Omar H Omar’s research while affiliated with Ain Shams University and other places

Background: Frailty as well as atherosclerotic diseases are commonly prevalent among elderly subjects and usually share both complex pathway and risk factors. Hence it was important to study if there is an association between frailty and risk factors of atherosclerosisat its early stages (subclinical atherosclerosis) using the Ankle Brachial Index (ABI), carotid intima media thickness (CIMT) and Abdominal Aortic Diameter (AAD) as markers of subclinical atherosclerosis. Material and Methods: A cross-sectional study conducted on 90 elderly participants (60-year-old and above), free of cardiovascular symptoms. They were dividedaccording to modified Fried criteria into: non-frail, pre-frail and frail groupsand they were subjected to comprehensive geriatric assessment, calculation of ABI, and radiological investigations including: carotid duplex to measure CIMT and abdominal ultrasound to measure AAD. Results: The study showed that frail participants had lower mean ABI value than non-frail group. Frail and pre-frail participants had higher maximum CIMT values than non-frail group. The mean AAD increased from 19.88 mm in the non-frail to 20.40 mm in the pre-frail group and 21.17 mm in the frail group, but this difference still not reaching a statistical significance. Conclusion: The study concluded that frailty is associated with subclinical atherosclerosis.

To evaluate the changes in subendometrial blood flow and endometrial volume after hysteroscopic lysis of severe intrauterine adhesions (IUA). (II1) it is a Pilot observational study. Classification: Forty patients with severe intrauterine adhesions were used as their own control and were included in this study only once to avoid selection bias. Endoscopy and Ultrasound unit, Ain Shams Medical School, Cairo, Egypt. Forty infertile women with severe intrauterine adhesions. Three-dimensional (3D) power Doppler ultrasound was performed in all patients one day before hysteroscopic lysis of severe IUA, and repeated one month later. ments: Assessment of subendometrial blood flow (Vascularization index (VI), Flow index (FI), vascularization flow index (VFI)) and endometrial volume. Subendometrial blood flow (Vascularization index (VI), Flow index (FI), vascularization flow index (VFI)) and endometrial volume. There was a statistically significant postoperative increase in endometrial volumes, Vascularization index (VI), Flow index (FI) and vascularization flow index (VFI). The subendometrial blood flow improved in 14 women (35%) and menstrual improvement occurred in 15 women (37.5%). Hysteroscopic lysis of severe intrauterine adhesions improves subendometrial blood flow with subsequent increases in endometrial volume. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Objectives To detect the prevalence of silent nontraumatic vertebral fractures (VFs) in patients with rheumatoid arthritis (RA) and its relation with disease duration, disease activity, corticosteroid (CS), and hip buckling ratio (BR). Patients and methods This cross-sectional study included a total of 150 RA patients. Disease activity was assessed using Disease Activity Score-28 (DAS-28). Dual-energy x-ray absorptiometry (DXA) was used to detect bone mineral density (BMD), VFs by vertebral fracture assessment (VFA), and hip BR by hip structural analysis program. Results A total of 17 (11.33%) RA patients had 27 silent VFs. Of the 17 VFs patients, 11 and six patients had single and multiple VFs, respectively. Of the 27 VFs, nine and 18 VFs had mild and moderate degree of VF. VF cases were significantly older in age (P = 0.001), had longer disease duration (P < 0.001), more active DAS-28 (P < 0.001), more cumulative CS dose, decreased spinal BMD (P = 0.02), and increased BR (P = 0.001). There were statistically significant relation between VFs and disease duration, DAS-28 and BR (P < 0.001 for all). VFs were independently associated with increased cumulative CS dose, high disease duration, and increased DAS-28 score (P < 0.001). Conclusion VFA-DXA should be performed on all RA patients. VF cases were significantly older in age, had long-standing disease duration, increased disease activity, reduced spinal BMD, increased cumulative CS dose, and increased BR. VFs were significantly related to increased disease duration, increased disease activity score, and increased BR of more than 10.

Framingham risk score (FRS) is a widely used tool to identify asymptomatic individuals who are at risk to cardiovascular disease. We aimed to investigate the association between subclinical atherosclerosis and FRS among elderly with both type 2 diabetes mellitus and healthy participants. As case-control study was done on 58 men and women, who had type 2 diabetes mellitus, and in 59 age and gender matched control participants. They were selected from a geriatric outpatient clinic at Ain Shams University Hospital, Cairo, Egypt. The carotid intima-media thickness (cIMT), clinical variables, plasma lipid profile, high-sensitivity C-reactive protein (hs-CRP) were measured for each participants. Diabetic patients had higher FRS, body mass index (BMI), fasting glucose, total cholesterol level, and LDL levels than control subjects. Mean cIMT values were higher in diabetic than healthy subjects. After multivariate regression analysis, FRS was independently associated with carotid IMT in type 2 diabetes patients after adjustment for other risk factors. However triglycerides and BMI were independently associated with cIMT among the control group. FRS is likely to be more informative about the atherosclerotic state in diabetics but not in the healthy elderly.

Objectives: the primary purpose was to compare the femoral narrow neck geometric measurements (total, trabecular, cross sectional areas and cortical thickness) and hip strength indices (buckling ratio, section modulus and hip strength index) in postmenopausal women with non-traumatic vertebral fracture against those without vertebral fracture. The secondary aim was to define the covariance between vertebral fracture and hip buckling ratio. Patients and methods: a cross-sectional case control study included 240 postmenopausal women 50 years or older, 60 with non-traumatic vertebral fracture and 180 controls. Lunar-dual energy x-ray absorptiometry was used to measure geometric properties and strength indices of the femoral narrow neck as well as bone mineral density. Results: vertebral fracture cases had significant increase in femoral narrow neck total and trabecular areas (p=0.009 and p<0.001 respectively) and had significant decrease in cross sectional area and cortical thickness (p<0.001 for both). Furthermore, vertebral fracture cases had significant decrease in hip strength indices expressed by decreased section modulus and hip strength index and increased buckling ratio (p<0.001 for all). 98.33% of vertebral fracture cases had buckling ratio >10 (versus 48.33% of controls) and this carried a risk of having fragile hips by 1.66 times the controls. Conclusions: vertebral fracture cases had significant increase in total narrow neck and trabecular areas and significant decrease in cross sectional area and thinner femoral cortices leading to increased risk of hip fragility by 1.66 times the controls when buckling ratio was taken into consideration.