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Article: Prevalence of Vancomycin-resistant enterococci (VRE) in Egypt (2010-2022): a systematic review and meta-analysis.

Azzam, Ahmed / Elkafas, Hoda / Khaled, Heba / Ashraf, Ahmed / Yousef, Mohammed / Elkashef, Aya Awny

The Journal of the Egyptian Public Health Association

2023 Volume 98, Issue 1, Page(s) 8

Abstract: Background: Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and ... ...

Abstract	Background: Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and antimicrobial resistance profiles among enterococci clinical isolates in Egypt. Methods: A PubMed, Scopus, Google Scholar, and Web of Science literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only published studies documenting the prevalence of VRE between 2010 and 2022 were included. Using the random effects model and the 95% confidence intervals, the pooled estimate of VRE was calculated by MedCalc Version 20.113. Cochran's Q and I Results: The pooled prevalence of VRE among enterococci clinical isolates in Egypt was estimated to be 26% (95% CI 16.9 to 36.3). E. faecalis had a greater pooled prevalence than E. faecium, with 61.22% (95% CI 53.65 to 68.53) and 32.47% (95% CI 27 to 38.2), respectively. The VanA gene is more frequent than the VanB gene among VRE, with a pooled prevalence of 63.3% (95% CI 52.1 to 73.7) and 17.95% (95% CI 7.8 to 31), respectively. The pooled resistance rate of linezolid was substantially lower than that of ampicillin and high-level gentamicin (HLG) 5.54% (95% CI 2.33 to 10%), 65.7% (95% CI 50.8 to 79.2%), and 61.1% (95% CI 47.4 to 73.9), respectively. Conclusion: The prevalence of VRE is alarmingly high in Egypt. It is imperative that antimicrobial stewardship activities and infection control programs are strictly adhered to and implemented to prevent further escalation of the problem.
Language	English
Publishing date	2023-04-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604779-8
ISSN	2090-262X ; 0013-2446
ISSN (online)	2090-262X
ISSN	0013-2446
DOI	10.1186/s42506-023-00133-9
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Article: Texture, microstructure, and antioxidant characteristics of bio-fermented milk fortified with buttermilk nano-powder

Elkashef, Hany / Mobdy, Ahmed Abdel / Hassan, Ashwaa

International dairy journal. 2022 Mar., v. 126

2022

Abstract: The impact of addition of buttermilk as a nano-powder on the microbiological, texture, microstructure, and antioxidant activity of fermented milk was investigated at day 1 and after 14 days of cold storage. Fermented milk treatments were manufactured ... ...

Abstract	The impact of addition of buttermilk as a nano-powder on the microbiological, texture, microstructure, and antioxidant activity of fermented milk was investigated at day 1 and after 14 days of cold storage. Fermented milk treatments were manufactured from bovine milk fortified with buttermilk powder or buttermilk nano-powder or without fortification. The addition of buttermilk nano-powder increased the viable count of probiotic Lactobacillus casei by 11.61%. Fortification with buttermilk nano-powder resulted in an increase in the viscosity and WHC of fermented milk in rate 60.47 and 44.48%, respectively. High firmness, cohesiveness, springiness, and antioxidant activity were observed in fermented milk fortified with buttermilk nano-powder. Sensorially, all treatments were acceptable. The supplementation of fermented milk with buttermilk nano-powder led to a more compact and dense gel structure accompanied by homogeneous systematic protein aggregate network. Buttermilk nano-powder may be a valuable prospect as a novel ingredient for the development of functional milk products.
Keywords	Lactobacillus casei ; antioxidant activity ; antioxidants ; buttermilk ; cohesion ; cold storage ; firmness ; gels ; ingredients ; microstructure ; milk ; probiotics ; texture ; viscosity
Language	English
Dates of publication	2022-03
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	1076400-8
ISSN	0958-6946
ISSN	0958-6946
DOI	10.1016/j.idairyj.2021.105248
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Article ; Online: EUS-guided ethanol ablation of metastatic functional insulinoma.

Altonbary, Ahmed / Hakim, Hazem / Elkashef, Wagdi

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy

2021 Volume 6, Issue 10, Page(s) 443–445

Abstract: Video 1EUS-guided ethanol ablation of metastatic functional insulinoma. ...

Abstract	Video 1EUS-guided ethanol ablation of metastatic functional insulinoma.
Language	English
Publishing date	2021-06-24
Publishing country	United States
Document type	Journal Article
ISSN	2468-4481
ISSN (online)	2468-4481
DOI	10.1016/j.vgie.2021.05.013
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Article ; Online: Prognostic value of S100A4 and Glypican-3 in hepatocellular carcinoma in cirrhotic HCV patients.

El-Bendary, Mahmoud / Farid, Khaled / Arafa, Mohammad / Elkashef, Wagdi / Abdullah, Talaat / El-Mesery, Ahmed

Journal of the Egyptian National Cancer Institute

2023 Volume 35, Issue 1, Page(s) 26

Abstract: Aims: Both S100A4 and Glypican-3 have been known to be engaged in HCC development and progression. This study aimed to evaluate both S100A4 and GPC3 expression in HCC tissues as a prognostic markers.: Methods: Tissues from 70 patients of HCC in ... ...

Abstract	Aims: Both S100A4 and Glypican-3 have been known to be engaged in HCC development and progression. This study aimed to evaluate both S100A4 and GPC3 expression in HCC tissues as a prognostic markers. Methods: Tissues from 70 patients of HCC in cirrhotic HCV patients were evaluated by immunohistochemistry using antibodies against SA100A4 and GPC3 and compared with tumor-adjacent tissue (controls). All cases were followed for 40 months. Results: GPC3 was more expressed in HCC (79%) than S100A4 (21%). S100A4 was more significantly expressed in cases showing metastasis, microscopic vascular emboli, necrosis, and grade III tumors. There was no relationship between overall survival and both S100A4 and GPC3. The only significant independent predictor for recurrence was decompensation (OR 3.037), while metastasis was significantly predicted by S100A4 expression (OR 9.63) and necrosis (OR 8.33). Conclusion: S100A4 might be used as a prognostic marker for HCC, while GPC3 is a reliable marker of HCC diagnosis.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/diagnosis ; Prognosis ; Glypicans ; Liver Neoplasms/diagnosis ; Necrosis ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Hepatitis C/complications ; S100 Calcium-Binding Protein A4/genetics
Chemical Substances	Glypicans ; S100A4 protein, human (142662-27-9) ; S100 Calcium-Binding Protein A4 ; GPC3 protein, human
Language	English
Publishing date	2023-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1176790-x
ISSN	2589-0409 ; 1110-0362
ISSN (online)	2589-0409
ISSN	1110-0362
DOI	10.1186/s43046-023-00184-1
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Article ; Online: Prevalence of Vancomycin-resistant enterococci (VRE) in Egypt (2010–2022)

Ahmed Azzam / Hoda Elkafas / Heba Khaled / Ahmed Ashraf / Mohammed Yousef / Aya Awny Elkashef

Journal of the Egyptian Public Health Association, Vol 98, Iss 1, Pp 1-

a systematic review and meta-analysis

2023 Volume 13

Abstract: Abstract Background Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE ... ...

Abstract	Abstract Background Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and antimicrobial resistance profiles among enterococci clinical isolates in Egypt. Methods A PubMed, Scopus, Google Scholar, and Web of Science literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only published studies documenting the prevalence of VRE between 2010 and 2022 were included. Using the random effects model and the 95% confidence intervals, the pooled estimate of VRE was calculated by MedCalc Version 20.113. Cochran’s Q and I 2 tests were used to evaluate the degree of heterogeneity, and publication bias was examined by visually examining the funnel plot and its associated tests (Begg’s and Egger’s tests). Results The pooled prevalence of VRE among enterococci clinical isolates in Egypt was estimated to be 26% (95% CI 16.9 to 36.3). E. faecalis had a greater pooled prevalence than E. faecium, with 61.22% (95% CI 53.65 to 68.53) and 32.47% (95% CI 27 to 38.2), respectively. The VanA gene is more frequent than the VanB gene among VRE, with a pooled prevalence of 63.3% (95% CI 52.1 to 73.7) and 17.95% (95% CI 7.8 to 31), respectively. The pooled resistance rate of linezolid was substantially lower than that of ampicillin and high-level gentamicin (HLG) 5.54% (95% CI 2.33 to 10%), 65.7% (95% CI 50.8 to 79.2%), and 61.1% (95% CI 47.4 to 73.9), respectively. Conclusion The prevalence of VRE is alarmingly high in Egypt. It is imperative that antimicrobial stewardship activities and infection control programs are strictly adhered to and implemented to prevent further escalation of the problem.
Keywords	Vancomycin-resistant Enterococci ; Linezolid ; VanA ; VanB ; Egypt ; Systematic review ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	SpringerOpen
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ameliorative effect of desloratadine against cisplatin-induced renal and testicular toxicity in rats: Attention to TLR4/NLRP3 inflammasome signaling pathway.

Shaaban, Ahmed A / Zaghloul, Randa A / Kafl, Hoda E / El-Kashef, Dalia H

Life sciences

2023 Volume 316, Page(s) 121441

Abstract: Cisplatin (CIS) is a potent anticancer drug that is used in the treatment of different types of cancer. Owing to its serious side effects, its clinical use is considerably limited.: Aims: This study was mapped to investigate the potential effects of ... ...

Abstract	Cisplatin (CIS) is a potent anticancer drug that is used in the treatment of different types of cancer. Owing to its serious side effects, its clinical use is considerably limited. Aims: This study was mapped to investigate the potential effects of desloratadine (DES) against CIS-induced nephrotoxicity and testicular injury. Main methods: DES (5 and 10 mg/kg) was orally administered for 10 days, and CIS was injected once (10 mg/kg, i.p.) in adult male rats on day 9 to induce both renal and testicular toxicity. Key findings: DES significantly attenuated CIS-induced alterations in histopathology and biomarkers. DES resulted in a significant reduction in serum levels of creatinine (Cr), urea, and blood urea nitrogen (BUN), in addition to a marked decrease in urinary levels of albumin and total protein. Additionally, DES efficiently reinstated the oxidative balance by preventing the elevation of malondialdehyde (MDA) and enhancing superoxide dismutase (SOD) activity, and increasing glutathione (GSH) levels. Moreover, DES produced a profound decrease in renal and testicular levels of nucleotide-binding domain-(NOD) like receptor 3 (NLRP3), interleukin (IL)-1β, and caspase-1 when compared to the CIS group. Furthermore, DES significantly decreased CIS-induced elevation in toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-α), and nuclear factor-kappa B (NF-κB) levels in both renal and testicular tissues. Significance: DES can be used as adjuvant therapy with CIS in cancerous cases, pending further clinical studies.
MeSH term(s)	Rats ; Male ; Animals ; Inflammasomes/metabolism ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Cisplatin/toxicity ; Toll-Like Receptor 4/metabolism ; Oxidative Stress ; Signal Transduction ; NF-kappa B/metabolism ; Glutathione/metabolism
Chemical Substances	Inflammasomes ; NLR Family, Pyrin Domain-Containing 3 Protein ; Cisplatin (Q20Q21Q62J) ; Toll-Like Receptor 4 ; desloratadine (FVF865388R) ; NF-kappa B ; Glutathione (GAN16C9B8O) ; Tlr4 protein, rat ; Nlrp3 protein, rat
Language	English
Publishing date	2023-01-26
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3378-9
ISSN	1879-0631 ; 0024-3205
ISSN (online)	1879-0631
ISSN	0024-3205
DOI	10.1016/j.lfs.2023.121441
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Article ; Online: Hepatoprotective effect of Baicalin against thioacetamide-induced cirrhosis in rats: Targeting NOX4/NF-κB/NLRP3 inflammasome signaling pathways.

Zaghloul, Randa A / Zaghloul, Ahmed M / El-Kashef, Dalia H

Life sciences

2022 Volume 295, Page(s) 120410

Abstract: Aim: Liver cirrhosis is the result of a vicious cycle of both chronic oxidative stress and inflammation. NADPH oxidase-4 (NOX4) and its companion, NOD-like receptor protein 3 (NLRP3) inflammasome, are emerging as therapeutic targets of liver fibrosis.!## ...

Abstract	Aim: Liver cirrhosis is the result of a vicious cycle of both chronic oxidative stress and inflammation. NADPH oxidase-4 (NOX4) and its companion, NOD-like receptor protein 3 (NLRP3) inflammasome, are emerging as therapeutic targets of liver fibrosis. Main methods: Baicalin (BA), a natural flavone, has been investigated for its therapeutic potential against cirrhosis induced by thioacetamide (TAA) (200 mg/kg, twice/week) for 12 weeks in Sprague-Dawley rats. Two doses of BA were administered (25 and 75 mg/kg/day, orally, a week after TAA was stopped and continued for 4 weeks). Key findings: BA was able to reduce fibrosis visualized by Masson trichrome and immunohistochemical staining of the hepatic α-smooth muscle actin (α-SMA) and transforming growth factor-β1. Moreover, BA was able to ameliorate inflammation by reducing hepatic NLRP3 inflammasome subunits, NLRP3 and caspase-1, both parts of the complex responsible for the activation of different interleukins (IL), measured as IL-1β. In addition, BA was able to reduce hepatic nuclear factor kappa B (NF-κB)-driven inflammation through IL-6. BA targeted inflammation through its anti-oxidant ability evidenced by the enhancement of the hepatic superoxide dismutase (SOD) and reduced glutathione (GSH) activity and level, respectively, and the reduction of both hepatic malondialdehyde (MDA) and nitric oxide (NOx) contents. Treatment with BA significantly decreased TAA-induced elevation in hepatic NOX4, a key enzyme for reactive oxygen species (ROS) generation, as well as, inducible nitric oxide synthase (iNOS). Significance: therefore, the study could conclude, the anti-fibrotic effect of BA through TGF- β1/NOX4/NF-κB/NLRP3 pathway, exerting both anti-inflammatory and anti-oxidant effects.
MeSH term(s)	Animals ; Antioxidants/pharmacology ; Fibrosis/chemically induced ; Fibrosis/drug therapy ; Fibrosis/metabolism ; Flavonoids/metabolism ; Flavonoids/pharmacology ; Inflammasomes/metabolism ; Inflammation/pathology ; Liver/metabolism ; Liver Cirrhosis/chemically induced ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/metabolism ; Male ; NADPH Oxidase 4/metabolism ; NF-kappa B/metabolism ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Oxidative Stress/drug effects ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism ; Signal Transduction/drug effects ; Thioacetamide/adverse effects ; Thioacetamide/pharmacology
Chemical Substances	Antioxidants ; Flavonoids ; Inflammasomes ; NF-kappa B ; NLR Family, Pyrin Domain-Containing 3 Protein ; Nlrp3 protein, rat ; Reactive Oxygen Species ; Thioacetamide (075T165X8M) ; baicalin (347Q89U4M5) ; NADPH Oxidase 4 (EC 1.6.3.-) ; Nox4 protein, rat (EC 1.6.3.-)
Language	English
Publishing date	2022-02-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3378-9
ISSN	1879-0631 ; 0024-3205
ISSN (online)	1879-0631
ISSN	0024-3205
DOI	10.1016/j.lfs.2022.120410
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Article: Isolation, identification, and biochemical characterization of five

Hassan, Ashwak A-M / Sakr, Sally S / Ali, Asmahan A / Mohamed Ahmed, Isam A / Elkashef, Hany

Food science & nutrition

2022 Volume 11, Issue 2, Page(s) 1040–1050

Abstract: This study investigates the isolation and characterization of the main lactic acid bacteria responsible for fermentation of Oggtt, a dried fermented buttermilk. Five isolates with Gram-positive staining and negative catalase and oxidase activity were ... ...

Abstract	This study investigates the isolation and characterization of the main lactic acid bacteria responsible for fermentation of Oggtt, a dried fermented buttermilk. Five isolates with Gram-positive staining and negative catalase and oxidase activity were identified using phenotypic and genotypic methods, and their antagonistic, exopolysaccharides and organic acid production, proteolytic activity, and antioxidant capacity were assessed. The isolates are classified as
Language	English
Publishing date	2022-11-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703010-6
ISSN	2048-7177
ISSN	2048-7177
DOI	10.1002/fsn3.3140
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Article: Role of endoscopic ultrasound in pediatric patients: A single tertiary center experience and review of the literature.

Altonbary, Ahmed Youssef / Hakim, Hazem / Elkashef, Wagdi

World journal of gastrointestinal endoscopy

2020 Volume 12, Issue 10, Page(s) 355–364

Abstract: Background: Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is ... ...

Abstract	Background: Although endoscopic ultrasound (EUS) is now widely available and has an established role in adults, the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in pediatrics is insufficiently described compared to adults and is supported by only a few studies. Aim: To report the experience of a single tertiary center in the use of EUS and EUS-FNA in a pediatric population and to further assess its safety, feasibility, and clinical impact on management. Methods: A retrospective study of 13 children (aged 18 years or younger) identified from our medical database was conducted. A retrospective review of demographic data, procedure indications, EUS findings, and the clinical impact of EUS on the subsequent management of these patients was performed. Results: During the 4-year study period, a total of 13 (1.7%) pediatric EUS examinations out of 749 EUS procedures were performed in our unit. The mean age of these 8 females and 5 males was 15.6 years (range: 6-18). Six of the 13 EUS examinations were pancreatobiliary (46.1%), followed by mediastinal 2/13 (15.4%), peri-gastric 2/13 (15.4%), abdominal lymphadenopathy 1/13 (7.7%), tracheal 1/13 (7.7%) and rectal 1/13 (7.7%). Overall, EUS-FNA was performed in 7 patients (53.8%) with a diagnostic yield of 100%. The EUS results had a significant impact on clinical care in 10/13 (77%) cases. No complications occurred in these patients during or after any of the procedures. Conclusion: EUS and EUS-FNA in the pediatric population are safe, feasible, and have a significant clinical impact on the subsequent management; thus avoiding invasive and unnecessary procedures.
Language	English
Publishing date	2020-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573698-X
ISSN	1948-5190
ISSN	1948-5190
DOI	10.4253/wjge.v12.i10.355
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Ameliorative effect of desloratadine against cisplatin-induced renal and testicular toxicity in rats: Attention to TLR4/NLRP3 inflammasome signaling pathway

Shaaban, Ahmed A. / Zaghloul, Randa A. / Kafl, Hoda E. / El-Kashef, Dalia H.

Life Sciences. 2023 Mar., v. 316 p.121441-

2023

Abstract: Cisplatin (CIS) is a potent anticancer drug that is used in the treatment of different types of cancer. Owing to its serious side effects, its clinical use is considerably limited. Aims: This study was mapped to investigate the potential effects of ... ...

Abstract	Cisplatin (CIS) is a potent anticancer drug that is used in the treatment of different types of cancer. Owing to its serious side effects, its clinical use is considerably limited. Aims: This study was mapped to investigate the potential effects of desloratadine (DES) against CIS-induced nephrotoxicity and testicular injury. Main methods: DES (5 and 10 mg/kg) was orally administered for 10 days, and CIS was injected once (10 mg/kg, i.p.) in adult male rats on day 9 to induce both renal and testicular toxicity. Key findings: DES significantly attenuated CIS-induced alterations in histopathology and biomarkers. DES resulted in a significant reduction in serum levels of creatinine (Cr), urea, and blood urea nitrogen (BUN), in addition to a marked decrease in urinary levels of albumin and total protein. Additionally, DES efficiently reinstated the oxidative balance by preventing the elevation of malondialdehyde (MDA) and enhancing superoxide dismutase (SOD) activity, and increasing glutathione (GSH) levels. Moreover, DES produced a profound decrease in renal and testicular levels of nucleotide-binding domain-(NOD) like receptor 3 (NLRP3), interleukin (IL)-1β, and caspase-1 when compared to the CIS group. Furthermore, DES significantly decreased CIS-induced elevation in toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-α), and nuclear factor-kappa B (NF-κB) levels in both renal and testicular tissues. Significance: DES can be used as adjuvant therapy with CIS in cancerous cases, pending further clinical studies.
Keywords	Toll-like receptor 4 ; adjuvants ; adults ; albumins ; biomarkers ; blood serum ; caspase-1 ; cisplatin ; creatinine ; glutathione ; histopathology ; inflammasomes ; interleukins ; males ; malondialdehyde ; nephrotoxicity ; protein content ; superoxide dismutase ; testes ; therapeutics ; transcription factor NF-kappa B ; tumor necrosis factor-alpha ; urea ; urea nitrogen ; Desloratadine ; Kidney ; NLRP3 inflammasome ; TLR4
Language	English
Dates of publication	2023-03
Publishing place	Elsevier Inc.
Document type	Article ; Online
ZDB-ID	3378-9
ISSN	1879-0631 ; 0024-3205
ISSN (online)	1879-0631
ISSN	0024-3205
DOI	10.1016/j.lfs.2023.121441
Database	NAL-Catalogue (AGRICOLA)

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