Nashaat Hamza - Academia.edu (original) (raw)

Papers by Nashaat Hamza

Cureus, 2021

The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations ... more The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations have reported. Information of COVID-19 atypical signs and symptoms is still emerging globally. One of these presentations is persistent hiccups. One of the hypotheses is that COVID-19 has been linked to several neurological manifestations and effects. Some observations noticed phrenic nerve paralysis after COVID-19 infection leading to pulmonary failure. We report one case of COVID-19-positive patient where he presented with persistent hiccups. Many predisposing factors might lead to the development of hiccups in COVID-19 infection such as a history of smoking, phrenic and vagus nerve damage or irritation, high inflammatory markers, lower lobe pneumonia, ground-glass-like appearance on x-rays. We hypothesize that hiccups are the first sign of serious deterioration of patients with COVID-19 and such patients are at high risk of developing kidney injury and intubation.

Radiology Case Reports, 2020

COVID-19 gastrointestinal symptoms COVID-19 Polymerase chain reaction testing CT abdomen in COVID... more COVID-19 gastrointestinal symptoms COVID-19 Polymerase chain reaction testing CT abdomen in COVID-19 patients Sensitivity of CT in COVID-19 patients' detection a b s t r a c t Patients with COVID-19 infection may present to the Emergency Department (ED) with gastrointestinal complaints and no respiratory symptoms. We are presenting 3 patients who came to the ED with abdominal pain; and the computed tomography [CT] of the abdomen showed findings suggestive of COVID-19 pneumonia. A 65-year-old male patient presented with symptoms of urinary tract infection and left renal angle tenderness. A 42-year-old male patient presented with right flank pain postextracorporeal shock wave lithotripsy. A 71-year-old male known to have type 2 diabetes mellitus and who had had whipple surgery for a neoplasm of the head of the pancreas presented with a painful epigasteric swelling. The 3 patients had positive COVID-19 polymerase chain reaction (PCR) tests and mild-to-moderate illness, and were discharged home after 2 weeks with a good recovery. The first patient had a false negative early PCR test, which turned positive on 2 repetitions of the test. A systematic review of CT abdomen, including inspection of the lung bases using the lung window in all CT abdomen, is essential to detect findings suggestive of COVID-19 pneumonia in patients requiring a CT abdomen study. As proven in the literature, CT findings of COVID-19 pneumonia have a higher sensitivity than the PCR test.

Cureus, 2021

The possibilities of coronavirus disease 2019 (COVID-19) to reinfect individuals have not been re... more The possibilities of coronavirus disease 2019 (COVID-19) to reinfect individuals have not been reported yet. All reported hypothesis of reinfection has been attributed to either relapse of the disease or having a mild course of symptoms. We report two cases of COVID-19 positive patients where they had complete resolution of symptoms and negative COVID-19 results. Weeks later, they returned with milder symptoms and a positive COVID-19 culture swab. In conclusion, early stages of COVID-19 where mild signs and symptoms are reported can be prolonged and the virus can stay dormant in the body for relapse later on.

Southern Medical Journal, 2003

We present our clinical experience with two complex cases of deep fascial space infections of the... more We present our clinical experience with two complex cases of deep fascial space infections of the neck. The first was a case of cervical necrotizing fasciitis involving the submental space. The second was an infection beginning at the soft palate and extending to the anterior mediastinum. Both infections emanated from an oral source in patients with diabetes mellitus, and both patients required multiple surgical debridements and endotracheal intubation for airway protection. Despite the declining incidence of deep space neck infections, our cases illustrate the challenging diagnostic and treatment dilemmas for the clinician managing patients with diabetes.

British Journal of Hospital Medicine, 2010

In January 2007, a 21-year-old woman presented to the emergency department with abdominal pain, f... more In January 2007, a 21-year-old woman presented to the emergency department with abdominal pain, fever, nausea, vomiting and diarrhoea for 6 hours. She had no other associated symptoms with unrevealing previous history. On examination she was ill-looking, conscious and oriented, with a temperature of 39.2°C, blood pressure 96/52 mmHg and pulse rate 140 beats per minute, and had clinical evidence of dehydration. Her abdomen was rigid, mainly in the right lower quadrant, with sluggish bowel sounds. The rest of the clinical examination was normal including the neurological examination. The results of blood tests were white blood cell count= 19 × 109/litre (normal range (NR) 4–11× 109/litre) with 91% neutrophils, sodium 138 mmol/litre (NR 135–145 mmol/litre), potassium 3.4 mmol/litre (NR 3.5–5 mmol/litre), serum glucose 7.1 mmol/litre (NR 4–6 mmol/litre). A chest radiograph was normal; the abdominal X-ray showed dilated bowel loops and no free gas under the diaphragm. The initial differe...

Infection, 2004

Isolated pulmonic valve infective endocarditis is an uncommon clinical entity. We report our expe... more Isolated pulmonic valve infective endocarditis is an uncommon clinical entity. We report our experience with three patients diagnosed with pulmonic valve endocarditis from our institution. Two cases were caused by Enterococcus faecalis (one was resistant to vancomycin) and one by coagulase-negative staphylococci (CNS). One of the cases of isolated pulmonic valve endocarditis due to the E. faecalis was nosocomially acquired; the case of CNS pulmonic valve endocarditis was dialysis catheter related. Each patient with isolated pulmonic valve endocarditis presented with hypotension and interstitial pulmonary infiltrates. Two patients were treated with linezolid. Both vancomycinresistant enterococci (VRE) and CNS were eliminated from blood cultures on linezolid therapy. The challenges inherent in the management of pulmonic valve endocarditis mandate the development of individual patient-specific guidelines.

British Journal of Haematology, 2004

Allogeneic stem cell transplantation following myeloablative conditioning is curative in a propor... more Allogeneic stem cell transplantation following myeloablative conditioning is curative in a proportion of patients with lifethreatening haematological disorders (Appelbaum, 1997; Lennard & Jackson, 2000). However, this treatment strategy is limited by the availability of human leucocyte antigen (HLA)matched sibling donors. For those patients lacking an histocompatible sibling donor, alternative graft sources for haemopoietic stem cells include HLA-matched unrelated adult donors (

Antimicrobial Agents and Chemotherapy, 2005

Acinetobacter spp. are emerging as opportunistic hospital pathogens that demonstrate resistance t... more Acinetobacter spp. are emerging as opportunistic hospital pathogens that demonstrate resistance to many classes of antibiotics. In a metropolitan hospital in Cleveland, a clinical isolate of Acinetobacter baumannii that tested resistant to cefepime and ceftazidime (MIC = 32 μg/ml) was identified. Herein, we sought to determine the molecular basis for the extended-spectrum-cephalosporin resistance. Using analytical isoelectric focusing, a β-lactamase with a pI of ≥9.2 was detected. PCR amplification with specific A. baumannii cephalosporinase primers yielded a 1,152-bp product which, when sequenced, identified a novel 383-amino-acid class C enzyme. Expressed in Escherichia coli DH10B, this β-lactamase demonstrated greater resistance against ceftazidime and cefotaxime than cefepime (4.0 μg/ml versus 0.06 μg/ml). The kinetic characteristics of this β-lactamase were similar to other cephalosporinases found in Acinetobacter spp. In addition, this cephalosporinase was inhibited by meropen...

Urinary Tract Infection - The Result of the Strength of the Pathogen, or the Weakness of the Host, Jun 27, 2018

Urinary tract infection (UTI) is one of the most common infections in both the community as well ... more Urinary tract infection (UTI) is one of the most common infections in both the community as well in hospital settings. It is mostly caused by Gram-negative bacteria (GNBs). Over the past two decades, GNBs have developed complex mechanisms of resistance against most of the potent antibiotics. This has been a global challenge which has been identified by the World Health Organization as "one of the greatest threats to human health." This crisis is mostly attributed to the overuse and misuse of these medications, as well as lack of new drug antimicrobials by the pharmaceutical industry. This resulted in prolonged hospital stay, marked increase in the cost as well as increase in morbidity and mortality. Furthermore, it increases the risks and complications of urological procedures. In this chapter, we review the management of the most common and challenging group of resistant Gram-negative organisms, the extended-spectrum β-lactamases producing organisms (ESBL) and the carbapenem-resistant organisms (CRE/CRP). The latter group includes carbapenem-resistant Enterobacteriaceae (CRE), as well as Pseudomonas aeruginosa carbapenemases (CRP). When treating these infections, clinicians have few effective antimicrobials options. A critical step in managing these organisms is the early recognition and appropriate empiric therapy. Both showed morbidity and mortality benefits.

Cureus, 2021

The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations ... more The possibilities of coronavirus disease 2019 (COVID-19) to present with atypical manifestations have reported. Information of COVID-19 atypical signs and symptoms is still emerging globally. One of these presentations is persistent hiccups. One of the hypotheses is that COVID-19 has been linked to several neurological manifestations and effects. Some observations noticed phrenic nerve paralysis after COVID-19 infection leading to pulmonary failure. We report one case of COVID-19-positive patient where he presented with persistent hiccups. Many predisposing factors might lead to the development of hiccups in COVID-19 infection such as a history of smoking, phrenic and vagus nerve damage or irritation, high inflammatory markers, lower lobe pneumonia, ground-glass-like appearance on x-rays. We hypothesize that hiccups are the first sign of serious deterioration of patients with COVID-19 and such patients are at high risk of developing kidney injury and intubation.

Radiology Case Reports, 2020

COVID-19 gastrointestinal symptoms COVID-19 Polymerase chain reaction testing CT abdomen in COVID... more COVID-19 gastrointestinal symptoms COVID-19 Polymerase chain reaction testing CT abdomen in COVID-19 patients Sensitivity of CT in COVID-19 patients' detection a b s t r a c t Patients with COVID-19 infection may present to the Emergency Department (ED) with gastrointestinal complaints and no respiratory symptoms. We are presenting 3 patients who came to the ED with abdominal pain; and the computed tomography [CT] of the abdomen showed findings suggestive of COVID-19 pneumonia. A 65-year-old male patient presented with symptoms of urinary tract infection and left renal angle tenderness. A 42-year-old male patient presented with right flank pain postextracorporeal shock wave lithotripsy. A 71-year-old male known to have type 2 diabetes mellitus and who had had whipple surgery for a neoplasm of the head of the pancreas presented with a painful epigasteric swelling. The 3 patients had positive COVID-19 polymerase chain reaction (PCR) tests and mild-to-moderate illness, and were discharged home after 2 weeks with a good recovery. The first patient had a false negative early PCR test, which turned positive on 2 repetitions of the test. A systematic review of CT abdomen, including inspection of the lung bases using the lung window in all CT abdomen, is essential to detect findings suggestive of COVID-19 pneumonia in patients requiring a CT abdomen study. As proven in the literature, CT findings of COVID-19 pneumonia have a higher sensitivity than the PCR test.

Cureus, 2021

The possibilities of coronavirus disease 2019 (COVID-19) to reinfect individuals have not been re... more The possibilities of coronavirus disease 2019 (COVID-19) to reinfect individuals have not been reported yet. All reported hypothesis of reinfection has been attributed to either relapse of the disease or having a mild course of symptoms. We report two cases of COVID-19 positive patients where they had complete resolution of symptoms and negative COVID-19 results. Weeks later, they returned with milder symptoms and a positive COVID-19 culture swab. In conclusion, early stages of COVID-19 where mild signs and symptoms are reported can be prolonged and the virus can stay dormant in the body for relapse later on.

Southern Medical Journal, 2003

We present our clinical experience with two complex cases of deep fascial space infections of the... more We present our clinical experience with two complex cases of deep fascial space infections of the neck. The first was a case of cervical necrotizing fasciitis involving the submental space. The second was an infection beginning at the soft palate and extending to the anterior mediastinum. Both infections emanated from an oral source in patients with diabetes mellitus, and both patients required multiple surgical debridements and endotracheal intubation for airway protection. Despite the declining incidence of deep space neck infections, our cases illustrate the challenging diagnostic and treatment dilemmas for the clinician managing patients with diabetes.

British Journal of Hospital Medicine, 2010

In January 2007, a 21-year-old woman presented to the emergency department with abdominal pain, f... more In January 2007, a 21-year-old woman presented to the emergency department with abdominal pain, fever, nausea, vomiting and diarrhoea for 6 hours. She had no other associated symptoms with unrevealing previous history. On examination she was ill-looking, conscious and oriented, with a temperature of 39.2°C, blood pressure 96/52 mmHg and pulse rate 140 beats per minute, and had clinical evidence of dehydration. Her abdomen was rigid, mainly in the right lower quadrant, with sluggish bowel sounds. The rest of the clinical examination was normal including the neurological examination. The results of blood tests were white blood cell count= 19 × 109/litre (normal range (NR) 4–11× 109/litre) with 91% neutrophils, sodium 138 mmol/litre (NR 135–145 mmol/litre), potassium 3.4 mmol/litre (NR 3.5–5 mmol/litre), serum glucose 7.1 mmol/litre (NR 4–6 mmol/litre). A chest radiograph was normal; the abdominal X-ray showed dilated bowel loops and no free gas under the diaphragm. The initial differe...

Infection, 2004

Isolated pulmonic valve infective endocarditis is an uncommon clinical entity. We report our expe... more Isolated pulmonic valve infective endocarditis is an uncommon clinical entity. We report our experience with three patients diagnosed with pulmonic valve endocarditis from our institution. Two cases were caused by Enterococcus faecalis (one was resistant to vancomycin) and one by coagulase-negative staphylococci (CNS). One of the cases of isolated pulmonic valve endocarditis due to the E. faecalis was nosocomially acquired; the case of CNS pulmonic valve endocarditis was dialysis catheter related. Each patient with isolated pulmonic valve endocarditis presented with hypotension and interstitial pulmonary infiltrates. Two patients were treated with linezolid. Both vancomycinresistant enterococci (VRE) and CNS were eliminated from blood cultures on linezolid therapy. The challenges inherent in the management of pulmonic valve endocarditis mandate the development of individual patient-specific guidelines.

British Journal of Haematology, 2004

Allogeneic stem cell transplantation following myeloablative conditioning is curative in a propor... more Allogeneic stem cell transplantation following myeloablative conditioning is curative in a proportion of patients with lifethreatening haematological disorders (Appelbaum, 1997; Lennard & Jackson, 2000). However, this treatment strategy is limited by the availability of human leucocyte antigen (HLA)matched sibling donors. For those patients lacking an histocompatible sibling donor, alternative graft sources for haemopoietic stem cells include HLA-matched unrelated adult donors (

Antimicrobial Agents and Chemotherapy, 2005

Acinetobacter spp. are emerging as opportunistic hospital pathogens that demonstrate resistance t... more Acinetobacter spp. are emerging as opportunistic hospital pathogens that demonstrate resistance to many classes of antibiotics. In a metropolitan hospital in Cleveland, a clinical isolate of Acinetobacter baumannii that tested resistant to cefepime and ceftazidime (MIC = 32 μg/ml) was identified. Herein, we sought to determine the molecular basis for the extended-spectrum-cephalosporin resistance. Using analytical isoelectric focusing, a β-lactamase with a pI of ≥9.2 was detected. PCR amplification with specific A. baumannii cephalosporinase primers yielded a 1,152-bp product which, when sequenced, identified a novel 383-amino-acid class C enzyme. Expressed in Escherichia coli DH10B, this β-lactamase demonstrated greater resistance against ceftazidime and cefotaxime than cefepime (4.0 μg/ml versus 0.06 μg/ml). The kinetic characteristics of this β-lactamase were similar to other cephalosporinases found in Acinetobacter spp. In addition, this cephalosporinase was inhibited by meropen...

Urinary Tract Infection - The Result of the Strength of the Pathogen, or the Weakness of the Host, Jun 27, 2018

Urinary tract infection (UTI) is one of the most common infections in both the community as well ... more Urinary tract infection (UTI) is one of the most common infections in both the community as well in hospital settings. It is mostly caused by Gram-negative bacteria (GNBs). Over the past two decades, GNBs have developed complex mechanisms of resistance against most of the potent antibiotics. This has been a global challenge which has been identified by the World Health Organization as "one of the greatest threats to human health." This crisis is mostly attributed to the overuse and misuse of these medications, as well as lack of new drug antimicrobials by the pharmaceutical industry. This resulted in prolonged hospital stay, marked increase in the cost as well as increase in morbidity and mortality. Furthermore, it increases the risks and complications of urological procedures. In this chapter, we review the management of the most common and challenging group of resistant Gram-negative organisms, the extended-spectrum β-lactamases producing organisms (ESBL) and the carbapenem-resistant organisms (CRE/CRP). The latter group includes carbapenem-resistant Enterobacteriaceae (CRE), as well as Pseudomonas aeruginosa carbapenemases (CRP). When treating these infections, clinicians have few effective antimicrobials options. A critical step in managing these organisms is the early recognition and appropriate empiric therapy. Both showed morbidity and mortality benefits.