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Rahman M, Ali MS. Drivers of tidal flow variability in the Pussur fluvial estuary: A numerical study by HEC-RAS. Heliyon 2024; 10:e25662. [PMID: 38370225 PMCID: PMC10867350 DOI: 10.1016/j.heliyon.2024.e25662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/20/2024] Open
Abstract
This paper aims at characterizing the longitudinal and temporal variability of tidal flows in the Gorai-Pussur River system of Bangladesh, which spans about 158 km, starting from Bordia upstream to Akram Point downstream. Considering the upstream fresh water discharge and the downstream tide level as the drivers of tidal flow variability, the spatiotemporal change in hydrodynamics of the Pussur Fluvial Estuary was simulated using HEC-RAS software at the neap-spring and seasonal scales. The model was calibrated by comparing the simulated discharge and water levels with available measured data at an intermediate station. During the dry season, the tidal effect from the sea reaches Bordia, while in the monsoon season, the tide reaches about 15 km less (up to Kalia) due to the increased flow of freshwater. The Pussur river experiences tidal amplification up to Chalna, located approximately 90 km from its mouth. Beyond Chalna, tidal dumping covers a distance of 100-170 km upto Bordia. The tidal range ratio between Akram Point and Mongla is 1.28. The phase shift of the high water is found approximately 1.0 h over a distance of 50 km. It is found that due to 50% increase of discharge in Bordia, the increase of discharges at Kalia and Chalna were found as 43% and 7%, respectively. For a 0.5 m increase in water level at downstream (Akram Point), the high and low water levels at Chalna are increased by 0.15 and 0.69 m, while for 1.0 m increase in water level at downstream, the high and low water levels at Chalna are increased by 0.67 and 1.20 m, respectively.
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Affiliation(s)
- Motiur Rahman
- Department of Civil Engineering, Khulna University of Engineering and Technology, Khulna, 9203, Bangladesh
- Mongla Port Authority, Mongla, Bagerhat, Bangladesh
| | - Md. Shahjahan Ali
- Department of Civil Engineering, Khulna University of Engineering and Technology, Khulna, 9203, Bangladesh
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Rahman M, Zhang K, Wang Y, Ahmad B, Ahmad A, Zhang Z, Khan D, Muhammad D, Ali A. Variations in soil physico-chemical properties, soil stocks, and soil stoichiometry under different soil layers, the major forest region Liupan Mountains of Northwest China. BRAZ J BIOL 2024; 84:e256565. [DOI: 10.1590/1519-6984.256565] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract Liupan Mountains are an important region in China in the context of forest cover and vegetation due to huge afforestation and plantation practices, which brought changes in soil physio-chemical properties, soil stocks, and soil stoichiometries are rarely been understood. The study aims to explore the distribution of soil nutrients at 1-m soil depth in the plantation forest region. The soil samples at five depth increments (0-20, 20-40, 40-60, 60-80, and 80-100 cm) were collected and analyzed for different soil physio-chemical characteristics. The results showed a significant variation in soil bulk density (BD), soil porosity, pH, cation exchange capacity (CEC), and electric conductivity (EC) values. More soil BD (1.41 g cm-3) and pH (6.97) were noticed in the deep soil layer (80-100 cm), while the highest values of porosity (60.6%), EC (0.09 mS cm-1), and CEC (32.9 c mol kg-1) were reflected in the uppermost soil layer (0-20 cm). Similarly, the highest contents of soil organic carbon (SOC), total phosphorus (TP), available phosphorus (AP), total nitrogen (TN), and available potassium (AK) were calculated in the surface soil layer (0-20 cm). With increasing soil depth increment a decreasing trend in the SOC and other nutrient concentration were found, whereas the soil total potassium (TK) produced a negative correlation with soil layer depth. The entire results produced the distribution of SOCs and TNs (stocks) at various soil depths in forestland patterns were 0→20cm > 20→40cm > 40→60cm ≥ 60→80cm ≥ 80→100 cm. Furthermore, the stoichiometric ratios of C, N, and P, the C/P, and N/P ratios showed maximum values (66.49 and 5.46) in 0-20 cm and lowest values (23.78 and 1.91) in 80-100 cm soil layer depth. Though the C/N ratio was statistically similar across the whole soil profile (0-100 cm). These results highlighted that the soil depth increments might largely be attributed to fluctuations in soil physio-chemical properties, soil stocks, and soil stoichiometries. Further study is needed to draw more conclusions on nutrient dynamics, soil stocks, and soil stoichiometry in these forests.
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Affiliation(s)
- M. Rahman
- Beijing Forestry University, China; Chinese Academy of Forestry, China
| | - K. Zhang
- Beijing Forestry University, China
| | - Y. Wang
- Chinese Academy of Forestry, China
| | - B. Ahmad
- Beijing Forestry University, China; Chinese Academy of Forestry, China; University of Swat, Pakistan
| | - A. Ahmad
- Shaheed Benazir Bhutto University, Pakistan
| | - Z. Zhang
- Beijing Forestry University, China; Chinese Academy of Forestry, China
| | - D. Khan
- Beijing Forestry University, China
| | | | - A. Ali
- Karakoram International University, Pakistan
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S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, 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Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Rahman M, Dal Pan G, Stein P, Levenson M, Kraus S, Chakravarty A, Rivera DR, Forshee R, Concato J. When can real-world data generate real-world evidence? Pharmacoepidemiol Drug Saf 2024; 33:e5715. [PMID: 37855046 DOI: 10.1002/pds.5715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Motiur Rahman
- Office of Medical Policy, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Gerald Dal Pan
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Peter Stein
- Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Mark Levenson
- Office of Biostatistics, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Stefanie Kraus
- Office of Regulatory Policy, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Aloka Chakravarty
- Office of the Commissioner, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Donna R Rivera
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Richard Forshee
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - John Concato
- Office of Medical Policy, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Rahman M, Jahan N, Hoque MM, Hossain MM, Ghosh K, Nupur NR, Zerin IJ, Badal MFA, Ali MA, Das K. Initial Six Month's Study of Neonatal Covid-19 in a Tertiary Care Hospital of Bangladesh. Mymensingh Med J 2024; 33:206-213. [PMID: 38163794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The pandemic Covid-19 affects mainly adult causing fatal illness specially who have co-morbidities. But as days pass by with increasing surveillances it's gradually obvious that this devastating disease also affects the children as well as neonates with greater number. The aim of study was to determine the Covid-19 in neonates. So, we can give proper emphasis on neonatal Covid-19. This cross-sectional study was conducted from April 2020 to September 2020 at Dhaka Shishu (Children) Hospital in Bangladesh. Neonates with suspected Covid-19 were tested for SARS-CoV-2 by RT- PCR. Newborn who had suspected or confirmed COVID-19 mother, exposed to relatives infected with Covid-19, related with cluster outbreak or with abnormal clinical courses such as respiratory distress, not responded to conventional treatment and also abnormal chest x-ray was selected for Covid-19 test. Data regarding gestational age, birth weight, gender, positive cases and other findings were collected and analyzed. Statistics analysis was done by SPSS version 26.0. Forty three cases were Covid-19 positive. Among them 28(65.1%) cases were male and 15(34.9%) female. Term was 39(90.6%) cases and preterm 4(9.4%). Twenty nine (67.5%) cases were belonged to medicine and 14(32.6%) surgical cases. Fourteen (32.5%) cases with Covid-19 lived in Dhaka and 29(67.5%) cases in outside of Dhaka. Eleven (25.5%) cases were positive for SARS -CoV-2 by RT- PCR within 3 days, among them 5 (11.6%) cases were within 24 hours of age. Nine (20.9%) and 23(53.5%) cases were test positive at day 4-7 and 8-28 days respectively. The main symptoms at admission were respiratory difficulty (12/43, 27.9%), fever (8/43, 18.6%), convulsion (8/43, 18.6%) and reluctance to feed (7/43, 16.6%). In neonate two or more diseases coexist in same cases. Sepsis was present in 20 (46.5%) cases with COVID-19. Perinatal asphyxia was present in 10(23.3%) and pneumonia in 8 (18.6%) cases. In laboratory findings low Hb% was present in 2/43(4.7%) cases, leukopenia in 4/43(9.3%), leukocytosis in 2/43(4.7%) and thrombocytopenia in 5/43(11.6%). Elevated CRP was present in 14/29 (32.6%) cases, hypernatremia in 10/33 (30.3%), hyponatremia in 1/33(3%), increased serum creatinine in 10/18(55.6%), and prolonged PT, aPTT in 2/2(100%). Hyperglycaemia was found in 1/15(6.7%) cases and hypoglycaemia in 2/15(13.3%). No organism was found in blood C/S. In chest X-ray, one showed patchy opacities in right lower lobe, another showed bilateral ground-glass opacity and third one revealed few patchy opacities in the right perihilar region. Among 43 cases 21(48.9%) were discharged with advice, 12(27.9%) cases referred to Covid-19 designated hospital, 2(4.7%) cases LAMA (Leave against medical advice) and 8(18.6%) cases died including one surgical case. A good number (43) of Covid-19 cases were found in this study. In neonates the clinical features could not be differentiated properly between Covid-19 or associated diseases unlike children and adult. The neonate may be a source of transmission of this disease. So, we should give proper emphasis on test, tracing and management of neonatal Covid-19.
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Affiliation(s)
- M Rahman
- Dr Maksudur Rahman, Associate Professor, Neonatology, Bangladesh Institute of Child Health (BICH), Dhaka Shishu (Children) Hospital, Bangladesh; E-mail:
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Yuan L, Rahman M, Concato J. Comparison of two assessments of real-world data and real-world evidence for regulatory decision-making. Clin Transl Sci 2024; 17:e13702. [PMID: 38093484 PMCID: PMC10766019 DOI: 10.1111/cts.13702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Real-world data (RWD) and real-world evidence (RWE) are increasingly used to support regulatory decision making, but regulatory agencies and stakeholders may apply different definitions for RWD and use different criteria to determine when analysis of such data are considered RWE in decisions on drug approvals. To explore this issue, we reviewed two prominent publications that operationalized the definitions of RWD and RWE when describing the use of RWE in drug approvals by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Both publications considered noninterventional (observational) studies, RWD as a comparator arm for a single-arm trial, product-related literature reviews, and RWD to support clinical trial implementation (e.g., to identify potential participants) as generating RWE. In contrast, inconsistencies were identified regarding types of data sources and study designs that were considered as not generating RWE. For example, a lack of agreement existed regarding whether RWE is generated when RWD describe therapeutic contexts or are used in phase I/II interventional trials, open-label extension studies, or pharmacovigilance activities. These discrepancies highlight opportunities to develop a consistent understanding of the role of RWE in regulatory decision making for drug approvals among regulatory agencies and stakeholders.
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Affiliation(s)
- Lily Yuan
- Office of Medical Policy, Center for Drug Evaluation and ResearchUS Food and Drug AdministrationSilver SpringMarylandUSA
- Division of New Technology, Technology Coding and Pricing Group, Center for MedicareCenters for Medicare & Medicaid ServicesWoodlawnMarylandUSA
| | - Motiur Rahman
- Office of Medical Policy, Center for Drug Evaluation and ResearchUS Food and Drug AdministrationSilver SpringMarylandUSA
| | - John Concato
- Office of Medical Policy, Center for Drug Evaluation and ResearchUS Food and Drug AdministrationSilver SpringMarylandUSA
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Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Thi Ngoc PN, My NN, Rasheed S, Khatun F, Van Nuil J, Thanh DN, Mạnh HL, Rahman M. Public healthcare system utilization for chronic hepatitis C infection in Vietnam. BMC Infect Dis 2023; 23:802. [PMID: 37974105 PMCID: PMC10652521 DOI: 10.1186/s12879-023-08726-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/18/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Healthcare utilization is typically adversely affected when the treatment is expensive and requires multiple visits. We examined the determinants of healthcare-seeking for Hepatitis C virus (HCV) infection which is asymptomatic, chronic, and requires costly treatment in an urban tertiary care referral hospital in Vietnam. METHODS We conducted a secondary analysis of hospital data for patients attending the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam between 2017 and 2020 specifically for HCV infection treatment. Poisson regression was used to determine the effect of personal factors (age, sex, comorbidities) and structural factors (health insurance, proximity to the facility, seasonality, year of visit) on the number of hospital visits. RESULTS From 2017 to 2020 a total of 22,052 eligible patients sought treatment in the hospital. Among the patients, 50.4% were males and 58.7% were > 50 years of age. The mean number of visits per person was 2.17. In the multivariate analysis compared to 2017, the number of hospital visits increased by 4% in 2018 and then significantly decreased in 2019 and 2020. Visit numbers were significantly lower (6%) among South East region residents compared to those from Central Highlands and for those who lived further away from the hospital. The visit numbers were significantly higher among older age groups (5-11%), those with health insurance (6%), and those with comorbidities (5%) compared to others. Although the number of hospital visits by females was higher (7%) than males in 2017, it significantly decreased in subsequent years. CONCLUSIONS Our study indicated that there are both structural and individual factors affecting the number of visits for HCV treatment. To meet the global strategy for elimination of HCV, Vietnam Government needs to address the structural and personal barriers to healthcare seeking, with a special focus on women.
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Affiliation(s)
- Phuong Nguyen Thi Ngoc
- Wellcome Asia Africa Programme, The Hospital for Tropical Diseases, Oxford University Clinical Research Unit, Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ngoc Nghiem My
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Sabrina Rasheed
- International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fatema Khatun
- International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jennifer Van Nuil
- Wellcome Asia Africa Programme, The Hospital for Tropical Diseases, Oxford University Clinical Research Unit, Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK
| | | | - Hung Le Mạnh
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Motiur Rahman
- Wellcome Asia Africa Programme, The Hospital for Tropical Diseases, Oxford University Clinical Research Unit, Ho Chi Minh City, Ho Chi Minh City, Vietnam.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK.
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Bloomfield-Clagett B, Rahman M, Smith K, Concato J. Use of Real-World Evidence in Neuroscience-Related New Drug and Biologics License Applications for Novel Therapeutics. Clin Pharmacol Ther 2023; 114:1002-1005. [PMID: 37548904 DOI: 10.1002/cpt.3018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
The US Food and Drug Administration (FDA) is evaluating the potential use of real-world evidence (RWE) in regulatory decision making. Some groups have evaluated the use of RWE in regulatory submissions in the United States and abroad, reporting that reliance on RWE to support new product approvals is relatively common. Confusion regarding the use of RWE in drug-approval decisions may arise, however, based on different application of the terms real-world data (RWD) and RWE. We evaluated RWE in new drug applications (NDAs) and biologics license applications (BLAs) from January 2019 to June 2021 for novel drugs and biologics approved by the FDA with indications related to psychiatry, neurology, pain, or sedation (here, termed neuroscience-related). We sought to determine whether the submissions included RWE and to describe the types of data and study designs used. Thirty neuroscience-related NDAs or BLAs were identified for novel drugs and biologics approved during the time-period of interest. Among these approvals, three applications (10%) were adjudicated as containing RWE, one of which included RWE as primary evidence of effectiveness. Our findings highlight how different operational definitions of the terms RWD and RWE can result in demonstrably different reporting of the use of RWE in regulatory decision making for neuroscience-related novel drugs and biologics. A better understanding of this topic, along with awareness of regulatory definitions of RWE, are important factors to promote accurate tracking and reporting of regulatory submissions involving RWE. These factors can also improve awareness among the stakeholder community regarding the role of RWD and RWE in regulatory decision making.
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Affiliation(s)
| | - Motiur Rahman
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kimberly Smith
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - John Concato
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
- Yale School of Medicine, New Haven, Connecticut, USA
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Elliston C, Rahman M, Sloop A, Wang YF, Xu Y, Zhang R, Adamovics JA, Wuu CS. 3D Dosimetry for Electron Flash Radiotherapy: Assessment of Radiochromic Dosimeter Phantoms with Optical CT Scanning as a 3D Dosimetry System. Int J Radiat Oncol Biol Phys 2023; 117:S142. [PMID: 37784363 DOI: 10.1016/j.ijrobp.2023.06.553] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Many of the dosimeters used in conventional radiation therapy exhibit dose rate dependence which prohibits their use in ultra-high-dose-rate (FLASH) radiation therapy. Radiochromic plastic dosimeter PRESAGE® has been used for 3D dosimetry for many years. We hypothesized that these phantoms would show dose-rate independence throughout both the conventional and FLASH RT regimes, indicating these phantoms exhibit qualities useful for relative 3D dosimetry in FLASH electron beams. MATERIALS/METHODS FLASH experiments were performed using a commercially available linear accelerator, converted to deliver an ultra-high-dose-rate 10 MeV electron beam. The LINAC delivered approximately 0.7 Gy/pulse for FLASH irradiations. Dose rate was varied from about 40 Gy/s to 240 Gy/s by changing the repetition rate. PRESAGE phantoms were irradiated en face at six FLASH dose rates: 40 Gy/s, 80 Gy/s, 120 Gy/s, 160 Gy/s, 200 Gy/s, and 240 Gy/s. EBT film and scintillator measurements were used to verify dose delivered. The optical response of the PESAGE phantom versus delivered dose was evaluated with various known doses. A novel parallel-beam optical CT scanner, utilizing fiber optic taper for collimated images, was developed for fast, high resolution, and accurate readout of 3D dosimeters. Percent depth dose curves for various FLASH dose rates and conventional dose rate beams were generated and compared based on the optical response versus dose measurements. Percent depth dose curves from Monte Carlo calculation of the presage phantom were also compared. RESULTS As shown in Table 1, the percent depth dose as a function of depth for six FLASH dose rates (240-40 Gy/s) are nearly identical, indicating that optical response of PRESAGE is dose-rate independent. The optical density of PRESAGE phantom was confirmed to be linear with absorbed dose for all FLASH dose rates, consistent with the observation at regular treatment dose rates. CONCLUSION PRESAGE phantoms show dose-rate independence in electron beams for a wide range of dose rates from conventional to ultra-high-dose-rates, indicating these phantoms can be useful for relative 3D dose measurements in FLASH electron beams. Future experiments will be undertaken as part of the commissioning of a commercially available FLASH radiotherapy unit.
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Affiliation(s)
- C Elliston
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - M Rahman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Sloop
- Thayer School of Engineering, Dartmouth College, Hanover, NH
| | - Y F Wang
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - Y Xu
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - R Zhang
- Thayer School of Engineering, Dartmouth College, Hanover, NH
| | - J A Adamovics
- Department of Chemistry, Rider University, Lawrenceville, NJ
| | - C S Wuu
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
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Mondal M, Islam MN, Ullah A, Haque MR, Rahman M, Bosak L, Rahman MF, Zaman SR, Rahman MM. Clinical manifestations and outcomes of COVID-19 in maintenance hemodialysis patients of a high infectious epidemic country: a prospective cross-sectional study. Ann Med Surg (Lond) 2023; 85:4293-4299. [PMID: 37663710 PMCID: PMC10473334 DOI: 10.1097/ms9.0000000000001046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The outbreak of COVID-19 poses great challenges for patients on maintenance haemodialysis. Here, we reported the clinical characteristics and laboratory features of maintenance haemodialysis (MHD) patients with COVID-19 in Bangladesh. Methods Altogether, 67 MHD patients were enroled in the study from two dedicated tertiary-level hospitals for COVID-19 after the prospective cross-sectional execution of selection criteria. Data were collected from medical records and interviews. Different statistical analysis was carried out in the data analysis. Results The mean age was 55.0±9.9 years, with 40 males (59.7%). The mean dialysis duration was 23.4±11.5 months. The most common symptoms were fever (82.1%), cough (53.7%), and shortness of breath (55.2%), while the common comorbid condition was hypertension (98.5%), followed by diabetes (56.7%). Among MHD patients, 52.2% to 79.1% suffered from severe to critical COVID-19, 48 patients (71.6%) had 26-75% lung involvement on high resolution computed tomography of the chest, 23 patients (34.3%) did not survive, 20 patients (29.9%) were admitted to ICU, and nine patients (13.4%) needed mechanical ventilation. Patients who did not survive were significantly older (mean age: 63.0 vs. 50.86 years, P=0.0001), had significantly higher cardiovascular risk factors (69.6% vs. 43.2%, P=0.04), severe shortness of breath (82.6% vs. 40.9%, P=0.0001), and longer hospital stays (mean days: 17.9 vs. 13.0, P=0,0001) compared to the survivor group. The white blood cell count, C-reactive protein, lactate dehydrogenase, pro-calcitonin, and thrombocytopenia were significantly (P<0.0001) higher, while the albumin level was significantly lower (P=0.0001) in non-survivor compared to patients who survived. Conclusion Maintenance haemodialysis patients had severe to critical COVID-19 and had a higher risk of non-survival if they were older and had comorbidities such as hypertension and diabetes. Therefore, MHD patients with COVID-19 need close monitoring to improve their outcomes.
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Affiliation(s)
- Mina Mondal
- Department of Nephrology, Khulna Medical College, Khulna
| | | | | | | | - Motiur Rahman
- Kalkini Upzilla Health Complex, Kalkini, Madaripur, Bangladesh
| | - Liza Bosak
- Basic Science Division, World University of Bangladesh
| | - Md. Foyzur Rahman
- Department of Community Medicine, National Institute of Preventive and Social Medicine (NIPSOM)
| | | | - Mohammad Meshbahur Rahman
- Department of Biostatistics, National Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Dhaka
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Uddin J, Uddin H, Rahman M, Saha P, Hossin MZ, Hajizadeh M, Kirkland S. Socioeconomic disparities in diabetes-concordant comorbidity: national health interview survey, 1997-2018. Public Health 2023; 222:160-165. [PMID: 37544127 DOI: 10.1016/j.puhe.2023.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Although social disparities in morbidity and mortality are well-documented, little is known how socioeconomic status (SES) shapes diabetes-concordant comorbidity (DCC). This study examines socioeconomic inequalities in DCC among adults with diabetes in the United States. STUDY DESIGN The study incorporated a cross-sectional nationally representative household health survey. METHODS This study used data from the National Health Interview Survey, 1997-2018. The analysis included 56,192 adults aged 30 or above with diabetes. Multinomial logistic regression was used to obtain relative risk ratios in gender-stratified models after adjusting for sociodemographic covariates. RESULTS The multivariable-adjusted analyses suggest that across all SES indicators and in both men and women, individuals with lower SES had greater odds of DCC than individuals with higher SES. The associations of SES indicators with DCC were larger in magnitude among women than in men. For example, compared to individuals with a college or higher degree, men with less than a high school degree were 2.06 times (95% confidence interval = 1.76-2.41) and women with less than a high school degree were 3.19 times (95% confidence interval = 2.67-3.82) more likely to have 3 or more DCCs. Similar associations were observed for other indicators of SES. CONCLUSION Study findings suggest strong social status and gender-based patterns in DCC. Identifying population groups with poor social status may be useful for informing interventions aiming to improve healthcare services of diabetes-related complications.
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Affiliation(s)
- J Uddin
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
| | - H Uddin
- Department of Global Public Health, Karolinska Institutet, Solna, 17177, Sweden; Department of Sociology, East West University, Dhaka, 1212, Bangladesh.
| | - M Rahman
- Department of Science and Humanities, Bangabandhu Sheikh Mujibur Rahman Aviation and Aerospace University, Dhaka, 1206, Bangladesh.
| | - P Saha
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - M Z Hossin
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, 171 76, Sweden.
| | - M Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
| | - S Kirkland
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
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Rahman A, Bhuiyan MR, Parvin T, Rahman M, Rahman MA, Huq AM, Farjana J, Ghosh TP, Siddike S, Hoque MF, Jahan F. Short-term Treatment Outcome of Patients with Acute ST-elevation Myocardial Infarction in a Tertiary Care Hospital. Mymensingh Med J 2023; 32:671-676. [PMID: 37391958] [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: 07/02/2023]
Abstract
Outcome of acute ST-elevation myocardial infarction patients varies time to time. The present study was intended to find out the short-term treatment outcome of the patients admitted in hospital. This descriptive study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 15 January 2014 to 14 July 2014. A total of 100 patients admitted with Acute ST-elevation Myocardial Infarction confirmed on the presence of the (a) Typical chest pain of acute ST-elevation Myocardial Infarction (b) Electrocardiogram (ECG) evidence of ST segment elevation in two or more contiguous leads (c) Raised cardiac marker (Troponin I) were included in the study. Patients were randomly enrolled according to the inclusion and exclusion criteria and observe for one week. Data were processed and analyzed by using computer bases software SPSS version 19.0. Descriptive statistical methods were applied for data analysis. P value was considered as statistically significant when it is less than 0.05. Short-term treatment outcome of acute ST-elevation myocardial infarction include mechanical, arrhythmic, ischemic and inflammatory sequelae, as well as left ventricular mural thrombus. In addition to these broad categories, heart failure, arrhythmia, death are other common complications of AMI. The initiation of the complications usually results in explicit sign and symptoms of the acute MI patients. Learning of the complications in the post infarction period and the clinical syndromes develop with each complication, will allow the health care worker to evaluate and manage the complication appropriately.
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Affiliation(s)
- A Rahman
- Dr Atikur Rahman, MD, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh; E-mail:
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Flower B, Nguyen Thi Ngoc P, McCabe L, Le Ngoc C, Vo Thi T, Thi Kim HV, Dang Trong T, Rahman M, Thwaites G, Walker AS, Hung LM, Vinh Chau NV, Cooke GS, Day JN. Rise in alanine aminotransferase after HCV treatment is a highly sensitive screen for treatment failure. Clin Liver Dis (Hoboken) 2023; 21:138-142. [PMID: 37274950 PMCID: PMC10237684 DOI: 10.1097/cld.0000000000000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 06/07/2023] Open
Abstract
Nucleic acid testing to confirm sustained virological response (SVR) after HCV therapy is technical, often expensive, and frequently unavailable where disease prevalence is highest. Alternative surrogate biomarkers merit evaluation. In a short-treatment trial in Vietnam (SEARCH-1; n = 52) we analysed how changes in alanine transaminase (ΔALT) and aspartate transaminase (ΔAST), from end of treatment (EOT) to EOT + 12 weeks, related to SVR, defined as HCV RNA < lower limit of quantification 12 weeks after EOT. In a separate UK trial (STOPHCV1; n = 202), we then tested the hypothesis that any elevation in ALT or AST between EOT and EOT12 is a sensitive screen for treatment failure. In SEARCH-1, among 48 individuals with data, 13 failed to achieve SVR. Median ΔALT and ΔAST were negative in cured patients but elevated when treatment failed [median ΔALT (IQR): -2 IU/L (-6, +2)] versus +17 IU/L (+7.5, +38) (p< 0.001). Amongst treatment failures, 12/13 had increase in ALT and 13/13 had increase in AST after EOT, compared with 12/35 in those cured. In STOPHCV1, 196/202 patients had evaluable data, of which 57 did not achieve SVR. A rise in ALT after EOT was 100% sensitive (95% C.I. [93.7 - 100%]) and 51% specific (42.4 - 59.7%) for detecting treatment failure. ΔAST >0 IU/L was 98.1% (89.9 - 99.9%) sensitive and 35.8% (27.3 - 45.1%) specific. A rise in ALT or AST after HCV therapy is a highly sensitive screen for treatment failure in mild liver disease. This finding could reduce costs and complexity of managing HCV.
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Affiliation(s)
- Barnaby Flower
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Department of Infectious Disease, Imperial College London, London, UK
| | - Phuong Nguyen Thi Ngoc
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Leanne McCabe
- MRC Clinical Trials Unit at UCL, University College London, London, UK
| | - Chau Le Ngoc
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Thu Vo Thi
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Hang Vu Thi Kim
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Thuan Dang Trong
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Motiur Rahman
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Guy Thwaites
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Ann Sarah Walker
- MRC Clinical Trials Unit at UCL, University College London, London, UK
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research, Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Le Manh Hung
- Department of Hepatology, Hospital for Tropical Diseases, Ho Chi Minh City
| | | | - Graham S. Cooke
- Department of Infectious Disease, Imperial College London, London, UK
| | - Jeremy N. Day
- Department of CNS Infection, HIV and Viral Hepatitis, Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
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Rahman M, Bansal S, Ravichandran R, Sankpal N, Angara S, Smith M, Bremner R, Mohanakumar T. Downregulation of LKB1-Stradα Pathway in Circulating Exosomes as a Biomarker for Chronic Murine Lung Allograft Rejection. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1542] [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: 04/05/2023] Open
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Saha K, Sarker UK, Rahman M, Razi RZ, Mahmud A, Apu SB, Jahan F, Ferdous F. Role of Doppler Ultrasound in Diagnosis of Hepatocellular Carcinoma with Histopathological Correlation. Mymensingh Med J 2023; 32:361-370. [PMID: 37002746] [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: 04/04/2023]
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the leading cause (possibly third) of cancer mortality. In a present scenario, HCC displays a challenging clinical problem worldwide. Good-quality ultra sound with careful evaluation of the hepatobiliary system can be a screening examination for HCC in patients at risk. The aim of the study was to determine the diagnostic accuracy of the Doppler sonography for differentiation of hepatocellular carcinoma (HCC) from other focal liver lesions. It was a cross-sectional survey, conducted in the Department of Radiology& Imaging, Mymensingh Medical College, Mymensingh, Bangladesh from January 2017 to December 2018. A total of 70 patients with space occupying lesions on ultrasound were included in this study while pregnant women were excluded. All patients were examined by gray scale ultrasonography, color Doppler and FNAC. To visualize the blood flow, standard color Doppler sonography was used for each lesion. Within the lesions, pulsed Doppler samples were assessed whenever possible on the basis of pulsatile flow & finally resistive index (RI) of intra-tumoral and peritumoral arterial flow was studied. After evaluating by Doppler sonography (CDFI and Spectral analysis), FNAC was done and the specimen was sent to the Department of Pathology for Cytopathological examination. Cytopathology were assessed for confirmation of positive and negative cases of HCC. The detection rate of arterial flow in malignant tumors was 85.1% and in benign lesions were 30.4%. Doppler spectrum analysis showed that the resistive index in primary malignant tumors were 0.76±0.12 and in metastatic tumors were 0.80±0.12 and below 0.6 in benign lesions. The difference was significant (p<0.001). This difference was related with its Cytopathological report. The arterial flow identified by CDFI within the liver lesion with RI >0.6 can be regarded as a criterion of malignant tumors and RI<0.6 can be regarded as benign lesions. This study concluded that the combination of color Doppler flow imaging and RI are more useful in differential diagnosis of liver neoplasms.
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Affiliation(s)
- K Saha
- Dr Khokan Saha, Radiologist, Department of Radiology & Imaging, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Khatun MM, Rahman M, Islam MJ, Haque SE, Adam IF, Chau Duc NH, Sarkar P, Haque MN, Islam MR. Socio-economic inequalities in undiagnosed, untreated, and uncontrolled diabetes mellitus in Bangladesh: is there a gender difference? Public Health 2023; 218:1-11. [PMID: 36933353 DOI: 10.1016/j.puhe.2023.01.035] [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] [Received: 06/08/2022] [Revised: 11/13/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender. STUDY DESIGN Cross-sectional nationally representative household-based survey. METHODS We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches-adjusted odds ratio, relative inequality index, and slope inequality index-to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes. RESULTS In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05-3.29) and 1.47 times (95% CI 1.18-1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33-0.77) and 0.55 times (95% CI 0.36-0.85) less likely to have undiagnosed and untreated DM. CONCLUSIONS In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups.
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Affiliation(s)
- M M Khatun
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M Rahman
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - M J Islam
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD 4122, Australia
| | - S E Haque
- Uchicago Research Bangladesh, Bangladesh
| | - I F Adam
- Faculty of Public Health, University of Khartoum, Sudan
| | - N H Chau Duc
- Hue University of Medicine and Pharmacy, Hue University, Viet nam
| | - P Sarkar
- Dr. Wazed Research and Training Institute, Begum Rokeya University, Rangpur, Bangladesh
| | - M N Haque
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M R Islam
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
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Rahman M, Keegan A, Mateus J, Kim C. Real-world assessment of the treatment patterns and outcomes among patients with multiple myeloma across different risk stratification criteria in the United States: a retrospective cohort study. Leuk Lymphoma 2023; 64:388-397. [PMID: 36371167 DOI: 10.1080/10428194.2022.2140283] [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: 11/15/2022]
Abstract
This study evaluated prognostic performance of International Staging System (ISS), revised ISS, and chromosomal abnormalities (CA) in newly diagnosed multiple myeloma patients to describe treatment patterns (cohort 1; n = 1979) and survival outcomes (cohort 2; n = 1382). In both cohorts, ∼18%, 41%, and 37% of patients were high-risk according to the R-ISS, ISS, and high-risk CA criteria, respectively. Across all risk stratification criteria, 60% of patients received triplets. In cohort 2, the median modified progression-free survival decreased with each increasing risk stage (23.5, 12.1, and 8.8 months in R-ISS I, II, and III, respectively, and 16.0, 12.7, and 10.4 months in ISS I, II, and III). Similar trends were observed in the proportions of two-year overall survival. In conclusion, R-ISS has greater discriminatory power than ISS or high-risk CA alone and can be implemented in a real-world setting. Accordingly, a more risk-adapted approach can be feasible, with a greater population-level impact.
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Flower B, Hung LM, Mccabe L, Ansari MA, Le Ngoc C, Vo Thi T, Vu Thi Kim H, Nguyen Thi Ngoc P, Phuong LT, Quang VM, Dang Trong T, Le Thi T, Nguyen Bao T, Kingsley C, Smith D, Hoglund RM, Tarning J, Kestelyn E, Pett SL, van Doorn R, Van Nuil JI, Turner H, Thwaites GE, Barnes E, Rahman M, Walker AS, Day JN, Chau NVV, Cooke GS. Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for hepatitis C in a single-arm mechanistic pilot study. eLife 2023; 12:e81801. [PMID: 36622106 PMCID: PMC9870305 DOI: 10.7554/elife.81801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/23/2022] [Indexed: 01/10/2023] Open
Abstract
Background World Health Organization has called for research into predictive factors for selecting persons who could be successfully treated with shorter durations of direct-acting antiviral (DAA) therapy for hepatitis C. We evaluated early virological response as a means of shortening treatment and explored host, viral and pharmacokinetic contributors to treatment outcome. Methods Duration of sofosbuvir and daclatasvir (SOF/DCV) was determined according to day 2 (D2) virologic response for HCV genotype (gt) 1- or 6-infected adults in Vietnam with mild liver disease. Participants received 4- or 8-week treatment according to whether D2 HCV RNA was above or below 500 IU/ml (standard duration is 12 weeks). Primary endpoint was sustained virological response (SVR12). Those failing therapy were retreated with 12 weeks SOF/DCV. Host IFNL4 genotype and viral sequencing was performed at baseline, with repeat viral sequencing if virological rebound was observed. Levels of SOF, its inactive metabolite GS-331007 and DCV were measured on days 0 and 28. Results Of 52 adults enrolled, 34 received 4 weeks SOF/DCV, 17 got 8 weeks and 1 withdrew. SVR12 was achieved in 21/34 (62%) treated for 4 weeks, and 17/17 (100%) treated for 8 weeks. Overall, 38/51 (75%) were cured with first-line treatment (mean duration 37 days). Despite a high prevalence of putative NS5A-inhibitor resistance-associated substitutions (RASs), all first-line treatment failures cured after retreatment (13/13). We found no evidence treatment failure was associated with host IFNL4 genotype, viral subtype, baseline RAS, SOF or DCV levels. Conclusions Shortened SOF/DCV therapy, with retreatment if needed, reduces DAA use in patients with mild liver disease, while maintaining high cure rates. D2 virologic response alone does not adequately predict SVR12 with 4-week treatment. Funding Funded by the Medical Research Council (Grant MR/P025064/1) and The Global Challenges Research 70 Fund (Wellcome Trust Grant 206/296/Z/17/Z).
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Affiliation(s)
- Barnaby Flower
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
| | - Le Manh Hung
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | - Leanne Mccabe
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
| | - M Azim Ansari
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Chau Le Ngoc
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Thu Vo Thi
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Hang Vu Thi Kim
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | | | | | - Vo Minh Quang
- Hospital for Tropical DiseasesHo Chi Minh CityVietnam
| | | | - Thao Le Thi
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Tran Nguyen Bao
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
| | - Cherry Kingsley
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
| | - David Smith
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Richard M Hoglund
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Faculty of Tropical MedicineBangkokThailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Joel Tarning
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Faculty of Tropical MedicineBangkokThailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Evelyne Kestelyn
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Sarah L Pett
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
| | - Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
- Oxford University Clinical Research UnitHanoiVietnam
| | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Hugo Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Guy E Thwaites
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Motiur Rahman
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | - Ann Sarah Walker
- MRC Clinical Trials Unit at UCL, University College LondonLondonUnited Kingdom
- Nuffield Department of Medicine, University of OxfordOxfordUnited Kingdom
- The National Institute for Health Research, Oxford Biomedical Research Centre, University of OxfordOxfordUnited Kingdom
| | - Jeremy N Day
- Oxford University Clinical Research UnitHo Chi Minh CityVietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford UniversityOxfordUnited Kingdom
| | | | - Graham S Cooke
- Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
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Dutta A, Rahman M, Ghosh A, Hasan T, Uddin A. Prevalence and Associated Risk Factors of Postpartum Anestrus in Dairy Cows of Sylhet District, Bangladesh. AJVS 2023. [DOI: 10.5455/ajvs.48060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The objectives of current study were to assess the prevalence and risk factors associated with postpartum anestrus in lactating dairy cows in Sylhet region, Bangladesh. A total of 420 postpartum cows of different breed and age were selected randomly from different dairy farms in studied area. Structured questionnaire was used to collect data from farm owner on prevalence and risk factors for postpartum anestrus. Observed heat within 60 days after parturition was considered as normal cyclic cows and others were considered as postpartum anestrus. The prevalence of postpartum anestrus was 36.20%. The study shows that older cows take relatively more time for ovarian resumption. Cow’s having first parity shows cyclicity within 60 days of parturition, and postpartum anestrus increases significantly with the advancement of parity. Postpartum anestrus was significantly higher (P< 0.001) in cows with poor (≤1.0) and excessive (>3) body condition scores (BCS), respectively, compared to those with moderate/optimal BCS (2–3). The postpartum cyclicity in cows within 60 days with a history of normal placental expulsion was significantly higher than in the cows with RFM. Ovarian cyclicity was highest (75.92%) among the cows that were maintained in adequate hygienic conditions and lowest (43.51%) in a poor environment. The highest percentage (88.10%) of cows showed postpartum cyclicity with a history of short lactation length (0-150 days) and resumption of postpartum estrous cycle increases significantly with lactation length. Resumption of postpartum estrus cycles in cows takes more time with a history of minimal (<15 liters) daily milk production than the cow with medium (>15-25 liters) daily milk production. Cows get an adequate feed supply (both concentrate and green grass), which shows a positive effect on postpartum cyclicity. Pre and postpartum complications have a significant (p<0.001) effect on the postpartum cyclicity of cows. Endometritis (81.25%) followed by pyometra (75.76%) were recorded as major reproductive obstacles in ovarian resumption, whereas uterine prolapse (70.59%) followed by abortion (61.54%), milk fever (58.33%), stillbirth (58.33%) and dystocia (57.63%) were the major recorded complications in post-partum phase. The study also revealed that the non-restricted suckling period has a significant (p<0.001) negative effect on ovarian resumption. The risk factors including parity, BCS, placental expulsion, hygienic condition, lactation length, daily milk production and management system were significantly (P<0.01) influenced the postpartum cyclicity. Maintaining optimal BCS of cows, proper hygienic and good management practice, and farmer's training on management of cattle reproduction would improve the number of cows for breeding by 60 days postpartum.
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Hasan MJ, Chowdhury SM, Khan AS, Rahman M, Fardous J, Adit T, Rahman M, Hossain MT, Yeasmin S, Raheem E, Amin MR. Clinico-epidemiological Characteristics of Asymptomatic and Symptomatic COVID-19-Positive Patients in Bangladesh. Mymensingh Med J 2023; 32:185-192. [PMID: 36594319] [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: 01/04/2023]
Abstract
As of August 15, 2020, Bangladesh lost 3591 lives since the first Coronavirus disease 2019 (COVID-19) case announced on March 8. The objective of the study was to report the clinical manifestation of both symptomatic and asymptomatic COVID-19-positive patients. An online-based cross-sectional survey was conducted for initial recruitment of participants with subsequent telephone interview by the three trained physicians in 237 adults with confirmed COVID-19 infection in Bangladesh. The study period was 27 April to 26th May 2020. Consent was ensured before commencing the interview. Collected data were entered in a pre-designed case record form and subsequently analyzed by SPSS 20.0. The mean±SD age at presentation was 41.59±13.73 years and most of the cases were male (73.0%). A total of 90.29% of patients reside in urban areas. Among the positive cases, 13.1% (n=31) were asymptomatic. Asymptomatic cases were significantly more common in households with 2 to 4 members (p=0.008). Both symptomatic and asymptomatic patients shared similar ages of presentation (p=0.23), gender differences (p=0.30) and co-morbidities (p=0.11). Only 5.3% of patients received ICU care during their treatment. The most frequent presentation was fever (88.3%), followed by cough (69.9%), chest pain (34.5%), body ache (31.1%), and sore throat (30.1%). Thirty-nine percent (n=92) of the patients had co-morbidities, with diabetes and hypertension being the most frequently observed. There has been an upsurge in COVID-19 cases in Bangladesh. Patients were mostly middle-aged and male. Typical presentations were fever and cough. Maintenance of social distancing and increased testing are required to meet the current public health challenge.
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Affiliation(s)
- M J Hasan
- Dr Mohammad Jahid Hasan, Executive Director, Pi Research Consultancy Center, Dhaka, Bangladesh; E-mail:
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22
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Borhan R, Lee J, Philpott M, Youssef G, Rahman M, Bensussan A. 583 RNA sequencing of immortalised balding and non balding DPCs identifies potential balding gene signatures. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.599] [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: 11/19/2022]
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23
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Rahman M, Huq Ronny F, Islam H. A Case of Ambiguous Lineage Acute Leukemia Posing Diagnostic Challenge. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.220] [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: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
N/A.
Methods/Case Report
Acute leukemias with ambiguous lineage encompass those leukemias that show no clear evidence of differentiation along a single lineage and account for less than 4% of all cases of acute leukemias and often poses diagnostic dilemma. We present a challenging case of an ambiguous lineage acute leukemia in a previously healthy 27-year-old male, who presented to the ED with acute fever, dyspnea on exertion, nausea and vomiting. A complete blood count (CBC) showed a white blood cell count of 323 × 109/L, Hemoglobin of 3.3 g/dl, Platelet count of 44 × 109/L and a differential count of Neutrophil: 11, Lymphocyte: 31, Monocyte: 02, Band Neutrophil:1, Myelocyte :1, Blast: 54. Bone marrow aspirate smears revealed a heterogenous population of small to large sized blasts comprising 83% of cellularity. They expressed scant to moderate basophilic cytoplasm, high N/C ratio, round to irregular nuclear contour, finely granular chromatin and some with nucleoli. Other lineages were markedly suppressed. Flow cytometric analysis revealed an abnormal blast population (~80% of total) expressing CD34, HLA-DR, Tdt (subset), CD71 (dim) and CD38. In addition, the blasts expressed myeloid associated antigens CD13, MPO (smaller subset), as well as B-cell associated antigens CD19 (dim), cytoplasmic CD22 and cytoplasmic CD79a. They also expressed T-cell associated antigens, CD2, CD3 (smaller subset), CD5 (subset) and CD7 (subset) but negative for cytoplasmic CD3. This unusual pattern of expression posed a challenge as to what type of mixed phenotype leukemia it should be with variable expressions from all three lineage of myeloid, B- and T-cell. Further work-up showed, scattered blasts are also positive for MPO by cytochemical (on aspirate smear) and immunohistochemical stain (on core). The latter also showed negativity for CD3. Based on all these findings, this mixed phenotype acute leukemia (MPAL) was best categorized as MPAL (B/myeloid) over so called “Triphenotypic (B/T/myeloid) acute leukemia”. We considered expression of myeloid and B cell markers as more lineage defining in this case as compared to small subset expressing T lineage marker CD3. This case exemplifies the importance of multimodal comprehensive analysis of acute leukemia, especially in the setting of MPAL with expression of multi- lineage markers posing a diagnostic challenge.
Results (if a Case Study enter NA)
N/A.
Conclusion
N/A.
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Affiliation(s)
- M Rahman
- Department of Pathology, Westchester Medical Center , Valhalla, New York , United States
| | - F Huq Ronny
- Department of Pathology, Westchester Medical Center , Valhalla, New York , United States
| | - H Islam
- Department of Pathology, Westchester Medical Center , Valhalla, New York , United States
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Rahman M, Ashraf R, Zhang R, Cao X, Gladstone D, Jarvis L, Hoopes P, Pogue B, Bruza P. In Vivo Cherenkov Imaging-Guided FLASH Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rahman M, Erhart K, Gladstone D, Bruza P, Thomas C, Jarvis L, Hoopes P, Pogue B, Zhang R. Intensity Modulation in Electron FLASH Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2248] [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]
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Sloop A, Sunnerberg J, Bruza P, Gladstone D, Jarvis L, Jr CT, Pogue B, Zhang R, Rahman M. Comparison of Two Modified Linear Accelerators for Use in FLASH Clinical Trials. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2153] [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: 11/30/2022]
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Puthiaparampil T, Rahman M. Making physical examination in medicine user-friendly. Med J Malaysia 2022; 77:631-634. [PMID: 36169079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Physical examination (PE) techniques used in medical schools appear redundant in several aspects: unnecessarily regimental, lacking in efficiency, and lengthy. Many techniques are sustained solely because of the age-old tradition. This commentary suggests a simplification of PE techniques to make them acceptable to all the stakeholders, such as patients, medical students, and medical teachers. This is especially relevant in this era when imaging is widely used for diagnosis, and the confidence and reliance on PE are declining. Opinions of 10 senior consultants active in medical practice, teaching, and assessment were sought to know their concurrence with the authors' views. Seven of them provided their opinions, which showed considerable agreement with the authors' views regarding PE. All the items presented in this paper are mostly supported by the opinions of the senior consultants, textbooks, and literature. We consider sharing this work with the fraternity worthwhile.
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Affiliation(s)
- T Puthiaparampil
- Universiti Malaysia Sarawak, Faculty of Medicine and Health Sciences, Department of Medicine, Sarawak, Malaysia
| | - M Rahman
- Universiti Malaysia Sarawak, Faculty of Medicine and Health Sciences, Department of Community Medicine and Public Health, Sarawak, Malaysia
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Begum LN, Hoque MH, Mahmood M, Rahman M, Ahmed SP, Islam MS. Echocardiographic Evaluation of Cardiac Changes in Patients with Hypothyroidism and the Response to Treatment. Mymensingh Med J 2022; 31:790-796. [PMID: 35780365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Thyroid hormone acts on heart and peripheral vascular system in multiple ways. Most of the cardiac manifestations are reversible with adequate and timely thyroid therapy. Echocardiographic changes are present in patients with untreated hypothyroidism and the changes are reversible with treatment. Aim of the study was to evaluate the structural and functional changes of the heart in hypothyroid patients and its response to treatment. This prospective observational study was performed in the Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from November 2012 to April 2013. The study included 35 cases and 35 control based on their thyroid hormonal status. The cases were previously untreated for hypothyroidism. By 2D and M-mode echocardiography LV septal wall and posterior wall thickness, LVIDD, LVIDS, LA and Aortic diameter and ejection fraction were measured. Mitral inflow pattern was observed through pulse wave Doppler and peak E velocity, a velocity and E/A ratio were noted. All the observations were noted both in cases and controls and in cases after normalization of hypothyroid status. Echocardiographic variables showed that septal wall and posterior wall thickness, LVIDD and LVIDS were higher in the cases than those in the control group. Left ventricular ejection fraction was lower in case group compared to control group. Of the mitral inflow parameters, a velocity was higher and E/A ratio lower in cases than those in control group. Following treatment of >3 months the septal wall and posterior wall thicknesses were reduced significantly (p<0.001 and p<0.001 respectively) and Left ventricular ejection fraction was also improved significantly (p<0.001) from its baseline status. Of the mitral inflow parameters, E-velocity was significantly increased, A-velocity significantly decreased and E/A ratio significantly increased from their baseline figures (p=0.016, p=0.032 and p<0.001 respectively). Cardiovascular complications of hypothyroidism increase the morbidity of the patients. Results of our study showed importance of early diagnosis and prompt treatment reversed the condition and that will diminish the extent of cardiac complications.
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Affiliation(s)
- L N Begum
- Dr Lutfun Nahar Begum, Assistant Professor of Cardiology, Cox's Bazar Medical College, Cox's Bazar, Bangladesh; E-mail:
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Schmalzing M, Kellner H, Askari A, De Toro Santos J, Vazquez Perez-Coleman JC, Foti R, Jeka S, Haraoui B, Allanore Y, Rahman M, Furlan F, Hachaichi S, Sheeran T. POS0640 REAL-WORLD EFFECTIVENESS AND SAFETY OF GP2015 IN PATIENTS WITH RHEUMATIC DISEASES: FINAL RESULTS OF THE COMPACT STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1110] [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: 11/04/2022]
Abstract
BackgroundCOMPACT is a non-interventional study evaluating the effectiveness and safety in patients (pts) with rheumatoid arthritis (RA), axial-spondyloarthritis (axSpA) or psoriatic arthritis (PsA) treated with GP2015 (an etanercept [ETN] biosimilar) in real-world conditions.ObjectivesWe present the effectiveness and safety data from the final analysis of the COMPACT study for all patient groups.MethodsPts aged ≥18 years on treatment with GP2015 were enrolled. Baseline visit corresponded with date of study inclusion and not with date of GP2015 treatment start. Pts were categorised based on prior treatment status: pts on clinical remission or low disease activity under treatment with reference ETN or biosimilar ETN (initial ETN: [iETN]) and switched to GP2015 (Group A) or pts who received non-ETN targeted therapies and switched to GP2015 (Group B) or biologic-naïve pts who started GP2015 after conventional therapy failure (Group C) or DMARD-naïve pts with recent diagnosis of RA considered suitable for treatment initiation with a biologic and started on treatment with GP2015 (Group D). Effectiveness assessments included Disease Activity Score 28-joint count Erythrocyte Sedimentation Rate (DAS28-ESR) or Ankylosing Spondylitis Disease Activity Score (ASDAS) until Month 12 after enrolment (baseline) in the study.ResultsOf the 1466 pts enrolled, 572 were switched from iETN (Group A), 171 were switched from other targeted therapies (Group B), 713 were biologic-naïve (Group C), and 10 were RA DMARD-naïve (Group D). Comorbidities were more frequent in pts with RA (68.7%,) followed by pts with PsA (59.4%) and axSpA (52.1%). After 12 months of treatment with GP2015, pts with RA or PsA achieved comparable DAS28-ESR scores irrespective of whether they switched from iETN, or from other targeted therapies or were biologic-naïve. At Month 12, the mean ASDAS scores were comparable between the treatment groups in pts with axSpA (Table 1). Across all pt groups, no major differences were observed in the disease activity scores between baseline and Month 12 that may be explained by the ongoing GP2015 treatment at the time of enrolment for an observed average of 138 days. Overall, the proportion of patients with at least one adverse event (AE) and serious AE (SAE) was 47.6% and 7.7% in pts who were switched from iETN, 56.7% and 9.9% in pts switched from other targeted therapies, 56% and 8.7% in biologic-naïve pts, and 60% and 0% in DMARD-naïve pts. Rate of injection site reaction was low across the groups (Figure 1).Table 1.Effectiveness outcomes in patients treated with GP2015Effectiveness outcomesGroup AGroup BGroup CGroup DOverall (A-D)RADAS28-ESR, n, mean (SD)N=295N=88N=451N=10N=844Baselinen=259n=70n=392n=8n=7292.5 (1.1)3.6 (1.3)3.3 (1.5)3.8 (1.2)3.0 (1.4)Month 12n=135n=47n=238n=2n=4222.5 (1.3)2.7 (1.0)2.8 (1.4)4.3 (2.5)2.7 (1.3)PsAN=117N=36N=135N=0N=288Baselinen=80n=30n=116-n=2262.1 (1.0)2.9 (1.6)2.9 (1.6)2.6 (1.5)Month 12n=32n=13n=60-n=1052.6 (1.9)2.6 (1.6)2.3 (1.4)2.4 (1.5)AxSpAASDAS, n, mean (SD)N=160N=47N=127N=0N=334Baselinen=77n=18n=59-n=1541.6 (0.6)1.8 (0.8)2.3 (0.9)1.9 (0.8)Month 12n=39n=8n=23-n=701.8 (0.9)1.9 (0.6)1.9 (1.0)1.8 (0.9)N, total number of patients in the treatment group; n, number of patients with available data at each time point, SD, standard deviationFigure 1.Overall safety outcomes in patients treated with GP2015Figure 1 represents the adverse events reported during GP2015 treatment.N, total number of patients in the treatment; n, number of patients in each treatment groupConclusionThe results show comparable disease activity scores between pts who were switched from iETN, pts switched from other targeted therapies and biologic-naïve pts after 12 months of treatment with GP2015. No impact on the effectiveness of ETN was observed in pts with RA, axSpA or PsA who switched to GP2015. No new safety signals were reported.Disclosure of InterestsMarc Schmalzing Speakers bureau: Novartis, AbbVie, Chugai/Roche, Janssen-Cilag, Lilly, Consultant of: AstraZeneca, Chugai/Roche, Hexal/Sandoz, Gilead, AbbVie, Janssen-Cilag, Boehringer/Ingelheim, Grant/research support from: Chugai/Roche, Boehringer/Ingelheim, Celgene, Medac, Herbert Kellner: None declared, Ayman Askari: None declared, Javier de Toro Santos: None declared, JULIO CESAR VAZQUEZ PEREZ-COLEMAN Speakers bureau: Sandoz, Abbvie, Sanofi, Fresenius, Rosario Foti Speakers bureau: Abbivie, Gilead, Lilly, Pfizer, UCB, Roche, Novartis, Pfizer, UCB, Sławomir Jeka: None declared, Boulos Haraoui Consultant of: Abbvie, Amgen, Fresenius Kabi, Lilly and Pfizer, Grant/research support from: Abbvie, Amgen, Fresenius Kabi, Lilly and Pfizer, Yannick Allanore Consultant of: Sandoz Hexal, Mylan, Astra-Zeneca, Masiur Rahman Employee of: Sandoz Hexal AG, Fabricio Furlan Employee of: Sandoz Hexal AG, Sohaib HACHAICHI Employee of: Sandoz Hexal AG, Tom Sheeran Speakers bureau: Pfizer, UCB, Roche, Consultant of: Novartis, Pfizer, Grant/research support from: Novartis, UCB, Roche
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Hewins B, Rahman M, Bermejo-Martin JF, Kelvin AA, Richardson CD, Rubino S, Kumar A, Ndishimye P, Toloue Ostadgavahi A, Mahmud-Al-Rafat A, Kelvin DJ. Alpha, Beta, Delta, Omicron, and SARS-CoV-2 Breakthrough Cases: Defining Immunological Mechanisms for Vaccine Waning and Vaccine-Variant Mismatch. Front Virol 2022. [DOI: 10.3389/fviro.2022.849936] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, is responsible for over 400 million cases and over 5. 5 million deaths worldwide. In response to widespread SARS-CoV-2 infection, immunization of the global population has approached 60% one dose and 54% full dose vaccination status. Emerging data indicates decreasing circulating antibody levels as well as decreases in other immune correlates in vaccinated individuals. Complicating the determination of vaccine effectiveness is the concomitant emergence of novel SARS-CoV-2 variants with substantial antigenic differences from the ancestral D614G strain. The Omicron variant (B.1.1.529) spike protein has over 30 mutations compared with the D614G spike protein, which was used to design most SARS-CoV-2 vaccines in use today. Therefore, breakthrough cases of SARS-CoV-2 infections or severe disease in fully vaccinated individuals must be interpreted with caution taking into consideration vaccine waning and the degree of vaccine variant-mismatch resulting in adaptive immune evasion by novel emerging SARS-CoV-2 variants.
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Mahmood MH, Maleque MA, Rahman M. Hard-Hydrophobic Nano-CuO Coating via Electrochemical Oxidation for Heat Transfer Performance Enhancement. Arab J Sci Eng 2022. [DOI: 10.1007/s13369-021-05824-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rahman M, Zhao M, Islam MS, Dong K, Saha SC. Numerical study of nano and micro pollutant particle transport and deposition in realistic human lung airways. POWDER TECHNOL 2022. [DOI: 10.1016/j.powtec.2022.117364] [Citation(s) in RCA: 1] [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: 02/07/2023]
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Islam MT, Sheikh SH, Reza E, Ferdaus AM, Islam F, Fatema B, Kamal MZ, Rahman M, Siddiquee MA. Evaluation of Short Term Outcome of Stapled Transanal Rectal Resection (STARR) for ODS (Obstructed Defecation Syndrome) by Comparing Pre and Post-operative ODS Score. Mymensingh Med J 2022; 31:355-359. [PMID: 35383750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Obstructed defecation syndrome (ODS) is a common anorectal problem and it can be corrected by various surgical approaches but most of these have high recurrence and complication rates. Antonio Longo introduced Stapled transanal rectal resection (STARR) in 2003 as a minimally invasive transanal operation for correction ODS associated with rectocele and or rectal intussusception. This study was designed to assess the short term outcome of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome (ODS). This is a quasi experimental study which was carried out in the department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2016 to June 2017. Seventeen (17) patients were included in the study. Patients with obstructed defecation syndrome and rectocele and or rectal intussusception admitted in the department of Colorectal Surgery were enrolled in the study as per inclusion and exclusion criteria. History, clinical examination, Proctoscopy, Colonoscopy and MR Defecography was done for evaluation of the patients. During evaluation preoperative Longo's ODS score of every patient also determined and compared with postoperative ODS score. The patient was followed up regularly at one, three and six months after each operation. The ODS score in 82.35% patients improved significantly. The postoperative score was high (13-15) only in 02(11.8%) patients probably due to presence of physiological factors. Post-operative defecatory urgency was developed in only 02(11.76%) patients. Major postoperative complication like hemorrhage or rectovaginal fistula did not develop in any patient. STARR is an effective, less invasive and simple procedure for the treatment of ODS with rectocele and/or rectal intussusception without major morbidity but other physiological causes of ODS should exclude preoperatively because its presence makes the surgical intervention fruitless.
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Affiliation(s)
- M T Islam
- Dr Md Touhidul Islam, Assistant Professor (Colorectal Surgery), Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Zhang X, Rahman M, Bereiter DA. Estrogen Status and Trigeminal Ganglion Responses to Jaw Movement. J Dent Res 2022; 101:1075-1081. [PMID: 35259995 PMCID: PMC9305844 DOI: 10.1177/00220345221077951] [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: 11/16/2022] Open
Abstract
Chronic temporomandibular joint disorders (TMDs) present with pain in the temporomandibular joint (TMJ) and muscles of mastication. Risk factors for TMD include localized joint/muscle inflammation and estrogen status. This study determined whether mild tissue inflammation and estrogen status influenced the responses of trigeminal ganglion neurons to jaw palpation or jaw movement, 2 key diagnostic features of clinical TMD, in adult rats. Neuronal activity was recorded from male rats, ovariectomized (OvX) female rats, and OvX female rats injected with 17β-estradiol 24 h prior to testing (OvXE). Neurons were tested for responses to deep press over the TMJ region and jaw movement in 3 directions (open, protrusion, lateral) 10 d after intra-TMJ injection of a low dose of complete Freund's adjuvant (CFA) or vehicle (sham). Deep press evoked similar responses in all treatment groups. The response magnitude to jaw opening and protrusion was significantly greater for neurons recorded from OvXE CFA-treated rats than from OvX CFA-treated or OvXE sham rats. The responses to lateral movement of the jaw were similar across all treatment groups. Most neurons (70% to 90%) displayed a static response pattern to jaw movement independent of direction. Estradiol treatment also increased the proportion of neurons that were excited by jaw movement in >1 direction as compared with untreated OvX females or males. These results suggest that mild localized inflammation in the TMJ region during periods of elevated estrogen were sufficient to increase the peripheral driving force for jaw movement-evoked hyperalgesia.
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Affiliation(s)
- X Zhang
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - M Rahman
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - D A Bereiter
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Berry I, Mangtani P, Rahman M, Greer A, Morris S, Anwar R, Lisa M, Shirin T, Islam M, Chowdhury F, Dunkle S, Brum E, Osmani M, Flora M, Fisman D. Seasonality of Human Influenza and Co-Seasonality with Avian Influenza in Bangladesh, 2010-2019. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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36
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Islam S, Rahman M, Hasan M. Evaluation of neutrophil to lymphocyte ratio as a predicted marker for the assessment of severe Coronavirus Disease-19 patients under a resource-constrained setting. Int J Infect Dis 2022. [PMCID: PMC8884889 DOI: 10.1016/j.ijid.2021.12.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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37
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Kirsten F, Marcote B, Nimmo K, Hessels JWT, Bhardwaj M, Tendulkar SP, Keimpema A, Yang J, Snelders MP, Scholz P, Pearlman AB, Law CJ, Peters WM, Giroletti M, Paragi Z, Bassa C, Hewitt DM, Bach U, Bezrukovs V, Burgay M, Buttaccio ST, Conway JE, Corongiu A, Feiler R, Forssén O, Gawroński MP, Karuppusamy R, Kharinov MA, Lindqvist M, Maccaferri G, Melnikov A, Ould-Boukattine OS, Possenti A, Surcis G, Wang N, Yuan J, Aggarwal K, Anna-Thomas R, Bower GC, Blaauw R, Burke-Spolaor S, Cassanelli T, Clarke TE, Fonseca E, Gaensler BM, Gopinath A, Kaspi VM, Kassim N, Lazio TJW, Leung C, Li DZ, Lin HH, Masui KW, Mckinven R, Michilli D, Mikhailov AG, Ng C, Orbidans A, Pen UL, Petroff E, Rahman M, Ransom SM, Shin K, Smith KM, Stairs IH, Vlemmings W. A repeating fast radio burst source in a globular cluster. Nature 2022; 602:585-589. [PMID: 35197615 DOI: 10.1038/s41586-021-04354-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/15/2021] [Indexed: 11/09/2022]
Abstract
Fast radio bursts (FRBs) are flashes of unknown physical origin1. The majority of FRBs have been seen only once, although some are known to generate multiple flashes2,3. Many models invoke magnetically powered neutron stars (magnetars) as the source of the emission4,5. Recently, the discovery6 of another repeater (FRB 20200120E) was announced, in the direction of the nearby galaxy M81, with four potential counterparts at other wavelengths6. Here we report observations that localized the FRB to a globular cluster associated with M81, where it is 2 parsecs away from the optical centre of the cluster. Globular clusters host old stellar populations, challenging FRB models that invoke young magnetars formed in a core-collapse supernova. We propose instead that FRB 20200120E originates from a highly magnetized neutron star formed either through the accretion-induced collapse of a white dwarf, or the merger of compact stars in a binary system7. Compact binaries are efficiently formed inside globular clusters, so a model invoking them could also be responsible for the observed bursts.
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Affiliation(s)
- F Kirsten
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden. .,ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.
| | - B Marcote
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - K Nimmo
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - J W T Hessels
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands.,Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - M Bhardwaj
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - S P Tendulkar
- Department of Astronomy and Astrophysics, Tata Institute of Fundamental Research, Mumbai, India.,National Centre for Radio Astrophysics, Pune, India
| | - A Keimpema
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - J Yang
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Snelders
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - P Scholz
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A B Pearlman
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - C J Law
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA.,Owens Valley Radio Observatory, California Institute of Technology, Pasadena, CA, USA
| | - W M Peters
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - M Giroletti
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - Z Paragi
- Joint Institute for VLBI ERIC, Dwingeloo, The Netherlands
| | - C Bassa
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - D M Hewitt
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - U Bach
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - V Bezrukovs
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - M Burgay
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - S T Buttaccio
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia Radiotelescopio di Noto, Noto, Italy
| | - J E Conway
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - A Corongiu
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - R Feiler
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - O Forssén
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - M P Gawroński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - R Karuppusamy
- Max Planck Institute for Radio Astronomy, Bonn, Germany
| | - M A Kharinov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - M Lindqvist
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - G Maccaferri
- Istituto Nazionale di Astrofisica, Istituto di Radioastronomia, Bologna, Italy
| | - A Melnikov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - O S Ould-Boukattine
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - A Possenti
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy.,Dipartimento di Fisica, Università di Cagliari, Monserrato, Italy
| | - G Surcis
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - N Wang
- Xinjiang Astronomical Observatory, Urumqi, China
| | - J Yuan
- Xinjiang Astronomical Observatory, Urumqi, China
| | - K Aggarwal
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - R Anna-Thomas
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - G C Bower
- Academia Sinica Institute of Astronomy and Astrophysics, Hilo, HI, USA
| | - R Blaauw
- ASTRON, Netherlands Institute for Radio Astronomy, Dwingeloo, The Netherlands
| | - S Burke-Spolaor
- Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada
| | - T Cassanelli
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - T E Clarke
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - E Fonseca
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,Department of Physics and Astronomy, West Virginia University, Morgantown, WV, USA.,Center for Gravitational Waves and Cosmology, West Virginia University, Morgantown, WV, USA
| | - B M Gaensler
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,David A. Dunlap Department of Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Gopinath
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands
| | - V M Kaspi
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - N Kassim
- Remote Sensing Division, US Naval Research Laboratory, Washington, DC, USA
| | - T J W Lazio
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - C Leung
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D Z Li
- Cahill Center for Astronomy and Astrophysics, California Institute of Technology, Pasadena, CA, USA
| | - H H Lin
- Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - K W Masui
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R Mckinven
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - D Michilli
- Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada.,MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A G Mikhailov
- Institute of Applied Astronomy of the Russian Academy of Sciences, St. Petersburg, Russia
| | - C Ng
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada
| | - A Orbidans
- Engineering Research Institute Ventspils International Radio Astronomy Centre (ERI VIRAC), Ventspils University of Applied Sciences (VUAS), Ventspils, Latvia
| | - U L Pen
- Dunlap Institute for Astronomy & Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Canadian Institute for Advanced Research, CIFAR Azrieli Global Scholar, Toronto, Ontario, Canada.,Canadian Institute for Theoretical Astrophysics, University of Toronto, Toronto, Ontario, Canada.,Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada.,Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan
| | - E Petroff
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam, The Netherlands.,Department of Physics, McGill University, Montreal, Quebec, Canada.,McGill Space Institute, McGill University, Montreal, Quebec, Canada
| | - M Rahman
- Sidrat Research, Toronto, Ontario, Canada
| | - S M Ransom
- National Radio Astronomy Observatory, Charlottesville, VA, USA
| | - K Shin
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - K M Smith
- Perimeter Institute for Theoretical Physics, Waterloo, Ontario, Canada
| | - I H Stairs
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Vlemmings
- Department of Space, Earth and Environment, Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
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Demidov V, Cao X, Ashraf R, Rahman M, Zhang R, Gladstone D, Hoopes P, Elliott J, Pogue B. FLASH Mechanisms Track (Oral Presentations) LONGITUDINAL IN-VIVO ASSESSMENT OF MOUSE SKIN DAMAGE WITH FUNCTIONAL OPTICAL COHERENCE TOMOGRAPHY IN FLASH VERSUS CONVENTIONAL RADIOTHERAPY. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01462-4] [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: 10/19/2022] Open
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Ashraf R, Rahman M, Zhang R, Hoopes C, Gladstone D, Williams B, Pogue B, Bruza P. FLASH Modalities Track (Oral Presentations) INDIVIDUAL PULSE MONITORING AND FEEDBACK SYSTEM FOR FLASH-RT BEAM CONTROL USING FIBER-COUPLED SCINTILLATING DETECTORS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Cao X, Zhang R, Ashraf R, Rahman M, Gunn J, Bruza P, Gladstone D, Williams B, Swartz H, Hoopes C, Pogue B. A COMPUTATINAL ANALYSIS OF IN VIVO OXYGEN KINETICS DURING ELECTRON FLASH IRRADIATION. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01604-0] [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: 10/19/2022] Open
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Rahman M, Ashraf R, Gladstone D, Bruza P, Jarvis L, Schaner P, Gill G, Cao X, Pogue B, Hoopes C, Zhang R. FLASH in the Clinic Track (Oral Presentations) ELECTRON FLASH FOR THE CLINIC: LINAC CONVERSION, COMMISSIONING AND TREATMENT PLANNING. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01468-5] [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: 10/19/2022] Open
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Zhang R, Bruza P, Duval K, Cao X, Ashraf R, Rahman M, Gill G, Hartford A, Zaki B, Schaner P, Jarvis L, Hoopes P, Pogue B, Gladstone D. LOGISTICS OF A FLASH-RT PROGRAM IN CLINICAL SETTING. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01673-8] [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: 11/29/2022] Open
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43
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Islam Z, Rahman M, Olive AH, Hasan MK. Prevalence rate of attention deficit hyperactivity disorder (ADHD) and computer vision syndrome (CVS) symptoms predisposition among digital device users of Bangladesh. Middle East Curr Psychiatry 2022. [PMCID: PMC8786446 DOI: 10.1186/s43045-022-00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Around 5.29% of the world population is suffering from ADHD, and 60 million people are suffering from CVS, with an increasing rate of prevalence of these disorders. This study aimed to determine the prevalence rate of ADHD and CVS symptoms among the Bangladeshi population.
Results
To assess the aim of the study, a cross-sectional survey was conducted online through stratified sampling, and 197 responses were collected from the participants. Our survey method follows these criteria where the ARSV1.1 standard questionnaire was followed for the ADHD questionnaire, and a self-administered questionnaire was established based on the symptoms of CVS. The male age ranges from 18–24 have the highest value of ADHD (34%) coincided with > 6 h digital device usage (51%), and the Stroop effect is significantly correlated with the ADHD score (0.498, p < 0.01). The Stroop effect value is also higher among the males aged 18–24, digital device users for > 6 h (48%).
Conclusions
With the advent of science, it is impossible to avoid digital devices as necessary. Notwithstanding, safe and appropriate use of digital media is a must for healthy living.
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Islam R, Islam S, Rahman M. Assessment of hygienic and sanitation practices among poultry butchers in selected Municipality areas of Assam (India). Journal of Veterinary and Animal Sciences 2022. [DOI: 10.51966/jvas.2022.53.2.269-278] [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: 11/20/2022] Open
Abstract
A study was conducted in Dhubri and Biswanath Chariali Municipality areas to assess the adoption of hygienic and sanitation practices being followed by poultry butchers. A total of 60 poultry butchers were selected randomly, 30 from each Municipality area so that the final sample consisted of 60 poultry butchers. Data were collected using a pre-tested structured interview schedule by personal interviews. The schedule was designed to collect information on the socioeconomic profile of the butchers, personal and meat shop hygiene, maintenance of meat shop and its equipment. The data revealed that all the poultry butchers were male among which (75%) of them had an education level only up to eight standard. The overall mean age of the poultry butchers was found to be 39.95±8.64 years of which majority (75%) of them belong to middle age group. The present study indicated that none of the poultry butchers underwent any formal training for hygienic meat handling. It was also pointed out that most (85%) of the butcheries were located at market area, while only a few (15%) were found in the residential area. Only 18.33 per cent of the poultry butchers wore clean clothes while 81.67 per cent of them did not adopt this practice during working. Majority (88.33%) of them did not wash their hands after smoking/ chewing tobacco.It was also revealed that majority (88.33%) of the butchers did not clean knives before and after cutting of meat. Majority of the butchers agreed that cleanliness of equipment (71.67%), the meat shop and its surrounding (68.33%) and personal hygiene (68.33%) were some of the important factors that were essential to ensure wholesome meat production. From the above study, it may be concluded that appropriate interventional measures by the concerned agencies such as awareness trainings for poultry butchers on crucial areas of food safety, hygienic practices relating to meat handling and personal safety are imperative. The results of the study also shed light on the need for measures to improve the infrastructural facilities in poultry meat butcheries and for appropriate interventions to strengthen the food quality control system by the government regulatory authorities.
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Badal FA, Ali MA, Islam MS, Rashid J, Alam MJ, Parvez AF, Rashid FJ, Alam MN, Rahman M. Diseases Pattern and Outcome among the Neonates in A Newly Established Special Care Newborn Unit (SCANU) At Secondary Level District Hospital in Bangladesh. Mymensingh Med J 2022; 31:129-134. [PMID: 34999692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although huge improvement in neonatal mortality reduction in last two decades in Bangladesh but it is still very high compare with many other countries. High neonatal mortality also significantly contribute deaths among the under five children. Neonatal mortality reflects a nation's socio-economic status, efficiency and effectiveness of health care services. This was cross sectional study. The objective of this study was to analyse the diseases pattern and outcome of the neonates admitted in the newly established SCANU (Special care neonatal unit) of 250 bedded General Hospital of Tangail district, Bangladesh. Study period was one year from January 2017 to December 2017. Information from medical records of the SCANU was analysed. During the study period 1,379 neonates were admitted in the SCANU. The ratio between male and female was 1.5:1, 61% of the neonates admitted at first day of life. The reasons for admissions in SCANU were 31% of preterm and low birth weight, 23%birth asphyxia, 13% neonatal sepsis, 9% transient tachypnea of newborn, 5% congenital anomalies and 4% neonatal jaundice. Out of all neonates survival rate was 56% (779), while 25% (349) ended with fatality, 9% (122) were referred to tertiary level hospital and 10% (129) were left the hospital against medical advice. Among the fatal cases 63% died in first 24 hours and 88% in first week of life. Data shows that 47% deaths were due to preterm and low birth weight with its complication, other significant causes were birth asphyxia (30%), septicemia (16%) and congenital anomalies were (6%). Preterm and low birth weight, neonatal sepsis, birth asphyxia, transient tachypnea of newborn; congenital anomalies were the main reasons for admission in SCANU. Prematurity and its complication, birth asphyxia and neonatal sepsis as the major contributors to the neonatal mortality. The study findings will help researchers and policy makers to initiate further research and interventions to reduce fatality among the neonates in the SCANU.
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Affiliation(s)
- F A Badal
- Dr Md Fakhrul Amin Badal, Resident Physician, Department of Pediatrics, 250 Bedded General Hospital, Tangail, Bangladesh; E-mail:
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Faroque MO, Islam SF, Hadiuzzaman KM, Islam MN, Alam MR, Hossain RM, Salahuddin AZ, Rahman M. A Middle-Aged Woman Presented with Catastrophic Anti-phospholipid Syndrome in Nephrology Department of BSMMU. Mymensingh Med J 2022; 31:267-271. [PMID: 34999714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A life threatening rare condition called catastrophic antiphospholipid syndrome leading to multiple organ failure is characterized by vascular thrombosis in the presence of anti-phospholipid antibody which often appear as a medical emergency. Antiphospholipid antibody syndrome whether primary or secondary cause thromboembolic manifestation resulting recurrent fetal loss, but catastrophic antiphospholipid antibody syndrome may not present in such a way, rather multi-system involvement occurs within a short period of time. We would like to present a case of 50 years old female who is hypertensive, non-diabetic, a known case of hypothyroidism for two years, who was admitted to our hospital after developing fever for 7 days and black discoloration of lateral three fingers of left hand for short period of time. The patient had no medical problems and had been in her usual state of health until 7 days before admission. Patient is anaemic and found to have severe renal failure. She was found high titer antiphospholipid antibody both IgM and IgG positive and anti-cardiolipin antibody positive. Her routine investigations revealed very high neutrophilic leukocytosis, high acute phase reactant, urinary findings revealed no active sediment; we thought that our patient might have sepsis that may trigger catastrophic antiphospholipid syndrome. Multi-disciplinary consultation gave us valuable opinion. Considering her septicemia, she was given broad spectrum antibiotic. Anticoagulation was given with unfractionated heparin followed by warfarin and as an immunosuppressive protocol methylprednisolone followed by prednisolone along with pulse cyclophosphamide was given. Treatment option with plasma pheresis and monoclonal antibody was not attempted, but she was given several session of hemodialysis, within a few days her biochemical parameters improved. Severe renal failure in this patient may be explained by septicemia or thrombotic micro-angiopathy that was reversed with anti-coagulation or proper antibiotic. Amputation of three digit of left hand was done by orthopedic surgeon but unfortunately two weeks after admission the patient expired due to sudden stroke.
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Affiliation(s)
- M O Faroque
- Dr Md Omar Faroque, Associate Professor, Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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Burnside RJ, Shaffer SA, Cuscó F, Rahman M, Scotland KM. Quantifying egg attendance behaviours of wild Asian houbara can improve artificial incubation outcomes. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01157] [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: 11/23/2022] Open
Abstract
Artificial incubation is fundamental in ex situ avian conservation interventions for an increasing range of threatened species, but incubation parameters can differ between species. Both egg-turning angle and frequency are critical for successful embryonic development, but measuring these parameters in wild birds has historically been difficult. Using data-loggers inside artificial eggs that accurately record parental egg attendance behaviours, we quantified turning angles and rates throughout the incubation of 6 nesting wild Asian houbaras Chlamydotis macqueenii, a species bred in captivity in response to human over-exploitation. Wild females turned their eggs 0.6 times h-1 with a mean angle of 40.9° turn-1. Mimicking the patterns of wild birds (‘wild’ treatment), we applied a mean angular change of 40-50° turn once h-1 to artificially incubated eggs and compared this to eggs treated with an existing protocol (‘control’) of 120-130° per turn. Mean hatchability for the wild treatment (78.8%, n = 766) was similar to the control (76.6%, n = 1196). The wild treatment (n = 591) produced significantly heavier hatchlings (2.7%) than the control treatment (n = 893). However, chick growth rates (g d-1 and daily % mass change) and survival to Day 10 were not different between groups. The wild treatment demonstrates that turning angles affect embryo development and, perhaps, hatchability. Investigating natural incubation behaviours using egg-loggers and applying these patterns to artificial incubation appears efficacious to achieve optimal incubation protocols and reduce the need for ex situ trial and error refinement in conservation interventions of captive-bred threatened bird species.
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Affiliation(s)
- RJ Burnside
- School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ, UK
| | - SA Shaffer
- Department of Biological Sciences, San José State University, San Jose, CA 95192, USA
| | - F Cuscó
- School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ, UK
| | - M Rahman
- Emirates Bird Breeding Center for Conservation, PO Box 17817, Al Ain, Abu Dhabi, UAE
| | - KM Scotland
- Emirates Bird Breeding Center for Conservation, PO Box 17817, Al Ain, Abu Dhabi, UAE
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Rahman M, Ashraf M, Gladstone D, Bruza P, Jarvis L, Schaner P, Cao X, Pogue B, Hoopes P, Zhang R. Treatment Planning System for Clinical Translation of Electron FLASH Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nguyen TH, Ho TTM, Nguyen-Hoang TP, Qumar S, Pham TTD, Bui QN, Bulach D, Nguyen TV, Rahman M. The endemic Helicobacter pylori population in Southern Vietnam has both South East Asian and European origins. Gut Pathog 2021; 13:57. [PMID: 34593031 PMCID: PMC8482589 DOI: 10.1186/s13099-021-00452-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/17/2021] [Indexed: 12/15/2022] Open
Abstract
Background The burden of Helicobacter pylori-induced gastric cancer varies based on predominant H. pylori population in various geographical regions. Vietnam is a high H. pylori burden country with the highest age-standardized incidence rate of gastric cancer (16.3 cases/100,000 for both sexes) in Southeast Asia, despite this data on the H. pylori population is scanty. We examined the global context of the endemic H. pylori population in Vietnam and present a contextual and comparative genomics analysis of 83 H. pylori isolates from patients in Vietnam. Results There are at least two major H. pylori populations are circulating in symptomatic Vietnamese patients. The majority of the isolates (~ 80%, 66/83) belong to the hspEastAsia and the remaining belong to hpEurope population (~ 20%, 17/83). In total, 66 isolates (66/83) were cagA positive, 64 were hspEastAsia isolates and two were hpEurope isolates. Examination of the second repeat region revealed that most of the cagA genes were ABD type (63/66; 61 were hspEastAsia isolates and two were hpEurope isolates). The remaining three isolates (all from hspEastAsia isolates) were ABC or ABCC types. We also detected that 4.5% (3/66) cagA gene from hspEastAsia isolates contained EPIYA-like sequences, ESIYA at EPIYA-B segments. Analysis of the vacA allelic type revealed 98.8% (82/83) and 41% (34/83) of the strains harboured the s1 and m1 allelic variant, respectively; 34/83 carried both s1m1 alleles. The most frequent genotypes among the cagA positive isolates were vacA s1m1/cagA + and vacA s1m2/cagA + , accounting for 51.5% (34/66) and 48.5% (32/66) of the isolates, respectively. Conclusions There are two predominant lineages of H. pylori circulating in Vietnam; most of the isolates belong to the hspEastAsia population. The hpEurope population is further divided into two smaller clusters. Supplementary Information The online version contains supplementary material available at 10.1186/s13099-021-00452-2.
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Affiliation(s)
- Trang Hoa Nguyen
- Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
| | - Trang Thi My Ho
- Department of Genetics, Faculty of Biology and Biotechnology, Ho Chi Minh University of Science, Ho Chi Minh City, Vietnam
| | - Thien-Phuc Nguyen-Hoang
- Department of Genetics, Faculty of Biology and Biotechnology, Ho Chi Minh University of Science, Ho Chi Minh City, Vietnam
| | | | - Thuc Tran Dang Pham
- Department of Genetics, Faculty of Biology and Biotechnology, Ho Chi Minh University of Science, Ho Chi Minh City, Vietnam
| | - Quy Nhuan Bui
- Department of Gastroenterology, Gia Dinh Hospital, Ho Chi Minh City, Vietnam
| | - Dieter Bulach
- Melbourne Bioinformatics, The University of Melbourne and Doherty Applied Microbial Genomics, The Doherty Institute, Melbourne, Australia
| | - Thuy-Vy Nguyen
- Department of Genetics, Faculty of Biology and Biotechnology, Ho Chi Minh University of Science, Ho Chi Minh City, Vietnam
| | - Motiur Rahman
- Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK.
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Hoa TN, Munshi SU, Ngoc KN, Ngoc CL, Thanh TTT, Akther T, Tabassum S, Parvin N, Baker S, Rahman M. A tightly clustered hepatitis E virus genotype 1a is associated with endemic and outbreak infections in Bangladesh. PLoS One 2021; 16:e0255054. [PMID: 34293039 PMCID: PMC8297744 DOI: 10.1371/journal.pone.0255054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/08/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) infection is endemic in Bangladesh and there are occasional outbreaks. The molecular characteristics and pathogenesis of endemic and outbreak HEV strains are poorly understood. We compared the genetic relatedness and virulence associated mutations of endemic HEV strains with outbreak strains. METHODS We analyzed systematically collected serum samples from HEV immunoglobulin M (IgM) positive patients attended at Bangabandhu Sheikh Mujib Medical University, Dhaka from August 2013 to June 2015. HEV RNA positive samples were subjected to whole genome sequencing. Genotype and subtype of the strains were determined by phylogenetic analysis. Virulence associated mutations e.g. acute viral hepatitis (AVH), fulminant hepatic failure (FHF), chronic hepatitis, ribavirin treatment failure (RTF), B and T cell neutralization epitopes were determined. RESULTS 92 HEV immunoglobulin M (IgM) antibody positive plasma samples (43 in 2013-2014 and 49 in 2014-2015) were studied. 77.1% (70/92) of the samples were HEV RNA positive. A 279 bp open reading frame (ORF) 2 and ORF 3 sequence was obtained from 54.2% (38/70) of the strains. Of these 38 strains, whole genome sequence (WGS) was obtained from 21 strains. In phylogenetic analysis of 38 (279 bp) sequence all HEV sequences belonged to genotype 1 and subtype 1a. Further phylogenetic analysis of 21 HEV WGS, Bangladeshi HEV sequences clustered with genotype 1a sequences from neighboring countries. Within genotype 1a cluster, Bangladesh HEV strains formed a separate cluster with the 2010 HEV outbreak strains from northern Bangladesh. 80.9 to 100% of the strains had A317T, T735I, L1120I, L1110F, P259S, V1479I, G1634K mutations associates AVH, FHF and RTF. Mutations in T cell recognition epitope T3, T5, T7 was observed in 76.1%, 100% and 100% of the strains respectively. CONCLUSION Strains of HEV genotype 1a are dominant in Bangladesh and are associated with endemic and outbreak of HEV infection. HEV isolates in Bangladesh have high prevalence of virulence associated mutations and mutation which alters antigenicity to B and T cell epitopes.
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Affiliation(s)
- Trang Nguyen Hoa
- Oxford University Clinical Research Unit, Wellcome Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Saif Ullah Munshi
- Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Khanh Nguyen Ngoc
- Oxford University Clinical Research Unit, Wellcome Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Chau Le Ngoc
- Oxford University Clinical Research Unit, Wellcome Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Thanh Tran Thi Thanh
- Oxford University Clinical Research Unit, Wellcome Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tahmina Akther
- Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Shahina Tabassum
- Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Nilufa Parvin
- Sir Salimullah Medical College and Hospital (SSMCH), Dhaka, Bangladesh
| | - Stephen Baker
- Cambridge Institute of Therapeutic Immunology & Infectious Disease, Cambridge University, Cambridge, England
| | - Motiur Rahman
- Oxford University Clinical Research Unit, Wellcome Asia Programme, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
- * E-mail:
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