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Search Results: 1 - 10 of 5459 matches for " Mohammed Hamdy "
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Anti-CD-20 Therapy in Refractory Adult Still’s Disease  [PDF]
Reem Hamdy A. Mohammed
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2012, DOI: 10.4236/ojra.2012.22002
Abstract: Adult Still’s disease is a relatively rare form of rheumatoid arthritis with systemic inflammatory features. The prevalence is around 1.5 cases per 100,000 - 1000,000. In the current case we display a 30-year-old male patient with refractory adult still’s disease who suffered recurrent attacks of fever 39.5°C, arthritis in proximal interphalangeal joints (PIPs), wrists, tempromandibular joints (TMJs), knees and ankles, stitching chest pain, dyspnea, erythematous rash over the trunk, sore throat, weight loss (15 Kilograms in 4 months). The patients’ disease remained uncontrolled despite of synthetic disease modifying anti-rheumatic drugs and repeated intramuscular corticosteroid injections. Laboratory workup revealed erythrocyte sedimentation rate (ESR) of 95, C-reactive protein (CRP) of 100 mg/L, hemoglobin 10.5 gm%, leukocytosis 12,000/microlitre, mild elevation of liver function tests and dyslipidemia. Serology revealed negative rheumatoid factor, anti-nuclear antibody titre of 1:80, elevated serum ferritin 4000 micrograms/litre. The patient was started on rituximab (375 mg/m2), prednisolone 20 mg/day and selective Cox-2 inhibitor. Follow up for over three months following the completion of his pulse therapy, revealed no relapse of fever or fatigue, with morning stiffness of 5 - 10 minutes, VAS of 3, DAS28 of 3.8, HAQDI of 0.62, ESR 23, CRP 4.9, Hb 12.5 gm%, leucocytic count 9000/microlitre, the dose of prednisolone was successfully reduced to a dose of 5 mg/day orally. Conclusion: Anti-CD20 therapy successfully controlled systemic and articular refractory disease with sustained efficacy over a follow up period of up to 24 weeks.
Utilizing Wiltse Approach for Minimal Access Posterolateral Lumbar Stabilization  [PDF]
Hamdy Mohammed Behairy
Open Journal of Modern Neurosurgery (OJMN) , 2018, DOI: 10.4236/ojmn.2018.81008
Abstract: An aggressive separation and prolonged overstretching of the paraspinal muscles in the posterior midline approach during lumbar non fusion dynamic stabilization in cases of spondylolisthesis resulting from pars interarticularis fracture may result in postoperative flat back deformity and intractable chronic pain. It is hypothesized that utilizing Wiltse paraspinal inter-muscular approach for this purpose may result in reduction of operative time, protection of integrity, vascularity, nerve supply and strength of paraspinal muscles, shortening of hospitalization and minimizing development of chronic postoperative back pain. So, I have performed this prospective descriptive study that involved 24 patients having single level lumbar instability at L4-5 or L5-S1 levels. All patients were operated upon using Wiltse minimal access posterolateral surgical technique for non-fusion dynamic stabilization. The final results revealed that males were 66%, females were 33% and ages were 42 ± 6 years. Trauma was reported in 12%. Low back pain and tenderness were reported in 100% and root affection reported in 25%. Plain X-ray and MRI were done in 100% and C.T. was done in 8% of cases. Level L4-5 was affected in 17% while level L5-S1 was affected in 83%. Anterolisthesis grades 0 was found in 8%, grades 1 in 88% and retrolisthesis in 4% of cases. Operative time was 1 hour ± 10 min., blood loss was 60 ± 20 ml., patients ambulation was after 6 - 8 hours, hospital stay was 12 - 24 hours. None of cases were complicated with infection, screw loosening, or fixation system break. Back pain VAS diminished from 7 preoperative to 5 in 2nd day, then became 4 by 1 week, 3 by 1 month and 0 by 6 months. It was concluded that utilizing Wiltse approach for posterolateral lumbar stabilization minimizes tissue damage and improves the speed of recovery and outcome.
Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma  [PDF]
Hamdy Mohammed Behairy
World Journal of Neuroscience (WJNS) , 2018, DOI: 10.4236/wjns.2018.81007
Abstract: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions occurring mostly in elderly and ideally treated with surgical drainage. Many surgical techniques of different degrees of invasiveness have been proposed for its treatment with controversy about the best surgical procedure. The study aims to evaluate the efficacy of the minimal access technique of single burr-hole craniostomy and massive irrigation for treatment of unilateral CSDH. The study is a prospective descriptive study involved all patients with symptomatic radiologically proven unilateral CSDH admitted and treated surgically in department of Neurosurgery, Al-Hussein University hospital, Al-Azhar University, Cairo, Egypt, over 3 years, from January 2013 to January 2016. In the results we found that total 64 patients of CSDH, treated surgically by this procedure. Men formed 72% and women 28%. Age range was 51 to 82 years; the mean age was 65 years. Clinical presentation was impaired consciousness in 7%, headache (59%), right hemiparesis in 56% and left hemiparesis in 37%. CT was done for 91% and MRI 27% patients. The hematoma was left in 61% and right in 39%. Surgical evacuation utilizing this procedure was done in all patients. Complete recovery was obtained in 82% of patients and partial recovery in 11% of patients. Follow up for 4 months was done. Recurrence was detected in 6% of patients. We concluded that unilateral CSDH can be treated effectively by single nondependent burr-hole craniostomy and massive irrigation with excellent outcome.
Endoscopic decompression of the median nerve for idiopathic Carpal tunnel syndrome  [PDF]
Hamdy Mohammed Behairy
Neuroscience & Medicine (NM) , 2018, DOI: 10.4236/nm.2018.91001
Abstract: Carpal tunnel syndrome is one of the commonest entrapment neuropathies. Hand pain and numbness are mostly the presenting symptoms. Endoscopic carpal tunnel release (ECTR) has been demonstrated to reduce recovery time and allow faster return to the work. The purpose of this prospective descriptive study was to evaluate the efficacy and advantages of (ECTR) through single proximal incision. In this study, the procedure was done for 36 hands in 36 patients. The results showed that females:male = 9:1, mean age was 42 years. Right hand dominance was 90% and affected in 67%. Preoperatively, the condition was moderate in 61% and severe in 39%. The average operating time was 10 minutes and the mean follow up period was 6 months with no major postoperative complications. In 8%, transient neurapraxia was found and resolved in 1 week and tenderness was found in 70% and resolved in 4 weeks. we concluded that endoscopic carpal tunnel release is an effective minimal incisional safe procedure with a high success rate, rapid return to work.
Exponential Brute-Force Complexity of A Permutation Based Stream Cipher
Mohammed Omari,Hamdy S. Soliman
International Journal of Computer Network and Information Security , 2013,
Abstract: This paper introduces a permutation generation mechanism based on a shared secret key. The generated permutation vectors are used as encryption keys in a stream ciphering cryptosystem. We investigated various types of attacks on the known stream cipher RC4 and patched most of its loopholes, especially biased-byte and state-related attacks. Unique to our approach, we prove mathematically that the complexity of brute-forcing such a system is (2n), where n is the key size in bytes. This paper also presents a complete security model using permutation-based encryption, in order to handle privacy. In addition, our approach achieved higher performance than that of existing peer techniques, while maintaining solid security. Experimental results show that our system is much faster than the existing security mechanisms, such as AES and DES.
Application of Synchronous Dynamic Encryption System (SDES) in Wireless Sensor Networks
Hamdy S Soliman,Mohammed Omari
International Journal of Network Security , 2006,
Abstract: Inherent to the wireless sensor networks are the two major problems of the broadcasting vulnerability, the limited computational capability and power budget. Even though security is a must in most applications, current sophisticated security protocols are not amenable to the primitiveness of the sensors. In this paper, we introduce a novel security protocol for wireless network of sensors that is very secure, yet simple and efficient. At the core of our security protocol is a simple and fast stream cipher cryptosystem that utilizes permutation vectors as encryption keys, forcing an intruder to a brute-force time complexity of $Omega(2^n)$. In addition, our mechanism alleviates the effect of sensor capture, via its synchronized re-keying feature. In addition to the encryption efficiency, our system utilizes the group deployment of newly joining sensors for sensors power budgeting considerations. Experimental results show very promising future of our system in the wireless networks domain, excelling over other peers of modern cryptosystems (AES, DES, TripleDES), especially in the power budget arena.
Use of the urinary trypsinogen-2 dipstick test in early diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)  [PDF]
Hasan El-Garem, Enas Hamdy, Sherif Hamdy, Mohammad El-Sayed, Aisha Elsharkawy, Azmi Mohammed Saleh
Open Journal of Gastroenterology (OJGas) , 2013, DOI: 10.4236/ojgas.2013.36049
Abstract: Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.
Risk Stratification Treatment of Pediatric Rhabdomyosarcoma: South Egypt Cancer Institute Experience  [PDF]
Hamza Abbas, Amany M. Ali, Heba Abdel Razik Sayed, Mohamed A. Salem, Mohammed Hamdy
Journal of Cancer Therapy (JCT) , 2012, DOI: 10.4236/jct.2012.35076
Abstract: Risk stratification allows tailoring of treatment protocol using, for selected patients, reduced total chemotherapy exposure, including decreases in alkylator therapy and avoidance of agents with recognized risk of late complications (anthracyclines), elimination of irradiation and reduction of radiotherapy dose. Patients and Methods: Twenty-nine newly diagnosed pediatric rhabdomyosarcoma patients attended the pediatric oncology department between January 2008 and May 2011. Patients were divided into 3 groups according to age, stage, group, pathology and site of the tumor. Treatment protocol tailored according to risk group. Results: Twenty-nine newly diagnosed pediatric rhabdomyosarcoma patients were evaluated. Seven patients had low risk, Intermediate risk included 12 patients, and 10 patients had high risk. After three years median follow up, event free survival was 51.7% for all patients however it was 86%, 67% and 10% for low, intermediate and high risk respectively (P = 0.0002). There was statistical difference for survival among different sites, histology, clinical group and stage as risk factors within each risk group, no statistically survival significance of any of these factors within the same risk group. Conclusion: Risk stratification is the best single predictor factor for pediatric rhabdomyosarcoma and allows tailoring of the treatment protocol. For selected patients, reductions in total chemotherapy exposure, elimination of irradiation in selected low risk patients and reduction of radiotherapy dose according to postoperative margin and nodal status is safe.
Resistant Tremors and Unexplained Weight Loss Could Also Be a Sign of HIV  [PDF]
Mohammed Hamdy Ibrahim, Shivram Kumar, Janhavi Sirsat, Mohamed Khalid, Kiran Kumar
Neuroscience & Medicine (NM) , 2015, DOI: 10.4236/nm.2015.63014
Abstract: This case study is done to show a different type of presentation of a HIV (Human Immunodeficiency Virus) patient. Neurological symptoms in HIV are normally due to Progressive Multifocal Leukoencephalopathy (PML) which is a reactivated infection caused by John Cunningham virus (JC virus). The disease causes fatal demyelination of the central nervous system (CNS). This case presented a 51-year-old Nigerian man who complained of resistant tremors and unexplained weight loss. The patient was suspected to have HIV when a MRI scan revealed T2/FLAIR hyper intensity of white matter which was a sign of PML. HIV ELISA was done and came back with a positive result. PML presenting in the form of tremors is very rare and more research is required to focus on the neurological presentation of HIV.
Efficacy of Nilotinib versus Imatinib in Philadelphia Positive Patients with Chronic Myeloid Leukemia in Early Chronic Phase Who Have a Warning Molecular Response to Imatinib  [PDF]
Amen Hamdy Zaky Aly, Ahmed EL Sayed Mohammed Khalifa, Esraa Abdallah Abdelkariem Gadallah
Journal of Cancer Therapy (JCT) , 2018, DOI: 10.4236/jct.2018.911073
Abstract: Background and Objectives: Chronic myeloid leukemia (CML) accounts for approximately 15% of newly diagnosed cases of leukemia in adults. In this study, the efficacy of nilotinib at 400 mg BID is compared with imatinib at 400 mg BID in CML patients with suboptimal molecular response after at least 12 months of daily dose 400 mg of imatinib therapy. Patients and Methods: This study included a total number of 50 patients, divided into two groups (25 patients each). The first group (Group I): Patients received imatinib at 400 mg BID, second group (Group II): Patients had a suboptimal molecular response to imatinib and received nilotinib at 400 mg BID in early chronic phase. During the two years period of data collection, the primary end included median survival. The secondary end included response rate, type of response, duration of response and progression free survival. Also side effects were recorded. Patients were followed up every month by complete and differential blood counts, liver function test, renal function test and (PCR) every three months for two year. Results: Nilotinib group had significantly higher frequency of major molecular response (MMR) where 23 (92%) patients achieved it while only 16 (64%) patients in Imatinib group achieved MMR (P = 0.01). Nilotinib had better toxicities profile than Imatinib. Conclusion: Both Nilotinib and high dose Imatinib achieved response in CML patients with suboptimal response with rapid and deeper molecular response, better survival outcomes and less side effects in nilotinib.
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