Samar Darweesh - Academia.edu (original) (raw)

Papers by Samar Darweesh

Research paper thumbnail of Thanks to reviewers

Clinical and Translational Oncology, 2018

Research paper thumbnail of Effect of N-Acetylcysteine on Mortality and Liver Transplantation Rate in Non-Acetaminophen-Induced Acute Liver Failure: A Multicenter Study

Clinical Drug Investigation, 2017

Introduction and Aim Previous studies and systematic reviews have not provided conclusive evidenc... more Introduction and Aim Previous studies and systematic reviews have not provided conclusive evidence on the effect of N-acetylcysteine (NAC) in non-acetaminopheninduced acute liver failure (NAI-ALF). We aimed to study the value of intravenous NAC in reducing liver transplantation and mortality in NAI-ALF. Patients and Methods In a prospective, multicenter, observational study, acute liver failure patients without clinical or historical evidence of acetaminophen overdose were enrolled. NAC infusion (in empirical dose) was given as 150 mg/kg in 100 ml dextrose 5% over half an hour, then 70 mg/kg in 500 ml dextrose 5% over 4 h, then 70 mg/kg in 500 ml dextrose 5% over 16 h. Thereafter continuous infusion was administered over 24 h of 150 mg/kg in 500 ml dextrose 5% until up to two consecutive normal international normalized ratios (INRs) were obtained. Our endpoints were recovery, transplantation, or death. The primary outcome of the study was to assess reduction in mortality or liver transplantation. The secondary outcome was the evaluation of other clinical outcomes (length of ICU and hospital stays, organ system failure, and hepatic encephalopathy). Results The study included a total of 155 adults; the NAC group (n = 85) were given NAC between January 2011 to December 2013 and the control group (n = 70) were not given NAC and were included from files dating between 2010 and 2011. Both groups (before NAC) were comparable with regard to etiology, age, sex, smoking, presence of co-morbidities, encephalopathy, liver profile, and INR. The success rate (transplant-free survival) in the NAC group was 96.4%. While in the control group, 17 patients (23.3%) recovered and 53 (76.6%) did not recover, of these 37 (53.3%) had liver transplantation and 16 (23.3%) died (p \ 0.01). The NAC group had significantly shorter hospital stays (p \ 0.001), less encephalopathy (p = 0.02), and less bleeding (p \ 0.01) than the control group. The control group reported a higher ICU admission (p = 0.01) rate and abnormal creatinine and electrolytes (p = 0.002, p \ 0.01, respectively). Liver profile and INR (after NAC infusion) differed significantly between the two groups with regard to bilirubin (increased in controls, p = 0.02), AST and INR (decreased in NAC group, p \ 0.001 for both), but the ALT decrease showed no statistical significance between the two groups. Conclusions When administered on admission, intravenous NAC caused a reduction in NAI-ALF mortality and need for transplantation. NAC decreased encephalopathy, hospital stay, ICU admission, and failure of other organs.

Research paper thumbnail of Etiology and prevalence of fatigue in chronic liver disease: clinical view

The Egyptian Journal of Internal Medicine, 2016

Research paper thumbnail of Virologic response and breakthrough in chronic hepatitis B Egyptian patients receiving lamivudine therapy

Background Lamivudine monotherapy is eff ective in suppressing hepatitis B virus (HBV) replicatio... more Background Lamivudine monotherapy is eff ective in suppressing hepatitis B virus (HBV) replication to undetectable levels by PCR, in ameliorating liver disease and to some extent in achieving HBsAg seroconversion. Th is study aimed at assessing the virological and biochemical responses as well as breakthrough in HBeAg-negative chronic HBV (CHB) Egyptian patients receiving lamivudine therapy.

Research paper thumbnail of Apolipoproteins A1 and 4 Genes and Proteins as Biomarkers for Early Diagnosis and Staging of Hepatocellular Carcinoma in Chronic HCV Patients

Transylvanian Review, 2018

Aim: The lack of sensitive and specific diagnostics for hepatocellular carcinoma causes an urgent... more Aim: The lack of sensitive and specific diagnostics for hepatocellular carcinoma causes an urgent need for early diagnosis by identifying new markers using genomics and proteomics. Our aim was to validate the diagnostic and prognostic performance of Apo-A1 & A4 genes and lipoproteins as new biomarkers for HCC diagnosis. Patients and Methods: This prospective study was conducted on 125 subjects. Group 1, (n= 35) HCC (on top of HCV cirrhosis). Group 2 (n= 35) cirrhosis without HCC, Group 3, (n= 35) chronic HCV (C-HCV) without HCC nor cirrhosis and Group 4, (n= 20) healthy controls. Apolipoprotein A1 & Apolipoprotein A4 by ELISA and their genes expression by RT-PCR were identified in plasma. Results: Apo-A1 gene and protein were significantly lowest in HCC and higher in C-HCV groups (p: 0.00 for both). Apo-A1 gene significantly decreased with worsening of HCC stage (p: 0.00). On the contrary, Apo-A4 gene and protein significantly decreased in all groups as compared to controls (p: 0.00...

Research paper thumbnail of Is Insulin-Like Growth Factor-I (IGF-I) efficient as a Diagnostic ‎Biomarker in Differentiating Cholangiocarcinoma from Benign ‎Biliary Obstruction?‎‎

Background and study aim: Cholangiocarcinoma (CCA) is a rarely curable cancer and is infrequently... more Background and study aim: Cholangiocarcinoma (CCA) is a rarely curable cancer and is infrequently diagnosed early. There is a ‎growing interest in evaluating CCA biomarkers in serum and bile. CCA cells express insulin-like growth ‎factor-I (IGF-I) which modulates cell growth and reduces apoptosis.‎ The aim of this study is to evaluate biliary and serum IGF-I as diagnostic biomarkers in patients with extrahepatic ‎cholangio-carcinoma vs. benign biliary obstruction‎‎‎‎. Patients and Method: We conducted a prospective cross-sectional study on 60 patients with extrahepatic biliary obstruction ‎divided into: CCA group (n=30) and benign obstruction (n=30). All patients had diagnostic and therapeutic ‎ERCP with IGF-I assessment in serum and bile‎‎.‎ Results: The CCA group mean age was significantly higher than the benign obstruction group (69.0±4.68 vs. ‎‎56.0±6.47years, p˂0.001). The etiologies of benign biliary obstruction were bile duct stones (n=18), benign ‎stricture (n=11) and chola...

Research paper thumbnail of Prevalence and predictive factors of microscopic colitis in patients with chronic watery non-bloody diarrhea: A tertiary center study

Microscopic colitis (MC) is increasingly recognized during colonoscopy and biopsy of normal mucos... more Microscopic colitis (MC) is increasingly recognized during colonoscopy and biopsy of normal mucosa in chronic watery non-bloody diarrhea (CWND) patients. The prevalence and predictive factors of MC among CWND patients with normal colonoscopy were ANALYSIS 24(104), July August, 2020 Medical Science ISSN 2321–7359 EISSN 2321–7367

Research paper thumbnail of Genetic variants in nicotinamide-N-methyltransferase (NNMT) gene are related to the stage of non-alcoholic fatty liver disease diagnosed by controlled attenuation parameter (CAP)-fibroscan

Journal of Gastrointestinal and Liver Diseases

Non-alcoholic fatty liver disease (NAFLD) is the hepatic m an i fe s t at i on of o b e s it y an... more Non-alcoholic fatty liver disease (NAFLD) is the hepatic m an i fe s t at i on of o b e s it y and is rapidly becoming the most common liver disease

Research paper thumbnail of Colonic mucosal changes in Egyptian patients with liver cirrhosis and portal hypertension

The Egyptian Journal of Internal Medicine, 2013

Background and Aims: In liver cirrhosis with portal hypertension, Portal Hypertensive Colopathy (... more Background and Aims: In liver cirrhosis with portal hypertension, Portal Hypertensive Colopathy (PHC) is thought to be an important cause of lower gastrointestinal bleeding. This study aimed at evaluating the prevalence and clinical significance of colonic mucosal changes in Egyptian patients with cirrhotic and Portal Hypertension (PHT). Patients and Methods: A prospective study done on 35 patients with liver cirrhosis and portal hypertension (proved by upper endoscopy and/or abdominal US). They were evaluated using full colonoscopy to detect changes in colonic mucosa and gastroscopy for presence of gastro-esophageal varices, and Portal Hypertensive Gastropathy (PHG) as well. Results: Colonic lesions were found in 27 patients (77.1%), including hemorrhoids in 20 patients (57.1%), diffuse hyperaemic mucosa in 16 patients (45.7%), angiodysplastic lesions in 12 patients (34.3%) and rectal varices in 5 (14.3%). Bleeding per rectum was detected in 7 patients (20%), and it significantly correlated with the presence of hemorrhoids (P: 0.02). The prevalence of PHC and the presence of hemorrhoids increased with worsening Child-Pugh class (P: 0.01 and 0.02 successively). Conclusion: The prevalence of PHC and haemorrhoids increases with progression of liver disease and worsening of Child-Pugh in cirrhotic patients.

Research paper thumbnail of Caspase recruitment domains. New potential markers for diagnosis of hepatocellular carcinoma associated with HCV in Egyptian patients

Annals of Hepatology

BACKGROUND AND RATIONALE FOR THE STUDY: Chronic HCV is a major cause of HCC development. Caspase ... more BACKGROUND AND RATIONALE FOR THE STUDY: Chronic HCV is a major cause of HCC development. Caspase Recruitment Domains (CARD) is protein modules that regulate apoptosis and play an important role in various carcinogenesis processes, our aim is to assess the possible role of CARD9, CARD10 and Caspase only protein (COP) in progression of liver fibrosis and pathogenesis of HCC in Egyptian chronic HCV patients.

Research paper thumbnail of Is Doppler/Dopplex ultrasonography reliable in the assessment of percutaneous ablative therapies of hepatocellular carcinoma

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Increased liver stiffness by transient elastography and acoustic radiation force impulse imaging in patients with extrahepatic cholestasis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Serum ammonia as a non-invasive marker for early prediction of esophageal varices

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Apelin Association With Hepatic Fibrosis and Esophageal Varices in Chronic HCV Patients

American Journal of Gastroenterology

Research paper thumbnail of Acoustic radiation forced impulse-based splenic prediction model using data mining for the noninvasive prediction of esophageal varices in hepatitis C virus advanced fibrosis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of High SVR rate following retreatment of non-sustained virological responders to sofosbuvir based anti-HCV therapies regardless RAS testing: A real-life multicenter study

Expert Review of Gastroenterology & Hepatology

Research paper thumbnail of Serum cytokeratin-18 and its relation to liver fibrosis and steatosis diagnosed by FibroScan and controlled attenuation parameter in nonalcoholic fatty liver disease and hepatitis C virus patients

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of The clinical usefulness of elastography in the evaluation of nonalcoholic fatty liver disease patients

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Liver stiffness measurement by acoustic radiation forced impulse and transient elastography in patients with intrahepatic cholestasis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Percutaneous microwave ablation for HCV-related hepatocellular carcinoma: Efficacy, safety, and survival

The Turkish Journal of Gastroenterology

Research paper thumbnail of Thanks to reviewers

Clinical and Translational Oncology, 2018

Research paper thumbnail of Effect of N-Acetylcysteine on Mortality and Liver Transplantation Rate in Non-Acetaminophen-Induced Acute Liver Failure: A Multicenter Study

Clinical Drug Investigation, 2017

Introduction and Aim Previous studies and systematic reviews have not provided conclusive evidenc... more Introduction and Aim Previous studies and systematic reviews have not provided conclusive evidence on the effect of N-acetylcysteine (NAC) in non-acetaminopheninduced acute liver failure (NAI-ALF). We aimed to study the value of intravenous NAC in reducing liver transplantation and mortality in NAI-ALF. Patients and Methods In a prospective, multicenter, observational study, acute liver failure patients without clinical or historical evidence of acetaminophen overdose were enrolled. NAC infusion (in empirical dose) was given as 150 mg/kg in 100 ml dextrose 5% over half an hour, then 70 mg/kg in 500 ml dextrose 5% over 4 h, then 70 mg/kg in 500 ml dextrose 5% over 16 h. Thereafter continuous infusion was administered over 24 h of 150 mg/kg in 500 ml dextrose 5% until up to two consecutive normal international normalized ratios (INRs) were obtained. Our endpoints were recovery, transplantation, or death. The primary outcome of the study was to assess reduction in mortality or liver transplantation. The secondary outcome was the evaluation of other clinical outcomes (length of ICU and hospital stays, organ system failure, and hepatic encephalopathy). Results The study included a total of 155 adults; the NAC group (n = 85) were given NAC between January 2011 to December 2013 and the control group (n = 70) were not given NAC and were included from files dating between 2010 and 2011. Both groups (before NAC) were comparable with regard to etiology, age, sex, smoking, presence of co-morbidities, encephalopathy, liver profile, and INR. The success rate (transplant-free survival) in the NAC group was 96.4%. While in the control group, 17 patients (23.3%) recovered and 53 (76.6%) did not recover, of these 37 (53.3%) had liver transplantation and 16 (23.3%) died (p \ 0.01). The NAC group had significantly shorter hospital stays (p \ 0.001), less encephalopathy (p = 0.02), and less bleeding (p \ 0.01) than the control group. The control group reported a higher ICU admission (p = 0.01) rate and abnormal creatinine and electrolytes (p = 0.002, p \ 0.01, respectively). Liver profile and INR (after NAC infusion) differed significantly between the two groups with regard to bilirubin (increased in controls, p = 0.02), AST and INR (decreased in NAC group, p \ 0.001 for both), but the ALT decrease showed no statistical significance between the two groups. Conclusions When administered on admission, intravenous NAC caused a reduction in NAI-ALF mortality and need for transplantation. NAC decreased encephalopathy, hospital stay, ICU admission, and failure of other organs.

Research paper thumbnail of Etiology and prevalence of fatigue in chronic liver disease: clinical view

The Egyptian Journal of Internal Medicine, 2016

Research paper thumbnail of Virologic response and breakthrough in chronic hepatitis B Egyptian patients receiving lamivudine therapy

Background Lamivudine monotherapy is eff ective in suppressing hepatitis B virus (HBV) replicatio... more Background Lamivudine monotherapy is eff ective in suppressing hepatitis B virus (HBV) replication to undetectable levels by PCR, in ameliorating liver disease and to some extent in achieving HBsAg seroconversion. Th is study aimed at assessing the virological and biochemical responses as well as breakthrough in HBeAg-negative chronic HBV (CHB) Egyptian patients receiving lamivudine therapy.

Research paper thumbnail of Apolipoproteins A1 and 4 Genes and Proteins as Biomarkers for Early Diagnosis and Staging of Hepatocellular Carcinoma in Chronic HCV Patients

Transylvanian Review, 2018

Aim: The lack of sensitive and specific diagnostics for hepatocellular carcinoma causes an urgent... more Aim: The lack of sensitive and specific diagnostics for hepatocellular carcinoma causes an urgent need for early diagnosis by identifying new markers using genomics and proteomics. Our aim was to validate the diagnostic and prognostic performance of Apo-A1 & A4 genes and lipoproteins as new biomarkers for HCC diagnosis. Patients and Methods: This prospective study was conducted on 125 subjects. Group 1, (n= 35) HCC (on top of HCV cirrhosis). Group 2 (n= 35) cirrhosis without HCC, Group 3, (n= 35) chronic HCV (C-HCV) without HCC nor cirrhosis and Group 4, (n= 20) healthy controls. Apolipoprotein A1 & Apolipoprotein A4 by ELISA and their genes expression by RT-PCR were identified in plasma. Results: Apo-A1 gene and protein were significantly lowest in HCC and higher in C-HCV groups (p: 0.00 for both). Apo-A1 gene significantly decreased with worsening of HCC stage (p: 0.00). On the contrary, Apo-A4 gene and protein significantly decreased in all groups as compared to controls (p: 0.00...

Research paper thumbnail of Is Insulin-Like Growth Factor-I (IGF-I) efficient as a Diagnostic ‎Biomarker in Differentiating Cholangiocarcinoma from Benign ‎Biliary Obstruction?‎‎

Background and study aim: Cholangiocarcinoma (CCA) is a rarely curable cancer and is infrequently... more Background and study aim: Cholangiocarcinoma (CCA) is a rarely curable cancer and is infrequently diagnosed early. There is a ‎growing interest in evaluating CCA biomarkers in serum and bile. CCA cells express insulin-like growth ‎factor-I (IGF-I) which modulates cell growth and reduces apoptosis.‎ The aim of this study is to evaluate biliary and serum IGF-I as diagnostic biomarkers in patients with extrahepatic ‎cholangio-carcinoma vs. benign biliary obstruction‎‎‎‎. Patients and Method: We conducted a prospective cross-sectional study on 60 patients with extrahepatic biliary obstruction ‎divided into: CCA group (n=30) and benign obstruction (n=30). All patients had diagnostic and therapeutic ‎ERCP with IGF-I assessment in serum and bile‎‎.‎ Results: The CCA group mean age was significantly higher than the benign obstruction group (69.0±4.68 vs. ‎‎56.0±6.47years, p˂0.001). The etiologies of benign biliary obstruction were bile duct stones (n=18), benign ‎stricture (n=11) and chola...

Research paper thumbnail of Prevalence and predictive factors of microscopic colitis in patients with chronic watery non-bloody diarrhea: A tertiary center study

Microscopic colitis (MC) is increasingly recognized during colonoscopy and biopsy of normal mucos... more Microscopic colitis (MC) is increasingly recognized during colonoscopy and biopsy of normal mucosa in chronic watery non-bloody diarrhea (CWND) patients. The prevalence and predictive factors of MC among CWND patients with normal colonoscopy were ANALYSIS 24(104), July August, 2020 Medical Science ISSN 2321–7359 EISSN 2321–7367

Research paper thumbnail of Genetic variants in nicotinamide-N-methyltransferase (NNMT) gene are related to the stage of non-alcoholic fatty liver disease diagnosed by controlled attenuation parameter (CAP)-fibroscan

Journal of Gastrointestinal and Liver Diseases

Non-alcoholic fatty liver disease (NAFLD) is the hepatic m an i fe s t at i on of o b e s it y an... more Non-alcoholic fatty liver disease (NAFLD) is the hepatic m an i fe s t at i on of o b e s it y and is rapidly becoming the most common liver disease

Research paper thumbnail of Colonic mucosal changes in Egyptian patients with liver cirrhosis and portal hypertension

The Egyptian Journal of Internal Medicine, 2013

Background and Aims: In liver cirrhosis with portal hypertension, Portal Hypertensive Colopathy (... more Background and Aims: In liver cirrhosis with portal hypertension, Portal Hypertensive Colopathy (PHC) is thought to be an important cause of lower gastrointestinal bleeding. This study aimed at evaluating the prevalence and clinical significance of colonic mucosal changes in Egyptian patients with cirrhotic and Portal Hypertension (PHT). Patients and Methods: A prospective study done on 35 patients with liver cirrhosis and portal hypertension (proved by upper endoscopy and/or abdominal US). They were evaluated using full colonoscopy to detect changes in colonic mucosa and gastroscopy for presence of gastro-esophageal varices, and Portal Hypertensive Gastropathy (PHG) as well. Results: Colonic lesions were found in 27 patients (77.1%), including hemorrhoids in 20 patients (57.1%), diffuse hyperaemic mucosa in 16 patients (45.7%), angiodysplastic lesions in 12 patients (34.3%) and rectal varices in 5 (14.3%). Bleeding per rectum was detected in 7 patients (20%), and it significantly correlated with the presence of hemorrhoids (P: 0.02). The prevalence of PHC and the presence of hemorrhoids increased with worsening Child-Pugh class (P: 0.01 and 0.02 successively). Conclusion: The prevalence of PHC and haemorrhoids increases with progression of liver disease and worsening of Child-Pugh in cirrhotic patients.

Research paper thumbnail of Caspase recruitment domains. New potential markers for diagnosis of hepatocellular carcinoma associated with HCV in Egyptian patients

Annals of Hepatology

BACKGROUND AND RATIONALE FOR THE STUDY: Chronic HCV is a major cause of HCC development. Caspase ... more BACKGROUND AND RATIONALE FOR THE STUDY: Chronic HCV is a major cause of HCC development. Caspase Recruitment Domains (CARD) is protein modules that regulate apoptosis and play an important role in various carcinogenesis processes, our aim is to assess the possible role of CARD9, CARD10 and Caspase only protein (COP) in progression of liver fibrosis and pathogenesis of HCC in Egyptian chronic HCV patients.

Research paper thumbnail of Is Doppler/Dopplex ultrasonography reliable in the assessment of percutaneous ablative therapies of hepatocellular carcinoma

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Increased liver stiffness by transient elastography and acoustic radiation force impulse imaging in patients with extrahepatic cholestasis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Serum ammonia as a non-invasive marker for early prediction of esophageal varices

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Apelin Association With Hepatic Fibrosis and Esophageal Varices in Chronic HCV Patients

American Journal of Gastroenterology

Research paper thumbnail of Acoustic radiation forced impulse-based splenic prediction model using data mining for the noninvasive prediction of esophageal varices in hepatitis C virus advanced fibrosis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of High SVR rate following retreatment of non-sustained virological responders to sofosbuvir based anti-HCV therapies regardless RAS testing: A real-life multicenter study

Expert Review of Gastroenterology & Hepatology

Research paper thumbnail of Serum cytokeratin-18 and its relation to liver fibrosis and steatosis diagnosed by FibroScan and controlled attenuation parameter in nonalcoholic fatty liver disease and hepatitis C virus patients

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of The clinical usefulness of elastography in the evaluation of nonalcoholic fatty liver disease patients

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Liver stiffness measurement by acoustic radiation forced impulse and transient elastography in patients with intrahepatic cholestasis

European Journal of Gastroenterology & Hepatology

Research paper thumbnail of Percutaneous microwave ablation for HCV-related hepatocellular carcinoma: Efficacy, safety, and survival

The Turkish Journal of Gastroenterology