Background: Reperfusion injury might be considered as the consequence of insufficient perfusion d... more Background: Reperfusion injury might be considered as the consequence of insufficient perfusion due to fibrin and fibrinogen deposition in the microvasculature. Therefore, streptokinase, being a fibrinolytic drug, injected in the culprit artery immediately after primary PCI can be a suitable solution for achieving better myocardial perfusion. Aim of study: To assess the impact of complementary low dose intracoronary streptokinase (ICSK) administration immediately after primary PCI on left ventricular functions. Patients and methods: This double blinded randomized controlled clinical trial included 64 patients within 12 h of presentation by first STEMI who were candidate for primary percutaneous coronary intervention (PPCI). They were randomized equally to 2 groups. Immediately after primary PCI the first group received 250 kU ICSK vs placebo in the second group. Evaluation of LV functions was done by comparing the baseline echocardiographic parameters including left ventricle (LV) global longitudinal strain (GLS) before and after PPCI. Assessment of ST segment resolution (STR) 90 min after primary PCI, enzymatic infarct size in addition to comparing post-PPCI TIMI flow grade, TIMI frame count (TFC), Myocardial blush grade (MBG) and TIMI myocardial perfusion grade (TMPG) between both groups. Successful reperfusion after PPCI was defined as patients who achieved (TIMI 3 flow, MBG 3, > 70% ST segment resolution) Results: Post-PPCI LV GLS and LVEF were significantly higher in ICSK group (P = 0.005, 0.02 respectively). Post PPCI E/e' was significantly lower in ICSK group (P = 0.007). Peak CK-MB, CK-MB area under the curve (AUC), Troponin-I (72-hr); representing the enzymatic infarct size, were significantly lower in the ICSK group (P = 0.015, < 0.001, < 0.001 respectively). STR > 70% after PPCI was significantly higher in ICSK group (P = 0.045). Post-PPCI TFC was significantly lower in the ICSK group (P = 0.05). Post-PPCI MBG & TMPG were significantly higher in ICSK group (P = 0.04, 0.03 respectively). Multivariate linear regression analysis showed that each of ICSK administration, pain to stent time interval, post-PPCI MBG were independent predictors for LV GLS improvement after PPCI. Multivariate logistic regression analysis showed that the likelihood of achieving successful reperfusion post-PPCI was also associated with ICSK administration [OR= 0.123, 95% CI (0.02-0.75), P = 0.024] and was inversely associated with pain to stent time interval [OR= 0.995, 95% CI (0.990-0.999), P = 0.015]. Conclusion: Low-dose ICSK given immediately after primary PCI significantly led to improvement of LV GLS and LVEF, E/e'. It also reduced the enzymatic infarct size and was an independent predictor of successful reperfusion and LV GLS improvement after PPCI.
Campylobacter species are primarily zoonotic pathogens and recognized as a major cause of human i... more Campylobacter species are primarily zoonotic pathogens and recognized as a major cause of human illnesses. Poultry, especially, chicken is the main reservoir of Campylobacter species. The uncontrolled use of antibiotics in prophylaxis and treatment of animals caused an increase in antibiotic resistance to macrolides and fluoroquinolones (FQ) which are considered the drugs of choice for treatment of Campylobacter infection. Recently, studies suggested that multidrug efflux systems have the main role in lowering the efficacy of new and old antibiotics. Consequently, efforts are made to find suitable substances to reverse the action of the efflux pumps and prevent antimicrobial resistance. The substances used for evaluation of efflux pumps modulation are either efflux pump inhibitors (EPIs) or efflux pump inducers. The different types of EPIs; phenylalanine arginyl β-naphthylamide, verapamil and phenothiazines, of different mode of actions were used to suppress the activity of different types of efflux pumps. Aspirin, a drug in livestock and poultry, is a nonsteroidal anti-inflammatory, which induces non-heritable resistance of different bacteria to multiple antibiotics. Moreover, it also increases campylobacter resistance to antimicrobials. Alpha-tocopherol represents a new alternative approach against bacterial resistance. It shows modulatory activity on efflux system, showing clinically relevant results. Therefore, it is important to study different resistance mechanisms of campylobacters.
CSF hydrocele as a complication of migration or extrusion of the peritoneal end of the V-P shunt ... more CSF hydrocele as a complication of migration or extrusion of the peritoneal end of the V-P shunt has rarely been reported. Here the case of a 6 month old infant, born at 28 weeks gestational age, is reported. The baby was noted to have scrotal swelling, exacerbated by crying, two months after insertion of ventriculoperitoneal shunt. The hydrocele resolved following revision of the shunt. Possible pathophysiological causes are discussed.
The SID/SuperSID receivers[1] are part of the United Nation's International Space Weather Ini... more The SID/SuperSID receivers[1] are part of the United Nation's International Space Weather Initiative (ISWI). These receivers, tuned in the VLF range, allow the detection of Sudden Ionospheric Disturbances (SID), which affect the VLF radio waves propagation in the earth-ionosphere waveguide and caused by solar flares. We propose here, a useful and convivial numerical tool ‘SIDLab1.0’, dedicated to a fast: detection, identification and classification of these VLF disturbances. Wide public: kids, amateurs and even students and researchers, can quickly and easily integrate it in their analyses. For instance, for a social impact and outreach goal, a public demonstration will be held in Tunis Science City (Tunisia) on 21 Jun 2013, a day called “Solar day” to celebrate the summer solstice.
Eating disorders, i.e. anorexia and bulimia nervosa, are disorders of eating behavior and body we... more Eating disorders, i.e. anorexia and bulimia nervosa, are disorders of eating behavior and body weight regulation. Most likely because there are few, if any, effective treatments, eating disorders are considered to be chronic disorders interrupted only by intermittent periods of shortlived remission. The neurobiology of eating, most of which explores hypothalamic mechanisms, has had no influence on the treatment of eating disorders, with the exception of psychopharmacology. However, while most patients are treated with psychoactive drugs, there is no evidence that these are effective. This may be because pharmacological attempts so far have targeted the wrong symptoms. We review the symptomatology of anorexia and bulimia and the outcome of presently used interventions. Everybody agrees that outcome must improve and to attack this clinical problem, we suggest a neurobiologically plausible framework for how the disorders develop and how they are maintained and outline a method of treatment and its results.
Background: Reperfusion injury might be considered as the consequence of insufficient perfusion d... more Background: Reperfusion injury might be considered as the consequence of insufficient perfusion due to fibrin and fibrinogen deposition in the microvasculature. Therefore, streptokinase, being a fibrinolytic drug, injected in the culprit artery immediately after primary PCI can be a suitable solution for achieving better myocardial perfusion. Aim of study: To assess the impact of complementary low dose intracoronary streptokinase (ICSK) administration immediately after primary PCI on left ventricular functions. Patients and methods: This double blinded randomized controlled clinical trial included 64 patients within 12 h of presentation by first STEMI who were candidate for primary percutaneous coronary intervention (PPCI). They were randomized equally to 2 groups. Immediately after primary PCI the first group received 250 kU ICSK vs placebo in the second group. Evaluation of LV functions was done by comparing the baseline echocardiographic parameters including left ventricle (LV) global longitudinal strain (GLS) before and after PPCI. Assessment of ST segment resolution (STR) 90 min after primary PCI, enzymatic infarct size in addition to comparing post-PPCI TIMI flow grade, TIMI frame count (TFC), Myocardial blush grade (MBG) and TIMI myocardial perfusion grade (TMPG) between both groups. Successful reperfusion after PPCI was defined as patients who achieved (TIMI 3 flow, MBG 3, > 70% ST segment resolution) Results: Post-PPCI LV GLS and LVEF were significantly higher in ICSK group (P = 0.005, 0.02 respectively). Post PPCI E/e' was significantly lower in ICSK group (P = 0.007). Peak CK-MB, CK-MB area under the curve (AUC), Troponin-I (72-hr); representing the enzymatic infarct size, were significantly lower in the ICSK group (P = 0.015, < 0.001, < 0.001 respectively). STR > 70% after PPCI was significantly higher in ICSK group (P = 0.045). Post-PPCI TFC was significantly lower in the ICSK group (P = 0.05). Post-PPCI MBG & TMPG were significantly higher in ICSK group (P = 0.04, 0.03 respectively). Multivariate linear regression analysis showed that each of ICSK administration, pain to stent time interval, post-PPCI MBG were independent predictors for LV GLS improvement after PPCI. Multivariate logistic regression analysis showed that the likelihood of achieving successful reperfusion post-PPCI was also associated with ICSK administration [OR= 0.123, 95% CI (0.02-0.75), P = 0.024] and was inversely associated with pain to stent time interval [OR= 0.995, 95% CI (0.990-0.999), P = 0.015]. Conclusion: Low-dose ICSK given immediately after primary PCI significantly led to improvement of LV GLS and LVEF, E/e'. It also reduced the enzymatic infarct size and was an independent predictor of successful reperfusion and LV GLS improvement after PPCI.
Campylobacter species are primarily zoonotic pathogens and recognized as a major cause of human i... more Campylobacter species are primarily zoonotic pathogens and recognized as a major cause of human illnesses. Poultry, especially, chicken is the main reservoir of Campylobacter species. The uncontrolled use of antibiotics in prophylaxis and treatment of animals caused an increase in antibiotic resistance to macrolides and fluoroquinolones (FQ) which are considered the drugs of choice for treatment of Campylobacter infection. Recently, studies suggested that multidrug efflux systems have the main role in lowering the efficacy of new and old antibiotics. Consequently, efforts are made to find suitable substances to reverse the action of the efflux pumps and prevent antimicrobial resistance. The substances used for evaluation of efflux pumps modulation are either efflux pump inhibitors (EPIs) or efflux pump inducers. The different types of EPIs; phenylalanine arginyl β-naphthylamide, verapamil and phenothiazines, of different mode of actions were used to suppress the activity of different types of efflux pumps. Aspirin, a drug in livestock and poultry, is a nonsteroidal anti-inflammatory, which induces non-heritable resistance of different bacteria to multiple antibiotics. Moreover, it also increases campylobacter resistance to antimicrobials. Alpha-tocopherol represents a new alternative approach against bacterial resistance. It shows modulatory activity on efflux system, showing clinically relevant results. Therefore, it is important to study different resistance mechanisms of campylobacters.
CSF hydrocele as a complication of migration or extrusion of the peritoneal end of the V-P shunt ... more CSF hydrocele as a complication of migration or extrusion of the peritoneal end of the V-P shunt has rarely been reported. Here the case of a 6 month old infant, born at 28 weeks gestational age, is reported. The baby was noted to have scrotal swelling, exacerbated by crying, two months after insertion of ventriculoperitoneal shunt. The hydrocele resolved following revision of the shunt. Possible pathophysiological causes are discussed.
The SID/SuperSID receivers[1] are part of the United Nation's International Space Weather Ini... more The SID/SuperSID receivers[1] are part of the United Nation's International Space Weather Initiative (ISWI). These receivers, tuned in the VLF range, allow the detection of Sudden Ionospheric Disturbances (SID), which affect the VLF radio waves propagation in the earth-ionosphere waveguide and caused by solar flares. We propose here, a useful and convivial numerical tool ‘SIDLab1.0’, dedicated to a fast: detection, identification and classification of these VLF disturbances. Wide public: kids, amateurs and even students and researchers, can quickly and easily integrate it in their analyses. For instance, for a social impact and outreach goal, a public demonstration will be held in Tunis Science City (Tunisia) on 21 Jun 2013, a day called “Solar day” to celebrate the summer solstice.
Eating disorders, i.e. anorexia and bulimia nervosa, are disorders of eating behavior and body we... more Eating disorders, i.e. anorexia and bulimia nervosa, are disorders of eating behavior and body weight regulation. Most likely because there are few, if any, effective treatments, eating disorders are considered to be chronic disorders interrupted only by intermittent periods of shortlived remission. The neurobiology of eating, most of which explores hypothalamic mechanisms, has had no influence on the treatment of eating disorders, with the exception of psychopharmacology. However, while most patients are treated with psychoactive drugs, there is no evidence that these are effective. This may be because pharmacological attempts so far have targeted the wrong symptoms. We review the symptomatology of anorexia and bulimia and the outcome of presently used interventions. Everybody agrees that outcome must improve and to attack this clinical problem, we suggest a neurobiologically plausible framework for how the disorders develop and how they are maintained and outline a method of treatment and its results.
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Papers by Ahmed Ammar