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Vasudevan V, Amatya B, Chopra S, Zhang N, Astrakhantseva I, Khan F. Minimum technical standards and recommendations for traumatic brain injury specialist rehabilitation teams in sudden-onset disasters (for Disaster Rehabilitation Committee special session). Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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102
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Lee S, Amatya B, Khan F. Applicability of clinical practice guidelines for rehabilitation in traumatic brain injury in disaster settings: A critical appraisal. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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103
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Song K, Amatya B, Khan F. Advance care planning in brain tumour survivors: A prospective study. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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104
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Munbauhal G, Khan F, Cartledge J. Does laparoscopic live donor nephrectomy lead to better perioperative outcomes than pathological nephrectomy in patients less than 40 years? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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105
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Sawhney V, Volkova E, Shaukat M, Khan F, Segal O, Ahsan S, Chow A, Ezzat V, Finlay M, Lambiase P, Lowe M, Dhinoja M, Sporton S, Earley MJ, Hunter RJ, Schilling RJ. Impact of attributed audit on procedural performance in cardiac electrophysiology catheter laboratory. J Interv Card Electrophysiol 2018; 56:199-203. [PMID: 29858762 DOI: 10.1007/s10840-018-0383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/15/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE Audit has played a key role in monitoring and improving clinical practice. However, audit often fails to drive change as summative institutional data alone may be insufficient to do so. We hypothesised that the practice of attributed audit, wherein each individual's procedural performance is presented will have a greater impact on clinical practice. This hypothesis was tested in an observational study evaluating improvement in fluoroscopy times for AF ablation. METHODS Retrospective analyses of fluoroscopy times in AF ablations at the Barts Heart Centre (BHC) from 2012-2017. Fluoroscopy times were compared pre- and post- the introduction of attributed audit in 2012 at St Bartholomew's Hospital (SBH). In order to test the hypothesis, this concept was introduced to a second group of experienced operators from the Heart Hospital (HH) as part of a merger of the two institutions in 2015 and change in fluoroscopy times recorded. RESULTS A significant drop in fluoroscopy times (33.3 ± 9.14 to 8.95 ± 2.50, p < 0.0001) from 2012-2014 was noted after the introduction of attributed audit. At the time of merger, a significant difference in fluoroscopy times between operators from the two centres was seen in 2015. Each operator's procedural performance was shared openly at the audit meeting. Subsequent audits showed a steady decrease in fluoroscopy times for each operator with the fluoroscopy time (min, mean±SD) decreasing from 13.29 ± 7.3 in 2015 to 8.84 ± 4.8 (p < 0.0001) in 2017 across the entire group. CONCLUSIONS Systematic improvement in fluoroscopy times for AF ablation procedures was noted byevaluating individual operators' performance. Attributing data to physicians in attributed audit can promptsignificant improvement and hence should be adopted in clinical practice.
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Abdaal A, Mushtaq Y, Khasati L, Moneim J, Khan F, Ahmed H, Bolton H. Post-menopausal bleeding - Is transvaginal ultrasound a useful first-line investigation in tamoxifen users? Post Reprod Health 2018; 24:72-78. [PMID: 29402191 DOI: 10.1177/2053369118755190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective To evaluate the role of transvaginal ultrasound triage in women with a history of tamoxifen treatment who present with post-menopausal bleeding. Study design A retrospective review was undertaken of patients who presented with symptoms of post-menopausal bleeding and underwent ultrasound triage. Endometrial thickness and ultrasonographic features were then correlated with hysteroscopic and histopathological outcome data. The findings and outcomes for women with a history of tamoxifen use (tamoxifen group) were compared to those who had not taken tamoxifen (non-tamoxifen group). Results A total of 614 women with post-menopausal bleeding underwent transvaginal ultrasound triage, of whom 53 had a history of current or previous tamoxifen treatment. An endometrial thickness of ≥5 mm or the presence of other abnormal features was used to triage women to further investigation by hysteroscopy and biopsy. Endometrial thickness was significantly greater in the tamoxifen group (11 mm vs. 6 mm). Nearly all of the tamoxifen group were triaged to further investigation (98.1%), compared with significantly fewer in the non-tamoxifen group (68.3%) Overall, the incidence of endometrial pathology was also significantly higher in tamoxifen patients (43.4% vs. 31.7%). Conclusion For women presenting with post-menopausal bleeding, the use of transvaginal ultrasound as a triage tool is rarely helpful in evaluating women who have a history as tamoxifen use, as most will require further investigation with hysteroscopy and biopsy. A post-menopausal bleeding protocol that omits transvaginal ultrasound for women with a history of tamoxifen use may be an appropriate and effective pathway for managing these patients.
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107
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Rangan V, George NS, Khan F, Geng Z, Gabbard S, Kichler A, Gittleman H, Fass R. Severity of ineffective esophageal motility is associated with utilization of skeletal muscle relaxant medications. Neurogastroenterol Motil 2018; 30:e13235. [PMID: 29027725 DOI: 10.1111/nmo.13235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/19/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Ineffective esophageal motility (IEM) is the most common finding on high-resolution esophageal manometry (HREM). The underlying mechanisms for IEM remain to be fully elucidated. The aim of this study was to determine if utilization of skeletal muscle relaxants is associated with IEM, and with more severe subtypes of the disorder. METHODS Patients with diagnosis of IEM were gender and age matched to patients with normal HREM. Demographic information, symptoms, endoscopic findings, medication usage and medical comorbidities were recorded. Patients with a diagnosis of IEM were divided into subgroups based on mean distal contractile integral (DCI) and percentage of ineffective swallows, and assessed for clinically significant differences among patients with varying severity of underlying IEM. KEY RESULTS A total of 118 patients were included in each group. There were no significant clinical differences between the group of patients with IEM and the group of patients with normal manometry. Within the group of IEM patients, those with mean DCI < 250 mm Hg/s/cm were more likely to be prescribed skeletal muscle relaxants (27.8% vs 11.0%, P = .044), and those using skeletal muscle relaxants had a larger mean percentage of ineffective swallows (81.1% vs 71.5%, P = .029). There were no significant differences across mean DCI subgroups in usage of any other medication, or in any of the demographic variables or disease comorbidities examined in this study. CONCLUSIONS & INFERENCES Use of skeletal muscle relaxants is associated with more severe IEM, which may suggest a causal association between this class of medications and weaker esophageal peristalsis.
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Mostafa AA, Kostur C, Stamm L, Khan F, Berka N. Characterization of a novel allele, HLA-C*02:135N, by full-length gene sequencing in a bone marrow donor. HLA 2018; 91:538-539. [PMID: 29575749 DOI: 10.1111/tan.13260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 11/28/2022]
Abstract
A frameshift because of a two-nucleotide deletion results in an HLA-C null allele, HLA-C*02:135N.
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Khan S, Tali M, Khan A, Bhat S, Ashraf A, Bhat MH, Khan F, Shah RA. Comparison of efficiency of in vitro cloned sheep embryo production by conventional somatic cell nuclear transfer and handmade cloning technique. Reprod Domest Anim 2018; 53:512-518. [DOI: 10.1111/rda.13138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/13/2017] [Indexed: 11/28/2022]
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110
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Khan F, Amatya B, Groote W, Owolabi M, Syed I, Hajjoui A, Babur M, Sayed T, Frizzell Y, Naicker A, Fourtassi M, Elmalik A, Galea M. Capacity-building in clinical skills of rehabilitation workforce in low- and middle-income countries. J Rehabil Med 2018; 50:472-479. [DOI: 10.2340/16501977-2313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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111
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Khan F, Govender S. Sacroiliac joint involvement in spinal tuberculosis. SA ORTHOPAEDIC JOURNAL 2018. [DOI: 10.17159/2309-8309/2018/v17n3a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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112
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Hasan N, Karkhanis M, Ghosh C, Khan F, Ghosh T, Kim H, Mastrangelo CH. Lightweight Smart Autofocusing Eyeglasses. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10545:1054507. [PMID: 32773917 PMCID: PMC7409531 DOI: 10.1117/12.2300737] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
More than 100 million people in the United States of America alone suffer from age-related presbyopia caused by a loss of focal accommodation of the eye crystalline lens as the lens stiffens with age. The resulting accommodative error or lag produces blurred images of objects placed at different distances. Conventional fixed uniform or graded power eyeglasses cannot provide accommodation thus resulting in significant visual impairment. In this paper we will discuss the implementation of lightweight auto-focusing eyeglasses that augment the accommodative range thus partially or fully restoring normal vision function. The paper discusses some aspects of the construction of tunable power eyepieces and the implementation of accommodation correction algorithms.
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Cheng K, Black A, Negishi K, Khan F, Marwick T. Twelve-Month Safety Outcome of the Rapid Access Chest Pain Clinic at the Royal Hobart Hospital. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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114
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Nicoara D, Khan F, Panchal R, Bennett J, Tufail M. Rapid talc slurry pleurodesis for malignant pleural effusion reduces the length of stay whilst maintaining the pleurodesis success rate. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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115
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Song K, Amatya B, Khan F. Advance care planning in rehabilitation: An implementation study. J Rehabil Med 2018; 50:652-660. [DOI: 10.2340/16501977-2356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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116
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Khan F, Mat A, Hogan AE, Kent BD, Eigenheer S, Corrigan MA, O'Shea D, Butler MW. Preliminary asthma-related outcomes following glucagon-like peptide 1 agonist therapy. QJM 2017; 110:853-854. [PMID: 28673015 DOI: 10.1093/qjmed/hcx125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 06/07/2017] [Indexed: 11/12/2022] Open
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117
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Mostafa AA, Petrosenko M, Stamm L, Khan F, Berka N. A novel HLA-A*26 allele, HLA-A*26:01:44, identified in a Caucasian individual. HLA 2017; 91:127-128. [PMID: 29168355 DOI: 10.1111/tan.13182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 11/29/2022]
Abstract
HLA-A*26:01:44 differs from HLA-A*26:01:01 by a single substitution in exon 5.
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119
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Khan F, Bhatnagar T, Gupta P, Saxena R. Chronic obstructive pulmonary disease: A study of serum biomarkers in cases of acute exacerbation. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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120
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Cobley J, Broadley G, Khan F, Harvey K, Parry C, Rajjayabun P. Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma - What Should We Tell Our Patients? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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121
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Mostafa AA, Petrosenko M, Stamm L, Khan F, Berka N. The novel HLA-B*08:183 allele identified by sequence-based typing in a Caucasian leukemia patient. HLA 2017; 90:367-368. [PMID: 28980457 DOI: 10.1111/tan.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 09/26/2017] [Accepted: 09/26/2017] [Indexed: 11/24/2022]
Abstract
HLA-B*08:183 differs from HLA-B*08:01:01 by a single substitution in exon 5.
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Sawhney V, Shaukat M, Volkova E, Khan F, Segal O, Ashan S, Chow A, Ezzat V, Finlay M, Lambiase P, Lowe M, Dhinoja M, Earley MJ, Sporton S, Hunter RJ, Schilling RJ. 55Impact of open audit on procedural performance in electrophysiology catheter laboratory. Europace 2017. [DOI: 10.1093/europace/eux283.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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123
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Khan F, Williams A, Weiner D, Dhakal S, Constine L. The Impact of Respiratory Developmental Stage on Sensitivity to Late Effects of Radiation in Pediatric Cancer Survivors. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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124
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Srinivasan NT, Orini M, Providencia R, Martin C, Dhinoja M, Hunter R, Lowe MD, Khan F, Taggart PD, Schilling RJ, Lambiase PD. 105Investigation of the transmural action potential duration and repolarization properties of scar borderzone in patients undergoing ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/europace/eux283.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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125
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Casanova F, Adingupu DD, Adams F, Gooding KM, Looker HC, Aizawa K, Dove F, Elyas S, Belch JJF, Gates PE, Littleford RC, Gilchrist M, Colhoun HM, Shore AC, Khan F, Strain WD. The impact of cardiovascular co-morbidities and duration of diabetes on the association between microvascular function and glycaemic control. Cardiovasc Diabetol 2017; 16:114. [PMID: 28915818 PMCID: PMC5603035 DOI: 10.1186/s12933-017-0594-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/04/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Good glycaemic control in type 2 diabetes (T2DM) protects the microcirculation. Current guidelines suggest glycaemic targets be relaxed in advanced diabetes. We explored whether disease duration or pre-existing macrovascular complications attenuated the association between hyperglycaemia and microvascular function. METHODS 743 participants with T2DM (n = 222), cardiovascular disease (CVD = 183), both (n = 177) or neither (controls = 161) from two centres in the UK, underwent standard clinical measures and endothelial dependent (ACh) and independent (SNP) microvascular function assessment using laser Doppler imaging. RESULTS People with T2DM and CVD had attenuated ACh and SNP responses compared to controls. This was additive in those with both (ANOVA p < 0.001). In regression models, cardiovascular risk factors accounted for attenuated ACh and SNP responses in CVD, whereas HbA1c accounted for the effects of T2DM. HbA1c was associated with ACh and SNP response after adjustment for cardiovascular risk factors (adjusted standardised beta (β) -0.096, p = <0.008 and -0.135, p < 0.001, respectively). Pre-existing CVD did not modify this association (β -0.099; p = 0.006 and -0.138; p < 0.001, respectively). Duration of diabetes accounted for the association between HbA1c and ACh (β -0.043; p = 0.3), but not between HbA1c and SNP (β -0.105; p = 0.02). CONCLUSIONS In those with T2DM and CVD, good glycaemic control is still associated with better microvascular function, whereas in those with prolonged disease this association is lost. This suggests duration of diabetes may be a better surrogate for "advanced disease" than concomitant CVD, although this requires prospective validation.
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