Eman Hafez | Mansoura University (original) (raw)
Papers by Eman Hafez
Mansoura Medical Journal
The polyunsaturated fatty acid profile in erythrocyte cell membranes among group of Egyptian rheu... more The polyunsaturated fatty acid profile in erythrocyte cell membranes among group of Egyptian rheumatoid arthritis patients
Mansoura Medical Journal, 2021
Background: The treatment decision of patients with moderately severe cases of degenerative lumba... more Background: The treatment decision of patients with moderately severe cases of degenerative lumbar spinal canal stenosis (LSS) whether conservative or surgical is highly dependable on physician evaluation without clear standards. The purpose of this study is to evaluate the effectiveness of conservative treatment of patients complaining of moderately severe degenerative LSS in comparison with surgical intervention throughout one year follow up. The present study was conducted on 60 patients with LSS: 30 patients treated with rehabilitation program and 30 patients treated with decompression surgery. All patients were assessed for pain and physical function before treatment, 3 months, 6 months and 12 months after treatment. Results: Both groups showed significant improvement of Oswestry Disability Index (ODI), ODI walk, and Zurich Claudication Questionnaire (ZCQ) symptoms and function subscales at 3, 6 and 12 months after treatment compared to baseline. However, at 1 year, the most pa...
Rheumatology International, 2017
IU/ml] than among controls [median, (range) = 68.820 (2.450-318.945) IU/ml], (p < 0.001). No diff... more IU/ml] than among controls [median, (range) = 68.820 (2.450-318.945) IU/ml], (p < 0.001). No difference was detected among RA patients either on traditional or biologic treatment regarding anti-Toxoplasma IgG antibodies. No positive anti-Toxoplasma IgM was detected. A positive correlation was detected between anti-Toxoplasma IgG titre and disease activity markers. Conclusion Higher seroprevalence of anti-Toxoplasma IgG antibodies among RA patients compared to controls reflects an association between latent Toxoplasma infection and RA. Our findings support previous studies and necessitate future large-scale studies to elucidate the exact role of Toxoplasma whether a trigger of autoimmunity in RA or an effect of immunosuppression. Keywords Toxoplasma gondii • Rheumatoid arthritis • Autoimmunity • Anti-TNF to systemic organ complications [2]. Toxoplasma gondii (T. gondii) is an intracellular protozoan parasite with a vast worldwide distribution. Infection with T. gondii results in asymptomatic disease in 90% of immunocompetent hosts, while in immunocompromised, devastating symptoms could result. T. gondii parasite has Abstract Objective To assess seroprevalence of anti-Toxoplasma gondii antibodies; both IgG and IgM in Egyptian rheumatoid arthritis (RA) patients versus a non-RA group and to compare anti-Toxoplasma antibodies seroprevalence among RA patients receiving traditional treatment and RA patients treated with biologic drug. Methods 60 RA patients and 60 healthy controls were enrolled in the study. Patients were categorized into two groups: one group included 30 patients receiving disease modifying anti-rheumatic drugs (DMARDs), while the other group included 30 patients receiving biologic agent, infliximab, a TNF-α antagonist. Serum samples of all investigated persons were examined for anti-Toxoplasma antibodies. RA activity markers including rheumatoid factor, anti-cyclic citrullinated protein antibodies, C reactive protein, ESR in addition to disease activity score 28 (DAS28) of RA patients were also evaluated to explore their association with Toxoplasma seropositivity. Results Anti-Toxoplasma IgG antibodies were detected among 46/60 RA patients (76.7%) versus 29/60 controls (48.3%), (p = 0.001). Anti-Toxoplasma IgG titre was higher among RA group [median, (range) = 232.940 Rheumatology INTERNATIONAL
Egyptian Rheumatology and Rehabilitation, 2018
Context There remains no gold standard or even true agreement among clinicians as to which electr... more Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS.
Egyptian Rheumatology and Rehabilitation, 2021
Background The advent of novel biologic agents for the treatment of rheumatoid arthritis (RA) has... more Background The advent of novel biologic agents for the treatment of rheumatoid arthritis (RA) has proven to be highly productive. Nonetheless, high cost, side effects, and unresponsiveness to these agents dictates the assignment of biomarkers that can foretell treatment response. Currently, calprotectin (a member of the S100 protein family) is amongst the enormously studied candidates in this perspective. Yet, conflicting results have been published. The main purpose of this study was to explore the role of serum concentration of calprotectin to predict the response to biological therapy in RA patients, so as to customize RA treatment. Results Baseline serum calprotectin levels were significantly higher in RA patients compared to the control subjects (P value < 0.001). After receiving biologic therapy, a remarkable reduction (P < 0.001) in serum calprotectin was noted in RA cohort. Moreover, no correlation was found between the 28 joint count disease activity score (DAS28) and...
ARTICLE INFO ABSTRACT Purpose: the assessment of the extent of damage of hand and wrist joints in... more ARTICLE INFO ABSTRACT Purpose: the assessment of the extent of damage of hand and wrist joints in rheumatoid arthritis. Material and methods: this prospective study included 25 patients, 20 females 43.48 years±13.64SD. Initial clinical assessment was carried out and Disease Activity Score (DAS28) was used for grading the disease activity; followed by ultrasound and MRI evaluation. Results: assessment of tenosynovitis with 100% sensitivity and specificity as well as synovial effusion (100 % sensitivity, 90% specificity). The least sensitivity was encountered in the detection of bony erosions (sensitivity 21.05%, specificity 100%). Significant correlations were found between US parameters for synovial thickening & bone erosions by MRI and DAS28 score. Yet, no significant correlation was found between synovial thickening by MRI and DAS28 score. Conclusion: changes and disease follow up. MRI is superior in the estimation of the severity of structural bony changes and recommended as the baseline study for proper treatment outcome.
Mansoura Medical Journal
The polyunsaturated fatty acid profile in erythrocyte cell membranes among group of Egyptian rheu... more The polyunsaturated fatty acid profile in erythrocyte cell membranes among group of Egyptian rheumatoid arthritis patients
Mansoura Medical Journal, 2021
Background: The treatment decision of patients with moderately severe cases of degenerative lumba... more Background: The treatment decision of patients with moderately severe cases of degenerative lumbar spinal canal stenosis (LSS) whether conservative or surgical is highly dependable on physician evaluation without clear standards. The purpose of this study is to evaluate the effectiveness of conservative treatment of patients complaining of moderately severe degenerative LSS in comparison with surgical intervention throughout one year follow up. The present study was conducted on 60 patients with LSS: 30 patients treated with rehabilitation program and 30 patients treated with decompression surgery. All patients were assessed for pain and physical function before treatment, 3 months, 6 months and 12 months after treatment. Results: Both groups showed significant improvement of Oswestry Disability Index (ODI), ODI walk, and Zurich Claudication Questionnaire (ZCQ) symptoms and function subscales at 3, 6 and 12 months after treatment compared to baseline. However, at 1 year, the most pa...
Rheumatology International, 2017
IU/ml] than among controls [median, (range) = 68.820 (2.450-318.945) IU/ml], (p < 0.001). No diff... more IU/ml] than among controls [median, (range) = 68.820 (2.450-318.945) IU/ml], (p < 0.001). No difference was detected among RA patients either on traditional or biologic treatment regarding anti-Toxoplasma IgG antibodies. No positive anti-Toxoplasma IgM was detected. A positive correlation was detected between anti-Toxoplasma IgG titre and disease activity markers. Conclusion Higher seroprevalence of anti-Toxoplasma IgG antibodies among RA patients compared to controls reflects an association between latent Toxoplasma infection and RA. Our findings support previous studies and necessitate future large-scale studies to elucidate the exact role of Toxoplasma whether a trigger of autoimmunity in RA or an effect of immunosuppression. Keywords Toxoplasma gondii • Rheumatoid arthritis • Autoimmunity • Anti-TNF to systemic organ complications [2]. Toxoplasma gondii (T. gondii) is an intracellular protozoan parasite with a vast worldwide distribution. Infection with T. gondii results in asymptomatic disease in 90% of immunocompetent hosts, while in immunocompromised, devastating symptoms could result. T. gondii parasite has Abstract Objective To assess seroprevalence of anti-Toxoplasma gondii antibodies; both IgG and IgM in Egyptian rheumatoid arthritis (RA) patients versus a non-RA group and to compare anti-Toxoplasma antibodies seroprevalence among RA patients receiving traditional treatment and RA patients treated with biologic drug. Methods 60 RA patients and 60 healthy controls were enrolled in the study. Patients were categorized into two groups: one group included 30 patients receiving disease modifying anti-rheumatic drugs (DMARDs), while the other group included 30 patients receiving biologic agent, infliximab, a TNF-α antagonist. Serum samples of all investigated persons were examined for anti-Toxoplasma antibodies. RA activity markers including rheumatoid factor, anti-cyclic citrullinated protein antibodies, C reactive protein, ESR in addition to disease activity score 28 (DAS28) of RA patients were also evaluated to explore their association with Toxoplasma seropositivity. Results Anti-Toxoplasma IgG antibodies were detected among 46/60 RA patients (76.7%) versus 29/60 controls (48.3%), (p = 0.001). Anti-Toxoplasma IgG titre was higher among RA group [median, (range) = 232.940 Rheumatology INTERNATIONAL
Egyptian Rheumatology and Rehabilitation, 2018
Context There remains no gold standard or even true agreement among clinicians as to which electr... more Context There remains no gold standard or even true agreement among clinicians as to which electrophysiological tests are most important and most relevant particularly in the mild and early carpal tunnel syndrome (CTS). Aim The aim of this study was to determine the sensitivity and specificity of electrodiagnostic (EDX) techniques to confirm the clinically diagnosed patients with mild CTS. Patients and methods This is a descriptive study. A total of 109 hands (68 right hands and 41 left hands) with symptoms consistent with mild idiopathic CTS, as well as 100 hands from controls, were clinically examined and underwent EDX evaluation. Results The ring-difference and thumb-difference had the highest sensitivity, with the distal sensory latency (DSL) of the median nerve coming next. Combined sensory index (CSI) test at a cutoff point more than 1.1 had 100% specificity and positive predictive value. Abnormal DSL of the median nerve had the best negative predictive value. In patients with early and mild CTS and with normal distal motor latency and DSL, the CSI at cutoff point more than 1.1 is the best EDX test that is able to detect most of these patients. Conclusion CSI and its individual components appear as the best EDX tests that help in the diagnosis of patients with early and mild idiopathic CTS.
Egyptian Rheumatology and Rehabilitation, 2021
Background The advent of novel biologic agents for the treatment of rheumatoid arthritis (RA) has... more Background The advent of novel biologic agents for the treatment of rheumatoid arthritis (RA) has proven to be highly productive. Nonetheless, high cost, side effects, and unresponsiveness to these agents dictates the assignment of biomarkers that can foretell treatment response. Currently, calprotectin (a member of the S100 protein family) is amongst the enormously studied candidates in this perspective. Yet, conflicting results have been published. The main purpose of this study was to explore the role of serum concentration of calprotectin to predict the response to biological therapy in RA patients, so as to customize RA treatment. Results Baseline serum calprotectin levels were significantly higher in RA patients compared to the control subjects (P value < 0.001). After receiving biologic therapy, a remarkable reduction (P < 0.001) in serum calprotectin was noted in RA cohort. Moreover, no correlation was found between the 28 joint count disease activity score (DAS28) and...
ARTICLE INFO ABSTRACT Purpose: the assessment of the extent of damage of hand and wrist joints in... more ARTICLE INFO ABSTRACT Purpose: the assessment of the extent of damage of hand and wrist joints in rheumatoid arthritis. Material and methods: this prospective study included 25 patients, 20 females 43.48 years±13.64SD. Initial clinical assessment was carried out and Disease Activity Score (DAS28) was used for grading the disease activity; followed by ultrasound and MRI evaluation. Results: assessment of tenosynovitis with 100% sensitivity and specificity as well as synovial effusion (100 % sensitivity, 90% specificity). The least sensitivity was encountered in the detection of bony erosions (sensitivity 21.05%, specificity 100%). Significant correlations were found between US parameters for synovial thickening & bone erosions by MRI and DAS28 score. Yet, no significant correlation was found between synovial thickening by MRI and DAS28 score. Conclusion: changes and disease follow up. MRI is superior in the estimation of the severity of structural bony changes and recommended as the baseline study for proper treatment outcome.