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Van der Watt ASJ, Du Plessis S, Ahmed F, Roos A, Lesch E, Seedat S. Hippocampus, amygdala, and insula activation in response to romantic relationship dissolution stimuli: A case-case-control fMRI study on emerging adult students. J Affect Disord 2024:S0165-0327(24)00664-5. [PMID: 38631423 DOI: 10.1016/j.jad.2024.04.059] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Romantic relationship dissolutions (RRD) are associated with posttraumatic stress symptoms (PTSS). Functional magnetic resonance imaging in RRD studies indicates overlapping neural activation similar to posttraumatic stress disorder. These studies combine real and hypothetical rejection, and lack contextual information and control groups exposed to non-RRD or DSM-5 defined traumatic events. AIM We investigated blood oxygen level dependent (BOLD) activation in the hippocampus, amygdala, and insula of participants with RRDs compared with other traumatic or non-trauma stressors. METHODS Emerging adults (mean age = 21.54 years; female = 74.7 %) who experienced an RRD (n = 36), DSM-5 defined trauma (physical and/or sexual assault: n = 15), or a non-traumatic stressor (n = 28) completed PTSS, depression, childhood trauma, lifetime trauma exposure, and attachment measures. We used a general and customised version of the International Affective Picture System to investigate responses to index-trauma-related stimuli. We used mixed linear models to assess between-group differences, and ANOVAs and Spearman's correlations to analyse factors associated with BOLD activation. RESULTS BOLD activity increased between index-trauma stimuli as compared to neutral stimuli in the hippocampus and amygdala, with no significant difference between the DSM-5 Trauma and RRD groups. Childhood adversity, sexual orientation, and attachment style were associated with BOLD activation changes. Breakup characteristics (e.g., initiator status) were associated with increased BOLD activation in the hippocampus and amygdala, in the RRD group. CONCLUSION RRDs should be considered as potentially traumatic events. Breakup characteristics are risk factors for experiencing RRDs as traumatic. LIMITATION Future studies should consider more diverse representation across sex, ethnicity, and sexual orientation.
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Affiliation(s)
- A S J Van der Watt
- Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa.
| | - S Du Plessis
- Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa
| | - F Ahmed
- Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa
| | - A Roos
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - E Lesch
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - S Seedat
- SAMRC Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
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Hasnat H, Shompa SA, Islam MM, Alam S, Richi FT, Emon NU, Ashrafi S, Ahmed NU, Chowdhury MNR, Fatema N, Hossain MS, Ghosh A, Ahmed F. Flavonoids: A treasure house of prospective pharmacological potentials. Heliyon 2024; 10:e27533. [PMID: 38496846 PMCID: PMC10944245 DOI: 10.1016/j.heliyon.2024.e27533] [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] [Received: 04/29/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
Flavonoids are organic compounds characterized by a range of phenolic structures, which are abundantly present in various natural sources such as fruits, vegetables, cereals, bark, roots, stems, flowers, tea, and wine. The health advantages of these natural substances are renowned, and initiatives are being taken to extract the flavonoids. Apigenin, galangin, hesperetin, kaempferol, myricetin, naringenin, and quercetin are the seven most common compounds belonging to this class. A thorough analysis of bibliographic records from reliable sources including Google Scholar, Web of Science, PubMed, ScienceDirect, MEDLINE, and others was done to learn more about the biological activities of these flavonoids. These flavonoids appear to have promising anti-diabetic, anti-inflammatory, antibacterial, antioxidant, antiviral, cytotoxic, and lipid-lowering activities, according to evidence from in vitro, in vivo, and clinical research. The review contains recent trends, therapeutical interventions, and futuristic aspects of flavonoids to treat several diseases like diabetes, inflammation, bacterial and viral infections, cancers, and cardiovascular diseases. However, this manuscript should be handy in future drug discovery. Despite these encouraging findings, a notable gap exists in clinical research, hindering a comprehensive understanding of the effects of flavonoids at both high and low concentrations on human health. Future investigations should prioritize exploring bioavailability, given the potential for high inter-individual variation. As a starting point for further study on these flavonoids, this review paper may promote identifying and creating innovative therapeutic uses.
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Affiliation(s)
- Hasin Hasnat
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka, 1207, Bangladesh
| | - Suriya Akter Shompa
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka, 1207, Bangladesh
| | - Md. Mirazul Islam
- Department of Pharmacy, State University of Bangladesh, 77 Satmasjid Road, Dhanmondi, Dhaka, 1207, Bangladesh
| | - Safaet Alam
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
- Drugs and Toxins Research Division, BCSIR Laboratories Rajshahi, Bangladesh Council of Scientific and Industrial Research, Rajshahi, 6206, Bangladesh
| | - Fahmida Tasnim Richi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Nazim Uddin Emon
- Department of Pharmacy, Faculty of Science and Engineering, International Islamic University Chittagong, Chittagong, 4318, Bangladesh
| | - Sania Ashrafi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Nazim Uddin Ahmed
- Drugs and Toxins Research Division, BCSIR Laboratories Rajshahi, Bangladesh Council of Scientific and Industrial Research, Rajshahi, 6206, Bangladesh
| | | | - Nour Fatema
- Department of Microbiology, Stamford University Bangladesh, Dhaka, 1217, Bangladesh
| | - Md. Sakhawat Hossain
- Pharmaceutical Sciences Research Division, BCSIR Dhaka Laboratories, Bangladesh Council of Scientific and Industrial Research (BCSIR), Dr. Qudrat-I-Khuda Road, Dhanmondi, Dhaka, 1205, Bangladesh
| | - Avoy Ghosh
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Firoj Ahmed
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
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Rakhi SA, Hara Y, Islam MS, Manome T, Alam S, Emon NU, Al-Mansur MA, Kuddus MR, Sarkar MR, Ishibashi M, Ahmed F. Isolation of bioactive phytochemicals from Crinum asiaticum L . along with their cytotoxic and TRAIL-resistance abrogating prospect assessment. Heliyon 2024; 10:e25049. [PMID: 38318065 PMCID: PMC10838800 DOI: 10.1016/j.heliyon.2024.e25049] [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: 11/13/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Crinum asiaticum L. (Amaryllidaceae) is a perennial bulbous herb, locally utilized for possessing multifaceted pharmacological properties including anticancer, immune-stimulating, analgesic, antiviral, antimalarial, antibacterial and antifungal, in addition to its popularity as an aesthetic plant. Separation of MeOH extract of C. asiaticum leaves yielded three known compounds as cycloneolitsol (1), hippeastrine (2) and β-sitosterol (3). Among these, compounds 1 and 2 were subjected to the cytotoxic assay and found that they induced mild effect against HCT116, Huh7 and DU145 cell lines with the IC50 values from 73.76 to 132.53 μM. When tested for TRAIL-resistance abrogating activity, 1 (100 μM) along with TRAIL (100 ng/mL) showed moderate activity in AGS cells producing 25 % more inhibition than the agent alone. Whereas 2 (20 and 30 μM) in combination with TRAIL (100 ng/mL) exhibited strong activity in abrogating TRAIL-resistance and caused 34 % and 36 % more inhibition in AGS cells, respectively. The in-silico studies of compound 2 revealed high docking hits with the TRAIL-associated anti-apoptotic proteins which give a justification for the regulatory interactions to induce such abrogating activity. It is still recommended to conduct further investigations to understand their exact molecular mechanism.
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Affiliation(s)
- Sharmin Ahmed Rakhi
- Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Yasumasa Hara
- Department of Natural Products Chemistry, Chiba University, Chiba, 260-8675, Japan
| | - Md. Saiful Islam
- Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, 1000, Bangladesh
- Pharmaceutical Sciences Research Division, BCSIR Laboratories, Dhaka, Bangladesh Council of Scientific and Industrial Research, Dhaka, 1205, Bangladesh
| | - Teruhisa Manome
- Department of Natural Products Chemistry, Chiba University, Chiba, 260-8675, Japan
| | - Safaet Alam
- Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, 1000, Bangladesh
- Drugs and Toxins Research Division, BCSIR Laboratories Rajshahi, Bangladesh Council of Scientific and Industrial Research, Rajshahi, 6206, Bangladesh
| | - Nazim Uddin Emon
- Department of Pharmacy, Faculty of Science and Engineering, International Islamic University Chittagong, Chittagong, 4318, Bangladesh
| | | | - Md. Ruhul Kuddus
- Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Raihan Sarkar
- Department of Pharmaceutical Technology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masami Ishibashi
- Department of Natural Products Chemistry, Chiba University, Chiba, 260-8675, Japan
| | - Firoj Ahmed
- Department of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
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Islam MS, Khalil MM, Hossain MI, Datta RK, Podder S, Khan ST, Ahmed F, Ahmed F, Rahman MM, Kibria MG. Frequency of Post Endoscopic Retrograde Cholangiopancreatography Acute Pancreatitis in an Academic Hospital of Bangladesh. Mymensingh Med J 2024; 33:133-139. [PMID: 38163784] [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: 01/03/2024]
Abstract
Post-ERCP acute pancreatitis (PEP) is a common and serious complication with high morbidity and mortality rates. There is a paucity of data on the frequency of PEP in a resource constraint setting like Bangladesh. Hence we have conducted a prospective study to determine the frequency of PEP and the factors associated with its occurrence. This prospective, observational study was carried out in Gastroenterology Department of Dhaka Medical College & Hospital, Dhaka, Bangladesh from April 2018 to December 2018 on the consecutive patients who underwent ERCP. PEP and its severity were diagnosed according to consensus definition. Serum lipase was done in all patients before procedure and 24 hours after procedure or if patient develops abdominal pain after the procedure which became earlier. Total 168 patients were included (mean age 46.97±14.35 years; male 72(43.0%). The most common indication of ERCP was choledocholithiasis 97(58.0%) followed by malignant biliary obstruction 45(27.0%), recurrent pyogenic cholangitis 8(5.0%), chronic pancreatitis 4(2.3%), biliary ascariasis 4(2.3%) and others 10(6.0%). Overall post ERCP complication rate was 46(27.3%) including cholangitis 29(17.3%), pancreatitis 16(9.5%), bleeding 12(7.1%), aspiration pneumonia 4(2.4%) and death 3(1.8%). Regarding the severity of PEP, 50.0%, 43.7% and 6.3% patients developed mild, moderate and severe pancreatitis respectively. Number of cannulation attempts >5 times [22(48%) vs. 17(14%); p=0.001], cannulation attempts duration more than 10 minutes [25(55%) vs. 27(22%); p=0.001], unintentional passage of guide wire into the pancreatic duct [8(17%) vs. 18(15%); p=0.001], pancreatic duct contrast injection [12(26%) vs. 2(1.6%); p=0.001] and pre-cut sphincterotomy [16(35%) vs. 6(4.9%); p=0.001] were significantly different between the patients who developed PEP compared to those who did not. In multiple logistic regressions analysis, pancreatic duct contrast injection was significantly associated with PEP [OR 25.523 with 95% CI (4.049- 100.0%)]. Around ten percent patients had developed PEP. Regarding the severity half of them were mild, 44.0% patients had moderate and 6.0% patient had severe type of pancreatitis. Difficult cannulation, unintentional passage of guide wire into the pancreas, pancreatic duct contrast injection and pre-cut sphincterotomy were associated with PEP. Among them pancreatic duct contrast injection had independent significance in the causation of PEP.
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Affiliation(s)
- M S Islam
- Dr Mohammad Shohidul Islam, Assistant Registrar, Department of Medical Gastroenterology, Sheikh Russel National Gastroliver Institute & Hospital (SRNGI&H), Dhaka, Bangladesh; E-mail:
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Alfheeaid H, Alhowail A, Ahmed F, Zaki A, Alkhaldy A. Influence of various intermittent fasting regimens on body weight and glycemic control in streptozotocin-induced diabetic rats. Eur Rev Med Pharmacol Sci 2023; 27:11433-11444. [PMID: 38095391 DOI: 10.26355/eurrev_202312_34582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE This study aims to compare the effects of various intermittent fasting (IF) regimens, i.e., time-restricted fasting (TRF), alternate day fasting (ADF), and periodic fasting (PF) on body weight, glycemic control and associated metabolic parameters in streptozotocin-induced diabetic rats. MATERIALS AND METHODS Sixty male Sprague-Dawley rats (aged 3 months) were randomly assigned to the normal control (NC), diabetic control (DC), TRF, ADF, and PF groups. Type 2 diabetes was induced in all groups, except for the NC group, by intramuscular administration of streptozotocin (55 mg/kg). The IF interventions were administered for 6 weeks. RESULTS The rats in all the groups, except for the NC group, exhibited significant weight loss (31.4%, 46.4%, 31.0%, and 33.9% in the DC, TRF, ADF, and PF groups, respectively). The fasting blood glucose levels decreased to varying degrees, with the PF group showing the most significant decrease (77.0%), followed by the ADF (55.0%) and TRF (32.2%) groups. The plasma insulin levels were significantly lower in the experimental groups than in the NC group, but no significant effects were observed on the lipid profile. CONCLUSIONS The study findings indicate that while the IF protocols led to body weight loss, they exhibited varying effects on glycemic control and other metabolic parameters.
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Affiliation(s)
- H Alfheeaid
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia.
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Sarker MR, Ali MA, Roy AK, Yesmin A, Dhar SK, Ahmed E, Ahmed F, Amin SE. Relationship between Clinical Profile, Severity and Outcome of Community Acquired Pneumonia with Hyponatremia in Children Aged 2-60 Months. Mymensingh Med J 2023; 32:613-619. [PMID: 37391948] [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: 07/02/2023]
Abstract
Hyponatremia is the most common electrolyte imbalance seen in clinical practice and a common laboratory findings in children with community acquired pneumonia. This study aimed to find out relationship between clinical profile, severity and outcome of community acquired pneumonia with hyponatremia in children aged 2-60 months. This descriptive cross-sectional study was done in pediatrics department of Mymensingh Medical College Hospital, Bangladesh. Study period was 6 month from November 2016 to April 2017. Data were collected from 2 months to 60 months old children who fulfill the selection criteria. In this study sampling technique was purposive. Detailed history was taken, and meticulous examinations and relevant investigations were performed. 100 patients with community acquired pneumonia were enrolled, 34.0% patient had hyponatremia and 66.0% patients had no hyponatremia. Hyponatremia is more marked (45.5%) in severe pneumonia followed by moderate pneumonia (33.3%) and no hyponatremia found in mild pneumonia. Mean temperature, respiratory rate, heart rate, head nodding, nasal flaring, grunting, stridor, cyanosis, convulsion, feeding problem, Poor air entry were significantly higher in patient of pneumonia with hyponatremia when compared to patient of pneumonia without hyponatremia. Mean duration of symptoms and mean duration of hospital stay were also significantly higher in patient of pneumonia with hyponatremia. The mean serum sodium concentration was 132.18±1.51mmol/L in hyponatremic patients and 137.91±1.94mmol/L in normonatremic patients. Mean values of total leucocyte count, ESR, and C-reactive protein were significantly higher in patient of pneumonia with hyponatremia. Serum hemoglobin was significantly lower in hyponatremic patients than normonatremic patients. Maximum (55.9%) patients of community acquired pneumonia (CAP) with hyponatremia had patchy opacity, 26.5% had consolidation, 11.8% had interstitial opacity and 5.9% had pneumatocele. All the patients were treated with appropriate antibiotics and fluid and discharged after complete recovery without any complication. There was no death in the study population. From this study we can conclude that, hyponatremia is directly related with the severity of community acquired pneumonia (CAP). The intensity of clinical profile and investigation findings are also directly related with the severity of pneumonia.
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Affiliation(s)
- M R Sarker
- Dr Mitu Rani Sarker, Registrar (Paediatric Gastroenterology and Nutrition), Department of Pediatrics, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Karmakar PK, Ahmed F, Momen A, Monwar M, Das PR, Ameen MH, Jannat S, Roy A, Uddin MJ, Karmoker KK, Dutta B, Rahman MS, Mandal SC, Mohiuddin M. Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve: A Case Report. Mymensingh Med J 2023; 32:888-892. [PMID: 37391991] [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: 07/02/2023]
Abstract
Among other valvular heart disease Aortic stenosis (AS) is the most common in the developed world. Transcatheter Aortic Valve Replacement (TAVR) is most acceptable treatment option for patient with severely calcified aortic stenosis with high and intermediate risk group. Among several challenges, one of the main challenges is to deal with bicuspid aortic valve (BAV). Non-circular annulus, bulky leaflets leading to perivalvular leaks and risk for rupture and often very severe calcification may contribute to periprocedural strokes leading to poor clinical outcome. This case, a 68-year-old woman with a history of type 2 diabetes mellitus (DM), hypothyroidism, bicuspid aortic valve and severe aortic stenosis, bronchial asthma, who had repeatedly refused any suggestion for open heart surgery, was our volunteer candidate for TAVR. After successful TAVR the peak pressure gradient decreased from 100mmHg to 17mmHg. So, TAVR could be a viable option for highly selected patients with severe aortic stenosis and bicuspid aortic valve who have favourable anatomy.
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Affiliation(s)
- P K Karmakar
- Dr Pradip Kumar Karmakar, Associate Professor, Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh; E-mail:
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Arnold R, Ahmed F, Clarke A, Quinn N, Beenstock J, Holland P. The relationship between parental adverse childhood experiences and the health, well-being and development outcomes of their children: a systematic review. Public Health 2023; 219:146-153. [PMID: 37186980 DOI: 10.1016/j.puhe.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES A growing body of research is emerging regarding the relationship between parental adverse childhood experiences (ACEs) and negative health, well-being and developmental outcomes in their children. This systematic review seeks to understand the relationship between parental ACEs and the health, well-being and developmental outcomes of their children and whether the relationships differ according to the number and type of parental ACEs. STUDY DESIGN Systematic review. METHOD The review includes articles published between 2000 and 2021 from studies using quantitative longitudinal methods and multivariate analysis to investigate the relationship between parental ACEs and their offspring's outcomes. Relevant studies were identified through a systematic search of five databases and findings synthesised using a narrative synthesis. This review was registered on PROSPERO (CRD42021274068). RESULTS Nineteen studies met the inclusion criteria and were included in the review. This resulted in a combined population sample of 124,043 parents and 128,400 children. Diversity in measurement of parental ACE exposure and in the type of ACEs measured within the studies precluded a meta-analysis. Offspring of parents exposed to ACEs had a higher risk of a range of negative health, well-being and developmental outcomes. This relationship differs according to the number and type of parental ACEs, with a positive relationship observed between the number of parental ACEs and the risk of negative health, well-being and development outcomes in their children. CONCLUSIONS These findings indicate that screening for parental ACEs by health visitors, midwives and other health or social care staff may identify an at-risk population of infants, children and adolescents and improve child outcomes.
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Affiliation(s)
- R Arnold
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, England, UK.
| | - F Ahmed
- Division of Health Research, Lancaster University, UK
| | - A Clarke
- Lancashire & South Cumbria NHS Foundation Trust, Preston, England, UK; Save the Children UK, London, England, UK
| | - N Quinn
- Lancashire & South Cumbria NHS Foundation Trust, Preston, England, UK
| | - J Beenstock
- Lancashire & South Cumbria NHS Foundation Trust, Preston, England, UK
| | - P Holland
- Division of Health Research, Lancaster University, UK
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Das Gupta R, Morshed S, Ahmed F, Hasan M, Bhuiyan G, Hasan M, Shamsuzzaman S, AL MAMUN D. WCN23-0033 PRESENTATION OF IDIOPATHIC MESANGIAL PROLIFERATIVE GLOMERULONEPHRITIS IN BANGLADESH- A SINGLE CENTRE STUDY AT TERTIARY CARE HOSPITAL Abstract paid for submission 2022-A-WCN23-0031(101403392091). Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.116] [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: 03/22/2023] Open
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Altamura C, Ornello R, Ahmed F, Negro A, Miscio AM, Santoro A, Alpuente A, Russo A, Silvestro M, Cevoli S, Brunelli N, Grazzi L, Baraldi C, Guerzoni S, Andreou AP, Lambru G, Frattale I, Kamm K, Ruscheweyh R, Russo M, Torelli P, Filatova E, Latysheva N, Gryglas-Dworak A, Straburzynski M, Butera C, Colombo B, Filippi M, Pozo-Rosich P, Martelletti P, Sacco S, Vernieri F. OnabotulinumtoxinA in elderly patients with chronic migraine: insights from a real-life European multicenter study. J Neurol 2023; 270:986-994. [PMID: 36326890 DOI: 10.1007/s00415-022-11457-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Although migraine prevalence decreases with aging, some older patients still suffer from chronic migraine (CM). This study aimed to investigate the outcome of OnabotulinumtoxinA (OBT-A) as preventative therapy in elderly CM patients. METHODS This is a post hoc analysis of real-life prospectively collected data at 16 European headache centers on CM patients treated with OBT-A over the first three treatment cycles (i.e., Cy1-3). We defined: OLD patients aged ≥ 65 years and nonOLD those < 65-year-old. The primary endpoint was the changes in monthly headache days (MHDs) from baseline to Cy 1-3 in OLD compared with nonOLD participants. The secondary endpoints were the responder rate (RR) ≥ 50%, conversion to episodic migraine (EM) and the changes in days with acute medication use (DAMs). RESULTS In a cohort of 2831 CM patients, 235 were OLD (8.3%, 73.2% females, 69.6 years SD 4.7). MHDs decreased from baseline (24.8 SD 6.2) to Cy-1 (17.5 SD 9.1, p < 0.000001), from Cy-1 to Cy-2 (14.8 SD 9.2, p < 0.0001), and from Cy-2 to Cy-3 (11.9 SD 7.9, p = 0.001). DAMs progressively reduced from baseline (19.2 SD 9.8) to Cy-1 (11.9 SD 8.8, p < 0.00001), to Cy-2 (10.9 SD 8.6, p = 0.012), to Cy-3 (9.6 SD 7.4, p = 0.049). The 50%RR increased from 30.7% (Cy-1) to 34.5% (Cy-2), to 38.7% (Cy-3). The above outcome measures did not differ in OLD compared with nonOLD patients. CONCLUSION In a population of elderly CM patients with a long history of migraine OBT-A provided a significant benefit, over the first three treatment cycles, as good as in non-old patients.
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Affiliation(s)
- Claudia Altamura
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - R Ornello
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - F Ahmed
- Department of Neurosciences, Hull University Teaching Hospitals, Hull, UK
| | - A Negro
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, 00189, Rome, RM, Italy
| | - A M Miscio
- Unit of Neurology, Headache Center, Fondazione IRCCS "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - A Santoro
- Unit of Neurology, Headache Center, Fondazione IRCCS "Casa Sollievo Della Sofferenza", San Giovanni Rotondo, FG, Italy
| | - A Alpuente
- Headache Unit, Department of Neurology, Vall d'Hebron University, Barcelona, Spain
- Headache and Neurological Pain Research Group, Department of Medicine, Vall d'Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - A Russo
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Silvestro
- Department of Medical, Surgical, Neurological, Metabolic, and Aging Sciences, Headache Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Cevoli
- IRCCS Istituto delle scienze Neurologiche di Bologna, Bologna, Italy
| | - N Brunelli
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - L Grazzi
- Neurology Department, Headache Center, IRCCS Foundation "Carlo Besta" Neurological Institute, Via Celoria,11, 20133, Milan, Italy
| | - C Baraldi
- Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse, Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico Di Modena, Modena, Italy
| | - S Guerzoni
- Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology-Headache Center and Drug Abuse, Laboratory of Clinical Pharmacology and Pharmacogenomics, Department of Specialist Medicines, AOU Policlinico Di Modena, Modena, Italy
| | - A P Andreou
- Headache Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G Lambru
- Headache Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Frattale
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - K Kamm
- Department of Neurology, Ludwig Maximilians University München, Munich, Germany
| | - R Ruscheweyh
- Department of Neurology, Ludwig Maximilians University München, Munich, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - M Russo
- Neurology Unit, Neuromotor and Rehabilitation Department, Headache Center, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - P Torelli
- Headache Center, University of Parma, Parma, Italy
| | - E Filatova
- Department of Neurology, Institute for Postgraduate Education, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | - M Straburzynski
- Headache Clinic, Terapia Neurologiczna Samodzielni, Maurycego Mochnackiego 10, 02-042, Warsaw, Poland
| | - C Butera
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - B Colombo
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Filippi
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - P Pozo-Rosich
- Headache Unit, Department of Neurology, Vall d'Hebron University, Barcelona, Spain
- Headache and Neurological Pain Research Group, Department of Medicine, Vall d'Hebron Institute of Research (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - P Martelletti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, 00189, Rome, RM, Italy
| | - S Sacco
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1 Coppito, 67100, L'Aquila, Italy
| | - F Vernieri
- Unit of Headache and Neurosonology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
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Alhariri S, Bies J, Ahmed F, Hassan M, Sairam S. Syphilis and seronegative spondyloarthropathy: a rare combined presentation. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, 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Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [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] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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Ara H, Paul SK, Kobayashi N, Nasreen SA, Ahmed F. Prevalence of Virulence Genes in Acinetobacter baumannii Isolated from Clinical Samples in Mymensingh Medical College Hospital, Bangladesh. Mymensingh Med J 2022; 31:914-919. [PMID: 36189532] [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: 06/16/2023]
Abstract
Acinetobacter baumannii is an opportunistic bacterial pathogen that is the most important cause of hospital-acquired infections. The objective of this study was to evaluate the predominance and determination of virulence encoding genes in A. baumannii isolates. During this cross-sectional study period from February 2019 to March 2020 of 380 clinical samples including endotracheal aspirates (70), wound swab or pus (175), urine (70) and blood (65) analysed in inpatients admitted to the hospital in different unit like ICU, Surgery and Burn unit of Mymensingh Medical College Hospital. Out of 380 studied samples, 130(34.21%) strains were yielded growth. Among 130 isolates, Acinetobacter spp. was 49(37.69%). Totally, 39(79.59%) were Acinetobacter baumannii which was detected by molecular technique PCR. Further more, the determination of virulence genes csgA and fimH detected by PCR. Among two studied virulence genes, csgA (38.46%) was the most prevalent virulent genes associated with disease severity and co-morbidity of the patient in A. baumannii infections.
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Affiliation(s)
- H Ara
- Dr Hosne Ara, MD (Thesis Part), Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Forberger S, Khan Z, Ahmad F, Ahmed F, Frense J, Kampfmann T, Ullah S, Dogar O, Siddiqi K, Zeeb H. Scoping Review of Existing Evaluations of Smokeless Tobacco Control Policies: What Is Known About Countries Covered, Level of Jurisdictions, Target Groups Studied, and Instruments Evaluated? Nicotine Tob Res 2022; 24:1344-1354. [PMID: 35428887 DOI: 10.1093/ntr/ntac102] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/17/2022] [Accepted: 04/12/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The implementation of smokeless tobacco control policies lags behind those for smoking. This scoping review summarizes the studies that evaluated public policies on smokeless tobacco regulation (SLT) and provides an overview of the jurisdictional level, target groups, and policy instruments. METHODS Seven databases were systematically searched for studies reporting on public policies regulating SLT. Two reviewers independently screened all studies. Data extraction was performed using a predefined extraction form. Extraction was replicated for 10% of the identified studies for quality assurance. A narrative synthesis of the included studies was used to analyze and interpret the data. The protocol was published beforehand with the Open Science Foundation (OSF). RESULTS Fourty articles comprising 41 studies were included. Most of the studies reported in the articles were conducted in the United States (n = 17) or India (n = 14). Most studies reported outcomes for students (n = 8), retailers/sellers (n = 8), and users/former users (n = 5). The impact of public policies on smokeless tobacco use, in general, was most frequently assessed (n = 9), followed by the impact of taxes (n = 7), product bans (n = 6), sales/advertising bans near educational institutions (n = 4), and health warnings (n = 3) on consumer behavior. CONCLUSIONS There are significant gaps in the evaluation of smokeless tobacco regulation studies that need to be filled by further research to understand the observed outcomes. WHO reporting on Framework Convention on Tobacco Control (FCTC) implementation should be linked to studies evaluating smokeless tobacco control measures at all levels of jurisdictions and in countries not members of the WHO FCTC or do not provide data. IMPLICATION Large gaps in the evaluation of SLT control policies exist. For some countries, WHO FCTC evaluations are available for different levels of jurisdictions. In countries with a strong federal structure, there is a lack of data beyond the national level to provide a more detailed look at compliance, indirect effects, or implementation gaps. More research is needed at all levels of jurisdictions, which add to the work of the WHO to understand what works for which target group, how the different levels of jurisdiction interact, how the real-world context can be incorporated, and what indirect effects may occur.
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Affiliation(s)
- Sarah Forberger
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - Z Khan
- Office of Research, Innovation, and Commercialization (ORIC), Khyber Medical University, Phase 5 Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - F Ahmad
- Faculty Institute of Public Health & Social Sciences, Khyber Medical University, F1 Phase-6 Rd, Phase 5 Hayatabad, Peshawar, Khyber Pakhtunkhwa 25100, Pakistan
| | - F Ahmed
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - J Frense
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - T Kampfmann
- Institute for Ethics and Transdisciplinary Sustainability Research, Leuphana University Universitätsallee 1, 21335 Lüneburg, Germany
| | - S Ullah
- Office of Research Innovation and Commercialization, Khyber Medical University Peshawar; Phase 5 Hayatabad, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - O Dogar
- Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
- Usher Institute, The University of Edinburgh, Old College, South Bridge, Edinburgh EH8 9YLUK
| | - K Siddiqi
- Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
- Hull York Medical School, John Hughlings Jackson Building, University Rd, Heslington, York YO10 5DD, UK
| | - H Zeeb
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
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Ahmed F, Lim R, Moseley I, Hoang M, Wisco O, Robinson-Bostom L, Qureshi A, Cho E. 227 Socioeconomic predictors of melanoma Breslow thickness at a Rhode Island academic center. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.234] [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: 10/17/2022]
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Sultana N, Chung HJ, Emon NU, Alam S, Taki MTI, Rudra S, Tahamina A, Alam R, Ahmed F, Mamun AA. Biological Functions of Dillenia pentagyna Roxb. Against Pain, Inflammation, Fever, Diarrhea, and Thrombosis: Evidenced From in vitro, in vivo, and Molecular Docking Study. Front Nutr 2022; 9:911274. [PMID: 35903446 PMCID: PMC9315376 DOI: 10.3389/fnut.2022.911274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/06/2022] [Indexed: 12/11/2022] Open
Abstract
Dillenia pentagyna Roxb. is traditionally used to treat cancer, wound healing, diabetes, and diarrhea in local tribes. This study was designed to evaluate the pharmacological potentiality of this plant. In vivo analgesic, anti-inflammatory, and antipyretic studies of the methanol extracts of D. pentagyna (MEDP) leaves were performed by using acetic acid-induced nociception, formalin-induced paw licking, and yeast-induced pyrexia assay methods, respectively. In vivo antidiarrheal activity was carried out in mice by following castor oil-induced diarrhea and gastrointestinal transit manner. In vitro thrombolytic experiment was performed employing the clot lysis activity. Besides, a molecular docking study was performed by executing the software (PyRx, Discovery Studio, and UCSF Chimera). In the acetic acid-induced writhing study, MEDP possesses significant writhing inhibition in a dose-dependent manner. It showed 50.86% of maximum inhibition of pain in the case of MEDP at a dose of 400 mg/kg body weight. In the anti-inflammatory study, maximum inhibition rate was observed at a value of 59.98 and 41.29% in early and late phases, respectively, at the dose of 400 mg/kg body weight. In the case of yeast-induced hyperpyrexia, MEDP reduced hyperpyrexia in a dose-dependent manner. In the antidiarrheal assay, MEDP moderately inhibited the occurrence of diarrhea in all the experiments. In the thrombolytic study, a moderate (17.76%) clot lysis potency has been yielded by MEDP. Again, the molecular docking simulation revealed strong binding affinities with almost all the targeted proteins. The present study suggests that the MEDP possesses remarkable pharmacological activity and this finding validated the ethnobotanical significance of D. pentagyna as the source of pain, fever, and diarrhea management agent.
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Affiliation(s)
- Nahida Sultana
- Department of Pharmacy, Faculty of Science and Engineering, International Islamic University Chittagong, Chittagong, Bangladesh
| | - Hea-Jong Chung
- Gwangju Center, Korea Basic Science Institute, Gwangju, South Korea
| | - Nazim Uddin Emon
- Department of Pharmacy, Faculty of Science and Engineering, International Islamic University Chittagong, Chittagong, Bangladesh
| | - Safaet Alam
- Drugs and Toxins Research Divison, BCSIR Laboratories Rajshahi, Bangladesh Council of Scientific and Industrial Research, Rajshahi, Bangladesh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
- *Correspondence: Safaet Alam,
| | - Md. Tohidul Islam Taki
- Department of Pharmacy, Faculty of Science and Engineering, International Islamic University Chittagong, Chittagong, Bangladesh
| | - Sajib Rudra
- Department of Botany, Faculty of Biological Science, University of Chittagong, Chattogram, Bangladesh
- Sajib Rudra,
| | - Afroza Tahamina
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China-Canada Joint Lab of Food Nutrition and Health (Beijing), Beijing Engineering and Technology Research Center of Food Additives, Beijing Technology and Business University, Beijing, China
| | - Rashedul Alam
- Department of Pharmacology, Medical School, Jeonbuk National University, Jeonju, South Korea
| | - Firoj Ahmed
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- Molecular Pharmacology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
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Howladeer SS, Gupta SD, Momen A, Rahman MH, Biswas PK, Sarkar SR, Rahman KS, Chanda PK, Ahmed F. Early Impact of Cardiopulmonary Bypass on Renal Function after Valve Replacement Surgery. Mymensingh Med J 2022; 31:711-718. [PMID: 35780355] [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: 06/15/2023]
Abstract
Renal dysfunction following cardiopulmonary bypass is well recognized. The pathophysiology of renal injury is multifactorial and culmination of the interplay of several pathophysiological mechanism. Cardiac surgery requiring cardiopulmonary bypass (CPB) is being carried out on an extended patient population of different age groups and undergoing complex surgical procedure, and thus it places them at an increased risk of renal impairment. Valve replacement surgery is a major and complex surgical procedure requiring CPB. This study was therefore designed to observe the impact of CPB and short term outcome on patients with reduced estimated Glomerular Filtration Rate (eGFR) (60-89ml/min/1.73m²) after valve replacement surgery. This cross-sectional study was conducted in the Department of Cardiac Surgery, National Institute of Cardio Vascular Diseases (NICVD) during the period of January 2015 to August 2016. After fulfillment of enrollment criteria 100 patients were studied for the purpose of the study and they were grouped in two, patients with normal eGFR (≥90ml/min/1.73m²) in Group A and patients with reduced eGFR (60-89ml/min/1.73m²) in Group B. A total of 100 patients, 50 in each group were studied for renal function alteration after valve replacement surgery under cardiopulmonary bypass. The incidence of Acute Kidney Injury (AKI) was higher in Group B. Chi-square test was done and p value was 0.011 which is statistically significant. Postoperative blood loss (ml/hr) (p=0.038), duration of Intensive Care Unit (ICU) stay (in hours) (p=0.009), postoperative hospital stay (days) (p=0.014) was significantly higher and postoperative Urine Output (ml/hr) (p=0.001) was significantly lower in patients with reduced eGFR (60-89ml/min/1.73m²) in Group B. Deterioration of renal function is more in patient with eGFR (60-89ml/min/1.73m²) after valve replacement surgery under cardiopulmonary bypass in comparison with patients with eGFR (≥90ml/min/1.73m²).
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Affiliation(s)
- S S Howladeer
- Dr Siddhartha Shankar Howlader, Senior Specialist, Department of Cardiothoracic and Vascular Surgery, Evercare Hospital Chattogram, Bangladesh; E-mail:
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Ara H, Paul SK, Kobayashi N, Nasreen SA, Ahmed F, Nila SS. Molecular Detection of MBL Encoding Genes in Acinetobacter baumannii strains Isolated from Various Samples at a Tertiary Care Hospital in Mymensingh. Mymensingh Med J 2022; 31:666-672. [PMID: 35780348] [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: 12/31/2022]
Abstract
MBL producing Acinetobacter baumannii is a major threat for therapeutic treatment of hospital acquired infections. The aim of this study was to determine the prevalence of metallo-β-lactamase genes VIM, IMP & SIM genes amongst isolated A. baumannii. This cross sectional study conducted in the department of Microbiology Mymensingh Medical College from March 2019 to February 2020. 49 Acinetobacter spp. were isolated from different clinical samples including endotracheal aspirates, wound swab/pus, urine and blood. Among 380 clinical samples 130 organisms were isolated growth was 34.21%. Out of 130 isolated strains, 49(37.69%) were Acinetobacter spp identified by standard bacteriological method and resistance to different antibiotics was assessed with Kirby- Bauer Disc diffusion method. Among 49 Acinetobacter spp, 39(79.59%) were Acinetobacter baumannii which was identified by molecular method PCR directing OXA-51 like gene. Multiplex PCR was done to determine MBL genes existence VIM, IMP & SIM. Ceftriaxone (79.48%) showing higher resistance and colistin (12.82%) showing lower resistance. All the strains were sensitive to tigecycline. The distribution of MBLs genes such as VIM 20(51.28%), IMP 5(12.82%) and SIM 0 (0%). This study showed that high level of antibiotic resistance and VIM was the most prevalent MBL genes among A. baumannii highlighting the need for indigenous antibiotic usage plan & infection control measures to prevent the spread of these resistance genes.
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Affiliation(s)
- H Ara
- Dr Hosne Ara, MD (Thesis) Part, Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Ben Tekaya A, Mehmli T, Boukriba S, Ahmed F, Saidane O, Leila R, Bouden S, Tekaya R, Mahmoud I, Mizouni H, Abdelmoula L. AB0852 Assessment of endothelial dysfunction in spondyloarthritis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3950] [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
BackgroundEndothelial dysfunction is the earliest step in the pathogenesis of atherosclerosis, preceding structural vascular alterations. Few studies have focused on the endothelial dysfunction in spondyloarthritis.ObjectivesThe aim of our study was to assess endothelial dysfunction using Flow-Mediated dilatation (FMD) in patients with spondyloarthritis.MethodsForty-seven consecutive patients meeting ASAS 2009 criteria for spondyloarthritis and 47 matched healthy subjects were included in the study. Subjects with traditional cardiovascular risk factors were excluded. Sociodemographic, clinical, biological and radiological features related to the disease as well as therapeutics were recorded. FMD was assessed ultrasonographically according to guidelines of American college of cardiology (ACC) (1).ResultsSpondyloarthritis group included 47 patients with a sex ratio of 2.35 and a median age of 36 years (IQR: 28-46). Median body mass index (BMI) was 24.5 kg/m2 (IQR 25-75%: 20.7-26.8) with no significant difference compared with the control group (p=0.238). Physical examination showed normal values of blood pressure (BP) with a median systolic BP of 121 mmHg (IQR 25-75%: 110-130) and a median diastolic BP of 71 mmHg (IQR 25-75%: 67-78). In laboratory findings, total cholesterol and triglyceride levels were increased in 2 and 3 patients respectively.Median age at onset of SpA was 20 years (IQR 25-75%; 18-32). For disease activity, median CRP level was 6.45 mg (IQR 25-75%: 1.45-19.9) and median ASDAS-CRP and BASDAI were respectively 2.18 (IQR 25-75%: 1.62-2.91) and 2.6 (IQR 25-75%: 1.8-3.8). Median MASES score was 0 (IQR 25-75%; 0-0). Median BASFI and BASMI were 3 (IQR 25-75%; 1.5-5.1) and 1.5 (IQR 25-75%: 0-4). Regarding treatment, 92% of patients were using NSAIDs, csDMARDs (51%) and 38% were on TNF inhibitors.Patients with spondyloarthritis exhibited significantly lower FMD values than healthy age and gender matched controls with a median value of FMD 14.6% (IQR; 9-24) versus 18.8% (IQR; 12.8-23.1%); p=0.008.ConclusionOur study demonstrates impairment of endothelial function in patients with spondyloarthritis compared with healthy population, confirming the accelerated atherosclerosis in spondyloarthritis.References[1]Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J. 2019 Aug 7;40(30):2534–47.Disclosure of InterestsNone declared
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Ahmed F, Ogdie A, Fitzsimmons R, Shin D, Takeshita J. AB0922 Psoriatic Arthritis Disease Activity Differs by Race/Ethnicity. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.212] [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: 11/03/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) affects up to 30% of individuals with psoriasis. Studies have demonstrated that the presenting disease severity and quality of life impact of psoriasis differs by race/ethnicity in patients with and without PsA, but little is known about disease activity among different racial/ethnic groups [1-3].ObjectivesThe objective of our study was to evaluate disease activity by race/ethnicity among patients with PsA.MethodsWe performed a cross-sectional study of adult (≥18 years old) patients with PsA who had at least one outpatient visit within the University of Pennsylvania health system between 2010 and 2019. Patients with PsA were identified by the presence of at least two International Classification of Diseases (ICD)-9 or ICD-10 codes for PsA associated with two different healthcare encounters. The primary outcome was disease activity as measured by the Routine Assessment of Patient Index Data 3 (RAPID3) assessment. The RAPID3 score is a validated patient-reported measure of physical function, pain, and global status [4]. RAPID3 scores range from 0 to 30, with higher scores indicating greater disease activity. Patients were included if they had at least one documented RAPID3 score. For patients with multiple RAPID3 scores, the median value was used. The primary independent variable was race/ethnicity categorized as White (reference), Black, Asian, Hispanic, or other race. Multivariable linear regression was used to assess the relationship between race/ethnicity and RAPID 3 score.ResultsThe study population included 742 patients. Mean (standard deviation [SD]) age was 47.2 (13.3) years and 57.4% were female. The racial/ethnic distribution was 79.4% White, 7.0% Black, 5.0% Asian, 3.1% Hispanic, 2.6% other race, and 3.0% missing race/ethnicity. The means of the median Rapid3 scores were statistically significantly different across racial/ethnic groups (p<.001): White mean (SD) 9.79 (6.02), Black mean (SD) 14.86 (14.86), Asian mean (SD) 9.79 (5.44), Hispanic mean (SD) 15.09 (7.11), other race mean (SD) 10.57 (6.91). In an adjusted multivariable model controlling for other sociodemographic factors, body mass index, treatment history, and medical comorbidity, Hispanic patients had higher RAPID3 scores compared to White patients, indicating greater disease activity (β 3.36; 95% confidence interval [CI] 1.04 – 5.67, p <.005). In exploratory stratified analyses to evaluate effect modification by sex, among males, Black (β 3.43; 95% CI 0.23 – 6.63, p=.04) and Hispanic (β 5.94; 95% CI 2.18 – 9.70, p <.005) patients had higher RAPID3 scores than White patients. Among females, no significant racial/ethnic differences in RAPID3 scores were identified.ConclusionBlack and Hispanic patients report greater disease activity as indicated by higher RAPID3 scores compared to White patients. Larger studies are necessary to confirm our findings and understand the causes of racial/ethnic differences in disease activity among patients with PsA.References[1]Abrouk M, Lee K, Brodsky M, Nakamura M, Singh R, Zhu TH, et al. Ethnicity affects the presenting severity of psoriasis. J Am Acad Dermatol. 2017;77(1):180-2.[2]Shah SK, Arthur A, Yang YC, Stevens S, Alexis AF. A retrospective study to investigate racial and ethnic variations in the treatment of psoriasis with etanercept. J Drugs Dermatol. 2011;10(8):866-72.[3]Takeshita J, Augustin M, de Jong E, Lafferty K, Langholff W, Langley R, Leonardi C, Menter A, Alexis A. Psoriasis-Related Quality-of-Life Differs by Race/Ethnicity. J Invest Dermatol. 2019; 139(5S, Supplement 1):S148.[4]Coates LC, Tillett W, Shaddick G, Pincus T, Kavanaugh A, Helliwell PS. Value of the Routine Assessment of Patient Index Data 3 in Patients With Psoriatic Arthritis: Results From a Tight-Control Clinical Trial and an Observational Cohort. Arthritis Care Res (Hoboken). 2018;70(8):1198-1205.Disclosure of InterestsFahad Ahmed: None declared, Alexis Ogdie Consultant of: A. Ogdie has received consulting fees from Amgen, AbbVie, Bristol Myers Squibb, Celgene, CorEvitas (formerly Corrona), Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Grant/research support from: A. Ogdie has received grant support from the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, National Psoriasis Foundation, Abbvie (University of Pennsylvania), Pfizer (University of Pennsylvania), Amgen (FORWARD), and Novartis (FORWARD)., Robert Fitzsimmons: None declared, Daniel Shin: None declared, Junko Takeshita Consultant of: JT has served as a consultant for Pfizer Inc. and Janssen Biotech receiving honoraria., Grant/research support from: JT has received a research grant (to the Trustees of the University of Pennsylvania) from Pfizer Inc.
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Ahmed F, Roy R. A Literature Review of Diagnostic Applicability of ICD 11 Classification of Personality Disorders in Comparison with ICD 10. Eur Psychiatry 2022. [PMCID: PMC9564016 DOI: 10.1192/j.eurpsy.2022.1142] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Personality disorders are frequently encountered by all healthcare professionals and can often pose a diagnostic dilemma due to the crossover of different traits amongst the various subtypes. The ICD 10 classification comprised of succinct parameters of the 10 subtypes of personality disorders but lacked a global approach to address the complexity of the disease. The ICD 11 classification provides a more structural approach to aid in clinical diagnosis. Objectives A literature review of the diagnostic applicability of ICD 11 classification of personality disorders is presented in comparison with the ICD 10 classification. Methods A retrospective analysis of the literature outlining the ICD 10 and 11 classifications of personality disorders, exploring the differences in evidence-based applications of both. Results The ICD 11 classification of personality disorders supersedes the ICD 10 classification in describing the severity of the personality dysfunction in conjunction with a wide range of trait domain qualifiers, thus enabling the clinician to portray the disease dynamically. The current evidence available on the utility of the ICD 11 classification gives a promising outlook for its application in clinical settings. Conclusions The ICD 11 has transformed the classification of personality disorders by projecting a dimensional description of personality functioning, aiming to overcome the diagnostic deficiencies in the ICD 10 classification. The versatility offered by the application of the ICD 11 classification can be pivotal in reshaping the focus and intensity of clinical management of the disease. Disclosure No significant relationships.
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Sucha S, Sorf A, Svoren M, Vagiannis D, Ahmed F, Visek B, Ceckova M. PB1790: ABCB1 AS A POTENTIAL BENEFICIAL TARGET OF MIDOSTAURIN IN ACUTE MYELOID LEUKEMIA. Hemasphere 2022. [PMCID: PMC9429552 DOI: 10.1097/01.hs9.0000850012.85946.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Ahmed F, Ogdie A, Fitzsimmons R, Shin D, Takeshita J. POS1049 ASSESSING TREATMENT PATTERNS WITH DISEASE-MODIFYING ANTIRHEUMATIC DRUGS AND PREDNISONE FOR PSORIATIC ARTHRITIS BY RACE/ETHNICITY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2483] [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
BackgroundPsoriatic arthritis (PsA) is a comorbidity commonly associated with psoriasis. Studies have demonstrated delays in the diagnosis and treatment of PsA[1] that may disproportionately affect racial/ethnic minority patients as indicated by one study that found Black Medicaid patients with PsA to be less likely to receive disease-modifying antirheumatic drugs [DMARDs] than White Medicaid patients with PsA [2]. Yet much remains unknown about potential racial/ethnic disparities in PsA management.ObjectivesThe objective of our study was to evaluate treatment patterns for PsA by race/ethnicity.MethodsWe performed a cross-sectional study of adult (≥18 years old) patients with PsA who had at least one outpatient visit within the University of Pennsylvania health system between 2010 and 2019. Patients with PsA were identified by the presence of at least two International Classification of Diseases (ICD)-9 or ICD-10 codes for PsA associated with two different healthcare encounters. The primary outcomes were receipt of a prescription for: (i) an oral DMARD, (ii) a biologic DMARD, and (iii) prednisone. Oral DMARDs included apremilast, methotrexate, sulfasalazine, leflunomide, azathioprine, cyclosporine, tofacitinib, hydroxychloroquine, and upadacitnib. Biologic DMARDs included abatacept, adalimumab, brodalumab, certolizumab, etanercept, golimumab, guselkumab, infliximab, ixekixumab, secukinumab, ustekinumab, and risankizumab. The primary independent variable was race/ethnicity categorized as White (reference), Black, Asian, Hispanic, or other race. Multivariable logistic regression was used to assess the relationship between race/ethnicity and each treatment outcome.ResultsThe study population included 1781 patients with PsA who were a mean age of 50.7 (SD 14.3), 54.6% female, and 72.5% commercially insured. The racial/ethnic distribution was 81.9% White, 5.6% Black, 4.0% Asian, 3.0% Hispanic, 2.5% other race, and 3.1% missing race/ethnicity. Of these patients, 64.3% were prescribed an oral DMARD, 55.6% were prescribed a biologic, and 44.1% were prescribed prednisone. There were no statistically significant differences across race/ethnicity for prescription of either oral or biologic DMARDs. However, prescription of prednisone did differ by race/ethnicity (p<.005) with Black (54.6%) and Hispanic (56.6%) patients being more likely to receive prednisone prescriptions and Asian (32.4%) patients being less likely to receive prednisone prescriptions than White (44.2%) patients. In adjusted logistic regression models controlling for sociodemographic and other factors, Hispanic patients were more likely to receive a prednisone prescription (OR 1.79, 95% CI 1.01 – 3.20, p=0.05) while Asian (OR 0.58, 95% CI 0.34 – 0.97, p=0.04) patients were less likely to receive a prednisone prescription compared to White patients.ConclusionWe found Hispanic patients with PsA to be more likely to receive prednisone prescriptions than White patients with PsA but did not identify any racial/ethnic differences in prescription patterns for oral or biologic DMARDs for PsA. Greater use of prednisone among Hispanic patients may reflect different diseases trajectories (e.g., more disease flares or greater disease severity) or other factors that affect prescription patterns that require further study.References[1]Favier G, Gladman DD, Merola JF, Armstrong AW, Boehncke WH, Helliwell PS. Benchmarking Care in Psoriatic Arthritis - The QUANTUM Report: A Report from the GRAPPA 2016 Annual Meeting. J Rheumatol. 2017;44(5):674-678.[2]Ogdie A, Matthias W, Thielen RJ, Chin D, Saffore CD. Racial Differences in Prevalence and Treatment for Psoriatic Arthritis and Ankylosing Spondylitis by Insurance Coverage in the USA. Rheumatol Ther. 2021;8(4):1725-1739.Disclosure of InterestsFahad Ahmed: None declared, Alexis Ogdie Consultant of: A. Ogdie has received consulting fees from Amgen, AbbVie, Bristol Myers Squibb, Celgene, CorEvitas (formerly Corrona), Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Grant/research support from: A. Ogdie has received grant support from the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, National Psoriasis Foundation, Abbvie (University of Pennsylvania), Pfizer (University of Pennsylvania), Amgen (FORWARD), and Novartis (FORWARD)., Robert Fitzsimmons: None declared, Daniel Shin: None declared, Junko Takeshita Consultant of: JT has served as a consultant for Pfizer Inc. and Janssen Biotech receiving honoraria., Grant/research support from: JT has received a research grant (to the Trustees of the University of Pennsylvania) from Pfizer Inc.
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Ben Tekaya A, Mehmli T, Ahmed F, Boukriba S, Saidane O, Leila R, Bouden S, Tekaya R, Mahmoud I, Mizouni H, Abdelmoula L. AB0777 Influence of TNF inhibitors on subclinical atherosclerosis in Spondyloarthritis patients. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4674] [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: 11/03/2022]
Abstract
BackgroundSpondyloarthritis is a chronic inflammatory disease associated with increased cardiovascular morbidity and mortality due to accelerated atherosclerosis. Recent studies have reported the benefit of TNF inhibitors in reducing the risk of cardiovascular events and its association with changes in lipid profile. Nevertheless, it remains controversial.ObjectivesWe aimed to investigate the effect of TNF inhibitors on subclinical atherosclerosis assessed with carotid intima-media thickness (CIMT) and flow mediated dilatation (FMD) in patients with spondyloarthritis (SpA).MethodsWe performed a cross sectional study including 47 patients meeting ASAS 2009 criteria for SpA. Patients with traditional cardiovascular risk factors were excluded. We collected clinical data, therapeutic modalities and biological tests including total cholesterol, HDL, LDL and triglyceride after 12 hours of fasting. FMD and mean CIMT (mean value of right and left carotid artery) were measured with a Mindray Resona 7 ZST+ ultrasound machine by an experienced radiologist.ResultsAmong the 47 subjects, 18 patients (38%) were receiving TNF inhibitors for a median duration of 36 months (IQR 25-75%: 24-72) (9 were on Etanercept, 7 were on Adalimumab, one patient was on Infliximab and one was on Golimumab). The group treated with TNF inhibitors had a median age of 43 years (IQR 25-75%: 36-46.5) and a median duration of the disease of 12 years (IQR 25-75%: 9.5-22). Median ASDAS and BASDAI scores were 2.40 (IQR 25-75%: 1.48-3.1) and 2.60 (IQR 25-75%: 1.55-3.75) respectively. On the other hand, patients naïve to TNF inhibitors had a median age of 32 years (IQR 25-75%: 55-42), median disease duration of 7 years (IQR 25-75%: 3-12.5), median ASDAS of 2.13 (IQR 25-75%: 1.61-2.91), and median BASDAI of 2.40 (IQR 25-75%: 1.55-3.75).When comparing the two groups, there was no significant difference regarding disease activity scores ASDAS (p=0.431) and BASDAI (p=0.793) as well as biochemical variables; total cholesterol (p=0.483), HDL (p=0.395), LDL (p=0.263) and triglyceride (0.092). In contrast, patients on TNF inhibitors were significantly more aged (p=0.009) and had a significantly higher duration of the disease (p=0.004).Doppler ultrasound examination showed a median CIMT of 0.56 mm (0.48-0.64) in patients treated with TNF inhibitors versus 0.55 mm (0.48-0.60) in patients naïve to TNF inhibitors with no significant difference (p=0.238). Patients on TNF inhibitors had lower values of FMD (with a median of 12.5 (6.7-16) versus 15.5 (10-24.5)). However this difference was not significant (p=0.182).ConclusionIn our study, biological treatment with TNF inhibitors did not affect endothelial function and subclinical atherosclerosis in patients with spondyloarthritis. Given the small size of our study population and its heterogeneity in terms of age and duration of the disease, no conclusions can be drawn. Further longitudinal studies that involve larger samples are necessary.Disclosure of InterestsNone declared
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Mahmud S, Alam S, Emon NU, Boby UH, Kamruzzaman, Ahmed F, Monjur-Al-Hossain A, Tahamina A, Rudra S, Ajrin M. Opportunities and challenges in stem cell therapy in cardiovascular diseases: Position standing in 2022. Saudi Pharm J 2022; 30:1360-1371. [PMID: 36249945 PMCID: PMC9563042 DOI: 10.1016/j.jsps.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/17/2022] [Indexed: 10/29/2022] Open
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Ben Tekaya A, Mehmli T, Boukriba S, Ahmed F, Saidane O, Leila R, Bouden S, Tekaya R, Mahmoud I, Mizouni H, Abdelmoula L. AB0857 Increased carotid intima-media thickness is correlated with renal function in spondyloarthritis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4102] [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: 11/03/2022]
Abstract
BackgroundCardiovascular diseases are the main cause of mortality in spondyloarthritis and seem to be multifactorial. Due to its easy application and reproductibility, carotid intima-media thickness (CIMT) is increasingly used for assessment of subclinical atherosclerosis and cardiovascular risk stratification.ObjectivesThe aim of our study was to investigate the relationship between CIMT and renal function in patients with spondyloarthritis (SpA).MethodsWe performed a cross sectional study including 47 patients with SpA and no history of cardiovascular disease. Clinical and biological data were recorded. Data related to renal involvement and creatinine level were extracted. CIMT was measured in the right and the left common carotid artery by an experienced radiologist; than mean CIMT was calculated.ResultsOur study included 33 men and 14 women with a sex ratio of 2.35, a median age of 36 years (IQR 25-75%: 28-46) and a median duration of the disease of 11 years (IQR 25-75%: 5-16). Renal involvement was found in 6 patients (13%): kidney stones (n=2), tubulo-interstitial nephritis (TIN) (n=2), IgA nephropathy (n=1) and AA amyloidosis (n=1). Median creatinine level was 63 μmol/l (IQR 25-75%: 58.5 - 64). No patient had kidney failure.Ultrasound examination found median right, left and mean (CIMT) of 0.54 mm (IQR 25-75%: 0.50-0.63), 0.55 mm (IQR 25-75%: 0.49-0.61) and 0.55 mm (IQR 25-75%: 0.48-0.62) respectively. Increased CIMT values were found in 8 patients (17%). No patient had atherosclerotic plaque.Patients with renal involvement had significantly higher values of CIMT (0.64 mm (IQR 25-75%: 0.56-0.70) vs 0.53 mm (IQR 25-75%: 0.47-0.59); p= 0.045). Significant positive correlation was also detected between CIMT values and creatinine level (p=0.002; r=0.445).In multivariate linear regression, creatinine level was identified as independent predictor of increased CIMT (B=0.002; 95% confidence interval=0.000-0.005; p=0.035).ConclusionAlthough all patients included have normal creatinine level, we identified creatinine level as independent predictor of subclinical atherosclerosis in SpA patients. This finding highlights the monitoring of this parameter.Disclosure of InterestsNone declared
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Ben Tekaya A, Mehmli T, Ahmed F, Boukriba S, Saidane O, Leila R, Bouden S, Tekaya R, Mahmoud I, Mizouni H, Abdelmoula L. AB0849 Assessment of Carotid Intima-Media Thickness in Spondyloarthritis patients. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3857] [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
BackgroundCardiovascular morbidity and mortality are increased in spondyloarthritis (SpA) (1), which is attributed to accelerated atherosclerosis. Recognition of subclinical atherosclerosis in asymptomatic population is important for risk stratification and optimal management. Due to its simplicity and non-invasive nature, carotid intima-media thickness (cIMT) is actually widely used for identifying subclinical atherosclerosis.ObjectivesThe aim of our study was to investigate the presence of subclinical atherosclerosis in SpA patients compared with healthy controls, by evaluating cIMT.MethodsWe performed a case control study including 47 patients and 47 age and gender matched healthy controls. All subjects were included without history of cardiovascular disease or cardiovascular risk factors. Sociodemographic features, disease characteristics, radiographic structural damage and therapeutics were recorded. cIMT was measured with Mindray Resona 7 ZST+ ultrasound machine, from the right and the left carotid artery; than mean cIMT was calculated. We considered that cIMT was increased if the measurements were between 0.7 mm and 1.5 mm. Measurements higher than 1.5 were defined as an atherosclerotic plaque.ResultsFourty seven patients with a sex ratio of 2.35 were included in our study. Median age was 36 years (IQR: 28-46) and median duration of the disease was 11 years (IQR: 5-16). Median BASDAI and ASDAS-CRP scores were 2.6 (IQR: 1.8-3.8) and 2.18 (IQR: 1.62-2.91) respectively. Of the 47 patients, 10 (21%) had an active disease according to BASDAI and 19 (40%) had an active disease according to ASDAS. Median BASFI score for functional impairment was 3 (IQR: 1.5-5.1). Median BASRI and mSASSS scores were 3 (IQR: 2-4) and 10 (IQR: 4-15) respectively. Regarding treatment, 92% of patients were using non-steroidal anti-inflammatory drugs (NSAIDs), 51% were on csDMARDs and 38% were on anti-TNF alpha drugs.Median right, left and mean cIMT were respectively 0.54 mm (IQR: 0.50-0.63), 0.55 mm (IQR: 0.49-0.61) and 0.55 mm (IQR: 0.48-0.62) respectively. Increased cIMT values were found in 8 patients (17%). No patient had atherosclerotic plaque.Median values of cIMT were significantly higher in patients with spondyloarthritis than the control subjects (p<0.0001) as shown in Table 1.Table 1.Comparaison of carotid intima-media thickness values between spondyloarthritis patients and control subjects.SpondyloarthritisPatientsControl grouppRight cIMT (mm)*0,54 (0,50-0,63)0,45 (0,42-0,50)< 0.0001**Left cIMT (mm)*0,55 (0,49-0,61)0,47 (0,45-0,50)<0.0001**Mean cIMT (mm)*0,55 (0,48-0,62)0,46 (0,43-0,50)<0.0001**cIMT: carotid intima-media thickness; mm: millimeters; *: median value (IQR 25-75%); **: p < 0.05 denotes statistical significance.ConclusionOur study demonstrated increased cIMT in patients with SpA compared with healthy population; which attests higher risk for subclinical atherosclerosis and cardiovascular atherosclerotic events.References[1]Bai R, Zhang Y, Liu W, Ma C, Chen X, Yang J, et al. The Relationship of Ankylosing Spondylitis and Subclinical Atherosclerosis: A Systemic Review and Meta-Analysis. Angiology. 2019 Jul;70(6):492–500.Disclosure of InterestsNone declared
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Mazumder K, Aktar A, Roy P, Biswas B, Hossain ME, Sarkar KK, Bachar SC, Ahmed F, Monjur-Al-Hossain ASM, Fukase K. A Review on Mechanistic Insight of Plant Derived Anticancer Bioactive Phytocompounds and Their Structure Activity Relationship. Molecules 2022; 27:molecules27093036. [PMID: 35566385 PMCID: PMC9102595 DOI: 10.3390/molecules27093036] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Cancer is a disorder that rigorously affects the human population worldwide. There is a steady demand for new remedies to both treat and prevent this life-threatening sickness due to toxicities, drug resistance and therapeutic failures in current conventional therapies. Researchers around the world are drawing their attention towards compounds of natural origin. For decades, human beings have been using the flora of the world as a source of cancer chemotherapeutic agents. Currently, clinically approved anticancer compounds are vincristine, vinblastine, taxanes, and podophyllotoxin, all of which come from natural sources. With the triumph of these compounds that have been developed into staple drug products for most cancer therapies, new technologies are now appearing to search for novel biomolecules with anticancer activities. Ellipticine, camptothecin, combretastatin, curcumin, homoharringtonine and others are plant derived bioactive phytocompounds with potential anticancer properties. Researchers have improved the field further through the use of advanced analytical chemistry and computational tools of analysis. The investigation of new strategies for administration such as nanotechnology may enable the development of the phytocompounds as drug products. These technologies have enhanced the anticancer potential of plant-derived drugs with the aim of site-directed drug delivery, enhanced bioavailability, and reduced toxicity. This review discusses mechanistic insights into anticancer compounds of natural origins and their structural activity relationships that make them targets for anticancer treatments.
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Affiliation(s)
- Kishor Mazumder
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
- School of Optometry and Vision Science, UNSW Medicine, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
- Correspondence: or (K.M.); (K.F.)
| | - Asma Aktar
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
| | - Priyanka Roy
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
| | - Biswajit Biswas
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
| | - Md. Emran Hossain
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
| | - Kishore Kumar Sarkar
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (A.A.); (P.R.); (B.B.); (M.E.H.); (K.K.S.)
| | - Sitesh Chandra Bachar
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1207, Bangladesh; (S.C.B.); (F.A.)
| | - Firoj Ahmed
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1207, Bangladesh; (S.C.B.); (F.A.)
| | - A. S. M. Monjur-Al-Hossain
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Dhaka, Dhaka 1207, Bangladesh;
| | - Koichi Fukase
- Department of Chemistry, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Correspondence: or (K.M.); (K.F.)
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Movassaghi M, Ahmed F, Patel H, Luk L, Hyams E, Wenske S, Shaish H. Association of Patient and Imaging-Related Factors with False Negative MRI-Targeted Prostate Biopsies of Suspicious PI-RADS 4 and 5 Lesions. Urology 2022; 167:165-170. [DOI: 10.1016/j.urology.2022.04.026] [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] [Received: 10/31/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
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Wadhwa M, Kang HN, Thorpe R, Knezevic I, Aprea P, Bielsky MC, Ekman N, Heim HK, Joung J, Kurki P, Lacana E, Njue C, Nkansah E, Savkina M, Thorpe R, Yamaguchi T, Wadhwa M, Wang J, Weise M, Wolff-Holz E, Allam M, Bahaa H, Sayed M, Al-Oballi A, Alshahrani A, Baek D, Kim J, Chua H, Gangakhedkar J, Jagtap MP, Lyaskovsky T, Okudaira S, Ondee W, Sotomayor P, Ricra JS, Uviase J, Ahmed F, Rajendran Y, Defendi HT, Cho SO, Qu A, Acha V, Gencoglu M, Ho K, Baldrighi M, Schiestl M, Watson K, Spitzer E, Chong S, Fukushima A, Kang HN, Knezevic I, Pante G, Simao M. WHO informal consultation on revision of guidelines on evaluation of similar biotherapeutic products, virtual meeting, 30 June – 2 July 2021. Biologicals 2022; 76:1-9. [PMID: 35466023 PMCID: PMC9109723 DOI: 10.1016/j.biologicals.2022.03.001] [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] [Received: 01/07/2022] [Revised: 02/28/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
The WHO informal consultation was held to promote the revision of WHO guidelines on evaluation of similar biotherapeutic products (SBPs) adopted by the Expert Committee on Biological Standardization (ECBS) in 2009. It was agreed in the past consultations that the evaluation principles in the guidelines are still valid, but a review was recommended to provide more clarity and case-by-case flexibility. The opportunity was therefore taken to review the experience and identify areas where the current guidance could be more permissive without compromising its basic principles, and where additional explanation could be provided regarding the possibility of reducing the amount of data needed for regulatory approval. The meeting participants applauded the leading role taken by the WHO in providing a much-needed streamlined approach for development and evaluation of SBPs which will provide efficient and cost-effective product development and increase patient access to treatments. It was recognized that the principles as currently described in the draft WHO guidelines are based on sound science and experience gained over the last fifteen years of biosimilar approvals. However, since these guidelines when finalised will constitute the global standard for biosimilar evaluation and assist national regulatory authorities in establishing revised guidance and regulatory practice in this complex area, it was felt that further revision and clarity on certain perspectives in specific areas was necessary to dispel uncertainties arising in the current revised version. This report describes the principles in the draft guidelines, including topics discussed and consensus reached. WHO guidelines serve as a basis for the development of national regulatory framework for biosimilars. Revision of guidelines is to provide more flexibility and clarification on data required for regulatory approval. Revised guidelines would contribute to improving consistency on regulatory decision and patient access to treatments.
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Bhattacharjee M, Hossain I, Roy S, Kamrul-Hasan AB, Ahmed F, Banerjee S, Bhuya SI, Losy SA, Biswas R, Mondal D. Post-Acute Covid Neurological Symptoms among Doctors and Nurses in A Tertiary Care Hospital: An Observational Study from Bangladesh. Mymensingh Med J 2022; 31:379-384. [PMID: 35383754] [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: 02/20/2023]
Abstract
A good number of patients experience post-Covid complications. Doctors and nurses are the front liners who are at greater risk of having this disease. Neurological symptoms are frequent in patients with post-COVID-19 infection. The study aims to observe the post-acute neurological symptoms among doctors and nurses of Mymensingh Medical College Hospital, a tertiary care hospital in Bangladesh, after they recover from initial infection or among the asymptomatic cases. It was a retrospective observational study among the doctors and nurses who became RT PCR positive from late April to mid-September 2020. A total of 100 subjects were interviewed over the phone for the presence or absence of neurological symptoms four weeks post Covid-19 infection. Total 54 doctors and 46 nurses were evaluated; the male-female ratio was 1:1.77, the mean age was 35.6±7.6 years. Post-acute COVID neurological symptoms (PACNS) were present in 60% of respondents. Fatigue (51%) was the most common symptom, followed by sleep disturbance, headache, myalgia, loss of taste and smell. PACNS were more in symptomatic patients at the initial Covid infection than asymptomatic cases.
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Affiliation(s)
- M Bhattacharjee
- Dr Manabendra Bhattacharjee, Associate Professor, Department of Neurology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Fujii K, Hara Y, Arai MA, Sadhu SK, Ahmed F, Ishibashi M. Natural Compounds with BMI1 Promoter Inhibitory Activity from Mammea siamensis and Andrographis paniculata. Chem Pharm Bull (Tokyo) 2022; 70:885-891. [PMID: 36450587 DOI: 10.1248/cpb.c22-00556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
A new coumarin derivative (1) and 30 known compounds were isolated from Mammea siamensis and Andrographis paniculata, guided by B cell-specific Moloney murine leukemia virus insertion region 1 (BMI1) promoter inhibitory activity. Among the isolated compounds, 15 compounds showed BMI1 promoter inhibitory activity, and five compounds were found to be cytotoxic. 14-Deoxy-11,12-dehydroandrographolide (18) was highly cytotoxic to DU145 cells with an IC50 value of 25.4 µM. Western blotting analysis of compound 18 in DU145 cells suggested that compound 18 suppresses BMI1 expression.
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Affiliation(s)
- Kazuki Fujii
- Graduate School of Pharmaceutical Sciences, Chiba University
| | - Yasumasa Hara
- Graduate School of Pharmaceutical Sciences, Chiba University
- Plant Molecular Science Center, Chiba University
| | | | | | - Firoj Ahmed
- Department of Pharmaceutical Chemistry, University of Dhaka
| | - Masami Ishibashi
- Graduate School of Pharmaceutical Sciences, Chiba University
- Plant Molecular Science Center, Chiba University
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Jitrangsri K, Takaya A, Hara Y, Sadhu SK, Ahmed F, Ishibashi M. Bioactivity-guided Isolation of TRAIL-Resistance-Overcoming Activity Compounds From the Leaves of Murraya exotica. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211065843] [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: 11/17/2022] Open
Abstract
Fractionation of the leaf extract from Murraya exotica led to the successful isolation of 12 compounds (1-12) with TRAIL-resistance-overcoming activity. Xanthinosin (1), 11α, 13-dihydroxanthinin (2), 11β, 13-dihydroxanthinosin (3), 4α, 11α, 13-trihydroxanthuminol (4), desacetylxanthanol (5), and lasidiol p-methoxybenzoate (6) were sesquiterpenes isolated from this plant for the first time, and 3 was isolated from natural sources for the first time. Among them, compounds 1 and 5 showed strong TRAIL-resistance-overcoming activity, but their mechanisms have already been revealed. Furthermore, dihydroxanthinin (2), 1, 5-dicaffeoylquinic acid (7), and (-) loliolide (8), which belong to different phytochemical groups, were investigated for their effects on increasing apoptosis induction to overcome TRAIL resistance using Western blot analysis. The results demonstrated that 2, 7, and 8 promoted TRAIL-induced apoptosis by increasing the expression of several proapoptotic markers, including cleaved caspases −3 and −8, and suppressing anti-apoptotic protein Bcl-2.
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Manton RN, Ahmed F, Ridha H. Preliminary experience using the VITOM-3D system for microvascular anastomosis in DIEP free flap breast reconstruction. J Plast Reconstr Aesthet Surg 2021; 75:893-939. [PMID: 34924322 DOI: 10.1016/j.bjps.2021.11.099] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 11/14/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
Free tissue transfer has become routine practice in modern plastic surgery. The technique permits surgeons the flexibility to transfer the most suitable tissue for reconstruction. This has become possible largely due to the continued advances in microscope technology. There are however several drawbacks with even the newest traditional operating microscopes. They are usually large, heavy and although highly adjustable often require surgeons to adopt an unnatural and uncomfortable position which many of us have simply learned to live with. We describe the use of a new high-definition 3D camera system (Stortz VITOM 3D) in place of a traditional microscope to perform DIEP flap breast reconstructions in two patients. The use of this equipment has been described in other surgical specialities where a number of its benefits, including improved ergonomics for surgical team, have been highlighted. We explore the specific benefits and considerations for its use in free flap reconstruction of the breast .
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Affiliation(s)
- R N Manton
- Department of Plastic and Reconstructive Surgery, Lister Hospital, Stevenage, UK.
| | - F Ahmed
- Department of Plastic and Reconstructive Surgery, Lister Hospital, Stevenage, UK
| | - H Ridha
- Department of Plastic and Reconstructive Surgery, Lister Hospital, Stevenage, UK
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Ahmed F, Ahmad G, Schumacher J, Brand T. Social media influencer marketing to build a counter-narrative for promoting sexuality education. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.168] [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: 11/14/2022] Open
Abstract
Abstract
Background
A recent cross sectional community readiness assessment carried out in Islamabad, Pakistan indicated that the community is at the denial or resistant stage for implementing school-based sexuality education in Pakistan. The resistance was attributed to lack of awareness and prevalent misconceptions regarding sexuality education. This study aims at qualitatively exploring strategies for targeting misconceptions and increase awareness regarding sexuality education with stakeholder involvement.
Methods
35 in-depth interviews and a focus group discussion was conducted to discuss the results of the readiness assessment comprising of community members, researchers, NGO representatives, and social media influencers. Discussion guide included topics on engagement strategies, intervention modes of delivery, target audience, misconceptions, community support, and optimizing sexuality education in local context. Qualitative content analysis was conducted for analyzing the data.
Results
Results indicate that current community support is usually passive in nature and digital or social media platforms are mostly used to talk about sexuality education. Participants believed social media can be used as a platform for disseminating information by involving social media influencers with careful narrative building around sexuality for rebranding the topic, as talking about sexuality is seen as a taboo in the society. Targeting misconceptions through counter narratives and scientific evidence was considered as a way forward for increasing community acceptability and readiness. Violence, staying safe, and age appropriateness were identified as some of the key features of sexuality education that need to be highlighted for garnering community support.
Conclusions
For promoting sexuality education in Pakistan, it is essential to tackle resistance by sensitizing the community and digital social media platforms offer an opportunity to do this through influencer marketing.
Key messages
Digital and social media offer an opportunity for promoting sexuality education in conservative settings like Pakistan. Social media influencer marketing might be useful in building counter narrative and for community engagement.
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Affiliation(s)
- F Ahmed
- Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - G Ahmad
- International Business & Marketing, NUST Business School, National University of Sciences and Technology, Islamabad, Pakistan
| | - J Schumacher
- Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - T Brand
- Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
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Moseley P, Jackson N, Omar A, Eldoadoa M, Samaras C, Birk R, Ahmed F, Chakrabarti P. Single-centre experience of using procalcitonin to guide antibiotic therapy in COVID-19 intensive care patients. J Hosp Infect 2021; 119:194-195. [PMID: 34656662 PMCID: PMC8516658 DOI: 10.1016/j.jhin.2021.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/26/2022]
Affiliation(s)
- P Moseley
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK.
| | - N Jackson
- Department of Critical Care, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - A Omar
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - M Eldoadoa
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - C Samaras
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - R Birk
- Department of Critical Care, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - F Ahmed
- Department of Biochemistry, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
| | - P Chakrabarti
- Department of Microbiology, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK
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Ahmed F, de Cates C, Bahadur Bohara R, Youngs R. 1556 Does Surgical Intervention Improve Quality of Life for Patients with Chronic Ear Disease in Nepal? Br J Surg 2021. [DOI: 10.1093/bjs/znab259.583] [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: 11/14/2022]
Abstract
Abstract
Aim
To assess change in quality of life (QoL) pre- and post-surgery for patients with chronic ear disease (CED) in Nepal. Hearing loss is the fourth leading cause of disability world-wide with 90% of those affected living in low and middle-income countries. A huge yet treatable contributor to this is chronic suppurative otitis media (CSOM). The Chronic Ear Survey is a sensitive and disease specific QoL measurement tool in patients with CSOM exploring activity restriction, symptoms and utilisation of medical services.
Method
This study was conducted at the Brinos Ear Care Centre in Nepalgunj, Nepal. A modified Chronic Ear Survey (mCES) was translated into Nepali and administered to patients before surgery and at post-operative follow up by community ear care assistants. The Mann-Whitney U test was used for statistical analysis.
Results
The mCES was administered to 64 patients pre-operatively and 28 patients post-operatively. Disease specific QOL in patients with CSOM was demonstrated to be better overall in patients post-surgery and specifically in the domains of activity limitation and symptoms. No significant change was demonstrated in utilisation of medical services (p < 0.1)
Conclusions
Surgical intervention for patients with CSOM in Nepal improves ear specific QOL. This manifests specifically in a reduction in severity of symptoms and fewer restrictions on activity. Surgery in this population does not significantly change healthcare seeking behaviour and this must be explored further in the context of access to surgery and attitudes towards healthcare in this population.
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Affiliation(s)
- F Ahmed
- West Middlesex Hospital, London, United Kingdom
| | - C de Cates
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - R Youngs
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Yeoh T, Tan A, Ahmed F. 387 Plastics Surgery and the COVID-19 Pandemic: How Our Practice Has Improved as A Consequence. Br J Surg 2021. [PMCID: PMC8524581 DOI: 10.1093/bjs/znab259.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim
Plastic trauma cases were impacted by the COVID-19 pandemic. Multiple plastic trauma theatres were lost due to redeployment and redistribution of staff and resources. Plastic surgery was essentially left with an emergency list to manage trauma cases. This retrospective study aims to highlight the pitfalls and solutions realised during COVID times and how different strategies can be implemented should a third national lock down occur.
Method
Plastic surgery data (trauma, elective) was analysed from the first national lockdown due to COVID-19 in 2020. This data was compared against plastic surgery trauma data from 2019. Theatre time, the number of trauma surgeries, anaesthetic used and delay to theatre were all analysed.
Results
There was a 47% reduction in plastic surgery trauma cases and a 42% reduction in delay to surgery during the national lockdown (2020) when compared with data from 2019. A significant increase in the use of Local Anaesthetic (LA) and Regional Anaesthetic (RA) during COVID times with a decrease in General Anaesthetic when compared with pre-COVID data of 2019 was also identified.
Conclusions
This study identified that the majority of plastic cases could be performed under RA/LA. This would lead to decreased aerosol generating procedures (GA) thus limiting the transmission of COVID, and decreased delay to surgery and theatre time. As a third national lockdown may be on the horizon, it would be prudent to implement these strategies into current practice and by doing so optimising theatre usage and assisting in curtailing the COVID-19 transmission rate.
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Affiliation(s)
- T Yeoh
- Lister Hospital, Stevenage, United Kingdom
| | - A Tan
- Lister Hospital, Stevenage, United Kingdom
| | - F Ahmed
- Lister Hospital, Stevenage, United Kingdom
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40
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Ahmed F, Subahan N, Menyah E, Koshy R, Khawaja A. 750 An Unusual Presentation of a Rare Clinical Entity – A Case Report of Spontaneous Common Bile Duct Perforation in an Adult. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.317] [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: 11/14/2022]
Abstract
Abstract
Spontaneous or non-traumatic perforation of the extrahepatic biliary system is a rare clinical phenomenon, with few cases reported since its first mention in medical literature by Freeland in 1882. Given the rarity, misdiagnosis is common with the diagnosis almost always made during urgent exploratory laparotomy. We describe a case of spontaneous common bile duct (CBD) perforation in an 83-year-old female with no associative underlying disease process identified.
The patient presented with sudden onset abdominal pain with no identifiable trigger, with minimal past medical history. Examination was remarkable for findings of epigastric tenderness and guarding. Haematological investigation was remarkable only for hyperamylasaemia and leucocytosis. Pneumoperitoneum was ruled out and following contrast CT abdomen and pelvis a working diagnosis of mild pancreatitis was made. US Abdomen and MRCP found no evidence of cholelithiasis, with minimal biliary duct dilatation. The patient continued to deteriorate on the ward, with aspiration of new intrabdominal fluid collection raising suspicion of perforated viscus. Exploratory laparotomy revealed a 1-cm defect in the CBD with frank bile leak. A T-tube was placed in the common bile duct defect, with an abdominal robertson drain also inserted. No further bile leak was identified via Tubogram, with the patient successfully discharged following multidisciplinary rehabilitation in intensive care and the ward setting.
Surgeons should seek out this uncommon diagnosis in patients with hyperamylasaemia and suspected cholelithiasis who do not conform to normal biliary/pancreatic disease progression patterns.
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Affiliation(s)
- F Ahmed
- QEQM Hospital, East Kent University Hospital Foundation Trust, Margate, United Kingdom
| | - N Subahan
- QEQM Hospital, East Kent University Hospital Foundation Trust, Margate, United Kingdom
| | - E Menyah
- QEQM Hospital, East Kent University Hospital Foundation Trust, Margate, United Kingdom
| | - R Koshy
- QEQM Hospital, East Kent University Hospital Foundation Trust, Margate, United Kingdom
| | - A Khawaja
- QEQM Hospital, East Kent University Hospital Foundation Trust, Margate, United Kingdom
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41
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Al-Manzo MIS, Biswas S, Das Gupta S, Rahman M, Basak B, Talukder QI, Chanda PK, Biswas SK, Ahmed F. 158 Effect of Preoperative Continuation of Aspirin on Postoperative Bleeding After Off-Pump Coronary Artery Bypass Grafting (OPCABG). Br J Surg 2021. [DOI: 10.1093/bjs/znab259.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Despite ample evidence of continued preoperative aspirin to improve outcomes in coronary artery bypass surgery, practice for routine continued preoperative aspirin use is still inconsistent due to concern for increased postoperative bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on postoperative bleeding after off-pump coronary artery bypass grafting (OPCABG).
Method
This cohort study involved patients (n = 74) who underwent OPCABG at a single center between August 2017 to January 2018. After considering the inclusion and exclusion criteria, they were divided into two groups: one (n = 37) received tablet Aspirin 75mg till the day of surgery and for the other group (n = 37) aspirin was stopped 5 days before surgery. Postoperative bleeding was recorded in both groups. After considering preoperative, intraoperative, and postoperative variables statistical analysis was done.
Results
There was no significant difference between the two groups concerning preoperative and peroperative variables. No significant difference was also observed between the two groups in chest tube drainage at 1sthour, 2ndhour, 3rdhour, 24thhour, next 24 hours (at 48th hour), and next 24 hours (at 72nd hour) (p = 0.845, 0.126, 0.568, 0.478, 0.342 and 0.717 respectively). No significant difference was seen in the transfusion requirement of blood and fresh frozen plasma (FFP).
Conclusions
Continuation of preoperative aspirin till the day of surgery is not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of blood and FFP.
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Affiliation(s)
- M I S Al-Manzo
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - S Biswas
- United Hospital Limited, Dhaka, Bangladesh
| | - S Das Gupta
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Md.Z Rahman
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - B Basak
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Q I Talukder
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - P K Chanda
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - S K Biswas
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - F Ahmed
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
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42
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Akhtar K, Akhtar K, Nahar S, Ahmed F. Patterns of Health Care Utilization during Breast Cancer Diagnosis and Treatment: A Cross Sectional Study in Bangladesh. Mymensingh Med J 2021; 30:1124-1130. [PMID: 34605486] [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
Female breast cancer can be diagnosed easily; but due to inappropriate health care utilization, health-seeking is lag behind. The objectives of the study were to find out the pattern of utilization of health care during breast cancer diagnosis and treatment and their health seeking time. We conducted this cross sectional study for one year; from July 2017 to June 2018 among 200 newly diagnose patients with breast cancer whose were selected randomly from National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from the listed patients who attended at the outpatient department of chemotherapy day care center for treatment. Delay in reporting, wrong reporting, double reporting, delay in hospital admission, long queue for administrative work and delay to reach cancer specialist play a role in utilization of health care. Results showed that health care service delivery and utilization was found to be significant by (p<0.05) associated with the provider delay (p=0.010), total delay (p=0.017), delay to consult with cancer specialist (p<0.0001). By logistic regression it analyzed that utilization of health care there had 2 times more likely to cause provider delay (OR=2.5; 95% CI 1.087-5.762) p=0.03. Utilization of health care influenced stage of cancer with delay help seeking and diagnostic institution also. As low middle income country, like Bangladesh, delays in seeking consultation, late presentation and the availability of breast cancer management for all patients, represent major challenges.
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Affiliation(s)
- K Akhtar
- Dr Khursheda Akhtar, Assistant Professor, Community Medicine, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh; E-mail:
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43
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Nasir M, Perveen RA, Saha SK, Nessa A, Zaman A, Nazneen R, Ferdous J, Farha N, Majumder TK, Hossain MJ, Parvin S, Chowdhury MR, Begum H, Ahmed F. Vaccination against COVID-19 in Bangladesh: Perception and Attitude of Healthcare Workers in COVID-dedicated Hospitals. Mymensingh Med J 2021; 30:808-815. [PMID: 34226472] [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
Healthcare professionals are the crucial and influencing source of information for vaccines and their communication among patients and communities that can accelerate successful vaccination in a country. This cross-sectional study was one of the first and foremost ones in Bangladesh to observe the basic perception and attitudes towards vaccination against COVID-19 among the healthcare workers (HCWs) - doctors, interns, nurses, ward boys, cleaners, and medical technologists of major COVID-dedicated hospitals. The cross-sectional questionnaire-based study was conducted in February 2021 among 550 HCWs to assess the perception and attitude towards vaccination against COVID-19. The study participants were targeted as the priority group for COVID-19 vaccination, working in two major COVID-dedicated hospitals, Holy Family Red Crescent Medical College Hospital (HF-center), and Sheikh Russel National Gastro-liver Institute and Hospital (SR-center) in Dhaka, Bangladesh during the pandemic. The questionnaire was structured with a three-point scale of responses from 'true', 'false', and 'do not know'. The responses were calculated on point-score as +1 for the correct response, -1 for the wrong response, and 0 for 'do not know' with an overall highest and the lowest possible score of +5 to -5. Absolute (n) and relative frequencies (%) were presented for qualitative variables, while quantitative variables were presented as mean (± standard deviation). Chi-square test was done for univariate analysis of qualitative variables and Student's t-test for quantitative variables. With the 95.27% response rate, including 204 males and 320 were female and the male: female ratio was 1: 1.56. The majority of the participants were doctors (45.8%) followed by nurses (27.9%), and MLSS (26.3%) respectively. The respondents were between 18 to 64 years of age with a mean of 36.17±10.94 years. Most of the respondents (95.99%) responded correctly about the cost-free availability of a vaccine against COVID-19 in the country, 87.40% preferred vaccination as safe and effective. Again 29.77% HCWs think the vaccine might not be safe or effective due to emergency authorization. Only 38.93% of respondents could respond correctly about the necessity of vaccines for children, 31.10% think the vaccination was not required instead of natural immunity. The positive perception and attitude of the frontline HCWs in COVID-dedicated hospitals in Bangladesh are crucial which will positively influence motivation and wide acceptance among the general population for the attainment of the nationwide vaccination program, and adopt effective strategic modification to minimize the gaps for a low-middle income country like Bangladesh with its resource constrain.
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Affiliation(s)
- M Nasir
- Professor Morshed Nasir, Professor and Head of Pharmacology, Holy Family Red Crescent Medical College (HFRCMC), Dhaka, Bangladesh; E-mail:
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44
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Ara H, Paul SK, Kobayashi N, Nasreen SA, Ahmed S, Haque N, Ahmed F, Khanam J, Nila SS, Titir SR, Rahman S, Islam MF, Roy S, Ifa IA, Abedin S, Chowdhury CS, Paul A, Nesa M. Prevalence of ESBL Encoding Genes in Acinetobacter baumannii Strains Isolated from Various Samples of a Tertiary Care Hospital in Mymensingh. Mymensingh Med J 2021; 30:625-632. [PMID: 34226447] [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 aim of this study was to find the prevalence of ESBL genes among A. baumannii isolates. In this cross sectional study, 49 Acinetobacter spp. were isolated from various clinical samples from March 2019 to February 2020 conducted in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Clinical samples including endotracheal aspirates, wound swab/pus, urine and blood. A total of 380 samples were analyzed. Growth was obtained in 34.21% of the samples yielding 130 organisms. Out of 130 organisms, 49(37.69%) were Acinetobacter spp. Among 49 Acinetobacter spp, 39(79.59%) were Acinetobacter baumannii which was identified by PCR targeting OXA-51 like gene. Amplification of the ESBL encoding genes, namely CTX-M, TEM, SHV done by molecular technique PCR. The most antibacterial resistance was against ceftriaxone (79.48%) and lower resistance only showed in colistin (12.82%). All the isolates were sensitive to tigecycline. The distribution of ESBLs genes such as TEM 20(51.28%), CTX-M 16(41.02%) and SHV 0(0%). The high resistance to most of the antibiotics among the studied strains and also a high prevalence of TEM gene in A. baumannii strains found in our study gives alarming sign towards the treatment complexity of these strains.
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Affiliation(s)
- H Ara
- Dr Hosne Ara, MD (Thesis Part) Student, Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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45
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Khalil MM, Ahmed F, Rahman MM, Islam MA, Majumder TK, Kibria MG, Islam MS, Islam MM, Akhter M, Islam A, Podder MK, Alam MN, Munmun UK, Lubna EK, Hossain MA, Mostafa T. Frequency of Eosinophilic Esophagitis among Patients with Gastroesophageal Reflux Symptoms in an Academic Hospital of Bangladesh: A Cross Sectional Study. Mymensingh Med J 2021; 30:744-750. [PMID: 34226464] [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
Eosinophilic esophagitis (EoE) is a disease of modern era. It was first described 40 years back. Since then it has drawn an immense interest among the clinicians. It is diagnosed by the presence of eosinophils count ≥15/HPF on esophageal biopsied mucosa in patients with symptoms of esopohageal dysfunction. It is more prevalent among patients with gastroesophageal reflux disease. As its symptoms overlap with that of gastroesophageal reflux disease (GERD), it is frequently overlooked & misdiagnosed which increases patients' sufferings. No data is available in Bangladesh. The objective of the study was to find out the frequency of eosinophilic esophagitis among patients with gastroesophageal reflux symptoms. The study was conducted at the Outpatient department of the department of Gastroenterology of Dhaka Medical College Hospital, Dhaka, Bangladesh from September 2018 to April 2019. One hundred and thirty three (133) consecutive patients with symptoms suggestive of gastroesophageal reflux disease based on validated questionnaire underwent upper GI endoscopy. Biopsies were taken from proximal and distal esophagus as well as any other endoscopically abnormal esophageal mucosal lesion. Among 133 patients with gastroesophageal reflux symptoms, 7 patients (5.3%) were found to be positive for eosinophilic esophagitis. Mean age at diagnosis was 37.28±13.38 years. It was more common in younger age group. Female patients (56%) were more than male patients (44%). Heart burn was the major symptom followed by acid regurgitation. Nocturnal cough showed statistically significant relationship with eosinophilic esophagitis. Although the frequency is low, it may be considered as a differential diagnosis among patients with GERD.
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Affiliation(s)
- M M Khalil
- Dr Md Musab Khalil, Assistant Registrar, Sheikh Russel Gastroliver Institute and Hospital (SRGIH), Mohakhali, Dhaka, Bangladesh; E-mail:
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Ahmed F, Abir M, Bhowmik PK, Deshpande V, Mollah A, Kumar D, Alam S. Computational assessment of thermo-hydraulic performance of Al2O3-water nanofluid in hexagonal rod-bundles subchannel. Progress in Nuclear Energy 2021. [DOI: 10.1016/j.pnucene.2021.103700] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Tozzi G, Ahmed F. Preface to ToScA 2018 Special Issue. J Microsc 2021; 277:133-134. [PMID: 32251536 DOI: 10.1111/jmi.12883] [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: 11/28/2022]
Affiliation(s)
- G Tozzi
- Zeiss Global Centre, School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth, U.K
| | - F Ahmed
- Exponent International Ltd, London, U.K
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48
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Ahmed F, Fakhruddin ANM, Fardous Z, Chowdhury MAZ, Rahman MM, Kabir MM. Accumulation and Translocation of Chromium (Cr) and Lead (Pb) in Chilli Plants (Capsicum annuum L.) Grown on Artificially Contaminated Soil. NEPT 2021. [DOI: 10.46488/nept.2021.v20i01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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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49
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Hallam S, Ahmed F, Gouvas N, Pandey S, Nicol D. Oncological outcomes and stoma-free survival following TaTME, a prospective cohort study. Tech Coloproctol 2021; 25:439-447. [PMID: 33606129 DOI: 10.1007/s10151-020-02390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Transanal TME (TaTME) was introduced to improve access to the pelvis in difficult cases (male sex, obesity and mid to low rectal cancers) and reduce the risk of anastomotic leak by avoiding cross stapling. In April 2018 the Norwegian hospital to whom all local; recurrences for rectal cancer are referred reported an unexpected rise in early multifocal local recurrences of 9.5% following TaTME compared with 3.4% following conventional TME leading to a nationwide moratorium on the procedure and ending, in an editorial published on the British Journal of Surgery in August 2020, by saying that other countries should consider the issue in the context of local practices and results. There are limited data concerning oncological outcomes of TaTME compared to conventional TME. The aim of this study was to report perioperative and oncological outcomes for patients with rectal cancer treated with TaTME in a high-volume, experienced UK centre. METHODS From January 2015 to January 2020 consecutive patients with histologically confirmed rectal cancer having TaTME at Worcestershire Royal Hospital NHS were prospectively entered into an online international registry. Patients were followed according to local protocol with clinical examination, tumour markers, endoscopy and radiology. RESULTS Seventy patients underwent TaTME for rectal cancer. The median distance of the tumour from the anorectal junction was 4 cm (IQR 2-5). The mesorectal margin was involved in 20 (1%) patients, all of whom received neoadjuvant chemoradiotherapy. Overall survival was 94% at a median follow-up of 15 months (IQR 9-31 months). Distant recurrence occurred in 12 (17%) of patients at a median of 14 months (IQR 10-17 months). The 18-month stoma-free survival rate was 66%. CONCLUSIONS A local recurrence rate of 5.7% supports the oncological safety of TaTME for rectal cancer.
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Affiliation(s)
- S Hallam
- Worcestershire Acute Hospitals NHS Trust, Colorectal Surgery, Worcester, UK.
| | - F Ahmed
- Worcestershire Acute Hospitals NHS Trust, Colorectal Surgery, Worcester, UK
| | - N Gouvas
- Worcestershire Acute Hospitals NHS Trust, Colorectal Surgery, Worcester, UK
| | - S Pandey
- Worcestershire Acute Hospitals NHS Trust, Colorectal Surgery, Worcester, UK
| | - D Nicol
- Worcestershire Acute Hospitals NHS Trust, Colorectal Surgery, Worcester, UK
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50
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Selina F, Talha KA, Maw K, Aung T, Ahmed F, Solaiman M. Cross-sectional Study on Assessment of First-pass Success of Video Laryngoscope Intubation in General Anesthesia Patients. Mymensingh Med J 2021; 30:123-127. [PMID: 33397862] [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: 06/12/2023]
Abstract
Traditional Direct laryngoscope (DL) has been used by anesthesiologist during intubation for general anesthesia patients for more than a century. Video laryngoscope (VL) helps in better visualization of laryngeal orifice during intubation and reduces intubation time. This was a cross sectional study conducted in two Asian Hospitals Queen Elizabeth II hospital of Kotakinabalu, Malaysia and King Faisal Hospital Taif of Saudi Arabia to assess the first-pass success of video laryngoscope and to compare with direct laryngoscope from July 2015 to December 2017. Random lottery technique was applied for sampling. Participants of both groups (VL and DL) were enrolled by simple lottery method. Total 146 patients were enrolled with a set inclusion criterion. Mallampati class, mouth opening, thyromental distance and mobility of atlantooccipital junction were set as predictors of first-pass success. The first-pass success was 98.7% in mallampati II patients and 92.8% in mallampati III patients. Average success rate was 95.75%. The mean success rate of VL and DL was compared and was found VL had a significantly better first-pass success rate than DL (p<0.05).
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Affiliation(s)
- F Selina
- Dr Farhana Selina, Associate Professor, Department of Anesthesiology, Sylhet Women's Medical College, Sylhet, Bangladesh; E-mail:
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