1
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Grezenko H, Shah IA, Sariza AA, Baluch AB, Kumar A, Abubakar M. Navigating the Uncharted Territory of Pediatric-Onset Multiple Sclerosis in a 12-Year-Old Male: A Case Study. Cureus 2024; 16:e56172. [PMID: 38618304 PMCID: PMC11015909 DOI: 10.7759/cureus.56172] [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: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
This case report presents an atypical instance of pediatric-onset multiple sclerosis (MS) in a 12-year-old male, a demographic less commonly affected by this condition. The patient's clinical course was marked by severe and progressive symptoms, including lower limb weakness and loss of bowel/bladder control, diverging from the typical relapsing-remitting pattern observed in pediatric MS. Despite initial resistance to high-dose steroid treatment, his condition was ultimately stabilized through plasmapheresis, following the detection of myelin oligodendrocyte glycoprotein antibodies. Unique aspects of this case included the patient's young age, male gender, and the occurrence of osteopenia, as identified by a dual-energy X-ray absorptiometry scan. This report highlights the variability in MS presentations among pediatric patients and underscores the importance of a personalized, multidisciplinary approach to diagnosis and treatment. It contributes to the growing body of knowledge on pediatric MS, emphasizing the need for heightened clinical vigilance and tailored management strategies in young patients with this complex and lifelong disease.
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Affiliation(s)
- Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Imam A Shah
- Internal Medicine, Chandka Medical College, Larkana, PAK
| | | | - Amna B Baluch
- Internal Medicine, Universidad Autónoma de Guadalajara, Guadalajara, MEX
| | - Ateesh Kumar
- Internal Medicine, Civil Hospital Karachi, Karachi, PAK
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2
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Grezenko H, Al-Deir SS, Eshete FD, Faran N, Mimms CS, Ibrahim M. Infantile Monosialoganglioside2 (GM2) Gangliosidosis With Concurrent Bronchopneumonia: An Extraordinary Case of Tay-Sachs Disease. Cureus 2024; 16:e51797. [PMID: 38322066 PMCID: PMC10846629 DOI: 10.7759/cureus.51797] [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: 01/07/2024] [Indexed: 02/08/2024] Open
Abstract
Tay-Sachs disease (TSD) is a rare, fatal neurodegenerative disorder characterized by the deficiency of the enzyme hexosaminidase-A (Hex A), which results in the accumulation of monosialoganglioside2 (GM2) ganglioside within nerve cells, predominantly affecting individuals of Ashkenazi Jewish descent. We report a remarkable case of a three-year-old South Asian male with infantile GM2 gangliosidosis, compounded by bronchopneumonia, a rarely documented complication in Tay-Sachs patients. The patient presented with recurrent seizures, fever, cough, and developmental delay. Confirmation of the diagnosis was obtained through reduced Hex A enzyme activity, corroborated by imaging and blood and urine analyses. Family history was significant for consanguinity and similar sibling fatalities. Despite the progressive nature of the disease, symptomatic management, including antiepileptic drugs, antibiotic therapy, and supportive care, led to an improvement in clinical condition, though ongoing monitoring remains essential. In this case, the coexistence of bronchopneumonia with Tay-Sachs disease is unusual, reflecting the necessity for this case report. The patient's response highlights the potential for symptomatic management, the importance of genetic counseling, and the imperative for research into gene and enzyme replacement therapies. The uniqueness of this case provides novel insights into the disease's spectrum, enhancing awareness, encouraging early diagnosis, and refining care strategies for Tay-Sachs disease, aligning with the broader goals of improving patient outcomes and advancing medical research.
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Affiliation(s)
- Han Grezenko
- Medicine and Surgery, Guangxi Medical University, Nanning, CHN
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Shadi S Al-Deir
- Internal Medicine, Misr University For Science and Technology, Amman, JOR
| | | | - Nuzhat Faran
- Internal Medicine, Fatima Memorial Hospital, Lahore, PAK
| | | | - Muhammad Ibrahim
- Medicine, Jinnah Hospital/Allama Iqbal Medical College, Lahore, PAK
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3
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Oliveira Souza Lima SR, Elamin AE, Al Balushi H, Shahzad K, Baluch SK, Khan FA, Shehryar A, Rehman A, Batu BJ, Ayalew BD, Abdullah Yahya N, Grezenko H. Intersecting Realms of Skin and Neurology in Systemic Lupus Erythematosus: A Systematic Review of Dermatological and Neurological Manifestations and Their Impact on Long-Term Prognosis. Cureus 2024; 16:e53142. [PMID: 38420059 PMCID: PMC10901037 DOI: 10.7759/cureus.53142] [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: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterized by diverse manifestations, notably in dermatological and neurological domains. This review aims to synthesize the current understanding of these manifestations and their impact on long-term prognosis. Adhering to PRISMA guidelines, we conducted a comprehensive search across multiple databases, focusing on studies exploring SLE's dermatological and neurological aspects. Selected studies were analyzed to understand their epidemiology, pathophysiology, clinical presentation, and impact on prognosis. Six pivotal studies were reviewed, highlighting the severity of neuropsychiatric SLE, the progression of skin diseases, and their systemic implications. Notably, studies underscored the role of high disease activity and specific antibodies in the development of neuropsychiatric symptoms and the progression of cutaneous manifestations. The review emphasizes the need for an interdisciplinary approach to managing SLE, considering the interplay between its dermatological and neurological manifestations. It suggests that tailored treatment strategies, early detection, and comprehensive care are crucial for improving patient outcomes. This synthesis provides a foundation for future research to develop integrated care protocols and advance patient care in SLE.
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Affiliation(s)
| | | | | | - Khalid Shahzad
- Internal Medicine, King Edward Medical University, Lahore, PAK
| | - Shariq K Baluch
- Internal Medicine, Universidad Autónoma de Guadalajara, Guadalajara, MEX
| | - Faraz A Khan
- Pediatrics, Hind Institute of Medical Sciences, Sitapur, IND
| | | | | | - Biniyam J Batu
- General Practice, St. Paul's Hospital Millennium Medical College, Addis Ababa, ETH
| | - Biruk D Ayalew
- Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, ETH
| | | | - Han Grezenko
- Neurology, Barrow Neurological Institute, Phoenix, USA
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4
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Grezenko H, Zafar F, Nathaniel E, Aguirre G, Baluch SK, Abubakar M. Navigating Neurological and Cardiac Complexities: A Case Study on Viral Meningoencephalitis in a Patient With Ischemic Heart Disease. Cureus 2024; 16:e52763. [PMID: 38389596 PMCID: PMC10882189 DOI: 10.7759/cureus.52763] [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] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
We present a case of viral meningoencephalitis in a 40-year-old male with ischemic heart disease, a combination that is rare and presents unique diagnostic and therapeutic challenges. The patient's symptoms included high-grade fever, severe headache, projectile vomiting, and altered consciousness. The diagnosis was supported by MRI and CSF analysis. Management, complicated by the patient's cardiac condition, required a personalized approach, including antiviral therapy, corticosteroids, and vigilant monitoring of cardiac and neurological status. Treatment adjustments were made in response to the patient's evolving condition, leading to improvement within a week. This case underscores the need for a multidisciplinary approach in such complex scenarios, highlighting the significance of tailored care for patients with neurological symptoms and concurrent cardiac comorbidities. The report contributes to the literature on managing meningoencephalitis in patients with significant cardiac histories, underscoring personalized medicine's role in successful outcomes.
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Affiliation(s)
- Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | | | | | - Guillermo Aguirre
- Internal Medicine, Ignacio A. Santos School of Medicine, Ciudad de México, MEX
| | - Shariq K Baluch
- Internal Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX
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5
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Yadav M, Grezenko H, Kanukollu VMR, Rehman A, Bokhari SFH, Reza T, Franco CD, Chilla SP, Fatima H, Choudhari J, Abdullah Yahya N, Amir M, Mohsin SN. A Systematic Review of the Neuroprotective Effects of Vascular Endothelial Growth Factor (VEGF) in Diabetic Retinopathy and Diabetic Macular Edema: Unraveling the Molecular Mechanisms and Clinical Implications. Cureus 2023; 15:e51351. [PMID: 38288195 PMCID: PMC10824587 DOI: 10.7759/cureus.51351] [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: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Diabetic retinopathy (DR) is a leading cause of global visual impairment, necessitating a comprehensive understanding of its vascular and neural components for effective therapeutic interventions. While vascular pathology is well-established, recent evidence suggests a neurodegenerative role in DR. Vascular endothelial growth factor (VEGF), traditionally implicated in angiogenesis, has emerged as a key player with neuroprotective potential. This systematic review evaluates the literature to shed light on molecular mechanisms and clinical implications in this regard. The review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, encompassing a thorough search strategy across multiple databases. Three in vitro studies met the inclusion criteria, highlighting the limited research in this evolving field. Findings suggest VEGF's neuroprotective effects on retinal ganglion cells (RGCs) and retinal neurons, unveiling potential therapeutic avenues. However, concerns arise regarding anti-VEGF therapies' impact on RGC survival. The review discusses the need for further research to delineate specific isoforms and signaling pathways responsible for VEGF-mediated neuroprotection. The delicate balance between angiogenesis and neuroprotection poses challenges in therapeutic development, emphasizing the importance of targeted interventions. Despite limitations, this review provides valuable insights into the intricate relationship between VEGF and neuroprotection in DR, paving the way for future investigations and redefining therapeutic strategies.
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Affiliation(s)
- Mansi Yadav
- Internal Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | | | | | | | - Taufiqa Reza
- Medicine, Avalon University School of Medicine, Youngstown, USA
| | | | - Srikar P Chilla
- Medicine, Care Hospitals, Hyderabad, IND
- Epidemiology and Public Health, School of Health Sciences, University of East London, London, GBR
| | - Hira Fatima
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Jinal Choudhari
- Research and Academic Affairs, Larkin Community Hospital, Miami, USA
| | | | - Maaz Amir
- Internal Medicine, King Edward Medical University, Lahore, PAK
| | - Syed Naveed Mohsin
- Orthopedics, St James Hospital, Dublin, IRL
- General Surgery, Cavan General Hospital, Cavan, IRL
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6
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Grezenko H, Alsadoun L, Farrukh A, Rehman A, Shehryar A, Nathaniel E, Affaf M, I Kh Almadhoun MK, Quinn M. From Nanobots to Neural Networks: Multifaceted Revolution of Artificial Intelligence in Surgical Medicine and Therapeutics. Cureus 2023; 15:e49082. [PMID: 38125253 PMCID: PMC10731389 DOI: 10.7759/cureus.49082] [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] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
This comprehensive exploration unveils the transformative potential of Artificial Intelligence (AI) within medicine and surgery. Through a meticulous journey, we examine AI's current applications in healthcare, including medical diagnostics, surgical procedures, and advanced therapeutics. Delving into the theoretical foundations of AI, encompassing machine learning, deep learning, and Natural Language Processing (NLP), we illuminate the critical underpinnings supporting AI's integration into healthcare. Highlighting the symbiotic relationship between humans and machines, we emphasize how AI augments clinical capabilities without supplanting the irreplaceable human touch in healthcare delivery. Also, we'd like to briefly mention critical findings and takeaways they can expect to encounter in the article. A thoughtful analysis of the economic, societal, and ethical implications of AI's integration into healthcare underscores our commitment to addressing critical issues, such as data privacy, algorithmic transparency, and equitable access to AI-driven healthcare services. As we contemplate the future landscape, we project an exciting vista where more sophisticated AI algorithms and real-time surgical visualizations redefine the boundaries of medical achievement. While acknowledging the limitations of the present research, we shed light on AI's pivotal role in enhancing patient engagement, education, and data security within the burgeoning realm of AI-driven healthcare.
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Affiliation(s)
- Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Lara Alsadoun
- Plastic Surgery, Chelsea and Westminster Hospital, London, GBR
| | - Ayesha Farrukh
- Family Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | | | | | | | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental College, Abbotabad, PAK
| | | | - Maria Quinn
- Internal Medicine, Jinnah Hospital, Lahore, PAK
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7
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Sunkara V, Abubakar M, Hamdani SAH, Grezenko H, Ali TE. Orbital Onslaught: An Atypical Presentation of Mucormycosis in a Diabetic and Hypertensive Patient. Cureus 2023; 15:e49658. [PMID: 38161814 PMCID: PMC10756330 DOI: 10.7759/cureus.49658] [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: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Mucormycosis, primarily known to affect the sinuses and brain, severely threatens immunocompromised individuals. Its occurrence in the orbital region is rare and potentially devastating. We report a unique case of a 50-year-old male with longstanding diabetes and hypertension who exhibited isolated orbital mucormycosis confined to the right eye. The patient presented with fever and acute vision loss without classic sinusitis symptoms; earlier mismanagement led to an aggressive relapse. An orbital computed tomography (CT) scan revealed inflammatory changes indicative of an early-stage invasive fungal infection. Comprehensive management involving surgical debridement and antifungal therapy successfully halted intracranial spread and further complications. This case underscores the necessity for high clinical vigilance in diagnosing atypical presentations of mucormycosis in susceptible populations, advocating for a rapid, multidisciplinary approach to ensure optimal outcomes. It also adds to the existing literature on the myriad manifestations of this formidable fungal infection.
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Affiliation(s)
| | | | | | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Thowaiba E Ali
- Healthcare Administration, University of Tennessee at Chattanooga, Chattanooga, USA
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8
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Ekomwereren O, Sunkara V, Grezenko H, Hamid YH, Faran N, Abubakar M. Orbital Onset: The Intricate Journey From Ear Abscess to Cavernous Sinus Thrombosis in a Diabetic Male. Cureus 2023; 15:e48922. [PMID: 38106764 PMCID: PMC10725519 DOI: 10.7759/cureus.48922] [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: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Cavernous sinus thrombosis (CST) is a rare, yet severe condition often linked to infections in the nasal and facial areas. We present a case of a 43-year-old male farmer with diabetes who initially showed ear abscess symptoms that progressed to vision loss and CST-like symptoms. Self-treatment and an unidentified medication regimen may have worsened his condition. Advanced diagnostic evaluations, particularly magnetic resonance imaging with magnetic resonance venography, confirmed CST, likely originating from the ear infection spreading to the eyes, causing bilateral orbital cellulitis. Treatment with antibiotics, anticoagulants, and supportive therapy stabilized the patient's condition. This case emphasizes the importance of early detection and intervention in CST, especially in atypical presentations, and the need for comprehensive diagnostic and therapeutic approaches.
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Affiliation(s)
- Osatohanmwen Ekomwereren
- Trauma and Orthopaedics, Royal Shrewsbury Hospital, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, GBR
| | | | - Han Grezenko
- Medicine and Surgery, Guangxi Medical University, Nanning, CHN
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Yusra H Hamid
- Community Medicine, University of Khartoum Faculty of Medicine, Khartoum, SDN
| | - Nuzhat Faran
- Internal Medicine, Fatima Memorial Hospital, Lahore, PAK
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9
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Tanveer Y, Sanipini S, Khleif R, Tsenteradze T, Gapizov A, Grezenko H, Affaf M, Abdelaziz AM, Rehman A, Zia U, Jama H, Shehryar A, Mohsin SN, Ekhator C, Khan R. Transforming Medical Paradigms: A Cutting-Edge Review of Genomic and Robotic Medical and Surgical Approaches in the Battle Against Diabetes, Hypertension, and Cardiovascular Issues. Cureus 2023; 15:e46998. [PMID: 37965396 PMCID: PMC10641027 DOI: 10.7759/cureus.46998] [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] [Accepted: 10/13/2023] [Indexed: 11/16/2023] Open
Abstract
This article provides an in-depth review of the current state of management for diabetes, hypertension, and cardiovascular disease, focusing on advancements from genomics to robotics. It explores the role of genomic markers in personalized medicine, offering tailored treatment options for these chronic conditions. The article also examines the efficacy of various pharmacological and surgical interventions, including bariatric surgery for diabetes and device-based treatments for hypertension. A comparative analysis is presented to evaluate the cost-effectiveness and patient outcomes between medical and surgical approaches. The review concludes that while personalized medicine and minimally invasive surgical techniques show promise, more high-quality comparative research is needed. The ultimate goal is to integrate these emerging technologies within a framework of evidence-based medicine to improve patient outcomes and health equity.
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Affiliation(s)
| | | | - Rafeef Khleif
- Medical School, Xavier University School of Medicine, Oranjestad, ABW
| | - Tamar Tsenteradze
- General Surgery, Tbilisi State Medical Univerity, Tbilisi, GEO
- Cardiology, Tbilisi State Medical Univerity, Tbilisi, GEO
- Internal Medicine, Tbilisi State Medical Univerity, Tbilisi, GEO
| | - Abubakar Gapizov
- General Surgery, American University of Antigua, Saint George, ATG
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental College, Abbotabad, PAK
| | - Ali M Abdelaziz
- Internal Medicine, Alexandria University Faculty of Medicine, Alexandria, EGY
| | | | - Umar Zia
- Internal Medicine, Khyber Medical University, Peshawar, PAK
| | - Huda Jama
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | | | | | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Rehman Khan
- Internal Medicine, Mayo Hospital, Lahore, PAK
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10
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Shams M, Choudhari J, Reyes K, Prentzas S, Gapizov A, Shehryar A, Affaf M, Grezenko H, Gasim RW, Mohsin SN, Rehman A, Rehman S. The Quantum-Medical Nexus: Understanding the Impact of Quantum Technologies on Healthcare. Cureus 2023; 15:e48077. [PMID: 38046499 PMCID: PMC10689891 DOI: 10.7759/cureus.48077] [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] [Accepted: 10/29/2023] [Indexed: 12/05/2023] Open
Abstract
In a world characterized by rapid technological evolution, the integration of quantum technologies into the realm of healthcare has emerged as a transformative force. This narrative review explores the journey of quantum innovations in medicine, delving into the fundamental principles of quantum mechanics that underpin quantum computing, sensing, and communication. From the birth of quantum theory to the advent of practical quantum applications, we journey through historical milestones that have paved the way for a quantum-powered future in healthcare. The narrative unfolds to reveal the profound implications of quantum technologies in healthcare, ranging from accelerated drug discovery and genomic analysis to secure data transmission and telemedicine. Real-world case studies illuminate successful applications, while the review addresses the ethical, societal, and regulatory considerations that accompany this quantum revolution. As we peer into the future, we contemplate the challenges that lie ahead and offer recommendations for researchers and policymakers to forge a harmonious and equitable synergy between quantum and medicine. In a world where innovation outpaces the tick of the clock, this narrative review serves as a timely guide for those poised to shape the quantum healthcare landscape, where precision and compassion converge and the possibilities are limitless.
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Affiliation(s)
| | - Jinal Choudhari
- Family Medicine, Division of Research and Academic Affairs, Larkin Community Hospital, Miami, USA
| | | | - Sophia Prentzas
- Internal Medicine, American University of Antigua, Osbourn, ATG
| | | | | | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental College, Abbottabad, PAK
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Rayan W Gasim
- Internal Medicine, University of Khartoum, Khartoum, SDN
| | - Syed Naveed Mohsin
- Orthopeadics, St. James Hospital, Dublin, IRL
- General Surgery, Cavan General Hospital, Cavan, IRL
| | | | - Shehryar Rehman
- Internal Medicine, Al Assad University Hospital, Damascus, SYR
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11
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Mohsin SN, Grezenko H, Khan S, Eshete FD, Shrestha S, Kamran M, Affaf M, Jama A, Gasim RW, Zubaer Ahmad D, Yadav I, Arif S, K C A, Khaliq AS. Bridging Development and Disruption: Comprehensive Insights into Focal Cortical Dysplasia and Epileptic Management. Cureus 2023; 15:e45996. [PMID: 37900524 PMCID: PMC10601976 DOI: 10.7759/cureus.45996] [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: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Focal cortical dysplasia (FCD) is a prominent neurological disorder characterized by disruptions in localized brain cell organization and development. This narrative review delineates the multi-faceted nature of FCD, emphasizing its correlation with drug-resistant epilepsy, predominantly in children and young adults. We explore the historical context of FCD, highlighting its indispensable role in shaping our comprehension of epilepsy and cortical anomalies. The clinical spectrum of FCD is broad, encompassing diverse seizure patterns, cognitive impairments, and associated neuropsychiatric disorders. We underscore the importance of differential diagnosis, with techniques ranging from electroencephalogram (EEG) interpretations to microscopic evaluations, and discuss advanced diagnostic modalities, such as the 3T magnetic resonance imaging (MRI) epilepsy protocols. Therapeutically, while anti-seizure medications are often first-line interventions, surgically refractory cases necessitate more invasive procedures, underscoring the importance of individualized treatment. Furthermore, the review touches upon the prognostic aspects of FCD, highlighting the importance of personalized care regimens, and provides insights into emerging therapeutic avenues, including the potential of the mammalian target of rapamycin (mTOR) pathway. Conclusively, this review accentuates the complex relationship between brain development and epileptogenicity inherent to FCD and underscores the promise of future research in enhancing patient outcomes.
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Affiliation(s)
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Saadia Khan
- Community Medicine, Khyber Girls Medical College, Peshawar, PAK
| | | | - Shraddha Shrestha
- Internal Medicine, Nepal Korea Friendship Municipality Hospital, Bhaktapur, NPL
| | | | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental College, Abbottabad, PAK
| | - Ayat Jama
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Rayan W Gasim
- Internal Medicine, University of Khartoum, Khartoum, SDN
| | | | - Indresh Yadav
- Internal Medicine, Samar Hospital and Research Center Pvt. Ltd., Janakpur, NPL
- Internal Medicine, Community Based Medical College, Mymensingh, BGD
| | - Sidra Arif
- Urology, Jinnah Postgraduate Medical Center, Karachi, PAK
| | - Anil K C
- Medicine and Surgery, Patan Academy of Health Sciences, Kathmandu, NPL
- Internal Medicine and Neurology, California Institute of Behavioral Neurosciences & Psychology, California, USA
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12
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Ekhator C, Grezenko H, Haider Z, Ali Cheema U, Haider H, Mohsin SN, Affaf M, Bellegarde SB, Amir S, Kumar S, Shehryar A, Arif S, Fareed MU, Rehman A. Beneath the Layers: Deciphering the Molecular Pathways, Therapeutic Avenues, and Neurological Connections of Soft Tissue Sarcomas. Cureus 2023; 15:e44694. [PMID: 37674761 PMCID: PMC10477814 DOI: 10.7759/cureus.44694] [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] [Accepted: 09/04/2023] [Indexed: 09/08/2023] Open
Abstract
Soft tissue sarcomas (STSs) are a heterogeneous group of malignancies that have long posed challenges in terms of diagnosis, treatment, and management. This narrative review provides a comprehensive exploration into the multifaceted realm of STS, spanning from its historical origins to the latest advancements in research and clinical care. We delve into the molecular intricacies of STS, highlighting the genetic and epigenetic aberrations that drive these tumors. The review emphasizes the neurological implications of STS, a relatively underexplored area, shedding light on the interplay between tumor biology and neural processes. The evolving therapeutic landscape is discussed, with a focus on the promise of targeted therapies, immunotherapy, and precision medicine. A significant portion is dedicated to the patient-centric approach, underscoring the importance of holistic care that addresses both the physical and psychological needs of STS patients. Furthermore, we highlight the gaps in current research and clinical practices, offering insights into potential avenues for future exploration. This review serves as a valuable resource for clinicians, researchers, and the broader scientific community, encapsulating the current state of STS knowledge and pointing toward future directions in this dynamic field.
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Affiliation(s)
- Chukwuyem Ekhator
- Neuro-oncology, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, USA
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Zaroon Haider
- Internal Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | | | - Haseeb Haider
- Medicine and Surgery, CMH Multan Institute of Medical Sciences, Multan, PAK
| | | | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental college, Abbottabad, PAK
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
| | - Saniya Amir
- Accident and Emergency, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Sahil Kumar
- Medicine, Liaquat National Hospital, Karachi, PAK
| | | | - Sidra Arif
- Urology, Jinnah Postgraduate Medical Center, Karachi, PAK
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13
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Shehryar A, Halappa Nagaraj R, Kanwal F, Reddy SM, Grezenko H, Raut Y, Fareed MU, Abdur Rehman, Şahin D, Bakht D, Ramteke P. Unraveling Monkeypox: An Emerging Threat in Global Health. Cureus 2023; 15:e43961. [PMID: 37753017 PMCID: PMC10518525 DOI: 10.7759/cureus.43961] [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] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Monkeypox, a viral zoonotic ailment originating in the Central and West African regions, has escalated into a global health issue of growing concern. The current analysis offers an exhaustive examination of monkeypox, emphasizing its historical progression, etiology, epidemiological patterns, pathophysiological mechanisms, clinical manifestations, diagnostic methodologies, treatment modalities, and preventive strategies. The worldwide discontinuation of smallpox vaccination has contributed to an increased incidence of monkeypox, driven by the expansion of vulnerable host populations. Significant strides in diagnostic procedures, prospective antiviral treatments, and vaccine development exhibit potential in managing this affliction, yet obstacles remain in terms of disease control, prevention, and treatment. Additionally, the international propagation of monkeypox underscores the need for robust public health initiatives and the significant role played by global health institutions in disease containment. Prospective research endeavors should strive to enhance our comprehension of the natural reservoirs of monkeypox and its transmission dynamics, evaluate sustained immune responses to novel vaccines, and investigate the potential impact of One Health strategies. This analysis underscores the pressing necessity for increased research and synchronized global efforts to tackle this emergent infectious malady.
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Affiliation(s)
| | | | - Fnu Kanwal
- Medicine, Chandka Medical College, Larkana, PAK
| | - Shivani M Reddy
- Student, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, IND
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Yogesh Raut
- Medicine, Narendra Kumar Prasadrao (NKP) Salve Institute of Medical Sciences, Nagpur, IND
| | | | | | - Defne Şahin
- Internal Medicine, Psychiatry, Ege University Hospital, İzmir, TUR
| | - Danyal Bakht
- Medicine and Surgery, Mayo Hospital, Lahore, PAK
| | - Palash Ramteke
- Medicine, Narendra Kumar Prasadrao (NKP) Salve Institute of Medical Sciences, Nagpur, IND
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14
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Grezenko H, Ekhator C, Nwabugwu NU, Ganga H, Affaf M, Abdelaziz AM, Rehman A, Shehryar A, Abbasi FA, Bellegarde SB, Khaliq AS. Epigenetics in Neurological and Psychiatric Disorders: A Comprehensive Review of Current Understanding and Future Perspectives. Cureus 2023; 15:e43960. [PMID: 37622055 PMCID: PMC10446850 DOI: 10.7759/cureus.43960] [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] [Accepted: 08/23/2023] [Indexed: 08/26/2023] Open
Abstract
The burgeoning field of epigenetics offers transformative insights into the complex landscape of neurological and psychiatric disorders. By unraveling the intricate interplay between genetic, epigenetic, environmental, and lifestyle factors, this comprehensive review highlights the multifaceted nature of mental health. The exploration reveals the potential of epigenetic modifications to revolutionize our understanding, diagnosis, treatment, and prevention of these disorders. Emphasizing the importance of multidisciplinary collaborations, large-scale studies, technological advancements, and ethical considerations, the review asserts the promise of epigenetics as a vital tool for personalized medicine, early intervention, and public health strategies. While acknowledging the challenges in a still-emerging field, the review paints an optimistic picture of epigenetics as a groundbreaking approach that can reshape mental healthcare, offering hope for those affected by neurological and psychiatric conditions. The future trajectory of the field relies on interdisciplinary efforts, ethical diligence, innovative technologies, and translating scientific insights into real-world applications, thereby unlocking the vast potential of epigenetics in mental health.
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Affiliation(s)
- Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Nkechi U Nwabugwu
- Public Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | | | - Maryam Affaf
- Internal Medicine, Women Medical College, Abbottabad, PAK
| | - Ali M Abdelaziz
- Internal Medicine, Alexandria University Faculty of Medicine, Alexandria, EGY
| | | | | | - Fatima A Abbasi
- Cardiology, Shifa International Hospital Islamabad, Islamabad, PAK
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
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15
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Saeed S, Halappa Nagaraj R, Grezenko H, Rehman A, Shehryar A, Anwaar MA, Lazarevic S, Shahzed SMI, Das A, Vargas KI. FLT3-ITD Mutation and Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: A Case Study. Cureus 2023; 15:e42504. [PMID: 37637651 PMCID: PMC10457020 DOI: 10.7759/cureus.42504] [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: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Acute myeloid leukemia (AML) is a hematologic cancer that is characterized by unchecked myeloid precursor cell growth in the bone marrow and peripheral circulation, which results in an overabundance of immature myeloid cells. The 22-year-old man featured in this case report had a fever, tiredness, and easy bruising. Pancytopenia was discovered through laboratory testing, and an AML diagnosis was confirmed by a bone marrow biopsy, with myeloid blasts making up 85% of the nucleated cells. FLT3-ITD and NPM1 mutations were found by genetic testing. After receiving induction chemotherapy using the drugs daunorubicin and cytarabine, the patient experienced complete remission after just one cycle of treatment. He then had an allogeneic stem cell transplant and was still in remission during follow-up. This example highlights the significance of early AML diagnosis and detection, as well as the function of molecular profiling and risk stratification in directing treatment choices. It emphasizes the requirement for continued study to produce novel treatments and enhance results for AML patients. In general, this case study advances knowledge of AML and its management techniques. For AML patients to experience the best results, early diagnosis, risk assessment, and individualized therapy plans based on molecular profiling are essential. AML patients' prognosis and quality of life can be improved by the development of targeted medicines, which require ongoing study to better understand the disease.
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Affiliation(s)
- Shahzeb Saeed
- Internal Medicine, Army Medical College, Rawalpindi, PAK
| | | | - Han Grezenko
- Translational Neurosciences, Barrow Neurological Institute, Phoenix, USA
| | | | | | - Mohammad Ahsan Anwaar
- Internal Medicine, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | | | | | - Archana Das
- Internal Medicine, North East Medical College and Hospital, Sylhet, BGD
| | - Karla I Vargas
- Medicine, Universidad Juárez del Estado de Durango, Durango, MEX
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16
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Saeed S, Grezenko H, Nisar L, Rehman A, Riyaz A, Cook DE, Kamran M. A Rare but Aggressive Malignancy: A Case Report of a Gastrointestinal Neuroectodermal Tumor (GNET). Cureus 2023; 15:e41509. [PMID: 37551252 PMCID: PMC10404388 DOI: 10.7759/cureus.41509] [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: 07/07/2023] [Indexed: 08/09/2023] Open
Abstract
Gastrointestinal neuroectodermal tumors (GNETs) are extremely rare and intriguing malignancies originating from neural crest cells in the digestive tract. The digestive tract's neural crest cells can give rise to incredibly unusual and interesting gastrointestinal neuroectodermal tumors (GNETs). GNETs present considerable hurdles in diagnosis and management because of their rarity and varied expression. In this case report, a 45-year-old male patient is described who had signs of GNET, such as exhaustion, weight loss, and abdominal pain. A 7-cm jejunum tumor and related thickening of the gut wall were discovered using imaging investigations. The diagnosis of malignant GNET was confirmed by surgical resection, and adjuvant treatment was given. A recurring tumor required a second surgical procedure despite an initial disease-free period. The report emphasizes the difficulties involved in the diagnosis, treatment, and long-term effects of GNETs. The rarity of GNETs necessitates the development of standardized treatment protocols as well as additional research to enhance diagnostic precision and explore novel therapeutic approaches for this aggressive malignancy.
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Affiliation(s)
- Shahzeb Saeed
- Internal Medicine, Army Medical College, Islamabad, PAK
| | - Han Grezenko
- Medicine, Guangxi Medical University, Nanning, CHN
| | - Lyba Nisar
- Internal Medicine, Quaid-e-Azam Medical College, Bahawalpur, PAK
| | | | - Amina Riyaz
- Medical School, Sree Uthradom Thirunal (SUT) Academy of Medical Sciences, Trivandrum, IND
| | - Daniel E Cook
- International Medical Graduate, Avalon University School of Medicine, Youngstown, USA
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17
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Halappa Nagaraj R, Grezenko H, Raut Y, Butt SRR, Ekhator C, Anwaar MA, Bellegarde SB, Shahzed SMI, Das A, Shehryar A, Rehman A. Recurrent Retroperitoneal Spindle Cell Sarcoma: A Challenging Case Report and Management Considerations. Cureus 2023; 15:e42658. [PMID: 37521593 PMCID: PMC10386891 DOI: 10.7759/cureus.42658] [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: 07/29/2023] [Indexed: 08/01/2023] Open
Abstract
Soft-tissue sarcomas (STS) comprise a heterogeneous category of malignant tumors originating from mesenchymal tissue. Spindle cell sarcoma, characterized by its infrequent occurrence, poses diagnostic and therapeutic complexities owing to its rarity. We present a case of an 80-year-old male with a diagnosis of spindle cell sarcoma in the retroperitoneal space. The patient underwent midline exploratory laparotomy for tumor excision and was planned for postoperative chemotherapy. Unfortunately, the tumor recurred aggressively, leading to a fatal outcome. This case highlights the uncommon occurrence of retroperitoneal spindle cell sarcoma (RPSCS) and the importance of accurate diagnosis, appropriate surgical management, and adjuvant therapy.
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Affiliation(s)
| | - Han Grezenko
- Translational Neurosciences, Barrow Neurological Institute, Phoenix, USA
| | - Yogesh Raut
- Medicine, Narendra Kumar Prasadrao Salve Institute of Medical Sciences, Nagpur, IND
| | - Samia Rauf R Butt
- General Practice, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Mohammad Ahsan Anwaar
- Internal Medicine, Combined Military Hospital Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St John's, ATG
| | | | - Archana Das
- Internal Medicine, North East Medical College Hospital, Sylhet, BGD
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18
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Irfan M, Abdelsamad O, Grezenko H, Patel A, Akram MR. Brain Metastasis With a Solitary Lesion Secondary to Knee Joint Ewing Sarcoma: A Case Report. Cureus 2023; 15:e39612. [PMID: 37384071 PMCID: PMC10299850 DOI: 10.7759/cureus.39612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 06/30/2023] Open
Abstract
Brain metastasis from Ewing sarcoma is rare and can present with various symptoms. We present a 21-year-old female who underwent surgery for Ewing sarcoma of the knee joint and, after six months, was reported with complaints of headache and vomiting. Considering recommended investigations, metastatic Ewing sarcoma of the brain was diagnosed, and a treatment protocol, such as a combination of surgery, chemotherapy, and radiation, was given. Our observation shows this is the first case reported with a solitary metastatic brain lesion associated with Ewing sarcoma.
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Affiliation(s)
- Muhammad Irfan
- Department of Neurosurgery, Nishtar Medical University, Multan, PAK
- Department of Neuroscience, Sheikh Zayed Hospital, Rahim Yar Khan, PAK
| | - Osama Abdelsamad
- Department of Clinical Oncology, Khartoum Oncology Hospital, Khartoum, SDN
- Department of Research, Michigan State University, Michigan, USA
| | - Han Grezenko
- Department of Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Anshum Patel
- Department of Internal Medicine, Narendra Modi Medical College, Ahmedabad, IND
| | - Muhammad Rizwan Akram
- Department of Internal Medicine, Sheikh Zayed Medical College, Rahim Yar Khan, PAK
- Department of Internal Medicine, BronxCare Health System, New York, USA
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