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Naz R, Khan MS, Hafeez A, Fazil M, Khan MN, Ali B, Javed MA, Imran M, Shati AA, Alfaifi MY, Elbehairi SEI, Ahmed AE. Assessment of phytoremediation potential of native plant species naturally growing in a heavy metal-polluted industrial soils. BRAZ J BIOL 2024; 84:e264473. [DOI: 10.1590/1519-6984.264473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/25/2022] [Indexed: 12/18/2022] Open
Abstract
Abstract The present study was carried out in Hayat Abad Industrial Estate located in Peshawar to assess the levels of cadmium (Cd) that were present in the soil as well as the plant parts (Roots and shoots). To evaluate the phytoremediation potential of the plants different factors i.e. Bioconcentration Factor (BCF), Translocation Factor (TF), and Bioaccumulation Coefficient were determined. These plants were grown in their native habitats (BAC). We have analysed, cadmium concentration from soil which are collected from 50 different locations ranged from 11.54 mg/Kg (the lowest) to 89.80 mg/Kg (highest). The maximum concentration (89.80 mg/Kg) of cadmium was found in HIE-ST-16L Marble City and HIE-ST-7 Bryon Pharma (88.51 mg/Kg) while its minimum concentration (12.47 mg/Kg) were detected in the soil of Site (HIE-ST-14L Royal PVC Pipe) and (11.54 mg/Kg) at the site (HIE-ST-11 Aries Pharma). Most plant species showed huge potential for plant based approaches like phyto-extraction and phytoremediation. They also showed the potential for phyto-stabilization as well. Based on the concentration of cadmium the most efficient plants for phytoextraction were Cnicus benedictus, Parthenium hysterophorus, Verbesina encelioides, Conyza canadensis, Xanthium strumarium, Chenopodium album, Amaranthus viridis, Chenopodiastrum murale, Prosopis juliflora, Convolvulus arvensis, Stellaria media, Arenaria serpyllifolia, Cerastium dichotomum, Chrozophora tinctoria, Mirabilis jalapa, Medicago polymorpha, Lathyrus aphaca, Dalbergia sissoo, Melilotus indicus and Anagallis arvensis. The cadmium heavy metals in the examined soil were effectively removed by these plant species. Cerastium dichotomum, and Chenopodium murale were reported to be effective in phyto-stabilizing Cd based on concentrations of selected metals in roots and BCFs, TFs, and BACs values.
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Affiliation(s)
- R. Naz
- Islamia College, Pakistan
| | | | | | | | - M. N. Khan
- Islamia College, Pakistan; The University of Agriculture, Pakistan
| | - B. Ali
- Quaid-i-Azam University, Pakistan
| | | | | | | | | | - S. E. I. Elbehairi
- King Khalid University, Saudi Arabia; Egyptian Organization for Biological Products and Vaccines – VACSERA Holding Company, Egypt
| | - A. E. Ahmed
- King Khalid University, Saudi Arabia; South Valley University, Egypt
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Betageri O, Ashraf H, Hafeez A, Kerensky R, Huber TS, Massoomi M. An Unusual Cause of Coronary Occlusion During an Abdominal Aortic Aneurysm Repair: Reperfusion With Diagnostic Angiography Only. Cureus 2023; 15:e39610. [PMID: 37388602 PMCID: PMC10306248 DOI: 10.7759/cureus.39610] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/01/2023] Open
Abstract
We present a unique case of a type I peri-operative myocardial infarction during an extensive abdominal aortic aneurysm repair occurring due to the occlusion of a severe stable ostial plaque stenosis by a small overlying thrombus. During coronary angiography, the thrombus was dislodged by the diagnostic catheter which restored normal flow without stent placement. We demonstrate a care approach that was carefully arrived upon through multidisciplinary management with vascular surgery and anesthesiology colleagues.
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Affiliation(s)
- Omkar Betageri
- Cardiology, Maine Medical Center - Tufts University, Portland, USA
| | - Hassan Ashraf
- Cardiology, University of Texas at Houston, Houston, USA
| | - Adam Hafeez
- Cardiology, University of Florida College of Medicine, Gainesville, USA
| | - Richard Kerensky
- Cardiology, University of Florida College of Medicine, Gainesville, USA
| | - Thomas S Huber
- Vascular Surgery, University of Florida College of Medicine, Gainesville, USA
| | - Michael Massoomi
- Cardiology, University of Florida College of Medicine, Gainesville, USA
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3
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Snipes GM, Hafeez A, Marek G, Winchester DE. Sinus bradycardia with haemodynamic compromise following lithium intoxication. Drug Ther Bull 2022; 60:188-191. [PMID: 36008098 DOI: 10.1136/dtb.2022.242946rep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Garrett Michael Snipes
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Adam Hafeez
- Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - George Marek
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - David E Winchester
- Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
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Nawaz H, Ali A, Saleem MH, Ameer A, Hafeez A, Alharbi K, Ezzat A, Khan A, Jamil M, Farid G. Comparative effectiveness of EDTA and citric acid assisted phytoremediation of Ni contaminated soil by using canola (Brassica napus). BRAZ J BIOL 2022; 82:e261785. [PMID: 35703635 DOI: 10.1590/1519-6984.261785] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022] Open
Abstract
Phytoremediation is an ecofriendly technique to clean heavy metals from contaminated soil by the use of high biomass producing plant species. Chelators can help to improve this biological technique by increasing metal solubility. Therefore, a pot experiment was conducted to determine the effect of the chelators EDTA and citric acid (CA) in phytoremediation of Ni contaminated soil by using Brassica napus (canola). Two cultivars of B. napus, Con-II (tolerant) and Oscar (sensitive), were selected after screening and exposed to NiSO4 at 30 ppm at the time of sowing. CA (10 mM) and EDTA (1.5 mM) were applied either alone or in combination with each other after two weeks of Ni treatments. Different parameters like morpho-physiological and biochemical data were recorded after 15 days of chelate application. The results highlighted the successful use of chelating agents (CA and EDTA) not only to ameliorate Ni stress but also to enhance Ni accumulation which is prerequisite for phytoremediation. The basal application of 10 mMCA and 1.5 mM EDTA concentration proved to be effective for the growth of plants. The combination of chelating agents failed to show any synergistic effects.
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Affiliation(s)
- H Nawaz
- University of Education, Division of Science and Technology, Department of Botany, Lahore, Punjab, Pakistan.,University of Sargodha, Department of Botany, Sargodha, Pakistan
| | - A Ali
- University of Sargodha, Department of Botany, Sargodha, Pakistan
| | - M H Saleem
- Agriculture University, College of Plant Science and Technology, MOA Key Laboratory of Crop Ecophysiology and Farming System in the Middle Researches of Yangtze River, Wuhan, China
| | - A Ameer
- University of Agriculture, Department of Botany, Faisalabad, Pakistan
| | - A Hafeez
- Quaid-i-Azam University, Department of Plant Sciences, Islamabad, Pakistan
| | - K Alharbi
- Princess Nourah bint Abdulrahman University, College of Science, Department of Biology, Riyadh, Saudi Arabia
| | - A Ezzat
- King Khalid University, College of Science, Department of Biology, Abha, Saudia Arabia.,South Valley University, Faculty of Veterinary Medicine, Department of Theriogenology, Qena, Egypt
| | - A Khan
- University of Education, Division of Science and Technology, Department of Botany, Lahore, Punjab, Pakistan
| | - M Jamil
- The Islamia University of Bahawalpur, Department of Botany, Bahawalpur, Pakistan
| | - G Farid
- Nuclear Institute for Agriculture and Biology - NIAB, Faisalabad, Pakistan
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O’Connell LV, Hayes C, Ismail M, O’Riordain D, Hafeez A. Attitudes and access of Irish general surgery trainees to robotic surgical training. Surg Open Sci 2022; 9:24-27. [PMID: 35541566 PMCID: PMC9079091 DOI: 10.1016/j.sopen.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/07/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although the use of robotic-assisted surgery is now mainstream for procedures such as robotic prostatectomy and hysterectomy, its role in general surgery is less well established. Access to training in robotics for general surgery trainees in the Republic of Ireland is variable. Further, there are no data on specific attitudes of Irish trainees toward the role of robotics. We aimed to establish attitudes of Irish general surgery trainees toward the perceived utility of robotic surgery as well as access and satisfaction with training. Methods A survey was disseminated to trainees in the Republic of Ireland enrolled in a General Surgery training scheme via email and social media. Data collected included stage of training, intended subspecialty, interest in developing robotic skills, previous exposure to robotic surgery, satisfaction with current access to robotic training, and opinion on formally incorporating training in robotics into the general surgery curriculum. Results The response rate was 53.8%. Of these, 83% reported interest in training in robotics and 66% anticipated using the technology regularly in consultant practice. Previous exposure to robotic-assisted surgery was significantly predictive of interest in developing the skillset (P = .014). More than 71% of trainees reported that they were not satisfied with access to robotic training. Of those satisfied with access, 40% felt there was a role for incorporating robotic training into the curriculum compared to 68% of those dissatisfied. Conclusion Irish general surgery trainees perceive robotic-assisted surgery to be highly relevant to their future practice. There is an unmet need to provide additional training in the skillset. Irish general surgery trainees perceive robotic surgery (RS) to be highly relevant to their future practice. Access to training in RS is limited, and the majority of trainees desire more access to RS training. Most trainees feel that there is a role for incorporating RS training into the curriculum.
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Betageri O, Thomas J, Hafeez A, Massoomi M, Park K. A HIGH RISK PREGNANCY WITH THROMBOTIC THROMBOCYTOPENIC PURPURA AND HEMOLYTIC UREMIC SYNDROME COMPLICATED BY ACUTE MYOCARDIAL INFARCTION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03857-8] [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: 11/24/2022]
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Betageri O, Thompson I, Hafeez A, Shields M, Kerensky R. STEMI IN A COVID-19 PATIENT WITH FACTOR V LEIDEN ON DIRECT-ORAL ANTICOAGULATION THERAPY. J Am Coll Cardiol 2022. [PMCID: PMC8972492 DOI: 10.1016/s0735-1097(22)03178-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Betageri O, Kamisetty S, Hafeez A, Parker A. PERIPARTUM CARDIOMYOPATHY IN THE SETTING OF A COMPLICATED PREGNANCY AND COVID-19 INFECTION. J Am Coll Cardiol 2022. [PMCID: PMC8972518 DOI: 10.1016/s0735-1097(22)03372-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Lithium is a well-established treatment for mood disorders and considered first-line pharmacological therapy for bipolar disorder as per the American Psychiatric Association guidelines. However, lithium is associated with significant toxicity. Cardiotoxicity including sinus node dysfunction is a rare but clinically significant presentation of lithium intoxication. This case report describes an adult male presenting with unstable sinus bradycardia in the setting of acute kidney injury and elevated serum lithium levels. The patient required temporary management with inotropic support and transcutaneous pacing. The patient's heart rate and hypotension improved in parallel with resolution of his acute kidney injury and elevated serum lithium level after treatment with intravenous fluids. Given the prevalence of bradycardia in both the outpatient and inpatient settings, a high index of suspicion is necessary for the prevention and identification of this clinical entity to guide appropriate management.
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Affiliation(s)
- Garrett Michael Snipes
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Adam Hafeez
- Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - George Marek
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - David E Winchester
- Department of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
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Ashraf H, Hafeez A, Ruth G, Choi C. Left Axillary Intra-Aortic Balloon Pump Prolapsing in the Ascending Aorta in an End-Stage Heart Failure Patient Awaiting Transplant. Cardiovasc Revasc Med 2021; 28S:166-168. [PMID: 33965335 DOI: 10.1016/j.carrev.2021.04.030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/11/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
Patients with end-stage heart failure with reduced ejection fraction requiring mechanical support while awaiting heart transplant present a clinical dilemma. Intra-aortic balloon pump (IABPs) provide a modest improvement in hemodynamics and are easy to implant. Left axillary IABP implantation allows patients to engage in daily physical activity pre-transplant. We present a case of a patient awaiting heart transplant with a left axillary IABP that prolapsed above the aortic valve in the ascending aortic root requiring immediate removal. We describe our multi-modal imaging evaluation, and technique to safely remove the IABP and replace a new one into the same left axillary access while preserving vascular access.
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Affiliation(s)
- Hassan Ashraf
- University of Florida College of Medicine, Department of General Internal Medicine, 1600 SW Archer Rd., Gainesville, FL 32610, USA.
| | - Adam Hafeez
- University of Florida College of Medicine, Department of Medicine Division of Cardiovascular Medicine, 1600 SW Archer Rd,, Gainesville, FL 32610, USA.
| | - Garrett Ruth
- University of Florida College of Medicine, Department of Medicine Division of Cardiovascular Medicine, 1600 SW Archer Rd,, Gainesville, FL 32610, USA.
| | - Calvin Choi
- University of Florida College of Medicine, Department of Medicine Division of Cardiovascular Medicine, 1600 SW Archer Rd,, Gainesville, FL 32610, USA.
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11
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Ashraf H, Hafeez A, Vilaro J. Cardiac Amyloid for the Internist. Cureus 2021; 13:e12915. [PMID: 33654598 PMCID: PMC7906274 DOI: 10.7759/cureus.12915] [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] [Accepted: 01/26/2021] [Indexed: 11/05/2022] Open
Abstract
Cardiac amyloid is an uncommon cause of diastolic dysfunction the recognition of which requires the internist to have clinical suspicion to guide diagnosis and treatment. Cardiac amyloid is an infiltrative cardiomyopathy with significant morbidity and mortality. Appropriate diagnosis is important because management of cardiac amyloid differs from typical heart failure with preserved ejection fraction. An astute internist must be able to recognize common findings of cardiac amyloidosis. Here we present a case of a patient presenting with diastolic heart failure and the steps leading towards diagnosis and subsequent treatment.
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Affiliation(s)
- Hassan Ashraf
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Adam Hafeez
- Cardiology, University of Florida College of Medicine, Gainesville, USA
| | - Juan Vilaro
- Cardiology, University of Florida College of Medicine, Gainesville, USA
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12
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Said A, Keeney S, Matka M, Hafeez A, George J, Halalau A. Concomitant use of direct oral anticoagulants and aspirin versus direct oral anticoagulants alone in atrial fibrillation and flutter: a retrospective cohort. BMC Cardiovasc Disord 2020; 20:263. [PMID: 32487114 PMCID: PMC7268433 DOI: 10.1186/s12872-020-01509-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background The benefit of combining aspirin and direct oral anticoagulants on the reduction of cardiovascular events in atrial fibrillation or flutter is not well studied. We aimed to assess whether concurrent aspirin and direct oral anticoagulant therapy for atrial fibrillation or flutter will result in less coronary, cerebrovascular and systemic ischemic events compared to direct oral anticoagulant therapy alone. Methods Retrospective study of adult patients between 18 and 100 years old who have nonvalvular atrial fibrillation or flutter and were started on a direct oral anticoagulant (apixaban, rivaroxaban, or dabigatran), between January 1, 2010 and September 1, 2015 within the Beaumont Health System. Exclusions were history of venous thromboembolic disease and use of other antiplatelet therapies such as P2Y12 inhibitors. Patients were classified into two groups based on concurrent aspirin use and observed for a minimum of 2 years. Primary outcome was major adverse cardiac events, defined as acute coronary syndromes, ischemic strokes, and embolic events. Secondary outcomes were bleeding and death. Results Six thousand four patients were in the final analysis, 57% males and 80% Caucasians, median age 71, interquartile range (63–80). The group exposed to aspirin contained 2908 subjects, and the group unexposed to aspirin contained 3096 subjects. After using propensity scores to balance the baseline characteristics in both groups, the analysis revealed higher rate of major adverse cardiac events in the exposed group compared to the unexposed group, (HR 2.11, 95% CI (1.74–2.56)) with a number needed to harm of 11 (95% CI [9–11]). The rate of bleeding was also higher in the exposed group, (HR 1.30, 95% CI (1.11–1.52)). The rate of death was not statistically different between the groups, (HR 0.87, 95% CI (0.61–1.25)). Conclusions In this observational analysis of patients with atrial fibrillation and flutter, the concomitant use of direct oral anticoagulants and aspirin was associated with an increased risk of both major adverse cardiac and bleeding events when compared to the use of direct oral anticoagulants alone. These findings underscore the potential harm of this combination therapy when used without a clear indication.
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Cami E, Tagami T, Raff G, Gallagher MJ, Fan A, Hafeez A, Willner SJ, Arce PS, George J, Bilolikar A, Chinnaiyan K, Safian RD. Importance of measurement site on assessment of lesion-specific ischemia and diagnostic performance by coronary computed tomography Angiography-Derived Fractional Flow Reserve. J Cardiovasc Comput Tomogr 2020; 15:114-120. [PMID: 32943356 DOI: 10.1016/j.jcct.2020.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 04/24/2020] [Revised: 06/11/2020] [Accepted: 08/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Values of fractional flow reserve (FFRCT) by coronary computed tomography angiography (CTA) decline from the ostium to the terminal vessel, irrespective of stenosis severity. The purpose of this study is to determine if the site of measurement of FFRCT impacts assessment of ischemia and its diagnostic performance relative to invasive FFR (FFRINV). METHODS 1484 patients underwent FFRCT; 1910 vessels were stratified by stenosis severity (normal; <25%, 25-50%, 50-70%, and >70% stenosis). The rates of positive FFRCT (≤0.8) were determined by measuring FFRCT from the terminal vessel and from distal-to-the-lesion. Reclassification rates from positive to negative FFRCT were calculated. Diagnostic performance of FFRCT relative to FFRINV was evaluated in 182 vessels using linear regression, Bland Altman analysis, and receiver operating characteristic (ROC) curves. RESULTS Positive FFRCT was identified in 24.9% of vessels using terminal vessel FFRCT and 10.1% using FFRCT distal-to-the-lesion (p < 0.001). FFRCT obtained distal-to-the-lesion resulted in reclassification of 59.6% of positive terminal FFRCT to negative FFRCT. Relative to FFRINV, there were improvements in specificity (50% to 86%, p < 0.001), diagnostic accuracy (65% to 88%, p < 0.001), positive predictive value (50% to 78%, p < 0.001), and area-under-the-curve (AUC, 0.83 to 0.91, p < 0.001) when FFRCT was measured distal-to-the-lesion. CONCLUSION FFRCT values from the terminal vessel should not be used to assess lesion-specific ischemia due to high rates of false positive results. FFRCT measured distal-to-the-lesion improves the diagnostic performance of FFRCT relative to FFRINV, ensures that FFRCT values are due to lesion-specific ischemia, and could reduce the rate of unnecessary invasive procedures.
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Affiliation(s)
- Elvis Cami
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Travis Tagami
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Gilbert Raff
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Michael J Gallagher
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Austin Fan
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Adam Hafeez
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Stacy J Willner
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Priscilla Sigua Arce
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Julie George
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Abhay Bilolikar
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Kavitha Chinnaiyan
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA
| | - Robert D Safian
- Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA.
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Gomez‐Rojas O, Hafeez A, Gandhi N, Berghea R, Halalau A. Bilateral Vertebral Artery Dissection: A Case Report with Literature Review. Case Rep Med 2020; 2020:8180926. [PMID: 33101417 PMCID: PMC7568148 DOI: 10.1155/2020/8180926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/24/2020] [Accepted: 04/13/2020] [Indexed: 12/20/2022] Open
Abstract
Vertebral artery dissection (VAD) is a rare cause of ischemic stroke in young patients. The largely nonspecific symptoms and delayed presentation pose a serious diagnostic challenge. Medical management with either anticoagulation or antiplatelet therapy is recommended, but there are no reports of successful dual therapy. We report a case of spontaneous bilateral vertebral artery dissections (VADs) treated with both anticoagulation and antiplatelet therapy and a literature review on clinical presentation and the current medical and surgical management options. A 37-year-old healthy female presented to the emergency department with worsening neck pain and headache for two weeks despite over-the-counter medication, block therapy, yoga, and deep tissue neck massage. She denied any trauma but admitted to multiple roller coaster rides over the past few months. CT angiography was concerning for VADs, and MRI brain revealed multiple strokes in the left posterior inferior cerebellar artery (PICA) territory. Cerebral arteriography confirmed the diagnosis of VADs. The patient was initiated on warfarin, along with atorvastatin and aspirin. She was discharged home with no complications and followed up with neurology as an outpatient. MR angiography after three months revealed complete resolution of the dissection. The patient did not report any bleeding complications from dual therapy.
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Affiliation(s)
- Olga Gomez‐Rojas
- Office of Occupational Health, Alexander von Humboldt Peruvian German School, Lima, Peru
| | - Adam Hafeez
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Nikhil Gandhi
- Internal Medicine Department, Ascension Health, St.John Hospital, Detroit, MI, USA
| | - Ramona Berghea
- Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Alexandra Halalau
- Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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15
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Liu MY, Yang Y, Zhang LJ, Pu LH, He DF, Liu JY, Hafeez A, Ding YC, Ma H, Geng QS. Potential predictors for mental stress-induced myocardial ischemia in patients with coronary artery disease. Chin Med J (Engl) 2019; 132:1390-1399. [PMID: 31205095 PMCID: PMC6629334 DOI: 10.1097/cm9.0000000000000260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mental stress-induced myocardial ischemia (MSIMI) is closely associated with adverse cardiac events in patients with coronary artery disease (CAD) and we aimed to determine whether biomarkers and blood pressure could be potential predictors of MSIMI. METHODS This study enrolled 82 patients with documented CAD between June 1, 2017 and November 9, 2017. Patient blood samples were obtained at resting period and at the end of mental arithmetic. Then, patients were assigned to MSIMI positive group and MSIMI negative group. The main statistical methods included linear regression, receiver operating characteristic (ROC) curves, and logistic regression. RESULTS Patients with CAD with MSIMI had significantly greater median resting N-terminal pro-brain natriuretic peptide (NT-proBNP, 141.02 [45.85-202.76] pg/mL vs. 57.95 [27.06-117.64] pg/mL; Z = -2.23, P = 0.03) and mean systolic blood pressure (SBP) (145.56 ± 16.87 mmHg vs. 134.92 ± 18.16 mmHg, Z = -2.13, P = 0.04) when compared with those without MSIMI. After 5-min mental stress task, those who developed MSIMI presented higher elevation of median post-stressor high sensitivity cardiac troponin I (hs-cTnI, 0.020 [0.009-0.100] ng/mL vs. 0.009 [0.009-0.010] ng/mL; Z = -2.45, P = 0.01), post-stressor NT-proBNP (138.96 [39.93-201.56] pg/mL vs. 61.55 [25.66-86.50] pg/mL; Z = -2.15, P = 0.03) compared with those without MSIMI. Using the ROC curves, and after the adjustment for basic characteristics, the multiple logistic regression analysis showed that patients presenting a post-stressor hs-cTnI ≥ 0.015 ng/mL had seven-fold increase in the risk of developing MSIMI (odds ratio [OR]: 7.09; 95% confidence interval [CI]: 1.65-30.48; P = 0.009), a rest NT-proBNP ≥ 80.51 pg/mL had nearly eight-fold increase (OR: 7.85; 95% CI: 1.51-40.82; P = 0.014), a post-stressor NT-proBNP ≥ 98.80 pg/mL had 35-fold increase (OR: 34.96; 95% CI: 3.72-328.50; P = 0.002), a rest SBP ≥ 129.50 mmHg had 11-fold increase (OR: 11.42; 95% CI: 1.21-108.17; P = 0.034). CONCLUSIONS The present study shows that CAD patients with higher hs-cTnI level, and/or greater NT-proBNP and/or SBP are at higher risk of suffering from MSIMI when compared with those without MSIMI, indicating that hs-cTnI, NT-proBNP, SBP might be potential predictors of MSIMI.
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Affiliation(s)
- Mei-Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Ya Yang
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Li-Jun Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Li-Hong Pu
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Dong-Fang He
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jian-Yang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Adam Hafeez
- Deparment of Internal Medicine, Beaumont Health affiliated with Oakland University William Beaumont School of Medicine, Royal Oak, MI 48201, USA
| | - Yu-Chuan Ding
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
| | - Qing-Shan Geng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
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Sadiq N, Qazi U, Rahman A, Hafeez A. Is health a priority among decision-makers of Pakistan? Evidence from Parliamentary questions screening. Public Health 2019; 170:140-145. [PMID: 31051314 DOI: 10.1016/j.puhe.2019.03.005] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/11/2019] [Accepted: 03/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of the study were to assess the interest of Pakistani parliamentarians in health issues, including the comparison of interest by gender, to determine the relation of health issues raised in the parliament with national health priorities set by Pakistan's Health Ministry and to assess the nature of health questions. STUDY DESIGN Cross-sectional study. METHODS We assessed the Pakistani parliamentarians' interest and importance given to the country's health problems by retrospectively counting parliamentary health-related questions raised on the floor of the house from 2012 to 2016. Categorical variables and themes were created and identified respectively based on questions' contents and analyzed in SAS v9.4. RESULTS A total of 25,496 questions were asked in the parliament, out of which 408 (1.60%) were related to health issues seeking basic information and policies. An even smaller proportion (1.31%) of the questions were related to national health priorities. Despite a low ratio of female to male members (1:4), females asked five times more questions about health than their male counterparts. CONCLUSIONS The members of parliament asked a low percentage of questions about health compared to other affairs in the country. It could, therefore, be assumed that they have low interest in health issues of the country, and this might be one of the reasons for the challenging state of health in the country. However, female members asked the majority of questions about health issues and could, therefore, play a vital role in improving the dismal state of the country's health.
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Affiliation(s)
- N Sadiq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.
| | - U Qazi
- Prime Institute of Public Health, Riphah International University, Islamabad, Pakistan.
| | - A Rahman
- Institute of Psychology Health and Society, University of Liverpool, UK.
| | - A Hafeez
- Ministry of National Health Services, Regulation & Coordination, Islamabad, Pakistan.
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Cami E, Tagami T, Raff G, Gallagher M, Chinnaiyan K, Bilolikar AN, Hafeez A, Willner S, Safian R. FRACTIONAL FLOW RESERVE BY CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY (FFRCT): IMPACT OF MEASUREMENT SITE ON ASSESSMENT OF LESION-SPECIFIC ISCHEMIA AND STATISTICAL PERFORMANCE. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32055-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cami E, Tagami T, Raff G, Fonte TA, Renard B, Gallagher MJ, Chinnaiyan K, Bilolikar A, Fan A, Hafeez A, Safian RD. Assessment of lesion-specific ischemia using fractional flow reserve (FFR) profiles derived from coronary computed tomography angiography (FFRCT) and invasive pressure measurements (FFRINV): Importance of the site of measurement and implications for patient referral for invasive coronary angiography and percutaneous coronary intervention. J Cardiovasc Comput Tomogr 2018; 12:480-492. [DOI: 10.1016/j.jcct.2018.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/07/2018] [Accepted: 09/09/2018] [Indexed: 11/27/2022]
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Yousaf MS, Goodarzi Boroojeni F, Vahjen W, Männer K, Hafeez A, Ur-Rehman H, Keller S, Peris S, Zentek J. Encapsulated benzoic acid supplementation in broiler diets influences gut bacterial composition and activity. Br Poult Sci 2017; 58:122-131. [PMID: 27869509 DOI: 10.1080/00071668.2016.1262000] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
1. The present study investigated the effects of encapsulated benzoic acid (BA) supplementation in broiler feed on performance and gastrointestinal microbiota. 2. Eighty broilers were randomly divided into two groups. Birds in the control group were fed on maize-soybean-based diets. Birds in the treatment group were provided the same diet supplemented with 2 g/kg BA encapsulated in a vegetable oil matrix. 3. At the end of the trial (d 35), pH, bacterial composition and metabolites were determined in the crop, jejunum, ileum and caecum. 4. Growth performance variables and pH were not significantly different. 5. BA concentration decreased rapidly in the proximal gut. However, the treatment diet showed higher BA in the crop, jejunum, ileum and caecum. 6. Total lactate in the crop and D-lactate in the jejunum was higher in the BA treated group. Caecal total and branched chain fatty acids were decreased due to the treatment. 7. Lactobacilli populations were significantly altered by BA supplementation. A trend for increased lactobacilli was observed in the crop, while it became significant in the jejunum and ileum. Lactobacillus species responded differently to the treatment. Four of 5 measured Lactobacillus species, particularly in the ileum, followed the course observed for total lactobacilli; only Lactobacillus salivarius was not modified. 8. Correlation analysis showed that BA modified the intestinal microbiota. Lactobacilli correlated negatively to all studied clostridial clusters and enterobacteria. Clostridial clusters IV and XIVa were significantly increased in the jejunum, whereas only clostridial cluster XIVa was increased in the caecum. 9. Encapsulated BA modified the intestinal microbiota which can lead to the conclusion, that the main beneficial mode of action of BA in the gut appears to be the enhancement of lactic acid bacteria, which in turn may act as a vanguard against pathogens.
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Affiliation(s)
- M S Yousaf
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany.,b Department of Physiology , University of Veterinary and Animal Sciences , Lahore , Pakistan
| | - F Goodarzi Boroojeni
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany
| | - W Vahjen
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany
| | - K Männer
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany
| | - A Hafeez
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany
| | - H Ur-Rehman
- b Department of Physiology , University of Veterinary and Animal Sciences , Lahore , Pakistan
| | - S Keller
- c Department of Technical Service , Novus Deutschland GmbH , Gudensberg , Germany
| | - S Peris
- d Department of Technical Service , Novus Europe , Woluwe-Saint-Lambert , Belgium
| | - J Zentek
- a Department of Veterinary Medicine, Institute of Animal Nutrition , Freie Universität Berlin , Berlin , Germany
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Li S, Hafeez A, Noorulla F, Geng X, Shao G, Ren C, Lu G, Zhao H, Ding Y, Ji X. Preconditioning in neuroprotection: From hypoxia to ischemia. Prog Neurobiol 2017; 157:79-91. [PMID: 28110083 DOI: 10.1016/j.pneurobio.2017.01.001] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [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: 09/16/2015] [Revised: 01/08/2017] [Accepted: 01/13/2017] [Indexed: 01/05/2023]
Abstract
Sublethal hypoxic or ischemic events can improve the tolerance of tissues, organs, and even organisms from subsequent lethal injury caused by hypoxia or ischemia. This phenomenon has been termed hypoxic or ischemic preconditioning (HPC or IPC) and is well established in the heart and the brain. This review aims to discuss HPC and IPC with respect to their historical development and advancements in our understanding of the neurochemical basis for their neuroprotective role. Through decades of collaborative research and studies of HPC and IPC in other organ systems, our understanding of HPC and IPC-induced neuroprotection has expanded to include: early- (phosphorylation targets, transporter regulation, interfering RNA) and late- (regulation of genes like EPO, VEGF, and iNOS) phase changes, regulators of programmed cell death, members of metabolic pathways, receptor modulators, and many other novel targets. The rapid acceleration in our understanding of HPC and IPC will help facilitate transition into the clinical setting.
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Affiliation(s)
- Sijie Li
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Adam Hafeez
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Fatima Noorulla
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xiaokun Geng
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA; Department of Neurology, Luhe Hospital, Capital Medical University, Beijing, China
| | - Guo Shao
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Changhong Ren
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Guowei Lu
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Heng Zhao
- Department of Neurosurgery, Stanford University, CA, USA
| | - Yuchuan Ding
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China; Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xunming Ji
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Disorders, Beijing, China.
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Hafeez A, Liu L, Ding Y. Ongoing progress and new developments in the clinical approach to stroke and cerebrovascular disease: new paradigms: a novel outlook into stroke. Neurol Res 2017; 38:477. [PMID: 27320242 DOI: 10.1080/01616412.2016.1192264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Adam Hafeez
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA
| | - Liping Liu
- b Department of Neurology, Tiantan Hospital , Capital Medical University , Beijing , China
| | - Yuchuan Ding
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA
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Wang Y, Hafeez A, Meng F, Zhang R, Wang X, Chen X, Kong Q, Du H, Ma X. The correlation of D-dimer levels with patient outcomes in acute ischemic cerebrovascular disease complicating coronary heart disease. Neurol Res 2017; 38:524-32. [PMID: 27320247 DOI: 10.1080/01616412.2016.1187829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate the correlation between nerve function defect, their degree of recovery, and D-dimer levels in patients with acute ischemic cerebrovascular disease (AICVD) complicating coronary heart disease (CHD) in winter. METHODS From 1 October, 2014 to 31 December, 2014, we enrolled patients in a consecutive manner with AICVD who were hospitalized in the Department of Neurology, Beijing Luhe hospital, Capital Medical University. The patients were selected that had an occurrence of AICVD within the last 14 days. A total of 151 cases were divided into CHD group (n = 77) or non-CHD group (n = 74) based on a diagnosis of CHD. The risk factors, hematological indices associated with the diseases, and the nerve function defect and recovery degrees were compared between the two groups. Moreover, according to the result of the preliminary analysis of the CHD and non-CHD groups, patients were further divided into two subgroups based on whether their D-dimer levels were higher than 0.5 mg/l or not. Finally, the nerve function defect and recovery degrees in each subgroups were compared in pairs. RESULTS Among the patients consecutively enrolled, the percentage of the patients with CHD was 50.99% (77/151) and non-CHD patients was 49.01%. On admission, there was no significant difference in NIHSS scores between the CHD and non-CHD groups. However, there was a significant difference between the CHD and non-CHD groups when comparing the NIHSS scores on 14th day and the mRs scores on 90 (±7)th day after the initial onset (p = 0.006, 0.005). The D-dimer levels of AICVD complicating CHD patients were higher than those not complicating CHD patients (p = 0.006). Those AICVD patients that complicating CHD with also elevated D-dimer levels had most severe neurologic function deficits on 14th day and worst neural function recoveries on 90 (±7)th day after onset (p = 0.001, <0.001). CONCLUSIONS AICVD patients complicating CHD is very common in clinical practice. The AICVD patients that complicating CHD showed worse outcomes within 90 days after initial onset of stroke. The D-dimer levels of patients with AICVD complicating CHD were higher. Patients in the CHD group, whose D-dimer levels were higher than the normal standard, had worst outcomes. Paying close attention to the stage of the coronary artery disease and indicators of the coagulation-fibrinolysis is beneficial in the optimization of the clinical treatment for AICVD patients. Maybe the results of this study could provide some reference for specific groups of stroke patients to accept anticoagulant therapy.
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Affiliation(s)
- Yanling Wang
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China.,c Department of Neurology , Xuanwu Hospital, Capital Medical University , Beijing , China
| | - Adam Hafeez
- b Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA
| | - Fanhua Meng
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China
| | - Ruihua Zhang
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China
| | - Xuemei Wang
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China
| | - Xiaomeng Chen
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China
| | - Qi Kong
- c Department of Neurology , Xuanwu Hospital, Capital Medical University , Beijing , China
| | - Huishan Du
- a Department of Neurology , Beijing Luhe Hospital, Capital Medical University , Beijing , China
| | - Xin Ma
- c Department of Neurology , Xuanwu Hospital, Capital Medical University , Beijing , China
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Shen J, Hafeez A, Stevenson J, Yang J, Yin C, Li F, Wang S, Du H, Ji X, Rafols JA, Geng X, Ding Y. Omega-3 fatty acid supplement prevents development of intracranial atherosclerosis. Neuroscience 2016; 334:226-235. [DOI: 10.1016/j.neuroscience.2016.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 07/15/2016] [Accepted: 08/07/2016] [Indexed: 11/26/2022]
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Hafeez A, Männer K, Schieder C, Zentek J. Effect of supplementation of phytogenic feed additives (powdered vs. encapsulated) on performance and nutrient digestibility in broiler chickens. Poult Sci 2016; 95:622-9. [DOI: 10.3382/ps/pev368] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/14/2015] [Indexed: 11/20/2022] Open
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Hafeez A, Mader A, Ruhnke I, Männer K, Zentek J. Effect of feed grinding methods with and without expansion on prececal and total tract mineral digestibility as well as on interior and exterior egg quality in laying hens. Poult Sci 2015; 95:62-9. [PMID: 26574028 DOI: 10.3382/ps/pev316] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2015] [Indexed: 11/20/2022] Open
Abstract
The grinding of cereals by various milling methods as well as thermal treatment of feed may influence mineral digestibility and egg quality. The present study investigated the effect of feed produced by disc mill (D) and wedge-shaped disc mill (WSD), as mash (M) or expandate (E) on apparent ileal absorption (AIA) and apparent total digestibility (ATD) of calcium, phosphorus, magnesium, zinc, manganese, copper and iron, as well as on egg quality in laying hens. A total of 192 hens (Lohmann Brown) aged 19 wk, were assigned using a randomized design with a 2 × 2 factorial arrangement. Four experimental diets were offered ad libitum. Eggs were analyzed for weight, shape index, area, shell weight per unit surface area, yolk color, air cell, blood spot, Haugh unit, albumen and yolk measures (index, weight, height, width and length), shell measures (surface area, stability, density, thickness and membrane weight), as well as percent contents of albumen, yolk, shell, and shell membrane. The ATD for phosphorus, manganese, and copper was higher in WSD compared with D treatment (P = 0.028, P = 0.028 and P = 0.016, respectively). The interaction between milling methods and thermal treatment influenced ATD of copper (P = 0.033), which was higher in WSD+M group (41.0 ± 20.2) compared with D+E group (-3.21 ± 25.1), whereas no differences were observed for D+M (1.90 ± 37.8) and WSD+E (8.02 ± 36.2) groups. Egg stability tended to be higher in E compared with M treatment (P = 0.055). Albumen weight, percentage albumen weight, and albumen: yolk were higher and percentage yolk weight was lower in D compared with WSD treatment (P = 0.043, P = 0.027, P = 0.024, and P = 0.041, respectively). Number of blood spots was higher in E than M treatment (P = 0.053). In conclusion, use of a wedge-shaped disc mill resulted in higher ATD for phosphorus, manganese, and copper than use of a disc mill; however, digestibility for majority of minerals as well as egg quality parameters was comparable. Therefore, feed produced by either disc mill or wedge-shaped disc mill as mash or expandate may be used for laying hens without negative effects on egg quality.
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Affiliation(s)
- A Hafeez
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - A Mader
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - I Ruhnke
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - K Männer
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - J Zentek
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
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Ruhnke I, Röhe I, Goodarzi Boroojeni F, Knorr F, Mader A, Hafeez A, Zentek J. Feed supplemented with organic acids does not affect starch digestibility, nor intestinal absorptive or secretory function in broiler chickens. J Anim Physiol Anim Nutr (Berl) 2015; 99 Suppl S1:29-35. [DOI: 10.1111/jpn.12313] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- I. Ruhnke
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - I. Röhe
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - F. Goodarzi Boroojeni
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - F. Knorr
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - A. Mader
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - A. Hafeez
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
| | - J. Zentek
- Department of Veterinary Medicine; Institute of Animal Nutrition; Freie Universität Berlin; Berlin Germany
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Kong Q, Hafeez A, Yu W, Ren C, Geng X, Xiao Y, Liu S, Zhang Y, Mao R, Zhou J, Ding Y, Ji X. Acute recanalization of carotid stenosis is not proper: an experimental ischaemic stroke study. Neurol Res 2015; 37:397-402. [DOI: 10.1179/1743132815y.0000000022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Xiao Y, Hafeez A, Zhang Y, Liu S, Kong Q, Duan Y, Luo Y, Ding Y, Shi H, Ji X. Neuroprotection by peripheral nerve electrical stimulation and remote postconditioning against acute experimental ischaemic stroke. Neurol Res 2015; 37:447-53. [PMID: 25819636 DOI: 10.1179/1743132815y.0000000032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Local electrical stimulation (ES) was reported to protect the brain during ischaemic injury, while the protective effect of limb remote ischaemic postconditioning (RIPostC) was confirmed. The aim of this study was to explore whether remote peripheral nerve ES exerted neuroprotection and whether this procedure shared the same neuroprotective mechanism underlying RIPostC. METHODS Stroke in Sprague-Dawley rats was induced by distal middle cerebral artery occlusion (dMCAO). Rats were divided into five groups: dMCAO, RIPostC, ES, nerve resection (NR) + ES and RIPostC+ES. Twenty-four hours after reperfusion, rats were examined for neurobehavioural function, including forelimb fault placing test, Ludmila Belayev 12 score test, and infarct volume. The expression of Bcl-2 and cleaved-caspase-3 in ischaemic cortex was assessed by Western blot. RESULTS In forelimb fault placing test, as compared to the highest score in the stroke-only group, RIPostC, ES and RIPostC+ES groups showed a significantly (P < 0.01) lower score. The results were similar for the Ludmila Belayev 12 score test. The infarct volume of the treatment groups also exhibited significant (P < 0.01) reduction as compared to the stroke-only group. The volume of infarct tissue in the combination of RIPostC+ES was significantly less than RIPostC and ES alone (P < 0.05). Furthermore, NR blocked the ES's protection (P < 0.05) as compared to the ES group by using above-mentioned methods. Bcl-2 was upregulated, while cleaved-caspase-3 was downregulated in the experimental groups as compared to the control group. No difference was found among the experimental groups. DISCUSSION Peripheral nerve ES appears to have a neuroprotective effect in a rat dMCAO model. This effect may indicate a neural protective mechanism underlying beneficial effect of RIPostC.
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Affiliation(s)
- Xiaokun Geng
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Omar Elmadhoun
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Changya Peng
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Xunming Ji
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Adam Hafeez
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Zongjian Liu
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Huishan Du
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Jose A. Rafols
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
| | - Yuchuan Ding
- From the China-America Institute of Neuroscience, Luhe Hospital (X.G., X.J., Z.L., H.D., Y.D.) and Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China; Departments of Neurological Surgery (X.G., O.E., C.P., A.H., Y.D.) and Anatomy and Cell Biology (J.A.R.), Wayne State University School of Medicine, Detroit, MI; and Beijing Institute for Brain Disorders, Beijing, China (X.J.)
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Hafeez A, Mader A, Ruhnke I, Röhe I, Boroojeni FG, Yousaf MS, Männer K, Zentek J. Implication of milling methods, thermal treatment, and particle size of feed in layers on mineral digestibility and retention of minerals in egg contents. Poult Sci 2015; 94:240-8. [PMID: 25630675 DOI: 10.3382/ps/peu070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/20/2022] Open
Abstract
Feed production with different milling methods, thermal treatment, and particle size may influence mineral digestibility and retention in eggs. The present study investigated the impact of roller (R) and hammer (H) mills, mash (M) and expandate (E) with fine (F) and coarse (C) particle sizes, on apparent ileal absorption (AIA) and apparent total digestibility (ATD) and retention of calcium, phosphorus, magnesium, zinc, manganese, copper and iron in yolk, albumen, and shell. A total of 384 hens (Lohmann Brown), 19 weeks old, were assigned using a randomized design with a 2×2×2 factorial arrangement. Eight experimental diets were offered ad libitum during the whole experimental period and one week before for diet adaption. The AIA of magnesium, zinc, copper, and iron was higher in treatment R in comparison with treatment H (P<0.01, P≤0.03, P<0.01 and P<0.01, respectively). The AIA of magnesium was higher in treatment M than treatment E (P<0.01). The AIA of magnesium was higher in treatment C in comparison with treatment F (P≤0.05) due to particle size. The ATD of copper and iron was higher in treatment R than treatment H (P<0.01 and P≤0.03, respectively). The ATD was higher for phosphorus and lower for iron in treatment F than treatment C (P≤0.05 and P≤0.02. respectively). The copper concentration in yolk and albumen was higher in treatment C than treatment F (P<0.01 and P≤0.03, respectively). Besides a few overall interactions, the AIA and ATD of copper and manganese were lower in H+M group than R+M group (P≤0.05). The ATD of iron was higher in the M+C group compared to the M+F group (P<0.01), whereas the albumen zinc concentration was higher in the E+C group than E+F group (P < 0.01). In conclusion, the feed produced by hammer mill had negative effects on AIA and ATD for trace elements in particular, but mineral concentrations in egg contents were mostly comparable for all treatments. Therefore, milling methods, thermal treatment, and particle sizes used in the present study can be used for layer feed formulation without negatively affecting egg quality.
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Affiliation(s)
- A Hafeez
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - A Mader
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - I Ruhnke
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - I Röhe
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - F Goodarzi Boroojeni
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - M S Yousaf
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - K Männer
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
| | - J Zentek
- Institute of Animal Nutrition, Department of Veterinary Medicine, Freie Universität Berlin, Königin-Luise-Str. 49, 14195 Berlin, Germany
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Muzaffar N, Hafeez A, Bashir N, Singh S. Open anterior hip dislocation in a young adult with exposed femoral head and no neurovascular damage. Malays Orthop J 2014; 6:40-2. [PMID: 25279041 DOI: 10.5704/moj.1203.012] [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] [Indexed: 11/05/2022] Open
Abstract
ABSTRACT Anterior hip dislocation is common in younger adults and is the result of severe, high energy trauma such as high-velocity motor vehicle accidents or falls from great heights. A similar mechanism of injury would cause a femur neck fracture in older patients. Of these, open anterior hip dislocations are extremely rare and are usually associated with other soft tissue and bony injuries. We report a case of an open anterior hip dislocation with normal neurovascular status in a third world setting. KEY WORDS trauma, open anterior, dislocation, hip, femoral head, osteonecrosis.
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Affiliation(s)
- N Muzaffar
- Department of Orthopaedics, Hospital for Bone and Joint Surgery, Barzalla, Srinagar, Kashmir, India
| | - A Hafeez
- Department of Orthopaedics, Hospital for Bone and Joint Surgery, Barzalla, Srinagar, Kashmir, India
| | - N Bashir
- Department of Orthopaedics, Hospital for Bone and Joint Surgery, Barzalla, Srinagar, Kashmir, India
| | - S Singh
- Department of Orthopaedics, Hospital for Bone and Joint Surgery, Barzalla, Srinagar, Kashmir, India
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32
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Hafeez A, Mader A, Boroojeni FG, Ruhnke I, Röhe I, Männer K, Zentek J. Impact of thermal and organic acid treatment of feed on apparent ileal mineral absorption, tibial and liver mineral concentration, and tibia quality in broilers. Poult Sci 2014; 93:1754-63. [DOI: 10.3382/ps.2013-03750] [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] [Indexed: 11/20/2022] Open
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33
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Goodarzi Boroojeni F, Vahjen W, Mader A, Knorr F, Ruhnke I, Röhe I, Hafeez A, Villodre C, Männer K, Zentek J. The effects of different thermal treatments and organic acid levels in feed on microbial composition and activity in gastrointestinal tract of broilers. Poult Sci 2014; 93:1440-52. [DOI: 10.3382/ps.2013-03763] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Goodarzi Boroojeni F, Mader A, Knorr F, Ruhnke I, Röhe I, Hafeez A, Männer K, Zentek J. The effects of different thermal treatments and organic acid levels on nutrient digestibility in broilers. Poult Sci 2014; 93:1159-71. [DOI: 10.3382/ps.2013-03563] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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35
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Ren C, Guingab-Cagmat J, Kobeissy F, Zoltewicz S, Mondello S, Gao M, Hafeez A, Li N, Geng X, Larner SF, Anagli J, Hayes RL, Ji X, Ding Y. A neuroproteomic and systems biology analysis of rat brain post intracerebral hemorrhagic stroke. Brain Res Bull 2014; 102:46-56. [PMID: 24583080 DOI: 10.1016/j.brainresbull.2014.02.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 01/19/2014] [Accepted: 02/18/2014] [Indexed: 12/26/2022]
Abstract
Intracerebral hemorrhage (ICH) is a devastating form of stroke leading to a high rate of death and disability worldwide. Although it has been hypothesized that much of the IHC insult occurs in the subacute period mediated via a series of complex pathophysiological cascades, the molecular mechanisms involved in ICH have not been systematically characterized. Among the best approaches to understand the underlying mechanisms of injury and recovery, protein dynamics assessment via proteomics/systems biology platforms represent one of the cardinal techniques optimized for mechanisms investigation and biomarker identification. A proteomics approach may provide a biomarker focused framework from which to identify candidate biomarkers of pathophysiological processes involved in brain injury after stroke. In this work, a neuroproteomic approach (LC-MS/MS) was applied to investigate altered expression of proteins that are induced in brain tissue 3 h after injury in a rat model of ICH. Data from sham and focal ischemic models were also obtained and used for comparison. Based on the differentially expressed protein profile, systems biology analysis was conducted to identify associated cellular processes and related interaction maps. After LC-MS/MS analysis of the 3 h brain lysates, 86 proteins were differentially expressed between hemorrhagic and sham tissues. Furthermore, 38 proteins were differentially expressed between ischemic and sham tissues. On the level of global pathway analysis, hemorrhagic stroke proteins were shown to be involved in autophagy, ischemia, necrosis, apoptosis, calpain activation, and cytokine secretion. Moreover, ischemic stroke proteins were related to cell death, ischemia, inflammation, oxidative stress, caspase activation and apoptotic injury. In conclusion, the proteomic responses identified in this study provide key information about target proteins involved in specific pathological pathways.
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Affiliation(s)
- Changhong Ren
- Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | - Joy Guingab-Cagmat
- Banyan Labs, Banyan Biomarkers Inc., Alachua, FL, USA; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | - Firas Kobeissy
- Department of Psychiatry, Center for Neuroproteomics and Biomarkers Research, University of Florida, Gainesville, FL, USA
| | - Susie Zoltewicz
- Banyan Labs, Banyan Biomarkers Inc., Alachua, FL, USA; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | | | - Mingqing Gao
- Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Adam Hafeez
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ning Li
- Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | - Xiaokun Geng
- Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Stephen F Larner
- Banyan Labs, Banyan Biomarkers Inc., Alachua, FL, USA; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | - John Anagli
- Banyan Labs, Banyan Biomarkers Inc., Alachua, FL, USA
| | - Ronald L Hayes
- Banyan Labs, Banyan Biomarkers Inc., Alachua, FL, USA; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China
| | - Xunming Ji
- Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
| | - Yuchuan Ding
- Xuanwu-Banyan Biomarker Research and Assay Center, Beijing 100053, China; Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
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Bile KM, Hafeez A, Kazi GN, Southall D. Protecting the right to health of internally displaced mothers and children: the imperative of inter-cluster coordination for translating best practices into effective participatory action. East Mediterr Health J 2012; 17:981-9. [PMID: 22355953 DOI: 10.26719/2011.17.12.981] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Substantive progress has been achieved in advancing emergency response interventions during disasters including assistance of internally displaced persons (IDPs). Explicit operational technical guidelines and management strategies have been successfully applied through the "cluster approach". In 2008-09 armed conflict in several districts of the Khyber Pakhtunkhwa (KP) province and the Federally Administered Tribal Areas (FATA) of Pakistan resulted in over 2.7 million IDPs. This report describes the response by the Pakistan government, assisted by the hosting populations and humanitarian partners, to deal with the crisis using the cluster approach to ensure the health protection of the IDPs, particularly mothers and children.
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Rathor H, Mnzava A, Bile K, Hafeez A, Zaman S. Launching the first postgraduate diploma in medical entomology and disease vector control in Pakistan. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.supp.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Sabih F, Bile K, Buehler W, Hafeez A, Nishtar S, Siddiqi S. Implementing the district health system in the framework of primary health care in Pakistan: can the evolving reforms enhance the pace towards the Millennium Development Goals? East Mediterr Health J 2010. [DOI: 10.26719/2010.16.supp.132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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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40
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Hafeez A, Khan Z, Bile KM, Jooma R, Sheikh M. Pakistan human resources for health assessment, 2009. East Mediterr Health J 2010; 16 Suppl:S145-S151. [PMID: 21495600] [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: 05/30/2023]
Abstract
Pakistan faces a human resources for health (HRH) crisis. A cross-sectional survey was conducted to overview frontline health workers. A total of 750 health facilities were surveyed across Pakistan. The median estimate of public sector health care workers in the district health system in Pakistan is 417 288, including 46 153 estimate of public sector health care workers in the district health system in Pakistan is 417 288, including 46 153 doctors and 41 032 nurses. Another estimated 20 000 doctors work in public sector tertiary care hospitals across the country. A total of 3549 health care workers were interviewed regarding job satisfaction and work environment. The private sector had better work environment scores compared with the public sector. Policy dimensions showed an absence of robust policies in practice. The public sector is inadequately staffed and job satisfaction and work environment need improvement. HRH crisis countries should share experiences, and developmental partners should support them in overcoming the HRH crisis.
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Affiliation(s)
- A Hafeez
- Health Services Academy, Islamabad, Pakistan
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41
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Rathor HR, Mnzava A, Bile KM, Hafeez A, Zaman S. Launching the first postgraduate diploma in medical entomology and disease vector control in Pakistan. East Mediterr Health J 2010; 16 Suppl:S76-S81. [PMID: 21495592] [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: 05/30/2023]
Abstract
The Health Services Academy has launched a 12-month postgraduate diploma course in medical entomology and disease vector control. The objective is to create a core of experts trained to prevent and control vector-borne diseases. The course is a response to the serious health and socioeconomic burden caused by a number of vector-borne diseases in Pakistan. The persistence, emergence and re-emergence of these diseases is mainly attributed to the scarcity of trained vector-control experts. The training course attempts to fill the gap in trained manpower and thus reduce the morbidity and mortality due to these diseases, resulting in incremental gains to public health. This paper aims to outline the steps taken to establish the course and the perceived challenges to be addressed in order to sustain its future implementation.
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Affiliation(s)
- H R Rathor
- Medical Entomology and Disease Vector Control, Health Services Academy, Islamabad, Pakistan.
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42
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Sabih F, Bile KM, Buehler W, Hafeez A, Nishtar S, Siddiqi S. Implementing the district health system in the framework of primary health care in Pakistan: can the evolving reforms enhance the pace towards the millennium development goals? East Mediterr Health J 2010; 16 Suppl:S132-S144. [PMID: 21495599] [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: 05/30/2023]
Abstract
There is growing renewed trust in primary health care as the best approach for ensuring equity in the delivery of essential health services. However, Pakistan with one of the most widely spread district health system networks in the region, has not delivered at the expected capacity. A series of health system reform agendas are now stipulated which include the promulgation of an essential health service package, public private partnerships and a people-centred focus. Nevertheless, success of these reforms will hinge on the ability of the three tiers of the government and other stakeholders to work together to improve the overall performance of the district health system. This paper provides an overview of the district health system infrastructure and organization of primary health care services in Pakistan, the evolving governance pattern and the operational significance and merit of health system pillars for effective service implementation.
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Affiliation(s)
- F Sabih
- World Health Organization, Country Office, Islamabad, Pakistan.
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O'Mahony DM, Quinn LM, Hafeez A, Dunne BM, Griffin M, Wilson GF, McDermott RA, Boyle TJ, Connolly EM. The value of preoperative axillary ultrasound staging in the management of early breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1023] [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: 11/16/2022]
Abstract
Abstract
Abstract #1023
Background: The prognosis of breast cancer is strongly associated with the presence of metastatic disease in the axillary lymph nodes at the time of diagnosis. Sentinel lymph node biopsy (SLNB) is the current standard of care for staging a clinically negative axilla in early breast cancer. Approximately 25% of women with early stage breast cancer undergoing SLNB are node positive and require completion axillary lymph node dissection (ALND). Ultrasound guided fine needle aspiration cytology (FNAC) of axillary lymph nodes is a minimally invasive technique that can be used preoperatively to stage the axilla in breast cancer patients, reducing the number of operative procedures required for staging and local control of disease. Aim: To determine the sensitivity and specificity of ultrasound guided axillary FNAC to detect positive axillary lymph nodes in breast cancer patients and to determine the number of patients who avoided unnecessary SLNB. Methods: Newly diagnosed invasive breast cancer patients were prospectively followed from January 2007 to June 2008. Patients with stage IV breast cancer, clinically node positive disease and patients who did not proceed to surgery were excluded. Criteria for a suspicious sonographic axillary node included diffuse cortical thickening >3mm, focal nodular cortical thickening and a mass-like appearance with loss of the fatty hilum. Results: 133 patients who met the inclusion criteria were diagnosed with invasive breast cancer between January 2007 and June 2008. Median age was 60 [21-87]. 49 patients had T1 tumours, 77 patients had T2, and 7 patients had T3 tumours. 126 (95%) patients had axillary ultrasounds, 44 ( 35%) of which showed abnormal axillary lymph nodes. 38 ( 86%) of these 44 patients proceeded to ultrasound guided axillary FNAC and 27 (71%) of these were positive for malignant cells. All patients with positive axillary nodal FNAC underwent axillary clearance and all had positive nodes on final histopathology. The median number of positive nodes was 2, range was 1 to 21. 26 (20%) patients avoided unnecessary SLNB. 82 patients had a negative axillary ultrasound and 27 of these had axillary node positive disease. The median number of positive nodes was 1, the range was 1 to 8.
 
 Conclusion: Ultrasound guided axillary FNAC has a high specificity and positive predictive value in radiologically suspicious nodes. A positive FNAC allows definitive treatment of the axilla in radiological node positive patients and avoids the unnecessary step of SLNB.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1023.
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Affiliation(s)
- DM O'Mahony
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - LM Quinn
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - A Hafeez
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - BM Dunne
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - M Griffin
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - GF Wilson
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - RA McDermott
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - TJ Boyle
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
| | - EM Connolly
- 1 Breast Surgery, Pathology and Radiology, St. James's Hospital, Dublin, Ireland
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Clover AJP, Athanassopoulos A, Hafeez A, Chakrobarty R, Budny PG. Atypical fibroxanthoma: 10-year experience from a single unit. Eur J Plast Surg 2008. [DOI: 10.1007/s00238-008-0229-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Minhas F, Hafeez A, Rehman A. Effect of maternal depression on intake of breastmilk in infants. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.265] [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: 11/25/2022] Open
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46
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Minhas F, Rehman A, Hafeez A, Bilal R. Comparative study of effect of Lactogouges (Metclopromide) and counselling on breastmilk production in mothers. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.266] [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: 11/27/2022] Open
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47
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Lee WS, Hafeez A, Hassan H, Raja NS, Puthucheary SD. Focal non-typhoidal Salmonella infections from a single center in Malaysia. Southeast Asian J Trop Med Public Health 2005; 36:678-82. [PMID: 16124437] [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: 05/04/2023]
Abstract
A retrospective review of patients with focal non-typhoidal Salmonella (NTS) infection was performed to determine its features and outcome. All patients with focal NTS infection admitted to the University of Malaya Medical Center, Malaysia, from 1993 to 2002 were studied. More than half (58%) of the 35 cases (54% male, median age 39 years, range 1.5 months to 79 years) were immunocompromized or had chronic medical conditions. One-third of the patients (34%) had superficial infections (lymphadenitis or subcutaneous tissue infection) and all recovered with antimicrobial therapy alone. Deep infections (66%) noted were: meningitis (9%), osteomyelitis or arthritis (26%), abscesses of the gastrointestinal tract or adjacent organs (20%), and others (11%). Deep infections were more likely to occur in the extremes of age (<6 months or >60 years, p< 0.04), associated with adverse outcomes with an overall mortality rate of 9%, or required major surgery (15%).
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Affiliation(s)
- W S Lee
- Department of Pediatrics, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
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Abstract
Pakistan lies in a zinc deficient area where oral zinc supplementation has been advocated for various reasons. A double blind, randomised case-control study was carried out on pregnant women to evaluate the effects of oral zinc supplementation on the weights of newborns. No significant difference was found in the birth weights between the cases supplemented with 20 mg elemental zinc and controls receiving oral placebos (p=0.57).
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Affiliation(s)
- A Hafeez
- KRL Hospital, Street 61, F-7/4, Islamabad, Pakistan.
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49
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Hafeez A, Kwong WY, Cunningham FO, McCrath JP. Acute cholecystitis — is interval cholecystectomy justifiable? Ir J Med Sci 2005. [DOI: 10.1007/bf03170204] [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]
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50
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Hafeez A, Kiani AG, ud Din S, Muhammad W, Butt K, Shah Z, Mirza Z. Prescription and dispensing practices in public sector health facilities in Pakistan: survey report. J PAK MED ASSOC 2004; 54:187-91. [PMID: 15241995] [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: 04/30/2023]
Abstract
OBJECTIVES To gather information on existing prescription practices, dispensing practices and patient satisfaction in government health services of the NWFP, Baluchistan and Punjab province. METHODS A cross sectional study design was used for this purpose. Ten health care facilities were selected from each province keeping appropriate representation from first level health facilities, district health facilities and tertiary care hospital. Analysis of selected indicators was carried out on the basis of provinces, health facilities, gender and different age groups. RESULTS Documentation of 914 responses was completed from three provinces. Almost equal distribution of encounters was maintained representing different health facilities. Forty seven percent of encounters involved children under 15 years of age. Female patients comprised of 56% and the mean age of the entire sample was 26 years. The mean dispensing time was only 38 seconds, the mean consultation time was 1.79 minutes and the average number of drugs per prescription turned out to be 2.7 out of which only 1.6 drugs were being dispensed from the facility. More than half of the prescriptions contained antibiotics and 15% of patients were prescribed with injectables. Only half of the patients expressed satisfaction with their visit to health facility. CONCLUSIONS Like many other developing countries, prescription and dispensing practices are not satisfactory in public sector health facilities of Pakistan. Appropriate and workable solutions need to be developed and implemented in the country to improve systems. Regular audits and qualitative studies should become part of the effort.
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Affiliation(s)
- A Hafeez
- Department of Pediatrics, KRL Hospital, Islamabad
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