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Lerner A, Lee AJX, Yan H, Van Griethuysen J, Bartlett AD, Veli M, Jiang Y, Luong M, Naban N, Kane C, Conibear J, Papadatos-Pastos D, Ahmad T, Chao D, Anand G, Asghar US. A Multicentric, Retrospective, Real-world Study on Immune-related Adverse Events in Patients with Advanced Non-small Cell Lung Cancers Treated with Pembrolizumab Monotherapy. Clin Oncol (R Coll Radiol) 2024; 36:193-199. [PMID: 38246850 DOI: 10.1016/j.clon.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
AIMS We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres. MATERIALS AND METHODS This multi-institutional retrospective cohort study included 226 metastatic NSCLC patients. Outcomes were number and severity of immune-related adverse events (irAEs), median progression-free survival (mPFS) and median overall survival (mOS). RESULTS Within our cohort, 119/226 (53%) patients developed irAEs. Of these, 54/119 (45%) experienced irAEs affecting two or more organ systems. The most common irAEs were diarrhoea and rash. The development of an irAE was associated with better mOS (20.7 versus 8.0 months; P < 0.001) and mPFS (12.0 versus 3.9 months; P < 0.001). The development of grade 3/4 toxicities was associated with worse outcomes compared with the development of grade 1/2 toxicities (mOS 6.1 months versus 25.2 months, P < 0.01; mPFS 5.6 months versus 19.3 months, P = 0.01, respectively). Females had a higher proportion of reported grade 3/4 toxicities (13/44 [29.5%] versus 10/74 [13.5%], P = 0.03). Using a multiple Cox regression model, the presence of irAEs was associated with a better overall survival (hazard ratio = 0.42, 95% confidence interval 0.29-0.61; P < 0.01) and better PFS (hazard ratio 0.38, 95% confidence interval 0.27-0.53; P < 0.001). CONCLUSION In this multicentre retrospective cohort study, the development of at least one irAE was associated with significantly longer mPFS and mOS; however, more severe grade 3 and 4 irAEs were associated with worse outcomes. Delayed-onset irAEs, after the 3-month timepoint, were associated with better clinical outcomes.
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Affiliation(s)
- A Lerner
- North Middlesex University Hospital, London, UK
| | - A J X Lee
- UCL Cancer Institute, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
| | - H Yan
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - M Veli
- University College London Hospitals NHS Foundation Trust, London, UK; Princess Alexandra Hospital, Harlow, UK
| | - Y Jiang
- University College London Hospitals NHS Foundation Trust, London, UK
| | - M Luong
- University College London Hospitals NHS Foundation Trust, London, UK
| | - N Naban
- North Middlesex University Hospital, London, UK
| | - C Kane
- Mount Vernon Cancer Centre, Northwood, UK
| | | | - D Papadatos-Pastos
- University College London Hospitals NHS Foundation Trust, London, UK; Princess Alexandra Hospital, Harlow, UK
| | - T Ahmad
- University College London Hospitals NHS Foundation Trust, London, UK
| | - D Chao
- Royal Free London Hospital, London, UK
| | - G Anand
- North Middlesex University Hospital, London, UK
| | - U S Asghar
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Concr LTD, Cambridge, UK; Croydon University Hospital, Thornton Heath, UK.
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Mir MA, Ahmad T, Gupta ID, Magotra A, Singh AP, Singh M, Pandit A, Muzhupilezhikethu Raveendran V. Association of polymorphisms in exon 6 and 3′-untranslated region of the OLR1 gene with milk production traits in Sahiwal cattle. Journal of Applied Animal Research 2023. [DOI: 10.1080/09712119.2023.2167822] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Mohsin Ayoub Mir
- Division of Animal Genetics and Breeding, Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Tavsief Ahmad
- Division of Animal Genetics and Breeding, Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Ishwar Dayal Gupta
- Animal Genetics and Breeding Division, ICAR-National Dairy Research Institute, Karnal, India
| | - Ankit Magotra
- Animal Genetics and Breeding Division, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, India
| | - Arun Pratap Singh
- Department of Livestock Production and Management, Krishi Vigyan Kendra, Ajmer, India
| | | | - Arif Pandit
- Assistant Director Research, Sher-e-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
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Rashid RH, Ali R, Zahid M, Ali M, Ahmad T. Flexor Hallucis Longus Transfer And V-Y Plasty: An Effective Treatment Modality for Chronic Achilles Rupture - A Case Series. Malays Orthop J 2023; 17:59-65. [PMID: 38107357 PMCID: PMC10722995 DOI: 10.5704/moj.2311.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/22/2022] [Indexed: 12/19/2023] Open
Abstract
Introduction To assess outcomes of FHL transfer and V-Y plasty for chronic Achilles rupture due to insertional Achilles tendinopathy. Materials and methods A case series of 12 patients was conducted between 1st January 2017 and 31st December 2018. The patients had short flexor hallucis longus tendon transfer with gastrocnemius lengthening by V-Y plasty for Achilles tendon rupture. Patients were allowed full weight bearing at six weeks post-operatively, and were followed up at three months and six months post-operatively, when the range of motion of the ankle was examined, and the outcome was assessed using the EFAS score. Results Of the 12 patients in the study, the majority were males; the mean age was 50.6±8.96 years. A significant improvement in dorsiflexion and plantarflexion was noted at the six-month follow-up compared to the three-month follow-up (P=<0.001 for both). When compared to the normal side, dorsiflexion and plantarflexion of the affected ankle were significantly less at three months but were comparable at six months post-operatively. A significant improvement was noted in the mean EFAS score at the six-month follow-up (25.5±5.71) compared to three months (18.6±0.90) post-surgery (P=0.001). Males were also noted to have significantly higher EFAS scores at their six-month follow-up than females (P=0.022). In contrast, a negative correlation was noted between the European Foot and Ankle Society (EFAS) score at the final follow-up and age (P=0.011). Conclusion FHL tendon transfer with V-Y plasty in chronic Achilles rupture due to insertional Achilles tendinopathy is an effective procedure resulting in the restoration of the ankle range of motion and improvement in functional scores.
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Affiliation(s)
- R H Rashid
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - R Ali
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - M Zahid
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - M Ali
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
| | - T Ahmad
- Section of Orthopaedics, Aga Khan University Hospital, Karachi, Pakistan
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Parveen A, Alqahtani F, Javaid S, Ashraf W, Siddique F, Rawat R, Rasool MF, Ahmad T, Alasmari F, Imran I. Anxiolytic potential of resveratrol and rufinamide combination by modulating GABA-ergic transmission: insights from experiments, molecular docking and dynamics simulations. J Physiol Pharmacol 2023; 74. [PMID: 38085514 DOI: 10.26402/jpp.2023.5.02] [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] [Received: 06/05/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023]
Abstract
Resveratrol is a polyphenolic phytocompound known to possess anxiolytic-like effects but its impact on central gammaaminobutyric acid (GABA) modulation has never been explored. The purpose of this study was to analyze the anxiolytic-like effects of resveratrol alone and in combination with rufinamide, an antiepileptic drug which has never been studied for its anxiolytic potential. The BALB/c mice were tested in a battery of behavior testing after administration of resveratrol (50 mg/kg) and rufinamide (50 mg/kg) alone and in combination. Moreover, molecular docking studies were also carried out to understand the interaction of resveratrol and rufinamide with GABA aminotransferase, GABA receptor and GABA-A transporter type 1. Resveratrol alone exerted notable anxiolytic-like effects and improved outcomes in few experiments but rufinamide alone did not yield any beneficial outcomes. However, the animal co-administered with resveratrol and rufinamide behaved exceptionally well (p<0.05) and preferred open, illuminated and exposed areas of open field, light/dark and elevated plus maze. Further, these animals showed reduced anxiety towards anxiogenic stimuli i.e. holes and marbles in hole board and marble bury tests, respectively. Resveratrol and rufinamide showed moderate to strong binding affinities with GABA proteins, indicating the potential to treat anxiety-like neurological disorders. Moreover, resveratrol and rufinamide were analyzed using molecular docking to determine their interaction with GABA receptors, transporters, and transaminase. The results suggest that their anxiolytic-like effects may be due to inhibiting GABA reuptake transporter 1 protein, leading to increased synaptic levels of GABA neurotransmitter, as seen in stable molecular dynamics results with the 7SK2 GABA transporter protein.
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Affiliation(s)
- A Parveen
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - F Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - S Javaid
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
- Department of Pharmacy, The Women University, Multan, Pakistan
| | - W Ashraf
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - F Siddique
- Departmenmt of Pharmaceutical Chemistry, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - R Rawat
- School of Health Sciences and Technology, UPES University, Dehradun, India
| | - M F Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - T Ahmad
- Institut for Advanced Biosciences, Research Center UGA/INSERM U1209/CNRS 5309, University of Grenoble Alpes, Grenoble, France
| | - F Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | - I Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
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Ponce SEB, Small CJ, Ahmad T, Patel K, Tsai S, Kamgar M, George B, Kharofa JR, Saeed H, Dua KS, Clarke C, Aldakkak M, Evans DB, Christians K, Paulson ES, de Choudens SO, Erickson BA, Hall WA. Patterns of Locoregional Pancreatic Cancer Recurrence after Total Neoadjuvant Therapy and Implications on Optimal Neoadjuvant Radiation Treatment Volumes. Int J Radiat Oncol Biol Phys 2023; 117:e284-e285. [PMID: 37785058 DOI: 10.1016/j.ijrobp.2023.06.1270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Neoadjuvant treatment for patients with localized pancreatic adenocarcinoma (PDAC) has improved survival duration. As survival increases, local disease control becomes even more important. We sought to understand the patterns of locoregional recurrence following total neoadjuvant therapy (TNT) and determine the impact of treatment volumes on recurrence. MATERIALS/METHODS Patients with PDAC managed with neoadjuvant chemotherapy and chemoradiation (TNT) followed by surgery who developed an isolated locoregional or simultaneously locoregional and distant recurrence were identified. Locoregional recurrences were individually contoured utilizing commercially available software. When available, original neoadjuvant dose distributions were registered to the scans on which the locoregional recurrences were contoured. Recurrences where then classified as in-field (> 95% of prescription dose), marginal (50-95% of prescription dose), or out of field (< 50% of prescription dose). Target volumes were created using four commonly utilized PDAC contouring guidelines to characterize the relationship of the local recurrence to the RT dose distribution. RESULTS Of 474 patients treated with TNT and surgery, 80 (17%) patients developed a locoregional recurrence with or without distant recurrence, visible on diagnostic imaging. Of the 80 patients, 56 (70%) had tumors in the pancreatic head; 46 (57.5%) were borderline resectable, 23 (28.8%) locally advanced, and 11 (13.6%) resectable. The most common initial neoadjuvant therapies were FOLFIRINOX (57.5%) and gemcitabine/nab-paclitaxel (18.8%). Chemoradiation included concurrent gemcitabine (47.5%) or 5-fluorouracil (26.3%). RT dose distributions were available for 38 patients; 22 (57.9%) had in-field failures, 9 (23.7%) marginal failures, and 7 (18.4%) out of field failures. Each published contouring atlas covered a relatively low percentage of recurrences, which are summarized in Table 1. Regions at particularly high likelihood of recurrence that were under covered on existing atlases included: aortic-diaphragmic junction, retro-pancreatic duodenal nodal basin, and the region to the right of the superior mesenteric artery (SMA). CONCLUSION We present the largest series (to our knowledge) of mapped locoregional recurrences for patients being treated with TNT in PDAC. These recurrences differ substantially from established atlases and highlight anatomical regions of highest priority for RT coverage. A novel visual contouring volume highlighting these regions will be presented which will strive to advance the use of RT in the TNT setting.
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Affiliation(s)
- S E Beltran Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - C J Small
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - T Ahmad
- Medical College of Wisconsin, Milwaukee, WI
| | - K Patel
- Medical College of Wisconsin, Milwaukee, WI
| | - S Tsai
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - M Kamgar
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - B George
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - J R Kharofa
- University of Cincinnati, Department of Radiation Oncology, University of Cincinnati Cancer Center, Cincinnati, OH
| | - H Saeed
- Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida, Boca Raton, FL
| | - K S Dua
- Department of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI
| | - C Clarke
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - M Aldakkak
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - D B Evans
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - K Christians
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - E S Paulson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - S Ortiz de Choudens
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI; Department of Radiation Oncology, Froedtert & the Medical College of Wisconsin, Milwaukee, WI
| | - B A Erickson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - W A Hall
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
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Ragnarsson S, Morrison A, Acuna Higaki A, Mullan C, Sen S, Ahmad T, Anwer M, Geirsson A, Maulion C, Davis R. Utilization of an Independent Procurement Team for Direct Procurement and Machine Perfusion of Cardiac Allografts Following Donation after Cardiac Death. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Alrashed FA, Ahmad T, Alsubiheen AM, Alghamdi SA, Mazi SI, Mohamed NA, Alhayssoni AM. Examining the prevalence of obesity in school children through an on-site obesity outpatient clinics survey based on student's lifestyles. Eur Rev Med Pharmacol Sci 2023; 27:2494-2503. [PMID: 37013767 DOI: 10.26355/eurrev_202303_31783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The purpose of this study was to identify the prevalence of obesity, overweight, and risk factors in pediatric patients attending outpatient clinics at a public sector hospital in the central province of Saudi Arabia. SUBJECTS AND METHODS This cross-sectional study was conducted in Riyadh, the capital of Saudi Arabia, between January 2022 and October 2022. The target population was aged 6-15 years. We conducted on-site obesity assessments utilizing questionnaire-based interviews with patients attending outpatient clinics. Data collection was carried out with the help of parents, where required. Using BMI growth charts for Saudi children and teenagers, the weight, height, and body mass index (BMI) of subjects were computed. RESULTS A total of 576 responses with a response rate of 64% were received and included in the study. In the current study, the majority (41.1%) of the patients were aged between 11 and 12 years old, followed by 37.0% of the students aged between 13 and 15 years old, and 21.9% of students aged between 8 and 10 years old. In the current study, 54.2% of the patients had normal weight, 15.6% of patients were underweight, 16.7% of patients were overweight, and 13.5% were obese. In this study, the prevalence of overall obesity was 2.3 times more prevalent in children aged 11 to 12 years (OR=2.30; p=0.03), followed by ~2 times higher levels in children aged 13 to 15 years (OR=2.30; p=0.03). Moreover, 2.11 times higher prevalence of obesity (OR=2.11; p=0.77) in those who regularly took food (especially lunch) from the school cafeteria. A significant ~2.5 high obesity level was recorded for students who consumed fizzy/soft drinks four or more times per week (OR=2.38; p=0.007). CONCLUSIONS Saudi Arabia still has a high rate of overweight and obesity among children of school-going age, which is a significant public health issue. To properly address and control this issue, policies at the national, local, and individual levels must be implemented. Notably, there was also a high prevalence of being underweight, and this issue needs to be brought up as well.
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Affiliation(s)
- F A Alrashed
- Department of Cardiac Sciences, College of Medicine, King Saud University (KSU), P.O. Box 7805, Riyadh 11472, Saudi Arabia.
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Khan ZI, Muhammad FG, Ahmad K, Alrefaei AF, Ahmad T, Ejaz A, Nadeem M, Shahzadi M, Muqaddas H, Mehmood N. Evaluation of potential ecological risk assessment of toxic metal (lead) in contaminated meadows in the vicinity of suburban city: soil vs forages vs livestock. BRAZ J BIOL 2023; 83:e272087. [PMID: 37075434 DOI: 10.1590/1519-6984.272087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/20/2023] [Indexed: 04/21/2023] Open
Abstract
Heavy metal toxicity is becoming an increasing concern for environmental, human and animal health. The current research analyzed the lead (Pb) contamination in the food chain under three different irrigation sources (ground, canal, and wastewater). Soil, plant and animal samples were collected from the Jhang district of Pakistan and processed with an atomic absorption spectrophotometer. Lead concentration varied in the samples as: 5.22-10.73 mg/kg in soil, 2.46-10.34 mg/kg in forages and 0.736-2.45 mg/kg in animal samples. The observed lead concentration in forage and animal blood samples was higher than the standard limits. The pollution load index (0.640-1.32) in soil showed that lead contamination mainly took place at the wastewater irrigating sites. Bio-concentration factor values (0.313-1.15) were lower than one in all samples except Zea mays, showing that lead metal was actively taken up by Zea mays tissues from the soil. Enrichment factor values ranged from 0.849-3.12, showing a moderate level of lead enrichment. Daily intake and health risk index varied between 0.004-0.020 mg/kg/day and 0.906-4.99, respectively. All the samples showed maximum lead concentration at the wastewater irrigating site compared to the ground or canal water application sites. These results recommended that consistent application of wastewater for forage irrigation must be avoided to prevent health hazards associated with lead in the animal and human food chain. Government must implement adequate strategies to protect the animal and human health from the harms of toxic heavy metals.
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Affiliation(s)
- Z I Khan
- University of Sargodha, Department of Botany, Sargodha, Punjab, Pakistan
| | - F G Muhammad
- University of Sargodha, Department of Botany, Sargodha, Punjab, Pakistan
| | - K Ahmad
- University of Sargodha, Department of Botany, Sargodha, Punjab, Pakistan
| | - A F Alrefaei
- King Saud University, College of Science, Department of Zoology, Riyadh, Saudi Arabia
| | - T Ahmad
- Pakki Thatti R&D Farm, Toba Tek Singh, Punjab, Pakistan
| | - A Ejaz
- University of Sargodha, Department of Botany, Sargodha, Punjab, Pakistan
| | - M Nadeem
- University of Sargodha, Institute of Food Science and Nutrition, Sargodha, Punjab, Pakistan
| | - M Shahzadi
- Ghazi University, Department of Plant Breeding and Genetics, Dera Ghazi Khan, Punjab, Pakistan
| | - H Muqaddas
- The Women University Multan, Department of Zoology, Multan, Punjab, Pakistan
| | - N Mehmood
- University of Sargodha, Department of Zoology, Sargodha, Punjab, Pakistan
- University of Sassari, Department of Veterinary Medicine, Sassari, Italy
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Bhandari M, Othus M, Kirkwood J, Sondak V, Ahmad T, Sharon E, Grossmann K, Ribas A, Patel S, Wuthrick E. Role of Adjuvant Regional Nodal Irradiation in Resected Melanoma: A Secondary Analysis of SWOG S1404. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Huq FN, Momenuzzaman NAM, Chowdhury AW, Hoque MM, Khan KN, Begum F, Shafique AM, Anis R, Rahman MA, Nahar S, Chakraborty S, Ahmad T, Khan TA, Ullah R, Rahman MM. Effect of telephone-monitored home-based cardiac rehabilitation exercise on functional capacity and quality of life in heart failure patients in a lower-middle-income country. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Chronic heart failure (CHF) prevails as one of the major cardiovascular diseases in lower-middle-income countries (LMICs) like Bangladesh. Home-Based Cardiac Rehabilitation (HBCR) is a cost-effective method of secondary prevention of chronic heart failure which, if provided, might not only improve the health status of the patients but might also reduce the financial and hospitalization burden on the health care system of these countries. The study aims to assess the scope and benefits of HBCR in such low resource settings.
Purpose
The study evaluates the effect of telephone-monitored HBCR exercise programme in improving the functional capacity and quality of life (QoL) in patients of CHF with reduced ejection fraction due to ischemic heart disease (IHD).
Method
This self-controlled interventional study was conducted from August 2019 to July 2020 at a heart failure clinic, a tertiary healthcare centre in Bangladesh. A total of 115 patients of CHF with ejection fraction <40% and in NYHA class II and III were included in the study according to selection criteria. The functional capacity of the patients was evaluated by NYHA classification and 6-minute walk test. The quality of life of the patients was evaluated by Minnesota Living with Heart Failure Questionnaire (MLHFQ). All patients were advised to perform HBCR exercise as per recommended guideline and were telephone-monitored 2-weekly. After the 3-months study period, the participants were divided into compliant and partial compliant groups based on their adherence to the guideline. Repeat evaluation of patients' condition was carried out. Results were then compared within the groups and data was analyzed through appropriate statistical methods.
Results
Significant improvement of NYHA class (p<0.05), and 6-minute walk test distance (6MWTD) (1102.01±215.90 feet vs 1243.30±217.86 feet; p<0.001) were noticed after the rehabilitation programme. Improvement of total MLHFQ score was also observed (35.53±14 vs 28.22±12.84; p<0.001) at 3-months follow up. The functional capacity and quality of life of the patients in both the compliant and partially compliant groups showed significant improvement after the rehabilitation programme (p<0.001); though no difference was found in the indicators when compared between compliant vs partially compliant groups after rehabilitation except for 6MWTD (1302.86±219.61 feet vs 1230.71±212.284 feet, p<0.001).
Conclusion
From the results, it can be concluded that any amount of routine exercise tends to improve quality of life and symptoms in patients of chronic heart failure with reduced ejection fraction. However, to achieve the best effect in functional capacity and overall health status, the addition of a structured exercise programme like HBCR can be beneficial for proper rehabilitation in low resource settings. Further validation of the results is recommended through randomized control trials in larger study groups.
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Affiliation(s)
- FN Huq
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | | | - AW Chowdhury
- Dhaka Medical College Hospital, Cardiology, Dhaka, Bangladesh
| | - MM Hoque
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Biochemistry, Dhaka, Bangladesh
| | - KN Khan
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - F Begum
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - AM Shafique
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - R Anis
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - MA Rahman
- Sorkari Karmachari Hospital, Cardiology, Dhaka, Bangladesh
| | - S Nahar
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | | | - T Ahmad
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - TA Khan
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - R Ullah
- United Hospital Ltd, Cardiology, Dhaka, Bangladesh
| | - MM Rahman
- Keraniganj Upazila Health Complex, Dhaka, Bangladesh
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Shoaib M, Khan I, Chanthima N, Alhuthali A, Intachai N, Kothan S, Ahad A, Ullah I, Khattak S, Rooh G, Kaewkhao J, Ahmad T. Photoluminescence analysis of Er3+-ions Doped P2O5-Gd2O3/GdF3-BaO-ZnO glass systems. Journal of Alloys and Compounds 2022. [DOI: 10.1016/j.jallcom.2022.163766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Shad AA, Ahmad T, Iqbal MF, Asad MJ. Effects of a Novel Protease from Bacillus Subtilis K-5 in Low Protein Corn Distiller Dried Grains with Solubles (cDDGS) Based Diets on Performance and Nutrients Digestibility in Broiler Chickens. Braz J Poult Sci 2022. [DOI: 10.1590/1806-9061-2021-1542] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- AA Shad
- Pir Mehr Ali Shah - Arid Agriculture University, Pakistan
| | - T Ahmad
- Pir Mehr Ali Shah - Arid Agriculture University, Pakistan
| | - MF Iqbal
- Pir Mehr Ali Shah - Arid Agriculture University, Pakistan
| | - MJ Asad
- Pir Mehr Ali Shah - Arid Agriculture University, Pakistan; Pir Mehr Ali Shah - Arid Agriculture University, Pakistan
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13
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Abbas MM, Ahmad T, Ahranjani RR, Antonov M, Farid MM, Goliandin D, Hussain A, Kamboj N, Krasnou I, Krumme A, Kumar R, Podgursky V, Viljus M. Tribological and circular economy aspects of polypropylene/cotton fibre hybrid composite. PEAS 2022. [DOI: 10.3176/proc.2022.2.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Abdulghani HM, Ahmed MM, Al-Rezqi AM, Althunayan SA, Mran AL, Alshaya AK, Alharbi FK, Abdulghani AH, Ahmad T. Knowledge and awareness levels of diabetes mellitus risk factors among nondiabetic visitors of primary health care centers: a multicenter study. Eur Rev Med Pharmacol Sci 2021; 25:7066-7077. [PMID: 34859871 DOI: 10.26355/eurrev_202111_27259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE People with a high risk of developing Type 2 Diabetes Mellitus are primarily due to lifestyle factors and can be reduced by implementing awareness programs. Therefore, this study evaluates the diabetic awareness level, risk factors, and lifestyle behaviors among nondiabetic participants. PATIENTS AND METHODS This is a cross-sectional study conducted among 538 nondiabetic participants based on American Diabetic Association (ADA) parameters via face-to-face interview. The sample was collected from five different primary health care centers from November 2019 to February 2020. The target population was nondiabetic with age ≥18 years and participants with other serious chronic illnesses, pregnant women, or unable to communicate effectively were excluded. RESULTS A total of 538 participants without diabetes data were analyzed, of which 363 (67.5%) were males. Good, moderate, and insufficient knowledge of Type 2 Diabetes Mellitus awareness was 34.6%, 52.4%, and 13.0%, respectively. The knowledge level in females' participants was significantly less than the males (OR=2.4; p=0.0005). About 44% had diabetic risk, and the prevalence of diabetes risk was significantly high in males (OR=1.7), obesity (OR=2.9), overweight (OR=2.3), and high blood pressure (OR= 2.2) (all p < 0.05). The risk of diabetes was increased in those participants who consumed more bakery items (p < 0.05). The diabetes risk score was negatively associated with diabetes awareness levels (r= -0.29, p= 0.063). CONCLUSIONS The risk of diabetes in the general population can be prevented by proactive public health awareness campaigns, particularly among elderly age group, with lower educational level, physically inactive, and obese.
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Affiliation(s)
- H M Abdulghani
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Freeman J, Bjerre J, Parzynski C, Minges K, Ahmad T, Desai N, Enriquez A, Spatz E, Friedman D, Curtis J, Hlatky M, Higgins A. Mortality and readmission in non-ischemic compared with ischemic cardiomyopathies after implantable cardioverter-defibrillator implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Uncertainty remains regarding the benefit of primary prevention ICDs overall in contemporary practice, and particularly in those with NICM compared with ICM.
Purpose
To evaluate the contemporary risk of death and readmission following following implantable cardioverter-defibrillator (ICD) implantation in patients with non-ischemic cardiomyopathies (NICM) compared with ischemic cardiomyopathies (ICM) in a large nationally representative cohort in the United States.
Methods
We used data from the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) ICD Registry linked with Medicare claims from April 1, 2010 to December 31, 2013 to establish a cohort of NICM and ICM patients with a left ventricular ejection fraction ≤35% who received a de novo, primary prevention ICD. We compared mortality, all-cause readmission, and heart failure readmission using Kaplan-Meier curves and Cox proportional hazard regressions models. We also evaluated temporal trends in mortality.
Results
Among 31,044 NICM and 68,458 ICM patients with a median follow up of 2.4 years, one-year mortality was significantly higher in ICM patients (12.3%) compared with NICM (7.9%, p<0.001). The higher mortality in ICM patients remained significant after adjustment for covariates (hazard ratio (HR) 1.40; 95% confidence interval (CI) 1.36 to 1.45), and was consistent in subgroup analyses. These findings were consistent across the duration of the study. ICM patients were also significantly more likely to be readmitted for all causes (adjusted HR 1.15, CI 1.12 to 1.18) and for heart failure (adjusted HR 1.25, CI 1.21 to 1.31).
Conclusions
The risks of mortality and hospital readmission after primary prevention ICD implantation were significantly higher in patients with ICM compared with NICM, and these findings were consistent across all patient subgroups tested and over the duration of the study.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Freeman
- Yale University, New Haven, United States of America
| | - J Bjerre
- Gentofte Hospital - Copenhagen University Hospital, Hellerup, Denmark
| | - C Parzynski
- Yale New Haven Hospital, New Haven, United States of America
| | - K Minges
- Yale New Haven Hospital, New Haven, United States of America
| | - T Ahmad
- Yale University, New Haven, United States of America
| | - N Desai
- Yale University, New Haven, United States of America
| | - A Enriquez
- Yale University, New Haven, United States of America
| | - E Spatz
- Yale University, New Haven, United States of America
| | - D Friedman
- Yale University, New Haven, United States of America
| | - J Curtis
- Yale University, New Haven, United States of America
| | - M Hlatky
- Stanford University Medical Center, Stanford, United States of America
| | - A Higgins
- Yale New Haven Hospital, New Haven, United States of America
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Magotra A, Gupta ID, Ahmad T, Alex R. Polymorphism in DNA repair gene BRCA1 associated with clinical mastitis and production traits in indigenous dairy cattle. Res Vet Sci 2020; 133:194-201. [PMID: 33011602 DOI: 10.1016/j.rvsc.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/10/2020] [Accepted: 09/16/2020] [Indexed: 11/24/2022]
Abstract
The present study was conducted on Karan Fries cows to identify SNPs in breast cancer 1 (BRCA1) gene and their association with inflammation of mammary gland and production traits. Chi square analysis showed significant association of both SNPs i.e. G43737229T (P < 0.01) and G43761121A (P < 0.05) with incidence of clinical mastitis. Logistic modeling showed that GG genotype cows of G43737229T SNP was less susceptible to mastitis in comparison to TT genotype cows as the odds ratio of TT against GG for the non-incidence of mastitis was less i.e. 0.23. Whereas, cows with genotype AA of G43761121A SNP were less prone to clinical mastitis in comparison to GG genotype cows. G-T haplotype and GGTT combined genotype exhibited maximum mastitis incidences. Least squares analysis revealed significant association of G43737229T SNP with total milk yield (P < 0.01), 305 days milk yield (P < 0.01) and lactation length (P < 0.05). The TT and GT genotyped Karan Fries cows were associated with higher milk yields during first and second lactation, as well as with first lactation length. These observations on SNPs, genotypes and combined genotypes of BRCA1 gene and their differential association with the incidence of mastitis and production traits can be utilized as an aid to selection for simultaneous improvement of both antagonistic traits.
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Affiliation(s)
- Ankit Magotra
- Department of Animal Genetics and Breeding, Lala Lajpat Rai University of Veterinary and Animal Sciences (LUVAS), Hisar, India.
| | - I D Gupta
- Dairy Cattle Breeding Division, ICAR- National Dairy Research Institute, 132001, Haryana, India
| | - Tavsief Ahmad
- Department of Animal Genetics and Breeding SKAUST-Kashmir, Jammu and Kashmir, India
| | - Rani Alex
- Dairy Cattle Breeding Division, ICAR- National Dairy Research Institute, 132001, Haryana, India
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Ahmad T, Arora P, Nalli Y, Ali A, Riyaz‐Ul‐Hassan S. Antibacterial potential of Juglomycin A isolated from
Streptomyces achromogenes
, an endophyte of
Crocus sativus
Linn. J Appl Microbiol 2020; 128:1366-1377. [DOI: 10.1111/jam.14568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 12/01/2022]
Affiliation(s)
- T. Ahmad
- Microbial Biotechnology Division CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
- Academy of Scientific and Innovative Research CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
| | - P. Arora
- Microbial Biotechnology Division CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
- Academy of Scientific and Innovative Research CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
| | - Y. Nalli
- Natural Products Chemistry Division CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
| | - A. Ali
- Academy of Scientific and Innovative Research CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
- Natural Products Chemistry Division CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
| | - S. Riyaz‐Ul‐Hassan
- Microbial Biotechnology Division CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
- Academy of Scientific and Innovative Research CSIR‐Indian Institute of Integrative Medicine Jammu Tawi India
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Stawiarski K, Agboola O, Park J, Mangi A, Geirsson A, Bellumkonda L, Lee F, Chen M, Jacoby D, Chou J, Ahmad T, Testani J, McCloskey G, Bonde P. The Effects of Less Invasive Extra-Pericardial Placement of Left Ventricular Assist Devices on Right Ventricular Failure in the Early Postoperative Period. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1087] [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: 11/25/2022] Open
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19
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Vinholo T, Mullan C, Mori M, Caraballo C, Ravindra N, Miller E, McCullough M, Clarke J, Geirsson A, Desai N, Ahmad T. Outcomes of Left Ventricular Assist Device Implantation with Mitral Regurgitation with and without Concomitant Mitral Operation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.251] [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: 10/24/2022] Open
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20
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Stawiarski K, Agboola O, Park J, Mangi A, Geirsson A, Lee F, Jacoby D, Bellumkonda L, Ahmad T, Chou J, Testani J, Chen M, McCloskey G, Bonde P. Blood Conservation Strategy at Time of Left Ventricular Assist Device Placement Improves Survival. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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21
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Mullan C, Mori M, Caraballo C, Ravindra N, Miller E, McCullough M, Clarke J, Geirsson A, Desai N, Ahmad T. Clinical Implications of Concomitant Surgical Intervention for Aortic Insufficiency with Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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Mullan C, Mori M, Caraballo C, Ravindra N, Miller E, McCullough M, Clarke J, Geirsson A, Desai N, Ahmad T. Questionable Value of Concomitant Tricuspid Valve Procedure with Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.997] [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: 10/24/2022] Open
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23
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Nabi N, Ganai NA, Shanaz S, Aalam S, Chakraborty D, Bukhari S, Majid R, Shabir M, Ahmad T, Hamadani A, Rather MA. Genetic analysis of fitness traits of corriedale sheep under temperate conditions of Kashmir. Applied Biological Research 2020. [DOI: 10.5958/0974-4517.2020.00032.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Yan H, Jiang Y, Luong M, Naban N, Kane C, Conibear J, Papadatos-Pastos D, Ahmad T, Chao D, Asghar U, Anand G. Delayed onset immune related adverse effects (IRAEs) of pembrolizumab in non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.032] [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: 11/14/2022] Open
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25
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Halle-Smith JM, Ahmad T, Mason G, Barlow A, Gout S. Twenty Years of Military Prehospital Care in the Eastern Sovereign Base Area, Cyprus. BMJ Mil Health 2019; 167:44-47. [PMID: 31320399 DOI: 10.1136/jramc-2019-001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Medical Reception Station (MRS) in Dhekelia provides a prehospital emergency care (PHEC) service for the Eastern Sovereign Base Area and surrounding Cypriot towns. This service has been evaluated previously but some important aspects of care have not yet been measured. The primary aim of this study was to undertake the most comprehensive service evaluation of the demand for the PHEC service at MRS Dhekelia over a 12-month period. The secondary aim of this study was to compare findings in 2018 to those in 1995-1998 and 2013-2016. METHODS All calls to the PHEC team between 01/07/2017 and 30/06/2018 were reviewed and compared with previously reported data from 1995 to 1998 and 2013 to 2016. Data were collected from the occurrence book, the logbook used by the PHEC team to record the details of each call. RESULTS There were 164 calls to the PHEC service during the current study period. The number of activations has decreased since the 2013-2016 period but remains greater than 1995-1998. In every month there was a call to a scene where more than one casualty was present, with the highest number being nine patients at one call. More calls were received during the day (55%). There were more calls because of trauma than medical complaints (55% vs 45%). Trauma calls have reduced over 20 years. The frequency of neurological and psychiatric complaints has increased over 20 years. CONCLUSIONS The PHEC service at MRS Dhekelia is frequently used. The team consistently face with scenes with more than one casualty. Trauma is becoming less frequent but psychiatric and neurological complaints are increasingly common. These findings are important for training and service provision.
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Affiliation(s)
- James Michael Halle-Smith
- Medical School, University of Birmingham, Birmingham, UK .,Medical Reception Station, Dhekelia Station, Dhekelia, Eastern Sovereign Base Area, UK
| | - T Ahmad
- Medical Reception Station, Dhekelia Station, Dhekelia, Eastern Sovereign Base Area, UK
| | - G Mason
- Medical Reception Station, Dhekelia Station, Dhekelia, Eastern Sovereign Base Area, UK
| | - A Barlow
- Medical Reception Station, Dhekelia Station, Dhekelia, Eastern Sovereign Base Area, UK
| | - S Gout
- Medical Reception Station, Dhekelia Station, Dhekelia, Eastern Sovereign Base Area, UK
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Stawiarski K, Agboola O, Jacoby D, Bellumkonda L, Ahmad T, Sugeng L, Chen M, McCloskey G, Geirsson A, Anwar M, Bonde P. Chloride Homeostasis in End Stage Heart Failure and LVAD Recipients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.974] [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] Open
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Stawiarski K, Agboola O, Jacoby D, Bellumkonda L, Sugeng L, Ahmad T, Chen M, McCloskey G, Geirsson A, Anwar M, Bonde P. LVAD Survival May Be Predicted by Preoperative Lymphopenia. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.142] [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] Open
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Akhtar M, Saleem S, Ahmad T, Ahmad E, Lashari M, Ayaz M, Lodhi L, Ahmad I, Hussain I, A khtar M. Effect of lecirelin acetate, hCG or progesterone administration on day 7 post-insemination on conception rate and progesterone concentration in cross-bred cattle. IJVS 2019. [DOI: 10.33899/ijvs.2019.153842] [Citation(s) in RCA: 3] [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: 11/23/2022] Open
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29
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Gomes F, Yip K, Tokaca N, Greystoke A, Escriu C, Conibear J, Ghosh S, Doherty G, Funingana I, Ahmad T, Ahmed S, Cox R, Newsom-Davis T, Mills H, Shah R, Dorey N, Harle A, Dancey G, Baijal S, Geldart T, Ghafoor Q, Tarver K, Talbot T, Forster M, Cove-Smith L, Califano R, Blackhall F, Popat S, Summers Y. The ALK project: a real-world national network and database. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30121-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nahar S, Momenuzzaman AM, Kabir J, Begum F, Khan KN, Ahmed MI, Ahmad T, Shakil SS. Transcatheter Aortic Valve Implantation (TAVI): First Case in Bangladesh. Mymensingh Med J 2019; 28:250-253. [PMID: 30755578] [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: 06/09/2023]
Abstract
We came across an 81 years old male with symptomatic severe aortic stenosis. He was hypertensive and had history of CABG 9 years back. Due to his advanced age and co morbidities, he was at high surgical risk. He underwent transcatheter aortic valve implantation in our centre (United Hospital Ltd) in July 2017 and no complications occurred during or in the peri-procedural period. He had good functional and haemodynamic results at 3 months follow-up.
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Affiliation(s)
- S Nahar
- Dr Samsun Nahar, Specialist (Cardiology), United Hospital Ltd., Dhaka, Bangladesh
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Ahmad T, Bouwman RA, Grigoras I, Aldecoa C, Hofer C, Hoeft A, Holt P, Fleisher LA, Buhre W, Pearse RM. Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery. Br J Anaesth 2018; 119:258-266. [PMID: 28854536 DOI: 10.1093/bja/aex185] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2017] [Indexed: 01/22/2023] Open
Abstract
Background The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a three-fold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failure-to-rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries.
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Affiliation(s)
- T Ahmad
- Queen Mary University of London, London EC1M 6BQ, UK
| | - R A Bouwman
- Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - I Grigoras
- Regional Institute of Oncology, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania
| | - C Aldecoa
- Hospital Universitario Rio Hortega, Valladolid, Spain
| | - C Hofer
- Triemli City Hospital, Zurich, Switzerland
| | - A Hoeft
- University Hospital of Bonn, 53105, Bonn, Germany
| | - P Holt
- St Georges University of London, London SW17 0RE, UK
| | - L A Fleisher
- University of Pennsylvania, Philadelphia, PA, USA
| | - W Buhre
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - R M Pearse
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
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Wang DL, Zhang XF, Jin H, Cheng XQ, Duan CX, Wang XC, Bao CJ, Zhou MH, Ahmad T. Post-exposure prophylaxis vaccination rate and risk factors of human rabies in mainland China: a meta-analysis. Epidemiol Infect 2018; 147:e64. [PMID: 30511609 PMCID: PMC6518593 DOI: 10.1017/s0950268818003175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022] Open
Abstract
Rabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1-98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0-75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7-17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%-83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9-22.1%) was higher than that in the western region (13.3%, 95% CI 11.1-15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6-73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4-44.9%) and only 6.1% (95% CI 4.4-8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.
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Affiliation(s)
- D. L. Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing (210009), China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing (210009), China
| | - X. F. Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, China
| | - H. Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing (210009), China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing (210009), China
| | - X. Q. Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing (210009), China
| | - C. X. Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing (210009), China
| | - X. C. Wang
- Jiangsu Provincial Center for Disease Control and Prevention, China
| | - C. J. Bao
- Jiangsu Provincial Center for Disease Control and Prevention, China
| | - M. H. Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, China
| | - T. Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing (210009), China
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Popat S, Januszewski A, Hughes L, O'Brien M, Ahmad T, Lewanski C, Dernedde U, Jankowska P, Mulatero C, Shah R, Hicks J, Geldart T, Cominos M, Gray G, Spicer J, Bell K, Roitt S, Howarth K, Cinelli M, Green E, Morris C, Ngai Y, Hackshaw A. P1.13-17 Multicentre Phase II Trial of First-Line Afatinib in Patients with Suspected/Confirmed EGFR Mutant NSCLC: ctDNA and Long-Term Efficacy. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.874] [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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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy 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Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Sanders-Branca N, Sosenko J, Arazo L, Arce R, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Eck SP, Finney L, Fischer TA, Martin A, Muzamhindo CJ, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, 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P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Abbott TEF, Ackland GL, Archbold RA, Wragg A, Kam E, Ahmad T, Khan AW, Niebrzegowska E, Rodseth RN, Devereaux PJ, Pearse RM. Preoperative heart rate and myocardial injury after non-cardiac surgery: results of a predefined secondary analysis of the VISION study. Br J Anaesth 2018; 117:172-81. [PMID: 27440628 PMCID: PMC4954612 DOI: 10.1093/bja/aew182] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 12/15/2022] Open
Abstract
Background Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). Methods We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia. The sample was divided into deciles by heart rate. Multivariable logistic regression models were used to determine relationships between preoperative heart rate and MINS (determined by serum troponin concentration), myocardial infarction (MI), and death within 30 days of surgery. Separate models were used to test the relationship between these outcomes and predefined binary heart rate thresholds. Results Patients with missing outcomes or heart rate data were excluded from respective analyses. Of 15 087 patients, 1197 (7.9%) sustained MINS, 454 of 16 007 patients (2.8%) sustained MI, and 315 of 16 037 patients (2.0%) died. The highest heart rate decile (>96 beats min−1) was independently associated with MINS {odds ratio (OR) 1.48 [1.23–1.77]; P<0.01}, MI (OR 1.71 [1.34–2.18]; P<0.01), and mortality (OR 3.16 [2.45–4.07]; P<0.01). The lowest decile (<60 beats min−1) was independently associated with reduced mortality (OR 0.50 [0.29–0.88]; P=0.02), but not MINS or MI. The predefined binary thresholds were also associated with MINS, but more weakly than the highest heart rate decile. Conclusions Preoperative heart rate >96 beats min−1 is associated with MINS, MI, and mortality after non-cardiac surgery. This association persists after accounting for potential confounding factors. Clinical trial registration NCT00512109.
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Affiliation(s)
- T E F Abbott
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - G L Ackland
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - A Wragg
- Barts Health NHS Trust, London, UK
| | - E Kam
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - T Ahmad
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - A W Khan
- Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
| | | | - R N Rodseth
- Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - P J Devereaux
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London, UK
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Kahatab AF, Ho YB, O'Reilly D, Tan C, McTernan J, Ahmad T, O'Halloran A, Sagheri D, Abdollahi A, Mac Giolla Phadraig C. Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study. Eur J Dent Educ 2018; 22:167-173. [PMID: 29193633 DOI: 10.1111/eje.12302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention. METHOD A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis. RESULTS Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course. CONCLUSIONS A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.
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Affiliation(s)
- A F Kahatab
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - Y B Ho
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - D O'Reilly
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - C Tan
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - J McTernan
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - T Ahmad
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - A O'Halloran
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - D Sagheri
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - A Abdollahi
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - C Mac Giolla Phadraig
- Division 1, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
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Walker GJ, Moore L, Heerasing N, Hendy P, Perry MH, McDonald TJ, Debenham T, Bethune R, Bewshea C, Hyde C, Heap GA, Singh A, Calvert C, Kennedy NA, Goodhand JR, Ahmad T. Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study. Aliment Pharmacol Ther 2018; 47:1103-1116. [PMID: 29508423 DOI: 10.1111/apt.14563] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/16/2017] [Accepted: 01/22/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Primary care faecal calprotectin testing distinguishes inflammatory bowel disease (IBD) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded patients with alarm symptoms. AIMS We sought to evaluate the diagnostic accuracy of calprotectin to distinguish IBD from functional gut disorder in young adults in whom general practitioners (GPs) suspected IBD; including patients reporting gastrointestinal alarm symptoms. We hypothesised that calprotectin would reduce secondary care referrals and healthcare costs. METHODS We undertook a prospective cohort study of 789 young adults (18-46 years old) presenting with gastrointestinal symptoms to 49 local general practices that had undergone calprotectin testing (1053 tests: between Jan 2014 and May 2016) because of suspected IBD. We considered calprotectin levels of ≥100 μg/g positive. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard. RESULTS Overall, 39% (308/789) patients reported gastrointestinal alarm symptoms and 6% (50/789) tested patients were diagnosed with IBD. The positive and negative predictive values of calprotectin testing for distinguishing IBD from functional gut disorder in patients with gastrointestinal alarm symptoms were 50% (95% CI 36%-64%) and 98% (96%-100%): and in patients without gastrointestinal alarm symptoms were 27% (16%-41%) and 99% (98%-100%), respectively. We estimate savings of 279 referrals and £160 per patient. CONCLUSIONS Calprotectin testing of young adults with suspected IBD in primary care accurately distinguishes IBD from functional gut disorder, even in patients with gastrointestinal alarm symptoms and reduces secondary care referrals and diagnostic healthcare costs.
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Stawiarski K, Zogg C, Park J, Jacoby D, Bellumkonda L, Chen M, Ahmad T, Testani J, McCloskey G, Sugeng L, Bonde P. Gender and Diastolic Dysfunction May be the Driver of Failure of Myocardial Recovery Following LVAD Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.790] [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: 11/25/2022] Open
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Magotra A, Gupta ID, Verma A, Alex R, Mr V, Ahmad T. Candidate SNP of CACNA2D1 Gene Associated with Clinical Mastitis and Production Traits in Sahiwal (Bos taurus indicus) and Karan Fries (Bos taurus taurus × Bos taurus indicus). Anim Biotechnol 2018; 30:75-81. [PMID: 29463160 DOI: 10.1080/10495398.2018.1437046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study was conducted to identify polymorphisms in CACNA2D1 gene and their association with clinical mastitis and production traits. Exon 18 and its flanking regions were screened for the presence of SNPs. Statistical analysis was performed to identify association of period of birth, breed, and genotype with mastitis incidence on randomly selected 103 Sahiwal and 102 Karan Fries cattle. PCR-RFLP analysis revealed that g.38819398G > A mutation in exon 18 (269 bp amplicon) of CACNA2D1 gene resolved into AA, AG, and GG genotypes in Sahiwal and Karan Fries cattle. Wald chi-square analysis revealed that the period of birth, breed, and genotype were significantly associated with mastitis incidence. GG genotyped cattle were found to be less susceptible to mastitis. Least square analysis revealed that GG and AG genotype animals of G38819398A SNP of CACNA2D1 gene in Sahiwal as well as in Karan Fries cattle were associated with higher average milk yields during 1st, 2nd, and 3rd lactations (P < 0.01). These observations and their differential association with the incidence of mastitis and production traits can be utilized as an aid to selection for simultaneous improvement of both antagonistic traits; however, validation of results on large number of animals is warranted.
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Affiliation(s)
- Ankit Magotra
- a Department of Animal Genetics and Breeding , LUVAS , Hisar , Haryana , India
| | - I D Gupta
- b Dairy Cattle Breeding Division , ICAR- National Dairy Research Institute , Karnal , Haryana , India
| | - Archana Verma
- b Dairy Cattle Breeding Division , ICAR- National Dairy Research Institute , Karnal , Haryana , India
| | - Rani Alex
- c Department of Animal Genetics and Breeding , Central Institute of Research on Cattle , Meerut , Uttar Pradesh , India
| | - Vineeth Mr
- b Dairy Cattle Breeding Division , ICAR- National Dairy Research Institute , Karnal , Haryana , India
| | - Tavsief Ahmad
- d Department of Animal Genetics and Breeding , FVSC & AH, SKUAST-K , Jammu and Kashmir , India
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Abbott TEF, Ahmad T, Phull MK, Fowler AJ, Hewson R, Biccard BM, Chew MS, Gillies M, Pearse RM. The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis. Br J Anaesth 2018; 120:146-155. [PMID: 29397122 DOI: 10.1016/j.bja.2017.08.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/30/2017] [Accepted: 09/18/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. METHODS Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. RESULTS We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); P<0.01], but no difference in complication rates [OR 1.02 (0.88-1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62-0.92); P<0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61-0.88); P<0.01; I2=89%). CONCLUSIONS Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
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Affiliation(s)
- T E F Abbott
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - T Ahmad
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - M K Phull
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - A J Fowler
- Guys and St. Thomas's NHS Foundation Trust, London SE1 7EH, UK
| | - R Hewson
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - M S Chew
- Department of Anaesthesia and Intensive Care, Faculty of Medicine and Health Sciences, Linköping University, 58185 Linköping, Sweden
| | - M Gillies
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh EH48 3DF, UK
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK.
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Abidin R, Ahamat M, Arif A, Ahmad T, Murad M. Investigation on spring characteristics for small arms. J Fundam and Appl Sci 2018. [DOI: 10.4314/jfas.v9i3s.28] [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: 11/17/2022] Open
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Evans J, Kitson R, Shah R, Li S, Ghosh S, Pouptsis A, Ahmed S, Walter H, Ahmad T, Asghar U, Lester J, Newsom-Davis T. 30-day mortality following initiation of immunotherapy for advanced stage lung cancer. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30108-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Uccello M, Kushnir M, Mak G, Murias Henriquez C, Abbosh C, Papadatos-Pastos D, Newsom-Davis T, Ahmad T, Swanton C, Forster M, Lanman R, Faull I, Arkenau HT. Circulating tumour DNA (ctDNA) in the clinical management of patients (pts) with advanced non-small cell lung cancer (NSCLC): A single centre experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.050] [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: 11/14/2022] Open
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Ahmad T. Bilateral bifid mandibular canal: A case report. J ANAT SOC INDIA 2017. [DOI: 10.1016/j.jasi.2017.08.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abbott T, Pearse R, Archbold R, Wragg A, Kam E, Ahmad T, Khan A, Niebrzegowska E, Rodseth R, Devereaux P, Ackland G. Association between preoperative pulse pressure and perioperative myocardial injury: an international observational cohort study of patients undergoing non-cardiac surgery. Br J Anaesth 2017; 119:78-86. [DOI: 10.1093/bja/aex165] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 01/23/2023] Open
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46
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Ahmad T, Malik A, Raza S, Kamran M, Manzoor M, Salman A, Hussain F, Riaz F, Ahmad R, Akhtar M. Thermal, electrochemical and mechanical properties of shape memory alloy developed by a conventional processing route. J Fundam and Appl Sci 2017. [DOI: 10.4314/jfas.v9i2.15] [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: 11/17/2022] Open
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47
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Rasheed F, Yameen A, Ahmad T, Bilal R. Rate of active Helicobacter pylori infection among symptomatic patients of Pakistan. Malays J Pathol 2017; 39:69-72. [PMID: 28413207] [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: 06/07/2023]
Abstract
Only few epidemiological studies have examined the rate of active H. pylori infection in the symptomatic population in Pakistan. This retrospective study presents the laboratory data collected during the past 13 years (2002 to 2015) from 2315 symptomatic patients referred to the BreathMAT Lab, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad for the diagnosis of active H. pylori infection using the 13C Urea Breath Test. Rate of infection and its association with gender and age were evaluated. The overall rate of active H. pylori infection was 49.5% and there was no association of this rate of infection with gender. An increase in rate of infection was observed with increasing age with significant difference (p < 0.05). The patients that tested negative for this infection might be having symptoms due to stress and indiscriminate use of non-steroidal antiinflammatory drugs (NSAIDs) in this community. The fact that half of the symptomatic patients were negative needs to be highlighted and further suggests that symptomatic patients should be tested by the 13C UBT before prescribing antibiotic treatment for H. pylori eradication. In addition, there is a need to educate this community about the harmful and side effects of self medication and overuse of NSAIDs.
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Affiliation(s)
- F Rasheed
- Oncology and Radiotherapy Institute, Nuclear Medicine, Islamabad, Pakistan.
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48
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Heerasing N, Thompson B, Hendy P, Heap GA, Walker G, Bethune R, Mansfield S, Calvert C, Kennedy NA, Ahmad T, Goodhand JR. Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease. Aliment Pharmacol Ther 2017; 45:660-669. [PMID: 28105752 DOI: 10.1111/apt.13934] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 11/20/2016] [Accepted: 12/18/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Few studies have reported the systematic use of exclusive enteral nutrition in the perioperative setting. AIM To test the hypothesis that exclusive enteral nutrition provides a safe and effective bridge to surgery and reduces post-operative complications, in adult patients with Crohn's disease requiring urgent surgery for stricturing or penetrating complications. METHODS Patients treated with exclusive enteral nutrition prior to surgery were each matched with two control patients for disease behaviour, type of surgery, age at diagnosis and disease duration. Data on disease phenotype, nutritional status, operative course and post-operative complications were obtained. RESULTS Twenty-five per cent [13/51] patients treated with exclusive enteral nutrition avoided surgery. Exclusive enteral nutrition had no effect on pre-operative weight, but it significantly reduced serum CRP [median at baseline 36 (interquartile range, IQR: 13-91] vs. pre-operation 8 (4-31) mg/L, P = 0.02]. The median (IQR) length of surgery was shorter in patients pre-optimised with exclusive enteral nutrition than controls [3.0 (2.5-3.5) vs. 3.5 (3.0-4.0) hours respectively, P < 0.001]. Multivariable logistic regression analysis confirmed that going straight-to-surgery compared exclusive enteral nutrition pre-optimisation was associated with a ninefold increase in the incidence of post-operative abscess and/or anastomotic leak [OR 9.1; 95% CI (1.2-71.2), P = 0.04]. CONCLUSIONS Exclusive enteral nutrition frequently down-stages the need for surgery in patients presenting with stricturing or penetrating complications of Crohn's disease; it is associated with a reduction in systemic inflammation, operative times and the incidence of post-operative abscess or anastomotic leak. Further trials are needed to elucidate how exclusive enteral nutrition may improve operative outcomes.
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Affiliation(s)
- N Heerasing
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - B Thompson
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - P Hendy
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - G A Heap
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - G Walker
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - R Bethune
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - S Mansfield
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - C Calvert
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N A Kennedy
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - T Ahmad
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - J R Goodhand
- Exeter IBD group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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49
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Moar K, El-Basyuni S, Ahmad T. The influence of primary repair technique for cleft lip and palate on secondary alveolar bone graft outcomes. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.240] [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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50
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Raza S, Ahmad T, Manzoor M, Kamran M, Ahmad R. Analysis of metallurgical aspects and their role in processing and performance of superalloys: A review. J Fundam and Appl Sci 2017. [DOI: 10.4314/jfas.v9i1.27] [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: 11/17/2022] Open
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