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Alsabri M, Elshanbary AA, Nourelden AZ, Fathallah AH, Zaazouee MS, Pincay J, Nakadar Z, Wasem M, Aeder L. Chest pain in pediatric patients in the emergency department- Presentation, risk factors and outcomes-A systematic review and meta-analysis. PLoS One 2024; 19:e0294461. [PMID: 38626180 PMCID: PMC11020527 DOI: 10.1371/journal.pone.0294461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/31/2023] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE This study aimed to assess and determine the presentation, risk factors, and outcomes of pediatric patients who were admitted for cardiac-related chest pain. BACKGROUND Although chest pain is common in children, most cases are due to non-cardiac etiology. The risk of misdiagnosis and the pressure of potentially adverse outcomes can lead to unnecessary diagnostic testing and overall poorer patient experiences. Additionally, this can lead to a depletion of resources that could be better allocated towards patients who are truly suffering from cardiac-related pathology. METHODS This review was conducted per PRISMA guidelines. This systematic review used several databases including MEDLINE, Embase, Scopus, and Web of Science to obtain its articles for review. RESULTS A total of 6,520 articles were identified, and 11 articles were included in the study. 2.5% of our study population was found to have cardiac-related chest pain (prevalence = 0.025, 95% CI [0.013, 0.038]). The most commonly reported location of pain was retrosternal chest pain. 97.5% of the study population had a non-cardiac cause of chest pain, with musculoskeletal pain being identified as the most common cause (prevalence = 0.357, 95% CI [0.202, 0.512]), followed by idiopathic (prevalence = 0.352, 95% CI [0.258, 0.446]) and then gastrointestinal causes (prevalence = 0.053, 95% CI [0.039, 0.067]). CONCLUSIONS The overwhelming majority of pediatric chest pain cases stem from benign origins. This comprehensive analysis found musculoskeletal pain as the predominant culprit behind chest discomfort in children. Scrutinizing our study cohort revealed that retrosternal chest pain stands as the unequivocal epicenter of this affliction. Thorough evaluation of pediatric patients manifesting with chest pain is paramount for the delivery of unparalleled care, especially in the context of potential cardiac risks in the emergency department.
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Affiliation(s)
- Mohammed Alsabri
- Department of Pediatrics/Emergency Pediatrics, Althawra Modern General Hospital, Sana’a, Yemen
| | | | | | | | | | - Jorge Pincay
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States of America
| | - Zaid Nakadar
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States of America
| | - Muhammad Wasem
- Pediatric Emergency Department NYC Health + Hospitals/Lincoln, Bronx, NY, United States of America
| | - Lita Aeder
- Pediatric Department, Brookdale Hospital, Brooklyn, NY, United States of America
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Alanazi IS, Altyar AE, Zaazouee MS, Elshanbary AA, Abdel-Fattah AFM, Kamel M, Albaik M, Ghaboura N. Effect of moringa seed extract in chlorpyrifos-induced cerebral and ocular toxicity in mice. Front Vet Sci 2024; 11:1381428. [PMID: 38659447 PMCID: PMC11041635 DOI: 10.3389/fvets.2024.1381428] [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: 02/03/2024] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
Chlorpyrifos (CPF) is one of the most commonly used organophosphosphate-based (OP) insecticides. Its wide use has led to higher morbidity and mortality, especially in developing countries. Moringa seed extracts (MSE) have shown neuroprotective activity, antioxidant, anti-inflammatory, and antibacterial features. The literature lacks data investigating the role of MSE against CPF-induced cerebral and ocular toxicity in mice. Therefore, we aim to investigate this concern. A total of 40 mature male Wistar Albino mice were randomly distributed to five groups. Initially, they underwent a one-week adaptation period, followed by a one-week treatment regimen. The groups included a control group that received saline, MSE 100 mg/kg, CPF 12 mg/kg, CPF-MSE 50 mg/kg, and CPF-MSE 100 mg/kg. After the treatment phase, analyses were conducted on serum, ocular, and cerebral tissues. MSE100 and CPF-MSE100 normalized the pro-inflammatory markers (interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α)) and AChE serum levels. CPF-MSE50 significantly enhanced these serum levels compared to CPF; however, it showed higher levels compared to the control. Moreover, the tissue analysis showed a significant decrease in oxidative stress (malondialdehyde (MDA) and nitric oxide (NO)) and an increase in antioxidant markers (glutathione (GSH), glutathione peroxidase (GSH-PX)), superoxide dismutase (SOD), and catalase (CAT) in the treated groups compared to CPF. Importantly, the significance of these effects was found to be dose-dependent, particularly evident in the CPF-MSE100 group. We conclude that MSE has a promising therapeutic effect in the cerebral and ocular tissues of CPF-intoxicated mice, providing a potential solution for OP public health issues.
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Affiliation(s)
- Ibtesam S. Alanazi
- Department of Biology, Faculty of Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia
| | - Ahmed E. Altyar
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | | | | | | | - Mohamed Kamel
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Mai Albaik
- Department of Chemistry, Preparatory Year Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Nehmat Ghaboura
- Pharmacy Practice Department, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia
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3
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Alsabri M, Eapen D, Sabesan V, Tarek Hassan Z, Amin M, Elshanbary AA, Alhaderi A, Elshafie E, Al-Sayaghi KM. Medication Errors in Pediatric Emergency Departments: A Systematic Review and Recommendations for Enhancing Medication Safety. Pediatr Emerg Care 2024; 40:58-67. [PMID: 38157396 DOI: 10.1097/pec.0000000000003108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 01/03/2024]
Abstract
OBJECTIVE This systematic review aims to investigate the prevalence, preventability, and severity of medication errors in pediatric emergency departments (P-EDs). It also aims to identify common types of medication errors, implicated medications, risk factors, and evaluate the effectiveness of interventions in preventing these errors. METHODS A systematic review analyzed 6 primary studies with sample sizes ranging from 96 to 5000 pediatric patients in P-EDs. The review followed Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and included observational studies and randomized controlled trials involving patients aged 18 years and younger. Comprehensive searches in biomedical databases were conducted, and conflicts in record screening were resolved by a third reviewer using systematic review software. RESULTS Medication errors in P-EDs are prevalent, ranging from 10% to 15%, with dosing errors being the most common, accounting for 39% to 49% of reported errors. These errors primarily stem from inaccurate weight estimations or dosage miscalculations. Inadequate dosing frequency and documentation also contribute significantly to medication errors. Commonly implicated medications include acetaminophen, analgesics, corticosteroids, antibiotics, bronchodilators, and intravenous fluids. Most errors are categorized as insignificant/mild (51.7% to 94.5%) or moderate (47.5%). Risk factors associated with medication errors in P-EDs include less experienced physicians, severely ill patients, and weekend/specific-hour ordering. Human factors such as noncompliance with procedures and communication failures further contribute to medication errors. Interventions such as health information technology solutions like ParentLink and electronic medical alert systems, as well as structured ordering systems, have shown promise in reducing these errors, although their effectiveness varies. CONCLUSIONS Overall, this systematic review provides valuable insights into the complexity of medication errors in the P-ED, emphasizes the need for targeted interventions, and offers recommendations to enhance medication safety and reduce preventable errors in this critical health care setting.
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Affiliation(s)
- Mohammed Alsabri
- From the Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana'a City, Yemen
| | - Diane Eapen
- Saba University School of Medicine, Dutch Caribbean, Netherlands
| | | | | | | | | | - Ayman Alhaderi
- Department Of Emergency Medicine, McLaren Oakland Hospital, Pontiac, MI
| | | | - Khaled M Al-Sayaghi
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, KSA
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Elshanbary AA, Zaazouee MS, Nourelden AZ, Al-Kafarna M, Matar SG, Elsaeidy AS, Ragab KM, Elhady MM, Albadrani GM, Altyar AE, Kensara OA, Abdel-Daim MM. Risk factors of diabetes and cancer-specific mortalities in patients with infiltrating ductal carcinoma of the breast: a population-based study. Eur J Cancer Prev 2023:00008469-990000000-00121. [PMID: 38190207 DOI: 10.1097/cej.0000000000000869] [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: 01/09/2024]
Abstract
BACKGROUND AND AIMS Breast cancer is considered one of the most common neoplasms worldwide. Diabetes (DM) increases mortality among postmenopausal patients with breast cancer. Our study aims to identify the risk factors of DM-specific mortality and infiltrating ductal carcinoma (IDC) mortality in patients with IDC of the breast. MATERIALS AND METHODS Data of IDC patients were obtained from the Surveillance, Epidemiology, and End Results database from 1975 to 2016. Independent variables included age, race, marital status, the primary site of IDC, breast subtype, the disease stage, grade, chemotherapy, radiation, and surgery. Kaplan-Meier, Cox and Binary regression tests were used to analyze the data using SPSS software. RESULTS A total of 673 533 IDC patients were analyzed. Of them, 4224 died due to DM and 116 822 died due to IDC. Factors that increase the risk of overall, IDC-specific, and DM-specific mortalities include older age, black race, widowed, uninsured, regional and distant stages, grade II and III, and no treatment with chemotherapy or radiotherapy or surgery. Additionally, the IDC mortality increased with separated status, all primary sites, all breast subtypes, and stage IV. CONCLUSION In patients with IDC, controlling DM besides cancer is recommended to reduce the mortality risk. Old, black, widowed, uninsured, regional and distant stages, grade II and III, and no treatment are common risk factors for DM- and IDC-mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ghadeer M Albadrani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh
| | - Ahmed E Altyar
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University
- Pharmacy Program, Batterjee Medical College, Jeddah
| | - Osama A Kensara
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah
| | - Mohamed M Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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Altyar AE, Kensara OA, Sayed AA, Aleya L, Almutairi MH, Zaazouee MS, Elshanbary AA, El-Demerdash FM, Abdel-Daim MM. Acute aflatoxin B1-induced hepatic and cardiac oxidative damage in rats: Ameliorative effects of morin. Heliyon 2023; 9:e21837. [PMID: 38027731 PMCID: PMC10663918 DOI: 10.1016/j.heliyon.2023.e21837] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Aflatoxins (AFs) are secondary metabolites produced by the fungus Aspergillus flavus, of which Aflatoxin-B1 (AFB1) appears to be the most cancerogenic and of the highest toxicity. AFB1 causes serious effects on several organs including the liver. Morin is a flavonol that exists in many fruits and plants and has diverse biological properties including anticancer, anti-atherosclerotic, antioxidant, anti-inflammatory, immunomodulatory, and multi-organ protective activities. The present study aims to evaluate the potential protective effects of morin against acute AFB1-induced hepatic and cardiac toxicity in rats. Forty rats were divided into five groups (n = 8) as follows: control received the vehicle, morin was orally administered 30/mg/kg body weight (MRN30), the AFB1 was administered orally at a dose of 2.5 mg/kg, twice on days 12 and 14 of the experiment for the 3rd, 4th, and 5th groups., AFB1-MRN15 was orally given morin at a dose of 15 mg/kg body weight, and AFB1-MRN30 orally received morin at 30 mg/kg body weight. The results indicated a significant decrease in serum AST, ALP, LDH, GGT, CK, CK-MB, 8-OHdG, IL-1β, IL-6, TNF-a levels in MRN30 compared to AFB1, and AFB1-MRN15 groups. However, the results indicated non-significant differences in the serum levels between MRN30, control, and AFB1-MRN30 groups. Meanwhile, regarding the hepatic and cardiac parameters, there were significant differences in the levels of MDA, NO, GSH, GSH-Px, SOD, and CAT in MRN30 compared to AFB1, and AFB1-MRN15 groups, overall implying the protective effects of morin. To conclude, morin at a dose of 30 mg/kg b. wt. showed significant enhancements in acute AFB1-induced hepatic and cardiac toxicity in rats, which could play a role in limiting the public health hazards of AFs.
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Affiliation(s)
- Ahmed E. Altyar
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
- Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah, 21442, Saudi Arabia
| | - Osama A. Kensara
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, P.O. Box 7067, Makkah, 21955, Saudi Arabia
| | - Amany A. Sayed
- Zoology Department, Faculty of Science, Cairo University, Giza, 12613, Egypt
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR, CNRS 6249, Franche-Comté University, CEDEX, F-25030, Besançon, Bourgogne, France
| | - Mikhlid H. Almutairi
- Zoology Department, College of Science, King Saud University, P.O. Box: 2455, 11451, Riyadh, Saudi Arabia
| | | | | | - Fatma M. El-Demerdash
- Department of Environmental Studies, Institute of Graduate Studies and Research, Alexandria University, Alexandria, Egypt
| | - Mohamed M. Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah, 21442, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt
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Zaazouee MS, Mahmoud AM, Elfar WH, Hana K, Shamshoon KF, Adly MH, Hussein TA, Hamza MM, Aly AA, Eguzo MA, Farhat AM, Elsnhory AB, Morsy MH, Ammar MF, Alnaji AA, Elshanbary AA, Shah J, AbdelQadir YH. Effect of ondansetron compared to lidocaine and placebo for reducing propofol injection pain: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e35021. [PMID: 37746949 PMCID: PMC10519458 DOI: 10.1097/md.0000000000035021] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/13/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Propofol is the most commonly used intravenous anesthetic medication and is most commonly associated with post-operative pain. Several drugs are investigated to reduce post-operative pain caused by propofol injection. Ondansetron is a potent anti-emetic drug showing promising results as an analgesic. This meta-analysis aims to compare the efficacy of ondansetron to placebo and lidocaine in reducing post-operative pain caused by propofol injection. METHODS PubMed, Embase, Cochrane Library, Web of Science, and Scopus were searched for relevant randomized controlled trials (RCTs) till May 2022. We conducted a meta-analysis using RevMan software version 5.4, and we assessed the quality of included RCTs using the Cochrane risk of bias tool. RESULTS In our study, we included 23 RCTs with 2957 participants. Compared to placebo, ondansetron significantly increased the rate of no pain [risk ratio (RR) = 2.36, 95% confidence interval (CI) (1.39-4.01)], and reduced moderate [RR = 0.39, 95% CI (0.30-0.52)] and severe pain [RR = 0.34, 95% CI (0.24-0.50)]. Furthermore, ondansetron significantly reduced PONV [RR = 0.73, 95% CI (0.58, 0.91)]. On the other hand, ondansetron showed an inferior efficacy to lidocaine regarding the incidence of no, moderate, and severe pain. CONCLUSION Ondansetron is effective in reducing post-operative propofol-induced pain. However, lidocaine is more effective than it.
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Affiliation(s)
| | | | | | - Kerolous Hana
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jaffer Shah
- Kateb University, Medical Research Center, Kateb University, Kabul
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Wahsh EA, Abou Warda AE, El-Gazar RA, Elshanbary AA, Elsayed SM, El Said NO. A cross-sectional analysis of the association between diabetes self-care practices and blood glucose regulation among Egyptian diabetic patients. Eur Rev Med Pharmacol Sci 2023; 27:6192-6199. [PMID: 37458624 DOI: 10.26355/eurrev_202307_32977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Diabetes Mellitus (DM) is a main public health issue worldwide, with Egypt among the world's top countries with diabetic patients. Data on the degree of self-care behaviors of Egyptian diabetic patients is not fully reported. Therefore, the study aimed to assess the adequacy of diabetes self-management (DSM) habits among diabetic patients in Egypt and to identify associated socio-demographic factors that could negatively impact the patients' glycemic state, using a structured questionnaire. SUBJECTS AND METHODS This study was a cross-sectional observational study. The diabetes self-management questionnaire (DSMQ) was used to assess diabetes self-care activities, which is a 16-item questionnaire. The statistical analysis was conducted on SPSS software, and the data were significant with a p-value <0.05. RESULTS A total of 2,164 participants were included. The majority of the patients (83.8%) had type 2 DM. The mean glycated hemoglobin (HbA1c) of the study group was 8.44±1.99. Significant differences were found between different glycemic control groups both in terms of the DSMQ sum scores and the subscale scores, with the exception of physical activity. Moreover, there was a significant weak inverse correlation between the total DSMQ sum score and HbA1c ≥9.0% (ρ=-0.116, p<0.01). The overall internal consistency (Cronbach's alpha) was acceptable (0.756). CONCLUSIONS The study indicated that patients with controlled blood glucose had significantly higher 'glucose management', and 'total DSMQ sum' scores compared to uncontrolled diabetic patients. All significant correlations between assessed parameters and DSMQ were weak.
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Affiliation(s)
- E A Wahsh
- Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza, Egypt.
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Albtoosh AS, Matar SG, Bishtawi SN, Elshanbary AA, Ramadan LI, Bradbeer A, Hasabo EA, Basheti IA. Effect of post‐COVID‐19 condition on sleep: A case report. Clin Case Rep 2023; 11:e7149. [PMID: 36992673 PMCID: PMC10041366 DOI: 10.1002/ccr3.7149] [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: 11/08/2022] [Revised: 02/27/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
Post‐COVID‐19 condition affects patients on various aspects. This 41‐year‐old female presented to the outpatient clinic complaining of severe insomnia characterized by inconsistent 2 h of sleep per day despite taking sleep aid pills after being infected with COVID‐19 and persisting for 6 months after recovery.
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Affiliation(s)
| | | | | | | | | | | | - Elfatih A. Hasabo
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
- Sudan Analytics Research GroupKhartoumSudan
| | - Iman A. Basheti
- Faculty of PharmacyApplied Science Private University11931AmmanJordan
- Faculty of PharmacyThe University of Sydney2006SydneyNew South WalesAustralia
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9
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Elshanbary AA, Zilai AH, Ishqair A, Matar SG, Nourelden AZ, Hafez AH, Altyar AE, Albadrani GM, Zaazouee MS. Demographic and treatment risk factors of cancer-specific mortality among children and adolescent leukemia patients: a population-based study. Environ Sci Pollut Res Int 2023; 30:19182-19193. [PMID: 36220963 DOI: 10.1007/s11356-022-23425-7] [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: 07/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Leukemia is the 15th most commonly diagnosed cancer and the 11th leading cause of cancer mortality. The high mortality rate of leukemia could be attributed to numerous factors. Therefore, we aimed to identify the demographic and treatment risk factors influencing mortality among patients diagnosed with leukemia. Patients' data from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We used the Person's chi-square test to examine the associations among the categorical variables. Kaplan-Meier and Cox regression were applied for univariate and multivariate analyses. Standardized mortality ratios were utilized to compare the mortality rates of leukemia patients and the general US population. We carried out the statistical analysis using SPSS software. A total of 18,880 patients with leukemia were studied. The leukemia incidence was increased in children than in adolescents. Acute lymphoid leukemia (ALL) was the most common type diagnosed among children and adolescents: 10,331 and 4112 patients, respectively. All mortality ratios were significantly higher in leukemia patients compared to the US population. The risk of mortality among leukemia patients was higher among adolescents, females, Black, urban areas with a 20,000 population, and patients not receiving chemotherapy. In contrast, the mortality risk was decreased in patients with higher family incomes, those not treated with radiation, and diagnosed from 2000 to 2016. In conclusion, Leukemia's incidence increases with time. Adolescents, males, Black, in some urban areas, and patients who have not received chemotherapy had the highest mortality risk among leukemia patients.
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Affiliation(s)
| | - Ayat Hassan Zilai
- Department of Pediatrics, King Salman Hospital, Riyadh, Saudi Arabia
| | - Anas Ishqair
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | | | | | | | - Ahmed E Altyar
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Ghadeer M Albadrani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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10
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Matar SG, Nourelden AZ, Assar A, Bahbah EI, Alfryjat AM, Hasabo EA, Matar SA, Bishtawi SN, Alhoubani M, Yahia AB, Ragab KM, Salameh LM, Salameh LSE, Zaazouee MS, Al‐kafarna M, Elshanbary AA, Almadhoon HW, Bakdash ST, Adam OAB, Malih AN, Habash SAE, Basiouny RMT, Ahmad A, Hamid RMA, Habib BY, Elokl DN, Abdalraheem HH, Atia EA, Yousif NIA, Al‐Ali FH, Alshaer IM, Abdulali FE, Ayesh HA, Jabari AY, Egzait RA, Munshar NAA, Alkhraibat AA, ibreerah AH, Basheti IA. Effect of COVID-19 vaccine on menstrual experience among females in six Arab countries: A cross sectional study. Influenza Other Respir Viruses 2022; 17:e13088. [PMID: 36578138 PMCID: PMC9835440 DOI: 10.1111/irv.13088] [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] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/29/2022] [Accepted: 12/04/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There have been varying reports on the potential occurrence and severity of changes to menstruation including the median cycle length, days of bleeding, bleeding heaviness, and menstrual pain, following receipt of COVID-19 vaccinations. We aimed to assess potential postvaccination menstrual changes in women residing in the Middle East. METHODS We implemented a cross-sectional online survey-based study. Data about the participants' demographic characteristics, menstruation experience, and vaccination status were collected and analyzed among six Arab countries. RESULTS Among 4942 menstruating females included in this study, females who had received one or more doses of COVID-19 vaccination reported a higher frequency of back pain, nausea, tiredness, pelvic pain with periods, unprescribed analgesics use, and passage of loose stools. They also reported higher scores describing average and worst menstrual pain. Fully vaccinated females reported heavier flow and more days of bleeding. CONCLUSION Our findings indicate that COVID-19 vaccine may have an effect on menstruation in terms of menstrual pain and bleeding heaviness. The evidence needs to be further investigated in longitudinal studies.
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Affiliation(s)
- Sajeda Ghassan Matar
- International Medical Research Association (IMedRA)CairoEgypt,School of PharmacyApplied Science Private UniversityAmmanJordan
| | - Anas Zakarya Nourelden
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityCairoEgypt
| | - Ahmed Assar
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMenoufia UniversityShebin El‐KomEgypt
| | | | | | - Elfatih A. Hasabo
- International Medical Research Association (IMedRA)CairoEgypt,Department of Anatomy, Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | - Suzan A. Matar
- Department of Clinical Laboratory SciencesThe University of Jordan, School of ScienceAmmanJordan
| | | | | | | | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMinia UniversityMiniaEgypt
| | | | | | - Mohamed Sayed Zaazouee
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityAssuitEgypt
| | - Mohammed Al‐kafarna
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyAl‐Azhar University – GazaGaza StripPalestine
| | - Alaa Ahmed Elshanbary
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Hossam Waleed Almadhoon
- International Medical Research Association (IMedRA)CairoEgypt,Institute of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
| | - Shahed Toulaq Bakdash
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineKalamoon UniversityRif‐DimashqSyria
| | - Ola Awad Babiker Adam
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Neelain UniversityKhartoumSudan
| | - Abdelkader Nabeel Malih
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineKalamoon UniversityRif‐DimashqSyria
| | - Shimaa Abo elfotoh Habash
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTanta UniversityTantaEgypt
| | - Rakia Mohamed Taha Basiouny
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineOctober 6 UniversityGizaEgypt
| | - Afaf Ahmad
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineDamascus UniversityDamascusSyria
| | - Raghda Mohammed Ahmed Hamid
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyUniversity of KhartoumKhartoumSudan
| | - Balsam Younan Habib
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTartus UniversityTartus CitySyria
| | - Dalia Nasr Elokl
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTanta UniversityTantaEgypt
| | - Hiba Hatim Abdalraheem
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyAl‐Neelain UniversityKhartoumSudan
| | - Esraa Adel Atia
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityDamiettaEgypt
| | - Nazik Ibrahim Ahmed Yousif
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | - Fida Hussien Al‐Ali
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Israa Mohammed Alshaer
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTripoli UniversityTripoliLibya
| | - Fatima Elsidieg Abdulali
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Hadil Abu Ayesh
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar University – GazaGaza StripPalestine
| | - Anwar Yousef Jabari
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Raneem Ahmed Egzait
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Nameer Amer Abu Munshar
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Aseel Ahmad Alkhraibat
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyJordan University of Science and TechnologyIrbidJordan
| | - Aisha Hasan ibreerah
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Iman A. Basheti
- Department of Clinical Pharmacy and TherapeuticsFaculty of Pharmacy Applied Science Private UniversityAmmanJordan,Faculty of PharmacyThe University of SydneySydneyAustralia
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11
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Zaazouee MS, Eleisawy M, Abdalalaziz AM, Elhady MM, Ali OA, Abdelbari TM, Hasan SM, Almadhoon HW, Ahmed AY, Fassad AS, Elgendy R, Abdel-Baset EA, Elsayed HA, Elsnhory AB, Abdraboh AB, Faragalla HM, Elshanbary AA, Kensara OA, Abdel-Daim MM. Hospital and laboratory outcomes of patients with COVID-19 who received vitamin D supplementation: a systematic review and meta-analysis of randomized controlled trials. Naunyn Schmiedebergs Arch Pharmacol 2022; 396:607-620. [PMID: 36508011 PMCID: PMC9743115 DOI: 10.1007/s00210-022-02360-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] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has a wide-ranging spectrum of clinical symptoms, from asymptomatic/mild to severe. Recent research indicates that, among several factors, a low vitamin D level is a modifiable risk factor for COVID-19 patients. This study aims to evaluate the effect of vitamin D on hospital and laboratory outcomes of patients with COVID-19.Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) and clinicaltrials.gov were searched until July 2022, using relevant keywords/Mesh terms. Only randomized clinical trials (RCTs) that addressed the topic were included. The Cochrane tool was used to assess the studies' risk of bias, and the data were analyzed using the review manager (RevMan 5.4).We included nine RCTs with 1586 confirmed COVID-19 patients. Vitamin D group showed a significant reduction of intensive care unit (ICU) admission (risk ratio = 0.59, 95% confidence interval (CI) [0.41, 0.84], P = 0.003), and higher change in vitamin D level (standardized mean difference = 2.27, 95% CI [2.08, 2.47], P < 0.00001) compared to the control group. Other studied hospital and laboratory outcomes showed non-significant difference between vitamin D and the control group (P ≥ 0.05).In conclusion, vitamin D reduced the risk of ICU admission and showed superiority in changing vitamin D level compared to the control group. However, other outcomes showed no difference between the two groups. More RCTs are needed to confirm these results.
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Affiliation(s)
| | - Mahmoud Eleisawy
- grid.411660.40000 0004 0621 2741Faculty of Medicine, Benha University, Benha, Egypt
| | - Amira M. Abdalalaziz
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mahmoud M. Elhady
- grid.411660.40000 0004 0621 2741Faculty of Medicine, Benha University, Benha, Egypt
| | - Omar Adel Ali
- grid.7269.a0000 0004 0621 1570Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Sara Mohamed Hasan
- grid.411303.40000 0001 2155 6022Faculty of Medicine, Al‐Azhar University, Assiut, Egypt
| | - Hossam Waleed Almadhoon
- grid.8756.c0000 0001 2193 314XInstitute of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Alaa Yehia Ahmed
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Alaa Shaban Fassad
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rewan Elgendy
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Hamis A. Elsayed
- grid.10251.370000000103426662Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Alaa Bahaaeldin Abdraboh
- grid.440876.90000 0004 0377 3957Faculty of Medicine, Modern University for Technology and Information (MTI), Cairo, Egypt
| | | | - Alaa Ahmed Elshanbary
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Osama A. Kensara
- grid.412832.e0000 0000 9137 6644Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamed M. Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia ,grid.33003.330000 0000 9889 5690Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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12
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Zaazouee MS, Alwarraqi AG, Mohammed YA, Badheeb MA, Farhat AM, Eleyan M, Morad A, Zeid MAA, Mohamed AS, AbuEl-Enien H, Abdelalim A, Elsnhory AB, Hrizat YSM, Altahir NT, Atef D, Elshanbary AA, Alsharif KF, Alzahrani KJ, Algahtani M, Theyab A, Hawsawi YM, Aldarmahi AA, Abdel-Daim MM. Dupilumab efficacy and safety in patients with moderate to severe asthma: A systematic review and meta-analysis. Front Pharmacol 2022; 13:992731. [PMID: 36263132 PMCID: PMC9574251 DOI: 10.3389/fphar.2022.992731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Dupilumab is a human monoclonal antibody directed against the alpha subunit of the interleukin-4 receptor and inhibits the signaling of IL-4 and IL-13. It is approved for treating asthma and other type-2 inflammatory diseases. There is a conflict in the literature regarding the safety and efficacy of dupilumab. Thus, we aimed to assess the safety and efficacy of dupilumab in patients with moderate to severe asthma. Methods: Six databases (PubMed, Embase, Scopus, Web of Science, Cochrane library, and clinicaltrials.gov registry) were searched until January 2022. We included randomized controlled trials that compared dupilumab with the placebo in moderate to severe asthma patients. We extracted the data at 12 and 24 weeks and analyzed them using review manager 5.4. Findings: Thirteen trials were included. Dupilumab significantly improved the forced expiratory volume in 1 s, asthma control questionnaire score, the fraction of exhaled nitric oxide level, and immunoglobulin E level at 12 and 24 weeks (p < 0.05). However, it was associated with increased blood eosinophils at 12 and 24 weeks. Dupilumab was generally a safe agent for asthmatic patients. It showed no significant difference compared with the placebo regarding most adverse events. Conclusion: Dupilumab improves pulmonary function and reduces local and systemic inflammatory markers with minimal adverse events in patients with moderate to severe asthma.
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Affiliation(s)
- Mohamed Sayed Zaazouee
- Faculty of Medicine, Al‐Azhar University, Assiut, Egypt
- *Correspondence: Mohamed Sayed Zaazouee, , orcid.org/0000-0003-0904-9153
| | | | | | | | | | - Mohammed Eleyan
- Department of Laboratory Medical Sciences, Alaqsa University, Gaza, Palestine
- Faculty of Medicine, Al-Azhar University, Gaza, Palestine
| | - Afnan Morad
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Marwa Abdel-Aziz Zeid
- Clinical Pharmacist, Pediatrics Department, Ministry of Health, Qalyubia, Egypt
- Faculty of Pharmacy, October 6 University, Giza, Egypt
| | - Aya Shaban Mohamed
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hazem AbuEl-Enien
- Faculty of Pharmacy and Drug Manufacturing, Pharos University, Alexandria, Egypt
| | | | | | | | | | - Doaa Atef
- Department of Emergency Medicine, Assiut University, Assiut, Egypt
| | | | - Khalaf F. Alsharif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Khalid J. Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Mohammad Algahtani
- Department of Laboratory and Blood Bank, Security Forces Hospital, Mecca, Saudi Arabia
| | - Abdulrahman Theyab
- Department of Laboratory and Blood Bank, Security Forces Hospital, Mecca, Saudi Arabia
- College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
| | - Yousef M. Hawsawi
- College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
- Research Center, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed A. Aldarmahi
- Basic Science Department, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Mohamed M. Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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13
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Elshanbary AA, Awad AA, Abdelsalam A, Ibrahim IH, Abdel-Aziz W, Darwish YB, Isa AS, Drid B, Mustafa MG, Allam RH, Abo Ali AA, Nourelden AZ, Ragab KM, AlGwaiz HIM, Awaji AA, Germoush MO, Albrakati A, Piscopo M, Ghaboura N, Zaazouee MS. The diagnostic accuracy of intraoperative frozen section biopsy for diagnosis of sentinel lymph node metastasis in breast cancer patients: a meta-analysis. Environ Sci Pollut Res Int 2022; 29:47931-47941. [PMID: 35543788 PMCID: PMC9252966 DOI: 10.1007/s11356-022-20569-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Sentinel lymph node (SLN) sampling is important for evaluating the nodal stage of breast cancer when the axillary nodes are clinically free of metastasis. The intraoperative frozen section (IFS) of SLN is used for lymph node assessment. This meta-analysis aims to provide evidence about the diagnostic accuracy and the applicability of IFS of SLN in breast cancer patients. Data were collected by searching PubMed, Cochrane, Scopus, and Web of Science electronic databases for trials matching our eligibility criteria. The statistical analysis included the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and pooled studies' diagnostic odds ratio outcomes. The analyses were conducted using the Open Meta-analyst software. This meta-analysis pooled the results of 110 studies. The overall sensitivity of IFS for SLN metastasis was 74.7%; 95% CI [72.0, 77.2], P < 0.001. It was 31.4% 95% CI [25.2, 38.3], P < 0.001 for the micro-metastasis, and 90.2%; 95% CI [86.5, 93.0], P < 0.001 for the macro-metastasis. The overall specificity was 99.4%; 95% CI [99.2, 99.6], P < 0.001. The overall positive likelihood ratio was 121.4; 95% CI [87.9, 167.6], P < 0.001, and the overall negative likelihood ratio was 0.226; 95% CI [0.186, 0.274], P < 0.001. The overall diagnostic odds ratio of IFS for diagnosing SLN metastasis was 569.5; 95% CI [404.2, 802.4], P < 0.001. The intraoperative frozen section of SLN has good sensitivity for diagnosing breast cancer macro-metastasis. However, the sensitivity is low for micro-metastasis. The specificity is very satisfactory.
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Affiliation(s)
- Alaa Ahmed Elshanbary
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
- International Medical Research Association (IMedRA), Cairo, Egypt
| | - Alaa Abdelsameia Awad
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Alaa Abdelsalam
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Islam H Ibrahim
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Walid Abdel-Aziz
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Youssef Bahaaeldin Darwish
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Alaa Saad Isa
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Boutheyna Drid
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Batna 2 University, Batna, Algeria
| | - Marwa Gamal Mustafa
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Pharmacy, Fayoum University, Fayoum, Egypt
| | - Radwa Hamdy Allam
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Amira A Abo Ali
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
- International Medical Research Association (IMedRA), Cairo, Egypt
| | - Anas Zakarya Nourelden
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA), Cairo, Egypt
- Faculty of Medicine, Minia University, Minia, Egypt
| | - Hussah I M AlGwaiz
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, 11474, Saudi Arabia
| | - Aeshah A Awaji
- Department of Biology, Faculty of Science, University College of Taymaa, University of Tabuk, Tabuk, 71491, Saudi Arabia
| | - Mousa O Germoush
- Biology Department, College of Science, Jouf University, P.O. Box: 2014, Sakaka, Saudi Arabia
| | - Ashraf Albrakati
- Department of Human Anatomy, College of Medicine, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, Via Cinthia, 80126, Naples, Italy
| | - Nehmat Ghaboura
- Department of Pharmacy Practice, Batterjee Medical College, Pharmacy Program, P.O. Box 6231, Jeddah, 21442, Saudi Arabia
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14
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Meshref M, Nourelden AZ, Elshanbary AA, AbdelQadir YH, Zaazouee MS, Ragab KM, Ahmed EMS, Swed S. Subdural empyema due to mixed infections successfully treated medically: A case report with review literature. Clin Case Rep 2022; 10:e6049. [PMID: 35846899 PMCID: PMC9280757 DOI: 10.1002/ccr3.6049] [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: 03/05/2022] [Revised: 05/20/2022] [Accepted: 06/25/2022] [Indexed: 11/12/2022] Open
Abstract
Subdural empyema is a rare intracranial infection with an accumulation of purulent material between the dura and arachnoid matter. We report a case of 17 years old presented with an altered conscious level. CSF analysis showed increased WBCs. His situation has improved after treating by acyclovir, ceftriaxone, vancomycin, and dexamethasone. Subdural empyema is a rare intracranial infection with an accumulation of purulent material between the dura and arachnoid matter. We report a case of 17 years old presented with an altered conscious level. CSF analysis showed increased WBCs. His situation has improved after treating by acyclovir, ceftriaxone, vancomycin, and dexamethasone. Bacterial infection medical treatment meningeal irritation subdural empyema viral infection.
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Affiliation(s)
| | - Anas Zakarya Nourelden
- Faculty of Medicine Al‐Azhar University Cairo Egypt
- International Medical Research Association (IMedRA) Cairo Egypt
| | - Alaa Ahmed Elshanbary
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Yossef Hassan AbdelQadir
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Mohamed Sayed Zaazouee
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Al‐Azhar University Assiut Egypt
| | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Minia University Minia Egypt
| | | | - Sarya Swed
- Faculty of Medicine Aleppo University Aleppo Syria
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15
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Zaazouee MS, Hamdallah A, Helmy SK, Hasabo EA, Sayed AK, Gbreel MI, Elmegeed AA, Aladwan H, Elshanbary AA, Abdel-Aziz W, Elshahawy IM, Rabie S, Elkady S, Ali AS, Ragab KM, Nourelden AZ. Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes. Diabetes Metab Syndr 2022; 16:102511. [PMID: 35623229 DOI: 10.1016/j.dsx.2022.102511] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS To assess the safety and efficacy of semaglutide compared with placebo and other anti-hyperglycaemic agents in type 2 diabetes (T2DM). METHODS We searched PubMed, Scopus, Web of Science, and Cochrane library for relevant randomized controlled trials (RCTs). A network meta-analysis was conducted to compare different doses, durations, and interventions in T2DM. We presented results as mean difference (MD) or relative risk (RR) and 95% confidence interval (CI). RESULTS Twenty-six included RCTs studied different doses of subcutaneous (SC) and oral semaglutide, tirzepatide, liraglutide, sitagliptin, canagliflozin, and empagliflozin compared with placebo. Tirzepatide showed the highest efficacy, however, it was comparable to semaglutide. SC semaglutide 1 mg once-weekly showed higher reduction in HbA1c (MD = -1.72, 95% CI [-2.32; -1.12]), and fasting blood glucose (MD = -1.93, 95% CI [-2.81; -1.04]) versus placebo at 30 weeks and other timepoints. Adverse events (ADs) were comparable to placebo with oral and SC semaglutide, oral sitagliptin, SC liraglutide, and oral empagliflozin at most timepoints. However, SC semaglutide 0.8 mg and tirzepatide 10 mg groups had the highest gastrointestinal adverse events. CONCLUSION Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. The adverse events were comparable to placebo; however, gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.
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Affiliation(s)
- Mohamed Sayed Zaazouee
- Faculty of Medicine, Al-Azhar University, Assiut, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Aboalmagd Hamdallah
- Faculty of Medicine Al-Azhar University, Damietta, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Sara Kamel Helmy
- Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Elfatih A Hasabo
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan; International Medical Research Association (IMedRA), Egypt
| | - Ahmed Kamal Sayed
- Faculty of Medicine, Minia University, Minia, Egypt; Minia Medical Research Society (MMRS), Minia University, Egypt
| | - Mohamed Ibrahim Gbreel
- Faculty of Medicine, October 6 University, Giza, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Aya Abd Elmegeed
- Faculty of Science, Menofia University, Shebin El-Kom, Menofia, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Hala Aladwan
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan; International Medical Research Association (IMedRA), Egypt
| | - Alaa Ahmed Elshanbary
- Faculty of Medicine, Alexandria University, Alexandria, Egypt; International Medical Research Association (IMedRA), Egypt.
| | - Walid Abdel-Aziz
- Faculty of Medicine, Al-Azhar University, Assiut, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Israa Mohamed Elshahawy
- Faculty of Pharmacy Zagazig University, Zagazig, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Shehab Rabie
- Faculty of Science, Al-Azhar University, Cairo, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Sherouk Elkady
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt; International Medical Research Association (IMedRA), Egypt
| | | | - Khaled Mohamed Ragab
- Faculty of Medicine, Minia University, Minia, Egypt; International Medical Research Association (IMedRA), Egypt
| | - Anas Zakarya Nourelden
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt; International Medical Research Association (IMedRA), Egypt
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16
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Assar A, Matar SG, Hasabo EA, Elsayed SM, Zaazouee MS, Hamdallah A, Elshanbary AA, Khaled A, Badr H, Abukmail H, Ragab KM, Soliman SS. Knowledge, attitudes, practices and perceived barriers towards research in undergraduate medical students of six Arab countries. BMC Med Educ 2022; 22:44. [PMID: 35042492 PMCID: PMC8767733 DOI: 10.1186/s12909-022-03121-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 02/26/2021] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The involvement of the undergraduates in the research field requires a better view of their potential and the anticipated barriers facing them. This study aims to assess the undergraduates' knowledge, attitudes, practices and perceived barriers towards research in six Arab countries. METHODS A cross sectional study included medical students from six Arab countries, where a self-administered five-section questionnaire was used to assess the students' demographics, knowledge, attitudes, practices and perceived barriers. The questionnaire was distributed in the online educational platforms of the participating medical schools in the six included countries. RESULTS The total sample of recruited students was 2989, the majority of students (91.6%) showed poor level of knowledge regarding research. Generally high levels of positive attitudes towards research, research relevance and usefulness were found, with moderate levels of perception of research anxiety and difficulty. 33.7% (n = 1006) participated in an actual research project before with a mean of .5 publications per student. Cross-sectional studies were the most common type of studies conducted by students (38.6%), followed by case reports (23.9%). Lack of access to lab equipment for lab research (68.1%), the priority of education over research (66.8%), and lack of time because of educational tasks (66.1%) were generally the top perceived barriers towards research practice. CONCLUSION In the current study, the participants showed a poor knowledge level with associated positive attitudes towards research. One third of the students participated in research projects that mostly were cross-sectional studies and case reports. Educational tasks and lack of support were the most prevalent barriers. The students' positive attitudes towards research need to be translated into better knowledge and appropriate practice, which can be done by development of better training systems and more structured mentoring.
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Affiliation(s)
- Ahmed Assar
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Menoufia University, Shebin El-kom, Egypt
| | - Sajeda Ghassan Matar
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
| | - Elfatih A Hasabo
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt.
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Sarah Makram Elsayed
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, October 6 University, Giza, Egypt
| | - Mohamed Sayed Zaazouee
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Aboalmagd Hamdallah
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Alaa Ahmed Elshanbary
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Asmaa Khaled
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Helmy Badr
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hanan Abukmail
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA), Al-Azhar University, Cairo, Egypt
- Faculty of Medicine, Minia University, Minia, Egypt
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17
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Elshanbary AA, Zaazouee MS, Darwish YB, Omran MJ, Elkilany AY, Abdo MS, Saadeldin AM, Elkady S, Nourelden AZ, Ragab KM. Efficacy and Safety of Pectoral Nerve Block (Pecs) Compared With Control, Paravertebral Block, Erector Spinae Plane Block, and Local Anesthesia in Patients Undergoing Breast Cancer Surgeries: A Systematic Review and Meta-analysis. Clin J Pain 2021; 37:925-939. [PMID: 34593675 DOI: 10.1097/ajp.0000000000000985] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/05/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We aimed to compare the safety and efficacy of pectoral nerve block (Pecs) I and II with control or other techniques used during breast cancer surgeries such as local anesthesia, paravertebral block, and erector spinae plane block (ESPB). METHODS We searched 4 search engines (PubMed, Cochrane Library, Scopus, and Web of Science) for relevant trials, then extracted the data and combined them under random-effect model using Review Manager Software. RESULTS We found 47 studies, 37 of them were included in our meta-analysis. Regarding intraoperative opioid consumption, compared with control, a significant reduction was detected in Pecs II (standardized mean difference [SMD]=-1.75, 95% confidence interval [CI] [-2.66, -0.85], P=0.0001) and Pecs I combined with serratus plane block (SMD=-0.90, 95% CI [-1.37, -0.44], P=0.0002). Postoperative opioid consumption was significantly lowered in Pecs II (SMD=-2.28, 95% CI [-3.10, -1.46], P<0.00001) compared with control and Pecs II compared with ESPB (SMD=-1.75, 95% CI [-2.53, -0.98], P<0.00001). Furthermore, addition of dexmedetomidine to Pecs II significantly reduced postoperative opioid consumption compared with Pecs II alone (SMD=-1.33, 95% CI [-2.28, -0.38], P=0.006). CONCLUSION Pecs block is a safe and effective analgesic procedure during breast cancer surgeries. It shows lower intra and postoperative opioid consumption than ESPB, and reduces pain compared with control, paravertebral block, and local anesthesia, with better effect when combined with dexmedetomidine.
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Affiliation(s)
- Alaa Ahmed Elshanbary
- Faculty of Medicine, Alexandria University, Alexandria
- International Medical Research Association (IMedRA), Cairo
| | - Mohamed Sayed Zaazouee
- Faculty of Medicine, Al-Azhar University
- International Medical Research Association (IMedRA), Cairo
| | - Youssef Bahaaeldin Darwish
- Faculty of Pharmacy, Mansoura University, Mansoura
- International Medical Research Association (IMedRA), Cairo
| | - Maha Jabir Omran
- International Medical Research Association (IMedRA), Cairo
- Faculty of Pharmacy, Al-Azhar University-Gaza, Gaza, Palestine
| | - Alaa Yousry Elkilany
- Faculty of Medicine, Menoufia University, Menoufia
- International Medical Research Association (IMedRA), Cairo
| | - Mohamed Salah Abdo
- Faculty of Medicine
- International Medical Research Association (IMedRA), Cairo
| | - Ayat M Saadeldin
- Department of Radiation Oncology, El Hussein University Hospital
- International Medical Research Association (IMedRA), Cairo
| | - Sherouk Elkady
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut
- International Medical Research Association (IMedRA), Cairo
| | - Anas Zakarya Nourelden
- Faculty of Medicine, Al-Azhar University
- International Medical Research Association (IMedRA), Cairo
| | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA), Cairo
- Faculty of Medicine, Minia University, Minia, Egypt
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Elshanbary AA, Zaazouee MS, Hasan SM, Abdel-Aziz W. Risk factors for suicide mortality and cancer-specific mortality among patients with gastric adenocarcinoma: A SEER based study. Psychooncology 2021; 30:2067-2076. [PMID: 34453467 DOI: 10.1002/pon.5804] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aims to investigate the risk factors for suicide in patients with gastric adenocarcinoma (GAC) to recognize patients at higher risk who require special mental health care. METHODS Patients' data were collected from the Surveillance, Epidemiology, and End Results database from 1975 to 2016. The relationships among categorical variables were assessed using Person's chi-square test. Standardized mortality ratio was used to compare ratios of suicide and other causes of death between the US population and adenocarcinoma patients. Cox regression and Kaplan-Meier were used for multivariate and univariate analyses. The probability of suicide was assessed using the binary regression analysis. All analyses were conducted using SPSS software. RESULTS Among 59,580 patients included in this study, 86 died due to suicide. The mean survival months was higher in patients <50 years (81.759) than in patients ≥50 years (42.961), and in females (49.116) than in males (44.591). The multivariate analysis showed a higher suicide mortality risk in divorced patients (HR = 2.461; 95% CI [1.015, 5.966], p = 0.046), patients not recommended for surgery (HR = 1.997; 95% CI [1.08, 3.694], p = 0.027) and patients with distant stage of the disease (HR = 2.68; 95% CI [1.395, 5.147], p = 0.003). Females had a lower suicide mortality risk (HR = 0.124; 95% CI [0.045, 0.314], p < 0.001). CONCLUSION GAS predisposes to suicide. The risk is higher in patients who are males, divorced, not recommended for surgery, or have a distant spread of the disease.
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Nourelden AZ, Elshanbary AA, El-Sherif L, Benmelouka AY, Rohim HI, Helmy SK, Sayed MK, Ismail A, Ali AS, Ragab KM, Zaazouee MS. Safety and Efficacy of Teplizumab for Treatment of Type One Diabetes Mellitus: A Systematic Review and Meta-analysis. Endocr Metab Immune Disord Drug Targets 2020; 21:1895-1904. [PMID: 33302842 DOI: 10.2174/1871530320999201209222921] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 06/26/2020] [Revised: 09/08/2020] [Accepted: 09/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Type one diabetes mellitus (T1DM) is an autoimmune disease characterized by gradual destruction of beta cells in islets of Langerhans. Teplizumab is a humanized anti-CD3 monoclonal antibody, which may have beneficial effects for T1DM patients. OBJECTIVE To assess the safety and efficacy of teplizumab in T1DM patients. METHODS We searched electronic databases using related keywords for randomized clinical trials that assessing the safety and efficacy of teplizumab. We evaluated the retrieved citations for eligibility, and we extracted the data then analyzed it using Review Manager Software. RESULTS We included eight randomized clinical trials with 866 patients. Teplizumab was associated with lower insulin use than placebo at 6 months (MD = -0.17, 95% CI [-0.24, -0.09], P < 0.001), 12 months (MD = -0.12, 95% CI [-0.18, -0.06], P < 0.001), 18 months (MD = -0.22, 95% CI [-0.32, -0.11], P < 0.001) and 24 months (MD = -0.17, 95% CI [-0.28, -0.06], P = 0.003). The area under the curve of C-peptide was significantly increased in teplizumab group at 12 months (MD = 0.08, 95% CI [0.01, 0.15], P = 0.03), 18 months (MD = 0.13, 95% CI [0.01, 0.25], P = 0.03) and 24 months (MD = 0.13, 95% CI [0.01, 0.24], P = 0.03). No significant effect of teplizumab on HbA1c levels at any time point. Teplizumab was associated with some side effects such as lymphopenia, skin and subcutaneous tissue disorders. CONCLUSIONS Teplizumab is associated with lower insulin use and higher AUC of C-peptide in type 1 diabetic patients with no significant effect on Hb1c levels. Besides, teplizumab showed some adverse effects.
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Affiliation(s)
| | | | | | | | - Hagar Ismail Rohim
- High institute of Public Health, Alexandria University, Alexandria,. Egypt
| | | | | | - Ammar Ismail
- Faculty of Medicine, Al-Azhar University, Cairo,. Egypt
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Doheim MF, Altaweel AA, Elgendy MG, Elshanbary AA, Dibas M, Ali AAHA, Dahy TM, Sharaf AK, Hassan AE. Association between Helicobacter Pylori infection and stroke: a meta-analysis of 273,135 patients. J Neurol 2020; 268:3238-3248. [PMID: 32447554 DOI: 10.1007/s00415-020-09933-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Stroke stands among the most leading causes of mortality worldwide. Although modifiable risk factors for stroke have been identified, current risk factors do not sufficiently explain the risk in young patients. Previous studies have postulated an association between infection by Helicobacter pylori (HP) and stroke. OBJECTIVE To investigate the association between HP infection and stroke by using a systematic review and meta-analysis approach. METHODS Four electronic search engines/libraries were systematically searched for relevant observational studies. Studies were screened for eligibility and data were extracted. The odds ratio (OR) and 95% confidence interval (95% CI) were combined under the random-effect model. The protocol was registered in PROSPERO (CRD42019123689). RESULTS Among the included studies, 25 studies were analyzed for anti-HP IgG, 9 studies were for anti-Cag A, and 6 studies were for the C-urea breath test. The results showed that positive anti-HP IgG was significantly associated with an increased risk of stroke [OR (95% CI) = 1.43 (1.25-1.46)]. Similarly, both antiCag A and C-urea breath test were significantly associated with an increased risk of stroke with [OR (95% CI) = 1.77 (1.25-2.49)], and [OR (95% CI) = 2.21 (1.33-3.66)], respectively. Furthermore, our results indicated that positive anti-HP IgG was associated with stroke caused by atherothrombosis and small artery disease. CONCLUSIONS This study suggests that HP infection is significantly associated with increased risk of stroke. However, more well-designed studies are required to investigate if early HP eradication might decrease the incidence of stroke.
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Affiliation(s)
| | | | | | | | - Mahmoud Dibas
- College of Medicine, Sulaiman Al Rajhi University, Qassim, Saudi Arabia
| | | | | | | | - Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley, Valley Baptist Medical Center, Harlingen, TX, USA.
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