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Ali W, Alam Khan S, Ullah Khan F, Khan S, Khan WA, Zafar R, Moqeet MA. Long-Term Clinical Outcome of Tacrolimus Skin Ointment (0.03%) for the Treatment of Vernal Keratoconjunctivitis: A Quasi-Experimental Study. Cureus 2023; 15:e50579. [PMID: 38226116 PMCID: PMC10788690 DOI: 10.7759/cureus.50579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
Background Vernal keratoconjunctivitis (VKC) is an allergic conjunctival inflammation with severe ocular complications if left untreated. The current management regimen is plagued with adverse effects, long-term problems, and clinical relapses. Tacrolimus offers an alternative treatment option, and long-term studies are needed to determine its efficacy. Methods A two-year follow-up based study was conducted on moderate to severe VKC patients, who were prescribed tacrolimus skin ointment. The 5-5-5 exacerbation scale was used for the monitoring and grading severity of the disease. Analysis of variance (ANOVA) and intergroup comparisons were conducted on exacerbation scale scores among follow-ups. Results A significant reduction was observed in the total score of severity from baseline (203.17±102.05) to three months' follow-up (69.94±70.54), and it kept reducing for 18 months post therapy. Similar results with statistically significant reduction were observed for all grades of the scale. The relapse rate was 5.71% within a month after therapy cessation, and none of the other patients showed relapse afterward. No significant ocular and systemic complications were observed during the study. Conclusion Tacrolimus is effective in the long-term management of VKC without the complications of conventional steroid-based therapy.
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Affiliation(s)
- Warda Ali
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Saad Alam Khan
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Fahim Ullah Khan
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Shama Khan
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Wajid A Khan
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Rabeeah Zafar
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
| | - Muhammad A Moqeet
- Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK
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Zafar R, Saleem T, Sheikh N, Maqbool H, Mukhtar M, Abbasi M. PRDM16, LRP1 and TRPM8 genetic polymorphisms are risk factor for Pakistani migraine patients. Saudi J Biol Sci 2021; 28:5793-5799. [PMID: 34588893 PMCID: PMC8459056 DOI: 10.1016/j.sjbs.2021.06.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Migraine is a chronic neurovascular condition characterized by recurring attacks of pulsating headaches. Genome-wide association studies (GWAS) identified many potential loci associated with migraine. To check the association of polymorphisms of PRDM16 (rs2651899), LRP1 (rs11172113), and TRPM8 (rs10166942) with migraine, the first time a case-control study was conducted in understudied Pakistani population. METHODS The study included 127 migraine patients (21 in migraine with aura and 106 with migraine without aura group) and 120 healthy control subjects from different areas of Punjab, Pakistan. Blood samples were collected from all the participants, and DNA was isolated from the lymphocytes by the modified organic method. Sanger's sequencing was done for PRDM16 (rs2651899), LRP1 (rs11172113), and TRPM8 (rs10166942) in all the samples to check the genotype. Logistic regression analysis was done using SPSS 20.0 to check the association of these SNPs with migraine susceptibility. RESULTS We found statistically significant differences between case and control group for PRDM16 (rs2651899) at genotypic level (p < 0.001), allelic level (p < 0.001; OR 3.088; 95% CI 2.082-4.579) and for dominant model (p < 0.001; OR 5.437; 95% CI 3.112-9.498). The major findings of this study suggested that PRDM16 rs2651899 is strongly associated with migraine in overall and subgroup analysis of genotypes. LRP1 (rs11172113) showed significant association with migraine except in subgroup comparison. A similar trend of association was found for TRPM8 (rs10166942) however, significant association was found only at the allelic level but no significant difference was seen at the genotypic level between case and control. One novel mutation c.67 + 4436_67 + 4438delA was also identified in the current study near LRP1 (rs11172113) polymorphic site. CONCLUSION In this first-ever replication report from Pakistan, PRDM16 (rs2651899) was found as a potential genetic marker in migraine susceptibility while LRP1 (rs11172113) and TRPM8 (rs10166942) showed partial association in subgroup analysis.
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Affiliation(s)
- R. Zafar
- Cell and Molecular Biology Laboratory, Institute of Zoology, University of the Punjab, Lahore 54590, Pakistan
| | - T. Saleem
- Cell and Molecular Biology Laboratory, Institute of Zoology, University of the Punjab, Lahore 54590, Pakistan
| | - N. Sheikh
- Cell and Molecular Biology Laboratory, Institute of Zoology, University of the Punjab, Lahore 54590, Pakistan
| | - H. Maqbool
- Cell and Molecular Biology Laboratory, Institute of Zoology, University of the Punjab, Lahore 54590, Pakistan
| | - M. Mukhtar
- Cell and Molecular Biology Laboratory, Institute of Zoology, University of the Punjab, Lahore 54590, Pakistan
| | - M.H. Abbasi
- Department of Zoology, University of Okara, Renala Khurd 56300, Pakistan
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Rizwan A, Zafar R, Asghar A, Obaid N, Naeem BA. Effect of Topical Versus Sub-conjunctival Anaesthesia during Administration of Intravitreal Bevacizumab Injection. pak J Ophthalmol 2021. [DOI: 10.36351/pjo.v37i4.1249] [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: 11/01/2022] Open
Abstract
Purpose: To compare the anesthetic effect of topical proparacaine hydrochloride 0.5% with sub-conjunctival lidocaine 2% for intravitreal injection of Bevacizumab.
Study Design: Quasi experimental study.
Place and Duration of Study: Department of Ophthalmology Fauji Foundation Hospital, Rawalpindi, from July 2017 to January 2018.
Methods: Sixty 60 patients who needed intravitreal Bevacizumab were included in the study after approval from the ethical review board. Exclusion criteria were patients with conditions that could affect pain sensation, acute ocular inflammation, history of intravitreal injection, using systemic analgesic/sedatives, uncooperative patients and unable to understand the pain scale. Written informed consent was taken. Name, age, gender, diagnosis, previous intravitreal injection, hospital registration number, address and contact numbers were noted. Patients were briefed about the visual analogue scale. Patients were divided into two groups. Group A received proparacaine drops and group B was given subconjunctival lidocaine injections before intravitreal bevacizumab.
Results: The mean age of patients in this study was 60.38 ± 10.55 years. There were 03 (5.0%) males and 57 (95.0%) females. Majority of the patients (30%) presented with choroidal neovascularization followed by diabetic maculopathy, vitreous hemorrhage, central retinal vein occlusion and proliferative diabetic retinopathy. Mean pain score among both the groups was 3.67 ± 1.97 (topical group) and 1.70 ± 1.51 (sub-conjunctival group) respectively which was statistically significant (p-value 0.000). Among age, diabetes, duration of diabetes and hypertension, only hypertension had moderate correlation with the pain score (correlation coefficient = 0.316, p values = 0.017).
Conclusion: Sub-conjunctival anaesthesia results in less pain during intravitreal drug administration as compared to the topical anaesthesia.
Key Words: Intravitreal injections, Bevacizumab, Intravitreal Anti-VEGF, Anesthesia.
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Zafar R, Rizwan A, Naeem BUDA, Asghar A, Obaid N. Immediate Effect of Intravitreal Bevacizumab Injection on Intraocular Pressure. pak J Ophthalmol 2020. [DOI: 10.36351/pjo.v36i4.1109] [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: 11/01/2022] Open
Abstract
Purpose: To determine the immediate effect of intravitreal Bevacizumab on intraocular pressure (IOP) in eyes with retinal vascular disorders.
Study Design: Interventional case series.
Place and Duration of Study: Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, from January 2019to July 2019.
Methods: One hundred and thirty one patients were included in this study using non probability consecutive sampling. IOP was measured before intravitreal injection (baseline) and at 5 and 30 minutes post-injection. Descriptive statistics were obtained using SPSS version 21.0.
Results: One hundred and thirty one eyes of 131 patients were observed for IOP change after intra vitreal injection of Bevacizumab. Among them 23 (18%) were males and 108 (82.4%) were females. Mean age was 57.57 ± 13.09 years. Mean IOP at baseline was 16.16 ± 2.52 mmHg. At 5 minutes after injection, 108 eyes (82.4%) had raised IOP, maximum IOP recorded was 44 mmHg. There was a statistically significant correlation between IOP at baseline and 5 minutes with p = 0.005 (≤0.05). At 30 minutes, 94 eyes (71.7%) had IOP fallen back to normal. Statistically, an insignificant correlation was present between IOP at baseline and 30 minutes (p = 0.081) post-injection. IOP rise was not significantly correlated to gender, age, hypertension and asthma at any interval (p value > 0.05). However, IOP rise was significantly correlated in diabetic patients at 30 minutes.
Conclusion: IOP elevation has been observed after intravitreal bevacizumab in immediate post-injection period which warrants the monitoring of IOP in this critical period to avoid serious blinding complications.
Key Words: Bevacizumab, Vascular endothelial growth factor, Intraocular pressure, Goldmann applanation tonometer.
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Hase Y, Polvikoski TM, Ihara M, Hase M, Zafar R, Stevenson W, Allan LM, Ennaceur A, Horsburgh K, Gallart‐Palau X, Sze SK, Kalaria RN. Carotid artery disease in post‐stroke survivors and effects of enriched environment on stroke pathology in a mouse model of carotid artery stenosis. Neuropathol Appl Neurobiol 2019; 45:681-697. [DOI: 10.1111/nan.12550] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/19/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Y. Hase
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - T. M. Polvikoski
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - M. Ihara
- Department of Stroke and Cerebrovascular Diseases National Cerebral and Cardiovascular Centre Osaka Japan
| | - M. Hase
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - R. Zafar
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - W. Stevenson
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - L. M. Allan
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - A. Ennaceur
- Department of Pharmacy Sunderland Pharmacy School University of Sunderland Sunderland UK
| | - K. Horsburgh
- Centre for Neuroregeneration University of Edinburgh Edinburgh UK
| | - X. Gallart‐Palau
- School of Biological Sciences Nanyang Technological University Singapore
| | - S. K. Sze
- School of Biological Sciences Nanyang Technological University Singapore
| | - R. N. Kalaria
- Neurovascular Research Group Institute of Neuroscience Newcastle University Newcastle upon Tyne UK
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Abstract
The natural root and root callus extracts of Cichorium intybus were compared for their anti-hepatotoxic effects in Wistar strain of Albino rats against carbon tetrachloride induced hepatic damage. The increased levels of serum enymes (aspartate transaminase, alanine transaminase) and bilirubin observed in rats treated with carbon tetrachloride were very much reduced in the animals treated with natural root and root callus extracts and carbon tetrachloride. The decreased levels of albumin and proteins observed in rats after treatment with carbon tetrachloride were found to increase in rats treated with natural root and root callus extracts and carbon tetrachloride. These biochemical observations were supplemented by histopathological examination of liver sections. Results of this study revealed that Cichorium intybus root callus extract could afford a better protection against carbon tetrachloride induced heptocellular damage as compared to the natural root extract.
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Affiliation(s)
- R Zafar
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi, India
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Bhandari U, Sharma JN, Zafar R. The protective action of ethanolic ginger (Zingiber officinale) extract in cholesterol fed rabbits. J Ethnopharmacol 1998; 61:167-171. [PMID: 9683348 DOI: 10.1016/s0378-8741(98)00026-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The effects of ethanolic extract of ginger (200 mg/kg, p.o.) were studied in cholesterol fed rabbits. The marked rise in serum and tissue cholesterol, serum triglycerides, serum lipoproteins and phospholipids that followed 10 weeks of cholesterol feeding, was significantly reduced by the ethanolic ginger extract and results were compared with gemfibrozil, a standard orally effective hypolipidaemic drug. The severity of aortic atherosclerosis as judged by gross grading was more marked in pathogenic, i.e. the hypercholesterolemic group, while animals receiving ginger extract along with cholesterol showed a lower degree of atherosclerosis. The results indicate that ginger is definitely an antihyperlipidaemic agent.
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Affiliation(s)
- U Bhandari
- Division of Pharmacology, Hamdard University, New Delhi, India
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Raafat AM, Franko AP, Zafar R, Dulchavsky SA, Diebel LN, Ksenzenko S. Effect of thyroid hormone (T3)-responsive changes in surfactant apoproteins on surfactant function during sepsis. J Trauma 1997; 42:803-8; discussion 808-9. [PMID: 9191660 DOI: 10.1097/00005373-199705000-00009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Long surfactant phospholipids are altered during sepsis; the role of surfactant apoproteins is unknown. This study investigates the effect of cecal ligation and puncture (CLP) on surfactant functional effectiveness and apoprotein transcriptional activity with or without T3 replacement. METHODS Male Sprague Dawley rats underwent sham laparotomy or CLP with or without T3 replacement. Lung compliance, surfactant adsorption, and surface tension were measured with a surfactometer. Surfactant apoproteins A, B, and C (SP-A, SP-B, SP-C) mRNA was quantified by Northern blot analysis. RESULTS Lung compliance was significantly decreased by sepsis; initial surface tension and adsorption values in CLP animals reflected apoprotein dysfunction. Sepsis decreased SP-A mRNA levels and increased SP-B mRNA; SP-C mRNA were unchanged. T3 treatment improved compliance, adsorption, and ST isotherms in septic animals. CONCLUSION T3 attenuated sepsis-induced surfactant dysfunction and SP-A and SP-B transcriptional changes during sepsis. This suggests an interaction between the thyroid, surfactant apoproteins, and lung surfactant functional effectiveness and requires further study.
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Affiliation(s)
- A M Raafat
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
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Affiliation(s)
- P F Boston
- Department of Psychiatry, Faculty of Medicine, University of Leicester, United Kingdom
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Zafar R. Momordica charantia--a review. Hamdard Med 1991; 34:49-61. [PMID: 11613982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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