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Hussain A, Malik F, Siegel N. Pseudohypopyon in an Adult with Amyloidosis. Ophthalmol Glaucoma 2023; 6:579. [PMID: 37702638 DOI: 10.1016/j.ogla.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Ahsan Hussain
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Farhan Malik
- Mid-Atlantic Permanente Medical Group, Ophthalmology Department, McLean, Virginia
| | - Nicole Siegel
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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Brown TN, Justice L, Malik F, Lehenbauer D, O'Donnell A, Brown JM, Powers T, Neogi S, Cooper DS, Mah KE. Improvement in Multidisciplinary Provider Rounding (Surgical Rounds) in the Pediatric Cardiac ICU: An Application of Lean Methodology. Pediatr Crit Care Med 2023; 24:e282-e291. [PMID: 36804342 DOI: 10.1097/pcc.0000000000003218] [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: 02/22/2023]
Abstract
OBJECTIVES Provider-only, combined surgical, and medical multidisciplinary rounds ("surgical rounds") are essential to achieve optimal outcomes in large pediatric cardiac ICUs. Lean methodology was applied with the aims of identifying areas of waste and nonvalue-added work within the surgical rounds process. Thereby, the goals were to improve rounding efficiency and reduce rounding duration while not sacrificing critical patient care discussion nor delaying bedside rounds or surgical start times. DESIGN Single-center improvement science study with observational and interventional phases from February 2, 2021, to July 31, 2021. SETTING Tertiary pediatric cardiac ICU. PARTICIPANTS Cardiothoracic surgery and cardiac intensive care team members participating in daily "surgical" rounds. INTERVENTIONS Implementation of technology automation, creation of work instructions, standardization of patient presentation content and order, provider training, and novel role assignment. MEASUREMENTS AND MAIN RESULTS Sixty-one multidisciplinary rounds were observed (30 pre, 31 postintervention). During the preintervention period, identified inefficiencies included prolonged preparation time, redundant work, presentation variability and extraneous information, and frequent provider transitions. Application of targeted interventions resulted in a 26% decrease in indexed rounds duration (2.42 vs 1.8 min; p = 0.0003), 50% decrease in indexed rounds preparation time (0.53 vs 0.27 min; p < 0.0001), and 66% decrease in transition time between patients (0.09 vs 0.03 min; p < 0.0001). The number of presenting provider changes also decreased (9 vs 4; p < 0.0001). Indexed discussion duration did not change (1 vs 0.98 min; p = 0.08) nor did balancing measures (bedside rounds and surgical start times) change (8.5 vs 9 min; p = 0.89 and 38 vs 22 min; p = 0.09). CONCLUSIONS Lean methodology can be effectively applied to multidisciplinary rounds in a joint cardiothoracic surgery/cardiac intensive care setting to decrease waste and inefficiency. Interventions resulted in decreased preparation time, transition time, presenting provider changes, total rounds duration indexed to patient census, and anecdotal improvements in provider satisfaction.
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Affiliation(s)
- Tyler N Brown
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Lindsey Justice
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Farhan Malik
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL
| | - David Lehenbauer
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Alan O'Donnell
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - James M Brown
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Tricia Powers
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Smriti Neogi
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David S Cooper
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kenneth E Mah
- The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
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Moniruzzaman M, Koli A, Malik F, Islam S. Association between body mass index (BMI) and severity of coronary artery disease in young onset acute coronary syndrome (ACS). Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
A high body mass index (BMI) is seems to be associated with an increased incidence of coronary artery disease. If the affected person is young, the consequences are more tragic. There are variable information on the relation of incidence and severity of coronary artery disease in high BMI populations. We have examined the association between BMI and severity of coronary artery disease in young onset Acute Coronary Syndrome (ACS).
Methods
In this prospective observational study a total number of 150 patients, aged ≤45 years presented with acute coronary syndrome were enrolled to analyze association between Body Mass Index (BMI) and severity of coronary artery disease.
Results
The mean BMI in male was 24.6±3.6 and the mean BMI in female was 25.4±3.3. Among the 150 patients, 2(1.3%) was underweight, 78(52%) was normal, 60(40%) was overweight & 10(6.7%) was obese. All underweighted patients were diagnosed as STEMI. Among the normal BMI patients, 18(23.1%) had UA, 12(15.4%) had NSTEMI & 48 (61.5%) had STEMI. Among the overweight patients, 23(38.3%) had UA, 9(15%) had NSTEMI & 28(46.7%) had STEMI. And among the obese patients, 4(40%) had UA, 1 (10%) had NSTEMI & 5(50%) had STEMI. Considering involving coronary artery, left main coronary artery involvement was 0(0%), 6 (7.7%), 5 (8.3%) & 0(0%) in underweight, normal, overweight & obese patients respectively. Left anterior descending coronary artery involvement was 2(100%), 54 (69%), 45 (75%) & 7 (70%) in underweight, normal, overweight & obese patients respectively. Left circumflex coronary artery involvement was 1(50%), 33 (42%), 25 (41.7%) & 1 (9%) in underweight, normal, overweight & obese patients respectively. And right coronary artery involvement was 1(50%), 35 (44.9%), 31 (51.7%) & 5 (50%) in underweight, normal, overweight & obese patients respectively. In underweight patients 1(50%) had SVD and 1 (50%) had TVD. In normal BMI patients 40 (51.3%) had SVD, 11(14.1%) had DVD and 19 (24.4%) had TVD. In overweight patients 27 (45%) had SVD, 15 (25%) had DVD and 13 (21.7%) had TVD. And in obese patients 5 (50%) had SVD, 3(30%) had DVD and 0 (0%) had TVD. In all BMI group SVD was more common.
Conclusion
There is no statistically significant differences in severity of coronary artery in respect to body mass index (BMI), in patients presented with acute coronary syndrome.
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Affiliation(s)
- M Moniruzzaman
- Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital , Dhaka , Bangladesh
| | - A Koli
- Khwaja Yunus Ali Medical College and Hospital, Medicine , Sirajganj , Bangladesh
| | - F Malik
- National Heart Foundation Hospital & Research Institute, Cardiology , Dhaka , Bangladesh
| | - S Islam
- Khwaja Yunus Ali Medical College and Hospital, Medicine , Sirajganj , Bangladesh
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Malik F, Rossi N, Barker JR, Bernard C, Ayathamattam J. 1186 IMPROVED PERFORMANCE AGAINST SSNAP PARAMETERS FOR THROMBOLYSED STROKE PATIENTS FOLLOWING CHANGES IN PRACTICE. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.107] [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: 01/17/2023] Open
Abstract
Abstract
Background
The CQC inspection of the Royal Lancaster Infirmary (RLI) in May 2021 rated the performance of the stroke department unsatisfactory, leading to a number of changes. A retrospective audit was performed to determine the impact of these changes for thrombolysed stroke patients.
Aim
This retrospective audit assessed the performance of the stroke department at the RLI against the parameters set by the ‘Sentinel Stroke National Audit Program’ (SSNAP), comparing 6-month periods before and after the CQC inspection in May 2021.
Method
Using electronic medical records and SSNAP data, we reviewed every thrombolysed stroke patient at the RLI between November 2020 until April 2021 and from May 2021 until November 2021, assessing 10 parameters and comparing the results with SSNAP targets. Since May 2021, changes to practice introduced included opening a new, larger stroke unit located directly opposite the Emergency Department, ring-fencing stroke beds, doubling the number of stroke specialists and stroke consultants reviewing all suspected stroke patients face-to-face within working hours.
Results
46 patients were thrombolysed with 42 confirmed as having had ischaemic strokes on subsequent MRI imaging. All patients were discussed with a stroke consultant before thrombolysis. Mean time from arrival to CT improved from 51 to 34.5 minutes, admission to stroke unit from 7hr53 to 4hr36 and to thrombolysis from 2hr18 to 1hr22. The number of thrombolysis complications decreased from 5 to 2. Since the changes, the SSNAP grade for stroke unit admission improved from C to A and specialist assessments from E to B.
Conclusion
The changes implemented following the May 2021 CQC inspection have had a positive impact on the care of thrombolysed stroke patients and overall SSNAP grades at RLI. Improvements are still required and the next steps include improving the efficiency of thrombolysis times and further improving SSNAP grades.
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Affiliation(s)
- F Malik
- Royal Lancaster Infirmary Department of Stroke Medicine,
| | - N Rossi
- Royal Lancaster Infirmary Department of Stroke Medicine,
| | - J R Barker
- Royal Lancaster Infirmary Department of Stroke Medicine,
| | - C Bernard
- Royal Lancaster Infirmary Department of Stroke Medicine,
| | - J Ayathamattam
- Royal Lancaster Infirmary Department of Stroke Medicine,
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Malik F, Wadhwa B. Clinical and Experimental investigation of AKT1/2/3 isoforms indicated non-redundant isoform specific role in driving stemness and Cisplatin resistance in TNBCs. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01582-9] [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: 11/20/2022]
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MEADE T, Côté J, Lyons L, Twomey P, O'Riordan A, Watson A, O'Regan J, Fitzgerald T, Malik F, Clince M, Teh J, Holian J, Murray P. POS-072 A PROSPECTIVE AUDIT OF THE CLINICAL IMPLEMENTATION OF URINE NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (uNGAL) AS A BIOMARKER OF ACUTE KIDNEY INJURY IN HOSPITALISED PATIENTS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Malik F, Kalimuddin M, Ishraquzzaman M, Mamun MA, Chowdhury MS, Dutta A, Rahman MH, Kanungo S, Laila N, Choudhury SR. Clinical Presentation, Management and In-Hospital Outcome of COVID-19 among Non-Healthcare Personnel and Healthcare Personnel in a Tertiary Cardiac Care Hospital. Mymensingh Med J 2021; 30:769-779. [PMID: 34226467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The huge numbers of non-healthcare personnel (non-HCP) who get infected by corona virus disease 2019 (COVID-19) not only paralyze health care systems but also put health care personnel (HCP) at potential risk globally. Objective of the study was to compare the Healthcare personnel (HCP) and non-HCP COVID-19 cases. This prospective observational study was carried out in National Heart Foundation Hospital and Research Institute of Bangladesh from March 08, 2020 to July 20, 2020. During this study period all admitted non-HCP who subsequently was diagnosed as COVID-19 positive by rRT-PCR and HCP of this hospital, who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace and become COVID-19 positive, were included. Out of 320 infected patients, 181(56.6%) patients were non-HCP and 139(43.4%) were HCP. Non-HCP were older than HCP (Mean age: 52.95±13.82 years vs. 34.08±11.11 years; p=0.001). Non-HCP were predominantly male and HCP were predominantly female (73.5% vs. 41% & 26.5% vs. 59%; p=0.001). Non-HCP had more risk factors and co-morbidities than HCP (p=0.001). Typical symptoms of COVID-19 such as fever and cough were prevalent in HCP. More aggressive treatment was required for non-HCP. Non-HCP had more severe disease and higher case fatality rate (9.4% vs. 0.7%; p=0.001) than HCP. Disease severity (OR 0.03, 95% CI 0.01-0.15) and DM (OR 0.09, 95% CI 0.01-0.94) were the independent predictor of mortality. Non-HCP was older in age, predominantly male and had more co-morbidities than HCP. Typical symptoms of COVID-19 were prevalent in HCP. Non-HCP had more severe disease and higher case fatality rate than HCP.
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Affiliation(s)
- F Malik
- Professor Fazila-Tun-Nesa Malik, Professor, Department of Cardiology, National Heart Foundation Hospital & Research Institute (NHFH&RI), Dhaka, Bangladesh; E-mail:
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El-Taji O, Al-Mitwalli A, Malik F, Agarwal S, Gogbashian A, Hughes R, Vasdev N, Sharma A. Secondary neoplasms of the urinary bladder-clinical management and oncological outcomes. Transl Androl Urol 2021; 10:2427-2434. [PMID: 34295729 PMCID: PMC8261409 DOI: 10.21037/tau-20-955] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 12/23/2020] [Indexed: 11/06/2022] Open
Abstract
Background Secondary neoplasms of the bladder account for 4.5% of all bladder neoplasms however there is limited literature reporting management and survival. This is the largest single centre series presented in current literature with long term oncological follow up. Methods This is a single institutional, retrospective cohort study of patients with a histological diagnosis of a secondary bladder neoplasm from January 2007 to December 2017 (n=40). Prognostic variables examined included age at diagnosis, histology, disease free survival and treatment. Kaplan-Meier analysis was used to calculate survival. We used multiple regression analysis to identify the most significant treatments for each population group in terms of their survival. Results Twenty-one patients were male (53%) with a median age of 68 and 19 were female (47%) with a median age of 64. The most common secondary neoplasms and their median survival were prostate [12 patients (30%), 446 days], colorectal [9 patients (23%), 403 days], ovarian [5 patients (13%), 369 days], cervical [4 patients (10%), 148 days], breast [3 patients (8%), 241 days], lymphoma [3 patients (8%), 145 days], gastric [2 patients (5%), 66 days], and renal [2 patients (5%), 854 days]. Those receiving treatment following a secondary diagnosis demonstrated statistical significance in survival for colorectal (surgery P=0.013), prostate (radiotherapy P=0.0012 and hormonal therapy P=0.004) and ovarian cancer (chemotherapy P=0.00002). Conclusions Prognosis and treatment depends upon the primary neoplasm. There is some survival benefit in well selected patients receiving treatment following a diagnosis of a bladder secondary.
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Affiliation(s)
- Omar El-Taji
- Department of Urology, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB UK
| | - Abdullah Al-Mitwalli
- Department of Urology, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB UK
| | | | - Samita Agarwal
- Department of Histopathology, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB, UK
| | - Andrew Gogbashian
- Department of Radiology, Mount Vernon Cancer Centre, Paul Strickland Scanner Centre, Northwood, HA6 2RN, UK
| | - Rob Hughes
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK
| | - Nikhil Vasdev
- Department of Urology, Lister Hospital, East and North Herts NHS Trust, Stevenage, SG1 4AB UK.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Anand Sharma
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood, HA6 2RN, UK
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Malik J, Laique T, Farooq MH, Khan U, Malik F, Zahid M, Majid A. Impact of Primary Percutaneous Coronary Intervention on Complete Atrioventricular Block With Acute Inferior ST-Elevation Myocardial Infarction. Cureus 2020; 12:e10013. [PMID: 32983709 PMCID: PMC7515546 DOI: 10.7759/cureus.10013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background and aims Complete atrioventricular block (CAVB) is associated with poor clinical outcomes in ST-elevation myocardial infarction (STEMI). This study determined the frequency and outcomes of primary percutaneous coronary intervention (PPCI) in patients with CAVB with acute inferior STEMI. Methods We conducted an observational, prospective study and enrolled 151 patients who were diagnosed with inferior STEMI. All patients received PPCI. The clinical outcomes were compared in patients with and without CAVB. The data was recorded on a collection form and analyzed on Statistical Package for Social Sciences (SPSS) software. Descriptive statistics were applied. For quantitative variables, standard deviation and mean were obtained, and statistical tests were also applied. Results Baseline characteristics were homogeneous in all patients. Half of the study population was either diabetic or hypertensive. Out of 151 participants, 21 (13.9%) developed CAVB. Two-thirds of the patients, who had developed heart block, reverted after PPCI. After a follow-up of two weeks, in-hospital mortality did not differ between the groups. Conclusion We conclude that PPCI can improve outcomes of CAVB-complicated acute inferior STEMI and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB with STEMI.
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Malik F, Middleton Z, Haque F, Tambe N, Roy R. P-273 Real-world experience of definitive chemoradiation in esophageal cancer: Correlation of tumour length, toxicity and disease control. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tanner K, Malik F, Smith T, Cosgriff R, Medhurst N, Keogh R. P066 Development of an online tool to provide accessible and personalised information on life expectancy in cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Malik F, Tanner K, Smith T, Cosgriff R, Medhurst N, Keogh R. P065 Perspectives on personalised life expectancy information and how it should be presented: a qualitative study. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30401-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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Malik F, Khaing T, Adlakha S, Aye T. Atypical presentation of ventricular tachycardia. Clin Med (Lond) 2020; 20:e15-e17. [PMID: 32414733 DOI: 10.7861/clinmed.2020-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cardiac syncope and epileptic seizure are two very similar presentations and difficult to differentiate without a proper history, physical examination and investigations. In a former study, 10 out of 22 episodes of induced ventricular tachycardia or fibrillation can result in stereotypical tonic-clonic movement with varied electroencephalography changes. We present a case which was diagnosed as ventricular tachycardia from seizure-like attack. It is to emphasise the importance of including ventricular tachycardia among other differential diagnoses of seizure-like activity in a patient with cardiovascular risks.
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Affiliation(s)
| | | | | | - Thandar Aye
- King's Mill Hospital, Sutton in Ashfield, UK
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Abstract
Objective To determine the pattern of microbes responsible for urinary tract infections and their susceptibility to antimicrobial agents. Methods This was a prospective, observational study conducted at Benazir Bhutto Hospital, Rawalpindi, Pakistan. The urine samples of 440 patients were collected and sent for culture and sensitivity analysis. The results were recorded on a proforma. The data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY). Descriptive statistics were used to describe the data. Chi-square test was applied to determine the significance of the difference between gender and microorganisms as well as microorganism and antimicrobial sensitivity. P-value of less than 0.05 was considered significant. Results Out of 440 urine samples, 144 culture-positive samples had been obtained from male participants and 296 culture-positive samples had been obtained from female participants. The most common organism on analysis was Escherichia coli. There were more rates of resistance in males. The organisms were most susceptible to fosfomycin and imipenem (p = 0.01). The organisms were resistant to ceftazidime (p = 0.01). Conclusion In Pakistan, most patients with resistance present with mild symptoms instead of severe clinical manifestations. Therefore, there is a need to reduce the over-prescription of antibiotics for urinary tract infections, especially in cases when other non-antimicrobial agents can be used.
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Affiliation(s)
- Jahanzeb Malik
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Nismat Javed
- Internal Medicine, Shifa College of Medicine - Shifa Tameer-E-Millat University, Islamabad, PAK.,Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Farhan Malik
- Internal Medicine, Blackpool Teaching Hospitals, NHS Foundation Trust, Blackpool, England, GBR
| | - Uzma Ishaq
- Hematology and Medical Oncology, Fauji Foundation Hospital, Rawalpindi, PAK
| | - Zubair Ahmed
- Internal Medicine, Benazir Bhutto Hospital Rawalpindi, Rawalpindi, PAK
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Malik F, Khaing TT, Shah F. Atypical presentation of Addison’s disease. Clin Med (Lond) 2020; 20:s39. [DOI: 10.7861/clinmed.20-2-s39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Malik F, Khaing TT. Atypical presentation of ventricular tachycardia. Clin Med (Lond) 2019. [DOI: 10.7861/clinmedicine.19-3s-s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Malik F, Khaing TT. Atypical presentation of ventricular tachycardia. Clin Med (Lond) 2019. [DOI: 10.7861/clinmedicine.19-3-s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Qammar M, Malik Z, Malik F, Baig T, Chaudhary AJ. Antibacterial activity of Mg1-xNixO(x=0.5) nano-solid solution; experimental and computational approach. J Mol Struct 2019. [DOI: 10.1016/j.molstruc.2018.11.040] [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: 01/09/2023]
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Abstract
SummaryThe intrahepatic kinetics of 111indium-labelled platelets have been studied using dynamic gamma camera scintigraphy immediately following injection. Platelets labelled in saline with mIn-oxine or 111In-acetylacetonate underwent rapidly reversible hepatic sequestration, indicating that they were “activated”. Platelets labelled in plasma with 111In-tropolonate, however, did not display this phenomenon. On the assumption that plasma-labelled platelets display a normal initial bio-distribution, mean intrahepatic platelet transit time, as a factor of the transit time of 99m-Tc labelled red cells, was 1.45 ± SE 0.12 (n = 6), implying the normal presence of a small intrahepatic platelet pool. Unlike the liver, transit through the spleen was not sensitive to the labelling medium; thus the mean intrasplenic transit time of plasma-labelled platelets was 9.3 ± SE 0.7 min (n = 10), and of saline-labelled platelets 9.5 ± SE 0.3 min (n = 8).
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Affiliation(s)
- A M Peters
- The Department of Diagnostic Radiology, Royal Postgraduate Medical School, London, UK
| | - S H Saverymuttu
- The Department of Medicine, Royal Postgraduate Medical School, London, UK
| | - F Malik
- The Department of Diagnostic Radiology, Royal Postgraduate Medical School, London, UK
| | - P W Ind
- The Department of Medicine, Royal Postgraduate Medical School, London, UK
| | - J P Lavender
- The Department of Diagnostic Radiology, Royal Postgraduate Medical School, London, UK
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Malik F, Cromar KR, Atkins CL, Price RE, Jackson WT, Siddiqui SR, Spencer CY, Mitchell NC, Haque IU, Johnston RA. Chemokine (C-C Motif) Receptor-Like 2 is not essential for lung injury, lung inflammation, or airway hyperresponsiveness induced by acute exposure to ozone. Physiol Rep 2018; 5:5/24/e13545. [PMID: 29242308 PMCID: PMC5742705 DOI: 10.14814/phy2.13545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/13/2017] [Accepted: 11/20/2017] [Indexed: 11/24/2022] Open
Abstract
Inhalation of ozone (O3), a gaseous air pollutant, causes lung injury, lung inflammation, and airway hyperresponsiveness. Macrophages, mast cells, and neutrophils contribute to one or more of these sequelae induced by O3. Furthermore, each of these aforementioned cells express chemokine (C‐C motif) receptor‐like 2 (Ccrl2), an atypical chemokine receptor that facilitates leukocyte chemotaxis. Given that Ccrl2 is expressed by cells essential to the development of O3‐induced lung pathology and that chemerin, a Ccrl2 ligand, is increased in bronchoalveolar lavage fluid (BALF) by O3, we hypothesized that Ccrl2 contributes to the development of lung injury, lung inflammation, and airway hyperresponsiveness induced by O3. To that end, we measured indices of lung injury (BALF protein, BALF epithelial cells, and bronchiolar epithelial injury), lung inflammation (BALF cytokines and BALF leukocytes), and airway responsiveness to acetyl‐β‐methylcholine chloride (respiratory system resistance) in wild‐type and mice genetically deficient in Ccrl2 (Ccrl2‐deficient mice) 4 and/or 24 hours following cessation of acute exposure to either filtered room air (air) or O3. In air‐exposed mice, BALF chemerin was greater in Ccrl2‐deficient as compared to wild‐type mice. O3 increased BALF chemerin in mice of both genotypes, yet following O3 exposure, BALF chemerin was greater in Ccrl2‐deficient as compared to wild‐type mice. O3 increased indices of lung injury, lung inflammation, and airway responsiveness. Nevertheless, no indices were different between genotypes following O3 exposure. In conclusion, we demonstrate that Ccrl2 modulates chemerin levels in the epithelial lining fluid of the lungs but does not contribute to the development of O3‐induced lung pathology.
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Affiliation(s)
- Farhan Malik
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Kevin R Cromar
- Marron Institute of Urban Management New York University, New York, New York
| | - Constance L Atkins
- Division of Pulmonary Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Roger E Price
- Comparative Pathology Laboratory, Center for Comparative Medicine, Baylor College of Medicine, Houston, Texas
| | - William T Jackson
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Saad R Siddiqui
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Chantal Y Spencer
- Section of Pediatric Pulmonology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Nicholas C Mitchell
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ikram U Haque
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Richard A Johnston
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas .,Department of Integrative Biology and Pharmacology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
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Chan O, Moore L, Lai B, Jeong E, Nelson L, Malik F, Sykes J, Mathur S, Wu K. WS04.5 Predicting six-minute walk distance in adults with cystic fibrosis during hospitalisation. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Elkhidir HS, Richards JB, Cromar KR, Bell CS, Price RE, Atkins CL, Spencer CY, Malik F, Alexander AL, Cockerill KJ, Haque IU, Johnston RA. Plasminogen activator inhibitor-1 does not contribute to the pulmonary pathology induced by acute exposure to ozone. Physiol Rep 2016; 4:4/18/e12983. [PMID: 27670409 PMCID: PMC5037925 DOI: 10.14814/phy2.12983] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 08/31/2016] [Indexed: 11/24/2022] Open
Abstract
Expression of plasminogen activator inhibitor (PAI)-1, the major physiological inhibitor of fibrinolysis, is increased in the lung following inhalation of ozone (O3), a gaseous air pollutant. PAI-1 regulates expression of interleukin (IL)-6, keratinocyte chemoattractant (KC), and macrophage inflammatory protein (MIP)-2, which are cytokines that promote lung injury, pulmonary inflammation, and/or airway hyperresponsiveness following acute exposure to O3 Given these observations, we hypothesized that PAI-1 contributes to the severity of the aforementioned sequelae by regulating expression of IL-6, KC, and MIP-2 following acute exposure to O3 To test our hypothesis, wild-type mice and mice genetically deficient in PAI-1 (PAI-1-deficient mice) were acutely exposed to either filtered room air or O3 (2 ppm) for 3 h. Four and/or twenty-four hours following cessation of exposure, indices of lung injury [bronchoalveolar lavage fluid (BALF) protein and epithelial cells], pulmonary inflammation (BALF IL-6, KC, MIP-2, macrophages, and neutrophils), and airway responsiveness to aerosolized acetyl-β-methylcholine chloride (respiratory system resistance) were measured in wild-type and PAI-1-deficient mice. O3 significantly increased indices of lung injury, pulmonary inflammation, and airway responsiveness in wild-type and PAI-1-deficient mice. With the exception of MIP-2, which was significantly lower in PAI-1-deficient as compared to wild-type mice 24 h following cessation of exposure to O3, no other genotype-related differences occurred subsequent to O3 exposure. Thus, following acute exposure to O3, PAI-1 neither regulates pulmonary expression of IL-6 and KC nor functionally contributes to any of the pulmonary pathological sequelae that arise from the noxious effects of inhaled O3.
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Affiliation(s)
- Hamza S Elkhidir
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Jeremy B Richards
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Kevin R Cromar
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York
| | - Cynthia S Bell
- Division of Nephrology, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Roger E Price
- Comparative Pathology Laboratory, Center for Comparative Medicine, Baylor College of Medicine, Houston, Texas
| | - Constance L Atkins
- Division of Pulmonary Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Chantal Y Spencer
- Section of Pediatric Pulmonology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Farhan Malik
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Amy L Alexander
- Pediatric Research Center, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Katherine J Cockerill
- Pediatric Research Center, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ikram U Haque
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Richard A Johnston
- Division of Critical Care Medicine, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas Pediatric Research Center, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas Department of Integrative Biology and Pharmacology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
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Riaz H, Finlayson AE, Bashir S, Hussain S, Mahmood S, Malik F, Godman B. Prevalence of Vitamin D deficiency in Pakistan and implications for the future. Expert Rev Clin Pharmacol 2016; 9:329-38. [PMID: 26582317 DOI: 10.1586/17512433.2016.1122519] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS vitamin D deficiency (25-hydroxyvitamin D) affects over one billion people worldwide. Vitamin D deficiency results in progression of osteoporosis as well as other conditions. Previous studies have shown high rates of vitamin D deficiency in Pakistan despite appreciable levels of sunshine. However, none have assessed vitamin D deficiency across all age groups, genders, incomes, and locations to guide future strategies. METHODS Questionnaire and blood sampling among 4830 randomly selected citizens. RESULTS High levels of deficiency among all age groups, genders, income levels, and locations. Amongst the selected citizens, 53.5% had vitamin D deficiency, 31.2% had insufficient vitamin D, and only 15.3% normal vitamin D. CONCLUSION High rates of vitamin D deficiency in Pakistan despite high levels of sunshine and previous Food Acts asking for food fortification with vitamin D. Public health strategies are needed to address high deficiency rates, including food fortification, i.e. nurture, alongside increasing exposure to sunlight, i.e. nature. This will involve all key stakeholder groups.
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Affiliation(s)
- H Riaz
- a Faculty of Pharmacy , Sargodha University , Sargodha , Pakistan
| | - A E Finlayson
- b Green Templeton College , Oxford University , Oxford , UK.,c Nuffield Department of Primary Care Health Sciences , University of Oxford , Oxford , UK
| | - S Bashir
- a Faculty of Pharmacy , Sargodha University , Sargodha , Pakistan
| | - S Hussain
- d Drugs Control and Traditional Medicines Division, National Institute of Health , Islamabad , Pakistan
| | - S Mahmood
- e Quaid-i-Azam University , Islamabad , Pakistan
| | - F Malik
- d Drugs Control and Traditional Medicines Division, National Institute of Health , Islamabad , Pakistan
| | - B Godman
- f Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute , Karolinska University Hospital Huddinge , Stockholm , Sweden.,g Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , UK
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Razvi SS, Richards JB, Malik F, Cromar KR, Price RE, Bell CS, Weng T, Atkins CL, Spencer CY, Cockerill KJ, Alexander AL, Blackburn MR, Alcorn JL, Haque IU, Johnston RA. Resistin deficiency in mice has no effect on pulmonary responses induced by acute ozone exposure. Am J Physiol Lung Cell Mol Physiol 2015; 309:L1174-85. [PMID: 26386120 DOI: 10.1152/ajplung.00270.2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 09/14/2015] [Indexed: 01/10/2023] Open
Abstract
Acute exposure to ozone (O3), an air pollutant, causes pulmonary inflammation, airway epithelial desquamation, and airway hyperresponsiveness (AHR). Pro-inflammatory cytokines-including IL-6 and ligands of chemokine (C-X-C motif) receptor 2 [keratinocyte chemoattractant (KC) and macrophage inflammatory protein (MIP)-2], TNF receptor 1 and 2 (TNF), and type I IL-1 receptor (IL-1α and IL-1β)-promote these sequelae. Human resistin, a pleiotropic hormone and cytokine, induces expression of IL-1α, IL-1β, IL-6, IL-8 (the human ortholog of murine KC and MIP-2), and TNF. Functional differences exist between human and murine resistin; yet given the aforementioned observations, we hypothesized that murine resistin promotes O3-induced lung pathology by inducing expression of the same inflammatory cytokines as human resistin. Consequently, we examined indexes of O3-induced lung pathology in wild-type and resistin-deficient mice following acute exposure to either filtered room air or O3. In wild-type mice, O3 increased bronchoalveolar lavage fluid (BALF) resistin. Furthermore, O3 increased lung tissue or BALF IL-1α, IL-6, KC, TNF, macrophages, neutrophils, and epithelial cells in wild-type and resistin-deficient mice. With the exception of KC, which was significantly greater in resistin-deficient compared with wild-type mice, no genotype-related differences in the other indexes existed following O3 exposure. O3 caused AHR to acetyl-β-methylcholine chloride (methacholine) in wild-type and resistin-deficient mice. However, genotype-related differences in airway responsiveness to methacholine were nonexistent subsequent to O3 exposure. Taken together, these data demonstrate that murine resistin is increased in the lungs of wild-type mice following acute O3 exposure but does not promote O3-induced lung pathology.
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Affiliation(s)
- Shehla S Razvi
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Jeremy B Richards
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Farhan Malik
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Kevin R Cromar
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York
| | - Roger E Price
- Comparative Pathology Laboratory, Center for Comparative Medicine, Baylor College of Medicine, Houston, Texas
| | - Cynthia S Bell
- Division of Nephrology, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Tingting Weng
- Department of Biochemistry and Molecular Biology, The University of Texas Medical School at Houston, Houston, Texas
| | - Constance L Atkins
- Division of Pulmonary Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Chantal Y Spencer
- Pediatric Pulmonary Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Katherine J Cockerill
- Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Amy L Alexander
- Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Michael R Blackburn
- Department of Biochemistry and Molecular Biology, The University of Texas Medical School at Houston, Houston, Texas
| | - Joseph L Alcorn
- Department of Biochemistry and Molecular Biology, The University of Texas Medical School at Houston, Houston, Texas; Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas; and
| | - Ikram U Haque
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Richard A Johnston
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas; Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas; Department of Integrative Biology and Pharmacology, The University of Texas Medical School at Houston, Houston, Texas
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Mohamedali AM, Gäken J, Ahmed M, Malik F, Smith AE, Best S, Mian S, Gaymes T, Ireland R, Kulasekararaj AG, Mufti GJ. High concordance of genomic and cytogenetic aberrations between peripheral blood and bone marrow in myelodysplastic syndrome (MDS). Leukemia 2015; 29:1928-38. [DOI: 10.1038/leu.2015.110] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/24/2015] [Accepted: 04/16/2015] [Indexed: 12/12/2022]
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26
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Shakoor S, Malik F, Hasan R. High proportion of multidrug resistant Mycobacterium tuberculosis among children in Pakistan. Int J Mycobacteriol 2015. [DOI: 10.1016/j.ijmyco.2014.10.019] [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: 11/26/2022] Open
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27
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Dahm PH, Richards JB, Karmouty-Quintana H, Cromar KR, Sur S, Price RE, Malik F, Spencer CY, Barreno RX, Hashmi SS, Blackburn MR, Haque IU, Johnston RA. Effect of antigen sensitization and challenge on oscillatory mechanics of the lung and pulmonary inflammation in obese carboxypeptidase E-deficient mice. Am J Physiol Regul Integr Comp Physiol 2014; 307:R621-33. [PMID: 25009214 DOI: 10.1152/ajpregu.00205.2014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Atopic, obese asthmatics exhibit airway obstruction with variable degrees of eosinophilic airway inflammation. We previously reported that mice obese as a result of a genetic deficiency in either leptin (ob/ob mice) or the long isoform of the leptin receptor (db/db mice) exhibit enhanced airway obstruction in the presence of decreased numbers of bronchoalveolar lavage fluid (BALF) eosinophils compared with lean, wild-type mice following antigen (ovalbumin; OVA) sensitization and challenge. To determine whether the genetic modality of obesity induction influences the development of OVA-induced airway obstruction and OVA-induced pulmonary inflammation, we examined indices of these sequelae in mice obese as a result of a genetic deficiency in carboxypeptidase E, an enzyme that processes prohormones and proneuropeptides involved in satiety and energy expenditure (Cpe(fat) mice). Accordingly, Cpe(fat) and lean, wild-type (C57BL/6) mice were sensitized to OVA and then challenged with either aerosolized PBS or OVA. Compared with genotype-matched, OVA-sensitized and PBS-challenged mice, OVA sensitization and challenge elicited airway obstruction and increased BALF eosinophils, macrophages, neutrophils, IL-4, IL-13, IL-18, and chemerin. However, OVA challenge enhanced airway obstruction and pulmonary inflammation in Cpe(fat) compared with wild-type mice. These results demonstrate that OVA sensitization and challenge enhance airway obstruction in obese mice regardless of the genetic basis of obesity, whereas the degree of OVA-induced pulmonary inflammation is dependent on the genetic modality of obesity induction. These results have important implications for animal models of asthma, as modeling the pulmonary phenotypes for subpopulations of atopic, obese asthmatics critically depends on selecting the appropriate mouse model.
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Affiliation(s)
- Paul H Dahm
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Jeremy B Richards
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Harry Karmouty-Quintana
- Department of Biochemistry and Molecular Biology, The University of Texas Medical School at Houston, Houston, Texas
| | - Kevin R Cromar
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York
| | - Sanjiv Sur
- Division of Allergy and Immunology, Department of Internal Medicine, The University of Texas Medical Branch at Galveston School of Medicine, Galveston, Texas
| | - Roger E Price
- Comparative Pathology Laboratory, Center for Comparative Medicine, Baylor College of Medicine, Houston, Texas
| | - Farhan Malik
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Chantal Y Spencer
- Pediatric Pulmonary Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and
| | - Ramon X Barreno
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Syed S Hashmi
- Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Michael R Blackburn
- Department of Biochemistry and Molecular Biology, The University of Texas Medical School at Houston, Houston, Texas
| | - Ikram U Haque
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
| | - Richard A Johnston
- Division of Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas; Pediatric Research Center, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, Texas
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Kim G, Ouzounova M, Quraishi AA, Davis A, Tawakkol N, Clouthier SG, Malik F, Paulson AK, D'Angelo RC, Korkaya S, Baker TL, Esen ES, Prat A, Liu S, Kleer CG, Thomas DG, Wicha MS, Korkaya H. SOCS3-mediated regulation of inflammatory cytokines in PTEN and p53 inactivated triple negative breast cancer model. Oncogene 2014; 34:671-80. [PMID: 24531711 PMCID: PMC4285772 DOI: 10.1038/onc.2014.4] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/18/2013] [Accepted: 01/06/2014] [Indexed: 02/07/2023]
Abstract
Somatic mutations or deletions of TP53 and PTEN in ductal carcinoma in situ (DCIS) lesions have been implicated in progression to invasive ductal carcinomas. A recent molecular and mutational analysis of breast cancers revealed that inactivation of tumor suppressors, p53 and PTEN are strongly associated with triple negative breast cancer. In addition, these tumor suppressors play important roles in regulating self-renewal in normal and malignant stem cells. To investigate their role in breast carcinogenesis, we knocked down these genes in human mammary cells and in non-transformed MCF10A cells. p53 and PTEN knockdown synergized to activate pro-inflammatory IL6/Stat3/NF-κB signaling. This resulted in generation of highly metastatic EMT-like cancer stem cells (CSCs) resulting in tumors whose gene expression profile mimicked that found in basal/claudin-low molecular subtype within the triple negative breast tumors. Constitutive activation of this loop in transformed cells was dependent on proteolytic degradation of SOCS3 resulting in low levels of this protein in basal/claudin low cell lines and primary tumors. In non-transformed cells, transient activation of the IL6 inflammatory loop induced SOCS3 expression leading to pathway inactivation. In transformed cells, enforced expression of SOCS3 or interfering with IL6 pathway via IL6R blockade inhibited tumor growth and metastasis in mouse xenograft models. Furthermore, circulating tumor cells were significantly reduced in tumor bearing animals when treated with anti-IL6R antibodies. These studies uncover important connections between inflammation and carcinogenesis and suggest that blocking pro-inflammatory cytokines may be utilized as an attractive strategy to target triple negative breast tumors which currently lacks molecularly targeted therapies.
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Affiliation(s)
- G Kim
- 1] Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA [2] Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam 463-712, Gyeonggi, Republic of Korea
| | - M Ouzounova
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - A A Quraishi
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Davis
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - N Tawakkol
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - S G Clouthier
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - F Malik
- 1] Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA [2] Department of Cancer Pharmacology, Indian Institute of Integrative Medicine, Jammu, India
| | - A K Paulson
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - R C D'Angelo
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - S Korkaya
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - T L Baker
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - E S Esen
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Prat
- Translational Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - S Liu
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - C G Kleer
- Department of Pathology, University of Michigan Medical School, Ann Arbor, USA
| | - D G Thomas
- Department of Pathology, University of Michigan Medical School, Ann Arbor, USA
| | - M S Wicha
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
| | - H Korkaya
- Comprehensive Cancer Center, Department of Internal medicine, University of Michigan, Ann Arbor, MI, USA
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Kumar S, Guru SK, Pathania AS, Kumar A, Bhushan S, Malik F. Autophagy triggered by magnolol derivative negatively regulates angiogenesis. Cell Death Dis 2013; 4:e889. [PMID: 24176847 PMCID: PMC3920944 DOI: 10.1038/cddis.2013.399] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/06/2013] [Accepted: 08/20/2013] [Indexed: 12/19/2022]
Abstract
Angiogenesis has a key role in the tumor progression and metastasis; targeting endothelial cell proliferation has emerged as a promising therapeutic strategy for the prevention of cancer. Previous studies have revealed a complex association between the process of angiogenesis and autophagy and its outcome on tumorigenesis. Autophagy, also known as type-II cell death, has been identified as an alternative way of cell killing in apoptotic-resistant cancer cells. However, its involvement in chemoresistance and tumor promotion is also well known. In this study, we used a derivate of natural product magnolol (Ery5), a potent autophagy inducer, to study the association between the autophagy and angiogenesis in both in vitro and in vivo model system. We found that the robust autophagy triggered by Ery5, inhibited angiogenesis and caused cell death independent of the apoptosis in human umbilical cord vein endothelial cells and PC-3 cells. Ery5 induced autophagy effectively inhibited cell proliferation, migration, invasion and tube formation. We further demonstrated that Ery5-mediated autophagy and subsequent inhibition of angiogenesis was reversed when autophagy was inhibited through 3-methyl adenine and knocking down of key autophagy proteins ATG7 and microtubule-associated protein light chain 3. While evaluating the negative regulation of autophagy on angiogenesis, it was interesting to find that angiogenic environment produced by the treatment of VEGF and CoCl2 remarkably downregulated the autophagy and autophagic cell death induced by Ery5. These studies, while disclosing the vital role of autophagy in the regulation of angiogenesis, also suggest that the potent modulators of autophagy can lead to the development of effective therapeutics in apoptosis-resistant cancer.
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Affiliation(s)
- S Kumar
- 1] Department of Cancer Pharmacology, Indian Institute of Integrative Medicine, Canal Road Jammu, Jammu and Kashmir 180001, India [2] Academy of Scientific and Innovative Research (AcSIR), New Delhi 110001, India
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Ottenheijm C, Buck D, de Winter J, Ferrara C, Piroddi N, Tesi C, Jasper R, Malik F, Meng F, Stienen G, Beggs A, Labeit S, Poggesi C, Lawlor M, Granzier H. P.9.10 Deleting exon 55 from the nebulin gene induces severe muscle weakness in a mouse model for nemaline myopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.523] [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: 10/26/2022]
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31
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Bausewein C, Malik F, Booth S, Higginson I. Recent developments in managing breathlessness: International researchers' meeting on Breathlessness in London, November 2006. Progress in Palliative Care 2013. [DOI: 10.1179/096992607x236434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Akram M, Nazar M, Ghaffar A, Malik F, Ali N, Mujahid SA, Rajput MU,   M. Neutron Induced Fission Track Estimation of Uranium Concentration and Its Associated Health Hazards in Drinking Water of the Faisalabad Industrial City. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/wjnst.2013.32009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Irfan S, Ahmad A, Guhar D, Khan E, Malik F, Mahmood S, Zafar A. Fluoroquinolone and macrolide co-resistance in clinical isolates of Campylobacter species: a 15-year study in Karachi, Pakistan. East Mediterr Health J 2012; 16:1226-30. [PMID: 24988396 DOI: 10.26719/2010.16.12.1226] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 03/05/2009] [Indexed: 11/09/2022]
Abstract
Fluoroquinolone and macrolide antibiotics are generally considered as first-line drugs for the treatment of severe campylobacteriosis. This study was conducted to analyse the trend of erythromycin and ofloxacin resistance among Campylobacter spp. isolated from stool specimens over a period of 15 years (1992-2007) at The Aga Khan University clinical laboratory in Karachi, Pakistan. A total of 83 396 stool specimens were processed, with a 14% isolation rate for enteric pathogens. The isolation rate of Campylobacter spp. was low during 1992-93 (6%-13%), peaked in 1996 (46%), then ranged from 20% to 40%. We report a rising trend in ofloxacin resistance, re-emergence of erythromycin resistance and indications of co-resistance to both drugs in clinical isolates of Campylobacter spp.
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Affiliation(s)
- S Irfan
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - A Ahmad
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - D Guhar
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - E Khan
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - F Malik
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - S Mahmood
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
| | - A Zafar
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
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Abstract
This retrospective study of 9,980 women who delivered at the James Paget Hospital, Norfolk, UK, over 5 years, aimed to primarily determine whether the incidence of hyperemesis gravidarum (HG) is higher in the presence of a female fetus. The results showed that more women with HG had a female fetus compared with women without HG. Also found was that heavy ketonuria was more prevalent in women with a female fetus compared with women with a male fetus, and the mean number of admissions per woman was also higher in women with a female fetus compared with women with a male fetus. It can be concluded that women presenting with HG are more likely to have a female fetus and that women with HG and a female fetus tend to a higher level of ketonuria and an increased number of hospital admissions.
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Affiliation(s)
- M Rashid
- Department of Obstetrics and Gynaecology, James Paget Hospital, Great Yarmouth, UK.
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Malik F, Russell A, Pannirselvam M, Hinken A, Thomsen K, Ardiana A, Godinez G, Jia Z, Saikali K, Chen M, Morgans D, Jasper J. The Fast Skeletal Troponin Activator, CK-2017357, Increases Muscle Function and Survival in SOD1 (G93A) Mice; a Model of ALS (P05.169). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.169] [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: 11/15/2022] Open
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Malik F, Akram M, Rajput MU. Measurement of natural radioactivity in sand samples collected along the bank of rivers Indus and Kabul in northern Pakistan. Radiat Prot Dosimetry 2011; 143:97-105. [PMID: 21062802 DOI: 10.1093/rpd/ncq356] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Radioactivity is a part of the natural environment. The presence of natural radioactivity in sand and other building materials results in internal and external exposure to the general public. Therefore, it is desirable to determine the concentration of naturally occurring radionuclides, namely (232)Th, (226)Ra and (40)K in sand, bricks and cement which are commonly used as building materials in Pakistan. In this context, sand samples were collected from 18 different locations covering an area of ∼1000 km(2) along the banks of river Indus (Ghazi to Jabba) and river Kabul (Nowshera to Kund) in the northern part of Pakistan, whereas bricks and cement samples were collected from local suppliers of the studied area. In order to measure the specific activities in these samples, a P-type coaxial high-purity germanium-based gamma-ray spectrometer was used. In sand samples, the average specific activities of (226)Ra, (232)Th, and (40)K were found to be 30.5±11.4, 53.2±19.5 and 531±49 Bq kg(-1), whereas in brick samples, specific activities of 30±14, 41±21 and 525±183 Bq kg(-1) were observed, respectively. In cement samples, measured specific activity values were 21±5, 14±3 and 231±30 Bq kg(-1), respectively. Radium equivalent activities were calculated and found to be 143.8±38.6, 124±49.8 and 56.69±7 Bq kg(-1) for sand, brick and cement samples, respectively. The annual mean effective dose for the studied sand samples was found to be 0.40 mSv. External and internal hazard indices were less than unity for all the studied samples. The present results have been compared with those reported in the literature.
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Affiliation(s)
- F Malik
- Physics Division, PINSTECH, P.O. Nilore, Islamabad, Pakistan.
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Hernandez-Ilizaliturri FJ, Deeb G, Zinzani PL, Pileri SA, Malik F, Macon WR, Witzig TE, Goy A, Czuczman MS. Response of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) with nongerminal center B-cell phenotype to lenalidomide (L) alone or in combination with rituximab (R). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8038] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
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Malik F, Khawar R, Chaudhry HR, Humphreys GW. Emotion recognition and duration of untreated first-episode psychosis among patients in Pakistan. East Asian Arch Psychiatry 2010; 20:31-38. [PMID: 22351808] [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: 05/31/2023]
Abstract
OBJECTIVE To investigate the impact of duration of untreated psychosis on emotion recognition in patients with first-episode psychosis. METHODS A sample of 60 patients with schizophrenia, schizoaffective and substance-induced psychoses were selected from psychiatric inpatients and outpatients of 3 hospitals in Lahore and 1 in Faisalabad, Pakistan. Patients were divided into short (n = 28) and long (n = 32) duration of untreated psychosis groups, according to whether they had had symptoms for < 80 or ≥ 80 weeks, respectively. Emotion recognition ability was assessed with the help of the Urdu version of a computerised experimental FEEL (Facially Expressed Emotion Labeling) test using 6 basic emotional expressions that appeared on a computer screen followed by possible responses. RESULTS Patients with prolonged durations of untreated psychosis showed poorer performance in recognition of facial expressions of emotion than those with short durations of untreated psychosis. This was apparent in general and especially for expressions of anger, surprise, and sadness. First-episode psychosis patients showed higher accuracy rates for recognising positive as opposed to negative emotions. The duration of untreated psychosis correlated positively with positive symptoms of psychosis. Symptom distribution differed across categories of psychosis, but there were similarities in patients with schizophrenia and schizoaffective disorders. CONCLUSIONS These findings support recourse to early detection and intervention strategies in psychosis and provide valuable information on how first-episode psychosis patients behave in complex emotional and social situations.
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Affiliation(s)
- F Malik
- Department of Psychology, GC University, Lahore, Pakistan
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Abstract
Female sexual dysfunction (FSD) incorporates various sexual disorders including hypoactive sexual desire disorder, sexual arousal disorder, orgasmic and sexual pain disorders. Although many strategies have been formulated for the treatment of male sexual problems, FSD remains an area that warrants further research and trial studies to identify the most efficacious treatment options. Research has highlighted numerous pharmacological interventions that have been trialled and found to exhibit positive effects. These include hormonal therapies, prostaglandins, dopaminergic agonists, phosphodiesterase type-5 (PDE-5) inhibitors and melanocortin agonists.
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Affiliation(s)
- K Wylie
- Porterbrook Clinic, Sheffield, UK
| | - F Malik
- Porterbrook Clinic, Sheffield, UK
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Springham S, Malik F, Roshan M, Talebitaher A, Rawat R, Lee P. Ferrofluidic masking of solid state nuclear track detectors during etching. RADIAT MEAS 2009. [DOI: 10.1016/j.radmeas.2009.01.007] [Citation(s) in RCA: 4] [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: 11/30/2022]
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Khawaja MR, Khawaja MR, Majeed A, Malik F, Merchant KA, Maqsood M, Malik R, Mazahir S, Naqvi H. Prescription pattern of benzodiazepines for inpatients at a tertiary care university hospital in Pakistan. J PAK MED ASSOC 2005; 55:259-63. [PMID: 16045100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients. METHODS This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0. RESULTS The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam was the most commonly used benzodiazepine, followed by Alprazolam and Lorazepam. Pre-anesthesia and psychiatric symptoms were the two most common indications. Oral route was used in 84% patients for drug administration and mean Valium equivalent dosage was 4.86 mg/day. Mean length of prescription was 3 days. Longer duration of hospitalization was a significant predictor of the requirement of benzodiazepine prescription (p-value = 0.020). CONCLUSION Prescription pattern of benzodiazepines at a tertiary care university hospital is similar to that reported in the developed countries through monitoring at various levels by physicians, clinical pharmacist and nursing staff. Data regarding the prescription pattern of benzodiazepines is scarce, and it needs to be expanded to formulate clear guidelines regarding their prescription.
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Uddin SN, Malik F, Bari MA, Siddiqui NI, Khan GK, Rahman S, Sadequzzaman M. Angiographic severity and extent of coronary artery disease in patients with type 2 diabetes mellitus. Mymensingh Med J 2005; 14:32-7. [PMID: 15695951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Coronary angiographic characteristics of fifty patients with type 2 diabetes mellitus and coronary artery disease (CAD) were compared with fifty non diabetic patients with CAD. Type 2 diabetic patients undergoing clinically indicated elective coronary angiography were individually matched with fifty non diabetic coronary artery disease patients for age, sex and major risk factors. No significant difference was present between the mean age, presenting complains and other coronary risk factors between the two groups. Severity and extent of coronary artery involvement was assessed by a coronary artery score (CAS) using the segmental distribution method for coronary artery lesions and morphometric analysis of atherosclerotic lesion was done. Type 2 diabetic patients had a higher CAS (11.74+/-5.04 vs 8.72+/-4.87; P<0.001) as compared to the non-diabetic patients. Multivessel disease were more prevalent in both the groups (82% vs 68%; P>0.05) but diabetic patients had significantly higher number of triple vessel disease (58% vs. 38%; P<0.001). Normal coronary arteries and single vessel disease were more prevalent in non-diabetic patients (32% vs. 18%; P<0.05). As compared to non-diabetic group diabetic patients had a higher total number of diseased vessels (78.66% vs. 68%; P<0.01), a higher lesion per patient ratio (3.94+/-1.80 vs 3+/-1.67:P<0.001) and more proximal lesions (40.83% vs. 34.70%; P>.05) though not statistically significant. Morphometric analysis of coronary artery lesions revealed that diabetic patients had significantly higher number of multiple irregularity lesions (24.37% vs. 15.33%; P<0.01) and lesions were more obstructive (lesion involving 70-90% of coronary lumen: 70.53.% vs. 57.33%; P<0.05). Though there was no significant difference between the systolic left ventricular function between the two groups but significant higher regional wall motion abnormality was found more in diabetic patients (76%vs 62%; P<0.01). So type 2 diabetic patients had more severe and extensive atherosclerotic lesion in their coronary arteries than the matched non diabetic control on coronary angiography suggesting an independent effect of diabetic mellitus on atherosclerotic process specially in our population.
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Affiliation(s)
- S N Uddin
- Department of Cardiology, Mymensingh Medical College, Mymensingh
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Bari MA, Rahman S, Uddin SN, Malik F, Ahsan SA, Rahman S. Comparison and outcome of commissurotomy by metallic valvotome and balloon commissurotomy. Mymensingh Med J 2005; 14:3-5. [PMID: 15695943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The purpose of this study was to compare the echocardiographic outcome of percutaneous transvenous metallic mitral commissurotomy (PMMC) and Percutaneous transvenous balloon mitral commissurotomy (PTMC). This prospective comparative study was carried out during the period of January 1999 to June 2000 in the department of Cardiology, National Institute of cardiovascular diseases (NICVD) and national heart foundation hospital, Dhaka Bangladesh. Two dimension, M-mode, spectral and colour Doppler studies were done to all patient of mitral stenosis both before and after PMMC and PTMC. The increased in mitral valve area in PMMC was statistically significant than PTMC. (P<0.047).
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Affiliation(s)
- M A Bari
- Mymensingh Medical College, Mymensingh, Bangladesh
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Abstract
This study examined the clinical workload, outcome and direct costs of managing women with sexual dysfunction in an NHS clinic in the UK. A retrospective analysis of a 3-month period showed that of 47 referrals to the clinic, 38 undertook treatment. The therapists' assessments suggested that over 80% of patients improved on treatment. The average cost per patient was pound 472 (compared to pound 335 per annum for erectile dysfunction, which included physician's and drug costs). The average cost by type of practitioner was pound 278 (psychologist), pound 322 (physician), pound 532 (physician and psychologist) and pound 597 (sex therapist). Patients required between 1 and 51 treatment sessions, which were mainly restricted to psychological therapy. Female sexual dysfunction (FSD) represents a significant economic burden to the NHS. Further research on the potential role and cost effectiveness of pharmacological agents for FSD is warranted.
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Affiliation(s)
- D Goldmeier
- JaneWadsworth Sexual Function Clinic, Jefferiss Wing, St Mary's Hospital, Praed Street, London W2 1NY, UK.
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Uddin SN, Siddiqui NI, Bagum F, Malik F, Rahman S, Ali MS. Coronary artery disease in young adults - angiographic profile. Mymensingh Med J 2004; 13:11-5. [PMID: 14747777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Angiographic profile of fifty young patients of coronary artery disease aged 40 or under were analysed and compared with those of fifty older patients. Mean age of younger and older group was 36.34 (range 28 to 40 years) and 55.28 (44-74 years) years respectively and most of the patients were male in both the group (92 Vs 94%). Older patients were more diabetes (40 Vs 24%) and hypertensive (38 Vs 60%) but the younger patients had more family history of premature coronary artery disease (50% Vs 24%). The incidence of smoking and dyslipidemia did not vary between the two groups. Older patients had more history of myocardial infarction (69 Vs 58%) but angina were more in young patients (42 Vs 31%). Coronary angiography revealed more number of multivessel disease in older patients (74 Vs 54%) but the younger patients had more normal coronary arteries and single vessel disease (46 vs 26%). Coronary athesclerosis was also extensive in older patients as revealed by the higher coronary score, more involvement of coronary segments, more number of diseased and diffusely involved coronary vessel in older patients. Older patients needed more revasalarization process (74 Vs 60%), more coronary bypass surgery (40 Vs 24%) and had more inoperable vessels (16% Vs 4%) than the younger patients. So the younger patients having less extensive coronary artery athesclerosis with better prognostic probability should be evaluated angiographically for further definitive management in the from of revascularization.
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Uddin SN, Siddiqui NI, Begum F, Malik F, Rahman S. Correlation between severity of coronary artery athesclerosis and duration and severity of diabetes mellitus in type 2 diabetic patients. Mymensingh Med J 2003; 12:85-8. [PMID: 12894038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Hundred patients of Type 2 diabetes mellitus with coronary artery disease undergoing diagnostic coronary angiography were studied to determine the relation between the severity and duration of diabetes mellitus and the severity of coronary artery disease. A coronary scoring system using segmental distribution method was used to determine the severity of coronary artery disease and severity of diabetes was assessed by the level of fasting blood glucose within 48 hours of the procedure and also considering the types of treatment received for diabetes mellitus. No significant correlation was demonstrated between the severity of coronary artery disease and the severity (r =.089602; P>0.1) nor the duration (r =0.07865; P> 0.1) of diabetes mellitus on univariate analysis. So the Type 2 diabetic patients had an increased incidence of atherosclerosis in their coronary angiograms did not reflect an angiographically evident progressive coronary artery disease and results of this study suggest that the progress of large vessel coronary athesclerotic disease in diabetes mellitus of adult onset takes place independently of the progress of diabetes mellitus itself.
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Affiliation(s)
- S N Uddin
- Cardiology, Mymensingh Medical College, Bangladesh
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Uddin SN, Begum F, Malik F, Rahman S. Coronary artery disease in young patients: clinical review and risk factor analysis. Mymensingh Med J 2003; 12:3-7. [PMID: 12715632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Fifty consecutive younger patients (< or = 40 years) with coronary artery disease, who underwent coronary angiography in National Institute of Cardiovascular Diseases were evaluated clinically and coronary risk factors were analyzed and compared with those of fifty older patients with coronary artery disease. Mean age of younger and older patients were 37.31 and 54.58 years respectively and myocardial infarction was the most common presenting complain in both the groups. Smoking and family history of premature coronary artery disease were more common in younger patients but the older patients were more diabetic and hypertensive. Central obesity and dyslipidemia did not vary between the two groups. Fifty percent of younger patients had one or two modifiable risk factors where sixty four percent of older patients had three or more modifiable risk factors. Forty four percent younger patients had hypercholesterolemia but a majority of patients had either isolated hypertriglyciredemia or decrease high density lipoprotein cholesterol or both with normal total cholesterol level but the total cholesterol and high density lipoprotein cholesterol index were more than 4.5. Younger patients had more number of normal coronary or single vessel diseases but older group had more number of triple vessel diseases. So the higher incidence of non-insulin dependent diabetes mellitus with central obesity suggesting insulin resistance along with unique profile of dyslipidemia, higher incidence of smoking and familial predisposition of premature coronary artery disease may be responsible for higher incidence of coronary artery disease at a premature younger age in this population.
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