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Airody A, Baseler HA, Seymour J, Allgar V, Mukherjee R, Downey L, Dhar-Munshi S, Mahmood S, Balaskas K, Empeslidis T, Hanson RLW, Dorey T, Szczerbicki T, Sivaprasad S, Gale RP. Treatment of age-related macular degeneration with aflibercept using a treat, extend and fixed protocol; A 4-year study of treatment outcomes, durability, safety and quality of life (An extension to the MATE randomised controlled trial). Acta Ophthalmol 2024; 102:e328-e338. [PMID: 37776074 DOI: 10.1111/aos.15774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 07/05/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Data are limited pertaining to the long-term benefits of aflibercept treatment for neovascular age-related macular degeneration (nAMD). The aim of this study was to provide outcomes, safety, durability and quality-of-life data with aflibercept using a modified treat, extend and fixed regime over 4 years. METHODS Prospective, multicentre, single cohort observational study of treatment-naïve nAMD participants treated with aflibercept as 2-year extension of the MATE-trial that compared early and late Treat-and-Extend for 2 years. Refracted ETDRS best corrected visual acuity (BCVA), central retinal thickness (CRT), treatment interval and adverse events were assessed. Quality-of-life was measured using the Macular Disease Dependent Quality of Life (MacDQoL) and Macular Disease Treatment Satisfaction Questionnaires (MacTSQ). RESULTS Twenty-six of 40 participants completing the MATE-trial were enrolled with 20 completing the total 4-year study. Mean BCVA was 60.7 at Month 0 and 64.8 ETDRS letters at Month 48 while CRT decreased from 423.7 μm to 292.2 μm. Five participants discontinued treatment due to inactivity. The mean number of treatments and visits for the remaining participants was 27 and 30.0, respectively, with treatment intervals extended to 12 weeks in four participants at Month 48. Both AMD-specific QoL and treatment satisfaction remained stable between Months 0 and 48 and mean BCVA significantly correlated with AMD-specific QoL scores at Months 12, 24 and 48. CONCLUSIONS Results suggest that BCVA can be maintained over 48 months when following a treat-extend-and-fix regimen of aflibercept with intervals out to 12 weeks, while maintaining AMD-specific QoL and treatment satisfaction.
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Affiliation(s)
- Archana Airody
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
| | - Heidi A Baseler
- Hull York Medical School, University of York, York, UK
- Department of Psychology, University of York, York, UK
| | - Julie Seymour
- Hull York Medical School, University of Hull, Hull, UK
| | - Victoria Allgar
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | | | | | - Sushma Dhar-Munshi
- Kings Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | | | - Konstantinos Balaskas
- University of Manchester, Manchester, UK
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theo Empeslidis
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachel L W Hanson
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
| | - Tracey Dorey
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tom Szczerbicki
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Richard P Gale
- Academic Unit of Ophthalmology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
- Hull York Medical School, University of York, York, UK
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Mahmood S, Momin P. Call to dental colleagues. Br Dent J 2024; 236:12. [PMID: 38225293 DOI: 10.1038/s41415-024-6726-z] [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] [Received: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 01/17/2024]
Affiliation(s)
- S Mahmood
- Specialty Registrar in Oral Surgery, Sheffield, UK.
| | - P Momin
- General Dental Practitioner, Manchester, UK.
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Weidhaas JB, Harris J, Gillison M, Blakaj DM, Krempl GA, Higgins KA, Phan J, Dunlap NE, Mahmood S, Dorth JA, Caudell JJ, Desai AB, Galloway TJ, Pennington JDD, Zhou Z, Lathrop J, Torres-Saavedra P, Hayes DN, Yom SS, Le QT. The KRAS-Variant and Cetuximab in HPV-Positive Oropharyngeal Cancer in NRG/RTOG 1016. Int J Radiat Oncol Biol Phys 2023; 117:S151. [PMID: 37784383 DOI: 10.1016/j.ijrobp.2023.06.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) NRG/RTOG 1016 was a non-inferiority phase III trial comparing radiation with cisplatin versus cetuximab monotherapy for patients with HPV-positive oropharyngeal squamous cell carcinoma (SCC). The trial did not meet the non-inferiority criteria for overall survival (OS) and had significantly worse progression-free survival (PFS) and locoregional failure (LRF) in patients treated with cetuximab. Based on prior evidence that HNSCC patients with a germ-line mutation in KRAS (the KRAS-variant) had a positive response to radiation with cisplatin plus cetuximab without increased toxicity, samples from RTOG 1016 were used to test the protocol-specified hypothesis that KRAS-variant patients will have better outcomes when receiving IMRT + cetuximab monotherapy compared to IMRT + cisplatin. MATERIALS/METHODS The KRAS-variant was tested in 562 samples at MiraDx, a CLIA-certified laboratory. OS, PFS, LRF, and distant metastases (DM) were as defined per the RTOG 1016 protocol, and hazard ratios (HRs) were estimated by (cause-specific) Cox models. Negative binomial regression was used to model the number of treatment-related acute and late (≤ and > 180 days from end of treatment, respectively) grade 3-5 adverse events. To assess the predictive role of the KRAS-variant, all models included KRAS, assigned treatment, and their interaction, with the interaction tested at two-sided 0.05. HRs and toxicity ratios are expressed as IMRT + cetuximab / IMRT + cisplatin. RESULTS The prevalence of the KRAS-variant was 16% with similar patient and tumor characteristics and well-balanced treatment arms for variant and non-variant patients. Median follow-up was 8.6 years. There was no significant interaction between KRAS and treatment for OS (p = 0.99), PFS (p = 0.56), LRF (p = 0.09), or DM (p = 0.19) (Table 1). In KRAS-variant patients the mean acute and late toxicity ratios were 0.53 (95% CI 0.36, 0.80) and 1.62 (95% CI 0.57, 4.62). In non-variant patients, the mean acute and late toxicity ratios were 0.80 (95% CI 0.67, 0.95) and 0.55 (95% CI 0.35, 0.87), respectively. The interaction of KRAS and treatment was not significant for acute (p = 0.07) or late toxicity (p = 0.07). CONCLUSION While this study does not directly refute prior evidence that KRAS-variant patients benefit from radiation + cisplatin and cetuximab, this study does not support the hypothesis that the KRAS-variant is a predictive biomarker of improved outcome in HPV+ oropharyngeal SCC patients treated with IMRT + cetuximab alone, and suggests that for KRAS-variant patients, potential benefits in LRF and acute toxicity with cetuximab may be offset by worse DM and worse late toxicity.
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Affiliation(s)
- J B Weidhaas
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - J Harris
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | | | - D M Blakaj
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - G A Krempl
- University of Oklahoma Health Sciences Center, OKLAHOMA CITY, OK
| | - K A Higgins
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - J Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N E Dunlap
- Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY
| | - S Mahmood
- Allan Blair Cancer Centre, Saskatchewan, SK, Canada
| | - J A Dorth
- Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH
| | | | | | - T J Galloway
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | | | - P Torres-Saavedra
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | | | - S S Yom
- University of California, San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Asher S, Shah R, Ings S, Horder J, Newrick F, Nesr G, Kesse Adu R, Streetly M, Trompeter S, Lee L, Wisniowski B, Mahmood S, Xu K, Papanikalaou X, McMillan A, Popat R, Yong K, Sive J, Kyriakou C, Rabin N. Haematopoietic stem cell mobilisation followed by high-dose chemotherapy and autologous stem cell transplantation for patients with sickle cell disease and myeloma. Br J Haematol 2023; 202:1224-1227. [PMID: 37488061 DOI: 10.1111/bjh.18990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/12/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Affiliation(s)
- S Asher
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Shah
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - S Ings
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - J Horder
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - F Newrick
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - G Nesr
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Kesse Adu
- Department of Haematology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - M Streetly
- Department of Haematology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - S Trompeter
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - L Lee
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - B Wisniowski
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - S Mahmood
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - K Xu
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - X Papanikalaou
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - A McMillan
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Popat
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - K Yong
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - J Sive
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - C Kyriakou
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - N Rabin
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
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Airody A, Baseler HA, Seymour J, Allgar V, Mukherjee R, Downey L, Dhar-Munshi S, Mahmood S, Balaskas K, Empeslidis T, Hanson RLW, Dorey T, Szczerbicki T, Sivaprasad S, Gale RP. The MATE trial: a multicentre, mixed-methodology, pilot, randomised controlled trial in neovascular age-related macular degeneration. Pilot Feasibility Stud 2023; 9:63. [PMID: 37081576 PMCID: PMC10116669 DOI: 10.1186/s40814-023-01288-0] [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: 07/15/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND/OBJECTIVES In healthcare research investigating complex interventions, gaps in understanding of processes can be filled by using qualitative methods alongside a quantitative approach. The aim of this mixed-methods pilot trial was to provide feasibility evidence comparing two treatment regimens for neovascular age-related macular degeneration (nAMD) to inform a future large-scale randomised controlled trial (RCT). SUBJECTS/METHODS Forty-four treatment-naïve nAMD patients were followed over 24 months and randomised to one of two treatment regimens: standard care (SC) or treat and extend (T&E). The primary objective evaluated feasibility of the MATE trial via evaluations of screening logs for recruitment rates, nonparticipation and screen fails, whilst qualitative in-depth interviews with key study staff evaluated the recruitment phase and running of the trial. The secondary objective assessed changes in visual acuity and central retinal thickness (CRT) between the two treatment arms. RESULTS The overall recruitment rate was 3.07 participants per month with a 40.8% non-participation rate, 18.51% screen-failure rate and 15% withdrawal/non-completion rate. Key themes in the recruitment phase included human factors, protocol-related issues, recruitment processes and challenges. Both treatment regimens showed a trend towards a visual acuity gain at month 12 which was not maintained at month 24, whilst CRT reduced similarly in both regimens over the same time period. These were achieved with one less treatment following a T&E regimen. CONCLUSION This mixed-methodology, pilot RCT achieved its pre-defined recruitment, nonparticipation and screen failure rates, thus deeming it a success. With some minor protocol amendments, progression to a large-scale RCT will be achievable.
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Affiliation(s)
- Archana Airody
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK.
| | - Heidi A Baseler
- Department of Psychology, University of York, York, UK
- Hull York Medical School, University of York, York, UK
| | - Julie Seymour
- Hull York Medical School, University of Hull, Hull, UK
| | - Victoria Allgar
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | | | | | - Sushma Dhar-Munshi
- Kings Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | | | - Konstantinos Balaskas
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theo Empeslidis
- Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachel L W Hanson
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK
| | - Tracey Dorey
- Research and Development, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Tom Szczerbicki
- Research and Development, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Richard P Gale
- Academic Unit of Ophthalmology, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, YO31 8HE, UK
- Hull York Medical School, University of York, York, UK
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Fisher L, Ahmed O, Chalchal H, Deobald R, El-Gayed A, Graham P, Groot G, Haider K, Iqbal N, Johnson K, Le D, Mahmood S, Manna M, Meiers P, Pauls M, Salim M, Sami A, Wright P, Younis M, Ahmed S. P058 Outcomes of Rural Men With Breast Cancer: A Multicenter Population Based Retrospective Cohort Study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Berner A, Howlett S, Baderinwa-Ahmed R, Nkechinyere David G, Mahmood S, Hall M, Khalique S. 48P Response to chemotherapy following PARP inhibition in ovarian cancer (OC) patients at Mount Vernon Cancer Centre. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100828] [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: 02/27/2023] Open
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Kumari V, Antonova E, Mahmood S, Shukla M, Saifullah A, Pandey R. Dispositional mindfulness, alexithymia and sensory processing: Emerging insights from habituation of the acoustic startle reflex response. Int J Psychophysiol 2023; 184:20-27. [PMID: 36513183 DOI: 10.1016/j.ijpsycho.2022.12.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/30/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
There is growing evidence of beneficial effects of mindfulness developed through engaging in mindfulness training/practices on sensory and cognitive processing, emotion regulation and mental health. Mindfulness has also been conceptualised as a dispositional 'trait', i.e. the naturally-occurring ability of meditation-naïve individuals to display, in varying degree, a non-judgmental non-reactive present-moment awareness in everyday life. In this study we examined possible associations between dispositional mindfulness, alexithymia and sensory processing. Eye-blink startle responses to acoustic stimuli of varying intensity [90-dB or 100-dB over 70-dB (A) background] were assessed in 26 meditation-naïve adults (50 % men) using electromyographic recordings of the orbicularis muscle. All participants completed the Five Facet Mindfulness Questionnaire and the 20-item Toronto Alexithymia Scale. A negative association was found between dispositional mindfulness and alexithymia (r = -0.513). There was stronger startle habituation to 100-dB, compared to 90-dB probes. Stronger startle habituation (larger negative habitation slope values) to 100-dB probes was significantly associated with higher dispositional mindfulness (r = -0.528) and with lower alexithymia at trend level (r = 0.333). As indicated by commonality analysis, 10.6 % of explained variance in habituation (100-dB probes) was common to both alexithymia and mindfulness, 17.3 % was unique to mindfulness, but alexithymia made negligible unique contribution (0.5 %). These findings indicate similar startle habituation pattern in people with a high level of dispositional mindfulness to that reported previously by Antonova et al. (2015) in people with moderate mindfulness meditation practice intensity. Future studies should investigate the mechanisms, such as interoceptive awareness, that might underly these relationships.
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Affiliation(s)
- V Kumari
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK.
| | - E Antonova
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - S Mahmood
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - M Shukla
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, India
| | - A Saifullah
- Divison of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, UK
| | - R Pandey
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, India
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Yousuf S, Mahmood S, Rahman R, Khatun R, Tanzin F, Arzoo S, Ferdous NE. Efficacy and Safety of Repeated Use of Ulipristal Acetate in Uterine Fibroids. Mymensingh Med J 2023; 32:168-176. [PMID: 36594317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Uterine fibroids are benign tumor of the uterus that often appear during child bearing ages. Medical treatments are considered the first-line treatment to preserve fertility, avoid or delaying surgery. This randomized control study was carried out in OPD of Obstetrics and Gynecology Department of BSMMU, Dhaka, Bangladesh from May 2018 to March 2019 to evaluate the efficacy and safety of ulipristal acetate (5mg) once daily in reproductive women with three months treatment courses. Total 52 samples with symptomatic uterine fibroids for treatment course-1, among them 36 were needed for treatment course-2 which was slow or non-responding in treatment course-1. Main outcome measures were amenorrhea, controlled bleeding, fibroid volume, anaemia, quality of life. Sixty one percent (61.0%) of patients were achieved amenorrheic during both treatment courses. Ninety percent (90.0%) patients were control of bleeding during both treatment courses. In treatment course-1, reductions from baseline in fibroid volume were 62.70%, whereas in course-2, reductions in fibroid volume were 75.33%. Five percent (5.0%) of patients were discontinuing Ulipristal acetate due to adverse effects. Renal and liver function tests were performed before and after each course of treatment. The level of creatinine, SGPT in the blood for both treatment courses had no statistically significant effects. Ulipristal acetate may be an alternative to surgical treatment, the safety profiles and prolong effects with improvement of symptoms, quality of life after cessation of drugs. Repeated use of drugs reduces the size and also improves the patient's condition.
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Affiliation(s)
- S Yousuf
- Dr Shereen Yousuf, Medical Officer, Department of Obstetrics and Gynaecology, BSMMU, Dhaka, Bangladesh; E-mail:
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Chandra S, McKibbin M, Mahmood S, Downey L, Barnes B, Sivaprasad S. The Royal College of Ophthalmologists Commissioning guidelines on age macular degeneration: executive summary. Eye (Lond) 2022; 36:2078-2083. [PMID: 35624304 PMCID: PMC9582190 DOI: 10.1038/s41433-022-02095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/16/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shruti Chandra
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | | | - Sajjad Mahmood
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | | | - Beth Barnes
- The Royal College of Ophthalmologists, London, UK
| | - Sobha Sivaprasad
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
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Rehman ZU, Raza A, Qayyum H, Ullah S, Mahmood S, Qayyum A. Characterization of laser-induced shock waves generated during infrared laser ablation of copper by the optical beam deflection method. Appl Opt 2022; 61:8606-8612. [PMID: 36255992 DOI: 10.1364/ao.472340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The shock waves generated during laser ablation of a copper target are investigated using the optical beam deflection method. The fluence of nanosecond pulsed infrared laser beam was in the range of 15-700J/cm2. The density jumps related with the influx of the shock wave at two interaction points were detected with the help of He-Ne laser probes. In general, a supersonic shock wave is produced, which propagates through air and gradually decays into an acoustic wave. Experiments were carried out to study the impact of laser fluence and propagation distance on the shock wave velocity and pressure. The shock wave velocity varies with laser fluence as v∝Fl0.3 and with propagation distance as v∝d-1.5. These results are compared with the predictions of the theoretical models. In the investigated fluence range, shock wave pressure rises by an order of magnitude (∼1-10MPa). We demonstrated that shock wave pressure and ablated mass can be related, yielding mass-specific shock wave pressure that increases linearly with laser fluence. We have also noticed the shock-wave-induced probe beam focusing under certain conditions, which indicates that the shock wave modifies the refractive index of the compressed layer of air. The reported results are useful for the fundamental understanding and pave the way for new applications of laser-induced shock waves.
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Bailey C, Cackett P, Kotagiri A, Mahmood S, Minos E, Narendran N, Patwardhan A, Sim DA, Morgan-Warren P, O'Neil C, Straw K. Practical implementation of a q4-q16 aflibercept treat-and-extend pathway for the treatment of neovascular age-related macular degeneration: Updated guidance from a UK expert panel. Eye (Lond) 2022:10.1038/s41433-022-02264-3. [PMID: 36207506 PMCID: PMC9542445 DOI: 10.1038/s41433-022-02264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This report, based on guidance from a panel of UK retina specialists, introduces a revised intravitreal aflibercept (IVT-AFL) treat-and-extend (T&E) pathway for the treatment of neovascular age-related macular degeneration (nAMD). The T&E pathway incorporates the updated IVT-AFL label (April 2021) allowing flexible treatment intervals of 4 weeks to 16 weeks, after three initiation doses and a further dose after 8 weeks. Practical guidance is provided on the clinical implementation of the revised pathway, with the aim of supporting clinical decision-making to benefit patients and addressing capacity issues in nAMD services. METHODS Three structured round-table meetings of UK retina specialists were held online on 19 May, 16 June and 13 October 2021. These meetings were organised and funded by Bayer. RESULTS The authors revised the previously published consensus pathway to reflect the changes to the IVT-AFL label and developed guidelines for the implementation of the pathway in UK clinical practice. The guidelines include topics such as recommendations for extending patients with 2- or 4-week adjustments, extending patients to 16-week treatment intervals, managing fellow eye involvement, and reducing treatment intervals for patients with particularly active disease. CONCLUSIONS The revised IVT-AFL T&E nAMD pathway offers guidance to clinicians seeking to increase the dosing flexibility of IVT-AFL, with 4- to 16-week treatment intervals, in line with the updated IVT-AFL label, to meet the continually evolving demands of nAMD service provision.
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Affiliation(s)
- Clare Bailey
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
| | - Peter Cackett
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Ajay Kotagiri
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | | | | | | | | | - Dawn A Sim
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Koyoda SK, Wahezi D, Kumthekar A, Xie X, Mahmood S, Tagoe C, Ayesha B. POS0840 MELANOMA DIFFERENTIATION-ASSOCIATED GENE 5 ANTIBODY (ANTI-MDA5) DERMATOMYOSITIS: CLINICAL FEATURES AND OUTCOME IN A RACIALLY DIVERSE PATIENT COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMelanoma differentiation associated gene 5 antibody (anti-MDA5) dermatomyositis, is an idiopathic inflammatory musculoskeletal disorder with specific phenotypic manifestations of rapidly progressing interstitial lung disease (RP-ILD) and ulcerative skin lesions, with or without muscle involvement. [1] There is currently a lack of consensus and guidelines on early diagnosis and timely escalation of therapy to avoid untoward outcomes.ObjectivesTo identify distinguishing clinical and laboratory features to assess disease progression amongst individuals with anti- MDA5 dermatomyositis based on the serologic, histopathologic, and radiographic status. We identified and compared the disease phenotype in a racially diverse juvenile and adult population with anti-MDA5 dermatomyositis.MethodsAfter Institutional review board approval, we queried the electronic health record at the Montefiore Medical Center, NY, and identified a total of 194 dermatomyositis patients. We included 21 dermatomyositis patients with MDA5 antibody. We performed a retrospective chart review to extract clinical data and analyzed data using Fischer’s exact test.ResultsOf the 21 dermatomyositis patients with anti-MDA5, 12 adult patients represented 8% of all adult dermatomyositis cases (12/148) and 9 patients represented 19 % of the pediatric dermatomyositis cases (9/46). There was a 2:1 female to male predominance in both groups.In adults, the mean age of disease onset was 45.2 years (SD 14.4 years). Nine ILD cases were noted, of which 2 were RP-ILD. The presence of the Ro52 antibody was associated with rapid disease progression. In children, the mean age of onset was 6.6 years (SD 4.9 years). All children had muscle weakness, with only 5 having ILD. Myositis was noted to be more prevalent in the pediatric population, compared to adults (9/9 Vs 4/12 cases; P=0.005).In this patient cohort, ILD was statistically significant between the African American population (9/10 cases) and non-African American population (5/11 cases), p=0.03, of these 3 African American cases had RP-ILD with mortality. The combined mortality rate of 14.2% was superior to 40-60% reported in the literature. [2]ConclusionAnti MDA5 dermatomyositis is relatively rare and difficult to diagnose. In this study, the general disease characteristics of our cohort were similar in both adult and pediatric patients except for myositis, which was more common in the pediatric population. The incidence of ILD by contrast was higher in the adults, especially in the African American population who had worse outcomes. The rapid escalation of therapy and use of rituximab may have improved our outcomes over historic controls. Controlled studies are needed to evaluate patients with anti-MDA5 dermatomyositis for appropriate treatment interventions and to avoid untoward outcomes.References[1]Fiorentino D, et al. The mucocutaneous and systemic phenotype of dermatomyositis patients with antibodies to MDA5; J Am Acad Dermatol. 2011;65(1):25-34. doi:10.101[2]Koga T, et al. The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology. 2012;51(7):1278-1284. doi:10.1093Figure 1.Disclosure of InterestsNone declared
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Mahmood S, Drakeley A, Homburg R, Bambang K. Fertility Preservation in Female Patients with Cancer. Clin Oncol (R Coll Radiol) 2022; 34:508-513. [PMID: 35491364 DOI: 10.1016/j.clon.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022]
Abstract
Advances in cancer treatment with resultant dramatic improvements in long-term survival have led to increasing awareness of the wide range of medical and social issues faced by survivors of malignancy. The potential deleterious effects on fertility are a significant worry of women and trans gender men, and the rising trend in delaying childbearing and the higher proportion of patients who have not completed their family at the time of diagnosis increases the demand for an optimised fertility-preservation service. Fertility preservation for this group following a diagnosis of cancer is a rapidly expanding area of reproductive medicine, although provision for such treatment often varies by region. In the past, there were few treatment options, but with dramatic improvements in oocyte cryopreservation and, more recently, ovarian tissue cryopreservation, this area of fertility care has broadened substantially. This review will be exploring areas that apply to all cisgender women, but not necessarily all trans men and non-binary individuals. There are specific considerations in fertility preservation for trans people, which are beyond the scope of this paper. All individuals with female reproductive organs should be offered the opportunity to discuss fertility preservation prior to starting potential gonadotoxic treatment. Failure to do this may negatively influence their anticancer treatment choices and adherence to treatment regimens. There are currently few networks streamlined around offering this service and as demand for these treatment options increases, it is recognised that these complex patients require specialist management within recognised care pathways. Here we are looking to describe some of the unique challenges associated with providing a state-of-the-art service, particularly in a financially unpredictable climate in the midst of the COVID-19 pandemic.
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Affiliation(s)
- S Mahmood
- Liverpool Women's NHS Foundation Trust, Liverpool, UK.
| | - A Drakeley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - R Homburg
- Homerton Fertility Centre, Homerton University Hospital NHS Foundation Trust, London, UK
| | - K Bambang
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
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Pearce I, Amoaku W, Bailey C, Downey L, Gale R, Ghanchi F, Hamilton R, Mahmood S, Menon G, Nosek J, Talks J, Yang Y. The changing landscape for the management of patients with neovascular AMD: brolucizumab in clinical practice. Eye (Lond) 2022; 36:1725-1734. [PMID: 35314774 PMCID: PMC8936380 DOI: 10.1038/s41433-022-02008-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 11/26/2021] [Revised: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022] Open
Abstract
Untreated neovascular age-related macular degeneration (nAMD) can lead to severe and permanent visual impairment. The chronic nature of the disease can have a significant impact on patients’ quality of life and an economic and time burden on medical retina (MR) services, with the care need outweighing the growth of resources that clinical services can access. The introduction of a new treatment into clinical services can be challenging, especially for services that are already under capacity constraints. Guidance for practical implementation is therefore helpful. Roundtable meetings, facilitated by Novartis UK, between a working group of MR experts with experience of leading and managing NHS retinal services in the intravitreal era were conducted between 2020 and 2021. These meetings explored various aspects and challenges of introducing a new anti-vascular endothelial growth factor (VEGF) therapy to the UK medical retina services. Provision of clear expert recommendations and practical guidance nationally, that can be adapted locally as required to support clinicians and healthcare professionals (HCPs), is valuable in supporting the introduction of a new anti-VEGF therapy within the NHS environment. The experts provide ophthalmologic HCPs with a collation of insights and recommendations to support the introduction and delivery of brolucizumab in their local service in the face of current and projected growth in demand for retina care.
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Affiliation(s)
- Ian Pearce
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
| | - Winfried Amoaku
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Clare Bailey
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Richard Gale
- University of York and York Teaching Hospital, York, UK
| | - Faruque Ghanchi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Robin Hamilton
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Sajjad Mahmood
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Geeta Menon
- Frimley Health NHS Foundation Trust, Frimley, UK
| | | | - James Talks
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Yit Yang
- Wolverhampton Eye Infirmary, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
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Parveen S, Rasool F, Akram MN, Khan N, Ullah M, Mahmood S, Rabbani G, Manzoor K. Effect of Moringa olifera leaves on growth and gut microbiota of Nile tilapia (Oreochromis niloticus). BRAZ J BIOL 2021; 84:e250916. [PMID: 34705952 DOI: 10.1590/1519-6984.250916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/05/2021] [Indexed: 11/22/2022] Open
Abstract
The study was conducted to evaluate the effect of Moringa olifera on the growth and gut health of Tilapia (Oreochromis niloticus). The feed having 30% crude protein was prepared as an experimental diet with 4%, 8% and 10% M. olifera leaf supplementation, respectively. The control diet was devoid of M. olifera leaves. The 10 weeks feeding trial was carried out on 60 fish in aquaria. Fish was fed @ 3% of body weight twice a day. Diet with the high level of inclusion of M. olifera leaves significantly increased the growth rate, Survival Rate (SR), Specific Growth Rate (SGR) and Feed Conversion Efficiency (FCE) in all treatment groups compared to the control group. Similarly, Feed Conversion Ratio (FCR) gradually decreased and found highly-significant. To check the gut health of the Tilapia, random samples were selected and dissected. Nutrient agar was used as culture media to check the growth of bacteria. Pour Plate Method was used for viable colonies count by colony counter. Through staining method, the different bacteria such as Escherichia coli, Salmonella, Shigella and Pseudomonas aeruginosa were identify abundantly in the intestine of control diet fish but less number present in treatment diets groups. These results showed that M. olifera leaves up to 10% of dietary protein can be used for Nile tilapia for significant growth and healthy gut microbiota of fish.
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Affiliation(s)
- S Parveen
- University of Agriculture, Faculty of Sciences, Department of Zoology, Wildlife & Fisheries, Faisalabad, Pakistan
| | - F Rasool
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M N Akram
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - N Khan
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M Ullah
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - S Mahmood
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - G Rabbani
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - K Manzoor
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
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Mahmood S, Gelovani D, Nona P, Lemor A, Basir M, Frisoli T, Lee J, Wang D, O'Neill B, Eng M, O'Neill W, Villablanca P. Use of left ventricular support devices during transcatheter aortic valve replacement and balloon aortic valvuloplasty: a single center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Transcatheter aortic valve replacement (TAVR) and balloon aortic valvuloplasty (BAV) are definitive and bridging therapies in patients with aortic stenosis. Data on utilization of mechanical circulatory support (MCS) in this population is scarce. This study sought to evaluate the clinical outcomes of the use of Impella (Abiomed, Danvers, MA) in patients undergoing TAVR or BAV at a tertiary-care center.
Methods
We reviewed all TAVRs and BAVs that required Impella from 2012 and 2020. Patient demographics, procedural outcomes, complications, and 30-day mortality were analyzed.
Results
A total of 1,965 TAVR and 715 BAV cases were performed in the study period. 30 TAVR and 94 BAV cases required an Impella. 65% of these cases were due to cardiogenic shock (CS) (100% of TAVR and 55% of BAV). 31% were performed in female patients. Transfemoral access was utilized in 98% of cases. Impella CP was used in 98% of cases, other types of MCS were used in 8.7% of cases. 32.2% of cases required MCS for more than 24 hours. In the TAVR population the indication for MCS was 46.6% profound hypotension post valve deployment requiring vasopressors, 16.6% cardiac arrest, 10% sustained ventricular arrhythmia, 10% cardiac tamponade [Office1] and 10% coronary occlusion. In the BAV group the indication was 44% high-risk PCI and 56% CS. The 30-day mortality in TAVR was 40% and 28% in BAV; from the BAV group in CS the mortality was 45%. VARC-2 vascular complications and bleeding complications were observed in 4.8% and 1.5%, respectively. 0.7% of the total cohort required conversion to open-heart surgery.
Conclusions
Impella support is required in a minority of TAVR or BAV cases. In those who require MCS with Impella for either BAV or TAVR, the total mortality remains high especially in those experiencing CS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mahmood
- Henry Ford Hospital, Detroit, United States of America
| | - D Gelovani
- Henry Ford Hospital, Detroit, United States of America
| | - P Nona
- Henry Ford Hospital, Detroit, United States of America
| | - A Lemor
- Henry Ford Hospital, Detroit, United States of America
| | - M Basir
- Henry Ford Hospital, Detroit, United States of America
| | - T Frisoli
- Henry Ford Hospital, Detroit, United States of America
| | - J Lee
- Henry Ford Hospital, Detroit, United States of America
| | - D Wang
- Henry Ford Hospital, Detroit, United States of America
| | - B O'Neill
- Henry Ford Hospital, Detroit, United States of America
| | - M Eng
- Henry Ford Hospital, Detroit, United States of America
| | - W O'Neill
- Henry Ford Hospital, Detroit, United States of America
| | - P Villablanca
- Henry Ford Hospital, Detroit, United States of America
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Mahmood S, Mair M, Hussain M, Conboy P. 165 Impact of COVID-19 on management of Foreign Bodies in Otolaryngology. Br J Surg 2021. [PMCID: PMC8524523 DOI: 10.1093/bjs/znab259.443] [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: 11/28/2022]
Abstract
Aim The primary aim was to assess safety of Ear, nose and throat foreign body extraction during the coronavirus pandemic as this procedure is considered a potential aerosol generating procedure. The secondary aim was to evaluate the potential risks to patients if foreign body removal was delayed. Method A prospective study of 50 patients presenting to our unit with foreign bodies between March 2020 and August 2020 during the COVID-19 pandemic was performed. All patients were seen within 1 week of referral. The sites and types of foreign bodies were studied and correlated with complications where present. We assessed the circumstances under which foreign body removal was performed and its effect on health care professionals. Results The most common age group was the paediatric age group (52%). The most frequent sites of foreign bodies were the Ears at 78%(39 patients), followed by the nose at 12% (26 patients). Non-organic foreign bodies (52%) were more prevalent than organic foreign bodies (48%). Removal was performed in 31 (62%) patients either in clinic or in theatre. However, 19 patients (38%) were managed conservatively adhering to the British Association for Paediatric Otolaryngology guidance. Only 2 patients developed complications secondary to retained non-organic aural foreign bodies. None of the patients with organic foreign bodies developed complications. No infection rates among medical staff managing these patients were identified. Conclusions Contrary to normal practice, it is safe to manage selective ENT foreign bodies in a semi-urgent manner allowing time to implement ample precautions to reduce infection risks.
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Affiliation(s)
- S Mahmood
- University Hospitals of Leicester, Leicester, United Kingdom
| | - M Mair
- University Hospitals of Leicester, Leicester, United Kingdom
| | - M Hussain
- University Hospitals of Leicester, Leicester, United Kingdom
| | - P Conboy
- University Hospitals of Leicester, Leicester, United Kingdom
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Ayub A, Rasool F, Khan N, Qaisrani SN, Parveen S, Anjum KM, Fatima M, Matiullah, Mahmood S, Zulfiqar T. Limiting amino acids supplementation in low crude protein diets and their impacts on growth performance and carcass composition in Labeo rohita (rohu) adult fish. BRAZ J BIOL 2021; 83:e249422. [PMID: 34495169 DOI: 10.1590/1519-6984.249422] [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] [Received: 03/04/2021] [Accepted: 04/07/2021] [Indexed: 11/21/2022] Open
Abstract
Ninety days study was conducted in hapas installed in earthen ponds. Fish of an average initial weight (220g) were evenly distributed in triplicate groups within fifteen hapas. Five experimental diets labeled as T1 (25% CP and NRC recommended amino acid level) as control diet, T2 (with 2% low protein and 5% amino acid supplementation), T3 (with 2% low protein and 10% amino acid supplementation), T4 (with 4% low protein and 10% amino acid supplementation) and T5 (with 4% low protein and 20% amino acid supplementation) were prepared. Fish were fed with @3% of their body weight twice a day at 10.00 & 16:00 hour. Significantly higher percent weight gain (420.18 ± 66.84a) and specific growth rate (13499.33±1273.54a) along with improved feed conversion ratio (1.29 ± 0.09b) and hundred percent survivals were recorded during the trial. Furthermore proximate analysis of meat showed significant improvement in the crude protein level (81.77 ± 0.19a) served with diet containing 20% limiting amino acids mixture. Therefore, limiting amino acids can be a source of cost effective feed and use safely in L. rohita diet.
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Affiliation(s)
- A Ayub
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - F Rasool
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - N Khan
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - S N Qaisrani
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan.,University of Veterinary and Animal Sciences, Faculty of Animal Production Technology, Department of Animal Nutrition, Lahore, Pakistan
| | - S Parveen
- University of Agriculture, Faculty of Sciences, Department of Zoology, Wildlife & Fisheries, Faisalabad, Pakistan
| | - K M Anjum
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - M Fatima
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - Matiullah
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - S Mahmood
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - T Zulfiqar
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
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Ullah Z, Mahmood S, Iqbal Z, Khan J, Akhtar N, Khan MA, Arif M, Khan RA, Khan MF, Saira, Qureshi BUD, Aksar N, Yasmin S. Habitat selection by Asiatic black bear (Ursus thibetanus) in Siran and Kaghan Valleys, Pakistan. BRAZ J BIOL 2021; 83:e247890. [PMID: 34468530 DOI: 10.1590/1519-6984.247890] [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] [Received: 01/23/2021] [Accepted: 02/16/2021] [Indexed: 11/22/2022] Open
Abstract
Asiatic black bear is present in variety of habitats like broad-leaves and coniferous forests, extending form sea level to 4300m elevation and change their habitat for food purpose seasonally. The present study was conducted at Kaghan and Siran Valleys, District Mansehra, Khyber Pakhtunkhwa, Pakistan to assess habitat of black bear. Line transect method was used for observation of bear signs. Twelve meter circular radius plots were selected for the concern vegetation's i.e. (trees, shrubs and herbs) and three to six plots were placed in each transect. At the result of sign survey, thirteen different categories of bear signs were recorded and encounter rate was calculated for each sign. A total of 1858 signs were observed during field surveys. Total (81%) coniferous species were recoded among trees, with the highest appearance of Pinus wallichiana (34.22%) and Spruce spp (27.76%), similarly broad leaves trees (18.56%) were also recoded from habitat plots. Most of the signs were encountered in bushy areas, whereas high number of Viburnum Spp (60.29%) was present. It is indicated that black bear prefers blend of Coniferous Trees, Viburnum and Ferns Species; probably because these plants provide enough food, protection, and meticulous shelter because more than 80% of habitat composed of these three species. Currently habitat destruction and increase in human population are the up-growing issues for wild animals (especially Asiatic black bear), which is highly sensitive to such problems. High levels of conservation efforts are recommended for the protection of black bear habitat and to avoid human interference in their territory.
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Affiliation(s)
- Z Ullah
- Hazara University Sub Campus Battagram, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Mahmood
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - Z Iqbal
- Hazara University Mansehra, Department of Botany, Khyber Pakhtunkhwa, Pakistan
| | - J Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Akhtar
- Hazara University Sub Campus Battagram, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M A Khan
- Sustainable Forest Management Project, Islamabad, Pakistan
| | - M Arif
- Sustainable Forest Management Project, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - R A Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M F Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - Saira
- University of Swabi, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - B U D Qureshi
- Government Degree College Athmuqam, Azad Jammu and Kashmir, Pakistan
| | - N Aksar
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Yasmin
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
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Khan RA, Ullah Z, Zaman IU, Khan MS, Mahmood S, Akhtar N, Khan MF, Yasmin S, Saqlain M, Rehman AU, Aksar N, Khan SN, Hussain SS. Population distribution and habitat analysis of Rufous treepie (Dendrocitta vagabunda) in Abbottabad, Pakistan. BRAZ J BIOL 2021; 83:e247018. [PMID: 34431914 DOI: 10.1590/1519-6984.247018] [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] [Received: 12/27/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
The Rufous treepie (Dendrocitta vagabunda) belongs to family corvidae, order Passeriformes which includes about 100 species. The current study was conducted to gather information about the Population distribution and habitat analysis of D. vagabunda at District Abbottabad, Pakistan. The data were collected on monthly basis both morning and evening times (2018-2019). "The ''Point count Method" was used for population estimation and ''Quadrates Method" for habitat analysis of study area. The result shows an average month-wise population density of D. vagabunda was maximum at Jhangra 0.14±0.039/ha, whereas minimum at Havelian 0.11±0.022/ha. There was no significant difference (p>0.05) among monthly population densities of D. vagabunda, however, a significant difference (p<0.05) was found between morning and evening times population of the specie. The present study revealed that importance value index (IVI) of plants species at Sherwan, Bakot, Havelian, Langra and Jhangra were 59.6±12.6, 50.1±6.9, 53.4±6.3, 66.8±10 and 60.1±7.7. Likewise, the frequency of shrubs at Sherwan, Bakot, Havelian, Langra and Jhangra were 33.3±4.2, 45±9.4, 46.7±8.2, 55.6±22.2 and 37.5±8.5. Similarly, the frequency of herbs at Sherwan, Bakot, Havelian, Langra and Jhangra were 40.4±6.0, 37.5±5.6, 53.3±7.4, 48.5±5.2 and 46.9±7.4 respectively. Our results show the study area as suitable habitat for D. vagabunda.
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Affiliation(s)
- R A Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - Z Ullah
- Hazara University, Department of Zoology, Sub-Campus Battagram, Khyber Pakhtunkhwa, Pakistan
| | - I Uz Zaman
- Khyber Pakhtunkhwa Wildlife Department, Pakistan
| | - M S Khan
- University of Swabi, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Mahmood
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Akhtar
- Hazara University, Department of Zoology, Sub-Campus Battagram, Khyber Pakhtunkhwa, Pakistan
| | - M F Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Yasmin
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M Saqlain
- Horizon Degree College Chakwal, Department of Zoology, Pakistan
| | - A Ur Rehman
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Aksar
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S N Khan
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S S Hussain
- Hazara University Mansehra, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
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Mair M, Raj L, Mahmood S, Fagiry R, Ahmed MM, Menon I, Ibrahim N, Ameerally P, Baker A, Vaidhyanath R. Diagnostic accuracy of magnetic resonance imaging in detecting depth of invasion of tongue cancers. Br J Oral Maxillofac Surg 2021; 59:1275-1279. [PMID: 34483009 DOI: 10.1016/j.bjoms.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
The recent eighth edition of the American Joint Committee on Cancer (AJCC) staging system has introduced depth of invasion (DOI) as one of its important components. DOI is also important for deciding neck management in superficial tongue cancers. Magnetic resonance imaging (MRI) is mainly used to assess DOI, and in this study we have evaluated the efficacy of MRI to detect it. This is a retrospective study consisting of 60 treatment-naïve tongue cancer patients operated on between July 2017 and June 2019. Patients underwent MR imaging on an Optima MR450W 1.5T unit, and MRI was reported by two experienced ead and eck adiologistss. Postoperative histological DOI was considered the gold standard. The correlation coefficient was derived for postoperative DOI and MRI-detected DOI. A subgroup analysis of superficial tongue cancer was also done. The mean MRI DOI was 13.7 mm and the mean histological DOI 12.45 mm. The shrinkage factor was 0.6 mm. Pearson's correlation coefficient was 0.80 (p=<0.001) for Radiologist 1 and 0.85 (p=<0.001) for Radiologist 2. The interobserver variation was low, with a correlation coefficient between the two radiologists of 0.965 (p=<0.001). For superficial tongue cancers there was moderate correlation for MRI and histologically-detected DOI with a kappa value of 0.681 (p=0.03). As per the ROC curve, the cut-off value for MRI DOI to predict nodal metastasis was 4.6 mm. MRI has high reliability to predict the DOI of tongue cancers. The interobserver variation was low. The diagnostic accuracy in cases of superficial tongue cancer was moderate.
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Affiliation(s)
- M Mair
- Head and Neck Surgery, University Hospitals of Leicester, United Kingdom.
| | - L Raj
- Head and Neck Surgery, University Hospitals of Leicester, United Kingdom
| | - S Mahmood
- Department of Oral & Maxillofacial Surgery, University Hospitals of Leicester, United Kingdom
| | - R Fagiry
- Department of Oral & Maxillofacial Surgery, University Hospitals of Leicester, United Kingdom
| | - M M Ahmed
- Department of Oral & Maxillofacial Surgery, University Hospitals of Leicester, United Kingdom
| | - I Menon
- Department of Radiology, University Hospitals of Leicester, United Kingdom
| | - N Ibrahim
- Department of Radiology, University Hospitals of Leicester, United Kingdom
| | - P Ameerally
- Department of Oral & Maxillofacial Surgery, Northampton General Hospital, United Kingdom
| | - A Baker
- Department of Oral & Maxillofacial Surgery, University Hospitals of Leicester, United Kingdom
| | - R Vaidhyanath
- Department of Radiology, University Hospitals of Leicester, United Kingdom
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Haiduc A, Ogunjimi M, Shammus R, Mahmood S, Harky A. 531 COVID-19 and Patients with Congenital Heart Disease: Are the Risk Higher? A Systematic Review. Br J Surg 2021. [PMCID: PMC8135769 DOI: 10.1093/bjs/znab134.063] [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
Introduction We aimed to determine if patients with CHD are at a higher risk of poor outcomes if they have COVID-19, compared to those without CHD. Method A systematic review was executed using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. To identify articles related to COVID-19 and CHD, an extensive literature search was performed on EMBASE, Medline, Scopus and Global Health databases using keywords and MeSH terms. Results 12 articles met the inclusion criteria and were included for analysis in this systematic review. Two themes were identified for data extraction: [1] evidence supporting higher risks in CHD patients and [2] evidence against higher risks in CHD patients. After combining the data, there were 99 patients with CHDs out of which 12 required admission to ICU. Conclusions This systematic review suggests that CHD may increase the risk of poor outcomes for those with COVID-19, but also highlights the necessity for more research with larger sample sizes in order to make a more justified conclusion, as the majority of papers that were analysed were case series and case reports. Future research should aim to quantify the risks if possible while accounting for various confounding factors such as age and treatment history.
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Affiliation(s)
- A Haiduc
- St George's, University of London, London, United Kingdom
| | - M Ogunjimi
- Imperial College London, London, United Kingdom
| | - R Shammus
- St George's, University of London, London, United Kingdom
| | - S Mahmood
- St George's, University of London, London, United Kingdom
| | - A Harky
- Department of Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, United Kingdom
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25
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Seekings AH, Warren CJ, Thomas SS, Mahmood S, James J, Byrne AMP, Watson S, Bianco C, Nunez A, Brown IH, Brookes SM, Slomka MJ. Highly pathogenic avian influenza virus H5N6 (clade 2.3.4.4b) has a preferable host tropism for waterfowl reflected in its inefficient transmission to terrestrial poultry. Virology 2021; 559:74-85. [PMID: 33839461 DOI: 10.1016/j.virol.2021.03.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
Highly-pathogenic avian influenza virus (HPAIV) H5N6 (clade 2.3.4.4b) incurred into Europe in late 2017 and was predominantly detected in wild birds, with very few terrestrial poultry cases. Pekin ducks directly-infected with a UK virus (H5N6-2017) were donors of infection to investigate contact transmission to three recipient species: Ducks, chickens and turkeys. H5N6-2017 transmission to ducks was 100% efficient, but transmission to in-contact galliforme species was infrequent and unpredictable, thereby reflecting the European 2017-2018 H5N6 epidemiology. Although only two of 28 (7%) infected ducks died, the six turkeys and one chicken which became infected all died and displayed systemic H5N6-2017 dissemination, while pathogenesis in ducks was generally milder. Analysis of H5N6-2017 progeny in the contacts revealed no emergent polymorphisms in an infected duck, but the galliforme species included changes in the polymerase (PB2 A199T, PA D347A), matrix (M1 T218A) and neuraminidase genes (T88I). H5N6-2017 environmental contamination was associated with duck shedding.
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Affiliation(s)
- A H Seekings
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - C J Warren
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S S Thomas
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S Mahmood
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - J James
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - A M P Byrne
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S Watson
- Animal Sciences Unit, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - C Bianco
- Pathology Department, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - A Nunez
- Pathology Department, APHA-Weybridge, Addlestone, Surrey, KT15 3NB, UK
| | - I H Brown
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - S M Brookes
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK
| | - M J Slomka
- Avian Virology and Mammalian Influenza Research, Virology Department, Animal and Plant Health Agency (APHA-Weybridge), Addlestone, Surrey, KT15 3NB, UK.
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Islam N, Furuya-Kanamori L, Mahmood S, Thalib L. Prophylactic antibiotics for preventing genital tract infection in women undergoing surgical procedures for incomplete abortion: a systematic review and meta-analysis of randomised controlled trials. BJOG 2021; 128:1273-1281. [PMID: 33346920 DOI: 10.1111/1471-0528.16637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Findings about the effect of prophylactic antibiotics in preventing genital tract infection (GTI) associated with surgical procedures used for incomplete abortions are conflicting. Some reported a decrease in infection associated with the use of antibiotic prophylaxis, whereas others found no significant reduction in GTI. OBJECTIVE To synthesise systematically the evidence on the effect of prophylactic antibiotics compared with placebo in women undergoing surgical procedures for incomplete abortion. SEARCH STRATEGY In February 2020, PubMed, Embase and Cochrane Central for Register of Controlled Trials were searched for relevant published randomised controlled trials. SELECTION CRITERIA Randomised controlled trials reporting GTI following surgical procedures for incomplete abortion and comparing antibiotic prophylaxis with placebo. DATA COLLECTION AND ANALYSIS Meta-analysis using inverse variance heterogeneity model included subgroup and sensitivity analyses determined a priori were conducted. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). MAIN RESULTS A total of 16 178 women who participated in 24 eligible randomised controlled trials published between 1975 and 2019 were included. Pooled estimates showed the risk of GTI following surgical procedures after incomplete abortion was significantly lower among those who had prophylactic antibiotics (relative risk [RR] = 0.72; 95% CI 0.58-0.90; I2 = 49%). There was no significant effect of antibiotics in women in low- and middle-income countries (three studies, 3579 participants, RR = 0.90; 95% CI 0.50-1.62; I2 = 63%), but it was clinically and statistically significant among women high-income countries (21 studies, 12 599 participants, RR = 0.67; 95% CI 0.53-0.84; I2 = 44%), with a strong level of evidence as assessed by GRADE. CONCLUSION This study provides evidence that antibiotic prophylaxis is beneficial in reducing post-abortion GTI among women undergoing surgical procedures for incomplete abortion. More studies are needed from low- and middle-income countries. TWEETABLE ABSTRACT Prophylactic antibiotics after incomplete abortion are effective in reducing GTI. More studies are needed from low- and middle-income countries.
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Affiliation(s)
- N Islam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - L Furuya-Kanamori
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - S Mahmood
- Endocrinology Department, Medicine, Hamad Medical Corporation, Doha, Qatar
| | - L Thalib
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Aslam TM, Mahmood S, Balaskas K, Hoyle DC. Statistical Modelling of the Visual Impact of Subretinal Fluid and Associated Features. Ophthalmol Ther 2021; 10:127-135. [PMID: 33420953 PMCID: PMC7796679 DOI: 10.1007/s40123-020-00327-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/16/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction The aim of this study was to develop a statistical model to determine the visual significance of subretinal fluid (SRF) in combination with other constructed optical coherence tomography (OCT) features in patients with wet age-related macular degeneration. Methods The project used labelled data from 1211 OCTs of patients with neovascular macular degeneration (nAMD) attending the macular treatment centre of Manchester Royal Eye Hospital to build a statistical model to determine vision for any virtual, constructed OCT. A four-dimensional plot was created to represent the visual impact of SRF in OCTs in the context of the associated OCT characteristics of atrophy and subretinal hyperreflective material (SHRM). Results The plot illustrates that at levels of SRF below 150 µm, the impact of SRF on vision is very low. Increasing the amount of fluid to 200 µm and beyond increases the impact on vision, but only if there is little atrophy or SHRM. Conclusions This study suggests that levels of SRF up to around 150 µm thickness on OCT have minimal impact on vision. Greater levels of SRF have greater impact on vision, unless associated with significant amounts of atrophy or SHRM, when the additional effect of the SRF on vision remains low. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-020-00327-w.
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Affiliation(s)
- Tariq M Aslam
- School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- Manchester Royal Eye Hospital, NHS Central Manchester University Hospitals, Manchester, UK.
| | - Sajjad Mahmood
- School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Royal Eye Hospital, NHS Central Manchester University Hospitals, Manchester, UK
| | - Konstantinos Balaskas
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - David C Hoyle
- School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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28
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Cohen O, Ismail A, Manwani R, Ravichandran S, Foard D, Mahmood S, Sachchithanantham S, Martinez-Naharro A, Fontana M, Lachmann H, Hawkins P, Gillmore J, Whelan C, Wechalekar A. Global longitudinal strain predicts survival and response in patients with systemic AL amyloidosis. analysis of 915 patients from the ALchemy prospective trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac involvement determines prognosis in systemic AL amyloidosis. The extent is assessed by biomarker-based staging systems. This a prospective report of a large cohort of patients assessing the utility of changes in longitudinal function by 2D strain (GLS%), impairment - a hallmark of amyloidosis.
Purpose
To evaluate the prognostic role of GLS% and other echocardiographic parameters in systemic AL amyloidosis.
Methods
915 newly diagnosed patients seen at the UK National Amyloidosis Centre (February 2010–August 2017) were included. All patients underwent 6-monthly comprehensive assessments inclusive of echocardiogram. The European modification of the Mayo 2004 staging was used with Mayo stage III patients stratified into IIIa (NT-proBNP <8500ng/L) and IIIb (NT-proBNP ≥8500ng/L).
Results
653/915 (71.4%) patients had cardiac involvement. Mayo stage 1, 2, 3a and 3b in 144 (15.7%), 302 (33.0%) 344 (37.6%) and 125 (13.7%) respectively. The median NT-proBNP was 2228ng/L and TNT was 0.54ng/ml. The GLS% significantly worsened with increasing Mayo stage (p<0.0001 between GLS% for each Mayo stage). Poorer baseline GLS% associated with significantly worse OS and stratified patients into three groups: GLS% <−12.8%: OS 69.1 months; GLS% −12.8% to −9%: OS 54.5 months; GLS% >−9%: OS 45.3 months (p<0.0001). On univariate analysis, 11/14 parameters predicted survival (LV wall thickness, LV ejection fraction, systolic velocities of the septal (s'sep) and lateral mitral annulus (s' lat), mitral annulus movement at the lateral corner (e' lat), transmitral early peak flow velocity (E) divided by tissue Doppler mitral annular motion velocity (e') – E/e' and mitral annular plane systolic excursion (MAPSE)). Baseline GLS% >−17% was independent of Mayo stage in predicting survival [Mayo II: Hazard ratio (HR) 2.10 (95% CI: 1.12–3.92) p=0.02, Mayo III: HR 3.94 (95% CI: 2.13–7.32) p<0.0001, Mayo IV: HR 7.49 (95% CI: 3.94–14.21) p<0.0001, GLS <17%: HR 2.14 (95% CI: 1.59–2.88) p<0.0001]. At 12 months, only patients in a haematological complete response (CR) had significant improvement in overall GLS% (p=0.02) as well as baso-lateral (p=0.0004) and baso-septal (p=0.0001) GLS% and MAPSE (p=0.002). The OS was significantly better in patients who achieved a minimum absolute improvement in GLS% of 1.5% improvement (not reached in those with improved GLS% vs. 72 mo in those without) (p=0.034)).
Conclusion
These data show that baseline GLS% is an independent predictor of survival in AL amyloidosis. GLS% is the first functional marker that is independent of the Mayo staging in predicting outcomes and should be incorporated in prognostic staging for patients with AL amyloidosis. GLS% shows improvement in patients who achieve a complete haematologic response to treatment and improvement in GLS% of 1.5% is associated with improved outcomes. An absolute improvement in GLS% should be considered as a criterion for cardiac response in AL amyloidosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O Cohen
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Ismail
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - R Manwani
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Ravichandran
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - D Foard
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Mahmood
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Sachchithanantham
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Martinez-Naharro
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - M Fontana
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - H Lachmann
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - P Hawkins
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - J Gillmore
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - C Whelan
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A.D Wechalekar
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
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Mair M, Mahmood S, Fagiry R, Mohamed Ahmed M, Rajaram K, Baker A, Avery C. Comparative analysis of paediatric and adult surgically drained dental infections at a university teaching hospital. Br J Oral Maxillofac Surg 2020; 58:e307-e311. [PMID: 33011021 DOI: 10.1016/j.bjoms.2020.08.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022]
Abstract
In the United Kingdom (UK) the estimated prevalence of dental infection involving the supporting bone is 2%, and from 2014-2015 there were 2281 admissions in England alone due to dental abscess. We undertook an analysis of 184 dental abscesses that required surgical drainage, as there is surprisingly little in the literature on the subject. This was a retrospective study of 184 consecutive patients with dental abscesses who were admitted between January 2016 and September 2019. On admission, all patients had orthopantomograms (OPG) and baseline blood tests. Surgical drainage was performed under a general or local anaesthetic and a pus swab sent for culture and sensitivity. The submandibular space was the most commonly involved site and paediatric patients most often presented with buccal space abscesses. A lower molar tooth was the cause in 132 patients. White blood cells (WBC) and C-reactive protein (CRP) were both raised in 63.6% (n=117), but were normal in 4.9% (n=9). The remaining patients had either raised WBC (2.7%) or CRP (28.8%). Streptococcus milleri was the most common organism isolated in 66.6% (n=42). There was no association between CRP or WBC values and duration of hospital stay. Paediatric patients had a shorter duration of admission (1.96 days vs 2.81 days) and significantly lower CRP values (120.9 vs 45.7; p=0.001). The submandibular space was the commonest site involved and mandibular molars the most frequent source of infection. An elevated CRP value appeared to be a more sensitive indicator of infection in this study population. Adult and paediatric patients present in a different manner.
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Affiliation(s)
- M Mair
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom.
| | - S Mahmood
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
| | - R Fagiry
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
| | - M Mohamed Ahmed
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
| | - K Rajaram
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
| | - A Baker
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
| | - C Avery
- Department of Maxillofacial Surgery, University Hospital Of Leicester, Leicester, United Kingdom
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Akbar MA, Shameem M, Mahmood S, Alsanad A, Gumaei A. Prioritization based Taxonomy of Cloud-based Outsource Software Development Challenges: Fuzzy AHP analysis. Appl Soft Comput 2020. [DOI: 10.1016/j.asoc.2020.106557] [Citation(s) in RCA: 4] [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] [Indexed: 10/23/2022]
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Gale RP, Mahmood S, Devonport H, Patel PJ, Ross AH, Walters G, Downey L, El-Sherbiny S, Freeman M, Berry S, Jain N. Action on neovascular age-related macular degeneration (nAMD): recommendations for management and service provision in the UK hospital eye service. Eye (Lond) 2020; 33:1-21. [PMID: 30926932 PMCID: PMC6474281 DOI: 10.1038/s41433-018-0300-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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] [Indexed: 12/19/2022] Open
Abstract
This publication and the expert roundtable meeting on which the article is based were sponsored by Bayer plc. Prescribing information for Eylea® (aflibercept solution for injection) can be found at the end of the article. This report by a group of UK retina specialists and health professionals considers best practice recommendations for the management of sight-threatening neovascular age-related macular degeneration (nAMD), based on collective experience and expertise in routine clinical practice. The authors provide an update for ophthalmologists, allied healthcare professionals and commissioners on practice principles for optimal patient care and service provision standards. Refinement of care pathways for nAMD has improved access to intravitreal anti-vascular endothelial growth factor therapy but there are still variations in care and reported outcomes between clinic centres. Innovative organisational models of service provision allow providers to better match capacity with increasing demand. The authors review the recent NICE guideline for diagnosis and management of AMD, considerations for switching therapies and stopping treatment and need for regular monitoring of non-affected fellow eyes in patients with unilateral nAMD. Actions for delivery of high-quality care and to improve long-term patient outcomes are discussed. Local pathways need to detail nAMD target time to treat, maintenance of review intervals to ensure proactive treatment regimens are delivered on time and appropriate discharge for patients deemed low risk or no longer benefiting from treatment. Actual visual acuity outcomes achieved and maintenance of the level of vision when disease stability is achieved are considered good measures for judging the quality of care in the treatment of patients with nAMD. Robust community referral pathways must be in place for suspected reactivation of choroidal neovascularisation and rapid referral for second eye involvement. Practical considerations for intravitreal injection therapy are outlined.
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Affiliation(s)
- Richard P Gale
- The Action on nAMD Group, Birmingham, UK. .,The York Hospital, York, UK.
| | - Sajjad Mahmood
- The Action on nAMD Group, Birmingham, UK.,Manchester Royal Eye Hospital, Manchester, UK
| | - Helen Devonport
- The Action on nAMD Group, Birmingham, UK.,Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Praveen J Patel
- The Action on nAMD Group, Birmingham, UK.,National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Adam H Ross
- The Action on nAMD Group, Birmingham, UK.,University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Gavin Walters
- The Action on nAMD Group, Birmingham, UK.,Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - Louise Downey
- The Action on nAMD Group, Birmingham, UK.,Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Samer El-Sherbiny
- The Action on nAMD Group, Birmingham, UK.,South Warwickshire NHS Foundation Trust, Warwickshire, UK
| | - Mary Freeman
- The Action on nAMD Group, Birmingham, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Simon Berry
- The Action on nAMD Group, Birmingham, UK.,Simon Berry Optometrist, Durham, UK
| | - Nitin Jain
- The Action on nAMD Group, Birmingham, UK.,Bayer, Reading, UK
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Akbar MA, Mahmood S, Shafiq M, Alsanad A, Alsanad AAA, Gumaei A. Identification and prioritization of DevOps success factors using fuzzy-AHP approach. Soft comput 2020. [DOI: 10.1007/s00500-020-05150-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, 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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Mahmood S, Talha KA, Mahmood W. Clinical Features and Location of Intracranial Edema in Posterior Reversible Encephalopathy Syndrome (PRES) Patients. Mymensingh Med J 2020; 29:633-637. [PMID: 32844805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This is an observational analytic study on clinical features and location of intracranial edema in case of posterior reversible encephalopathy syndrome (PRES). Place of study was Square Hospitals Ltd. Dhaka, Bangladesh. Study period was 1 year (from January 2010 to January 2011). Number of total cases was 5. Mean age of patients was 21 years. Common clinical features were headache, seizure and visual disturbance. Mean time of developing clinical feature(s) was 4.6 days after NVD or LUCS. Intracranial edema was common in occipital, frontal and parietal lobes.
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Affiliation(s)
- S Mahmood
- Dr Shagufta Mahmood, Consultant, Radiology and Imaging, Square Hospitals Ltd. Dhaka, Bangladesh; E-mail:
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Mitchell P, Sheidow TG, Farah ME, Mahmood S, Minnella AM, Eter N, Eldem B, Al-Dhibi H, Macfadden W, Parikh S, Dunger-Baldauf C, Mahgoub MM, Schmidt-Erfurth U. Effectiveness and safety of ranibizumab 0.5 mg in treatment-naïve patients with diabetic macular edema: Results from the real-world global LUMINOUS study. PLoS One 2020; 15:e0233595. [PMID: 32492069 PMCID: PMC7269267 DOI: 10.1371/journal.pone.0233595] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 05/08/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To assess the one-year effectiveness and safety of ranibizumab 0.5 mg in treatment- naïve patients with diabetic macular edema (DME) enrolled in the real-world LUMINOUS study. PATIENTS AND METHODS A 5-year, prospective, observational, open-label, global study which recruited 30,138 patients across all approved indications. Consenting patients (≥18 years) who were treatment-naïve or previously treated with ranibizumab or other ocular treatments were treated as per the local ranibizumab label. Here, we present the change in visual acuity (VA) (Early Treatment Diabetic Retinopathy Study letter score; primary treated eye) at Year 1, as well as the change in VA based on injection frequencies (≤4 and ≥5), treatment exposure, and the overall adverse events (AEs) and serious AEs (SAEs) in treatment-naïve DME patients. RESULTS Of the 4,710 DME patients enrolled in the study, 1,063 were treatment-naïve. At baseline, mean age was 64.5 years, 54.7% were male, and 69.2% were white. At 1 year, mean VA letter score improved by +3.5 (n = 502) from a baseline of 57.7 with a mean of 4.5 injections. Presented by injection frequencies ≤4 and ≥5, VA letter score gains were 0.5 (n = 264) and 6.9 (n = 238) from baseline letter scores of 56.6 and 59.0, respectively. Over 5 years, the incidence of ocular/non-ocular AEs and SAEs was 7.2%/10.1% and 0.3%/5.8%, respectively. No endophthalmitis cases were reported. CONCLUSIONS The LUMINOUS study included patients with DME with more diverse baseline characteristics than those in randomized clinical trials. The 1-year data showed improvement in VA with low number of injections in treatment- naïve patients with DME. Greater VA gains were observed in patients who received ≥5 injections. No new safety findings were identified. LUMINOUS confirms the effectiveness and safety of ranibizumab for the treatment of patients with DME in a real-world clinical practice.
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Affiliation(s)
- Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Tom G. Sheidow
- Ivey Eye Institute, Schulich School of Medicine, Western University, Ontario, Canada
| | - Michel E. Farah
- Department of Ophthalmology, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil
| | - Sajjad Mahmood
- Royal Eye Hospital, Oxford Road, Manchester, United Kingdom
| | - Angelo M. Minnella
- Institute of Ophthalmology, Catholic University "Sacro Cuore" Foundation "A. Gemelli", Rome, Italy
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Bora Eldem
- Department of Ophthalmology, Hacettepe University, Faculty of Medicine, Sıhhiye, Ankara, Turkey
| | - Hassan Al-Dhibi
- Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | | | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
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Amoaku W, Bailey C, Downey L, Gale RP, Ghanchi F, Hamilton R, Mahmood S, Menon G, Nosek J, Pearce I, Yang Y. Providing a Safe and Effective Intravitreal Treatment Service: Strategies for Service Delivery. Clin Ophthalmol 2020; 14:1315-1328. [PMID: 32546938 PMCID: PMC7239611 DOI: 10.2147/opth.s233061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/03/2020] [Indexed: 11/23/2022] Open
Abstract
An aging population leads to increasing demand for medical retina services with chronic diseases being managed in long-term care pathways. Many hospital services struggle to deliver efficient and effective MR care due, at least in part, to infrastructure that does not expand responsively enough to meet the increased demand. A steering committee of retinal specialists from a variety of UK NHS hospital ophthalmology departments with experience of leading and managing NHS retinal services in the intravitreal era came together for the generation of this document to review and compile key aspects that should be considered when optimising intravitreal treatment capacity within MR services. This article aims to provide a useful collation and signposting of key published evidence, consensus and insights on aspects of delivering an intravitreal service, including treatment regimens, virtual clinics, staff training and governance, telemedicine and information technology, and data collection and key performance indicators. The objective is to equip ophthalmologic healthcare professionals with the necessary tools to develop and adapt their local service in the face of current and projected increased demand.
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Affiliation(s)
- Winfried Amoaku
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Clare Bailey
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Louise Downey
- Hull and East Yorkshire Eye Hospital, Hull University Teaching Hospital, Hull, UK
| | | | - Faruque Ghanchi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Geeta Menon
- Frimley Health NHS Foundation Trust, Frimley, UK
| | | | - Ian Pearce
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Yit Yang
- Wolverhampton Eye Infirmary, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
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Chakravarthy U, Bailey CC, Scanlon PH, McKibbin M, Khan RS, Mahmood S, Downey L, Dhingra N, Brand C, Brittain CJ, Willis JR, Venerus A, Muthutantri A, Cantrell RA. Progression from Early/Intermediate to Advanced Forms of Age-Related Macular Degeneration in a Large UK Cohort: Rates and Risk Factors. Ophthalmol Retina 2020; 4:662-672. [PMID: 32144084 DOI: 10.1016/j.oret.2020.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To estimate rates and risk factors for progression to geographic atrophy (GA) or choroidal neovascularization (CNV) among eyes diagnosed with early or intermediate age-related macular degeneration (AMD) in clinical practice. DESIGN Retrospective cohort analysis of a multicenter electronic medical record (EMR) database from the United Kingdom. PARTICIPANTS Patients aged 50 years or more with diagnosis of early/intermediate AMD in at least 1 eye (the study eye) and no evidence of CNV or GA in the study eye, from 10 clinical sites using the EMR. METHODS Anonymized data for 40 543 patients with a diagnosis of early/intermediate AMD were extracted between October 2000 and February 2016 from EMR database records held in the 10 sites. A sample of records randomly selected from each center was used to validate disease definitions. Records were analyzed by subgroup, based on the AMD status of the fellow eye. Multivariate Cox regression models identified other predictors of disease progression. MAIN OUTCOME MEASURES Progression rate (per 100 person-years) to GA or CNV in study eyes with early/intermediate AMD by fellow eye status and identified risk factors for progression. RESULTS Study eyes with early/intermediate AMD and a diagnosis of CNV in the fellow eye progressed to CNV fastest (at a rate of 15.2 per 100 person-years), and those with a diagnosis of GA in the fellow eye progressed to GA fastest (11.2 per 100 person-years), compared with the rates per 100 person-years of progression to CNV (3.2-11.9) or GA (2.0-7.8) in the other subgroups. In individuals with bilateral early/intermediate AMD, rates of progression to GA or CNV were 2.0 and 3.2 per 100 person-years, respectively. In the multivariate model, age, female sex, and cardiovascular disease were associated with an increased risk for progression to advanced AMD, whereas diabetes and glaucoma were associated with a decreased rate of progression (hazard ratios, 0.45 and 0.64, respectively). CONCLUSIONS Progression to GA or CNV was observed frequently in eyes with early/intermediate AMD, with the status of the fellow eye affecting the rate of progression. Novel associations with risk factors were observed and require replication in other cohorts.
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Affiliation(s)
- Usha Chakravarthy
- Queen's University of Belfast Royal Victoria Hospital, Belfast, Ireland.
| | - Clare C Bailey
- University Hospitals Bristol National Health Service Foundation Trust, Bristol, United Kingdom
| | - Peter H Scanlon
- Gloucestershire Hospitals National Health Service Foundation Trust, Cheltenham, United Kingdom
| | - Martin McKibbin
- Leeds Teaching Hospitals National Health Service Trust, Leeds, United Kingdom
| | - Rehna S Khan
- Calderdale and Huddersfield National Health Service Foundation Trust, Huddersfield, West Yorkshire, United Kingdom
| | - Sajjad Mahmood
- Central Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Louise Downey
- Hull and East Yorkshire Hospitals National Health Service Trust, Hull, United Kingdom
| | - Narendra Dhingra
- Mid Yorkshire Hospitals National Health Service Trust, Wakefield, United Kingdom
| | - Christopher Brand
- Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom
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Horani M, Mahmood S, Aslam TM. A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II. Ophthalmol Ther 2020; 9:35-75. [PMID: 31907843 PMCID: PMC7054566 DOI: 10.1007/s40123-019-00227-8] [Citation(s) in RCA: 5] [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: 10/16/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction To explore the potential link between macular atrophy (MA) of the retinal pigment epithelium (RPE) in patients with neovascular age-related macular degeneration (nAMD) and anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods Through a balanced overview of the field from a largely clinical perspective, we looked at available evidence on the topic of MA correlation with anti-VEGF therapy and examined possible risk factors for MA development in the context of nAMD treatment with anti-VEGF. Results Links have been reported to connect both MA incidence and progression to treatment frequency and to the anti-VEGF drug type. Conclusions All reports agree on the fact that de novo development of MA in anti-VEGF-treated eyes is frequent and multifactorial. Research data shows an expansion of atrophy during anti-VEGF treatment. There are mixed conclusions about the correlation of MA incidence or progression with treatment-related risk factors. It mostly appears that there is no straightforward link. More clinical research is still needed to further understand this association.
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Affiliation(s)
- Mania Horani
- Manchester Royal Eye Hospital, Manchester University Foundation NHS Trust, Manchester, UK.
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Tariq M Aslam
- Manchester Royal Eye Hospital, Manchester University Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
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Ross AH, Downey L, Devonport H, Gale RP, Kotagiri A, Mahmood S, Mehta H, Narendran N, Patel PJ, Parmar N, Jain N. Recommendations by a UK expert panel on an aflibercept treat-and-extend pathway for the treatment of neovascular age-related macular degeneration. Eye (Lond) 2020; 34:1825-1834. [PMID: 31900438 PMCID: PMC7608090 DOI: 10.1038/s41433-019-0747-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 09/17/2019] [Accepted: 10/31/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives This report aims to provide clear recommendations and practical guidance from a panel of UK retinal experts on an aflibercept treat-and-extend (T&E) pathway that can be implemented in clinical practice. These recommendations may help service providers across the NHS intending to implement a T&E approach, with the aim of effectively addressing the capacity and resource issues putting strain on UK neovascular age-related macular degeneration (nAMD) services while promoting patients’ best interests throughout. Methods Two structured roundtable meetings of retinal specialists were held in London, UK on 7 December 2018 and 1 March 2019. These meetings were organised and funded by Bayer. Results The panel provided recommendations for an aflibercept T&E pathway and developed specific criteria based on visual acuity, retinal morphology and optical coherence tomography imaging to guide reduction, maintenance and extension of injection intervals. They also discussed the extension of treatment intervals by 2- or 4-week adjustments to a maximum treatment interval of 16 weeks, the management of retinal fluid and the stopping of treatment. Conclusions The long-term benefits of implementing a T&E pathway may include superior visual outcomes compared with a pro re nata (PRN; as needed) protocol, and a lower treatment burden compared with a fixed protocol, which is likely to improve service capacity. Furthermore, the predictable nature of a T&E approach compared with a PRN service may aid capacity planning for the future nAMD treatment demand.
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Affiliation(s)
- Adam H Ross
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
| | - Louise Downey
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Helen Devonport
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Ajay Kotagiri
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Hemal Mehta
- Royal Free London NHS Foundation Trust, London, UK
| | | | - Praveen J Patel
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Ahmad N, Saleem M, Atta BM, Mahmood S. Characterization of Desi Ghee Extracted by Different Methods Using Fluorescence Spectroscopy. J Fluoresc 2019; 29:1411-1421. [PMID: 31758370 DOI: 10.1007/s10895-019-02453-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/20/2019] [Accepted: 10/15/2019] [Indexed: 12/17/2022]
Abstract
In the current study, the effect of ghee extraction methods (direct cream DC, milk butter MB and milk skin MS) on its molecular composition has been investigated using Fluorescence spectroscopy. The excitation wavelength of 300 nm was found the best to produce pronounced spectral signatures of beta-carotene, vitamins and conjugated linoleic acid (CLA) in both cow and buffalo ghee types. Principal component analysis (PCA) has been applied on the spectral data to visualize the classification among ghee samples extracted by three methods. Both cow and buffalo ghee contain spectral signatures of vitamin A, E, K, D and CLA which has been verified through plotting loading vectors. The analysis of loading plots has been suggested that for cow ghee, MS extraction method conserve relatively higher concentration of beta carotene while DC and MB methods are a good choice for preserving relatively more concentrations of vitamins D, E and K. Similarly, for buffalo ghee, MS extraction method appear with higher concentration of CLA, whereas DC extraction method looks to preserve relatively higher concentration of vitamin A while MB method retains relatively low concentration of CLA and vitamins as compared to other two methods.
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Affiliation(s)
- Naveed Ahmad
- Department of Physics, Mirpur University of Science and Technology (MUST), Mirpur, 10250(AJK), Pakistan
| | - M Saleem
- Agri. & Biophotonics Division, National Institute of Lasers and Optronics (NILOP), College Pakistan Institute of Engineering and Applied Sciences (PIEAS), Lehtrar road, Islamabad, Pakistan.
| | - Babar Manzoor Atta
- Agri. & Biophotonics Division, National Institute of Lasers and Optronics (NILOP), College Pakistan Institute of Engineering and Applied Sciences (PIEAS), Lehtrar road, Islamabad, Pakistan
| | - S Mahmood
- Department of Physics, Mirpur University of Science and Technology (MUST), Mirpur, 10250(AJK), Pakistan
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Kopsidas K, Javidi H, Kelly SP, Aslam T, Black G, Mahmood S. Unique Case of Bilateral Exudative Retinal Detachment following Creatine Supplementation in a Patient with Autosomal Dominant Bestrophinopathy. Case Rep Ophthalmol 2019; 10:374-378. [PMID: 31762771 PMCID: PMC6873073 DOI: 10.1159/000503853] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 10/02/2019] [Indexed: 11/19/2022] Open
Abstract
We report a case of bilateral serous retinal detachment in a patient with rod-cone dystrophy caused by mutation of BEST1. This followed creatine monohydrate use as a dietary supplement. A 39-year-old male with rod-cone dystrophy and low hyperopia developed extensive bilateral exudative retinal detachment following creatine monohydrate diet supplementation. Five days after stopping creatine use, the bilateral retinal detachments resolved completely. This may indicate a causative relation of creatine supplementation to development of serous retinal detachment in a susceptible patient with pre-existing retinal dystrophy.
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Affiliation(s)
- Konstantinos Kopsidas
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Hedayat Javidi
- Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Simon P. Kelly
- Department of Ophthalmology, Bolton NHS Foundation Trust, Bolton, United Kingdom
| | - Tariq Aslam
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Graeme Black
- Manchester Centre for Genomic Medicine, University of Manchester, Manchester, United Kingdom
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
- *Sajjad Mahmood, Royal Eye Hospital, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL (UK), E-Mail
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Creer RC, Roberts SA, Aslam TM, Balaskas K, Chhabra R, Mahmood S, Turner GS, Harper RA. Treatment decisions of UK hospital optometrists and ophthalmologists in patients with nAMD: a vignette study. Ophthalmic Physiol Opt 2019; 39:432-440. [DOI: 10.1111/opo.12644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/12/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Rosalind C Creer
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
| | | | - Tariq M Aslam
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
- Division of Optometry and Pharmacy University of Manchester Manchester UK
| | - Konstantinos Balaskas
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
| | - Ramandeep Chhabra
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
| | - George S Turner
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
| | - Robert A Harper
- Manchester Royal Eye Hospital Manchester University NHS Foundation Trust Manchester UK
- Manchester Academic Health Sciences Centre Manchester UK
- Division of Optometry and Pharmacy University of Manchester Manchester UK
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Young JF, Walkden A, Stone A, Mahmood S. Clinical Effectiveness of Intravitreal Fluocinolone Acetonide (FAc) (ILUVIEN™) in Patients with Diabetic Macular Oedema (DMO) Refractory to Prior Therapy: The Manchester Experience. Ophthalmol Ther 2019; 8:477-484. [PMID: 31309417 PMCID: PMC6692423 DOI: 10.1007/s40123-019-0197-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Diabetic macular oedema (DMO) remains a significant cause of sight loss in the UK. Despite macular laser and anti-VEGF agents, a large proportion of patients remain with persistent DMO. We present our results of using 0.19 mg fluocinolone acetonide (FAc) intravitreal implant in this cohort with up to 3 years of follow-up. METHODS This is a single-centre retrospective review of patients treated with FAc implant for refractory DMO. The primary efficacy end point was visual acuity and secondary efficacy end point was central retinal thickness (CRT) on OCT. A primary safety end point was a rise in IOP requiring treatment. RESULTS Twenty-one eyes were identified with an average follow-up of 27 months (6-36 months). Visual acuity change from baseline was - 0.1 ETDRS letters at year 1 (n = 13), 8.1 letters at year 2 (n = 13) and 10.7 letters at year 3 (n = 10). CRT improved by - 132.1 µm at year 1 (n = 15), - 172.8 µm at year 2 (n = 13) and - 157.8 µm at year 3 (n = 10). Five eyes (24%) required further anti-VEGF during follow-up and two (9.5%) required further focal laser. IOP rise requiring treatment was noted in eight eyes (38%). Seven were steroid induced. One was caused by rubeotic glaucoma. Six (75%) were managed medically and the remaining two also required surgery. CONCLUSION This data add to the limited real-world data on FAc in DMO with 3 years of follow-up. Vision and macular architectures both improved at varying rates over 3 years in patients with refractory DMO. IOP rise is a risk but, in the majority, it can be managed medically.
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Affiliation(s)
- James F Young
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - Andrew Walkden
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Amy Stone
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Zeymer U, Ludman P, Danchin N, Kala P, Maggioni AP, Weidinger F, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy VK, Nedoshivin A, Petronio AS, Roos-Hesselink J, Wallentin L, Zeymer U, Weidinger F, Zeymer U, Danchin N, Ludman P, Sinnaeve P, Kala P, Ferrari R, Maggioni AP, Goda A, Zelveian P, Weidinger F, Karamfilov K, Motovska Z, Zeymer U, Raungaard B, Marandi T, Shaheen SM, Lidon RM, Karjalainen PP, Kereselidze Z, Alexopoulos D, Becker D, Quinn M, Iakobishvili Z, Al-Farhan H, Sadeghi M, Caporale R, Romeo F, Mirrakhimov E, Serpytis P, Erglis A, Kedev S, Balbi MM, Moore AM, Dudek D, Legutko J, Mimoso J, Tatu-Chitoiu G, Stojkovic S, Shlyakhto E, AlHabib KF, Bunc M, Studencan M, Mourali MS, Bajraktari G, Konte M, Larras F, Lefrancq EF, Mekhaldi S, Laroche C, Maggioni AP, Goda A, Shuka N, Pavli E, Tafaj E, Gishto T, Dibra A, Duka A, Gjana A, Kristo A, Knuti G, Demiraj A, Dado E, Hasimi E, Simoni L, Siqeca M, Sisakian H, Hayrapetyan H, Markosyan S, Galustyan L, Arustamyan N, Kzhdryan H, Pepoyan S, Zirkik A, Von Lewinski D, Paetzold S, Kienzl I, Matyas K, Neunteufl T, Nikfardjam M, Neuhold U, Mihalcz A, Glaser F, Steinwender C, Reiter C, Grund M, Hrncic D, Hoppe U, Hammerer M, Hinterbuchner L, Hengstenberg C, Delle Karth G, Lang I, Weidinger F, Winkler W, Hasun M, Kastner J, Havel C, Derntl M, Oberegger G, Hajos J, Adlbrecht C, Publig T, Leitgeb MC, Wilfing R, Jirak P, Ho CY, Puskas L, Schrutka L, Spinar J, Parenica J, Hlinomaz O, Fendrychova V, Semenka J, Sikora J, Sitar J, Groch L, Rezek M, Novak M, Kramarikova P, Stasek J, Dusek J, Zdrahal P, Polasek R, Karasek J, Seiner J, Sukova N, Varvarovsky I, Lazarák T, Novotny V, Matejka J, Rokyta R, Volovar S, Belohlavek J, Motovska Z, Siranec M, Kamenik M, Kralik R, Raungaard B, Ravkilde J, Jensen SE, Villadsen A, Villefrance K, Schmidt Skov C, Maeng M, Moeller K, Hasan-Ali H, Ahmed TA, Hassan M, ElGuindy A, Farouk Ismail M, Ibrahim Abd El-Aal A, El-sayed Gaafar A, Magdy Hassan H, Ahmed Shafie M, Nabil El-khouly M, Bendary A, Darwish M, Ahmed Y, Amin O, AbdElHakim A, Abosaif K, Kandil H, Galal MAG, El Hefny EE, El Sayed M, Aly K, Mokarrab M, Osman M, Abdelhamid M, Mantawy S, Ali MR, Kaky SD, Khalil VA, Saraya MEA, Talaat A, Nabil M, Mounir WM, Mahmoud K, Aransa A, Kazamel G, Anwar S, Al-Habbaa A, Abd el Monem M, Ismael A, Amin Abu-Sheaishaa M, Abd Rabou MM, Hammouda TMA, Moaaz M, Elkhashab K, Ragab T, Rashwan A, Rmdan A, AbdelRazek G, Ebeid H, Soliman Ghareeb H, Farag N, Zaki M, Seleem M, Torki A, Youssef M, AlLah Nasser NA, Rafaat A, Selim H, Makram MM, Khayyal M, Malasi K, Madkour A, Kolib M, Alkady H, Nagah H, Yossef M, Wafa A, Mahfouz E, Faheem G, Magdy Moris M, Ragab A, Ghazal M, Mabrouk A, Hassan M, El-Masry M, Naseem M, Samir S, Marandi T, Reinmets J, Allvee M, Saar A, Ainla T, Vaide A, Kisseljova M, Pakosta U, Eha J, Lotamois K, Sia J, Myllymaki J, Pinola T, Karjalainen PP, Paana T, Mikkelsson J, Ampio M, Tsivilasvili J, Zurab P, Kereselidze Z, Agladze R, Melia A, Gogoberidze D, Khubua N, Totladze L, Metreveli I, Chikovani A, Eitel I, Pöss J, Werner M, Constantz A, Ahrens C, Zeymer U, Tolksdorf H, Klinger S, Sack S, Heer T, Lekakis J, Kanakakis I, Xenogiannis I, Ermidou K, Makris N, Ntalianis A, Katsaros F, Revi E, Kafkala K, Mihelakis E, Diakakis G, Grammatikopoulos K, Voutsinos D, Alexopoulos D, Xanthopoulou I, Mplani V, Foussas S, Papakonstantinou N, Patsourakos N, Dimopoulos A, Derventzis A, Athanasiou K, Vassilikos VP, Papadopoulos C, Tzikas S, Vogiatzis I, Datsios A, Galitsianos I, Koutsampasopoulos K, Grigoriadis S, Douras A, Baka N, Spathis S, Kyrlidis T, Hatzinikolaou H, Kiss RG, Becker D, Nowotta F, Tóth K, Szabó S, Lakatos C, Jambrik Z, Ruzsa J, Ruzsa Z, Róna S, Toth J, Vargane Kosik A, Toth KSB, Nagy GG, Ondrejkó Z, Körömi Z, Botos B, Pourmoghadas M, Salehi A, Massoumi G, Sadeghi M, Soleimani A, Sarrafzadegan N, Roohafza H, Azarm M, Mirmohammadsadeghi A, Rajabi D, Rahmani Y, Siabani S, Najafi F, Hamzeh B, Karim H, Siabani H, Saleh N, Charehjoo H, Zamzam L, Al-Temimi G, Al-Farhan H, Al-Yassin A, Mohammad A, Ridha A, Al-Saedi G, Atabi N, Sabbar O, Mahmood S, Dakhil Z, Yaseen IF, Almyahi M, Alkenzawi H, Alkinani T, Alyacopy A, Kearney P, Twomey K, Iakobishvili Z, Shlomo N, Beigel R, Caldarola P, Rutigliano D, Sublimi Saponetti L, Locuratolo N, Palumbo V, Scherillo M, Formigli D, Canova P, Musumeci G, Roncali F, Metra M, Lombardi C, Visco E, Rossi L, Meloni L, Montisci R, Pippia V, Marchetti MF, Congia M, Cacace C, Luca G, Boscarelli G, Indolfi C, Ambrosio G, Mongiardo A, Spaccarotella C, De Rosa S, Canino G, Critelli C, Caporale R, Chiappetta D, Battista F, Gabrielli D, Marziali A, Bernabò P, Navazio A, Guerri E, Manca F, Gobbi M, Oreto G, Andò G, Carerj S, Saporito F, Cimmino M, Rigo F, Zuin G, Tuccillo B, Scotto di Uccio F, Irace L, Lorenzoni G, Meloni I, Merella P, Polizzi GM, Pino R, Marzilli M, Morrone D, Caravelli P, Orsini E, Mosa S, Piovaccari G, Santarelli A, Cavazza C, Romeo F, Fedele F, Mancone M, Straito M, Salvi N, Scarparo P, Severino P, Razzini C, Massaro G, Cinque A, Gaudio C, Barillà F, Torromeo C, Porco L, Mei M, Iorio R, Nassiacos D, Barco B, Sinagra G, Falco L, Priolo L, Perkan A, Strana M, Bajraktari G, Percuku L, Berisha G, Mziu B, Beishenkulov M, Abdurashidova T, Toktosunova A, Kaliev K, Serpytis P, Serpytis R, Butkute E, Lizaitis M, Broslavskyte M, Xuereb RG, Moore AM, Mercieca Balbi M, Paris E, Buttigieg L, Musial W, Dobrzycki S, Dubicki A, Kazimierczyk E, Tycinska A, Wojakowski W, Kalanska-Lukasik B, Ochala A, Wanha W, Dworowy S, Sielski J, Janion M, Janion-Sadowska A, Dudek D, Wojtasik-Bakalarz J, Bryniarski L, Peruga JZ, Jonczyk M, Jankowski L, Klecha A, Legutko J, Michalowska J, Brzezinski M, Kozmik T, Kowalczyk T, Adamczuk J, Maliszewski M, Kuziemka P, Plaza P, Jaros A, Pawelec A, Sledz J, Bartus S, Zmuda W, Bogusz M, Wisnicki M, Szastak G, Adamczyk M, Suska M, Czunko P, Opolski G, Kochman J, Tomaniak M, Miernik S, Paczwa K, Witkowski A, Opolski MP, Staruch AD, Kalarus Z, Honisz G, Mencel G, Swierad M, Podolecki T, Marques J, Azevedo P, Pereira MA, Gaspar A, Monteiro S, Goncalves F, Leite L, Mimoso J, Manuel Lopes dos Santos W, Amado J, Pereira D, Silva B, Caires G, Neto M, Rodrigues R, Correia A, Freitas D, Lourenco A, Ferreira F, Sousa F, Portugues J, Calvo L, Almeida F, Alves M, Silva A, Caria R, Seixo F, Militaru C, Ionica E, Tatu-Chitoiu G, Istratoaie O, Florescu M, Lipnitckaia E, Osipova O, Konstantinov S, Bukatov V, Vinokur T, Egorova E, Nefedova E, Levashov S, Gorbunova A, Redkina M, Karaulovskaya N, Bijieva F, Babich N, Smirnova O, Filyanin R, Eseva S, Kutluev A, Chlopenova A, Shtanko A, Kuppar E, Shaekhmurzina E, Ibragimova M, Mullahmetova M, Chepisova M, Kuzminykh M, Betkaraeva M, Namitokov A, Khasanov N, Baleeva L, Galeeva Z, Magamedkerimova F, Ivantsov E, Tavlueva E, Kochergina A, Sedykh D, Kosmachova E, Skibitskiy V, Porodenko N, Namitokov A, Litovka K, Ulbasheva E, Niculina S, Petrova M, Harkov E, Tsybulskaya N, Lobanova A, Chernova A, Kuskaeva A, Kuskaev A, Ruda M, Zateyshchikov D, Gilarov M, Konstantinova E, Koroleva O, Averkova A, Zhukova N, Kalimullin D, Borovkova N, Tokareva A, Buyanova M, Khaisheva L, Pirozhenko A, Novikova T, Yakovlev A, Tyurina T, Lapshin K, Moroshkina N, Kiseleva M, Fedorova S, Krylova L, Duplyakov D, Semenova Y, Rusina A, Ryabov V, Syrkina A, Demianov S, Reitblat O, Artemchuk A, Efremova E, Makeeva E, Menzorov M, Shutov A, Klimova N, Shevchenko I, Elistratova O, Kostyuckova O, Islamov R, Budyak V, Ponomareva E, Ullah Jan U, Alshehri AM, Sedky E, Alsihati Z, Mimish L, Selem A, Malik A, Majeed O, Altnji I, AlShehri M, Aref A, AlHabib K, AlDosary M, Tayel S, Abd AlRahman M, Asfina KN, Abdin Hussein G, Butt M, Markovic Nikolic N, Obradovic S, Djenic N, Brajovic M, Davidovic A, Romanovic R, Novakovic V, Dekleva M, Spasic M, Dzudovic B, Jovic Z, Cvijanovic D, Veljkovic S, Ivanov I, Cankovic M, Jarakovic M, Kovacevic M, Trajkovic M, Mitov V, Jovic A, Hudec M, Gombasky M, Sumbal J, Bohm A, Baranova E, Kovar F, Samos M, Podoba J, Kurray P, Obona T, Remenarikova A, Kollarik B, Verebova D, Kardosova G, Studencan M, Alusik D, Macakova J, Kozlej M, Bayes-Genis A, Sionis A, Garcia Garcia C, Lidon RM, Duran Cambra A, Labata Salvador C, Rueda Sobella F, Sans Rosello J, Vila Perales M, Oliveras Vila T, Ferrer Massot M, Bañeras J, Lekuona I, Zugazabeitia G, Fernandez-Ortiz A, Viana Tejedor A, Ferrera C, Alvarez V, Diaz-Castro O, Agra-Bermejo RM, Gonzalez-Cambeiro C, Gonzalez-Babarro E, Domingo-Del Valle J, Royuela N, Burgos V, Canteli A, Castrillo C, Cobo M, Ruiz M, Abu-Assi E, Garcia Acuna JM. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry. European Heart Journal - Quality of Care and Clinical Outcomes 2019; 6:100-104. [DOI: 10.1093/ehjqcco/qcz042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022]
Abstract
Abstract
Aims
The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.
Methods and results
Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.
Conclusion
The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
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Affiliation(s)
- Uwe Zeymer
- Hospital of the City of Ludwigshafen, Medical Clinic B and Institute of Heart Attack Research, Ludwigshafen on the Rhine, Germany
| | - Peter Ludman
- Institute of Cardiovascular Sciences, Birmingham University, Birmingham, UK
| | - Nicolas Danchin
- Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Petr Kala
- Internal Cardiology Department, University Hospital Brno, Czech Republic
| | - Aldo P Maggioni
- EURObservational Research Programme, ESC, Sophia Antipolis, France
- ANMCO Research Center, Florence, Italy
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Mahmood S, Dixon WT, Bruce HL. Cattle production practices and the incidence of dark cutting beef. Meat Sci 2019; 157:107873. [PMID: 31255898 DOI: 10.1016/j.meatsci.2019.107873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 01/27/2023]
Abstract
The effects of cattle sex, production system, growth promotant use, slaughter season, carcass phenotype, and pre-slaughter cattle management on the incidence of beef carcasses grading Canada B4 (dark cutting) were investigated using two data sets (A, n = 2009, and B, n = 86,408) containing data from cattle that produced Canada Prime, AAA, AA, A, and B4 carcasses. The probability of producing a Canada B4 carcass was greater (P < .0001) for heifers than steers in both data sets, with the likelihood of dark cutting decreasing with increased carcass weight in heifers in data set B. The incidence of dark cutting was increased (P < .0001) in Winter-born calf-fed (WC) and Fall-born calf-fed (FC) heifers. Production system and phenotype appear to interact to influence the incidence of dark cutting.
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Affiliation(s)
- S Mahmood
- Department of Agricultural, Food and Nutritional Science, 410 Agriculture/Forestry Building, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada
| | - W T Dixon
- Department of Agricultural, Food and Nutritional Science, 410 Agriculture/Forestry Building, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada
| | - H L Bruce
- Department of Agricultural, Food and Nutritional Science, 410 Agriculture/Forestry Building, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada.
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Jain N, Mahmood S, Shellikeri S, Cahill A, Krishnamurthy G, Srinivasan A. 04:03 PM Abstract No. 303 Percutaneous image-guided bone biopsy for suspected pediatric osteomyelitis. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.369] [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: 12/01/2022] Open
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Mahmood S, Zakaria M, Abdul Razak I, Yusof L, Abubakar A, Mahmood Z, Bin Ab Latip M. In Vivo evaluation of the novel nanocomposite porous 3D scaffold in a rabbit model: hematology and biochemistry analysis. IJVS 2019. [DOI: 10.33899/ijvs.2019.153853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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49
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Patel S, Mahmood S, Nguyen T, Yeap B, Jimenez R, Meyersohn N, Neilan T, MacDonald S. Comparing Whole Heart Versus Coronary Artery Dosimetry in Predicting the Risk of Cardiac Toxicity Following Breast Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.091] [Citation(s) in RCA: 6] [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] [Indexed: 11/16/2022]
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50
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Amoaku W, Balaskas K, Cudrnak T, Downey L, Groppe M, Mahmood S, Mehta H, Mohamed Q, Mushtaq B, Severn P, Vardarinos A, Yang Y, Younis S. Initiation and maintenance of a Treat-and-Extend regimen for ranibizumab therapy in wet age-related macular degeneration: recommendations from the UK Retinal Outcomes Group. Clin Ophthalmol 2018; 12:1731-1740. [PMID: 30237693 PMCID: PMC6136415 DOI: 10.2147/opth.s174560] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 01/28/2023] Open
Abstract
The treatment of neovascular (wet) age-related macular degeneration (AMD) with ranibizumab is now very well established in terms of efficacy and safety. Recent clinical trials and real-world studies have demonstrated the advantages of a Treat-and-Extend (T&E) regimen, and many hospital departments are now in the process of adopting this new regimen in favor of the pro re nata regimen for initiating and continuing ranibizumab therapy for patients with wet AMD. The comprehensive spectrum of issues related to implementation of the regimen is covered qualitatively in ten didactic topics provided by a group of clinicians with direct experience of this regimen in their department. The topics include definition, new and previously treated eyes, management of high-frequency injections, maximum extensions, discontinuing T&E, bilateral cases, clerical, audit, and patient counseling. This article aims to provide a useful resource for the implementation of the T&E regimen. A quantitative summary of the visual outcomes in key publications is also provided in this article. This article should be a valuable resource for staff training.
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Affiliation(s)
- Winfried Amoaku
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Konstantinos Balaskas
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and University College of London Institute of Ophthalmology, London, UK.,University of Manchester, Manchester, UK
| | - Tomas Cudrnak
- Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Louise Downey
- Hull and East Yorkshire Eye Hospital, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Markus Groppe
- Ophthalmology, Stoke Mandeville, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | - Sajjad Mahmood
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Hemal Mehta
- Royal Free London NHS Foundation Trust, London, UK
| | - Quresh Mohamed
- Gloucestershire Eye Unit, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Bushra Mushtaq
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Philip Severn
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Athanasios Vardarinos
- Eye Treatment Centre, West Suffolk Hospital, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK
| | - Yit Yang
- Wolverhampton Eye Infirmary, The Royal Wolverhampton NHS Trust, Wolverhampton, UK,
| | - Saad Younis
- Ophthalmology, Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK
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