Alaa Fawzi - Academia.edu (original) (raw)

Papers by Alaa Fawzi

International Urology and Nephrology, 2007

Introduction Haemodialysis (HD) patients appear to have particular susceptibility for cardiovascu... more Introduction Haemodialysis (HD) patients appear to have particular susceptibility for cardiovascular (CV) diseases with lipid abnormalities among its significant contributors. However, there is controversy concerning the combined effect on lipid constituents during HD of the three commonly used variables; the type of heparin, dialysis membrane and the constituent of dialysate buffer bases. Consequently, this controlled prospective study was thought of. Patients Randomly 63 patients were assigned from Urology and Nephrology haemodialysis (HD) unit, Mansoura, Egypt for the planned study. Their mean age was 45.79 ± 13.11 years. Fourteen patients with end-stage renal disease (ESRD) served as control group for the remaining 49 HD patients. They were subdivided according to the HD duration ( 1 year), anticoagulant used (unfractionated [UFH] and low-molecular weight heparin [LMWH, Enoxaparin), membrane type (Hemophane [HP] and polysulfone [PS] membrane) and dialysate buffer bases (bicarbonate versus acetate based). Methods Determining the fasting lipid value of total cholesterol (TC) and triglycerides (TG) as well as lipoproteins including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and lipoprotein (a) [Lp (a)] was completed. Results Bicarbonate dialysate was associated with significantly lower TG (134.7 ± 11 mg/dl vs. 153 ± 14 mg/dl, p = 0.004), higher HDL-C (33.1 ± 3 vs. 28.3 ± 2, p = 0.0002) and subsequently better atherosclerosis risk ratio [TC/HDL-C (ARR)] (6.02 ± 0.09 vs. 5.3 ± 0.9, p = 0.001) despite its insignificant effect on TC and LDL-C. However, logarithm (log) Lp (a) level was significantly higher (1.92 ± 0.05 vs. 1.82 ± 0.04 p = 0.001) in comparison with acetate dialysate. Membrane type was not influential in those dialyzed for n = 11) compared to HP filters (n = 11) significantly lowered TC (151.7 ± 16 vs. 172.6 ± 12, p = 0.003), TG (127.8 ± 15 vs. 155.7 ± 15, p = 0.004), LDL-C (122.1 ± 5 vs. 130.6 ± 7, p = 0.006) levels as well as ARR (5.9 ± 0.5 vs. 5.4 ± 0.3, p = 0.02). Likewise was the reduction in log Lp (a) (1.9 ± 0.03 vs. 1.8 ± 0.04, p = 0.002) with insignificant effect on HDL-C. After 6 months, Enoxaparin caused significant improvement of TC (0.0004), TG (p = 0.018), LDL-C (p = 0.006), HDL-C (0.041) and Lp (a) (0.047) compared to UFH. Patients who continued on Enoxaparin for 3 more months displayed an even better attenuation in most of lipid parameters whilst continuation of UFH was insignificant. Switching few patients (n = 4) from UFH to LMWH for 3 months resulted in significant lowering of TC (153 ± 7 vs. 177.7 ± 3, p = 0.01), TG (127.5 ± 5 vs. 137.3 ± 4, p = 0.03) and LDL-C (124.7 ± 5 vs. 127.5 ± 5, p = 0.005). However, switching equal number of patients from LMWH to UFH caused no significant change. Conclusion Dyslipidaemia in Egyptian haemodialysis patients was improved when bicarbonate-based haemodialysis, the use of polysulfone membrane, and more so when the low-molecular weight heparin Enoxaparin were used.

Journal of Rheumatology, 2010

To describe enhanced magnetic resonance imaging (MRI) features and characteristic entheseal chang... more To describe enhanced magnetic resonance imaging (MRI) features and characteristic entheseal changes in the knees in patients with seronegative spondyloarthropathy (SpA). The 56 patients included 30 with psoriatic arthritis, 5 with ankylosing spondylitis, 5 with reactive arthritis, 5 with ulcerative colitis (UC), 5 with Crohn's disease, and another 6 with skin psoriasis. Controls were 20 healthy subjects without knee complaints. MRI was performed in all participants, emphasizing entheseal sites. Both knees were studied in 45 (80.3%) patients and one knee in 11 (19.6%). MRI showed evidence of bone marrow edema in 13 (23.2%) patients, cartilaginous erosions in 18 (32.1%), and bone erosions in 9 (16.1%). Enthesitis was found in medial collateral ligaments in 18 (32.1%), lateral collateral ligaments in 8 (14.3%), posterior cruciate ligaments in 3 (5.35%), patellar tendon in 18 (32.1%), biceps femoris insertion in 3 (5.35%), medial patellofemoral ligaments (MPFL) in 5 (8.9%), and lateral patellofemoral ligament in 1 patient (1.8%). In the UC and Crohn's patients (n = 10), 2 had bone erosions and 5 had enthesitis. In the skin psoriasis group (n = 6), one had bone marrow edema; enthesitis was detected in 5 at the patellar tendon insertion and in one in the MPFL. Entheseal-related changes were absent in the controls. This is the first study showing entheseal-related changes in the knees in patients with inflammatory bowel disease or skin psoriasis without clinical arthritis. Enthesitis of the knee on MRI may be an early finding in SpA.

... Alaa J. Al-Joubory1, Fawzi M. Al-Naima2, Samir S. Raouf3 1Department of Electronic Engineerin... more ... Alaa J. Al-Joubory1, Fawzi M. Al-Naima2, Samir S. Raouf3 1Department of Electronic Engineering, College of Engineering, Nahrain University, Baghdad, Iraq 2Faculty of Telecommunication and Information Engineering, University of Engineering and Technology ... i Ki k ik i ik ik K ...

Biology of Blood and Marrow Transplantation, 2011

Hematopoietic stem cell transplantation (HSCT) activity was surveyed in the 9 countries in the WH... more Hematopoietic stem cell transplantation (HSCT) activity was surveyed in the 9 countries in the WHO Eastern Mediterranean (EM) region that are reported to carry out transplants. Between the years of 1984 and 2007, 7933 transplants were reported. The total number of HSCT per year has continued to increase, with a plateau in allogeneic HSCT (allo-HSCT) between 2005 and 2007. Overall, a greater proportion of transplants were allogeneic HSCT (allo-HSCT) (n=5761, 77%) compared to autologous HSCT (ASCT) (n=2172, 23% ASCT). Of 5761 allo-HSCT, acute leukemia constituted the main indication (n=2124, 37%). There was a relatively high proportion of allo-HSCT for bone marrow failure (n=1001, 17%) and hemoglobinopathies (n=885, 15%). The rate of unrelated donor transplants remained low, with only 2 non-umbilical cord matched unrelated donor (MUD) allo-HSCT reported. One hundred umbilical cord (UCB) transplants were reported (0.017% of allo-HSCT). Peripheral blood stem cells (PBSC) were the main source of graft in allo-HSCT, and PBSCT increasingly constitutes the main source of stem cells. Reduced intensity conditioning was utilized in 5.7% of allografts over the surveyed period. ASCT numbers continue to increase. There has been a shift in the indication for ASCT from acute leukemia to lymphoproliferative disorders (45%) followed by myeloma (26%). The survey reflects transplantation activity according to the unique health settings of this region. Notable differences

Journal of Rheumatology, 2009

To compare findings as observed on enhanced magnetic resonance imaging (MRI) of the knee joints, ... more To compare findings as observed on enhanced magnetic resonance imaging (MRI) of the knee joints, in oligoarticular-undifferentiated arthritis (UA) in those with established rheumatoid arthritis (RA) and spondyloarthropathy (SpA). A total of 55 patients with knee arthritis were consecutively recruited for the study, including 25 with undifferentiated oligoarthritis of the knee joint(s), 15 fulfilling the American College of Rheumatology criteria for RA and 15 with SpA. Laboratory investigations included erythrocyte sedimentation rate, C-reactive protein, complete blood count, aspartate aminotransferase, alanine aminotransferase, serum creatinine, and urine analysis. In all patients in the UA and in the RA group, rheumatoid factor and anti-CCP2 antibody (ELISA) were tested. All patients underwent enhanced MRI of the more symptomatic knee. All groups were compared in terms of demographics, laboratory investigations, and MRI findings. Synovial thickness differed significantly in the RA group compared to UA and SpA groups (p < 0.001). The RA group showed a higher rate of bony and cartilaginous erosions and bone marrow edema compared to UA and SpA groups (p < 0.001). Enthesitis was found in all patients in the SpA group (100%) and differed from RA and UA groups (p < 0.001). Patients with RA showed more destructive changes in terms of synovial thickening, bone marrow edema, cartilaginous and bone erosions compared to UA and SpA groups. Enthesitis is a common feature on MRI in SpA, while absent in the RA and UA groups. This latter finding may have important clinical implications for classification purposes, and can help to determine the evolving pattern of patients with UA of the knee joint.

Journal of Pharmaceutical and Biomedical Analysis, 2004

Three methods are presented for the simultaneous determination of cyproheptadine hydrochloride (C... more Three methods are presented for the simultaneous determination of cyproheptadine hydrochloride (CP), thiamine hydrochloride (B1), riboflavin-5-phosphate sodium dihydrate (B2), nicotinamide (B3), pyridoxine hydrochloride (B6), and sorbic acid (SO). The chromatographic method depends on a high performance liquid chromatographic (HPLC) separation on a reversed-phase, RP 18 column. Elution was carried out with 0.1% methanolic hexane sulphonic acid sodium salt (solvent A) and 0.01 M phosphate buffer containing 0.1% hexane sulphonic acid sodium salt, adjusted to an apparent pH of 2.7 (solvent B). Gradient HPLC was used with the solvent ratio changed from 20:80 to 70:30 (over 9 min), then to 80:20 (over 11 min) for solvent A:B, respectively. Quantitation was achieved with UV detection at 220 and 288 nm based on peak area. The other two chemometric methods applied were principal component regression (PCR) and partial least squares (PLS). These approaches were successfully applied to quantify each drug in the mixture using the information included in the UV absorption spectra of appropriate solutions in the range 250-290 nm with the intervals λ = 0.4 nm at 100 wavelengths. The chemometric methods do not require any separation step. The three methods were successfully applied to a pharmaceutical formulation and the results were compared with each other. (A. El-Gindy). dispensed with some water-soluble vitamins such as thiamine hydrochloride (B1), riboflavin-5-phosphate sodium dihydrate (B2), nicotinamide (B3), and pyridoxine hydrochloride (B6). They are formulated in the form of syrup containing sorbic acid (SO) as antibacterial and antifungal. The studied drugs show a severe overlap between their absorption spectra. There is, in addition, a strong UV absorption due to 0731-7085/$ -see front matter

Archives of Gynecology and Obstetrics, 2008

Objective To compare the use of enoxaparin alone with combination therapy of prednisone, aspirin ... more Objective To compare the use of enoxaparin alone with combination therapy of prednisone, aspirin and progesterone in the treatment of women with idiopathic recurrent miscarriage (IRM) in terms of live births and pregnancy outcome. Methods A prospective, randomized, single-blinded, placebo-controlled trial was conducted at a tertiary referral obstetric hospital. The participants were 170 women with a diagnosis of IRM. Women were recruited after full investigative screening. Women with ≥3 fetal losses and after exclusion of all known causes of recurrent miscarriage were randomly allocated to receive either enoxaparin alone, combination treatment consisting of prednisone, aspirin, and progesterone or placebo. Rates of live births, antenatal complications, delivery and neonatal outcomes were recorded prospectively. Data were statistically analyzed as appropriate. Results Ten patients were dropped out after random assignment. Eighty-one percent of the enoxaparin (46/57) group and 85% of the combination-treated group (45/53) were delivered of live infants compared to 48% (24/50) of the placebo (P Miscarriage rates were significantly lower in the treated groups compared with placebo (P Conclusions A combination treatment consisting of high-dose, low-duration prednisone, progesterone and aspirin might be an effective treatment as enoxaparin alone. Both regimens were associated with a good pregnancy outcome.

International Urology and Nephrology, 2007

Introduction Haemodialysis (HD) patients appear to have particular susceptibility for cardiovascu... more Introduction Haemodialysis (HD) patients appear to have particular susceptibility for cardiovascular (CV) diseases with lipid abnormalities among its significant contributors. However, there is controversy concerning the combined effect on lipid constituents during HD of the three commonly used variables; the type of heparin, dialysis membrane and the constituent of dialysate buffer bases. Consequently, this controlled prospective study was thought of. Patients Randomly 63 patients were assigned from Urology and Nephrology haemodialysis (HD) unit, Mansoura, Egypt for the planned study. Their mean age was 45.79 ± 13.11 years. Fourteen patients with end-stage renal disease (ESRD) served as control group for the remaining 49 HD patients. They were subdivided according to the HD duration ( 1 year), anticoagulant used (unfractionated [UFH] and low-molecular weight heparin [LMWH, Enoxaparin), membrane type (Hemophane [HP] and polysulfone [PS] membrane) and dialysate buffer bases (bicarbonate versus acetate based). Methods Determining the fasting lipid value of total cholesterol (TC) and triglycerides (TG) as well as lipoproteins including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and lipoprotein (a) [Lp (a)] was completed. Results Bicarbonate dialysate was associated with significantly lower TG (134.7 ± 11 mg/dl vs. 153 ± 14 mg/dl, p = 0.004), higher HDL-C (33.1 ± 3 vs. 28.3 ± 2, p = 0.0002) and subsequently better atherosclerosis risk ratio [TC/HDL-C (ARR)] (6.02 ± 0.09 vs. 5.3 ± 0.9, p = 0.001) despite its insignificant effect on TC and LDL-C. However, logarithm (log) Lp (a) level was significantly higher (1.92 ± 0.05 vs. 1.82 ± 0.04 p = 0.001) in comparison with acetate dialysate. Membrane type was not influential in those dialyzed for n = 11) compared to HP filters (n = 11) significantly lowered TC (151.7 ± 16 vs. 172.6 ± 12, p = 0.003), TG (127.8 ± 15 vs. 155.7 ± 15, p = 0.004), LDL-C (122.1 ± 5 vs. 130.6 ± 7, p = 0.006) levels as well as ARR (5.9 ± 0.5 vs. 5.4 ± 0.3, p = 0.02). Likewise was the reduction in log Lp (a) (1.9 ± 0.03 vs. 1.8 ± 0.04, p = 0.002) with insignificant effect on HDL-C. After 6 months, Enoxaparin caused significant improvement of TC (0.0004), TG (p = 0.018), LDL-C (p = 0.006), HDL-C (0.041) and Lp (a) (0.047) compared to UFH. Patients who continued on Enoxaparin for 3 more months displayed an even better attenuation in most of lipid parameters whilst continuation of UFH was insignificant. Switching few patients (n = 4) from UFH to LMWH for 3 months resulted in significant lowering of TC (153 ± 7 vs. 177.7 ± 3, p = 0.01), TG (127.5 ± 5 vs. 137.3 ± 4, p = 0.03) and LDL-C (124.7 ± 5 vs. 127.5 ± 5, p = 0.005). However, switching equal number of patients from LMWH to UFH caused no significant change. Conclusion Dyslipidaemia in Egyptian haemodialysis patients was improved when bicarbonate-based haemodialysis, the use of polysulfone membrane, and more so when the low-molecular weight heparin Enoxaparin were used.

Journal of Rheumatology, 2010

To describe enhanced magnetic resonance imaging (MRI) features and characteristic entheseal chang... more To describe enhanced magnetic resonance imaging (MRI) features and characteristic entheseal changes in the knees in patients with seronegative spondyloarthropathy (SpA). The 56 patients included 30 with psoriatic arthritis, 5 with ankylosing spondylitis, 5 with reactive arthritis, 5 with ulcerative colitis (UC), 5 with Crohn's disease, and another 6 with skin psoriasis. Controls were 20 healthy subjects without knee complaints. MRI was performed in all participants, emphasizing entheseal sites. Both knees were studied in 45 (80.3%) patients and one knee in 11 (19.6%). MRI showed evidence of bone marrow edema in 13 (23.2%) patients, cartilaginous erosions in 18 (32.1%), and bone erosions in 9 (16.1%). Enthesitis was found in medial collateral ligaments in 18 (32.1%), lateral collateral ligaments in 8 (14.3%), posterior cruciate ligaments in 3 (5.35%), patellar tendon in 18 (32.1%), biceps femoris insertion in 3 (5.35%), medial patellofemoral ligaments (MPFL) in 5 (8.9%), and lateral patellofemoral ligament in 1 patient (1.8%). In the UC and Crohn's patients (n = 10), 2 had bone erosions and 5 had enthesitis. In the skin psoriasis group (n = 6), one had bone marrow edema; enthesitis was detected in 5 at the patellar tendon insertion and in one in the MPFL. Entheseal-related changes were absent in the controls. This is the first study showing entheseal-related changes in the knees in patients with inflammatory bowel disease or skin psoriasis without clinical arthritis. Enthesitis of the knee on MRI may be an early finding in SpA.

... Alaa J. Al-Joubory1, Fawzi M. Al-Naima2, Samir S. Raouf3 1Department of Electronic Engineerin... more ... Alaa J. Al-Joubory1, Fawzi M. Al-Naima2, Samir S. Raouf3 1Department of Electronic Engineering, College of Engineering, Nahrain University, Baghdad, Iraq 2Faculty of Telecommunication and Information Engineering, University of Engineering and Technology ... i Ki k ik i ik ik K ...

Biology of Blood and Marrow Transplantation, 2011

Hematopoietic stem cell transplantation (HSCT) activity was surveyed in the 9 countries in the WH... more Hematopoietic stem cell transplantation (HSCT) activity was surveyed in the 9 countries in the WHO Eastern Mediterranean (EM) region that are reported to carry out transplants. Between the years of 1984 and 2007, 7933 transplants were reported. The total number of HSCT per year has continued to increase, with a plateau in allogeneic HSCT (allo-HSCT) between 2005 and 2007. Overall, a greater proportion of transplants were allogeneic HSCT (allo-HSCT) (n=5761, 77%) compared to autologous HSCT (ASCT) (n=2172, 23% ASCT). Of 5761 allo-HSCT, acute leukemia constituted the main indication (n=2124, 37%). There was a relatively high proportion of allo-HSCT for bone marrow failure (n=1001, 17%) and hemoglobinopathies (n=885, 15%). The rate of unrelated donor transplants remained low, with only 2 non-umbilical cord matched unrelated donor (MUD) allo-HSCT reported. One hundred umbilical cord (UCB) transplants were reported (0.017% of allo-HSCT). Peripheral blood stem cells (PBSC) were the main source of graft in allo-HSCT, and PBSCT increasingly constitutes the main source of stem cells. Reduced intensity conditioning was utilized in 5.7% of allografts over the surveyed period. ASCT numbers continue to increase. There has been a shift in the indication for ASCT from acute leukemia to lymphoproliferative disorders (45%) followed by myeloma (26%). The survey reflects transplantation activity according to the unique health settings of this region. Notable differences

Journal of Rheumatology, 2009

To compare findings as observed on enhanced magnetic resonance imaging (MRI) of the knee joints, ... more To compare findings as observed on enhanced magnetic resonance imaging (MRI) of the knee joints, in oligoarticular-undifferentiated arthritis (UA) in those with established rheumatoid arthritis (RA) and spondyloarthropathy (SpA). A total of 55 patients with knee arthritis were consecutively recruited for the study, including 25 with undifferentiated oligoarthritis of the knee joint(s), 15 fulfilling the American College of Rheumatology criteria for RA and 15 with SpA. Laboratory investigations included erythrocyte sedimentation rate, C-reactive protein, complete blood count, aspartate aminotransferase, alanine aminotransferase, serum creatinine, and urine analysis. In all patients in the UA and in the RA group, rheumatoid factor and anti-CCP2 antibody (ELISA) were tested. All patients underwent enhanced MRI of the more symptomatic knee. All groups were compared in terms of demographics, laboratory investigations, and MRI findings. Synovial thickness differed significantly in the RA group compared to UA and SpA groups (p < 0.001). The RA group showed a higher rate of bony and cartilaginous erosions and bone marrow edema compared to UA and SpA groups (p < 0.001). Enthesitis was found in all patients in the SpA group (100%) and differed from RA and UA groups (p < 0.001). Patients with RA showed more destructive changes in terms of synovial thickening, bone marrow edema, cartilaginous and bone erosions compared to UA and SpA groups. Enthesitis is a common feature on MRI in SpA, while absent in the RA and UA groups. This latter finding may have important clinical implications for classification purposes, and can help to determine the evolving pattern of patients with UA of the knee joint.

Journal of Pharmaceutical and Biomedical Analysis, 2004

Three methods are presented for the simultaneous determination of cyproheptadine hydrochloride (C... more Three methods are presented for the simultaneous determination of cyproheptadine hydrochloride (CP), thiamine hydrochloride (B1), riboflavin-5-phosphate sodium dihydrate (B2), nicotinamide (B3), pyridoxine hydrochloride (B6), and sorbic acid (SO). The chromatographic method depends on a high performance liquid chromatographic (HPLC) separation on a reversed-phase, RP 18 column. Elution was carried out with 0.1% methanolic hexane sulphonic acid sodium salt (solvent A) and 0.01 M phosphate buffer containing 0.1% hexane sulphonic acid sodium salt, adjusted to an apparent pH of 2.7 (solvent B). Gradient HPLC was used with the solvent ratio changed from 20:80 to 70:30 (over 9 min), then to 80:20 (over 11 min) for solvent A:B, respectively. Quantitation was achieved with UV detection at 220 and 288 nm based on peak area. The other two chemometric methods applied were principal component regression (PCR) and partial least squares (PLS). These approaches were successfully applied to quantify each drug in the mixture using the information included in the UV absorption spectra of appropriate solutions in the range 250-290 nm with the intervals λ = 0.4 nm at 100 wavelengths. The chemometric methods do not require any separation step. The three methods were successfully applied to a pharmaceutical formulation and the results were compared with each other. (A. El-Gindy). dispensed with some water-soluble vitamins such as thiamine hydrochloride (B1), riboflavin-5-phosphate sodium dihydrate (B2), nicotinamide (B3), and pyridoxine hydrochloride (B6). They are formulated in the form of syrup containing sorbic acid (SO) as antibacterial and antifungal. The studied drugs show a severe overlap between their absorption spectra. There is, in addition, a strong UV absorption due to 0731-7085/$ -see front matter

Archives of Gynecology and Obstetrics, 2008

Objective To compare the use of enoxaparin alone with combination therapy of prednisone, aspirin ... more Objective To compare the use of enoxaparin alone with combination therapy of prednisone, aspirin and progesterone in the treatment of women with idiopathic recurrent miscarriage (IRM) in terms of live births and pregnancy outcome. Methods A prospective, randomized, single-blinded, placebo-controlled trial was conducted at a tertiary referral obstetric hospital. The participants were 170 women with a diagnosis of IRM. Women were recruited after full investigative screening. Women with ≥3 fetal losses and after exclusion of all known causes of recurrent miscarriage were randomly allocated to receive either enoxaparin alone, combination treatment consisting of prednisone, aspirin, and progesterone or placebo. Rates of live births, antenatal complications, delivery and neonatal outcomes were recorded prospectively. Data were statistically analyzed as appropriate. Results Ten patients were dropped out after random assignment. Eighty-one percent of the enoxaparin (46/57) group and 85% of the combination-treated group (45/53) were delivered of live infants compared to 48% (24/50) of the placebo (P Miscarriage rates were significantly lower in the treated groups compared with placebo (P Conclusions A combination treatment consisting of high-dose, low-duration prednisone, progesterone and aspirin might be an effective treatment as enoxaparin alone. Both regimens were associated with a good pregnancy outcome.