PubMed İndeksli Yayınlar Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8

Browse

Filters

20263

Settings

Author: search.filters.author.Elewa, MandyPublication Index: search.filters.publicationIndex.PubMed

Search Results

Now showing 1 - 3 of 3
  • 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, Mandy
    Aims 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
    Efficacy and Safety of Deferiprone for Parkinson’s Disease: A Systematic Review and Meta-Analysis of Motor Function and Overall Disease Severity
    (Springer-Verlag Italia SRL, 2026) Ehab, Menna; Ibrahim, Ismail A.; Hekal, Rawan Gameel; Solah, Israa A.; Ezz-Alarab, Moaz; Elewa, Mandy; Zidat, Ayham R. A.
    Background The accumulation of iron in brain regions is one of the characteristics of Parkinson's disease (PD). Deferiprone (DFP) is an iron chelator that reduces iron overaccumulation in certain diseases. The efficacy and safety of DFP in the management of PD have been assessed; however, the results remain controversial. Method A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A comprehensive search was conducted across five databases to identify all randomized clinical trials and observational studies. The primary outcomes included changes in motor function (MDS-UPDRS III) and overall disease severity (MDS-UPDRS total score). Additionally, the safety of DFP was assessed by analyzing adverse events. A network meta-analysis using a random-effects model was conducted. Results Four randomized clinical trials were identified. The studies included 567 patients with early-stage PD. The DFP doses across the included studies ranged from 3.75 to 15 mg/kg twice daily. None of the doses showed a significant Improvement in motor function (I2 = 0%), or in overall disease severity (I2 = 82.5%), compared with placebo in the network analysis. However, a non-significant improvement in motor function was observed at 7.5 mg/kg twice daily, whereas higher doses were associated with worsening clinical scores. Adverse events were generally mild, although there were some safety concerns at higher doses. Conclusion DFP can reduce accumulated iron across brain regions. However, current evidence does not support the use of DFP for the clinical and symptomatic management of PD within the assessed range of doses and treatment periods.
  • 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 Samir
    Purpose: 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.