Ayman Seddik | Ain Shams University (original) (raw)

Papers by Ayman Seddik

European Journal of Clinical Medicine, Feb 1, 2022

Introduction: Therapeutic plasma exchange is used to manage immunemediated diseases as early as 1... more Introduction: Therapeutic plasma exchange is used to manage immunemediated diseases as early as 1970th. Nevertheless, the evidence beyond the therapeutic indication is still anecdotal and depends on observational data and national registries from different parts of the world. Aim of the Study: To review the use of therapeutic plasma exchange (TPE) to manage different conditions in the Dubai Hospital-nephrology department and benchmark against standard indications categories by American Society of Apheresis (ASFA) guidelines. Methods: The study included all adult patients who performed TPE in Dubai Hospital during 24 months period from January 2017 until December 2019. Patient demographics, indications, anticoagulation used, the number of sessions, duration of hospitalization, ICU admission, mortality outcome, and occurrence of procedure-related complications were included. Results: During the 24 months, 142 TPE sessions were performed for 33 registered patients (an average of 4.3 sessions/patient). The most common indications for TPE use in our registry were nephrology-related indications in 119 sessions (85%), while non-nephrology indications contributed for 21 sessions (15%). Among Nephrology related Indications, Thrombotic Thrombocytopenic purpura was the most common indication (47.8%), followed by post kidney transplantation (21%), while non-Nephrology-related indications were mainly for pancreatitis with Hypertriglyceridemia (9.2%). Complications arose in 2 sessions (1.4%), and mortality occurred in one (3%) critically ill patient related to nonprocedure consequences and the severity of the underlying disease. Conclusion: Our registry data confirm the safety of therapeutic plasma exchange in a professional, well-equipped nephrology setting when used for proper evidence-based indications with a lower rate of morbidity and mortality.

Saudi Journal of Kidney Diseases and Transplantation, 2017

Epidemiological data of renal diseases have great geographic variability throughout the world. Du... more Epidemiological data of renal diseases have great geographic variability throughout the world. Due to the lack of a national renal data registry system, there is no information on the prevalence rate, clinical and pathological features of various glomerulonephritis (GN) in the United Arab Emirates (UAE). In a retrospective cross-sectional study, we analyzed 158 renal biopsies done in Dubai Hospital, UAE, between the years of 2005 and September 2014, with an aim to determine the prevalence rate and frequency of different pathological patterns of GN in adult patients who presented with proteinuria ± hematuria. In our study, primary GN still remains more common than secondary GN (66.4% vs. 33.5%). Among the primary GN in our analysis, minimal change disease was the most common primary GN affecting 20% of the study population (13.2% of the total GN causes) followed with membranous GN (18.2%), then membrano- proliferative GN (15.3%) and focal segmental glomerulosclerosis (13.46%), while among the secondary causes lupus nephritis (LN) is the most prevalent GN in UAE, predominantly in the Emirati national population whom constituted 48% of total biopsies. Indeed, LN had the highest incidence among all types of GN even the primary ones, constituting 23.4% of total GN in Dubai (74% of the total secondary causes). Furthermore, systemic lupus erythematosus was the most common GN in women while the minimal change was widely affecting male patients. Among elderly, the most common pathology was diabetic glomerulosclerosis followed by amyloidosis.

Dubai Diabetes and Endocrinology Journal

Background: De novo post-transplant diabetes mellitus (PTDM) is a frequent complication among ren... more Background: De novo post-transplant diabetes mellitus (PTDM) is a frequent complication among renal transplant recipients; it confers a high risk for graft failure and patient mortality. This single-centre study aimed to determine the incidence and risk factors of PTDM and its effects on graft outcome and mortality. Methods: In a single-centre longitudinal cohort analysis of 383 non-diabetic renal transplant follow-up recipients, outcomes were analysed through a detailed chart review. We hypothesized that different donor and recipient characters such as age, gender, and HLA mismatch would affect PTDM development in renal transplant recipients. PTDM is defined on basis of fasting plasma sugar (≥7 mmol/L or ≥126 mg/dL), random plasma sugar (≥11.1 mmol/L or ≥200 mg/dL), and glycated haemoglobin (HBA1C: >6.5% or 48 mmol/mol). We assessed PTDM incidence, risk factors, and its effect on patient mortality and graft outcome using Cox regression. Results: The mean age at the time of trans...

Indian Journal of Transplantation

European Journal of Clinical Medicine

Introduction: Therapeutic plasma exchange is used to manage immune-mediated diseases as early as ... more Introduction: Therapeutic plasma exchange is used to manage immune-mediated diseases as early as 1970th. Nevertheless, the evidence beyond the therapeutic indication is still anecdotal and depends on observational data and national registries from different parts of the world. Aim of the Study: To review the use of therapeutic plasma exchange (TPE) to manage different conditions in the Dubai Hospital-nephrology department and benchmark against standard indications categories by American Society of Apheresis (ASFA) guidelines. Methods: The study included all adult patients who performed TPE in Dubai Hospital during 24 months period from January 2017 until December 2019. Patient demographics, indications, anticoagulation used, the number of sessions, duration of hospitalization, ICU admission, mortality outcome, and occurrence of procedure-related complications were included. Results: During the 24 months, 142 TPE sessions were performed for 33 registered patients (an average of 4.3 s...

International Journal of Research in Medical Sciences, 2021

Background: Hyponatremia is common among hospitalized patients. Unfortunately, articles describin... more Background: Hyponatremia is common among hospitalized patients. Unfortunately, articles describing the management of profound hyponatremia (serum sodium <125 mEq/l) in the background of kidney disease are scarce. This review focuses on the incidence, prevalence, patient characteristics, and clinical features among hospitalized chronic kidney disease (CKD) patients with particular attention to CKD stage 3 to 5. Methods: 71 adult patients with CKD stage 3 to 5 and had presented with profound hyponatremia (serum sodium <125 mEq/l) were included. Patient demographic data, laboratory parameters and treatment received were recorded. The primary endpoint was the development of central nervous syste (CNS) manifestations, while the secondary outcomes included early mortality (death within 30 days). Results: 97 episodes of hyponatremia were recorded in 71 patients. 35 patients (49%) were UAE national and 53.5% patients were females. 52% were in CKD stage-5 refusing dialysis. Diabetic ne...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2019

Chronic kidney disease is associated with accumulation of uremic toxins that increases insulin re... more Chronic kidney disease is associated with accumulation of uremic toxins that increases insulin resistance which will lead to blunted ability to suppress hepatic gluconeogenesis and reduce peripheral utilization of insulin. CKD patients fail to increase insulin secretion in response to insulin resistance because of acidosis, 1,25 vitamin D deficiency, and secondary hyperparathyroidism. Haemodialysis causes further fluctuations in glycemic control due to alterations in insulin secretion, clearance and resistance. DKA is uncommon in hemodialysis patients because of the absence of glycosuria and osmotic diuresis which accounts for most of the fluid and electrolyte losses seen in DKA, anuric patients may be somewhat protected from dehydration and shock, although still subject to hyperkalemia and metabolic acidosis. However, substantial volume loss can still occur due to a prolonged decrease in oral intake or increased insensible water losses related to tachypnoea and fever. There is no current guidelines for the management of diabetic ketoacidosis in anuric haemodialysis patients considering their differences than general population. In this review article we reviewed the literature and came with specific recommendations for management of Ketoacidosis in patients with CKD treated by hemodialysis.

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2009

Hyperkalemia is common in patients with ESRD and may contribute to mortality. Dates have been rep... more Hyperkalemia is common in patients with ESRD and may contribute to mortality. Dates have been reported to be high in potassium content. One of the concerns on hemodialysis (HD) is convincing patients to give up ingestion of dates as a part of their diet. To determine the effect of dates on serum potassium on patients, we studied 9 (M: F, 6:3, mean age 47.6) non diabetic patients on chronic hemodialysis, without evidence of hyperkalemia on monthly labs. Nearly all the patients had been on dialysis for an average of four years. The average monthly potassium was 4.6 mmol/L. The patients ingested 100 gm of dates (Rothana and Sukari) on two separate dialysis sessions. Serum potassium was measured at two and four hours post ingestion along with ECG monitoring. The patients underwent their regular dialysis as scheduled. The patients acted as their own controls and underwent the same protocol with 20meq of KCl on a separate session. The potassium levels did not change significantly over the...