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Banu B, Khan MMH, Ali L, Barnighausen T, Sauerborn R, Souares A. Pattern and predictors of non-adherence to diabetes self-management recommendations among patients in peripheral district of Bangladesh. Trop Med Int Health 2024; 29:233-242. [PMID: 38221661 DOI: 10.1111/tmi.13966] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study was designed to determine the extent of non-adherence to the different dimensions of diabetes self-management and to identify the factors influencing non-adherence among peripheral patients in Bangladesh. METHODS A cross-sectional study was conducted among 990 adult diabetic patients residing in Thakurgaon district, Bangladesh. Data were collected through face-to-face interviews including socio-demographic information, disease and therapeutic, health services, knowledge and adherence to self-management components. RESULTS The proportion of non-adherence to drug prescription was 66.7%, dietary regimen (68.9%), physical exercise (58.0%), follow-up visit/blood glucose test (88.2%), stopping tobacco (50.6%), and regular foot care (93.9%). Significant predictors for non-adherence to drug were poorest socio-economic status (OR = 2.47), absence of diabetic complications (OR = 1.43), using non-clinical therapy (OR = 5.61), and moderate level of knowledge (OR = 1.87). Non-adherence to dietary recommendations was higher for women (OR = 1.72), poorest socio-economic status (OR = 3.17), and poor technical knowledge (OR = 4.68). Non-adherence to physical exercise was lower for women (OR = 0.62), combined family (OR = 0.63), middle socio-economic status (OR = 0.54), and moderate knowledge on physical exercise (OR = 0.55). Non-adherence to follow-up visits/blood glucose test was higher among patients who did not have diabetic complications (OR = 1.81) and with own transport (OR = 2.57), and respondents from high-income group (OR = 0.23) were less likely to be non-adherent. Non-adherence to stopping tobacco was higher for older individuals (OR = 1.86); but lower for women (OR = 0.48), individuals with higher education level (OR = 0.17) and patients sick for a longer time (OR = 0.52). Non-adherence to foot care was higher for patients who needed longer time to go to hospital (OR = 4.07) and had poor basic knowledge on diabetes (OR = 17.80). CONCLUSION An alarmingly high proportion of diabetic patients did not adhere to diabetes self-management. Major predictors for non-adherence were related to patient's demographic characteristics and their experience with disease, treatment and health care services.
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Affiliation(s)
- Bilkis Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | | | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Till Barnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Imam YZ, Chandra P, Singh R, Hakeem I, Al Sirhan S, Kotob M, Akhtar N, Kamran S, Al Jerdi S, Muhammad A, Haroon KH, Hussain S, Perkins JD, Elalamy O, Alhatou M, Ali L, Abdelmoneim MS, Joseph S, Morgan D, Uy RT, Bhutta Z, Azad A, Ayyad A, Elsotouhy A, Own A, Deleu D. Incidence, clinical features, and outcomes of posterior circulation ischemic stroke: insights from a large multiethnic stroke database. Front Neurol 2024; 15:1302298. [PMID: 38385041 PMCID: PMC10879388 DOI: 10.3389/fneur.2024.1302298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024] Open
Abstract
Background Posterior cerebral circulation ischemic stroke (PCS) comprises up to 25% of all strokes. It is characterized by variable presentation, leading to misdiagnosis and morbidity and mortality. We aim to describe PCS in large multiethnic cohorts. Methods A retrospective review of a large national stroke database from its inception on the 1st of January 2014 till 31 December 2020. Incidence per 100,000 adult population/year, demographics, clinical features, stroke location, and outcomes were retrieved. We divided the cohort into patients from MENA (Middle East and North Africa) and others. Results In total, 1,571 patients were identified. The incidence of PCS was observed to be rising and ranged from 6.3 to 13.2/100,000 adult population over the study period. Men were 82.4% of the total. The mean age was 54.9 ± 12.7 years (median 54 years, IQR 46, 63). MENA patients comprised 616 (39.2%) while others were 954 (60.7%); of these, the majority (80.5%) were from South Asia. Vascular risk factors were prevalent with 1,230 (78.3%) having hypertension, 970 (61.7%) with diabetes, and 872 (55.5%) having dyslipidemia. Weakness (944, 58.8%), dizziness (801, 50.5%), and slurred speech (584, 36.2%) were the most commonly presenting symptoms. The mean National Institute of Health Stroke Score (NIHSS) score was 3.8 ± 4.6 (median 3, IQR 1, 5). The overall most frequent stroke location was the distal location (568, 36.2%). The non-MENA cohort was younger, less vascularly burdened, and had more frequent proximal stroke location (p < 0.05). Dependency or death at discharge was seen in 39.5% and was associated with increasing age, and proximal and multilocation involvement; while at 90 days it was 27.4% and was associated with age, male sex, and having a MENA nationality (p < 0.05). Conclusion In a multiethnic cohort of posterior circulation stroke patients from the MENA region and South Asia, we noted a rising incidence over time, high prevalence of vascular risk factors, and poor outcomes in older men from the MENA region. We also uncovered considerable disparities between the MENA and non-MENA groups in stroke location and outcome. These disparities are crucial factors to consider when tailoring individualized patient care plans. Further research is needed to thoroughly investigate the underlying reasons for these variations.
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Affiliation(s)
- Yahia Z. Imam
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Prem Chandra
- Statistics, Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Cardiology Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Ishrat Hakeem
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Mona Kotob
- College of Medicine, Qatar University, Doha, Qatar
| | - Naveed Akhtar
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Saadat Kamran
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Ahmad Muhammad
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Suhail Hussain
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Jon D. Perkins
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Osama Elalamy
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohamed Alhatou
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Liaquat Ali
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Sujatha Joseph
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Deborah Morgan
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ryan Ty Uy
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Zain Bhutta
- Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Aftab Azad
- College of Medicine, Qatar University, Doha, Qatar
- Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ali Ayyad
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Elsotouhy
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Own
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
| | - Dirk Deleu
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
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Chowdhury HA, Harrison CL, Siddiquea BN, Tissera S, Afroz A, Ali L, Joham AE, Billah B. The effectiveness of diabetes self-management education intervention on glycaemic control and cardiometabolic risk in adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2024; 19:e0297328. [PMID: 38306363 PMCID: PMC10836683 DOI: 10.1371/journal.pone.0297328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/01/2024] [Indexed: 02/04/2024] Open
Abstract
Diabetes mellitus (DM) poses a significant challenge to public health. Effective diabetes self-management education (DSME) interventions may play a pivotal role in the care of people with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). A specific up-to-date systematic review is needed to assess the effect of DSME interventions on glycaemic control, cardiometabolic risk, self-management behaviours, and psychosocial well-being among T2DM across LMICs. The MEDLINE, Embase, CINAHL, Global Health, and Cochrane databases were searched on 02 August 2022 and then updated on 10 November 2023 for published randomised controlled trials (RCTs) and quasi-experimental studies. The quality of the studies was assessed, and a random-effect model was used to estimate the pooled effect of diabetes DSME intervention. Heterogeneity (I2) was tested, and subgroup analyses were performed. Egger's regression test and funnel plots were used to examine publication bias. The risk of bias of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trial (RoB 2). The overall assessment of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. A total of 5893 articles were retrieved, and 44 studies (n = 11838) from 21 LMICs met the inclusion criteria. Compared with standard care, pooled analysis showed that DSME effectively reduced the HbA1c level by 0.64% (95% CI: 0.45% to 0.83%) and 1.27% (95% CI: -0.63% to 3.17%) for RCTs and quasi-experimental design studies, respectively. Further, the findings showed an improvement in cardiometabolic risk reduction, diabetes self-management behaviours, and psychosocial well-being. This review suggests that ongoing support alongside individualised face-to-face intervention delivery is favourable for improving overall T2DM management in LMICs, with a special emphasis on countries in the lowest income group.
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Affiliation(s)
- Hasina Akhter Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sanuki Tissera
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Afsana Afroz
- Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Liaquat Ali
- Pothikrit Institute of Health Studies (PIHS), Dhaka, Bangladesh
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Departments of Endocrinology and Diabetes, Monash Health, Melbourne, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Naeem S, Ali L, Jaffar N, Khan SS, Shafiq Y, Suri S, Tahir A. Shark fish oil prevents scopolamine-induced memory impairment in an experimental model. Metab Brain Dis 2024; 39:15-27. [PMID: 38008885 DOI: 10.1007/s11011-023-01320-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023]
Abstract
Fish oil has been known for its antioxidant, cardioprotective, anti-inflammatory, and neuroprotective characteristics due to the presence of polyunsaturated fatty acids (PUFAs) that are essential for optimal brain function and mental health. The present study investigated the effect of Carcharhinus Bleekeri (Shark Fish) oil on learning and memory functions in scopolamine-induced amnesia in rats. Locomotor and memory-enhancing activity in scopolamine-induced amnesic rats was investigated by assessing the open field and passive avoidance paradigm. Forty male Albino mice were divided into 4 equal groups (n = 10) as bellow: 1 - control (received 0.9% saline), 2 - SCOP (received scopolamine 2 mg/kg for 21 days), 3 - SCOP + SFO (received scopolamine and fish oil 5 mg/kg/ day for 21 days), 4 - SCOP + Donepezil groups (received 3 mg/kg/day for 21 days). SFO produced significant (P < 0.01) locomotor and memory-enhancing activities in open-field and passive avoidance paradigm models. Additionally, SFO restored the Acetylcholine (ACh) concentration in the hippocampus (p < 0.05) and remarkably prevented the degradation of monoamines. Histology of brain tissue showed marked cellular distortion in the scopolamine-treated group, while the SFO treatment restored distortion in the brain's hippocampus region. These results suggest that the SFO significantly ameliorates scopolamine-induced spatial memory impairment by attenuating the ACh and monoamine concentrations in the rat's hippocampus.
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Affiliation(s)
- Sadaf Naeem
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan.
- Department of Pharmacology, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan.
| | - Liaquat Ali
- Department of Pharmacology, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan
| | - Nazish Jaffar
- Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Saira Saeed Khan
- Department of Pharmacology, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan
| | - Yousra Shafiq
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Sadia Suri
- Department of Pharmacology, Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
| | - Anosh Tahir
- Dow Institute of Medical Technology, Dow University of Health Sciences, Karachi, Pakistan
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Haroon KH, Ali L, Muhammad A. Super-giant fusiform basilar artery aneurysm. J R Coll Physicians Edinb 2023; 53:181-183. [PMID: 37489105 DOI: 10.1177/14782715231187440] [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] [Indexed: 07/26/2023] Open
Abstract
Intracranial aneurysms are focal pathological dilatation of the arteries with a prevalence of 3.2%. Fusiform aneurysms are rare and mainly due to dissection or atherosclerosis. They may manifestas as stroke, cranial nerve palsies, brainstem compression and Sub-arachnoid hemorrhage. A diameter greater than 10 mm is a risk factor for rupture and warrants early intervention.
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Affiliation(s)
- Khawaja Hassan Haroon
- Neuroscience Institute, Department of Neurology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
| | - Liaquat Ali
- Neuroscience Institute, Department of Neurology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
| | - Ahmad Muhammad
- Neuroscience Institute, Department of Neurology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
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Muhammad A, Ali L, Hussain S, Zafar A, Own A, Naqvi SGA, Haroon KH. An In-Depth Analysis of Medullary Strokes at a Tertiary Care Stroke Center: Incidence, Clinical and Radiological Characteristics, Etiology, Treatment, and Prognosis. Cureus 2023; 15:e43017. [PMID: 37674953 PMCID: PMC10478147 DOI: 10.7759/cureus.43017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Medullary infarctions (MI) are a rare medical entity that is classified mainly as the more commonly lateral medullary infarcts (LMI) and the less common medial medullary infarcts (MMI). Lateral medullary syndrome, also known as Wallenberg syndrome, results when the medulla oblongata is affected and predominantly occurs secondary to atherosclerotic occlusion of the vertebrobasilar arteries. Previous studies have focused more on the anatomical, clinical, and topographical aspects of medullary infarcts. We describe the incidence of their presentation, radiological findings, etiology, treatment, and outcome at our comprehensive stroke center. Material and method This is a retrospective cohort study of 108 medullary stroke patients with confirmed clinical and radiological diagnoses of MI at Hamad General Hospital, Doha, between January 1, 2018 and December 31, 2020. We evaluated the electronic medical records of all stroke patients. Result During the selected period, a total of 2,912 ischemic strokes were reported. Of these, 843 (28.8%) were posterior circulation strokes. Only 108 (3.7%) patients had medullary strokes. Commonly encountered neurological features were dizziness (94.4%), limb ataxia (84.3%), dysarthria (44.4%), ipsilateral facial sensory loss (32.4%), headache (32.4%), contralateral limb sensory loss (25%), ipsilateral hemiparesis (24%), dysphagia (19.4%), and hiccups (13%). Most strokes reported were either minor (73% with National Institutes of Health Stroke Scale [NIHSS] 1-4) or moderate (26% with NIHSS 5-15). LMIs (87.9%) were the most common, followed by medial paramedian MI (10%). Twenty-five percent had extramedullary involvement, predominantly of the cerebellum (17.6%). Out of the total number of patients, 44 (40.7%) had large vessel atherosclerotic disease, followed by 41 (37.6%) whose stroke was due to small vessel disease, 15 (13.8 %) due to undetermined etiology, and 6 (5.5%) due to arterial dissection. Twenty-eight patients (25.4%) underwent 48-hour Holter monitoring, which detected atrial fibrillation in two patients (1.85%). The majority of patients (98.2%, or 106 patients) received antiplatelet therapy, while 68.5% (74 patients) received single antiplatelet therapy (SAPT), and 29.6% (32 patients) received dual antiplatelet therapy (DAPT). Noteworthy is that only 2.7% (three patients) received thrombolysis as an acute reperfusion therapy. Forty-seven percent (51 patients) were discharged home (mRS 0-2), and 51.9% (56 patients) were transferred to rehabilitation facilities. Follow-up assessments were performed at the stroke clinic for 57.4% (62) of the patients. The assessments found that 46 of the follow-up patients were functionally independent at that time (mRS 0-2). Conclusion This is the first large local study of medullary strokes to determine their frequency, presentation, etiology, treatment, and clinical outcome. Medullary strokes represent 3.7% of total ischemic strokes at our comprehensive stroke center. MI is rare and could present with a variety of neurological and non-specific symptoms that mimic common benign conditions. Prompt and early recognition with a high index of suspicion, the use of posterior NIHSS (POST-NIHSS), and urgent MRI-diffusion-weighted imaging (DWI) of the brain in acute settings can improve early diagnosis and the rate of reperfusion therapy. Further studies are needed to enable the early recognition and treatment of medullary infarcts.
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Affiliation(s)
- Ahmad Muhammad
- Neurology, Hamad General Hospital, Doha, QAT
- Neurology, Weill Cornell Medicine - Qatar, Doha, QAT
| | - Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT
- Neurology, Weill Cornell Medicine - Qatar, Doha, QAT
| | | | | | - Ahmed Own
- Neuroradiology, Neurosciences Institute, Doha, QAT
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Ali L, Sharif M, Naqvi SGA, Mohammed I, Baig MA, Sidratul Muntaha K, Chalil AR, Ali H, Aweida HA, Iqrar A. To Study the Correlation of Clinical Severity and Cytokine Storm in COVID-19 Pulmonary Embolism Patients by Using Computed Tomography Pulmonary Angiography (CTPA) Qanadli Clot Burden Scoring System. Cureus 2023; 15:e39263. [PMID: 37342749 PMCID: PMC10278873 DOI: 10.7759/cureus.39263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Pulmonary embolism (PE) is a fatal form of venous thromboembolism (VTE), with an overall untreated mortality of up to 30%. Greater than 50% of patients with lower extremity proximal DVT have concurrent PE at presentation. VTE has been seen in up to one-third of patients with COVID-19 infections requiring intensive care unit (ICU) admission. The objective of this study is to determine the correlation between CT pulmonary angiography, pulmonary embolism clot burden, and the Qanadli scoring system with clinically severe COVID-19 pneumonia and cytokine storm. MATERIAL AND METHOD 153 COVID-19 hospitalized patients who underwent CT pulmonary angiography (CTPA) for likely PE on pretest probability modified Wells criteria were enrolled. COVID-19 pneumonia was classified as URTI (upper respiratory tract infection), mild, severe, and critical COVID pneumonia. For data analysis, we categorized into two groups: (1) the non-severe group included URTI and mild pneumonia, and (2) the severe group included severe and critical pneumonia. We used the Qanadli scoring system to assess the PE percentages of pulmonary vascular obstruction using CTPA. Results: 41.8% (64) of COVID-19 patients were diagnosed with pulmonary embolism (PE) on CTPA. The majority of 51.6% of pulmonary vascular occlusions using the Qanadli scoring system for pulmonary embolism were at segmental arterial levels. Out of 104 COVID-19 cytokine storm patients, 45 (43%) were associated with pulmonary embolism. Overall, a 25% (16) mortality rate was observed in COVID-19 patients with pulmonary embolism. DISCUSSION The pathogenesis of hypercoagulability in COVID-19 may include direct endothelial cell invasion by the virus, microvascular inflammation, endothelial exocytosis, and endotheliitis. A meta-analysis of 71 studies to investigate the occurrence of PE on CTPA in COVID-19 patients found 48.6% in ICU settings and 65.3% of patients have clots in the peripheral pulmonary vasculature. CONCLUSIONS There is a significant correlation between pulmonary embolism and high clot burden Qanadli CTPA scores, as well as between the severity of COVID-19 pneumonia and mortality. The association between critically ill COVID-19 pneumonia and pulmonary embolism may result in higher mortality and a poor prognostic marker.
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Affiliation(s)
- Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT
- Neurology, Weill Cornell Medicine-Qatar, Doha, QAT
| | | | | | | | | | | | | | - Hanna Ali
- Medicine, Hamad General Hospital, Doha, QAT
| | | | - Ambreen Iqrar
- Neurology, Aga Khan University Hospital, Karachi, PAK
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Siddiquea BN, Afroz A, Chowdhury MRK, Savira F, Alif SM, Bhattacharya O, Hossain MN, Ali L, Chowdhury HA, Shetty A, Islam MS, Billah B. Knowledge, attitudes and practices of COVID-19 in rural Bangladesh: a cross-sectional study. BMJ Open 2023; 13:e064754. [PMID: 36792336 PMCID: PMC9933131 DOI: 10.1136/bmjopen-2022-064754] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES Understanding the knowledge, attitudes and practices (KAP) of COVID-19 within distinct populations may aid further public health messaging. This study's aims were to explore KAP towards COVID-19 in rural Bangladesh and identify any potential links to sociodemographics, existing clinical conditions and sources of information. DESIGN Cross-sectional community-based study. SETTING Participants were recruited from 18 villages using multistage cluster random sampling. METHODS Data were collected through face-to-face interviews, from June to November 2021, using a structured questionnaire. Data included sociodemographics, clinical conditions, sources of information and KAP of COVID-19 questions. Χ2 test, multiple logistic regression and correlation analyses were performed. RESULTS A total of 1603 participants were included with mean ages of 42.3±14.2 years, ranging from 18 to 60 years. Of these, 51% were male, 42.2% had secondary education and 45% had comorbidities. Television was the main source of COVID-19 information (55.8%). The overall correct response rate of KAP questions was 90%, 78% and 59%, respectively. In stepwise multiple logistic regression, good knowledge was associated with higher education (adjusted OR (AOR): 4.61, 95% CI: 2.40 to 8.85, p<0.001), employment, high body mass index (overweight and obese) and trust in the sources of information. Being female (AOR: 1.48, 95% CI: 1.19 to 1.85, p<0.001), having depression (AOR: 1.80, 95% CI: 1.34 to 2.43, p<0.001), being a past smoker and sources of information (family members/friends/relatives/neighbours) were associated with positive attitudes. Good practices were associated with older age (AOR: 1.52, 95% CI: 1.10 to 2.11, p=0.01), higher education (AOR: 2.78, 95% CI: 1.58 to 4.89, p<0.001) and having anxiety, while current smokers and fully vaccinated people were less likely to be engaged in good practices. Positive significant correlations between domains of KAP were observed as well as between past vaccination KAP and COVID-19 KAP. CONCLUSION This study uncovered gaps in understanding and practices, and identified targeted intervention especially for young and less educated people using mass media to promote updated knowledge regarding COVID-19 and the efficacy of preventive practices.
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Affiliation(s)
- Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Afsana Afroz
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Biochemistry and Pharmacology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mohammad Rocky Khan Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Feby Savira
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Sheikh M Alif
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Oashe Bhattacharya
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Md Nassif Hossain
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Liaquat Ali
- Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Hasina Akhter Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Aishwarya Shetty
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Md Shariful Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Mondal R, Banik PC, Faruque M, Mashreky SR, Ali L. Association of exposure to salinity in groundwater with chronic kidney disease among diabetic population in Bangladesh. PLoS One 2023; 18:e0284126. [PMID: 37040382 PMCID: PMC10089349 DOI: 10.1371/journal.pone.0284126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/24/2023] [Indexed: 04/12/2023] Open
Abstract
Globally, chronic kidney disease (CKD) is one of the major public health concerns. CKD and renal failure are reported to be high in the areas with higher salinity, however, the association is still unclear. We aimed at assessing the association of degree of groundwater salinity with CKD among diabetic populations of two selected areas in Bangladesh. This cross-sectional analytic study was carried out among 356 diabetic patients aged 40-60 years in high groundwater salinity exposed Pirojpur (n = 151) and non-exposed Dinajpur (n = 205), the southern and northern districts of Bangladesh, respectively. The primary outcome was the presence of CKD (via estimated glomerular filtration rate <60 ml/min) using Modification of Diet in Renal Disease equation. Binary logistic regression analyses were done. In non-exposed (mean age 51.2±6.9 years) and exposed (mean age 50.8±6.9 years) respondents, men (57.6%) and women (62.9%) were predominant, respectively. The proportion of patients with CKD was found to be higher in the exposed group than that of the non-exposed group (33.1% vs. 26.8%; P 0.199). The odds (OR [95% confidence interval]; P) of CKD were not found to be significantly higher in high salinity exposed respondents (1.35 [0.85-2.14]; 0.199), compared to the non-exposed. However, the odds of hypertension were found to be significantly higher in high salinity exposed respondents (2.10 [1.37-3.23]; 0.001), compared to the non-exposed. And, the interaction of high salinity and hypertension showed a significant association with CKD (P = 0.009). In conclusion, the findings suggest that groundwater salinity may not be directly associated with CKD in southern Bangladesh, however, it may have an indirect association with the disorder through the association of hypertension with groundwater salinity. Further large scaled studies are required to answer the research hypothesis more clearly.
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Affiliation(s)
- Rajib Mondal
- Department of Public Health, Hamdard University Bangladesh, Munshiganj, Bangladesh
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Mithila Faruque
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Liaquat Ali
- Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
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10
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Rahman MM, Salim SI, Khan I, Hossain KM, Ali L, Hassan Z. Angiotensinogen Gene M235T and T174M Polymorphisms in Diabetic Nephropathy in a Bangladeshi Population. Avicenna J Med Biochem 2022. [DOI: 10.34172/ajmb.2022.2358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Marker gene polymorphisms linked with the renin-angiotensin-aldosterone system (RAAS) have been broadly studied in diabetic nephropathy (DN) patients considering that RAAS is a potential drug target to slow down kidney disease progression. Objectives: The aim of the present study was to determine the link between M235T and T174M variants of angiotensinogen (AGT) gene and DN. Methods: A total of 93 patients with DN, mean age of 56±8 years, systolic blood pressure (SBP) of 141±14, and diastolic blood pressure (DBP) of 84±7 mm Hg (mean±SD) were investigated, among whom 59 patients had a family history of type 2 diabetes mellitus. A total of 96 healthy subjects served as the control group with no family history of diabetic nephropathy (FHDN) and type 2 diabetes mellitus, a mean age of 47±10 years, SBP of 126±11, and DBP of 76±6 mm Hg. PCR–restriction fragment length polymorphism was employed for genotyping M235T and T174M molecular variants. Results: Genotype frequencies of the variants M235T (χ2=2.038, P=0.361) and T174M (χ2=2.952, P=0.229) did not show any statistically significant association with type 2 diabetic nephropathy (T2DN) compared to the control. Based on FHDN and family history of diabetes mellitus (FHDM), the frequency of genotypes of M235T marker (P=0.360) in FHDN, and (P=0.886) FHDM; T174M marker (P=0.641) in FHDN, and (P=0.425) FHDM also did not show any statistically significant association with T2DN compared to the controls. Conclusion: M235T and T174M variants were not associated with DN in a Bangladeshi population.
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Affiliation(s)
- Md. Mizanur Rahman
- Department of Medicine, Division of Nephrology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, T6G2G3, Canada
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna-9208, Bangladesh
| | - Shahidul Islam Salim
- Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka-1000, Bangladesh
| | - Imran Khan
- Incepta Vaccines Limited, Dhaka, Bangladesh
| | - Khondoker Moazzem Hossain
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna-9208, Bangladesh
| | - Liaquat Ali
- Department of Biochemistry & Cell Biology, Bangladesh University of Health Sciences, 125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh
- Department of Research & Development, Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Zahid Hassan
- Department of Physiology & Molecular Biology, Bangladesh University of Health Sciences, 125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh
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11
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Savira F, Alif SM, Afroz A, Siddiquea BN, Shetty A, Chowdhury HA, Bhattacharya O, Chowdhury MRK, Islam MS, Ali L, Billah B. Evaluation of COVID-19 vaccine acceptance and uptake in rural Bangladesh: a cross-sectional study. BMJ Open 2022; 12:e064468. [PMID: 36523245 PMCID: PMC9748515 DOI: 10.1136/bmjopen-2022-064468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the acceptance and uptake of COVID-19 vaccines in rural Bangladesh. DESIGN This was a cross-sectional study conducted between June and November 2021. SETTING This study was conducted in rural Bangladesh. PARTICIPANTS People older than 18 years of age, not pregnant and no history of surgery for the last 3 months were eligible to participate. PRIMARY AND SECONDARY OUTCOMES The primary outcomes were proportions of COVID-19 vaccine acceptance and roll-out participation among the rural population. The secondary outcome was identification of correlates which contributed to COVID-19 vaccine acceptance and roll-out participation. Χ2 tests and multivariable logistic regression analyses were performed to identify relevant correlates such as sociodemographic factors, clinical conditions and COVID-19-related factors. RESULTS A total of 1603 participants were enrolled. The overall COVID-19 vaccine acceptance was very high (1521/1601, 95%), and half of the participants received at least one dose of the COVID-19 vaccine. Majority of participants wanted to keep others safe (89%) and agreed to the benefits of COVID-19 vaccines (88%). To fulfil the requirement of online registration for the vaccine at the time, 62% of participants had to visit an internet café and only 31% downloaded the app. Over half (54%) of participants were unaware of countries they knew and trust to produce the COVID-19 vaccine. Increased age, being housewives, underweight and undergraduate education level were associated with vaccine acceptance, while being female, increased age and being overweight/obese were associated with vaccine uptake. Trust in the health department and practical knowledge regarding COVID-19 vaccines were positively associated with both vaccine acceptance and uptake. CONCLUSION This study found a very high COVID-19 vaccine acceptance in rural Bangladesh. Policymakers should support interventions aimed at increasing vaccine and general health literacy and ensure ongoing vaccine supply and improvement of infrastructure in rural areas.
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Affiliation(s)
- Feby Savira
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Sheikh M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Afsana Afroz
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre of Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bodrun Naher Siddiquea
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Aishwarya Shetty
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hasina Akhter Chowdhury
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Oashe Bhattacharya
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Md Shariful Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
| | - Liaquat Ali
- Pothikrit Institute of Health Studies, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Baki Billah
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Ali L, Malik SH, Ahmed K, Nasir S. Chronic Pelvic Pain; a tragic miss. Anaesth pain intensive care 2022. [DOI: 10.35975/apic.v26i6.2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Chronic pelvic pain is defined as pain in the perineal region that can be somatic or visceral in origin which persists for more than 6 months duration and is unresponsive to analgesic therapy. Its diagnosis is made on the basis of patient’s history, detailed physical examination and radiological studies. One of the important, rare and mostly missed cause of this pain is coccydynia either traumatic or atraumatic. The treatment of coccydynia includes supportive care, analgesic therapy as well as ganglion impar neurolysis.
Here, we report a case of a 42-year-old female suffering from severe chronic pelvic pain for past 15 years for which she had taken multiple analgesics including opiates and underwent multiple surgeries without any relief.
She was a misdiagnosed case of coccygeal fracture which was causing chronic pelvic pain for the past 15 years which when treated with ganglion impar neurolysis gave her complete pain relief.
After 1 month of the intervention, on follow up in the pain clinic the patient was absolutely pain free with NRS 1/10.Coccydynia must be considered in differential diagnosis of chronic pelvic pain especially in females of child bearing age.
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13
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Ali L, Alhatou M, Adeli G, Elalamy O, Zada Y, Mohammed I, Sharif M, Noor Illahi M, Naeem M, Iqrar A. Lesion Localization and Prognosis Using Electrodiagnostic Studies in Facial Diplegia: A Rare Variant of Guillain-Barre Syndrome. Cureus 2022; 14:e25047. [PMID: 35719795 PMCID: PMC9200109 DOI: 10.7759/cureus.25047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background The etiology of facial nerve palsy is diverse and includes herpes zoster virus, Guillain-Barre syndrome (GBS), otitis media, Lyme disease, sarcoidosis, human immunodeficiency virus, etc. The lower motor neuron type facial nerve palsy is usually caused by an ipsilateral facial nerve lesion; however, it may be caused by a central lesion of the facial nerve nucleus and tract in the pons. Facial diplegia is an extremely rare condition that occurs in approximately 0.3% to 2.0% of all facial palsies. Electrodiagnostic studies including direct facial nerve conduction, facial electromyography (EMG), and blink reflex studies are useful for the prognosis and lesion localization in facial nerve palsy. Methodology This retrospective, observational study was conducted at the Neurophysiology Unit, Hamad General Hospital, Doha, Qatar. This study included 11 patients with bilateral facial weakness who visited for electrodiagnostic studies in the neurophysiology laboratory. Results In total, eight (72.7%) patients had facial diplegia, eight (72.7%) had hypo/areflexia, seven (63.6%) had facial numbness, and five (45.5%) had cerebrospinal fluid albuminocytological dissociation. The most frequent cause of facial diplegia in this study was GBS (81.9%). Direct facial nerve conduction stimulation showed that nine (81.8%) patients had bilateral facial nerve low compound muscle action potential amplitudes. The bilateral blink reflex study showed that eight (88.8%) patients had absent bilateral evoked responses. Finally, the EMG study showed that five (55.5%) patients had active denervation in bilateral sample facial muscles. Conclusions Bilateral facial nerve palsy is an extremely rare condition with a varied etiology. Electrodiagnostic studies are useful in detecting the underlying pathophysiologic processes, prognosis, and central or peripheral lesion localization in patients with facial diplegia.
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14
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Allerby K, Goulding A, Ali L, Waern M. Increasing person-centeredness in psychosis inpatient care: staff experiences from the Person-Centered Psychosis Care (PCPC) project. BMC Health Serv Res 2022; 22:596. [PMID: 35505358 PMCID: PMC9066767 DOI: 10.1186/s12913-022-08008-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background Interventions to increase person-centeredness in hospital care for persons with psychotic illness are needed. Changing care delivery is however a complex venture, requiring staff to reconsider their mindsets and ways of working. A multidisciplinary educational intervention for hospital staff at four wards was launched to increase person-centeredness in the care of patients with schizophrenia and similar psychoses. This study aims to explore staff experiences of working to increase person-centeredness. Methods A heterogenic sample of staff (n = 23) from all participating wards were recruited for six focus group interviews. Semi-structured questions covered staff perceptions of person-centered care and the process of increasing person-centeredness. Transcribed data was analyzed using thematic analysis according to Braun and Clarke. Results Staff viewed person-centered care as an approach rather than a method. They described central aspects of person-centered care, such as recognizing the patient as a capable person who can participate in her/his care. Statements further showed how these core features were put into practice. Changes related to the intervention were presented in terms of evolving patient and staff roles, improved contact with patients, more flexible care routines, and a more positive ward climate. Neither psychotic symptoms nor involuntary status were considered barriers for person-centered care, but organizational factors beyond staff control seemed to impact on implementation. Conclusions After implementation, participants displayed good understanding of the core concepts of person-centered care in both thinking and action. They attributed several improvements in the care milieu to an increased level of person-centeredness. Psychotic behavior and involuntary treatment did not present major barriers to person-centered care. Findings suggest person-centered care is feasible in the psychosis inpatient setting and could improve quality of care. Trial registration The study is part of a larger study evaluating the intervention Person-Centered Psychosis Care (PCPC). It was registered retrospectively at clinicaltrials.gov, identifier NCT03182283.
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Affiliation(s)
- K Allerby
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden. .,Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden. .,Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden.
| | - A Goulding
- Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - L Ali
- Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden.,Region Västra Götaland, Psychiatry Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - M Waern
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden.,Region Västra Götaland, Psychosis Department, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden.,Institute of Health Care Sciences, Centre for Person-Centered Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden
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15
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Wadiwala MF, Ali L, Khan A, Alhatou M. The great imposter: A case report of IgG4‐RD hypertrophic pachymeningitis with skull lytic lesion and pulmonary nodules. Clin Case Rep 2022; 10:e05470. [PMID: 35414929 PMCID: PMC8978985 DOI: 10.1002/ccr3.5470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 12/24/2022] Open
Abstract
Immunoglobulin G4‐related disease (Ig4RD) is an inflammatory condition with unique clinical, serological, and pathological features. In this study, we report a challenging diagnostic clinical case of Ig4RD diagnosed based on histopathology. This unique imitating nature reinforces that it is crucial to consider the diagnosis of IgG4‐RD in those presenting with pachymeningitis.
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Affiliation(s)
| | - Liaquat Ali
- Neurology Department and Neuroscience Institute Hamad Medical Corporation Doha Qatar
| | - Adnan Khan
- Research Division Department of Medicine Weill Cornell Medicine‐Qatar Doha Qatar
| | - Mohammad Alhatou
- Neurology Section Al Khor Hospital Hamad Medical Corporation Doha Qatar
- Neurology Department and Neuroscience Institute Hamad Medical Corporation Doha Qatar
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16
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Ahmad F, Ali L, Ahmed M, Yasrab M, Khusdil A. Thoracic Epidural Versus General Anaesthesia For Laparoscopic Cholecystectomy: A Randomized Controlled Trial. J Ayub Med Coll Abbottabad 2022; 34:279-282. [PMID: 35576286 DOI: 10.55519/jamc-02-9071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Laparoscopic cholecystectomy is one of the most commonly performed surgeries worldwide. Aim of our study was to compare the effectiveness of thoracic epidural anaesthesia with general anaesthesia for Laparoscopic cholecystectomy in terms of changes in blood pressure during surgery, postoperative pain, respiratory complications and average length of hospital stay. It was a randomized controlled trial conducted from 1stOctober 2018 to 31st October 2019. METHODS Eightytwo patients planned to undergo elective laparoscopic cholecystectomy were randomly divided into two groups, T and G. In Group T all patients underwent laparoscopic cholecystectomy under thoracic epidural anaesthesia with 12 ml of 0.25% bupivacaine and 1% lignocaine plain whereas in group G all patients underwent surgery under general anaesthesia. Intra-operative mean arterial pressure (MAP) and postoperative opioid consumption in first 24hrs were recorded as primary outcomes whereas presence or absence of respiratory complication and duration of hospital stay as secondary outcome.. RESULTS Out of 82 patients, 41 patients underwent laparoscopic cholecystectomy under thoracic epidural anaesthesia and 41 patients had surgery under general anaesthesia. Mean arterial pressure was lower in Group T and the difference was statistically significant. The average time of first complaint of postoperative pain in Group T was 5.4±1.26 hours as compared to less than 0.79±0.25 hours in Group G. Patients in group T required lower doses of opioid analgesia in first twenty-four hours as compared to patients in group G. Mean hospital stay in group T was 1 day as compared to 3 days in group G. CONCLUSIONS Thoracic epidural anaesthesia provides a better alternative to general anaesthesia for Laparoscopic cholecystectomy with lower intraoperative mean arterial blood pressure, 24 hours postoperative consumption of opioids, respiratory complications and length of hospital stay.
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Affiliation(s)
- Fariha Ahmad
- Department of Anesthesiology, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | - Liaquat Ali
- Department of Anesthesiology, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | - Madiha Ahmed
- Department of Gynecology, City Med Hospital Rawalpindi,Pakistan
| | - Mohammed Yasrab
- Department of Anesthesiology, Combined Military Hospital, Sargodha, Pakistan
| | - Arshad Khusdil
- Department of Pediatrics, Combined Military Hospital, Quetta,Pakistan
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17
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Ali L, Muhammad A, Khan A, Mohammed I, Janjua I, Zada Y, Sharif M, Naeem M, Iqrar A, Haroon KH. Acute Neurological Manifestations of COVID-19 Patients From Three Tertiary Care Hospitals in Qatar. Cureus 2022; 14:e23150. [PMID: 35433146 PMCID: PMC9007182 DOI: 10.7759/cureus.23150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction Worldwide, there are more than 424 million confirmed cases of COVID-19. Most of the hospitalized critical COVID-19 patients manifested neurological signs and symptoms and higher mortality. The majority of COVID-19 fatalities occurred mostly in patients with advanced age and underlying medical comorbidities. This is the first local retrospective study in Qatar, which reported neurologic manifestations (48.5%) of hospitalized COVID-19 patients. The primary objective of this study is to evaluate acute neurological manifestations in COVID-19 hospitalized patients in the country. Methods This is a retrospective, observational study of 413 hospitalized COVID-19 patients. They were admitted to three different COVID-19 designated hospitals (Hazm Mebaireek, Ras Laffan, and Cuban tertiary care Hospitals) under the Hamad Medical Corporation, Qatar from 1st January 2020, to 31 January 2021. We evaluated electronic medical records of these patients and data were collected while their neurological manifestations were confirmed by two trained neurologists. These neurologic manifestations were categorized into three major groups: central nervous system (CNS), peripheral nervous system (PNS), and neuromuscular system. Results Of 413 patients, 94% (389) were male and 6% (24) were female; the mean age was 52 years. Among all different nationalities of COVID-19 patients, 20.3% (84) were Indian, 12.5% (52) were Bangladeshi, 10.1% (42) were Qatari and 9.2% (38) were Nepali. The most common symptoms at the onset of COVID-19 illness were as follows: 77.5% (321) had a fever, 67.4% (279) experienced cough, 58.7% (243) experienced shortness of breath and 26.1% (108) developed a sore throat. Overall 48.5% (201) patients developed different neurologic manifestations. The most common neurologic symptoms were myalgia (28%; 116), headache (10.4%; 43), dizziness (5.8%; 24) and hemiparesis due to strokes (5.3%; 22). In this study, the most common risk factors were hypertension (47.6%), diabetes (46.9%), obesity (21%), chronic kidney disease (10%), ischemic heart disease (9.7%), and smoking (6.8%). About 45.2% (187) patients were admitted to MICU and 8.5% (35) died due to COVID-19 complications. Significant other extrapulmonary multiorgan system involvement were skeletal muscle injury (39.4%), kidney injury (36.7%), liver injury (27.5%), myocardial injury (23.9%), rhabdomyolysis (15.7%) heart failure (11.4%) and acute pancreatitis (11.1%). Discussion The most common neurologic signs and symptoms were myalgia, headache, dizziness, and strokes, mainly due to large vessel thrombosis, lacunar, and posterior circulation strokes. Conclusions Patients with COVID-19 are at high risk of developing neurological manifestations. The most common COVID-19-related acute neurological manifestations were myalgia, headache, dizziness, and acute ischemic stroke. Prompt recognition, early diagnosis, and appropriate management of these manifestations could potentially lead to better patient outcomes in COVID-19 patients.
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Hashimoto T, Kunieda T, Honda T, Scalzo F, Ali L, Hinman J, Rao N, Nour M, Bahr-Hosseini M, Saver J, Raychev R, Liebeskind D. Reduced Leukoaraiosis, Noncardiac Embolic Stroke Etiology, and Shorter Thrombus Length Indicate Good Leptomeningeal Collateral Flow in Embolic Large-Vessel Occlusion. AJNR Am J Neuroradiol 2022; 43:63-69. [PMID: 34794948 PMCID: PMC8757540 DOI: 10.3174/ajnr.a7360] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Acute leptomeningeal collateral flow is vital for maintaining perfusion to penumbral tissue in acute ischemic stroke caused by large-vessel occlusion. In this study, we aimed to investigate the clinically available indicators of leptomeningeal collateral variability in embolic large-vessel occlusion. MATERIALS AND METHODS Among prospectively registered consecutive patients with acute embolic anterior circulation large-vessel occlusion treated with thrombectomy, we analyzed 108 patients admitted from January 2015 to December 2019 who underwent evaluation of leptomeningeal collateral status on pretreatment CTA. Clinical characteristics, extent of leukoaraiosis on MR imaging, embolic stroke subtype, time of imaging, occlusive thrombus characteristics, presenting stroke severity, and clinical outcome were collected. The clinical indicators of good collateral status (>50% collateral filling of the occluded territory) were analyzed using multivariate logistic regression analysis. RESULTS Good collateral status was present in 67 patients (62%) and associated with independent functional outcomes at 3 months. Reduced leukoaraiosis (total Fazekas score, 0-2) was positively related to good collateral status (OR, 9.57; 95% CI, 2.49-47.75), while the cardioembolic stroke mechanism was inversely related to good collateral status (OR, 0.17; 95% CI, 0.02-0.87). In 82 patients with cardioembolic stroke, shorter thrombus length (OR, 0.91 per millimeter increase; 95% CI, 0.82-0.99) and reduced leukoaraiosis (OR, 5.79; 95% CI, 1.40-29.61) were independently related to good collateral status. CONCLUSIONS Among patients with embolic large-vessel occlusion, reduced leukoaraiosis, noncardiac embolism mechanisms including embolisms of arterial or undetermined origin, and shorter thrombus length in cardioembolism are indicators of good collateral flow.
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Affiliation(s)
- T. Hashimoto
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - T. Kunieda
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - T. Honda
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - F. Scalzo
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - L. Ali
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - J.D. Hinman
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - N.M. Rao
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - M. Nour
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - M. Bahr-Hosseini
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - J.L. Saver
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - R. Raychev
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - D. Liebeskind
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
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Ali L, Jahangiri FR, Ali A, Belkhair S, Elalamy O, Adeli G, Alghazow M, Krishnan R, Karim F, Iqrar A, Raza A. Emerging Super-specialty of Neurology: Intraoperative Neurophysiological Monitoring (IONM) and Experience in Various Neurosurgeries at a Tertiary Care Hospital in Doha, Qatar. Cureus 2021; 13:e20432. [PMID: 35047269 PMCID: PMC8759984 DOI: 10.7759/cureus.20432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Intraoperative neurophysiological monitoring (IONM) helps in better patient outcomes by minimizing risks related to the functional status of the nervous system during surgical procedures. An IONM alert to the surgical team during the surgery can help them identify the cause and take immediate corrective action. IONM confers possible benefits, including improved surgical morbidity and mortality, better patient care, minimal neurological deficits, reduced hospital stay, medical costs, and litigation risk. In addition, a highly skilled IONM team will make a better patient outcome. Methods We retrospectively reviewed 62 consecutive patients who underwent intracranial and spinal neurosurgical procedures. Multimodality IONM was utilized, including somatosensory evoked potentials, transcranial electrical motor evoked potential, spontaneous and triggered electromyography, electroencephalography, electrocorticography, cortical sensory mapping, and direct electrical cortical stimulation. Of a total of 62 patients, two patients revealed neurotonic EMG discharges during IONM, and most patients woke up without any new neurological deficit. Results Sixty-two patients were included, ranging from age 5 to 77 years (mean 43.5 years), with 54.8% men and 45.2% female. Multimodality IONM was used in all patients. Two EMG alerts were recorded during IONM, during a brain tumor resection, and right acetabular hip surgery with postoperative right foot drop. Conclusion Multimodality IONM is the gold standard of care for any surgical services and is used as real-time monitoring of functional integrity of neural structures at risk. If utilized by trained and expert teams, numerous surgeries may benefit from multimodality intraoperative neurophysiologic monitoring.
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Ali L, Mohammed I, Janjua I, Naeem M, Adeli G, Elalamy O, Alhatou M, Akhtar N, Canibano B, Iqrar A. Acute Myocardial Injury and Rhabdomyolysis in COVID-19 Patients: Incidence and Mortality. Cureus 2021; 13:e18899. [PMID: 34804738 PMCID: PMC8599434 DOI: 10.7759/cureus.18899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background Myocardial injury has been defined as an elevated troponin level. The frequency of acute myocardial injury of hospitalized coronavirus disease 2019 (COVID-19) patients ranges from 7% to 36%. COVID-19 patients with cardiovascular disease (CVD) have a four-fold higher risk of mortality (odds ratio, 4.33; CI 95%, 3.16-5.94). In COVID-19 hospitalized patients' study showed mortality rate was 18.5%. Rhabdomyolysis is considered as muscle necrosis and the release of intracellular muscles elements and enzymes into blood. In one of retrospective cohort study of COVID-19 hospitalized patients, incidence of rhabdomyolysis was 16.7%. Materials and methods This retrospective observational study consisted of 413 COVID-19 hospitalized patients. Patients with rhabdomyolysis was defined as creatine kinase level greater than 1,000 U/L and acute myocardial injury was defined as serum high-sensitivity troponin-T for males greater than 30 ng/l and for female greater than 20 ng/l. The primary outcome was in-hospital mortality of COVID-19 patients with acute myocardial injury and rhabdomyolysis. Results The incidence of acute myocardial injury and rhabdomyolysis in hospitalized COVID-19 patients was 23.9% (99) and 15.7% (65), respectively. The mortality rate of in hospitalized COVID-19 patients who developed acute myocardial injury (28.3%) was significantly higher in comparison to patients who developed rhabdomyolysis (13.8%). Discussion The binding of SARS-CoV-2 virus to the angiotensin-converting enzyme 2 (ACE2) is a critical step in the pathophysiology in patients with COVID-19. There may be diverse direct and indirect mechanisms of acute myocardial injury in COVID-19 including ischemic injury, hypoxic injury (MI type 2), direct viral myocarditis, stress cardiomyopathy and systemic cytokine storm. Musculoskeletal injury may be caused by direct viral myositis or indirectly by host immune hyperinflammatory cytokine storm response that leads to skeletal muscle fiber proteolysis and fibrosis. Conclusions Acute myocardial injury and rhabdomyolysis were underreported in COVID-19 patients. The incidence and mortality of acute myocardial injury are higher than that of rhabdomyolysis in COVID-19 hospitalized patients. The outcome was worse in COVID-19 patients with severe acute myocardial injury. Patients with acute myocardial injury and rhabdomyolysis may get benefits from rehabilitation programs.
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Affiliation(s)
- Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT.,Neurology, Weill Cornell Medicine, Doha, QAT
| | | | - Imran Janjua
- Internal Medicine, Hamad General Hospital, Doha, QAT
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Nadeem S, Iqbal S, Javed M, Ahmad MN, Alsaab HO, Awwad NS, Ibrahium HA, Ibrar A, Mohyuddin A, Haroon SM, Ali L. Kinetic and Isothermal Studies on the Adsorptive Removal of Direct Yellow 12 Dye from Wastewater Using Propionic Acid Treated Bagasse. ChemistrySelect 2021. [DOI: 10.1002/slct.202103509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Sohail Nadeem
- Department of Chemistry Scholl of Science University of Management and Technology Lahore Pakistan
| | - Shahid Iqbal
- Department of Chemistry School of Natural Sciences (SNS) National University of Science and Technology (NUST), H-12 Islamabad 46000 Pakistan
| | - Mohsin Javed
- Department of Chemistry Scholl of Science University of Management and Technology Lahore Pakistan
| | - Mirza Nadeem Ahmad
- Department of Applied Chemistry Government College University Faisalabad Pakistan
| | - Hashem O. Alsaab
- Department of Pharmaceutics and Pharmaceutical Technology Taif University, P.O. Box 11099 Taif 21944 Saudi Arabia
| | - Nasser S. Awwad
- Research Center for Advanced Materials Science (RCAMS) King Khalid University, P.O. Box 9004 Abha 61413 Saudi Arabia
| | - Hala A. Ibrahium
- Research Center for Advanced Materials Science (RCAMS) King Khalid University, P.O. Box 9004 Abha 61413 Saudi Arabia
- Department of Semi Pilot Plant Nuclear Materials Authority, P.O. Box 530 El Maadi Egypt
| | - Aliya Ibrar
- Department of Chemistry Faculty of Natural Sciences The University of Haripur Haripur KPK 22620 Pakistan
| | - Ayesha Mohyuddin
- Department of Chemistry Scholl of Science University of Management and Technology Lahore Pakistan
| | - Shah Muhammad Haroon
- Department of Chemistry Scholl of Science University of Management and Technology Lahore Pakistan
| | - Liaquat Ali
- Department of Applied Chemistry Government College University Faisalabad Pakistan
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Ali L, Mohammed I, Zada Y, Salem H, Iqrar A. COVID-19-Associated Acute Transverse Myelitis: A Case Series of a Rare Neurologic Condition. Cureus 2021; 13:e18551. [PMID: 34754695 PMCID: PMC8571429 DOI: 10.7759/cureus.18551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 11/05/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection is not confined to the respiratory system, but has also shown extra-pulmonary invasion including the nervous system. About 36.4% of hospitalized patients in China with confirmed coronavirus disease 2019 (COVID-19) infection had neurological manifestations. SARS-CoV-2 virus enters the human body through angiotensin converting enzyme-2 (ACE-2) receptors on the surface of human cells and causes disease. ACE2 receptors are also expressed on the surface of spinal cord cells. More rare neurologic conditions have been reported in the literature to be associated with COVID-19 such as acute transverse myelitis (ATM), Guillain Barre syndrome, acute flaccid myelitis, etc. We report two cases of confirmed COVID-19 who presented four to five days of their COVID-19 symptoms and progressive bilateral lower limb weakness and urinary retention. ATM is an acquired spinal cord disorder. ATM is a relatively common neurological complication of COVID-19, accounting for 1.2% of all neurological complications associated with COVID-19. The mechanism by which COVID-19 causes ATM is not completely understood but has been assumed to be due to the structural resemblance of RNA viruses. Entrance of SARS-CoV-2 to the nervous system can take place through two pathways, either directly or indirectly. The direct pathway is through trans-synaptic transmission from the peripheral nervous system or by hematogenous spread into the blood-brain barrier through ACE-2, while the indirect pathway is through a systemic immune response.
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Affiliation(s)
- Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT.,Neurology, Weill Cornell Medicine-Qatar, Doha, QAT
| | | | - Yasin Zada
- Internal Medicine, Hamad General Hospital, Doha, QAT
| | - Haya Salem
- Medicine, College of Medicine, Qatar University, Doha, QAT
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Ali L, Naeem M, Canibano B, John A, Iqrar A. Bilateral Acute Optic Perineuritis Associated With COVID-19 in a Patient With Seronegative Myelin Oligodendrocyte Glycoprotein (MOG) Antibody. Cureus 2021; 13:e18234. [PMID: 34712522 PMCID: PMC8542256 DOI: 10.7759/cureus.18234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/30/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) may cause various neuro-ophthalmologic manifestations including optic perineuritis. Optic perineuritis is a rare form of orbital inflammatory disease in which optic nerve sheath is inflamed and nonspecific fibrotic thickening with classic radiological finding is a perineural enhancement of optic nerve sheath. A 45-year-old gentleman with known diabetes mellitus, hypertension and dyslipidemia was admitted with a critically ill COVID-19 infection. During the recovery period, the patient developed sudden onset of painless loss of vision. MRI head and orbit with gadolinium was suggestive of optic perineuritis. Other secondary causes of autoimmune or vasculitis myelin oligodendrocyte glycoprotein (MOG) antibody disease and other common central nervous system (CNS) infection were excluded. The patient had dramatic response with steroids. This is the first rare case report of COVID-19-related optic perineuritis in critically ill COVID-19 patients with seronegative MOG antibody. Optic perineuritis is a rare orbital inflammatory disease and underlying mechanisms may arise from systemic response to COVID-19 infection as well as direct effects of the virus via angiotensin-converting enzyme 2 (ACE-2) receptors on ocular tissues. Optic perineuritis is a rare disease with inflammation restricted to the optic nerve sheath. Neuroimaging of the brain and orbit is the most important modality of choice for visualizing optic nerve sheath and optic nerve. Delay in the diagnosis of COVID-19-related optic perineuritis, may result in permanent optic nerve injury and irreversible vision loss.
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Affiliation(s)
- Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT.,Neurology, Weill Cornell Medicine-Qatar, Doha, QAT
| | | | | | - Anju John
- Internal Medicine, Hamad General Hospital, Doha, QAT
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Ali L, Bukhari S. An Approach Based on Mutually Informed Neural Networks to Optimize the Generalization Capabilities of Decision Support Systems Developed for Heart Failure Prediction. Ing Rech Biomed 2021. [DOI: 10.1016/j.irbm.2020.04.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ali L, Safan A, Kamran S, Akhtar N, Elalamy O. Acute Thromboembolic Ischemic Stroke From Complex Aortic Arch Plaque. Cureus 2021; 13:e16977. [PMID: 34540387 PMCID: PMC8423320 DOI: 10.7759/cureus.16977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 12/04/2022] Open
Abstract
Atherosclerosis is a systemic pathologic process, may involve aorta and is important cause of systemic embolization. The risk of embolism is increased for mobile and complex aortic plaques that are >4 mm thick. The most common manifestations are stroke, transient ischemic attack (TIA) and peripheral embolization. Imaging modalities used include transesophageal echocardiogram (TEE), CT angiography and magnetic resonance angiography (MRA). The mainstays of medical treatment are antiplatelets and statin. The role of anticoagulation is reserved for plaques with thrombotic component. There were two patients who presented with large acute ischemic stroke with high grade, floating aortic arch thrombus and complex aortic arch plaques. In one of cases, after 10-day follow-up CT aortic angiography showed completely resolved thrombus after being treated with IV tissue plasminogen activator (TPA) followed by low molecular weight heparin (LMWH). The risk of embolism depends on size of aortic plaques and mobility. TEE is modality of choice for thoracic aortic plaques. Aortic plaques >4 mm are independent predictors of recurrent ischemic stroke. There are limited data available for off-label use of intravenous thrombolysis and mechanical thrombectomy (MT) in presence of aortic arch thrombus in acute ischemic strokes. These two case reports help in recognition of aortic arch complex plaques as independent risk factor for recurrent stroke. The right patients may consider about the use of intravenous alteplase and MT performed via trans-brachial access after excluding aortic dissection and aneurysm. In future, multicenter, randomized controlled trials will be required for safety of IV TPA and MT.
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Affiliation(s)
- Liaquat Ali
- Neurology, Hamad General Hospital, Doha, QAT
| | - Abeer Safan
- Neurology, Hamad Medical Corporation, Doha, QAT
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Shetty A, Afroz A, Ali L, Siddiquea BN, Sumanta M, Billah B. Health-related quality of life among people with type 2 diabetes mellitus - A multicentre study in Bangladesh. Diabetes Metab Syndr 2021; 15:102255. [PMID: 34479101 DOI: 10.1016/j.dsx.2021.102255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 06/03/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 11/21/2022]
Abstract
AIMS This study aimed to explore the health-related quality of life and the various demographics and clinical characteristics associated with it among people with type 2 diabetes mellitus in Bangladesh. METHODS A total of 1253 participants with type 2 diabetes were recruited from a cross-sectional and retrospective study conducted in Bangladesh in 2017. Participants were recruited from six rural and urban diabetes hospitals. The health-related quality of life of the participants was assessed using the validated EuroQol-5D-5L scale and EuroQol-VAS score. Information was collected via face-to-face interviews and existing medical records. Data was analysed using univariate and multivariable regression analyses with bootstrap resampling. RESULTS The average health-related quality of life was 0.64 (±0.20) for EQ-5D-5L score and 61.69 (±34.98) for EQ-VAS score. Old age, low income, low education level, residing in an urban area, longer duration of diabetes, being physically inactive, the presence of macro- and/or micro-vascular complications, impaired cognitive function, being depressed and having anxiety were related to poor health-related quality of life. CONCLUSION The health-related quality of life among people with type 2 diabetes in Bangladesh is low, and various socio-demographic and psychological factors and diabetes-related complications are associated with it. This finding will help reform treatments and enforce lifestyle modifications to ensure that the burden of diabetes on people's quality of life is minimal.
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Affiliation(s)
- Aishwarya Shetty
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Afsana Afroz
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Liaquat Ali
- Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Bodrun N Siddiquea
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Baki Billah
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Ali M, Iqbal R, Waseem M, Ali L, Talib T, Khawar M. EFFICACY OF TWO APPROACHES OF TRANSFORAMINAL EPIDURAL INJECTIONS IN PATIENTS OF LUMBAR RADICULOPATHY. PAFMJ 2021. [DOI: 10.51253/pafmj.v71i4.5704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective: To determine the efficacy of transforaminal epidural steroid injection (TFESI) using conventional versus Kambin’s triangle approaches in patients of lumbar radiculopathy.
Study Design: Quasi experimental study.
Place and Duration of Study: Department of Pain Medicine, Combined Military Hospital Rawalpindi Pakistan, from Oct 2019 to Apr 2020.
Methodology: Eighty patients suffering from lumbar radiculopathy fulfilling the inclusion criteria were included in this study and were randomly assigned to undergo transforaminal epidural steroid injection using either conventional approach (group C) or the Kambin’s triangle (group K) approach. Pain scores and patient satisfaction levels were recorded at 4 and 8 weeks after the procedure.
Results: In both groups, the pain score (group C pre-procedure NRS =7.28 ± 1.26 vs post-procedure NRS = 2.14 ± 0.81, group K pre-procedure NRS = 7.33 ± 1.16 vs post-procedure NRS=2.70 ± 0.94) and patient satisfaction improved 4 and 8 weeks after the procedure. The pain score (p-value=0.21) and patient satisfaction score (p-value=0.88) however were not significantly different between groups.
Conclusion: This study demonstrated that using conventional or Kambin’s approach exhibits no difference in decreasing pain score or patient satisfaction level.
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Ahmad K, Ali L, Maan MAM. THE EFFECTS OF INJECTING INTRA ARTICULAR PLATELET-RICH PLASMA ON PAIN SCORES IN KNEE JOINT OSTEOARTHRITIS. PAFMJ 2021. [DOI: 10.51253/pafmj.v71i4.4791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective: To determine the effects of intra articular platelet rich plasma (PRP) injection on level of pain of knee joint in patients with knee osteoarthritis.
Study Design: Prospective observational study.
Place and Duration of Study: Combined Military Hospital Rawalpindi, from Aug 2018 to Jan 2019.
Methodology: Forty patients with pain due to knee osteoarthritis for intra-articular injection were included in this observational clinical trial after informed consent and fulfilling inclusion criteria. After measuring pain by numerical rating scale, patients received intra articular platelet rich plasma (10ml) therapy in affected knee under fluoroscopy. Using the Numerical rating scale level of pain was evaluated and recorded for each patient at different intervals.
Results: There was dramatic improvement in pain score after first and second injection of platelet rich plasma. There was 33.33% improvement at 3rd week, 54.32% at 6th week and 71.60% at 6th month.
Conclusion: Platelet rich plasma is safe, cost effective and minimally invasive in reducing pain scores and functional limitation in knee osteoarthritis.
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Nayeem J, Chowdhury HA, Afroze N, Mili US, Ali L. Proportion and predictors of SMBG use among type 2 diabetic subjects in three tertiary care hospitals in Dhaka City. Heliyon 2021; 7:e07619. [PMID: 34355103 PMCID: PMC8321936 DOI: 10.1016/j.heliyon.2021.e07619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 10/08/2020] [Accepted: 07/14/2021] [Indexed: 11/28/2022] Open
Abstract
Aims The aim was to find out the proportion of Self-monitoring of Blood Glucose (SMBG) Users and factors affecting the nonuse in three large hospitals of Dhaka city. Methods Under an observational cross-sectional design 598 type 2 diabetic subjects were recruited (convenient sampling) from the OPDs of 3 large tertiary care hospitals [one public hospital (PUBH), one Not-for-profit Hospital (NFPPH), and one For-profit private hospital (FPPH)] in Dhaka City. Data were analyzed by both univariate and multivariate analysis as appropriate. Results Overall 71% of subjects were SMBG Nonusers (PUBH 86%, NFPPH 67%, and FPPH 46%). Monthly income status and advice showed the highest impact (OR 4.66 and 3.74 respectively) on the use. Physicians (54%), relatives (34%), and friends (8.2%) were the major sources of advice. Irregular diabetes check-up and distrust of results were also among the major reasons for not using SMBG among the Nonusers. Conclusion Nearly three-fourth of type 2 diabetic patients in Dhaka city do not use SMBG and the proportion is especially high in public hospitals. Poor income status of patients, lack of coordinated advice/motivation by Caregivers, irregularity in diabetes checking, and distrust on results are major predictors for not using SMBG by the patients.
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Affiliation(s)
- Jannatul Nayeem
- Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam, Mirpur-1, Dhaka, Bangladesh
| | - Hasina Akhter Chowdhury
- Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam, Mirpur-1, Dhaka, Bangladesh
| | - Nowrin Afroze
- Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam, Mirpur-1, Dhaka, Bangladesh
| | - Umme Sadia Mili
- Department of Diabetology & Endocrinology, Bangladesh Institute of Health Sciences & Hospital, 125/1 Darussalam, Mirpur-1, Dhaka, Bangladesh
| | - Liaquat Ali
- Pothikrit Institute of Health Studies, Sangskriti Bikash Kendra Bhaban, 1/E/1, Paribagh, Dhaka 1000, Bangladesh
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Haq IU, Mehmood Z, Afzal T, Khan N, Ahmed B, Nawsherwan, Ali L, Khan A, Muhammad J, Khan EA, Khan J, Zakki SA, Xu J, Shu Y. Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan. BRAZ J BIOL 2021; 82:e249971. [PMID: 34259717 DOI: 10.1590/1519-6984.249971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/13/2021] [Indexed: 11/22/2022] Open
Abstract
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
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Affiliation(s)
- I Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Z Mehmood
- Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Pakistan
| | - T Afzal
- Basic Health Unit Rakhi Mounh, Tehsil Koh-e-Suleman, District Health Authority Dera Ghazi Khan, Pakistan
| | - N Khan
- Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department Khyber Pakhtunkhwa, Pakistan
| | - B Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Nawsherwan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, China
| | - L Ali
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - A Khan
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Muhammad
- Department of Microbiology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - E A Khan
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - J Khan
- Department of Agriculture, University of Swabi, Khyber Pakhtunkhwa, Pakistan
| | - S A Zakki
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Shu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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Riaz BK, Ahmad SA, Islam MZ, Ali L. Community Clinic in Bangladesh: Empowering women through utilization and participation. APJHM 2021. [DOI: 10.24083/apjhm.v16i2.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Community Clinics (CC) has been established to provide basic healthcare services at the doorstep of the community people in Bangladesh. Besides health care, government has taken a development program through CC to improve maternal health care with an aim to reduce the maternal mortality. This study was an attempt to find out the role of community women in the utilization and participation of CC management.
Methods: This cross-sectional study was carried out in 32 randomly selected CCs from 16 randomly selected districts. A total of 63 service providers, 2238 service users (patients) and 3285 community members were included as the respondents of this study. For data collection respondents were interviewed face to face by using a pretested questionnaire.
Results: The majority of the service providers of the CC were from the local community, and a higher proportion of them were female (52.4%). The providers provided healthcare services both in CC and at community level. A total of 2238 patients visited the 32 studied CCs per day for getting treatment and significantly a higher proportion of them were female (71.2%). Most of the patients (83.0%) expressed satisfaction with the services provided in the CCs and most of them were female (83.8%). Of the total 3285 respondents, 60.3% were the women from the catchment communities. The activities of the CC were known by all of them (98.3%) and they participated in the management of CC.
Conclusions: The study revealed that because of utilization and participation in the management of CC, the women became an imperative person in the community, thus empowering them in healthcare development.
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Farooqi MI, Chandra Banik P, Saleh F, Ali L, Baqa K, Fawwad A, Hakeem R, Basit A. Macronutrient intake and association with the risk factors of diabetic complications among people with type 2 diabetes. Clinical Epidemiology and Global Health 2021. [DOI: 10.1016/j.cegh.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Faruque M, Barua L, Banik PC, Sultana S, Biswas A, Alim A, Gupta PKS, Ali L. Prevalence of non-communicable disease risk factors among nurses and para-health professionals working at primary healthcare level of Bangladesh: a cross-sectional study. BMJ Open 2021; 11:e043298. [PMID: 33741665 PMCID: PMC7986941 DOI: 10.1136/bmjopen-2020-043298] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To determine the prevalence of non-communicable disease (NCD) risk factors among nurses and para-health professionals (PHPs) working at primary healthcare centres in Bangladesh. In addition to this, we also investigated the association of these risk factors with the categories of health professions. DESIGN Cross-sectional study and the sampling technique was a census. SETTING The study site was a medical university of Bangladesh where the study population was recruited by NCD Control Programme of Directorate General of Health Services to participate in a 3-day training session from November 2017 to May 2018. PARTICIPANTS A total of 1942 government-employed senior staff nurses (SSNs) and PHPs working at Upazila Health Complexes. PRIMARY AND SECONDARY OUTCOME MEASURES The data were collected using a modified STEPwise approach to NCD risk factors surveillance questionnaire of the World Health Organisation (V.3.2). The prevalence of NCD risk factors was presented descriptively and the χ² test was used to determine the association between NCD risk factors distribution and categories of health professions. RESULTS The mean age of the participants was 37.6 years (SD 9.5) and most of them (87.6%) had a diploma in their respective fields. Physical inactivity (86.9%), inadequate fruits and/vegetable intake (56.3%) and added salt intake (35.6%) were the most prevalent behavioural risk factors. The prevalence of central obesity, overweight, raised blood glucose and raised BP were 83.5%, 42.6%, 19.2% and 12.8% respectively. Overall, the NCD risk factors prevalence was higher among PHPs compared with SSNs. A highly significant association (p<0.001) was found between risk factors and the categories of health professions for tobacco use, alcohol intake, added salt intake and physical inactivity. CONCLUSION High NCD risk factors prevalence and its significant association with SSNs and PHPs demand an appropriate risk-reduction strategy to minimise the possibility of chronic illness among them.
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Affiliation(s)
- Mithila Faruque
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Lingkan Barua
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Sharmin Sultana
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Animesh Biswas
- Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Abdul Alim
- Noncommunicable Disease Control Program, Directorate General of Health Service, Government of the People's Republic of Bangladesh, Dhaka, Bangladesh
| | | | - Liaquat Ali
- Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Naeem S, Ali L, Ikram R, Khan SS, Shareef H, Shafiq Y, Alam N, Adil A. Comparative antioxidant and analgesic effect of sesame oil, fish oil and their combination in experimental animal model. Pak J Pharm Sci 2021; 34:499-506. [PMID: 34275822] [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: 06/13/2023]
Abstract
Natural oils are rich in polyunsaturated fatty acids (PUFs) like omega 3, omega 6 and other nutrients that boost physical and mental health. Traditionally these oils have been used to treat joint pain associated with several inflammatory conditions. In this study, we investigated the antioxidant and analgesic properties of the sesame oil (SO), fish oil (FO) and combination of these two oils (SO+FO). Different concentrations of the SO, FO and SO+FO combination 0.02-4mg/ml were used for assessing the free radical scavenging activity by DPPH method and the IC50 value was calculated. Acetic acid-induced abdominal writhing test, tail immersion and hot plate models were used to determined analgesic effect. Results showed that both oils were well tolerated as no signs of toxicity or death were noticed during the observational study period. SO+FO combination showed the best antioxidant properties as shown by DPPH assay. Similarly in analgesic models, SO and FO significantly reduced the number of abdominal contractions (p<0.05) however, SO+FO (1:1) exhibited highly significant results (p<0.001) in writhing reflex test. Furthermore, SO and FO both increased the reaction time on a hot plate as well as in tail flick test (p<0.05) whereas, SO+FO significantly increased reaction time (p<0.001) in hot plate and in tail flick test as compared to SO and FO single treatments. Conclusively, our results suggest that the combination of both oils (SO+FO) exhibited significant antioxidant and analgesic potential that it could be considered as one of the active combinations for relieving pain in adjunctive treatment for joint pain associated with rheumatoid arthritis.
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Affiliation(s)
- Sadaf Naeem
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Liaquat Ali
- Department of Pharmacology, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan
| | - Rahila Ikram
- Department of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Saira Saeed Khan
- Department of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Huma Shareef
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Yousra Shafiq
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Nausheen Alam
- Department of Pharmacology, Faculty of Pharmacy, Federal Urdu University Science and Technology, Karachi, Pakistan
| | - Anum Adil
- Department of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
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Barua L, Faruque M, Chowdhury HA, Banik PC, Ali L. Health-related quality of life and its predictors among the type 2 diabetes population of Bangladesh: A nation-wide cross-sectional study. J Diabetes Investig 2021; 12:277-285. [PMID: 32564501 PMCID: PMC7858106 DOI: 10.1111/jdi.13331] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/29/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to assess the health-related quality of life (HRQoL) and identify its predictors among type 2 diabetes patients of Bangladesh. MATERIALS AND METHODS This nationwide cross-sectional study assessed HRQoL among 1,806 type 2 diabetes patients using the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L), and the responses were further translated into a single summary crosswalk index score using the UK time trade-off value set. The predictors were determined using multinomial logistic regression analysis. RESULTS The mean EQ-5D-5L index score was 0.62 (standard deviation 0.25), and men scored better than women. More than half of the study participants (53.4%) were ranked as "average" HRQoL. Overall, 64% of respondents had a "problem" at least in one of the dimensions of the EQ-5D-5L, and the burden of reported "problems" was higher among women (70%). Among the five dimensions, the highest reported "problem" was 79.8% for anxiety/depression, 77.7% for pain/discomfort and 60.1% for mobility. However, younger participants (aged <30 years) showed a higher burden of anxiety/depression (95%) compared with the rest of the population. The specific predictors of average/good HRQoL (odds ratio >1) were being men, living in a rural area, married, literate, a monthly income >19,488 BDT, absence of comorbidity and had a duration of diabetes ≤5 years. CONCLUSIONS The majority of Bangladesh's type 2 diabetes patients had an "average" HRQoL based on the EQ-5D-5L index score. In broad terms, the identified predictors were sex, place of residence, marital status, literacy, monthly income, comorbidity and duration of diabetes.
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Affiliation(s)
- Lingkan Barua
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Mithila Faruque
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | | | - Palash Chandra Banik
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Liaquat Ali
- Department of Biochemistry and Cell BiologyBangladesh University of Health Sciences (BUHS)DhakaBangladesh
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Ali L, Akhter A, Saeed M, Khalid U, Rehmani J. COMPARISON OF INTRAVENOUS LIGNOCAINE VS NALBUPHINE IN ATTENUATION OF HEMODYNAMIC RESPONSE TO AWAKE TRACHEAL EXTUBATION IN ENT SURGERIES. PAFMJ 2021. [DOI: 10.51253/pafmj.v71isuppl-1.2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective: To compare intravenous lignocaine vs. intravenous nalbuphine in terms of mean change in heart rate and mean arterial pressures (MAP) during awake tracheal extubation.
Study Design: Randomized control trial.
Place and Duration of Study: Main Operation Theatre, Combined Military Hospital Rawalpindi, from May 2016to Dec 2016.
Methodology: After approval of the study by the institution’s research ethics committee, the patients meetinginclusion criteria were assigned randomly to one of the two groups by lottery method. On return of spontaneous ventilation, patients in group L received intravenous lignocaine 1.5 mg/kg while group N patients received intravenous Nalbuphine 0.2mg/kg. Data recorded immediately (T1) and 5min after (T2) extubation.
Results: After stratification of data in terms of age, gender, duration of surgery and ASA classification, evaluation of hemodynamic parameters (HR and MAP) between the two groups was done. The mean change in HR in group L was 6.66 ± 1.53 bpm and in group N was 4.43 ± 1.35. The mean change in MAP in group L was 4.90 ± 1.49 mm of Hg and in group N was 3.23 ± 1.33. p-value in both parameters was found to be less than 0.05 and thus declared significant.Conclusion: We concluded that intravenous nalbuphine, in the dose of 0.2mg/kg, is a better attenuator ofhemodynamic response to extubation as compared to intravenous lignocaine and provides better stability ofHeart rate and Mean arterial Pressure.
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Wahiduzzaman M, Hossain S, Islam SM, Banning F, Ali L, Lechner A. Knowledge on diabetes and its determinants among type 2 diabetic subjects in a low-resource setting: A cross-sectional study in a tertiary care hospital in Bangladesh. J Diabetol 2021. [DOI: 10.4103/jod.jod_87_20] [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: 11/04/2022] Open
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Hossain MS, Hasan MK, Shoeb M, Mamun MIR, Nahar N, Ali L, Mosihuzzaman M, Rokeya B, Chaudhury HS. Antidiabetic Activity of Momordica charantia L. and Mechanism of Insulin Secretion of 1-Butanol Soluble Part on Type 2 Diabetic Model Rats. Dhaka Univ J Pharm Sci 2020; 19:111-117. [DOI: 10.3329/dujps.v19i2.50625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Abstract
The in vivo effects of fruit pulp juice (MC-PJ) of Momordica charantia and its 1-butanol soluble part (MC-BP) and aqueous soluble part (MC-AP) on blood glucose of type 2 diabetic rats were studied. In vitro insulin secretion in response to MC-BP and MC-AP from whole perfused pancreas was measured. For elucidating the mechanism of insulinotropic action, the insulin secretory activity of MC-BP in the presence of 11 mM glucose, 50 μM verapamil (Ca++ channel blocker), 8 mM diazoxide (K+ ATP channel opener) and 10 mM theophylline (cAMP phosphodiesterase inhibitor) were studied. Serum glucose was measured by glucose oxidase-peroxidase method and rat insulin was assayed by specific ELISA. In the in vivo study, MC-BP significantly opposed the rise of serum glucose compared to control at 105 min (p<0.05). Although the MC-AP and MC-PJ lowered the serum glucose both at 60 and 105 min, these were not statistically significant. In the in vitro study, only MC-BP produced 22-fold increase in insulin secretion from the perfused pancreas at nonstimulatory glucose level, which was significant (basal vs. MC-BP, 0.071±0.009 vs. 1.563±0.150 ng/ml, p<0.001). The MC-BP also enhanced the insulin secretion from the glucose-stimulated pancreas (p<0.001). The MC-BP induced insulin secretion was not affected in presence of diazoxide and verapamil. The obtained results also showed that MC-BP enhanced the insulin secretory effect of theophylline (p<0.001). The findings indicate that MC-BP has stimulatory effects on physiological pathways of insulin secretion which may underlie its reported antidiabetic action.
Dhaka Univ. J. Pharm. Sci. 19(2): 111-117, 2020 (December)
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Schnitzler J, Hoogeveen R, Ali L, Prange K, Weeghel M, Versloot M, Waissi F, Houtkooper R, De Kleijn D, De Winther M, Koschinsky M, Tsimikas S, Witztum J, Stroes E, Kroon J. Atherogenic lipoprotein(A) increases vascular glycolysis, thereby facilitating inflammation and leukocyte extravasation. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zeba Z, Fatema K, Sumit AF, Zinnat R, Ali L. Early screening of chronic kidney disease patients among the asymptomatic adult population in Bangladesh. J Prev Epidemiol 2020. [DOI: 10.34172/jpe.2020.10] [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: 11/09/2022] Open
Abstract
Introduction: Early identification of chronic kidney disease (CKD) provides valuable opportunities for effective interventions that reduce the risk of outcomes, particularly renal failure. Objectives: This study aimed to screen the Bangladeshi asymptomatic adult population for CKD to identify potential risk factors for its development. Patients and Methods: The screening program was carried out among the 400 subjects in the Thakurgaon district of Bangladesh to identify people with the risk of CKD. All the subjects were asymptomatic and previously been never diagnosed with kidney diseases. Demographic data were collected by a structured questionnaire. Urinary protein was tested by dipstick method, and serum creatinine was measured by an auto-analyzer. Estimated glomerular filtration rate (eGFR) was calculated by using standard formula. CKD was diagnosed and classified according to the National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. Results: A total of 18.2% respondents were found to have likely CKD to whom 82% were in stage 1 and 18% were in stage 2. The majority of the likely CKD respondents (30.1%) were in age >60 years. The prevalence of proteinuria was significantly (P=0.0001) higher among previously documented CKD patients compared to the control group. Logistic analysis revealed that after adjustments, CKD showed a significant association with diabetes mellitus (ORs: 7.46, P=0.00), smoking (ORs: 2.36, P=0.02), obesity (ORs: 3.98, P=0.00) and hypertension (ORs: 1.16, P=0.66) compared to control. Conclusion: A substantial number of adults were found to be unaware of the existence of CKD hence, large-scale prevention programs should be undertaken to reduce the classical risk factors of these disorders.
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Affiliation(s)
- Zebunnesa Zeba
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh
| | - Kaniz Fatema
- Centre for Health Equity Training Research & Evaluation (CHETRE), UNSW, Sydney, Australia
| | - Ahmed Faisal Sumit
- Department of Genetic Engineering and Biotechnology, University of Dhaka, , Dhaka, Bangladesh
| | - Rahelee Zinnat
- Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Liaquat Ali
- Pothikrit Centre for Health Studies (PCHS), Sangckriti Bikash Bhaban 1/E/1 Paribag, Dhaka, Bangladesh
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Javaid A, Majid A, Aslam S, Ali L, Razaq MK, Bukhari SNI, Shaikh A, Rizwan A. Maternal and Fetal Outcome of Pregnant Patients Having Preexisting Cardiovascular Disease. Cureus 2020; 12:e9563. [PMID: 32905531 PMCID: PMC7473608 DOI: 10.7759/cureus.9563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Cardiovascular disease is common in woman of all age, including child bearing age. In this study, we aim to compare maternal and fetal outcome in pregnant woman with and without preexisting cardiovascular disease. Methods This case control single center study was conducted by Obstetrics & Gynecology department and Cardiology department Shaikh Zayed Medical College/Hospital Rahimyar Khan from 1st March 2020 to 30th June 2020. Results Pregnant woman with preexisting cardiovascular disease had more preterm births and newborn with lower birth weight. Maternal and fetal deaths were numerical higher in pregnant women with preexisting cardiovascular disease but statistically non-significant compared to woman without preexisting cardiovascular disease. Conclusion It is important to identify underlying cardiovascular disease in pregnant woman. Proper counselling throughout pregnancy is needed and efforts should be made to minimize risk of maternal and fetal complications.
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Affiliation(s)
- Aamir Javaid
- Cardiology, Shaikh Zayed Medical College, Rahimyar Khan, PAK
| | - Abdul Majid
- Cardiology, Shaikh Zayed Medical College, Rahimyar Khan, PAK
| | - Shahida Aslam
- Cardiology, Shaikh Zayed Medical College, Rahimyar Khan, PAK
| | - Liaquat Ali
- Cardiology, Nishtar Hospital Medical University, Multan, PAK
| | | | | | - Anam Shaikh
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Amber Rizwan
- Family Medicine, Dr. Ruth Pfau Hospital, Karachi, PAK
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Ahmad Z, Ali L, Ahmed H, Shah AH, Andrabi SMH. Superoxide Dismutase in Extender Improves the in vitro Quality and in vivo Fertility of Cryopreserved Water Buffalo (Bubalus bubalis) Spermatozoa. Cryo Letters 2020; 41:194-201. [PMID: 33988647] [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: 06/12/2023]
Abstract
BACKGROUND Superoxide dismutase (SOD) as an antioxidant in semen extender may be used for the cryopreservation of buffalo spermatozoa and in vivo fertility. OBJECTIVE This study was aimed to evaluate the effects of SOD (SOD1, 100 IU/mL; SOD2, 200 IU/mL; SOD3, 300 IU/mL) and control (0.0) in Tris citric acid extender on in vitro quality and in vivo fertility of cryopreserved water buffalo bull spermatozoa. MATERIALS AND METHODS Semen collection was carried out on a weekly basis (four bulls, three replicates, and n = 24 ejaculates). The conventional freezing of semen loaded straws (0.5 mL) was undertaken by placing them horizontally on a steel rack inside a Styrofoam box for 10 min containing liquid nitrogen (LN2) vapours, and plunging into a liquid nitrogen tank (-196 °C) for storage, followed by thawing at 37 °C for 30 s and analysis by computer-assisted sperm analyzer (CASA) and other assays. RESULTS At post-dilution, the acrosome integrity (ACR-I, %) was significantly improved (P < 0.05) in extender supplemented with SOD3 as compared to other experimental groups. In addition, DNA integrity (DNA-I, %) was significantly higher (P < 0.05) in SOD1 and SOD3 compared to SOD2 and control. At post-thawing, the mean values of sperm progressive motility (PM, %), average path velocity (VAP, µm/s) and straight line velocity (VSL, µm/s) were significantly higher (P < 0.05) in extender supplemented with SOD3 compared to the control. At post-thawing, mean values of subjective motility (SM, %), plasma membrane integrity (PMI, %) and ACR-I were significantly higher (P < 0.05) in extender supplemented with SOD3 compared to the control. At post-thawing, sperm DNA-I was significantly higher (P < 0.05) in extender supplemented with all SOD doses compared to the control in a dose-dependent manner. The in vivo fertility rate (%) was significantly higher with SOD3 compared to the control (68.2 % vs. 49.5 %). CONCLUSION The supplementation of SOD3 (300 IU/mL) in Tris citric acid extender improves both in vitro quality and in vivo fertility of buffalo bull spermatozoa.
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Affiliation(s)
- Z Ahmad
- Animal Reproduction Laboratory, Animal Sciences Institute, National Agricultural Research Center, Islamabad, Pakistan
| | - L Ali
- Animal Reproduction Laboratory, Animal Sciences Institute, National Agricultural Research Center, Islamabad, Pakistan
| | - H Ahmed
- Animal Reproduction Laboratory, Animal Sciences Institute, National Agricultural Research Center, Islamabad, Pakistan
| | - A H Shah
- Animal Reproduction Laboratory, Animal Sciences Institute, National Agricultural Research Center, Islamabad, Pakistan
| | - S M H Andrabi
- Animal Reproduction Laboratory, Animal Sciences Institute, National Agricultural Research Center, Islamabad, Pakistan.
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Yasmin F, Nahar N, Banu B, Ali L, Sauerborn R, Souares A. The influence of mobile phone-based health reminders on patient adherence to medications and healthy lifestyle recommendations for effective management of diabetes type 2: a randomized control trial in Dhaka, Bangladesh. BMC Health Serv Res 2020; 20:520. [PMID: 32513164 PMCID: PMC7282058 DOI: 10.1186/s12913-020-05387-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/01/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In 2017, 80% of 425 million adults with diabetes worldwide were living in low and middle-income countries. Diabetes affected 6.9 million adults in Bangladesh and accounted for 3% of the country's total mortality. Proper management of diabetes is the key to positive health outcomes. This study investigated how mobile phone-based health intervention could increase patient adherence and thereby improve the disease outcomes for diabetes type 2 in Bangladesh. METHODS A mobile phone-based health project (including mobile phone reminders and 24/7 call center) was implemented in Dhaka District, Bangladesh from January to December 2014. A randomized control trial was carried out, recruiting randomly in intervention and control groups among the patients receiving treatment for type 2 diabetes at the Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. A total of 320 patients from both groups at baseline and 273 at endline were interviewed. RESULTS A significant improvement in patient adherence to diet, physical exercise, the cessation of use of tobacco and betel nut, and blood glycaemic control was found in the intervention group, whereas no such significant improvement was found in the control group. Cost and other co-morbidities were found to be the main reasons for non-adherence. CONCLUSION A mobile-health intervention should be considered as an additional option for non-communicable disease programs.
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Affiliation(s)
- Farzana Yasmin
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
- Friede Springer Endowed Professorship for Global Child Health, Faculty of Health/Department of Human Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany.
| | | | - Bilkis Banu
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
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Ahmed Siddiqui M, Ali L, Fawwad A, Banu B, Chowdhury HA, Waris N, Butt A, Nawab SN, Basit A. Mobile SMS: A tool for management of diabetes via patients-relative’s knowledge and belief. Clinical Epidemiology and Global Health 2020. [DOI: 10.1016/j.cegh.2019.10.008] [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: 10/25/2022] Open
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Mumu SJ, Merom D, Ali L, Fahey PP, Hossain I, Rahman AKMF, Allman-Farinelli M. Validation of a food frequency questionnaire as a tool for assessing dietary intake in cardiovascular disease research and surveillance in Bangladesh. Nutr J 2020; 19:42. [PMID: 32410632 PMCID: PMC7227307 DOI: 10.1186/s12937-020-00563-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has emerged as a major public health concern in Bangladesh. Diet is an established risk factor for CVD but a tool to assess dietary intake in Bangladesh is lacking. This study aimed to validate a food frequency questionnaire (FFQ) using the 24-h dietary recall method and corresponding nutritional biological markers among rural and urban populations of Bangladesh. METHOD Participants of both genders aged 18-60 years were included in the analysis (total n = 146, rural n = 94 and urban n = 52). Two FFQs of 166 items were administered three-months apart, during which time three 24-h dietary recalls were also completed. Participants were asked to recall their frequency of consumption over the preceding 3 months. Urine and blood samples were collected for comparison between FFQ-estimates of nutrients and their corresponding biomarkers. Methods were compared using unadjusted, energy-adjusted, de-attenuated correlation coefficients, 95% limits of agreement (LOA) and quartile classification. RESULTS Fair to moderate agreement for ranking energy, macro and micronutrients into quartiles was observed (weighted k value ranged from 0.22 to 0.58; p < 0.001 for unadjusted data) except for vitamin D (weighted k - 0.05) and zinc (weighted k 0.09). Correlation coefficients of crude energy, macronutrients and common micronutrients including vitamin E, thiamine, riboflavin, niacin, pyridoxine, folate, iron, magnesium, phosphorus, potassium, and sodium were moderately good, ranging from 0.42 to 0.78; p < 0.001 but only fair for vitamin A, β carotene and calcium (0.31 to 0.38; p < 0.001) and poor for vitamin D and zinc (0.02 and 0.16; p = ns, respectively). Energy-adjusted correlations were generally lower except for fat and vitamin E, and in range of - 0.017 (for calcium) to 0.686 (for fat). De-attenuated correlations were higher than unadjusted and energy- adjusted, and significant for all nutrients except for vitamin D (0.017) to 0.801 (for carbohydrate). The Bland Altman tests demonstrated that most of the coefficients were positive which indicated that FFQ provided a greater overestimation at higher intakes. More than one in three participants appeared to overestimate their food consumption based on the ratio of energy intake to basal metabolic rate cut points suggested by Goldberg. Absolute intake of macronutrients was 1.5 times higher and for micronutrients it ranged from 1.07 (sodium) to 26 times (Zinc). FFQ estimates correlated well for sodium (0.32; p < 0.001), and vitamin D (0.20; p = 0.017) with their corresponding biomarkers and iron (0.25; p = 0.003) with serum ferritin for unadjusted data. Folate, iron (with haemoglobin) and total protein showed inverse association; and fat and potassium showed poor correlation with their corresponding biomarkers for unadjusted data. However, folate showed significant positive correlation (0.189; p = 0.025) with biomarker after energy adjustment. CONCLUSION Although FFQ showed overestimation for absolute intake in comparison with 24-h recalls, the validation study demonstrated acceptable agreement for ranking dietary intakes from FFQ with 24-h recall methods and some biomarkers and therefore could be considered as a tool to measure dietary intake for research and CVD risk factors surveillance in Bangladesh. The instrument may not be appropriate for monitoring population adherence to recommended intakes because of the overestimation.
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Affiliation(s)
- Shirin Jahan Mumu
- School of Health Science, Western Sydney University, Sydney, Australia. .,Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh.
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Liaquat Ali
- Pothikrit Centre for Health Studies, Dhaka, 1000, Bangladesh
| | - Paul P Fahey
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Israt Hossain
- Dept of Biochemistry & Cell Biology, BUHS, Dhaka, 1216, Bangladesh
| | - A K M Fazlur Rahman
- Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh
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Naeem S, Ali L, Rizwani GH, Ikram R, Khan SS, Shareef H, Younus I, Malick TZ, Aleem U. A comparative neurobehavioral study of sesame oil and fish oil on experimental animals. Pak J Pharm Sci 2020; 33:511-521. [PMID: 32276892] [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: 06/11/2023]
Abstract
Natural oils are enriched with polyunsaturated fatty acids (PUFAs) which are important for our health. Recent experimental data explained that PUFAs might have a beneficial effect on various brain functions such as anxiety, dementia, epileptic seizures, depression or bipolar and other neurobehavioral diseases. The objective of the current research work was to evaluate the effect of sesame oil, fish oil and mixture of both oils (1:1) on neurobehavioral changes and cognition. For this purpose shark fish oil and sesame oil were extracted out and there poly unsaturated and saturated fatty acids were analyzed by using GCFID that exposed the presence of different PUFs in shark fish oil, sesame oil and mixture of both oils. Neurobehavioral changes were seen after 5ml/kg/day sesame oil, 5ml/kg/day shark fish oil and 1:1 combination of both oil 5ml/kg/day administration on open field, cage crossing, light and dark, stationary rod, forced swimming induced depression test and water maze test. Our GCFID results showed sesame and fish oil enriched with higher amount of PUFs and showed significant anxiolytic and antidepressant like effect after 30 days of treatment (P<0.05) however combination of these both oils exhibited greater efficacy (P<0.01) in reducing anxiety and depression as imipramine standard drug. Results showed that combination of both oils (sesame oil and fish oil) could be a better option to treat neurobehavioral problems as compared to alone.
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Affiliation(s)
- Sadaf Naeem
- Hamdard University, Madinat al-Hikmah, Karachi, Pakistan/Jinnah Sindh Medical University, Institute of Pharmaceutical Sciences, Karachi, Pakistan
| | - Liaquat Ali
- Hamdard University, Madinat al-Hikmah, Karachi, Pakistan
| | | | - Rahila Ikram
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Saira Saeed Khan
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
| | - Huma Shareef
- Jinnah Sindh Medical University, Institute of Pharmaceutical Sciences, Karachi, Pakistan
| | - Ishrat Younus
- Hamdard University, Madinat al-Hikmah, Karachi, Pakistan
| | - Tabinda Zareen Malick
- Jinnah Sindh Medical University, Institute of Pharmaceutical Sciences, Karachi, Pakistan
| | - Umer Aleem
- Saidu Medical College, Swat, Khyber Pakhtunkhwa, Pakistan
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Morley J, Moayyeri A, Ali L, Taylor A, Feudjo-Tepie M, Hamilton L, Bayly J. Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink. Osteoporos Int 2020; 31:533-545. [PMID: 31758206 PMCID: PMC7076063 DOI: 10.1007/s00198-019-05228-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 11/06/2019] [Indexed: 12/16/2022]
Abstract
UNLABELLED Gaining full benefits from osteoporosis medications requires long-term treatment. Investigating the real-world persistence of women receiving osteoporosis medications in the UK, we found that most patients stop treatment within a year. To prevent osteoporotic fragility fractures, long-term treatment persistence must be improved. INTRODUCTION Persistence with osteoporosis therapies has historically been poor. To treat this chronic and progressive disease, it is essential that patients receive the full benefit of these medications. We estimated persistence and compliance with osteoporosis therapies in a large sample of postmenopausal women in the UK. METHODS Data were obtained from the Clinical Practice Research Datalink for all women aged 50 years and over or women with early menopause, who received at least one prescription in primary care for any licensed osteoporosis therapy between January 1, 2010 and December 31, 2015. Persistence and compliance at 24 months (primary objective) and at 5 years (exploratory objective) were estimated in three patient cohorts: "All Patients," "Naïve Patients," and "Drug-Specific." RESULTS The All Patients cohort included 72,256 women. Persistence with any therapy was 56.1%, 43.6%, 36.4%, and 31.0% at 6, 12, 18, and 24 months, respectively, and 23.2% and 13.1% at 3 years and 5 years, respectively. Patients were generally more persistent and compliant if evaluated from their first exposure to osteoporosis therapy (Naïve Patients cohort). In the drug-specific analysis, 64% of patients receiving denosumab (administered subcutaneously every 6 months) were persistent at 24 months compared with 28% and 23% of those taking oral bisphosphonates and intravenous bisphosphonates, respectively. CONCLUSIONS Only about one in three patients who received osteoporosis therapy continued to be on treatment after 2 years. There is a need to improve persistence with osteoporosis therapy, especially for high-risk patients.
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Affiliation(s)
| | | | | | | | | | | | - J Bayly
- University of Derby, Derby, UK
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Banik PC, Barua L, Moniruzzaman M, Mondal R, Zaman F, Ali L. Risk of diabetic foot ulcer and its associated factors among Bangladeshi subjects: a multicentric cross-sectional study. BMJ Open 2020; 10:e034058. [PMID: 32114471 PMCID: PMC7050319 DOI: 10.1136/bmjopen-2019-034058] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/14/2019] [Accepted: 01/20/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To assess the risk of diabetic foot ulcer (DFU) and find out its associated factors among subjects with type 2 diabetes (T2D) of Bangladesh. DESIGN, SETTING AND PARTICIPANTS This cross-sectional study recruited 1200 subjects with T2D who visited 16 centres of Health Care Development Project run by Diabetic Association of Bangladesh. PRIMARY AND SECONDARY OUTCOME MEASURES Risk of DFU was assessed using a modified version of International Working Group on the Diabetic Foot (IWGDF) Risk Classification System. The modified system was based on five parameters, namely peripheral neuropathy (PN), peripheral arterial diseases (PAD), deformity, ulcer history and amputation. The risks were categorised as group 0 (no PN, no PAD), group 1 (PN, no PAD and no deformity), group 2A (PN and deformity, no PAD), group 2B (PAD), group 3A (ulcer history) and group 3B (amputation). The associated factors of DFU risk were determined using multinomial logistic regression for each risk category separately. RESULTS Overall, 44.5% of the subjects were found 'at risk' of DFU. This risk was higher among men (45.6%) than women and among those who lived in rural areas (45.5%) as compared with the urban population. According to IWGDF categories, the risk was distributed as 55.5%, 4.2%, 11.6%, 0.3%, 20.6% and 7.9% for group 0, group 1, group 2A, group 2B, group 3A and group 3B, respectively. The associated factors of DFU (OR >1) were age ≥50 years, rural area, low economic status, insulin use, history of trauma, diabetic retinopathy and diabetic nephropathy. CONCLUSION A significant number of the subjects with T2D under study were at risk of DFU, which demands an effective screening programme to reduce DFU-related morbidity and mortality.
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Affiliation(s)
- Palash Chandra Banik
- Community Medicine, Bangladesh Institute of Health Sciences, Dhaka, Bangladesh
- Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Lingkan Barua
- Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | | | - Rajib Mondal
- Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Farhana Zaman
- Community Medicine, Bangladesh Institute of Health Sciences, Dhaka, Bangladesh
| | - Liaquat Ali
- Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Yasmin F, Ali L, Banu B, Rasul FB, Sauerborn R, Souares A. Understanding patients' experience living with diabetes type 2 and effective disease management: a qualitative study following a mobile health intervention in Bangladesh. BMC Health Serv Res 2020; 20:29. [PMID: 31918704 PMCID: PMC6953219 DOI: 10.1186/s12913-019-4811-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2017, 425 million adults worldwide had diabetes; 80% were living in low and middle-income countries. Bangladesh had 6.9 million adults with diabetes; death from diabetes comprised 3% of the country's total mortality. This study looked at different factors (personal, familial, social, and financial) affecting both the life of patients with diabetes type 2 and the management of the disease. It also explored patient's perception of the mobile health intervention in the context of disease management and helped to explain the findings obtained from the quantitative part of this study. METHOD The study was a mixed-method, sequential explanatory design. A mobile health project (interactive voice call and call center) was implemented in Dhaka district, Bangladesh from January to December, 2014. Patients received treatment at the outpatient department of Bangladesh Institute of Health Science Hospital, Dhaka, Bangladesh, were included in intervention and control groups of the main study following a Randomized Control Trial. Among them, a total of 18 patients (9 + 9) were selected purposefully for the qualitative study, which was conducted in July, 2015. The sample was selected purposefully considering the age, sex, socio-economic status and proximity of living due to the political instability of the country during the data collection period. The interviews were transcribed and analyzed applying investigator triangulation. RESULTS Most patients stated that diabetes has affected their lives. In general, both groups´ evaluation of mobile health services were good and both regarded the recommendations for medication, diet, physical exercise, and other lifestyle behaviors (use of tobacco and betel nuts) as helpful. The cost of overall treatment (medications, physician consultations, laboratory investigations), the lack of availability of safe public places for physical exercise and unfavorable weather conditions (heat, rainfall) were mentioned as barriers to the overall management of the disease. CONCLUSION A patient-centered mobile health intervention supported by a collaborative patient-provider relationship, a strong family support system, available public spaces for exercise and the introduction of a functional public health insurance system could be beneficial for the better management of diabetes.
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Affiliation(s)
- F Yasmin
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany.
- Faculty of Health/Department of Human Medicine, University Witten/Herdecke, 58448, Witten, Germany.
| | - L Ali
- Bangladesh University of Health Sciences (BUHS), Mirpur-1, Dhaka, 1216, Bangladesh
| | - B Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - F B Rasul
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
- BRAC James P. Grant School of Public Health, BRAC University, Mohakhali, Dhaka, 1212, Bangladesh
| | - R Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - A Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
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Barua L, Faruque M, Banik PC, Ali L. Concordance between two versions of world health organization/international society of hypertension risk prediction chart and framingham risk score among postmenopausal women in a rural area of Bangladesh. Indian J Public Health 2019; 63:101-106. [PMID: 31219057 DOI: 10.4103/ijph.ijph_178_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Prevention of cardiovascular disease (CVD) among postmenopausal women with limited resource is a great challenge for a country like Bangladesh. Objectives This study aimed to evaluate the level of agreement among different risk prediction tools to find out the cost-effective and suitable one that can be applied in a low-resource setting. Methods This was a cross-sectional study conducted from February through December 2016 among 265 postmenopausal women of 40-70 years age. Data were collected from the outpatient department of a rural health-care center situated in the village Karamtola of Gazipur district, Bangladesh. The CVD risk was estimated using the World Health Organization/International Society of Hypertension (WHO/ISH) "with" and "without" cholesterol risk charts and the Framingham Risk Score (FRS). Concordance among the tools was evaluated using Cohen's kappa (κ), prevalence-adjusted bias-adjusted kappa (PABAK), and first-order agreement coefficient (AC1). Results The "without" cholesterol version showed 79% concordance against the "with" cholesterol and 75.4% concordance against the FRS. In between the WHO/ISH risk charts, slight-to-substantial levels of agreement (κ = 0.14, PABAK = 0.58, and AC1 = 0.72; P = 0.023) were observed. With FRS, the "without" cholesterol version showed higher agreement (κ = 0.38, fair; PABAK = 0.50, moderate; and AC1 = 0.60, moderate; P = 0.000) compared to "with" cholesterol version (κ = 0.13, slight; PABAK = 0.30, fair; and AC1 = 0.44, moderate; P = 0.013). Predictability of CVD risk positive (≥10%) cases was similar for both the versions of WHO/ISH risk charts. Conclusion In a low-resource setting, the "without" cholesterol version of WHO/ISH risk chart is a good option to detect and target the population with high CVD risk.
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Affiliation(s)
- Lingkan Barua
- Lecturer, Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Mithila Faruque
- Assistant Professor and Head, Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Palash Chandra Banik
- Assistant Professor, Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Liaquat Ali
- Honorary Professor, Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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