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Hijazi I, Faisal M, Mahmood A, Muzaffar H, Nazir H, Hussain J. Higher expression of Micro-RNA and Wnt signaling cascade in RNASEL candidate gene in prostate cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx679.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Topiwala A, Allan C, Valkanova V, Zsoldos E, Filippini N, Sexton C, Mahmood A, Fooks P, Singh-Manoux A, Mackay C, Kivimiki M, Ebmeier K. S22-3MODERATE ALCOHOL CONSUMPTION MAY BE A RISK FACTOR FOR ADVERSE BRAIN OUTCOMES AND COGNITIVE DECLINE. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx075.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Alharby E, Albalawi A, Nasir A, Alhijji S, Mahmood A, Ramzan K, Abdusamad F, Aljohani A, Abdelsalam O, Eldardear A, Basit S. A homozygous potentially pathogenic variant in thePAXBP1gene in a large family with global developmental delay and myopathic hypotonia. Clin Genet 2017; 92:579-586. [DOI: 10.1111/cge.13051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/26/2017] [Accepted: 05/05/2017] [Indexed: 11/30/2022]
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Muska M, Naeem A, Hamayun M, Badshah SL, Farooq M, Fida M, Mahmood A, Shah KH, Mabkhot YN. Comparative sorption studies of chromate by nano-and-micro sized Fe2O3 particles. OPEN CHEM 2017. [DOI: 10.1515/chem-2017-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractThe comparative adsorption studies of Cr (VI) on nano and micro-powder Fe2O3 were investigated using kinetics and batch adsorption techniques. The uptake of chromate onto both the oxides of iron was observed to be dependent on the pH, contact time, temperature, media dosage and concentration of chromate anions. The values of sorption maxima were higher in the case of Fe2O3 nanopowder than the micro-powder which can be ascribed to the high surface area and point of zero charge (PZC) of the former oxide. The Dubinin-Radushkivech and Langmuir models were found well fitted for the description of the batch adsorption data. The FTIR studies confirmed that the hexavalent chromium was adsorbed onto both the iron oxides in the form of the Cr2O72−.
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Anwar M, Ahmad S, Akhtar R, Mahmood A, Mahmood S. Antioxidant Supplementation: A Linchpin in Radiation-Induced Enteritis. Technol Cancer Res Treat 2017; 16:676-691. [PMID: 28532242 PMCID: PMC5762044 DOI: 10.1177/1533034617707598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Radiation enteritis is one of the most feared complications of abdominal and pelvic regions. Thus, radiation to abdominal or pelvic malignancies unavoidably injures the intestine. Because of rapid cell turnover, the intestine is highly sensitive to radiation injury, which is the limiting factor in the permissible dosage of irradiation. Bowel injuries such as fistulas, strictures, and chronic malabsorption are potentially life-threatening complications and have an impact on patient quality of life. The incidence of radiation enteritis is increasing because of the current trend of combined chemotherapy and radiation. The consequences of radiation damage to the intestine may result in considerable morbidity and even mortality. The observed effects of ionizing radiation are mediated mainly by oxygen-free radicals that are generated by its action on water and are involved in several steps of signal transduction cascade, leading to apoptosis. The oxyradicals also induce DNA strand breaks and protein oxidation. An important line of defense against free radical damage is the presence of antioxidants. Therefore, administration of antioxidants may ameliorate the radiation-induced damage to the intestine.
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Qamar Z, Zakria M, Shakoor RI, Raffi M, Mehmood M, Mahmood A. Reinforcement of electroactive characteristics in polyvinylidene fluoride electrospun nanofibers by intercalation of multi-walled carbon nanotubes. JOURNAL OF POLYMER RESEARCH 2017. [DOI: 10.1007/s10965-017-1196-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wahab NHA, Rahim AFA, Mahmood A, Yusof Y. Investigation on the structural characterization of pulsed p-type porous silicon. AIP CONFERENCE PROCEEDINGS 2017. [DOI: 10.1063/1.4998356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ibrahim J, Mukhopadhyay A, Lostarakos V, Mahmood A, Khan S, Maddekar N, Bikmalla S, Lea A, Satur C, Abid Q, Ghosh S, Haris M. P105 Lung cancer staging – are we getting it right? Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ibrahim J, Mukhopadhyay A, Lostarakos V, Mahmood A, Khan S, Maddekar N, Hussain I, Lea A, Satur C, Abid Q, Ghosh S, Haris M. P108 Lung cancer resection outcomes in the first year: a 5 year review. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mahmood A, Lau G. A complication of a femoral arterial catheter. Anaesthesia 2016; 71:1497-1498. [PMID: 27870188 DOI: 10.1111/anae.13695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mahmood A, Durrans C, Naik S, Anwar M. P259 Cost analysis of implementing a pe pathway incorporating 3-level wells scoring, perc rules and age-adjusted d-dimers. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Elsafadi M, Manikandan M, Dawud RA, Alajez NM, Hamam R, Alfayez M, Kassem M, Aldahmash A, Mahmood A. Transgelin is a TGFβ-inducible gene that regulates osteoblastic and adipogenic differentiation of human skeletal stem cells through actin cytoskeleston organization. Cell Death Dis 2016; 7:e2321. [PMID: 27490926 PMCID: PMC5108308 DOI: 10.1038/cddis.2016.196] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/08/2016] [Accepted: 05/30/2016] [Indexed: 12/11/2022]
Abstract
Regenerative medicine is a novel approach for treating conditions in which enhanced bone regeneration is required. We identified transgelin (TAGLN), a transforming growth factor beta (TGFβ)-inducible gene, as an upregulated gene during in vitro osteoblastic and adipocytic differentiation of human bone marrow-derived stromal (skeletal) stem cells (hMSC). siRNA-mediated gene silencing of TAGLN impaired lineage differentiation into osteoblasts and adipocytes but enhanced cell proliferation. Additional functional studies revealed that TAGLN deficiency impaired hMSC cell motility and in vitro transwell cell migration. On the other hand, TAGLN overexpression reduced hMSC cell proliferation, but enhanced cell migration, osteoblastic and adipocytic differentiation, and in vivo bone formation. In addition, deficiency or overexpression of TAGLN in hMSC was associated with significant changes in cellular and nuclear morphology and cytoplasmic organelle composition as demonstrated by high content imaging and transmission electron microscopy that revealed pronounced alterations in the distribution of the actin filament and changes in cytoskeletal organization. Molecular signature of TAGLN-deficient hMSC showed that several genes and genetic pathways associated with cell differentiation, including regulation of actin cytoskeleton and focal adhesion pathways, were downregulated. Our data demonstrate that TAGLN has a role in generating committed progenitor cells from undifferentiated hMSC by regulating cytoskeleton organization. Targeting TAGLN is a plausible approach to enrich for committed hMSC cells needed for regenerative medicine application.
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Torche M, Mahmood A, Araujo R, Dujovny M, Dragovic L, Ausman JI. Microsurgical anatomy of the lower basilar artery. Neurol Res 2016; 14:259-62. [PMID: 1355281 DOI: 10.1080/01616412.1992.11740066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study was designed to study the microvascular anatomy of the basilar artery between the superior cerebellar artery and the vertebrobasilar junction (i.e. the lower basilar artery). Twenty unfixed brains were injected with silicone rubber solution and studied with a Zeiss OPMI microscope. The length of this segment of the basilar artery was 28.1 + 1.35 mm and its course was straight in 9 (45%) brains, curved in 7 (35%) and tortuous in 4 (20%). The total number of perforators found in 20 brains was 340 with an average of 17 per brain. Of these, 118 (34.7%) were median and 222 (65.2%) were lateral. Median branches had a mean length of 5.8 + 1.25 mm, whereas left and right lateral branches had a mean length of 16 + 1.25 mm and 16 + 1.58 mm respectively.
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Kongstorp M, Moen A, Jacobsen D, Haugen F, Mahmood A, Gjerstad J. Activation of epidermal growth factor receptors (EGFRs) following disc herniation induces hyperexcitability in the pain pathways. Scand J Pain 2016. [DOI: 10.1016/j.sjpain.2016.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Aims
Low back pain and sciatica after disc herniation may be caused by mechanical compression of the nerve roots, but also by the release of pro-inflammatory agents including growth factors from the nucleus pulposus (NP).
Methods
Here, in an animal model mimicking the clinical situation following disc herniation, CLIA protein analyses, extracellular single-cell recordings in the spinal dorsal horn and qPCR were performed to examine the nociceptive signaling due to disc herniation.
Results
The present data demonstrated that EREG may be released from NP - and that administration of EREG onto the spinal dorsal nerve roots increased spontaneous activity in nociceptive neurons. An up-regulation of EGFR and HER4 in the dorsal horn as well as an up-regulation of HER3 in the DRG were demonstrated after application of NP onto the dorsal nerve roots.
Conclusion
Our findings suggest that EREG and signaling through its receptors may be involved in pain hypersensitivity and other sensory abnormalities after disc herniation.
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Duran I, Fink M, Bahl A, Hoefeler H, Mahmood A, Lüftner D, Ghazal H, Wei R, Chung K, Hechmati G, Green J, Atchison C. Health resource utilisation associated with skeletal-related events in patients with bone metastases secondary to solid tumours: regional comparisons in an observational study. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12452] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 12/25/2022]
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Malik W, Abid MA, Cheema HMN, Khan AA, Iqbal MZ, Qayyum A, Hanif M, Bibi N, Yuan SN, Yasmeen A, Mahmood A, Ashraf J. From Qutn to Bt cotton: Development, adoption and prospects. A review. CYTOL GENET+ 2015. [DOI: 10.3103/s0095452715060055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maik W, Abid MA, Cheema HMN, Khan AA, Iqbal MZ, Qayyum A, Hanif M, Bibi N, Yuan SN, Yasmeen A, Mahmood A, Ashraf J. FROM Qutn TO Bt COTTON: DEVELOPMENT, ADOPTION AND PROSPECTS. A REVIEW. TSITOLOGIIA I GENETIKA 2015; 49:73-85. [PMID: 26841496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cotton has unique history of domestication, diversification, and utilization. Globally it is an important cash crop that provides raw material for textile industry. The story of cotton started from human civilization and the climax arrived with the efforts of developing transgenic cotton for various traits. Though conventional breeding brought steady improvement in developing resistance against biotic stresses but recent success story of gene transferfrom Bacillus thuringiensis into cotton showed game changing effects on cotton cultivation. Amongst various families of insecticidal proteins Bt Cry-toxins received more attention because of specificity against receptors on the cell membranes of insect midgut epithelial cells. Rapid Bt cotton adoption by farmers due to its economic and environmental benefits has changed the landscape of cotton cultivation in many countries. But the variable expression of Bt transgene in the newly developed Bt cotton genotypes in tropical environment is questionable. Variability of toxin level in different plant parts at various life stage of plant is an outcome of genotypic interaction with environmental factors. Temporal gene expression of Cry1Ac is also blamed for the epigenetic background in which transgene has been inserted. The presence of genotypes with sub-lethal level of Bt toxin might create resistance in Lepidopteron insects, limiting the use of Bt cotton in future, with the opportunityfor other resistance development strategies to get more attention like gene stacking. Until the farmers get access to more recent technology, best option is to delay the development of resistance by applying Insect Resistance Management (IRM) strategies.
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Mahmood A, Ramaswamy K. Idiopathic thoracic spinal cord herniation: the unknown anaesthetic implications. Anaesth Intensive Care 2015; 43:787-788. [PMID: 26603808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Zaman M, Sarfraz RM, Adnan S, Mahmood A, Hanif M, Qureshi J, Chaudhary MT, Akram MA, Bashir I. Development and in-vitro Evaluation of Once Daily Tablet Dosage Form of Loxoprofen Sodium. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i9.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To formulate and characterize once daily controlled release tablet of loxoprofen sodium.Methods: Eudragit RS-100, hydroxylpropyl methylcellulose (HPMC) and pectin were used as release retarding polymers. All the formulations were prepared by direct compression method. Various precompression studies were carried out to determine Hausner’s ratio, Carr’s index, angle of repose, bulk density and tapped density Differential scanning calorimetry (DSC) studies and also post-compression studies to evaluate hardness, friability, weight variation, drug content, in-vitro drug release were conducted on the tablets. The drug release data were subjected to kinetic models, including zero order, first order, Hixon Crowell, Higuchi and Korsmeyer-Peppas.Results: Compressibility index (7.6 ± 1.32 - 12.5 ± 1.43%), Hausner’s ratio (1.08 ± 0.04 - 1.14 ± 0.03), angle of repose (27.78 ± 0.47 - 30.49 ± 0.46°), hardness (6.25 ± 0.27 - 7.21±0.21 kg/cm2), friability (0.14 ± 0.06 - 0.28 ± 0.0 %), weight variation (249.5 ± 2.09 - 251.35 ± 2.41 mg) and drug content (97.30 ± 0.28 - 103.70 ± 0.31 %) were within generally accepted limits for the pre-and post-compression formulations, respectively. The tablets having the maximum amount of among the three polymers tested as matrix materials, HPMC, represented by F3 tablets, exerted better sustained release properties after 12 h. Release pattern was more of Fickian diffusion followed by Higuchi mechanism.Conclusion: The release of the loxoprofen sodium was optimized up to 12 h.Keywords: Loxoprofen, Sustained release, hydroxypropyl methylcelluose, Pectin, Eudragit, Matrix tablets
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MacFarlane RJ, Gillespie S, Cashin F, Mahmood A, Cheung G, Brown DJ. Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach. J Hand Surg Eur Vol 2015; 40:825-31. [PMID: 26056129 DOI: 10.1177/1753193415578305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 02/28/2015] [Indexed: 02/03/2023]
Abstract
Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device (Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary. The mean age was 33 years (range 18-67). The mean time to surgery was 7 days. At final follow-up (mean 22 months, range 6-52) the mean proximal interphalangeal joint range of motion was 85° (range 60°-110°). The mean QuickDASH functional outcome score was 4.8 (range 0-36.4). Our results compare favourably with other devices reported in the literature.
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Anwar M, Kochhar R, Singh R, Bhatia A, Vaiphei K, Mahmood A, Mahmood S. Frequent activation of the β-catenin gene in sporadic colorectal carcinomas: A mutational & expression analysis. Mol Carcinog 2015; 55:1627-1638. [PMID: 26373808 DOI: 10.1002/mc.22414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/02/2015] [Accepted: 08/31/2015] [Indexed: 01/11/2023]
Abstract
β-catenin (CTNNB1), an oncogene/onco-protein and an adhesion molecule is a key effector in colorectal cancer (CRC). Its activation, and subsequent up-regulation of Wnt-signaling, is an important event in the development of certain human cancers including CRC. Mutations in the β-catenin gene in the region of serine-threonine glycogen kinase (GSK)-3β phosphorylation target sites have been identified in colorectal cancer in humans. In the current study, we investigated 60 sporadic colorectal adenocarcinomas along with adjoining and normal mucosa cases in humans for β-catenin mutations. Thirteen of sixty colorectal tumors from humans had point mutations with a frequency of 21.66% at codons 24, 26, 27, 32, 34, 35, 41, 42,43, 46, 49, 54, 55, or 67 sites which are mutated in colorectal cancer and some of these sites in other cancers. Thus, there appears to be a key involvement of β-catenin activation in human colorectal carcinogenesis. mRNA expression analysis using q-Real Time PCR showed 21.5-fold up-regulation of β-catenin mRNA in tumor tissue compared to normal and adjoining mucosa. Protein expression analysis using immunohistochemistry, confocal microscopy, and Western blot confirmed aberrant accumulation of β-catenin protein along the nucleus and cytoplasm following mutation. The observed mutations and up-regulation of mRNA in tumors, and the increased expression of β-catenin protein in CRC suggest that these alterations are early and prognostic events in sporadic colorectal carcinogenesis in humans. © 2015 Wiley Periodicals, Inc.
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Saratzis A, Melas N, Mahmood A, Sarafidis P. Incidence of Acute Kidney Injury (AKI) after Endovascular Abdominal Aortic Aneurysm Repair (EVAR) and Impact on Outcome. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.03.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sarfraz RM, Khan HU, Mahmood A, Ahmad M, Maheen S, Sher M. Formulation and evaluation of mouth disintegrating tablets of atenolol and atorvastatin. Indian J Pharm Sci 2015; 77:83-90. [PMID: 25767322 PMCID: PMC4355887 DOI: 10.4103/0250-474x.151602] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 10/22/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
In this study, mouth-disintegrating tablets of atenolol and atorvastatin combination were formulated using superdisintegrants to impart fast disintegration. Fifteen formulations were prepared based on different concentrations of two superdisintegrants, croscarmellose sodium and Kyron-T134. Three different techniques such as direct compression, effervescent and sublimation were used to study the effect of manufacturing processes, nature and concentration of superdisintegrants on various features of these tablets. Five formulations were made using each method. Precompression studies like bulk density, tapped density, angle of repose, Carr's compressibility index, Hausner's ratio and compatibility studies such as Fourier transform infrared spectroscopy and differential scanning calorimetry were performed. Various features such as hardness, thickness, diameter, weight variation, friability, disintegration time, dissolution studies, wetting time, wetting volume, water absorption ratio, modified disintegration, uniformity of contents and stability were evaluated. Finally results were statistically analyzed by the application of one way ANOVA test. Formulation F13 containing Kyron-T134 (6%) and croscarmellose sodium (2%) was found to be the best among all fifteen formulations prepared in all aspects evaluated. Sublimation method is found to be the best among three methods of preparation used.
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Saratzis A, Melas N, Mahmood A, Sarafidis P. Incidence of Acute Kidney Injury (AKI) after Endovascular Abdominal Aortic Aneurysm Repair (EVAR) and Impact on Outcome. Eur J Vasc Endovasc Surg 2015; 49:534-40. [PMID: 25736516 DOI: 10.1016/j.ejvs.2015.01.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 01/05/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is an important post-operative complication that may impact on mortality, morbidity, and cost. The incidence after endovascular aneurysm repair (EVAR) remains unknown, as the current literature has not employed consistent definitions. The aim of this study is to assess the incidence of AKI after elective EVAR and examine the impact of AKI on mortality and cardiovascular morbidity using the current universally accepted definitions. METHODS This was a cohort study using prospectively collected data, including consecutive patients undergoing elective EVAR for an infrarenal abdominal aortic aneurysm (AAA). Those with end stage renal failure were excluded. The primary endpoint was incidence of AKI as per the "Acute Kidney Injury Network" (AKIN), and "Kidney Disease Improving Global Outcomes" (KDIGO) criteria. Secondary endpoints included AKI stage, drop in estimated glomerular filtration rate (eGFR), and mortality and cardiovascular morbidity. RESULTS 149 patients were included (16 females, 11%; mean age: 69 ± 8 years; mean AAA diameter: 6.0 ± 1.1 cm), 28 (18.8%) of whom developed AKI (26 patients classified as stage 1 and 2 as stage 2). Within 48 hours, those with AKI dropped their eGFR from 61 ± 20 mL/kg/1.73 m(2) to 51 ± 20 units (p < .001), and those without from 75 ± 9 to 74 ± 10 units (p < .001). None required dialysis during a 33 ± 11 month follow up. Development of AKI was associated with mortality (HR 0.035, 95% CI: 0.005 to 0.240, p < .001) and cardiovascular morbidity (HR: 0.021, 95% CI: 0.004 to 0.11, p < .001) on adjusted regression analysis. CONCLUSIONS The incidence of AKI after EVAR is significant and is independently associated with medium-term mortality and morbidity.
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Saedon M, Mt-Isa S, Saratzis A, Leung E, Mahmood A. Outcome of open versus endovascular abdominal aortic aneurysm repair in obese patients: a systemic review and meta-analysis. INT ANGIOL 2015; 34:9-15. [PMID: 24824839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Obesity is increasingly common among patients diagnosed with vascular disease. This article aims to perform systemic review and meta-analysis on 30-day postoperative mortality and complication rate between open (OAR) and endovascular (EVAR) abdominal aortic aneurysm repair in obese patients. METHODS A systematic search was performed using the PubMed, Embase and Cochrane databases to identify original articles on obese (BMI ≥30) patients undergoing abdominal aortic aneurysm (AAA) repair. Outcomes considered were 30-day mortality and postoperative complication rate following OAR or EVAR. Random-effects Poisson regressions were fitted for each outcome to estimate the risk ratios comparing EVAR to OAR. RESULTS Four studies were included in the final analyses, all of which were observational in nature. There was no evidence of publication bias as suggested by funnel plots of the outcomes. Meta-analysis showed statistically significant fewer 30-day postoperative mortality in favour of EVAR (risk ratio 0.34 [95% confidence interval 0.25, 0.48], 4 studies, 2440 patients) and early postoperative complications: myocardial infarction (0.29 [0.13, 0.64]), chest infection (0.21 [0.12, 0.38]), renal failure (0.24 [0.11, 0.51]), wound infection (0.59 [0.48, 0.74]). Risk of postoperative bowel ischemia (0.26 [0.06, 1.13]) and stroke (0.32 [0.07, 1.55]) were equivocal between EVAR and OAR. CONCLUSION The current study strongly suggests EVAR is superior to OAR with regards to 30-day mortality and early postoperative outcome in obese patients.
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