WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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 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.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.Review Citation - WoS: 1Citation - Scopus: 1Effect of Everolimus on Prognosis of Neurofibromatosis Type 1 Lesions: a Systematic Review and Meta Analysis(Elsevier, 2024) Ibrahim, Ismail A.; Abdelkader, Rem Ehab; Nada, Ahmed Hosney; Younes, Siham; Hanen, George; Shahwan, Ghena; Nashwan, Abdulqadir J.Purpose: This study addresses the effectiveness of oral everolimus in treating various malignancies associated with Neurofibromatosis Type 1 (NF1). The purpose is to determine whether everolimus reduces lesion size in NF1 patients, considering the controversial findings from previous clinical trials. The scientific hypotheses and questions involve evaluating the impact of everolimus on NF1-associated lesions and understanding the variability in treatment outcomes. Methods: A systematic review and meta-analysis were conducted following PRISMA and Cochrane Collaboration guidelines. The study included four-phase II, single-arm, nonrandomized trials investigating the effect of oral everolimus on NF1-associated lesion size. The search covered multiple databases, and data extraction involved evaluating studies for inclusion criteria and assessing quality using the Cochrane Collaboration's Risk of Bias in Nonrandomized Studies tool. Statistical analysis utilized Open Meta(Analyst). Findings: The search yielded 388 studies, with 10 selected for full-text review and four included in the final analysis. The quality of the studies ranged from low to moderate. The meta-analysis indicated no observed heterogeneity (I2 = 0%), and the overall estimate suggested no significant reduction in NF1-associated lesion size with everolimus ( P = 0.069). Implications: The findings reveal a varied and inconsistent picture of everolimus efficacy in NF1 treatment. The study highlights the need for personalized approaches, considering individual genetic and clinical differences. The limitations, including small sample sizes and nonrandomized trials, call for larger, more standardized research efforts. The study emphasizes ongoing trials and the importance of future research in understanding predictors of everolimus response and optimizing treatment strategies for NF1 patients. Conclusion: While everolimus shows promise in reducing lesion size in a subset of NF1 patients, the study cannot draw conclusive results due to limitations in the included studies. Ongoing, adequately powered trials are crucial for advancing the evidence base and informing the potential role of everolimus in NF1 treatment. Others: There was no funding for this review and no conflicts of interest.
