Papers by Hebatallah Assal
BackgroundCOVID-19 impacts the cardiovascular system resulting in myocardial damage and also affe... more BackgroundCOVID-19 impacts the cardiovascular system resulting in myocardial damage and also affects the kidneys leading to renal dysfunction. This effect is mostly through the binding with angiotensin-converting enzyme-2 (ACE2) and Neuropilin-1(NRP-l) receptors. Toll-Like Receptors (TLRs) typically combine with microbial pathogens and provoke an inflammatory response.AimThis work aims to compare the changes in kidney and heart function bioindicators and expressions of TLRs (TLR2 and TLR2) as well as ACE2 and NRP-l receptors in moderate and severe COVID-19 patients. The correlations between kidney and heart function bioindicators and expressions of these receptors are also studied.Patients and MethodsIn this study, 50 healthy control and 100 COVID-19 patients (55 male and 45 female) were enrolled. According to WHO guidelines, these participants were divided into severe (50 cases) and moderate (50 cases). Serum creatinine, blood urea, CKMB, LDH, and Troponin I were estimated. We meas...
The Egyptian Journal of Bronchology, 2022
Background Due to limited capacity, health care systems worldwide have been put in challenging si... more Background Due to limited capacity, health care systems worldwide have been put in challenging situations since the emergence of COVID-19. To prioritize patients who need hospital admission, a better understanding of the clinical predictors of disease severity is required. In the current study, we investigated the predictors of mortality and severity of illness in COVID-19 from a single center in Cairo, Egypt. Methods This retrospective cohort study included 175 patients hospitalized with COVID-19 pneumonia and had positive real-time polymerase chain reaction (RT-PCR) results for SARS-CoV-2 from 1 May 2020 to 1 December 2020. Severe COVID-19 was defined as requiring high-flow oxygen (flow rate of more than 8 L/min or use of high flow oxygen cannula), noninvasive ventilation, or invasive mechanical ventilation at any time point during the hospitalization. We used univariate and multivariate regression analyses to examine the differences in patient demographics and clinical and labora...
International Journal of Infectious Diseases, 2022
The Egyptian Journal of Bronchology, 2021
Background Routine administration of antibacterials in patients with Covid-19 has been a subject ... more Background Routine administration of antibacterials in patients with Covid-19 has been a subject of debate, with no solid data about the true prevalence of respiratory coinfections in Covid-19 patients in different geographic areas. The aim of the current study was to identify respiratory coinfections in Covid-19 patients admitted to the hospital and to identify its genetic resistance pattern using the respiratory multiplex polymerase chain reaction (PCR). Results The study included 40 patients, 32 males (80%) and 8 (20%) females with a mean age of 59.3 ± 12.6. Half of the patients had respiratory bacterial coinfections documented by pneumonia (PN) panel. The most common isolate was Klebsiella pneumoniae (10/20, 50%), followed by Acinetobacter calcoaceticus baumanni complex (7/20, 35%). Regarding genetic resistance, thirteen (13/20, 65%) isolates were proven extended spectrum beta lactamase (ESBL)-producing Enterobacteriaceae. Thirteen (13/20, 65%) isolates were proven carbapenemase...
The Journal of medical research, 2015
The superior vena cava (SVC) syndrome is a clinical entity caused by obstruction of the superior ... more The superior vena cava (SVC) syndrome is a clinical entity caused by obstruction of the superior vena cava by infiltration, compression or thrombosis. Cancer is the most common underlying cause of superior vena cava obstruction. The incidence of catheter-induced superior vena cava obstruction is rapidly increasing. Fibrosing mediastinitis and Behçet disease are rare causes of SVC syndrome. Clinical presentation of SVC syndrome may include cough, dyspnea, dysphagia, and swelling or discoloration of the neck, face and upper extremities. Aim of this study is to evaluate the role of Multislice CT in study of superior vena cava obstruction syndromes and assessment of collateral circulation in different causes of superior vena caval
Tuberculosis and Respiratory Diseases, 2020
Background Weaning failure is common in mechanically ventilated patients, and if ultrasound can p... more Background Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration ...
Egyptian Journal of Bronchology, 2016
Original article 173 was significantly shorter in the NIV group than in the SMT group. Conclusion... more Original article 173 was significantly shorter in the NIV group than in the SMT group. Conclusion This supports the use of NIV early after extubation in all patients regardless of risk for respiratory failure.
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
The Egyptian Journal of Radiology and Nuclear Medicine, 2016
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Tuberculosis and Respiratory Diseases
Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions m... more Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (P EL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of P EL after the aspiration of 500 mL of fluid was done with "P EL 0.5" (cm H 2 O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The P EL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The P EL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of P EL 0.5 >14.5 cm H 2 O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: P EL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.
Egyptian Journal of Radiology and Nuclear Medicine
Background Conducted studies showed that the ADC (apparent diffusion coefficient) values of malig... more Background Conducted studies showed that the ADC (apparent diffusion coefficient) values of malignant mediastinal lesions are significantly lower than those of benign lesions. Investigators determined cut-off ADC values to differentiate the two; concluding that ADC value is a promising noninvasive, imaging parameter that helps assess and characterize mediastinal tumors. Taking this a step forward, the primary objective of our prospective study was to investigate the potential of DW-MRI (diffusion-weighted magnetic resonance imaging) to characterize malignant mediastinal lesions using their ADC values. Thirty-three patients that underwent MRI of the chest with DWI and latter pathologically diagnosed with a malignant mediastinal lesion were included in this study. Lesions’ ADC values were measured and correlated with the histopathological results. The statistical significance of differences between measurements was tested using the one-way ANOVA (analysis of variance) test; p values e...
European Archives of Oto-Rhino-Laryngology, 2008
In this study, we evaluated the gender diVerences in body mass index (BMI), age and their eVects ... more In this study, we evaluated the gender diVerences in body mass index (BMI), age and their eVects on apnea-hypopnea index during total sleep time (AHI TST) in the Turkish population who were diagnosed with obstructive sleep apnea syndrome (OSAS) and compared them with data from the literature. A computerized database of 244 Turkish patients (194 males, 50 females) who had undergone overnight polysomnography (PSG) and diagnosed with OSAS at BayÂndÂr Hospital sleep laboratory between October 2004 and January 2007 was reviewed. The male:female ratio of the patients was 3.88:1. Male patients were signiWcantly younger compared to females (48.87 § 10.82 vs 52.94 § 12.14 years, respectively, P = 0.003). The BMI and AHI TST were similar in male and female patients (BMI = 29.52 § 4.63 vs 31.17 § 6.08 kg/ m 2 , respectively, P = 0.083) (AHI TST = 27.45 § 22.97 vs 24.77 § 23.83, respectively, P = 0.149). For the male and female groups, AHI TST increased as BMI increased (P = 0.03, 0.04). The median values of AHI TST in male group, for the normal, overweight and obese + pathological obese groups were 12.45, 20.20 and 23.50, respectively, whereas the median values of AHI TST in female group were 11.10, 10.95 and 26.20, respectively. In the normal and obese + pathological obese groups, there was no statistically signiWcant diVerence according to gender, whereas in the overweight group, male patients had signiWcantly higher AHI TST (P = 0.02). There was no statistically signiWcant diVerence between the male and female patients regarding the severity of OSAS (P = 0.358). However, there was a male tendency to moderate and severe OSAS in the normal and overweight BMI groups. In Turkish patients with OSAS, there was no gender diVerence in BMI and AHI TST and female patients were signiWcantly older than the males. The OSAS was diagnosed in men nearly four times more often than in women.
Egyptian Journal of Radiology and Nuclear Medicine
Background: To determine the sensitivity, specificity, positive predictive value, negative predic... more Background: To determine the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of thoracic ultrasound (TUS) in patients with moderate to high clinical suspicion of pulmonary embolism (PE). Twenty-five patients with moderate or high clinical suspicion of PE were enrolled in a prospective study. The patients' ages were 20 to 50 years (mean age = 36 years). They were evaluated by TUS and standard contrast-enhanced CT pulmonary angiography (CTPA). Results: In comparison to and in correlation with CTPA, TUS was found true positive in 12 patients (48%), false positive in one patient (4%), true negative in eight patients (32%), and false negative in four patients (8%), with an overall sensitivity (75%), specificity (89%), positive predictive value (92%), negative predictive value (67%), and accuracy (80%). Conclusion: TUS with its high specificity and diagnostic accuracy is a noninvasive, widely available, cost-effective method which can be rapidly performed. A negative TUS study cannot rule out PE with certainty, but positive TUS findings with moderate/high suspicion for PE may prove a valuable bedside tool in the diagnosis of PE especially for critically ill and immobile patients, facilitating their immediate treatment.
The Egyptian Journal of Radiology and Nuclear Medicine, 2016
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Egyptian Journal of Chest Diseases and Tuberculosis, 2014
Background: Rapid and accurate diagnosis and management can be lifesaving for patients with acute... more Background: Rapid and accurate diagnosis and management can be lifesaving for patients with acute dyspnea. However, making a differential diagnosis and selecting early treatment for patients with acute dyspnea in the emergency setting are a clinical challenge that requires complex decision-making in order to achieve hemodynamic balance, decrease unnecessary usage of antibiotic therapy, and decrease mortality.
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Papers by Hebatallah Assal