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Patel A, Arora GS, Roknsharifi M, Javed H, Kaur P. Relamorelin in Gastroparesis and Diabetic Gastroparesis: A Meta-Analysis on Its Efficacy and Safety. Cureus 2023; 15:e48303. [PMID: 38058346 PMCID: PMC10696281 DOI: 10.7759/cureus.48303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
This meta-analysis aimed to evaluate the efficacy and safety of relamorelin, a synthetic ghrelin receptor agonist, for the treatment of gastroparesis and diabetic gastroparesis. A total of 1,033 participants from five randomized controlled trials were included. The primary outcome was the mean change in gastric emptying time from baseline. Relamorelin demonstrated a statistically significant improvement in gastric emptying time with a mean difference of -11.40 minutes compared to the placebo group. Furthermore, a significant improvement was observed specifically in diabetic gastroparesis patients, with a mean difference of -8.43 minutes. However, adverse effects, such as headaches, dizziness, and gastrointestinal symptoms, were more prevalent in the relamorelin group. Despite these adverse effects, the study concludes that relamorelin offers a promising avenue for gastroparesis treatment, especially given the limited existing therapeutic options. This comprehensive meta-analysis synthesizes existing evidence to inform clinical practice and guides future research in this domain.
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Affiliation(s)
- Akash Patel
- Internal Medicine, Eisenhower Health, Rancho Mirage, USA
| | - Gagandeep Singh Arora
- Hepatobiliary Pancreatic Surgery and Liver Transplant, BLK-Max Super Speciality Hospital, New Delhi, IND
- Internal Medicine, University of California, Riverside, San Bernardino, USA
| | - Mona Roknsharifi
- Internal Medicine, University of California, Riverside, San Bernardino, USA
| | - Hamna Javed
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
| | - Parneet Kaur
- Emergency, Civil Hospital Mukerian, Mukerian, IND
- Internal Medicine, Suburban Community Hospital, Philadelphia, USA
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Umer MR, Mejia Crespo WE, Dugan S, Javed H, Suleman M, Afzal MW, Mumtaz H, Saqib M, Malik HM, Iftikhar M. Lansoprazole plus levosulpiride versus esomeprazole in participants with gastroesophageal reflux disease and erosive esophagitis: a double blinded randomized control trial. Ann Med Surg (Lond) 2023; 85:4866-4876. [PMID: 37811050 PMCID: PMC10553095 DOI: 10.1097/ms9.0000000000001235] [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: 04/11/2023] [Accepted: 08/16/2023] [Indexed: 10/10/2023] Open
Abstract
Aim The aim was to compare the efficacy and safety of lansoprazole plus levosulpiride over esomeprazole. Methodology This randomized control trial recruited 1000 participants having symptomatic gastroesophageal reflux disease (GERD) and erosive esophagitis and they were blindly randomized into two groups in a 1:1 ratio with appropriate concealment. Group 1 was given lansoprazole plus levosulpiride combination twice daily whereas group 2 was prescribed only esomeprazole twice daily. The primary efficacy endpoint was the healing of erosive esophagitis and GERD at week 49. Secondary assessments included improvement in quality of life. Participants' quality of life was assessed before starting the treatment and post-treatment using a short-form health survey questionnaire (SF-36). Results The lansoprazole plus levosulpiride group had significantly lower rates of positive postintervention GERD and erosive esophagitis status, and higher rates of sustained resolution of heartburn compared to the esomeprazole alone group. However, the lansoprazole plus levosulpiride group also had a higher risk of nausea. Conclusion Lansoprazole plus levosulpiride is a more effective and safe treatment for GERD than esomeprazole alone. Participants in the lansoprazole plus levosulpiride group showed a significantly higher rate of sustained resolution of GERD, lower rates of postintervention GERD and erosive esophagitis status, and a higher incidence of nausea compared to the esomeprazole alone group. Although quality of life worsened in both groups, adverse effects did not significantly differ. These findings strongly support the use of lansoprazole plus levosulpiride as a preferred treatment option for GERD and erosive esophagitis, which could have significant clinical implications for managing this common condition.
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Affiliation(s)
| | | | | | | | - Muhammad Suleman
- Riphah International University Islamic International Medical College, Rawalpindi
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Patel A, Arora GS, Roknsharifi M, Kaur P, Javed H. Artificial Intelligence in the Detection of Barrett's Esophagus: A Systematic Review. Cureus 2023; 15:e47755. [PMID: 38021699 PMCID: PMC10676286 DOI: 10.7759/cureus.47755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Barrett's esophagus (BE) remains a significant precursor to esophageal adenocarcinoma, requiring accurate and efficient diagnosis and management. The increasing application of machine learning (ML) technologies presents a transformative opportunity for diagnosing and treating BE. This systematic review evaluates the effectiveness and accuracy of machine learning technologies in BE diagnosis and management by conducting a comprehensive search across PubMed, Scopus, and Web of Science databases up to the year 2023. The studies were organized into five categories: computer-aided systems, natural language processing and text-based systems, deep learning on histology and biopsy images, real-time and video analysis, and miscellaneous studies. Results indicate high sensitivity and specificity across machine learning applications. Specifically, computer-aided systems showed sensitivities ranging from 84% to 100% and specificities from 64% to 90.7%. Natural language processing and text-based systems achieved an accuracy as high as 98.7%. Deep learning techniques applied to histology and biopsy images displayed sensitivities up to greater than 90% and a specificity of 100%. Furthermore, real-time and video analysis technologies demonstrated high performance with assessment speeds of up to 48 frames per second (fps) and a mean average precision of 75.3%. Overall, the reviewed literature underscores the growing capability and efficiency of machine learning technologies in diagnosing and managing Barrett's esophagus, often outperforming traditional diagnostic methods. These findings highlight the promising future role of machine learning in enhancing clinical practice and improving patient care for Barrett's esophagus.
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Affiliation(s)
- Akash Patel
- Internal Medicine, Eisenhower Health, Rancho Mirage, USA
| | - Gagandeep Singh Arora
- Hepatobiliary Pancreatic Surgery and Liver Transplant, BLK-Max Super Speciality Hospital, New Delhi, IND
- Internal Medicine, University of California, Riverside, San Bernardino, USA
| | - Mona Roknsharifi
- Internal Medicine, University of California, Riverside, San Bernardino, USA
| | - Parneet Kaur
- Emergency, Civil Hospital, Mukerian, IND
- Internal Medicine, Suburban Community Hospital, Philadelphia, USA
| | - Hamna Javed
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
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Javed H, Ali HT, Soliman ZA, Caprara ALF, Rissardo JP. Three Cases of Myoclonus Secondary to Ciprofloxacin: "Ciproclonus". Clin Neuropharmacol 2023; 46:200-203. [PMID: 37748004 DOI: 10.1097/wnf.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVES Ciprofloxacin is a fluoroquinolone that is used for bacterial infections involving different systems. In some cases, ciprofloxacin was reported to induce myoclonus. METHODS We performed a chart review of 3 patients with myoclonus secondary to ciprofloxacin and reviewed the literature for similar cases. Written consent for publication was obtained from each patient, and their identities were concealed for ethical reasons. RESULTS We describe 3 cases of myoclonus secondary to ciprofloxacin, 2 males and a female aged 61, 26, and 48 years, respectively. The myoclonus appeared within 3 days of ciprofloxacin intake. In all 3 cases, ciprofloxacin was prescribed for urinary tract infection. Electroencephalogram and neuroimaging studies were normal and possible causes were excluded. Thus, ciprofloxacin was believed to be the underlying cause and hence it was withdrawn. The patients had complete recovery on follow-up. CONCLUSIONS Although ciprofloxacin is widely prescribed for different infections, only 13 cases were reported to develop myoclonus secondary to ciprofloxacin. The mean age of patients was 62 years. Fifty-four percent of cases were males. Cessation of ciprofloxacin was the most common management course. All individuals fully recovered after ciprofloxacin withdrawal. The mechanism of ciprofloxacin-induced myoclonus is probably associated with γ-aminobutyric acid and glutamate pathways.
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Affiliation(s)
- Hamna Javed
- Lahore Medical and Dental College, Lahore, Pakistan
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Arora GS, Javed H, Kaur P, Singh S. Hepatopulmonary Syndrome in a Patient With Autoimmune Hepatitis and Chronic Hepatitis C: A Case Report Highlighting Typical Echo Findings. Cureus 2023; 15:e41491. [PMID: 37484786 PMCID: PMC10359196 DOI: 10.7759/cureus.41491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 07/25/2023] Open
Abstract
Hepatopulmonary syndrome (HPS) is a rare complication of liver disease characterized by intrapulmonary vascular dilatations leading to arterial hypoxemia. We present the case of a 59-year-old female with a past medical history of bilateral breast cancer status post mastectomy who presented with progressive dyspnea on exertion and fatigue. A comprehensive diagnostic workup was conducted to exclude other cardiac, pulmonary, and systemic etiologies. She was diagnosed with autoimmune hepatitis along with chronic hepatitis C. Echocardiography revealed characteristic findings of intrapulmonary shunting characteristic of HPS. The patient showed improvement in pulmonary symptoms and oxygenation status following the initiation of steroid therapy. Although corticosteroids are not the definitive treatment for HPS, they were considered a supportive measure in this case. However, it is important to note that liver transplantation remains the definitive treatment for HPS. This case underscores the importance of echocardiography and the potential role of supportive measures, like corticosteroids, in managing HPS-related symptoms, particularly in patients with autoimmune hepatitis, as a bridging therapy while awaiting liver transplantation.
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Affiliation(s)
| | - Hamna Javed
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
| | - Parneet Kaur
- Internal Medicine, Suburban Community Hospital, Philadelphia, USA
| | - Simran Singh
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
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Javed H, Kogilathota Jagirdhar GS, Kashyap R, Vekaria PH. Liraglutide-Induced Pancreatitis: A Case Report and Literature Review. Cureus 2023; 15:e38263. [PMID: 37252522 PMCID: PMC10225244 DOI: 10.7759/cureus.38263] [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: 03/12/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Liraglutide is an anti-diabetic medication used for the treatment of type 2 diabetes mellitus, obesity, and chronic weight management. It is a glucagon-like peptide-1 (GLP-1) agonist that helps reduce postprandial hyperglycemia for up to 24 h after administration. It stimulates endogenous insulin secretion according to glucose levels, and also delays gastric emptying and suppresses prandial glucagon secretion. Some of the common complications associated with liraglutide include hypoglycemia, headache, diarrhea, nausea, and vomiting. Uncommon adverse effects include pancreatitis, kidney failure, pancreatic cancer, and injection site reactions. In this article, we discussed a case of a 73-year-old male with a history of uncontrolled type 2 diabetes mellitus on long-term insulin and liraglutide who presented with abdominal pain, subjective fevers, dry heaves, tachycardia, and mildly reduced oxygen saturation. The patient was diagnosed with pancreatitis on the basis of laboratory and imaging findings. Liraglutide was discontinued, and the patient received supportive care with significant clinical improvement. The use of GLP-1 inhibitors has been increasing not only for diabetes mellitus management, but also for its promising effect on weight management. The literature review endorses our case report findings, and also discusses other complications of liraglutide. Therefore, we recommend to be cognizant of these side-effects upon starting liraglutide.
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Affiliation(s)
- Hamna Javed
- Internal Medicine, Lahore Medical and Dental College, Lahore, PAK
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Aslam M, Faisal M, Nazeer H, Hussain J, Muzaffar H, Mahmood A, Javed H, Tanveer Q. 14P Up-regulated PI3K/mTOR/AKT pathway behind the downregulation of PTEN, FBXW7, genes and miRNA 140-145, ALK mediated chemotherapy resistance in non-small cell lung carcinoma (NSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bhojwani D, Javed H, Amala C, Hashmi S. 330 An End to Doctor’s Handwriting in the Digital Age: Evaluating the Legibility of Operation Notes in Otolaryngology. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.219] [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
According to GMC Good Medical Practice, clinicians must record their work ‘clearly, accurately and legibly’. Operation notes are no exception and have several key functions. They serve reminder of procedural events, communicate information to the wider team and may be used as evidence when there are complications or complaints.
The aim of this audit was to evaluate the legibility of operation notes within the Otolaryngology department at Peterborough City Hospital.
Handwritten operation notes were audited from 8 dates chosen at random over a 2-month period (n = 27). Multiple surgeons and a variety of operations were included. Parameters such as legibility of the surgeon’s name, patient identification, date, name of procedure, events, findings, closure and post-op instructions were recorded.
Only 11% of the operation notes were legible in all relevant parameters. The surgeon’s name was either absent or not identifiable from the handwriting in 48%. Documentation of the procedure itself and post-op instructions was illegible in 18% and 29% of notes respectively.
Illegibility of operation notes is ultimately a patient safety-issue. Not only does it contribute to confusion about what happened during the surgery but also leaves room for error in terms of post-operative care and follow up. The results of the audit were discussed as part of a departmental meeting to highlight the importance of readable operation notes and help foster a culture of good record keeping.
A switch to computerised operation notes could ensure legibility and thus improve standards of patient care in the hospital.
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Affiliation(s)
- D. Bhojwani
- Peterborough City Hospital, Peterborough, United Kingdom
| | - H. Javed
- Peterborough City Hospital, Peterborough, United Kingdom
| | - C. Amala
- Peterborough City Hospital, Peterborough, United Kingdom
| | - S. Hashmi
- Peterborough City Hospital, Peterborough, United Kingdom
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Javed H, Chieng C, Paraneetharan S. Silent presentation of B-Cell Lymphoma in the mandible. Advances in Oral and Maxillofacial Surgery 2022. [DOI: 10.1016/j.adoms.2021.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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10
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Sabato A, Zanchi E, Molin S, Cempura G, Javed H, Herbrig K, Walter C, Boccaccini A, Smeacetto F. Mn-Co spinel coatings on Crofer 22 APU by electrophoretic deposition: Up scaling, performance in SOFC stack at 850 °C and compositional modifications. Ann Ital Chir 2021. [DOI: 10.1016/j.jeurceramsoc.2021.03.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Javaid A, Akbar I, Javed H, Khan U, Iftikhar H, Zahra D, Rashid F, Ashfaq UA. Role of Heavy Metals in Diabetes: Mechanisms and Treatment Strategies. Crit Rev Eukaryot Gene Expr 2021; 31:65-80. [PMID: 34369715 DOI: 10.1615/critreveukaryotgeneexpr.2021037971] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Toxic metals affecting metabolic pathways have a broad range in the ecosystem from both natural and anthropogenic sources. Because of constant contamination from waste and untreated chemical effluents, their emissions have risen significantly over the last few decades, quickly gaining attention due to their crucial role in the development of several metabolic disorders, notably diabetes mellitus. Cadmium and arsenic not only spread widely in our atmosphere but are also linked to a wide range of health hazards. These are primarily accumulated in the liver, kidney, and pancreas once they reach the human body, where they have deleterious effects on the metabolism of glucose and its association with other metabolic pathways, particularly glycolysis, glycogenesis, and gluconeogenesis, by altering and impairing the specific activity of major enzymes. Impairment of hepatic glucose homeostasis plays a crucial role in diabetes mellitus pathogenesis. Impaired liver and kidney functions, as well as decreased pancreatic and muscle function, also contribute significantly to elevated levels of blood glucose. Heavy metals have the potential to cause changes in the conformation in these enzymes. They also impair hormonal balance by destroying the pancreas and adrenal glands. Such metals often facilitate the development of reactive oxygen species and inhibit antioxidant defense mechanisms, with multiple organs subsequently damaged. This review briefly discusses the involvement of heavy metals in metabolic disorders such as diabetes mellitus, the enzymes involved in this pathway, and glucose homeostasis.
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Affiliation(s)
- Anam Javaid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Iqra Akbar
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Hamna Javed
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Ujala Khan
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Hira Iftikhar
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Duaa Zahra
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Fatima Rashid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
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Ferraris M, De la Pierre S, Sabato A, Smeacetto F, Javed H, Walter C, Malzbender J. Torsional shear strength behavior of advanced glass-ceramic sealants for SOFC/SOEC applications. Ann Ital Chir 2020. [DOI: 10.1016/j.jeurceramsoc.2020.04.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tahir ul Qamar M, Shokat Z, Muneer I, Ashfaq UA, Javed H, Anwar F, Bari A, Zahid B, Saari N. Multiepitope-Based Subunit Vaccine Design and Evaluation against Respiratory Syncytial Virus Using Reverse Vaccinology Approach. Vaccines (Basel) 2020; 8:E288. [PMID: 32521680 PMCID: PMC7350008 DOI: 10.3390/vaccines8020288] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023] Open
Abstract
Respiratory syncytial virus (RSV) is primarily associated with respiratory disorders globally. Despite the availability of information, there is still no competitive vaccine available for RSV. Therefore, the present study has been designed to develop a multiepitope-based subunit vaccine (MEV) using a reverse vaccinology approach to curb RSV infections. Briefly, two highly antigenic and conserved proteins of RSV (glycoprotein and fusion protein) were selected and potential epitopes of different categories (B-cell and T-cell) were identified from them. Eminently antigenic and overlapping epitopes, which demonstrated strong associations with their respective human leukocyte antigen (HLA) alleles and depicted collective ~70% coverage of the world's populace, were shortlisted. Finally, 282 amino acids long MEV construct was established by connecting 13 major histocompatibility complex (MHC) class-I with two MHC class-II epitopes with appropriate adjuvant and linkers. Adjuvant and linkers were added to increase the immunogenic stimulation of the MEV. Developed MEV was stable, soluble, non-allergenic, non-toxic, flexible and highly antigenic. Furthermore, molecular docking and molecular dynamics (MD) simulations analyses were carried out. Results have shown a firm and robust binding affinity of MEV with human pathogenic toll-like receptor three (TLR3). The computationally mediated immune response of MEV demonstrated increased interferon-γ production, a significant abundance of immunoglobulin and activation of macrophages which are essential for immune-response against RSV. Moreover, MEV codons were optimized and in silico cloning was performed, to ensure its increased expression. These outcomes proposed that the MEV developed in this study will be a significant candidate against RSV to control and prevent RSV-related disorders if further investigated experimentally.
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Affiliation(s)
| | - Zeeshan Shokat
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad 38000, Pakistan; (Z.S.); (U.A.A.); (H.J.)
| | - Iqra Muneer
- School of Life Sciences, University of Science and Technology of China, Hefei 230052, China;
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad 38000, Pakistan; (Z.S.); (U.A.A.); (H.J.)
| | - Hamna Javed
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad 38000, Pakistan; (Z.S.); (U.A.A.); (H.J.)
| | - Farooq Anwar
- Department of Chemistry, University of Sargodha, Sargodha 40100, Pakistan;
| | - Amna Bari
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China;
| | - Barira Zahid
- Key Laboratory of Horticultural Plant Biology (Ministry of Education), Huazhong Agricultural University, Wuhan 430070, China;
| | - Nazamid Saari
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
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Faizan M, Anwar S, Kashif R, Saleem R, Javed H, Zafar A, Hameed A, Taj M, Maysam H, Miguela C, Rathore A, Sadiq M, Gonzalez M, Zaidi A. Improvement in Infection Prevention and Control Measures at The Children Hospital, Lahore. A My Child Matters Collaborative Project. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.90400] [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: 11/20/2022] Open
Abstract
Background: Overcrowding, lack of operational funds, and healthcare associated infections are major challenges at the Children Hospital Lahore, a public healthcare facility in Pakistan with 900 new pediatric cancer admissions annually. In 2014, a collaboration between My Child Matters (MCM), St. Jude Global Infectious Diseases Program (SJ-GID), and our institution was established to address these issues. Aim: To describe the effect of a collaborative improvement strategy on the infection prevention and control (IPC) standards in a pediatric oncology unit in a resource-limited setting. Methods: Our study was a prospective before-and-after study. We compare the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and 4 modules of the St. Jude modified Infection Control Assessment Tool (ICAT) scores. Our strategy included: (1) creating a multidisciplinary team of pediatric hematology-oncology, infectious disease physicians, nurses, microbiologist, and a data manager, (2) engaging on monthly online IPC mentoring sessions with the SJ-GID and MCM mentors, (3) performing daily inpatient healthcare associated (HAI) surveillance rounds, and (4) providing regular hand hygiene training and compliance audits. Results: Our hand hygiene facility level per WHO scores increased from “Inadequate” during the baseline assessment to “Intermediate/Consolidation” by the end of 3-year implementation (122 vs 352 HHSAF scores). The sink: bed and hand sanitizer: bed ratios improved to 1:6 and 1:1 respectively. Six washrooms were added to our unit. ICAT general infection control module increased by 40% (45 vs 78 ICAT score) and hygiene compliance improved by 20% from baseline. Identification of HAI increased from baseline (4.07 vs 8.7 infections per 1000 patient days). A 25% of the isolates were multidrug-resistant microorganisms. Conclusion: Implementing a collaborative improvement strategy improved the IPC standards in our pediatric cancer center. The increase of HAI might be a result of a better surveillance and laboratory identification. Further targeted interventions should be develop to decrease HAI rates and infection-related morbidity and mortality in our population.
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Affiliation(s)
- M. Faizan
- The Children Hospital and Institute of Child Health, Department of Pediatric Hematology/Oncology, Lahore, Pakistan
| | - S. Anwar
- The Children Hospital and Institute of Child Health, Department of Pediatric Hematology/Oncology, Lahore, Pakistan
| | - R.U.A. Kashif
- The Children Hospital and Institute of Child Health, Department of Pediatric Hematology/Oncology, Lahore, Pakistan
| | - R. Saleem
- The Children Hospital and Institute of Child Health, Department of Pediatric Hematology/Oncology, Lahore, Pakistan
| | - H. Javed
- The Children Hospital and Institute of Child Health, Department of Pediatric Microbiology, Lahore, Pakistan
| | - A. Zafar
- The Children Hospital and Institute of Child Health, Department of Pediatric Microbiology, Lahore, Pakistan
| | - A. Hameed
- The Children Hospital and Institute of Child Health, Department of Pediatric Hematology/Oncology, Lahore, Pakistan
| | - M. Taj
- Royal Marsden Hospital, Department of Paediatric Oncology, London, United Kingdom
| | - H. Maysam
- St. Jude Children's Research Hospital, Department of Global Pediatric Medicine, Memphis, TN
| | - C. Miguela
- St. Jude Children's Research Hospital, Department of Global Pediatric Medicine, Memphis, TN
- St. Jude Children's Research Hospital, Department of Pediatric Infectious Disease, Memphis, TN
| | - A.W. Rathore
- The Children Hospital and Institute of Child Health, Department of Pediatric Medicine, Lahore, Pakistan
| | - M. Sadiq
- The Children Hospital and Institute of Child Health, Department of Pediatric Cardiology, Lahore, Pakistan
| | - M. Gonzalez
- St. Jude Children's Research Hospital, Department of Global Pediatric Medicine, Memphis, TN
| | - A. Zaidi
- St. Jude Children's Research Hospital, Department of Global Pediatric Medicine, Memphis, TN
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Saeed S, Faisal M, Majeed W, Hussain J, Muzaffar H, Mahmood A, Javed H. Micro-RNA down express ABCG2 gene in adjuvant chemotherapy in female breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx679.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Javed H, Khan MM, Ahmad A, Vaibhav K, Ahmad ME, Khan A, Ashafaq M, Islam F, Siddiqui MS, Safhi MM, Islam F. Rutin prevents cognitive impairments by ameliorating oxidative stress and neuroinflammation in rat model of sporadic dementia of Alzheimer type. Neuroscience 2012; 210:340-52. [PMID: 22441036 DOI: 10.1016/j.neuroscience.2012.02.046] [Citation(s) in RCA: 208] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 02/15/2012] [Accepted: 02/25/2012] [Indexed: 01/19/2023]
Abstract
The objective of the present study was to assess the neuroprotective role of rutin (vitamin P) and delineate the mechanism of action. Recent evidence indicates that rutin exhibits antioxidant potential and protects the brain against various oxidative stressors. More precisely, the aim of the present study was to examine the modulating impacts of rutin against cognitive deficits and oxidative damage in intracerebroventricular-streptozotocin (ICV-STZ)-infused rats. Rats were injected bilaterally with ICV-STZ (3 mg/kg), whereas sham rats received the same volume of vehicle. After 2 weeks of streptozotocin (STZ) infusion, rats were tested for cognitive performance using Morris water maze tasks and thereafter euthanized for further biochemical, histopathological, and immunohistochemical studies. Rutin pretreatment (25 mg/kg, orally, once daily for 3 weeks) significantly attenuated thiobarbituric acid reactive substances (TBARS), activity of poly ADP-ribosyl polymerase, and nitrite level and decreased level of reduced glutathione (GSH) and activities of its dependent enzymes (glutathione peroxidase [GPx] and glutathione reductase [GR]) and catalase in the hippocampus of ICV-STZ rats. ICV-STZ rats showed significant cognitive deficits, which was improved significantly by rutin supplementation. The results indicate that rutin attenuates STZ-induced inflammation by reducing the expression of cyclooxygenase-2 (COX-2), glial fibrillary acidic protein (GFAP), interleukin-8 (IL-8), inducible nitric oxide synthase (iNOS), nuclear factor-kB, and preventing the morphological changes in hippocampus. The study thereby suggests the effectiveness of rutin in preventing cognitive deficits and might be beneficial for the treatment of sporadic dementia of Alzheimer type (SDAT).
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Affiliation(s)
- H Javed
- Neurotoxicology laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), Hamdard Nagar, New Delhi-110062, India
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Manzar S, Fazalullah M, Khan A, Javed H. Effect of maternal age on fetal growth: a regional perspective. Saudi Med J 2000; 21:782-3. [PMID: 11423898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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Javed H, Nair MP, Koul RL, Chacko A, Fazalullah M. Long term intubation and successful weaning in two children with Guillain-Barre syndrome. Saudi Med J 2000; 21:686-8. [PMID: 11500736] [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: 02/21/2023] Open
Abstract
No definite criteria exists in Guillian-Barre syndrome in children regarding prolonged ventilation through an endo-tracheal tube without tracheostomy and successful weaning using a T-piece. Here we report two such cases of Guillian-Barre syndrome requiring prolonged intubation for 56 days and ventilation for 30 days and ultimately successfully weaning them using the T-piece. Both the children eventually made a complete recovery, highlighting the point that in children prolonged intubation and ventilation using the portex tube is equally good, if not, better than tracheostomy with its attendant risks.
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Affiliation(s)
- H Javed
- Department of Child Health, Sultan Qaboos University Hospital, Al-Khod 123 Muscat, Sultanate of Oman
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Goldman JN, Broughton W, Javed H, Lauderdale V. Ampicillin, erythromycin and chloramphenicol penetration into rabbit aqueous humor. Ann Ophthalmol 1973; 5:147-56. [PMID: 4701066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Javed H, Arif T, Arshad S, Baloch SK, Anwar B, Khan MA, Shahzad MF. SPECTRUM OF HEPATITIS C VIRUS (HCV) GENOTYPES AMONG DIAGNOSED CASES OF HCV IN RAWALPINDI AND ISLAMABAD REGION OVER THE PERIOD OF SIX YEARS. ACTA ACUST UNITED AC 1970. [DOI: 10.32413/pjph.v7i1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Determination of an individual's HCV genotypes prior to antiviral therapy has become increasingly important for the deciding clinical management and predicting prognosis of HCV infection. Relative genotype proportions are needed to inform to healthcare models, which should be geographically tailored. To our knowledge, there are no studies reporting genotype pattern in Rawalpindi/Islamabad region. We aimed to determine the frequency of different genotypes in HCV positive cases in the population of Rawalpindi/ Islamabad over the period of five years. Methods: Data of total of three thousand eight hundred and eighteen (n=3818) HCV positive adult of both genders were screened for genotype testing over the period of six years were analyzed. Results: Most frequent genotype identified in our study was genotype 3, accounting for 95.8% (n=3657) of HCV positive cases. The second most common genotype was Type 1 accounting for 2.9% (n=109) of HCV positive cases. Other genotypes were Type 2 (0.3%, n=12) and Type 4 (0.1%, n=5). Mixed genotype (Type 1 and 3) were detected in almost 1 % (n=35) of cases. We did not find genotype 5 and 6 in our study sample. No significant difference was observed among males and females in genotype distribution (P>0.05). Conclusion: The most common genotype among HCV patients were found to be genotype 3 followed by genotype 1 as the second most common in Rawalpindi/Islamabad region during the study period.
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