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Bahbah E, abu-Elfatth A, Alzamzamy A, Nagui GG, Elwazzan D, Abdeen N, Tharwat M, Elbahr O, Charif I, Aboufarrag G, Elbadry M, Abd-Elsalam S, Ali-Eldin Z. Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis. Global Gastroenterology 2023; 0:0-0. [DOI: https:/doi.org/10.21608/gg.2023.203591.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
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Bahbah E, abu-Elfatth A, Alzamzamy A, Nagui GG, Elwazzan D, Abdeen N, Tharwat M, Elbahr O, Charif I, Aboufarrag G, Elbadry M, Abd-Elsalam S, Ali-Eldin Z. Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis. Global Gastroenterology 2023; 0:0-0. [DOI: 10.21608/gg.2023.203591.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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El-Kassas M, Elakel W, Alboraie M, Ezzat R, Abdelhakam S, Hassany M, Ali-Eldin Z, Sherief AF, Yosry A, El-Serafy M, El-Sayed MH, Waked I, Doss W, Esmat G. Egyptian revalidation of non-invasive parameters for predicting esophageal varices in cirrhotic patients: A retrospective study. Arab J Gastroenterol 2022; 23:120-124. [PMID: 35473688 DOI: 10.1016/j.ajg.2022.04.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/27/2022] [Accepted: 04/15/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND STUDY AIMS In resource-limited countries, non-invasive tests for assessing liver fibrosis are a potential alternative to costly endoscopic screening for esophageal varices. We aimed to validate several non-invasive parameters for predicting the presence of varices. PATIENTS AND METHODS Between September 2006 and August 2017, a total of 46,014 patients who underwent upper gastrointestinal endoscopy as one of the perquisites for receiving hepatitis C virus (HCV) therapy were enrolled and divided into group I (without varices) and group II (with varices). Non-invasive parameters of fibrosis, namely Lok index, Bonacini score, liver stiffness, FIB-4, Baveno, and extended Baveno criteria, were validated. RESULTS Lok index, Bonacini score, liver stiffness, and FIB-4 had areas under the receiver operating characteristic curve (AUCs) of >0.6 (all P < 0.01 for the null hypothesis that the AUC was 0.5) for determination of the presence/absence of varices, with cutoff values of 0.80, 6.5, 21.9 kPa, and 2.94, and sensitivities of 74%, 74%, 66%, and 83%, respectively. The expanded Baveno VI criteria performed better than the Baveno VI criteria (spared endoscopy rate 81% versus 63%). CONCLUSION The use of non-invasive methods is of limited value in predicting esophageal varices. The limited accuracy of ≤60% may delay the use of appropriate primary prophylaxis against variceal bleeding in a large proportion of cirrhotic patients.
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Affiliation(s)
- Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; National Committee for Control of Viral Hepatitis, Egypt
| | - Wafaa Elakel
- National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Alboraie
- National Committee for Control of Viral Hepatitis, Egypt; Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Reem Ezzat
- Internal Medicine Department, Assiut University, Assiut, Egypt
| | - Sara Abdelhakam
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Hassany
- National Committee for Control of Viral Hepatitis, Egypt; National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt
| | - Zainab Ali-Eldin
- Internal Medicine Department, Faculty of Medicine, Ain Shams University, Egypt
| | - Ahmed F Sherief
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman Yosry
- National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magdy El-Serafy
- National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Manal Hamdy El-Sayed
- National Committee for Control of Viral Hepatitis, Egypt; Pediatrics Department, Hematology-Oncology Division, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Imam Waked
- National Committee for Control of Viral Hepatitis, Egypt; National Liver Institute, Menofia, Egypt
| | - Wahid Doss
- National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gamal Esmat
- National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Makhlouf NA, Abdel-Gawad M, Mahros AM, Lashen SA, Zaghloul M, Eliwa A, Elshemy EE, Ali-Eldin Z, Abdeltawab D, El-Raey F, Omran D, Khalaf M, Fanous N, Abdelmohsen AS, Abu-Elfatth A, Abdelghani M, Farouk M, Abdelaziz M, Alboraie M. Colorectal cancer in Arab world: A systematic review. World J Gastrointest Oncol 2021; 13:1791-1798. [PMID: 34853651 PMCID: PMC8603455 DOI: 10.4251/wjgo.v13.i11.1791] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 08/08/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of colorectal cancer (CRC) is increasing among young individuals in the Arab world as well as in other regions of the world. AIM To explore the incidence and prevalence of CRC in the Arab world. METHODS The PubMed, Scopus, Web of Science, EBSCO and Wiley databases were searched to retrieve relevant articles irrespective of the language or the publication year. The search terms were "("colon OR rectum OR sigmoid OR rectal OR colonic OR colorectal") AND ("cancer OR malignancy OR malignant OR neoplasm") AND ("Jordan" OR "United Arab Emirates" OR "Bahrain" OR "Tunisia" OR "Algeria" OR "Djibouti" OR "Saudi Arabia" OR "Sudan" OR "Syria" OR "Somalia" OR "Iraq" OR "Oman" OR "Palestine" OR "Qatar" OR "Comoros" OR "Kuwait" OR "Lebanon" OR "Libya" OR "Egypt" OR "Morocco" OR "Mauritania" OR "Yemen"). Reviews, meta-analyses, and articles containing nonoriginal data were excluded. Retrieved articles were screened, and relevant data were extracted. Descriptive statistics were used for data analysis. RESULTS Nine studies were included. Five of the studies provided information regarding the prevalence of CRC. The prevalence of CRC was 0.72% in Saudi Arabia and 0.78% in the United Arab Emirate, while in Egypt, it ranged from 0.4% to 14%. Four studies showed information regarding the incidence. The annual incidence rate of CRC in Qatar was 7.5/100000/year. In Egypt, the crude incidence rate (CIR) in males was 3.1 for colon cancer and 1 for rectal cancer, while in females, it was 2.3 for colon cancer and 0.8 for rectal cancer. The age-standardized rate for CRC incidence in 2003 was 36.90 for males, 26.50 for females, and 30.49 for both sexes in Saudi Arabia. In 2016, the CIRs in Saudi Arabia were 3.6 and 2.1 in females for colon cancer and rectal cancer, respectively, while in males, it was 3.3 and 2.8 for colon cancer and rectal cancer, respectively. One study in Egypt revealed that 25% of CRC cases occurred among individuals younger than 40 years old. CONCLUSION There is a considerable prevalence of CRC in some Arab countries. More studies are needed to explore the incidence and prevalence of CRC in the rest of the Arab world.
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Affiliation(s)
- Nahed A Makhlouf
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Muhammad Abdel-Gawad
- Department of Hepatology, Gastroenterology, and Infectious Diseases, Al-Azhar University, Assiut 71631, Egypt
| | - Aya M Mahros
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafrelsheikh 33656, Egypt
| | - Sameh A Lashen
- Department of Internal Medicine, Alexandria University, Alexandria 21521, Egypt
| | - Mariam Zaghloul
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafrelsheikh 33656, Egypt
| | - Ahmed Eliwa
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Eman E Elshemy
- Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Cairo 11651, Egypt
| | - Zainab Ali-Eldin
- Department of Internal Medicine, Ain Shams University, Cairo 11646, Egypt
| | - Doaa Abdeltawab
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Fathiya El-Raey
- Department of Hepatogastroenterology and Infectious diseases, Faculty of Medicine, Al-Azhar University, Damietta 34511, Cairo, Egypt
| | - Dalia Omran
- Department of Endemic Medicine, Cairo University, Cairo 12613, Egypt
| | - Marwa Khalaf
- Department of Tropical Medicine and Gastroenterology, Assiut Liver Center, Assiut 71511, Egypt
| | - Nancy Fanous
- Department of Gastroenterology, Hepatology and Endoscopy, Police Authority Hospital, Cairo 12654, Egypt
| | - Ahmed Shawkat Abdelmohsen
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Ahmed Abu-Elfatth
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed Abdelghani
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mahmoud Farouk
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed Abdelaziz
- Department of Clinical Oncology and Nuclear Medicine, Al-Azhar University, Cairo 11824, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
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Afify S, Abdel-gawad M, Bahbah E, Zaghloul M, Abu-elfatth A, Alzamzamy A, Naguib G, Elwazzan D, Abdeen N, Tharwat M, Elbahr O, Charif I, Aboufarrag G, badry ME, Omran D, Abd-elsalam S, Ali-eldin Z, Makhlouf N, Alboraie M. Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis.. [DOI: 10.22541/au.162184164.44494990/v1] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Purpose: We aimed to conduct an updated systematic review and network
meta-analysis (NMA) to estimate the efficacy of Helicobacter pylori (H.
pylori) treatment strategies in Arab countries. Methods: We
systematically searched PubMed, Scopus, Web of Science (WOS), EBSCO, and
EMBASE from inception to July 18, 2020, using boolean operators.
Retrieved articles were screened, and relevant data were extracted. We
used R programming software to analyze extracted data. Results:
Fifty-four articles (n= 7829 patients) were included in the NMA. Pooled
overall analysis demonstrated that adjuvant therapy (standard triple or
sequential therapy plus another adjuvant drug) was the best treatment
with higher odds of eradication rate [OR= 6.42, 95% CI (1.37: 30.05),
P-score= 0.21]. Moreover, Seqential therapy (SQT) and Quinolone based
therapy (QBT) were associated with higher eradication rate compared to
other regimens [OR= 4.83, 95% CI (1.49: 15.64), P-score= 0.30] and
[OR= 4.32, 95% CI (1.15: 16.16), P-score= 0.36], respectively. In
adults, the efficacy of QBT was higher than other stratigies in terms of
H. pylori eradication [OR= 2.00, 95% CI (1.09, 3.69), P score=
0.19]. In naïve population, QBT and SQT were associated with
substantial eradication rate [OR= 1.94, 95% CI (1.19: 3.16), P
score=0.19] and [OR= 1.66, 95% CI (1.10: 2.50), P score=0.33],
respectively. Conclusion: Our findings suggest that standard triple or
sequential therapy plus another adjuvant drug, QBT and SQT therapies
were the most effective regimens for eradicating H.pylori in Arab
countries.
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Affiliation(s)
- Shimaa Afify
- National Hepatology and Tropical Medicine Research Institute
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Alboraie M, Youssef N, Sherief AF, Afify S, Wifi MN, Omran D, Hafez E, Omar H, Eltabbakh M, Abdellah M, El Badry M, Salaheldin M, Ahmed Y, Ali-Eldin Z, Farid A, Abdeen N, El Halwagy H, Abdalgaber M, Moaz I, Ezzat S, El Kassas M. Egyptian liver library: An indexed database for liver disease evidence in Egypt. Arab J Gastroenterol 2019; 20:109-113. [PMID: 31175077 DOI: 10.1016/j.ajg.2019.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/27/2019] [Accepted: 05/25/2019] [Indexed: 12/20/2022]
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El Kassas M, El Sheemy R, Alboraie M, El Badry M, Wifi MN, Youssef N, Ezzat S, Tahoon M, Abdelsalam L, Abdelhakam SM, Ali-Eldin Z. Real-world results of direct-acting antivirals use for the treatment of chronic hepatitis C in old patients. Eur Geriatr Med 2019; 10:295-302. [PMID: 34652758 DOI: 10.1007/s41999-019-00167-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/17/2018] [Accepted: 01/17/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Old people with chronic hepatitis C (HCV) were considered a difficult-to-treat category with more frequent adverse events until recently. Interferon-free direct-acting antivirals (DAAs) improved treatment adherence and quality of life of old patients. In this study, we aimed at reporting the real-world efficacy and safety of DAAs, in addition to predictors of sustained virological response (SVR) in old chronic HCV population. METHODS This is a prospective observational intention-to-treat analysis that included old chronic hepatitis C genotype-4 patients (> 65 years) treated in a single specialized viral hepatitis treatment center in Egypt. Treatment regimens were allocated according to national guidelines for treatment of hepatitis C. Primary outcome was undetectable HCV-RNA at 12-week post-treatment by PCR. Secondary outcomes were identification of predictors of SVR and assessment of safety related issues. RESULTS Our study included 864 patients (64% females) with mean age of 67.7 ± 2.8 years. Overall SVR rate was 98.9% while SVR rates for sofosbuvir/daclatasvir/ribavirin, paritaprevir/ombitasvir/ritonavir/ribavirin, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir/ribavirin, sofosbuvir/simeprevir/daclatasvir/ribavirin, sofosbuvir/simeprevir, interferon/sofosbuvir/ribavirin and sofosbuvir/ribavirin were 100%, 100%, 100%, 100%, 100%, 99.3%, 98% and 94.2%, respectively. DAAs were well tolerated. None of the patients discontinued the treatment due to adverse effects. Higher albumin, higher platelet count, lower bilirubin and lower stage of fibrosis were among predictors of favourable response. CONCLUSION Different DAAs regimens were safe and effective in old Egyptian patients with chronic HCV.
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Affiliation(s)
- Mohamed El Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Reem El Sheemy
- Tropical Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt
| | | | - Mohamed El Badry
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mohamed Naguib Wifi
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa Youssef
- Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Sameera Ezzat
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin El Kom, Egypt
| | - Marwa Tahoon
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin El Kom, Egypt
| | - Lobna Abdelsalam
- Genome Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sara M Abdelhakam
- Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Khalifa El-Maamon St., Abbassia, Cairo, 11341, Egypt.
| | - Zainab Ali-Eldin
- Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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El Kassas M, Shimakawa Y, Ali-Eldin Z, Funk AL, Wifi MN, Zaky S, El-Raey F, Esmat G, Fontanet A. Risk of hepatitis B virus reactivation with direct-acting antivirals against hepatitis C virus: A cohort study from Egypt and meta-analysis of published data. Liver Int 2018; 38:2159-2169. [PMID: 29738637 DOI: 10.1111/liv.13874] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Hepatitis B virus (HBV) reactivation in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAAs) became an issue. However, its frequency has been poorly estimated, because of the varying definitions used and evaluation of heterogeneous study populations, including those concurrently treated for HBV. METHODS We prospectively followed HBV surface antigen (HBsAg)-positive Egyptians undergoing interferon-free DAAs, to estimate the risk of HBV reactivation and HBV-related hepatitis. We also conducted a meta-analysis to estimate the reactivation risk using published data obtained from a systematic review of PubMed/Embase, in addition to our Egyptian data. We applied a standard definition of HBV reactivation proposed by the international liver associations (APASL and AASLD). RESULTS Of 4471 CHC patients, 35 HBsAg-positive patients started interferon-free DAAs without HBV nucleos(t)ide analogues in our Egyptian cohort. Ten experienced HBV reactivation (28.6%), of whom 1 developed hepatitis (10.0%). Our systematic review identified 18 papers. The pooled reactivation risk in HBsAg-positive patients was 18.2% (95% CI: 7.9%-30.7%) without HBV therapy and 0.0% (95% CI: 0.0%-0.0%) with HBV nucleos(t)ide analogue. The pooled risk of hepatitis in those with HBV reactivation was 12.6% (95% CI: 0.0%-34.7%). The pooled reactivation risk in HBsAg-negative, antibody to HBV core antigen-positive (anti-HBc-positive) patients was negligible (0.1%, 95% CI: 0.0%-0.3%), irrespective of the presence of antibody to HBsAg (anti-HBs). CONCLUSIONS We confirmed high HBV reactivation risk in HBsAg-positive patients undergoing DAAs, with only a minority developing clinically important hepatitis. The risk is negligible for HBsAg-negative anti-HBc-positive patients.
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Affiliation(s)
- Mohamed El Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Yusuke Shimakawa
- Unité d'Epidémiolotie des Maladies Emergentes, Institut Pasteur, Paris, France
| | - Zainab Ali-Eldin
- Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Anna-Louise Funk
- Unité d'Epidémiolotie des Maladies Emergentes, Institut Pasteur, Paris, France
| | - Mohamed Naguib Wifi
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samy Zaky
- Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Fathiya El-Raey
- Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Gamal Esmat
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Arnaud Fontanet
- Unité d'Epidémiolotie des Maladies Emergentes, Institut Pasteur, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
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