miércoles, 23 de febrero de 2022
Melatonin could be used for Treatment of COVID-19?
Melatonin could be used for
Treatment of COVID-19?
Rehab Mohamed Ali Mohamed (1),
Ghada Essam El-Din Amin (1,2), Salwa Mostafa Mohammad Abdel Rahman (1,3),
Mohamed Farouk Allam (1,4)*
1. Department of Family
Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2. Department of Community,
Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
3. Department of
Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams
Univer[1]sity, Cairo, Egypt
4. Department of Preventive
Medicine and Public Health, School of Medicine, University of Cordoba, Cordoba
14004, Spain
*Correspondence: farouk.allam@med.asu.edu.eg
Coronaviruses (CoVs) are a
broad family of potentially serious RNA viruses that are now causing an
outbreak of respiratory disease known as CoV disease 2019 (COVID-19). Melatonin
is a pineal hormone that is predominantly produced and released at night from the
amino acid trypto[1]phan. Melatonin and its
metabolites are also important in immunomodulation, and they have anti[1]oxidative properties due
to their capacity to scavenge reactive oxygen species both directly and in[1]directly. COVID-19 leads
to changes of altered consciousness levels in about 15% of hospitalized
patients, starting from somnolence to disorientation, delirium, stupor, and
coma. Melatonin can de[1]crease the molecules
that cause delirium in the elderly and central respiratory depression, such as
benzodiazepines and antipsychotics. Melatonin may help alleviate
infection-induced acute respira[1]tory distress as well as
its diverse effects, which include anti-inflammatory, antioxidative, and im[1]mune-enhancing
properties. Its supplemental dose may be able to prevent SARS-COV-2 infections
by reversing aerobic glycolysis via suppression of both HIF-1 and mTOR,
allowing pyruvate dehy[1]drogenase complex
activity to be suppressed and acetyl-coenzyme A to be produced. When mito[1]chondrion-produced and
parenteral melatonin are combined, the cytokine storm is reduced, and COVID-19
infection-induced damage is alleviated. In conclusion, melatonin could have an
im[1]portant role in the
management of COVID-19.
viernes, 17 de diciembre de 2021
Role of Colchicine in Management of COVID-19?
Role of Colchicine in Management of COVID-19?
Kholoud Mohamed Elawady Elhefnawy
Elshiwy (1), Ghada Essam El-Din Amin (1,2), Mohamed Nazmy (3), Rasha Samir (3),
Mohamed Farouk Allam (1,4)*
1. Department of Family Medicine,
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2. Department of Community,
Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams
University, Cairo, Egypt.
3. Department of Internal Medicine,
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
4. Department of Preventive Medicine
and Public Health, School of Medicine, University of Cordoba, Cordoba 14004,
Spain
*Correspondence:
farouk.allam@med.asu.edu.eg
DOI:
10.31586/gjeid.2022.177
Abstract:
CoV-2 disease 2019 (COVID-19)
pandemic has exerted a great burden on the health and economic systems
worldwide. One of the most important factors that affect the severity and
prognosis of COVID-19 is the occurrence of hyperstimulation of the immune
system resulting in “cytokine storm”. Similar to SARS-CoV, an intracellular
complex called nod like receptor family pyrin domain containing 3 (NLRP3)
inflammasome was found to be activated by SARS-CoV-2, then in turn stimulates
several interleukins and initiates the inflammatory cascade. In addition, other
inflammatory mediators such as interferons e.g., IFN-α, and IFN-γ, interleukins e.g., IL-1β, IL-12, IL-18, tumor necrosis
factor-α (TNF- α), and chemokines e.g., CCL2, CXCL10
have been reported in severely ill patients. These mediators represent the
corner stone in developing cytokine storm that results in uncontrolled systemic
inflammatory reaction with subsequent acute respira[1]tory
distress syndrome (ARDS), multiple organ failure and eventually death. Based on
its an[1]ti-inflammatory effects,
colchicine has also gained attention to be utilized in the management of
COVID-19 patient. Colchicine exerts its anti-inflammatory effect through
inhibition of formation of microtubules which is considered an essential step
in several cellular processes such as division, signalling, and migration.
Also, colchicine affects the cytokine cascade by inhibiting IL-1β leading to reduction in neutrophils
recruitment, free radicles production and inflammasome stimulation. This raises
the concerns about the effectiveness of colchicine in COVID-19 treatment and
the pos[1]sibility of providing an
improvement of the clinical course of the disease.
Keywords: Coronavirus, COVID-19,
Colchicine, Management, Review
Global Journal of Epidemiology and
Infectious Disease, 2022, 1, 1-3
https://www.scipublications.com/journal/index.php/gjeid/article/view/177
lunes, 15 de noviembre de 2021
The Link between Vitamin D and SARS-COV-2
The Link
between Vitamin D and SARS-COV-2
Bahaa
El-Din LM (a), Amin GE (a,b), Samir R (c), Nazmy M (c) and Allam MF (a,d*)
a.
Department of Family Medicine, Faculty of Medicine, Ain Shams University,
Cairo, Egypt
b.
Department of Community, Environmental and Occupational Medicine, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
c.
Department of Internal Medicine, Faculty of Medicine, Ain Shams University,
Cairo, Egypt
d.
Department of Preventive Medicine and Public Health, Faculty of Medicine,
University of Cordoba, Cordoba 14004, Spain
DOI:
https://doi.org/10.36266/JPDRM/107
Abstract
Vitamin
D is a fat-soluble vitamin that crosses through membranes and binds to a
specific receptor; the Vitamin D receptor (VDR). It is becoming clearer that
microbes decelerate immune reactivity by dysregulating the VDR ultimately to
increase their chance of survival, and that is why Immune[1]modulatory
therapies that enhance VDR expression and activity are considered in the clinic
today to a greater extent. Recent studies found that vitamin D supplementation
reduced the risk of acute respiratory infection. It has been shown that vitamin
D triggers innate cellular immunity, through the production of antimicrobial
peptides, such as cathelicidins, IL-37, and defensins. It also hinders the
cytokine storm, decreasing the production of pro-inflammatory cytokines such as
IFNγ and TNFα. The SARS-COV-2 outbreak rapidly spread across the world and it
has spurred a global effort to tackle the disease and to establish risk factors
and prognostic markers like for example serum vitamin D. Over the past months,
the evidence continued to grow and there’s more publications in peer-reviewed
medical journals about the possible connection between vitamin D and
SARS-COV-2. Literature about the correlation of vitamin D status in the context
of clinical outcomes of SARS-COV-2 infection is limited. Further studies are
needed to explore possible associations between Vitamin D status and disease
severity and survival in SARS-COV-2 patients.
Keywords: Vitamin
D; COVID-19; SARS-COV-2; Vitamin D receptor; IFNγ; TNFα.
Journal of Pulmonary
Disease and Respiratory Medicine 2021;1(2):1-2.
miércoles, 14 de julio de 2021
Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19
Shaimaa Hani Fouad (1),
Mohamed Farouk Allam (2), Sara Ibrahim Taha (3), Ahmed Ashraf Okba (4), Amr
Hosny (5), Mayada Moneer (1) and Sylvia Wefky Roman (1)
1. Departments of
Internal Medicine and Allergy and Clinical Immunology, Faculty of Medicine, Ain
Shams University, Cairo, Egypt.
2. Department of Family
Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
3. Department of Clinical
Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
4. Department of
Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
5. Department of
Anesthesiology and Intensive Care, Faculty of Medicine, Ain Shams University,
Cairo, Egypt.
Journal of International
Medical Research 2021;49(7):1-15.
DOI: 10.1177/03000605211030124
Abstract
Background.
Anemia can negatively affect the outcome
of many diseases, including infections and inflammatory conditions.
Aim. To compare the prognostic value of hemoglobin level
and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease
2019 (COVID-19) severity.
Methods.
In this retrospective cohort study,
clinical data from patients with laboratory-confirmed COVID-19 were collected
from hospital records from 10 April 2020 to 30 July 2020.
Results.
The proportions of patients with mild,
moderate, and severe COVID-19 differed significantly in association with
hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total
leukocyte counts. Patients with severe COVID-19 had significantly lower
hemoglobin levels than those with moderate or mild COVID-19. There were
statistically significant negative associations between hemoglobin and D-dimer,
age, and creatinine. The optimal hemoglobin cut-off value for prediction of
disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher
negative predictive value and sensitivity than NLR (92.4% and 51.3%,
respectively). The specificity of hemoglobin as a prognostic marker was 79.3%.
Conclusion.
Both NLR and hemoglobin level are of
prognostic value for predicting severity of COVID-19. However, hemoglobin level
displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon
admission in all patients and closely monitored throughout the disease course.
Keywords. Coronavirus disease 2019, hospital, anemia, neutrophil/lymphocyte
ratio, patient stratification, hemoglobin, intensive care unit, severity.
Journal of International Medical Research 2021;49(7):1-15.
https://journals.sagepub.com/doi/full/10.1177/03000605211030124
Prevalence and predictive factors for exclusive breastfeeding in the first 6 months among mothers attending Primary Health Care Centers in Cairo, Egypt
Prevalence and predictive
factors for exclusive breastfeeding in the first 6 months among mothers
attending Primary Health Care Centers in Cairo, Egypt
Zeinab Abdelhay Emara (1), Ghada Essam Eldin Amin (2), Diaa Marzouk Abdel
Hamid (2), Mohamed Farouk Allam (2)
1. Pediatrics Specialist,
International Lactation Consultant and Family Physician in Primary Health Care
MOHAP Dubai, United Arab Emirates.
2. Department of Family
Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
European Journal of Clinical
and Experimental Medicine 2021;19(2):145–152.
DOI: 10.15584/
ejcem.2021.2.5
Abstract
Introduction. Although most organizations recommend breastfeeding
for at least one year due to its well-known beneficial effects, the prevalence
of exclusive breastfeeding in many developing countries was quite low.
Aim. To identify prevalence and predictive factors
affecting exclusive breastfeeding in Primary Healthcare (PHC) Centers in Cairo,
Egypt.
Material and
methods. A cross-sectional study, among
mothers attended first six months immunization sessions in three PHC Centers
were selected via a convenient sample, A total sample of 180 mothers, 60 from
each PHC Center, were subjected to an interview questionnaire. The
questionnaire used was previously validated and pre-tested. Data collection
took the period from April to August 2019. Comparison between exclusive and
nonexclusive breastfeeding according to possible risk factors was done.
Results. The frequency of breastfeeding among the participants
was 90.6%; however the total exclusive breastfeeding frequency was only 39.4%.
Our logistic regression model showed that exclusive breastfeeding decreased
with progressive increase in infant’s age (OR 0.74), and mothers with good
knowledge about proper practice of breastfeeding adhered more to exclusive
breastfeeding (OR 2.51). Also, it showed that, during working hours, mothers
who fed their infants other than breast milk adhered less to exclusive
breastfeeding (OR 0.19).
Conclusion. The prevalence of exclusive breastfeeding is quite
low. The predictive factors for exclusive breastfeeding are, younger infant’s
age, good knowledge of the mothers about proper practice of breastfeeding, and
mothers insisting on breastfeeding during working hours.
Keywords.
breastfeeding, cross sectional, infants formula, primary healthcare, risk
factors.
European Journal of Clinical
and Experimental Medicine 2021;19(2):145–152.
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