Journal of Stem Cells and Regenerative Medicine, May 30, 2016
Long-term evaluation of cisplatin induced nephrotoxicity and the probable renal protective activi... more Long-term evaluation of cisplatin induced nephrotoxicity and the probable renal protective activities of stem cells are lacking up until now. We evaluated the early and long-term role of human adipose derived mesenchymal stem cells (ADMSCs) in prevention or amelioration of cisplatin induced acute kidney injury (AKI) in Sprague-Dawley rats. For this, we determined the kidney tissue level of oxidative stress markers in conjugation with a renal histopathological scoring system of both acute and chronic renal changes. This study used eighty Sprague-Dawley (SD) rats weighing 250-300g. They were assigned into four equal groups (each group n=20): (I) Negative control group, rats injected with single dose of 1 ml normal saline. (II) Positive control cisplatin, rats injected with a single dose of 5 mg/kg I.P in 1 ml saline. (III) Cisplatin and culture media group, rats injected with 0.5 ml of culture media single dose into the tail vein and (IV) Cisplatin and ADMSCs group, rats injected with...
The pathogenesis of cirrhosis associated with HCV is a multifactor. Among theories of this disord... more The pathogenesis of cirrhosis associated with HCV is a multifactor. Among theories of this disorder is host factors associated with genetic polymorphism. Glutathione –s-transferases enzymes appear to have a role in hepatic fibrosis. The aim of the present study is to determine the distribution of GSTM1 gene and GSTT1 gene polymorphisms in some Egyptian patients with chronic hepatitis C associated with cirrhosis compared to healthy control subjects. This study included seventy one patients complaining of advanced liver cirrhosis associated with HCV infection. In addition, one hundred healthy subjects with cross age and sex were included as healthy control. Blood samples were obtained from each subject and subjected to determination of GSTT1 and GSTM1 genotypes polymorphism by multiplex polymerase chain reaction. Patients have more frequent GSTM1 and GSTT1 null genotypes compared to control subjects (29.6% OR 2.20, 95% CI: 1.05- 4.6, P=0.03) and (28.2% OR 0.2, 95%CI: 0.09-0.53, P=0.03...
International Journal of Health Sciences and Research, 2016
Background and Objectives: Nocturnal enuresis is any type of bed wetting occurring in children at... more Background and Objectives: Nocturnal enuresis is any type of bed wetting occurring in children at night when they are asleep in discrete amount after 5 years of age, according to International Children’s Continence Society (ICCS). It leads to frustration in the child leading to poor self esteem, social withdrawal causing family stress. There are various methods to assess and evaluate the condition, but questionnaire is one of the popular and widely used methods in conducting big inquiries. It can be used as an outcome measure for evaluating the prevalence and awareness; hence our aim was to construct a new questionnaire on nocturnal enuresis in children with emphasis on awareness among parents on nocturnal enuresis by considering the standard definition. Materials and Methods: Questionnaire was formulated by thorough literature review, opinions and comments from the medical professionals and language translation from the university professor. Questionnaire consist of 2 components, t...
Many apoptotic and fibrotic markers are known to be important in the development of renal fibrosi... more Many apoptotic and fibrotic markers are known to be important in the development of renal fibrosis. In Unilateral Ureteral Obstruction (UUO) the Obstructed Kidney (OK) develops fibrosis, while the Contralateral (CL) does not. In this study we investigated the gene expression of different apoptotic and fibrotic molecules which may affect fibrosis developments due to UUO. UUO was prepared under isoflurane anesthesia, and the animals were sacrificed after 3, 7 and 14 days post UUO. UUO caused hydronephrosis, dilation of renal tubules, loss of parenchymal thickness, apoptosis and fibrosis. Damage was most severe in mice sacrificed after 14 days of UUO, while both 3 and 7 days groups showed considerably milder hydronephrosis, no tubular necrosis, and less tubular dilation. We detected increased levels of transforming growth factor β (TGF-β) and alpha-smooth muscle actin (α-SMA), Matrix metalloproteinase 2 (MMP2) and MMP9 (fibroblast activation marker) and TNF as apoptotic marker in the k...
Background: Substance abuse is a worldwide problem with rapidly expanding prevalence. Liver is hi... more Background: Substance abuse is a worldwide problem with rapidly expanding prevalence. Liver is highly vulnerable to xenobiotics toxicities. Methods: We have investigated the effect of substances of 5 commonly abused in Egypt (tramadol, opiates, cannabis, barbiturates and benzodiazepines) on liver functions in persons attending to Mansoura university hospitals. After exclusion of cases with chronic liver diseases, participants were screened by enzyme multiplied immunoassay. Positive cases were confirmed by gas chromatography-mass spectroscopy and examined by abdominal ultrsonography and live functions tests were done. Results: GC-MS showed only 125 positive cases. No abnormalities were detected by ultrasonography in the examined populations. SGOT, SGPT and direct bilirubin were significantly increased, while albumin was significantly decreased in abusers in comparison to nonabusers. Tramadol and other opioids were shown to be the most hepatotoixc agents. In addition, SGOT was shown t...
Hepatitis C viral infection is a common health problem in Egypt. The complications of HCV include... more Hepatitis C viral infection is a common health problem in Egypt. The complications of HCV include cirrhosis and hepatocellular carcinoma. Zinc is a micronutrient that plays role in immune system and antioxidant system. Zinc is thought to be associated with HCV-related hepatic complications. The aim of the present study was to evaluate the level of serum zinc in patients with different stages of hepatitis C associated liver cirrhosis and HCC. This cross-sectional study was carried out in 75 patients with various stages of HCVassociated liver affections. They included 25 early cirrhotic patients on top of HCV with positive U/S and laboratory tests for cirrhosis with positive viral markers for HCV, 25 patients with advanced cirrhosis on top of HCV and 25 patients with primary hepatocellular carcinoma on top of HCV with a positive U/S and triphasic CT for malignant focal lesions with positive viral markers for HCV. In addition, 25 healthy subjects were recruited as a control group. Bloo...
Background: Aromatase inhibitors (Als) may cause a rise in estrogen levels due to ovarian functio... more Background: Aromatase inhibitors (Als) may cause a rise in estrogen levels due to ovarian function recovery in women with clinical chemotherapy-induced ovarian failure (CIOF). We carried out a prospective registry trial to identify predictors of ovarian function recovery during AI therapy. Patients and Methods: Women with hormone receptor (HR) positive breast cancer who attend the Clinical Oncology and Nuclear Medicine Department from January 2011 to March 2013 who remained amenorrheic and had hormonal levels consistent with ovarian failure after adjuvant chemotherapy subjects underwent frequent assessment using an ultrasensitive estradiol assay. Multivariable analysis was used to evaluate clinical and biochemical predictors of ovarian function recovery within 48 weeks. Results: Recovery of ovarian function during AI therapy was observed in 13 of 45 (28.9%) assessable subjects after a median 2.1 months (range 0.6-11.9). Median age at chemotherapy initiation was statistically signifi...
Background Hepatitis C virus (HCV) infection is still a main health problem in hemodialysis (HD) ... more Background Hepatitis C virus (HCV) infection is still a main health problem in hemodialysis (HD) patients. The prevalence of occult hepatitis C infection (OCI) in HD patients may be underestimated, and its possible influence on anemia management has not been studied. We aimed to determine the existence of OCI in Egyptian HD patients as well as its possible effect on anemia management. Patients and methods This cross-sectional multicenter study included 98 HCV-negative HD patients (negative for both anti-HCV antibody and HCV-RNA), 43 anti-HCV-positive HD patients, and 10 volunteer people matched for age and sex as a healthy control group. Serology test for anti-HCV antibody, reverse-transcription PCR for HCV-RNA (both serum and peripheral mononuclear cell (PMNC)), complete blood count (CBC), liver transaminases, serum iron, serum ferritin, and high-sensitivity C-reactive protein (hsCRP) were done. The average erythropoiesis-stimulating agent (ESA) doses were calculated over 6 months,...
Alzheimer’s disease (AD) is characterized by alterations in monoamines, oxidative stress, and met... more Alzheimer’s disease (AD) is characterized by alterations in monoamines, oxidative stress, and metabolic dysfunctions. We aim to assess the therapeutic impacts of roots or leaf extract from Urtica dioica (UD; stinging nettle) against scopolamine (SCOP)-induced memory dysfunction, amnesia, and oxidative stress in rats. Spatial memory was assessed by Y maze test. Tissue analyses of norepinephrine (NE), dopamine (DA), serotonin (5-HT), malondialdehyde (MDA), nitric oxide (NO), glutathione (GSH, GSSG), AMP, ADP, and ATP were assessed by HPLC. mRNA levels of Tau and Hsp70 were estimated by PCR. UD extracts particularly nettle root (NR) significantly normalized the SCOP-induced memory deficits even more potent than sermion (SR) and donepezil (DON). Similarly, NR had potent therapeutic impacts on the levels of cortical and hippocampal monoamines e.g. DA, NE, and 5-HT. SCOP induced a dramatic oxidative stress as measured by MDA, NO, and GSSG levels; however, UD extracts showed significant anti-oxidative stress impacts. Additionally, UD extracts restored ATP levels and reduced the levels of AMP and ADP compared to SCOP-treated rats. Furthermore, cortical Tau and hippocampal Hsp70 were modulated by UD extracts particularly NR compared to the SCOP group. In conclusion, UD extracts particularly roots have potential therapeutic impacts against SCOP-induced neuroinflammatory and/or Alzheimer-like phenotype in rats.
Objectives To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Reg... more Objectives To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990–2015. Methods We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. Results A total of 1.4 million CVD deaths (95% UI: 1.3–1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. Conclusions The age-standardized DALY rates in the EMR are considerably higher than the global average. These fi...
Objectives Assessing the burden of maternal mortality is important for tracking progress and iden... more Objectives Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. Methods We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. Results The maternal mortality ratio in the EMR decreased 16.3% from 283 (241–328) maternal deaths per 100,000 live births in 1990 to 237 (188–293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Conclusion Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are availab...
Objectives We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burde... more Objectives We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. Methods We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. Results In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095–12,396,566) DALYs and 191,114 (95% UI 170,934–210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter...
Objectives We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern... more Objectives We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern Mediterranean Region (EMR) between 1990 and 2015. Methods The Global Burden of Disease (GBD) study defines intentional injuries as a combination of self-harm (including suicide), interpersonal violence, collective violence (war), and legal intervention. We estimated number of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for each type of intentional injuries. Results In 2015, 28,695 individuals (95% UI: 25,474–37,832) died from self-harm, 35,626 (95% UI: 20,947–41,857) from interpersonal violence, and 143,858 (95% UI: 63,554–223,092) from collective violence and legal interventions. In 2015, collective violence and legal intervention was the fifth-leading cause of DALYs in the EMR and the leading cause in Syria, Yemen, Iraq, Afghanistan, and Libya; they account for 49.7% of total DALYs in Syria. Conclusions Our findings...
Objectives To estimate incidence, mortality, and disability- adjusted life years (DALYs) caused b... more Objectives To estimate incidence, mortality, and disability- adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer preventi...
The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including ... more The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders ...
Diarrheal diseases (DDs) are leading causes of disease burden and death and disability, especiall... more Diarrheal diseases (DDs) are leading causes of disease burden and death and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For box sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs a...
Background Oesophageal cancer is a common and often fatal cancer that has two main histological s... more Background Oesophageal cancer is a common and often fatal cancer that has two main histological subtypes: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Updated statistics on the incidence and mortality of oesophageal cancer, and on the disability-adjusted life-years (DALYs) caused by the disease, can assist policy makers in allocating resources for prevention, treatment, and care of oesophageal cancer. We report the latest estimates of these statistics for 195 countries and territories between 1990 and 2017, by age, sex, and Socio-demographic Index (SDI), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD). Methods We used data from vital registration systems, vital registration-samples, verbal autopsy records, and cancer registries, combined with relevant modelling, to estimate the mortality, incidence, and burden of oesophageal cancer from 1990 to 2017. Mortality-to-incidence ratios (MIRs) were estimated and fed into a Cause of Death Ensemble model (CODEm) including risk factors. MIRs were used for mortality and non-fatal modelling. Estimates of DALYs attributable to the main risk factors of oesophageal cancer available in GBD were also calculated. The proportion of oesophageal squamous cell carcinoma to all oesophageal cancers was extracted by use of publicly available data, and its variation was examined against SDI, the Healthcare Access and Quality (HAQ) Index, and available risk factors in GBD that are specific for oesophageal squamous cell carcinoma (eg, unimproved water source and indoor air pollution) and for oesophageal adenocarcinoma (gastro-oesophageal reflux disease). Findings There were 473 000 (95% uncertainty interval [95% UI] 459 000-485 000) new cases of oesophageal cancer and 436 000 (425 000-448 000) deaths due to oesophageal cancer in 2017. Age-standardised incidence was 5•9 (5•7-6•1) per 100 000 population and age-standardised mortality was 5•5 (5•3-5•6) per 100 000. Oesophageal cancer caused 9•78 million (9•53-10•03) DALYs, with an age-standardised rate of 120 (117-123) per 100 000 population. Between 1990 and 2017, age-standardised incidence decreased by 22•0% (18•6-25•2), mortality decreased by 29•0% (25•8-32•0), and DALYs decreased by 33•4% (30•4-36•1) globally. However, as a result of population growth and ageing, the total number of new cases increased by 52•3% (45•9-58•9), from 310 000 (300 000-322 000) to 473 000 (459 000-485 000); the number of deaths increased by 40•0% (34•1-46•3), from 311 000 (301 000-323 000) to 436 000 (425 000-448 000); and total DALYs increased by 27•4% (22•1-33•1), from 7•68 million (7•42-7•97) to 9•78 million (9•53-10•03). At the national level, China had the highest number of incident cases (235 000 [223 000-246 000]), deaths (213 000 [203 000-223 000]), and DALYs (4•46 million [4•25-4•69]) in 2017. The highest national-level agestandardised incidence rates in 2017 were observed in Malawi (23•0 [19•4-26•5] per 100 000 population) and Mongolia (18•5 [16•4-20•8] per 100 000). In 2017, age-standardised incidence was 2•7 times higher, mortality 2•9 times higher, and DALYs 3•0 times higher in males than in females. In 2017, a substantial proportion of oesophageal cancer DALYs were attributable to known risk factors: tobacco smoking (39•0% [35•5-42•2]), alcohol consumption (33•8% [27•3-39•9]), high BMI (19•5% [6•3-36•0]), a diet low in fruits (19•1% [4•2-34•6]), and use of chewing tobacco (7•5% [5•2-9•6]). Countries with a low SDI and HAQ Index and high levels of indoor air pollution had a higher proportion of oesophageal squamous cell carcinoma to all oesophageal cancer cases than did countries with a high SDI and HAQ Index and with low levels of indoor air pollution. Interpretation Despite reductions in age-standardised incidence and mortality rates, oesophageal cancer remains a major cause of cancer mortality and burden across the world. Oesophageal cancer is a highly fatal disease, requiring increased primary prevention efforts and, possibly, screening in some high-risk areas. Substantial variation exists in age-standardised incidence rates across regions and countries, for reasons that are unclear. Funding Bill & Melinda Gates Foundation.
Journal of Stem Cells and Regenerative Medicine, May 30, 2016
Long-term evaluation of cisplatin induced nephrotoxicity and the probable renal protective activi... more Long-term evaluation of cisplatin induced nephrotoxicity and the probable renal protective activities of stem cells are lacking up until now. We evaluated the early and long-term role of human adipose derived mesenchymal stem cells (ADMSCs) in prevention or amelioration of cisplatin induced acute kidney injury (AKI) in Sprague-Dawley rats. For this, we determined the kidney tissue level of oxidative stress markers in conjugation with a renal histopathological scoring system of both acute and chronic renal changes. This study used eighty Sprague-Dawley (SD) rats weighing 250-300g. They were assigned into four equal groups (each group n=20): (I) Negative control group, rats injected with single dose of 1 ml normal saline. (II) Positive control cisplatin, rats injected with a single dose of 5 mg/kg I.P in 1 ml saline. (III) Cisplatin and culture media group, rats injected with 0.5 ml of culture media single dose into the tail vein and (IV) Cisplatin and ADMSCs group, rats injected with...
The pathogenesis of cirrhosis associated with HCV is a multifactor. Among theories of this disord... more The pathogenesis of cirrhosis associated with HCV is a multifactor. Among theories of this disorder is host factors associated with genetic polymorphism. Glutathione –s-transferases enzymes appear to have a role in hepatic fibrosis. The aim of the present study is to determine the distribution of GSTM1 gene and GSTT1 gene polymorphisms in some Egyptian patients with chronic hepatitis C associated with cirrhosis compared to healthy control subjects. This study included seventy one patients complaining of advanced liver cirrhosis associated with HCV infection. In addition, one hundred healthy subjects with cross age and sex were included as healthy control. Blood samples were obtained from each subject and subjected to determination of GSTT1 and GSTM1 genotypes polymorphism by multiplex polymerase chain reaction. Patients have more frequent GSTM1 and GSTT1 null genotypes compared to control subjects (29.6% OR 2.20, 95% CI: 1.05- 4.6, P=0.03) and (28.2% OR 0.2, 95%CI: 0.09-0.53, P=0.03...
International Journal of Health Sciences and Research, 2016
Background and Objectives: Nocturnal enuresis is any type of bed wetting occurring in children at... more Background and Objectives: Nocturnal enuresis is any type of bed wetting occurring in children at night when they are asleep in discrete amount after 5 years of age, according to International Children’s Continence Society (ICCS). It leads to frustration in the child leading to poor self esteem, social withdrawal causing family stress. There are various methods to assess and evaluate the condition, but questionnaire is one of the popular and widely used methods in conducting big inquiries. It can be used as an outcome measure for evaluating the prevalence and awareness; hence our aim was to construct a new questionnaire on nocturnal enuresis in children with emphasis on awareness among parents on nocturnal enuresis by considering the standard definition. Materials and Methods: Questionnaire was formulated by thorough literature review, opinions and comments from the medical professionals and language translation from the university professor. Questionnaire consist of 2 components, t...
Many apoptotic and fibrotic markers are known to be important in the development of renal fibrosi... more Many apoptotic and fibrotic markers are known to be important in the development of renal fibrosis. In Unilateral Ureteral Obstruction (UUO) the Obstructed Kidney (OK) develops fibrosis, while the Contralateral (CL) does not. In this study we investigated the gene expression of different apoptotic and fibrotic molecules which may affect fibrosis developments due to UUO. UUO was prepared under isoflurane anesthesia, and the animals were sacrificed after 3, 7 and 14 days post UUO. UUO caused hydronephrosis, dilation of renal tubules, loss of parenchymal thickness, apoptosis and fibrosis. Damage was most severe in mice sacrificed after 14 days of UUO, while both 3 and 7 days groups showed considerably milder hydronephrosis, no tubular necrosis, and less tubular dilation. We detected increased levels of transforming growth factor β (TGF-β) and alpha-smooth muscle actin (α-SMA), Matrix metalloproteinase 2 (MMP2) and MMP9 (fibroblast activation marker) and TNF as apoptotic marker in the k...
Background: Substance abuse is a worldwide problem with rapidly expanding prevalence. Liver is hi... more Background: Substance abuse is a worldwide problem with rapidly expanding prevalence. Liver is highly vulnerable to xenobiotics toxicities. Methods: We have investigated the effect of substances of 5 commonly abused in Egypt (tramadol, opiates, cannabis, barbiturates and benzodiazepines) on liver functions in persons attending to Mansoura university hospitals. After exclusion of cases with chronic liver diseases, participants were screened by enzyme multiplied immunoassay. Positive cases were confirmed by gas chromatography-mass spectroscopy and examined by abdominal ultrsonography and live functions tests were done. Results: GC-MS showed only 125 positive cases. No abnormalities were detected by ultrasonography in the examined populations. SGOT, SGPT and direct bilirubin were significantly increased, while albumin was significantly decreased in abusers in comparison to nonabusers. Tramadol and other opioids were shown to be the most hepatotoixc agents. In addition, SGOT was shown t...
Hepatitis C viral infection is a common health problem in Egypt. The complications of HCV include... more Hepatitis C viral infection is a common health problem in Egypt. The complications of HCV include cirrhosis and hepatocellular carcinoma. Zinc is a micronutrient that plays role in immune system and antioxidant system. Zinc is thought to be associated with HCV-related hepatic complications. The aim of the present study was to evaluate the level of serum zinc in patients with different stages of hepatitis C associated liver cirrhosis and HCC. This cross-sectional study was carried out in 75 patients with various stages of HCVassociated liver affections. They included 25 early cirrhotic patients on top of HCV with positive U/S and laboratory tests for cirrhosis with positive viral markers for HCV, 25 patients with advanced cirrhosis on top of HCV and 25 patients with primary hepatocellular carcinoma on top of HCV with a positive U/S and triphasic CT for malignant focal lesions with positive viral markers for HCV. In addition, 25 healthy subjects were recruited as a control group. Bloo...
Background: Aromatase inhibitors (Als) may cause a rise in estrogen levels due to ovarian functio... more Background: Aromatase inhibitors (Als) may cause a rise in estrogen levels due to ovarian function recovery in women with clinical chemotherapy-induced ovarian failure (CIOF). We carried out a prospective registry trial to identify predictors of ovarian function recovery during AI therapy. Patients and Methods: Women with hormone receptor (HR) positive breast cancer who attend the Clinical Oncology and Nuclear Medicine Department from January 2011 to March 2013 who remained amenorrheic and had hormonal levels consistent with ovarian failure after adjuvant chemotherapy subjects underwent frequent assessment using an ultrasensitive estradiol assay. Multivariable analysis was used to evaluate clinical and biochemical predictors of ovarian function recovery within 48 weeks. Results: Recovery of ovarian function during AI therapy was observed in 13 of 45 (28.9%) assessable subjects after a median 2.1 months (range 0.6-11.9). Median age at chemotherapy initiation was statistically signifi...
Background Hepatitis C virus (HCV) infection is still a main health problem in hemodialysis (HD) ... more Background Hepatitis C virus (HCV) infection is still a main health problem in hemodialysis (HD) patients. The prevalence of occult hepatitis C infection (OCI) in HD patients may be underestimated, and its possible influence on anemia management has not been studied. We aimed to determine the existence of OCI in Egyptian HD patients as well as its possible effect on anemia management. Patients and methods This cross-sectional multicenter study included 98 HCV-negative HD patients (negative for both anti-HCV antibody and HCV-RNA), 43 anti-HCV-positive HD patients, and 10 volunteer people matched for age and sex as a healthy control group. Serology test for anti-HCV antibody, reverse-transcription PCR for HCV-RNA (both serum and peripheral mononuclear cell (PMNC)), complete blood count (CBC), liver transaminases, serum iron, serum ferritin, and high-sensitivity C-reactive protein (hsCRP) were done. The average erythropoiesis-stimulating agent (ESA) doses were calculated over 6 months,...
Alzheimer’s disease (AD) is characterized by alterations in monoamines, oxidative stress, and met... more Alzheimer’s disease (AD) is characterized by alterations in monoamines, oxidative stress, and metabolic dysfunctions. We aim to assess the therapeutic impacts of roots or leaf extract from Urtica dioica (UD; stinging nettle) against scopolamine (SCOP)-induced memory dysfunction, amnesia, and oxidative stress in rats. Spatial memory was assessed by Y maze test. Tissue analyses of norepinephrine (NE), dopamine (DA), serotonin (5-HT), malondialdehyde (MDA), nitric oxide (NO), glutathione (GSH, GSSG), AMP, ADP, and ATP were assessed by HPLC. mRNA levels of Tau and Hsp70 were estimated by PCR. UD extracts particularly nettle root (NR) significantly normalized the SCOP-induced memory deficits even more potent than sermion (SR) and donepezil (DON). Similarly, NR had potent therapeutic impacts on the levels of cortical and hippocampal monoamines e.g. DA, NE, and 5-HT. SCOP induced a dramatic oxidative stress as measured by MDA, NO, and GSSG levels; however, UD extracts showed significant anti-oxidative stress impacts. Additionally, UD extracts restored ATP levels and reduced the levels of AMP and ADP compared to SCOP-treated rats. Furthermore, cortical Tau and hippocampal Hsp70 were modulated by UD extracts particularly NR compared to the SCOP group. In conclusion, UD extracts particularly roots have potential therapeutic impacts against SCOP-induced neuroinflammatory and/or Alzheimer-like phenotype in rats.
Objectives To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Reg... more Objectives To report the burden of cardiovascular diseases (CVD) in the Eastern Mediterranean Region (EMR) during 1990–2015. Methods We used the 2015 Global Burden of Disease study for estimates of mortality and disability-adjusted life years (DALYs) of different CVD in 22 countries of EMR. Results A total of 1.4 million CVD deaths (95% UI: 1.3–1.5) occurred in 2015 in the EMR, with the highest number of deaths in Pakistan (465,116) and the lowest number of deaths in Qatar (723). The age-standardized DALY rate per 100,000 decreased from 10,080 in 1990 to 8606 in 2015 (14.6% decrease). Afghanistan had the highest age-standardized DALY rate of CVD in both 1990 and 2015. Kuwait and Qatar had the lowest age-standardized DALY rates of CVD in 1990 and 2015, respectively. High blood pressure, high total cholesterol, and high body mass index were the leading risk factors for CVD. Conclusions The age-standardized DALY rates in the EMR are considerably higher than the global average. These fi...
Objectives Assessing the burden of maternal mortality is important for tracking progress and iden... more Objectives Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. Methods We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. Results The maternal mortality ratio in the EMR decreased 16.3% from 283 (241–328) maternal deaths per 100,000 live births in 1990 to 237 (188–293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Conclusion Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are availab...
Objectives We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burde... more Objectives We used data from the Global Burden of Disease 2015 study (GBD) to calculate the burden of lower respiratory infections (LRIs) in the 22 countries of the Eastern Mediterranean Region (EMR) from 1990 to 2015. Methods We conducted a systematic analysis of mortality and morbidity data for LRI and its specific etiologic factors, including pneumococcus, Haemophilus influenzae type b, Respiratory syncytial virus, and influenza virus. We used modeling methods to estimate incidence, deaths, and disability-adjusted life-years (DALYs). We calculated burden attributable to known risk factors for LRI. Results In 2015, LRIs were the fourth-leading cause of DALYs, causing 11,098,243 (95% UI 9,857,095–12,396,566) DALYs and 191,114 (95% UI 170,934–210,705) deaths. The LRI DALY rates were higher than global estimates in 2015. The highest and lowest age-standardized rates of DALYs were observed in Somalia and Lebanon, respectively. Undernutrition in childhood and ambient particulate matter...
Objectives We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern... more Objectives We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern Mediterranean Region (EMR) between 1990 and 2015. Methods The Global Burden of Disease (GBD) study defines intentional injuries as a combination of self-harm (including suicide), interpersonal violence, collective violence (war), and legal intervention. We estimated number of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for each type of intentional injuries. Results In 2015, 28,695 individuals (95% UI: 25,474–37,832) died from self-harm, 35,626 (95% UI: 20,947–41,857) from interpersonal violence, and 143,858 (95% UI: 63,554–223,092) from collective violence and legal interventions. In 2015, collective violence and legal intervention was the fifth-leading cause of DALYs in the EMR and the leading cause in Syria, Yemen, Iraq, Afghanistan, and Libya; they account for 49.7% of total DALYs in Syria. Conclusions Our findings...
Objectives To estimate incidence, mortality, and disability- adjusted life years (DALYs) caused b... more Objectives To estimate incidence, mortality, and disability- adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer preventi...
The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including ... more The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders ...
Diarrheal diseases (DDs) are leading causes of disease burden and death and disability, especiall... more Diarrheal diseases (DDs) are leading causes of disease burden and death and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For box sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs a...
Background Oesophageal cancer is a common and often fatal cancer that has two main histological s... more Background Oesophageal cancer is a common and often fatal cancer that has two main histological subtypes: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Updated statistics on the incidence and mortality of oesophageal cancer, and on the disability-adjusted life-years (DALYs) caused by the disease, can assist policy makers in allocating resources for prevention, treatment, and care of oesophageal cancer. We report the latest estimates of these statistics for 195 countries and territories between 1990 and 2017, by age, sex, and Socio-demographic Index (SDI), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD). Methods We used data from vital registration systems, vital registration-samples, verbal autopsy records, and cancer registries, combined with relevant modelling, to estimate the mortality, incidence, and burden of oesophageal cancer from 1990 to 2017. Mortality-to-incidence ratios (MIRs) were estimated and fed into a Cause of Death Ensemble model (CODEm) including risk factors. MIRs were used for mortality and non-fatal modelling. Estimates of DALYs attributable to the main risk factors of oesophageal cancer available in GBD were also calculated. The proportion of oesophageal squamous cell carcinoma to all oesophageal cancers was extracted by use of publicly available data, and its variation was examined against SDI, the Healthcare Access and Quality (HAQ) Index, and available risk factors in GBD that are specific for oesophageal squamous cell carcinoma (eg, unimproved water source and indoor air pollution) and for oesophageal adenocarcinoma (gastro-oesophageal reflux disease). Findings There were 473 000 (95% uncertainty interval [95% UI] 459 000-485 000) new cases of oesophageal cancer and 436 000 (425 000-448 000) deaths due to oesophageal cancer in 2017. Age-standardised incidence was 5•9 (5•7-6•1) per 100 000 population and age-standardised mortality was 5•5 (5•3-5•6) per 100 000. Oesophageal cancer caused 9•78 million (9•53-10•03) DALYs, with an age-standardised rate of 120 (117-123) per 100 000 population. Between 1990 and 2017, age-standardised incidence decreased by 22•0% (18•6-25•2), mortality decreased by 29•0% (25•8-32•0), and DALYs decreased by 33•4% (30•4-36•1) globally. However, as a result of population growth and ageing, the total number of new cases increased by 52•3% (45•9-58•9), from 310 000 (300 000-322 000) to 473 000 (459 000-485 000); the number of deaths increased by 40•0% (34•1-46•3), from 311 000 (301 000-323 000) to 436 000 (425 000-448 000); and total DALYs increased by 27•4% (22•1-33•1), from 7•68 million (7•42-7•97) to 9•78 million (9•53-10•03). At the national level, China had the highest number of incident cases (235 000 [223 000-246 000]), deaths (213 000 [203 000-223 000]), and DALYs (4•46 million [4•25-4•69]) in 2017. The highest national-level agestandardised incidence rates in 2017 were observed in Malawi (23•0 [19•4-26•5] per 100 000 population) and Mongolia (18•5 [16•4-20•8] per 100 000). In 2017, age-standardised incidence was 2•7 times higher, mortality 2•9 times higher, and DALYs 3•0 times higher in males than in females. In 2017, a substantial proportion of oesophageal cancer DALYs were attributable to known risk factors: tobacco smoking (39•0% [35•5-42•2]), alcohol consumption (33•8% [27•3-39•9]), high BMI (19•5% [6•3-36•0]), a diet low in fruits (19•1% [4•2-34•6]), and use of chewing tobacco (7•5% [5•2-9•6]). Countries with a low SDI and HAQ Index and high levels of indoor air pollution had a higher proportion of oesophageal squamous cell carcinoma to all oesophageal cancer cases than did countries with a high SDI and HAQ Index and with low levels of indoor air pollution. Interpretation Despite reductions in age-standardised incidence and mortality rates, oesophageal cancer remains a major cause of cancer mortality and burden across the world. Oesophageal cancer is a highly fatal disease, requiring increased primary prevention efforts and, possibly, screening in some high-risk areas. Substantial variation exists in age-standardised incidence rates across regions and countries, for reasons that are unclear. Funding Bill & Melinda Gates Foundation.
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Papers by Nahla Anber