Maged Hassan

Iraqi University

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Najib M. Rahman

University of Oxford

Rachelle Asciak

Churchill Hospital

Rachel Mercer

Churchill Hospital

Eihab O. Bedawi

University of Oxford

Rob Hallifax

Oxford University Hospitals NHS Trust

John Corcoran

Oxford University Hospitals NHS Trust

Cyrus Daneshvar

University Hospitals Plymouth NHS Trust

Ioannis Psallidas

AstraZeneca (United Kingdom)

David McCracken

Piedmont HealthCare

John Wrightson

Oxford University Hospitals NHS Trust

Cooperative Institutions

University of Oxford

Oxford University Hospitals NHS Trust

Alexandria University

Churchill Hospital

University Hospitals Plymouth NHS Trust

Oxford Centre for Diabetes, Endocrinology and Metabolism

National Institute for Health Research

John Radcliffe Hospital

National Health Service

Derriford Hospital

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P96 Neck ultrasound and lymph node biopsy by respiratory physicians in patients with thoracic disease

Basma El-Shaarawy Ahmed Elsayed Elhefny Heba Said Gharraf Maged Hassan

Background

Prevalence of cervical lymph node (LN) involvement in thoracic disease manifesting with mediastinal LN is not well studied. Neck LN sampling provides less invasive diagnostic procedure and neck LN have prognostic implications particularly in thoracic malignancy.

Aim

We aimed to prospectively determine the prevalence of abnormal cervical LNs in patients with suspected thoracic malignancy or with enlarged mediastinal lymph nodes in the setting of a systemic disease. We aimed to assess the yield from cervical LN biopsy of suspicious nodes when conducted by respiratory physicians.

Methods

NUS was performed for all patients admitted with undiagnosed lung lesions ± mediastinal lymphadenopathy at a University Hospital by a respiratory trainee who received a period of 3-month of training in focused neck ultrasound and real-time lymph node sampling. Cases with suspicious LNs (rounded shape, size >5 mm in shortest diameter, loss of hilum) who were screened by NUS and who were not waiting for results from other diagnostic procedures were referred for sampling of the abnormal LNs. Fine needle aspiration ± core biopsies from were done.

Results

Over 24-week period 114 patients were screened (median age 59.5 [50–66] years, 74.6% males). Suspicious LNs were present in 41 cases (prevalence of 35.9%, 95% C! 27.2–45.5%); FNA and core biopsies were conducted in 26 patients. Median short axis diameter of sampled LNs was 10 [8–12.75] mm. 24 (92.3%) of the biopsies were diagnostic. The final diagnosis was lung cancer in 12 cases (9 NSCLC, 3 SCLC), lymphoma in 5 cases, sarcoidosis in 5 cases, extra-thoracic malignancy in 1 case, and TB in 1 case. NUS with LN sampling allowed avoiding 14 EBUS procedures, 4 thoracoscopies, 6 bronchoscopies in the included cohort with average saving in time to diagnostic test of 3–5 working days. Conclusion training respiratory physicians in routine NUS and LN biopsy is feasible and provides less invasive and timely diagnostic modality in substantial proportion of patients with thoracic disease.

Hilum (anatomy)

Cervical lymphadenopathy

10.1136/thorax-2022-btsabstracts.232

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Citations (0)

Securing Blockchain based Supply Chain in Agriculture using Isolated Forests with Local Outlier Factor for Anomalies Detection

A Padmavathi Maged Hassan Jashanpreet Singh F. Anitha Florence Vinola N. Naga Saranya

Local outlier factor

Factor (programming language)

10.1109/icmnwc63764.2024.10872393

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A Patient With Effusion Undergoing Pleural Biopsy

CHEST Journal (2018)

Maged Hassan Maaz Rana Najib M. Rahman

Parapneumonic effusion

Parietal Pleura

Echogenicity

10.1016/j.chest.2018.02.041

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Citations (3)

P125 Diaphragm dynamics in pleural effusion

ER Graham Maged Hassan Taylor Lm WE Falconer Ben Probyn

Introduction and Objectives

The relationship between symptoms, pleural effusion size and the diaphragm is unclear. We conducted a pilot study to understand the role of diaphragm shape and movement in patients with unilateral pleural effusions.

Method

We prospectively recruited patients with unilateral pleural effusions. Routine investigations were collected. Study-specific thoracic ultrasounds (TUS) were performed at baseline, post intervention, and at day 7. A seven-day visual analogue score (VAS) diary was completed for breathlessness, starting at baseline, immediately post aspiration and then daily thereafter.

Results

Of the 45 patients recruited, 17/45(38%) were female. The median [interquartile] age was 71[66–77] years. The most common reported symptom was breathlessness in 43/45(96%). At baseline, the medial effusion depth was 100[80–126]mm over 4[3–5] rib spaces. Procedures were performed in 40/45(89%), including 32 therapeutic-interventions and 8 diagnostic aspirations. A median of 1,000 [481–1,500]mls of pleural fluid was aspirated. Malignancy was diagnosed in 20/45(44%) patients. A diaphragm abnormality (abnormal shape, movement or both) was seen in 22/45(49%) with a flattened diaphragm in 7/45(16%), an inverted diaphragm in 2/45(4%), paradoxical movement in 13/45(29%) and no movement in 8/45(36%). A malignant diagnosis was found in 14/22(64%) of those with a diaphragm abnormality at baseline, compared to 6/23(35%) with normal diaphragm (p<0.05). Of those undergoing a therapeutic intervention diaphragm abnormalities persisted in 4/21(19%) with improvement in 15/21(71%) (two were unreported). Diaphragm shape improved in all patients, however two patients had a persistent paradoxically moving diaphragm and two had no movement. In 27 patients undergoing therapeutic intervention and completing follow up, 19/27(70%) had a diaphragm abnormality at baseline, 4/27(15%) post intervention and 11/27(41%) at day 7. VAS scores at baseline, post aspiration and day 7 were 44[27–53.5]mm, 25[13–44]mm and 36[13.5–58.5]mm in those with a diaphragm abnormality compared with 46.5[34.25–72.5]mm, 34.5[18.5–54.75]mm and 22.5[14.25–32.25]mm in those with an normal diaphragm. In those with an abnormal diaphragm at day 7, the change in VAS was -4[-11.5–1] in the abnormal diaphragm group and -23[-31- -10.25] in the normal diaphragm group (p<0.05).

Conclusion

A diaphragm abnormality was common, demonstrated reversibility, but recurrence by day 7 was associated with loss of therapeutic benefit.

Diaphragm (acoustics)

Abnormality

Interquartile range

10.1136/thorax-2022-btsabstracts.260

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Development and Clinical Application of a Prednisolone/Cortisol Assay to Determine Adherence to Maintenance Oral Prednisolone in Severe Asthma

CHEST Journal (2020)

Adel Mansur Maged Hassan Joanne Duffy Craig Webster

Prednisolone

Interquartile range

10.1016/j.chest.2020.03.056

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Citations (14)

Prospective Analysis of the Predictive Value of Sonographic Pleural Fluid Echogenicity for the Diagnosis of Exudative Effusion

Respiration (2019)

Rachelle Asciak Maged Hassan Rachel Mercer Rob Hallifax John Wrightson

Background: Pleural effusion echogenicity on ultrasound has previously been suggested to allow identification of exudates. A case series suggested that homogenously echogenic effusions are always exudates. With modern imaging techniques and more advanced ultrasound technology, this may no longer be true. Objectives: This study aims to prospectively assess the predictive value of echogenicity in the identification of exudates. Method: Patients undergoing thoracic ultrasound before pleural fluid sampling were analysed prospectively (n = 140). Pleural fluid was classified as an exudate if both fluid total protein (TP) > 29 g/L and fluid lactate dehydrogenase (LDH) > 2/3 upper limit of normal serum LDH (which is 255 IU/L in females and 235 IU/L in males) were present. If only one of these criteria was met, the effusion was considered to have discordant biochemistry. Results: Fifty-five (39%) patients had non-echogenic and 85 (61%) had echogenic effusions. Six (7.1%) patients with echogenic effusions had transudates; the median fluid TP for this group was 18.5 g/L (IQR 9.75) and median LDH 63.0 IU/L (IQR 40.3). The specificity of echogenicity identifying exudates from transudates, excluding patients with discordant biochemistry, was 57.1%, positive predictive value (PPV) 90.3%, sensitivity 65.1%, and negative predictive value (NPV) 21.0%. The specificity of echogenicity identifying exudates (including discordant biochemistry) from transudates was 57.1%, PPV 92.9%, sensitivity 62.7%, and NPV 14.5%. Conclusions: Echogenicity of a pleural effusion has a low specificity for identifying an underlying exudate, and the echogenic qualities of the fluid should not influence clinical decision-making.

Echogenicity

Transudate

10.1159/000496153

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Citations (21)

Medical Thoracoscopy Unveils a Hidden Choroidal Melanoma

Annals of the American Thoracic Society (2015)

Mahmoud Reda Maged Hassan Mervat Ahmed Ismail

Thoracoscopy

10.1513/annalsats.201501-013le

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Citations (1)

Assessment of respiratory muscle functions before and after exercise training in stable chronic obstructive pulmonary disease patients

Egyptian Journal of Chest Diseases and Tuberculosis (2020)

HebaA Eshmawey Maged Hassan

Background Respiratory muscle dysfunction and dynamic hyperinflation are considered important factors leading to exercise intolerance in chronic obstructive pulmonary disease (COPD) patients.Aim We hypothesized that respiratory muscle functions would improve after an exercise training program in COPD patients.Patients and methods The study included 24 stable COPD patients, their mean value of forced expiratory volume in the first second (%) was 44.5±15%. The training program was performed three times weekly for 4 weeks. Patients underwent ultrasonographic assessment of diaphragmatic excursion. Maximal inspiratory and expiratory pressures were detected by a handheld manometer. Exercise capacity was assessed using 6-min walking distance. Dyspnea was rated using modified Medical Research Council. Assessment of all parameters was done at baseline and after 4 weeks.Results Maximal diaphragmatic excursion mean value demonstrated a significant increase (from 3.6±1.6 to 4.5±1.2 cm with P=0.006). PImax mean value illustrated a significant increase (from −40.2±13.8 to −43.8±12.1 cmH2O with P=0.010). PEmax mean value showed a statistically significant increase (from 93.9 to 105 cmH2O). There was a significant increase of exercise capacity presented by an increase of 6-min walking distance mean value (from 185.4±68.5 to 358.5±103 m with P<0.001.) Also, a significant improvement in modified Medical Research Council grade was detected (P<0.001).Conclusion Exercise can result in significant improvements of respiratory muscle functions in stable COPD patients. This could be an important factor in the improvement of dyspnea and exercise capacity.

Dynamic hyperinflation

Exercise intolerance

Hyperinflation

10.4103/ejcdt.ejcdt_143_18

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Rapid on-site evaluation: what a microscope will add to the bronchoscopy unit? a concise review

Egyptian Journal of Bronchology (2016)

Maged Hassan

Rapid on-site evaluation (ROSE) of samples obtained by transbronchial needle aspiration during flexible bronchoscopy or endobronchial ultrasound has been practised for more than two decades. Earlier studies evaluating its role have reported a magical impact on improving the diagnostic yield and the adequacy of samples produced by transbronchial needle aspiration. Subsequent studies with more rigorous methodologies failed to find a significant increase in sensitivity with ROSE but consistently demonstrated a trend toward performing shorter procedures with fewer complications when ROSE is utilized. There are new exciting fronts for ROSE, such as using it to direct molecular testing for lung cancer. In the future, we expect more centers to apply ROSE, now that pulmonologists have succeeded in doing so and telecytopathology has become reality.

Pulmonologists

Endobronchial ultrasound

10.4103/1687-8426.193634

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Citations (3)

Utilizing Photogrammetry as a Proficient Tool in Creating Diverse Photorealistic Digital Environments

التصميم الدولية (2024)

Esraa Dissoki Maged Hassan Samah Mohamed

Photogrammetry, which literally translates to 'measurement from photographs' when traced back to its Latin origins, is a scientific technique with a lineage and evolution spanning a century. It represents a three-dimensional scanning technology equivalent to three-dimensional laser scanning, yet it relies on photographic images in this process. Photogrammetry has historically been closely associated with land surveying and topography, finding widespread use in mapmaking during World War II. Over the course of this century, photogrammetry, and its methods of collecting and processing image data have undergone numerous advancements. Initially reliant solely on mechanical and optical measuring tools, it has evolved into a fully digital process in our modern era, where image capture and processing occur entirely on computer systems, rendering it faster and more straightforward. The pursuit of reality simulation remains a persistent goal in digital content design, particularly in creating digital environments for diverse applications across various industries. In this context, photogrammetry emerges as a key technology, offering an unparalleled path toward achieving unparalleled realism in digital scenes. Rapidly, photogrammetric imaging has shifted from relative obscurity to becoming intricately linked with the design of realistic digital environments. Subsequently, it has appeared in numerous films, games, and technical presentations. Thanks to this technology, obtaining a digital replica of any physical object has become more accessible. Several virtual libraries have been established, housing vast arrays of digital replicas, often available, sometimes freely, to diverse digital environment designers. (Frazer, 2021). Research Problem: Despite the evident progress and increasing prevalence of photogrammetry in designing various realistic digital environments, this technology is not optimally utilized due to a lack of understanding regarding its functionality and application across different domains. This research aims to shed light on employing photogrammetry as an effective tool for designing diverse realistic digital environments. Integrating photogrammetric outputs into various industries such as gaming, film production, virtual and augmented reality underscores its significance in enriching visual realism and user experiences. Research Methodology: This research paper follows the Descriptive-Analytical approach by leveraging the technology of photogrammetry and applying it in the design of various realistic digital environments.

10.21608/idj.2024.338398

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Citations (1)