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Article: Comparative Evaluation of Sildenafil Citrate and Estrogen as an Adjuvant Therapy for Treatment of Unexplained Infertility in Women.

Altyar, Ahmed E / Boshra, Marian S / Abou Warda, Ahmed Essam / Shawkey, Sherwet M / Abdallah Mohamed Salem, Sara / Sarhan, Rania M / Sarhan, Neven

Journal of personalized medicine

2023 Volume 13, Issue 5

Abstract: Background: Uterine blood flow determines endometrial thickness. This study examined how vaginal sildenafil citrate and estradiol valerate altered endometrial thickness, blood flow, and fertility in infertile women.: Methods: This study observed 148 ... ...

Abstract	Background: Uterine blood flow determines endometrial thickness. This study examined how vaginal sildenafil citrate and estradiol valerate altered endometrial thickness, blood flow, and fertility in infertile women. Methods: This study observed 148 infertile women whose infertility was unexplained. Group 1 comprised 48 patients who received oral estradiol valerate (Cyclo-Progynova 2 mg/12 h white tablets) from day 6 till ovulation was initiated with clomiphene citrate. A number of 50 participants in group 2 received oral sildenafil (Respatio 20 mg/12 h film-coated tablets) for 5 days starting the day after their previous menstrual period and finishing on the day they ovulated with clomiphene citrate. Group 3 was the control group, with 50 patients receiving clomiphene citrate (Technovula 50 mg/12 h tablets) ovulation induction from the 2nd to 7th day of cycle. All patients had transvaginal ultrasounds to determine ovulation, follicle count, and fertility. Miscarriage, ectopic pregnancy, and multiple pregnancies were monitored for three months. Results: The three groups' mean ETs differed statistically at Conclusion: It is possible to claim that adding oral estrogen to clomiphene citrate therapy as an adjuvant therapy can improve endometrial thickness and, as a result, increase the pregnancy rates in unexplained infertility compared to sildenafil, especially in cases where the infertility has lasted less than two years. Most people who take sildenafil end up with a mild headache.
Language	English
Publishing date	2023-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13050842
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Article ; Online: Differential clinical diagnosis and prevalence rate of allergic rhinitis, asthma and chronic obstructive pulmonary disease among COVID-19 patients.

Sarhan, Rania M / Mohammad, Mohammad F / Boshra, Marian S

International journal of clinical practice

2021 Volume 75, Issue 10, Page(s) e14532

Abstract: Background: There is a great need to make a rapid differential clinical diagnosis of COVID-19 among respiratory disease patients and determining the prevalence rate of these diseases among the COVID-19 population.: Method: Approximately 522 patients ... ...

Abstract	Background: There is a great need to make a rapid differential clinical diagnosis of COVID-19 among respiratory disease patients and determining the prevalence rate of these diseases among the COVID-19 population. Method: Approximately 522 patients with allergic rhinitis, asthma, COPD, and COVID-19 were analysed for demographic and clinical features. Radiological features were analysed only for COVID-19 patients. Results: COPD and asthma were more common among COVID-19 patients than allergic rhinitis. All chest CT scans of COVID-19 patients showed bilateral ground-glass opacity. Fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips were significantly higher in all COVID-19 patients compared to COPD, asthma, and allergic rhinitis patients. Conclusion: The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID-19 patients, can be used for differential diagnosis between COVID-19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID-19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID-19 infection among other respiratory disease patients.
MeSH term(s)	Asthma/diagnosis ; Asthma/epidemiology ; COVID-19 ; Diagnosis, Differential ; Humans ; Prevalence ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Rhinitis, Allergic/diagnosis ; Rhinitis, Allergic/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2021-06-29
Publishing country	India
Document type	Journal Article
ZDB-ID	1386246-7
ISSN	1742-1241 ; 1368-5031
ISSN (online)	1742-1241
ISSN	1368-5031
DOI	10.1111/ijcp.14532
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Article: Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial.

Sarhan, Rania M / E Altyar, Ahmed / Essam Abou Warda, Ahmed / Saied, Yasmine Mohamed / Ibrahim, Haytham Soliman Ghareeb / Schaalan, Mona F / Fathy, Shaimaa / Sarhan, Neven / Boshra, Marian S

Pharmaceuticals (Basel, Switzerland)

2023 Volume 16, Issue 4

Abstract: COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many ... ...

Abstract	COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at
Language	English
Publishing date	2023-04-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph16040631
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Article ; Online: Evidence for the Efficacy of a High Dose of Vitamin D on the Hyperinflammation State in Moderate-to-Severe COVID-19 Patients: A Randomized Clinical Trial.

Sarhan, Neven / Abou Warda, Ahmed E / Sarhan, Rania M / Boshra, Marian S / Mostafa-Hedeab, Gomaa / ALruwaili, Bashayer F / Ibrahim, Haytham Soliman Ghareeb / Schaalan, Mona F / Fathy, Shaimaa

Medicina (Kaunas, Lithuania)

2022 Volume 58, Issue 10

Abstract: Background and Objectives: ...

Abstract	Background and Objectives:
MeSH term(s)	Adult ; Humans ; COVID-19/complications ; SARS-CoV-2 ; Cytokine Release Syndrome ; Vitamin D/therapeutic use ; Prospective Studies ; Cholecalciferol ; Oxygen ; Angiotensins
Chemical Substances	Vitamin D (1406-16-2) ; Cholecalciferol (1C6V77QF41) ; Oxygen (S88TT14065) ; Angiotensins
Language	English
Publishing date	2022-09-27
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina58101358
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Article ; Online: Hydroxychloroquine and Azithromycin Combination in the Management of COVID-19 Infection: Safety and Effectiveness Challenges.

Abou Warda, Ahmed E / Tammam, Mahmoud / El-Gazar, Rabab A / Sarhan, Rania M / Gaber, Sayed

Current drug safety

2021 Volume 17, Issue 2, Page(s) 143–151

Abstract: Background: The treatment of COVID-19 disease remains a dilemma so far because there is no approved therapy for it. This study aimed to evaluate the use of hydroxychloroquine and azithromycin combination in treatment.: Objectives: This study was ... ...

Abstract	Background: The treatment of COVID-19 disease remains a dilemma so far because there is no approved therapy for it. This study aimed to evaluate the use of hydroxychloroquine and azithromycin combination in treatment. Objectives: This study was carried out to determine the safety and effectiveness of hydroxychloroquine and azithromycin combination in COVID 19 patients. Methods: This study included 90 adult COVID 19 patients. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocols, receiving a combination of hydroxychloroquine 400mg twice on day 1, then 200 mg twice daily in addition to azithromycin 500mg/day for 5 days. ECG findings, especially the QTc interval, were assessed before and after 5 days from the administration. Results: All patients showed a statistically significant higher post-treatment QTc readings (433.6 ± 37.2) compared to baseline QTc (402.4 ± 31.3) at p<0.005 with a median QTc prolongation by 26 mSec and IQR (17.8-41.3), but without serious clinical complications. Only 5.6% of patients showed QTc more than 500 mSec and no torsade de points or cardiac arrest. Geriatric patients were at higher risk for QTc prolongation compared to patients aged less than 65 years but without a significant difference as regards the median max QTc difference p˂0.65. The expected therapeutic effectiveness was 82.5% for moderate patients compared to 26% for severe patients (P<0.005). Conclusion: In a modest safety profile, we support the evidence that HQ/AZ therapy can be used to treat Covid-19 infection with more effectiveness in moderate rather than severe cases, which might be a reflection of the time of administration in the disease course.
MeSH term(s)	Adult ; Aged ; Azithromycin/adverse effects ; COVID-19/drug therapy ; Electrocardiography ; Humans ; Hydroxychloroquine/adverse effects ; Long QT Syndrome/chemically induced ; Long QT Syndrome/epidemiology ; SARS-CoV-2
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH) ; Azithromycin (83905-01-5)
Language	English
Publishing date	2021-07-27
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2250840-5
ISSN	2212-3911 ; 1574-8863
ISSN (online)	2212-3911
ISSN	1574-8863
DOI	10.2174/1574886316666210727152609
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Article: A Battle against COVID-19: Vaccine Hesitancy and Awareness with a Comparative Study between Sinopharm and AstraZeneca.

Boshra, Marian S / Hussein, Raghda R S / Mohsen, Marwa / Elberry, Ahmed A / Altyar, Ahmed E / Tammam, Mahmoud / Sarhan, Rania M

Vaccines

2022 Volume 10, Issue 2

Abstract: Background: Awareness about the COVID-19 vaccine's adverse effects is crucial for gaining public trust. As we still lack proof of vaccines' safety, this survey aimed to investigate Egyptians' general awareness of the Sinopharm and AstraZeneca vaccines ... ...

Abstract	Background: Awareness about the COVID-19 vaccine's adverse effects is crucial for gaining public trust. As we still lack proof of vaccines' safety, this survey aimed to investigate Egyptians' general awareness of the Sinopharm and AstraZeneca vaccines against COVID-19 and provide considerable evidence on their side effects and complications. Methods: A cross-sectional questionnaire-based study was conducted in Egypt between 20 September and 10 October in 2021, with multiple-choice questions (MCQs) covering all data on vaccine administration confusion, adverse effects or intensity, and complications. Results: Among the 390 participants, 42.3% reported being hesitant before receiving one of the vaccines. About 40.3% of participants were previously infected before getting vaccinated while only 4.6% reported being infected after vaccination. The AstraZeneca vaccine demonstrated higher side effects and symptoms than the Sinopharm vaccine while the Sinopharm vaccine showed a significantly higher rate of COVID-19 infection after vaccination. Conclusions: People with higher educational levels and chronic respiratory diseases represent an excellent model for accepting COVID-19 vaccination. A booster shot is recommended for people vaccinated with the Sinopharm vaccine due to a significantly higher rate of COVID-19 infection after vaccination; however, the Sinopharm vaccine shows a more acceptable safety profile.
Language	English
Publishing date	2022-02-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10020292
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Article ; Online: Therapeutic efficacy, mechanical ventilation, length of hospital stay, and mortality rate in severe COVID-19 patients treated with tocilizumab.

Sarhan, Rania M / Madney, Yasmin M / Abou Warda, Ahmed E / Boshra, Marian S

International journal of clinical practice

2021 Volume 75, Issue 6, Page(s) e14079

Abstract: Background: The treatment of severe cases of COVID-19 disease remains a dilemma so far, because there is no approved therapy for it. This study aimed to estimate the therapeutic efficacy of tocilizumab and its role in reducing the need for mechanical ... ...

Abstract	Background: The treatment of severe cases of COVID-19 disease remains a dilemma so far, because there is no approved therapy for it. This study aimed to estimate the therapeutic efficacy of tocilizumab and its role in reducing the need for mechanical ventilation, length of hospital stay, mortality rate for these cases. Method: The study included 25 adult patients with confirmed severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol in addition to tocilizumab IV (400-800 mg) as a single dose and then the dose was repeated after at least 12 hours and up to 24 hours from the previous dose. All laboratory and clinical parameters were assessed before and within 24 hours after tocilizumab administration. Results: After receiving TCZ, all patients showed significantly lower median IL 6, LDH, CRP, ferritin , TLC at P < .001, and D-Dimer at P = .223 than their baseline levels. Also, the number of patients who required mechanical ventilation decreased from 11 to 8. Only five patients died after TCZ treatment. A moderate correlation was found between therapeutic failure and death outcomes and mechanical ventilation need at baseline. The median days of hospitalisation (IQR) were 10 (6-16). Conclusion: Tocilizumab treatment in patients with severe COVID-19 is safe and has significant therapeutic effects and a significant role in the improvement of all laboratory parameters. Also TCZ plays a significant role in the reduction of the length of stay in hospital and ICU, need for mechanical ventilation, and mortality rate.What's known IL-6 plays the main role in the acute respiratory distress syndrome (ARDS) associated with severe COVID-19 infection. Consequently, serum IL-6 can be considered as an important target in therapeutic management of severe COVID-19 patients. What's new Prospective study, carried on 25 adult patients with confirmed severe COVID-19 infection using tocilizumab, showed significant improvement in their case. Tocilizumab, as an IL-6 inhibitor, not only lowered IL-6 level put also showed a significant reduction on median LDH, CRP, ferritin , TLC at P < .001 and D-Dimer at P = .223 than their baseline levels. Improvement of all laboratory parameters using TCZ was reflected in the reduction of the length of stay in hospital and ICU, need for mechanical ventilation and mortality rate.
MeSH term(s)	Adult ; Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Egypt ; Humans ; Length of Stay ; Prospective Studies ; Respiration, Artificial ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Antibodies, Monoclonal, Humanized ; tocilizumab (I031V2H011)
Language	English
Publishing date	2021-03-17
Publishing country	India
Document type	Journal Article
ZDB-ID	1386246-7
ISSN	1742-1241 ; 1368-5031
ISSN (online)	1742-1241
ISSN	1368-5031
DOI	10.1111/ijcp.14079
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Article: Effect of Pirfenidone on Risk of Pulmonary Fibrosis in COVID-19 Patients Experiencing Cytokine Storm.

Boshra, Marian S / Abou Warda, Ahmed E / Sayed, Mahmoud Abdulbasser / Elkomy, Mohammed H / Alotaibi, Nasser H / Mohsen, Marwa / Sarhan, Rania M

Healthcare (Basel, Switzerland)

2022 Volume 10, Issue 12

Abstract: Objectives: Severe stages of COVID-19 infection have been associated with the excessive discharge of pro-inflammatory mediators such as cytokines, resulting in lung deterioration, which progresses rapidly to lung fibrosis leading to acute respiratory ... ...

Abstract	Objectives: Severe stages of COVID-19 infection have been associated with the excessive discharge of pro-inflammatory mediators such as cytokines, resulting in lung deterioration, which progresses rapidly to lung fibrosis leading to acute respiratory distress syndrome. In this investigation, the efficacy and safety of the novel antifibrotic and anti-inflammatory agent, Pirfenidone, were assessed in COVID-19 patients with pulmonary fibrosis secondary to cytokine storm. In this randomized controlled study, we assigned 100 adult COVID-19 patients cytokine storm and admitted to the intensive care isolation unit into either pirfenidone added to the standard therapy (n = 47), or the standard protocol only (n = 53). High-resolution computed tomography of the chest was performed in all patients to evaluate fibrotic lesions and their progression. The results showed that the percentage of patients who developed pulmonary fibrosis during cytokine storm onset in the pirfenidone group relative to the standard group was 29.8% and 35.8%, respectively, with no significant difference between the two groups; while there was a significant increase in the proportion of patients discharged from the isolation unit with pulmonary fibrosis without progression in fibrotic lesions in the pirfenidone group compared to the standard group (21.3% and 5.7%, respectively). Furthermore, there was a significant difference concerning liver enzyme elevation and GIT disturbance incidences in the studied groups (
Language	English
Publishing date	2022-11-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare10122387
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Article ; Online: Knowledge, Attitude, and Acceptance of Sinopharm and AstraZeneca's COVID-19 Vaccines among Egyptian Population: A Cross-Sectional Study.

Boshra, Marian S / Elgendy, Marwa O / Abdelaty, Lamiaa N / Tammam, Mahmoud / Alanazi, Abdullah S / Alzarea, Abdulaziz Ibrahim / Alsahali, Saud / Sarhan, Rania M

International journal of environmental research and public health

2022 Volume 19, Issue 24

Abstract: Background: This study aimed to evaluate the Egyptian population's preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines.: Methods: A cross-sectional web- ... ...

Abstract	Background: This study aimed to evaluate the Egyptian population's preference and awareness related to available COVID-19 vaccines and to determine different factors that can affect beliefs concerning these vaccines. Methods: A cross-sectional web-based study was carried out among the general population in Egypt. Data collection was conducted via an online questionnaire. Results: About 426 subjects participated in the survey. Vaccine preference is nearly equally even (50%) among all respondents. There was no significant difference in vaccine preference according to age, gender, residence, educational level, or social status. About 50% of public respondents mentioned that both AstraZeneca and Sinopharm vaccines do not offer protection against new variant COVID-19 strains. Healthcare workers are the lowest respondents to agree that vaccines offer protection against new COVID-19 variants (10.9%) compared to unemployed respondents (20.3%) and other professions (68.8%) with a statistically significant difference ( Conclusions: Most of the study population has satisfying knowledge about the COVID-19 vaccine. Continuous awareness campaigns must be carried out so that the people's background is updated with any new information that would help in raising the trust in vaccination.
MeSH term(s)	Child ; Humans ; COVID-19 Vaccines/therapeutic use ; Cross-Sectional Studies ; Egypt/epidemiology ; Health Knowledge, Attitudes, Practice ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Vaccination ; Vaccines
Chemical Substances	COVID-19 Vaccines ; Vaccines
Language	English
Publishing date	2022-12-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph192416803
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Article: Continuous Versus Intermittent Linezolid Infusion for Critically Ill Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: Efficacy and Safety Challenges.

Abou Warda, Ahmed E / Sarhan, Rania M / Al-Fishawy, Hussein Saeed / Moharram, Ayman N / Salem, Heba F

Pharmaceuticals (Basel, Switzerland)

2022 Volume 15, Issue 3

Abstract: High variability of linezolid blood concentrations with partial subtherapeutic levels was observed in critically ill patients who received a standard intravenous dose of linezolid, contributing to drug resistance and toxicity. Continuous infusions of ... ...

Abstract	High variability of linezolid blood concentrations with partial subtherapeutic levels was observed in critically ill patients who received a standard intravenous dose of linezolid, contributing to drug resistance and toxicity. Continuous infusions of linezolid have been suggested as an alternative and provide good serum and alveolar levels without fluctuations in trough concentration. This study aimed to assess the effectiveness and safety of continuous linezolid infusion versus the standard regimen in critically ill patients. A prospective randomized controlled study was conducted on 179 patients with nosocomial pneumonia. Patients were randomized into two groups. The first group received IV linezolid 600 mg twice daily, while the second group received 600 mg IV as a loading dose, followed by a continuous infusion of 1200 mg/day (50 mg/h) for at least 8−10 days. The continuous infusion group showed a higher clinical cure rate than the intermittent infusion group (p = 0.046). Furthermore, efficacy was proven by greater improvement of P/F ratio (p = 0.030) on day 7 of treatment, a lower incidence of developing sepsis after beginning treatment (p = 0.009), and a shorter time to reach clinical cure (p < 0.001). Hematological parameters were also assessed during the treatment to evaluate the safety between the two groups. The incidence of thrombocytopenia was significantly lower in the continuous infusion group than in the intermittent infusion group. In addition, a stepwise logistic regression model revealed that the intermittent infusion of linezolid was significantly associated with thrombocytopenia (OR =4.128; 95% CI = 1.681−10.139; p =0.001). The current study is the first to assess the clinical aspects of continuous infusion of linezolid beyond pharmacokinetic studies. Continuous infusion of linezolid outperforms intermittent delivery in safety and improves clinical effectiveness in critically ill patients with Gram-positive nosocomial pneumonia.
Language	English
Publishing date	2022-02-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph15030296
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