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Feasibility and reliability of the revised Edmonton Symptom Assessment System(ESAS-r)in Egyptian patients with advanced cancer:A single institutional experience

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Oncology and Translational medicine 2016年第2期2卷 132-137页

作者： Dina A.Salem azza m.adel Ahmed E.Essa mohamed O Alorabi Zeinab m.Elsayed Department of Clinical Oncology Ain Shams University HospitalsCairoEgypt

Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the revised Edmonton Symptom AssesSment System （ESAS-r） among Egyptian patients with advanced cancer and to compare the rates of symptoms documented by patients and physicians. methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was completed twice, first by the treating physician （as part of the basic assessment） and a second time by the patient, with a maximum of 2 hours between the two assessments. An additional survey was included to assess patients＇ acceptance of the survey and their preferences. Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and 10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved for 119 patients who were included for further analyses. The 78 （65%） patients declared that the test was clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients and physicians. Tiredness was the only symptom showing a significant difference between the two rating methods, patient-rated scores being higher （P = 0.032）. Cronbach＇s alpha showed that both tests com- pleted by the physician and the patients were internally consistent： the physician-rated test had a coefficient of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consis- tency, with a Cmnbach＇s alpha coefficient of 0.88. The internal consistency remained high after removal of individual symptom scores, with Cronbach＇s alpha coefficients ranging from 0.823 to 0.902, indicating that no individual question had undue influence on the total ESAS score. Conclusion The ESAS-r

关键词： advanced cancer palliative care Egypt Edmonton Symptom Assessment System (ESAS)

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Clinicopathological Data of Breast Cancer in Diabetic Patients

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Journal of Cancer Therapy 2021年第12期12卷 663-673页

作者： azza m. adel Department of Clinical Oncology Faculty of Medicine Ain Shams University Cairo Egypt

Background: Diabetes mellitus and breast cancer are both chronic diseases. Breast cancer in patients with diabetes is often diagnosed at an advanced stage and has worse prognosis. Aim of work: To investigate the clinicopathological factors, hormonal receptor status and molecular subtypes of breast cancer in diabetic breast cancer patients. Patients and methods: Records of patients presenting to the radiotherapy committee of the breast cancer clinic of Ain Shams University Hospital in the period between January 2017 and January 2018 were revised regarding age, presence of diabetes, presence of comorbidities, and type of the surgery performed. Pathological data such as: Tumor size (T), LN staging (LN), ER, PR, Her2/neu and Ki67 status were also recorded. Patients were divided into 2 groups: Group (I): those with diabetes and Group (II): those without diabetes. Inclusion criteria were Breast cancer cases with proven pathological diagnosis, available IHC studies, clear record of comorbidity status, age > 18 years, cases who underwent upfront surgery. Exclusion criteria were metastatic cases, bilateral cases, cases with double primary, male breast cancer cases, and those with missing data for ER, PR and Her2/neu. Results:mily:Verdana;"> Retrieving

关键词： Breast Cancer Diabetes Clinicopathological molecular Subtypes Running Head: Diabetes in Breast Cancer Patients

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Correlation between Cancer Breast Subtypes and Age at Presentation in Egyptian Patients;Single Institution Experience

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Journal of Cancer Therapy 2020年第1期11卷 26-34页

作者： azza m. adel Dalia Abdelghani Department of Clinical Oncology Faculty of Medicine Ain Shams University Cairo Egypt

Background: Breast cancer is defined according to molecular subtypes. Each molecular subtype defines different disease behavior and requires different treatment. The different molecular subtypes have different risk factors and different distribution across age classes. Aim of the study: To detect the incidence of cancer breast subtypes by age among Egyptian patients treated at the Clinical Oncology Department, Faculty of medicine, Ain Shams University, in the period between April 2016 and December 2018. Patients and methods: Inclusion criteria: Cases with proven pathological diagnosis and underwent IHC studies for the molecular subtype while exclusion criteria were: Bilateral cases, cases with unknown molecular subtype or age at presentation, cases with multiple primaries, cases with in situ cancer, male breast cancer cases, and cases diagnosed during pregnancy. Age classes were computed in four groups: from 20 - 35, >35 - 50, >50 - 65 and those older than 65 years of age. Immunohistochemical studies were done;ER, PR and HER2 were recorded for each case, molecular subtypes were defined as follows: HR+/HER2-, HR+/HER2+, HER2 overexpressed (HER2 positive, HR-) and Triple Negative Breast Cancer;TNBC (HER2 negative, ER negative and PR negative). Results: one thousand and two cases were included in the study. The median age was 51 years and the mean age was 51.64 ± 11.74, with range from 24 to 85 years. The total number of ER positive patients was 706 patients (70.5%), the total number of PR positive patients was 667 (66.6%), and the total number of Her2 positive patients was 286 patients (28.5%). While there were no statistically significant differences in the incidence of ER and PR positivity among all age classes, Her2 over expression decreased with age and the difference was statistically significant (P-value: 0.012). Her2 overexpression subtype incidence decreased by age and it was highest in the younger age group 17.6% compared to 8.2% in the older age group and th

关键词： Breast Cancer molecular Subtypes Egyptian Age

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Obesity in Terms of BmI and BSA in Egyptian Breast Cancer Patients: Can Tumor Behavior Be Predicted?

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Journal of Cancer Therapy 2022年第6期13卷 337-352页

作者： azza m. adel Khalid N. Abdelhakam Dalia Abdelghany Department of Clinical Oncology Nuclear Medicine Faculty of Medicine Ain Shams University Hospitals Cairo Egypt

Background: Obesity is a major health problem worldwide and is involved in etiology of breast cancer. Egypt is ranked among the highest globally in obesity problem. Body mass index (BmI) is the most widely used tool to define obesity. Body surface area (BSA) is another measure used widely in clinical practice, particularly in calculating doses of chemotherapeutic agents. Both Body Surface Area (BSA) and Body mass Index (BmI) rely on weight and height and can be used as indicators of obesity. Patients and methods: This is a cross-sectional observational study that was carried out in the department of clinical oncology, Faculty of medicine, Ain Shams University Hospitals. medical records of patients scheduled for adjuvant chemotherapy were revised regarding age, comorbidity, side of the tumor, stage, and type of the surgery performed. Immunohistochemistry (IHC) to detect ER, PR, and Her2 and molecular subtypes of the tumors was recorded. BmI and BSA were calculated for all patients. Inclusion Criteria: Female patients with newly diagnosed breast cancer, cases that didn’t start the adjuvant treatment, data for IHC available, weight, and height of the patients recorded in the files. Exclusion Criteria: male breast cancer cases, bilateral cases, metastatic cases, age above 80 years, cases with multiple primaries. Results: The mean age of patients was 48 ± 11 years and 60% of them were premenopausal. The mean weight in Kgs was 81 ± 13 and the mean height in cm was 156 cm ± 5. mean BmI was 33.8 ± 6.0 and mean BSA was 1.84 ± 0.15. Comorbidities were present in 10.6% of patients. In the studied group of patients, tumors were more common of right side (55.7%), T2 tumor (40%), N1 (40.9%), and stage III in 57.4%. Regarding the hormonal receptor status, most of the patients were ER+ (76.5%), PR+ (66.1%) and Her2? (73.9%). The molecular subtypes were also estimated with HR+ subtype most common in (60%) and Her2+ subtype least common in (10.4%). Neither BmI nor BSA was different b

关键词： BmI BSA Cancer Breast ROC

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Vibrational, rotational, and triaxiality features in extended O(6) dynamical symmetry of IBm using three-body interactions

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Nuclear Science and Techniques 2020年第5期31卷 44-56页

作者： A.m.Khalaf azza O.El-Shal m.m.Taha m.A.El-Sayed Physics Department Faculty of ScienceAl-Azhar UniversityCairoEgypt mathematics and Theoretical Physics Department Nuclear Research CenterAtomic Energy AuthorityCairo 13759Egypt

The shape transition between the vibrational U(5)and deformed c-unstable O(6)dynamical symmetries of sd interacting boson model has been investigated by considering a modified O(6)Hamiltonian,providing that the coefficients of the Casimir operator of O(5)are N-dependent,where N is the total number of *** modified O(6)Hamiltonian does not contain the number operator of the d boson,which is responsible for the vibrational *** addition,the deformation features can be achieved without using the SU(3)limit by adding to the O(6)dynamical symmetry the three-body interaction[QQQ]^(0),where Q is the O(6)symmetric quadrupole ***,triaxiality can be generated through the inclusion of the cubic d-boson interaction[d+d+d+]^(3)·∣ddd∣^(3).The classical limit of the potential energy surface(PES),which represents the expected value of the total Hamiltonian in a coherent state,is studied and *** modified O(6)model is applied to the even–even^124-132 Xe *** parameters for the Hamiltonian and the PESs are calculated using a simulated search program to obtain the minimum root mean square deviation between the calculated and experimental excitation energies and B(E2)values for a number of low-lying levels.A good agreement between the calculations and experiment results is found.

关键词： Nuclear structure Extended O(6)of IBm Three-body interactions Coherent state

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Fixed Dose Rate versus Standard Dose Rate Infusion of Gemcitabine and Cisplatin in Advanced Stage Non-Small Cell Lung Cancer

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Journal of Cancer Therapy 2015年第1期6卷 45-52页

作者： Dina A. Salem Dina R. Ibrahim Ahmed Ezzat azza m. adel Department of Clinical Oncology and Nuclear medicine Faculty of Medicine Ain-Shams University Cairo Egypt

Background: Comparing the efficacy and safety of gemcitabine at a fixed-dose rate (FDR) infusion (10 mg/m2/min) with the standard dose rate infusion in patients with locally advanced and metastatic non-small squamous cell carcinoma (NSCLC). methods: The study randomized 60 patients with confirmed diagnosis of NSCLC to receive gemcitabine at a dose of 1000 mg/m2 on days 1 and 8 given as a 30-min infusion (Arm A) or at a rate of 10 mg/m2/min (Arm B). Cisplatin 75 mg/m2 was administered intravenously on day 2 in both arms. Results: No difference in overall response rate (46.6% versus 43.3%). median time to progression for Arm A was 7 months (95% CI, 6.207 - 7.793 months), versus 6 months for Arm B (95% CI, 4.990 - 7.010 months). median survival time was comparable [12 months (95% CI, 8.588 - 15.412 months) versus 11 months (95% CI, 9.066 - 12.934 months)] respectively. Two-year survival (18% versus 11%, p = 0.38) was detected. No treatment related deaths occurred. main hematological toxicities were grade I and II neutropenia, in 36.7% and 53.3% respectively (p = 0.044). Grade III anemia was observed in 10% and 6.7% in both arms respectively (p = 0.024). Grade I and II nausea and vomiting was observed in 50% and 46.7%. Conclusions: FDR gemcitabine in combination with cisplatin had equivalent efficacy and more severe hematologic toxicities compared to the standard 30-min gemcitabine infusion with cisplatin in patients with advanced NSCLC.

关键词： Non-Small Cell Lung Cancer Gemcitabine Fixed-Dose Rate Toxicities

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Vitamin D status and viral response to therapy in hepatitis C infected children

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World Journal of Gastroenterology 2015年第4期21卷 1284-1291页

作者： azza A Eltayeb madleen adel A Abdou Amal m Abdel-aal mostafa H Othman Children University Hospital Assiut University71515 AssiutEgypt Assiut University Hospital 71515 AssiutEgypt Department of Radiology Assiut University hospital71515 AssiutEgypt

AIm: To study the frequency of vitamin D deficiency in patients with hepatitis C virus(HCV) infection and to evaluate the role of vitamin D supplementation in improving antiviral ***: Sixty-six children aged from 7-14 years(mean ± SD, 11.17 ± 2.293) diagnosed with HCV infection were matched to 28 healthy controls. Serum levels of 25(OH) D3, calcium, phosphorus, alkaline phosphatase and plasma level of parathormone were measured. Quantitative PCR for HCV was performed Bone density was determined by dual energy X-ray absorptiometry. All cases received conventional therapy, and only 33 patients received vitamin D ***: Children with HCV showed significantly increased levels of HCV RNA(P mone(P min D levels(P mpared with controls. Abnormal bone status(Z score-1.98 ± 0.75) was found in ribs, L-spine, pelvis and total body. Cases treated with vitamin D showed significant higher early(P min D deficiency among the Egyptian HCV children, with significant decrease in bone density. The vitamin D level should be assessed before the start of antiviral treatment with the correction of any detected deficiency. CONCLUSION: Adding vitamin D to conventional Peg/RBV therapy significantly improved the virological response and helped to prevent the risk of emerging bone fragility.

关键词： Vitamin D Viral response Hepatitis C Children

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Contralateral eye study of refractive,topographic and aberrometric outcomes after femtosecond assisted myo Ring implantation and DALK for management of keratoconus

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International Journal of Ophthalmology(English edition) 2018年第10期11卷 1621-1630页

作者： mohamed Omar Yousif azza mohamed Ahmed Said Department of Ophthalmology Faculty of Medicine Ain Shams University

AIm：To evaluate the efficacy of femtosecond laser assisted myoRing intrastromal corneal implant and deep anterior lamellar keratoplasty （DALK） for management of moderate to advanced keratoconus regarding the degree of changes in visual acuity, refraction, corneal asphericity and ***：A prospective non comparative interventional case study was conducted in Ophthalmology Department,Ain Shams University Hospital in the period from January 2015 to February 2017. The study included 30 eyes of moderate to advanced keratoconus. myoRing was implanted in one eye （Group Ⅰ） and DALK operation was performed in the contralateral eye of the same patient （Group Ⅱ）.Preoperative and 6mo post-operative uncorrected visual acuity（UCVA）, corrected distance visual acuity （CDVA）, spherical equivalent （SE）, corneal and refractive astigmatisms,keratometry and Q-value using topography images were acquired. Quality of vision was assessed in all eyes including total corneal, anterior corneal high order aberrations analysis at 5 mm pupil size and the Strehl ratio of point spread function （PSF） as an objective measure of ***：mean postoperative UCVA, CDVA, SE, refractive astigmatism,keratometryreadingsandasphericity were statistically improved compared to preoperative parameters in both groups （P〈0.05）. Significant reduction of all corneal aberrations following both techniques（P〈0.05） was achieved except mean trefoil and mean PSF in Group Ⅰ （P〉0.05）. Postoperative corneal aberrations were significantly lower in Group Ⅱ compared to Group Ⅰ.A statistically significant negative correlation was found in Group Ⅰ between the mean change in CDVA （logmAR）and the mean preoperative and mean postoperative total corneal aberrations root mean square （RmS; r=-0.78,P=0.04）. Also a statistically significant negative correlation was found between mean preoperative coma RmS and mean post PSF （r=-0.86, P=0.01）. In Group Ⅱ, there was a statistically significant positive correlation between m

关键词： aberrations deep anterior lamellar keratoplasty femtosecond laser keratoconus myoRing

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Efficacy and Safety of Ombitasvir plus Paritaprevir,Ritonavir and Ribavirin in Non-cirrhotic Treatment-naive and Treatment-experienced Egyptians with Chronic HCV Genotype-4 Infection

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Current medical Science 2021年第3期41卷 581-586页

作者： manar Ahmed azza E.mansey Engy A.Wahsh Ahmed A.Gomaa Hoda m.Rabea Department of Clinical Pharmacy Faculty of PharmacyBeni Suef UniversityBeni Suef 62521Egypt Department of Clinical Pharmacy Faculty of PharmacyMenoufia UniversityAl Menoufia 32511Egypt Department of Clinical Pharmacy Faculty of PharmacyOctober 6 universityGiza 12573Egypt Department of Tropical medicine Faculty of MedicineFayoum UniversityFayoum 63511Egypt

Hepatitis C virus genotype 4(HCV-GT4)is a risk factor for cirrhosis,hepatocellular carcinoma and liver failure.A combination of three new direct-acting antivirals ombitasvir,paritaprevir,and ritonavir has been recommended for treatment of HCV-GT4 *** current study was aimed to assess the efficacy and safety of this combination plus ribavirin in non-cirrhotic,treatment-naive and-experienced Egyptians with HCV-GT4 infection in a real-world setting.A total of 255 Egyptians with HCV-GT4 infection were enrolled,including 82 treatment-experienced and 173 treatment-naive *** of them completed 12-week treatment protocol of ombitasvir,paritaprevir and ritonavir as an oral dose combination with *** response(VR)was measured,as well as the biochemical parameters related to treatment efficacy and adverse events at baseline and after treatment,at 4(VR4)and 12(VR12)weeks *** results showed that the VR4 rates were 98.8%in both groups,and VR12 rates were 97.7%and 96.3%in treatment-naive and-experienced patients,respectively,with no significant differences found between the groups concerning VR4(P=0.9)and VR 12(P=0.3).The most common adverse events were headache and fatigue,which were significantly more common(P=0.001 and 0.003,respectively)in treatment-experienced than in treatment-naive *** quadruple regimen was well-tolerated,and the reported adverse events were generally mild to *** real-world setting study confirms that the combination of ombitasvir,paritaprevir,ritonavir,and ribavirin is highly effective in the treatment of HCV-GT4 infection with a good safety and tolerability profile.

关键词： hepatitis C virus genotype-4 ombitasvir paritaprevir ribavirin

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Higher Endogenous Erythropoietin Levels in Hemodialysis Patients with Hepatitis C Virus Infection and Effect on Anemia

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Open Journal of Nephrology 2015年第2期5卷 29-34页

作者： Karima Boubaker madiha mahfoudhi Amel Gaieb Battikh azza Bounemra Chokri maktouf adel Kheder Department of Internal medicine A Charles Nicolle Hospital Tunis Tunisia Cellular Immunology Blood Transfusion Center Tunis Tunisia Nuclear medicine and Clinical Research Department Pasteur institute Tunis Tunisia

Study for influence of chronic Hepatitis C (HCV) on endogenous erythropoietin production and on anemia in dialysis patients remains inconclusive. We hypothesize that chronic hemodialysis patients with co-existing Hepatitis C infection will have higher hemoglobin levels than chronic hemodialysis patients without hepatitis C infection. Secondly, we hypothesize that the higher hemoglobin levels will be associated with higher erythropoietin levels. Therefore we conducted a cross-sectional study of chronic hemodialysis patients with and without hepatitis C infection and evaluated associations with hemoglobin and erythropoietin levels. Our primary outcome was level of hemoglobin. Secondary outcome included association of hemoglobin and erythropoietin levels. 57 chronic hemodialysis patients (33 male, 24 female, mean age 46.05 ± 12.7 years) were included. The mean time spent on hemodialysis was 7.16 ± 6.2 years. None of the patients received any recombinant EPO therapy. Biochemical analyses include ALT, AST, Albumin, C-Reactive Protein, cholesterol levels and complete blood counts. Iron status of patients (transferrin saturation and serum ferritin levels) and parathyroid hormone were measured. Endogenous EPO serum levels were measured by a standardized enzyme-linked immunoassay. 23 of the hemodialysed patients (38.5%) were HCV (+). There was no difference in age, sex, distribution of primary renal diseases, iron status, albumin, C-Reactive-Protein and parathyroid hormone levels between HCV (+) and (-) patients. mean duration time on dialysis was higher in HCV (+) than HCV (-) patients. Hemoglobin levels were similar between study groups. However serum endogenous erythropoietin levels were significantly higher in HCV (+) patients than HCV (-) patients (19.6 ± 10 mUI/ml vs 7.8 ± 7.7 mUI/ml, p = 0.03). No correlation has been found between the severity of anemia and HCV infection. However, HCV (+) hemodialysed patients had higher serum endogenous erythropoietin levels as comp

关键词： Anemia Hepatitis C Hemodialysis Erythropoietin

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