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Iqbal N, Ali AS, Zahid A, Jabeen K, Irfan M. Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan. Ther Adv Infect Dis 2024; 11:20499361231223887. [PMID: 38164127 PMCID: PMC10757795 DOI: 10.1177/20499361231223887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
Background and objective Fungal empyema is a rare entity which is associated with high mortality. It is mostly seen in immune-compromised hosts. However, there is limited data available on fungal empyema from developing countries regarding risk factors, treatment, and outcome. This study was conducted to determine the risk factors, clinical features, treatment, and outcome of fungal empyema. Methods A retrospective observational study was performed on proven fungal empyema cases, admitted at Aga Khan University Hospital, Karachi, Pakistan during January 2018 to May 2021. We excluded all those patients with polymicrobial bacterial and fungal empyema or with negative pleural fluid cultures. A preformed questionnaire was filled out for each case. Results A total of 26 patients were diagnosed with fungal empyema with a mean age of 43.6 ± 20.3 years. Of these, 16 (61.5%) patients were male. Diabetes mellitus was the most frequent comorbidity (n = 11, 42.3%), followed by hypertension (n = 9, 34.6%), malignancy (n = 6, 23.1%), and asthma (n = 1, 3.8%). Ten (38.5%) patients had multiple comorbidities. Candida spp. was isolated in 21 (80.8%) patients and Aspergillus spp. in 7 (26.9%) patients. Fusarium spp. was isolated from one (3.9%) patient. Video-assisted thoracoscopy surgery was done in 14 (53.8%) patients and 12 (46.1%) patients were managed with tube thoracostomy. Twenty-one (80.8%) patients received antifungal agents. Overall, in-hospital mortality was 38.5% (n = 10) and all patients developed respiratory failure. Clinical improvement was seen in 16 (61.5%) patients. Conclusion Our data suggest that fungal empyema has a poor outcome as almost one-third of our patients died. Early diagnosis and intervention can improve outcome.
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Affiliation(s)
- Nousheen Iqbal
- Department of Medicine, Jinnah Medical and Dental College, 22-23, Shaheed-e-Millat Road, Karachi-74000, Pakistan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Stadium Road Karachi 74800, Pakistan
| | - Akbar Shoukat Ali
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Aqusa Zahid
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Kausar Jabeen
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan
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Ali D, Zubairi M, Ayub M, Awan S, Ali AS, Sarwar Zubairi AB. An Easy-To-Use Prehospital Severity Scoring Tool To Triage COVID-19 Positive Adults In A Resource-Limited Setting. J PAK MED ASSOC 2023; 73:1959-1964. [PMID: 37876051 DOI: 10.47391/jpma.6058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Objectives To develop an easy-to-use severity scoring tool for prehospital triage of patients infected by the coronavirus disease-2019 in resource-limited settings. METHODS The cohort study was conducted at a tertiary care hospital in Karachi, from August to September 2020, and comprised adult patients of either gender who tested positive for coronavirus disease-2019 on real-time polymerase chain reaction. The scoring system and categorisation were based on validated scales for the detection of pneumonia and opinions from pulmonologists. Data was analysed using SPSS 19. RESULTS Of the 206 participants, 100(48.5%) were in-patients and 106(51.5%) were out-patients. There were 144(69.9%) males and 62(30.1%) females with an overall mean age of 48.4±16.2 years. After categorisation based on severity, significantly higher number of in-patients were found to be in categories III and IV (p<0.05). CONCLUSIONS The severity scoring tool could effectively help classify coronavirus disease-2019 patients into mild, moderate and severe cases.
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Affiliation(s)
| | - Mustafa Zubairi
- Final Year MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Maaha Ayub
- Final Year MBBS Student, Aga Khan University Medical College, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Akbar Shoukat Ali
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Sarwar Zubairi AB, Rabbani U, Hassan M, Fatmi Z, Ahmed N, Ali AS, Rizvi N. Risk Factors Of Idiopathic Pulmonary Fibrosis In Pakistani Population: A Matched Case-Control Studyy. J PAK MED ASSOC 2023; 73:1782-1787. [PMID: 37817684 DOI: 10.47391/jpma.6099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
OBJECTIVE To evaluate the factors associated with idiopathic pulmonary fibrosisrisk. Methods The case-controlstudywas conductedfromJanuary 5, 2017,toSeptember 4, 2018, attheprivate-sectorAga Khan University Hospital and the public-sector Jinnah Postgraduate Medical Centre, two large tertiary care centres in Karachi, andcomprisedadultpatientsof eithergenderwithdiagnosedidiopathicpulmonary fibrosis, asdefinedby the IndianChest Registry. Subjects without idiopathic pulmonary fibrosis but registered with the department of pulmonology of the two hospitalswere enrolledas controls.Datawas collectedusinga structuredquestionnaire, andanthropometricmeasurements were noted for each subject. Gastroesophageal reflux disease was assessed using GerdQ. This wasfollowed by serological evaluations and spirometry. Data was analysed using SPSS 21. RESULTS Of the 459 subjects, 154(33.6%)were cases and305(66.4%)were controls.Amongthe cases, 81(52.6%)were females and 73(47.4%) were males with mean age 66.1±10.9 years. Among the controls, 162(53.1%) were females and 143(46.9%) were males with mean age 64.6±11.1 years(p>0.05.)The most common ethnicity wasUrdu-speaking; 89(58%) among the cases and 150(49%) among the controls (p<0.05). Ethnicity, number of persons in the household per room, and type of house were significantly associated with the risk of developing idiopathic pulmonary fibrosis(p<0.05). CONCLUSIONS Ethnicity,type of house and the number of personsin a household perroom were found to be the significant risk factorsfor idiopathic pulmonary fibrosisIPF.
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Affiliation(s)
| | - Unaib Rabbani
- Family Medicine Academy, Qassim Health Cluster, Buraidah, Saudi Arabia
| | - Maryam Hassan
- Department of Medicine, Aga Khan University Hospital, Karachi,Pakistan
| | - Zafar Fatmi
- Department of Community Health Sciences, Aga Khan University Hospital karachi, Pakistan
| | - Naseem Ahmed
- Department of Chest Medicine, Jinnah Post-Graduate MedicalCenter, Karachi,Pakistan
| | - Akbar Shoukat Ali
- Department of Medicine, Aga Khan University Hospital, Karachi,Pakistan
| | - Nadeem Rizvi
- Department of Chest Medicine, Jinnah Post-Graduate MedicalCenter, Karachi,Pakistan
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Martins RS, Hussain H, Chaudry M, Rizvi NA, Mustafa MA, Ayub B, Aamdani SS, Rehman AA, Pervez A, Nadeem S, Khalid R, Ali AS, Shahid S, Zubairi ABS, Haider AH, Irfan M. GRADE-ADOLOPMENT of clinical practice guidelines and creation of clinical pathways for the primary care management of chronic respiratory conditions in Pakistan. BMC Pulm Med 2023; 23:123. [PMID: 37069600 PMCID: PMC10111762 DOI: 10.1186/s12890-023-02409-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION In Pakistan, chronic respiratory conditions contribute a large burden of morbidity and mortality. A major reason for this is the lack of availability of local evidence-based clinical practice guidelines (EBCPGs) in Pakistan, particularly at the primary care level. Thus, we developed EBCPGs and created clinical diagnosis and referral pathways for the primary care management of chronic respiratory conditions in Pakistan. METHODS The source guidelines were selected by two local expert pulmonologists after a thorough literature review on PubMed and Google Scholar from 2010 to December 2021. The source guidelines covered idiopathic pulmonary fibrosis, asthma, chronic obstructive pulmonary disorders, and bronchiectasis. The GRADE-ADOLOPMENT process consists of three key elements: adoption (using recommendations as is or with minor changes), adaptation (effective context-specific changes to recommendations) or additions (including new recommendations to fill a gap in the EBCPG). We employed the GRADE-ADOLOPMENT process to adopt, adapt, adopt with minor changes, or exclude recommendations from a source guideline. Additional recommendations were added to the clinical pathways based on a best-evidence review process. RESULTS 46 recommendations were excluded mainly due to the unavailability of recommended management in Pakistan and scope beyond the practice of general physicians. Clinical diagnosis and referral pathways were designed for the four chronic respiratory conditions, explicitly delineating the role of primary care practitioners in the diagnosis, basic management, and timely referral of patients. Across the four conditions, 18 recommendations were added (seven for IPF, three for bronchiectasis, four for COPD, and four for asthma). CONCLUSION The widespread use of the newly created EBCPGs and clinical pathways in the primary healthcare system of Pakistan can help alleviate the morbidity and mortality related to chronic respiratory conditions disease in the country.
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Affiliation(s)
- Russell Seth Martins
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
| | - Hawra Hussain
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Maryam Chaudry
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Nashia Ali Rizvi
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
| | - Mohsin Ali Mustafa
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
| | - Bushra Ayub
- Learning Research Centre, Patel Hospital, Karachi, 75300, Pakistan
| | | | - Alina Abdul Rehman
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
| | - Alina Pervez
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
| | - Sarah Nadeem
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
- Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Rameesha Khalid
- Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Akbar Shoukat Ali
- Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Shayan Shahid
- Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Ali Bin Sarwar Zubairi
- Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan
- Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Adil H Haider
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Muhammad Irfan
- Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan.
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Alosaimi NS, Sattar Ahmad MAA, Alkreathy HM, Ali AS, Khan LM. Pharmacological basis of the putative therapeutic effect of Topical Vitamin D3 on the experimental model of atopic dermatitis in mice. Eur Rev Med Pharmacol Sci 2022; 26:6827-6836. [PMID: 36196731 DOI: 10.26355/eurrev_202209_29785] [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: 06/16/2023]
Abstract
OBJECTIVE The aim of the study was to explore the effect of topical vitamin D3 in atopic dermatitis (AD) induced by ovalbumin (OVA) in contrast with topical betamethasone in mice. MATERIALS AND METHODS 35 BALB/c adult male mice, weighing between 25-30 gm were used to induce AD by topically sensitizing the dorsal surface of the skin with the OVA patch. Subsequently, treatments were performed in each group by application of vitamin D3 cream (0.0003%), betamethasone cream (0.1%), or vehicles (QV cream) on the skin. RESULTS Remarkably, vitamin D3 had a marked improvement in the skin of OVA-induced AD mice. Additionally, vitamin D3 revealed a considerable diminution in the levels of IgE, IL-5, filaggrin, and epidermal thickness, whereas a significant augmentation in the levels of IL-4 and IL-13 was observed when compared with the control group, and histopathological studies had further confirmed these findings. CONCLUSIONS This study essentially highlighted the anti-inflammatory effect of vitamin D3 by effective alteration in the immunological components responsible for AD. Moreover, this pioneer experimental work represents a new paradigm and sheds a light on the importance of vitamin D3 in the implications of AD. A comprehensive creative approach is crucial to concretely establish and further corroborate vitamin D3 for this therapeutic role.
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Affiliation(s)
- N S Alosaimi
- Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Siddiqui HF, Saleem A, Javed SO, Saadia S, Qasim P, Ali SS, Zubairi ABS, Ali AS. A meta-analysis on incidence of barotrauma in patients with COVID-19 ARDS undergoing invasive mechanical ventilation. Adv Respir Med 2022; 90:ARM.a2022.0027. [PMID: 35199847 DOI: 10.5603/arm.a2022.0027] [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: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022]
Abstract
Barotrauma is a common complication in patients with Acute Respiratory Distress Syndrome (ARDS) undergoing Invasive Mechanical Ventilation (IMV) [...]
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Affiliation(s)
| | - Aqsa Saleem
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Sheema Saadia
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Syed Saad Ali
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Akbar Shoukat Ali
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Al-Qahtani AA, S Alenzi AA, Ali AS. Is clinical diagnosis of diabetic kidney disease through persistent albuminuria is superseded by histopathological footprints? Saudi J Kidney Dis Transpl 2022; 32:584-585. [PMID: 35017358 DOI: 10.4103/1319-2442.335476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zubairi ABS, Shaikh A, Zubair SM, Ali AS, Awan S, Irfan M. Persistence of post-COVID lung parenchymal abnormalities during the three-month follow-up. Adv Respir Med 2021; 89:477-483. [PMID: 34612504 DOI: 10.5603/arm.a2021.0090] [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: 03/08/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19. MATERIAL AND METHODS An observational study was conducted in patients with post-COVID lung parenchymal abnormalities from April till September 2020. Patients ≥18 years of age with COVID-19 who were diagnosed as post-COVID lung parenchymal abnormality based on respiratory symptoms and HRCT chest imaging after the recovery of acute infection. Data was recorded on a structured pro forma, and descriptive analysis was performed using Stata version 12.1. RESULTS A total of 30 patients with post-COVID lung parenchymal abnormalities were identified. The mean age of patients was 59.1 (SD 12.6), and 27 (90.0%) were males. Four HRCT patterns of lung parenchymal abnormalities were seen; organizing pneumonia in 10 (33.3%), nonspecific interstitial pneumonitis in 17 (56.7%), usual interstitial pneumonitis in 12 (40.0%) and probable usual interstitial pneumonitis in 14 (46.7%). Diffuse involvement was found in 15 (50.0%) patients, while peripheral predominance in 15 (50.0%), and other significant findings were seen in 8 (26.7%) patients. All individuals were treated with corticosteroids. The case fatality rate was 16.7%. Amongst the survivors, 32.0% recovered completely, 36.0% improved, while 32.0% of the patients had static or progressive disease. CONCLUSION This is the first study from Southeast Asia that identified post-COVID lung parenchymal abnormalities in patients who had no pre-existing lung disease highlighting the importance of timely recognition and treatment of this entity that might lead to fatal outcome.
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Affiliation(s)
| | - Anjiya Shaikh
- Medical College, Aga Khan University, Karachi, Pakistan
| | | | - Akbar Shoukat Ali
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Khan ZA, Allana R, Afzal I, Ali AS, Mariam O, Aslam R, Shah IA, Allana A, Mohsin Haider M, Jandani R, Khan Z, Siddiqui AM, Shah JA, Butt U. Assessment of attitude and hesitancy towards vaccine against COVID-19 in a Pakistani population: A mix methods survey. ACTA ACUST UNITED AC 2021; 23:S26-S32. [PMID: 34512220 PMCID: PMC8421102 DOI: 10.1016/j.vacun.2021.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
Objective The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population. Materials and methods A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020. Results The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females; 60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001). Conclusion This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.
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Affiliation(s)
- Zainab Aqeel Khan
- Research Lead, Research and development department, AO Hospital, Karachi, Pakistan
| | - Raheel Allana
- Research Associate, Department of Paediatrics, Agha Khan University Hospital, Karachi, Pakistan
| | - Irrum Afzal
- Research Lead, Academic surgical unit, South West London Elective Orthopaedic Centre, London, UK
| | - Akbar Shoukat Ali
- Research Associate, Department of medicine, Agha Khan University Hospital, Karachi, Pakistan
| | - Omama Mariam
- Postgraduate trainee in Biostatistics and Epidemiology, School of public health, Dow University of Health Science, Karachi, Pakistan
| | - Reema Aslam
- Postgraduate trainee in Biostatistics and Epidemiology, School of public health, Dow University of Health Sciences, Karachi, Pakistan
| | - Imran Ali Shah
- Consultant Orthopaedic and Trauma Surgeon, Department of trauma and orthopaedics, Medical Director, AO Hospital, Karachi, Pakistan
| | - Asad Allana
- MSc candidate in epidemiology and biostatistics, Department of community health sciences, Agha Khan University Hospital, Karachi, Pakistan
| | - M Mohsin Haider
- Lecturer, Department of community dentistry, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Rahim Jandani
- Lecturer, Dow Institute of nursing and midwifery, Dow University of Health Sciences, Karachi, Pakistan
| | - Zeeshan Khan
- Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, AO Hospital, Karachi, Pakistan
| | - Athar M Siddiqui
- Consultant Orthopaedic and Spine Surgeon, Department of spinal surgery, A.O Hospital, Karachi, Pakistan and Consultant Spinal Surgeon, Guys and St Thomas's NHS trust, UK
| | - Junaid Ali Shah
- Consultant Orthopaedic and Trauma Surgeon, AO Hospital, Karachi, Pakistan
| | - Umer Butt
- Sports Injury Unit, AO Hospital, Karachi, Pakistan and Circle Bath Hospital, UK
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Ali AS, Khan Z, Pemberton M. A RARE CASE OF CHEILITIS GLANDULARIS AFFECTING THE UPPER LIP: CASE REPORT AND LITERATURE REVIEW. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Al-Qahtani AA, Alenzi AAS, Jandani R, Shoukat Ali A. Early Projection of Kidney Allograft Rejection Through Deep Learning: A Way Forward. EXP CLIN TRANSPLANT 2020; 19:176-177. [PMID: 32967601 DOI: 10.6002/ect.2020.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ali AS, Allana R, Jandani R. Comments on Jahan et al (JPMA 70: 390-393; 2020) Association of single nucleotide polymorphism of transforming growth factor β1 (T29C) in breast cancer patients: A case control study in Rawalpindi. J PAK MED ASSOC 2020; 70:1295. [PMID: 32799299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Akbar Shoukat Ali
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Raheel Allana
- School of Public Health, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Rahim Jandani
- Institute of Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Al-Qahtani AA, S Alenzi AA, Ali AS. Sample Size Estimation: Often A Disregarded, And Yet An Essential Driver Of Research Quality And Integrity. J Ayub Med Coll Abbottabad 2020; 32:424-425. [PMID: 32829567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | | | - Akbar Shoukat Ali
- Department of Medicine, Aga Khan University Hospital, and School of Public Health, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Ali AS, Graham RM. Perils of intermaxillary fixation screws. Br J Oral Maxillofac Surg 2020; 58:728-730. [PMID: 32418762 PMCID: PMC7200358 DOI: 10.1016/j.bjoms.2020.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/19/2022]
Affiliation(s)
- A S Ali
- Oral and Maxillofacial Surgery Department, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester, M8 5RB
| | - R M Graham
- Oral and Maxillofacial Surgery Department, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester, M8 5RB.
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Ali AS, Allana R, Jandani R. Letter to the Editor: Pediatric Injuries in Kids Cafés and Risk Factors for Significant Injuries: a 6-Year Cross-Sectional Study Using a Multicenter Injury Registry in Korea. J Korean Med Sci 2020; 35:e146. [PMID: 32329260 PMCID: PMC7183841 DOI: 10.3346/jkms.2020.35.e146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 03/01/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Akbar Shoukat Ali
- School of Public Health, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
- Department of Medicine, The Aga Khan University, Karachi, Pakistan.
| | - Raheel Allana
- School of Public Health, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Rahim Jandani
- Institute of Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Al-Qahtani AA, S Alenzi AA, Ali AS. Playerunknown's Battlegrounds: Yet Another Internet Gaming Addiction. J Ayub Med Coll Abbottabad 2020; 32:145-146. [PMID: 32468776] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The overarching goal of video games is to amuse the end-users by means of interactive systems that are now existent across numerous platforms such as personal computer, mobile phones, tablets and game consoles. Player Unknown's Battlegrounds (PUBG) is a multiplayer online game. The addiction of PUBG is soaring worldwide and it has thick user-base. It is suggested that inhuman attitudes such as lack of empathy and war-related sentiments are likely to emerge among children who play aggressive and violent games like PUBG. In 2018, World Health Organisation (WHO) acknowledged online gaming compulsion as a grave mental health problem. Some of the well-known repercussions of playing PUBG video game are eyes strain, exhaustion, headache, obesity, poor quality of sleep, insomnia, withdrawal symptoms (rage and irritability) and even drug abuse owing to compulsive disorder. This game craze is unfortunately triggering world's young population to invest their valuable time, money and effort in a no-return business, and therefore needs urgent measures.
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Nuruddin R, Ali AS, Mohammed N. Time to adopt Developmental Origins of Health and Disease (DOHaD) science in Pakistan. J PAK MED ASSOC 2019; 69:1581-1583. [PMID: 31740858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Rozina Nuruddin
- Department of Community Health Sciences, Aga Khan University, Pakistan
| | - Akbar Shoukat Ali
- Department of Community Health Sciences, Aga Khan University, Pakistan
| | - Nuruddin Mohammed
- Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan
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Khan MT, Hamid R, Ali AS. Long-term health consequences of living kidney donation: From the perspective of donors. Saudi J Kidney Dis Transpl 2019; 30:995-997. [PMID: 31464263 DOI: 10.4103/1319-2442.265482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Muhammad Tassaduq Khan
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Rashid Hamid
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Akbar Shoukat Ali
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Hamid RB, Khan MT, Ali AS. Prognostication of acute kidney allograft rejection through urinary molecular signatures: A noninvasive approach to ameliorate kidney rejection dynamics. Saudi J Kidney Dis Transpl 2019; 30:752-753. [PMID: 31249250 DOI: 10.4103/1319-2442.261369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rashid Bin Hamid
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Muhammad Tassaduq Khan
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Akbar Shoukat Ali
- Renal Transplant Unit, National Institute of Solid Organ and Tissue Transplantation, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Björkman A, Shakely D, Ali AS, Morris U, Mkali H, Abbas AK, Al-Mafazy AW, Haji KA, Mcha J, Omar R, Cook J, Elfving K, Petzold M, Sachs MC, Aydin-Schmidt B, Drakeley C, Msellem M, Mårtensson A. From high to low malaria transmission in Zanzibar-challenges and opportunities to achieve elimination. BMC Med 2019; 17:14. [PMID: 30665398 PMCID: PMC6341737 DOI: 10.1186/s12916-018-1243-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 06/29/2018] [Accepted: 12/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substantial global progress in the control of malaria in recent years has led to increased commitment to its potential elimination. Whether this is possible in high transmission areas of sub-Saharan Africa remains unclear. Zanzibar represents a unique case study of such attempt, where modern tools and strategies for malaria treatment and vector control have been deployed since 2003. METHODS We have studied temporal trends of comprehensive malariometric indices in two districts with over 100,000 inhabitants each. The analyses included triangulation of data from annual community-based cross-sectional surveys, health management information systems, vital registry and entomological sentinel surveys. RESULTS The interventions, with sustained high-community uptake, were temporally associated with a major malaria decline, most pronounced between 2004 and 2007 and followed by a sustained state of low transmission. In 2015, the Plasmodium falciparum community prevalence of 0.43% (95% CI 0.23-0.73) by microscopy or rapid diagnostic test represented 96% reduction compared with that in 2003. The P. falciparum and P. malariae prevalence by PCR was 1.8% (95% CI 1.3-2.3), and the annual P. falciparum incidence was estimated to 8 infections including 2.8 clinical episodes per 1000 inhabitants. The total parasite load decreased over 1000-fold (99.9%) between 2003 and 2015. The incidence of symptomatic malaria at health facilities decreased by 94% with a trend towards relatively higher incidence in age groups > 5 years, a more pronounced seasonality and with reported travel history to/from Tanzania mainland as a higher risk factor. All-cause mortality among children < 5 years decreased by 72% between 2002 and 2007 mainly following the introduction of artemisinin-based combination therapies whereas the main reduction in malaria incidence followed upon the vector control interventions from 2006. Human biting rates decreased by 98% with a major shift towards outdoor biting by Anopheles arabiensis. CONCLUSIONS Zanzibar provides new evidence of the feasibility of reaching uniquely significant and sustainable malaria reduction (pre-elimination) in a previously high endemic region in sub-Saharan Africa. The data highlight constraints of optimistic prognostic modelling studies. New challenges, mainly with outdoor transmission, a large asymptomatic parasite reservoir and imported infections, require novel tools and reoriented strategies to prevent a rebound effect and achieve elimination.
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Affiliation(s)
- A Björkman
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.
| | - D Shakely
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A S Ali
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - U Morris
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden
| | - H Mkali
- MEASURE Evaluation, Dar es Salaam, Tanzania
| | - A K Abbas
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - A-W Al-Mafazy
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - K A Haji
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - J Mcha
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - R Omar
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - J Cook
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,London School of Hygiene and Tropical Medicine, London, UK
| | - K Elfving
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
| | - M Petzold
- Centre for Applied Biostatistics, University of Gothenburg, Gothenburg, Sweden
| | - M C Sachs
- Biostatistics Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B Aydin-Schmidt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden
| | - C Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Msellem
- Training and Research, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - A Mårtensson
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Ali AS. The dynamics of microRNA in aging: Embrace, trace and ace. J PAK MED ASSOC 2019; 69:136. [PMID: 30623932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Ali AS, Benton JA, Yates JM. Risk of inferior alveolar nerve injury with coronectomy vs surgical extraction of mandibular third molars-A comparison of two techniques and review of the literature. J Oral Rehabil 2017; 45:250-257. [PMID: 29171914 DOI: 10.1111/joor.12589] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 11/28/2022]
Abstract
The removal of mandibular third molar teeth is one of the most common oral surgical procedures. In a significant number of patients, it carries a degree of associated morbidity, including damage to the inferior alveolar nerve (IAN). For this reason, practitioners desire the most up-to-date guidance on the most appropriate technique, informed by the best available evidence that will produce the lowest incidence of iatrogenic complications. The aim of this study was to perform a systematic review comparing the effect of coronectomy vs complete surgical extraction of mandibular third molar teeth on the risk of IAN injury and other complications in adults. Studies were identified through Embase (1980-2016) and Ovid MEDLINE (1946-2016) database searches. Search terms included coronectomy, partial root removal, deliberate vital root retention, odontectomy, surgical removal, surgical extraction, complete tooth extraction and extract. Limits of the study included humans, English language and randomised controlled trials (RCTs). Only RCTs comparing IAN damage associated with surgical extraction of mandibular third molars vs coronectomy were included. From our database searches, we identified two unique RCTs matching the inclusion criteria. Both evaluated patients who had specific radiographic signs of intimate relationships with the IAN. Upon detailed analysis, the studies were noted to exhibit a high risk of bias in many categories, thereby rendering their results inconclusive. Although evidence from two RCTs suggests that coronectomy can reduce the risk of IAN injury compared to surgical removal of high-risk mandibular third molars, the quality of evidence is insufficient to provide definitive conclusions regarding the preferred technique.
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Affiliation(s)
- A S Ali
- Department of Oral and Maxillofacial Surgery, Division of Dentistry, University of Manchester, Manchester, UK
| | - J A Benton
- Department of Oral and Maxillofacial Surgery, Division of Dentistry, University of Manchester, Manchester, UK
| | - J M Yates
- Department of Oral and Maxillofacial Surgery, Division of Dentistry, University of Manchester, Manchester, UK
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Ali AS, Ajaz A. The role of mucin-educated platelet activation in tumor invasiveness: An unfolding concern in the realm of cancer biology. Biomedicine (Taipei) 2017; 7:21. [PMID: 29130446 PMCID: PMC5682980 DOI: 10.1051/bmdcn/2017070421] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/11/2017] [Indexed: 01/04/2023] Open
Abstract
Metastasis is a complex and well-coordinated phenotypic transformation of cancer cells governed by aberrant genetic and molecular pathways. It has been approved as the most consistent cause of cancer death. With emerging insight into the genomics, transcriptomics and proteomics, progress has been made and reasonably large number of molecular pathways of metastasis has been forwarded, but our understanding of precise underlying molecular mechanisms remains largely scarce. It has been well-known for around a decade and more that platelets are intriguingly contributing to the cancer metastasis. However, it is only recently that cancer cells can activate platelets have started to become apparent. Surprisingly, platelets in response to cancer cell activation, supported by research observations, allow cancer cells to escape immune removal, prolong survival in vascular compartment, increased cellular adhesion and develop new cellular niches which eventually help to favor cancer metastasis. Although a widely acknowledged plausible explanation that cancer cells activate platelets to facilitate in their distant spread, the description of this remains to be confirmed. In recent years, mucins, heavily glycosylated peptide structure, have been introduced to be released by several types of cancer cells. They account for poor prognosis in wide array of malignancies, because of their significant ability to induce metastatic process. The mechanism responsible for their increased metastatic propensity remains uncharacterized, but recent work suggested the role of cancer expressed mucins in initiating platelet thrombus. The association of cancer yield mucins, platelets and metastasis therefore suggests a pressing need to explore novel molecular mechanisms and therapeutic targets thereafter.
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Affiliation(s)
- Akbar Shoukat Ali
- Senior Research Assistant, Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, The Aga Khan University Hospital, Karachi 74800, Pakistan
| | - Arzoo Ajaz
- Pharm. D Student, Department of Pharmacy, Jinnah University for Women, Karachi 74600, Pakistan
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Affiliation(s)
- Akbar Shoukat Ali
- Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Afroza Aftab
- School of Nursing and Midwifery (SONAM), The Aga Khan University, Karachi, Pakistan
| | - Arzoo Ajaz
- Department of Pharmacy, Jinnah University for Women, Karachi, Pakistan
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Ali AS, Ajaz A, Hamid H. Emerging protagonists in cancer metastasis: An oath of allegiance by platelets. J PAK MED ASSOC 2017; 67:330-332. [PMID: 28303976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Akbar Shoukat Ali
- Department of Anaesthesiology, The Aga Khan University, Karachi, & Bachelor of Science in Nursing (BSN), Institute of Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Arzoo Ajaz
- Pharm D Students, Jinnah University of Women, Karachi, Pakistan
| | - Heeba Hamid
- Pharm D Students, Jinnah University of Women, Karachi, Pakistan
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Ali AS, Ahmed J, Ali AS, Sonekhi GB, Fayyaz N, Zainulabdin Z, Jindani R. Practices of self-medication with antibiotics among nursing students of Institute of Nursing, Dow University of Health Sciences, Karachi, Pakistan. J PAK MED ASSOC 2016; 66:235-237. [PMID: 26819180] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Self-medication practice among nursing students is of growing concern. Access to drugs and handling them in their future practices make nursing students susceptible to self-prescription and self-medication. This cross-sectional study assesses the prevalence and pattern of self-medication with antibiotics among nursing students of Institute of Nursing, Dow University of Health Sciences, Karachi, Pakistan. A random sample of convenience of 160 nursing students underwent a predesigned questionnaire. More than half of nursing students 79 (52.7%) experienced self-medication with antibiotics. It was more prevalent among males 49 (62%) . Knowledge about the drug 59 (74.7%) and convenience 13 (16.5%) were the key reasons to self-medicate. Fever 37 (46.8%) and sore throat 27 (34.2%) were the common symptoms predisposing to self-medication. Beta-lactam group of antibiotics 35 (44.3%) was most frequent used. Only 26 (32.9%) respondents completed the entire antibiotic course. Efforts must be directed towards educating nursing students about responsible and informed self-medication practices.
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Affiliation(s)
- Akbar Shoukat Ali
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Javed Ahmed
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Akbar Shoukat Ali
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Gomand Beekho Sonekhi
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Nargis Fayyaz
- Nursing Student, Bachelor of Science in Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Zeeshan Zainulabdin
- Nursing Student, Bachelor of Science in Nursing, Indus College of Nursing, Islamic Mission Hospital, Karachi, Pakistan
| | - Rahim Jindani
- Nursing Student, Master of Science in Nursing, Institute of Nursing, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
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Ali AS, Fejzic J, Grant GD, Nissen LM. Pharmacists' self-perceptions in relation to the 'Advanced Pharmacy Practice Framework'. Res Social Adm Pharm 2015; 12:496-508. [PMID: 26385722 DOI: 10.1016/j.sapharm.2015.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 08/12/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Australian Pharmacy Practice Framework was developed by the Advanced Pharmacy Practice Steering Committee and endorsed by the Pharmacy Board of Australia in October 2012. The Steering Committee conducted a study that found practice portfolios to be the preferred method to assess and credential Advanced Pharmacy Practitioner, which is currently being piloted by the Australian Pharmacy Council. Credentialing is predicted to open to all pharmacists practising in Australia by November 2015. OBJECTIVE To explore how Australian pharmacists self-perceived being advanced in practice and how they related their level of practice to the Australian Advanced Pharmacy Practice Framework. METHOD This was an explorative, cross-sectional study with mixed methods analysis. Advanced Pharmacy Practice Framework, a review of the recent explorative study on Advanced Practice conducted by the Advanced Pharmacy Practice Framework Steering Committee and semi-structured interviews (n = 10) were utilized to create, refine and pilot the questionnaire. The questionnaire was advertised across pharmacy-organizational websites via a purposive sampling method. The target population were pharmacists currently registered in Australia. RESULTS Seventy-two participants responded to the questionnaire. The participants were mostly female (56.9%) and in the 30-40 age group (26.4%). The pharmacists self-perceived their levels of practice as either entry, transition, consolidation or advanced, with the majority selecting the consolidation level (38.9%). Although nearly half (43.1%) of the participants had not seen the Framework beforehand, they defined Advanced Pharmacy Practice similarly to the definition outlined in the Framework, but also added specialization as a requirement. Pharmacists explained why they were practising at their level of practice, stating that not having more years of practice, lacking experience, or postgraduate/post-registration qualifications, and more involvement and recognition in practice were the main reasons for not considering themselves as an Advanced Pharmacy Practitioner. To be considered advanced by the Framework, pharmacists would need to fulfill at least 70% of the Advanced Practice competency standards at an advanced level. More than half of the pharmacists (64.7%) that self-perceived as being advanced managed to fulfill 70% or more of these Advanced Practice competency standards at the advanced level. However, none of the self-perceived entry level pharmacists managed to match at least 70% of the competencies at the entry level. CONCLUSION Participants' self-perception of the term Advanced Practice was similar to the definition in the Advanced Pharmacy Practice Framework. Pharmacists working at an advanced level were largely able to demonstrate and justify their reasons for being advanced practitioners. However, pharmacists practising at the other levels of practice (entry, transition, consolidation) require further guidance regarding their advancement in practice.
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Affiliation(s)
- A S Ali
- School of Pharmacy, Griffith University, Gold Coast, Qld, Australia.
| | - J Fejzic
- School of Pharmacy, Griffith University, Gold Coast, Qld, Australia; School of Pharmacy, University of Queensland, Brisbane, Australia
| | - G D Grant
- School of Pharmacy, Griffith University, Gold Coast, Qld, Australia
| | - L M Nissen
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld, Australia
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Ahmad A, Asghar N, Taj M, Faizan M, Ali AS. Challenges in Treating Hodgkin Lymphoma in a Developing Country: Children Hospital Lahore Experience. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371148] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Clinicians are routinely challenged in their management of cancer patients because of the complexities of obesity and diabetes that are often found as comorbid conditions. Although attention has been given to optimizing treatment planning for these patients, less attention has been given to manage their obesity and diabetes. This suggests that newer, comprehensive approaches must be developed for the treatment of cancer patients as a 'whole' rather than as a single disease. While the specific pathologies of each are unique, years of research have indicated intimate molecular links between these chronic diseases. The contribution of sedentary lifestyles and poor dietary habits is recognized; however, the precise molecular links are still not well-explored. In addition, emerging evidence suggests the important role of microRNAs (miRNAs) in the development and progression of several diseases, yet their roles in linking obesity, diabetes and cancer are only now beginning to be recognized. It is hoped that miRNAs will serve as novel biomarkers and molecular targets for cancer therapy in patients with comorbid conditions. In this review, we discuss the current understanding of the pathobiology of obesity, diabetes and cancer, and document molecular roles of miRNAs linking cancer with obesity and diabetes.
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Affiliation(s)
- A S Ali
- Department of Pathology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan 48201, USA
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Baker A, Tóth A, Horváth D, Walkush J, Ali AS, Morgan W, Kukovecz A, Pantaleone JJ, Maselko J. Precipitation pattern formation in the copper(II) oxalate system with gravity flow and axial symmetry. J Phys Chem A 2009; 113:8243-8. [PMID: 19569701 DOI: 10.1021/jp9007703] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chemical systems that are far from thermodynamic equilibrium may form complex temporal and spatiotemporal structures. In our paper, we present unusual precipitation patterns that have been observed in the system of Cu(II)-oxalate. Starting with a pellet of copper sulfate immersed in or by pumping copper sulfate solution into a horizontal layer of sodium oxalate solution, we have observed the formation of a precipitate ring and an array of radially oriented thin fingers. The development of these patterns is related to the internal structure of the different crystals, the gravity flow, and the circular symmetry of the experimental arrangement.
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Affiliation(s)
- A Baker
- Chemistry Department, University of Alaska, Anchorage, USA
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Ali AS, Rosman H, Alam M, Singireddy S, Craven B, Lesch M. The clinical implications (or lack thereof) of vegetations detected by echocardiography in patients not thought to have endocarditis. Clin Cardiol 2009; 21:191-3. [PMID: 9541763 PMCID: PMC6655654 DOI: 10.1002/clc.4960210311] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The clinical impact of echocardiographic demonstration of a vegetation (Veg) in patients in whom infective endocarditis (IE) is not suspected has not previously been analyzed. HYPOTHESIS In this study, an echocardiographic database was interrogated to test whether discovery of a vegetation by echocardiography should result in treatment for endocarditis if IE is not suspected. METHODS In all, 2,750 serial transthoracic echocardiograms (TTE) were reviewed to generate a list of reports containing the word Veg or thickening (Thk). A chart review of cases identified the impact the report had on patient management. To analyze reader bias due to echocardiographic requests, stating "rule out Veg or IE" as the reason for the study, an additional 1,000 serial TTE requests were segregated into two groups with and without this term. The incidence of the terms Veg or Thk in TTE reports of these groups was tabulated. RESULTS Of 2,750 reports, 20 contained the word Veg. Blood cultures were drawn in 16 of 20, with 7 of 16 being positive. Therapy for IE was initiated in 5 of 7 patients with positive cultures. Of 1,000 requests reviewed in the second phase, 24% of those with rule out Veg as the indication for TTE (n = 29) had Veg and 7% had Thk, while in 971 cases with other indications for TTE 0.2% had Veg and 9.3% had Thk. CONCLUSIONS Clinicians disregard TTE demonstration of Veg if clinical suspicion for IE is low. It is not clear whether the initial echo request biases the interpretation.
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Affiliation(s)
- A S Ali
- Department of Medicine, Henry Ford Hospital, Detroit, Michigan, USA
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Abstract
BACKGROUND AND HYPOTHESIS Limited data exist regarding racial differences in heart failure. The objective of this prospective study was to document racial differences in the baseline demographics and patterns of health care utilization and outcomes in patients with heart failure. METHODS The data on 163 consecutive patients (113 black, 50 white) admitted with a diagnosis of heart failure confirmed by pulmonary congestion on chest x-ray were prospectively evaluated. Patient demographics, physical examination findings at admission, comorbid conditions, and medications at admission and discharge were analyzed. Follow-up was performed to document visits to the physician's office after discharge and readmission rate during a 6-month time period. RESULTS Compared with whites, blacks were younger in age (mean age 63.8 +/- 13.7 years vs. 70.8 +/- 13.1, p = 0.003), and had a higher prevalence of hypertension (86 vs. 66%, p = 0.004), left ventricular hypertrophy (24 vs. 8%, p = 0.02), ejection fraction < 40% (64 vs. 43%, p = 0.03), and readmission rate (33 vs. 18%, p = 0.05). Whites had a higher prevalence of atrial fibrillation (42 vs. 21%, p = 0.006) and more frequently followed up with their cardiologists as outpatients (58 vs. 39%, p = 0.04). CONCLUSION Significant racial differences exist in patients with heart failure with regard to age, incidence, etiologic factors, left ventricular hypertrophy, left ventricular function, and clinical follow-up. It is important to consider these racial differences in the evaluation and management of patients with heart failure.
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Affiliation(s)
- A Afzal
- Henry Ford Heart and Vascular Institute, Detroit, Michigan 48202, USA
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Ahmad MS, Ali SA, Ali AS, Chaubey KK. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent 2006; 24:84-9. [PMID: 16823233 DOI: 10.4103/0970-4388.26022] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An etiological and epidemiological study of oral submucous fibrosis (OSMF) has been done in Patna, Bihar. Total 157 cases of OSMF and 135 control subjects were selected for study in the period of 2002-2004. It was observed that Male:Female ratio was 2.7:1. The youngest case of OSMF was 11 year old and the oldest one was 54 years of age. Maximum number of cases were belonging to 21-40 years of age and they were belonging to low or middle socioeconomic class. Most of the OSMF cases used heavy spices and chillies, where as control mild spices and chillies. Gutkha was the most commonly used by the OSMF cases only 3 per cent did not use any gutkha or other areca nut product where as 80 per cent control did not have any chewing habit. The OSMF cases used gutkha and other products 2-10 pouches per day and kept in the mouth for 2-10 minutes and they were using since 2-4 years. Most of the OSMF cases kept gutkha in the buccal vestibule or they chewed and swallowed it, only a small number of patients chewed and spitted it out. It was also observed that OSMF developed on one side of the buccal vestibule where they kept the chew and other side was normal.
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Affiliation(s)
- M S Ahmad
- Dental Public Health Science College, Dammam 31481, Saudi Arabia
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Thomas DR, Kamel H, Azharrudin M, Ali AS, Khan A, Javaid U, Morley JE. The relationship of functional status, nutritional assessment, and severity of illness to in-hospital mortality. J Nutr Health Aging 2005; 9:169-75. [PMID: 15864397] [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: 05/02/2023]
Abstract
BACKGROUND Prediction of in-hospital mortality may direct hospital resources towards those patients most at risk. A number of single domain risk instruments have been developed, indicating that functional status, nutritional assessment, and severity of illness individually predict in-hospital mortality. The interaction among these predictors is less well described. OBJECTIVE To determine the relationship of functional status, nutritional assessment, and severity of illness to in-hospital mortality. DESIGN, SETTING, SUBJECTS Cohort study of 1712 consecutive admissions over a one year period to an Internal Medical Service at a tertiary university teaching hospital. MAIN OUTCOME MEASURES Death during hospital admission. RESULTS Dependency in activities of daily living (OR = 3.37, 95% CI 1.78 to 6.37, p = 0.0002) and body mass index less than 20 (OR = 2.38, 95% CI 1.20 to 4.74, p = 0.01) predicted in-hospital mortality after adjusting for nutritional risk assessment, and severity of illness score. CONCLUSIONS Impairment in functional status and low body mass index produce the best predictors of inhospital mortality, after adjusting for nutritional risk and severity of illness score. Among these factors, functional impairment may be amenable to correction.
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Affiliation(s)
- D R Thomas
- Division of Geriatric Medicine, Saint Louis Health Sciences Center and, GRECC, Veterans Administration Center, MO 63104, USA.
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Zeenathul NA, Mohd-Azmi ML, Ali AS, Aini I, Sheik-Omar AR, Abdul-Rahim AM, Bahaman AR, Kamarudin AI. Genomic variations among wildtype and mutant strains of pseudorabies virus. Rev Argent Microbiol 2002; 34:7-14. [PMID: 11942085] [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: 02/24/2023] Open
Abstract
Both wild-type virulent and mutant strains of pseudorabies virus (PrV) were used in this study. Mutants used were derived from the plaque purified strain PrVmAIP. A total of six drug resistant mutants, three bromodeoxyuridine (BUdR) resistant and three iododeoxyuridine (IUdR) resistant, respectively, were isolated and passaged in chicken embryo fibroblast (CEF) cells. The DNA of these PrVs were compared with the wild-type isolates by means of the restriction fragment pattern (RFP) findings produced with Bam HI, Kpn I, Hind III and Bgl II restriction enzymes (RE). Compared to the wild-type PrVs (PrV-VBA1-parental strain of PrVmAIP; PrV-VBA2; PrV-VBA3), the RFP of PrVmAIP showed the presence of mutations within the RE sites studied. Both PrV-VBA1 and PrV-VBA2 appeared to be closely related but their RFPs differed from PrV-VBA3. Significant differences either in the number, size or migrations of the DNA fragments could also be detected in the BUdR resistant strains. Even though different features of cytopathic effect (GPE) were observed in the IUdR resistant PrVs, the RFP findings remained identical. The PrVs studied showed considerable differences from the reference PrV (PrV-CD).
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Affiliation(s)
- N A Zeenathul
- Faculty of Veterinary Medicine, University Putra Malaysia 43400 UPM, Serdang, Selangor, Malaysia.
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Islam SI, Ali AS, Fida NM. An evaluation of theophylline dosing. Suggested by the Saudi national protocol for children with severe asthma. Saudi Med J 2001; 22:1092-5. [PMID: 11802183] [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: 02/23/2023] Open
Abstract
OBJECTIVE To evaluate the impact of Saudi national protocol on the diagnosis and management of asthma for optimizing theophylline use in children with severe asthma. To also review theophylline clearance and provide guidelines for individualization of doses. METHODS Theophylline level was estimated in blood samples of 66 children with severe asthma who were admitted to King Abdulaziz University Hospital during the period 1998-1999. The theophylline doses given to these patients was reviewed and patients were categorized into 2 groups: Group one had received doses recommended by Saudi national protocol +/- 10%, group 2 had received doses <90% of that recommended by Saudi national protocol. The distribution of theophylline levels in blood samples of each group was estimated. Theophylline steady state level was used to estimate theophylline clearance using a standard pharmacokinetic equation. RESULTS Out of the total samples from group one, 70% of theophylline levels were within therapeutic range, while only 10% of the total samples of group 2 were within therapeutic range. The mean theophylline clearance in children (1-8 years) was estimated as 0.092 +/- 0.023 and was found significantly higher than the mean theophylline clearance (0.069 +/- 0.014) which is observed in older children (9-13 years). CONCLUSION Saudi national protocol theophylline dose guidelines had a favorable impact on the optimization of theophylline use in children with severe asthma. Guidelines that ensure accurate adjustment of doses on individual basis in view of drug level were suggested.
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Affiliation(s)
- S I Islam
- Drug Monitoring Unit, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
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Abstract
Telomerase is a telomere-specific DNA polymerase consisting of protein and RNA components, which is activated in germline cells and the majority of cancers and serves to counter the consequences of telomere shortening. The protein component, hTERT, is believed to be the catalytic subunit of human telomerase and its expression at the mRNA level correlates well with telomerase activity in vitro. Current techniques for assaying telomerase activity detect only the mean activity in a sample and are unable to isolate specific cell sub-populations. This report describes the development and validation of a cellular, immunofluorescence-based flow cytometry assay that allows detection of intranuclear hTERT while maintaining identifiable cell population characteristics. The assay was shown to be both sensitive to changes in telomerase expression and was semi-quantitative. In both cell line differentiation experiments and in primary cells, a good correlation existed between hTERT expression measured by flow cytometry and telomerase activity detected by the telomeric repeat amplification protocol (TRAP). The method developed offers a quick, simple and reproducible cellular-based assay for hTERT expression. This assay will provide a useful, new tool for future investigations, facilitating the analysis of hTERT expression in mixed cell populations.
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Affiliation(s)
- A S Ali
- Department of Experimental Haematology, Paterson Institute for Cancer Research, Manchester, UK
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Ali AS, Rybicki BA, Alam M, Wulbrecht N, Richer-Cornish K, Khaja F, Sabbah HN, Goldstein S. Clinical predictors of heart failure in patients with first acute myocardial infarction. Am Heart J 1999; 138:1133-9. [PMID: 10577445 DOI: 10.1016/s0002-8703(99)70080-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The occurrence of heart failure associated with an acute myocardial infarction has a strong adverse effect on long-term morbidity and mortality. The prediction and prevention of heart failure could influence these adverse events. METHODS AND RESULTS We studied 483 consecutive patients who had their first acute myocardial infarction and who were admitted within 24 hours of the onset of symptoms. Heart failure was defined as the presence of pulmonary rales or an S3 gallop, or the presence of alveolar or interstitial edema by radiograph. Baseline demographic data, determination of peak creatine phosphokinase level, echocardiographic left ventricular ejection fraction, blood pressure, and pulse were obtained. Heart failure occurred in 41.6% (201 of 483) of the patients. We observed a bimodal occurrence of heart failure with an early occurrence at admission in 4% (20 of 483) followed by a second increase beginning after the fourth day of admission in 39% of the remaining patients (181 of 463). Predictors of early heart failure were older age, diabetes mellitus, or previous cardiac symptoms, whereas the predictors of heart failure after the fourth day included the same demographic predictors in addition to a history of hypertension, male sex, increased peak creatine phosphokinase level and heart rate, and decrease in left ventricular ejection fraction. In-hospital death occurred in 5.3% compared with 1.4% (P =.012) in patients who did and did not have heart failure, respectively. The occurrence of heart failure during hospital admission also adversely affected the 18-month follow-up, with 14.9% deaths in the patients with heart failure and 6.4% in those without heart failure (P =.002). CONCLUSION Heart failure is frequently associated with acute myocardial infarction and occurs with a bimodal distribution and is associated with increased risk of death during hospitalization and during 18 months of follow-up. Predictors of early heart failure include previous medical conditions and age. The second peak occurrence can be predicted by similar characteristics in addition to increased peak creatine phosphokinase level, decreased left ventricular ejection fraction, and increased heart rate.
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Affiliation(s)
- A S Ali
- Sacred Heart Mercy Center, Alma, MI, USA
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Abstract
Two cases of optic neuropathy associated with cimetidine therapy are reported. Recovery occurred in both after drug withdrawal. Rechallenge with the same agent totally reproduced the condition in the first case. Cimetidine exerts an unequivocal toxicity on the central and peripheral nervous systems. Since its introduction in 1976, it has been used in over 100 million patients, but only 3 cases of optic neuropathy have been reported as far as we know. Although the mechanism of toxicity is still unclear, cimetidine is a well-recognized zinc chelator, and zinc deficiency has been implicated in causing optic neuropathy. Hence, it can be concluded that cimetidine produced this toxicity through its mechanism of zinc chelation. However, close ophthalmic follow-up of such patients is unnecessary, but an unexplained visual deterioration should prompt immediate drug withdrawal.
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Affiliation(s)
- M A Sa'adah
- Medical Department, Islamic Hospital, Amman, Jordan.
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Abstract
The changes that take place in the structure and form of the left ventricle have become closely related to increase in clinical events in patients with heart failure. These changes are included in the term remodeling and occur as a response to the initial loss of left ventricular muscle mass. The mechanisms that initiate and maintain this remodeling process have become of great importance since a variety of effective pharmacologic agents have become available. A more complete understanding of remodeling has the potential of preventing the progression of heart failure. This article considers the various aspects of left ventricular remodeling including the cardiomyocytes, the myocardial interstitium, the importance that apoptosis plays the remodeling process.
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Affiliation(s)
- S Goldstein
- Department of Medicine, Case Western Reserve University, Michigan, USA
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Abstract
Histamine and 2-methyl histamine caused dose-dependent aggregation of the integumental melanophores of Rana tigerina both in vitro and in vivo. The aggregating effects were antagonised by mepyramine and metiamide, specific H1 and H2 receptor blockers, respectively. Compound 48/80 and EDTA augmented the melanin-aggregating effects of exogenously applied histamine and 2-methyl histamine in in vivo experiments. 4-Methyl histamine, a specific H2 receptor agonist, dispersed the frog melanophores in in vitro studies, the dispersing effects were blocked by metiamide.
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Affiliation(s)
- S A Ali
- Post Graduate Zoology Department, Saifia College of Science and Education, Bhopal, India
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Syed MA, Al-Malki Q, Kazmouz G, Kharrat H, Ali AS, Jacobsen G, Jafri SM. Usefulness of exercise echocardiography in predicting cardiac events in an outpatient population. Am J Cardiol 1998; 82:569-73. [PMID: 9732881 DOI: 10.1016/s0002-9149(98)00397-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prognostic value of exercise echocardiography in an outpatient population is not well defined. A total of 1,020 consecutive patients referred for exercise echocardiography in an ambulatory care setting were studied by reviewing their medical records and exercise echocardiographic data. Of these, 71 (7%) were excluded due to technically inadequate tests, leaving 949 patients who were included in the analysis. A positive exercise echocardiogram (EE) was defined as an appearance of a new wall motion abnormality or worsening of a baseline abnormality. Cardiac events, defined as myocardial infarction, coronary angioplasty, coronary bypass surgery, and death, were documented during a 12-month follow-up period. Cardiac events occurred in 17% of patients (26 of 152) with a positive exercise echocardiogram (EE) and in 2.5% (20 of 797) with a negative EE (p <0.001). The incidence of myocardial infarction (2.6% vs 0.4%, p <0.02), coronary angioplasty (7% vs 1%, p <0.001), and coronary bypass surgery (9% vs 1%, p <0.001) were higher in patients with a positive versus a negative EE. There was 1 death in the positive study group and none in the negative group. Significant independent variables (p <0.05) that predicted cardiac events included a positive exercise electrocardiogram, history of coronary angioplasty, nonspecific ST-T changes on the baseline electrocardiogram, double product <25,000, men, chest pain on exercise test, and a positive exercise electrocardiogram. On a stepwise logistic regression model, exercise echocardiography emerged as an independent predictor of future cardiac events in an outpatient population. This predictive value was enhanced in the presence of a positive exercise electrocardiogram compared with a negative exercise electrocardiogram (24.2% vs 7.9%, p <0.03). Our study suggests that exercise echocardiography is an independent predictor of future cardiac events in an outpatient population.
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Affiliation(s)
- M A Syed
- Henry Ford Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan 48202, USA
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Abstract
Progressive deterioration of left ventricular function is a characteristic feature of the heart failure state and is often speculated to result from ongoing loss of viable myocytes. We previously showed that in dogs with chronic heart failure, cardiocyte death through apoptosis occurs in the border region of fibrous scars (old infarcts). In the present study we examined the structural integrity of cardiocytes in regions bordering fibrous scars using transmission electron microscopy. Morphometric studies were performed using left ventricular tissue obtained from ten dogs with chronic heart failure produced by intracoronary microembolizations. Mitochondrial number increased significantly with proximity to the scar, while mitochondrial size decreased leading to a gradual decrease in mitochondrial volume fraction. Severe injury to mitochondria was present in only 5% of organelles in myocytes far from the scar but increased markedly to 28-41% in myocytes adjacent to or incorporated within the scar. Similarly, severe myofibrillar abnormalities were present in only 3% of myocytes that were far from the scar but increased significantly to 12-73% in myocytes adjacent to or incorporated within the scar. These results indicate that in dogs with chronic heart failure, constituent myocytes of left ventricular regions bordering fibrous scars manifest heterogeneity in the extent of degeneration. The extent of degeneration is greatest in myocytes closest to the scar and least in myocytes far from the scar. We postulate that this wavefront of myocyte degeneration is a dynamic process that may lead to progressive expansion of the scar through loss of viable myocytes and ultimately may contribute, in part, to the progressive left ventricular dysfunction that characterizes the heart failure state.
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Affiliation(s)
- V G Sharov
- Department of Medicine, Henry Ford Heart and Vascular Institute, Detroit, MI 48202, USA
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Peter J, Ali AS, Ali SA. Effect of histaminergic drugs on integumental melanophores of adult Bufo melanostictus. Indian J Exp Biol 1996; 34:427-30. [PMID: 9063075] [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: 02/03/2023]
Abstract
Histamine and 2-methyl histamine caused dose-dependent aggregation of melanophores in toad B. melanostictus. The effects were effectively antagonised by mepyramine, a specific H1 histamine receptor antagonist, and metiamide a specific H2 receptor antagonist. On the other, hand 4-methyl histamine, a specific H2 receptor agonist dispersed the melanophores. The results suggest that adult Bufo melanophores have H1 histamine receptors which mediate melanophore aggregation, however, dispersion of melanophores may be controlled by undifferentiated histamine receptors of H2 type.
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Affiliation(s)
- J Peter
- PG Zoology Department, Saifia Postgraduate College of Science and Education, Bhopal, India
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Abstract
Reaction of pyridine-3-carbaldehyde methylhydrazone with 1,1'-carbonylbis-1H-imidazole afforded (E)-1'-methyl-2'-(3"-pyridyl) methylidene ]-1H-imidazole-1-carbohydrazide (2). Reaction of (2) with ethylamine, ethanol, ethanethiol, hydrazine monohydrate and methoxyamine afforded the corresponding semicarbazide, carbazate, thiocarbazate, carbonohydrazide and 4-methoxysemicarbazide derivatives (3a-d,g). Reaction of (2) with methylhydrazine gave the carbonohydrazide derivative (3f) together with 2,4-dimethyl-6-(3'-pyridyl)-1,4,5,6-tetrahydro-1,2,4,5-tetrazin-3(2H)-one (4a). The preparation of (E)-3-[(3'-pyridyl) methylideneamino ]oxazolidin-2-one (5a) and (E)-3-[(3'-pyridyl) methylideneamino ]tetrahydro-2H-1,3-oxazin-2-one (5b) is described.
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Affiliation(s)
- A S Ali
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202
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48
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Abstract
We examined the incidence and severity of abnormalities of contractile structures of residual viable cardiomyocytes in the left ventricular free wall, septum and right ventricular free wall of 10 dogs with chronic heart failure produced by multiple intracoronary microembolizations and in septal biopsies of 13 patients with chronic heart failure. The abnormalities were evaluated by transmission electron microscopy and classified as either (i) type-1, defined as complete interruption of myofibrils; (ii) type-2, defined as disconnection of end-sarcomeres from the intercalated disc; or (iii) type-3, sarcomere abnormalities defined as Z-bands irregularities and/or focal myofilament disarray. In the left ventricular free wall of dogs, type-1 abnormalities were present in 33 +/- 8% of myocytes, type-2 in 26 +/- 8%, and type-3 in 63 +/- 9%. The incidence of a type-3 abnormality but not type-1 or type-2 was greater in the left ventricular wall compared with the septum and right ventricular wall (P < 0.05). Among abnormal myocytes, 29 +/- 3% of myofibrils were interrupted, 18 +/- 4% of end-sarcomeres were disconnected from the intercalated disc and 12 +/- 2% of sarcomeres were abnormal. The severity of a type-1 but not type-2 or type-3 abnormalities was greater in the left ventricular wall compared with the septum and right ventricular wall. A similarly high incidence of abnormalities was observed in septal myocytes of patients. The results indicate that abnormalities of contractile structures are common among viable myocytes of the failing heart. The incidence of these abnormalities is sufficiently high to warrant serious consideration of their potential role in the progression of left ventricular dysfunction that characterizes the heart failure state.
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Affiliation(s)
- V G Sharov
- Henry Ford Heart and Vascular Institute, Department of Medicine, Detroit, MI 48202
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Ali AS, Liepa AJ, Thomas MD, Wilkie JS, Winzenberg KN. Preparation of Cyclohexane-1,3-dione Herbicide Precursors by Birch Reduction of 3,5-Dimethoxyphenyl-Substituted Silane Derivatives. Aust J Chem 1994. [DOI: 10.1071/ch9941205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Birch reduction of the silane derivatives (3a-d), prepared from Grignard cross-coupling reactions, afforded the cyclohexane-1,3-dione derivatives (5a-d) after acid hydrolysis. Compounds (5a-d) are precursors to silicon-containing herbicides of the general structure (8).
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Ali AS, Fenn NM, Zarowitz BJ, Niemyski P, Vitarelli A, Gheorghiade M. Epidemiology of atrial fibrillation in patients hospitalized in a large hospital. Panminerva Med 1993; 35:209-13. [PMID: 8202333] [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: 01/29/2023]
Abstract
The prevalence of atrial fibrillation varies widely depending on the population studied. To understand the incidence of atrial fibrillation and its significance in relation to other diseases, 3 years (1989 through 1991) of consecutive hospital discharges from the neurology and internal medicine services at Henry Ford Hospital were studied. Of the 26,964 patients who qualified for analysis, 1346 (5%) had atrial fibrillation as 1 of their 5 recorded discharge diagnoses. Comparing the group without atrial fibrillation to those with atrial fibrillation, there were 51% males in both groups (p = 0.88). African-Americans comprised 33% of the patients with atrial fibrillation and 50% of the patients without atrial fibrillation (p < 0.001). The average age of those with atrial fibrillation was 72 +/- 13 years, and 58 +/- 18 years for those without atrial fibrillation (p < 0.001). Length of hospital stay was 9.6 +/- 8.6 days with atrial fibrillation and 7.6 +/- 9.2 days for those without atrial fibrillation (p < 0.001). After adjusting for the effects of age, significant positive associations were noted in those patients with atrial fibrillation whose co-existing condition was either stroke, heart failure, myocardial infarction, hyperthyroidism, or mitral valve disease. There was also a significant negative relationship between hypertension and atrial fibrillation. The most common of the 5 discharge diagnoses observed in patients with atrial fibrillation was congestive heart failure (40%), followed by hypertension (23%) and ischemic heart disease (21%). The existence of a comorbid disease in patients with atrial fibrillation is important, as it can influence medical management and prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A S Ali
- Henry Ford Hospital, Detroit, MI
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