Ehab Mahgoub

Ehab Mahgoub
Pfizer

About

54
Publications
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1,752
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Publications

Publications (54)
Conference Paper
Background Biologic therapy has improved RA management, enabling some patients to achieve remission. Many clinicians decrease the biologic dose for patients in low disease activity (LDA) or remission. However, it is unclear which patients may flare and if flare contributes to radiographic progression. Objectives To assess whether patients who flar...
Poster
Full-text available
Switching to Biosimilars in Rheumatology: Evidence-Based Practice Moots R,1 Azevedo VF,2 Dörner T,3 Mysler E,4 Scheinberg M,5 Coindreau JL,6 Mahgoub E,6 Marshall L6 1. University of Liverpool, Liverpool, UK 2. Federal University of Parana and Edumed Health Research Center and Biotech, Curitiba, Brazil 3. Department Medicine, Rheumatology and Clinic...
Article
Background The term “intended copy” (IC) is used to describe biotherapeutic medicinal products that have not been approved via a regulatory pathway aligned with WHO's Similar Biotherapeutic Product (SBP) guidelines to ensure quality, safety and efficacy. In some countries, the WHO SBP guidelines are not being consistently adopted or implemented and...
Article
Full-text available
Mycetoma can be caused by bacteria (actinomycetoma) or fungi (eumycetoma) and typically affects poor communities in remote areas. It is an infection of subcutaneous tissues resulting in mass and sinus formation and a discharge that contains grains. The lesion is usually on the foot but all parts of the body can be affected. The causative microorgan...
Article
Background Implementing a treat-to-target (T2T) strategy can require complex therapeutic adjustments to achieve remission or low disease activity (LDA) in rheumatoid arthritis (RA). Management guidelines and evidence from clinical trials with rigid eligibility/treatment protocols may be of limited usefulness in real world practice. Moreover, biolog...
Article
Background Tumor necrosis factor (TNF) inhibitors, including etanercept (ETN), have demonstrated efficacy in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and an inadequate response to NSAIDs. However, not all patients respond to TNF-inhibitors. Thus, it is of interest to determine whether responders and non-responders have diff...
Article
Full-text available
Psoriasis prevalence and characteristics in Asia, Central Europe, and Latin America have not been thoroughly investigated and there are no large trials for biologic treatments for patients from these regions. The goal of this analysis was to report clinical response to anti-tumor necrosis factor-alpha treatment in these patients. Patients from Arge...
Article
Full-text available
Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the b...
Article
Full-text available
This communication reports on the Mycetoma Research Centre of the University of Khartoum, Sudan experience on 6,792 patients seen during the period 1991-2014.The patients were predominately young (64% under 30 years old) males (76%). The majority (68%) were from the Sudan mycetoma belt and 28% were students. Madurella mycetomatis eumycetoma was the...
Article
Full-text available
Patients with mycetoma usually present late with advanced disease, which is attributed to lack of medical and health facilities in endemic areas, poor health education and low socio-economic status. With this background, an integrated patient management model at the village level was designed to address the various problems associated with mycetoma...
Article
Full-text available
Treatment of mycetoma depends on the causative organism and since many organisms, both actinomycetes (actinomycetoma) and fungi (eumycetoma), are capable of producing mycetoma, an accurate diagnosis is crucial. Currently, multiple diagnostic tools are used to determine the extent of infections and to identify the causative agents of mycetoma. These...
Article
Full-text available
Abstract Eumycetoma is a chronic progressive disabling and destructive inflammatory disease which is commonly caused by the fungus Madurella mycetomatis. It is characterized by the formation of multiple discharging sinuses. It is usually treated by antifungal agents but it is assumed that the therapeutic efficiency of these agents is reduced by the...
Article
Full-text available
Objective: To determine the prevalence of diabetic peripheral neuropathic pain (DPNP) among South African adults with type 1 or type 2 diabetes. Methods: This cross-sectional study recruited patients with diabetes from 50 institutional/private clinics. DPNP was diagnosed using Douleur Neuropathique 4 (DN4) questionnaire (score ≥4). Health-relate...
Article
Full-text available
Eumycetoma is a chronic progressive disabling and destructive inflammatory disease which is commonly caused by the fungus Madurella mycetomatis. It is characterized by the formation of multiple discharging sinuses. It is usually treated by antifungal agents but it is assumed that the therapeutic efficiency of these agents is reduced by the co-exist...
Article
Background Whilst studies addressing the burden of rheumatoid arthritis (RA) in both developed and developing countries have been published, there is limited information available comparing these environments. Objectives To evaluate and compare the burden of RA in developed and emerging countries. Methods Data were analysed from the 2011 and 2012 N...
Article
Full-text available
The study was done to characterize at the species level Mycobacterium spp. isolates from Yemeni pulmonary tuberculosis patients. Early-morning sputum samples were collected from 170 patients referred to the National Tuberculosis Institute in Sana'a city with suspected pulmonary tuberculosis. Samples were processed with Ziehl-Neelsen stain and cultu...
Article
Full-text available
Mycetoma is a major mycological health problem in many tropical and subtropical areas and Sudan is considered the mycetoma homeland. In the Sudan, Mycetoma is endemic in Central, and Western parts of the country. It affects different ethnic groups with evidence of familial trends. The frequency of HLA-DRB1 and HLADQB1 alleles in Sudanese patients w...
Article
Full-text available
The blood supply to the mycetoma lesion and its vasculature were studied in patients with various types of mycetoma using histological, ultrastructural, angiographic and sonographic techniques. The mycetoma lesion proved to be well vascularized. However, certain vascular abnormalities were demonstrated. In histological sections, the small arteries...
Article
The ultrasonographic appearance of mycetoma is described in this prospective study. One hundred patients with foot swellings had sonographic evaluation of the swelling and surgical excision within 2 weeks of ultrasonography. The histopathological findings were compared with the preoperative images. Some of the excised swellings and grains were also...
Article
This paper reports 2 hitherto undescribed complications of mycetoma, urinary extravasation and expectoration of mycetoma grains due to cutaneo-urethral and cutaneo-pleuro-bronchial fistulae, respectively. The first patient had an infection with Actinomadura madurae which started in the foot and had spread progressively to involve the whole limb, an...
Article
Full-text available
Thyroid function was assessed in seventy two patients with various types of mycetoma. There was no evidence of clinical or biochemical thyroid dysfunction in these patients. The symptoms encountered in some of the mycetoma patients mimic those of hypothyroidism should be attributed to other factors possibly mental depression and apathy.
Article
Full-text available
In this prospective study, three types of tissue reaction to mycetoma grains are described. Type I reaction is characterized by the adherence of neutrophils to the surface of the grain leading to its disintegration. In Type II reaction, the fragmented grain and the dead neutrophils are cleared by macrophages and multinucleated giant cells, while in...
Article
Full-text available
This is the first report on the fine structure of Actinomadura pelletieri. The in vitro ultrastructure of the organism and that of the grain in vivo were similar. The grain consisted of packed filaments with a faintly electron-dense matrix in between. The individual filament was septate, the cytoplasm was either vacuolated or contained intracellula...
Article
Full-text available
Three cases of abdominal wall mycetoma in Sudan, caused by Streptomyces somaliensis, presenting as renal and retroperitoneal masses and a desmoid tumour, respectively, are reported.
Article
Paranasal Aspergillus granuloma is an invasive infection, seen mainly in tropical countries, involving the paranasal sinuses, orbit and brain. Previously surgical excision has been followed by a high relapse rate, 80% in some series, and mortality. This study involved the use of post-operative therapy with oral itraconazole in doses of 200–300 mg d...
Article
Ten Streptomyces somaliensis strains isolated from mycetoma patients were tested in vitro against 13 antibacterial agents. Rifampicin was the most effective antibiotic in terms of low minimum inhibitory concentration (MIC) followed by erythromycin, tobramycin, fusidic acid and streptomycin sulphate. The S. somaliensis strains were all resistant to...
Article
Levels of antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 13 patients with eumycetomas due to Madurella mycetomatis infections. Raised levels of specific IgM were observed in 12 patients, compared with normal human controls. By contrast, low levels of specific IgG were detected in some patients. Specific responses to sepa...
Article
This study compares the in vitro ultrastructure of Streptomyces somaliensis with the grain formation seen in vivo. Cultured forms were cocco-bacillary with thick cell walls and septa. Individual cells stained with PAS.TCH and Alcian blue. Grains were largely composed of an electron-dense fibrillar matrix surrounding clear areas, some of which conta...
Article
Full-text available
A case of mycetoma of the mandibular region caused by Actinomadura madurae is presented. Diagnostic procedures and rationale for treatment are discussed. In tropical and subtropical areas where mycetoma is endemic it should be included in the differential diagnosis of tumours of the facio-maxillary region.
Article
The differences in the fine structure and antigenic determinants of mycetoma fungi in the mycelial phase in vitro and in grains in vivo facilitate an interpretation of grain formation. Aggreagates of hyphal elements with multiple and thickened walls was a feature of the fungi in vivo. Associated with hyphal wall material, numerous polysaccharide mi...
Article
Cranial mycetoma is not as rare as was believed. In the Sudan, the majority of cases are caused by S. somaliensis; no cases were found to be caused by Nocardia species. Cranial actinomycetoma proved to be potentially fatal and was the most difficult to treat. The best treatment results were achieved in cases of A. madurae infection.
Article
Eumycetoma is, at present, treated only by surgery which is amputation at times and mutilating excision at others. Surgical treatment is often followed by local, or rarely distant recurrence to regional lymph nodes and surrounding tissue. The results of the clinical trial with ketoconazole reported in this paper show that five of 13 patients were c...
Article
Bovine demodicidosis, caused by Demodex folliculorum var. bovis, was diagnosed for the first time in the Sudan; it occurred in 10% of 10 000 cattle surveyed in Kordofan Province. A new technique is described for the isolation of this mite. Other mange mites responsible for severe skin lesions were Sarcoptes scabiei var. cameli (camels) and S. scabi...
Article
Naturally occurring mycetomas were found in 3 goats. Two had mycetomas on their hind legs and the third on its left scapula. In 2 goats the causative agents were identified by culture, histopathology and serology as Actinomadura madurae. In the remaining goat diagnosis was based only on histopathology and the causative agent was considered to be A....
Article
Experiments with athymic nude mice "nu nu" strain showed grains of Madurella mycetomi as early as 9 days, and they were well developed by 21 days, after inoculation. Grains were similar to those of humans, in pigment production and tissue reaction.
Article
Mycoses in the Sudan are still significant and, as well as mycetoma, there are a number of fungal diseases: paranasal aspergillus granuloma, which came into eminence in 1966; actinomycosis; subcutaneous phycomycosis; systemic phycomycosis; post-operative opportunistic infection of the eye with Trichosporon cutaneum and rhinosporidiosis. Mycetoma an...
Article
Mycetoma patients were investigated for cell-mediate immunity by means of the tuberculin test, DNCB sensitization and lymphocyte transformation induced by phytohaemagglutinin. Levels of immunoglobulins, IgG, IgM and IgA were also determined. Results seem to point towards deficiency in cell-mediated immunity at least partial if not whole. There was...
Article
Dermatophilus congolensis was isolated in culture from 36 of 39 field cases of streptothricosis in cattle in the Sudan. The morphological and cultural characteristics and the in vitro sensitivity of the organism to antibiotics are outlined. The lesions were characterised by thick scab, degeneration of the epidermis and a granulomatous reaction in t...
Article
A severe outbreak of ringworm among thirty, 6–12 months old calves, is described. The causative agent was identified as Trichophyton verrucosum on (a) the appearance of the lesions, (b) the demonstration of large characteristic ectothrix arthrospores 2–7 μ. in diameter in skin scraping and (c) the heavy infection of hair follicles with mycelia and...
Article
Counterimmunoelectrophoresis used for the diagnosis of mycetoma was found superior to immunodiffusion (ID) especially when using neat serum and 1:2 dilution (P=less than 0.0001 with neat serum; and less than 0.01 with 1:2 dilution). It is recommended for routine use in mycology laboratories for following up patients on treatment and for confirming...
Article
Locally applied clotrimazole (Canesten) proved to be effective in the treatment of dermatophytosis. It was also effective but to a lesser degree in cases of Onychomycosis mostly due toCandida albicans. The drug was well tolerated.
Article
Microsporum canis infection, seldom reported in calves, is described. The organism was isolated from skin scrapings collected from ringworm lesions mainly on the heads of 2 naturally infected calves. The organism was studied in vitro, and experimentally on guinea-pigs.
Article
A case of mycetoma of the mandible caused by Madurella mycetomii is reported. Diagnosis was established by culture, histopathology and serology.
Article
Four cases of mycetoma are described from the Sudan. The first is an authentic case due to Curvularia lunata. The others were due to Madurella grisea, Aspergillus nidulans and Nocardia brasiliensis. Quatre cas de mycétome en République Démocratique du Soudan sont décrits. Le premier d'entre eux est un cas authentique causé par Curvularia lunata, le...
Article
CF antibodies are demonstrated in 83 sera from 25 patients, with mycetoma due to Streptomyces somaliensis. The level of CF antibodies was of diagnostic significance and results are comparable to those obtained with immunodiffusion test (ID). In the follow up of patients, CFT readings conformed with the clinical condition of the patient, i.e. droppe...
Article
Lymphatic spread of mycetoma agents to regional lymph nodes with consequent enlargement is reported in 13 cases. 9 of these were due to Streptomyces somaliensis, 3 Madurella mycetomi and 1 to Nocardia species. Fungal grains were seen inside lymphatic tissue. The pathological changes of lymph nodes involved in mycetoma are described.

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Archived project
diagnosis, treatment and epidemiology