PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8
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Article Prevalence and Risk of Carpal Tunnel Syndrome in Parkinson’s Disease: A Systematic Review and Meta-Analysis(MDPI, 2026) Raafat, Kareem Wael; Amin, Ahmed M.; Ezz, Mohamed R.; Sabry, Ehab Naser; Ibrahim, Ismail A.; Attia, Amir N.; Mohammed, Mariam M.Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterised by motor and non-motor symptoms. Several studies have reported varying prevalence of Carpal Tunnel Syndrome (CTS) among individuals with PD. Objective: This study aimed to estimate the pooled prevalence of CTS in people with PD and explore any potential association between the two conditions. Methods: This systematic review and meta-analysis was conducted and reported in accordance with the PRISMA 2020 guidelines. A systematic search was performed across PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WoS), Scopus, and EMBASE from inception to April 2024. Studies reporting CTS prevalence data in individuals with PD were included. Methodological quality was assessed using the National Institutes of Health (NIH) quality assessment tool. Pooled prevalence estimates were calculated using a random-effects model. Risk difference (RD) and risk ratio (RR) were calculated to assess the association between PD and CTS compared with control groups. Results: A total of 7 studies involving 411 participants (343 with PD and 68 controls) met the inclusion criteria, with 679 wrists assessed. The pooled prevalence of CTS in PD was estimated at 15% (95% CI: 0.07-0.28) with significant heterogeneity (p < 0.001, I-2 = 91%). The RD was 10% (95% CI: 0.04-0.16, p = 0.002), with low heterogeneity (p = 0.29, I-2 = 19%). The RR of CTS in PD compared with controls was 3.31 (95% CI: 0.60-18.42, p = 0.17), with moderate heterogeneity (p = 0.13, I-2 = 52%). Conclusions: This meta-analysis provides preliminary pooled estimates indicating a potentially increased prevalence of carpal tunnel syndrome in individuals with PD. Although the findings suggest a possible association, clinicians should maintain increased vigilance for CTS symptoms in patients with PD presenting with upper-limb sensory or motor complaints. From a biomechanical and functional perspective, these findings highlight the importance of routine upper-limb screening and the implementation of rehabilitation strategies targeting hand use, dexterity, and sensorimotor control within physiotherapy practice. Further high-quality studies with larger, well-characterised samples are required to confirm this relationship and clarify its clinical and functional implications.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 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 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 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.Review Citation - WoS: 5Citation - Scopus: 4A Systematic Review and Meta-Analysis for the Efficacy of Transcranial Direct Current Stimulation (tdcs) in Ocd Treatment: A Non-Pharmacological Approach To Clinical Interventions(Pergamon-elsevier Science Ltd, 2024) Ibrahim, Ismail A.; Nada, Ahmed Hosney; Asar, Nada Khalid; Ibrahim, Rand; Farouk, Rawan Ahmed; Al-Qiami, Almonzer; Noorbakhsh, Seyed AliObsessive-compulsive disorder (OCD) is a prevalent mental condition characterized by recurrent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions), significantly disrupting daily functioning and social interactions. Transcranial direct current stimulation (tDCS) presents a promising non-invasive treatment modality aimed at alleviating symptoms. However, the evidence regarding its effectiveness remains inconclusive. This study seeks to address this gap by conducting a systematic review and meta-analysis of clinical trials, offering improved guidance for clinical intervention. A comprehensive search strategy was implemented across multiple databases, including PubMed, Cochrane CENTRAL, Embase, Scopus, and Web of Science. This search focused strictly on randomized controlled trials (RCTs) involving 147 patients. These trials evaluated the efficacy of tDCS in OCD patients. Subsequent data extraction, risk of bias assessment, and statistical analysis using Review Manager software revealed the potential efficacy of tDCS in reducing OCD symptoms. The meta-analysis not only fails to demonstrate significant superiority of active tDCS over sham tDCS but also suggests that sham tDCS may be more effective than active tDCS in reducing OCD symptoms. This finding diminishes the promise of tDCS as an effective treatment for OCD. Larger trials are warranted to further elucidate these findings.Article Citation - WoS: 3Citation - Scopus: 3Psychological Distress Among Students in Egypt and Jordan During the Initial Months of the Gaza War(Springernature, 2024) Hendawy, Mohamed; Abouzid, Mohamed; Gamal, Aliaa; Ghanayem, Aseel; Amer, Muna; Tanashat, Mohammad; Ibrahim, Ismail A.BackgroundPsychological distress has significantly impacted students in Egypt and Jordan. These countries have faced many challenges, including the COVID-19 pandemic, the fallout from the conflict in Syria, and the war in Ukraine. These crises have had far-reaching consequences, affecting the economy, food security, and energy supplies, particularly with the increased number of refugees in these countries. Amid these existing complexities, the ongoing war in Gaza further exacerbates the situation, compounding mental health challenges. Therefore, this study aimed to analyze how the war in Gaza impacted the mental health of students in Egypt and Jordan. MethodsWe conducted a cross-sectional study involving students from Egypt and Jordan between December 2023 and January 2024. The questionnaire incorporated the Brief Symptom Inventory 18 (BSI-18) to assess the overall general distress score, as well as the domains of anxiety, somatization, and depression. ResultsA total of 1509 Jordanian and Egyptian students were included in the study, of which 66% were female. Approximately 18% of the students had an elevation (>= 50) in their BSI-18 total score. Females scored significantly higher in general distress [30 (18-44.25) vs. 24 (11-41), p < 0.001], and all three dimensions. The univariate predictors for elevated general distress (>= 50) were being Egyptian (OR 1.49, 95% CI 1.08 to 2.08, p = 0.014), watching social media multiple times a day (OR 3.04, 95% CI 1.97 to 4.69, p < 0.001), and having a Palestinian connection (friend, neighbor, colleague, or relative) (OR 1.63, 95% CI 1.23 to 2.16, p < 0.001). These three predictors were retained in the backward stepwise multivariate regression analysis model. The univariate predictors for moderate and marked general distress (>= 57) were watching social media multiple times a day (OR 3.26, 95% CI 1.78 to 5.99, p < 0.001) and having a Palestinian connection (OR 1.49, 95% CI 1.05 to 2.14, p = 0.026). Only the former was retained in the backward stepwise multivariate regression analysis. ConclusionGeneral distress has increased among students in Egypt and Jordan throughout the War in Gaza. Mental, psychological, and social support activities are necessary for these students, particularly those watching social media multiple times daily. The development of coping skills to manage the additional stressors of war and socioeconomic status necessitates further research within this group of students.