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Zeshan M, Amjed N, Ashraf H, Farooq A, Akram N, Zia KM. A review on the application of chitosan-based polymers in liver tissue engineering. Int J Biol Macromol 2024; 262:129350. [PMID: 38242400 DOI: 10.1016/j.ijbiomac.2024.129350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/29/2023] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
Chitosan-based polymers have enormous structural tendencies to build bioactive materials with novel characteristics, functions, and various applications, mainly in liver tissue engineering (LTE). The specific physicochemical, biological, mechanical, and biodegradation properties give the effective ways to blend these biopolymers with synthetic and natural polymers to fabricate scaffolds matrixes, sponges, and complexes. A variety of natural and synthetic biomaterials, including chitosan (CS), alginate (Alg), collagen (CN), gelatin (GL), hyaluronic acid (HA), hydroxyapatite (HAp), polyethylene glycol (PEG), polycaprolactone (PCL), poly(lactic-co-glycolic) acid (PGLA), polylactic acid (PLA), and silk fibroin gained considerable attention due to their structure-properties relationship. The incorporation of CS within the polymer matrix results in increased mechanical strength and also imparts biological behavior to the designed PU formulations. The significant and growing interest in the LTE sector, this review aims to be a detailed exploration of CS-based polymers biomaterials for LTE. A brief explanation of the sources and extraction, properties, structure, and scope of CS is described in the introduction. After that, a full overview of the liver, its anatomy, issues, hepatocyte transplantation, LTE, and CS LTE applications are discussed.
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Affiliation(s)
- Muhammad Zeshan
- Department of Chemistry, University of Agriculture, Faisalabad, Pakistan
| | - Nyla Amjed
- Department of Chemistry, The University of Lahore, Lahore, Pakistan
| | - Humna Ashraf
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Ariba Farooq
- Department of Chemistry, The University of Lahore, Lahore, Pakistan
| | - Nadia Akram
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Khalid Mahmood Zia
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan.
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2
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Qazi S, Ashraf H, Qadri S, Amin D, Mushtaq A, Mushtaq A, Rasheed U. To do or not to do? Is acetylsalicylic acid a safe drug to continue in bipolar turp? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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3
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Strümpell C, Loerbroks A. Der Zusammenhang zwischen sozialen Stressoren und sozialen Ressourcen
am Arbeitsplatz sowie Work-Family-Conflict mit schlechter Gesundheit bei
Beschäftigen in Textilfabriken in Bangladesch: Eine
Querschnittsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753820] [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: 12/12/2022]
Affiliation(s)
- A Dreher
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Düsseldorf,
Deutschland
| | - R Yusuf
- Independent University, International Center for Biotechnology and
Health (ICBH), Center for Health Population and Development (CHPD), Dhaka,
Bangladesch
| | - H Ashraf
- Jahangirnagar University, Department of Anthropology, Dhaka,
Bangladesch
| | - SAKS Ahmed
- Independent University, International Center for Biotechnology and
Health (ICBH), Center for Health Population and Development (CHPD), Dhaka,
Bangladesch
| | - C Strümpell
- Universität Hamburg, Institut für Ethnologie, Hamburg,
Deutschland
| | - A Loerbroks
- Heinrich-Heine-Universität Düsseldorf, Institut
für Arbeits-, Sozial- und Umweltmedizin, Düsseldorf,
Deutschland
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4
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Rashid H, Gala T, Ain Q, Ashraf H, Vesamia S, Vig S. 1358 Does A COVID Protected Hospital Within A COVID Hospital Enable Elective Care and Training Opportunities? Br J Surg 2021. [PMCID: PMC8524575 DOI: 10.1093/bjs/znab259.502] [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
Introduction Elective care in the UK came to a standstill with the advent of the COVID-19 pandemic. A restart could only be enabled with ‘green site’ separation and a ‘covid protected’ zone. A ‘hospital within the hospital’ concept was developed including 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen, and a separated entrance. This model was underpinned with PPE, enhanced infection control and guidance for staff. The study documented the ability to recover elective activity and therefore provide a training environment for surgical trainees. Method Data was collected weekly (7/20 to 1/21) through the business informatics system with regard to theatres cases completed compared to the activity achieved in the 11-theatre elective estate pre COVID-19. Results Pre COVID-19, an average of 263 cases were completed per week. In the first week of operation, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. This was maintained until the impact of the second wave where activity has reduced to 50% but is not anticipated to reduce further as local anaesthetic and blocks maybe utilised. Conclusions This ‘hospital within the hospital’ has enabled elective care to return to above normal levels, with increased efficiencies. This has enabled a rapid return to a training environment for trainees disheartened with deployment to critical care in the first wave.
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Affiliation(s)
- H Rashid
- Croydon University Hospital, London, United Kingdom
| | - T Gala
- Croydon University Hospital, London, United Kingdom
| | - Q Ain
- Croydon University Hospital, London, United Kingdom
| | - H Ashraf
- Croydon University Hospital, London, United Kingdom
| | - S Vesamia
- Croydon University Hospital, London, United Kingdom
| | - S Vig
- Croydon University Hospital, London, United Kingdom
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Ain Q, Solanki P, Georgi T, Gala T, Ashraf H, Kelleher D, Vig S. 845 Diabetic Foot Care Services in COVID-19 Era – A University Hospital Multi specialty Team Experience. Br J Surg 2021. [PMCID: PMC8524504 DOI: 10.1093/bjs/znab259.481] [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: 11/12/2022]
Abstract
Abstract
Introduction
Multidisciplinary foot care services contribute to the reduction in amputations from foot ulceration secondary to diabetes. The COVID-19 pandemic pressurised services and required a pause of elective care. This study reports the patient’s experience of foot care provision during the first wave where self-care, virtual appointments and patient directed appointments were utilised.
Method
Diabetic foot patients were retrospectively identified over a one-month period booked for MDT care (in hospital, OPD, diabetic foot clinic, community podiatry clinic or at home). All patients>16 years of age diagnosed with a new or previous diabetic foot ulcer or post-operative foot wound were included. Data was collated via a patient survey form and descriptive statistics were used to characterize the study population and responses.
Results
63 patients were identified (1/10 – 30/10) with data collated from 51 respondents (81%). 78% (40/51) were male. Median age was 69 years (IQR 59–76). 86% were comfortable attending a hospital appointment. 92% reported continuing to receive an appropriate level of care. All of the patients felt well supported and knew how to access the foot care service. 29% utilised virtual care. 82% (42/51) considered face to face appointments were more suitable for follow up rather than virtual/phone appointments.
Conclusions
It was possible to continue to provide safe diabetic foot care despite the COVID-19 pandemic but careful patient selection and communication is the key.
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Affiliation(s)
- Q Ain
- Croydon University Hospital, London, United Kingdom
| | - P Solanki
- Croydon University Hospital, London, United Kingdom
| | - T Georgi
- Croydon University Hospital, London, United Kingdom
| | - T Gala
- Croydon University Hospital, London, United Kingdom
| | - H Ashraf
- Croydon University Hospital, London, United Kingdom
| | - D Kelleher
- Croydon University Hospital, London, United Kingdom
| | - S Vig
- Croydon University Hospital, London, United Kingdom
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6
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Ashraf H, Anderson RG, Anderson DJ, Moug SJ. Feasibility of a perioperative smartphone application in colorectal surgery. Br J Surg 2021; 108:e282-e283. [PMID: 34409440 DOI: 10.1093/bjs/znab143] [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] [Received: 01/10/2021] [Accepted: 04/03/2021] [Indexed: 11/13/2022]
Affiliation(s)
- H Ashraf
- University of Glasgow, Glasgow, UK
| | - R G Anderson
- Department of Surgery, Royal Alexandra Hospital, Paisley, UK
| | - D J Anderson
- Department of Surgery, Royal Alexandra Hospital, Paisley, UK
| | - S J Moug
- Department of Surgery, Royal Alexandra Hospital, University of Glasgow, Paisley, UK
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Dreher A, Yusuf R, Ashraf H, Shifat Ahmed SA, Strümpell C, Loerbroks A. Psychosocial stressors among Bangladesh’s ready-made garment workers: a pilot study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Dreher
- Institute of Occupational, Social, and Environmental Medicine, University of Düsseldorf
| | - R Yusuf
- School of Life Sciences, Independent University Bangladesh
| | - H Ashraf
- Department of Anthropology, Jahangirnagar University
| | | | - C Strümpell
- Institute of Social and Cultural Anthropology, University of Hamburg
| | - A Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, University of Düsseldorf
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Ashraf H, Sodergren M, Mylonas G, Darzi A. 837 The Identification of Gaze Behaviour and Physiological Markers Associated With Making An Error During Laparoscopic Cholecystectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.026] [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: 11/12/2022]
Abstract
Abstract
Introduction
Adverse surgical events remain at an unacceptably high level despite multiple global safety initiatives being introduced. As yet, however there is no conclusive evidence to identify whether physiological markers can be used to predict whether a surgeon will make an error
Method
Surgeons were asked to complete a simulated laparoscopic cholecystectomy task while physiological metrics and gaze behaviour was tracked. LightGBM and CatBoost were used to predict the physiological metric most useful in predicting whether a surgeon was about to make an error. The binary task used a boolean value of “does an error occur in the next 5 seconds” as the dependent variable, while the multiclass task classified the severity of error (0, 1, 2, 3).
Results
Autocorrelation with lag (eventually calculated with a lag of timestep 2) measured the tendency of this timeseries to correlate with itself. The degree of correlation, or lack of correlation, and sudden changes in correlation over time were gleaned from this feature.
Conclusions
Skin conductance was most likely to successfully predict impending error. However when gaze features were added, overall model performance improved by 6.4%. The potential for reduction in surgical error rate and improvement in patient safety are important factors to consider.
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Affiliation(s)
- H Ashraf
- Imperial College, London, United Kingdom
| | | | - G Mylonas
- Imperial College, London, United Kingdom
| | - A Darzi
- Imperial College, London, United Kingdom
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Shahzad MI, Anwar S, Ashraf H, Manzoor A, Naseer M, Rani U, Aslam Z, Saba N, Kamran Z, Ali S, Aslam J, Arshad M. Antiviral activities of Cholistani plants against common poultry viruses. Trop Biomed 2020; 37:1129-1140. [PMID: 33612765 DOI: 10.47665/tb.37.4.1129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Herbal medicines are becoming more popular and acceptable day by day due to their effectiveness, limited side effects, and cost-effectiveness. Cholistani plants are reported as a rich source of antibacterial, antifungal, antiprotozoal, antioxidant, and anticancer agents. The current study has evaluated antiviral potential of selected Cholistani plants. The whole plants were collected, ground and used in extract formation with n-hexane, ethyl acetate and n-butanol. All the extracts were concentrated by using a rotary evaporator and concentrate was finally dissolved in an appropriate vol of the same solvent. All of the extracts were tested for their antiviral potential by using 9-11 days old chick embryonated eggs. Each extract was tested against the Avian Influenza virus H9N2 strain (AIV), New Castle Disease virus Lasoota strain (NDV), Infectious bronchitis virus (IBV) and an Infectious bursal disease virus (IBDV). Hemagglutination test (HA) and Indirect Hemagglutination (IHA) tests were performed for different viruses. The overall order of the antiviral potential of Cholistani plants against viruses was NDV>IBV>IBDV>AIV. In terms of antiviral activity from extracts, the order of activity was n-butanol>ethyl acetate>n-hexane. The medicinal plants Achyranthes aspera, Neuroda procumbens, Panicum antidotale, Ochthochloa compressa and Suaeda fruticose were very effective against all four poultry viruses through their extracts. The low IC50 values of these extracts confirm the high antiviral potential against these viruses. It is worth to mention that Achyranthes aspera was found positive against IBDV through all its extracts which overcome the problem of unavailability of any known drug against IBDV. In short, the study proved that Cholistani plants are rich source of antiviral agent and their extracts can be used as good source of antiviral drugs both in crude and in purified form.
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Affiliation(s)
- M I Shahzad
- Department of Biochemistry and Biotechnology. The Islamia University of Bahawalpur, Pakistan
| | - S Anwar
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - H Ashraf
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - A Manzoor
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - M Naseer
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - U Rani
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - Z Aslam
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - N Saba
- Department of Botany. The Govt Sadiq College Women University, Bahawalpur, Pakistan. Pakistan
| | - Z Kamran
- University college of Veterinary and Animal Sciences, The Islamia University, Bahawalpur
| | - S Ali
- Govt. poultry farm, Model Town A, Bahawalpur. Pakistan
| | - J Aslam
- Department of Biochemistry and Biotechnology. The Islamia University of Bahawalpur, Pakistan
| | - M Arshad
- Department of Biochemistry, College of Veterinary and Animal Sciences, Jhang Campus, UVAS Lahore, Pakistan
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Agasthi P, Lee JZ, Pujari SH, Tseng AS, Shipman J, Almader-Douglas D, Ashraf H, Mookadam F, Fortuin FD, Beohar N, Arsanjani R, Mulpuru SK. P473Safety and efficacy of direct oral anticoagulants compared to vitamin K antagonists in patients with atrial fibrillation undergoing percutaneous coronary interventions: A meta-analysis. Europace 2020. [DOI: 10.1093/europace/euaa162.008] [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: 11/12/2022] Open
Abstract
Abstract
Background
Coronary artery disease (CAD) and atrial fibrillation (AF) are commonly associated. Co-treatment with multiple anti-thrombotic agents can increase the risk of bleeding.
Purpose
We sought to evaluate patient-centered outcomes in patients with AF on double therapy with direct oral anticoagulants (DOACs) compared to patients with standard triple therapy, [a vitamin K antagonist (VKA) plus dual antiplatelet therapy].
Methods
We performed an extensive systematic review of the literature and meta-analysis of randomized controlled trials reporting outcomes of patients receiving double therapy with DOACs compared to triple therapy with VKAs in patients with AF undergoing percutaneous coronary intervention (PCI). Patient-centered outcomes were the International Society of Thrombosis and Hemostasis (ISTH) major or clinically relevant non-major bleeding (CRNB), all-cause mortality, major adverse cardiovascular events (MACE), myocardial infarction, stent thrombosis, and stroke.
Results
Four randomized controlled trials (9602 patients) met our inclusion criteria. Compared to VKAs, DOACs were associated with significantly lower ISTH major bleeding/ CRNB (RR - 0.75, 95% CI: 0.67-0.82, p < 0.00001, I2 = 11%). There were no statistically significant differences in the efficacy outcomes, including myocardial infarction (RR- 0.99, 95% CI :0.79-1.25, p = 0.96, I2 = 0%), stent thrombosis (RR - 0.97, 95% CI: 0.6-1.55, p = 0.89, I2 = 0%), ischemic stroke (RR - 0.76, 95% CI: 0.5-1.15, p = 0.19, I2 = 0%), all-cause mortality (RR - 1.06, 95% CI: 0.85-1.31, p = 0.61, I2 = 0%) and MACE (RR - 1.06, 95% CI: 0.91-1.22, p = 0.97, I2 = 0%).
Conclusion
Compared with triple therapy with VKAS, double therapy with DOACs is associated with a reduced risk of bleeding and is as effective in patients with AF undergoing PCI.
Abstract Figure.
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Affiliation(s)
- P Agasthi
- Mayo Clinic, Phoenix, United States of America
| | - J Z Lee
- Mayo Clinic, Rochester, United States of America
| | - S H Pujari
- Mayo Clinic, Phoenix, United States of America
| | - A S Tseng
- Mayo Clinic, Rochester, United States of America
| | - J Shipman
- Mayo Clinic, Phoenix, United States of America
| | | | - H Ashraf
- Mayo Clinic, Phoenix, United States of America
| | - F Mookadam
- Mayo Clinic, Phoenix, United States of America
| | - F D Fortuin
- Mayo Clinic, Phoenix, United States of America
| | - N Beohar
- Mount Sinai Medical Center, Cardiovascular Diseases, Miami Beach, United States of America
| | - R Arsanjani
- Mayo Clinic, Phoenix, United States of America
| | - S K Mulpuru
- Mayo Clinic, Rochester, United States of America
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Faraz A, Ashraf H, Singhal S, Hussain F, Jaiswal J. P47 Correlation of Neurophysiological parameters with HRV in patients of Diabetic peripheral neuropathy. A cross sectional study. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Saeed A, Larik FA, Jabeen F, Mehfooz H, Ghumro SA, El-Seedi HR, Ali M, Channar PA, Ashraf H. Synthesis, Antibacterial and Antileishmanial Activity, Cytotoxicity, and Molecular Docking of New Heteroleptic Copper(I) Complexes with Thiourea Ligands and Triphenylphosphine. RUSS J GEN CHEM+ 2018. [DOI: 10.1134/s1070363218030246] [Citation(s) in RCA: 10] [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: 11/23/2022]
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13
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Gualeni B, Coulman S, Shah D, Eng P, Ashraf H, Vescovo P, Blayney G, Piveteau LD, Guy O, Birchall J. Minimally invasive and targeted therapeutic cell delivery to the skin using microneedle devices. Br J Dermatol 2018; 178:731-739. [DOI: 10.1111/bjd.15923] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 12/21/2022]
Affiliation(s)
- B. Gualeni
- School of Pharmacy and Pharmaceutical Sciences; Redwood Building; Cardiff University; Cardiff CF10 3NB U.K
- Extraject Technologies Ltd; Cardiff Medicentre, Heath Park; Cardiff CF14 4UJ U.K
| | - S.A. Coulman
- School of Pharmacy and Pharmaceutical Sciences; Redwood Building; Cardiff University; Cardiff CF10 3NB U.K
- Extraject Technologies Ltd; Cardiff Medicentre, Heath Park; Cardiff CF14 4UJ U.K
| | - D. Shah
- The Hillingdon Hospital NHS Foundation Trust; Pield Heath Road Uxbridge UB8 3NN U.K
| | - P.F. Eng
- Centre for NanoHealth; College of Engineering; Swansea University; Swansea SA2 8PQ U.K
| | - H. Ashraf
- SPTS Technologies; Ringland Way Newport NP18 2TA U.K
| | - P. Vescovo
- Debiotech SA; Avenue de Sévelin 28 1004 Lausanne Switzerland
| | - G.J. Blayney
- Centre for NanoHealth; College of Engineering; Swansea University; Swansea SA2 8PQ U.K
| | - L.-D. Piveteau
- Debiotech SA; Avenue de Sévelin 28 1004 Lausanne Switzerland
| | - O.J. Guy
- Centre for NanoHealth; College of Engineering; Swansea University; Swansea SA2 8PQ U.K
| | - J.C. Birchall
- School of Pharmacy and Pharmaceutical Sciences; Redwood Building; Cardiff University; Cardiff CF10 3NB U.K
- Extraject Technologies Ltd; Cardiff Medicentre, Heath Park; Cardiff CF14 4UJ U.K
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14
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Erridge S, Ashraf H, Purkayastha S, Darzi A, Sodergren MH. Comparison of gaze behaviour of trainee and experienced surgeons during laparoscopic gastric bypass. Br J Surg 2017; 105:287-294. [DOI: 10.1002/bjs.10672] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/04/2017] [Accepted: 07/11/2017] [Indexed: 01/13/2023]
Abstract
Abstract
Background
Eye tracking presents a novel tool that could be used to profile skill levels in surgery objectively. The primary aim of this study was to identify differences in gaze behaviour between expert and junior surgeons performing a laparoscopic Roux-en-Y gastric bypass (LRYGB) for obesity.
Methods
This prospective observational study used a lightweight eye-tracking apparatus to determine the difference in gaze behaviours between expert (more than 75 procedures) and junior (75 or fewer procedures) surgeons at defined stages of LRYGB. Primary endpoints were normalized dwell time and fixation frequency. Secondary endpoints were blink rate, maximum pupil size and rate of pupil change.
Results
A total of 20 procedures (12 junior, 8 expert) were analysed. Compared with juniors, experts showed a prolonged dwell time on the screen during angle of His dissection (median (range) 91·20 (83·40–94·40) versus 68·95 (59·80–87·60) per cent; P = 0·001), formation of the retrogastric tunnel (91·50 (85·80–95·50) versus 73·60 (34·60–90·50) per cent; P = 0·001) and gastric pouch formation (86·95 (83·60–90·20) versus 67·60 (37·10–80·00) per cent P < 0·001). Juniors had a greater blink frequency throughout all recorded segments (P < 0·010) and had a larger maximum pupil size during all recorded operative segments (P < 0·010). Rate of pupil change was greater in juniors in all analysed segments (P < 0·010).
Conclusion
These results suggest that experts display more focused attention on significant stimuli, alongside experiencing a reduced mental workload and having increased concentration. This has the potential for future use in validation of surgical skill in high-stakes assessment.
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Affiliation(s)
- S Erridge
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - H Ashraf
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - S Purkayastha
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - M H Sodergren
- Department of Surgery and Cancer, Imperial College London, London, UK
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15
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Saghir Z, Ashraf H, Pedersen J, Mortensen J. P3.13-011 Use of Volume Growth and Fluor-Deoxy-Glucose Positron Emission Tomography in Evaluating Indeterminate Lung Nodules in Lung Cancer Screening. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1746] [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: 10/18/2022]
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16
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Thorgeirsson TE, Steinberg S, Reginsson GW, Bjornsdottir G, Rafnar T, Jonsdottir I, Helgadottir A, Gretarsdottir S, Helgadottir H, Jonsson S, Matthiasson SE, Gislason T, Tyrfingsson T, Gudbjartsson T, Isaksson HJ, Hardardottir H, Sigvaldason A, Kiemeney LA, Haugen A, Zienolddiny S, Wolf HJ, Franklin WA, Panadero A, Mayordomo JI, Hall IP, Rönmark E, Lundbäck B, Dirksen A, Ashraf H, Pedersen JH, Masson G, Sulem P, Thorsteinsdottir U, Gudbjartsson DF, Stefansson K. A rare missense mutation in CHRNA4 associates with smoking behavior and its consequences. Mol Psychiatry 2016; 21:594-600. [PMID: 26952864 PMCID: PMC5414061 DOI: 10.1038/mp.2016.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 11/22/2022]
Abstract
Using Icelandic whole-genome sequence data and an imputation approach we searched for rare sequence variants in CHRNA4 and tested them for association with nicotine dependence. We show that carriers of a rare missense variant (allele frequency=0.24%) within CHRNA4, encoding an R336C substitution, have greater risk of nicotine addiction than non-carriers as assessed by the Fagerstrom Test for Nicotine Dependence (P=1.2 × 10(-4)). The variant also confers risk of several serious smoking-related diseases previously shown to be associated with the D398N substitution in CHRNA5. We observed odds ratios (ORs) of 1.7-2.3 for lung cancer (LC; P=4.0 × 10(-4)), chronic obstructive pulmonary disease (COPD; P=9.3 × 10(-4)), peripheral artery disease (PAD; P=0.090) and abdominal aortic aneurysms (AAAs; P=0.12), and the variant associates strongly with the early-onset forms of LC (OR=4.49, P=2.2 × 10(-4)), COPD (OR=3.22, P=2.9 × 10(-4)), PAD (OR=3.47, P=9.2 × 10(-3)) and AAA (OR=6.44, P=6.3 × 10(-3)). Joint analysis of the four smoking-related diseases reveals significant association (P=6.8 × 10(-5)), particularly for early-onset cases (P=2.1 × 10(-7)). Our results are in agreement with functional studies showing that the human α4β2 isoform of the channel containing R336C has less sensitivity for its agonists than the wild-type form following nicotine incubation.
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Affiliation(s)
- T E Thorgeirsson
- deCODE genetics/Amgen, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
| | | | | | | | - T Rafnar
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - I Jonsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | | | - S Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | | | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - T Tyrfingsson
- SAA National Center of Addiction Medicine, Reykjavik, Iceland
| | - T Gudbjartsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - H J Isaksson
- Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland
| | - H Hardardottir
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - A Sigvaldason
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Haugen
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - S Zienolddiny
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - H J Wolf
- Community & Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | - W A Franklin
- Department of Pathology, University of Colorado Denver, Aurora, CO, USA
| | - A Panadero
- Division of Medical Oncology, Hospital Ciudad de Coria, Coria, Spain
| | - J I Mayordomo
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, CO, USA
| | - I P Hall
- Division of Respiratory Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - E Rönmark
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - B Lundbäck
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Krefting Research Centre, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Dirksen
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark
| | - H Ashraf
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark,Centre for Diagnostic Imaging—Thoracic Section, Akershus University Hospital, Loerenskog, Norway
| | - J H Pedersen
- Department of Thoracic Surgery RT, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - G Masson
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - P Sulem
- deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | - K Stefansson
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
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Moemenbellah-Fard MD, Benafshi O, Rafinejad J, Ashraf H. Tick-borne relapsing fever in a new highland endemic focus of western Iran. Annals of Tropical Medicine & Parasitology 2013; 103:529-37. [DOI: 10.1179/136485909x451852] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ghasemi M, Ashraf H, Koushyar H, Mousavifar N. The cycle characteristics of clomiphene with clomiphene and menotropins in polycystic ovary syndrome and non polycystic ovary syndrome infertile patients. Minerva Ginecol 2013; 65:311-317. [PMID: 23689174] [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: 06/02/2023]
Abstract
AIM This study compares the cycle characteristics of clomiphene (CC) with CC+HMG (Human Menopausal Gonadotropin or Menotropins) in Polycystic Ovary Syndrome (PCOS) and non-PCOS infertile patients. METHODS Patients were treated by CC + minimal HMg protocol. The cancellation rate, the mean number of different follicle sizes and endometrial thickness and pattern were compared. RESULTS The cancelled cycles due to non-responsiveness were significantly higher in CC compared to CC+ minimal HMg protocol. PCOS patients are significantly nonresponsive in CC cycle and hyperresponsive in CC+ minimal HMg cycles. The mean number of different sizes of follicles and the endometrial thickness were significantly higher in CC+ minimal HMg. PCOS patients were significantly different from non-PCOS regarding the number of mature follicle and endometrial thickness. The pregnancy rate was 11% (10.2% in non-PCOS and 12.2% in PCOS). CONCLUSION CC+ minimal HMg is a viable alternative to HMg /FSH only protocol in CC failure or resistant patients, and its efficacy can be mostly attributed to improvement of endometrial quality and increase in follicle number. Moreover, due to high cancellation of PCOS patients treated by this protocol, seemingly other alternatives should be found; perhaps sequential letrozole+HMg/FSH that have been shown to improve the ovarian response in this group of patients.
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Affiliation(s)
- M Ghasemi
- Department of Gynecology and Obstetrics, Faculty of Medicine, Zahedan University of Medical Sciences Zahedan, Iran
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Sabermoghadam Ranjbar AA, Rajabi O, Salari R, Ashraf H. Lidocaine Cyclodextrin complex Ophthalmic Drop, a New Topical Anesthetic Choice. Iran Red Crescent Med J 2012; 14:569-73. [PMID: 23115719 PMCID: PMC3482329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 02/18/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Topical anesthesia is a safe and cost-effective method considered as the first-choice in many procedures. Due to the physiological characteristics of eye, most of the local anesthetics cannot efficiently penetrate through the conjunctiva deep to tenon. The aim of this pilot study was to find a new form of lidocaine to give a sufficient level of anesthesia. METHODS Lidocaine Cyclodextrin complex ophthalmic drop was produced and its pharmacological properties were studied [tested] in standard temperature and pressure. 30 patients (18 males, 12 females) with the mean age of 30.68±8.02 years enrolled in this clinical trial. All the patients were fully informed and signed the ethics committee consent forms. The patients were given tetracaine drop as the anesthetic: 3 drops separated 2 minute apart 10 min before the intervention. If we achieved a sufficient level of anesthesia, the procedure was done after. If the patient could not tolerate the procedure, the method was changed to lidocaine drop (administered after wash-out period like the first drop).The last option was conventional injection method if the patient could not tolerate the procedure with the second method either.We used this type of anesthesia for conventional procedures such as forced duction test, symblepharon, pterygium, and disport injection into extra-ocular muscles. All the procedures were done by one surgeon in a university hospital. We used a 0 to 10 visual analogue scale for pain and two 0 to 4 patient and physician satisfaction scales designed for this study. RESULTS The mean pain score was 7.53±0.90 in group 1 and 3.03±1.83 in group 2 (P=0.00). Patient and surgeon satisfaction in group 1 were 1.33±0.48 and 1.40±0.56 respectively; while 3.23±1.00 and 3.56±0.77 for group 2 (P=0.00). Tetracaine drop could not induce sufficient anesthesia for none of the patients. Cyclodextrin based lidocaine drop was successful except For two patients for whom we changed the anesthesia to Sub-conjunctival injection method. CONCLUSION Our newly manufactured cyclodextrin based lidocaine eye drop could successfully induce sufficient anesthesia for 28 of 30 patients. Further studies with larger sample sizes are now being designed to find more clinical evidence about this method.
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Affiliation(s)
| | - O Rajabi
- Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Salari
- Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Ashraf
- Orthopedics research center, Mashhad University of Medical Sciences, Mashhad, Iran ,Correspondence: Hami Ashraf, General practitioner Research assistant, Orthopedics research center, Mashhad University of Medical Sciences, Mashhad, Iran. Tel.: +989153213658, Fax: +985118417453, E-mail:
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Pandey R, Ashraf H, Bhalla AP, Garg R. Optimal wrist angulation shortens time needed for radial artery catheterization: a prospective, randomized, and blinded study. Acta Anaesthesiol Belg 2012; 63:187-90. [PMID: 23610857 DOI: pmid/23610857] [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: 02/07/2023]
Abstract
INTRODUCTION Optimal wrist position is essential for successful catheterization of the radial artery. We planned to study the success rate of radial artery catheterization at various degrees of wrist extension angulations. METHODS This prospective, randomized study was performed in 60 consenting patients aged between 18-65 years and undergoing variable surgeries where the anesthetic management required an arterial catheterization. All patients were randomized into three groups of 20 patients each, according to wrist angulation during radial artery catheterization : either 30 degrees (Group 30), 45 degrees (Group 45), or 60 degrees (Group 60). Three metallic angulated wrist boards with angles of 30 degrees, 45 degrees, and 60 degrees (angle measured with calipers) were prepared, on which patient's wrist was kept at the above-mentioned angles of extension. Radial artery catheterization success rate, catheterization time, and numbers of attempts were recorded. RESULTS The catheterization time was minimal in group 45 (30.50 +/- 16.82 sec) as compared to 36.00 +/- 14.19 sec and 43.50 +/- 13.80 sec in group 30 and 60, respectively. Radial artery was catheterized at first attempt in 60% of Group 45 and Group 60 patients, and in 50% of Group 30 patients. The arterial catheterization was successful in 14/20 patients in Group 30, 19/20 patients in group 45, and 16/20 patients in group 60. CONCLUSION We conclude that a wrist extension of 450 appears to be the optimal wrist joint extension for a successful radial artery cannula insertion.
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Affiliation(s)
- R Pandey
- Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi -110029, India.
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Hosseini H, Nowroozzadeh MH, Razeghinejad MR, Ashraf H, Salouti R, Ashraf MJ. Anterior lens capsule has more affinity to trypan blue in patients with pseudoexfoliation. Eye (Lond) 2011; 25:1245-6. [PMID: 21681218 DOI: 10.1038/eye.2011.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Alam NH, Raqib R, Ashraf H, Qadri F, Ahmed S, Zasloff M, Agerberth B, Salam MA, Gyr N, Meier R. L-isoleucine-supplemented oral rehydration solution in the treatment of acute diarrhoea in children: a randomized controlled trial. J Health Popul Nutr 2011; 29:183-190. [PMID: 21766553 PMCID: PMC3131118 DOI: 10.3329/jhpn.v29i3.7864] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Antimicrobial peptides represent an important component of the innate immune defenses of living organisms, including humans. They are broad-spectrum surface-acting agents secreted by the epithelial cells of the body in response to infection. Recently, L-isoleucine and its analogues have been found to induce antimicrobial peptides. The objectives of the study were to examine if addition of L-isoleucine to oral rehydration salts (ORS) solution would reduce stool output and/or duration of acute diarrhoea in children and induce antimicrobial peptides in intestine. This double-blind randomized controlled trial was conducted at the Dhaka Hospital of ICDDR,B. Fifty male children, aged 6-36 months, with acute diarrhoea and some dehydration, attending the hospital, were included in the study. Twenty-five children received L-isoleucine (2 g/L)-added ORS (study), and 25 received ORS without L-isoleucine (control). Stool weight, ORS intake, and duration of diarrhoea were the primary outcomes. There was a trend in reduction in mean +/- standard deviation (SD) daily stool output (g) of children in the L-isoleucine group from day 2 but it was significant on day 3 (388 +/- 261 vs. 653 +/- 446; the difference between mean [95% confidence interval (CI) (-)265 (-509, -20); p = 0.035]. Although the cumulative stool output from day 1 to day 3 reduced by 26% in the isoleucine group, it was not significant. Also, there was a trend in reduction in the mean +/- SD intake of ORS solution (mL) in the L-isoleucine group but it was significant only on day 1 (410 +/- 169 vs. 564 +/- 301), the difference between mean (95% CI) (-)154 (-288, -18); p = 0.04. The duration (hours) of diarrhoea was similar in both the groups. A gradual increase in stool concentrations of beta-defensin 2 and 3 was noted but they were not significantly different between the groups. L-isoleucine-supplemented ORS might be beneficial in reducing stool output and ORS intake in children with acute watery diarrhoea. A further study is warranted to substantiate the therapeutic effect of L-isoleucine.
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Affiliation(s)
- N H Alam
- Clinical Sciences Division, ICDDR,B GPO Box 128, Dhaka 1000, Bangladesh.
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Abstract
Total elbow allograft transplantation is an option for patients who have extensive joint defects secondary to tumor surgery, trauma, or failed total elbow arthroplasty. This salvage procedure provides patients with a useful, painless range of motion of the elbow. We report our experience with two complete elbow allograft reconstructions after tumor resection surgery with 5 and 6 years of follow-up.
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Affiliation(s)
- E M Hossein
- Department of Orthopedics, School of Medicine, Mashhad University of Medical Sciences, Ghaem University Hospital, Mashhad Orthopedics Research Center.
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Amoli HA, Notash AY, Shahandashti FJ, Kenari AY, Ashraf H. A randomized, prospective, double-blind, placebo-controlled trial of the effect of topical diltiazem on posthaemorrhoidectomy pain. Colorectal Dis 2011; 13:328-32. [PMID: 19912283 DOI: 10.1111/j.1463-1318.2009.02138.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM Spasm of the internal anal sphincter plays a role in haemorrhoidal disease and may be a source of anal pain after haemorrhoid surgery. In this study, we investigated the effect of topical diltiazem (DTZ) on postoperative pain following Milligan-Morgan haemorrhoidectomy. METHOD After haemorrhoidectomy, 33 patients were randomly assigned to receive DTZ ointment (2%; n = 16) or a placebo ointment (n = 17). Ointments were applied to the perianal region three times daily for 7 days. A Visual Analogue Scale was used to assess postoperative pain. The primary end-point was reduction in postoperative pain. RESULTS Patients using the DTZ cream had significantly less pain and greater benefit than those in the placebo group throughout the first postoperative week, and total and daily narcotic analgesic use was higher in the placebo group. There were no differences in morbidity between the two groups. CONCLUSION Perianal application of DTZ cream after haemorrhoidectomy significantly reduces postoperative pain and is perceived as beneficial, with no increase in associated morbidity.
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Affiliation(s)
- H A Amoli
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences Sina Hospital, Tehran University of Medical Sciences Sina Research Development Center, Tehran University of Medical Sciences, Tehran, Iran
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Hadadi A, Zehtab MJ, Babagolzadeh H, Ashraf H. Contributing risk factors for orthopedic device related infections in sina hospital, tehran, iran. Iran Red Crescent Med J 2011; 13:117-22. [PMID: 22737445 PMCID: PMC3371915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 08/20/2010] [Accepted: 08/28/2010] [Indexed: 11/01/2022]
Abstract
BACKGROUND In spite of decreasing incidence of orthopedic device-related infections to 1%, nowadays, device-related infection still remains a diagnostic, therapeutic and cost-related problem. The objective of this study is to evaluate the contributing risk factors for orthopedic device-related infections in Sina Hospital, Tehran, Iran. METHODS Three hundred and thirty patients who underwent orthopedic device implantation from 2002-2006 were enrolled; among them, 110 patients were complicated with infection. Descriptive and logistic regression analyses were performed to determine the risk factors for device related infections. RESULTS Patients with infection were older compared to those without infection. The Staphylococcus aureus was the commonest organism. A correlation was observed between wound infection and external fixation, an underlying health condition, and addiction which were independent risk factors for a device related infection. CONCLUSION Orthopedic device-related infection puts a great financial burden on patients and hospital resources and could lead to morbidity and mortality in patients. So, appropriate pre and postoperative wound care for dirty wounds, especially when external fixators are used, and in patients with poor conditions or addiction should be done with more caution.
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Affiliation(s)
- A Hadadi
- Department of Infectious Disease, Research Development Center, Sina Hospital, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Azar Hadadi, MD, Associate Professor of Infectious Diseases, Research Development Center, Sina Hospital, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-21-66716546, Fax: +98-21-66716546, E-mail:
| | - M J Zehtab
- Department of Orthopedic Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - H Babagolzadeh
- General Practitioner, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - H Ashraf
- Department of Cardiology, Research and Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Akhlagh SH, Vaziri MTM, Nemati MH, Ashraf H. Changes in liver enzymes and bilirubin after coronary artery bypass grafting using acute normovolemic hemodilution. Acta Anaesthesiol Belg 2011; 62:11-14. [PMID: 21612140] [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: 05/30/2023]
Abstract
The aim of this clinical case-control trial was to compare postoperative early jaundice and transient liver damage in patients receiving autologous or homologous blood transfusion in coronary artery bypass grafting (CABG) surgery. In this randomized clinical trial 40 patients scheduled for CABG were randomly allocated to ANH (Acute Normovolemic Hemodilution) group or control group. Both groups were compared in relation to bilirubin (total and direct), alanine transferase (ALT), aspartate transferase (AST) and alkaline phosphatase (ALP) in the first 24 hours. There was a significant difference in bilirubin (total and direct) change between groups (both p<0.00001). However, there were no changes in ALT, AST and ALP compared with baseline values, and there were no differences in the values between the two study groups. Our randomized, double blinded case control study suggested that patients receiving autologous blood (ANH group) following CABG had significantly lower bilirubin levels compared to patients who received homologous transfusion. However larger studies with more patients are needed to confirm the results.
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Affiliation(s)
- S H Akhlagh
- Department of Anesthesiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Ashraf H, Dirksen A, Loft A, Bertelsen AK, Bach KS, Hansen H, Pedersen JH, Mortensen J. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning. Thorax 2010; 66:315-9. [DOI: 10.1136/thx.2010.136747] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Esteghamati A, Ashraf H, Khalilzadeh O, Rashidi A, Mohammad K, Asgari F, Abbasi M. Trends of diabetes according to body mass index levels in Iran: results of the national Surveys of Risk Factors of Non-Communicable Diseases (1999-2007). Diabet Med 2010; 27:1233-40. [PMID: 20950380 DOI: 10.1111/j.1464-5491.2010.03103.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIMS The prevalence of diabetes is increasing dramatically worldwide. Less is known about whether this trend is similar among obese and lean individuals. METHODS We analysed the data sets of three cross-sectional national surveys in adults aged 25-64 years: the National Health Survey-1999 (n=21,576), and the national Surveys of Risk Factors of Non-Communicable Diseases (SuRFNCD)-2005 (n=70,981) and SuRFNCD-2007 (n=4233). Diagnosed diabetes was ascertained, and height and weight were measured in all surveys. In SuRFNCD-2005 and SuRFNCD-2007, fasting plasma glucose was used to identify subjects with newly diagnosed diabetes (≥ 7 mmol/l) and impaired fasting glucose (5.6 - 6.9 mmol/l) among individuals not reporting diabetes. RESULTS The prevalence of diagnosed diabetes (after adjustment for age, sex and residential area) was 2.5, 4.0 and 4.6% in 1999, 2005 and 2007, respectively. The total prevalence of diabetes increased from 7.7% in 2005 to 8.7% in 2007, about half of which was attributed to newly diagnosed disease (in both surveys). The prevalence of diabetes increased in all categories of obesity, with the most evident trend being among subjects with body mass index <25 kg/m(2) . CONCLUSIONS The prevalence of diabetes among Iranian adults has increased more than 1.8-fold in a period of only 8 years since 1999. This is the first report from Iran, and urgent measures need to be taken in order to prevent the progression and worsening of the problem and emergence of its undesired consequences.
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Affiliation(s)
- A Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Zeraati AA, Naghibi M, Kianoush S, Kianoosh S, Ashraf H. Impact of slow and delayed graft function on kidney graft survival between various subgroups among renal transplant patients. Transplant Proc 2010; 41:2777-80. [PMID: 19765433 DOI: 10.1016/j.transproceed.2009.07.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Renal allografts with excellent graft function show good long-term outcomes, while grafts with delayed function have been associated with poor long-term survivals, although few reports have analyzed outcomes among these groups. We compared first-week postoperative graft function among renal transplant patients to analyze the impact of slow graft function (SGF) and delayed graft function (DGF) on graft survival. MATERIALS AND METHODS Renal transplantations were performed from 362 unrelated, 46 related, and 163 deceased donors. Kidney transplant patients were divided into 3 groups according to their initial graft function. First-week dialyzed patients formed the DGF group. Nondialyzed patients were divided into a SGF or an excellent graft function (EGF) cohort according to whether the serum creatinine at day 7 was higher vs lower than 2.5 mg/dL, respectively. RESULTS Of the 570 renal transplant recipients, DGF was observed in 39 patients (6.8%), SGF in 64 (11.2%), and EGF in 467 (81.8%). There was no significant difference in SGF vs DGF between patients who received kidneys from unrelated vs related living or deceased donors. Graft survival was worse among the DGF than the SGF or EGF patients, with no significant difference between the last 2 groups. The 6-month graft survivals were 74%, 93%, and 96%; the 3-year graft survivals were 70%, 88%, and 90%, respectively (P < .001). CONCLUSIONS We observed a similar impact of EGF and SGF on kidney graft survival. Kidney transplant recipients who developed DGF showed worse graft survival than those with EGF or SGF.
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Affiliation(s)
- A A Zeraati
- Mashhad Transplant Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
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Alam NH, Ashraf H, Sarker SA, Olesen M, Troup J, Salam MA, Gyr N, Meier R. Efficacy of partially hydrolyzed guar gum-added oral rehydration solution in the treatment of severe cholera in adults. Digestion 2009; 78:24-9. [PMID: 18769066 DOI: 10.1159/000152844] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 05/15/2008] [Indexed: 02/04/2023]
Abstract
BACKGROUND Partially hydrolyzed guar gum (PHGG) is a water-soluble fiber if added to oral rehydration solution (ORS) and undergoes fermentation in the colon liberating short chain fatty acids (SCFAs). SCFAs potentiate the effect of ORS, reducing the severity of diarrhea. AIM To examine the effect of PHGG-added ORS in reducing the stool output and duration of diarrhea in adult cholera. METHODS 195 male patients were studied in a randomized controlled trial: (a) 65 received ORS + 25 g PHGG; (b) 65 received ORS + 50 g PHGG, and (c) 65 received ORS alone (control). Major outcomes were stool weight and duration of diarrhea. RESULTS No significant differences were found in mean +/- SD stool weight (g/kg b.w.) during the first and second 24 h. In the subgroup analysis (excluding very high purging patients, stool weight in the first 24 h was >10 kg), the stool weight (g/kg b.w.) was significantly reduced in the first 24 h in both groups receiving PHGG (PHGG 25 g, 136 +/- 68 vs. PHGG 50 g, 144 +/- 49 vs. control, 176 +/- 43, p = 0.01). CONCLUSION PHGG-added ORS might have a beneficial effect in moderately purging adult cholera. However, further studies are warranted to confirm the preliminary findings.
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Affiliation(s)
- N H Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (ICDDRB), Mohakhali, Dhaka, Bangladesh.
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Esteghamati A, Ashraf H, Nakhjavani M, Najafian B, Hamidi S, Abbasi M. Insulin resistance is an independent correlate of increased urine albumin excretion: a cross-sectional study in Iranian Type 2 diabetic patients. Diabet Med 2009; 26:177-81. [PMID: 19236623 DOI: 10.1111/j.1464-5491.2008.02653.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To assess the association of insulin resistance with increased urinary albumin excretion (UAE) in a cohort of Iranian Type 2 diabetic patients. METHODS Three hundred and sixty-one men and 472 women with Type 2 diabetes were enrolled from three different outpatient clinics (Tehran, Iran) during the period 2005-2008. Patients with obstructive uropathy, severe heart failure, liver disease, cancer, autoimmune disease and macroalbuminuria were not included. Microalbuminuria (MA; defined as UAE >or= 30 mg/day) was found in 242 (29.1%) patients; 591 (70.9%) subjects had normoalbuminuria (UAE < 30 mg/day). Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS HOMA-IR index values were higher in subjects with MA than those with normoalbuminuria (P < 0.00001). Adjusted values (for age, sex and duration of diabetes) of UAE and HOMA-IR were 11.81 +/- 7.51 (mg/day) and 3.30 +/- 2.21 in normoalbuminuric and 75.36 +/- 55.57 (mg/day) and 4.98 +/- 3.22 in the MA group, respectively (P < 0.00001 for all). Multiple regression analysis showed that UAE was predicted by HOMA-IR, independently of age, duration of diagnosed diabetes, triglycerides, waist circumference, metabolic control, blood pressure and related treatments (P < 0.00001). When patients were categorized into quartiles of HOMA-IR, those of the fourth quartile (i.e. the most insulin resistant) were at a higher risk of increased UAE than other quartiles [odds ratio (OR) 3.7 (95% confidence intervals 2.7-6.2)]. CONCLUSIONS In Iranian Type 2 diabetic patients, albuminuria was strongly associated with insulin resistance. HOMA-IR is an independent predictor of UAE.
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Affiliation(s)
- A Esteghamati
- Department of Endocrinology, Endocrinology and Metabolism Research Center, Vali-asr Hospital, Tehran University of Medical Sciences/University of Tehran, Tehran, Iran.
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Ashraf H, Tonnesen P, Holst Pedersen J, Dirksen A, Thorsen H, Dossing M. Effect of CT screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening Trial (DLCST). Thorax 2008; 64:388-92. [DOI: 10.1136/thx.2008.102475] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ashraf H, Jahan SA, Alam NH, Mahmud R, Kamal SM, Salam MA, Gyr N. Day-care management of severe and very severe pneumonia, without associated co-morbidities such as severe malnutrition, in an urban health clinic in Dhaka, Bangladesh. Arch Dis Child 2008; 93:490-4. [PMID: 17804591 DOI: 10.1136/adc.2007.118877] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Management of severe and very severe pneumonia in children relies on hospital-based treatment, but practical barriers often prevent children in areas with the highest rates from receiving hospital care. OBJECTIVE To develop and prospectively evaluate a day-care clinic approach, which provided antibiotics, feeding and supportive care during the day with continued care provided by parents at home, as an effective alternative to hospitalisation. METHODS Children aged 2-59 months with severe or very severe pneumonia without associated co-morbidities, denied admission to hospital because of lack of beds, were enrolled at Radda Clinic, Dhaka and received antibiotics, feeding and supportive care from 08:00 to 17:00 every day, while mothers were educated on continuation of care at home during the night. RESULTS From June 2003 to May 2005, 251 children were enrolled. Severe and very severe pneumonia was present in 189 (75%) and 62 (25%) children, respectively, and 143 (57%) were hypoxaemic with a mean (SD) oxygen saturation of 93 (4)%, which increased to 98 (3)% on oxygen therapy. The mean (SD) day-care period was 7 (2) days. Successful management was possible in 234 children (93% (95% CI 89% to 96%)), but 11 (4.4% (95% CI 2.5% to 7.7%)) had to be referred to hospital, and six (2.4% (95% CI 1.1% to 5.1%)) discontinued treatment. There were no deaths during the day-care study period; however, four children (1.6% (95% CI 0.6% to 4.0%)) died during the 3-month follow-up period, and 11 (4.4% (95% CI 2.5% to 7.7%)) required hospital admission. CONCLUSION Severe and very severe pneumonia in children without associated co-morbidities such as severe malnutrition can be successfully managed at day-care clinics.
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Affiliation(s)
- H Ashraf
- Clinical Sciences Division, ICDDR,B, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh.
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Taheri SA, Yeh J, Batt RE, Fang Y, Ashraf H, Heffner R, Nemes B, Naughton J. Uterine myometrium as a cell patch as an alternative graft for transplantation to infarcted cardiac myocardium: a preliminary study. Int J Artif Organs 2008; 31:62-7. [PMID: 18286456 DOI: 10.1177/039139880803100109] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Currently, only a small fraction of patients are able to receive reperfusion therapy for myocardial infarctions. We hypothesize that myometrial cell patch transplantation could be an alternative approach for the treatment of myocardial infarction. DESIGN We performed a preliminary study to determine the feasibility of this novel therapeutic approach in a rabbit model. PROCEDURES Six adult female New Zealand rabbits were used. Myocardial infarction was induced by left anterior descending artery ligation. A segment of uterus was removed via a laparotomy incision, and this uterine segment was transplanted as an autologous graft over the infarcted myocardium, which was then reinforced by greater omentum. Statistical methods and outcome measures: Hemodynamic measurements and histological studies. MAIN FINDINGS All uterine myometrial patches survived in the test animals. Fluoroscopic hemodynamic measurements were made for ejection fractions at 8 weeks after the application of the uterine patch. Histological study demonstrated well-healed myometrial-myocardium junctions with minimum scar tissue. Angiogenesis occurred in the transplanted myometrium. Connexin 43 expression was demonstrated in the transplanted patches. CONCLUSION Our noncontrolled preliminary rabbit experiments indicate that patches of uterine myometrium reinforced by greater omentum can be used as autologous transplant therapy for infracted myocardium. This is an innovative technique that could lead to future treatment for individuals who may suffer from an infarcted myocardium and may not be eligible for traditional reperfusion therapy.
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Affiliation(s)
- S A Taheri
- Department of Thoracic and Cardiovascular Surgery, University at Buffalo and Kaleida Health, Buffalo, New York - USA.
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Khan R, Pervez M, Tauheed A, Ashraf H, Jilani FA, Sherwani R. Conjunctival cytology in glaucomatous patients using long-term topical therapy. J Cytol 2008. [DOI: 10.4103/0970-9371.42442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ashraf H, Ahmed T, Hossain MI, Alam NH, Mahmud R, Kamal SM, Salam MA, Fuchs GJ. Day-care management of children with severe malnutrition in an urban health clinic in Dhaka, Bangladesh. J Trop Pediatr 2007; 53:171-8. [PMID: 17369617 DOI: 10.1093/tropej/fmm005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Management of severely malnourished children with associated complications relies on hospital-based treatment. Implementation of a standardized protocol at the Dhaka Hospital, ICDDR,B reduced case fatality approximately 50%. We developed and prospectively evaluated a day-care clinic approach that provided antibiotics, micronutrients and feeding during the day with continued care by parents at home at night as an alternative to hospitalization. Severely malnourished children aged 6-23 months denied admission to hospital were enrolled at Radda Clinic, Dhaka and received protocolized management with antibiotics, micronutrients and milk-based diet from 8:00 am to 5:00 pm each day, while mothers were educated on continuation of care at home. They were transitioned to the day-care nutrition rehabilitation (NR) unit of Radda Clinic following resolution of acute illness, received NR diet (Khichuri, halwa and milk-based) daily until children attained 80% weight-for-length. From February 2001 to November 2003, 264 children were enrolled; 52% were boys and 78%, 21% and 1% had marasmus, marasmus-kwashiorkor and kwashiorkor, respectively. Only 13% had severe malnutrition alone while 35% had pneumonia, 35% had diarrhea and 17% had both pneumonia and diarrhea. The mean (SD) duration of acute and NR phases were 8 (4) and 14 (13) days, respectively. Children gained weight [mean (SD) g/kg day] more rapidly during acute 10 (7) than NR phase 6 (5). Successful management was possible in 82% (95% CI 77-86%) children, 12% discontinued treatment and 6% referred to hospitals. Only one child died during NR phase. Severely malnourished children can be successfully managed at existing day-care clinics using a protocolized approach.
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Affiliation(s)
- H Ashraf
- Clinical Sciences Division, ICDDR, B, Dhaka 1212, Bangladesh.
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Alam NH, Ashraf H, Khan WA, Karim MM, Fuchs GJ. Efficacy and tolerability of racecadotril in the treatment of cholera in adults: a double blind, randomised, controlled clinical trial. Gut 2003; 52:1419-23. [PMID: 12970133 PMCID: PMC1773819 DOI: 10.1136/gut.52.10.1419] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND The enkephalins, endogenous opiate substances, act as neurotransmitters along the entire digestive tract where they elicit intestinal antisecretory activity without affecting intestinal transit time or motility. Racecadotril, through inhibition of enkephalinase, reinforces the physiological activity of endogenous enkephalins and, therefore, shows intestinal antisecretory activity. AIM We conducted the study to determine the role of racecadotril as an adjunct to the standard treatment of cholera in adults. METHODS The study was a double blind, randomised, placebo controlled clinical trial involving 110 adult male cholera patients who received either racecadotril or placebo in addition to standard cholera treatment. The major outcome measures (stool output, oral rehydration solution (ORS) intake, requirements for unscheduled intravenous fluid infusion, and duration of diarrhoea) were compared between the groups. RESULTS Of 110 patients enrolled, 54 received racecadotril and 56 received placebo. Admission clinical characteristics were comparable between the groups. There was no significant difference in (mean (SD)) total stool output (racecadotril v placebo 315 (228) v 280 (156) g/kg), total ORS intake (390 (264) v 369 (240) ml/kg), or duration of diarrhoea (35 (15) v 32 (13) hours) between the groups. Clinical success, defined as resolution of diarrhoea within 72 hours of initiation of study intervention, was similar in both groups (racecadotril v placebo 96% v 89%). The number of patients receiving unscheduled intravenous infusions was not significantly different between the groups (racecadotril v placebo 22% v 14%). No drug related adverse effect was noted. CONCLUSION The study demonstrated that racecadotril therapy, although found to be safe, does not provide additional benefit in the treatment of severe cholera in adults.
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Affiliation(s)
- N H Alam
- Clinical Sciences Division, International Centre for Diarrhoeal Disease Research (ICDDR,B): Centre for Health and Population Research, Dhaka, Bangladesh.
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Vatandoost H, Ashraf H, Lak SHS, Mahdi RE, Abai MR, Nazari M. Factors involved in the re-emergence of malaria in borderline of Iran, Armenia, Azerbaijan and Turkey. Southeast Asian J Trop Med Public Health 2003; 34 Suppl 2:6-14. [PMID: 19238663] [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: 05/27/2023]
Abstract
The borderline of Iran with Azerbaijan, Armenia and Turkey had been considered a malaria free region. However, in 1991, after the independence of the southern countries of the former Soviet Union, a new threat of malaria importation emerged from those countries into Iran, which was affected by serious epidemics of Plasmodium vivax malaria. Various factors can affect malaria resurgence in this region, such as socioeconomic conditions, especially the displacement of massive populations from war-stricken zones in the Republic of Azerbaijan. Accordingly, in some parts of West-Azerbaijan, East-Azerbaijan, Ardebile and Gilan provinces of Iran, several malaria foci were observed. Construction of dams, people traveling from neighboring countries to Iran, urbanization, irrigation projects, lack of malaria vector control, shortage of drug supplies are also major factors in malaria outbreaks in the region. An investigation was carried out on the bionomics of the main malaria vectors in the region. The result showed that Anopheles sacharovi plays an important role in malaria transmission and An. maculipennis and An. superpictus can be secondary vectors. Larvae were found in slow flowing water and channels with water plants. They were more abundant in June. The parity rate of blood-fed females was high in May. An. sacharovi is active from May to October with two peaks of activity, which occur in August and October. The population of this species is higher in animal shelters with a zoophicity of 95%. About 90% of bites took place in the second half of the night. A CDC light trap can also catch this species. Susceptibility testing using the WHO-recommended diagnostic doses of insecticides, revealed that this species is resistant to DDT and dieldrin, but susceptible to malathion, fenitrothion, propoxur, bendiocarb, lambdacyhalothrin, permethrin, cyfluthrin, etofenprox and deltamethrin.
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Affiliation(s)
- H Vatandoost
- School of Public Health and Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.
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Ashraf H. S Africa must treat HIV-infected pregnant women, says high court judge. Lancet 2001; 358:2139. [PMID: 11784643 DOI: 10.1016/s0140-6736(01)07243-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ashraf H. UK study finds wide variation in cancer surgery services. Lancet 2001; 358:1967. [PMID: 11747926 DOI: 10.1016/s0140-6736(01)06999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ashraf H, Mahalanabis D, Mitra AK, Tzipori S, Fuchs GJ. Hyperimmune bovine colostrum in the treatment of shigellosis in children: a double-blind, randomized, controlled trial. Acta Paediatr 2001; 90:1373-8. [PMID: 11853331 DOI: 10.1080/08035250152708743] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED Immunological approaches have been considered as an alternative therapeutic option for the treatment of enteric infections over the past few years. Hyperimmune bovine colostrum (HBC) is a potentially innovative immunological option in the management of shigellosis together with traditional antibiotic therapy. Children aged 1-12 y with a history of bloody mucoid diarrhoea of less than 5 d duration were enrolled after their stool specimen was found to be positive for Shigella dysenteriae type I antigen by a rapid diagnostic fluorescent antibody staining test. They were randomized to receive either HBC containing very high titres of antibody against S. dysenteriae type I antigen or bovine colostrum (BC) without any antibody. The study group received 100 ml of HBC three times a day orally for 3 d and control group received BC. Children also received pivmecillinam in a dose of 50 mg kg(-1) d(-1) in four divided doses orally for 5 d. Admission characteristics of the 34 children in the HBC group and 35 in the BC group were comparable. No significant differences were observed in duration of diarrhoea, fever, anorexia, abdominal pain, tenesmus, stool frequency or visible blood in the stool between the groups. Two (6%) children in the study and five (14%) in the control group remained stool culture positive for S. dysenteriae type 1, even after 5 d of sensitive antimicrobial therapy. CONCLUSION The results indicate that HBC as an adjuvant is unable to show any beneficial effect in reducing the stool frequency, duration or severity of childhood shigellosis due to S. dysenteriae type I infection.
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Affiliation(s)
- H Ashraf
- ICDDR, B: Centre for Health and Population Research, Dhaka, Bangladesh.
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Ashraf H. UK government pledges support for health workers to tackle health inequalities. Lancet 2001; 358:1621. [PMID: 11716905 DOI: 10.1016/s0140-6736(01)06707-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ashraf H. US state given go ahead to reduce drug prices for uninsured people. Lancet 2001; 357:1683. [PMID: 11425388 DOI: 10.1016/s0140-6736(00)04873-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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