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Papers by maha yousif

Background: Asthma is one of the most common chronic diseases worldwide and has been increasing i... more Background: Asthma is one of the most common chronic diseases worldwide and has been increasing in prevalence over the last few decades. Magnesium (Mg++) has been shown to relax bronchial smooth muscle and influence the function of respiratory muscles. Hypomagnesemia has been associated with diminished respiratory muscle power. Objective: The purpose of the present study was to assess the serum Mg++ level in bronchial asthma patients during stable state and during exacerbation (Acute severe asthma).

Egyptian Journal of Chest Diseases and Tuberculosis, 2018

Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are lin... more Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are linked with microvascular changes. Retinal microvasculature can be examined in a direct noninvasive way. Aim The aim was to evaluate tortuosity of the retinal vessels in patients with COPD, OSA, and overlap syndrome. Patients and methods A total of 60 participants were included: 15 patients with OSA, 15 patients with COPD, 15 patients with COPD-OSA overlap syndrome, and 15 matched controls. All participants underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, Epworth sleepiness scale, and STOP-BANG questionnaires. Results Tortuosity of most retinal vessels was higher in all patient groups when compared with the control group, and tortuosity was more marked in the overlap syndrome group. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 saturation, and a positive correlation with PCO2, apnea hypopnea index, O2 desaturation index, BMI, and smoking index. Conclusion Retinal vascular tortuosity occurs in OSA, COPD, and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index, and BMI.

Egyptian Journal of Chest Diseases and Tuberculosis/Egyptian Journal of Chest Diseases and Tuberculosis, Apr 1, 2024

The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotini... more The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotinic acetylcholine receptors (nAChRs). It is a strong predisposing factor for the development of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the associations between single nucleotide polymorphism (SNP) of nAChRs rs1051730 and demographic (including smoking index and cigarette consumption per day), physiologic and lab characteristics of Egyptian males with COPD. This study was conducted on 68 COPD smoker patients and 32 non-COPD smokers who were selected from Chest Department, Faculty of Medicine, Menoufia University during the period from October 2015 to January 2016. A blood sample was taken and a spirometry was performed. Genotyping was performed for nAChRs rs1051730 by SNP assay real time PCR methods. The distribution of nAChRs rs1051730 AA genotypes is more frequent in COPD patients with increase susceptibility to COPD by 5.19 fold. AA genotypes ...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Although there is well-proved association between type 2 diabetes mellitus (T2DM) and ... more Background Although there is well-proved association between type 2 diabetes mellitus (T2DM) and active tuberculosis, factors involved in the association between T2DM and latent tuberculosis infection (LTBI) are scarcely known. Aim The aim of this study was to study the prevalence and risk factors of LTBI in a cohort of Egyptian adults with T2DM including studying the effect of oral hypoglycemic drugs on this prevalence. Patients and methods All patients with T2DM were recruited from Menoufia University Endocrinology outpatient clinic during the period from June to December 2018. Demographic and clinical data, serum glucose and glycosylated hemoglobin (HbA1c) level, and QuantiFERON-TB Gold In-Tube and tuberculin skin test were assessed. Results In all, 102 patients were recruited, according to the QuantiFERON test; 22 (21.6%) patients were diagnosed with LTBI. Their mean age was 54.91±8.85, mean T2DM duration was 9.82±6.54/year, mean HbA1c% was 10.29±1.59, which is significantly hig...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Despite obesity hypoventilation syndrome (OHS) having more mortality than obstructive ... more Background Despite obesity hypoventilation syndrome (OHS) having more mortality than obstructive sleep apnea (OSA), the characteristics of those patients in relation to their PaCO2 have not been clarified. Aim The aim was to evaluate anthropometric, physiologic, and laboratory characteristics of patients with OHS in relation to OHS severity (according to PaCO2) and to identify OHS predictors. Patients and methods A total of 59 patients with OHS were compared with 118 BMI-matched patients with OSA as a control group. Patient demographics, arterial blood gases, polysomnographic data, and blood chemistry were compared. The patients with OHS were classified into three subgroups according to their daytime PaCO2 level: mild OHS (46 mmHg ≤PaCO2 ≤50 mmHg), moderate OHS (51 mmHg ≤PaCO2 ≤55 mmHg), and severe OHS (PaCO2≥56 mmHg). Results Patients with OHS had significantly more comorbidities, hemoglobin, and hematocrit levels, and lower PaO2 and nocturnal oxygenation parameters (baseline O2 sa...

Pleural effusions are a common clinical presentation of many diseases and can present as diagnost... more Pleural effusions are a common clinical presentation of many diseases and can present as diagnostic challenge to the clinician. The development of disease-specific diagnostic biomarkers for pleural effusions is an active area of research. Among the potentially available laboratory parameters is procalcitonin (PCT). ) It is a propeptide of calcitonin produced by C-cells of the thyroid gland. Normally, PCT levels are undetectable in healthy humans. In severe bacterial infections, intact PCT is found in blood. One major advantage of PCT compared to other parameters is its early and highly specific increase in response to sepsis. A correlation between serum PCT concentration and sepsis has been previously reported. But, What about pleural fluid PCT? Can PCT play a role in resolving the myth of many cases with undiagnosed pleural effusion? Can it constitute another piece of the diagnostic puzzle? This research has been the winner of Minoufiya University award for international publicatio...

The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotini... more The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotinic acetylcholine receptors (nAChRs). It is a strong predisposing factor for the development of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the associations between single nucleotide polymorphism (SNP) of nAChRs rs1051730 and demographic (including smoking index and cigarette consumption per day ), physiologic and lab characteristics of Egyptian males with COPD. This study was conducted on 68 COPD smoker patients and 32 non-COPD smokers who were selected from Chest Department, Faculty of Medicine, Menoufia University during the period from October 2015 to January 2016. A blood sample was taken and a spirometry was performed. Genotyping was performed for nAChRs rs1051730 by SNP assay real time PCR methods. The distribution of nAChRs rs1051730 AA genotypes is more frequent in COPD patients with increase susceptibility to COPD by 5.19 fold. AA genotypes...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2021

Background Diffuse parenchymal lung diseases (DPLD) compromise heterogeneous subtypes. Establishi... more Background Diffuse parenchymal lung diseases (DPLD) compromise heterogeneous subtypes. Establishing an accurate diagnosis is paramount. Lung tissue biopsy is the gold standard diagnostic tool. Aim To assess the role of medical thoracoscopy with electrocautery in the diagnosis of DPLD. Patients and methods A total of 20 patients who had undiagnosed DPLD on chest high-resolution computed tomography were randomly selected from Menoufia Chest Department from March 2017 to March 2019. Lung biopsy was taken by medical thoracoscopy under conscious sedation with the aid of electrocautery device. Results A total of 12 (60%) patients were males, and seven (35%) patients were smokers. The mean age was 58.1±10.5 years. High-resolution computed tomography patterns were reticulonodular (65%), ground glass (35%), miliary shadow (15%), and consolidation (15%). Diagnoses were granulomatous lung disease (40%), idiopathic interstitial pneumonias (30%), malignant lung disease (15%), and interstitial lu...

© 2018 The Egyptian Journal of Chest Diseases and Tu Background Various thyroid hormone states ha... more © 2018 The Egyptian Journal of Chest Diseases and Tu Background Various thyroid hormone states have been described in patients with respiratory failure. Domiciliary noninvasive positive airway pressure (NPAP) can be used for management of chronic respiratory failure. Aim This study aims to assess thyroid function in patients with chronic respiratory failure and to evaluate the effect of domiciliary NPAP on thyroid hormone levels. Patients and methods Forty-five patients were admitted with acute on top of chronic respiratory failure of various causes; all were addressed after discharge to domiciliary NPAP, either continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP). Thyroid hormones and arterial blood gas were assessed on admission, at the time of discharge, and at 2-month follow-up. Results On admission, 21 (46.67%) patients had nonthyroidal illness syndrome (NTIS) and eight (17.78%) patients had subclinical hypothyroidism. PO2 level was significant...

Menoufia Medical Journal, 2019

Objective To assess the level of serum leptin in patients with active pulmonary tuberculosis (TB)... more Objective To assess the level of serum leptin in patients with active pulmonary tuberculosis (TB). Background One of the most important and common complaint of patients with TB, which also affects the immune status, is weight loss. When TB infection occurs, a variety of chemokines and cytokines are secreted from infected cells and tissue macrophages. Leptin is a 16-kDa protein, and its level varies with active pulmonary TB. Patients and methods Serum leptin level was measured in 40 newly diagnosed patients with active pulmonary TB (group I) and 20 matched control (group II). Results Serum leptin level was significantly lower in patients with active pulmonary TB than controls. There was a highly significant positive correlation between leptin level and BMI. Serum leptin had a significantly negative correlation with grades of Ziehl–Neelsen stain and chest radiography. The cutoff point of leptin was found to be 0.54 ng/ml for discrimination of patients with active pulmonary TB. Conclus...

Objective The aim of the paper was to investigate the relationship between serum YKL-40 levels an... more Objective The aim of the paper was to investigate the relationship between serum YKL-40 levels and severity of chronic obstructive pulmonary disease (COPD). Background COPD is a major health problem with increasing morbidity and mortality throughout the world. A newly recognized biomarker, YKL-40, is a chitin-binding glycoprotein, and its serum level is elevated in inflammatory diseases. However, it has not been thoroughly investigated in COPD. Patients and methods A total of 30 patients with stable COPD and 10 healthy individuals as a control group were enrolled for estimation of modified Medical Research Counseling dyspnea scale, spirometry, and serum YKL-40 levels. Results Serum YKL-40 level was increased significantly in patients with COPD compared with healthy controls. There was a positive correlation between serum YKL-40 level and each of modified Medical Research Counseling dyspnea scale severity and age, and a negative correlation with forced expiratory volume in the first ...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Chronic obstructive pulmonary disease (COPD) is a widespread lung disease with a high ... more Background Chronic obstructive pulmonary disease (COPD) is a widespread lung disease with a high mortality and morbidity especially with co-morbid cardiac impairment. Severity of COPD can be assessed using BODE Index (body mass index, obstruction of airflow, dyspnea degree and exercise capacity). Aim To study the relationship between BODE index and right ventricle (RV) and left ventricle (LV) functions using Two-dimensional speckle-tracking echocardiography (2D-STE) in COPD patients. Subjects and methods Fifty stable COPD patients and matched fifty control subjects underwent transthoracic echocardiography, where conventional and speckle tracking parameters were taken. BODE indices were calculated and divided to quartiles (Q) (Q1; BODE index = 0–2, Q2; BODE index = 3–4 Q3; BODE index = 5–6, Q4; BODE index = 7–10). Results COPD patients had lower RV fractional area change (FAC%, P<0.0001), tricuspid annular plane systolic excursion (TAPSE, P<0.0001), lateral wall strain of RV (P<0.0001) and RV average global strain (P<0.0001) than controls. Regarding LV, they had lower LV end diastolic dimension (EDD, P<0.0001), LV end systolic dimension (P<0.003), E/A ratio (P<0.0001) and LV global longitudinal strain (GLS, P<0.028) than controls. BODE index had negative correlation with TAPSE (P<0.0001), LVEDD (P<0.022) and global RV strain (P<0.014). Significant differences were demonstrated among BODE quartiles regarding RV FAC%, TAPSE and RV average global strain. Significant differences were between BODE quartiles and controls regarding RV FAC%, TAPSE, RV lateral wall strain, RV average global strain, E/A ratio and LVEDD. Conclusion COPD patients had RV, LV systolic dysfunction and LV diastolic dysfunction. The more COPD severity increased (assessed by BODE index) the more impairment of RV systolic function and LV diastolic function would be.

Pulmonary hypertension, 2019

Egyptian Journal of Bronchology, 2019

Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is... more Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed. Aim The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PESI) and modified version (m-PESI) as predictors of in-hospital mortality and homeostatic morbidities (nonlethal repeated venous thromboembolism, and/or nonlethal serious hemorrhage) in patients with PE. Patients and methods Patients proved to have acute PE admitted to Menoufia and Cairo University Hospitals between March 2017 and March 2019 were included in the study. The o-PESI, s-PESI, and m-PESI were calculated for each patient. In-hospital mortality, homeostatic morbidities, and major adverse events (mortality and homeostatic morbidities) were registered. Results One hundred and two patients were recruited. Inhospital mortality rate was 13.7%, morbidity rate was 21.6%, whereas major adverse events rate was 31%. The s-PESI classified 31.4% of patients as low risk, and none of them had in-hospital mortality. The frequencies of major adverse events in the low-risk groups were 31.2, 9.1, and 75% for o-PESI, s-PESI, and m-PESI, respectively. Difference between adverse events and non-adverse events groups was significant when s-PESI was applied (P=0.008). The s-PESI had the highest sensitivity and negative predictive value in detecting mortality, morbidity, and major adverse events compared with o-PESI and m-PESI. The area under the curve for s-PESI was significantly above the other two indices (area under the curve=0.78, P=0.04). Conclusion In addition to its easy application, the s-PESI has a preferably superior prognostic accuracy than o-PESI and m-PESI in prognostication of low-risk patients with acute PE.

Clinical Neuropharmacology, 2019

Abstract This review describes the characteristics of a number of pathologies, which are consider... more Abstract This review describes the characteristics of a number of pathologies, which are considered from the point of view of chronobiology, that is, the way in which biological processes are expressed throughout the 24-hour day. This perspective is a relatively new way of thinking about disease and additionally about how to treat diseases. It has called attention to the importance of not only the quantity of a drug that is administered but also when it is administered. In addition, the review presents an overview of the emerging clinical strategies known as chronotherapeutics, that is, the effects of the daily scheduling of drug administration and the consequences of the activity and efficacy of therapies that are applied in this manner. This article also reviews innovative ways in which physicians are applying time-specified drug treatment (chronopharmacology) for sleep disorders. Here, we present a systematic description of chronopharmacology as well as definitions of key terms that, we believe, will be helpful for newcomers to the field. It is hoped that greater awareness of this new perspective on pharmacology will promote its adoption by researchers and clinicians.

Sleep and control of breathing, 2018

Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are lin... more Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are linked with microvascular changes. Retinal microvasculature can be examined in a direct noninvasive way. Aim The aim was to evaluate tortuosity of the retinal vessels in patients with COPD, OSA, and overlap syndrome. Patients and methods A total of 60 participants were included: 15 patients with OSA, 15 patients with COPD, 15 patients with COPD-OSA overlap syndrome, and 15 matched controls. All participants underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, Epworth sleepiness scale, and STOP-BANG questionnaires. Results Tortuosity of most retinal vessels was higher in all patient groups when compared with the control group, and tortuosity was more marked in the overlap syndrome group. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 saturation, and a positive correlation with PCO2, apnea hypopnea index, O2 desaturation index, BMI, and smoking index. Conclusion Retinal vascular tortuosity occurs in OSA, COPD, and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index, and BMI.

Journal of the Egyptian Society of Cardio-Thoracic Surgery, 2016

Objectives: Pulmonary Tuberculosis (TB) is a disease that is often treated medically. However, me... more Objectives: Pulmonary Tuberculosis (TB) is a disease that is often treated medically. However, medical treatment usually fails in the management of tuberculosis e related hemoptysis. In this study, we aimed to assess the role of surgery in the treatment of hemoptysis due to pulmonary TB. Methods: Fifty two patients presented by hemoptysis and underwent pulmonary resection were enrolled in this study. Patients were divided into two groups according to the timing of surgical procedures: Group A (n ¼ 22) included patients who underwent surgery within two days of presentation which was major to massive hemoptysis causing hemodynamic instability. Group B (n ¼ 30) included patients who underwent surgery within 4 days after presentation with hemoptysis which was persistent and minor. Results: There was no significant difference in the demographic data between both groups. Major and massive hemoptysis were the common presentation of group A, whereas minor hemoptysis was the main presentation in group B. Tuberculous cavities were the most common lung lesions in both groups (40.9% in group A, versus 40% in group B). Lobectomy was the main surgical procedure performed in both groups (50% in group A, versus 56.7% in group B). Regarding the complications, Bronchopleural fistula occurred in one case in each group after pneumonectomy. Recurrent hemoptysis occurred in only one case in group A. There was one case (4.5%) of mortality in group A. Conclusion: Early pulmonary resection in patients with hemoptysis is an effective and safe method to insure good outcome. Limited resections are associated with higher incidence of recurrence.

Background: Asthma is one of the most common chronic diseases worldwide and has been increasing i... more Background: Asthma is one of the most common chronic diseases worldwide and has been increasing in prevalence over the last few decades. Magnesium (Mg++) has been shown to relax bronchial smooth muscle and influence the function of respiratory muscles. Hypomagnesemia has been associated with diminished respiratory muscle power. Objective: The purpose of the present study was to assess the serum Mg++ level in bronchial asthma patients during stable state and during exacerbation (Acute severe asthma).

Egyptian Journal of Chest Diseases and Tuberculosis, 2018

Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are lin... more Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are linked with microvascular changes. Retinal microvasculature can be examined in a direct noninvasive way. Aim The aim was to evaluate tortuosity of the retinal vessels in patients with COPD, OSA, and overlap syndrome. Patients and methods A total of 60 participants were included: 15 patients with OSA, 15 patients with COPD, 15 patients with COPD-OSA overlap syndrome, and 15 matched controls. All participants underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, Epworth sleepiness scale, and STOP-BANG questionnaires. Results Tortuosity of most retinal vessels was higher in all patient groups when compared with the control group, and tortuosity was more marked in the overlap syndrome group. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 saturation, and a positive correlation with PCO2, apnea hypopnea index, O2 desaturation index, BMI, and smoking index. Conclusion Retinal vascular tortuosity occurs in OSA, COPD, and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index, and BMI.

Egyptian Journal of Chest Diseases and Tuberculosis/Egyptian Journal of Chest Diseases and Tuberculosis, Apr 1, 2024

The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotini... more The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotinic acetylcholine receptors (nAChRs). It is a strong predisposing factor for the development of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the associations between single nucleotide polymorphism (SNP) of nAChRs rs1051730 and demographic (including smoking index and cigarette consumption per day), physiologic and lab characteristics of Egyptian males with COPD. This study was conducted on 68 COPD smoker patients and 32 non-COPD smokers who were selected from Chest Department, Faculty of Medicine, Menoufia University during the period from October 2015 to January 2016. A blood sample was taken and a spirometry was performed. Genotyping was performed for nAChRs rs1051730 by SNP assay real time PCR methods. The distribution of nAChRs rs1051730 AA genotypes is more frequent in COPD patients with increase susceptibility to COPD by 5.19 fold. AA genotypes ...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Although there is well-proved association between type 2 diabetes mellitus (T2DM) and ... more Background Although there is well-proved association between type 2 diabetes mellitus (T2DM) and active tuberculosis, factors involved in the association between T2DM and latent tuberculosis infection (LTBI) are scarcely known. Aim The aim of this study was to study the prevalence and risk factors of LTBI in a cohort of Egyptian adults with T2DM including studying the effect of oral hypoglycemic drugs on this prevalence. Patients and methods All patients with T2DM were recruited from Menoufia University Endocrinology outpatient clinic during the period from June to December 2018. Demographic and clinical data, serum glucose and glycosylated hemoglobin (HbA1c) level, and QuantiFERON-TB Gold In-Tube and tuberculin skin test were assessed. Results In all, 102 patients were recruited, according to the QuantiFERON test; 22 (21.6%) patients were diagnosed with LTBI. Their mean age was 54.91±8.85, mean T2DM duration was 9.82±6.54/year, mean HbA1c% was 10.29±1.59, which is significantly hig...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Despite obesity hypoventilation syndrome (OHS) having more mortality than obstructive ... more Background Despite obesity hypoventilation syndrome (OHS) having more mortality than obstructive sleep apnea (OSA), the characteristics of those patients in relation to their PaCO2 have not been clarified. Aim The aim was to evaluate anthropometric, physiologic, and laboratory characteristics of patients with OHS in relation to OHS severity (according to PaCO2) and to identify OHS predictors. Patients and methods A total of 59 patients with OHS were compared with 118 BMI-matched patients with OSA as a control group. Patient demographics, arterial blood gases, polysomnographic data, and blood chemistry were compared. The patients with OHS were classified into three subgroups according to their daytime PaCO2 level: mild OHS (46 mmHg ≤PaCO2 ≤50 mmHg), moderate OHS (51 mmHg ≤PaCO2 ≤55 mmHg), and severe OHS (PaCO2≥56 mmHg). Results Patients with OHS had significantly more comorbidities, hemoglobin, and hematocrit levels, and lower PaO2 and nocturnal oxygenation parameters (baseline O2 sa...

Pleural effusions are a common clinical presentation of many diseases and can present as diagnost... more Pleural effusions are a common clinical presentation of many diseases and can present as diagnostic challenge to the clinician. The development of disease-specific diagnostic biomarkers for pleural effusions is an active area of research. Among the potentially available laboratory parameters is procalcitonin (PCT). ) It is a propeptide of calcitonin produced by C-cells of the thyroid gland. Normally, PCT levels are undetectable in healthy humans. In severe bacterial infections, intact PCT is found in blood. One major advantage of PCT compared to other parameters is its early and highly specific increase in response to sepsis. A correlation between serum PCT concentration and sepsis has been previously reported. But, What about pleural fluid PCT? Can PCT play a role in resolving the myth of many cases with undiagnosed pleural effusion? Can it constitute another piece of the diagnostic puzzle? This research has been the winner of Minoufiya University award for international publicatio...

The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotini... more The major reinforcing component of tobacco smoke is Nicotine which acts through neuronal nicotinic acetylcholine receptors (nAChRs). It is a strong predisposing factor for the development of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the associations between single nucleotide polymorphism (SNP) of nAChRs rs1051730 and demographic (including smoking index and cigarette consumption per day ), physiologic and lab characteristics of Egyptian males with COPD. This study was conducted on 68 COPD smoker patients and 32 non-COPD smokers who were selected from Chest Department, Faculty of Medicine, Menoufia University during the period from October 2015 to January 2016. A blood sample was taken and a spirometry was performed. Genotyping was performed for nAChRs rs1051730 by SNP assay real time PCR methods. The distribution of nAChRs rs1051730 AA genotypes is more frequent in COPD patients with increase susceptibility to COPD by 5.19 fold. AA genotypes...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2021

Background Diffuse parenchymal lung diseases (DPLD) compromise heterogeneous subtypes. Establishi... more Background Diffuse parenchymal lung diseases (DPLD) compromise heterogeneous subtypes. Establishing an accurate diagnosis is paramount. Lung tissue biopsy is the gold standard diagnostic tool. Aim To assess the role of medical thoracoscopy with electrocautery in the diagnosis of DPLD. Patients and methods A total of 20 patients who had undiagnosed DPLD on chest high-resolution computed tomography were randomly selected from Menoufia Chest Department from March 2017 to March 2019. Lung biopsy was taken by medical thoracoscopy under conscious sedation with the aid of electrocautery device. Results A total of 12 (60%) patients were males, and seven (35%) patients were smokers. The mean age was 58.1±10.5 years. High-resolution computed tomography patterns were reticulonodular (65%), ground glass (35%), miliary shadow (15%), and consolidation (15%). Diagnoses were granulomatous lung disease (40%), idiopathic interstitial pneumonias (30%), malignant lung disease (15%), and interstitial lu...

© 2018 The Egyptian Journal of Chest Diseases and Tu Background Various thyroid hormone states ha... more © 2018 The Egyptian Journal of Chest Diseases and Tu Background Various thyroid hormone states have been described in patients with respiratory failure. Domiciliary noninvasive positive airway pressure (NPAP) can be used for management of chronic respiratory failure. Aim This study aims to assess thyroid function in patients with chronic respiratory failure and to evaluate the effect of domiciliary NPAP on thyroid hormone levels. Patients and methods Forty-five patients were admitted with acute on top of chronic respiratory failure of various causes; all were addressed after discharge to domiciliary NPAP, either continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP). Thyroid hormones and arterial blood gas were assessed on admission, at the time of discharge, and at 2-month follow-up. Results On admission, 21 (46.67%) patients had nonthyroidal illness syndrome (NTIS) and eight (17.78%) patients had subclinical hypothyroidism. PO2 level was significant...

Menoufia Medical Journal, 2019

Objective To assess the level of serum leptin in patients with active pulmonary tuberculosis (TB)... more Objective To assess the level of serum leptin in patients with active pulmonary tuberculosis (TB). Background One of the most important and common complaint of patients with TB, which also affects the immune status, is weight loss. When TB infection occurs, a variety of chemokines and cytokines are secreted from infected cells and tissue macrophages. Leptin is a 16-kDa protein, and its level varies with active pulmonary TB. Patients and methods Serum leptin level was measured in 40 newly diagnosed patients with active pulmonary TB (group I) and 20 matched control (group II). Results Serum leptin level was significantly lower in patients with active pulmonary TB than controls. There was a highly significant positive correlation between leptin level and BMI. Serum leptin had a significantly negative correlation with grades of Ziehl–Neelsen stain and chest radiography. The cutoff point of leptin was found to be 0.54 ng/ml for discrimination of patients with active pulmonary TB. Conclus...

Objective The aim of the paper was to investigate the relationship between serum YKL-40 levels an... more Objective The aim of the paper was to investigate the relationship between serum YKL-40 levels and severity of chronic obstructive pulmonary disease (COPD). Background COPD is a major health problem with increasing morbidity and mortality throughout the world. A newly recognized biomarker, YKL-40, is a chitin-binding glycoprotein, and its serum level is elevated in inflammatory diseases. However, it has not been thoroughly investigated in COPD. Patients and methods A total of 30 patients with stable COPD and 10 healthy individuals as a control group were enrolled for estimation of modified Medical Research Counseling dyspnea scale, spirometry, and serum YKL-40 levels. Results Serum YKL-40 level was increased significantly in patients with COPD compared with healthy controls. There was a positive correlation between serum YKL-40 level and each of modified Medical Research Counseling dyspnea scale severity and age, and a negative correlation with forced expiratory volume in the first ...

The Egyptian Journal of Chest Diseases and Tuberculosis, 2020

Background Chronic obstructive pulmonary disease (COPD) is a widespread lung disease with a high ... more Background Chronic obstructive pulmonary disease (COPD) is a widespread lung disease with a high mortality and morbidity especially with co-morbid cardiac impairment. Severity of COPD can be assessed using BODE Index (body mass index, obstruction of airflow, dyspnea degree and exercise capacity). Aim To study the relationship between BODE index and right ventricle (RV) and left ventricle (LV) functions using Two-dimensional speckle-tracking echocardiography (2D-STE) in COPD patients. Subjects and methods Fifty stable COPD patients and matched fifty control subjects underwent transthoracic echocardiography, where conventional and speckle tracking parameters were taken. BODE indices were calculated and divided to quartiles (Q) (Q1; BODE index = 0–2, Q2; BODE index = 3–4 Q3; BODE index = 5–6, Q4; BODE index = 7–10). Results COPD patients had lower RV fractional area change (FAC%, P<0.0001), tricuspid annular plane systolic excursion (TAPSE, P<0.0001), lateral wall strain of RV (P<0.0001) and RV average global strain (P<0.0001) than controls. Regarding LV, they had lower LV end diastolic dimension (EDD, P<0.0001), LV end systolic dimension (P<0.003), E/A ratio (P<0.0001) and LV global longitudinal strain (GLS, P<0.028) than controls. BODE index had negative correlation with TAPSE (P<0.0001), LVEDD (P<0.022) and global RV strain (P<0.014). Significant differences were demonstrated among BODE quartiles regarding RV FAC%, TAPSE and RV average global strain. Significant differences were between BODE quartiles and controls regarding RV FAC%, TAPSE, RV lateral wall strain, RV average global strain, E/A ratio and LVEDD. Conclusion COPD patients had RV, LV systolic dysfunction and LV diastolic dysfunction. The more COPD severity increased (assessed by BODE index) the more impairment of RV systolic function and LV diastolic function would be.

Pulmonary hypertension, 2019

Egyptian Journal of Bronchology, 2019

Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is... more Background Acute pulmonary embolism (PE) is a potentially fatal disease. Prognostic assessment is needed for proper management. Several prognostic models have been proposed. Aim The aim was to validate the original pulmonary embolism severity index (o-PESI) with its simplified version (s-PESI) and modified version (m-PESI) as predictors of in-hospital mortality and homeostatic morbidities (nonlethal repeated venous thromboembolism, and/or nonlethal serious hemorrhage) in patients with PE. Patients and methods Patients proved to have acute PE admitted to Menoufia and Cairo University Hospitals between March 2017 and March 2019 were included in the study. The o-PESI, s-PESI, and m-PESI were calculated for each patient. In-hospital mortality, homeostatic morbidities, and major adverse events (mortality and homeostatic morbidities) were registered. Results One hundred and two patients were recruited. Inhospital mortality rate was 13.7%, morbidity rate was 21.6%, whereas major adverse events rate was 31%. The s-PESI classified 31.4% of patients as low risk, and none of them had in-hospital mortality. The frequencies of major adverse events in the low-risk groups were 31.2, 9.1, and 75% for o-PESI, s-PESI, and m-PESI, respectively. Difference between adverse events and non-adverse events groups was significant when s-PESI was applied (P=0.008). The s-PESI had the highest sensitivity and negative predictive value in detecting mortality, morbidity, and major adverse events compared with o-PESI and m-PESI. The area under the curve for s-PESI was significantly above the other two indices (area under the curve=0.78, P=0.04). Conclusion In addition to its easy application, the s-PESI has a preferably superior prognostic accuracy than o-PESI and m-PESI in prognostication of low-risk patients with acute PE.

Clinical Neuropharmacology, 2019

Abstract This review describes the characteristics of a number of pathologies, which are consider... more Abstract This review describes the characteristics of a number of pathologies, which are considered from the point of view of chronobiology, that is, the way in which biological processes are expressed throughout the 24-hour day. This perspective is a relatively new way of thinking about disease and additionally about how to treat diseases. It has called attention to the importance of not only the quantity of a drug that is administered but also when it is administered. In addition, the review presents an overview of the emerging clinical strategies known as chronotherapeutics, that is, the effects of the daily scheduling of drug administration and the consequences of the activity and efficacy of therapies that are applied in this manner. This article also reviews innovative ways in which physicians are applying time-specified drug treatment (chronopharmacology) for sleep disorders. Here, we present a systematic description of chronopharmacology as well as definitions of key terms that, we believe, will be helpful for newcomers to the field. It is hoped that greater awareness of this new perspective on pharmacology will promote its adoption by researchers and clinicians.

Sleep and control of breathing, 2018

Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are lin... more Background Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are linked with microvascular changes. Retinal microvasculature can be examined in a direct noninvasive way. Aim The aim was to evaluate tortuosity of the retinal vessels in patients with COPD, OSA, and overlap syndrome. Patients and methods A total of 60 participants were included: 15 patients with OSA, 15 patients with COPD, 15 patients with COPD-OSA overlap syndrome, and 15 matched controls. All participants underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, Epworth sleepiness scale, and STOP-BANG questionnaires. Results Tortuosity of most retinal vessels was higher in all patient groups when compared with the control group, and tortuosity was more marked in the overlap syndrome group. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 saturation, and a positive correlation with PCO2, apnea hypopnea index, O2 desaturation index, BMI, and smoking index. Conclusion Retinal vascular tortuosity occurs in OSA, COPD, and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index, and BMI.

Journal of the Egyptian Society of Cardio-Thoracic Surgery, 2016

Objectives: Pulmonary Tuberculosis (TB) is a disease that is often treated medically. However, me... more Objectives: Pulmonary Tuberculosis (TB) is a disease that is often treated medically. However, medical treatment usually fails in the management of tuberculosis e related hemoptysis. In this study, we aimed to assess the role of surgery in the treatment of hemoptysis due to pulmonary TB. Methods: Fifty two patients presented by hemoptysis and underwent pulmonary resection were enrolled in this study. Patients were divided into two groups according to the timing of surgical procedures: Group A (n ¼ 22) included patients who underwent surgery within two days of presentation which was major to massive hemoptysis causing hemodynamic instability. Group B (n ¼ 30) included patients who underwent surgery within 4 days after presentation with hemoptysis which was persistent and minor. Results: There was no significant difference in the demographic data between both groups. Major and massive hemoptysis were the common presentation of group A, whereas minor hemoptysis was the main presentation in group B. Tuberculous cavities were the most common lung lesions in both groups (40.9% in group A, versus 40% in group B). Lobectomy was the main surgical procedure performed in both groups (50% in group A, versus 56.7% in group B). Regarding the complications, Bronchopleural fistula occurred in one case in each group after pneumonectomy. Recurrent hemoptysis occurred in only one case in group A. There was one case (4.5%) of mortality in group A. Conclusion: Early pulmonary resection in patients with hemoptysis is an effective and safe method to insure good outcome. Limited resections are associated with higher incidence of recurrence.