ICU Department

  • Vision
  • Mission
  • Head of the Department
  • Staff Members
  • Research field
  • Achievements
  • Techniques
  • Structure
  • Training
  • Services Scope
  • Medical services
  • Projects
  • Publications
We envision that our doctors will positively impact the health of critically ill patients through their leadership, research contributions, and excellence in patient care.

We have three missions:

Patient Care: To improve the standard of practice and ensure the highest quality of care to patients in our hospitals.

Research: Pursue new knowledge through high-quality research that explores unanswered questions and challenges and refines previously established ideas on mechanisms of disease and clinical aspects of critical care medicine.

Education: Impart knowledge, instills excitement for learning, and translates and refines questions into focused areas of research for our trainees.

Associate Prof. Amna Ahmed Metwaly
E mail: [email protected]

 

 

Former Head

    • Associate Prof. Ashraf Abd El-Khalik
    • Emeritus Prof. Mervat Eldamarawy

Staff Members

    • Emeritus Prof. Mervat Eldamarawy
    • Emeritus Prof. Ashraf Abd El-khalik
    • Emeritus Prof. Fatma Mohmed Nasr
    • Researcher Ibrahim Mohamed AbdElazim
    • Researcher Ehab Esmeel
    • Researcher Ahmed Aly
    • Researcher Shady Mamdooh
    • Assistant Researcher Mohamed Amin Abdel Ghani
    • Assistant Researcher Mohamed Makram Hammam
    • Assistant Researcher Ayman Mahmoud Al-Zamzami
    • Assistant Researcher Hamdy Abdel Wareth Abdel Halim
    • Assistant Researcher Mohammed Youssef Abdel Hamid
    • Assistant Researcher Mohammed Rabie Anwar
    • Assistant Researcher Antonio Safwat Zarif
    • Assistant Researcher Ahmed Al Maghraby
    • Resident Heba Saeed Al Sayed
    • Resident Ahmed Nasser Abdel Fatah
    • Resident Ahmed Mohamad Abdel Mageed
    • Resident Eslam Atta Alla
    • Resident Mai Al Raee
    • Resident Amr Al Refaee
    • Resident Mahmoud Ebrahim
    • Resident Amr Ahmed Abdel Fatah

1- Diagnosis and management of complications of cardiovascular and pulmonary complications of liver diseases; electrolytes, trace elements, hematological and endocrinal disturbances in liver diseases and renal impairment in liver diseases.

2- Diagnosis, and management of cardiovascular and pulmonary complications of renal diseases and electrolytes, trace elements, hematological and endocrinal disturbances in renal diseases.

3- Pathogenesis, diagnosis and management of critically ill patients (either post –surgical or non surgical patients); cardiovascular and pulmonary complications in critically ill patients; renal and liver complications in critically ill patients and electrolytes , trace elements , hematological , metabolic and endocrinal disturbances in critically ill patients.

4- Evaluation of different ICU scoring systems in critically ill patients.


Our researches on cardiovascular complications of liver diseases concluded that:

1- Patients with liver cirrhosis or NAFLD should be evaluated for CVD risk and could be candidates not only for aggressive treatment of the liver disease, but also for aggressive treatment of underlying CVD risk factors; this would help to modify and potentially decrease the global CVD risk of these patients.

2- Tissue Doppler is more sensitive in diagnosing diastolic dysfunction and can better assess filling dynamics than can conventional Doppler.

    • It is important to evaluate cardiovascular function and filling dynamics in every patient with cirrhosis, especially if the patient is a candidate for any intervention that may affect haemodynamics.

3- Patients with decompensated liver cirrhosis have low systemic vascular resistance and Doppler echocardiography provides an easy noninvasive tool to assess systemic vascular resistance.

    • Follow-up of SVR by Doppler echocardiography may be a predictor for severity of liver disease.
    • Measuring IVC diameter and collapsibility are of value in the prediction of intravascular fluid status in liver cirrhosis. This is especially true with renal dysfunction.

4-Hyponatremia is a common finding in patients with decompensated liver cirrhosis indicates an advanced disease with severe cardiovascular dysfunction. It is associated with increased risk of hepatic encephalopathy, refractory ascites, illness severity scores, renal failure, infectious complications, and pleural effusion.

5- The echocardiographic assessment of EpFT and the carotid Doppler assessment of CIMT may provide appropriate and simple screening markers for subclinical atherosclerosis and cardiovascular risk in patients with chronic hepatitis C virus with and without cirrhosis.

    • Patients undergoing LT would likely benefit from echocardiographic assessment of EpFT and carotid Doppler for evaluation of CIMT in addition to stress testing to help identify those patients who are at high or low risk for cardiac outcomes in the LT.

6-It is important to understand the benefits and limitations of BNP as a heart failure biomarker in hepatic patients, where the relationship between BNP level and myocardial function is complex and is altered by the liver disease.

7-Elevated hs-cTnT level in cirrhotic patients can be considered one of the tools used to early diagnose subclinical myocardial necrosis and cirrhotic cardiomyopathy that can prevent adaptation to acute hemodynamic disturbance such as during liver transplantation or intrahepatic portosystemic shunt.

Our researches on cardiovascular complications of renal diseases concluded that:

1-Measurementof CIMT by carotid ultrasound is noninvasive and relatively inexpensive and can be used in addition to echocardiogram repeatedly with no adverse effects to evaluate cardiovascular performance in hemodialysis patients.

2-Epicardial fat thickness which can be easily measured by Echocardiography is an effective marker for the prediction of cardiovascular disease risk in hemodialysis patients and is used as a surrogate marker of early atherosclerosis and was shown to be a strong predictor of future myocardial infarction and stroke.

3-CKD patients have high levels of TM, vWF, t-PA, PAI-1 that is correlated with hsCRP and CIMT. So, these abnormalities in hemostasis may account for the increased risk of atherothrombosis in these patients.

4- Inflammation and endothelial dysfunction are common pathological events in many diseases, including ischemic heart disease and chronic kidney disease. Thus, determining ways to block inflammatory cytokines may provide a vital approach for preventing, or at least retarding, the progression of such diseases.

5- FGF-23 could represent a promising therapeutic target that might improve the fatal prognosis of patients with CKD.

6-Hemodialysis patients with a low s-Klotho were more often associated with increased CIMT, LV dysfunction, and CAD, and it seems that there was an independent association between s-Klotho and CIMT, LVEF, and CAD.

Our researches on sepsis concluded that:

1-BNP level correlates with the severity of sepsis.

  • Atrial ejection force in the third day maybe a good predictor for survival of patients presenting with sepsis.

2- sepsis carries a high risk of multiorgan dysfunction syndrome and death in critically ill patients.

  • PIRO score is an effective model for staging of sepsis and seems to be predictive of mortality.
  • Measuring serial procalcitonin levels may be the most useful to understand the trend, identify the peak, and be able to identify resolution of sepsis.
  • Early high lactate level is a predictor for poor prognosis of sepsis.
  • Adiponectin is similar to procalcitonin in early detection of sepsis and can be used as a prognostic indicator with considering that adiponectin level could be affected by other metabolic disorders.

Our researches on the effect of the abdominal perfusion pressure on visceral circulation in critically ill patients with multiorgan dysfunction concluded that:

1- Considering APP as a measure of visceral perfusion instead of IAP alone if feasible. Avoiding extensive positive fluid balance and deal seriously with fluid overload.

Our researches on scanning of electron microscopic Biofilm grading and ventilator associated pneumonia in relation to duration of intubation concluded that:

1- Biofilm formation and grading as well as bacterial colonization with multidrug-resistant (MDR) bacteria were time dependent in patients on mechanical ventilation in ICU which may enhance their morbidity and mortality rates.

  • Also a role of ETT biofilm is emphasized in the pathogenesis and prognostic outcome of VAP in patients intubated for a prolonged period.
  1. Insertion of central venous access.
  2. Insertion of endotracheal tube.
  3. Inpatient and emergency consultation.
  4. Interpretation of radiological imaging.
  5. Conscious sedation and narcotic prescription
  6. ECG interpretation.
  7. Carotid massage.
  8. Elective cardioversion.
  9. Pleural, peritoneal & pericardial tapping.
  10. Basic & advanced cardiac life support.
  11. Performing of Echocardiography and its interpretation.
  12. Performing of Abdominal ultrasonography and its interpretation.
  13. Performing ultrasonography on Carotid arteries.

The Critical Care Department consists of:

  • 11  ICU beds
  •  7 Ventilators
  •  3 D.C. Shock Device.
  • 11 Monitors and one central monitor station.
  • 11 Syringe Pumps.
  • 4 ECG Devices.
  • 2 Laryngoscopes.
  • 2 Nebulizer Devices.
  • 1 Portable X-Ray.
  • 4 Suction Devices.
  • 11 Air Mattresses.
  • 2 Crush Tables.
  • 3 Blood Sugar Measurement device.
  • 6 Sphygmomanometers.
  • 2 Trolleys.
  • Echocardiograhy machine
  • Portable ultrasound Machine

A- Training courses in different I.C.U procedures e.g. central line insertion, arterial line insertion, endotracheal intubation& E.C.G. interpretation.

B- Training courses are dealing with different equipments in I.C.U e.g. echocardiography, syringe pumps& mechanical ventilators.

C- Training courses are dealing with critical cases referred from different hospitals & dealing with different types of shocks, myocardial infarction, respiratory failure, heart failure &electrolyte imbalance.

D- Training courses are dealing with postoperative critical cases and their complications from different specialties as:

    •  Surgery.
    •  Urology.
    •  Gastroenterology and Hepatology.
    •  Nephrology.

E- Continuous nursing & doctors training on infection control in I.C.U.


  •  Periodic lectures and scientific meetings for residents and physicians.
  •  Periodic training programs for nursing staff and workers in order to improve the level of services provided to the patients.
  •  Daily morning report to discuss the progress of the patients’ conditions and effectiveness of the treatment.
  •  Admission, discharge and referral of patients with daily on-call schedule for emergencies.
  •  Examine patients in the outpatient clinic.

 A) Routine activities

  1. Managing of adult patients presenting with illness, injuries, and disorder of cardiovascular system (acute MI cases, unstable angina, malignant ventricular arrhythmias, acute pulmonary edema).
  2. Monitoring and preventing complication in high risk patients undergoing major surgical procedures.
  3. Management of patients presenting with respiratory failure and requiring mechanical ventilation as ARDS.
  4. Management of patients presenting with coma.
  5. Management of patients presenting with acute renal failure.
  6. Management of advanced systemic sepsis.
  7. Management of patients with coagulopathies or uncontrolled bleeding.
  8. Management of hepatic failure.
  9. Inpatient and emergency consultation.
  10. Nutrition in ICU.
  11. Echocardiography for critically ill patients to help their diagnosis and management and for evaluation of patients preoperatively and for patients from outpatient clinics.

B) Scientific and Clinical Services:

Service / Consultation
Requesting Department
Provided Services
Pre-operative Assessment
– General Surgery.
– Urological Surgery.
– Emergency Operations.
– Emergency Department.
– Nephrology Department
– GIT Department.
– Outpatient Clinics.
 
Anesthesia, surgical ICU and pain management department.
– Preoperative assessment and management of patients before and after major Surgeries.
 
 
– Admission, Diagnosis and Treatment of Critically ill patients from ER and different departements.
Admission of Critically ill patients from ER, OR and wards.


Researcher : Prof. Amna Metwaly (PI)
Project : Early diagnosis of Cardiovascular Complications in Chronic Liver Diseases

Researcher : Prof. Ashraf Abdel Khalek (PI)
Project : Early diagnosis and detection of cardiovascular complications in patients with sepsis and septic shock.

Researcher : Prof. Fatma Mohamad Nasr (Researcher) 
Project : Diagnostic Value of Sepsis Biomarkers in Intensive Care Unit Patients. 

Researcher : Amna Metwaly (Researcher) 
Project : Atherosclerosis risk in patients with chronic kidney disease: role of cytotoxic T-lymphocyte and systemic inflammation.

Researcher : Ashraf Abdel Khalek  (Consultant)
Project : Biofilm on endotracheal tubes.

Researcher : Ashraf Abdel Khalek  and Prof. Amna Metwaly (Researchers) 
Project : Pathophysiology of anemia in Chronic Renal Failure: New Treatment Alternative.

  1. El Damarawy M, Hamed G, Heikal A, Darwish H (2012): MELD score as a predictor for hepatoadrenal syndrome. The Journal of American Science,8 (7):1545-1553
  2. Shawky A, Mohamed A, Hussein M, Sany D, Darwish H (2012) Value of RIFLE classification for predicting outcome of critically ill cirrhotic patients. African Journal of Nephrology, 16 (2) :159 – 168.
  3. Raafa M, Metwaly A, Abdel Khalik A , Abu Zikri N, Madkour M and Hussein N (2012): Inflammatory and nutritional biomarkers : Role as Non-Traditional Risk factors for cardiovascular morbidity in patients with Chronic kidney disease. Life Sci J, 9 (2): 1109-1116.
  4. Abdel khalik A, Metwaly A, Mohammad F. Nasr, Al Damarawy M, Youssef Y. (2012): Evaluation of Carotid Intima- Media Thickness, Left Ventricular Mass and Left Atrium Diameter in Chronic Liver Diseases. Life Science Journal; 9 (2): 1199-1206.
  5. Mohammad F. Nasr , Metwaly A., Abdel Khalik A., Amal I. Sabry A. I., Hassan M. and Desouky A. M . (2013): VEGF and PDGF in liver cirrhosis and their relation to echocardiographic parameters and Carotid Intima-Media Thickness Life Science Journal; 10 (4):1102- 1110.
  6. Mohsen Maher,TarekYossef,HeshamDarwesh, Ahmed El Saady, Amal I. Sabry, Waled A Hamed and Antonio Safwat. (2013):Role of interleukin 6 as a predictor of hepatic encephalopathy in critically ill patients. Life Science Journal,10 (12s) :987-991.
  7. Mohsen Maher,TarekYossef, Amal I. Sabry,Shereen A. Saleh and H. Alkady. (2013):
    Hyponatremia and zinc deficiency as a risk factor for hepatic encephalopathy in cirrhotic patients.Life Science Journal10 (3) :1493-1500.
  8. Alsherif A, Darwesh H, Badr M, El DamarawyM,Shawky A, Emam A (2013) – SOFA score as a predictor of mortality in cirrhotic patients. Life Science Journal 10 (2) :2384 – 2392
  9. Badawi H, El Damarawy M, Atteya A, Bastawesy R, El Said M, Helmy A, Helmy O and Ismail E (2014) – Detection of Bioliogical Nano-Particles in Egyptian Patients with Coronary Artery Disease. Life science Journal; 11 (2).
  10. Abd El-Khalik A, Raafat A, Metwaly A, Mohammad F Nasr, Sherif N, Nessim I. (2014): Cardiovascular calcification in chronic hemodialysis patients: Contributors interplay. American journal of life science; 2(5): 251- 259.
  11. Hatem H. Elatroush, Nashwa Abed, Amna A. Metwaly, MohamedI. Afify, Mayada M. Hussien. (2014): The effect of the rising abdominal perfusion pressure on kidney Function assessed by the RIFLE criteria in critically ill patients with multiorgan dysfunction American Journal of Life Sciences; 2(6): 333-337.
  12. Emam Waked; Emad Abdallah; Ashraf Abd El-Khalik; Malak Nabil and Faten El-Shanawani. (2014): The Prognostic value of N-Terminal-ProBrain Natriuretic Peptide in the Diagnosis and to Detect the Progression of Left Ventricular Mass and Function in Patients with Chronic Kidney Disease. Life Science Journal;11(8). 51-59
  13. Mohamed Badr Salim, Hesham Elaasr, Ashraf Wadee, Mervat El Damarawy, AlaaAshour, Fatma Mohammad Nasr. (2014): Atrial Ejection Force and Brain Natriuretic Peptide as Markers for Mortality in Sepsis. The Egyptian Journal of critical care medicine, http://dx.doi.org/10.1016/j.ejccm.2014.11.001
  14. Abd El-Khalik A Barakat, Mohammed A Nasr, Metwaly A, Abd El-Rouf M RaafatAmeen. (2015): Correlation between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. American Journal of Internal Medicine; 3(3): 86-94.
  15. H. EL Atroush , N. Abed , A. Metwaly , M. Afify , M. Hussien . (2015): The effect of the abdominal perfusion pressure on visceral circulation in critically ill patients with multiorgan dysfunction. The Egyptian Journal of critical care medicine; 3,63-67.
  16. Abd El-Khalik A, Mohammad F Nasr, Metwaly A, El-Ghannam A. (2015): Systemic vascular resistance and fluid status in patients with decompensated liver cirrhosis with or without functional renal failure in Egypt. Electronic Physician.; 7(4(: 1174-1182.
  17. Mohammad F Nasr, Metwaly A, Abdel khalik A, Darwish H. (2015): Cardiac dysfunction in liver cirrhosis: a tissue Doppler imaging study from Egypt Electronic Physician; 7(4): 1135-1143.
  18. Abd El-Khalik A Barakat, Metwaly A, Mohammad F Nasr, El-Ghannam M, Darwish A El-Talkawy, Abu Taleb H.( 2015): Impact of hyponatremia on frequency of complications in patients with decompensated liver cirrhosis. Electronic Physician; 7 ( 6): 1349-1358 .
  19. ManarRaafat, Mona Madkour, AmnaMetwaly, Fatma Mohammad Nasr, Osama Mosbah, Noha El-Sheikh.( 2015): Clinical significance of FGF-23 in Chronic Kidney Disease. Patients. Sch. J. App. Med. Sci.,; 3(2C):741-750.
  20. Manal Zahran, Fatma Mohammad Nasr, AmnaMetwaly, Noha El-Sheikh, NevineSherif Ali Khalil and TarekHarb. (2015): The Role of Hemostatic Factors in Atherosclerosis in Patients with Chronic Renal Disease. Electronic Physician.; 7 (5): 1270-1276.
  21. Metwaly A, Abdel khalik A, Mohammad F Nasr, Ismail A Sabry, Fathy M Gouda, Hassan M. ; (2015): Brain Natriuretic Peptide in Liver Cirrhosis and Fatty Liver: Correlation with Cardiac Performance. Electronic Physician; 8 (2): 1984-1993.
  22. Mohammed Amin Abd-Elghany, Nahed Salah Eldin, Sherif Wadie, Mervat Mohammed El- Damarawy, Fady Adib Abd-El-Malek, Ashraf Abd El-Khalik Barakat (2015): Adiponectin as a Predictor for the Severity of Sepsis in ICU Patients. American Journal of Internal Medicine.; 3(1): 6-14.
  23. Shendy Mohammed Shendy, Mohamed Darwish El-Talkawy, Abdel Aziz Ali Saleem, WaelSafwat, Mona Adel, Ashraf Abd El- Khalik and Hoda Abu Taleb.( 2015): Relation between Non-Alcoholic Fatty Liver Disease and Epicardial Fat in Metabolic Syndrome. The Egyptian Journal of Hospital Medicine., 60, 314-323.
  24. Hassan S El-Shishtawy, Mosbah O, Sherif N, Metwaly A, Hanafy A, Kamel L.( 2016): Association between serum visfatin and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis. Electronic Physician.; 8(2): 1966-1972.
  25. AbdallahA ;Mosbah O; Khalifa G; Metwaly A; El-Bendary O. (2016): Assessment the relationship between serum soluble klotho and carotid intima-media thickness and left ventricular dysfunction in hemodialysis patients. Kidney Res Clin Pract 35 42-49.
  26. Magda Azmy, Lobna Ghanem, Fatma Kassem, Doaa Gamal, Ashraf Abdelkhalek, Emtethal El-Kholy, Mervat Abo EL Eneen (2016): Scanning Electron Microscopic Biofilm Grading and Ventilator Associated Pneumonia in Relation to Duration of Intubation. EJMM, 25, 3, 81-88.
  27. Ashraf Abd El-KhalikBarakat, Fatma Mohammad Nasr , Amna Ahmed Metwaly, Sherif Morsy , Mervat El damarawy.( 2016):Atherosclerosis in chronic hepatitis C virus patients with and without liver cirrhosis. Egyptian Heart Journal; 62(2), 139-147.
  28. Noha El Sheikh, Nevin Sherif, Mervat Eldamarawy, Ahmed Ali, Amal I. Sabri (2016): The link between bone disease and cardiovascular complications in hemodialysis patients. Electronic Physician 6, 8(6): 2483-2488.
  29. Rania K. Darwish, Afaf Abd El-Hady, Doa M. Aly, Amal I. Sabry and Fatma A. Fathy. The role of intercellular adhesion molecule-1 gene polymorphism in the development of cardiovascular disease.
  30. A. A. E.-K. Barakat, F.M. Nasr, A.A. Metwaly, S. Morsy, M. El Damarawy (2017): Atherosclerosis in chronic hepatitis C virus patientswith and without liver Cirrhosis. The Egyptian Heart Journal 69, 139-147. http://dx.doi.org/10.1016/j.ehj.2016.10.004. 1110-2608 _ 2016 Egyptian Society of Cardiology. Production and hosting by Elsevier B.V.
  31. Ashraf Abd El-Khalik Barakat, Fatma Mohammad Nasr, Amna Ahmed Metwaly, Amal I. Sabry, Mona Hassan (2017): High Sensitivity Troponin T Level and Cardiovascular Performance in Patients with Liver Cirrhosis. High Sensitivity Troponin T Level and Cardiovascular Performance in Patients with Liver Cirrhosis. Int J Med Res Prof.; 3(3):155-58.
  32. Ashraf Abd El-Khalik Barakat, Fatma Mohammad Nasr, Amna Ahmed Metwaly (2017): Tissue Doppler Study of Right and Left Ventricular Function in Nonalcoholic Fatty Liver Disease. Int J Med Res Prof.; 3(3):53-59. DOI:10.21276/ijmrp.2017.3.3.072.
  33. Nevine Fam, Doaa Gamal, Magda Azmy, Reham Wasfy, Laila Aboul-Fadl, Mohamed Badr, Mervat El-Damarawy (2017). Antimicrobial Efficacy of Doripenem Colistin Combination on Carbapenem-Resistant Acinetobacter baumanii Isolates by E-test Agar Dilution and Ultrastrastructural Methods. Egyptian Journal of Medical Microbiology Volume 26 / No.1 / January 2017 1-7
  34. Ayman M Alzamzamy, Ashraf A Barakat, Hany V Zaki, Walid H Nofal, Walid A Altaher, Ayman M Kamaly. Serum Lactate & Cystatin C Based Model of End Stage Liver Disease (MELD) As Prognostic Factors in Patients with Liver Cirrhosis in Intensive Care Unit. Int J Med Res Prof.2018 July; 4(4); 187-94.  
  35.  Khaled Abd ElHamed  Mohammed , Inas El Khedr Mohammed, Hany Haroun Kaiser, Khaled Rafik Albaz, Hesham Darwesh. Role of Serum Dipeptdyle Peptidase IV (DDP IV) Activity in Development of Non-Alcoholic . Steatohepatitis in Patients with Non-Alcoholic Fatty Liver Disease.  Int. J. Med. Research Prof. 2018 Sept. 4 95): 248-56 P-ISSN: 2454-6356: E- ISSM: 2454 – 6364 DOL. 10, 21276/Ijmrp 
  36. Khalil Ali Khalik, Fadi Mostafa Attia, Fawzy Attia Khalil, Ahmed Hamdey El Tabey, Hany Haron, Hesham Drwesh. Study of Zinc Level in Egyptian Cirrhotic Patients with Different Stages of Liver Cirrhosis       Int. J. Med. Res. Prof. 2018 Nov. 4 (6): 40-47, P-ISSN: 2954-6356, EISSN: 2454-6364 DOL.10-21276(1)mrp 
  37. Hazem Mohamed Fawzi, Amna Ahmed Metwaly, Eman Mohamed Kamal, Riham Fathy Galal, Mahmoud Ibrahim Eldosoky Mahmoud. MELD Score in Critical Cirrhotic and Non Cirrhotic Patients Nature and Science 2019;17(11) 
  38. Doaa Gamal , Dalia Salema, Marta Fernandez-Martinezb, Ashraf Abdelkhalik, Inas EL-Defrawy. Colonization with OXA-23 and NDM Positive Clonally Related Carbapenem Resistant Acinetobacter baumannii in ICU Patients from Egypt. Int. J. Pharma. Research | J 2019,11(3): 331-337. 
  39. Osama Saad Arafa, Hesham Mohamed Abo El enein, Neima Ali El Melegy , Hisham Darwesh , Ahmed Mohamed El Saied. Cardiopulomary Efficacy of a Single Dose of Sildenafil in Patients with Chronic Heart Failure          Internation a Journal of medical research progessionals P-ISSN: 2454- 6356: E –ISSN: 2454-6364 DOL: 10 , 21276 / Iymrp, 2019 Mar, 5 (2) 155-58   
  40. Ahmed Abdel Monein, El Sayed Abdel Khalik , Neama El Melegy, Mohamed Abdou Salam, Walid Abdalla Mesaliman, Hisham Drwesh. Prevalence and Clinical Predictors of Heparin Induced Thrombocytopenia   Int. J. Med Res. Prof. 2019 Mar, 5 (2): 155-58,     P-ISSN 2454-6356:E- ISSN : 2454-6364, DOL: 10- 21276.Ijmrp 
  41. Heba Abdel Kader, Tarek Helimy Abo EL Azm, neima Ali El Melegy, Hesham Drwesh. Prognostic Value of Elevated Biomarkers in Diabetic and Non Diabetic Patients Admitted for Acute Coronary Syndromes, Int. J. Med Res. Prof. 2019 Mar, 5 (2): 155-58, P-ISSN 2454-6356:E- ISSN : 2454-6364, DOL: 10- 21276.Ijmrp 
  42. Sherif Wadie Nashed Srtgios, Ashraf Mahmoud Hazem Mohamed, Hesham Mahmoud Hassan Darwesh , Marwa Ahmed Khairy EL Beialy, Ahmed Mohamed Abdel Maguid Serageldin. Serum Sodium as a Predictor to the Outcome of Critically in Cirrhotic Patients    Nuture and Science 2019, 17 (10) Volume17 Number 10 October 25, 2019 ISSN : 1545-0740 
  43. Ahmed Fayed, Ahmed Soliman, Mohamed Badr, Mohamed Abdel moniem, Hesham Darwish. The  Relation Between Flow Mediated Dilatation of the Brachial Artery and Acute kidney Injury in the Patients Admitted to the ICU.  Researcher 2019, 11 (8) Volume 11, Number 8 August 25, 2019, ISSN : 1553-9865.
  44. Mervat Mohamed Marzouk, Mervat Mohamed Eldmarawy, Sameh Salem Hefny, Rania Mahrous Aly, Ahmed Nasser Abdel Fattah Mahmoud (2019). Evaluation of the usefulness of sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation III (APACHE III) scoring systems in outcomes prediction of critically ill cirrhotic patients. Nat Sci 2019,17(11):24-30]. ISSN 1545-0740 (print), ISSN 2375-7167 (online) http://www.sciencepub.net/nature. 3. doi:10.7537/marsnsj171119.03.
  45. Fatma Mohammad Nasr, Amna Metwaly, Ashraf Abdel khalik, Manar Raafat, Malak Nabil, Noha Elsheikh. Value of troponin T as a screening test of cardiac structure and function in chronic kidney disease. Presented at the 47th Annual International Congress of the Egyptian Society of Cardiology, February 2020. 
  46.  Manar Raafat, Malak Nabil, Nevine Sherif1, Amnna Metwaly, Manal Zahran, Omar Sabry. Evaluation of statin anti-inflammatory effect on atherosclerosis in chronic kidney disease. Medical Science.  2020; 24(103), May – June,  
  47.  El Hadidy S, Albadry A, Radwan W, Metwaly A, Farouk K. Non invasive hemodynamic monitoring of fluid resuscitationin cirrhotic patients with acute kidney injury. Open Access Maced J Med Sci. 2020 Jun 11; 8(B):319-323 
  48. Ahmed Fayed, Ahmed Soliman, Mohamed Badr, Mohamed Abdelmoniem, Hesham Drwesh, Mohamed Fakher and Mahmoud Salem Soliman. Fasting Insulin Level and homatest IR as predictors of Acute Kidney Injury in Critically ill Patients. Bulletin of The National Research Center , 2020 Fayed et al . Bulletin of the National research Center , https://doi.org/10.1186/s42269-020-00326-8, Springer Open 
  49. Nasr FM, Metwaly A, Khalik AA, Raafat M, Nabil M, Kamel L, Elsheikh N. Value of troponin T as a screening test of cardiac structure and function in chronic kidney disease, Global Cardiology Science and Practice 2021:26. https://doi.org/10.21542/gcsp.2021.26
  50. Reham Mohammed El-Shabrawy, Awny Aly Gawish, Rania Mahdy Abdelaziz Elgabry, Fatma Mohammad Nasr, Manal Diab, Doaa Gamal. Presepsin, procalcitonin and C-reactive protein as diagnostic biomarkers of sepsis in intensive care unit patients. Microbes and Infectious Diseases 2021; 2(1):119-129.DOI: 10.21608/MID.2021.54196.1100.
  51. Abdallah E, Sherif N, Mosbah O, Metwally A, Abd ElAzim I, Mahmoud O, Farouk M, Mamdouh S, El-Shishtawy S, Mohamed A. The Relationship between Serum Sclerostin Levels and Bone Mineral Disorders and Vascular Calcification in Hemodialysis Patients. Open Access Maced J Med Sci [Internet]. 2021 Dec. 13 [cited 2022 Aug. 4];9(B):1664-71. Available from: https://oamjms.eu/index.php/mjms/article/view/7578
  52. Hatem H. Al Atroush, Khaled H. Mohammed, Fatma M. Nasr, Mohammed I. Al Desouky, Mohammed A. Rabie. Cardiac dysfunction in patients with end‑stage liver disease, prevalence, and impact on outcome: a comparative prospective cohort study. Egyptian Liver Journal 2022; 1-11. https://doi.org/10.1186/s43066-022-00200-4.
  53. Mamdouh D, Shawky H, Moustafa El-Assaly N, El-Shishtawy S, Sherif N, Metwaly A, Mohamed Fteah A. Role of Transcription Factor 7 like 2 and Silent Information Regulator 1 Genes in the Development of Cardiovascular Complications in a Group of Egyptian Patients with Chronic Kidney Disease. Open Access Maced J Med Sci [Internet]. 2022 Jan. 1 [cited 2022 Aug. 4];10(A):16-24. Available from: https://oamjms.eu/index.php/mjms/article/view/8107
  54. Hala Gomaa Salama Awad, Mervat Mohamed El Damarawy, Waleed Abdallah Ibrahim Ahmed, Ashraf Nabil Saleh, Ibrahim Mohammed Abd El Azim, May Elraey Abdelaziz Aly Ghonim (2022). Serum Procalcitonin, CRP, Lactate and Albumin as Predictors of Mortality in Critically Ill Cirrhotic Patients. The 42nd Annual conference of ain shams faculty of medicine march2022 (online-Under publication)