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Cammareri G, Lanzani C, Cirillo F, Macalli E, Turri A, Rehman S, Buzzella F, Ferrazzi E. O128 ISOBARIC MYOMECTOMY: SURGICAL AND REPRODUCTIVE OUTCOMES OF 5 YEARS EXPERIENCE. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cammareri G, Turri A, Lanzani C, Rehman S, Cirillo F, Buzzella F, Ferrazzi E, Di Francesco S. O129 OFFICE HYSTEROSCOPIC MYOMECTOMY: EFFECTIVE AND EFFICIENT PROCEDURE. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sharif M, Shahzad MA, Rehman S, Khan S, Ali R, Khan ML, Khan K. Nutritional evaluation of distillery sludge and its effect as a substitute of canola meal on performance of broiler chickens. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2012; 25:401-9. [PMID: 25049579 PMCID: PMC4092959 DOI: 10.5713/ajas.2011.11279] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 11/07/2011] [Accepted: 11/02/2011] [Indexed: 11/27/2022]
Abstract
The study was conducted to investigate the chemical composition of distillery yeast sludge and its inclusion in broiler diets to replace canola meal. Raw distillery yeast sludge was washed with water using water and sludge in the ratio 6:1, respectively. Proximate analysis of raw distillery yeast sludge and washed distillery sludge was carried out for crude protein (CP), true protein (TP), ether extract (EE), ash, acid insoluble ash and nitrogen free extract (NFE) determination. Mineral contents and amino acid profile of raw distillery yeast sludge and washed distillery sludge were also determined. After chemical evaluation, four iso-caloric and iso-nitrogenous broiler starter and finisher diets were prepared in mash form using 0 (control), 4, 8 and 12% levels of washed distillery sludge replacing canola meal. One hundred and twenty day-old broiler chicks were randomly distributed into 12 experimental units in such a way that each diet was offered to three experimental units, each comprising of 10 chicks. It was observed that washing affected the nutrients either by decreasing or increasing their concentration. It decreased the total mineral contents whereas CP, TP, EE and NFE contents increased. Washing also increased amino acid profile. Average feed intake and weight gain were higher in birds fed diet containing 8% washed distillery sludge and lower in birds fed diet containing 0% washed distillery sludge. Feed cost per kg live weight gain decreased significantly as the level of washed distillery sludge was increased in the diet. Average heart, liver and pancreas weights decreased with increased level of washed distillery sludge in the diet. The study revealed that after washing, distillery yeast sludge can be used successfully in broiler diets up to the level of 8% without any adverse effect on broiler’s performance.
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Fowler JR, Kleiner MT, Das R, Gaughan JP, Rehman S. Assisted closure of fasciotomy wounds: A descriptive series and caution in patients with vascular injury. Bone Joint Res 2012; 1:31-5. [PMID: 23610668 PMCID: PMC3626192 DOI: 10.1302/2046-3758.13.2000022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 03/09/2012] [Indexed: 01/20/2023] Open
Abstract
Introduction Negative pressure wound therapy (NPWT) and vessel loop assisted
closure are two common methods used to assist with the closure of
fasciotomy wounds. This retrospective review compares these two
methods using a primary outcome measurement of skin graft requirement. Methods A retrospective search was performed to identify patients who
underwent fasciotomy at our institution. Patient demographics, location
of the fasciotomy, type of assisted closure, injury characteristics,
need for skin graft, length of stay and evidence of infection within
90 days were recorded. Results A total of 56 patients met the inclusion criteria. Of these,
49 underwent vessel loop closure and seven underwent NPWT assisted
closure. Patients who underwent NPWT assisted closure were at higher
risk for requiring skin grafting than patients who underwent vessel
loop closure, with an odds ratio of 5.9 (95% confidence interval
1.11 to 31.24). There was no difference in the rate of infection
or length of stay between the two groups. Demographic factors such
as age, gender, fracture mechanism, location of fasciotomy and presence
of open fracture were not predictive of the need for skin grafting. Conclusion This retrospective descriptive case series demonstrates an increased
risk of skin grafting in patients who underwent fasciotomy and were
treated with NPWT assisted wound closure. In our series, vessel
loop closure was protective against the need for skin grafting.
Due to the small sample size in the NPWT group, caution should be
taken when generalising these results. Further research is needed
to determine if NPWT assisted closure of fasciotomy wounds truly
leads to an increased requirement for skin grafting, or if the vascular
injury is the main risk factor.
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Rehman S, Ahmad J, Lanzoni C, Autonell CR, Ratti C. First Report of Citrus tristeza virus in National Germplasm of Citrus in Afghanistan. PLANT DISEASE 2012; 96:296. [PMID: 30731841 DOI: 10.1094/pdis-08-11-0647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Rejuvenation of the horticulture industry is a government priority in Afghanistan. With that purpose, European Commission-supported programs specifically focus on greater access to improved and appropriate planting materials to increase the quantity and quality of more competitive horticultural products. Establishment of a biotechnology laboratory was considered essential support to horticulture sector development. This laboratory has begun screening the health status of the Afghan Germplasm National Collection to ensure multiplication of not only the best selected varieties or ecotypes but also to avoid reproduction and distribution of virus-infected fruit trees. Symptom inspection and sample collection for viral diseases was carried out in the citrus orchard during survey activity at the National Collection Experimental Farm in Jalalabad (Nangarhar Province). Ninety-nine variety plots (one row of five plants) were inspected visually and samples from two plants for each plot were collected and analyzed by double-antibody sandwich (DAS)-ELISA. Plants showing vein flecking, yellowing, and plant decline symptoms were observed in several plots. Four accessions were found to be infected by Citrus tristeza virus (CTV): kumquat cv. Margarita (isolates J4 and J8), orange cv. Mahali (J61), mandarin group cv. Fruter (J76), and rough lemon cv. Mahali (J101). Identified isolates have been characterized molecularly. A 655-nt fragment, corresponding to the major coat protein gene, has been amplified from all ELISA-positive samples by reverse transcription (RT)-PCR using CTVF (5'-TAATGGACGACGAACAAAGA-3') and CTVR (5'-CCAAGCTGCCTGACATTAGT-3') primers. Sequence analysis revealed high similarity, ranging from 91.1 to 99.8%, within CTV isolates detected in Jalalabad. In accordance with the phylogenetic groups previously defined (page 8 in: Proceedings of the 15th Conference of the International Organization of Citrus Virologists, 2002), nucleotide sequences of Afghan CTV isolates investigated in the current work cluster in Group 1 (J4 and J8), Group 4 (J61 and J76), and Group 5 (J101). In particular, J4 and J8 isolates show, respectively, identity of 99.4 and 99.2% with reference isolate T36 (GenBank Accession No. M76485) from the United States (Florida). Moreover, in Group 4, isolate J61 and J76 were more similar to ANO-1 isolate (GenBank Accession No. DQ211658) from Egypt (identity of 98.5 and 98.0%, respectively) than to isolate 443-4 (GenBank Accession No. AY791844) from Croatia (97.4 and 97.5%, respectively). Finally, isolate J101 in Group 5, shows identity of 95.6% with isolates C268-2 (GenBank Accession No. AY750770) and C269-6 (GenBank Accession No. AY750775) from Argentina. To our knowledge, our results identified for the first time CTV-infected plants in Afghanistan. The presence of CTV in four accessions of the national citrus collection is of concern for Afghan horticulture. Implementation of the certification schemes is therefore necessary to guarantee the production and the employment of virus-free propagating material.
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Ahmed J, Mehmood S, Rehman S, Ilyas C, Khan L. Impact of a structured template and staff training on compliance and quality of clinical handover. Int J Surg 2012; 10:571-4. [DOI: 10.1016/j.ijsu.2012.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 08/11/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
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Rehman S, Tangri A, Shin J, Mehta V, Moore A, Breen D, Black E. 187 Endobronchial intervention at Oxford – two year experience and outcomes. Lung Cancer 2012. [DOI: 10.1016/s0169-5002(12)70188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Zhang JB, Balla NK, Gao C, Sheppard CJR, Yung LYL, Rehman S, Teo JY, Kulkarni SR, Fu YH, Yin SJ. Surface Modified Gold Nanorods in Two Photon Luminescence Imaging. Aust J Chem 2012. [DOI: 10.1071/ch12037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Gold nanorods (AuNRs) possess unique optical properties which make them good contrast agents for optical microscopy. Their longitudinal plasmon resonance peak can be easily tuned from red to near infrared wavelength by increasing their aspect ratio to match the wavelengths of different imaging modalities. AuNRs are also stronger scatterers of light as compared with gold nanospheres. Nevertheless what sets them apart from other gold nanoparticles is their strong multiphoton luminescence. AuNRs are therefore being increasingly used as contrast agents for multiphoton microscopy of biological samples. In this study, control of the longitudinal resonance peak of gold nanorods is investigated with comparison of two chemical synthesis approaches. Both based on a seed-mediated method, one approach is to tune the aspect ratio through manipulation of the ratio of gold seeds to gold salt and the other is through variation of the volume of hydrochloric acid. The synthesized gold nanorods were made biocompatible by replacing the cytotoxic cetyltrimethylammonium bromide (CTAB) molecules with either silica (SiO2) or polyethylene glycol (PEG). Multiphoton imaging of gold nanorods taken up by cells was demonstrated and the effect of PEG chain length on passive uptake of gold nanorods by cells is discussed.
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Wasim M, Rehman S, Arif M, Fatima I, Zaidi JH. Neutron activation analysis and atomic absorption spectrophotometry for the analysis of fresh, pasteurised and powder milk. RADIOCHIM ACTA 2012. [DOI: 10.1524/ract.2012.1890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
This study shows the application of semi-absolute k
0 instrumental neutron activation analysis (k
0-INAA), epithermal neutron activation analysis (ENAA) and atomic absorption spectrophotometry (AAS) for the determination of 21 elements (Br, Ca, Cl, Co, Cr, Cs, Cu, Fe, Hf, I, K, Mg, Mn, Na, Ni, P, Pb, Rb, Sc Sr, and Zn) in different types of milk samples. The ENAA was required for the determination of iodine, AAS for Cu, Ni and Pb and the rest of the elements were measured by k
0-INAA. Thirteen elements (Br, Ca, Cl, Cs, Cu, Fe, K, Mg, Na, P, Rb, Sr and Zn) were identified in all milk samples. Ni was detected in eleven and Pb in two samples. Concentrations of most of the elements were within the ranges of the world reported data. The data was further explored by principal component analysis to find relationships between samples and elements.
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Cammareri G, Lanzani C, Di Francesco S, Macalli E, Turri A, Rehman S, Zampogna G, Ferrazzi E. A New Generation Reusable Flexible Coaxial Bipolar Hook Electrode in Office Hysteroscopy. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cammareri G, Lanzani C, Di Francesco S, Macalli E, Turri A, Rehman S, Zampogna G, Ferrazzi E. Two-Steps Office Hysteroscopy for the Treatment of Endometrial Polyps. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brockway K, Hunter G, Reddy C, Rehman S, Stephans K, Ciezki J, Xia P, Tendulkar R. Late Toxicity after 70 Gray of Intensity Modulated and Image Guided Radiation Therapy Following Radical Prostatectomy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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63
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Rehman S, Reddy C, Shukla M, Tendulkar R. Impact of Radiation Dose on Locoregional Recurrences in Lymph Node Positive Breast Cancer Treated with Mastectomy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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64
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Tendulkar R, Rehman S, Shukla M, Reddy C. Locoregional Recurrence after Mastectomy in Breast Cancer Patients with 1-3 Positive Lymph Nodes Treated with Modern Systemic Therapy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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65
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Rehman S, Khan S, Pervaiz A, Perry EP. Recurrence of inguinal herniae following removal of infected prosthetic meshes: a review of the literature. Hernia 2011; 16:123-6. [PMID: 21858435 DOI: 10.1007/s10029-011-0873-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 07/31/2011] [Indexed: 10/17/2022]
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66
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Ali N, Shah S, Khan J, Rehman S, Imran M, Hussian I, Shehbaz N, Jamshed H, Khan S. Pharmacotherapy-Based Problems in the Management of Diabetes Mellitus: Needs Much More to be Done! J Young Pharm 2011; 2:311-4. [PMID: 21042492 PMCID: PMC2964773 DOI: 10.4103/0975-1483.66801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A total of 856 diabetic patients were evaluated for pharmacotherapy-based problems like for possible drug interactions, adverse drug reactions, and other mismatches, if any. Poor correlation between the advised insulin therapy and patients’ fasting blood glucose levels (12%, n=103) was observed. To most of the patients (41.66%, n= 357), insulin therapy was advised in combination with glucocorticoides, thiazides diuretics, and propranolol. Prescribing beta blocker (propranolol) with insulin is contraindicated. The higher incidence of diabetic foot patients was in the mean age of 57±3.4 years that was controlled with combination therapy of insulin and oral antidiabetics (63.0%, n=516). 11.1% of the treated patients could not take the prescribed therapy due to poor acceptance of insulin therapy due to its syringe needle prick. 41.66% risks of potential drug interactions, 7.93% adverse drug reactions, and 6.6% mismatches were recorded, as per the international approved algorithm, for managing a diabetes mellitus that reflects poor health care system. All these events necessitate for coordinating with other health professionals to make the therapy safer in the better interest of the patients. It is concluded that in practice prescribing pattern carries more risks for patients. It is imperative to improve the practice of pharmacotherapeutics rather than to practice in routine.
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Rehman S, Tendulkar RD, Reddy CA, Macklis RM. Outcomes of inflammatory versus noninflammatory T4 breast cancers in the age of taxanes and trastuzumab. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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68
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Ali A, Krishnan A, Rehman S, Rao V, Pearson HJ. Giant colonic mucocele following palliative surgery for metastatic adenocarcinoma. J Surg Case Rep 2011; 2011:1-4. [PMID: 24950564 PMCID: PMC3649222 DOI: 10.1093/jscr/2011.3.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We report an unusual case of a giant colonic mucocele following ileo-sigmoid bypass surgery in a patient with advanced adenocarcinoma of the splenic flexure. The formation of a giant colonic mucocele resulted from distal splenic flexure obstruction due to tumour relapse and proximal caecal obstruction due to peritoneal disease with subsequent accumulation of mucus in the closed loop.
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69
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Rehman S, Shawl AS, Kour A, Andrabi R, Sudan P, Sultan P, Verma V, Qazi GN. An endophytic Neurospora sp. from Nothapodytes foetida producing camptothecin. APPL BIOCHEM MICRO+ 2011. [DOI: 10.1134/s0003683808020130] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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70
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Zhang X, Arnott JA, Rehman S, Delong WG, Sanjay A, Safadi FF, Popoff SN. Src is a major signaling component for CTGF induction by TGF-beta1 in osteoblasts. J Cell Physiol 2010; 224:691-701. [PMID: 20432467 DOI: 10.1002/jcp.22173] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Connective tissue growth factor (CTGF/CCN2) is induced by transforming growth factor beta1 (TGF-beta1) where it acts as a downstream mediator of TGF-beta1 induced matrix production in osteoblasts. We have shown the requirement of Src, Erk, and Smad signaling for CTGF induction by TGF-beta1 in osteoblasts; however, the potential interaction among these signaling pathways remains undetermined. In this study we demonstrate that TGF-beta1 activates Src kinase in ROS17/2.8 cells and that treatment with the Src family kinase inhibitor PP2 prevents Src activation and CTGF induction by TGF-beta1. Additionally, inhibiting Src activation prevented Erk activation, Smads 2 and 3 activation and nuclear translocation by TGF-beta1, demonstrating that Src is an essential upstream signaling partner of both Erk and Smads in osteoblasts. MAPKs such as Erk can modulate the Smad pathway directly by mediating the phosphorylation of Smads or indirectly through activation/inactivation of required nuclear co-activators that mediate Smad DNA binding. When we treated cells with the Erk inhibitor, PD98059, it inhibited TGF-beta1-induced CTGF protein expression but had no effect on Src activation, Smad activation or Smad nuclear translocation. However PD98059 impaired transcriptional complex formation on the Smad binding element (SBE) of the CTGF promoter, demonstrating that Erk activation was required for SBE transactivation. These data demonstrate that Src is an essential upstream signaling transducer of Erk and Smad signaling with respect to TGF-beta1 in osteoblasts and that Smads and Erk function independently but are both essential for forming a transcriptionally active complex on the CTGF promoter in osteoblasts.
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Jain A, Rehman S, Smith G. Long-term results following osteotomy of the thumb delta phalanx in Rubinstein-Taybi Syndrome. J Hand Surg Eur Vol 2010; 35:296-301. [PMID: 20031997 DOI: 10.1177/1753193409354523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Rubinstein-Taybi Syndrome is a rare condition affecting 1:125,000 children. It is associated with short broad radially deviated thumbs, secondary to a delta proximal phalanx of the thumb. We undertook a retrospective review of seven children (13 thumbs) with Rubinstein-Taybi syndrome whose thumbs were treated using a corrective osteotomy to the delta phalanx over a 13 year period. The types of osteotomy used in the series were reverse wedge osteotomy, opening wedge osteotomy and dome shaped osteotomy. The mean preoperative radial deviation of thumbs was 68 degrees (range 45-85 degrees ). At follow up five of the 13 thumbs demonstrated some residual radial deviation. All recurrences occurred in the dome shaped osteotomy group. Our data suggest that surgery is effective in correcting the deformity, but there is a risk of incomplete correction or recurrence. Despite the recurrence the mean postoperative deformity was significantly better than preoperatively and the majority of patients families subjectively reported good function. No patient in our series has yet undergone further corrective surgery.
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Schold JD, Santos A, Rehman S, Magliocca J, Meier-Kriesche HU. Sizzling Issues in Clinical Renal Transplantation. Clin J Am Soc Nephrol 2010. [DOI: 10.2215/01.cjn.0000927088.58673.c3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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73
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Schold JD, Santos A, Rehman S, Magliocca J, Meier-Kriesche HU. The success of continued steroid avoidance after kidney transplantation in the US. Am J Transplant 2009; 9:2768-76. [PMID: 19845594 DOI: 10.1111/j.1600-6143.2009.02838.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
There has been a significant increase in the use of steroid avoidance regimens as initial treatment for kidney transplant recipients. Early results of the effectiveness of this strategy has been mixed with certain prospective trials indicating increased acute rejection but population-based studies indicating similar or better graft survival as compared to steroid maintenance. We conducted a retrospective study of national registry data to evaluate risk factors for discontinuation of steroid avoidance protocols based on patient characteristics and concomitant immunosuppression. We evaluated 84 647 solitary kidney transplant recipients in the US with at least 6 months graft survival including 24 218 initially discharged without maintenance steroids. We utilized logistic models to assess risk factors for new initiation of steroids after initial steroid-avoidance and survival models to describe graft survival for patients after return to steroids. The most prominent risk factors for new initiation of steroids after deceased donor kidney transplantation included African-American race (AOR = 1.32, p < 0.01), retransplants (AOR = 1.81, p < 0.01), highly sensitized recipients (AOR = 1.29, p < 0.01), recipients with Medicaid (AOR = 1.85, p < 0.01), elevated HLA-MM (AOR = 1.26, p < 0.01) and older donor age (AOR = 1.19, p < 0.01). Concomitant medications were also significantly associated with the propensity to newly initiate steroids. Cumulatively the study suggests that both patient characteristics and concomitant medications are strongly associated with the success of steroid avoidance immunosuppressive regimens.
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Darvish K, Shafieian M, Rehman S. The effect of tip geometry on the mechanical performance of unused and reprocessed orthopaedic drill bits. Proc Inst Mech Eng H 2009; 223:625-35. [DOI: 10.1243/09544119jeim555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although reprocessed drill bits have been in clinical use as a cost-saving measure, their performance has not been critically evaluated in comparison with the performance of unused drill bits. The effect of three commonly used reprocessing methods on the geometry and mechanical performance of 2.5 mm orthopaedic drill bits was investigated and compared with that for unused drill bits. Four mechanically significant drill parameters including chisel edge, chisel edge angle, point angle, and lip length of 36 drill bits in four groups were measured and compared. Group A included unused drill bits. Group B included drill bits reprocessed once by one company whereas group C included those reprocessed twice by the same method. Group D included drill bits reprocessed once by another company. For mechanical performance, a test set-up was developed in which the time of travel of the drill bits through layers of cortical and trabecular synthetic bone materials under constant compressive force were measured. The geometrical parameters were found to be significantly altered as a result of the reprocessing methods. A linear relationship was derived to relate the chisel edge to the drill time through cortical and trabecular bones. The mechanical performance of drill bits is correlated largely to the chisel edge length. A larger chisel edge is correlated to a reduced drill time, particularly in the cortical bone.
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Baig MS, Humail SM, Zaidi SI, Noor S, Bano S, Rehman S, Fawwad A. The efficacy of disease modifying anti-rheumatic drugs in rheumatoid arthritis in local patients of Karachi. Pak J Biol Sci 2009; 12:339-45. [PMID: 19579967 DOI: 10.3923/pjbs.2009.339.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The primary objective of the study is to assess the efficacy of the 'Disease Modifying AntiRheumatic Drugs (DMARDs) on the disease activity in Rheumatoid Arthritis (RA) in the local patients of Karachi. The secondary objective is to evaluate whether the combination of two concurrent DMARDs (Combination Therapy) is superior to a single DMARD (Mono-therapy). This is an open labeled retrospective case series. One hundred and five consecutive patients fulfilling 1987 ACR criteria for the diagnosis of RA were initially selected from the case notes of out patients department. Sixty nine patients fulfilled the inclusion criteria and were finally recruited for analysis. Details of the Tender Joint Count (TJC), Swolen Joint Count (SJC), Patient Global Assessment (PGA) and ESR were obtained at six weeks, three months, six months and one year. Out of the 69 patients studied 48 were in the mono-therapy group and 21 in the combination therapy group. Methotrexate (MTX) was the most commonly used single DMARD (75%) as well as the most frequent component of the combination groups (85%). The TJC, SJC and PGA analyses of all patients show that DMARDs are effective agents for clinically controlling RA activity. The speed of their beneficial effect is slow and unlike analgesics and NSAIDS, may take up to six weeks to start working. The 6 week responses showed 32.49% improvement in TJC, 33.19% improvement in SJC and 59% better responses in PGA. This response continued to show further improvement and at six months when TJC improved by 63.41%, SJC by 53.21% and PGA with 81% better responses. After 6 months the response reached a plateau but nevertheless maintained until 1 year with improvements in TJC by 66.23%, SJC by 56.48% and PGA with 88.23% better responses. The changes in ESR did not go parallel with the other three outcome measures. The mean baseline ESR of 56 reduced to 44 at 6 weeks but rose again gradually to 54 at 1 year. The sub-group analysis did not show the overall superiority of combination therapy over mono-therapy. DMARDs are effective in controlling disease activity in RA. Their effect starts slowly over 6 week and may take up to 6 months to show full benefits. The beneficial effect was maintained for at least 1 year. Sub-group analysis did not show any advantage of combination therapy over mono-therapy in this series of patients. Methotrexote being the most frequently used DMARDs in both groups and being most cost effective agent seems to be the most useful drug in RA in the developing world.
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