Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/7
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Article Oral Antipyretics for Fatigue Alleviation and Exercise Enhancement in Adults with Multiple Sclerosis: A Systematic Review and Meta-Analysis(Springer-Verlag Italia SRL, 2026) Hamdy, Ahmed Mohamed; Elmandrawi, Sara Wael; Ibrahim, Ismail A.; Shehata, Mazen Momtaz; Raza, Muhammad Liaquat; Elemam, Ahmed Mahmoud Elsayed; Elewa, MandyAims This review aims to explore the potential role of oral antipyretics (aspirin (ASA)/ acetaminophen), commonly known for fever and pain control, in managing fatigue, temperature regulation, and exercise capacity in patients with Multiple Sclerosis (MS), with a focus on nursing implications for symptom management. Design A systematic review of existing clinical studies assessing the effects of aspirin/ acetaminophen on MS-related fatigue, thermoregulation, and exercise performance. Data sources Electronic databases including Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PubMed, Scopus, Web of Science, Wiley, Google Scholar, and ClinicalTrials.gov were searched up to March 2024. Review methods Quality assessment was conducted using the Cochrane risk of bias tool 2. to evaluate the methodological rigor of included studies. Outcomes analyzed included clinically assessed fatigue scores, exercise endurance, and postexercise thermoregulation, with attention to potential risks associated with aspirin use. Results After assessment of 57 reports for eligibility, only seven studies met inclusion criteria; results indicated that aspirin pretreatment significantly improved Time to Exhaustion (TTE) in heat-sensitive MS patients (p = 0.013), though one study reported no significant effect. Aspirin reduced post-exercise temperature rise by 56%, but this was not statistically significant in one trial (p = 0.178), while another showed significant reductions (p = 0.002). Conclusion Aspirin and acetaminophen may offer benefits in alleviating fatigue, enhancing thermoregulation, and improving exercise endurance in MS patients. These findings suggest that nurses should consider the potential role of aspirin in symptom management, with further research needed to confirm efficacy and safety. Impact This review highlights a potential adjunct therapy for nurses to incorporate into comprehensive MS care, emphasizing symptom control and quality of life improvements.Article Ramadan Fasting and Seizure Activity in Adults with Epilepsy: A Systematic Review and Meta-Analysis(Academic Press Inc Elsevier Science, 2026) Ibrahim, Ismail A.; Shaaban, Sally; Elewa, Mandy; Rahman, Muhammad Samir Haziq Bin Abd; Mohamed, Lobna Ahmed; Talaia, Ahmed M.; Khoo, Ching Soong; Haziq bin Abd Rahman, Muhammad SamirPurpose: Ramadan fasting in Muslims entails abstaining from food and fluids from dawn to sunset, which can influence sleep patterns, medication timing, and food intake. Building on evidence that ketogenic diets and intermittent fasting may improve seizure control, we aim to analyze the link between intermittent Ramadan fasting in adults with epilepsy and seizure activity. Method: We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase between 2000 and January 2025 for articles that appeared between these dates. The terms used for searching included fasting in Ramadan with epilepsy or seizures. The seizure frequency and seizure status of the participants are the outcomes that we analyzed. Two reviewers independently screened and extracted data, with a third resolving any differences that arose between them. Meta-analysis was done using the random-effects model with statistical heterogeneity using the I2 statistic. Results: Of the 1485 articles, only eight were found to be relevant, and 4 of these included 564 patients who met the inclusion criteria. The analysis of the pooled data demonstrated that 61.1% of patients remained seizure-free throughout Ramadan (95% CI: 38.8%-83.4%), with considerable heterogeneity (I2 = 87.7%). Seizure risk was higher in patients on polytherapy with poor baseline seizure control, increased fasting times, or high potassium levels. In contrast, extended seizure-free intervals and increased sleep duration pre-Ramadan were good predictors of safe fasting, and each seizure-free week increased the chance of remaining seizure-free by 10%, as did each extra hour of sleep by 30%. Seizure frequency increases were caused by interruption of daily rhythms, psychological tension, tiredness, and extended fasting. Conclusion: While many patients remained seizure-free during Ramadan, high study variability highlights the need for standardized research. With proper medical supervision, fasting may be safely practiced for selected epilepsy patients.Article Psychological Effects of Robotic Rehabilitation in Individuals With Spinal Cord Injury: A Narrative Review(BMC, 2025) Ibrahim, Ismail A.; Mounir, Mennatallah M.; Hussein, Omar; Parnian, Nadieh; Sefertas, Ece; Ravanbod, Amin; Arican, Tuna ErenIntroductionSpinal cord injury (SCI) is associated with severe physical, psychological, and social burdens. Robotic rehabilitation, especially robotic-assisted gait training, is increasingly used to improve functional recovery. Nonetheless, its psychological effects which are key to motivation, compliance, and long-term prognosis have received little scrutiny.MethodsWe conducted a narrative review across five databases (PubMed, Web of Science, Scopus, Cochrane, Embase) from inception to January 2025. Studies were included if they evaluated robotic rehabilitation in SCI and reported psychological outcomes. Findings were synthesized thematically into domains of anxiety/technophobia, motivation/engagement, self-efficacy/dependence, and frustration/quality of life.ResultsRobotic systems frequently improved autonomy, motivation, and self-confidence, which corresponded to less depression and a better quality of life. Nevertheless, negative effects including technophobia, frustration from technological malfunction, and loss of self-efficacy from excessive dependence were found. Patient experiences ranged: empowerment and new optimism were reported by some patients, whereas others experienced the devices as complicated, emotionally alienating, or inadequately adjustable.DiscussionRobotic rehabilitation has a dual psychological effect. On one hand, it encourages engagement and emotional resilience; on the other, it carries risks of interdependence and diminished autonomy. There are ethical issues to be resolved access disparities, data protection, and preserving human connection that require careful management. The inclusion of psychological screening, education of patients, and specific goal-setting within protocols can maximize results.ConclusionRobotic rehabilitation is highly capable of promoting progress after SCI if psychological considerations are completely incorporated into rehabilitation interventions. A multimodal approach that is interdisciplinary and ethically solid is required to achieve optimized functional improvement as well as psychosocial health.Article Unraveling the Potential of Stem Cell Therapy in Motor Neuron Disease: A Narrative Review(Bentham Science Publ, 2025) Essa, Syed Muhammad; Khosa, Noor Ahmed; Kakar, Amanullah; Ozturk, Basar; Ibrahim, Ismail A.; Haq, NomanMotor neuron disorders (MNDs), including ALS, are deadly neurodegenerative conditions that cause progressive motor neuron degeneration. With neuroprotection and the potential for neuron regeneration employing MSCs, ESCs, iPSCs, and NSCs, stem cell treatment presents a viable alternative to current medicines, which only control a limited number of symptoms. Following PRISMA criteria, this narrative review methodically screened 1248 records from the Cochrane, Web of Science, PubMed, and Scopus databases. Following a thorough screening process, 22 studies, including preclinical models and 19 clinical trials, were analysed to assess the therapeutic mechanisms, safety, and efficacy of stem cell therapies for MNDs. Mesenchymal stem cell (MSC) therapy has shown a promising safety profile and possible therapeutic efficacy in ALS, with no substantial transplant-related toxicity noted. ALS functional rating scale-revised (ALSFRS-R) scores and forced vital capacity (FVC) assessments from clinical trials, such as those evaluating autologous bone marrow-derived MSCs, demonstrated stabilisation in ALS development. Studies have also emphasised as to how immunomodulation and neurotrophic factors play a part in MSC-based therapies. Recent data indicate that repeated intrathecal MSC injection could extend the duration of therapeutic advantages. Clinical trials have shown safety and early efficacy signals for motor neurons produced from embryonic stem cells (ESCs), especially using AstroRx (R). This suggests that ESCs could be a viable option for regenerative medicine. Nonetheless, issues, like host integration and differentiation optimisation, still exist. Although clinical translation is still in its early stages, induced pluripotent stem cells (iPSCs) and their derivatives provide disease modelling and patient-specific therapeutic applications. Stem cell therapy holds promise for treating MND, with MSCs leading the way in current trials. It is necessary to enhance ESC- and iPSC-based techniques to tackle integration issues. To ensure long-term safety and efficacy, therapies must be developed using standardised protocols, patient stratification, optimised delivery, and large-scale studies.Article Safety and Efficacy of Colchicine in COVID-19 Treatment: Systematic Review and Meta-Analysis(Elsevier, 2025) Nada, Ahmed Hosney; Ibrahim, Ismail A.; Asar, Nada Khalid; Qenawy, Abdulrahman; Mohammed, Mariam M.; Wagdy, Mohamed; Farouk, Heidi SherifBackground: Colchicine is an anti-inflammatory drug used for the treatment of gout and other autoinflammatory conditions. Several trials reported promising results of the efficacy of colchicine in Covid-19 due to its antiinflammatory properties. However, applying these results to clinical settings remains the subject of ongoing research. Methods: We performed a systematic review and meta-analysis on the efficacy and safety of colchicine in the treatment of Covid-19. PubMed, Cochrane Library, Web of Science, and Scopus were searched for relevant studies. The primary outcomes were 28-day mortality, invasive mechanical ventilation, non-invasive mechanical ventilation, and ICU admissions. The risk ratio was used to compare effectiveness between the two groups. Subgroup analysis was done for C-reactive protein and duration of hospitalization. Results: 17 randomized controlled trials with a total of 25478 patients were included. The overall Risk ratio didn't favor any of the two groups in terms of 28-day mortality (RR =1.03, 95 % CI [0.93:1.15], P = 0.58), noninvasive mechanical ventilation (RR = 0.81, 95 % CI [0.44:1.48], P = 0.49), ICU admission (RR = 0.89, 95 % CI [0.56:1.41], P = 0.62). The overall mean difference (MD) did not show statistical significance between both groups in terms of Creactive protein (CRP) (mg/dl) (MD = -1.21, 95 % CI [-2.42:0.01], P = 0.05), lactate dehydrogenase (LDH) (U/ L) (MD = 50.95, 95 % CI [-92.07: 193.98], Ferritin (ng/ml) (MD = 128.08, 95 % CI [51.97:204.18], P = 0.001), ICU length of stay (MD = -0.09, 95 % CI [-0.34:0.15], P = 0.45) and duration of hospitalization (MD = -0.41, 95 % CI [-1.56:0.73], P = 0.48). Conclusion: In Covid-19 treatment, colchicine didn't result in significant benefits in terms of clinical outcomes. More large-scale randomized clinical trials with standardized dosages and long-term follow-up are needed for further investigation into the colchicine effect.Article Citation - WoS: 2Citation - Scopus: 1Safety and Efficacy of Umbilical Cord Mesenchymal Stem Cells in the Treatment of Type 1 and Type 2 Diabetes Mellitus: a Systematic Review and Meta-Analysis(Routledge Journals, Taylor & Francis Ltd, 2025) Nada, Ahmed Hosney; Ibrahim, Ismail A.; Oteri, Vittorio; Shalabi, Laila; Asar, Nada Khalid; Aqeilan, Saja Rami; Hafez, WaelIntroduction Many patients struggle to control glucose without side effects. Due to their immunomodulatory and regenerative properties, mesenchymal stem cells (MSCs) might treat Diabetes Mellitus (DM). The authors employed this meta-analysis to evaluate the efficacy and safety of umbilical cord MSCs (UCMSCs) for DM management. Methods The PubMed, Cochrane, WOS, Embase, and Scopus databases were searched for randomized controlled trials (RCTs) investigating the effects of UCMSCs on DM (Types 1, 2) till January 2024. Patient demographics, interventions, and outcomes, including glycated hemoglobin (HbA1c%), C-peptide levels, and insulin requirements, were extracted. A comprehensive meta-analysis software was used. Results Eight CTs of 334 patients (172 experimental and 162 controls) were included. UMSCs treatment substantially lowered HbA1c levels (MD = -1.06, 95% CI [-1.27, -0.85], p < 0.00001) with consistent outcomes (i(2) = 0%, p = 0.43). Fasting C-peptide levels were heterogeneous but favored placebo (MD = 0.35, 95% CI [0.15, 0.56], p = 0.0007). In T1D patients, daily insulin requirements decreased considerably (MD = -0.24, 95% CI [-0.29, -0.18], p < 0.00001), with heterogeneity addressed by sensitivity analysis. Conclusion UMSCs therapy reduced HbA1c and insulin requirements, and increased C-peptide levels. Multicenter clinical trials are required to confirm the long-term efficacy and safety of UMSC therapy.Article Citation - WoS: 2Citation - Scopus: 2Perfusion-Mri for Differentiating Cerebral Metastatic Lesions and Gliomas: an Evidence-Based Review(Elsevier Sci Ltd, 2025) Azab, Mohammed A.; El-Gohary, Nour; Atallah, Oday; Shama, Mohsen; Ibrahim, Ismail A.Background: Lesions affecting the brain are variable and have multiple pathologies. Brain metastasis is a common entity of lesions that can be misleading in diagnosis. Brain metastasis affects the patient's life and survival in about 40% of cases; all patients with metastatic brain lesions are indicated for surgery, so proper diagnosis is crucial for each patient. Non-invasive diagnosis is a promising way to confirm the diagnosis of cerebral metastatic lesions for patients who are not indicated for surgery for medical reasons. To our knowledge, this is the first evidence-based review article regarding utilizing perfusion-MRI for approaching cerebral metastatic lesions. Methods: A comprehensive database search on PubMed/Medline, Scopus and Google Scholar was done by the relevant keywords. Eligibility of articles was done by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cochrane risk of bias assessment tool was used to determine the risk of bias among the included studies. Results: From 2989 articles, only 31 studies were eligible for the qualitative synthesis. A comprehensive summary of the included study was made according to population, intervention, comparator and outcomes (PICO) method. Conclusions: Diagnosing cerebral metastases, categorizing subtypes, and monitoring their response to treatment is a challenging endeavor for neurosurgeons, neuroradiologists, and oncologists. Technological advances in MRI software as perfusion-based MRIs are designated to facilitate diagnosis and follow-up for patients with cerebral metastases.Review Citation - WoS: 2Citation - Scopus: 2Effectiveness of Non-Invasive Vagal Nerve Stimulation in Parkinson's Disease: a Comprehensive Systematic Review And<i> Meta</I>-analysis(Elsevier Sci Ltd, 2025) Abouelmagd, Moaz Elsayed; Yousef, Obai; Ibrahim, Ismail A.; Elshahat, AhmedBackground: Parkinson's disease (PD) is a debilitating neurodegenerative disorder characterized by movement impairments. Vagus nerve stimulation (VNS) is a non-invasive brain stimulation technique that has shown promise in treating various neurological conditions, including PD. This systematic review aimed to evaluate the existing evidence on the efficacy of nVNS in managing PD symptoms. Methods: A comprehensive literature search was conducted to identify relevant studies published up to July 2024. The included studies investigated the effect of nVNS on various PD motor symptoms. The quality of studies was assessed using the Cochrane Risk of Bias 2 (ROB-2) and NIH tool for RCTs, single-arm studies, and case series studies respectively. Statistical analysis was conducted using Review Manager version 5.4.1 with outcomes expressed as Mean differences (MD) with 95% confidence intervals (CI). Results: The systematic review included eight randomized controlled trials (RCTs), one single-arm study, and one case series, encompassing a total of 217 patients with PD. The review revealed that nVNS in increasing Freezing of Gait (FOG) in PD (p = 0.04). However, no significant differences were found in UPDRS-III (p = 0.19 and p = 0.89 for on and off-medication conditions, respectively), UPDRS-II (p = 0.9), UPDRS-I (p = 0.46), Time Up and Go (p = 0.61), stand time (p = 0.87), walking speed (p = 0.22), or step length measured in meters (p = 0.8). Interestingly, a significant improvement was observed in step length measured in centimetres (p = 0.0005). No study reported serious adverse effects associated with nVNS treatment. Conclusion: Our finding suggests a potential benefit of nVNS in reducing FOG in PD, but did not demonstrate a significant improvement in other motor symptoms. Larger, longer follow-up studies are needed to confirm the effect nVNS on PD management. PROSPERO number: CRD42024574822.Review Citation - WoS: 7Citation - Scopus: 6The Impact of Interaction Between Verteporfin and Yes-Associated Protein 1/Transcriptional Coactivator With Pdz-Binding Motif-Tea Domain Pathway on the Progression of Isocitrate Dehydrogenase Wild-Type Glioblastoma(Sage Publications Ltd, 2023) Osama, Mahmoud; Essibayi, Muhammed Amir; Osama, Mona; Ibrahim, Ismail A.; Mostafa, Mostafa Nasr; Eksi, Murat Sakir; Şakir Ekşi, Murat; Nasr Mostafa, MostafaVerteporfin and 5-ALA are used for visualizing malignant tissue components in different body tumors and as photodynamic therapy in treating isocitrate dehydrogenase (IDH) wild-type glioblastoma (GBM). Additionally, verteporfin interferes with Yes-associated protein 1 (YAP)/Transcriptional coactivator with PDZ-binding motif - TEA domain (TAZ-TEAD) pathway, thus inhibiting the downstream effect of these oncogenes and reducing the malignant properties of GBM. Animal studies have shown verteporfin to be successful in increasing survival rates, which have led to the conduction of phase 1 and 2 clinical trials to further investigate its efficacy in treating GBM. In this article, we aimed to review the novel mechanism of verteporfin's action, the impact of its interaction with YAP/TAZ-TEAD, its effect on glioblastoma stem cells, and its role in inducing ferroptosis.Article A Rare Presentation of Bilateral Periventricular Nodular Heterotopia With Intra-Axial Pontine Lesion: A Case Report and Treatment Approach(Elsevier, 2024) Shenno, Milad; Al-Qiami, Almonzer; Ibrahim, Ismail A.; Elhaw, Lojin; Nashwan, Abdulqadir J.This report presents a rare case of a 19-year-old male with bilateral periventricular nodular heterotopia (PVNH), a congenital brain abnormality resulting from failed neural cell migration, along with an intra-axial pontine lesion of unknown pathology. The differential diagnosis of childhood brainstem tumors in such cases commonly includes diffuse midline glioma (DMG), which is associated with a dismal prognosis due to H3 K27 gene mutation. However, this case exhibits a unique focal dorsal exophytic brainstem glioma variant, accounting for only a small percentage (approximately 10 %) of pontine tumors and carrying a more favorable prognosis. The lesion is suspected to be a pilocytic astrocytoma, presenting distinct neurological symptoms. In this case, the patient presented with symptoms include mainly occasional tonic-clonic seizures, right side mild spasticity with ataxic gait and right eye blurring of vision along with right side facial palsy. The patient's clinical evaluation, in conjunction with various medical diagnostic tests and MRI with and without contrast, led to the final diagnosis. Management began with anti-epileptic medication, with a plan for further treatment and follow-up.
