Basic Informations
C.V
Shafiq Nageib Shafiq Azer
15 El Shahid Mohammed Gaber street - Beni Suef
+201220047907
• shafikazer@gmail.com
Employment History
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Beni Suef university Hospital
Internal medicine resident doctor
(may 2007 — May 2010)
St.Therese Hospital - Beni Suef
(May 2010 — Feb 2011)
Beni Suef university Hospital
Gastroenterology and Hepatology assistant lecturer
(may 2010 — Present)
Elsalam Charity Hospital
Endoscopist
(Sep 2013 — Present)
Education & Qualifications
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M.B.B.CH
Faculty of Medicine - Beni Suef University
(Nov 2005 – very Good)
Master degree of Internal Medicine – Beni Suef University
(may 2010 — very good)
MD degree of Internal Medicine(1st part) – Beni Suef University
(may 2014 — very good)
Courses & Other Skills
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- First Aid & BLS Certified.
- ALS Certified.
- Upper GIT endoscopy.
- lower GIT endoscopy.
- Certified Attendance of :
• Management of Hypertension.
• IMCI (Integrated Medical Care of Infancy).
• Basic Principles of Ultrasonography.
• Endoscopic hands on training.
- EGYPTIAN WORKSHOP ON THERAPEUTIC ENDOSCOPY.
Language Ability
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- Arabic : Native
- English : Fluent
Hobbies & Interests
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- Reading.
- Travelling.
- Sports.
- Cinemas.
References
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References are available upon request.
Master Title
Prevalence of HCV Infection and its Association with Diabetes Mellitus in Residents of Ehwa Village , Bani suef Governorate, Egypt.
Master Abstract
Summary
Egypt has the highest HCV prevalence in the world (10%-20%) of general population are infected and HCV is the leading cause of HCC and chronic liver disease in the country.
Approximetly 90% of egyption HCV isolates belong to asingle sub type (4a) whivh responds less successifuly to interferon therapy than other subtypes.
Our study aims to evaluate the prevalence of HCV infection and its association with diabetes mellitus in randomly selected residents of Ehwa village , Bani Suef governorate, as an example of rural areas of Bani Suef governorate. Our study was conducted in Ehwa village ,Bani Suef governorate in the period between june 2009 and june 2010.
Four hundred residents participated, aged from 15 to70 years, selected by systematic random sample (we chose all residents of one house every ten house).
We asked the residents for risk factors of HCV infection including (surgical operation, blood transfusion, anti bilharzial treatment, endoscopy, pinprick) and history suggestive of chronic liver disease ( jaundice, lower oedema , abdominal distension , bleeding)and history of diabetes mellitus.
Physical examination were done to all participents
Abdominal ultrasound were done for HCV positive patients.
Laboratoryinvestigation included
- HCV antibodies by ELISA 3rd generation.
- Liver enzyme ALT.
- Fasting blood glucose & 2 hours post prandial.
- HCV RNA by PCR for HCV Ab positive cases.
In our study we found that the prevalence rate of HCV antibody in Ehwa village was 36% which is more in older groups and nearly equal in both sex (in males 35.7%& female36.4%).
In this study , we found (26.2%) of the residents reported hisrory of shistomiasis with tarter emetic injection especially above the age of 30 years old and this shows the stronig reation between the prevalence of HCV and shistomiasis.in our study, we found significant relation between HCV and invasive procedures especially (wound suturing,surgery, abscess drainage, intravenous and urinary cathetheterization) mainly above age of 30 years old.
We also found asignificant association between HCV and obstetric intervention in the women above age of 20 years old . as regards blood transfusion there is significant relation between it and HCV in both age groups.
In our study group 33% gave ahistory of dental procedures which was statisticaly significant.
The individuals mostly had elevated ALT levels.
We found 94.4% of HCV antibody positive cases to be PCR positive.
We found significant relation between HCV antibody positivity and blood glucose levels(14.6% of HCV positive group were diabetics compared to 8.6% of HCV negative group).
PHD Title
Studying Impact Of Insulin Resistence On Response To Hepatitis C Virus Therapy
PHD Abstract
Summary
There are 170 million people worldwide with persistent hepatitis C virus (HCV) infection that are at significant risk of progressive liver injury leading to cirrhosis, death from liver failure, and hepatocellular carcinoma. (Liang TJ, et al; 2000; Lauer GM& Walker BD,2001). Currently standard treatment includes a combination of sofosbuvir, pegylated interferon (peg-IFN) and ribavirin. A substantial proportion of patients infected with HCV still do not respond to sofosbuvir, peg-IFN/ribavirin therapy,therefore predictive factors that identify potential non responders are needed to limit drug exposure in patients unlikely to benefit from treatment and to save healthcare resources.
Our study included one hundred non-diabetic, non-cirrhotic Egyptian patients with chronic HCV infection. Study included 55 males (55%) and 45 females (45 %) their ages ranged from (25-48) years. Patients then divided in two groups according to type of treatment which they received.
Group (I): 50 cases treated with standard treatment (pegylated interferon plus ribavirin) for 48 weeks.
Group (II):50 cases treated by new regimen (sofosbuvir,pegylated interferon plus ribavirin) for 12 weeks.
Each group was further sub divided in two groups according to insulin resistence (HOMA- IR).
Group (I) Group (A): 25 cases with HOMA –IR Less than 2.
Group (B): 25 cases with HOMA –IR more than 2.
Group (II) Group (C): 25 cases with HOMA –IR Less than 2.
Group (D): 25 cases with HOMA –IR more than 2.
Our aim was to identify the role of insulin resistance as a disease modifier affecting progression of liver fibrosis and sustained virological response in chronic HCV infection and effect of SVR on insulin resistence.
In our study.by Studying the impact of IR on SVR, we found statistical significant difference in the SVR between patients with IR < 2 and patients with IR> 2 in group one treated by old regimen pegylated interferon&ribavirin but no statistical significant difference in the SVR between patients with IR < 2 and patients with IR> 2 in group two treated by new regimen pegylated interferon,ribavirin&sofosbuvir.
In our study we found a direct correlation between IR an BMI in all patients.There is inverse relationship between BMI&SVR in patients treated by pegylated interferon&ribavirin but had no effect on patients treated by sofosbuvir,interferon&ribavirin.
Also in our study we found a direct correlation between IR and liver steatosis.but not with necroinflammation or liver fibrosis which had negative impact on SVR in patients treated by old regimen pegylated interferon &ribavirin but had no effect on SVR in patients treated by new regimen sofosbuvir,interferon&ribavirin.
As regarding pretreatment viral load in our study we found that it is not a predictor of SVR in all patients.
In our study also pretreatment ALT is not a predictor of response to SVR in both groups.
In our study we found significant improvement in insulin resistence in both groups after the end of treatment .This means that HCV therapy, regardless of achievement of SVR, appeared to improve IR.
conclusion
1- when using precise measurements of IR, IR appear to have negative impact on achievement of SVR in patients treated by old regimen pegylated interferon &ribavirin but had no effect on SVR in patients treated by new regimen sofosbuvir,interferon&ribavirin.
2-we found a direct correlation between IR and BMI and steatosis in all patients.There is inverse relationship between BMI,steatosis&SVR in patients treated by pegylated interferon&ribavirin but had no effect on patients treated by sofosbuvir,interferon&ribavirin.
3- Successful viral eradication did not appear to substantially influence IR when compared with HCV therapy that does not result in SVR. However, HCV therapy, regardless of achievement of SVR, appeared to improve IR. This suggests that individuals with higher degrees of IR may benefit from receipt of HCV therapy in an attempt to decrease their risk of clinical sequelae of IR.This study highlights the potential limitations of use of surrogate measures of IR within the context of HCV therapy by new regimens sofosbuvir,prgylated interferon&ribavirin.