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Alam A, Soeroto AA, Susilohadi RA, Chandra LA. Severity of COVID-19 manifestations in HIV patients: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2024; 28:2569-2583. [PMID: 38567616 DOI: 10.26355/eurrev_202403_35763] [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: 04/04/2024]
Abstract
OBJECTIVE The incidence of coronavirus disease 2019 (COVID-19) pandemic among people living with HIV (PLWH) is experiencing major increases. This demographic is vulnerable due to compromised immune function, but the individuals are subjected to antiretroviral therapy (ART), which shows potential as a treatment for the pandemic. Therefore, this study aimed to investigate the severity of various forms of COVID-19 in PLWH as opposed to the general population. MATERIALS AND METHODS The study followed PRISMA guidelines and included a systematic review of literature from Pubmed, Science Direct, and Cochrane Library, comprising English-language articles from 2019 to 2022. This study included articles discussing HIV and COVID-19 case prevalence data by severity. A random effect model was used to demonstrate the pooled prevalence of COVID-19 among PLWH, as well as the prevalence of moderate and critical severity of COVID-19 among PLWH. The Joanna Briggs Institute checklist was used to assess the quality of studies. This study is registered in INPLASY No. INPLASY2023100063. RESULTS Out of a total of 1,965 articles relevant to the specified keyword combination, 13 articles conformed with inclusion and exclusion criteria. For HIV and non-HIV COVID-19 patients, the mean age was 52.98 ± 6.45 years and 55.84 ± 9.73 years, respectively. Approximately 73% of HIV COVID-19 patients were male. Symptoms among PLWH included fever (57%), cough (48.9%), and shortness of breath (37%). The pooled prevalence of COVID-19 among PLWH was 3.0% (95% CI, 1.0 - 8.5%), with critical, moderate, and mild severity in 4.8% (95% CI, 1.6 - 13.3%), 24.4% (95% CI, 1.9 - 29.8%), and 9.9% (95% CI, 1.9 - 38%), respectively. CONCLUSIONS PLWHs and HIV-negative individuals showed comparable rates and intensity of COVID-19. ART users exhibited immunological health comparable to immunocompetent people, demonstrating the essential role of ART in reducing the severity and mortality of PLWH with COVID-19.
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Affiliation(s)
- A Alam
- Infectious and Tropical Diseases Division, Department of Child Health, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia.
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Loban K, Alam A, Sandal S. The need for better donor engagement and outreach with legacy living kidney donors. Clin Kidney J 2024; 17:sfad271. [PMID: 38186875 PMCID: PMC10768765 DOI: 10.1093/ckj/sfad271] [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] [Received: 08/03/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Katya Loban
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec
- Research Institute of the McGill University Health Centre, Montreal, Quebec
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec
- Research Institute of the McGill University Health Centre, Montreal, Quebec
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec
| | - Shaifali Sandal
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec
- Research Institute of the McGill University Health Centre, Montreal, Quebec
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec
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Iqbal W, Iram U, Nisar S, Musa N, Alam A, Khan MR, Ullah B, Ullah M, Ali I. Epidemiology and clinical features of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2024; 84:e249124. [DOI: 10.1590/1519-6984.249124] [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] [Received: 02/25/2021] [Accepted: 07/22/2021] [Indexed: 12/23/2022] Open
Abstract
Abstract Current cross-sectional study was carried out between September 2019 to January 2020 at the Department of Pathology, Mardan Medical Complex (MMC), Mardan, and District Headquarter Hospital North Waziristan, Khyber Pakhtunkhwa (KP), Pakistan. The objectives of the current study were to determine the prevalence of leishmaniasis and its associated risk factors in selected districts of KP province, Pakistan. Altogether, three hundred and seventy-four (n=374) leishmaniosis patients were included in the current study. Skin specimen from the ulcer border were collected. The slides were stained by Giemsa stain and examined for the presence of amastigote. The prevalence of leishmania infected patients in different region of KP were as follows: North Waziristan region 53.7 (n=201) District Mardan 34.7% (n=130); District Nowshera 6.7% (n=25), District Swabi 1.1% (n=4) and other Districts i.e. Dir, Malakand, Buner and Bajawarr were 3.7% (n=14). The frequency of leishmaniasis were more in male and majority of the infected patients were in the age group of <10 years. Among n=374 patients 95.7% (n= 358) had cutaneous leishmaniasis while 3% (n= 11) had mucocutaneous type of infection and 1.3% (n= 5) patients had both cutaneous and mucocutaneous infection. Upon treatment by Sodium stibogluconate (SSG) 97% (n=362) showed clinical signs of complete or partial recovery of their skin lesions. Conclusively, highest incidence of leishmania infection occurred during short study period and majority of the cases showed positive response to treatment.
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Affiliation(s)
- W. Iqbal
- The University of Haripur, Pakistan; Mardan Medical Complex, Pakistan
| | - U. Iram
- Abdul Wali Khan University Mardan, Pakistan
| | - S. Nisar
- Bacha Khan Medical College, Pakistan
| | - N. Musa
- Khyber Medical College, Pakistan
| | - A. Alam
- Khyber Medical College, Pakistan
| | | | - B. Ullah
- Khyber Medical University, Pakistan
| | - M. Ullah
- Khyber Medical University, Pakistan
| | - I. Ali
- Khyber Medical University, Pakistan
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Fathallah N, Akaffou M, Haouari MA, Spindler L, Alam A, Barré A, Pommaret E, Fels A, de Parades V. Deep remission improves the quality of life of patients with Crohn's disease and anoperineal fistula treated with darvadstrocel: results of a French pilot study. Tech Coloproctol 2023; 27:1201-1210. [PMID: 36811811 DOI: 10.1007/s10151-023-02765-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The injection of allogeneic adipose tissue-derived mesenchymal stem cells (MSC) into anal fistulas in patients with Crohn's disease has never been evaluated in "real-life" conditions in France. METHODS We prospectively studied the first patients receiving MSC injections at our center and undergoing 12 months of follow-up. The primary endpoint was the clinical and radiological response rate. The secondary endpoints were symptomatic efficacy, safety, anal continence, quality of life (Crohn's anal fistula-quality of life scale, CAF-QoL), and predictive factors of success. RESULTS We included 27 consecutive patients. The complete clinical and radiological response rates at M12 were 51.9% and 50%, respectively. The combined complete clinical-radiological response (deep remission) rate was 34.6%. No major adverse effects or changes in anal continence were reported. The perianal disease activity index decreased from 6.4 to 1.6 (p < 0.001) for all patients. The CAF-QoL score also decreased from 54.0 to 25.5 (p < 0.001). At the end of the study, M12, the CAF-QoL score was significantly lower only in patients with a complete combined clinical-radiological response relative to those without a complete clinical-radiological response (15.0 versus 32.8, p = 0.01). Having a multibranching fistula and infliximab treatment were associated with a combined complete clinical-radiological response. CONCLUSIONS This study confirms reported efficacy data for the injection of MSC for complex anal fistulas in Crohn's disease. It also shows a positive impact on the quality of life of patients, particularly those for whom a combined clinical-radiological response was achieved.
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Affiliation(s)
- N Fathallah
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
| | - M Akaffou
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - M A Haouari
- Radiology Department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - L Spindler
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alam
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Barré
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - E Pommaret
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Fels
- Clinical Research Centre, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - V de Parades
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
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de Chickera S, Alam A. Dialysis and Transplant Considerations in Autosomal Dominant Polycystic Kidney Disease. Adv Kidney Dis Health 2023; 30:461-467. [PMID: 38097334 DOI: 10.1053/j.akdh.2023.06.005] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 12/18/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the fourth leading cause of kidney replacement therapy. Unfortunately, the need for dialysis or kidney transplantation is a foreseeable outcome for many patients affected by ADPKD. We review some of the unique issues that should be considered in the management of patients with ADPKD who require dialysis or kidney transplantation. The choice of dialysis modality may be influenced by the enlarged kidneys and liver, but peritoneal dialysis should not be excluded as an option, as studies do not consistently show that there is an increased risk for technique failure or peritonitis. The optimal kidney replacement therapy option remains kidney transplantation; however, nephrectomy may be needed if there is insufficient space for the allograft. Living donor candidates from at-risk families need to be excluded from carrying the disease either by diagnostic imaging criteria or genetic testing. Other potential transplant issues, such as malignancy and cardiovascular and metabolic risks, should also be recognized. Despite these issues, patients with ADPKD requiring dialysis or kidney transplantation generally have more favorable outcomes as compared to those with other causes of chronic kidney disease. Further studies are still needed to personalize the therapeutic approach for those receiving kidney replacement therapy and eventually improve clinical outcomes.
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Affiliation(s)
- Sonali de Chickera
- Division of Nephrology and Multiorgan Transplant Program, McGill University Health Centre, Montreal, QC, Canada
| | - Ahsan Alam
- Division of Nephrology and Multiorgan Transplant Program, McGill University Health Centre, Montreal, QC, Canada.
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Abstract
Every year, over 30,000 healthy individuals globally donate a kidney to a patient with kidney failure. These living kidney donors are at higher risk of some medical complications post-donation when compared with matched controls. Although the absolute risk of these complications is low, appropriate long-term care is essential to allow early detection and timely interventions. Some transplant centers follow living donors long-term, but many recommend that donors regularly see a primary care practitioner post-donation. However, primary care is currently not integrated with transplant centers, and the two often work in silos with little to no channels of communication with each other. As this model of care is suboptimal, existing evidence suggests that post-donation care and follow-up are inadequate. We argue for an integrated model of living donor care with stronger continuity and coordination between primary care and transplant centers that are developed with the input of all relevant stakeholders.
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Affiliation(s)
- Katya Loban
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Canada
- Research Institute of the McGill University Health Centre, Metabolic Disorders and Complications (MeDiC) Program, Montreal, Canada
| | - Jorane-Tiana Robert
- Research Institute of the McGill University Health Centre, Metabolic Disorders and Complications (MeDiC) Program, Montreal, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Canada
- Research Institute of the McGill University Health Centre, Metabolic Disorders and Complications (MeDiC) Program, Montreal, Canada
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Shaifali Sandal
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Canada
- Research Institute of the McGill University Health Centre, Metabolic Disorders and Complications (MeDiC) Program, Montreal, Canada
- Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Canada
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Aggarwal R, Mukhopadhyay I, George R, Alam A. Patient safety in radiology: Our experience. Med J Armed Forces India 2023; 79:373-377. [PMID: 37441298 PMCID: PMC10334132 DOI: 10.1016/j.mjafi.2020.09.006] [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: 03/27/2020] [Accepted: 09/22/2020] [Indexed: 11/15/2022] Open
Abstract
Background Present-day radiology departments have very high footfall of patients and are prone to patient safety errors. This study analyses such errors in our hospital. Methods Observational cross-sectional analysis of errors over the last 30 months was performed. These were classified using the Eindhoven classification model into technical, organizational, and human errors. Technical errors focused on equipment safety. Organizational errors related to policies. Human errors were subclassified as per the skill rule knowledge model. Root cause analysis was performed wherever necessary, and possible mitigation strategies for ensuring safety were suggested. Errors peculiar to the Armed Forces environment were specifically addressed. Results Seventy-seven errors were analyzed. Two were equipment based including faulty pressure injector syringes and radiation leakage from the computed tomography gantry. Of 44 skill-based errors, 09 involved dispatch of wrong reports to dependents owing to identifying patients with serving personnel's name. Four were due to scanning wrong sites. Eleven involved reporting abnormality on the wrong side. Six involved underreporting due to not viewing specific images. The rest were due to failure to omit conflicting elements in the report. Rule-based errors included wrong protocol selection (9 errors), omitting a particular sequence due to individual preference (6 errors), and so on. Knowledge-based errors were due to misinterpretation of findings (4 errors), reporting an abnormality as normal (3 errors), and selection of wrong modality (3 errors). Conclusion The findings of this study highlights the importance of voluntary reporting, diligent recording, and in-depth analysis of errors for understanding the causes and formulating possible mitigation strategies.
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Affiliation(s)
- Rohit Aggarwal
- Senior Advisor (Radiology), 7 Air Force Hospital, Kanpur, India
| | - Indrani Mukhopadhyay
- Associate Professor, Department of Obstetrics & Gynaecology, Armed Forces Medical College, Pune, India
| | - R.A. George
- Senior Advisor (Radiology), Command Hospital (Air Force), Bengaluru, India
| | - A. Alam
- Commandant, Command Hospital (Western Command), Chandimandir, India
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Maliakkal N, Shakoor H, McKean S, Harrison C, van Zyl J, Patel R, Sherwood M, Hall S, Alam A. Impella 5.5 Use as a Bridge to Transplant in Hereditary Transthyretin Amyloidosis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.798] [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: 04/05/2023] Open
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Alam A, Cornec-Le Gall E, Perrone RD. What Is Autosomal Dominant Polycystic Kidney Disease? JAMA 2023; 329:1128. [PMID: 36930140 DOI: 10.1001/jama.2023.2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This JAMA Patient Page describes autosomal dominant polycystic kidney disease, its signs and symptoms, diagnosis, and treatment options.
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Affiliation(s)
- Ahsan Alam
- Division of Nephrology, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Ronald D Perrone
- Division of Nephrology, Tufts University Medical Center, Boston, Massachusetts
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Alam A, Jeay M, Roger C, Spindler L, Barré A, de Parades V. An increasingly frequent rash to be aware of…. Tech Coloproctol 2023; 27:165-166. [PMID: 35996043 DOI: 10.1007/s10151-022-02692-z] [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] [Received: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 01/18/2023]
Affiliation(s)
- A Alam
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
| | - M Jeay
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - C Roger
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - L Spindler
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Barré
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - V de Parades
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France
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Mustafa G, Hossain MS, Sheikh SH, Faruk I, Taher MA, Ferdaus AM, Fatema B, Alam A, Tasnim T. Clinical Outcome of 0.2% Glyceryl Trinitrate Topical Ointment Compared to Lateral Internal Sphincterotomy in the Treatment of Patient with Chronic Anal Fissure: A Randomized Control Trial. Mymensingh Med J 2022; 31:1034-1039. [PMID: 36189549] [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: 06/16/2023]
Abstract
The objective of study was to evaluate the clinical outcome of topical 0.2% Glyceryl trinitrate topical (GTN) ointment in the treatment of chronic anal fissure. This randomized control trial was carried out in the Colorectal Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2015 to April 2016. Total 94 patients were included in this trial, where 47(50.0%) patients were treated by 0.2% GTN ointment as Trial group 12 hourly for 8 weeks and 47(50.0%) patients by lateral internal sphincterotomy (LIS) as Control group in this study. Patients were randomized in two groups by lottery following purposive sampling. Post-procedural outcome variables with 6 months follow up were evaluated. Majority of the patients were found in between 20 to 40 years of age in both groups. The mean age was 34.6±10.4 years and 33.2±8.6 years in GTN and LIS respectively. Overall male female ratio was 0.88:1. All (100.0%) patients presented with pain in anus and 86.15% patients presented with per rectal bleeding. Pain relief in GTN arm versus LIS arm in 2nd and 6th week was 55.31% vs. 76.6%, 74.5% vs. 87.23% with no significant difference between two groups. But at 6 month it was 57.44% vs. 93.6% respectively. The fall in pain relief at 6th month in GTN arm was due to recurrence of fissure. At the end of 2nd, 6th week and 6month, cessation of bleeding improved gradually in both groups after treatment but the improvement was significantly better in LIS group than in GTN group indicating sphincterotomy stops bleeding better. Healing after 2nd week in both groups was minimum but equal 2(4.26%) patients. After 6 weeks LIS group had significant better healing than GTN 40(85.1%) versus 26(55.3%) with p value <0.001. In 6 month time GTN group had increased healing but LIS group had significant better healing than GTN group 42(89.36) vs. 32(68.08) with p value 0.004. Transient flatus and liquid incontinence were 8.51% and 6.4% respectively in LIS group with 0.0% in GTN group. Headache and recurrence were significantly higher in GTN group 61.7% and 34.04% with p<0.001. Lateral internal anal sphincterotomy is superior to the topical application of 0.2% nitroglycerin ointment in the treatment of chronic anal fissure with the advantages of good symptomatic relief, high rate of healing and a very low rate of transient continence disturbances.
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Affiliation(s)
- G Mustafa
- Dr Golam Mustafa, Assistant Professor, Department of Colorectal Surgery, Dhaka Medical College, Dhaka, Bangladesh;
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Klein M, Watson D, Castro M, Kapoor S, Nair P, Rajagopalan S, Macpherson M, Christie J, Alam A, Qin H, Glaser M, Lala D, Prasad S, G P, Ullal Y, Sahu D, Kulkarni S, Narvekar Y, Ghosh A, Choudhury S, Birajdar S, Roy K, Singh D, Kumar C, Joseph V, Mundkur N, Patel S, Ganti A. EP16.03-024 Cellworks Singula™ Therapy Response Index (TRI) Identifies Superior OS Outcomes for NSCLC Patients: myCare-203A. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1085] [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: 11/17/2022]
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Sandal S, Yao H, Alam A, Arienzo DD, Baran D, Cantarovich M. Granulocyte colony-stimulating factor with or without immunosuppression reduction in neutropenic kidney transplant recipients. Clin Transplant 2022; 36:e14766. [PMID: 35822347 DOI: 10.1111/ctr.14766] [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: 01/14/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
Neutropenia post-kidney transplantation is associated with adverse graft and patient outcomes. We aimed to analyze the effect of granulocyte colony-stimulating factor (G-CSF) use with and without immunosuppression reduction on graft outcomes in neutropenic recipients. In this retrospective cohort study, we identified 120 recipients with neutropenia, within the first-year post-transplant. Of these, 45.0% underwent no intervention, 17.5% had immunosuppression reduced, 18.3% were only given G-CSF, and 19.2% had both interventions. Overall, 61 patients experienced the composite outcome of de-novo DSA, biopsy-proven acute rejection, and all-cause graft failure and the cumulative incidence of this outcome did not vary by any of the four interventions (p = 0.93). When stratifying the cohort by G-CSF use alone, those who received G-CSF were more likely to have had severe neutropenia (<500/mm3 :51.1%vs.12.0%, p<0.001), and immunosuppression reduction (51.1%vs.28.0%, p = 0.003). However, the composite outcome was not different in the G-CSF and no G-CSF cohort (53.3%vs.49.3%, p = 0.67), and in a multivariate model, G-CSF use was not associated with this outcome (aHR = 1.18, 95%CI:0.61-2.30). However, a trend towards higher DSA production was noted in the G-CSF cohort (87.5%vs.62.2%) and this observation warrants prospective evaluation. Overall, we conclude that G-CSF use with or without immunosuppression reduction was not associated with graft outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shaifali Sandal
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Han Yao
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - David D Arienzo
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dana Baran
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Marcelo Cantarovich
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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van Zyl J, Afzal A, Alam A, Parker L, Meyer D, Carey S. Impact on Donor Derived Cell Free DNA (dd-cfDNA) of Procurement Using Paragonix SherpaPak™ (SP) Cardiac Transport System versus ICE Transportation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.271] [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] Open
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Hasse J, Alam A, Jackson R, Parker L, Felius J, Lima B, van Zyl J. Body Composition After Cardiac Transplantation via Bioimpedance Spectroscopy. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.133] [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: 10/18/2022] Open
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Islam MR, Ahmed S, Mostafa MG, Khan L, Alam MM, Alam A, Ahmed MB, Rahman MA. Predictors of Malignancy in Thyroid Nodules. Mymensingh Med J 2022; 31:372-378. [PMID: 35383753] [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: 06/14/2023]
Abstract
Thyroid swellings are common clinical problem throughout the world and also in Bangladesh. Most of thyroid swellings are multinodular, but a good percentage is solitary thyroid nodule. There is no robust, feasible method for malignancy differentiation has not been well established. The study evaluated thyroid nodules for risk of malignancy and compared history, clinical, sonographic features and FNAC findings with histopathology. This was a cross sectional study on 160 consecutive subjects of thyroid nodules done in the department of ENT and Head Neck Surgery of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh during from July 2018 to December 2019. All patients were admitted and diagnosed by detail history, clinical examination, investigations and underwent thyroidectomy. Detailed history, clinical examination, ultrasonographic finding and FNAC variables were documented retrospectively and a mathematical model was established for malignancy prediction. In this study mean age of the patients of thyroid nodules was 37.54±11.49 years and majority of the patients were within 21-40 years of age. Frequency of thyroid nodules is more in female with male female ratio 1:7. Most of the thyroid nodules appeared in this study within 0-2 years (61.9%). In this series of thyroid nodules constituted 88.1% firm, 8.8% hard, 3.1% cystic. Among the patients 89(55.6%) cases have solitary thyroid nodule and 71(44.4%) cases have multinodular goitre Majority of the nodules were warm 57.5% followed by cold 42.5%. FNAC showed nodular goitre 72.5%, Follicular neoplasm 1.3%, Papillary carcinoma of thyroid 7.5%, colloid goitre 9.4%, suspicious papillary carcinoma 3.8% and lymphocytic thyroiditis 1.3%. In this study out of 85 solid nodule, 69(81.18%) were benign and 16(18.82%) was malignant and out of 3 cystic nodule 3(100%) were benign. In this study most of the benign and malignant nodules were predominantly solid. Study showed the malignancy is significantly (p=0.001) more in solid than cystic nodules. Final diagnosis in this study was done on the basis of histopathological reports. Out of 160 patients, histopathologically benign lesion was 120(75%) and malignant was 40(25%). Among malignant cases 36(22.5%) cases were papillary carcinoma, 1 case was medullary carcinoma and 3 cases were follicular carcinoma.
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Affiliation(s)
- M R Islam
- Dr Md Rafiqul Islam, Associate Professor, ENT and Head Neck Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Park S, Milligan G, Spak C, Sherwood M, Hall S, Alam A. Managing Infectious Complications in the Immunocompromised Stage D Heart Failure Patient: A Case of Left Ventricular Assist Device Placement in a Patient with Chronic Lymphocytic Leukemia. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.701] [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: 10/18/2022] Open
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18
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Blair J, Miranda CG, Enter D, Alam A. Abnormal Surveillance Echo Parameters Following Orthotopic Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Alam A, Uriel N, Shah K, Shah P, Zeng J, Dhingra R, Bellumkonda L, Pinney S, DePasquale E, Hall S. Impact of Donor Characteristics on AlloSure Scores. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1398] [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: 11/29/2022] Open
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20
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Manns BJ, Garg AX, Sood MM, Ferguson T, Kim SJ, Naimark D, Nesrallah GE, Soroka SD, Beaulieu M, Dixon SN, Alam A, Allu S, Tangri N. Multifaceted Intervention to Increase the Use of Home Dialysis: A Cluster Randomized Controlled Trial. Clin J Am Soc Nephrol 2022; 17:535-545. [PMID: 35314481 PMCID: PMC8993468 DOI: 10.2215/cjn.13191021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/03/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Home dialysis therapies (peritoneal and home hemodialysis) are less expensive and provide similar outcomes to in-center hemodialysis, but they are underutilized in most health systems. Given this, we designed a multifaceted intervention to increase the use of home dialysis. In this study, our objective was to evaluate the effect of this intervention on home dialysis use in CKD clinics across Canada. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a cluster randomized controlled trial in 55 CKD clinic clusters in nine provinces in Canada between October 2014 and November 2015. Participants included all adult patients who initiated dialysis in the year following the intervention. We evaluated the implementation of a four-component intervention, which included phone surveys from a knowledge translation broker, a 1-year center-specific audit/feedback on home dialysis use, delivery of an educational package (including tools aimed at both providers and patients), and an academic detailing visit. The primary outcome was the proportion of patients using home dialysis at 180 days after dialysis initiation. RESULTS A total of 55 clinics were randomized (27 in the intervention and 28 in the control), with 5312 patients initiating dialysis in the 1-year follow-up period. In the primary analysis, there was no difference in the use of home dialysis at 180 days in the intervention and control clusters (absolute risk difference, 4%; 95% confidence interval, -2% to 10%). Using a difference-in-difference comparison, the use of home dialysis at 180 days was similar before and after implementation of the intervention (difference of 0% in intervention clinics; 95% confidence interval, -2% to 3%; difference of 0.8% in control clinics; 95% confidence interval, -1% to 3%; P=0.84). CONCLUSIONS A multifaceted intervention did not increase the use of home dialysis in adults initiating dialysis. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER A Cluster Randomized Trial to Assess the Impact of Patient and Provider Education on Use of Home Dialysis, NCT02202018.
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Affiliation(s)
- Braden J Manns
- Department of Medicine and Community Health Sciences, Libin Cardiovascular Institute and O'Brien Public Health Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amit X Garg
- Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Manish M Sood
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Thomas Ferguson
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - S Joseph Kim
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada
| | - David Naimark
- Division of Nephrology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada
| | - Gihad E Nesrallah
- Li Ka Shing Knowledge Institute, Keenan Research Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Steven D Soroka
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Monica Beaulieu
- Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie N Dixon
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Ahsan Alam
- Division of Nephrology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Selina Allu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Navdeep Tangri
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
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21
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Rigas C, Park H, Nassim M, Su CL, Greenway K, Lipman M, McVeigh C, Novak M, Trinh E, Alam A, Suri RS, Mucsi I, Torres-Platas SG, Noble H, Sekhon H, Rej S, Lifshitz M. Long-term Effects of a Brief Mindfulness Intervention Versus a Health Enhancement Program for Treating Depression and Anxiety in Patients Undergoing Hemodialysis: A Randomized Controlled Trial. Can J Kidney Health Dis 2022; 9:20543581221074562. [PMID: 35273807 PMCID: PMC8902179 DOI: 10.1177/20543581221074562] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Depression and anxiety affect approximately 50% of patients with kidney
failure receiving hemodialysis and are associated with decreased quality of
life and increased risk of hospitalization and mortality. A Brief
Mindfulness Intervention (BMI) may be promising in treating depressive and
anxiety symptoms in this population, but the long-term sustainability of the
intervention’s effects is unknown. Objective: We previously conducted a randomized controlled trial (RCT; n = 55) comparing
an 8-week BMI with an active control (Health Enhancement Program [HEP]) for
patients receiving dialysis, with depression and/or anxiety. Here, we
examine the 6-month follow-up data to determine the long-term sustainability
of BMI versus HEP in reducing (1) depressive symptoms, (2) anxiety symptoms,
and (3) the efficacy of BMI versus HEP in reducing the likelihood of
hospitalization. Design: In this study, we analyzed 6-month follow-up data from an 8-week
assessor-blinded parallel RCT, which evaluated the efficacy of a BMI against
an active control, HEP, in patients receiving hemodialysis with symptoms of
depression and/or anxiety. Setting: The study took place at hemodialysis centers in 4 tertiary-care hospitals in
Montreal, Canada. Participants: Participants included adults aged ≥18 years who were receiving in-center
hemodialysis 3 times per week and had symptoms of depression and/or anxiety
as indicated by a score ≥6 on the Patient Health Questionnaire–9 (PHQ-9)
and/or the General Anxiety Disorder–7 (GAD-7). Methods: Participants were randomized to the treatment arm (BMI) or the active control
arm (HEP) and completed assessments at baseline, 8 weeks, and 6-month
follow-up. Depression was assessed using the PHQ-9, and anxiety was assessed
by the GAD-7. Hospitalization rates were assessed using medical chart
information. Results: We observed significant decrease in depression scores over 6 months in both
BMI and HEP groups, with no significant difference between groups. Anxiety
scores significantly decreased over 6 months, but only in the BMI group.
Brief Mindfulness Intervention and Health Enhancement Program were
comparable in terms of hospitalization rates. Limitations: The limitations of our study include the modest sample size and lack of a
third arm such as a waitlist control. Conclusions: Our results suggest that the beneficial effects of BMI and HEP for improving
mood disorder symptoms in patients receiving dialysis persist at 6-month
follow-up. Both interventions showed sustained effects for depressive
symptoms, but BMI may be more useful in this population given its efficacy
in reducing anxiety symptoms as well. Trial registration: Prior to recruitment, the trial had been registered (ClinicalTrials.gov
Identifier: NCT03406845).
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Affiliation(s)
- Christina Rigas
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Haley Park
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Marouane Nassim
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Chien-Lin Su
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Kyle Greenway
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mark Lipman
- Division of Nephrology, Jewish General Hospital, Montreal, QC, Canada
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Clare McVeigh
- School of Nursing and Midwifery, Queen’s University, Belfast, UK
| | - Marta Novak
- Department of Psychiatry, University Health Network, University of Toronto, ON, Canada
| | - Emilie Trinh
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
| | - Ahsan Alam
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
| | - Rita S. Suri
- Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, QC, Canada
| | - Istvan Mucsi
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
- Transplant Inpatient Unit, Division of Nephrology, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, ON, Canada
| | | | - Helen Noble
- School of Nursing and Midwifery, Queen’s University, Belfast, UK
| | - Harmehr Sekhon
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Soham Rej
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michael Lifshitz
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Medicine, University of Toronto, ON, Canada
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22
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Rai A, Singh R, Mehana O, Alam A. 164 Testicular Torsion: A Race to Beat the Golden Hours. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.095] [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
Testicular torsion is a condition requiring immediate attention and the golden time period for its management is 6 hours at which rate of salvageability of the testes is 90 percent (NICE). This decreases considerably with passing time. Imaging has minimal value.
Method
The electronic data of 36 patients from June 2020 to May 2021 were reviewed and analysed. Majority of patients were between the age of 11–20 i.e., 21. We analysed the mode of admission of these patients, the time between the A&E triage and surgical clerking and A&E triage and induction of anaesthesia.
Results
Majority (70 percent) patients were admitted through Emergency A&E. The time between the A&E triage and surgical clerking was less than 30 minutes for 10 patients while 11 patients had no proper documentation of time. The time between the A&E triage and the induction of anaesthesia was less than 6 hours in 23 patients, and more than 6 hours for 7 of them. 14 underwent Scrotal Exploration and Bilateral orchidopexy and 13 orchidectomies. Out of 13 orchidectomies, 6 had crossed the golden time period at the time of induction. Out of 10 patients booked for USS testis, 8 underwent Orchidectomy and 6 had crossed the golden hour (6 Hours).
Conclusions
Early presentation, diagnosis and exploration of testicular torsion improves the salvable rate of testes. 6 patients who underwent USS testis passed the golden timeframe which shows that there is a scope for faster and appropriate management of testicular torsion.
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Affiliation(s)
- A. Rai
- Luton and Dunstable University Hospital, Luton, United Kingdom
| | - R. Singh
- Luton and Dunstable University Hospital, Luton, United Kingdom
| | - O. Mehana
- Luton and Dunstable University Hospital, Luton, United Kingdom
| | - A. Alam
- Luton and Dunstable University Hospital, Luton, United Kingdom
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23
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Pond J, Wang X, Lu Z, Duque Gomez F, Alam A, Gitt S, McGuire D, Young J, Lamant G. State-of-the-art and next-generation integrated photonic design. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226601010] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The relentless need for higher bandwidth, lower power and lower cost data communications has driven tremendous innovation in integrated photonics in recent years. This innovation has been supported by state-of-the-art electronic-photonic design automation (EPDA) workflows, which enable process design kit (PDK) centred schematic driven design and layout, as well as statistically enabled electro-optical simulation. In addition, custom components can be introduced and optimized for a specific foundry process using advanced methods such as photonic inverse design and machine learning. While much of the innovation has been motivated by data communications, it has enabled a variety of different applications such as sensing, integrated LiDAR and quantum information technologies. We discuss the latest innovations in EPDA workflows and show how a silicon photonic ring-based wavelength demultiplexing (WDM) system can be easily designed, simulated and implemented. In addition, we discuss the extension of these workflows to support the design and simulation of quantum photonic devices, enabling designers to consider the effects of realistic sources and manufacturing imperfections when designing quantum building blocks to meet specific fidelity and fault tolerance thresholds.
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Kutky M, Cross E, Treleaven DJ, Alam A, Lanktree MB. The Impact of COVID-19 on Patients With ADPKD. Can J Kidney Health Dis 2021; 8:20543581211056479. [PMID: 34777845 PMCID: PMC8586165 DOI: 10.1177/20543581211056479] [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: 05/17/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE OF REVIEW Patients with autosomal dominant polycystic kidney disease (ADPKD) have kidney cysts and kidney enlargement decades before progressing to advanced chronic kidney disease (CKD), meaning patients live most of their adult life with a chronic medical condition. The coronavirus disease 2019 (COVID-19) pandemic has created common questions among patients with ADPKD. In this review, we discuss COVID-19 concerns centered around a patient with a common clinical vignette. SOURCES OF INFORMATION We performed PubMed and Google scholar searches for English, peer-reviewed studies related to "COVID-19," "ADPKD," "CKD," "tolvaptan," "angiotensin-converting enzyme inhibitors" (ACEi), "angiotensin receptor blockers" (ARB), and "vaccination." We also evaluated transplant data provided by the Ontario Trillium Gift of Life Network. METHODS Following an assessment of available literature, this narrative review addresses common questions of patients with ADPKD in the context of the COVID-19 pandemic. KEY FINDINGS Data regarding the risk of developing COVID-19 and the risk of adverse COVID-19 outcomes in patients with ADPKD remain limited, but patients with ADPKD with impaired estimated glomerular filtration rate (eGFR), kidney transplants, or on dialysis are likely at similar increased risk as those with generally defined CKD. We provide strategies to improve virtual care, which is likely to persist after the pandemic. Current evidence suggests ACEi, ARB, and tolvaptan treatment should be continued unless contraindicated due to severe illness. When available, and in the absence of a severe allergy, vaccination is recommended for all patients with ADPKD. LIMITATIONS This narrative review is limited by a paucity of high-quality data on COVID-19 outcomes in patients specifically with ADPKD. IMPLICATIONS Patients with ADPKD who have developed advanced CKD, require dialysis, or who have received a kidney transplant are at elevated risk of COVID-19 complications.
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Affiliation(s)
- Meherzad Kutky
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Erin Cross
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Darin J. Treleaven
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Matthew B. Lanktree
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
- St. Joseph’s Healthcare Hamilton, ON, Canada
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25
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Nayab S, Alam A, A. Khan F, Khan H, Khan S, A. Khan F. Synthesis, characterization and urease inhibitory activities of Zn(II) complexes bearing C1-symmetric ligands derived from (R)-phenylethanamine. B CHEM SOC ETHIOPIA 2021. [DOI: 10.4314/bcse.v35i2.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ABSTRACT. A series of Zn(II) complexes, supported with N-substituted phenylethanamine derivatives, [LnZnCl2] (where Ln = LA ((R)-1-phenyl-N-(thiophene-2-ylmethyl)ethanamine; LB (R)-N-(5-meyhylthiophene-2-yl)methyl-1-phenylethanamine; LC ((R)-N-(furan-2-ylmeththyl)-1-phenylethanamine and LD (R)-N-((5-methylfuran-2-yl)methyl)-1-phenylethanamine) were synthesized and characterized. The urease inhibitory activities of these complexes were determined against selected urease inhibitors where [LBZnCl2] was found to be the most prominent inhibitor of Jack bean urease (J. B. urease) (IC50 = 10.39±0.78 μM), whereas the activity of Bacillus pasteurii urease (B. P. urease) was predominantly inhibited by [LAZnCl2] (IC50 = 8.68±0.7 μM). Additionally, MOE-Dock program was used to affirm the probable binding modes of these complexes into the crystal structure of J. B. urease which certainly verified the inhibitory mechanism of these novel complexes.
KEY WORDS: Zn(II) complexes, (R)-Phenylethanamine, Urease inhibition, Molecular docking
Bull. Chem. Soc. Ethiop. 2021, 35(2), 301-314.
DOI: https://dx.doi.org/10.4314/bcse.v35i2.7
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Alam A, Fathallah N, Spindler L, El Mituialy A, Pommaret E, Benfredj P, Rentien AL, Aubert M, Safa Far E, Fellous K, Abbes L, Beaussier H, de Parades V. Hemorrhoidal surgery in patients with IBD: caution is the parent of safety. Tech Coloproctol 2021; 25:1319-1321. [PMID: 34609635 DOI: 10.1007/s10151-021-02531-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the outcome of hemorrhoidal surgery in patients with inflammatory bowel disease (IBD) undergoing surgery at our center. METHODS All adult patients with IBD undergoing hemorrhoidal surgery in our department between November 1, 2013 and July 7, 2020 were included in the study. At the time of surgery, the patients' IBD was in clinical, biological and endoscopic remission, and none of the patients had specific primary anoperineal lesions. RESULTS We included 25 patients (48% female) with a mean age 48 years (± 13.1 years). There were 13 cases of CD (52%) and 12 of ulcerative colitis (UC). Pharmacological and instrumental hemorrhoidal treatment had failed in all patients. The CD lesions were exclusively ileal (77%) or ileocolic (23%). The surgical procedures performed for CD were mono-hemorrhoidectomy in three patients (21.4%), tripedicular hemorrhoidectomy in six patients (42.9%), and artery ligations with mucopexy in five patients (35.7%). UC was rectal (16.7%), rectosigmoid (66.7%), or pancolic (16.6%). The surgical procedures performed for UC were a tripedicular hemorrhoidectomy in ten patients (83.3%) and artery ligations with mucopexy in two patients (16.7%). The mean duration of postoperative follow-up was 15.1 months. None of the patients was lost to follow-up. The mean time to wound healing after resection was 71.1 days (± 21 days) for patients with CD and 56.9 days (± 6.7 days) for patients with UC (p = 0.05). Postoperative complications were reported for four patients with CD (28.8%) and two patients with UC (16.7%). There was no suppuration, stenosis, or anal incontinence sequelae. CONCLUSIONS Hemorrhoidal surgery resulted in a non-negligible frequency of complications in our series of IBD patients, especially in those with CD. Caution is, therefore, still necessary in this patient population.
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Affiliation(s)
- A Alam
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France.
| | - N Fathallah
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - L Spindler
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - A El Mituialy
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - E Pommaret
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - P Benfredj
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - A L Rentien
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - M Aubert
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - E Safa Far
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - K Fellous
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - L Abbes
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
| | - H Beaussier
- Department of Clinical Research, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - V de Parades
- Department of MedicoSurgical Proctology, Institut Léopold Bellan, Paris, France
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Yuwono Soeroto A, Purwiga A, Alam A, Prasetya D. Plasma convalescent decrease mortality in COVID-19 patients: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2021; 25:4841-4853. [PMID: 34337734 DOI: 10.26355/eurrev_202107_26398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the role of Convalescent Plasma (CP) in reducing mortality of COVID-19 patients. MATERIALS AND METHODS A systematic literature search was conducted from PubMed, Embase, Medrxiv, and Google Scholar from April and finalized in December 2020 using the following terms: covid-19, convalescent plasma, cp, ccp, copla. The studies were screened, extracted, and evaluated by two authors independently. Comparative retrospective or prospective studies with a control group were included. Mortality was defined as the outcome of interest. Research articles not published in the English language, not available in full text, review articles, no measured outcome of interest were excluded from this study. RESULTS Eighteen studies were included in this meta-analysis. There were 5658 patients with 2092 patients treated with CP and 3536 patients as a control group. Forest plot showed CP use was associated with decreased mortality with OR = 0.64 (95% CI 0.49 to 0.84, p<0.001) and heterogeneity (I2)= 27.62%. Few patients experienced an adverse event, but no fatal case was reported. CONCLUSIONS Convalescent plasma is effective in reducing mortality of severe and critical COVID-19 with tolerable adverse effects.
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Affiliation(s)
- A Yuwono Soeroto
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.
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Abstract
AbstractCardiac MRI is a valuable and an accurate modality used in the evaluation of structure and function of the heart. It is increasingly considered as a useful non invasive examination in management of cardiovascular conditions, a situation resulting from significant advances in MR technologies. Evaluation of congenital heart disease is an important application of Cardiac MRI since the morphological details of chambers, septum, defects and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts and shunts are also provided. Its utility is further increased especially during follow up of patients after corrective surgery. This article reviews current state-of-the-art MRI application in common congenital heart diseases.
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Affiliation(s)
- MN Sree Ram
- Department of Radiodiagnosis, AMFC, Pune, India
| | - CM Sreedhar
- Department of Radiodiagnosis, AMFC, Pune, India
| | - A Alam
- Department of Radiodiagnosis, AMFC, Pune, India
| | - IK Indrajit
- Department of Radiodiagnosis, AMFC, Pune, India
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Tangri N, Garg AX, Ferguson TW, Dixon S, Rigatto C, Allu S, Chau E, Komenda P, Naimark D, Nesrallah GE, Soroka SD, Beaulieu M, Alam A, Kim SJ, Sood MM, Manns B. Effects of a Knowledge-Translation Intervention on Early Dialysis Initiation: A Cluster Randomized Trial. J Am Soc Nephrol 2021; 32:1791-1800. [PMID: 33858985 PMCID: PMC8425657 DOI: 10.1681/asn.2020091254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/19/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Initiating Dialysis Early and Late (IDEAL) trial, published in 2009, found no clinically measurable benefit with respect to risk of mortality or early complications with early dialysis initiation versus deferred dialysis start. After these findings, guidelines recommended an intent-to-defer approach to dialysis initiation, with the goal of deferring it until clinical symptoms arise. METHODS To evaluate a four-component knowledge translation intervention aimed at promoting an intent-to-defer strategy for dialysis initiation, we conducted a cluster randomized trial in Canada between October 2014 and November 2015. We randomized 55 clinics, 27 to the intervention group and 28 to the control group. The educational intervention, using knowledge-translation tools, included telephone surveys from a knowledge-translation broker, a 1-year center-specific audit with feedback, delivery of a guidelines package, and an academic detailing visit. Participants included adults who had at least 3 months of predialysis care and who started dialysis in the first year after the intervention. The primary efficacy outcome was the proportion of patients who initiated dialysis early (at eGFR >10.5 ml/min per 1.73 m2). The secondary outcome was the proportion of patients who initiated in the acute inpatient setting. RESULTS The analysis included 3424 patients initiating dialysis in the 1-year follow-up period. Of these, 509 of 1592 (32.0%) in the intervention arm and 605 of 1832 (33.0%) in the control arm started dialysis early. There was no difference in the proportion of individuals initiating dialysis early or in the proportion of individuals initiating dialysis as an acute inpatient. CONCLUSIONS A multifaceted knowledge translation intervention failed to reduce the proportion of early dialysis starts in patients with CKD followed in multidisciplinary clinics. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER ClinicalTrials.gov, NCT02183987. Available at: https://clinicaltrials.gov/ct2/show/NCT02183987.
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Affiliation(s)
- Navdeep Tangri
- Department of Internal Medicine, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada,Seven Oaks Hospital Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Amit X. Garg
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada,Department of Medicine, Western University, London, Ontario, Canada,Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Thomas W. Ferguson
- Department of Internal Medicine, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada,Seven Oaks Hospital Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Stephanie Dixon
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada,Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Claudio Rigatto
- Department of Internal Medicine, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada,Seven Oaks Hospital Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Selina Allu
- Department of Medicine and Community Health Sciences, Libin Cardiovascular Institute, Calgary, Canada,O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Elaine Chau
- Department of Internal Medicine, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada,Seven Oaks Hospital Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Paul Komenda
- Department of Internal Medicine, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada,Seven Oaks Hospital Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - David Naimark
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Gihad E. Nesrallah
- Institute for Clinical Evaluative Sciences, London, Ontario, Canada,Division of Nephrology, Humber River Hospital, Toronto, Ontario, Canada
| | - Steven D. Soroka
- Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada,Nova Scotia Health Authority Renal Program, Halifax, Nova Scotia, Canada
| | - Monica Beaulieu
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,BC Renal Agency, Vancouver, British Columbia, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - S. Joseph Kim
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Manish M. Sood
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Braden Manns
- Department of Medicine and Community Health Sciences, Libin Cardiovascular Institute, Calgary, Canada,O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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30
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Luqman L, Saeed K, Muhammad K, Ahmad MS, Akbar F, Rasool A, Israr M, Jabeen H, Mehmood SA, Ahmed S, Alam A, Ullah S, Saeed N, Usman K, Hussain I, El Halim HMA, Khan W, Shah M. Biodiversity of orb-web spiders (family: araneidae) of buner valley, Pakistan. BRAZ J BIOL 2021; 82:e238339. [PMID: 34161423 DOI: 10.1590/1519-6984.238339] [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] [Received: 05/20/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022] Open
Abstract
The present research was carried out to explore the spider fauna of Buner valley with taxonomic study from February 2018 to January 2019. For this purpose samples were collected, four times at each month from 4 tehsils: Daggar, Gagra, Mandan and Totalai. Two methods were used, hand picking and sweep net for collection of samples. During day and night, three habitats, arid area, agriculture land and building area were search for collection. A total of 534 samples of spider were collected from four sampling sites, in which 379 were belonging to family Araniedae. After confirmation, the identified species were belonging to 8 genera (Neoscona, Argiope, Cyclosa, Araneus, Cyrtophora, Larinia, Erivoxia and Poltys) and 19 species. 18 of them were identified to specie level while a single specie to its generic level. The genus Neoscona was the dominant genus 26.31% having 5 species while the genus Argiope 21.05% is the second dominant having 4 species followed by Cyclosa 15.78% having 3 species followed by Cyrtophora and Araneus 10.52% having two species both. The Poltys and Larinia 5.26% are the rarest genera represent single-single specie both. Statistical analysis show that specie richness (D) = 5.77, Simpson index (1-D) = 0.87, Shannon index (H) = 2.33. Diversity of spiders was evenly distributed and calculated Evenness value was H/InS = 0.5408. There is also few atypical species and Fisher alpha estimate high value (Fisher α) = 4.42. Chao-1 estimated we have reported 22 species.
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Affiliation(s)
- L Luqman
- Department of Zoology, University of Buner, Khyber Pakhtunkhwa, Pakistan
| | - K Saeed
- Department of Zoology, University of Buner, Khyber Pakhtunkhwa, Pakistan
| | - K Muhammad
- Department of Genetics, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakista
| | - M S Ahmad
- Department of Zoology, University of Swabi, Khyber Pakhtunkhwa, Pakistan
| | - F Akbar
- Centre for Biotechnology & Microbiology, University of Swat, Khyber Pakhtunkhwa, Pakistan
| | - A Rasool
- Centre for Biotechnology & Microbiology, University of Swat, Khyber Pakhtunkhwa, Pakistan
| | - M Israr
- Department of Forensic Sciences, University of Swat, Khyber Pakhtunkhwa, Pakistan
| | - H Jabeen
- Department of Microbiology, Women University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - S A Mehmood
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - S Ahmed
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - A Alam
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - S Ullah
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - N Saeed
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - K Usman
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - I Hussain
- Department of Zoology, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | | | - W Khan
- Department of Zoology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - M Shah
- Centre for Animal Sciences & Fisheries, University of Swat, Khyber Pakhtunkhwa, Pakistan
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31
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Nisa NU, Khan W, Khan A, Das SN, Rafiq N, Anwar K, Khan BT, Ullah I, Khan M, Alam A. Description of Lutziella swatensis sp.n. (Trematoda: Dicrocoelidae) from Rattus rattus in Swat, Pakistan. BRAZ J BIOL 2021; 82:e225092. [PMID: 34037073 DOI: 10.1590/1519-6984.225092] [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] [Received: 06/11/2019] [Accepted: 04/13/2020] [Indexed: 11/21/2022] Open
Abstract
A new species of the genus Lutziella (Rohde, 1966) Yamaguti, 1971 is described here and named Lutziella swatensis sp.nov. from the liver of rat (Rattus rattus L.). The new species is characterized by having body flat, smooth, longer than broad with maximum width at the level of the ovary, oral sucker with weak musculature, pharynx small; eosophagus long; caeca of irregular shape which bifurcate on the anterior border of the ovary in to unequal portions, acetabulum weakly muscular, post-testicular, testes lobed, cirrus pouch somewhat median, small in size containing winding seminal vesicle, prostatic complex and short ejaculatory duct. Genital pore median. Ovary post testicular, submedian; seminal receptacle overlapping ovary, laurer's canal present. Vitellaria follicular extending on each side from almost the level of testes to anterior portion of posterior half of the body. Uterus filled with eggs occupying most of the body, eggs oval rather small, numerous, brownish in colour, excretory vesicle tubular with terminal pore. Lutziella swatensis n. sp. is the second species of the genus known from Pakistan as well as the second species described from murid rodents in the world.
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Affiliation(s)
- N Un Nisa
- University of Karachi, Vertebrate Pest Control Institute - VPCI, Southern Zone-Agricultural Research Centre - SARC, Pakistan Agricultural Research Council - PARC old Block 9 &10, Karachi, Pakistan
| | - W Khan
- University of Malakand Chakdara Lower Dir, Department of Zoology, Laboratory of Parasitology, Khyber Pakhtunkhwa, Pakistan
| | - A Khan
- University of Karachi, Crop Diseases Research Institute - C.D.R.I, Southern Zone-Agricultural Research Centre - SARC, Pakistan Agricultural Research Council - PARC, Karachi, Pakistan
| | - S N Das
- University of Sindh, Department of Zoology, Hyderabad, Pakistan
| | - N Rafiq
- Abdul Wali Khan University, Department of Zoology, Mardan, Pakistan
| | - K Anwar
- Veterinary Research and Diseases Investigation Center, Department of Livesstock and Dairy Development, Balogram Swat, Khyber Pakhtunkhwa, Pakistan
| | - B T Khan
- University of Buner, Department of Zoology, Buner, Pakistan
| | - I Ullah
- University of Agriculture Peshawar, Department of Veterinary and Animals Sciences, Peshawar, Pakistan
| | - M Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - A Alam
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
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32
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Khan W, Hadi N, Dad I, Panhwar WA, Khan T, Shah M, Imran, Khan AA, Habiba U, Khaliq G, Alam A. Euphlyctis Cyanophlyctis Schneider, 1799 (Amphibia: Dicroglossidae) in district Lower Dir, Pakistan. BRAZ J BIOL 2021; 82:e236496. [PMID: 34037074 DOI: 10.1590/1519-6984.236496] [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] [Received: 04/12/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022] Open
Abstract
Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.
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Affiliation(s)
- W Khan
- University of Malakand, Department of Zoology, Lower Dir, Khyber Pakhtukhwa, Pakistan
| | - N Hadi
- University of Malakand, Department of Zoology, Lower Dir, Khyber Pakhtukhwa, Pakistan.,Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - Islam Dad
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - W A Panhwar
- University Khairpur Miris Sindh, Department of Zoology Shah Abdul Latif, Khairpur, Pakistan
| | - T Khan
- Virtual University of Lahore, Department of Molecular Biology, Lahore, Pakistan
| | - M Shah
- University of Swat, Centre for Animal Sciences & Fisheries, Swat, Pakistan
| | - Imran
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - A A Khan
- Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - U Habiba
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Pakistan
| | - G Khaliq
- Lasbela University of Agriculture Water and Marine Sciences, Department of Horticulture, Faculty of Agriculture, Uthal, Balochistan
| | - A Alam
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
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33
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Hussain I, Mehmood SA, Ahmed S, Salim M, Hussain A, Noureen S, Ahmed D, Israr M, Akbar F, Rasool A, Jabeen H, Saeed K, Alam A, Sanaullah, Usman K, Saeed N, Khan W, Shah M. Systematic analysis of leisler's bat Nyctalus leisleri (Kuhl, 1817) captured from FATA region, Pakistan. BRAZ J BIOL 2021; 82:e238337. [PMID: 33978080 DOI: 10.1590/1519-6984.238337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022] Open
Abstract
Extensive field surveys were carried out to explore the distribution of Leisler's Bat Nyctalus leisleri (Kuhl, 1819) in selected area of FATA regions, Pakistan. Specimens of Leisler's Bat Nyctalus leisleri (Kuhl, 1819) (n5) were collected from Kurram Agency (Shublan) (N33.8229788 E70.1634414) at elevation 1427m and Khyber Agency (Landi Kotel) (N34.0909899 E71.1457517) at elevation 1091m for two years survey extending from May 2013 through August 2015. The mean head and body length, hind foot length, ear length and tail length the Nyctalus leisleri specimens captured from the study area was 65.08 ± 1.58 mm, 44.06 ± 0.52 mm, 8.38 ± 0.60 mm, 13.20 ± 0.99 mm and 39.46 ± 1.46 mm, respectively. For molecular analysis the sequences of COI gene were obtained and analyzed. The mean intraspecific divergences of Nyctalus leisleri was 0.04%. The mean interspecific divergences of Nyctalus noctula and Nyctalus leisleri was 0.2%. The mean concentration of each nucleotides was A = (26.3%), T = (32.8%), G = (15.9%) and C = (25.0%). The mean A+T contents were 59.2%and C+G were 40.9%. In the phylogenetic tree Nyctalus leisleri and Nyctalus noctula clustered with significant bootstrap support value.
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Affiliation(s)
- I Hussain
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - S A Mehmood
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - S Ahmed
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - M Salim
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Khyber-Pakhtunkhwa, Pakistan
| | - A Hussain
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Khyber-Pakhtunkhwa, Pakistan
| | - S Noureen
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Khyber-Pakhtunkhwa, Pakistan
| | - D Ahmed
- University of Haripur, Department of Medical Lab Technology, Haripur, Khyber-Pakhtunkhwa, Pakistan
| | - M Israr
- University of Swat, Department of Forensic Sciences, Swat, Khyber-Pakhtunkhwa, Pakistan
| | - F Akbar
- University of Swat, Centre for Biotechnology & Microbiology, Swat, Khyber-Pakhtunkhwa, Pakistan
| | - A Rasool
- University of Swat, Centre for Biotechnology & Microbiology, Swat, Khyber-Pakhtunkhwa, Pakistan
| | - H Jabeen
- Women University Mardan, Department of Microbiology, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - K Saeed
- University of Buner, Department of Zoology, Swari, Khyber Pakhtunkhwa, Pakistan
| | - A Alam
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - Sanaullah
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - K Usman
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - N Saeed
- Hazara University Mansehra, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - W Khan
- University of Malakand, Department of Zoology, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - M Shah
- University of Swat, Centre for Animal Science & Fisheries, Saidu Sharif, Khyber Pakhtunkhwa, Pakistan
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Raja U, Hussain YK, Qureshi H, Iqbal S, Alam A, Bidiwala S. Re: UK undergraduate aspirations and attitudes survey: do we have a perception problem in clinical radiology? Clin Radiol 2021; 76:547. [PMID: 33962780 DOI: 10.1016/j.crad.2021.02.028] [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] [Received: 01/10/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Affiliation(s)
- U Raja
- King's College London, London, UK.
| | | | | | - S Iqbal
- King's College London, London, UK
| | - A Alam
- King's College London, London, UK
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35
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Gadre A, Gupta V, Olken M, Mehta A, Kumar D, Rayasam V, Alam A. SPONTANEOUS CORONARY ARTERY DISSECTION IN A PATIENT WITH DERMATOMYOSITIS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)03933-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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36
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Kopecky K, Mathew C, Gong T, Enter D, Shalabi M, Blough B, Alam A, Hall S. Drugs, Bugs, and the ECMO Unplugged: A Case of a 61-year-old with Cardiogenic Shock and Utility of Palliative Bedside ECMO De-Escalation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1298] [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: 11/29/2022] Open
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37
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Milligan G, Patel N, Gong T, Mathew C, Tejani I, Hall S, Banerjee S, Minniefield N, Jermyn R, Michelis K, Cheeran D, Alam A. Procedural Safety Profile of Cardiomems Heart Failure Sensor Implantation in a Veterans Association Patient Population. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.737] [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: 10/21/2022] Open
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Das MC, Islam N, Hasan M, Khanam F, Alam A, Akter A, Khan MH, Rahman KS, Khan A, Das D. Pandemic Now and Then: A Historical Perspective of Non-Pharmaceutical Interventions Adopted In Covid-19. Mymensingh Med J 2021; 30:562-569. [PMID: 33830144] [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: 06/12/2023]
Abstract
The coronavirus disease 2019 (COVID-19), first reported in Wuhan, China is now a major global health threat - a pandemic. Public health control measures are the cornerstones in the fight against COVID-19 in the absence of an effective vaccine or proven treatment. The aim of this review was to explore the historical use case of various public health measures adopted today to tackle COVID-19 spread. Although our knowledge about this novel coronavirus transmission is evolving over time, the fundamental non-pharmaceutical interventions e.g., handwashing, wearing a mask, physical distancing, isolation, quarantine and border control which are adopted globally at present are not new. This review highlighted that historically and religiously similar approaches were practised in the medieval past for controlling disease outbreaks. The successful implementation of the public health control measures largely depends on health systems resilience, community engagement and changes in population behaviour. Combined global efforts are essential to strengthen health systems, improve the capability of research and transparent information sharing with both public and international bodies to combat the pandemic.
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Affiliation(s)
- M C Das
- Dr Manik Chandra Das, Coordinator, School of Public Health and Life Sciences, University of South Asia; E-mail:
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Hamadeh A, Milligan G, Minniefield N, Cheeran D, Banerjee S, Hall S, Joseph S, Alam A. Variation in CardioMEMS Pressure Measurements Due to Frequent Changes in Altitude in a Patient with HeartMate III LVAD. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2010] [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] Open
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40
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ALKINDI F, Al Blooshi M, Al-Awadhi A, Alam A, Al Hakim M, Chaaban A, Eljack H, Budruddin M, Mzayen K, Khan I, Boobes Y. POS-690 Outcomes of Malignancy in Kidney Transplant Recipients. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.722] [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: 11/29/2022] Open
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41
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Alqallaf A, Alam A, Sapir-Pichhadze R, Ghali P, Cantarovich M. Pretransplant Use of the Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI) to Estimate Glomerular Filtration Rate Predicts Outcomes in Liver Transplant Recipients. EXP CLIN TRANSPLANT 2021; 19:231-236. [PMID: 33719946 DOI: 10.6002/ect.2020.0557] [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
OBJECTIVES Kidney dysfunction is common in liver transplant candidates and is a well-established predictor of increased mortality after liver transplant. However, the best method for determination of the glomerular filtration rate before liver transplant remains unclear. MATERIALS AND METHODS We analyzed the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Modification of Diet in Renal Disease (MDRD) Study equation, before liver transplant, compared with radionuclide glomerular filtration rate and examined the association of the 2 equations with a composite outcome of stage 4 chronic kidney disease, initiation of chronic dialysis, or patient death. RESULTS We studied 426 consecutive adult liver transplant recipients from 1990 to 2014. The correlation coefficient of the radionuclide glomerular filtration rate with the Chronic Kidney Disease Epidemiology Collaboration equation was 0.61 and with the Modification of Diet in Renal Disease Study equation was 0.58. The Modification of Diet in Renal Disease Study equation showed a bias of -4.7 mL/min and precision of 32.9 mL/min, whereas the Chronic Kidney Disease Epidemiology Collaboration equation showed a bias of -11.1 mL/min but was more precise (28.1 mL/min). Only the Chronic Kidney Disease Epidemiology Collaboration equation remained significantly associated with the composite outcome in the multivariable analysis. CONCLUSIONS The use of the Chronic Kidney Disease Epidemiology Collaboration equation in the period before liver transplant provided independent prognostic information regarding long-term outcomes after liver transplant.
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Affiliation(s)
- Ahmed Alqallaf
- From the Division of Nephrology and Multi-Organ Transplant Program, McGill University Health Center, Montreal, Quebec, Canada
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42
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Khan W, Nisa NN, Ilahi I, Romman M, Parvez R, Khan N, Ujjan AA, Salim M, Hussain A, Habiba U, Alam A. Distribution of commensal rodents in rain-fed and irrigated areas of Swat district, Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2021; 82:e236499. [PMID: 33729383 DOI: 10.1590/1519-6984.236499] [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] [Received: 04/12/2020] [Accepted: 07/28/2020] [Indexed: 11/22/2022] Open
Abstract
Distribution pattern and relative abundance of the agricultural rodent pests of rain-fed and irrigated areas of district Swat Khyber Pakhtunkhwa, Pakistan were recorded from April 2011 to November 2013 using wire mesh live traps. A total of 350 rodents (269 Rattus rattus and 81 Mus musculus) were captured under 2268 trap nights (trap success: 0.15). Regression of daily captures on cumulative captures revealed an estimate of 350 rodents from all the sampled structures with an average of 21.8 rodents per crop field. House rats (R. rattus; 76.8% of captures) were numerically dominant in almost all types of agricultural fields, and were significantly different from the mice (Mus musculus; 23.1% of captures). Both species were found together in some fields. The sex ratio revealed that males outnumbered the females in both of the reported species.
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Affiliation(s)
- W Khan
- University of Malakand, Department of Zoology, Lower Dir, Khyber Pakhtukhwa, Pakistan
| | - N N Nisa
- Karachi University Campus Karachi,Vertebrate Pest Control Institute, Southern Zone-Agricultural Research Center, Pakistan Agricultural Research Council, old Block 9&10, Karachi, Pakistan
| | - I Ilahi
- University of Malakand, Department of Zoology, Lower Dir, Khyber Pakhtukhwa, Pakistan
| | - M Romman
- University of Chitral, Department of Botany, Chitral, Pakistan
| | - R Parvez
- Government Girls Degree College Dargai, Department of Botany, Malakand, KP, Pakistan
| | - Naeem Khan
- Islamia College University, Department of Zoology, Peshawar, Pakistan
| | - A A Ujjan
- University of Sindh, Institute of Plant Sciences, Allams I.I. Kazi Campus, Jamshoro, Pakistan
| | - M Salim
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Pakistan
| | - A Hussain
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Pakistan
| | - U Habiba
- University of Haripur, Department of Forestry and Wildlife Management, Haripur, Pakistan
| | - A Alam
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
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Iwuala E, Odjegba V, Unung O, Alam A. Expression of stress responsive β-1,3-glucanase and chitinase genes in Arachis hypogaea seedlings against Macrophomina phaseolina. Gene Reports 2020. [DOI: 10.1016/j.genrep.2020.100693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mavrakanas TA, Giannetti N, Sapir-Pichhadze R, Alam A. Mineralocorticoid Receptor Antagonists and Renal Outcomes in Heart Failure Patients with and without Chronic Kidney Disease. Cardiorenal Med 2019; 10:32-41. [PMID: 31665724 DOI: 10.1159/000503223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 05/13/2019] [Accepted: 09/05/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The effect of mineralocorticoid receptor antagonists (MRAs) on chronic kidney disease (CKD) progression in patients with heart failure (HF) and with or without preexisting CKD has not been adequately studied. METHODS We conducted a retrospective cohort study including consecutive adult patients followed at the HF clinic of a tertiary care center who had already been on an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB). Exposure to MRAs was assessed at 6 months from registration. Patients who were never exposed to an MRA were the control group. RESULTS A total of 314 patients who were prescribed an MRA were compared to 1,116 patients who never received an MRA. Among them, 121 and 408 patients, respectively, had CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2). MRAs had to be discontinued in 36/121 patients with CKD (29.8%) and 57/165 patients without CKD (34.5%) (p = 0.39). MRA treatment was associated with a higher risk for persistent creatinine doubling among patients without CKD (hazard ratio 4.07, 95% confidence interval 1.41-11.73). A numerically lower risk was identified among CKD patients (hazard ratio 0.33, 95% confidence interval 0.04-2.78) (p for interaction = 0.009). The primary safety outcome, a composite of any doubling of serum creatinine or any episode of serious hyperkalemia (K+ >6 mmol/L), occurred more commonly in MRA users compared with nonusers in the subgroup of patients without CKD, but not in CKD patients (p for interaction = 0.02). CONCLUSION MRA treatment in addition to an ACEI or an ARB could be safely prescribed in HF patients with CKD as it is not associated with persistent renal function decline, acute kidney injury, or serious hyperkalemia, compared with ACEI/ARB monotherapy.
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Affiliation(s)
- Thomas A Mavrakanas
- Divisions of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada, .,Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland,
| | - Nadia Giannetti
- Division of Cardiology, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Ruth Sapir-Pichhadze
- Divisions of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Ahsan Alam
- Divisions of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
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Ballesteros N, Moscardi PRM, Blachman-Braun R, Salvitti M, Alam A, Castellan M, Kozakowski K, Gosalbez R, Labbie A. Use of small intestinal submucosa for corporal body grafting in cases of epispadias and epispadias/exstrophy complex. J Pediatr Urol 2019; 15:406.e1-406.e6. [PMID: 31221598 DOI: 10.1016/j.jpurol.2019.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 12/29/2018] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Male epispadias is a rare congenital urogenital anomaly in which the meatus is ectopically located along the dorsal midline of the penile shaft. In cases associated with severe curvature, functional and cosmetic outcomes could be accomplished by lengthening the shorter dorsal surface with the use of corporal grafting. Various graft materials have been used in the past for hypospadias repair including tunica vaginalis, dermis, and small intestinal submucosa (SIS). The use of SIS grafting for corporoplasty during epispadias repair has rarely been described in the literature. OBJECTIVE To report the experience in the management of dorsal corporal body grafting using SIS in children with severe penile curvature due to epispadias. STUDY DESIGN The authors retrospectively reviewed the charts of all patients with epispadias or bladder exstrophy/epispadias complex and severe dorsal chordee (>40°) who underwent epispadias repair with single-layer SIS for corporal body grafting. Clinical variables, surgical technique, and outcomes were analyzed. RESULTS A total of nine consecutive patients underwent staged epispadias repair with dorsal corporal single-layer SIS grafting (summary figure). Of these, four (44.4%) had primary penopubic epispadias, one (11.1%) had mid-shaft epispadias, and four (44.4%) had bladder exstrophy/epispadias complex. The mean age at surgery was 13.4 ± 6 months. After phalloplasty with SIS grafting, there were no reported complications related to the graft during the post-operative period or follow-up visits. DISCUSSION Although traditional techniques for epispadias repair allow some degree of corporal lengthening, they also result in abrupt medial rotation of the corporal bodies leading to torqueing and potential unsatisfactory cosmetic results. In contrast, the authors use single-layer SIS for corporal body grafting, and this study technique results in a more gradual inward rotation thus allowing more anatomical accuracy. Furthermore, an advantage of the use of SIS over other grafting materials is that there is no need to harvest an autologous graft such as tunica vaginalis or dermis. CONCLUSION Epispadias repair using single-layer SIS corporal body grafting is an effective, safe, and feasible method, which provides satisfactory cosmesis and correction of dorsal curvature in congenital epispadias in children. Furthermore, a more normal penis appearance, without a decrease in the corporal length or diameter, is achieved with this technique.
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Affiliation(s)
- N Ballesteros
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA
| | - P R M Moscardi
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA.
| | - R Blachman-Braun
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA
| | - M Salvitti
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | - A Alam
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | - M Castellan
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | - K Kozakowski
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | - R Gosalbez
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | - A Labbie
- Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, USA; Division of Pediatric Urology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA
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Ferguson TW, Garg AX, Sood MM, Rigatto C, Chau E, Komenda P, Naimark D, Nesrallah GE, Soroka SD, Beaulieu M, Alam A, Kim SJ, Dixon S, Manns B, Tangri N. Association Between the Publication of the Initiating Dialysis Early and Late Trial and the Timing of Dialysis Initiation in Canada. JAMA Intern Med 2019; 179:934-941. [PMID: 31135821 PMCID: PMC6547160 DOI: 10.1001/jamainternmed.2019.0489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Published in 2010, the Initiating Dialysis Early and Late (IDEAL) randomized clinical trial, which randomized patients with an estimated glomerular filtration rate (GFR) between 10 and 15 mL/min/1.73 m2 to planned initiation of dialysis with an estimated GFR between 10 and 14 mL/min/1.73 m2 (early start) or an estimated GFR between 5 and 7 mL/min/1.73 m2 (late start), concluded that early initiation was not associated with improved survival or clinical outcomes. OBJECTIVE To assess the association between the IDEAL trial results and the proportion of early dialysis starts over time. DESIGN, SETTING, AND PARTICIPANTS This interrupted time series analysis used data from the Canadian Organ Replacement Register to study adult (≥18 years of age) patients with incident chronic dialysis between January 1, 2006, and December 31, 2015, in Canada, which has a universal health care system. Patients from the province of Quebec were excluded because its privacy laws preclude submission of deidentified data without first-person consent. The patients included in the study (n = 28 468) had at least 90 days of nephrologist care before starting dialysis and a recorded estimated GFR at dialysis initiation. Data analyses were performed from November 2016 to January 2019. MAIN OUTCOMES AND MEASURES The primary outcome was the proportion of early dialysis starts (estimated GFR >10.5 mL/min/1.73 m2), and the secondary outcomes included the proportions of acute inpatient dialysis starts, patients who started dialysis using a home modality, and patients receiving hemodialysis who started with an arteriovenous access. Measures included the trend prior to the IDEAL trial publication, the change in this trend after publication, and the immediate consequence of publication. RESULTS The final cohort comprised 28 468 patients, of whom 17 342 (60.9%) were male and the mean (SD) age was 64.8 (14.6) years. Before the IDEAL trial, a statistically significant increasing trend was observed in the monthly proportion of early dialysis starts (adjusted rate ratio, 1.002; 95% CI, 1.001-1.004; P = .004). After the IDEAL trial, an immediate decrease was observed in the proportion of early dialysis starts (rate ratio, 0.874; 95% CI, 0.818-0.933; P < .001), along with a statistically significant change in trend between the pretrial and posttrial periods (rate ratio, 0.994; 95% CI, 0.992-0.996; P < .001). No statistically significant differences were found in acute inpatient dialysis initiations, the proportion of patients receiving home dialysis as the initial modality, or the proportion of arteriovenous access creation at hemodialysis initiation after the IDEAL trial publication. CONCLUSIONS AND RELEVANCE The publication of the IDEAL trial appeared to be associated with an immediate and meaningful change in the timing of dialysis initiation in Canada.
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Affiliation(s)
- Thomas W Ferguson
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Amit X Garg
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Department of Medicine, Western University, London, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Manish M Sood
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Claudio Rigatto
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Elaine Chau
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - Paul Komenda
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
| | - David Naimark
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Gihad E Nesrallah
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Humber River Hospital, Toronto, Ontario, Canada
| | - Steven D Soroka
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Monica Beaulieu
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,BC Renal Agency, Vancouver, British Columbia, Canada
| | - Ahsan Alam
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - S Joseph Kim
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Dixon
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Braden Manns
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Navdeep Tangri
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
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Alam A, Mukherjee A, Xu J, Pagan E, Hiltner E, Rios E, Pollack S, Iyer D, Mody K, Kassotis J, James D, Jermyn R, Almendral J. Validating the Newly Reported ASA Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.965] [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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Alam A, Doshi H, Hiltner E, Rios E, Kassotis J, Mody K, Iyer D, Almendral J. Efficacy and Safety of Short-Term Universal Prophylaxis for Invasive Aspergillosis after Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and one of the most common causes of end-stage kidney disease. Multiple clinical manifestations, such as enlarged kidneys filled with growing cysts, hypertension, and multiple extrarenal complications, including liver cysts, intracranial aneurysms, and cardiac valvular disease, show that ADPKD is a systemic disorder. New information derived from clinical research using molecular genetics and advanced imaging techniques has provided enhanced tools for assessing the diagnosis and prognosis for individual patients and their families. Phase 3 randomised, placebo-controlled clinical trials have clarified aspects of disease management and a disease-modifying therapeutic drug is now available for patients with high risk of rapid disease progression. These developments provide a strong basis on which to make clear recommendations about the management of affected patients and families. Implementation of these advances has the potential to delay kidney failure, reduce the symptom burden, lessen the risk of cardiovascular complications, and prolong life.
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Affiliation(s)
- Emilie Cornec-Le Gall
- Service de Néphrologie, Hémodialyse et Transplantation Rénale, Centre Hospitalier Universitaire, Brest, France; UMR1078 Génétique, Génomique Fonctionnelle et Biotechnologies, INSERM, Université de Brest, Brest, France; Université de Bretagne Occidentale, Brest, France
| | - Ahsan Alam
- Division of Nephrology, McGill University Health Centre, Montreal, QC, Canada
| | - Ronald D Perrone
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
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Sandal S, Charlebois K, Fiore JF, Wright DK, Fortin MC, Feldman LS, Alam A, Weber C. Health Professional-Identified Barriers to Living Donor Kidney Transplantation: A Qualitative Study. Can J Kidney Health Dis 2019; 6:2054358119828389. [PMID: 30792874 PMCID: PMC6376531 DOI: 10.1177/2054358119828389] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 10/02/2018] [Accepted: 12/18/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Living donor kidney transplantation (LDKT) has several advantages over deceased donor kidney transplantation. Yet rates of living donation are declining in Canada and there exists significant interprovincial variability. Efforts to improve living donation tend to focus on the patient and barriers identified at their level, such as not knowing how to ask for a kidney or lack of education. These efforts favor those who have the means and the support to find living donors. Thus, a Canadian Institutes of Health Research (CIHR)-organized workshop recommended that education efforts to understand and remove barriers should focus on health professionals (HPs). Despite this, little attention has been paid to what they identify as barriers to discussing LDKT with their patients. OBJECTIVE Our aim was to explore HP-identified barriers to discuss living donation with patients in 3 provinces of Canada with low (Quebec), moderate (Ontario), and high (British Columbia) rates of LDKT. DESIGN This study consists of an interpretive descriptive approach as it enables to move beyond description and inform clinical practice. SETTING Purposive criterion and quota sampling were used to recruit HPs from Quebec, Ontario, and British Columbia who are involved in the care of patients with kidney disease and/or with transplant coordination. PATIENTS Not applicable. MEASUREMENTS Semistructured interviews were conducted. The interview guide was developed based on a preliminary analytical framework and a review of the literature. METHODS Thematic analysis was used to analyze the data stemming from the interviews. The coding process comprised of a deductive and inductive approach, and the use of a qualitative analysis software (NVivo 11). Following this, themes were identified and developed. Interviews were conducted until thematic saturation was obtained. In total, we conducted 16 telephone interviews as thematic saturation was attained. RESULTS Six predominant themes emerged: (1) lack of communication between transplant and dialysis teams, (2) absence of referral guidelines, (3) role perception and lack of multidisciplinary involvement, (4) HP's lack of information and training, (5) negative attitudes of some HP toward LDKT, (6) patient-level barriers as defined by the HP. HPs did mention patients' attitudes and some characteristics as the main barriers to discussions about living donation; this was noted in all provinces. HPs from Ontario and British Columbia indicated multiple strategies being implemented to address some of these barriers. Those from Ontario mentioned strategies that center on the core principles of provincial-level standardization, while those from British Columbia center on engaging the entire multidisciplinary team and improved role perception. We noted a dearth of such efforts in Quebec; however, efforts around education and promotion, while tentative, have emerged. LIMITATIONS Social desirability and selection bias. Our analysis might not be applicable to other provinces. CONCLUSIONS HPs involved with the referral and coordination of transplantation play a major role in access to LDKT. We have identified challenges they face when discussing living donation with their patients that warrant further assessment and research to inform policy change.
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Affiliation(s)
- Shaifali Sandal
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | | | - Julio F. Fiore
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - David Kenneth Wright
- St. Mary’s Research Center, Montreal, QC, Canada
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Marie-Chantal Fortin
- Division of Nephrology, Department of Medicine, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Liane S. Feldman
- Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Catherine Weber
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
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