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Ali N, Faheem M, Ullah H, Shabana H, Kassem A, Ahmed MO, Elmahdi E. Atorvastatin as an Antihypertensive Agent: A Pilot Study. Cureus 2023; 15:e49532. [PMID: 38156151 PMCID: PMC10753094 DOI: 10.7759/cureus.49532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Objective Hypertension (HTN) is among the most common causes of chronic disease burden, along with dyslipidemia. It is a prominent risk factor for cardiovascular and cerebrovascular morbidity and mortality. More often than not, HTN coexists with dyslipidemia. This study aimed to see the antihypertensive effect of statins (atorvastatin), as certain animal models have shown that statins have a voltage-gated calcium channel-blocking effect. Material and methods This was a randomized controlled trial done at the Ayub Hospital Complex in Abbottabad, Pakistan. After ethical approval, 120 patients with newly diagnosed hypertension belonging to either gender and aged 35 and above were enrolled in the trial. They were randomly divided into two groups, with each group comprising 60 patients. One group was administered amlodipine 5 mg per oral (PO) once a day, while the other group was given 5 mg of amlodipine PO plus 10 mg of atorvastatin PO. The patients were examined on a follow-up visit 14 days later, and blood pressure was recorded as per protocols. Results A total of 120 newly diagnosed patients were studied in this trial. The mean age was 51.07 years, with a standard deviation of ±6.15 years and a range of 41-60 years. There were 64 (53.3%) males and 56 (46.7%) females in the study. The mean systolic blood pressures (SBPs) and diastolic blood pressures (DBPs) in Group 2 (amlodipine 5 mg + atorvastatin 10 mg) were significantly lower than the patients in Group 1 (only amlodipine 5 mg) in the follow-up visit, which was 14 days after starting the medication (p≤0.05). Conclusion The addition of a lipid-lowering drug to an antihypertensive regimen results in a better lowering of blood pressure in hypertensive individuals.
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Affiliation(s)
- Niaz Ali
- Pharmacology, College of Medicine, Shaqra University, Shaqra, SAU
| | | | - Himayat Ullah
- Medicine, College of Medicine, Shaqra University, Shaqra, SAU
| | - Hosam Shabana
- Medicine, College of Medicine, Shaqra University, Shaqra, SAU
| | - Arafat Kassem
- Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, EGY
| | - Mahmoud O Ahmed
- Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, EGY
| | - Essam Elmahdi
- Internal Medicine, Faculty of Medicine, Mansoura University, Al Mansoura, EGY
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Elmoursi A, Abdelsattar AT, Khalil F, Shabana H, Abdel-Moety Zedan H, Mohamed El Mancy I, Ramadan IG, Mostafa S. Efficacy and Safety of Rifaximin in the Prevention of Recurrent Episodes of Hepatic Encephalopathy: A Systematic Review and Meta-analysis. Turk J Gastroenterol 2023; 34:584-592. [PMID: 37051626 PMCID: PMC10441098 DOI: 10.5152/tjg.2023.22575] [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] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/22/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Rifaximin is an oral antimicrobial drug with a broad-spectrum effect. It locally regulates the function and structure of intestinal bacteria and decreases intestinal endotoxemia. We aimed to investigate the preventive role of rifaximin in recurrent episodes of hepatic encephalopathy in cases with a history of hepatic diseases. METHODS We searched PubMed, Scopus, and Web of Science for the relevant studies using the following search strategy: "(Rifaximin) OR (Xifaxan) AND (cirrhosis) OR (encephalopathy)." We assessed the risk of bias using Cochrane's risk of bias tool. We included the following outcomes: recurrence of hepatic encephalopathy, adverse events, mortality rate, and time to the first episode of hepatic encephalopathy from the time of randomization (days). We performed the analysis of homogeneous data under the fixed-effects model, while analysis of heterogeneous data was performed under the random-effects model. RESULTS We analyzed data obtained from 999 patients from 7 included trials. The overall risk ratio proved that the rifaximin group was associated with a lower recurrence rate than the control group (risk ratio [RR] = 0.61[0.50, 0.73], P = .001). We found no significant variation in both groups regarding adverse events (RR = 1.08 [0.89, 1.32], P = .41), and mortality rates (RR = 0.98 [0.61, 1.57], P = .93). The overall risk of bias results was low. CONCLUSION The meta-analysis showed that in patients allocated to the rifaximin group, the incidence rate of hepatic encephalopathy was significantly lower when compared with those in the control group with no difference in both groups regarding adverse events and mortality rates.
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Affiliation(s)
- Ahmed Elmoursi
- University of Kentucky Faculty of Medicine, Lexington, Kentucky, USA
| | | | - Farag Khalil
- Department of Internal Medicine, Al Azhar University Faculty of Medicine, Cairo, Egypt
| | - Hosam Shabana
- Department of Internal Medicine, Al Azhar University Faculty of Medicine, Cairo, Egypt
| | | | | | | | - Sadek Mostafa
- Department of Internal Medicine, Al Azhar University Faculty of Medicine, Cairo, Egypt
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Mostafa S, Shabana H, Khalil F, Mancy IME, Zedan HAM, Elmoursi A, Ramadan IG, Mohamed SED, Kassem A, Kamel IS. Evaluation of the Safety and Efficacy of Dual Therapy Perindopril/Amlodipine in the Management of Hypertension. A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 2022; 29:565-576. [PMID: 36287359 DOI: 10.1007/s40292-022-00544-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/28/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Hypertension represent the commonest cause of death in 2017. Hypertension is classified into two types which are primary or essential hypertension and secondary hypertension. The perindopril-amlodipine combination showed a significant effect in reduction of the elevated BP and the cardiovascular complications. AIM To evaluate the efficacy and safety of a fixed-dose single-pill combination of perindopril-amlodipine in hypertensive patients. METHODS We searched PubMed, Medline, SCOPUS, and Web of Science for relevant clinical trials. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using Cochrane's risk of bias tool. We included the following outcomes: systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, heart rate, cough, dizziness, headache, and peripheral edema. We performed the analysis of homogeneous data under the fixed-effects model, while analysis of heterogeneous data was analyzed under the random-effects model. We conducted a meta-regression according to the dose. RESULTS We included ten clinical trials. The pooled analysis showed that there was a significant reduction of the systolic blood pressure, diastolic blood pressure, pulse plessure, mean blood pressure, and heart rate after the the perindopril-amlodipine combination (MD = 18.96 [14.32, 23.60], P < 0.0001), (MD = 11.90 [8.45, 15.35], P < 0.0001), (MD = 8.44 [6.91, 9.97], P = 0.0001), (MD = 13.07 [5.86, 20.29], P = 0.0004), and (MD = 2.93 [0.89, 4.96], P = 0.005), respectively. The results of the meta-regression revealed that the efficacy is increased by increasing the dose (P < 0.001) CONCLUSION: The use of the perindopril-amlodipine combination had a significant effect on the reduction of SBP, DBP, mean blood pressure, pulse pressure, and HR.
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Affiliation(s)
- Sadek Mostafa
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Hosam Shabana
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Farag Khalil
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | | | | | - Ahmed Elmoursi
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | | | | | - Arafat Kassem
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
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Dardor R, Abd El Moniem S, Shabana H, Elbaiomy M, Megahed N. PROTEIN KINASE B AS A PREDICTOR OFMETASTATIC GASTRIC ADENOCARCINOMA. ESGE Days 2022 2022. [DOI: 10.1055/s-0042-1745344] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- R. Dardor
- Gharyan University, Internal Medicine Dep., Gharyan, Libya
| | - S. Abd El Moniem
- Mansoura University, Specilized Medical Hospital, Internal Medicine Dep. Hepatology & Gastroenterology Unit, Mansoura, Egypt
| | - H. Shabana
- Mansoura University, Specilized Medical Hospital, Internal Medicine Dep. Hepatology & Gastroenterology Unit, Mansoura, Egypt
| | - M. Elbaiomy
- Mansoura University – Faculty of Medicine, Internal Medicine Dep. Oncology Centre, Mansoura, Egypt
| | - N. Megahed
- Mansoura University – Faculty of Medicine, Pathology Dep., Mansoura, Egypt
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Saad M, Abd El moneim S, Shabana H, Ibrahim D. GERD QUESTIONNAIRE SCORE IS A SIGNIFICANT PREDICTOR OF HISTOLOGICALLY PROVEN REFLUX ESOPHAGITIS. ESGE Days 2022 2022. [DOI: 10.1055/s-0042-1745135] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- M. Saad
- Mansoura University, Specialized Medical Hospital, Internal Medicine Dep. Hepatology & Gastroenterology unit, Mansoura, Egypt
| | - S. Abd El moneim
- Mansoura University, Specialized Medical Hospital, Internal Medicine Dep. Hepatology & Gastroenterology unit, Mansoura, Egypt
| | - H. Shabana
- Mansoura University – Faculty of Medicine, Internal Medicine Dep. Hepatology & Gastroenterology unit, Mansoura, Egypt
| | - D. Ibrahim
- Mansoura University – Faculty of Medicine, Pathology Dep., Mansoura, Egypt
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Abd El Razek M, Maher MM, Amin M, Shabana H. Lymphocytic Colitis is the Most Common Cause of Non- Irritable Bowel Syndrome Chronic Diarrhea. ESGE Days 2021 2021. [DOI: 10.1055/s-0041-1724769] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
| | - MM Maher
- Mansoura University, Specialized Medical Hospital, Internal Medicine, Gastroenterology & Hepatology Unit
| | - M Amin
- Mansoura University, Clinical Pathology Department
| | - H Shabana
- Mansoura University, Specialized Medical Hospital, Internal Medicine, Gastroenterology & Hepatology Unit
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Ho A, O'Boyle C, Shabana H, Lee K. The impact of bariatric surgery on framingham risk score. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3218] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although morbid obesity is strongly associated with cardiovascular disease (CVD) risk, relatively little research has been performed to evaluate the long-term effect of bariatric surgery (BS) on CVD risk reduction.
Purpose
To evaluate the 2-year effects of laparoscopic gastric bypass (LGBYP) & laparoscopic sleeve gastrectomy (LSG) on blood pressure, lipid profile, diabetic profile and Framingham risk score (FRS).
Methods
It was a retrospective review of patients undergoing BS between January 2009–2017. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid & diabetic profile were recorded preoperatively & 2-year postoperatively.
Results
Of 416 patients, 77% (320) were females, 88% (365) were non-smokers & mean (sd) age was 48 (11) years. 69% (286) underwent LGBYP. 27% (114) were diabetic, 78% (324) were hyperlipidaemic and 65% (269) were hypertensive. The mean SBP & DBP decreased progressively while mean high-density-lipoprotein (HDL) & total-cholesterol (TC) increased progressively (table 1). LGBYP has a greater reduction in DBP than LSG (p<0.001, t-test). 10-year CVD risk reduced by 37% at 2-year, with a greater effect in LGBYP than LSG (40% vs 28%, p<0.001, t-test).
Conclusion
The 10-year risk of CVD reduced by 37% 2-years after bariatric surgery, with a greater risk reduction in LGBYP compared to LSG.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A.K.H Ho
- University College Cork, School of Medicine, Cork, Ireland
| | - C.J O'Boyle
- Bons Secours Hospital, Department of Surgery, Cork, Ireland
| | - H Shabana
- Bons Secours Hospital, Department of Surgery, Cork, Ireland
| | - K.J Lee
- University College Cork, School of Medicine, Cork, Ireland
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Ali MA, Abdelaziz A, Ali M, Abonar A, Hanafy M, Hussein H, Shabana H, Abd El-Hmid R, Kaddafy S. PADI4 (rs2240340), PDCD1 (rs10204525), and CTLA4 (231775) gene polymorphisms and polyarticular juvenile idiopathic arthritis. Br J Biomed Sci 2020; 77:123-128. [PMID: 32163016 DOI: 10.1080/09674845.2020.1730626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Certain single nucleotide polymorphisms (SNPs) in genes such as PADI4 (coding for peptidyl arginine deiminase 4), PDCD1 (coding for programmed cell death 1), and CTLA4 (coding for cytotoxic T-lymphocyte-associated protein 4) are linked to rheumatoid arthritis (RA). However, links between SNPs rs2240340, rs10204525 and rs231775 in PADI4, PDCD1 and CTLA4 respectively, and juvenile idiopathic arthritis (JIA), the commonest type of childhood arthritis, are unclear. We aimed to determine whether any of these SNPs are associated with JIA, and to clinical indices disease activity score (JADAS 71) and functional disability score (CHAQ). METHODS We genotyped the three SNPs in 150 children with polyarticular JIA and 160 healthy children, recording standard health questionnaires, clinical features and laboratory markers. RESULTS The TT genotype of PADI4 rs2240340 (aOR/95%CI 2.64: 1.31-5.30, P = 0.006) and CT genotype of PDCD1 rs10204525 (aOR/95%CI 4.99: 2.98-8.36, P < 0.0001) were associated with JIA. The AG+GG genotype of CTLA4 rs231175 was modestly linked to disease activity (aOR/95%CI 2.44 (1.19-5.04), p = 0.015). PADI4 rs2240340 was linked to CHAQ score (genotypes p = 0.013, alleles p = 0.006), whilst PDCD1 rs10204525 was linked to anti-CCP antibodies (genotypes p = 0.004), RF (genotypes p = 0.01), and the CHAQ score (genotypes p = 0.005, alleles p = 0.013). CONCLUSIONS There are various roles for these SNPs in PADI4, CTLA4 and PDCD1 in the diagnosis and, potentially, in the management of JIA.
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Affiliation(s)
- M A Ali
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University , Fayoum, Egypt
| | - A Abdelaziz
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University , Cairo, Egypt
| | - M Ali
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University , Cairo, Egypt
| | - A Abonar
- Department of Clinical Pathology, Faculty of Medicine, Al Azhar University , Cairo, Egypt
| | - M Hanafy
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University , Cairo, Egypt
| | - H Hussein
- Department of Internal Medicine, Faculty of Medicine, Fayoum University , Fayoum, Egypt
| | - H Shabana
- Department of Internal Medicine, Faculty of Medicine, Al Azhar University , Cairo, Egypt
| | - R Abd El-Hmid
- Department of Pediatrics, Faculty of Medicine, Fayoum University , Fayoum, Egypt
| | - S Kaddafy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University , Fayoum, Egypt
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