Shibin El Kom

Researchers are evaluating a fully digital, facially driven approach for full-mouth rehabilitation in adults aged 20 to 45 years who have bite difficulties, smile dissatisfaction, and missing mandibular molars. This prospective study focuses on patients with malocclusion requiring precise esthetic and functional dental restoration through advanced digital planning integrating intraoral, facial, and CBCT imaging data. The treatment involves creating a 3D virtual patient model to guide prosthetic design, occlusion, and implant planning. Participants receive conservative anterior rehabilitation with lithium disilicate veneers, monolithic zirconia crowns, temporary anchorage device (TAD)-assisted molar intrusion, and guided implant placement for missing molars. This digital workflow aims to achieve accurate restoration positioning, harmonious bite function, and improved smile esthetics. Participants will undergo assessments including implant stability measured 12 months after treatment. Follow-up visits will monitor the precision and durability of restorations and overall functional outcomes. The study evaluates how this comprehensive digital process supports full-mouth rehabilitation by combining esthetic and functional improvements over time.

Researchers are evaluating the clinical performance of maxillary All-on-X implant rehabilitation, which supports full-arch dental prostheses for patients with terminal maxillary dentition. This retrospective study analyzes data from patients treated using a fully digital stackable guided surgery protocol combined with immediate loading. The purpose is to assess implant survival and peri-implant health outcomes over a two-year follow-up period, including the influence of surgical and prosthetic factors such as basal seating guide design. The treatment involves placing six implants in the upper jaw under local anesthesia using a standardized surgical approach guided by stackable surgical guides. Implant placement is planned with three-dimensional imaging and digital software to determine optimal implant number, position, angulation, and depth relative to the prosthesis. Implants with sufficient stability are immediately restored with a screw-retained provisional fixed prosthesis supported by multi-unit abutments, minimizing occlusal contacts during healing. Participants are followed through a predefined clinical and radiographic schedule for at least two years. Evaluations include implant survival at six months, peri-implant clinical parameters such as plaque index, bleeding on probing, probing depth, and marginal bone level changes assessed via standardized radiographs at prosthesis delivery, one year, and two years. Implant success is measured according to established criteria to monitor the long-term outcomes of the rehabilitation.

Researchers are investigating the effects of early treatment with dapagliflozin (DAPA), a sodium-glucose cotransporter-2 inhibitor, in patients who have experienced an acute myocardial infarction (AMI). The study focuses on whether starting DAPA during the ischemic phase and before primary percutaneous coronary intervention (pPCI) can reduce the size of the heart infarct, protect the heart from damage related to reperfusion injury, and prevent heart failure and kidney injury after AMI. This study addresses the current lack of sufficient data on DAPA's benefits in AMI patients, although it is already approved for heart failure treatment. Participants will be randomly assigned to receive either dapagliflozin 10 mg or a placebo tablet once daily for three months. The treatment starts as early as possible before pPCI and continues throughout the follow-up period. The study compares the two groups to evaluate the impact of early DAPA administration on heart damage and related outcomes following AMI. During the study, patients will be monitored regularly for changes in infarct size and levels of cardiac biomarkers such as NT-proBNP over three months. The researchers will assess cardioprotective and kidney-protective effects by measuring these outcomes. Safety and heart function will be closely observed to understand the treatment's influence on the progression of heart failure after AMI.

Researchers are evaluating the clinical performance of implant-supported restorations made from a novel 3D-printed resin material (CROWNTEC) compared to conventionally milled monolithic zirconia. This randomized controlled clinical trial focuses on patients needing one or two restorations in the lower front jaw area, where both function and appearance are important. The study aims to provide clinical evidence about whether 3D-printed resin can be a viable alternative to zirconia in implant prosthodontics. Participants are randomly assigned to receive either 3D-printed permanent resin restorations or milled zirconia prostheses. All restorations are created using a fully digital process including intraoral scanning, computer-aided design, and standardized manufacturing methods. Restorations may be either screw-retained or cement-retained single crowns or short-span fixed partial dentures (up to 3 units) supported by implants in the mandibular anterior region. Treatments are followed by careful fitting and adjustments. Participants are monitored at baseline and at 3, 6, and 12 months, with follow-up planned through 24 months. Researchers assess restoration survival rates, technical issues like fractures or screw loosening, biological health around implants including plaque and bleeding, changes in bone levels via X-rays, and patient satisfaction with appearance, comfort, and chewing ability using questionnaires. This comprehensive evaluation helps determine the performance and potential role of 3D-printed resin implant restorations over time.

Researchers are studying how genetic variations in VEGFA and KDR affect the treatment of hepatocellular carcinoma (HCC) in Egyptian patients using sorafenib. This clinical pharmacogenetic study aims to improve the effectiveness and reduce side effects of sorafenib by analyzing how these genetic differences influence treatment outcomes. The study is conducted in phases 1 and 2 to evaluate both safety and efficacy. Participants will receive sorafenib tablets at doses ranging from 200 to 400 mg twice daily. The study focuses on patients with HCC and excludes those who have previously received systemic tyrosine kinase inhibitors (TKIs). Genetic testing for VEGFA and KDR will be done at the start of treatment, and again at 3 and 6 months to monitor changes and response. During the study, participants will undergo genotyping assessments at baseline, 3 months, and 6 months after starting sorafenib. Researchers will monitor treatment safety and effectiveness, including any adverse effects. The study spans at least 6 months of treatment, with careful follow-up to understand how genetic factors influence sorafenib therapy in HCC patients.

Researchers are evaluating the potential of esomeprazole as a treatment for patients with non-alcoholic steatohepatitis (NASH). The study aims to assess the drug's effects on liver health using ultrasound and fibrosis risk scores, along with measuring blood levels of liver fibrosis markers, insulin resistance, and various metabolic and inflammatory markers. This is a combined Phase 1 and Phase 2 randomized controlled trial focusing on safety and effectiveness. Participants will receive either esomeprazole at a dose of 20 mg once daily or a placebo once daily. The treatment period lasts for three months during which the impact on liver fibrosis and other health indicators will be monitored and compared between the two groups. Throughout the study, participants will undergo evaluations including imaging tests like liver ultrasonography and blood tests to measure liver fibrosis scores, biomarkers such as fibronectin 1, and metabolic parameters. The main outcome is the change in the non-alcoholic fatty liver disease fibrosis score before and after the three-month intervention. Safety and treatment effects will be closely observed over the course of participation.

Researchers are evaluating the possible effectiveness and safety of a combined treatment using Diosmin and Hesperidin in adults with confirmed Helicobacter pylori infection. This clinical study is conducted in early phases (Phase 1 and Phase 2) and aims to assess how this treatment affects the presence of H. pylori through stool antigen testing and levels of inflammatory markers such as TNF-A and MDA in the blood. Participants in the study will be randomly assigned to receive either Daflon (which contains Diosmin and Hesperidin) at a dose of 500 mg twice daily by mouth or a placebo tablet twice daily for 14 days. This treatment period is followed by evaluations to measure the eradication of the infection and changes in inflammatory markers. During the study, participants will undergo stool antigen tests and blood tests to measure inflammatory biomarkers at the start and after six weeks of treatment. Researchers will monitor participants for safety and treatment effects, with a focus on measuring the rate at which the H. pylori infection is cleared. The total participation period includes the 14-day treatment and follow-up assessments at six weeks.

Researchers are evaluating two prostate biopsy methods to detect prostate cancer in patients who have not had a biopsy before but are suspected of having the disease based on abnormal digital rectal exams and prostate-specific antigen levels between 4 and 20 ng/mL. The study focuses on comparing cognitive-targeted biopsy (CTB) and magnetic resonance imaging-ultrasound fusion-targeted biopsy (FTB) to see which technique better identifies prostate cancer and how the skill of the operator affects the results. Both methods target suspicious areas found on prostate imaging scored as category 4 or 5 by the Prostate Imaging-Reporting and Data System (PI-RADS). Eligible patients will have multiparametric magnetic resonance imaging (mpMRI) of the prostate using a 1.5-Tesla scanner interpreted by an experienced radiologist. During a single biopsy session under local or regional anesthesia using ultrasound guidance, participants will receive both cognitive-targeted biopsy and fusion-targeted biopsy. Two different operators will perform the procedures according to the study protocol, and detailed data about the biopsy process and findings will be collected. Participants will be closely monitored during the biopsy session, with researchers collecting information about cancer detection rates through histopathological examination of biopsy samples, including the presence of clinically significant prostate cancer defined by international pathology grading. Additional data such as lesion location, serum prostate-specific antigen levels, lesion length, and procedure duration will also be recorded. The study aims to gather comprehensive information to improve prostate cancer diagnosis and biopsy techniques.

Septic shock is a severe form of sepsis where the body's response to infection causes dangerous low blood pressure and organ problems, despite receiving fluids. This condition has high death rates worldwide, making quick diagnosis and treatment critical. Managing fluid intake and medications to support blood pressure must be carefully adjusted to each patient to avoid complications like fluid overload. This research compares two methods for predicting how well patients with septic shock respond to fluids. One method uses bedside ultrasound to measure changes in the size of the inferior vena cava during breathing cycles. The other is non-invasive cardiometry, which uses advanced bio-impedance technology to measure heart function parameters like stroke volume and cardiac output without invasive procedures. These approaches aim to guide fluid therapy effectively in critically ill patients. Participants will undergo assessments using both methods to evaluate fluid responsiveness. Researchers will monitor heart function and blood pressure, measuring outcomes within two hours. The study involves critically ill patients with septic shock, focusing on real-time, non-invasive monitoring to improve fluid management. Data collected includes hemodynamic parameters to help predict fluid responsiveness and optimize treatment plans.

Ulcerative colitis is a chronic autoimmune disease that causes inflammation in the colon and is known to be difficult to treat. This research aims to study the safety and effectiveness of adding the antihistamine desloratadine to the standard therapy mesalamine for patients with mild to moderate ulcerative colitis. The study is based on earlier findings that desloratadine may help reduce inflammation and disease activity through its anti-inflammatory and antioxidant effects. Participants will be divided into two groups: one receiving mesalamine alone and the other receiving mesalamine combined with desloratadine. Mesalamine will be taken at a dose of 1000 mg three times daily, while desloratadine will be given once daily at 5 mg. Both treatments will be administered for three months. This phase 2 study compares these two treatment approaches to evaluate potential benefits of adding desloratadine. During the study, participants will be monitored for changes in disease activity and severity over a three-month follow-up period. Researchers will assess safety and therapeutic effects, focusing on inflammation and symptom improvement. The study includes regular evaluations and follow-up visits to collect data and monitor participants' progress throughout the treatment period.