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Article ; Online: Role of zonisamide in advanced Parkinson's disease: a randomized placebo-controlled study.

Essam, Mohamed / Hamid, Eman / Abushady, Eman / El-Balkimy, Mahmoud / Antonini, Angelo / Shalash, Ali

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

2024 Volume 45, Issue 4, Page(s) 1725–1734

Abstract: Background: Zonisamide (ZNS) has shown some efficacy in motor symptoms of PD; however, more evidence is lacking, and its effects on nonmotor symptoms (NMSs) and quality of life (QoL) remain to be investigated. This randomized double-blinded placebo- ... ...

Abstract	Background: Zonisamide (ZNS) has shown some efficacy in motor symptoms of PD; however, more evidence is lacking, and its effects on nonmotor symptoms (NMSs) and quality of life (QoL) remain to be investigated. This randomized double-blinded placebo-controlled crossover study investigated the effect of ZNS on motor and NMS symptoms and QoL in advanced PD. Methods: PD patients with Hoehn and Yahr stage ≥ 2 ("On" state) and at least 2 h off time daily were randomized to groups: ZNS 25 mg, ZNS 50 mg and placebo. Groups were assessed at baseline and at the 1- and 3-month follow-ups. The primary endpoint was the change in the total MDS-UPDRS III "On", while the secondary endpoint was the change in the total and parts I and IV MDS-UPDRS, Nonmotor Symptoms Scale and Parkinson's disease questionnaire-39 at the final assessment. Results: Sixty-nine patients were assessed for efficacy at the 1-month follow-up, and 58 patients were assessed at the 3-month follow-up. The primary endpoint showed significant improvement in the ZNS 25 mg group compared to the placebo group (p = 0.009). At the final assessment, the ZNS 25 mg group showed significant improvement of total and part VI MDS-UPDRS, bradykinesia, tremor and functional impact of fluctuations compared to placebo. There was no change in dyskinesia, NMSs, QoL or side effects except for sedation. Conclusion: ZNS has a favourable effect on motor symptoms in patients with wearing off as adjunctive therapy with other dopaminergic drugs, with no exacerbation of dyskinesia and a limited impact on NMSs and QoL. Trial registration: Clinicaltrials.gov, NCT04182399, in 24/11/2019.
MeSH term(s)	Humans ; Zonisamide/therapeutic use ; Parkinson Disease/complications ; Quality of Life ; Cross-Over Studies ; Tremor/complications
Chemical Substances	Zonisamide (459384H98V)
Language	English
Publishing date	2024-02-20
Publishing country	Italy
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2016546-8
ISSN	1590-3478 ; 1590-1874
ISSN (online)	1590-3478
ISSN	1590-1874
DOI	10.1007/s10072-024-07396-w
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Article: Outcomes of Hallux Valgus Corrective Osteotomy: A Tertiary Hospital Experience.

Alshehri, Ali S / Alzahrani, Faisal A / Aljaafri, Ziad A / Shalash, Nada A

Cureus

2023 Volume 15, Issue 10, Page(s) e46422

Abstract: Background: A common form of forefoot deformity, hallux valgus (HV) is characterized by a prominent first metatarsal head, lateral deviation of the hallux, and medial deviation of the first metatarsal bone. In the case of HV, corrective osteotomies are ... ...

Abstract	Background: A common form of forefoot deformity, hallux valgus (HV) is characterized by a prominent first metatarsal head, lateral deviation of the hallux, and medial deviation of the first metatarsal bone. In the case of HV, corrective osteotomies are performed with good results and patient satisfaction. Methods: A retrospective cohort study of patients who underwent corrective osteotomy for hallux valgus from 2016 to 2022 was conducted at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Data were collected by chart review using the BestCARE system. IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) was used for statistical analysis. Results: Our study included 166 patients. The mean age of the patients was found to be 41.3 years old and about 152 (91.6%) of them were females. The most frequently reported comorbidity was hypertension (10.2%). The mean hallux valgus angle was found to be 36.1 ± 9.9 and the mean intermetatarsal angle was found to be 15 ± 4.4 degrees. Seventy-six (45.8%) patients underwent nonoperative management first. The mean age at diagnosis among males was found to be 28.5 ± 11.3 years and among females was 37.9 ± 14.4 years; a significant difference between means was noted (p-value = 0.019) with mean age at diagnosis in males being significantly lesser than in females. Conclusion: Significant improvement and reduction were seen in HV angle post surgery. Nearly half of the patients underwent nonoperative management first. Age at diagnosis is significantly younger in males compared to females.
Language	English
Publishing date	2023-10-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.46422
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Article ; Online: Critical attributes of fine excipient materials in carrier-based dry powder inhalation formulations: The particle shape and surface properties.

Elsayed, Mustafa M A / Alfagih, Iman M / Brockbank, Katrina / Aodah, Alhassan H / Ali, Raisuddin / Almansour, Khaled / Shalash, Ahmed O

International journal of pharmaceutics

2024 Volume 655, Page(s) 123966

Abstract: The potential of fine excipient materials to improve the aerodynamic performance of carrier-based dry powder inhalation (DPI) formulations is well acknowledged but not fully elucidated. To improve the understanding of this potential, we studied two fine ... ...

Abstract	The potential of fine excipient materials to improve the aerodynamic performance of carrier-based dry powder inhalation (DPI) formulations is well acknowledged but not fully elucidated. To improve the understanding of this potential, we studied two fine excipient materials: micronized lactose particles and silica microspheres. Inhalation formulations, each composed of a coarse lactose carrier, one of the two fine excipient materials (0.0-15.0 % w/w), and a spray-dried drug (fluticasone propionate) material (1.5 % w/w) were prepared. The physical structure, the flow behavior, the aerosolization behavior, and the aerodynamic performance of the formulations were studied. The two fine excipient materials similarly occupied carrier surface macropores. However, only the micronized lactose particles formed agglomerates and appeared to increase the tensile strength of the formulations. At 2.5 % w/w, the two fine excipient materials similarly improved drug dispersibility, whereas at higher concentrations, the micronized lactose material was more beneficial than the silica microspheres. The findings suggest that fine excipient materials improve drug dispersibility from carrier-based DPI formulations at low concentrations by filling carrier surface macropores and at high concentrations by forming agglomerates and/or enforcing fluidization. The study emphasizes critical attributes of fine excipient materials in carrier-based DPI formulations.
MeSH term(s)	Excipients/chemistry ; Powders/chemistry ; Lactose/chemistry ; Drug Carriers/chemistry ; Dry Powder Inhalers ; Administration, Inhalation ; Surface Properties ; Silicon Dioxide ; Particle Size ; Aerosols/chemistry
Chemical Substances	Excipients ; Powders ; Lactose (J2B2A4N98G) ; Drug Carriers ; Silicon Dioxide (7631-86-9) ; Aerosols
Language	English
Publishing date	2024-03-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	428962-6
ISSN	1873-3476 ; 0378-5173
ISSN (online)	1873-3476
ISSN	0378-5173
DOI	10.1016/j.ijpharm.2024.123966
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Zs.A 1409: Show issues

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Article ; Online: Quantifying odour impacts from aged organic waste to be considered as a priority constraint in route optimization for waste collection trucks.

Haddad, Assal / Harb, Ali / Abujeish, Fahed / Manaseer, Naizak / Shalash, Osama

Waste management & research : the journal of the International Solid Wastes and Public Cleansing Association, ISWA

2022 Volume 41, Issue 2, Page(s) 401–406

Abstract: Route optimization has been used for years to plan the routes for municipal solid waste (MSW) collection trucks to achieve cost reductions. Historically, optimized routes had overlooked a number of aspects and parameters in their design. This study aims ... ...

Abstract	Route optimization has been used for years to plan the routes for municipal solid waste (MSW) collection trucks to achieve cost reductions. Historically, optimized routes had overlooked a number of aspects and parameters in their design. This study aims to consider MSW odour detection as a performance indicator and a priority constraint in the optimization process by quantifying the impact of objectionable odours from uncollected aged MSW that contains a high percentage of food waste (typically called wet garbage). Odours from 48 aged food waste samples were rated on a scale from 0 to 3 to mark the beginning of the critical time of objectionable odour detection. The critical time was found to take place approximately at the hour 13.6, which was then used, along with the estimated food waste weight in the bin, to define the beginning of a time window that puts the bin on a high priority status for collection over the other, less odoriferous bins. Three optimization scenarios for collection of 100 MSW bins in the city of Madaba, Jordan, were conducted under different constraints: least travelled distance, maximum collected volume and least odour impact. Without the application of the odour consideration, a total travelled distance of 143 km was the shortest travelled distance achieved, with 53 bins emitting odours and leaving 81 m
MeSH term(s)	Refuse Disposal ; Waste Management ; Odorants ; Food ; Solid Waste ; Motor Vehicles
Chemical Substances	Solid Waste
Language	English
Publishing date	2022-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1480483-9
ISSN	1096-3669 ; 1399-3070 ; 0734-242X
ISSN (online)	1096-3669 ; 1399-3070
ISSN	0734-242X
DOI	10.1177/0734242X221122574
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Article ; Online: The clinical and neuroimaging differences between vascular parkinsonism and Parkinson's disease: a case-control study.

George, Peter / Roushdy, Tamer / Fathy, Mai / Hamid, Eman / Ibrahim, Yosra Abdelzaher / El-Belkimy, Mahmoud / Abdulghani, Mohamed Ossama / Shalash, Ali

BMC neurology

2024 Volume 24, Issue 1, Page(s) 56

Abstract: Background: Parkinson's disease (PD) and vascular parkinsonism (VaP) have highly overlapping phenotypes, and different prognosis. This study comprehensively investigated the clinical, brain MRI and transcranial sonography differences between VaP and PD.! ...

Abstract	Background: Parkinson's disease (PD) and vascular parkinsonism (VaP) have highly overlapping phenotypes, and different prognosis. This study comprehensively investigated the clinical, brain MRI and transcranial sonography differences between VaP and PD. Methods: Forty-eight patients with PD, 27 patients with VaP, and 29 healthy controls were compared. All patients were assessed using the MDS-UPDRS, Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), Time Up and Go Test, and Non-Motor Symptoms Scale. Beck Depression Inventory, PD questionnaire- 39, international urine incontinence scale, cognitive assessment scales, MRI brain and transcranial colour-coded doppler. The study was registered on clinical-Trial.gov (NCT04308135) on 03/12/2020. Results: VaP patients showed significantly older age of onset, shorter disease duration, lower drug doses and levodopa responsiveness, higher On and Off axial scores, On and Off BBS, higher On scores for PIGD, rigidity, bradykinesia and total motor MDS-UPDRS, lower On and Off tremor, lower-half predominance, lower asymmetrical presentation and symmetric index than PD patients. VaP patients had worse non-motor symptoms Scale (NMSS) than controls except for perceptual problems/hallucinations but better symptoms than PD patients except for urinary dysfunction. Quality of life (QoL) was impaired in VaP patients and was correlated with motor function and NMSs. The VaP group had significantly higher white matter lesions and brain atrophy, with lower hyperechogenicity of the substantia nigra and more impaired cerebral vascular resistance and vasoreactivity than the PD group. Conclusions: VaP has a characteristic motor and non-motor profile, with impaired QoL, white matter, and transcranial sonography abnormalities that differentiate it from PD. Further studies are warranted to explore the role of vascular lesions in the pathogenesis of VaP. Trial registration: The registered identifier NCT04308135 on clinical-Trial.gov. Registered on 03/12/2020.
MeSH term(s)	Humans ; Parkinson Disease ; Quality of Life/psychology ; Case-Control Studies ; Postural Balance ; Time and Motion Studies ; Ultrasonography, Doppler, Transcranial
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-024-03556-9
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Article ; Online: Tremor in Patients with Relapsing-Remitting Multiple Sclerosis: Clinical Characteristics and Impact on Quality of Life.

Shalash, Ali / Elhodeby, Ahmed Mohamed / Saad, Mahmoud / Abdelzaher Ibrahim, Yosra / Hamid, Eman / Nasef, Ayman

Movement disorders clinical practice

2023 Volume 10, Issue 7, Page(s) 1099–1106

Abstract: Background: Little is known about the prevalence and clinical characteristics of tremors in patients with multiple sclerosis (MS), their associated clinical disability, and their impact on quality of life (QoL).: Objective: This study aimed to ... ...

Abstract	Background: Little is known about the prevalence and clinical characteristics of tremors in patients with multiple sclerosis (MS), their associated clinical disability, and their impact on quality of life (QoL). Objective: This study aimed to investigate the frequency and types of tremors in patients with relapsing remitting MS (RRMS) in remission, and their impact on patients' QoL. Methods: A total of 250 patients with RRMS in remission were examined for tremors. All patients were assessed using the Expanded Disability Status Scale (EDSS). Patients with tremors underwent further assessment using the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS), the Beck Depression Inventory (BDI), the Montreal Cognitive Assessment (MoCA) scale, and the Short Form 36 Health Survey Questionnaire (SF-36). Brain MRI was obtained for a subgroup of patients. Results: Tremors were detected in 36 patients (14.4%) and were associated with significantly worse EDSS scores, BDI ( Conclusion: The current study confirms the common occurrence of tremors and their subtypes among patients with RRMS with mild disability and demonstrates their association with increased disability and impaired QoL.
Language	English
Publishing date	2023-05-26
Publishing country	United States
Document type	Journal Article
ISSN	2330-1619
ISSN (online)	2330-1619
DOI	10.1002/mdc3.13784
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Article ; Online: Global Perspective on Telemedicine for Parkinson's Disease.

Shalash, Ali / Spindler, Meredith / Cubo, Esther

Journal of Parkinson's disease

2021 Volume 11, Issue s1, Page(s) S11–S18

Abstract: Telemedicine programs are particularly suited to evaluating patients with Parkinson's disease (PD) and other movement disorders, primarily because much of the physical exam findings are visual. Telemedicine uses information and communication technologies ...

Abstract	Telemedicine programs are particularly suited to evaluating patients with Parkinson's disease (PD) and other movement disorders, primarily because much of the physical exam findings are visual. Telemedicine uses information and communication technologies to overcome geographical barriers and increase access to healthcare service. It is particularly beneficial for rural and underserved communities, groups that traditionally suffer from lack of access to healthcare. There is a growing evidence of the feasibility of telemedicine, cost and time savings, patients' and physicians' satisfaction, and its outcome and impact on patients' morbidity and quality of life. In addition, given the unusual current situation with the COVID-19 pandemic, telemedicine has offered the opportunity to address the ongoing healthcare needs of patients with PD, to reduce in-person clinic visits, and human exposures (among healthcare workers and patients) to a range of infectious diseases including COVID-19. However, there are still several challenges to widespread implementation of telemedicine including the limited performance of parts of the neurological exam, limited technological savvy, fear of loss of a personal connection, or uneasiness about communicating sensitive information. On the other hand, while we are facing the new wave of COVID-19 pandemic, patients and clinicians are gaining increasing experience with telemedicine, facilitating equity of access to specialized multidisciplinary care for PD. This article summarizes and reviews the current state and future directions of telemedicine from a global perspective.
MeSH term(s)	COVID-19/complications ; Health Services Accessibility ; Humans ; Pandemics ; Parkinson Disease/diagnosis ; Parkinson Disease/therapy ; Telemedicine
Language	English
Publishing date	2021-02-10
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2620609-2
ISSN	1877-718X ; 1877-7171
ISSN (online)	1877-718X
ISSN	1877-7171
DOI	10.3233/JPD-202411
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Article: Baseline predictors of progression of Parkinson's disease in a sample of Egyptian patients: clinical and biochemical.

Helmy, Asmaa / Hamid, Eman / Salama, Mohamed / Gaber, Ahmed / El-Belkimy, Mahmoud / Shalash, Ali

The Egyptian journal of neurology, psychiatry and neurosurgery

2022 Volume 58, Issue 1, Page(s) 9

Abstract: Background: Clinical progression of Parkinson's disease (PD) is highly heterogeneous, and its predictors are generally lacking. Identifying predictors of early disease progression is important for patients' management and follow-up. The current study ... ...

Abstract	Background: Clinical progression of Parkinson's disease (PD) is highly heterogeneous, and its predictors are generally lacking. Identifying predictors of early disease progression is important for patients' management and follow-up. The current study aims to identify clinical, neuroimaging and biochemical baseline predictors of motor progression in patients with PD. Forty-five PD patients were assessed at baseline, 6 months and 1 year using MDS-UPDRS total and subscores, Hoehn and Yahr (H&Y), Schwab and England (S&E), International Physical Activity Questionnaire (IPAQ). Baseline New Freezing of Gait Questionnaire (NFOG-Q), Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT) Results: Significant worsening of MDS-UPDRS total, part III scores, H&Y, S&E and IPAQ ( Conclusion: Despite the significant motor and physical activity progression over 1 year that was correlated to baseline motor and gait severity, but without predictive value, further similar and longitudinal studies are warranted to detect predictors of early progression and confirm findings. Supplementary information: The online version contains supplementary material available at 10.1186/s41983-022-00445-1.
Language	English
Publishing date	2022-01-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2686351-0
ISSN	1687-8329 ; 1110-1083
ISSN (online)	1687-8329
ISSN	1110-1083
DOI	10.1186/s41983-022-00445-1
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Article: A 6-month longitudinal study on worsening of Parkinson's disease during the COVID-19 pandemic.

Shalash, Ali / Helmy, Asmaa / Salama, Mohamed / Gaber, Ahmed / El-Belkimy, Mahmoud / Hamid, Eman

NPJ Parkinson's disease

2022 Volume 8, Issue 1, Page(s) 111

Abstract: Further studies are required to investigate the impact of the COVID-19 pandemic on Parkinson's disease (PD) progression. This study investigated the motor and non-motor progression of people with PD (PWP) at 6 months during the COVID-19 pandemic compared ...

Abstract	Further studies are required to investigate the impact of the COVID-19 pandemic on Parkinson's disease (PD) progression. This study investigated the motor and non-motor progression of people with PD (PWP) at 6 months during the COVID-19 pandemic compared with that during the pre-pandemic period. Patients were recruited from Ain Shams University Hospitals, Cairo, in the period between April 2019 and December 2020. Fifty patients were included, of whom 17 and 33 patients were followed for 6 months before and during the pandemic, respectively. All patients were assessed at baseline and at 6 months using the MDS-UPDRS, Schwab and England scale (S&E), Hoehn and Yahr scale (H&Y), Berg Balance Scale, Timed Up and Go test (TUG), International Physical Activity Questionnaire, New Freezing of Gait Questionnaire, Non-Motor Symptoms Scale, and Beck Depression Inventory (BDI). Both groups were matched in age, gender, and disease characteristics. Patients followed during the pandemic showed more significant worsening of the total, part I and motor part of MDS-UPDRS, and balance scores (p < 0.001) than those followed during the pre-COVID-19 period. Gait (TUG), balance, and physical activity worsening were significantly correlated with baseline BDI, gait and balance scores, total and part I MDS-UPDRS scores, H&Y, and S&E OFF scores. Gait deterioration (TUG) was correlated with baseline physical activity (r = -0.510, p = 0.002). PWP showed worsening of motor and non-motor symptoms during the COVID-19 pandemic at the 6-month follow-up. Worsening of gait, balance, and physical activity was correlated with baseline motor and physical activity OFF scores.
Language	English
Publishing date	2022-08-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819218-7
ISSN	2373-8057
ISSN	2373-8057
DOI	10.1038/s41531-022-00376-x
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Article ; Online: Evaluating the Effect of Lactobacillus casei FEGY 9973 and Curcumin on Experimental Giardiasis.

Shady, Omima M Abou / Shalash, Ibrahim Ali / Elshaghabee, Fouad M F / Negm, Mohamed S I / Yousef, Gehad A B / Rizk, Enas M A

Acta parasitologica

2023 Volume 69, Issue 1, Page(s) 302–308

Abstract: Background and objective: Giardia is a parasitic hard protozoan that causes a variety of parasitological and pathological changes in gastrointestinal epithelial cells and is resistant to a variety of disinfectants and treatments. This study used ... ...

Abstract	Background and objective: Giardia is a parasitic hard protozoan that causes a variety of parasitological and pathological changes in gastrointestinal epithelial cells and is resistant to a variety of disinfectants and treatments. This study used experimental animals infected with Giardia Lamblia to assess the potential therapeutic effect of Lactobacillus casei, Lactobacillus bulgaricus (Lactobacillus in yoghurt) and curcumin in comparison to one of the commonly used drugs (metronidazole). Methods: The study included 54 Syrian hamsters (Mesocricetus auratus) that ranged in weight from 80 to 100 g and were divided into six groups: The effect of the used preparations was assessed in terms of parasitological and histopathological aspects in Group I non-infected healthy control, Group II infected non-treated, Group III infected treated with metronidazole MTZ, Group IV infected treated with Lactobacillus casei, Group V infected treated with curcumin, and Group VI infected treated with, Lactobacillus bulgaricus (Lactobacillus in yoghurt). The number of G. lamblia cysts per gram of stool was counted during the parasitological examination. Results: The difference between the infected non-treated group and all the treated groups was statistically significant (P0.05). When compared to the infected untreated group, Lactobacillus casei and, Lactobacillus bulgaricus (Lactobacillus in yoghurt) produced a 100% reduction in G. lamblia cyst shedding, curcumin produced an 87.80% reduction in number of cysts, and metronidazole produced a 78.4% reduction in number of cysts. Conclusion: Our results highlight the potentially effective therapeutic effect of different preparations of probiotics and curcumin against Giardiasis.
MeSH term(s)	Animals ; Curcumin/pharmacology ; Giardiasis/drug therapy ; Giardiasis/parasitology ; Lacticaseibacillus casei/drug effects ; Giardia lamblia/drug effects ; Probiotics/administration & dosage ; Mesocricetus ; Cricetinae ; Metronidazole/therapeutic use ; Metronidazole/pharmacology ; Feces/parasitology ; Feces/microbiology ; Antiprotozoal Agents/pharmacology ; Disease Models, Animal
Chemical Substances	Curcumin (IT942ZTH98) ; Metronidazole (140QMO216E) ; Antiprotozoal Agents
Language	English
Publishing date	2023-12-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1132735-2
ISSN	1896-1851 ; 0065-1478 ; 1230-2821
ISSN (online)	1896-1851
ISSN	0065-1478 ; 1230-2821
DOI	10.1007/s11686-023-00744-4
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