Tamer Farid | Ain Shams University (original) (raw)

Papers by Tamer Farid

Egyptian Journal of Geriatrics and Gerontology, Mar 1, 2019

Background Egyptian Geriatric population demography The report by Central Agency for Public Mobil... more Background Egyptian Geriatric population demography The report by Central Agency for Public Mobilization and Statistics (CAPMAS) in 2016 found that the Egyptian geriatric population in 2016 was 6.9% of the total population. The age group 60-64 represented 2.6% of total population, age 65-69 was 1.8%, age 70-74 was 1.2% and above 75% represented 1.3%. 1 There was an increase when comparing these figures with previous years; in 1950 it was 3% reaching 5.5% in 2010. 2 In Egypt, life expectancy has been increased over the past years for both males and females. When comparing 2006 to 2015, life expectancy in males increased from 66.5 years to 70.1 years, while in females it increased from 69.1 years to 72.9 years. 2 These demographic changes have made the study of elderly function and independence of increasing importance. This originates from the significant effect of comorbidities on elderly function and quality of life,

Indian journal of applied research, 2016

Background Peripheral arterial disease (PAD)in the lower extremities is a marker of widespread va... more Background Peripheral arterial disease (PAD)in the lower extremities is a marker of widespread vascular disease particularly in the coronary and cerebral circulationand is the leading cause of mortality especially in diabetic population. Coronary heart diseases(CHD) may be related to genetic mutations in the production of apolipoprotein E (ApoE), partly via alterations to the metabolism of CHD-related lipids as LDL and TG,in addition to other unexplained and interacting factors. In this work, we studied the association of apoE4 genotypes with PAD and CHD in a cohort of elderly diabetic Egyptian patients compared to controls. Methods Our study was a case-control study, conducted on 90 elderly subjects categorized into 30 patients with type2 diabetes mellitus (T2DM) with atherosclerotic cardiovascular (CV) complications,30 patients with type T2DM without atherosclerotic CV complications and 30 normal healthy elderly subjects without DM or evidence of atherosclerotic CV disease. Lipid ...

QJM: An International Journal of Medicine, 2018

recent well designed individually randomised RCTs and metaanalyses have been disappointing, proba... more recent well designed individually randomised RCTs and metaanalyses have been disappointing, probably related to compliance issues. Models of Care: Several models of care have been developed over the last two decades. These include the fracture liaison service and primary care identification of fracture risk. Close working between geriatricians, orthopaedic surgeons and anaesthetists and timely and appropriate care of hip fracture patients have improved outcomes and the sub-speciality of ortho-geriatrics is rapidly growing worldwide.

The Egyptian Journal of Hospital Medicine, 2014

Background Frailty is a state of vulnerability describes a syndrome characterized by progressive ... more Background Frailty is a state of vulnerability describes a syndrome characterized by progressive multi system decline, loss of physiologic reserve, and increase vulnerability to disease and death. Frailty has emerged as a condition associated with an increased risk of functional decline among the elderly population, which may be differentiated from aging, disability, and comorbidity. Objectives: The aim of this study is to assess the prevalence of functional impairment and cognitive functions among frail elderly. Methods:We examined104 frail elderly. Frailty criteria included unintentional weight loss, exhaustion, weakness, low physical activity, and slow walking speed. physical function was assessed using Activities of daily living (ADL) and Instrumental activities of daily living (IADL). The cognitive function was assessed using the Mini-Mental State Examination (MMSE). Results:The mean age of the studied population was 69 years, 53.85% were males, 46.15% were females, the majority of our participants were illiterates (89.4%), and were living with family (84.62%), only 6.73% were smokers. 36.5% of frail participants were assisted in activity of daily living (ADL) and 7.7% were dependents, while 63.5% were assisted in instrumental activity of daily living (IADL) and 8.7% were dependents; the sample participants in general had borderline scores for MMSE, indicating a cognitive performance in the lower normal range. Conclusions Frail elderly had low normal score on MMSE, and high prevalence of functional impairment.

The Egyptian Journal of Hospital Medicine, 2013

Background: There is a high prevalence of common geriatric problems (falls, urinary incontinence,... more Background: There is a high prevalence of common geriatric problems (falls, urinary incontinence, visual and hearing impairment) among frail elderly leading to more disability and functional impairment. Objectives: The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. Design: A Case control study. Participants: 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A (30 frail elderly females and 30 frail elderly males) and Group B (30 healthy elderly subjects; 15 males and 15 females).Measurements: Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria ]. Results: Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< (0.001,0.009,0.006) consequently, visual impairment was statistically significant in cases more than controls with p value (0.012). Conclusion: There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly.

Psychometric properties of the extended Care Dependency Scale for older persons in Egypt Thomas B... more Psychometric properties of the extended Care Dependency Scale for older persons in Egypt Thomas Boggatz, Tamer Farid, Ahmed Mohammedin, Ate Dijkstra, Christa Lohrmann and Theo Dassen Aim. The aim of this study was to determine the validity and reliability of the modified Arabic Care Dependency Scale for self-assessment of older persons in Egypt and to compare these self-assessments to proxy assessments by care givers and family members. Background. The Care Dependency Scale is an internationally used instrument to measure care dependency. The Arabic version may improve data collection on this phenomenon in the Middle East where the population is ageing. Design. A cross-sectional study with a sample of 611 older persons living in Greater Cairo. Participants belonged to three groups: nursing home residents, home care recipients and non-care recipients; 459 participants were also rated by proxies and 171 repeated their self-assessment after two weeks. Methods. The correlation between s...

Advances in Aging Research, 2017

The WHO project for conforming PHC to requirements of all age groups has resulted in publishing a... more The WHO project for conforming PHC to requirements of all age groups has resulted in publishing a toolkit for age-friendly PHC in 2008. The toolkit included checklists for physical environment and signage properties. This study matched the current physical environment properties of DHA's PHC Health Centers against WHO's recommendations. This is a cross sectional descriptive study that included visits to all 12 Primary Health Care Centers in Dubai city during August-September 2016 with the objective to assess the degree of fulfillment of current properties of Health Centers building to the recommendations of WHO as listed in "Age-friendly Primary Health Care Centres Toolkit" [1]. The study found that 81.86% of physical environment properties are matching the recommendation of WHO, while signage matching was 44.6%. The study concluded that most PHC properties have a physical design that met WHO's recommendations. The two major deviations were accessibility by public transportations and presence of grab bars. Factors that had a significant impact on design were compliance with multiple international and local standards, the availability of private cars, and the availability of wheel chairs. Signage in DHA's health centers followed a central plan that differed from WHO's recommendations.

International journal of nursing studies, 2009

Socio-demographic changes may deprive older Egyptians from receiving care by family members and r... more Socio-demographic changes may deprive older Egyptians from receiving care by family members and raise the question of how they react if they become dependent on help. The objective of this study was to determine factors related to the acceptance of home care and nursing homes among older Egyptians. A two group comparative design based on self-reports. The sample was composed of 344 older persons receiving home care or staying in a nursing home and 267 non-care recipients. The study was conducted in Greater Cairo. Factors related to the acceptance of home care and nursing homes were determined separately for each group by logistic regression. Lesser feelings of shame while receiving care from non-family members were related to an increased acceptance of both kinds of care. For non-care recipients disagreement to the traditional idea of family care had a similar effect. For care recipients the experience made with a particular kind of care was strongly related to its acceptance. Home ...

Advances in Aging Research, 2014

Objective: This study aimed to explore the relation between bone mineral density (BMD), inflammat... more Objective: This study aimed to explore the relation between bone mineral density (BMD), inflammation, coronary risk factors, and Insulin growth factor (IGF) in frail elderly. Design: A casecontrol study. Setting: Ain Shams University Hospital Cairo, Egypt. Participants: Ninety aged 60 years and above; sixty frail (30 males and 30 females; mean age 70.03 ± 8.10) and thirty matched controls (15 males and 15 females; mean age 69.07 ± 5.93). Measurements: History, examination, comprehensive geriatric assessment, measurement of BMD, and laboratory investigations including; high sensitivity C-reactive protein (hs-CRP) glycated haemoglobin, IGF, lowdensity lipoprotein (LDL), high-density lipoprotein, total cholesterol, and triglycerides. Results: The frail group had significantly lower levels of triglycerides and LDL, hs-CRP and glycated haemoglobin levels were significantly higher (P < 0.001), and BMD and IGF levels were significantly lower when compared with the control group (P < 0.00 * , P = 0.05) respectively. We also found that BMD had a significant positive linear correlation with IGF and negative correlation with age. Conclusion: Frailty was associated with low BMD, lower triglycerides & LDL levels, and higher hs-CRP levels. A borderline significance was found between IGF levels and frailty. A positive correlation was found between BMD and IGF in frail.

Journal of Transcultural Nursing, 2008

Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of... more Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of the Care Dependency Scale (CDS), an internationally used instrument to measure care needs by either self-reports or external assessment. Method: A Delphi study in two rounds about the Arabic version was performed with 37 panelists in Cairo. Acceptance of CDS items was rated on a 4-point Likert-type scale. Results: Agreement among panelists in the second round was found for 11 CDS items, but 2 items had decreased acceptance after rephrasing and 2 were rejected. Discussion: Rejected items seem to reflect a heterogeneous perception in the target population. Despite some limitations, the CDS is a promising instrument to detect care needs among older Egyptians.

Journal of Clinical Nursing, 2009

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Journal of Public Health Research

Background: The emergence of the COVID-19 pandemic has changed the delivery of medical care acros... more Background: The emergence of the COVID-19 pandemic has changed the delivery of medical care across the world. The objective of the study is to understand and document the preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic. Design and Methods: This is a retrospective study carried on geriatric services utilization (Geriatric clinic- osteoporosis clinic – Memory and dementia clinic) in primary health care centers in Dubai Health Authority in 2020.Results: The study showed that the overall in person visits for all geriatric service in 2020 declined by almost 70%. The total number of telephone consultations in geriatric clinics, osteoporosis clinics and memory clinics were 1479, 1149 and 104 respectively. The COVID-19 pandemic had led to a reduction in most of the geriatric services including outpatient clinics, screening and referral. Telephone consultation provided a foundation for delivery of the service.Conclusion: This st...

Aging Medicine and Healthcare

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major public health problem and one... more Background: Chronic Obstructive Pulmonary Disease (COPD) is a major public health problem and one of the well-known age-associated diseases. Objective: To study the quality of life and functional status among elderly with COPD. Methods: We carried out a case control study on 90 elderly patients above sixty years old who had attended Ain Shams University Hospitals, Egypt. Thirty elderly male patients diagnosed to have COPD and Thirty elderly female patients diagnosed to have COPD and Thirty healthy elderly participants (both males and females), age matched with no apparent evidence of COPD. Each patient gave an oral consent then subjected to history taking, full clinical examination, diagnosis of COPD by (GOLD, 2014) criteria, assessment of quality of life by St George's Respiratory Questionnaire (SGRQ) and Short form 36 (SF-36) and assessment of functional status using Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL). Results: We found statistically significant higher frequency of COPD complications: orthopnea, cyanosis and lower limbs edema among male group in comparison to the other two groups and a higher percentage of dependency in ADL and IADL among male group in comparison to the other two groups and that all SF-36 subscales were significantly lower indicating worse Health-related quality of life (HRQOL) in male group followed by female group and less affected in control group (better HRQOL) and that all SGRQ components were significantly higher (near to 100 indicates worse HRQOL) in male group followed by female group and less affected in the control group (near to zero indicates better HRQOL) and statistically significant negative correlation between SGRQ components and Forced Expiratory Volume 1 (FEV1), indicating worse HRQOL in groups with lower mean FEV1. Conclusion: Quality of life is significantly impaired in patients with COPD and increasing severity of COPD is associated with a significant increase in SGRQ score and significant decrease in SF36 subscales which indicate impairment in Quality of Life (QOL).

Advances in Aging Research

Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many service... more Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding these services. Thus, this study was conducted to investigate the age-friendliness of outpatient clinic's services provided in PHCSS from perspective of elderly service recipients. Methods: Three focus groups were designed. The focus groups included receivers of care (senior patients and caregivers for senior patients) and healthcare providers (physicians, nurses, administrators and medical record officers). The discussed topics in the focus groups were based on WHO's recommended three domains of improvement for an age-friendly Primary Health Care (PHC): Information, education and training, community-based health care management systems, and the physical environment.

Clinical and Applied Thrombosis/Hemostasis

A rapid and accurate diagnosis of venous thromboembolism (VTE) in the elderly individuals represe... more A rapid and accurate diagnosis of venous thromboembolism (VTE) in the elderly individuals represents a dilemma due to nonspecific clinical presentation, confusing laboratory results, and the hazards of radiological examination in this age-group. D-Dimer test is used mainly in combination with non-high clinical pretest probability (PTP) to exclude VTE. D-Dimer testing retains its sensitivity, however, its specificity decreases in the elderly individuals. Raising the cutoff level improves the specificity of the D-dimer test without compromising its sensitivity. The current study aimed to explore the reliability of higher D-dimer cutoff values for the diagnosis of asymptomatic VTE in a population of bedridden hospitalized elderly patients with non-high clinical PTP. This retrospective study included 252 bedridden hospitalized elderly patients (>65 years) who were admitted to the Ain shams University Specialized Hospital with non-high clinical probability and developed later reduced mobility; all underwent quantitation of D-dimer and Doppler examination. Considering the whole population (>65 years), the age-adjusted cutoff achieved the best performance in comparison with the conventional and receiver operating characteristic (ROC)-derived cutoffs. When stratified according to age, the age-adjusted cutoff showed the best performance in the age-group 65-70 and comparable performance with the ROC-derived cutoff in the age-group 71-80, however, its sensitivity compromised in those older than 80 years. In conclusion, it is recommended to use age-adjusted cutoff value of D-dimer together with the clinical probability score in elderly individuals (65-80 years).

Indian Journal of Applied Research, Dec 1, 2014

Ain Shams Medical Journal, 2013

The Egyptian Journal of Hospital Medicine, 2015

Background: Elderly patients are a significant and increasing proportion of ICU patients. With ad... more Background: Elderly patients are a significant and increasing proportion of ICU patients. With advancing age, the comorbidities critically ill elderly patients have substantial mortality. The early recognition of patients at high risk of mortality is needed to plan care in advance and to control healthcare costs. Aim: To find out the relation between chronic diseases and outcome in critically ill elderly admitted to ICU. Study design: A prospective study. Participants: seventy elderly patients aged 60 years and above. Method: This study was performed in Geriatric ICU in Ain Shams University Hospitals including 70 critically ill elderly patients admitted for 24 hours or more. Each patient was subjected to on admission clinical assessment including detailed history taking, in addition to laboratory investigations. Results: The results of our study showed that ischemic heart disease was the only chronic diseases that had significant statistical effect on mortality in critically ill elderly admitted to ICU with p. value= 0.002. Conclusion: In the current study we found that mortality was associated with history of ischemic heart disease.

Objectives: To study the assess the relationship between coronary risk factors, insulin growth fa... more Objectives: To study the assess the relationship between coronary risk factors, insulin growth factor, C-reactive protein, and protein mass in frail elderly. Method: A case-control study conducted among three groups each one comprised 30 elderly participants (60years or older) recruited from the inpatients wards and the outpatient clinic of Ain Shams University Hospitals. Participants were categorized to frail and non-frail using Fried's criteria into 3 groups; Group A: 30 frail elderly females, group B: 30 frail elderly males and group C: 30 controls. All participants were subjected to comprehensive geriatric assessment, measuring of protein mass using dual-energy x-ray absorptiometry by GE Lunar DPX-MD Plus. Measurement of Insulin growth factor-1 (IGF-1), C-reactive protein (CRP), glycated haemoglobin, total cholesterol, triglycerides (TG) and lipoproteins (HDL and LDL) in serum was done. Results: The mean lean body mass was significantly lower among the frail group than contr...

Journal of Clinical Gerontology and Geriatrics, 2015

ABSTRACT There have been many conflicting reports on the effects of type 2 diabetes mellitus (DM)... more ABSTRACT There have been many conflicting reports on the effects of type 2 diabetes mellitus (DM) and the level of vitamin B12 on bone mineral density (BMD) in elderly patients. Moreover, conflicting data exists regarding the prevalence of vitamin B12 deficiency among elderly diabetics. The aim of this study was to investigate the link between vitamin B12 levels, type 2 DM, and BMD in elderly patients.