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Subri S, Ali AM, Salleh SN. Computer vision syndrome and dry eye symptoms among breastfeeding women. Med J Malaysia 2024; 79:128-133. [PMID: 38555897] [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: 04/02/2024]
Abstract
INTRODUCTION Breastfeeding women are susceptible to musculoskeletal symptoms and hormonal changes that can affect the ocular surface. As exposure to visual display units (VDU) that is known to cause symptoms of dry eye and computer vision syndrome (CVS) is increasing worldwide, including among breastfeeding women, it is unknown whether this group of VDU users would experience CVS more than non-breastfeeding women. Therefore, this study aimed to investigate the association between breastfeeding status and symptoms of CVS and dry eye. MATERIALS AND METHODS In this cross-sectional study, selfreported CVS and dry eye symptoms were compared between 80 breastfeeding and 72 non-breastfeeding VDU users. Two questionnaires were administered online, which were the CVS-Questionnaire (CVS-Q) and the Ocular Surface Disease Index (OSDI) questionnaire, to evaluate symptoms of CVS and dry eye, respectively. Mann-Whitney test was used to compare CVS and OSDI scores between groups, while correlations between the scores were analyzed using Spearman's test. RESULT Results showed that OSDI scores were significantly higher in the non-breastfeeding group (U = 2263, z-score = - 2.276, p = 0.023), indicating more dry eye symptoms experienced by respondents in this group, while no significant group difference was found in terms of CVS scores (U = 2772, z-score = -0.400, p = 0.689). Additionally, no significant association was observed between breastfeeding status and severity of dry eye symptoms as well as CVS symptoms. CONCLUSION This study reported the possible benefit of breastfeeding in reducing dry eye symptoms. The CVS symptoms found in the breastfeeding group were possibly due to VDU usage rather than caused by breastfeeding. Public education on preventive measures to reduce the occurrence of CVS symptoms and ocular dryness among VDU users is essential to improve the quality of life.
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Affiliation(s)
- S Subri
- Universiti Teknologi MARA, Faculty of Health Sciences, Centre for Optometry Studies, Puncak Alam Campus, Selangor, Malaysia.
| | - A M Ali
- UCSI University, Faculty of Medicine and Health Sciences, Cheras, Kuala Lumpur, Malaysia
| | - S N Salleh
- Focus Point Vision Care Group, 105 Jalan Sultan Abdul Jalil, Ipoh, Perak, Malaysia
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2
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Zakaraia HG, Salem HF, Mostafa MAA, Ali AM, Rabea H. Adding empagliflozin to sitagliptin plus metformin vs. adding sitagliptin to empagliflozin plus metformin as triple therapy in Egyptian patients with type 2 diabetes: a 12-week open trial. Eur Rev Med Pharmacol Sci 2023; 27:7289-7298. [PMID: 37606137 DOI: 10.26355/eurrev_202308_33300] [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: 08/23/2023]
Abstract
OBJECTIVE This study aimed to compare 12.5 mg empagliflozin effectiveness and safety vs. 50 mg sitagliptin twice daily as an add-on triple medication in Egyptians with type 2 diabetes. PATIENTS AND METHODS Patients with hemoglobin A1c (HbA1c) between 53 and 86 mmol/mol after receiving open-label either sitagliptin 50 mg (n = 85) or empagliflozin 12.5 mg (n = 85) twice daily for 12 weeks were afterward taken into account for the administration of open-label empagliflozin 12.5 mg (n = 40) and sitagliptin 50 mg (n = 28) respectively twice daily for another 12 weeks of treatment as an added-on triple therapy. Both groups of patients kept taking metformin and empagliflozin 12.5 mg or sitagliptin 50 mg twice daily as prescribed. The HbA1c change from baseline after 12 weeks of triple-added-on therapy was the main endpoint. RESULTS The sitagliptin group receiving empagliflozin saw a substantial drop in HbA1c, fasting and postprandial plasma glucose levels, body weight, and blood pressure compared to the starting point. As opposed to that, adding sitagliptin to the empagliflozin group non-significantly reduced HbA1c, fasting, and postprandial plasma glucose levels, and systolic blood pressure from baseline but significantly reduced body weight and diastolic blood pressure. Comparing the two groups, adding empagliflozin significantly reduced HbA1c, fasting, and postprandial plasma glucose levels (p < 0.001 for all except fasting plasma glucose level, p = 0.002). While the patient's weight and blood pressure were not significantly affected. CONCLUSIONS Empagliflozin was superior to sitagliptin in relation to glycemic control, weight, and systolic/diastolic blood pressure reduction.
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Affiliation(s)
- H G Zakaraia
- Clinical Pharmacy Department, Faculty of Pharmacy, University of Sadat City, Menoufia, Egypt.
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Dalab AS, Ali AM, Althnaian TA, Alkhodair KM, Al-Ramadan SY. Molecular Investigations of the Effect of Thermal Manipulation During Embryogenesis on the Enzymatic Activity of Creatine Kinase and Lactate Dehydrogenase in Broiler Muscle. Braz J Poult Sci 2022. [DOI: 10.1590/1806-9061-2020-1369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- AS Dalab
- An-Najah National University, Saudi Arabia
| | - AM Ali
- King Faisal University, Saudi Arabia
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Saint J, England A, Ali AM, Bonnett L. The effect of different statistical approaches on image quality data obtained from radiological examinations. Radiography (Lond) 2021; 28:518-523. [PMID: 34848136 DOI: 10.1016/j.radi.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/03/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Selection of optimal image acquisition protocols in medical imaging remains a grey area, the superimposed use of the Likert scale in radiological image quality evaluations creates an additional challenge for the statistical analysis of image quality data. Using a simulation study, we have trialled a novel approach to analysing radiological image quality Likert scale data. METHODS A simulation study was undertaken where simulated datasets were generated based on the distribution of Likert scale values according to varying image acquisition protocols from a real dataset. Simulated Likert scale values were pooled in four different ways; the mean, median, mode and the summation of patient Likert scale values of which the total was assigned a categorical Likert scale value. Estimates of bias, MAPE and RMSPE were then calculated for all four pooling approaches to determine which method most accurately represented an expert's opinion. RESULTS When compared to an expert's opinion, the method of summation and categorisation of Likert scale values was most accurate 49 times out of the 114 (43.0%) tests. The mean 28 times out of 114 (24.6%), the median 23 times out of 114 (20.2%) and the mode 17 times out of 114 (14.9%). CONCLUSION We conclude that our method of summation and categorisation of Likert scale values is most often the best representation of the simulated data compared to the expert's opinion. IMPLICATIONS FOR PRACTICE There is scope to reproduce this simulation study with multiple observers to reflect clinical reality more accurately with the dynamic nature of multiple observers. This also prompts future investigation into other anatomical areas, to see if the same methods produce similar results.
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Affiliation(s)
- J Saint
- Department of Biostatistics, University of Liverpool, United Kingdom.
| | - A England
- Directorate of Radiography, University of Salford, United Kingdom
| | - A M Ali
- Directorate of Radiography, University of Salford, United Kingdom
| | - L Bonnett
- Department of Biostatistics, University of Liverpool, United Kingdom
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Halim UA, Elbayouk A, Ali AM, Cullen CM, Javed S. O44 Gender bias and sexual discrimination in orthopaedics: time for change. Br J Surg 2021. [DOI: 10.1093/bjs/znab282.049] [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
Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, as well as mitigating strategies.
Method
A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were reviewed.
Result
Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. 13 papers discussed the prevalence of GBSD, 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. Effects include poor workforce representation, lower salaries, and less career success for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions.
Conclusion
GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty.
Take-home Message
Gender bias and sexual discrimination remain common within orthopaedics. The international orthopaedic community is obliged to do more to tackle this problem.
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Affiliation(s)
| | | | - A M Ali
- London North West University Healthcare NHS Trust
| | | | - S Javed
- North Manchester General Hospital
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6
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Abstract
BACKGROUND Chronic renal failure is increasing in prevalence and reported to have deleterious effects on the outcome of total hip arthroplasty (THA). AIM To investigate the clinical and functional outcomes of THA in patients receiving haemodialysis or who have previously undergone renal transplantation. METHODS Systematic review of the literature using bibliographic databases up to July 2018 to determine the functional outcome, complications and revision rates of THA in patients receiving haemodialysis for end-stage renal failure and those with a previous renal transplant. RESULTS 25 studies were identified with a total of 797 THAs. 166 patients (20.8%) were receiving haemodialysis and 631 patients (79.2%) had undergone transplantation. All studies reported a marked improvement in hip function following THA. There were 27 failures (15.7% revision rate) in the haemodialysis group and 101 failures (16.0% revision rate) in the transplant group. The revision rate for cemented implants was higher in haemodialysis versus transplant patients (23% vs. 15%), with the converse being true for uncemented implants (3.8% vs. 6.9%). The deep infection rate was higher in the haemodialysis group (10.8% vs. 2.1%). CONCLUSIONS Patients receiving haemodialysis or with a history of renal transplantation can expect good functional outcome following THA. However, the revision rate and deep infection rate are higher than would be expected in patients receiving THA for primary OA. Aseptic loosening is the most common reason for revision. Uncemented implants appear to be associated with lower failure rates both in haemodialysis patients and those who have had a transplant.
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Affiliation(s)
- Ravi Popat
- Hillingdon Hospitals NHS Foundation Trust, Uxbridge, London, UK
| | - Adam M Ali
- Hillingdon Hospitals NHS Foundation Trust, Uxbridge, London, UK
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Ali AM, Loeffler MD, Aylin P, Bottle A. Timing of Readmissions After Elective Total Hip and Knee Arthroplasty: Does a 30-Day All-Cause Rate Capture Surgically Relevant Readmissions? J Arthroplasty 2021; 36:728-733. [PMID: 32972776 DOI: 10.1016/j.arth.2020.07.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The 30-day all-cause readmission rate is a widely used metric of hospital performance. However, there is lack of clarity as to whether 30 days is an appropriate time frame following surgical procedures. Our aim is to determine whether a 90-day time window is superior to a 30-day time window in capturing surgically relevant readmissions after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS We analyzed readmissions following all primary THAs and TKAs recorded in the English National Health Service Hospital Episode Statistics database from 2008 to 2018. We compared temporal patterns of 30- and 90-day readmission rates for the following types of readmission: all-cause, surgical, return to theater, and those related to specific surgical complications. RESULTS A total of 1.47 million procedures were recorded. After THA and TKA, over three-quarters of 90-day surgical readmissions took place within the first 30 days (78.5% and 75.7%, respectively). All-cause and surgical readmissions both peaked at day 4 and followed a similar temporal course thereafter. The ratio of surgical to medical readmissions was greater for THA than for TKA, with THA dislocation both being one of the most common surgical complications and clustering early after discharge, with 73.5% of 90-day dislocations occurring within the first 30 days. CONCLUSION The 30-day all-cause readmission rate is a good reflection of surgically relevant readmissions that take place in the first 90 days after THA and TKA.
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Affiliation(s)
- Adam M Ali
- London North West University Healthcare NHS Trust, London, UK
| | | | - Paul Aylin
- Dr Foster Unit at Imperial College, London, UK
| | - Alex Bottle
- Dr Foster Unit at Imperial College, London, UK
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8
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Elhassan MMO, Ali AM, Kehlet AB, Ali OHA, Harrington D. The Response of Broiler Chicks to Dietary Supplementation with a Probiotic, Acidifiers Blend, and Their Combination. Braz J Poult Sci 2021. [DOI: 10.1590/1806-9061-2021-1511] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - AM Ali
- King Faisal University, Saudi Arabia
| | | | - OHA Ali
- University of Khartoum, Sudan
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9
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Abstract
AIMS Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. METHODS A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. RESULTS Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. CONCLUSION GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty. Cite this article: Bone Joint J 2020;102-B(11):1446-1456.
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Affiliation(s)
- Usman A Halim
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
| | - Abdulrahman Elbayouk
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
| | - Adam M Ali
- Trauma and Orthopaedic Surgery Department, London North West University Healthcare NHS Trust, London, UK
| | - Clare M Cullen
- Trauma and Orthopaedic Surgery Department, Burnley General Hospital, Burnley, UK
| | - Saqib Javed
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
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10
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Halim UA, Elbayouk A, Ali AM, Cullen CM, Javed S. The prevalence and impact of gender bias and sexual discrimination in orthopaedics, and mitigating strategies. Bone Joint J 2020:1-11. [PMID: 32951434 DOI: 10.1302/0301-620x.102b9.bjj-2020-0982.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. METHODS A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. RESULTS Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. CONCLUSION GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty.
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Affiliation(s)
- Usman A Halim
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
| | - Abdulrahman Elbayouk
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
| | - Adam M Ali
- Trauma and Orthopaedic Surgery Department, London North West University Healthcare NHS Trust, London, UK
| | - Clare M Cullen
- Trauma and Orthopaedic Surgery Department, Burnley General Hospital, Burnley, UK
| | - Saqib Javed
- Trauma and Orthopaedic Surgery Department, North Manchester General Hospital, Manchester, UK
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Ali AM, Bottle A. Understanding patient flow is necessary to determine hospital level outcomes. BMJ 2020; 368:m1161. [PMID: 32213512 DOI: 10.1136/bmj.m1161] [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: 11/04/2022]
Affiliation(s)
- Adam M Ali
- Harvard University, Cambridge, MA 02138, USA
| | - Alex Bottle
- Dr Foster Unit, Imperial College London, London, UK
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12
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Ali AM, Lewis A, Sarraf KM. Surgical treatment of an ischial tuberosity avulsion fracture with delayed presentation. J Clin Orthop Trauma 2020; 11:S4-S6. [PMID: 31992908 PMCID: PMC6978189 DOI: 10.1016/j.jcot.2019.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/19/2019] [Indexed: 11/27/2022] Open
Abstract
Avulsion fractures of the ischial tuberosity usually occur in skeletally immature athletes following eccentric contraction of the hamstrings. When displaced fractures are left untreated, subsequent non-union and proximal hamstring fibrosis may lead to chronic pain and reduced activity. However, the indications for and outcomes of operative fixation when presentation is delayed remain unclear. We report the case of a 14 year old male athlete who presented to our institution 6 weeks after sustaining a displaced ischial tuberosity avulsion fracture. He underwent open reduction and internal fixation using a cannulated screw system via a posterior approach, with excellent results at 18 months follow-up. We report our surgical findings in detail as well as a novel method for post-operatively assessing functional screw head prominence-the seated radiograph.
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Affiliation(s)
- Adam M. Ali
- Corresponding author. Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London. W2 1NY, UK.
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Abstract
This article gives a practical guide to the management of supracondylar fractures of the humerus in paediatric patients, from initial presentation to definitive treatment. It reviews the optimal management of this common and serious injury based on current evidence including the British Orthopaedic Association Standards for Trauma (BOAST) 11 standard.
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Affiliation(s)
- Anna Kropelnicki
- Specialist Trainee in Trauma and Orthopaedics, Department of Trauma and Orthopaedics, The Hillingdon Hospitals NHS Trust, London UB8 3NN
| | - Adam M Ali
- Specialist Trainee in Trauma and Orthopaedics, Department of Trauma and Orthopaedics, The Hillingdon Hospitals NHS Trust, London UB8 3NN
| | - Ravi Popat
- Specialist Trainee in Trauma and Orthopaedics, Department of Trauma and Orthopaedics, The Hillingdon Hospitals NHS Trust, London UB8 3NN
| | - Khaled M Sarraf
- Consultant Trauma and Orthopaedic Surgeon, Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, London
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El-Enein SAA, Ali AM, Abdel-Monem YK, Senna MH, Madkour M. Novel lanthanide(III) 4-methylbenzoylhydrazide complexes as precursors for lanthanide oxide nanophotocatalysts. RSC Adv 2019; 9:42010-42019. [PMID: 35542881 PMCID: PMC9076505 DOI: 10.1039/c9ra08080e] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 11/14/2019] [Indexed: 12/03/2022] Open
Abstract
A series of metal complexes were prepared from separate reactions of lanthanide nitrate salts (La(iii), Ce(iii), Sm(iii), Gd(iii) and Ho(iii)) with 4-methylbenzoylhydrazide. The structures of the complexes were confirmed by analytical studies, spectral measurements and thermal studies. Complexes were formed with different stoichiometries of 1 : 2 and 1 : 3 (M : L). The ligand chelates by the nitrogen and oxygen atoms of the amino and carbonyl groups of the hydrazide moiety in the neutral keto form. The coordination compounds were converted to metal oxide nanoparticles (MONPs) through solid state thermal decomposition as monocular source precursors. The obtained MONPs were investigated via XRD, TEM and UV-Vis spectra. As a representative, CeO2 was utilized as a nanophotocatalyst to examine the photocatalytic activity of the MONPs for methylene blue (MB) photodegradation. CeO2 showed high removal of MB dye by 90.1% after UV illumination for 220 min. The reported method provides a generalized and systematic method for the preparation of many metal oxide nanoparticles with manageable and reproducible features. A series of metal complexes were prepared from separate reactions of lanthanide nitrate salts (La(iii), Ce(iii), Sm(iii), Gd(iii) and Ho(iii)) with 4-methylbenzoylhydrazide.![]()
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Affiliation(s)
- S A Abou El-Enein
- Department of Chemistry, Faculty of Science, Menoufia University Shibin El Kom Egypt
| | - A M Ali
- Department of Chemistry, Faculty of Science, Menoufia University Shibin El Kom Egypt
| | - Y K Abdel-Monem
- Department of Chemistry, Faculty of Science, Menoufia University Shibin El Kom Egypt
| | - M H Senna
- Radiation Chemistry Department, National Center for Radiation Research and Technology Cairo Egypt
| | - Metwally Madkour
- Department of Chemistry, Faculty of Science, Kuwait University P. O. Box: 5969 13060 Kuwait
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15
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Said DA, Ali AM, Khayyat MM, Boustimi M, Loulou M, Seoudi R. A study of the influence of plasmonic resonance of gold nanoparticle doped PEDOT: PSS on the performance of organic solar cells based on CuPc/C6 0. Heliyon 2019; 5:e02675. [PMID: 31840116 PMCID: PMC6893062 DOI: 10.1016/j.heliyon.2019.e02675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Received: 04/18/2019] [Revised: 08/18/2019] [Accepted: 10/14/2019] [Indexed: 12/14/2022] Open
Abstract
This work studied the role of gold nanoparticles (AuNPs) with different spherical sizes mixed with poly (3, 4-ethylene dioxythiophene): polystyrene sulfonate (PEDOT: PSS) as a hole transfer layer to enhance the efficiency (ITO/PEDOT:PSS (AuNPs)/CuPc/C60/Al) organic photovoltaic cell (OPV). AuNPs were synthesized using the thermochemical method and the results of the transmission electron microscope (TEM) images showed that the gold nanoparticles mostly dominated by spherical shapes and sizes were calculated in the range (12–23 nm). Measurements of UV-VIS spectra for AuNPs have shown that the surface plasmon resonance shifted to a higher wavelength with decreasing the particle size. Surface morphology and absorption spectra of OPV cells were studied using atomic force microscope and UV-VIS spectrometer techniques. The efficiency of the OPV cell was calculated without and with AuNPs. Efficiency was increased from 0.78% to 1.02% due to the embedded of AuNPs with (12 nm) in PEDOT/PSS. The increase in the light absorption in CuPc is due to the good transparent conducting of PEDOT:PSS and the increase in the electric field around AuNPs embedded in PEDOT:PSS and inbuilt electric field at the interfacial between CuPc and C60 is due to the surface plasmon resonance of AuNPs. The increase in these two factors increase the exciton generation in CuPc, dissociation at the interfacial layer, and charge carrier transfer which increases the collection of electrons and holes at cathode and anode.
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Affiliation(s)
- D A Said
- Physics Department, Faculty of Women for Art, Sciences and Education, Ain Shams University, Cairo, Egypt
| | - A M Ali
- Department of Physics, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Physics, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - M M Khayyat
- King Abdulaziz City for Science and Technology, Riyadh 11442, Kingdom of Saudi Arabia
| | - M Boustimi
- Department of Physics, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - M Loulou
- Department of Physics, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R Seoudi
- Department of Physics, College of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Spectroscopy Department, Physics Division, NRC, Dokki, Cairo 12622, Egypt
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16
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Abstract
This review gives a practical guide to the investigation and management of osteoporotic vertebral compression fractures. With an ageing population, the burden of disease and health system costs attributable to this common injury continue to rise. This article outlines the epidemiology, clinical and radiological assessment of vertebral compression fractures, and key decisions that must be made in their management. It reviews the indications and evidence for conservative vs operative treatment, discusses the rationale for vertebroplasty, kyphoplasty and spinal stabilization, and looks at outcomes in this vulnerable patient population. It also reviews key evidence underlying decision making including National Institute for Health and Care Excellence guidelines.
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Affiliation(s)
- Omar Musbahi
- Academic Foundation Doctor, Oxford University Hospitals NHS Trust, Oxford OX3 9DU
| | - Adam M Ali
- Academic Clinical Fellow in Trauma and Orthopaedics, Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London
| | - Hamid Hassany
- Consultant Orthopaedic Spine Surgeon, Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London
| | - Reza Mobasheri
- Consultant Orthopaedic Spine Surgeon, Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London
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17
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Abstract
1. Avipoxvirus (APV) infections are one of many threats inflicting economic losses within the poultry industry, particularly in tropical and subtropical countries. A proper and comprehensive study for APVs is needed to increase the knowledge concerning the diversity and evolution of the virus.2. For this purpose, 136 bird flocks of different species and breeding types were examined for APV infection between October 2016 and November 2017. One hundred and thirty samples had visible pocks on the chorioallantoic membrane (CAM) which were designated as fowl pox-like viruses via amplification of 578 bp from the P4b gene and 1800 bp from the fpv140 locus.4. A comprehensive phylogenetic analysis of fpv167 locus (P4b), fpv140 locus (fpv139 and fpv140) and fpv94 (DNA polymerase) revealed that all the analysed strains belong to fowl pox-like viruses (clade A; subclade A1 and A2). Based on the fpv140 locus full nucleotide sequence, three turkey originated strains were seen to be divergent from chicken originated sequences and branched into novel subclade A1.b.5. Trees comparison, within the term of speculation of virus-host specificity, clearly highlighted a high order specific subgrouping among subclades in the case of the fpv140 locus (including fpv139 and fpv140). Hence, the fowl poxvirus, turkey poxvirus and pigeon poxvirus strains clustered into distinct host-specific subclades A1a, A1.b and A2, respectively, which could not be seen in the FWPV-P4b and DNA polymerase phylogeny.
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Affiliation(s)
- M Lebdah
- Department of Avian and Rabbit Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - A M Ali
- The Veterinary Hospital, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - A A Ali
- Department of Pathology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - O Hassanin
- Department of Avian and Rabbit Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
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Affiliation(s)
- Adam M Ali
- The Hillingdon Hospitals NHS Foundation Trust, London, UK
| | - Ali Hani
- The Hillingdon Hospitals NHS Foundation Trust, London, UK
| | - Htwe Zaw
- The Hillingdon Hospitals NHS Foundation Trust, London, UK
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Ali AM, Loeffler MD, Aylin P, Bottle A. Predictors of 30-Day Readmission After Total Knee Arthroplasty: Analysis of 566,323 Procedures in the United Kingdom. J Arthroplasty 2019; 34:242-248.e1. [PMID: 30477965 DOI: 10.1016/j.arth.2018.10.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/08/2018] [Accepted: 10/23/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND All-cause 30-day readmission after total knee arthroplasty (TKA) is currently used as a measure of hospital performance in the United States and elsewhere. Readmissions from surgical causes may more accurately reflect preventability and costs. However, little is known about whether predictors of each type of readmission differ. METHODS All primary TKAs recorded in England's National Health Service administrative database from 2006 to 2015 were included. Multilevel logistic regression analysis was used to describe the effects of patient-related factors on 30-day readmission risk using 3 different readmission metrics: all-cause, surgical (defined using International Classification of Disease-10 primary admission diagnoses), and those resulting in return to theater (RTT). RESULTS In total, 566,323 procedures were recorded. The comorbidity with the highest odds ratio (OR) for all types of readmission was psychoses (RTT OR 2.52, P < .001). Obesity was a strong independent predictor of RTT (OR 1.36, P < .001) and had the highest population attributable fraction of any comorbidity (4.7%). Unicompartmental arthroplasty was associated with a significantly lower risk of all types of readmission when compared with TKA, with the effect being most pronounced for surgical readmission (OR 0.66, P < .001). RTT in the index episode increased the risk of RTT readmission (OR 2.80, P < .001), as did any emergency admission to hospital in the preceding 12 months (for >2 emergency admissions, all-cause OR 2.38, P < .001). Length of stay either more than or less than 2 days was associated with an increased risk of all-cause and surgical readmission but not RTT readmission. CONCLUSION Patient-related predictors of surgical and RTT readmission following TKA differ from those for all-cause readmission, but only the latter metric is in widespread use.
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Affiliation(s)
- Adam M Ali
- Department of Orthopaedic Surgery, Hillingdon Hospital, London, United Kingdom
| | - Mark D Loeffler
- Department of Orthopaedic Surgery, Colchester General Hospital, Colchester, United Kingdom
| | - Paul Aylin
- Department of Primary Care and Public Health, Dr Foster Unit, Imperial College London, London, United Kingdom
| | - Alex Bottle
- Department of Primary Care and Public Health, Dr Foster Unit, Imperial College London, London, United Kingdom
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Dalab AS, Ali AM. Morphological Investigations of the Effect of Thermal Manipulation During Embryogenesis on Body Performance and Structure of Pectoral and Thigh Muscle of Ross Broiler Chicken. Braz J Poult Sci 2019. [DOI: 10.1590/1806-9061-2019-1100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- AS Dalab
- King Faisal University, Saudi Arabia
| | - AM Ali
- King Faisal University, Saudi Arabia
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Musbahi O, Khan AHA, Anwar MO, Chaudery H, Ali AM, Montgomery AS. Immobilisation in occipital condyle fractures: A systematic review. Clin Neurol Neurosurg 2018; 173:130-139. [PMID: 30125835 DOI: 10.1016/j.clineuro.2018.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 04/23/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The objectives of this review are to determine the level of evidence for the management of OCF, compare outcomes of different immobilisation, and to review the prognosis. PATIENTS AND METHODS A literature search was conducted using 3 databases (MEDLINE, PubMed and EMBASE). All papers between 1940 and July 2017 were screened using PRISMA guidelines. Inclusion criteria were patients with a confirmed diagnosis of occipital condyle fracture(s) on CT managed with any form of immobilisation with no age restriction. Primary outcome was clinical improvement in symptoms or Neck Disability Index. MINORS and OCEBM level was assigned to each study. RESULTS 25 studies met the inclusion criteria. Most studies used a single form of C-spine immobilisation support (58%) with a semi rigid collar and halo device being the most common. From these studies, the average length of time for immobilisation was 11.7 weeks, 9 weeks and 8.3 weeks for halo, semi-rigid and rigid cervical collars respectively. Neuro deficit was found in 20.3% of patients. OCEBM level of evidence and MINORS score was low. CONCLUSION Management of OCF is associated with low level of evidence. Further studies are needed to determine optimal management of these under-diagnosed fractures.
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Affiliation(s)
- Omar Musbahi
- Oxford University Clinical Academic Graduate School, Oxford, UK.
| | | | | | - Hannan Chaudery
- Spinal Department, The Royal London Hospital, Whitechapel, London, UK
| | - Adam M Ali
- Department of Trauma and Orthopaedics, Imperial College NHS Trust, London, UK
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22
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Affiliation(s)
- Adam M Ali
- Harvard University, Cambridge, MA 02138, USA
| | - Alex Bottle
- Dr Foster Unit, Imperial College London, London, UK
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23
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Ali AM, Felemban N, El-Bakary MA. Characterization of the 3Dimension optical, geometrical, and mechanical profiles of iPP fiber with necking deformation. Microsc Res Tech 2018; 81:755-760. [PMID: 29633458 DOI: 10.1002/jemt.23033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/06/2017] [Revised: 02/27/2018] [Accepted: 03/25/2018] [Indexed: 11/06/2022]
Abstract
We present a method for evaluating the 3D refractive indices and 3D true stress and/or 3D true strain profiles of "isotactic polypropylene iPP" fibers during necking deformation. Observing the changes in geometrical shape during the deformation process is necessary to understand the mechanical performance of iPP fibers. 3D geometric shape profile and actual stress and strain profiles were measured for iPP fibers during the propagation of neck deformation. These measurements were performed with the aid of an in-situ opto- mechanical device to dynamically characterize different properties of fibers at different strain rates. A software image analysis program was used to calculate the 3D opto-mechanical properties of iPP fibers. The obtained results show that the used dynamic stretching device can be easily used to monitor the deformation process with high accuracy. The effective stress and strain can be determined from the filaments profile. For illustration microinterferograms are given.
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Affiliation(s)
- A M Ali
- Department of Physics, Faculty of Science, Umm Al- Qura University, KSA.,Physics Department, Faculty of Science, Mansoura University, Egypt
| | - Nuha Felemban
- Department of Physics, Faculty of Science, Umm Al- Qura University, KSA
| | - M A El-Bakary
- Physics Department, Faculty of Science, Mansoura University, Egypt
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Ali AM, Pillai JK, Gulati V, Gibbons CER, Roberton BJ. Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury? Skeletal Radiol 2018; 47:173-179. [PMID: 28856482 DOI: 10.1007/s00256-017-2754-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. MATERIALS AND METHODS Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. MRIs, plain radiographs and clinical details of these patients were reviewed. RESULTS Twenty-five patients were identified (median time from injury to MRI = 24 days). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. Meniscal injury was unrelated to the extent or pattern of bone bruising. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). CONCLUSIONS Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Other structures are injured less frequently and have weaker associations with bone bruise distribution. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury.
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Affiliation(s)
- A M Ali
- Department of Orthopaedic Surgery, Chelsea and Westminster Hospital, London, UK.
| | - J K Pillai
- Department of Radiology, Chelsea and Westminster Hospital, London, UK
| | - V Gulati
- Department of Orthopaedic Surgery, Homerton University Hospital, London, UK
| | - C E R Gibbons
- Department of Orthopaedic Surgery, Chelsea and Westminster Hospital, London, UK
| | - B J Roberton
- Department of Radiology, Chelsea and Westminster Hospital, London, UK
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25
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AlDala'een NFD, Mohamad WNKW, Alias N, Ali AM, Shaikh Mohammed J. Bioinspired dynamic microcapsules. Soft Matter 2017; 14:124-131. [PMID: 29215674 DOI: 10.1039/c7sm01682d] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is an increasing interest in bioinspired dynamic materials. Abundant illustrations of protein domains exist in nature, with remarkable ligand binding characteristics and structures that undergo conformational changes. For example, calmodulin (CaM) can have three conformational states, which are the unstructured Apo-state, Ca2+-bound ligand-exposed binding state, and compact ligand-bound state. CaM's mechanical response to biological cues is highly suitable for engineering dynamic materials. The distance between CaM globular terminals in the Ca2+-bound state is 5 nm and in the ligand-bound state is 1.5 nm. CaM's nanoscale conformational changes have been used to develop dynamic hydrogel microspheres that undergo reversible volume changes. The current work presents the fabrication and preliminary results of layer-by-layer (LbL) self-assembled Dynamic MicroCapsules (DynaMicCaps) whose multilayered shell walls are composed of polyelectrolytes and CaM. Quasi-dynamic perfusion results show that the DynaMicCaps undergo drastic volume changes, with up to ∼1500% increase, when exposed to a biochemical ligand trifluoperazine (TFP) at pH 6.3. Under similar test conditions, microcapsules without CaM also underwent volume changes, with only up to ∼290% increase, indicating that CaM's bio-responsiveness was retained within the shell walls of the DynaMicCaps. Furthermore, DynaMicCaps exposed to 0.1 M NaOH underwent volume changes, with only up to ∼580% volume increase. Therefore, DynaMicCaps represent a new class of polyelectrolyte multilayer (PEM) capsules that can potentially be used to release their payload at near physiological pH. With over 200 proteins that undergo marked, well-characterized conformational changes in response to specific biochemical triggers, several other versions of DynaMicCaps can potentially be developed.
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Affiliation(s)
- N F D AlDala'een
- Faculty of Innovative Design & Technology, Universiti Sultan Zainal Abidin (UniSZA), Gong Badak Campus, 21300 Kuala Terengganu, Malaysia.
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Ali AM, Loeffler MD, Aylin P, Bottle A. Factors Associated With 30-Day Readmission After Primary Total Hip Arthroplasty: Analysis of 514 455 Procedures in the UK National Health Service. JAMA Surg 2017; 152:e173949. [PMID: 28979994 DOI: 10.1001/jamasurg.2017.3949] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Importance Thirty-day readmission to hospital after total hip arthroplasty (THA) has significant direct costs and is used as a marker of hospital performance. All-cause readmission is the only metric in current use, and risk factors for surgical readmission and those resulting in return to theater (RTT) are poorly understood. Objective To determine whether patient-related predictors of all-cause, surgical, and RTT readmission after THA differ and which predictors are most significant. Design, Setting, and Participants Analysis of all primary THAs recorded in the National Health Service (NHS) Hospital Episode Statistics database from 2006 to 2015. The effect of patient-related factors on 30-day readmission risk was evaluated by multilevel logistic regression analysis. The analysis comprised all acute NHS hospitals in England and all patients receiving primary THA. Main Outcomes and Measures Thirty-day readmission rate for all-cause, surgical (defined using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision primary admission diagnoses), and readmissions resulting in RTT. Results Across all hospitals, 514 455 procedures were recorded. Seventy-nine percent of patients were older than 60 years, 40.3% were men, and 59.7% were women. There were 30 489 all-cause readmissions (5.9%), 16 499 surgical readmissions (3.2%), and 4286 RTT readmissions (0.8%); 54.1% of readmissions were for surgical causes. Comorbidities with the highest odds ratios (ORs) of RTT included those likely to affect patient behavior: drug abuse (OR, 2.22; 95% CI, 1.34-3.67; P = .002), psychoses (OR, 1.83; 95% CI, 1.16-2.87; P = .009), dementia (OR, 1.57; 95% CI, 1.11-2.22; P = .01), and depression (OR, 1.52; 95% CI, 1.31-1.76; P < .001). Obesity had a strong independent association with RTT (OR, 1.46; 95% CI, 4.45-6.43; P < .001), with one of the highest population attributable fractions of the comorbidities (3.4%). Return to theater in the index episode was associated with a significantly increased risk of RTT readmission (OR, 5.35; 95% CI, 4.45-6.43; P < .001). Emergency readmission to the hospital in the preceding 12 months increased the risk of readmission significantly, with the association being most pronounced for all-cause readmission (for >2 emergency readmissions, OR, 2.33; 95% CI, 2.11-2.57; P < .001). Hip resurfacing was associated with a lower risk of RTT when compared with cemented implants (OR, 0.69; 95% CI, 0.54-0.88; P = .002) but for other types of readmission, implant type had no significant association with readmission risk. Increasing age and length of stay were strongly associated with all-cause readmission. Conclusions and Relevance Many patient-related risk factors for surgical and RTT readmission differ from those for all-cause readmission despite the latter being the only measure in widespread use. Clinicians and policy makers should consider these alternative readmission metrics in strategies for risk reduction and cost savings.
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Affiliation(s)
- Adam M Ali
- St Mary's Hospital, London, England.,Imperial College, London, England
| | | | - Paul Aylin
- Dr Foster Unit at Imperial College, London, England
| | - Alex Bottle
- Dr Foster Unit at Imperial College, London, England
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Sokkar TZN, El-Farhaty KA, El-Bakary MA, Ali AM, Ahmed AA. The effect of short heat treatment on different properties of PET fiber using double beam interference microscopy. Microsc Res Tech 2017; 81:283-291. [PMID: 29193422 DOI: 10.1002/jemt.22977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 10/17/2017] [Accepted: 11/19/2017] [Indexed: 11/09/2022]
Abstract
Pluta microscope used to throw light on the effect of heat treatment time on the different properties of poly (ethylene terephthalate) PET fibers. PET fibers were annealed at times ranged from 5 to 30 min at different temperatures (150, 170, 190, 210°C) using two different processes (fast cooling and slow cooling processes) in air. The refractive indices, the shrinkage, orientation factor and crystallinity of PET fibers were determined for different annealing temperature during the short time treatment. The shrinkage percentage and degree of crystallinity increased with increasing the temperature and time of annealing. Microinterferograms are given for illustration.
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Affiliation(s)
- T Z N Sokkar
- Physics Department, Faculty of Science, Mansoura University, Egypt
| | - K A El-Farhaty
- Physics Department, Faculty of Science, Mansoura University, Egypt
| | - M A El-Bakary
- Physics Department, Faculty of Science, Mansoura University, Egypt
| | - A M Ali
- Physics Department, Faculty of Science, Mansoura University, Egypt.,Physics Department, Faculty of Science, UMM El-QURA University, Makkah, Kingdom of Saudi Arabia
| | - A A Ahmed
- Physics Department, Faculty of Science, Mansoura University, Egypt
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Ali AM, Newman SDS, Hooper PA, Davies CM, Cobb JP. The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty: A Biomechanical Model Using Digital Image Correlation. Bone Joint Res 2017; 6:522-529. [PMID: 28855192 PMCID: PMC5579314 DOI: 10.1302/2046-3758.68.bjr-2017-0067.r1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/27/2017] [Indexed: 11/06/2022] Open
Abstract
Objectives Unicompartmental knee arthroplasty (UKA) is a demanding procedure, with tibial component subsidence or pain from high tibial strain being potential causes of revision. The optimal position in terms of load transfer has not been documented for lateral UKA. Our aim was to determine the effect of tibial component position on proximal tibial strain. Methods A total of 16 composite tibias were implanted with an Oxford Domed Lateral Partial Knee implant using cutting guides to define tibial slope and resection depth. Four implant positions were assessed: standard (5° posterior slope); 10° posterior slope; 5° reverse tibial slope; and 4 mm increased tibial resection. Using an electrodynamic axial-torsional materials testing machine (Instron 5565), a compressive load of 1.5 kN was applied at 60 N/s on a meniscal bearing via a matching femoral component. Tibial strain beneath the implant was measured using a calibrated Digital Image Correlation system. Results A 5° increase in tibial component posterior slope resulted in a 53% increase in mean major principal strain in the posterior tibial zone adjacent to the implant (p = 0.003). The highest strains for all implant positions were recorded in the anterior cortex 2 cm to 3 cm distal to the implant. Posteriorly, strain tended to decrease with increasing distance from the implant. Lateral cortical strain showed no significant relationship with implant position. Conclusion Relatively small changes in implant position and orientation may significantly affect tibial cortical strain. Avoidance of excessive posterior tibial slope may be advisable during lateral UKA. Cite this article: A. M. Ali, S. D. S. Newman, P. A. Hooper, C. M. Davies, J. P. Cobb. The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty: A Biomechanical Model Using Digital Image Correlation. Bone Joint Res 2017;6:522–529. DOI: 10.1302/2046-3758.68.BJR-2017-0067.R1.
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Affiliation(s)
- A M Ali
- Imperial College London, Charing Cross Campus, London, W6 8RP, UK
| | - S D S Newman
- Imperial College London, Charing Cross Campus, London, W6 8RP, UK
| | - P A Hooper
- Department of Mechanical Engineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - C M Davies
- Department of Mechanical Engineering, Imperial College London, Exhibition Road, London SW7 2AZ, UK
| | - J P Cobb
- Imperial College London, Charing Cross Campus, London, W6 8RP, UK
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Affiliation(s)
- Adam M. Ali
- Frank Knox Fellow; Harvard University; Cambridge Massachusetts
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30
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Ali AM. Engaging doctors in management: the need to start early. BMJ 2017; 356:j1005. [PMID: 28235821 DOI: 10.1136/bmj.j1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Adam M Ali
- Harvard University, Cambridge, Boston, MA 02138, USA
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Ali AM, Gibbons CER. Predictors of 30-day hospital readmission after hip fracture: a systematic review. Injury 2017; 48:243-252. [PMID: 28063674 DOI: 10.1016/j.injury.2017.01.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/26/2016] [Accepted: 01/01/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Early readmission to hospital after hip fracture is associated with increased mortality and significant costs to the healthcare system. There is growing interest in the use of 30-day readmission rates as a metric of hospital performance. Identifying patients at increased risk of readmission after hip fracture may enable pre-emptive action to mitigate this risk and the development of effective methods of risk-adjustment to allow readmission to be used as a reliable measure of hospital performance. METHODS We conducted a systematic review of bibliographic databases and reference lists up to July 2016 to identify primary research papers assessing the effect of patient- and hospital-related risk factors for 30-day readmission to hospital after hip fracture. RESULTS 495 papers were found through electronic and reference search. 65 full papers were assessed for eligibility. 22 met inclusion criteria and were included in the final review. Medical causes of readmission were significantly more common than surgical causes, with pneumonia consistently being cited as the most common readmission diagnosis. Age, pre-existing pulmonary disease and neurological disorders were strong independent predictors of readmission. ASA grade and functional status were more robust predictors of readmission than the Charlson score or individual co-morbidities. Hospital-related risk factors including initial length of stay, hospital size and volume, time to surgery and type of anaesthesia did not have a consistent effect on readmission risk. Discharge location and the strength of hospital-discharge facility linkage were important determinants of risk. CONCLUSIONS Patient-related risk factors such as age, co-morbidities and functional status are stronger predictors of 30-day readmission risk after hip fracture than hospital-related factors. Rates of 30-day readmission may not be a valid reflection of hospital performance unless a clear distinction can be made between modifiable and non-modifiable risk factors. We identify a number of deficiencies in the existing literature and highlight key areas for future research.
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Affiliation(s)
- Adam M Ali
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
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Nickelsen MN, Snoer A, Ali AM, Wienecke T. Semi-automatic software based detection of atrial fibrillation in acute ischaemic stroke and transient ischaemic attack. Eur J Neurol 2016; 24:322-325. [PMID: 27928866 DOI: 10.1111/ene.13199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/18/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Paroxysmal atrial fibrillation (PAF) is often asymptomatic and increases the risk of ischaemic stroke. Detection of PAF is challenging but crucial because a change of treatment decreases the risk of ischaemic stroke. Post-stroke investigations recommend at least 24-h continuous cardiac rhythm monitoring. Extended monitoring detects more PAF but is limited by costs due to manual analysis. Interpretive software might be a reasonable screening tool. The aim was to validate the performance and utility of Pathfinder SL software compared to manual analysis. METHODS In all, 135 ischaemic stroke patients with no prior history of PAF or atrial fibrillation and who had done a 7-day continuous electrocardiogram monitoring (Holter) were included. Manual analysis was compared with Pathfinder SL software including a systematic control of registered events. RESULTS Seventeen (12.6%) patients were diagnosed with PAF (atrial fibrillation > 30 s). Pathfinder SL software including a systematic control of events registered 16 (94.1%) patients with PAF. Manually 15 (88.2%) patients were detected with PAF. Pathfinder SL had a negative predictive value of 99% and sensitivity of 94%. CONCLUSIONS Pathfinder SL software including a systematic evaluation of events is an acceptable alternative compared to manual analysis in PAF detection following ischaemic stroke. It is less time consuming and therefore a reliable, cheaper alternative compared to manual analysis.
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Affiliation(s)
- M N Nickelsen
- Neurovascular Centre, Department of Neurology, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A Snoer
- Neurovascular Centre, Department of Neurology, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A M Ali
- Neurovascular Centre, Department of Neurology, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - T Wienecke
- Neurovascular Centre, Department of Neurology, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
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Affiliation(s)
- A M Ali
- Bone Marrow Transplantation and Leukemia Section, Division of Oncology, Washington University School of Medicine, St Louis, MO, USA
| | - J F DiPersio
- Bone Marrow Transplantation and Leukemia Section, Division of Oncology, Washington University School of Medicine, St Louis, MO, USA
| | - M A Schroeder
- Bone Marrow Transplantation and Leukemia Section, Division of Oncology, Washington University School of Medicine, St Louis, MO, USA
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Garg N, Bakhshinyan D, Venugopal C, Mahendram S, Rosa DA, Vijayakumar T, Manoranjan B, Hallett R, McFarlane N, Delaney KH, Kwiecien JM, Arpin CC, Lai PS, Gómez-Biagi RF, Ali AM, de Araujo ED, Ajani OA, Hassell JA, Gunning PT, Singh SK. CD133 + brain tumor-initiating cells are dependent on STAT3 signaling to drive medulloblastoma recurrence. Oncogene 2016; 36:606-617. [PMID: 27775079 PMCID: PMC5541269 DOI: 10.1038/onc.2016.235] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 04/27/2016] [Accepted: 06/01/2016] [Indexed: 12/11/2022]
Abstract
Medulloblastoma (MB), the most common malignant paediatric brain tumor, is currently treated using a combination of surgery, craniospinal radiotherapy and chemotherapy. Owing to MB stem cells (MBSCs), a subset of MB patients remains untreatable despite standard therapy. CD133 is used to identify MBSCs although its functional role in tumorigenesis has yet to be determined. In this work, we showed enrichment of CD133 in Group 3 MB is associated with increased rate of metastasis and poor clinical outcome. The signal transducers and activators of transcription-3 (STAT3) pathway are selectively activated in CD133+ MBSCs and promote tumorigenesis through regulation of c-MYC, a key genetic driver of Group 3 MB. We screened compound libraries for STAT3 inhibitors and treatment with the selected STAT3 inhibitors resulted in tumor size reduction in vivo. We propose that inhibition of STAT3 signaling in MBSCs may represent a potential therapeutic strategy to treat patients with recurrent MB.
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Affiliation(s)
- N Garg
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - D Bakhshinyan
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - C Venugopal
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - S Mahendram
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - D A Rosa
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - T Vijayakumar
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - B Manoranjan
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - R Hallett
- McMaster Centre for Functional Genomics, McMaster University, Hamilton, Ontario, Canada
| | - N McFarlane
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - K H Delaney
- Departement of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - J M Kwiecien
- Departement of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - C C Arpin
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - P-S Lai
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - R F Gómez-Biagi
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - A M Ali
- Department of Medicinal Chemistry, Faculty of Pharmacy, Assiut University, Assiut, Egypt
| | - E D de Araujo
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - O A Ajani
- Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - J A Hassell
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,McMaster Centre for Functional Genomics, McMaster University, Hamilton, Ontario, Canada.,Departments of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - P T Gunning
- Department of Chemistry, University of Toronto, Mississauga, Ontario, Canada
| | - S K Singh
- McMaster Stem Cell and Cancer Research Institute, Hamilton, Ontario, Canada.,Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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Ali AM, El-Sayed MI. Metronomic chemotherapy and radiotherapy as salvage treatment in refractory or relapsed pediatric solid tumours. ACTA ACUST UNITED AC 2016; 23:e253-9. [PMID: 27330362 DOI: 10.3747/co.23.2873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Metronomic chemotherapy (mctx) combined with radiation therapy (rt) is an emerging anticancer strategy. The aim of the present study was to assess the efficacy of mctx combined with rt as salvage treatment in children with refractory or relapsed solid malignancies. METHODS This prospective study enrolled patients with refractory or relapsed pediatric solid tumours from January 2013 to January 2015. Treatment consisted of 3-12 courses of mctx in all patients, followed by rt in patients who experienced local recurrence, distant metastases, or both. Each course of mctx consisted of oral celecoxib 100-400 mg twice daily (days 1-42), intravenous vinblastine 3 mg/m(2) weekly (weeks 1-6), oral cyclophosphamide 2.5 mg/m(2) daily (days 1-21), and oral methotrexate 15 mg/m(2) twice weekly (days 21-42). Statistical methods used were the log-rank test and binary logistic regression. RESULTS A favourable disease response (partial response or stable disease) was seen in 49 of 64 patients (76.6%), with mild acute toxicity occurring in 41 (64%). After a median follow-up of 14 months, 1-year overall survival was 62%. Pattern of disease relapse (p < 0.0001), time from initial treatment to relapse (p = 0.0002), and response to treatment (p < 0.0001) significantly affected survival. Age was the only factor that significantly correlated with treatment toxicity (p = 0.002; hazard ratio: 3.37; 95% confidence interval: 1.53 to 7.35). CONCLUSIONS Combining mctx with rt resulted in a favourable response rate, minimal toxicity, and 62% 1-year overall survival in patients with heavily pretreated recurrent disease. Patients with localized late recurrence or disease progression are the most likely to benefit from this regimen.
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Affiliation(s)
- A M Ali
- Department of Pediatric Oncology, South Egypt Cancer Institute, Assiut University, Egypt
| | - M I El-Sayed
- Department of Radiotherapy, South Egypt Cancer Institute, Assiut University, Egypt
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Ali AM, Pandit H, Liddle AD, Jenkins C, Mellon S, Dodd CAF, Murray DW. Does activity affect the outcome of the Oxford unicompartmental knee replacement? Knee 2016; 23:327-30. [PMID: 26758852 DOI: 10.1016/j.knee.2015.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 07/30/2015] [Accepted: 08/03/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND High levels of activity are considered to be a contraindication to unicompartmental knee replacement (UKR) and are not recommended after UKR. To determine if these recommendations should apply to the mobile-bearing Oxford UKR, this study assessed the effect of post-operative activity level on the outcome of this device. METHODS The outcome of the first 1000 Phase 3 cemented Oxford UKRs implanted between 1998 and 2010 was assessed using survival analysis, the Oxford Knee Score (OKS) and the American Knee Society Objective (KSS-O) and Functional (KSS-F) Scores. Patients were grouped according to the maximum post-operative Tegner Activity Score. RESULTS The mean follow-up was 6.1 years (range 1 to 14). Overall, increasing activity was associated with superior survival (p=0.025). In the high activity group, with Tegner≥5 (n=115) 2.6% were revised and the 12-year survival was 97.3% (confidence interval (CI): 92.0% to 99.1%). In the low activity group, with Tegner≤4, (n=885) 4.3% were revised and the 12-year survival was 94.0% (CI: 91.4 to 95.8). The difference between the two groups was not significant (p=0.44). Although the final OKS and KSS-F were significantly better in the high activity group compared to the low activity group (OKS 45v40, KSS-F 95v78), there was no difference in the change in OKS or KSS-O. CONCLUSIONS High activity does not compromise the outcome of the Oxford UKR and may improve it. Activity should not be restricted nor considered to be a contraindication.
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Affiliation(s)
- Adam M Ali
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Hemant Pandit
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Orthopaedic Centre, Oxford, United Kingdom
| | - Alexander D Liddle
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Stephen Mellon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | | | - David W Murray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Orthopaedic Centre, Oxford, United Kingdom.
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Meawed TE, Mansour MA, Mansour SA, Mohamed ML, Ibrahim EM, Ali AM. Functional and prognostic relevance of -173 G/C gene polymorphism of macrophage migration inhibitory factor in sepsis patients in Egyptian intensive care units. East Mediterr Health J 2015; 21:762-9. [PMID: 26750167 DOI: 10.26719/2015.21.10.762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 06/19/2012] [Indexed: 11/09/2022]
Abstract
This study aimed to evaluate the association of plasma MIF level and -173 G/C single nucleotide polymorphism of the MIF gene with the occurrence, severity and mortality of sepsis patients. A study was conducted in adult surgical intensive care units of Zagazig University Hospitals, Egypt on 25 patients with sepsis, 27 with severe sepsis and 28 controls. Gram-negative bacilli were the most common isolates in both severe sepsis (63.0%) and sepsis (56.0%) patients. A highly statistically significant difference was found in MIF levels between sepsis cases and controls and a statistically significant difference as regards MIF level in different genotypes of the studied groups. MIF level was significantly associated with mortality in sepsis cases. High MIF levels and MIF -173G/C gene polymorphism are powerful predictors of the severity of sepsis and its outcome.
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Affiliation(s)
- T E Meawed
- Department of Microbiology and Immunology, Zagazig University Hospitals, Zagazig, Egypt
| | - M A Mansour
- Department of Microbiology and Immunology, Zagazig University Hospitals, Zagazig, Egypt
| | - S A Mansour
- Department of Microbiology and Immunology, Zagazig University Hospitals, Zagazig, Egypt
| | - M L Mohamed
- Department of Obstetrics and Gynaecology, Zagazig University Hospitals, Zagazig, Egypt
| | - E M Ibrahim
- Department of General Surgery, Zagazig University Hospitals, Zagazig, Egypt
| | - A M Ali
- Department of Anaesthesiology and Intensive Care, Zagazig University Hospitals, Zagazig, Egypt
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Abstract
INTRODUCTION In April 2012 the John Radcliffe Hospital in Oxford became a major trauma centre (MTC). The British Orthopaedic Association and British Association of Plastic, Reconstructive and Aesthetic Surgeons joint standards for the management of open fractures of the lower limb (BOAST 4) require system-wide changes in referral practice that may be facilitated by the MTC and its associated major trauma network. METHODS From 2008 to 2013 a multistep audit of compliance with BOAST 4 was conducted to assess referral patterns, timing of surgery and outcomes (surgical site infection rates), to determine changes following local intervention and the establishment of the MTC. RESULTS Over the study period, 50 patients had soft tissue cover for an open lower limb fracture and there was a significant increase in the proportion of patients receiving definitive fixation in our centre (p=0.036). The median time from injury to soft tissue cover fell from 6.0 days to 3.5 days (p=0.051) and the median time from definitive fixation to soft tissue cover fell from 5.0 days to 2.0 days (p=0.003). The deep infection rate fell from 27% to 8% (p=0.247). However, in 2013 many patients still experienced a delay of >72 hours between injury and soft tissue cover, primarily owing to a lack of capacity for providing soft tissue cover. CONCLUSIONS Our experience may be relevant to other MTCs seeking to identify barriers to optimising the management of patients with these injuries.
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Affiliation(s)
- A M Ali
- Oxford University Hospitals NHS Trust , UK
| | | | - D Noyes
- Oxford University Hospitals NHS Trust , UK
| | - A J Brent
- Oxford University Hospitals NHS Trust , UK
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Abstract
A photo-controlled version of the engrailed homeodomain (zENG) was created by inserting the homeodomain into a surface loop of a circularly permuted version of the photoactive yellow protein (cPYP). The two proteins fold independently as judged by NMR and fluorescence denaturation measurements. In the dark, the affinity of the zENG domain for its cognate DNA is inhibited >100-fold compared to wild-type zENG. Blue-light irradiation of the hybrid protein leads to enhanced conformational dynamics of the cPYP portion and a two-fold enhancement of the DNA binding affinity of the zENG domain. These results suggest that insertion into a surface loop of cPYP can be a general approach for conferring an initial level of photo-control on a given target protein. Focussed mutation/selection strategies may then be used to enhance the degree of photo-control.
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Affiliation(s)
- A Kumar
- Dept. of Chemistry, University of Toronto, 80 St. George St., Toronto, CanadaM5S 3H6.
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Abstract
BACKGROUND Hospital admission rates for a number of conditions have been linked to variations in the weather. It is well established that trauma workload displays significant seasonal variation. A reliable predictive model might enable targeting of high-risk groups for intervention and planning of hospital staff levels. To our knowledge there have been no systematic reviews of the literature on the relationship between weather and trauma workload, and predictive models have thus far been informed by the results of single studies. METHODS We conducted a systematic review of bibliographic databases and reference lists up to June 2014 to identify primary research papers assessing the effect of specified weather conditions including temperature, rainfall, snow, fog, hail, humidity and wind speed on trauma workload, defined as admission to hospital, fracture or a Road Traffic Accident (RTA) resulting in a seriously injured casualty or fatality. RESULTS 11,083 papers were found through electronic and reference search. 83 full papers were assessed for eligibility. 28 met inclusion criteria and were included in the final review; 6 of these related to the effect of the weather on trauma admissions, one to ambulance call out for trauma, 13 to fracture rate and 8 to RTAs. Increased temperature is positively correlated with trauma admissions. The rate of distal radius fractures is more sensitive to adverse weather than the rate of hip fractures. Paediatric trauma, both in respect of trauma admissions and fracture rate, is more sensitive to the weather than adult trauma. Adverse weather influences both RTA frequency and severity, but the nature of the relationship is dependent upon the timecourse of the weather event and the population studied. Important methodological differences between studies limit the value of the existing literature in building consensus for a generalisable predictive model. CONCLUSIONS Weather conditions may have a substantial effect on trauma workload independent of the effects of seasonal variation; the population studied and timecourse of weather events appear critical in determining this relationship. Methodological differences between studies limit the validity of conclusions drawn from analysis of the literature, and we identify a number of areas that future research might address.
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Affiliation(s)
- A M Ali
- Kadoorie Centre for Critical Care Research; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom.
| | - K Willett
- Kadoorie Centre for Critical Care Research; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom
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Abstract
IMPORTANCE There is an ever-increasing drive to improve surgical patient outcomes. Given the benefits which robotics has bestowed upon a wide range of industries, from vehicle manufacturing to space exploration, robots have been highlighted by many as essential for continued improvements in surgery. OBJECTIVE The goal of this review is to outline the history of robotic surgery, and detail the key studies which have investigated its effects on surgical outcomes. Issues of cost-effectiveness and patient acceptability will also be discussed. RESULTS AND CONCLUSION Robotic surgery has been shown to shorten hospital stays, decrease complication rates and allow surgeons to perform finer tasks, when compared to the traditional laparoscopic and open approaches. These benefits, however, must be balanced against increased intraoperative times, vast financial costs and the increased training burden associated with robotic techniques. The outcome of such a cost-benefit analysis appears to vary depending on the procedure being conducted; indeed the strongest evidence in favour of its use comes from the fields of urology and gynaecology. It is hoped that with the large-scale, randomised, prospective clinical trials underway, and an ever-expanding research base, many of the outstanding questions surrounding robotic surgery will be answered in the near future.
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Affiliation(s)
- A Hussain
- John Radcliffe Hospital, University of Oxford, Oxford, UK
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Ali AM, Maya E, Lakhoo K. Challenges in managing paediatric osteomyelitis in the developing world: analysis of cases presenting to a tertiary referral centre in Tanzania. Afr J Paediatr Surg 2014; 11:308-11. [PMID: 25323179 DOI: 10.4103/0189-6725.143136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The literature on paediatric osteomyelitis in the developing world is scarce, and there have been calls for further characterisation of its epidemiology and the identification of factors that limit effective management in order to guide local service delivery. Our centre is a hospital serving a population of 11 million people in Tanzania. MATERIALS AND METHODS We identified patients <18 years admitted between 1 st January 2008 and 31 st December 2010 with a diagnosis of osteomyelitis through a search of admission logbooks. Patient notes were reviewed for information regarding the nature of the presentation, treatment given and outcome, with the primary outcome measure being recurrence of infection at follow-up. RESULTS A total of 63 patients were identified, notes available for 55: 40 males and 15 females, mean age of 11 years. The most common sites were the tibia and femur with other sites including the skull, humerus and foot. At presentation, 8 cases were categorised as acute, 5 as acute with X-ray changes, 40 as chronic localised and 2 as chronic systemic.A total of 11 patients were treated with antibiotics only, 11 with incision and drainage and 30 with surgical debridement. Bacterial cultures were available in 11 cases. all Staphylococcus aureus tested were gentamicin-sensitive, but at least one patient had S. aureus resistant to cloxacillin, erythromycin, co-trimoxazole, tetracycline or a combination of these. Of 29 patients attending follow-up, 20 made a full recovery and 9 developed recurrence of infection. Eight out of nine with recurrence had time from symptom onset to presentation of >3 months. Twelve out of 13 with a time from symptom onset to presentation of <2 months did not develop recurrence. CONCLUSIONS This is, to the best of our knowledge, the second largest study of paediatric osteomyelitis in the developing world. Major challenges facing this centre include a lack of availability of bacterial cultures and failure to attend follow-up. Delayed presentation of osteomyelitis to our centre is associated with recurrence of infection.
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Affiliation(s)
- Adam M Ali
- Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, United Kingdom
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Ali AM, Seddiek SA, Khater HF. Effect of butyrate, clopidol and their combination on the performance of broilers infected with Eimeria maxima. Br Poult Sci 2014; 55:474-82. [PMID: 25207431 DOI: 10.1080/00071668.2014.920488] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
1. The effect of butyric acid glycerides (BAGs) with and without clopidol (CLP) on Eimeria maxima on growth and associated biochemical variables was investigated in broiler chickens. 2. One-day-old chicks were divided into 6 equal groups (Gps) of 30 chicks each; each group was subdivided into 6 equal subgroups. Gp 1 was not infected and not treated. Chicks in Gp 2 were not infected and fed on a ration mixed with 4 g BAGs/kg for 6 successive weeks. Chicks of the other groups were directly inoculated intra-crop with 1 × 10(4) sporulated oocysts of E. maxima at 14 d of age. Gp 3 was infected and not treated. Chicks in the remaining three groups were given diets mixed with the tested drugs for 6 successive weeks. Gp 4 was fed on a diet mixed with CLP (125 g/kg). Gp 5 was given a diet mixed with BAGs (4 g/kg diet). Gp 6 was fed on a diet mixed with both BAGs (4 g/kg diet) and CLP (125 g/kg). 3. Birds in Gps 5 and 6 showed a reduction in the mean oocyst count, lesion scores and developmental stages in the lamina propria and improved growth and biochemical variables. BAG supplementation enhanced growth and production of healthy broilers. 4. It was concluded that BAGs were a useful supplement in broiler diets as an alternative to growth promoters and antimicrobial drugs.
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Affiliation(s)
- A M Ali
- a Chemistry Department, Pharmacology Unit , Animal Health Research Institute , Benha Branch, Benha , Egypt
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Thariat J, Clément-Colmou K, Vogin G, Beckendorf V, Ducassou A, Ali AM, Salas S, Saada E, Thyss A, Lapeyre M, Isambert N. [Radiation therapy of cardiac sarcomas]. Cancer Radiother 2014; 18:125-31. [PMID: 24637021 DOI: 10.1016/j.canrad.2014.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 10/15/2013] [Revised: 12/23/2013] [Accepted: 02/05/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary cardiac sarcomas represent less than 10 yearly cases in France. Their median survival is approximately 18 months. The treatment consists of surgery when possible. The role of chemotherapy and radiation therapy is controversial, especially with respect to limiting cardiac radiation dose that is theoretically incompatible with the requirement of a tumoricidal dose for sarcoma. A recent series of 124 cases of the French Sarcoma Group suggested a benefit of radiation therapy on progression-free survival. PATIENTS AND METHODS The dosimetric data of 12 patients were analyzed. RESULTS There was variety in radiotherapy modalities and definition of target volumes, doses and techniques are evolving more conformal plans. Irradiation appeared feasible with conventional fractionation with respect to toxicities (although probably underestimated due to short follow-up and dismal prognosis) and previously demonstrated benefit of radiotherapy for primitive cardiac sarcomas. CONCLUSION A scheme of 45Gy in 1.8Gy per fraction to a preoperative volume with an additional dose of 14Gy in 7 fractions on areas at risk or residual disease and margins 1cm, may be proposed based on the preliminary data of this study. Intensity modulated radiotherapy with daily cone-beam CT-scanner should be evaluated.
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Affiliation(s)
- J Thariat
- Département d'oncologie-radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France; Université Nice Sophia-Antipolis, 06200 Nice, France.
| | - K Clément-Colmou
- Oncologie-radiothérapie, centre René-Gauducheau, institut de cancérologie de l'Ouest, 44805 Saint-Herblain, France
| | - G Vogin
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - V Beckendorf
- Oncologie-radiothérapie, centre Alexis-Vautrin, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - A Ducassou
- Oncologie-radiothérapie, centre Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31300 Toulouse, France
| | - A M Ali
- Clinical oncology, Sohag University, Sohag, Égypte
| | - S Salas
- Oncologie médicale, CHU la Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - E Saada
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - A Thyss
- Oncologie médicale, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
| | - M Lapeyre
- Oncologie-radiothérapie, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - N Isambert
- Oncologie médicale, centre Georges-Francois-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
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Penfold RS, Ali MA, Ali AM, Patel I, MacGregor T, Shankar S, Cahill TJ, Finlayson AE, Mahmud I. Evaluation of the first year of the Oxpal Medlink: A web-based partnership designed to address specific challenges facing medical education in the occupied Palestinian territories. JRSM Open 2014; 5:2042533313517692. [PMID: 25057373 PMCID: PMC4012652 DOI: 10.1177/2042533313517692] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives To (1) evaluate educational needs of clinical students at Al-Quds University Medical School in the West Bank; (2) address these needs where possible using synchronous distance learning, with clinicians in Oxford providing case-based tutorials to undergraduates in the West Bank via an online platform (WizIQ) and (3) assess the impact of this education. Design Review of online OxPal Medlink database for tutorials held between March 2012 and April 2013. Needs assessment and evaluation of student and tutor experiences through online questionnaires, focus groups and semi-structured interviews. Setting Oxford University Hospitals, Oxford, UK, and Al-Quds University Medical School, Abu Dies, Palestine. Participants Doctors at Oxford University Hospitals and fourth-, fifth- and sixth-year medical students and faculty members at Al-Quds Medical School. Main outcome measures Number of tutorials, student participation, student-rated satisfaction and qualitative feedback from tutors and students. Results Students demonstrated strong theoretical knowledge but struggled to apply this in presentation-based scenarios. Between March 2012 and April 2013, 90 tutorials were delivered to 60 students. Feedback: >95% respondents rated tutorials as ‘Excellent’ or ‘Good’ and ‘Very’ or ‘Fairly’ relevant to their future practice in Palestine. Students reported the programme had modified their approach to patients but requested better synchronization with concurrent attachments and clarification of learning outcomes. Conclusions OxPal Medlink is a novel, web-based distance-learning partnership designed to overcome some of the challenges to local medical education in the occupied Palestinian territories. Evaluation of the first year indicates teaching is relevant to local practice and of high quality. This approach may have the potential to strengthen local capacity for medical education.
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Affiliation(s)
- Rose S Penfold
- Medical Sciences Division, University of Oxford, Oxford OX2 6HG, UK
| | - Mohammad A Ali
- Medical Sciences Division, University of Oxford, Oxford OX2 6HG, UK
| | - Adam M Ali
- Oxford University Clinical Academic Graduate School, Oxford OX3 9DU, UK
| | - Ishita Patel
- Senior Medical Registrar, Oxford Deanery, Oxford OX3 9DU, UK
| | - Thomas MacGregor
- Department of Upper GI Surgery, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Sushma Shankar
- Nuffield Department of Surgical Sciences, Oxford OX3 9DU, UK
| | - Thomas J Cahill
- Department of Cardiovascular Medicine, University of Oxford, Oxford OX2 6HG, UK
| | | | - Imran Mahmud
- Fulbright Scholar, Harvard School of Public Health, Boston, MA 02115, USA
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Abstract
This article gives a practical guide for the management of open lower limb fractures. It outlines the referral criteria and pathway for definitive care in a specialist centre, the initial management steps that should be taken in the emergency department, and the principles of fixation, soft tissue coverage and antibiotic therapy.
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Affiliation(s)
- Adam M Ali
- Foundation Doctor in the Oxford University Clinical Academic Graduate School
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Ali AM, Handuleh J, Patel P, Whitwell S, Harris K, Ali FR, Southgate RJ, Godman B, Al-Hadithy N, Gustafsson LL, Finlayson AET. The most fragile state: healthcare in Somalia. Med Confl Surviv 2014; 30:28-36. [PMID: 24684021 DOI: 10.1080/13623699.2014.874085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Kapitonova MY, Salim N, Othman S, Muhd Kamauzaman TMHT, Ali AM, Nawawi HM, Froemming GRA. Alteration of cell cytoskeleton and functions of cell recovery of normal human osteoblast cells caused by factors associated with real space flight. Malays J Pathol 2013; 35:153-163. [PMID: 24362479] [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: 06/03/2023]
Abstract
Experiments involving short-term space flight have shown an adverse effect on the physiology, morphology and functions of cells investigated. The causes for this effect on cells are: microgravity, temperature fluctuations, mechanical stress, hypergravity, nutrient restriction and others. However, the extent to which these adverse effects can be repaired by short-term space flown cells when recultured in conditions of normal gravity remains unclear. Therefore this study aimed to investigate the effect of short-term spaceflight on cytoskeleton distribution and recovery of cell functions of normal human osteoblast cells. The ultrastructure was evaluated using ESEM. Fluorescent staining was done using Hoechst, Mito Tracker CMXRos and Tubulin Tracker Green for cytoskeleton. Gene expression of cell functions was quantified using qPCR. As a result, recovered cells did not show any apoptotic markers when compared with control. Tubulin volume density (p<0.001) was decreased significantly when compared to control, while mitochondria volume density was insignificantly elevated. Gene expression for IL-6 (p<0.05) and sVCAM-1 (p<0.001) was significantly decreased while alkaline phosphatase (p<0.001), osteocalcin and sICAM (p<0.05) were significantly increased in the recovered cells compared to the control ones. The changes in gene and protein expression of collagen 1A, osteonectin, osteoprotegerin and beta-actin, caused by short-term spaceflight, were statistically not significant. These data indicate that short term space flight causes morphological changes in osteoblast cells which are consistent with hypertrophy, reduced cell differentiation and increased release of monocyte attracting proteins. The long-term effect of these changes on bone density and remodeling requires more detailed studies.
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Affiliation(s)
- M Y Kapitonova
- Universiti Teknologi Mara, Faculty of Medicine, Institute of Medical Molecular Biotechnology (IMMB), 47000, Sungai Buloh, Selangor, Malaysia
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Muid S, Froemming GRA, Ali AM, Nawawi H. Interleukin-6 and intercellular cell adhesion molecule-1 expression remains elevated in revived live endothelial cells following spaceflight. Malays J Pathol 2013; 35:165-176. [PMID: 24362480] [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: 06/03/2023]
Abstract
The effects of spaceflight on cardiovascular health are not necessarily seen immediately after astronauts have returned but can be delayed. It is important to investigate the long term effects of spaceflight on protein and gene expression of inflammation and endothelial activation as a predictor for the development of atherosclerosis and potential cardiovascular problems. The objectives of this study were to investigate the (a) protein and gene expression of inflammation and endothelial activation, (b) expression of nuclear factor kappa B (NFκB), signal transducer and activator of transcription-3 (STAT-3) and endothelial nitric oxide synthase (eNOS) in human umbilical vein endothelial cells (HUVEC) 3 months post-space flight travel compared to ground controls. HUVEC cultured on microcarriers in fluid processing apparatus were flown to the International Space Station (ISS) by the Soyuz TMA-11 rocket. After landing, the cells were detached from microcarriers and recultured in T-25 cm(2) culture flasks (Revived HUVEC). Soluble protein expression of IL-6, TNF-α, ICAM-1, VCAM-1 and e-selectin were measured by ELISA. Gene expression of these markers and in addition NFκB, STAT-3 and eNOS were measured. Spaceflight induced IL-6 and ICAM-1 remain elevated even after 3 months post spaceflight travel and this is mediated via STAT-3 pathway. The downregulation of eNOS expression in revived HUVEC cells suggests a reduced protection of the cells and the surrounding vessels against future insults that may lead to atherosclerosis. It would be crucial to explore preventive measures, in relation to atherosclerosis and its related complications.
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Affiliation(s)
- S Muid
- University Teknologi MARA, Faculty of Medicine, Centre of Pathology, Diagnostics and Research Laboratory, Sg. Buloh, Selangor, Malaysia
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Zuhaida AA, Ali AM, Tamilselvan S, Alitheen NB, Hamid M, Noor AM, Yeap SK. Construction of single-chain variable fragment antibodies against MCF-7 breast cancer cells. Genet Mol Res 2013; 12:5547-59. [PMID: 24301925 DOI: 10.4238/2013.november.18.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A phage display library of single chain variable fragment (scFv) against MCF-7 breast cancer cells was constructed from C3A8 hybridoma cells. RNA from the C3A8 was isolated, cDNA was constructed, and variable heavy and light immunoglobulin chain gene region were amplified using PCR. The variable heavy and light chain gene regions were combined with flexible linker, linked to a pCANTAB 5E phagemid vector and electrophoresed into supE strain of Escherichia coli TG1 cells. Forty-eight clones demonstrated positive binding activity to MCF-7 breast cancer cell membrane fragments and the strongest of 48 clones was selected for analysis. The anti-MCF-7 library evaluated by SfiI and NotI digests demonstrated that anti-MCF-7 scFv antibodies possess individual patterns that should be able to recognize distinct human breast cancer cells. The C3A8 scFv, with an apparent molecular weight of 32 kDa, showed high homology (99%) with single chain antibody against rice stripe virus protein P20. In summary, the anti MCF-7 scFv antibody can be used for pretargeting breast cancer for clinical diagnosis of patients; it also has potential for therapeutic applications.
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Affiliation(s)
- A A Zuhaida
- Laboratory of Molecular Biomedicine, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia
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