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Zekri, W., Yehia D., ElShafie M., Zaghloul M. S., El-Kinaai N., Taha H., et al. (2015).  Bilateral Clear Cell Sarcoma of the Kidney. Journal of the Egyptian National Cancer Institute. Abstract

Clear cell sarcoma of the kidney (CCSK) accounts for 2-5% of all pediatric renal malignancies, which is known for its probability to metastasize to bone and other sites. We are reporting two cases with bilateral CCSK that were diagnosed at our institution. One patient initially presented with bilateral renal masses, as well as pulmonary, hepatic and bone metastasis; while other present only with bilateral masses with no evident distant metastasis. Both patients received aggressive neo-adjuvant chemotherapy to decrease tumor size. One patient completed his designated treatment and initially showed complete remission (CR); eventually suffering from relapse. The other patient's tumor progressed during the course of chemotherapy. Both cases manifested brain dissemination at the time of relapse or progression. This emphasizes the importance of staging stratification in CCSK. This also illustrates CCSK's ability to metastasize to bone and other sites including the brain (a primary relapse site in our cases).

Alfaar, A. S., Zamzam M., Abdalla B., Magdi R., & El-Kinaai N. (2015).  Childhood Ewing sarcoma of the orbit. Journal of pediatric hematology/oncology. Abstract

In the span of the last 48 years, only 16 cases of children with orbital Ewing’s sarcoma have been reported. This study is to present 3 cases that were admitted to Children's Cancer Hospital Egypt 57357, during the period from 2009 to 2013. We have Two cases were treated using the hospital standard Ewing’s sarcoma treatment protocol, to completion, while the third discontinued treatment. All tumors have confirmed CD99 positivity while translocation (11;22) was positive in one patient and negative in the third. With earlier diagnosis and adequate surgical resection and integration of chemo- and radiotherapy one patient survived for about four years, while the other two cases died due to disease progression or recurrence.

ElZomor, H., Taha H., Aleieldin A., Nour R., Zaghloul M. S., Fawzi M., et al. (2015).  High Risk Retinoblastoma; prevalence and success of treatment in developing countries. Ophthalmic Genetics. Abstract
Taha, H., Amer H. Z., El-Zomor H., Alieldin A., Zekri W., ElNadi E., et al. (2015).  Phthisis Bulbi: Clinical and Pathologic Findings in Retinoblastoma. Fetal and Pediatric Pathology. Abstract
Samir AlFaar, A., Kestler H. A., & Rodriguez-Galindo C. (2014).  Ordinal Classification of Pediatric Tumor Samples. Abstract


Alfaar, A. S., Bakry M. S., Kamal M., Ezzat S., Zaky I., Taha H., et al. (2014).  Accelerating Innovation in Outcomes and Quality of Care Research Through Integration of Clinical Databases; Pediatric Oncology Experience in Egypt. American Society of Clinical Oncology. Abstract

Background: Children’s Cancer Hospital -Egypt was established to serve as the country major referral center. Within 6 years the hospital has received 13,865 patients with cancer among 19,744 screened ones. With this rapidly growing number the hospital looked for developing a reliable method for examining the quality of care and supporting health services research as an emerging field in the country. The aim of this paper is to describe the role of integrating several databases in providing a 360 view for healthcare picture. Methods: We have developed an online cancer registry database using RedCap data capture system to gather patients data from different sources. This database was integrated with the electronic medical records to share new patients data instantaneously. Two nurses were trained to curate the database daily and act as human quality control gateway. Cancer registry provided data about 19,927 patients were examined between 2007 and 2013. The second aspect was provided by digitizing and Optical Character Recognition of 12,573 pathology paper-based reports. Pathology reports were analysed electronically to extract dates, initial and final diagnoses, gross and microscopic pictures and markers used for diagnosis. A third aspect was added to the model by mining Radiology Information System database to extract 258,632 studies for all patients. Radiological studies were organized to show the type of investigation, time needed and outcome. Results: A unified comprehensive new database was developed showing uncountable number of quality of care indices and correlations between different initial and final timepoints. Those indicators included delay of diagnosis, reporting and difference in outcomes correlated with epidemiological aspects. The time used to develop this database was two weeks in the first time. A standard operating procedures was developed to decrease time during future updates. Conclusions: Accelerated pathway to research can be acquired in any settings including unprivileged low-middle income countries via structured reporting, integration between different databases and using simple information technology skills.

Zekri, W., Hammad M., ElBoraie Y., Taha H., Refaat A., AlFaar A. S., et al. (2014).  Adrenocortical Carcinoma In The Pediatric Age Group; Experience At Children Cancer Hospital Of Egypt (CCHE). American Society of Pediatric Hematology/Oncology. Abstract
Ezzat, S., Labib R., Mostafa M., Alfaar A. S., Sabry M., Shaaban K., et al. (2014).  Building a State of Art Biorepository in a Limited Resource Country. . The International Society for Biological and Environmental Repositories Annual Meeting. Abstract
Alfaar, A. S., Bakry M. S., & Ezzat S. (2014).  Childhood Orbital, Ocular and Optic nerve tumors in Egypt . ARVO Annual Meeting 2014. Abstract

Purpose: Our aim is to study the incidence of different ocular, orbital and optic nerve tumors in childhood age group (between 0-18 years old) in the largest Egyptian pediatric oncology referral center and correlate the features of each disease and its survival outcomes.

Methods: Institutional cancer registry database was reviewed for patients who presented with orbital tumors as a primary site of involvement between July 2007 and November 2013. REDCap (Research Electronic Data Capture) system was used for data collection and organization. Integration between clinical information system and RedCap was established for real-time registry updating. Relevant ICD-O-3 topography codes were used to identify the sites. Data were presented in terms of frequencies and percentages. Other demographic properties were presented. Survival was demonstrated using kaplan-meier curves.

Results: Among 7277 patients presented with different childhood tumors 425 had the mentioned lesions. Males were affected more than females. Retinoblastoma, Astrocytomas of optic nerve and Rhabdomyosarcoma of orbit were the most frequent tumors. Mean age of retinoblastoma cases was 1.4 years while it was higher in other diseases except germ cell tumors. We've presented correlations of our findings with the current Egyptian population-based cancer registry and previous results from Cancer in five continents report. Overall Survival of Retinoblastoma was 95.4% while it was better in Germ cell tumors and less in all other tumor categories. Orbital bones masses were hard to identify due to the broad classification in current ICD-O topography coding.

Conclusions: Childhood orbital tumors distribution was similar to international publications except increased incidence of orbital lymphomas. Special attention should be paid to updating the ICD-O classification system to present different skull bones

Zekri, W., Alfaar A. S., Yehia D., Elshafie M. M., Zaghloul M. S., El-Kinaai N., et al. (2014).  Clear Cell Sarcoma of the Kidney; Patients’ Characteristics and Improved Outcome in Developing Countries. .. Pediatric Blood and Cancer.. 61(12), 2185-2190. Abstract

BACKGROUND: Clear cell sarcoma of the kidney (CCSK) is a rare and aggressive tumor accounting for 5% of pediatric renal tumors with an incidence of 20 patients per year in the USA. It is bone metastasizing with poor prognosis. Our aim was to show characteristics of patients in relation to improved outcome in one of the developing countries. PROCEDURE: We included all patients diagnosed as CCSK in the period between July 2007 and March 2012 at Children's Cancer Hospital, Egypt. Patients' demographics, clinical presentation, pathology, and management were reviewed. Follow up was continued until April 2013. RESULTS: Twenty-five patients were identified in the defined time interval, accounting for 7% all renal tumors diagnosed at the hospital. Mean age was 36 months. Abdominal swelling and hematuria were the most common presentations. Stages I, II, III, IV, and V represented 9 (36%), 3 (12%), 8 (32%), 3 (12%), and 2 (8%), respectively. Twenty-four patients had radical nephrectomy either upfront or after neo-adjuvant chemotherapy. Surgery was followed by adjuvant chemotherapy. Abdominal radiotherapy was given for local stages II and III. Twenty-two patients reached complete remission, while one patient had stationary disease and two patients died due to progression and relapse. Overall survival was 88.5% and event-free survival was 87.8% at 45 months. CONCLUSION: Although previous studies indicate poor prognosis of CCSK, our experience shows that those patients can be treated using extensive chemotherapy combined with proper local control. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.

AlFaar, A. S., & Labib R. (2014).  eBanking of what really matters; Children’s Cancer Hospital-Egypt experience in electronic management of BioBanks.. Conference on Cancer Biobanking “Establishing the First Cancer Biobank in Jordan”.. Abstract
Amgad, M., & Alfaar A. S. (2014).  Integrating Web 2.0 in Clinical Research Education in a Developing Country.. Journal of cancer education : the official journal of the American Association for Cancer Education. 29(3), 536-540. Abstract

The use of Web 2.0 tools in education and health care has received heavy attention over the past years. Over two consecutive years, Children's Cancer Hospital - Egypt 57357 (CCHE 57357), in collaboration with Egyptian universities, student bodies, and NGOs, conducted a summer course that supports undergraduate medical students to cross the gap between clinical practice and clinical research. This time, there was a greater emphasis on reaching out to the students using social media and other Web 2.0 tools, which were heavily used in the course, including Google Drive, Facebook, Twitter, YouTube, Mendeley, Google Hangout, Live Streaming, Research Electronic Data Capture (REDCap), and Dropbox. We wanted to investigate the usefulness of integrating Web 2.0 technologies into formal educational courses and modules. The evaluation survey was filled in by 156 respondents, 134 of whom were course candidates (response rate = 94.4 %) and 22 of whom were course coordinators (response rate = 81.5 %). The course participants came from 14 different universities throughout Egypt. Students' feedback was positive and supported the integration of Web 2.0 tools in academic courses and modules. Google Drive, Facebook, and Dropbox were found to be most useful.

Labib, R., Mostafa M., Samir A., Alfaar S. E., & Abouelnaga. S. (2014).  Omics-Ready Bio/Data Repository For Childhood Cancers in Egypt.. The International Society for Biological and Environmental Repositories Annual Meeting.. Abstract
Hassan, W. M., Alfaar A. S., Bakry M. S., & Ezzat S. (2014).  Orbital tumors in USA: Difference in survival patterns.. Cancer epidemiology. 38(5), 515-22. Abstract

INTRODUCTION: There is a wide range of tumors affecting the orbital adnexa. Key such tumors include lymphomas, carcinomas, melanomas and rhabdomyosarcomas. Several studies have proposed that these histological subtypes differ in their survival outcomes. In this study we aim to describe the difference in survival outcomes between such subtypes. METHODS: The SEER database was used to gather patient information. All 18 SEER registries were used. Patients diagnosed from 1996 to 2005 were included in the analysis. Observed five-year survival rate was calculated using the SEER*Stat software version 8.1.2. Data were extracted into IBM SPSS version 20 to generate Kaplan Meier curve for each group. RESULTS: There were 2180 patients in the SEER databases who met the selection criteria. Lymphomas were the most common histology in adults. The overall five-year observed survival for all lymphoma patients was 75.9% (95% CI: 73.7-78.1). There was statistically significant difference between observed survival rates of lymphoma subtypes. Carcinomas were the second most common tumors. Their five-year observed survival rate in our study was 60.4%. There was no statistically significant difference between carcinoma subtypes' observed survival rates in the 20-49 age group, while, in the older age group, the difference was found to be statistically significant. Rhabdomyosarcomas were the most common tumors in children. The overall five-year observed survival rate for rhabdomyosarcomas patients was 89.8%. There was no statistically significant difference between observed survival rates of rhabdomyosarcomas subtypes. There was no statistically significant difference between relative survival rates according to gender and treatment received except within melanomas. CONCLUSION: In adults, lymphomas have better survival rates than carcinomas. Whereas the lymphoma subtype can be used as a determinant prognostic factor in any age, the carcinoma subtype can be used as such a determinant in older age groups only. In children, rhabdomyosarcomas are the predominant tumors affecting the orbital adnexa. Further studies are needed to determine if the difference between embryonal rhabdomyosarcoma and alveolar rhabdomyosarcoma observed survival rates are statistically significant.

Alfaar, A. S., Labib R., Ezzat S., Mostafa M., Taha H., & Abouelnaga S. (2014).  Telepathology to Improve Collaboration and Quality of Samples Annotation in Biorepository. . ISBER Annual Meeting. Abstract

Background: Telemedicine is the field of using information and communication technologies for facilitating diagnosis and treatment at distance. Using such disciplines in pathology has started long time ago with using closed TV circuits between teams. We’ve piloted the integration between caTissue open source biorepository suite and our telepathology system to facilitate verifying the diagnosis of stored and released samples. Methods: We have used LeicaTM telepathology system to produce digital formats for pathology slides of samples sent for biobanking. The diagnosis of scanned sets was discussed with our partners in US. We had implemented caTissue biorepository suite for handling the samples data including annotation. We’ve piloted using both caTissue 1.2 and caTissue plus 3.0 systems for integration with shared slides and reports. Results: Ninety-four tissue samples have been collected and stored . 109 slides/samples have been digitized for archival and assisting later annotation . Samples have been shared with our partners for discussion. H&E and biomarkers-labeled studies was used. New caTissue Plus 3.0 has proven more flexibility in sharing the annotations and reviewing the online slides. Conclusions: Telepathology has provided a new dimension for annotating sampled specimens giving an opportunity for researchers to discuss the cases without the need to get the physical samples.

Alfaar, A. S., & Nour R. (2014).  What a reference manager can add for a physician in web 2.0 era. The Egyptian Journal of Cardiothoracic Anesthesia. 8(2), 55. Abstract
Alfaar, A. S., Nour R., Kamal M., Ezzat S., & Bakry M. S. (2013).  Automating clinical protocol monitoring: a model from developing countries.. European Multidisciplinary Cancer Congress. Abstract
Zekri, W., AlFaar A. S., Yehia D., ElShafie M., Saad Zaghlol M., Taha H., et al. (2013).  Clear Cell Sarcoma of The Kidney. European Multidisciplinary Cancer Congress. Abstract
Alei Eldin, A., Haddad A., Elzomor H., Medhat Y., Taha H., Saad M., et al. (2013).  Evaluation of Retinoblastoma management in the first Multidisciplinary system in the Cancer children hospital in Egypt. International Society of Ocular Oncology Meeting. Abstract

Purpose: To evaluate the success of ocular survival following chemoreduction and efficency of local treatment in the management of Retinoblastoma in the first multidisciplinary system for the treatment of childhood cancer in egypt Methods: A total number of 262 retinoblastomas cases managed between July 2007 to December 2012 with six cycles of chemoreduction (vincristine, etoposide, and carboplatin (COG protocols). The tumors were then managed with local treatment alone (group A) or chemoreduction combined with , cryotherapy or Diode laser (group B and C) and some cases of group D. In addition to enucleation for group E and advanced cases . Results: Of 262 retinoblastomas cases , (0.9%) were in group A, (8.4%) in group B, (11.7%) in group C, (44.4%) in group D,and (33.6) in group E. The mean age at presentation is 21.17 months .Bilateral affection was in 43% and unilateral in 57%. Family history of cancer was 11% and consangunity was positive in 19%. Extraocular involvement was in 18% of cases . Incidence of ocular survival for bilateral cases was 95% in group A ,80% in group B 45% in group C and 35% in group D ,while in unilateral cases it was 80%in group B ,50% in group C ,15% in group D . Conclusions: There is no doubt that the application of different treatment modalities among a multidisciplinary system in the treatment of retinoblastoma in the cancer children hospital gives a very good percentage of success despite the relatively late presentation and the higher incidence of advanced cases Financial disclosure: There is no financial disclosure Paper

Elzomor, H., Nour R., Alfaar A. S., Alei Eldin A., Zaghloul M. S., & Taha H. (2013).  High Risk Histopathologic features of Retinoblastoma in Egypt. International Society of Genetic Eye Diseases and Retinoblastoma meeting.. Abstract

Introduction / Purpose: Retinoblastoma is the most common intraocular malignancy of infancy and early childhood. In developing countries the decreased access to health care poses a major challenge and increases the possibility of extra-ocular dissemination. Surgical pathological examination aim at discerning histopathological features that pose a higher risk for extraocular spread and are indicative of a need for adjuvant therapy. Our aim is to study the prevalence of histopathological high risk features amongst the enucleated eyes, measure the Event- free survival (EFS) in those patients and compare the EFS in two groups 1) the ones who received adjuvant chemotherapy, 2) the ones who did not. Materials & Methods: We retrospectively analyzed patients who were presented to Children’s Cancer Hospital - Egypt 57357 between July 2007 and April 2012. Only unilateral cases were included in the study. Pathological examination of the enucleated eyes was conducted for all cases. Pathologists were trained for detection of high risk features. Designated high risk features included massive choroidal invasion, retrolaminar invasion or any degree of combined choroidal with optic nerve invasion. Patients were followed up till June 2013. Results: During the period from July 2007 to end of April 2012 a total of 219 patients presented to CCHE-57357 with retinoblastoma. Only 40 patients had unilateral retinoblastoma and had undergone enucleation and their pathology reports revealed high risk features.Three patients have been histopathologically diagnosed with extra-ocular retinoblastoma. Conclusions / Significance: Introducing adjuvant chemotherapy for our cases has improved event-free survival. Only followup with no adjuvant treatment is sufficient for patients with no high risk features. Training pathologists in developing countries on detection of high risk features is a cost-effective measure for improving retinoblastoma integrated management.

Shohdy, K. S., & Alfaar A. S. (2013).  Nanoparticles targeting mechanisms in cancer therapy: current limitations and emerging solutions.. Therapeutic delivery. 04(09), 1197-209. Abstract

It has been more than one century since Paul Ehrlich spoke about the idea of targeting specific molecules in the cell when he coined the 'Magic Bullet' principle. In most occasions, we seek new pharmacodynamic models for therapy, but nanoparticles provide a chance to modify the already existing pharmacokinetics of drugs to meet needed pharmacodynamic models. In the scope of 'nanoscale', every entity has different characters, and no general rules control pharmacokinetics of nanoparticulate drugs as new physical and physicochemical properties are added to equations. However, such remarkable drug models are still quite far from achieving their potential in clinical application. Among the major obstacles is that most available results in nanoparticles targeting rely upon in vitro and animal models that do not match the tumor environment characteristics in humans. This Review discusses the concept of targeting tumor cells with nanoparticles, the limitations that lead to its incomplete application in clinical practice along with some of the promising solutions to such limitations.

Taha, H., Elzomor H., Alei Eldin A., Elhaddad A., Nour R., Zaghloul S. M., et al. (2013).  Pathological findings of Retinoblastoma in Egypt; implementing CAP protocol in developing countries.. International Society of Genetic Eye Diseases and Retinoblastoma meeting.. Abstract

Introduction / Purpose: Retinoblastoma is the most common intra-ocular tumour of childhood. Radiotherapy and chemotherapy has improved survival for the disease over the last 40 years. Looking for prognostic criteria is one of the major research areas that inspires disease management teams all-over the world. Many protocols were designed over the years to correlate the presence of certain pathological and/or molecular features and prognosis of the disease. Children’s Cancer Hospital Egypt 57357 (CCHE) is a new cancer center in Egypt that serves about 25-40% of the pediatric oncology population in the country. The aim of this study is to present the histopathological findings in Egypt leading pediatric oncology center and impact of implementing CAP protocol on the improvement of patient care. Materials & Methods: CCHE Retinoblastoma study team implemented College of American Pathologist (CAP) protocol of Retinoblastoma version 3.0 (Based on AJCC/UICC TNM, 7th edition) for examining enucleation specimens. Pathology team has conducted an internal training for pathologists. New electronic case report forms (eCRFs) were designed for reporting the progress. Real-time online statistical analysis system was integrated with eCRFs. Implementation included prospective processing and data entry of new specimens properties beside revising of all specimens prior to the implementation of the protocol. Healthcare quality measures included required time for releasing the reports. Results: Between July 2007 and May 2013 we’ve examined 198 enucleation specimens. Mean of all ocular diameters was 22.2 mm. Mean Optic nerve stump length was 6.35 mm. Invaded structures included Cornea (5.3%), Anterior chamber (15.4%), Iris (8.3%), Lens (5.9%), Ciliary body (18.3%), Choroid, (72.2%), Sclera (17.2%), and Orbital tissue (7.1%). Any degree of Optic Nerve invasion was noted in 51% of specimens while surgical margin was involved in 10.8%. Validation rules in eCRFs helped the team to complete missing data and provide systematic reporting. Integrated online analysis system provided a real-time reporting facility for detecting protocol implementation progress. Conclusions / Significance: Implementing CAP retinoblastoma protocol resembled a roadmap for improving patients’ care. It supported the systematic reporting of cases, decreasing errors and missing data and provided research informatics team with a blueprint for developing a real-time monitoring system. This system can be integrated in the practice of emerging teams to ensure adherence to quality measures.

Elzomor, H., Nour R., Alfaar A. S., Alei Eldin A., Zaghloul S. M., Taha H., et al. (2013).  Presentation Of Extra-Ocular Retinoblastoma In Egypt. International Society of Genetic Eye Diseases and Retinoblastoma meeting.. 71. Abstract

Introduction: Extraocular Retinoblastoma is a disease of developing countries. It represents a challenge for oncologists with its poor prognosis and resistance to chemotherapy. There is a major discrepancy in reporting its incidence between developing and developed world. Egypt represents the third most populous African country, hence, establishing Childrenâ?Ts Cancer Hospital Egypt 57357 (CCHE) -­a non for profit institute-­ represents a hope for childhood cancer patients in Egypt and the middle-­east. The aim of this paper is to report the magnitude of the disease and presenting features of extraocular retinoblastoma in Egypt over the last 6 years. Materials & Methods: We reviewed all the cases that were presented with extraocular retinoblastoma to our center between July 2007 and December 2012. This included ISGEDR 2013 72 reviewing clinical, radiological and pathological investigations. Cases were classified based on international staging of Retinoblastoma and milestone of diagnosing the disease. Results: Between July 2007 and December 2012 our team has diagnosed 48 cases of metastatic disease accounting for 18.3% of all cases with retinoblastoma. Mean age of presentation was 27.3 months and duration of prior symptoms was 17 months. 40% of the cases presented initially with extra-­ocular retinoblastoma while 49% was diagnosed after enucleation and about 9% of the cases ignored followup sessions and came later with metastases. Stage II represented 32.4% of the cases while Stage III was 26.4% and Stage IV accounted for 42.2 % of the cases. Conclusions: Extraocular retinoblastoma is still an under-­studied field due to the few diagnosed cases in developed world. But in the settings of developing countries it represents a real nightmare specially with the increasing number of advanced intra-­ ocular retinoblastoma patients and lack of access to healthcare services.

Alfaar, A. S., Nour R., Kamal M., Bakry M. S., & Ezzat S. (2013).  Retinoblastoma Clinical Research in Egypt, 5 years experience.. International Society of Genetic Eye Diseases and Retinoblastoma meeting.. Abstract

Introduction and purpose: Institution-lead clinical research is a systematic effort for understanding diseases and its management in relation to local situation and needs. In Egypt, Children’s Cancer Hospital Egypt has initiated a clinical research program that aims at standardising treatment protocols for different diseases including Retinoblastoma. The aim of this study is to present the steps we’ve conducted, specific challenges we’ve faced, key performance indicators that we’ve designed and achievements we have accomplished. Methods: During the evolution of this program we’ve tracked events and progress in the retinoblastoma program over an online shared application. This was reported on observational basis by research team for practices of clinical, pharmacy, nursing and other supporting teams beside research team itself. Retinoblastoma Research Team has used shared online documents for facilitating collaborative building of reports. Results: Between July 2007 and and July 2012 we’ve adopted 5 treatment protocols. We’ve enrolled 250 patients over those protocols. Follow-up of challenges revealed different factors related to nature of the retinoblastoma disease and management, knowledge of clinical and research teams, settings in developing countries and factors related to registration and follow-up of huge numbers of patients. Physicians were engaged in the program through weekly discussions and tumour board meetings. We’ve implemented a tailored training program for nurses and pharmacists about the disease and treatment protocols. The research team has developed an online protocols portal to disseminate the latest versions of treatment roadmaps to clinical management teams. We succeeded to integrate a real-time follow-up system that reports full picture of the performance of retinoblastoma patients. Significance: This model represents an example for facilitating the transformation into clinical research in developing countries with the aid of international best practices and information technology tools. The paper represents a blueprint for other institutions in low resource countries to integrate its unique knowledge about the disease and its response into practice.

Alfaar, A., Hamza H., Abouelnaga S., & AbdelBaki A. (2012).  Genetic and Molecular Targeting of Retinoblastoma. 141. Abstract


Alfaar, A., Kamal M., Hassanain O., Sabry M., Ezzat S., & AbouElNaga S. (2012).  Advancing Clinical Oncology Practice in Developing Countries: Integrating Research Informatics for Continuous Process Improvement.. European Society of Medical Oncology. Abstract
Hassanain, O., Adel N., Kamal M., AbouElNaga S., & Samir AlFaar A. (2012).  Building the First ELearning Paediatric Oncology Clinical Pharmacy Program for Developing Countries.. European Conference of Oncology Pharmacy. Abstract
Hanafy, N., & Samir Al-Faar A. (2012).  Developing A Specialized Central Venous Catheter Nursing Team In Pediatric Oncology Setting.. International Conference on Cancer Nursing. Abstract
Kamal, M., Hassanain O., AbouElNaga S., Hussein H., Hosny H., Sabry M., et al. (2012).  Integrating Treatment Protocol Monitoring System with Real-Time Statistics: A Research Oriented In-House developed Solution.. International Society of Pediatric Neuro-oncology.. Abstract
Alfaar, A., AlAsmar M., AbdelHameed M., Aamer I., & Sabry N. (2012).  Integrating Virtual Reality with eLearning in Medical Education: Cost Effective Model in Developing Countries.. Online Educa. Abstract
Alfaar, A. S., Kamal S., Abouelnaga S., Greene W. L., Quintana Y., Ribeiro R. C., et al. (2012).  International telepharmacy education: another venue to improve cancer care in the developing world.. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 18(6), 470-4. Abstract

OBJECTIVE: In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. MATERIALS AND METHODS: Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. RESULTS: The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. CONCLUSIONS: Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered.

Alfaar, A., Kamal M., & Sabry M. (2012).  Next Generation Cancer Registry; Opportunities of web 3.0 and physician perspective.. European Society of Medical Oncology. Abstract
Meselhy, G. T., Sallam K. R., Elshafiey M. M., Refaat A., Samir A., & Younes A. A. (2012).  Sonographic guidance for tunneled central venous catheters insertion in pediatric oncologic patients: guided punctures and guide wire localization. The Chinese-German Journal of Clinical Oncology. 11(8), 484-490. Abstract
Taha, G., Sallam K., ElShafie M., A. S., Younes A., & Refaat A. (2012).  Sonographic guidance for tunneled central venuos catheters insertion in pediatric oncologic patients: guided punctures and guide wire localization.. 5th Scientific Annual Conference of South Egypt Cancer.. Abstract
Kamal, M., Hassanain O., AbouElNaga S., Hosny H., & Samir A. (2012).  Treatment Protocols' Monitoring Solution for Real-Time Tracking of Pediatric Cancer Patients: A Research Oriented System.. 21st Pediatric Pharmacy Conference and PPAG Annual Meeting.. Abstract
Bakry, M. S., Kamal M., Ezzat S., & AlFaar A. S. (2011).  Integrating Web-based Real-time Analysis System with Clinical Research Database Facilitates Interim Analysis.. European Multidisciplinary Cancer Congress. p. 2.163. Abstract
AlFaar, A. S. (2011).  Teaching Clinical Research Leadership Skills for Undergraduate Medical Students and Impact on Public Health. . Washington DC: US Department of State Fellows Congress.. Abstract
Samir AlFaar, A., Ezzat S., & AbouElNaga S. (2011).  “Bringing them together” – An essential role in retinoblastoma team; a disease coordinator. Two years experience in a developing country.. International Society of Genetic Eye Diseases and Retinoblastoma meeting.. p. 62. Abstract
Samir, A., & Kamal S. (2010).  Using hybrid solutions for maximizing the return on investment from telemedicine in pharmacy education. 5th Annual Pediatric Telehealth Colloquium. 846-854. Abstract