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Ahmed A, Hossain L, Banik G, Sayeed A, Sajib MRUZ, Hasan MM, Hoque DE, Hasan ASM, Raghuyamshi V, Zaman S, Akter E, Nusrat N, Rahman F, Raza S, Hasan MR, Uddin J, Sarkar S, Adnan SD, Rahman A, Ameen S, Jabeen S, El Arifeen S, Rahman AE. Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh. J Hosp Infect 2024; 145:22-33. [PMID: 38157940 DOI: 10.1016/j.jhin.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION The integrated intervention package improved IPCAF score in all facilities.
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Affiliation(s)
- A Ahmed
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - L Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - G Banik
- Health and Nutrition Sector, Save the Children, Dhaka, Bangladesh
| | - A Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R U-Z Sajib
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois Urbana-Champaign, USA
| | - M M Hasan
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | | | - E Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - N Nusrat
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - F Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Raza
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R Hasan
- Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh
| | - J Uddin
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - S Sarkar
- Hospital Service Management, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S D Adnan
- Hospital and Clinics, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - A Rahman
- Communicable Disease Control, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S Ameen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Jabeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A E Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Tarar ZI, Farooq U, Zafar Y, Gandhi M, Raza S, Kamal F, Tarar MF, Ghouri YA. Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: a nationwide analysis. Ir J Med Sci 2023; 192:2159-2166. [PMID: 36593438 DOI: 10.1007/s11845-022-03258-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIM Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder that affects patients both physically and mentally. Our study aimed to investigate the burden of psychiatric disorders in IBS patients. METHODS We conducted a retrospective analysis of the National inpatient sample (NIS) from 2016 to 2019. We recruited patients admitted with a diagnosis of IBS and determined the prevalence of anxiety, depression, and suicide attempt/ideation. RESULTS We found a total of 1,256,325 hospitalizations with a diagnosis of IBS. Among them, 478,515 (38.1%) had anxiety and 344,165 (27.4%) had depression. The prevalence of psychiatric disorders including anxiety (38.1% vs. 15.1%), depression (38.1% vs. 15.1%), bipolar disorder (5.22% vs. 2.38%), suicidal attempt/Ideation (3.22% vs. 2.38%), and eating disorder (0.32% vs. 0.08%) was significantly higher in IBS patient population when compared to general adult population (p < 0.001). Patients with IBS had greater odds of anxiety (AOR 2.88, 95% CI 2.85-2.91, P < 0.001), depression (AOR 2.16, 95% CI 2.14-2.19, P < 0.001) and suicidal attempt/ideation (AOR 1.94, 95% CI 1.88-2.00, P < 0.001) in comparison to general population. IBS subtypes including diarrhea-predominant, constipation-predominant and mixed type were independently associated with increased odds of anxiety, depression, and suicide attempt/ideation. Patients with IBS and a co-diagnosis of anxiety or depression had increased mean length of hospital stay by 0.48 (95% CI 0.43-0.52, P < 0.001) and 0.52 (95% CI 0.06-0.97, P < 0.03) days, respectively. CONCLUSION The presence of IBS is associated with an increased associated prevalence of psychiatric disorders such as anxiety, depression, and suicide attempt/ideation.
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Affiliation(s)
- Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA.
| | - Umer Farooq
- Rochester General Hospital, Rochester, NY, USA
| | - Yousaf Zafar
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Samina Raza
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Faisal Kamal
- Department of Gastroenterology, University of California, San Francisco, USA
| | - Moosa F Tarar
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Yezaz A Ghouri
- Division of Gastroenterology & Hepatology, School of Medicine at Columbia, University of Missouri, Columbia, MO, USA
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Jonasch D, Raza S, Voutsinas N. Abstract No. 176 Influence of Clinical and Procedural Factors on Rate of Cholecystostomy Tube Dislodgement and Other Complications. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.232] [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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Talenfeld C, Lansing A, Clarke K, Wright G, Lee D, Ghosh S, Raza S, Zhang Y, McClure T. Abstract No. 542 Microwave Ablation versus Cryoablation for T1a Renal Cell Carcinoma: A Systematic Literature Review and Meta-Analysis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.400] [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: 02/26/2023] Open
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5
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Khan ZW, Bains N, Raza S, French BR, Siddiq F, Chandrasekaran PN, Gomez CR, Qureshi AI. Abstract TP130: Effect Of Antifibrinolytic Medication On Hematoma Expansion In Acute Ischemic Stroke Patients With Post Thrombolytic Intracerebral Hemorrhages. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tp130] [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: 02/05/2023]
Abstract
Background and Purpose:
Antifibrinolytic medications such as the synthetic lysine analogs tranexamic acid and ε-aminocaproic acid inhibit fibrinolysis by attaching to the lysine-binding site of the plasminogen molecule. However, the efficacy of intravenous (IV) antifibrinolytic medication in the prevention of hematoma expansion in acute ischemic stroke patients who develop post thrombolytic intracerebral hemorrhage (ICH) is unclear.
Methods:
We analyzed the effect of antifibrinolytic medication in acute ischemic stroke patients with post thrombolytic ICH on hematoma expansion over an 8-year period. The Region-of-Interest; method on a Horos Medical Image Viewer (Version 3.3.6) was utilized for hematoma volume measurement on serial computed tomographic scans. We compared changes in hemorrhage volume in patients who did and did not receive IV antifibrinolytic medication.
Results:
A total of 53 patients (mean age 69.7±14.3, 53% were men) with post thrombolytic ICH were analyzed. Twenty-six patients received antifibrinolytic treatment: 20 and 6 patients received a single IV dose of ε-aminocaproic acid (5 g) or tranexamic acid (1 g), respectively. Ten patients (38%) had a reduction or stabilization in hematoma volume (overall pre and post-treatment volumes were 17.43±16.23 cm3 and 25.14±26.57 cm3 respectively). Mean fibrinogen level in the antifibrinolytic medication group was 277 mg/dL; 3 patients had levels <200 mg/dL. In patients that did not receive antifibrinolytics, 16 (59%) out of 27 patients had a reduction or stabilization in hematoma volume (overall pre and post-treatment volumes were 19.74±32.32 cm3 and 27.15±52.58 cm3 respectively). The mean percent change in hematoma volume with antifibrinolytic medication treatment was 48% and without was 27%. [Figure 1]
Conclusion:
We did not identify any reduction in any of the measures of hematoma expansion with antifibrinolytic treatment in acute ischemic stroke patients with post thrombolytic ICH.
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Affiliation(s)
| | | | | | | | - Farhan Siddiq
- Neurological Surgery, Univ of Missouri, Columbia, MO
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Curtis F, Li L, Kolanko M, Lai H, Daniels S, True J, Del Giovane M, Golemme M, Lyall R, Raza S, Hassim N, Patel A, Beal E, Walsh C, Purnell M, Whitethread N, Nilforooshan R, Norman C, Wingfield D, Barnaghi P, Sharp D, Dani M, Fertleman M, Parkinson M. 1362 ANTICHOLINERGIC PRESCRIBING HABITS AND ITS ASSOCIATIONS IN A COMMUNITY POPULATION OF PEOPLE LIVING WITH DEMENTIA. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.039] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Many commonly prescribed medications have inadvertent anticholinergic effects. People with Dementia (PwD) are more vulnerable to these effects and at risk of adverse outcomes, the risk being higher with a greater degree of anticholinergic exposure. We investigated prescribing patterns and Anticholinergic burden (ACB) in a cohort of community-dwelling older adults with dementia and aimed to explore the effect of ACB on cognition, mood, and quality of life(QoL).
Method
The medication and demographic information for 87 (39 female) community-dwelling PwD were obtained from Electronic Care Summaries. We used the German Anticholinergic Burden Scale (GABS) to measure ACB. Additionally, we investigated associations between ACB and cognitive (ADAS-Cog), functional (BADL) and QoL (DemQoL) assessments.
Results
28.7% of participants had a clinically significant score (ACB> 2). The most commonly prescribed medications with ACB were Lansoprazole(18.3%), Mirtazapine(12.6%) and Codeine(12.6%). ACB was higher in males and negatively correlated with age, r(87)=-.21,p=.03. There was no association between ACB and cognition, QoL, functional independence, and neuropsychiatric symptoms. Over six months, PLWD with no ACB had a greater negative change in neuropsychiatric symptoms[t(18)=2.27,p=.04] and functional independence[t(23)=-3.8,p=.001], indicating greater dependence and worsening neuropsychiatric symptoms.
Conclusion
A third of PLWD in the community had clinically significant ACB. No ACB was associated with worsening neuropsychiatric symptoms and functional dependence over a six-month period. Community prescribers should consider regular medication reviews with PLWD and carers to ensure medications are prescribed safely and appropriately.
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Affiliation(s)
- F Curtis
- Imperial College London , Department of Brain Sciences
| | - L Li
- Imperial College London , Department of Brain Sciences
| | - M Kolanko
- Imperial College London , Department of Brain Sciences
| | - H Lai
- Imperial College London , Department of Brain Sciences
| | - S Daniels
- Imperial College London , Department of Brain Sciences
| | - J True
- Imperial College London , Department of Brain Sciences
| | - M Del Giovane
- Imperial College London , Department of Brain Sciences
| | - M Golemme
- Imperial College London , Department of Brain Sciences
| | - R Lyall
- Imperial College London , Department of Brain Sciences
| | - S Raza
- Imperial College London , Department of Brain Sciences
| | - N Hassim
- Imperial College London , Department of Brain Sciences
| | - A Patel
- Imperial College London , Department of Brain Sciences
| | - E Beal
- Imperial College London , Department of Brain Sciences
| | - C Walsh
- Imperial College London , Department of Brain Sciences
| | - M Purnell
- Imperial College London , Department of Brain Sciences
| | - N Whitethread
- Imperial College London , Department of Brain Sciences
| | | | - C Norman
- Imperial College London , Department of Brain Sciences
| | - D Wingfield
- Imperial College London , Department of Brain Sciences
| | - P Barnaghi
- Imperial College London , Department of Brain Sciences
| | - D Sharp
- Imperial College London , Department of Brain Sciences
| | - M Dani
- Imperial College London , Department of Brain Sciences
| | - M Fertleman
- Imperial College London , Department of Brain Sciences
| | - M Parkinson
- UK DRI Centre for Care Research and Technology
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Khan T, Raza S, Lawrence AJ. Medicinal Utility of Thiosemicarbazones with Special Reference to Mixed Ligand and Mixed Metal Complexes: A Review. RUSS J COORD CHEM+ 2022. [DOI: 10.1134/s1070328422600280] [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: 12/31/2022]
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8
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Niu J, Milhem M, Vanderwalde A, Chmielowski B, Beasley G, Samson A, Sacco J, Bowles T, Jew T, He S, Raza S, Harrington K, Middleton M. Safety and Efficacy of RP1 + Nivolumab in Patients with Non-Melanoma Skin Cancer of the Head and Neck: Results From IGNYTE Phase 1/2 Multi-Cohort Clinical Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Huynh L, Raza S, Deibert C. Self-reported Post-vasectomy Fournier's Gangrene Complication Among Practitioners. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Emamekhoo H, Patel S, Rodriguez E, Riaz M, Giaccone G, Furqan M, Sacco J, Bommareddy P, Raza S, He S, Harrington K, Middleton M. IGNYTE: A Phase 1/2 Multi-Cohort Clinical Trial of RP1 ± Nivolumab in Patients with Non-Small Cell Lung Cancer and Other Solid Tumors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.10.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Eftekhari H, Maddock H, Pearce G, Raza S, Kavi L, Lim PB, Osman F, Hayat SA. Understanding the future research needs in Postural Orthostatic Tachycardia Syndrome (POTS): Evidence mapping the POTS adult literature. Auton Neurosci 2021; 233:102808. [PMID: 33901811 DOI: 10.1016/j.autneu.2021.102808] [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: 10/13/2020] [Revised: 03/15/2021] [Accepted: 03/27/2021] [Indexed: 01/01/2023]
Abstract
POTS is under diagnosed with an estimated prevalence of 0.2%. North American and Australian researchers, as well as patient groups have called for more research into POTS. However, there has been no comprehensive appraisal of the current POTS evidence base. AIM To map the POTS evidence base. METHODS Two reviewers systematically searched 12 databases until July 1st 2019 using the search term "Postural Tachycardia Syndrome" (n = 7280) and categorised the literature. Inclusion criteria included all adult published literature with no language restrictions. 779 papers are analysed and mapped. RESULTS Seven themes were identified: symptomology and quality of life 16.8% (n = 132), biomedical topics 16.5% (n = 130), co-morbidities 10.3% (n = 81), non-pharmacological management 9.8% (n = 77), aetiologies 6.9% (n = 53), pharmacological management 6.7% (n = 53), and clinical management 6.6% (n = 52). There 45 subthemes. Quality appraisal of the research studies (n = 233) evaluated design, sample size, outcome measures, data analysis and research biases. 74.8% (n = 175) were observational designs and 25.2% (n = 59) were experimental designs (16 using a randomised controlled design, 11 of which had a sample size greater than 21). 47.4% (n = 111) of studies only measured duration of effect for <1 day. 11.5% (n = 27) of studies reported outcomes using an unvalidated subjective measurement tool. CONCLUSION The volume of adult POTS literature is small and the validity and reliability of the research lacks rigour. The evidence map methodology provides POTS researchers with a benchmark for research thus far. This paper adds an in-depth research appraisal to the broad calls for action, highlighting the pressing need for multicentre, good quality research in POTS, to support guidelines and consensus development in the future.
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Affiliation(s)
- H Eftekhari
- University Hospitals Coventry & Warwickshire NHS Trust, United Kingdom of Great Britain and Northern Ireland.
| | - H Maddock
- Faculty of Health and Life Sciences, Coventry University, United Kingdom of Great Britain and Northern Ireland.
| | - G Pearce
- Faculty of Health and Life Sciences, Coventry University, United Kingdom of Great Britain and Northern Ireland.
| | - S Raza
- Biomedical Sciences, Coventry University, United Kingdom of Great Britain and Northern Ireland.
| | - L Kavi
- PoTS UK, United Kingdom of Great Britain and Northern Ireland.
| | - P B Lim
- Imperial College NHS Healthcare Trust, United Kingdom of Great Britain and Northern Ireland.
| | - F Osman
- University Hospitals Coventry & Warwickshire NHS Trust, United Kingdom of Great Britain and Northern Ireland; Warwick Medical School, University of Warwick, Coventry, United Kingdom of Great Britain and Northern Ireland.
| | - S A Hayat
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
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Xie N, Zhang J, Raza S, Zhang N, Chen X, Wang D. Generation of low-symmetry perovskite structures for ab initio computation. J Phys Condens Matter 2020; 32:315901. [PMID: 32163934 DOI: 10.1088/1361-648x/ab7f6a] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Ion displacements are the fundamental cause of ferroelectricity in perovskites. By properly shifting ions, ab initio computations have been extensively used to investigate the properties of perovskites in various structural phases. In addition to the relatively simple ion displacements, perovskites have another type of structural distortion known as antiferrodistortion or oxygen octahedron tilting. The interplay between these two types of distortions have generated abundant structural phases that can be tedious to prepare for ab initio computation, especially for large supercells. Here, we design and implement a computer program to facilitate the generation of distorted perovskite structures, which can be readily used for ab initio computation to gain further insight into the perovskite of a given structural phase.
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Affiliation(s)
- N Xie
- School of Microelectronics & State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
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Matthiae M, Nielsen KES, Larroche A, Zhou C, Kristensen A, Raza S. Probing optical resonances of silicon nanostructures using tunable-excitation Raman spectroscopy. Opt Express 2019; 27:38479-38492. [PMID: 31878614 DOI: 10.1364/oe.385088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
Optical materials with a high refractive index enable effective manipulation of light at the nanoscale through strong light confinement. However, the optical near field, which is mainly confined inside such high-index nanostructures, is difficult to probe with existing measurement techniques. Here, we exploit the connection between Raman scattering and the stored electric energy to detect resonance-induced near-field enhancements in silicon nanostructures. We introduce a Raman setup with a wavelength-tunable laser, which allows us to tune the Raman excitation wavelength and thereby identify Fabry-Pérot and Mie type resonances in silicon thin films and nanodisk arrays, respectively. We measure the optical near-field enhancement by comparing the Raman response on and off resonance. Our results show that tunable-excitation Raman spectroscopy can be used as a complimentary far-field technique to reflection measurements for nanoscale characterization and quality control. As proof-of-principle for the latter, we demonstrate that Raman spectroscopy captures fabrication imperfections in the silicon nanodisk arrays, enabling an all-optical quality control of metasurfaces.
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Pace L, Dusengimana J, Rugema V, Hategekimana V, Bigirimana J, Shyirambere C, Shabani K, Butonzi J, Raja S, Umwizerwa A, Shulman L, Sebahungu F, Muvugabigwi G, Mpunga T, Raza S. Early Clinical Impact of Diagnostic Breast Ultrasound Performed by General Practitioners and Nurses in Rwanda. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.49400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diagnostic breast ultrasound (US) could be an important tool for early detection of breast cancer in low-resource settings, where efficient strategies to refine the likelihood of malignancy among palpable breast masses are needed. However, the feasibility and clinical role of diagnostic ultrasound in such settings has not been described. We trained 4 general practitioner doctors (GPs) and 5 nurses in diagnostic breast US at a rural district hospital in Rwanda that serves as a cancer referral facility. Aim: Assess management plans, biopsy rates and patient diagnoses after nurse- and GP-performed breast ultrasounds to determine the impact of diagnostic US on clinical care. Methods: We reviewed outcomes from trainees' ultrasounds during 21 months of in-person and electronic training and mentorship by Boston-based radiologists. Trainees' US assessments and management plans were recorded on structured clinical forms. Patient diagnoses and follow-up were extracted from medical records using a standardized data collection form. Among patients who received breast US, we examined a) clinicians' management plans; b) biopsy rate; c) cancer detection rate; c) rate of benign diagnoses; d) cancers diagnosed among patients who were sent home after initial evaluation. Results: Between January 1, 2016 and September 30, 2017, 307 patients with breast concerns had a diagnostic breast US and a documented trainee US assessment. Of these, following their initial US, 158 (51%) were recommended to receive a biopsy, 30 (10%) were recommended to have aspiration/drainage, 49 (16%) were recommended for clinical or US surveillance, 1 (0.3%) was referred to another facility, 65 (21%) were discharged, and 4 (all with no abnormalities on US) had missing recommendations. Of those recommended for biopsy at initial presentation, 151 (96%) had a biopsy at that time. 56 (37%) were diagnosed with breast cancer, 37 (25%) with fibroadenoma, 7 (5%) with lactating adenoma, and 50 (33%) with other benign diagnoses. Among those with breast masses on US (n=255), 149 (58%) received a biopsy and 55 (22%) were diagnosed with cancer. As of November 23, 2017, all patients ultimately diagnosed with cancer had had a biopsy at their initial visit, and no patients who had been discharged or recommended for clinical or radiographic surveillance had been subsequently diagnosed with cancer. Conclusion: Diagnostic breast US by GPs and nurses has been a useful tool in the evaluation of breast lesions, including palpable masses, at a rural cancer facility in Rwanda. Early findings suggest that it has allowed avoidance of biopsy for 42% of patients with breast masses noted on US. Clinical follow-up and evaluation are ongoing to assess longer-term patient outcomes, cancer detection rates among patients who are not initially biopsied, and rates of follow-up among patients recommended to have clinical or radiographic surveillance.
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Affiliation(s)
- L.E. Pace
- Brigham and Women's Hospital, Boston, MA
| | | | - V. Rugema
- Brigham and Women's Hospital, Boston, MA
| | | | | | | | - K. Shabani
- Brigham and Women's Hospital, Boston, MA
| | - J. Butonzi
- Brigham and Women's Hospital, Boston, MA
| | - S.C. Raja
- Brigham and Women's Hospital, Boston, MA
| | | | | | | | | | - T. Mpunga
- Brigham and Women's Hospital, Boston, MA
| | - S. Raza
- Brigham and Women's Hospital, Boston, MA
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Rugema V, Pace L, Mpunga T, Dusengimana J, Frost E, Umwizerwa A, Huang C, Hategekimana V, Shabani K, Bigirimana J, Butonzi J, Sebahungu F, Kwait D, Shulman L, Shyirambere C, Raza S. Impact of In-Person and Electronic Training by Breast Radiologists on Rwandan General Practitioners' and Nurses' Skills in Diagnostic Breast Ultrasound. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.16400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Ultrasound (US) is a key tool in evaluation of palpable breast masses and can help refine the likelihood of malignancy and the need for further diagnostic studies. US technology is available in many low-resource settings, but there are few specialized radiologists. We launched a diagnostic breast ultrasound training program for general practitioner doctors (GPs) and nurses at a rural Rwandan district hospital that serves as a cancer referral facility. Aim: Assess GPs' and nurses' skill in diagnostic breast ultrasound over 23 months of intensive in-person and online supervision and mentorship. Methods: 4 rotating breast radiologists from Brigham and Women's Hospital trained 5 nurses and 4 doctors in Rwanda over 9 weeks of in-person training and 21 months of weekly remote case consultations and mentorship using electronic review of images with emailed feedback. During in-person trainings, trainees and radiologists evaluated patients separately, while radiologists' electronic assessments were based on emailed images and assessments from trainees. Among breast lesions with documented radiologist and trainee assessments, we compared written trainee and radiologist assessments to calculate the sensitivity of trainee assessments, with radiologist assessments as the gold standard. We used paired t-tests to examine whether the sensitivity varied between the first 14 months (stage I) and the last 9 months (stage 2), after the final in-person training. Results: Of 323 breast and axillary lesions assessed by trainees and radiologists, 279 were breast lesions. Of these, 114 (41%) were evaluated by radiologists in-person, and 165 (59%) through electronic evaluation. 237 (85%) were determined to be breast masses by the radiologists, with 164 of these solid masses, 25 complex solid/cystic lesions, 15 definite or probable simple cysts, 31 normal intramammary lymph nodes, and 2 other masses. Sensitivity of trainees' assessments for identifying a solid mass was 90.2% (95% CI 85.9-94.9) overall. Among trainees who scanned ≥ 10 lesions each, mean sensitivity was 90.6% in stage I, and 94.0% in stage 2 ( P = 0.3). In cases where both radiologists and trainees perceived solid masses (n=148), trainees' assessments had a sensitivity of 81.4% (95% CI 72.3-90.5) overall for detecting masses suspicious for malignancy, or probably benign but needing further evaluation (versus benign with no further evaluation needed). Among trainees who scanned ≥ 10 lesions each, sensitivity was 79.1% during stage I and 96.2% during the stage 2 ( P = 0.03). Conclusion: Nurses and GPs in a rural sub-Saharan African facility built strong skills in diagnostic ultrasound over 23 months of combined in-person training and distance learning via electronic case reviews. The sensitivity of their assessments for identifying masses concerning for malignancy showed significant improvement after sustained mentorship. Assessment of impact on patient care and outcomes is ongoing.
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Affiliation(s)
- V. Rugema
- Ministry of Health, Rwanda, Butaro, Rwanda
| | - L.E. Pace
- Ministry of Health, Rwanda, Butaro, Rwanda
| | - T. Mpunga
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | - E. Frost
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | - C.C. Huang
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | - K. Shabani
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | - J. Butonzi
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | - D. Kwait
- Ministry of Health, Rwanda, Butaro, Rwanda
| | | | | | - S. Raza
- Ministry of Health, Rwanda, Butaro, Rwanda
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Hurvitz S, Galsky M, Shahidi J, Zhang G, Raza S, Necchi A. A phase Ib, multicenter, open-label study of the antibody-drug conjugate trastuzumab deruxtecan (DS-8201a) combination with nivolumab for advanced HER2-expressing breast or urothelial cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsai J, Phan D, Lee H, Raza S, Graham J, Levy M, Tucker M. Rate of development of euploid blastocyst affects clinical outcomes of frozen embryo transfer. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sotiriou A, Patel HC, Tyebally S, Raza S, Qudah T, Malik K, Patel K, Bhattacharyya S, Hayward C. 134Implantable cardioverter defibrillator use in octogenarians. Europace 2017. [DOI: 10.1093/europace/eux283.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sotiriou A, Patel HC, Tyebally S, Raza S, Qudah T, Malik K, Patel K, Bhattacharyya S, Chow A, Hayward C. 60Is this the beginning of the end for warfarin? Europace 2017. [DOI: 10.1093/europace/eux283.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tyebally S, Patel K, Raza S, Qudah T, Patel H, Primus C, Bhattarcharyya S, Hayward C. P2614The effect of age on the prevalence of aortic stenosis in a large retrospective echocardiographic study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tyebally S, Patel K, Raza S, Qudah T, Patel H, Primus C, Bhattarcharyya S, Hayward C. P624Trends in the prescribing of drugs to prevent cardiovascular disease (CVD) in England between 1998-2015. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Koprivanac M, Pham D, Raza S, Meyer D, Klodell C, Salerno C, Kelava M, Chow J, Graham J, Moazami N. An Evaluation of Long-Term Durability of the Motor and Driveline of the HVAD System. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok J, Woodman T, Deguara J, Garcea G, Babu BI, Dennison AR, Malde D, Lloyd D, Satheesan S, Al-Taan O, Boddy A, Slavin JP, Jones RP, Ballance L, Gerakopoulos S, Jambulingam P, Mansour S, Sakai N, Acharya V, Sadat MM, Karim L, Larkin D, Amin K, Khan A, Law J, Jamdar S, Smith SR, Sampat K, M O'shea K, Manu M, Asprou FM, Malik NS, Chang J, Johnstone M, Lewis M, Roberts GP, Karavadra B, Photi E, Hewes J, Gould L, Chambers A, Rodriguez D, O'Reilly DA, Rate AJ, Sekhar H, Henderson LT, Starmer BZ, Coe PO, Tolofari S, Barrie J, Bashir G, Sloane J, Madanipour S, Halkias C, Trevatt AEJ, Borowski DW, Hornsby J, Courtney MJ, Virupaksha S, Seymour K, Robinson S, Hawkins H, Bawa S, Gallagher PV, Reid A, Wood P, Finch JG, Parmar J, Stirland E, Gardner-Thorpe J, Al-Muhktar A, Peterson M, Majeed A, Bajwa FM, Martin J, Choy A, Tsang A, Pore N, Andrew DR, Al-Khyatt W, Taylor C, Bhandari S, Chambers A, Subramanium D, Toh SKC, Carter NC, Mercer SJ, Knight B, Tate S, Pearce B, Wainwright D, Vijay V, Alagaratnam S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, Rajaganeshan R, Hancorn K, Hargreaves A, Prasad R, Longbotham DA, Vijayanand D, Wijetunga I, Ziprin P, Nicolay CR, Yeldham G, Read E, Gossage JA, Rolph RC, Ebied H, Phull M, Khan MA, Popplewell M, Kyriakidis D, Hussain A, Henley N, Packer JR, Derbyshire L, Porter J, Appleton S, Farouk M, Basra M, Jennings NA, Ali S, Kanakala V, Ali H, Lane R, Dickson-Lowe R, Zarsadias P, Mirza D, Puig S, Al Amari K, Vijayan D, Sutcliffe R, Marudanayagam R, Hamady Z, Prasad AR, Patel A, Durkin D, Kaur P, Bowen L, Byrne JP, Pearson KL, Delisle TG, Davies J, Tomlinson MA, Johnpulle MA, Slawinski C, Macdonald A, Nicholson J, Newton K, Mbuvi J, Farooq A, Sidhartha Mothe B, Zafrani Z, Brett D, Francombe J, Spreadborough P, Barnes J, Cheung M, Al-Bahrani AZ, Preziosi G, Urbonas T, Alberts J, Mallik M, Patel K, Segaran A, Doulias T, Sufi PA, Yao C, Pollock S, Manzelli A, Wajed S, Kourkulos M, Pezzuto R, Wadley M, Hamilton E, Jaunoo S, Padwick R, Sayegh M, Newton RC, Hebbar M, Farag SF, Spearman J, Hamdan MF, D'Costa C, Blane C, Giles M, Peter MB, Hirst NA, Hossain T, Pannu A, El-Dhuwaib Y, Morrison TEM, Taylor GW, Thompson RLE, McCune K, Loughlin P, Lawther R, Byrnes CK, Simpson DJ, Mawhinney A, Warren C, McKay D, McIlmunn C, Martin S, MacArtney M, Diamond T, Davey P, Jones C, Clements JM, Digney R, Chan WM, McCain S, Gull S, Janeczko A, Dorrian E, Harris A, Dawson S, Johnston D, McAree B, Ghareeb E, Thomas G, Connelly M, McKenzie S, Cieplucha K, Spence G, Campbell W, Hooks G, Bradley N, Hill ADK, Cassidy JT, Boland M, Burke P, Nally DM, Hill ADK, Khogali E, Shabo W, Iskandar E, McEntee GP, O'Neill MA, Peirce C, Lyons EM, O'Sullivan AW, Thakkar R, Carroll P, Ivanovski I, Balfe P, Lee M, Winter DC, Kelly ME, Hoti E, Maguire D, Karunakaran P, Geoghegan JG, Martin ST, McDermott F, Cross KS, Cooke F, Zeeshan S, Murphy JO, Mealy K, Mohan HM, Nedujchelyn Y, Fahad Ullah M, Ahmed I, Giovinazzo F, Milburn J, Prince S, Brooke E, Buchan J, Khalil AM, Vaughan EM, Ramage MI, Aldridge RC, Gibson S, Nicholson GA, Vass DG, Grant AJ, Holroyd DJ, Jones MA, Sutton CMLR, O'Dwyer P, Nilsson F, Weber B, Williamson TK, Lalla K, Bryant A, Carter CR, Forrest CR, Hunter DI, Nassar AH, Orizu MN, Knight K, Qandeel H, Suttie S, Belding R, McClarey A, Boyd AT, Guthrie GJK, Lim PJ, Luhmann A, Watson AJM, Richards CH, Nicol L, Madurska M, Harrison E, Boyce KM, Roebuck A, Ferguson G, Pati P, Wilson MSJ, Dalgaty F, Fothergill L, Driscoll PJ, Mozolowski KL, Banwell V, Bennett SP, Rogers PN, Skelly BL, Rutherford CL, Mirza AK, Lazim T, Lim HCC, Duke D, Ahmed T, Beasley WD, Wilkinson MD, Maharaj G, Malcolm C, Brown TH, Shingler GM, Mowbray N, Radwan R, Morcous P, Wood S, Kadhim A, Stewart DJ, Baker AL, Tanner N, Shenoy H, Hafiz S, Marchi JA, Singh-Ranger D, Hisham E, Ainley P, O'Neill S, Terrace J, Napetti S, Hopwood B, Rhys T, Downing J, Kanavati O, Coats M, Aleksandrov D, Kallaway C, Yahya S, Weber B, Templeton A, Trotter M, Lo C, Dhillon A, Heywood N, Aawsaj Y, Hamdan A, Reece-Bolton O, McGuigan A, Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
| | - R S Vohra
- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
| | - M Elmasry
- Aintree University Hospital NHS Foundation Trust
| | - Q Nunes
- Aintree University Hospital NHS Foundation Trust
| | - D Kennedy
- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
| | | | - S Zafar
- Barnet and Chase Farm Hospital
| | | | - N Samuel
- Barnsley District General Hospital
| | - F Dar
- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
| | - S Ayaani
- Sandwell and West Birmingham Hospitals NHS Trust
| | - H Youssef
- Heart of England Foundation NHS Trust
| | | | - H Watkin
- Heart of England Foundation NHS Trust
| | - D Naumann
- Heart of England Foundation NHS Trust
| | - S Emeshi
- Heart of England Foundation NHS Trust
| | | | - K Lee
- Heart of England Foundation NHS Trust
| | - N Joji
- Heart of England Foundation NHS Trust
| | - J Heath
- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
| | - H Welbourn
- Bradford Teaching Hospitals NHS Foundation Trust
| | - L Forster
- Bradford Teaching Hospitals NHS Foundation Trust
| | - D Finch
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | - W Robb
- University Hospitals Bristol NHS Trust
| | | | | | | | | | | | | | | | - B Dobbins
- Calderdale and Huddersfield NHS Trust
| | | | | | | | - M Pellen
- Hull and East Yorkshire NHS Trust
| | | | - W-M Ho
- Hull and East Yorkshire NHS Trust
| | - V Miu
- Hull and East Yorkshire NHS Trust
| | - T J White
- Chesterfield Royal Hospital NHS Foundation Trust
| | - K A Hodgkins
- Chesterfield Royal Hospital NHS Foundation Trust
| | - A Kinghorn
- Chesterfield Royal Hospital NHS Foundation Trust
| | - M G Tutton
- Colchester Hospital University NHS Foundation Trust
| | - Y A Al-Abed
- Colchester Hospital University NHS Foundation Trust
| | - D Menzies
- Colchester Hospital University NHS Foundation Trust
| | - A Ahmad
- Colchester Hospital University NHS Foundation Trust
| | - J Reed
- Colchester Hospital University NHS Foundation Trust
| | - S Khan
- Colchester Hospital University NHS Foundation Trust
| | - D Monk
- Countess of Chester NHS Foundation Trust
| | - L J Vitone
- Countess of Chester NHS Foundation Trust
| | - G Murtaza
- Countess of Chester NHS Foundation Trust
| | - A Joel
- Countess of Chester NHS Foundation Trust
| | | | - D Shier
- Croydon Health Services NHS Trust
| | - C Zhang
- Croydon Health Services NHS Trust
| | | | | | | | - M J Jones
- North Cumbria University Hospitals Trust
| | - M Elsayed
- North Cumbria University Hospitals Trust
| | - L Tuck
- North Cumbria University Hospitals Trust
| | - J Wayman
- North Cumbria University Hospitals Trust
| | - K Carney
- North Cumbria University Hospitals Trust
| | | | | | | | | | | | | | | | | | | | | | - M P Tilston
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - M Gough
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T Wallace
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - S Singh
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - J Downing
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - K A Mockford
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - E Issa
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Shah
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Chauhan
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T R Wilson
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - A Forouzanfar
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - J R L Wild
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - E Nofal
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - C Bunnell
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - K Madbak
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - S T V Rao
- Dorset County Hospital NHS Foundation Trust
| | - L Devoto
- Dorset County Hospital NHS Foundation Trust
| | - N Siddiqi
- Dorset County Hospital NHS Foundation Trust
| | - Z Khawaja
- Dorset County Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | - D M Rae
- Frimley Park Hospital NHS Trust
| | | | | | | | | | - O J Old
- Gloucestershire Hospitals NHS Trust
| | | | - R Shah
- Gloucestershire Hospitals NHS Trust
| | | | - K Keogh
- Gloucestershire Hospitals NHS Trust
| | - L Frank
- Gloucestershire Hospitals NHS Trust
| | - M Al-Akash
- Great Western Hospitals NHS Foundation Trust
| | | | - R J Frame
- Harrogate and District NHS Foundation Trust
| | - M Hughes
- Harrogate and District NHS Foundation Trust
| | - C Jelley
- Harrogate and District NHS Foundation Trust
| | | | | | | | | | - T Cuming
- Homerton University Hospital NHS Trust
| | - P Cunha
- Homerton University Hospital NHS Trust
| | - S Tayeh
- Homerton University Hospital NHS Trust
| | | | | | - A Eisawi
- Tees Hospitals NHS Foundation Trust
| | | | - W S Ngu
- Tees Hospitals NHS Foundation Trust
| | | | | | - V Chitre
- Paget University Hospitals NHS Foundation Trust
| | - K Aryal
- Paget University Hospitals NHS Foundation Trust
| | - P Ferris
- Paget University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | - H Ebdewi
- Kettering General Hospital NHS Foundation Trust
| | - M Elshaer
- Kettering General Hospital NHS Foundation Trust
| | - G Gravante
- Kettering General Hospital NHS Foundation Trust
| | - B Drake
- Kettering General Hospital NHS Foundation Trust
| | - A Ogedegbe
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - D Mukherjee
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - C Arhi
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | | | | | | | | | | | | | - K Wa
- Kingston Hospital NHS Foundation Trust
| | - J Mok
- Kingston Hospital NHS Foundation Trust
| | - T Woodman
- Kingston Hospital NHS Foundation Trust
| | - J Deguara
- Kingston Hospital NHS Foundation Trust
| | - G Garcea
- University Hospitals of Leicester NHS Trust
| | - B I Babu
- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
| | - D Lloyd
- University Hospitals of Leicester NHS Trust
| | | | - O Al-Taan
- University Hospitals of Leicester NHS Trust
| | - A Boddy
- University Hospitals of Leicester NHS Trust
| | - J P Slavin
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - L Ballance
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - S Gerakopoulos
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - P Jambulingam
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - S Mansour
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - N Sakai
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - V Acharya
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - M M Sadat
- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
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- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
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- Central Manchester NHS Foundation Trust
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- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
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- North Tees and Hartlepool NHS Foundation Trust
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- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
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- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
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- Northampton General Hospital NHS Trust
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- Northampton General Hospital NHS Trust
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- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
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- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
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- United Lincolnshire Hospitals NHS Trust
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- Portsmouth Hospitals NHS Trust
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- The Princess Alexandra Hospital NHS Trust
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- The Princess Alexandra Hospital NHS Trust
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- The Princess Alexandra Hospital NHS Trust
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- King's College Hospital NHS Foundation Trust
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- Gateshead Health NHS Foundation Trust
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- Gateshead Health NHS Foundation Trust
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- Gateshead Health NHS Foundation Trust
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- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
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- East Kent Hospitals University NHS Foundation Trust
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- East Kent Hospitals University NHS Foundation Trust
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- East Kent Hospitals University NHS Foundation Trust
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- East Kent Hospitals University NHS Foundation Trust
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- Burton Hospitals NHS Foundation Trust
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- Burton Hospitals NHS Foundation Trust
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- Burton Hospitals NHS Foundation Trust
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- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
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- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
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- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
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- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
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- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
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- Royal Berkshire NHS Foundation Trust
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- Royal Berkshire NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
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- Royal Bolton Hospital NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
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- Royal Derby NHS Foundation Trust
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- Hampshire Hospital NHS Foundation Trust
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- Hampshire Hospital NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Lancashire Teaching Hospitals NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
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- Royal Surrey County Hospital NHS Foundation Trust
| | - D J Puntis
- Royal Surrey County Hospital NHS Foundation Trust
| | - S V Williams
- Royal Surrey County Hospital NHS Foundation Trust
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- Royal United Hospital Bath NHS Trust
| | - M Doe
- Royal United Hospital Bath NHS Trust
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- Salford Royal NHS Foundation Trust
| | - N Carty
- Salisbury Hospital Foundation Trust
| | - J Ahmed
- Salisbury Hospital Foundation Trust
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- Southport and Ormskirk Hospital NHS Trust
| | - C Hindley
- Southport and Ormskirk Hospital NHS Trust
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- St George's Healthcare NHS Trust
| | - R Kenny
- St George's Healthcare NHS Trust
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- St Helens and Knowsley Teaching Hospitals NHS Trust
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- St Helens and Knowsley Teaching Hospitals NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Imperial College Healthcare NHS Trust
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- Mid Staffordshire NHS Foundation Trust
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- Mid Staffordshire NHS Foundation Trust
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- City Hospitals Sunderland NHS Foundation Trust
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- City Hospitals Sunderland NHS Foundation Trust
| | - H Ali
- Tunbridge Wells and Maidstone NHS Trust
| | - R Lane
- Tunbridge Wells and Maidstone NHS Trust
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- University Hospital Birmingham NHS Foundation Trust
| | - S Puig
- University Hospital Birmingham NHS Foundation Trust
| | - K Al Amari
- University Hospital Birmingham NHS Foundation Trust
| | - D Vijayan
- University Hospital Birmingham NHS Foundation Trust
| | - R Sutcliffe
- University Hospital Birmingham NHS Foundation Trust
| | | | - Z Hamady
- University Hospital Coventry and Warwickshire NHS Trust
| | - A R Prasad
- University Hospital Coventry and Warwickshire NHS Trust
| | - A Patel
- University Hospital Coventry and Warwickshire NHS Trust
| | - D Durkin
- University Hospital of North Staffordshire NHS Trust
| | - P Kaur
- University Hospital of North Staffordshire NHS Trust
| | - L Bowen
- University Hospital of North Staffordshire NHS Trust
| | - J P Byrne
- University Hospital Southampton NHS Foundation Trust
| | - K L Pearson
- University Hospital Southampton NHS Foundation Trust
| | - T G Delisle
- University Hospital Southampton NHS Foundation Trust
| | - J Davies
- University Hospital Southampton NHS Foundation Trust
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- University Hospital South Manchester NHS Foundation Trust
| | - J Nicholson
- University Hospital South Manchester NHS Foundation Trust
| | - K Newton
- University Hospital South Manchester NHS Foundation Trust
| | - J Mbuvi
- University Hospital South Manchester NHS Foundation Trust
| | - A Farooq
- Warrington and Halton Hospitals NHS Trust
| | | | - Z Zafrani
- Warrington and Halton Hospitals NHS Trust
| | - D Brett
- Warrington and Halton Hospitals NHS Trust
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- South Warwickshire NHS Foundation Trust
| | - M Cheung
- South Warwickshire NHS Foundation Trust
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- Worcestershire Acute Hospitals NHS Trust
| | - E Hamilton
- Worcestershire Acute Hospitals NHS Trust
| | - S Jaunoo
- Worcestershire Acute Hospitals NHS Trust
| | - R Padwick
- Worcestershire Acute Hospitals NHS Trust
| | - M Sayegh
- Western Sussex Hospitals NHS Foundation Trust
| | - R C Newton
- Western Sussex Hospitals NHS Foundation Trust
| | - M Hebbar
- Western Sussex Hospitals NHS Foundation Trust
| | - S F Farag
- Western Sussex Hospitals NHS Foundation Trust
| | | | | | | | - C Blane
- Yeovil District Hospital NHS Trust
| | - M Giles
- York Teaching Hospital NHS Foundation Trust
| | - M B Peter
- York Teaching Hospital NHS Foundation Trust
| | - N A Hirst
- York Teaching Hospital NHS Foundation Trust
| | - T Hossain
- York Teaching Hospital NHS Foundation Trust
| | - A Pannu
- York Teaching Hospital NHS Foundation Trust
| | | | | | - G W Taylor
- York Teaching Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - T Diamond
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - P Davey
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - C Jones
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - J M Clements
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - R Digney
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - W M Chan
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S McCain
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Gull
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Janeczko
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - E Dorrian
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Harris
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Dawson
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
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- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
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- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Philips A, Pinelli M, de Bie C, Mustonen A, Määttä T, Arts H, Wu K, Roepman R, Moilanen J, Raza S, Varilo T, Scala G, Cocozza S, Gilissen C, van Gassen K, Järvelä I. Identification ofC12orf4as a gene for autosomal recessive intellectual disability. Clin Genet 2016; 91:100-105. [DOI: 10.1111/cge.12821] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/03/2016] [Accepted: 06/13/2016] [Indexed: 02/02/2023]
Affiliation(s)
- A.K. Philips
- Department of Medical Genetics; University of Helsinki; Helsinki Finland
| | - M. Pinelli
- Department of Human Genetics, Donders Centre for Neuroscience; Radboud University Medical Centre; Nijmegen the Netherlands
- The Telethon Institute of Genetics and Medicine (TIGEM); Naples Italy
| | - C.I. de Bie
- Department of Genetics; University Medical Center Utrecht; Utrecht the Netherlands
| | - A. Mustonen
- Department of Clinical Genetics, PEDEGO Research Unit and Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
| | - T. Määttä
- Disability Services; Joint Authority for Kainuu; Kainuu Finland
| | - H.H. Arts
- Department of Human Genetics; Radboud University of Molecular Sciences, Radboud University Medical Centre; Nijmegen the Netherlands
- Department of Biochemistry; University of Western Ontario; London Ontario Canada
| | - K. Wu
- Department of Human Genetics; Radboud University of Molecular Sciences, Radboud University Medical Centre; Nijmegen the Netherlands
| | - R. Roepman
- Department of Human Genetics; Radboud University of Molecular Sciences, Radboud University Medical Centre; Nijmegen the Netherlands
| | - J.S. Moilanen
- Department of Clinical Genetics, PEDEGO Research Unit and Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
| | - S. Raza
- Department of Medical Genetics; University of Helsinki; Helsinki Finland
| | - T. Varilo
- Department of Medical Genetics; University of Helsinki; Helsinki Finland
| | - G. Scala
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università Degli Studi di Napoli “Federico II”; Naples Italy
| | - S. Cocozza
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università Degli Studi di Napoli “Federico II”; Naples Italy
| | - C. Gilissen
- Department of Human Genetics, Donders Centre for Neuroscience; Radboud University Medical Centre; Nijmegen the Netherlands
| | - K.L.I. van Gassen
- Department of Genetics; University Medical Center Utrecht; Utrecht the Netherlands
| | - I. Järvelä
- Department of Medical Genetics; University of Helsinki; Helsinki Finland
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Younus M, Abbas T, Zafar M, Raza S, Khan A, Saleem AH, Idrees MA, Nisa QU, Akhtar R, Saleem G. Assessment of heavy metal contamination in raw milk for human consumption. S AFR J ANIM SCI 2016. [DOI: 10.4314/sajas.v46i2.7] [Citation(s) in RCA: 8] [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: 11/17/2022]
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Masood I, Majid Z, Sohail S, Zia A, Raza S. The Deadly Heat Wave of Pakistan, June 2015. Int J Occup Environ Med 2016; 6:247-8. [PMID: 26498053 PMCID: PMC6977047 DOI: 10.15171/ijoem.2015.672] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 09/15/2015] [Indexed: 11/09/2022]
Affiliation(s)
- I Masood
- Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan.
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Deeken C, Ray S, Zihni A, Thompson D, Gluckstein J, Lake S, Roll S, Ndungu B, Njihia B, Saidi H, Lorenz R, Stechemesser B, Reinpold W, Dietz U, Germer CT, Winstanley J, Miserez M, Fitzgibbons R, Schumpelick V, de Beaux AC, Zollinger R, Matthews BD, Baalman S, Frisella P, Bandyopadhyay S, Raza S, Manu M, Okinyi W, Macharia M, Neema O. Education. Hernia 2015; 19 Suppl 1:S63-7. [PMID: 26518863 DOI: 10.1007/bf03355328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Deeken
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - S Ray
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - A Zihni
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - D Thompson
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - J Gluckstein
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - S Lake
- Dept. of Mechanical Engineering & Materials Science, Washington University in St. Louis, St. Louis, MO, USA
| | - S Roll
- Santa Casa of Sao Paulo Medical School, Sao Paulo, Brazil
| | - B Ndungu
- The University of Nairobi, Kenya
| | - B Njihia
- Agakhan University Hospital, Nairobi, Kenya
| | - H Saidi
- The University of Nairobi, Kenya
| | - R Lorenz
- Hernia Center 3 CHIRURGEN, Berlin, Germany
| | | | - W Reinpold
- Krankenhaus Wilhelmsburg, Hamburg, Germany
| | - U Dietz
- University of Wuerzburg, Wuerzburg, Germany
| | - C T Germer
- University of Wuerzburg, Wuerzburg, Germany
| | | | | | | | | | - A C de Beaux
- Department of Clinical Surgery, The Royal Infirmary of Edinburgh, UK
| | - R Zollinger
- Univ AZ College of Medicine, Tucson, AZ, USA
| | | | - S Baalman
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - P Frisella
- School of Medicine, Dept. of Surgery, Section of Minimally Invasive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | | | - S Raza
- New Cross Hospital, Wolverhampton, UK
| | - M Manu
- New Cross Hospital, Wolverhampton, UK
| | - W Okinyi
- The University of Nairobi, Nairobi, Kenya
| | - M Macharia
- The University of Nairobi, Nairobi, Kenya
| | - O Neema
- The University of Nairobi, Nairobi, Kenya
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Harker A, Raza S, Williamson K, Kolb B, Gibb R. Preconception paternal stress in rats alters dendritic morphology and connectivity in the brain of developing male and female offspring. Neuroscience 2015; 303:200-10. [PMID: 26149350 DOI: 10.1016/j.neuroscience.2015.06.058] [Citation(s) in RCA: 18] [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: 12/03/2014] [Revised: 06/12/2015] [Accepted: 06/26/2015] [Indexed: 02/02/2023]
Abstract
The goal of this research was to examine the effect of preconception paternal stress (PPS) on the subsequent neurodevelopment and behavior of male and female offspring. Prenatal (gestational) stress has been shown to alter brain morphology in the developing brain, and is presumed to be a factor in the development of some adult psychopathologies. Our hypothesis was that paternal stress in the preconception period could impact brain development in the offspring, leading to behavioral abnormalities later in life. The purpose of this study was to examine the effect of preconception paternal stress on developing male and female offspring brain morphology in five brain areas; medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), parietal cortex (Par1), hippocampus (CA1) and nucleus accumbens (NAc). Alterations in dendritic measures and spine density were observed in each brain area examined in paternal stress offspring. Our two main findings reveal; (1) PPS alters brain morphology and organization and these effects are different than the effects of stress observed at other ages; and, (2) the observed dendritic changes were sexually dimorphic. This study provides direct evidence that PPS modifies brain architecture in developing offspring, including dendritic length, cell complexity, and spine density. Alterations observed may contribute to the later development of psychopathologies and maladaptive behaviors in the offspring.
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Affiliation(s)
- A Harker
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada.
| | - S Raza
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada.
| | - K Williamson
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada.
| | - B Kolb
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada; Canadian Institute for Advanced Research Program in Child Brain Development, 180 Dundas Street West, Toronto, ON M5G 1Z8, Canada.
| | - R Gibb
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada.
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Al-Tartir T, Raza S, Alotaibi M, Khan A, Hara I, Fujisawa M, Guru K. Robot-assisted surgical approach to bladder cancer: a decade of progress! MINERVA UROL NEFROL 2015; 67:55-63. [PMID: 25386697] [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: 06/04/2023]
Abstract
Robot-assisted radical cystectomy (RARC) has gained popularity and proven its efficacy, safety and reproducibility in the last decade. RARC has resulted in less blood loss, enhanced recovery, and shorter hospital stay. RARC has proven to have similar or better postoperative morbidity, mortality and equal oncologic, outcomes. Limiting factors to the acceptance of this surgical approach have included its steep learning curve and the lack of both long-term outcome data. This article systematically reviews the literature comparing the outcomes for RARC (comparisons with open radical cystectomy when performed at the same institution) with a focus on operative, complications, oncologic, functional and survival outcomes.
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Affiliation(s)
- T Al-Tartir
- Urology Department Roswell Park Cancer Institute, Buffalo, NY, USA -
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Raza S, Harker A, Richards S, Kolb B, Gibb R. Tactile stimulation improves neuroanatomical pathology but not behavior in rats prenatally exposed to valproic acid. Behav Brain Res 2014; 282:25-36. [PMID: 25557797 DOI: 10.1016/j.bbr.2014.12.055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/20/2014] [Accepted: 12/25/2014] [Indexed: 12/11/2022]
Abstract
Autism is a severe neurodevelopmental disorder with a population prevalence of 1 in 68, and dramatically increasing. While no single pharmacologic intervention has successfully targeted the core symptoms of autism, emerging evidence suggests that postnatal environmental manipulations may offer greater therapeutic efficacy. Massage therapy, or tactile stimulation (TS), early in life has repeatedly been shown to be an effective, low-cost, therapeutic approach in ameliorating the cognitive, social, and emotional symptoms of autism. While early TS treatment attenuates many of the behavioral aberrations among children with autism, the neuroanatomical correlates driving such changes are unknown. The present study assessed the therapeutic effects of early TS treatment on behavior and neuroanatomy using the valproic acid (VPA) rodent model of autism. Rats were prenatally exposed to VPA on gestational day 12.5 and received TS shortly following birth. Whereas TS reversed almost all the VPA-induced alterations in neuroanatomy, it failed to do so behaviorally. The TS VPA animals, when compared to VPA animals, did not exhibit altered or improved behavior in the delayed non-match-to-sample T-maze, Whishaw tray reaching, activity box, or elevated plus maze tasks. Anatomically, however, there were significant increases in dendritic branching and spine density in the medial prefrontal cortex, orbital frontal cortex, and amygdala in VPA animals following early TS treatment, suggesting a complete reversal or remediation of the VPA-induced effects in these regions. The results suggest that postnatal TS, during a critical period in development, acts as a powerful reorganization tool that can ameliorate the neuroanatomical consequences of prenatal VPA exposure.
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Affiliation(s)
- S Raza
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Canada.
| | - A Harker
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Canada
| | - S Richards
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Canada
| | - B Kolb
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Canada; Canadian Institute for Advanced Research Program in Child Brain Development, Canada
| | - R Gibb
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Canada
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Raza S, Quinones-Hinojosa A, Boahene K. Expanded Endoscopic Multiaxial Access to the Midline Cranial Base and Infratemporal Fossa Through the Maxillary Osteoplastic Window. Skull Base Surg 2013. [DOI: 10.1055/s-0033-1336406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Boahene K, Raza S, Ishii M, LIm M, Reh D, Gallia G, Quinone-Hinojosa A. The Endoscopic Paramandibular Window to the Infratemporal Fossa: Surgical Anatomy and Expanding Clinical Indications. Skull Base Surg 2013. [DOI: 10.1055/s-0033-1336297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Raza S, Pandey S, Bhatt CP. Microbiological analysis of isolates in Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. Kathmandu Univ Med J (KUMJ) 2012; 9:295-7. [PMID: 22710542 DOI: 10.3126/kumj.v9i4.6348] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Urinary tract infections (UTIs) are the common cause of bacterial infection. Recently UTI become more complicated and difficult to treat because of appearance of pathogen with increasing resistance to antimicrobial agents. OBJECTIVE To determine the etiology of the urinary tract infections and their susceptibility to antimicrobial agents. METHODS This study was carried out in Kathmandu Medical College, at department of microbiology. Total 3,460 urine samples were tested microbiologically by standard procedure. Antibiotic susceptibility test was performed for all the isolates by Kirby Bauer disc diffusion method and result was interpreted according to National Committee for Clinical Laboratory Standards (NCCLS) guide line. RESULTS Out of 3,460 urine samples 680 (19.7%) showed the significant bacteriuria. The most common pathogens isolated were Escherichia coli 75.7% followed by Klebsiella pneumoniae 10.7%, Acinetobacter spp 5.5%, Proteus spp 3.5% and Pseudomonas aeruginosa 1.2%. Most susceptible antibiotic was Amikacin, Ceftriaxone and Ciprofloxacin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin 96.1%, Nitrofurantoin 91.3% and Gentamicin 77.7% followed by Ceftriaxone 65.8% and Ciprofloxacin 64.1%. CONCLUSION Regular surveillance of the resistance rate among uro-pathogens is needed to ensure the appropriate therapy of UTI.
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Affiliation(s)
- S Raza
- Department of Microbiology, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
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Furuse M, Miyatake SI, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Karajannis MA, Fisher MJ, Milla SS, Cohen KJ, Legault G, Wisoff JH, Harter DH, Hartnett E, Merkelson A, Bloom MC, Dhall G, Jones D, Korshunov A, Pfister S, Eberhart CG, Zagzag D, Allen JC, Chinot O, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Hilton M, Abrey L, Cloughesy T, Field KM, Simes J, Nowak AK, Hovey E, Wheeler H, Cher L, Brown C, Livingstone A, Sawkins K, Rosenthal MA, McCrea HJ, Kesavabhotla K, Boockvar J, Kleinberg L, Blakeley J, Mikkelsen T, Stevens G, Ye X, Ryu S, Desideri S, Desai B, Giranda V, Grossman S, Badruddoja MA, Pazzi M, Stea B, Lefferts P, Contreras N, Wallen K, Shah R, Rance N, Schroeder K, Sanan A, Kut C, Raza S, Liang W, Abutaleb A, Xi J, Mavadia J, Ye X, Guerrero-Cazares H, McVeigh E, Li X, Quinones-Hinojosa A, Sloan AE, Reese J, Rogers LR, Embree H, Lazarus HM, Fung H, Kane D, Dropulic B, Gerson SL, Tsung GE, Green SD, Lai A, Green RM, Filka E, Cloughesy TF, Nghiemphu PL, Saito R, Yamashita Y, Sonoda Y, Kanamori M, Kumabe T, Tominaga T, Mohammadi AM, Chao ST, Peereboom DM, Barnett GH, Suh JH, Brewer C, Vogelbaum MA, Desjardins A, Peters KB, Herndon JE, Bailey LA, Alderson LM, Ranjan T, Sampson JH, Friedman AH, Bigner DD, Friedman HS, Vredenburgh JJ, Kaley TJ, Pentsova E, Omuro A, Mellinghoff I, Nolan C, Gavrilovic I, DeAngelis LM, Holland E, Lacouture ME, Ludwig E, Lassman AB, Shih KC, Bacha J, Brown DM, Garner WJ, Schwartz R, Burris HA, Shih K, Rosenblatt P, Chowdhary S, Weir A, Shepard G, Shastry M, Griner P, Hainsworth J, Sloan AE, Nock CJ, Kerstetter A, Supko J, Ye X, Barnholtz-Sloan JS, Miller R, Rich J, Takebe N, Prados M, Grossman S. CLIN-ONGOING CLINICAL TRIALS. Neuro Oncol 2012; 14:vi101-vi105. [PMCID: PMC3488786 DOI: 10.1093/neuonc/nos232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
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Raza S, Tamrakar R, Bhatt CP, Joshi SK. Antimicrobial susceptibility patterns of Salmonella typhi and Salmonella paratyphi A in a tertiary care hospital. J Nepal Health Res Counc 2012; 10:214-217. [PMID: 23281454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Enteric fever is still an important public health problem in developing countries including Nepal. A changing antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A and emergence of multi drug resistance has increased to a great concern. Aim of the study was to investigate the antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A. METHODS Study was carried out at the department of microbiology in Kathmandu Medical College. Blood culture samples were collected from suspected enteric fever patient and tested microbiologically by standard procedure. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method and results were interpreted by National Committee for Clinical Laboratory (NCCLS) guideline. RESULTS Of total 78 (2.0%) Salmonella serotype isolated from 3,980 blood culture samples, in which 47 (60.3%) were S. typhi and 31 (39.7%) were S. paratyphi A. Isolates were from all age group median age being the 25 years. Among the tested antibiotics S. typhi was susceptible towards Ciprofloxacin (100%) followed by Gentamicin (97.9%), Ofloxacine (95.7%), Ceftriaxone (95.7%) and Chloramphenicol (93.6%). In case of S. paratyphi A most of the tested antibiotics showed high percentage of susceptibility and least susceptible antibiotic for S. paratyphi A was Ampicillin (25.8%). Three isolates of S. typhi showed multidrug resistance. CONCLUSIONS A considerable variation was observed in the antimicrobial susceptibility pattern of S.typhi and S. paratyphi A. Hence antibiotic susceptibility test must be sought before instituting appropriate therapy to prevent from further emergence of drug resistance.
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Affiliation(s)
- S Raza
- Department of Microbiology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.
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Toscano G, Raza S, Xiao S, Wubs M, Jauho AP, Bozhevolnyi SI, Mortensen NA. Surface-enhanced Raman spectroscopy: nonlocal limitations. Opt Lett 2012; 37:2538-2540. [PMID: 22743447 DOI: 10.1364/ol.37.002538] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Giant field enhancement and field singularities are a natural consequence of the commonly employed local-response framework. We show that a more general nonlocal treatment of the plasmonic response leads to new and possibly fundamental limitations on field enhancement with important consequences for our understanding of surface-enhanced Raman spectroscopy (SERS). The intrinsic length scale of the electron gas serves to smear out assumed field singularities, leaving the SERS enhancement factor finite, even for geometries with infinitely sharp features. For silver nanogroove structures, mimicked by periodic arrays of half-cylinders (up to 120 nm in radius), we find no enhancement factors exceeding 10 orders of magnitude (10(10)).
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Affiliation(s)
- G Toscano
- Department of Photonics Engineering, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
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Abstract
Adjuvant chemotherapy for early breast cancer improves disease-free and overall survival in pre- and postmenopausal women. The importance of maintaining relative dose intensity (rdi) is well-known; however, little information is available from routine clinical practice regarding how well dose intensity is maintained with modern chemotherapy regimens. In a retrospective review of patients undergoing chemotherapy for early breast cancer at a single institution in Canada from January 2006 to November 2007, a total of 263 patients received one of the following regimens: ac-t [doxorubicin (Adriamycin: Pharmacia, Kalamazoo, MI, U.S.A.)–cyclophosphamide, paclitaxel (Taxol: Bristol–Myers Squibb, Princeton, NJ, U.S.A.)] fec-100 (5-fluorouracil–epirubicin–cyclophosphamide) fec-d (5-fluorouracil–epirubicin–cyclophosphamide, docetaxel)
Overall, only 14.4% of patients had a rdi less than 85%. Dose delay or reduction (or both) occurred in 46%, 37%, and 20% of patients receiving fec-100, ac-t, and fec-d respectively. Optimal rdi was delivered to 96%, 95%, and 70.7% of patients for ac-t, fec-d and fec-100 regimens respectively. Patients over 65 years of age accounted for 14% of the total cohort and were more likely to receive a suboptimal rdi than were patients younger than 65 years of age (35% vs. 6.6%). Optimal chemotherapy rdi (>85%) for early breast cancer can be achieved at an academic cancer centre. This goal is less often accomplished in elderly patients, and thus a proactive approach is required for managing toxicity in that population.
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Affiliation(s)
| | | | - J. Younus
- Correspondence to: Jawaid Younus, London Regional Cancer Program, 790 Commissioners Road East, London, Ontario N6A 4L6. E-mail:
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Ahmed P, Chaudhry QUN, Satti TM, Raza S, Mahmood SK. Erythrocytosis following allogeneic hemopoietic SCT in three cases of aplastic anemia. Bone Marrow Transplant 2010; 46:1163-5. [PMID: 21057557 DOI: 10.1038/bmt.2010.265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Raza M, Raza S, Latif Z, Sachdev JC. Effect of race and comorbidities on patterns of bevacizumab toxicity: A single-institution experience. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Raza S, Sharma Y, Chaudry Q, Young AN, Wang MD. Automated classification of renal cell carcinoma subtypes using scale invariant feature transform. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2009:6687-90. [PMID: 19964707 DOI: 10.1109/iembs.2009.5334009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The task of analyzing tissue biopsies performed by a pathologist is challenging and time consuming. It suffers from intra- and inter-user variability. Computer assisted diagnosis (CAD) helps to reduce such variations and speed up the diagnostic process. In this paper, we propose an automatic computer assisted diagnostic system for renal cell carcinoma subtype classification using scale invariant features. We capture the morphological distinctness of various subtypes and we have used them to classify a heterogeneous data set of renal cell carcinoma biopsy images. Our technique does not require color segmentation and minimizes human intervention. We circumvent user subjectivity using automated analysis and cater for intra-class heterogeneities using multiple class templates. We achieve a classification accuracy of 83% using a Bayesian classifier.
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Affiliation(s)
- S Raza
- Georgia Institute of Technology, Atlanta, GA 30332, USA.
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Raza S, Narayana A, Morsi A, Parker E, Rush S, Golfinos J, Novik Y. Outcomes of Stereotactic Radiosurgery in the Management of Brain Metastasis in Patients with HER2 Positive Metastatic Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:We present single institution experience on the effect of Her 2 status on results of Gamma knife radiosurgery (SRS) for brain metastases (BM) as to local control, pattern of relapse and survival.Material and Methods:From 2004 to 2008, 65 patients with metastatic breast cancer (MBC) were treated with GK-SRS at our center, 52 had documented Her 2 status. We performed analysis based on Her 2 status of the original tumor defined as positive by 3+ DAKO or FISH. SRS was delivered using cobalt leksell GKS to a median dose of 20Gy (range 16-20 Gy) at 50% isodose line. Responses were evaluated by gadolinium enhanced MRI. We analyzed the data as to: objective response (OR) defined as radiologic response or stable disease, and local progression –free survival (PFS) defined as freedom from progression of treated BM, appearance of new brain metastases and/or leptomeningeal progression, as well as overall survival (OS) measured from the time of SRS .ResultsTwenty-eight patients were identified as HER2 positive (Group A) and 24 patients were HER2 negative (Group B). Median time to develop BM in group A was 60 months (4 -240 months) versus 48 months (4-156) in group B. Median follow-up was 12 months (1-48) from the time of onset of BM. 66% patients in group A and 82% patients in group B have no more than 2 BM at the time of SRS.In group A, OR was 78.6% (22 pts)and 21.4%(6 pts) had progressive disease (PD) where as in group B the OR was 83% (20 pts) and 17%(4 pts) had PD. Median time to local recurrence of the treated lesion in group A was 13 months (95% CI 5.84 to 20.15) compared to 8 months (95%CI 6.75 to 9.25) in group B. Local PFS at 1 year for Group A vs. B was: control of the treated lesions 69% versus 41.2% respectively, p= 0.97 by log rank test; and development of new BM 67% compared to 86% (p=0.2).Out of all CNS relapses, almost a quarter of patients in both groups received second SRS whereas 25% patients in group A and 31% patients in group B received whole brain irradiation respectively. Interestingly, 28% (9 pts) failed as leptomeningeal disease following SRS, 7 of them with Her 2 positive tumors. Leptomeningeal relapses were seen both as only pattern of recurrence (4 pts) or associated with other types of CNS progression: local re-growth or new BM (5pts).ConclusionsSRS provides high rate of objective response and local control for BM from both Her 2 positive and Her 2 negative breast cancer. No statistically significant difference in local PFS was seen. More frequent pattern of relapse as leptomeningeal disease was seen in Her 2 positive after SRS. Evaluation of novel systemic targeted therapies in conjunction with local therapies is needed for effective management of BM from breast cancer.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6152.
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Affiliation(s)
- S. Raza
- 1New York University School of Medicine, NY,
| | - A. Narayana
- 1New York University School of Medicine, NY,
| | - A. Morsi
- 2New York University School of Medicine, NY,
| | - E. Parker
- 2New York University School of Medicine, NY,
| | - S. Rush
- 1New York University School of Medicine, NY,
| | - J. Golfinos
- 2New York University School of Medicine, NY,
| | - Y. Novik
- 3New York University School of Medicine, NY,
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Raza S, Lymberis S, DeWyngaert K, Fenton-Kerimian M, Donach M, Formenti S. Six-week Standard Fractionation Breast Radiotherapy versus Five-weeks with a Concomitant Boost: Acute and Late Toxicity. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gruber ML, Raza S, Gruber D, Narayana A. Bevacizumab in combination with radiotherapy plus concomitant and adjuvant temozolomide for newly diagnosed glioblastoma: Update progression-free survival, overall survival, and toxicity. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2017 Background: Prognosis of glioblastoma (GBM) is very poor. Standard treatment includes surgical resection (SR), radiation (RT), concomitant and adjuvant chemotherapy with temozolomide (TMZ). Our objective is to assess the treatment efficacy, safety and survival in patients with newly-diagnosed GBM treated with RT, TMZ, and bevacizumab in the upfront management. Methods: From 2006–2008, 51 eligible patients (age >18, KPS >70) with newly-diagnosed GBM divided into two groups. Group A (n = 20) was treated with RT (60Gy) and concomitant TMZ (75mg/m2 daily for 42 days) with bevacizumab (10mg/kg every 2 weeks), 29 days following surgery, followed by up to six cycles of adjuvant TMZ (150mg/m2,daily x 7d, q28 with bevacizumab at 10mg/kg days 8 and 22 of each 28 day cycle. Group B (n = 31) received similar treatment without bevacizumab. Both groups were followed up until tumor progression (PFS). Recurrence was defined according to MacDonald Criteria. The end points were PFS, overall survival (OS) and toxicity. Results: Median bevacizumab infusions were 12 (4–32). Median follow-up was14 months for both groups. 6 months PFS survival in Group A was 77.5% and in Group B was 51.6%. Median PFS in Group A was 17 months compared to 7 months in Group B (p < 0.0001, HR = 0.26). Median OS has not been reached in Group A and was 17 months in Group B. One and 2 year OS were 83% and 57% in Group A compared to 72% and 6.5% in Group B (p = 0.02) ). Post-RT and temodar toxicities include thrombocytopenia (1 patient; Gr 3 and fatigue (3 patient;1 Gr 3), bevacizumab related toxicities with RT include leg ulcer with cellulites (1 patient; Gr 3) and pulmonary embolism with thrombocytopenia (1 patient; Gr 4), hypertension (2 patients; Gr 1), and asymptomatic blood products on MRI (2 patients). Conclusions: Bevacizumab has demonstrated efficacy, acceptable toxicity, improved PFS and OS in the upfront management of GBM. No significant financial relationships to disclose.
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Affiliation(s)
- M. L. Gruber
- NYU Clinical Cancer Center, New York, NY; New York University Medical Center, New York, NY; New York University School of Medicine, New York, NY
| | - S. Raza
- NYU Clinical Cancer Center, New York, NY; New York University Medical Center, New York, NY; New York University School of Medicine, New York, NY
| | - D. Gruber
- NYU Clinical Cancer Center, New York, NY; New York University Medical Center, New York, NY; New York University School of Medicine, New York, NY
| | - A. Narayana
- NYU Clinical Cancer Center, New York, NY; New York University Medical Center, New York, NY; New York University School of Medicine, New York, NY
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Basit A, Espinosa F, Avila R, Raza S, Irfan N. Simulation of atmospheric dispersion of radionuclides using an Eulerian-Lagrangian modelling system. J Radiol Prot 2008; 28:539-561. [PMID: 19029589 DOI: 10.1088/0952-4746/28/4/007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In this paper we present an atmospheric dispersion scenario for a proposed nuclear power plant in Pakistan involving the hypothetical accidental release of radionuclides. For this, a concept involving a Lagrangian stochastic particle model (LSPM) coupled with an Eulerian regional atmospheric modelling system (RAMS) is used. The atmospheric turbulent dispersion of radionuclides (represented by non-buoyant particles/neutral traces) in the LSPM is modelled by applying non-homogeneous turbulence conditions. The mean wind velocities governed by the topography of the region and the surface fluxes of momentum and heat are calculated by the RAMS code. A moving least squares (MLS) technique is introduced to calculate the concentration of radionuclides at ground level. The numerically calculated vertical profiles of wind velocity and temperature are compared with observed data. The results obtained demonstrate that in regions of complex terrain it is not sufficient to model the atmospheric dispersion of particles using a straight-line Gaussian plume model, and that by utilising a Lagrangian stochastic particle model and regional atmospheric modelling system a much more realistic estimation of the dispersion in such a hypothetical scenario was ascertained. The particle dispersion results for a 12 h ground release show that a triangular area of about 400 km(2) situated in the north-west quadrant of release is under radiological threat. The particle distribution shows that the use of a Gaussian plume model (GPM) in such situations will yield quite misleading results.
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Affiliation(s)
- Abdul Basit
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan.
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Narayana A, Raza S, Golfinos JG, Johnson G, Knopp EA, Zagzag D, Fischer I, Medabalmi P, Eagan P, Gruber ML. Bevacizumab therapy in recurrent high grade glioma: Impact on local control and survival. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.13000] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Shah PN, Kumar VA, Jung E, Knopp EA, Babb JS, Johnson G, Gruber ML, Zagzag D, Raza S, Narayana A. Comparison of dynamic susceptibility contrast MRI with conventional MRI in evaluating tumor response following bevacizumab therapy in recurrent high-grade gliomas. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Raza S, Baig M, Ali J, Rizvi S. To study hypoactive sexual desire disorder in a fragile X carrier female successfully treated with local testosterone application. Int J Impot Res 2007; 20:226-8. [PMID: 17851581 DOI: 10.1038/sj.ijir.3901611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is still considerable controversy concerning the role of androgen therapy for hypoactive sexual desire disorder in females. Clinical trials have shown that exogenous testosterone therapy improves arousability, sexual desire and fantasy, frequency of sexual activity and orgasm, and satisfaction and pleasure from the sexual act. We report our experience of 36-year-old fragile X carrier female presented to our department with low sex drive and subjectively poor arousal for the past 1 year. We decided to treat her with local testosterone in a pump form (1% 5 g twice a week). She responded very well to the treatment, and in 3 weeks her libido and sexual functions improved dramatically. We decided to continue the same treatment for almost 1 year following up her free and total testosterone, complete lipid profiles, liver functions and complete blood picture every 3 months. During the whole course of treatment, she had mild facial acne, which was resolved in 2 months after completing treatment with testosterone. This is our first and only case of this syndrome with low sexual desire disorder treated with local testosterone in a pump form. Based upon our 1 year follow-up, low-dose testosterone is a safe and effective approach in treating hypoactive sexual desire disorder in a fragile X carrier female, provided the patient is monitored every 3 months for blood counts, lipid profiles, liver functions and free and total testosterone levels.
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Affiliation(s)
- S Raza
- Department of Oncology, School of Medicine, New York University, New York, NY, USA
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Hasan S, Rahman N, Hussain K, Raza S. SIMULTANEOUS HPLC-UV QUANTIFICATION OF DILTIAZEM AND N-DEMETHYLDILTIAZEM IN HUMAN PLASMA. ACTA ACUST UNITED AC 2006. [DOI: 10.21608/bfsa.2006.64822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
The immersion doses from external exposure to a Gaussian plume of noble gases accidentally released into the atmosphere have been calculated. A numerical integration procedure employing Gauss-Legendre of 64th order has been used. The numerical procedure allows calculating the dose rate at any downwind horizontal or vertical distance. The dose rates were calculated using various forms of gamma dose build-up factors, including Linear, Berger and Geometric Progression (GP). The GP form, having an extraordinarily precise formulation, is a favored choice because the build-up factor levels off for large distances and does not increase exponentially as does the Berger form. The Linear form much under predicts the build-up and subsequently the dose rates for large distances from the source. The dose predictions using a simple uniform cloud model (that does not use any form of build-up factor) is also presented for comparison purposes. The comparison of dose rates with the already reported results indicated that the numerical procedure could be used for dose calculations from a Gaussian plume for all downwind and crosswind distances. The comparison of dose rates obtained using different forms of the build-up factors indicated that the Geometric Progression form was a favored choice and has a wider range of applicability as compared to the Linear or Berger form. The simple uniform cloud model for dose calculations is only suitable for plume centerline doses and should be used with caution for off-center distances.
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Affiliation(s)
- S Raza
- Pakistan Institute of Nuclear Science and Technology (PINSTECH), P.O. Nilore, Islamabad, Pakistan.
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Hashmi K, Raza S, Khattak B, Ahmed P, Hussain I. Allogeneic bone marrow transplantation in β-thalassaemia—single center study. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.061] [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]
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