1
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Sarkar PK, Karanjia R, Akhtar M, Streeter E. Massive Small Bowel Enterolith in Post Cystoprostatectomy Ileal Cul-de-sac : A Unique Presentation of a Rare Clinical Condition. J West Afr Coll Surg 2024; 14:241-243. [PMID: 38562391 PMCID: PMC10980318 DOI: 10.4103/jwas.jwas_124_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/22/2023] [Indexed: 04/04/2024]
Abstract
Enterolithiasis or formation of gastrointestinal concretions is an unusual medical entity that typically occurs in patients suffering from persistent intestinal stasis. We present a rare case of non-obstructive enterolith wedged in the blind end of bowel reconstruction following cystoprostatectomy and ileal conduit formation due to muscle-invasive bladder cancer. Although we watched it grow over the years, radiological characterisation was made possible when it grew to a significant size. We, herein, will discuss the aetiology and complexities associated with the diagnosis and management of such orphan cases given their non-specific clinical presentations in an already hostile abdomen due to multiple laparotomies.
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Affiliation(s)
- Pallab Kumar Sarkar
- Department of Urology, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
| | - Rustam Karanjia
- Department of Urology, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
| | - Mansoor Akhtar
- Department of General Surgery, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
| | - Edward Streeter
- Department of Urology, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
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NOBI F, Debnath M, Mahjabin S, Biswas T, Ashraf I, Azad S, Ahmad M, Mobashwera B, Akhtar M, Emon R, Chowdhury M, Islam M, Miah M. WCN23-0334 VITAMIN D LEVEL IN SLE PATIENTS WITH OR WITHOUT RENAL INVOLVEMENT AND IT’S RELATIONSHIP WITH DISEASE ACTIVITY (SLEDAI SCORE). Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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3
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Akhtar M, Bonus F, Lebrun-Gallagher FR, Johnson NI, Siegele-Brown M, Hong S, Hile SJ, Kulmiya SA, Weidt S, Hensinger WK. A high-fidelity quantum matter-link between ion-trap microchip modules. Nat Commun 2023; 14:531. [PMID: 36754957 PMCID: PMC9908934 DOI: 10.1038/s41467-022-35285-3] [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: 06/30/2022] [Accepted: 11/25/2022] [Indexed: 02/10/2023] Open
Abstract
System scalability is fundamental for large-scale quantum computers (QCs) and is being pursued over a variety of hardware platforms. For QCs based on trapped ions, architectures such as the quantum charge-coupled device (QCCD) are used to scale the number of qubits on a single device. However, the number of ions that can be hosted on a single quantum computing module is limited by the size of the chip being used. Therefore, a modular approach is of critical importance and requires quantum connections between individual modules. Here, we present the demonstration of a quantum matter-link in which ion qubits are transferred between adjacent QC modules. Ion transport between adjacent modules is realised at a rate of 2424 s-1 and with an infidelity associated with ion loss during transport below 7 × 10-8. Furthermore, we show that the link does not measurably impact the phase coherence of the qubit. The quantum matter-link constitutes a practical mechanism for the interconnection of QCCD devices. Our work will facilitate the implementation of modular QCs capable of fault-tolerant utility-scale quantum computation.
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Affiliation(s)
- M. Akhtar
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK ,Universal Quantum Ltd, Brighton, BN1 6SB UK
| | - F. Bonus
- Universal Quantum Ltd, Brighton, BN1 6SB UK ,grid.83440.3b0000000121901201Department of Physics and Astronomy, University College London, London, WC1E 6BT UK
| | - F. R. Lebrun-Gallagher
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK ,Universal Quantum Ltd, Brighton, BN1 6SB UK
| | - N. I. Johnson
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK
| | - M. Siegele-Brown
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK
| | - S. Hong
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK
| | - S. J. Hile
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK
| | - S. A. Kulmiya
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK ,grid.5337.20000 0004 1936 7603Quantum Engineering Centre for Doctoral Training, University of Bristol, Bristol, BS8 1TH UK
| | - S. Weidt
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK ,Universal Quantum Ltd, Brighton, BN1 6SB UK
| | - W. K. Hensinger
- grid.12082.390000 0004 1936 7590Sussex Centre for Quantum Technologies, University of Sussex, Brighton, BN1 9QH UK ,Universal Quantum Ltd, Brighton, BN1 6SB UK
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Tong J, Yang X, Song X, Liang J, Huang S, Mao H, Akhtar M, Liu A, Shan GG, Li G. AIE-active Ir(III) complexes as type-I dominant photosensitizers for efficient photodynamic therapy. Dalton Trans 2023; 52:1105-1112. [PMID: 36602243 DOI: 10.1039/d2dt03404b] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The ability of a photosensitizer (PS) to generate reactive oxygen species (ROS) including type I oxygen free radicals and type II 1O2 is pivotal for photodynamic therapy. Luminescent Ir(III) complexes are effective PSs with high 1O2 generation ability owing to their high intersystem crossing ability and effective energy transfer to 3O2. However, so far, reports on type I ROS based on ˙OH generation induced by Ir(III) PS are still rare. In this work, four novel aggregation-induced emission (AIE)-active Ir(III) PSs, namely MFIriqa, MFIrqa, SFIriqa, and SFIrqa have been designed and synthesized, which show highly efficient emission in the aggregated state. Cell imaging experiment results indicate that all four Ir(III) PSs can effectively improve the signal-to-noise ratio of imaging by reducing the interference from the background due to their fascinating AIE properties. Importantly, in vitro, Ir(III) PSs MFIrqa, SFIriqa, and SFIrqa nanoparticles show obvious photodynamic activity toward cancer cells upon irradiation accompanied by type I ˙OH generation, which may be attributed to the unique excited-state characteristics of Ir(III) complexes. This work will provide guidance for the construction of a type I photosensitizer based on the AIE-active Ir(III) complex, which offers great advantages for potential clinical applications under hypoxic conditions.
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Affiliation(s)
- Jialin Tong
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | - Xinyue Yang
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | | | - Jie Liang
- Ji Hua Laboratory, Foshan 528200, P. R. China.
| | - Shanshan Huang
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | - Huiting Mao
- College of Life Science, Dalian Minzu University, Dalian, 116600, Liaoning, P. R. China.
| | - Mansoor Akhtar
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | - Ao Liu
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | - Guo-Gang Shan
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
| | - Guangfu Li
- Institute of Functional Material Chemistry and National & Local United Engineering Lab for Power Battery, Faculty of Chemistry, Northeast Normal University, Changchun 130024, P. R. China.
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Gumaa D, Agrawal A, Akhtar M. TU3.2 Has Covid-19 Pandemic affected the management of patient's with colorectal cancer? Br J Surg 2022. [PMCID: PMC9384764 DOI: 10.1093/bjs/znac248.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction Patients on the cancer pathway should be investigated on the 2 weeks wait pathway, but Covid-19 pandemic had universal impact on the Healthcare systems. One of the main worries was the impact on cancer patients due to delayed diagnosis and management. Our study looks at the timeframe of investigations for colorectal cancer during the second wave of the pandemic compared to pre covid time. Method Retrospective study looking at the waiting time to investigate patients with +ve qFIT test during the second wave of pandemic (from November 2020 till March 2021). Results During this period 150 patients had +ve qFIT test, the main presenting symptom was Change in bowel habits. 90 patients were investigated with colonoscopy, only 16 (17%) patients had the colonoscopy done within 2 weeks from the qFIT result. 23 patients had colonoscopy 2–3 weeks from the result. 30 patients (33%) had the colonoscopy between 3–4 weeks, and 21 patients had to wait between 1–6 months to have the colonoscopy. Out of the 150 patients, 60 patients were investigated primarily with CT scan or CT colon. Conclusion During the covid-19 pandemic, majority of patients in our trust were investigated within one month of +ve qFIT test but yet there was some delay in carrying out the investigations compared to the normal pathway and more patients had CT scans as primary investigations before being referred for colonoscopy.
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Affiliation(s)
- Duaa Gumaa
- East Kent Hospitals NHS Foundation Trust
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Agrawal A, Gumaa D, Akhtar M. TU4.6 Comparison between the outcome of patient's with qFIT>120 and patients with qFIT<120.Can qFIT<120 be considered a negative test?? Br J Surg 2022. [PMCID: PMC9384812 DOI: 10.1093/bjs/znac248.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction When FIT is used for symptomatic patients presenting to primary care a positive result is considered ≥10 mcgHb/gStool. When qFIT is used for the asymptomatic screening population (i.e NBCSP) a positive result is ≥120mcgHb/gStool. During covid-19 Pandemic the 120 cut off was used in some of the hospitals to triage patients who require further investigations for either colonoscopy or CT scan. Methods Retrospective cohort study done in general district hospital comparing the pathology identified in patients with Qfit results>120 and patients with result <120. Results In the period between July 2020 and November 2021, 448 patients had +ve qFIT result (≥10 micrograms).In the first group, 340 patients had qFIT result <120. 191 patients had colonoscopy with 8 confirmed colorectal cancer, and 137 patients had CT/CT colon with only 1 patient was found to have colorectal cancer. Overall 2.6% of the patients had cancer. While in the second group, 108 patients had qFIT>120. 69 patients had colonoscopy with 9 confirmed cancer. the rest of the patients had CT/CT colon with 2 patients showing features of malignancy. Overall 10.1% of the patients had cancer. Conclusion The incidence of colorectal cancer in patients with qFIT result >120 is much higher than the other group, but the incidence of colorectal cancer in patients with qFIT<120 is still significant and the patients shouldn't be discharged without investigations.
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Affiliation(s)
| | - Duaa Gumaa
- East Kent University Hospitals NHS Foundation Trust
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7
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Agrawal A, Gumaa D, Akhtar M. TU4.5 qFIT test: the future of colorectal cancer investigation. Br J Surg 2022. [DOI: 10.1093/bjs/znac248.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Introduction
Colorectal cancer is one of the most common cancers. In 2013 in the UK, 41,112 people were diagnosed with colorectal cancer and 15,903 people died from it.
The qFIT(quantitative faecal immunochemical test) is now widely used in the National Bowel Cancer Screening Program (NBSCP). It is also a good test to identify symptomatic people at higher risk of having a diagnosis of colorectal cancer. We present single center experience with Q fit testing.
Methods
Retrospective cohort study performed in a large district general hospital looking at the outcome of patients with +ve qFIT test (≥10 micrograms).
Results
Over the period from July 2020 till November 2021, over 2000 patients had qFIT tests to investigate red flag lower GI symptoms. Out of the 2000 patients, 448 patients had +ve qFIT. Over 70% of the patients Referred by the GP with Change in bowel habits, the test was organized by the hospital not the primary care.
260 patients were investigated with colonoscopy, 17 patients had histology confirming colorectal cancer. 172 patients were not fit enough for colonoscopy and were investigated with CT colon/CT, only 3 patients out of this group had features suggesting colorectal cancer on the CT scan.
Conclusion
20 out of 448 patients were diagnosed with colorectal cancer, the rest of the patients had either benign colorectal polyps or diverticular disease. As the qFIT test is now more widely used, it needs to be organised by the primary care centers to speed up the process of diagnosis and management.
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Affiliation(s)
| | - Duaa Gumaa
- East Kent University Hospitals NHS Foundation Trust
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8
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Waseem M, Irfan-Ur-Rehman Khan M, Usman Mehmood M, Riaz A, Akhtar M. 145 Comparison of various buffalo sera collected during different phases of estrous cycle for in vitro maturation and culturing of Nili-Ravi buffalo oocytes. Reprod Fertil Dev 2021; 34:310-311. [PMID: 35231352 DOI: 10.1071/rdv34n2ab145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- M Waseem
- Buffalo Research Institute Pattoki, Kasur, Punjab, Pakistan
| | - M Irfan-Ur-Rehman Khan
- Department of Theriogenology, University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan
| | - M Usman Mehmood
- Department of Theriogenology, University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan
| | - A Riaz
- Department of Theriogenology, University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan
| | - M Akhtar
- Buffalo Research Institute Pattoki, Kasur, Punjab, Pakistan
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Akhtar M, Shafi A, Khanna V, Mukhopadhyay S, Patel K, Ozkor M, Baumbach A, Mathur A, Kennon S, Awad W, Mullen MM. The management of severe aortic stenosis during the COVID-19 pandemic: an observational study comparing TAVI and SAVR. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1655] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Outcomes and characteristics of patients with severe aortic stenosis (AS) treated during the COVID-19 pandemic is unknown.
Methods
This was a single-centre observational study of patients undergoing AS treatment with transcatheter (TAVI) or surgical (SAVR) therapy during the first-wave of the UK COVID-19 pandemic compared to a control cohort undergoing treatment in 2019.
Demographics, baseline echocardiogram, CT, procedural characteristics and outcome data were collated. The primary outcome was 30-day all-cause mortality. The secondary endpoint was duration of post-procedural hospitalisation.
Results
319 patients were recruited - 122 underwent intervention during the pandemic [73 TAVI; 49 SAVR] and 197 in 2019 [127 TAVI; 70 SAVR].
In 2020, TAVI patients had a higher Euroscore II (p<0.001) but there were no differences in procedural complications or mortality [p=0.16] compared to TAVI 2019 cases. Duration from TAVI to discharge was shorter in 2020 (p<0.001).
SAVR 2020 patients had similar baseline profile [p=0.48], surgical characteristics, mortality (p=0.68) and duration from SAVR to discharge compared to those in 2019.
During the pandemic, TAVI patients were older (p<0.001) and had a higher Euroscore II (p<0.001) than SAVR counterparts. TAVI patients had reduced 30-day mortality [0 (0%) vs 3 (6%); p=0.06] and were discharged more rapidly post-intervention than SAVR patients [median 1 [1] vs 7 [4] days; p<0.001) translating into shorter hospitalization (p<0.001).
Conclusions
TAVI and SAVR can be safely delivered with predictable resource utilisation during a pandemic. Despite the TAVI cohort incorporating higher risk, older patients, outcomes were at least as good as SAVR with a shorter length of post-procedural hospitalisation.
Funding Acknowledgement
Type of funding sources: None. Procedural Complications TAVI/SAVRDuration to discharge post TAVI/SAVR
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Affiliation(s)
- M Akhtar
- Barts Heart Centre, London, United Kingdom
| | - A Shafi
- Barts Heart Centre, London, United Kingdom
| | - V Khanna
- Barts Heart Centre, London, United Kingdom
| | | | - K Patel
- Barts Heart Centre, London, United Kingdom
| | - M Ozkor
- Barts Heart Centre, London, United Kingdom
| | - A Baumbach
- Barts Heart Centre, London, United Kingdom
| | - A Mathur
- Barts Heart Centre, London, United Kingdom
| | - S Kennon
- Barts Heart Centre, London, United Kingdom
| | - W Awad
- Barts Heart Centre, London, United Kingdom
| | - M M Mullen
- Barts Heart Centre, London, United Kingdom
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Ayoub N, Gareb F, Akhtar M. 638 The Implication of Telephone Consultations During COVID-19 Pandemic on Informed Consent. Br J Surg 2021. [PMCID: PMC8524512 DOI: 10.1093/bjs/znab259.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Aim Is to find whether telephone consultations have affected patient’s comprehension of the proposed surgical management and possible risks until the day of surgery and accordingly ability for informed consent. Method This study included a sample of patients admitted to QEQM hospital for elective day case surgery during November 2020 and had only telephone consultation when referred for surgery. A feedback survey assessing quality of information given to patients before and on day of surgery was filled by the patients after the procedure. Results The sample included 40 patients undergoing different procedures [cholecystectomy (25), inguinal hernia repair (25), rectal examination under anaesthesia (5), ventral hernia repair (2), incisional hernia (2), inguinal lymph node biopsy (1)]. It was found that 27.5% of patients didn’t have thorough explanation of possible risks and no explanation about postoperative care in 35%.20% were not provided a leaflet about procedure, 57.5% had concerns before surgery and 75% of patients wished for a leaflet with illustrative diagrams, explanation of risks with their management to be able to take the right decision and majority of these patients were from cholecystectomy subgroup. Conclusions The lack of face-face appointment affected greatly the informed consent process resulting in patient dissatisfaction which raised the need for new leaflets containing diagrammatic explanation of procedures and possible risks with their management to ensure fulfilment of autonomy principle.
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Affiliation(s)
- N Ayoub
- East Kent university hospitals, margate, United Kingdom
| | - F Gareb
- East kent university hospitals, margate, United Kingdom
| | - M Akhtar
- East Kent university hospitals, margate, United Kingdom
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Rees C, Huang Y, Akhtar M, Mischi M, Humberstone A, Schoot B. P–362 The effect of nolasiban on uterine contractility at the time of embryo transfer in in vitro fertilisation patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What is the effect of nolasiban on the uterine contractility of in-vitro fertilisation (IVF) patients prior to embryo transfer (ET) ?
Summary answer
A single oral dose of nolasiban 900 mg administered 4 h before ET significantly decreased contraction frequency and increased coordination compared to placebo.
What is known already
Nolasiban is an investigational oral oxytocin receptor antagonist (OTRa) being developed to improve the chance of pregnancy following ET. Increased uterine contraction frequency can influence embryo implantation, and the coordination of these uterine contractions is equally important. OTRa have been shown to decrease uterine contractions and increase endometrial perfusion. Recently, an automated and quantitative measurement tool using transvaginal ultrasound (TVUS) to better characterise uterine contractility has been developed which can be used to quantify the effect of nolasiban on uterine contractility.
Study design, size, duration
This study is part of a completed multi-centre randomised placebo-controlled trial (IMPLANT 1 – NCT02310802) in IVF patients (n = 247) carried out in 2015. Our study retrospectively assessed a sub-set of patients with good quality TVUS recordings to evaluate their mechanical uterine motion that were randomised to receive either nolasiban 900mg (n = 39) or placebo (n = 42).
Participants/materials, setting, methods
Subjects were < 37 years, undergoing ET on Day 3 following IVF/ICSI and with evidence of uterine contractions 4 h before ET. Nolasiban was administered 4 h before ET. Patients underwent TVUS immediately before drug administration and again immediately before ET. Uterine contraction frequency, amplitude, power and coordination were measured by applying dedicated speckle tracking and strain analysis. The Shapiro–Wilk test, followed by the Wilcoxon rank-sum test were applied to compare features between treatment groups.
Main results and the role of chance
The mean (SD) frequency of uterine contractions was 1.54 (0.25) in the nolasiban group versus 1.57 (0.12) in the placebo group (p = 0.016). The mean (SD) coordination was 0.10 (0.17) in the nolasiban group versus 0.02 (0.16) in the placebo group (p = 0.034). The coordination feature was measured by assessing the presence of simultaneous movements of the anterior and posterior uterine walls, a higher value reflects increased coordination. There was no difference in contraction amplitude or power.
Limitations, reasons for caution
This was a retrospective analysis of TVUS videos. The small sample size limits the generalisability of the findings. Furthermore, our initial results do not show how the changes in uterine motion may affect pregnancy rate after ET, meaning that the clinical relevance of our results remains to be proven.
Wider implications of the findings: Our results show that in patients taking one 900mg dose of nolasiban prior to ET, beneficial uterine contractions are seen, which could be promising for embryo implantation and pregnancy in IVF patients. Our quantitative TVUS measurement tool can be applied to different patient populations to accurately quantify uterine motion.
Trial registration number
NCT02310802
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Affiliation(s)
- C Rees
- Catharina Hospital Eindhoven, Obstetrics and Gynaecology, Eindhoven, The Netherlands
| | - Y Huang
- Eindhoven University of Technology, Electrical Engineering, Eindhoven, The Netherlands
| | - M Akhtar
- Catharina Hospital Eindhoven, Obstetrics and Gynaecology, Eindhoven, The Netherlands
| | - M Mischi
- Eindhoven University of Technology, Electrical Engineering, Eindhoven, The Netherlands
| | | | - B Schoot
- Catharina Hospital Eindhoven, Obstetrics and Gynaecology, Eindhoven, The Netherlands
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12
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Samanta J, Lacey L, Isdale M, Akhtar M. P–747 Implementation of the ESHRE Congenital uterine anomaly classification into practice and clinical pregnancy outcomes at a Tertiary University Teaching Hospital Fertility department. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What’s the incidence of class U1-U6 CUAs in subfertile women? What’s the clinical pregnancy rate in women with the most common anomaly, a septate uterus?
Summary answer
The incidence of CUAs is 5.9% in our subfertile population, with a septate uterus (U2) being the most common abnormality in 4.2% of the population
What is known already
Congenital uterine anomalies (CUAs) are common. A systematic review suggested an estimated overall prevalence of 5.5% in an unselected population, 8.8% in the subfertile population, 13.3% in those with a history of recurrent miscarriage and 24.5% in those with a history of subfertility and recurrent miscarriage. A septate uterus (U2) is the most common CUA and is amenable to surgical intervention although at present there is a lack of evidence suggesting benefit in subfertile patients. Women with a septate uterus are known to have poorer reproductive outcomes, including reduced conception rate and increased first trimester loss.
Study design, size, duration
All patients referred to our department for subfertility had a 2D pelvic ultrasound scan as part of their baseline investigations. Since it was established in 2016, all patients with a suspected CUA based on clinical history and investigations, were referred to the clinic and data collected prospectively. Prior to this, women with suspected CUAs required a hysteroscopy or MRI scan for confirmation of diagnosis, often leading to long waiting lists and treatment delays.
Participants/materials, setting, methods
Out of the 4716 patients referred to the department for subfertility from 2016–2018, 302 women were referred to the 3D clinic due to suspicion of a CUA. Transvaginal 3D-ultrasound scan was performed and CUAs classified according to the ESHRE/ESGE working groups. Patients diagnosed with a septate uterus were given options of conservative versus surgical treatment, in the light of unclear benefits of hysteroscopic septum resection. Clinical pregnancy data were collected about this cohort.
Main results and the role of chance
Of the 302 women referred to the service, the uteri of 25 patients were unable to be assessed accurately, most commonly as the cavity was unclear due to a thin endometrium. The remaining 277 patients were classified as having the following CUAs; Normal (U0) 63 patients, Dysmorphic (U1) 5 patients, Septate (U2) 199 patients, Bicorporeal (U3) 6 patients and Hemi uterus (U4) 4 patients. No women were classified as having an aplastic uterus (U5) or unclassified (U6).
Of the 199 women with a septate uterus, 15 women opted for surgical intervention, 143 women decided to have conservative management and 41 women were lost to follow up. The women who had hysteroscopic resection of the septum had a mean age of 35 years, 6/15 had primary subfertility and 6/15 had a history of recurrent miscarriage. The women who had conservative management had a mean age of 32.5 years, 100/143 had primary subfertility and 20/143 had a history of recurrent miscarriage. At present, 89/143 women who have had conservative management and 12/15 women who had surgical interventions have had a clinical pregnancy, 72/89 and 6/12 of these pregnancies were IVF/ICSI pregnancies respectively.
Limitations, reasons for caution
This is an observational study, these findings can be useful for patient counselling. However, ideally randomised controlled trials are needed as evidence for the different treatment options for the cohort of patients with septate uterus, which are largely lacking in the current literature, as their feasibility remains a challenge.
Wider implications of the findings: Three-dimensional transvaginal ultrasonography clinics are cost-effective one-stop services, successfully providing a diagnosis and management plan in 92% of patients referred with a suspected CUA. They increase patient satisfaction by providing an opportunity to discuss risks in future pregnancies and reducing reliance on hysteroscopy and MRI scans.
Trial registration number
Not applicable
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Affiliation(s)
- J Samanta
- Saint Mary’s Hospital- Manchester University Hospitals NHS Foundation Trust, Obstetrics and Gynaecology, Manchester, United Kingdom
| | - L Lacey
- Warwick Medical School- University of Warwick- Coventry, Obstetrics and Gynaecology, Coventry, United Kingdom
| | - M Isdale
- Saint Mary’s Hospital- Manchester University Hospitals NHS Foundation Trust, Reproductive Medicine, Manchester, United Kingdom
| | - M Akhtar
- Saint Mary’s Hospital- Manchester University Hospitals NHS Foundation Trust, Reproductive Medicine, Manchester, United Kingdom
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13
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Tam A, Elhadi M, Ong CT, Bhat A, Akhtar M. 167 The Experience and Outcomes of Elective Urgent and Cancer Surgery in A District General Hospital in The United Kingdom During Covid-19 Pandemic. Br J Surg 2021. [PMCID: PMC8135822 DOI: 10.1093/bjs/znab134.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Many urgent and elective surgeries were postponed to cope with the Coronavirus disease (COVID-19) pandemic, with latest data found a substantial postoperative mortality risk (25·6%, 18.9%) after emergency and elective surgery, respectively.
Our institution was one of the first trust to offer essential elective surgery using a “COVID-free” designated site during the start of the pandemic.
The aim of this study is to analyse the clinical outcomes of patients who underwent essential elective procedures during the virus outbreak in the UK.
Method
Retrospective analysis of outcomes all patients who had undergone urgent elective and cancer surgery, from 30th March 2020 to 21st May 2020, using an implemented “Super Green Pathway”.
The primary endpoints were 30 days mortality and COVID related morbidities, and the secondary endpoints were surgical related complications and oncological outcomes.
Results
92 patients (Male:45%; Female:55%) across 5 surgical specialties were identified. There was no record of mortality in our cohort. Only 1 patient was tested positive for SARS-CoV-2, 18 days after the initial operation without any pulmonary complications.
Conclusions
It is possible to mitigate the high mortality risk of postoperative complications associated with COVID-19, with no delay to essential surgeries for cancer patients, thus delivering safe practice during the pandemic.
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Affiliation(s)
- A Tam
- Wye Valley NHS Trust, Hereford, United Kingdom
| | - M Elhadi
- Wye Valley NHS Trust, Hereford, United Kingdom
| | - C T Ong
- Wye Valley NHS Trust, Hereford, United Kingdom
| | - A Bhat
- Wye Valley NHS Trust, Hereford, United Kingdom
| | - M Akhtar
- Wye Valley NHS Trust, Hereford, United Kingdom
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14
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Okwu N, Gooneratne S, Piedad J, Akhtar M. 915 Post-Nephrectomy Recurrence Rates in T3 Renal Cell Carcinoma Over A 10-Year Period. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
The objective of the study was to estimate the post-nephrectomy recurrence rate and assess practice around peri-op investigation and treatment.
Method
Imaging, histopathology, and clinical data were gathered using electronic and paper medical records of patients who underwent nephrectomy for T3 RCC. Recurrence defined as local recurrence.
Results
Fifty-one patients with T3 RCC were identified, 74.5% of whom were male with a median age 71 (range 45-91).
One-third had metastatic disease. The majority (96.0%) underwent radical nephrectomy with adrenalectomy (49.0%) and lymph node dissection (19.6%).
Clear cell RCC was the main histopathological type (92.2%) with chromophobe making up 3.9%.
At year one there was recurrence in 20.0% of patients at a median time of 5months (range 1-10, 90.0% grade 3, 10% grade 4).
At year five recurrence was identified in 16.7% in a median time 50months (range 41-56; 50% grade 2 and 3 each).
Ten-year follow-up identified recurrence in 85.7% at a median time 64.5 months (range 62-91; 50% grade 2 and 3 each) with the remaining patient developing jejunal metastatic recurrence in 168 months.
Adjuvant treatment was administered in 57.1%.
Conclusions
Establishing the right time to follow-up patients especially males, 17 months median recurrence time with the most frequently occurring was clear cell RCC.
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Affiliation(s)
- N Okwu
- Hereford County Hospital, Hereford, United Kingdom
| | - S Gooneratne
- Hereford County Hospital, Hereford, United Kingdom
| | - J Piedad
- Hereford County Hospital, Hereford, United Kingdom
| | - M Akhtar
- Hereford County Hospital, Hereford, United Kingdom
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15
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Bibi F, Qaisrani SN, Akhtar M. Nutritive evaluation, metabolisable energy and digestible amino acid contents of different indigenous feedstuff for Nile tilapia (Oreochromis niloticus). BRAZ J BIOL 2021; 81:44-52. [PMID: 32159614 DOI: 10.1590/1519-6984.216198] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/06/2019] [Indexed: 11/21/2022] Open
Abstract
Three trials were executed to examine the nutritive profile, metabolisable energy and digestible amino acid (AA) contents of four indigenous feed ingredients including wheat (W), wheat middling (WM), canola meal (CM) and rapeseed meal (RSM) in Nile tilapia. Three samples of each test ingredient were collected from three different locations of Multan (MUL) and Sukkar (SKR), of Pakistan. The collected three samples were pooled thereafter to make a homogenous/ representative sample of each test ingredient from a particular study site. Nutrients composition, AA and energy digestibility of these indigenous ingredients were evaluated by using laboratory analyses and fish studies. Proximate analysis indicated variations in some of the nutrients due to location (p < 0.05). Differences were also observed in some AA including arginine, lysine, serine, cysteine, glutamic and aspartic acids, histidine, valine and glycine contents of these ingredients (p < 0.05). Digestibility of leucine, glycine and glutamic acid was higher (p < 0.05) in RSM from MUL. Among W samples from MUL, AA digestibility for lysine, threonine, and aspartic acid was higher (p < 0.05). Crude protein, arginine, alanine, serine, and aspartic acid had higher digestibility (p < 0.05), whereas digestibility was lower (p < 0.05) for threonine, valine and tyrosine in RSM from MUL. Metaboliseable energy contents did not differ among W, WM, CM and RSM regarding their origin (p > 0.05). The results indicated that nutritional profiles and their digestibility indices vary with the location for Nile tilapia.
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Affiliation(s)
- F Bibi
- Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - S N Qaisrani
- Department of Animal Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - M Akhtar
- Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
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16
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Akhtar M, Arif AM, Ullah Khan S, Shan GG, Xu HL, Su ZM. Tuning the NLO response of bis-cyclometalated iridium( iii) complexes by modifying ligands: experimental and structural DFT analysis. NEW J CHEM 2021. [DOI: 10.1039/d1nj00114k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
DFT calculations have been carried out to investigate two synthesized iridium(iii) complexes with substituted Phbd (1-phenyl-2-(pyridin-2-yl)-1H-benzo[d]imidazole) and Crbd (9-(4-(2-(pyridin-2-yl)-1H-benzo[d]imidazol-1-yl)phenyl)-9H-carbazole) as ancillary ligands.
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Affiliation(s)
- Mansoor Akhtar
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
| | - Ali Muhammad Arif
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
| | - Shifa Ullah Khan
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
| | - Guo-Gang Shan
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
| | - Hong-liang Xu
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
| | - Zhong-Min Su
- Institute of Functional Material Chemistry
- Faculty of Chemistry
- Northeast Normal University
- Changchun 130024
- People's Republic of China
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17
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Khan M, Safdar R, Ishaq M, Akhtar M, Farooq U, Arif K, Rehman M, Ikram A. Experience of Cat Scratch Disease (CSD) in Rawalpindi, Pakistan – Could Physician's vigilance help in detection and case management? Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1058] [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: 11/15/2022] Open
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18
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Cannie D, Protonotarios A, Lorenzini M, Akhtar M, Syrris P, Lopes L, Elliott P. The influence of age on the diagnostic yield of genetic testing in dilated cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2102] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Dilated cardiomyopathy (DCM) has an estimated population prevalence of 1/250 and is the underlying diagnosis in a third of heart failure patients. A substantial proportion of patients have familial disease caused by dominant mutations in one of more than 50 genes, but clinical practice guidelines recommend genetic testing in young patients with idiopathic DCM. There is an absence of robust data on the influence of age on the diagnostic yield of genetic testing.
Methods
The study cohort comprised 825 consecutive and unrelated patients (524 male (63.5%)) with DCM who underwent genetic testing from 2015 to 2019. Genetic variants were classified using American College of Medical Genetics (ACMG) criteria. Analyses were stratified by age and sex.
Results
173 (20.1%) patients had a positive genetic test (“pathogenic” or “likely pathogenic” variant); 292 (34.4%) had a variant of unknown significance. Mean age at genetic testing was 49.9±14.4 years. Mean age of patients with a positive test was 47.6±13.6 years. 99 (18.9%) men and 67 (22.3%) women had a positive test (p=0.246).
Mutations in the TTN gene, encoding for titin, accounted for 46.1% of positive results. 13.8% of mutations were in DSP, 8.4% in RBM20, 6% in FLNC, 4.2% in LMNA, 3.6% in BAG3 and 3.6% in MYH7.
There was a trend to declining yield with age (likelihood ratio chi-square p value = 0.047). The yield was 17.2% in the 56–65 year age group and 11.5% above 66 years of age (figure 1).
Conclusions
Approximately 1 in 5 patients with DCM had a positive genetic test. The yield declined in patients over 66 years but remained above 11%, suggesting that genetic testing should not be confined to younger patients with DCM.
Figure 1. Yield of Genetic Testing by Age
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- D.E Cannie
- University College London & Barts Heart Centre, London, United Kingdom
| | - A Protonotarios
- University College London & Barts Heart Centre, London, United Kingdom
| | - M Lorenzini
- University College London & Barts Heart Centre, London, United Kingdom
| | - M Akhtar
- University College London & Barts Heart Centre, London, United Kingdom
| | - P Syrris
- University College London & Barts Heart Centre, London, United Kingdom
| | - L Lopes
- University College London & Barts Heart Centre, London, United Kingdom
| | - P Elliott
- University College London & Barts Heart Centre, London, United Kingdom
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19
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Khan S, Khan H, Khan S, Akhtar M. Evaluation of variation of D-dimer levels in COVID-19 patients to predict the disease outcome in a hospital based study. APIC 2020. [DOI: 10.35975/apic.v24i5.1355] [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: 11/13/2022] Open
Abstract
Objectives: To determine the variation of d-dimers in COVID-19.
To determine the contribution of demographic factors (age and gender) toward an elevated d-dimers values. To determine the probability of surviving in different age groups in COVID-19, with d-dimer > 0.5 µg/ml.
Methodology: A total of 193 patients were enrolled from COVID-19 isolation units, Hayatabad medical complex Peshawar, whose d-dimer levels were performed as per instructions of the treating physician and were followed. Relevant information’s were recorded on a pre-designed performa prepared in accordance with the objectives of the study.
Results: Out of total 193 patients 152(78.8%) were males and 41(21.2%) females. 94(48.7%) patients were in the age range 35-55 y while 76(39.4%) patients had age more than 55 y. Regarding d-dimer readings, 162(83.9%) had d-dimer levels more than 0.5 µg/ml. The mean with standard deviation of age of the patients was 52 ± 13 y. The mean with standard deviation of d-dimer values of the patients was 4.9 ± 13.3 µg/ml. It was observed that, the relative risk of deranged values of d-dimers was 1.18 (rr = 1.18) in patients with age > 55 y. Similarly in female gender the relative risk of higher values of d-dimers above normal was 1.26 (rr = 1.26) without reaching a statistically significant p-value (p = 0.48). The probability of worse outcome in term of death was 2.06 times more in patients with d dimers > 0.5 µg/ml (OR = 2.06). Furthermore the probability of surviving was 90-100% by age < 50 y, 80% in age range 51-60 y, 45% in age range 61-70 y and 30% at age > 80 y.
Conclusion: The deranged d-dimer levels were noted in 84% of the COVID-19 patients. Age > 55 y and female gender are at higher risk of deranged d-dimers and further consequences. Survival rate of patients with deranged d-dimers drops to 30% in patients with age > 80 y, 45% at age < 70 y.
Key word: COVID-19, D-dimers, survival rate, prognostic values
Anaesth. pain intensive care 2020;24(5):
Received: 20 June 2020, Reviewed: 24, 28 June 2020, Accepted: 1 July 2020
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20
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Khan H, Khalid M, Akhtar M, Hairs M. COVID-19 Surveillance in Nowshera District Pakistan. CAJMS 2020. [DOI: 10.24079/cajms.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Hamzullah Khan
- Associate Professor Hematology, Nowshera Medical College, MTI Nowshera, Pakistan
| | - Muhammad Khalid
- Associate Professor Medicine, Nowshera Medical College, Nowshera, Pakistan
| | - Mansoor Akhtar
- Medical Officer, In-charge Anesthesia, Mian Rashid Hussain Shaheed Memorial Hospital Pabbi, Nowshera, Pakistan
| | - Muhammad Hairs
- Assistant Professor, Nowshera Medical College, Nowshera, Pakistan
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21
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Mazhar N, Aftab M, Mahmud T, Basra MR, Akhtar M, Mitu L. Synthesis, Characterization and Biological Evaluation of New Schiff Base Ligand derived from 3-hydroxy-benzaldehyde and p-toluidine and its Divalent Metal Ions. Rev Chim 2020. [DOI: 10.37358/rc.20.4.8042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A new Schiff base ligand (L) and its transition divalent metal complexes were prepared by the condensation reaction; Reaction was carried out at 70-80 oC by refluxing equimolar ratio of toluidine and aldehyde by continuous stirring for 5-6 hours. Synthesized ligand and Ni(II), Fe(II), Co(II), Mn(II) and Zn(II) bimetallic complexes were characterized by using FT-IR, UV-visible spectroscopy, AAS, Single crystal X-ray analysis, 1H-NMR, molar conductance. Compounds were screened against two fungus Candida glabrata and Candida albicans by agar tube dilution protocol. In vivo anti-inflammatory activity via induced paw edema method and in vitro results by heat induced protein denaturation method were checked. Synthesized compounds were also showed antioxidant activity by using DPPH (diphenylpicrylhydrazyl) and Trolox was used as standard. These studies show that ligand and almost all metal complexes are reactive towards biological assays against reported standard drugs. Zn-L indicates more activeness for antioxidant activity and free ligand while Co-L recognized as more effective anti-inflammatory drug.
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22
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Akhtar M, Rangel-Sousa D, Palomino-Doza J, Arana Achaga X, Bilinska Z, Zamarreno Golvano E, Climent V, Navarro Penalver M, Barriales-Villa R, Charron P, Yotti R, Zorio E, Jimenez-Jaimez J, Garcia-Pavia P, Elliott PM. 5163Predictors of adverse cardiovascular events in patients with truncating variants in the filamin c (flnc) gene. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0048] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Truncating variants in Filamin C (FLNCtv) are associated with arrhythmogenic (AC) and dilated cardiomyopathies (DCM). Affected patients are reported to demonstrate a high incidence of arrhythmic and heart-failure related cardiovascular events. The aim of this study was to determine factors that predict adverse events in mutation carriers.
Methods
The study cohort comprised 168 FLNCtv carriers followed at 19 European centres. Baseline and longitudinal follow-up clinical data were collected. The primary endpoint was a composite of sudden cardiac death (SCD), aborted SCD, appropriate implantable cardioverter-defibrillator (ICD) shock, cardiac transplantation (HTx) and mortality from end-stage heart failure (ESHF).
Results
47 different pathogenic or likely-pathogenic FLNCtv were identified in 60 unrelated probands. In those with baseline and longitudinal data (160 patients; 57 probands), 114 (71.3%) patients exhibited evidence of cardiac disease at initial evaluation. Gene penetrance was 85% by the age of 40 years. During a median follow-up of 1.5 years (IQR 4.1), 24 individuals (15%) reached the primary endpoint – 16 arrhythmic (SCD/aborted SCD/ICD shock) and 8 heart failure (ESHF/HTx) related-events. Univariable predictors at baseline evaluation of the composite primary endpoint included proband status (HR 4.0, 95% CI: 1.5–10.9, p=0.01), symptoms of dyspnoea (HR 2.8, 95% CI: 1.2–6.4, p=0.02), LV systolic dysfunction (LVSD) (HR 12.4, 95% CI: 2.9–53.2, p=0.001), frequent ventricular ectopy (VE>500) on 24-hour Holter (HR 9.3, 95% CI: 1.2–74.7, p=0.04) and the presence of late gadolinium enhancement on CMR (HR 8.9, 95% CI: 1.2–68.5, p=0.04).
Multivariable analysis identified LVSD (LVEF <50%) at baseline as an independent predictor of the primary endpoint with a hazard ratio of 8.6 (95% CI: 1.8–41.5, p=0.007). ROC analysis using LV systolic dysfunction to predict the primary endpoint demonstrated an area under the curve of 0.84 (95% CI: 0.76–0.91, p<0.001) and identified an optimal LVEF “cut-off” of 47% for predicting adverse events with a Youden's index of 0.61 (sensitivity 0.91; specificity 0.70).
Kaplan-Meier plot to demonstrate freedom
Conclusions
LVSD is associated with an over 8-fold increase in the hazard of a primary endpoint event in FLNCtv gene carriers indicating that these patients should be considered for implantable cardioverter-defibrillator (ICD) implantation, optimal heart failure medical therapy and close clinical follow-up.
Acknowledgement/Funding
NIHR Biomedical Research Centre; Instituto de Salud Carlos III; DETECTIN-HF project; Wellcome Trust;CIBERCV; EU Regional Development Fund; FEDER.
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Affiliation(s)
- M Akhtar
- Barts Health NHS Trust, London, United Kingdom
| | | | | | - X Arana Achaga
- University Hospital Donostia, Donostia-San Sebastian, Spain
| | - Z Bilinska
- The Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland
| | | | - V Climent
- General University Hospital of Alicante, Alicante, Spain
| | | | - R Barriales-Villa
- Instituto de Investigaciόn Biomédica de A Coruña (INIBIC), A Coruna, Spain
| | - P Charron
- Hospital Pitie-Salpetriere, Paris, France
| | - R Yotti
- University Hospital Gregorio Maranon, Madrid, Spain
| | - E Zorio
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - P M Elliott
- University College London, London, United Kingdom
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23
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Zameer S, Vohora D, Ali J, Akhtar M. Brain targeted alendronate loaded chitosan nanoparticles exerts neuroprotective effect against intracerebroventricular streptozotocin induced Alzheimer’s disease in mice. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Arif AM, Yousaf A, Zhong RL, Akhtar M, Muhammad S, Xu HL, Su ZM. Metal ions doped into merocyanine form of coumarin derivatives: nonlinear optical molecular switches. J Mol Model 2019; 25:212. [PMID: 31280370 DOI: 10.1007/s00894-019-4068-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Abstract
In the present study, DFT calculations are carried out on domestically designed 7-methyl-2-phenyl-5'H-spiro[chromene-4,2'-chromeno[3,4-e][1,3]oxazin]-5'-one spiropyran and merocyanine derivatives to recognize alkali and alkaline earth metal ions. Detection of these metal ions can be attained by exploiting the variation of the second-order nonlinear optical properties. Merocyanine forms of these derivatives exhibit the ability to complex with different metal ions (Li+, Na+, K+, and Ca2+), which is associated with large contrasts in the hyper-Rayleigh scattering (HRS) response as a function of metal size and charge. Interestingly, in this study, Mero-Li+ shows significant nonlinear optical response with dynamic HRS first hyperpolarizability amounting to 7607 a.u., which is about nine times higher than its corresponding spiro form (846 a.u.) at the CAM-B3LYP/6-311G* level of theory. The present investigation clarifies the effect of metal nature on the enhancement of the first hyperpolarizability between the closed and open forms of the studied coumarin derivatives. Graphical abstract The coumarin-based compound 3 demonstrate the higher second-order NLO responses as a function of metal cation size and charges. Complexation of smaller alkali metal ions leads to the formation of stronger metal-ligand bonds, larger geometrical relaxations and significant enhancement of the HRS first hyperpolarizabilities. This present investigation elucidates the effect of metal nature on the enhancement of the first hyperpolarizability between the closed and open forms of studied coumarin derivatives.
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Affiliation(s)
- Ali Muhammad Arif
- Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun, 130024, Jilin, People's Republic of China
| | - Afifa Yousaf
- Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun, 130024, Jilin, People's Republic of China
| | - Rong-Lin Zhong
- Laboratory of Theoretical and Computational Chemistry, Institute of Theoretical Chemistry, Jilin University, Changchun, 130023, Jilin, People's Republic of China
| | - Mansoor Akhtar
- Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun, 130024, Jilin, People's Republic of China
| | - Shabbir Muhammad
- Department of Physics, College of Science, King Khalid University, P.O. Box 9004, Abha, 61413, Saudi Arabia
| | - Hong-Liang Xu
- Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun, 130024, Jilin, People's Republic of China.
| | - Zhong-Min Su
- Institute of Functional Material Chemistry, Faculty of Chemistry, Northeast Normal University, Changchun, 130024, Jilin, People's Republic of China. .,School of Chemistry and Environmental Engineering, Changchun University of Science and Technology, Changchun, Jilin, People's Republic of China.
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25
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Akhtar AMA, Patel K, Chahal A, Akhtar M, Nay A, Fung K, Sekhri N, Treibel T, Westwood M, Davies C, Khanji M, Manisty C, Lorenzini M, Moon J, Petersen SE. P593Hypereosinophilic carditis (HEC): a cmr-based case series from a quaternary cardiology centre. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A M A Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Patel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Chahal
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Akhtar
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - A Nay
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - K Fung
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - N Sekhri
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - T Treibel
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Westwood
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Davies
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Khanji
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - M Lorenzini
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts Health NHS Trust, Cardiology , London, United Kingdom of Great Britain & Northern Ireland
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26
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Sagheer M, Shah S, Hussain S, Akhtar M. Impact of Non-Uniform Heat Source/Sink on Magnetohydrodynamic Maxwell Nanofluid Flow Over a Convectively Heated Stretching Surface with Chemical Reaction. j nanofluids 2019. [DOI: 10.1166/jon.2019.1622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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27
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Akhtar M, Boshnaq M, Nagendram S. Quality improvement measures: effects on rectal cancer tissue biopsy process. Int J Health Care Qual Assur 2019; 31:775-783. [PMID: 30354890 DOI: 10.1108/ijhcqa-06-2017-0097] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention. Multidisciplinary colorectal meetings indicate that there are patients who require multiple tissue biopsy episodes prior to histologically confirming rectal cancer. The purpose of this paper is to examine a quality improvement (QI) measure's impact on tissue biopsy process diagnostic yield. DESIGN/METHODOLOGY/APPROACH The authors performed the study in two phases (pre- and post-QI), between February 2012 and April 2014 in a district general hospital. The QI measures were derived from process mapping a rectal cancer diagnostic pathway. The primary outcome was to assess the tissue biopsy process diagnostic yield. The secondary outcome included total breaches for a 62-day target in the pre- and post-QI study phases. FINDINGS There was no significant difference in demographics or referral mode in both study phases. There were 81 patients in the pre-QI phase compared to 38 in the post-QI phase, 68 per cent and 74 per cent were referred via the two-week wait urgent pathway, respectively. Diagnostic tissue biopsy process yield improved from 58.1 to 77.6 per cent after implementing the QI measure ( p=0.02). The 62-day target breach was reduced from 14.8 to 3.5 per cent ( p=0.42). PRACTICAL IMPLICATIONS Simple QI measures can achieve significant improvements in rectal cancer diagnostic tissue biopsy process yields. A multidisciplinary approach, involving process mapping and cause and effect modelling, proved useful tools. ORIGINALITY/VALUE A process mapping exercise and QI measures resulted in significant improvements in diagnostic yield, reducing the episodes per patient before histological diagnosis was confirmed.
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Affiliation(s)
- Mansoor Akhtar
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | - Mohamed Boshnaq
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
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Khan SU, Du J, Ma Y, Akhtar M, Nawaz MH, Peng J, Cheng S, Zhao Y, Li Y. Keggin type butterfly core phosphate-bridged poly-nuclear copper (II) complex photo/bi-functional electro-catalytic material. INORG CHEM COMMUN 2019. [DOI: 10.1016/j.inoche.2018.12.008] [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: 11/16/2022]
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Akhtar M, Saleem S, Ahmad T, Ahmad E, Lashari M, Ayaz M, Lodhi L, Ahmad I, Hussain I, A khtar M. Effect of lecirelin acetate, hCG or progesterone administration on day 7 post-insemination on conception rate and progesterone concentration in cross-bred cattle. IJVS 2019. [DOI: 10.33899/ijvs.2019.153842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Nickkho-Amiry M, Horne G, Akhtar M, Mathur R, Brison DR. Hydatidiform molar pregnancy following assisted reproduction. J Assist Reprod Genet 2019; 36:667-671. [PMID: 30612209 DOI: 10.1007/s10815-018-1389-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION The use of assisted reproduction techniques (ART) is increasing; however, reports of molar pregnancy following ART remain scarce. Currently, the Human Fertility and Embryology Authority (HFEA) collates data on the molar pregnancies that have resulted through the use of ART. Recently, they have indicated that they will no longer collect these data. AIM This paper aimed to examine the incidence of molar pregnancy amongst patients undergoing assisted reproduction. METHODS We contacted HFEA and placed a request under the Freedom of Information Act (2000) for the number of molar pregnancies that resulted from fresh/frozen embryo transfer since HFEA started collecting data in 1991 to February 2018. We also asked how many patients who had suffered a molar pregnancy went on to have a normal pregnancy and how many had subsequent molar pregnancies, in subsequent treatment cycles. RESULTS Between 68 and 76 molar pregnancies occurred within this period using ART (n = 274,655). The incidence of molar pregnancy using fresh intracytoplasmic sperm injection (ICSI) (1/4302) and fresh in vitro fertilisation (IVF) (1/4333) was similar. The risk of recurrence of molar pregnancy following a previous molar was higher following ART compared to spontaneous conceptions. CONCLUSION The use of ICSI should be protective against triploidy; however, the retrospective data suggests that molar pregnancy is not eliminated with the use of ART. It is pertinent to continue to record this data, through the gestational trophoblastic disease centres, in order to ensure no further increase in incidence, appropriate follow-up, and transparency in communication.
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Affiliation(s)
- M Nickkho-Amiry
- Department of Obstetrics and Gynaecology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-lyne, OL6 9RW, UK.
| | - G Horne
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - M Akhtar
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - R Mathur
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - D R Brison
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.,Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Ullah MZ, Awais MM, Akhtar M, Anwar MI, Navid MT, Khan I, Razzaq A. Seroprevalence, associated risk factors and hematological impacts of toxoplasmosis in small ruminants of Multan, Punjab-Pakistan. Trop Biomed 2018; 35:1028-1040. [PMID: 33601850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Toxoplasmosis is a protozoal infection of zoonotic potential with worldwide geographical distribution which affects nearly all warm-blooded animals including mammals and birds. Keeping in view, this study was conducted to determine the seroprevalence of toxoplasmosis along with associated risk factors and its haematological impacts in small ruminants of district Multan, Pakistan. In this study, a total of 250 sera samples collected from sheep (n=125) and goats (n=125) from three tehsils of Multan were examined using commercially available Latex agglutination test kit for the presence of anti-T. gondii antibodies. The haematological profiles of Toxoplasma seropositive and seronegative animals were determined by using automated haematology analyser. Overall seroprevalence of toxoplasmosis in small ruminants was 42.80% with a higher prevalence rate (44.80%) in sheep as compared to goats (40.80%). Sex, existence of co-morbid conditions, feeding pattern and presence of pet cats and dogs were identified as significant (P<0.05) risk factors associated with the presence of antibodies against toxoplasmosis. The breed was found to be a significant (P=0.026) risk factor for the seroprevalence of toxoplasmosis in goats but not in sheep. Haematological analysis revealed significantly altered leukocytic counts (P<0.05) in seropositive sheep and goats as compared to seronegative ones. Our findings showed that small ruminants of the Multan District in Pakistan are toxoplasma seropositive and may pose a serious threat of public health concern in the region.
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Affiliation(s)
- M Z Ullah
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - M M Awais
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - M Akhtar
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - M I Anwar
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - M T Navid
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - I Khan
- Department of Clinical Sciences, College of Veterinary and Animal Sciences, Jhang, Pakistan
| | - A Razzaq
- Pakistan Agricultural Research Council, Islamabad, Pakistan
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Khan SU, Liu BL, Akhtar M, Du J, Peng J, Zhao X, Xi WG, Zang HY, Li YG. Proton conductive watery channels constructed by in situ generated 3D lanthanide connected monolacunary polyoxometalate. INORG CHEM COMMUN 2018. [DOI: 10.1016/j.inoche.2018.09.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Foutz C, Godden S, Bender J, Diez-Gonzalez F, Akhtar M, Vatulin A. Exposure to antimicrobials through the milk diet or systemic therapy is associated with a transient increase in antimicrobial resistance in fecal Escherichia coli of dairy calves. J Dairy Sci 2018; 101:10126-10141. [DOI: 10.3168/jds.2018-14598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/30/2018] [Indexed: 11/19/2022]
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Khan SU, Akhtar M, Khan FU, Peng J, Hussain A, Shi H, Du J, Yan G, Li Y. Polyoxometalates decorated with metal-organic moieties as new molecular photo- and electro-catalysts. J COORD CHEM 2018. [DOI: 10.1080/00958972.2018.1500694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Shifa Ullah Khan
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Mansoor Akhtar
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Faheem Ullah Khan
- Department of Biotechnology Women University of AJ&K, Bagh, Pakistan
| | - Jun Peng
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Aftab Hussain
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Hongfei Shi
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Jing Du
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Gang Yan
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
| | - Yangguang Li
- Key Laboratory of Polyoxometalate Science of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin, PR China
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Bugiardini E, Phadke R, Maas R, Pittman A, Kusters B, Morrow J, Parton M, Nunes A, Akhtar M, Syrris P, Lopes L, Fotelonga T, Houlden H, Elliott P, Hanna M, Raaphorst J, Burkin D, Matthews E. CONGENITAL MUSCULAR DYSTROPHIES. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Bicho Augusto JA, Eiros R, Treibel T, Captur G, Akhtar M, Protonotarios A, Gkosios T, Savvatis K, Mohiddin S, Moon J, Elliott P, Lopes L. P3431A comparison of phenotypes of left-dominant arrhythmogenic cardiomyopathy and dilated cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - R Eiros
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - T Treibel
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - G Captur
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - M Akhtar
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - A Protonotarios
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - T Gkosios
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - K Savvatis
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - S Mohiddin
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - J Moon
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - P Elliott
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
| | - L Lopes
- Barts Health NHS Trust, Cardiac Imaging, London, United Kingdom
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37
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Dominguez Rodriguez F, Cuenca S, Bilinska Z, Toro R, Charron P, Barriales-Villa R, Asselbergs F, Akhtar M, Morris Hey T, Rangel-Sousa D, Limeres JM, Garcia-Pinilla JM, Ochoa JP, Elliott P, Garcia-Pavia P. P3169Clinical characteristics and natural history of dilated cardiomyopathy due to BAG3 mutations. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Dominguez Rodriguez
- University Hospital Puerta de Hierro Majadahonda, Inherited Cardiac Disease Unit, CNIC, CIBERCV, Madrid, Spain
| | - S Cuenca
- University Hospital Gregorio Maranon, Madrid, Spain
| | - Z Bilinska
- The Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland
| | - R Toro
- University Hospital Puerta del Mar, Cadiz, Spain
| | - P Charron
- Hospital Pitie-Salpetriere, Paris, France
| | | | - F Asselbergs
- University Medical Center Utrecht, Utrecht, Netherlands
| | - M Akhtar
- St Bartholomew's Hospital, London, United Kingdom
| | | | | | - J M Limeres
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J M Garcia-Pinilla
- University Hospital Virgen de la Victoria, IBIMA, CIBERCV, Malaga, Spain
| | | | - P Elliott
- St Bartholomew's Hospital, London, United Kingdom
| | - P Garcia-Pavia
- University Hospital Puerta de Hierro Majadahonda, Inherited Cardiac Disease Unit, CNIC, CIBERCV, Madrid, Spain
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Hussain M, Ganjoo G, Akhtar M, Najmi A. Knowledge, awareness and preventive practices regarding chikungunya fever after a major outbreak. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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39
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Boshnaq M, Phan YC, Martini I, Harilingam M, Akhtar M, Tsavellas G. Limberg flap in management of pilonidal sinus disease: systematic review and a local experience. Acta Chir Belg 2018; 118:78-84. [PMID: 29390948 DOI: 10.1080/00015458.2018.1430218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 10/18/2022]
Abstract
OBJECTIVES To review published evidence of Limberg flap (LF) use in pilonidal sinus disease (PSD). We also included our local experience of LF. METHODS Medline and Embase database were searched for the words 'pilonidal, sinus, Limberg, flap'. Non-English articles and those not-related to our scope of search were omitted. We included a retrospective study of patients underwent LF in our district hospital. Data including length of hospital stay, post-operative complications and recurrence were collected. RESULTS Literature review revealed 68 studies (22 case series, 35 comparative studies, nine RCTs and two meta-analyses). Recurrence rate was 0-7.4% in case series. Recurrence rate in comparative studies was 0-8.3%, compared to 4-37.7% for primary closure and 0-11% for Karydakis flap. RCTs showed that LF or its modification is superior to primary closure, with comparable results to Karydakis flap. About 26 patients included in the cohort study (16 male, average age 27 years). Six patients presented with recurrent disease. Post-operative length of hospital stay was four to seven days. Post-operative complication rate was 11.5% - [two partial wound dehiscence, one wound infection]. Recurrence rate was 7.7%. Average follow-up was 18 months. CONCLUSIONS Limberg flap presents a safe and effective method that can be offered for patients with primary or recurrent PSD.
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Affiliation(s)
- Mohamed Boshnaq
- General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK
- Lecturer of General Surgery, Ain Shams University Hospital, Cairo, Egypt
| | - Yih Chyn Phan
- General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK
| | - Iana Martini
- General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK
| | | | - Mansoor Akhtar
- General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK
| | - George Tsavellas
- General Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK
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40
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Imran M, Hassan MQ, Akhtar MS, Rahman O, Akhtar M, Najmi AK. Sacubitril and valsartan protect from experimental myocardial infarction by ameliorating oxidative damage in Wistar rats. Clin Exp Hypertens 2018; 41:62-69. [PMID: 29595329 DOI: 10.1080/10641963.2018.1441862] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 12/14/2022]
Abstract
BACKGROUND Sacubitril (SAC), a neprilysin inhibitor prevent degradation of neprilysin and activate cGMP signaling pathways leading to rise in blood volume concurrent to blood pressure by means of vasoactive peptides, adrenomedullin, and bradykinin. OBJECTIVE The aim of this study was to evaluate the anti-ischemic effects of SAC through inhibiting neprilysin in isoproterenol (ISO) induced myocardial infarction (MI) in Wistar albino rats. ISO (85 mg/kg) was injected subcutaneously at the end of 14 days pre-treatment with SAC and valsartan (VAL). RESULT Biochemical investigation revealed that SAC along with VAL significantly prevented the antioxidant enzymes (SOD, Catalase, GR, GPx, GST, and GSH) degradation and malondialdehyde (MDA) induced by ISO intoxication in Wistar rats. Along with this, cardiac biomarkers (LDH, CK-MB, ALT, AST, and ALP) were also significantly ameliorated by SACand VAL in ISO-treated rats. Concurrently, decreased infarction area (IA)and marked reduction in myofibril damage by SACand VAL further supported its protective benefits in MI. CONCLUSION Taken together, the results suggest that inhibition of enzyme neprilysin alleviated the ISO induces myocardial damage mediated by its strong antioxidant potential.
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Affiliation(s)
- Mohd Imran
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India
| | - Md Quamrul Hassan
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India.,b Department of Pharmacology (Ilmul Advia), Ajmal Khan Tibbiya College , Aligarh Muslim University , Uttar Pradesh , India
| | - Md Sayeed Akhtar
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India.,c School of Allied Health Science , Sharda University , Uttar Pradesh , India
| | - Obaid Rahman
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India
| | - M Akhtar
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India
| | - Abul Kalam Najmi
- a Department of Pharmacology, Faculty of Pharmacy , Jamia Hamdard , New Delhi , India
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Navid MT, Farooq U, Latif A, Awais MM, Anwar MI, Akhtar M, Zahur AB. Prevalence of foot and mouth disease virus in apparently healthy buffaloes brought to Islamabad slaughterhouse in Pakistan. Trop Biomed 2018; 35:161-167. [PMID: 33601788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study was conducted to determine the sero-prevalence of foot and mouth disease (FMD) in buffaloes (Bubalus bubalis) slaughtered at Islamabad slaughterhouse, Pakistan. Sera and oro-pharyngeal (OP) fluid were collected from 630 healthy buffaloes. These animals originated from various livestock markets from 14 districts of Punjab. The age of animals ranged from 1 to 15 years. Sera were analyzed using FMD virus (FMDV) nonstructural proteins (NSP) and indirect ELISA. The sero-prevalence of FMD was 47.1% (n=297). There was a strong association between age of animal and its risk of being positive for FMD NSP ELISA (Odds ratio 1.27; p<0.001; CI 1.22-1.32). The OP fluids were tested for the presence of FMDV by real time PCR. FMDV specific signals were detected in 33 samples (11.1%). Virus recovery attempts were made after treating them with tri-chloro-tri-flouroethane onto LFBK cell line and four FMD isolates were recovered. This study indicated high sero-prevalence of FMDV in buffaloes slaughtered at abattoir in Islamabad. Furthermore, the virus recovery from these animals is suggestive of their possible role in persistence and transmission of FMDV to other animals.
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Affiliation(s)
- M T Navid
- Animal Health Laboratories, Animal Sciences Institute, National Agricultural Research Centre, Park Road, Islamabad, 45500, Pakistan
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - U Farooq
- Animal Health Laboratories, Animal Sciences Institute, National Agricultural Research Centre, Park Road, Islamabad, 45500, Pakistan
| | - A Latif
- Animal Health Laboratories, Animal Sciences Institute, National Agricultural Research Centre, Park Road, Islamabad, 45500, Pakistan
| | - M M Awais
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - M I Anwar
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - M Akhtar
- Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - A B Zahur
- Animal Health Laboratories, Animal Sciences Institute, National Agricultural Research Centre, Park Road, Islamabad, 45500, Pakistan
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Monim-ul-Mehboob M, Ramzan M, Zierkiewicz W, Michalczyk M, Mahmood R, Altaf M, Nadeem S, Akhtar M, Ahmad S. Synthesis, Characterization, and DFT Investigation of a Zinc(II)–Silver(I) Bimetallic Complex, [Zn(Dmen)2{Ag(CN)2}2][Zn(Dmen)2(H2O)2]{Ag(CN)2}2 (Dmen = N,N′-Dimethylethylenediamine). RUSS J COORD CHEM+ 2018. [DOI: 10.1134/s1070328418030041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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43
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Nickkho-Amiry M, Savant R, Majumder K, Edi-O'sagie E, Akhtar M. The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis. Arch Gynecol Obstet 2018; 297:1043-1057. [PMID: 29344847 PMCID: PMC5849664 DOI: 10.1007/s00404-017-4640-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 06/13/2017] [Accepted: 12/22/2017] [Indexed: 01/13/2023]
Abstract
Objective To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART). Design A systematic review and meta-analysis. Setting Department of reproductive medicine at teaching university hospital, UK. Patients Subfertile women with endometrioma undergoing ART. Interventions Surgical removal of endometrioma or expectant management. Main outcome measures Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins. Results An extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not. Conclusion Current evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.
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Affiliation(s)
- M Nickkho-Amiry
- University Hospital of South Manchester, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, UK.
| | - R Savant
- Central Manchester Foundation Trust, Manchester, UK
| | - K Majumder
- Central Manchester Foundation Trust, Manchester, UK
| | | | - M Akhtar
- Central Manchester Foundation Trust, Manchester, UK
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Abdulla S, Lynes K, Nagendram S, Akhtar M. Amyand's hernia managed with open repair and laparoscopic appendicectomy. J Surg Case Rep 2017; 2017:rjx223. [PMID: 29383236 PMCID: PMC5786248 DOI: 10.1093/jscr/rjx223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/07/2017] [Accepted: 11/15/2017] [Indexed: 12/04/2022] Open
Abstract
We present a rare case of Amyand's hernia that was surgically managed using an open repair of hernia combined with laparoscopic appendicectomy. A 68-year-old man presented with an irreducible recurrent right-sided inguinal hernia and abdominal pain. This gentleman had undergone three previous inguinal hernia repairs on the right, and one on the left using the open mesh technique. Ultrasound suggested the possibility of the appendix within the hernial sac and clinical correlation was advised. An open groin approach was taken to repair the incarcerated hernia. This revealed an indirect inguinal hernia containing the appendix with signs of inflammation. The base of the appendix was not visible due to there being a long appendix with fixed cecum in the abdomen. To safely resect the appendix, a laparoscopy was performed and the appendix was successfully removed. The inguinal hernia was repaired using a sutured technique without mesh. There were no post-operative complications.
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Affiliation(s)
- Suha Abdulla
- King’s College London School of Medical Education, Medicine, London SE1 9RT, UK
| | - Kathryn Lynes
- Queen Elizabeth The Queen Mother Hospital, General Surgery Margate, UK
| | - Sathyan Nagendram
- Queen Elizabeth The Queen Mother Hospital, General Surgery Margate, UK
| | - Mansoor Akhtar
- Queen Elizabeth The Queen Mother Hospital, General Surgery Margate, UK
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45
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Gurunathan S, Zacharias K, Akhtar M, Ahmed A, Mehta V, Karogiannis N, Vamvakidou A, Khattar R, Senior R. P6025A management strategy based on exercise echocardiography is more cost-effective than exercise ecg in patients presenting with suspected angina during long term follow up: a randomised study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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46
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Gurunathan S, Ahmed A, Karogiannis N, Ramzy I, Vamvakidou A, Young G, Zidros S, Akhtar M, Elghamaz A, Senior R. P6026Diagnostic concordance and clinical outcomes in patients undergoing fractional flow reserve and stress echocardiography for the assessment of coronary stenosis of intermediate severity. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Merali N, Yousuff M, Lynes K, Akhtar M. A case report on a rare presentation of solitary rectal ulcer syndrome. J Surg Case Rep 2017; 2017:rjw197. [PMID: 28458840 PMCID: PMC5400492 DOI: 10.1093/jscr/rjw197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 02/28/2017] [Indexed: 11/13/2022] Open
Abstract
We describe a highly unusual case of solitary rectal ulcer syndrome (SRUS) that presented as a large polyp protruding from the anal canal. A 67-year-old man presented with rectal bleeding and mucus discharge. At examination under anaesthesia, a large pedunculated polypoidal lesion was found, measuring 25 × 20 mm, arising posterolaterally from the anorectal junction and protruding externally 50 mm in size. SRUS can be a misnomer as the condition can present in a number of different ways and only a minority of patients has a solitary ulcer. Other findings include multiple ulcers, hyperaemic mucosa or a broad-based polypoidal mass. In this case, a rare presentation of SRUS in the form of a large polyp was confirmed by histology. A key learning point is to remember that although less common than other causes of rectal symptoms, it should be considered as part of the differential diagnosis once sinister causes have been excluded.
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Affiliation(s)
- N Merali
- General Surgery Department, Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University Health Trust, NHS, Canterbury, Margate, UK
| | - M Yousuff
- General Surgery Department, Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University Health Trust, NHS, Canterbury, Margate, UK
| | - K Lynes
- General Surgery Department, Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University Health Trust, NHS, Canterbury, Margate, UK
| | - M Akhtar
- General Surgery Department, Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University Health Trust, NHS, Canterbury, Margate, UK
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48
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Husain I, Akhtar M, Abdin MZ, Islamuddin M, Shaharyar M, Najmi AK. Rosuvastatin ameliorates cognitive impairment in rats fed with high-salt and cholesterol diet via inhibiting acetylcholinesterase activity and amyloid beta peptide aggregation. Hum Exp Toxicol 2017; 37:399-411. [PMID: 28441890 DOI: 10.1177/0960327117705431] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 11/17/2022]
Abstract
Amyloid beta (Aβ) peptide aggregation and cholinergic neurodegeneration are involved in the development of cognitive impairment. Therefore, in this article, we examined rosuvastatin (RSV), an oral hypolipidemic drug, to determine its potential as a dual inhibitor of acetylcholinesterase (AChE) and Aβ peptide aggregation for the treatment of cognitive impairment. Molecular docking study was done to examine the affinity of RSV with Aβ1-42 and AChE in silico. We also employed neurobehavioral activity tests, biochemical estimation, and histopathology to study the anti-Aβ1-42 aggregation capability of RSV in vivo. Molecular docking study provided evidence that RSV has the best binding conformer at its receptor site or active site of an enzyme. The cognitive impairment in female Wistar rats was induced by high-salt and cholesterol diet (HSCD) ad libitum for 8 weeks. RSV ameliorated serum cholesterol level, AChE activity, and Aβ1-42 peptide aggregations in HSCD induced cognitive impairment. In addition, RSV-treated rats showed greater scores in the open field (locomotor activity) test. Moreover, the histopathological studies in the hippocampus and cortex of rat brain also supported that RSV markedly reduced the cognitive impairment and preserved the normal histoarchitectural pattern of the hippocampus and cortex. Taken together, these data indicate that RSV may act as a dual inhibitor of AChE and Aβ1-42 peptide aggregation, therefore suggesting a therapeutic strategy for cognitive impairment treatment.
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Affiliation(s)
- I Husain
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), New Delhi, India
| | - M Akhtar
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), New Delhi, India
| | - M Zainul Abdin
- 2 Department of Biotechnology, Faculty of Science, Jamia Hamdard (Hamdard University), New Delhi, India
| | - M Islamuddin
- 2 Department of Biotechnology, Faculty of Science, Jamia Hamdard (Hamdard University), New Delhi, India
| | - M Shaharyar
- 3 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), New Delhi, India
| | - A K Najmi
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), New Delhi, India
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49
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Caine EA, Newman TH, Marzouk O, Lynes K, Akhtar M. Subacute bowel obstruction secondary to an obturator hernia: case report and a review of the literature. J Surg Case Rep 2017; 2017:rjx061. [PMID: 28458870 PMCID: PMC5400480 DOI: 10.1093/jscr/rjx061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/11/2017] [Accepted: 03/12/2017] [Indexed: 11/14/2022] Open
Abstract
Obturator hernias are rare and are often diagnosed late. This case report discusses an 82-year-old female who had symptoms of subacute bowel obstruction. Following a computed tomography abdomen pelvis, she underwent a laparotomy for an incarcerated right obturator hernia. The hernia was repaired using a single suture and she made a good recovery. A review of the literature around obturator hernias is discussed.
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Affiliation(s)
- Eline A. Caine
- Department of General Surgical, Queen Elizabeth the Queen Mother Hospital, St Peters Road, MargateCT 9 4AN, UK
| | - Thomas H. Newman
- Department of General Surgical, Queen Elizabeth the Queen Mother Hospital, St Peters Road, MargateCT 9 4AN, UK
| | - Omar Marzouk
- Department of General Surgical, Queen Elizabeth the Queen Mother Hospital, St Peters Road, MargateCT 9 4AN, UK
| | - Kathryn Lynes
- Department of General Surgical, Queen Elizabeth the Queen Mother Hospital, St Peters Road, MargateCT 9 4AN, UK
| | - Mansoor Akhtar
- Department of General Surgical, Queen Elizabeth the Queen Mother Hospital, St Peters Road, MargateCT 9 4AN, UK
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50
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Nazir MM, Akhtar M, Maqbool A, Waheed A, Sajid MA, Ali MA, Oneeb M, Alam MA, Ahmad AN, Nazir N, Fatima S, Lindsay DS. Antibody Prevalence and Risk Factors forToxoplasma gondiiInfection in Women from Multan, Pakistan. Zoonoses Public Health 2017; 64:537-542. [DOI: 10.1111/zph.12336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Indexed: 12/01/2022]
Affiliation(s)
- M. M. Nazir
- Department of Pathobiology; Faculty of Veterinary Sciences; B.Z University; Multan Pakistan
| | - M. Akhtar
- Department of Pathobiology; Faculty of Veterinary Sciences; B.Z University; Multan Pakistan
| | - A. Maqbool
- Department of Parasitology; University of Veterinary and Animal Sciences; Lahore Pakistan
| | - A. Waheed
- Department of Pathobiology; Faculty of Veterinary Sciences; B.Z University; Multan Pakistan
| | - M. A. Sajid
- Veterinary Research Institute; Lahore Pakistan
| | - M. A. Ali
- Department of Parasitology; University of Veterinary and Animal Sciences; Lahore Pakistan
| | - M. Oneeb
- Department of Parasitology; University of Veterinary and Animal Sciences; Lahore Pakistan
| | - M. A. Alam
- Department of Parasitology; University of Veterinary and Animal Sciences; Lahore Pakistan
| | - A. N. Ahmad
- Department of Pathobiology; Faculty of Veterinary Sciences; B.Z University; Multan Pakistan
| | - N. Nazir
- Shifa International Hospital; Islamabad Pakistan
| | - S. Fatima
- The Urban Unit Company; Lahore Pakistan
| | - D. S. Lindsay
- Department of Biomedical Sciences and Pathobiology; Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg VA USA
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