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Alfaar, A. S., R. Nour, M. Kamal, S. Ezzat, and M. S. Bakry, "Automating clinical protocol monitoring: a model from developing countries.", European Multidisciplinary Cancer Congress, Amsterdam, Elsevier, 2013. Abstract
Ezzat, S., R. Labib, M. Mostafa, A. S. Alfaar, M. Sabry, K. Shaaban, H. Taha, and S. A. Naga, "Building a State of Art Biorepository in a Limited Resource Country. ", The International Society for Biological and Environmental Repositories Annual Meeting, Orlando, 2014. Abstract
Alei Eldin, A., A. Haddad, H. Elzomor, Y. Medhat, H. Taha, M. Saad, E. Zaky, R. A. ElRazk, M. Elshamy, S. Abouelnaga, et al., "Evaluation of Retinoblastoma management in the first Multidisciplinary system in the Cancer children hospital in Egypt", International Society of Ocular Oncology Meeting, 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 , 2013. 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., R. Nour, A. S. Alfaar, A. Alei Eldin, M. S. Zaghloul, and H. Taha, "High Risk Histopathologic features of Retinoblastoma in Egypt", International Society of Genetic Eye Diseases and Retinoblastoma meeting., Gent, Belgium, 2013. 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.

Taha, H., H. Elzomor, A. Alei Eldin, A. Elhaddad, R. Nour, S. M. Zaghloul, and A. S. Alfaar, "Pathological findings of Retinoblastoma in Egypt; implementing CAP protocol in developing countries.", International Society of Genetic Eye Diseases and Retinoblastoma meeting., Gent, Belgium, 2013. 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., R. Nour, A. S. Alfaar, A. Alei Eldin, S. M. Zaghloul, H. Taha, and A. Elhaddad, "Presentation Of Extra-Ocular Retinoblastoma In Egypt", International Society of Genetic Eye Diseases and Retinoblastoma meeting., Gent, Belgium, pp. 71, 2013. 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., R. Nour, M. Kamal, M. S. Bakry, and S. Ezzat, "Retinoblastoma Clinical Research in Egypt, 5 years experience.", International Society of Genetic Eye Diseases and Retinoblastoma meeting., Gent, Belgium, 2013. 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.

aly Nareman, M., A. L. A. Sayeda, and E. N. A., Assessment of suicidality risk factors and its management at poison control center Cairo University, , Deutschland, Lambert Academic Publishing Company, 2013. lktb_llktrwn-nrymn.pdf
Nassef, M., A. Badr, and I. Farag, BOOK: Exploring the Referentially-compressed Genomes: Advantages and Challenges, : LAP Lambert Academic Publishing, 2015. Abstract


Negm-eddin, D. M., Brirf History of Ancient Egypt, , Giza, 2014. d.mhsn_njm_ldyn.pdf
Nassar, M. I., Buy Ultrastructure and bioactivity of Ipomrea carnea extract , , Germany, LAP-Lambert Publisher, 2015.
Nassar, M. I., Colege of Entomology, , Cairo, Arabic Publisher institute, 1998.
Borovitz, I., and S. Neumann, Computer {Systems} {Performance} {Evaluation}, {Criteria}, {Measurement}, {Techniques} and {Costs}, , Lexington, Massachusetts, Heath, 1980. Abstract
Ng, N. Q., P. Perrino, F. Attere, and H. Zedan, Crop Genetic Resources of Africa, Volume II, , , London, The Trinity Press, U.K., 1991.
soliman Nasr, A., A. L. Aboul Nasr, and E. Amin, Down Syndrome Prenatal Screening and Diagnosis , Comprehensive Review, , Germany, Lambert Academic Publishing , 2012.
Nasr, A. S., A.L.Aboul-Nasr, and E.Amin, Down Syndrome prenatal screening and diagnosis,comprehensive review, , Germany, Lambert Academic Publishing, 2012.
marwa abd el rahman mohamed huessin, and engy mohamed ibrahem el nahas, electromagnetic therapy and menopausal wellness, , GERMAN, LAMBERT, 2015. AbstractWebsite

Postmenopausal female with osteoporosis had an impaired quality of Life, Although there are some treatment methods for osteoporosis, they usually impose serious side effects. magnetic therapy and aerobic training have been promising modalities for better treatment of osteoporosis and increase the bone mineral density that have a long term effect as it decrease the rate of bone deterioration, significantly reduce bone pain and aches, improve the quality of life and greatly alleviate insomnia. Finally, magnetic therapy and exercise training is an effective, noninvasive, safe, successful ways that help postmenopausal female to sail through her menopause.

Wagih, A., S. Abd El-Salam, G. Abd El-Hafez, and S. Negim, English for Life 1, (Pathways, Faculty of Engineering, Cairo University), , Cairo University, Faculty of Engineering Press, 2014.
Wagih, A., S. Abd El-Salam, G. Abd El-Hafez, and S. Negim, English for Life 2, , Cairo University, Faculty of Engineering Press, 2017.