1
|
Alsarraf F, Ali DS, Almonaei K, Al-Alwani H, Khan AA, Brandi ML. Hypophosphatasia: presentation and response to asfotase alfa. Osteoporos Int 2024; 35:717-725. [PMID: 37993691 DOI: 10.1007/s00198-023-06943-z] [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: 05/28/2023] [Accepted: 10/04/2023] [Indexed: 11/24/2023]
Abstract
Hypophosphatasia (HPP) is a rare bone disease with limited scientific evidence on the tolerability and safety of its novel treatment, Asfotase Alfa (AA). We report 7 HPP patients' heterogenous presentations and the significant improvement in various clinical outcomes attained with AA shedding light on this highly effective and safe therapy. INTRODUCTION Hypophosphatasia (HPP) is a rare inherited metabolic bone disorder characterized by a deficiency in the tissue non-specific alkaline phosphatase (TNSALP) due to loss of function mutation in the ALPL gene. HPP is associated with impaired skeletal mineralization due to elevations in inorganic pyrophosphate and altered phosphate : pyrophosphate ratio. Asfotase alfa (AA) "enzyme replacement" was approved for treatment of HPP in 2015. We present 7 patients with HPP, 5 with pediatric-onset, and 2 with adult-onset, who have been treated with AA and describe the efficacy and safety in these patients. METHODS 7 patients (4 females, 3 males) aged 19-68 years with HPP were included in this study. Diagnosis of HPP was confirmed by DNA analysis. AA was administered in doses of 6mg/kg/week with a mean follow-up of 6 months (SD= 5). RESULTS Subjective improvement in muscle strength, muscle pain, walking ability, and walking distance with a reduction in the use of gait aids was seen "with AA in HPP patients." Muscle strength and pain improved by up to 70% from baseline as quantified subjectively by patients. Walking distance improved by up to 100%. Patients also reported improved cognition, mood, and energy levels, with up to 90% improvement in mood and 75% improvement in energy levels. 4 out of 6 patients first noted clinical signs of improvement after 3 months of being on therapy. 1 out of the 7 patients sustained a toe fracture 10 months from being on AA. AA was well-tolerated with injection site reactions being the most reported adverse effect. CONCLUSION HPP treatment with AA in individuals with both pediatric and adult-onset forms resulted in significant subjective improvement in musculoskeletal and cognitive manifestations in addition to patients' quality of life. The drug was well tolerated in 6 patients. 1 patient discontinued therapy because of minor adverse effects with myalgias.
Collapse
Affiliation(s)
- F Alsarraf
- Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada.
| | - D S Ali
- Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada
| | - K Almonaei
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - H Al-Alwani
- Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - A A Khan
- Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada
| | - M L Brandi
- F.I.R.M.O. Italian Foundation for the Research on Bone Diseases, Florence, Italy
- Donatello Bone Clinic, Villa Donatello Hospital, Florence, Italy
| |
Collapse
|
2
|
Saeed U, Uppal R, Khan AA, Uppal MR, Piracha ZZ, Uppal SR. Analytical assessment of clinical sensitivity and specificities of pharmaceutical rapid SARS-CoV-2 detection nasopharyngeal swab testing kits in Pakistan. BRAZ J BIOL 2024; 84:e265550. [PMID: 38451627 DOI: 10.1590/1519-6984.265550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/28/2022] [Indexed: 03/08/2024] Open
Abstract
Despite of the global unity against COVID-19 pandemic, the threat of SARS-CoV-2 variants on the lives of human being is still not over. SARS-CoV-2 pandemic has urged the need of rapid viral detection at earliest. To cope with gradually expanding scenario of SARS-CoV-2, accurate diagnosis is extremely crucial factor which should be noticed by international health organizations. Limited research followed by sporadic marketing of SARS-CoV-2 rapid pharmaceutical detection kits raises critical questions against quality assurance and quality control measures. Herein we aimed to interrogate effectivity and specificity analysis of SARS-CoV-2 pharmaceutical rapid detection kits (nasopharyngeal swab based) using conventional gold standard triple target real-time polymerase chain reaction (USFDA approved). A cross-sectional study was conducted over 1500 suspected SARS-CoV-2 patients. 100 real time-PCR confirmed patients were evaluated for pharmaceutical RDT kits based upon nasopharyngeal swab based kits. The SARS-CoV-2 nasopharyngeal swab based rapid diagnostic kit (NSP RDTs) analysis showed 78% reactivity. Among real time PCR confirmed negative subjects, 49.3% represented false positivity. The positive predictive analysis revealed 67.82%, while negative predictive values were 64.40%. The NSP RDTs showed limited sensitivities and specificities as compared to gold standard real time PCR. Valid and authentic detection of SARS-CoV-2 is deemed necessary for accurate COVID-19 surveillance across the globe. Current study highlights the potential consequences of inadequate detection of SARS-CoV-2 and emerging novel mutants, compromising vaccine preventable diseases. Current study emphasizes need to wake higher authorities including strategic organizations for designing adequate measures to prevent future SARS-CoV-2 epidemics.
Collapse
Affiliation(s)
- U Saeed
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
- Foundation University Islamabad Pakistan, Foundation University School of Health Sciences, Clinical and Biomedical Research Center, Islamabad, Pakistan
| | - R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - A A Khan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - M R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| | - Z Z Piracha
- International Center of Medical Sciences Research - ICMSR, Islamabad, Pakistan
- International Center of Medical Sciences Research - ICMSR, Austin, TX, United States of America
- International Center of Medical Sciences Research - ICMSR, Chadwell Health, United Kingdom
| | - S R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, Islamabad, Pakistan
| |
Collapse
|
3
|
Rahmani AH, Almatroudi A, Allemailem KS, Alharbi HOA, Babiker AY, Althwab SA, Alsuhaymi N, Alsugoor MH, Khan AA, Al-Megrin WAI. Oleuropein, a phenolic component of Olea europaea L. ameliorates CCl4-induced liver injury in rats through the regulation of oxidative stress and inflammation. Eur Rev Med Pharmacol Sci 2024; 28:1259-1271. [PMID: 38436159 DOI: 10.26355/eurrev_202402_35447] [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: 03/05/2024]
Abstract
OBJECTIVE This study aimed to assess the hepatoprotective role of oleuropein (Olp), a phenolic compound found in olive, against carbon tetrachloride (CCl4)-induced liver damage in rats. MATERIALS AND METHODS The research involved male albino rats, which received intraperitoneal injections of 100 mg/kg b.w. of oleuropein for 8 consecutive weeks before being subjected to carbon tetrachloride (CCl4) at a dosage of 1.0 ml/kg b.w. Changes induced by CCl4 in antioxidant and inflammatory marker levels were assessed using ELISA assay kits. Moreover, CCl4-induced liver tissue architecture alteration, fibrosis, and expression pattern of protein were evaluated by performing H&E, Sirius red, Masson trichrome, and immunohistochemistry staining. RESULTS Increased serum transaminases and massive hepatic damage were observed by this liver toxicant. The hepatic injury was further evidenced by a significant decrease in antioxidant enzyme activity [superoxide dismutase (SOD), glutathione peroxidase (GPx), Glutathione (GSH) and Total Antioxidant Capacity (T-AOC)]. The administration of CCl4 resulted in an increased inflammatory response, which was measured by C-reactive protein, interleukin-6, as well as tumor necrosis factor-alpha. Olp as a curative regimen led to significant attenuation in the inflammatory response and oxidative/nitrosative stress. This polyphenol treatment improved the hepatic tissue architecture and decreased fibrosis. In the CCl4 treatment group, the expression pattern of IL-6 protein was high, whereas expression was decreased after Olp, as evidenced by immunohistochemistry staining. CONCLUSIONS The study suggests that oleuropein treatment has the potential to reduce liver damage caused by CCl4 induction by inhibiting oxidative stress and inflammation and maintaining liver tissue architecture. This could make it a promising treatment option for liver pathogenesis.
Collapse
Affiliation(s)
- A H Rahmani
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Alanazi AM, Khan AA, Mahmood A, Bajwa HA, Kamal MA, Baig EA. Disinfection by methylthionine chloride and chitosan in combination with Photo radiation therapy on caries affected dentin nano hardness, adhesive integrity, and bond failure. Eur Rev Med Pharmacol Sci 2024; 28:39-48. [PMID: 38235896 DOI: 10.26355/eurrev_202401_34889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE The aim of the study was to assess the disinfection efficacy, bond integrity, and nano hardness of caries-affected dentin (CAD) surface bonded to resin cement when disinfected with chlorhexidine (CHX), Methylene blue activated by Photodynamic therapy (MB-PDT), chitosan, silver diamine fluoride (SDF), chitosan activated by PDT, and SDF-diode laser against S. mutans. MATERIALS AND METHODS A total of 60 human mandibular molars were extracted non-traumatically and gathered using ICDAS criteria. The dentin surface was prepared, leaving CAD to receive a disinfection procedure. After inoculation with S. mutans, the CAD samples were divided into six groups and disinfected with various disinfectants (n = 10) CHX, MB-PDT, chitosan, chitosan-PDT, SDF, and SDF+ diode laser. Survival rates of S. mutans were analyzed following the restoration of samples with resin cement via the etch and rinse method to assess SBS. Also, nano hardness was analyzed. Statistical analysis was performed by using the ANOVA and the Tukey multiple test (p<0.05). The Kruskal-Wallis test was used to evaluate the change in survival rate. RESULTS Related to the survival rates, the SDF+ diode laser displayed the highest reduction in S. mutans levels and chitosan presented the lowest level of disinfection. The intergroup comparison revealed that CHX and chitosan-PDT displayed comparable outcomes of S. mutans survival rate to that of SDF+ diode laser (p>0.05). Likewise, MB-PDT and SDF displayed a comparable survival rate of S. mutans to Chitosan disinfection (p>0.05). Considering SBS and nano hardness, the highest SBS and NH were exhibited by the SDF+ diode laser, and the lowest SBS and NH values were exhibited by MB-PDT. The intragroup comparison revealed that CAD specimens disinfected with Chitosan-PDT showed comparable SBS and NH values to the SDF+ diode laser (p>0.05). CHX, chitosan, and SDF exhibited bond values and NH comparable to MB-PDT (p<0.05). CONCLUSIONS Synergistic use of Silver diamine fluoride with diode laser and chitosan activated by PDT can be used as an alternative to CHX for controlling S. mutans growth, promoting enhanced bond efficacy and nano hardness for bonding resin cement to the caries-affected dentin.
Collapse
Affiliation(s)
- A M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | | | | | | | | | | |
Collapse
|
5
|
Lew B, Meir A, Khan AA, Khan MA, Tarre S, Green M. Ammonia gas treatment in low cost biological reactor. Bioresour Technol 2024; 391:129949. [PMID: 37926359 DOI: 10.1016/j.biortech.2023.129949] [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: 08/09/2023] [Revised: 10/20/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
Ammonia gas contributes to a number of environmental and human health concerns. The use of chalk, a cheap alkalinity source may reduce costs for biological systems. This research studies a closed liquid flow reactor to treat ammonia gas using chalk as biomass media and alkalinity source with high value calcium nitrate fertilizer production. The proposed reactor showed complete ammonia gas removal at high rate (500 mg N/L/day) and with low cost; where chalk dissolution and ammonia gas absorption contributed to alkalinity in the water for nitrification. High calcium ion concentration (up to 10,000 mg Ca2+ as CaCO3/L) showed only minor effects on ammonia absorption and nitrification rate.
Collapse
Affiliation(s)
- B Lew
- Department of Civil Eng, Ariel University, Israel.
| | - A Meir
- Faculty of Civil and Environmental Engineering, Technion, Israel
| | - A A Khan
- Department of Civil Engineering Jamia Millia Islamia (A Central University), New Delhi, India
| | - M A Khan
- Centre for Rural Development and Technology, Indian Institute of Technology Delhi, Delhi, India
| | - S Tarre
- Faculty of Civil and Environmental Engineering, Technion, Israel
| | - M Green
- Faculty of Civil and Environmental Engineering, Technion, Israel
| |
Collapse
|
6
|
Kim HS, Khan AA, Park JY, Lee S, Ahn YH. Mechanical Control of Polaritonic States in Lead Halide Perovskite Phonons Strongly Coupled in THz Microcavity. J Phys Chem Lett 2023; 14:10318-10327. [PMID: 37943739 DOI: 10.1021/acs.jpclett.3c02717] [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: 11/12/2023]
Abstract
We demonstrate the generation and control of polaritonic states in perovskite phonon polaritons, which are strongly coupled in the middle of a flexible Fabry-Perot cavity. We fabricated flexible perovskite films on a microporous substrate coated with graphene oxide, which led to a virtually free-standing film incorporated into the microcavity. Rabi splitting was observed when the cavity resonance was in tune with that of the phonons. The Rabi splitting energy increased as the film thickness increased, reaching 1.9 meV, which is 2.4-fold higher than the criterion for the strong coupling regime. We obtained dispersion curves for various perovskite film thicknesses exhibiting two polariton branches; clear beats between the two polaritonic branches were observed in the time domain. Flexible cavity devices with perovskite phonons enable macroscopic control over the polaritonic energy states through bending processes, which add an additional degree of freedom in the manipulation of polaritonic devices.
Collapse
Affiliation(s)
- H S Kim
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, Korea
| | - A A Khan
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, Korea
| | - J-Y Park
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, Korea
| | - S Lee
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, Korea
| | - Y H Ahn
- Department of Physics and Department of Energy Systems Research, Ajou University, Suwon 16499, Korea
| |
Collapse
|
7
|
Khan AA, Ullah S, Altanji M, Amin R, Haider N, Alshehri A, Riaz MB. A numerical study of spatio-temporal COVID-19 vaccine model via finite-difference operator-splitting and meshless techniques. Sci Rep 2023; 13:12108. [PMID: 37495630 PMCID: PMC10372105 DOI: 10.1038/s41598-023-38925-w] [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: 10/06/2022] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
In this paper, a new spatio-temporal model is formulated to study the spread of coronavirus infection (COVID-19) in a spatially heterogeneous environment with the impact of vaccination. Initially, a detailed qualitative analysis of the spatio-temporal model is presented. The existence, uniqueness, positivity, and boundedness of the model solution are investigated. Local asymptotical stability of the diffusive COVID-19 model at steady state is carried out using well-known criteria. Moreover, a suitable nonlinear Lyapunov functional is constructed for the global asymptotical stability of the spatio-temporal model. Further, the model is solved numerically based on uniform and non-uniform initial conditions. Two different numerical schemes named: finite difference operator-splitting and mesh-free operator-splitting based on multi-quadratic radial basis functions are implemented in the numerical study. The impact of diffusion as well as some pharmaceutical and non-pharmaceutical control measures, i.e., reducing an effective contact causing infection transmission, vaccination rate and vaccine waning rate on the disease dynamics is presented in a spatially heterogeneous environment. Furthermore, the impact of the aforementioned interventions is investigated with and without diffusion on the incidence of disease. The simulation results conclude that the random motion of individuals has a significant impact on the disease dynamics and helps in setting a better control strategy for disease eradication.
Collapse
Affiliation(s)
- Arshad A Khan
- Department of Mathematics, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Saif Ullah
- Department of Mathematics, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Mohamed Altanji
- Department of Mathematics College of Science, King Khalid University, Abha, 61413, Saudi Arabia
| | - Rohul Amin
- Department of Mathematics, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Nadeem Haider
- Department of Mathematics, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Ahmed Alshehri
- Department of Mathematics, Faculty of Sciences, King Abdulaziz University, Jidda, 21589, Saudi Arabia
| | - Muhammad Bilal Riaz
- Faculty of Applied physics and Mathematics, Gdansk University of Technology, Gdansk, Poland.
- Department of Computer Science and Mathematics, Lebanese American University, Byblos, Lebanon.
- Department of Mathematics, University of Management and Technology, Lahore, Pakistan.
| |
Collapse
|
8
|
Saeed U, Uppal MR, Uppal MS, Uppal R, Khan AA, Hassan A, Piracha ZZ. Hepatitis C virus associated ALT, AST, GGT, Bili T, HB, HBA1C, CREAT, PT, aPPT, AFP, CEA, CA 125, CA 19-9, iPTH biomarkers, computed tomography and HCV burden of disease during pre COVID-19 era (2018-2019) and post COVID-19 era (2020-2022) in Pakistan. BRAZ J BIOL 2023; 84:e271451. [PMID: 37341223 DOI: 10.1590/1519-6984.271451] [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: 01/25/2023] [Accepted: 03/30/2023] [Indexed: 06/22/2023] Open
Abstract
The national burden of HCV has significantly mounted over the period of last few decades placing Pakistan at the worst placement of second largest burden of HCV globally. Herein for the first time from Pakistan, we examined clinical correlation of potential biomarkers with HCV. Nation-wide study was conducted on 13,348 suspected HCV patients during 2018-2022. During pre-COVID-19 era of 2018-2019, prevalence of HCV remained 30%. During 2018, among HCV positive patients, 91% of ALT, 63% of AST, 67% of GGT, 28% of Bili T, 62% of HB, 15% of HBA1C, 25% of CREAT, 15% of PT, 15% of aPTT and 64% of AFP were abnormal. During 2019, among HCV infected 74.47% of ALT, 63.54% of AST, 70.24% of GGT, 24.71% of Bili T, 8.77% of HB and 75% of AFP were raised. CT/CAT scan revealed 4.65% liver complications (mild 13.04%, moderate 30.43% and severe 56.52%). During 2020, HCV prevalence remained 25%. 65.17% of ALT, 64.20% of AST, 68.75% of GGT, 31.25% of Bili T, 20.97% of HB, 4.65% of CREAT and 73.68% of AFP levels were raised. CAT analysis revealed liver complications among 4.41% (14.81% mild, 40.74% moderate, and 44.44% sever). 85.71% of participants diabetes was out of control. During 2021, HCV prevalence remained 27.1%. ALT (73.86%), AST (50.6%), GGT (67.95%), Bili T (28.21%), HB (20%), CREAT (5.8%) and AFP (82.14%) levels were abnormal. During 2022, the levels of ALT (56.06%), AST (56.36%), GGT (56.6%), Bili T (19.23%), HB (43.48%), HBA1C (14.81), CREAT (18.92%), AFP (93.75%) were abnormal. CAT analysis revealed 7.46% liver complications (25% mild, 30.36% moderate, and 42.86% sever). During 2021-2022, 83.33% of subject's diabetes was not controlled.
Collapse
Affiliation(s)
- U Saeed
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
- Foundation University Islamabad, Foundation University School of Health Sciences, Clinical and Biomedical Research Center, Islamabad, Pakistan
| | - M R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - M S Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - R Uppal
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - A A Khan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - A Hassan
- Islamabad Diagnostic Center - IDC, Department of Research and Development, F-8 Markaz, Islamabad, Pakistan
| | - Z Z Piracha
- International Center of Medical Sciences Research - ICMSR, Islamabad, Pakistan
| |
Collapse
|
9
|
Farooq M, Khan AA. Evaluation of histo-toxicity of nimesulide in Black Kites (Milvus migrans): a pharmacodynamic study. BRAZ J BIOL 2023; 83:e271454. [PMID: 37222370 DOI: 10.1590/1519-6984.271454] [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: 01/25/2023] [Accepted: 04/19/2023] [Indexed: 05/25/2023] Open
Abstract
The present experimental work was conducted to elucidate the toxicity of nimesulide at three different doses in black kites (Milvus migrans). M. migrans is one of the most common raptors near human habitations. The goal of the current investigation was to determine whether nimesulide is similarly hazardous to raptors as was diclofenac sodium and to investigate the acute oral toxicity of nimesulide in these birds. For this study, eight adult male black kites (M. migrans) were randomly divided into four groups. M. migrans in the control group (n = 02) were not treated with nimesulide. The other three groups were given nimesulide doses. The birds in the first (n = 02) were declared the control group. The second (n = 02), third (n = 02), and fourth groups were administered nimesulide at a low, medium, and high dose of 2, 4, and 6 mg/kg live body weight of bird/day, respectively, for 10 days. Nimesulide-addled birds became listless and despondent, then anorexic. The birds were standing there with their eyes closed and showing no signs of life. There was an increase in saliva production, a slowing of breathing, and dilated pupils. No clinical signs were observed in the control group. No mortality was seen in the control or treated groups. The control group did not show lesions of gout, but black kites intoxicated with nimesulide at 2, 4, and 6 mg/kg live body weight of bird/day showed inflammation, apoptosis, hemorrhage, necrosis, and leukocytic infiltration tissues of the liver, kidney, and heart of black kites (M. migrans) treated with different concentrations of nimesulide. The treated groups also showed apoptosis of myofibrils and hyperplasia. The hypertrophy, atrophy, fibrosis, necrosis of skeletal muscles and hemorrhage were prominent in the muscles of black kites (M. migrans) intoxicated with nimesulide. All observed histological alterations got worse in a dose-related way. There was no significant difference in AST, ALT, ALP, serum uric acid, but a significant difference was observed in the values of serum urea (p = 0.001) and serum creatinine (p = 0.019).
Collapse
Affiliation(s)
- M Farooq
- Ghazi University, Department of Zoology, Dera Ghazi Khan, Pakistan
| | - A A Khan
- Bahauddin Zakariya University, Institute of Zoology, Multan, Pakistan
| |
Collapse
|
10
|
Khan AA, Shah N, Raison K, Khan T, Esmail M, Watkin R, Basavarajaiah S. A novel scoring system to predict cardiac device implantation in patients presenting with syncope. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac syncope occurs when the heart fails to maintain cardiac output to match cerebral need and can occur due to either mechanical/structural defect of the heart or secondary to an arrhythmia. It has a raised 1-year mortality with some figures estimating this as high as 30%. Implantable loop recorders (ILR) are a useful diagnostic tool in patients presenting with syncope or pre-syncope to ascertain a cardiac cause. A higher number of patients are presenting with advancing age and undergoing ILR implantation. Subsequently, they end up requiring a cardiac implantable electronic device (CIED) implantation, adding to additional costs, exposure to procedural complications and frequent hospitalisations.
Purpose
To investigate the number of patients undergoing CIED implantation following implantation of ILRs for syncope and identify predictors of CIED implantation in patients presenting with syncope.
Methods
A retrospective analysis of 736 patients who underwent ILR implantation at our teaching hospital trust between November 2012 to October 2020. Data on demographics, clinical characteristics, pathology results, ECGs, holter findings and CIED implanted was collected using the local electronic patient record system. The data was analysed using SPSS software. Univariable and multivariable regression analysis and ROC curve analysis was carried out to determine prediction model for CIED implantation.
Results
The mean age of patients who underwent an ILR implantation was 65±19 years. 22% of patients required CIED implantation, 68% of patients did not require a cardiac device and were safely discharged and 10% of patients died during follow up. Age (p<0.001), male sex (p=0.006), impaired left ventricular function (p=0.04) and presence of hypertension (p=0.04) were found to be independent predictors of CIED implantation on univariable and multivariable regression analysis (see Table 1).
Conclusions
Old age, presence of coronary artery disease, impaired left ventricular function and presence of hypertension are inter-linked and in our study were found to be key predictors of poor prognosis and thus requiring CIED implantation. We propose a scoring system based on age >75, male sex, presence of ischaemic heart disease, heart failure and hypertension as key markers of conduction abnormalities requiring CIED implantation (see fi−ure 1).
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A A Khan
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - N Shah
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - K Raison
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - T Khan
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - M Esmail
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - R Watkin
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| | - S Basavarajaiah
- Heart of England NHS Foundation Trust , Birmingham , United Kingdom
| |
Collapse
|
11
|
Khan AA, Javed S, Yaqoob E, Wellington J. 163 Anterior Sacral Meningocystocele Manifesting as Vague Gastrointestinal and Urinary Syndromes – Two Case Reports. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.120] [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: 11/06/2022]
Abstract
Abstract
Aim
Anterior Sacral Meningocystocele (ASM) carries a unique place in the current literature regarding its rarity. The condition arises in association with a congenital defect of the sacrum and coccyx through which the caudal part of the meninges may herniate to form a cyst-like structure. The disorder derives from a genetic defect of the coccyx and sacrum of which some meningeal segments protrude or herniate, forming a cyst-like entity.
Method
We report two cases of ASM. The first is a 65-year-old male with active complaints of urinary retention and hesitancy for two weeks and chronic constipation associated with lower back pain. The second, a 17-year-old girl, was presenting with abdominal bloating, pain, and backache. Magnetic resonance imaging (MRI) of the pelvis and lumbosacral spine was conducted for both patients, respectively, each scan exhibiting evidence of ASM development. Surgical correction and closure of the ASM's were performed via a posterior midline approach, which successfully alleviated the symptoms presented clinically by both patients.
Conclusions
ASM may develop asymptomatically, often with incidental discovery. Although ASM is well-regarded as a rare anomaly, diagnosis of such a defect must always be kept pertinent when a cystic structure in the pelvis is unveiled on ultrasound or during surgery. Puncture or aspiration of the cyst should be avoided if the diagnosis is in doubt. A posterior midline approach with careful obliteration of the meningocele sac opening may be curative.
Collapse
Affiliation(s)
- AA Khan
- Department of Neurosurgery, Holy Family Hospital , Rawalpindi , Pakistan
| | - S Javed
- Department of Neurosurgery, Holy Family Hospital, Rawalpindi Medical University , Rawalpindi , Pakistan
| | - E Yaqoob
- Department of Neurosurgery, Fauji Foundation Hospital , Rawalpindi , Pakistan
| | - J Wellington
- Cardiff University School of Medicine , Cardiff , United Kingdom
| |
Collapse
|
12
|
Ali I, Salah KBH, Sher H, Ali H, Ullah Z, Ali A, Alam N, Shah SA, Iqbal J, Ilyas M, Al-Quwaie DAH, Khan AA, Mahmood T. Drought stress enhances the efficiency of floral dip method of Agrobacterium-mediated transformation in Arabidopsis thaliana. BRAZ J BIOL 2022; 84:e259326. [PMID: 35703626 DOI: 10.1590/1519-6984.259326] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/30/2022] [Indexed: 11/22/2022] Open
Abstract
The Agrobacterium-mediated floral dip protocol is the most extensively used transformation method for a model plant Arabidopsis thaliana. Several useful methods for Agrobacterium tumefaciens-mediated transformations of Arabidopsis are existing, but they are time consuming and with low transformation efficiency. Here, we developed a transgenic Arabidopsis lines TET12p::TET12-RFP in a short period of time and enhanced transformation efficiency by using a modified transformation method by applying drought stress after floral dip. In this protocol, Agrobacterium cells carrying TET12p::TET12-RFP recombinant vectors were resuspended in a solution of 5% sucrose, 0.05% (v/v) silwet L-77 to transform female gametes of developing Arabidopsis inflorescences. Treated Arabidopsis were then applied with different levels of drought stresses to stimulate plants for the utilization of maximum plant energy in seed maturation process. The applied stresses achieved the fast maturation of already treated inflorescences while stopped the growing of newly arising untreated inflorescence, thus decreased the chances of wrong collection of untransformed seeds. Consequently, the collected seeds were mostly transgenic with a transformation frequency of at least 10%, thus the screening for positive transformants selection was more advantageous on a selective medium as compared to a classical floral dip method. Within 2-3 months, two hundred of individual transgenic plants were produced from just 10 infiltrated plants. This study concludes that application of drought stresses in a specific stage of plant is a beneficial strategy for achieving the transgenic Arabidopsis in a short period of time with high transformation efficiency.
Collapse
Affiliation(s)
- I Ali
- University of Swat, Centre for Plant Science and Biodiversity, Charbagh, Pakistan.,Chinese Academy of Sciences, Institute of Genetics and Developmental Biology, State Key Laboratory of Molecular Developmental Biology, Beijing, China
| | - K B H Salah
- King Abdulaziz University, College of Science & Arts, Biological Sciences Department, Rabigh, Saudi Arabia.,University of Monastir, Faculty of Pharmacy, Laboratory of Transmissible Diseases and Biologically Active Substances, Monastir, Tunisia
| | - H Sher
- University of Swat, Centre for Plant Science and Biodiversity, Charbagh, Pakistan
| | - H Ali
- University of Swat, Centre for Plant Science and Biodiversity, Charbagh, Pakistan
| | - Z Ullah
- University of Swat, Centre for Plant Science and Biodiversity, Charbagh, Pakistan
| | - A Ali
- University of Swat, Centre for Plant Science and Biodiversity, Charbagh, Pakistan
| | - N Alam
- University of Swat, Centre for Agricultural Sciences and Forestry, Charbagh, Pakistan
| | - S A Shah
- National University of Medical Sciences, Department of Biological Sciences, Rawalpindi, Pakistan
| | - J Iqbal
- Bacha Khan University, Department of Botany, Charsadda, Khyber Pakhtunkhwa, Pakistan
| | - M Ilyas
- Kohsar University Murree, Department of Botany, Murree, Pakistan
| | - D A H Al-Quwaie
- King Abdulaziz University, College of Science & Arts, Biological Sciences Department, Rabigh, Saudi Arabia
| | - A A Khan
- Nankai University, College of Life Sciences, Department of Plant Biology and Ecology, Tianjin, China
| | - T Mahmood
- Quaid-i-Azam University, Department of Plant Sciences, Islamabad, Pakistan
| |
Collapse
|
13
|
Khan AA, Syarifah Adilah MY, Mamat MH, Yahaya SZ, Setumin S, Ibrahim MN, Daud K, Abdullah MH. Magnesium sulfate as a potential dye additive for chlorophyll-based organic sensitiser of the dye-sensitised solar cell (DSSC). Spectrochim Acta A Mol Biomol Spectrosc 2022; 274:121140. [PMID: 35305518 DOI: 10.1016/j.saa.2022.121140] [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: 10/21/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
In this work, a new chlorophyll dye-sensitiser derived from mitragyna speciosa (MS) leaves, also known as Kratom, was employed for dye-sensitised solar cells (DSSCs). The influence of magnesium sulfate (MgSO4), a low-cost dye additive, and suitable extraction solvents on the performance of DSSCs were examined. Here, the optical properties were investigated using UV-Visible spectroscopy and the functional anchoring group were investigated by FTIR spectroscopy. Meanwhile, the photovoltaic parameters were investigated by I-V measurements. The highest conversion efficiency is obtained when using a dye extracted from methanol solvent in combination with MgSO4 additive, namely methanolic magnesium sulfate (MMSO). This higher power conversion efficiency is mainly attributed to the enhancement of the hydroxyl group in the MMSO dye solutions, which promotes higher dye adsorption and provides an organic dye passivation layer that reduces back-recombination in the cell. Furthermore, MgSO4 aids in the replenishment of magnesium lost in the chlorophyll porphyrin ring during the degradation process. These combined effects have contributed to the overall conversion efficiency of the MMSO cell at 0.26 %, followed by 0.24 % for ethanolic magnesium sulfate (EMSO), respectively.
Collapse
Affiliation(s)
- A A Khan
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - M Y Syarifah Adilah
- Department of Computer and Mathematical Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - M H Mamat
- NANO-ElecTronic Centre (NET), School of Electrical Engineering, College of Engineering, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia
| | - S Z Yahaya
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - S Setumin
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - M N Ibrahim
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - K Daud
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia
| | - M H Abdullah
- Center for Electrical Engineering Studies, Universiti Teknologi MARA, Cawangan Pulau Pinang, 13500 Permatang Pauh, Pulau Pinang, Malaysia..
| |
Collapse
|
14
|
Sugarbaker PH, Sabri S, Khan AA, Aljundi MN, Chang G. Two methodologies of the rendezvous procedure to establish ureteral continuity from a delayed ureteral leak following pelvic surgery. Surg Oncol 2022; 40:101697. [PMID: 35030409 DOI: 10.1016/j.suronc.2021.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/17/2021] [Accepted: 12/28/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ureteral trauma recognized in the operating theater is managed, for the most part, at the same surgical procedure oftentimes with urologic consultation. A delayed urine leak presents unique problems in that direct access to the site of the leak is not possible except by a reoperative procedure. METHODS In patients who develop delayed urine leakage following cancer surgery, the leakage may be controlled by the collaborative efforts of a urologist and interventional radiologist. Success depends on placement of a nephroureteral stent by the rendezvous procedure. RESULTS The sequence of procedures to reestablish ureteral continuity following a delayed leak are important in the successful placement of a nephroureteral stent. In the first methodology, through a percutaneous nephrostomy, a guidewire is placed in the ureter and down to the ureteral defect. The guidewire is then recovered and advanced into the bladder using a ureteroscope and grasping forceps. A nephroureteral stent is placed over the guidewire to bridge the gap and stent the ureteral defect. In the second methodology, the urologist passed a guidewire into the distal ureter, out of the ureteral defect, and into the free peritoneal space. Under fluoroscopic control, the wire loop must snare the ureteral guidewire and pull it out at the percutaneous nephrostomy. The nephroureteral stent is passed over the ureteral wire into the bladder. CONCLUSIONS Two different methodologies were described to complete the rendezvous procedure. It can be successful a large percentage of the time with a delayed ureteral leakage. Success requires a combined interventional radiology and urologic procedure.
Collapse
Affiliation(s)
- Paul H Sugarbaker
- Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA.
| | - Saher Sabri
- Department of Interventional Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Arshad A Khan
- Department of Interventional Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Moutasem N Aljundi
- Department of Interventional Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - George Chang
- Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
| |
Collapse
|
15
|
Abbas SR, Khan RT, Shafique S, Mumtaz S, Khan AA, Khan AM, Hassan Z, Hussain SA, Abbas S, Abbas MR, Batool A, Safder MA. Study of resveratrol against bone loss by using in-silico and in-vitro methods. BRAZ J BIOL 2021; 83:e248024. [PMID: 34932613 DOI: 10.1590/1519-6984.248024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/29/2021] [Indexed: 11/22/2022] Open
Abstract
By applying the in-silico method, resveratrol was docked on those proteins which are responsible for bone loss. The Molecular docking data between the resveratrol and Receptor activator of nuclear factor-kappa-Β ligand [RANKL] receptors proved that resveratrol binds tightly to the receptors, showed the highest binding affinities of -6.9, -7.6, -7.1, -6.9, -6.7, and -7.1 kcal/mol. According to in-vitro data, Resveratrol reduced the osteoclasts after treating Marrow-Derived Macrophages [BMM] with Macrophage colony-stimulating factor [MCSF] 20ng / ml and RANKL 50ng / ml, with different concentrations of resveratrol (2.5, 10 μg / ml) For 7 days, the cells were treated with MCSF (20 ng / ml) and RANKL (40 ng / ml) together with concentrated trimethyl ether and resveratrol (2.5, 10 μg / ml) within 12 hours. Which, not affect cell survival. After fixing osteoclast cells with formaldehyde fixative on glass coverslip followed by incubation with 0.1% Triton X-100 in PBS for 5 min and after that stain with rhodamine phalloidin staining for actin and Hoechst for nuclei. Fluorescence microscopy was performed to see the distribution of filaments actin [F.actin]. Finally, resveratrol reduced the actin ring formation. Resveratrol is the best bioactive compound for drug preparation against bone loss.
Collapse
Affiliation(s)
- S R Abbas
- Karakoram International University, Department of Biological Sciences, Gilgit, Pakistan
| | - R T Khan
- University of Azad Jammu and Kashmir, Department of Botany, Azad Jammu and Kashmir, Pakistan
| | - S Shafique
- University of Poonch, Department of Plant Breeding and Molecular Genetics, Rawalakot, Azad Jammu and Kashmir, Pakistan
| | - S Mumtaz
- Karakoram International University, Department of Biological Sciences, Gilgit, Pakistan
| | - A A Khan
- Bahauddin Zakariya University, College of Agriculture Bahadur Campus, Layyah, Pakistan
| | - A M Khan
- University of Sargodha, Department of Biotechnology, Sargodha, Pakistan
| | - Z Hassan
- Bahauddin Zakariya University, College of Agriculture Bahadur Campus, Layyah, Pakistan
| | - S A Hussain
- Karakoram International University, Department of Biological Sciences, Gilgit, Pakistan
| | - S Abbas
- Karakoram International University, Department of Biological Sciences, Gilgit, Pakistan
| | - M R Abbas
- University of Azad Jammu and Kashmir, Department of Computer Sciences and IT, Muzaffarabad, Pakistan
| | - A Batool
- Virtual University Lahore, Department of Biotechnology, Lahore, Pakistan
| | - M A Safder
- Karakoram International University, Department of Biological Sciences, Gilgit, Pakistan
| |
Collapse
|
16
|
Baig A, Mahmood T, Munawar N, Saman A, Razzaq A, Akrim F, Fatima H, Farooq M, Khan AA, Irshad N. Dietary habits of lesser bandicoot rat (Bandicota Bengalensis) in an agro-ecosystem, Pothwar Plateau, Pakistan. BRAZ J BIOL 2021; 84:e251410. [PMID: 34932631 DOI: 10.1590/1519-6984.251410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/24/2021] [Indexed: 11/21/2022] Open
Abstract
Dietary habits of bandicoot rats (bandicota bengalensis) were investigated in the agricultural crops of the Pothwar Plateau, Pakistan by analysing stomach contents. The research activities were conducted in major field crops including wheat-groundnut and in the fallow lands during non-crop season at the field boundaries. The specimens were captured from the fields using kill/snap traps, and dissected to collect their stomach samples for laboratory analysis. Light microscopic slides of the plant material were recovered from stomach samples and the reference materials were collected from the field. Results revealed that the bandicoot rat predominantly fed upon cultivated crops during cropping season but consumed wild vegetation during non-cropping season. There was no significance difference between summer and winter diets. Most frequently consumed crop food items were wheat (Triticum aestivum; 28.57%), groundnut (Arachis hypogea; 11.26%), sorghum (Sorghum bicolor; 10.17%), chickpea (Cicer arietinum; 9.52%), maize (Zea mays; 6.49%), millet (Pennisetum glaucum; 5.84%), barley (Hordeum vulgare; 4.98%) and mustard (Brassica campestris; 4.98%). Among wild vegetation were consumed khbal gha (Cynodon dactylon; 7.79%), baron dhab (Demostachya bipinnata; 7.36%) and Prickly flower (Achyranthes aspera; 3.03%). The study concludes that, in addition to consuming wheat and groundnut crops, the Lesser bandicoot rat also subsists on grasses, weeds, and some fodder crops, as important component of its diet in agro-ecosystem of the Pothwar Plateau.
Collapse
Affiliation(s)
- A Baig
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - T Mahmood
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - N Munawar
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - A Saman
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - A Razzaq
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - F Akrim
- Department of Zoology, University of Kotli, Azad Jammu and Kashmir, Pakistan
| | - H Fatima
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - M Farooq
- PMAS-Arid Agriculture University Rawalpindi, Department of Wildlife Management, Rawalpindi, Pakistan
| | - A A Khan
- Pakistan Agricultural Research Council - PARC, Islamabad, Pakistan
| | - N Irshad
- University of Poonch, Department of Zoology, Rawalakot, Azad Jammu and Kashmir, Pakistan
| |
Collapse
|
17
|
Khan W, Khan AA, Khan J, Khatoon N, Arshad S, Los Ríos Escalante PD. Death caused by covid-19 in top ten countries in Asia affected by covid-19 pandemic with special reference to Pakistan. BRAZ J BIOL 2021; 83:e248281. [PMID: 34852158 DOI: 10.1590/1519-6984.248281] [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: 02/02/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 is a contagious viral disease, was first emerged in Wuhan, China in December 2019 and became the whole world on alert. The mortality rate in top most countries in Asia with special reference to Pakistan has been focused. Since February 26 to September 2020 the total confirmed cases and mortality rate was measured through Wikipedia and the notable journals. Iran is the only country having highest number of deaths (5.73%) followed by Indonesia (3.77%) while Saudi Arabia shows the lowest number of deaths as 1.39%. In Pakistan the first case was confirmed in 26th February, 2020. The nCov-19 has closely related to severe acute respiratory syndrome (SARS) hence SARS COV-2 was named. This virus is responsible for more than 33.9 million deaths in over all the world as of 20th September, 2020. The number of new cases is increasing time to time. Sindh province of Pakistan has reported the highest number of cases till September, 20, 2020 as compared to other parts of the country and has the highest number of death followed by Khyber Pakhtunkhwa. Because of the person to person contact the disease is spreading rapidly. The individuals who has already infected with other diseases like cancer or diabetic etc. are vulnerable. The nCOV-19 is the most contagious due to its mode of transmission. There is still no vaccine is available for the treatment of disease caused by nCoV-2019. It is therefore the only option to control this pandemic is to adopt effective preventive measures.
Collapse
Affiliation(s)
- W Khan
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - A A Khan
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - J Khan
- University of Malakand, Department of Pharmacy, Lower Dir, Pakistan
| | - N Khatoon
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - S Arshad
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - P De Los Ríos Escalante
- Universidad Católica de Temuco, Facultad de Recursos Naturales, Departamento de Ciencias Biológicas y Químicas, Temuco, Chile.,Núcleo de Estudios Ambientales UC Temuco, Casilla, Temuco, Chile
| |
Collapse
|
18
|
Godden AR, Micha A, Wolf LM, Pitches C, Barry PA, Khan AA, Krupa KDC, Kirby AM, Rusby JE. Three-dimensional simulation of aesthetic outcome from breast-conserving surgery compared with viewing photographs or standard care: randomized clinical trial. Br J Surg 2021; 108:1181-1188. [PMID: 34370833 PMCID: PMC10364871 DOI: 10.1093/bjs/znab217] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Over half of women with surgically managed breast cancer in the UK undergo breast-conserving treatment (BCT). While photographs are shown prior to reconstructive surgery or complex oncoplastic procedures, standard practice prior to breast conservation is to simply describe the likely aesthetic changes. Patients have expressed the desire for more personalized information about likely appearance after surgery. The hypothesis was that viewing a three-dimensional (3D) simulation improves patients' confidence in knowing their likely aesthetic outcome after surgery. METHODS A randomized, controlled trial of 117 women planning unilateral BCT was undertaken. The randomization was three-way: standard of care (verbal description alone, control group), viewing two-dimensional (2D) photographs, or viewing a 3D simulation before surgery. The primary endpoint was the comparison between groups' median answer on a visual analogue scale (VAS) for the question administered before surgery: 'How confident are you that you know how your breasts are likely to look after treatment?' RESULTS The median VAS in the control group was 5.2 (i.q.r. 2.6-7.8); 8.0 (i.q.r. 5.7-8.7) for 2D photography, and 8.9 (i.q.r. 8.2-9.5) for 3D simulation. There was a significant difference between groups (P < 0.010) with post-hoc pairwise comparisons demonstrating a statistically significant difference between 3D simulation and both standard care and viewing 2D photographs (P < 0.010 and P = 0.012, respectively). CONCLUSION This RCT has demonstrated that women who viewed an individualized 3D simulation of likely aesthetic outcome for BCT were more confident going into surgery than those who received standard care or who were shown 2D photographs of other women. The impact on longer-term satisfaction with outcome remains to be determined.Registration number: NCT03250260 (http://www.clinicaltrials.gov).
Collapse
Affiliation(s)
- A R Godden
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- Independent patient co-designer, Institute of Cancer Research, Sutton, Surrey, UK
| | - A Micha
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - L M Wolf
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - C Pitches
- Independent patient co-designer, Institute of Cancer Research, Sutton, Surrey, UK
| | - P A Barry
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - A A Khan
- Department of Plastic Surgery, The Royal Marsden NHS Foundation Trust, London, UK
| | - K D C Krupa
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - A M Kirby
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- Independent patient co-designer, Institute of Cancer Research, Sutton, Surrey, UK
| | - J E Rusby
- Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- Independent patient co-designer, Institute of Cancer Research, Sutton, Surrey, UK
| |
Collapse
|
19
|
Bengali R, Siddiqi DA, Mehmood M, Khan AA, Baig Q, Khan AJ, Chandir S. Feasibility of youth empowerment initiative for identifying never- and under-immunized children. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.555] [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: 11/15/2022] Open
Abstract
Abstract
Background
One-in-every 5 children globally remains deprived of life-saving vaccines. We developed and implemented the Adolescent Health and Leadership Program (AHLP) among school girls from grades 8-10 (Kiran Sitaras (KSs); Shining Stars) to provide them with soft skills and community mobilization skills and equipping them to become community advocates for immunization. We evaluated the feasibility of KS community mobilization through validating KSs' ability to accurately identify and link never- and under-immunized children with immunization services.
Methods
We implemented a mixed-methods study in six public schools located in peri-urban areas of Karachi, Pakistan. After the development and roll-out of AHLP in schools, KSs conducted door-to-door visits in their neighborhoods to identify never-and under-immunized children. This was followed by verification visits by field staff to establish accuracy and immunization camps to vaccinate never- and under-immunized children identified by KSs.
Results
From January 28 to February 22, 2020, 591 KSs visited 10,330 households, screened 3,295 under-2 children and identified 7.5% (247/3,295) never- and 27.0% (889/3,295) under-immunized children, with an accuracy of 90.4% and 49.6%, respectively. In January 2021, 291 never- and under-immunized children were invited to immunization camps, of which 28.9% (84/291) received vaccinations, while 57.0% (166/291) did not respond to the invite and 14.1% (41/291) were deemed ineligible (illness, overage, etc.).
Conclusions
We demonstrated the feasibility of empowering adolescent girls to boost immunization uptake in LMIC settings. Engaging young women from within the community provides an organic and sustainable solution for promoting immunization coverage and equity today and ensuring they will continue to champion the cause in their capacity as tomorrow's mothers. We are actively scaling-up our solution across the country to create a force of 100,000+ KSs to magnify our efforts.
Key messages
The Kiran Sitara initiative, via its community-centered approach, leverages the force of adolescent school girls to boost demand and referrals for immunization in unreached geographical pockets. The Kiran Sitara initiative utilizes the power of youth engagement to identify never- and under-immunized children, and subsequently increase vaccine-uptake.
Collapse
Affiliation(s)
- R Bengali
- MCH, IRD Pakistan, Karachi, Pakistan
| | | | - M Mehmood
- MCH, IRD Pakistan, Karachi, Pakistan
| | - AA Khan
- MCH, IRD Pakistan, Karachi, Pakistan
| | - Q Baig
- MCH, IRD Pakistan, Karachi, Pakistan
| | - AJ Khan
- MCH, IRD Global, Singapore, Singapore
| | - S Chandir
- MCH, IRD Global, Singapore, Singapore
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Munir M, Miraj F, Raza H, Hussain OA, Khan AA, Siddiqi DA, Khan AJ, Habib A, Chandir S. Feasibility of an artificially intelligent vaccines chatbot in Pakistan: A mixed methods evaluation. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite free vaccination services, gaps in information access impede immunization uptake in low and middle-income countries (LMICs), including Pakistan. We developed Bablibot (Babybot), a local-language, text-based chatbot to connect caregivers with immunization-related information in real-time, and evaluated its feasibility and acceptability in resolving immunization-related queries among Karachi's low-income communities.
Methods
We developed Bablibot using Natural Language Processing (NLP), Machine Learning, and Human in the Loop features. We conducted a sequential mixed-methods pilot in Karachi where caregivers were recruited when visiting selected immunization centers for any childhood vaccine except Measles 2 (last vaccine visit) or were informed through targeted text messages. We assessed Bablibot's feasibility and acceptability through user-engagement metrics and thematic analysis of qualitative interviews conducted with 20 pilot participants.
Results
Between March 9, 2020 and April 15, 2021, Bablibot accrued 677 users and participated in 874 conversations. Of 2,202 pilot-enrolled caregivers, 210 (10%) interacted with the bot; other 467 users were not pilot participants. Most queries were about due dates (25%; 221/874), delaying vaccination (17%; 146/874), or side-effect management (16%;137/874). The conversations now constitute a valuable training database for future local-language bots. Over 90% (277/307) of responses to text-based exit surveys indicated user satisfaction. Qualitative analysis showed caregivers appreciate Bablibot's convenience, reliability, and responsiveness.
Conclusions
Our results demonstrate the feasibility and acceptability of local-language NLP chatbots in providing immunization information. Text-based chatbots can minimize workload on helpline operators, in addition to quickly resolving queries that otherwise lead to delay or default. Bablibot's conversation data provides learning infrastructure for future health-related bots.
Key messages
An AI-based NLP chatbot is a feasible and acceptable intervention for providing immunization-related information to large number of caregivers 24/7 in limited resource setting. By serving as a remote, low-cost and confidential bi-directional channel, chatbots can address gaps in information access, especially for women, and have long term impact on immunization uptake.
Collapse
Affiliation(s)
- M Munir
- MCH, IRD Global, Singapore, Singapore
| | - F Miraj
- MCH, IRD Pakistan, Karachi, Pakistan
| | - H Raza
- MCH, IRD Pakistan, Karachi, Pakistan
| | | | - AA Khan
- MCH, IRD Pakistan, Karachi, Pakistan
| | | | - AJ Khan
- MCH, IRD Global, Singapore, Singapore
| | | | - S Chandir
- MCH, IRD Global, Singapore, Singapore
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
21
|
Chandir S, Siddiqi DA, Mehmood M, Iftikhar S, Siddique M, Jai S, Dharma VK, Khan AA, Akhter MA, Khan AJ. 1-year impact of COVID-19 on childhood immunizations in Pakistan: analysis of > 3.7 million children. Eur J Public Health 2021. [PMCID: PMC8574899 DOI: 10.1093/eurpub/ckab164.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Covid-19 has universally disrupted primary health care, but routine childhood immunizations are one the most affected services. We analyzed big data in vaccines for measuring the 1-year impact of Covid-19 on outline childhood immunizations for the 48 million population in the Sindh province of Pakistan. We extracted and analyzed >3.7m real-time immunization records of 0-23 months old children from the Sindh Government's Electronic Immunization Registry (EIR). Using a 6-month baseline preceding the COVID-19 lockdown, we quantified the lockdown's (March 23-May 9, 2020) impact on daily immunization rates by geographical area and the change in coverage rates at the one-year mark since the lockdown. The lockdown resulted in 53% drop in the number of immunizations. The impact in rural areas as more than in urban areas (54.9% decline vs 47.5% decline from baseline), and slums had a slightly larger decrease in immunization coverage than non-slum areas (53.8% vs. 51.3%). Of 1,246,321 children who missed immunizations during first year of the pandemic, 76% of these children were eventually vaccinated by the end of March 2021. Similarly, of the 417,553 children who had dropped out during the initial 7-week national lockdown (March 23-May 10, 2020), 79% were immunized by March 2021. Our analysis of EIR data shows that the catch-up and recovery of coverage rates have primarily been driven through intensive outreach vaccination efforts instead of an increase in demand. One year since the onset of the pandemic, the average daily immunization doses administered through outreach increased by 121 percent above baseline estimates. In contrast, vaccines administered at immunization clinics were still 22 percent below baseline. The example of Pakistan shows LMICs can successfully deploy mitigation strategies to catch up with missed children during Covid-19 and sustain routine childhood immunizations to close immunity gaps. Key messages Although the lockdown resulted in a 53% drop in immunizations, at the 1-year mark since the pandemic started, 76% of children who missed immunizations are vaccinated. Pakistan data shows LMICs can rectify routine immunization coverage and immunity gaps and rebound successfully to their pre-COVID-19 coverage rates.
Collapse
Affiliation(s)
- S Chandir
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
- IRD Global, Singapore, Singapore
| | | | - M Mehmood
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - S Iftikhar
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - M Siddique
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - S Jai
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - VK Dharma
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - AA Khan
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - MA Akhter
- Maternal & Child Health, IRD Pakistan, Karachi, Pakistan
| | - AJ Khan
- IRD Global, Singapore, Singapore
| |
Collapse
|
22
|
Rahman HU, Khan W, Mehmood SA, Ahmed S, Yasmin S, Ahmad W, Haq ZU, Shah MIA, Khan R, Ahmad U, Khan AA, De Los Ríos Escalante P. Prevalence of cestodes infection among school children of urban parts of Lower Dir district, Pakistan. BRAZ J BIOL 2021; 82:e242205. [PMID: 34644726 DOI: 10.1590/1519-6984.242205] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022] Open
Abstract
Tapeworms of zoonotic importance have been described as a leading public health problem. Current research was aim to assess the prevalence of tapeworms among 5-12years school children residing in district Lower Dir, Pakistan from January 2019-December 2019. The wet mount preparation in saline/iodine/methods were used for stool examination. Data was analyzed using appropriate descriptive, static methods. Of the 400 children studied 71.7% were infected with one or more species of intestinal parasites. Single infection of cestode species was found in 69 individuals with 17.2% prevalence and multiple parasitic infections were identified in 19.7% (n=79/400) individuals. The multiple infection were comprised as 10% (n=40) double, 6.75% (n=27) triple and 3% (n=12) quadruple. A total of 9 species of helminths and one species of protozoan infection. Among the helminths Ascaris lumbricoides was the most prevalent 33.1% (n=95), Taenia saginata 22.6% (n=65), hookworm 19.8% (n=57), Hymenolepis nana 18.8% (n=54), Enterobius vermicularis and Hymenolepis diminuta 1.39% (n=4each), Trichuris trichura 1.04% (n=3), Toxocara spp 0.69% (n=2) and Schistosoma japonicum 0.34% (n=1) were reported. One protozoan species was Cryptosporidium spp 0.69% (n=2) in current study. In case of A.lumbricoides, hookworm, E.vermicularis, T.trichura, T.saginata, H.nana and H.diminuta the male children of below 8 years of age were highly infected. Other infections are reported in the same prevalence with slight difference if any. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children and the need for development of effective poverty control programs because deworming alone is not adequate to control parasitic infections.
Collapse
Affiliation(s)
- H Ur Rahman
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - W Khan
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - S A Mehmood
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - S Ahmed
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - S Yasmin
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - W Ahmad
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - Z Ul Haq
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - M I A Shah
- Abdul Wali Khan Unuversity Mardan, Department of Chemistry, Mardan, Pakistan
| | - R Khan
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - U Ahmad
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - A A Khan
- University of Malakand, Department of Zoology, Lower Dir, Pakistan
| | - P De Los Ríos Escalante
- Universidad Católica de Temuco, Facultad de Recursos Naturales, Departamento de Ciencias Biológicas y Químicas, Casilla 15-D, Temuco, Chile.,Núcleo de Estudios Ambientales UC Temuco, Casilla, Temuco, Chile
| |
Collapse
|
23
|
Khan AA, Junejo RT, Thomas GN, Fisher JP, Lip GYH. Association between atrial high rate episode burden and autonomic and vascular function in patients with implanted cardiac device. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients who experience frequent atrial high rate episodes (AHREs), recorded on implantable cardiac devices, are at an increased risk of stroke and systemic embolism. Increased duration of AHRE is related to higher risk of thromboembolic event. The underlying pathophysiology is unclear; however, autonomic and/or endothelial dysfunction may contribute.
Purpose
We tested the hypothesis that patients with high AHRE burden have worse autonomic and vascular function compared to patients with low AHRE burden.
Design
We studied 44 patients split in two groups: high AHRE burden (longest AHRE ≥24 hours; n=22) and low AHRE burden (longest AHRE <24 hours; n=22). Resting time- and frequency-domain measures of HRV were determined to index cardiac autonomic function. High-resolution ultrasound was used to measure brachial artery diameter at rest and during reactive hyperaemia (endothelium-dependent flow mediated dilation (FMD)).
Results
FMD was higher in the low AHRE burden group compared to high AHRE group (5.5% [95% confidence interval (CI):3.4–7.6] vs 3.1% [95% CI: 1.9–6.2]; p=0.04) (table 1). Mean heart rate (p<0.001) and AHRE burden (p=0.02) were independent predictors of FMD on multivariate analysis. Time-domain, frequency-domain and non-linear indices of HRV were not significantly different between the groups. A slower heart rate (Spearman's rho 0.369; p=0.01) and high AHRE burden (Spearman's rho −0.315; p=0.04) were independently associated with changes seen on FMD following adjustment for multiple variables (p=0.001 and p=0.03 respectively).
Conclusion
Endothelium-dependent FMD is impaired in patients with high AHRE burden, while HRV derived indices of autonomic function were not affected by AHRE burden. Endothelial dysfunction may play an important role in the adverse outcomes seen in patients who experience frequent AHRE.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A A Khan
- University of Birmingham, Institute of Applied Health Research, Birmingham, United Kingdom
| | - R T Junejo
- Manchester Metropolitan University, Department of Life Sciences, Manchester, United Kingdom
| | - G N Thomas
- University of Birmingham, Institute of Applied Health Research, Birmingham, United Kingdom
| | - J P Fisher
- The University of Auckland, Department of Physiology, Auckland, New Zealand
| | - G Y H Lip
- University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
| |
Collapse
|
24
|
Khan AA, Mohimeed AA, Sayeeda S, Rajan NG, Kabir MF. Self-Inflicted Pneumomediastinum: A Case Report. Mymensingh Med J 2021; 30:1183-1186. [PMID: 34605495] [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: 06/13/2023]
Abstract
Self-inflicted wound can present with various scenarios. It is well known that the purpose of a self-inflicted wound is to avoid obligatory duties. During war, soldiers get self-inflicted wounds to seek medical leave in the hope to save their lives from deadly battle. Self-induced pneumomediastinum from oral lesion with valsalva maneuver was a rare practice among prisoners to get rid of that imprisoned life and to stay in the hospital. Self-inflicted wound is also commonly seen in patient with psychosomatic disorders. It relates observations from forensic medicine and psychiatry to specific clinical symptoms, toxicological circumstances and social influences e.g. stress incurred by everyday life, war, imprisonment etc. In particular cases, it clears up criminal and civil jurisdiction. It also gives importance to private insurers about cases of self-mutilation. There is also concern about insurers, forensic scientists and psychiatrist about their responsibilities and the procedure they follow in the examination, their jurisdiction and the treatment involving the cases of self-inflected injuries. To our knowledge, self-inflicted subcutaneous emphysema causing pneumomediastinum by a normal young boy out of curiosity and without any apparent ill motive, is an unusual finding and possibly no such case report was published before.
Collapse
Affiliation(s)
- A A Khan
- Dr AKM Anisuzzaman Khan, Radiologist, King Khalid General Hospital, Hafr Al Batin-31991, Kingdom of Saudi Arabia; E-mail:
| | | | | | | | | |
Collapse
|
25
|
Hussain A, Khan AA. Wild birds trade in Dera Ismael Khan and Bannu divisions of Khyber PakhtunKhwa (KPK) Province, Pakistan. BRAZ J BIOL 2021; 83:e247915. [PMID: 34550285 DOI: 10.1590/1519-6984.247915] [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: 01/24/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022] Open
Abstract
Wildlife trade is a profitable economic activity. Birds are among the most heavily traded animals worldwide, with numerous species threatened by pet trade. The present case study was stretched for period of one year to find out the status of wild birds' trade in Bannu and Dera Ismael Khan Divisions. The study was aimed to find out the types of species, commercial prices of bird, trade routes, overall income generated from birds' trade and the status of dealers whether licensed or not. Bimonthly visits were conducted to interview 52 bird dealers/pet shops owners/venders (23 in Dera Ismael Khan and 29 in Bannu). A sum of 16 conceivable sites were visited during the study period. Out of these, 8 sites were located in Dera Ismael Khan and 8 sites in Bannu Division. The highest priced species was Demoiselle crane (Grus virgo) and the lowest priced species was house sparrow (Passer domesticus). Total number of species traded in both regions were 8 and 14 while the income generated by bird trade was amounting to PkR 1,322,200 and 7,128,950 in Dera Ismael Khan and Bannu respectively. Majority of the birds were trapped locally with the exception of few from adjacent areas. Commercial activity led by illegal bird traders was found 75% and 100% species in Dera Ismael Khan and Bannu respectively. There was no significant difference between prices of birds, number of species sold and income generated by bird trade in two divisions.
Collapse
Affiliation(s)
- A Hussain
- Bahauddin Zakariya University, Institute of Pure & Applied Biology, Multan, Pakistan
| | - A A Khan
- Bahauddin Zakariya University, Institute of Pure & Applied Biology, Multan, Pakistan
| |
Collapse
|
26
|
Ilahi I, Yousafzai AM, Attaullah M, Haq TU, Rahim A, Khan W, Khan AA, Ullah S, Jan T, Khan MM, Rahim G, Zaman N. Mosquitocidal activities of Chenopodium botrys whole plant n-hexane extract against Culex quinquefasciatus. BRAZ J BIOL 2021; 83:e240842. [PMID: 34550279 DOI: 10.1590/1519-6984.240842] [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: 07/11/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022] Open
Abstract
This research aimed to investigate various mosquitocidal activities of Chenopodium botrys whole- plant n-hexane extract against Culex quinquefasciatus. The extract showed remarkable larvicidal, pupicidal, adulticidal, oviposition deterrent and adult emergence inhibitory activities against Cx. quinquefasciatus. During the larvicidal and pupicidal activities, the 24-hour lethal concentration (LC50) of extract against 2nd instar larvae, 4th instar larvae and pupae were 324.6, 495.6 and 950.8 ppm, respectively. During the CDC (Centers for Disease Control and Prevention) bottle bioassay for adulticidal activity, the median knockdown times (KDT50) at 1.25% concentration was 123.4 minutes. During the filter paper impregnation bioassay for adulticidal activity, the KDT50 value at 0.138 mg/cm2 concentration was 48.6 minutes. The extract was fractionated into 14 fractions through silica gel column chromatography which were then combined into six fractions on the basis of similar retention factor (Rf) value. These fractions were screened for adulticidal activity by applying CDC bottle bioassay. The fraction obtained through 60:40 to 50:50% n-hexanes-chloroform mobile phase with 0.5 Rf value showed 100% adulticidal activity at 0.2% concentration. During oviposition deterrent activity, the highest concentration (1000 ppm) showed 71.3 ± 4.4% effective repellence and 0.6 ± 0.1 oviposition activity index. During adult emergence inhibition activity, the median emergence inhibition (EI50) value was 312.3 ppm. From the outcome of the present investigation, it is concluded that the n-hexane extract of C. botrys whole- plant possesses strong larvicidal, pupicidal, adulticidal, oviposition deterrent and adult emergence inhibitory activities against Cx. quinquefasciatus.
Collapse
Affiliation(s)
- I Ilahi
- University of Malakand, Department of Zoology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan.,Islamia College Peshawar, Department of Zoology, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - A M Yousafzai
- Islamia College Peshawar, Department of Zoology, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - M Attaullah
- University of Malakand, Department of Zoology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - T U Haq
- University of Malakand, Department of Biotechnology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - A Rahim
- University of Malakand, Department of Zoology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - W Khan
- University of Malakand, Department of Zoology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - A A Khan
- University of Malakand, Department of Biotechnology, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - S Ullah
- University of Malakand, Department of Botany, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - T Jan
- University of Malakand, Department of Botany, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - M M Khan
- The University of Haripur, Department of Microbiology, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - G Rahim
- University of Malakand, Department of Botany, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - N Zaman
- University of Swat, Centre for Biotechnology and Microbiology, Swat, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
27
|
Nadeem A, Tahir HM, Khan AA. Plant age, crop stage and surrounding habitats: their impact on sucking pests and predators complex in cotton (Gossypium hirsutum L.) field plots in arid climate at district Layyah, Punjab, Pakistan. BRAZ J BIOL 2021; 82:e236494. [PMID: 34133551 DOI: 10.1590/1519-6984.236494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 11/25/2020] [Indexed: 11/21/2022] Open
Abstract
Sucking pests are major threat to cotton field crop which cause unbearable losses to the crop yield. Aim of the current study was to record seasonal dynamics of major sucking insect pests including whitefly, jassid, thrips and their natural arthropod predators i.e. green lacewings and spiders in cotton field plots. The effects of surrounding field crops on pests' density and predatory efficiency of predators were also recorded. For sampling and survey of insects, the visual counting was found to be the most efficient method for recording the abundance of insects, trailed by net sweeping and tapping. Whitefly was the most dominant sucking pest found on the vegetative stage of cotton, followed by jassid and thrips. Fluctuated populations of predatory arthropods, spiders and green lacewings were also recorded during whole cropping season however, the densities of pests and predators varied with crop phenology. Spiders' population was encouraging at both vegetative and flowering stage and also the same trend of jassid and whitefly were observed at both stages of the crop. Surrounding habitats showed non-significant effect on population densities of insect pests and predators. For abiotic factors, the spiders showed strong positive correlation with humidity and temperature. However, green lacewing was only positively correlated with humidity. On the other hand, the populations of whitefly, jassid and thrips showed non-significant correlation with both temperature and humidity. Overall densities of sucking insect pests were found above economic threshold level. The plant age, crop stage and surrounding habitats effect on the population fluctuation of pests as well as the predators' abundance. The future studies are also warranted to investigate the altered habitats and multiple trap cropping to find out their impact on unattended insect predators and parasitoids in cotton crop.
Collapse
Affiliation(s)
- A Nadeem
- Government College University, Department of Zoology, Lahore, Pakistan
| | - H M Tahir
- Government College University, Department of Zoology, Lahore, Pakistan
| | - A A Khan
- Bahauddin Zakariya University, College of Agriculture, Bahadur Sub Campus, Layyah, Pakistan
| |
Collapse
|
28
|
Fatima K, Abbas SR, Zia M, Sabir SM, Khan RT, Khan AA, Hassan Z, Zaman R. Induction of secondary metabolites on nanoparticles stress in callus culture of Artemisia annua L. BRAZ J BIOL 2021; 81:474-483. [PMID: 33053134 DOI: 10.1590/1519-6984.232937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
Nanoparticles are known bio elicitors in plant biotechnology. Different concentrations of ZnO, CuO and CoO nanoparticles were used for the enhanced accumulation of secondary metabolites and antioxidant activities in the callus derived from root, shoot and leaf of Artemisia annua L. Biomass of callus was somehow affected on high concentrations of Nps. Phenolic content was observed maximum (60µg) in shoot callus at 0.1mg/l of CuONps. Total antioxidant activity was observed maximum (33µg) in root callus at 0.1mg/l of ZnOnps. Total reducing power maximum (33µg) was observed in root callus at concentration of 0.05 mg/l of CoONps. Maximum radical scavenging activity was observed in shoot callus at 0.05mg/l of ZnONps. Rutin gallic acid and caffic acid were also determined in most of the samples by HPLC. The study concludes that different Nps have positive effect on the induction of secondary metabolites in A.annua plant.
Collapse
Affiliation(s)
- K Fatima
- Department of Biotechnology, Quaid-e-Azam University Isalmabad, Pakistan
| | - S R Abbas
- Department of Biological Sciences, Hunza Campus, Karakorum International University Gilgit, Pakistan
| | - M Zia
- Department of Biotechnology, Quaid-e-Azam University Isalmabad, Pakistan
| | - S M Sabir
- Department of Chemistry, University of Poonch, Rawalakot, Pakistan
| | - R T Khan
- Department of Botany, University of Azad Jammu and Kashmir, Pakistan
| | - A A Khan
- College of Agriculture, Bahauddin Zakariya University, Bahadur Sub Campus Layyah, Pakistan
| | - Z Hassan
- College of Agriculture, Bahauddin Zakariya University, Bahadur Sub Campus Layyah, Pakistan
| | - R Zaman
- Department of Biochemistry, University of Haripur, Pakistan
| |
Collapse
|
29
|
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.
Collapse
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
| |
Collapse
|
30
|
Khan AA, Al-Omary MS, Collins NJ, Attia J, Boyle AJ. Natural history and prognostic implications of left ventricular end-diastolic pressure in reperfused ST-segment elevation myocardial infarction: an analysis of the thrombolysis in myocardial infarction (TIMI) II randomized controlled trial. BMC Cardiovasc Disord 2021; 21:243. [PMID: 34001032 PMCID: PMC8130170 DOI: 10.1186/s12872-021-02046-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/04/2021] [Indexed: 12/15/2022] Open
Abstract
Background The aim of the current study is to assess the natural history and prognostic value of elevated left ventricular end-diastolic pressure (LVEDP) in patients with ST-segment elevation myocardial infarction (STEMI) after reperfusion with thrombolysis; we utilize data from the Thrombolysis in Myocardial Infarction (TIMI) II study.
Methods A total of 3339 patients were randomized to either an invasive (n = 1681) or a conservative (n = 1658) strategy in the TIMI II study following thrombolysis. To make the current cohort as relevant as possible to modern pharmaco-invasively managed cohorts, patients in the invasive arm with TIMI flow grade ≥ 2 (N = 1201) at initial catheterization are included in the analysis. Of these, 259 patients had a second catheterization prior to hospital discharge, and these were used to define the natural history of LVEDP in reperfused STEMI. Results The median LVEDP for the whole cohort was 18 mmHg (IQR: 12–23). Patients were divided into quartiles by LVEDP measured during the first cardiac catheterization. During a median follow up of 3 (IQR: 2.1–3.2) years, quartile 4 (highest LVEDP) had the highest incidence of mortality and heart failure admissions. In the cohort with paired catheterization data, the LVEDP dropped slightly from 18 mmHg (1QR: 12–22) to 15 mmHg (IQR: 10–20) (p = 0.01) from the first to the pre-hospital discharge catheterization. Conclusions LVEDP remains largely stable during hospitalisation post-STEMI. Elevated LVEDP is a predictor of death and heart failure hospitalization in STEMI patients undergoing successful thrombolysis. Graphic abstract ![]()
Collapse
Affiliation(s)
- Arshad A Khan
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Mohammed S Al-Omary
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Nicholas J Collins
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - John Attia
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Andrew J Boyle
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia. .,The University of Newcastle, Newcastle, Australia. .,Hunter Medical Research Institute, Newcastle, Australia.
| |
Collapse
|
31
|
Foster HS, Tabori NE, Sabri SS, Horton KM, Khan AA, Sivananthan G. Effect of intra-arterial vasodilator administration during radial artery access on systemic blood pressure in patients receiving moderate sedation. J Vasc Access 2021; 23:725-729. [PMID: 33845682 DOI: 10.1177/11297298211008099] [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] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The hemodynamic effects of intra-arterial vasodilator administration for the prevention of radial artery spasm during transradial access have not been well characterized. This study evaluates the effect of intra-arterial Verapamil and Nitroglycerine administration on systemic blood pressure and its correlation with timing of moderate sedation administration. MATERIALS AND METHODS Institutional review board approval was granted. Patients who underwent transradial access from 4/2018 to 4/2019 and received both intra-arterial vasodilators and moderate sedation were identified and their electronic medical records reviewed. Patients were divided into three cohorts based on the timing of sedation and intra-arterial vasodilator administration. Decrease in systolic blood pressure (SBP) was expressed as means with standard deviation which were then compared using Student's t-test. RESULTS A total of 84 patients who met inclusion criteria demonstrated an overall mean decrease in SBP of 16.45 mmHg ± 15.45 mmHg. Patients receiving sedation and intra-arterial vasodilators within their expected peak SBP effect times had similar SBP change following the intra-arterial vasodilators as those in whom the interval was greater than 10 min (4.2 mmHg; 95% CI (-4.11 to 12.52), p = 0.3171). Two patients experienced asymptomatic hypotension. CONCLUSIONS Patients undergoing transradial access for procedures utilizing moderate sedation can safely receive intra-arterial Verapamil and Nitroglycerine for prevention of radial artery spasm.
Collapse
Affiliation(s)
- Haley S Foster
- MedStar Georgetown University Hospital, Washington, DC, USA
| | - Nora E Tabori
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Saher S Sabri
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Arshad A Khan
- MedStar Washington Hospital Center, Washington, DC, USA
| | | |
Collapse
|
32
|
Ahmad B, Yousafzai AM, Zeb A, Khan AA, Attaullah M, Ahmad S. In-vitro and in-vivo evaluation of the antibacterial potential of Typha elephantina. Trop Biomed 2021; 38:1-7. [PMID: 33797516 DOI: 10.47665/tb.38.1.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The present study was aimed to evaluate the in-vitro and in-vivo antibacterial effects of the Typha elephantina aqueous extract (TE.AQ), ethanolic extract (TE.ET) and T. elephantina methanolic extract (TE.ME) against eight selected clinical pathogens. The test samples were tested for in-vitro analysis (by disc diffusion method) at different concentrations of 5, 15, 25, 50 and 100 mg/dL against both gram positive and gram-negative strains. The highest potential was observed in TE.ME at a concentration of 100 mg/dL against Pseudomonas aeruginosa exhibiting 19.67 ± 0.577 mm zone of inhibition (ZOI). The same fraction also showed good activity against Staphylococus aureus with ZOI of 17.50 ± 0.70 mm. The TE.ET was found most active against P. aeruginosa and Streptococcus pyogenes having ZOI of 18.53 ± 0.503 and 16.2 ± 1.55 mm respectively at a concentration of 100 mg/dL. The most sensitive bacteria P. aeruginosa was selected for in-vivo study (using poultry chicks) for induction of infection in chicks. The effects of TE.AQ, TE.ET and TE.ME were determined at concentrations of 300 mg/kg body weight based on hematological parameters, liver enzymes and gross pathological findings of lungs and livers. The findings of the in-vivo study in chick's model showed that treatment of experimental animals with TE.ME significantly restored the hematological parameters, liver enzymes and architecture of lungs and livers. Based on scientific evidence, the current study suggests that TE.ME may serve as a best and new natural antibacterial agent and can be used against infections caused by P. aeruginosa.
Collapse
Affiliation(s)
- B Ahmad
- Department of Zoology, Islamia College, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - A M Yousafzai
- Department of Zoology, Islamia College, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - A Zeb
- Department of Biotechnology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - A A Khan
- Department of Biotechnology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - M Attaullah
- Department of Zoology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| | - S Ahmad
- Department of Zoology, University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
33
|
Abstract
Foot drop represents a complex pathologic condition, requiring a multidisciplinary approach for appropriate evaluation and treatment. Multiple etiologic factors require recognition before considering invasive/operative intervention. When considering surgical management for the treatment of foot drop, it is first and foremost imperative to establish the cause of the condition. Not all causes resulting in clinical foot drop have surgical options. Establishing a cause allows the provider to more appropriately curtail a multidisciplinary approach to working-up, and ultimately, treating the patient. The authors offer an algorithm for evaluating and treating foot drop conditions associated with lumbar spine radiculopathy and peripheral nerve lesions.
Collapse
Affiliation(s)
- Arshad A Khan
- Department of Orthopedic Surgery, Indiana University School of Medicine, Gary/Northwest; SpineTech, Brain and Spine Centers of Southeast Texas, 6025 Metropolitan Drive, Suite 205, Beaumont, TX 77706, USA.
| | - Edgardo R Rodriguez-Collazo
- Chicago Foot and Ankle Deformity Correction Center, 2913 North Commonwealth Avenue, Chicago, IL 60657, USA; Reconstructive Foot & Ankle Fellowship Program, Saint Anthony Hospital; Department of Pediatrics, Center for Excellence in Limb Lengthening and Reconstruction
| | - Erwin Lo
- University of Texas Medical School, Mischer Neuroscience Institute, Houston, TX, USA; SpineTech, Brain and Spine Center of Southeast Texas, 111 Vision Park Boulevard, Shenandoah, TX 77384, USA
| | - Asim Raja
- PMSR/RRA, Department of Orthopedics and Rehabilitation (DO&R), Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310, USA
| | - Sujin Yu
- SpineTech, Brain and Spine Center of Southeast Texas, 111 Vision Park Boulevard, Shenandoah, TX 77384, USA
| | - Hamid A Khan
- SpineTech, Brain and Spine Center of Southeast Texas, 111 Vision Park Boulevard, Shenandoah, TX 77384, USA
| |
Collapse
|
34
|
Khan AA, Urs AB, Augustine J, Singh H. Comparative forensic analysis of reverse root canal filing and conventional method for DNA isolation from extracted teeth under different environmental conditions: A prospective study. J Forensic Odontostomatol 2020; 38:35-41. [PMID: 33507165 PMCID: PMC8565656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The grinding of a whole tooth specimen has been considered the conventional method to extract genomic deoxyribonucleic acid (DNA) in forensic science. However, we have tried the less destructive reverse root canal filing (RRCF) method without disturbing the morphology of the tooth to achieve competent amplifiable DNA. A total of 27 pairs of bilateral intact extracted teeth from the same subject were used in three different simulated environmental conditions for the respective RRCF and conventional methods: (a) soil burial for six months, (b) incineration at 200º C for four minutes, and (c) immersion in water for two months. Qualitative agarose gel electrophoresis assessment and downstream amplification were performed. The results showed significantly higher mean DNA concentration for the RRCF method in all three environmental conditions (p value = 0.008) in comparison to the conventional method. However, comparable qualitative results were found in both methods for the mean DNA concentration for incinerated (159.49 ng/ml), soil (119.52 ng/ml), and water (108.60 ng/ml) samples. It was concluded that the RRCF method is better quantitively (ng/ml) and comparable in terms of quality with respect to the conventional method, with the added advantage of preservation of the tooth morphology.
Collapse
Affiliation(s)
- A A Khan
- Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - A B Urs
- Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - J Augustine
- Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - H Singh
- Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| |
Collapse
|
35
|
Chang G, Khan AA, Sabri S, Sugarbaker PH. Rendezvous procedure to establish ureteral continuity from a delayed ureteral leak following pelvic surgery. A case report. Int J Surg Case Rep 2020; 76:505-509. [PMID: 33207420 PMCID: PMC7596013 DOI: 10.1016/j.ijscr.2020.10.014] [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: 09/22/2020] [Accepted: 10/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Iatrogenic damage to the ureter as a result of an abdominal or pelvic surgical procedure is unusual. However, it does occur and the surgeon must be prepared to deal knowledgeably with the injury. Leaks that are recognized within the operating theater are managed, for the most part, at the same surgical procedure oftentimes with urologic consultation. A delayed leak presents unique problems in that direct access to the site of the leak is not possible except by a reoperative procedure. Delayed leaks present a clinical situation involving the urologist, interventional radiologist, as well as the surgeon. METHODS A patient who developed delayed urine leakage following a partial sacrectomy to remove recurrent mucinous appendiceal malignancy was studied. The leakage was controlled using a nephroureteral stent. Placement of the nephroureteral stent was made possible by the rendezvous procedure. RESULTS The sequence of procedures to reestablish ureteral continuity following a delayed leak are important in the successful placement of a nephroureteral stent. After establishing the site of the injury a percutaneous nephrostomy must be placed. Then, through the nephrostomy, a guidewire is placed in the ureter to be recovered and advanced into the bladder using a ureteroscope and grasping forceps. A nephroureteral stent is placed over the guidewire to bridge the gap and stent the ureteral defect. CONCLUSIONS The rendezvous procedure can be successful a large percentage of the time with a delayed ureteral leakage. Successful recovery of a guidewire in the ureter by ureteroscopy requires a combined interventional radiology and urologic procedure.
Collapse
Affiliation(s)
- George Chang
- Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Arshad A Khan
- Department of Interventional Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Saher Sabri
- Department of Interventional Radiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Paul H Sugarbaker
- Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, 3629 Fulton St. NW, 20007, Washington, DC, USA.
| |
Collapse
|
36
|
Khan AA, Davies AJ, Whitehead NJ, McGee M, Al-Omary MS, Baker D, Bhagwandeen R, Renner I, Majeed T, Hatton R, Collins NJ, Attia J, Boyle AJ. Targeting elevated left ventricular end-diastolic pressure following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction – a phase one safety and feasibility study. European Heart Journal. Acute Cardiovascular Care 2020; 9:758-763. [DOI: 10.1177/2048872618819657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Elevated left ventricular end diastolic pressure (LVEDP) is an independent predictor of mortality and heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Whether lowering elevated LVEDP improves outcomes remains unknown.
Methods:
This non-randomized, single blinded study with prospective enrolment and sequential group allocation recruited patients undergoing primary percutaneous coronary intervention for STEMI with LVEDP ⩾ 20 mmHg measured immediately after primary percutaneous coronary intervention. The intervention arm (n=10) received furosemide 40 mg intravenous bolus plus escalating doses of glyceryl trinitrate (100 µg per min to a maximum of 1000 µg) during simultaneous measurement of LVEDP. The control group (n=10) received corresponding normal saline boluses with simultaneous measurement of LVEDP (10 readings over 10 min). Efficacy endpoints were final LVEDP achieved, and the dose of glyceryl trinitrate needed to reduce LVEDP by ⩾ 20%. Safety endpoint was symptomatic hypotension (systolic blood pressure < 90 mmHg).
Results:
From 1 April 2017 to 23 August 2017 we enrolled 20 patients (age: 64±9 years, males: 60%, n=12, anterior STEMI: 65%, n=13). The mean LVEDP for the whole cohort (n=20) was 29±4 mmHg (intervention group: 28±3 mmHg vs. control group: 31±5 mmHg; p=0.1). The LVEDP dropped from 28±3 to 16±2 mmHg in the glyceryl trinitrate + furosemide group (p <0.01) but remained unchanged in the control group. The median dose of glyceryl trinitrate required to produce ⩾ 20% reduction in LVEDP in the intervention group was 200 µg (range: 100–800). One patient experienced asymptomatic decline in systolic blood pressure to below 90 mmHg. There was no correlation between LVEDP and left ventricular ejection fraction.
Conclusion:
The administration of glyceryl trinitrate plus furosemide in patients with elevated LVEDP following primary percutaneous coronary intervention for STEMI safely reduces LVEDP.
Collapse
Affiliation(s)
- Arshad A Khan
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | | | | | | | - Mohammed S Al-Omary
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
| | | | | | | | - Tazeen Majeed
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | | | - Nicholas J Collins
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - John Attia
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Andrew J Boyle
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| |
Collapse
|
37
|
Abstract
Management of extensive lower extremity soft tissue and skin loss can be a very difficult to achieve by any surgeon. There can be several associated comorbidities that need to be considered and addressed with these patients. The approach is multifactorial and requires commitment from both the surgeon as well as the patient. There are several protocols that have been formulated throughout the literature addressing soft tissue and skin coverage of the limbs. This article provides a review of the literature and describes the evaluation, harvesting, transplantation, and management of skin grafting techniques to the lower extremities.
Collapse
Affiliation(s)
- Arshad A Khan
- Department of Orthopedic Surgery, Indiana University School of Medicine, Gary/Northwest, Gary, IN, USA; SpineTech Neurosurgeons, SpineTech Brain and Spine of South East Texas, Shenandoah, TX, USA.
| | - Isra M Khan
- Chicago Foot and Ankle Deformity Correction Center, Chicago, IL, USA; 111 Vision Park Boulevard, Suite 200, Shenandoah, TX 77384, USA
| | - Phi P Nguyen
- McGowan Medical School, Houston, TX, USA; MIA Plastic Surgery, 4126 Southwest Fwy Suite 999, Houston, TX 77027, USA; MILA Med Spa Group, Houston, TX, USA
| | - Erwin Lo
- University of Texas Medical Branch, Mischer Neuroscience Institute, Houston, TX, USA; Brain and Spine Center of Southeast Texas, 6025 Metropolitan Drive, Suite 205, Beaumont, TX 77706, USA
| | - Hassan Chahadeh
- Vision Park of Surgery Center, 111 Vision Park Boulevard, Suite 200, Shenandoah, TX 77384, USA
| | - Mathew Cerniglia
- Private Practice, 816 Towne Ct Suite 100, Saginaw, TX 76179, USA
| | - James A Noriega
- Department of Surgery, LSU School of Medicine, Our Lady of Lourdes Hospital, 203 West Brentwood Boulevard, Suite 2, Lafayette, LA 70506, USA
| |
Collapse
|
38
|
Chandir S, Siddiqi DA, Khan AA, Abdullah S, Dharma VK, Shah MT, Khan AJ. Evaluating mobile conditional cash transfers for improving immunization coverage in Pakistan. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1252] [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] Open
Abstract
Abstract
Background
Despite progress in increasing immunization coverage, poor uptake of vaccines remains a challenge, particularly in LMICs. In part, this is due to the poor socio-economic status of caregivers, lack of motivation, and parental procrastination. While there is evidence that large (≥100 USD) incentives can overcome these problems, research on small incentives that are more appropriate for an LMIC setting is sparse. Our study addresses this gap by evaluating the impact of small (≤12 USD) CCTs in increasing immunization coverage for children under the age of two.
Methods
A 2-year program utilizing two small incentive schemes of different amounts (high: USD9; low: USD5) was implemented in Shikarpur District, Pakistan. Caregivers (with children 0-24 months) visiting any of the 33 study immunization centers were given the opportunity to enroll. All consenting parent-child pairs were randomized in one of the two incentive schemes and incentives were disbursed following each immunization visit, using mobile money. A baseline and end-line survey was conducted to evaluate changes in pre-post coverage.
Results
A total of 63,336 participants were enrolled between March 2016 - April 2018, of which 41,483 were randomized in the high or low incentive schemes (remaining caregivers were enrolled in the no-incentive group). Results show a 13% and 28% increase in age-appropriate coverage for Measles-1 (M1) and fully immunized children (FIC) compared to the baseline (FIC:16%, M1: 38%). There was no difference in M1 coverage between the high and low incentive schemes.
Discussion
Small CCTs have induced positive behavioral change and are a powerful tool for improving immunization coverage and compliance within LMICs.
Key messages
Small mobile conditional cash transfers (USD<12) can serve as nudges to parents and lead to behavioral shifts resulting in improved immunization outcomes for children. There was no significant difference in outcomes between high and low incentives, indicating that small mobile conditional cash transfers were equally effective in improving immunization coverage.
Collapse
Affiliation(s)
- S Chandir
- IRD Global, Perry Hall, USA
- Harvard Medical School, Boston, USA
| | | | | | | | | | | | - A J Khan
- IRD Global, Singapore, Singapore
- Harvard Medical School, Boston, USA
| |
Collapse
|
39
|
Ahmed HMA, Che Ab Aziz ZA, Azami NH, Farook MS, Khan AA, Mohd Noor NS, Ayoub AA, Imran ZA, Halim MS, Pai ARV, Kacharaju KR, Mohammad N, Nagendrababu V, Nabhan MS, Dummer PMH. Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia. Int Endod J 2020; 53:871-879. [PMID: 32003029 DOI: 10.1111/iej.13271] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/29/2020] [Indexed: 12/23/2022]
Abstract
AIM To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice. METHODS One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05). RESULTS A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P < 0.001). Overall, 97% of students reported the new system helped their understanding of root and canal morphology compared with the Vertucci classification (P < 0.001). Over 97% of students recommended the use of the new system in teaching, pre-clinical courses and clinical practice (P < 0.001). Except for two schools, no significant difference was detected between the responses of students for all questions at the different schools (P > 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05). CONCLUSIONS The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.
Collapse
Affiliation(s)
- H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Z A Che Ab Aziz
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N H Azami
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - M S Farook
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - A A Khan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - N S Mohd Noor
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - A A Ayoub
- Comprehensive Care Centre of Studies, Faculty of Dentistry, University Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Z A Imran
- Endodontic Unit, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia
| | - M S Halim
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - A R V Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Melaka-Manipal Medical College (MMMC), Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - K R Kacharaju
- Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Jenjarom, Selangor, Malaysia
| | - N Mohammad
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Selangor, Malaysia
| | - V Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - M S Nabhan
- Department of Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| |
Collapse
|
40
|
Khan BA, Cheng L, Khan AA, Ahmed H. Unsafe small clinics cause new human immunodeficiency virus outbreaks in Pakistan. J Hosp Infect 2019; 104:393-394. [PMID: 31606434 DOI: 10.1016/j.jhin.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Affiliation(s)
- B A Khan
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China.
| | - L Cheng
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - A A Khan
- School of Economics and Management, Southeast University, Nanjing, China
| | - H Ahmed
- Institute of Business Administration, University of Sindh, Jamshoro, Sindh, Pakistan
| |
Collapse
|
41
|
Khan AA, Josse R, Kannu P, Villeneuve J, Paul T, Van Uum S, Greenberg CR. Hypophosphatasia: Canadian update on diagnosis and management. Osteoporos Int 2019; 30:1713-1722. [PMID: 30915507 DOI: 10.1007/s00198-019-04921-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/27/2019] [Indexed: 12/22/2022]
Abstract
UNLABELLED Hypophosphatasia (HPP) is a rare inherited disorder of bone and mineral metabolism caused by loss of function mutations in the ALPL gene. The presentation in children and adults can be extremely variable and natural history is poorly understood particularly in adults. Careful patient evaluation is required with consideration of pharmacologic intervention in individuals meeting criteria for therapy. INTRODUCTION The purposes of this review are to present current evidence regarding the diagnosis and management of hypophosphatasia in children and adults and provide evidence-based recommendations for management. METHOD A MEDLINE, EMBASE, and Cochrane database search and literature review was completed. The following consensus recommendations were developed based on the highest level of evidence as well as expert opinion. RESULTS Hypophosphatasia is a rare inherited disorder of bone and mineral metabolism due to loss of function mutations in the tissue non-specific alkaline phosphatase (ALPL) gene causing reductions in the activity of the tissue non-specific isoenzyme of alkaline phosphatase (TNSALP). Deficient levels of alkaline phosphatase result in elevation of inhibitors of mineralization of the skeleton and teeth, principally inorganic pyrophosphate. The impaired skeletal mineralization may result in elevations in serum calcium and phosphate. Clinical features include premature loss of teeth, metatarsal and subtrochanteric fractures as well as fragility fractures. Poor bone healing post fracture has been observed. Myalgias and muscle weakness may also be present. In infancy and childhood, respiratory and neurologic complications can occur. CONCLUSIONS HPP is associated with significant morbidity and mortality. Pharmacologic intervention can result in significant clinical improvement. This Canadian position paper provides an overview of the musculoskeletal, renal, dental, respiratory, and neurologic manifestations of hypophosphatasia. The current state of the art in the diagnosis and management of hypophosphatasia is presented.
Collapse
Affiliation(s)
- A A Khan
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
| | - R Josse
- St. Michael's Hospital and University of Toronto , Toronto, Canada
| | - P Kannu
- Hospital for Sick Kids , Toronto, Canada
| | - J Villeneuve
- Le Centre Hospitalier Universitaire de Quebec, Quebec, Canada
| | - T Paul
- St. Joseph's Health Care London, London, Ontario, Canada
| | | | | |
Collapse
|
42
|
Abstract
In the article mentioned above an author's name was misspelled.
Collapse
Affiliation(s)
- A A Khan
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
| | - R Josse
- St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - P Kannu
- Hospital for Sick Kids, Toronto, Canada
| | - J Villeneuve
- Le Centre Hospitalier Universitaire de Quebec, Quebec, Canada
| | - T Paul
- St. Joseph's Health Care London, London, Ontario, Canada
| | | | | |
Collapse
|
43
|
Ezad S, Khan AA, Cheema H, Ashraf A, Ngo DTM, Sverdlov AL, Collins NJ. Ibrutinib-related atrial fibrillation: A single center Australian experience. Asia Pac J Clin Oncol 2019; 15:e187-e190. [PMID: 31250562 DOI: 10.1111/ajco.13179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 08/31/2018] [Accepted: 05/23/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Ibrutinib increases the risk of atrial fibrillation (AF) and is associated with bleeding tendencies. Reported rates of arrhythmia are variable in different studies. The aim of the current analysis was to evaluate the incidence of AF in a single-center cohort of patients. METHODS This analysis was conducted at Hunter New England Local Health District, Australia between April 1, 2015 and June 30, 2017. We included all consecutive patients commenced on ibrutinib for hematological malignancies. Patients with a history of paroxysmal AF were excluded. The primary end point was incidence of AF. Time to diagnosis and management were secondary outcomes of interest. RESULTS A total of 24 patients (age 73 ± 9 years, males n = 16 [67%]) were commenced on ibrutinib treatment during the study period with chronic lymphocytic leukemia (n = 21, 88%) as the main indication. During a median follow-up of 12 months, four (17%) patients were diagnosed with AF with increasing age, duration of ibrutinib treatment as associations. The median time to AF diagnosis was 9 (interquartile range [IQR]: 7-18) months. All patients were managed with a rate control strategy with beta blockers as the preferred agents. Three (75%) patients were commenced on anticoagulation for stroke prevention. During a follow-up of 18 (IQR: 17-23) months following AF onset, one patient required hospitalization for AF. There were no bleeding complications reported. CONCLUSIONS In conclusion, this series noted a higher incidence of AF than previously reported. Oncologists and cardiologists need to be aware of the increased risk of AF in patients receiving ibrutinib.
Collapse
Affiliation(s)
- Saad Ezad
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Arshad A Khan
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Hooria Cheema
- Hematology Department, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Asma Ashraf
- Hematology Department, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Doan T M Ngo
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aaron L Sverdlov
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas J Collins
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
44
|
Khan AA, Williams T, Al-Omary MS, Feeney AL, Majeed T, Savage L, Stewart P, Faddy S, Collins NJ, Fletcher P, Boyle AJ. Pre-hospital thrombolysis for ST-segment elevation myocardial infarction in regional Australia: long-term follow up. Intern Med J 2019; 50:711-715. [PMID: 31237408 DOI: 10.1111/imj.14412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/27/2019] [Revised: 06/10/2019] [Accepted: 06/18/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Delivering reperfusion therapy to patients with ST-segment elevation myocardial infarction (STEMI) in regional areas without access to tertiary cardiology care remains challenging. The systems of care in Hunter New England Health, New South Wales, Australia (area covered = 130 000 km2 ) to provide reperfusion to patients with STEMI involve a 12-lead electrocardiogram in the ambulance, discussion between cardiologist and paramedic, followed by pre-hospital thrombolysis (PHT) delivered in ambulance to appropriate patients >60 min from the cardiac catheterisation laboratories. Patients who can access the cardiac catheterisation laboratories within 60 min are treated with primary percutaneous coronary intervention (PCI). AIMS We have previously reported excellent 12-month outcomes for patients receiving PHT and the aim of the current analysis is to look at the long term outcomes. METHODS We assessed long-term all-cause mortality and major adverse cardiovascular events of STEMI patients undergoing PHT in our health district from August 2008 to August 2013 and compared with the primary PCI group. RESULTS One hundred and fifty (mean age: 62 ± 13 years, males: 76%, n = 114) patients were administered PHT and 334 patients (mean age: 65 ± 13 years, males: 75%, n = 251) underwent primary PCI during the study period. During a median follow up of 6.2 years (interquartile range: 4.8-7.4 years) all-cause mortality was 16% and 19% in the PHT and primary PCI groups respectively (P = 0.4). CONCLUSION Our real-world experience shows that PHT followed by early transfer to a primary PCI-capable centre is an effective reperfusion strategy, with comparable results to primary PCI, and mortality benefits are sustained to more than 6 years.
Collapse
Affiliation(s)
- Arshad A Khan
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Trent Williams
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Mohamed S Al-Omary
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Alex L Feeney
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia
| | - Tazeen Majeed
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Lindsay Savage
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia
| | - Paul Stewart
- NSW Ambulance, Sydney, New South Wales, Australia
| | - Steven Faddy
- NSW Ambulance, Sydney, New South Wales, Australia
| | - Nicholas J Collins
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Peter Fletcher
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Andrew J Boyle
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Health, Newcastle, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| |
Collapse
|
45
|
Lindegren A, Schultz I, Sinha I, Cheung L, Khan AA, Tekle M, Wickman M, Halle M. Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. Br J Surg 2019; 106:563-573. [PMID: 30802303 DOI: 10.1002/bjs.11072] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/20/2018] [Accepted: 11/01/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Radiation-induced fibrosis, an adverse effect of breast cancer treatment, is associated with functional and cosmetic impairment as well as surgical complications. Clinical reports suggest improvement following autologous fat transplantation, but the mechanisms underlying this effect are unknown. A global gene expression analysis was undertaken to identify genetic pathways dysregulated by radiation and evaluate the impact of autologous fat transplantation on gene expression. METHODS Adipose tissue biopsies were taken synchronously from irradiated and contralateral non-irradiated breasts, before and 1 year after autologous fat transplantation. Whole-genome gene expression analyses were performed, and Hallmark gene set analysis used to explore the effect of radiotherapy and autologous fat transplantation on gene expression. RESULTS Forty microarrays were analysed, using bilateral biopsies taken from ten patients before and after autologous fat transplantation. Forty-five pathways were identified among the 3000 most dysregulated transcripts after radiotherapy in irradiated compared with non-irradiated breast (P ≤ 0·023; false discovery rate (FDR) no higher than 0·026). After autologous fat transplantation, 575 of the 3000 genes were again altered. Thirteen pathways (P ≤ 0·013; FDR 0·050 or less) were identified; the top two canonical pathways were interferon-γ response and hypoxia. Correlative immunohistochemistry showed increased macrophage recruitment in irradiated tissues. CONCLUSION The present findings contribute to understanding of how autologous fat transplantation can ameliorate radiation-induced fibrosis. This further supports the use of autologous fat transplantation in the treatment of radiation-induced fibrosis. Surgical relevance Clinical studies have indicated that autologous fat transplantation (AFT) stimulates regression of chronic inflammation and fibrosis caused by radiotherapy in skin and subcutaneous fat. However, there is a paucity of biological evidence and the underlying processes are poorly understood. Human data are scarce, whereas experimental studies have focused mainly either on the effect of irradiation or AFT alone. The present results indicate that radiotherapy causes dysregulated gene expression in fibrosis-related pathways in adipose tissues in humans. They also show that AFT can cause a reversal of this, with several dysregulated genes returning to nearly normal expression levels. The study provides biological evidence for the impact of AFT on radiation-induced dysregulated gene expression in humans. It supports the use of AFT in the treatment of radiation-induced fibrosis, associated with severe morbidity and surgical challenges.
Collapse
Affiliation(s)
- A Lindegren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - I Schultz
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - I Sinha
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - L Cheung
- Cardiovascular Medicine Unit, Department of Medicine, Centre for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A A Khan
- Targeted Therapy Team, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - M Tekle
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - M Halle
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
46
|
Giangregorio LM, Gibbs JC, Templeton JA, Adachi JD, Ashe MC, Bleakney RR, Cheung AM, Hill KD, Kendler DL, Khan AA, Kim S, McArthur C, Mittmann N, Papaioannou A, Prasad S, Scherer SC, Thabane L, Wark JD. Build better bones with exercise (B3E pilot trial): results of a feasibility study of a multicenter randomized controlled trial of 12 months of home exercise in older women with vertebral fracture. Osteoporos Int 2018; 29:2545-2556. [PMID: 30091064 DOI: 10.1007/s00198-018-4652-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 03/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
UNLABELLED We pilot-tested a trial of home exercise on individuals with osteoporosis and spine fracture. Our target enrollment was met, though it took longer than expected. Participants stayed in the study and completed the exercise program with no safety concerns. Future trials should expand the inclusion criteria and consider other changes. PURPOSE Osteoporotic fragility fractures create a substantial human and economic burden. There have been calls for a large randomized controlled trial examining the effect of exercise on fracture incidence. The B3E pilot trial was designed to evaluate the feasibility of a large trial examining the effects of home exercise on individuals at high risk of fracture. METHODS Community-dwelling women ≥ 65 years with radiographically confirmed vertebral compression fractures were recruited at seven sites in Canada and Australia. We randomized participants in a 1:1 ratio to a 12-month home exercise program or equal attention control group, both delivered by a physiotherapist (PT). Participants received six PT home visits in addition to monthly phone calls from the PT and a blinded research assistant. The primary feasibility outcomes of the study were recruitment rate (20 per site in 1 year), retention rate (75% completion), and intervention adherence rate (60% of weeks meeting exercise goals). Secondary outcomes included falls, fractures and adverse events. RESULTS One hundred forty-one participants were recruited; an average of 20 per site, though most sites took longer than anticipated. Retention and adherence met the criteria for success: 92% of participants completed the study; average adherence was 66%. The intervention group did not differ significantly in the number of falls (IRR 0.97, 95% CI 0.58 to 1.63) or fragility fractures (OR 1.11, 95% CI 0.60 to 2.05) compared to the control group. There were 18 serious adverse events in the intervention group and 12 in the control group. CONCLUSION An RCT of home exercise in women with vertebral fractures is feasible but recruitment was a challenge. Suggestions are made for the conduct of future trials.
Collapse
Affiliation(s)
- L M Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada.
| | - J C Gibbs
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - J A Templeton
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - J D Adachi
- McMaster University, Hamilton, Ontario, Canada
- St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M C Ashe
- University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
| | | | - A M Cheung
- University of Toronto, Toronto, Ontario, Canada
| | - K D Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - D L Kendler
- University of British Columbia, Vancouver, Canada
| | - A A Khan
- McMaster University, Hamilton, Ontario, Canada
| | - S Kim
- University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - C McArthur
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
- McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Aging Sciences Centre, Hamilton, Ontario, Canada
| | - N Mittmann
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - A Papaioannou
- McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Aging Sciences Centre, Hamilton, Ontario, Canada
| | - S Prasad
- McMaster University, Hamilton, Ontario, Canada
| | - S C Scherer
- Broadmeadows Health Service, Broadmeadows, Australia
- University of Melbourne, Melbourne, Australia
| | - L Thabane
- McMaster University, Hamilton, Ontario, Canada
- St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - J D Wark
- University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital, Parkville, Australia
| |
Collapse
|
47
|
Khan AA, Hernan I, Adamthwaite JA, Ramsey KWD. Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer-related lymphoedema. Br J Surg 2018; 106:100-110. [PMID: 30295931 DOI: 10.1002/bjs.10983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/10/2018] [Accepted: 07/22/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Breast cancer-related lymphoedema (BCRL) presents a significant healthcare burden and adversely affects quality of life of breast cancer survivors. A prospective feasibility study was performed on lymphaticovenous anastomosis (LVA) for the treatment of BCRL. METHODS Patients with BCRL underwent near-infrared spectroscopy with indocyanine green lymphatic mapping to identify suitable lymphatic channels for LVA. End-to-end anastomoses to subdermal venules were performed and patients recommenced compression garment therapy (CGT) after surgery. Volumetric assessment of the affected limb was performed at regular intervals using infrared perometry to calculate the excess volume reduction. RESULTS Over a 24-month interval, 27 patients with BCRL underwent LVA. The mean duration of lymphoedema was 3·5 (range 0·5-18) years, and the mean number of LVAs performed was 3 (range 2-5). Twenty-four of the 27 patients completed 12-month follow-up. Patients exhibited three patterns of volumetric response following LVA: sustained response (16 patients), transient response (5) or no response (6). Sustained responders showed an excess volume reduction of -33·2 per cent at 12 months, and this correlated positively with the number of LVAs performed (r = -0·56, P = 0·034). Overall, ten patients were able to downgrade CGT after surgery, and two patients were CGT-free at 12 months. CONCLUSION LVA resulted in a sustained volume reduction in selected patients and may offset the burden of CGT. Further work is required to identify biomarkers that predict a favourable response to LVA surgery.
Collapse
Affiliation(s)
- A A Khan
- Institute of Cancer Research, London, UK
| | - I Hernan
- Department of Plastic and Reconstructive Surgery, Royal Marsden Hospital, London, UK
| | - J A Adamthwaite
- Department of Plastic and Reconstructive Surgery, Royal Marsden Hospital, London, UK
| | - K W D Ramsey
- Department of Plastic and Reconstructive Surgery, Royal Marsden Hospital, London, UK
| |
Collapse
|
48
|
Khan AA, Shahid F, Lip GYH, Shantsila E. P670Predictors of exercise capacity in the elderly population with permanent atrial fibrillation and preserved left ventricular function. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A A Khan
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - F Shahid
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - G Y H Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - E Shantsila
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| |
Collapse
|
49
|
Khan AA, Al-Omary M, Renner I, Ul Haque E, Ekmejian A, Hussain M, Quiqueree L, Collins NJ, Turner S. Echocardiographic assessment of pulmonary artery systolic pressure following treadmill stress testing. Eur Heart J Cardiovasc Imaging 2018; 18:1278-1282. [PMID: 28011667 DOI: 10.1093/ehjci/jew308] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/22/2016] [Indexed: 11/14/2022] Open
Abstract
Aims The use of treadmill stress echocardiography (SE) for the diagnosis of nascent pulmonary hypertension (PH) has been hampered by a lack of well-defined, post-exercise pulmonary artery systolic pressure (PASP) values across representative age groups in a normal cohort. Methods and results Five hundred and eleven subjects (mean age: 53 ±14, 68% female) with normal resting PASP were included in the study. All participants performed treadmill exercise using the Bruce protocol to a high level of perceived exertion. PASP was calculated before and immediately after exercise using Doppler assessment of tricuspid regurgitation. For the cohort, post-exercise PASP was 39 ± 7 mmHg (range: 23-64 mmHg) representing an increase of 11 ± 6 mmHg (44%) from resting values (P < 0.001). The 95th centile values for post-exercise PASP were calculated for the following age cohorts: <30 years; 46 mmHg, 31-50 years; 50 mmHg, 51-70 years; 52 mmHg, >70 years; 53 mmHg. There was a modest independent correlation between post-exercise PASP and (i) increasing age and (ii) resting PASP (r2 = 0.35 and 0.49, respectively, P = 0.01). Conclusion An increase of post-exercise PASP was seen in all patients undergoing SE in this study. Age was directly correlated with post-exercise PASP. Using normative data from healthy controls, treadmill SE-derived post-exercise PASP may be a useful adjunct in the diagnosis of PH.
Collapse
Affiliation(s)
- Arshad A Khan
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| | - Mohammad Al-Omary
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| | - Ian Renner
- University of Newcastle, Newcastle, NSW, Australia
| | | | - Avedis Ekmejian
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| | | | - Laurent Quiqueree
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| | - Nicholas J Collins
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| | - Stuart Turner
- Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia
| |
Collapse
|
50
|
Vishwakarma SK, Lakkireddy C, Sravani G, Sastry BVS, Raju N, Ahmed SI, Khan AA, Owaisi N, Jaisawal A, Khan MA, Khan AA. Association of CD14 and macrophage migration inhibitory factor gene polymorphisms with inflammatory microRNAs expression levels in ankylosing spondylitis and polyarthralgia. Int J Immunogenet 2018; 45:190-200. [PMID: 29863307 DOI: 10.1111/iji.12366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 09/26/2017] [Accepted: 03/22/2018] [Indexed: 01/18/2023]
Abstract
This study aimed to investigate the genetic basis of ankylosing spondylitis (AS) and polyarthralgia (PA) conditions among Indian subjects through genotyping two immune regulatory genes CD14 (-159C>T) and MIF (-173G>C) and find their association with the expression levels of three circulating inflammatory miRNAs. This investigation may provide early genetic cause of these two forms of arthritis and more optimal biological targets to predict early therapeutic outcomes. A total of 140 patients (AS: 70 and PA: 70) and 156 controls were recruited from Indian population. CD14 and MIF genotyping was performed using ARMS-PCR. Expression level of three inflammatory miRNAs (miRNA-146a, miRNA-155 and miRNA-181) was quantified using RT-qPCR. C/T genotype of CD14 gene was found to cause 2.06-fold risk of developing AS (CI 1.06-5.98, p = .04) as compared to others and G/C genotype in MIF also shown significant variation between AS and control subjects. In PA subjects, CD14 genotypes (C/T) was found to be associated with disease susceptibility and G/C genotype of MIF gene polymorphism showed 4.71-fold risk of developing PA (CI 2.58-8.62, p = .0001). The study also revealed significant upregulation of miRNA-155 expression in AS subjects (p = .0001) with more than 1.3-fold difference between AS and PA as compared to the control subjects. miRNA-155 had strong association with AS patients with CD14 genotypes (p < .05) than PA and control subjects. This study provides better understanding of the mechanisms and disease susceptibility for MIF and CD14 genetic variants and inflammatory miRNAs networks involved in AS and PA.
Collapse
Affiliation(s)
- S K Vishwakarma
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - C Lakkireddy
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - G Sravani
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - B V S Sastry
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - N Raju
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - S I Ahmed
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - A A Khan
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - N Owaisi
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - A Jaisawal
- Department of Orthopedics, Owaisi Hospital and Research Centre, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - M A Khan
- Department of Orthopedics, Owaisi Hospital and Research Centre, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - A A Khan
- Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| |
Collapse
|