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Pepin ME, Kamal Y, Reisman BJ, Rockman ME, Waller JP. Making the match and breaking it: values, perceptions, and obstacles of trainees applying into physician-scientist training programs. BMC Med Educ 2023; 23:763. [PMID: 37828457 PMCID: PMC10571326 DOI: 10.1186/s12909-023-04736-w] [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] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Replenishing the physician-scientist workforce constitutes a central mission of medical education, but the loss of qualified trainees to non-academic positions remains an ongoing threat. Among the barriers facing physician-scientists today is the game-like model of U.S. medical residency matching through the National Research Matching Program (NRPM), which applies several assumptions regarding the comparability of applicant qualifications, cohort size, and the institutional breadth of applicants' training needs. METHODS The current report therefore summarizes the survey-based views and experiences of physician-scientist trainees obtained following the 2021-2022 application cycle for research-oriented residency programs, or physician-scientist training programs (PSTPs). From among this small cohort of applicants, we obtained survey-based feedback of 27 PSTP applicants across 17 U.S. medical universities, among whom 85% (23/27) matched into a PSTP. RESULTS Among these PSTP applicants, 25/27 (93%) recognized "scientific community" as the most important feature of a postgraduate training program, with applicants identifying as female placing a higher value on the program's infrastructure of personal and/or family support. Most (18/27) respondents found "waiting for interviews" as the most stressful phase of their application cycle, and roughly half of all respondents encountered at least one NRMP policy violation through post-interview communication. Specifically, 93% (25/27) respondents were contacted by at least one PSTP following interviews, and 1/3 of them admitted to feeling pressured into sharing their ranking preferences. CONCLUSION We highlight many previously unrecognized priorities among applicants to PSTPs, which include fostering community among its trainees and reinforcing structured mentoring. We uncover an inconsistency among PSTPs regarding the post-interview process, which represents an opportunity to better support applicants seeking to gauge programs according to their clinical, scientific, and academic interests as physician-scientists, while still adhering to NRMP policies.
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Affiliation(s)
- M E Pepin
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Institut Für Experimentelle Kardiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 669, 69120, Heidelberg, Germany.
| | - Y Kamal
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - B J Reisman
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M E Rockman
- University of Wisconsin Hospitals & Clinics, Madison, WI, USA
| | - J P Waller
- Emory University Hospital, Atlanta, GA, USA
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Kamal Y, Khan T, Haq I, Zahra SS, Asim MH, Shahzadi I, Mannan A, Fatima N. Phytochemical and biological attributes of Bauhinia variegata L. (Caesalpiniaceae). BRAZ J BIOL 2022; 82:e257990. [DOI: 10.1590/1519-6984.257990] [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: 11/07/2021] [Accepted: 01/16/2022] [Indexed: 05/31/2023] Open
Abstract
Abstract Bauhinia variegata plant is a very popular and traditionally potent ethnomedicine. Therefore, it is need of hour to study ameliorative characteristics of B. variegata for novel secondary metabolites. The current study was designed to explore antiproliferative potential of B. variegata due to scant reports on this aspect. Extracts of various parts (flowers, leaves, bark, stem, and roots) were prepared by successive maceration using organic solvents in increasing order of polarity (n-hexane, ethyl acetate, methanol, and water). The determination of polyphenolic contents was done by using colorimetric methods while antioxidant potential was measured using reducing power assay. Brine shrimp lethality assay was performed for determining preliminary cytotoxicity and antiproliferative activity against breast cancer MCF-7 cell line using MTT protocols. Moreover, antimicrobial activities were detected by using disc diffusion assay. The alpha-amylase assay was performed to monitor the antidiabetic potential of the plant. In case of phytochemical analysis methanolic extract of leaves and bark showed highest phenolic and flavonoids contents. n-Hexane and ethyl acetate extracts of stem and roots exhibited more than 90% mortality with LD50 ranges between 1-25 µg/mL when studied by brine shrimp lethality assay. n-Hexane and ethyl acetate extracts of roots and stem also showed antiproliferative activity against human breast cancer MCF-7 cell line with IC50 values ranges between 12.10-14.20 µg/mL. Most of the extracts displayed moderately high antibacterial and antifungal activities. The n-hexane extract of roots showed antidiabetic activity with 60.80 ± 0.20% inhibition of alpha-amylase. In sum, these preliminary results will be useful for further compound isolation from selected plant parts for the discovery of antibacterial, antidiabetic, and anticancer lead candidates.
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Affiliation(s)
- Y. Kamal
- COMSATS University Islamabad, Pakistan; Hamdard University, Pakistan
| | - T. Khan
- COMSATS University Islamabad, Pakistan
| | - I. Haq
- Quaid-i-Azam University, Pakistan
| | | | | | | | - A. Mannan
- COMSATS University Islamabad, Pakistan
| | - N. Fatima
- COMSATS University Islamabad, Pakistan
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Norazlina H, Kamal Y. Elucidating the plasticizing effect on mechanical and thermal properties of poly(lactic acid)/carbon nanotubes nanocomposites. Polym Bull (Berl) 2020. [DOI: 10.1007/s00289-020-03471-2] [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: 10/23/2022]
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Abdelmajid Y, Kamal Y, Rashid A. Lymphocytic autoimmune hypophysitis in a female outside the perinatal period, diagnosed non-invasively and treated successfully. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.882] [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: 11/15/2022]
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Norazlina H, Hadi AA, Qurni AU, Amri M, Mashelmie S, Kamal Y. Effects of multi-walled carbon nanotubes (MWCNTs) on the degradation behavior of plasticized PLA nanocomposites. Polym Bull (Berl) 2018. [DOI: 10.1007/s00289-018-2454-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ahmad Khan H, Bashir Shah A, Kamal Y. Vertical Patellar Dislocation: Reduction by the Push Up and Rotate Method, A Case Report and Literature Review. Trauma Mon 2017; 21:e24705. [PMID: 28184358 PMCID: PMC5292022 DOI: 10.5812/traumamon.24705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/07/2015] [Accepted: 01/10/2015] [Indexed: 11/26/2022] Open
Abstract
Introduction Patellar dislocation is an emergency. Vertical patellar dislocation is rare, often seen in adolescents and mostly due to sports injuries or high-velocity trauma. Few cases have been reported in the literature. Closed or open reduction under general anesthesia is often needed. We report a case of vertical locked patellar dislocation in a 26-year-old male, which was reduced by a simple closed method under spinal anaesthesia. A literature review regarding the various methods of treatment is also discussed. Case Presentation A 26-year-old male experienced a trivial accident while descending stairs, sustaining patellar dislocation. The closed method of reduction was attempted, using a simple technique. Reduction was confirmed and postoperative rehabilitation was started. Follow-up was uneventful. Conclusions Vertical patellar dislocations are encountered rarely in the emergency department. Adolescents are not the only victims, and high-velocity trauma is not the essential cause. Unnecessary manipulation should be avoided. The closed reduction method is simple, but the surgeon should be prepared for open reduction.
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Affiliation(s)
- Hayat Ahmad Khan
- Department of Orthopaedics B and J Hospital, GMC Srinagar, Kashmir, India
- Corresponding author: Hayat Ahmad Khan, Department of Orthopaedics B and J Hospital, GMC Srinagar, Kashmir, India. Tel: +91-9906672626, Fax: +91-1942423389, E-mail:
| | - Adil Bashir Shah
- Department of Orthopaedics B and J Hospital, GMC Srinagar, Kashmir, India
| | - Younis Kamal
- Department of Orthopaedics B and J Hospital, GMC Srinagar, Kashmir, India
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Kamal Y, Khan HA, Gani NU, Farooq M, Shah AB, Khan MA. Interobserver Agreement and Intraobserver Reproducibility of Barzullah Working Classification of Distal End Radius Fractures among Orthopaedic Residents. J Hand Surg Asian Pac Vol 2016; 21:24-9. [PMID: 27454498 DOI: 10.1142/s2424835516500028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study is to test the hypothesis of the new classification system of distal end radius fractures (Barzullah working classification) proposed by one of the author in a prospective cohort study, among the orthopaedic residents. METHODS The initial post-injury radiographs of 300 patients with distal radius fractures in a tertiary centre were classified by two junior residents (JR1 and JR2) and two senior residents (SR1 and SR2) in the emergency department over a period of two years. The collected data was analysed statistically by using Cohan's kappa for measuring Intraobserver reproducibility and Fleiss kappa for measuring Interobserver agreement. RESULTS The mean kappa value for Interobserver agreement was 0.53 (moderate agreement) at the end of one year and the mean kappa value at the end of study period was 0.64 (substantial agreement). The mean kappa value for Intraobserver reproducibility of JR1 was 0.45 (moderate agreement), JR2 was 0.39 (fair agreement), SR1 was 0.62 (substantial agreement) and SR2 was 0.67 (substantial agreement). CONCLUSIONS Barzullah working classification of distal radius fractures presented in this study has good characteristics compared to those of already studied classification systems among orthopaedic residents.
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Affiliation(s)
- Younis Kamal
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
| | - Hayat Ahmad Khan
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
| | - Naseem Ui Gani
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
| | - Munir Farooq
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
| | - Adil Bashir Shah
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
| | - Mohammad Ashraf Khan
- 1 Department of Orthopaedics, Hospital for Bone and Joint Surgery Barzullah, GMC SRINAGAR, India
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El Bastawisy A, Hilal A, Samir Z, Kamal Y. RM-009 Clinical differences between right and left colonic cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw201.09] [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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Kamal Y, Ahmad Khan H, Ahmad Latoo I, Gani N, Farooq M, Gul S. Squat Winnowing: Cause of Meniscus Injuries in Non-Athletic Females. Trauma Mon 2016; 21:e19178. [PMID: 27218040 PMCID: PMC4869424 DOI: 10.5812/traumamon.19178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 07/12/2014] [Accepted: 09/26/2014] [Indexed: 11/16/2022] Open
Abstract
Background: Sports activities were thought to be the major cause of meniscus injury in both men and woman, but our observations of non-athletic females show that the cause of meniscus injury was unrelated to any type of sports activity. Objectives: This study revealed squat winnowing to be a major cause of meniscus injury in non-athletic females. Patients and Methods: This retrospective study was conducted in a tertiary care orthopaedic hospital which caters to a population of 10 million people. We assessed 120 non-athletic females who had received treatment in our hospital over a period of 2 years. The most probable cause of knee injury, per initial patient history, was recorded for all non-athletic females who presented clinical signs and symptoms of meniscus injury. The diagnoses were confirmed by relevant MRI and arthroscopy of patients’ knees. All females who engaged in athletic activity and other females with unrelated, non-traumatic knee pathologies were excluded from the study. Results: Through our study, we found that 42% (n = 50) of females suffered an injury during squat winnowing of rice, either at home or at work. Another 29% (n = 35) of females cited a history of slipping and spraining their knee as a cause of knee injury, while 19% (n = 16) of females suffered a knee injury during complex accidents such as a traffic accident. Finally, 13% (n = 16) of the females had no definite history of knee injury. Conclusions: Our observations add to the knowledge base of the various causes of meniscus tears; this study also revealed that socio-cultural factors influence and contribute to the mechanism of various types of knee injury.
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Affiliation(s)
- Younis Kamal
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
- Corresponding author: Younis Kamal, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India. Tel: +91-9906966960, Fax: +19-4430155, E-mail:
| | - Hayat Ahmad Khan
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
| | - Irfan Ahmad Latoo
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
| | - Naseemul Gani
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
| | - Munir Farooq
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
| | - Snobar Gul
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, India
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Farooq M, Kamal Y, Ahmad Khan H, Gani N, Bashir Shah A, Ashraf Khan M, Bhat S. Concurrent Lateral Condyle Mass Fracture With Olecranon Fracture: A Case Report and Brief Review of Literature. Arch Trauma Res 2016; 5:e24760. [PMID: 28138434 PMCID: PMC5240449 DOI: 10.5812/atr.24760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/09/2015] [Accepted: 11/30/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There is very limited literature describing the association of lateral condyle mass (LCM) fracture of the distal humerus associated concurrently with olecranon fracture. Herein, a case is reported of a displaced LCM fracture with displaced olecranon fracture, due to complex trauma while getting out of a vehicle, which was managed by open reduction and internal fixation. CASE PRESENTATION A 4.5- year- old boy suffered severe pain and swelling around his right elbow due to trauma which he suffered while trying to get out of a vehicle which was in motion. Plain radiographs of the anteroposterior, lateral, and oblique views showed a displaced lateral mass fracture associated with a displaced olecranon fracture. Open reduction and internal fixation was carried out and near normal function was achieved. CONCLUSIONS In view of the paucity of literature and rare incidence of this injury, this case report highlights the need to be aware of other injuries which can occur in association with LCM fractures in children.
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Affiliation(s)
- Munir Farooq
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
| | - Younis Kamal
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
- Corresponding author: Younis Kamal, Postgraduate Department of Orthopaedics, Government Medical College, Srinagar, Jammu and Kashmir, India. Tel: +91-06966960, Fax +91-1942423389, E-mail:
| | - Hayat Ahmad Khan
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
| | - Naseemul Gani
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
| | - Adil Bashir Shah
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
| | - Mohammed Ashraf Khan
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
| | - Shahid Bhat
- Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
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Kamal Y, Khan HA, Gani N, Gupta A, Singh D, Gul S. A Study to Analyses Pattern and Treatment of Upper Cervical Spine Injuries Experience From Developing World. Trauma Mon 2015; 20:e19174. [PMID: 26543839 PMCID: PMC4630596 DOI: 10.5812/traumamon.19174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 05/07/2014] [Accepted: 05/24/2014] [Indexed: 12/02/2022] Open
Abstract
Background: The literature regarding the different patterns of upper cervical spine injuries, their appropriate management, and management development of such injuries is scarce in the world. Objectives: The current study aimed to present the experience regarding the high velocity trauma of upper cervical spine injuries. Patients and Methods: Thirty patients (22 males, 8 females) with upper cervical spine injuries were treated and followed-up for an average of 24 months. The corresponding data were analyzed with respect to various types of injuries and different treatment modalities used to treat such patients keeping the basic healthcare facilities in view. Results: The clinical as well as radiological outcomes of the treatment of such injuries were mostly achievable with minimum facilities in India, with only few complications. Conclusions: Managing such patients needs a proper transport facility, proper care during transport, appropriate evaluation in the hospital and prompt conservative or operative treatment. Treatment is usually safe and effective by well trained professionals with good clinical and radiological outcomes.
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Affiliation(s)
- Younis Kamal
- Postgraduate Department of Orthopaedics, Government Medical College (GMC) Srinagar, Srinagar, India
- Corresponding author: Younis Kamal, Postgraduate Department of Orthopaedics, Government Medical College (GMC) Srinagar, Srinagar, India. Tel: +91-9906966960, E-mail:
| | - Hayat Ahmad Khan
- Postgraduate Department of Orthopaedics, Government Medical College (GMC) Srinagar, Srinagar, India
| | - Naseemul Gani
- Postgraduate Department of Orthopaedics, Government Medical College (GMC) Srinagar, Srinagar, India
| | - Anil Gupta
- Postgraduate Department of Orthopedics, Government Medical Collage Jammu, University of Jammu, Jammu, India
| | - Dara Singh
- Postgraduate Department of Orthopedics, Government Medical Collage Jammu, University of Jammu, Jammu, India
| | - Snobar Gul
- Postgraduate Department of Anatomy, Government Medical College Srinagar, Kashmir University, Srinagar, India
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Gani N, Khan HA, Kamal Y, Farooq M, Jeelani H, Shah AB. Anterior Tarsal Tunnel Syndrome With Thrombosed Dorsalis Pedis Artery: A Case Report. Arch Trauma Res 2015; 4:e21738. [PMID: 26064866 PMCID: PMC4460259 DOI: 10.5812/atr.21738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/23/2014] [Accepted: 12/28/2014] [Indexed: 11/25/2022]
Abstract
Introduction: The aanterior tarsal tunnel syndrome denotes the entrapment of the deep peroneal nerve under the inferior extensor retinaculum. Although various etiological factors have been reported to cause anterior tarsal syndrome, its occurrence with thrombosed dorsalis pedis artery has not been reported in the English literature. Case Presentation: A 40 -year-old male patient was presented with the history of persistent pain along the dorsal surface of right foot, which was aggravated with the activities. Conservative management was tried without much relief. Diagnosis of anterior tarsal tunnel syndrome was made and the patient was planned for surgery. Thrombosed dorsalis pedis artery was found along with two adjacent collateral vessels. Retinaculum was released and nerve was mobilized. Tight compartment got released. Postoperative period was uneventful. No recurrence was seen on follow-up. Conclusion: The anterior tarsal tunnel syndrome is a known disease. A high index of clinical suspicion is required while dealing with the chronic cases. A detailed history to rule out any traumatic event is necessary too. Timely investigations and surgical release give dramatic relief.
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Affiliation(s)
- Naseemul Gani
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
| | - Hayat Ahmad Khan
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
- Corresponding author: Hayat Ahmad Khan, Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India. Tell: +91-9906672626, Fax: +91-194-2423389, E-mail:
| | - Younis Kamal
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
| | - Munir Farooq
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
| | - Hina Jeelani
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
| | - Adil Bashir Shah
- Department of orthopedics, Govt hospital for bone and joint surgery Barzullah, Srinager, India
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Kamal Y, Khan HA, Farooq M, Gani N, Lone AUH, Shah AB, Latto IA, Khan MA. Functional Outcome of Distal Radius Fractures Managed by Barzullah Working Classification. Arch Trauma Res 2015; 4:e20056. [PMID: 25798417 PMCID: PMC4360600 DOI: 10.5812/atr.20056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/28/2014] [Accepted: 12/28/2014] [Indexed: 11/16/2022]
Abstract
Background: Management of distal radius fractures (DRFs) is still controversial and may be influenced by the initial fracture classification. Even though numerous classification systems have been proposed in this regard, the evaluation and management of this fracture has remained problematic. Objectives: The purpose of this study was to evaluate the functional outcome of DRF managed on the basis of a new classification. This classification named as Barzullah Working Classification represents a modification of Melone classification, which is based on fracture stability. Patients and Methods: A total of 310 DRFs of patients skeletally matured referred to a tertiary care hospital at a period of 18 months were classified as per the new classification system into four types; metaphyseal stable, metaphyseal unstable, radiocarpal stable, and radiocarpal unstable fractures. They were managed and followed over a mean period of 15.10 ± 5.4 months, and the results were recorded at the final follow-up. Results: The mean age of the patients was 51.22 ± 20.58 years. Most of the patients were females (n=189, 64.19%). The minimal follow up was 6 months with a mean of 15.10 ± 5.4 months. Mean mayo wrist scores were 95 ± 4, 80 ± 7.4, 75 ± 7.4, and 70 ± 6.9, for stable metaphyseal fractures, unstable metaphyseal radial, stable radiocarpal fractures and unstable radiocarpal fractures, respectively. The overall mean mayo wrist functional score was 80.58 ± 12.3 (good results) at final follow up. Conclusions: Various modalities of treatment used differentially in different types of DRFs based on the Barzullah Working Classification give good results in spite of conflicting literature.
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Affiliation(s)
- Younis Kamal
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
- Corresponding author: Younis Kamal, Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India. Tel: +91-9906966960, E-mail:
| | - Hayat Ahmad Khan
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Munir Farooq
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Naseemul Gani
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Ansar Ul Haq Lone
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Adil Bashir Shah
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Irfan Ahmad Latto
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
| | - Mohammad Ashraf Khan
- Post Graduate Department of Orthopedics, Bone and Joint Hospital, GMC Srinagar, Jammu and Kashmir, India
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Khan HA, Ahad H, Sharma P, Bajaj P, Hassan N, Kamal Y. Correlation between magnetic resonance imaging and arthroscopic findings in the knee joint. Trauma Mon 2015; 20:e18635. [PMID: 25825695 PMCID: PMC4362030 DOI: 10.5812/traumamon.18635] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/13/2014] [Accepted: 05/19/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The knee joint is the largest and the most complex joint of the human body. It is not covered by any thick muscular covering anteriorly. OBJECTIVES The purpose of this study was to explore the diagnostic capabilities of clinical examination, magnetic resonance imaging (MRI), and arthroscopy in traumatic disorders of the knee joint, to seek correlation between clinical findings, MRI findings and arthroscopic. PATIENTS AND METHODS A total of 26 patients with a presentation suggestive of traumatic knee pathology were studied prospectively. A detailed history was taken and relevant clinical examination was done, which was followed by MRI of the knee. The patients were scheduled for arthroscopy under general/spinal anesthesia, whenever indicated. RESULTS Keeping arthroscopic examination as standard, the correlation between clinical and arthroscopy showed a sensitivity of 80%, specificity of 86%, accuracy of 63.16%, negative predictive value of 93.48%; whereas MRI vs. arthroscopy showed a sensitivity of 74.42%, specificity of 93.10%, accuracy of 84.21%, and negative predictive value of 88.04%. CONCLUSIONS The clinical examination is an important and accurate diagnostic modality for evaluation of traumatic derangement of the knee joint. It is noninvasive, easy, available, and valuable diagnostic modality. The MRI is an accurate diagnostic modality. It can be used whenever there is an uncertain indication for arthroscopy. However, costs have to be kept in mind, especially in patients with low socio-economic status.
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Affiliation(s)
- Hayat Ahmad Khan
- Department of Orthopedics, Bone and Joint Hospital, GOVT Medical College Srinagar, University of Kashmir, Srinagar, India
- Corresponding author: Hayat Ahmad Khan, Department of Orthopedics, Bone and Joint Hospital, GOVT Medical College Srinagar, University of Kashmir, Srinagar, India. Tel: +91-9906672626 Fax: +91-1942423389, E-mail:
| | | | | | | | | | - Younis Kamal
- Department of Orthopedics, Bone and Joint Hospital, GOVT Medical College Srinagar, University of Kashmir, Srinagar, India
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Kamal Y, Khan HA, Gani N. Atlas and Axis Injuries Role of Halovest. Int J Health Sci (Qassim) 2014. [DOI: 10.12816/0023991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
Background. Injuries of the midfoot are often missed and therefore underestimated. Early diagnosis and treatment are crucial for the final outcome. The primary aim of this study was to assess the pattern and results of early operative management of mid-foot injuries after a midterm follow up. Material and methods. This study was conducted on 25 patients (19 Males, 6 Females ) with mean age of 34.6 years (range 18-60 years) with mid-foot fracture dislocations who were admitted consecutively at our centre from May 2008 through November 2010. 25 patients fulfilling our inclusion criteria with mid-foot fracture dislocations were included in this study. Mechanism of injury, its pattern and results of operative management of midfoot injuries were assessed after acute management of these fractures on urgent basis. Evaluation of results was done by AOFAS Score. Results. Most common mode of injury was indirect trauma due to fall (n=12) followed by road traffic accident (n=9). Males (n=19) outnumbered females (n=6). The pattern of injuries requiring operative treatment as per our criteria were Lisfranc fracture dislocations (n=22) and navicular fractures (n=3). The mean follow up was 3.2 years and mean AOFAS score at 3.2 years was 78.36, with most patients losing points to pain and decreased recreational function. Conclusion. The Lisfranc fracture dislocations are the most common injuries around midfoot requiring operative treatment, and we believe that operative treatment considerably improves functional outcome in these injuries.
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Affiliation(s)
- Irfan A Latoo
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
| | - Iftikhar H Wani
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
| | - Munir Farooq
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
| | - G R Wali
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
| | - Younis Kamal
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
| | - Naseem Ul Gani
- Postgraduate Department of Orthopaedics, Hospital for Bone and Joint Surgery Government Medical College Srinagar, Kashmir, India
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Gani NU, Khan HA, Kamal Y, Farooq M, Jeelani H, Shah AB. Long term results in refractory tennis elbow using autologous blood. Orthop Rev (Pavia) 2014; 6:5473. [PMID: 25568727 PMCID: PMC4274448 DOI: 10.4081/or.2014.5473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/25/2014] [Accepted: 09/07/2014] [Indexed: 11/30/2022] Open
Abstract
Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males) were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years). The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment.
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Affiliation(s)
- Naseem Ul Gani
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
| | - Hayat Ahmad Khan
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
| | - Younis Kamal
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
| | - Munir Farooq
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
| | - Hina Jeelani
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
| | - Adil Bashir Shah
- The Government Hospital for Bone and Joint Surgery , Barzullah, Srinagar, India
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Kamal Y, Ortho MS, Khan HA, Gani N, Haq AU, Gul S, Singh D. Atlas and axis injuries role of Halovest. Int J Health Sci (Qassim) 2014; 8:335-345. [PMID: 25780353 PMCID: PMC4350888] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest. MATERIALS AND METHODS Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E). RESULTS The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodeficit was observed during the follow up period. CONCLUSION The clinical as well as radiological outcome of these injuries is mostly satisfactory with the conservative management using Halovest. More studies should be conducted to form the guidelines regarding patient selection for conservative management using halovest.
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Affiliation(s)
- Younis Kamal
- Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email
| | - M S Ortho
- Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email
| | - Hayat Ahmad Khan
- DNB ortho, Senior Resident, Postgraduate Department of Orthopaedics, GMC SRINAGAR, Email
| | - Naseemul Gani
- Assistant Professor, Postgraduate Department of Orthopaedics, GMC SRINAGAR
| | - Ansar Ul Haq
- Resident, Postgraduate Department of Orthopaedics, GMC, Jammu
| | | | - Dara Singh
- Professor, Postgraduate Department of Orthopaedics, GMC, Jammu
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Khan HA, Kamal Y, Hassan N. Considerations Regarding Autologus Blood Injection for Tennis Elbow Tendinopathy. Trauma Mon 2014; 19:e19225. [PMID: 25337522 PMCID: PMC4199299 DOI: 10.5812/traumamon.19225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/13/2014] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hayat Ahmad Khan
- Department of Orthopedics, Bone and Joint Hospital, Govt. Medical College, University of Kashmir, Srinagar, India
- Corresponding author: Hayat Ahmad Khan, Department of Orthopedics, Bone and Joint Hospital, Srinagar, Jammu and Kashmir, India. Tel: +91-9906672626 Fax: +91-1942423389, E-mail:
| | - Younis Kamal
- Department of Orthopedics, Bone and Joint Hospital, Govt. Medical College, University of Kashmir, Srinagar, India
| | - Nazia Hassan
- Govt. Medical College, University of Kashmir, Srinagar, India
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Ahmad Khan H, Kamal Y, Lone AUH. Fish hook injury: removal by ''push through and cut off'' technique: a case report and brief literature review. Trauma Mon 2014; 19:e17728. [PMID: 25032153 PMCID: PMC4080619 DOI: 10.5812/traumamon.17728] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 02/11/2014] [Accepted: 02/24/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction: Fishing is a leisure activity for some people around the world. Accidently the fish hook can get hooked in the hand. If the hook is barbed, removal becomes difficult. We report a case of such a injury in the hand and discuss the technique for its removal with a brief review of the literature. Case Presentation: A thirty-two year old male accidently suffered a fishhook injury to his hand. He came to the orthopaedic ward two hours after the incident with pain; the fish hook was hanging from the hand. Unsuccessful attempts to remove it were made by his relatives. A push-through and cut-off technique was used for removal of barbed hook. Discussion: Barbed hooks are to be removed atraumatically with controlled incision over properly anaesthetised skin. Proper wound management and prophylactic antibiotics suitable for treatment of Aeromonas species should be initiated to prevent complications.
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Affiliation(s)
- Hayat Ahmad Khan
- Department of Orthopaedics, Bone and Joint Hospital, Kashmir, India
- Corresponding author: Hayat Ahmad Khan, Department of Orthopaedics, Bone and Joint Hospital, Kashmir, India. Tel.: +91-9906672626, Fax: +91-1942423389, E-mail:
| | - Younis Kamal
- Department of Orthopaedics, Bone and Joint Hospital, Kashmir, India
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Ali N, Sharma S, Sharma S, Kamal Y, Sharma S. Congenital Insensitivity to Pain with Anhidrosis (HSAN Type IV), Extremely Rare Syndrome that Can Be Easily Missed by Bone and Joint Surgeons: A Case Report. Iran J Pediatr 2012; 22:559-63. [PMID: 23429452 PMCID: PMC3533163] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 03/25/2012] [Accepted: 04/08/2012] [Indexed: 11/04/2022]
Abstract
BACKGROUND Congenital insensitivity to pain with anhidrosis is an extremely rare disorder in which injuries can often be missed by patient, parents and even by orthopedic surgeon. Pain and tenderness, on which a trauma team so much depends to make a clinical diagnosis and to decide whether to go for radiological evaluation can be misleading in this rare syndrome. So complete clinical examination still forms the corner stone to avoid misdiagnosis and pick up the rare disorders. CASE PRESENTATION We present a 5 year old girl child, who was brought to us as a case of one and a half month old neglected trauma left leg and was diagnosed to be suffering from congenital insensitivity to pain with anhidrosis (HSAN Type IV). CONCLUSION Congenital insensitivity to pain with anhidrosis is extremely rare entity, in which patients are subjected to repeated injuries which are often neglected. There is no specific treatment but patient training and parent education are key to avoid further neglect and damage.
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Affiliation(s)
- Nadeem Ali
- Corresponding Author:Address: PG Boys Hostel, Govt. Medical College Jammu, Bakshi Nagar, Jammu, Jammu and Kashmir, Pin 180001, India. E-mail:
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Unterscheider J, Kamal Y, Breathnach F, Geary MP. Morbidly adherent placentation: conservative management is an acceptable option in selected cases. J OBSTET GYNAECOL 2011; 31:181-3. [PMID: 21281040 DOI: 10.3109/01443615.2010.539721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kamal Y, Adnan N, Wingfield M. Pregnant until proven otherwise. Ir Med J 2010; 103:60-61. [PMID: 20666062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Affiliation(s)
- Y Kamal
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin 1, Ireland
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Al-Joudi FS, Iskandar ZA, Hasnan J, Rusli J, Kamal Y, Imran AK, Ahmed M, Zakaria J. Expression of survivin and its clinicopathological correlations in invasive ductal carcinoma of the breast. Singapore Med J 2007; 48:607-14. [PMID: 17609820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Survivin is a 16.5-kDa intracellular protein that inhibits apoptosis and regulates cell division, and belongs to the inhibitors of apoptosis gene family. It appears to have an important role in regulating apoptosis at the cell cycle checkpoints. Survivin has been found to have a differential distribution in cancer compared to normal tissue, as it is over-expressed in malignant tumours. METHODS In addition to the demographical analysis of the disease, data from 382 women with invasive ductal carcinoma of the breast were collected from three hospitals in Northeast Malaysia, and analysed for survivin expression by immunohistochemistry. RESULTS Invasive ductal carcinoma of the breast was found to be the most prevalent breast cancer type. Survivin was detected in 260 (68.1 percent) study cases. In addition, significant correlations have been shown between survivin expression on one hand, and tumour size and lymph node involvement on the other hand (p-value is less than 0.05). However, no significant correlations were found with other clinicopathological factors, such as tumour histological grade, tumour side, oestrogen and progesterone receptors. Nuclear expression of survivin was detected in 16.5 percent of the study cases, cytoplasmic expression was detected in 24.1 percent, and 27.5 percent of the cases expressed survivin in both nuclear and cytoplasmic locations simultaneously. The subcellular localisation of survivin was significantly correlated (p is less than 0.001) with the lymph node involvement indicating its value in predicting the aggressiveness of tumour cells, since it increases the resistance to apoptosis and promotes cell proliferation. CONCLUSION This is the fi rst known report on survivin expression in cancer in West Malaysia and Southeast Asia. It emphasises the importance of the detection of survivin in breast cancer to aid in diagnosis, confirm malignancy, and to assess the disease progress and response to therapy.
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Affiliation(s)
- F S Al-Joudi
- School of Dental Sciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia.
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