Accelerated Rehabilitation after Anterior Cruciate Ligament Reconstruction: Comparison of Closed Kinetic Chain (CKC) Versus Open Kinetic Chain (OKC) Exercises, SAMIA M.H. FADDA, A.Azab Noha, Raafat Hala A., and Kholeif Ahmad M. , Med. J. Cairo Univ., , Volume 77, Issue 3, p.79-86, (2009)
Renal angiographic findings in systemic sclerosis: 'The Egyptian experience', Emad, Y., El-gohary T., Mustafa H., Bassyouni IH, and Azab NA , APLAR Journal of Rheumatology, Volume 10, Issue 1, p.43-48, (2007)
Laryngeal involvement in juvenile idiopathic arthritis patients., Abdel-Aziz, Mosaad, Azab Noha A., Bassyouni Iman H., and Hamdy Gehan , Clinical rheumatology, 2011 Sep, Volume 30, Issue 9, p.1251-6, (2011) Abstract

Juvenile idiopathic arthritis (JIA) is an autoimmune diseases characterized by chronic arthritis and systemic manifestations. Autoimmune diseases can affect the upper airways including the larynx. The aim of this study was to investigate laryngeal involvement in JIA patients and its possible association with JIA disease parameters. Fifty consecutive JIA patients were screened for laryngeal abnormalities using flexible fiberoptic laryngoscope and laryngeal computerized tomography. Laryngeal abnormalities were detected in nine (18%) of our cases, with cricoarytenoiditis in six cases (12%) and a rheumatoid nodule in the pyriform fossa in only one case (2%). Diffuse congestion and edema of the posterior part of the larynx with normal vocal cord mobility was detected in two cases (4%). In our study, laryngeal abnormalities were significantly higher in patients with polyarticular seropositive disease subtype and also were significantly higher in patients with longer disease duration, higher disease activity scores, and those with erosive disease. JIA may affect the larynx. Laryngeal involvement in JIA patients is more in polyarticular seropositive cases. JIA patients have to be subjected to thorough otolaryngologic examination for early diagnosis and prompt management.

Signal transducer and activator of transcription 4 (STAT4) G/T gene polymorphism in Egyptian systemic lupus erythematosus female patients, I.Raafat, Inas, A.Azab Noha, M.Khorshied Mervat, H.Yacoub Marium, and A.Samy Lamees , The Egyptian Rheumatologist , Volume 37, Issue 2, p.75-80, (2015)
The role of intraocular methotrexate in the management of uveitis and posterior segment involvement in Behçet’s disease patients, Khalil, Hossam Eldin M., Raafat Hala Ahmed, Azab Noha Ahmed, Haroun Hazem E., and Elgendi Heba A. , The Egyptian Rheumatologist , Volume 37, Issue 3, p.113-118, (2015)
Swallowing disorders among patients with diffuse idiopathic skeletal hyperostosis., Abdel-Aziz, Mosaad, Azab Noha, Lasheen Hisham, Naguib Nader, and Reda Ramez , Acta oto-laryngologica, 2017 Jun, Volume 137, Issue 6, p.623-626, (2017) Abstract

CONCLUSION: Diffuse idiopathic skeletal hyperostosis (DISH) is a cause of swallowing disorders in elderly, and otolaryngologists should be aware of the disease on dealing with old patients complaining of dysphagia. The condition may be treated conservatively in most patients; however, surgical reduction of cervical osteophytes may be needed in severe cases.

OBJECTIVE: Large cervical osteophytes may cause dysphagia; they compress the pharynx leading to mechanical impairment of swallowing. DISH is characterized by ossification of the anterior longitudinal spinal ligament with formation of osteophytes. The aim was to investigate swallowing disorders among patients with DISH.

METHOD: The study included 139 patients with DISH. Their swallowing was evaluated using the eating assessment tool (EAT-10), and patients with swallowing disorders were subjected to fiber-optic endoscopic evaluation of swallowing (FEES), they received conservative treatment for 6 months. Patients were assessed again after treatment using the same measures that were employed before treatment.

RESULTS: Twenty-three patients (16.5%) demonstrated swallowing disorder, and FEES showed residues of food in the pharynx after swallow in all of them. Significant overall improvement after conservative treatment was achieved, with two patients resuming their normal regular diet. However, one patient demonstrated no improvement, and he needed surgical reduction of his large cervical osteophytes.

Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms., Abdel-Aziz, Mosaad, Azab Noha, and amr el-badrawy , Current opinion in otolaryngology & head and neck surgery, 2018 Dec, Volume 26, Issue 6, p.375-381, (2018) Abstract

PURPOSE OF REVIEW: The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia.

RECENT FINDINGS: Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3-C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter.

SUMMARY: Cervical osteophytosis and abnormal cervical curvature may be overlooked by the Otolaryngologists as causes of swallowing disorders. The diagnosis is usually confirmed by radiologic study for the cervical spine. Cervical abnormality should be kept in mind while we are investigating patients with swallowing problem, and postural modification may help in treatment of such cases.

Otolaryngologic manifestations of diffuse idiopathic skeletal hyperostosis., Abdel-Aziz, Mosaad, Azab Noha A., Rashed Mohammed, and ahmed talaat , European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2014 Jun, Volume 271, Issue 6, p.1785-90, (2014) Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by formation of large cervical osteophytes that may compress the posterior wall of the aerodigestive tract. It is a rare cause of dysphagia in the elderly. The aim of this study was to investigate the various otolaryngologic manifestations of DISH. Eleven elderly patients with DISH were included in the study. All patients presented with dysphagia that was graded on the swallowing screening tool (EAT-10), and the diagnosis of DISH was based on computed tomographic criteria. The patients were subjected to otolaryngologic examination and flexible laryngoscopy. Polysomnography was used for patients with excessive daytime sleepiness for detection of obstructive sleep apnea (OSA). In addition to dysphagia of varying severity, OSA was found in nine patients, change of voice in six, globus sensation in seven, aspiration in three, and cervical pain in seven. Flexible laryngoscopy showed bulging of the posterior pharyngeal wall in all patients. DISH may be an unrecognized contributory factor to both dysphagia and OSA in the elderly. Change of voice, aspiration, globus sensation, and cervical pain are other otolaryngologic manifestations that may be encountered symptoms of the disease. An otolaryngologist should be aware of the disease that may be overlooked, and computed tomography is a confirmatory diagnostic method.

CD4+CD25+ regulatory T cells (TREG) in systemic lupus erythematosus (SLE) patients: the possible influence of treatment with corticosteroids., Azab, NA, Bassyouni IH, Emad Y., Abd El-Wahab GA, Hamdy G., and Mashahit MA , Clinical immunology (Orlando, Fla.), 2008 May, Volume 127, Issue 2, p.151-7, (2008) Abstract

Systemic Lupus Erythematosus (SLE) is a chronic, systemic autoimmune disease characterized by loss of tolerance to self-antigens. Regulatory T cells (T(REG)) are those CD4+ T cells that constitutively express high levels of CD25 and exhibit powerful suppressive properties. The aim of this work was to quantify CD4+CD25+ (T(REG)) cells and the Mean Fluorescence Index (MFI) of T(REG) in the peripheral blood of patients with SLE and to correlate these findings with their disease activity scores and drug therapy. This study included 24 SLE patients with various disease activity scores (SLEDAI) and 24 healthy age and sex matched controls. Flow cytometry was used to examine the frequency of CD4+CD25+ T cells and the MFI of CD4+CD25+(high) T cells (T(REG)). CD4+CD25+ T cells % and MFI of CD4+CD25+(high) T cells were higher in SLE patients than controls (p value=0.62 and=0.037 respectively) and both CD4+CD25+ T cell % and the MFI of CD4+CD25+(high) T cells showed highly significant correlation with SLEDAI scores (both with a p value<0.001) and were higher in patients taking glucocorticoids than those not on glucocorticoids (p= 0.023, 0.048 respectively). We conclude that the increase in T(REG) cells in our patients may be due to corticosteroid treatment.

A case of Schwartz-Jampel syndrome with cleft palate., Abdel-Aziz, Mosaad, and Azab Noha A. , International journal of pediatric otorhinolaryngology, 2009 Nov, Volume 73, Issue 11, p.1601-3, (2009) Abstract

Schwartz-Jampel syndrome is a rare inherited autosomal recessive disorder characterized by generalized myotonia, joint contractures, skeletal abnormalities and facial dysmorphism. The gene defect involves the 1p34-p36.1 region of chromosome 1. Also, one of the candidate genes for orofacial clefting is the 1p36 region. Cleft palate is the most common congenital anomaly in the head and neck. Despite both diseases share a genetic defect in chromosome 1p36 region, the association of both conditions has not yet been investigated. Feeding problems due to the presence of the cleft may add to the growth retardation that is already present in those patients, so palatoplasty is mandatory. We described a case of Schwartz-Jampel syndrome with cleft palate.

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