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Meo SA, Klonoff DC, Akram J. Reply Letter - Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19. Eur Rev Med Pharmacol Sci 2021; 25:4445. [PMID: 34286484 DOI: 10.26355/eurrev_202107_26232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S A Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. /
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Meo SA, Bukhari IA, Akram J, Meo AS, Klonoff DC. COVID-19 vaccines: comparison of biological, pharmacological characteristics and adverse effects of Pfizer/BioNTech and Moderna Vaccines. Eur Rev Med Pharmacol Sci 2021; 25:1663-1669. [PMID: 33629336 DOI: 10.26355/eurrev_202102_24877] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" disease has caused a worldwide challenging and threatening pandemic (COVID-19), with huge health and economic losses. The US Food and Drug Administration, (FDA) has granted emergency use authorization for treatment with the Pfizer/BioNTech and Moderna COVID-19 vaccines. Many people have a history of a significant allergic reaction to a specific food, medicine, or vaccine; hence, people all over the world have great concerns about these two authorized vaccines. This article compares the pharmacology, indications, contraindications, and adverse effects of the Pfizer/BioNTech and Moderna vaccines. MATERIALS AND METHODS The required documents and information were collected from the relevant databases, including Web of Science (Clarivate Analytics), PubMed, EMBASE, World Health Organization (WHO), Food and Drug Authorities (FDA) USA, Local Ministries, Health Institutes, and Google Scholar. The key terms used were: Coronavirus, SARS-COV-2, COVID-19 pandemic, vaccines, Pfizer/BioNTech vaccine, Moderna vaccine, pharmacology, benefits, allergic responses, indications, contraindications, and adverse effects. The descriptive information was recorded, and we eventually included 12 documents including research articles, clinical trials, and websites to record the required information. RESULTS Based on the currently available literature, both vaccines are beneficial to provide immunity against SARS-CoV-2 infection. Pfizer/BioNTech Vaccine has been recommended to people 16 years of age and older, with a dose of 30 μg (0.3 m) at a cost of $19.50. It provides immunogenicity for at least 119 days after the first vaccination and is 95% effective in preventing the SARS-COV-2 infection. However, Moderna Vaccine has been recommended to people 18 years of age and older, with a dose of 50 μg (0.5 mL) at a cost of $32-37. It provides immunogenicity for at least 119 days after the first vaccination and is 94.5% effective in preventing the SARS-CoV-2 infection. However, some associated allergic symptoms have been reported for both vaccines. The COVID-19 vaccines can cause mild adverse effects after the first or second doses, including pain, redness or swelling at the site of vaccine shot, fever, fatigue, headache, muscle pain, nausea, vomiting, itching, chills, and joint pain, and can also rarely cause anaphylactic shock. The occurrence of adverse effects is reported to be lower in the Pfizer/BioNTech vaccine compared to the Moderna vaccine; however, the Moderna vaccine compared to the Pfizer vaccine is easier to transport and store because it is less temperature sensitive. CONCLUSIONS The FDA has granted emergency use authorization for the Pfizer/BioNTech and Moderna COVID-19 vaccines. These vaccines can protect recipients from a SARS-CoV- 2 infection by formation of antibodies and provide immunity against a SARS-CoV-2 infection. Both vaccines can cause various adverse effects, but these reactions are reported to be less frequent in the Pfizer/BioNTech vaccine compared to the Moderna COVID-19 vaccine; however, the Moderna vaccine compared to the Pfizer vaccine is easier to transport and store because it is less temperature sensitive.
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Affiliation(s)
- S A Meo
- Department of Physiology, Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Meo SA, Abukhalaf AA, Alomar AA, Aljudi TW, Bajri HM, Sami W, Akram J, Akram SJ, Hajjar W. Impact of weather conditions on incidence and mortality of COVID-19 pandemic in Africa. Eur Rev Med Pharmacol Sci 2020; 24:9753-9759. [PMID: 33015822 DOI: 10.26355/eurrev_202009_23069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The weather-related conditions change the ecosystem and pose a threat to social, economic and environmental development. It creates unprecedented or unanticipated human health problems in various places or times of the year. Africa is the world's second largest and most populous continent and has relatively changeable weather conditions. The present study aims to investigate the impact of weather conditions, heat and humidity on the incidence and mortality of COVID-19 pandemic in various regions of Africa. MATERIALS AND METHODS In this study, 16 highly populated countries from North, South, East, West, and Central African regions were selected. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization. The daily temperature and humidity figures were obtained from the weather web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the African region, from Feb 14 to August 2, 2020. RESULTS In African countries, the daily basis mean temperature from Feb 14, 2020 to August 2, 2020 was 26.16±0.12°C, and humidity was 57.41±0.38%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.192, p<0.001) and deaths (r= -0.213, p<0.001). Similarly, a significant inverse correlation was found between temperature and the number of cases (r= -0.25, p<0.001) and deaths (r=-0.18, p<0.001). Furthermore, the regression results showed that with 1% increase in humidity the number of cases and deaths was significantly reduced by 3.6% and 3.7% respectively. Congruently, with 1°C increase in temperature, the number of cases and deaths was also significantly reduced by 15.1% and 10.5%, respectively. CONCLUSIONS Increase in relative humidity and temperature was associated with a decrease in the number of daily cases and deaths due to COVID-19 pandemic in various African countries. The study findings on weather events and COVID-19 pandemic have an impact at African regional levels to project the incidence and mortality trends with regional weather events which will enhance public health readiness and assist in planning to fight against this pandemic.
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Affiliation(s)
- S A Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Meo SA, Abukhalaf AA, Alomar AA, Sumaya OY, Sami W, Shafi KM, Meo AS, Usmani AM, Akram J. Effect of heat and humidity on the incidence and mortality due to COVID-19 pandemic in European countries. Eur Rev Med Pharmacol Sci 2020; 24:9216-9225. [PMID: 32965017 DOI: 10.26355/eurrev_202009_22874] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The weather allied conditions have an impact on air, water, soil, food, ecosystem, feelings, behaviors, and pattern of health and disease. The present study aims to investigate the impact of heat and humidity on the daily basis incidence and mortality due to COVID-19 pandemic in European countries. MATERIALS AND METHODS We selected 10 European countries, Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus. This region has a relatively low temperature and high humidity, and has homogenous European ethnicity with almost similar socioeconomic culture and health care system. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization (WHO). The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the European region, from Jan 27, 2020 to July 17, 2020. RESULTS In 10 European countries, (Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus), the daily basis mean temperature from Jan 27, 2020 to July 17, 2020 was 17.07±0.18°C, and humidity was 54.78±0.47%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.134, p<0.001) and deaths (r= -0.126, p<0.001). Moreover, an increase in temperature was linked with an increase in the number of cases (r=0.062, p=0.013) and deaths (r=0.118, p<0.001). The regression analysis results further revealed that with an increase of 1% humidity the number of cases (β = -15.90, p<0.001) and deaths (β=-1.56, p<0.001) reduced significantly. Whereas, with an increase of 1°C in temperature the number of cases (β = 20.65, p<0.001) and deaths (β = 3.71, p<0.001) increased significantly. CONCLUSIONS Increase in relative humidity was associated with a decrease in the number of daily cases and deaths, however, a rise in temperature was allied with an upsurge in the number of daily cases and daily deaths due to COVID-19 pandemic in European countries. The study findings on weather events and COVID-19 pandemic have an impact at European regional levels to project the incidence and mortality trends with regional weather events to enhance public health readiness and assist in planning to fight against this pandemic situation.
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Affiliation(s)
- S A Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Meo SA, Abukhalaf AA, Alomar AA, Al-Beeshi IZ, Alhowikan A, Shafi KM, Meo AS, Usmani AM, Akram J. Climate and COVID-19 pandemic: effect of heat and humidity on the incidence and mortality in world's top ten hottest and top ten coldest countries. Eur Rev Med Pharmacol Sci 2020; 24:8232-8238. [PMID: 32767355 DOI: 10.26355/eurrev_202008_22513] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (β = -5.40, p<0.001) and (β = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (β = -1.35. p<0.001). CONCLUSIONS The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.
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Affiliation(s)
- S A Meo
- Department of Physiology, Strategic Centre for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia. /
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Meo SA, Klonoff DC, Akram J. Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19. Eur Rev Med Pharmacol Sci 2020; 24:4539-4547. [PMID: 32373993 DOI: 10.26355/eurrev_202004_21038] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also called COVID-19, has caused a pandemic which has swiftly involved the entire world and raised great public health concerns. The scientific community is actively exploring treatments that would potentially be effective in combating COVID-19. Hydroxychloroquine has been demonstrated to limit the replication of SARS-CoV-2 virus in vitro. In malarial pandemic countries, chloroquine is widely used to treat malaria. In malarial non-pandemic nations, chloroquine is not widely used. Chloroquine and hydroxychloroquine share similar chemical structures and mechanisms of action. The aim of this study was to indirectly investigate the efficacy of chloroquine and hydroxychloroquine for the treatment of COVID-19 by determining the prevalence of COVID-19 in malaria pandemic and non-pandemic nations. We sought evidence to support or refute the hypothesis that these drugs could show efficacy in the treatment of COVID-19. MATERIALS AND METHODS We reviewed in vitro studies, in vivo studies, original studies, clinical trials, and consensus reports, that were conducted to evaluate the antiviral activities of chloroquine and hydroxychloroquine. The studies on "COVID-19 and its allied treatment were found from World Health Organization (WHO), ISI-Web of Science, PubMed, EMBASE, Scopus, Google Scholar, and clinical trial registries. The search was based on keywords: antiviral drugs, chloroquine, hydroxychloroquine, COVID-19, COVID-19 treatment modalities, and coronavirus. In addition, we analyzed the prevalence of COVID-19 in malaria pandemic and non-pandemic countries. The review and analyses were performed on March 28, 2020. RESULTS For this study, we identified a total of 09 published articles: 03 clinical trials with sample size 150; 03 in vitro studies and 03 expert consensus reports. These studies were all suggestive that chloroquine and hydroxychloroquine can successfully treat COVID-19 infections. We found that COVID-19 infections are highly pandemic in countries where malaria is least pandemic and are least pandemic in nations where malaria is highly pandemic. CONCLUSIONS Chloroquine and hydroxychloroquine have antiviral characteristics in vitro. The findings support the hypothesis that these drugs have efficacy in the treatment of COVID-19. People are currently using these drugs for malaria. It is reasonable, given the hypothetical benefit of these two drugs, that they are now being tested in clinical trials to assess their effectiveness to combat this global health crisis.
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Affiliation(s)
- S A Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Riazuddin S, Hussain M, Razzaq A, Iqbal Z, Shahzad M, Polla DL, Song Y, van Beusekom E, Khan AA, Tomas-Roca L, Rashid M, Zahoor MY, Wissink-Lindhout WM, Basra MAR, Ansar M, Agha Z, van Heeswijk K, Rasheed F, Van de Vorst M, Veltman JA, Gilissen C, Akram J, Kleefstra T, Assir MZ, Grozeva D, Carss K, Raymond FL, O’Connor TD, Riazuddin SA, Khan SN, Ahmed ZM, de Brouwer APM, van Bokhoven H, Riazuddin S. Correction: Exome sequencing of Pakistani consanguineous families identifies 30 novel candidate genes for recessive intellectual disability. Mol Psychiatry 2020; 25:3101-3102. [PMID: 30171209 PMCID: PMC7962566 DOI: 10.1038/s41380-018-0128-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This Article was originally published under a CC BY-NC-SA 4.0 license, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the Article have been modified accordingly.
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Affiliation(s)
- S. Riazuddin
- grid.411024.20000 0001 2175 4264Department of Otorhinolaryngology—Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD USA ,grid.417348.d0000 0000 9687 8141Center for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - M. Hussain
- grid.411024.20000 0001 2175 4264Department of Otorhinolaryngology—Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD USA ,grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.412956.dAllama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan ,grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - A. Razzaq
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.412956.dAllama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan ,grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - Z. Iqbal
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.55325.340000 0004 0389 8485Present Address: Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - M. Shahzad
- grid.411024.20000 0001 2175 4264Department of Otorhinolaryngology—Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD USA ,grid.417348.d0000 0000 9687 8141Center for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - D. L. Polla
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.456760.60000 0004 0603 2599Center for Genetic Diseases, CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Y. Song
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences and Program in Personalized and Genomic Medicine, University of Maryland, School of Medicine, Baltimore, MD USA
| | - E. van Beusekom
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A. A. Khan
- grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - L. Tomas-Roca
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. Rashid
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.412956.dAllama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan ,grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - M. Y. Zahoor
- grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - W. M. Wissink-Lindhout
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. A. R. Basra
- grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - M. Ansar
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan ,grid.8591.50000 0001 2322 4988Present Address: Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Z. Agha
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.418920.60000 0004 0607 0704Department of Biosciences, Faculty of Science, COMSATS Institute of Information Technology, Islamabad, Pakistan
| | - K. van Heeswijk
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - F. Rasheed
- grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - M. Van de Vorst
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. A. Veltman
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Clinical Genetics, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C. Gilissen
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. Akram
- grid.417348.d0000 0000 9687 8141Center for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - T. Kleefstra
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. Z. Assir
- grid.412956.dAllama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan
| | - UK10K
- grid.10306.340000 0004 0606 5382The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
| | - D. Grozeva
- grid.5335.00000000121885934Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - K. Carss
- grid.5335.00000000121885934Department of Haematology, University of Cambridge, Cambridge, UK
| | - F. L. Raymond
- grid.5335.00000000121885934Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - T. D. O’Connor
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences and Program in Personalized and Genomic Medicine, University of Maryland, School of Medicine, Baltimore, MD USA
| | - S. A. Riazuddin
- grid.21107.350000 0001 2171 9311Department of Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - S. N. Khan
- grid.11173.350000 0001 0670 519XNational Centre of Excellence in Molecular Biology, University of The Punjab, Lahore, Pakistan
| | - Z. M. Ahmed
- grid.411024.20000 0001 2175 4264Department of Otorhinolaryngology—Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD USA
| | - A. P. M. de Brouwer
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H. van Bokhoven
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S. Riazuddin
- grid.417348.d0000 0000 9687 8141Center for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan ,grid.412956.dAllama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan
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Assir M, Mansoor H, Waseem T, Ahmed H, Bukhari S, Akram J. Effect of papaya leaf extract on platelet count in dengue fever: a randomized controlled trial (PLEAD Trial). Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Assir M, Kamran U, Bashir S, Ahmed H, Anees S, Akram J. Platelet transfusion in dengue fever: a randomized controlled trial. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Mushtaq MU, Majrooh MA, Ahmad W, Rizwan M, Luqman MQ, Aslam MJ, Siddiqui AM, Akram J, Shad MA. Knowledge, attitudes and practices regarding tuberculosis in two districts of Punjab, Pakistan. Int J Tuberc Lung Dis 2010; 14:303-310. [PMID: 20132621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
SETTING Pakistan ranks eighth among the world's highest tuberculosis (TB) burden countries, and Punjab province accounts for 60% of TB cases nationally. OBJECTIVE To explore knowledge, attitudes and practices regarding TB in the general population of two districts of Punjab province, and the effect of socio-economic determinants. DESIGN In a cross-sectional survey, subjects aged > or =20 years were randomly selected using multistage cluster sampling and interviewed. A knowledge score was formulated based on nine questions. Bivariate analysis using the chi(2) test was employed to independently correlate socio-economic factors with understanding of disease and information sources. Attitudes, practices and information sources were also compared with TB knowledge. RESULTS Forty-two per cent of the surveyed population had good knowledge about TB, which was associated with better education, high income and good housing (all P < 0.001). Despite the fact that the majority (82.2%) knew about correct treatment, less than half (48.8%) were aware that diagnosis and treatment were free. Intended health-seeking behaviour was determined by better education (P = 0.011), good housing (P = 0.004) and good knowledge about TB (P < 0.001). Television (69.4%) and health workers (43.6%) were the main sources of information. CONCLUSION Socio-economic factors should be considered when designing communication strategies and prioritising TB prevention and control interventions.
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Affiliation(s)
- M U Mushtaq
- Research Society, Allama Iqbal Medical College, Lahore, Pakistan.
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Akram J, Sheikh UE, Mahmood M, Donnelly R. Antihypertensive efficacy of indapamide SR in hypertensive patients uncontrolled with a background therapy: the NATIVE study. Curr Med Res Opin 2007; 23:2929-36. [PMID: 17931463 DOI: 10.1185/030079907x242674] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/23/2022]
Abstract
OBJECTIVES Antihypertensive monotherapy rarely achieves blood pressure (BP) control. NATIVE (NATrilix SR use in combInation antihypertensiVe thErapy) evaluated indapamide sustained release (SR) in hypertensive patients receiving background therapy. RESEARCH DESIGN AND METHODS Patients remaining hypertensive (systolic BP [SBP], 145-180 mmHg; diastolic BP [DBP], 95-105 mmHg) while receiving an angiotensin-converting enzyme (ACE) inhibitor (n = 709), beta-blocker (n = 629), calcium-channel blocker (CCB; n = 493), angiotensin II type 1 receptor blocker (ARB; n = 75), alpha-blocker (n = 29) or other therapy (n = 6) were enrolled, recruited by physicians from 228 centres in Pakistan. Indapamide SR 1.5 mg was administered daily for 3 months with background therapy. BP was assessed every 2 weeks, and blood glucose and total cholesterol were evaluated at baseline and study end in a patient subgroup. Adverse events were also recorded. MAIN OUTCOME MEASURES AND RESULTS Of 2073 enrolled patients (49% males; mean age 51 years), 1941 received indapamide SR and background therapy. SBP and DBP decreased significantly (SBP, 166 +/- 16 mmHg at baseline vs. 132 +/- 12 mmHg at 3 months; DBP, 102 +/- 8 mmHg vs. 83 +/- 6 mmHg; both p < 0.0001 vs. baseline). Patients uncontrolled with an ACE inhibitor, beta-blocker, CCB or ARB achieved an SBP/DBP decrease of 34 +/- 15/19 +/- 9, 33 +/- 17/19 +/- 10, 33 +/- 15/18 +/- 8 or 35 +/- 16/20 +/- 12 mmHg, respectively (all p < 0.0001). In all, 84% of patients achieved target SBP (< or = 140 mmHg) and 61% achieved BP normalisation (SBP < 140, DBP < 90 mmHg). The absence of placebo control may lead to an overestimation of the extent of the BP reduction achieved. Glucose and cholesterol levels were unaffected by indapamide SR. Four percent of patients experienced side-effects, which were mild-to-moderate in severity. CONCLUSIONS In patients with hypertension despite antihypertensive therapy, indapamide SR significantly reduced BP with a good acceptability profile. Indapamide SR may represent an effective additional therapy for patients who do not achieve BP goals with other antihypertensive agents.
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Affiliation(s)
- J Akram
- Medicine and Cardiology Dept, King Edward Medical College, Lahore 54660, Pakistan
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Kadiri A, Al-Nakhi A, El-Ghazali S, Jabbar A, Al Arouj M, Akram J, Wyatt J, Assem A, Ristic S. Treatment of type 1 diabetes with insulin lispro during Ramadan. Diabetes Metab 2001; 27:482-6. [PMID: 11547222] [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: 02/21/2023]
Abstract
OBJECTIVE To compare insulin lispro with regular human insulin with respect to blood glucose control and frequency of hypoglycaemia in patients with type 1 diabetes who wished to fast during the month of Ramadan. RESEARCH DESIGN AND METHODS Insulin lispro or regular human insulin was given together with NPH insulin, twice daily before the morning and evening meals, for two weeks each in an open-label, randomised, cross-over design, and 64 patients completed the protocol. Blood glucose was self-monitored at fasting morning and evening, and 1-h and 2-h after the post-sunset meal on three consecutive days at the end of each treatment period. RESULTS The 2-h blood glucose excursion after the post-sunset meal was significantly (p=0.026) lower with insulin lispro (2.50 +/- 0.46 mmol/l) than with regular human insulin (3.47 +/- 0.49 mmol/l). Daily insulin doses did not differ between treatments but compliance with recommended time of injection was better with insulin lispro. Hypoglycaemia incidence (insulin lispro, 15 (23.4%) patients; regular human insulin 31 (48.4%) patients; p=0.004) and frequency (insulin lispro, 0.70 +/- 0.19; regular human insulin 2.25 +/- 0.36 episodes/patient/30 days; p<0.001) were lower with insulin lispro. Five (22.7%) of the episodes during insulin lispro occurred during the nocturnal period compared with 27 (36.5%) of the episodes while on regular human insulin. CONCLUSIONS Glycaemic control, measured by postprandial glycemic excursions, was improved and hypoglycaemia was significantly reduced with insulin lispro compared with regular human insulin. Patients with type 1 diabetes who insist on fasting during Ramadan may be better managed with insulin lispro.
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Affiliation(s)
- A Kadiri
- Service d'Endocrinologie, Chu Ibn Sina Rabat, Morocco
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Abstract
AIMS To compare insulin lispro with soluble human insulin in patients with Type 2 diabetes mellitus fasting during Ramadan, with respect to the rate of hypoglycaemic episodes and postprandial blood glucose values after the main meal after sunset. METHODS The insulins were compared in an open-label, randomized, cross-over study of 70 outpatients. Hypoglycaemic episodes were recorded by the patients in a self-monitoring diary. Fasting, 1-h and 2-h postprandial blood glucose values were recorded by the patient on three consecutive days at the end of each treatment period. RESULTS The fasting blood glucose values before sunrise (P>0.4) and after sunset (P>0.6) were similar and did not differ significantly between both treatment groups. The rise in blood glucose after the main meal after sunset was 3.0+/-0.4 mmol/l after 1 h in the insulin lispro treatment group compared to 4.3+/-0.4 mmol/l in the soluble insulin treatment group (P<0.01), and 2.6+/-0.4 mmol/l after 2h with insulin lispro compared to 4.0+/-0.5 mmol/l with soluble insulin (P<0.008). Mean hypoglycaemic episodes per patient over 14 days were 1.3+/-0.1 vs. 2.6+/-0.2, P<0.002, respectively, for insulin lispro and soluble insulin. Most hypoglycaemic episodes occurred during the time period from 6 h after the before sunrise meal until breaking the fast after sunset. CONCLUSIONS The significantly lower rate of hypoglycaemic episodes combined with better control of postprandial blood glucose suggest insulin lispro may be more suitable prandial insulin for patients treated with Type 2 diabetes who fast during Ramadan.
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Affiliation(s)
- J Akram
- Akram Medical Complex, Lahore, Pakistan
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Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) recently has been reported as an outpatient pathogen. We assessed this and found our institution's frequency quite low. Only 16 patients (4%) had true community-acquired MRSA bacteremia. Ten had no recorded previous hospitalization; twelve (75%) had significant underlying medical problems. Substance abuse and prior outpatient antibiotic use were not identified as major risks for community-acquired MRSA bacteremia.
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Streian C, Luca C, Akram J. [Indications for a pacemaker implant in the sick sinus syndrome]. Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Med Interna 1985; 37:211-6. [PMID: 2865783] [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: 01/03/2023]
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