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Khursheed S, Wazir S, Saleem MK, Majeed AI, Ahmad M, Khan QU, Jadoon A, Akbar A, Jadoon SK, Tasneem S, Saleem H, Khan MS, Alvi S. Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study. Medicine (Baltimore) 2024; 103:e37787. [PMID: 38608068 PMCID: PMC11018243 DOI: 10.1097/md.0000000000037787] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Tuberculosis (TB) remains a serious problem for public health and a leading cause of death after COVID-19 and superior to even HIV/AIDS. It is a social health issue and can cause stigma and economic loss as the person cannot perform professionally due to lethargy caused by disease. It is a retrospective study done on data from National TB program Muzaffarabad chapter. The details were noted on SPSS and analysis was done to find important demographic characteristics. The total number of patients was 3441; among which 48.76% were males. Most of them (81.11%) belonged to the Muzaffarabad division of Azad Jammu and Kahmir (AJK). The microbiologically or culture positive cases were 440. Rifampicin resistance was present in 147 cases, further categorized as high (n = 143), very high (n = 3), or true positive (n = 1) resistance. Muti drug resistance was found in 19 cases. The microscopy culture is more sensitive (AUC = 0.511) than MTB/RIF or serology (AUC = 0.502) according to ROC. The rate of positive smear results is not very satisfactory in the present study as it cannot detect dormant or latent cases. There is a need to establish more sensitive tests for detection of cases and more research to combat the disease.
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Affiliation(s)
| | - Samia Wazir
- Pakistan Institute of Medical Science, Islamabad, Pakistan
| | - Muhammad Khurram Saleem
- University Hospital, Bristol and Weston NHS Foundation Trust, Royal College of Physicians and Surgeons of Glasgow, Glasgow, UK
| | | | - Mumtaz Ahmad
- Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan
| | | | - Arzu Jadoon
- Ziauddin University Hospital Karachi, Karachi, Pakistan
| | - Amna Akbar
- CHPE Health Services Academy, Islamabad, Pakistan
| | | | | | | | - Mohammad Saleem Khan
- Chief Consultant Physician/Head of Department of Medicine DHQ Teaching, Hospital Kotli AJK, Kotli, Pakistan
| | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Adnan K, Hussain S, Amir M, Ahmed S, Akbar A, Jadoon SK, Khan S, ZiLong Z, Saleem Khan M. A Clinical Study of Intraoperative Perfusion Chemotherapy With Raltitrexed in Colon Cancer: A Prospective Cohort Study. Cureus 2024; 16:e58481. [PMID: 38644947 PMCID: PMC11032147 DOI: 10.7759/cureus.58481] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) ranks as the second leading cause of cancer-related mortality among women and the third leading cause of cancer-associated mortality among men. Treatment of colon cancer is very crucial for a patient's survival. In this study, we assessed the reliability, efficacy, and safety of raltitrexed in intraoperative intraperitoneal chemotherapy for colon cancer. METHODOLOGY A total of 57 patients with clinical stages II and III of colon cancer were included in the study. R0 resection surgery + hyperthermic intraperitoneal chemotherapy (HIPEC) procedure was done with raltitrexed. It was given in a dose of 3 mg/m2 in a 0.9% NS injection in a volume of 500 milliliters. Postoperative complications were observed. RESULT The most common postoperative complication was nausea/vomiting, which was seen in 21 out of 57 patients (37%). The second most common complication was fever (18/57). None of the patients died or developed renal toxicity, hepatic toxicity, and intestinal obstruction. CONCLUSION Raltitrexed is a reliable, efficient, and safe drug and can be used in intraoperative intraperitoneal chemotherapy of colon cancer.
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Affiliation(s)
- Khan Adnan
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | | | - Muhammad Amir
- Emergency, Midland Doctors Medical Institute, Muzaffarabad, PAK
| | - Sohail Ahmed
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | - Amna Akbar
- Emergency and Accident, District Headquarter (DHQ) Hospital Jhelum, Muzaffarabad, PAK
| | | | - Sania Khan
- Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Zhang ZiLong
- Oncology, Jingzhou Central Hospital, Jingzhou, CHN
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Ahmed S, Amir M, Adnan K, Zilong Z, Akbar A, Khan S, Jadoon SK, Saleem Khan M. A Clinical Study of Intraoperative Perfusion Chemotherapy in Gastric Cancer: A Prospective Cohort Study. Cureus 2024; 16:e58482. [PMID: 38644943 PMCID: PMC11031129 DOI: 10.7759/cureus.58482] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
INTRODUCTION Gastric cancer (GC) is the third largest cause of cancer-related death worldwide, with major geographic disparities in incidence and outcomes. Sociodemographic indicators, food habits, and genetic predispositions all add to the load. Despite advances in systemic treatments, peritoneal metastasis remains a concern, with intraperitoneal chemotherapy (IPC) emerging as a promising treatment option. METHODS A prospective cohort research was done, with 30 GC patients receiving cytoreductive surgery (CRS) followed by lobaplatin-based intraoperative chemotherapy. The study evaluated postoperative complications, survival rates, and disease recurrence using Statistical Package for the Social Sciences (SPSS) version 25.0 (IBM SPSS Statistics, Armonk, NY) for data analysis. The purpose of this study is to assess the effectiveness, safety, and dependability of lobaplatin as an intraoperative chemotherapeutic agent in patients having gastric cancer surgery, with a particular emphasis on those patients who do not have distant metastases. RESULTS The study population had a balanced gender distribution, with an average age of 44.83 years. Most patients had advanced-stage cancer (T3 and T4), and lobaplatin treatment resulted in a low frequency of serious postoperative sequelae. Preliminary studies suggest that lobaplatin is a safe and potentially effective IPC drug for GC, with few side effects and adequate survival rates. CONCLUSION Lobaplatin shows promise as an intraoperative chemotherapeutic treatment for gastric cancer, necessitating more research in bigger, randomized controlled studies to determine its efficacy and safety profile. The study emphasizes the need for novel treatment strategies to enhance the prognosis of GC patients, particularly those with peritoneal involvement.
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Affiliation(s)
- Sohail Ahmed
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | - Muhammad Amir
- Emergency, Midland Doctors Medical Institute, Muzaffarabad, PAK
| | - Khan Adnan
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | - Zhang Zilong
- Oncology, Jingzhou Central Hospital, Jingzhou, CHN
| | - Amna Akbar
- Surgery, District Headquarter Hospital, Jhelum Valley, Muzaffarabad, PAK
| | - Sania Khan
- Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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Mughal HB, Majeed AI, Aftab M, Ubaid MF, Zahra S, Abbasi MSR, Qadir M, Ahmad M, Akbar A, Tasneem S, Jadoon SK, Tariq M, Hussain S, Khandker SS, Alvi S. Brain natriuretic peptide in acute heart failure and its association with glomerular filtration rate: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e36933. [PMID: 38394539 DOI: 10.1097/md.0000000000036933] [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: 02/25/2024] Open
Abstract
BACKGROUND Acute heart failure (AHF) is one of the most common cardiovascular diseases. Early diagnosis and prognosis are essential, as they can eventually lead to a fatal condition. Recently, brain natriuretic peptide (BNP) has been recognized as one of the most popular biomarkers for AHF. Changes in glomerular filtration rate (GFR) are often observed in AHF. METHODS We searched PubMed, Google Scholar, and ScienceDirect between March and June 2023. Original case control studies written in English that assessed levels oh BNP in AHF were included. Systematic reviews, letters to editor, correspondence, comprehensive reviews, and duplicated studies were excluded. Funnel plots were constructed to assess publication bias. RESULTS A total of 9 studies were selected and we obtained the mean difference (MD) of BNP level to be 2.57 (95% CI: 1.35, 3.78), and GFR to be -15.52, (95% CI: -23.35, -7.70) in AHF patients. Sensitivity analyses supported the robustness of the outcome. CONCLUSION Results indicated that BNP was a promising prognostic biomarker of AHF, whereas GFR was found to be negatively correlated with AHF.
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Affiliation(s)
- Hamdah Bashir Mughal
- Registered Medical Practitioner, Azad Jammu & Kashmir Medical College, Muzaffarabad, Azad Jammu and Kashmir, Pakistan
| | | | - Maria Aftab
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Sabahat Zahra
- Acute and General Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Mamoon Qadir
- Head of Cardiology Department Fed Govt Polyclinic and Kulsum International Hospital, Islamabad, Pakistan
| | - Mumtaz Ahmad
- Abbas Institute of Medical Sciences, Muzaffarabad AJK, Pakistan
| | - Amna Akbar
- District Headquarter Hospital Jhelum Valley, Muzaffarabad AJK, Pakistan
| | | | | | - Maham Tariq
- Gujranwala, Teaching Hospital, Gujranwala, Pakistan
| | | | | | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Nizami AA, Mustafa W, Qadir M, Shahzad M, Iqbal H, Ali A, Jadoon SK, Akbar A, Tasneem S, Saleem Khan M. Risk Factors of Cardiovascular and Cerebrovascular Events in Patients With Uraemia Complicated With Hypertension During Maintenance Haemodialysis Treatment. Cureus 2024; 16:e53411. [PMID: 38435216 PMCID: PMC10908417 DOI: 10.7759/cureus.53411] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the risk factors associated with major adverse cardiovascular (group of events that affect heart and blood vessels) and cerebrovascular (events affecting blood vessels supplying the brain) events (MACCE) in patients with uraemia complicated with hypertension who required maintenance haemodialysis (MHD) treatment. METHODOLOGY Clinical data and laboratory indicators of 156 uraemia patients complicated with hypertension were collected and retrospectively analysed. The patients were admitted to a tertiary care hospital (Abbas Institute of Medical Sciences AIMS) in Muzaffarabad, Pakistan, from February 2018 to February 2022. The data was collected through consecutive sampling and patients were recruited after following the inclusion and exclusion criteria. RESULTS Eighty-one out of 156 patients were not complicated with MACCE, and 75 patients were complicated with MACCE during the MHD treatment cycle, with an incidence of 48.08%. Compared to the non-MACCE group, the MACCE group's diabetes, body mass growth rate, triglyceride (TG), NT-proBNP, standard deviation and coefficient of variance for systolic and diastolic blood pressure (SBP-SD, SBP-CV, DBP-SD, and DBP-CV) showed significant differences (P<0.05) between the groups. Diabetes, body mass growth rate, TG, NT-proBNP, SBP-SD, SBP-CV, DBP-SD, and DBP-CV with odds ratios of 3.074, 3.202, 2.188, 2.512, 2.357, 2.431, 2.299, and 2.062 respectively were risk factors for MACCE in uraemia patients with hypertension. CONCLUSION From the results of this study, we inferred that patients with uraemia and hypertension complicated by MACCE in the treatment cycle of MHD were related to diabetes, body mass growth rate, TG, NT-proBNP, SBP-SD, SBP-CV, DBP-SD, and DBP-CV.
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Affiliation(s)
| | - Waqar Mustafa
- Cardiology, Combined Military Hospital, Muzaffarabad, PAK
| | - Mamoon Qadir
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Maria Shahzad
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Hamid Iqbal
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Anwar Ali
- Cardiology, Kulsum International Hospital, Islamabad, PAK
| | | | - Amna Akbar
- Emergency and Accident, District Headquarters Hospital, Muzaffarabad, PAK
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Saleem MK, Sattar K, Ejaz KF, Rehman MU, Saleem H, Khursheed S, Akbar A, Ahmed J, Tariq M, Jadoon SK, Saleem Khan M, Tasneem S, Khandker SS, Kundu S, Alvi S. Use of telemedicine to tackle health problems in South Asia during the COVID-19 era and beyond: a systematic review. Ann Med Surg (Lond) 2024; 86:1012-1020. [PMID: 38333256 PMCID: PMC10849386 DOI: 10.1097/ms9.0000000000001649] [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: 10/02/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Telemedicine (TM) and teleconsultation services flourished during coronavirus disease 2019 (COVID-19) transmission to avoid COVID-19 infection and physical contact. Many physicians switched to the virtual treatment mode and nearly all types of health disciplines were covered. Through this systematic review, the authors tried to explore the strengths and weaknesses of TM, identify the barriers to adopting TM by population, and explain the limitations of this healthcare delivery model. Methods and results In this systematic review, 28 studies were included (>53% high-quality studies) as eligible, where nearly 75% (n=21) of the studies were from India, and the remaining 25% (n=7) were from Pakistan, Bangladesh, Sri Lanka, and Nepal. Advice related to cancer, autoimmune diseases, and neurological diseases were the most common among the health disciplines in which TM was used. A peak in teleconsultation was observed during the high transmission phase of COVID-19, although major queries were associated with existing health complications and comorbidities. Conclusion Other than a few concerns regarding connectivity, privacy, and diagnosis, TM was in fact affordable, timesaving, feasible, and accurate, which ensured a highly satisfying experience among the participants (>80%).
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Affiliation(s)
- Muhammad K. Saleem
- General Internal Medicine, Royal College of Physicians and Surgeons of Glasgow, Tipperary University Hospital, Ireland
| | - Komal Sattar
- Russell’s Hall Hospital Dudley, MRCP Royal College
| | | | | | | | | | - Amna Akbar
- Poonch Medical College, Rawalakot, Muzaffarabad
| | - Jahanzeb Ahmed
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Maham Tariq
- Mohtarma Benazir Bhutto Shaheed Medical College Mirpur
| | | | | | - Sabahat Tasneem
- Public Health Professional (MSPH), Health Services Academy, Islamabad, Pakistan
| | | | - Shoumik Kundu
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Saleem H, Jadoon SK, Akbar A, Hamid Awan N, Arshad Abbasi E, Qadeer Abbasi J, Khursheed S, Ahmed J, Saleem Khan M, Tasneem S. The Impact of Respiratory Function Training and Rehabilitation Nursing on the Recovery of Patients With Mycoplasma Pneumoniae Pneumonia. Cureus 2024; 16:e53461. [PMID: 38435183 PMCID: PMC10909399 DOI: 10.7759/cureus.53461] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The goal of this study was to see how people who had been diagnosed with Mycoplasma pneumoniae pneumonia (MPP) responded to respiratory function training and rehabilitation (RFTR) nursing. Methodology A total of 122 patients (five to 12 years of age) diagnosed with Mycoplasma pneumoniae pneumonia (MPP) and refractory Mycoplasma pneumoniae pneumonia (RMPP) using enzyme-linked immunoassay and PCR were included in this study. These patients were hospitalized at a tertiary care hospital from February 2022 to December 2022. Upon admission, they were assigned a numerical identifier based on the order of admission. Subsequently, they were randomly allocated into two equal groups: the observation (OG) and the control (CG), with each group consisting of 61 patients. Nano-acupoint sticking (NAS) therapy along with respiratory function training and rehabilitation (RFTR) nursing interventions were implemented for patients in the OG. Results The observed disparities in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC among the patients did not exhibit significant disparity prior to the commencement of treatment (p values of 0.700, 0.105, and 0.829, respectively). There was no significant difference observed in the range of inflammation in the right lung (p=0.523). Inflammation in the left lung and fluid volume in both lungs are statistically different in both groups (p values of 0.001 and 0.000, respectively). The patients in the observation group exhibited a shorter duration of cough and sputum, disappearance of lung sounds, and length of hospital stays (LOS) compared to the other groups, with statistical significance (p<0.05). Conclusion Nano-acupoint sticking (NAS) therapy with respiratory function training and rehabilitation (RFTR) in nursing practice has shown enhanced rehabilitation outcomes for individuals diagnosed with Mycoplasma pneumoniae pneumonia (MPP). The present study focuses on the application of NAS therapy in the context of RFTR for individuals diagnosed with MPP.
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Affiliation(s)
- Humayun Saleem
- Public Health, Health Services Academy, Muzaffarabad, PAK
| | | | - Amna Akbar
- Accident and Emergency, District Headquarter Hospital Jhelum Valley, Muzaffarabad, PAK
| | | | | | | | - Soffia Khursheed
- Pathology, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Jhanzeb Ahmed
- General Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, CHN
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Nadeem A, Hussain S, Fareed A, Fahim M, Iqbal T, Ahmad Z, Saeedullah, Karim R, Akbar A. Genetic variations among the isolates of Bipolaris Maydis based on phenotypic and molecular markers. BRAZ J BIOL 2024. [DOI: 10.1590/1519-6984.253147] [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: 11/22/2022] Open
Abstract
Abstract Maydis leaf blight, caused by Bipolaris maydis, is an important disease of maize crop in Khyber Pakhtunkhwa (KP) Pakistan. Fifteen isolates of the pathogen, collected across KP, were studied for variability based on phenotypic and molecular markers. Significant variability among the isolates was observed when assessed using phenotypic traits such as radial growth, spore concentration, fungicide sensitivity and virulence. The isolates were classified into six culture groups based on colour, texture and margins of the colony. Conidial morphology was also variable. These were either straight or slightly curved and light to dark brown in colour. Fungicide test showed significant variation in the degree of sensitivity against Carbendazim. Isolate Bm8 exhibited maximum radial growth on carbendazim spiked plates. Conversely, isolate Bm15 showed the lowest radial growth. Variations in virulence pattern of the isolates were evident when a susceptible maize variety Azam was inoculated with spores of B. maydis. Genetic variability amongst the isolates was also estimated by RAPD as well as sequencing of ITS region. The RAPD dendrogram grouped all the isolates into two major clusters. Average genetic distance ranged from 0.6% to 100%, indicating a diverse genetic gap among the isolates. Maximum genetic distance was found between isolates Bm9 and Bm10 as well as Bm2 and Bm8. Conversely, isolates Bm13 and Bm15 were at minimum genetic distance. Phylogenetic dendrogram based on sequencing of ITS region grouped all the isolates into a single major cluster. The clusters in both the dendrogram neither correlate to the geographical distribution nor to the morphological characteristics.
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Affiliation(s)
- A. Nadeem
- The University of Agriculture Peshawar, Pakistan
| | - S. Hussain
- The University of Agriculture Peshawar, Pakistan
| | - A. Fareed
- The University of Agriculture Peshawar, Pakistan
| | - M. Fahim
- dIslamia College University, Pakistan
| | - T. Iqbal
- The University of Agriculture Peshawar, Pakistan
| | - Z. Ahmad
- Adaptive Research Program, Pakistan
| | - Saeedullah
- The University of Agriculture Peshawar, Pakistan
| | - R. Karim
- The University of Agriculture Peshawar, Pakistan
| | - A. Akbar
- National Agricultural Research Centre, Pakistan
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Saleem Khan M, Faizan Ejaz K, Adnan K, Ahmed S, Saleem H, Jadoon SK, Akbar A, Tasneem S. Evaluation of the District Health Information System in District Kotli, Azad Jammu and Kashmir: A Retrospective Analysis. Cureus 2024; 16:e53242. [PMID: 38425611 PMCID: PMC10902741 DOI: 10.7759/cureus.53242] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND It is essential to implement a high-quality electronic database for keeping important information. The District Health Information System (DHIS) is an active data-keeping system in Pakistan. This study aimed to evaluate the patients' data from the DHIS dashboard for the District Headquarters Hospital, Kotli, Azad Jammu and Kashmir (AJK). METHODOLOGY The data was requested from the hospital administration at District Headquarters Hospital, Kotli, AJK, and the data was analyzed after permission was granted. The data was given in two forms; one was a hard copy of the data for August and September and the other was a comma-separated values file for October and November, 2023. RESULTS The highest frequency of patients was received in the department of emergency and trauma and the patient's median age was between 15 and 49 years. The second department was medicine with the >50 years of age. Common conditions that needed more attention were chronic obstructive pulmonary disease, acute respiratory infection, diarrhea, pneumonia, diabetes mellitus, hypertension, and ischemic heart disease. CONCLUSION For nations with constrained healthcare systems and funds, primary health care (PHC) is the only viable approach for managing non-communicable diseases (NCDs). However, PHC systems intended for infectious diseases have not sufficiently adapted to the growing requirement of chronic care for NCD. Research using health information databases offers numerous benefits, such as the evaluation of large data sets and unexpected prevalence of disease in certain populations, such as a higher prevalence of disease in one gender or age group. Health information system-based data analysis or studies are less expensive and faster but lack scientific control over data collection.
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Affiliation(s)
| | | | - Khan Adnan
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | - Sohail Ahmed
- Gastrointestinal Surgery, Yangtze University, Jingzhou, CHN
| | | | | | - Amna Akbar
- Emergency and Accident, District Headquarters Hospital, Muzaffarabad, PAK
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Qadir M, Mustafa W, Nizami AA, Iqbal H, Shahzad M, Ali A, Akbar A. Unveiling the Knowledge Gap Regarding Standard Antibiotic Prophylaxis for Infective Endocarditis Among Physicians, Dentists and Cardiologists in Pakistan: A Cross-Sectional Study. Cureus 2024; 16:e52938. [PMID: 38405996 PMCID: PMC10893973 DOI: 10.7759/cureus.52938] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION Infective endocarditis is a microbial infection of the endocardial surface of the native and prosthetic valves. This study aimed to evaluate knowledge regarding the current guidelines for antibiotic prophylaxis for infective endocarditis. METHODS This cross-sectional study was conducted among physicians, cardiologists, and dentists in Rawalpindi and Islamabad. The questionnaire was distributed as Google Forms among the required population, and responses were collected on a Google Response Sheet. RESULTS The participants viewed rheumatic heart disease (83.7%) and heart transplant (96.7%) as the most vulnerable conditions that warrant the need for antibiotic prophylaxis. The other questions yielded average responses. CONCLUSION The findings of this study emphasize the importance of adhering to standard guidelines and highlight the need for knowledge of the current guidelines.
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Affiliation(s)
- Mamoon Qadir
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Waqar Mustafa
- Cardiology, Combined Military Hospital, Muzaffarabad, PAK
| | | | - Hamid Iqbal
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Maria Shahzad
- Cardiology, Federal Government Polyclinic, Islamabad, PAK
| | - Anwar Ali
- Cardiology, Kulsum International Hospital, Islamabad, PAK
| | - Amna Akbar
- Emergency and Accident, District Headquarter Jhelum, Muzaffarabad, PAK
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Khan Raja S, Rafique Shiekh R, Arshad Abbasi MA, Tariq S, Saleem H, Tariq M, Akbar A, Jadoon SK, Tasneem S, Saleem Khan M. Exploring the Relationship of Comorbidities, Smoking Status, HRCT Findings With COVID-19 Disease Severity and Outcomes. Cureus 2024; 16:e52937. [PMID: 38406150 PMCID: PMC10893976 DOI: 10.7759/cureus.52937] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is a serious illness that can affect multiple organs including the lungs. The COVID-mortality risk is attributed to the quick transmission of the virus, the severity of disease, and preclinical risk factors, such as the presence of comorbidities. High-resolution computed tomography (HRCT) can predict disease severity in COVID-19 patients. METHODOLOGY This was a retrospective cohort study in which data were obtained from COVID centers at tertiary care hospitals in Azad Jammu and Kashmir. Details of clinical characteristics and HRCT findings along with details of smoking and comorbid history were obtained. RESULTS Fever at hospital admission, HRCT findings, and having a partner predicted disease severity showed a significant p-value of <0.05. Old age and living in a combined household were associated with severe outcomes (p<0.05). Symptoms of shortness of breath (SOB) on hospital admission could predict the need for ICU admission in COVID-19 patients. CONCLUSION HRCT has a good predictive value for disease severity in patients with COVID-19, and old age is a risk factor. Although, limited associations were established in the analysis, in this study hyperlipidemia and hypertension significantly affected the course of disease. Further studies should be done to explore the relationship.
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Affiliation(s)
- Sohail Khan Raja
- Pulmonology, Azad Jammu Kashmir Medical College, Muzaffarabad, PAK
| | | | | | - Samia Tariq
- Medicine, Women Medical and Dental College Abbottabad, Abbottabad, PAK
| | | | - Maham Tariq
- Radiology, Gujranwala Teaching Hospital, Gujranwala, PAK
| | - Amna Akbar
- Emergency and Accident, District Headquarters Hospital (DHQ), Jhelum, PAK
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Khan ZU, Khan SU, Tariq M, Mustafa W, Saleem H, Akbar A, Jadoon SK, Tasneem S. Relationship Between Cardiometabolic Index in Early Pregnancy and Hypertensive Disorder Complicating Pregnancy. Cureus 2024; 16:e51598. [PMID: 38205084 PMCID: PMC10777440 DOI: 10.7759/cureus.51598] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Background This study aimed to examine the cardiometabolic index during early pregnancy in individuals with hypertension-complicating pregnancy, especially preeclampsia. Additionally, this study sought to determine the relationship between cardiometabolic index and the incidence of varying degrees of preeclampsia. Methodology This study included 289 pregnant women diagnosed with preeclampsia who were registered and delivered at our hospital. These women were assigned to the preeclampsia group. Additionally, a group of 289 healthy pregnant women of identical gestational ages within the same time frame was included for comparison. Clinical data on pregnancy, including body mass index (BMI), blood pressure, waistline, triglyceride levels, and cardiometabolic index, were compared between the two groups. An analysis was conducted to examine the association between early pregnancy cardiometabolic index and the occurrence of preeclampsia. Results There was a significant association between the quartile of cardiometabolic index and the proportion of preeclampsia patients (p < 0.001). Furthermore, after controlling for age and BMI, the risk of preeclampsia remained significantly elevated and was associated with the cardiometabolic index. Conclusions A positive correlation was observed between cardiometabolic index during early pregnancy and the occurrence of preeclampsia.
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Affiliation(s)
| | - Shakir Ullah Khan
- Trauma and Orthopedics, University Hospital Southampton NHS Foundation Trust, Southampton, GBR
| | - Musaira Tariq
- Gynecology, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Waqar Mustafa
- Cardiology, Combined Military Hospital, Muzaffarabad, PAK
| | - Humayun Saleem
- Public Health, Health Services Academy, Muzaffarabad, PAK
| | - Amna Akbar
- Emergency and Accident, District Headquarter Jhelum, Muzaffarabad, PAK
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Rafiq Abbasi MS, Sultan K, Manzoor R, Nizami AA, Ullah N, Mushtaq A, Saleem H, Umaira Khan Q, Akbar A, Khan Jadoon S, Tasneem S, Saleem Khan M, Alvi S. Assessment of renal function and prevalence of acute kidney injury following coronary artery bypass graft surgery and associated risk factors: A retrospective cohort study at a tertiary care hospital in Islamabad, Pakistan. Medicine (Baltimore) 2023; 102:e35482. [PMID: 37861475 PMCID: PMC10589541 DOI: 10.1097/md.0000000000035482] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
Acute kidney injury (AKI) is a sudden decline in renal function after cardiac surgery. It is characterized by a significant reduction in glomerular filtration rate, alterations in serum creatinine (S.Cr) levels, and urine output. This study aimed to retrospectively analyze a cohort of 704 patients selected using stringent inclusion and exclusion criteria. AKI was defined by an increase of 0.3 mg/dL in S.Cr levels compared to baseline. Data were collected from the hospital and analyzed using SPSS 16.0. Data analysis revealed that 22% (n = 155) of the patients developed AKI on the second post-operative day, accompanied by a substantial increase in S.Cr levels (from 1.064 ± 0.2504 to 1.255 ± 0.2673, P < .000). Age and cardiopulmonary bypass duration were identified as risk factors along with ejection fraction and days of hospital stay, contributing to the development of AKI. Early renal replacement therapy can be planned when the diagnosis of AKI is established early after surgery.
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Affiliation(s)
| | - Khawar Sultan
- Rawal Institute of Health Sciences, Islamabad, Pakistan
| | - Rukhsana Manzoor
- IMT-2, East Kent University Hospital, Canterbury, United Kingdom
| | - Awais Ahmad Nizami
- Director Cath Lab, Department of Cardiology, Shahida Islam Institute of Cardiology, Bahawalpur, Pakistan
| | - Naeem Ullah
- Post Graduate Resident Nephrology, Pakistan Institute of Medical Sciences, PIMS, Islamabad, Pakistan
| | - Adnan Mushtaq
- Registrar Nephrology, Pakistan institute of Medical Sciences (PIMS) Islamabad, Islamabad, Pakistan
| | | | | | - Amna Akbar
- District Headquarter Hospital Jhelum Valley, Muzaffarabad AJK, Pakistan
| | | | - Sabahat Tasneem
- Public Health Professional, Health Services Academy, Islamabad, Pakistan
| | | | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Ullah Z, Ur Rehman M, Akbar A, Tasneem S, Jadoon SK. Unidentified Intracranial Foreign Body in an Epileptic Child: Infanticide or Child Abuse? Cureus 2023; 15:e47167. [PMID: 38022250 PMCID: PMC10652028 DOI: 10.7759/cureus.47167] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Although intracranial foreign bodies are typically associated with penetrating injuries or surgical interventions, they can also occur as a result of rare instances of child abuse. Enduring such abuse and neglect as an infant can lead to life-long neurological problems, developmental delays, and impairments. The present case involved a 14-year-old male adolescent who was brought to the emergency room due to recurrent generalized tonic seizures. A computed tomography (CT) scan revealed a ring-like metallic object within the right temporal lobe. The neurosurgeon declined the surgical removal of the object due to its position and orientation, as well as the patient's guardian's refusal to consent to surgery. Instead, drug treatment and care are advised. In infants, foreign objects are typically inserted through cranial sutures, fontanelles and less frequently into the orbits, often with the intention of harming unwanted children. However, no history of such an attempt is present in this case. The incidental discovery of intracranial foreign bodies typically occurs during investigations when patients present with neurological symptoms such as epileptic seizures (foreign body-induced epilepsy). The selection of an ideal treatment regimen is often challenging in such cases. If a patient can be effectively treated with drugs, surgical removal is usually avoided.
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Affiliation(s)
| | | | - Amna Akbar
- Emergency and Accident, District Headquarter Jehlum, Muzaffarabad, PAK
| | - Sabhat Tasneem
- Public Health Sciences, Health Services Academy, Islamabad, PAK
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Cerrato C, Autorino R, Simone G, Yang B, Uzzo R, Porpiglia F, Capitanio U, Montorsi F, Porter J, Beksac A, Minervini A, Lau C, Akbar A, Eun D, Mottrie A, Mir C, Meagher M, Nguyen M, Pandolfo S, Kutikov A, Cerruto M, Antonelli A, Sundaram C, Kaouk J, Derweesh I. Partial or radical nephrectomy for complex renal mass: A comparative analysis of oncological outcomes and complications from the rosula (robotic surgery for large renal mass) collaborative group. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00891-6] [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: 02/12/2023]
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Yeoh SA, Kimpton J, Shipa M, Hawkins E, Akbar A, Ehrenstein M. OP0011 HIGHLY DIFFERENTIATED CD4 AND CD8 T EFFECTOR MEMORY CELLS RE-EXPRESSING CD45RA (TEMRA) ARE ASSOCIATED WITH ACTIVE DISEASE REFRACTORY TO ANTI-TNF THERAPY IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1726] [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: 11/04/2022]
Abstract
BackgroundHighly differentiated T cells have been reported to be enriched in rheumatoid arthritis (RA) compared to healthy individuals1. The role of terminally differentiated T effector memory re-expressing CD45RA (Temra) in RA pathogenesis and disease activity is still unclear, including whether they can be used as a marker of sustained disease activity in RA patients receiving anti-TNF therapy.ObjectivesTo investigate whether the frequency of peripheral blood Temra can be used as a biomarker to identify disease refractory to anti-TNF therapy in RA, if they correlate with inflammation in anti-TNF treated patients, and whether they associate with a flare following tapering anti-TNF.MethodsRA patients on anti-TNF therapy were recruited from rheumatology clinic (cross-sectional cohort). Clinical data and whole blood were collected. Patients were stratified based on disease activity. Remission was defined as no recorded DAS28-CRP≥2.4, no swollen joints, no C-reactive protein (CRP) of >5mg/L, and on a stable DMARD dose and no reported disease flare/loss of remission in the 6 months prior. Non-remission was defined as any other disease activity which does not fulfil the remission definition. Patients on abatacept, or methotrexate monotherapy and healthy volunteers were recruited as comparison groups. A separate cohort of anti-TNF patients (longitudinal cohort) who have been in remission on a stable dose of anti-TNF for ≥6 months and no use of corticosteroids in the last 6 months, was also recruited. Whole blood was obtained prior to dose tapering (dose halving) and at the point of a flare. Whole blood was processed by gradient centrifugation to obtain peripheral blood mononuclear cells (PBMC). PBMC were stained with fluorochrome-conjugated antibodies for multi-parameter flow cytometry. Analysis was performed on live lymphocytes using FlowJo software version 10.8. Two-tailed Mann-Whitney U test or unpaired t-test were used to obtain unadjusted values, analysis of variance (ANOVA) of log-transformed data was used to obtain age-adjusted values, Spearman’s rank correlation was used to compare correlation between Temra and CRP.ResultsRA patients (36 anti-TNF, 12 abatacept, 16 methotrexate monotherapy) and 14 healthy individuals were recruited. There was a higher proportion of CD4 (age-adjusted p = 0.004) and CD8 Temra (age-adjusted p = 0.0007) in RA patients on anti-TNF with persistent disease activity compared to those who had achieved remission. These differences were confirmed when analysing absolute numbers of CD4 and CD8 Temra. Unexpectedly, the difference in Temra frequency between remission and non-remission RA was not observed in patients treated with methotrexate or abatacept. The median CD4 and CD8 Temra frequencies in RA patients in remission with all treatments studied were similar to healthy individuals.Temra were not observed to increase with age in the anti-TNF, abatacept, or methotrexate cohorts in contrast to previous reports in healthy individuals2. The frequency of CD4 and CD8 Temra correlated with CRP only in patients on anti-TNF (CD4 Temra Spearman r = 0.5185, p = 0.001, and CD8 Temra Spearman r = 0.5040, p = 0.005).There was an increase in CD4 (p = 0.003) but not CD8 Temra at 3 months in patients who flared on tapering anti-TNF compared to those who remained in remission (Figure 1).ConclusionIncreased CD4 and CD8 Temra frequency were associated with persistent disease activity in anti-TNF treated patients but not with other DMARD therapies (abatacept and methotrexate). CD4 Temra increased in those who flared on tapering anti-TNF. These results suggest that Temra may play a role in driving persistent disease activity refractory to anti-TNF therapy rather than merely a marker of inflammation.References[1]Weyand CM, Yang Z, Goronzy JJ. T-cell aging in rheumatoid arthritis. Curr Opin Rheumatol. 2014;26(1):93-100.[2]Callender LA, Carroll EC, Bober EA, et al. Mitochondrial mass governs the extent of human T cell senescence. Aging Cell. 2020;19(2):e13067.AcknowledgementsSAY is funded by research grants by Versus Arthritis, Royal College of Physicians/Rosetrees Trust, NIHR University College London Hospitals Biomedical Research Centre and UCLH Charities.Disclosure of InterestsSu-Ann Yeoh: None declared, James Kimpton: None declared, Muhammad Shipa: None declared, Eleanor Hawkins: None declared, Arne Akbar Grant/research support from: AA has received funding from the Leo Skin Foundation (Denmark), Michael Ehrenstein Consultant of: MRE has received consultancy fees from Galapagos and Sanofi., Grant/research support from: MRE has received financial grants from GlaxoSmithKline.
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Rashid N, Shafee M, Iqbal S, Samad A, Khan SA, Hasni MS, Rehman ZU, Ullah S, Rehman FU, Khan GI, Ahmad S, Akbar A. Enterotoxigenic methicillin resistant Staphylococcus aureus contamination in salted fish from Gwadar Balochistan. BRAZ J BIOL 2021; 83:e247701. [PMID: 34468529 DOI: 10.1590/1519-6984.247701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Staphylococcus aureus is an important foodborne pathogen associated to food intoxication and other multiple infections in human being. Its presence in salted food is a serious issue due to its salt tolerance potential. A study was conducted to analyze the presence of enterotoxins producing drug resistance S. aureus in salted sea fish from Gwadar. Freshly persevered samples (n=50) of salted fish were subjected to analyze the presence of S. aureus using 16S rRNA and Nuc genes primers. The isolates were then evaluated for drug resistance and enterotoxins producing potential using specific primers for MecA (methicillin resistance gene), (SEA) staphylococcal enterotoxin A and (SEB) staphylococcal enterotoxin B genes. Total 13/50 (26%) of the samples were found positive for the presence of S. aureus, preliminary confirmed with biochemical profiling and finally with the help of target genes presence. The isolates were found showing 100% resistant to methicillin, which were molecularly confirmed by the presence of MecA gene present in genome. The isolates 5/13 (38%) were positive for SEA and 3/13 (23%) for SEB genes, whereas 2/13 (15%) were confirmed having both SEA and SEB genes in its genome. It was also confirmed that all the isolates were capable to form biofilm over the glass surfaces. It was concluded that the study confirmed the presence of enterotoxigenic methicillin resistance Staphylococcus aurous (MRSA) in salted fish product, that poses gross food safety concern. Preventive and control measures are necessary to handle this serious food safety concern.
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Affiliation(s)
- N Rashid
- University of Balochistan, Department of Microbiology, Quetta, Pakistan
| | - M Shafee
- University of Balochistan, Center of Advanced Studies in Vaccinology and Biotechnology - CASVAB, Quetta, Pakistan
| | - S Iqbal
- University of Information Technology Engineering and Management Sciences, Department of Chemistry Balochistan, Quetta, Pakistan
| | - A Samad
- University of Balochistan, Center of Advanced Studies in Vaccinology and Biotechnology - CASVAB, Quetta, Pakistan
| | - S A Khan
- University of Balochistan, Center of Advanced Studies in Vaccinology and Biotechnology - CASVAB, Quetta, Pakistan
| | - M S Hasni
- University of Balochistan, Institute of Biochemistry, Quetta, Pakistan
| | - Z U Rehman
- University of Balochistan, Institute of Biochemistry, Quetta, Pakistan
| | - S Ullah
- University of Balochistan, Department of Chemistry, Quetta, Pakistan
| | - F U Rehman
- University of Balochistan, Department of Microbiology, Quetta, Pakistan
| | - G I Khan
- University of Balochistan, Department of Microbiology, Quetta, Pakistan
| | - S Ahmad
- University of Balochistan, Department of Microbiology, Quetta, Pakistan
| | - A Akbar
- University of Balochistan, Department of Microbiology, Quetta, Pakistan
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Humayun W, Khokhar M, Yaqub S, Goraya A, Akbar A, Abid M. 395P Randomized control trial to assess radiological and pathological response after neo adjuvant concomitant chemo radiotherapy vs. sequential short course radiotherapy (SCRT) followed by chemotherapy in locally advanced rectal cancer (LARC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.917] [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: 11/16/2022] Open
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Shah SIA, Tipu MY, Aslam A, Khan AU, Shafee M, Khan SA, Khan NU, Akbar A. Elucidating antiviral activity of Curcuma longa against H9 N2 influenza virus using embryonated chicken egg model. Trop Biomed 2021; 38:353-359. [PMID: 34508343 DOI: 10.47665/tb.38.3.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Curcumin is a potent antimicrobial herb used traditionally as a spice in culinary. This study was designed to evaluate the antiviral effects of curcuma longa extract against H9 influenza virus. A total of 60 embryonated eggs were equally divided into 5 groups with 12 eggs in each group. Group 1 (G1) served as uninfected negative control. Whereas Group 2 (G2) was kept as positive control infected with known virus @ 0.2 ml with 10-9.3 EID50. Group 3 (G3) was offered Curcuma longa @ 0.2 mg/0.2 ml and H9N2 virus (@ 0.2 ml with 10-9.3 EID50. Similarly, Group 4 (G4) was inoculated with extract of Curcuma longa @ 0.2 mg/0.2 ml per egg, whereas Group 5 (G5) was given Ribazole @ 0.2 ml/ egg. The crude extract and virus were administered on the 15th day of incubation and were checked after every 24 hours up to 96th hour post inoculation by random selection of 3 eggs. Death and survival rate were noted in all groups. Gross and histopathological lesions were also observed. Results revealed that Curcuma longa extract had significantly (p<0.05) reduced the mortality rate of embryos infected with H9N2 virus. In G3, increased lymphocytes and mild fatty changes were seen in liver. Whereas, mature RBCs, plasma cells and some lymphoblast's were observed in Spleen. Similarly, the bursa follicles were with lymphocytic aggregation. The G4 (Curcuma longa) and G5 (Ribazole) were with maximum embryo survival after 48 and 72 h post inoculation. This study revealed potential antiviral activity of Curcuma longa against H9N2 influenza viruses and can be opted as alternative to antibiotics and antiviral drugs to minimize the antimicrobial resistance in human and animal population.
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Affiliation(s)
- S I A Shah
- Department of Pathology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - M Y Tipu
- Department of Pathology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - A Aslam
- Department of Pathology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - A U Khan
- Department of Pathology, University of Veterinary & Animal Sciences, Lahore, Pakistan
| | - M Shafee
- Center for Advanced Studies in Vaccinology & Biotechnology (CASVAB) University of Balochistan, Quetta, Pakistan
| | - S A Khan
- Center for Advanced Studies in Vaccinology & Biotechnology (CASVAB) University of Balochistan, Quetta, Pakistan
| | - N U Khan
- Abdul Wali Khan University, Mardan Khyber Pakhtunkhwa, Pakistan
| | - A Akbar
- Department of Microbiology, University of Balochistan, Quetta 87300 Balochistan, Pakistan
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20
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Muhammad J, Rabbani M, Sheikh AA, Rabaan AA, Khan A, Haq IU, Ghori MT, Khan SA, Akbar A. Molecular detection of Mycoplasma gallisepticum in different poultry breeds of Abbottabad and Rawalpindi, Pakistan. BRAZ J BIOL 2021; 83:e246514. [PMID: 34378682 DOI: 10.1590/1519-6984.246514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/27/2021] [Indexed: 11/22/2022] Open
Abstract
The poultry sector in Pakistan is contributing mainly in bridging gap between demand and supply for protein. Mycoplasma gallisepticum is an emerging bacterium causing serious problems in poultry industry of Pakistan. A cross-sectional study was conducted to evaluate the M. gallisepticum load in poultry populated regions of Pakistan. Total 600 serum and 600 swab samples were collected, 200 from each broiler, layers and breeders poultry in Rawalpindi and Abbottabad districts. Serum samples were analyzed through ELISA for seroprevalence. Swabs were cultured on Frey's medium followed by PCR and partial mgc2 gene sequencing. Results of seroprevalence of M. gallisepticum showed that layers (75%, n=150) are more positive as compared to breeders (70%, n=140) and broilers (50%, n=100). Typical colonies of the M. gallisepticum were observed in breeder (26.5%), followed by layer (21%) and broilers (9%). A total of 37.1% (n=42) samples were identified positive through PCR out of total 113 cultured based positive samples. A total of six M. gallisepticum isolates of current study showed 98-99 percent similarity with previously reported isolates on the basis of mgc2 gene partial sequencing. The M. gallisepticum was found highly prevalent in different poultry breads. Results of this study would add into basic data and provide a direction for livestock sector to strengthen a control strategy for mycoplasmosis in poultry farms.
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Affiliation(s)
- J Muhammad
- The University of Haripur, Department of Microbiology, Haripur, Pakistan.,University of Veterinary and Animal Sciences, University Diagnostic Lab, Lahore, Pakistan
| | - M Rabbani
- University of Veterinary and Animal Sciences, Department of Microbiology, Lahore, Pakistan
| | - A A Sheikh
- University of Veterinary and Animal Sciences, University Diagnostic Lab, Lahore, Pakistan
| | - A A Rabaan
- Johns Hopkins Aramco Healthcare, Molecular Diagnostic Laboratory, Dhahran, Saudi Arabia
| | - A Khan
- The University of Haripur, Department of Public Health & Nutrition, Haripur, Pakistan
| | - I Ul Haq
- The University of Haripur, Department of Public Health & Nutrition, Haripur, Pakistan
| | - M T Ghori
- The Islamia University of Bahawalpur, Department of Clinical Medicine and Surgery, Punjab, Pakistan
| | - S A Khan
- University of Balochistan, Department of Microbiology, Quetta, Balochistan, Pakistan
| | - A Akbar
- University of Balochistan, Department of Microbiology, Quetta, Balochistan, Pakistan
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Abanamy R, Akbar A, Alhatmi H, Ablakhail M, Almansour S, Bosaeed M, Alalwan B, Aljohani S, Alsaedy A, Alothman A. The epidemiology and clinical characteristics of candida blood stream infection: 6 years experience in a tertiary care center. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Akbar A, Abanamy R, Abalkhail M, Almansour S, Alhatmi H, Bosaeed M, Alwan B, Aljohani S, Alsaedy A, Alothman A. Evaluation of Candida species and antifungal susceptibilities among patients with bloodstream infection. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Khan A, Ahmed H, Simsek S, Gondal MA, Afzal MS, Irum S, Muhammad I, Mansur H, Fatima A, Ali MS, Riaz N, Akbar A, Weiping W, Yayi G. Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study. Trop Biomed 2019; 36:324-334. [PMID: 33597393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral risk factors, the diversity and ecology of animal host interactions and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is a neglected, economic and socio-cultural problem in Pakistan. The available data about the incidence of CE is very limited and no extensive study has been reported in Pakistan. The current study was aimed to analyze the hospital reported cases of CE and the associated risk factors related to the incidence of CE. The hospital-based data of CE for the time period of January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The data covered demographic characteristics including age, gender, and cyst localization of infected individuals and socioeconomic determinants. The data was analyzed based upon different risk factors along with the different socioeconomic parameters that has an important impact on the distribution of disease. A total of 228 cases were presented in the selected hospitals of different cities during the study period. Out of total 228 patients, 59.21% were males and 40.78% were females (P<0.001). Most infections have been recorded in young adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing 10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134) followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities (84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an important impact on the intensity of disease (P<0.001). The occurrence of cases in children and young adults was an important finding as it indicated an active transmission of the parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan showed that emerging health issues in Pakistan could bring the disease to limelight for future research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years 325 underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.
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Affiliation(s)
- A Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - H Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - S Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, 23119, Elazig, Turkey
| | - M A Gondal
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - M S Afzal
- Department of Life Sciences, University of Management and Technology (UMT), Lahore Pakistan
| | - S Irum
- Department of Zoology, University of Gujrat, Gujrat, Pakistan
| | - I Muhammad
- Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Pakistan
| | - H Mansur
- Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Pakistan
| | - A Fatima
- Department of Pathology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan
| | - M S Ali
- Department of Ecology and Zoology, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - N Riaz
- Department of Bioinformatics and Biotechnology, International Islamic University Female campus, Islamabad, Pakistan
| | - A Akbar
- Department of Histopathology, Rawal Medical Complex, Islamabad, Pakistan
| | - W Weiping
- Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center of Tropical Diseases, National Center for International Researches on Tropical Diseases, Ministry of Science and Technology, 207 Ruijin Er Lu, Shanghai 200025, China
| | - G Yayi
- Center for Global Health, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collab orating Center of Tropical Diseases, National Center for International Researches on Tropical Diseases, Ministry of Science and Technology, 207 Ruijin Er Lu, Shanghai 200025, China
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Rahmeh R, Akbar A, Kishk M, Al-Onaizi T, Al-Azmi A, Al-Shatti A, Shajan A, Al-Mutairi S, Akbar B. Distribution and antimicrobial activity of lactic acid bacteria from raw camel milk. New Microbes New Infect 2019; 30:100560. [PMID: 31193267 PMCID: PMC6522851 DOI: 10.1016/j.nmni.2019.100560] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/08/2019] [Accepted: 04/11/2019] [Indexed: 12/13/2022] Open
Abstract
Consumer demand for natural pathogen-control agents for substitution of synthetic food preservatives and traditional antibiotics is increasing. This study aimed to reveal the distribution of lactic acid bacteria (LAB) in raw camel milk and to characterize their antimicrobial traits. The genetic identification by 16S rRNA sequencing of 58 LAB isolates showed the predominance of Enterococcus (24.2%), Lactococcus (22.4%) and Pediococcus (20.7%) genera in raw camel milk. These genera exhibited inhibitory activity against a broad spectrum of Gram-positive and Gram-negative bacteria including multidrug-resistant Salmonella. Among these LAB, two isolates-identified as Pediococcus pentosaceus CM16 and Lactobacillus brevis CM22-were selected for their strong bacteriocinogenic anti-listerial activity estimated at 1600 and 800 AU/mL, respectively. The bacteriocins produced were partially purified by ammonium sulphate precipitation and gel filtration and then biochemically characterized. The proteinaceous nature of bacteriocins was confirmed by the susceptibility to enzymes. These bacteriocins showed significant technological characteristics such as heat-resistance, and stability over a wide range of pH (2.0-10.0). In conclusion, these results indicated that Pediococcus pentosaceus CM16 and Lactobacillus brevis CM22 could be useful as potential probiotics. Moreover, their partially purified bacteriocins may play an important role as food preservatives and feed additives. To our knowledge, this is the first report describing the distribution of LAB population in raw camel milk and the characterization of their bacteriocins from the Arabian Peninsula of western Asia.
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Affiliation(s)
- R Rahmeh
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - A Akbar
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - M Kishk
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - T Al-Onaizi
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - A Al-Azmi
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - A Al-Shatti
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - A Shajan
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - S Al-Mutairi
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - B Akbar
- Biotechnology Programme, Environment & Life Sciences Research Centre, Kuwait Institute for Scientific Research, Safat, Kuwait
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Al Otaibi M, Al Barak J, Al Abbad J, Akbar A. Differences in presentation and outcomes among young and old patients with gastric cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.078] [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: 11/12/2022] Open
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Worley G, Nordenvall C, Askari A, Pinkney T, Burns E, Akbar A, Olén O, Ekbom A, Bottai M, Myrelid P, Faiz O. Restorative surgery after colectomy for ulcerative colitis in England and Sweden: observations from a comparison of nationwide cohorts. Colorectal Dis 2018; 20:804-812. [PMID: 29603863 DOI: 10.1111/codi.14113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/26/2018] [Indexed: 12/29/2022]
Abstract
AIM A longstanding disparity exists between the approaches to restorative surgery after colectomy for patients with ulcerative colitis (UC) in England and Sweden. This study aims to compare rates of colectomy and restorative surgery in comparable national cohorts. METHOD The English Hospital Episode Statistics (HES) and Swedish National Patient Register (NPR) were interrogated between 2002 and April 2012. Patients with two diagnostic episodes for UC (age ≥ 15 years) were included. Patients were excluded if they had an episode of inflammatory bowel disease or colectomy before 2002. The cumulative incidences of colectomy and restorative surgery were calculated using the Kaplan-Meier method. RESULTS A total of 98 691 patients were included in the study, 76 129 in England and 22 562 in Sweden. The 5-year cumulative incidence of all restorative surgery after colectomy in England was 33% vs 46% in Sweden (P-value < 0.001). Of the patients undergoing restorative surgery, 92.3% of English patients had a pouch vs 38.8% in Sweden and 7.7% vs 59.1% respectively had an ileorectal anastomosis (IRA). The 5-year cumulative incidence of colectomy in this study cohort was 13% in England and 6% in Sweden (P-value < 0.001). CONCLUSION Following colectomy for UC only one-third of English patients and half of Swedish patients underwent restorative surgery. In England nearly all these patients underwent pouches, in Sweden a less significant majority underwent IRAs. It is surprising to demonstrate this discrepancy in a comparable cohort of patients from similar healthcare systems. The causes and consequences of this international variation in management are not fully understood and require further investigation.
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Affiliation(s)
- G Worley
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital and Academic Institute, Harrow, Middlesex, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - C Nordenvall
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Digestive Disease, Division of Coloproctology, Karolinska University Hospital, Stockholm, Sweden
| | - A Askari
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital and Academic Institute, Harrow, Middlesex, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - T Pinkney
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E Burns
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital and Academic Institute, Harrow, Middlesex, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Akbar
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital and Academic Institute, Harrow, Middlesex, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - O Olén
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - A Ekbom
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Bottai
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Myrelid
- Division of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Surgery, County Council of Östergötland, Linköping, Sweden
| | - O Faiz
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital and Academic Institute, Harrow, Middlesex, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
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McElhaney J, Kuchel G, Akbar A. NEW INSIGHTS INTO IMMUNOLOGIC MECHANISMS OF PROTECTION THROUGH VACCINATION IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4673] [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: 11/14/2022] Open
Affiliation(s)
- J.E. McElhaney
- Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | | | - A. Akbar
- University College London, London, United Kingdom
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Akbar A, Fülöp T. CIRCULATING IMMUNE CELLS AND THEIR CONTRIBUTION TO AGE-RELATED DISEASES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4556] [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: 11/12/2022] Open
Affiliation(s)
- A. Akbar
- University College London, London, United Kingdom
| | - T. Fülöp
- Universite De Sherbrooke, Sherbrooke, Quebec, Canada
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Akbar A. DECREASED ZOSTER VIRUS SPECIFIC T CELL RESPONSES LINKED TO EXCESSIVE INFLAMMATION IN AGED SKIN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4676] [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: 11/13/2022] Open
Affiliation(s)
- A. Akbar
- University College London, London, United Kingdom
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Affiliation(s)
- A. Lanna
- Division of Infection and Immunity, University College of London, London, United Kingdom
| | - S.M. Henson
- Division of Infection and Immunity, University College of London, London, United Kingdom
| | - A. Akbar
- Division of Infection and Immunity, University College of London, London, United Kingdom
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Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal (GI) disorder. Increasing evidence implicates the GI microbiota in IBS pathogenesis and its modulation represents an emerging therapeutic strategy. SOURCES OF DATA Original and review articles were identified through selective searches performed on PubMed and Google Scholar. AREAS OF AGREEMENT The role of gut microbiota in IBS is supported by evidence from animal and human studies. Randomized controlled trials demonstrate efficacy of the non-systemic antibiotic rifaximin in reducing IBS symptoms. AREAS OF CONTROVERSY Existing studies on microbiota alterations are often inconsistent and limited by the heterogeneity of IBS. The exact mechanism of rifaximin remains to be elucidated. Identifying predictors of response to rifaximin and treatment strategies for symptom recurrence are important clinical questions. GROWING POINTS High-throughput molecular methods are leading to rapid advances in our understanding of GI microbiota in IBS AREAS TIMELY FOR DEVELOPING RESEARCH: Future well designed longitudinal studies are required to identify characteristic microbial signatures and potential biomarkers to identify therapeutic targets and predict clinical response.
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Affiliation(s)
- O F Ahmad
- Department of Gastroenterology, Whittington Hospital, Magdala Avenue, London N19 5NF, UK
| | - A Akbar
- Department of Gastroenterology, St Mark's Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK
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Akbar A, Medina A, Magan N. Impact of interacting climate change factors on growth and ochratoxin A production by Aspergillus section Circumdati and Nigri species on coffee. WORLD MYCOTOXIN J 2016. [DOI: 10.3920/wmj2016.2041] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objectives of this study were to evaluate the effect of interacting climate change (CC) factors (water stress [water activity, aw; 0.99-0.90]); temperature [30, 35 °C]; and elevated CO2 [400 and 1000 ppm] on (1) lag phases prior to growth, (2) growth and (3) ochratoxin A (OTA) production by species of Aspergillus sections Circumdati and Nigri on coffee-based media and stored coffee beans. The lag phases, prior to growth, of all strains/species were slightly increased as aw, temperature and CO2 were modified. The interacting CC factors showed that most strains/species examined grew well at 30 °C and slightly less so at 35 °C except for Aspergillus niger (A 1911) which could tolerate the higher temperature. In addition, the interaction of elevated CO2 (1000 ppm) + temperature (35 °C) increased OTA production when compared with 30 °C but only for strains of Aspergillus westerdijkiae (B2), Aspergillus ochraceus (ITAL 14) and Aspergillus steynii (CBS 112814). Most of the strains had optimum growth at 0.95 aw at 35 °C, while at 30 °C the optimum was at 0.98 aw. On stored coffee beans there was only a significant stimulation of OTA production by A. westerdijkiae strains in elevated CO2 (1000) at 0.90 aw. These results suggest differential effects of CC factors on OTA production by species in the Sections Circumdati and Nigri in stored coffee and that for most species there is a reduction in toxin production.
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Affiliation(s)
- A. Akbar
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield MK43 AL5, United Kingdom
| | - A. Medina
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield MK43 AL5, United Kingdom
| | - N. Magan
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield MK43 AL5, United Kingdom
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Akbar A, Medina A, Magan N. Efficacy of different caffeine concentrations on growth and ochratoxin A production by Aspergillus species. Lett Appl Microbiol 2016; 63:25-9. [PMID: 27203680 DOI: 10.1111/lam.12586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/31/2016] [Accepted: 05/15/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED The objective of this study was to evaluate the effect of different caffeine concentrations (0-4%) on (i) lag phase prior to growth, (ii) growth rates and (iii) ochratoxin A (OTA) production by strains from the Aspergillus section Circumdati and Aspergillus section Nigri groups, isolated from coffee, when grown on a conducive medium at 0·98 water activity and 30°C. The lag phases prior to growth increased with caffeine concentration. A strain of Aspergillus niger and Aspergillus carbonarius were the most sensitive to caffeine with growth being inhibited by <1% caffeine. For strains of Aspergillus westerdijkiae, Aspergillus ochraceus and Aspergillus steynii, although growth was inhibited significantly, some growth (10-15% of controls) occurred in 4% caffeine. OTA production was significantly inhibited by only 0·5% caffeine for strains of A. westerdijkiae, A. niger and A. carbonarius. For A. steynii at least 1·5% caffeine was required to inhibit OTA production. In contrast, for the strain of A. ochraceus there was a stimulation of OTA at 3% with a reduction at 4% caffeine. These results are discussed in the context of the different concentrations of caffeine found in Arabica and Robusta coffee and the development of minimization strategies. SIGNIFICANCE AND IMPACT OF THE STUDY Arabic (0·6%) and Robusta coffee (4%) have significantly different amounts of endogenous caffeine. The growth of six ochratoxigenic fungi which contaminate coffee with ochratoxin A (OTA) had differential tolerance/sensitivity to concentrations of caffeine in vitro in this range. However, low concentrations of caffeine (<0·5%) was inhibitory to OTA production. These results are discussed in the context of the potential for using such information for the design of minimization strategies to control mycotoxin production in such products.
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Affiliation(s)
- A Akbar
- Applied Mycology Group, AgriFood Theme, Cranfield University, Cranfield, UK
| | - A Medina
- Applied Mycology Group, AgriFood Theme, Cranfield University, Cranfield, UK
| | - N Magan
- Applied Mycology Group, AgriFood Theme, Cranfield University, Cranfield, UK
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Patel N, Sandhu D, Vukmanovic-Stejic M, Rustin M, Akbar A. 026 Boosting of the delayed-type hypersensitivity response to varicella-zoster virus antigen following zoster vaccination in ageing individuals is associated with a local reduction in regulatory T cells. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.050] [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: 11/16/2022]
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Ali M, Saeed S, Sajjad A, Akbar A. Linking pollination effectiveness and interspecific displacement success in bees. Neotrop Entomol 2015; 44:101-108. [PMID: 26013126 DOI: 10.1007/s13744-014-0259-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 11/07/2014] [Indexed: 06/04/2023]
Abstract
Pollen deposition, a surrogate for bee efficiency, becomes increasingly important during their interspecific interactions. We conducted field experiments on highly cross-pollinated melon (Cucumis melo) and watermelon (Citrullus lanatus) in order to understand how bee species with different pollination efficiencies displace each other from floral resources. We observed significant displacement of less abundant but more efficient bees by the more abundant but less efficient bees in both crops, which may lead to deficient pollination. We did not find significant relationship of the bee displacement success and body size or abundance. Apis florea (Fabricius) and Nomia sp.2 (Latreille) had significantly more winner events in melon, while the former also had significantly more winner events in watermelon. A. florea was the only bee species that foraged mostly within the 1-m(2) virtual area after their displacement, which may indicate its behavior of geitinogamous pollination. The two bee species, Ceratina sexmaculata (Smith) and Lasioglossum sp. (Curtis), were more sensitive to displacement as their proportion of leaving the 1-m(2) virtual area was higher.
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Affiliation(s)
- M Ali
- Dept of Entomology, Faculty of Agricultural Sciences and Technology, Bahauddin Zakariya Univ, Multan, Pakistan
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Abstract
INTRODUCTION Food is a recognized trigger for most patients with irritable bowel syndrome (IBS). In recent years, an emerging evidence base has identified dietary manipulation as an important therapeutic approach in IBS. SOURCES OF DATA Original and review articles were identified through selective searches performed on PubMed and Google Scholar. AREAS OF AGREEMENT Randomized controlled trials have supported the use of a diet that restricts a group of short-chain carbohydrates known collectively as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). There is evidence that specific probiotics may improve symptoms in IBS. AREAS OF CONTROVERSY The role of a high-fibre diet remains subject to ongoing debate with a lack of high-quality evidence. The long-term durability and safety of a low FODMAP diet are unclear. GROWING POINTS A paradigm shift has led to a focus on the relationship between diet and pathophysiological mechanisms in IBS such as effects on intestinal microbiota, inflammation, motility, permeability and visceral hypersensitivity. AREAS TIMELY FOR DEVELOPING RESEARCH Future large, randomized controlled trials with rigorous end points are required. In addition, predictors of response need to be identified to offer personalized therapy.
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Affiliation(s)
- O F Ahmad
- Department of Gastroenterology, Whittington Hospital, Magdala Avenue, London N19 5NF, UK
| | - A Akbar
- Department of Gastroenterology, St Mark's Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK
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Klein TJ, Al-Ghasani T, Al-Ghasani M, Akbar A, Tang E, Al-Farsi Y. A mobile application to screen for autism in Arabic-speaking communities in Oman. Lancet Glob Health 2015. [DOI: 10.1016/s2214-109x(15)70134-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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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Bukhari M, Aslam MA, Khan A, Iram Q, Akbar A, Naz AG, Ahmad S, Ahmad MM, Ashfaq UA, Aziz H, Ali M. TLR8 gene polymorphism and association in bacterial load in southern Punjab of Pakistan: an association study with pulmonary tuberculosis. Int J Immunogenet 2015; 42:46-51. [PMID: 25572425 DOI: 10.1111/iji.12170] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 10/13/2014] [Accepted: 12/01/2014] [Indexed: 01/24/2023]
Abstract
Only 5-10% of people infected with Mycobacterium tuberculosis develop active tuberculosis which suggests a role of genetic variation in host immunity. Genetic variants in TLRs are potential indicator for host susceptibility and outcome of several diseases. We explored the association of nonsynonymous genetic variants (Met1Val) with Toll-like receptor 8 in Pakistani population. Genotypic and allelic distribution of TLR8 polymorphism (rs3764880) in patients with TB and healthy donors from different areas of southern Punjab, Pakistan, was determined. Results provide that our population is highly influenced by TLR8 Met1Val SNP for TB, and G allele appeared to increase TB susceptibility. Mutant genotype GG or G/- and G allele was significantly higher among all the categories of cases than in controls. Among different levels of bacillary load and genotypes, GG or G/- and G allele significantly supports the incidence of 2 + class for bacterial load.
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Affiliation(s)
- M Bukhari
- Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, Pakistan
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Akbar A, Bhatti A, Syed A, Khattak S, Jamshed A, Kazmi S. P10 Induction chemotherapy followed by chemoradiotherapy before surgery for rectal adenocarcinoma. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70041-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Plastic stents have been used in the pancreatic duct for a variety of indications. However, unlike in the bile duct, the use of covered self-expanding metal stents (CSEMSs) has been discouraged because multiple side branches drain into main pancreatic duct (MPD) and the ductal diameter is relatively small. This report aims to describe our experience using CSEMSs in the pancreatic duct in a series of nine patients, with special focus on adverse events. Indications were strictures (n = 5), intraductal mucinous neoplasm (IMPN; n = 1), pancreatic duct leak (n = 1), disconnected duct syndrome (n = 1), and severe acute pancreatitis/necrosis with disrupted duct (n = 1). Eight patients had symptomatic improvement, or radiological resolution of or improvement in their strictures, leaks, perforation, and necrosis. Two of these have indwelling CSEMSs for ongoing treatment. One patient (disconnected duct syndrome) was considered a treatment failure as the stent migrated and the patient underwent distal pancreatectomy for refractory pain. Two patients underwent pancreaticoduodenectomy for their malignancies after their CSEMSs had been in place for 43 and 49 days, respectively. Importantly no patients, including those with indwelling CSEMSs, developed stent-related acute pancreatitis with a median follow-up of 4 months. One patient developed post-procedure pain requiring hospitalization for 1 day. Median stent duration was 77 days. These observations suggest there is a potential role for the use of CSEMSs in the MPD in selected patients with pancreatic pathology.
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Affiliation(s)
- A Akbar
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Akbar A, Abimanyu B, Dachlan E, Abadi A. PP006. The comparison of serum VEGF and sFlt-1 on preeclampsia and eclampsia pregnant woman before and after delivery at Ulin Hospital, Banjarmasin, Indonesia. Pregnancy Hypertens 2012; 2:243. [DOI: 10.1016/j.preghy.2012.04.117] [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: 11/16/2022]
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Akbar A, Dachlan E. PP132 Comparison between Early-onset and Late-onset Preeclampsia based on maternal cardiac output, Total Peripheral Vascular Resistance, and Uterine Artery Resistance Index. Pregnancy Hypertens 2012; 2:310. [DOI: 10.1016/j.preghy.2012.04.243] [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: 10/28/2022]
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Akbar A, Wicaksono B, Dachlan E. OS018. Maternal mortality and its mainly possible causepre-eclampsia/eclampsia in developing country (Surabaya-Indonesia as themodel). Pregnancy Hypertens 2012; 2:184. [DOI: 10.1016/j.preghy.2012.04.019] [Citation(s) in RCA: 2] [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: 10/28/2022]
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Akbar A, Ariningtyas ND, Krismariono A, Dachlan EG. OS002. Comparison TNF-α level and pathogen periodontal microorganismbetween normal pregnant women, periodontitis pregnant women, and lateonset severe preeclampsia women. Pregnancy Hypertens 2012; 2:175-6. [PMID: 26105217 DOI: 10.1016/j.preghy.2012.04.004] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Preeclampsia Morbidity and Mortality is still high because of unknown etiology and pathogenesis. One of the theory about pathogenesis of preeclampsia in developing country is infections. Periodontitis is found in 10-60% preeclampsia cases in our center. So we held this research to evaluate the association between preeclampsia, periodontal pathogen, and TNF-α level. OBJECTIVES To compare and analyse the TNF-α level and pathogen periodontal microorganism between normal pregnant women, periodontitis pregnant women, and late onset severe preeclampsia women. Furthermore the research want to find any relationship between periodontitis and late onset severe preeclampsia. METHODS Analytic observational research with cross sectional study design at Soetomo Hospital from November 2010 until February 2011. Thirty patients divided into 3 groups, normal pregnant women, periodontitis pregnant women, and late onset severe preeclampsia women group. All patients were evaluated whether any periodontitis. Periodontal swab were performed and blood samples were taken from all of the patients. TNF-α level and pathogen periodontal microorganism were evaluated and analysed. RESULTS There is a significant difference TNF-α level between normal pregnant women, periodontitis pregnant women, and late onset severe preeclampsia p=0.000 (p<0.05). The highest TNF-α level is late onset preeclampsia, and the lowest is normal pregnant women. There is a significant difference pathogen periodontal microorganism between normal pregnant women, periodontitis pregnant women, and late onset severe preeclampsia p=0.001 (p<0.05). Porpyromonas ginggivalis is the most pathogen periodontal microorganism found at the samples. There is a significant difference TNF-α level between the samples with positive and negative pathogen periodontal microorganism p=0.04 (p<0.05). CONCLUSION There is a significant difference about the TNF-α level and pathogen periodontal microorganism between normal pregnant women, periodontitis pregnant women, and late onset severe preeclampsia. Furthermore the TNF-α level between the samples with positive and negative pathogen periodontal microorganism is significantly difference. Maybe periodontitis has association with late onset severe preeclampsia.
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Affiliation(s)
- A Akbar
- Obstetrics Gynaecologic (Fetomaternal Division)
| | | | - A Krismariono
- Dentistry Division of Periodontal, Soetomo Hospital University of Airlangga, Surabaya, Indonesia
| | - E G Dachlan
- Obstetrics Gynaecologic (Fetomaternal Division)
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Peake STC, Landy J, Hussein M, Tee CT, O'Connor M, Tyrrell T, Akbar A, Hart AL. Patient preference in choosing biological therapy in Crohn's disease. Inflamm Bowel Dis 2011; 17:E79. [PMID: 21538722 DOI: 10.1002/ibd.21767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 04/12/2011] [Indexed: 12/09/2022]
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Abstract
BACKGROUND Although development of visceral pain is an important defensive mechanism, hypersensitivity results in a significant clinical problem and is likely to be one of the major factors involved in the pathogenesis of abdominal and chest pain in functional bowel disorders (FBDs). Understanding of the molecular mechanisms involved in peripheral sensitization of visceral nociceptors has advanced as a result of the experimental studies, especially in animal models, which have led to knowledge and identification of key mediators and receptors. AIM To provide a comprehensive review focused on the peripheral mechanisms believed to be responsible for sensitization and potential molecular targets for a disorder which is common, distressing and has sub-optimal treatment options. METHODS Literature review using Ovid and Pubmed from 1966. RESULTS There is substantial interest in the development of new drugs for treatment of FBDs in the background of advances in understanding the molecular and physiological mechanisms of visceral hypersensitivity. The potential drug targets include TPRV1, ASICs, voltage-gated sodium channels, ATP, PAR-2, cannabinoid, prostaglandin, tachykinin and 5HT(3) receptors. CONCLUSION It is anticipated that with advancing molecular understanding of the basis of visceral hypersensitivity, the next decade will see accelerated development of new molecules for treatment of functional bowel diseases.
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Affiliation(s)
- A Akbar
- Department of Gastroenterology, Imperial College London, London, UK
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Akbar A, Wijffels N, Cunningham C, Lindsey I. CR16�*COLONIC INERTIA HAS NO ADVERSE IMPACT ON THE SHORT-TERM FUNCTIONAL RESULTS OF LAPAROSCOPIC ANTERIOR RECTOPEXY FOR INTERNAL RECTAL PROLAPSE CAUSING OBSTRUCTED DEFAECATION. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04915_16.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Akbar A, Wijffels N, Cunningham C, Dixon A, Lindsey I. CR06�*LAPAROSCOPIC ANTERIOR RECTOPEXY FOR EXTERNAL PROLAPSE IS SAFE IN THE ELDERLY AND MAKES PERINEAL PROCEDURES ALMOST OBSOLETE. ANZ J Surg 2009. [DOI: 10.1111/j.1445-2197.2009.04915_6.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Henson S, Macaulay R, Kiani-Alikhan S, Akbar A. The Use of the Inhibitory Receptors for Modulating the Immune Responses. Curr Pharm Des 2008; 14:2643-50. [DOI: 10.2174/138161208786264124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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