Background. Emotional and psychological effects following abortion are more common than physical ... more Background. Emotional and psychological effects following abortion are more common than physical side effects and can range from mild regret to more serious complications such as depression. In the last decade, it has been suggested that low dose of ketamine is a fast-acting antidepressant. Purpose. The aim of this study was to investigate the impact of intraoperative ketamine infusion on postoperative mood score in patients undergoing Dilation and Curettage (D&C) under spinal anesthesia. We hypothesized that a single low-dose administration of ketamine infusion during D&C surgery can improve mood scores in the immediate postoperative period. Methods. A prospective, randomized, double-blind, parallel-group, placebo-controlled trial. The study included a total of 60 patients, ≥18 years, physical status ASA II, with up to 12-week gestation undergoing elective D&C surgery. Patients were divided randomly into a ketamine group (group K) and a control group (group C). In group K, 0.4 mg/k...
ABSTRACT Background: Eliminating propofol injection pain (PIP) should be multimodal, including ph... more ABSTRACT Background: Eliminating propofol injection pain (PIP) should be multimodal, including pharmacological and non-pharmacological interventions. Understanding risk factors – body mass index, menstrual cycle phase and age for example – leading to increased pain sensitivity will identify patients at most risk for PIP, permitting effective treatment strategies to be initiated at an early stage. Objective: Our goal is to determine occurrence and severity of propofol injection pain among female patients, whether they are obese or non-obese, during different menstrual cycle phases. Methods: Design: A prospective observational study. Setting: Single university teaching hospital’s operating rooms. Patients: 84 female undergoing surgeries under general anesthesia, classified as American Society of Anesthesiologists (ASA) physical status I–II, between 18 and 65 years of age were enrolled. Interventions: We evaluated propofol injection pain using visual analogue scale (VAS) during induction of general anesthesia. Main outcome measure: The relation between propofol induced peripheral venous pain and female body mass index, menstrual cycle phase and age. Results: 71.4% of patients experienced PIP. Of those patients who experienced PIP; 40.5% (34/84 patients) had moderate to severe pain. Age <35 years was the only independent predictor of moderate/severe PIP (sensitivity 62%, specificity 78%). After adjustment for age category, there was no statistically significant association between occurrence of moderate/severe PIP and obesity or menstruation. Conclusion: Propofol injection pain prophylactic measures should be considered in young females <35 years as they may be more prone to moderate/severe PIP. Trial Registration: NCT04078087
Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence ... more Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence of PONV could be as high as 70% to 80% in high-risk populations such as female sex, obese patients, age younger than 40 years, nonsmoker patients, history of PONV or motion sickness. Objectives: The study aimed to investigate whether dextrose 10% decreases the incidence of postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy Materials and Methods: This prospective, double-blind randomized placebo-controlled study comprised 130 ASA physical status I and II nonsmoker female patients, 20-40 years of age, scheduled for laparoscopic cholecystectomy at Ain Sham University – Assembled operating theater from August 2018 to October 2018. Patients were arbitrarily divided into two study groups of 65 patients each. Group LR received lactated Ringer’s solution and group D received 10% dextrose. The primary objective of this study was to compare the incidence o...
Research on childhood diseases represents a great global challenge. This challenge is maximized i... more Research on childhood diseases represents a great global challenge. This challenge is maximized in both childhood cancer disciplines and developing world. In this paper, we aim at describing our institution experience in starting a structured childhood cancer research program in one of the developing countries in a short time based on philanthropic efforts. We used retinoblastoma as an example for what was conducted in this program. Starting in 2008, this program included improving clinical practice and its related supporting services besides developing new research services that both complement the clinical activities and pave the way towards creating a research foundation in the country. Results included developing hospital standard treatment protocols, developing national clinical trials, joining international consortia for childhood cancers clinical trials, developing data collection tools and real-time analytics, establishing a biobanking facility, and developing highly qualifi...
Introduction and purpose: Institution-lead clinical research is a systematic effort for understan... more Introduction and purpose: Institution-lead clinical research is a systematic effort for understanding diseases and its management in relation to local situation and needs. In Egypt, Children’s Cancer Hospital Egypt has initiated a clinical research program that aims at standardising treatment protocols for different diseases including Retinoblastoma. The aim of this study is to present the steps we’ve conducted, specific challenges we’ve faced, key performance indicators that we’ve designed and achievements we have accomplished. Methods: During the evolution of this program we’ve tracked events and progress in the retinoblastoma program over an online shared application. This was reported on observational basis by research team for practices of clinical, pharmacy, nursing and other supporting teams beside research team itself. Retinoblastoma Research Team has used shared online documents for facilitating collaborative building of reports. Results: Between July 2007 and and July 2012...
Heavy metal contamination was examined in the carpet shell clam, Tapes deccussatus from six sites... more Heavy metal contamination was examined in the carpet shell clam, Tapes deccussatus from six sites in three main Egyptian natural fisheries (Ismailia, Alexandria and Damietta) over a six months period representing the winter and spring seasons (December 2010 – May 2011). Clams were collected monthly from six stations that were selected from locations exposed to different levels of industrial and municipal discharge. Clams were opened and whole soft tissue was removed and weighed to 15±1 g soft tissues. Four heavy metals, Pb, Cu, Cd and Zn (ppm) were measured using SHIMADZU Atomic Absorption Spectrophotometer AA-6800. Results (Table 1) showed that clams were more heavily polluted (bold font) in the spring than in winter months. Pb, Cu and Cd exceeded the permissible limits in most of the studied stations in the spring. Zn did not exceed the permissible limit in any of the station in both seasons. Damietta showed the least contamination by Cu, Cd, and Zn but showed high contamination w...
FAO fisheries circular = FAO circulaire sur les pêches = FAO circular de pesca
In Egypt due to the Nile delta and the presence of large shallow waters (0-20 m), with areas comp... more In Egypt due to the Nile delta and the presence of large shallow waters (0-20 m), with areas composed of sand and mud, there could be a great potential for the exploitation of a variety of clams. Given the big gap in knowledge on clams in Egypt the FAO EastMed project has started a study to support Egypt in exploring the possibility to determine if the clam resources exists, and then assist Egypt in developing a potential fishery. The study was conducted between Rasheed and Burullus, where there is a large extend of 60 km of shallow water sandy bottoms. The depth was decided to be limited to 10 m depth contour and target the main potential stock present, that of the clam Chamelea gallina. In total 126 hauls were conducted covering a coastline of about 60 km from 3 - 10 m in depth. All the species sampled were counted and weighed and Chamelea gallina samples were also kept for further processing in the laboratory, where the collection of stock parameters, microbiological and heavy me...
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2009
The clinical significance of pretransplant donor specific antihuman leukocyte antigen antibodies ... more The clinical significance of pretransplant donor specific antihuman leukocyte antigen antibodies that occur despite negative cytotoxicity crossmatches is still unclear. In this study, we assessed the impact of those antibodies on the outcome of renal transplants. Our study subjects consisted of 153 living-donor kidney transplant recipients whose pretransplant sera were available. All subjects had a negative complement-dependent cytotoxic crossmatch and were retrospectively evaluated for antihuman leukocyte antigen antibodies and their donor specificities by means of LABScan 100 Flow analyzer (Luminex Corporation, Texas, USA). The follow-up data of all subjects were reviewed. Antihuman leukocyte antigen antibodies were detected in 49 patients, donor nonspecific antihuman leukocyte antigen antibodies were found in 33, and donor specific antihuman leukocyte antigen antibodies were identified in 16. There was a trend toward more acute rejection in the patients with antihuman leukocyte a...
We adopt a standards-based approach in the development of our semantic interoperability layer. Th... more We adopt a standards-based approach in the development of our semantic interoperability layer. The semantics of the clinical terms will be captured by standard terminology systems such as SNOMED CT, ICD, LOINC, and scalability will be achieved by modularization, identifying a core dataset which covers the chosen clinical domain and our data. The core dataset will be validated by clinical and knowledge engineering experts to assure proper coverage and soundness. Relevant clinical scenarios have been identified and formalized in technical use cases, and are used as basis for our requirements analysis. We have defined an open, service-oriented architecture which provides the technical blueprint for the implementation of the INTEGRATE framework (www.fp7integrate.eu). Conclusions: The huge potential of the current biomedical research in oncology cannot be fully exploited in the absence of a coordinated and systematic approach. Our infrastructure will enable the sharing within a large biomedical community of comprehensive datasets and knowledge generated by clinical trials. The project will support BIG in promoting in the clinical community new methodologies and standards concerning the collection, processing and sharing of data. This will improve the reproducibility of high resolution translational research embedded in clinical trials and facilitate future research. Acknowledgement: This project is partially funded by the European Commission under the 7 th Framework Programme.
Background Cerebellar pilomyxoid astrocytomas (PMAs) and intermediate pilomyxoid astrocytomas (IP... more Background Cerebellar pilomyxoid astrocytomas (PMAs) and intermediate pilomyxoid astrocytomas (IPAs) are collectively called "pilomyxoid-spectrum astrocytomas (PMSAs)." Cerebellar PMSAs are thought to behave more aggressively than pilocytic astrocytomas (PAs). Our objective is to compare PMSAs to PAs in terms of surgical and clinical profiles. Methods This retrospective study included 66 cases (35 males and 31 females) with cerebellar astrocytomas treated between July 2007 and December 2012 at Children's Cancer Hospital Egypt (CCHE 57357) with a mean age of 7 (±1.5) years. Cases were divided into three subgroups as follows: 44 PAs, 10 IPAs, and 12 PMAs. Comparison between all groups was focusing on brain stem invasion, intrinsic necrotic cavitation, extent of resection, recurrence, leptomeningeal dissemination (LD), metastases, need for CSF diversion, and cerebellar mutism (CM). Results Cerebellar PMAs and IPAs separately and collectively had higher incidence of brain stem invasion, intrinsic necrotic cavitation, tumor recurrence, and LD when compared to PAs (P<0.001). Gross total resection was 13.6 % in PMSAs versus 90.9 % in PAs (P<0.001). PMAs had a higher incidence of tumor recurrence than IPAs (66.7 versus 20 %, P<0.001). Incidence of recurrence in PAs was 9.1 % in partially resected cases. Mean interval to recurrence was 9 (±1.5) months in PMSAs and 42 (±2) months in PAs. Conclusions Cerebellar PMSAs express an aggressive clinical behavior and impose more operative challenges than PAs. These tumors may represent a clinical spectrum-at its benign end lies PA, while PMA lies at the aggressive end, with IPA lying just behind. Such concepts could be used to guide management in the future.
Background. Emotional and psychological effects following abortion are more common than physical ... more Background. Emotional and psychological effects following abortion are more common than physical side effects and can range from mild regret to more serious complications such as depression. In the last decade, it has been suggested that low dose of ketamine is a fast-acting antidepressant. Purpose. The aim of this study was to investigate the impact of intraoperative ketamine infusion on postoperative mood score in patients undergoing Dilation and Curettage (D&C) under spinal anesthesia. We hypothesized that a single low-dose administration of ketamine infusion during D&C surgery can improve mood scores in the immediate postoperative period. Methods. A prospective, randomized, double-blind, parallel-group, placebo-controlled trial. The study included a total of 60 patients, ≥18 years, physical status ASA II, with up to 12-week gestation undergoing elective D&C surgery. Patients were divided randomly into a ketamine group (group K) and a control group (group C). In group K, 0.4 mg/k...
ABSTRACT Background: Eliminating propofol injection pain (PIP) should be multimodal, including ph... more ABSTRACT Background: Eliminating propofol injection pain (PIP) should be multimodal, including pharmacological and non-pharmacological interventions. Understanding risk factors – body mass index, menstrual cycle phase and age for example – leading to increased pain sensitivity will identify patients at most risk for PIP, permitting effective treatment strategies to be initiated at an early stage. Objective: Our goal is to determine occurrence and severity of propofol injection pain among female patients, whether they are obese or non-obese, during different menstrual cycle phases. Methods: Design: A prospective observational study. Setting: Single university teaching hospital’s operating rooms. Patients: 84 female undergoing surgeries under general anesthesia, classified as American Society of Anesthesiologists (ASA) physical status I–II, between 18 and 65 years of age were enrolled. Interventions: We evaluated propofol injection pain using visual analogue scale (VAS) during induction of general anesthesia. Main outcome measure: The relation between propofol induced peripheral venous pain and female body mass index, menstrual cycle phase and age. Results: 71.4% of patients experienced PIP. Of those patients who experienced PIP; 40.5% (34/84 patients) had moderate to severe pain. Age <35 years was the only independent predictor of moderate/severe PIP (sensitivity 62%, specificity 78%). After adjustment for age category, there was no statistically significant association between occurrence of moderate/severe PIP and obesity or menstruation. Conclusion: Propofol injection pain prophylactic measures should be considered in young females <35 years as they may be more prone to moderate/severe PIP. Trial Registration: NCT04078087
Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence ... more Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence of PONV could be as high as 70% to 80% in high-risk populations such as female sex, obese patients, age younger than 40 years, nonsmoker patients, history of PONV or motion sickness. Objectives: The study aimed to investigate whether dextrose 10% decreases the incidence of postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy Materials and Methods: This prospective, double-blind randomized placebo-controlled study comprised 130 ASA physical status I and II nonsmoker female patients, 20-40 years of age, scheduled for laparoscopic cholecystectomy at Ain Sham University – Assembled operating theater from August 2018 to October 2018. Patients were arbitrarily divided into two study groups of 65 patients each. Group LR received lactated Ringer’s solution and group D received 10% dextrose. The primary objective of this study was to compare the incidence o...
Research on childhood diseases represents a great global challenge. This challenge is maximized i... more Research on childhood diseases represents a great global challenge. This challenge is maximized in both childhood cancer disciplines and developing world. In this paper, we aim at describing our institution experience in starting a structured childhood cancer research program in one of the developing countries in a short time based on philanthropic efforts. We used retinoblastoma as an example for what was conducted in this program. Starting in 2008, this program included improving clinical practice and its related supporting services besides developing new research services that both complement the clinical activities and pave the way towards creating a research foundation in the country. Results included developing hospital standard treatment protocols, developing national clinical trials, joining international consortia for childhood cancers clinical trials, developing data collection tools and real-time analytics, establishing a biobanking facility, and developing highly qualifi...
Introduction and purpose: Institution-lead clinical research is a systematic effort for understan... more Introduction and purpose: Institution-lead clinical research is a systematic effort for understanding diseases and its management in relation to local situation and needs. In Egypt, Children’s Cancer Hospital Egypt has initiated a clinical research program that aims at standardising treatment protocols for different diseases including Retinoblastoma. The aim of this study is to present the steps we’ve conducted, specific challenges we’ve faced, key performance indicators that we’ve designed and achievements we have accomplished. Methods: During the evolution of this program we’ve tracked events and progress in the retinoblastoma program over an online shared application. This was reported on observational basis by research team for practices of clinical, pharmacy, nursing and other supporting teams beside research team itself. Retinoblastoma Research Team has used shared online documents for facilitating collaborative building of reports. Results: Between July 2007 and and July 2012...
Heavy metal contamination was examined in the carpet shell clam, Tapes deccussatus from six sites... more Heavy metal contamination was examined in the carpet shell clam, Tapes deccussatus from six sites in three main Egyptian natural fisheries (Ismailia, Alexandria and Damietta) over a six months period representing the winter and spring seasons (December 2010 – May 2011). Clams were collected monthly from six stations that were selected from locations exposed to different levels of industrial and municipal discharge. Clams were opened and whole soft tissue was removed and weighed to 15±1 g soft tissues. Four heavy metals, Pb, Cu, Cd and Zn (ppm) were measured using SHIMADZU Atomic Absorption Spectrophotometer AA-6800. Results (Table 1) showed that clams were more heavily polluted (bold font) in the spring than in winter months. Pb, Cu and Cd exceeded the permissible limits in most of the studied stations in the spring. Zn did not exceed the permissible limit in any of the station in both seasons. Damietta showed the least contamination by Cu, Cd, and Zn but showed high contamination w...
FAO fisheries circular = FAO circulaire sur les pêches = FAO circular de pesca
In Egypt due to the Nile delta and the presence of large shallow waters (0-20 m), with areas comp... more In Egypt due to the Nile delta and the presence of large shallow waters (0-20 m), with areas composed of sand and mud, there could be a great potential for the exploitation of a variety of clams. Given the big gap in knowledge on clams in Egypt the FAO EastMed project has started a study to support Egypt in exploring the possibility to determine if the clam resources exists, and then assist Egypt in developing a potential fishery. The study was conducted between Rasheed and Burullus, where there is a large extend of 60 km of shallow water sandy bottoms. The depth was decided to be limited to 10 m depth contour and target the main potential stock present, that of the clam Chamelea gallina. In total 126 hauls were conducted covering a coastline of about 60 km from 3 - 10 m in depth. All the species sampled were counted and weighed and Chamelea gallina samples were also kept for further processing in the laboratory, where the collection of stock parameters, microbiological and heavy me...
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2009
The clinical significance of pretransplant donor specific antihuman leukocyte antigen antibodies ... more The clinical significance of pretransplant donor specific antihuman leukocyte antigen antibodies that occur despite negative cytotoxicity crossmatches is still unclear. In this study, we assessed the impact of those antibodies on the outcome of renal transplants. Our study subjects consisted of 153 living-donor kidney transplant recipients whose pretransplant sera were available. All subjects had a negative complement-dependent cytotoxic crossmatch and were retrospectively evaluated for antihuman leukocyte antigen antibodies and their donor specificities by means of LABScan 100 Flow analyzer (Luminex Corporation, Texas, USA). The follow-up data of all subjects were reviewed. Antihuman leukocyte antigen antibodies were detected in 49 patients, donor nonspecific antihuman leukocyte antigen antibodies were found in 33, and donor specific antihuman leukocyte antigen antibodies were identified in 16. There was a trend toward more acute rejection in the patients with antihuman leukocyte a...
We adopt a standards-based approach in the development of our semantic interoperability layer. Th... more We adopt a standards-based approach in the development of our semantic interoperability layer. The semantics of the clinical terms will be captured by standard terminology systems such as SNOMED CT, ICD, LOINC, and scalability will be achieved by modularization, identifying a core dataset which covers the chosen clinical domain and our data. The core dataset will be validated by clinical and knowledge engineering experts to assure proper coverage and soundness. Relevant clinical scenarios have been identified and formalized in technical use cases, and are used as basis for our requirements analysis. We have defined an open, service-oriented architecture which provides the technical blueprint for the implementation of the INTEGRATE framework (www.fp7integrate.eu). Conclusions: The huge potential of the current biomedical research in oncology cannot be fully exploited in the absence of a coordinated and systematic approach. Our infrastructure will enable the sharing within a large biomedical community of comprehensive datasets and knowledge generated by clinical trials. The project will support BIG in promoting in the clinical community new methodologies and standards concerning the collection, processing and sharing of data. This will improve the reproducibility of high resolution translational research embedded in clinical trials and facilitate future research. Acknowledgement: This project is partially funded by the European Commission under the 7 th Framework Programme.
Background Cerebellar pilomyxoid astrocytomas (PMAs) and intermediate pilomyxoid astrocytomas (IP... more Background Cerebellar pilomyxoid astrocytomas (PMAs) and intermediate pilomyxoid astrocytomas (IPAs) are collectively called "pilomyxoid-spectrum astrocytomas (PMSAs)." Cerebellar PMSAs are thought to behave more aggressively than pilocytic astrocytomas (PAs). Our objective is to compare PMSAs to PAs in terms of surgical and clinical profiles. Methods This retrospective study included 66 cases (35 males and 31 females) with cerebellar astrocytomas treated between July 2007 and December 2012 at Children's Cancer Hospital Egypt (CCHE 57357) with a mean age of 7 (±1.5) years. Cases were divided into three subgroups as follows: 44 PAs, 10 IPAs, and 12 PMAs. Comparison between all groups was focusing on brain stem invasion, intrinsic necrotic cavitation, extent of resection, recurrence, leptomeningeal dissemination (LD), metastases, need for CSF diversion, and cerebellar mutism (CM). Results Cerebellar PMAs and IPAs separately and collectively had higher incidence of brain stem invasion, intrinsic necrotic cavitation, tumor recurrence, and LD when compared to PAs (P<0.001). Gross total resection was 13.6 % in PMSAs versus 90.9 % in PAs (P<0.001). PMAs had a higher incidence of tumor recurrence than IPAs (66.7 versus 20 %, P<0.001). Incidence of recurrence in PAs was 9.1 % in partially resected cases. Mean interval to recurrence was 9 (±1.5) months in PMSAs and 42 (±2) months in PAs. Conclusions Cerebellar PMSAs express an aggressive clinical behavior and impose more operative challenges than PAs. These tumors may represent a clinical spectrum-at its benign end lies PA, while PMA lies at the aggressive end, with IPA lying just behind. Such concepts could be used to guide management in the future.
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Papers by mohamed kamal