Abdelalim A, El-Azizi H, El-Tamawy M, Darwish M, Taha S. The influence of physical therapy on oropharyngeal dysphagia in acute stroke patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2015;52(3):201-5. AbstractWebsite

BackgroundDysphagia occurs in 65% of acute stroke patients, resulting in airway obstruction, malnutrition, and chest infection.
Objective
The aim of this study was to evaluate the effect of a designed physical therapy program that consists of therapeutic physical exercises in addition to neuromuscular electrical stimulation on severe swallowing disorders (oropharyngeal dysphagia) in acute ischemic cerebrovascular stroke patients.
Methods
Thirty stroke patients suffering from severe dysphagia were assigned randomly to two equal groups: the study group (G1) and the control group (G2). The patients in the study group (G1) received medical treatment in addition to a designed physical therapy program mainly directed at strengthening and stimulating the elevator muscles of the larynx above and below the hyoid bone, whereas the patients in the control group (G2) were under medical treatment only. Digital fluoroscopy was used to assess the following variables: oral transit time, laryngeal elevation, hyoid elevation, esophageal sphincter opening, and aspiration or penetration. Assessment was carried out before and at the end of treatment after 6 weeks.
Results
Before treatment, there were no significant differences in different variables between G1 and G2. After treatment there was significant improvement in all variables in G1 compared with G2, as measured by digital fluoroscopy.
Conclusion
The suggested physical therapy program could be an effective and safe method for improving and restoring the normal swallowing mechanism in ischemic stroke patients suffering from severe dysphagia.

Abdelalim A, Shehata H, Sherbiny NE, Ahmed S. Knowledge and attitude towards stroke among workers in Cairo University Hospitals. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2016;53(1):54-9. AbstractWebsite

BackgroundStroke is a major cause of mortality and morbidity worldwide. Poor knowledge of stroke risk factors, symptoms and appropriate response to stroke are possible causes of poor outcome.
Objective
The aim of this study was to evaluate the knowledge and attitude towards different aspects of stroke in a sample of Cairo University Hospitals' workers.
Patients and methods
A structured self-administered questionnaire was administered by 111 workers who were classified into clinical workers (physicians, house officers, nurses, laboratory technician and pharmacists) and nonclinical workers (administrative, sanitary and security workers).
Results
Out of 111 participants, 92 completed the questionnaire. Most participants had heard of stroke (91.3%), mostly through encountering a family member with a stroke rather than through mass media (10.9%). Hypertension was the most common identified stroke risk factor (66.3%). Clinical workers were more likely to identify risk factors. The most common identified stroke symptoms were slurring of speech (38.5%) and elevated blood pressure (38.5%). Clinical workers were more likely to identify symptoms such as slurring of speech (P = 0.042) and altered state of consciousness (P < 0.001). The most frequent response to an attack of stroke was transferring the patients to a hospital (59.8%).
Conclusion
Knowledge and perception of stroke in Cairo University Hospitals' workers appear to be poor, especially among nonclinical workers. Planning educational programs for raising the level of knowledge and awareness of stroke, both on the level of hospital workers and on the public level, is important to improve stroke management and outcome.

Sayed A, Abdelalim A, Khairy H, Nagah M, Ahmed S. Is peripheral arterial disease associated with carotid artery disease in Egyptians? A pilot study. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2016;53(1):12-8. AbstractWebsite

BackgroundAtherosclerosis involves various vascular segments. The association of carotid artery disease (CAD) to peripheral arterial disease (PAD) is not well investigated in Egyptian patients.
Objective
In this pilot study, our aim was to examine the relationship between PAD and CAD in an Egyptian population.
Patients and methods
We examined 37 consecutive patients with PAD for the presence of CAD. Vascular and neurologic examination and duplex assessment of extracranial and intracranial carotid system and ankle-brachial index measurement were carried out to determine whether CAD is symptomatic or not.
Results
CAD was found in 20 (54.1%) patients. Eight (21.6%) patients had significant extracranial internal carotid stenosis and 13(37%) had intracranial stenosis and were more significantly above the age of 60 years. All patients with intracranial stenosis were men. PAD with RC6 was significantly associated with cerebrovascular events (P = 0.001) and significant extracranial stenosis (P = 0.013) and intracranial internal carotid stenosis (P = 0.001).
Conclusion
Intracranial and extracranial carotid stenoses are commonly present in patients with critical PAD. Duplex ultrasound screening for CAD presence and severity may be of great benefit, especially in the elderly and patients with critical limb ischemia. These findings need to be further confirmed in a study on larger population of Egyptians.

Talaat F, Nassef SA, El-Fayomy N, Abdelalim AM, El-Mazny AN. Arterial stiffness and carotid artery changes in multiple sclerosis. In: EFNS-ENS joint Meeting. Istanbul-Turkey; 2014.
El-Mously S, Hamdy H, Abdel-Monem A, Abdelalim AM, Sherbiny EN, Ahmed SM, et al. Knowledge and attitudes towards stroke among workers in three university hospitals in Egypt. In: World Congerss of Neuology. Vienna- Austria; 2013.
Metwally LI, El-din SE, Abdelaziz O, Hamdy IM, ElSamman AK, Abdelalim AM. Predicting grade of cerebral gliomas using Myo-inositol/Creatine ratio . Egypt J Radiol Nucl Med. 2014;45(1):211-7.
Falaky OE, Metwally LI, Abdelalim AM. Diagnostic Value of MRI CSF Flowmetry for the Diagnosis of Normal Pressure Hydrocephalus . Egypt J Neurol Psychiat Neurosurg. 2012;49(3):277-82.
Helmy S, Edward R, Abdelalim AM, Abdelbary R. The Value of Diffusion-Weighted Magnetic Resonance Imaging in Patients with Mesial Temporal Lobe Epilepsy . Egypt J Neurol Psychiat Neurosurg. 2011;48(3):305-10.
Zaki MA, Allah FA, Abdelalim AM, Abo-Krysha N, Salah M. Cerebral Hemodynamics in Hypertension: A Transcranial Duplex Study. Egypt J Neurol Psychiat Neurosurg. 2011;48(3): 277-84.
Talaat FM, Fahmy E, Abdelalim AM, Ahmed SM, Sabbah A. Effect of Age, Sex, Body Mass Index and Smoking on Carotid Intima Media Thickness in Normal Egyptian. Egypt J Neurol Psychiat Neurosurg. 2011;48(2):191-8.