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Okasha, H. H., M. - N. A. S. Wifi, M. El-Nady, R. E. Mahdy, emad al-gemeie, W. El-Nabwey, W. M. Aref, A. A. - M. Al-Naggar, karim essam, and A. H. Ramadan, "Role of endoscopic ultrasound and endoscopicultrasound-guided fine-needle aspiration in endoscopic biopsy negative gastrointestinal lesions", endoscopic ultrasound journal, vol. 6, issue 3, pp. 156-61, 1975 Sep 01, 2017. smls_paper.pdf
Okasha, T. M., Y. A. E. S. Seloma, and K. S. Anbar, "Cerebral Perfusion Pressure among Acute Traumatic Brain Injury Patients at Supine versus Semi-Fowler Positions", Advances in life Science and Technology , vol. 12, issue 12, pp. 33-45, 2013. AbstractCerebral Perfusion Pressure among Acute Traumatic Brain Injury Patients at Supine versus Semi-Fowler Positions

Positioning is one of the most frequently performed nursing activities in the intensive care units. However literature review documented lack of knowledge about the relationship of cerebral dynamics and different body positions among acute traumatic brain injury patients. Aim: the aim of this study is to assess the effect of supine and semi-fowler position on cerebral perfusion pressure among patients with acute traumatic brain injuries at Cairo University Hospital as indicated by: Glasgow coma score (GCS), arterial blood gases values (ABG), oxygen saturation and vital signs (pulse, blood pressure and respiratory rate). Research questions: What is the effect of supine position on cerebral perfusion pressure among patients with acute traumatic brain injuries? And what is the effect of semi fowler position on cerebral perfusion pressure among patients with acute traumatic brain injuries? Sample: Convenience sample of 39 patients admitted with acute traumatic brain injury. Design: Descriptive exploratory repeated measures study. Setting: University Hospital in Cairo. Tools: Initial acute traumatic brain injury patient’s assessment sheet, and cerebral oxygenation and physiological parameters assessment sheet for acute traumatic brain injury patients. Result: The mean age was 28.5 ±7.9 years. (74.4%) have normal body weight, (25.6%) were having cerebral contusion. Significant increase of CPP, Pao2, SaO2, SPO2, mean arterial pressure and systolic blood pressure, in 15 min post semi-fowler position assessment with a significant decrease of PaCo2. Significant decrease of pulse rate in supine position was evident. With no significant changes in diastolic blood pressure and GCS. Conclusion: Semi-fowler position was found to affect the ABG values, mean arterial pressure, respiratory rate, SpO2 and CPP positively. Recommendation: Studying the effect of side lying and prone position to establish data base about the optimal body position for acute traumatic head injury patients is highly recommended with replication of this study on larger probability sample.

Okasha, H., S. Elkholy, M. Sayed, A. Salman, Y. Elsherif, and E. El-Gemeie, "Endoscopic ultrasound-guided fine-needle aspiration and cytology for differentiating benign from malignant lymph nodes", Arab journal of Gastroenterology, vol. 18, pp. 74-79, 2017.
Okasha, T. M., K. S. Anbar, and Y. A. E. S. Seloma, "Cerebral Perfusion Pressure among Acute Traumatic Brain Injury Patients at Supine versus Semi-Fowler Positions", Advances in Life Science and Technology, vol. 12, no. 2, pp. 33–45, 2013. Abstract
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Okasha, H. H., R. E. Mahdy, S. Elkholy, M. S. Hassan, A. N. El-Mazny, K. E. E. Hadad, M. Saeed, M. El-Nady, O. S. Elbalky, A. Ashraf, et al., "Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in differentiating malignant from benign pancreatic lesions?", Medicine, vol. 97, issue 36, pp. e11689, 2018. Abstract

Evaluating the role of endoscopic ultrasound (EUS) elastography and strain ratio in differentiation between malignant and benign pancreatic lesions.Three hundred twenty-five patients with solid pancreatic lesions were enrolled in this prospective study from 2014 to 2017. EUS real-time elastography scoring and strain ratio were done to all patients and compared to the final diagnosis to assess its sensitivity, specificity, positive and negative predictive values (PPV and NPV) in differentiating malignant from benign lesions.A cut-off value of 4.2 we had sensitivity of 95%, specificity of 63%, PPV of 89%, NPV of 81%, and accuracy of 87%. Another cut-off value of 10.9 showed a sensitivity of 75%, specificity of 88%, PPV of 95%, NPV of 54%, and accuracy of 79%. Adding the elastography to the better cut-off value gave a sensitivity of 97%, specificity of 63%, PPV of 89%, NPV of 88%, and accuracy of 89%.Real-time elastography and strain ration are valuable in differentiating malignant from pancreatic lesions.

Okasha, H., M. E. behiry, N. Ramadan, R. Ezzat, A. Yamany, S. El-Kholi, and G. Ahmed, "Endoscopic ultrasound-guided fine needle aspiration in diagnosis of cystic pancreatic lesions.", Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, vol. 20, issue 2, pp. 86-90, 2019. Abstract

BACKGROUND AND STUDY AIMS: pancreatic cysts are commonly found lesions and proper diagnosis is very important for planning further management. The study aims to evaluate the role of cyst fluid amylase and tumour markers as cancer antigen (CA 19-9) and carcinoembryonic antigen (CEA) in addition to mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign lesions.

PATIENTS AND METHODS: This prospective study was conducted on 184 patients diagnosed to have pancreatic cystic lesions from January 2013 to January 2018. Fluid analysis for CA 19-9, CEA, amylase, mucin stain and cytopathology were done. We compared these data with the final diagnosis based on histopathology after surgical resection, positive cytopathology and long period of follow up of the patients for at least 18 months.

RESULTS: The highest AUC was that of cystic CEA with cut-off value of 160 ng/ml; it had a sensitivity of 60.4% and a specificity of 85%. The best cut-off value for cystic CA 19-9 was 1318 U/ml with a sensitivity of 64.1% and a specificity of 68.1%. The cut-off value of cyst amylase level was 5500 U/L, with 84.2% sensitivity and 37.1% specificity. The sensitivity of mucin stain in detecting mucinous cystic neoplasm was 85.45%, specificity was 86.05% with accuracy 85.87%.

CONCLUSION: Cyst fluid analysis by investigating amylase, mucin, CA 19-9, CEA and EUS examination improves the diagnosis of different pancreatic cysts.

Okasha, H. H., M. Mansour, K. A. Attia, H. M. Khattab, A. Y. Sakr, M. Naguib, W. Aref, A. A. - M. Al-Naggar, and R. Ezzat, "Role of high resolution ultrasound/endosonography and elastography in predicting lymph node malignancy", Endoscopic ultrasound, vol. 3, issue 1: Medknow Publications, pp. 58, 2014. Abstract
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Okasha, H., and M. Wahba, "EUS in the diagnosis of rare groove pancreatitis masquerading as malignancy.", Gastrointestinal endoscopy, vol. 92, issue 2, pp. 427-428, 2020.
Okasha, H., A. M. Abu-Seida, A. A. Hashem, S. E. H. Ashry, and M. M. Nagy, "Inflammatory response and immunohistochemical characterization of experimental calcium silicate-based perforation repair material", International Journal of Experimental Pathology, vol. 103, issue 3, 2022. experimental_furcation_material.pdf
Okasha, H. H., M. Mansour, K. A. Attia, H. M. Khattab, A. Y. Sakr, M. N. Abdalla, W. Aref, A. A. - M. Al-Naggar, and R. Ezzat, "Role of high resolution ultrasound/endosonography and elastography in predicting lymph node malignancy", Endoscopic Ultrasound Journal, vol. 3, issue 1, pp. 58-62, 2014. role_of_hrus-eus_and_elastgraphy_in_predicting_ln_malignancy.pdf
Okasha, A., and C. G. Johnson, "The effect of level of rationality on macro-activities of the Lucas-Island model", IEEE Congress on Evolutionary Computation: IEEE, pp. 1–8, 2010. Abstract
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Okasha, T. M., W. Y. Mohamed, M. S. Ismail, and K. S. Anbar, Cerebral Oxygenation among Acute Traumatic Brain Injury Patients , , Germany, LAP LAMBERT, Submitted.
Okasha, L. A., A. A, M. A. El-Hady, S. A, S. A.A, A. M, and E. - J. J, "Identification of common fish bacterial pathogens in Kafr el Sheikh Governorate Egypt using PCR", IJBPAS, February,, vol. 5(2):, pp. 522-537., 2016.
Okasha, T. M., and H. Ibrahim, Clinical pathway for postoperative organ transplants, , Germany , LAP LAMBERT , 2014. 978-3-659-58969-0_coverpreview_1.pdf
Okasha, H., S. Elkholy, R. Ezzat, and A. El-Kafrawi, "Isolated Pulmonary Valve Vegetations in a Patient with Gastric Lymphoma Diagnosed by Endoscopic Ultrasound", Acta Gastro-Enterologica Belgica, vol. 80, pp. 430-431, 2017.
Okasha, H., S. Elkholy, R. El-Sayed, M. - N. Wifi, M. El-Nady, W. El-Nabawi, W. A. El-Dayem, M. I. Radwan, A. L. I. FARAG, Y. El-sherif, et al., "Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions.", World journal of gastroenterology, vol. 23, issue 32, pp. 5962-5968, 2017. Abstract

AIM: To evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions (SPL).

METHODS: A total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area (A) representing the region of interest and area (B) representing the normal area. Area (B) was then divided by area (A). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final diagnoses.

RESULTS: SPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL.

CONCLUSION: Combining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL.

Okasha, H., S. Elkholy, M. Sayed, M. El-Sherbiny, R. El-Hussieny, E. El-Gemeie, W. Al-Nabawy, M. S. Mohamed, and Y. Elsherif, "Ultrasound, endoscopic ultrasound elastography, and the strain ratio in differentiating benign from malignant lymph nodes.", Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, vol. 19, issue 1, pp. 7-15, 2018. Abstract

BACKGROUND AND STUDY AIMS: Endoscopic ultrasound elastography (EUS-elastography), or sono-elastography, has emerged in the past 2 decades as a qualitative method of estimating tissue stiffness. Strain elastography allows for semi-quantitative measurements of the average elasticity of a lesion, and previous studies have proposed the strain ratio (SR) for overcoming the limitations of the elasticity score. The main objective of this study is to assess the specificity, sensitivity and predictive values of the SR measured by EUS-elastography in differentiating benign from malignant lymph nodes (LNs). This study also aims to find significant ultrasonographic features other than the SR which could help in predicting LN malignancy.

PATIENTS AND METHODS: This prospective study included 126 Egyptian patients with lymphadenopathy. US and EUS-elastography and the SR were assessed, in addition to detailed sonographic features, including size, longest diameter, shortest diameter, ratio of shortest/longest diameter, echotexture (echogenic or echo-poor) and hilum (lost or preserved).

RESULTS: The SR cut-off value of 4.61 showed a sensitivity and specificity of 89.8% and 83.3%, respectively. This parameter had high positive and negative predictive values of 82.5% and 90.2%, respectively, for predicting malignant LNs. Univariate regression analysis showed that echogenicity, hilum preservation, elastography, the shortest dimension, the ratio of the shortest/longest dimension, ultrasound diagnosis and SR could be potential predictors of the final lymph node diagnosis. Sono-diagnosis depending on echogenicity, the shortest/longest diameter ratio and a preserved hilum in combination was the only predictive parameter in multivariate regression analysis.

CONCLUSION: EUS-elastography and the SR could be excellent prognostic indices in differentiating benign from malignant lymph nodes if combined with other US features.

Okasha, H., M. Wahba, H. A. El-Fol, and Y. Elsherif, "Preoperative EUS-guided tattooing of a small, firm, deep pancreatic mass.", Gastrointestinal endoscopy, vol. 93, issue 3, pp. 769-771, 2021.
Okasha, E., M. Hussien, M. Abdou, and M. Koronfel, "Fodder beet, Beta vulgaris (L.) as affected by soil texture, compost quantity, diluted seawater and their interactions", Egyptian Journal of Applied Sciences, vol. 24, pp. 116–138, 2009. Abstract
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