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Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

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World Journal of Methodology 2024年第2期14卷 1-16页

作者： Rabea Ahmed Gadelkareem amr mostafa Abdelgawad Nasreldin Mohammed Mohammed Ali Zarzour Mahmoud Khalil Ahmed Reda Hisham Mokhtar Hammouda Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal ***,this health service is not available to all patients,especially in developing *** deceased donor KT programs are mostly absent,and the living donor KT centers are ***-center studies presenting experiences from developing countries usually report a variety of *** review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing *** financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical *** sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up *** interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT *** medical literacy about KT advantages is prevalent among clinicians,patients,and the *** inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT *** challenges resulted in noticeable differences between KT services in developed and developing *** coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT *** latter warrants the expansion of the public sector and the elimination of non-ethical KT *** second mechanism is recru

关键词： Challenges Coping strategies Developing countries Kidney transplantation Low resources Single-center

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Simultaneous kidney transplantation and ipsilateral native nephrectomy in patients with autosomal dominant polycystic kidney disease

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World Journal of Transplantation 2022年第9期12卷 310-312页

作者： Rabea Ahmed Gadelkareem amr mostafa Abdelgawad Nasreldin Mohammed Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

The simultaneous kidney transplantation and ipsilateral native nephrectomy for autosomal dominant polycystic kidney disease does not seem to be associated with increased rates of comorbidity and *** outcome can effici... 详细信息

关键词： Autosomal dominant polycystic kidney disease Kidney transplantation Native nephrectomy Retroperitoneal approach Surgical complications

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Reasons and effects of the decline of willing related potential living kidney donors

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World Journal of Transplantation 2023年第5期13卷 276-289页

作者： Rabea Ahmed Gadelkareem amr mostafa Abdelgawad Nasreldin Mohammed Ahmed Reda Nashwa mostafa Azoz Mohammed Ali Zarzour Hisham Mokhtar Hammouda Mahmoud Khalil Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Internal Medicine-Nephrology Unit Assiut University HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

BACKGROUND Although the availability of related living donors(LDs)provides a better chance for receiving kidney transplantation(KT),the evaluation protocols for LD selection remain a safeguard for the LD’s *** protocols are variable from one center to another,resulting in variable rates of decline of the potential LDs(PLDs).The decline of willing PLDs may occur at any stage of evaluation,starting from the initial contact and counseling to the day of *** To identify the causes of the decline of PLDs,the predictors of PLD candidacy,and the effect on achieving *** A retrospective study was performed on the willing PLDs who attended our outpatient clinic for kidney donation to their related potential recipients between October 2015 and December *** variables influencing their candidacy rate and the fate of their potential recipients were *** groups of PLDs were compared:Candidate PLDs after a completed evaluation vs non-candidate PLDs with a complete or incomplete evaluation.A multivariate logistic regression was performed to assess the factors contributing to the achievement of PLD *** Of 321 willing PLDs,257 PLDs(80.1%)accessed the evaluation to variable extents for 212 potential recipients,with a mean age(range)of 40.5±10.4(18-65)years,including 169 females(65.8%).The remaining 64 PLDs(19.9%)did not access the *** 58 PLDs(18.1%)succeeded in donating,but 199 PDLs(62.0%)were declined;exclusion occurred in 144 PLDs(56.0%)for immunological causes(37.5%),medical causes(54.9%),combined causes(9.7%),and financial causes(2.1%).Regression and release occurred in 55 PLDs(17.1%).The potential recipients with candidate PLDs were not significantly different from those with non-candidate PLDs,except in age(P=0.041),rates of completed evaluation,and exclusion of PLDs(P<0.001).There were no factors that independently influenced the rate of PLD *** patients who failed to have KT after the decline of their P

关键词： Donor decline Donor evaluation Donor exclusion Kidney transplantation Living kidney donors Related living donors

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Preemptive living donor kidney transplantation:Access,fate,and review of the status in

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World Journal of Nephrology 2023年第3期12卷 40-55页

作者： Rabea Ahmed Gadelkareem amr mostafa Abdelgawad Ahmed Reda Nashwa mostafa Azoz Mohammed Ali Zarzour Nasreldin Mohammed Hisham Mokhtar Hammouda Mahmoud Khalil Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Internal Medicine Assiut University HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

BACKGROUND Preemptive living donor kidney transplantation(PLDKT)is recommended as the optimal treatment for end-stage renal *** To assess the rate of PLDKT among patients who accessed KT in our center and review the status of PLDKT in *** We performed a retrospective review of the patients who accessed KT in our center from November 2015 to November *** addition,the PLDKT status in Egypt was reviewed relative to the *** Of the 304 patients who accessed KT,32 patients(10.5%)had preemptive access to KT(PAKT).The means of age and estimated glomerular filtration rate were 31.7±13 years and 12.8±3.5 mL/min/1.73 m2,***-nine patients had KT,including 3 PLDKTs only(5.1%of total KTs and 9.4%of PAKT).Twenty-nine patients(90.6%)failed to receive PLDKT due to donor unavailability(25%),exclusion(28.6%),regression from donation(3.6%),and patient regression on starting dialysis(39.3%).In multivariate analysis,known primary kidney disease(P=0.002),patient age(P=0.031)and sex(P=0.001)were independent predictors of achievement of KT in our ***,PAKT was not significantly(P=0.065)associated with the achievement of *** of the literature revealed lower rates of PLDKT in Egypt than those in the *** Patient age,sex,and primary kidney disease are independent predictors of achieving living donor *** its non-significant effect,PAKT may enhance the low rates of *** main causes of non-achievement of PLDKT were patient regression on starting regular dialysis and donor unavailability or exclusion.

关键词： Access to kidney transplantation Donor regression Kidney transplantation Living donors Preemptive kidney transplantation Transplantation

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Chiari Malformation Type 1 in Adults Managed by Surgical Decompression: New Prospective

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Open Journal of Modern Neurosurgery 2020年第3期10卷 382-391页

作者： amr Abdelmonam mostafa Elkatatny Mohamed H. Aly Department of Neurosurgery Faculty of Medicine Cairo University Giza Egypt

Aim of the work: This study aims to assess the value of the surgical management in the improvement of the symptoms & signs of patients with Chiari malformation type 1 and radiological follow up in adults. Patients and methods: This study included 30 consecutive patients with Chiari malformation type I who were indicated for surgery at neurosurgery department. Data were collected prospectively from the involved patients who were evaluated preoperatively and underwent evaluation by CT scanning of the brain & skull and MRI imaging of the brain and spine. CT and MRI were done as the routine follow up investigations for all patients. We operated through midline suboccipital craniectomy, durotomy in y shaped manner, shrinkage of cerebellar tonsils by bipolar electrocautery, duroplasty by fascia lata graft, watertight closure. Results: The assessment from E. J. N. S. (Egyptian Journal of Neurosurgery) vol. 24 no. 2 June 2009 used for evaluating the patients clinically. 18 patients reported good outcome, 6 fair, 6 poor. We evaluated the size of the syrinx if present preoperative in follow up. 15 (50%) patients showed marked reduction (more than or equal to 60%) in size of syrinx, 3 (10%) mild reduction (less than or equal to 30%) in size and 12 (40%) with no change. Conclusion: The Chiari type 1 malformation constitutes a controllable malformation with good outcomes. With current microsurgical techniques, the results of the bony decompression and duroplasty became excellent. Before undergoing surgical treatment for CM-I, symptomatic patients and their families should be given clear information about the success of treatment and potential complications.

关键词： Chiari Malformation Type 1 Hydrocephalus Posterior Fossa Decompression Duroplasty Water Tight Closure Fascia Lata

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Predictive Factors of Successful Treatment of Gestational Diabetes with Metformin Monotherapy

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Open Journal of Obstetrics and Gynecology 2020年第8期10卷 1036-1044页

作者： amr mostafa Kamel Aboelfath Mustafa Taha Abdelfattah Sharaf El din Gynecology & Obstetrics Department Faculty of Medicine Zagazig University Zagazig Egypt

Objective: To evaluate the factors affecting the success of metformin in management of GDM. Methods: A prospective cohort study was done for 94 patients diagnosed with GDM from April 2019 to March 2020 who needed pharmacological treatments in addition to diet and lifestyle modification. Cases treated with metformin monotherapy were compared with others who needed insulin in addition to metformin for glycemic control. Patient characteristics, glycemic control data and neonatal outcome were evaluated. Univariate and multivariate analysis was done to find the independent factors affecting the success of metformin. Results: Of 94 patients with GDM who needed pharmacological treatment, 73 (77.6%) used only metformin for treatment of GDM and 21 (22.4%) needed insulin to be added to metformin. Multivariate analysis revealed that BMI was the only significant factor that affects the success of metformin alone in control of GDM (p = 0.03). ROC curve of BMI showed that the cut off value of the highest sensitivity is 32.1 above which metformin monotherapy failed to control GDM. Conclusion: Metformin can be considered as a safe and effective drug for treatment of GDM. Obesity was found as a predictive factor for failure of metformin monotherapy.

关键词： Gestational Diabetes Metformin Insulin

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Standardization of meibomian gland dysfunction in an Egyptian population sample using a non-contact meibography technique

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 61-65页

作者： Ahmed Mohamed Karara Zeinab El-Sanabary mostafa Ali El-Helw Tamer Ahmed Macky Mohamad amr Salah Eddin Abdelhakim Department of Ophthalmology Kasr Al-Ainy HospitalCairo UniversityCairo 11431Egypt

AIM:To develop normative data for meibomian gland dysfunction(MGD)parameters,using non-contact meibography technique of Sirius Costruzione Strumenti Oftalmici(CSO)machine,in an Egyptian population ***:Observational,cross-sectional,analytic study,in which 104 Egyptian volunteers were *** upper lids were examined,using“Sirius CSO”*** eyelid was given a degree of meibomian gland loss(MGL),which was calculated by the software of the ***:Mean percentage MGL in right upper lid was of 30.9%±12.6%,and that of left upper lid was 32.6%±11.8%.Thirty-four volunteers(32.7%)had first-degree MGL in their right upper lid,and 67.3%had second-degree *** volunteer(1%)had zero-degree MGL in left upper lid,28(26.9%)had first-degree loss,and 75(72.1%)had second-degree *** of MGL in right upper eyelid was not related to age,but degree of MGL in left upper eyelid increased with *** was statistically significant difference between both genders for degree of MGL in right eye(P=0.036)and in left eye(P=0.027).CONCLUSION:Noncontact meibography is a useful non-invasive tool for diagnosing *** is diagnosed in 100%of apparently normal individuals;26.9%-32.7%of which have first-degree MGL,and 67.3%-72.1%have second-degree MGL.

关键词： Egyptian population meibomian gland dysfunction non-contact meibography standardization upper lid

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New Antenna Array Beamforming Techniques Based on Hybrid Convolution/Genetic Algorithm for 5G and Beyond Communications

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Computer Modeling in Engineering & Sciences 2024年第3期138卷 2749-2767页

作者： Shimaa M.Amer Ashraf A.M.Khalaf amr H.Hussein Salman A.Alqahtani mostafa H.Dahshan Hossam M.Kassem Electronics and Communications Engineering Department Higher Institute of Engineering and TechnologyKafr ElsheikhEgypt Electronics and Electrical Communications Engineering Department Faculty of EngineeringMinia UniversityMiniaEgypt Electronics and Electrical Communications Engineering Department Faculty of EngineeringTanta UniversityTantaEgypt Electronics and Electrical Communications Engineering Department Faculty of EngineeringHorus University EgyptNew DamiettaEgypt Department of Computer Engineering College of computer and Information SciencesKing Saud UniversityRiyadh11543Saudi Arabia School of Computing Mathematics and EngineeringCharles Sturt UniversityBathurstNSW2795Australia

Side lobe level reduction(SLL)of antenna arrays significantly enhances the signal-to-interference ratio and improves the quality of service(QOS)in recent and future wireless communication systems starting from 5G up to ***,it improves the array gain and directivity,increasing the detection range and angular resolution of radar *** study proposes two highly efficient SLL reduction *** techniques are based on the hybridization between either the single convolution or the double convolution algorithms and the genetic algorithm(GA)to develop the Conv/GA andDConv/GA,*** convolution process determines the element’s excitations while the GA optimizes the element *** M elements linear antenna array(LAA),the convolution of the excitation coefficients vector by itself provides a new vector of excitations of length N=(2M−1).This new vector is divided into three different sets of excitations including the odd excitations,even excitations,and middle excitations of lengths M,M−1,andM,*** the same element spacing as the original LAA is used,it is noticed that the odd and even excitations provide a much lower SLL than that of the LAA but with amuch wider half-power beamwidth(HPBW).While the middle excitations give the same HPBWas the original LAA with a relatively higher *** the increased HPBWof the odd and even excitations,the element spacing is optimized using the ***,the synthesized arrays have the same HPBW as the original LAA with a two-fold reduction in the ***,for extreme SLL reduction,the DConv/GA is *** this technique,the same procedure of the aforementioned Conv/GA technique is performed on the resultant even and odd excitation *** provides a relatively wider HPBWthan the original LAA with about quad-fold reduction in the SLL.

关键词： Array synthesis convolution process genetic algorithm(GA) half power beamwidth(HPBW) linear antenna array(LAA) side lobe level(SLL) quality of service(QOS)

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Viable Second Trimester Cervical Ectopic Pregnancy Managed Successfully with Uterine Preservation: Case Report

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Open Journal of Obstetrics and Gynecology 2021年第9期11卷 1236-1247页

作者： Suzan Elsharkawy Abdullah Elrashidy Nazem Badran Gawed Ekbal Shahda Yakob Salamah Elnagar Ashraf Elaggan amr mostafa Mohamed Abdelaziz Assistant Professor of Obstetrics and Gynecology Alexandria University ARE and Consultant of Obstetrics and Gynecology Hail General Hospital Hail KSA Consultant of Urology King Khalid Hospital Hail KSA Consultants of Obstetrics and Gynecology Alkasim Maternity Hospital Alkasim KSA Consultants of Obstetrics and Gynecology Hail General Hospital Hail KSA Consultants of Radiology King Salman Hospital Hail KSA Faculty of Medicine Mansoura University Mansoura Egypt

Cervical pregnancy is a rare clinical entity that accounts for less than 1% of all ectopic pregnancies. It results from implantation of the blastocyst in the cervical canal below the level of the internal os. Although non-tubal ectopic pregnancies account for only 5% of ectopics, they contribute to a significant morbidity. The cornerstone in the management of cervical ectopic is early diagnosis by high index of suspension and a qualified sonographer. Management options for cervical ectopic pregnancies range from conservative drug treatment to radical hysterectomy. Over the last few years, the mortality and morbidity rates of ectopic pregnancies have been reduced. This is mainly due to the early recognition of the condition and the wide availability of minimally invasive surgical procedures. We present a case of a 33-year-old woman that was 16 weeks pregnant. She presented initially with recurrent vaginal bleeding followed by minimal lower abdominal pain. Her early US scans were misleading. Several weeks later, a follow up MRI scan suggested cervical ectopic. She was managed surgically with uterine preservation.

关键词： Ectopic Pregnancy Cervical Ectopic Uterine Artery Embolization Hystroscopic Resection Conservative Management of Ectopic Methotrexate Cervical Tamponade Bakri Balloon Cervical Cerclage

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Viscoelastic potential flow instability theory of Rivlin-Ericksen electrified fluids of cylindrical interface

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Journal of Ocean Engineering and Science 2024年第4期9卷 311-316页

作者： D.M.mostafa Department of Mathematics College of ScienceQassim UniversityPO Box 6644Buraidah 51452Saudi Arabia Department of Mathematics Faculty of EducationAin Shams UniversityRoxyCairoEgypt

A linear electrohydrodynamic Kelvin-Helmholtz instability of the interface between two viscoelastic Rivlin-Ericksen fluids enclosed by two concentric horizontal cylinders has been studied via the viscoelastic potential flow *** dispersion equation of complex coefficients for asymmetric disturbance has been obtained by using normal mode *** stability criteria are analyzed theoretically and illustrated *** imaginary part of growth rate is plotted versus the wave *** influences of dynamic viscoelastic,uniform velocities,Reynolds number,electric field,dynamic viscosity,density fluids ratio,dielectric constant ratio and inner fluid fraction on the stability of the system are *** study finds its significance in Ocean pipelines to transfer oil or gas such as Eastern Siberia-Pacific Ocean oil pipeline.

关键词： Rivlin-Ericksen fluid Cylindrical flow Viscoelastic potential flow Electrohydrodynamics stability

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