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Al Minyā, Egypt

Mohsen L.A.,University of Cambridge | Mohsen L.A.,Al Minya University Hospital | Shi V.,University of Cambridge | Jena R.,Addenbrookes Hospital | And 2 more authors.
British Journal of Neurosurgery | Year: 2013

Introduction. Glioblastomas multiformes (GBM) remain incurable in most cases. Their invasion into normal brain makes current therapies ineffective. Post-mortem studies suggest about a 25% of GBMs invade less than 1 cm from the tumour bulk and 20% invade more than 3 cm. Aim of study. The study aims to use DTI to assess tumour extension and determine how previously reported patterns relate to the progression-free survival (PFS). Materials and methods. Twenty-five patients with GBM treated according to the EORTC/NCIC protocol were retrospectively analysed. Patients were imaged post-operatively at 1.5 T. The sequences were composed of standard anatomical and a standard DTI sequence. As described earlier p and q maps were constructed. For each of the p and q maps, regions of interest were drawn around the visible abnormality. Patients were assigned a diffuse, localised or minimally invasive pattern. Progression was defined according to the RANO criteria and PFS determined in days. Kaplan-Meier plots of survival for the three groups were plotted as were the proportion of patients who had not progressed at 24 months. Results. The median PFS for the diffuse group was 278 days, for the localised group 605 days and 820 days for the minimally invasive group. Three-fourth of the minimally invasive group were progression-free at 24 months (LOG RANK 9.25; p = 0.010). Conclusion. It is possible to identify three invasive phenotypes in GBMs using Diffusion tensor imaging , and these three phenotypes have different progression free survival. A minimal phenotype (20% of patients) predicts a greater delay to progression. © 2013 The Neurosurgical Foundation.

Mohsen L.A.,Al Minya University Hospital | Gawad E.A.A.,Al Minya University Hospital | Ibrahiem M.A.,Al Minya University Hospital
Egyptian Journal of Radiology and Nuclear Medicine | Year: 2014

Objective To evaluate whether a simple semi-quantitative method aided by software enhanced visualization can be reliable enough for the quantification of emphysema during the daily workload. Patients and methods Thirty patients with COPD were included. Patients had a standard non enhanced MDCT study of the chest using a 16 slice machine. The images were evaluated visually and scored. This scoring was repeated after applying a density mask. Three radiologists evaluated the images on separate occasions. Repeatability was also tested. The CT emphysema index and the mean lung attenuation were calculated. The extent of airway disease was not assessed. Results Kappa test between the 3 readers revealed slight agreement (k = 0.122, p = 0.001) before the density mask and substantial agreement (k = 0.75, p < 0.0005) after its application. A high degree of repeatability was found. The median visual score after density mask application, showed a stronger correlation to the emphysema index (r = 0.81, p < 0.0005) than before. Conclusion We present a simple visual score for quantitation of emphysema, that when combined with a simple density mask, the inter-rater agreement and repeatability of scoring are markedly improved. This method appears to be fast and easy to perform. © 2014 Production and hosting by Elsevier B.V.

Attia S.K.,Al Minya University Hospital | Moftah N.H.,Al Minya University Hospital | Abdel-Azim E.S.,Al Minya University Hospital
International Journal of Dermatology | Year: 2014

Objectives: Cutaneous schistosomal granuloma (CSG) is a rare dermatological disease, the clinical and histopathological features of which are well defined. Although a panoramic picture of its immunopathogenesis in humans is not yet available, it is believed to be induced by T helper 1 (Th1), Th2, or Th17 cytokines in animals. This study evaluated the expression of different types of Th cytokines, including Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4), and Th17 cytokine IL-17, in human CSG. Methods: This study included nine patients with CSG. Dermatological examinations were conducted in all subjects. Skin biopsy specimens were stained with hematoxylin and eosin (H&E). Immunohistochemical examination was performed using three monoclonal anti-human antibodies against IFN-γ, IL-4, and IL-17 to evaluate Th1, Th2, and Th17 cytokines, respectively. Results: The most common site of CSG manifestation was the paraumbilical area, which was affected in 66.7% of patients. All lesional skin biopsy specimens revealed multiple dermal granulomas surrounding schistosomal eggs. Positive immunoreactivity for IFN-γ, IL-4, and IL-17 was present in dermal inflammatory infiltrate in 88.9, 11.1, and 88.9% of subjects, respectively. There were statistically significant negative correlations between the duration of disease and both IFN-γ and IL-17 (P ≤ 0.05), and a statistically significant positive correlation between IFN-γ and IL-17 (P ≤ 0.05). Conclusions: This study suggests that CSG is formed by the action of both Th1 (IFN-γ) and Th17 (IL-17) cytokines, which have been shown to be directed against the schistosomal egg to induce a cell-mediated immune response. © 2014 The International Society of Dermatology.

Mahmoud K.S.,Al Minya University Hospital | Ismail T.T.,Al Minya University Hospital | Saad M.,Al Minya University Hospital | Mohsen L.A.,Al Minya University Hospital | And 3 more authors.
Egyptian Heart Journal | Year: 2015

Background: Hypertension has been shown to carry an increased risk not only for cerebrovascular stroke but also for cognitive impairment and dementia. Ambulatory blood pressure monitoring (ABPM) is a good predictor of cardiac, renal, and cerebral disease in middle-aged and older people with hypertension. Patients and methods: The study included 77 elderly (mean age: 69. years) subjects. Based on the history of hypertension, office blood pressure, and ABPM, patients were classified into 2 groups, Group I: 22 persons as a control group and Group II: 55 hypertensive patients. The hypertensive group was further sub classified by using data of ABPM into dippers and non-dippers. Both groups were subjected to clinical examination, laboratory analysis, ABPM, Transthoracic Echocardiographic Examination, brain magnetic resonance imaging (MRI) and mini-mental state examination (MMSE) of their cognitive function. Results: There was a statistically significant positive correlation between the cerebral MRI score and each of the average 24-h systolic, diastolic and mean arterial blood pressure, average morning systolic, diastolic, mean arterial blood pressure, average night systolic, diastolic and mean arterial blood pressure. There was also a statistically significant negative correlation between the MMSE score and the previous parameters. A non significant correlation was noted between the cerebral MRI score and the office systolic and diastolic blood pressure in hypertensive group. Conclusion: The study demonstrated that hypertensive patients diagnosed by ABPM have significantly more impaired cognitive function than control subjects as proved by the mini-mental state examination and brain MRI score of white matter disease. © 2014.

Sayed K.,Al Minya University Hospital | Taha T.T.I.,Al Minya University Hospital | Saad M.,Al Minya University Hospital | Mohsen L.A.,Al Minya University Hospital | And 3 more authors.
Journal of Clinical Hypertension | Year: 2014

Essential hypertension is an important risk factor for target organ damage. The brain is among the target organs infrequently visited. The authors evaluated whether an abnormal Mini-Mental Score Examination (MMSE) score predicts uncontrolled hypertension even if office blood pressure is normal. Seventy-seven hypertensive patients were included. The cognitive function of each patient was assessed using MMSE and a customized brain magnetic resonance imaging study. Patients were classified into normal cognitive function group and mild, moderate, and severe cognitive impairment groups. A significance level of P=.05 was used. There was a higher percentage of uncontrolled BP in every cognitive impairment class. In patients older than 65 years, MMSE score had a sensitivity and specificity of 94% and 83%, respectively, in the prediction of uncontrolled hypertension. MMSE is a simple test to run in the clinic to predict whether patients have well-controlled blood pressure. ©2014 Wiley Periodicals, Inc.

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