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Kaur M, Anderson P, Shahid S, Wong FSL. Chemical kinetics of silver diammine fluoride in demineralization and remineralization solutions-an in vitro study. Front Oral Health 2024; 5:1374333. [PMID: 38708061 PMCID: PMC11069299 DOI: 10.3389/froh.2024.1374333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/08/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Silver Diammine Fluoride (SDF) is a clinical minimal intervention to manage dentin caries. Its chemistry in demineralization conditions has been investigated widely, but far less in remineralization conditions. The aim was to investigate and compare the chemical reactions when SDF is added to remineralization and demineralization solutions. Methods 0.01 ml SDF (Riva Star) was added to deionized water (DW); demineralization (DS = pH4) and remineralization (RS = pH7.0) solutions. The time sequence of concentrations of NH4+, F-, and Ag+ were measured using ion selective electrodes (ISEs) every 2 min. The pH was also measured. Precipitates were characterized using x-ray Diffraction (XRD) and, 31P and 19F nuclear magnetic resonance spectroscopy (NMR). Results The concentrations of NH4+ and Ag+ showed decreasing trends in DW (-0.12 and -0.08 mM/h respectively), and in DS (-1.06 and -0.5 mM/h respectively); with corresponding increase in F- concentration (0.04 and 0.7 mM/h respectively). However, in RS, NH4+ concentration showed little change (0.001 mM/h), and Ag+ and F- concentrations were negligible. XRD results showed that precipitates (in RS only) contained AgCl, and metallic Ag. NMR showed that fluorapatite/carbonated fluorapatite (FAP/CFAP) were formed. The pH increased after SDF addition in all three solutions. Discussion SDF dissolved to release NH4+, F- and Ag + . In DW and DS, NH4+ combined with Ag+ to form diamminesilver, causing an increase of F- and pH. In RS, F- reacted with Ca2+ and (PO)43- to form FAP/CFAP, and Ag+ reacted with Cl- to form AgCl/Ag. These suggests why SDF is effective in managing dentin caries.
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Affiliation(s)
| | | | | | - F. S. L. Wong
- Dental Physical Sciences Unit, Centre for Oral Bioengineering, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Kaur M, Shahid S, Karpukhina N, Anderson P, Wong FSL. Characterization of chemical reactions of silver diammine fluoride and hydroxyapatite under remineralization conditions. Front Oral Health 2024; 5:1332298. [PMID: 38496333 PMCID: PMC10940413 DOI: 10.3389/froh.2024.1332298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/24/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Silver Diammine Fluoride (SDF) is a clinically used topical agent to arrest dental caries. However, the kinetics of its chemical interactions with hydroxyapatite (HA), the principal inorganic component of dental enamel, are not known. The aim was to characterize the step-wise chemical interactions between SDF and HA powder during the clinically important process of remineralization. Methods Two grams of HA powder were immersed in 10 ml acetic acid pH = 4.0 for 2 h to mimic carious demineralization. The powder was then washed and dried for 24 h and mixed with 1.5 ml SDF (Riva Star) for 1 min. The treated powder was then air-dried for 3 min, and 0.2 g was removed and stored in individual tubes each containing 10 ml remineralizing solution. Powder was taken from each tube at various times of exposure to remineralization solution (0 min, 10 min, 2 h, 4 h, 8 h, 24 h, and 10 days), and characterized using Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR) spectroscopy. Results and discussion 19F MAS-NMR spectra showed that calcium fluoride (CaF2) started to form almost immediately after HA was in contact with SDF. After 24 h, the peak shifted to -104.5 ppm suggesting that fluoride substituted hydroxyapatite (FSHA) was formed with time at the expense of CaF2. The 31P MAS-NMR spectra showed a single peak at 2.7 ppm at all time points showing that the only phosphate species present was crystalline apatite. The 35Cl MAS-NMR spectra showed formation of silver chloride (AgCl) at 24 h. It was observed that after the scan, the whitish HA powder changed to black color. In conclusion, this time sequence study showed that under remineralization conditions, SDF initially reacted with HA to form CaF2 which is then transformed to FSHA over time. In the presence of chloride, AgCl is formed which is subsequently photo-reduced to black metallic silver.
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Affiliation(s)
| | | | | | | | - F. S. L. Wong
- Dental Physical Sciences Unit, Centre for Oral Bioengineering, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Rubab ZE, Naz S, Ashraf M, Shahid S, Rehman R. Identification of a Single Nucleotide Polymorphism of Vitamin D Receptor (VDR) and Vitamin D Binding Protein (VDBP) Gene and Its Dysregulated Pathway Through VDR-VDBP Interaction Network Analysis in Vitamin D-Deficient Infertile Females. Cureus 2024; 16:e55602. [PMID: 38586664 PMCID: PMC10995750 DOI: 10.7759/cureus.55602] [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: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION The prevalence of female infertility in Pakistan is currently estimated at 22%, and emerging research suggests that vitamin D (VD) deficiency (VDD) may play a significant role in influencing female fertility. The focus of this study was to investigate the single nucleotide polymorphism (SNP) patterns within the VD binding protein (VDBP). The study aimed to explore dysregulated pathways and gene enrichment through an interaction network analysis, specifically focusing on the interplay between the VD receptor (VDR) and VDBP in females experiencing unexplained infertility (UI) coupled with VDD. METHODS A cross-sectional study was conducted on VD-deficient, fertile, and UI female subjects. VDBP and VDR were assessed by enzyme-linked immunoassay and genotyping performed. FunRich (version 3.1.3; http://funrich.org/index.html) was employed for analysis of the identified proteins: VDR and VDBP and with their mapped gene datasets, gene enrichment, and protein-protein interaction (PPI) network. RESULTS The mean VD and VDR values of infertile females were significantly lower than those of fertile females. VDBP in infertile females (median (IQR)): 296.05 (232.58-420.23)) was lower than that of fertile females (469.9 (269.57-875.55), (p=0.01)). On sequence analysis, a mutation rs 4588 SNP (Thr 436 Lys) was found in exon 11 of the VDBP gene of UI females, but no mutation in exons 8 and 9 of the VDR gene, with some insignificant intronic variants, was observed. The proteins such as plasma membrane estrogen receptor signaling pathway (p < 0.001), VDR, SMAD3, NCOR1, CREBBP, NCOA1, STAT1, GRB2, PPP2CA, TP53, and NCOA2 were enriched after biological pathway grouping when VDR was made the focused gene and directly interacting with VDBP. CONCLUSION The females with UI exhibited significantly low VD, VDBP, and VDR. The plasma membrane estrogen receptor signaling pathway was enriched in VDD infertile females.
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Affiliation(s)
- Zil E Rubab
- Department of Biochemistry, Ziauddin University, Karachi, PAK
| | - Sumaira Naz
- Department of Obstetrics and Gynaecology, The Aga Khan University, Karachi, PAK
| | - Mussarat Ashraf
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, PAK
| | - Saba Shahid
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, PAK
| | - Rehana Rehman
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, PAK
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Kanani F, Shahid S, Sameer D, Maqsood S. Selective screening for inherited metabolic disorders in a tertiary care hospital of Karachi - A retrospective chart review. Pak J Med Sci 2024; 40:S80-S84. [PMID: 38328645 PMCID: PMC10844909 DOI: 10.12669/pjms.40.2(icon).8985] [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: 10/20/2023] [Accepted: 11/24/2023] [Indexed: 02/09/2024] Open
Abstract
Background & Objective Selective high-risk screening of children suspected of having inherited metabolic disorders was conducted jointly by Chemical Pathology section and the Pediatric Department of Indus Hospital and Health Network- (IHHN) from October 2020-March 2022. Tandem mass spectrometry (MS) for newborn screening was recently introduced in a local laboratory. We did a selective high screening of children for metabolic disorders by using MS for neonates and other relevant tests for older children in our hospital. The present study was undertaken to get an estimate of the number of metabolic cases screened and identified after inclusion of an extended workup. Methods This is a retrospective chart review of children who were selectively screened for IMDs. Patients' records with ages ranging from birth to fourteen years of age were retrieved from the electronic records department of IHHN from October 2020 to March 2022. Records were searched for demographic data, history, signs, symptoms, and lab investigations. All relevant information was recorded on a pre-designed questionnaire. Results A total of 178 children were screened for inherited metabolic disorders. Majority of the children screened were less than one month of age 96 (54%). Consanguinity was noted in 74 (41.5%) children. Most common symptoms observed were failure to thrive in 77 children (43%), hypoglycemia in 45 children (25%), and feeding difficulty in 36 children (20%). Inherited metabolic disorders were confirmed in 12 children out of which five had congenital adrenal hyperplasia, four had cystic fibrosis and three children had congenital hypothyroidism. Conclusion In the present study, we were able to screen several children after inclusion of an extended metabolic workup. However, confirmation of many disorders like fatty acid oxidation defects, disorders of carbohydrate metabolism, and sphingolipidosis could not be done due to lack of confirmatory tests. We recommend that confirmatory tests of these disorders be included in local labs.
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Affiliation(s)
- Fatima Kanani
- Saba Shahid, Chemical Pathology Section, Department of Pathology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saba Shahid
- Fatima Kanani, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
| | - Dua Sameer
- Dua Sameer, Department of Research, Indus Hospital & Health Network, Karachi, Pakistan
| | - Sidra Maqsood
- Sidra Maqsood, Department of Research, Indus Hospital & Health Network, Karachi, Pakistan
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Mazhar A, Ghouse AN, Shahid S, Samad L. Kasabach-Merritt Syndrome: a case study of successful treatment with vincristine and propranolol. J PAK MED ASSOC 2023; 73:2476-2479. [PMID: 38083937 DOI: 10.47391/jpma.9185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Kasabach-Merritt syndrome is a rare condition, characterised by the presence of an enlarging vascular tumour associated with thrombocytopenia, microangiopathic haemolytic anaemia and consumptive coagulopathy. The syndrome manifests in infancy, with high morbidity and mortality rates. No standard guidelines have been established for the treatment of Kasabach-Merritt syndrome to date. To existing literature we add this report of a four-month-old female child with Kasabach-Merritt syndrome who was successfully treated with propranolol and vincristine. This drug combination helped reverse the severe thrombocytopenia as well as decrease in size of her haemangioma. Management of Kasabach-Merritt syndrome continues to be a challenge, with varying response to first line drugs. Early diagnosis and initiation of treatment in a closely monitored setting is essential to ensure good outcomes. Since this is a relatively rare condition and large studies are not feasible, documenting treatment experience for single cases or small series becomes even more important.
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Affiliation(s)
- Aqsa Mazhar
- Vascular Anomalies Center, Indus Hospital and Health Network, Karachi, Pakistan
| | | | - Saba Shahid
- Department of Pediatric Medicine, The Indus Hospital, Karachi, Pakistan
| | - Lubna Samad
- Interactive Research and Development (IRD), Global, Karachi, Pakistan
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Junejo S, Shahid S, Khursheed N, Maqsood S, Adnan F, Khalid F, Zahid QUA. Cholera outbreak in 2022 among children in Karachi: Study of cases attending to a Tertiary Care Hospital. Pak J Med Sci 2023; 39:1496-1501. [PMID: 37680823 PMCID: PMC10480713 DOI: 10.12669/pjms.39.5.7395] [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: 11/24/2022] [Revised: 05/03/2023] [Accepted: 05/26/2023] [Indexed: 09/09/2023] Open
Abstract
Objective & Background Repeated outbreaks of cholera have occurred in Karachi. Changing patterns in seasonality, serotypes and antibiotic resistance have been observed in these outbreaks. Recently, in the year 2022, a surge of cholera cases has been reported from Karachi during the months of April-June. This study aimed to identify clinical features, antibiotic susceptibility, complications, and response to treatment of V. cholerae infection among children attending Indus hospital, Karachi. Methods A retrospective chart review of pediatric patients was conducted for children aged 0-16 years. All children treated for culture-proven cholera infection at Indus Hospital from March to June 2022 were included. Details of clinical features, complications, antibiotic susceptibility, and response to treatment were retrieved from the health management information system (HMIS) of the hospital. Results Twenty children were included. The median age was 01 (0.50-3.75) years. There were 9 (45%) males and 11 (55%) females. All the culture isolates belonged to serogroup O1 Ogawa of the Vibrio cholerae. Vomiting and diarrhea were the most common symptoms. Dehydration, acute kidney injury, and shock were seen in 19 (95%), 6 (30%), and 2 (10%) children respectively. Eleven children were admitted with an average hospital stay of 5 (Median-IQR 3-6) days. The isolates were completely susceptible to tetracycline, ciprofloxacin, and azithromycin. Different antibiotics were given which included cefotaxime, ceftriaxone, doxycycline, and ciprofloxacin. All children responded completely to the antibiotics. Conclusion In present study all V. cholerae isolates belonged to the O1 Ogawa serotype that showed complete susceptibility to tetracycline, ciprofloxacin, and azithromycin. Dehydration, electrolyte imbalance, and renal impairment were the most common complications observed. Drinking unboiled water was identified as a potential source of cholera in most children. Therefore, advocacy of hygienic practices and disinfection of water supplies is recommended to prevent future cholera outbreaks.
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Affiliation(s)
- Samina Junejo
- Samina Junejo, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saba Shahid
- Saba Shahid, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
| | - Nazia Khursheed
- Nazia Khursheed, Department of Microbiology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Sidra Maqsood
- Sidra Maqsood, Research Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Fareeha Adnan
- Fareeha Adnan, Department of Microbiology, Indus Hospital & Health Network, Karachi, Pakistan
| | - Fatima Khalid
- Fatima Khalid, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
| | - Qurat-ul-Ain Zahid
- Qurat-ul-Ain Zahid, Department of Microbiology, Indus Hospital & Health Network, Karachi, Pakistan
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Anis S, Abid A, Kodwavwala SAU, Sarfaraz S, Junejo S, Shahid S, Sultan S, Rizvi AH. Rare and heterogeneous manifestations of leucocyte adhesion deficiency type 1: report of two cases with diagnostic dilemmas and novel ITGB2 mutation. Allergy Asthma Clin Immunol 2023; 19:36. [PMID: 37131167 PMCID: PMC10155398 DOI: 10.1186/s13223-023-00786-3] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/27/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Primary immunodeficiency disorders (PID) are rare disorders with heterogeneous manifestations, overlapping with other diseases such as autoimmunity, malignancy, and infections. This makes the diagnosis very challenging and delays management. Leucocyte adhesion defects (LAD) are a group of PIDs in which patients lack adhesion molecules on leukocytes needed for their emigration through blood vessels to the site of infection. Patients with LAD can present with diverse clinical features including severe and life-threatening infections, early in life, and the absence of pus formation around infection or inflammation. There is often delayed umbilical cord separation, omphalitis, late wound healing, and a high white blood cell count. If not recognized and managed early, can lead to life-threatening complications and death. CASE PRESENTATION LAD 1 is characterized by homozygous pathogenic variants in the integrin subunit beta 2 (ITGB2) gene. We report two cases of LAD1 with unusual presentations (post-circumcision excessive bleeding and chronic inflammation of the right eye) which were confirmed by flow cytometric analysis and genetic testing. We found two disease-causing ITGB2 pathogenic variants in both cases. CONCLUSIONS These cases highlight the importance of a multidisciplinary approach to recognizing clues in patients with uncommon manifestations of a rare disease. This approach initiates a proper diagnostic workup of primary immunodeficiency disorder leading to a better understanding of the disease, and appropriate patient counseling, and helps clinicians to be better equipped to deal with complications.
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Affiliation(s)
- Sabiha Anis
- Department of Pathology and Medicine & Allied, Section: Immunology, The Indus Hospital and Health Network (IHHN), Karachi, Pakistan.
| | - Aiysha Abid
- Department of Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Sadaf Aba Umer Kodwavwala
- Department of Pediatric Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Sabahat Sarfaraz
- Department of Immunology, Department of Pathology, Dow International Medical College, Dow University of Health Science, Karachi, Pakistan
| | - Samina Junejo
- Department of Pediatrics, The Indus Hospital and Health Network (IHHN), Karachi, Pakistan
| | - Saba Shahid
- Department of Pediatrics, The Indus Hospital and Health Network (IHHN), Karachi, Pakistan
| | - Sajid Sultan
- Department of Pediatric Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Adibul Hasan Rizvi
- Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
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Abid A, Raza A, Khan AR, Firasat S, Shahid S, Hashmi S, Zafar MN, Sultan S, Khaliq S, Rizvi SAUH. Primary hyperoxaluria: Comprehensive mutation screening of the disease causing genes and spectrum of disease-associated pathogenic variants. Clin Genet 2023; 103:53-66. [PMID: 36185032 DOI: 10.1111/cge.14240] [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: 07/19/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 12/13/2022]
Abstract
The primary hyperoxalurias are rare disorders of glyoxylate metabolism. Accurate diagnosis is essential for therapeutic and management strategies. We conducted a molecular study on patients suffering from recurrent calcium-oxalate stones and nephrocalcinosis and screened primary hyperoxaluria causing genes in a large cohort of early-onset cases. Disease-associated pathogenic-variants were defined as missense, nonsense, frameshift-indels, and splice-site variants with a reported minor allele frequency <1% in controls. We found pathogenic-variants in 34% of the cases. Variants in the AGXT gene causing PH-I were identified in 81% of the mutation positive cases. PH-II-associated variants in the GRHPR gene are found in 15% of the pediatric PH-positive population. Only 3% of the PH-positive cases have pathogenic-variants in the HOGA1 gene, responsible to cause PH-III. A population-specific AGXT gene variant c.1049G>A; p.Gly350Asp accounts for 22% of the PH-I-positive patients. Pathogenicity of the identified variants was evaluated by in-silico tools and ACMG guidelines. We have devised a rapid and low-cost approach for the screening of PH by using targeted-NGS highlighting the importance of an accurate and cost-effective screening platform. This is the largest study in Pakistani pediatric patients from South-Asian region that also expands the mutation spectrum of the three known genes.
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Affiliation(s)
- Aiysha Abid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Ali Raza
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Abdul Rafay Khan
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Sadaf Firasat
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Saba Shahid
- Molecular Diagnostic Laboratory, Al Qassimi Hospital, Sharjah, UAE
| | - Seema Hashmi
- Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Mirza Naqi Zafar
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Sajid Sultan
- Department of Pediatric Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Shagufta Khaliq
- Department of Human Genetics & Molecular Biology, University of Health Sciences, Lahore, Pakistan
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Shahid S, Irfan M. Clinical features, microbiology and lung function in post-TB bronchiectasis compared to other aetiologies. Int J Tuberc Lung Dis 2022; 26:992-994. [PMID: 36163673 DOI: 10.5588/ijtld.22.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- S Shahid
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - M Irfan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan
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Pasha T, Okorocha C, Okafor C, Manoharan S, Roszpopa J, Shahid S. 401 Squamous Cell Carcinoma Surgery During a Global Pandemic – a Single UK Tertiary Centre Experience. Br J Surg 2022. [PMCID: PMC9452100 DOI: 10.1093/bjs/znac269.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aim Method Results Conclusions
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Affiliation(s)
- T Pasha
- Department of Plastic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - C Okorocha
- Department of Plastic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - C Okafor
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - S Manoharan
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - J Roszpopa
- Department of Plastic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - S Shahid
- Department of Plastic Surgery, Addenbrooke’s Hospital, Cambridge, United Kingdom
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Hemani F, Naveed A, Akhtar S, Shahid S. Lemierre’s syndrome in a child. Pak J Med Sci 2021; 38:433-435. [PMID: 35310801 PMCID: PMC8899900 DOI: 10.12669/pjms.38.icon-2022.5773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022] Open
Abstract
Lemierre’s Syndrome (LS) is a rare syndrome most frequently due to an anaerobic organism, Fusobacterium Necrophorum. It is commonly a complication of an acute oropharyngeal infection, but there are exceptions to its presentations. In our case the cause of LS was otitis media caused by Streptococcus species. This is a rather unusual presentation of LS. LS is caused due to septic complications of oropharyngeal infections, which lead to thrombophlebitis of internal jugular vein leading to thrombosis formation. In this case report, we present a case of Lemierre’s syndrome in a seven-year-old male child. The patient presented with high grade fever spikes and earache, which were unresponsive to oral antibiotics. LS was diagnosed in this patient on the basis of clinical, microbiological and radiological findings. After the diagnosis, treatment involved using broad spectrum antibiotics and anticoagulants, followed by surgery. Though role of anticoagulants is controversial in LS, but there is no specific guideline contraindicating the use of anti-coagulants. In our case, timely diagnosis and management enabled us to discharge the patient without any symptoms.
doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773
How to cite this:Hemani F, Naveed A, Akhtar S, Shahid S. Lemierre’s syndrome in a child. Pak J Med Sci. 2022;38(2):433-435. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Fatima Hemani
- Dr. Fatima Hemani, MBBS. Resident, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
- Correspondence: Dr. Fatima Hemani, Pediatric Medicine Resident, Department of Pediatrics, Indus Hospital & Health Network, Korangi Crossing, Karachi, Pakistan.
| | - Anjum Naveed
- Dr. Anjum Naveed, FRCS. Senior Consultant, Department of ENT, Indus Hospital & Health Network, Karachi, Pakistan
| | - Shakil Akhtar
- Dr. Shakil Akhtar, FCPS. Junior Consultant, Department of ENT, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saba Shahid
- Dr. Saba Shahid MBBS, FCPS, MHPE. Head of Department, Department of Pediatrics, Indus Hospital & Health Network, Karachi, Pakistan
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Anwar N, Memon FA, Shahid S, Shakeel M, Irfan M, Arshad A, Naz A, Ujjan ID, Shamsi T. The Dawn of next generation DNA sequencing in myelodysplastic syndromes- experience from Pakistan. BMC Genomics 2021; 22:903. [PMID: 34915860 PMCID: PMC8679965 DOI: 10.1186/s12864-021-08221-w] [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] [Received: 05/29/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Myelodysplastic syndromes (MDS) are clonal disorders of hematopoietic stem cells exhibiting ineffective hematopoiesis and tendency for transformation into acute myeloid leukemia (AML). The available karyotyping and fluorescent in situ hybridization provide limited information on molecular abnormalities for diagnosis/prognosis of MDS. Next generation DNA sequencing (NGS), providing deep insights into molecular mechanisms being involved in pathophysiology, was employed to study MDS in Pakistani cohort.
Patients and methods
It was a descriptive cross-sectional study carried out at National institute of blood diseases and bone marrow transplant from 2016 to 2019. Total of 22 cases of MDS were included. Complete blood counts, bone marrow assessment and cytogenetic analysis was done. Patients were classified according to revised WHO classification 2016 and IPSS score was applied for risk stratification. Baseline blood samples were subjected to analysis by NGS using a panel of 54 genes associated with myeloid malignancies.
Results
The median age of patients was 48.5 ± 9.19 years. The most common presenting complaint was weakness 10(45.45%). Cytogenetics analysis revealed abnormal karyotype in 10 (45.45%) patients. On NGS, 54 non-silent rare frequency somatic mutational events in 29 genes were observed (average of 3.82 (SD ± 2.08) mutations per patient), including mutations previously not observed in MDS or AML. Notably, two genes of cohesin complex, RAD21 and STAG2, and two tumor suppressor genes, CDKN2A and TP53, contained highest number of recurrent non-silent somatic mutations in the MDS. Strikingly, a missense somatic mutation p.M272Rof Rad21 was observed in 13 cases. Overall, non-silent somatic mutations in these four genes were observed in 21 of the 22 cases. The filtration with PharmGKB database highlighted a non-synonymous genetic variant rs1042522 [G > C] located in the TP53. Genotype GG and GC of this variant are associated with decreased response to cisplatin and paclitaxel chemotherapy. These two genotypes were found in 13 cases.
Conclusion
Sequencing studies suggest that numerous genetic variants are involved in the initiation of MDS and in the development of AML. In countries like Pakistan where financial reservation of patients makes the use of such analysis even more difficult when the availability of advanced techniques is already a prevailing issue, our study could be an initiating effort in adding important information to the local data. Further studies and large sample size are needed in future to enlighten molecular profiling and ultimately would be helpful to compare and contrast the molecular characteristics of Asian versus global population.
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Herekar F, Sarfaraz S, Imran M, Ghouri N, Shahid S, Mahesar M. Clinical spectrum and outcomes of patients with different resistance patterns of Salmonella enterica. Pak J Med Sci 2021; 38:356-361. [PMID: 35310803 PMCID: PMC8899895 DOI: 10.12669/pjms.38.icon-2022.5789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/26/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objective: Unceasing rise in cases of enteric fever, in particular extensively drug resistant (XDR) strain of Salmonella enterica, has led to a growing threat, leaving only carbapenems and azithromycin as the precious option. In this regard, we determined the burden and clinical course of XDR salmonella in comparison to multidrug-resistant (MDR) and drug sensitive (DS) strains. Methods: A retrospective chart review of 1515 Salmonella Typhi (S.typhi) culture positive patients was conducted at Indus Hospital and Health Network, Karachi from July 2017 to December 2018. Results: During our study, we observed children at the age of 5-6 years and adults at the age of 20-22 years were the chief targets of S.typhi. Further, we witnessed a rapid shift of drug resistance from MDR to XDR over the one year of study. Almost all patients presented with fever. However other signs and symptoms like malaise, body aches, anorexia, diarrhea, vomiting and abdominal pain were more common in XDR Typhoid patients. Further, the need of hospitalization, total hospital stay and mortality was also greater for XDR typhoid patients. Conclusion: There is a crucial requirement for consolidated steps to curtail the spread of XDR Salmonella tyhi disease as its management is challenging, and it is associated with increased morbidity and mortality.
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Affiliation(s)
- Fivzia Herekar
- Dr. Fivzia Herekar, FCPS, Indus Hospital and Health Network, Karachi, 75190, Pakistan
- Correspondence: Dr. Fivzia Herekar, FCPS. Chair Medicine and allied Indus Hospital and Health Network, Karachi, 75190, Pakistan. E-mail:
| | - Samreen Sarfaraz
- Dr. Samreen Sarfaraz, FRCP, Indus Hospital and Health Network, Karachi, 75190, Pakistan
| | - Muhammad Imran
- Dr. Muhammad Imran, PhD, Department of Pharmacy, Iqra University, Karachi, 71500, Pakistan
| | - Nida Ghouri
- Nida Ghouri, M.Phil, Indus Hospital and Health Network, Karachi, 75190, Pakistan
| | - Saba Shahid
- Dr. Saba Shahid, FCPS, Indus Hospital and Health Network, Karachi, 75190, Pakistan
| | - Marvi Mahesar
- Dr. Marvi Mahesar, Indus Hospital and Health Network, Karachi, 75190, Pakistan
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Masood KI, Yameen M, Ashraf J, Shahid S, Mahmood SF, Nasir A, Nasir N, Jamil B, Ghanchi NK, Khanum I, Razzak SA, Kanji A, Hussain R, E Rottenberg M, Hasan Z. Upregulated type I interferon responses in asymptomatic COVID-19 infection are associated with improved clinical outcome. Sci Rep 2021; 11:22958. [PMID: 34824360 PMCID: PMC8617268 DOI: 10.1038/s41598-021-02489-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022] Open
Abstract
Understanding key host protective mechanisms against SARS-CoV-2 infection can help improve treatment modalities for COVID-19. We used a blood transcriptome approach to study biomarkers associated with differing severity of COVID-19, comparing severe and mild Symptomatic disease with Asymptomatic COVID-19 and uninfected Controls. There was suppression of antigen presentation but upregulation of inflammatory and viral mRNA translation associated pathways in Symptomatic as compared with Asymptomatic cases. In severe COVID-19, CD177 a neutrophil marker, was upregulated while interferon stimulated genes (ISGs) were downregulated. Asymptomatic COVID-19 cases displayed upregulation of ISGs and humoral response genes with downregulation of ICAM3 and TLR8. Compared across the COVID-19 disease spectrum, we found type I interferon (IFN) responses to be significantly upregulated (IFNAR2, IRF2BP1, IRF4, MAVS, SAMHD1, TRIM1), or downregulated (SOCS3, IRF2BP2, IRF2BPL) in Asymptomatic as compared with mild and severe COVID-19, with the dysregulation of an increasing number of ISGs associated with progressive disease. These data suggest that initial early responses against SARS-CoV-2 may be effectively controlled by ISGs. Therefore, we hypothesize that treatment with type I interferons in the early stage of COVID-19 may limit disease progression by limiting SARS-CoV-2 in the host.
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Affiliation(s)
- Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Javeria Ashraf
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Saba Shahid
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | | | - Asghar Nasir
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | | | | | - Najia Karim Ghanchi
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | | | - Safina Abdul Razzak
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Rabia Hussain
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan
| | - Martin E Rottenberg
- Department of Microbiology and Tumor Cell Biology, Karolinska Institute, Solna, Sweden
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 75400, Pakistan.
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15
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Shahid S. 632 Analysing Laser Doppler Images - A Modified Approach to the Assessment of Burn Depth. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To establish a method of quantifiably determining burn depth from Laser Doppler (LD) images of burns.
Method
NICE advises for LD scanning to be utilised for the assessment of intermediate depth burns, where there is doubt about burn depth following experienced clinician examination. However, these scan images do not provide a quantifiable measure of burn depth. LD determines burn perfusion, with deeper burns appear blue, and superficial burns appearing red. We retrospectively studied LD images from 110 patients over the course of 2019. Using Adobe Photoshop, Histogram software, we highlighted the burns using the selection tool, and determined the proportion of the burn that was deep/poorly perfused. We then correlated these results with time till recovery.
Results
Burns with a poorly perfused region of larger than 20%, had a proportional increase in time till full recovery. This proportional increase was also reflected in burns with a 30% and 40% poor perfusion. Burns with less than 20% of poor perfusion were found to recover at the same rate as superficial burns. This novel method for the measurement of burn depth will allow for the examining plastic surgeon to make a decision on treatment based on concrete and quantifiable burn depth data.
Conclusions
We have demonstrated the initial validity of a novel method for the quantifiable measurement of burn depth. Further study is required, to establish the validity of this novel approach to the quantifiable detection of burn depth.
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Affiliation(s)
- S Shahid
- Broomfield Hospital, Chelmsford, United Kingdom
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16
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Shahid S. 636 Optimising Operative Capacity for Hand Trauma - An audit. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.077] [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: 11/12/2022]
Abstract
Abstract
Aim
Assess compliance with departmental and BSSH guidelines for hand trauma. Optimise operative capacity within the department. Promote minor ops experience among the junior doctors.
Method
Retrospective review of the overbooked patients seen in the Hand trauma Unit (HTU) in August 2020 using the eTrauma system and time to operation using the Lorenzo patient record system.
Results
Overall Local Compliance rates
Overall BSSH Compliance rates
Main area of non-compliance was waiting time for tendon operations, with a 30% breech rate (>5 days waiting time).
Conclusions
Interventions before re-audit: On call junior doctor to be based in HTU for the whole day- will allow for minor procedures (nail beds and skin lacerations) to be done at bedside. The above will free up capacity in the minor ops theatre for tendons.
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Affiliation(s)
- S Shahid
- Broomfield Hospital, Chelmsford, United Kingdom
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17
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Shahid S, Mahesar M, Ghouri N, Noreen S. A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug-resistant (XDR) Salmonella Typhi isolates in children in Karachi. BMC Infect Dis 2021; 21:900. [PMID: 34479478 PMCID: PMC8418039 DOI: 10.1186/s12879-021-06599-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A, B, and C. There is an emergence of Typhoid fever caused by extensively drug-resistant Salmonella Typhi strain called XDR S.Typhi. This strain is resistant to recommended first-line antibiotics and cephalosporins. WHO estimated 5274 cases of XDR S.Typhi in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and response to treatment of XDR S.Typhi among the pediatric population coming to Indus Hospital. Method We reviewed the records of children who had culture-proven XDR S.Typhi infection at Indus Hospital from July 2017 to December 2018. A pre-designed data abstraction form was used to record information about seasonality, demographic details, clinical features and course, treatment, complications and outcomes of the cases of XDR S.Typhi. Results The records of 680 children were reviewed. The median (IQR) age of the patients was 5 (2–8) years. More than half (n = 391, 57.5%) of the patients were males. The outcomes were recorded in 270 (40%) patients. Out of these, 234 (86.7%) children got cured within 14 days, while a delayed response to antibiotics was noted in 32 (11.9%) children. Seventy-six (29%) children recovered on a combination of meropenem and azithromycin, 72 (27%) got cured on azithromycin alone, while 15 (6%) responded to meropenem alone. Conclusion Our review indicated that children under 5 years of age were affected more with XDR S.Typhi. Azithromycin alone or in combination with meropenem were effective antibiotics for treating XDR S.Typhi in children.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital, Karachi, Pakistan.
| | - Marvi Mahesar
- Indus Hospital Research Centre, The Indus Hospital, Karachi, Pakistan
| | - Nida Ghouri
- Indus Hospital Research Centre, The Indus Hospital, Karachi, Pakistan
| | - Saba Noreen
- Department of Pediatrics, The Indus Hospital, Karachi, Pakistan
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18
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Shahid S, Sultana T, Sultana S, Hussain B, Irfan M, Al-Ghanim KA, Misned FA, Mahboob S. Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River. BRAZ J BIOL 2021; 81:814-821. [DOI: 10.1590/1519-6984.234266] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/19/2020] [Indexed: 11/22/2022] Open
Abstract
Abstract Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.
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Affiliation(s)
- S. Shahid
- Government College University, Pakistan
| | | | | | | | - M. Irfan
- Government College University, Pakistan
| | | | | | - Shahid Mahboob
- Government College University, Pakistan; King Saud University, Saudi Arabia
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Ghanchi NK, Nasir A, Masood KI, Abidi SH, Mahmood SF, Kanji A, Razzak S, Khan W, Shahid S, Yameen M, Raza A, Ashraf J, Ansar Z, Dharejo MB, Islam N, Hasan Z, Hasan R. Higher entropy observed in SARS-CoV-2 genomes from the first COVID-19 wave in Pakistan. PLoS One 2021; 16:e0256451. [PMID: 34464419 PMCID: PMC8407562 DOI: 10.1371/journal.pone.0256451] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 03/25/2021] [Accepted: 08/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan. MATERIALS AND METHODS We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020. RESULTS In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The highest diversity of clades was present in Sindh and Islamabad Capital Territory and the least in Punjab province. Initial introductions of SARS-CoV-2 GH (B.1.255, B.1) and S (A) clades were associated with overseas travelers. Additionally, GH (B.1.255, B.1, B.1.160, B.1.36), L (B, B.6, B.4), V (B.4) and S (A) clades were transmitted locally. SARS-CoV-2 genomes clustered with global strains except for ten which matched Pakistani isolates. RNA substitution rates were estimated at 5.86 x10-4. The most frequent mutations were 5' UTR 241C > T, Spike glycoprotein D614G, RNA dependent RNA polymerase (RdRp) P4715L and Orf3a Q57H. Strains up until June 2020 exhibited an overall higher mean and site-specific entropy as compared with sequences after June. Relative entropy was higher across GH as compared with GR and L clades. More sites were under selection pressure in GH strains but this was not significant for any particular site. CONCLUSIONS The higher entropy and diversity observed in early pandemic as compared with later strains suggests increasing stability of the genomes in subsequent COVID-19 waves. This would likely lead to the selection of site-specific changes that are advantageous to the virus, as has been currently observed through the pandemic.
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Affiliation(s)
- Najia Karim Ghanchi
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Asghar Nasir
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Syed Hani Abidi
- Department of Biological and Biomedical Sciences, AKU, Karachi, Pakistan
| | | | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Safina Razzak
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Waqasuddin Khan
- Department of Pediatrics and Child Health, AKU, Karachi, Pakistan
| | - Saba Shahid
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Ali Raza
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Javaria Ashraf
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Zeeshan Ansar
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | | | - Nazneen Islam
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
| | - Rumina Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University (AKU), Karachi, Pakistan
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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20
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Shahid S, Mahesar M, Rahim A, Sadiq Y. Experience of using home-based fortified diet in rehabilitation of malnourished children at Indus Hospital, Karachi, Pakistan: an institution based retrospective chart review study. BMC Nutr 2021; 7:49. [PMID: 34384500 PMCID: PMC8361784 DOI: 10.1186/s40795-021-00455-x] [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: 08/17/2020] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3 and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study explores use of energy dense, home fortified diet in achieving weight gain of malnourished children in Karachi. Methods A descriptive, retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up. Results A total of 361 patients were included in the final analysis. The median age (IQR) of children was 15 (14) months. Forty eight percent (n = 172) children had diarrhea and 54% (n = 195) children had respiratory tract infection. The median length of stay in the program was 28 days. The median (IQR) for average weight gain was 4.8 (0–10.3) g/Kg/day, 64.6% (n = 226) children defaulted, 29% (n = 102) were cured and 3% (n = 10) died. Conclusion This study showed adequate weight gain and recovery in malnourished children by using home fortified diet in real life situations without using therapeutic food or monetary support. Home fortified diets may serve as effective strategy in community-based rehabilitation of malnourished children.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital, Karachi City, Pakistan.
| | - Marvi Mahesar
- Indus Hospital Research Center, The Indus Hospital, Karachi City, Pakistan
| | - Anum Rahim
- Indus Hospital Research Center, The Indus Hospital, Karachi City, Pakistan
| | - Yumna Sadiq
- Nutrition and Food Services Department, The Indus Hospital, Karachi City, Pakistan
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21
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Shahid S, Raza M, Junejo S, Maqsood S. Clinical features and outcome of COVID-19 positive children from a tertiary healthcare hospital in Karachi. J Med Virol 2021; 93:5988-5997. [PMID: 34228363 PMCID: PMC8427002 DOI: 10.1002/jmv.27178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022]
Abstract
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Mohammad Raza
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Samina Junejo
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Sidra Maqsood
- Indus hospital Research Centre, Indus Hospital and Health network, Karachi, Pakistan
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Batool K, Wajid A, Ain Q, Shahid S, Namat T, Batool A, Hussain T, Babar ME. Sequence-Based Structural and Evolution of Polymorphisms in Bovine Toll-Like Receptor2 Gene in Dhanni and Jersey Cattle Breeds. Genetic polymorphisms in bovine TLR2. RUSS J GENET+ 2021. [DOI: 10.1134/s1022795420120030] [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: 11/22/2022]
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23
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Shahid S, Masood K, Riaz M, Abubakar S, Ali S. PO-1423: Ionizing radiation dose-effect indicator for cancer risks in medical radiation personnel. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01441-9] [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: 11/27/2022]
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24
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Shahid S, Shakeel M, Siddiqui S, Ahmed S, Sohail M, Khan IA, Abid A, Shamsi T. Novel Genetic Variations in Acute Myeloid Leukemia in Pakistani Population. Front Genet 2020; 11:560. [PMID: 32655615 PMCID: PMC7324646 DOI: 10.3389/fgene.2020.00560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/07/2020] [Indexed: 12/22/2022] Open
Abstract
Acute myeloid leukemia (AML) is a hematological malignancy characterized by clonal expansion of blast cells that exhibit great genetic heterogeneity. In this study, we describe the mutational landscape and its clinico-pathological significance in 26 myeloid neoplasm patients from a South Asian population (Pakistan) by using ultra-deep targeted next-generation DNA sequencing of 54 genes (∼5000×) and its subsequent bioinformatics analysis. The data analysis indicated novel non-silent somatic mutational events previously not reported in AML, including nine non-synonymous and one stop-gain mutations. Notably, two recurrent somatic non-synonymous mutations, i.e., STAG2 (causing p.L526F) and BCORL1 (p.A400V), were observed in three unrelated cases each. The BCOR was found to have three independent non-synonymous somatic mutations in three cases. Further, the SRSF2 with a protein truncating somatic mutation (p.Q88X) was observed for the first time in AML in this study. The prioritization of germline mutations with ClinVar, SIFT, Polyphen2, and Combined Annotation Dependent Depletion (CADD) highlighted 18 predicted deleterious/pathogenic mutations, including two recurrent deleterious mutations, i.e., a novel heterozygous non-synonymous SNV in GATA2 (p.T358P) and a frameshift insertion in NPM1 (p.L258fs), found in two unrelated cases each. The WT1 was observed with three independent potential detrimental germline mutations in three different cases. Collectively, non-silent somatic and/or germline mutations were observed in 23 (88.46%) of the cases (0.92 mutation per case). Furthermore, the pharmGKB database exploration showed a missense SNV rs1042522 in TP53, exhibiting decreased response to anti-cancer drugs, in 19 (73%) of the cases. This genomic profiling of AML provides deep insight into the disease pathophysiology. Identification of pharmacogenomics markers will help to adopt personalized approach for the management of AML patients in Pakistan.
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Affiliation(s)
- Saba Shahid
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Muhammad Shakeel
- Jamil-ur-Rahman Center for Genome Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Saima Siddiqui
- Department of Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation Karachi, Karachi, Pakistan
| | - Shariq Ahmed
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Misha Sohail
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Ishtiaq Ahmad Khan
- Jamil-ur-Rahman Center for Genome Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Aiysha Abid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Tahir Shamsi
- Department of Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation Karachi, Karachi, Pakistan
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Shahid S, Zaidi S, Ahmed S, Siddiqui S, Abid A, Malik S, Shamsi T. A Novel Nonsense Mutation in FERMT3 Causes LAD-III in a Pakistani Family. Front Genet 2019; 10:360. [PMID: 31068971 PMCID: PMC6491447 DOI: 10.3389/fgene.2019.00360] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/04/2019] [Indexed: 01/13/2023] Open
Abstract
Leukocyte adhesion deficiency-III (LAD3) is an extremely rare primary immunodeficiency disorder, transmitted with autosomal-recessive inheritance. It is caused by genetic alteration in the FERMT3 gene, which leads to abnormal expression of kindlin-3. This cytoplasmic protein is highly expressed in leukocytes and platelets, and acts as an important regulator of integrin activation. LAD3 has features like bleeding syndrome of Glanzmann-type and leukocyte adhesion deficiency. FERMT3 mutation(s) have not been well characterized in Pakistani patients with LAD3. In this study, an infant and his family of Pakistani origin, presenting with clinical features of LAD, were investigated to determine the underlying genetic defect. Targeted next generation sequencing (TGS) and Sanger sequencing were performed to identify and confirm the causative mutations, respectively, and their segregation within the family. A novel, homozygous FERMT3 nonsense mutation (c.286C > T, p.Q96∗) was found in the proband, and its co-segregation with LAD3 phenotype within the family was consistent with an autosomal recessive inheritance. Both parents were carriers of the same mutation. This family was offered prenatal diagnosis during first trimester of the subsequent pregnancy; the fetus carried the variant. In conclusion, our study is the first report to identify the novel homozygous variant c.286C > T, p.Q96∗in the FERMT3 gene, which might be the causative mutation for LAD3 patients of Pakistani origin.
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Affiliation(s)
- Saba Shahid
- Department of Genomics and Clinical Genetics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Samreen Zaidi
- Department of Pediatrics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Shariq Ahmed
- Department of Genomics and Clinical Genetics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Saima Siddiqui
- Department of Genomics and Clinical Genetics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Aiysha Abid
- Center of Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Shabbir Malik
- Department of Pediatrics, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Tahir Shamsi
- Department of Clinical Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
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Bashir A, Althagafi A, Alduheim M, Alshaikhi, A, Eid Alrashidi A, Alqwayee M, Ginawi I, Ginawi T, Shahid S, Ahmed M, Kausar M. The Prevalence of Obesity and the Relationship of Food Intake in the Body Weight of Medical Students of Hail University – Northern Saudi Arabia. Egyptian Academic Journal of Biological Sciences C, Physiology and Molecular Biology 2019. [DOI: 10.21608/eajbsc.2019.30334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Mughal MA, Soomro MS, AlSaani SMAJ, Shahid S, Ahmed S. Association of Thrombomodulin Gene Polymorphism (C1418T) With Coronary Artery Disease in Pakistani Population. Pak J Med Sci 2018; 34:730-735. [PMID: 30034448 PMCID: PMC6041510 DOI: 10.12669/pjms.343.14864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives To find out the association between Thrombomodulin gene polymorphism (C1418T) with coronary artery disease in population of Karachi, Pakistan. Methods This case-control study was conducted in Tabba Heart Institute in collaboration with the National Institute of Blood Diseases, Karachi. We compared C/T dimorphism in 92 cases with 90 control subjects by allele-specific amplification. The results of PCR were confirmed by Gene sequencing. All the laboratory methods were strictly in compliance with the international standards. All variables that were either statistically significant in the univariate analyses or potentially important with respect to prevention or biologically relevant variables were included in logistic-regression analyses. Potential confounding was assessed with the use of multivariate models adjusted for participant's characteristics and other major risk factors for coronary artery disease. All reported p values are two-tailed, with statistical significance at p value < 0.05. Results The frequency of CC, C/T and TT genotype was 81 (90%), 6 (6.7%) 3 (3.3%) in controls and 67 (72.8%), 20 (21.7%) and 5 (5.4%) in cases respectively. In cases group the CT/TT genotypes were found to be significantly highly represented among the patients with coronary artery diseases when compared with control group (p-value 0.009). Conclusion TM C1418T polymorphism emerges as a risk marker in Coronary Artery Disease patients in the population of Karachi, Pakistan.
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Affiliation(s)
- Muhammad Akbar Mughal
- Dr. Muhammad Akbar Mughal, MBBS, MPhil. Associate Professor, Department of Physiology, Karachi Medical & Dental College, Karachi, Pakistan
| | - Muhammad Saleh Soomro
- Prof. Dr. Muhammad Saleh Soomro, Ph.D. Chairman. Department of Physiology, Baqai Medical University, Karachi, Pakistan
| | | | - Saba Shahid
- Dr. Saba Shahid, Ph.D. Assistant Professor, Genomics and Molecular Pathology Lab, National Institute of Blood Disease (NIBD), Karachi, Pakistan
| | - Shariq Ahmed
- Shariq Ahmed, MSc, Clinical Scientist/Lab. Supervisor, Genomics and Molecular Pathology Lab, National Institute of Blood Disease (NIBD), Karachi, Pakistan
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Abid A, Shahid S, Shakoor M, Lanewala AA, Hashmi S, Khaliq S. Screening of the LAMB2, WT1, NPHS1, and NPHS2 Genes in Pediatric Nephrotic Syndrome. Front Genet 2018; 9:214. [PMID: 30013592 PMCID: PMC6036290 DOI: 10.3389/fgene.2018.00214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 05/25/2018] [Indexed: 02/04/2023] Open
Abstract
Mutations in the NPHS1, NPHS2, LAMB2, and the WT1 genes are responsible for causing nephrotic syndrome (NS) in two third of the early onset cases. This study was carried out to assess the frequencies of mutations in these genes in a cohort of pediatric NS patients. A total of 64 pediatric familial or sporadic SRNS cases were recruited. Among these, 74% had a disease onset of up to 3 years of age. We found one homozygous frameshift mutation in the NPHS1 gene in one CNS case and two homozygous mutations in the NPHS2 gene. Six mutations in four cases in the LAMB2 gene were also identified. No mutation was detected in the WT1 gene in isolated SRNS cases. LAMB2 gene missense mutations were segregating in NS cases with no extra-renal abnormalities. Analysis of the population genomic data (1000 genome and gnomAD databases) for the prevalence estimation revealed that NS is more prevalent than previously determined from clinical cohorts especially in Asian population compared with overall world populations (prevalence worldwide was 1in 189036 and in South-Asian was 1in 56689). Our results reiterated a low prevalence of mutations in the NPHS1, NPHS2, LAMB2, and WT1 genes in the studied population from Pakistan as compared to some European population that showed a high prevalence of mutations in these genes. This is a comprehensive screening of the genes causing early onset NS in sporadic and familial NS cases suggesting a more systematic and robust approach for mutation identification in all the 45 disease-causing genes in NS in our population is required.
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Affiliation(s)
- Aiysha Abid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Saba Shahid
- Department of Genomic, National Institute of Blood Diseases, Karachi, Pakistan
| | - Madiha Shakoor
- Department of Human Genetics, University of Health Sciences, Lahore, Pakistan
| | - Ali A Lanewala
- Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Seema Hashmi
- Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Shagufta Khaliq
- Department of Human Genetics, University of Health Sciences, Lahore, Pakistan
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Shahid S, Khan SA, Ahmad W, Fatima U, Knawal S. Size-dependent Bacterial Growth Inhibition and Antibacterial Activity of Ag-doped ZnO Nanoparticles under Different Atmospheric Conditions. Indian J Pharm Sci 2018. [DOI: 10.4172/pharmaceutical-sciences.1000342] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Iqbal M, Clement-Pervaiz MV, Ansari MJ, Pervaiz S, Sheikh S, Katpar S, Meo SA, Sattar K, Schofield S, Karabulut AK, Memon AI, Memon FN, Ahmed H, Rahman AA, Ujjan ID, Ahmed M, Altaf J, Mahesar MA, Jatoi T, Sunder J, Jewat S, Memon A, Feroz H, Aijaz R, Bux KH, Rathore MI, Memon S, Goswami P, Samejo J, Humaira M, Zakria K, Ghani RH, Ghani H, Ansari S, Nizamani MA, Memon JM, Talpur KI, Memon IU, Mangrio KB, Shaikh S, Kumar M, Arafat Y, Fatima N, Qazi M, Hashmi SFA, Bohyo MA, Bibi S, Sikundar R, Shahani Y, Waryah AM, Bano U, Sheikh P, Gul S, Rafique N, Memon S, Muhammad SW, Memon YA, Sheikh S, Shaikh MK, Wagan G, Das PC, Zahiruddin S, Sham N, Jabeen N, Maree S, Syed BM, Derajani BR, Talpur A, Abbas S, Memon AG, Abbas A, Iqbal M, Riaz W, Hussain M, Qadri F, Shaikh AR, Naz A, Soomro AK, Bajaj D, Shah S, Syed MA, Rahman AAU, Shamsi TS, Patoli AQ, Sehto N, Aijaz S, Arshad A, Mukry SN, Saud M, Shamim I, Nadeem M, Shamsi T, Khan AH, Muneeb M, Talpur A, Chang F, Bhatti FA, Effendi S, Memon FA, Memon KN, Memon P, Usman G, Memon BR, Memon FA, Memon F, Rahmaan AAU, Siddiqui MI, Ahmed FS, Fatima F, Rajpar F, Shaikh F, Memon MY, Shah T, Ansari S, Mangi FH, Qureshi JN, Laghari NA, Syed FS, Shah M, Pahnwar S, Riaz H, Laghari Z, pirzada S, Shaikh H, Jeeaindo S, Mahesar H, Narejo NT, Badvi MJ, Badvi JA, Jawed K, Haroon MI, Khan N, Perveen N, Fatima N, Borhany M, Anwar N, Naseer I, Ansari R, Boota S, Zaidi M, Hafeez N, Memon FA, Akhtar P, Khatoon Z, Vectoria M, Abass G, Talpur R, Ahmed R, Naz R, Memon AR, Memon Z, Munwar R, Rajpar S, Memon F, Bilquees M, Shoukat R, Abbasi S, Qazi SS, paras S, Fatima S, Shaikh ARK, Zaheeruddin S, Memon S, Shaikh M, Memon SK, Qadir S, Shaikh S, Ahmad SF, Nasir Z, Singha SP, Kazi AS, Isaac U, Shaikh TA, Devrajani T, Shah SZA, Raza S, Bhatti U, Nayab T, Syed N, Waryah YM, Zaidi U, Shahid S, Fatima N, Ahmed S, Safaida G. Proceedings of the 1st Liaquat University of Medical & Health Sciences (LUMHS) International Medical Research Conference. Eur J Med Res 2017. [PMCID: PMC5808744 DOI: 10.1186/s40001-017-0296-3] [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: 11/10/2022] Open
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Hakeem R, Fawwad A, Shaheen F, Waris N, Nawab S, Shahid S, Basit A. Fat Mass and Obesity Associated Gene (FTO) and Differences in Food Intake and Diet-Disease Relationships. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zaidi U, Shahid S, Fatima N, Ahmed S, Sufaida G, Nadeem M, Shamsi T. Genomic profile of a patient with triple negative essential thrombocythemia, unresponsive to therapy: A case report and literature review. J Adv Res 2017; 8:375-378. [PMID: 28560052 PMCID: PMC5435578 DOI: 10.1016/j.jare.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/12/2017] [Accepted: 04/14/2017] [Indexed: 11/15/2022] Open
Abstract
Clonal analysis of patients with triple negative myeloproliferative neoplasm (MPN) has provided evidence of additional aberrations, including epigenetic alterations. To discover such novel genetic aberrations, patients were screened through next-generation sequencing using a myeloid sequencing panel of 54 genes using a genetic analyser. Genetic variants in 28 genes, including TET2, BCOR, BCR, and ABL1 were identified in a triple negative essential thrombocythemia (ET) patient. The individual role of some of these variants in disease pathogenesis has yet to be studied. Somatic mutations in the same genes have been reported with variable frequencies in myeloid malignancies. However, no pathogenic impact of these variants could be found; therefore, long-term follow up of patients with genetic analysis of a large cohort and the use of whole genome sequencing is required to assess the effects of these variants.
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Affiliation(s)
- Uzma Zaidi
- Department of Clinical Haematology, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
| | - Saba Shahid
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
- Corresponding author.
| | - Naveen Fatima
- Department of Research & Molecular Medicine, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
| | - Shariq Ahmed
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
| | - Gul Sufaida
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
| | - Muhammad Nadeem
- Department of Genomics, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
| | - Tahir Shamsi
- Department of Clinical Haematology, National Institute of Blood Diseases and Bone Marrow Transplantation, P.O. Box 75300, Pakistan
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Shahid S, Nadeem M, Zahid D, Hassan J, Ansari S, Shamsi T. Alpha thalassemia deletions found in suspected cases of beta thalassemia major in Pakistani population. Pak J Med Sci 2017; 33:411-416. [PMID: 28523047 PMCID: PMC5432714 DOI: 10.12669/pjms.332.11834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND & OBJECTIVE Alpha (α) thalassemia is a hereditary disorder and is caused by deletions or mutations in globin genes. It is present in two clinically significant forms: hemoglobin Bart hydrops fetalis (Hb Bart) syndrome and hemoglobin H (HbH) disease. It is highly prevalent in South-East Asia or Mediterranean countries. The most common deletion reported in alpha thalassemia in Pakistani population was -α3.7 with a frequency of 8.3%, and the rare forms were -α4.2 (0.2%) and αααanti3.7 (0.9%). In our study, diagnosis of severe anemia cases without any α and β mutations or deletions were made by using extended alpha thalassemia deletions panel. The main objective of this study was to determine the prevalence and to study the spectra of alpha thalassemia gene deletions in beta thalassemia patients with the use of an extended panel including --SEA, --FIL, --MED, --20.5, --THAI in addition to -α3.7, -α4.2 & -αααanti3.7. METHODS The samples were collected in ethylenediaminetetraacetic acid (EDTA) vacutainers. A total of 156 samples were analyzed for alpha thalassemia mutations. This cohort included 121 samples of beta thalassemia major, nine samples of beta thalassemia minor and 26 without any evidence of beta thalassemia mutations. DNA was extracted with Qiagen extraction kit. The primers for determination of different subsets of alpha thalassemia deletions were included. PCR amplification was performed and result interpreted on agarose gel. RESULTS Co-inheritance of alpha thalassemia (-α3.7, -α4.2) with homozygous beta thalassemia was detected in 30% cases of studied cohort (37 out of 121). The most common found was -α3.7 deletion (35/37) as single/double deletions or in combination with -αααanti3.7. In undiagnosed cases screened for beta thalassemia major, we found Mediterranean (-αMED) deletion at specifically 875 bp on agarose gel. This is distinctive finding in case of detecting -αMED instead of any other deletion from Pakistan. CONCLUSION Alpha thalassemia deletions (-α3.7, -α4.2) are the common co-inherited deletions found in beta thalassemia major patients. On the basis of results, we propose an extended alpha thalassemia genetic mutation panel should be used for screening of children presenting with anemia with suspicion of haemoglobinopathy.
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Affiliation(s)
- Saba Shahid
- Saba Shahid, PhD. Department of Genomics, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
| | - Muhammad Nadeem
- Muhammad Nadeem, FCPS (Haem). Department of Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
| | - Danish Zahid
- Danish Zahid, M.Sc Genetics, Department of Genomics, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
| | - Jawad Hassan
- Jawad Hassan, FCPS (Haem). Department of Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
| | - Saqib Ansari
- Saqib Ansari, PhD. Department of Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
| | - Tahir Shamsi
- Tahir Shamsi, FRC Path. Department of Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
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Rosenblatt E, Jones G, El-Mongy M, Mahmood H, Marinello J, Elzawawy A, Shahid S, Filali-Benaceur D, Yarney J, Moscol Ledesma J, Bese N, Campbell O. OC-0189: Irradiation of the supraclavicular nodal region in postmastectomy radiotherapy; an IAEA randomized trial. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40187-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Obaid HA, Shahid S, Basim KN, Chelliapan S. Modeling of wastewater quality in an urban area during festival and rainy days. Water Sci Technol 2015; 72:1029-1042. [PMID: 26360765 DOI: 10.2166/wst.2015.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Water pollution during festival periods is a major problem in all festival cities across the world. Reliable prediction of water pollution is essential in festival cities for sewer and wastewater management in order to ensure public health and a clean environment. This article aims to model the biological oxygen demand (BOD(5)), and total suspended solids (TSS) parameters in wastewater in the sewer networks of Karbala city center during festival and rainy days using structural equation modeling and multiple linear regression analysis methods. For this purpose, 34 years (1980-2014) of rainfall, temperature and sewer flow data during festival periods in the study area were collected, processed, and employed. The results show that the TSS concentration increases by 26-46 mg/l while BOD(5) concentration rises by 9-19 mg/l for an increase of rainfall by 1 mm during festival periods. It was also found that BOD(5) concentration rises by 4-17 mg/l for each increase of 10,000 population.
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Affiliation(s)
- H A Obaid
- Department of Hydraulics and Hydrology, Faculty of Civil Engineering, Universiti Teknologi Malaysia, 81310 Skudai, Johor Bahru, Malaysia E-mail:
| | - S Shahid
- Department of Hydraulics and Hydrology, Faculty of Civil Engineering, Universiti Teknologi Malaysia, 81310 Skudai, Johor Bahru, Malaysia E-mail:
| | - K N Basim
- Department of Civil Engineering, Karbala University, Karbala, Iraq
| | - S Chelliapan
- Razak School of Engineering and Advance Technology, Universiti Teknologi Malaysia, Kuala Lumpur, Malaysia
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Shahid S, Sunitha Viswanathan K, George Koshy A, Gupta P, Sivaprasad K. Prognostic value of myocardial performance index assessed by tissue Doppler imaging in acute STEMI patients undergoing reperfusion therapy. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Khaliq S, Ajaz S, Firasat S, Shahid S, Hasan AS, Sultan G, Mohsin R, Hashmi A, Mubarak M, Naqvi SAA, Rizvi SAUH, Mehdi SQ, Abid A. Unique molecular alteration patterns in von Hippel-Lindau (VHL) gene in a cohort of sporadic renal cell carcinoma patients from Pakistan. Mutat Res 2014; 763-764:45-52. [PMID: 24727139 DOI: 10.1016/j.mrfmmm.2014.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/05/2014] [Accepted: 03/26/2014] [Indexed: 01/10/2023]
Affiliation(s)
- Shagufta Khaliq
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan; Department of Human Genetics, University of Health Sciences (UHS), Lahore, Pakistan
| | - Sadia Ajaz
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Sadaf Firasat
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Saba Shahid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Asad Shahzad Hasan
- Department of Oncology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Gauhar Sultan
- Department of Oncology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Rehan Mohsin
- Department of Oncology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Altaf Hashmi
- Department of Oncology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Muhammed Mubarak
- Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Syed Ali Anwar Naqvi
- Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | | | - Syed Qasim Mehdi
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
| | - Aiysha Abid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
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Ashiq U, Jamal R, Mesaik M, Mahroof-Tahir M, Shahid S, Khan K. Synthesis, Immunomodulation and Cytotoxic Effects of Vanadium (IV) Complexes. Med Chem 2014; 10:287-99. [DOI: 10.2174/15734064113099990033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 11/22/2022]
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Shahid S, Hassan U, Billington RW, Hill RG, Anderson P. Glass ionomer cements: effect of strontium substitution on esthetics, radiopacity and fluoride release. Dent Mater 2014; 30:308-13. [PMID: 24418629 DOI: 10.1016/j.dental.2013.12.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 03/25/2013] [Revised: 10/18/2013] [Accepted: 12/04/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE SrO and SrF2 are widely used to replace CaO and CaF2 in ionomer glasses to produce radiopaque glass ionomer cements (GIC). The purpose of this study was to evaluate the effects of this substitution on release of ions from GIC as well as its effect on esthetics (translucency) and radiopacity. MATERIALS AND METHODS Cements were produced from ionomer glasses with varying content of Sr, Ca and F. The cements were stored in dilute acetic acid (pH 4.0) for up to 7 days at 37°C. Thereafter, the cements were removed and the solution was tested for F(-), Sr(2+), Ca(2+), and Al(3+) release. Radiopacity and translucency were measured according to BS EN ISO 9917-1:2003. RESULTS Ion release was linear to t(1/2) suggesting that this is a diffusion controlled mechanism rather than dissolution. The fluoride release from the cements is enhanced where some or all calcium is replaced by strontium. Radiopacity shows a strong linear correlation with Sr content. All cements were more opaque than the C0.70 0.55 standard but less opaque than the C0.70 0.90 standard which is the limit for the ISO requirement for acceptance. SIGNIFICANCE This study shows that the replacement of calcium by strontium in a glass ionomer glass produces the expected increase in radiopacity of the cement without adverse effects on visual properties of the cement. The fluoride release from the cements is enhanced where some or all calcium is replaced by strontium.
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Affiliation(s)
- S Shahid
- Dental Physical Sciences Unit, Institute of Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK.
| | - U Hassan
- Dental Physical Sciences Unit, Institute of Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - R W Billington
- Dental Physical Sciences Unit, Institute of Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - R G Hill
- Dental Physical Sciences Unit, Institute of Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - P Anderson
- Dental Physical Sciences Unit, Institute of Dentistry, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
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Gomathi K, Shaafie IA, Mummigatti K, Shahid S, Sreedharan J. Biochemical Parameters in Women with Polycystic Ovary Syndrome in Ajman, UAE. Nepal j obstet gynaecol 2012. [DOI: 10.3126/njog.v6i2.6748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5 -10% of women and is a major cause of anovulatory infertility. Prevalence varies among population based on genetic and environmental factors. Etiology of PCOS remains unknown but hyperandrogenism and insulin resistance have both been associated with PCOS. The aim of this study was to measure levels of Homocysteine and other biochemical parameters in women diagnosed with PCOS attending Gulf Medical College Hospital & Research Centre (GMCHRC), Ajman, UAE. Methods: Young women, aged between 18 and 35 years of age, diagnosed with PCOS (N =37), not on any treatment, attending GMCHRC were included in the study. Biochemical parameters were measured using standard procedures. Laboratory normal reference ranges were used for comparison. Results: 54 % of the women with PCOS were overweight or obese according to the Body mass index (BMI) and 51% had a waist circumference >88cm. Fasting and postprandial Glucose and Insulin levels and HOMA-IR were within the normal reference range indicating that no Insulin resistance was seen in these women. 40% of the women had a serum total Cholesterol level above 200 mg/dL, while Low Density Lipoprotein (LDL) Cholesterol was above and High Density Lipoprotein (HDL) cholesterol was lower than the desirable value. Serum Triacylglycerol was within the normal reference range. Serum Testosterone, Estradiol, Prolactin Thyroid Stimulating Hormone (TSH) and Plasma Homocysteine level were found to be within the normal reference ranges. Homocysteine levels correlated with Testosterone, total Cholesterol and LDL cholesterol levels. Conclusions: BMI was high in 54% of the women. No Insulin resistance was seen in these patients. Hormone levels and Homocysteine were within normal reference ranges. Dyslipidermia was observed. These findings differ from reports in literature where Insulin resistance, Hyperandrogenism and high Homocysteine levels have been associated with PCOS. NJOG 2011 Nov-Dec; 6 (2): 7-10 DOI: http://dx.doi.org/10.3126/njog.v6i2.6748
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Shahid S, Abid A, Mehdi SQ, Firasat S, Lanewala A, Naqvi SAA, Rizvi SAUH, Khaliq S. Erratum to “Association of the ACE-II genotype with the risk of nephrotic syndrome in Pakistani children” [Gene 493 (2012) 165–168]. Gene X 2012. [DOI: 10.1016/j.gene.2012.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kim S, Shahid S, Kim S, Park J, Lee H, Jung K, Chai Y. Comparative analysis of virulence factors secreted by Bacillus anthracis Sterne at host body temperature. Lett Appl Microbiol 2012; 54:306-12. [DOI: 10.1111/j.1472-765x.2012.03209.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Shah SH, Abid A, Shahid S, Khaliq S. Identification of LIPH gene mutation in a consanguineous family segregating the woolly hair/hypotrichosis phenotype. J PAK MED ASSOC 2011; 61:1060-1064. [PMID: 22125978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To identify the disease causing gene in a four generation consanguineous family in which eleven family members were suffering from Woolly hair/hypotrichosis phenotype. METHODS Linkage analysis was carried out to identify the disease-causing gene in this family. Genomic DNA of all the available family members was genotyped for the microsatellite markers for all the known woolly hair/hypotrichosis loci.Automated DNA sequencing of the candidate gene was performed to identify the disease-causing mutation. RESULTS By using homozygosity linkage analysis we have mapped the family on chromosome 3q27.3 with a two point LOD score of 4.04, Mutation screening of the LIPH gene revealed a homozygous c.659_660delTA deletion mutation segregating with the disease phenotype. CONCLUSION The results indicate that the c.659_660delTA mutation in the LIPH gene cause autosomal recessive WH/hypotrichosis phenotype in this family. This mutation has been reported in several Pakistani and Guyanese families suggesting a founder mutation in the LIPH gene in Indo-Pak sub-continent.
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Affiliation(s)
- Sayed Hajan Shah
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
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Shahid S, Billington RW, Hill RG. The effect of ultrasound on the uptake of fluoride by glass ionomer cements. J Mater Sci Mater Med 2011; 22:247-251. [PMID: 21221738 DOI: 10.1007/s10856-010-4209-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 12/08/2010] [Indexed: 05/30/2023]
Abstract
Ultrasound has been shown to improve the set of glass ionomer cements (GICs) and also other cement properties. In particular, the release of fluoride is enhanced. These cements also can take up fluoride ion from liquids. The aim of this study is to investigate the effect of ultrasound on this cement property. Two commercial dental restorative GICs were used together with a modified commercial material and an experimental material based on a F-free glass. All three commercial materials came in capsules which were mixed as makers directed, the experimental material was mixed as in previous papers. Mixed cement was placed polyethylene moulds to create 3 × 2 mm thick discs. These were either allowed to standard set for 6 min or set with ultrasound for 55 s. 18 samples were made for each material/set. Three samples were placed in 4 ml of 0.2% NaF solution for 24 h at 37°C. The cylinders were removed and the F concentration of the solutions measured by ISE using TISAB decomplexant. F uptake was determined by difference from the original NaF concentration. The two conventional GICs showed reductions of 17.4 and 8.5% for ultrasound compared to standard set whereas the modified material increased by 32.3% and the experimental one by 20.6%. It is suggested that the effect of ultrasound may increase the surface area of the residual glass particles in the GIC which would increase F uptake. In GICs where considerable F ion is released into the cement matrix by the enhanced reaction caused by ultrasound this may be sufficient to reverse the former effect producing the reduced uptake observed.
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Affiliation(s)
- S Shahid
- Department of Dental Physical Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End, London, E1 4NS, UK.
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Shahid S, Billington RW, Hill RG, Pearson GJ. The effect of ultrasound on the setting reaction of zinc polycarboxylate cements. J Mater Sci Mater Med 2010; 21:2901-2905. [PMID: 20717709 DOI: 10.1007/s10856-010-4146-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 08/03/2010] [Indexed: 05/29/2023]
Abstract
The set of glass ionomer cement (GIC) is accelerated by application of ultrasound. Although GIC has somewhat displaced zinc polycarboxylate cement (ZPC) in dental applications the latter is still extensively used. Like GIC, it provides direct adhesion to tooth and can provide F release, but is more radiopaque and biocompatible than GIC. The aim of this study is to examine the effect of ultrasound on the setting of ZPC using Fourier transform infra red spectroscopy and any interaction with SnF(2) addition. ZPC with and without SnF(2) addition (+/-S) at luting (L) 2:1 P/L ratio and restorative (R) 4:1 P/L ratio consistencies. Ultrasound is applied to the cement using Piezon-Master 400, EMS, Switzerland at 60 s from start of mixing for 15 s. The ratios of absorbance peak height at 1,400 cm(-1) -COO(-) to that at 1,630 cm(-1) -COOH were measured and compared those obtained for the cement not treated with US. These values were taken at the elapsed time at which no further change in spectrum [ratio] was observed at room temperature [10-20 min]. The US results are taken at 2 or 3 min. No US: R/+S (1.09), R/-S (1.2), L/+S (1.07), L/-S (1.04); US: R/+S (1.50), R/-S (1.64), L/+S (1.38), L/-S (1.05). The results show all four ZPC formulations are very sensitive to ultrasound whether with or without SnF(2). Reducing US to 10 s produces lower initial ratios but these increase up to 10 min when very high ratios (>2) are obtained. Previous studies with restorative GICs found that 40-55 s US was needed to produce the effect found with 15 s on ZPCs. ZPC powder is more basic than GIC glass; this may account for ZPC's greater sensitivity to US. Ultrasound may provide a useful adjunct to the clinical use of ZPC both as luting agent and temporary restorative.
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Affiliation(s)
- S Shahid
- Department of Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Francis Bancroft Building, Mile End, London E1 4NS, UK.
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Thanjal NK, Billington RW, Shahid S, Luo J, Hill RG, Pearson GJ. Kinetics of fluoride ion release from dental restorative glass ionomer cements: the influence of ultrasound, radiant heat and glass composition. J Mater Sci Mater Med 2010; 21:589-595. [PMID: 19851843 DOI: 10.1007/s10856-009-3901-3] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 10/05/2009] [Indexed: 05/28/2023]
Abstract
To compare the effect of ultrasonic setting with self curing on fluoride release from conventional and experimental dental glass ionomer cements. To compare hand mixed and capsule mixing and the effect of replacing some of the reactive glass with zirconia. In a novel material which advocated using radiant heat to cure it, to compare the effect of this with ultrasound. To evaluate the effect of ultrasound on a glass ionomer with fluoride in the water but not in the glass. 10 samples of each cement were ultrasonically set for 55 s; 10 controls self cured for 6 min. Each was placed in 10 ml of deionised water which was changed at 1, 3, 7, 14, 21, 28 days. The solution fluoride content was measured using a selective ion electrode. All ultrasound samples released more fluoride than the controls. Release patterns were similar; after a few days, cumulative fluoride was linear with respect to t(1/2). Slope and intercept of linear regression plots increased with ultrasound. With radiant heat the cement released less fluoride than controls. The effect of ultrasound on cement with F in water increased only slope not intercept. Zirconia addition enhances fluoride release although the cement fluorine content is reduced. Comparison of capsule and hand mixing showed no consistent effect on fluoride release. Ultrasound enhances fluoride release from GICs. As heat has an opposite effect the heat from ultrasound is not its only action. The lesser effect on cement with fluoride only in the water indicates that of ultrasound enhances fluoride release from glass.
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Affiliation(s)
- N K Thanjal
- Department of Dental Physical Sciences, Barts and London School of Medicine and Dentistry, Francis Bancroft Building, Queen Mary University of London, Mile End, London, E1 4NS, UK
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Ponnuswamy A, Shahid S, Govin B, Hatton K, Ledson M, Walshaw M. Increased allergic bronchopulmonary aspergillosis (ABPA) in CF – a result of global warming? J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60226-5] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
14153 Background: Thymidine phosphorylase (TP) activity is found at higher levels in gall bladder cancer (GBC) tissues than in adjacent healthy tissues. GBC is relatively sensitive to 5-FU. TP activated capecitabine (CAP) mimics the continuous infusion of 5-FU. In view of drug potentiality this present study was initiated. Our aim was to evaluate the therapeutic efficacy and safety of CAP in previously untreated GBC patients (Pts). Methods: It was an open-labelled, single-centred, non-randomised and prospective study. Outcome measures were response rate and type of response for efficacy measurement and safety was measured by adverse events & laboratory blood values (LBV). All LBV were within reference range at baseline. The patients had no prior chemo/ radio therapy or a family history of malignancy; adenocarcinoma (stage III–IV); age 40–70 yrs; male/female: 16/ 30; KPS ≥ 70%. 46 pts were treated with 306 cycles (min 3–max 12) of CAP at a dose of 2500 mg/day in two divided doses from day 1–14 followed by 1-week rest. Results: Median age was 50 yrs. Hand foot syndrome occurred in 17.39% pts, diarrhoea (grade 3 & 4) 21.75% and both 15.21%, all toxicities were manageable. Mean LBV before and after CAP therapy were hemoglobin: 11.38–0.35 g/dl (95% CI, 10.66–2.10); total count of WBC: 9,260–580/mm3 (95% CI, 8,680–9,840); platelet count: 251,000–2,000/mm3 (95% CI, 227,000–275,000) and serum bilirubin: 1.17–0.33 mg/dl (95% CI, 0.5–1.84). The LBV between baseline and after CAP therapy were not statistically significant. Partial response was found in 12 pts (26.08%), stable disease in 26 pts (56.21%), and progressive disease in 8 pts (17.39%). Mean KPS value after therapy was 76% (95% CI, 69–84). Conclusion: This clinical experience indicates that CAP is a convenient choice in phase II chemo naïve GBC pts not adversely affecting haematological values. No significant financial relationships to disclose.
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Affiliation(s)
- Q. Chowdhury
- National Institute of Cancer Research, Dhaka, Bangladesh; Ahsania Mission Cancer Hospital, Dhaka, Bangladesh; Central Hospital, Dhaka, Bangladesh
| | - S. Reza
- National Institute of Cancer Research, Dhaka, Bangladesh; Ahsania Mission Cancer Hospital, Dhaka, Bangladesh; Central Hospital, Dhaka, Bangladesh
| | - M. Hai
- National Institute of Cancer Research, Dhaka, Bangladesh; Ahsania Mission Cancer Hospital, Dhaka, Bangladesh; Central Hospital, Dhaka, Bangladesh
| | - S. Shahid
- National Institute of Cancer Research, Dhaka, Bangladesh; Ahsania Mission Cancer Hospital, Dhaka, Bangladesh; Central Hospital, Dhaka, Bangladesh
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