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Salahuddin M, Shahid S, Tariq U, Aqeel M, Arif AU, Aslam M, Sattar S. Outcomes of patients with elevated pulmonary artery systolic pressure on echocardiography due to chronic lung diseases. Respir Investig 2024; 62:69-74. [PMID: 37952288 DOI: 10.1016/j.resinv.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Pulmonary hypertension is associated with increased mortality, and lung diseases are the second most common cause of pulmonary hypertension. We aimed to evaluate the prognostic value of echocardiography in low-middle income countries where right heart catheterization is difficult to perform. METHODS This retrospective chart review study included adult patients hospitalized from June 2012 to May 2021, with a pulmonary artery systolic pressure (PASP) of ≥35 mmHg on echocardiography. The control arm consisted of patients with similar lung diseases who did not have an elevated PASP. RESULTS The study and control arm consisted of 128 patients each, with both groups having similar lung diseases. Obesity hypoventilation syndrome was the most common etiology of elevated PASP (28.1 %), followed by pulmonary embolism (20.3 %). The overall 1-year mortality of the study cohort, after diagnosis of elevated PASP, was 20.3 %. The control cohort with normal PASP had a 1-year mortality of 4.7 %. In the study cohort, patients with bronchiectasis had the highest cause-specific 1-year mortality (45.5 %). In the normal PASP cohort, the highest cause-specific 1-year mortality was observed in patients with interstitial lung disease (13.0 %). One-year hospital readmission was observed in 46.9 % and 33.6 % of patients in the study and control arms, respectively. On multivariate analysis, increased odds of 1-year mortality were observed in patients with elevated PASP, patients with 1-year hospital readmission, and in patients with interstitial lung disease or bronchiectasis. CONCLUSION Elevated PASP on echocardiography may be a prognostic factor for mortality in patients with chronic lung diseases.
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Affiliation(s)
- Moiz Salahuddin
- Department of Medicine, Aga Khan University, Karachi, Pakistan.
| | - Shayan Shahid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Umar Tariq
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Masooma Aqeel
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Ali Usman Arif
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Mehwish Aslam
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Saadia Sattar
- Department of Medicine, Aga Khan University, Karachi, Pakistan
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Aqeel M, Medhora M, Gore E, Borkenhagen J, Klawikowski S, Eastwood D, Banerjee A, Jacobs ER. Evaluation of Radiation-induced Pleural Effusions after Radiotherapy to Support Development of Animal Models of Radiation Pneumonitis. Health Phys 2021; 121:434-443. [PMID: 34546223 PMCID: PMC8500166 DOI: 10.1097/hp.0000000000001462] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
ABSTRACT Not all animal models develop radiation-induced pleural effusions (RIPEs) as a form of radiation-induced lung injury (RILI). Such effusions are also not well characterized in humans. The purpose of this study is to identify occurrences of RIPE in humans, provide justification for development of relevant animal models, and further characterize its risk factors in cancer patients. We also aim to identify dose thresholds for cardiopulmonary toxicity in humans to shed light on possible pathogenic mechanisms for RIPEs. We carried out a retrospective review of medical records of 96 cancer patients receiving thoracic irradiation (TRT) at our institution. Fifty-three (53%) patients developed a new pleural effusion post TRT; 18 (19%) had RIPE; and 67% developed RIPE ipsilateral to the site irradiated. None developed "contralateral only" effusions. Median time to development was 6 mo (IQR; 4-8 mo). Of 18, 8 patients (44%) had concomitant asymptomatic (radiographic only) or symptomatic radiation pneumonitis and pericardial effusion. Dosimetric factors, including combined and ipsilateral mean lung dose (MLD), were significantly associated with increased risk of RIPE. Angiotensin converting enzyme inhibition, steroids, or concurrent chemotherapy did not modify incidence of RIPE. Our results substantiate the occurrence and incidence of RIPEs in humans. In cancer patients, a median time to development of effusions around 6 mo also supports the onset of RIPEs concurrent with radiation pneumonitis. Future work needs to include large populations of cancer survivors in whom delayed RIPEs can be tracked and correlated with cardiovascular changes in the context of injury to multiple organs.
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Affiliation(s)
- Masooma Aqeel
- Current Affiliation: Section of Pulmonary & Critical
Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan.
Formerly at Division of Pulmonary Medicine, Department of Medicine, Froedtert
Hospital & Medical College of Wisconsin, Milwaukee, WI, United States
| | - Meetha Medhora
- Division of Pulmonary Medicine, Department of Medicine,
Froedtert Hospital & Medical College of Wisconsin, Milwaukee, WI, United
States
- Department of Radiation Oncology, Froedtert Hospital &
Medical College of Wisconsin, Milwaukee, WI, United States
- Research Service, Department of Veteran’s Affairs,
Clement J. Zablocki VA Medical Center, Milwaukee, WI, United States
| | - Elizabeth Gore
- Department of Radiation Oncology, Froedtert Hospital &
Medical College of Wisconsin, Milwaukee, WI, United States
- Research Service, Department of Veteran’s Affairs,
Clement J. Zablocki VA Medical Center, Milwaukee, WI, United States
| | - Jenna Borkenhagen
- Department of Radiation Oncology, Froedtert Hospital &
Medical College of Wisconsin, Milwaukee, WI, United States
| | - Slade Klawikowski
- Department of Radiation Oncology, Froedtert Hospital &
Medical College of Wisconsin, Milwaukee, WI, United States
| | - Daniel Eastwood
- Department of Biostatistics, Medical College of Wisconsin,
Milwaukee, WI, United States
| | - Anjishnu Banerjee
- Department of Biostatistics, Medical College of Wisconsin,
Milwaukee, WI, United States
| | - Elizabeth R. Jacobs
- Division of Pulmonary Medicine, Department of Medicine,
Froedtert Hospital & Medical College of Wisconsin, Milwaukee, WI, United
States
- Research Service, Department of Veteran’s Affairs,
Clement J. Zablocki VA Medical Center, Milwaukee, WI, United States
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Abstract
A young man presented to the emergency department with seizures and recurrent episodes of polymorphic ventricular tachycardia (PMVT)/torsades de pointes (TdP) requiring cardioversion and administration of intravenous magnesium. A battery of tests performed to identify a cause for his arrhythmias and seizures were all normal. A revisit of history with family revealed he had consumed over 100 tablets/day of loperamide for the past 1 year. A prolonged QT interval on his ECG raised concerns for long QT syndrome (LQTS) (congenital or acquired). Our patient was suspected to have loperamide-induced cardiotoxicity. TdP is a specific PMVT that occurs with a prolonged QT interval and is usually drug-induced. Less frequently, congenital LQTS may be implicated. With supportive care, including mechanical ventilation, vasopressors and temporary transvenous overdrive pacing, our patient recovered completely. We describe the importance of a systematic and time-sensitive approach to diagnosing critical illness. Loperamide overdose may cause QT prolongation, life-threatening arrhythmias/cardiogenic shock, or cardiac arrest. Seizures/epilepsy may also be a manifestation in young patients. There is a substantial need to revisit the safety of over-the-counter medications and increasing awareness of manifestations of drug overdose.
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Affiliation(s)
- Sameen Iqbal
- Section of Cardiology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Sidra Malik Fayyaz
- Section of Pulmonology & Critical Care Medicine, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Yawer Saeed
- Section of Cardiology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Masooma Aqeel
- Section of Pulmonology & Critical Care Medicine, Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Altaf S, Ijaz H, Haider J, Naz M, Aqeel M, Ul-Hamid A, Ikram M, Zulfiqar S, Ditta SA, Shahbaz A, Ikram M. Influence of various transition metals incorporated into tellurium used as antimicrobial agent and textile dye degrader. Appl Nanosci 2020. [DOI: 10.1007/s13204-020-01547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hassan J, Ikram M, Ul-Hamid A, Imran M, Aqeel M, Ali S. Application of Chemically Exfoliated Boron Nitride Nanosheets Doped with Co to Remove Organic Pollutants Rapidly from Textile Water. Nanoscale Res Lett 2020; 15:75. [PMID: 32266606 PMCID: PMC7138897 DOI: 10.1186/s11671-020-03315-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/30/2020] [Indexed: 05/26/2023]
Abstract
Two-dimensional layered materials doped with transition metals exhibit enhanced magnetization and improved catalytic stability during water treatment leading to potential environmental applications across several industrial sectors. In the present study, cobalt (Co)-doped boron nitride nanosheets (BN-NS) were explored for such an application. Chemical exfoliation process was used to exfoliate BN-NS and the hydrothermal route was adopted to incorporate Co dopant in various concentrations (e.g., 2.5, 5, 7.5, and 10 wt%). X-ray diffraction (XRD) study indicated that crystallinity improved upon doping with the formation of a hexagonal phase of the synthesized material. Selected area electron diffraction (SAED) confirmed enhanced crystallinity, which corroborates XRD results. Interlayer spacing was evaluated through a high-resolution transmission electron microscope (HR-TEM) equipped with Gatan digital micrograph software. Compositional and functional group analysis was undertaken with energy dispersive X-ray (EDS) and Fourier transform infrared (FTIR) spectroscopy, respectively. Field emission scanning electron microscope (FE-SEM) and HR-TEM were utilized to probe surface morphologies of prepared samples. Bonding modes in the sample were identified through Raman analysis. Optical properties were examined using UV-vis spectroscopy. Photoluminescence spectra were acquired to estimate the separation and recombination of excitons. Magnetic properties were studied by means of hysteresis loop acquired using VSM measurements. Methylene blue dye was degraded with as-prepared host and doped nanosheets used as catalysts and investigated through absorption spectra ranging from 250 to 800 nm. The experimental results of this study indicate that Co-doped BN-NS showed enhanced magnetic properties and can be used to degrade dyes present as an effluent in industrial wastewater.
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Affiliation(s)
- J. Hassan
- Solar Cell Applications Research Lab, Department of Physics, Government College University Lahore, Lahore, Punjab 54000 Pakistan
- Department of Physics, Riphah Institute of Computing and Applied Sciences (RICAS), Riphah International University, 14 Ali Road, Lahore, Pakistan
| | - M. Ikram
- Solar Cell Applications Research Lab, Department of Physics, Government College University Lahore, Lahore, Punjab 54000 Pakistan
| | - A. Ul-Hamid
- Center for Engineering Research, Research Institute, King Fahd University of Petroleum & Minerals, Dhahran, 31261 Saudi Arabia
| | - M. Imran
- State Key Laboratory of Chemical Resource Engineering, Beijing Advanced Innovation Centre for Soft Matter Science and Engineering, Beijing Engineering Center for Hierarchical Catalysts, Beijing University of Chemical Technology, Beijing, 100029 China
| | - M. Aqeel
- Solar Cell Applications Research Lab, Department of Physics, Government College University Lahore, Lahore, Punjab 54000 Pakistan
| | - S. Ali
- Department of Physics, Riphah Institute of Computing and Applied Sciences (RICAS), Riphah International University, 14 Ali Road, Lahore, Pakistan
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Altaf S, Ajaz H, Imran M, Ul-Hamid A, Naz M, Aqeel M, Shahzadi A, Shahbaz A, Ikram M. Synthesis and characterization of binary selenides of transition metals to investigate its photocatalytic, antimicrobial and anticancer efficacy. Appl Nanosci 2020. [DOI: 10.1007/s13204-020-01350-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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7
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Ewy M, Aqeel M, Kozeniecki M, Patel K, Banerjee A, Heyland DK, Patel JJ. Impact of Enteral Feeding on Vasoactive Support in Septic Shock: A Retrospective Observational Study. Nutr Clin Pract 2020; 35:540-547. [PMID: 32134146 DOI: 10.1002/ncp.10480] [Citation(s) in RCA: 5] [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] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Introducing enteral nutrition (EN) during hemodynamic instability may induce the splanchnic steal phenomenon, which may worsen systemic oxygen delivery and increase vasopressor dose. We aimed to determine the change in vasopressor dose in septic shock patients who received concomitant EN. We hypothesize that EN delivery is not associated with worsening hemodynamic instability, as defined by an increase in vasopressor dose ≥50% at 24 hours. METHODS This is a retrospective observational cohort study of adult patients with septic shock who were admitted to the intensive care unit from January 2015 to June 2015 and received EN. Vasopressor and EN parameters were collected at 6-hour intervals for the first 24 hours. RESULTS Data were available for 28 consecutive patients. The mean age was 60 years (SD = 18), and 54% were females. Norepinephrine (NE) was used in 100%. EN and vasopressor overlap totaled 36 hours (interquartile range [IQR], 27-69). Median NE dose when starting EN was 5.9 μg/min (IQR, 3.88). Median change in dose from 0 to 6 hours was 0.85 μg/min (95% CI, 0.681.06; P = 0.136), corresponding to a median increase of 14.5%. Total NE duration was 60.5 hours (IQR, 47.5-75.5). No serious complications occurred. CONCLUSION The median vasopressor dose did not increase by ≥50% during the first 24 hours of EN. This suggests early EN delivered during septic shock is not associated with worsening hemodynamic instability. Limitations include a small sample size and residual confounding. Prospective data are needed.
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Affiliation(s)
- Matthew Ewy
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Masooma Aqeel
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Sindh, Pakistan
| | - Michelle Kozeniecki
- Nutrition Services Department, Froedtert Hospital, Milwaukee, Wisconsin, USA
| | - Kadam Patel
- Institute for Health & Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anjishnu Banerjee
- Institute for Health & Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Daren K Heyland
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Jayshil J Patel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Aqeel M, Ikram M, Imran M, Ul-Hamid A, Qumar U, Shahbaz A, Ikram M, Saeed A. TiO2 Co-doped with Zr and Ag shows highly efficient visible light photocatalytic behavior suitable for treatment of polluted water. RSC Adv 2020; 10:42235-42248. [PMID: 35516777 PMCID: PMC9057920 DOI: 10.1039/d0ra08718a] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
The objective of this study is to analyze the effects of zirconium (Zr) and silver (Ag) doping on the photoactivity of titania (TiO2). Zr–Ag (ZA) co-doped TiO2 products were fabricated via sol–gel technique and their properties (structural and chemical) were characterized. The weight ratio of TiO2 was fixed, while weight ratios of Zr and Ag were varied from 2 to 4, 6 and 8 wt% while synthesized samples were calcined at 400 °C for 3 h. The XRD results demonstrated that the incorporation of metal doping agents failed to alter the host material's lattice structure, however, its crystallite size was reduced from 13.54 to 5.05 nm with increasing Zr4+ and Ag+ concentrations. FTIR spectroscopy was used to examine various functional groups. In the attained spectra, an ample absorption peak between 500 and 1000 cm−1 was recorded, which was ascribed to Ti–O–Ti linkage vibration mode present within TiO2. Surface morphology, microstructure, SAED patterns and elemental composition were examined with FE-SEM, HR-TEM and EDX, which served to confirm the ZA-doped TiO2 product. Band gap energy of the co-doped material was significantly reduced as indicated by a higher wavelength redshift in the spectra. The photoactivity and kinetics of photo-products were investigated by observing photo-decolorization of methylene blue (MB) under a radiation source. Photodecomposition of MB was dramatically enhanced when titania co-doped with Zr and Ag was employed compared to un-doped or mono-doped TiO2. The ZA (8 wt%) co-doped TiO2 photocatalyst depicted the maximum MB removal efficiency (∼93%) within 90 min under a light source. The objective of this study is to analyze the effects of zirconium (Zr) and silver (Ag) doping on the photoactivity of titania (TiO2).![]()
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Affiliation(s)
- M. Aqeel
- Solar Cell Applications Research Lab
- Department of Physics
- Government College University Lahore
- Paksitan
| | - M. Ikram
- Solar Cell Applications Research Lab
- Department of Physics
- Government College University Lahore
- Paksitan
| | - M. Imran
- State Key Laboratory of Chemical Resource Engineering
- Beijing Advanced Innovation Centre for Soft Matter Science and Engineering
- Beijing Engineering Center for Hierarchical Catalysts
- Beijing University of Chemical Technology
- Beijing 100029
| | - A. Ul-Hamid
- Center for Engineering Research
- Research Institute
- King Fahd University of Petroleum & Minerals
- Dhahran 31261
- Saudi Arabia
| | - U. Qumar
- Department of Physics
- Riphah Institute of Computing and Applied Sciences (RICAS)
- Riphah International University
- Lahore
- Pakistan
| | - A. Shahbaz
- Department of Physics
- Government College University Lahore
- Pakistan
| | - M. Ikram
- Institute of Chemical Engineering and Technology (ICET)
- University of the Punjab
- Lahore 54000
- Pakistan
| | - A. Saeed
- Department of Chemistry
- Quaid-i-Azam University
- Islamabad 45320
- Pakistan
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Rafiq A, Imran M, Aqeel M, Naz M, Ikram M, Ali S. Correction to: Study of Transition Metal Ion Doped CdS Nanoparticles for Removal of Dye from Textile Wastewater. J Inorg Organomet Polym Mater 2019. [DOI: 10.1007/s10904-019-01374-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aqeel M, Uysal-Biggs N, Fenske TS, Rao N. One Pulmonary Lesion, 2 Synchronous Malignancies. J Investig Med High Impact Case Rep 2018; 6:2324709618785934. [PMID: 30083559 PMCID: PMC6062774 DOI: 10.1177/2324709618785934] [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: 02/17/2018] [Revised: 05/28/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction. Mantle cell lymphoma (MCL) comprises approximately 3% to 10% of all non-Hodgkin lymphomas. Although there is an increased risk for secondary malignancies after treatment among non-Hodgkin lymphomas survivors, a synchronous diagnosis of primary lung cancer arising in conjunction with lymphoma at the same site has rarely been reported. We report an unusual case of primary lung adenocarcinoma with coexistent MCL within the same lung lesion. Case Presentation. A 55-year-old female with newly diagnosed stage IV-B MCL was referred for workup of a right upper lobe cavitary lesion detected during lymphoma staging. A whole-body positron-emission tomography-computed tomography scan revealed diffuse adenopathy but also identified a cavitary right upper lobe lesion atypical for lymphoma. Bronchoscopy was unremarkable with cytology (on lavage) negative for malignancy. At 2 months, a computed tomography scan of the chest showed a persistent lesion. A video-assisted thoracoscopic wedge resection was performed. Histopathological examination revealed a lepidic predominant, well-differentiated adenocarcinoma (stage T1a) and foci of lymphoid infiltrate within and adjacent to the adenocarcinoma consistent with lung involvement by MCL. Discussion. Synchronous presentation of primary lung adenocarcinoma and lymphoma at a single site is exceedingly rare. Nonresolving pulmonary lesions with features atypical for lymphoma should be viewed with caution and worked up comprehensively to rule out occult second malignancies, in order to guide a prompt diagnosis and appropriate treatment.
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Hussain T, Musthafa M, Babar M, Khan W, Ullah Z, Aqeel M, Yaqub A, Marikar F. Analysis of molecular genetic diversity of endangered Punjab urial (Ovis vignei punjabiensis) based on interleukin 2 gene sequences. BJVM 2018. [DOI: 10.15547/bjvm.1076] [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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12
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Aqeel M, Ahmad S, Patel JJ, Rice TW. Immunonutrition in Acute Respiratory Distress Syndrome. Curr Pulmonol Rep 2017. [DOI: 10.1007/s13665-017-0171-2] [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: 10/19/2022]
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13
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Aqeel M, Batdorf B, Olteanu H, Patel JJ. An Unusual Suspect Causing Hypoxemic Respiratory Failure. J Investig Med High Impact Case Rep 2017; 5:2324709616687587. [PMID: 28210638 PMCID: PMC5298528 DOI: 10.1177/2324709616687587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 12/08/2016] [Accepted: 12/11/2016] [Indexed: 01/15/2023] Open
Abstract
Introduction: Antisynthetase syndrome (ASS) is characterized by the presence of anti-Jo-1 antibodies in conjunction with clinical findings of fever, polymyositis-dermatomyositis, and interstitial lung disease (ILD). Inflammatory myopathies carry a high risk of malignancy, but this association is less well outlined in ASS. We present the case of a patient with ASS who developed non-Hodgkin's lymphoma with acute hypoxemic respiratory failure. Case Presentation: A 44-year-old female with ASS presented with acute hypoxemic respiratory failure. She was empirically treated with broad-spectrum antibiotics for a health care-associated pneumonia; however, she failed to improve. Chest computed tomography revealed extensive bilateral ground glass opacities as well as extensive mediastinal and axillary lymphadenopathy. Infectious workup was negative. A surgical lung biopsy revealed peripheral T-cell lymphoma (PTCL). The patient was started on chemotherapy with complete resolution of hypoxemic respiratory failure. Conclusions: Malignancy is very rare in the setting of ASS; and our case illustrates the unique presentation of PTCL in ASS. In addition, lung involvement in PTCL is variable (incidence ranging from 8% to 20%); and in this case, bilateral multifocal consolidation was biopsied and proven to be PTCL involving the lungs. This case highlights the rare noninfectious conditions that can present as acute hypoxemic respiratory failure in the setting of ASS.
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Qureshi MZA, Rubbab Q, Irshad S, Ahmad S, Aqeel M. Heat and Mass Transfer Analysis of MHD Nanofluid Flow with Radiative Heat Effects in the Presence of Spherical Au-Metallic Nanoparticles. Nanoscale Res Lett 2016; 11:472. [PMID: 27778306 PMCID: PMC5078136 DOI: 10.1186/s11671-016-1692-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/15/2016] [Indexed: 06/06/2023]
Abstract
Energy generation is currently a serious concern in the progress of human civilization. In this regard, solar energy is considered as a significant source of renewable energy. The purpose of the study is to establish a thermal energy model in the presence of spherical Au-metallic nanoparticles. It is numerical work which studies unsteady magnetohydrodynamic (MHD) nanofluid flow through porous disks with heat and mass transfer aspects. Shaped factor of nanoparticles is investigated using small values of the permeable Reynolds number. In order to scrutinize variation of thermal radiation effects, a dimensionless Brinkman number is introduced. The results point out that heat transfer significantly escalates with the increase of Brinkman number. Partial differential equations that govern this study are reduced into nonlinear ordinary differential equations by means of similarity transformations. Then using a shooting technique, a numerical solution of these equations is constructed. Radiative effects on temperature and mass concentration are quite opposite. Heat transfer increases in the presence of spherical Au-metallic nanoparticles.
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Affiliation(s)
| | - Qammar Rubbab
- Department of Computer Science, Air University, Multan Campus, Islamabad, Pakistan
| | - Saadia Irshad
- Department of Management Sciences, Air University, Multan Campus, Islamabad, Pakistan
| | - Salman Ahmad
- Department of Applied Mathematics and Statistics, Institute of Space Technology, Islamabad, Pakistan
| | - M. Aqeel
- Department of Applied Mathematics and Statistics, Institute of Space Technology, Islamabad, Pakistan
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15
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Aqeel M, Patel J. An Unusual Suspect: Hypoxemic Respiratory Failure in Antisynthetase Syndrome. Chest 2015. [DOI: 10.1378/chest.2261044] [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: 11/01/2022] Open
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16
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Aqeel M, Uysal-Biggs N, Fenske T. Coexistent Primary Lung Adenocarcinoma and Mantle Cell Lymphoma: A Case Report. Chest 2015. [DOI: 10.1378/chest.2281272] [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: 11/01/2022] Open
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17
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Hasan Z, Salahuddin N, Rao N, Aqeel M, Mahmood F, Ali F, Ashraf M, Rahman F, Mahmood S, Islam M, Dildar B, Anwer T, Oiighor F, Sharif N, Ullah AR. Change in serum CXCL10 levels during anti-tuberculosis treatment depends on vitamin D status [Short Communication]. Int J Tuberc Lung Dis 2014; 18:466-9. [PMID: 24670704 DOI: 10.5588/ijtld.13.0460] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Serum levels of the inflammatory C-X-C motif chemokine 10 (CXCL10) are raised in tuberculosis (TB). CXCL10 gene expression is downregulated in monocytes by metabolically active vitamin D3 (1,25dihydroxy vitamin D). Stratification of patients by serum 25hydroxyvitamin D (25[OH]D) levels at baseline showed that treatment-induced decrease in CXCL10 occurred in those with 'insufficient' and 'deficient' but not in those with 'optimal' levels. In the deficient group, 25(OH)D showed an inverse correlation with CXCL10 levels. CXCL10 may thus be a useful biomarker for the follow-up of response to treatment. However, CXCL10 levels should be interpreted taking into account the baseline serum vitamin D levels of the TB patients.
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Affiliation(s)
- Z Hasan
- Department of Pathology and Microbiology, the Aga Khan University, Karachi, Pakistan
| | - N Salahuddin
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - N Rao
- Ojha Institute for Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - M Aqeel
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - F Mahmood
- Department of Medicine, the Aga Khan University, Karachi, pakistan
| | - F Ali
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - M Ashraf
- Department of Pathology and Microbiology, the Aga Khan University, Karachi, Pakistan
| | - F Rahman
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - S Mahmood
- Department of Pathology and Microbiology, the Aga Khan University, Karachi, Pakistan
| | - M Islam
- Department of Pathology and Microbiology, the Aga Khan University, Karachi, Pakistan
| | - B Dildar
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - T Anwer
- Ojha Institute for Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan
| | - F Oiighor
- Department of Medicine, the Aga Khan University, Karachi, pakistan
| | - N Sharif
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
| | - A R Ullah
- Department of Medicine, the Aga Khan University, Karachi, Pakistan
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Salahuddin N, Ali F, Hasan Z, Rao N, Aqeel M, Mahmood F. Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis'. BMC Infect Dis 2013; 13:22. [PMID: 23331510 PMCID: PMC3556334 DOI: 10.1186/1471-2334-13-22] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 01/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin D supplementation to patients with tuberculosis (TB) could influence recovery. METHODS Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood stimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables at 0 and 12 weeks were performed using Student's t-test and Chi2 tests. RESULTS After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain (kg)+3.75, (3.16-4.34) versus+2.61 (95% CI 1.99-3.23) p 0.009 and lesser residual disease by chest radiograph; number of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79) and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline 'Deficient' 25-hydroxyvitamin D serum levels (p 0.021). CONCLUSIONS Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all TB patients and increased host immune activation in patients with baseline 'Deficient' serum vitamin D levels. These results suggest a therapeutic role for vitamin D in the treatment of TB. TRIAL REGISTRATION ClinicalTrials.gov; No. NCT01130311; URL: clinicaltrials.gov.
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Affiliation(s)
- Nawal Salahuddin
- Department of Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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Salahuddin N, Ali F, Hasan Z, Rao N, Aqeel M, Mahmood F. Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis'. BMC Infect Dis 2013. [PMID: 23331510 DOI: 10.1186/1471-2334-13-22]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin D supplementation to patients with tuberculosis (TB) could influence recovery. METHODS Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood stimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables at 0 and 12 weeks were performed using Student's t-test and Chi2 tests. RESULTS After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain (kg)+3.75, (3.16-4.34) versus+2.61 (95% CI 1.99-3.23) p 0.009 and lesser residual disease by chest radiograph; number of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79) and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline 'Deficient' 25-hydroxyvitamin D serum levels (p 0.021). CONCLUSIONS Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all TB patients and increased host immune activation in patients with baseline 'Deficient' serum vitamin D levels. These results suggest a therapeutic role for vitamin D in the treatment of TB. TRIAL REGISTRATION ClinicalTrials.gov; No. NCT01130311; URL: clinicaltrials.gov.
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Affiliation(s)
- Nawal Salahuddin
- Department of Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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Aqeel M, Shafquat A, Salahuddin N. Pacemaker patients' perception of unsafe activities: a survey. BMC Cardiovasc Disord 2008; 8:31. [PMID: 19014563 PMCID: PMC2600817 DOI: 10.1186/1471-2261-8-31] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 11/14/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. METHODS A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. RESULTS The final sample included 93 adult patients (45% males). 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%), passing through metal detectors (31%), bending over (37%), and sleeping on the side of the pacemaker (30%). Also considered unsafe were operation of household appliances--TV/VCR (television/video cassette recorders) (53%), irons (55%)) and electrical wall switches (56%). For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. CONCLUSION This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these problems also exist in, and hinder, other patient populations.
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Affiliation(s)
- Masooma Aqeel
- Department of Medicine, The Aga Khan University Hospital, Stadium Road, Karachi, Pakistan.
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