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Semenov S, Costigan C, Ismail MS, McNamara D. Low Colon Capsule Endoscopy (CCE) False Negative Rate for Polyps Excluding Reader Error. Diagnostics (Basel) 2022; 13:diagnostics13010056. [PMID: 36611348 PMCID: PMC9818729 DOI: 10.3390/diagnostics13010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND CCE is a diagnostic tool lacking clinical data on false negative rates. We aimed to assess this rate and the reader/technical error breakdown. METHODS False negative CCEs were identified after comparing to a colonoscopy database. Missed pathology characteristics and study indications/quality were collated. Cases were re-read by experts and newly identified lesions/pathologies were verified by an expert panel and categorised as reader/technical errors. RESULTS Of 532 CCEs, 203 had an adequately reported comparative colonoscopy, 45 (22.2%) had missed polyps, and 26/45 (57.8%) reached the colonic section with missed pathology. Of the cases, 22 (84.6%) had adequate bowel preparation. Indications included 13 (50%) polyp surveillance, 12 (46%) GI symptoms, 1 (4%) polyp screening. CCE missed 18 (69.2%) diminutive polyps and 8 (30.8%) polyps ≥ 6 mm, 18/26 (69.2%) of these were adenomas. Excluding incomplete CCE correlates, colonoscopy total and significant polyp yield were 97/184 (52.7%) and 50/97 (51.5%), respectively. CCE total polyp and significant polyp false negative rate was 26.8% (26/97) and 16% (8/50), respectively. Following re-reading, reader and technical error was 20/26 (76.9%) and 6/26 (23.1%). Total and significant missed polyp rates were 20.6% (20/97) and 14% (7/50) for reader error, 6.2% (6/97) and 2% (1/50) for technical error. CONCLUSIONS False negative CCE rate is not insubstantial and should be factored into clinical decision making.
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Affiliation(s)
- Serhiy Semenov
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght Hospital, Trinity College Dublin, D02 R590 Dublin, Ireland
- Correspondence:
| | - Conor Costigan
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght Hospital, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Gastroenterology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
| | - Mohd Syafiq Ismail
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght Hospital, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Deirdre McNamara
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght Hospital, Trinity College Dublin, D02 R590 Dublin, Ireland
- Department of Gastroenterology, Tallaght University Hospital, D24 NR0A Dublin, Ireland
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Ismail MS, Murphy G, Semenov S, McNamara D. Comparing Colon Capsule Endoscopy to colonoscopy; a symptomatic patient’s perspective. BMC Gastroenterol 2022; 22:31. [PMID: 35073873 PMCID: PMC8785487 DOI: 10.1186/s12876-021-02081-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Colon Capsule Endoscopy (CCE) has proven efficacy in a variety of gastrointestinal diseases. Few studies have assessed patient-reported outcomes and preference between colonoscopy and CCE.
Methods
Patients from our centre who had both a CCE and colonoscopy within a 12-month period were identified. We performed over-the-phone interviews focused on satisfaction, comfort, and overall preference with a 10-point Likert scale. Electronic records were reviewed; reported Modified-Gloucester-Comfort-Scale (GCS) score, sedation, bowel preparation and endoscopist grade were documented. Data was compared between procedures. A Fishers exact test was used to compare proportions and a Student t-test was used to compare means, a p < 0.05 was considered significant.
Results
In all, 40 patients were identified, 57.5% (23/40) were female and the mean age was 48 years (24–78). All patients were referred for investigation of lower gastrointestinal symptoms as part of an ongoing study [Endosc Int Open. 2021;09(06):E965–70]. There was a significance difference in mean comfort (9.2 vs 6.7, p < 0.0001, 95% CI − 3.51 to − 1.44) but not satisfaction (8.3 vs 7.7, p = 0.2, 95% CI − 1.48 to 0.33) between CCE and colonoscopy. Main cause of dissatisfaction with CCE was bowel preparation and for colonoscopy was discomfort. Age and gender were not found to be variables. The correlation between GCS and patient reported values was weak (R = − 0.28). Overall, 77.5% (31/40) of patients would prefer a CCE if they required further bowel investigation. Of these, 77.4% (24/31) preferred a CCE despite the potential need for follow-up colonoscopy.
Conclusions
CCE has a high satisfaction rating (8.3 vs 7.7) and has a higher patient reported comfort rating (9.2 vs 6.7) than colonoscopy. Studies have confirmed CCE and colonoscopy have equivalent diagnostic yields. The majority of patients in our cohort prefer CCE to colonoscopy. CCE should be considered as an alternative to colonoscopy in selected individuals.
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Zailani MA, Azma RZ, Aniza I, Rahana AR, Ismail MS, Shahnaz IS, Chan KS, Jamaludin M, Mahdy ZA. Drone versus ambulance for blood products transportation: an economic evaluation study. BMC Health Serv Res 2021; 21:1308. [PMID: 34863156 PMCID: PMC8645114 DOI: 10.1186/s12913-021-07321-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/16/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medical transportation is an essential step in health care services, and includes ground, air and water transportation. Among the important uses of medical transportation is the delivery of blood products in the event of a clinical emergency. Drone technology is the latest technological advancement that may revolutionize medical transportation globally. Nonetheless, its economic evaluation is scant and insufficient, whilst its cost-effectiveness remains controversial. The aim of this study was to compare the cost-effectiveness of drone transportation versus the ambulance. METHODS The setting of the study was within a developing nation. An economic evaluation study of drone versus ambulance for emergency blood products transportation between the Sabah Women and Children Hospital (SWACH) and the Queen Elizabeth II Hospital (QEH2) on Borneo Island was conducted using the Cost-Effectiveness Analysis (CEA) technique. The total cost of each mode of transportation was calculated using the Activity Based Costing (ABC) method. Travel time was used as a denominator to estimate the Incremental Cost Effectiveness Ratio (ICER). RESULTS For one clinical emergency in SWACH, a round trip of blood products transportation from SWACH to QEH2 costs RM1,266.02 (USD307.09) when using the ambulance, while the drone costs RM1,313.28 (USD319.36). The travel time for the drone was much shorter (18 min) compared to the ambulance (34 min). The Cost-Effectiveness Ratio (CER) of ambulance transportation was RM37.23 (USD9.05) per minute whilst the CER of drone transportation was RM72.96 (USD17.74) per minute. The ICER of drone versus ambulance was - 2.95, implying an increase of RM2.95 in cost for every minute saved using a drone instead of an ambulance. CONCLUSION Although drone transportation of blood products costs more per minute compared to the ambulance, the significantly shorter transport time of the drone offset its cost. Thus, we believe there is good economic potential for drone usage for blood products transportation in developing nations particularly if the drone price decreases and its operational lifespan increases. Our limitation of a non-clinical denominator used in this study leads to the recommendation for use of clinical outcomes in future studies.
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Affiliation(s)
- M A Zailani
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - R Z Azma
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - I Aniza
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - A R Rahana
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - M S Ismail
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - I S Shahnaz
- Queen Elizabeth II Hospital (QEHII), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - K S Chan
- Sabah Women and Children Hospital (SWACH), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - M Jamaludin
- Sabah Women and Children Hospital (SWACH), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - Z A Mahdy
- Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia.
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Semenov S, Ismail MS, O'Hara F, Sihag S, Ryan B, O'Connor A, O'Donnell S, McNamara D. Addition of castor oil as a booster in colon capsule regimens significantly improves completion rates and polyp detection. World J Gastrointest Pharmacol Ther 2021; 12:103-112. [PMID: 34877028 PMCID: PMC8611183 DOI: 10.4292/wjgpt.v12.i6.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/02/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Incomplete excretion rates are problematic for colon capsule endoscopy (CCE). Widely available booster regimens are suboptimal. Recently published data on one day preparation CCE protocol using castor oil appeared effective.
AIM To assess the impact of adding castor oil to a standard split-dose (2-d) preparation in an unselected Western patient cohort.
METHODS All patients aged 18 or more referred to our unit for a CCE over a 5-mo period were prospectively recruited. Controls were retrospectively identified from our CCE database. All patients received split bowel preparation with Moviprep® [polyethylene glycol (PEG)-3350, sodium sulphate, sodium chloride, potassium chloride, sodium ascorbate and ascorbic acid for oral solution; Norgine B. V, United States], a PEG-based solution used predominantly in our colonoscopy practice. Control booster regimen included Moviprep® with 750 mL of water (booster 1) on reaching the small bowel. A further dose of Moviprep® with 250 mL of water was given 3 h later and a bisacodyl suppository (Dulcolax®) 10 mg after 8 h, if the capsule was not excreted. In addition to our standard booster regimen, cases received an additional 15 mL of castor oil given at the time of booster 1. A nested case control design with 2:1 ratio (control:case) was employed. Basic demographics, completion rates, image quality, colonic transit time, diagnostic yield and polyp detection were compared between groups, using a student t or chi-square tests as appropriate.
RESULTS One hundred and eighty-six CCEs [mean age 60 years (18-97), 56% females, n = 104], including 62 cases have been analysed. Indication breakdown included 96 polyp surveillance (51.6%), 42 lower gastrointestinal symptoms (22.6%), 28 due to incomplete colonoscopy (15%), 18 anaemia (9.7%) and 2 inflammatory bowel disease surveillance (1.1%). Overall, CCE completion was 77% (144/186), image quality was adequate/diagnostic in 91% (170/186), mean colonic transit time was 3.5 h (0.25-13), and the polyp detection rate was 57% (106/186). Completion rates were significantly higher with castor oil, 87% cases (54/62) vs 73% controls (90/124), P = 0.01. The number needed to treat with castor oil to result in an additional complete CCE study was 7, absolute risk reduction = 14.52%, 95% confidence interval (CI): 3.06- 25.97. This effect of castor oil on excretion rates was more significant in the over 60 s, P < 0.03, and in females, P < 0.025. Similarly, polyp detection rates were higher in cases 82% (51/62) vs controls 44% (55/124), P = 0.0001, odds ratio 5.8, 95%CI: 2.77-12.21. Colonic transit times were similar, 3.2 h and 3.8 h, respectively. Image quality was similar, reported as adequate/ diagnostic in 90% (56/62) vs 92% (114/124).
CONCLUSION In our capsule endoscopy centre, castor oil addition as a CCE booster significantly improved completion rates and polyp detection in an unselected Western cohort.
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Affiliation(s)
- Serhiy Semenov
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
- Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin D 2, Ireland
| | - Mohd Syafiq Ismail
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
- Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin D 2, Ireland
| | - Fintan O'Hara
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
- Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin D 2, Ireland
| | - Sandeep Sihag
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
- Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin D 2, Ireland
| | - Barbara Ryan
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
| | - Anthony O'Connor
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
| | - Sarah O'Donnell
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
| | - Deirdre McNamara
- Gastroenterology Department, Tallaght University Hospital, Dublin D 24, Ireland
- Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin D 2, Ireland
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Ismail MS, Semenov S, Sihag S, Manoharan T, Douglas AR, Reill P, Kelly M, Boran G, O’Connor A, Breslin N, O’Donnell S, Ryan B, McNamara D. Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study. Endosc Int Open 2021; 9:E965-E970. [PMID: 34079884 PMCID: PMC8159609 DOI: 10.1055/a-1401-9528] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background and study aims Colon capsule endoscopy (CCE) is a recommended viable alternative to colonoscopy for colonic visualisation in a variety of clinical settings with proven efficacy in polyp detection, surveillance, screening and Inflammatory Bowel Disease (IBD) assessment. CCE efficacy in an unselected average risk symptomatic cohort has yet to be established. The aim of this study was to determine the feasibility of CCE imaging assessment in average risk symptomatic patients as an alternative to colonoscopy with and without additional biomarker assessment. Patients and methods This was a prospective, single-center comparison study of colonoscopy, CCE and biomarker assessment. Results Of 77 invited subjects, 66 underwent both a CCE and colonoscopy. A fecal immunochemical test (FIT) and fecal calprotectin (FC) were available in 56 and 59 subjects. In all 64 % (n = 42) had any positive finding with 16 (24 %) found to have significant disease (high-risk adenomas, IBD) on colonoscopy. The CCE completion rate was 76 %, five (8 %) had an inadequate preparation, the CCE polyp detection rate was high at 35 %. The sensitivity, specificity, positive and negative predictive values of CCE for significant disease were 81 %, 98 %, 93 % and 94 % respectively. In addition, three (5 %) significant small bowel diagnoses were made on CCE. FC and FIT were frequently elevated in patients with both colitis (5/7, 71 %) and high-risk adenomas (4/7 57 %). While both had a low positive predictive value for clinically significant disease, FIT 32 % and FC 26 %. Conclusions CCE is a safe and effective alternative to colonoscopy in symptomatic average risk patients with or without the addition of biomarker screening.
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Affiliation(s)
- Mohd Syafiq Ismail
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
- TAGG Research Centre, School of Medicine, Trinity College, Dublin, Ireland
| | - Serhiy Semenov
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
- TAGG Research Centre, School of Medicine, Trinity College, Dublin, Ireland
| | - Sandeep Sihag
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | | | | | - Phyllis Reill
- Department of Clinical Chemistry, Tallaght University Hospital, Dublin, Ireland
| | - Michael Kelly
- Department of Clinical Chemistry, Tallaght University Hospital, Dublin, Ireland
| | - Gerard Boran
- Department of Clinical Chemistry, Tallaght University Hospital, Dublin, Ireland
| | - Anthony O’Connor
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
- TAGG Research Centre, School of Medicine, Trinity College, Dublin, Ireland
| | - Niall Breslin
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Sarah O’Donnell
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Barbara Ryan
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Deirdre McNamara
- Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland
- TAGG Research Centre, School of Medicine, Trinity College, Dublin, Ireland
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Semenov S, Ismail MS, McNamara D. Impairment of colorectal cancer screening during the COVID-19 pandemic. Lancet Gastroenterol Hepatol 2021; 6:426. [PMID: 34015353 PMCID: PMC9259281 DOI: 10.1016/s2468-1253(21)00136-9] [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: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Serhiy Semenov
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght University Hospital, Dublin D24 NR0A, Ireland.
| | - Mohd Syafiq Ismail
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght University Hospital, Dublin D24 NR0A, Ireland
| | - Deirdre McNamara
- Trinity Academic Gastroenterology Group, Trinity Centre, Tallaght University Hospital, Dublin D24 NR0A, Ireland
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Ismail MS, Aoko O, Sihag S, Connolly E, Omorogbe J, Semenov S, O'Morain N, O'Connor A, Breslin N, Ryan B, McNamara D. Lower gastrointestinal symptoms and symptoms-based triaging systems are poor predictors of clinical significant disease on colonoscopy. BMJ Open Gastroenterol 2020; 7:e000221. [PMID: 32337053 PMCID: PMC7170406 DOI: 10.1136/bmjgast-2018-000221] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/18/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Lower gastrointestinal symptoms (LGS) are a common cause of referral to the gastroenterology service. International guidelines are available to prioritise referrals. Some studies have reported that symptoms alone are a poor marker of clinically significant disease (CSD) but symptoms remain the main way to prioritise referrals in routine clinical practice. Aims/background To correlate LGS with colonoscopy findings in an unselected patient cohort and to investigate whether using National Institute for Health and Care Excellence (NICE) guidelines improve risk stratification. Method Colonoscopy data over a 2-year period were obtained from our endoscopy database. Only patients with assessment of symptoms as their primary indication for colonoscopy were included. Patient records were retrospectively reviewed. Exclusion criteria: known inflammatory bowel disease (IBD), familial cancer syndromes, polyp and colorectal cancer (CRC) surveillance, and prior colonoscopy within 5 years. Demographics, symptoms and colonoscopy findings were recorded and analysed. Results 1116 cases were reviewed; 493 (44%) males, age 54.3 years (16–91). CSD occurred in only 162 (14.5%); CRC 19 (1.7%), high-risk adenoma 40 (3.6%), inflammation 97 (8.7%) (IBD 65 (5.8%), microscopic colitis 9 (0.8%) and indeterminate-inflammation 23 (2%)), angiodysplasia 6 (0.5%). Diarrhoea gave the highest diagnostic yield for CSD of 5.3% (OR 3.15, 95% CI 2.2 to 4.7, p<0.001), followed by PR bleeding, 2.9% (OR 1.9, 95% CI 1.24 to 2.9, p=0.003). Weight loss gave the lowest diagnostic yield of 0.4%; (OR 0.79, 95% CI 0.28 to 2.24, p=0.65). 592 (53%) and 517 (46%) fitted the NICE guidelines for CRC and IBD, respectively. Using NICE positivity improved detection but overall yield remained low 3% vs 0.4% (OR 7.71, 95% CI 1.77 to 33.56, p=0.0064) for CRC, and 9% vs 2.8% (OR 3.5, 95% CI 1.99 to 6.17, p<0.0001) for IBD. Conclusions The overall prevalence of CSD in our unselected symptomatic patients is low (14.5%). A holistic approach including combining symptoms and demographics with novel tools including stool biomarkers and minimally invasive colonoscopy alternatives should be applied to avoid unnecessary colonoscopy.
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Affiliation(s)
- Mohd Syafiq Ismail
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland.,Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland
| | - Olufemi Aoko
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Sandeep Sihag
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Eimear Connolly
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Joseph Omorogbe
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Serhiy Semenov
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland.,Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland
| | - Neil O'Morain
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | | | - Niall Breslin
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Barbara Ryan
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland
| | - Deirdre McNamara
- Gastroenterology, Tallaght University Hospital, Dublin, Ireland.,Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland
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Ismail MS, Syafiq MR, Siti-Zahrah A, Fahmi S, Shahidan H, Hanan Y, Amal MNA, Zamri Saad M. The effect of feed-based vaccination on tilapia farm endemic for streptococcosis. Fish Shellfish Immunol 2017; 60:21-24. [PMID: 27864157 DOI: 10.1016/j.fsi.2016.11.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 07/18/2016] [Revised: 11/12/2016] [Accepted: 11/13/2016] [Indexed: 06/06/2023]
Abstract
A tilapia farm experiencing endemic streptococcosis was selected to study the effect of vaccination with a feed-based vaccine on naturally ocurring streptococcosis. A total of 9000 red tilapia, Oreochromis niloticus × Oreochromis mossambicus of 100 ± 20 g were divided into 9 cages. Fish of Group 1 in cages 1, 2 and 3 were not vaccinated. Group 2 in cages 4, 5 and 6 were vaccinated on days 0 and 14 (single booster) while Group 3 in cages 7, 8 and 9 were vaccinated on days 0, 14 and 42 (double booster). Vaccination was done by oral administration of the feed-based bacterin vaccine at 4% bodyweight. Samples of serum for antibody study and the brain, eyes and kidney for bacterial isolation were collected at 14-day intervals. The study was carried out during the critical months between April and June. Following vaccination and booster, there was significant (p < 0.05) increase in the antibody levels in all vaccinated groups from week 1 that reached the peak at week 3 before declining gradually until week 6. However, second booster on week 6 significantly (p < 0.05) increased the antibody level that remained high until the end of the 16-week study period (double booster). Streptococcus agalactiae was isolated at the start of the experiment (day 0) at an average of 10 ± 5.0% of the sampled fish. In week 4, the isolation rate was 13 ± 5.7% but increased to 18 ± 7.6% in week 8, to 25 ± 10.0% in week 10, to 28 ± 5.8% in week 12 and 25 ± 7.3% in week 14. The average isolation rate was 28 ± 7.2%, 18 ± 7.1% and 13 ± 8.2% of the fish sampled from unvaccinated, single booster and double booster groups, respectively. At the end of the study period, the survival rate was 45.2 ± 2.45% for unvaccinated, 65.3 ± 4.8% for single booster and 75.1 ± 2.1% for double booster groups. Vaccinating fish in endemic farm might not eliminate the disease but was able to significantly improve the survival rate.
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Affiliation(s)
- M S Ismail
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - M R Syafiq
- National Fish Health Research Centre, Batu Maung, 11960 Penang, Malaysia
| | - A Siti-Zahrah
- National Fish Health Research Centre, Batu Maung, 11960 Penang, Malaysia
| | - S Fahmi
- National Fish Health Research Centre, Batu Maung, 11960 Penang, Malaysia
| | - H Shahidan
- National Fish Health Research Centre, Batu Maung, 11960 Penang, Malaysia
| | - Y Hanan
- Freshwater Fisheries Research Division, FRI Glami Lemi, 71650 Jelebu, Negeri Sembilan, Malaysia
| | - M N A Amal
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Serdang, Malaysia
| | - M Zamri Saad
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Malaysia.
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Abstract
BACKGROUND At the emergency triage center, assessment of the present of the danger signs and measurement of vital signs are measured according to the guidelines. The respiration rate is still posing a challenge to the doctor as it is impractical to use conventional devices. Attaching measurement devices to the patient will induce artificial measurements (self-awareness stress effects) besides being time-consuming. Currently, the medical officers visually count the number of times the chest movement in a minute, sometimes poses cultural challenges especially for female patients. OBJECTIVE The main objective of this paper is to develop a robust algorithm to extract respiration rate using the contactless displacement sensor. METHODS In this study, chest movements were used as an indicative of inspiration and expiration to measure respiratory rate using the contactless displacement sensor. The contactless optical signals were recorded from 32 healthy subjects in four different controlled breathing conditions: rest, coughing, talking and hand movement to obtain the motion artifacts that the patients may have in the emergency department. The Empirical mode decomposition (EMD) algorithm was used to derive continuous RR signal from the contactless optical signal. RESULTS The analysis showed that there is a good correlation (0.9702) with RMSE of 0.33 breaths per minutes between the contact respiration rate and contactless respiration rate using empirical mode decomposition method. CONCLUSION It can be concluded that the empirical mode decomposition method can extract the respiration rate of the contactless optical signal from chest movement.
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Affiliation(s)
- K B Gan
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - E S Yahyavi
- Department of Electrical, Electronic and Systems Engineering, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - M S Ismail
- Department of Emergency Medicine, UKM Medical Centre Jalan Yaacob Latif, Kuala Lumpur, Malaysia
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Ismail MS, Siti-Zahrah A, Syafiq MRM, Amal MNA, Firdaus-Nawi M, Zamri-Saad M. Feed-based vaccination regime against streptococcosis in red tilapia, Oreochromis niloticus x Oreochromis mossambicus. BMC Vet Res 2016; 12:194. [PMID: 27608936 PMCID: PMC5016990 DOI: 10.1186/s12917-016-0834-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 09/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Streptococcosis is an important disease of tilapia throughout the world. In Malaysia, streptococcosis outbreak was commonly reported during the 3-month period of high water temperature between April and July. This study describes the duration of protection following single and double booster dose regimes against streptococcosis in tilapia using a feed-based vaccine containing formalin-killed Streptococcus agalactiae. A total of 510 tilapias of 120 ± 10 g were selected and divided into 3 groups. Fish of Group 1 were vaccinated at weeks 0 and 2 (single booster group) while fish of Group 2 were vaccinated at weeks 0, 2 and 6 (double booster group) with a feed-based vaccine against streptococcosis. Fish of Group 3 was not vaccinated. Serum samples were collected weekly to determine the antibody level while samples of eye, brain and kidney were collected for bacterial isolation. At week 10, all fish were challenged with live S. agalactiae and the survival rate was determined. RESULTS Both vaccinated groups showed significant (p < 0.05) increase in the antibody levels following the first booster dose, which lasted until week 6. Group 2 showed consistent high level of antibody following the second booster dose at week 6 and remained high until week 12. Challenge trial at week 10 resulted in 45 %, 70 % and 0 % rate of survival for Groups 1, 2 and 3, respectively. CONCLUSION Double booster regime is most suitable to be applied for feed-based vaccination against streptococcosis prior to the start of the hot season.
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Affiliation(s)
- M S Ismail
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - A Siti-Zahrah
- National Fish Research and Disease Diagnosis, Fisheries Research Institute, 11960, Batu Maung, Penang, Malaysia
| | - M R M Syafiq
- National Fish Research and Disease Diagnosis, Fisheries Research Institute, 11960, Batu Maung, Penang, Malaysia
| | - M N A Amal
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - M Firdaus-Nawi
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - M Zamri-Saad
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400, Serdang, Malaysia. .,Present address: Institute of Bioscience, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
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Othman FEC, Yusof N, Jaafar J, Ismail AF, Hasbullah H, Abdullah N, Ismail MS. Preparation and characterization of Polyacrylonitrile/ Manganese Dioxides- based Carbon Nanofibers via electrospinning process. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1755-1315/36/1/012006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ismail MS, Torsten U, Dressler C, Diederichs JE, Hüske S, Weitzel H, Berlien HP. Photodynamic Therapy of Malignant Ovarian Tumours Cultivated on CAM. Lasers Med Sci 2014; 14:91-6. [PMID: 24519162 DOI: 10.1007/s101030050028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The disappointing results with either surgery alone and/or chemotherapy in the treatment of malignant ovarian tumours have led to an increased interest in additional treatment schedules. Photodynamic therapy (PDT), a modality involving the use of a photosensitising drug and activating light, is being used increasingly as a local treatment for neoplastic lesions. The synthesis and evaluation of new photosensitisers for the treatment of gynaecological lesions and malignancies continues to be an active area of investigation for proper application of the photodynamic process in the gynaecological field. The effect of PDT using methylene blue (free and combined with liposomes) as a photosensitiser for treating human ovarian malignant tumours cultivated on the chorioallantoic membrane was evaluated. Two days after PDT, the treated implanted tumours were markedly decreased in size. Areas of necrosis with black coloration, dryness and eschar formation were observed. Five days after PDT, tumour remission was clearly observed in all the treated tumours. Photodynamic therapy using methylene blue (aqueous and coupled with liposomes) is effective for treating the ovarian malignancies and it will be capable of achieving complete eradication of visible tumours in patients with superficial lesions.
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Affiliation(s)
- M S Ismail
- Department of Laser Medicine, Neukölln Hospital, DE
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13
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Ismail MS, Philipp C, Torsten U, Weitzel H, Berlien HP. Laser-Induced Thermotherapy (LITT) for Retreatment of Locally Advanced Recurrences of Breast Cancer. Lasers Med Sci 2014; 14:136-42. [PMID: 24519169 DOI: 10.1007/s101030050035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The effect of laser-induced thermotherapy (LITT) as a palliative method for treatment of patients with local recurrence of breast cancer is investigated. This report describes the use of interstitial laser photocoagulation to manage such lesions. The interstitial laser applications were performed in seven women with locally recurrent breast carcinoma on the chest wall after mastectomy. All patients had been heavily pretreated with conventional modes of therapy (radiotherapy, chemotherapy, hormonal therapy, surgical resection). A Nd:YAG laser with a wavelength of 1064 nm was used to heat the lesions. Heat expansion was controlled digitally and monitored by ultrasonography and colour-coded duplex sonography (CCDS). In five women this minimally invasive method enabled the precise coagulation of the subcutaneous tumour without destruction of the skin or ulceration, although these areas had been pretreated by irradiation up to 60 Gy. In two patients with extensive multiple metastases and with skin infiltration, secondary skin ulceration and delayed healing was observed. For palliative reasons, LITT under CCDS guide can aid in local control of chest wall recurrence following mastectomy in selected patients.
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Affiliation(s)
- M S Ismail
- Department of Laser Medicine, Neukölln Hospital, Berlin, DE
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14
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Ismail MS, Hasinah AB, Syaiful MN, Murshidah HB, Thong TJ, Zairi Z, Idzwan Z, Herbosa TJ, Johar MJ, Ho SE, Das S. Study on advanced life support devices in the ambulances for emergency cases in Klang Valley, Malaysia. Clin Ter 2012; 163:115-122. [PMID: 22555825] [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: 05/31/2023]
Abstract
BACKGROUND AND AIMS In an effort to improve pre-hospital care, the authors assessed the availability and utility of ambulance devices. The study aimed to identify commonly used devices for managing emergency cases in Klang Valley of Malaysia. MATERIALS AND METHODS This was a prospective study comprising of 1075 emergency ambulances running on 30 days. The study analyzed the availability and utilization of life support equipment in nine ambulance providers of Klang Valley in Malaysia. The devices were classified into: (a) airway and ventilation, (b) immobilization and haemorrhage control and (c) communication. The percentage of device utilization was analysed using computerised software. RESULTS Results showed only one ambulance service had complete equipment in accordance to international standards. In term of utilisation of life support equipment, oxygen delivery devices were used in 493 (45.86%) runs. The most used devices in immobilisation and haemorrhage control were:- (a) scoop stretcher in 321 (29.86%) runs, (b) wound dressings in 250 (23.26%) runs and (c) rigid spinal board in 206 (19.16%) runs. Two-way radios were used in 745 (69.30%) runs while mobile phones were used in 429 (39.91%) runs. CONCLUSION In conclusion, ambulances in Klang Valley had a large variation in the availability of life support devices. This emphasizes a need for standardization of equipment.
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Affiliation(s)
- M S Ismail
- Departments of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia.
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Saw A, Sallehuddin AY, Chuah UC, Ismail MS, Yoga R, Hossain MG. Comparison of fracture patterns between rural and urban populations in a developing country. Singapore Med J 2010; 51:702-708. [PMID: 20938610] [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: 05/30/2023]
Abstract
INTRODUCTION The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment. METHODS This was a retrospective multicentre study involving two urban and three rural hospitals in Malaysia. The demographic data and anatomical location of fracture of patients admitted in 2007 were collected for analysis. RESULTS A total of 7,973 patients were admitted for fractures between January and December 2007. The femur was the commonest fracture site that required admission in the urban population (21.9 percent), followed by the tibia-fibula (18.7 percent), while the radius-ulna was the commonest site among the rural population (22.0 percent), followed by the tibia-fibula (19.4 percent). The rates of head and pelvic fractures were comparatively higher in the urban population, while hand fractures were more common in the rural population. The higher rate of femur fracture in the urban group, especially among the elderly, may be due to the higher incidence of osteoporosis or a higher proportion of older people in the population. CONCLUSION The anatomical locations of common fractures differed between the urban and rural populations. A higher rate of upper limb fractures was observed in the rural areas, while femur fractures in the elderly was the main cause of fracture admission in the urban areas. The relatively high rate of hand fractures in the rural areas, especially among children and young adults, may require further investigation.
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Affiliation(s)
- A Saw
- Department of Orthopaedic Surgery, University Malaya Medical Centre, Lembah Pantai, Kuala Lumpur 59100, Malaysia.
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16
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Ismail MS, Amer AS, Wahba O, Shalby H, Arian F. Effect of antioxidants on markers of apoptosis in postoperative radiotherapy of cancer cervix. Gulf J Oncolog 2010:8-13. [PMID: 20164003] [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] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
Abstract
AIM OF THE WORK To investigate whether a mixture of antioxidant supplementation can ameliorate damaging effects of ionizing radiation in cancer cervix patients during radiotherapy Accordingly apoptosis, lipid peroxides and Fas among cancer cervix patients undergoing postoperative radiotherapy (n=40) were measured before and after administration of a mixture of antioxidants including 60 mg vitamin C, 10 mg vitamin E, 1000 IU vitamin A and 50 mg Selenium. PATIENTS AND METHODS Patients were divided into 2 groups each of 20 patients. Antioxidant mixture was administered to one group thrice per day during the duration of radiotherapy and one more week post cessation of radiotherapy. Twenty normal healthy women participated as controls. RESULTS Results revealed that following the first and second sessions of radiotherapy, both the groups with and without antioxidant administration showed higher frequency of lipid peroxidation and the frequency of micronuclei compared to their level before radiotherapy as measured 24 hours and 48 hours post first session of radiotherapy. Patients undergoing radiotherapy showed a decrease in all parameters of the study after one-week, one-month post irradiation and one week post cessation of radiotherapy. However, the antioxidants group showed significantly lower levels of apoptosis and lipid peroxides and Fas compared to patients who did not receive antioxidant supplementation. CONCLUSION The results of the present study reveals adaptation to radiation during radiotherapy and evaluate the prophylactic effect of a mixture of antioxidants during radiotherapy.
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17
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Ismail MS. Characterization of a new photosensitizer (13(2)-hydroxy- bacteriopheophorbide-a methylester) for future treatment of ovarian carcinoma (an experimental study). Gulf J Oncolog 2008:54-57. [PMID: 20084798] [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: 05/28/2023]
Abstract
UNLABELLED The photosensitizer 132-hydroxy bacteriopheophorbide-a methyl ester (13(2) OH- BPME) is characterized by a high absorption coefficient at the far red wavelength 750 nm and a good singlet oxygen quantum yield. METHODS & RESULTS The pharmacokinetics of 132-OH- BPME were studied in ovarian carcinoma on mice after i.v. administration of 7.8 micromole/kg body weight at different incubation intervals. The accumulated dye was chemically extracted from selected tissues and the concentrations were measured by absorption spectroscopy. The parenchymatous organs (liver, spleen and kidney) showed maximum 13(2)- OH- BPME concentrations after 2 hours incubation (liver, spleen), and 4 hours post injection (kidney). A high uptake was detected in the lung with maximum concentration at 2 hours. The malignant tissue accumulated high 13(2)- OH- BPME concentrations between 2-12 hours post injection with peaking at 8 hours. The 13(2)- OH- BPME concentrations in muscle tissue, representing the normal tumour surroundings, and in the skin were very low. CONCLUSION The results of our study suggest that PDT using 13(2)-OH-BPME could be effective at 8h post injection, where the tumour 13(2)- OH-BPME uptake is maximum and the muscle and skin uptake will be minimum.
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Affiliation(s)
- M S Ismail
- Department of Obstetrics and Gynecology, King Fahd University Hospital, King Faisel University, Al Khobar, KSA.
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Ismail MS, Sharaf I, Thambidorai CR, Zainal A, Somasundaram S, Adeeb S, Sajjad MY, Bilkis B, Felicia LSK. Cardiopulmonary bypass in surgery for complex-combined vascular malformation of the lower limb: case report. Pediatr Surg Int 2005; 21:392-5. [PMID: 15806424 DOI: 10.1007/s00383-005-1367-z] [Citation(s) in RCA: 6] [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] [Accepted: 02/11/2004] [Indexed: 11/27/2022]
Abstract
A 16-year-old boy was referred with features of Parkes Weber syndrome (PWS) involving the right lower limb. He had presented at birth with cutaneous vascular malformations (VM) in the right thigh and at the age of 7 years developed congestive cardiac failure, which was controlled with drugs. He received alpha interferon and steroids during this period without any benefit. He defaulted follow-up and at 12 years of age presented with further enlargement of the VM in the right thigh and leg with skin and soft tissue thickening. At this stage, embolization and subsequent excision of the VM were tried, but the surgery was abandoned because of massive hemorrhage. Over the next 4 years, the boy became totally bedridden because of massive increase in the size of the limb, repeated hemorrhages, and secondary infection of the VM. Right hip disarticulation was considered the best option to improve his quality of life. To prevent uncontrollable hemorrhage during surgery, the disarticulation was done under cardiopulmonary bypass with low circulatory flow. Postoperatively, the patient required intensive care nursing for a week. He is presently ambulatory with crutches. Cardiopulmonary bypass with low flow has been used for treating posttraumatic arteriovenous malformations. However, its use in surgery for PWS has not been reported earlier.
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Affiliation(s)
- M S Ismail
- Department of Orthopaedics, Kebangsaan University, Kuala Lumpur, Malaysia.
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Azhar AA, Ismail MS, Ham FL. Patient attendance at a major accident and emergency department: are public emergency services being abused? Med J Malaysia 2000; 55:164-168. [PMID: 19839143] [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: 05/28/2023]
Abstract
A total of 37,152 patients attended the Accident & Emergency (A&E) Department of Hospital Universiti Kebangsaan Malaysia (HUKM) from 1st January to 31st December 1998. Attendance during early hours (midnight to 0659 hrs.) constituted only 10.4% (3853 cases) whereas that for three other time periods of 0700-1159 hrs., 1200-1759 hrs., and 1800-2359 hrs. was 29.4% (10,927 cases), 30.8% (11,448 cases), and 29.4% (10,924 cases) respectively. Two hundred and fifty-one patients were direct admissions from other hospitals into our hospital wards and they attended the A&E department for registration purposes only. Of the remaining 36,901 that were triaged, 196 (0.5%) were resuscitation cases [Triage 1], 3648 (9.9%) were emergency cases [Triage 21, 18,935 (51.3%) were urgent cases [Triage 3], and 14,122 (38.3%) were non-urgent cases [Triage 4]. Despite fluctuations in monthly patient attendance, the proportions of patients according to time of attendance, age group, gender and triage categories remained similar throughout. As majority of patients attended during convenient hours (89.6% from 0700-2359 hrs.) and a high proportion of patients (38.3%) belonged to the non-urgent Triage category, we feel that public emergency services are possibly being abused.
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Affiliation(s)
- A A Azhar
- Accident & Emergency Department, Hospital Universiti Kebangsaan Malaysia, Bandar Tun Razak, Jalan Tenteram, Cheras, 56000 Kuala Lumpur
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20
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Ismail MS, Dressler C, Röder B, Berlien HP. 13(2)-hydroxy-bacteriopheophorbide a methyl ester pharmacokinetics measurements with fluorescence versus absorption spectroscopy. Is there a difference? J Clin Laser Med Surg 1998; 16:203-10. [PMID: 9796488 DOI: 10.1089/clm.1998.16.203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Quantification of photosensitizer concentration in tissue improves the planning and, subsequently, the outcome of photodynamic therapy. This study was designed to determine if the method of photosensitizer evaluation influences the accuracy of pharmacokinetic results. MATERIALS AND METHODS In vivo 13(2)-Hydroxy-bacteriopheophorbide a methyl ester (13(2)-OH-BPME) pharmacokinetics in mice bearing LEWIS lung carcinoma was studied using fluorescence in situ and absorption spectroscopy (following photosensitizer chemical extraction) as photosensitizer quantification methods. The correlation of 13(2)-OH-BPME fluorescence intensity and its concentration using the absorption spectroscopy were determined for each tissue. RESULTS The parenchymatous organs showed maximum 13(2)-OH-BPME concentration and fluorescence intensity at 2 h post-injection (lung, liver, spleen), and at 2 h post-injection in the kidney with both quantification methods (identical correlation). There was a difference in the time of maximum photosensitizer fluorescence intensity and its concentration in tumor, muscle, and skin (low correlation). The time of maximum fluorescence intensity in muscle, skin, and tumor was at 4 h, 12 h, and 12 h post injection respectively while its maximum concentration was at 2 h, 4 h, and 8 h post-injection. CONCLUSION The method of photosensitizer evaluation affects the accuracy of its pharmacokinetic results.
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Affiliation(s)
- M S Ismail
- Department of Laser Medicine, Neukölln Hospital, Berlin, Germany
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21
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Ismail MS, Dressler C, Koeppe P, Senz RG, Röder B, Weitzel H, Berlien HP. Pharmacokinetic analysis of octa-alpha-butyloxy-zinc phthalocyanine in mice bearing Lewis lung carcinoma. J Clin Laser Med Surg 1998; 15:157-61. [PMID: 9612163 DOI: 10.1089/clm.1997.15.157] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In this study, the pharmacokinetics of octa-alpha-butyloxy-zinc phthalocyanine (8-alpha-bo-ZnPc) was studied with regard to Lewis lung carcinoma in mice after intravenous administration of 7.8 mumole/kg body weight at different incubation intervals. SUMMARY BACKGROUND DATA The newly synthesized potential photosensitizer 8-alpha-bo-ZnPc is characterized by a high absorption coefficient at the far red wavelength (735 nm) with a good singlet oxygen quantum yield. METHODS After intravenous administration of 7.8 mumole/kg body weight in mice bearing Lewis lung carcinoma, the accumulated photosensitizer was chemically extracted (at incubation intervals of 2, 6, 12, 24, 48, and 168 hours) from selected tissues, and the concentrations were measured by absorption spectroscopy. RESULTS The parenchymatous organs, liver, and spleen showed maximum 8-alpha-bo-ZnPc concentrations after 6 hours of incubation. An extensive uptake was detected in lung extracts taken at 6, 12, 24, and 48 hours. The malignant tissue did not accumulate high 8-alpha-bo-ZnPc during the entire investigation period. The photosensitizer extracted from muscle, representing normal tumor-surrounding tissue and skin, was even lower. CONCLUSIONS Because of the extremely low accumulation rate of the tumor, 8-alpha-bo-ZnPc is suggested to be administered topically or in combination with a suitable carrier system in order to increase the photosensitizer concentration in the target tissue, as well as to decrease the loss of dye to other tissues.
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Affiliation(s)
- M S Ismail
- Department of Laser Medicine, Neukölln Hospital, Berlin, Germany
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Ismail MS, Torsten U, Serour GI, Weitzel H, Berlien HP. Is endometrial ablation a safe contraceptive method? Pregnancy following endometrial ablation. EUR J CONTRACEP REPR 1998; 3:99-102. [PMID: 9710714 DOI: 10.3109/13625189809051411] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A case of pregnancy following thermal endometrial ablation is presented in this report.
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Affiliation(s)
- M S Ismail
- Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
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Effendy AW, Zamri-Saad M, Maswati MA, Ismail MS, Jamil SM. Stimulation of the bronchus-associated lymphoid tissue of goats and its effect on in vitro colonization by Pasteurella haemolytica. Vet Res Commun 1998; 22:147-53. [PMID: 9618886 DOI: 10.1023/a:1006064703662] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Twenty goats of about 7 months of age were divided into five groups. The goats in groups 1 and 2 were exposed once, using an intranasal spray to 2 ml of an inoculum containing 10(6) colony-forming units/ml of living or dead Pasteurella haemolytica A2, respectively. The goats in groups 3 and 4 were similarly exposed twice at a 2-week interval. Group 5 was the untreated control. The number and size of the bronchus-associated lymphoid tissue (BALT) in goats exposed twice to either living or dead organisms were significantly (p < 0.05) increased compared with those exposed once and with the unexposed control. In vitro colonization by living P. haemolytica A2 onto the lung tissue in which the BALT had been stimulated by two exposures of either living or dead organisms was significantly (p < 0.05) reduced. The study indicates that stimulation of the respiratory mucosal immunity may prevent P. haemolytica A2 infection.
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Affiliation(s)
- A W Effendy
- Faculty of Veterinary Medicine and Animal Science, Universiti Pertanian Malaysia, Selangor, Malaysia
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Abstract
BACKGROUND AND OBJECTIVES There are currently groups of women using high-dose estrogen contraceptive pills, especially in the developing countries. The aim of this study was to determine the correlation between the duration of contraceptive pill intake, the dose of steroid contained in the contraceptive pills and the incidence and degree of serum prolactin level elevation in those women. STUDY DESIGN This study was conducted in 100 contraceptive pill users. Women were randomly selected for this study with an age range from 19 to 35 years and duration of contraceptive pill intake from 6 to 120 months. Cases were classified into two groups. The first group (50 cases) were taking high-dose estrogen pills (50 micrograms) and the second group (50 cases) were taking low-dose estrogen pills (30 micrograms). RESULTS The results of the present study showed that there was a significant elevation in serum prolactin level in both groups, with a more significant elevation in the high-dose pill users. CONCLUSIONS There is a positive relationship between serum prolactin level and the duration of pill intake and their steroid content, and this relationship is not related to the age and parity of the women. The groups of women studied are scheduled for follow-up to determine if there is any future drawback which results as a consequence of the developed hyperprolactinemia. Prolactin determination should be considered for all women prior to pill intake. This determination of serum prolactin level prior to pill use will be useful in the evaluation of the future relationship between the estrogen content of the pills and the later development of hyperprolactinemia.
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Affiliation(s)
- M S Ismail
- Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
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Ismail MS, Serour GI. Assisted reproductive medicine: current Islamic bioethical rules. EUR J CONTRACEP REPR 1997; 2:161-5. [PMID: 9678087 DOI: 10.3109/13625189709167471] [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: 11/13/2022]
Abstract
The advances and wide availability of assisted reproductive techniques represent the dramatic changes that have occurred in infertility treatment and in attitudes towards the different options faced by both physicians and patients. It is a human right that individuals can freely choose reproductive options. Though reproductive choice is basically a personal decision, yet it is not totally so. Islam is a comprehensive system that regulates the spiritual as well as civil aspects of individual and communal life. It aims to develop the unique personality of the individual and a distinct culture for the community based on Islamic ideals and values. The basic concept of Islam is to avoid mixing genes as Islam enjoins the purity of genes and heredity.
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Affiliation(s)
- M S Ismail
- Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
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Khalil HM, Bebars MA, Abdallah HM, el-Zayyat EA, Ismail MS. Variations of direct fluorescent antibody test and serum bile acids levels following praziquantel treatment in Schistosoma mansoni experimentally infected mice. J Egypt Soc Parasitol 1995; 25:583-597. [PMID: 8586855] [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: 05/22/2023]
Abstract
This study was performed to evaluate the efficiency and use of an immunopathological test viz "Direct Fluorescent Antibody Test (DFAT) for detection of IgG and IgM deposits in liver and kidney biopsies" and a biochemical test viz "estimation of serum bile acids by enzymatic colorimetric technique" for follow up Schistosoma mansoni infection using Swiss albino mice. Test were done during infection and after Praziquantel (PZQ) treatment. Mice were classified according to the duration of infection and post-therapy periods. It was found that both tests should be used together to provide good parameters to demonstrate S. mansoni infection and to test the regression of the disease after treatment.
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Affiliation(s)
- H M Khalil
- Department of Parasitology, Faculty of Medicine, Ain-Shams University, Abbassia, Cairo, Egypt
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Khalil HM, Bebars MA, Abdallah HM, Khalil NM, el Zayyat EA, Ismail MS. Immune complexes as monitors of cure in Schistosoma mansoni infected mice. J Egypt Soc Parasitol 1995; 25:355-65. [PMID: 7665932] [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: 01/26/2023]
Abstract
This study was done to assess the use of immune complexes estimated by micro-ELISA as monitors of cure of schistosomiasis mansoni experimentally infected Swiss albino mice which received praziquantel (PZQ) treatment. They were grouped according to duration of infection (4, 8, 12, 16w) and then subgrouped owing to post-treatment life span (4, 6, 8w). It was found that the changes observed in serum level of immune complexes (IC) would provide a good parameter to demonstrate the severity of infection and being an indication of improvement after treatment. The recorded changes confirmed the relationship between schistosomal hepatic affection and serum levels of IC. The study showed the potent anti-schistosomal effect of PZQ. It cured completely when it was given early after infection or improved moderately when given late.
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Affiliation(s)
- H M Khalil
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Ismail MS. Needs assessment. Integration 1993:8. [PMID: 12345394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Zamri-Saad M, Roshidah I, al-Ajeeli KS, Ismail MS, Kamarzaman A. Severe complications induced by experimental bacterial superinfection of orf lesions. Trop Anim Health Prod 1993; 25:85-8. [PMID: 8236484 DOI: 10.1007/bf02236511] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Twelve goats about 3 months of age were divided into 4 equal groups. Goats in Groups 1 and 2 were infected with orf virus followed by Corynebacterium pyogenes infection of Groups 1 and 3, 3 days after the first appearance of orf lesions. Goats in Group 4 were uninfected controls. Complicated orf lesions which consisted of wet suppurative scabs around the entire lips were observed in goats in Group 1. The lesions persisted for 24 days but were most severe from days 8 to 13. Goats in Group 2 developed lesions typical of orf virus infection that lasted 10 days, while goats in Group 3 developed small nodules of about 1 cm diameter, 48 hours following the introduction of C. pyogenes, which persisted for only 6 days. No lesion was observed in goats in Group 4. Two goats in Group 1 with complicated orf died after 16 and 22 days respectively.
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Affiliation(s)
- M Zamri-Saad
- Faculty Veterinary Medicine and Animal Science, Universiti Pertanian Malaysia, Serdang
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Bebars MA, Soffar SA, Abbas MM, Ismail MS, Tamara FA. Circulating immune complex in bilharzial arthropathy. J Egypt Soc Parasitol 1992; 22:51-7. [PMID: 1578179] [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: 12/27/2022]
Abstract
Using the enzyme-linked immunosorbent assay (ELISA), the immune complex (IC) level was estimated in sera of 100 individuals grouped as follows; Group 1: 40 cases with bilharzial arthropathy. Group II: 20 cases with bilharziasis. Group III: 20 cases with rheumatoid arthritis. Group IV: 20 apparently healthy individuals. IC level was also estimated in synovial fluid of 4 cases with knee joint effusion. A significant increase in IC level in cases with bilharzial infection (with or without arthropathy) was noticed. This was higher in intestinal than in urinary bilharziasis. Further more IC level was significantly higher in cases of bilharzial arthropathy than in cases with bilharziasis alone. The IC level in synovial fluid was higher than in serum with a positive correlation. The role of IC as a causative agent in the pathogenesis of bilharzial arthropathy is clearly discussed.
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Affiliation(s)
- M A Bebars
- Department of Parasitology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
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Teichmann W, Völkner S, Ismail MS, Mohamed I. [Screening for hypertension by means of automatic measurement of the systolic blood pressure according to the Penáz-principle]. Z Gesamte Inn Med 1980; 35:717-8. [PMID: 7445615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The plethysmomanometer after Penáz allows the automatic measurement of the systolic blood pressure in a finger artery. On the basis of the comparative measurements on 250 patients the result was a probably linear correlation with a correlation coefficient r = 0.821 between the systolic blood pressure after Riva-Rocci and the systolic pressure of the finger artery. Only in few cardiologic diseases (e.g. disturbances of the cardiac rhythm, severe cyanotic failures, arteriovenous fistules on the forearm) the devices cannot be used. Provided with adequate technical improvements the device might be used for the screening of hypertension.
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