Papers by Mahmoud Berengy
Journal of gastrointestinal & digestive system, Jan 4, 2017
Purpose: Endoscopic approaches to obesity may help fulfill the unmet need of over half the most a... more Purpose: Endoscopic approaches to obesity may help fulfill the unmet need of over half the most adult population who would benefit from therapy for obesity but are not receiving it. Endoluminal approaches have the potential to be more efficacious than anti-obesity medications and have a lower risk-cost profile compared with bariatric surgery. This session outlines the current state of primary endoscopic weight loss and metabolic therapies and sheds light on the challenges faced towards making endoscopic bariatric therapies 'ready for prime time'. Recent Findings: Endoscopic approaches to obesity are being increasingly modeled on the proposed mechanisms contributing to the benefits of bariatric surgery. Therapies targeted at the stomach induce weight loss with only a proportional benefit to underlying metabolic disorders.Therapies targeting the proximal small bowel appear to modulate various neuro-hormonal pathways resulting in an improvement in metabolic profile in excess to that accounted for by weight-loss itself. Summary: Rigorous scientific assessment of endoscopic approaches to obesity is necessary to allow its integration into the treatment algorithm of obesity. The endoscopic armamentarium against obesity continues to evolve with the Endoscopist poised to be a key player in the management of this disease.
The Egyptian Journal of Hospital Medicine, Oct 1, 2018
Background: Hepatitis C virus (HCV) infection is a challenging health problem in Egypt. Esophagea... more Background: Hepatitis C virus (HCV) infection is a challenging health problem in Egypt. Esophageal varices are a major complication of it which may bleed and endanger patient's life. Aim of the work: to assess the relationship between type-2 DM and the development of gastroesophageal varices and explore the role of insulin resistance as a predictor of gastroesophageal varices. Patients and methods: This study included 100 patients with Child A, HCV-induced cirrhosis. They were divided into two main groups: Group A included 50 patients with type-2 DM, while Group B: included 50 non-diabetic which were subdivided into: Group B1: patients without DM but, with insulin resistance (IR) {32}, and Group B2: patients without DM or IR {18}. All patients were subjected to full history taking, clinical examination, laboratory and imaging studies (abdominal ultrasound) and upper GI endoscopy. Results: The prevalence of esophageal varices in patients with Child A HCV-induced cirrhosis was 80%, elevated to 88% in patients with type-2 DM. Insulin resistance played the major role in development of esophageal varices. There are statistically significant elevated HOMA-IR score, lower platelet count/spleen diameter ratio and higher right liver lobe diameter/albumin ratio in patients with varices. Conclusion: Insulin resistance is a major contributor for development of esophageal varices in HCV induced cirrhosis. Platelet count/spleen diameter ratio, right liver lobe diameter/albumin ratio and insulin resistance measured by HOMA-IR are good predictors for the presence of esophageal varices.
Introduction: A high proportion of women in the developing countries become anemic during pregnan... more Introduction: A high proportion of women in the developing countries become anemic during pregnancy. Iron deficiency anemia is the most common type during pregnancy. However, many of these women were already anemic before pregnancy, the most common causes of anemia in Egypt are poor nutrition, deficiencies of iron and other micronutrients Current knowledge indicates that iron deficiency anemia in pregnancy is a risk factor for preterm delivery and subsequent low birth weight. there is no sufficient Data to determine the extent to which maternal anemia might contribute to maternal mortality., iron supplements improve iron status during pregnancy. Maternal iron deficiency anemia is a risk for decrease iron stores in neonate in the first year in life. Serum ferritin usually falls markedly between 15 and 25 wks of gestation, as a result of iron utilization for expansion of the maternal red blood cell mass. When maternal iron status is poor, the placental transferrin receptors will incre...
International Journal of Medical Arts
Article information Background: The most prevalent form of heart disease is coronary artery disea... more Article information Background: The most prevalent form of heart disease is coronary artery disease [CAD], which is currently one of the leading causes of death in the world and is predicted to remain that way for the next 20 years. Atherosclerosis, genetic predisposition, environment and lifestyle are the main risk factors for CAD. Paraoxonase1 [PON1] is a glycoprotein enzyme associated with high-density lipoprotein [HDL] particles in the blood. It can prevent lipid oxidation, lowering the risk of atherogenesis, by doing so. The aim of the work: This work aims to study the frequency of association of PON1 gene polymorphism and risk of coronary artery diseases. This could help in better understanding of molecular basis and pathogenesis of coronary artery disease. Patients and Methods: The study included 80 subjects, 40 patients who admitted in Al-Azhar medical hospital in Damietta with established diagnosis of coronary artery disease by coronary angiography and 40 healthy participants. Genotyping of PON1 Q192R [A/G] was done. Results: A statistically significant association was observed with AG and GG genotypes of PON1 gene with CAD with P= 0.017. The G allele of PON1 was higher in CAD patients than controls suggesting that this allele may demonstrate a susceptibility effect to CAD in our cohort with P=0.025. Conclusion: The Q192R polymorphism in the PON1 gene may be a susceptibility gene associated with increased risk of CAD among Egyptians.
PLOS ONE
Objectives To investigate the clinical characteristics, risk factors, and predictors of esophagog... more Objectives To investigate the clinical characteristics, risk factors, and predictors of esophagogastric variceal bleeding in patients with hepatitis C virus (HCV)-induced liver cirrhosis. Methods This comparative observational study was carried out on 100 patients suffering from post hepatitis cirrhosis and portal hypertension who were admitted to the Internal Medicine Department, Al-Azhar University Hospital, Damietta Egypt. Patients were classified into two groups: 50 of them presented with esophagogastric varices with acute variceal bleeding, and 50 patients presented without bleeding. Data were collected, coded, revised, and entered into the Stata software version 16. Results The mean age of patients with bleeding was slightly higher than those without bleeding (55.58 ± 5.89 vs. 52.54 ± 9.01 years), p = 0.049. Mild ascites, positive H.Pylori, and Child-Pugh score B and C were an independent predictors of esophagogastric variceal bleeding (OR = 0.036, 95% CI: 0.0004–0.36; p = 0.0...
International Journal of Medical Arts, 2021
Article information Background: Diabetes mellitus [DM] and thyroid dysfunction are the most commo... more Article information Background: Diabetes mellitus [DM] and thyroid dysfunction are the most commonly coexistent disorders. Hypo-and hyperthyroidism are causes of dysglycemia. However, the relation between normal thyroid hormone levels and insulin resistance [IR] is unclear. The aim of the work: This study aimed to examine the association between the normal values of thyroid hormones and glucose metabolism and to investigate whether improvement of metabolic status can restore thyroid function in patients with uncontrolled type-2 diabetes mellitus [T2DM]. Patients and Methods: This study was a retrospective observational study. A total of 120 euthyroid participants were recruited. They were classified into four groups: Normal glucose tolerance [NGT, n =28], Prediabetes [n=32], well controlled DM [T2DM with glycated hemoglobin [HbA1c] ≤ 7%, n =26], and uncontrolled DM [T2DM with HbA1c > 7%, n = 34]. The results were compared between groups and the changes before and after treatment in uncontrolled DM group were observed and documented. Results: A total sample of 120 participants showed that mean age of DM uncontrolled patients was 40.2± 19.5 and there were no significant differences among groups regarding their age, body mass index [BMI], blood pressure [BP]. However, groups showed significant differences regarding cholesterol, free t4, serum glucose, two hours post prandial glucose, HbA1c, fasting insulin and insulin resistance. Regression analysis revealed that BMI, HbA1C, low density lipoprotein [LDL], triglycerides [TG] and total thyroxine [TT4] had statistically significant association with insulin resistance. there is statistically significant difference between uncontrolled DM patients before and after treatment regarding HbA1C and glucose. Conclusion: Reduced levels of free thyroid hormones [although in normal range] were significantly associated with high levels of serum glucose and HOMA-IR. There was significant improvement of blood glucose levels and insulin resistance.
The Egyptian Journal of Hospital Medicine, 2019
Background: Newly diagnosed type 2 diabetes mellitus (DM) is associated with insulin resistance (... more Background: Newly diagnosed type 2 diabetes mellitus (DM) is associated with insulin resistance (IR). This insulin resistance is related to state of chronic inflammation and inflammatory marker such as neutrophil lymphocyte ratio, which can be used as a predictor inflammatory marker for insulin resistance. Objectives: The aim of this study was to evaluate the relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus in New Demitta Hospital patients. Patients and methods: This study is a prospective one that was carried out on thirty (30) populations and sixty (60) patients newly diagnosed type 2 diabetes mellitus attending to Outpatient Clinic and Inpatient Department of Internal Medicine at Al-Azhar University Hospital, Damietta. All were subjected to full history and clinical examination, laboratory tests include, HOMA IR, HbA1c, serum fasting insulin, CBC, Fasting blood sugar, post prandial glucose level, ALT, AST, serum a...
Background: Portal hypertensive gastropathy (PHG) is one of the clinical conditions that can caus... more Background: Portal hypertensive gastropathy (PHG) is one of the clinical conditions that can cause chronic gastrointestinal hemorrhage in patients with cirrhosis, manifested by chronic anemia. It is generally diagnosed on the basis of endoscopic features. A new thermal modality has recently been introduced to endoscopy: the argon plasma coagulator (APC). Hemostasis is a main target for the use of APC and its role in ceasing PHG related acute and chronic bleeding is being efficient and safe when studied in the past few years. Aim of the study: To evaluate the role of argon plasma coagulation in comparison with non-selective beta blockers for the treatment of chronic blood loss and iron deficiency anemia in cirrhotic patients with severe portal hypertensive gastropathy. Patients and methods: This study included 112 cirrhotic anemic patients who had severe PHG. The patients were divided into two groups, group (A) included 56 patients who had argon plasma coagulation (APC) sessions and ...
The Egyptian Journal of Medical Microbiology, 2017
Background: Hepatitis C virus (HCV) is associated with many dermatoses including psoriasis throug... more Background: Hepatitis C virus (HCV) is associated with many dermatoses including psoriasis through stimulating inflammatory cells to infiltrate skin lesions. Objectives : To assess serumosteopontin ( OPN ) in psoriatic patients associated with HCV infection and its relation to severity and progression of psoriasis. Methodology: OPN was assayed by ELISA for 60 patients with psoriasis and 30 healthy individuals as control group. Results: OPN levels (pg/ml) were 49.8±12.2; 110.9±32.2 and 284.0±45.3 in mild, moderate and severe psoriasis; respectively. OPN levels (pg/ml) were increased in 21(35%) psoriatic patients with positive HCV antibodies (182.1±47.4) as compared to negative patients (49.87±13.5). OPN correlated positively (r= 0.81; p< 0.0001) with psoriasis lesions and calculation of psoriasis area and severity index . Area under the ROC of OPN to discriminate psoriasis patients from healthy individuals; mild severity from moderate severity; mild severity from severe; moderate ...
International Journal of Internal Medicine, 2017
Background: Scientific interest has focused on the association between osteocalcin, ( which origi... more Background: Scientific interest has focused on the association between osteocalcin, ( which originates from the skeletal system) and glucose metabolism. Although the association between lipid metabolism, adiponectin, and metabolic syndrome is well known, that between obesity, insulin resistance, and osteocalcin has not been clarified yet. Aim of the work: assessment of insulin resistance in Egyptian obese persons, and to identify whether or not there is a difference between patients with or without metabolic syndrome in respect to osteocalcin and adiponectin levels and the relation of both cytokines to different parameters of metabolic syndrome. Patients and methods: This study was done at Al-Azhar University Hospital (New Damietta), Internal Medicine Department, in the period from February 2014, to October 2014, sixty obese patients (31 male and 29 female), with criteria of metabolic syndrome (group I); and thirty obese persons (16 male and 14 female) without criteria of metabolic ...
Electronic Journal of Biology, 2017
Background: Systemic lupus erythematosus is a chronic disease which had diverse clinical manifest... more Background: Systemic lupus erythematosus is a chronic disease which had diverse clinical manifestations, course and prognosis. Search for diagnostic markers is continuous process to enhance the diagnostic and treatment process. Objective: It was to investigate Neutrophil/ Lymphocyte Ratio (NLR) and platelet/lymphocyte ratio (PLR) as activity markers in Systemic Lupus Erythematous (SLE) patients. Patients and methods: This study was carried out on 60 patients with SLE selected from outpatient's clinic and Internal Medicine Department of AL-Azhar University hospital and 20 healthy volunteers as a control group. The patients and controls included in this study were divided as follow: 1) Group A: forty (40) SLE patients with mild or moderate activity; 2) Group B: twenty (20) SLE patients without activity; and 3) Group C: twenty (20) normal healthy volunteers as a control. All patients and controls were subjected to: complete history and clinical assessment, abdominal ultrasonography...
Clinical Medicine and Diagnostics, 2018
Background: Intradialytic hypertension is a common problem observed in patients on maintenance he... more Background: Intradialytic hypertension is a common problem observed in patients on maintenance hemodialysis and considered as an independent predictor of adverse clinical outcomes. Aim of the work: estimation the serum levels of endothelin-1, and nitric oxide and its relation to occurrence of intradialytic hypertension in patients on maintenance hemodialysis. Methodology: the study is a case control study included 60 patients with end stage chronic renal disease (ESRD) on maintenance hemodialysis, selected from Nephrology Units of Al-Azhar University hospital New Damietta, Kafr Saad and Elzarka General Hospitals during the period from Feb. 2015 to March 2017. They were divided into two groups according to the presence of intradialytic hypertension. Group A: 30 patients with intradialytic hypertension (IHD). Group B: 30 patients without intradialytic hypertension (IHD), All patients were submitted to full history taking and clinical examination; laboratory investigations included rou...
Egyptian Journal of Obesity, Diabetes and Endocrinology, 2018
Introduction Hepatitis C virus (HCV) infection is known to be associated with insulin resistance ... more Introduction Hepatitis C virus (HCV) infection is known to be associated with insulin resistance (IR). The latter occurs early in the course of the disease and adversely affect it. The mechanism of this association seems to be different from that occurring in the metabolic syndrome. The aim of the study was to test this relationship in non-diabetic patients with early cirrhosis who are not fulfilling the criteria of metabolic syndrome. Patients and methods This cross-sectional study, included 100 patients with Child A cirrhosis induced by HCV. The patients were subjected to clinical, laboratory, ultrasonographic, and endoscopic evaluation. On the basis of homeostasis model assessment for insulin resistance (HOMA-IR) categorization, the patients were divided into two groups, with and without IR. Results A total of 63 patients had a higher HOMA-IR score, hence assigned as group 1, with significant elevation of liver enzymes, less albumin levels and more esophageal varices than in group 2. In a cohort of patients previously eradicated from the virus, HOMA-IR is lower than the non-treated patients. Conclusion Even in the absence of diabetes and metabolic syndrome, IR is evident in nearly two-thirds of patients having early HCV-induced cirrhosis. This link is associated with more inflammation of the liver and more drawbacks on the portal circulation. Sustained clearance of the virus improves insulin sensitivity.
Egyptian Rheumatology and Rehabilitation, 2019
Background Patients on regular hemodialysis (HD) are vulnerable to develop different articular an... more Background Patients on regular hemodialysis (HD) are vulnerable to develop different articular and skeletal problems that interfere with life quality and affect morbidity and mortality in these patients. To, properly, overcome or even prevent the development of these complications, early detection, especially of the commonly affected parts, is required. Aim The aim was to detect articular and skeletal manifestations in patients with endstage renal disease on regular HD, their relation to duration of dialysis, and which is more affected. Patients and methods A total of 50 patients (34 males and 16 females) with end-stage renal disease on regular HD, who were attendants of the dialysis unit of Internal Medicine Department at Al-Azhar University hospital, New Damietta, with duration of dialysis ranging between 3 and 15 years and age ranging from 26 to 70 years old were recruited for the study. They were classified into three groups: group I: mild, group II: moderate, and group III: severe joint affection. Full history taking, thorough clinical examination, especially for uremic and rheumatologic manifestations; laboratory investigations (inflammatory and metabolic markers); synovial fluid analysis and culture; and radiological investigations (radiography, dual-energy X-ray absorptiometry scan, ultrasound, computed tomography, and MRI of the affected parts) were done. Results There was a significant association between the duration of dialysis and the presence of joint affection. The most common affected joints were knee joints [n=23 patients (46%)] and shoulder joints [n=10 (20%)]. There was a statistically significant association between the severity of joints involvement and the prolonged duration of dialysis. The most common crystals present were the urate crystals (26%) followed by calcium pyrophosphate dihydrate (12%), and lastly oxalate crystals (8%). Carpal tunnel syndrome was diagnosed in 12 patients, with high significant association between the duration of dialysis and presence of carpal tunnel syndrome. There was increase in the level of parathyroid hormone with increase in the duration of renal dialysis. Moreover, 64% of patients had hyperparathyroid bone disease. The mean alkaline phosphatase level was increased in all groups of patients but was more in patients with severe joint affection. Serum albumin was maintained within normal level in HD patients. Radiological study of our HD patients showed that the most frequent radiological findings were signs of secondary hyperparathyroidism (subperiosteal resorption; acroosteolysis in the terminal tufts; pathological fracture, with two fractures in the spine, one in the neck of femur, and one fracture in the rib; and periarticular calcification, with one was found in the hand, and two were found in the pelvis). The incidence of these radiological findings increased with the increase of duration of HD. In addition, 18 patients had normal bone mineral density values, 18 patients had osteopenia, whereas 14 patients had osteoporosis. Conclusion The increased duration of dialysis is associated with increased incidence of articular and skeletal complications mainly renal osteodystrophy in the form of crystalinduced arthritis, osteoporosis, and periarticular calcification. Knee and shoulder joints, spine, neck of femur, wrist joints, and ribs are the main targets for complications and then for proper prophylaxis. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
The Turkish Journal of Gastroenterology, 2018
Current Opinion in Gastroenterology, 2015
Endoscopic approaches to obesity may help fulfill the unmet need of over half the US adult popula... more Endoscopic approaches to obesity may help fulfill the unmet need of over half the US adult population who would benefit from therapy for obesity but are not receiving it. Endoluminal approaches have the potential to be more efficacious than antiobesity medications and have a lower risk-cost profile compared with bariatric surgery. This review outlines the current state of primary endoscopic weight loss and metabolic therapies and sheds light on the challenges faced toward making endoscopic bariatric therapies &amp;amp;amp;amp;amp;amp;amp;amp;#39;ready for prime time&amp;amp;amp;amp;amp;amp;amp;amp;#39;. Endoscopic approaches to obesity are being increasingly modeled on the proposed mechanisms contributing to the benefits of bariatric surgery.Therapies targeted at the stomach induce weight loss with only a proportional benefit to underlying metabolic disorders.Therapies targeting the proximal small bowel appear to modulate various neurohormonal pathways resulting in an improvement in metabolic profile in excess to that accounted for by weight loss itself. Rigorous scientific assessment of endoscopic approaches to obesity is necessary to allow its integration into the treatment algorithm of obesity. The endoscopic armamentarium against obesity continues to evolve with the endoscopist poised to be a key player in the management of this disease. http://links.lww.com/COG/A12.
Current Opinion in Gastroenterology, 2015
Endoscopic approaches to obesity may help fulfill the unmet need of over half the US adult popula... more Endoscopic approaches to obesity may help fulfill the unmet need of over half the US adult population who would benefit from therapy for obesity but are not receiving it. Endoluminal approaches have the potential to be more efficacious than antiobesity medications and have a lower risk-cost profile compared with bariatric surgery. This review outlines the current state of primary endoscopic weight loss and metabolic therapies and sheds light on the challenges faced toward making endoscopic bariatric therapies &amp;amp;amp;amp;amp;amp;amp;amp;#39;ready for prime time&amp;amp;amp;amp;amp;amp;amp;amp;#39;. Endoscopic approaches to obesity are being increasingly modeled on the proposed mechanisms contributing to the benefits of bariatric surgery.Therapies targeted at the stomach induce weight loss with only a proportional benefit to underlying metabolic disorders.Therapies targeting the proximal small bowel appear to modulate various neurohormonal pathways resulting in an improvement in metabolic profile in excess to that accounted for by weight loss itself. Rigorous scientific assessment of endoscopic approaches to obesity is necessary to allow its integration into the treatment algorithm of obesity. The endoscopic armamentarium against obesity continues to evolve with the endoscopist poised to be a key player in the management of this disease. http://links.lww.com/COG/A12.
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Papers by Mahmoud Berengy