WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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 The Role of High-Fidelity Simulators in Vascular Surgery Training: A Systematic Review(Springer Nature, 2026) Abdelkader, Rem Ehab; Amgad, Ahmed; Alshurman, Saba Hussein; Almanaseer, Ghadeer M.; Manoj, Rachel Mary; Iqbal, Uzair; Ibrahim, Ismail A.BackgroundIn vascular surgery, endovascular procedures demonstrated lower morbidity and shorter hospital stays. However, learning these skills is highly challenging. A new method that offers secure, controlled settings for skill development is simulation-based training.AimThis systematic review aims to examine the different high-fidelity simulation programs and their effectiveness in enhancing endovascular skills among vascular surgery trainees.MethodsA comprehensive literature search was conducted across PubMed, SCOPUS, Cochrane CENTRAL, and Web of Science using PRISMA guidelines. We included all studies of all designs involving high-fidelity simulation in vascular surgery training. The eligibility criteria focused on studies assessing simulation interventions comparing pre- and post-course outcomes. Data extraction was done manually using Excel spreadsheets by two independent reviewers, and quality assessment was performed using a 19-point scale. The studies were also evaluated using Kirkpatrick's adapted hierarchy based on their educational impact.ResultsA total of 35 studies met the inclusion criteria, covering a range of simulation modalities, including virtual reality, augmented reality, and physical simulators. The findings demonstrated significant improvements in procedural skills, operation time, operative errors, and participant's confidence across all training levels. However, there were great variations in study methods and design, as well as a lack of a specific framework for skill assessment.ConclusionFor endovascular training, high-fidelity simulation is a useful tool for skill development. However, Standardized training techniques and additional research are needed to assess long-term skill retention.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: 1Technical Approaches for Preservation of the Temporalis Muscle in Neurosurgery: A Systematic Review(Lippincott Williams & Wilkins, 2025) Azab, Mohammed A.; Sarhan, Khalid; Atallah, Oday; Hernandez-Hernandez, Alan; Ibrahim, Ismail A.; Shama, Mohsen Nabih; Kammoun, BrahimBackground:The temporalis muscle is commonly dissected and mobilized during craniotomy. Cosmetic and functional complications may arise from the improper handling of this muscle. Surgery for recurrent pathologies may be challenging due to adhesions and muscle damage.Material and methods:A systematic review following PRISMA guidelines was conducted to consolidate literature on the potential techniques used for preserving the temporalis muscle during neurosurgical interventions. PubMed, Scopus, and Web of Science were systematically searched using predefined criteria from inception to 2025. A qualitative synthesis was done summarizing the primary cranial pathology, type of surgical approach, the technical clue for temporalis muscle preservation, follow up and complications.Results:We included 27 eligible articles with a total number of 811 patients. About 508 (62.6%) of patients underwent pterional approach, while 150 (18.4%) patients had decompressive craniotomies. Aneurysm clipping was the surgical indication in 172 (21.2%) patients, while decompressive surgery was done for traumatic brain injuries in about 48 (5.9%) patients. Osteoplastic temporalis muscle flap was used in 178 (21.9%) patients, while some authors sutured the temporalis muscle to the cranioplasty plate in 79 (9.7%) patients. Fixation of the temporalis muscle to the bone using sutures through small holes was done in 100 (12.33%) patients. No chewing problems were recorded among all the patients analyzed. Temporalis muscle atrophy was observed in only 13 (1.6%) patients.Conclusion:Proper manipulation of the temporalis muscle during surgery is crucial for the vitality of its fibers and to prevent postoperative functional or cosmetic drawbacks.Conference Object Role of Cardiac Myosin Inhibitors in the Treatment of Hypertrophic Cardiomyopathy: an Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials(Elsevier Science inc, 2025) Almansouri, Naiela Ennaji; Ibrahim, Ahmed; Mujahed, Ahmed Samir; Ghattas, Ahmad S.; Ahmed, Mahmoud Sayed; Ramdan, Omar M.; Ibrahim, Ismail A.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.Conference Object Ucscs in Treatment of T1dm and T2dm; a Meta-Analysis(Elsevier Ireland Ltd, 2024) Nada, Ahmed Hossney; Ibrahim, Ismail A.; Shalabi, Laila; Oteri, Vittorio; Asar, Nada Khalid; Aqeilan, Saja Rami; Hafez, Wael[No Abstract Available]