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Maged AM, Saad H, Meshaal H, Salah E, Abdelaziz S, Omran E, Deeb WS, Katta M. Editorial Expression of Concern: Maternal serum homocysteine and uterine artery Doppler as predictors of preeclampsia and poor placentation. Arch Gynecol Obstet 2024; 309:2259. [PMID: 38502191 DOI: 10.1007/s00404-024-07454-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt.
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt
| | - Suzy Abdelaziz
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt
| | - Eman Omran
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St., Haram, Giza, 12151, Egypt
| | - Wesam S Deeb
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Maha Katta
- Department of Obstetrics and Gynecology, Faculty of Medicine, BeniSuef University, Beni Suef, Egypt
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Hashem AT, Mahmoud M, Aly Islam B, Ibrahem Eid M, Ahmed N, Mohamed Mamdouh A, Elkomy R, Fouad Elgamel A, Hamada AAA, Khalil EM, Ashour ASA, Said Ali A, Taher A, Hasan Hussein A, Elzahaby I, Hafez Mohamed Younes M, Salah E, Mojahed EM, Talaat B, ElHodiby M, Kamal Osman N, Adel Nour D, Khamis Y, Aly Hamed Elsallamy A, Ahmed Gehad M, Kotb MMM, Gad Allah SH. Comparative efficacy of lidocaine-prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial. Int J Gynaecol Obstet 2024; 165:634-643. [PMID: 35212402 DOI: 10.1002/ijgo.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/18/2021] [Accepted: 02/23/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare efficacy of lidocaine-prilocaine (LP) cream versus misoprostol versus placebo before levonorgestrel-releasing intrauterine device (LNG-IUD) insertion. METHODS This randomized controlled trial (RCT) was conducted in a tertiary referral hospital from April 30, 2020 to March 1, 2021 on 210 parous women willing to receive LNG-IUD and delivered only by elective cesarean delivery (CD). Participants received 200 μg vaginal misoprostol or 5 ml of LP cream 5% or placebo 3 h before LNG-IUS insertion. Primary outcome was pain during LNG-IUD insertion, while secondary outcomes were pain 10 min post-procedure, ease of insertion, patient satisfaction, insertion time, and drug side effects. RESULTS Pain during LNG-IUS insertion was reduced in LP group and misoprostol group compared to placebo group (2.1 ± 1.0 vs 3.7 ± 1.6; p <0.001) and (2.3 ± 1.3 vs 3.7 ± 1.6; p <0.001), respectively. Ease of procedure and patient satisfaction were significantly higher in LP and misoprostol groups than placebo (P <0.001). Need for additional analgesia was significantly higher in placebo group than in the other two groups (P = 0.009). Adverse events were not significantly different between the three groups except vomiting and abdominal cramps, which were higher with misoprostol. CONCLUSION LP cream and 200 μg of vaginal misoprostol administration before LNG-IUD insertion in women delivered only by elective CD effectively reduced pain during insertion and 10 min post-procedure with easier insertions, high patient satisfaction, and tolerable side effects. Pain reduction with LP cream was clinically significant.
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Affiliation(s)
- Ahmed T Hashem
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Mahmoud
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Bassem Aly Islam
- Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Ibrahem Eid
- Department of Obstetrics & Gynecology, Faculty of Medicine, Mansoura University, Mansoura City, Egypt
| | - Nancy Ahmed
- Department of Obstetrics &Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - Ahmed Mohamed Mamdouh
- Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Elkomy
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amira Fouad Elgamel
- Department of Obstetrics &Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - A A Ali Hamada
- Department of Obstetrics &Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - Eman M Khalil
- Department of Obstetrics &Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - Ahmed S A Ashour
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Ayman Taher
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amr Hasan Hussein
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Elzahaby
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Emad Salah
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman M Mojahed
- Department of Obstetrics &Gynecology, Faculty of Medicine, Fayoum University, Faiyum, Egypt
| | - Bassem Talaat
- Department of Obstetrics &Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed ElHodiby
- Department of Obstetrics and Gynecology, Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
| | - Nada Kamal Osman
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Adel Nour
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasser Khamis
- Department of Obstetrics &Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
| | - Ayman Aly Hamed Elsallamy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
| | - Mahmoud Ahmed Gehad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Benha University, Benha, Egypt
| | | | - Sherine H Gad Allah
- Department of Obstetrics &Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Maged AM, Saad H, Meshaal H, Salah E, Abdelaziz S, Omran E, Deeb WS, Katta M. Expression of Concern: Maternal serum homocysteine and uterine artery Doppler as predictors of preeclampsia and poor placentation. Arch Gynecol Obstet 2024:10.1007/s00404-024-07491-5. [PMID: 38619554 DOI: 10.1007/s00404-024-07491-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt.
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Suzy Abdelaziz
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Eman Omran
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Wesam S Deeb
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Maha Katta
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
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Alhefnawy MA, Salah E, Bakry S, Khalifa TM, Rafaat A, Hammad R, Sobhy A, Wahsh A. Autologous mesenchymal stem cell therapy for diabetic men with erectile dysfunction. Is it promising? A pilot study. Arch Ital Urol Androl 2023; 95:11669. [PMID: 37990987 DOI: 10.4081/aiua.2023.11669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/07/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE to assess safety and efficacy of autologous mesenchymal bone marrow stem cell injection in penile cavernosal tissue for erectile dysfunction therapy in diabetic men. METHODS The subjects of this study were diabetic men suffering erectile dysfunction, non-responding to maximum dose of oral PDE5I. Mesenchymal bone marrow stem cells were aspirated and injected after preparation in both corpora cavernosa at 3, 9 o'clock position. Erectile function was assessed by the International Index of Erectile Function and penile Doppler study, before and after 6 months after injection. RESULTS 4 patients out of 10 achieve hard erection adequate for satisfactory coitus, and 2 patients achieved penile hardness with addition of pharmacological therapy with sildenafil 100mg. Peak systolic velocity increased significantly in 4 patients (2 arteriogenic and 2 mixed erectile dysfunction), from 12∼22 cm/s to 32∼69 cm/s. Variations in end-diastolic velocity increased substantially in 2 patients with venogenic insufficiency alone at follow-up from 4∼5 cm /s to -4∼-3 cm/s. CONCLUSIONS Despite promising stem cell treatment efficacy for patients with erectile dysfunction, more clinical studies and researches are still warranted.
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Affiliation(s)
| | - Emad Salah
- Department of Urology, Al-Azhar University.
| | - Sayed Bakry
- Department of Embriology and Genetic engineering, Faculty of Science, Al-Azhar University.
| | | | | | - Refaat Hammad
- Department of Dermatology and Andrology, Al-Azhar University.
| | - Ali Sobhy
- Department of Dermatology and Andrology, Al-Azhar University.
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Darwish A, Abdel-Raouf M, Kamel R, Salah E, Salah M, Okasha A. Fetal echocardiographic parameters in pregnancies complicated by diabetes: a case control study. BMC Pregnancy Childbirth 2022; 22:650. [PMID: 35982412 PMCID: PMC9386926 DOI: 10.1186/s12884-022-04969-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background At present, the prevalence of pregestational diabetes is 2.2% with an overall prevalence of hyperglycaemia in pregnancy of about 16.2%. Fetuses of diabetic mothers are at risk of functional cardiac abnormalities without structural cardiac anomalies especially in the third trimester. The main aim of this study was to assess the association of diabetes with different fetal echocardiographic parameters. Methods A case control study comprising a total of 120 pregnant women (60 cases and 60 controls). The cases group included fetuses of mothers known to have pre-gestational type 2 diabetes (DM group) while the control group included fetuses of euglycaemic healthy pregnant women. They were examined twice at 23–24 weeks' gestation (visit 1) and followed up at 27–28 weeks’ gestation (visit 2). The Modified Myocardial Performance Index (Mod MPI) was obtained in all fetuses. Also, M-mode echocardiography was used to measure the interventricular septum thickness at diastole in a transverse four chamber view. Results There was a significant increase in Iso-volumetric contraction time (ICT) (45.4 ms ± 8.9), Iso-volumetric relaxation time (IRT) (54.7 ms ± 11.22), Interventricular septal thickness (IVST) (4.08 mm ± 0.8), aortic acceleration time (AAT) (54.16 ms ± 12.77) and MPI (0.64 ± 0.09) in the diabetic group compared to the normal control group ICT (38.5 ms ± 9.59), IRT (46.13 ms ± 10.29), IVST (3.17 mm ± 0.6), AAT (49.73 ms ± 10.68) and MPI (0.5 ± 0.1) (all P values were < 0.001). When comparing parameters assessed at both visits among diabetic patients, there was a significant increase in IVST in the second visit (4.74 ± 0.78 mm) compared to the first visit (4.08 ± 0.8 mm) (P value < 0.05). The incidence of hypertrophic cardiomyopathy (HCM) was significantly higher in diabetic patients than in the control group. This is was observed in both first and second visit (33.4% and 56.7%) (P value < 0.001). Conclusions Fetuses of diabetic pregnant females show a significant increase in MPI, decrease in E\A ratio and HCM. These alterations in cardiac functions and structure were found to be continuous throughout the period of time between the two visits. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04969-5.
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Affiliation(s)
- Amal Darwish
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kasr El Aini Hospital, Cairo University, Cairo, Egypt
| | - Maged Abdel-Raouf
- High Risk Pregnancy Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Kasr El Aini Hospital, Cairo University, Cairo, Egypt
| | - Rasha Kamel
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Kasr El Aini Hospital, Cairo University, Cairo, Egypt
| | - Emad Salah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kasr El Aini Hospital, Cairo University, Cairo, Egypt
| | - Mai Salah
- Department of Obstetrics and Gynecology, Embaba General Hospital, Egyptian Ministry of Health and Population, Giza, Egypt
| | - Ahmed Okasha
- Department of Reproductive Health and Family Planning, Medical Research Institute, National Research Centre, Cairo, Egypt.
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Meshaal H, Salah E, Fawzy E, Abdel-Rasheed M, Maged A, Saad H. Hysteroscopic management versus ultrasound-guided evacuation for women with first-trimester pregnancy loss, a randomised controlled trial. BMC Womens Health 2022; 22:190. [PMID: 35614405 PMCID: PMC9131545 DOI: 10.1186/s12905-022-01774-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the hysteroscopic management of first-trimester pregnancy loss compared to surgical evacuation either blind or under ultrasonographic guidance. METHODS This clinical trial included 315 women with first-trimester pregnancy loss, divided equally into three groups. Group 1 underwent traditional blind surgical evacuation, group 2 underwent ultrasound-guided evacuation, and group 3 underwent hysteroscopic management. All women were assessed for retained products, surgical complications, the need for further management, and pregnancy occurrence after evacuation within 2 years of follow up. RESULTS The rate of presence of conception remnants and the need for further treatment was significantly higher in group 1 compared to groups 2 and 3 (4.8% vs. 0% vs. 0%, P = 0.012). The conception rate within 2 years was significantly lower in group 1 compared to groups 2 and 3 (57.4% vs. 73.2% vs. 82.7%, P = 0.002), and the duration needed to conceive was significantly prolonged in group 1 compared to groups 2 and 3 (9.8 vs. 8.3 vs. 6.9 months, P < 0.001). Interestingly, women who underwent hysteroscopic management needed a significantly shorter time to conceive than those who underwent ultrasound-guided evacuation (6.9 vs. 8.3 months, P = 0.006). CONCLUSIONS Hysteroscopic management of first-trimester pregnancy loss was superior to ultrasound-guided surgical evacuation regarding the time interval to conceive. Both techniques were superior to the blind evacuation technique regarding removal of the whole conception remnants, need for further treatment and fertility outcomes. Clinical trial registration: It was first registered at ClinicalTrials.gov on 16/03/2017 with registration number NCT03081104.
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Affiliation(s)
- Hadeer Meshaal
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman Fawzy
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mazen Abdel-Rasheed
- Reproductive Health Research Department, National Research Centre, 33 El-Buhouth St, Dokki, Cairo, 12622, Egypt.
| | - Ahmed Maged
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany Saad
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Saad H, Maged AM, Meshaal H, Hassan SM, Kamel A, Salah E. Delayed versus early pushing during the second stage of labour in primigravidas under epidural anaesthesia with occipitoposterior malposition: a randomised controlled study. J OBSTET GYNAECOL 2022; 42:23-27. [PMID: 33892614 DOI: 10.1080/01443615.2020.1867973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This randomised controlled trial aimed to compare the effect of early and delayed pushing during the second stage of labour in women with occipitoposterior (OP) malposition. It included 184 nulliparous women with OP position randomised to early pushing in which women were allowed to push within one hour after full cervical dilatation or delayed pushing in which women were asked not to push for maximum of three hours or start pushing when the vertex was visible. The primary outcome was successful vaginal delivery. The rate of spontaneous vaginal delivery was significantly higher in the early pushing group (80.4 vs. 60.9%, p=.004) while the rate of instrumental vaginal delivery (30.4 vs. 15.4%) and CS (8.7 vs. 4.3%) was significantly higher in the delayed pushing group. Women in the delayed pushing group showed a significantly longer duration of the second stage (129.4 ± 7.5 vs. 61.6 ± 15.3 minutes, p<.001) and shorter duration of pushing (219.8 ± 74.8 vs. 693.9 ± 145.2 seconds, p<.001) .The rate of 2nd and 3rd degree perineal lacerations (19.6 and 13% vs. 5.4 and 8.7% respectively, p=.013) and vaginal tears (41.3 vs. 8.7%, p<.001) was significantly higher in the early pushing group. We concluded that early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations.Clinical trial registration NCT03121274.Impact StatementWhat is already known on this subject? Occipitoposterior malposition is common during delivery especially in primigravida and is associated with higher rates of instrumental delivery and caesarean section. It can be managed through early or delayed pushing.What the results of this study add? Early pushing is associated with higher rates of spontaneous vaginal delivery, perineal and vaginal tears, shorter duration of second stage of labour, shorter duration of pushing, lower rates of both instrumental vaginal delivery and caesarean section.What the implications are of these findings for clinical practice and/or further research? Early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations in women with OP malposition and should be tried and not delaying the pushing.
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Affiliation(s)
- Hany Saad
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
| | - Ahmed M Maged
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
| | - Sarah M Hassan
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
| | - Ahmed Kamel
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Kasr AlAini Hospital, Cairo University, Cairo, Egypt
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Van Hout MC, Stöver H, Benamara K, Bauer P, Salah E. 90-90-90: catalysing the response to HIV by enhancing prison visibility in the Joint United Nations Programme on HIV and AIDS (UNAIDS) strategy beyond 2021. Public Health 2020; 190:e5-e6. [PMID: 33250154 DOI: 10.1016/j.puhe.2020.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Affiliation(s)
- M C Van Hout
- Public Health Institute, Liverpool John Moores University, United Kingdom.
| | - H Stöver
- Faculty of Health and Social Work, Frankfurt University of Applied Sciences, Germany.
| | - K Benamara
- HIV/AIDS Section, United Nations Office on Drugs and Crime (UNODC), Austria.
| | - P Bauer
- HIV/AIDS Section, United Nations Office on Drugs and Crime (UNODC), Austria.
| | - E Salah
- HIV/AIDS Section, United Nations Office on Drugs and Crime (UNODC), Austria.
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Salah E. Women’s health in prisons in Africa: prevalence and challenges to address HIV among women in prison in Africa. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In Africa around 3.2% of the prison population is represented by women. People in prison are 5 times more likely to be living with HIV than adults in the general population. Moreover, women in prison have a higher HIV prevalence than men. The factors that lead to women becoming incarcerated are often also those that lead to their increased risk of acquiring HIV infection.
Their situation in prison is exacerbated by stigma and discrimination, gender-based violence and inequality. Women have limited access to health care in prison settings and are less likely to receive treatment than men. This is even more the case in Africa, where the precarious and sometimes inhuman prison conditions, render the health-related interventions addressing women health particularly challenging. Their specific health care needs, such as sexual and reproductive health care, treatment of infectious diseases including STIs, as well as nutrition and hygiene requirements, are often neglected. The limited access for women (and their children) to ante- and postnatal care, labour and delivery services and antiretroviral therapy also leads to infants born in prisons being at high risk of contracting HIV. Women in prison should be able to access gender-responsive health care services which are equivalent and of the same quality as those available in the community.
The presentation will present the latest available data on health status and HIV in particular among women in prison in Africa and will present the international standards in health interventions of women in prison.
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Affiliation(s)
- E Salah
- HIV/AIDS Section, United Nations Office on Drugs and Crime, Vienna, Austria
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10
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Maged AM, Nada AM, Abdelwahab H, Salah E, Soliman M, Hussein EA, Essam A, Nabil H. The value of ultrasound guidance during IUD insertion in women with RVF uterus: A randomized controlled trial. J Gynecol Obstet Hum Reprod 2020; 50:101875. [PMID: 32687890 DOI: 10.1016/j.jogoh.2020.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/31/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The study objective is to evaluate the benefits of using ultrasound guidance during insertion of Intrauterine device IUD in women with retroverted flexed RVF uteri. STUDY DESIGN A randomized controlled trial conducted on 400 women with RVF uteri eligible for IUD insertion. They were randomly divided into 2 groups. Group 1 underwent IUD insertion under ultrasound guidance while in group 2 no ultrasound guidance was used. The primary outcome measure was the(Visual Analogue Scale) VAS pain score reported by the women during insertion. Other outcome included easiness of insertion, the procedure time and occurrence of complications as nausea, vomiting, abdominal cramps, failure of insertion, uterine perforation and bleeding. RESULTS The VAS pain score was significantly lower (2.36 ± 1.77 vs. 4.74 ± 2.35, p < 0.001), the insertion was much easier (score 4.0 ± 0.9 vs. 2.5 ± 1.27, p < 0.001) and the time needed for the procedure was significantly shorter (5.82 ± 2.56 vs. 9.4 ± 4.99 min, p < 0.001) in women within the ultrasound guided group when compared to control group. The total rate of complications was significantly lower (6 vs. 16 %, p 0.001) especially bleeding (2 vs. 9%, p = 0.002), abdominal cramps (10.5 vs. 28 %, p 0.012) and failure of the procedure (0 vs. 3%, p = 005) in ultrasound guided group women when compared to control. CONCLUSION Insertion of Intrauterine device IUD under ultrasound guidance in women with Retroverted flexed RVF uterus easier and less painful than the blind standard technique.
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Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Adel M Nada
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Hala Abdelwahab
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Emad Salah
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Mahmoud Soliman
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Eman A Hussein
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Aimy Essam
- Obstetrics and Gynecology Department Cairo University, Egypt.
| | - Hala Nabil
- Obstetrics and Gynecology Department Cairo University, Egypt.
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Patil RK, Malhotra G, Venugopal S, Salah E, Ramadan A. Replantation of Nine Fingers in a Patient: A case report. Sultan Qaboos Univ Med J 2019; 19:e248-e252. [PMID: 31728224 PMCID: PMC6839683 DOI: 10.18295/squmj.2019.19.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 11/16/2022] Open
Abstract
Amputation of multiple fingers of both hands is a rare and serious injury. We report a case of a 41-year-old male patient who presented to Khoula Hospital, Muscat, Oman, in 2015 with the amputation of nine fingers due to a workplace injury. With two teams working in tandem, all the amputated fingers were re-attached. A total of seven fingers survived and the patient regained reasonable functionality of his hands. To the best of the authors' knowledge, this is the first case of several finger amputations in Oman.
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Affiliation(s)
- Rahul K Patil
- Department of Hand Surgery, Khoula Hospital, Muscat, Oman
| | - Gopal Malhotra
- Department of Hand Surgery, Khoula Hospital, Muscat, Oman
| | | | - Emad Salah
- Department of Hand Surgery, Khoula Hospital, Muscat, Oman
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Maged AM, Saad H, Salah E, Meshaal H, AbdElbar M, Omran E, Eldaly A. Urine test for HPV genotypes as a predictor of precancerous cervical lesions and for cervical cancer screening. Int J Gynaecol Obstet 2018; 141:332-336. [PMID: 29383718 DOI: 10.1002/ijgo.12453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 01/26/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of high-grade squamous intra-epithelial lesion (HSIL) and its correlation with pathologic precancerous lesions. METHODS The present prospective cross-sectional study included women referred to Kasr AlAiny Medical School, Cairo, Egypt, for cervical smear anomalies, a history of cervical smear anomalies, or for suspicious cervix between May 1, 2015, and April 30, 2017. Paired urine tests and cervical smears were performed. HPV DNA was detected in urine using polymerase chain reaction and cervical smears were performed with a cervical spatula and a cytobrush. Agreement between urine test results and pathology was examined. RESULTS In total, 1375 women were included. Urine test for high-risk HPV DNA demonstrated 97.8% (95% confidence interval [CI] 92.1%-99.7%) sensitivity and 100% (95% CI 99.7%-100.0%) specificity for HSIL. Overall, 87 women had a positive urine test for high-risk HPV; of these, 82 (94.3%, 95% CI 87.1%-98.1%) had pathologic findings of cervical intra-epithelial neoplasia 2 or 3 (CIN2/3). Similarly, 89 women had HSIL cytology; again, 82 had CIN2/3 (92.1%; 95% CI, 84.3%-96.4%). CONCLUSION There was good agreement between a positive urine test for high-risk HPV DNA genotypes and pathologic findings of CIN2/3.
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Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Mostafa AbdElbar
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Eman Omran
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Ashraf Eldaly
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
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Essam-Eldin S, Salah E, Ahmed H, Elhalawani H, Abdel-Rahman O. Hematological toxicities following treatment of cancer patients with PARP inhibitors. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx668.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maged AM, Saad H, Meshaal H, Salah E, Abdelaziz S, Omran E, Deeb WS, Katta M. Maternal serum homocysteine and uterine artery Doppler as predictors of preeclampsia and poor placentation. Arch Gynecol Obstet 2017; 296:475-482. [PMID: 28689278 DOI: 10.1007/s00404-017-4457-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and uterine artery (Ut-A) Doppler as predictors of preeclampsia (PE), intrauterine growth restriction (IUGR), and other complications related to poor placentation. PATIENTS AND METHODS A prospective cohort study was conducted on 500 women with spontaneous pregnancies. tHcy was measured at 15-19 weeks, and then, Ut-A Doppler was performed at 18-22 weeks of pregnancy. RESULTS 453 pregnant women completed the follow-up of the study. The tHcy and Ut-A resistance index were significantly higher in women who developed PE, IUGR, and other complications when compared to controls (tHcy: 7.033 ± 2.744, 6.321 ± 3.645, and 6.602 ± 2.469 vs 4.701 ± 2.082 μmol/L, respectively, p value <0.001 and Ut-A resistance index: 0.587 ± 0.072, 0.587 ± 0.053, and 0.597 ± 0.069 vs 0.524 ± 0.025, respectively, p value <0.001). The use of both tHcy assessment and Ut-A Doppler improved the sensitivity of prediction of PE relative to the use of each one alone (85.2 relative to 73.33 and 60%, respectively). CONCLUSION The use of elevated homocysteine and uterine artery Doppler screening are valuable in prediction of preeclampsia, IUGR, and poor placentation disorders. CLINCALTRIAL. GOV ID NCT02854501.
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Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt.
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Suzy Abdelaziz
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Eman Omran
- Obstetrics and Gynecology Department, Cairo University, 135 King Faisal St. Haram, Giza, 12151, Egypt
| | - Wesam S Deeb
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Maha Katta
- Department of Obstetrics and Gynecology, Faculty of Medicine, BeniSuef University, Beni Suef, Egypt
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Affiliation(s)
- E. Salah
- Lecturer of Dermatology, Venereology & Andrology; Faculty of Medicine; Zagazig University; Zagazig Egypt
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Kamel A, El-Mazny A, Salah E, Ramadan W, Hussein AM, Hany A. Manual removal versus spontaneous delivery of the placenta at cesarean section in developing countries: a randomized controlled trial and review of literature. J Matern Fetal Neonatal Med 2017; 31:3308-3313. [DOI: 10.1080/14767058.2017.1369522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ahmed Kamel
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Akmal El-Mazny
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Emad Salah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wafaa Ramadan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed M. Hussein
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Hany
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Maged AM, Salah E, Kamel AM, Hussein AM, Saad H, Meshaal H, Kamal WM. Effect of oral contraceptives on balance in women: A randomized controlled trial. Taiwan J Obstet Gynecol 2017; 56:463-466. [PMID: 28805601 DOI: 10.1016/j.tjog.2017.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To detect the effect of combined oral contraceptive pills (COC) on dynamic postural balance in healthy middle aged women. MATERIALS AND METHODS A prospective randomized controlled study included 200 patients classified into two groups. Group I received COC containing 30 μg of EE and 3 mg of drospirenone for 12 consecutive cycles and Group II received no treatment. Overall, medio-lateral and antero-posterior stability were measured using Biodex system after 12 months. RESULTS There was a highly statistically significant difference between the 2 study groups regarding estradiol level (12.84 ± 1.96 vs. 38.86 ± 3.99, P value < 0.001) and progesterone level (0.52 ± 0.25 vs. 11.64 ± 4.53, P value < 0.001). There was a highly statistically significant difference between the 2 study groups regarding mediolateral stability (1.84 ± 0.23 vs. 2.40 ± 0.56, P value < 0.001), antereoposterior stability (1.91 ± 0.29 vs. 2.33 ± 0.61, P value < 0.001) or overall stability (2.42 ± 0.29 vs. 2.95 ± 0.53, P value < 0.001). CONCLUSION COC are effective method of contraception to improve postural balance and decrease risk of injury in normal and athletic women. NCT02855294.
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Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Ahmed M Kamel
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Ahmed M Hussein
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, Egypt.
| | - Wafaa M Kamal
- Physical Therapy Department, Cairo University, Egypt.
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Borghetti P, Bonù M, Roca E, Salah E, Baiguini A, Pedretti S, Maddalo M, Buglione M, Magrini S. EP-1219: Concomitant radiotherapy and TKI in EGFR mutant or ALK positive stage IV non-small cell lung cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maged AM, Abdelaal H, Salah E, Saad H, Meshaal H, Eldaly A, Katta MA, Deeb WS. Prevalence and diagnostic accuracy of Doppler ultrasound of placenta accreta in Egypt. J Matern Fetal Neonatal Med 2017; 31:933-939. [DOI: 10.1080/14767058.2017.1303667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ahmed M. Maged
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Hoda Abdelaal
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Emad Salah
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Hany Saad
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Hadeer Meshaal
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Ashraf Eldaly
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Maha A. Katta
- Department of Obstetrics and Gynecology, Beni-Suef University, Beni-Suef, Egypt
| | - Wesam S. Deeb
- Department of Obstetrics and Gynecology, Fayoum University, Fayoum, Egypt
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Maged AM, Abdelhafiz A, Mostafa WA, El-Nassery N, Fouad M, Salah E, Kotb A. The role of prophylactic use of low dose aspirin and calheparin in patients with unexplained recurrent abortion. Gynecol Endocrinol 2016; 32:970-972. [PMID: 27426855 DOI: 10.1080/09513590.2016.1203408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To study the effect of prophylactic use of low dose aspirin and heparin on patients with recurrent unexplained pregnancy loss. METHODS Prospective case control study conducted on 180 pregnant women randomized into two equal groups. Group 1 received low-dose aspirin 75 mg and heparin 5000 IU subcutaneous every 12 h. Group 2 received no treatment. RESULTS There was a statistically significant difference between the two study groups regarding number of patients who completed their first trimester (66 versus 39) (p values 0.018). The outcome regarding completion of first trimester was not related to age, BMI or number of previous abortions in both the study groups. Complications of the use of aspirin calheparin occurred in 60% of the patients. The most common complication was bruising at injection site occurring in 60% of the patients followed by bleeding gums (14.4%), gastrointestinal troubles (12.2%), epistaxis (10%) and transient thrombocytopenia in only 2.22% of the patients (Table 4). CONCLUSION The use of prophylactic dose of calheparin and aspirin is associated with increased chance of passing 1st trimester safely regardless the age, body mass index or number of abortion in women with unexplained recurrent spontaneous abortion.
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Affiliation(s)
- Ahmed M Maged
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Aly Abdelhafiz
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Walaa Ai Mostafa
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Noura El-Nassery
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Mona Fouad
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Emad Salah
- a Obstetrics and Gynecology Department, Kasr AlAini Hospital Cairo University , Cairo , Egypt and
| | - Amal Kotb
- b Obstetrics and Gynecology Department, Beni Suef University , Beni-Suef , Egypt
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Tolba AM, Azab AAH, Nasr MA, Salah E. Dartos Fascio-Myo-Cutaneous Flap for Penile Skin Loss: A Simple Flap with an Immense Potential. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ss.2014.51002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chira I, Ambert V, Braticevici B, Jinga V, Salah E, Gutuie S, Pisoschi M, Tata E. UP-03.074 Stone and Patient Related Factors in Connection with Short Term Complications Following E.S.W.L. Stone Management. Urology 2011. [DOI: 10.1016/j.urology.2011.07.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Filippakopoulos P, Kofler M, Gish G, Salah E, Neudecker P, Kay L, Turk B, Pawson T, Knapp S. Fes kinase structure reveals cooperative interactions between SH2-kinase domains and substrate. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308089630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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D'Angelo A, Davies R, Salah E, Nix BA, Amso NN. Value of the serum estradiol level for preventing ovarian hyperstimulation syndrome: a retrospective case control study. Fertil Steril 2004; 81:332-6. [PMID: 14967369 DOI: 10.1016/j.fertnstert.2003.06.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2002] [Revised: 06/26/2003] [Accepted: 06/26/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the value of different serum E(2) cut-off levels for predicting women at risk for ovarian hyperstimulation syndrome (OHSS). DESIGN Retrospective case-control study of a cohort of women undergoing assisted reproduction treatment (ART) over 12 months. SETTING Tertiary university hospital. PATIENT(S) The study group included women with OHSS who fulfilled the endocrine inclusion criteria (n = 40). The control group was a random sample (n = 40) from the cohort of women undergoing ART. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) To evaluate the sensitivity and specificity of different serum E(2) cut-off levels on day 11 of ovarian stimulation in preventing the establishment of OHSS. RESULT(S) Three hundred ninety-nine cycles (IVF and intracytoplasmic sperm injection) were undertaken between June 2000 and May 2001. The study group (n = 40) was compared with the control group (n = 40) undergoing ART during the same period of time. On day 8 of ovarian stimulation, the mean (SD) E(2) level in the study group was 8,517(5.3) pmol/L (2,320 pg/mL), and in the control group it was 2,540 (2.6) pmol/L (691 pg/mL). On day 11 of stimulation the mean (SD) E(2) level was 15,662 (4.2) pmol/L (4,266 pg/mL) and 5,804 (4.5) pmol/L (1,581 pg/mL), respectively. Twenty-four (60%) women who developed OHSS had E(2)levels >6,000 pmol/L (1,634 pg/mL) on day 8 and above 11,000 pmol/L (2,996 pg/mL) on day 11. Sixteen (40%) had E(2) levels <6,000 pmol/L (1,634 pg/mL) on day 8, but all had levels above 11,000 pmol/l (2,996 pg/mL) on day 11. CONCLUSION(S) A serum E(2) level of 12,315 pmol/L (3,354 pg/mL) on day 11 of ovarian stimulation gives a sensitivity and specificity of 85% for the detection of women at risk for OHSS.
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Affiliation(s)
- Arianna D'Angelo
- Department of Obstetrics and Gynaecology, University Hospital of Wales College of Medicine, Cardiff, United Kingdom
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Belal A, Salah E, Hajjar W, El-Foudeh M, Memon M, Ezzat A, Al-Kattan K. Pulmonary metastatectomy for soft tissue sarcomas: is it valuable? J Cardiovasc Surg (Torino) 2001; 42:835-40. [PMID: 11698958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND A retrospective study and analysis was performed to determine the value and benefit of pulmonary metastatectomy for soft tissue sarcomas, and which factors predict prognosis following resection. METHODS Twenty-three patients underwent resections for pulmonary metastases from a soft tissue sarcoma (STS) at King Faisal Specialist Hospital and Research Center (KFSH&RC), between January 1985 and December 1998. There were 11 male and 12 female patients. Thirteen of 23 patients (57%) had one to three metastases, and 10 (43%) had four or more metastases. A total of 41 thoracic explorations was performed for the 23 evaluable patients. Median sternotomy was used only for three patients and lateral thoracotomy was used for 20 patients as an initial surgical approach. Pulmonary resections performed included one or more wedge resections (n=16), segmentectomy (n=5), and lobectomy (n=2). No one in this series underwent pneumonectomy. The number of resected metastatic nodules ranged from one-six with average three. Eight patients (35%) received various kinds of postoperative adjuvant chemotherapy. RESULTS The overall and disease-free survival rate post-metastatectomy at five years was 24% and 21%, respectively. Various prognostic indicators were examined to evaluate their association with improved survival. Age, sex localization of the primary site and histologic type, tumor grade, size of the resected nodules, laterality (unilateral or bilateral), types of resection, adjuvant chemotherapy, and local recurrence did not significantly affect survival. However, patient with disease free interval >6 months, and those with three or fewer metastases showed a trend toward a higher five-year overall survival (p=0.06, 0.07, respectively). CONCLUSIONS Surgical excision of lung metastases from soft tissue sarcomas is well accepted and should be considered as a first line of treatment if preoperative evaluation indicated that complete resection of the metastases is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy.
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Affiliation(s)
- A Belal
- Department of Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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