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Müller A, Wouters EF, Koul P, Welte T, Harrabi I, Rashid A, Loh LC, Al Ghobain M, Elsony A, Ahmed R, Potts J, Mortimer K, Rodrigues F, Paraguas SN, Juvekar S, Agarwal D, Obaseki D, Gislason T, Seemungal T, Nafees AA, Jenkins C, Dias HB, Franssen FME, Studnicka M, Janson C, Cherkaski HH, El Biaze M, Mahesh PA, Cardoso J, Burney P, Hartl S, Janssen DJA, Amaral AFS. Association between lung function and dyspnoea and its variation in the multinational Burden of Obstructive Lung Disease (BOLD) study. Pulmonology 2024:S2531-0437(24)00044-8. [PMID: 38614859 DOI: 10.1016/j.pulmoe.2024.03.005] [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: 01/17/2024] [Revised: 03/14/2024] [Accepted: 03/31/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Dyspnoea is a common symptom of respiratory disease. However, data on its prevalence in general populations and its association with lung function are limited and are mainly from high-income countries. The aims of this study were to estimate the prevalence of dyspnoea across several world regions, and to investigate the association of dyspnoea with lung function. METHODS Dyspnoea was assessed, and lung function measured in 25,806 adult participants of the multinational Burden of Obstructive Lung Disease study. Dyspnoea was defined as ≥2 on the modified Medical Research Council (mMRC) dyspnoea scale. The prevalence of dyspnoea was estimated for each of the study sites and compared across countries and world regions. Multivariable logistic regression was used to assess the association of dyspnoea with lung function in each site. Results were then pooled using random-effects meta-analysis. RESULTS The prevalence of dyspnoea varied widely across sites without a clear geographical pattern. The mean prevalence of dyspnoea was 13.7 % (SD=8.2 %), ranging from 0 % in Mysore (India) to 28.8 % in Nampicuan-Talugtug (Philippines). Dyspnoea was strongly associated with both spirometry restriction (FVC CONCLUSION The prevalence of dyspnoea varies substantially across the world and is strongly associated with lung function impairment. Using the mMRC scale in epidemiological research should be discussed.
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Affiliation(s)
- A Müller
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - E F Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - P Koul
- Department of Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - T Welte
- Department of Respiratory Medicine/Infectious Disease, Member of the German Centre for Lung Research, Hannover School of Medicine, Hannover, Germany
| | - I Harrabi
- Faculté de Médecine, Sousse, Tunisia
| | - A Rashid
- RCSI and UCD Malaysia Campus, Penang, Malaysia
| | | | - M Al Ghobain
- King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - A Elsony
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | - J Potts
- National Heart and Lung Institute, Imperial College London, London, UK
| | - K Mortimer
- University of Cambridge, Cambridge, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - F Rodrigues
- Pulmonology Department, Lisbon North Hospital Centre, Lisbon, Portugal; Institute of Environmental Health, Associate Laboratory TERRA, Lisbon Medical School, Lisbon University, Lisbon, Portugal
| | - S N Paraguas
- Philippine College of Chest Physicians, Manila, Philippines
| | - S Juvekar
- KEM Hospital Research Centre, Pune, India
| | - D Agarwal
- KEM Hospital Research Centre, Pune, India
| | - D Obaseki
- Department of Medicine, Obafemi Awolowo University, Nigeria; Faculty of Medicine, University of British Columbia, Canada
| | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - T Seemungal
- Faculty of Medical Sciences, University of West Indies, St Augustine, Trinidad and Tobago
| | | | - C Jenkins
- Woolcock Institute of Medical Research, Sydney, Australia
| | - H B Dias
- Escola Superior de Tecnologia da Saúde de Lisboa, Politecnico de Lisboa, Lisbon, Portugal
| | - F M E Franssen
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Research and Development, Ciro, Horn, the Netherlands
| | - M Studnicka
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | - C Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - H H Cherkaski
- Faculty of Medicine, University Badji Mokhtar, Annaba, Algeria
| | - M El Biaze
- Department of Respiratory Medicine, Faculty of Medicine, Mohammed Ben Abdellah University, Fes, Morocco
| | - P A Mahesh
- Department of Respiratory Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - J Cardoso
- Pulmonology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal; NOVA Medical School, Nova University Lisbon, Lisboa, Portugal
| | - P Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - S Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - D J A Janssen
- Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Research and Development, Ciro, Horn, the Netherlands
| | - A F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
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Rashid A, Kumar M, Lee MJ. A systematic review of participant descriptors reported in studies of adhesive small bowel obstruction. Colorectal Dis 2024. [PMID: 38609340 DOI: 10.1111/codi.16986] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/05/2023] [Accepted: 11/05/2023] [Indexed: 04/14/2024]
Abstract
AIM Reporting of participant descriptors in studies of adhesive small bowel obstruction (ASBO) can help identify characteristics associated with favourable outcomes and allow comparison with other studies and real-world clinical populations. The aim was to identify the pattern of participant descriptors reported in studies assessing interventions for ASBO. METHOD This systematic review was registered with PROSPERO (CRD42021281031) and reported in line with the PRISMA checklist. Systematic searches of Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were undertaken to identify studies assessing operative and non-operative interventions for adults with ASBO. Studies were dual screened for inclusion. Descriptors were categorised into conceptual domains by the research team. RESULTS Searches identified 2648 studies, of which 73 were included. A total of 156 unique descriptors were identified. On average, studies reported 12 descriptors. The most frequently reported descriptors were sex, age, SBO aetiology, history of abdominal surgery, BMI and ASA classification. The highest number of descriptors in a single study was 34, compared to the lowest number of descriptors which was one. Pathway factors were the least frequently described domain. Overall, 37 descriptors were reported in just one study. CONCLUSION There is a lack of consistency in participant descriptors reported in studies of SBO. Furthermore, a significant proportion of the descriptors were used infrequently. This makes it challenging to assess whether study participants are representative of the wider population. Further work is required to develop a Core Descriptor Set to standardise the reporting of patient characteristics and reduce heterogeneity between studies.
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Affiliation(s)
- Adil Rashid
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
| | - Mithun Kumar
- Department of General Surgery, University Hospital Coventry and Warwickshire, Coventry, UK
| | - Matthew J Lee
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
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Amini B, Cuthbert R, Rashid A. Optimising exposure in shoulder arthroplasty: novel use of the Gripper table retraction system. Ann R Coll Surg Engl 2024; 106:195-196. [PMID: 37458213 PMCID: PMC10830334 DOI: 10.1308/rcsann.2022.0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 02/02/2024] Open
Affiliation(s)
- B Amini
- University College London Hospital, UK
| | | | - A Rashid
- University College London Hospital, UK
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Adiamah A, Rashid A, Crooks CJ, Hammond J, Jepsen P, West J, Humes DJ. The impact of urgency of umbilical hernia repair on adverse outcomes in patients with cirrhosis: a population-based cohort study from England. Hernia 2024; 28:109-117. [PMID: 38017324 PMCID: PMC10891219 DOI: 10.1007/s10029-023-02898-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/18/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION Umbilical hernia is common in patients with cirrhosis; however, there is a paucity of dedicated studies on postoperative outcomes in this group of patients. This population-based cohort study aimed to determine the outcomes after emergency and elective umbilical hernia repair in patients with cirrhosis. METHODS Two linked electronic healthcare databases from England were used to identify all patients undergoing umbilical hernia repair between January 2000 and December 2017. Patients were grouped into those with and without cirrhosis and stratified by severity into compensated and decompensated cirrhosis. Length of stay, readmission, 90-day case fatality rate and the odds ratio of 90-day postoperative mortality were defined using logistic regression. RESULTS In total, 22,163 patients who underwent an umbilical hernia repair were included and 297 (1.34%) had cirrhosis. More patients without cirrhosis had an elective procedure, 86% compared with 51% of those with cirrhosis (P < 0.001). In both the elective and emergency settings, patients with cirrhosis had longer hospital length of stay (elective: 0 vs 1 day, emergency: 2 vs 4 days, P < 0.0001) and higher readmission rates (elective: 4.87% vs 11.33%, emergency:11.39% vs 29.25%, P < 0.0001) than those without cirrhosis. The 90-day case fatality rates were 2% and 0.16% in the elective setting, and 19% and 2.96% in the emergency setting in patients with and without cirrhosis respectively. CONCLUSION Emergency umbilical hernia repair in patients with cirrhosis is associated with poorer outcomes in terms of length of stay, readmissions and mortality at 90 days.
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Affiliation(s)
- A Adiamah
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - A Rashid
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - C J Crooks
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - J Hammond
- Division of Hepatobiliary and Transplant Surgery, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Upon Tyne, NE7 7DN, UK
| | - P Jepsen
- Department of Hepatology and Gastroenterology and Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - J West
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, UK
| | - D J Humes
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, UK
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Adiamah A, Rashid A, Crooks CJ, Hammond JS, Jepsen P, West J, Humes DJ. Outcomes after emergency appendicectomy in patients with liver cirrhosis: a population-based cohort study from England. Langenbecks Arch Surg 2023; 408:362. [PMID: 37718378 PMCID: PMC10505594 DOI: 10.1007/s00423-023-03072-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 08/17/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The mortality risk after appendicectomy in patients with liver cirrhosis is predicted to be higher than in the general population given the associated risk of perioperative bleeding, infections and liver decompensation. This population-based cohort study aimed to determine the 90-day mortality risk following emergency appendicectomy in patients with cirrhosis. METHODS Adult patients undergoing emergency appendicectomy in England between January 2001 and December 2018 were identified from two linked primary and secondary electronic healthcare databases, the clinical practice research datalink and hospital episode statistics data. Length of stay, re-admission, case fatality and the odds ratio of 90-day mortality were calculated for patients with and without cirrhosis, adjusting for age, sex and co-morbidity using logistic regression. RESULTS A total of 40,353 patients underwent appendicectomy and of these 75 (0.19%) had cirrhosis. Patients with cirrhosis were more likely to be older (p < 0.0001) and have comorbidities (p < 0.0001). Proportionally, more patients with cirrhosis underwent an open appendicectomy (76%) compared with 64% of those without cirrhosis (p = 0.03). The 90-day case fatality rate was 6.67% in patients with cirrhosis compared with 0.56% in patients without cirrhosis. Patients with cirrhosis had longer hospital length of stay (4 (IQR 3-9) days versus 3 (IQR 2-4) days and higher readmission rates at 90 days (20% vs 11%, p = 0.019). Most importantly, their odds of death at 90 days were 3 times higher than patients without cirrhosis, adjusted odds ratio 3.75 (95% CI 1.35-10.49). CONCLUSION Patients with cirrhosis have a threefold increased odds of 90-day mortality after emergency appendicectomy compared to those without cirrhosis.
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Affiliation(s)
- Alfred Adiamah
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK.
| | - Adil Rashid
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK
| | - Colin J Crooks
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK
| | - John S Hammond
- Division of Hepatobiliary and Transplant Surgery, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Upon Tyne, NE7 7DN, UK
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Joe West
- Population and Lifesciences, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, UK
| | - David J Humes
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, E Floor West Block, QMC Campus, Nottingham, NG7 2UH, UK
- Population and Lifesciences, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, UK
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Ashmore DL, Rashid A, Wilson TR, Halliday V, Lee MJ. Identifying malnutrition in emergency general surgery: systematic review. BJS Open 2023; 7:zrad086. [PMID: 37749757 PMCID: PMC10519817 DOI: 10.1093/bjsopen/zrad086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/27/2023] [Accepted: 07/08/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Emergency general surgery practice is high risk. Surgery is a key part of treatment, with resultant catabolic stress and frequent need for nutritional support. The aim of this study was to examine the current methods of defining and determining malnutrition in emergency general surgery. This included examining the use of nutrition screening and assessment tools and other measures of malnutrition. METHODS MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, trial registries, and relevant journals published between January 2000 and January 2022 were searched for studies of adult patients with any emergency general surgery diagnosis, managed conservatively or operatively, with an assessment of nutritional status. Mixed populations were included if more than 50 per cent of patients were emergency general surgery patients or emergency general surgery results could be separately extracted. Studies in which patients had received nutritional support were excluded. The protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42021285897). RESULTS From 6700 studies screened, 324 full texts were retrieved and 31 were included in the analysis. A definition of malnutrition was provided in 23 studies (75 per cent), with nutritional status being determined by a variety of methods. A total of seven nutrition screening tools and a total of nine 'assessment' tools were reported. To define malnutrition, the most commonly used primary or secondary marker of nutritional status was BMI, followed by albumin level. CONCLUSION Wide variation exists in approaches to identify malnutrition risk in emergency general surgery patients, using a range of tools and nutrition markers. Future studies should seek to standardize nutrition screening and assessment in the emergency general surgery setting as two discrete processes. This will permit better understanding of malnutrition risk in surgical patients.
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Affiliation(s)
- Daniel L Ashmore
- School of Medicine and Population Health, Faculty of Health, University of Sheffield, Sheffield, UK
- Department of General Surgery, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Adil Rashid
- School of Medicine and Population Health, Faculty of Health, University of Sheffield, Sheffield, UK
| | - Timothy R Wilson
- Department of General Surgery, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Vanessa Halliday
- School of Medicine and Population Health, Faculty of Health, University of Sheffield, Sheffield, UK
| | - Matthew J Lee
- School of Medicine and Population Health, Faculty of Health, University of Sheffield, Sheffield, UK
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Leow TW, Rashid A, Lewis-Lloyd CA, Crooks CJ, Humes DJ. Risk of Postoperative Venous Thromboembolism After Benign Colorectal Surgery: Systematic Review and Meta-analysis. Dis Colon Rectum 2023; 66:877-885. [PMID: 37134222 DOI: 10.1097/dcr.0000000000002915] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Venous thromboembolism is a well-established preventable complication after colectomy. Specific guidance on venous thromboembolism prevention after colectomy for benign disease is limited. OBJECTIVE This meta-analysis aimed to quantify the venous thromboembolism risk after benign colorectal resection and determine its variability. DATA SOURCES Following Preferred Reporting Items for Systematic Review and Meta-Analysis and Meta-analysis of Observational Studies in Epidemiology Guidelines (PROSPERO: CRD42021265438), Embase, MEDLINE, and 4 other registered medical literature databases were searched from the database inception to June 21, 2021. STUDY SELECTION Inclusion criteria: randomized controlled trials and large population-based database cohort studies reporting 30-day and 90-day venous thromboembolism rates after benign colorectal resection in patients aged ≥18 years. Exclusion criteria: patients undergoing colorectal cancer or completely endoscopic surgery. MAIN OUTCOME MEASURES Thirty- and 90-day venous thromboembolism incidence rates per 1000 person-years after benign colorectal surgery. RESULTS Seventeen studies were eligible for meta-analysis reporting on 250,170 patients. Pooled 30-day and 90-day venous thromboembolism incidence rates after benign colorectal resection were 284 (95% CI, 224-360) and 84 (95% CI, 33-218) per 1000 person-years. Stratified by admission type, 30-day venous thromboembolism incidence rates per 1000 person-years were 532 (95% CI, 447-664) for emergency resections and 213 (95% CI, 100-453) for elective colorectal resections. Thirty-day venous thromboembolism incidence rates per 1000 person-years after colectomy were 485 (95% CI, 411-573) for patients with ulcerative colitis, 228 (95% CI, 181-288) for patients with Crohn's disease, and 208 (95% CI, 152-288) for patients with diverticulitis. LIMITATIONS High degree of heterogeneity was observed within most meta-analyses attributable to large cohorts minimizing within-study variance. CONCLUSIONS Venous thromboembolism rates remain high up to 90 days after colectomy and vary by indication for surgery. Emergency resections compared to elective benign resections have higher rates of postoperative venous thromboembolism. Further studies reporting venous thromboembolism rates by type of benign disease need to stratify rates by admission type to more accurately define venous thromboembolism risk after colectomy. REGISTRATION NO CRD42021265438.
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Affiliation(s)
- Tjun Wei Leow
- Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Nottingham, United Kingdom
| | - Adil Rashid
- Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Nottingham, United Kingdom
| | - Christopher A Lewis-Lloyd
- Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Nottingham, United Kingdom
| | - Colin J Crooks
- Gastrointestinal and Liver Theme, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Nottingham, United Kingdom
| | - David J Humes
- Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Nottingham, United Kingdom
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Morton AJ, Rashid A, Shim JSC, West J, Humes DJ, Grainge MJ. Long-term adverse effects and healthcare burden of rectal cancer radiotherapy: systematic review and meta-analysis. ANZ J Surg 2023; 93:42-53. [PMID: 36189976 DOI: 10.1111/ans.18059] [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: 05/29/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND As rectal cancer survival increases, more patients survive with potentially severe, long-term gastrointestinal and genitourinary complications from radiotherapy. The burden of these complications for patients and healthcare services is unclear, which this review aims to quantify. METHODS Systematic search of Medline and Embase for randomized-controlled trials (RCTs) and multicentre observational studies published since 2000, reporting hospitalization/procedural intervention for long-term (>6 months post-treatment) gastrointestinal or genitourinary complications after radiotherapy and surgery for rectal cancer. Prevalence values were pooled in a meta-analysis assuming random effects. Organ-preservation patients were excluded. RESULTS 4044 records screened; 24 reports from 23 studies included (15 RCTs, 8 Observational), encompassing 15 438 patients. Twenty-one studies (median follow-up 60 months) reported gastrointestinal complications post-radiotherapy: pooled prevalence 11% (95% confidence interval (95% CI) 8-14%). Thirteen reported small bowel obstruction: prevalence 9% (95% CI 6-12%), a 58% increased risk compared with surgery alone (RR 1.58, 95% CI 1.26-1.98, n = 5 studies). Seven reported fistulas: prevalence 1% (95% CI 1-2%). Thirteen reported genitourinary complications: prevalence 4% (95% CI 1-6%); RR 1.10 (95% CI 0.88-1.38, n = 3 studies) compared with surgery alone. CONCLUSIONS Over 10% of patients are hospitalized for long-term complications following rectal cancer radiotherapy. Serious gastrointestinal complications are commonplace; late small bowel obstruction is more common in patients having radiotherapy and surgery compared with surgery alone. Patients and clinicians need to be aware of these risks.
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Affiliation(s)
- Alastair J Morton
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Colorectal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Adil Rashid
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Colorectal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanna S C Shim
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Joe West
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Colorectal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - David J Humes
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Nottingham Colorectal Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Matthew J Grainge
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.,Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
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Conroy D, Sholklapper T, Lawlor M, Cantalino J, Zwart A, Ayoob M, Danner M, Yung T, Collins B, Lei S, Rashid A, Kumar D, Suy S, Aghdam N, Collins S. Correlation between Obesity and Treatment Failure Following Stereotactic Body Radiation Therapy (SBRT) for Clinically Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1159] [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: 11/16/2022]
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Leow TW, Rashid A, Lewis-Lloyd CA, Crooks CJ, Humes DJ. O042 Risk of postoperative venous thromboembolism following benign colorectal surgery: systematic review and meta-analysis. Br J Surg 2022. [DOI: 10.1093/bjs/znac242.042] [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: 11/05/2022]
Abstract
Abstract
Introduction
Venous thromboembolism (VTE) is a well-established complication after colectomy. VTE prophylaxis guidelines for benign colorectal disease is scarce, partly due to the paucity of studies reporting post-operative VTE rates of benign disease. This meta-analysis aimed to quantify the VTE risk after benign colorectal resection and determine its variability.
Methods
Embase, Medline, and 4 other registered medical databases were searched from database inception to 21 June 2021. Inclusion criteria: RCTs and large population-based database cohort studies reporting 30-day and 90-day VTE rates after benign colorectal resection in patients aged ≥18 years. Exclusion criteria: Patients undergoing colorectal cancer surgery. Studies were grouped for meta-analysis according to post-operative follow-up duration, admission type and indication for surgery.
Results
17 studies were eligible for meta-analysis reporting on 250,170 patients. Pooled 30-day and 90-day VTE incidence rates after benign colorectal resection were 284 (95%CI, 224–360) and 84 (95%CI, 33–218) per 1,000 person-years. Stratified by admission type, 30-day VTE incidence rates per 1,000 person-years were 532 (95% CI, 447–664) for emergency and 213 (95% CI, 100–453) for elective colorectal resections. 30-day VTE incidence rates per 1,000 person-years postcolectomy were 485 (95%CI, 411–573) for ulcerative colitis, 228 (95%CI, 181–288) for Crohn's disease and 208 (95%CI, 152–288) for diverticulitis patients.
Conclusion
VTE rates remain high up to 90-days after colectomy. Emergency compared to elective benign resections have higher rates of post-operative VTE. Further studies reporting VTE rates by type of benign disease need to stratify rates by admission type to more accurately define postcolectomy VTE risk.
Take-home message
VTE risk following benign colorectal surgery is high, especially among those who underwent emergency surgery. Extended venous thromboprophylaxis should be considered for these group of patients.
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Affiliation(s)
- TW Leow
- Gastrointestinal Surgery, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen’s Medical Centre , Nottingham
| | - A Rashid
- Gastrointestinal Surgery, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen’s Medical Centre , Nottingham
| | - CA Lewis-Lloyd
- Gastrointestinal Surgery, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen’s Medical Centre , Nottingham
| | - CJ Crooks
- Gastrointestinal Surgery, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen’s Medical Centre , Nottingham
| | - DJ Humes
- Gastrointestinal Surgery, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen’s Medical Centre , Nottingham
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11
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Alam M, Paul SK, Das BR, Hoque N, Rashid A, Sultana M, Khatun MN, Ahmed S, Nasreen SA, Kobayashi N. Study of Human Brucellosis among Patients with Pyrexia of Unknown Origin by Antibody Detection. Mymensingh Med J 2022; 31:622-629. [PMID: 35780342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study was performed to determine the seropositivity of human brucellosis among the patients suffering from pyrexia of unidentified origin. This cross-sectional study was performed at department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from September 2018 to August 2019; among the patients of pyrexia of unknown origin visited inpatient and outpatient facility of department of Medicine and department of Paediatrics, Mymensingh Medical College Hospital (MMCH) in Mymensingh division of Bangladesh. A total of 400 serum samples were screened by Brucella-specific latex agglutination test to determine seropositivity. Seven percent (7.0%) (28/400) serum samples were found to be seropositive for brucellosis by detecting Brucella-specific antibody at a titer ≥1:160. Therefore, Brucella-specific latex agglutination test may be recommended as a screening test for human brucellosis in developing and underdeveloped countries.
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Affiliation(s)
- M Alam
- Dr Mahbubul Alam, MD Resident, Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Rashid A. Authors' Reply: Mortality Following Appendicectomy in Patients with Liver Cirrhosis-A Systematic Review and Meta-Analysis. World J Surg 2022; 46:2549-2550. [PMID: 35691966 DOI: 10.1007/s00268-022-06618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
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13
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Arain F, Tohid A, Jawad M, Rashid A, Korenis P, Sanchez-Lacay J. Snapshot of a Child and Adolescent Psychiatric ER during Pandemic. Eur Psychiatry 2022. [PMCID: PMC9567720 DOI: 10.1192/j.eurpsy.2022.1085] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The COVID-19 pandemic has disrupted numerous fundamental systems ranging from businesses to education system. The long-term consequences of the Pandemic, namely virtual learning and prolonged social isolation are coming to fruition in Child/Adolescent-Psychiatric Emergency-Rooms (CAP-ER). Discontinuity of in-person attendance of schools has poorly impacted the mental health of children and adolescents (C&A) of low-socioeconomic areas, who often rely on schools for meals, physical activity, and mental-health support. An increase in agitation, suicidal ideation, and a declining school performance has been observed in such situations. Objectives The primary objective of this study is to explore the increase in these symptoms as the presenting complaint in the psychiatric ER. Methods Between April to June 2021 a cross-sectional quality improvement (QI) study was done on children presenting to CAP-ER BronxCare-Hospital NY with psychiatric complaints. Concomitant substance use disorder was determined using CRAFT questionnaire. Results Our data comprised 209 patients (84 M/125 F) with 79 children and 130 adolescents. Ethnicity: 116 Hispanics (56%), 84 African Americans (40%), and 9 others. The most common presenting complaints were aggression (111, 53%), suicidal ideation/suicide attempt (50, 24%), acute exacerbation of chronic illness (7, 3.3%), accidental overdosage (5, 2.3%) and others (36, 17.4). Marijuana was the most used substance (34 patients). Conclusions There has been a surge in severity of presentation of psychiatric disorders among children and adolescents, aggression so far, the most prevalent. Further studies are needed to delineate the social links with this high emergent load and pandemic. Disclosure No significant relationships.
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Arain F, Motamedi N, Hassan N, Zamiri A, Rashid A, Jennings M, Sanchez-Lacay A, Korenis P. “I rather talk on the phone”: Factors affecting compliance with outpatient visits during COVID-19 Pandemic. Eur Psychiatry 2022. [PMCID: PMC9567929 DOI: 10.1192/j.eurpsy.2022.1459] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The COVID-19 pandemic presented a global public-health crisis that demanded healthcare to adapt at an unprecedented pace. While challenging, it also created opportunities for the advancement of novel electronic-treatment-modalities. Telepsychiatry has emerged as an effective method to ensure continuity of care and ensure social distancing.1 Studies indicate that mental-health patients have higher rates of noncompliance to follow-up,
1 thus finding means to increase compliance is critical.
Objectives
The objectives of this study are to determine the impact of telepsychiatry on compliance to follow-up and to identify numbers of psychiatric/medical emergency-room visits, most common contributing factors for admission, and compliance in terms of diagnosis.
Methods
This IRB approved study is a retrospective chart-review, that aims to study children/adolescents (5-18 years) who presented to the Child&Adolescent-Psychiatry Outpatient-clinic from July-December 2020 and engaged in telepsychiatry, compared to a group of patients presented in July-December 2019-Pre-Covid19-Pandemic. A review of clinical characteristics including diagnosis, demographic information, medication, and treatment compliance will be compared as well as admissions to inpatient-psychiatry/emergency-room visits.
Results
Our total sample (N=252) included patients from 2019-Pre-COVID19 (N=111) and 2020 Telehealth during COVID19-Pandemic (N=141). Our data analysis using SPSF and T-test has shown that Telehealth has significantly increased follow-up compliance (Two-tailed P-value=0.04); 2019-Pre-COVID outreach mean=0.06, 2020-Telehealth-during COVID outreach mean=0.02); significantly decreased ER/CPEP visits (P-value=0.02), and decreased In-patient-unit admissions (P-value=0.02).
Conclusions
According to the presented study, the incorporation of telepsychiatry has increased the compliance to psychiatric-care in outpatient and decreased the emergency-room visits and inpatient admission. Sufficient resources and steps need to be taken to further strengthen telehealth services.
Disclosure
No significant relationships.
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Adiamah A, Lewis-Lloyd C, Seehra JK, Rashid A, Dickson E, Moody N, Blackburn L, Reilly JJ, Saunders J, Brooks A. Patterns and mechanisms of major trauma injuries during and after the UK Covid-19 Nationwide lockdown: analysis from a UK Major Trauma Centre. Eur J Trauma Emerg Surg 2022; 48:2831-2839. [PMID: 35583669 PMCID: PMC9115743 DOI: 10.1007/s00068-022-01964-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/22/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare patterns and mechanisms of injuries during and after the UK Nationwide lockdown during the COVID-19 pandemic. METHODS This prospective cohort study included all major trauma admissions during the 10-week period of the nationwide lockdown (09/03/2020-18/05/2020), compared with admissions in the 10-weeks following the full lifting of lockdown restrictions (04/07/20-12/09/2020). Differences in the volume, spectrum and mechanism of injuries presenting during and post-lockdown were compared using Fisher's exact and Chi-squared tests as appropriate. The associated risk of 30-day mortality was examined using univariable and multivariable logistic regression. RESULTS A total of 692 major trauma admissions were included in this analysis. Of these, 237 patients were admitted during the lockdown and 455 patients were admitted post-lockdown. This represented a twofold increase in trauma admission between the two periods. Characteristically, both cohorts had a higher proportion of male patients (73.84% male during lockdown and 72.5% male post-lockdown). There was a noted shift in age groups between both cohorts with an overall more elderly population during lockdown (p = 0.0292), There was a significant difference in mechanisms of injury between the two cohorts. The 3-commonest mechanisms during the lockdown period were: Road traffic accidents (RTA)-31.22%, Falls of less than 2 m-26.58%, and falls greater than 2 m causing 22.78% of major trauma admissions. However, in the post-lockdown period RTAs represented 46.15% of all trauma admissions with falls greater than 2 m causing 17.80% and falls less than 2 m causing 15.16% of major trauma injuries. With falls in the elderly associated with an increased risk of mortality. In terms of absolute numbers, there was a twofold increase in major trauma injuries due to stabbings and shootings, rising from 25 admitted patients during the lockdown to 53 admitted patients post-lockdown. CONCLUSIONS The lifting of lockdown restrictions resulted in a twofold increase in major trauma admissions that was also associated with significant changes in both the demographic and patterns of injuries with RTA's contributing almost half of all injury presentations. TRIAL REGISTRATION This study was classed as a service evaluation and registered with the local audit department, registration number: 20-177C.
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Affiliation(s)
- Alfred Adiamah
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Christopher Lewis-Lloyd
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Jaspreet K Seehra
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Adil Rashid
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Edward Dickson
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Nick Moody
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Lauren Blackburn
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - John-Joe Reilly
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - John Saunders
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Adam Brooks
- East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
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Rashid A, Gupta A, Adiamah A, West J, Grainge M, Humes DJ. Mortality Following Appendicectomy in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis. World J Surg 2022; 46:531-541. [PMID: 34988603 PMCID: PMC8731215 DOI: 10.1007/s00268-021-06373-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 02/07/2023]
Abstract
Introduction With the global prevalence of liver cirrhosis rising, this systematic review aimed to define the perioperative risk of mortality in these patients following appendicectomy. Methods Systematic searches of Medline, EMBASE, Cochrane Library databases, ICTRP, and Clinical trials.gov were undertaken to identify studies including patients with cirrhosis undergoing appendicectomy, published since database inception to March 2021. Studies had to report mortality. Two review authors independently identified eligible studies and extracted data. Pooled analysis of in-patient and 30-day mortality was performed. Results Of the 948 studies identified, four were included and this comprised three nationwide database studies (USA and Denmark) and one multi-centre observational study (Japan). A total of 923 patients had cirrhosis and 167,211 patients did not. In-patient mortality ranged from 0 to 1.7% in patients with cirrhosis and 0.17 to 0.3% in patients without. 30-day mortality was 9% in patients with cirrhosis compared to 0.3% in those without. One study stratified cirrhotic patients into compensated and decompensated groups. In patients with compensated cirrhosis, mortality following laparoscopic appendicectomy (0.5%) was significantly lower than open appendicectomy (3.2%). The meta-analysis highlighted a tenfold increase in perioperative mortality in cirrhotic patients (OR 9.92 (95% CI 4.67 to 21.06, I2 = 28%). All studies reported an increased length of stay in patients with cirrhosis. Conclusion This review suggests that appendicectomy in the cirrhotic population is associated with increased mortality. LA may be safer in this population. Lack of information on cirrhosis severity and failure to control for age and co-morbidities make the results difficult to interpret. Further large population-based studies are required.
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Affiliation(s)
- Adil Rashid
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Alisha Gupta
- School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Alfred Adiamah
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK
| | - Joe West
- Division of Epidemiology and Public Health, School of Medicine, Clinical Sciences Building, City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Matthew Grainge
- Division of Epidemiology and Public Health, School of Medicine, Clinical Sciences Building, City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK
| | - David J Humes
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, E Floor West Block, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.,Division of Epidemiology and Public Health, School of Medicine, Clinical Sciences Building, City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK
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Kokare S, Asif FMA, Mårtensson G, Shoaib-ul-Hasan S, Rashid A, Roci M, Salehi N. A comparative life cycle assessment of stretchable and rigid electronics: a case study of cardiac monitoring devices. Int J Environ Sci Technol (Tehran) 2022; 19:3087-3102. [PMID: 34054976 PMCID: PMC8150627 DOI: 10.1007/s13762-021-03388-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/20/2021] [Accepted: 05/07/2021] [Indexed: 05/20/2023]
Abstract
Stretchable electronics is a new innovation and becoming popular in various fields, especially in the healthcare sector. Since stretchable electronics use less printed circuit boards (PCBs), it is expected that the environmental performance of a stretchable electronics-based device is better than a rigid electronics-based device that provides the same functionalities. Yet, such a study is rarely available. Thus, the main purpose of this research is to perform a comparative life cycle analysis of stretchable and rigid electronics-based devices. This research combines both the case study approach and the research review approach. For the case study, a cardiac monitoring device with both stretchable and rigid electronics is used. The ISO 14044:2006 standard's prescribed LCA approach and ReCiPe 2016 Midpoint (Hierarchist) are followed for the impact assessment using the SimaPro 9.1 software. The LCA results show that the stretchable cardiac monitoring device has better environmental performance in all eighteen impact categories. This research also shows that the manufacturing process of stretchable electronics has lower environmental impacts than those for rigid electronics. The main reasons for the improved environmental performance of stretchable electronics are lower consumption of raw material as well as decreased energy consumption during manufacturing. Based on the LCA results of a cardiac monitoring device, the study concludes that stretchable electronics and their manufacturing process have better environmental performance in comparison with the rigid electronics and their manufacturing process.
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Affiliation(s)
- S. Kokare
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
| | - F. M. A. Asif
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
| | - G. Mårtensson
- Department of Protein Science, KTH Royal Institute of Technology, Mycronic AB Nytorpsvägen 9, 183 03 Täby, Sweden
| | - S. Shoaib-ul-Hasan
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
| | - A. Rashid
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
| | - M. Roci
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
| | - N. Salehi
- Department of Production Engineering, KTH Royal Institute of Technology, Brinellvägen 68, 100 44 Stockholm, Sweden
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Nathan A, Rashid A, Shukla S, Sinha A, Sivathasan S, Rassam J, Smart S, Patel K, Shah N, Lamb B. 198 Immediate Post-Operative PDE5i Therapy Improves Early Erectile Function Outcomes after Robot-Assisted Radical Prostatectomy (RARP). Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function, continence, or safety outcomes.
Method
Data was prospectively collected from a single surgeon in one tertiary centre and retrospectively evaluated. 158 patients were treated with PDE5i therapy post RARP over a two-year period.
Results
There were no significant differences in pre-operative characteristics between the therapy groups. Patients that had bilateral nerve sparing had a mean drop in Erectile Function (EF) score by 5.4 compared to 8.8 in the unilateral group. Additionally, 34.9% of bilateral nerve sparing patients returned to baseline compared to 12.1% of unilateral. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was respectively 9 and 11.1% of immediate (day 1-2), 7 and 14.8% of early (day 3-14) and 9.7 and 9.5% of late (day >14) therapy (p = 0.9 and p = 0.6). For bilateral nerve sparing this was respectively 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p = 0.017 and p = 0.045). Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication, or readmission outcomes.
Conclusions
Immediate PDE5i therapy should be considered in patients following nerve sparing RARP in order to maximise functional outcomes, especially in those undergoing bilateral nerve spare.
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Affiliation(s)
- A Nathan
- Addenbrooke's Hospital, Cambridge, United Kingdom
- University of Cambridge, Cambridge, United Kingdom
| | - A Rashid
- University of Cambridge, Cambridge, United Kingdom
| | - S Shukla
- University of Cambridge, Cambridge, United Kingdom
| | - A Sinha
- University of Cambridge, Cambridge, United Kingdom
| | - S Sivathasan
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Rassam
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Smart
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Patel
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - N Shah
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - B Lamb
- Addenbrooke's Hospital, Cambridge, United Kingdom
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Nathan A, Hanna N, Rashid A, Patel S, Phuah Y, Flora K, Fricker M, Cleaveland P, Kasivisvanathan V, Williams N, Miah S, Shah N, Hines J, Collins J, Sridhar A, Kelkar A, Briggs T, Kelly J, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. 141 New Guidelines to Reduce Unnecessary Blood Tests, Delayed Discharge and Costs Following Robot Assisted Radical Prostatectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
Routine postoperative blood tests (POBT) following robot assisted radical prostatectomy (RARP) are used to evaluate the impact of surgery on pre-existing co-morbidities and to detect early complications. This practice dates back to an era of open surgery, when blood loss and complication rates were higher. We propose new guidelines to improve the specificity of POBT.
Method
The cases of 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in the United Kingdom were retrospectively reviewed to form new guidelines. The new guidelines were prospectively validated in a sample of 300 patients.
Results
Derivation Dataset: 3% and 5% had intra- and post-operative Clavien-Dindo complications, respectively. 15% had clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% had routine blood tests without clinical concerns, none of whom developed a complication. 98% of complications were suspected by clinical judgement. 6% of patients had a discharge delay of ≥ 1 day due to delayed or incomplete blood tests. Validation Dataset: No significant difference existed in complication, clinical concern or transfusion rates between the derivation and validation datasets. Number of POBT requested reduced by 73% (p < 0.001). The new guidelines improved POBT sensitivity for complications from 98% to 100% and specificity from 0% to 74%. Discharge delays reduced from 6% to 0% (p = 0.008). Cost savings were £178 per patient.
Conclusions
Postoperative complications and transfusion following RARP are rare. Routine POBT without clinical indication are unnecessary and inefficient. A guideline-based approach to POBT can reduce costs and optimise discharge without compromising patient safety or care.
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Affiliation(s)
- A Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- University College London, London, United Kingdom
| | - N Hanna
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- University of Cambridge, Cambridge, United Kingdom
| | - A Rashid
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- University of Cambridge, Cambridge, United Kingdom
| | - S Patel
- University College London, London, United Kingdom
| | - Y Phuah
- University College London, London, United Kingdom
| | - K Flora
- University College London, London, United Kingdom
| | - M Fricker
- Newcastle University, Newcastle, United Kingdom
| | - P Cleaveland
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - V Kasivisvanathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - N Williams
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - S Miah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - N Shah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Hines
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - J Collins
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - A Sridhar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - A Kelkar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - T Briggs
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - J Kelly
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - G Shaw
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - P Sooriakumaran
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - P Rajan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Barts Cancer Institute, CR-UK Barts Centre, Queen Mary University of London, London, United Kingdom
| | - B Lamb
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - S Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Hebestreit H, Ullrich M, Graeßner H, Rashid A, Ertl M, Maisch T. Digitale Systeme für Konsile und Fallkonferenzen bei Seltenen Erkrankungen. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01225-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Fricker M, Nathan A, Hannah N, Rashid A, Patel S, Phuah Y, Flora K, Cleaveland P, Kasivisvanathan V, Williams N, Miah S, Shah N, Hines J, Collins J, Sridhar A, Kelkar A, Briggs T, Kelly J, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. O50 New guidelines to reduce unnecessary blood tests, delayed discharge and costs following robot assisted radical prostatectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab282.055] [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: 11/12/2022]
Abstract
Abstract
Introduction
Routine postoperative blood tests (POBT) are used to evaluate the impact of surgery on pre-existing co-morbidities and to detect early complications. This practice dates back to an era of open surgery, when blood loss and complication rates were higher. We propose new guidelines to improve the specificity of POBT.
Method
The cases of 1040 consecutive patients who underwent a primary or salvage RARP at two large tertiary urology centres in the United Kingdom were retrospectively reviewed, and new guidelines were designed. The guidelines were prospectively validated in a cohort of 300 patients.
Result
Derivation Dataset 3% and 5% had intra- and post-operative Clavien-Dindo complications, respectively. 15% had clinical concerns postoperatively. 0.9% required perioperative transfusion. 78% had routine blood tests without clinical concerns, none of whom developed a complication. 98% of complications were suspected by clinical judgement. 6% of patients had a discharge delay of ≥ 1 days due to delayed or incomplete blood tests.
Validation Dataset No significant difference existed in complication, clinical concern or transfusion rates between the derivation and validation datasets. New guidelines improved sensitivity for complications from 98% to 100% and specificity from 0% to 74%. The number of blood tests requested reduced by 73% (P < 0.001). Discharge delays reduced from 6% to 0% (P = 0.008). Cost savings were £178 per patient.
Conclusion
Postoperative complications and transfusion following RARP are rare. Routine POBT without clinical indication are unnecessary and inefficient. A guideline-based approach to POBT can reduce costs and optimise discharge without compromising patient safety or care.
Take-home Message
Routine postoperative blood tests following robot assisted radical prostatectomy are often unnecessary. A guideline-based approach can reduce costs and optimise patient care.
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Affiliation(s)
| | - A Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- University College London
| | - N Hannah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
- University of Cambridge
| | - A Rashid
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
- University of Cambridge
| | | | | | | | - P Cleaveland
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - V Kasivisvanathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - N Williams
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - S Miah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - N Shah
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - J Hines
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - J Collins
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - A Sridhar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - A Kelkar
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - T Briggs
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - J Kelly
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - G Shaw
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
| | - P Sooriakumaran
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- Nuffield Department of Surgical Sciences, University of Oxford
| | - P Rajan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
- Barts Cancer Institute, CR-UK Barts Centre, Queen Mary University of London
| | - B Lamb
- Department of Uro-oncology, Cambridge University Hospitals NHS Foundation Trust
| | - S Nathan
- Department of Uro-oncology, University College London Hospitals NHS Foundation Trust
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Nathan A, Hanna N, Rashid A, Patel S, Phuah Y, Flora K, Sharma A, Cleaveland P, Kasivisvanatha V, William N, Mia S, Collin J, Sridha A, Kelka A, Sha N, Kell J, Briggs T, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. 236 Novel Guidelines to Avoid Routine Blood Tests After Robotic Assisted Radical Prostatectomy (RARP). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.388] [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: 11/13/2022]
Abstract
Abstract
Introduction
Patients undergoing RARP commonly require routine post-operative blood tests. This practice dates from an era of open surgery, with increased blood loss and complications. We aim to improve specificity of blood test requests with novel guidelines.
Method
1039 consecutive RARP patients at two tertiary urology centres in the UK were audited. Novel guidelines constructed based on risk stratified evidence from the initial audit were used to prospectively audit 133 patients.
Results
16% had clinical concerns post-operatively. 1% and 4% had an intra- and post-operative complication. Intra- or post-operative clinical judgement flagged post-operative complications in 99.9%. 80% had routine blood tests with no clinical concerns. 6% had delayed discharge due to delayed processing of blood tests. 0.9% received a peri-operative transfusion.
Re-Audit Novel guidelines reduced the number of blood tests requested from 100% to 36%. Specificity in diagnosing a complication improved from 0% to 67%. Discharge delays reduced from 6% to 0% and no post-operative complications were missed (sensitivity 100%).
Conclusions
Routine blood tests, without an indication, did not flag any additional post-operative complications. Blood transfusion is rare for RARP. Novel guidelines to request post-operative blood tests will reduce costs and discharge delays whilst maintaining appropriate patient safety and care.
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Affiliation(s)
- A Nathan
- University College London Hospitals, London, United Kingdom
| | - N Hanna
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - A Rashid
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - S Patel
- University College London Hospitals, London, United Kingdom
| | - Y Phuah
- University College London Hospitals, London, United Kingdom
| | - K Flora
- University College London Hospitals, London, United Kingdom
| | - A Sharma
- University College London Hospitals, London, United Kingdom
| | - P Cleaveland
- University College London Hospitals, London, United Kingdom
| | | | - N William
- University College London Hospitals, London, United Kingdom
| | - S Mia
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - J Collin
- University College London Hospitals, London, United Kingdom
| | - A Sridha
- University College London Hospitals, London, United Kingdom
| | - A Kelka
- University College London Hospitals, London, United Kingdom
| | - N Sha
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - J Kell
- University College London Hospitals, London, United Kingdom
| | - T Briggs
- University College London Hospitals, London, United Kingdom
| | - G Shaw
- University College London Hospitals, London, United Kingdom
| | | | - P Rajan
- University College London Hospitals, London, United Kingdom
| | - B Lamb
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - S Nathan
- University College London Hospitals, London, United Kingdom
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Nathan A, Shukla S, Sinha A, Sivathasan S, Rashid A, Rassam J, Smart S, Patel K, Shah N, Lamb B. 31 Immediate Post-Operative Phosphodiesterase-5 Inhibitors (PDE5i) Therapy Improves Early Erectile Function Outcomes After Robot Assisted Radical Prostatectomy (RARP). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
To assess whether the timing of post-RARP PDE5i therapy affects early erectile function, continence, or safety outcomes.
Method
Data from 158 patients treated with PDE5is post-RARP was prospectively collected over two years from a single surgeon at one tertiary centre and retrospectively evaluated. Therapy was started: immediately (day 1-2) in 29%, early (day 3-14) in 37% and late (after day 14) post-op in 34%. EPIC-26 Erectile Function (EF) scores were collected pre-op and post-op after a median 43-day follow-up interval.
Results
Drop in EF scores and percentage return to baseline post unilateral nerve sparing (UNS) compared to bilateral nerve sparing (BNS) RARP was respectively 9 and 11.1% versus 3.5 and 42.9% of immediate therapy, 7 and 14.8% versus 5.5 and 35.5% of early and 9.7 and 9.5% versus 7.3 and 25% of late. Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early and 26% and 54% for late.
Conclusions
Immediate post RARP PDE5i therapy may protect EF and should be considered clinically, with more benefits for BNS than UNS patients. Immediate or early, rather than late, PDE5i therapy improved early continence in BNS patients.
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Affiliation(s)
- A Nathan
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - S Shukla
- University of Cambridge, Cambridge, United Kingdom
| | - A Sinha
- University of Cambridge, Cambridge, United Kingdom
| | - S Sivathasan
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - A Rashid
- University of Cambridge, Cambridge, United Kingdom
| | - J Rassam
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - S Smart
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - K Patel
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - N Shah
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - B Lamb
- Addenbrooke’s Hospital, Cambridge, United Kingdom
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Hayes J, Clements J, McGarry K, Rashid A. 610 Virtual Burns Care in The Era Of COVID-19: A Regional Burns Unit’s Experience. Br J Surg 2021. [PMCID: PMC8135957 DOI: 10.1093/bjs/znab134.457] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
In response to the COVID-19 pandemic a virtual burns service was established in Northern Ireland to reduce face-to-face consultations to only complex burns or those necessitating hospital admission to the regional unit.
Method
A combination of telephone calls, emails, photography, and Microsoft Teams software was utilised to facilitate a virtual review service. Our initial adoption of the system was audited during April and May 2020. Through Plan-Do-Study-Act (PDSA) methodology an electronic tertiary-referral proforma was established prior to closure of the audit cycle in July 2020.
Results
From the start of lockdown a significant reduction in face-to-face consultations was observed. Given the increasing use of virtual telephone consultation only 19.5% of the unit's total referrals (April, May, and July) were either reviewed face-to-face in dressing clinic or admitted. A target of 100% data point entry (including demographic, clinical, and initial management) for patients entering the virtual service was set. Following implementation of the e-Referral pathway an improvement in both the detail and completeness (95%) of patient referral information was achieved.
Conclusions
Our experience demonstrates that virtual burns care can be safely and rapidly adapted in response to evolving need. The potential role of virtual care post-COVID, in selected patients, is an exciting one.
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Affiliation(s)
- J Hayes
- Royal Victoria Hospital, Belfast, United Kingdom
| | - J Clements
- Royal Victoria Hospital, Belfast, United Kingdom
| | - K McGarry
- Royal Victoria Hospital, Belfast, United Kingdom
| | - A Rashid
- Royal Victoria Hospital, Belfast, United Kingdom
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25
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Katuri V, Tang Y, Li C, Jogunoori W, Deng CX, Rashid A, Sidawy AN, Evans S, Reddy EP, Mishra B, Mishra L. Correction: critical interactions between TGF-β signaling/ELF, and E-cadherin/β-catenin mediated tumor suppression. Oncogene 2021; 40:3348-3349. [PMID: 33875789 DOI: 10.1038/s41388-020-01632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- V Katuri
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA
| | - Y Tang
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA.,Fels Institute for Cancer Research and Molecular Biology, Temple University, Philadelphia, PA, USA
| | - C Li
- Genetics of Development and Disease Branch, NIDDK, NIH, Bethesda, MD, USA
| | - W Jogunoori
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA
| | - C-X Deng
- Genetics of Development and Disease Branch, NIDDK, NIH, Bethesda, MD, USA
| | - A Rashid
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A N Sidawy
- Department of Surgery, Washington, DC, USA.,Department of Veterans Affairs, Washington, DC, USA
| | - S Evans
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA
| | - E P Reddy
- Fels Institute for Cancer Research and Molecular Biology, Temple University, Philadelphia, PA, USA
| | - B Mishra
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA.
| | - L Mishra
- Laboratory of Cancer Genetics, Digestive Diseases, and Developmental Molecular Biology, Department of Surgery, Medicine, Lombardi Cancer Center, Georgetown University, Washington, DC, USA. .,Department of Surgery, Washington, DC, USA. .,Department of Veterans Affairs, Washington, DC, USA.
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26
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Raza MA, Amin M, Muhammad G, Rashid A, Adnan A. Retraction Note to: Synthesis of Biologically Active Nickelocenyl–Amino
Acid Conjugates Using 1,3-Dipolar Cycloaddition Click Reactions. RUSS J GEN CHEM+ 2021. [DOI: 10.1134/s1070363221040290] [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: 11/23/2022]
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27
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Singh VK, Rathore KS, Khan G, Rahim A, Rashid A, Chauhan S. Clinical and Radiological Study of Serum Fluoride in Relation to Knee Osteoarthritis. Malays Orthop J 2021; 14:151-154. [PMID: 33403076 PMCID: PMC7751991 DOI: 10.5704/moj.2011.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Fluorosis has been associated with an increased risk of degenerative changes in the knee. Multiple studies have found an association between arthritis and elevated fluoride levels. We aim to delineate if elevated fluoride level has any direct correlation with the degree of radiological grading and clinical symptoms in knee arthritis. Materials and Methods A cross-sectional study of 80 knee arthritis patients was conducted from February 2017 to April 2018. Serum fluoride levels were measured and patient's pain scores, WOMAC scores and radiological grading were correlated with the elevated fluoride levels. Results In our study, 30 out of 80 patients had increased serum fluoride level. Statistically significant differences were noted in VAS score, WOMAC score and Kellgren and Lawrence radiological grades between patients with normal serum fluoride level and those with elevated fluoride level. Conclusion There is an increased risk of knee arthritis in patients with elevated blood fluoride levels and patients with increased fluoride levels are associated with more severe symptoms and radiographic disease.
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Affiliation(s)
- V K Singh
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
| | - K S Rathore
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
| | - G Khan
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
| | - A Rahim
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
| | - A Rashid
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
| | - S Chauhan
- Department of Orthopaedics, NIMS Medical College and Hospital, Jaipur, India
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28
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Nathan A, Shukla S, Sinha A, Sivathasan S, Rashid A, Rassam J, Smart S, Patel K, Shah N, Lamb B. Immediate post-operative PDE5i therapy improves early Erectile Function Outcomes after Robot Assisted Radical Prostatectomy (RARP). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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Nathan A, Hanna N, Rashid A, Patel S, Phuah Y, Flora K, Cleaveland P, Kasivisvanathan V, Miah S, Collins J, Sridhar A, Kelkar A, Hines J, Kelly J, Shah N, Briggs T, Shaw G, Sooriakumaran P, Rajan P, Lamb B, Nathan S. Novel guidelines to avoid routine blood tests after Robot Assisted Radical Prostatectomy (RARP). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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30
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Wang E, Forsthoefel M, Rashid A, McGunigal M, Carrasquilla M, Unger K. Patterns of Failure Following Preoperative Chemotherapy and Stereotactic Body Radiation Therapy for Patients with Borderline Resectable or Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Sleiwah A, Moradzadeh J, Ghaffari I, Rashid A. PLASTIC AND RECONSTRUCTIVE SURGERY JOURNALS: FEASIBILITY OF ACCESS BY SURGEONS AND TRAINEES IN THE UNITED KINGDOM. Ulster Med J 2020; 89:44-45. [PMID: 32218632 PMCID: PMC7027171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- A Sleiwah
- MBChB MRCS Ed MSc. Senior Clinical Fellow. Guy’s and St Thomas’s. London. UK,Corresponding author: Aseel Sleiwah. E-mail:
| | | | - I Ghaffari
- MB BCh BAO. Queen’s University Belfast. UK
| | - A Rashid
- Royal Victoria Hospital. Belfast. UK
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33
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Rashid A, Memon M, Hashim A. Five fractions plus “SRS” boost combined with temozolamide for newly diagnosed and recurrent glioblastoma multiforme (GBM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz419.007] [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: 11/14/2022] Open
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34
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Abdelmajid Y, Kamal Y, Rashid A. Lymphocytic autoimmune hypophysitis in a female outside the perinatal period, diagnosed non-invasively and treated successfully. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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35
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Kaseb A, Duda D, Tran Cao H, Abugabal Y, Vence L, Rashid A, Carmagnani Pestana R, Blando J, Singh S, Vauthey J, Chun Y, Tzeng CWD, Sakamuri D, Wolff R, Yao J, Allison J, Sharma P. Randomized, open-label, perioperative phase II study evaluating nivolumab alone versus nivolumab plus ipilimumab in patients with resectable HCC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Scoto M, Muntoni F, Hall S, Eaton S, Rashid A, Avendano J, Samsuddin S, Balashkina J, Finkel R, Mercuri E. P.399The international spinal muscular atrophy (SMA) registry: longitudinal collection and refinement of outcome measures for spinal muscular atrophy. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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37
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Chin DM, Kader Maideen SF, Rashid A. Knowledge, attitude and practice towards dietary iron among patients with thalassemia and their caregivers in Peninsular Malaysia. Med J Malaysia 2019; 74:365-371. [PMID: 31649210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Thalassemias are the most common human monogenic disorders in the world. Regular blood transfusion and increased intestinal absorption of iron among thalassemia patients will lead to iron overload, which will not only markedly decrease their life expectancy but also pose a heavy burden to the healthcare system. The objective of this study was to evaluate the level of knowledge, attitude and practice towards dietary iron among thalassemia patients and their caregivers. METHODS An analytical cross-sectional study using purposive sampling method was conducted at eight thalassemia societies in Peninsular Malaysia. 260 respondents comprised of patients and caregivers were assessed with two separate sets of questionnaires. RESULTS Knowledge on dietary iron among the respondents was unsatisfactory, despite them having good knowledge on thalassemia disorder. Female patients were found to have better dietary knowledge, attitude and practice compared to males. The percentage of caregivers with good attitude and good practice were significantly higher compared to adult patients. Caregivers with children on iron chelators were noted to have better dietary attitude and practice. Thalassemia knowledge and children on vitamins were found to be the predictors of dietary knowledge among the patients and caregivers respectively. CONCLUSION The level of knowledge on dietary iron among the patients and caregivers was unsatisfactory in spite of their attitude and practice towards dietary iron were good. Effective delivery of dietary information to the patients and caregivers is essential to enable them to choose a healthy diet for their condition.
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Affiliation(s)
- D M Chin
- Penang Medical College, Department of Public Health, George Town, Penang, Malaysia.
| | - S F Kader Maideen
- Penang Medical College, Department of Public Health, George Town, Penang, Malaysia
| | - A Rashid
- Penang Medical College, Department of Public Health, George Town, Penang, Malaysia
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38
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Granville-Chapman J, Torrance E, Rashid A, Funk L. The Rockwood classification in acute acromioclavicular joint injury does not correlate with symptoms. J Orthop Surg (Hong Kong) 2019; 26:2309499018777886. [PMID: 29792117 DOI: 10.1177/2309499018777886] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Rockwood classified acromioclavicular (AC) joint injuries by displacement of the joint on radiographs. This classification has driven the management dogma of acute AC dislocation. The correlation between Rockwood grade and symptoms has not been described in acute injury. This study assesses that relationship. METHODS This series included 77 patients with acute AC joint injury (<6 weeks), treated between 2006 and 2015. Objective and patient-reported measures enabled correlation between clinical measures and Rockwood grade. RESULTS The mean age was 32 years (±11.86; range 17-59 years); 88% were male. Forty-four per cent were professional athletes and 43% suffered injury during rugby. The mean time from injury to presentation was 2 weeks (±1.64; range 0-5 weeks). There was poor correlation between Rockwood classification and pain (visual analogue scale) ( rs = 0.05; p = 0.752). Poor correlation was noted between Rockwood grade and functional deficit (elevation ( rs = 0.18; p = 0.275), abduction ( rs = 0.19; p = 0.246) and strength ( rs = 0.09; p = 0.579) vs. contralateral side). Oxford and Constant scores did not correlate with Rockwood grade ( rs = 0.13; p = 0.972 and 0.01; p = 0.448, respectively). CONCLUSION The Rockwood grade does not correlate with clinical symptoms in acute AC joint injury. Previous evidence demonstrates the Rockwood classification's limitations in predicting the structures injured. Therefore, the reliability of using the Rockwood grade as a decision-making tool in the management of acute AC joint dislocation is unclear.
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Affiliation(s)
- J Granville-Chapman
- 1 Frimley Health NHS Foundation Trust, Wexham Park Hospital, Slough, Berkshire, UK
| | - E Torrance
- 2 The Arm Clinic, The Wilmslow Hospital, Wilmslow, Cheshire, UK
| | - A Rashid
- 3 University College Hospital Medical School, London, UK
| | - L Funk
- 2 The Arm Clinic, The Wilmslow Hospital, Wilmslow, Cheshire, UK
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39
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Wang E, Aziz A, Danner M, Yung T, Ayoob M, Lei S, Rashid A, Dritschilo A, Lischalk J, Collins B, Lynch J, Suy S, Aghdam N, Collins S. Patterns of Recurrence Following Stereotactic Body Radiation Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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40
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Zou C, Du Y, Rashid A, Ram H, Savasli E, Pieterse PJ, Ortiz-Monasterio I, Yazici A, Kaur C, Mahmood K, Singh S, Le Roux MR, Kuang W, Onder O, Kalayci M, Cakmak I. Simultaneous Biofortification of Wheat with Zinc, Iodine, Selenium, and Iron through Foliar Treatment of a Micronutrient Cocktail in Six Countries. J Agric Food Chem 2019; 67:8096-8106. [PMID: 31260296 DOI: 10.1021/acs.jafc.9b01829] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Field experiments were conducted on wheat to study the effects of foliar-applied iodine(I) alone, Zn (zinc) alone, and a micronutrient cocktail solution containing I, Zn, Se (selenium), and Fe (iron) on grain yield and grain concentrations of micronutrients. Plants were grown over 2 years in China, India, Mexico, Pakistan, South Africa, and Turkey. Grain-Zn was increased from 28.6 mg kg-1 to 46.0 mg-1 kg with Zn-spray and 47.1 mg-1 kg with micronutrient cocktail spray. Foliar-applied I and micronutrient cocktail increased grain I from 24 μg kg-1 to 361 μg kg-1 and 249 μg kg-1, respectively. Micronutrient cocktail also increased grain-Se from 90 μg kg-1 to 338 μg kg-1 in all countries. Average increase in grain-Fe by micronutrient cocktail solution was about 12%. The results obtained demonstrated that foliar application of a cocktail micronutrient solution represents an effective strategy to biofortify wheat simultaneously with Zn, I, Se and partly with Fe without yield trade-off in wheat.
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Affiliation(s)
- Chunqin Zou
- Key Laboratory of Plant-Soil Interactions, Ministry of Education, Center for Resources, Environment and Food Security , China Agricultural University , Beijing 100193 , PR China
| | - Yunfei Du
- Key Laboratory of Plant-Soil Interactions, Ministry of Education, Center for Resources, Environment and Food Security , China Agricultural University , Beijing 100193 , PR China
| | - A Rashid
- Pakistan Academy of Sciences , 44000 Islamabad , Pakistan
| | - H Ram
- Punjab Agricultural University , Ludhiana , 141004 Punjab , India
| | - E Savasli
- Transitional Zone Agricultural Research Institute , 26002 Eskisehir , Turkey
| | - P J Pieterse
- Department of Agronomy , Stellenbosch University , Stellenbosch 7600 , South Africa
| | - I Ortiz-Monasterio
- CIMMYT International , AP370, P.O. Box 60326, Houston , Texas 77205 , United States
| | - A Yazici
- Faculty of Engineering and Natural Sciences , Sabanci University , 34956 Istanbul , Turkey
| | - C Kaur
- Punjab Agricultural University Regional Research Station , Gurdaspur , 143521 Punjab , India
| | - K Mahmood
- Soil and Environmental Sciences Division , Nuclear Institute for Agriculture & Biology , 38000 Faisalabad , Pakistan
| | - S Singh
- Punjab Agricultural University Regional Research Station , Bathinda , 151001 Punjab , India
| | - M R Le Roux
- Department of Agronomy , Stellenbosch University , Stellenbosch 7600 , South Africa
| | - W Kuang
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography , Chinese Academy of Sciences , Urumqi 830011 , China
| | - O Onder
- Transitional Zone Agricultural Research Institute , 26002 Eskisehir , Turkey
| | - M Kalayci
- Transitional Zone Agricultural Research Institute , 26002 Eskisehir , Turkey
| | - Ismail Cakmak
- Faculty of Engineering and Natural Sciences , Sabanci University , 34956 Istanbul , Turkey
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Christou N, Rashid A, Gorissen KJ, Ris F, Gosselink MP, Shorthouse JR, Smith AD, Pandit JJ, Lindsey I, Crabtree NA. Response to Hamid et al., 'The role of laparoscopic-guided transversus abdominis plane block in laparoscopic colorectal surgery'. Colorectal Dis 2019; 21:605-606. [PMID: 30875447 DOI: 10.1111/codi.14609] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/12/2019] [Indexed: 02/08/2023]
Affiliation(s)
- N Christou
- University Hospital of Limoges, Limoges, France.,Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - A Rashid
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K J Gorissen
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - F Ris
- Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - M P Gosselink
- Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - J R Shorthouse
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A D Smith
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J J Pandit
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - I Lindsey
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N A Crabtree
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Muñoz N, Dixon K, Williams M, Maldonado K, Dupuis C, Rashid A, Yevich S, Tam A. Abstract No. 609 Development of a transplantable colon adenocarcinoma model in the Buffalo rat. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Eder PA, Dormann H, Krämer RM, Lödel SK, Shammas L, Rashid A. Telemedizinische Voranmeldung durch den Rettungsdienst bei Schwerverletzten. Notf Rett Med 2019. [DOI: 10.1007/s10049-018-0436-5] [Citation(s) in RCA: 2] [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: 11/29/2022]
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Khaleeq U, Rashid A, Abbas T, Rasheed S, Raza A, Khan M, Mahmood H, Hameed Y, Hussain R, Jamshed A. Function preservation with trimodality therapy in locally advanced oral tongue squamous cell carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy438.023] [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: 11/13/2022] Open
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Kioh SH, Rashid A. The prevalence and the risk of falls among institutionalised elderly in Penang, Malaysia. Med J Malaysia 2018; 73:212-219. [PMID: 30121683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES Over the years, falls has been increasingly the most common public health issue worldwide that affects all age groups. However, the risk is nine times higher in older persons especially among those residing in nursing homes. The objective of this study is to determine the prevalence and the risk of falls and their associated factors among elderly living in nursing homes in Penang, Malaysia. METHODOLOGY Data were obtained from a cross-sectional survey in ten different nursing homes in the state of Penang, Malaysia. Participants were selected through convenience sampling were interviewed face-to-face using a questionnaire. Information concerning demographic characteristics, fall risk and depression status were collected. RESULTS Of the 357-elderly aged 60 years and above interviewed in the nursing homes, 32.8% (n=354) reported having one or more falls in the past 12 months whereas 13.3% were at moderate/high risk of fall. Depression (Adjusted Odds Ratio (aOR)=1.71, 95%CI: 1.00 to 2.91) and respiratory illnesses (aOR=3.38, 95%CI: 1.11 to 10.30) were shown to be associated with prevalence of falls. Depression (aOR=2.12, 95%CI: 1.06 to 4.23) and history of fall more than once in the past 12 months (aOR=3.90, 95%CI: 1.72 to 8.8) were found to be associated with moderate/high risk of falls. CONCLUSION This study showed that the prevalence of fall was higher among depressed elderly and those with respiratory illness. Elderly with higher history of falls were also at higher risk of falls. These findings suggest the importance of screening the elderly for the risk factors of falls as a preventive measure.
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Affiliation(s)
- S H Kioh
- Penang Medical College, Faculty of Medicine, Department of Public Health, Penang, Malaysia.
| | - A Rashid
- Penang Medical College, Faculty of Medicine, Department of Public Health, Penang, Malaysia
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Rashid A, Novak E, Kulkarni A, Brown D. P2546High birth weight and cardiovascular outcomes in the ARIC cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Rashid
- Washington University School of Medicine, Internal Medicine, St. Louis, United States of America
| | - E Novak
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
| | - A Kulkarni
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
| | - D Brown
- Washington University School of Medicine, Cardiovascular Division, St. Louis, United States of America
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Sleiwah A, Moradzadeh J, Ghaffari I, Rashid A. Plastic and reconstructive surgery journals: Feasibility of access by surgeons and trainees in the UK. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Affiliation(s)
| | | | - T R Jan
- University of Kashmir, Srinagar, India
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Abstract
ZusammenfassungGegenstand und Zie: Es wird eine Übersicht über die laufenden Projekte in der prähospitalen neurologischen Notfallversorgung gegeben. Material und Methoden: An Beispielen telemedizinischer Projekte in der Notfallversorgung, mit Schwerpunkt in der Akutversorgung des Schlaganfalls, werden die unterschiedlichen Ansätze und Möglichkeiten aufgezeigt und erste Ergebnisse referiert. Ergebnisse: Prähospitale telemedizinische Projekte unterstützen die Akutversorgung neurologischer Notfälle und wirken als Katalysator für die Vernetzung medizinischer Versorgungseinrichtungen in der Region und für die Kommunikation zwischen Notärzten/Rettungsdienst präklinisch und den Klinikteams. Durch die EDV-basierte Datenerhebung ist eine kontinuierliche Prozessoptimierung möglich, sodass z. B. beim Schlaganfall innerklinische Prozesse beschleunigt und die Lyserate unter einer konstanten Mortalitätsrate erhöht werden konnte. Schlussfolgerungen: Telemedizin ist bei der prähospitalen Schlaganfallversorgung anwendbar und führt durch die EDV-basierte Datensammlung zu mehr Transparenz der Prozesse, wodurch innerklinische Abläufe um die Stroke-Unit-Konzeption optimiert werden können.
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Raza MA, Amin M, Muhammad G, Rashid A, Adnan A. Synthesis of biologically active nickelocenyl–amino acid conjugates using 1,3-dipolar cycloaddition click reactions. RUSS J GEN CHEM+ 2017. [DOI: 10.1134/s107036321711024x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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