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Panwar S, Uniyal P, Kukreti N, Hashmi A, Verma S, Arya A, Joshi G. Role of autophagy and proteostasis in neurodegenerative diseases: Exploring the therapeutic interventions. Chem Biol Drug Des 2024; 103:e14515. [PMID: 38570333 DOI: 10.1111/cbdd.14515] [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: 01/10/2024] [Revised: 03/02/2024] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
Neurodegenerative disorders are devastating disorders characterized by gradual loss of neurons and cognition or mobility impairment. The common pathological features of these diseases are associated with the accumulation of misfolded or aggregation of proteins. The pivotal roles of autophagy and proteostasis in maintaining cellular health and preventing the accumulation of misfolded proteins, which are associated with neurodegenerative diseases like Huntington's disease (HD), Alzheimer's disease (AD), and Parkinson's disease (PD). This article presents an in-depth examination of the interplay between autophagy and proteostasis, highlighting how these processes cooperatively contribute to cellular homeostasis and prevent pathogenic protein aggregate accumulation. Furthermore, the review emphasises the potential therapeutic implications of targeting autophagy and proteostasis to mitigate neurodegenerative diseases. While advancements in research hold promise for developing novel treatments, the article also addresses the challenges and complexities associated with modulating these intricate cellular pathways. Ultimately, advancing understanding of the underlying mechanism of autophagy and proteostasis in neurodegenerative disorders provides valuable insights into potential therapeutic avenues and future research directions.
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Affiliation(s)
- Surbhi Panwar
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Prerna Uniyal
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Afreen Hashmi
- Faculty of Pharmacy, Babu Banarasi Das Northern India Institute of Technology, Lucknow, India
| | - Shivani Verma
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Aanchal Arya
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Gaurav Joshi
- Department of Pharmaceutical Sciences, Hemvati Nandan Bahuguna Garhwal University, Srinagar, India
- Department of Biotechnology, Graphic Era (Deemed to be University), Dehradun, India
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Raheja H, Waheed M, Harris C, Patel N, Hashmi A, Kundal S, Patel J, Malik B, Frankel R, Shani J. Racial disparities in the use of mechanical circulatory support devices in cardiogenic shock. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1484] [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: 11/12/2022] Open
Abstract
Abstract
Background
Racial bias has always been a concern for healthcare. Lack of guideline directed utilization of mechanical circulatory support (MCS) devices in cardiogenic shock (CS) may lead to implicit and racial bias.
Purpose
To identify the racial differences in the use of mechanical circulatory support in cardiogenic shock and its association with outcomes.
Methods
National Inpatient Database from 2015–2018 using ICD 10 codes was used. Patients >18 years of age admitted for cariogenic shock were included.
Results
Among 1,021,274 patients hospitalized for cardiogenic shock, overall MCS was utilized in 11.4% (N=116,539). Use of MCS for patients stratified by race was 12.2% white (N=85543), 8% Blacks (N=14688), 11.3% Hispanics (N=11067), 13.8% Asian (N=4417), 12.3% Native American (N=825). IABP was the most commonly used MCS device, followed by Impella, ECMO and LVAD. Overall odds of MCS insertion was significantly higher in white population [1.18 (1.13–1.23) <0.001] and significantly lower in Blacks [0.65 (0.61–0.69) <0.001] and Hispanics [0.89 (0.83–0.97) 0.004]. Among black patients with CS requiring MCS, odds of LVAD insertion were similar compared to other races [1.03 (0.89–1.19) 0.714], while odds of all other types of MCS devices including ECMO [0.83 (0.72–0.95) 0.009], IABP [0.63 (0.59–0.68) <0.001] and Impella [0.61 (0.54–0.70) <0.001] were significantly lower compared to other races. This trend also holds true for patients with CS associated with acute myocardial infarction. Among all patients with CS, the odds of mortality were significantly lower among white patients [0.92 (0.90–0.95) <0.001], on the contrary, odds of mortality were significantly higher in Blacks [1.06 (1.02–1.10) 0.001] and Asians [1.11 (1.02–1.20) 0.012]. Interestingly, when only comparing patients who underwent MCS utilization for CS, odds of mortality were similar in black population compared to other races. [1.03 (0.91–1.17) 0.636].
Conclusion(s)
There still exist significant racial differences in the use of mechanical circulatory devices for cardiogenic shock potentially leading to significantly higher mortality in black population compared to whites. This difference in mortality is mitigated with equal use of MCS devices in cardiogenic shock among all races.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Raheja
- Maimonides Medical Center, Brooklyn, United States of America
| | - M Waheed
- Maimonides Medical Center, Brooklyn, United States of America
| | - C Harris
- Maimonides Medical Center, Brooklyn, United States of America
| | - N Patel
- Maimonides Medical Center, Brooklyn, United States of America
| | - A Hashmi
- Maimonides Medical Center, Brooklyn, United States of America
| | - S Kundal
- Maimonides Medical Center, Brooklyn, United States of America
| | - J Patel
- Maimonides Medical Center, Brooklyn, United States of America
| | - B Malik
- Maimonides Medical Center, Brooklyn, United States of America
| | - R Frankel
- Maimonides Medical Center, Brooklyn, United States of America
| | - J Shani
- Maimonides Medical Center, Brooklyn, United States of America
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Bowen R, Hashmi A, Lewis J, Hassani A, Mohanraj R, Mott J, Pearson R. PO-1398 SRS for brain metastases from renal cell carcinoma; UK tertiary referral centre 5-year experience. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07849-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: 10/20/2022]
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Rahnemai-Azar A, Rajeswaran H, Hashmi A, Kondray V, Al-Natour M, Davidson J. Abstract No. 189 Characteristics of patients who died or underwent hospice care after inferior vena cava filter placement. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hashmi A, Al-Natour M, Azar N, Sutter C, Davidson J, Tavri S. Abstract No. 589 Assessing the role of interventional radiology during the initial phase of COVID-19: a large health system experience. J Vasc Interv Radiol 2021. [PMCID: PMC8079606 DOI: 10.1016/j.jvir.2021.03.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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6
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Rahnemai-Azar A, Rajeswaran H, Hashmi A, Kondray V, Walker L, Al-Natour M, Davidson J. Abstract No. 542 Factors associated with increased fluoroscopy time during inferior vena cava retrieval procedure. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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West N, Pearson R, Hashmi A, Jiang X, Ogilvie A, Simmons T. PO-1250: Palliation of vertebral metastases and cord compressions: single field or VMAT? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01268-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meldon S, Saxena S, Muir M, Briskin I, Masciarelli McFarland A, Delgado F, Hashmi A. 362 The Effect of Geriatric Consultation on Admission Rates of Older Patients in the Emergency Department. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rahnemai-Azar A, Azeze S, Rajeswaran H, Hashmi A, Walker L, Davidson J, Al-Natour M. Abstract No. 671 The effect of inferior vena cava size on filter complications: one size does not fit all. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Stevens A, Gilder ME, Moo P, Hashmi A, Toe SET, Doh BB, Nosten S, Chotivanich K, Somerset S, McGready R. Folate supplementation to prevent birth abnormalities: evaluating a community-based participatory action plan for refugees and migrant workers on the Thailand-Myanmar border. Public Health 2018; 161:83-89. [PMID: 29935473 PMCID: PMC6086336 DOI: 10.1016/j.puhe.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/22/2022]
Abstract
Objectives Preconception folic acid (PFA) taken at least 3 months before conception can decrease the incidence of neural tube defects (NTDs) by approximately 46%. NTDs contribute significantly to neonatal morbidity and mortality in migrant and refugee populations on the Thailand-Myanmar border (incidence 1.57/1000 live births). This audit aimed to assess uptake of PFA among migrant and refugee women, evaluate knowledge about PFA among local healthcare workers and implement a participatory community intervention to increase PFA uptake and decrease NTD incidence in this population. Study design A mixed-methods baseline evaluation was followed by an intervention involving health worker education and a community outreach program. A follow-up audit was performed 18 months post-intervention. Methods Data were gathered via surveys, short interviews and focus group discussions. The intervention program included community-based workshops, production and distribution of printed flyers and posters, and outreach to various local organisations. Results Uptake of PFA was <2% both before and after the intervention. Despite a substantial increase in local healthcare worker knowledge of PFA, no significant improvement in PFA uptake after the intervention was detected. Most pregnancies in this local community sample were reported to be unplanned. Conclusions High rates of NTDs with low PFA uptake remains a major public health challenge in this transient population. Results indicate that improved health worker knowledge alone is not sufficient to enhance PFA uptake in this population. Integration of PFA education within expanded family planning programs and broad-based food fortification may be more effective. Audited preconception folic acid (PFA) campaign on Thai-Myanmar border. Low awareness of PFA among health workers and migrant/refugee pregnant women. Improved local health worker PFA knowledge after campaign and follow-up held after 18 months. Overall, campaign proved ineffective in increasing PFA uptake among pregnant women.
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Affiliation(s)
- A Stevens
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - M E Gilder
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - P Moo
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - A Hashmi
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - S E T Toe
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - B B Doh
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - S Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
| | - K Chotivanich
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Shawn Somerset
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
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Qureshi H, Shehzad A, Mohsin R, Sultan G, Laghari R, Mubarak M, Hashmi A, Naqvi S, Rizvi S. Impact of radical nephrectomy on renal functional outcome in patients with no other co-morbidity as determined by 24-h urinary creatinine clearance. African Journal of Urology 2015. [DOI: 10.1016/j.afju.2015.08.001] [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: 01/10/2023] Open
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Friese RS, Wynne J, Joseph B, Hashmi A, Diven C, Pandit V, O'Keeffe T, Zangbar B, Kulvatunyou N, Rhee P. Age and mortality after injury: is the association linear? Eur J Trauma Emerg Surg 2014; 40:567-72. [PMID: 26814513 DOI: 10.1007/s00068-014-0380-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/20/2014] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Multiple studies have demonstrated a linear association between advancing age and mortality after injury. An inflection point, or an age at which outcomes begin to differ, has not been previously described. We hypothesized that the relationship between age and mortality after injury is non-linear and an inflection point exists. METHODS We performed a retrospective cohort analysis at our urban level I center from 2007 through 2009. All patients aged 65 years and older with the admission diagnosis of injury were included. Non-parametric logistic regression was used to identify the functional form between mortality and age. Multivariate logistic regression was utilized to explore the association between age and mortality. Age 65 years was used as the reference. Significance was defined as p < 0.05. RESULTS A total of 1,107 patients were included in the analysis. One-third required intensive care unit (ICU) admission and 48 % had traumatic brain injury. 229 patients (20.6 %) were 84 years of age or older. The overall mortality was 7.2 %. Our model indicates that mortality is a quadratic function of age. After controlling for confounders, age is associated with mortality with a regression coefficient of 1.08 for the linear term (p = 0.02) and a regression coefficient of -0.006 for the quadratic term (p = 0.03). The model identified 84.4 years of age as the inflection point at which mortality rates begin to decline. CONCLUSIONS The risk of death after injury varies linearly with age until 84 years. After 84 years of age, the mortality rates decline. These findings may reflect the varying severity of comorbidities and differences in baseline functional status in elderly trauma patients. Specifically, a proportion of our injured patient population less than 84 years old may be more frail, contributing to increased mortality after trauma, whereas a larger proportion of our injured patients over 84 years old, by virtue of reaching this advanced age, may, in fact, be less frail, contributing to less risk of death.
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Affiliation(s)
- R S Friese
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - J Wynne
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - B Joseph
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
| | - A Hashmi
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - C Diven
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - V Pandit
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - T O'Keeffe
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - B Zangbar
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - N Kulvatunyou
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
| | - P Rhee
- Division of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA
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Hashmi A, Rhee P, Pandit V, Kulvatunyou N, Tang A, O'Keeffe T, Zangbar B, Wynne J, Gries L, Vercruysse G, Friese R, Joseph B. Shock Index Predicts Mortality in Geriatric Trauma Patients: An Analysis of The National Trauma Data Bank. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.998] [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: 10/25/2022]
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Sabegh BZ, Joseph B, Hashmi A, Kulvatunyou N, Aziz H, Wynne J, Tang A, O'keeffe T, Vercruysse G, Green D, Friese R, Rhee P. Mortality After Trauma Laparotomy in Geriatric Patients. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hashmi A, Friese R, Joseph B, Zangbar B, Wynne J, Gries L, Pandit V, O'Keeffe T, Tang A, Kulvatunyou N, Vercruysse G, Rhee P. The Effect of Age on Mortality In Patients With Traumatic Brain Injury. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.844] [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: 11/27/2022]
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Rizvi SAH, Sultan S, Zafar MN, Naqvi SAA, Lanewala AA, Hashmi S, Aziz T, Hassan AS, Ali B, Mohsin R, Mubarak M, Farasat S, Akhtar SF, Hashmi A, Hussain M, Hussain Z. Pediatric kidney transplantation in the developing world: challenges and solutions. Am J Transplant 2013; 13:2441-9. [PMID: 23865679 DOI: 10.1111/ajt.12356] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 05/07/2013] [Accepted: 05/21/2013] [Indexed: 01/25/2023]
Abstract
The prevalence of pediatric RRT and transplantation are low in developing countries, 6-12 and <1 to 5 per million child population (pmcp), respectively. This is due to low GDP/capita of <$10 000, government expenditure on health of <2.6-9% of GDP and paucity of facilities. The reported incidence of pediatric CKD and ESRD is <1.0-8 and 3.4-35 pmcp, respectively. RRT and transplantation are offered mostly in private centers in cities where HD costs $20-100/session and transplants $10 000-20 000. High costs and long distance to centers results in treatment refusal in up to 35% of the cases. In this backdrop 75-85% of children with ESRD are disfranchised from RRT and transplantation. Our center initiated an integrated dialysis-transplant program funded by a community-government partnership where RRT and transplantation was provided "free of cost" with life long follow-up and medication. Access to free RRT at doorsteps and transplantation lead to societal acceptance of transplantation as the therapy of choice for ESRD. This enabled us to perform 475 pediatric transplants in 25 years with 1- and 5-year graft survival of 96% and 81%, respectively. Our model shows that pediatric transplantation is possible in developing countries when freely available and accessible to all who need it in the public sector.
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Affiliation(s)
- S A H Rizvi
- Department of Urology, Sindh Institute of Urology and Transplantation, Dewan Farooq Medical Complex, Karachi, Pakistan
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Rafi M, Ali S, Hashmi A. AOSP38 TREATMENT OF LOCALISED PROSTATE CANCER STAGE T2B–T4A WITH EXTERNAL BEAM RADIOTHERAPY PLUS HIGH DOSE RATE BRACHYTHERAPY: SINGLE INSTITUTIONAL EXPERIENCE IN SINDH INSTITUTE OF UROLOGY AND TRANSPLANTATION, SIUT, KARACHI. Eur J Cancer 2013. [DOI: 10.1016/s0959-8049(13)70049-2] [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: 10/27/2022]
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Yu T, Chahrour M, Coulter M, Jiralerspong S, Okamura-Ikeda K, Ataman B, Schmitz-Abe K, Harmin D, Adli M, Malik A, D’Gama A, Lim E, Sanders S, Mochida G, Partlow J, Sunu C, Felie J, Rodriguez J, Nasir R, Ware J, Joseph R, Hill R, Kwan B, Al-Saffar M, Mukaddes N, Hashmi A, Balkhy S, Gascon G, Hisama F, LeClair E, Poduri A, Oner O, Al-Saad S, Al-Awadi S, Bastaki L, Ben-Omran T, Teebi A, Al-Gazali L, Eapen V, Stevens C, Rappaport L, Gabriel S, Markianos K, State M, Greenberg M, Taniguchi H, Braverman N, Morrow E, Walsh C. Using whole-exome sequencing to identify inherited causes of autism. Neuron 2013; 77:259-73. [PMID: 23352163 PMCID: PMC3694430 DOI: 10.1016/j.neuron.2012.11.002] [Citation(s) in RCA: 318] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 01/01/2023]
Abstract
Despite significant heritability of autism spectrum disorders (ASDs), their extreme genetic heterogeneity has proven challenging for gene discovery. Studies of primarily simplex families have implicated de novo copy number changes and point mutations, but are not optimally designed to identify inherited risk alleles. We apply whole-exome sequencing (WES) to ASD families enriched for inherited causes due to consanguinity and find familial ASD associated with biallelic mutations in disease genes (AMT, PEX7, SYNE1, VPS13B, PAH, and POMGNT1). At least some of these genes show biallelic mutations in nonconsanguineous families as well. These mutations are often only partially disabling or present atypically, with patients lacking diagnostic features of the Mendelian disorders with which these genes are classically associated. Our study shows the utility of WES for identifying specific genetic conditions not clinically suspected and the importance of partial loss of gene function in ASDs.
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Affiliation(s)
- T.W. Yu
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA, 02114
| | - M.H. Chahrour
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - M.E. Coulter
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - S. Jiralerspong
- Department of Human Genetics and Pediatrics, McGill University, Montreal Children’s Hospital Research Institute, Montreal, Quebec, Canada, H3H1P3
| | - K. Okamura-Ikeda
- Institute for Enzyme Research, The University of Tokushima, Tokushima, Japan
| | - B. Ataman
- Department of Neurobiology, Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - K. Schmitz-Abe
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - D.A. Harmin
- Department of Neurobiology, Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - M. Adli
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, Virginia, USA, 22908
| | - A.N. Malik
- Department of Neurobiology, Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - A.M. D’Gama
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - E.T. Lim
- Analytic and Translational Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA, 02114
| | - S.J. Sanders
- Department of Genetics, Center for Human Genetics and Genomics and Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA, 06510
| | - G.H. Mochida
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA, 02114
| | - J.N. Partlow
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - C.M. Sunu
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - J.M. Felie
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - J. Rodriguez
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - R.H. Nasir
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - J. Ware
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - R.M. Joseph
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA, 02118
| | - R.S. Hill
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - B.Y. Kwan
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, N6A 5C1
| | - M. Al-Saffar
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - N.M. Mukaddes
- Istanbul Faculty of Medicine, Department of Child Psychiatry, Istanbul University, Istanbul, Turkey
| | - A. Hashmi
- Armed Forces Hospital, King Abdulaziz Naval Base, Jubail, Kingdom of Saudi Arabia
| | - S. Balkhy
- Department of Neurosciences and Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - G.G. Gascon
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA, 02114
- Istanbul Faculty of Medicine, Department of Child Psychiatry, Istanbul University, Istanbul, Turkey
- Clinical Neurosciences and Pediatrics, Brown University School of Medicine, Providence, Rhode Island, 02912
| | - F.M. Hisama
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, USA, 98195
| | - E. LeClair
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - A. Poduri
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA,02115
| | - O. Oner
- Department of Child and Adolescent Psychiatry, Dr Sami Ulus Childrens’ Hospital, Telsizler, Ankara, Turkey
| | - S. Al-Saad
- Kuwait Center for Autism, Kuwait City, Kuwait
| | | | - L. Bastaki
- Kuwait Medical Genetics Center, Kuwait City, Kuwait
| | - T. Ben-Omran
- Section of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Departments of Pediatrics and Genetic Medicine, Weil-Cornell Medical College, New York and Doha, Qatar
| | - A. Teebi
- Section of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Departments of Pediatrics and Genetic Medicine, Weil-Cornell Medical College, New York and Doha, Qatar
| | - L. Al-Gazali
- Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - V. Eapen
- Academic Unit of Child Psychiatry South West Sydney (AUCS), University of New South Wales, Sydney, New South Wales, Australia
| | - C.R. Stevens
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA, 02142
| | - L. Rappaport
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
| | - S.B. Gabriel
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA, 02142
| | - K. Markianos
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - M.W. State
- Department of Genetics, Center for Human Genetics and Genomics and Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA, 06510
| | - M.E. Greenberg
- Department of Neurobiology, Harvard Medical School, Boston, Massachusetts, USA, 02115
| | - H. Taniguchi
- Institute for Enzyme Research, The University of Tokushima, Tokushima, Japan
| | - N.E. Braverman
- Department of Human Genetics and Pediatrics, McGill University, Montreal Children’s Hospital Research Institute, Montreal, Quebec, Canada, H3H1P3
| | - E.M. Morrow
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, 02912
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, 02912
| | - C.A. Walsh
- Division of Genetics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, Massachusetts, USA, 02115
- The Autism Consortium, Boston, Massachusetts, USA, 02115
- Harvard Medical School, Boston, Massachusetts, USA, 02115
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Rizvi SAH, Naqvi SAA, Zafar MN, Hussain Z, Hashmi A, Hussain M, Akhtar SF, Ahmed E, Aziz T, Sultan G, Sultan S, Mehdi SH, Lal M, Ali B, Mubarak M, Faiq SM. A renal transplantation model for developing countries. Am J Transplant 2011; 11:2302-7. [PMID: 21883911 DOI: 10.1111/j.1600-6143.2011.03712.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The estimated incidence of end-stage renal disease (ESRD) in Pakistan is 100 per million population. Paucity and high costs of renal replacement therapy allows only 10% to get dialysis and 4-5% transplants. Our center, a government organization, started a dialysis and transplant program in 1980s where all services were provided free of charge to all patients. It was based on the concept of community government partnership funded by both partners. The guiding principles were equity, transparency, accountability and development of all facilities under one roof. This partnership has sustained itself for 30 years with an annual budget of $25 million in 2009. Daily 600 patients are dialyzed and weekly 10-12 receive transplants. One- and 5-year graft survival of 3000 transplants is 92% and 85%, respectively. The institute became a focus of transplantation in Pakistan and played a vital role in the campaign against transplant tourism and in promulgation of transplant law of 2007, and also helped to increase altruistic transplants in the country. This model emphasizes that in developing countries specialized centers in government sector are necessary for transplantation to progress and community support can make it available to the common man.
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Affiliation(s)
- S A H Rizvi
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan.
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Khan U, Hashmi A, Zia N, Awan S, Razzak J. P2-520 Injury- related mortality among women aged 12-49 years: Demographic and Health Survey (DHS) Pakistan. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976m.47] [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: 11/04/2022]
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Tunio MA, Hashmi A, Rafi M. Need for a new trial to evaluate postoperative radiotherapy in renal cell carcinoma: a meta-analysis of randomized controlled trials. Ann Oncol 2010; 21:1839-1845. [PMID: 20139152 DOI: 10.1093/annonc/mdq028] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A meta-analysis was conducted to assess the impact of postoperative radiotherapy (PORT) in renal cell carcinoma (RCC) on overall survival (OS), disease-free survival (DFS) and locoregional failure (LRF). MATERIALS AND METHODS The Medline, CANCERLIT, Cochrane library database and search engines were searched to identify randomized controlled studies comparing radical nephrectomy alone with radical nephrectomy followed by PORT for localized RCC. Further, radiotherapy techniques and associated side-effects were evaluated. RESULTS Seven controlled trials with a total patient population of 735 were identified. Pooled results from these trials showed a significant reduction of LRF in patients treated with PORT (P < or = 0.0001). However, there was no difference in OS (P = 0.29) and DFS (P = 0.14). The majority of patients was treated with larger field sizes with parallel-opposed anteroposterior fields. PORT was generally well tolerated; in total, six PORT-related deaths were seen. The resultant funnel plot was broader (Egger test P = 0.14) due to low number of patients. CONCLUSIONS PORT significantly reduces LRF but has no effect on OS and DFS. However, due to poor patient accrual and older radiotherapy techniques in previous studies, there is a need for a new trial to evaluate PORT using conformal and intensity-modulated radiotherapy techniques.
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Affiliation(s)
| | - A Hashmi
- Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - M Rafi
- Departments of Radiation Oncology
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Rizvi SAH, Anwar Naqvi SA, Zafar MN, Hussain Z, Hashmi A, Akhtar F, Hussain M, Ahmed E. Pakistan abolishes kidney market and ushers in a new era of ethical transplantation. Int J Organ Transplant Med 2010; 1:193-7. [PMID: 25013586 PMCID: PMC4089237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hashmi A, Enns E, Frost T, Schäfer S, Frey W, Rominger F. Gold-Catalysis: Reactions
of Furandialkynes. SYNTHESIS-STUTTGART 2008. [DOI: 10.1055/s-0028-1083144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rizvi SAH, Naqvi SAA, Hashmi A, Akhtar F, Hussain M, Ahmed E, Zafar MN, Abbas Z, Jawad F, Sultan S, Hasan SM. Improving kidney and live donation rates in Asia: Living donation. Transplant Proc 2004; 36:1894-5. [PMID: 15518688 DOI: 10.1016/j.transproceed.2004.08.135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/26/2022]
Abstract
Organ transplantation started with organs donated by living subjects. Increasing demands brought cadaveric organ donation. The brain-death law, mandatory for this procedure, is prevalent in all countries involved in organ transplantation except Pakistan. Spain is the leading country in cadaveric organ donation (32.5 pmp). Despite the sources of living and cadaveric organs, both heart-beating and non-heart-beating, the gap between the demand and supply has widened. An example is the United States, where the numbers of patients on the waiting list for kidney transplantation have risen from 30,000 in 1988 to more than 116,000 in 2001. This has caused a resurgence in living donors all over the world. These can be related, unrelated, spousal, marginal, or ABO-incompatible donors. Family apprehensions, medical care costs, and nonexistent social security can be barriers to this form of organ donation. Unrelated organ donation can open the doors to commercialism. To make this process more successful, transplantation should be made reachable by all sectors of the population. This is possible when transplantation is taken to the public sector institutions and financed jointly by the government and community. To increase living organ donation especially in Asian countries, which face barriers of low literacy rates, ignorance, and cultural and religious beliefs, more efforts are needed. Public awareness and education play an important role. Appreciation and supporting the donors is necessary and justified. It is a noble act and should be recognized by offering job security, health insurance, and free education for the donor's children.
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Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan.
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Ahmed E, Akhtar F, Hashmi A, Imtiaz S, Hussain Z, Hafeez S, Naqvi A, Rizvi A. Acute graft dysfunction due to pyelonephritis: value and safety of graft biopsy. Ren Fail 2003; 25:509-12. [PMID: 12803516 DOI: 10.1081/jdi-120021813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- E Ahmed
- Sindh Institute of Urology and Transplantation, Karachi, Pakistan
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Rizvi SA, Naqvi SA, Hussain Z, Hashmi A, Hussain M, Zafar MN, Sultan S, Mehdi H. Management of pediatric urolithiasis in Pakistan: experience with 1,440 children. J Urol 2003; 169:634-7. [PMID: 12544331 DOI: 10.1097/01.ju.0000041402.50707.c0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We evaluated the efficacy and safety of different modalities for pediatric urolithiasis in a developing country in 2 eras, namely before and after the advent of minimally invasive surgery. MATERIALS AND METHODS We retrospectively reviewed the records of 1,440 children younger than 14 years treated with various modalities during a 14-year period. From 1987 to 1995, 486 and 50 patients were treated with open surgery, and extracorporeal shock wave lithotripsy (ESWL, Dornier Medical Systems, Inc., Marietta, Georgia) and minimally invasive methods, respectively. Between 1996 and 2000, 518 and 386 children were treated with surgery and minimally invasive methods, respectively. RESULTS Of the 1,440 children 795 (55.2%) had renal, 198 (13.8%) had ureteral and 447 (31%) had bladder calculi. Of the renal stones 556 (70%), 177 (22%) and 62 (7.8%) were treated with open surgery, ESWL and percutaneous nephrolithotomy, respectively. Of the ureteral calculi 85 (43%), 37 (18.6%) and 76 (38%) were managed by ESWL, ureterorenoscopy and open surgery, respectively. Of the bladder calculi 307 (68%), 77 (17.2%) and 63 (14%) were treated with open vesicolithotomy, transurethral pneumatic cystolithotripsy and ESWL, respectively. The renal stone clearance rate was 98% after open surgery, 84% after ESWL and 68% after percutaneous nephrolithotomy monotherapy at 3 months of followup. Similarly the ureteral stone-free rate was 54% after ESWL and 86.9% after ureterorenoscopy. Of the patients with bladder calculi 48% and 93% become stone-free after ESWL and transurethral pneumatic cystolithotripsy, respectively. CONCLUSIONS The use of ESWL, percutaneous nephrolithotomy and ureterorenoscopy has resulted in treating a large number of children with a short hospital stay and early return to school. Open surgery is reserved only for complex stones.
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Affiliation(s)
- S A Rizvi
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Akhtar F, Hussain M, Ahmed E, Zafar MN, Muzaffar R, Hafiz S. Emerging challenges in transplantation in developing countries. Transplant Proc 2002; 34:3146-9. [PMID: 12493403 DOI: 10.1016/s0041-1345(02)03680-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan.
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Abstract
PURPOSE We evaluated epidemiology, etiology, dietary and urinary risk factors, and the composition of calculi in pediatric stone formers in Pakistan. MATERIALS AND METHODS This retrospective study includes 1,440 children treated between 1987 and 2000. Case records were reviewed for demographics, etiology and clinical symptoms. Dietary and urinary risk factors were analyzed prospectively in idiopathic stone formers. Stone composition was analyzed by infrared spectroscopy. RESULTS There were 1,075 males and 365 females for a male-to-female ratio of 3:1. The peak age for renal and bladder stones was 6 to 10 and 1 to 5 years, respectively. Overall 795 stones (55%) were renal, 198 (14%) were ureteral and 447 (31%) were vesical. Bladder stones were present in 60% of cases in the mid 1980s but decreased to 15% in the mid 1990s. The clinical symptoms were abdominal pain in 511 patients (51%) and fever in 193 (19.5%). There were anatomical abnormalities in 96 patients (12%), metabolic abnormalities in 206 (25%), infection stones in 60 (7%) and idiopathic stones in 444 (55%). Urinary analysis in idiopathic stone formers revealed hypercalciuria in 17 (11%), hyperoxaluria in 62 (40%), hyperuricosuria in 41 (27%) and hypocitruria in 97 (63%). Diet involved a low intake of protein in 60 cases (44%), calcium in 45 (33%), potassium in 105 (77%) and high oxalate in 75 (55%). The composition was calcium oxalate in 362 stones (47%), ammonium hydrogen urate in 210 (27%) and struvite in 49 (6.4%). Stones recurred in 30 patients (2%). CONCLUSIONS The pattern of calculous disease changed from a predominantly lower tract site in the mid 1980s to the upper tract in the mid 1990s. Stone composition, urinary risk factors and dietary analysis suggest that diet, dehydration and poor nutrition are the main causative factors of stone disease.
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Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Abstract
PURPOSE We evaluated epidemiology, etiology, dietary and urinary risk factors, and the composition of calculi in pediatric stone formers in Pakistan. MATERIALS AND METHODS This retrospective study includes 1,440 children treated between 1987 and 2000. Case records were reviewed for demographics, etiology and clinical symptoms. Dietary and urinary risk factors were analyzed prospectively in idiopathic stone formers. Stone composition was analyzed by infrared spectroscopy. RESULTS There were 1,075 males and 365 females for a male-to-female ratio of 3:1. The peak age for renal and bladder stones was 6 to 10 and 1 to 5 years, respectively. Overall 795 stones (55%) were renal, 198 (14%) were ureteral and 447 (31%) were vesical. Bladder stones were present in 60% of cases in the mid 1980s but decreased to 15% in the mid 1990s. The clinical symptoms were abdominal pain in 511 patients (51%) and fever in 193 (19.5%). There were anatomical abnormalities in 96 patients (12%), metabolic abnormalities in 206 (25%), infection stones in 60 (7%) and idiopathic stones in 444 (55%). Urinary analysis in idiopathic stone formers revealed hypercalciuria in 17 (11%), hyperoxaluria in 62 (40%), hyperuricosuria in 41 (27%) and hypocitruria in 97 (63%). Diet involved a low intake of protein in 60 cases (44%), calcium in 45 (33%), potassium in 105 (77%) and high oxalate in 75 (55%). The composition was calcium oxalate in 362 stones (47%), ammonium hydrogen urate in 210 (27%) and struvite in 49 (6.4%). Stones recurred in 30 patients (2%). CONCLUSIONS The pattern of calculous disease changed from a predominantly lower tract site in the mid 1980s to the upper tract in the mid 1990s. Stone composition, urinary risk factors and dietary analysis suggest that diet, dehydration and poor nutrition are the main causative factors of stone disease.
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Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Zafar MN, Ahmed E, Alam A, Akhtar F, Zafar H, Hashmi A, Naqvi A, Rizvi A. Study of a new generic cyclosporine, Consupren, in de novo renal transplant recipients. Transplant Proc 2002; 34:2480-1. [PMID: 12270485 DOI: 10.1016/s0041-1345(02)03183-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M N Zafar
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan.
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Saeed SA, Rasheed H, Gilani AH, Hashmi A, Shah BH. An investigation of cyclooxygenase and signalling inhibitors on 5-hydroxytryptamine- and epinephrine-induced platelet activation. Proc West Pharmacol Soc 2002; 44:159-62. [PMID: 11793969] [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: 02/23/2023]
Affiliation(s)
- S A Saeed
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi-74800, Pakistan
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Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Akhtar F, Zafar MN, Hussain M, Ahmed E, Kazi JI, Hasan AS, Khalid R, Aziz S, Sultan S. Living-related pediatric renal transplants: a single-center experience from a developing country. Pediatr Transplant 2002; 6:101-10. [PMID: 12000464 DOI: 10.1034/j.1399-3046.2002.01039.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [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: 11/23/2022]
Abstract
We retrospectively analyzed the results of 75 living-related pediatric renal transplants performed at our center between January 1986 and December 1999. The major causes of end-stage renal disease (ESRD) were glomerulonephritis (26%) and nephrolithiasis (16%), while the etiology was unknown in 50%. The mean age of the recipients was 12 yr (range 6-17 yr) and that of the donors was 39 yr (range 20-65 yr). The majority (73%) of donors were parents. Eighty five per cent of donors were one-haplotype matched and the rest identical. Immunosuppression was based on a triple drug regimen. Thirty per cent of recipients were rapid metabolizers of cyclosporin A (CsA) (area under the curve [AUC]: < 6,000 ng/mL/h), while 16% were slow metabolizers (AUC: > 8,000 ng/mL/h). Forty three (57%) children encountered 59 rejection episodes, the majority of which (59%) were recorded in the first month post-transplant. Seventy-four per cent of the rejection episodes were steroid sensitive and the rest, except two, were resolved by therapy with antithymocyte globulin (ATG) or orthoclone thymocyte 3 (OKT3). After a mean follow-up of 37 months, 17 (22%) grafts had chronic rejection and 76% of these recipients had previously experienced acute rejection episodes. The overall infection rate was high, necessitating two hospital admissions/patient/year. The majority (53%) of the infections were bacterial. Urinary tract infections (UTIs) were seen in 17 (23%) recipients. Twelve of these had ESRD as a result of stone disease and eight grafts were lost because of UTIs. Eight per cent of recipients developed tuberculosis (TB), and extra-pulmonary lesions were seen in 50%. Surgical complications were encountered in eight patients. Free medication to all recipients and parental support ensured a compliance rate of 93%. Baseline growth deficit was seen in children of the two groups studied (the 6-12 yr and 13-17 yr age-groups), with Z-scores of - 2.39 and - 2.12, respectively. No growth catch-up was observed at 12 and 24 months in either group. Post-donation complications were seen most commonly in donors > 50 yr of age and included: proteinuria (> 300 mg/24 h, four patients), hypertension (three patients), and diabetes (one patient). Twenty-four grafts were lost, 54% as a result of immunological and the rest as a result of non-immunological causes, and 17 recipients died during the follow-up period. Infections were the main cause of patient and graft loss. Overall 1- and 5-yr graft and patient survival rates were 88% and 65%, and 90% and 75%, respectively.
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Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation, Dow Medical College and Civil Hospital, Karachi, Pakistan.
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Affiliation(s)
- S A H Rizvi
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi 74200, Pakistan.
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Kuhn M, Hashmi A, Deming D, Cephus C, Robie S, Chinnock R, Larsen R. Management of post-transplant coronary artery disease (PTCAD) using intravascular ultrasound (IVUS) improves outcome in pediatric heart transplant (htx) recipients. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00461-2] [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] [Indexed: 12/01/2022] Open
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Morgan H, Khan I, Hashmi A, Hebert D, McCrindle BW, Balfe JW. Ambulatory blood pressure monitoring after renal transplantation in children. Pediatr Nephrol 2001; 16:843-7. [PMID: 11685585 DOI: 10.1007/s004670100668] [Citation(s) in RCA: 71] [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] [Received: 12/07/2000] [Accepted: 05/29/2001] [Indexed: 11/24/2022]
Abstract
Hypertension occurs commonly following renal transplantation and may cause end organ damage, such as cardiac hypertrophy. This study seeks to determine which features of hypertension are related to cardiac hypertrophy in children after renal transplantation. Ambulatory blood pressure monitoring (ABPM) was performed in 45 pediatric patients, 4.9+/-3.0 years after renal transplantation. ABPM data were related to clinical features and echocardiographic measurements. Hypertension was demonstrated in 33% of patients by casual blood pressure (BP) measurement and in 40% by ABPM. The mean percentage nighttime decline in BP (dipping) was 8.9+/-5.0% for systolic and 13.9+/-7.7% for diastolic BP. Abnormal dipping (<10%) was seen in 58% of patients. BP load (percentage of BP recordings above 95th percentile) was >30% in 44% of patients. Patients taking antihypertensive medication had more abnormal dipping and greater nighttime BP load. The prevalence of left ventricular hypertrophy was 72% before transplantation, 75% after transplantation, and 54% near to ABPM. Left ventricular mass (LVM) indexed to height(3) decreased significantly after transplantation. (40.2+/-14.7 vs. 35.0+/-8.3 g/m(3), P=0.0002). There was no significant relationship between ABPM data and LVM. ABPM was not able to differentiate those patients with persistently elevated LVM. The results suggest that hypertension is not always associated with cardiac hypertrophy following pediatric renal transplantation.
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Affiliation(s)
- H Morgan
- Department of Pediatrics, Division of Nephrology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, M5G 1X8, Canada
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Affiliation(s)
- K J Lee
- Department of Pediatrics, The Division of Cardiology, The Hospital for Sick Children, University of Toronto Medical School, Toronto, Ontario, Canada
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Hussain Z, Hashmi A, Hussain M, Askari H, Tauqir R, Khan ZA, Naqvi A, Rizvi A. Single-centre experience of living related donor nephrectomy. Transplant Proc 2001; 33:2648. [PMID: 11498105 DOI: 10.1016/s0041-1345(01)02130-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Z Hussain
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan
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Abstract
OBJECTIVES To determine cardiovascular risk profiles of patients with Kawasaki disease and to relate them to a noninvasive measure of endothelial function. STUDY DESIGN Case-control study. Cardiovascular risk assessment including brachial artery reactivity was performed in 24 patients 11.3 +/- 1.8 (mean +/- SD) years after Kawasaki disease and in 11 subjects in a normal control group. RESULTS The case versus control groups were similar regarding age, sex, race, body mass index, and percentage of ideal body weight, although cases had a higher mean z score of body mass index than normal (+1.00 +/- 1.18; P <.001). Cases had normal fasting total cholesterol levels but a higher mean z score of triglyceride levels (+1.35 +/- 2.04; P <.004). The case group had significantly higher mean systolic and diastolic resting blood pressure z scores (+0.76 +/- 1.06; P <.01 and +0.96 +/- 1.19; P <.01, respectively) than the control group and population norms. Endothelial function as indicated by brachial artery reactivity was not significantly different between the case versus control groups. In the case group higher blood pressure, increasing adiposity, and higher fasting triglyceride levels were significantly interrelated but did not relate to brachial artery reactivity or coronary artery abnormalities. CONCLUSIONS Patients after Kawasaki disease tend to have a more adverse cardiovascular risk profile potentially indicative of an increased predisposition to premature atherosclerotic changes.
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Affiliation(s)
- A A Silva
- Division of Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
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Naqvi A, Rizvi A, Hussain Z, Hafeez S, Hashmi A, Akhtar F, Hussain M, Ahmed E, Akhtar S, Muzaffar R, Naqvi R. Developing world perspective of posttransplant tuberculosis: morbidity, mortality, and cost implications. Transplant Proc 2001; 33:1787-8. [PMID: 11267512 DOI: 10.1016/s0041-1345(00)02680-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- A Naqvi
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan
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Rizvi A, Naqvi A, Hussain Z, Hussain M, Hashmi A, Akhtar F, Zafar MN, Ahmed E, Sultan S, Aziz S, Shehzad A, Khalid R. Why is it more difficult to transplant children? A perspective in developing countries. Transplant Proc 2001; 33:1742-3. [PMID: 11267494 DOI: 10.1016/s0041-1345(00)02664-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Rizvi
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan.
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Justino H, Justo RN, Ovaert C, Magee A, Lee KJ, Hashmi A, Nykanen DG, McCrindle BW, Freedom RM, Benson LN. Comparison of two transcatheter closure methods of persistently patent arterial duct. Am J Cardiol 2001; 87:76-81. [PMID: 11137838 DOI: 10.1016/s0002-9149(00)01276-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/18/2022]
Abstract
A randomized trial of arterial duct occlusion with a double umbrella (DU) or wire coil (WC) was undertaken for patients <18 years of age, weighing >10 kg with isolated ducts < or = 3 mm in diameter. Baseline, procedural, and outcome characteristics were compared in an intention-to-treat analysis according to randomization group. From 40 consecutively screened patients, 2 were not enrolled due to a ductal diameter of >3 mm on initial aortography, 38 patients were randomized to either the DU (n = 20) or WC (n = 18) groups. The groups did not differ significantly with respect to age, weight, gender, duct size, type, or branch pulmonary artery diameters. Crossover occurred only in the DU group, where 4 patients (20%) had a ductal diameter of < or = 1 mm and could not be entered for umbrella placement. All remaining DU group patients had ductal diameters of > or = 1.3 mm (p <0.0001). There were no embolizations or secondary implants in the DU group, but in the WC group there was 1 early and 1 late embolization, with 6 patients (33%) with > or = 2 coils. Mean times for the procedure (DU 68+/-19 minutes; WC 65+/-27 minutes; p = 0.70) and fluoroscopy (DU 14+/-4 minutes; WC 11+/-6 minutes; p = 0.22) did not differ significantly. Angiographic duct closure was documented in 4 of 13 patients (31%) of the DU group and 4 of 18 patients (22%) of the WC group (p = 0.69). Combined with an echocardiogram, closure in 11 of 17 patients with DU (65%) and 13 of 18 patients with WC (72%) (p = 0.64) was documented before hospital discharge. One WC group patient received thrombolytic therapy for a femoral artery thrombus. Follow-up at a median of 6.5 months (range 3.2 to 37) showed closure by Doppler echocardiography in 15 of 19 patients with DU (79%) versus 14 of 18 patients with WC (78%) (p = 1.0). Thus, with a tendency toward similar procedural characteristics and outcomes, the higher cost of the DU system compared with coil implants favors the use of coils for closure of the small arterial duct.
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Affiliation(s)
- H Justino
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto School of Medicine, Ontario, Canada
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Hussain M, Khalique M, Askari H, Lal M, Hashmi A, Hussain Z, Naqvi A, Rizvi A. Surgical complications after renal transplantation in a living-related transplantation program at SIUT. Transplant Proc 1999; 31:3211. [PMID: 10616445 DOI: 10.1016/s0041-1345(99)00694-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Hussain
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan
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45
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Affiliation(s)
- R Naqvi
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Askari H, Hashmi A, Lal M, Ali B, Hussain M, Hussain Z, Naqvi Z, Rizvi A. Postrenal transplant malignancies in a living-related donor program: 13-year experience--an update. Transplant Proc 1999; 31:3236. [PMID: 10616459 DOI: 10.1016/s0041-1345(99)00708-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- H Askari
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Abstract
This case report describes extrinsic compression of the right pulmonary artery, following aortic reconstructive surgery, to create a neo-ascending aorta in a 5-year-old boy with aortic atresia, coarctation of the aorta, and a ventricular septal defect, in an effort to achieve a biventricular circulation (Yasui operation). The obstruction was successfully relieved by transcatheter implantation of a balloon-expandable stent.
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Affiliation(s)
- A Hashmi
- Department of Pediatrics, Hospital for Sick Children, University of Toronto Faculty of Medicine, Ontario, Canada
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Abstract
Coronary artery lesions can develop in Kawaski disease as a major complication, and result in aneurysm formation and stenosis. Reported is the evolution of important coronary artery stenosis in a pediatric patient managed with an endovascular stent.
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Affiliation(s)
- A Hashmi
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto School of Medicine, Ontario, Canada
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Hussain M, Zafar N, Bux A, Sultan S, Hashmi A, Hussain Z, Hafiz S, Naqvi A, Rizvi A. Pharmacokinetics of cyclosporine microemulsion in Pakistani renal allograft recipients: correlation of trough peak levels with 7-point and 3-point AUC. Transplant Proc 1998; 30:3555. [PMID: 9838556 DOI: 10.1016/s0041-1345(98)01133-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- M Hussain
- Sindh Institute of Urology and Transplantation, Dow Medical College, Karachi, Pakistan
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Akhtar F, Rana TA, Kazi J, Zafar N, Hashmi A, Bhatti S, Naqvi R, Mohsin R, Naqvi A, Rizvi A. Correlation between biopsies and noninvasive assessment of acute graft dysfunction. Transplant Proc 1998; 30:3069. [PMID: 9838352 DOI: 10.1016/s0041-1345(98)00933-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- F Akhtar
- Sindh Institute of Urology and Transplantation (SIUT), Dow Medical College, Karachi, Pakistan
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