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Article: Forgettable in the care of liver cirrhosis: the unseen culprits of progression from bad to worse.

Elsabaawy, Maha / Alhaddad, Omkosoum

2024 Volume 19, Issue 1, Page(s) 6–17

Abstract: Patients with liver cirrhosis constitute a critically ill and unique population, and their stability relies on a well-coordinated multidisciplinary team with a carefully structured plan. Overlooking any aspect of this plan can expedite disease ... ...

Abstract	Patients with liver cirrhosis constitute a critically ill and unique population, and their stability relies on a well-coordinated multidisciplinary team with a carefully structured plan. Overlooking any aspect of this plan can expedite disease progression, leading to severe complications. The lack of disease-specific nutritional guidance, the prevalent sedentary lifestyle among patients, and insufficient screening for hepatocellular carcinoma, oesophageal varices, sarcopaenia, minimal hepatic encephalopathy, and diabetes mellitus, along with fibrosis progression and cirrhosis decompensation, can add further complexities. Additionally, devaluing the impact of obesity in triggering liver cirrhosis can be disadvantageous. Prolonged and inappropriate use of proton pump inhibitors also poses a significant challenge with a wide range of complications. These often-unheeded aspects in the care of liver cirrhosis patients represents the unseen culprits of progression from bad to worse and warrant serious consideration.
Language	English
Publishing date	2024-03-14
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	2596134-2
ISSN	1897-4317 ; 1895-5770
ISSN (online)	1897-4317
ISSN	1895-5770
DOI	10.5114/pg.2024.136361
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Article ; Online: Appraisal of a newly developed ALBI-sarcopenia score as a prognostic marker in patients with hepatocellular carcinoma.

Elsabaawy, Maha / Badran, Hanaa / Ragab, Amr / Abdelwahab, Rasha / Sayed, Eman / Afify, Sameh / Othman, Warda

European journal of gastroenterology & hepatology

2024

Abstract: Objective: This study aimed to evaluate the impact of the combined Albumin-bilirubin (ALBI)/sarcopenia score as a newly developed prognostic model for hepatocellular carcinoma (HCC), with a focus on its utility in predicting mortality.: Methods: This ...

Abstract	Objective: This study aimed to evaluate the impact of the combined Albumin-bilirubin (ALBI)/sarcopenia score as a newly developed prognostic model for hepatocellular carcinoma (HCC), with a focus on its utility in predicting mortality. Methods: This prospective study was conducted on HCC patients who were followed for 1 year or until death. Sarcopenia was assessed radiologically by computed tomography at the level of L3. The study consisted of two sets: a development set in which the new ALBI-sarcopenia score was created, comprising 262 HCC patients, followed by an internal validation set with 100 patients. Results: The development cohort primarily included males (69.5%), aged 59.6 ± 8.09 years. In patients with sarcopenia, the ALBI score was -2.03 ± 0.42 (P < 0.006), the model for end-stage liver disease (MELD) score was 11.29 ± 2.43 (P < 0.001), and the MELD-sarcopenia score was 21.29 ± 2.43 (P < 0.001). The distribution of barcelona clinic liver cancer (BCLC) staging was as follows: BCLC A 18 (15.9%), BCLC B 63 (55.8%) and BCLC C 32 (28.3%) (P < 0.001), with a notable association with higher mortality (P < 0.001). Multivariate analysis identified sarcopenia and ALBI scores as independent predictors of mortality in HCC (P < 0.001). In the development set, the ALBI-sarcopenia score successfully predicted mortality at a cutoff >-11 with an area under a curve of 0.837 (95% CI, 0.784-0.889), while in the validation set, it predicted mortality at a cutoff >-11.55 with an area under a curve of 0.842 (95% CI, 0.753-0.930). Conclusion: The newly introduced ALBI-sarcopenia score has demonstrated superior effectiveness in comparison to MELD-sarcopenia score, overcoming the shortcomings associated MELD score in forecasting outcomes for patients with HCC.
Language	English
Publishing date	2024-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000002776
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Zs.A 2932: Show issues

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Article ; Online: Comparison of transient elastography and shear wave elastography in patients with MAFLD: A single-center experience.

Kohla, Mohamed Ahmed Samy / Fayoumi, Ahmed El / Sameea, Eman Abdel / Elsabaawy, Maha / Aly, Rasha Abdelhafiz / Waheed, Sally / Gerges, Mina / Mahrous, Medhat Assem

Romanian journal of internal medicine = Revue roumaine de medecine interne

2024

Abstract: Background: Metabolic-associated fatty liver disease and liver fibrosis are intimately linked to insulin resistance, type 2 diabetes, obesity, and metabolic syndrome. Transient elastography (TE) and point shear wave elastography (pSWE) were used to ... ...

Abstract	Background: Metabolic-associated fatty liver disease and liver fibrosis are intimately linked to insulin resistance, type 2 diabetes, obesity, and metabolic syndrome. Transient elastography (TE) and point shear wave elastography (pSWE) were used to measure liver stiffness in patients who met the ultrasound criteria for steatotic liver diseases (SLD). This study compared two methods for estimating liver stiffness in patients with SLD, which in turn correlated with liver fibrosis. Method: Ultrasound B-mode imaging was used to identify SLD. In total, 250 MAFLD patients were recruited. Patient characteristics, laboratory investigations, and liver stiffness measurements using TE and pSWE were assessed on the same day. Results: In the study, 56.0% of the patients were male, with a mean age of 41.5 ± 10.7 years. The correlation between TE and pSWE was significant (Spearman's r = 0.867, p < .001). The Bland-Altman Plot analysis confirmed this, with 97.5% of variations in LSM falling within 95% agreement ranges. Cohen's κ was used to assess the agreement between TE and pSWE fibrosis stages, showing almost perfect agreement (83.5% kappa agreement) and a strong association between pSWE and TE in the assessment fibrosis stages. Conclusion:* In patients with MAFLD, TE, and SWE are reliable methods for measuring liver stiffness and can be used as non-invasive screening tools for the assessment of fibrosis in SLD.
Language	English
Publishing date	2024-04-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2015966-3
ISSN	2501-062X ; 0035-3973 ; 1582-3296
ISSN (online)	2501-062X
ISSN	0035-3973 ; 1582-3296
DOI	10.2478/rjim-2024-0019
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Zs.A 738: Show issues

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Article: CD62P (P-selectin) expression as a platelet activation marker in patients with liver cirrhosis with and without cholestasis.

Hegazy, Sara / Elsabaawy, Maha / Eltabakh, Mohamed / Hammad, Reham / Bedair, Hanan

Clinical and experimental hepatology

2021 Volume 7, Issue 2, Page(s) 231–240

Abstract: Aim of the study: P-selectin (CD62P) is a platelet activation marker that was claimed to mediate the accumulation of platelets induced by cholestasis. The nature of platelet dysfunction and hemostasis abnormalities in cholestatic liver disease needs to ... ...

Abstract	Aim of the study: P-selectin (CD62P) is a platelet activation marker that was claimed to mediate the accumulation of platelets induced by cholestasis. The nature of platelet dysfunction and hemostasis abnormalities in cholestatic liver disease needs to be more explored. The aim of this study was to assess platelet CD62P expression in cirrhotic patients with and without cholestasis, and to evaluate its relationship with a bleeding tendency. Material and methods: 150 patients were included in this case-control study. Participants were divided into 84 patients with liver cirrhosis (group I), 44 of whom had cholestasis (Group Ia) and 40 patients were without cholestasis (group Ib); 36 patients who were cholestatic without liver cirrhosis (group II); and 30 healthy subjects who formed the control group (group III). Platelet CD62P expression was assessed by a flow cytometer. Results: Platelets expressing CD62P were significantly increased in all patient groups compared to controls ( Conclusions: Up-regulation of platelet CD62P expression can serve as a GIT bleeding predictor in liver cirrhosis.
Language	English
Publishing date	2021-06-30
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2937940-4
ISSN	2449-8238 ; 2392-1099
ISSN (online)	2449-8238
ISSN	2392-1099
DOI	10.5114/ceh.2021.107566
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Article ; Online: A case report of COVID-19 evoked cholangitic liver abscess.

Alhaddad, Omkolsoum / Elsabaawy, Maha / Edrees, Ahmed / Elshimy, Essam / Elsabaawy, Dalia / Mansour, Tarek

Egyptian liver journal

2022 Volume 12, Issue 1, Page(s) 5

Abstract: Background: Lately, the humanity has been being threatened by the coronavirus disease (COVID-19). The virus-related destructive motives can damage not only the lungs but also the brain, blood vessels, kidneys, and the heart.: Case presentation: A ... ...

Abstract	Background: Lately, the humanity has been being threatened by the coronavirus disease (COVID-19). The virus-related destructive motives can damage not only the lungs but also the brain, blood vessels, kidneys, and the heart. Case presentation: A middle-aged female presented with jaundice post-COVID-19 pneumonia. The patient had past history of cholecystectomy 20 years ago. Both laboratory and imaging data revealed a picture of cholestasis with right lobe liver abscess. Despite drainage and culture-based antibiotics, no improvement ensued. Endoscopic retrograde cholangiopancreatography was done revealing mildly dilated common bile duct (CBD), multiple large stones, mildly dilated central biliary radicals, and an old overlooked stent inside the dilated CBD. Papillotomy and papilloplasty were undertaken followed by stones' extraction with insertion of 2 plastic stents (10 cm× 10 f), and a flow of thick dark bile was inspected. The patient was finally improved and safely discharged. Conclusion: Herein, we present the first case of long-retained quiescent biliary stent which was over-headed by a cholangitic abscess in the vicinity of COVID pneumonia.
Language	English
Publishing date	2022-01-11
Publishing country	Egypt
Document type	Case Reports
ISSN	2090-6226
ISSN (online)	2090-6226
DOI	10.1186/s43066-021-00169-6
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Article ; Online: Portal vein thrombosis in hepatitis C virus-related cirrhotic patients: Prevalence and clinical characteristics in an Egyptian cohort.

Alhaddad, Omkolsoum / Elsabaawy, Maha / Elshaaraawy, Omar / Elhalawany, Mohamed / Houseni, Mohamed Mohamed / Abdelsameea, Eman

Tropical doctor

2021 Volume 51, Issue 3, Page(s) 314–318

Abstract: Portal vein thrombosis is a catastrophe not uncommonly complicating hepatitis C virus-related liver cirrhosis. To estimate its prevalence and clinical characteristics, we investigated 1000 cirrhotic patients by abdominal ultrasound or Doppler study at ... ...

Abstract	Portal vein thrombosis is a catastrophe not uncommonly complicating hepatitis C virus-related liver cirrhosis. To estimate its prevalence and clinical characteristics, we investigated 1000 cirrhotic patients by abdominal ultrasound or Doppler study at least. Portal vein thrombosis was found in 21.6%, of whom 157 (72.7%) had malignancy. Complete portal vein thrombosis was found in 70.4%. Half of all these patients had at least one episode of portal hypertensive bleeding, a third had abdominal pain and a quarter presented with jaundice. Portal bilopathy was diagnosed in two cases (0.9%). There was significant association between severity of liver disease, ascites, male gender and site of segmental focal lesion and portal vein thrombosis.
MeSH term(s)	Cross-Sectional Studies ; Egypt/epidemiology ; Hepacivirus/isolation & purification ; Humans ; Liver/physiopathology ; Liver Cirrhosis/complications ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/pathology ; Male ; Portal Vein/diagnostic imaging ; Portal Vein/pathology ; Prevalence ; Venous Thrombosis/diagnosis ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/epidemiology ; Venous Thrombosis/etiology
Language	English
Publishing date	2021-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	193169-6
ISSN	1758-1133 ; 0049-4755
ISSN (online)	1758-1133
ISSN	0049-4755
DOI	10.1177/0049475521998509
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Zs.A 1056: Show issues

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Article: Impact of intermittent fasting on laboratory, radiological, and anthropometric parameters in NAFLD patients.

Badran, Hanaa / Elsabaawy, Maha / Sakr, Ahmed / Eltahawy, Mahmoud / Elsayed, Mahitab / Elsabaawy, Dalia M / Abdelkreem, Mervat

Clinical and experimental hepatology

2022 Volume 8, Issue 2, Page(s) 118–124

Abstract: Aim of the study: Despite the ample flow of non-alcoholic fatty liver disease (NAFLD) drugs in the pipeline, lifestyle modifications are still the optimal solution of NAFLD. The aim of the study was to assess short term effects of Ramadan fasting (RF) ... ...

Abstract	Aim of the study: Despite the ample flow of non-alcoholic fatty liver disease (NAFLD) drugs in the pipeline, lifestyle modifications are still the optimal solution of NAFLD. The aim of the study was to assess short term effects of Ramadan fasting (RF) as a sort of intermittent fasting (IF) on biochemical, radiological, and anthropometric parameters of NAFLD patients. Material and methods: Ninety-eight NAFLD patients were recruited and voluntarily subjected to 16 hours daily fasting for an average of 22-29 days, without special dietary recommendations. Anthropometric, laboratory and radiological parameters were measured before, at 30 days, and one month after fasting (fasting and non-fasting phases). Results: Patients were mostly rural (76%), hypertensive (34.7%), diabetic (43.9%), and female (76.8%), with overt criteria of metabolic syndrome (67.3%). Liver transaminases (ALT and AST) were ameliorated significantly after fasting ( Conclusions: Intermittent fasting led to momentous improvements in ultrasonographic, biochemical, and anthropometric parameters of NAFLD especially in early phases and prediabetics.
Language	English
Publishing date	2022-05-30
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2937940-4
ISSN	2449-8238 ; 2392-1099
ISSN (online)	2449-8238
ISSN	2392-1099
DOI	10.5114/ceh.2022.115056
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Article ; Online: Role of liver biopsy in management of liver diseases without hepatic nodules following end of the interferon era: experience of a tertiary referral center.

Ehsan, Nermine A / Elsabaawy, Maha M / Sweed, Dina M / Karman, Esraa A / Abdelsameea, Eman / Mohamed, Anwar A

Clinical and experimental medicine

2022 Volume 23, Issue 1, Page(s) 97–105

Abstract: Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, a lot of queries had emerged about its role following the end of the interferon era. The aim of this study was to re-evaluate the current role of LB in the ... ...

Abstract	Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, a lot of queries had emerged about its role following the end of the interferon era. The aim of this study was to re-evaluate the current role of LB in the diagnosis of liver diseases. All patients who had underwent LB at the Department of Hepatology, National Liver Institute, from January 2015 through December 2018 were recruited. Indications for LB, pathology reports and medical records of all cases were retrieved, reviewed and statistically analyzed. A total of 275 liver biopsies were collected, 191 males and 84 females with mean age 41.22 ± 13.36 years. Etiological diagnosis made by histopathological evaluation was 48 drug-induced liver injury (DILI), 42 nonalcoholic fatty liver disease (NAFLD), 34 chronic hepatitis B, or C with cholestasis, 29 autoimmune hepatitis, 34 primary sclerosing cholangitis, 13 primary biliary cholangitis, 7 autoimmune overlap syndrome, 13 active bilharziasis and 10 Wilson's disease. Minor number of cases was diagnosed by different other etiologies. Initial diagnosis was made by liver biopsy and confirmed by clinical response and laboratory findings. Liver biopsy is still considered as the gold standard diagnostic measure of different liver diseases representing an integral component of management decisions in hepatology.
MeSH term(s)	Male ; Female ; Humans ; Adult ; Middle Aged ; Tertiary Care Centers ; Interferons ; Liver Diseases/diagnosis ; Liver/pathology ; Non-alcoholic Fatty Liver Disease/pathology ; Biopsy
Chemical Substances	Interferons (9008-11-1)
Language	English
Publishing date	2022-03-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2053018-3
ISSN	1591-9528 ; 1591-8890
ISSN (online)	1591-9528
ISSN	1591-8890
DOI	10.1007/s10238-022-00797-1
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Zs.A 5481: Show issues

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Article ; Online: Evaluation of ABCA1 gene polymorphism as a prognostic index of fibrosis progression in NAFLD patients.

Ghanem, Samar E / Elsabaawy, Maha M / Abdelkareem, Mervat M / Helal, Marwa L / Othman, Warda / Elsayed, Mahitab / Elsabaawy, Dalia M / El Fert, Ashraf

Endocrinology, diabetes & metabolism

2022 Volume 6, Issue 1, Page(s) e394

Abstract: Introduction: It had been evident that non-alcoholic fatty liver disease (NAFLD) is the new era epidemic. Despite emergence of many drugs on the pipeline that considered candidates to cure NAFLD/NASH, the critical need for defining the cohort liable to ... ...

Abstract	Introduction: It had been evident that non-alcoholic fatty liver disease (NAFLD) is the new era epidemic. Despite emergence of many drugs on the pipeline that considered candidates to cure NAFLD/NASH, the critical need for defining the cohort liable to fibrosis progression is yet unmet. Aim: Evaluate ABCA1 (rs1800977) genotyping as a noninvasive predictor of liver fibrosis severity. Materials and methods: This study included 118 liver biopsy-proven NAFLD-patients. According to Metavir-fibrosis-staging, cases were divided to early fibrosis (74 cases), and 44 cases with significant fibrosis (>F2), added to 49 healthy control subjects. All patients were subjected to liver function tests, lipids profile, triglyceride TG index, and hepatic steatosis index (HSI) and real-time PCR ABCA1 SNP (rs1800977). Results: Significant differences in transaminases (p > .05), albumin (p < .009), cholesterol (p0.03), low density lipoproteins (LDL) (0.006), triglycerides (p < .001), HSI (p < .001), FIB4 (p < .001) and APRI (p < .001) were reported in those with significant than early fibrosis and control groups. CC was the most prevalent in significant (36.4%) than early fibrosis (13.5%) and control groups (8.2%), with prevalence of C allele in significant fibrosis (p ≤ .003). Univariate analysis revealed that DM (p ≤ .001), TG index (p ≤ .022), cholesterol (p ≤ .03), HSI (p ≤ .006), LDL (p ≤ .02), HDL (p ≤ .01), APRI (p ≤ .02) and CC genotype (p ≤ .005) were the main factors affecting fibrosis progression in NAFLD. However multivariate analysis proved only the role of HSI (p ≤ .005), LDL (p ≤ .02), HDL (p ≤ .003) and CC genotype (p ≤ .03) in predicting fibrosis severity. Conclusion: Dyslipidemias, hepatic steatosis index and ABCA1 (rs1800977) gene polymorphism CC genotype; were the only independent predictors of advanced fibrosis in NAFLD-patients.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/genetics ; Prognosis ; Liver Cirrhosis/genetics ; Liver Cirrhosis/epidemiology ; Polymorphism, Genetic ; Cholesterol ; Triglycerides ; ATP Binding Cassette Transporter 1/genetics
Chemical Substances	Cholesterol (97C5T2UQ7J) ; Triglycerides ; ABCA1 protein, human ; ATP Binding Cassette Transporter 1
Language	English
Publishing date	2022-11-29
Publishing country	England
Document type	Journal Article
ISSN	2398-9238
ISSN (online)	2398-9238
DOI	10.1002/edm2.394
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Article: FIB-5 versus FIB-4 index for assessment of hepatic fibrosis in chronic hepatitis B affected patients.

Metwally, Khaled / Elsabaawy, Maha / Abdel-Samiee, Mohamed / Morad, Wessam / Ehsan, Nermine / Abdelsameea, Eman

Clinical and experimental hepatology

2020 Volume 6, Issue 4, Page(s) 335–338

Abstract: Aim of the study: Chronic hepatitis B virus (HBV) infection is one of the major health problems worldwide. Use of non-invasive tests for assessment of hepatic fibrosis such as the FIB-4 index could be used to avoid liver biopsy. Another promising ... ...

Abstract	Aim of the study: Chronic hepatitis B virus (HBV) infection is one of the major health problems worldwide. Use of non-invasive tests for assessment of hepatic fibrosis such as the FIB-4 index could be used to avoid liver biopsy. Another promising noninvasive test, FIB-5, could also be used to detect significant hepatic fibrosis. The aim of the study was to compare the use of FIB-5 and FIB-4 as noninvasive markers to assess chronic HBV-related hepatic fibrosis. Material and methods: This study was done on 176 chronic HBV patients who underwent liver biopsy. Grading and staging of liver fibrosis was done according to the METAVIR scoring system. FIB-5 and FIB-4 scores were calculated for all patients. Results: As regards FIB-4 for differentiation between non-significant fibrosis (group I) and significant fibrosis (group II), at a cutoff level of 1.28 with positive predictive value (PPV) 41.4% and specificity 48% while at a cutoff level of 7.08 with PPV 98.8% and specificity 98% for FIB-5. Conclusions: As regards both scores, the FIB-5 score was more specific than FIB-4 for diagnosing significant from nonsignificant hepatic fibrosis in patients with chronic HBV infection.
Language	English
Publishing date	2020-12-30
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2937940-4
ISSN	2449-8238 ; 2392-1099
ISSN (online)	2449-8238
ISSN	2392-1099
DOI	10.5114/ceh.2020.102157
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