range 4-72) years, with a male to female ratio of 2.1:1. The most frequent presenting complaint was disturbance of gait (90.7%). The majority (92%) were ambulatory, but only 9.3% were independently self-caring. CONCLUSION This population-based study provides an insight into acquired cerebellar ataxia within a defined region, and may inform decisions about the rational use of health care resources for patients with acquired cerebellar ataxia. The most common causes of acquired cerebellar ataxia in this region were cerebrovascular injury and cerebral palsy.
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Affiliation(s)
- Wafaa Ma Farghaly
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
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Abstract
Few comprehensive epidemiological studies of the prevalence of muscle diseases have been undertaken, and none has been carried out in our locality. The present cross-sectional study was conducted in Assiut Governorate (Upper Egypt) to estimate the prevalence of different types of primary muscular disorder in 1997. The study involved 52,203 subjects, 15,617 (30%) from the rural community and 36,586 (70%) from the urban community. Patients were identified from a door-to-door survey, and all were subjected to a full clinical examination, with confirmation of the diagnosis through electrophysiological, and biochemical investigations. Histopathological studies were performed for the classification of muscular dystrophies. Forty patients with muscular disorders were identified, with a point prevalence of 76.6 per 100,000 in the total community with no significant differences between the rural and urban communities. The creatine kinase level was abnormally high (>225 IU/l) in 80% of the cases, increased in all patients with muscular dystrophy or myositis, in 88.8% of patients with systemic myopathy and 66.6% of patients with myotonia. None of the cases of myasthenia showed an increase in the creatine kinase level. The lifetime prevalence per 100,000 was 26.8 for muscular dystrophy, 11.49 for myotonia, 11.49 for myositis, 17.24 for systemic myopathy and 9.57 for myasthenia.
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