Background To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection a... more Background To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection and extracorporeal shock wave therapy (ESWT) on refractory non-calcific partial thickness supraspinatous tendon tear. Results Significant improvement in all outcome measures achieved in both groups at 4 weeks follow-up period (the end of treatment course) (P< 0.05). At 12 weeks follow-up period, group I, showed significant improvement in all outcome measures compared to baseline and group II; however, in group II, there was no significant difference compared to baseline; moreover, deterioration in the previous improvement was noticed. Conclusion Both PRP (group I) and ESWT (group II) are effective therapeutic methods in the management of refractory non-calcific partial thickness supraspinatous tendon tear; however, PRP (group I) has better long-term effects on both pain and function.
Objectives: To investigate the relationship between acro-osteolysis (AO), bone mineral density (B... more Objectives: To investigate the relationship between acro-osteolysis (AO), bone mineral density (BMD) and peripheral vascularity in premenopausal female patients with diffuse systemic sclerosis (dcSSc). Methods: An observational cohort study that included thirty premenopausal female patients with dcSSc. The recruited patients were categorized into two groups according to the presence of radiological signs of AO. Patients were assessed clinically, laboratory and radiologically by X-ray imaging of both hands and wrists, dual-energy X-ray absorptiometry for measuring BMD and Doppler ultrasonography for evaluation of upper limbs peripheral vascularity. Results: Overall, 80% patients had AO; comparing patients with and without AO, the former had significant increase in the frequencies of Raynaud's phenomenon, calcinosis and digital pits (88.5, 94.7, 91.7) versus (11.5, 5.3, 8.3) in the latter, respectively. Additionally, they had significantly lower distal radius BMD and higher macrovascular abnormalities at both radial and ulnar arteries ( P < 0.05). On regression analysis, the most important factors associated with AO were calcinosis (OR= 1.7; 95% CI: 1.01- 3.02; P = 0.02), Raynaud's phenomenon (OR= 3.5; 95% CI: 0.6-19.4; P = 0.003), digital pits (OR= 2.8; 95% CI: 0.9-8.8; P = 0.001), low BMD at the distal radius (OR= 1.9; 95% CI: 1.1-3.0; P = 0.002), and macrovascular changes at radial and ulnar arteries (OR = 2.2; 95% CI: 0.7-6.5; P = 0.04 and OR =1.6; 95% CI: 0.9-3.0; P = 0.05) respectively. Conclusion: Calcinosis, Raynaud's phenomenon, digital pits, vascular alterations at radial and ulnar arteries, and low BMD at the distal radius are the most important factors associated with AO in dcSSc patients.
Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder associated wi... more Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder associated with various comorbid conditions. Here, we assessed the burden of comorbidity in patients with SLE in Egypt using the Charlson Comorbidity Index (CCI) and determined its association with the disease characteristics. Patients and Methods: In this retrospective study, data of patients with SLE in Egypt were collected from the medical records. This included demographic data, clinical characteristics, comorbidities, and baseline SLE disease activity index (SLEDAI) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) scores at the last visit. The CCI score was calculated for each patient. The data of deceased patients were also collected. Results: Overall, 152 patients were included in this study. The most common comorbidities excluded from the CCI were serious infections (27%) and hypertension (23%); the most common comorbidities included in the CCI, apart from the connective tissue disease, were moderate or severe renal disease (12.5%), peptic ulcer (9.9%), and diabetes mellitus (9.9%) without end-organ damage. The mean CCI score was 1.9 and was significantly correlated with the disease duration, SLEDAI, and SDI. The death rate was 7.9%; the most common cause of death was infection (50%). Death was significantly associated with a high score of SLEDAI, SDI, and CCI. The mortality rate was higher in patients with SLE along with hypertension, renal affection, hyperlipidemia, infection, and tumors (P < 0.05). Conclusion: Patients with SLE in Egypt experienced comorbidities and high CCI scores that affected their survival.
Background To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection a... more Background To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection and extracorporeal shock wave therapy (ESWT) on refractory non-calcific partial thickness supraspinatous tendon tear. Results Significant improvement in all outcome measures achieved in both groups at 4 weeks follow-up period (the end of treatment course) (P< 0.05). At 12 weeks follow-up period, group I, showed significant improvement in all outcome measures compared to baseline and group II; however, in group II, there was no significant difference compared to baseline; moreover, deterioration in the previous improvement was noticed. Conclusion Both PRP (group I) and ESWT (group II) are effective therapeutic methods in the management of refractory non-calcific partial thickness supraspinatous tendon tear; however, PRP (group I) has better long-term effects on both pain and function.
Objectives: To investigate the relationship between acro-osteolysis (AO), bone mineral density (B... more Objectives: To investigate the relationship between acro-osteolysis (AO), bone mineral density (BMD) and peripheral vascularity in premenopausal female patients with diffuse systemic sclerosis (dcSSc). Methods: An observational cohort study that included thirty premenopausal female patients with dcSSc. The recruited patients were categorized into two groups according to the presence of radiological signs of AO. Patients were assessed clinically, laboratory and radiologically by X-ray imaging of both hands and wrists, dual-energy X-ray absorptiometry for measuring BMD and Doppler ultrasonography for evaluation of upper limbs peripheral vascularity. Results: Overall, 80% patients had AO; comparing patients with and without AO, the former had significant increase in the frequencies of Raynaud's phenomenon, calcinosis and digital pits (88.5, 94.7, 91.7) versus (11.5, 5.3, 8.3) in the latter, respectively. Additionally, they had significantly lower distal radius BMD and higher macrovascular abnormalities at both radial and ulnar arteries ( P < 0.05). On regression analysis, the most important factors associated with AO were calcinosis (OR= 1.7; 95% CI: 1.01- 3.02; P = 0.02), Raynaud's phenomenon (OR= 3.5; 95% CI: 0.6-19.4; P = 0.003), digital pits (OR= 2.8; 95% CI: 0.9-8.8; P = 0.001), low BMD at the distal radius (OR= 1.9; 95% CI: 1.1-3.0; P = 0.002), and macrovascular changes at radial and ulnar arteries (OR = 2.2; 95% CI: 0.7-6.5; P = 0.04 and OR =1.6; 95% CI: 0.9-3.0; P = 0.05) respectively. Conclusion: Calcinosis, Raynaud's phenomenon, digital pits, vascular alterations at radial and ulnar arteries, and low BMD at the distal radius are the most important factors associated with AO in dcSSc patients.
Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder associated wi... more Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder associated with various comorbid conditions. Here, we assessed the burden of comorbidity in patients with SLE in Egypt using the Charlson Comorbidity Index (CCI) and determined its association with the disease characteristics. Patients and Methods: In this retrospective study, data of patients with SLE in Egypt were collected from the medical records. This included demographic data, clinical characteristics, comorbidities, and baseline SLE disease activity index (SLEDAI) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) scores at the last visit. The CCI score was calculated for each patient. The data of deceased patients were also collected. Results: Overall, 152 patients were included in this study. The most common comorbidities excluded from the CCI were serious infections (27%) and hypertension (23%); the most common comorbidities included in the CCI, apart from the connective tissue disease, were moderate or severe renal disease (12.5%), peptic ulcer (9.9%), and diabetes mellitus (9.9%) without end-organ damage. The mean CCI score was 1.9 and was significantly correlated with the disease duration, SLEDAI, and SDI. The death rate was 7.9%; the most common cause of death was infection (50%). Death was significantly associated with a high score of SLEDAI, SDI, and CCI. The mortality rate was higher in patients with SLE along with hypertension, renal affection, hyperlipidemia, infection, and tumors (P < 0.05). Conclusion: Patients with SLE in Egypt experienced comorbidities and high CCI scores that affected their survival.
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Papers by Sahar Khalil