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Fatima R, Yaqoob A, Qadeer E, Khan MA, Ghafoor A, Jamil B, Haq MU, Ahmed N, Baig S, Rehman A, Abbasi Q, Khan AW, Ikram A, Hicks JP, Walley J. Community- vs. hospital-based management of multidrug-resistant TB in Pakistan. Int J Tuberc Lung Dis 2022; 26:929-933. [PMID: 36163662 DOI: 10.5588/ijtld.21.0695] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multidrug-resistant TB (MDR-TB) treatment takes 18-24 months and is complex, costly and isolating. We provide trial evidence on the WHO Pakistan recommendation for community-based care rather than hospital-based care.METHODS Two-arm, parallel-group, superiority trial was conducted in three programmatic management of drug-resistant TB hospitals in Punjab and Sindh Provinces, Pakistan. We enrolled 425 patients with MDR-TB aged >15 years through block randomisation in community-based care (1-week hospitalisation) or hospital-based care (2 months hospitalisation). Primary outcome was treatment success.RESULTS Among 425 patients with MDR-TB, 217 were allocated to community-based care and 208 to hospital-based care. Baseline characteristics were similar between the community and hospitalised arms, as well as in selected sites. Treatment success was 74.2% (161/217) under community-based care and 67.8% (141/208) under hospital-based care, giving a covariate-adjusted risk difference (community vs. hospital model) of 0.06 (95% CI -0.02 to 0.15; P = 0.144).CONCLUSIONS We found no clear evidence that community-based care was more or less effective than hospital-based care model. Given the other substantial advantages of community-based care over hospital based (e.g., more patient-friendly and accessible, with lower treatment costs), this supports the adoption of the community-based care model, as recommended by the WHO.
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Affiliation(s)
- R Fatima
- Common Management Unit (TB, HIV/AIDS and Malaria), Islamabad, Pakistan
| | - A Yaqoob
- Common Management Unit (TB, HIV/AIDS and Malaria), Islamabad, Pakistan, University of Bergen, Bergen, Norway
| | - E Qadeer
- Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan
| | - M A Khan
- Association for Social Development, Islamabad, Pakistan
| | - A Ghafoor
- National TB Control Program, Islamabad, Pakistan
| | - B Jamil
- Common Management Unit (TB, HIV/AIDS and Malaria), Islamabad, Pakistan
| | - M U Haq
- University of Bergen, Bergen, Norway, National TB Control Program, Islamabad, Pakistan
| | - N Ahmed
- Ojha Institute of Chest Diseases, Karachi, Pakistan
| | - S Baig
- Ojha Institute of Chest Diseases, Karachi, Pakistan
| | - A Rehman
- Gulab Devi Chest Hospital, Lahore, Pakistan
| | - Q Abbasi
- TB Samli Sanatorium Hospital, Murree, Pakistan
| | - A W Khan
- National TB Control Program, Islamabad, Pakistan
| | - A Ikram
- National Institute of Health, Islamabad, Pakistan
| | - J P Hicks
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, UK
| | - J Walley
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, UK
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FANDRI B, Toumi S, Abid H, Chaker H, Ikram A, Najla D, Kammoun K, Yaich S, Ben Hmida M. POS-614 AORTIC ARCH CALCIFICATIONS AND MORTALITY IN HEMODIALYSIS PATIENTS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.647] [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: 10/19/2022] Open
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3
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Rana MS, Usman M, Raisani A, Alam MM, Umair M, Salman M, Ikram A, Zahoor Zaidi SS, Alzahrani KJ, Mehmood N. Age, sex, and comorbidities related trajectories of deceased COVID-19 patients in Balochistan, Pakistan. Eur Rev Med Pharmacol Sci 2022; 26:740-742. [PMID: 35179738 DOI: 10.26355/eurrev_202202_27980] [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: 06/14/2023]
Affiliation(s)
- M S Rana
- National Institute of Health, Islamabad, Pakistan.
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FANDRI B, Ikram A, Najla D, Salma T, Soumaya Y, Hanen C, Khawla K, Mariem S, Tahya B, Mohamed B. POS-512 COMPLEMENT-MEDIATED THROMBOTIC MICROANGIOPATHY IN NEPHROLOGY. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.543] [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: 11/25/2022] Open
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5
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Wang K, Ahmadizar F, Arshi B, Kors J, Ikram A, Kavousi M. Heart rate variability and incident type 2 diabetes mellitus. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3139] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hyperglycemia and autonomic dysfunction are bidirectionally related. The implications from former cross-sectional studies regarding the association of autonomic dysfunction and diabetes are limited due to the potential reverse causation. We aimed to investigate the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes mellitus (T2D) among the general population.
Methods
Using data from the prospective population-based cohort study, 7630 participants with available repeated assessments of HRV, who were free of T2D and atrial fibrillation, were included. Measurements of HRV were analyzed from standard 10-s electrocardiograms records, including heart rate and two time-domain HRV markers: the heart-rate corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and heart-rate corrected root mean square of successive RR-interval differences (RMSSDc). Joint models with the Bayes approach were performed to assess the associations between longitudinal evolutions of heart rate and different HRV metrics with incident T2D during follow-up. Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, use of blood pressure-lowering or lipid-lowering medication, and prevalent cardiovascular disease. Spearmen correlation was used to examine the associations between HRV metrics and glycemic traits (fasting blood glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β)) at baseline.
Results
During a median follow-up time of 8.6 years, 871 individuals developed T2D. Based on joint models, one standard deviation (SD) increment of heart rate (hazard ratio [HR], 1.21; 95% CI, 1.09–1.34), log(SDNNc) (HR, 1.10; 95% CI, 0.94–1.27), and log(RMSSDc) (HR, 1.15; 95% CI, 1.02–1.31) was associated with the risk of developing T2D in fully-adjusted models. Subgroup analyses suggested stronger associations among men. The HRs of incident T2D per SD increment were 1.25 (1.09, 1.43) for men and 1.16 (0.99, 1.35) for women for heart rate, 1.23 (1.01, 1.51) for men and 0.97 (0.78, 1.20) for women for log(SDNNc), and 1.24 (1.05, 1.48) for men and 1.09 (0.89, 1.31) for women for log(RMSSDc). Results did not change after excluding participants who were prediabetes at baseline or after exclusion of underweight participants. Spearmen correlation indicated that heart rate was significantly associated with baseline glycemic traits, while RMSSDc was only related to fasting blood glucose.
Conclusion
Our study suggests that both higher heart rate and heart rate variability are associated with an increased risk of T2D development, especially among men.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Erasmus MC and Erasmus University Rotterdam; Netherlands Organization for Scientific Research; Netherlands Organization for Health Research and Development (ZonMw); Research Institute for Diseases in the Elderly; Netherlands Genomics Initiative; Netherlands Ministry of Education, Culture and Science; Netherlands Ministry of Health, Welfare and Sports; European Commission; and Municipality of Rotterdam. We would like to thank the China Scholarship Council for the scholarship to K.W. Forest plot
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Affiliation(s)
- K Wang
- Erasmus University Medical Centre, Epidemiology, Rotterdam, Netherlands (The)
| | - F Ahmadizar
- Erasmus University Medical Centre, Epidemiology, Rotterdam, Netherlands (The)
| | - B Arshi
- Erasmus University Medical Centre, Epidemiology, Rotterdam, Netherlands (The)
| | - J Kors
- Erasmus University Medical Centre, Medical Informatics, Rotterdam, Netherlands (The)
| | - A Ikram
- Erasmus University Medical Centre, Epidemiology, Rotterdam, Netherlands (The)
| | - M Kavousi
- Erasmus University Medical Centre, Epidemiology, Rotterdam, Netherlands (The)
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Ahmed A, Sana F, Ikram A, Yousaf S, Khan A. Reinfection or relapse of COVID-19 in health care workers; case series of 2 patients from Pakistan. New Microbes New Infect 2021; 42:100896. [PMID: 33996101 PMCID: PMC8106188 DOI: 10.1016/j.nmni.2021.100896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/06/2021] [Revised: 04/24/2021] [Accepted: 05/04/2021] [Indexed: 11/09/2022] Open
Abstract
During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2, main question which has arisen in everyone's mind is about the immune response that may protect from reinfection. Coronaviruses are known for short-term immunity. Their ability of mutations enables them to escape host immunity, thus increasing chances of reinfection. Here we report two cases of reinfection among health care workers who presented with symptoms of COVID-19 disease, after 3 months of first infectious course. Such documentations are necessary for epidemiological purposes and also to monitor response of virus on re-exposure.
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Affiliation(s)
- A Ahmed
- Department of Pathology, Combined Military Hospital Malir, Karachi, Pakistan
| | - F Sana
- Department of Pathology, Combined Military Hospital Malir, Karachi, Pakistan
| | - A Ikram
- National Institute of Health, Islamabad, Pakistan
| | - S Yousaf
- Department of Pathology, Combined Military Hospital Malir, Karachi, Pakistan
| | - A Khan
- Department of Pathology, Combined Military Hospital Malir, Karachi, Pakistan
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Hinduja D, Ikram A, Idoye M, Bidwai A. 789 Improving Compliance of The MUST Tool Through Multiple Interventions, Improves Documentation and Assessment of Nutritional Status in Trauma and Orthopaedic Patients Undergoing Surgery. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.489] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The Malnutrition Universal Screening Tool (MUST) is a nationally validated risk tool, used to identify adults who are malnourished. 40% of surgical patients are malnourished which significantly impacts the outcomes of elderly patients. The primary aim of this study was to ascertain its utilisation in elderly patients undergoing trauma and orthopaedic surgery in a district general hospital.
Method
We completed a closed-loop audit from October2019-June2020 over two, three-week periods Inclusion criteria was age ≥65 years, and patients undergoing surgery. Data collected included MUST score, nutritional support, pre-operative fasting time, and prescription of fluids. Our intervention included departmental teaching sessions, posters, and the addition of the MUST tool to clerking proformas.
Results
We included analysis of 70 patients. Following our intervention, admission MUST score calculation improved by 8%, and providing nutritional support increased by 21%. However, there was no improvement in reducing pre-operative fasting time and prescription of pre-operative fluids.
Conclusions
Through our intervention’s documentation and assessment of nutritional status in elderly patients has improved. However further work must be completed to reduce time spent ‘nil-by-mouth’ and prescribe fluids for maintenance before surgery. This requires better pre-operative planning and communication between the surgical and ward-based teams.
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Affiliation(s)
- D Hinduja
- Kings Mill Hospital, Sutton-In-Ashfield, United Kingdom
- Nottingham University Hospital, Nottingham, United Kingdom
| | - A Ikram
- Nottingham University Hospital, Nottingham, United Kingdom
- Kings Mill Hospital, Sutton-In-Ashfield, United Kingdom
| | - M Idoye
- Kings Mill Hospital, Sutton-In-Ashfield, United Kingdom
| | - A Bidwai
- Kings Mill Hospital, Sutton-In-Ashfield, United Kingdom
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8
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Khan M, Safdar R, Ishaq M, Akhtar M, Farooq U, Arif K, Rehman M, Ikram A. Experience of Cat Scratch Disease (CSD) in Rawalpindi, Pakistan – Could Physician's vigilance help in detection and case management? Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1058] [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] Open
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9
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Ahad A, Salman M, Ikram A, Ashraf Z, Amir A, Saeed A, Ahmad A. Prevalence and molecular Characterization of ESBL-producing Escherichia coli in waste water samples from Pakistan. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.119] [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: 11/25/2022] Open
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10
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Salam A, Majooka I, Ikram A. Development of multi-drug resistance among relapsed tuberculosis drug addicts patients in Punjab Pakistan. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.152] [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: 10/22/2022] Open
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11
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Amir A, Ikram A, Ali Z, Rizwan M, Saeed A, Salman M. Pangenome analysis and reverse vaccinology of XDR Salmonella typhi strain from Pakistan identified novel vaccine targets. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1242] [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: 10/22/2022] Open
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12
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Umair M, Salman M, Ikram A. Genetic diversity and phylogenetic analysis of Crimean Congo hemorrhagic fever virus in Pakistan. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.118] [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: 11/24/2022] Open
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13
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Khattak M, Ikram A, Singh K, Murray B, Shah A. Molecular typing of Enterococcus faecium from clinical specimens: Prevalence of virulence factors in correlation with biofilm formation. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.108] [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: 10/22/2022] Open
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14
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Farooq H, Beveridge N, Fletcher T, Ghani E, Jamil B, Hasan Z, Ikram A, Safdar R, Salman M, Umair M, Latif M, Khan S, Pirkani G, Beeching N. A systematic review on the incidence and mortality of Crimean-Congo Haemorrhagic Fever (CCHF) in Pakistan. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.088] [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: 10/22/2022] Open
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15
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Khan M, Akbar N, Ahmd E, Safdar R, Ansari J, Hussain A, Ikram A. Investigation of a mysterious sking disease; Xeroderma pigmentosum, reported in a tribe in Bolan district of Pakistan, 2019. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.448] [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: 10/22/2022] Open
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Chaudhri M, Bashir U, Rasmussen Z, Hansen C, Ikram A. Development of a Biorisk Management (BRM) program in Pakistan: A Potential Sustainable Country Outreach Model. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Khan MA, Ikram A, Savul S, Lalani FK, Khan MA, Sarfraz M. Decontamination and Reuse of N95 Masks: A Narrative Review. Can J Infect Dis Med Microbiol 2020; 2020:8869472. [PMID: 33299504 PMCID: PMC7710392 DOI: 10.1155/2020/8869472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/01/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has presented an unprecedented strain on healthcare supplies. Currently there is a global shortage of personal protective equipment (PPE), especially N95 masks. In order to safeguard healthcare personnel in this critical time and to mitigate shortages of N95 respirators, reuse of N95 respirators has to be considered. METHODS Using PubMed and Science Direct, a literature search was conducted to find and synthesize relevant literature on decontamination of N95 respirators for their subsequent reuse. Peer-reviewed publications related to methods of decontamination from January 2007 to April 2020 in the English language are included in this narrative review. Bibliographies of articles for relevant literature were also scrutinized. Findings. A total of 19 studies are included in this narrative review. The appraised methods include ultraviolet germicidal irradiation (UVGI), moist heat incubation (MHI), ethylene oxide (EtO), hydrogen peroxide vapor (HPV), microwave steam bags (MSB), microwave-generated steam (MGS), dry microwave oven irradiation, hydrogen peroxide gas plasma (HPGP), dry heat, liquid hydrogen peroxide, and bleach and alcohol. CONCLUSION In light of the COVID-19 pandemic, reuse of N95 respirators, although suboptimal, can be considered. Evidence reveals that UVGI, MHI, and HPV are amongst the safest and efficacious methods for decontamination of N95 masks. More research is needed to establish the safety and effectiveness of MGS, MSB, dry heat, EtO, liquid hydrogen peroxide, and HPGP. Alcohol, microwave irradiation, and bleach are not recommended because they damage N95 respirators.
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Affiliation(s)
- M. A. Khan
- National Institute of Health, Islamabad, Pakistan
| | - A. Ikram
- National Institute of Health, Islamabad, Pakistan
| | - S. Savul
- National Institute of Health, Islamabad, Pakistan
| | - F. K. Lalani
- National Institute of Health, Islamabad, Pakistan
| | - M. A. Khan
- National Institute of Health, Islamabad, Pakistan
| | - M. Sarfraz
- National Institute of Health, Islamabad, Pakistan
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Lloyd TD, Neal‐Smith G, Fennelly J, Claireaux H, Bretherton C, Carr AJ, Murphy M, Kendrick BJ, Palmer AJR, Wong J, Sharma P, Osei‐Bonsu PK, Ashcroft G, Baigent T, Shirland E, Espey R, Stokes M, Liew I, Dhawal A, Watchorn D, Lum J, Qureshi M, Khaled AS, Kauser S, Hodhody G, Rogers S, Haywood‐Alexander B, Sheikh G, Mahapatra P, Twaij H, Chicco M, Arnaout F, Atherton T, Mutimer J, Sinha P, Oliver E, Stedman T, Gadd R, Kutuzov V, Sattar M, Robiati L, Plastow R, Howe T, Hassan A, Lau B, Collins J, Doshi A, Tan G, Baskaran D, Hari Sunil Kumar K, Agarwal R, Horner M, Gwyn R, Masud S, Beaumont O, Pilarski A, Lebe M, Dawson‐Bowling S, Nolan D, Tsitskaris K, Beamish RE, Jordan C, Alsop S, Hibbert E, Deshpande G, Gould A, Briant‐Evans T, Kilbane L, Crowther I, Ingoe H, Naisbitt A, Gourbault L, Muscat J, Goh EL, Gill J, Elbashir M, Modi N, Archer J, Ismael S, Petrie M, O'Brien H, McCormick M, Koh NP, Lloyd T, King A, Ikram A, Peake J, Yoong A, Rye DS, Newman M, Naraen A, Myatt D, Kapur R, Sgardelis P, Kohli S, Culverhouse‐Mathews M, Haynes S, Boden H, Purmah A, Shenoy R, Raja S, Koh NP, Donovan R, Yeomans D, Ritchie D, Larkin R, Aladwan R, Hughes K, Unsworth R, Cooke R, Samra I, Barrow J, Michael K, Byrne F, Anwar R, Karatzia L, Drysdale H, Wilson H, Jones R, Dass D, Liaw F, Aujla R, Kheiran A, Bell K, Ramavath AL, Telfer R, Nachev K, Lawrence H, Garg V, Shenoy P, Lacey A, Byrom I, Simons M, Manning C, Cheyne N, Williams J. Peri‐operative administration of tranexamic acid in lower limb arthroplasty: a multicentre, prospective cohort study. Anaesthesia 2020; 75:1050-1058. [DOI: 10.1111/anae.15056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2020] [Indexed: 12/20/2022]
Affiliation(s)
- T. D. Lloyd
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Oxford Surgical Collaborative for Audit and Research Oxford UK
| | - G. Neal‐Smith
- Oxford Surgical Collaborative for Audit and Research Oxford UK
| | - J. Fennelly
- Oxford Surgical Collaborative for Audit and Research Oxford UK
| | - H. Claireaux
- Oxford Surgical Collaborative for Audit and Research Oxford UK
| | - C. Bretherton
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Oxford Surgical Collaborative for Audit and Research Oxford UK
| | - A. J. Carr
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | - M. Murphy
- University of Oxford UK
- NHS Blood and Transplant Oxford UK
| | - B. J. Kendrick
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
| | - A. J. R. Palmer
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
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Salam A, Majooka I, Ikram A. Development of multi-drug resistance among Relapsed Tuberculosis drug addicts patients in Punjab Pakistan. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.050] [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: 10/25/2022] Open
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Van Der Toorn J, Ochoa OR, Bos D, Vernooij M, Ikram A, Kavousi M. Cardiovascular Risk Profiles For Atherosclerosis In Different Vessels Among Women And Men: A Population-Based Cohort Study. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Khan M, Salman M, Ansari J, Ikram A. Implementation status of international health regulations (IHR) 2005 in Pakistan. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.276] [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: 10/27/2022] Open
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22
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Badar N, Salman M, Ansari J, Bashir U, Mushtaq N, Ahmad H, Ikram A. Chikungunya virus: A major threat to human population and its molecular epidemiology in pakistan. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3847] [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: 10/28/2022] Open
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23
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Thiart M, Ikram A, Lamberts RP. How well can step-off and gap distances be reduced when treating intra-articular distal radius fractures with fragment specific fixation when using fluoroscopy. Orthop Traumatol Surg Res 2016; 102:1001-1004. [PMID: 27751844 DOI: 10.1016/j.otsr.2016.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 08/30/2016] [Accepted: 09/06/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although fragment specific fixation has proved to be an effective treatment regime, it has not been established how successfully this treatment could be performed using fluoroscopy and what the added value of arthroscopy could be. Establish gap and step-off distances after in intra-articular distal radius fractures that have been treated with fragment specific fixation while using fluoroscopy. MATERIAL Forty-four patients with an intra-articular distal radius fracture were treated with fragment specific fixation while using fluoroscopy. METHODS After the treatment of the intra-articular distal radius fracture with fragment specific fixation and the use of fluoroscopy, but before the completion of the surgical intervention, all gap, and step-off distances were determined by using arthroscopy. In addition, the joint was checked for any other wrist pathologies. RESULTS Arthroscopy after the surgical intervention showed that in 37 patients no gap distances could be detected, while in six patients a gap distance of≤2mm was found and in one patient, a gap distance of 3mm. Similarly, arthroscopy revealed no step-off distances in 33 patients, while in 11 patients a step-off distance of≤2mm was found. Although additional wrist pathologies were found in 48% of our population, only one patient needed surgical intervention. Three months after the surgical intervention wrist flexion was 41±10°, wrist extension 51±17°, ulnar deviation 19±10°, radial deviation 32±12° while patients could pronate and supinate their wrist to 85±5° and 74±20°, respectively. CONCLUSION Intra-articular distal radius fractures can be treated successfully with fragment specific fixation and the use of fluoroscopy. As almost all gap and step-off distances could be reduced to an acceptable level, the scope for arthroscopy to further improve this treatment regime is limited. The functional outcome scores that were found 3 months after the surgical intervention were similar to what has been reported in other studies using different treatment option. These findings suggest that fragment specific fixation is a good alternative for treating intra-articular distal radius fractures. As in most cases, only fluoroscopy is needed for fragment specific fixation, this treatment technique is a good treatment option for resource-limited hospitals, setting who do not have access to arthroscopy. LEVEL OF EVIDENCE III, case-control study.
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Affiliation(s)
- M Thiart
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, P.O. Box 19063, Tygerberg, Cape Town 7505, South Africa
| | - A Ikram
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, P.O. Box 19063, Tygerberg, Cape Town 7505, South Africa
| | - R P Lamberts
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, P.O. Box 19063, Tygerberg, Cape Town 7505, South Africa.
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Ikram A, Roche A. Achillon Achilles tendon suture system technical tip. Ann R Coll Surg Engl 2016; 99:337. [PMID: 27791413 DOI: 10.1308/rcsann.2016.0329] [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: 11/22/2022] Open
Affiliation(s)
- A Ikram
- Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust , London , UK
| | - A Roche
- Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust , London , UK
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Rizwan M, Ikram A, Zaman G, Satti L, Ahmed P. Surveillance of device-associated infections in intensive care units of a tertiary care hospital. J Hosp Infect 2016; 95:101-102. [PMID: 27837929 DOI: 10.1016/j.jhin.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022]
Affiliation(s)
- M Rizwan
- Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan
| | - A Ikram
- Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan
| | - G Zaman
- Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan
| | - L Satti
- Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan.
| | - P Ahmed
- Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan
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Ikram A, Singh J, Jagernauth S, Hambidge J. We present our experience (the first in the UK) using the Humelock hemiarthroplasty device for both primary and failed management of proximal humerus fractures. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.392] [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: 11/28/2022]
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Martin A, Imperiale B, Ravolonandriana P, Coban AY, Akgunes A, Ikram A, Satti L, Odoun M, Pandey P, Mishra M, Affolabi D, Singh U, Rasolofo V, Morcillo N, Vandamme P, Palomino JC. Prospective multicentre evaluation of the direct nitrate reductase assay for the rapid detection of extensively drug-resistant tuberculosis. J Antimicrob Chemother 2013; 69:441-4. [DOI: 10.1093/jac/dkt353] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kavousi M, Leening M, Ikram A, Heeringa J, Koudstaal P, Hofman A, Steyerberg E, Franco O, Witteman J. Cardiovascular risk assessment in women: prediction of short-term and long-term risk; the Rotterdam study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1548] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amin N, Byrne E, Johnson J, Chenevix-Trench G, Walter S, Nolte IM, Vink JM, Rawal R, Mangino M, Teumer A, Keers JC, Verwoert G, Baumeister S, Biffar R, Petersmann A, Dahmen N, Doering A, Isaacs A, Broer L, Wray NR, Montgomery GW, Levy D, Psaty BM, Gudnason V, Chakravarti A, Sulem P, Gudbjartsson DF, Kiemeney LA, Thorsteinsdottir U, Stefansson K, van Rooij FJA, Aulchenko YS, Hottenga JJ, Rivadeneira FR, Hofman A, Uitterlinden AG, Hammond CJ, Shin SY, Ikram A, Witteman JCM, Janssens ACJW, Snieder H, Tiemeier H, Wolfenbuttel BHR, Oostra BA, Heath AC, Wichmann E, Spector TD, Grabe HJ, Boomsma DI, Martin NG, van Duijn CM. Genome-wide association analysis of coffee drinking suggests association with CYP1A1/CYP1A2 and NRCAM. Mol Psychiatry 2012; 17:1116-29. [PMID: 21876539 PMCID: PMC3482684 DOI: 10.1038/mp.2011.101] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [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] [Indexed: 12/18/2022]
Abstract
Coffee consumption is a model for addictive behavior. We performed a meta-analysis of genome-wide association studies (GWASs) on coffee intake from 8 Caucasian cohorts (N=18 176) and sought replication of our top findings in a further 7929 individuals. We also performed a gene expression analysis treating different cell lines with caffeine. Genome-wide significant association was observed for two single-nucleotide polymorphisms (SNPs) in the 15q24 region. The two SNPs rs2470893 and rs2472297 (P-values=1.6 × 10(-11) and 2.7 × 10(-11)), which were also in strong linkage disequilibrium (r(2)=0.7) with each other, lie in the 23-kb long commonly shared 5' flanking region between CYP1A1 and CYP1A2 genes. CYP1A1 was found to be downregulated in lymphoblastoid cell lines treated with caffeine. CYP1A1 is known to metabolize polycyclic aromatic hydrocarbons, which are important constituents of coffee, whereas CYP1A2 is involved in the primary metabolism of caffeine. Significant evidence of association was also detected at rs382140 (P-value=3.9 × 10(-09)) near NRCAM-a gene implicated in vulnerability to addiction, and at another independent hit rs6495122 (P-value=7.1 × 10(-09))-an SNP associated with blood pressure-in the 15q24 region near the gene ULK3, in the meta-analysis of discovery and replication cohorts. Our results from GWASs and expression analysis also strongly implicate CAB39L in coffee drinking. Pathway analysis of differentially expressed genes revealed significantly enriched ubiquitin proteasome (P-value=2.2 × 10(-05)) and Parkinson's disease pathways (P-value=3.6 × 10(-05)).
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Affiliation(s)
- N Amin
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - E Byrne
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - J Johnson
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - G Chenevix-Trench
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - S Walter
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - I M Nolte
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - J M Vink
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - R Rawal
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - M Mangino
- Department of Twin Research and Genetic Epidemiology, St Thomas' Hospital Campus, King's College London, London, UK
| | - A Teumer
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University of Greifswald, Greifswald, Germany
| | - J C Keers
- LifeLines Cohort Study and Biobank, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G Verwoert
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S Baumeister
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - R Biffar
- Department of Prosthodontics, Gerodontology and Dental Materials, Center of Oral Health, University of Greifswald, Greifswald, Germany
| | - A Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Greifswald, Germany
| | - N Dahmen
- Department of Psychiatry, University of Mainz, Mainz, Germany
| | - A Doering
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - A Isaacs
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - L Broer
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - N R Wray
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - G W Montgomery
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - D Levy
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA,Center for Population Studies, NHLBI, Bethesda, MD, USA
| | - B M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA,Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland,University of Iceland, Reykjavik, Iceland
| | - A Chakravarti
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology and Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - P Sulem
- deCODE Genetics, Reykjavik, Iceland
| | | | - L A Kiemeney
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands,Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands,Comprehensive Cancer Center East, BG Nijmegen, The Netherlands
| | - U Thorsteinsdottir
- deCODE Genetics, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - K Stefansson
- deCODE Genetics, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - F J A van Rooij
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Y S Aulchenko
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J J Hottenga
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - F R Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - C J Hammond
- Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - S-Y Shin
- Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - A Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J C M Witteman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A C J W Janssens
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H Snieder
- Unit of Genetic Epidemiology and Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,LifeLines Cohort Study and Biobank, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B H R Wolfenbuttel
- LifeLines Cohort Study and Biobank, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B A Oostra
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A C Heath
- Department of Psychiatry, Washington University, St Louis, MI, USA
| | - E Wichmann
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany,Institute of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - T D Spector
- Department of Twin Research and Genetic Epidemiology, St Thomas' Hospital Campus, King's College London, London, UK
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University of Greifswald, Stralsund, Germany
| | - D I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - N G Martin
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - C M van Duijn
- Unit of Genetic Epidemiology, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands,Centre of Medical Systems Biology, Netherlands Consortium on Healthy Aging, Leiden and National Genomics Initiative, The Hague, The Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Dr Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands. E-mail:
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Satti L, Ikram A, Abbasi S, Malik N, Mirza IA, Martin A. Evaluation of thin-layer agar 7H11 for the isolation of Mycobacterium tuberculosis complex. Int J Tuberc Lung Dis 2010; 14:1354-1356. [PMID: 20843431] [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: 05/29/2023] Open
Abstract
We evaluated the thin-layer agar (TLA) method for the recovery of Mycobacterium tuberculosis complex and compared the results with the BACTEC Mycobacteria Growth Indicator Tube (MGIT) 960 system. A total of 53 mycobacterial isolates were isolated on both media. The recovery rates of mycobacteria on TLA and BACTEC MGIT 960 system were respectively 90.6% and 96.2%. Mean time to detection of mycobacteria on TLA was 12.5 compared to 11.2 days on BACTEC MGIT 960. TLA is a simple technique and can be used as an alternative to the Löwenstein-Jensen medium and BACTEC MGIT 960 for the isolation of mycobacteria in resource-poor settings.
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Affiliation(s)
- L Satti
- Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
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Ikram A, Rahman AA, Mostafa NA, Shamsuddin AH. Path flow study of a lab scale cyclonic combustor for coal-biomass co-combustion. 2009 3rd International Conference on Energy and Environment (ICEE) 2009. [DOI: 10.1109/iceenviron.2009.5398604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Putra EGR, Ikram A, Santoso E, Bharoto B. Performance of the 36 m small-angle neutron scattering spectrometer at BATAN, Serpong, Indonesia. J Appl Crystallogr 2007. [DOI: 10.1107/s002188980700605x] [Citation(s) in RCA: 12] [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] [Indexed: 11/11/2022] Open
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Jenkinson R, Ikram A, Horsewill A, Trommsdorff H. The quantum dynamics of proton transfer in benzoic acid measured by single crystal NMR spectroscopy and relaxometry. Chem Phys 2003. [DOI: 10.1016/j.chemphys.2003.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Brougham DF, Horsewill AJ, Ikram A, Ibberson RM, McDonald PJ, Pinter‐Krainer M. The correlation between hydrogen bond tunneling dynamics and the structure of benzoic acid dimers. J Chem Phys 1996. [DOI: 10.1063/1.471940] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Al-Zahrani S, Kremli M, Saadeddin M, Ikram A, Takroni T, Zeidan H. Ultrasonography detection of radiolucent foreign bodies in soft tissue compared to computed tomography scan. Ann Saudi Med 1995; 15:110-2. [PMID: 17587917 DOI: 10.5144/0256-4947.1995.110] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Thirty-one patients with suspected radiolucent foreign bodies (wooden splinters) in soft tissues of extremities were investigated by plain radiography, computed tomography (CT) scan and ultrasonography to the area suspected clinically. Ultrasonography detected and localized radiolucent foreign bodies in 18 of the 31 patients, while only 14 were seen on CT scan. Following surgical exploration, the presence of foreign bodies was confirmed in 20 patients; thus, the accuracy of ultrasonography was 90% while that of CT scan was 70%. The size of foreign body, the presence of infection or the delay in diagnosis had no effect on results. Ultrasonography is clearly a reliable method of detecting radiolucent foreign bodies in soft tissues of extremities.
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Affiliation(s)
- S Al-Zahrani
- Division of Orthopedics, King Khalid University Hospital, Riyadh, and Department of Radiology, Prince Abdullah Bin Abdul Aziz Hospital, Bisha
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Abstract
In this mapping study, the goal was to investigate in 10 subjects the phenomenon of the travelling waves (TW), especially of alpha activity, under conditions of (1) rest, (2) calculations, (3) emotional experience and (4) pain. The TW during wakefulness usually arose from the areas with the highest amplitude of alpha, called major peaks, for both positive (pos.) and negative (neg.) polarities. These areas were Pz (pos. and neg.) at rest, O2 (pos.) and Pz (neg.) during calculation, O1 (pos.) and O2 (neg.) during emotion and T6 (pos.) and O1 (neg.) during pain. When differences were determined between the latter 3 conditions and the resting state, a focal event-related desynchronization (ERD) became evident on T5 during math, on Pz during emotion and on both CP areas during pain. Surrounding the areas of ERD were areas of event-related synchronization (ERS). The TW were related to phase differences between the different electrode locations, seen more frequently with the pos. polarity, and more often with emotion or calculation. The direction of the TW was most often toward the midline during rest, from the right to midline (calculation), from the left to midline (emotion) and from the midline to the left (pain). Changes on one side of the head were often associated with opposite types of changes on the other side. Sleep spindles were also analyzed showing the major peaks on Fz and F4 with pos. polarities often seen anteriorly and neg. polarities posteriorly. TW were also seen with spindles, more often with the positive polarity. The direction was usually from the midline for the positive polarity and toward the midline for the neg. phase. The phenomenon of the TW is discussed, especially its possible neurophysiological significance as a means of transmitting information throughout the brain.
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Affiliation(s)
- J R Hughes
- Epilepsy Clinic, University of Illinois Medical Center, Chicago 60612
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Abstract
We report on 27 patients illustrating the use of non-vascularized single fibular strut graft, augmented with a corticocancellous bone graft to bridge bone defects. The indications were varied and included infection, fracture with bone loss, non-union, bone tumour, bone cyst and congenital pseudarthrosis. Primary union was achieved in 92 per cent. Stress fracture occurred in 26 per cent and no significant fibular graft hypertrophy occurred. The aim of this paper is to show that the non-vascularized single fibular graft, if augmented with corticocancellous bone graft along its whole length, is a simple procedure that is still valid to bridge bone defects.
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Affiliation(s)
- S al-Zahrani
- King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia
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Al-Zahrani SM, Moslem AA, Kremli M, Algosabi NA, Ikram A, Khan FA. Treatment of ipsilateral fractures of the femoral neck and shaft. Ann Saudi Med 1993; 13:365-8. [PMID: 17590702 DOI: 10.5144/0256-4947.1993.365] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We studied 43 patients with ipsilateral femoral shaft and femoral neck fractures who had dynamic hip screw fixation alone or in combincation with dynamic compression plate. All patients except two were diagnosed early; 37 patients had other associated injuries. There were 41 males and two females. The follow-up ranged from eight months to four years (mean 2-1/2 years). Six patients were lost to follow-up. Fracture of the neck of the femur healed in all 37 patients. Four patients had delayed union and two patients developed nonunion of the shaft of the femur. The aim of this paper is to show our experience and results using one technique for the treatment of such fractures.
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Affiliation(s)
- S M Al-Zahrani
- Department of Orthopedics, King Khalid University Hospital, and Department of Orthopedics, Riyadh Central Hospital, Riyadh, Saudi Arabia
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