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Dachepally R, Allen B, Almasri M, Akmyradov C, Qasim A, Seib PM, Prodhan P. Factors associated with prolonged length of stay after balloon aortic valvuloplasty for congenital aortic stenosis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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2
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Roy A, Afroze T, Hassan FIA, Anees M, Qasim A. Risk factors to develop hungry bone syndrome following parathyroidectomy in end stage renal disease patient. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00147-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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3
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Ali S, Qasim A, Salah R, Sarwar MR, Usman M, Shams S. Isolated late intradural cauda equina metastasis of renal cell carcinoma. Surg Neurol Int 2021; 12:481. [PMID: 34754531 PMCID: PMC8571253 DOI: 10.25259/sni_721_2021] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The cauda equina (CE) is the most common site for intradural extramedullary metastasis from systemic malignancies such as lung, breast, and thyroid carcinomas. However, renal cell carcinomas (RCC), with their high metastatic potential, are rarely responsible for CE metastatic lesions. Here, we report an intradural cauda equina mass, as the first and only site of metastasis of a renal cell carcinoma. Case Description: A 55-year-old female had undergone a left nephrectomy for renal cell carcinoma 8 years ago. She now presented with a unifocal renal cell metastasis to the CE. As such metastases are rare, establishing the correct pathological diagnosis proved to be a challenge. Conclusion: The cauda equina was the first and only site of an 8-year-delayed metastasis attributed to a renal cell carcinoma.
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Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Rahmatullah Salah
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Rizwan Sarwar
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Usman
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Shahzad Shams
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
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Ali S, Qasim A, Tasdique S, Sarwar MR, Shams S. Extra-axial Desmoplastic Medulloblastoma in Adult Cerebellopontine Angle: Case Report and Noninvasive Molecular Subgrouping Utilizing Magnetic Resonance Imaging-Based Radiomics Nomogram. Asian J Neurosurg 2021; 16:618-622. [PMID: 34660382 PMCID: PMC8477825 DOI: 10.4103/ajns.ajns_525_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/01/2021] [Accepted: 03/20/2021] [Indexed: 12/04/2022] Open
Abstract
Cerebellopontine angle (CPA) is an atypical site for adult medulloblastoma (MB) with only 12 cases reported in pure extra-axial location. None was predicted on preoperative imaging while the most common misdiagnosis was petrous meningioma. We add the 13th case to this list, attempting to reiterate the radiological features for preoperative prediction of this rare pathology on conventional magnetic resonance imaging (MRI). Molecular subtyping also is not yet reported for adult extra-axial CPA MB. We propose the routine use of MRI-based nomograms, in atypical CPA extra-axial masses, for noninvasive prediction of molecular subgroup, especially in resource-limited setups that lack the facility of genetic profiling.
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Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Shahzaib Tasdique
- Department of Neurosurgery, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Rizwan Sarwar
- Department of Neurosurgery, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Shahzad Shams
- Department of Neurosurgery, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
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5
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Ali S, Qasim A, Anwar B, Choudhary N, Akmal M. Intradural extension of mucocele secondary to giant frontal sinus osteoma: Diagnostic pitfalls. Surg Neurol Int 2021; 12:252. [PMID: 34221583 PMCID: PMC8247709 DOI: 10.25259/sni_11_2021] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Paranasal sinus osteoma in association with intracranial mucocele is a rare entity while intradural extension is even rarer. Our aim of presenting this case is to highlight the diagnostic pitfalls and reiterate the importance of prompt treatment of expected complications. Case Description: A 35-year-old known epileptic, for the past 5 years, presented with altered sensorium for the past 2 days. Computed tomography (CT) of the brain plain showed ventriculomegaly and cystic lesion in the left frontal lobe adjacent to a calvarial osteoma. A ventriculoperitoneal (VP) shunt was done which resulted in tension pneumocephalus and led us to discover the origin of osteoma from the left frontal sinus on CT functional endoscopic sinus surgery (FESS) protocol. He underwent left frontal craniotomy. The osteoma and mucocele were excised completely and watertight primary dural closure was done. Postoperative meningitis was treated with antibiotics according to the culture report. Conclusion: Intracranial extension of mucocele led to meningitic hydrocephalus, prompting us for VP shunt. Resulting tension pneumocephalus revealed what was missed on preop CT, a small pocket of air adjacent to osteoma intracranially. Therefore, this case underscores the importance of obtaining a preoperative CT FESS to elaborate the origin of osteoma, thus planning approach differently.
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Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Bilal Anwar
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
| | - Nabeel Choudhary
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Akmal
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
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6
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Ali S, Qasim A, Sarwar MR, Munam AU, Shams S. Primary Intraosseous Xanthogranuloma in Adult Cervical Spine: A Case Report of Benign Cause of Lytic Bone Lesion. Asian J Neurosurg 2021; 16:208-211. [PMID: 34211897 PMCID: PMC8202395 DOI: 10.4103/ajns.ajns_480_20] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 10/31/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022] Open
Abstract
Lytic lesions in adult spine are a common manifestation of aggressive disease such as primary bone tumor, metastasis, myeloma, or infectious pathology. Xanthoma arising in the spine with purely intraosseous component is an extremely rare occurrence with only six cases reported in the adult population, none in the cervical region. We report the first case of primary xanthoma of the cervical spine in a 50-year-old male solely confined to osseous compartment. The imaging mimics of lytic lesion with expansile mass in adult spine are reiterated.
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Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Muhammad Rizwan Sarwar
- Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Attah Ul Munam
- Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Shahzad Shams
- Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
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Dwiyanto J, Hussain MH, Reidpath D, Ong KS, Qasim A, Lee SWH, Lee SM, Foo SC, Chong CW, Rahman S. Ethnicity influences the gut microbiota of individuals sharing a geographical location: a cross-sectional study from a middle-income country. Sci Rep 2021; 11:2618. [PMID: 33514807 PMCID: PMC7846579 DOI: 10.1038/s41598-021-82311-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [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: 05/20/2020] [Accepted: 01/19/2021] [Indexed: 02/08/2023] Open
Abstract
No studies have investigated the influence of ethnicity in a multi-ethnic middle-income country with a long-standing history of co-habitation. Stool samples from 214 Malaysian community members (46 Malay, 65 Chinese, 49 Indian, and 54 Jakun) were collected. The gut microbiota of the participants was investigated using 16S amplicon sequencing. Ethnicity exhibited the largest effect size across participants (PERMANOVA Pseudo-F = 4.24, R2 = 0.06, p = 0.001). Notably, the influence of ethnicity on the gut microbiota was retained even after controlling for all demographic, dietary factors and other covariates which were significantly associated with the gut microbiome (PERMANOVA Pseudo-F = 1.67, R2 = 0.02, p = 0.002). Our result suggested that lifestyle, dietary, and uncharacterized differences collectively drive the gut microbiota variation across ethnicity, making ethnicity a reliable proxy for both identified and unidentified lifestyle and dietary variation across ethnic groups from the same community.
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Affiliation(s)
- Jacky Dwiyanto
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | - M H Hussain
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - D Reidpath
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,South East Asia Community Observatory, Segamat, Malaysia
| | - K S Ong
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - A Qasim
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.,Genomics Facility, Monash University Malaysia, Bandar Sunway, Malaysia
| | - S W H Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - S M Lee
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - S C Foo
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - C W Chong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Sadequr Rahman
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia. .,Tropical Medicine and Biology Platform, Monash University Malaysia, Bandar Sunway, Malaysia.
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8
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Raut R, Shams S, Rasheed M, Niaz A, Mehdi W, Ahsan AB, Tasdique S, Qasim A, Sarwar Z. Impact of COVID-19 on Neurosurgery in LMIC: Training and Service Delivery in a Tertiary Care Hospital in Pakistan. Indian Journal of Neurotrauma 2020. [DOI: 10.1055/s-0040-1716422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rupesh Raut
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Shahzad Shams
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Muddassar Rasheed
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Azam Niaz
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Waqas Mehdi
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Ammar Bin Ahsan
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Shahzaib Tasdique
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Zainab Sarwar
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
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9
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Qasim A, Mayhew AJ, Ehtesham S, Alyass A, Volckmar AL, Herpertz S, Hinney A, Hebebrand J, Meyre D. Gain-of-function variants in the melanocortin 4 receptor gene confer susceptibility to binge eating disorder in subjects with obesity: a systematic review and meta-analysis. Obes Rev 2019; 20:13-21. [PMID: 30306707 DOI: 10.1111/obr.12761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/24/2018] [Revised: 07/20/2018] [Accepted: 08/02/2018] [Indexed: 01/21/2023]
Abstract
The association between coding variants in the melanocortin 4 receptor gene (MC4R) and binge eating disorder (BED) in patients with obesity is controversial. Two independent reviewers systematically searched MEDLINE, Embase, PsycINFO, BIOSIS Previews, Web of Science Core Collection and Google Scholar up to February 2018, using terms describing the MC4R gene and BED. Six of 103 identified references were included. Studies examined associations between at least one coding variant/mutation in MC4R and BED and screened for BED as per the Diagnostic and Statistical Manual of Mental Disorders. Risk of bias was assessed using a modified version of the Q-Genie tool, and overall quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation guidance. Meta-analysis was conducted via logistic regression models. A positive association between gain-of-function (GOF) variants in the MC4R and BED was observed (odds ratio [OR] = 3.05; 95% confidence interval [CI]: 1.82, 5.04; p = 1.7 × 10-5 ), while no association was detected between loss-of-function (LOF) mutations and BED (OR = 1.50; 95% CI: 0.73, 2.96; p = 0.25). Similar results were found after accounting for study quality (GOF variants: OR = 3.15; 95% CI: 1.76, 5.66; p = 1.1 × 10-4 ; LOF mutations: OR = 1.50; 95% CI: 0.73, 2.97; p = 0.25). Our systematic review and meta-analysis provides evidence that GOF variants as opposed to LOF mutations in MC4R are associated with BED in subjects with obesity.
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Affiliation(s)
- A Qasim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - A J Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - S Ehtesham
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - A Alyass
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - A-L Volckmar
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg - Essen, Essen, Germany
| | - S Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Clinic, Ruhr University Bochum, Bochum, Germany
| | - A Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg - Essen, Essen, Germany
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg - Essen, Essen, Germany
| | - D Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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10
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Qasim A, Turcotte M, de Souza RJ, Samaan MC, Champredon D, Dushoff J, Speakman JR, Meyre D. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. Obes Rev 2018; 19:121-149. [PMID: 29144594 DOI: 10.1111/obr.12625] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [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: 06/29/2017] [Revised: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 12/12/2022]
Abstract
Genetic predisposition to obesity presents a paradox: how do genetic variants with a detrimental impact on human health persist through evolutionary time? Numerous hypotheses, such as the thrifty genotype hypothesis, attempt to explain this phenomenon yet fail to provide a justification for the modern obesity epidemic. In this critical review, we appraise existing theories explaining the evolutionary origins of obesity and explore novel biological and sociocultural agents of evolutionary change to help explain the modern-day distribution of obesity-predisposing variants. Genetic drift, acting as a form of 'blind justice,' may randomly affect allele frequencies across generations while gene pleiotropy and adaptations to diverse environments may explain the rise and subsequent selection of obesity risk alleles. As an adaptive response, epigenetic regulation of gene expression may impact the manifestation of genetic predisposition to obesity. Finally, exposure to malnutrition and disease epidemics in the wake of oppressive social systems, culturally mediated notions of attractiveness and desirability, and diverse mating systems may play a role in shaping the human genome. As an important first step towards the identification of important drivers of obesity gene evolution, this review may inform empirical research focused on testing evolutionary theories by way of population genetics and mathematical modelling.
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Affiliation(s)
- A Qasim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - M Turcotte
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - R J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - M C Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, ON, Canada
| | - D Champredon
- Department of Biology, McMaster University, Hamilton, ON, Canada.,Agent-Based Modelling Laboratory, York University, Toronto, ON, Canada
| | - J Dushoff
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - J R Speakman
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.,State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - D Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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Subhani F, Nizamuddin R, Qasim A, Idrees N, Ahmed I, Nizami S, Shakoor S, Beg MA. The emerging threat of schistosomiasis spread in Pakistan. Trop Biomed 2014; 31:118-121. [PMID: 24862051] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Schistosomiasis is among the thirteen neglected tropical diseases of the world. While prevalent in a number of countries, it has only rarely been reported in Pakistan. Here we report a 25 year old male who acquired the infection during travel to Malawi and presented with haematuria and dysuria. He was successfully treated with praziquantel. The possibility of schistosomiasis becoming endemic in the country is discussed. A number of risk factors are present including dams, irrigation, increased travel and geographical proximity to endemic countries. The local presence of at least one snail species of potential hosts for Schistosoma mansoni is confirmed. We see that schistosomiasis endemicity is a possible threat in Pakistan. Solutions to prevent this include reducing travel to endemic areas, prompt recognition and treatment of cases, and health education.
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Affiliation(s)
- F Subhani
- Aga Khan University Medical College, Karachi, Pakistan
| | - R Nizamuddin
- Aga Khan University Medical College, Karachi, Pakistan
| | - A Qasim
- Aga Khan University Medical College, Karachi, Pakistan
| | - N Idrees
- Aga Khan University Medical College, Karachi, Pakistan
| | - I Ahmed
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan
| | - S Nizami
- Aga Khan University Medical College, Karachi, Pakistan
| | - S Shakoor
- Department of Pediatrics and Pathology, Aga Khan University, Karachi, Pakistan
| | - M A Beg
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan
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Chan K, Patel RS, Newcombe P, Nelson CP, Qasim A, Epstein SE, Burnett S, Vaccarino VL, Zafari AM, Shah SH, Anderson JL, Carlquist JF, Hartiala J, Allayee H, Hinohara K, Lee BS, Erl A, Ellis KL, Goel A, Schaefer AS, Mokhtari NE, Goldstein BA, Hlatky MA, Go AS, Shen GQ, Gong Y, Pepine C, Laxton RC, Wittaker JC, Tang WHW, Johnson JA, Wang QK, Assimes TL, Nöthlings U, Farrall M, Watkins H, Richards AM, Cameron VA, Muendlein A, Drexel H, Koch W, Park JE, Kimura A, Shen WF, Simpson IA, Hazen SL, Horne BD, Hauser ER, Quyyumi AA, Reilly MP, Samani NJ, Ye S. 126 CHROMOSOME 9P21 LOCUS AND ANGIOGRAPHIC CORONARY ARTERY DISEASE BURDEN: A COLLABORATIVE META-ANALYSIS. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Pang B, Matthias D, Ong CW, Dhewar AN, Gupta S, Lim GL, Nga ME, Seet JE, Qasim A, Chin TM, Soo R, Soong R, Salto-Tellez M. The positive impact of cytological specimens for EGFR mutation testing in non-small cell lung cancer: a single South East Asian laboratory’s analysis of 670 cases. Cytopathology 2012; 23:229-36. [DOI: 10.1111/j.1365-2303.2012.01000.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Keane RA, O'Connor A, Ryan B, Breslin N, O'Connor HJ, Qasim A, O'Morain C. Inappropriate colonoscopic surveillance of hyperplastic polyps. Ir Med J 2011; 104:211-214. [PMID: 21957689] [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: 05/31/2023]
Abstract
Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.
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McNamara D, Qasim A, Lee N, Condon C, O'Morain C. Round one of the Adelaide and Meath Hospital/Trinity College Colorectal Cancer Screening Programme: programme report and analysis based on established international key performance indices. Ir J Med Sci 2011; 180:549-52. [PMID: 21264524 DOI: 10.1007/s11845-010-0650-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 11/21/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND In Ireland, colorectal cancer (CRC) is the second most frequently diagnosed cancer in men, after prostate cancer, and the second most frequently diagnosed cancer in women, after breast cancer. By 2020, the number of new cases diagnosed annually in Ireland is projected to have increased by 79% in men and 56% in women. Organised screening for CRC is already underway or is in the process of being rolled out in several European countries, either at a regional or national level. The Adelaide and Meath Hospital/ Trinity College Dublin Colorectal Cancer Screening Programme (TTC-CRC-SP) is Ireland's first pilot population based bowel screening programme. METHOD Based on a biennial test model the pilot aimed to assess the accuracy of FIT and to evaluate the whole programme based on established international key performance indices. RESULTS To date 9,993 individuals aged 50-74 years have been invited to participate in the TTC-CRC-SP with over 5,000 FIT's analysed. Overall uptake was 51% and FIT positivity was 10%. The programme has undertaken over 400 screening colonoscopies and detected 154 precancerous adenomas and 38 cancerous lesions. CONCLUSIONS The first round of The Adelaide and Meath Hospital Tallaght/Trinity College Dublin Colorectal Cancer Screening Programme has been highly successful and confirmed that there is an advantage for FIT based two stage bowel cancer screening programmes.
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Affiliation(s)
- D McNamara
- Department of Clinical Medicine, Trinity Centre, The Adelaide and Meath Hospital, Trinity College Dublin, Tallaght, Dublin 24, Ireland.
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16
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Shuhaibar M, Walsh C, Lindsay F, Lee N, Walsh P, O’Gorman P, Boran G, McLoughlin R, Qasim A, Breslin N, Ryan B, O’Connor H, O’Morain C. A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers. Ir J Med Sci 2010; 180:103-8. [DOI: 10.1007/s11845-010-0605-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 09/30/2010] [Indexed: 12/22/2022]
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Jawed Zafar S, Tai S, Bashir S, Saleem M, Zaki A, Kazmi M, Majeed M, Qasim A. MS545 TO ASSESS THE ATTITUDE AND NEGLIGENCE OF HYPERTENSIVE PATIENTS TOWARDS LIFESTYLE MODIFICATION. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)71045-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Jawed S, Tai S, Saleem M, Bashir S, Majid M, Zaki A, Kazmi M, Qasim A. MS296 TO ASSESS THE ATTITUDE AND NEGLIGENCE OF HYPERTENSIVE PATIENTS TOWARDS LIFESTYLE MODIFICATION. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70797-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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O'Donnell S, Qasim A, Ryan BM, O'Connor HJ, Breslin N, O Morain CA. The role of capsule endoscopy in small bowel Crohn's disease. J Crohns Colitis 2009; 3:282-6. [PMID: 21172288 DOI: 10.1016/j.crohns.2009.07.002] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 06/12/2009] [Accepted: 07/13/2009] [Indexed: 02/08/2023]
Abstract
UNLABELLED Video capsule endoscopy is an invaluable tool for examining the small bowel. It is non-invasive and generally well tolerated, however its role in the assessment of the severity and extent of small bowel Crohn's disease has not, to date, been adequately evaluated. METHODS All capsule endoscopies performed over a two year period in a tertiary referral centre in subjects with known or suspected Crohn's disease were reviewed. RESULTS Twenty-six capsule endoscopy studies in total were included. These were performed in 15 cases of known Crohn's disease, 5 cases of suspected Crohn's disease, 3 cases of endoscopically diagnosed non-specific terminal ileal inflammation and finally 3 post colectomy cases of indeterminant being considered for IPAA formation. Ten patients known to have small bowel Crohn's disease were prospectively recruited; of 3 with normal small bowel follow through or CT exams, one had an abnormal capsule endoscopy. The other 7 patients had small bowel follow through or abdominal CT scans consistent with small bowel Crohn's disease; additional mucosal abnormalities were detected by capsule endoscopy in 6 cases with capsule retention in the stomach in one. Of 5 with colonic Crohn's disease normal small bowel imaging corresponded with normal capsule endoscopy in all but one. A diagnosis of Crohn's disease was made in 2 out of 5 cases of suspected Crohn's disease on the basis of the capsule endoscopy findings. Three patients with non-specific acute terminal ileal inflammation at ileocolonoscopy were confirmed to have ongoing inflammation. The capsule was retained in four subjects beyond 24 h. CONCLUSION Capsule endoscopy more accurately determines the severity and extent of the Crohn's disease in the small bowel than traditional imaging modalities.
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Affiliation(s)
- S O'Donnell
- Department of Gastroenterology, AMNCH/Trinity College Dublin, Ireland
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Gerber RT, Latib A, Ielasi A, Cosgrave J, Qasim A, Airoldi F, Chieffo A, Montorfano M, Carlino M, Michev I, Tobis J, Colombo A. Defining a new standard for IVUS optimized drug eluting stent implantation: the PRAVIO study. Catheter Cardiovasc Interv 2009; 74:348-56. [PMID: 19213067 DOI: 10.1002/ccd.21973] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Preliminary Investigation to the Angiographic Versus IVUS Optimization Trial is a single center prospective observational intravascular ultrasound (IVUS) guided stent implantation study assessing new criteria for optimal drug eluting stent (DES) deployment. BACKGROUND IVUS assessment of DES often reveals underexpansion and malapposition. Optimal stent deployment is currently poorly defined and previous criteria may not be suitable in long and complex lesions. METHODS Optimization was defined as achieving >/or 70% of the cross-sectional area (CSA) of the postdilation balloon. This criterion was applied in 113 complex lesions. The size of this balloon was calculated according to vessel media-to-media diameters at various sites inside the stented segment. The IVUS guided treated lesions were matched according to diabetes, vessel type, reference vessel diameter, minimum lumen diameter (MLD), and lesion length with a group of angiographic treated lesions to compare final MLD achieved. RESULTS Mean minimum stent CSA according to the postdilation balloon utilized was 4.62 mm(2), 6.26 mm(2), 7.87 mm(2), and 9.87 mm(2) for 2.5 mm, 3.0 mm, 3.5 mm, and 4 mm balloons, respectively. Final MLD (mm) was significantly larger in the IVUS compared to the angiographic-guided group (3.09 +/- 0.50 vs. 2.67 +/- 0.54; P < 0.0001). There were no procedural complications related to IVUS use. CONCLUSIONS We propose new IVUS criteria based on vessel remodeling that results in an increment in the final MLD, compared to angiographic guidance, which is much larger than any previously published study. This criterion seems to be safely achievable. A proposed randomized study (angiographic vs. IVUS optimization trial) has been launched to test these concepts.
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Affiliation(s)
- R T Gerber
- Catheterisation Laboratory, San Raffaele Hospital, Milan, Italy
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21
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Taneike I, Nami A, O'Connor A, Fitzgerald N, Murphy P, Qasim A, O'Connor H, O'Morain C. Analysis of drug resistance and virulence-factor genotype of Irish Helicobacter pylori strains: is there any relationship between resistance to metronidazole and cagA status? Aliment Pharmacol Ther 2009; 30:784-90. [PMID: 19604178 DOI: 10.1111/j.1365-2036.2009.04095.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [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: 01/06/2023]
Abstract
BACKGROUND Helicobacter pylori infection is eradicated with antimicrobial agents and drug-resistant strains make successful treatment difficult. Geographical variations in virulence-factor genotype also exist. AIM To evaluate prevalence of drug resistance and virulence-factor genotype in Irish H. pylori strains and to investigate if there is any relationship between drug resistance and genotype. METHODS Helicobacter pylori strains isolated from 103 patients were examined. Antimicrobial susceptibilities were tested by Etest. The virulence-factor genotypes were determined using PCR. Frequencies of spontaneous metronidazole-resistance were measured in vitro. RESULTS Metronidazole resistance was present in 37.9% of strains examined. 16.5% of strains were clarithromycin-resistant and resistance to both agents observed was found in 12.6% of strains. 68% of strains were cagA(+). The dominant vacA type was s1/m2, followed by s1/m1 and s2/m2. The metronidazole resistance rate in cagA(-) group was significantly higher than in cagA(+) (P = 0.0089). Spontaneous resistance to metronidazole in cagA(-) occurred in higher frequency when compared with cagA(+). CONCLUSIONS cagA(+) and vacAs1/m2 type was the dominant genotype in Irish H. pylori strains. Significant rates of metronidazole resistance were observed in cagA(-) group. cagA(-) strains tend to acquire metronidazole resistance in vitro. Absence of cagA might be a risk factor in development of metronidazole resistance.
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Affiliation(s)
- I Taneike
- Department of Clinical Medicine, Trinity College Dublin, Ireland.
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Qasim A, Zaman BM, Geoghegan J, Maguire D, Traynor O, Hegarty J, McCormick PA. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation. Ir J Med Sci 2008; 178:47-51. [PMID: 18982406 DOI: 10.1007/s11845-008-0234-z] [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] [Received: 07/12/2007] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are many indications for hepatic retransplantation. AIM To identify factors influencing retransplantation needs and outcomes. PATIENTS AND METHODS Retransplantation records from January 1993 to March 2005 were analysed. Patient and disease characteristics and survival outcomes for retransplantation were compared between various groups. RESULTS Totally, 286 primary and 42 hepatic retransplantations were performed. Retransplantation indications included primary sclerosing cholangitis (PSC), primary biliary cirrhosis, chronic hepatitis C (HCV), chronic active hepatitis (CAH), and alcohol-related disease. Mean follow-up post-retransplantation was 31 +/- 9 months. Actuarial patient survival at 3 months, 1 year, 3 years, 5 years, and at the end of study was 71.4, 69, 59.5, 54.7, and 50%, respectively. Early and late retransplantation had 1-year survival of 73 and 68.5%, respectively. Retransplantation need was significantly higher for PSC, HCV, and CAH. CONCLUSIONS Hepatic retransplantation remains a successful salvage option for transplant complications; however, its need is significantly influenced by the primary liver disease.
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Affiliation(s)
- A Qasim
- Liver Transplant Unit, St Vincent's University Hospital, Dublin, Ireland.
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Qasim A, McCormick PA, Tajuddin T, Zaman MB, Traynor O, Hegarty J, Geoghegan J. Improved survival outcomes for liver transplantation. Ir Med J 2007; 100:389-90. [PMID: 17491536] [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: 05/15/2023]
Abstract
UNLABELLED Liver transplantation is the treatment of choice for end stage liver disease and fulminant hepatic failure. Outcome of the procedure may be dependent on multiple factors including patient selection, donor selection, and centre experience. AIM To determine whether the outcome for liver transplantation has improved over the time for the Irish National Liver Transplant Unit since its initial set up in 1993. METHODS All patients who underwent liver transplantation between Jan 1993 to Oct 2004 were included. Patients were sub-divided into three sequential cohorts of 90 patients each. Survival outcomes were compared between the groups. RESULTS 270 patients (male = 137) underwent 323 liver transplants (median age 49 yrs, range 16-68 yrs). Indications included primary biliary cirrhosis (14.1%), alcohol related liver disease (6.2%), fulminant hepatic failure (14.2%), primary sclerosing cholangitis (10.1%), chronic active hepatitis (9.5%), viral hepatitis (9.5%) and cryptogenic cirrhosis (7.1%). Most procedures (85.8%) were elective. Re-transplantation rates within the first 3 months of primary procedure were 9%, 5%, and 5% for the three chronological groups. Overall calculated 3-month, 1-year and 3 year survival rates for group 1 were 87%, 82% and 77%. For the groups 2 and 3 the figures were 86%, 81%, 77% and 89%, 89%, and 81% respectively. One- and 3-year survival rates were significantly better for group 3 compared to group 1 (p < 0.05). CONCLUSIONS Survival outcome has improved significantly over the past 12 years and is likely attributed to increasing experience of the transplant centre.
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Affiliation(s)
- A Qasim
- Hepatology Department, St Vincent's University Hospital, Elm Park, Donnybrook, Dublin.
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Zaman MB, Hoti E, Qasim A, Maguire D, McCormick PA, Hegarty JE, Geoghegan JG, Traynor O. MELD score as a prognostic model for listing acute liver failure patients for liver transplantation. Transplant Proc 2006; 38:2097-8. [PMID: 16980011 DOI: 10.1016/j.transproceed.2006.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The King's College Hospital (KCH) criteria are widely used for listing patients with acute liver failure (ALF) for liver transplantation (LT). Recent reports have suggested that the Model for End-Stage Liver Disease (MELD) score may be useful in assessing prognosis in ALF (nonparacetamol). This study compares prognostic accuracy of the two systems in patients with paracetamol (POD)-induced ALF treated in this unit. METHODS Seventy-two patients (average age 38 years; F:M ratio 2:1) admitted from 1994 to 2005 with POD-related ALF were studied. Clinical and biochemical parameters were recorded. The effect of applying a MELD score of greater than 30 as listing criteria for LT was calculated and compared with the KCH criteria. Outcomes were defined as LT, death, or full recovery. RESULTS Thirty-one patients (43%) recovered with medical therapy, 29 (40%) patients died, and 12 (17%) underwent LT. Sixty five percent of patients had a MELD > 30 and therefore could potentially be listed on admission; however, using KCH criteria only 24% patients were listed immediately. Sensitivity and negative predictive value of MELD was higher then KCH; however, we found KCH to have much higher specificity and positive predictive value. CONCLUSION MELD has higher sensitivity and negative predictive value for POD-induced ALF than the KCH criteria. However, the high false-positive rate associated with MELD limits its clinical utility. The high negative predictive value of MELD score may allow it to be used in conjunction with KCH criteria to avoid unneeded LT in patients who will likely recover spontaneously.
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Affiliation(s)
- M B Zaman
- National Liver Unit, St Vincent's University Hospital, Elm Park, Dublin-4, Ireland.
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Wolters FL, Russel MG, Sijbrandij J, Ambergen T, Odes S, Riis L, Langholz E, Politi P, Qasim A, Koutroubakis I, Tsianos E, Vermeire S, Freitas J, van Zeijl G, Hoie O, Bernklev T, Beltrami M, Rodriguez D, Stockbrügger RW, Moum B. Phenotype at diagnosis predicts recurrence rates in Crohn's disease. Gut 2006; 55:1124-30. [PMID: 16361306 PMCID: PMC1856253 DOI: 10.1136/gut.2005.084061] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning. AIMS To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis. METHODS A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease. RESULTS A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)). CONCLUSIONS A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.
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Affiliation(s)
- F L Wolters
- Department of Gastroenterology and Hepatology, University Hospital Maastricht, the Netherlands.
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McCormick A, Qasim A. Advances in portal hypertension. Med J Malaysia 2005; 60 Suppl B:6-11. [PMID: 16108165] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- A McCormick
- Liver Unit, St Vincent's University Hospital and University College, Dublin, Ireland
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Abstract
BACKGROUND Recent data indicate an exponential increase in proton pump inhibitor (PPI) prescribing, and concerns are raised regarding the appropriateness of these prescriptions and the financial implications. AIM To survey the appropriateness of PPI prescription in a cohort of patients in a tertiary referral hospital. METHODS Prescription records of all inpatients on a randomly selected day were reviewed. The appropriateness of prescription and relevant investigations were identified by interview of patients, review of patient records and of a computerised endoscopy records system. RESULTS Thirty-two per cent (87 of 272) of all patients were on PPIs. A valid indication for therapy was not apparent in 63% of the patients on PPIs with the only predictive factor for inappropriate prescription being increasing age. Only 36 of the 87 patients on PPIs had undergone appropriate investigations for their gastrointestinal symptoms. Gender, age, speciality of admission or duration of hospital stay did not influence the appropriateness of prescription or performance of relevant investigations. CONCLUSION There appears to be a widespread and inappropriate use of PPIs in hospital practice.
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Affiliation(s)
- S S Sebastian
- Department of Gastroenterology, Adelaide Hospital, Tallaght, Dublin, Ireland
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Sebastian S, McLoughlin R, Qasim A, O'Morain CA, Buckley MJ. Endoscopic argon plasma coagulation for the treatment of gastric antral vascular ectasia (watermelon stomach): long-term results. Dig Liver Dis 2004; 36:212-7. [PMID: 15046192 DOI: 10.1016/j.dld.2003.11.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Gastric antral vascular ectasia is a rare but well-recognised cause of occult gastrointestinal bleeding. Various endoscopic treatments have been tried in this condition. We report our experience with argon plasma coagulation in the treatment of gastric antral vascular ectasia. PATIENTS AND METHODS Twelve patients with endoscopically proved gastric antral vascular ectasia were included. All patients received argon plasma coagulation with power of 40 W at a median interval of 4 weeks. The pre-treatment haemoglobin and transfusion requirements were compared with the post-treatment values. RESULTS There was a sustained increase in mean haemoglobin levels post-treatment. The mean haemoglobin levels pre- and post-treatment were 8.13 +/- 0.70 and 12.2 +/- 0.32 g/dl, respectively (P = 0.008). All patients were anaemic and 58.3% of the patients were transfusion dependent. The mean number of units of blood transfusion in the period 6 months prior to treatment was 11.3 +/- 5.68. Following argon plasma coagulation, the number of transfusions decreased significantly to 1.1 +/- 0.57 units (P = 0.018). No significant procedure-related complications were identified. CONCLUSION Argon plasma coagulation is a safe and effective alternative to the currently available endoscopic modalities of treatment for gastric antral vascular ectasia.
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Affiliation(s)
- S Sebastian
- Department of Gastroenterology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
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Qasim A, O'Brien H, Sebastian S, O'Sullivan M, Buckley M, O'Moran C. Platelet activation in patients with irritable bowel syndrome may reflect a subclinical inflammatory response. Gut 2003; 52:1799-800. [PMID: 14633969 PMCID: PMC1773872 DOI: 10.1136/gut.52.12.1799-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Affiliation(s)
- R McLoughlin
- Department of Gastroenterology, Adelaide and Meath Hospitals, Dublin, Ireland.
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Affiliation(s)
- A Qasim
- Gastroenterolgy Department, AMNCH, Tallaght, Dublin 24, Ireland
| | - J Seery
- Gastroenterolgy Department, AMNCH, Tallaght, Dublin 24, Ireland
| | - M Buckley
- Gastroenterolgy Department, AMNCH, Tallaght, Dublin 24, Ireland
| | - C O Morain
- Gastroenterolgy Department, AMNCH, Tallaght, Dublin 24, Ireland
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Abstract
A patient with hemi-facial erythematous swelling as a result of borderline leprosy and reversal reaction is reported. This uncommon presentation of the disease poses initial diagnostic difficulties to the otolaryngologist. The otolaryngologist must be familiar with otolaryngologic manifestations of leprosy, since early diagnosis and treatment reduces the risk of transmission of the disease and may avoid permanent nerve damage.
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Affiliation(s)
- W K Low
- Department of Otolaryngology, Singapore General Hospital, Singapore.
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Affiliation(s)
- A Qasim
- Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland
| | - M Buckley
- Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland
| | - C A O' Morain
- Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland
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Abstract
Currently available Helicobacter pylori eradication therapies are considered very effective and safe. The most recent eradication guidelines proposed in the Maastricht 2-2000 Consensus Report recommend the use of proton pump inhibitors (standard b.d.) along with clarithromycin (500 mg b.d.) and amoxycillin (1000 mg b.d.) or metronidazole (500 mg b.d.) for a minimum of 7 days. The combination of amoxycillin and clarithromycin is preferred because it may favour best results with a second-line proton pump inhibitor quadruple therapy. The recommended second-line therapy includes a combination of a proton pump inhibitor (standard b.d.) with bismuth salt (subsalicylate/subcitrate 120 mg q.d.s.), metronidazole (500 mg t.d.s.), and tetracycline (500 mg q.d.s.) for a minimum of 7 days. Extended proton pump inhibitor-based triple therapy can be used if bismuth is not available. Specialists should manage subsequent failures. Based on direct and indirect evidence from well-designed studies and clinical experience, eradication is recommended in gastric and duodenal ulcers, MALToma, atrophic gastritis, postgastric cancer resection, and in first-degree relatives of gastric cancer patients. The most common reason for treatment failure is poor compliance with eradication guidelines. Antibiotic resistance may be a significant factor in certain geographical areas. Proton pump inhibitors are an integral part of the eradication regimens as proved by meta-analyses of clinical trials. Novel agents used in secondary failure are few and depend on the use of new antibiotics. The role of H. pylori-specific antibiotics, probiotics, and vaccines is not established as yet. Widespread acceptance of the eradication guidelines should be regarded as the single most important factor in eradication success.
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Affiliation(s)
- A Qasim
- Gastroenterology Department, Adelaide and Meath Hospital, Trinity College, Dublin, Ireland
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Qasim A, Seery J, O'Morain CA. Re: Scolapio et al.--Normal endoscopy, dysphagia, and esophageal dilation. Am J Gastroenterol 2001; 96:3036. [PMID: 11693349 DOI: 10.1111/j.1572-0241.2001.04689.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
A 23 year old man presented with a clinical history and ECG compatible with acute myocardial infarction, having taken a single tablet of ecstasy (3,4-methylenedioxymetamphetamine) 18 hours previously. He was treated with aspirin and thrombolytic therapy; however, cardiac catheterisation showed angiographically normal coronary arteries and left ventricular function. Sympathomimetic drugs are freely available and widely abused in Britain, but there is little evidence of the mechanisms or management of cardiac complications. In such cases the use of standard treatment for acute myocardial infarction is recommended with agents such as glyceryl trinitrate and phentolamine to reduce coronary artery spasm. Early coronary angiography may help to determine the relative contribution of spasm, thrombus, and underlying atherosclerotic disease.
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Affiliation(s)
- A Qasim
- Department of Cardiology, Queen Elizabeth Hospital, Edgbaston, Birmingham B29 6JD, UK.
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Affiliation(s)
- A Qasim
- Department of Medicine, Adelaide and Meath Hospital, Tallaght, Dublin, Eire
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Abstract
Prompt treatment with thrombolytic therapy in acute myocardial infarction has been proven to reduce infarct size and mortality. However, reperfusion fails to occur in 30-50% of patients, either due to impaired epicardial artery flow or microvascular occlusion, with these patients experiencing a higher morbidity and mortality. We review the diagnosis and management of failed thrombolysis in acute myocardial infarction.
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Affiliation(s)
- A Qasim
- St. Mary's Hospital, Portsmouth, UK.
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Affiliation(s)
- A Qasim
- St Mary's Hospital, Portsmouth PO3 6AD, UK.
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Bilgrami G, Tyagi SP, Qasim A. Some observations on serum haptoglobin changes in cases of viral hepatitis and obstructive jaundice. INDIAN J PATHOL MICR 1981; 24:285-9. [PMID: 7338405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Abstract
Serum haptoglobin (Hp) was estimated in 76 cases of ischemic heart diseases (IHD) and 151 healthy individuals. A statistically significant rise in Hp level was observed in IHD cases. The rise was independent on the age and blood type of the cases but was more predominent in males as compared to females. The increase in Hp level was noticed after the third day of coronary attack and peak level was obtained between the 7th to 9th day. Hp level was closely related to the degree of myocardial damage. No rise was seen in cases of angina whereas maximum rise was noticed in patients with multiple infarcts. Hp phenotype pattern in IHD cases was not different from that of control cases.
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