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Neuroscience & Medicine 2014年第5期5卷 201-204页

作者： Mohamed Hamdy Ibrahim taha kamel alloush Mohamed Khalid Abdul Rahim Neurology Department Faculty of Medicine Ain Shams University Cairo Egypt Internal Medicine Department Gulf Medical University Ajman United Arab of Emirates

Objectives: To study the prevalence of vitamin D deficiency among newly diagnosed multiple sclerosis patients. Patients and Methods: It is a case control cross matching age related study done on totally 40 subjects (20 patients are newly diagnosed as MS;patients don’t start any medication for MS (naive patients) and 20 subjects are controls with the same age and sex). Base line vitamin D level was measured (i.e. vitamin D, 25-OH (total)) and MRI brain with contrast was done for all patients. Results: Low total vitamin D level was seen among 65% of patients with MS (13/20);however, this was only 20% of normal controls (4/20). Conclusion: Hypovitaminosis D is common in MS patients.

关键词： Low Vitamin D Multiple Sclerosis

Neutrophil to Lymphocyte Ratio in Acute Ischemic Stroke

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Neuroscience & Medicine 2020年第2期11卷 52-62页

作者： Menat-Allah Mohamed Lashin Salma Hamed Khalil taha kamel alloush Sherif Anis Mohamed Mahmoud Fouad Department of Neurology Faculty of Medicine Ain Shams University Cairo Egypt Department of Anesthesia Faculty of Medicine Ain Shams University Cairo Egypt

Introduction: The neutrophil to lymphocyte ratio (NLR) can be used as a marker of subclinical inflammation, and may have a predictive power in prognosis and severity of atherosclerosis-related diseases. This study aimed to assess an association between the NLR, and clinical characteristics and one-month outcome in acute ischemic stroke (AIS). Subjects and Methods: This case-control observational prospective study included 75 patients admitted to stroke unit of Ain Shams University hospitals with AIS, sub grouped into 3 equal groups according to subtype of AIS, in addition to 25 healthy individuals. The demographic characteristics of the patients, complete blood picture test results at presentation, National Institutes of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores were recorded. The clinical outcome was assessed by the NIHSS and mRS scores after one month. Results: The total leucocyte count was significantly higher in large artery atherosclerosis (P = 0.004) and cardioembolic (P = 0.020) stroke groups, unlike lacunar stroke group (P = 0.082), when compared to controls. The neutrophils count was higher (P Conclusion: NLR was significantly higher among AIS subtypes compared to controls, but not a good predictor for one month outcome.

关键词： Neutrophil to Lymphocyte Ratio Acute Ischemic Stroke

Volumetric Assessment of Corticospinal Tract Infiltration by Astrocytoma Using Diffusion Tensor Tractography

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Open Journal of Medical Imaging 2014年第2期4卷 65-71页

作者： Marwa Adel Shaaban taha kamel alloush Mohamed Hamdy Ibrahim Ahmed Abd el bar Sherif Hashim Morad Department of Neurology Ain Shams University Cairo Egypt Department of Neurosurgery Ain Shams University Cairo Egypt Department of Radiology Misr University for Science and Technology Cairo Egypt

Objectives: The aim of the study is to assess volumetric Corticospinal Tract infiltration by Astro-cytoma using Diffusion Tensor Tractography. Material and Methods: Preoperative, anatomic (T1- and T2-weighted) and diffusion tensor MRI were performed in 9 patients with supratentorial gliomas (WHO grade II and III). The tumors were manually segmented from the T1- and T2-weighted MRI, and their volume calculated. A three-dimensional tractography was performed in each case. A second segmentation and volume measurement was performed on the tumor regions intersecting adjacent white matter fiber tracts. Results: We identified that white matter tracts were infiltrated by 6 Astrocytoma tumors. The median tumor volume (±standard deviation) in our patient population was 33 ± 26.82 ml. The median tumor volume (±standard deviation) infiltrating white matter fiber tracts was 4.15 ± 9.23 ml. The median fraction of tumor volume infiltrating white matter fiber tracts was 26.3% ± 10.1%. Conclusions: Diffusion tensor MR Tractography is a reliable preoperative assessment tool since it detects extensive white matter infiltration by Astrocytoma irrespective of brain tumors volume. Recommendations: Prospective large population studies are required to clarify how infiltration relates to tumor location.

关键词： Tractography Astrocytoma Brain Tumor Corticospinal Tract Infiltration

Silent Cerebral Infarctions in Type II Diabetes Mellitus Patients;Could Brain MRI Be a Routine Investigation?

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Open Journal of Medical Imaging 2014年第3期4卷 112-116页

作者： Mohamed Hamdy Ibrahim taha kamel alloush Marwa Adel Shaaban Mohammed Khalid Abdul Rahim Mohammad Ahmad M. Saad Internal Medicine Department Gulf Medical University Ajman UAE Neurology Department Faculty of medicine Ain shams University Cairo Egypt Radiology Department Fayoom University Fayoom Egypt Radiology Department Misr University for Science and Technology Cairo Egypt

Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. Patients were type II diabetics as described by the American Diabetes Association, 2011 criteria. All patients underwent full metabolic profiles to diagnose diabetes mellitus and MRI brain scans to detect cerebral infarction. Results: Silent cerebral infarctions were detected in 60% of patients (48/80 patients) predominately along periventricular white matter area and subcortical areas (Basal ganglia, Thalamus). Conclusion: Asymptomatic Type II diabetes mellitus patients could have vascular cerebral changes without neurological symptoms. MRI brain scans could be recommended as routine diagnosis (if possible) for early cerebral infarct detection in type II diabetic patients.

关键词： Prevalence Silent Brain Infarction Diabetes Mellitus

Effect of Atrial Fibrillation on Acute Ischemic Stroke Severity

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Open Journal of Medical Imaging 2014年第2期4卷 95-101页

作者： taha kamel alloush Mahmoud Haroun Ibrahim Nahed Salah El Dein Ahmed Ibrahim Ghada Samir El-Shahed Lobna Mohamed Nabil El-Sayed Mohamed Hamdy Ibrahim Hosam Ahmed Azmy Faculty of Medicine Ain Shams University Cairo Egypt Ministry of Health Cairo Egypt

Objectives: To assess the impact of atrial fibrillation on stroke severity and short-term (1 month) mortality. Materials and Methods: Totally 200 patients admitted to Ain Shams University Specialized Hospital were recruited and diagnosed clinically to have acute ischemic stroke within 3 days. Patients with hemorrhagic infarctions were excluded. History taking about previous heart disease was taken, full general and neurological examinations were done. Full metabolic profile, full cardiac investigations, carotid duplex, MRI brain stroke protocol with initial clinical evaluation and after 1 month re-evaluation using (NIHSS ) scale. Results: All patients underwent transthoracic echocardiography which revealed absence of “A” wave corresponding to atrial fibrillation in 33 patients (16.5%). Those Patients with atrial fibrillation had a median NIHSS score of 11.00 with IQR of 6.00 - 18.50 at admission and 6.00 with IQR of 2.00 - 14.50 after one month. Patients with atrial fibrillation showed significantly higher NIHSS at admission than patients in sinus rhythm, P < 0.05. Magnetic resonance imaging findings showed that MRA showed significant intracranial vessel stenosis in 117 (79.1%) patients. 51 (34.4%) patients had lacunar infarction, 65 (43.9%) patients had partial anterior circulation infarction, 25 (16.2%) patients had posterior circulation infarction and 7 (4.7%) patients had total anterior circulation infarction. 111 (75%) patients showed leucoaraiosis. Conclusion: Atrial fibrillation was found not to have significantly statistical effect on stroke severity and short term mortality.

关键词： Atrial Fibrillation (AF)

Clinical and Radiological Localization of Language Dysfunctions in Acute Ischemic Stroke

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Open Journal of Medical Imaging 2014年第2期4卷 80-85页

作者： Amira Ahmed Zaki Dwidar taha kamel alloush Mahmoud Youssef Abou El-Ella Nahed Salah El-Din Ahmed Karima Moustafa Maher Maha Ali Mohamed Nada Mohamed Hamdy Ibrahim Faculty of Medicine Ain Shams University Cairo Egypt

Objective: To study the effect of cerebral ischemic vascular insult on the localization of language areas as regard to automatic speech, initiation, and mutism. Materials and Methods: Seventy ischemic stroke patients were selected within the first 48 h of the onset of stroke with left hemispheric stroke with aphasia. Inclusion criteria: any age above seven years, both sexes, first ever clinical stroke, admitted within the first 2 days of stroke insult. Patients underwent careful history taking, neurological examination, routine laboratory investigations, echo cardiography, and carotid duplex and language assessments. Results: Automatic speech disorders were mainly seen along left insular, left supramarginal and left frontal inferior orbital lesions. Initiation difficulty is seen mainly along as left insular, left temporal superior and left periventricular lesions. Mutism is seen along left external capsule, left internal capsule, left pallidum, left frontal inferior orbital and left inferior trigone lesions. Conclusions: Deep periventricular white matter and insular area in the dominant hemisphere play an important role in many language tasks. Thus aphasia is not a mere cortical function.

关键词： Clinicoradiological Localization Aphasia Stroke White Matter Perventricular

Effect of Heart Failure on Acute Ischemic Stroke Severity

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Open Journal of Medical Imaging 2014年第3期4卷 103-107页

作者： taha kamel alloush Mahmoud Haroun Ibrahim Nahed Salah El-Dein Ahmed Ghada Samir El-Shahed Lobna M. El-Nabil El-Sayed Mohamed Hamdy Ibrahim Hosam Ahmed Azmy Faculty of Medicine Ain Shams University Cairo Egypt Ministry of Health Cairo Egypt

Objectives: To assess the impact of heart failure diseases on stroke severity and short term (1 month mortality). Materials and Methods: Totally, 200 patients admitted to Ain Shams university specialized hospital, were diagnosed clinically to have acute ischemic stroke within 3 days. History taking about previous heart disease was taken, and full general and neurological examinations were done. Full metabolic profile, cardiac examination and investigations were done. Carotid duplex, MRI stroke protocol and lastly clinical reevaluation using NIH Stroke Scale (NIHSS) after 1 month from stroke onset were done. Results: Patients with systolic dysfunction (EF ≤ 40%) had lacunar infarction in 18.75% of cases, partial anterior circulation infarction in 62.5% of cases, posterior circulation infarction in 6.25% of cases and total anterior circulation infarction in 12.5% of cases. Leucoaraiosis was present in 87% of cases and significant intracranial vessel stenosis was showed in 87.5% who had done MRI. Their median NIHSS score at admission was 10.5 with IQR of 5 - 21 and at follow-up it was 5 with IQR of 2.5 - 10.5. At follow-up 22.7% (5 patients) were dead. Conclusion: Systolic dysfunction (EF < 40) i.e. heart failure has no significant effect on stroke severity and 1 month follow up prognosis.

关键词： Heart Failure Stroke Prognosis Ejection Fraction

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

Prevalence of Sarcopenia among Nursing Home Older Residents in Cairo, Egypt

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Advances in Aging Research 2014年第2期3卷 118-123页

作者： Tomader taha Abdel Rahman Nehal Mahmoud Elkholy Ahmad kamel Mortagy Geriatrics Medicine Department Faculty of Medicine Ain Shams University Cairo Egypt

Sarcopenia is highly prevalent in community dwelling older adults in many countries;however, the prevalence of sarcopenia in nursing home older residents is not well characterized. The aim of this study is to assess the prevalence of sarcopenia in nursing home older residents in Cairo. Cross sectional study was performed among 357 nursing home residents in Cairo. The European Working Group on Sarcopenia in Older People (EWGSOP) recommendation was used for diagnosing sarcopenia. The study showed that the prevalence of sarcopenia in nursing home older residents in Cairo was 17.7%, 22.2% in elderly men and 14.4% in elderly women. Age, underweight and lack of physical activity were found to be associated with sarcopenia among studied participants. The study concluded that sarcopenia is an emerging health problem in nursing home older residents in Cairo.

关键词： Nursing Homes Prevalence Sarcopenia

Erratum to “Prevalence of Sarcopenia among Nursing Home Older Residents in Cairo, Egypt” [Advances in Aging Research 3 (2014) 118-123]

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Advances in Aging Research 2014年第4期3卷 326-328页

作者： Tomader taha Abdel Rahman Hoda Mohammed Farid Nehal Mahmoud Elkholy Ahmad kamel Mortagy Ahmad kamel Mortagy Geriatrics Medicine Department Faculty of Medicine Ain Shams University Cairo Egypt

Sarcopenia is highly prevalent in community dwelling older adults in many countries;however, the prevalence of sarcopenia in nursing home older residents is not well characterized. The aim of this study is to assess the prevalence of sarcopenia in nursing home older residents in Cairo. Cross sectional study was performed among 150 nursing homes residents in Cairo. The European Working Group on Sarcopenia in Older People (EWGSOP) recommendation was used for diagnosing sarcopenia. The study showed that the prevalence of sarcopenia in nursing home older residents in Cairo was 17.3%;22.6% in elderly men and 13.6% in elderly women. Age, underweight and lack of physical activity were found to be associated with sarcopenia among studied participants. The study concluded that sarcopenia is an emerging health problem in nursing home older residents in Cairo.

关键词： Nursing Homes Prevalence Sarcopenia