Hanaa El-Karaksy

Prof. Hanaa El-Karaksy has worked in the field of Pediatric Hepatology (Pediatric Liver Diseases) for the last 25 years. She has actively worked in the Pediatric Hepatology Unit at Cairo University since it was founded in 1984 by Late Prof. Mohammad Safouh. Both her MS and MD theses were in this field. Her MD thesis was titled: “Alpha-1-Antitrypsin in Infants with Cholestasis” and her MS thesis was titled: “Urinary Changes in Infantile Cholestasis”. Both were supervised by Late Prof. Mohammad Safouh, the father of Pediatric Hepatology in Egypt.

Over the last 2 decades she has worked in this field and was attempting through her research to solve evolving problems in pediatric liver diseases. Her training at Cairo University was enriched by being an active scholar to a highly respectable professor. Late Prof. Mohammad Safouh provided his students with his great experience, hands-on training and the opportunity to meet eminent figures in the field of pediatric liver disease. He invited on several occasions great professors to visit his unit, to give presentations and to attend clinical rounds; namely Prof. Alex Mowat from King’s College, London UK, Prof. Harvey Sharp from USA and Prof. Daniel Alagille from France. All aforementioned scientists are renowned figures in the field of pediatric liver disease. Direct contact with such great scientists during her early training was very stimulating to follow her mentor’s scientific school.

After finishing her training as resident in Pediatrics and obtaining her MD degree, she started her research in the field. She supervised 78 MS and MD theses; more than 80% were in pediatric hepatology specialty. She shared in the discussion of over 35 theses in Cairo University and other universities in the same specialty. Her research focused on this field putting cholestatic disorders of infancy, viral hepatitis, portal hypertension and inherited metabolic disorders on the top of the list of priorities in the field.

She has shared over the last 25 years in direct patient care of pediatric liver diseases. She actively attend the outpatient Pediatric Hepatology Clinic that works 3 sessions weekly at Cairo University Pediatric Hospital. This busy clinic receives from 60-80 patients per session. New cases per year range from 1200-1500 cases. From 200-250 liver biopsies are carried out in the unit annually. Regular monthly sessions in liver pathology are carried out under her supervision jointly with Prof. Ahmad El-Hennawy, Prof. of Pathology, Cairo University, both to continue her medical education in the field and to train her students in the field.  Patient archiving was actively carried out at the unit over the last 25 years. One of her goals is to institute electronic archiving and in the near future National Registry for Pediatric Liver Diseases in Egypt.

She have actively shared with her colleagues in founding the inpatient unit in 2006 and isplanning to have a specialized intensive care unit for emergencies in pediatric liver diseases with the help of the pediatric intensive care specialists.

She have shared in training of both under-graduate and post-graduate students in her specialty. She have tried to raise the awareness of her students to the spectrum of pediatric liver diseases that are met in Egypt, which are definitely different from those affecting the adult Egyptian population (overlap in liver diseases affecting both age groups occurs in no more than 10-20% of the cases). Her goal in under-graduate teaching has always been to orient the future general practioner to “what a general physician has to know about pediatric liver diseases” in an attempt to save the lives of children from under-recognition of their problems. In her specialty she has trained her younger colleagues and her students in pediatric liver diseases and has supervised most of the MS and MD degrees in the unit. She has also shared in the MS and MD exams in Pediatric Hepatology in the National Liver Institute at Menoufeya University as an external examiner. She trained physicians in the field of Pediatric Hepatology in courses organized by the Ministry of Health, the Medical Sydicate and the Egyptian Board of Pediatrics.

She have shared in the multi-disciplinary care of patients from other specialties, particularly newborns, diabetics, patients with hematologic disorders, immunodeficiencies and rheumatologic diseases. She has also supervised the care of pediatric liver emergencies in the emergency department. To achieve improvement in patient care she has encouraged her students and shared with them regular meetings with the radiology and clinical pathology departments.

Her interest in inherited metabolic diseases extended to contacts with Sapporo City Institute of Public Health, Japan, King Faisal Specialty Hospital and Research Center, Riyahd, Saudi Arabia, Prof. Hwei Chang in Taiwan and her colleagues at the National Research Center in Egypt. To improve the molecular genetics services a joint work is carried out with Prof. Fatma El-Mougy, Prof. of Chemical Pathology, Cairo University.

Entering the new millennium, many parties in Egypt became interested in living related liver transplantation. She was invited by Dar Al-Fouad Hospital to join the team of liver transplantation and head the pediatric team. Dar Al-Fouad Hospital was the 1^st hospital in Egypt to carry the 1^st living donor liver transplantation in August 2001. By that time laying the infrastructure for liver transplantation at Cairo University School of Medicine was begun. By October 2004, the 1^st living related donor liver transplantation was carried out at Kasr Al-Aini, in Manial Specialized Hospital. The 1^st 5 cases were pediatric cases and she was honored to head the pediatric team since that time. The program was successfully initiated and over 100 cases were transplanted from living donors, hoping for the executive steps for a deceased donor program to progress into practice.

For the last decade she became more involved in studying hepatitis C virus (HCV) in children. With the deficiency of pediatric reports all over the world, she had the opportunity to publish internationally several papers in this field in a trial to uncover its natural course in children. This was funded by an NIH grant, the Principle Investigator (PI) was Prof. Gamal Esmat, Prof. of Tropical Medicine, Cairo University and acted as co-PI. She has joined the pediatric subcommittee of the National Advisory Board on Viral Hepatitis. Efforts were made to provide funding for pediatric HCV treatment. Lately, she headed the team at Cairo University for HCV treatment in children starting April 2010.

Since 2006, she became interested in Hospital Infection Control and the Hospital Infection Prevention, which also reflects on Viral Hepatitis Prevention Program. She became clinical coordinator of the Infection Control Committee at Cairo University Pediatric Hospital. The program became active and several hospital activities were carried out starting with hand hygiene campaign, implementation of policies and procedures particularly for needle prick and sharps injury, establishment of hepatitis B prevention program for hospital personnel through HBV vaccination. She was promoted to become a member of the Supreme Council for Infection Control at Cairo University Hospitals, part of the program for accreditation for Faculty of Medicine and its Hospitals. Despite being a member in the supreme Council, she was still interested in hands-on training within Cairo University Pediatric Hospital. She shared in the organization of the infection control training courses for residents and house officers carried out every 6 months. She aimed at producing intervention material to raise the awareness on viral hepatitis transmission and prevention. This hopefully will be achieved through a project titled: “Assessment of the Impact of Educational Interventions on Health Care Workers' Knowledge, Attitude and Practices towards Occupational Exposure to Blood, Body Fluids and Blood Borne Pathogens”.

She was awarded the Cairo University award for international publications for 3 successive years since 2009. She was awarded the "Excellent teacher" award from Kasr Alainy School of Medicine in 2010. She was awarded the Cairo University award of "Scientific Excellence" in 2011. She was honoured and awarded the shield of the Medical Syndicate on the Physician's day in April 2012.