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Syed A, Htwe O, Naicker MS, Rashid AHA, Yuliawiratman BS, Naicker AS. Walking further. How surgery can help the cerebral palsy child. Med J Malaysia 2023; 78:566-569. [PMID: 37775480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
INTRODUCTION The prevalence of cerebral palsy (CP) in Malaysia is estimated at 2.6 per 1000 live births which is comparable to that of Australian and European data with ranges of 2.3- 4.21,2. Surgical intervention for the improvement of gait function and mobility in CP is a common practice, however scarce literature of its outcomes is available in Southeast Asia. This paper aims to address and compare outcomes of surgical interventions in our centre with other countries. MATERIAL AND METHODS Patients with Spastic CP with Gross Motor Function Classification System (GMFCS) I-III that underwent lower limb surgical intervention in our centre from 2008-2018 were retrospectively reviewed for The Spinal Alignment and Range of Motion Measure ROM subscale (SAROMM) scores and Functional Mobility Scale (FMS) 18 months after surgery. Changes in SAROMM, FMS scores and minimal clinically important difference (MCID) were determined. RESULTS 19 patients were included in the study with mean age of 12.58. All patients underwent muscle tendon procedures. Box plot analysis of SAROMM showed reduction of median scores at 6(26.3%) and 12(47.4%) months which plateaus at 18 months post-surgery. Repeated measure ANOVA analysis showed there was a statistically significant effect of time on SAROMM scores (p <0.001) with MCID of 13.4. Improvement of FMS scores was the most at 50m with 13 children (p < 0.05), one at 5m and five at 500m. None reported worsening of FMS scores at 18 months. There were no changes of GMFCS levels by the end of 18 months. CONCLUSION Surgeries performed on GMFCS I-III patients with the aim of gait improvement translates into improved mobility with results comparable to other countries.
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Affiliation(s)
- A Syed
- Hospital Tuanku Ampuan Najihah, Department of Orthopaedics & Traumatology, Kuala Pilah Negeri Sembilan, Malaysia.
| | - O Htwe
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Orthopaedics & Traumatology, Rehabilitation Medicine Unit, Kuala Lumpur Malaysia
| | - M S Naicker
- University of Malaya, Faculty of Medicine, Department of Pathology, Kuala Lumpur Malaysia
| | - A H A Rashid
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Orthopaedics & Traumatology, Kuala Lumpur Malaysia
| | - B S Yuliawiratman
- IHT Rehabilitation Centre, Persiaran SILC, Kawasan Perindustrian SILC, lskandar Puteri, Johor, Malaysia
| | - A S Naicker
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Orthopaedics & Traumatology, Rehabilitation Medicine Unit, Kuala Lumpur Malaysia
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Master A, Saad A, George A, Syed A, Laing P, Hickey B. 155 Audit of Functional Outcome of Mason and Molloy Type 2 Posterior Malleolar Ankle Fractures Treated with Open Reduction and Internal Fixation Using A Posterolateral Approach. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
It has been shown that direct fixation of the posterior malleolus improves functional outcomes. Our aim was to audit the functional outcome of patients with these fractures which were fixed with an isolated posterolateral approach.
Method
A consecutive case series of patients who underwent direct fixation of the posterior malleolus using a posterolateral approach between 20/12/2012 and 23/1/2020 was identified. Fractures were classified according to Mason and Molloy classification based on preoperative CT. Type 2a and 2b fractures were included. Functional outcome was assessed using Olerud-Molander score.
Result
18 patients were included. Mean age at time of surgery was 52 years (range 20 to 75 years). 56% (n = 10) were female. Mean follow up was 18.1 months (range 4.2 months to 7.2 years). OMAS score for type 2a fractures (n = 9) was 71.1 (95% CI 65.3 to 77.0). OMAS score for type 2b fractures (n = 9) was 67.8 (95% CI 54.6 to 81.0). There was no significant difference between groups (p = 0.65).
Conclusions
Fixation of Mason and Molloy Type 2 fractures using an isolated posterolateral approach results in satisfactory functional results for the majority of patients. Further prospective comparative study is needed to identify which patients benefit most from alternative approaches.
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Affiliation(s)
- A Master
- Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - A Saad
- Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - A George
- Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - A Syed
- Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - P Laing
- Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - B Hickey
- Wrexham Maelor Hospital, Wrexham, United Kingdom
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Nafis A, Ouedrhiri W, Iriti M, Mezrioui N, Marraiki N, Elgorban AM, Syed A, Hassani L. Chemical composition and synergistic effect of three Moroccan lavender EOs with ciprofloxacin against foodborne bacteria: a promising approach to modulate antimicrobial resistance. Lett Appl Microbiol 2021; 72:698-705. [PMID: 33570805 DOI: 10.1111/lam.13460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine the chemical profile of the essential oils (EOs) of three Moroccan lavender species (Lavandula pedunculata, LP; Lavandula angustifolia, LA; and Lavandula maroccana, LM) and to investigate, for the first time, the synergistic effect of the optimal mixture of the EOs with conventional antibiotic ciprofloxacin against three pathogenic foodborne bacteria. Gas chromatography/mass spectrometry analysis showed that eucalyptol (39·05%), camphor (24·21%) and borneol (8·29%) were the dominant compounds of LA-EO. LP-EO was characterized by the abundance of camphor (74·51%) and fenchone (27·06%), whereas carvacrol (42·08%), camphor (17·95%) and fenchone (12·05%) were the main constituents of LM-EO. EOs alone or combined showed a remarkable antimicrobial activity against the tested bacteria with minimum inhibitory concentrations (MICs) ranging from 3·53 to 15·96 mg ml-1 . The optimal mixture, calculated using a mixture design, corresponded to 19% LA, 38% LP and 43% LM. All combination of the EOs and the best EO mixture with ciprofloxacin exhibited a total synergism with fractional inhibitory concentration index values ranging from 0·27 to 0·37. The best EO mixture showed the highest gain of 128-fold, especially against Salmonella spp., more than that found testing the EOs separately. These findings should be taken into consideration for a possible application in the pharmaceutical and food industries.
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Affiliation(s)
- A Nafis
- Biology Department, Faculty of Sciences, Chouaïb Doukkali University, El Jadida, Morocco.,Laboratory of Microbial Biotechnologies, Agrosciences and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - W Ouedrhiri
- Laboratoire d'Ingénierie, d'Electrochimie, de Modélisation et d'Environnement, Département de chimie, Faculté des Sciences, Université Sidi Mohamed Ben Abdellah, Fès, Morocco
| | - M Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, Milan, Italy
| | - N Mezrioui
- Laboratory of Microbial Biotechnologies, Agrosciences and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - N Marraiki
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A M Elgorban
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A Syed
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - L Hassani
- Laboratory of Microbial Biotechnologies, Agrosciences and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
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Jonnada P, Arjunan R, Karjol U, Syed A, Chandranath A, Anwar A. 94P Prognostic influence of mean platelet volume on stage III rectal cancer patients: A tertiary cancer center study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sharma S, Saxena S, Ravi B, Syed A, Rao S, Dev R, Gupta A, Arunachalam V. Correlation of ultrasound elastography of breast lesions with histopathology and immunohistochemistry: Looking for prognostic significance. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30857-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hanif W, Patel V, Ali SN, Karamat A, Saeed M, Hassanein M, Syed A, Chowdhury TA, Farooqi A, Khunti K. The South Asian Health Foundation (UK) guidelines for managing diabetes during Ramadan. Diabetes Res Clin Pract 2020; 164:108145. [PMID: 32335096 DOI: 10.1016/j.diabres.2020.108145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fasting in the holy month of Ramadan is among the five pillars of Islam and is considered as a religious obligation by the Muslim population. People with diabetes observing the practice of fasts are at a higher risk of complications such as hypoglycaemia, hyperglycaemia and ketoacidosis due to changes in eating patterns and circadian rhythms. With the objective of mitigating these complications, the South Asian Health Foundation (UK) has developed the present guidelines based on robust evidence derived from epidemiological studies and clinical trials. METHODS We have highlighted the role of pre-Ramadan risk stratification and counselling by healthcare professionals with emphasis on the need for advice on adequate dietary and fluid intake, blood glucose monitoring and awareness of when to break the fast. RESULTS We reviewed the current literature and have given clinically-relevant recommendations on lifestyle modifications and glucose-lowering therapies such as metformin, sulphonylureas, dipeptidyl peptidase-4 inhibitors, sodium glucose co-transporter-2 inhibitors, thiazolidinediones, glucagon-like peptide-1 receptor agonists and insulin. CONCLUSIONS An individualised patient-centric treatment plan is essential to not only achieve optimal glycaemic outcomes but also enable people with diabetes to observe a risk-free month of fasting during Ramadan.
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Affiliation(s)
- W Hanif
- University Hospital Birmingham. UK.
| | | | - S N Ali
- Department of Diabetes & Endocrinology, Royal Free Hospital, London, UK
| | | | - M Saeed
- University Hospital Birmingham, UK
| | - M Hassanein
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - A Syed
- Heartlands Hospital Birmingham, UK
| | | | | | - K Khunti
- Diabetes Research Centre, University of Leicester, UK
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Jonnada P, R R, C R, Syed A, C S. Negative to positive lymph node ratio-prognostic marker of survival in node positive rectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Adam S, Azmi S, Liu Y, Ferdousi M, Siahmansur T, Kalteniece A, Marshall A, Ho J, Iqbal Z, Dhage S, D'Souza Y, Natha S, Kalra P, Donn R, Syed A, Ammori B, Durrington P, Malik R, Soran H. Changes In Serum Triglycerides Are Associated With Improvements In Small Fibre Neuropathy In Obese Persons Following Bariatric Surgery. ATHEROSCLEROSIS SUPP 2019. [DOI: 10.1016/j.atherosclerosissup.2019.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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9
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Albury C, Hall A, Syed A, Ziebland S, Stokoe E, Roberts N, Webb H, Aveyard P. Communication practices for delivering health behaviour change conversations in primary care: a systematic review and thematic synthesis. BMC Fam Pract 2019; 20:111. [PMID: 31376830 PMCID: PMC6679536 DOI: 10.1186/s12875-019-0992-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 07/09/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Clinical guidelines exhort clinicians to encourage patients to improve their health behaviours. However, most offer little support on how to have these conversations in practice. Clinicians fear that health behaviour change talk will create interactional difficulties and discomfort for both clinician and patient. This review aims to identify how healthcare professionals can best communicate with patients about health behaviour change (HBC). METHODS We included studies which used conversation analysis or discourse analysis to study recorded interactions between healthcare professionals and patients. We followed an aggregative thematic synthesis approach. This involved line-by-line coding of the results and discussion sections of included studies, and the inductive development and hierarchical grouping of descriptive themes. Top-level themes were organised to reflect their conversational positioning. RESULTS Of the 17,562 studies identified through systematic searching, ten papers were included. Analysis resulted in 10 top-level descriptive themes grouped into three domains: initiating; carrying out; and closing health behaviour change talk. Of three methods of initiation, two facilitated further discussion, and one was associated with outright resistance. Of two methods of conducting behaviour change talk, one was associated with only minimal patient responses. One way of closing was identified, and patients did not seem to respond to this positively. Results demonstrated a series of specific conversational practices which clinicians use when talking about HBC, and how patients respond to these. Our results largely complemented clinical guidelines, providing further detail on how they can best be delivered in practice. However, one recommended practice - linking a patient's health concerns and their health behaviours - was shown to receive variable responses and to often generate resistance displays. CONCLUSIONS Health behaviour change talk is smoothly initiated, conducted, and terminated by clinicians and this rarely causes interactional difficulty. However, initiating conversations by linking a person's current health concern with their health behaviour can lead to resistance to advice, while other strategies such as capitalising on patient initiated discussions, or collaborating through question-answer sequences, may be well received.
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Affiliation(s)
- C. Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - A. Hall
- Primary Healthcare Research Unit, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John’s, NL A1B 3V6 Canada
| | - A. Syed
- Department of English Language, Faculty of Languages and Linguistics, University of Malaya, Kuala Lumpur, Malaysia
| | - S. Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - E. Stokoe
- School of Social Sciences, Brockington Building, Loughborough University, Loughborough, Leicestershire LE 11 3TU UK
| | - N. Roberts
- Bodleian Health Care Libraries, Knowledge Centre, ORC Research Building, Old Road Campus, Oxford, OX3 7DQ UK
| | - H. Webb
- Department of Computer Science, Human Centred Computing (HCC) Group, University of Oxford, 39a St Giles, Oxford, OX1 3LW UK
| | - P. Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
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10
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Ho J, Adam S, Liu Y, Azmi S, Dhage S, Syed A, Ammori B, Donn R, Malik R, Yang X, Tsimikas S, Soran H. Reduction In Autoantibodies To Oxidised Ldl And Apob-Immune Complexes Following Metabolic Surgery. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sunsoa H, Glennon E, Slatter G, Syed A, Whitehouse J, Nash E. WS15-5 A prospective mixed-methods randomised controlled pilot study of a novel group educational program for people with Cystic Fibrosis-Related Diabetes. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30209-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Kempegowda P, Sunsoa H, Amrelia P, Chandan J, Teh Y, Atta S, Amir S, Chaudhry S, De Bray A, Rashid R, Whitehouse J, Nash E, Syed A. P295 Regular specialist follow-up is essential for early detection and management of diabetes-related complications in patients with Cystic Fibrosis-Related Diabetes. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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de Bray A, Sunsoa H, McKemey E, Kempegowda P, Nash E, Syed A. P300 Outcomes for patients using mono-or dual DPP4-inhibitor therapy for Cystic Fibrosis-Related Diabetes - a regional centre's 2-year experience. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30593-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Worsfold J, Eleti S, Syed A, Thomas H. P159. Margin re-excision rates following wide local excision with surgeon-operated intraoperative ultrasound. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2019.01.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Syed A, Borgaonkar M. A237 PROSTATE EXAMINATION AT TIME OF COLONOSCOPY: A SURVEY OF PATIENTS, GENERAL PRACTITIONERS (GP’S), AND ENDOSCOPISTS. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Syed
- GI, calgary, Calgary, AB, Canada
| | - M Borgaonkar
- Medicine, Memorial University, St. John’s, Canada
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Silva R, Poon R, Milne J, Syed A, Zhitomirsky I. New developments in liquid-liquid extraction, surface modification and agglomerate-free processing of inorganic particles. Adv Colloid Interface Sci 2018; 261:15-27. [PMID: 30293697 DOI: 10.1016/j.cis.2018.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022]
Abstract
This review describes new methods for the particle extraction through liquid-liquid interface (PELLI). The discovery of new surface modification techniques, advanced extractors and new adsorption mechanisms enabled novel applications of PELLI in nanotechnology of metals, quantum dots, oxides and hydroxides. Colloidal and interface chemistry of PELLI is emerging as a new area of technological and scientific interest. The progress achieved in the understanding of particle behavior and interactions at the liquid-liquid interface, phase transfer and interface reactions allowed for the development of new extraction mechanisms. An important breakthrough was the development of surface modification techniques for extraction of functional oxides. Especially important is the possibility of particle transfer from the synthesis medium to the device processing medium, which facilitates agglomerate-free processing of functional nanoparticles. Multifunctional extractor molecules were discovered and used as capping and reducing agents for particle synthesis or dispersing and charging agents for colloidal processing. The progress achieved in the development of extractors and extraction mechanisms has driven the advances in the surface modification and functionalization of materials. New PELLI techniques were used for the development of advanced materials and devices for optical, photovoltaic, energy storage, electronic, biomedical, sensor and other applications.
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Cook N, Catlin B, Drescher L, Syed A, Chamberlain K, Mackay K, Achtem L. PULLING THE EXPERTS TOGETHER: DEVELOPMENT OF PROVINCIAL TAVI PATIENT EDUCATION RESOURCES. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Di Lella D, Syed A, Asuncion J. TAVI: RAPID RECOVERY, EARLY DISCHARGE. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Syed A, Eleti S, Kumar V, Ahmad A, Thomas H. Validation of Memorial Sloan Kettering Cancer Center nomogram to detect non-sentinel lymph node metastases in a United Kingdom cohort. G Chir 2018; 39:12-19. [PMID: 29549676 DOI: 10.11138/gchir/2018.39.1.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AIM Axillary lymph node dissection, although associated with long-term morbidity, has been the standard of treatment for all nodepositive breast cancer patients. We assessed the risk prediction ability (validity) of Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for non-sentinel lymph node metastases and analysed the outcome of patients with sentinel node metastases. PATIENTS AND METHODS All operable early breast cancer patients with sentinel node macro metastases (size > 2mm) who underwent axillary dissection from April 2009 to March 2015 were considered eligible. The risk of non-sentinel lymph node metastases was calculated using an online MSKCC calculator, and accuracy was determined based on the area under the receiver-operating characteristic curve (AUC-ROC). Tumour characteristics and overall survival were also analysed as secondary end points. RESULTS Of 1745 patients who were diagnosed with operable breast cancer during the study period, 114 patients were considered eligible. The AUC-ROC was 0.66 suggestive of lesser accuracy in prediction and not statistically significant (p value = 0.7303). Seventysix (50.7%) of these patients did not have any non-sentinel node metastases. At a mean follow up of four years, the disease-free survival was 86.4% and overall survival rate was 88.4%. CONCLUSIONS The MSKCC nomogram was unable to accurately predict the risk in our cohort of patients with more than half of this cohort of patients not requiring axillary dissection. These findings are consistent with other European studies. This study thus highlights the need for modified prediction model for European cohorts.
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Syed A, Lee S, Israelson H, Pinto J, Coffin CS. A189 A RETROSPECTIVE ANALYSIS OF OUTCOMES ASSOCIATED WITH PEGYLATED-INTERFERON (PEG-IFN) TREATMENT IN CHRONIC HEPATITIS B (CHB). J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Syed
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Lee
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - H Israelson
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - J Pinto
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - C S Coffin
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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Syed A, Samal M, Bhasin V. Identification of constitutive parameters for high temperature deformation of pressure tube of Indian PHWR considering multi-axial state of stress. Nuclear Engineering and Design 2018. [DOI: 10.1016/j.nucengdes.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Syed A, Maradey-Romero C, Fass R. The relationship between eosinophilic esophagitis and esophageal cancer. Dis Esophagus 2017; 30:1-5. [PMID: 30052901 DOI: 10.1093/dote/dox050] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/13/2017] [Indexed: 12/11/2022]
Abstract
Eosinophilic esophagitis (EoE) is a disorder characterized by long-term chronic eosinophilic inflammation, which may predispose patients for malignant transformation. To determine if EoE is associated with an increased risk for esophageal cancer (EC) over time. This was a cross-sectional population-based study using the Explorys Platform. Data were collected from January 1999 to December 2014 and the search terms 'Eosinophlic esophagitis', gastroesophageal reflux disease, and Barrett's esophagus were used. The latter two served as comparison groups. The term 'malignant tumor of esophagus' was searched in Explorys and was accepted only if it was established after the aforementioned diagnoses. Analysis was performed using social science statistical software. A total of 27,183,310 subjects were included in the study. Of those 5,370 (0.02%) had the diagnosis of EoE, 25,610 (0.09%) BE, and 2,606,640 (9.59%) gastroesophageal reflux (GERD). In general, diagnosis of EC was rare prior to age 40. Therefore, subsequent analysis was done on subjects between 40 to 79 years of age (N = 20,257,480). The prevalence of EC was 0.05% (N = 2420), in BE (N = 19,640) 2.65%, and in GERD (N = 1,696,230) 0.22%. No cases of EC were identified among those with EoE. We found no significant difference or increased risk in the rate of EC in the EoE group (P = 0.575) when compared to the control population. In this largest study, we found no association between esophageal cancer and EoE. Further long-term prospective studies are needed to better characterize the relationship between EoE and esophageal malignancy.
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Affiliation(s)
- A Syed
- Department of Internal Medicine
| | - C Maradey-Romero
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - R Fass
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
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Syed A, Alvin T, Fazrina A, Abdul R. Determining if Positive Predictive Value using Laboratory Risk Indicator for Necrotising Fasciitis is Applicable in Malaysian Patients with Necrotising Fasciitis. Malays Orthop J 2017; 11:36-39. [PMID: 29021877 PMCID: PMC5630049 DOI: 10.5704/moj.1707.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction: Necrotising fasciitis (NF) is a rapidly progressive infection of the subcutaneous tissue and fascia which spreads rapidly. The scoring system of Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) developed by Wong et al has been proposed as a tool for distinguishing NF and other soft tissue infections (STI) in Singapore. We set out to establish whether the LRINEC score is applicable in our Malaysian setting. Materials and Methods: A cross sectional study of all patients admitted to our hospital diagnosed with NF or To Rule Out NF (TRO NF) between January 1st 2016 to 30th June 2016. The sensitivity, specificity, positive and negative predictive values were then calculated for LRINEC score of ≥ 6 and ≥ 8. Results: Fourty-four patients were identified with the diagnosis of NF or TRO NF in the study. Twenty-seven patients (61.4%) were deemed post-operatively as having NF and 17 patients (38.6%) not having NF. A sensitivity of 59.3% and specificity of 47.1% when a LRINEC score of ≥ 6 was taken with positive predictive value (PPV) of 64.0% and the negative predictive value (NPV) of 42.1%. When score ≥ 8 was taken, the sensitivity was 48.1% and specificity of 58.8% with PPV of 65% and NPV of 41.7%. Conclusion: The low sensitivity and low PPV achieved in this study as well as other studies makes the LRINEC score unsuitable to be used solely to distinguish NF with other soft tissue infections.
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Affiliation(s)
- A Syed
- Department of Orthopaedics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - T Alvin
- Department of Orthopaedics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - A Fazrina
- Department of Orthopaedics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
| | - R Abdul
- Department of Orthopaedics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia
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Syed A, Eleti S, Ahmed A, Gray E, Thomas H. 230. Validation of Memorial Sloan Kettering Cancer Center nomogram to detect non-sentinel lymph node metastases in a U.K. cohort. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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25
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Liu Y, Siahmansur T, Schofield J, Hama S, Yadav R, Adam S, France M, Kwok S, Donn R, Stevens A, Ho J, Ammori B, Syed A, Durrington P, Soran H. Effects of obesity and bariatric surgery on HDL functionality and microvascular complications of obesity. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Syed A, Eleti S, Mahdi N, Eleti A. 232. Role of axillary ultrasound with nodal biopsy for early breast cancer: Should it change in the post Z 0011 era? Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
BACKGROUND Intravenous (IV) iron is commonly used for correcting iron deficiency anaemia in patients with chronic kidney disease (CKD). There remains a concern for its use in patients with asthma as it may trigger an acute exacerbation. Pre-treatment with a single dose of parenteral hydrocortisone may obviate this risk. METHOD We carried out a prospective study of known asthmatic patients with CKD requiring single-dose iron repletion therapy. We analysed the efficacy and safety of IV CosmoFer (low molecular weight iron dextran). Twenty non-dialysis CKD patients with iron deficiency anaemia and a history of asthma were enrolled. Severity of asthma and level of control were recorded as per British Thoracic Society Guidelines and Royal Collage of Physician questionnaire, respectively. All patients received IV hydrocortisone 30 min before the test dose of CosmoFer followed by the remaining total dose. Patients were monitored for adverse reactions. Haemoglobin, serum ferritin levels and estimated glomerular filtration rate were measured pre and 6-weeks post-infusion. All patients were followed up until 6 weeks to assess the control of their asthma. RESULTS All 20 patients completed the study. No patient experienced acute hypersensitivity or infusion reactions. At 6 weeks follow-up, no patient reported worsening of their asthma. There was an increase in mean haemoglobin from 10.1 to 11.1 g/dl and mean ferritin from 93.5 to 302.6 ng/ml. CONCLUSIONS This study demonstrates that IV CosmoFer may be administered safely in asthmatics by administering a single 50 mg dose of hydrocortisone pre-infusion.
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Affiliation(s)
- A Syed
- From the Department of Renal Medicine, Bradford Teaching Hospital NHS Foundation Trust, Duckworth lane, Bradford BD9 6RJ, UK and
| | - S Bhandari
- Department of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust and Hull York Medical School, Anlaby Road, Kingston-upon-Hull HU3 2JZ, UK
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Liu Y, Siahmansur T, Hama S, Schofield J, Yadav R, France M, Kwok S, Donn R, Stevens A, Ammori B, Syed A, Durrington P, Soran H. Effect of bariatric surgery on HDL quantity and quality. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2015.10.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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29
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Hew KM, Walker AI, Kohli A, Garcia M, Syed A, McDonald-Hyman C, Noth EM, Mann JK, Pratt B, Balmes J, Hammond SK, Eisen EA, Nadeau KC. Childhood exposure to ambient polycyclic aromatic hydrocarbons is linked to epigenetic modifications and impaired systemic immunity in T cells. Clin Exp Allergy 2015; 45:238-48. [PMID: 25048800 DOI: 10.1111/cea.12377] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/01/2014] [Accepted: 04/11/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence suggests that exposure to polycyclic aromatic hydrocarbons (PAHs) increases atopy; it is unclear how PAH exposure is linked to increased severity of atopic diseases. OBJECTIVE We hypothesized that ambient PAH exposure is linked to impairment of immunity in atopic children (defined as children with asthma and/or allergic rhinitis) from Fresno, California, an area with elevated ambient PAHs. METHODS We recruited 256 subjects from Fresno, CA. Ambient PAH concentrations (ng/m(3) ) were measured using a spatial-temporal regression model over multiple time periods. Asthma diagnosis was determined by current NHLBI criteria. Phenotyping and functional immune measurements were performed from isolated cells. For epigenetic measurements, DNA was isolated and pyrosequenced. RESULTS We show that higher average PAH exposure was significantly associated with impaired Treg function and increased methylation in the forkhead box protein 3 (FOXP3) locus (P < 0.05), conditional on atopic status. These epigenetic modifications were significantly linked to differential protein expression of FOXP3 (P < 0.001). Methylation was associated with cellular functional changes, specifically Treg dysfunction, and an increase in total plasma IgE levels. Protein expression of IL-10 decreased and IFN-γ increased as the extent of PAH exposure increased. The strength of the associations generally increased as the time window for average PAH exposure increased from 24 hr to 1 year, suggesting more of a chronic response. Significant associations with chronic PAH exposure and immune outcomes were also observed in subjects with allergic rhinitis. CONCLUSIONS AND CLINICAL RELEVANCE Collectively, these results demonstrate that increased ambient PAH exposure is associated with impaired systemic immunity and epigenetic modifications in a key locus involved in atopy: FOXP3, with a higher impact on atopic children. The results suggest that increased atopic clinical symptoms in children could be linked to increased PAH exposure in air pollution.
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Affiliation(s)
- K M Hew
- Department of Pediatric Allergy and Immunology, Stanford University, Stanford, CA, USA
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Tye A, Wharton H, Wright A, Yang Y, Gibson J, Syed A, Mills A, Dodson P. Evaluating digital diabetic retinopathy screening in people aged 90 years and over. Eye (Lond) 2015; 29:1442-5. [PMID: 26183285 DOI: 10.1038/eye.2015.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/06/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of digital diabetic retinopathy screening in patients aged 90 years and over. METHODS This is a retrospective analysis of 200 randomly selected patients eligible for diabetic retinopathy screening aged 90 years and over within the Birmingham, Solihull, and Black Country Screening Programme. RESULTS One hundred and seventy-nine (90%) patients attended screening at least once. OUTCOMES 133 (74%) annual screening after their first screen, of whom 59% had no detectable diabetic retinopathy; 38 (21%) were referred for ophthalmology clinical assessment-36 for nondiabetic retinopathy reasons and two for diabetic maculopathy. Cataract accounted for 50% of all referrals for ophthalmology clinical assessment. Of the 133 patients placed on annual screening, 93 (70%) were screened at least once more. In terms of level of diabetic retinopathy, assessability or other ocular pathologies, 8 improved, 51 remained stable, and 31 deteriorated. Of the latter, 19 patients were referred for ophthalmology clinical assessment; none of these for diabetic retinopathy. CONCLUSIONS Screening provides opportunistic identification of important nondiabetic retinopathy eye conditions. However, in view of the low identification rate of sight-threatening diabetic retinopathy in patients aged 90 years and over, and the current mission statement of the NHS Diabetic Eye Screening Programme, systematic annual diabetic retinopathy screening may not be justified in this age group of patients, but rather be performed in optometric practice.
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Affiliation(s)
- A Tye
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
| | - H Wharton
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
| | - A Wright
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
| | - Y Yang
- School of Health and Life Sciences, Aston University, Birmingham, UK.,Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK
| | - J Gibson
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.,School of Health and Life Sciences, Aston University, Birmingham, UK
| | - A Syed
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
| | - A Mills
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK
| | - P Dodson
- Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.,School of Health and Life Sciences, Aston University, Birmingham, UK
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31
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Syed A, Eleti S, Buhain R. Outcome analysis of patients with breast cancer and positive sentinel node. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv114.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Syed A, Nabi W, Lawrence J, Eleti S, Gray E. ZOO 11 trial: Does it influence our clinical practice in the United Kingdom. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv114.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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33
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Manuelyan I, Syed A, Koide M, Shui B, Sonkusare S, Kotlikoff M, Nelson M, Wellman G. TRPV1‐mediated Ca
2+
Influx and Middle Meningeal Artery Constriction. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.943.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- I. Manuelyan
- PharmacolUniv of VermontBurlingtonVTUnited States
| | - A Syed
- PharmacolUniv of VermontBurlingtonVTUnited States
| | - M. Koide
- PharmacolUniv of VermontBurlingtonVTUnited States
| | - B Shui
- Coll. of VeterinaryMedicine Cornell UnivIthacaNYUnited States
| | - S. Sonkusare
- PharmacolUniv of VermontBurlingtonVTUnited States
| | - M. Kotlikoff
- Coll. of VeterinaryMedicine Cornell UnivIthacaNYUnited States
| | - M. Nelson
- PharmacolUniv of VermontBurlingtonVTUnited States
| | - G. Wellman
- PharmacolUniv of VermontBurlingtonVTUnited States
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Al Mulhim F, Syed A, Bagatadah W, Al Muhanna A. Breast cancer screening programme: experience from Eastern province, Saudi Arabia. Easter Mediterr Health J 2015; 21:111-9. [DOI: 10.26719/2015.21.2.111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 11/25/2014] [Indexed: 11/09/2022]
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35
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Syed A, Mangano L, Mao P, Han J, Song YA. Creating sub-50 nm nanofluidic junctions in a PDMS microchip via self-assembly process of colloidal silica beads for electrokinetic concentration of biomolecules. Lab Chip 2014; 14:4455-60. [PMID: 25254651 PMCID: PMC4213239 DOI: 10.1039/c4lc00895b] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
In this work we describe a novel and simple self-assembly process of colloidal silica beads to create a nanofluidic junction between two microchannels. The nanoporous membrane was used to induce ion concentration polarization inside the microchannel and this electrokinetic preconcentration system allowed rapid concentration of DNA samples by ~1700 times and of protein samples by ~100 times within 5 minutes.
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Affiliation(s)
- A Syed
- New York University Abu Dhabi, Division of Engineering, PO Box 129188, Abu Dhabi, UAE.
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36
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Lachi P, Irrakula M, Syed F, Uppin M, Joseph D, Syed A, Nair D, Krishna V, Pamidighantam S, Naidu K. RT-16 * LARGE OCULOMOTOR NERVE SCHWANNOMA - RARE ENTITY. A CASE REPORT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Syed F, Lachi P, Keshava R, Syed A, Nair D, Krishna V, Joseph D, Irrakula M, Pamidighantam S, Naidu K. RT-32 * CLINICAL PROFILE AND OUTCOMES IN BRAINSTEM GLIOMA. AN INSTITUTIONAL EXPERIENCE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Lachi P, Syed F, Keshava R, Syed A, Nair D, Joseph D, Irrakula M, Krishna V, Pamidighantam S, Naidu K. RT-17 * RADIOTHERAPY FOR INTRACRANIAL AND SPINAL EPENDYMOMAS. A RETROSPECTIVE ANALYSIS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Syed F, Lachi P, Chakravarthy P, Uppin S, Syed A, Nair D, Joseph D, Irrakula M, Pamidighantam S, Naidu K. MS-26 * EXTRA CRANIAL METASTASIS IN A CASE OF CEREBRAL MENINGIOMA: A RARE CASE REPORT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou260.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Lachi P, Syed F, Ramgopal K, Syed A, V D, E V, J D, I M, P S, Naidu K. Radiotherapy for Intracranial and Spinal Ependymomas. a Retrospective Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu330.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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41
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Ali MN, Ali MNA, Syed A, Syed AB, Bhandari S, Bhandari SC. Case series: hemolytic uremic syndrome--another cause of transplant dysfunction. Transplant Proc 2014; 45:3284-8. [PMID: 24182801 DOI: 10.1016/j.transproceed.2013.07.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/14/2013] [Accepted: 07/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Renal transplantation is the optimal treatment for suitable patients with end-stage renal disease (ESRD). However, acute graft dysfunction occurs in 5%-35% of patients. This is commonly due to acute rejection, drug toxicity, ureteric obstruction, or infection. Atypical hemolytic uremic syndrome (aHUS), either recurrent or de novo, is uncommon after transplantation. CASES We highlight three cases of acute transplant dysfunction in which transplant biopsy revealed HUS without associated clinical or hematologic clues to the etiology. Two cases had recurrent HUS and 1 had de novo HUS secondary to tacrolimus therapy. Screenings for ADAMTS-13 and gene mutations of complement regulatory proteins were negative. Thrombocytopenia and red blood cell fragments on blood film appeared some days later. TREATMENT Treatment comprised a combination of plasma exchange with fresh-frozen plasma and switching immunosuppressive therapy, which led to the recovery of the above hematologic features but salvaged graft function in only 1 case. CONCLUSIONS Classical hematologic findings of HUS appeared late in these cases. HUS should be considered in cases of allograft dysfunction where there is no obvious cause, and biopsy should be performed. This enables early initiation of therapy to gain rapid recovery of hematologic parameters and potentially of transplant function.
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Affiliation(s)
| | - M N A Ali
- Department of Renal Medicine, Hull and East Yorkshire Hospitals, NHS Trust, and Hull and York Medical School, Hull, East Yorkshire, United Kingdom
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Golshahi L, Longest PW, Azimi M, Syed A, Hindle M. Intermittent Aerosol Delivery to the Lungs During High-Flow Nasal Cannula Therapy. Respir Care 2014; 59:1476-86. [DOI: 10.4187/respcare.02903] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
The underdevelopment or absence of the splenic suspensary ligaments can lead to an uncommon condition termed the wandering spleen. It is usually asymptomatic but can present with an acute abdomen when associated with torsion. Most authors advocate surgical treatment. Herein, we report a case of torsion with infarction of the spleen and intestinal obstruction in a 36-year-old female patient which was successfully managed conservatively.
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Affiliation(s)
- U Ihedioha
- Specialist Registrar in General Surgery, Department of Surgery, University Hospitals of Leicester NHS Trust, UK
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Hernandez R, Singh S, Mallidi H, Hoang D, Syed A, Elayda M, Frazier O, Meyers D. Patterns of Readmission With Contemporary Continuous Flow Circulatory Support. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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45
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Geletzke A, Phillips B, Mobley S, Syed A, Kelleher S, Soybel D. Amplification of Local and Regional Innate Immune Response Following Chemical Peritonitis in Mice with Mild Zinc Imbalances. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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46
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Syed O, Khan F, Syed A, Khan S, Husain N, Chaudhry H. Problems of child psychiatry in low income countries. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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47
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Martineau AR, Hanifa Y, Hooper RL, Witt KD, Patel M, Syed A, Jolliffe DA, Timms PM, Balayah Z, Stevens N, Clark DA, Eldridge S, Barnes N, Griffiths CJ. S123 Increased risk of upper respiratory infection with addition of intermittent bolus-dose vitamin D supplementation to a daily low-dose regimen. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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48
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Syed A, Hakham S, Halin N. Drainage and sclerosis of lymphatic malformations. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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49
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Hembrom R, Goodall L, Bateman V, MacDonald R, Syed A, Taylor R, Clutterbuck DJ. BASHH Scotland/Scottish HIV and AIDS group national audit 2009-2010: sexual health care for people living with HIV. Int J STD AIDS 2013; 23:439-40. [PMID: 22807540 DOI: 10.1258/ijsa.2011.011379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A national Scottish audit of 282 patients with HIV infection attending 11 clinics showed the following levels of performance against quality improvement Scotland Sexual Health Services Standards: syphilis serology was offered in the previous six months to 55% of patients (range: 12-97% of patients in individual clinics), sexual history documented within four weeks of initial HIV diagnosis in 67% (12-100%) and offer of tests for sexually transmitted infections (STIs) documented within four weeks of HIV diagnosis in 45% (4-96%). Considerable variation in performance exists between clinics. The audit prompted interventions to further improve the sexual health care of people living with HIV infection.
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Affiliation(s)
- R Hembrom
- Chalmers Sexual Health Centre, Edinburgh, UK.
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50
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Syed A, Zainal AA, Hanif H, Naresh G. Endovascular Aneurysm Repair (EVAR) for Infra-renal Abdominal Aortic Aneurysm (AAA) under Local Anaesthesia - Initial Experience in Hospital Kuala Lumpur. Med J Malaysia 2012; 67:610-612. [PMID: 23770955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This is our initial report on the first 4 cases of infra-renal abdominal aortic aneurysm undergoing Endovascular Aneurysm Repair (EVAR) with local anaesthesia, controlled sedation and monitoring by an anaesthetist. All four patients were males with a mean age of 66.7 years. Only one required ICU stay of two days for cardiac monitoring due to bradycardia and transient hypotension post procedure. No mortality or major post operative morbidity was recorded and the mean hospital stay post procedure was 3.5 days (range 2-5 days).
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Affiliation(s)
- A Syed
- Hospital Kuala Lumpur, Department of General Surgery, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
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