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Yousuf MS, Samad K, Ullah H. Postoperative Cognitive Dysfunction following General Anaesthesia in Patients Undergoing Elective Non-cardiac Surgery. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2020; 30:417-419. [PMID: 32513364 DOI: 10.29271/jcpsp.2020.04.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 09/16/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine frequency of early postoperative cognitive dysfunction (POCD) in patients aged 40 to 60 years, following general anaesthesia in patients undergoing elective, non-cardiac surgery. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Anaesthesiology, The Aga Khan University Hospital (AKUH), Karachi, from December 2015 to May 2016. METHODOLOGY After obtaining approval from Ethical Review Committee of AKUH and informed consent, ASA I and II patients, aged between 40 to 60 years of either gender, undergoing general anaesthesia for elective non-cardiac surgical procedures, were recruited. Patients were assessed preoperatively by using mini-mental state examination (MMSE); and patients having a score equal to or greater than 23 (maximum 30) were included in the study. All patients were reassessed at 24 hours postoperatively by MMSE. Both the MMSE evaluations were performed by primary investigator on predesigned data collection form. RESULTS A total of 150 patients were enrolled in the study. Preoperative MMSE score ranged from 24 to 30 while postoperative MMSE score (at 24 hours) was between 25 and 30. Thus, no patient developed POCD following general anaesthesia for elective, non-cardiac surgery in this study. CONCLUSION Early POCD was not found in the presently studied population of middle aged patients having elective non-cardiac surgery under general anaesthesia. Key Words: Postoperative cognitive dysfunction (POCD), General anaesthesia, Non-cardiac surgery, Mini- mental state examination.
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Hameed M, Samad K, Ullah H. [Comparison of two supraglottic airway devices on postoperative sore throat in children: a prospective randomized controlled trial]. Rev Bras Anestesiol 2020; 70:240-247. [PMID: 32507285 DOI: 10.1016/j.bjan.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 02/16/2020] [Accepted: 03/08/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Sore throat is well recognized complaint after receiving general anesthesia. This study is conducted to compare the severity and frequency of postoperative sore throat in children undergoing elective surgery - following the use of Ambu laryngeal mask airway) or I-gel® - who are able to self-report postoperative sore throat. METHOD Seventy children, 6 to 16 years-old, undergoing elective surgery randomly allocated to either Ambu laryngeal mask (Ambu Group) or I-gel® (I-gel Group). After the procedure, patients were interviewed in the recovery room immediately, after one hour, 6 and 24 hours postoperatively by an independent observer blinded to the device used intra-operatively. RESULTS On arrival in the recovery room 17.1% (n=6) of children of the Ambu Group complained of postoperative sore throat, against 5.7% in I-gel Group (n=2). After one hour, the results were similar. After 6 hours, postoperative sore throat was found in 8.6% (n=3) of the children in Ambu group vs. 2.9% (n=1) in I-gel Group. After 24hours, 2.9% (n=1) of the kids in Ambu Group compared to none in I-gel Group. There was no significant difference found in the incidence of postoperative sore throat in both devices on arrival (p=0.28); after 1 hour (p=0.28); after 6 hours (p=0.30); and after 24 hours (p=0.31). The duration of the insertion was shorter in Ambu Group and it was easier to insert the I-gel® (p=0.029). Oropharyngeal seal pressure of I-gel® was higher than that of Ambu laryngeal mask (p=0.001). CONCLUSION The severity and frequency of postoperative sore throat in children is not statistically significant in the I-gel Group compared to Ambu Group.
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Hameed M, Samad K, Ullah H. Comparison of two supraglottic airway devices on postoperative sore throat in children: a prospective randomized controlled trial. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32507285 PMCID: PMC9373649 DOI: 10.1016/j.bjane.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background and objective Sore throat is well recognized complaint after receiving general anesthesia. This study is conducted to compare the severity and frequency of postoperative sore throat in children undergoing elective surgery, following the use of Ambu laryngeal mask airway or I-gel®, who are able to self-report postoperative sore throat. Method Seventy children, 6 to 16 years-old, undergoing elective surgery randomly allocated to either Ambu laryngeal mask (Ambu Group) or I-gel® (I-gel Group). After the procedure, patients were interviewed in the recovery room immediately, after one hour, 6 and 24 hours postoperatively by an independent observer blinded to the device used intra-operatively. Results On arrival in the recovery room 17.1% (n = 6) of children of the Ambu Group complained of postoperative sore throat, against 5.7% in I-gel Group (n = 2). After one hour, the results were similar. After 6 hours, postoperative sore throat was found in 8.6% (n = 3) of the children in Ambu group vs. 2.9% (n = 1) in I-gel Group. After 24 hours, 2.9% (n = 1) of the children in Ambu Group complained of postoperative sore throat compared to none in I-gel Group. There was no significant difference found in the incidence of postoperative sore throat in both devices on arrival (p = 0.28); after 1 hour (p = 0.28); after 6 hours (p = 0.30); and after 24 hours (p = 0.31). The duration of the insertion of Ambu laryngeal mask was shorter and it was easier to insert than I-gel® (p = 0.029). Oropharyngeal seal pressure of I-gel® was higher than that of Ambu laryngeal mask (p = 0.001). Conclusion The severity and frequency of postoperative sore throat in children is not statistically significant in the I-gel Group compared to Ambu Group.
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Ullah A, Pirzada M, Jahan S, Ullah H, Razak S, Rauf N, Khan MJ, Mahboob SZ. Prenatal BPA and its analogs BPB, BPF, and BPS exposure and reproductive axis function in the male offspring of Sprague Dawley rats. Hum Exp Toxicol 2020; 38:1344-1365. [PMID: 31514588 DOI: 10.1177/0960327119862335] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Research in the past has indicated associated long-term and low levels of exposure of bisphenol A (BPA) in early life and neuroendocrine disorders, such as obesity, precocious puberty, diabetes, and hypertension. BPA and its analogs bisphenol B (BPB), bisphenol F (BPF), and bisphenol S (BPS) have been reported to have similar or even more toxic effect as compared to BPA. Exposure of rats to BPA and its analogs BPB, BPF, and BPS resulted in decreased sperm production, testosterone secretion, and histological changes in the reproductive tissues of male rats. In the present study, BPA, BPB, BPF, and BPS were administered in drinking water at concentrations of (5, 25, and 50 μg/L) from pregnancy day (PD) 1 to PD 21. Body weight (BW), hormonal concentrations, antioxidant enzymes, and histological changes were determined in the reproductive tissues. BPA and its analogs prenatal exposure to female rats induced significant statistical difference in the antioxidant enzymes, plasma testosterone, and estrogen concentrations in the male offspring when compared with the control. Histological parameters of both testis and epididymis revealed prominent changes in the reproductive tissues. The present study suggests that BPA and its analogs BPB, BPF, and BPS different concentrations led to marked alterations in the development of the male reproductive system.
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Abstract
Stab wound in right ventricle of heart requires a prompt and focused surgical intervention. Cardiac tamponade is a common finding when dealing with stabbed hearts, which must be diagnosed and treated in a timely fashion. We report a case of 28-year-old man who presented in emergency department following accidental stab trauma during a religious ceremony. The challenges faced in the perioperative period were the management of impending cardiac tamponade and hemodynamic stability.
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Rehman N, Alam S, Mian I, Ullah H. Environmental friendly method for the extraction of cellulose from Triflolium resopinatum and its characterization. B CHEM SOC ETHIOPIA 2019. [DOI: 10.4314/bcse.v33i1.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ullah H, Guerin K, Bonnet P. Synthesis of Nb
2
O
5
Nanoplates and their Conversion into NbO
2
F Nanoparticles by Controlled Fluorination with Molecular Fluorine. Eur J Inorg Chem 2019. [DOI: 10.1002/ejic.201801174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Khan J, Ullah H, Sajjad M, Ali A, Thebo KH. Synthesis, characterization and electrochemical performance of cobalt fluoride nanoparticles by reverse micro-emulsion method. INORG CHEM COMMUN 2018. [DOI: 10.1016/j.inoche.2018.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khan KA, Ullah H, Bonnet P, Nawaz M, Irfan M. Fabrication and Characterization of Manganese-based Self-assembled Cubic Structures. ChemistrySelect 2018. [DOI: 10.1002/slct.201801106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Rehman IU, Ishaq M, Ali L, Khan S, Ahmad I, Din IU, Ullah H. Enrichment, spatial distribution of potential ecological and human health risk assessment via toxic metals in soil and surface water ingestion in the vicinity of Sewakht mines, district Chitral, Northern Pakistan. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2018; 154:127-136. [PMID: 29459162 DOI: 10.1016/j.ecoenv.2018.02.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/05/2018] [Accepted: 02/08/2018] [Indexed: 05/25/2023]
Abstract
This study focuses on enrichment, spatial distribution, potential ecological risk index (PERI) and human health risk of various toxic metals taken via soil and surface water in the vicinity of Sewakht mines, Pakistan. The samples of soils (n = 54) of different fields and surface water (n = 38) were analyzed for toxic metals including cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), lead (Pb), nickel (Ni), zinc (Zn) and molybdenum (Mo). Soil pollution level was evaluated using pollution indices including geo-accumulation index (Igeo), contamination factor (CF), degree of contamination (CD), enrichment factor (EF) and PERI. CF showed moderate contamination of soil with Cd, Co, Fe and Mo, while Igeo values indicated moderate accumulation of Cu. For Cd, EF> 1.5 was found in agricultural soils of the study area. PERI findings presented a very high ecological risk (PERI > 380) at two sites (4%), considerable ecological risk at four sites (7.4%). Non-carcinogenic risk from exposure to Fe in soil was higher than limit (HI > 1) for both children and adults. Moreover, carcinogenic risk postured by soil contaminants i.e. Cd, Cr, Co and Ni in children was higher than their limits (except Pb), while in adults only Co posed higher risk of cancer than the limit (10-4) through soil exposure. Non-carcinogenic risks in children due to Cd, Co, Mo via surface water intake were higher than their safe limits (HQ > 1), while in adults the risk order was Cr > Cd > Cu > Pb > Co > Mo. Moreover, carcinogenic risk exposure due to Co > Cd > Cr > Ni from surface water (except Pb) was higher than the tolerable limit (1 × 10-4) both for children and adults. However, Pb concentrations in both soil and surface water exposure were not likely to cause cancer risk in the local population.
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Siddique MA, Ali MR, Alam ASMRU, Ullah H, Rahman A, Chakrabarty RP, Amin MA, Hoque SA, Nandi SP, Sultana M, Hossain M. Emergence of two novel sublineages Ind2001BD1 and Ind2001BD2 of foot-and-mouth disease virus serotype O in Bangladesh. Transbound Emerg Dis 2018; 65:1009-1023. [DOI: 10.1111/tbed.12834] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Indexed: 12/21/2022]
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Alam S, Rehman N, Ul Amin N, A. Shah L, Mian I, Ullah H. Removal of basic green 5 by carbonaceous adsorbent: Adsorption kinetics. B CHEM SOC ETHIOPIA 2018. [DOI: 10.4314/bcse.v31i3.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Imad-Ud-Din, Nawaz M, Price GJ, Baloch MK, Bangesh MA, Rehman W, Ullah H, Ahmad S. Preparation, morphology and sonication time dependence of silver nanoparticles in amphiphilic block copolymers of PEO with polystyrene or PMMA. JOURNAL OF POLYMER RESEARCH 2017. [DOI: 10.1007/s10965-017-1295-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Qamarul Hoda M, Samad K, Ullah H. ProSeal versus Classic laryngeal mask airway (LMA) for positive pressure ventilation in adults undergoing elective surgery. Cochrane Database Syst Rev 2017; 7:CD009026. [PMID: 28727896 PMCID: PMC6483343 DOI: 10.1002/14651858.cd009026.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 3) in the Cochrane Library; MEDLINE (Ovid SP, 1997 to April 2017); Embase (Ovid SP, 1997 to April 2017); the Institute for Scientific Information (ISI) Web of Science (1946 to April 2017); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO host, 1982 to April 2017).We searched trial registries for ongoing studies to April 2017.We did not impose language restrictions. We restricted our search to the time from 1997 to April 2017 because pLMA was introduced into clinical practice in the year 2000. SELECTION CRITERIA We included randomized controlled trials (RCTs) that compared the effectiveness of pLMA and cLMA for positive pressure ventilation in adults undergoing elective surgery. We planned to include only data related to the first phase of cross-over RCTs. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by the Cochrane Collaboration. MAIN RESULTS We included eight RCTs that involved a total of 829 participants (416 and 413 participants in the pLMA and cLMA groups, respectively). We identified six cross-over studies that are awaiting classification; one is completed but has not been published, and data related to the first treatment period for the other five studies were not yet available. Seven included studies provided data related to the primary outcome, and eight studies provided data related to more than one secondary outcome.Our analysis was hampered by the fact that a large proportion of the included studies reported no events in either study arm. No studies reported significant differences between devices in relation to the primary review outcome: failure to adequately mechanically ventilate. We evaluated this outcome by assessing two variables: inadequate oxygenation (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.17 to 3.31; four studies, N = 617) and inadequate ventilation (not estimable; one study, N = 80).More time was required to establish an effective airway using pLMA (mean difference (MD) 10.12 seconds, 95% CI 5.04 to 15.21; P < 0.0001; I² = 73%; two studies, N = 434). Peak airway pressure during positive pressure ventilation was lower in cLMA participants (MD 0.84, 95% CI 0.02 to 1.67; P = 0.04; I² = 0%; four studies, N = 259). Mean oropharyngeal leak (OPL) pressure was higher in pLMA participants (MD 6.93, 95% CI 4.23 to 9.62; P < 0.00001; I² = 87%; six studies, N = 709).The quality of evidence for all outcomes, as assessed by GRADE score, is low mainly owing to issues related to blinding and imprecision.Data show no important differences between devices with regard to failure to insert the device, use of an alternate device, mucosal injury, sore throat, bronchospasm, gastric insufflation, regurgitation, coughing, and excessive leak. Data were insufficient to allow estimation of differences for obstruction related to the device. None of the studies reported postoperative nausea and vomiting as an outcome. AUTHORS' CONCLUSIONS We are uncertain about the effects of either of the airway devices in terms of failure of oxygenation or ventilation because there were very few events. Results were uncertain in terms of differences for several complications. Low-quality evidence suggests that the ProSeal laryngeal mask airway makes a better seal and therefore may be more suitable than the Classic laryngeal mask airway for positive pressure ventilation. The Classic laryngeal mask airway may be quicker to insert, but this is unlikely to be clinically meaningful.
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Khan H, Khan M, Qureshi MS, Ahmad S, Gohar A, Ullah H, Ullah F, Hussain A, Khatri P, Shah SSA, Rehman H, Khan A. Effect of Green Tea Extract (Camellia sinensis) on Fertility Indicators of Post-Thawed Bull Spermatozoa. PAK J ZOOL 2017. [DOI: 10.17582/journal.pjz/2017.49.4.1243.1249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Khan AM, Mehmood A, Sayed M, Nazar MF, Ismail B, Khan RA, Ullah H, Abdur Rehman HM, Khan AY, Khan AR. Influence of acids, bases and surfactants on the photocatalytic degradation of a model dye rhodamine B. J Mol Liq 2017. [DOI: 10.1016/j.molliq.2017.04.063] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Azfar MF, Khan MF, Habib SS, Aseri ZA, Zubaidi AM, Aguila DO, Suriya MO, Ullah H. Prognostic value of ADAMTS13 in patients with severe sepsis and septic shock. ACTA ACUST UNITED AC 2017; 40:E49-E58. [PMID: 28447577 DOI: 10.25011/cim.v40i2.28195] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 11/03/2022]
Abstract
PURPOSE ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. METHODS This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Khalid University Hospital. Detailed clinical evaluations were performed on 84 patients (56.08±18.18 years of age) with severe sepsis and septic shock. ADAMTS13 levels were determined (three blood samples at 24 hours intervals) and APACHE II scores, hematological profiles, indices of organ hypo-perfusion, renal functions and coagulation profiles were recorded. Primary outcome was 30 days ICU mortality and secondary outcomes were its comparison with APACHE II score, length of ICU stay and use of vasopressor agents. RESULTS Hypertension (53.6%) and diabetic mellitus (45.2%) were the commonest comorbidities. The median ADAMTS13 levels were 336.65, 339.35 and 313.9, respectively. ROC analysis showed maximum area under the curve for second ADAMTS13 (AUC=0.760) compared with first (AUC=0.660) and third samples (AUC=0.707) and APACHE II scores (AUC=0.662). Patients were divided into low and high ADAMTS13 groups according to the best cut-off point. Mortality was high in the low ADAMTS13 level group [OR=4.5]and was significantly associated with age, DBP, ADAMTS13, APACHE II score, DIC score and platelet count. ADAMTS13 (OR=5.3), APACHE II (OR=4.13) and DIC scores (OR=7.32) were significant risk factors for mortality. CONCLUSIONS Low ADAMTS13 was associated with increased mortality in patients with severe sepsis and septic shock and was comparable to APACHE II scores for predicting mortality.
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Khan MF, Ullah H. Multi-Organ Dysfunction Secondary To Yellow Scorpion Sting. J Ayub Med Coll Abbottabad 2017; 29:347-349. [PMID: 28718263] [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
Scorpion stings are common in tropical and subtropical regions. The history and clinical manifestation warrant urgent recognition and treatment. The incidence of scorpion stings in Pakistan is not known as there is no published data available in literature. We report our experience of a yellow scorpion sting victim who required intensive care admission after developing multi-organ dysfunction.
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Ishaq M, Sultan S, Ahmad I, Ullah H, Yaseen M, Amir A. Adsorptive desulfurization of model oil using untreated, acid activated and magnetite nanoparticle loaded bentonite as adsorbent. JOURNAL OF SAUDI CHEMICAL SOCIETY 2017. [DOI: 10.1016/j.jscs.2015.02.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ahmed Z, Samad K, Ullah H. Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial. Saudi J Anaesth 2017; 11:54-57. [PMID: 28217054 PMCID: PMC5292853 DOI: 10.4103/1658-354x.197342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS. MATERIALS AND METHODS Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. RESULTS The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. CONCLUSION Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.
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Saidullah S, Shah B, Ullah H, Aslam Z, Khan MA. Localization Of Accessory Pathway In Patients With Wolff-Parkinson-White Syndrome From Surface Ecg Using Arruda Algorithm. J Ayub Med Coll Abbottabad 2016; 28:441-444. [PMID: 28712209] [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 To ablate accessory pathway successfully and conveniently, accurate localization of the pathway is needed. Electrophysiologists use different algorithms before taking the patients to the electrophysiology (EP) laboratory to plan the intervention accordingly. In this study, we used Arruda algorithm to locate the accessory pathway. The objective of the study was to determine the accuracy of the Arruda algorithm for locating the pathway on surface ECG. METHODS It was a cross-sectional observational study conducted from January 2014 to January 2016 in the electrophysiology department of Hayat Abad Medical Complex Peshawar Pakistan. A total of fifty nine (n=59) consecutive patients of both genders between age 14-60 years presented with WPW syndrome (Symptomatic tachycardia with delta wave on surface ECG) were included in the study. Patient's electrocardiogram (ECG) before taking patients to laboratory was analysed on Arruda algorithm. Standard four wires protocol was used for EP study before ablation. Once the findings were confirmed the pathway was ablated as per standard guidelines. RESULTS A total of fifty nine (n=59) patients between the age 14-60 years were included in the study. Cumulative mean age was 31.5 years±12.5 SD. There were 56.4% (n=31) males with mean age 28.2 years±10.2 SD and 43.6% (n=24) were females with mean age 35.9 years±14.0 SD. Arruda algorithm was found to be accurate in predicting the exact accessory pathway (AP) in 83.6% (n=46) cases. Among all inaccurate predictions (n=9), Arruda inaccurately predicted two third (n=6; 66.7%) pathways towards right side (right posteroseptal, right posterolateral and right antrolateral). CONCLUSIONS Arruda algorithm was found highly accurate in predicting accessory pathway before ablation.
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Siddiqui KM, Ali MA, Ullah H. Comparison of spinal anesthesia dosage based on height and weight versus height alone in patients undergoing elective cesarean section. Korean J Anesthesiol 2016; 69:143-8. [PMID: 27066205 PMCID: PMC4823409 DOI: 10.4097/kjae.2016.69.2.143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/16/2015] [Accepted: 09/22/2015] [Indexed: 11/22/2022] Open
Abstract
Background Spinal anesthesia with bupivacaine, typically used for elective and emergency cesarean section, is associated with a significant incidence of hypotension resulting from sympathetic blockade. A variety of dosing regimens have been used to administer spinal anesthesia for cesarean section. The objective of this study was to compare the incidence of hypotension following two different fixed dosing regimens. Methods This was a randomized double-blind clinical trial with a two-sided design, 5% significance level and 80% power. After approval of the hospital ethics review committee, 60 patients were divided randomly into two groups. In one group, the local anesthetic dose was adjusted according to height and weight, and in the other, the dose was adjusted according to height only. Results Sixty women with a singleton pregnancy were included. Of the factors that could affect dose and blood pressure, including age, weight, height, and dose, only height differed between the groups. Mean heart rate was similar between the groups. Hypotension was significantly more frequent with dosage based on height alone than with two-factor dose calculation (56.7% vs. 26.7%; P = 0.018). Conclusions Adjusting the dose of isobaric bupivacaine to a patient's height and weight provides adequate anesthesia for elective cesarean section and is associated with a decreased incidence and severity of maternal hypotension and less use of ephedrine.
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Khan MF, Abdou MA, Rajendrum R, Ullah H. Impacted tooth presenting as airway obstruction during spontaneous breathing trial. Saudi J Anaesth 2016; 10:113-4. [PMID: 26955323 PMCID: PMC4760031 DOI: 10.4103/1658-354x.169491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Iqbal N, Wang X, Yu J, Jabeen N, Ullah H, Ding B. In situ synthesis of carbon nanotube doped metal–organic frameworks for CO2 capture. RSC Adv 2016. [DOI: 10.1039/c5ra25465e] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Metal organic–frameworks (MOFs) with intriguing structural motifs and unique properties are potential candidates for carbon dioxide (CO2) storage.
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Farhan M, Hoda MQ, Ullah H. Prevention of hypotension associated with the induction dose of propofol: A randomized controlled trial comparing equipotent doses of phenylephrine and ephedrine. J Anaesthesiol Clin Pharmacol 2015; 31:526-30. [PMID: 26702213 PMCID: PMC4676245 DOI: 10.4103/0970-9185.169083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS Propofol, the most commonly used intravenous (IV) anesthetic agent is associated with hypotension on induction of anesthesia. Different methods have been used to prevent hypotension but with variable results. The objective of this study was to evaluate efficacy of equipotent doses of phenylpehrine and ephedrine in preventing the hypotensive response to the induction dose of propofol. MATERIAL AND METHODS One hundred thirty five adult patients were randomised to one of the study groups: propofol-saline (PS), propofol-phenylephrine (PP) or propofol-ephedrine (PE) by adding study drugs to propofol. Anesthesia was induced with a mixture of propofol and the study drug. Patients were manually mask-ventilated for 5 min using 40% oxygen in nitrous oxide and isoflurane at 1%. A baseline mean arterial pressure (MAP) was recorded prior to induction of anesthesia. Systolic, diastolic and mean blood pressure and heart rate were recorded every minute for up to 5 min after induction. Hypotension was defined as a 20% decrease from the baseline MAP. RESULTS There were no significant demographic differences between the groups. Overall incidence of hypotension in this study was 38.5% (52/135). Rate of hypotension was significantly higher in group PS than group PP (60% vs. 24.4% P = 0.001) and group PE (60% vs. 31.1% P = 0.005). In contrast, a significant difference in rate of hypotension was not observed between groups PP and group PE. CONCLUSION In equipotent doses, phenylephrine is as good as ephedrine in preventing the hypotensive response to an induction dose of propofol.
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