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Mazhar U, Mushtaq MN, Khan HU, Maheen S, Malik MNH, Ahmad T, Latif F, Tabassum N, Khan AQ, Ahsan H, Khan W, Javed I, Ali H. Evaluation of anti-inflammatory, analgesic and antipyretic activities of Thymus serphyllum Linn. in mice. Acta Pol Pharm 2015; 72:113-118. [PMID: 25850206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present study was conducted to evaluate the analgesic, anti-inflammatory and antipyretic activities of Thymus serphyllum Linn. in mice. Anti-inflammatory activity was evaluated by carrageenan and egg albumin induced paw edema in mice, while analgesic activity was assessed using formalin induced paw licking and acetic acid induced abdominal writhing in mice. For determination of antipyretic activity, pyrexia was induced by subcutaneous injection of 20% yeast. All the extracts produced significant anti-inflammatory effect however, ether extract produced maximum effect 34% inhibition (p < 0.001) against carrageenan and 22% (p < 0.01) inhibition against egg albumin induced paw edema in mice at the end of 3 h. Ether extract produced prominent analgesic effect 77% (p < 0.001) inhibition in acetic acid induced abdominal writhing and 59% inhibition in formalin induced paw licking model in mice, respectively. Ether extract also demonstrated significant (p < 0.001) antipyretic activity against yeast induced pyrexia. The plant showed no sign of toxicity up to the dose of 2000 mg/kg in mice. This study supports the use of Thymus serphyllum in traditional medicine for inflammation accompanied by pain and fever.
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Longo U, Ripalda P, Salvatore G, Berton A, Khan W, Maffulli N, Forriol F, Denaro V. Fibronectin Expression in the Intervertebral Disc of Monkey. Curr Stem Cell Res Ther 2014; 10:64-8. [DOI: 10.2174/1574888x09666140710114414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/03/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
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Akyol E, Hindocha S, Khan W. Use of Stem Cells and Growth Factors in Rotator Cuff Tendon Repair. Curr Stem Cell Res Ther 2014; 10:5-10. [DOI: 10.2174/1574888x09666140710101001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 05/25/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
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Caudwell M, Crowley C, Khan W, Wong J. Systematic Review of Preclinical and Clinical Studies on Scaffold Use in Knee Ligament Regeneration. Curr Stem Cell Res Ther 2014; 10:11-8. [DOI: 10.2174/1574888x09666140710101435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/10/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
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205
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Loppini M, Longo U, Niccoli G, Khan W, Maffulli N, Denaro V. Histopathological Scores for Tissue-Engineered, Repaired and Degenerated Tendon: A Systematic Review of the Literature. Curr Stem Cell Res Ther 2014; 10:43-55. [DOI: 10.2174/1574888x09666140710110723] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 03/08/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
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206
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Forriol F, Longo U, Duart J, Ripalda P, Vaquero J, Loppini M, Romeo G, Campi S, Khan W, Muda A, Denaro V. VEGF, BMP-7, Matrigel TM, Hyaluronic Acid, In Vitro Cultured Chondrocytes and Trephination for Healing of the Avascular Portion of the Meniscus. An Experimental Study in Sheep. Curr Stem Cell Res Ther 2014; 10:69-76. [DOI: 10.2174/1574888x09666140710115356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 06/19/2014] [Accepted: 07/07/2014] [Indexed: 11/22/2022]
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Mafi R, Khan W, Mafi P, Hindocha S. Orthopaedic approaches to proximal humeral fractures following trauma. Open Orthop J 2014; 8:437-41. [PMID: 25408786 PMCID: PMC4235069 DOI: 10.2174/1874325001408010437] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 09/10/2014] [Accepted: 09/12/2014] [Indexed: 11/22/2022] Open
Abstract
Proximal humeral fractures have been a topic of discussion in medical literature dating back as far as 3rd century BC. Today, these fractures are the most common type of humeral fractures and account for about 5-6% of all fractures in adults with the incidence rising rapidly with age. In broad terms the management of proximal humeral fractures can be divided into two categories: conservative versus surgical intervention. The aim of treatment is to stabilize the fracture, aid better union and reduce pain during the healing process. Failure to achieve this can result in impairment of function, and significantly weaken the muscles inserting onto the proximal humerus. With the rising incidence of proximal humeral fractures, especially among the elderly, the short and long term burden for patients as well as the wider society is increasing. Furthermore, there is a lack of consistency in the definitive treatment and management of displaced fractures. This systematic review of literature compares the surgical treatment of proximal humeral fractures with their conservative management, by evaluating the available randomised controlled trials on this topic.
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Affiliation(s)
- Reza Mafi
- Department of Orthopaedic Surgery, Diana Princess of Wales Hospital, Grimsby, DN33 2BA, UK
| | | | - Pouya Mafi
- Hull York Medical School, Heslington, York, YO10 5DD, UK
| | - Sandip Hindocha
- Department of Plastic Surgery, Whiston Hospital, Merseyside, L35 5DR, UK
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Khan W, Elsherif Z, Daoud Y, Mukhtar A, Omer H, Saeed B, Halim M. Characteristics, treatment, and outcome of patients with acute coronary syndrome presenting at King Abdulaziz Cardiac Center compared with the European patients. Eur Heart J Suppl 2014. [DOI: 10.1093/eurheartj/suu003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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209
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Khan W, Westman E, Jones N, Wahlund LO, Mecocci P, Vellas B, Tsolaki M, Kłoszewska I, Soininen H, Spenger C, Lovestone S, Muehlboeck JS, Simmons A. Automated Hippocampal Subfield Measures as Predictors of Conversion from Mild Cognitive Impairment to Alzheimer's Disease in Two Independent Cohorts. Brain Topogr 2014; 28:746-759. [PMID: 25370484 PMCID: PMC4529880 DOI: 10.1007/s10548-014-0415-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 10/24/2014] [Indexed: 01/05/2023]
Abstract
Previous studies have shown that hippocampal subfields may be differentially affected by Alzheimer’s disease (AD). This study used an automated analysis technique and two large cohorts to (1) investigate patterns of subfield volume loss in mild cognitive impairment (MCI) and AD, (2) determine the pattern of subfield volume loss due to age, gender, education, APOE ε4 genotype, and neuropsychological test scores, (3) compare combined subfield volumes to hippocampal volume alone at discriminating between AD and healthy controls (HC), and predicting future MCI conversion to AD at 12 months. 1,069 subjects were selected from the AddNeuroMed and Alzheimer’s disease neuroimaging initiative (ADNI) cohorts. Freesurfer was used for automated segmentation of the hippocampus and hippocampal subfields. Orthogonal partial least squares to latent structures (OPLS) was used to train models on AD and HC subjects using one cohort for training and the other for testing and the combined cohort was used to predict MCI conversion. MANCOVA and linear regression analyses showed multiple subfield volumes including Cornu Ammonis 1 (CA1), subiculum and presubiculum were atrophied in AD and MCI and were related to age, gender, education, APOE ε4 genotype, and neuropsychological test scores. For classifying AD from HC, combined subfield volumes achieved comparable classification accuracy (81.7 %) to total hippocampal (80.7 %), subiculum (81.2 %) and presubiculum (80.6 %) volume. For predicting MCI conversion to AD combined subfield volumes and presubiculum volume were more accurate (81.1 %) than total hippocampal volume. (76.7 %).
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Affiliation(s)
- Wasim Khan
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Eric Westman
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nigel Jones
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK
- NIHR Biomedical Research Centre for Mental Health, London, UK
| | - Lars-Olof Wahlund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Bruno Vellas
- INSERM U 558, University of Toulouse, Toulouse, France
| | - Magda Tsolaki
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Christian Spenger
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Simon Lovestone
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - J-Sebastian Muehlboeck
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK
- NIHR Biomedical Research Centre for Mental Health, London, UK
| | - Andrew Simmons
- Department of Neuroimaging, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK.
- NIHR Biomedical Research Centre for Mental Health, London, UK.
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Haddad B, Alam M, Prasad V, Khan W, Tucker S. Case report: spondylodiscitis. J Fam Pract 2014; 63:640-644. [PMID: 25362494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Behrooz Haddad
- Spinal Deformity Unit, Royal National Orthopaedic Hospital, London, England.
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211
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Jordan DJ, Malahias M, Khan W, Hindocha S. The ortho-plastic approach to soft tissue management in trauma. Open Orthop J 2014; 8:399-408. [PMID: 25408781 PMCID: PMC4235068 DOI: 10.2174/1874325001408010399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/03/2014] [Accepted: 05/27/2014] [Indexed: 01/25/2023] Open
Abstract
Fractures with associated soft tissue injuries, or those termed 'open,' are not uncommon. There has been much discussion regarding there management, with the guidance from the combined British Orthopaedic Association and British Association and Aesthetic Surgeons teams widely accepted as the gold level of therapy. We aim to discuss the current evidence about the initial management of this group of injuries, taking a journey from arrival in the accident and emergency department through to the point of definitive closure. Other modes of therapy are also reviewed.
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Affiliation(s)
- Daniel J Jordan
- Plastic Surgery Unit, The Christie NHS Foundation Trust, Manchester, UK
| | - Marco Malahias
- Plastic Surgery Department, Good Hope Hospital, West Midlands, UK
| | - Wasim Khan
- Royal National Orthopaedic Hospital, London, UK
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212
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Malahias M, Jordan DJ, Hindocha S, Khan W, Juma A. The development and future of reconstructive and microvascular surgery of the hand. Open Orthop J 2014; 8:415-22. [PMID: 25408783 PMCID: PMC4235081 DOI: 10.2174/1874325001408010415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/03/2014] [Accepted: 05/27/2014] [Indexed: 11/22/2022] Open
Abstract
The hand is often thought of as a key discriminator in what makes humans human. The hand is both intricate and fascinating in its design and function, allowing humans to interact with their surroundings, and each other. Due to its use in manipulation of the person’s environment, injury to the hand is common. Devastating hand injuries have a profound, physical, psychological, financial and socially crippling effect on patients. Advances in operative techniques and improvements in microscopes and instruments allowed Malt &McKhann to perform the first successful arm replantation in 1962 [1]. This was followed by a myriad of autologous free flaps of varying composition, that were discovered after the mapping of the cutaneous blood circulation by Taylor and Palmer [2] and Mathes & Nahai’s classification of muscle flaps [3] providing us with countless options to harvest and transfer healthy, well vascularised tissues into areas of injury. Since the late sixties, with the emerging subspecialty of microvascular reconstruction, surgeons have had the technical ability to salvage many amputated parts, even entire limbs. The measure of functional outcomemust incorporate the evaluation and severity ofthe initial injury and the subsequent reconstructive surgeries [4].
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Affiliation(s)
- Marco Malahias
- Plastic Surgery Department, Good Hope Hospital, West Midlands, UK
| | | | | | - Wasim Khan
- Royal National Orthopaedic Hospital, London, UK
| | - Ali Juma
- Plastic Surgery Unit, Countess of Chester Hospital, Chester, UK
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Kerrigan D, Waters P, Ryan M, Irfan M, Hanaghan J, Khan W, Kerin MJ, Barry K. Follow-up arrangements for breast cancer patients; is it appropriate to transfer surveillance to general practitioners? Ir Med J 2014; 107:273-275. [PMID: 25417384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this study was to examine the evidence for hospital follow up of breast cancer survivors and to identify patient preferences for hospital or community follow-up. We surveyed General Practitioner attitudes towards community follow-up and quantified the incidence of new or recurrent cancers within a patient cohort to identify their primary symptoms and thus cancer detection in the community. A 22 item questionnaire was distributed to 101 breast cancer survivors from a cohort of 921 treated patients. A 9 item questionnaire was distributed to 81 General Practitioners. Patients are reassured by hospital outpatient appointments, n=63 (74%) but have high levels of confidence in General Practitioner follow-up, n=57 (67%). General Practitioners are equally divided regarding their support for the transfer of follow-up (51%, 49%). Ten of the 14 new cancer episodes were associated with obvious clinical signs (p < 0.05). The proposed transfer of follow-up for patients to general practice by the national cancer control programme is appropriate.
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214
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Ong E, Chimutengwende-Gordon M, Khan W. Stem cell therapy for knee ligament, articular cartilage and meniscal injuries. Curr Stem Cell Res Ther 2014; 8:422-8. [PMID: 24016325 DOI: 10.2174/1574888x1130800059] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/30/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022]
Abstract
Knee injuries involving ligament, articular cartilage and meniscus are common. The capacity for regeneration and repair of these tissues is limited due to their poor vascularity. Autologous or allogeneic stem cell transplantation has the potential to stimulate healing of these tissues. A number of preclinical studies of stem cell therapy for repair of these injuries have produced promising results. Further clinical trials are needed to test the efficacy of this technique. This paper reviews the development strategies, advances and clinical applications of stem cell therapies that are applicable to knee ligament, articular cartilage and meniscal injuries.
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Affiliation(s)
- Edward Ong
- University College London, Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom.
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Chimutengwende-Gordon M, Khan W, Haddad B. Advances and controversies in stem cell therapies and tissue engineering strategies applicable to trauma and orthopaedic surgery. Curr Stem Cell Res Ther 2014; 8:415-7. [PMID: 24016328 DOI: 10.2174/1574888x1130800057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Mukai Chimutengwende-Gordon
- Department of Trauma and Orthopaedics West Suffolk Hospital, Hardwick Lane Bury St Edmunds Suffolk IP33 2QZ United Kingdom
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Keerthi N, Chimutengwende-Gordon M, Sanghani A, Khan W. The potential of stem cell therapy for osteoarthritis and rheumatoid arthritis. Curr Stem Cell Res Ther 2014; 8:444-50. [PMID: 24016323 DOI: 10.2174/1574888x1130800062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 07/27/2013] [Accepted: 09/01/2013] [Indexed: 12/12/2022]
Abstract
Joint diseases are a major cause of disability and are a significant financial burden on health care systems. Regenerative medicine offers exciting possibilities for treating osteoarthritis and rheumatoid arthritis. As well as possessing the ability to differentiate into other tissue lineages, some stem cells such as mesenchymal stem cells possess immmunomodulatory properties that make them useful in the search for alternative treatments for rheumatoid arthritis specifically. Various studies have been carried out using animal models to evaluate the role of stem cells in the treatment of arthritis, with some research being translated into clinical studies. However, the number of patients used in some studies has left questions on the ability of stem cell therapy to treat arthritic conditions unanswered. This article reviews the innovative studies that have been carried out to treat arthritis using stem cells and also highlights the key challenges associated with these techniques.
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Affiliation(s)
- Naveen Keerthi
- University College London, Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom.
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217
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Sanghani A, Chimutengwende-Gordon M, Adesida A, Khan W. Applications of stem cell therapy for physeal injuries. Curr Stem Cell Res Ther 2014; 8:451-5. [PMID: 24016322 DOI: 10.2174/1574888x1130800063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022]
Abstract
Physeal injuries may lead to the formation of a bone bridge resulting in limb length discrepancies and angular deformity in children. Current treatment of physeal injuries may be challenging. A number of strategies have been used to repair physeal defects with varying results. Biological regeneration using stem cells is therefore an attractive potential future option to repair physeal defects. Preclinical animal studies using stem cells have shown mixed results. Studies have investigated the use of various scaffolds including chitin, collagen and gelfoam. Significant progress has been made in discovering appropriate growth factors such as transforming growth factor (TGF-β), insulin-like growth factor (IGF-1), bone morphogenetic proteins (BMPs) and fibroblast growth factor (FGF-2) that could induce physeal repair and be used in combination with stem cell therapy. Advances have been made in the use of gene therapy to maintain sustainable delivery of growth factors to injury sites. This review discusses the current stem cell therapy available to repair physeal injuries.
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Affiliation(s)
- Anita Sanghani
- University College London, Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom.
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Abstract
INTRODUCTION Coccygodynia is a condition associated with severe discomfort in the region of the coccyx. While traditional procedures had poor outcomes and high complication rates, recent literature suggests better outcomes and lower complication rates with coccygectomy. METHODS Data were collected retrospectively from clinical notes. A questionnaire was used to evaluate the outcomes. The outcome measures included pain analogue score (PAS) in sitting and during daily activities as well as patients' overall pain relief. Overall improvement in pain and complications were documented. RESULTS Between 2000 and 2010, 14 patients underwent total coccygectomy for refractory coccygodynia. All patients were available for follow-up appointments and the follow-up duration ranged from 24 to 132 months (mean: 80 months). The aetiology was traumatic in eight patients and non-traumatic in six. The PAS improved from a median of 9 to 4 for sitting and from 7.5 to 2.5 for daily activities. One patient had mild discharge for more than two weeks. No patients required further surgery. Twelve patients (85.7%) had excellent or good pain relief. Only one patient was unsatisfied. A Wilcoxon signed-rank test revealed significant improvement in pain when sitting (p<0.05) and during activities of daily living (p<0.05) at the final follow-up visit. A Mann-Whitney U test did not show a significant difference in improvement in PAS between the traumatic and non-traumatic groups (p=0.282 and 0.755). CONCLUSIONS In our series, total coccygectomy offered satisfactory relief of pain in the majority of patients with a low wound complication rate.
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Affiliation(s)
- B Haddad
- Royal National Orthopaedic Hospital NHS Trust, UK
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219
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Akhtar MS, Jabeen Q, Khan HU, Maheen S, Karim S, Rasool S, Malik MNH, Khan K, Mushtaq MN, Latif F, Tabassum N, Khan AQ, Ahsan H, Khan W. Pharmacological evaluation of antihypertensive effect of aerial parts of Thymus linearis benth. Acta Pol Pharm 2014; 71:677-682. [PMID: 25272894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Traditionally Thymus linearis Benth. have been used for treatment of various diseases including hypertension. The present study was conducted to evaluate the hypotensive and antihypertensive effect of aqueous methanolic extract of aerial parts of Thymus linearis Benth. in normotensive and hypertensive rats. Acute and subchronic studies were also conducted. The aqueous methanolic extract produced a significant decrease in SBP, DBP, MBP and heart rate of both normotensive and hypertensive rats. LDv, of the extract was found to be 3000 mg/kg. The extract also exhibited a reduction in serum ALT, AST, ALP, cholesterol, triglycerides and LDL levels, while a significant increase in HDL level was observed. It is conceivable therefore, that Thymus linearis Benth. contains certain active compound(s) that are possibly responsible for the observed antihypertensive activity. Moreover, these findings further authenticate the traditional use of this plant in folklore medicine.
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220
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Akhtar MS, Jabeen Q, Bashir S, Malik MNH, Karim S, Mushtaq MN, Rasool S, Latif F, Tabbasum N, Khan AQ, Ahsan H, Khan W, Javed I. Possible mechanism of cardiac depressant activity of Berberis orthobotrys roots in isolated rabbit heart. Acta Pol Pharm 2014; 71:667-675. [PMID: 25272893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Berberis orhob, otrvs Bien. ex Aitch. (B.o.) has been reported to have antihypertensive effect in different experimental models. The aim of present study was to evaluate the possible antihypertensive mechanism. Aqueous methanolic extract of B.o. roots and its various fractions namely (ethyl acetate, n-butanol or aqueous) in different concentrations (10 ng/mL, 100 ng/mL, I pg/mL, 10 pg/mL, 100 pg/mL ) were evaluated in isolated perfused rabbit heart to assess their effect on force of contraction, HR and perfusion pressure. The crude extract of B.o. and its fractions exhibited a significant decrease in heart rate, contractility and perfusion pressure of isolated rabbit heart, however, butanolic fraction produced more prominent effect and was selected for further study. The effects of butanol fraction were not blocked by atropine (10' M) in isolated perfused heart. However, butanol fraction significantly blocked the effects of adrenaline (10' M). It is therefore conceivable that cardiac depressant activity of B.o. butanol fraction might be due to the presence of certain 3-blocking agents which might be responsible for antihypertensive effect However, further experiments are required to isolate the active compound(s) and elucidate exact mechanism of action.
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Abstract
Patients presenting to the emergency department with bite injuries to the hand sustain them through a number of causes including domesticated as well as stray animal bites, and human bites commonly sustained as a result of violence. The nature of the injuries sustained can be very deceptive. A small tooth mark on the exterior can be a fulminant infection in the tissues deeper down. Tendon injuries, fractures of the metacarpals and phalanges and management of the wound are critical issues faced by a surgeon in dealing with such patients. Similarly the less common bite injuries to the hand, often with disastrous and sometimes fatal complications, do also present to the emergency department. A high incidence of suspicion is needed in dealing with these injuries effectively. In our article we discuss the common as well as uncommon causes of bite injuries to the hand and their management. In addition to reviewing the literature to ascertain the management of such injuries, we also discuss interesting and rare case reports.
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Affiliation(s)
- Pradyumna Raval
- Department of Orthopaedic Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Wasim Khan
- University College London Institute of Orthopaedics & Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Behrooz Haddad
- University College London Institute of Orthopaedics & Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, UK
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Hiregoudar V, Raghavendra B, Ramesh K, Sameena ARB, Hemagiri K, Basavaraj S, Goud TG, Aravind K, Khan W. Proportion and determinants of adherence to antiretroviral therapy among HIV positive people registered under ART centre in South India. BMC Infect Dis 2014. [PMCID: PMC4080402 DOI: 10.1186/1471-2334-14-s3-p33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Khan W, Giampietro V, Ginestet C, Dell'Acqua F, Bouls D, Newhouse S, Dobson R, Banaschewski T, Barker GJ, Bokde AL, Büchel C, Conrod P, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Lemaître H, Nees F, Paus T, Pausova Z, Rietschel M, Smolka MN, Ströhle A, Gallinat J, Westman E, Schumann G, Lovestone S, Simmons A. No Differences in Hippocampal Volume between Carriers and Non-Carriers of the ApoE ε4 and ε2 Alleles in Young Healthy Adolescents. ACTA ACUST UNITED AC 2014; 40:37-43. [DOI: 10.3233/jad-131841] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Wasim Khan
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | | | - Cedric Ginestet
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
| | - Flavio Dell'Acqua
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | - David Bouls
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | - Steven Newhouse
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | - Richard Dobson
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | - Tobias Banaschewski
- Central Institute of Mental Health, Mannheim, Germany
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | | | - Arun L.W. Bokde
- Institute of Neuroscience and Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Patricia Conrod
- King's College London, Institute of Psychiatry, London, UK
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Herta Flor
- Central Institute of Mental Health, Mannheim, Germany
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Vincent Frouin
- Neurospin, Commissariat à l'Energie Atomique et aux Energies Alternatives, Paris, France
| | - Hugh Garavan
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Penny Gowland
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Anreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Berlin, Germany
| | - Hervé Lemaître
- Institut National de la Santé et de la Recherche Médicale, INSERM CEA Unit 1000 “Imaging & Psychiatry”, University Paris Sud, Orsay, and AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France
| | - Frauke Nees
- Central Institute of Mental Health, Mannheim, Germany
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Tomas Paus
- Rotman Research Institute, University of Toronto, Toronto, Canada
- School of Psychology, University of Nottingham, Nottingham, UK
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Marcella Rietschel
- Central Institute of Mental Health, Mannheim, Germany
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Michael N. Smolka
- Neuroimaging Center, Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Jean Gallinat
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | | | - Gunther Schumann
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
| | - Simon Lovestone
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
| | - Andrew Simmons
- King's College London, Institute of Psychiatry, London, UK
- NIHR Biomedical Research Centre for Mental Health, King's College London, London, UK
- NIHR Biomedical Research Unit for Dementia, King's College London, London, UK
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Casey MC, Robertson I, Lang B, Bennani F, Khan W, Barry K. Farm-related trauma in the west of Ireland: an occupational hazard. Ir J Med Sci 2014; 183:601-4. [PMID: 24481926 DOI: 10.1007/s11845-013-1058-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 12/08/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Farm fatalities in Ireland remain at their highest recorded levels despite the introduction and implementation of several farm safety initiatives during recent years. AIMS The aim of this study was to examine all farm-related morbidity and mortality presenting to a general hospital in the west of Ireland. METHODS A consecutive series of all farm-related fatal and non-fatal injuries presenting to our institution over a 7-year period (2005-2011) was compiled by examining the hospital inpatient enquiry system and mortuary records. RESULTS One hundred and thirty patients were admitted to Mayo General Hospital with non-fatal farm-related injuries during the study period. This cohort was comprised 104 males and 26 females with an average age at presentation of 46 (range 19-75) years. The most common mechanism of non-fatal injury was animal attack. The mean length of hospital stay, mean length of ICU stay and total number of bed days used were 5.2, 5.3 and 677 days, respectively. There were seven farm-related fatalities during the same study period. Four were livestock-related, two due to machinery accident and one due to fall of a heavy object. The post-mortem findings were analysed in each case. CONCLUSIONS This analysis outlines the incidence and severity of fatal and non-fatal injuries sustained in the farming workplace and presenting to a general hospital serving a rural catchment population. Greater awareness of our results may help reduce the longterm incidence and magnitude of such injuries.
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Affiliation(s)
- M C Casey
- Department of General Surgery, Mayo General Hospital, Castlebar, Co Mayo, Ireland
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Casey MC, Robertson I, Waters PS, Hanaghan J, Khan W, Barry K. Non-operative management of diverticular perforation in a patient with suspected Ehlers-Danlos syndrome. Int J Surg Case Rep 2014; 5:135-7. [PMID: 24534685 PMCID: PMC3955225 DOI: 10.1016/j.ijscr.2013.12.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/18/2013] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION No consensus exists regarding definitive management of colonic perforation in Ehlers-Danlos syndrome (EDS), with various authors advocating different operative techniques. Spontaneous colonic perforation is a recognised complication of vascular-type EDS (type IV), with many reported cases in the literature. No such cases have been reported concerning classical-type EDS (type I/II). PRESENTATION OF CASE A 55-year-old male with a family history of EDS presented with acute lower abdominal pain and signs of localised peritonitis. Following resuscitation, computerised tomography identified perforation of a sigmoid diverticulum with localised intraperitoneal air. Considering the potential complications associated with laparotomy in a patient with EDS, a trial of conservative management was undertaken including image-guided drainage of a mesenteric abscess. Intensive care monitoring, nutritional support and intravenous antibiotics also facilitated successful non-operative management. Following discharge, molecular studies confirmed COL5A1 mutation, and a diagnosis of classical Ehlers-Danlos syndrome was established. DISCUSSION This is the first reported case of successful conservative management of colonic diverticular perforation in a patient with classical Ehlers-Danlos syndrome. CONCLUSION EDS is highly significant in the surgical context, with the causative genetic factors serving to further complicate the course of surgical intervention. In the absence of consensus regarding best surgical management, due consideration should be given to non-operative management of benign colonic perforation.
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Affiliation(s)
- M C Casey
- Department of General Surgery, Mayo General Hospital, Ireland
| | - I Robertson
- Department of General Surgery, Mayo General Hospital, Ireland.
| | - P S Waters
- Department of General Surgery, Mayo General Hospital, Ireland
| | - J Hanaghan
- Department of Diagnostic and Interventional Radiology, Mayo General Hospital, Ireland
| | - W Khan
- Department of General Surgery, Mayo General Hospital, Ireland
| | - K Barry
- Department of General Surgery, Mayo General Hospital, Ireland
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Parine NR, Kumar D, Pathan AAK, Elrobh MS, Khan W, Alanazi M. Characterization and cross-species amplification of microsatellite markers in African Silverbill (Lonchura cantans). Genet Mol Res 2013; 12:5634-9. [PMID: 24301932 DOI: 10.4238/2013.november.18.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We tested the cross-amplification of eight microsatellites developed for Bengalese finch in African Silverbill (Lonchura cantans). In order to develop resources for conservation genetic studies in the species L. cantans, we tested the amplification success and polymorphism in eight previously developed microsatellite loci, in L. cantans. All eight microsatellite markers were successfully amplified, of which all were polymorphic, with 3 to 9 alleles and an expected heterozygosity (HE) ranging from 0.606 to 0.718. On average, there were 5.25 alleles/locus and a mean HE of 0.6456. These eight polymorphic markers could be of potential use in studies of genetic variability, population structure, and reproductive strategy of African Silverbills. The markers tested should be useful for population and conservation genetic studies in this genus, and, in particular, for species closely related to the source species, L. cantans.
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Affiliation(s)
- N R Parine
- Genomics Research Chair, Department of Biochemistry, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Longo U, Rizzello G, Berton A, Fumo C, Battaglia G, Khan W, Denaro V. A Review of Preclinical and Clinical Studies Using Synthetic Materials for Meniscus Replacement. Curr Stem Cell Res Ther 2013; 8:438-43. [DOI: 10.2174/1574888x1130800061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 05/30/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022]
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Longo U, Rizzello G, Berton A, Fumo C, Maltese L, Khan W, Denaro V. Synthetic Grafts for Anterior Cruciate Ligament Reconstruction. Curr Stem Cell Res Ther 2013; 8:429-37. [DOI: 10.2174/1574888x1130800060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/05/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022]
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Longo U, Rizzello G, Berton A, Maltese L, Fumo C, Khan W, Denaro V. Biological Strategies to Enhance Rotator Cuff Healing. Curr Stem Cell Res Ther 2013; 8:464-70. [DOI: 10.2174/1574888x113086660065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/28/2013] [Accepted: 09/01/2013] [Indexed: 11/22/2022]
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Haq Z, Mahjour J, Khan W. Report: communicable diseases in the Eastern Mediterranean Region: prevention and control 2010-2011. East Mediterr Health J 2013. [DOI: 10.26719/2013.19.10.888] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Haq Z, Mahjour J, Khan W. Communicable diseases in the Eastern Mediterranean Region: prevention and control 2010-2011. East Mediterr Health J 2013; 19:888-891. [PMID: 24313154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
One-third of all morbidities and mortalities in the Eastern Mediterranean Region are attributed to communicable diseases. A continued situation of war and conflict, and growing political unrest in the Region, coupled with factors such as travel and migration, and insufficient infrastructure and inadequate technical and managerial capacity ofthe programmes are the major challenges. Despite these challenges, the Region continued making progress towards the elimination of specific diseases such as lymphatic filariasis, measles, malaria, schistosomiasis and dracunculiasis during 2010-11. Coverage for vaccine-preventable diseases was enhanced. Preparedness and response to emerging (e.g. dengue fever in Pakistan and Yemen) and re-emerging (e.g. cholera in Sudan) infections was improved. The Region has continued its efforts for controlling tuberculosis and curbing HIV/AIDS. Looking ahead, the Region aims to improve surveillance and response capacities, legislation issues, coordination, bio-risk and bio-security and quality management in the coming years.
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Affiliation(s)
- Z Haq
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
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Piggott R, Hogan A, Sharkey M, Waldron R, Khan W, Barry K. The impact of changes in work practice and service delivery on surgical infection rates in a general surgical unit. Ir Med J 2013; 106:281-283. [PMID: 24416854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ring-fencing of elective orthopaedic beds has been shown to significantly reduce surgical site infection (SSI) rates. There are fewer studies in general surgical practice. Comparison of overall surgical workload in 2007 and 2011 was performed. Data pertaining to SSI were collected and analysis of this prospectively maintained database was performed on all SSI diagnosed in 2007 and 2011. There was a significant reduction in the crude SSI rate from 117 cases in 2007 (8%) to 42 cases in 2011 (3.5%). A statistically significant reduction in SSI rate for elective surgery was observed, 7.6% vs. 2.5% (p<0.001 Chi-square test). Apart from the introduction of ring fencing, all other contributory variables remained unchanged. Ring-fencing of inpatient general surgical beds has been associated with a significant reduction in SSI rates. These data provide timely supportive evidence that ring-fencing of inpatient beds is an appropriate patient-orientated strategy.
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Affiliation(s)
- R Piggott
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo.
| | - A Hogan
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
| | - M Sharkey
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
| | - R Waldron
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
| | - W Khan
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
| | - K Barry
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
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Haddad B, Pakravan AH, Konan S, Adesida A, Khan W. A systematic review of tissue engineered meniscus: cell-based preclinical models. Curr Stem Cell Res Ther 2013; 8:222-31. [PMID: 23317471 DOI: 10.2174/1574888x11308030007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/15/2012] [Accepted: 01/01/2013] [Indexed: 11/22/2022]
Abstract
Meniscal injuries are one of the common sports injuries and their natural healing is limited. Removal of injured meniscus alters knee biomechanics and predisposes patients to osteoarthritis. Tissue engineered meniscus provides a novel approach for the treatment of severe meniscus injury. The aim of this review is to review preclinical studies that used cell based approaches for tissue engineered meniscus. Studies were assessed for inclusion following a search in PubMed, UK PubMed central and Embase. All preclinical studies that used cell based approaches for meniscus regeneration were included in the study. Nineteen articles that used cellular approaches were reviewed. The cell types used were mesenchymal stem cells (derived from bone marrow or synovium), meniscal fibrochondrocytes, chondrocytes and bone marrow stromal cells. One study used xenogeneic bone marrow derived mesenchymal stem cells. Sixteen out of nineteen studies showed better tissue regeneration with cell based approaches when compared to acellular controls. The review included preclinical studies. The diversity of the studies made it impossible to adhere to full guidelines or perform a meta-analysis. Overall,experiments have demonstrated superior tissue integration and favourable biochemical properties of the regenerated tissues compared to acellular techniques. Few approaches however, have measured the chondroprotective ability at preclinical testing.
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Affiliation(s)
- Behrooz Haddad
- University College London Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP United Kingdom.
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Burke T, Waters P, Hanaghan J, Bennani F, Khan W, Barry K. Splenic metastases from caecal carcinoma: Diagnostic considerations and therapeutic strategy. Int J Surg Case Rep 2013; 4:1017-20. [PMID: 24096024 PMCID: PMC3825930 DOI: 10.1016/j.ijscr.2013.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The spleen is a highly vascular organ and is in close proximity to many potential primary sites such as the stomach, breast, pancreas and colon. It is however an unusual site for metastatic disease. The reasons for this are not fully understood at the present time. A number of hypotheses have been postulated. Definitive diagnosis and subsequent treatment of metastatic disease to the spleen presents a number of challenges for the surgeon and the wider multi disciplinary team. PRESENTATION OF CASE A 60 year old male presented with a three week history of lower abdominal pain, distension, nausea and a palpable mass in the right iliac fossa. Imaging revealed a large circumferential caecal mass consistent with malignancy with secondary small bowel obstruction. The patient underwent an emergency right hemicolectomy and was subsequently treated with systemic chemotherapy for lymph node positive caecal adenocarcinoma. Two years following initial presentation, two suspicious lesions were noted within the spleen during routine surveillance imaging with computerised tomography of the thorax, abdomen and pelvis. Of note, one month prior to this the patient had a normal surveillance colonoscopy performed with multiple interval carcinoembryonic antigen (CEA) levels recorded within the normal range. Image guided splenic biopsy and subsequent histology confirmed metastatic caecal adenocarcinoma. DISCUSSION Splenic metastases from any source including the colon are a rare phenomenon. CONCLUSION This case questions the value of routine post operative CEA monitoring, underlines the importance of multimodal pathways of surveillance and highlights recent advances in image guided splenic biopsy techniques.
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Affiliation(s)
- T.P. Burke
- Department of Surgery, Mayo General Hospital, Mayo, Ireland
| | - P.S. Waters
- Department of Surgery, Mayo General Hospital, Mayo, Ireland
| | - J. Hanaghan
- Department of Radiology, Mayo General Hospital, Mayo, Ireland
| | - F. Bennani
- Department of Pathology, Mayo General Hospital, Mayo, Ireland
| | - W. Khan
- Department of Surgery, Mayo General Hospital, Mayo, Ireland
| | - K. Barry
- Department of Surgery, Mayo General Hospital, Mayo, Ireland
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Abstract
A 67-year-old woman presented with synchronous breast and colonic tumours, in the absence of family history. Following multidisciplinary discussion, the patient was started on endocrine therapy for breast cancer. Initial surgical management consisted of right hemicolectomy together with segmental resection of a serosal deposit adherent to the distal ileum, for a moderately differentiated pT4NO caecal carcinoma. Three months later, right mastectomy and axillary clearance confirmed node positive invasive ductal carcinoma. The original treatment plan was to prioritise adjuvant chemotherapy for breast cancer postmastectomy. However, the subsequent CT finding of an enlarged, suspicious mesenteric lymph node mass on repeat staging raised concern regarding its origin. Image-guided biopsy revealed metastatic colonic adenocarcinoma and the patient was switched to a colon cancer chemotherapy regime. Following adjuvant chemotherapy for colonic carcinoma, an en-bloc surgical resection of the enlarging metastatic nodal mass was performed with clear resection margins. The patient is currently asymptomatic.
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Affiliation(s)
- L Higgins
- Department of Surgery, Mayo General Hospital, Co Mayo, Ireland
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Khan W, Giampietro V, Ginestet C, Newhouse S, Dobson R, Schumann G, Lovestone S, Simmons A. P4–377: Effects of APOE‐ε4 and APOE‐ε2 alleles on hippocampal volumes in 1,412 healthy young adolescents: The IMAGEN study. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.08.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Wasim Khan
- King's College London London United Kingdom
| | | | | | | | | | | | | | - Andy Simmons
- King's College London, Institute of Psychiatry London United Kingdom
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Irfan M, McGovern M, Robertson I, Waldron R, Khan I, Khan W, Barry K. Operative surgical yield from general surgical outpatient clinics; time to change the way we practice? Ir Med J 2013; 106:209-211. [PMID: 24218748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of this study was to compare the number of patients attending surgical outpatient clinics in a general hospital to the number of resulting elective procedures scheduled in a single year. Patients initially assessed at private consulting rooms are not included in this study. The number of surgical outpatient appointments issued in 2011 totalled 6503 with non-attendances running at 1489 (22.9%). The number of elective surgical theatre cases performed in 2011 (i.e. the surgical yield from that period) came to 1078 with an additional 1470 patients referred for endoscopy and 475 patients referred for minor operations. Operative surgical yield from the currently structured outpatient clinic model is low, with the number of theatre cases coming to only 16.58% of the original number of outpatient appointments issued. Recommendations for the improvement of outpatient services are made. These findings are relevant in the context of streamlining access to surgical services.
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Affiliation(s)
- M Irfan
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo
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Kiddle S, Khan W, Aguilar C, Thambisetty M, Sattlecker M, Newhouse S, Dobson R, Simmons A. P1–204: Identifying novel CSF markers of brain atrophy in Alzheimer's disease and mild cognitive impairment using a multiplex panel of analytes. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Wasim Khan
- King's College London London United Kingdom
| | | | | | | | | | | | - Andy Simmons
- King's College London, Institute of Psychiatry London United Kingdom
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Chughtai AA, MacIntyre CR, Wang YA, Gao Z, Khan W. Treatment outcomes of various types of tuberculosis in Pakistan, 2006 and 2007. East Mediterr Health J 2013; 19:535-541. [PMID: 24975182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 04/22/2012] [Indexed: 06/03/2023]
Abstract
Measuring treatment outcome is important for successful tuberculosis (TB) control programmes. The purpose of this study was to examine the outcomes of various types of TB cases registered in Pakistan over a 2-year period and compare those outcomes among the different provinces and regions of the country. A retrospective, cohort study was conducted in which TB treatment outcome reports were reviewed. Of the 349 694 pulmonary TB cases registered in Pakistan during 2006 and 2007, 309154 (88.4%) were treated successfully. Treatment success was significantly higher in new smear-positive cases and lower in retreatment cases. Among the provinces and regions, treatment success was significantly higher in 4 out of 8 provinces. Treatment success needs to be improved, particularly in retreatment cases. The national TB control programme should review the provincial and regional programmes and learn lessons from well-performing programmes. Patient factors that may affect the treatment outcome should be also studied.
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Chughtai A, MacIntyre C, Wang Y, Gao Z, Khan W. Treatment outcomes of various types of tuberculosis in Pakistan, 2006 and 2007. East Mediterr Health J 2013. [DOI: 10.26719/2013.19.6.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Pastides P, Chimutengwende-Gordon M, Maffulli N, Khan W. Stem cell therapy for human cartilage defects: a systematic review. Osteoarthritis Cartilage 2013; 21:646-54. [PMID: 23485933 DOI: 10.1016/j.joca.2013.02.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 01/11/2013] [Accepted: 02/19/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The use of stem cell therapy for the repair of cartilage defects has shown promising results in in vitro and animal studies. However, only a small number of studies have been performed to evaluate the benefits in human subjects. The aim of this study is to systematically review studies that focus on the clinical application of stem cell therapy to treat cartilage defects in human subjects. DESIGN A literature search was performed, adhering to the PRISMA guidelines, to review any studies using such techniques in humans. Our initial search retrieved 105 articles listed on MEDLINE, EMBASE, Google Scholar, CINHal and SPortDiscus. From these studies, 11 studies meeting the eligibility criteria were selected and formed the basis of our systematic review. RESULTS There is limited evidence showing the benefit in humans. The study designs, follow-up methods and criteria reporting and evaluation vary greatly between the studies and are outlined in our systematic review. CONCLUSION With an increasing body of evidence in non-human and in vitro studies, more human trials are required. More high level studies with extensive and robust validated reporting methods should be conducted to evaluate the true effect of such techniques in human cartilage defect repairs.
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Affiliation(s)
- P Pastides
- University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore HA7 4LP, United Kingdom.
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Javed QUA, Wang F, Toufiq AM, Mahmood H, Rafique MY, Khan W, Li Q. Effect of atomic percentage of Zn on the size and optical properties of porous ZnMn2O4 nanoparticles. J Nanosci Nanotechnol 2013; 13:2917-2921. [PMID: 23763179 DOI: 10.1166/jnn.2013.7351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The porous ZnMn2O4 nanostructures have been synthesized by hydrothermal method by using Mn3O4 and Zn powder as precursors. The morphology of the nanoparticles could be tuned by changing the molar ratio of Zn in the reaction system. The final products have been characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, UV-visible spectroscopy and the florescence spectrometer. Room temperature photoluminescence investigation indicates that the nanostructures have strong band-gap emission at yellow and orange bands. Absorption properties of ZnMn2O4 nanostructures indicated that the band gap energy varied with change in the atomic percentage of Zn in hetaerolite ZnMn2O4. The mechanism of this peculiar optical property was analyzed.
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Affiliation(s)
- Qurat-Ul-Ain Javed
- Department of Physics, School of Mathemetics and Physics, University of Science and Technology Beijing, Beijing 100083, PR China
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244
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Robertson I, Traynor O, Khan W, Waldron R, Barry K. Higher surgical training opportunities in the general hospital setting; getting the balance right. Ir J Med Sci 2013; 182:589-93. [PMID: 23494706 DOI: 10.1007/s11845-013-0932-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 02/25/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND The general hospital can play an important role in training of higher surgical trainees (HSTs) in Ireland and abroad. Training opportunities in such a setting have not been closely analysed to date. AIMS The aim of this study was to quantify operative exposure for HSTs over a 5-year period in a single institution. METHODS Analysis of electronic training logbooks (over a 5-year period, 2007-2012) was performed for general surgery trainees on the higher surgical training programme in Ireland. The most commonly performed adult and paediatric procedures per trainee, per year were analysed. RESULTS Standard general surgery operations such as herniae (average 58, range 32-86) and cholecystectomy (average 60, range 49-72) ranked highly in each logbook. The most frequently performed emergency operations were appendicectomy (average 45, range 33-53) and laparotomy for acute abdomen (average 48, range 10-79). Paediatric surgical experience included appendicectomy, circumcision, orchidopexy and hernia/hydrocoele repair. Overall, the procedure most commonly performed in the adult setting was endoscopy, with each trainee recording an average of 116 (range 98-132) oesophagogastroduodenoscopies and 284 (range 227-354) colonoscopies. CONCLUSIONS General hospitals continue to play a major role in the training of higher surgical trainees. Analysis of the electronic logbooks over a 5-year period reveals the high volume of procedures available to trainees in a non-specialist centre. Such training opportunities are invaluable in the context of changing work practices and limited resources.
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Affiliation(s)
- I Robertson
- Department of Surgery, Mayo General Hospital, Castlebar, Co Mayo, Ireland,
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245
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Chughtai AA, Qadeer E, Khan W, Hadi H, Memon IA. Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan. East Mediterr Health J 2013; 19:213-218. [PMID: 23879071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.
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Affiliation(s)
- A A Chughtai
- National TB Control Programme, Islamabad, Pakistan.
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Chughtai A, Qadeer E, Khan W, Hadi H, Memon I. Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan. East Mediterr Health J 2013. [DOI: 10.26719/2013.19.3.213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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247
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Haq Z, Khan W, Rizwan S. Advocacy, communication and social mobilisation for tuberculosis control in Pakistan: a qualitative case study. Int J Tuberc Lung Dis 2013; 17:394-9. [PMID: 23407229 DOI: 10.5588/ijtld.12.0541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A national-level study in four districts, one each in all four provinces of Pakistan, a high tuberculosis (TB) burden country. OBJECTIVES To examine how advocacy, communication and social mobilisation (ACSM) campaigns by the National Tuberculosis Programme (NTP) in Pakistan engaged the populations of interest, to what extent they were successful in promoting services and desired behaviours, and how these campaigns could be improved. DESIGN This was a qualitative case study comprising 13 focus groups and 36 individual interviews in four districts. All three levels of the ACSM programme, i.e., planners, implementers and beneficiaries, were included among the respondents. RESULTS Improved political commitment, availability of funds, partnership with the private sector, visibility of the NTP and access to directly observed treatment (DOT) were achieved. Individual and social environmental issues of poor patients and marginalised communities were addressed to some extent, and could be improved in the future. Empathy and respect from physicians, and better service delivery of the DOTS-based programme were desired by the patients. CONCLUSIONS The strategic advocacy ensured political and financial commitment; however, identification and targeting of vulnerable populations, and carrying out context-based social mobilisation and effective counselling are crucial to increase the use of DOT. Evaluations should be built-in from the beginning to increase the evidence on effectiveness of ACSM campaigns.
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Affiliation(s)
- Z Haq
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA.
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248
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Hogan AM, Mannion M, Ryan RS, Khan W, Waldron R, Barry K. Beware the ischiorectal abscess. Int J Surg Case Rep 2013; 4:299-301. [PMID: 23396392 DOI: 10.1016/j.ijscr.2012.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/01/2012] [Accepted: 08/06/2012] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Ischiorectal abscesses have been shown to form sinuses with various deep structures but continuity with the spinal canal is extremely rare. PRESENTATION OF CASE A previously healthy sixty-five year old man presented emergently with rectal pain, weight loss and recurrent severe tension headaches. He had systemic sepsis and resultant coagulapathy (INR 3.4) which precluded investigation of neurological symptoms by lumbar puncture. MRI rectum demonstrated a well circumscribed fluid collection with direct connection to the spinal canal and containing meningeal tissue. It extended inferiorly to the right ischiorectal fossa and abutted the natal cleft. A radiological diagnosis of ischiorectal abscess which had become continuous with a previously existing anterior sacral myelomeningocoele (ASM) was made. He was treated with broad spectrum antibiotics and a neurosurgical opinion was sought. He remained clinically unwell (septic and coagulopathic) until the abscess fistulated through the perianal skin, draining pus mixed with clear fluid (likely CSF) at which point he improved systemically. DISCUSSION Few general surgeons would be faced with acute management of complicated ASM. Paucity of literature made application of evidence based medicine difficult. In fit healthy patients surgery is the mainstay of treatment as myelomengingoceles do not regress spontaneously. Conservative management is associated with up to 30% mortality (largely due to bacterial meningitis). The patient in this case was adamant that he did not consent to definitive surgical intervention. CONCLUSION This case highlights challenges encountered in the management of complicated ASM in a general hospital.
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Affiliation(s)
- A M Hogan
- Department of Surgery, Mayo General Hospital, Castlebar, Co. Mayo, Ireland; Department of Radiology, Mayo General Hospital, Castlebar, Co. Mayo, Ireland.
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Hammouche S, Khan W, Drouin H, Procter H, McNicholas M. Calcium salts bone regeneration scaffolds: a review article. Curr Stem Cell Res Ther 2013; 7:336-46. [PMID: 22804347 DOI: 10.2174/157488812802481436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 05/15/2012] [Accepted: 05/22/2012] [Indexed: 11/22/2022]
Abstract
A growing array of synthetic bone regeneration scaffolds has been in use over the last century. These scaffolds aim to provide a three dimensional substrate for bone cells to populate on and to function appropriately. The majority of commercially-available scaffolds are based on calcium sulphate salts, calcium phosphate salts, or composites of the two. The mechanical and biological properties of these scaffolds are a result of the properties of the constituent materials and their ratio in the composite. This review addresses the mechanical and biological characteristics and provides an up-to-date summary of the clinical data available about the use of these calcium-based scaffolds. It will also assess the benefit of using stem cell technology along with this type of scaffolds. This article links between the basic science evidence and the clinical outcomes and details the commercially-available options.
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Affiliation(s)
- Salah Hammouche
- Institute of Medical and Biological Engineering University of Leeds, Leeds, The United Kingdom.
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Haddad B, Makki D, Konan S, Park D, Khan W, Okafor B. Dynesys dynamic stabilization: less good outcome than lumbar fusion at 4-year follow-up. Acta Orthop Belg 2013; 79:97-103. [PMID: 23547523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Dynamic semirigid stabilization of the lumbar spine was introduced in 1994 in an attempt to overcome the drawbacks of fusion. It is supposed to preserve motion at the treated levels, while avoiding hypermobility and thus spondylosis at the adjacent levels. Although the early reports showed promising results, the long term effects are still debated. We retrospectively compared outcomes of Dynesys dynamic stabilization with those of the traditional fusion technique. Thirty-two patients who had undergone Dynesys between 2004 and 2006 (group 1) were compared to 32 patients who had been treated with fusion between 2005 and 2006 (group 2). VAS for back and leg pain, and ODI improved significantly in both groups (p < 0.001). These scores were all better in the fusion group, and even significantly so as far as VAS for back pain was concerned (p = 0.014). Similarly, more patients were satisfied or very satisfied after fusion than after Dynesys: 87.5% versus 68.8% (p = 0.04). Interestingly, in the Dynesys group scatter plot graphs showed a positive correlation between older age and improvement in the two VAS scores and in ODI. Dynamic stabilization with Dynesys remains controversial. Older patients are relatively more satisfied about it, probably because of their low level of demands.
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Affiliation(s)
- Behrooz Haddad
- Department of Trauma and Orthopaedics, Whipps Cross University Hospital, London.
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