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Jairoun AA, Ping CC, Ibrahim B. Pharmacotherapeutic considerations and treatment patterns of antihyperglycemic agents for diabetic nephropathy: a review of the literature. Eur Rev Med Pharmacol Sci 2023; 27:12058-12069. [PMID: 38164868 DOI: 10.26355/eurrev_202312_34804] [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: 01/03/2024]
Abstract
Diabetes can have several macrovascular and microvascular complications in addition to diabetic nephropathy, also referred to as diabetic kidney disease (DKD). DKD is found to occur in approximately 40% of patients with type 2 diabetes and 30% of patients with type 1 diabetes. However, research on the effects of antihyperglycemic agents on the renal outcomes of these patients is still in its infancy. The current review explores glycemic management in patients with DKD, focusing on the challenges faced as well as the clinical considerations of antihyperglycemic agents in this population. A comprehensive literature review was conducted using EMBASE, Web of Science, and PubMed databases. This review was completed by the end of March 2023, and the following keywords were used for the search: diabetic nephropathy, diabetic kidney disease, safety, efficacy, and antihyperglycemic therapies. The several concerns about the use of antihyperglycemic agents in treating diabetes in patients with DKD highlight the need for substantial efforts in educating both patients and healthcare practitioners in this regard. In addition, it is suggested that patients receive individualized treatments, considering the potential long-term benefits of each agent; this would entail prospectively modifying doses in line with the stage of DKD to prevent the progression of renal damage. As some classes of agents offer better renoprotective effects for patients with DKD, it would be wise for nephrologists and endocrinologists to collaborate to offer an antihyperglycemic regime for patients with DKD who are at a high risk of further progression. Further study is needed on the beneficial renal effects of specific classes of agents; more knowledge of their mechanisms and renoprotective effects may contribute to the development of novel treatments for patients with DKD.
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Affiliation(s)
- A A Jairoun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinan, Malaysia.
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Isaac WE, Jalo I, Yohanna G, Aliu R, Ebiseke K, Girbo A, Olatoke L, Raymond PM, Iliya A, Ndubusi V, Rabo Y, Daniel GE, Apollos D, Bakura B, Usman MO, Kamaludden H, Abdulshaheed B, Tukur H, Joel Z, Abdulkarim H, Abdulrahman S, Adeniran OA, Ibrahim B, Meller BT, Adamu A. IN-PATIENT PNEUMONIA BURDEN AND CASE FATALITY RATES IN CHILDREN OVER TWO DECADES IN FEDERAL TEACHING HOSPITAL, GOMBE (FTHG). West Afr J Med 2023; 40:S10. [PMID: 37971711] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction Pneumonia is the leading cause of death among children globally accounting for an estimated 1.2 million (18%) total deaths annually. The number of childhood-related deaths from pneumonia is approximately 2000-fold higher in developing than in developed countries. Nigeria contributes the highest of pneumonia-related deaths globally. Objectives To determine the case fatality rates (CFR) of pneumonia from 2000-2019 in paediatric ward, FTHG. Methodology All cases of pneumonia admissions and deaths in patients aged 0-18 years, using ICD-10 classification, were retrieved and analysed. The mainstay of diagnosis is clinical and/or radiographic features. Results A total of 26,716 children were admitted during this period, 1151 had pneumonia (4.3%) and 118 died. Males constituted 647 (56.2%) and females 43.8% of the total pneumonia admissions. Children aged 0-5 years had the highest pneumonia admissions, followed by 6-9 years. Admissions were highest in the wet than the dry season. Pneumonia CFR was 10.2%; 10.9% in females and 9.7% in males. Under-5 constituted 84% (969/1151) of pneumonia admission with a CFR of 9.3%. CFR were 10.3% and 21% in 6-10 years, and 11-18 years respectively. The CFR between2000-2004 was 14.1%, 2005-2009:21.1%, 2010-2014:10.2% and 2015-2019:7.2%. Kanuri had the highest CFR of 56.2%.(P <0.05) Other ethnic groups were 29.4% in Waja, 25% in Tula, 21.4% in Igbo, 16.6% in Yoruba, 12.1% in Tangale, 10.2% in Hausa, 8.8%in Bolewa and 8.3% in Fulani. The CFR was highest in February20.2%. Conclusion Pneumonia Case fatality is high.
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Affiliation(s)
- W E Isaac
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - I Jalo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G Yohanna
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - R Aliu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - K Ebiseke
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Girbo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - L Olatoke
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - P M Raymond
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Iliya
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - V Ndubusi
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Y Rabo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G E Daniel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - D Apollos
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Bakura
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - M O Usman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Kamaludden
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Abdulshaheed
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Tukur
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Z Joel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Abdulkarim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - S Abdulrahman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - O A Adeniran
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Ibrahim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B T Meller
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Adamu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
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Isaac WE, Jalo I, Yohanna G, Aliu R, Ebiseke K, Girbo A, Olatoke L, Raymond PM, Iliya A, Ndubusi V, Rabo Y, Daniel GE, Apollos D, Bakura B, Usman MO, Kamaludden H, Abdulshaheed B, Tukur H, Joel Z, Abdulkarim H, Abdulrahman S, Adeniran OA, Adamu A, Ibrahim B, Meller BT. EPIDEMIOLOGIC TREND AND CASE FATALITY OF CHILDHOOD TETANUS IN FEDERAL TEACHING HOSPITAL GOMBE; A 20YEARS REVIEW. West Afr J Med 2023; 40:S9. [PMID: 37971497] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction Tetanus is a vaccine-preventable disease, it remains a significant cause of morbidity and mortality in both neonatal and post-neonatal periods, especially in developing countries with limited health facilities and inadequate vaccination. The overall case fatality rate (CFR) is 13.2% globally, highest in the neonatal period and in sub-Saharan Africa. CFR is 64%, 47%, and 43% in Nigeria, Uganda, and Tanzania respectively. Objectives To determine the Case Fatality Rate of Childhood tetanus in FTHG from 2000-2019. Methodology All cases and deaths from tetanus amongst children aged 0-18 years in paediatric medical ward of FTHG over the last two decades diagnosed clinically and classified using ICD-10 were analysed. Results 95 cases of tetanus out of 26,716 total admissions constituting 0.004%. There were 49 tetanus deaths out of 3956 total childhood deaths (0.012%) over the study period. Males constituted 66% (63/95). 30% (28/95) were aged 0-28 days; 23.1% (22/95) were adolescents. Fulani and Hausa constituted 37% (34/95) and 31% (29/95) respectively. Admission was highest in the dry season 52% (50/95 %). The overall tetanus CFR was 51.6%; 78% of deaths were in males (38/49), 30% in neonates, and 23% in adolescents. CFR was highest during the dry season (67.3%). Hausa and Fulani had CFR of 51% and 40% respectively. P-value <0.05 The CFR was 88% between 2000-2004, 72% from 2005-2009, 71% between 2010-2014 and 33% from 2015-2019. Conclusion Tetanus CFR is still high among neonates and adolescents. Maternal tetanus vaccine and booster doses in children need strengthening.
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Affiliation(s)
- W E Isaac
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - I Jalo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G Yohanna
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - R Aliu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - K Ebiseke
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Girbo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - L Olatoke
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - P M Raymond
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Iliya
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - V Ndubusi
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Y Rabo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G E Daniel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - D Apollos
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Bakura
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - M O Usman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Kamaludden
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Abdulshaheed
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Tukur
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Z Joel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Abdulkarim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - S Abdulrahman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - O A Adeniran
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Adamu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Ibrahim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B T Meller
- Department of Paediatrics, Federal Teaching Hospital, Gombe
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Isaac WE, Jalo I, Yohanna G, Aliu R, Ebiseki K, Girbo A, Olatoke L, Raymond PM, Iliya A, Ndubusi V, Rabo Y, Daniel GE, Apollos D, Bakura B, Usman MO, Kamaludden H, Abdulshaheed B, Tukur H, Joel Z, Abdulkarim H, Abdulrahman S, Adeniran OA, Adamu A, Ibrahim B, Meller BT. REVEALING THE VARIED REALITY OF MALARIA-RELATED DEATHS IN CHILDREN ACROSS GENDER, AGE, AND ETHNICITY IN FEDERAL TEACHING HOSPITAL GOMBE OVER 20 YEARS: AN ESSENTIAL EPIDEMIOLOGIC IMPERATIVE. West Afr J Med 2023; 40:S7. [PMID: 37971220] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction Nigeria recorded 31% of 619,000 malaria deaths globally and accounts for 25-30% of all childhood mortality in the country. Few studies in Nigeria, have reported malaria's case fatality rate over a long period. Objective To determine Malaria Case Fatality Rate among Children admitted from 2000-2019. Methodology All severe malaria cases and deaths amongst children aged 0-18 over the last two decades were analysed using ICD-10. The diagnosis was based on clinical and microscopic findings. Results 26,716 children were admitted, 2494 (9.3%) were diagnosed with malaria and 209 died. Malaria constituted 5.3% (209/3956) of all childhood mortality. Males constituted 58.9 % (1468/2494) while 65% (1642/2494) were aged 0-5 years. Of the malaria admissions, Fulani and Hausa constituted 948(38%) and 438(17.6%) respectively. Admissions were highest in October (15%) and in 2012 (9.6%). The overall malaria CFR was 8.3%; 8.8% in Females (91/1026) and 8.03% in Males P-value <0.05 (X2=54.735); 8.6% in children aged 0-5years, 8.2% in 6-10 years and 7.4% in 11-18 years, P-value <0.05 (X2=893.164). CFR was highest in April (11.4%)and lowest in November (5.2%). Kanuri and Igbo had CFR of 70% and 38.4% respectively while it was lowest in Tera tribe (4.3%), P-value<0.05. The CFR was highest in the year 2004 (22%), 3.5% in 2000 and 2006. Over the years, case fatality rate was 15.9% between 2000-2004, 6.1% from 2005-2009. Between 2010-2015, it was 7.3% and 8.5% from 2016-2019. Conclusion This study revealed the deadly reality of severe malaria with increased CFR among females, aged 0-5 and the Kanuri tribe.
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Affiliation(s)
- W E Isaac
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - I Jalo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G Yohanna
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - R Aliu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - K Ebiseki
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Girbo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - L Olatoke
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - P M Raymond
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Iliya
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - V Ndubusi
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Y Rabo
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - G E Daniel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - D Apollos
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Bakura
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - M O Usman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Kamaludden
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Abdulshaheed
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Tukur
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - Z Joel
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - H Abdulkarim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - S Abdulrahman
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - O A Adeniran
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - A Adamu
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B Ibrahim
- Department of Paediatrics, Federal Teaching Hospital, Gombe
| | - B T Meller
- Department of Paediatrics, Federal Teaching Hospital, Gombe
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Jairoun AA, Ping CC, Ibrahim B. Statin therapy for patients with diabetic nephropathy: balance between safety and efficacy of statin treatment for patients with impaired kidney function. Eur Rev Med Pharmacol Sci 2023; 27:10595-10604. [PMID: 37975384 DOI: 10.26355/eurrev_202311_34339] [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: 11/19/2023]
Abstract
The International Diabetes Federation estimates that by 2035, there will be 592 million people with diabetes worldwide, substantially increasing from the 382 million patients with diabetes recorded in 2013. Diabetes-related nephropathy is a leading cause of end-stage renal disease. Recently, the therapeutic use of statins in patients with chronic kidney disease (CKD) was explored in a series of meta-analyses, which revealed their potential for decreasing mortality and cardiovascular complications in this population, although not in patients undergoing hemodialysis. The current study reviews the current state of knowledge on statin therapy regarding its safety and efficacy concerning renal outcomes in diabetic patients with CKD. The evidence shows that statins may offer a beneficial renoprotective effect in inhibiting the progression of renal function decline. This effect is time-dependent and particularly strong in patients with type 2 diabetes and nephropathy. In addition, whether certain statin types are more beneficial than others in slowing renal function loss and reducing proteinuria remains unclear. Prior research has not examined the impact of high-intensity statin therapy on CKD patient outcomes.
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Affiliation(s)
- A A Jairoun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, Malaysia.
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Odeibat YM, Hiasat MY, Ibrahim B, Dabbas WF, Alhazaimeh MH, Samara QA, Marji A, Alomari AA. WhatsApp-Based Record-Keeping System in a Private Neurosurgical Clinic Chain. Cureus 2023; 15:e45823. [PMID: 37876404 PMCID: PMC10593181 DOI: 10.7759/cureus.45823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/26/2023] Open
Abstract
Background The demanding nature of neurosurgical practice requires a reliable system for documentation and record-keeping. The cost of electronic health record systems can limit their availability in low- and middle-income countries. That is why less expensive and easily accessible technological alternatives should be sought. In this article, we describe our adopted system for medical record-keeping based on WhatsApp (Meta Platforms, Inc., Menlo Park, CA). Methods In our chain of six clinics, each clinic has its record-keeping WhatsApp group dedicated to sharing medical data of outpatients following up in that specific clinic and of inpatients cared for in hospitals in its area. After each encounter, our surgeons share smartphone-captured pictures of their patients' medical data on the WhatsApp group of the related clinic. The medical data are then categorized and stored by the secretary on the clinic's computer to be accessed at any time for record retrieval. Discussion Our five years of experience with the WhatsApp-based record-keeping system with medical records of 11,729 patients proved to be reliable, cost-effective, user-friendly, and efficient, and it positively impacted patient care. Responsible behavior, security precautions, and regulating policies are essential to protect patient confidentiality. Conclusion Our system can be an inexpensive alternative to the electronic health record system in small healthcare facilities. It can help physicians practicing in low- and middle-income countries to improve medical records documentation, thereby improving patient care. There is a need for policies to regulate the use of instant messaging applications in professional medical communication.
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Affiliation(s)
| | | | - Bilal Ibrahim
- Department of Neurological Surgery, Al-Balqa Applied University, Al-Salt, JOR
| | - Waleed F Dabbas
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | | | - Qais A Samara
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Ala Marji
- Department of Neurosurgery, King Hussein Cancer Center, Amman, JOR
| | - Amer A Alomari
- Department of Neurosurgery, San Filippo Neri Hospital/Azienda Sanitaria Locale (ASL) Roma 1, Rome, ITA
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Dabbas WF, Hiasat MY, Ibrahim B, Allababede R, Alkhaldi TA, Al Warawrah A, Nadi M. A Report of Two Simultaneous Different Skull Vault Boney Pathologies: An Extremely Rare Clinical Scenario. Cureus 2023; 15:e40248. [PMID: 37440816 PMCID: PMC10334685 DOI: 10.7759/cureus.40248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/15/2023] Open
Abstract
Primary calvarial boney tumors are generally rare in clinical practice. Multiple primary skull neoplasms are less frequent, typically associated with genetic disorders or familial syndromes. Sporadic cases of multiple skull tumors are exceptionally rare. We present a unique scenario of a 32-year-old female patient who had two right-sided skull vault lesions, one located over the right parietal area and the other in the right retro-auricular region. The lesions exhibited different behaviors over several years. The workup revealed that the two skull lesions were of two pathologies. The standard academic approach for clinical analysis attributes the symptoms often to one pathological process until proven otherwise. This case highlights the significance of expanding the differential diagnoses and incites clinicians to consider multiple pathologies in specific clinical settings.
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Affiliation(s)
- Waleed F Dabbas
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | | | - Bilal Ibrahim
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Razan Allababede
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Tareq A Alkhaldi
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Ayah Al Warawrah
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Mustafa Nadi
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
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Nagarajan K, Ibrahim B, Bawadikji A, Khaw KY, Tong WY, Leong CR, Ramanathan S, Tan WN. Characterization of Metabolites in an Endophytic Fungus Diaporthe fraxini via NMR-based Metabolomics and Cholinesterase Inhibitory Activity. APPL BIOCHEM MICRO+ 2023; 59:316-322. [DOI: 10.1134/s0003683823030134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 10/18/2023]
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Kaye B, Ali A, Correa Bastianon Santiago RA, Ibrahim B, Isidor J, Awad H, Sabahi M, Obrzut M, Adada B, Ranjan S, Borghei-Razavi H. The Role of EGFR Amplification in Deep Venous Thrombosis Occurrence in IDH Wild-Type Glioblastoma. Curr Oncol 2023; 30:4946-4956. [PMID: 37232831 DOI: 10.3390/curroncol30050373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction: Glioblastoma (GBM) patients have a 20-30 incidence of venous thromboembolic events. EGFR is a widely used prognostic marker for many cancers. Recent lung cancer studies have described relationships between EGFR amplification and an increased incidence of thromboembolic complications. We aim to explore this relationship in glioblastoma patients. Methods: Two hundred ninety-three consecutive patients with IDH wild-type GBM were included in the analysis. The amplification status of EGFR was measured using fluorescence in situ hybridization (FISH). Centromere 7 (CEP7) expression was recorded to calculate the EGFR-to-CEP7 ratio. All data were collected retrospectively through chart review. Molecular data were obtained through the surgical pathology report at the time of biopsy. Results: There were 112 subjects who were EGFR-amplified (38.2%) and 181 who were non-amplified (61.8%). EGFR amplification status was not significantly correlated with VTE risk overall (p = 0.2001). There was no statistically significant association between VTE and EGFR status after controlling for Bevacizumab therapy (p = 0.1626). EGFR non-amplified status was associated with an increased VTE risk in subjects greater than 60 years of age (p = 0.048). Conclusions: There was no significant difference in occurrence of VTE in patients with glioblastoma, regardless of EGFR amplification status. Patients older than 60 years of age with EGFR amplification experienced a lower rate of VTE, contrary to some reports on non-small-cell lung cancer linking EGFR amplification to VTE risk.
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Affiliation(s)
- Brandon Kaye
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA
| | - Assad Ali
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | | | - Bilal Ibrahim
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | - Julio Isidor
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | - Hany Awad
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | | | - Michal Obrzut
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | - Badih Adada
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
| | - Surabhi Ranjan
- Cleveland Clinic Florida, Department of Neurosurgery, Weston, FL 33331, USA
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Santiago RACB, Ali A, Ibrahim B, Mandel M, Muhsen BA, Obrzut M, Ranjan S, Borghei-Razavi H, Adada B. Safety of craniotomy for brain tumor resection in octogenarians and older patients - a matched - cohort analysis. Int J Neurosci 2023:1-7. [PMID: 36724879 DOI: 10.1080/00207454.2023.2174866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The incidence of brain tumors has increased in elderly population overtime. Their eligibility to a major surgery remains a questionable subject. This study evaluated prognostic factors and 30-days morbidity and mortality in octogenarian population who underwent craniotomy for resection of brain tumor. MATERIALS AND METHODS A total of 154 patients were divided into two different groups: patients above 80 years old and patients below 65 years old. In both groups, patients were stratified based on diagnosis with benign tumors [meningioma] and malignant tumors [high-grade gliomas and metastases]. Multivariable logistic regression model with backward elimination method was utilized to identify the independent risk factors for 30-days readmission and post-operative complications. RESULTS The analysis revealed no significant difference in 30-day readmission (p = 0.7329), 30-day mortality (0.6854) or in post-operative complication (p = 0.3291) between age ≥ 80 and age ≤ 65 groups. A longer length of stay (LOS) was observed in the older patients (p = 0.0479). There was a significant difference in the pre-post KPS between the two groups (p < 0.0001). ASA (p = 0.0315) and KPS (p = 0.071) were found as important prognostic factors associated with post-operative mortality in both groups. CONCLUSION Octogenarians can withstand craniotomy without any significant increase in 30-day readmission, 30-day mortality and post-operative complications as compared to patients younger than age 65. The ASA score (>3) and/or KPS (<70) were the most important prognostic factors for 30-days readmission and mortality.
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Affiliation(s)
| | - Assad Ali
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Mauricio Mandel
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | | | - Michal Obrzut
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Surabhi Ranjan
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
| | | | - Badih Adada
- Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA
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11
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Naik A, Kenyon R, Taheri A, BergerWolf T, Ibrahim B, Shinagawa Y, Llano D. V-NeuroStack: Open-source 3D time stack software for identifying patterns in neuronal data. J Neurosci Res 2023; 101:217-231. [PMID: 36309817 PMCID: PMC9742979 DOI: 10.1002/jnr.25139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/07/2022] [Accepted: 10/12/2022] [Indexed: 12/14/2022]
Abstract
Understanding functional correlations between the activities of neuron populations is vital for the analysis of neuronal networks. Analyzing large-scale neuroimaging data obtained from hundreds of neurons simultaneously poses significant visualization challenges. We developed V-NeuroStack, a novel network visualization tool to visualize data obtained using calcium imaging of spontaneous activity of neurons in a mouse brain slice as well as in vivo using two-photon imaging. V-NeuroStack creates 3D time stacks by stacking 2D time frames for a time-series dataset. It provides a web interface to explore and analyze data using both 3D and 2D visualization techniques. Previous attempts to analyze such data have been limited by the tools available to visualize large numbers of correlated activity traces. V-NeuroStack's 3D view is used to explore patterns in dynamic large-scale correlations between neurons over time. The 2D view is used to examine any timestep of interest in greater detail. Furthermore, a dual-line graph provides the ability to explore the raw and first-derivative values of activity from an individual or a functional cluster of neurons. V-NeuroStack can scale to datasets with at least a few thousand temporal snapshots. It can potentially support future advancements in in vitro and in vivo data capturing techniques to bring forth novel hypotheses by allowing unambiguous visualization of massive patterns in neuronal activity data.
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Affiliation(s)
- A.G. Naik
- Department of Computer Science, University of Illinois at Chicago, USA
| | - R.V. Kenyon
- Department of Computer Science, University of Illinois at Chicago, USA
| | - A. Taheri
- Department of Computer Science, University of Illinois at Chicago, USA
| | - T. BergerWolf
- Department of Computer Science Engineering, Ohio State University, USA
| | - B. Ibrahim
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign,Beckman Institute for Advanced Science and Technology, Urbana, Il 61801
| | - Y. Shinagawa
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign,Beckman Institute for Advanced Science and Technology, Urbana, Il 61801
| | - D.A. Llano
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign,Beckman Institute for Advanced Science and Technology, Urbana, Il 61801
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12
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Akkaif MA, Daud NAA, Noor DAM, Sha'aban A, Sk Abdul Kader MA, Wahab MJA, Ibrahim B. The use of ticagrelor versus clopidogrel in Malaysian patients with coronary artery disease undergoing percutaneous coronary intervention (PCI): Does the age tertile affect the platelet reactivity? Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.122] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Previous studies have shown that the prevalence of cardiovascular diseases is related to the patient's age and gender differences, but the effect of age on platelet function remains controversial. Platelet function should be tested and its efficacy correlates with the age of patients undergoing percutaneous coronary intervention (PCI) using vasodilator-associated stimulated phosphoprotein (VASP). VASP is a gold standard to assess P2Y12 receptor inhibition among patients using ticagrelor or clopidogrel.
Purpose
We sought to compare the effect of ticagrelor versus clopidogrel on the platelet function of patients undergoing PCI and the correlation of age in this effect.
Method
This study was a prospective, randomized, parallel design, an open-label investigation conducted on Malaysian patients undergoing PCI. It included 84 patients (40 patients taking ticagrelor, and 44 patients taking clopidogrel). The induced platelet reactivity was assessed by measuring total whole blood at one standardized time point after 4 hours of loading dose of ticagrelor 180 mg or clopidogrel with 600 mg and by age tertiles.
Result
The study population consisted of 23 (57.5%) patients in Tertile 1 <60 years of age, 11 (27.5%) patients in Tertile 2 between 60-70 years of age and 6 (15.0%) patients in Tertile 3 >70 years of age. The number of patients who used ticagrelor was 17 (38.64%) in Tertile 1, 21 (47.73%) in Tertile 2, and 6 (13.64%) in Tertile 3 of those who used clopidogrel. The results of platelet reactivity index was high in the patients who used clopidogrel compared to the ticagrelor group, which were 52.3% and 2.5 %, P <0.001. This effect in the clopidogrel group included all age groups without exception and at different rates (52.9%, 52.4%, and 50%, P= 0.992), respectively, but this effect was numerical and not statistically significant. In contrast to the ticagrelor group, no numerical or significant effect was observed in all age groups (4.3%, 0.0%, and 0.0%, P= 0.259), respectively (Figure 1). In addition, the results of the current cross-sectional age classification study showed no statistical differences between the clopidogrel and ticagrelor groups based on non high platelet reactivity (NHPR) (P = 0.284, P = 0.270, P = 0.796 respectively) (Figure2).
Conclusion
Our study showed that age could not be considered a risk factor in the Malaysian population, as it did not significantly affect platelet aggregation in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI).
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - A Sha'aban
- Cardiff University, School of Medicine , Cardiff , United Kingdom of Great Britain & Northern Ireland
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - M J A Wahab
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University of Malaya, Faculty of Pharmacy , Wilayah Persekutuan Kuala Lumpur , Malaysia
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Akkaif MA, Daud NAA, Noor DAM, Sha'aban A, Wahab MJA, Sk Abdul Kader MA, Ibrahim B. Platelet reactivity index after treatment of clopidogrel versus ticagrelor based on CYP2C19 genotypes among patients undergoing percutaneous coronary intervention: results of a randomized study. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.120] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although clopidogrel is the basic drug for antiplatelet therapy in patients with coronary artery disease (CAD). However, loss of function (LOF) allelic variants located within the CYP2C19 gene may reduce the production of clopidogrel active metabolites and weaken the antiplatelet effect, increasing platelet rates reactivity and associated with increased rates of adverse events after percutaneous coronary intervention (PCI). Thus, drug regulatory authorities have warned of clopidogrel's reduced efficacy and suggested using alternative treatments (such as ticagrelor). However, in clinical practice, the strategy of genotype-guided selection for antiplatelet therapy has been limited by the lack of access to immediately available results.
Purpose
We sought to evaluate the effect of point-of-care genetic testing for CYP2C19 genotypes on the antiplatelet choice of therapy (i.e., clopidogrel vs ticagrelor), using platelet reactivity index (PRI) as a proxy of clinical outcome
Method
This study was a prospective, randomized, parallel design, an open-label investigation conducted among Malaysian patients with stable coronary artery disease (SCAD) undergoing PCI. Patients underwent rapid point-of-care genetic testing using the nested allele-specific multiplex PCR assay, which defines CYP2C19 genetic status within 3 hours, allowing patients to be genotyped on the same day before PCI. Patients who were carriers of at least one +LOF or -LOF (*2 or *3) allele was randomized to receive either clopidogrel [600mg loading dose (LD) - 75mg/day maintenance dose (MD)] or ticagrelor (180mg LD - 90mg MD). The induced platelet reactivity index (PRI) was assessed by Vasodilator-Associated Stimulated Phosphoprotein (VASP) Assay to whole blood at one standardized time point after 4 hours of LD. All patients were treated with aspirin. The primary endpoint of the study was the non-inferiority in platelet reactivity, measured as PRI, at 4 hours of clopidogrel vs ticagrelor in +LOF or -LOF allele carriers
Result
In 1638 SCAD patients, 94 underwent PCI and were genotyped and randomized to receive either clopidogrel (n=44) or ticagrelor (n=50). A total of 42 (44.68%) were carriers of at least one +LOF. PRI levels at 4 hours for clopidogrel vs ticagrelor 44 and 40, respectively (mean difference = 23.08; 95% CI: 17 to 30; p=<0.001); this will meet the primary endpoint of superiority in a non-inferiority. Ticagrelor significantly reduced PRI more than clopidogrel. The cross-tabulation of the response classification showed that ticagrelor is superior to clopidogrel based on the -LOF and +LOF (P= 0.005 and <0.001, respectively)
Conclusion
A rapid point-of-care genetic test using a nested allele-specific multiplex PCR assay can be used to personalize antiplatelet therapy and provides timely results for patients undergoing PCI. In addition, the results showed that ticagrelor was superior to clopidogrel in the level of platelet inhibition in both groups (+LOF or -LOF)
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia, School of pharmaceutical sciences , Gelugor, Penang , Malaysia
| | - A Sha'aban
- Cardiff University, School of Medicine , Cardiff , United Kingdom of Great Britain & Northern Ireland
| | - M J A Wahab
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University of Malaya, Faculty of Pharmacy , Wilayah Persekutuan Kuala Lumpur , Malaysia
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Abdelwahab M, Ibrahim B, Huang A, Yoon A, Chou C, Liu S. Precision in Performing Distraction Osteogenesis Maxillary Expansion For OSA. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Azmi NHM, Suppiah S, Ibrahim NSN, Ibrahim B, Seriramulu VP, Piersson AD, Mohamad M, Karuppiah T, Omar NF, Ibrahim N, Razali RM, Harrun NH, Sallehuddin H, Nasser NS, Saripan MI. Brain morphometry and Seed-based analysis of resting-state functional connectivity in default mode network of Alzheimer's disease patients compared with healthy control subjects in the Klang Valley, Malaysia. J Med Imaging Radiat Sci 2022. [DOI: 10.1016/j.jmir.2022.10.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Ibrahim B, Mandel M, Ali A, Najera E, Obrzut M, Adada B, Borghei-Razavi H. Pituitary Adenomas: Classification, Clinical Evaluation and Management. Skull Base Surg 2022. [DOI: 10.5772/intechopen.103778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pituitary adenomas are one of the most common brain tumors. They represent approximately 18% of all intracranial, and around 95% of sellar neoplasms. In recent years, our understanding of the pathophysiology and the behavior of these lesions has led to better control and higher curative rates. The treatment decision is largely dependent on type of the adenoma, clinical presentation, and the size of the lesion. In addition, incidental pituitary lesions add uncertainty in the decision-making process, especially for pituitary adenomas that can be medically managed. When surgery is indicated, the endoscopic endonasal transsphenoidal approach is the technique of choice, but open standard craniotomy approaches can also be the option in selected cases. The following chapter will review the classification, clinical presentation, pathophysiology, diagnostic work-up, selection of surgical approach, and treatment complications in pituitary adenomas.
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Ibrahim B, Jeyakumar G, Kouli O, Ibrahim I. Percutaneous nephrostomy versus ureteral stenting in the management of malignant ureteral obstruction: A systematic review. Clin Radiol 2022. [DOI: 10.1016/j.crad.2022.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Ibrahim B, Baker P, Jeyakumar G, Ali K. MRI as gold standard for scaphoid fracture diagnosis. Clin Radiol 2022. [DOI: 10.1016/j.crad.2022.09.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ibrahim B, Jeyakumar G, Ibrahim I, Hounat A. CT-KUB as gold standard for renal colic: A closed loop audit. Clin Radiol 2022. [DOI: 10.1016/j.crad.2022.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sliwa-Hahnle K, Van Der Meer P, Viljoen C, Jackson AM, Petrie MC, Maggioni AP, Laroche C, Regitz-Zagrosek V, Tavazzi L, Roos-Hesselink JW, Seferovic P, Frogoudaki A, Ibrahim B, Al-Farham H, Bauersachs J. Socio-economic factors determine maternal and noenatal outcomes in women with peripartum cardiomyopathy: a study of the ESC EORP PPCM registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2509] [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
Peripartum cardiomyopathy (PPCM) is a global disease associated with substantial morbidity and mortality.
Purpose
The aim of this study was to analyse to what extent country- and individual-level socioeconomic factors were associated with maternal and neonatal outcomes.
Methods
In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global registry on PPCM, under the auspices of the ESC EORP Programme. Country-level sociodemographic factors were Gini coefficient (GINI), health expenditure (HE) and human developmental index (HDI). Individual-level sociodemographic factors were income and educational attainment. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-specific socioeconomic status.
Results
739 women from 49 countries were enrolled (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]). Overall, 142 (19%) of women were from countries with low HDI, 307 (42%) medium HDI and 290 (39%) high HDI. Patients of Black African ethnicity were almost all from low HDI countries (99.3%), Middle Eastern and Asian patients from medium HDI (37.7% and 26.2%), and Caucasian patients were mostly from high HDI (72%, p<0.001). Women from countries with low HDI had lower income and educational attainment. They also underwent fewer Caesarian sections, but breastfed for longer (20 versus 6 months, p<0.001). Low HDI and low GINI were associated with greater LV dilatation at time of diagnosis (p<0.001), but LV ejection fraction (LVEF) did not differ according to HDI, HE or GINI. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Low HE was associated with more frequent mortality (p<0.002), whereas HDI and GINI were not. Women from countries with low HDI and low HE had significantly less recovery of LV function. Analysis of maternal outcome as per highest level of educational attainment (i.e., primary [n=154], secondary [n=342], tertiary [n=126]), showed significant differences in LVEF at 6 months (43.7+12.9, 46.5+13.0 and 48.9+11.7 respectively, p=0.022). Low maternal income, irrespective of region of origin, was independently associated with poor outcome (composite of maternal death, re-hospitalization, or LV non-recovery). Neonatal death was more prevalent in countries with low HE (p=0.009) and low HDI (p=0.023) but was not influenced by maternal sociodemographic parameters.
Conclusion
Maternal and neonatal outcomes depended on country-specific socioeconomic characteristics, with a greater prevalence of maternal and neonatal deaths in women from countries with low HE. Globally, women with low income and lower levels of educational attainment had poorer outcomes, irrespective of region. Attempts should be made to improve patient education, and allocation of adequate health resources to improve maternal and neonatal outcomes in PPCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): 1. EurObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy2. Cape Heart Institute, University of Cape Town, Cape Town, South Africa
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Affiliation(s)
| | - P Van Der Meer
- University Medical Centre Groningen , Groningen , The Netherlands
| | - C Viljoen
- University of Cape Town , Cape Town , South Africa
| | - A M Jackson
- Cardiovascular Research Centre of Glasgow , Glasgow , United Kingdom
| | - M C Petrie
- Cardiovascular Research Centre of Glasgow , Glasgow , United Kingdom
| | | | - C Laroche
- European Society of Cardiology , Sophia-Antipolis , France
| | - V Regitz-Zagrosek
- Charite Universitatsmedizin Berlin, Berlin Institute of Gender in Medicine (GiM) , Berlin , Germany
| | - L Tavazzi
- Maria Cecilia Hospital, GVM Care & Research , Cotignola , Italy
| | | | - P Seferovic
- University Belgrade Medical School , Belgrade , Serbia
| | | | - B Ibrahim
- North Cumbria University Hospitals NHS Trust , Carlisle , United Kingdom
| | - H Al-Farham
- Iraqi Board for Medical Specializations, Baghdad Heart Center , Baghdad , Iraq
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Akkaif MA, Sha'aban A, Daud NAA, Noor DAM, Musa NF, Sk Abdul Kader MA, Ibrahim B. Fast and more affordable CYP2C19 LOF testing to personalized of clopidogrel therapy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3025] [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
Clopidogrel is an antiplatelet drug used to treat coronary artery disease (CAD) to reduce blood clotting by inhibiting platelet activity. However, many patients experience ischemic events due to changes in clopidogrel metabolism attributed to various genetic and non-genetic factors. CYP2C19 is one of the important genes responsible for the metabolism of clopidogrel, but this gene has polymorphisms in cytochrome P450 (CYP), and this CYP2C19 Loss-of-function (LoF) polymorphisms impair clopidogrel metabolism between individuals and races. Therefore, genetic testing is an effective strategy to personalized clopidogrel and reduce the incidence of ischemic events in CAD patients.
Purpose
We sought to develop a nested allele-specific multiplex polymerase chain reaction (PCR) method for the detection of CYP2C9 LOF alleles.
Method
Genomic DNA was extracted from blood taken from 7 healthy volunteers using a commercial DNA extraction kit. A two-step PCR method was developed. First, DNA was subjected to a first PCR used to amplify exons 4 and 5 simultaneously in a single reaction tube. Second, The products of 1st PCR were then used as a template in the second PCR to detect CYP2C9 polymorphisms alleles (CYP2C19*2 and *3) using allele-specific primers. The test results were validated via sequencing.
Result
We successfully detected clinically important CYP2C19 LOF polymorphisms alleles by the nested allele-specific multiplex PCR method (Figure 1). This method is fast and doesn't require high-quality and expensive laboratory equipment. It was reproducible and specific and can reliably detect CYP2C19 variants. Direct sequencing of target variants has been used to validate this strategy further, and the amplified sequences were 100% identical to the CYP2C9 sequence.
Conclusion
The developed methods were specific to identify polymorphisms in CYP2C19 (rs4244285 and rs4986893). However, to understand ethnic differences and their potential implications for clopidogrel therapy, we highly recommend identifying relevant genetic polymorphisms before clinical manifestations arise.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M A Akkaif
- Universiti Sains Malaysia , Penang , Malaysia
| | - A Sha'aban
- Universiti Sains Malaysia , Penang , Malaysia
| | - N A A Daud
- Universiti Sains Malaysia , Penang , Malaysia
| | - D A M Noor
- Universiti Sains Malaysia , Penang , Malaysia
| | - N F Musa
- Hospital University Sains Malaysia, Human Genome Center, School of Medical Sciences , Kota Bharu , Malaysia
| | - M A Sk Abdul Kader
- Penang Island General Hospital, Department of Cardiology , Penang , Malaysia
| | - B Ibrahim
- University Malaya Medical Centre, Kuala Lumpur, Faculty of Pharmacy, University of Malaya , Kuala Lumpur , Malaysia
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al 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Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Najera E, Ibrahim B, Muhsen BA, Ali A, Sanchez C, Obrzut M, Borghei-Razavi H, Adada B. Blood Supply of Cranial Nerves Passing Through the Cavernous Sinus: An Anatomical Study and Its Implications for Microsurgical and Endoscopic Cavernous Sinus Surgery. Front Oncol 2021; 11:702574. [PMID: 34692480 PMCID: PMC8531550 DOI: 10.3389/fonc.2021.702574] [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: 05/13/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background Despite improvements in surgical techniques, cranial nerve (CN) deficits remain the most frequent cause of disability following cavernous sinus (CS) surgery. The most common tumor affecting the CS is meningioma. They originate from lateral wall and have their blood supply from meningohypophyseal trunk (MHT) and inferolateral trunk (ILT). Pituitary adenomas commonly invade the CS through its medial wall and receive blood supply form medial branches of the internal carotid artery (ICA) (superior and inferior hypophyseal arteries). Some tumors may grow within the CS (e.g. trigeminal schwannomas, hemangiomas). These tumors are fed by all the intracavernous ICA branches. Tumors involving the CS may also displace the neurovascular structures, therefore, a better understanding of intracavernous neurovascular anatomy may reduce the postoperative morbidity associated with approaching CS tumors. In this anatomical study, the anatomic variations and their clinical implications of the intracavernous CNs' blood supply were evaluated through transcranial and endonasal routes. Methods Twenty sides of ten adult cadaveric formalin-fixed, latex-injected specimens were dissected in stepwise fashion under microscopic and endoscopic magnification. The origin and course of the intracavernous ICA branches supplying the intracavernous CNs are studied. Results The proximal segment of the oculomotor nerve receives blood supply from the ILT in 85%, and the tentorial artery of the MHT in 15% of specimens. The distal segment is exclusively supplied by the ILT. The proximal trochlear nerve receives blood supply from the ILT (75%) and the tentorial artery (25%); the distal segment is exclusively supplied by the superior orbital branch. The proximal third of the abducens nerve receives its vascularity exclusively from the dorsal meningeal artery, and its middle and distal thirds from the ILT. The ophthalmic and proximal maxillary segments of the trigeminal nerve also receive blood supply from the ILT. The distal maxillary segment is supplied by the artery of the foramen rotundum. All ILT branches terminate on the inferomedial aspects of the intra-cavernous CNs. Extensive anastomoses are found between ILT branches and the branches arising from external carotid artery. Conclusion Understanding the anatomy of the intracavernous ICA's branches is important to improving surgical outcomes with tumors involving the CS.
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Affiliation(s)
| | | | | | - Assad Ali
- Cleveland Clinic Florida, Weston, United States
| | | | | | | | - Badih Adada
- Cleveland Clinic Florida, Weston, United States
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Dhouib W, Ibrahim B, Bannour R, ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Said Latiri H, Ben Rejeb M. The burden of Alzheimer’s caregivers and social support in the Tunisian family. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.577] [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
Alzheimer is a pathology that concers the patient and his family having a physical, social, economic and psychological impact. Research on family caregivers is still lacking and little is known about caregivers burden and ist associated factors in Tunisia. The aim of this study were to describe caregiver burden among Tunisian family caregivers of patients with alzheimeŕs disease, its associated factors and ist relationship to social support.
Methods
We conducted a cross-sectional study among 118 family caregivers during three months at the neurology outpatient departments of two university hospitals. Sahloul, Sousse and Taher Sfar, Mahdia. Using the Zarit Burden Interview-22 (ZBI)items and the Medical Outcome Study-Social Support Survey to assess burden and social support among the caregivers.
Results
We included 118 caregivers of patients with Alzheimeŕs disease,with an average age of 45±15 years. Women were more predominant with a sex ratio of 0.57.Half of caregivers were the descent of patients. The Mean years of caregiving was 5±3 years with an average of 13 hours ±3 of care assistance per day. The mean ZBI Score was 38.4±18.5 and 16.1% of caregivers percived a severe burden. The mean ZBI Score was higher in female, retired, lowmsocio economic status and in rural area with a statistically significance difference. We found that caregiver burden and social support were highly correlated (p < 0.001,r=-0.41)indicating that a high level of caregiver burden was asoociated with a less level of social support.
Conclusions
The level of burden in family caregivers who are caring for a patient with alzheimeŕs disease is high. A considerate help and support from helth care and social institutions is required by taking into account the factors that contribute to caregivers burden and considering the importance of social support in alleviating caregiver burden.
Key messages
The level of burden in family caregivers who are caring for a patient with alzheimeŕs disease is high. High level of caregiver burden was asoociated with a less level of social support.
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Affiliation(s)
- W Dhouib
- University, Medecine, Sousse, Tunisia
| | - B Ibrahim
- University, Health Technology, Sousse, Tunisia
| | - R Bannour
- University, Medecine, Sousse, Tunisia
| | | | - S Bhiri
- University, Medecine, Sousse, Tunisia
| | - H Ghali
- University, Medecine, Sousse, Tunisia
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Chowdhury S, Bhandari M, Quake S, Ahmed I, Ibrahim B. 783 Digital Weekend Handover an Effective Documentation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To assess quality of completion for weekend handover for surgical weekend and to plan and design a Digital handover, the implementation and effect of which is studied.
Method
Data collection from TRAKCARE for documentation completion criteriae including diagnosis, further investigations to chase (e.g., bloods, imaging), discharge plans, escalation and DNAR status identified.
First cycle collected in August 2020 for pre-implementation status and standard. Second cycle was collected after implementation and raising awareness about new system in October 2020.
Exclusion criteria: patients discharged prior to weekend
Results
32 (10f 22m) and 22 (9 f 13m) patients were studied in first and second cycle with a respective median length stay of 243 hours and 161.5 hours. Handover entries had improved from 40.6% completion rate to 77.3% these included a diagnosis and management plan. Required blood investigation plans were recorded in 54.5% patients (previously 9.4%). Escalation plans including DNACPR and ceiling of care were improved from 25% to 31%.
Conclusions
Digital Medical recording left a gap in documentation for weekend ward rounds when personnels are thinned and busy. To optimize clinical care, the use of a E weekend handover has improved documentation greatly. Future Ongoing project includes improving escalation plans further.
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Affiliation(s)
- S Chowdhury
- North Tees Hospital, Stockton, United Kingdom
| | - M Bhandari
- North Tees Hospital, Stockton, United Kingdom
| | - S Quake
- James Cook University, Middlesborough, United Kingdom
| | - I Ahmed
- North Tees Hospital, Stockton, United Kingdom
| | - B Ibrahim
- North Tees Hospital, Stockton, United Kingdom
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Jain A, Ibrahim B, Ali A, Muhsen BA, Najera E, Adada B, Borghei-Razavi H, Obrzut M. Percutaneous balloon compression technique using intraoperative contrasted DynaCT for the treatment of refractory trigeminal neuralgia: initial experience. Neurosurg Rev 2021; 45:1393-1399. [PMID: 34599700 DOI: 10.1007/s10143-021-01649-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/24/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Percutaneous balloon compression (BC) is a well-established technique that can provide immediate relief to patients suffering from trigeminal neuralgia (TN). The general procedure of BC uses fluoroscopy imaging to guide the needle through the foramen ovale (FO). The aim of this study was to describe our experience with a novel technique using intraoperative contrast-enhanced DynaCT as an adjunct for more accurate and safer guidance of the needle to the FO. METHODS In this study, DynaCT was used to perform BC in 20 TN cases. The three-dimensional path of the needle was pre-planned using DynaCT obtained during the administration of IV contrast. The FO was accessed in a single pass along the path pre-determined from the DynaCT images, avoiding any major arteries and veins. DynaCT was also used for confirmation of the final position of the needle prior to insertion of the balloon as well as for confirmation of the position of the balloon after inflation. RESULTS Intravenous contrast-enhanced DynaCT-guided percutaneous BC allowed precise advancement and positioning of the needle within the FO. It facilitated cannulation of the FO along a pre-determined path that avoided any major vascular structures. Clinical outcomes were excellent-all patients had a quick postoperative recovery, and there were no complications. CONCLUSIONS The advantages of the contrast-enhanced DynaCT-guided technique include a single precise needle pass and avoidance of vessel injury. Precise placement of the balloon into different aspects of the FO can target trigeminal branches more selectively and allow for a better outcome.
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Affiliation(s)
- Aakangsha Jain
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Assad Ali
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Baha'eddin A Muhsen
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Edinson Najera
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Badih Adada
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Hamid Borghei-Razavi
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
| | - Michal Obrzut
- Department of Neurosurgery, Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
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Cordier G, Sigaux N, Rasteau S, Ibrahim B, Cresseaux P. Long-term stability of basilar mandible osteotomy: Chin Wing. J Stomatol Oral Maxillofac Surg 2021; 123:337-344. [PMID: 34260981 DOI: 10.1016/j.jormas.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
The Chin Wing is a modified genioplasty extended along the basilar border and the angles of the mandible. This technique may be a better choice than standard genioplasty for correction of lip incompetence, retrogenia and high angle position associated with hyperdivergent cases. Our objective was to analyse the overall movement realized during surgery and the long-term stability of this procedure. Ten patients underwent a Chin Wing surgery from June 2018 to August 2019. All patients were operated on by the same surgeon. We performed a preoperative (PO), an immediate postoperative (POI), and an over 6 months postoperative (PO6) Cone Beam Computed Tomography (CBCT) for every patient. 3D reconstructions were performed for each CBCT with Proplan software. We were thus able to determine by subtractions acquired and resorbed bone volume. Some section plans were chosen in order to perform 2D measurements. The CBCT volume comparisons reveal a gain of 7.6cc between the PO and the POI, for a bone resorption of 2.5cc between POI and PO6 (33% of the volume gained). In 2D evaluation, we observe an average resorption of 1.7 mm corresponding to approximately 20% of the height gained, at the level of the mandibular angle. Given the low bone resorption we can consider Chin Wing stable over time. The important quantity of mobilized bone and the basilar rotational movement may explain over-standing aesthetic and functional outcome, compared to classical genioplasty.
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Affiliation(s)
- G Cordier
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France
| | - S Rasteau
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre Benite, Claude Bernard Lyon 1 University, France
| | - B Ibrahim
- Department of surgery ORL-CCF, Faculty of Medicine, Univeristé de Montreal, Quebec, Canada
| | - P Cresseaux
- Chirurgie Maxillo-Faciale, Hôpital Privé Jean Mermoz, Lyon, France.
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Ibrahim B, Muhsen BA, Najera E, Borghei-Razavi H, Adada B. Case report of unusual cause of trigeminal neuralgia: Trigeminal neuralgia secondary to enlarged suprameatal tubercle. Ann Med Surg (Lond) 2021; 66:102308. [PMID: 34040761 PMCID: PMC8141507 DOI: 10.1016/j.amsu.2021.102308] [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: 03/12/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background Classic trigeminal neuralgia (TN) is caused by vessels compressing the trigeminal nerve root entry zone. The cause is usually impingement of the superior cerebellar artery, anterior inferior cerebellar artery, or a vein. Other rare causes have been reported including aneurysmal compression, skull base tumors, and vascular malformations. An enlarged suprameatal tubercle (EST) as a cause of TN has not yet been described. Case presentation We report the first case of 37 year old female patient presented with severe TN involving the three branches of trigeminal nerve who failed medical treatment and underwent multiple balloon compression for left TN with minimal improvement. The severity of pain was assessed using Barrow Neurological Institute (BNI) pain intensity score. Patient had brain MRI with CISS sequence and CT scan for the brain. After careful revision of her imaging studies, patient found to have prominent and heavily calcified left supra meatal tubercle. Her preoperative BNI score was 5. Patient had left retrosigmoid craniotomy and drilling of left suprameatal tubercle. No other structures were seen in contact with left trigeminal nerve root entry zone. Patient had significant improvement on her pain, postoperative BNI score was 1 until the last follow-up 4 years. Conclusion EST is a rare cause of TGN and should be suspected as the offending compressing structure when no other causes seen on imaging studies. Enlarged suprameatal tubercle as a rare cause of trigeminal neuralgia. Trigeminal neuralgia due to bony compression have to be ruled out in obscured cases. Drilling of suprameatal tubercle to decompress trigeminal nerve root entry zone.
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Affiliation(s)
- Bilal Ibrahim
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Baha'eddin A Muhsen
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Edinson Najera
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Hamid Borghei-Razavi
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Badih Adada
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
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Ibrahim B, Suppiah S, Piersson AD, Razali RM, Mohamad M, Abu Hassan H, Ibrahim N. Cardiovascular risk factors of Alzheimer's disease and other neurocognitive disorders in Malaysia. Med J Malaysia 2021; 76:291-297. [PMID: 34031325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Risk factors for cardiovascular disease (CVD) have been increasingly implicated in the development of dementia but little is known about the effects in a Malaysian population. We aimed to determine the interaction between sociodemographic and CVD risk factors among the dementia and mild cognitive impairment (MCI) patients in Malaysia. MATERIALS AND METHODS A cross-sectional study was conducted in the memory clinic at Hospital Kuala Lumpur (HKL). Medical records data from 2014 to 2019 were extracted. Mini Mental State Examination (MMSE) test was used to assess the neurocognitive function of patients. RESULTS A total of 298 patients (30 MCI, and 268 dementia) were evaluated, with dementia patients consisting of 78 Alzheimer's disease (AD), 93 Vascular dementia (VaD), 94 Mixed dementia, 2 early-onset Alzheimer's disease (EOAD) and 1 Logopenic Progressive Aphasia type of AD (LPA). MCI and dementia were significantly associated with a history of CVD, particularly stroke (p=0.023). CONCLUSION Given that stroke significantly predicted the risk of developing vascular dementia among the patients in a central Malaysian population, lifestyle modifications are recommended to alleviate these risk factors of CVD.
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Affiliation(s)
- B Ibrahim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, Malaysia
| | - S Suppiah
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, Malaysia.
| | - A D Piersson
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Therapeutic and Investigative Studies, Centre for Diagnostic, Malaysia
| | - R M Razali
- Hospital Kuala Lumpur, Department of Medicine, Geriatric Unit, Malaysia
| | - M Mohamad
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Therapeutic and Investigative Studies, Centre for Diagnostic, Malaysia
| | - H Abu Hassan
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, Malaysia
| | - N Ibrahim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Psychiatry, Malaysia
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Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries. Lancet 2021; 397:387-397. [PMID: 33485461 PMCID: PMC7846817 DOI: 10.1016/s0140-6736(21)00001-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. METHODS This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. FINDINGS Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70-8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39-8·80) and upper-middle-income countries (2·06, 1·11-3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26-11·59) and upper-middle-income countries (3·89, 2·08-7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. INTERPRETATION Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. FUNDING National Institute for Health Research Global Health Research Unit.
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Muhsen BA, Ali AM, Jain A, Ibrahim B, Nagera E, Borghei-Razavi H, Adada B. Microsurgical resection of petroclival meningiomas treated with stereotactic radiosurgery to address persistent post-treatment trigeminal pain. Clin Neurol Neurosurg 2021; 202:106533. [PMID: 33548878 DOI: 10.1016/j.clineuro.2021.106533] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Petroclival meningiomas (PCM) are challenging tumors to manage. Observation, Stereotactic radiosurgery (SRS) and surgical resection have typically been offered as treatment options. A percentage of patients with PCMs present with trigeminal pain. We present four patients with small PCMs presenting with Trigeminal neuralgia (TN) that were treated with radiosurgery and continued to have debilitating trigeminal pain afterwards. All of them underwent microsurgical resection (MR) of their tumor to manage their trigeminal pain. OBJECTIVE Trigeminal Neuralgia in the setting of PCM is rare. Oftentimes in these subset of patients TN pain persists after radiation and medical therapy. We explore the possibility of addressing intractable TN pain with microsurgical resection. METHODS Patients with petroclival meningiomas presenting with trigeminal pain and having persistent pain after treatment with radiosurgery were included in our review. Those patients were treated with microsurgical resection of their tumor to help control their persistent pain. The patients' demographics, clinical, and radiological data were reviewed. The primary aim of the review was to assess the patients' Barrow Neurological Institute (BNI) trigeminal neuralgia scores following microsurgical resection. RESULTS Four female patients were identified. The tumors were locally controlled after SRS, however all four patients continued to have debilitating trigeminal pain despite medical management. All patients had complete resolution of their TN pain in the immediate postoperative period, with a BNI score of I on their last follow up. CONCLUSION Microsurgical resection is an appropriate option for patient's petroclival meningiomas with persistent facial pain after treatment with SRS.
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Affiliation(s)
- Baha'eddin A Muhsen
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA.
| | - Assad M Ali
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Aakangsha Jain
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Edinson Nagera
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Hamid Borghei-Razavi
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Badih Adada
- Department of Neurosurgery, Braathen Center, Cleveland Clinic Florida, Weston, FL, USA
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Borghei-Razavi H, Lee J, Ibrahim B, Muhsen BA, Raghavan A, Wu I, Poturalski M, Stock S, Karakasis C, Adada B, Kshettry V, Recinos P. Accuracy and Interrater Reliability of CISS Versus Contrast-Enhanced T1-Weighted VIBE for the Presence of Optic Canal Invasion in Tuberculum Sellae Meningiomas. World Neurosurg 2021; 148:e502-e507. [PMID: 33444830 DOI: 10.1016/j.wneu.2021.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The magnetic resonance imaging sequence used to assess optic canal invasion by tuberculum sella meningiomas (TSMs) has not been standardized. Both constructive interference in steady state (CISS) and contrast-enhanced T1-weighted volume-interpolated breath-hold examination (VIBE) sequences are frequently used. The aim of the present study was to compare the accuracy and interrater reliability of these sequences in predicting optic canal invasion by TSMs. METHODS In the present retrospective study of 27 patients (54 optic canals) who had undergone endoscopic transtuberculum transplanum resection of TSMs, images from preoperative CISS and contrast-enhanced T1-weighted VIBE sequences were assessed by 5 neuroradiologists who were unaware of the operative findings. The readers evaluated the optic canal in 4 quadrants at 2 locations (the posterior tip of the anterior clinoid process and the optic strut). A quadrant was considered positive for tumor invasion if invasion was present at either of these 2 locations. The reference standard was intraoperative observation of gross optic canal invasion. RESULTS The interrater agreement was good for the presence or absence of tumor involvement in a particular quadrant (CISS, 0.635; VIBE, 0.643; 95% confidence interval for the difference, -0.086 to 0.010). The mean sensitivity and specificity for optic nerve invasion were 0.643 and 0.438 with CISS and 0.643 and 0.454 with VIBE, respectively. No significant differences were seen between the sequences in terms of reader accuracy when the intraoperative findings were used as the reference standard. CONCLUSION CISS and VIBE sequences both have good accuracy in predicting for optic canal tumor invasion by TMEs.
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Affiliation(s)
- Hamid Borghei-Razavi
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA.
| | - Jonathan Lee
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bilal Ibrahim
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Baha'eddin A Muhsen
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Alankrita Raghavan
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ingrid Wu
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Matthew Poturalski
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sarah Stock
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Christopher Karakasis
- Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Badih Adada
- Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA
| | - Varun Kshettry
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Pablo Recinos
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Ibrahim B, Muhsen BA, Najera E, Borghei-Razavi H, Adada B. Trigeminal Neuralgia (TGN) Secondary to Enlarged Suprameatal Tubercle (EST). Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Muhsen BA, Ibrahim B, Najera E, Borghei-Razavi H, Adada B. Posterior petrosal approach for retrochiasmatic craniopharyngioma. Interdisciplinary Neurosurgery 2020. [DOI: 10.1016/j.inat.2020.100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sha’aban A, Ibrahim B, Albitar O, Mohiuddin S, Omar C, Harun S. Transition to online teaching and learning for clerkship activities during COVID-19 in Malaysia. Pharm Educ 2020; 20:7-8. [DOI: 10.46542/pe.2020.202.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Prior-to the COVID-19 outbreak, undergraduate PharmCare II Clerkship activities consisted of two phases. The first phase requires pharmacy students to clerk infectious disease and endocrine-related cases of patients admitted into wards at a teaching hospital, whilst in the second phase, the students are required to present the clerked cases in front of their group members with a thorough assessment by lecturers at Universiti Sains Malaysia. Due to sudden outbreak of COVID-19, presentations at hospitals and face-to-face learning were no longer feasible; therefore an online methodology was executed. Each student was assigned a real completed case clerked by a previous Master’s in Clinical Pharmacy graduate. The students then critically evaluated any pharmaceutical care issues (PCIs) in each of the cases, recorded a video presentation for assessment by the lecturers and discussed each case with other group members in a synchronous online session via web-conferencing software.
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Cordier G, Sigaux N, Giai J, Ibrahim B, Cresseaux P. Assessing the incidence of nerve injuries according to different mandibular osteotomies including Wing osteotomies. Journal of Stomatology, Oral and Maxillofacial Surgery 2020; 122:472-476. [DOI: 10.1016/j.jormas.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/23/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
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Nasser NS, Loh JL, Rashid AA, Sharifat H, Ahmad U, Ibrahim B, Mustafa S, Hoo FK, Ching SM, Suppiah S S. A survey on smartphone dependence and psychological effects among undergraduate students in a Malaysian University. Med J Malaysia 2020; 75:356-362. [PMID: 32723994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Problematic smartphone use (PSU) is the development of pathological dependence at the expense of performing activities of daily living, thus having negative health and psychological impact on the users. Previous PSU studies focused on medical students and little is known regarding its effect on students undergoing other courses. The objective of this study is to identify the pattern of smartphone usage and determine the psychological factors affecting PSU among undergraduate students in Malaysia and compare the pattern among students from different fields of study. METHOD A prospective cross-sectional study was conducted using the validated Smartphone Addiction Scale-Malay version (SAS-M) questionnaire. One-way ANOVA was used to determine the correlation between the PSU among the students categorised by their ethnicity, hand dominance and by their field of study. MLR analysis was applied to predict PSU based on socio-demographic data, usage patterns, psychological factors and fields of study. RESULTS A total of 1060 students completed the questionnaire. Most students had some degree of problematic usage of the smartphone. Students used smartphones predominantly to access SNAs, namely Instagram. Longer duration on the smartphone per day, younger age at first using a smartphone and underlying depression carried higher risk of developing PSU, whereas the field of study (science vs. humanities based) did not contribute to an increased risk of developing PSU. CONCLUSION Findings from this study can help better inform university administrators about at- risk groups of undergraduate students who may benefit from targeted intervention designed to reduce their addictive behaviour patterns.
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Affiliation(s)
- N S Nasser
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia
| | - J L Loh
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia
| | - A A Rashid
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Imaging, Serdang, Selangor, Malaysia
| | - H Sharifat
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia
| | - U Ahmad
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Genetics and Regenerative Medicine Research Centre, Medical Genetics Laboratory (MGL), Serdang, Selangor, Malaysia
| | - B Ibrahim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia
| | - S Mustafa
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia
| | - F K Hoo
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medicine, Neurology Unit, Serdang, Selangor, Malaysia
| | - S M Ching
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Family Medicine, Serdang, Selangor, Malaysia
| | - S Suppiah S
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Centre for Diagnostic Nuclear Imaging, Serdang, Selangor, Malaysia.
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Ibrahim B, Guillemaud A, Sigaux N, Pouzet C, Gormand F, Bouletreau P. The sleep board: impact of a multidisciplinary assessment model in CPAP failing OSA patients. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Keteepe-Arachi T, Malhotra A, Basu J, Parry-Williams G, Ensam B, Miles C, Dassanayake S, MacLachlan H, Ibrahim B, Papdakis M, Tome M, Khong T, Sharma S, Anderson L. P3839Hypertension or hypertrophic cardiomyopathy? Using cardiovascular magnetic resonance imaging to unmask the great imitator. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0680] [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
Structural cardiac adaptations due to hypertension (HTN) present a diagnostic challenge when differentiating from hypertrophic cardiomyopathy (HCM), using traditional imaging techniques such as echocardiography (echo). Cardiac magnetic resonance imaging (CMR) offers reproducible anatomical, functional quantification and myocardial tissue characterisation which discriminates between hypertension and HCM.
Purpose
To identify hypertensive individuals with undiagnosed HCM using CMR imaging.
Methods
100 consecutive hypertensive patients underwent CMR at a tertiary centre dedicated blood pressure clinic (55% male, mean age 51 years). In keeping with ESC guidelines, end diastolic wall thickness (EDWT) ≥15mm identified individuals within the “grey zone” between hypertension and with a potential HCM diagnosis. 19 individuals were referred on to the dedicated inherited cardiac conditions clinic for further evaluation. Four patients expressed a definitive LV phenotype and were diagnosed with HCM. CMR parameters were compared in three groups: Hypertensive (HTN), “grey zone” Hypertensive (GZH) and HCM.
Results
CMR demonstrated end diastolic wall thickness (EDWT) >11 mm in 50% of hypertensives. 73% of the referred patients were Afro-Caribbean (AC) and all 4 HCM patients were AC. All referrals demonstrated EDWTs ≥14mm, 9 (47%) demonstrated late gadolinium enhancement of which 3 (16%) had HCM. Three had asymmetrical septal hypertrophy – 2 were in the HCM cohort and one underwent endomyocardial biopsy confirming HTN. Left ventricular mass index (LVMI) was significantly higher in GZH compared to HTN (p<0.0001) and in HCM compared to HTN (p=0.0004). EDWT was significantly greater in GZH compared to HTN (p<0.0001) and in HCM compared to HTN (p=0.0002). There was no significant difference in these parameters between GZH and HCM.
Table 1. P-values for CMR data in hypertensive (HTN), gray zone hypertensive (GZH) and hypertrophic cardiomyopathy (HCM) cohorts CMR Parameter HCM vs. HTN GZH vs. HTN GZH vs. HCM EDVI NS p=0.025 NS EDWT p=0.0002 p<0.0001 NS LVMI p=0.0004 p<0.0001 NS
Conclusion
This study reports a 4% prevalence of HCM among hypertensive patients - 20 x greater than in the general population - which would be left undiagnosed using echo alone. Screening hypertensive individuals with CMR is not routine but we advocate its use in these individuals especially in Afro Caribbeans and in those in the “grey zone”, to identify undiagnosed HCM, which has significant implications for lifestyle modification and family screening.
Acknowledgement/Funding
Cardiac Risk in the Young
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Affiliation(s)
- T Keteepe-Arachi
- St George's University of London, St Geor, London, United Kingdom
| | - A Malhotra
- St George's University of London, St Geor, London, United Kingdom
| | - J Basu
- St George's University of London, St Geor, London, United Kingdom
| | - G Parry-Williams
- St George's University of London, St Geor, London, United Kingdom
| | - B Ensam
- St George's University of London, St Geor, London, United Kingdom
| | - C Miles
- St George's University of London, St Geor, London, United Kingdom
| | - S Dassanayake
- St George's University of London, St Geor, London, United Kingdom
| | - H MacLachlan
- St George's University of London, St Geor, London, United Kingdom
| | - B Ibrahim
- St George's University of London, St Geor, London, United Kingdom
| | - M Papdakis
- St George's University of London, St Geor, London, United Kingdom
| | - M Tome
- St George's University of London, St Geor, London, United Kingdom
| | - T Khong
- St George's University of London, St Geor, London, United Kingdom
| | - S Sharma
- St George's University of London, St Geor, London, United Kingdom
| | - L Anderson
- St George's University of London, St Geor, London, United Kingdom
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Cordier G, Sigaux N, Ibrahim B, Cresseaux P. The intermediate length BSSO: Finding the balance between the classical and short designs. J Stomatol Oral Maxillofac Surg 2019; 121:70-73. [PMID: 31479765 DOI: 10.1016/j.jormas.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/25/2019] [Indexed: 11/17/2022]
Abstract
Bilateral Sagittal Split Osteotomy (BSSO) is performed in orthognathic surgery to treat cases of dento-skeletal malformation. We present a shorter BSSO variant that allows for the realization of all orthognathic movements. This line respects the basilar rim and allows to modify the position of the mandibular angles. The splitting is more natural, separating the mandible into two anatomical subunits: the rising branch and the horizontal branch. This variant layout may also be associated with Chin Wing genioplasty.
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Affiliation(s)
- G Cordier
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - B Ibrahim
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, 165, chemin du grand Revoyet 69495 Pierre Benite cedex, France.
| | - P Cresseaux
- Chirurgie Maxillo-Faciale, Hôpital Privé Jean Mermoz, 55, avenue Jean Mermoz, 69008 Lyon, France.
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Ibrahim B, Poveda P, Papadakis M, Sharma S, Bunce N, Tome M. P186Prevalence of left ventricular dysfunction in marfan syndrome patients with mild dilated aortic root. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.048] [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)
- B Ibrahim
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
| | - P Poveda
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
| | - M Papadakis
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
| | - S Sharma
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
| | - N Bunce
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
| | - M Tome
- St George"s University of London, Cardiology Clinical Academic Group, St George"s Hospitals NHS Foundation Trust, UK, London, United Kingdom of Great Britain & Northern Ireland
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Muneswarao J, Ahmad Hassali M, Ibrahim B, Saini B, Hyder Ali I, ur Rehman A. HOME VISITS FOR ADULT PATIENTS WITH ASTHMA? A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. Chest 2019. [DOI: 10.1016/j.chest.2019.02.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Ibrahim I, Ibrahim B, Yong GL, Coats M, Vujovic Z, Wilson MS. A multispecialty study of determining the possibility of pregnancy and the documentation of pregnancy status in surgical patients: a cause for concern? Scott Med J 2018; 63:108-112. [PMID: 30253702 DOI: 10.1177/0036933018801486] [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: 11/17/2022]
Abstract
BACKGROUND Determining the possibility of pregnancy and the documentation of pregnancy status are important considerations in the assessment of females of reproductive age when admitted to hospital. OBJECTIVES Our aim was to determine the adequacy of the documentation of pregnancy status and possibility of pregnancy across multiple surgical specialties. MATERIALS AND METHODS A prospective audit of surgical specialties (general, orthopaedics, urology, vascular, maxillofacial, ENT, gynaecology and neurosurgery) within NHS Tayside, in May 2015. RESULTS A total of 129 females of reproductive age were admitted; 69 (53.5%) elective and 60 (46.5%) emergencies. Eighty-four patients (65%) were asked 'Is there any possibility of pregnancy?' Pregnancy status was documented in 74% of patients. Eleven (8.5%) patients were not asked about possibility of pregnancy and did not have a documented pregnancy status. Documentation of the use of contraception, sexual activity and date of last menstrual period was noted in 53 (41.1%), 31 (24.0%) and 66 (51.2%) patients, respectively. CONCLUSIONS There is a wide variation in the documentation of pregnancy status and possibility of pregnancy amongst surgical specialties. This was not an issue in gynaecology but is an issue in ENT, maxillofacial, neurosurgery, vascular and general surgery. The reasons are unclear. Documentation of pregnancy status using ßhCG assays should be the gold standard, and national guidelines are required.
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Affiliation(s)
- Ibrahim Ibrahim
- Foundation Doctor, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
| | - Bilal Ibrahim
- Medical student, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
| | - Guo Liang Yong
- Foundation Doctor, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
| | - Maria Coats
- Specialty Registrar, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
| | - Zorica Vujovic
- Consultant Surgeon, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
| | - Michael Sj Wilson
- Specialty Registrar, Department of General Surgery, Ninewells Hospital and Medical School, Scotland
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Ibrahim B, Ibrahim I, Porter D, Wilson M, Patil P. Higher operative mortalities are associated with laparotomy, bowel resection and stoma formation in emergency surgical admissions. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mohamed Amin Mostafa A, Sheau Chin L, Ali SK Abdul Kader M, Ismail O, Mohamed Noor D, Kah Hay Y, Ibrahim B. PS171 The Effect of Haematological Variables on the Verifynow P2Y12 Assay in Coronary Artery Disease Patients (CAD) Undergoing Interventional Angiographic Procedure. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bawadikji A, Abdul Kader M, Teh CH, Sulaiman S, Ibrahim B. PM165 Identification of Plasma Metabolites for Patients on Warfarin With Unstable and Stable International Normalized Ratio. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nicotra F, Molinari C, Dozio N, Castiglioni MT, Ibrahim B, Zambon A, Corrao G, Scavini M. Screening for gestational diabetes in the Lombardy region: A population-based study. Diabetes Metab 2014; 41:319-325. [PMID: 25530450 DOI: 10.1016/j.diabet.2014.11.008] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/24/2014] [Accepted: 11/18/2014] [Indexed: 12/12/2022]
Abstract
AIM As the treatment of hyperglycaemia during pregnancy with diet or insulin reduces the risk of adverse maternal outcomes and perinatal complications, screening for gestational diabetes mellitus (GDM) is included, albeit to variable extents, in all guidelines of care for pregnant women. The aim of the present investigation was to estimate the proportion of pregnancies screened for GDM in Lombardy between 2007 and 2010, and to identify predictors of screening. METHODS A retrospective cross-sectional study using regional healthcare utilization databases of Lombardy was conducted. The study included all residents of Lombardy without pregestational diabetes who delivered between 1 January 2007 and 31 December 2010. The proportion of pregnancies with at least one screening test for GDM was calculated, along with the odds ratios and 95% confidence intervals associated with selected covariates for GDM screening. RESULTS Of the 362,818 pregnancies included in the sample, 30% were screened for GDM. The proportion of pregnancies screened increased slightly from 2007 (27%) to 2010 (33%) and with maternal age (from 28% among women<25 years to 32% among those ≥35 years), and varied widely across local health management organizations (HMOs) of residence (range: 20% to 68%). Socioeconomic indicators (education, immigrant status), obstetric history and prepregnancy hypertension were independent predictors of GDM screening. CONCLUSION The study finding of a low rate of pregnant women screened for GDM among residents of Lombardy supports the need for programmes to improve training of healthcare professionals, to raise women's awareness of GDM and to eliminate barriers to GDM screening.
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Affiliation(s)
- F Nicotra
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - C Molinari
- Università Vita Salute San Raffaele, Department of Internal Medicine, Division of General Internal Medicine, Diabetes and Endocrine Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy
| | - N Dozio
- Università Vita Salute San Raffaele, Department of Internal Medicine, Division of General Internal Medicine, Diabetes and Endocrine Diseases, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy
| | - M T Castiglioni
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy
| | - B Ibrahim
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - A Zambon
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
| | - G Corrao
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - M Scavini
- Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy
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Baalash A, Ibrahim B. Matrix Metalloproteinase-9 Promoter polymorphism in primary spontaneous pneumothorax. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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