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Khan MS, Ibrahim SM, Adamu AA, Rahman MBA, Bakar MZA, Noordin MM, Loqman MY. Pre-grafting histological studies of skin grafts cryopreserved in α helix antarctic yeast oriented antifreeze peptide (Afp1m). Cryobiology 2019; 92:26-33. [PMID: 31580830 DOI: 10.1016/j.cryobiol.2019.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
A number of living creatures in the Antarctic region have developed characteristic adaptation of cold weather by producing antifreeze proteins (AFP). Antifreeze peptide (Afp1m) fragment have been designed in the sequence of strings from native proteins. The objectives of this study were to assess the properties of Afp1m to cryopreserve skin graft at the temperature of -10 °C and -20 °C and to assess sub-zero injuries in Afp1m cryopreserved skin graft using light microscopic techniques. In the present study, a process was developed to cryopreserve Sprague-Dawley (SD) rat skin grafts with antifreeze peptide, Afp1m, α-helix peptide fragment derived from Glaciozyma antractica yeast. Its viability assessed by different microscopic techniques. This study also described the damages caused by subzero temperatures (-10 and -20 °C) on tissue cryopreserved in different concentrations of Afp1m (0.5, 1, 2, 5 and 10 mg/mL) for 72 h. Histological scores of epidermis, dermis and hypodermis of cryopreserved skin grafts showed highly significant difference (p < 0.01) among the different concentrations at -10 and -20 °C. In conclusion, the integrity of cryopreserved skin grafts with lower concentrations of Afp1m (0.5, 1 and 2 mg/mL) or at -20 °C was not maintained. The present study attested that Afp1m is a good cryoprotective agent for the cryopreservation of skin graft. Higher Afp1m concentrations (5 and 10 mg/mL) at -10 °C found to be suitable for the future in vivo study using (SD) rat skin grafts.
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Connelly TM, Khan MS, Alzamzami M, Cooke F. An evaluation of the quality and content of web-based stoma information. Colorectal Dis 2019; 21:349-356. [PMID: 30472797 DOI: 10.1111/codi.14497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 10/23/2018] [Indexed: 02/08/2023]
Abstract
AIM Although the internet is commonly the first port of call for medical information, it provides unregulated data of variable quality. We aimed to evaluate commonly accessed web-based information on intestinal stomas using validated and novel scoring systems. METHOD The keywords 'stoma', 'colostomy', 'ileostomy' and 'bowel bag' were entered into the most commonly used internet search engines (Google, Bing and Yahoo). The first ten websites from each search were analysed using the validated Journal of the American Medical Association (JAMA) benchmark criteria and DISCERN scoring systems. A novel stoma-specific score was devised and applied. RESULTS Forty-three unique websites were identified. The majority (49%) were from nonprofit or governmental agencies and 9% were from commercial entities. The mean total DISCERN score for all websites was 42.4 ± 10.2 (maximum possible score = 75). The mean JAMA and stoma-specific scores were 2.1 ± 1.0 (maximum possible score = 4) and 12.9 ± 6.1 (maximum possible score = 27). The lowest JAMA scores were in the category of attribution, with 70% of websites lacking references for the information provided. A total of 88% displayed disclosure/paid advertiser information. Surgery was described in 67%. An image or diagram was provided in 58% and in 72% a stoma therapist/nurse was mentioned. Information on when to seek medical help was provided in 51%. CONCLUSION Web-based information on stomas is of variable content and quality. Authorship and information sources are often unclear. Only half provided information on when to seek medical help for complications including high output and dehydration. These findings should be highlighted to patients who utilize the internet to obtain information on stomas.
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Catagni MA, Azzam W, Guerreschi F, Lovisetti L, Poli P, Khan MS, Di Giacomo LM. Trifocal versus bifocal bone transport in treatment of long segmental tibial bone defects. Bone Joint J 2019; 101-B:162-169. [PMID: 30700126 DOI: 10.1302/0301-620x.101b2.bjj-2018-0340.r2] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIMS Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. PATIENTS AND METHODS A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54). RESULTS The size of the bone defect was significantly longer (p = 0.005), the number of previous operations was significantly higher (p < 0.001), the operating time was significantly longer (p < 0.001), and the bone transport distance was significantly increased (p = 0.017) in the TFT group. However, the external fixation time (p < 0.001), the healing index (p < 0.001), the number of additional procedures (p = 0.013), and the number of true complications (p < 0.001) were significantly reduced in this group. Both groups achieved highly satisfactory bone and functional results. CONCLUSION TFT can significantly reduce the treatment time, the number of additional surgical procedures, and true complications compared with BFT in the treatment of long segmental tibial bone defects.
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Khan MS, Dighe K, Wang Z, Srivastava I, Daza E, Schwartz-Dual AS, Ghannam J, Misra SK, Pan D. Detection of prostate specific antigen (PSA) in human saliva using an ultra-sensitive nanocomposite of graphene nanoplatelets with diblock-co-polymers and Au electrodes. Analyst 2019; 143:1094-1103. [PMID: 29387841 DOI: 10.1039/c7an01932g] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Prostate-specific antigen (PSA) is a commonly used biomarker for the detection of prostate cancer (PCa) and there are numerous data available for its invasive detection in the serum and whole blood. In this work, an electrochemical sensing method was devised to detect traces of PSA in human saliva using a hybrid nanocomposite of graphene nanoplatelets with diblock co-polymers and Au electrodes (GRP-PS67-b-PAA27-Au). The pure graphitic composition on filter paper provides significantly high electrical and thermal conductivity while PS67-b-PAA27 makes an amphiphilic bridge between GRP units. The sensor utilizes the binding of an anti-PSA antibody with an antigen-PSA to act as a resistor in a circuit providing an impedance change that in turn allows for the detection and quantification of PSA in saliva samples. A miniaturized electrical impedance analyzer was interfaced with a sensor chip and the data were recorded in real-time using a Bluetooth-enabled module. This fully integrated and optimized sensing device exhibited a wide PSA range of detection from 0.1 pg mL-1 to 100 ng mL-1 (R2 = 0.963) with a lower limit of detection of 40 fg mL-1. The performance of the biosensor chip was validated with an enzyme-linked immunosorbent assay technique with a regression coefficient as high as 0.940. The advantages of the newly developed saliva-PSA electrical biosensor over previously reported serum-PSA electrochemical biosensors include a faster response time (3-5 min) to achieve a stable electrical signal for PSA detection, high selectivity, improved sensitivity, no additional requirement of a redox electrolyte for electron exchange and excellent shelf life. The presented sensor is aimed for clinical commercialization to detect PSA in human saliva.
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Sumi SA, Sultana SZ, Mannan S, Paul UK, Khan MS, Faruque MO, Rahman M, Sultana N, Khan NJ, Jabeen L, Jannat T, Bose SK. Variations in the Position of Vermiform Appendix in Bangladeshi People. Mymensingh Med J 2019; 28:54-59. [PMID: 30755551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This cross sectional descriptive study was performed on 70 postmortem vermiform appendices (male 34 and female 36) to find out the various positions of vermiform appendix of Bangladeshi people. The specimens were collected from autopsy laboratory of the Department of Forensic Medicine, Mymensingh Medical College, Mymensingh, Bangladesh by purposive sampling technique from October 2016 to March 2017. The collected samples were divided into four age groups. They were Group A (upto 20 years), Group B (21 to 40 years), Group C (41 to 60 years) and Group D (above 60 years). Dissection was performed according to standard autopsy technique. During postmortem examination abdominal cavity was routinely exposed by classical midline incision from xiphoid process to the symphysis pubis and a semicircular incision around the umbilicus and the flaps were reflected to give a good view of the abdominal cavity along with its contents and then the taeniae coli of the caecum were identified. The three taeniae coli of the caecum converge at the base of the appendix and become its longitudinal muscle coat. The anterior caecal taeniae coli acts as the best guide for identification of the vermiform appendix. The relation of the base of the appendix to the caecum is constant but the position of the vermiform appendix, which is variable, was studied in relation to caecum and the terminal part of the ileum. Accordingly the position of the vermiform appendix was noted either retrocaecal, pelvic, preileal or postileal, subcaecal. All data were recorded in the predesigned data sheet, analyzed by SPSS program (version 21, 2012) and compared with the findings of other national and international studies and standard text books. Among 70 specimens, 44(62.9%) vermiform appendices were retrocaecal in position. The next common position was pelvic which was in 22(31.4%) specimen followed by postileal in 3(4.3%) specimen and subcaecal was observed only in 1(1.4%) specimen. In this study in all age groups incidence of retrocaecal vermiform appendix was highest and it was about 67.6%, 50%, 69.2% and 72.7% in Group A, B, C, D respectively. Pelvic position was 7.1%, 46.9%, 23.1% and 27.3% in Group A, B, C, D respectively. Subcaecal vermiform appendix was absent in Group A, B and Group D. On the other hand postileal vermiform appendix was absent in Group C and Group D. The findings of this study may help the physician and the surgeons for proper diagnosis, management and treatment of disease of vermiform appendix.
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Khan MS, Rahlves M, Lachmayer R, Roth B. Polymer-based diffractive optical elements for rear end automotive applications: design and fabrication process. APPLIED OPTICS 2018; 57:9106-9113. [PMID: 30461900 DOI: 10.1364/ao.57.009106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/26/2018] [Indexed: 06/09/2023]
Abstract
Advances in illumination technology in the automotive industry are heading toward the use of coherent sources for adaptable and high-resolution head lamps as well as interior and rear-end lights. We present a cost-effective method to fabricate and design laser-based lighting systems for the rear end in automobiles and other vehicles. The design relies on using binary gratings to generate a desired intensity distribution. For cost-effective fabrication, an optical maskless UV lithography system that employs a spatial light modulator (SLM) for projection of the desired structure onto photoresist is introduced. To replicate the structures onto polymers like poly(methyl methacrylate) (PMMA), we use polydimethylsiloxane soft stamps and a hot embossing system. The experimental results show that the proposed design and fabrication process is promising for high-resolution rear-end lights that might be employed to project symbols or information to guide road users in future.
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Fayad MI, Alruwaili HHT, Khan MS, Baig MN. Bite Force Evaluation in Complete Denture Wearer with Different Denture Base Materials: A Randomized Controlled Clinical Trial. J Int Soc Prev Community Dent 2018; 8:416-419. [PMID: 30430068 PMCID: PMC6187881 DOI: 10.4103/jispcd.jispcd_2_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 04/24/2018] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study is to evaluate the maximum bite force (MBF) with different denture base materials in completely edentulous patients. MATERIALS AND METHODS MBF was evaluated in randomly selected 100 completely edentulous patients. Patients were selected from the Outpatient Clinic, College of Dentistry, Aljouf University, Saudi Arabia. The patients were randomly divided into two equal groups: Group I (control group): Patient received a conventional heat-cured acrylic complete denture (Vertex™ Regular, Vertex-Dental B.V., The Netherlands) and Group II (experimental group): Patient received a thermoplastic complete denture (Vertex™ ThermoSens, Vertex-Dental B.V., The Netherlands). MBF measurements were taken at the time of new denture placement and after 6 months of denture use. Statistics were analyzed using independent t-test to compare the MBF measurements between both groups. RESULTS At the time of denture placement, there was no significant difference in bite force measurements between both groups. Bite force is increasing considerably after 6 months of denture use, and it was higher than MBF recorded at the time of new prosthesis placement in the same group. The MBF values were considerably higher in patients with a thermoplastic denture than patients with conventional acrylic denture with statistically significant difference after 6 months of denture use. CONCLUSION After 6 months of denture use, patients with a thermoplastic denture have a higher biting force than patients with a conventional acrylic denture. Therefore, it could be considered a treatment plan option according to the ridge nature and quality to solve the problem of diminished bite force in old age patients.
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Khan MS, Ning Y, Jinou C, Hutchison C, Yoong J, Lin X, Coker RJ. Are global tuberculosis control targets overlooking an essential indicator? Prolonged delays to diagnosis despite high case detection rates in Yunnan, China. Health Policy Plan 2018; 32:i15-i21. [PMID: 29028224 DOI: 10.1093/heapol/czx046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 11/14/2022] Open
Abstract
Delay in treating active tuberculosis (TB) impedes disease control by allowing ongoing transmission, and may explain the unexpectedly modest declines in global TB incidence. Even though China has achieved TB control targets under the global Directly Observed Treatment, Short course (DOTS) strategy, TB prevalence in western provinces, including Yunnan, is not decreasing. This cross-sectional study investigates whether prolonged delay in identifying and correctly treating TB patients, which is not routinely monitored, persists even when there is a well-functioning TB control programme and global targets are being met. Records of adult smear-positive pulmonary TB patients diagnosed with between 2006 and 2013 were extracted from the Yunnan Centre for Disease Control electronic database, which contains information on the entire population of TB patients managed across 129 diagnostic centres. Delay was investigated at three stages: delay to DOTS facility (period between symptom onset and first visit to at a CDC unit providing standardized treatment); delay to TB confirmation (period between reaching a CDC unit and confirmation of smear-positive TB) and delay to treatment (period between confirmation of TB and initiation of treatment). Data from 76 486 patients was analysed. Delay to reaching a DOTS facility was by far the largest contributor to total delay to treatment initiation. The median delay to reaching a DOTS facility, to TB confirmation and to treatment was 57 days (IQR 25-112), 2 days (IQR 1-6) and 1 day (IQR 0-1) respectively. Prolonged delays to reaching a facility providing standardized TB care occurred in a substantial subset of the population despite all TB control targets being met; overall, 32% (24 676) of patients experienced a delay of more than 90 days to reaching a DOTS facility. Policies that focus on reducing delays in accessing appropriate health services, rather than only on increasing overall case-detection rates, may result in greater progress towards reducing TB incidence.
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Shah M, Aydin A, Moran A, Khan MS, Dasgupta P, Ahmed K. The role of cognitive training in endourology: a randomised controlled trial. Actas Urol Esp 2018; 42:163-169. [PMID: 29292040 DOI: 10.1016/j.acuro.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/24/2017] [Accepted: 06/27/2017] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Cognitive training is an important training modality which allows the user to rehearse a procedure without physically carrying it out. This has led to recent interests to incorporate cognitive training within surgical education but research is currently limited. The use of cognitive training in surgery is not clear-cut and so this study aimed to determine whether, relative to a control condition, the use of cognitive training improves technical surgical skills on a ureteroscopy simulator, and if so whether one cognitive training method is superior. METHODS This prospective, comparative study recruited 59 medical students and randomised them to one of three groups: control- simulation training only (n=20), flashcards cognitive training group (n=20) or mental imagery cognitive training group (n=19). All participants completed three tasks at baseline on the URO Mentor simulator followed by the cognitive intervention if randomised to receive it. Participants then returned to perform an assessment task on the simulator. Outcome measures from the URO Mentor performance report was used for analysis and a quantitative survey was given to all participants to assess usefulness of training received. RESULTS This study showed cognitive training to have minimal effects on technical skills of participants. The mental imagery group had fewer laser misfires in the assessment task when compared to both control and flashcards group (P=.017, P=.036, respectively). The flashcards group rated their preparation to be most useful when compared to control (P=.0125). Other parameters analysed between the groups did not reach statistical significance. Cognitive training was found to be feasible and cost effective when carried out in addition to simulation training. CONCLUSION This study has shown that the role of cognitive training within acquisition of surgical skills is minimal and that no form of cognitive training was superior to another. Further research needs to be done to evaluate other ways of performing cognitive training.
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Nazar M, Khan MS, Ijaz M, Anjum AA, Sana S, Setyawan EMN, Saleem MI, Ahmad I. Prevalence of Degnala disease in bovine along with screening of toxigenic fungi isolated from contaminated rice straw. J BIOL REG HOMEOS AG 2018; 32:269-274. [PMID: 29685005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Toxigenic potential of different candidate fungi, isolated from rice straw feed of Degnala disease affected bovines was analyzed along with species, age, gender and seasonal prevalence. Of 1,536 cases, 104 (6.77%) showed positive signs with a significant association (p less than 0.05) between this disease and rice straw feeding, in buffaloes, and bovine aged over 1 year in the winter season. Complete blood count showed a marked increase in erythrocyte sedimentation rate and all white blood cells numbers, except lymphocytes in positive cases. There was a significant increase (p less than 0.05) in alanine amino transferase, aspirate amino transferase and alkaline phosphatase in the liver function test. At the same time, an increased value of creatinine was noted in the renal function test. For isolation and screening of toxigenic fungi, rice straw samples (n=40) being fed to the positive cases were processed further, and 85 fungal isolates were found, mainly of Aspergillus (57), Penicillium (10), Fusarium (04), Zygomycetes (03), Curvularia (01) and unidentified (10). All isolated fungi were subjected for mycotoxin production and only 11 showed mycotoxin-producing capability (including Aspergillus, Penicillium and Fusarium isolates) analyzed by thin layer chromatography and quantified through high performance liquid chromatography. It is concluded that all the fungi contaminating rice straw feed of Degnala affected animals were not toxigenic. This work will help in establishing major mycotoxin-producing fungi leading to the probable cause of Degnala disease in bovine.
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Khan MS, Séron O, Thuillier G, Thévenot O, Gournay P, Piquemal F. Development of a programmable standard of ultra-low capacitance values. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2017; 88:055109. [PMID: 28571446 DOI: 10.1063/1.4983337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A set of ultra-low value capacitance standards together with a programmable coaxial multiplexer (mux) have been developed. The mux allows the connection of these capacitances in parallel configuration and they together form the programmable capacitance standard. It is capable of producing decadic standard capacitances from 10 aF to at least 0.1 pF, which are later used to calibrate commercial precision capacitance bridges. This paper describes the realization and the characterization of this standard together with results obtained during the calibration of Andeen-Hagerling AH2700A bridges with a maximum uncertainty of 0.8 aF for all the capacitances generated ranging from 10 aF to 0.1 pF, at 1 kHz. These latter could be then integrated to functionalized AFMs or probe stations for quantitative capacitance measurements. Sources of uncertainties of the programmable capacitance standard, such as parasitic effects due to stray impedances, are evaluated and a method to overcome these hindrances is also discussed.
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Imran Y, Raza M, Khan MS, Hayat Y. Effect Of Cobalt-Chromium Alloy Re-Use In Dentistry On Its Castability Value. J Ayub Med Coll Abbottabad 2017; 29:270-274. [PMID: 28718246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Re-use of dental casting alloy is a routine practice, which is carried out with the motive to conserve resources. There have been studies on the re-use of alloys but a controversy exists as to the proportioning ratio of fresh to used alloy and the number of time an alloy can be recast. The objective of the study was to measure the effect of addition of 50% by weight used alloy to the fresh Cobalt-Chromium alloy on the castability. METHODS In the present in-vitro experimental study A total of 20 specimens were cast by flame centrifuge, using modified Whitlock's method. The total sample size was divided into four groups of five specimens each. Group 1 was the control group with 100% fresh alloy cast once. In group 2, 3 and 4, a 50% by weight cut off of previous castings were mixed to the fresh alloy. The reused alloy for the group 2 and 3 was further aged or exposed to flame casting separately. The number of completely cast segments were counted and castability value was calculated according to the Whitlock's formula. RESULTS There was no significant difference of castability value among the entire tested group (p=0.085). CONCLUSIONS Within the limitations of the present study, it is recommended that commercial Co-Cr-Mo alloy can be re-used six times without affecting its castability, when 50% fresh alloy is added on each re-use.
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Hutchison C, Khan MS, Yoong J, Lin X, Coker RJ. Financial barriers and coping strategies: a qualitative study of accessing multidrug-resistant tuberculosis and tuberculosis care in Yunnan, China. BMC Public Health 2017; 17:221. [PMID: 28222724 PMCID: PMC5320743 DOI: 10.1186/s12889-017-4089-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) and multidrug-resistance tuberculosis (MDR-TB) pose serious challenges to global health, particularly in China, which has the second highest case burden in the world. Disparities in access to care for the poorest, rural TB patients may be exacerbated for MDR-TB patients, although this has not been investigated widely. We examine whether certain patient groups experience different barriers to accessing TB services, whether there are added challenges for patients with MDR-TB, and how patients and health providers cope in Yunnan, a mountainous province in China with a largely rural population and high TB burden. METHODS Using a qualitative study design, we conducted five focus group discussions and 47 in-depth interviews with purposively sampled TB and MDR-TB patients and healthcare providers in Mandarin, between August 2014 and May 2015. Field-notes and interview transcripts were analysed via a combination of open and thematic coding. RESULTS Patients and healthcare providers consistently cited financial constraints as the most common barriers to accessing care. Rural residents, farmers and ethnic minorities were the most vulnerable to these barriers, and patients with MDR-TB reported a higher financial burden owing to the centralisation and longer duration of treatment. Support in the form of free or subsidised treatment and medical insurance, was deemed essential but inadequate for alleviating financial barriers to patients. Most patients coped by selling their assets or borrowing money from family members, which often strained relationships. Notably, some healthcare providers themselves reported making financial and other contributions to assist patients, but recognised these practices as unsustainable. CONCLUSIONS Financial constraints were identified by TB and MDR-TB patients and health care professionals as the most pervasive barrier to care. Barriers appeared to be magnified for ethnic minorities and patients coming from rural areas, especially those with MDR-TB. To reduce financial barriers and improve treatment outcomes, there is a need for further research into the total costs of seeking and accessing TB and MDR-TB care. This will enable better assessment and targeting of appropriate financial support for identified vulnerable groups and geographic development of relevant services.
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Naseer O, Khan JA, Khan MS, Omer MO, Chishti GA, Sohail ML, Saleem MU. Comparative Efficacy of Silymarin and Choline Chloride (Liver Tonics) in Preventing the Effects of Aflatoxin B1 in Bovine Calves. Pol J Vet Sci 2017; 19:545-551. [PMID: 27760040 DOI: 10.1515/pjvs-2016-0068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aflatoxins are secondary metabolites produced by Aspergillus spp. which are injurious to animals and humans The aim of this study was to determine the effects of aflatoxin B1 (AFB1) on Average Daily Feed Intake (ADFI), Average Daily Weight Gain (ADWG), haematological and serum biochemical responses of Bovine Calves and to determine the comparative efficacy of two different liver tonics against AFB1. Twenty seven calves were selected from herd and divided into 3 groups. All calves were fed with 1.0 mg/kg AFB1 for a period of 10 days. After that they were fed with liver tonics: Silymarin fed at a rate of 600 mg/kg and Choline chloride 500 mg/kg for 7 days. The results indicate that the ADFI and ADWG of AFB1 treated calves decreased significantly. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and creatinine significantly increased due to AFB1. In haematology the total erythrocyte count (TEC), total leukocyte count (TLC), haemoglobin concentration (HGB), haematocrit levels (HCT), mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC), lymphocyte %, neutrophil % and monocyte % significantly decreased in AFB1 treated calves after 10 days of feeding. Both liver tonics significantly (p<0.05) improved all the parameters, including ADFI, ADWG, hematologial and serum biochemical test. However, Silymarin comparatively more efficiently ameliorate the effects induced by AFB1 than choline chloride.
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Iqbal MZAN, Khan MS. A novel DNase like compound that inhibits virus propagation from Asian Green Mussel, Perna viridis (Linn.). INDIAN JOURNAL OF EXPERIMENTAL BIOLOGY 2016; 54:816-821. [PMID: 30183177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Viral diseases are not only responsible for health related issues but also exert pressure on the State economy. Tropical and subtropical countries have more prevalence of virus associated pathological conditions such as chickenpox, adenovirus related infections, dengue, chickengunya, infectious mononucleosis, etc. Treatment options with effective antiviral drugs are limited and are unfortunately not free from undesirable effects. The Asian Green Mussel, Perna viridis (Linn.) (Mytilidae) are not only important for their evolutionary significance, high caloric index, ecological role in the sequestration of environmental pollutants especially heavy metals, but also are potential source for extraction of therapeutic and bioactive compounds. On the other hand, generally in bivalves, virus mediated mortality is not uncommon. In this study, we made a maiden attempt of exploring DNAse like bioactivity for natural non-protenacious compound(s) extracted from P. viridis. Crude Methanol Extract (CME) of soft tissue of P. viridis and subsequently its partially purified component (PPC) possess exceptional ability to degrade indiscriminately both low and high molecular weight DNAs. In vitro digestions for1, 2 and 3 h with CME and PPC were found to be comparable to commercial (Sigma-Aldrich) enzyme, DNase I. Bioactive assays conducted to evaluate antimicrobial property, have shown that CME and PPC exclusively inhibit viral propagation. Nonetheless, CME & PPC have no effect on the propagation of bacteria (0 mm ZOI). These results indicate the possibility of a source of potential antiviral drug against DNA Group I viruses. Although our study does not provide any data to correlate to any physiological functions of these substances but provides a clue towards an important role in the biology of mussels. Any conclusion at this stage is premature. However, taking into consideration the significantly high virus mediated mortality in bivalves and the antiviral bioactivity of these substances, it appears that mussels have evolved some mechanisms to counteract some viruses.
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Khan MS, Zhao N, Sica AL, Gootman N, Gootman PM. Changes in R-R and Q-T Intervals Following Cardiac Vagotomy in Neonatal Swine. Exp Biol Med (Maywood) 2016; 226:32-6. [PMID: 11368235 DOI: 10.1177/153537020122600105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Asymmetric innervation of the myocardium, especially a predominance of sympathetic innervation, may establish conditions whereby electrical instability could result. Using a swine animal model, we studied the effect of right cardiac vagal denervation on the variability of R-R and Q-T intervals. Newborn pigs were assigned randomly to two groups: sham-operated controls (C), or denervation of the right cardiac vagus nerve (RCVX). EKGs were recorded weekly until the two groups exhibited significant heart rate differences. Analysis of the EKG included measurements of R-R and Q-T intervals and corrected Q-T intervals (QTc). Poincaré plots were used to display age-related differences in R-R and Q-T intervals. For RCVX animals, decreased QTc and R-R intervals were noted at 6 and 7 weeks after denervation, respectively. Unexpectedly, one RCVX animal exhibited marked sudden pauses in sinus rhythm. These data indicated that reduced vagal cardiac modulation during development might alter cardiac electrical stability in conscious swine.
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Thiessen JD, Shams E, Stortz G, Schellenberg G, Bishop D, Khan MS, Kozlowski P, Retière F, Sossi V, Thompson CJ, Goertzen AL. MR-compatibility of a high-resolution small animal PET insert operating inside a 7 T MRI. Phys Med Biol 2016; 61:7934-7956. [DOI: 10.1088/0031-9155/61/22/7934] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Roberts KJ, Karkhanis S, Pitchaimuthu M, Khan MS, Hodson J, Zia Z, Mehrzad H, Marudanayagam R, Muiesan P, Isaac J, Mirza D, Sutcliffe RP. Comparison of preoperative CT-based imaging parameters to predict postoperative pancreatic fistula. Clin Radiol 2016; 71:986-992. [PMID: 27426676 DOI: 10.1016/j.crad.2016.06.108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/04/2016] [Accepted: 06/08/2016] [Indexed: 12/12/2022]
Abstract
AIM To review all reported methods of preoperative computed tomography (CT) in one patient cohort and to identify which were the strongest to predict postoperative pancreatic fistula (POPF) after pancreatoduodenectomy. MATERIALS AND METHODS Consecutive patients undergoing pancreatoduodenectomy were included if they had unenhanced CT images for review. Eighteen variables and two scores were tested. Receiver operator characteristics (ROC) were explored. RESULTS POPF affected 26 of 107 patients (24.3%). Nine variables were significantly related to POPF with pancreatic duct width having the largest area under the ROC curve (AUROC; 0.808, p<0.001). An obese body habitus was associated with POPF with six of nine related variables using data from CT images associated with POPF; of these intra-abdominal wall thickness yielded the largest AUROC (0.713, p=0.001). This corresponded to the finding that body mass index (BMI) was related to POPF (AUROC 0.705, p=0.002). The largest AUROC of all was associated with one of the predictive scores (0.828, p<0.001). Substituting BMI for intra-abdominal wall thickness in this score yielded a non-significant increase to predict POPF (AUROC 0.840, p=0.676). None of the assessments of organ density (in Hounsfield Units) were associated with POPF. CONCLUSION Data from preoperative CT imaging provides valuable information regarding a patient's risk of POPF. Obesity as assessed by CT images strongly relates to POPF, but the largest single risk factor for POPF is a narrow pancreatic duct.
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Khattak I, Mushtaq MH, Ahmad MUD, Khan MS, Haider J. Zoonotic tuberculosis in occupationally exposed groups in Pakistan. Occup Med (Lond) 2016; 66:371-6. [PMID: 27032413 DOI: 10.1093/occmed/kqw039] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Bovine tuberculosis (bTB) remains a public health threat in low-income countries. Data on human tuberculosis (TB) due to Mycobacterium bovis are poorly documented in developing countries. AIMS To determine the occurrence of active pulmonary TB due to M. bovis in abattoir workers, butchers, livestock farmers and veterinarians and to document their knowledge and practices regarding bTB. METHODS A cross-sectional study of abattoir workers, butchers, livestock farmers, veterinary doctors and veterinary assistants, which obtained data on socio-demographic conditions, knowledge and practices regarding TB. Sputum samples were collected from respondents with a chronic cough. The chi-squared test was used for statistical analysis. RESULTS A total of 141 abattoir workers, 317 butchers, 50 livestock farmers, five veterinary doctors and three veterinary assistants took part. Four out of 16 abattoir workers and 1 out of 50 livestock farmers were positive for M. bovis by PCR analysis. Duration of work as an abattoir worker was significantly associated (P < 0.05) with prevalence of zoonotic TB. The knowledge of abattoir workers, butchers, livestock farmers and veterinary assistants regarding transmission of bTB from animals to humans and the symptoms of TB in humans was very poor. Most of these workers did not use protective equipment and appropriate safe working techniques and were considered at high risk of acquiring zoonotic TB. CONCLUSIONS Zoonotic TB is a significant public health issue among professionally exposed groups in Peshawar, Pakistan and suggests a need for further detailed investigations of the disease in this and similar areas.
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Khan MS, Khine TM, Hutchison C, Coker RJ, Hane KM, Innes AL, Aung S. Are current case-finding methods under-diagnosing tuberculosis among women in Myanmar? An analysis of operational data from Yangon and the nationwide prevalence survey. BMC Infect Dis 2016; 16:110. [PMID: 26940910 PMCID: PMC4778364 DOI: 10.1186/s12879-016-1429-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/10/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although there is a large increase in investment for tuberculosis control in Myanmar, there are few operational analyses to inform policies. Only 34 % of nationally reported cases are from women. In this study, we investigate sex differences in tuberculosis diagnoses in Myanmar in order to identify potential health systems barriers that may be driving lower tuberculosis case finding among women. Methods From October 2014 to March 2015, we systematically collected data on all new adult smear positive tuberculosis cases in ten township health centres across Yangon, the largest city in Myanmar, to produce an electronic tuberculosis database. We conducted a descriptive cross-sectional analysis of sex differences in tuberculosis diagnoses at the township health centres. We also analysed national prevalence survey data to calculate additional case finding in men and women by using sputum culture when smear microscopy was negative, and estimated the sex-specific impact of using a more sensitive diagnostic tool at township health centres. Results Overall, only 514 (30 %) out of 1371 new smear positive tuberculosis patients diagnosed at the township health centres were female. The proportion of female patients varied by township (from 21 % to 37 %, p = 0.0172), month of diagnosis (37 % in February 2015 and 23 % in March 2015 p = 0.0004) and age group (26 % in 25–64 years and 49 % in 18–25 years, p < 0.0001). Smear microscopy grading of sputum specimens was not substantially different between sexes. The prevalence survey analysis indicated that the use of a more sensitive diagnostic tool could result in the proportion of females diagnosed at township health centres increasing to 36 % from 30 %. Conclusions Our study, which is the first to systematically compile and analyse routine operational data from tuberculosis diagnostic centres in Myanmar, found that substantially fewer women than men were diagnosed in all study townships. The sex ratio of newly diagnosed cases varied by age group, month of diagnosis and township of diagnosis. Low sensitivity of tuberculosis diagnosis may lead to a potential under-diagnosis of tuberculosis among women.
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Konto M, Fufa GI, Zakaria A, Tukur SM, Watanabe M, Ola-Fadunsin SD, Khan MS, Shettima YM, Babjee SMA. Tick fauna of Malaysian red jungle fowl (Gallus gallus) in Bangi, Malaysia. Vet World 2015; 8:1167-71. [PMID: 27047012 PMCID: PMC4774650 DOI: 10.14202/vetworld.2015.1167-1171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/24/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022] Open
Abstract
Aim: The red jungle fowl is generally considered as one of the endangered Asian wild Galleopheasants due to man-made encroachment of their habitats, coupled with the effect of disease and disease causing organisms like ticks and tick-borne infections. This study aimed to determine the tick fauna of the red jungle fowl and their predilection sites based on developmental stages. Materials and Methods: A total of 33 jungle fowls were sampled for this study from Bangi area of Selangor State, Peninsular Malaysian. The birds were captured using a locally made trap made-up of loops and bites. Ticks present on their bodies were detached using fine forceps and identified morphologically under a dissecting microscope. Results: 91% of the jungle fowls were infested with ticks, all of which belongs to the species Haemaphysalis wellingtoni. The ear region appeared to be the most common predilection site (63%) for all the developmental stages in which the larval stages are solely restricted to that region. Nymphal and adult stages were distributed on the comb, wattle, and facial region in addition to the ear region. Conclusion: This study was the first in its kind and showed a high prevalence of tick infestation among jungle fowls. H. wellingtoni was known to be a vector in transmission of many tick-borne pathogens. Therefore, there is the need for further investigation to identify the various pathogens associated with this tick.
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Cresswell J, Mariappan P, Thomas SA, Khan MS, Johnson MI, Fowler S. Radical cystectomy: Analysis of trends in UK practice 2004–2012, from the British Association of Urological Surgeons’ (BAUS) Section of Oncology Dataset. JOURNAL OF CLINICAL UROLOGY 2015. [DOI: 10.1177/2051415815595325] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To analyse the British Association of Urological Surgeons’ (BAUS) radical cystectomy (RC) dataset, to examine the trends in patient selection, use of neoadjuvant chemotherapy (NAC) and operative technique. Methods: Data for RC were entered into a database voluntarily, by operating surgeons. A comparison was made to the Hospital Episode Statistics (HES) data, to estimate the proportion of cases captured by the dataset. Results: From 2004 to 2012, data was collected on 5321 patients undergoing RC. This constituted 37.1% of all HES RC cases during the corresponding time period. Notable trends were: An increasing use of NAC, the introduction of minimally-invasive surgery (23.5% in 2012), a dramatic reduction in blood transfusion rates and the increasing yields from lymph node dissection. The ileal conduit urinary diversion predominated as the urinary diversion of choice (80% of cases). Conclusions: This analysis of a large multi-centre dataset provides insight into RC practice in the UK, over 8 years. The major weaknesses of the study were that only one-third of cases were recorded and that outcome data was very limited. Mandatory publication of outcome data from 2016 should increase the recording of cases and provide material for a more complete analysis.
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Siddiqui S, Ahmad E, Gupta M, Rawat V, Shivnath N, Banerjee M, Khan MS, Arshad M. Cissus quadrangularis Linn exerts dose-dependent biphasic effects: osteogenic and anti-proliferative, through modulating ROS, cell cycle and Runx2 gene expression in primary rat osteoblasts. Cell Prolif 2015; 48:443-54. [PMID: 26079044 DOI: 10.1111/cpr.12195] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/02/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This report highlights phytoconstituents present in Cissus quadrangularis (CQ) extract and examines biphasic (proliferative and anti-proliferative) effects of its extract on bone cell proliferation, differentiation, mineralization, ROS generation, cell cycle progression and Runx2 gene expression in primary rat osteoblasts. MATERIALS AND METHODS Phytoconstituents were identified using gas chromatography-mass spectroscopy (GC-MS). Osteoblasts were exposed to different concentrations (10-100 μg/ml) of CQ extract and cell proliferation and cell differentiation were investigated at different periods of time. Subsequently, intracellular ROS intensity, apoptosis and matrix mineralization of osteoblasts were evaluated. We performed flow cytometry for DNA content and real-time PCR for Runx2 gene expression analysis. RESULTS CQ extract's approximately 40 bioactive compounds of fatty acids, hydrocarbons, vitamins and steroidal derivatives were identified. Osteoblasts exposed to varying concentrations of extract exhibited biphasic variation in cell proliferation and differentiation as a function of dose and time. Moreover, lower concentrations (10-50 μg/ml) of extract slightly reduced ROS intensity, although they enhanced matrix mineralization, DNA content in S phase of the cell cycle, and levels of Runx2 expression. However, higher concentrations (75-100 μg/ml) considerably induced the ROS intensity and nuclear condensation in osteoblasts, while it reduced mineralization level, proportion of cells in S phase and Runx2 level of the osteogenic gene. CONCLUSIONS These findings suggest that CQ extract revealed concentration-dependent biphasic effects, which would contribute notably to future assessment of pre-clinical efficacy and safety studies.
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Allwood LJ, Raine CH, Becconsall K, Khan MS, Gill C. Bilingualism and cochlear implants--issues and answers? Adv Otorhinolaryngol 2015; 50:177-85. [PMID: 7610957 DOI: 10.1159/000424456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ramachandran R, Bech P, Murphy KG, Caplin ME, Patel M, Vohra S, Khan MS, Dhillo WS, Sharma R, Palazzo FF, Win Z, Tan T, Khoo B, Meeran K, Frilling A, Ghatei MA, Bloom SR, Martin NM. Comparison of the utility of Cocaine- and Amphetamine-Regulated Transcript (CART), chromogranin A, and chromogranin B in neuroendocrine tumor diagnosis and assessment of disease progression. J Clin Endocrinol Metab 2015; 100:1520-8. [PMID: 25664601 DOI: 10.1210/jc.2014-3640] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Prognosis in patients with neuroendocrine tumors (NETs) is often poor, frequently reflecting delayed diagnosis. Hence, accurate and practical NET markers are needed. Cocaine- and amphetamine-regulated transcript (CART) peptide is a potential novel NET marker. DESIGN AND PARTICIPANTS Circulating levels of CART peptide and the established NET markers chromogranin A (CgA) and chromogranin B (CgB) were measured using RIA in 353 patients with NET (normal renal function) and in controls. Clinical data were collected retrospectively. MAIN OUTCOME MEASURE(S) The comparative and combined utility of CART, CgA, and CgB for diagnosis and assessment of disease progression was measured in different NET subtypes. RESULTS CgA and CgB in combination improved diagnostic accuracy in patients with gut NETs, nongastroenteropancreatic NETs, and NETs with an unknown primary origin compared with each biomarker alone. Measuring CART did not further improve diagnosis in these NET subtypes. For pancreatic NETs, CgB was superior to CgA and CART in detecting stable disease (P < .007), whereas CgA and CART in combination were most effective in identifying progressive disease. In phaeochromocytomas/paragangliomas (PCC/PGL), CART was the most useful biomarker for identifying stable (P < .001) and progressive (P = .001) disease. Consistent with this, plasma CART decreased following PCC/PGL tumor resection, remaining low in all patients in remission, but increasing in those with progressive disease. CONCLUSIONS CART is a useful marker for identifying progressive pancreatic NETs. CART is superior to CgA and CgB in detecting stable and progressive PCC/PGLs, and may have a role as a surveillance marker for PCC/PGL patients.
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