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Rehman S, Madni A, Jameel QA, Usman F, Rafi Raza M, Ahmad F, Shoukat H, Aali H, Shafiq A. Retraction Note: Natural Polymer-Based Graphene Oxide Bio-nanocomposite Hydrogel Beads: Superstructures with Advanced Potentials for Drug Delivery. AAPS PharmSciTech 2024; 25:63. [PMID: 38502375 DOI: 10.1208/s12249-024-02788-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Affiliation(s)
- Sadia Rehman
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Asadullah Madni
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
| | - Qazi Adnan Jameel
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Faisal Usman
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - M Rafi Raza
- Department of Mechanical Engineering, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Faiz Ahmad
- Department of Mechanical Engineering, Universiti Teknologi PETRONAS, Seri Iskandar, Perak, Malaysia
| | - Hina Shoukat
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
- Quaid-E-Azam College of Pharmacy, Sahiwal, 57000, Pakistan
| | - Hamdan Aali
- Department of Microbiology and Molecular Genetics, Bahauddin Zakariya University, Multan, Pakistan
| | - Afifa Shafiq
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Sultana H, Aamir MN, Madni A, Rehman MU, Shafiq A, Shirazi JH, Hassan S, Sumaira. Polymeric Nanogel for Oral Delivery of the Chemotherapeutic Agent: Fabrication and Evaluation Alongside Toxicological Studies and Histopathological Examination. AAPS PharmSciTech 2023; 24:43. [PMID: 36702971 DOI: 10.1208/s12249-023-02499-7] [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: 08/16/2022] [Accepted: 12/27/2022] [Indexed: 01/27/2023] Open
Abstract
Nanogel has attracted considerable attention as one of the most versatile drug delivery systems, especially for site-specific and/or time-controlled delivery of the chemotherapeutic agent. The main objective of this study was to prepare the polymeric nanogel characterized by Fourier transform infrared spectroscopy, x-ray diffraction, thermogravimetric analysis, differential scanning, and oral acute toxicity. Free radical polymerization was done for the fabrication of polymeric nanogel. Fourier transform infrared spectroscopy was used to confirm the successful free radical polymerization. Various techniques such as x-ray diffraction, differential scanning calorimetric, and thermogravimetric analysis measurement were used to investigate the thermal behavior and crystallinity of developed nanogel. Parameters such as swelling, drug loading, and in vitro drug release is enhanced as polymers and monomers concentrations increase while these parameters decrease in case of increasing crosslinker concentration. The oral biocompatibility results of developed nanogel exhibited no toxicity in rabbits. Histopathological changes were observed between empty and loaded group. The nanosized gel offers a specific surface area which increases the stability of loaded drug (oxaliplatin) and bioavailability of the drug (oxaliplatin) as compared to the conventional drug delivery systems.
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Affiliation(s)
- Humaira Sultana
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan
| | - Muhammad Naeem Aamir
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan. .,School of Pharmacy, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK.
| | - Asadullah Madni
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan
| | - Masood Ur Rehman
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, 45320, Pakistan
| | - Afifa Shafiq
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan
| | - Jafir Hussain Shirazi
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan
| | - Sidra Hassan
- Bahawalpur College of Pharmacy, Bahawalpur Medical and Dental College, Bahawalpur, Pakistan
| | - Sumaira
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, 63100, Bahawalpur, Pakistan
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Shamshuddin MD, Mebarek-Oudina F, Salawu SO, Shafiq A. Thermophoretic Movement Transport of Reactive Casson Nanofluid on Riga Plate Surface with Nonlinear Thermal Radiation and Uneven Heat Sink/Source. j nanofluids 2022. [DOI: 10.1166/jon.2022.1892] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The flow of magnetized Casson nanofluid past a Riga surface is examined in this study. The model scrutinizes the impacts of nonlinear radiative, uneven heat sink/source, thermophoretic movement and chemical reaction. Additionally, model is considered water based nanofluid with nanoparticles
CuO (Copper Oxide) and MgO (Magnesium Oxide). The flow mechanics transport through Riga plate is developed using coupled system of higher order equations have been mutated into ordinary order from partial order utilizing established similarity transform. These nonlinear equations are calculated
by the usage of through the Galerkin weighted residual method (GWRM) along with Simpson’s one-third rule and procured results are visualized graphically. Verifications of attained numerical outcomes through available literature for limiting case are also presented and found in excellent
agreement. Further, the results of engineering physical parameters were also highlighted. More so, the analysis show that an increment in the Casson term causes rise in the temperature profile for CuO and MgO nanofluid and also dominant behavior is noted in case of CuO nanofluid comparing
with MgO nanofluid. Furthermore, higher values of volume fraction parameter rises the both velocity profiles f′ (η), g′ (η) for both MgO and CuO nanofluid cases.
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Affiliation(s)
- MD. Shamshuddin
- Department of Mathematics, Vaagdevi College of Engineering (Autonomous), Warangal 506005, Telangana, India
| | - F. Mebarek-Oudina
- Department of Physics, Faculty of Sciences, University of 20 Août 1955-Skikda, Road El-Hadaeik, B.P. 26, Skikda 21000, Algeria
| | - S. O. Salawu
- Department of Physical Science, College of Pure and Applied Sciences, Landmark University, Omu-Aran, 251103, Nigeria
| | - A. Shafiq
- School of Mathematics and Statistics, Nanjing University of Information Science and Technology, Nanjing 210044, China
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Rehman S, Madni A, Jameel QA, Usman F, Raza MR, Ahmad F, Shoukat H, Aali H, Shafiq A. Natural Polymer-Based Graphene Oxide Bio-nanocomposite Hydrogel Beads: Superstructures with Advanced Potentials for Drug Delivery. AAPS PharmSciTech 2022; 23:304. [PMID: 36396831 DOI: 10.1208/s12249-022-02456-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
The current study sought to create graphene oxide-based superstructures for gastrointestinal drug delivery. Graphene oxide has a large surface area that can be used to load anti-cancer drugs via non-covalent methods such as surface adsorption and hydrogen bonding. To enhance the bio-applicability of graphene oxide, nano-hybrids were synthesized by encapsulating the graphene oxide into calcium alginate hydrogel beads through the dripping-extrusion technique. These newly developed bio-nanocomposite hybrid hydrogel beads were evaluated in structural analysis, swelling study, drug release parameters, haemolytic assay, and antibacterial activity. Doxorubicin served as a model drug. The drug entrapment efficiency was determined by UV-spectroscopy analysis and was found to be high at ⁓89% in graphene oxide hybrid hydrogel beads. These fabricated hydrogel beads ensure the drug release from a hybrid polymeric matrix in a more controlled and sustained pattern avoiding the problems associated with a non-hybrid polymeric system. The drug release study of 12 h shows about 83% release at pH 6.8. In vitro drug release kinetics proved that drug release was a Fickian mechanism. The cytotoxic effect of graphene oxide hybrid alginate beads was also determined by evaluating the morphology of bacterial cells and red blood cells after incubation. Additionally, it was determined that the sequential encapsulation of graphene oxide in alginate hydrogel beads hides its uneven edges and lessens the graphene oxide's negative impacts. Also, the antibacterial study and biocompatibility of fabricated hydrogel beads made them potential candidates for gastrointestinal delivery.
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Affiliation(s)
- Sadia Rehman
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Asadullah Madni
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
| | - Qazi Adnan Jameel
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Faisal Usman
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - M Rafi Raza
- Department of Mechanical Engineering, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan
| | - Faiz Ahmad
- Department of Mechanical Engineering, Universiti Teknologi PETRONAS, Seri Iskandar, Perak, Malaysia
| | - Hina Shoukat
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
- Quaid-E-Azam College of Pharmacy, Sahiwal, 57000, Pakistan
| | - Hamdan Aali
- Department of Microbiology and Molecular Genetics, Bahauddin Zakariya University, Multan, Pakistan
| | - Afifa Shafiq
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Shafiq A, Ahmad M, Minhas MU, Shoukat H, Pervaiz F, Shafique M, Ashraf S. Tolterodine tartrate loaded biodegradable and pH-responsive amphiphilic block copolymer (PF127) hydrogels: synthesis, characterization, and acute toxicity evaluation. POLYM-PLAST TECH MAT 2022. [DOI: 10.1080/25740881.2022.2075274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Afifa Shafiq
- Department of Pharmaceutics, Faculty of pharmacy, The Islamia University of Bahawalpur, Punjab, Pakistan
| | - Mahmood Ahmad
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan
| | | | - Hina Shoukat
- Department of Pharmaceutics, Faculty of pharmacy, The Islamia University of Bahawalpur, Punjab, Pakistan
| | - Fahad Pervaiz
- Department of Pharmaceutics, Faculty of pharmacy, The Islamia University of Bahawalpur, Punjab, Pakistan
| | - Mamuna Shafique
- Department of Pharmaceutics, Faculty of pharmacy, The Islamia University of Bahawalpur, Punjab, Pakistan
| | - Shazia Ashraf
- Department of Pharmaceutics, Faculty of pharmacy, The Islamia University of Bahawalpur, Punjab, Pakistan
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Khan S, Madni A, Shah H, Jan N, Shafiq A, Basit A, Rai N, Ali A, Khan MM. Folate decorated lipid chitosan hybrid nanoparticles of 5-fluorouracil for enhanced anticancer efficacy against colon cancer. Int J Biol Macromol 2022; 222:497-508. [PMID: 36174854 DOI: 10.1016/j.ijbiomac.2022.09.196] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022]
Abstract
The study aimed to develop folate decorated lipid chitosan hybrid nanoparticles for targeted delivery of 5-fluorouracil in colon cancer by utilizing the overexpressed folate receptors on the surface of HT-29 and HCT 116 cancer cell lines. The developed formulations were prepared by the ionic gelation method with slight modifications. The developed formulations exhibited spherical morphology, smaller particle size (158 to 225 nm), zeta potential (32.24 to 35.95 mV), PDI (0.19 to 0.35), and high encapsulation efficiency (85.3 % to 94.2 %) with optimal physicochemical characteristics. The in vitro release showed a biphasic release pattern with an initial burst release followed by a sustained release for 48 h. Moreover, the in vitro cell line study revealed that FA-CLPN-2 exhibited an enhanced cellular uptake and greater cytotoxic effect in HT-29 and HCT 116 cell lines compared to non-targeted CLPN-2 and free drug solution due to the folate receptor facilitated endocytosis process. The in vivo toxicity study revealed the safety and biocompatibility of the developed formulations in biological systems. The stability study demonstrates the stability of the developed formulations. Overall, these results suggest that the folate decorated lipid chitosan hybrid nanoparticles could be used as a potential delivery system for tumor-targeted therapy with reduced side effects.
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Affiliation(s)
- Safiullah Khan
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Asadullah Madni
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan.
| | - Hassan Shah
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; Center of Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston 02115, MA, USA
| | - Nasrullah Jan
- Akson College of Pharmacy, Mirpur University of Science and Technology (MUST), Mirpur 10250, AJ&K, Pakistan
| | - Afifa Shafiq
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Abdul Basit
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Nadia Rai
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Ahsan Ali
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; Center of Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston 02115, MA, USA
| | - Muhammad Muzamil Khan
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
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Shafiq A, Madni A, Khan S, Sultana H, Sumaira, Shah H, Khan S, Rehman S, Nawaz M. Core-shell Pluronic F127/chitosan based nanoparticles for effective delivery of methotrexate in the management of rheumatoid arthritis. Int J Biol Macromol 2022; 213:465-477. [PMID: 35661673 DOI: 10.1016/j.ijbiomac.2022.05.192] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/29/2022] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022]
Abstract
This study was designed to improve oral bioavailability of the methotrexate (MTX) by sustaining its release profile and integration into core-shell polymeric nanoparticles. The self-micellization and ionotropic gelation technique was employed which resulted into spherical shaped nanoparticles (181-417 nm) with encapsulation efficiency of 80.14% to 85.54%. Furthermore, Fourier Transform Infrared Spectroscopy and Differential Scanning Calorimetry analyses were carried out to investigate physicochemical and thermal stability of the produced engineered core shell nanoparticles of the methotrexate. . Entrapment of drug in polymeric core was confirmed by X-ray diffraction analysis. In-vitro sustained release behavior of nanoparticles was observed at pH 6.8 for 48 h while low drug release was observed at pH 1.2 due to pH-responsive nature of Pluronic F127. Acute toxicity study confirmed safety and biocompatible profile of nanoparticles. MTX loaded polymeric nanoparticles ameliorated the pharmacokinetic profile (8 folds greater half-life, 6.26 folds higher AUC0-t and 3.48 folds higher mean residence time). In vivo study conducted in rat model depicted the improved therapeutic efficacy and healing of arthritis through MTX loaded polymeric nanoparticles, preferentially attributable to high accretion of MTX in the inflamed site. In conclusion, MTX loaded polymeric nanoparticles is an attractive drug delivery strategy for an effective management and treatment of rheumatoid arthritis.
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Affiliation(s)
- Afifa Shafiq
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Asadullah Madni
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan.
| | - Shahzeb Khan
- Department of Pharmacy, University of Malakand, Chakdara 18800, Pakistan
| | - Humaira Sultana
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Sumaira
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Hassan Shah
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Safiullah Khan
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Sadia Rehman
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Mehwish Nawaz
- Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
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Ramtoola MT, Hartemink JW, Dhuny S, Nathan J, Shabbir H, Shafiq A, Garg SA. Comparing one-year outcomes of invasive versus medical management of patients with prior coronary artery bypass graft surgery presenting with non-ST elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1244] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early percutaneous coronary intervention (PCI) has a Class 1A recommendation for patients with non-ST elevation myocardial infarction (NSTEMI). However, the benefits of this invasive approach in patients with previous coronary artery bypass graft (CABG) surgery are uncertain, as these patients have previously been excluded from pivotal trials.
Purpose
We hypothesised that routine invasive management in patients with previous CABG presenting with NSTEMI, but otherwise medically stable, carried similar prognostic outcomes to patients who were medically managed.
Methods
This single centre retrospective observational study screened patients with prior CABG presenting with NSTEMI between January 2015 and December 2019. Patients either underwent coronary angiography with or without PCI at their physician's discretion or received standard acute coronary syndrome (ACS) medical therapy. Follow up time was 365 days from admission date, and clinical, demographic, procedural and outcome data were collected. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause mortality and rehospitalisation for unstable angina, myocardial infarction, or heart failure.
Results
The study included 267 patients (mean ±SD age: 72±10 years, 82% male), of whom 80.1% (N=214) underwent cardiac catheterisation, and 19.9% (N=53) only received standard ACS medical therapy. Amongst the invasive group, 65.4% (N=140) received PCI. No one was referred for re-do CABG. At 1-year follow up, the primary composite outcome occurred in 18 (13%) patients in the PCI group, 13 (18%) in those managed conservatively following angiography, and in 27 (51%) patients receiving medical therapy only. Cox regression modelling showed no significant difference in the 1-year primary endpoint amongst those having an angiogram who received PCI versus those treated medically after invasive assessment (HR: 0.75 [95% CI: 0.38–1.48; P=0.412]). Previous revascularisation with PCI (HR: 1.90 [CI, 1.11–3.24; P=0.018]) and chronic kidney disease (CKD) (HR: 2.60 [CI, 1.56–4.34; P<0.001]) at any stage, were the most important predictors of poor outcomes in CABG patients with NSTEMI irrespective of management strategy.
Conclusion
Patients with previous CABG who are admitted with NSTEMI who were not considered suitable for invasive angiography experienced significantly higher rates of MACE at 1-year follow up. The presence of CKD or previous PCI were key indicators of poor outcomes irrespective of management strategy. Outcomes amongst those deemed fit enough for invasive angiography were similar irrespective of treatment, suggesting that additional non-invasive testing may help further define which patients would benefit from an invasive strategy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M T Ramtoola
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | | | - S Dhuny
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - J Nathan
- Royal Preston Hospital, Preston, United Kingdom
| | - H Shabbir
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - A Shafiq
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - S A Garg
- Royal Blackburn Hospital, Blackburn, United Kingdom
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Berrington JE, Clarke P, Embleton ND, Ewer AK, Geethanath R, Gupta S, Lal M, Oddie S, Shafiq A, Vasudevan C, Bührer C. Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro-BNP performance. Acta Paediatr 2018; 107:1722-1725. [PMID: 29617052 DOI: 10.1111/apa.14354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/11/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022]
Abstract
AIM Urinary N-terminal B-type natriuretic peptide NTproBNP levels are associated with the development of retinopathy of prematurity (ROP) in infants <30 weeks of gestation. The incidence of ROP in more mature infants who meet other ROP screening criteria is very low. We therefore aimed to test whether urinary NTproBNP predicted ROP development in these infants. METHODS Prospective observational study in 151 UK infants ≥30 + 0 weeks of gestation but also <32 weeks of gestation and/or <1501 g, to test the hypothesis that urinary NTproBNP levels on day of life (DOL) 14 and 28 were able to predict ROP development. RESULTS Urinary NTproBNP concentrations on day 14 and day 28 of life did not differ between infants with and without ROP (medians 144 vs 128 mcg/mL, respectively, p = 0.86 on DOL 14 and medians 117 vs 94 mcg/mL, respectively, p = 0.64 on DOL28). CONCLUSION The association previously shown for infants <30 completed weeks between urinary NTproBNP and the development of ROP was not seen in more mature infants. Urinary NTproBNP does not appear helpful in rationalising direct ophthalmoscopic screening for ROP in more mature infants, and may suggest a difference in pathophysiology of ROP in this population.
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Affiliation(s)
- JE Berrington
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - P Clarke
- Norfolk and Norwich University Hospitals NHS Foundation Trust; Norfolk UK
| | - ND Embleton
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - AK Ewer
- Birmingham Womens Hospital; Birmingham UK
| | | | - S Gupta
- University Hospital of North Tees; Stockton UK
| | - M Lal
- South Tees NHS Foundation Trust; Middlesbrough UK
| | - S Oddie
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - A Shafiq
- Department of Ophthalmology; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
| | - C Vasudevan
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - C Bührer
- Charité Universitätsmedizin; Berlin Germany
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Hajibandeh S, Hajibandeh S, Deering R, McEleney D, Guirguis J, Dix S, Sreh A, Toner E, El Muntasar A, Kausar A, Sheikh G, OShea D, Shafiq A, Kelly A, Khan A, Arumugam D, Evans A. Accuracy of co-morbidity data in patients undergoing abdominal wall hernia repair: a retrospective study. Hernia 2017; 22:243-248. [PMID: 29243213 DOI: 10.1007/s10029-017-1713-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 12/09/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routinely collected co-morbidity data in patients undergoing abdominal wall hernia repair. METHODS All patients aged > 18 who underwent umbilical, para-umbilical, inguinal or incisional hernia repair between 1 January 2015 and 1 November 2016 were identified. All parts of the clinical notes were searched for co-morbidities by two authors independently. The following co-morbidities were considered: hypertension, ischaemic heart disease (IHD), diabetes, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CVD), chronic kidney disease (CKD), hypercholesterolemia, obesity and smoking. The co-morbidities data from clinical notes were compared with corresponding data in hospital episode statistics (HES) database to calculate accuracy, sensitivity, specificity, PPV and NPV of HES codes for co-morbidities. To assess the agreement between clinical notes and HES data, we also calculated Cohen's Kappa index value as a more robust measure of agreement. RESULTS Overall, 346 patients comprising 3460 co-morbidity codes were included in the study. The overall accuracy of HES codes for all co-morbidities was 77% (Kappa: 0.13). When calculated separately for each co-morbidity, the accuracy was 72% (Kappa: 0.113) for hypertension, 82% (Kappa: 0.232) for IHD, 85% (Kappa: 0.203) for diabetes, 86% (Kappa: 0.287) for asthma, 91% (Kappa: 0.339) for COPD, 92% (Kappa: 0.374) for CVD, 94% (Kappa: 0.424) for CKD, 74% (Kappa: 0.074) for hypercholesterolemia, 71% (Kappa: 0.66) for obesity and 24% (Kappa: 0.005) for smoking. The overall sensitivity, specificity, PPV and NPV of HES codes were 9, 100, 100, and 77%, respectively. The results were consistent when individual co-morbidities were analyzed separately. CONCLUSIONS Our results demonstrated that HES co-morbidity codes in patients undergoing abdominal wall hernia repair are specific with good positive predictive value; however, they have substandard accuracy, sensitivity, and negative predictive value. The presence of a relatively large number of false negative or missed cases in HES database explains our findings. Better documentation of co-morbidities in admission clerking proforma may help to improve the quality of source documents for coders, which in turn may improve the accuracy of coding.
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Affiliation(s)
- S Hajibandeh
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK.
- Department of General Surgery, Salford Royal Foundation Trust, Salford, UK.
| | - S Hajibandeh
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
- Department of General Surgery, North Manchester General Hospital, Manchester, UK
| | - R Deering
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - D McEleney
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - J Guirguis
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - S Dix
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Sreh
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - E Toner
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A El Muntasar
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Kausar
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - G Sheikh
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - D OShea
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Shafiq
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Kelly
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Khan
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - D Arumugam
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
| | - A Evans
- Department of General Surgery, Royal Blackburn Hospital, Haslingden Rd, Blackburn, UK
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11
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Fleck BW, Williams C, Juszczak E, Cocker K, Stenson BJ, Darlow BA, Dai S, Gole GA, Quinn GE, Wallace DK, Ells A, Carden S, Butler L, Clark D, Elder J, Wilson C, Biswas S, Shafiq A, King A, Brocklehurst P, Fielder AR. An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials. Eye (Lond) 2017; 32:74-80. [PMID: 28752837 PMCID: PMC5669461 DOI: 10.1038/eye.2017.150] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 02/24/2017] [Accepted: 06/21/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose To investigate whether the observed international differences in retinopathy of prematurity (ROP) treatment rates within the Benefits of Oxygen Saturation Targeting (BOOST) II trials might have been caused by international variation in ROP disease grading. Methods Groups of BOOST II trial ophthalmologists in UK, Australia, and New Zealand (ANZ), and an international reference group (INT) used a web based system to grade a selection of RetCam images of ROP acquired during the BOOST II UK trial. Rates of decisions to treat, plus disease grading, ROP stage grading, ROP zone grading, inter-observer variation within groups and intra-observer variation within groups were measured. Results Forty-two eye examinations were graded. UK ophthalmologists diagnosed treat-requiring ROP more frequently than ANZ ophthalmologists, 13.9 (3.49) compared to 9.4 (4.46) eye examinations, P=0.038. UK ophthalmologists diagnosed plus disease more frequently than ANZ ophthalmologists, 14.1 (6.23) compared to 8.5 (3.24) eye examinations, P=0.021. ANZ ophthalmologists diagnosed stage 2 ROP more frequently than UK ophthalmologists, 20.2 (5.8) compared to 12.7 (7.1) eye examinations, P=0.026. There were no other significant differences in the grading of ROP stage or zone. Inter-observer variation was higher within the UK group than within the ANZ group. Intra-observer variation was low in both groups. Conclusions We have found evidence of international variation in the diagnosis of treatment-requiring ROP. Improved standardisation of the diagnosis of treatment-requiring ROP is required. Measures might include improved training in the grading of ROP, using an international approach, and further development of ROP image analysis software.
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Affiliation(s)
- B W Fleck
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - C Williams
- Department of Paediatric Ophthalmology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - E Juszczak
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - K Cocker
- Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh, UK
| | - B J Stenson
- Neonatal Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - B A Darlow
- Cure Kids Professor of Paediatric Research, Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - S Dai
- Department of Paediatric Ophthalmology, Starship Children's Hospital, University of Auckland, Auckland, New Zealand
| | - G A Gole
- Department of Ophthalmology, University of Queensland, Brisbane, Australia
| | - G E Quinn
- Department of Pediatric Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - D K Wallace
- Department of Pediatric Ophthalmology, Duke University, Durham, USA
| | - A Ells
- Department of Ophthalmology, University of Calgary, Alberta, Canada
| | - S Carden
- Department of Ophthalmology, Royal Children's Hospital, Victoria, Australia
| | - L Butler
- Department of Paediatric Ophthalmology, Birmingham and Midlands Eye Centre, Birmingham, UK
| | - D Clark
- Department of Ophthalmology, Aintree University Hospital, Liverpool, UK
| | - J Elder
- Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - C Wilson
- Department of Ophthalmology, Chelsea and Westminster Hospital, London, UK
| | - S Biswas
- Department of Paediatric Ophthalmology, Manchester Royal Eye Hospital, Central Manchester Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK
| | - A Shafiq
- Department of Ophthalmology, Newcastle Eye Centre, Newcastle, UK
| | - A King
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - P Brocklehurst
- Clinical Trials Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - A R Fielder
- Department of Ophthalmology, Division of Optometry and Visual Sciences, City University, London, UK
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12
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Affiliation(s)
| | - M. Nawaz
- Institute of Space Technology, Pakistan
| | - T. Hayat
- Quaid-i-Azam University, Pakistan; King Abdulaziz University, Saudi Arabia
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13
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Alirhayim Z, Qureshi W, Shafiq A, Hassan S. Aortic arch variant presenting as an acute ST elevation myocardial infarction. Case Reports 2013; 2013:bcr-2012-007962. [DOI: 10.1136/bcr-2012-007962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Atkinson E, George SM, Shafiq A, Clark JE, Ogjnanovic M, Berrington JE. Two high pressure conundrums and a possible congenital link. Arch Dis Child Educ Pract Ed 2011; 96:210-5. [PMID: 20961865 DOI: 10.1136/adc.2010.184440] [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: 11/03/2022]
Affiliation(s)
- E Atkinson
- Royal Victoria Infirmary, Newcastle upon Tyne, UK
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15
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Murphy K, Shafiq A, Corrigan MA, Redmond HP. A descriptive study of consent documentation. Ir Med J 2011; 104:238-240. [PMID: 22125877] [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
The aim of this study was to observe the error rate in the consent process of a university hospital and to illicit the opinions of the consenting doctors on the process. A prospective observational review of theatre consent forms was performed along with an anonymous survey of non-consultant hospital doctors (NCHD's). No potential risks were documented in 95.3% of the 64 scrutinized consents and late alterations were required in 9%. Respondents to the NCHD survey estimated that they were unsure of the procedure or risks involved in an average of 29% of occasions. Interns admitted to being unsure of the details of the procedure in almost a third (32%) of cases, making them less well informed than their senior colleagues (p=0.024). This study highlights the difficulties encountered by consenting doctors, an issue which may lead to patient dissatisfaction, threaten the efficient running of a surgical unit and potentially expose its staff to avoidable litigation. It also recommends the use of multimedia adjuncts to facilitate both patient and doctor education in the consent process.
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Affiliation(s)
- K Murphy
- Cork University Hospital, Wilton, Cork.
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16
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Quinn E, Neary P, O’Connor O, Shafiq A, Kelly J, Redmond H. Routine calcium measurement is not necessary after most thyroid surgeries: a prospective clinical study. Clin Otolaryngol 2010; 35:468-73. [DOI: 10.1111/j.1749-4486.2010.02222.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Various aspects of the clinical management of infantile esotropia (IE) are unclear - mainly, the most effective type of intervention and the age at intervention. OBJECTIVES The objective of this review was to assess the effectiveness of various surgical and non-surgical interventions for IE and to determine the significance of age at treatment with respect to outcome. SEARCH STRATEGY Trials were identified from the Cochrane Central Register of Controlled Trials - CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) in The Cochrane Library (Issue 3 2004), MEDLINE (1966 to July 2004), EMBASE (1980 to August 2004) and LILACS (July 2004). We manually searched the conference proceedings of the European Strabismological Association (ESA) (1975-1997, 1999-2002), International Strabismological Association (ISA) (1994) and American Academy of Paediatric Ophthalmology and Strabismus meeting (AAPOS) (1995-2003). Efforts were made to contact researchers who are active in the field for information about further published or unpublished studies. SELECTION CRITERIA Randomised trials comparing any surgical or non-surgical intervention for infantile esotropia. DATA COLLECTION AND ANALYSIS Each reviewer independently assessed study abstracts identified from the electronic and manual searches. MAIN RESULTS No studies were found that met our selection criteria and therefore none were included for analysis. AUTHORS' CONCLUSIONS The main body of literature on interventions for IE are either retrospective studies or prospective cohort studies. It has not been possible through this review to resolve the controversies regarding type of surgery, non-surgical intervention and age of intervention. There is clearly a need for good quality trials to be conducted in these areas to improve the evidence base for the management of IE.
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Affiliation(s)
- S Elliott
- Ophthalmology Department, Salisbury Health Care NHS Trust, Salisbury District Hospital, Salisbury, Wiltshire, UK, SP2 8BJ.
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18
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Abstract
A 12-year-old boy presented with a traumatic hyphaema that failed to settle with the standard treatment. Subsequent investigation showed that despite a normal APTT, he had a low factor VIII:C. Treatment with DDAVP precipitated further bleeding despite correction of the fVIII:C to normal, possibly caused by the vasodilation induced by the therapy. Bleeding was effectively treated with recombinant fVIII concentrate. DDAVP may be contraindicated in mild Haemophilia and von Willebrand patients for treatment of traumatic hyphaema.
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Affiliation(s)
- C Hallet
- Department of Ophthalmology, Royal Liverpool Children's Hospital, Liverpool, UK
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19
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Shafiq A, De Meyer H, Grosjean C. The albedo problem in the case of multiple synthetic scattering taking place in a plane-symmetric slab—I. ANN NUCL ENERGY 1985. [DOI: 10.1016/0306-4549(85)90003-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
The intramembrane particles in erythrocytes of chickens with hereditary muscular dystrophy and normal controls were compared by the freeze-fracture technique. Reduction of particles in both fracture faces and greater clustering of them was found in dystrophic samples. The concept of a generalized membrane abnormality in dystrophic chickens is supported.
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Abstract
The cellular RNA content of mouse fibroblasts incubated with actinomycin decreases at a rate of about 1 to 1.5 per cent per hour, while DNA and protein content remain unchanged. This degradation affects nuclear and cytoplasmic RNA, ribosomal and soluble RNA. The breakdown products appear quantitatively in the acid-soluble fraction of the cells and the medium. Polynucleotides synthesized a short period (120 minutes) prior to exposure to actinomycin are degraded before those synthesized 8 to 12 hours previously.
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