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Uddin R, Burton NW, Maple M, Khan SR, Tremblay MS, Khan A. Low physical activity and high sedentary behaviour are associated with adolescents' suicidal vulnerability: Evidence from 52 low- and middle-income countries. Acta Paediatr 2020; 109:1252-1259. [PMID: 31709627 DOI: 10.1111/apa.15079] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/09/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
Abstract
AIM To examine the relationships of physical activity (PA) and sedentary behaviour (SB) with suicidal thoughts and behaviour among adolescents in low- and middle-income countries (LMICs). METHODS Global School-based Student Health Survey data from 206 357 students (14.6 ± 1.18 years; 51% female) in 52 LMICs were used. Students reported on suicidal ideation, suicide planning, suicide attempts, PA, leisure-time SB and socio-demographic characteristics. Multilevel mixed-effects generalised linear modelling was used to examine the associations. RESULTS High leisure-time SB (≥3 hours/day) was independently associated with higher odds of suicidal ideation, suicide planning and suicide attempts for both male and female adolescents. Insufficient PA (<60 mins/day) was not associated with higher odds of ideation for either sex; however, it was associated with planning and attempts for male adolescents. The combination of insufficient PA and high SB, compared with sufficient PA and low SB, was associated with higher odds of suicidal ideation and suicide planning for both male and female adolescents, and suicide attempts for male adolescents. CONCLUSION High SB may be an indicator of suicidal vulnerability among adolescents in LMICs. Low PA may be a more important risk for suicidal thoughts and behaviours among male, than female, adolescents. Promoting active lifestyle should be integrated into suicide prevention programmes in resource-poor settings.
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Uddin MJ, Rahman AF, Rahman S, Momenuzzaman NM, Rahman A, Majumder AS, Mohibullah AM, Chowdhury AH, Malik FN, Ahsan SA, Mohsin K, Haq MM, Chowdhury AW, Sohrabuzzaman AM, Rahman M, Chakraborty B, Rahman R, Khan SR, Khan KN, Reza AM, Hussain KS, Rashid M, Choudhury AK, Karmakar KK, Ali Z, Alam N, Rahman Z, Kabir CS, Banik D, Dutta A, Badiuzzaman M, Islam AW, Sium AH, Hossain MD, Ahmed N, Jahan J, Islam MS, Arefin MM, Cader FA, Banerjee SK, Hoque H, Shofiuddin M, Selim A, Das PK, Ahmed M, Dutto B, Alam S, Paul GK, Paul SK, Azam MG. National Clinical Guidance for the Management of Cardiovascular Intervention in the COVID-19 Pandemic: From Bangladesh Society of Cardiovascular Interventions (BSCI). Mymensingh Med J 2020; 29:488-494. [PMID: 32506111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.
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Tariq A, Khan SR, Basharat A. Assessment of knowledge, attitudes and practice towards Vitamin D among university students in Pakistan. BMC Public Health 2020; 20:355. [PMID: 32183774 PMCID: PMC7079348 DOI: 10.1186/s12889-020-8453-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/04/2020] [Indexed: 02/08/2023] Open
Abstract
Background Pakistan has one of the highest reported incidence of vitamin D deficiency in studies conducted worldwide. However, there has been very limited exploration of vitamin D related knowledge, attitudes and practices among healthy youth in Pakistan. Methods A cross-sectional survey was conducted among youth (aged > 16 years) from two engineering universities in Pakistan. Participants were asked questions on their concern about vitamin D levels, testing, and supplementation practices. Knowledge was examined using questions about food sources, health benefits and factors affecting vitamin D production within the human body. Of the 900 eligible students invited to participate, 505 (56%) completed the questionnaire and were included in the analysis. Results Only 9% participants were able to identify the correct food sources of vitamin D, 33% were aware of the bone health benefits (bone health and calcium absorption) of vitamin D and 36% identified sunlight exposure as a factor influencing vitamin D production. Knowledge about food sources and health benefits of vitamin D was not associated with gender and individuals concern about their levels. Those tested and taking supplements were more likely to identify bone related health benefits and factors affecting vitamin D production. Forty percent male and 52% female students expressed concern that their vitamin D levels were too low. However, 72% participants reported that they had never been tested for vitamin D levels. Use of supplements was significantly higher among female students (F = 52% vs M = 37%; P = 0.003). Those who had been tested for vitamin D deficiency were more likely to take supplements. Conclusion Despite being identified as a high-risk population, knowledge about vitamin D was limited among university students. Interventions are needed to increase awareness about the importance of vitamin D for health, including the need for exposure to sunlight and adequate dietary intake of vitamin D. Our study provides much needed baseline evidence for making health-policy recommendations for this vulnerable population group.
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Uddin R, Lee EY, Khan SR, Tremblay MS, Khan A. Clustering of lifestyle risk factors for non-communicable diseases in 304,779 adolescents from 89 countries: A global perspective. Prev Med 2020; 131:105955. [PMID: 31862205 DOI: 10.1016/j.ypmed.2019.105955] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/04/2019] [Accepted: 12/16/2019] [Indexed: 11/30/2022]
Abstract
The precursors of non-communicable diseases (NCDs) are often manifested during childhood and adolescence with little knowledge about co-occurrence of their related lifestyle risk factors. To address this deficit, we estimated the prevalence and clustering of six major NCD-risk factors in adolescents around the world. Data from the Global School-based Student Health Survey, collected between 2007 and 2016, were analysed in 304,779 adolescents aged 11-17 years (52.2% females) from 89 countries. We compared the observed (O) to expected (E) prevalence ratios of 64 possible combinations of six risk factors to determine their clustering patterns. Overall, 82.4% (95% CI 82.1-82.7) of adolescents had ≥2 risk factors, while 34.9% (34.6-35.3) had ≥3. Adolescents aged 16-17 years, compared to those aged 11-13 years, had higher odds (OR 1.33; 95% CI 1.31-1.36) of reporting ≥3 risk factors. Risk factors clustered in multiple combinations and differed by sex. The clustering of physical inactivity and low fruit and vegetable intake was evident in both males (O/E 1.10; 95% CI 1.07-1.12) and females (1.08; 1.06-1.10). The co-occurrence of cigarette smoking, alcohol drinking, physical inactivity, and low fruit and vegetable intake was 165% greater in females (2.65; 2.28-3.07) and 110% greater in males (2.10; 1.90-2.32) than expected. Globally, adolescents exhibit multiple modifiable risk factors for future development of NCDs. Early gender-specific prevention strategies targeting clusters of lifestyle risk factors should be prioritised to help mitigate future burden of NCDs globally. Periodical collection of behavioural risk factor data should be encouraged to facilitate a sustainable global surveillance.
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Ullah AKMA, Maksud MA, Khan SR, Quraishi SB. Morning (First) Urine Copper Concentration: a New Approach for the Diagnosis of Wilson's Disease. Biol Trace Elem Res 2019; 190:283-288. [PMID: 30324502 DOI: 10.1007/s12011-018-1547-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
Twenty-four-hour (h) urinary copper content is considered as the most suitable tool for the diagnosis of Wilson's disease (WD); however, it is less accurate, time-consuming, and non-economical. Consequently, in the present study, an alternative method through measuring the morning (first) urine copper (Cu) concentration is proposed for the diagnosis of WD, which is more accurate, precise, faster, and cheaper. For this purpose, a sensitive, accurate, and precise analytical method was developed and validated in regard to Commission Decision 657/2002/EC, Council Directive 333/2007/EC, ISO/IEC 17025:2005, and EURACHEM 1998 for the determination of Cu in urine using flame atomic absorption spectrometry (FAAS). The methods LoD and LoQ for urine Cu were estimated as 6.68 μg/L and 16.7 μg/L respectively. The accuracy of the method was found to be 93.70-101.88% calculated from the spike recovery experiment. The RSDs for the repeatability and reproducibility precision were measured as 0.67-3.16 and 0.26-1.95 respectively. The method validation performance criteria indicated that the method was suitable for the determination of Cu in urine. The validated method was then applied for the determination of Cu in both 24 h and first urine. From the analysis, it was found that the amount of Cu per liter in the first urine was almost equivalent to the amount of Cu per 24 h indicating that instead of considering the 24-h urine, morning (first) urine investigation might be an alternative approach for the diagnosis of WD.
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Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol 2019; 181:907-915. [PMID: 30945275 DOI: 10.1111/bjd.17980] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sunscreen use can prevent skin cancer, but there are concerns that it may increase the risk of vitamin D deficiency. OBJECTIVES We aimed to review the literature to investigate associations between sunscreen use and vitamin D3 or 25 hydroxyvitamin D [25(OH)D] concentration. METHODS We systematically reviewed the literature following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We identified manuscripts published in English between 1970 and 21 November 2017. Eligible studies were experimental [using an artificial ultraviolet radiation (UVR) source], field trials or observational studies. The results of each of the experimental studies and field trials are described in detail. Two authors extracted information from observational studies, and applied quality scoring criteria that were developed specifically for this question. These have been synthesized qualitatively. RESULTS We included four experimental studies, three field trials (two were randomized controlled trials) and 69 observational studies. In the experimental studies sunscreen use considerably abrogated the vitamin D3 or 25(OH)D production induced by exposure to artificially generated UVR. The randomized controlled field trials found no effect of daily sunscreen application, but the sunscreens used had moderate protection [sun protection factor SPF) ~16]. The observational studies mostly found no association or that self-reported sunscreen use was associated with higher 25(OH)D concentration. CONCLUSIONS There is little evidence that sunscreen decreases 25(OH)D concentration when used in real-life settings, suggesting that concerns about vitamin D should not negate skin cancer prevention advice. However, there have been no trials of the high-SPF sunscreens that are now widely recommended. What's already known about this topic? Previous experimental studies suggest that sunscreen can block vitamin D production in the skin but use artificially generated ultraviolet radiation with a spectral output unlike that seen in terrestrial sunlight. Nonsystematic reviews of observational studies suggest that use in real life does not cause vitamin D deficiency. What does this study add? This study systematically reviewed all experimental studies, field trials and observational studies for the first time. While the experimental studies support the theoretical risk that sunscreen use may affect vitamin D, the weight of evidence from field trials and observational studies suggests that the risk is low. We highlight the lack of adequate evidence regarding use of the very high sun protection factor sunscreens that are now recommended and widely used.
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Tariq A, Khan SR, Vela I, Williams ED. Assessment of the use of the Internet and social media among people with bladder cancer and their carers, and the quality of available patient-centric online resources: a systematic review. BJU Int 2019; 123 Suppl 5:10-18. [DOI: 10.1111/bju.14720] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Khan A, Khan SR, Burton NW. Missing breakfast is associated with overweight and obesity in Bangladeshi adolescents. Acta Paediatr 2019; 108:178-179. [PMID: 30144164 DOI: 10.1111/apa.14553] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kabir CMS, Khan SR. P5521Comparison of left radial versus femoral approaches for coronary procedures in patients with previous coronary artery bypass grafts. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Khan SR, Whiteman DC, Kimlin MG, Janda M, Clarke MW, Lucas RM, Neale RE. Effect of solar ultraviolet radiation exposure on serum 25(OH)D concentration: a pilot randomised controlled trial. Photochem Photobiol Sci 2018; 17:570-577. [PMID: 29619453 DOI: 10.1039/c7pp00378a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sunlight generates vitamin D, but there are scant human data from randomised trials on which to base health policy advice about how much sun exposure is necessary to change 25(OH)D concentrations. The purpose of the study was to evaluate the feasibility of using solar ultraviolet (UV) radiation exposure to generate a change in 25(OH)D concentration in a randomised controlled trial (RCT). The intervention tested in this RCT was supervised exposure to one standard erythemal dose (SED; 100 J m-2) of solar UV radiation three days per week for three weeks with approximately 35% of the body surface area not covered by clothing. Thirty-six fair-skinned (skin type II and III) indoor workers from Brisbane, Australia were randomised into either the intervention group (n = 16) or the control group (n = 20); the latter did not receive any supervised sun exposure. We asked both groups to use sunscreen and to minimise time outdoors during the study period. We collected blood samples at baseline, once per week during the three week intervention period, and four weeks after the intervention finished. The cumulative UV radiation exposure over the intervention period measured using polysulphone badges was higher in the intervention group than in the control group (median 8 vs. 4 SEDs, p = 0.14). After three weeks, the mean serum 25(OH)D concentration increased from 60 to 65 nmol l-1 in the intervention group and from 55 to 57 nmol l-1 in the control group. After adjustment for baseline 25(OH)D, the mean change per week during the intervention phase was non-significantly higher in the intervention than in the control group (0.7 vs. 0.3; p = 0.35). This difference was not sustained during the follow-up period. Large field trials are needed to inform policy about how much natural sun exposure is required to raise 25(OH)D concentrations. This pilot identified key issues that need to be considered in the design of such a trial.
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Khan SR, Qazi SR. Extraction of maxillary teeth by dental students without palatal infiltration of local anaesthesia: a randomised controlled trial. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:e39-e42. [PMID: 27324934 DOI: 10.1111/eje.12215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Palatal infiltration of local anaesthesia (LA) for maxillary tooth extractions is painful. One of the techniques for reducing the discomfort of this injection is to avoid it altogether. Given enough time, LA administered only as buccal infiltration diffuses to reach and anaesthetise the palatal tissues. The aim of this double-blind randomised controlled trial was to test the hypothesis that buccal infiltration alone of LA by dental students should be adequate for maxillary tooth extractions. PATIENTS AND METHODS Fifty adult patients presenting for single-tooth maxillary extractions were randomly allocated between two groups. The control group received palatal injections of 0.1 ml 2% lidocaine with 1:100,000 adrenaline, whilst the experimental group received a similar amount of saline (placebo). Extractions performed without further administration of LA were categorised as successful. RESULTS Palatal infiltration of lidocaine with adrenaline was significantly more effective than saline (P = 0.002). Overall buccal infiltration alone was successful in 28% patients, with a 40% success rate in the posterior maxilla. CONCLUSION Results suggest that dental students should, as a matter of routine, extract maxillary teeth with both buccal and palatal infiltration of LA, whilst buccal infiltration alone may be considered in the posterior maxilla.
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Poulsen MG, Khan A, Poulsen EE, Khan SR, Poulsen AA. Work engagement in cancer care: The power of co-worker and supervisor support. Eur J Oncol Nurs 2016; 21:134-8. [DOI: 10.1016/j.ejon.2015.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/17/2015] [Accepted: 09/22/2015] [Indexed: 11/15/2022]
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Khan SR, Berendt RT, Ellison CD, Ciavarella AB, Asafu-Adjaye E, Khan MA, Faustino PJ. Bupropion Hydrochloride. PROFILES OF DRUG SUBSTANCES, EXCIPIENTS, AND RELATED METHODOLOGY 2016; 41:1-30. [PMID: 26940167 DOI: 10.1016/bs.podrm.2015.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Bupropion hydrochloride is a norepinephrine-dopamine disinhibitor (NDDI) approved for the treatment of depression and smoking cessation. Bupropion is a trimethylated monocyclic phenylaminoketone second-generation antidepressant, which differs structurally from most antidepressants, and resides in a novel mechanistic class that has no direct action on the serotonin system. Comprehensive chemical, physical, and spectroscopic profiles are presented. This analytical profile provides an extensive spectroscopic investigation utilizing mass spectrometry, one- and two-dimensional NMR, solid-state NMR, IR, NIR, Raman, UV, and X-ray diffraction. The profile also includes significant wet chemistry studies for pH, solubility, solution, and plasma stability. Both HPLC and UPLC methodology are presented for bupropion and its related impurities or major metabolites. The profile concludes with an overview of biological properties that includes toxicity, drug metabolism, and pharmacokinetics.
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Ansari AS, Hussain M, Khan SR, Lohiya NK. Relative suitability of DMSO and NaHCO3 for reversal of RISUG® induced long-term contraception. Andrology 2016; 4:306-13. [PMID: 26748683 DOI: 10.1111/andr.12155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/04/2015] [Accepted: 12/03/2015] [Indexed: 11/30/2022]
Abstract
Among the vas-based methods on trial, reversible inhibition of sperm under guidance (RISUG(®) ), a co-polymer of styrene and maleic anhydride is being projected as an effective alternative to No Scalpel Vasectomy. RISUG offers long-term contraception with safety, efficacy in human trials and can be delivered by no-scalpel injection. Currently, the procedure is under phase-III clinical trial. However, reversal of this vas-based drug-induced contraception needs to be established in animal models prior to clinical trials to ensure its claim as an effective alternative for vasectomy. In the present investigation, the relative suitability of dimethyl sulphoxide (DMSO) and NaHCO3 for RISUG induced long-term vas occlusion reversal was carried out in albino rats. Animals were allocated into four groups (n = 10), viz., sham-operated control (group-I), vas occlusion with RISUG for 360 days (group-II), vas occlusion with RISUG for 360 days and reversal with DMSO (group-III) and vas occlusion with RISUG for 360 days and reversal with NaHCO3 (group-IV). A variable response in fertility was observed in different groups. Absolute sterility in group III at all mating intervals, while, zero percent fertility in groups II and IV following 90 days of occlusion was observed. Following reversal restoration of fertility with DMSO at 45 days, whereas, reversal by NaHCO3 at 30 days was noticed. Ejaculated spermatozoa of RISUG injected and initial intervals of reversed animals exhibited various degrees of abnormalities. The testes exhibited focal degeneration in vas occluded animals. The occluded lumen of the vas deferens contained an eosinated polymer with exfoliated epithelium. Following vas occlusion reversal, a complete regeneration in the vas epithelium was seen. All other parameters remained unaltered. The reversal with NaHCO3 resulted into an early resumption of fertility when compared with DMSO and the procedure found to be successful, feasible and safe up to F1 generation. Thus, RISUG provides a hope for reversible male contraceptives.
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Poulsen MG, Poulsen AA, Khan A, Poulsen EE, Khan SR. Recovery experience and burnout in cancer workers in Queensland. Eur J Oncol Nurs 2014; 19:23-8. [PMID: 25227460 DOI: 10.1016/j.ejon.2014.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 08/07/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Two key recovery experiences mediating the relationship between work demands and well-being are psychological detachment and relaxation over leisure time. The process of recovery from work-related stress plays an important role in maintaining well-being, but is poorly understood in cancer workers. The aim of this exploratory study was to examine the relationships of burnout, psychological well-being and work engagement with the recovery experiences of psychological detachment and relaxation in oncology staff. METHODS A cross sectional survey of 573 cancer workers in Queensland was conducted (response rate 56%). Oncology nurses (n = 211) represented the largest professional group. Staff completed surveys containing demographics and psychosocial questionnaires measuring burnout, psychological distress, work engagement and recovery experience. Multiple regression analyses were performed to identify explanatory variables which were independently associated with Recovery Experience Score (RES). RESULTS There was a negative association between the RES and burnout (p = 0.002) as well as psychological distress (p < 0.0001), but not work engagement. Age >25 years was negatively correlated with RES as was having a post graduate qualification, being married or divorced, having carer commitments. Participating in strenuous exercise was associated with high recovery (p = 0.015). CONCLUSIONS The two recovery experiences of psychological detachment and relaxation had a strong negative association to burnout and psychological well-being, but not work engagement. Further research needs to be undertaken to better understand if improving recovery experience reduces burnout and improves the well-being of cancer workers.
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Poulsen AA, Meredith P, Khan A, Henderson J, Castrisos V, Khan SR. Burnout and Work Engagement in Occupational Therapists. Br J Occup Ther 2014. [DOI: 10.4276/030802214x13941036266621] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Work engagement, characterized by vigour, dedication, and absorption, is often perceived as the opposite of burnout. Occupational therapists with burnout feel exhausted and disengaged from their work. This study aims to investigate demographic and work-related psychosocial factors associated with burnout and work engagement. Method: A cross-sectional postal survey of 951 occupational therapists was conducted. Findings: Two models representing factors associated with burnout (F(15,871) = 28.01, p < .001) and work engagement (F(10,852) = 16.15, p < .001) accounted for 32.54% and 15.93% of the variance respectively. Burnout and work engagement were inversely associated (χ2(n = 941) = 55.16, p < .001). Conclusion: Factors associated with burnout and work engagement were identified. The variables associated with burnout included: low psychological detachment from work during out-of-work hours, low income satisfaction, perceived work overload, difficulty saying ‘no’, < 10 years' experience, low frequency of having a ‘belly laugh’, and not having children. High levels of work engagement were reported by therapists with the following: low psychological detachment from work, high income satisfaction, postgraduate qualifications, > 40 hours work/week, high frequency of having a ‘belly laugh’, and having children. Understanding the factors associated with burnout and work engagement provides prerequisite information to inform strategies aimed at building healthy workforces.
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Haq MM, Ahsan CH, Amin MN, Karim MR, Ali ML, Khan SR, Chowdhury MZ, Mansur M, Millat MH, Rashid MA. Comparison of P2Y12 receptor inhibition by clopidogrel and prasugrel in patients undergoing percutaneous coronary intervention. BANGLADESH MEDICAL RESEARCH COUNCIL BULLETIN 2013; 39:139-45. [PMID: 26118162 DOI: 10.3329/bmrcb.v39i3.20315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Dual antiplatelet treatment (DAPT) with aspirin and clopidogrel is vital after percutaneous coronary intervention (PCI). Clopidogrel and prasugrel act on P2Y12 platelet surface receptors. Both these P2Y12 inhibitors are pro-drugs and depend on cytochrome system of the liver for their conversion to active metabolite. There is growing concern regarding suboptimal response in platelet inhibition by clopidogrel. Verify Now system got approval by Federal Drug Administration, USA, for assessing platelet function as its result is almost comparable to gold standard Light Transmission Aggregometry (LTA). There are no data on the prevalence of clopidogrel resistance in Bangladeshi population. Prasugrel, as an antiplatelet drug, is a newer introduction in this country. This study will show light on the efficacy of these drugs on our population especially in patients who undergo PCI where DAPT is mandatory. A total 120 (60 diabetics) patients with Acute Coronary Syndrome (ACS), were alternatively given 600 mg clopidogrel loading dose (LD) followed by 75 mg maintenance dose (MD) daily or 60 mg LD of prasugrel followed by 10 mg MD daily. Five samples of blood were taken at different time intervals over a period of 2 weeks. Measurement of percent inhibition of P2Y12 was done by VerifyNow. Patients who showed less than 20% inhibition (clopidogrel resistant) at any stage were switched to prasugrel. The outcomes of clopidogrel, prasugrel and clopidogrel switched to prasugrel groups were then compared. Nearly half (46.7%) of the patients in the clopidogrel group was found resistant to the drug as opposed to none in the prasugrel group. No difference was found between diabetic and non-diabetic subjects with respect to drug resistance. Intracoronary blood samples showed high degree of platelet inhibition with prasugrel. There was a gradual decline of platelet inhibition over two weeks with prasugrel. Almost fifty percent of the population is clopidogrel resistant in our study. Prasugrel is a much more potent antiplatelet drug and should be preferred in patients undergoing PCI. Prasugrel may also show resistance over time.
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Khan SR. Stress oxidative: nephrolithiasis and chronic kidney diseases. Minerva Med 2013; 104:23-30. [PMID: 23392535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The association between nephrolithiasis and many chronic kidney diseases suggests a common causative link. There are indications that stone formation can lead to hypertension, diabetes, chronic disease and myocardial infarct. The reverse also appears to be true in that diabetes and hypertension can lead to stone formation. The production of reactive oxygen species (ROS) and the development of oxidative stress (OS) are common features of many renal and cardiovascular diseases including, hypertension, diabetes, metabolic syndrome and nephrolithiasis. It is my hypothesis that oxidative stress produced by one disease may lead to another under suitable conditions. For example mild hypercalciuria, hyperoxaluria, hypocitraturia which under normal conditions may just be a curiosity or nuisance can promote crystallization when cells are injured by ROS produced by the co-morbid condition. On the other hand OS produced during or as a result of nephrolithiasis may promote hypertension or diabetic nephropathy.
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Poulsen MG, Poulsen AA, Khan A, Poulsen EE, Khan SR. Factors associated with subjective well-being in cancer workers in Queensland. J Med Imaging Radiat Oncol 2012; 56:347-53. [DOI: 10.1111/j.1754-9485.2012.02368.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Poulsen MG, Poulsen AA, Khan A, Poulsen EE, Khan SR. Work engagement in cancer workers in Queensland: The flip side of burnout. J Med Imaging Radiat Oncol 2011; 55:425-32. [DOI: 10.1111/j.1754-9485.2011.02281.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Islam MN, Khan ZI, Khan SR, Haque MA. Morphometry of the intercommissural distances and other structures of the aortic valve of bovine heart. Mymensingh Med J 2006; 15:153-8. [PMID: 16878096 DOI: 10.3329/mmj.v15i2.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The morphometry of the intercommissural distances and their relation with other structures of the aortic valve of bovine heart was carried out. A total of 32 apparently healthy bovine hearts of indigenous cattle of both sexes (50% male and 50% female), 2-4 years of age, weighing 500 to 800 gms were used in this study. The external intercommissural distances were higher in all cusps of the valve compared to the internal intercommissural distances. The internal intercommissural distance was larger in the RC sinus in case of male animals followed by that of the LC and NC sinus. The mean external intercommissural distances were 34.67+/-3.40, 34.40+/-3.64 and 34.97+/-4.37 mm and the internal intercommissural distances were 21.60+/-4.21, 21.20+/-4.70 and 20.67+/-4.06 mm for LC, RC and NC respectively. Analyzing the internal intercommissural distance, value in the LC sinus was higher followed by the RC and the NC but this variation was non-significant. In regard to the position of the coronary ostia, there were two coronary ostia, the right coronary ostium present in the RC sinus and the left coronary ostium in the LC sinus respectively and the right coronary ostium was supracommissural in position in bovine heart. Data about the morphometrical analysis of intercommissural distances and the position of the coronary ostia of the aortic valve facilitate the knowledge of manufacturing bovine tissue valve as well as those might be involved in valve replacement in human.
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Khan SR, Glenton PA, Byer KJ. Modeling of hyperoxaluric calcium oxalate nephrolithiasis: experimental induction of hyperoxaluria by hydroxy-L-proline. Kidney Int 2006; 70:914-23. [PMID: 16850024 DOI: 10.1038/sj.ki.5001699] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A number of animal models have been developed to investigate calcium oxalate (CaOx) nephrolithiasis. Ethylene glycol (EG)-induced hyperoxaluria in rats is most common, but is criticized because EG and some of its metabolites are nephrotoxic and EG causes metabolic acidosis. Both oxalate (Ox) and CaOx crystals are also injurious to renal epithelial cells. Thus, it is difficult to distinguish the effects of EG and its metabolites from those induced by Ox and CaOx crystals. This study was performed to investigate hydroxy-L-proline (HLP), a common ingredient of many diets, as a hyperoxaluria-inducing agent. In rats, HLP has been shown to induce CaOx nephrolithiasis in only hypercalciuric conditions. Five percent HLP mixed with chow was given to male Sprague-Dawley rats for 63 days, resulting in hyperoxaluria, CaOx crystalluria, and nephrolithiasis. Crystal deposits were surrounded by ED-1-positive inflammatory cells. Cell injury and death was followed by regeneration, as suggested by an increase in proliferating cell nuclear antigen-positive cells. Both osteopontin (OPN) and CD44 were upregulated. Staining for CD44 and OPN was intense in cells lining the tubules that contained crystals. Along with a rise in urinary Ox and lactate dehydrogenase, there were significant increases in 8-isoprostane and hydrogen peroxide excretion, indicating that the oxidative stress induced cell injury. Thus, HLP-induced hyperoxaluria alone can induce CaOx nephrolithiasis in rats.
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Burton BJL, Khan SR, Lee JP. Chronic eye movement induced pain and a possible role for its treatment with botulinum toxin. Br J Ophthalmol 2003; 87:1194-5. [PMID: 12928305 PMCID: PMC1771841 DOI: 10.1136/bjo.87.9.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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