Gehan Hussein | Cairo University (original) (raw)

Papers by Gehan Hussein

Journal of the Saudi Heart Association, May 21, 2024

Endothelial dysfunction linked to ventricular dysfunction in Endothelial dysfunction linked to ve... more Endothelial dysfunction linked to ventricular dysfunction in Endothelial dysfunction linked to ventricular dysfunction in children with sickle cell disease, a 3D speckle tracking study. children with sickle cell disease, a 3D speckle tracking study.

I In nt tr ro od du uc ct ti io on n: : To evaluate bone mineral density (BMD) and levels of bone... more I In nt tr ro od du uc ct ti io on n: : To evaluate bone mineral density (BMD) and levels of bone turnover markers in Egyptian children with juvenile rheumatoid arthritis (JRA), and its relationship with disease-related variables. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : A case-control study included thirty children having JRA and 25 healthy controls. They were subjected to measurement of BMD of lumbar spines (L2-L4) and femoral neck using dual-energy-X-ray absorptiometry (DXA) with laboratory evaluation of bone turnover markers including serum receptor activator of nuclear factor κB-ligand (RANKL) and osteoprotegerin (OPG). R Re es su ul lt ts s: : Patients had significantly lower femoral neck BMD than controls (p = 0.02), and it was significantly lower in patients with corticosteroid therapy (p = 0.04). Eight patients (26.7%) and only 2 (8%) controls had low BMD at lumbar spine, while 13 patients (43.3%) and 2 (8%) controls had low BMD at femoral neck. Patients showed significantly higher RANKL, OPG and deoxypyridinolin (p = 0.0001, p = 0.049, p = 0.047), while calcium, osteocalcin, bone-specific alkaline phosphatase and OPG/RANKL ratio were significantly lower in them (p = 0.015, p = 0.031, p = 0.041, p = 0.0001). Patients with normal BMD were significantly taller than patients with low BMD (p = 0.035), while the number of active painful joints and swollen restricted mobility joints were significantly higher in patients with low BMD (p = 0.03, p = 0.02), with no significant difference regarding disease duration and bone turnover markers (p > 0.05). C Co on nc cl lu us si io on ns s: : JRA patients had lower BMD, higher frequency of low BMD (more prominent in the femoral neck) and higher OPG and RANKL levels compared with healthy children; suggesting that they may be at risk of developing premature osteoporosis and fractures later in life.

Introduction: Respiratory syncytial virus (RSV) is one of major causes of viral respiratory tract... more Introduction: Respiratory syncytial virus (RSV) is one of major causes of viral respiratory tract disease in young children and infants. We aimed to study the frequency of respiratory syncytial virus and its subtypes in pneumonia and bronchopneumonia in pediatric patients less than two years old tested by nested polymerase chain reaction with the evaluation of routinely used methods of diagnosis which are clinical manifestations and chest X-ray. Material and Methods: The study included 70 patients exhibited lower respiratory tract symptoms in the form of pneumonia and bronchopneumonia. Their age ranged from two months to eighteen months. All participants were subjected to clinical examination, chest X-ray examination, nasopharyngeal aspirate (NPA) samples for microbiological examination and nested reverse transcriptase polymerase chain reaction for diagnosis of respiratory syncytial virus. Results: RSV was highly prevalent infection in our studied patients, as 60 patients (86%) out ...

European Heart Journal - Cardiovascular Imaging, 2019

Background tetralogy of fallot (TOF) is a common congenital cyanotic heart disease in which arrhy... more Background tetralogy of fallot (TOF) is a common congenital cyanotic heart disease in which arrhythmias could develop even after successful operative repair. Pulmonary regurgitation (PR) and consequently, right ventricular dilatation develop in many cases.Purpose: to study the incidence of arrhythmias and correlate it with MRI parameters in this group of patients. Methodology: Cross sectional descriptive study was conducted on 32 cases after successful surgical repair. Transthoracic colour Doppler echocardiography, 24 hours Holter monitoring and functional cardiac MRI for assessment of pulmonary regurgitant fraction (PR fraction), ventricular volume and function were performed. Cases were classified according to right ventricular end diastolic volume index (RVEDVI) into 2 groups with cut off value 150 ml/m2, the value above which pulmonary valve replacement was recommended. Results: Mean age of the studied cases was (12.96 ± 3.38) years, mean age at time of surgical repair was (34.23± 22.1) months, and mean duration postoperatively was (121.72± 41.03) months, range 30-192 (2.5-16 years). 18 cases(56%) had RVEDVI ≥150 ml/m2, PR fraction was significantly higher in cases of increased RVEDVI(p 0.007), left ventricular ejection fraction (LVEF) was significantly lower in the same group (p 0.002).Arrhythmias were detected in 18 cases (56%), most common of which was infrequent supraventricular ectopy, no significant difference in incidence of arrhythmias between the 2 groups (p 1), no significant correlation between arrhythmias and increased RVEDVI(p value 0.76, r 0.05). Arrhythmias were significantly more common in older age group (p0.001) with no difference between cases with and without arrhythmias in RVEDVI (p 0.56), PR fraction (p 0.5) Left ventricular end diastolic volume index LVEDVI(p 0.25) RVEF (p 0.06) or LVEF(p 0.06) conclusion: Holter detected arrhythmias after successful surgical repair of TOF significantly were associated with increased postoperative duration but not related to cardiac MRI parameters Abstracts ii487

Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 2014

Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy of childhood. It leads to... more Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy of childhood. It leads to progressive deterioration in cardiac and skeletal muscles. Corticosteroids are considered an effective therapy. This study aimed to evaluate the role of short-term prednisone therapy in improving left ventricular (LV) systolic function, LV mass (LVM), and motor power in cases of muscular dystrophies. Twenty-five cases of muscular dystrophy including 17 cases of DMD, 3 cases of Becker muscular dystrophies, and 5 cases of female patients with DMD-like phenotype were included in the study. The diagnosis of 12 patients was confirmed by muscle biopsy with immunohistochemistry; the patients were subjected to motor assessment, measurement of creatine kinase level, and echocardiographic examination before and after prednisone therapy. Transthoracic echocardiographic assessment of the LV systolic function (fractional shortening) was done. Myocardial performance index and LVM were calculated. Int...

Left ventricular hypertrophy (LVH) is associated with cardiovascular morbidity and mortality in h... more Left ventricular hypertrophy (LVH) is associated with cardiovascular morbidity and mortality in hemodialysis patients. Cardiac troponins (cTn) were proposed as markers of cardiac damage, but their value is still debated in hemodialysis patients. Objective: To assess LVH and cTnI in Egyptian pediatric patients on regular hemodialysis and their relationship to dialysis-related hypotension episodes and mortality over a period of one year. Patients and Methods: This study included 30 children on regular hemodialysis. Patients were subjected to 2-D, M-mode Doppler echocardiography with calculation of the left ventricular mass index (LVMI). Serum cTnI was assessed using an immunoassay test. Patients were clinically followed up for one year. Results: LVH (as measured by LVMI) was detected in 66.7 % of patients. Concentric hypertrophy was present in 43.3 % and eccentric hypertrophy in 23.3 % of patients. Although serum cTnI was < 1 ng/ml hypotension episodes occurred in 13.3 % of patient...

Archives of Medical Science, 2009

Egyptian Journal of Radiology and Nuclear Medicine

Background Tetralogy of Fallot (TOF) is a common congenital cyanotic heart disease in which arrhy... more Background Tetralogy of Fallot (TOF) is a common congenital cyanotic heart disease in which arrhythmias could develop even after successful operative repair. Pulmonary regurgitation and right ventricular dilatation develop in many cases. The relation between arrhythmias and right ventricular dilatation is not established. Our aim is to assess the relation in between the degree of right ventricular volume affection and the severity of the pulmonary regurgitation, associated arrhythmias and the need for pulmonary valve repair in Egyptian pediatric and adolescent cases after successful TOF repair. Results A cross sectional descriptive study was conducted on 32 cases after successful surgical repair. Transthoracic Doppler echocardiography, 24 h Holter monitoring and cardiac MRI for assessment of pulmonary regurgitation fraction (PRF), ventricular volumes and function were measured. Cases were classified according to right ventricular end diastolic volume index (RVEDVI) into 2 groups wit...

Journal of Clinical & Experimental Cardiology, 2014

Objective: To assess the value of conventional echocardiographic measurements for quantification ... more Objective: To assess the value of conventional echocardiographic measurements for quantification of pulmonary regurge and right ventricular function in comparison to Cardiac Magnetic Resonance Imaging (CMR) after surgical repair of Tetralogy Of Fallot (TOF). Methods: Twenty five asymptomatic children after TOF repair (9.2 ± 4 years) were compared to twenty five age matched healthy children. Echocardiographic quantification of pulmonary regurge was assessed by (1) pulmonary regurge jet width/pulmonary artery diameter, (2) pulmonary pressure half time, (3) pulmonary regurge index; pulmonary regurge duration to diastole duration, (4) no flow time; diastole duration-pulmonary regurge duration and (5) diastole/systole velocity time integral ratio. Measurements derived from conventional echocardiography were compared to pulmonary regurgitant fraction, right ventricular volumes and ejection fraction by CMR. Results: On CMR, the pulmonary regurgitant fraction was 28.64 ± 10.2%. By conventional echocardiography, pulmonary regurge index and no flow time were found to offer the best prediction for severity of pulmonary regurge. Pulmonary regurge index of <0.8 has sensitivity of 86.36% and specificity of 100% (AUC=0.924) and no flow time of >64 msec has sensitivity of 81% and specificity of 100% (AUC=0.894) in identifying significant pulmonary regurge. Compared to controls, patients after TOF repair showed significantly lower right ventricle myocardial velocities, higher E/ E' ratio and prolonged MPI. Among the TOF patients, right ventricular MPI showed significant negative correlation (r=-0.402; P=0.008) with tricuspid valve annulus peak systolic velocity (S') and significant positive correlation (r= 0. 413; P=0.04) with right ventricle stroke volume by CMR. Conclusion: Conventional echocardiography can offer a simple, readily available and accurate tool for quantification of pulmonary regurge and right ventricular function during mid-term follow up after surgical repair of tetralogy of Fallot.

Pediatric Nephrology, 2008

Cardiovascular morbidity and mortality are highly prevalent among patients with chronic renal fai... more Cardiovascular morbidity and mortality are highly prevalent among patients with chronic renal failure (CRF). Endothelial dysfunction is regarded as the initial reversible step in the development of atherosclerosis and has been demonstrated in all stages of renal failure. Non-invasive techniques to assess endothelial function have been recently developed and have been proven to predict future mortality in adults. We aimed

Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 2012

One of the major organs affected in neonatal sepsis is the heart. Echocardiogram provides real-ti... more One of the major organs affected in neonatal sepsis is the heart. Echocardiogram provides real-time information on the cardiovascular performance rather than dependence on the clinical signs alone, which might lead to misjudgment. To assess left ventricular (LV) functions in septic neonates early after admission using transthoracic color Doppler Echocardiography. Echocardiography was done to 30 septic and 30 nonseptic newborns who were divided among 4 groups (septic full-term, 14; septic preterm, 16; nonseptic full-term, 21; and nonseptic preterm, 9). Comparisons were made among the 4 groups using analysis of variance and post hoc test regarding the systolic function (using ejection fraction and fractional shortening), the diastolic function (using the early patrial peak/atrial peak flow velocity ratio), and the global LV function (using myocardial performance index). The E-wave and the early peak flow velocity/atrial peak flow velocity ratio were significantly lower in the septic n...