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Article ; Online: Diagnostic accuracy of hepatic vein arrival time performed with contrast-enhanced ultrasonography for HCV liver cirrhosis.

Makhlouf, Nahed A / Moustafa, Ehab F / Hassany, Sahar M

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology

2022 Volume 23, Issue 3, Page(s) 195–200

Abstract: Background and study aims: Contrast-enhanced ultrasonography (CEUS) has increased considerably the use of ultrasound for hemodynamical analyses and quantification. Bolus injection of microbubble agents is used to evaluate transit times. This study aimed ...

Abstract	Background and study aims: Contrast-enhanced ultrasonography (CEUS) has increased considerably the use of ultrasound for hemodynamical analyses and quantification. Bolus injection of microbubble agents is used to evaluate transit times. This study aimed to determine the diagnostic accuracy of arrival time (seconds) to the hepatic artery (HAAT), hepatic vein (HVAT), and portal vein (PVAT), based on CEUS used for the diagnosis of cirrhosis, and to correlate these arrival times with the liver stiffness and disease severity. Patients and methods: This study evaluated 29 HCV cirrhotic and 19 chronic hepatitis C patients. History, clinical examination, laboratory investigations, abdominal ultrasonography, point shear-wave elastography (pSWE), and CEUS were conducted. Results: The mean liver stiffness increased significantly in cirrhotic versus chronic HCV (22.7 versus 5.1; p-value < 0.001). The mean HAAT (p-value = 0.001), PVAT (p-value = 0.002), and HVAT values (p-value: 0.001) were significantly prolonged in cirrhotic compared with chronic HCV. The HVAT cut-off point of cirrhotic patients was 18 s with a sensitivity, specificity, and accuracy of 96.6%, 63.2%, and 83.3%, respectively (area under curve: 0.801). Significant positive correlation was found between liver stiffness (kPa) and HVAT (s) (r = 0.585; p-value = 0.005). No significant correlation was detected between HVAT (s) and the severity of liver disease, as assessed by the Child or MELD scores in cirrhotic patients. Conclusion: Measuring HVAT by CEUS yielded high-accuracy and correlation outcomes for cirrhosis detection. It could be a valuable noninvasive method for the diagnosis of cirrhosis.
MeSH term(s)	Child ; Contrast Media ; Hepatic Veins/diagnostic imaging ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/diagnostic imaging ; Humans ; Liver Cirrhosis/diagnostic imaging ; Ultrasonography/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2022-06-07
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2502114-X
ISSN	2090-2387 ; 1687-1979
ISSN (online)	2090-2387
ISSN	1687-1979
DOI	10.1016/j.ajg.2022.05.003
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Article ; Online: Retraction Note: Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: A Randomized, Multicenter Trial.

Abd-Elsalam, Sherief / Soliman, Shaimaa / Esmail, Eslam Saber / Khalaf, Mai / Mostafa, Ehab F / Medhat, Mohammed A / Ahmed, Ossama Ashraf / Ghafar, Mohamed Samir Abd El / Alboraie, Mohamed / Hassany, Sahar M

Biological trace element research

2024

Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Retraction of Publication
ZDB-ID	445336-0
ISSN	1559-0720 ; 0163-4984
ISSN (online)	1559-0720
ISSN	0163-4984
DOI	10.1007/s12011-024-04150-3
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Article ; Online: Hematological, Biochemical Properties, and Clinical Correlates of Hemoglobin S Variant Disorder: A New Insight Into Sickle Cell Trait.

Khaled, Safaa A A / Ahmed, Heba A / Elbadry, Mahmoud I / NasrEldin, Eman / Hassany, Sahar M / Ahmed, Shimaa A

Journal of hematology

2022 Volume 11, Issue 3, Page(s) 92–108

Abstract: Background: The sickle cell trait (SCT) disorder possesses a clinical heterogeneity ranging from a symptomless condition to sudden death. This study aimed to develop a diagnostic approach that helps the characterization and identification of SCT from ... ...

Abstract	Background: The sickle cell trait (SCT) disorder possesses a clinical heterogeneity ranging from a symptomless condition to sudden death. This study aimed to develop a diagnostic approach that helps the characterization and identification of SCT from normal subjects and sickle cell disease (SCD) patients, and to assess its severity. Methods: Sixty controls, 24 SCD patients and 31 SCT subjects were assessed clinically, radiologically and by laboratory investigations. Results: Of the SCT subjects, 12.8% were symptomatic (3.2% anemic, 6.4% hemolytic crisis, and 3.2% painful crises). Anemia was normocytic in 66.6%, and normochromic and polychromatic in 33.4%. Significantly lower red blood cells (RBCs), hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hematocrit (Hct), Shine and Lal index (SL), and hemoglobin A (Hb A), and higher mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), Ricerca index (RI), and Huber-Herklotz index (HH) were found in SCT subjects compared with the controls. Hb A and hemoglobin S (Hb S) were excellent in discriminating SCT from SCD (cut-off for SCT > 50% and < 40%) followed by Hct, MCHC, Hb, Green and King index (GK), and England and Fraser index (EF) (cut-off for SCT > 33%, > 32, > 11, < 71, and < 10, respectively). Radiologically normal findings were detected in 87% of SCT subjects; they had nearly normal liver and renal function tests (except one case each). A schematic diagnostic paradigm for SCT was proposed. Conclusion: This study allowed understanding of SCT in various aspects, i.e., clinical, hematological, biochemical and radiological. Thus, it could help prevention of the Hb S variant disorder and proper management of carriers. This might be applied in pre-marital screening, particularly in those with family history of Hb S disorder.
Language	English
Publishing date	2022-06-27
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2662519-2
ISSN	1927-1220 ; 1927-1220
ISSN (online)	1927-1220
ISSN	1927-1220
DOI	10.14740/jh977
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Article ; Online: Infection and Severity of COVID-19 Infection Among Healthcare Workers: A Report from Egypt.

Moustafa, Ehab F / Hassany, Sahar M / Soliman, Asmaa Mohamed Ahmed / Ezz-Eldin, Mohammed / Zaghloul, Nariman / Abd-Elsalam, Sherief

Infectious disorders drug targets

2022 Volume 22, Issue 7, Page(s) 39–48

Abstract: Backgrounds & Aim: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome caused by Coronavirus. Knowledge of the fate of infection and risk factors among health care workers is essential to enforce special infection control measures. ...

Abstract	Backgrounds & Aim: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome caused by Coronavirus. Knowledge of the fate of infection and risk factors among health care workers is essential to enforce special infection control measures. We aimed to determine the percentage of COVID-19 infection and the associated risk factors as well as the predictors of COVID- 19 among health care workers in Assiut University Hospital. Methods: A cross-sectional study was performed that included one hundred health care workers that were confirmed by PCR to be COVID-19 cases admitted to Assiut University Hospital over six months between May 2020 and November 2020. All participants were subjected to thorough history taking and full clinical examination as well as investigations. Results: Out of the 100 HCWs enrolled in the study, 52% were males, 26% were obese, 68% were doctors, and 38% were from the medical department. Fourteen percent of healthcare workers were admitted to ICU, of which 93% were cured. The predictors for severity of cases were as follows: being a doctor OR (6.804) P=0.037, old age OR (1.179) P=0.000, and hospital stay OR (0.838) P=0.015. Conclusion: Health care workers are at risk for severe COVID-19 infection. Being a doctor, old age, and duration of hospitalization were the predictors for the severity of cases of health care workers.
Language	English
Publishing date	2022-04-22
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2234298-9
ISSN	2212-3989 ; 1871-5265
ISSN (online)	2212-3989
ISSN	1871-5265
DOI	10.2174/1871526522666220422105740
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Article ; Online: Noninvasive assessment of liver fibrosis in children with chronic hepatitis C: Shear wave elastography and APRI versus liver biopsy.

Galal, Shereen M / Soror, Shaban M / Hussien, Omima / Moustafa, Ehab F / Hassany, Sahar M

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology

2020 Volume 21, Issue 4, Page(s) 253–259

Abstract: Background and study aims: Hepatitis C virus (HCV) is a major cause of chronic hepatitis. Although liver histopathological examination remains the reference standard for liver fibrosis assessment, noninvasive means of assessment such as shear wave ... ...

Abstract	Background and study aims: Hepatitis C virus (HCV) is a major cause of chronic hepatitis. Although liver histopathological examination remains the reference standard for liver fibrosis assessment, noninvasive means of assessment such as shear wave elastography (SWE) and aspartate aminotransferase-platelet ratio index (APRI) have been developed to reduce the need for biopsy. We evaluated the efficacy of SWE and APRI versus liver biopsy for liver fibrosis assessment in children with chronic HCV infection. Patients and methods: Fibrosis staging was performed in 46 children (35 boys, 11 girls; mean age: 15.52 ± 2.71 years) with liver biopsy-proven chronic HCV infection according to the METAVIR system. SWE was performed within 6 months of liver biopsy. APRI scores were calculated using data collected on the day of biopsy. Results: Eighteen children had no or mild fibrosis (<F2, 39.1%) and 28 had significant fibrosis (≥F2, 60.9%), with a significant difference between the corresponding mean APRI scores (0.43 ± 0.23 vs 1.26 ± 1.24; p = 0.043). The APRI scores exhibited a significant correlation with the METAVIR stage (r = 0.630; p < 0.001). The SWE values were significantly higher in those with significant fibrosis than in those with no or mild fibrosis (10.43 vs 4.26 kPa; p < 0.000). These values exhibited significant correlations with the METAVIR stage and APRI score (r = 0.863 and 0.544, respectively; both p < 0.001). For differentiating significant fibrosis, the sensitivity, specificity and positive and negative predictive values for an APRI cutoff value of 0.62 were 46.43%, 94.4%, 92.9% and 53.1%, respectively, and these values for an SWE cutoff value of 7.6 kPa were 55.88%, 100%, 100% and 44.4%, respectively.<br />Conclusion: In the clinical assessment of children, the APRI score and SWE can help differentiate between no or mild fibrosis and significant fibrosis. The routine use of SWE and APRI may help decrease the number of liver biopsies performed.
MeSH term(s)	Adolescent ; Aspartate Aminotransferases ; Biopsy ; Elasticity Imaging Techniques ; Female ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/pathology ; Humans ; Liver/pathology ; Liver Cirrhosis/etiology ; Liver Cirrhosis/pathology ; Male
Chemical Substances	Aspartate Aminotransferases (EC 2.6.1.1)
Language	English
Publishing date	2020-10-09
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2502114-X
ISSN	2090-2387 ; 1687-1979
ISSN (online)	2090-2387
ISSN	1687-1979
DOI	10.1016/j.ajg.2020.08.002
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Article: Direct-Acting Antiviral Drugs and Occurrence of Hepatocellular Carcinoma: Unjust or Oppressed.

Hassany, Sahar M / Hassan, Wesam / Abo-Alam, Hany / Khalaf, Marwa / Nafeh, Amany M / Nasr-Eldin, Eman / Mostafa, Ehab F

Infection and drug resistance

2020 Volume 13, Page(s) 1873–1880

Abstract: Purpose: In interferon-free era, direct-acting antiviral agents (DAAs) have achieved high eradication rates with an excellent safety profile since revolutionized the management of hepatitis c virus (HCV) patients. Published papers have suggested a ... ...

Abstract	Purpose: In interferon-free era, direct-acting antiviral agents (DAAs) have achieved high eradication rates with an excellent safety profile since revolutionized the management of hepatitis c virus (HCV) patients. Published papers have suggested a possible increased incidence of hepatocellular carcinoma (HCC) after successful DAAs treatment. Other papers have been published about the problem but without conclusive results. Because of this debate, we aim to evaluate the effects of antiviral therapy (Sofosbuvir plus Daclatasvir with or without Ribavirin) on the de novo occurrence of HCC in patients with liver cirrhosis (LC). Patients and methods: A prospective cohort study has included 350 patients who have visited our center for HCV treatment. Pretreatment history, examination, complete blood picture, liver function tests, kidney function tests, HA1C for diabetic patients, HCV PCR, HBsAg, alpha-fetoprotein (AFP), and abdominal ultrasound have been done, also Child-Pogh (CP) and Model for End-Stage Liver Disease (MELD) score before treatment. These investigations have been repeated for 3 months after the end of treatment. Abdominal ultrasound (US) has been done for 3 months after treatment and every 4 months for 2 years after the end of treatment to detect HCC occurrence. Results: Patients age (58.11 ± 7.48), 55.4% of patients were males, 30.3% of patients were diabetic, 84.3% of them were treatment naïve and sustained virological response (SVR) occured in 94% of them. HCC occurrence after treatment was 6.7% in patients with SVR and 23.8% in patients with non-SVR (P value=0.016) during follow-up period. There is significant improvement of CP score. No significant changes in MELD score. Conclusion: Treatment of HCV-related LC patients with sofosbuvir and daclatasvir with or without ribavirin for 3 or 6 months showed high SVR and significant improvement in CP score, but still at risk of HCC even if treated and should be followed up regularly according to screening programs with special meticulous attention to those with non-SVR.
Language	English
Publishing date	2020-06-18
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S241948
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Article ; Online: Hepatitis C virus associated skin manifestations in upper Egypt: Before and after direct acting antiviral treatment.

Tawfik, Yasmin Mostafa / Hassany, Sahar M / Badran, Aya Y / El-Gazzar, Amira F / Alemam, Mohamed F / Sayed, Doaa S

Dermatologic therapy

2020 Volume 33, Issue 6, Page(s) e14365

Abstract: Egypt displays a high-hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV-related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous ... ...

Abstract	Egypt displays a high-hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV-related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.
MeSH term(s)	Antiviral Agents/adverse effects ; Egypt/epidemiology ; Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology ; Humans
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2020-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1354801-3
ISSN	1529-8019 ; 1396-0296
ISSN (online)	1529-8019
ISSN	1396-0296
DOI	10.1111/dth.14365
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Article ; Online: Predictors of Severity and Co-Infection Resistance Profile in COVID-19 Patients

Ramadan, Haidi Karam-Allah / Mahmoud, Manal A / Aburahma, Mohamed Zakaria / Elkhawaga, Amal A / El-Mokhtar, Mohamed A / Sayed, Ibrahim M / Hosni, Amal / Hassany, Sahar M / Medhat, Mohammed A

First Report from Upper Egypt

2020

Abstract: Haidi Karam-Allah Ramadan,1 Manal A Mahmoud,2 Mohamed Zakaria Aburahma,1 Amal A Elkhawaga,3 Mohamed A El-Mokhtar,3 Ibrahim M Sayed,3,4 Amal Hosni,5 Sahar M Hassany,1 Mohammed A Medhat1 1Department of Tropical Medicine and Gastroenterology, Faculty of ... ...

Abstract	Haidi Karam-Allah Ramadan,1 Manal A Mahmoud,2 Mohamed Zakaria Aburahma,1 Amal A Elkhawaga,3 Mohamed A El-Mokhtar,3 Ibrahim M Sayed,3,4 Amal Hosni,5 Sahar M Hassany,1 Mohammed A Medhat1 1Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Department of Pathology, School of Medicine, University of California, San Diego, CA, USA; 5Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, EgyptCorrespondence: Haidi Karam-Allah RamadanDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, EgyptEmail haidikaram@aun.edu.egBackground: The emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide devastating effect with a diagnostic challenge. Identifying risk factors of severity aids in assessment for the need of early hospitalization. We aimed to demonstrate, for the first time, the clinical, laboratory and radiological characteristics of coronavirus disease 2019 (COVID-19) patients, to identify the predictors of severity and to describe the antimicrobial resistance profile in patients from Upper Egypt.Materials and Methods: Demographic characters, clinical presentations, laboratory, and radiological data were recorded and analyzed. Presence of other respiratory microorganisms and their sensitivity patterns were identified using the VITEK2 system. Resistance-associated genes were tested by PCR.Results: The study included 260 COVID-19 patients. The majority were males (55.4%) aged between 51 and 70 years. Hypertension, diabetes, and ischemic heart disease were common comorbidities. Main clinical manifestations were fever (63.8%), cough (57.7%), dyspnea (40%) and fatigue (30%). According to severity, 51.5% were moderate, 25.4% mild and 23% severe/critical. Lymphopenia, elevated CRP, ferritin, and D-dimer occurred in all patients with significantly higher value in the severe group. Age > 53 years and elevated ferritin ≥ 484 ng/mL were significant risk factors for severity. About 10.7% of the COVID-19 patients showed bacterial and/or fungal infections. Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus were the predominant isolated bacteria while Candida albicans and Candida glabrata were the predominant isolated fungi. All Staphylococci were methicillin-resistant and carried the mecA gene. Gram-negative isolates were multidrug-resistant and carried different resistance-associated genes, including NDM-1, KPC, TEM, CTX-M, and SHV.Conclusion: Older age and elevated serum ferritin were significant risk factors for severe COVID-19. Bacterial co-infection and multidrug resistance among patients with COVID-19 in Upper Egypt is common. Testing for presence of other co-infecting agents should be considered, and prompt treatment should be carried out according to the antimicrobial sensitivity reports.Keywords: COVID-19, clinical characteristics, ESBL, KPC, NDM-1, risk factors, disease severity, Upper Egypt
Keywords	Infection and Drug Resistance ; covid19
Subject code	610
Language	English
Publishing date	2020-10-05
Publisher	Dove Press
Publishing country	us
Document type	Article ; Online
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Article: Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial

Abd-Elsalam, Sherief / Soliman, Shaimaa / Esmail, Eslam Saber / Khalaf, Mai / Mostafa, Ehab F. / Medhat, Mohammed A. / Ahmed, Ossama Ashraf / El Ghafar, Mohamed Samir Abd / Alboraie, Mohamed / Hassany, Sahar M.

Biological trace element research. 2021 Oct., v. 199, no. 10

2021

Abstract: No specific treatment for COVID-19 infection is available up till now, and there is a great urge for effective treatment to reduce morbidity and mortality during this pandemic. We aimed to evaluate the effect of combining chloroquine/hydroxychloroquine ( ... ...

Abstract	No specific treatment for COVID-19 infection is available up till now, and there is a great urge for effective treatment to reduce morbidity and mortality during this pandemic. We aimed to evaluate the effect of combining chloroquine/hydroxychloroquine (CQ/HCQ) and zinc in the treatment of COVID-19 patients. This was a randomized clinical trial conducted at three major University hospitals in Egypt. One hundred ninety-one patients with a confirmed diagnosis of COVID-19 infection were randomized into two groups: group I (96) patients received both HCQ and zinc, and group II (95) received HCQ only. The primary endpoints were the recovery within 28 days, the need for mechanical ventilation, and death. The two groups were matched for age and gender. They had no significant difference regarding any of the baseline laboratory parameters or clinical severity grading. Clinical recovery after 28 days was achieved by 79.2% in the zinc group and 77.9% in zinc-free treatment group, without any significant difference (p = 0.969). The need for mechanical ventilation and the overall mortality rates did not show any significant difference between the 2 groups either (p = 0.537 and 0.986, respectively). The age of the patient and the need for mechanical ventilation were the only risk factors associated with the patients’ mortality by the univariate regression analysis (p = 0.001 and < 0.001, respectively). Zinc supplements did not enhance the clinical efficacy of HCQ. More randomized studies are needed to evaluate the value of adding zinc to other therapies for COVID 19. ClinicalTrials.gov Identifier: NCT04447534
Keywords	COVID-19 infection ; chloroquine ; death ; gender ; morbidity ; mortality ; pandemic ; patients ; randomized clinical trials ; regression analysis ; research ; zinc ; Egypt
Language	English
Dates of publication	2021-10
Size	p. 3642-3646.
Publishing place	Springer US
Document type	Article
ZDB-ID	445336-0
ISSN	1559-0720 ; 0163-4984
ISSN (online)	1559-0720
ISSN	0163-4984
DOI	10.1007/s12011-020-02512-1
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Article ; Online: Retraction Note: Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial.

Dabbous, Hany M / El-Sayed, Manal H / El Assal, Gihan / Elghazaly, Hesham / Ebeid, Fatma F S / Sherief, Ahmed F / Elgaafary, Maha / Fawzy, Ehab / Hassany, Sahar M / Riad, Ahmed R / TagelDin, Mohamed A

Scientific reports

2021 Volume 11, Issue 1, Page(s) 18983

Language	English
Publishing date	2021-09-18
Publishing country	England
Document type	Journal Article ; Retraction of Publication
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-98683-5
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