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Lex JR, Entezari B, Toor J, Abbas A, Nousiainen M, Rahman C, Whyne C, Ravi B. Intraoperative scrub nurse turnover in orthopaedic surgery procedures: An opportunity for improved operating room efficiency. J Healthc Qual Res 2024:S2603-6479(24)00021-6. [PMID: 38580507 DOI: 10.1016/j.jhqr.2024.03.002] [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: 09/09/2023] [Revised: 02/08/2024] [Accepted: 03/15/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Scrub nurses play a crucial role in facilitating orthopaedic surgeries, and thus intraoperative scrub nurse turnover may disrupt the workflow of the surgical team and prolong duration of surgery (DOS). The purpose of this study was to quantify the impact of intraoperative scrub nurse turnover on operative time of orthopaedic surgeries lasting less than 3h in duration. METHODS Prospectively collected databases from two institutions were retrospectively queried to identify all orthopaedic procedures of maximum mean duration of 180min from March 4th, 2018 to August 31st, 2022. Cases were divided into two groups, those with scrub nurse turnover and those without. Propensity score matching was conducted to match groups by surgeon, hospital, patient age, gender, and ASA classification. Unpaired t-tests were used to compare mean DOS for each surgical procedure. Average treatment effect on treated (ATET) with 95% confidence intervals (CIs) were calculated. RESULTS Scrub nurse turnover significantly prolonged DOS for both bone forearm facture open reduction and internal fixation (ORIF) (ATET=21.08, p=0.001), ankle ORIF (ATET=21.26, p<0.001), clavicle ORIF (ATET=16.16, p=0.028), femur intramedullary nail (ATET=11.52, p=0.003), rotator cuff repair (ATET=16.88, p<0.001), partial discectomy (ATET=10.52, p=0.001), total knee arthroplasty (TKA) (ATET=5.69, p<0.001), anterior total hip arthroplasty (THA) (ATET=8.80, p<0.001), lateral THA (ATET=7.02, p<0.001), and uncemented hip hemiarthroplasty (ATET=16.79, p=0.049). CONCLUSION Intraoperative scrub nurse turnover significantly prolongs surgical times in orthopaedic surgeries lasting up to 3h in duration. This highlights the importance of developing strategies to prevent intraoperative scrub nurse turnover to improve OR efficiency and decrease healthcare costs.
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Affiliation(s)
- J R Lex
- Orthopaedic Biomechanics Lab, Sunnybrook Research Institute, Toronto, ON, Canada; Division of Orthopaedic Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - B Entezari
- Granovsky Gluskin Division of Orthopaedics, Mount Sinai Hospital, Toronto, ON, Canada; Queen's University School of Medicine, Kingston, ON, Canada.
| | - J Toor
- Division of Orthopaedic Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A Abbas
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Nousiainen
- Division of Orthopaedic Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - C Rahman
- Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - C Whyne
- Orthopaedic Biomechanics Lab, Sunnybrook Research Institute, Toronto, ON, Canada; Division of Orthopaedic Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - B Ravi
- Division of Orthopaedic Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Abbas A, Okpapi JU, Njoku CH, Abba AA. Impact of Seasonal Changes on Asthma Control in North-Western Nigeria. West Afr J Med 2023; 40:1304-1310. [PMID: 38261305] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Asthma control is poor worldwide and is often affected by changes in environmental conditions. Effort to determine the cause of this heavy burden on patients and the healthcare system is crucial. AIM To determine the role of seasonal changes on asthma control in Sokoto, North-Western Nigeria. METHODS One hundred and one (101) patients with physician diagnosed asthma were consecutively recruited after obtaining informed consent. A structured researcher administered questionnaire was used as instrument of data collection and asthma control test questionnaire was also used to assess level of asthma control in each participant. Five items with a 4-week recall were assessed. Data for temperature, humidity, wind and rain was obtained from the Nigerian Meteorological Agency (NIMET), Sokoto. We computed frequency and level of asthma control with seasons of the year and weather variables. RESULTS One hundred and one patients comprising 71 females and 30 males with a mean age of 32.14 ± 10.68 years participated in the study. Level of asthma control was found to be poor among the participants with 41(40.6%) having very poorly controlled asthma, 30(29.7%) with not well controlled and 30(24.8%) well controlled asthma respectively. Among patients with very poorly controlled asthma, 22(48.9%) occurred during harmattan season and 14(31.1%) during rainy season. Weather parameters such as humidity shows significant relationship with asthma control (B= -0.504, P= 0.031, 95% CI [-0.012, -0.0253]). CONCLUSION The study shows that asthma control is poor among the participants and presentation with poor asthma control is more during harmattan season.
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Affiliation(s)
- A Abbas
- Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
| | - J U Okpapi
- Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - C H Njoku
- Department of Medicine, University of Calabar Teaching Hospital, Calabar Nigeria
| | - A A Abba
- Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Pickhardt PJ, Blake GM, Kimmel Y, Weinstock E, Shaanan K, Hassid S, Abbas A, Fox MA. Detection of Moderate Hepatic Steatosis on Portal Venous Phase Contrast-Enhanced CT: Evaluation Using an Automated Artificial Intelligence Tool. AJR Am J Roentgenol 2023; 221:748-758. [PMID: 37466185 DOI: 10.2214/ajr.23.29651] [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] [Indexed: 07/20/2023]
Abstract
BACKGROUND. Precontrast CT is an established means of evaluating for hepatic steatosis; postcontrast CT has historically been limited for this purpose. OBJECTIVE. The purpose of this study was to evaluate the diagnostic performance of portal venous phase postcontrast CT in detecting at least moderate hepatic steatosis using liver and spleen attenuation measurements determined by an automated artificial intelligence (AI) tool. METHODS. This retrospective study included 2917 patients (1381 men, 1536 women; mean age, 56.8 years) who underwent a CT examination that included at least two series through the liver. Examinations were obtained from an AI vendor's data lake of data from 24 centers in one U.S. health care network and 29 centers in one Israeli health care network. An automated deep learning tool extracted liver and spleen attenuation measurements. The reference for at least moderate steatosis was precontrast liver attenuation of less than 40 HU (i.e., estimated liver fat > 15%). A radiologist manually reviewed examinations with outlier AI results to confirm portal venous timing and identify issues impacting attenuation measurements. RESULTS. After outlier review, analysis included 2777 patients with portal venous phase images. Prevalence of at least moderate steatosis was 13.9% (387/2777). Patients without and with at least moderate steatosis, respectively, had mean postcontrast liver attenuation of 104.5 ± 18.1 (SD) HU and 67.1 ± 18.6 HU (p < .001); a mean difference in postcontrast attenuation between the liver and the spleen (hereafter, postcontrast liver-spleen attenuation difference) of -7.6 ± 16.4 (SD) HU and -31.8 ± 20.3 HU (p < .001); and mean liver enhancement of 49.3 ± 15.9 (SD) HU versus 38.6 ± 13.6 HU (p < .001). Diagnostic performance for the detection of at least moderate steatosis was higher for postcontrast liver attenuation (AUC = 0.938) than for the postcontrast liver-spleen attenuation difference (AUC = 0.832) (p < .001). For detection of at least moderate steatosis, postcontrast liver attenuation had sensitivity and specificity of 77.8% and 93.2%, respectively, at less than 80 HU and 90.5% and 78.4%, respectively, at less than 90 HU; the postcontrast liver-spleen attenuation difference had sensitivity and specificity of 71.4% and 79.3%, respectively, at less than -20 HU and 87.0% and 62.1%, respectively, at less than -10 HU. CONCLUSION. Postcontrast liver attenuation outperformed the postcontrast liver-spleen attenuation difference for detecting at least moderate steatosis in a heterogeneous patient sample, as evaluated using an automated AI tool. Splenic attenuation likely is not needed to assess for at least moderate steatosis on postcontrast images. CLINICAL IMPACT. The technique could promote early detection of clinically significant nonalcoholic fatty liver disease through individualized or large-scale opportunistic evaluation.
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Affiliation(s)
- Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252
| | - Glen M Blake
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom
| | | | | | | | | | - Ahmad Abbas
- Department of Radiology, Barzilai University Medical Center, Ashkelon, Israel
| | - Matthew A Fox
- Nanox-AI, Ltd., Neve Ilan, Israel
- Department of Radiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
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El-Magd ESA, Elgeidie A, Elmahdy Y, El Sorogy M, Elyamany MA, Abulazm IL, Abbas A. Impact of laparoscopic repair on type III/IV giant paraesophageal hernias: a single-center experience. Hernia 2023; 27:1555-1570. [PMID: 37642773 DOI: 10.1007/s10029-023-02851-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/14/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Giant paraesophageal hernia (GPEH) is a challenging problem for surgeons because of its high recurrence rate. This study was conducted to compare the outcomes in type IV vs. type III GPEHs after laparoscopic repair. Other outcomes included peri-operative morbidity and long-term quality of life. METHODS A retrospective analysis of 130 GPEH patients in a period between 2010 and 2019 underwent a tailored laparoscopic repair in our tertiary center with a minimum follow-up of 48 months. Operative steps included hernial sac excision, crural repair, relaxing incisions, and mesh cruroplasty with special indications. RESULTS The study enrolled 90 patients with type III and 40 patients with type IV GPEH. Type IV GPEH patients were older, more fragile, and scored worse on ASA classification, aside from having a more challenging surgical technique (wider crura, weaker muscles, increased need for release incisions, and mesh cruroplasty).Type IV GPEHs had a prolonged operative durations, and a higher conversion rate. Additionally, the same group showed increased morbidity, mortality, and re-operation rates. With a mean follow-up of 65 months (range 48-150 months), the incidence of recurrence was 20.7%, with an increased incidence in type IV GPEH (37.5% vs. 13.33% in type III GPEH). Type IV GPEH, low pre-operative albumin, larger crural defect, and low surgeon experience were significant risk factors for recurrence after laparoscopic repair of GPEH. CONCLUSION Type IV GPEH has a higher peri-operative morbidity and recurrence rate; so, a more tailored laparoscopic repair with a high surgeon experience is needed.
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Affiliation(s)
- E-S A El-Magd
- Faculty of Medicine, Mansoura University, Mansoura, Egypt.
- Department of General Surgery, Faculty of Medicine, Gastrointestinal Surgical Center GISC, Mansoura University, Gehan Street, Mansoura, 35511, Al Dakahlia Governorate, Egypt.
| | - A Elgeidie
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Y Elmahdy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - M El Sorogy
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - M A Elyamany
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - I L Abulazm
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - A Abbas
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Alhalabi M, Alaa Eddin K, Abbas A. Therapeutic effects of biological treatments on AA amyloidosis associated with inflammatory bowel disease: a case report and literature review. Eur J Gastroenterol Hepatol 2023; 35:1298-1305. [PMID: 37724477 DOI: 10.1097/meg.0000000000002649] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
AA amyloidosis is a rare and significant complication of long-term inflammation that can be caused by a variety of disorders, including inflammatory bowel disease, and is linked to an increased risk of morbidity and mortality. To date, there has been no effective direct treatment, and treatment aims at treating the underlying condition with potent immunosuppression to limit inflammatory activity and, as a result, switch off amyloidogenesis. Theoretically, biological treatment can control AA amyloidosis by inducing and maintaining inflammatory bowel disease remission and inhibiting the synthesis of Serum Amyloid A, which is an acute phase reactant and precursor protein of AA amyloidosis that accumulates in the organs. We report the first case of ustekinumab's therapeutic effect after infliximab's loss of response in AA amyloidosis associated with Crohn's disease. We also conducted a literature review of the therapeutic effect of biological treatment on AA amyloidosis.
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Affiliation(s)
- Marouf Alhalabi
- Gastroenterology Department of Damascus Hospital, M.D, Syrian Board in Gastroenterology
| | - Kamal Alaa Eddin
- Gastroenterology Department of Damascus Hospital, M.D, Syrian Board in Gastroenterology
| | - Ahmad Abbas
- Damascus Hospital, Gastroenterology Department of Damascus hospital, M.D, Syrian Board in Gastroenterology
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Abbas A, Jarjees H. EVALUATION THE EFFECT OF THE ADDITION OF ZIRCONIUM OXIDE AND TITANIUM DIOXIDE NANOPARTICLES ON SHEAR BOND STRENGTHS OF ORTHODONTIC ADHESIVE: IN-VITRO STUDY. Georgian Med News 2023:113-121. [PMID: 37805884] [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: 10/09/2023]
Abstract
OBJECTIVES the study aims to assess the shear bond strength of modified- 3M orthodontic adhesive Transbond™ XT with different concentrations of Titanium Dioxide and zirconium oxide nanoparticles. In a retrospective cross-sectional study a hundred sound-extracted human upper premolars were collected. 3M orthodontic adhesive Transbond™ XT was modified by (0,02%, 0.04%, and 0.06% Zirconium Oxide), and (0,02%, 0.04%, and 0.06% Titanium Dioxide) nanoparticles, and (0,02%, 0.04%, and 0.06% Zirconium Oxide and Titanium Dioxide). dentaurum discovery pearl ceramic bracket were bonded to buccal enamel surfaces of the samples of control and nine modified adhesive groups. At 24 h after bonding, shear bond strength was measured. Adhesive remnant index was scored under (10X) magnification power of stereomicroscope after de-bonding. The chemical characteristics of orthodontic adhesive material were explored before and after mixing with Titanium Dioxide and zirconium oxide nanoparticles by using FTIR. (Zirconium Oxide nanoparticles) group and combination (Zirconium Oxide and Titanium Dioxide nanoparticles) had a higher shear bond strength mean value than the control group, 0.06% combination (Zirconium Oxide and Titanium Dioxide nanoparticles) group had the highest mean value. About adhesive remnant index, no significant differences were found among the studying groups. The addition of 0.06% combination (Zirconium Oxide and Titanium Dioxide nanoparticles) had the best performance and improved shear bond strength of 3M orthodontic adhesive Transbond™ XT.
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Affiliation(s)
- A Abbas
- Department of Pedodontic orthodontics and Preventive Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - H Jarjees
- Department of Pedodontic orthodontics and Preventive Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
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Liman HM, Tambuwal SH, Abbas A, Awosan KJ, Udegbunam CE. Clinical Profile and Determinants of Loss to Follow-Up in Patients Enrolled in an Urban Antiretroviral Treatment Programme in Northwestern Nigeria. West Afr J Med 2023; 40:634-639. [PMID: 37390349] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Loss of follow up in patients enrolled on antiretroviral treatment programmes has the potential to reduce their quality of life. We set out to describe the profile and risk factors for loss to follow up in patients enrolled on our programme. MATERIALS AND METHODS In this retrospective study, we reviewed the records of patients who were identified as lost to follow up between August 2008 to July 2018. Determinants of loss to follow-up were identified by the use of binary logistic regression with SPSS to compare the data of patients lost to follow-up with randomly selected patients who were still in care. RESULTS A total of 4,250 patients were enrolled on our programme during the study period. Of these, 965 patients were identified as lost to follow-up, giving a loss to follow up rate of 22.7%. Compared to patients still in care, patients who were lost to follow up were significantly male (male, n =395, 56% versus female, n= 310, 44%, p<0.0001), of younger age (33.53+9.05 versus 34.48+9.25 years, p = 0.028), married (married, n = 669, 58.9% versus not married n = 467, 41.1%, p<0.0001) and with evidence of low crude weight at the time of recruitment (58.58+12.12 versus 60.09+14.58 kg, p = 0.018). CONCLUSION Our study showed that patients who are young, male, married, recently enrolled, with evidence of the low crude weight, with WHO Clinical Stages III and IV and anaemia at enrolment are commonly lost to follow-up. Clinicians need to target this population to reduce the loss of follow up in patients on antiretroviral therapy.
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Affiliation(s)
- H M Liman
- Department of Medicine, College of Health Sciences, Usmanu Danfodiyo University, Sokoto State, Nigeria. Mobile: 08035959280
| | - S H Tambuwal
- Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria
| | - A Abbas
- Department of Medicine, College of Health Sciences, Usmanu Danfodiyo University, Sokoto State, Nigeria. Mobile: 08035959280
| | - K J Awosan
- Department of Community Health, College of Health Sciences, Usmanu Danfodiyo University, Sokoto State, Nigeria
| | - C E Udegbunam
- Department of Family Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria
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Abbas A, Muhammad SA, Ashar A, Mehfooz SA, Rauf A, Bakhsh M, Nadeem T, Fu H. Comparison of the effect of zinc oxide nanoparticles and extract of Acorus calamus applied topically on surgical wounds inflicted on the skin of rabbits. Pol J Vet Sci 2023; 26:285-293. [PMID: 37389426 DOI: 10.24425/pjvs.2023.145035] [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] [Indexed: 07/01/2023]
Abstract
Antibiotics are used for postsurgical wound healing purposes but unfortunately, resistance against them demands some alternatives for quick recovery. Sepsis of wounds is a challenge for medical as well as veterinary professionals. Nanoparticles have significant advantages in wound treatment and drug resistance reversal. This study was conducted to appreciate emerging alternates of antibiotics like zinc oxide nanoparticles and plant extracts in topical application. Zinc oxide is considered a good wound healer and its nanoparticles are easy to access. So, the efficacies of zinc oxide nanoparticles and sweet flag plant extract ointments were tested to compare modern and traditional therapeutics as sweet flag is considered a pure medicinal plant. Rabbits were selected for this study due to the healing properties of their skin. Wounds were inflicted on the thoracolumbar region and treated for 29 days post-surgically daily with normal saline and the ointment of zinc oxide nanoparticles and sweet flag extract ointment, prepared in a hydrophilic solvent. Wound shrinkage was observed daily and histopathological analysis was made and results were compared. Zinc oxide nanoparticles ointment showed the most satisfactory results for every parameter included in the study. No side effects of its topical application were observed. Healing was normal without any complications. The preparations of zinc oxide nanoparticles may help in the era of antibiotic resistance as topical drugs in the future.
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Affiliation(s)
- A Abbas
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38000, Pakistan
| | - S A Muhammad
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - A Ashar
- Wilson College of Textiles, North Carolina State University, North Carolina, USA
| | - S A Mehfooz
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38000, Pakistan
| | - A Rauf
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - M Bakhsh
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - T Nadeem
- University of Veterinary and Animal Sciences, Lahore, Para Veterinary Institute (PVI), Karor 31100, Layyah, Pakistan
| | - H Fu
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
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Ramakrishnan S, Abbas A, Jordan N. Removal of breast implants as primary treatment for autoimmune/inflammatory syndrome induced by adjuvants. Scand J Rheumatol 2023; 52:219-220. [PMID: 36178439 DOI: 10.1080/03009742.2022.2114187] [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: 10/14/2022]
Affiliation(s)
- S Ramakrishnan
- Department of Medicine, Wirral University Teaching Hospital NHS Foundation Trust, Upton, UK
| | - A Abbas
- Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - N Jordan
- Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Fady M, Rizwana H, Alarjani KM, Alghamdi MA, Ibrahim SS, Geyer J, Abbas A. Evaluation of antibiofilm and cytotoxicity effect of Rumex vesicarius methanol extract. OPEN CHEM 2023. [DOI: 10.1515/chem-2022-0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Abstract
Background
Bacterial resistant to antibiotics represents an obstacle in medication management in hospitals. Biofilm can be easily formed by bacteria in indwelling medical devices. By increasing numbers of patients using indwelling medical devices, we have to find an effective antibiofilm for the eradication of biofilm-associated infections.
Methods
The present study was designed to evaluate the antibiofilm and cytotoxicity effect of methanol extract of Rumex vesicarius L. leaves (Polygonaceae). Antibacterial and antibiofilm assays were investigated in this study against different standard and pathogenic bacteria isolates from endotracheal tubes in intensive care units (Staphylococcus aureus, Staphylococcus epidermidis, Proteus vulgaris, Klebsiella pneumoniae, and Pseudomonas aeruginosa). Scanning electron microscopy was used to demonstrate the reduction of biofilm formation using methanol extract of R. vesicarius. Also, cytotoxicity of R. vesicarius L. was evaluated by using the lactate dehydrogenase assay.
Results
R. vesicarius displayed a broad spectrum and antibacterial activity against the tested organisms. The minimal inhibitory concentration of the methanol extract was 62.5–125 mg/mL for gram positive while in case of gram negative, it was 125–250 mg/mL. While the result in case of minimal bactericidal concentration was 250–500 mg/mL in case of gram positive and was 500–1,000 mg/mL in case of gram negative.
Conclusion
Our results recommend usage of R. vesicarius as a promising antibiofilm to combat infection in indwelling medical devices.
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Affiliation(s)
- Marwa Fady
- Zagazig University Hospitals, Infection Control Unit , Zagazig , 44519 , Egypt
- Department of Microbiology and Immunology, Modern University for Technology & Information, Pharmacy College , Cairo , Egypt
| | - Humaira Rizwana
- Department of Botany and Microbiology, College of Science, King Saud University , Riyadh 11451 , Saudi Arabia
| | - Khaloud Mohammed Alarjani
- Department of Botany and Microbiology, College of Science, King Saud University , Riyadh 11451 , Saudi Arabia
| | - Mai Ahmed Alghamdi
- Department of Botany and Microbiology, College of Science, King Saud University , Riyadh 11451 , Saudi Arabia
| | - Shebl Salah Ibrahim
- Department of Biochemistry, King Saud University, College of Science , Riyadh 11451 Saudi Arabia
| | - Jessica Geyer
- Department of Biology, University of Dayton , Dayton , OH 45469 , USA
| | - Ahmad Abbas
- Chest Department, Zagazig University , 44519 , Zagazig , Egypt
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Kandula UR, Tuji TS, Gudeta DB, Bulbula KL, Mohammad AA, Wari KD, Abbas A. Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review. J Blood Med 2023; 14:159-187. [PMID: 36855559 PMCID: PMC9968437 DOI: 10.2147/jbm.s397722] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Worldwide pandemic with coronavirus disease-2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As November 2, 2022, World Health Organization (WHO) received 628,035,553 reported incidents on COVID-19, with 6,572,800 mortalities and, with a total 12,850,970,971 vaccine doses have been delivered as of October 31, 2022. The infection can cause mild or self-limiting symptoms of pulmonary and severe infections or death may be caused by SARS-CoV-2 infection. Simultaneously, antivirals, corticosteroids, immunological treatments, antibiotics, and anticoagulants have been proposed as potential medicines to cure COVID-19 affected patients. Among these initial treatments, COVID-19 convalescent plasma (CCP), which was retrieved from COVID-19 recovered patients to be used as passive immune therapy, in which antibodies from cured patients were given to infected patients to prevent illness. Such treatment has yielded the best results in earlier with preventative or early stages of illness. Convalescent plasma (CP) is the first treatment available when infectious disease initially appears, although few randomized controlled trials (RCTs) were conducted to evaluate its effectiveness. The historical record suggests with potential benefit for other respiratory infections, as coronaviruses like Severe Acute Respiratory Syndrome-CoV-I (SARS-CoV-I) and Middle Eastern Respiratory Syndrome (MERS), though the analysis of such research is constrained by some non-randomized experiments (NREs). Rigorous studies on CP are made more demanding by the following with the immediacy of the epidemics, CP use may restrict the ability to utilize it for clinical testing, non-homogenous nature of product, highly decentralized manufacturing process; constraints with capacity to measure biologic function, ultimate availability of substitute therapies, as antivirals, purified immune globulins, or monoclonal antibodies. Though, it is still not clear how effectively CCP works among hospitalized COVID-19 patients. The current review tries to focus on its efficiency and usage in clinical scenarios and identifying existing benefits of implementation during pandemic or how it may assist with future pandemic preventions.
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Affiliation(s)
- Usha Rani Kandula
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Techane Sisay Tuji
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | | | - Kassech Leta Bulbula
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | | | - Ketema Diriba Wari
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Ahmad Abbas
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
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Al-Otaibi T, Abbas A, Ashry Gheith O, Nair P, Zahab MA, Hammouda MAA, Farid MM, Aljowaie RM, AlKubaisi NA, Mohamed EF, Abassi AM, Eisa YH. Determinants, predictors and negative impacts of burnout among health care workers during COVID-19 pandemic. J King Saud Univ Sci 2023; 35:102441. [PMID: 36405649 PMCID: PMC9650511 DOI: 10.1016/j.jksus.2022.102441] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/24/2022] [Accepted: 11/07/2022] [Indexed: 05/28/2023]
Abstract
The first defense line of the battle, healthcare workers (HCWs), faces a significant challenge in managing the current COVID-19 pandemic. An online electronic survey was sent to HCWs via email and social media networks. Socio-demographic data and work environment-related variables were assessed. Consequences of burnout (BO) were reported, e.g., elicited medical errors. Maslach burnout inventory was used to diagnose BO. Two hundred and eighty-four participants were included with a mean age of 39.83 ± 7.34 years, 70.8% worked in the COVID-19 frontline, 91.9% were followed daily updates about COVID-19, 63.7% were not satisfied with the coordination between triage and isolation, 64.4% got COVID-19 infection, 91.9% had a colleague or family member developed COVID-19 infection, and 21.5% experienced a colleague /a family member died due to COVID-19. Multivariate analysis by linear regression revealed that; working as a frontline HCW (OR 1.28, CI = 0.14-2.55) and sleep deprivation (OR 3.93, CI = 1.88-8.22) were the predictors of burnout.
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Affiliation(s)
- Torki Al-Otaibi
- The Nephrology Department, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah Area, Kuwait
| | - Ahmad Abbas
- The Nephrology Department, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah Area, Kuwait
- Chest Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Osama Ashry Gheith
- The Nephrology Department, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah Area, Kuwait
- Department of Dialysis and Transplantation, Urology Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Prasad Nair
- The Nephrology Department, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah Area, Kuwait
| | - Mohamed A Zahab
- The Nephrology Department, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah Area, Kuwait
| | - Mryhan A A Hammouda
- Lecturer of Industrial Medicine and Occupational Health, Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mahmoud M Farid
- Clinical Pathology Specialist, National Blood Transfusion Services, Egypt
- Health Care Management Consultant, Technical Office, MOH, Kuwait
| | - Reem M Aljowaie
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh 11451, Saudi Arabia
| | - Noorah A AlKubaisi
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh 11451, Saudi Arabia
| | | | - Arshad Mehmood Abassi
- Department of Environmental Sciences, COMSATS University Islamabad, Abbottabad Campus, 22060, Pakistan
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, 12042 Pollenzo, Italy
| | - Yasmine H Eisa
- Community Medicine Department, Public Health and Preventive Medicine, Faculty of Medicine October 6 University, Giza, Egypt
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Al-Otaibi T, Abbas A, Nagib AM, Gheith OA, Nair P, Farid MM, Albader MAS. COVID-somnia: anxiety, insomnia, and poor sleep among second-line healthcare workers during COVID-19 pandemic. Egypt J Bronchol 2022. [PMCID: PMC9368694 DOI: 10.1186/s43168-022-00143-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Little information is available about the linkage between sleep affection and COVID-19. Preliminary reports and clinical observations focused on the appearance of related mental health issues, especially in healthcare workers (HCWs).
Methods
A cross-sectional study is conducted on the COVID-19 second-line HCWs using an English online survey prepared via Google forms. The survey focused on sociodemographic and profession-related characteristics (age, sex, smoking, history of previous sleep disorders or medications affecting sleep, comorbidities specialty, years of experience, and number of hours worked per week) and COVID-19-associated risks (being on the second line of COVID-19 management, following updates and news about COVID-19, and getting an infection with COVID-19 or having a colleague/friend who was infected with or died of COVID-19). Assessment of anxiety, insomnia, and sleep quality was done using the relevant diagnostic scales.
Results
This study included 162 second-line HCWs with a mean age of 34.36 ± 8.49 years. Although being in second lines, there was a high prevalence of anxiety (49.38%), insomnia (56.17%), and poor sleep quality (67.9%) during the pandemic. One condition was recently developed after the pandemic: insomnia in 6.6%, anxiety in 5.7%, and poor sleep in 16%. Two conditions were developed: insomnia and poor sleep in 21.7%, anxiety and poor sleep in 7.5%, and insomnia and anxiety in 10.4%. The three conditions were de novo experienced in 19.8%. A total of 22.4% of those who followed daily COVID-19 updates developed de novo combined anxiety, insomnia, and poor sleep. A total of 38.5% of participants that had been infected with COVID-19 developed de novo combined anxiety, insomnia, and poor sleep. A total of 50% of participants who had a colleague/friend who died with COVID-19 developed de novo combined anxiety, insomnia, and poor sleep.
Conclusion
Although being in second lines, there was a high prevalence of anxiety, depression, and poor sleep concerning COVID-19-related factors.
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Alhalabi M, Ali Deeb S, Ali F, Abbas A. Ulcerative colitis-associated bronchiectasis: A rare extraintestinal manifestation of inflammatory bowel disease: A case report. Medicine (Baltimore) 2022; 101:e30202. [PMID: 36042661 PMCID: PMC9410614 DOI: 10.1097/md.0000000000030203] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Inflammatory bowel disease patients may suffer from extraintestinal manifestations. Although muscles, joints, and skin are the most commonly affected, respiratory involvement is more prevalent than previously believed, and the majority of these patients have no symptoms. Although the large airways are the most frequently affected, the small airways, lung parenchyma, and pulmonary vasculature may also be affected. PATIENT CONCERNS A 24-year-old nonsmoking Syrian female was referred to the pulmonary medicine clinic in December 2020 due to a chronic cough. Her cough had been present for the last year, it was described as scratchy, and produced small amounts of mucoid sputum occasionally. She denied any related wheeze, hemoptysis, weight loss, or night sweats. Multiple courses of antibiotics were prescribed by many doctors, also previous chest radiographs were reported as normal. She was diagnosed with ulcerative colitis in 2012 after presentation with abdominal pain and per rectal bleeding. The diagnosis was confirmed via colonoscopy and colon biopsies, with no prior surgery. Her past medications included prednisone, mesalamine, azathioprine, and infliximab. Tests, including complete blood count, C-reactive protein (CRP), fecal calprotectin, and chest X-ray, were normal. DIAGNOSIS Ulcerative colitis-associated bronchiectasis was established through history and clinical examination beside pulmonary function test, which revealed a mild obstructive pattern, and a chest computed tomography follow-up that revealed bilateral bronchiectasis. INTERVENTIONS Bronchiectasis was treated with inhaled oral steroids and sputum expectoration while she continued mesalamine and azathioprine for ulcerative colitis. OUTCOME Cough improvement and sustained ulcerative colitis remission. CONCLUSIONS Identification of inflammatory bowel disease pulmonary exacerbation is probably poor, as pulmonary symptoms might emerge at any moment during the illness, and are most commonly diagnosed later in life and with the disassociation of inflammatory bowel disease activity. Pulmonologists should be involved in the care of inflammatory bowel disease patients who developed lung symptoms.
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Affiliation(s)
- Marouf Alhalabi
- Gastroenterology department of Damascus hospital, Damascus, Syria
- *Correspondence: Marouf Alhalabi, Damascus, Almujtahed Street, Damascus Hospital (e-mail: )
| | - Sawsan Ali Deeb
- Gastroenterology department of Damascus hospital, Damascus, Syria
| | - Fadwa Ali
- Gastroenterology department of Damascus hospital, Damascus, Syria
| | - Ahmad Abbas
- Gastroenterology department of Damascus hospital, Damascus, Syria
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Patel A, Abbas A, Bhattacharyya R, Galaktionova D. Appendiceal diverticulum masquerading as acute appendicitis. J Surg Case Rep 2022; 2022:rjac248. [PMID: 35665397 PMCID: PMC9156021 DOI: 10.1093/jscr/rjac248] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/07/2022] [Indexed: 11/14/2022] Open
Abstract
Appendiceal diverticula present as rare clinical finding and are most confused with acute appendicitis. A 65-year-old female was presented to our surgical service after 1 day of right lower quadrant abdominal pain and a computed tomography evaluation, read as a diagnosis of acute appendicitis. Due to the location and quality of pain and intraoperative findings acute appendicitis was our preliminary diagnosis. Follow up with histopathology confirmed acute inflammation of an appendiceal diverticulum. With discordance in original diagnosis from final pathological evaluation, we suggest appendiceal diverticula as an important differential to consider in patients of similar clinical presentation. Surgical treatment with appendectomy and final histological diagnosis are essential in the proper treatment of this rare clinical finding.
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Affiliation(s)
- A Patel
- School of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - A Abbas
- School of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - R Bhattacharyya
- St. Joseph's University Medical Center, Department of Surgery, Paterson, NJ, USA
| | - D Galaktionova
- St. Joseph's University Medical Center, Department of Surgery, Paterson, NJ, USA
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16
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Wall SL, Velin L, Abbas A, Allorto NL, Graner M, Moeller E, Ryan-Coker MFD, Pompermaier L. Who tells the story of burns in low-and-middle income countries? – A bibliometric study. Burns 2022; 49:854-860. [PMID: 35787966 DOI: 10.1016/j.burns.2022.06.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/12/2022] [Accepted: 06/01/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Low- and middle-income countries (LMICs) remain drastically underrepresented in health research, with African countries producing less than 1% of the global output. This work investigates authorship patterns of publications on burns in LMICs. Original research studies addressing burn injuries in LMICs and published between 1st January 2015 and 31st December 2020 were included in the review. Descriptive statistics were performed for country affiliations of authors, World Bank Country Income Groups, WHO group, study-focus and country studied. Of the 458 results, 426 studies met the inclusion criteria. Nearly a quarter of papers on burns in LMICs had both first and senior authors from high-income countries (HICs, n = 95, 24.4%), more than half of the papers had both first and senior authors from upper middle- income countries (upper MICs, n = 222, 57.2%), while less than 1% (n = 3) had first and senior authors exclusively from lower-income countries (LICs). Eleven percent (n = 41/388) of all papers were written without either first nor senior author being from the country studied, and 17 of them (41%) had both first and senior authors from the USA. Twenty-five (6%) of the papers had the first author and not the senior author from the country of focus, while six (2%) had the senior and not the first author from the country of interest. To overcome global health challenges such as burns, locally led research is imperative. The maximum benefit of HIC-LMIC collaborations is achieved when LMICs play an active role in leading the research. When LMICs direct the research being conducted in their country, the harm of inherently inequitable relationships is minimized.
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Affiliation(s)
- S L Wall
- School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa; Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa; Developing Research, Innovation, Localization and Leadership (DRILL), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - L Velin
- Centre for Teaching & Research in Disaster Medicine and Traumatology (KMC), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - A Abbas
- The Aga Khan University, Pakistan
| | - N L Allorto
- School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa; Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - M Graner
- School of Medicine, University of Sāo Paulo, Sāo Paulo, Brazil
| | - E Moeller
- Department of Surgery, Oregon Health and Science University, United States
| | - M F D Ryan-Coker
- Department of Surgery, Faculty of Health Sciences, University of Nairobi, Kenya
| | - L Pompermaier
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping University, Sweden; Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
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Ashry Ahmed Gheith O, Maher Nagib A, Elserwy N, Abbas A, Elsawi IS, Nair P, Khalid M, Hammad M, Fayyad Z, Atta A, Mostafa A, Deraz A, Abdelmonem M, Alotaibi T. MO297: Acute Kidney Injury Among COVID-19 Positive Patients is Associated With Higher Mortality: Single Center Experience. Nephrol Dial Transplant 2022. [PMCID: PMC9383933 DOI: 10.1093/ndt/gfac068.007] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Despite the lungs are the major targets of COVID-19, other organs such as the kidneys are also affected. Renal complications of COVID-19 are not yet well studied. We aimed to study the prevalence of acute kidney injury (AKI) among positive COVID-19 cases that were managed in the intensive care unit (ICU) in a single isolation hospital during the pandemic, and to explore its impact on patient outcome.
METHOD
This retrospective study included 616 patients with COVID-19 who were managed in the ICU in a single isolation hospital in Kuwait during the pandemic, from February to December 2020. AKI was defined according to the serum creatinine criteria in the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Of the 616 patients, 40.2% developed AKI (group 1, n = 248) and were compared with the patients without AKI (group 2, n = 368).
RESULTS
Most of cases in the two groups were males (73% versus 70.7%), aged (60.8 ± 14 versus 51.7 ± 16 years), respectively. The two groups were comparable regarding chronic kidney disease (2% versus 0.8%) and chronic pulmonary disease. Other factors were significantly predominating among group 1 as diabetes mellitus (63.7 versus 40.5%), hypertension (74.2% versus 40.5%) and ischemic heart disease (26.2% versus 12.5%) (P < .05).
Fever, cough, shortness of breath and dehydration were significantly more frequent presentations among patients of group 1, and had radiological findings that were synchronized with COVID-19 (89.5% versus 50.8%) (P < .05). Moreover, sepsis, volume depletion, shock, arrhythmias and ARDS predominated among the AKI group (P < .05). The number of cases who were managed by therapeutic anticoagulation was significantly higher in AKI patients (89.9% versus 51.9%); also, cases who received supportive vasopressors and convalescent plasma transfusion as well as steroid were significantly higher in the same group (P < .05). Other therapeutic modalities such as antivirals, tocilizumab and hydroxychloroquine were comparable in both groups.
We found that acute respiratory failure requiring mechanical ventilation was significant among the AKI group (66.8% versus 29.4%), and the overall mortality rate was significantly higher in the same group (62.5% versus 32.8%).
CONCLUSION
The prevalence of AKI in patients with COVID-19 was 40.2%, and it was associated with poor prognosis among ICU COVID-19 positive cases.
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Affiliation(s)
| | - Ayman Maher Nagib
- Nephrology, Mansoura University, Mansoura, Egypt
- Nephrology, OTC kuwaitFf, Kuwait
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18
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Ajjan RA, Hensor EMA, Del Galdo F, Shams K, Abbas A, Fairclough RJ, Webber L, Pegg L, Freeman A, Taylor AE, Arlt W, Morgan AW, Tahrani AA, Stewart PM, Russell DA, Tiganescu A. Oral 11β-HSD1 inhibitor AZD4017 improves wound healing and skin integrity in adults with type 2 diabetes mellitus: a pilot randomized controlled trial. Eur J Endocrinol 2022; 186:441-455. [PMID: 35113805 PMCID: PMC8942338 DOI: 10.1530/eje-21-1197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/03/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic wounds (e.g. diabetic foot ulcers) reduce the quality of life, yet treatments remain limited. Glucocorticoids (activated by the enzyme 11β-hydroxysteroid dehydrogenase type 1, 11β-HSD1) impair wound healing. OBJECTIVES Efficacy, safety, and feasibility of 11β-HSD1 inhibition for skin function and wound healing. DESIGN Investigator-initiated, double-blind, randomized, placebo-controlled, parallel-group phase 2b pilot trial. METHODS Single-center secondary care setting. Adults with type 2 diabetes mellitus without foot ulcers were administered 400 mg oral 11β-HSD1 inhibitor AZD4017 (n = 14) or placebo (n = 14) bi-daily for 35 days. Participants underwent 3-mm full-thickness punch skin biopsies at baseline and on day 28; wound healing was monitored after 2 and 7 days. Computer-generated 1:1 randomization was pharmacy-administered. Analysis was descriptive and focused on CI estimation. Of the 36 participants screened, 28 were randomized. RESULTS Exploratory proof-of-concept efficacy analysis suggested AZD4017 did not inhibit 24-h ex vivoskin 11β-HSD1 activity (primary outcome; difference in percentage conversion per 24 h 1.1% (90% CI: -3.4 to 5.5) but reduced systemic 11β-HSD1 activity by 87% (69-104%). Wound diameter was 34% (7-63%) smaller with AZD4017 at day 2, and 48% (12-85%) smaller after repeat wounding at day 30. AZD4017 improved epidermal integrity but modestly impaired barrier function. Minimal adverse events were comparable to placebo. Recruitment rate, retention, and data completeness were 2.9/month, 27/28, and 95.3%, respectively. CONCLUSION A phase 2 trial is feasible, and preliminary proof-of-concept data suggests AZD4017 warrants further investigation in conditions of delayed healing, for example in diabetic foot ulcers. SIGNIFICANCE STATEMENT Stress hormone activation by the enzyme 11β-HSD type 1 impairs skin function (e.g. integrity) and delays wound healing in animal models of diabetes, but effects in human skin were previously unknown. Skin function was evaluated in response to treatment with a 11β-HSD type 1 inhibitor (AZD4017), or placebo, in people with type 2 diabetes. Importantly, AZD4017 was safe and well tolerated. This first-in-human randomized, controlled, clinical trial found novel evidence that 11β-HSD type 1 regulates skin function in humans, including improved wound healing, epidermal integrity, and increased water loss. Results warrant further studies in conditions of impaired wound healing, for example, diabetic foot ulcers to evaluate 11β-HSD type 1 as a novel therapeutic target forchronic wounds.
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Affiliation(s)
- R A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - E M A Hensor
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - F Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - K Shams
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - A Abbas
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - R J Fairclough
- Emerging Innovations Unit, Discovery Sciences, BioPharmaceuticals R&D
| | - L Webber
- Emerging Portfolio Development, Late Oncology, Oncology R&D, AstraZeneca, Cambridge, UK
| | - L Pegg
- Emerging Portfolio Development, Late Oncology, Oncology R&D, AstraZeneca, Cambridge, UK
| | - A Freeman
- Emerging Innovations Unit, Discovery Sciences, BioPharmaceuticals R&D
| | - A E Taylor
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - W Arlt
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A W Morgan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - A A Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - P M Stewart
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - D A Russell
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Tiganescu
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Center, Leeds Teaching Hospitals, NHS Trust, Leeds, UK
- Correspondence should be addressed to A Tiganescu;
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Redding LE, Tu V, Abbas A, Alvarez M, Zackular JP, Gu C, Bushman FD, Kelly DJ, Barnhart D, Lee JJ, Bittinger KL. Genetic and phenotypic characteristics of Clostridium (Clostridioides) difficile from canine, bovine, and pediatric populations. Anaerobe 2022; 74:102539. [PMID: 35217150 PMCID: PMC9359814 DOI: 10.1016/j.anaerobe.2022.102539] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives: Carriage of Clostridioides difficile by different species of animals has led to speculation that animals could represent a reservoir of this pathogen for human infections. The objective of this study was to compare C. difficile isolates from humans, dogs, and cattle from a restricted geographic area. Methods: C. difficile isolates from 36 dogs and 15 dairy calves underwent whole genome sequencing, and phenotypic assays assessing growth and virulence were performed. Genomes of animal-derived isolates were compared to 29 genomes of isolates from a pediatric population as well as 44 reference genomes. Results: Growth rates and relative cytotoxicity of isolates were significantly higher and lower, respectively, in bovine-derived isolates compared to pediatric- and canine-derived isolates. Analysis of core genes showed clustering by host species, though in a few cases, human strains co-clustered with canine or bovine strains, suggesting possible interspecies transmission. Geographic differences (e.g., farm, litter) were small compared to differences between species. In an analysis of accessory genes, the total number of genes in each genome varied between host species, with 6.7% of functional orthologs differentially present/absent between host species and bovine-derived strains having the lowest number of genes. Canine-derived isolates were most likely to be non-toxigenic and more likely to carry phages. A targeted study of episomes identified in local pediatric strains showed sharing of a methicillin-resistance plasmid with dogs, and historic sharing of a wide range of episomes across hosts. Bovine-derived isolates harbored the widest variety of antibiotic-resistance genes, followed by canine Conclusions: While C. difficile isolates mostly clustered by host species, occasional co-clustering of canine and pediatric-derived isolates suggests the possibility of interspecies transmission. The presence of a pool of resistance genes in animal-derived isolates with the potential to appear in humans given sufficient pressure from antibiotic use warrants concern.
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Affiliation(s)
- L E Redding
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA.
| | - V Tu
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - A Abbas
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - M Alvarez
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - J P Zackular
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - C Gu
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - F D Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D J Kelly
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - D Barnhart
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - J J Lee
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - K L Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
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20
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Abstract
Background The challenge in treating severe COVID-19 in the absence of targeted medication is enforcing physicians to search carefully for clinical predictors of severity. Aim To define the profile of patients at risk of severe COVID-19 and to assess for certain predictors. Methods Confirmed COVID-19 cases were classified into the following: group A: mild/moderate cases and group B: severe/critical cases according to the selected criteria. History, radiological assessment, complete blood count, lactate dehydrogenase (LDH), myocardial enzymes, serum ferritin, and D dimer were assessed. Patients were followed for the need of ICU and mechanical ventilation. Duration till conversion, length of stay, and mortality were recorded. Results A total of 202 patients were analyzed. Group B had higher age (53.2 ± 12.6 vs 40.3 ± 10.3, P < 0.001), more prevalence of DM (60.61% vs 16.57% P < 0.001), hypertension (51.52% vs 20.12%, P < 0.001), ischemic heart (27.27% vs 3.55%, P < 0.001), bronchial asthma (36.36% vs 3.55%, P < 0.001), COPD (9.09% vs 1.18%, P = 0.03), higher mean platelet volume (MPV) (12.76 ± 7.13 vs 10.51 ± 7.78 (fL), P < 0.001), higher serum ferritin (954 ± 138 vs 447 ± 166 ng/ml, P < 0.001), higher LDH (604 ± 220 vs 384 ± 183 U/L, P-value < 0.001), higher creatine phosphokinase (24.27 ± 5.82 vs 16.4 ± 4.87 IU/L, P < 0.001), and higher mortality (30.3% vs 0.6%, P < 0.001). Multivariate regression of predictors of severity identified three predictors; age, MPV, serum ferritin, and IHD. Conclusions The current study places of interest the characteristic host-related features of severe COVID-19 and draws attention to potential predictors.
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Alhalabi M, Eddin KA, Ali F, Abbas A. SARS-CoV-2 (COVID-19) pneumonia patient treated with two doses of infliximab within 2 weeks for acute severe ulcerative colitis: A case report. Medicine (Baltimore) 2022; 101:e28722. [PMID: 35089243 PMCID: PMC8797526 DOI: 10.1097/md.0000000000028722] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 02/07/2023] Open
Abstract
RATIONALE The ongoing coronavirus pandemic has caused severe acute respiratory syndrome, posing a significant challenge for patients receiving immunotherapy for immune-mediated inflammatory diseases. As of January 2022, immunosuppressants such as tumor necrosis factor inhibitors (anti-TNFα) and azathioprine are inadvisable for an infectious disease caused by the SARS-CoV-2 virus (COVID-19). We continued infliximab as a second induction dose nine days after the onset of COVID-19 symptoms in a patient with acute severe ulcerative colitis. PATIENT CONCERNS We report the case of a 34-year-old male with 6 to 8 times bloody diarrhea, fever, and cramping abdominal pain. Ulcerative colitis was diagnosed 6 months earlier and treated with mesalamine 80 mg/kg/day and azathioprine 2.5 mg/kg/day. The patient had never undergone surgery before. Sigmoidoscopy revealed multiple ulcerations and spontaneous bleeding, and the colon samples tested negative for cytomegalovirus and Clostridium difficile. However, intravenous corticosteroids did not induce remission. A nasopharyngeal swab tested positive for SARS-CoV-2. DIAGNOSIS Acute severe ulcerative colitis and SARS-CoV-2 (COVID-19) pneumonia. INTERVENTIONS The second loading dose of infliximab was administered nine days after the diagnosis of COVID-19. OUTCOME The patient completed infliximab induction at a dose of 5 mg/kg at weeks 0, 2, and 6, with no complications. LESSONS It is unclear whether anti-TNF-α treatment improves or deteriorates COVID-19 patient outcomes, and this case demonstrates that infliximab can be used safely. Current guidelines make a weak recommendation to avoid using anti-TNFα agents in the presence of acute COVID-19 infection. There is an urgent need for research on biologics therapy.
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Ramirez J, Jones C, Gourbault L, Hurst W, Abbas A, Zucker B, Shah M, Scroggie D. 1158 Summarising the Reporting of Study Outcomes in Robotic Oesophagectomy: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
There is an increasing adoption of robotic oesophagectomy in place of standard techniques for oesophageal cancer resection. This is potentially due to its perceived technical benefits and improved short-term outcomes. Consistency in outcome selection, definition and reporting between studies is required for effective evidence synthesis and prevention of research waste. The aim of this review is to perform an in-depth analysis of outcome reporting in robotic oesophagectomy.
Method
Systematic searches were conducted using key words for robotic surgery and oesophageal cancer, from inception to February 2020. Studies reporting any outcome for robotic oesophagectomy were included. Outcomes in each study were recorded verbatim and categorised into twelve domains. Outcomes were independently categorised by two reviewers. Where reported, the follow-up period was also recorded.
Results
Of 954 abstracts screened, 226 full texts were reviewed and 102 included. Only one study was a RCT. A total of 1422 outcomes were reported. Each study had a median of 14 reported outcomes (range 1-25). Outcomes related to complications (n = 578, 99 studies), technical/operative factors (n = 290, 90 studies), and pathology (e.g., resection margin) (n = 197, 83 studies) were reported most frequently. No single outcome, or outcome domain was reported in all studies. No studies used a core outcome set for reporting. Forty-five studies stated a follow-up period, ranging from <1 month to 58 months.
Conclusions
There is significant heterogeneity in the selection and reporting of outcomes in robotic oesophagectomy. This calls for the use of a core outcome set to allow standardisation and transparency of outcome reporting.
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Affiliation(s)
- J Ramirez
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - C Jones
- University of Bristol, Bristol, United Kingdom
- North Bristol NHS Trust, Bristol, United Kingdom
| | - L Gourbault
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - W Hurst
- North Bristol NHS Trust, Bristol, United Kingdom
| | - A Abbas
- University of Bristol, Bristol, United Kingdom
| | - B Zucker
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - M Shah
- University of Bristol, Bristol, United Kingdom
| | - D Scroggie
- University of Bristol, Bristol, United Kingdom
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Alhalabi M, Eddin KA, Cheha K, Abbas A. Subcutaneous golimumab induced and maintained clinical response in a child with a biological-experienced steroid-refractory flare of ulcerative colitis: A case report. Medicine (Baltimore) 2021; 100:e27283. [PMID: 34559136 PMCID: PMC8462589 DOI: 10.1097/md.0000000000027283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/20/2021] [Accepted: 09/02/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Golimumab is a fully human antitumor necrosis monoclonal antibody that can be administered by either subcutaneous injection or intravenous infusion. Golimumab is approved for the treatment of the adults with rheumatic diseases, and ulcerative colitis, Whereas in children, golimumab is indicated only for the treatment of active polyarticular juvenile idiopathic arthritis. We have written on the off-label use of subcutaneous golimumab, which helped to induce and maintain remission on a low-weight biologically experienced child with steroid-refractory ulcerative colitis flare. PATIENT CONCERNS A 13-year-old pancolitis Syrian boy presented with abdominal pain and six to seven times bloody diarrhea. The child had treated with mesalamine 80 mg/kg/day, azathioprine 2.5 mg/kg/day, infliximab with an induction dose of 5 mg/kg at weeks 0, 2, and 6 followed by 5 mg/kg every 8 weeks. Infliximab did not maintain remission as the patient suffered from two flares that required hospital admission, intravenous corticosteroids, and infliximab escalation. Initial tests disclosed leukocytosis, anemia, hypoalbuminemia, an elevation in C-reactive protein and fecal calprotectin. All Stool studies were negative including routine stool cultures, Clostridium difficile toxin, Escherichia coli O157:H7, Cryptosporidium, and microscopy for ova and parasites. A sigmoidoscopy revealed multiple large ulcerations and spontaneous bleeding, colon biopsies were negative for Clostridium difficile and Cytomegalovirus. Cyclosporine, tacrolimus, and adalimumab were unavailable in Syria. Child's parents opposed colectomy as a treatment option. DIAGNOSIS Ulcerative colitis flare. INTERVENTIONS A subcutaneous golimumab with a loading dose of 200 mg at week 0, followed by 100 mg at week 2, then 50 mg every 4 weeks. OUTCOMES The patient achieved clinical remission by week sixth and maintained the remission for the next 90 weeks. At the time of last evaluation, tests, including C-reactive protein and fecal calprotectin, were within normal limits, complete colonoscopy revealed erythema, edema, mucosal friability, loss of vascular patterns, and pseudo-polyps. The Pediatric Ulcerative Colitis Activity Index and Mayo scores were 5 and 2 points, respectively. No adverse events were documented. CONCLUSION Golimumab has shown potential efficacy and safety in the treatment of ulcerative colitis in children which may indicate a significant future role for subcutaneous golimumab in pediatrics ulcerative colitis.
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Yi X, Rehman A, Akhtar R, Abbas A, Hussain K, Yasin R, Ishaq H, Abbas R, Raza M, Hu H, Li G. Effects on egg production and quality of supplementing drinking water with calcium and magnesium. S AFR J ANIM SCI 2021. [DOI: 10.4314/sajas.v51i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to appraise the effects on egg quality and production performance of laying hens when drinking water was supplemented with calcium (Ca) and magnesium (Mg). A total of 384 (64-week-old) Hy-line Brown laying hens were assigned at random to four treatments, which consisted of CON: unsupplemented drinking water; T1: drinking water + 2 mg/L Ca + 250 mg/L Mg; T2: drinking water + 4 mg/L Ca + 510 mg/L Mg /10 L; and T3: drinking water + 5 mg/L Ca and 760 mg/L Mg. The experiment lasted six weeks. Water intake increased linearly in week 1 with the rising levels of Ca and Mg in the drinking water. Increasing the Ca and Mg levels improved eggshell strength (week 2 (P =0.01), week 5 (P =0.01), and week 6 (P = 0.03), and eggshell thickness (week 6) (P =0.02) and reduced the rate at which eggs were broken (week 4) (P =0.01). The supplemental Ca and Mg did not affect egg production, egg weight, Haugh unit, albumen height, eggshell colour, and yolk colour compared with CON. Nor did they influence the Haugh unit and albumen height after storing for 1, 5, 10 and 15 days. In conclusion, adding Ca and Mg to the drinking water increased the thickness and strength of the eggshells.
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Abdul-Maksoud RS, Rashad NM, Elsayed WSH, Elsayed RS, Sherif MM, Abbas A, El Shabrawy M. The diagnostic significance of circulating lncRNA ADAMTS9-AS2 tumor biomarker in non-small cell lung cancer among the Egyptian population. J Gene Med 2021; 23:e3381. [PMID: 34312940 DOI: 10.1002/jgm.3381] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/18/2021] [Revised: 06/29/2021] [Accepted: 07/19/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Long non-coding RNA ADAM metallopeptidase with thrombospondin type 1 motif, 9 antisense RNA 2 (ADAMTS9-AS2) was recognized as a novel tumor suppressor and plays an important role in the initiation and progression of malignant behavior in human cancers, although its plasma expression and clinical value in patients with non-small cell lung cancer (NSCLC) remain unknown. We aimed to analyze the diagnostic role of ADAMTS9-AS2 and cytokeratin 19 fragmentation antigen (CYFRA 21-1) in NSCLC. METHODS The present study included 80 control subjects, 80 patients with benign lung lesion and 80 NSCLC patients. The expression of ADAMTS9-AS2 in the tissue and plasma was detected by a real-time polymerase chain reaction. Serum CYFRA 21-1 was analyzed using an enzyme-linked immunosorbent assay. RESULTS In comparison with benign lung lesion and controls, tissue and plasma ADAMTS9-AS2 expression were significantly down-regulated in NSCLC (p < 0.001). Decreased ADAMTS9-AS2 expression was associated with TNM stages in NSCLC patients (p < 0.001). Up-regulation of CYFRA 21-1 was reported among NSCLC patients and it was associated with TNM staging. Tissue and plasma ADAMTS9-AS2 expression levels were the predicting factors for NSCLC and they both correlated negatively with CYFRA 21-1 levels. Plasma ADAMTS9-AS2 levels had a significant positive correlation with their tumor tissue levels. Plasma ADAMTS9-AS2 showed a higher sensitivity (95%) and specificity (99.1%) in the diagnosis of NSCLC than CYFRA 21-1 (61.3% sensitivity and 60% specificity). CONCLUSIONS Our results suggested that decreased plasma ADAMTS9-AS2 expression might act as a novel non-invasive tumor biomarker in NSCLC diagnosis. Furthermore, plasma ADAMTS9-AS2 might predict aggressive tumor behavior.
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Affiliation(s)
- Rehab S Abdul-Maksoud
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nearmeen M Rashad
- Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Walid S H Elsayed
- Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rasha S Elsayed
- General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Magda M Sherif
- Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmad Abbas
- Chest department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Zheng A, Kira M, Adam RD, Papageorgiou P, Shambrook J, Abbas A, Vedwan K, Long J, Walkden M, Harden S, Peebles C, Flett AS. Characteristics and long-term outcomes of patients with reduced ejection fraction referred for adenosine stress perfusion cardiac magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.004] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Adenosine stress perfusion has been shown to be of minimal incremental benefit in distinguishing between ischaemic and non-ischaemic aetiology of severe left ventricular systolic dysfunction (LVSD) over and above that obtained from Cardiac Magnetic Resonance (CMR) with Late Gadolinium Enhancement (LGE). Stress CMR has, however, been shown to be effective in risk-stratifying LVSD patients, with ischaemia being an independent predictor of cardiovascular death or myocardial infarction (MI) and associated with higher rates of further intervention.
Purpose
Evaluate real world data from a single tertiary UK cardiac MRI centre to determine the characteristics and long-term clinical outcomes of patients with LVSD referred for stress CMR.
Methods
As part of an ongoing registry, all consenting patients with Ejection Fraction (EF) ≤40% and a completed adenosine stress perfusion CMR between January 2015 and December 2019 were included with prospective baseline data collection. All-cause mortality and cardiac hospitalisation, coronary angiography/revascularisation was determined from electronic hospital records. Outcomes were compared between the inducible ischaemia vs. no ischaemia groups, and LGE present vs. no LGE groups using chi square.
Results
The sample included 86 patients. The mean EF was 32 ± 6%. Median follow up was 3.8 years (range 41-2222 days). The indications for CMR were: 30 (35%) assess ischaemia, 35 (41%) assess LVSD aetiology and 21 (24%) LVSD assess viability.
Inducible ischemia was present in 30 (35%) patients and absent in 56 (65%). Patient characteristics and outcomes are shown in Table 1. Baseline characteristics were similar between the groups but there was a higher rate of hypertension and ischaemic heart disease in the ischaemia group. There was a non-significant difference in combined mortality and cardiac hospitalisation rates between the groups (40% vs. 27% p = 0.20).
LGE was present in 69 (80%) patients (28 with ischaemia; 41 without) and absent in 17 (20%, 2 with ischaemia, 15 without). The event rate was 23 (33%) vs. 4 (24%) between LGE vs. No LGE groups (p = 0.44). Of the 15 patients (17%) with no LGE or ischaemia; 2 died and 1 was hospitalised, there were no MI"s and no Percutaneous Coronary Intervention (PCI).
The lack of statistical difference in event rates between ischaemia and no ischaemia groups may be due to our relatively small sample size or could reflect the effectiveness of contemporary disease modifying treatment for Heart Failure with reduced EF.
Conclusion
This real-world data supports published findings that in patients with LVSD and no LGE on CMR, ischaemia is very uncommon and stress CMR is unlikely to increase diagnostic yield. Conversely, if stress CMR is performed and ischaemia is absent, incidence of subsequent angiography and revascularisation is very low, which is reassuring in clinical practice. In those patients without ischaemia and LGE, likelihood of MI is low.
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Affiliation(s)
- A Zheng
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Kira
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - RD Adam
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - P Papageorgiou
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - J Shambrook
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - A Abbas
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - K Vedwan
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - J Long
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Walkden
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - S Harden
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - C Peebles
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - AS Flett
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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McGillivray E, Jain R, Ramamurthy C, Sheng J, Granina E, Yu D, Lu X, Abbas A, Dotan E, Meyer J, Fang C, Denlinger C. P-103 Associations between quality-of-life, symptom burden, and demographic characteristics in long-term esophageal and gastroesophageal junction cancer survivors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.158] [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] Open
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Abbas A, Turner N, MacNeill F. Managing breast gangrene during the COVID-19 pandemic. Ann R Coll Surg Engl 2021; 103:e141-e143. [PMID: 33682434 DOI: 10.1308/rcsann.2020.7068] [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] [Indexed: 11/22/2022] Open
Abstract
At the onset of the COVID-19 crisis, a 63-year-old woman with multiple life-limiting comorbidities was referred with a necrotic infected left breast mass on a background of breast cancer treated with conservation surgery and radiotherapy 22 years previously. The clinical diagnosis was locally advanced breast cancer, but four separate biopsies were non-diagnostic. Deteriorating renal function and incipient sepsis and endocarditis resulted in urgent salvage mastectomy during the peak of the COVID19 pandemic. The final diagnosis was infected ischaemic/infarcted breast (wet gangrene) secondary to vascular insufficiency related to diabetes, cardiac revascularisation surgery and breast radiotherapy.
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Affiliation(s)
- A Abbas
- The Royal Marsden NHS Foundation Trust, UK
| | - N Turner
- The Royal Marsden NHS Foundation Trust, UK
| | - F MacNeill
- The Royal Marsden NHS Foundation Trust, UK
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Abbas A, Al-Otaibi T, Gheith OA, Nagib AM, Farid MM, Walaa M. Sleep Quality Among Healthcare Workers During the COVID-19 Pandemic and Its Impact on Medical Errors: Kuwait Experience. Turk Thorac J 2021; 22:142-148. [PMID: 33871338 PMCID: PMC8051301 DOI: 10.5152/turkthoracj.2021.20245] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Millions of people suffer from sleep disturbances. In addition, the coronavirus disease 2019 (COVID-19) pandemic created several new challenges-particularly for frontline healthcare workers (HCWs). This study assessed the sleep quality (SQ) among HCWs. MATERIAL AND METHODS A cross-sectional study was conducted using an English-language online survey. The participants were invited via a web link sent using social network platforms. It included sociodemographic- and profession-related characteristics. COVID-19-associated risks were assessed (e.g., being on the front line, doing swabs, satisfaction about protective equipment, and management protocols). Assessment of SQ was done using the Pittsburgh Sleep Quality Index (PSQI) and various medical errors were recorded. RESULTS A total of 217 HCWs completed the survey with mean (±standard deviation) age of 35.8 (±7.3) years; 56.2% were male, 18.43% had comorbidities, and 61.75% experienced sleep difficulties before the COVID-19 crisis. This work reports a 78.8% prevalence of poor SQ, with the mean (standard deviation) global PSQI score of 9.36 (±4.4). HCWs with poor sleep experienced more positive comorbid profile (23.64% versus 6.52%, p=0.01). Working on the front lines of COVID-19 was associated with poor sleep (69.59% versus 47.83%, p=0.006). Among the participants, 77.42% performed medical errors, particularly not checking for drug allergies (17.97%), dispensing medication with incomplete instructions (20.74%), providing incorrect doses or overdosing (14.75%), incorrectly explaining the use of medication (9.22%), and prescribing a drug to the wrong patient (10.14%). CONCLUSION This nationwide survey reported high prevalence of poor SQ among HCWs during the COVID-19 pandemic. Being an HCW on the front lines of COVID-19 and doing swabs with a positive comorbidity was associated with poor sleep.
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Affiliation(s)
- Ahmad Abbas
- Department of Chest Diseases, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah area, Kuwait
| | - Torki Al-Otaibi
- Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah area, Kuwait
| | - Osama Ashry Gheith
- Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah area, Kuwait
- Department of Dialysis and Transplantation, Urology Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ayman Maher Nagib
- Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Ibn Sina Hospital, Sabah area, Kuwait
- Department of Dialysis and Transplantation, Urology Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mahmoud M. Farid
- National Blood Transfusion Services, Egypt & Health Care Management Consultant, Technical Office, MOH, Kuwait
| | - Mohammad Walaa
- Department of Chest Diseases, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Bus SRM, Zambreanu L, Abbas A, Rajabally YA, Hadden RDM, de Haan RJ, de Borgie CAJM, Lunn MP, van Schaik IN, Eftimov F. Intravenous immunoglobulin and intravenous methylprednisolone as optimal induction treatment in chronic inflammatory demyelinating polyradiculoneuropathy: protocol of an international, randomised, double-blind, placebo-controlled trial (OPTIC). Trials 2021; 22:155. [PMID: 33608058 PMCID: PMC7894234 DOI: 10.1186/s13063-021-05083-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/15/2020] [Accepted: 01/29/2021] [Indexed: 11/28/2022] Open
Abstract
Background International guidelines recommend either intravenous immunoglobulin (IVIg) or corticosteroids as first-line treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). IVIg treatment usually leads to rapid improvement and is generally safe, but does not seem to lead to long-term remissions. Corticosteroids act more slowly and are associated with more side effects, but may induce long-term remissions. The hypothesis of this study is that combined IVIg and corticosteroid induction treatment will lead to more frequent long-term remissions than IVIg treatment alone. Methods An international, randomised, double-blind, placebo-controlled trial, in adults with ‘probable’ or ‘definite’ CIDP according to the EFNS/PNS 2010 criteria. Three groups of patients are included: (1) treatment naïve, (2) known CIDP patients with a relapse after > 1 year without treatment, and (3) patients with CIDP who improved within 3 months after a single course of IVIg, who subsequently deteriorate at any interval without having received additional treatment. Patients are randomised to receive 7 courses of IVIg and 1000 mg intravenous methylprednisolone (IVMP) (in sodium chloride 0.9%) or IVIg and placebo (sodium chloride 0.9%), every 3 weeks for 18 weeks. IVIg treatment consists of a loading dose of 2 g/kg (over 3–5 days) followed by 6 courses of IVIg 1/g/kg (over 1–2 days). The primary outcome is remission at 1 year, defined as improvement in disability from baseline, sustained between week 18 and week 52 without further treatment. Secondary outcomes include changes in disability, impairment, pain, fatigue, quality of life, care use and costs and (long-term) safety. Discussion In case of superiority of the combined treatment, patients will experience the advantages of two proven efficacious treatments, namely rapid improvement due to IVIg and long-term remission due to corticosteroids. Long-term remission would reduce the need for maintenance IVIg treatment and may decrease health care costs. Additionally, we expect that the combined treatment leads to a higher proportion of patients with improvement as some patients who do not respond to IVIg will respond to corticosteroids. Risks of short and long-term additional adverse events of the combined treatment need to be assessed. Trial registration ISRCTN registry ISRCTN15893334. Prospectively registered on 12 February 2018.
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Affiliation(s)
- S R M Bus
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L Zambreanu
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Centre for Neuromuscular Disease, London, UK
| | - A Abbas
- Department of Neurology, University Hospitals of Birmingham, Regional Neuromuscular Service, Birmingham, UK
| | - Y A Rajabally
- Department of Neurology, University Hospitals of Birmingham, Regional Neuromuscular Service, Birmingham, UK
| | - R D M Hadden
- Department of Neurology, King's College Hospital, London, UK
| | - R J de Haan
- Clinical Research Unit, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - C A J M de Borgie
- Clinical Research Unit, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M P Lunn
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Centre for Neuromuscular Disease, London, UK
| | - I N van Schaik
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Spaarne Gasthuis, Haarlem, the Netherlands
| | - F Eftimov
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Hussain K, Abbas RZ, Abbas A, Rehman MA, Raza MA, Rehman T, Hussain R, Mahmood MS, Imran M, Zaman MA, Sindhu ZD, Khan MK, Ali S. Anticoccidial and Biochemical Effects of Artemisia Brevifolia Extract in Broiler Chickens. Braz J Poult Sci 2021. [DOI: 10.1590/1806-9061-2020-1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- K Hussain
- Muhammad Nawaz Sharif University of Agriculture, Pakistan
| | - RZ Abbas
- University of Agriculture, Pakistan
| | - A Abbas
- Muhammad Nawaz Sharif University of Agriculture, Pakistan
| | | | - MA Raza
- Muhammad Nawaz Sharif University of Agriculture, Pakistan
| | - T Rehman
- The Islamia University of Bahawalpur, Pakistan
| | - R Hussain
- The Islamia University of Bahawalpur, Pakistan
| | | | - M Imran
- University of Agriculture, Pakistan
| | - MA Zaman
- University College of Veterinary and Animal Sciences, Pakistan
| | | | - MK Khan
- University of Agriculture, Pakistan
| | - S Ali
- University of Agriculture, Pakistan
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Ternacle J, Guimaraes L, Vincent F, Côté N, Côté M, Lachance D, Clavel M, Abbas A, Pibarot P, Rodes-Cabau J. Reclassification of prosthesis-patient mismatch after transcatheter aortic valve replacement using predicted versus measured indexed effective orifice area. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lotfy SM, Abbas A, Shouman W. Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study. Turk Thorac J 2021; 22:62-66. [PMID: 33646106 DOI: 10.5152/turkthoracj.2021.20180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is no consensus on a certain drug therapy for COVID-19 infection. Growing reports argue about the potential benefits of hydroxychloroquine (HCQ) in reducing morbidity and mortality in patients hospitalized with COVID-19, but with inconsistent results.This study aimed to assess the potential benefits of HCQ on viral conversion, reducing the need for ICU or mechanical ventilation, and its impact on mortality. MATERIAL AND METHODS This retrospective observational study was conducted enrolling confirmed SARS-CoV2 patients. They were subjected to plain CXR (HRCT of chest if needed), routine laboratory tests for COVID-19 (including CBC, CRP, LDH, D-Dimer, ferritin, and blood sugar), ECG, and blood gases. They were allocated to either HCQ or non-HCQ groups. Both groups were followed-up for symptoms resolution, need for ICU admission, non-invasive or invasive ventilation, duration till conversion, and mortality. RESULTS A total of 202 patients with moderate COVID-19 were enrolled with a mean age of 55.05±10.15, out of whom 80% were male patients. The most common presenting symptom was fever (87.38% in the control group versus 92% in the HCQ group), followed by cough (82.52% versus 89.9%). In total, 24.27% of patients in the control group versus 28.3% in the HCQ group deteriorated and necessitated ICU admission (p=0.52), 13.6% of the control group versus 19.2% in the HCQ group required mechanical ventilation (p=0.28), and 69.9% of the control group versus 68.9% in the HCQ group converted negative on day 7 (p=0.85). No significant mortality difference between both groups was observed (4.9% versus 6.1%, p=0.47). CONCLUSION This work did not support any benefits of using HCQ in patients with COVID-19, neither in reducing the need for ICU, mechanical ventilation, nor mortality.
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Affiliation(s)
| | - Ahmad Abbas
- Department of Chest Diseases, Zagazig University Hospitals, Zagazig, Egypt
| | - Waheed Shouman
- Department of Chest Diseases, Zagazig University Hospitals, Zagazig, Egypt
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Abdel Ghany M, Rashed M, Abbas A, Youssef A, Sayed M. Severe preeclampsia is associated with postpartum diastolic dysfunction and non-dipping blood pressure profile pattern. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3302] [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
Left ventricular diastolic dysfunction and non-dipping profile, detected by ambulatory blood pressure monitoring (ABPM), are two features recorded to be associated with sustained hypertension. Both are predictors of an increased cardiovascular morbidity later in life. Complete normalization of blood pressure (BP) in preeclampsia is detected over a variable period of time.
Methods
A prospective cohort study was conducted in a tertiary university hospital including normotensive women with a history of preeclampsia in the current pregnancy enrolled within the first week postpartum. All cases were subjected to 24 h-ABPM and 2D trans-thoracic echocardiography three months post postpartum concomitantly with a clinical evaluation. Chi2-test was used to compare the qualitative data while student t-test was used to compare the quantitative data. Multivariate regression analysis was used for prediction of non-dippers and diastolic dysfunction in our cohort.
Results
Hundred twenty eight women were included in the study. Their mean age was 28.6±5.1 years and the mean basal BP was 123.1±6.4/74.6±5.9 mm Hg. Out of the studied women, 90 (70.3%) women were dippers and 38 (29.7%) women were non-dippers. It was noticed that diastolic dysfunction was presented in 28 (73.7%) of non-dippers while none of dippers had diastolic dysfunction. Women with severe preeclampsia had higher frequency of non-dipper (35.5% vs. 24.2%; P=0.02) and diastolic dysfunction (29% vs. 15%; P=0.01) in comparison to those women with mild preeclampsia. Severe preeclampsia and previous history of preeclampsia were significant predictors for non-dipping status (OR=1.1, 95% CI: 0.05–10.56 and 1.4, 95% CI: 0.30–4.26 respectively, R2 = 0.7; P<0.001). They were also predictors for diastolic dysfunction in our studied population (OR = 1.6, 95% CI: 1.1–2.2 and 1.3, 95% CI: 1.2–2.2 respectively, R2 = 0.6; P<0.05).
Conclusion
Women with a history of preeclampsia have the risk for developing cardiovascular events later in life. The severity and recurrence of preeclampsia were significant predictors for both non-dipping profile and diastolic dysfunction.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Orman Heart Hospital-Assiut University; Women Health Hospital-Assiut University
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Affiliation(s)
- M Abdel Ghany
- Assiut University, Cardiovascular medicine department, Assiut, Egypt
| | - M Rashed
- Assiut University, Cardiovascular medicine department, Assiut, Egypt
| | - A Abbas
- Assiut University, Obstetrics and Gynecology department, Assiut, Egypt
| | - A.M.R Youssef
- Assiut University, Cardiovascular medicine department, Assiut, Egypt
| | - M Sayed
- Assiut University, Cardiovascular medicine department, Assiut, Egypt
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Shetty S, Malik H, Abbas A, Ying Y, Aronow W, Briasoulis A. Impact of acute kidney injury on in-hospital outcomes among patients hospitalized with acute heart failure: a propensity score matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1247] [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
Acute kidney injury (AKI) is frequently present in patients admitted for acute heart failure (AHF). Several studies have evaluated the mortality risk and have concluded poor prognosis in any patient with AKI admitted for AHF. For the most part, the additional morbidity and mortality burden in AHF patients with AKI has been attributed to the concomitant comorbidities, and/or interventions.
Purpose
We sought to determine the impact of acute kidney injury (AKI) on in-hospital outcomes in patients presenting with acute heart failure (AHF). We identified isolated AKI patients after excluding other concomitant diagnoses and procedures, which may contribute to an increased risk of mortality and morbidity.
Methods
Data from the National Inpatient Sample (2012- 14) were used to identify patients with the principal diagnosis of AHF and the concomitant secondary diagnosis of AKI. Propensity score matching was performed on 30 baseline variables to identify a matched cohort. The outcome of interest was in-hospital mortality. We further evaluated in-hospital procedures and complications.
Results
Of 1,470,450 patients admitted with AHF, 24.3% had AKI. After propensity matching a matched cohort of 356,940 patients was identified. In this matched group, the AKI group had significantly higher in-hospital mortality (3.8% vs 1.7%, p<0.001). Complications such as sepsis and cardiac arrest were higher in the AKI group. Similarly, in-hospital procedures including CABG, mechanical ventilation and IABP were performed more in the AKI group. AHF patients with AKI had longer in-hospital stay of ∼1.7 days.
Conclusions
In a propensity score-matched cohort of AHF with and without AKI, the risk of in-hospital mortality was >2-fold in the AKI group. Healthcare utilization and burden of complications were higher in the AKI group.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Shetty
- University of Iowa, Iowa city, United States of America
| | - H Malik
- New York Medical College, Internal Medicine, Valhalla, United States of America
| | - A Abbas
- University of Iowa, Iowa city, United States of America
| | - Y Ying
- University of Iowa, Iowa city, United States of America
| | - W Aronow
- New York Medical College, Internal Medicine, Valhalla, United States of America
| | - A Briasoulis
- University of Iowa, Iowa city, United States of America
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Olabi B, Abbas A, Shah J, Tidman MJ, Ayob S, Abhishek A. Multicentric reticulohistiocytosis: an association with chronic sagittal sinus thrombosis. Clin Exp Dermatol 2020; 46:554-556. [PMID: 32875639 DOI: 10.1111/ced.14433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/25/2020] [Indexed: 01/09/2023]
Affiliation(s)
- B Olabi
- Department of Dermatology, Lauriston Building, Edinburgh, UK
| | - A Abbas
- Histopathology Department, Queen's Medical Centre, Nottingham, UK
| | - J Shah
- Departments of, Department of, Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - M J Tidman
- Department of Dermatology, Lauriston Building, Edinburgh, UK
| | - S Ayob
- Department of, Dermatology, NHS Treatment Centre, Nottingham, UK
| | - A Abhishek
- Academic Rheumatology, Clinical Sciences Building, City Hospital Nottingham, Nottingham, UK.,Nottingham NIHR-BRC, Nottingham, UK.,Department of Rheumatology, Queens Medical Centre, Nottingham, UK
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Chaudhry IUH, Cheema A, Aqeel C, Al Haji Z, Alqahtani YA, Abbas A. Radical resection and improvised manubriosternal reconstruction technique for solitary manubriosternal metastasis from papillary thyroid cancer. Int J Surg Case Rep 2020; 76:278-281. [PMID: 33059205 PMCID: PMC7566078 DOI: 10.1016/j.ijscr.2020.09.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Thyroid papillary carcinoma rarely present as manubriosternum metastasis. The standard treatment for patients with metastatic disease is iodine ablation therapy. A surgical resection is a good option for patients with resectable limited bony metastasis. CASE PRESENTATION We report a case of a 50-year-old female with thyroid gland enlargement. Positron emission tomography scan (PET) showed a solitary manubriosternal metastasis. The patient underwent total thyroidectomy and claviculo-manubriosternal en-bloc resection and improvised reconstruction using Methyl methacrylate marlex mesh plate (MMS). Post-operative recovery was uneventful, and the patient received adjuvant radioactive iodine (RAI) treatment. At five year follow up patient remained disease-free. CONCLUSION In conclusion, we report a case of papillary carcinoma of thyroid with solitary manubriosternal metastasis treated with total thyroidectomy and radical en-bloc resection of clavicular heads, manubriosternal and reconstruction by our modified reconstruction technique, which provides the best MMS plate stability, cosmoses, and good disease-free survival. In solitary bony metastasis for thyroid cancer, radical resection followed by a RAI ablation, is the best treatment modality.
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Affiliation(s)
- Ikram Ul Haq Chaudhry
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
| | - Ahsan Cheema
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Chaudhry Aqeel
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Zahra Al Haji
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Yousif A Alqahtani
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Ahmad Abbas
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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Lescanne E, van der Mee-Marquet N, Juvanon JM, Abbas A, Morel N, Klein JM, Hanau M, Couloigner V. Best practice recommendations: ENT consultations during the COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:303-308. [PMID: 32419879 PMCID: PMC7225709 DOI: 10.1016/j.anorl.2020.05.007] [Citation(s) in RCA: 22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
These best practice recommendations for ENT consultations during the COVID-19 pandemic have been drawn up because ENT examinations and treatments are at risk of contamination by the SARS-Cov-2 virus in certain instances. Thus, ENT specialists are among the professionals who are most exposed to this infection. During the pandemic, insofar as an asymptomatic patient may be infected and contagious, the same precautions must be employed whether the patient is ill with, suspected of having, or without any clinical evidence of COVID-19 infection. According to the scientific data available, the examinations and procedures potentially exposing to projections/aerosolizations of organic material of human origin are considered to be at risk of staff contamination. For ENT examinations and procedures without exposure to such projections/aerosolizations, the professional is advised to a long sleeve clean outfit, a surgical mask and gloves in case of contact with the patient's mucosa. ENT examinations and procedures with exposure to these projections/aerosolizations require the so-called "airborne", "contact", and "droplets" additional precautions: FFP2/N95 respiratory protection device, eye protection, disposable headwear and long sleeve overgown.
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Affiliation(s)
- E Lescanne
- Department of Otorhinolaryngology, Head and Neck Surgery, Tours University Hospital, Tours, France.
| | - N van der Mee-Marquet
- Support Centre for the Prevention of Healthcare-associated Infections (CPias Centre Val de Loire), Tours University Hospital, Tours, France
| | | | | | - N Morel
- ENT practice, Echirolles, France
| | - J-M Klein
- French National Professional ENT Council (CNPORL), Paris, France
| | - M Hanau
- ENT practice, Amiens, France
| | - V Couloigner
- Department of Otorhinolaryngology, Head and Neck Surgery, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, Paris, France
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Nanning N, Abbas A, Ibrahim AR, Mujahidah M. INCREASING THE ECONOMY OF VILLAGE COMMUNITY THROUGH BANANA WASTE MANAGEMENT. JCRS 2020; 4:1. [DOI: 10.24114/jcrs.v4i1.17354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The program of this community service is designed to increase the village economy through the waste recycle. This program aims to assist the community in Tanete Village of Sidenreng Rappang of South Sulawesi to increase the family economy by utilizing the banana waste. It was carried out using Participatory Action Research (PAR) approach. The sample of village community consisted of twenty people in Tanete Village of Sidenreng Rappang of South Sulawesi. The stages of its implementation were socialization, training and demonstration. The result of this program encouraged the village community successfully to make banana waste become the painting and food jam. Keywords: Banana Waste; Economy; Village.
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Hamilton NE, Adam GH, Ifan DL, Lam SS, Johnson K, Vedwan KAG, Shambrook JS, Peebles CR, Harden SP, Abbas A. Diagnostic utility of additional whole-chest CT as part of an acute abdominal pain CT imaging pathway during the COVID-19 pandemic. Clin Radiol 2020; 75:592-598. [PMID: 32546365 PMCID: PMC7280125 DOI: 10.1016/j.crad.2020.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/03/2020] [Indexed: 12/30/2022]
Abstract
AIM To evaluate the diagnostic utility of additional whole-chest computed tomography (CT) in identifying otherwise unheralded COVID-19 lung disease as part of an acute abdominal pain CT imaging pathway in response to the COVID-19 pandemic. MATERIALS AND METHODS Consecutive patients (n=172) who underwent additional whole-chest CT via a COVID-19 acute abdominal pain CT imaging pathway between 27 March and 3 May 2020 were evaluated in this retrospective single-centre study. Chest CT examinations were graded as non-COVID-19, indeterminate for, or classic/probable for COVID-19. CT examinations in the latter two categories were further divided into one of three anatomical distributions (lung base, limited chest [below carina], whole chest [above carina]) based on location of findings. Reverse transcriptase-polymerase chain reaction (RT-PCR) results and clinical features of COVID-19 were assessed to determine if COVID-19 was clinically suspected at the time of CT referral. RESULTS Twenty-seven of the 172 (15.7%) patients had CT features potentially indicative of COVID-19 pneumonia, 6/27 (3.5%) demonstrating a classic/probable pattern and 21/27 (12.2%) demonstrating an indeterminate pattern. After correlation with clinical features and RT-PCR 8/172 (4.7%) were defined as COVID-19 positive, of which only 1/172 (0.6%) was clinically unsuspected of COVID-19 at the time of CT referral. All COVID-19 positive cases could be identified on review of the lung base alone. CONCLUSION Whole-chest CT as part of an acute abdominal pain CT imaging pathway has a very low diagnostic yield for our cohort of patients. All COVID-19-positive patients in our cohort were identified on review of the lung bases on the abdominal CT and this offers an alternative imaging approach in this patient group.
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Affiliation(s)
- N E Hamilton
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - G H Adam
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - D L Ifan
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - S S Lam
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - K Johnson
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; Department of Radiology, Salisbury District Hospital, Odstock Rd, Salisbury SP2 8BJ, UK
| | - K A G Vedwan
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - J S Shambrook
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - C R Peebles
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - S P Harden
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - A Abbas
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
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Abbas A, Akintoye E, Duque ER, Briasoulis A, Alvarez P. Relationship between NT-pro Brain Natriuretic Peptide and Filling Pressures in Ambulatory Patients with Left Ventricular Assist Devices and Accuracy to Detect Need for Optimization. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Koh SM, Chan CK, Teo SH, Singh S, Merican A, Ng WM, Abbas A, Kamarul T. Elevated plasma and synovial fluid interleukin-8 and interleukin-18 may be associated with the pathogenesis of knee osteoarthritis. Knee 2020; 27:26-35. [PMID: 31917106 DOI: 10.1016/j.knee.2019.10.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 10/06/2019] [Accepted: 10/31/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE Osteoarthritis (OA) of the knee is a multifactorial degenerative disease typically defined as the 'wear and tear' of articular joint cartilage. However, recent studies suggest that OA is a disease arising from chronic low-grade inflammation. We conducted a study to investigate the relationship between chronic inflammatory mediators present in both the systemic peripheral blood system and localised inflammation in synovial fluid (SF) of OA and non-OA knees; and subsequently made direct comparative analyses to understand the mechanisms that may underpin the processes involved in OA. METHODS 20-Plex proteins were quantified using Human Magnetic Luminex® assay (R&D Systems, USA) from plasma and SF of OA (n = 14) and non-OA (n = 14) patients. Ingenuity Pathway Analysis (IPA) software was used to predict the relationship and possible interaction of molecules pertaining to OA. RESULTS There were significant differences in plasma level for matrix metalloproteinase (MMP)-3, interleukin (IL)-27, IL-8, IL-4, tumour necrosis factor-alpha, MMP-1, IL-15, IL-21, IL-10, and IL-1 beta between the groups, as well as significant differences in SF level for IL-15, IL-8, vascular endothelial growth factor (VEGF), MMP-1, and IL-18. Our predictive OA model demonstrated that toll-like receptor (TLR) 2, macrophage migration inhibitory factor (MIF), TLR4 and IL-1 were the main regulators of IL-1B, IL-4, IL-8, IL-10, IL-15, IL-21, IL-27, MMP-1 and MMP-3 in the plasma system; whilst IL-1B, TLR4, IL-1, and basigin (BSG) were the regulators of IL-4, IL-8, IL-10, IL-15, IL-18, IL-21, IL-27, MMP-1, and MMP-3 in the SF system. CONCLUSION The elevated plasma IL-8 and SF IL-18 may be associated with the pathogenesis of OA via the activation of MMP-3.
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Affiliation(s)
- S M Koh
- Tissue Engineering Group (TEG), Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - C K Chan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S H Teo
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S Singh
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Merican
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - W M Ng
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A Abbas
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - T Kamarul
- Tissue Engineering Group (TEG), Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Abbas A, Zayed N, Awad M. Predictors of atrial fibrillation among patients with obstructive sleep apnea. Egypt J Chest Dis Tuberc 2020. [DOI: 10.4103/ejcdt.ejcdt_194_19] [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] Open
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Abbas A, Zayed NE, Lutfy SM. Post ICU syndrome among survivors from respiratory critical illness. A prospective study. Egypt J Bronchol 2019. [DOI: 10.4103/ejb.ejb_35_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alhaddad A, Abdel Kawy H, Ramadan W, Abbas A. Hepatoprotective Effects of Suberoylanilide Hydroxamic Acid (A Histone Deacetylase Inhibitor) in Immunological Liver Injury in Rats. JPRI 2019. [DOI: 10.9734/jpri/2019/v30i330271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One of the main reasons for the development of chronic liver disease is autoimmune hepatitis (AIH). There is no clear etiological factor for AIH occurrence and no drug has been approved for its treatment. Vorinostat, a Histone deacetylase inhibitor (HDACi) has been shown to reduce inflammation. Our aim was to explore the therapeutic potential of vorinostat in a rat model of AIH induced by Concanavalin A (Con A). The rats were randomly divided into 4 groups; control group, con A (20 mg/kg/iv/wk) group, vorinostat (15 mg/kg/day p.o) group and Con A with vorinostat group. Blood and liver samples were collected at the end of the fourth and eighth weeks for biochemical and histopathological examinations. Results revealed that administration of Con A elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) liver enzymes, which were reduced to 52.8% and to 61.8% respectively on simultaneous administration of Vorinostat as compare to Con A group. Furthermore, Vorinostat reduced fibrosis and diminished apoptosis as deduced by the decrease in the hepatic hydroxyproline content of the liver and tumor necrosis factor-alpha levels. Relative gene expression analysis of interleukin 1b and transforming growth factor beta were significantly decreased in groups treated with vorinostat. Histopathological analysis showed that administration of vorinostat significantly restored the well organized structure of the liver, decreased initial inflammation produced by Con A, reduced liver fibrosis and mitigated hepatic stellate cell’s activities. In conclusion, administration of vorinostat in Con A model of autoimmune hepatitis, significantly decreased liver inflammation and fibrosis. So vorinostat might show a novel therapeutic approach for management of autoimmune hepatitis and its obstacles.
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Youssef G, Mekkawy D, El-Fayoumy N, Abbas A, Allam M. P1817Assessment of carotid stiffness indices in patients with ischemic stroke. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0569] [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
Arterial stiffness is considered as an emerging new important risk factor for stoke development. Measuring carotid stiffness is easy and non-invasive and thus can be widely applicable.
Purpose
To evaluate the carotid stiffness indices in patients with ischemic stroke compared to normal healthy subjects.
Methods
Included in this study are 60 patients (group 1) with ischemic stroke and 60 healthy control subjects (group 2). Participants were exposed to routine clinical examination and Duplex assessment of both carotid arteries. A specific wall tracking system was used for the semiautomatic calculation of the carotid stiffness indices, which included; compliance coefficient (CC), distensibility coefficient (DC), carotid pulse wave velocity (PWV) and carotid intima media thickness (IMT). Results from both carotid arteries were averaged and data from group 1 patients were compared to group 2 subjects.
Results
The mean age was (60.1±6.9 years) in group 1 compared to (60.1±6.6 years) in group 2 (p=0.9). A significant difference was found between both groups in all carotid stiffness indices; including average CC (0.64±0.29 vs 0.82±0.36 m2/kpa, p=0.004); average DC (11.69±5.42 vs 18.61±11.87 1/kpa, p<0.001); average PWV (16.5±0.6 vs 12.5±3.7 m/s, p<0.001) and average IMT (0.78±0.13 vs 0.68±0.18 mm, p=0.001). Only the carotid PWV was found to be a predictor of vascular stroke (p=0.001)
Conclusion
Patients with vascular stroke have higher carotid stiffness indices than age matched control subjects. Measuring carotid stiffness indices in patients who have atherosclerotic risk factors may help predict those at risk of vascular stroke and thus guide a tighter and a more efficient risk factors control.
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Affiliation(s)
- G Youssef
- Cairo University Hospitals, CardioVascular Department, Cairo, Egypt
| | - D Mekkawy
- Cairo University Hospitals, Neurology Department, Cairo, Egypt
| | - N El-Fayoumy
- Cairo University Hospitals, Neurology Department, Cairo, Egypt
| | - A Abbas
- Cairo University Hospitals, Neurology Department, Cairo, Egypt
| | - M Allam
- Cairo University Hospitals, Neurology Department, Cairo, Egypt
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Willis J, Awogbade M, Howard J, Breen C, Abbas A, Harber M, Shendi M A, Andrews P, Galliford J, Shah S, Sharpe C. SUN-053 OUTCOMES FOLLOWING KIDNEY TRANSPLANTATION IN PATIENTS WITH SICKLE CELL DISEASE WITH AND WITHOUT EXCHANGE BLOOD TRANSFUSION. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.449] [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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Higgi S, Gavillet H, Abbas A, Rivett D, Green H, Daniels T, van der Gast C. P154 Investigation of the microbial community associated with Mycobacterium abscessus infection. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30448-5] [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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Briosa E Gala A, Dimarco A, Battison S, Shambrook J, Mahmoudi M, Abbas A. 77CT coronary angiography clinches the diagnosis in a patient with ST elevation following a suicide attempt. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez139.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Briosa E Gala
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - A Dimarco
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - S Battison
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - J Shambrook
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Mahmoudi
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - A Abbas
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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