Publications by authors named "Hala Agha"

Objectives: To assess the outcome of pediatric pulmonary arterial hypertension (PAH) and to identify the predictors of morbidity and mortality of this progressive disease.

Patients And Methods: This prospective observational cohort study was conducted on consecutive pediatric patients with PAH. Medical history was taken with a grading of the WHO functional class as well as the serum N-terminal pro-BNP (NT pro-BNP), 6 min' walk test (6MWT), and echocardiography at the initial assessment and at follow-up.

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Article Synopsis
  • The study investigates the prevalence of giant aneurysms (GiAn) and Kawasaki disease (KD) research trends across 16 Arab countries over a span of 45 years, revealing a 30% annual growth rate in KD publications.
  • It finds that while UAE, KSA, and Egypt produced the majority of KD research, developing nations lag behind, and highlights significant issues like initial misdiagnosis and incomplete cases contributing to an underestimated epidemiology.
  • The review emphasizes the need for strategic initiatives to improve KD research and collaboration among Arab countries to better understand and address these health challenges.
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Background: Sickle Cell Disease (SCD) is not a hematologic disease that occurs in isolation; it results in multi-organ complications. There is growing evidence of vascular stiffness as its underlying cause. This study aimed to investigate the relationship between endothelial stiffness and LV dysfunction in SCD patients and to explore its pathophysiology, particularly regarding the depletion of vasodilators such as Nitric Oxide (NO).

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Background: Congenital portosystemic shunt (CPSS) is a vascular malformation in which portal blood drains toward the systemic circulation, leading to pulmonary hypertension.

Case Presentation: A 10-year-old patient was brought for evaluation because of dyspnea on exertion. Echocardiography revealed a pulmonary hypertension of 75 mmHg, and multi-slice CT angiography revealed the presence of a CPSS.

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Objectives: To identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in nine Middle Eastern countries.

Methods: We conducted a prospective cohort study between 1 January 2014 and 2 December 2022 in 212 intensive care units (ICUs) of 67 hospitals in 38 cities in nine Middle Eastern countries (Bahrain, Egypt, Jordan, Kuwait, Lebanon, Morocco, Saudi Arabia, Turkey, and the UAE). To estimate CAUTI incidence, we used the number of UC days as denominator and the number of CAUTIs as numerator.

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Background: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East.

Methods: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI).

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Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors.

Design: A prospective cohort study.

Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.

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Background: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden.

Methods: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates.

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Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal.

Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods.

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Article Synopsis
  • - Kawasaki disease (KD) is the leading cause of acquired heart disease in children from developed countries, necessitating detailed studies within Arab nations to enhance diagnosis and care.
  • - Kawarabi is a collaborative initiative involving North American and Arab experts aimed at improving knowledge and management of KD and similar conditions, primarily initiated during the COVID-19 pandemic's emergence of multisystem inflammatory syndrome in children.
  • - Founded in 2021, Kawarabi has identified gaps in awareness and resources concerning KD in Arab countries, and it has organized educational webinars and meetings to promote better understanding of the disease and its long-term outcomes.
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Article Synopsis
  • - Kawasaki Disease (KD) remains the leading acquired heart disease in children under five, with limited data available from Arab nations, prompting the creation of the KD Arab Initiative (Kawarabi) in 2021 to enhance research and access to care.
  • - A survey conducted across thirteen Arab countries revealed that while access to KD care was generally equal in urban and rural areas for over half of the countries surveyed, many rural areas still experienced significant disparities in healthcare access, especially in mid-size cities.
  • - The survey indicated a difference in the quality of medical services for KD, with urban children receiving better care, and highlighted that the availability of intravenous immunoglobulin (IVIG) was critically low in rural and mid-size areas,
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Objective: To identify central-line (CL)-associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs).

Design: From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms.

Setting: The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries.

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Background: Post-cardiotomy extracorporeal membrane oxygenation (ECMO) was associated with significant neurological complications affecting the overall outcome. The aim of the work is to determine the incidence and the predictors of neurological events during pediatric extracorporeal life support after cardiac surgery.

Patients & Methods: This is a retrospective study that encompassed all neonates, infants, and children (<18 years of age) who need extracorporeal life support following cardiac surgery between January 2015 and December 2018 at San Donato Hospital, Italy.

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Article Synopsis
  • The study aimed to identify risk factors for ventilator-associated pneumonia (VAP) in intensive care units (ICUs) of low- and middle-income countries, where VAP rates are significantly higher than in high-income countries.
  • The research was a prospective cohort analysis covering 743 ICUs across 282 hospitals in 42 diverse countries over 24 years, following 289,643 patients for a total of nearly 2 million patient days.
  • Key identified risk factors for acquiring VAP included male sex, prolonged ICU stay, use of mechanical ventilation, and specific ICU admissions (such as oncology and respiratory ICUs), with CPAP showing the highest associated risk.
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Background: Several reports of unheeded complications secondary to the current mass international rollout of SARS-COV-2 vaccines, one of which is myocarditis occurring with the FDA fully approved vaccine, Pfizer, and others.

Main Body Of The Abstract: Certain miRNAs (non-coding RNA sequences) are involved in the pathogenesis in viral myocarditis, and those miRNAs are interestingly upregulated in severe COVID-19. We hypothesize that the use of mRNA-based vaccines may be triggering the release of host miRNAs or that trigger the occurrence of myocarditis.

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Purpose: The International Nosocomial Infection Control Consortium (INICC) found a high mortality rate in ICUs of the Middle East (ME). Our goal was to identify mortality risk factor (RF) in ICUs of the ME.

Materials: From 08/01/2003 to 02/12/2022, we conducted a prospective cohort study in 236 ICUs of 77 hospitals in 44 cities in 10 countries of ME.

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Article Synopsis
  • The International Nosocomial Infection Control Consortium identified high mortality rates in ICU patients and aimed to find risk factors associated with all-cause mortality.
  • A study involving over 300,000 patients in ICUs across multiple countries revealed key mortality risk factors, including infections and longer hospital stays.
  • To improve patient outcomes, the study recommends targeting modifiable factors like infection prevention and managing the length of stay in ICUs.
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Article Synopsis
  • Studies on Kawasaki disease in Arab countries show limited data, leading to the formation of the KD Arab Initiative (Kawarabi) consortium for collaborative research.
  • An anonymous survey among 19 physicians from 12 institutions revealed that while 79% refer to American Heart Association guidelines, there are significant variations in treatment availability, particularly with intravenous immunoglobulin (IVIG).
  • The survey found low awareness of Kawasaki disease among the general population (median score 3) but relatively higher knowledge within the medical community (median score 7), highlighting the need for more proactive collaboration and education.
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Objectives: Percutaneous patent ductus arteriosus (PDA) stenting is a therapeutic modality in patients with duct-dependent pulmonary circulation with reported success rates from 80-100%. The current study aims to assess the outcome and the indicators of success for PDA stenting in different ductal morphologies using various approaches.

Methods: A prospective cohort study from a single tertiary center presented from January 2018 to December 2019 that included 96 consecutive infants with ductal-dependent pulmonary circulation and palliated with PDA stenting.

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Background: This study examines the impact of the COVID-19 pandemic on health care-associated infection (HAI) incidence in low- and middle-income countries (LMICs).

Methods: Patients from 7 LMICs were followed up during hospital intensive care unit (ICU) stays from January 2019 to May 2020. HAI rates were calculated using the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System applying the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC-NHSN) criteria.

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Background: Early diagnosis and treatment of myocardial affection in patients with systemic lupus erythematosus (SLE) are crucial.

Objectives: To evaluate the ventricular systolic function in juvenile-onset systemic lupus erythematosus (j-SLE) patients by 3-D speckle tracking echocardiography (3D-STE) and to determine the predictors of left ventricular (LV) dysfunction if present.

Methods: Twenty-six SLE patients without heart failure and 21 healthy controls were studied by standard echocardiogram and 3D-STE.

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In infants with ductal dependent pulmonary blood flow, Blalock-Taussig (BT) shunt and Patent Ductus Arteriosus (PDA) stent, are two palliative procedures aimed to restore circulation. A systematic review and metanalysis was performed on studies comparing PDA stents and BT shunts, in accordance with PRISMA guidelines. Meta-analysis revealed the following; (1) a reduced risk of mortality [RR = 0.

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Background: We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific.

Methods: Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied.

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Objectives: To analyze the acute and short-term deformation changes of both right (RV) and left (LV) ventricular wall before and after transcatheter closure of atrial septal defect (ASD) secundum in children.

Outcome Measures: To determine the feasibility of tissue Doppler and myocardial deformation imaging for evaluating RV and LV functions in children undergoing transcatheter ASD closure.

Patients And Methods: A prospective study was performed for 32 children with hemodynamic significant ASD secundum before and 6 months after percutaneous ASD closure in the Pediatric Cardiology Division of Specialized Pediatric Hospital, Cairo University.

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Coronavirus disease 2019 (COVID-19) has been declared a pandemic on 11 March 2020 by the WHO. Despite being mainly a respiratory virus, cardiac complications have been described. These range from sudden cardiac death to subtle diastolic dysfunction after recovery from COVID-19.

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