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Papers by Samar Hasanein

Reumatología Clínica, Dec 31, 2023

Egyptian Rheumatology and Rehabilitation, Oct 1, 2019

Background Quality of life (QOL) is a multidimensional concept that is used to describe the indiv... more Background Quality of life (QOL) is a multidimensional concept that is used to describe the individuals' perceptions, satisfaction, and evaluation of different areas of their own lives, such as physical health and functioning, psychological and emotional wellbeing, social roles, and relationships. Few studies have addressed the effect of rheumatoid disease on the QOL in the Egyptian community. Results Functional disability based on health assessment questionnaire disability index was significantly increased with the increase in disease activity based on disease activity score-28, where all patients on remission and 56% of those with low disease activity had mild functional disability. Approximately 89% of patients with low disease activity had mild anxiety based on Hamilton anxiety scale, and the majority (75%) of those patients with moderate disease activity and 83.3% of patients on remission had mild anxiety. The majority (85.7%) of those with high disease activity were depressed based on Zung self-rating depression score. Disease activity score-28 score had a positive significant correlation with health assessment questionnaire disability index (P=0.01, r=0.40), Hamilton anxiety scale-A (P=0.01, r=0.46), Zung score (P=0.01, r=0.46), and rheumatoid arthritis QOL (r=0.70, P=0.00), and negative correlation with female sexual index (r=−0.80, P=0.00), all domains of SF-36, and all five domains of WHOQOL. Conclusion This study confirms that rheumatoid arthritis causes impairment of all aspects of QOL (limitation of physical function, physical disability, and pain), mental health disorders (anxiety and depression), and social, environmental, and also sexual dysfunction.

Aktuelle Rheumatologie, Sep 11, 2017

Neurological involvement in Behcet disease (BD) is one of the most serious causes of long term mo... more Neurological involvement in Behcet disease (BD) is one of the most serious causes of long term morbidity and mortality and can be found in up to 49 % of cases. There are 2 main types of CNS involvement, parenchymal and non-parenchymal. Transcranial Doppler (TCD) ultrasonography provides a relatively inexpensive, noninvasive, evaluation of the haemodynamics within intracranial arteries. Material and Methods Case control study of 15 patients with NBD all of them fulfilled the criteria of the International Study Group for Behcet's disease and fifteen apparently healthy volunteers age and sex matched. All patients and healthy controls were examined by TCD. Cranial Magnitic Resonance Imaging (MRI) examination was performed to the patients group. results Transcranial Doppler showed significant decline in the mean velocity (MV) of all the examined cerebral arteries in all 109 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Background: Rheumatologic diseases are the most prevalent diseases worldwide. About one-third of ... more Background: Rheumatologic diseases are the most prevalent diseases worldwide. About one-third of physical disabilities in elderly are due to rheumatologic etiological disorders as a primary cause. They are one of the main causes of disability and morbidity all over the world with great impact on the quality of life. Aim: The aim of this study was to examine the profiles of rheumatic diseases of the admitted patients to Assiut University hospital and to compare them with that of non-Arabic countries. Material and Methods: Descriptive study of 939 patients with rheumatologic diseases during the period study (from January 2011 and April 2014). Diagnosis of the patients was done after fulfilling ACR/EULAR diagnostic criteria of each disease and required investigations were also done for verifying related diagnosis. Results: The total number of patients was 939, with (79.1%) female predominance. Age ranged from 7-79 years with a mean ± SD 38 ±15.32. Rheumatoid Arthritis (RA) was presented in 36.8%, Systemic Lupus Erythematosus (SLE) in 14.3%, Crystal Arthropathy in 11.7%, Seronegative Spondyloarthropathy (SpA) in 10.3%, Behçet disease (BD) in 8.3%, Juvenile Idiopathic Arthritis (JIA) in 6.4%, Systemic Sclerosis (SSc) in 5.8%, Overlap Syndrome in 2.9%, Antiphospholipid Syndrome (APS) in 0.3% and Adult onset Still`s Disease in 0.3%. Conclusion: Rheumatoid arthritis was the most common rheumatologic disease followed by Systemic Lupus Erythematosus in admitted patients of the

Aktuelle Rheumatologie, Nov 27, 2017

This document was downloaded for personal use only. Unauthorized distribution is strictly prohibi... more This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Rheumatoid arthritis (RA) is one of the common autoimmune diseases, which affected by genetic and... more Rheumatoid arthritis (RA) is one of the common autoimmune diseases, which affected by genetic and environmental factors. IL-12 is important cytokine that play an effective role in the inflammatory reaction of RA. It regulates the balance between Th1 and Th2 cells. Gene polymorphism of cytokines may predispose to susceptibility and severity of RA. To assess the association between single nucleotide polymorphism (SNP) in IL-12B gene (rs3212227 A/C) and serum level of IL-12 with the development and or activity of RA disease in Egyptian population. Sixty RA patients and thirty healthy individuals were studied for IL-12B gene (rs3212227 A/C) polymorphism using PCR-RFLP. Serum level of IL-12 was measured by ELISA. The frequency of genotype AC, CC, AC+CC and C allele were significantly higher in patients compared to control group (P<0.02, 0.007, 0.02) respectively. Serum level of IL-12 was significantly higher in patients compared to control (P<0.000). Patients who carry AC+CC genotypes had significantly higher DAS28, RF, ACCP and IL-12 compared to AA genotype patients (P<0.05, 0.000, 0.000, 0.000) respectively. RA patients who carry AC, CC genotypes had more positive inflammatory markers (RF, ACCP) with P<0.000, 0.05 respectively. Significant positive correlation was found between serum IL-12 and number of swollen joints, RF and ACCP. Present findings suggest that IL-12B gene (rs3212227 A/C) may be associated with development and activity of RA and that serum IL-12 can be used as predictor of activity of the disease.

Brain Stimulation, Sep 1, 2017

Aktuelle Rheumatologie

Background Patients with rheumatic disease are assumed to have low muscle performance, but few st... more Background Patients with rheumatic disease are assumed to have low muscle performance, but few studies have been performed to prove this. Objective To investigate and compare muscle performance in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients and detect its correlation with disease activity, physical function level and quality of life. Patients and Methods Fifty RA patients, 50 SLE patients and 50 healthy controls were recruited for this observational, cross-sectional study. Muscle performance tests for the upper and lower limbs and the fatigue severity score were recorded. Assessments of the physical activity level using the frequency intensity time index and quality of life using the SF36 questionnaire were performed. The study was conducted over 4 months from January to April 2019. Results SLE patients showed better results of muscle performance than RA patients; however, both had lower results as compared to control. Disease activity was correlated to...

The Egyptian journal of immunology, 2020

Spectrum of Rheumatic Diseases in Egypt is Similar/Different from that in Non-Arabic Countries: A... more Spectrum of Rheumatic Diseases in Egypt is Similar/Different from that in Non-Arabic Countries: An Inpatient Comparison Samar H Goma1*, Dalia G Mahran2, Eman H El-Hakeim1, Abeer M Ghandour1, Marwa Mahmoud Abdelaziz1, Marwa AA Galal1 and Rania M Gamal1 1Department of Rheumatology, Rehabilitation, and Physical medicine, Assiut University Hospital, Assiut, Egypt 2Department of Public Health and Community medicine, Assiut University Hospital, Assiut, Egypt

Journal of Current Medical Research and Practice, 2020

Introduction Rheumatoid arthritis (RA) is a systemic autoimmune disease presented by inflammatory... more Introduction Rheumatoid arthritis (RA) is a systemic autoimmune disease presented by inflammatory polyarthritis, affecting predominantly smaller joints such as hands and feet but can also affect large joints. Heat shock protein 70 (HSP70) is released from damaged cells after stress and has been found in the bloodstream of patients with RA. Aim To study the applicability of HSP70 serum levels as a diagnostic factor and a severity indicator in patients with RA Patients and methods The study included 59 patients with RA and 14 controls. Patients were classified according to disease activity score 28 into four groups: 10 patients in remission, 12 patients with low disease activity, 18 patients with moderate disease activity, and 19 patients with high disease activity. HSP70 and anti-cyclic citrullinated peptide assessments were done by ELISA technique. Results Patients with RA had a higher HSP70 level than the control group (P < 0.001), irrespective of presence or absence of rheumato...

Revista Colombiana de Reumatología, 2021

Introduction Transcranial Doppler ultrasonography (TCD) is a technique that allows measurement of... more Introduction Transcranial Doppler ultrasonography (TCD) is a technique that allows measurement of blood flow from the basal intracerebral vessels. It is relatively inexpensive, non-invasive, can be performed at the bedside, and allows monitoring in acute emergency settings and for prolonged periods with a high temporal resolution, making it ideal for studying the haemodynamics within the intracranial arteries in neuro-Behcet's disease (NBD) and neuro-psychiatric lupus (NPSLE). Our aim was to assess the cerebral haemodynamic patterns in patients with NBD and NPSLE using TCD, while brain lesions were examined using magnetic resonance imaging (MRI). Material and methods Case–control prospective study of 30 neuro-Behcet's disease patients, 25 neuro-psychiatric lupus patients and 26 healthy age-matched volunteers. All patients and healthy controls were examined by TCD. Only the groups of patients underwent cranial magnetic resonance imaging (MRI). Results Transcranial Doppler (TC...

Revista Colombiana de Reumatología, 2021

Abstract Introduction Rheumatoid arthritis and systemic lupus erythematosus are chronic autoimmun... more Abstract Introduction Rheumatoid arthritis and systemic lupus erythematosus are chronic autoimmune diseases affecting quality of life. Patients and methods Two hundred patients diagnosed with RA and SLE were enrolled in this study. Four questionnaires (SF36, The Hamilton anxiety scale, The Zung Self-Rating Depression Scale, The Female Sexual Function Index) were administered. Results In this cross-sectional study, all domains of SF36 had significant negative correlations with DAS 28. Patients with no flare and those with mild to moderate SLEDAI had significantly higher SF36 domains as compared to patients with severe SLEDAI (P Conclusion This study confirms that RA and SLE impair all aspects of quality of life. In RA patients disease activity negatively correlates with quality of life and sexual function, while there is a positive correlation with depression and anxiety. In SLE patients disease activity negatively correlates with quality of life and sexual dysfunction.

The Egyptian Rheumatologist, 2020

Background: Cardiovascular disease (CVD) has become increasingly recognized as a cause of mortali... more Background: Cardiovascular disease (CVD) has become increasingly recognized as a cause of mortality, especially in patients with long-standing systemic lupus erythematosus (SLE). Aim of the work: To detect subclinical cardiac involvement and its relation to clinical characteristics, disease activity and damage. Patients and methods: Transthoracic echocardiography (TTE) was performed in 36 SLE patients. Cardiac magnetic resonance (CMR) sections were obtained. T1-weighted inversion recovery scout images were obtained after injection of gadolinium. Results: Thirty-six patients were included with a mean age of 32.4 ± 8.5 years; 35 females and 1 male; with disease duration of 7.9 ± 5 years. The frequent cardiac presentations on TTE were tricuspid regurgitation (TR) (41.6%), mitral regurgitation (MR) (36.1%), mitral thickening (25%), early diastolic mitral flow/ mitral flow during atrial contraction (E/A) < 1 (19.4%). The most frequent cardiac presentations by CMR were MR (25%), pericarditis (25%), mitral thickening (13.9%), TR (13.9%), myocarditis (8.3). Neither SLE Disease Activity Index (SLEDAI) nor Systemic Lupus International Collaborating Clinics (SLICC) damage index, high-sensitivity-C reactive protein (hsCRP), C3 and C4 levels were significantly correlated with the ejection fraction (EF) by CMR. There was significant negative correlation between disease duration and EF by CMR (r = À0.36, p = 0.03). Using multiple regression, EF by CMR was strongly predicted by disease duration (p = 0.025). The analysis of EF and MR fraction by CMR and TTE showed acceptable moderate agreement. CMR and TTE showed 83.3% agreement in the detection of pericarditis. Conclusion: CMR is superior to echocardiography in detection of subclinical abnormalities in SLE.

Journal of Nutritional Science and Vitaminology, 2020

Rheumatoid arthritis (RA) is one of the most widespread autoimmune disorders and it has a genetic... more Rheumatoid arthritis (RA) is one of the most widespread autoimmune disorders and it has a genetic background with a variety of genes affecting the degradation of the immune system. Along these lines, we assessed the relationship between the BsmI, and FokI VDR polymorphisms and inflammable records identified with infections activity. Such as interleukins (IL-6, IL-8), hypoxia inducible factor-alpha (HIF-a), soluble receptor of advanced glycation end product (sRAGE), oxidized low-density lipoprotein cholesterol (oxLDL), neutrophil gelatinase-associated lipocalin (NGAL) and procollagen N-propeptide of type III collagen (P3NP) and the allelic frequencies of BsmI VDR rs1544410 and FokI VDR rs2228570 polymorphism on the RA. Total of 131 subjects [70 RA patients and 61 age and sex matched apparently healthy controls (HC)] were monitored for inflammatory biomarkers using ELISA. All patients were screened for the BsmI and FokI using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The all biomarkers were significantly higher in RA patients in comparison with HC. There were positive correlations between NGAL, oxLDL and s-RAGE, oxLDL. On BsmI, 'GG' and ' AG' genotypes were significantly associated with high RA activity as well as the frequency of genotypes ' AG & GG" were higher in high activity RA as compared to low RA activity. However on FokI, was observed that in high activity patients the frequency of 'CC' & 'CT' was more prevalent as compared to low activity ones. These outcomes support the immunoregulatory role of vitamin D which is associated with several inflammatory diseases, signifying a credible anti-inflammatory role in perturbation of the RA.

Egyptian Rheumatology and Rehabilitation, 2020

Background Intolerance to MTX is the most common cause of non-compliance that leads to poor disea... more Background Intolerance to MTX is the most common cause of non-compliance that leads to poor disease control. Treatment is usually discontinued due to intolerance which interferes with compliance of the patient to long-term treatment. Caffeine causes most of its biological effects via antagonizing all types of adenosine receptors (ARs). Our aim was to investigate the effect of caffeine intake on reducing symptoms of MTX intolerance in patients with RA. Methods Ninety patients were diagnosed as RA with MTX intolerance divided into 2 groups. Sixty patients were prescribed caffeine or dark chocolate. Control group included 30 patients who will continue MTX regimen without addition of any extra caffeine. Results Group A (caffeine group): There was no statistically significant difference between patients and controls at the start of the study. There was statistically significant decrease in methotrexate intolerance severity score (MISS) all over the study period (P = 0.001), and also MISS...

Egyptian Rheumatology and Rehabilitation, 2018

The objective of this paper is to evaluate the role of prolactin and estrogen levels on disease a... more The objective of this paper is to evaluate the role of prolactin and estrogen levels on disease activity in patients with systemic lupus erythematosus (SLE). Patients and methods This study included 60 female patients with SLE, with a mean age of 33.5±13.12 years. It was conducted between November 2014 and October 2015. Disease activity was defined according to Systemic Lupus Erythematosus Activity Index; score of at least 6 was considered as an active disease. Prolactin (PRL) and estrogen levels and other serological markers of lupus disease activity, namely, complement 3,4 (C3 and C4), erythrocyte sedimentation rate, C-reactive protein, and anti-double-stranded DNA (anti-dsDNA) titer were calculated. Results Hyperprolactinemia was present in 25.0% of patients, and low estrogen level was present in 33.3% of patients. There was no significant correlation between either of estrogen or prolactin levels and all clinical and laboratory features, except for a significant positive correlation between anti-dsDNA and hyperprolactinemia. Conclusion There was no significant correlation between either of PRL or estrogen levels and Systemic Lupus Erythematosus Activity Index score. Overall, 80.0% of patients with hyperprolactinemia and 80.0% with low estrogen level had SLE activity. There was a significant difference in the frequency of further indicators of disease activity in SLE such as raised erythrocyte sedimentation rate, raised C-reactive protein, or decrease in complement factors with high serum PRL and low estrogen level.

Journal of Current Medical Research and Practice, 2020

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that affects mult... more Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that affects multiple systems and is associated with an inflammatory status. The aim of our study is to estimate the serum level of vitamin D and bone mineral density (BMD) in SLE patients and their relation to disease activity. Patients and methods: Ninety SLE patients, fulfilling the updated American College of Rheumatology criteria 2012 and 60 age-matched and sex-matched controls were included in this study. The level of serum 25-hydroxyvitamin D (25(OH)D3) and dual-energy radiograph absorptiometry were done for patients and controls. Results: There was significant difference between systemic lupus erythematosus disease activity index (SLEDAI) score and vitamin D (P <0.02). There were significant difference (P <0.01) between SLE and control with BMD of total lumbar (L1–L4) and total hip and highly significant difference (P <0.001) with neck of the femur, Ward's angle of the femur, trochanter of the femur, and the radius. There was significant difference (P<0.05) between SLE and control groups regarding T score of lumbar spine (L1–L4) (P <0.03), neck of the femur (P<0.01), and total hip bone (P <0.02). Our results showed that there was significant difference between SLEDAI score and T score of neck of the femur (P <0.02) and radius bone (P <0.012), while there was no significant difference between SLEDAI score and T score of total hip, lumbar spine (L1–L4), Ward's angle of the femur, and the trochanter of the femur. Conclusion: Vitamin D deficiency and low BMD are common in SLE patients. There was significant difference between SLE patients and control group regarding vitamin D, BMD, and T score at different sites.

January 2018, 2018

Background: Nowadays, pain and disability due to chronic knee arthritis is a very common problem ... more Background: Nowadays, pain and disability due to chronic knee arthritis is a very common problem in middle aged people. A lot of modalities for management are available, including conservative analgesics and up to surgical interventions. Radiofrequency ablation of genicular nerves is assumed to be an effective less invasive and safe pain alleviation modality. Objectives: To evaluate the efficacy of fluoroscopic guided radiofrequency neurotomy of the genicular nerves for alleviation of chronic pain and improvement of function in patients with knee osteoarthritis. Study Design: A single-blind randomized controlled trial. Setting: Pain management unit, and Rheumatology and Rehabilitation clinics of Assiut University hospitals, Assiut, Egypt. Methods: This study involved 60 patients with chronic knee osteoarthritis. Radiofrequency neurotomy of the genicular nerves was done for 30 patients (Group A) while the other 30 patients (Group C) received conventional analgesics only. The outcome ...

Abstracts Accepted for Publication, 2019

Background: Biologic therapies have considerably improved clinical management of autoimmune disea... more Background: Biologic therapies have considerably improved clinical management of autoimmune diseases. Over the past few years, several biosimilars have been introduced in Europe for these conditions. Limited information is available evaluating the impact of switching stable patients from originators to their respective biosimilars in clinical practice for nonmedical reasons. Objectives: This real-world study reported and compared patient characteristics, clinical outcomes, and healthcare resource utilization (HRU) associated with stable patients who switched from the originator biologic etanercept to its biosimilar (switchers) vs. those who stayed on the originator (non-switchers) in adults with a rheumatic condition such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), or rheumatoid arthritis (RA). Methods: Medical record data were retrospectively collected anonymously from rheumatologists in the UK and Germany. Adult patients who were diagnosed with RA, AS, or PsA, treated with originator etanercept for at least 6 months with a stable dosing schedule, and had no emergency department visit or hospitalization for the disease of interest over the 6month period were eligible for the study. The index date for a nonswitcher was the prescription date closest to one year after the initiation of originator etanercept and with a stable dosing for at least 6 months. The index date for a switcher was the biosimilar initiation date. Chart data available for at least 12 months prior to and post the index date were required. Patient characteristics, disease severity, symptoms and signs, and HRU were extracted anonymously. Unadjusted and adjusted comparisons of the outcomes between non-switchers and switchers were conducted among all patients and for each individual disease. Results: Data were extracted from 242 patient records (non-switchers = 123, 50.8%; switchers = 119, 49.2%; AS=26.4%; PsA=26.0%; RA=47.5%) from 162 rheumatologists. At baseline, non-switchers were significantly younger than switchers (44.5 vs. 48.4 years, p<0.05), had a significantly shorter time on the originator etanercept (11.7 vs. 23.8 months), and more patients had been treated with NSAIDS (55.3% vs. 37.8%). Significantly more non-switchers had moderate, or severe disease (27.6% vs 16.0%, p<0.05; 26.8% vs 5.9%, p<0.01) and non-switchers on average had worse joint or spine pain (4.4 vs 2.4, p <0.01) than switchers. During the follow-up period, significantly more non-switchers' disease status improved (58.5% vs. 25.2%. p<0.01), resulting comparable disease severity (moderate: 10.6% vs 10.9%; severe: 0% vs 0%) and joint or spine pain scale (2.0 vs 1.0) between the two cohorts. After adjusting for potential confounding factors, compared to switchers, more AS and PsA non-switchers improved in disease severity (AS: p<0.05; PsA: p<0.01), and RA non-switchers had a fewer number of swollen joints (0.5 vs 1.5, p<0.01). Non-switchers generally had numerically lower HRU than switchers during the one-year follow-up period (patients with outpatient visits: 76.4% vs 89.1%; average number of outpatient visits: 1.8 vs 2.0). Conclusion: When compared with stable patients who underwent nonmedical switching, stable patients who continued therapy with the originator biologic demonstrated significantly more improvement in disease severity. Other outcomes such as HRU appeared more similar between patients who underwent non-medical switching and patients who continued therapy with the originator biologic. The value of biosimilar non-medical switching requires continued evaluation in real-world clinical practice. Acknowledgement: Medical writing support provided by Cinzia Metallo of Analysis Group, and funded by AbbVie.

Reumatología Clínica, Dec 31, 2023

Egyptian Rheumatology and Rehabilitation, Oct 1, 2019

Aktuelle Rheumatologie, Sep 11, 2017

Aktuelle Rheumatologie, Nov 27, 2017

Brain Stimulation, Sep 1, 2017

Aktuelle Rheumatologie

The Egyptian journal of immunology, 2020

Journal of Current Medical Research and Practice, 2020

Revista Colombiana de Reumatología, 2021

The Egyptian Rheumatologist, 2020

Journal of Nutritional Science and Vitaminology, 2020

Egyptian Rheumatology and Rehabilitation, 2020

Egyptian Rheumatology and Rehabilitation, 2018

Journal of Current Medical Research and Practice, 2020

January 2018, 2018

Abstracts Accepted for Publication, 2019