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Gewirtz-Meydan A, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako R, Fernandez DP, Fujiwara H, Fernandez EF, Fuss J, Gabrhelík R, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lin CY, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, De Tubino Scanavino M, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strong C, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B. Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries. Public Health 2024; 229:13-23. [PMID: 38382177 DOI: 10.1016/j.puhe.2023.12.031] [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: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVES This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. STUDY DESIGN The study design is a cross-sectional self-report study conducted across 42 countries. METHODS A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. RESULTS The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. CONCLUSIONS The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.
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Affiliation(s)
- A Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. Agewirtz-@univ.haifa.ac.il
| | - M Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Forensic Psychiatry and Sex Research, University of Duisburg-Essen, Essen, Germany
| | - L Nagy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - S W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - M N Potenza
- Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - R Ballester-Arnal
- Departmento de Psicología Básica, Clínica y Psicobiología, University Jaume I of Castellón, Spain
| | - D Batthyány
- Institute for Behavioural Addictions, Sigmund Freud University Vienna, Austria
| | - S Bergeron
- Département de Psychologie, Université de Montréal, Montréal, Canada
| | - J Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - G Cárdenas-López
- Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico
| | - J Carvalho
- William James Center for Research, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
| | - J Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - L Chen
- Department of Psychology, College of Humanity and Social Science, Fuzhou University, China
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - O Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, UK; Department of Psychology and Cognitive Science, University of Trento, Italy
| | - R Csako
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | | | - H Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | | | - J Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - R Gabrhelík
- Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; General University Hospital in Prague, Department of Addictology, Czech Republic
| | - B Gjoneska
- Macedonian Academy of Sciences and Arts, Macedonia
| | - M Gola
- Institute of Psychlogy, Polish Academy of Sciences, Poland; Institute for Neural Computations, University of California San Diego, USA
| | - J B Grubbs
- University of New Mexico, Albuquerque, USA; Center for Alcohol, Substance Use, And Addiction (CASAA), University of New Mexico, Albuquerque, USA
| | - H T Hashim
- University of Baghdad, College of Medicine, Iraq
| | - M S Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; Centre for Advanced Research Excellence in Public Health, Savar, Dhaka 1342, Bangladesh
| | - M Ismail
- University of Baghdad, College of Medicine, Iraq
| | - M C Jiménez-Martínez
- Universidad Pedagógca y Tecnológica de Colombia, Colombia; Grupo de Investigación Biomédica y de Patología, Colombia
| | - T Jurin
- Department of Psychology, Humanities and Social Sciences, University of Zagreb, Croatia
| | - O Kalina
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Slovakia
| | - V Klein
- School of Psychology, University of Southampton, UK
| | - A Költő
- Health Promotion Research Centre, University of Galway, Ireland, UK
| | - S-K Lee
- Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, South Korea; Chuncheon Addiction Management Center, South Korea
| | - K Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - C-Y Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch University, South Africa
| | | | - K Lukavská
- Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; Charles University, Faculty of Education, Department of Psychology, Prague, Czech Republic
| | - P Mayta-Tristán
- Facultad de Medicina, Universidad Científica del Sur, Lima, Peru
| | - D J Miller
- College of Healthcare Sciences, James Cook University, Australia
| | - O Orosová
- Pavol Jozef Safarik University in Kosice, Department of Educational Psychology and Psychology of Health, Slovakia
| | | | - F P Ponce
- Facultad de Psicología, Universidad de Talca, Chile
| | - G R Quintana
- Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
| | - G C Quintero Garzola
- Florida State University, Panama; Sistema Nacional de Investigación (SNI), SENACYT, Panama
| | - J Ramos-Diaz
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
| | | | - A Rousseau
- Leuven School for Mass Communication, KU Leuven, Leuven, Belgium
| | - M De Tubino Scanavino
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, Brazil; Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | | | - P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S Shoib
- Department of Psychology, Shardha University, India; Department of Health Kashmir, India
| | - V Sigre-Leirós
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - L Sniewski
- Auckland University of Technology, New Zealand
| | - O Spasovski
- Faculty of Philosophy, Ss. Cyril and Methodius University in Skopje, Macedonia; Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Slovakia
| | - V Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - D J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - C Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - B C Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - M-P Vaillancourt-Morel
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - M C Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, UK
| | - B Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada; Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Abboud Y, Shah M, Simmons B, Mandava K, Morales JEM, Jaber F, Alsakarneh S, Ismail M, Hajifathalian K. Hypertriglyceridemia-induced acute necrotizing pancreatitis: Poor clinical outcomes requiring revisiting management modalities. JGH Open 2024; 8:e13061. [PMID: 38617108 PMCID: PMC11015164 DOI: 10.1002/jgh3.13061] [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] [Received: 12/14/2023] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is the third most common cause of AP after gallstones and alcohol. Supportive measures, intravenous insulin, and plasmapheresis are possible treatment modalities for HTG-AP; however, definitive guidelines evaluating the best therapeutic approach are not clearly established. We present a rare case of a 42-year-old male without known comorbidities who was found to have HTG-AP. Despite early initiation of intravenous insulin and plasmapheresis and the initial decline in his triglycerides level, his condition was complicated by necrotizing pancreatitis and subsequent multi-organ failure. Future studies are warranted to evaluate the role of plasmapheresis in HTG-AP and its efficacy.
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Affiliation(s)
- Yazan Abboud
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Meet Shah
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Benjamin Simmons
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Kranthi Mandava
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - John E M Morales
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Fouad Jaber
- Department of Internal MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Saqer Alsakarneh
- Department of Internal MedicineUniversity of Missouri‐Kansas CityKansas CityMissouriUSA
| | - Mohamed Ismail
- Department of Internal MedicineRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Kaveh Hajifathalian
- Division of Gastroenterology and HepatologyRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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3
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Ismail M, Singh S, Elaskandrany MA, Kim DS, Abboud Y, Bebawy M, Oduro A, Goyal RM, Mohamed O, Wang W. Fibrolamellar Hepatocellular Carcinoma (FLHCC) in a Young Patient Presenting With Nausea and Vomiting After a Greasy Meal. Cureus 2024; 16:e55863. [PMID: 38595871 PMCID: PMC11002470 DOI: 10.7759/cureus.55863] [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: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare and distinct subtype of liver cancer, predominantly affecting younger patients without underlying liver diseases. This case report discusses a unique presentation of FLHCC in a 38-year-old male with a past medical history of a well-controlled seizure disorder. The patient presented with nausea, vomiting, and abdominal pain following a fatty meal. Laboratory tests revealed elevated liver enzymes and anemia, and imaging showed a large hepatic lesion. Initial management included a septic workup and broad-spectrum antibiotics. However, a liver biopsy performed subsequently revealed the presence of FLHCC. The patient underwent a successful open right hepatectomy and was managed postoperatively with consideration of his seizure disorder. Follow-up at six months showed a stable postoperative condition without any evidence of recurrence. The diagnosis of FLHCC is challenging due to its rarity and nonspecific presentation. The case emphasizes the importance of considering FLHCC in the differential diagnosis of hepatic lesions, particularly in young patients. Surgical resection remains the primary treatment modality. This case underscores the importance of a thorough evaluation of hepatic lesions, especially in younger patients. It also illustrates the complexities in managing patients with FLHCC, requiring a multidisciplinary approach for optimal outcomes. Further research is necessary to better understand the pathogenesis of FLHCC and to develop more effective treatment strategies.
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Affiliation(s)
- Mohamed Ismail
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Sahiba Singh
- College of Osteopathic Medicine, Michigan State University, East Lansing, USA
| | | | - David S Kim
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Yazan Abboud
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Michael Bebawy
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Abena Oduro
- Department of Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Ritik Mahaveer Goyal
- Department of Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Omar Mohamed
- Department of Medicine, Saint Barnabas Medical Center, Livingston, USA
| | - Weizheng Wang
- Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA
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4
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De Souza LM, Ismail M, Elaskandrany MA, Fratella-Calabrese A, Grossman IR. Primary Hepatic EBV-DLBCL Lymphoma in the Setting of COVID-19 Infection. ACG Case Rep J 2024; 11:e01276. [PMID: 38328768 PMCID: PMC10849344 DOI: 10.14309/crj.0000000000001276] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
This case study describes an instance of primary hepatic diffuse large B cell lymphoma (DLBCL) in a patient who had prolonged coronavirus disease 2019 (COVID-19). DLBCL rarely presents as a primary hepatic mass. The 53-year-old man sought emergency care because of fatigue and weight loss. Diagnostic tests showed mildly elevated liver enzymes and imaging pointed to several low-density liver lesions. A liver biopsy paired with immunohistochemical testing verified the DLBCL diagnosis. Notably, the patient had COVID-19 4 months before the liver-related symptoms. The link between COVID-19 and the emergence of solid tumor cancers is unclear, but this case underscores its potential significance and the need for further research. This report stresses the importance of recognizing and documenting instances where COVID-19 might influence the onset of solid tumor cancers, including primary hepatic DLBCL.
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Affiliation(s)
- Luisa Maria De Souza
- Department of Internal Medicine, Rutgers New Jersey Medical School University Hospital, Newark, NJ
| | - Mohamed Ismail
- Department of Internal Medicine, Rutgers New Jersey Medical School University Hospital, Newark, NJ
| | | | | | - I. Robert Grossman
- Department of Hematology and Oncology, Saint Barnabas Medical Center, NJ
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5
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Ismail M, Goyal R, Elaskandrany MAA, Bebawy M, Singh S, Ruane C, Wang W. Atypical Clostridium difficile Infection in a Pregnant Patient: A Case Study on Non-Diarrheal Presentation and Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Complication. Cureus 2024; 16:e53449. [PMID: 38435144 PMCID: PMC10909384 DOI: 10.7759/cureus.53449] [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: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Clostridium difficile (C. difficile) is a Gram-positive, spore-producing bacterium that often leads to pseudomembranous colitis, typically manifesting as watery diarrhea. The risk factors for C. difficile infection (CDI) include exposure to broad-spectrum antibiotics, immunocompromised states, advanced age, usage of proton pump inhibitors (PPI), and comorbid conditions such as chronic kidney disease (CKD). This report details a case involving a 23-year-old pregnant woman who presented with symptoms of abdominal pain and constipation. She was diagnosed with a urinary tract infection (UTI) and treated with ceftriaxone. During her hospitalization, she was administered opioid pain relievers and underwent an intensive bowel regimen. Despite these measures, her constipation and abdominal discomfort persisted, and magnetic resonance imaging (MRI) of the abdomen revealed significant dilatation of the large bowel. The patient, discovered to have hyponatremia, underwent further evaluation. This revealed elevated urine osmolality and decreased blood plasma osmolality, indicative of a syndrome of inappropriate antidiuretic hormone secretion (SIADH). The patient received treatment with hypertonic saline. Later in her hospital stay, she tested positive for CDI through stool analysis and was treated with oral vancomycin. This case underscores the importance of considering CDI as a differential diagnosis in cases of ileus, abdominal pain, and constipation, especially in patients with notable risk factors for CDI. It highlights that the presence of diarrhea or watery bowel movements is not a necessary symptom for CDI testing.
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Affiliation(s)
- Mohamed Ismail
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Ritik Goyal
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | | | - Michael Bebawy
- Department of Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Sahiba Singh
- Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, USA
| | - Claire Ruane
- Department of Internal Medicine and Pediatrics, Rutgers University New Jersey Medical School, Newark, USA
| | - Weizheng Wang
- Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA
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6
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Abratenko P, Alterkait O, Andrade Aldana D, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow D, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Brunetti MB, Camilleri L, Cao Y, Caratelli D, Cavanna F, Cerati G, Chappell A, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Cross R, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Englezos P, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Franco D, Furmanski AP, Gao F, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Gramellini E, Green P, Greenlee H, Gu L, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Imani Z, Irwin B, Ismail M, James C, Ji X, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Liu H, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Martynenko S, Mastbaum A, Mawby I, McConkey N, Meddage V, Micallef J, Miller K, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Moudgalya MM, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Pophale I, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Safa I, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector. Phys Rev Lett 2024; 132:041801. [PMID: 38335355 DOI: 10.1103/physrevlett.132.041801] [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] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150 MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245 MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35
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Affiliation(s)
- P Abratenko
- Tufts University, Medford, Massachusetts 02155, USA
| | - O Alterkait
- Tufts University, Medford, Massachusetts 02155, USA
| | - D Andrade Aldana
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - L Arellano
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Asaadi
- University of Texas, Arlington, Texas 76019, USA
| | - A Ashkenazi
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - S Balasubramanian
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - B Baller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Barr
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - D Barrow
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - J Barrow
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - V Basque
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | | | - S Berkman
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Michigan State University, East Lansing, Michigan 48824, USA
| | - A Bhanderi
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Bhat
- University of Chicago, Chicago, Illinois 60637, USA
| | - M Bhattacharya
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Bishai
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Blake
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - B Bogart
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - T Bolton
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Y Book
- Harvard University, Cambridge, Massachusetts 02138, USA
| | - M B Brunetti
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - L Camilleri
- Columbia University, New York, New York 10027, USA
| | - Y Cao
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Caratelli
- University of California, Santa Barbara, California 93106, USA
| | - F Cavanna
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Cerati
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A Chappell
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Y Chen
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J M Conrad
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - M Convery
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | | | - J I Crespo-Anadón
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
| | - R Cross
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - M Del Tutto
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - S R Dennis
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - P Detje
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - A Devitt
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - R Diurba
- Universität Bern, Bern CH-3012, Switzerland
| | - Z Djurcic
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - R Dorrill
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - K Duffy
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - S Dytman
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - B Eberly
- University of Southern Maine, Portland, Maine 04104, USA
| | - P Englezos
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - A Ereditato
- University of Chicago, Chicago, Illinois 60637, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J J Evans
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Fine
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - O G Finnerud
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Foreman
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - B T Fleming
- University of Chicago, Chicago, Illinois 60637, USA
| | - D Franco
- University of Chicago, Chicago, Illinois 60637, USA
| | - A P Furmanski
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - F Gao
- University of California, Santa Barbara, California 93106, USA
| | | | - S Gardiner
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - G Ge
- Columbia University, New York, New York 10027, USA
| | - S Gollapinni
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - E Gramellini
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Green
- University of Oxford, Oxford OX1 3RH, United Kingdom
| | - H Greenlee
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Gu
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - W Gu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R Guenette
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Guzowski
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Hagaman
- University of Chicago, Chicago, Illinois 60637, USA
| | - O Hen
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - C Hilgenberg
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | | | - Z Imani
- Tufts University, Medford, Massachusetts 02155, USA
| | - B Irwin
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M Ismail
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - C James
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - X Ji
- Nankai University, Nankai District, Tianjin 300071, China
| | - J H Jo
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - R A Johnson
- University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - Y-J Jwa
- Columbia University, New York, New York 10027, USA
| | - D Kalra
- Columbia University, New York, New York 10027, USA
| | - N Kamp
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
| | - G Karagiorgi
- Columbia University, New York, New York 10027, USA
| | - W Ketchum
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Kirby
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Kobilarcik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - I Kreslo
- Universität Bern, Bern CH-3012, Switzerland
| | - M B Leibovitch
- University of California, Santa Barbara, California 93106, USA
| | - I Lepetic
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - J-Y Li
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - K Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Li
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - K Lin
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - B R Littlejohn
- Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
| | - H Liu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - W C Louis
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | - X Luo
- University of California, Santa Barbara, California 93106, USA
| | - C Mariani
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Viriginia 24061, USA
| | - D Marsden
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Marshall
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N Martinez
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - D A Martinez Caicedo
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - S Martynenko
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Mastbaum
- Rutgers University, Piscataway, New Jersey 08854, USA
| | - I Mawby
- University of Warwick, Coventry CV4 7AL, United Kingdom
| | - N McConkey
- University College London, London WC1E 6BT, United Kingdom
| | - V Meddage
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - J Micallef
- Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
- Tufts University, Medford, Massachusetts 02155, USA
| | - K Miller
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Mogan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Mohayai
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
- Indiana University, Bloomington, Indiana 47405, USA
| | - M Mooney
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - A F Moor
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - C D Moore
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L Mora Lepin
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M M Moudgalya
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | | | - D Naples
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Navrer-Agasson
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - N Nayak
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Nebot-Guinot
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - J Nowak
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - N Oza
- Columbia University, New York, New York 10027, USA
| | - O Palamara
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - N Pallat
- University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Paolone
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A Papadopoulou
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - V Papavassiliou
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - H B Parkinson
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - S F Pate
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - N Patel
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Z Pavlovic
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - E Piasetzky
- Tel Aviv University, Tel Aviv, Israel, 69978
| | - I Pophale
- Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - X Qian
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - J L Raaf
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - V Radeka
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - A Rafique
- Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
| | - M Reggiani-Guzzo
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Ren
- New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
| | - L Rochester
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Rodriguez Rondon
- South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
| | - M Rosenberg
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Ross-Lonergan
- Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
| | | | - I Safa
- Columbia University, New York, New York 10027, USA
| | - G Scanavini
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D W Schmitz
- University of Chicago, Chicago, Illinois 60637, USA
| | - A Schukraft
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - W Seligman
- Columbia University, New York, New York 10027, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - R Sharankova
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Shi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - E L Snider
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - M Soderberg
- Syracuse University, Syracuse, New York 13244, USA
| | | | - J Spitz
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - M Stancari
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J St John
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Strauss
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - W Tang
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - N Taniuchi
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - K Terao
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - C Thorpe
- Lancaster University, Lancaster LA1 4YW, United Kingdom
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Torbunov
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - D Totani
- University of California, Santa Barbara, California 93106, USA
| | - M Toups
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - J Tyler
- Kansas State University (KSU), Manhattan, Kansas 66506, USA
| | - M A Uchida
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - T Usher
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Viren
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - M Weber
- Universität Bern, Bern CH-3012, Switzerland
| | - H Wei
- Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - A J White
- University of Chicago, Chicago, Illinois 60637, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - T Wongjirad
- Tufts University, Medford, Massachusetts 02155, USA
| | - M Wospakrik
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - K Wresilo
- University of Cambridge, Cambridge CB3 0HE, United Kingdom
| | - W Wu
- University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - E Yandel
- University of California, Santa Barbara, California 93106, USA
| | - T Yang
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - L E Yates
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - H W Yu
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
| | - G P Zeller
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - J Zennamo
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
| | - C Zhang
- Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
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Ismail M, Elaskandrany MA, Singh S, Chmielewska N, Wang W. A Novel Case of a Massive Amebic Liver Abscess in the Setting of Uncontrolled Diabetes Mellitus and Concurrent Pulmonary Embolism. Cureus 2024; 16:e52533. [PMID: 38371135 PMCID: PMC10874467 DOI: 10.7759/cureus.52533] [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: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Amebic liver abscesses (ALAs), one of the most common extraintestinal manifestations of invasive amebiasis, pose diagnostic challenges due to their various clinical presentations and difficulty in distinguishing them from pyogenic abscesses. This case presentation highlights the intricacy of determining the source of an unusually large liver abscess that had an even rare occurrence of a coinciding pulmonary embolus without any evidence of a deep vein thrombosis. This unusual combination underscores the challenges in identifying and managing atypical cases of ALA and emphasizes the need for more comprehensive data to enhance our understanding of such occurrences.
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Affiliation(s)
- Mohamed Ismail
- Department of Internal Medicine, New Jersey Medical School, Rutgers University, Newark, USA
| | | | - Sahiba Singh
- College of Osteopathic Medicine, Michigan State University, East Lansing, USA
| | - Natalia Chmielewska
- Department of Internal Medicine, New Jersey Medical School, Rutgers University, Newark, USA
| | - Weizheng Wang
- Department of Gastroenterology and Hepatology, New Jersey Medical School, Rutgers University, Newark, USA
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Hayat F, Ismail M, Alqhtani MM, Almayman T, Sardar N, Ismaeel A, AlJohani M, Alruwaili RS. Dandy-Walker Syndrome: Delayed Acute Presentation With Unusual Symptoms. Cureus 2023; 15:e50262. [PMID: 38196410 PMCID: PMC10774835 DOI: 10.7759/cureus.50262] [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: 12/10/2023] [Indexed: 01/11/2024] Open
Abstract
Dandy-Walker syndrome (DWS) is a rare congenital brain malformation defined by the presence of an expanded posterior fossa, full or partial absence of the cerebellar vermis, and a cystic expansion of the fourth ventricle. We report an 18-month-old girl with DWS presenting with atypical clinical manifestations and unusual symptoms. She initially presented with persistent vomiting and abdominal pain for four days, not responding to antiemetic medication. In addition, she was found to have abnormal postural arching of the back, extension of the lower limbs, and neck extension. MRI and CT head suggested Dandy-Walker syndrome with hydrocephalus (the lateral ventricle, third ventricle, and fourth ventricle are all significantly dilated with evidence of trans-ependymal cerebrospinal fluid permeation, severe compression anterior displacement of the brain stem). The patient underwent urgent, lifesaving right sub-occipital craniotomy, evacuation, and decompression of the posterior fossa cyst and external ventricular drain (EVD) insertion along with left supra-tentorial EVD insertion. A series of brain magnetic imaging and CT brain post-procedure studies showed a significant reduction in the size of the ventricular system and mass effect on the brain stem.
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Affiliation(s)
- Fakhar Hayat
- Neurosurgery, King Hamad University Hospital, Busaiteen, BHR
| | - Mohamed Ismail
- Neurological Surgery, King Hamad University Hospital, Busaiteen, BHR
| | | | - Talal Almayman
- Neurosurgery, King Hamad University Hospital, Busaiteen, BHR
| | - Noor Sardar
- Internal Medicine, Divisional Headquarter (DHQ) Teaching Hospital, Dera Ismail Khan, PAK
| | | | | | - Rayan S Alruwaili
- General Surgery, Hafar Al-Batin Central Hospital, Hafar Al-Batin, SAU
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Ismail M, Parikh N, Zhai M, Elaskandrany MA, Wang W. Levofloxacin-Induced Hepatotoxicity in Patients With Legionnaires' Disease: Implications and Management. Cureus 2023; 15:e51248. [PMID: 38283526 PMCID: PMC10821815 DOI: 10.7759/cureus.51248] [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: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Legionnaires' disease (LD), caused by the Legionella bacterium, primarily manifests as pneumonia and could result in a spectrum of clinical severity. As treatment necessitates the use of antibiotics, levofloxacin, a fluoroquinolone, is a commonly preferred option due to its broad-spectrum activity. However, the potential side effects of levofloxacin, including rare instances of hepatotoxicity, introduce a therapeutic challenge. This case report explores the association between levofloxacin and hepatotoxicity and its implications for treating LD.
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Affiliation(s)
- Mohamed Ismail
- Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Nishi Parikh
- Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | - Merry Zhai
- Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA
| | | | - Weizheng Wang
- Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA
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Medina-Morales E, Ismail M, Barba Bernal R, Abboud Y, Sierra L, Marenco-Flores A, Goyes D, Saberi B, Patwardhan V, Bonder A. Two Decades of Liver Transplants for Primary Biliary Cholangitis: A Comparative Study of Living Donors vs. Deceased Donor Liver Transplantations. J Clin Med 2023; 12:6536. [PMID: 37892674 PMCID: PMC10607081 DOI: 10.3390/jcm12206536] [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: 09/11/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Primary biliary cholangitis (PBC) prompts liver transplantation (LT) due to cholestasis, cirrhosis, and liver failure. Despite lower MELD scores, recent studies highlight higher PBC waitlist mortality, intensifying the need for alternative transplantation strategies. Living donor liver transplant (LDLT) has emerged as a solution to the organ shortage. This study compares LDLT and deceased donor liver transplant (DDLT) outcomes in PBC patients via retrospective analysis of the UNOS database (2002-2021). Patient survival, graft failure, and predictors were evaluated through Kaplan-Meier and Cox-proportional analyses. Among 3482 DDLTs and 468 LDLTs, LDLT showed superior patient survival (92.3%, 89.1%, 87.6%, 85.0%, 77.2% vs. 91.5%, 88.3%, 86.3%, 82.2%, 71.0%; respectively; p = 0.02) with no significant graft survival difference at 1-, 2-, 3-, 5-, and 10-years post-LT (91.0%, 88.0%, 85.7%, 83.0%, 75.4% vs. 90.5%, 87.4%, 85.3%, 81.3%, 70.0%; respectively; p = 0.06). Compared to DCD, LDLT showed superior patient and graft survival (p < 0.05). Younger male PBC recipients with a high BMI, diabetes, and dialysis history were associated with mortality and graft failure (p < 0.05). Our study showed that LDLT had superior patient survival to DDLT. Predictors of poor post-LT outcomes require further validation studies.
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Affiliation(s)
- Esli Medina-Morales
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (E.M.-M.); (M.I.); (Y.A.)
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
| | - Mohamed Ismail
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (E.M.-M.); (M.I.); (Y.A.)
| | - Romelia Barba Bernal
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Yazan Abboud
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (E.M.-M.); (M.I.); (Y.A.)
| | - Leandro Sierra
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
| | - Ana Marenco-Flores
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
| | - Daniela Goyes
- Section of Digestive Diseases, Yale School of Medicine, New Haven, CT 06510, USA;
| | - Behnam Saberi
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
| | - Vilas Patwardhan
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
| | - Alan Bonder
- Division of Gastroenterology, Hepatology and Nutrition, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.B.B.); (L.S.); (A.M.-F.); (B.S.)
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11
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Ismail M, Doelger E, Eckert D, Irvine AD, Chu AD, Teixeira HD, Liu W, Nader A. Population pharmacokinetic and exposure-response modelling to inform upadacitinib dose selection in adolescent and adult patients with atopic dermatitis. Br J Clin Pharmacol 2023; 89:3139-3151. [PMID: 37232215 DOI: 10.1111/bcp.15803] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/07/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
AIMS First, population pharmacokinetic analyses were used to characterize upadacitinib pharmacokinetics in adolescent and adult participants with atopic dermatitis (AD) and to identify patient covariates that may impact upadacitinib pharmacokinetics. Second, the exposure-response relationship for upadacitinib with efficacy and safety endpoints, and the effect of age and concomitant use of topical corticosteroids (TCS) on the exposure-response relationship and dose selection for patients with AD were evaluated. METHODS A two-compartment model with combined first- and zero-order absorption adequately characterized the upadacitinib concentration-time profiles in 911 healthy volunteer adolescent and adult participants with AD who received upadacitinib 15 or 30 mg orally once daily (QD) as monotherapy or in combination with TCS for 16 weeks. Logistic regression models were developed to characterize the exposure-efficacy and safety relationships, and simulations were performed based on final exposure-response models to predict efficacy responses in participants with AD who received placebo or upadacitinib as monotherapy or in combination with TCS. RESULTS Upadacitinib exposures were comparable between adolescents and adults. Mild or moderate renal impairment was predicted to increase the upadacitinib area under the plasma concentration-time curve from time zero to 24 h after dosing (AUC24 ) approximately 12% and 25%, respectively, compared to participants with normal renal function. Female participants were predicted to have 20% higher AUC24 compared to male participants. Participants with AD were predicted to have 18% higher AUC24 compared to healthy participants. Simulated clinical efficacy responses showed added clinical efficacy benefit for all endpoints evaluated (8-14%) with the upadacitinib 30 mg once-daily regimen compared to 15 mg once-daily in both age groups. In participants receiving upadacitinib in combination with TCS, significant exposure-dependent increases in upadacitinib efficacy endpoints were observed. No significant effects of age or weight were identified in any of the exposure-response models. CONCLUSION The results of these analyses support the dose justification for upadacitinib in adult and adolescent patients with moderate to severe AD.
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Affiliation(s)
- Mohamed Ismail
- Clinical Pharmacology, AbbVie Inc., Chicago, Illinois, USA
| | - Eva Doelger
- Clinical Pharmacology, AbbVie Deutschland GmbH & Co KG, Ludwigshafen, Germany
| | - Doerthe Eckert
- Clinical Pharmacology, AbbVie Deutschland GmbH & Co KG, Ludwigshafen, Germany
| | - Alan D Irvine
- Clinical Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
- Wellcome-HRB Clinical Research Facility, St James' Hospital, Dublin, Ireland
| | - Alvina D Chu
- Immunology Clinical Development, AbbVie Inc., Chicago, Illinois, USA
| | | | - Wei Liu
- Clinical Pharmacology, AbbVie Inc., Chicago, Illinois, USA
| | - Ahmed Nader
- Clinical Pharmacology, AbbVie Inc., Chicago, Illinois, USA
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12
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Moore Ude RG, Herring RP, Ismail M, Oda K, Bahjri K, Reis WP, Gaio J, Dos Santos H. Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program. Cureus 2023; 15:e41649. [PMID: 37565122 PMCID: PMC10411653 DOI: 10.7759/cureus.41649] [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: 07/09/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction As the leading cause of preventable chronic diseases in adults 18 years and older, tobacco usage in the U.S. results in over 20 million premature deaths annually. Current smokers might need extra support on the path to successfully quitting. Aim To evaluate the influence of predictors of smoking-on-smoking cessation in the Freedom From Tobacco Program (FFT) offered by Southern California Permanente Medical Group (SCPMG). Methods This was a quasi-experimental study to evaluate rates of smoking cessation among participants in the FFT program. There were 471 participants in the study. Factors of the Social Ecological Model (SEM) and demographics were examined to determine if they could predict tobacco cessation. The SEM suggests that an individual's behavior is integrated into a network of intrapersonal characteristics, interpersonal processes, institutional factors, community features, and public policy. In particular, the study mainly addressed the institutional factor. It was promoted within a Health Management Organization and the interpersonal process because it was a group intervention. Findings After multiple regression analyses with all predictors from the SEM and demographics, the only significant predictor was the number of previous attempts to quit. Smokers who tried to stop four or more times in the past were 2.6 times (p<0.03) more likely to quit than those who tried fewer times. As we are aware, this was the first time this result was found for programs implemented by Health Management Organizations. The general quit rate at 12 months for the FFT program was 43.1%. Conclusion As the only predictor of quitting in this study was the number of previous attempts to quit smoking, the recommendation is to develop longer-term smoking cessation programs or a longer follow-up to facilitate smokers who relapse to go back and try to quit again. Another recommendation is to identify the main reasons for relapse and try to address these factors in further interventions.
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Affiliation(s)
- Regina G Moore Ude
- Health and Human Ecology, California State University, San Bernardino, USA
| | - R Patti Herring
- School of Public Heath, Loma Linda University Medical Center, Loma Linda, USA
| | | | - Keiji Oda
- School of Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Khaled Bahjri
- Clinical Research, New World Medical, Rancho Cucamonga, USA
| | - Wenes P Reis
- Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Josileide Gaio
- Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Hildemar Dos Santos
- Preventive Care, Loma Linda University School of Public Health, Loma Linda, USA
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13
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer K, Torres E, Conrey S, Wang K, Staat MA, Back N, Gomez Marin J, Peyron F, Houze S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. medRxiv 2023:2023.04.26.23289132. [PMID: 37162985 PMCID: PMC10168490 DOI: 10.1101/2023.04.26.23289132] [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: 05/11/2023]
Abstract
Background Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. Methods/ Findings In our ongoing USA feasibility/efficacy clinical trial, data collated with other ongoing and earlier published results proved high performance of an Immunochromatographic-test(ICT) that enables accurate, rapid diagnosis/treatment, establishing new paradigms for care. Overall results from patient blood and/or serum samples tested with ICT compared with gold-standard-predicate-test results found ICT performance for 4606 sera/1876 blood, 99.3%/97.5% sensitive and 98.9%/99.7% specific. However, in the clinical trial the FDA-cleared-predicate test initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO ASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. Conclusions/Significance This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. Author’s Summary Toxoplasmosis is a major health burden for developed and developing countries, causing damage to eyes and brain, loss of life and substantial societal costs. Prompt diagnosis in gestational screening programs enables treatment, thereby relieving suffering, and leading to > 14-fold cost savings for care. Herein, we demonstrate that using an ICT that meets WHO ASSURED-criteria identifying persons with/without antibody to Toxoplasma gondii in sera and whole blood with high sensitivity and specificity, is feasible to use in USA clinical practice. We find this new approach can help to obviate the problem of detection of false positive anti- T.gondii IgM results for those without IgG antibodies to T.gondii when this occurs in present, standard of care, predicate USA FDA cleared available assays. Thus, this accurate test facilitates gestational screening programs and a global initiative to diagnose and thereby prevent and treat T.gondii infection. This minimizes likelihood of false positives (IgG and/or IgM) while maintaining maximum sensitivity. When isolated IgM antibodies are detected, it is necessary to confirm and when indicated continue follow up testing in ∼2 weeks to establish seroconversion. Presence of a positive ICT makes it likely that IgM is truly positive and a negative ICT makes it likely that IgM will be a false positive without infection. These results create a new, enthusiastically-accepted, precise paradigm for rapid diagnosis and validation of results with a second-line test. This helps eliminate alarm and anxiety about false-positive results, while expediting needed treatment for true positive results and providing back up distinguishing false positive tests.
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14
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Ismail M, Gharieb M, Sultan M, Hammad H. Synergetic effect of cement kiln flue dust for enhancing physico-mechanical properties of metakaolin-blended cement. Egypt J Chem 2023. [DOI: 10.21608/ejchem.2023.183762.7391] [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: 03/13/2023]
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15
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Abdel Hamid E, Ismail M, Moussa M, Abdel Aziz M, Sobhy M, Mohamed R, Mohamed Y. Optimization and Characterization of Bio-Silica Extraction from Rice Straw Using RSM. Egypt J Chem 2023. [DOI: 10.21608/ejchem.2023.161205.6968] [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: 03/05/2023]
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16
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Salem MR, Youssef MRL, Shalaby SF, Mahmoud AT, Ismail M, Ibrahim SK. Perspectives on Antibiotic Stewardship Programs among Health Care Providers at Two University Hospitals in Egypt. Int J Environ Res Public Health 2023; 20:3777. [PMID: 36900787 PMCID: PMC10001175 DOI: 10.3390/ijerph20053777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The perspectives of healthcare professionals on antibiotic stewardship programs (ASPs) should be explored. Any antibiotic stewardship strategy must be individualized based on patient needs, prescription habits, and local resources. The current study aimed to explore the perspectives of healthcare providers on antibiotics stewardship and their awareness of these perspectives. Furthermore, potential barriers to the application of ASPs should be identified and addressed. This exploratory cross-sectional study utilized a qualitative method to evaluate critical care physicians, pediatricians, and clinical pharmacists (n = 43). The mean age of the physicians was 32 ± 1.5 years. Among them, approximately two-thirds (66%) were women. A thematic content analysis was performed to examine the responses of the participants and to prioritize the recommendations for and barriers to the implementation of ASPs from the perspective of healthcare providers. According to the interviewees, the primary obstacles include lack of time in implementation and monitoring and lack of awareness of the need for ASPs. All respondents recommended the implementation of supervised and continuous trainings. In conclusion, the abovementioned barriers must be adequately addressed to facilitate the implementation of ASPs.
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Affiliation(s)
- Marwa Rashad Salem
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Manial, Cairo 11559, Egypt
| | | | - Silvia Farouk Shalaby
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Manial, Cairo 11559, Egypt
| | - Ahmed Taher Mahmoud
- Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Manial, Cairo 11559, Egypt
| | - Mohamed Ismail
- Department of Pediatrics, Faculty of Medicine, Cairo University, Manial, Cairo 11559, Egypt
| | - Sally Kamal Ibrahim
- Department of Pediatrics, Faculty of Medicine, Cairo University, Manial, Cairo 11559, Egypt
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17
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Al-Dewik N, Samara M, Younes S, Al-Jurf R, Nasrallah G, Al-Obaidly S, Salama H, Olukade T, Hammuda S, Marlow N, Ismail M, Abu Nada T, Qoronfleh MW, Thomas B, Abdoh G, Abdulrouf PV, Farrell T, Al Qubaisi M, Al Rifai H. Prevalence, predictors, and outcomes of major congenital anomalies: A population-based register study. Sci Rep 2023; 13:2198. [PMID: 36750603 PMCID: PMC9905082 DOI: 10.1038/s41598-023-27935-3] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Congenital anomalies (CAs) are a leading cause of morbidity and mortality in early life. We aimed to assess the incidence, risk factors, and outcomes of major CAs in the State of Qatar. A population-based retrospective data analysis of registry data retrieved from the Perinatal Neonatal Outcomes Research Study in the Arabian Gulf (PEARL-Peristat Study) between April 2017 and March 2018. The sample included 25,204 newborn records, which were audited between April 2017 and March 2018, of which 25,073 live births were identified and included in the study. Maternal risk factors and neonatal outcomes were assessed for association with specific CAs, including chromosomal/genetic, central nervous system (CNS), cardiovascular system (CVS), facial, renal, multiple congenital anomalies (MCAs) using univariate and multivariate analyses. The incidence of any CA among live births was 1.3% (n = 332). The most common CAs were CVS (n = 117; 35%), MCAs (n = 69, 21%), chromosomal/genetic (51; 15%), renal (n = 39; 12%), CNS (n = 20; 6%), facial (14, 4%), and other (GIT, Resp, Urogenital, Skeletal) (n = 22, 7%) anomalies. Multivariable regression analysis showed that multiple pregnancies, parity ≥ 1, maternal BMI, and demographic factors (mother's age and ethnicity, and infant's gender) were associated with various specific CAs. In-hospital mortality rate due to CAs was estimated to be 15.4%. CAs were significantly associated with high rates of caesarean deliveries (aOR 1.51; 95% CI 1.04-2.19), Apgar < 7 at 1 min (aOR 5.44; 95% CI 3.10-9.55), Apgar < 7 at 5 min (aOR 17.26; 95% CI 6.31-47.18), in-hospital mortality (aOR 76.16; 37.96-152.8), admission to neonatal intensive care unit (NICU) or perinatal death of neonate in labor room (LR)/operation theatre (OT) (aOR 34.03; 95% CI 20.51-56.46), prematurity (aOR 4.17; 95% CI 2.75-6.32), and low birth weight (aOR 5.88; 95% CI 3.92-8.82) before and after adjustment for the significant risk factors. This is the first study to assess the incidence, maternal risk factors, and neonatal outcomes associated with CAs in the state of Qatar. Therefore, a specialized congenital anomaly data registry is needed to identify risk factors and outcomes. In addition, counselling of mothers and their families may help to identify specific needs for pregnant women and their babies.
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Affiliation(s)
- Nader Al-Dewik
- Department of Research, Women's Wellness and Research Center, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar. .,Translational Research Institute (TRI), Hamad Medical Corporation (HMC), Doha, Qatar. .,Genomics and Precision Medicine (GPM), College of Health and Life Science (CHLS), Hamad Bin Khalifa University (HBKU), 34110, Doha, Qatar. .,Faculty of Health and Social Care Sciences, Kingston University, St. George's University of London, London, UK. .,Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, UK
| | - Salma Younes
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Rana Al-Jurf
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Gheyath Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Sawsan Al-Obaidly
- Obstetrics and Gynecology Department, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Tawa Olukade
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, UK
| | - Neil Marlow
- Institute for Women's Health, UCL, London, UK
| | - Mohamed Ismail
- Translational Research Institute (TRI), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Taghreed Abu Nada
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - M Walid Qoronfleh
- Q3CG Research Institute, Research & Policy Division, 7227 Rachel Drive, Ypsilanti, MI, 48917, USA
| | - Binny Thomas
- Department of Pharmacy, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Ghassan Abdoh
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Palli Valapila Abdulrouf
- Department of Pharmacy, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Thomas Farrell
- Obstetrics and Gynecology Department, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Mai Al Qubaisi
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit, Newborn Screening Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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Ismail M, Martin SR, George R, Houghton F, Kelly G, Chaleil RAG, Anastasiou P, Wang X, O'Reilly N, Federico S, Joshi D, Nagaraj H, Cooley R, Hui NS, Molina-Arcas M, Hancock DC, Tavassoli A, Downward J. Characterisation of a cyclic peptide that binds to the RAS binding domain of phosphoinositide 3-kinase p110α. Sci Rep 2023; 13:1889. [PMID: 36732563 PMCID: PMC9894841 DOI: 10.1038/s41598-023-28756-0] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
P110α is a member of the phosphoinositide 3-kinase (PI3K) enzyme family that functions downstream of RAS. RAS proteins contribute to the activation of p110α by interacting directly with its RAS binding domain (RBD), resulting in the promotion of many cellular functions such as cell growth, proliferation and survival. Previous work from our lab has highlighted the importance of the p110α/RAS interaction in tumour initiation and growth. Here we report the discovery and characterisation of a cyclic peptide inhibitor (cyclo-CRVLIR) that interacts with the p110α-RBD and blocks its interaction with KRAS. cyclo-CRVLIR was discovered by screening a "split-intein cyclisation of peptides and proteins" (SICLOPPS) cyclic peptide library. The primary cyclic peptide hit from the screen initially showed a weak affinity for the p110α-RBD (Kd about 360 µM). However, two rounds of amino acid substitution led to cyclo-CRVLIR, with an improved affinity for p110α-RBD in the low µM (Kd 3 µM). We show that cyclo-CRVLIR binds selectively to the p110α-RBD but not to KRAS or the structurally-related RAF-RBD. Further, using biophysical, biochemical and cellular assays, we show that cyclo-CRVLIR effectively blocks the p110α/KRAS interaction in a dose dependent manner and reduces phospho-AKT levels in several oncogenic KRAS cell lines.
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Affiliation(s)
- Mohamed Ismail
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Stephen R Martin
- Structural Biology, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Roger George
- Structural Biology, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Francesca Houghton
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Geoff Kelly
- Structural Biology, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Raphaël A G Chaleil
- Biomolecular Modelling Lab, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Panayiotis Anastasiou
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Xinyue Wang
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Nicola O'Reilly
- Peptide Chemistry, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Stefania Federico
- Peptide Chemistry, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Dhira Joshi
- Peptide Chemistry, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Hemavathi Nagaraj
- Peptide Chemistry, Science Technology Platforms, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Rachel Cooley
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Ning Sze Hui
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Miriam Molina-Arcas
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - David C Hancock
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Ali Tavassoli
- School of Chemistry, University of Southampton, Southampton, SO17 1BJ, UK
| | - Julian Downward
- Oncogene Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
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Ismail M, El-Hefnawy A, Shoma A, Elzalouey E. Tadalafil versus combined tamsolusin and ciprofloxacin for treatment of chronic pelvic pain syndrome: A randomized controlled trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00197-5] [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: 02/12/2023]
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20
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Buchfuhrer M, Baker F, Singh H, Kolotovska V, Adlou B, Anand H, de Zambotti M, Ismail M, Raghunathan S, Charlesworth J. Noninvasive peroneal nerve stimulation reduces symptoms of Restless Legs Syndrome. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.621] [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: 11/17/2022]
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21
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Blakeway H, Amin‐Chowdhury Z, Prasad S, Kalafat E, Ismail M, Abdallah FN, Rezvani A, Amirthalingam G, Brown K, Le Doare K, Heath PT, Ladhani SN, Khalil A. Evaluation of immunogenicity and reactogenicity of COVID-19 vaccines in pregnant women. Ultrasound Obstet Gynecol 2022; 60:673-680. [PMID: 36318630 PMCID: PMC9538835 DOI: 10.1002/uog.26050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy is associated with increased risk of adverse maternal and perinatal outcomes. Vaccines are highly effective at preventing severe coronavirus disease 2019 (COVID-19), but there are limited data on COVID-19 vaccines in pregnancy. This study aimed to investigate the reactogenicity and immunogenicity of COVID-19 vaccines in pregnant women when administered according to the 12-week-interval dosing schedule recommended in the UK. METHODS This was a cohort study of pregnant women receiving COVID-19 vaccination between April and September 2021. The outcomes were immunogenicity and reactogenicity after COVID-19 vaccination. Pregnant women were recruited by phone, e-mail and/or text and were vaccinated according to vaccine availability at their local vaccination center. For immunogenicity assessment, blood samples were taken at specific timepoints after each dose to evaluate nucleocapsid protein (N) and spike protein (S) antibody titers. The comparator group comprised non-pregnant female healthcare workers in the same age group who were vaccinated as part of the national immunization program in a contemporaneous longitudinal cohort study. Longitudinal changes in serum antibody titers and association with pregnancy status were assessed using a two-step regression approach. Reactogenicity assessment in pregnant women was undertaken using an online questionnaire. The comparator group comprised non-pregnant women aged 18-49 years who had received two vaccine doses in primary care. The association of pregnancy status with reactogenicity was assessed using logistic regression analysis. RESULTS Overall, 67 pregnant women, of whom 66 had received a mRNA vaccine, and 79 non-pregnant women, of whom 50 had received a mRNA vaccine, were included in the immunogenicity study. Most (61.2%) pregnant women received their first vaccine dose in the third trimester, while 3.0% received it in the first trimester and 35.8% in the second trimester. SARS-CoV-2 S-antibody geometric mean concentrations after mRNA vaccination were not significantly different at 2-6 weeks after the first dose but were significantly lower at 2-6 weeks after the second dose in infection-naïve pregnant compared with non-pregnant women. In pregnant women, prior infection was associated with higher antibody levels at 2-6 weeks after the second vaccine dose. Reactogenicity analysis included 108 pregnant women and 116 non-pregnant women. After the first dose, tiredness and chills were reported less commonly in pregnant compared with non-pregnant women (P = 0.043 and P = 0.029, respectively). After the second dose, feeling generally unwell was reported less commonly (P = 0.046) in pregnant compared with non-pregnant women. CONCLUSIONS Using an extended 12-week interval between vaccine doses, antibody responses after two doses of mRNA COVID-19 vaccine were found to be lower in pregnant compared with non-pregnant women. Strong antibody responses were achieved after one dose in previously infected women, regardless of pregnancy status. Pregnant women reported fewer adverse events after both the first and second dose of vaccine. These findings should now be addressed in larger controlled studies. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- H. Blakeway
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
| | - Z. Amin‐Chowdhury
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security Agency (previously known as Public Health England)LondonUK
| | - S. Prasad
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
| | - E. Kalafat
- Koc University, School of Medicine, Department of Obstetrics and GynecologyIstanbulTurkey
- Department of Statistics, Faculty of Arts and SciencesMiddle East Technical UniversityAnkaraTurkey
| | - M. Ismail
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
| | - F. N. Abdallah
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
| | - A. Rezvani
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
| | - G. Amirthalingam
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security Agency (previously known as Public Health England)LondonUK
| | - K. Brown
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security Agency (previously known as Public Health England)LondonUK
| | - K. Le Doare
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, Institute of Infection and Immunity, St George's University of LondonLondonUK
| | - P. T. Heath
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, Institute of Infection and Immunity, St George's University of LondonLondonUK
| | - S. N. Ladhani
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security Agency (previously known as Public Health England)LondonUK
- Centre for Neonatal and Paediatric Infection and Vaccine Institute, Institute of Infection and Immunity, St George's University of LondonLondonUK
| | - A. Khalil
- Fetal Medicine Unit, St George's Hospital, St George's University of LondonLondonUK
- Vascular Biology Research CentreMolecular and Clinical Sciences Research Institute, St George's University of LondonLondonUK
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22
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Ahmad A, Liu J, Liu Q, Ullah S, Khalid F, Taimur, Ismail M, Mannan A. Tree species composition, growing stock and biomass carbon dynamics of the major timber species in Hindu Kush regions of Pakistan. BRAZ J BIOL 2022; 84:e256425. [PMID: 35293534 DOI: 10.1590/1519-6984.256425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/19/2022] [Indexed: 11/22/2022] Open
Abstract
Using inventory data, this study evaluates the species composition, growing stock volume (GSV), and biomass carbon (BMC) of the five major timber species in the sub-tropical, and temperate/sub-alpine regions of Pakistan. It was found that the stem density varies between 50 and 221 trees ha -1, with a mean of 142 trees ha-1 (13.68 million trees for entire forest area). Among the species, Pinus wallichiana showed a high species composition (27.80%) followed by Picea smithiana (24.64%). The GSV was found in the range of 67.81 to 425.94 m3 ha-1, with a total GSV value of 20.68 million m3 for the entire region. Similarly, The BMC ranged from 27.04 to 169.86 Mg ha-1, with a mean BMC value of 86.80 Mg ha-1. The total amount of stored carbon was found at 8.69 million tons for a total of 95842 ha of commercially managed forest. Furthermore, the correlation analysis between the basal area (BA) and GSV and BMC showed that BA is the best predictor of GSV and BMC. The findings provide insights to the policy makers and forest managers regarding the sustainable commercial forest management as well as forest carbon management in the recent global carbon management for climate change mitigation.
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Affiliation(s)
- A Ahmad
- Northwest A&F University, College of Natural Resources and Environment, Yangling, Shaanxi, China.,Beijing Forestry University, Department of Forest Sciences, Beijing, China.,Shaheed Benazir Bhutto University, Department of Forestry, Sheringal Dir Upper, Pakistan.,Institute of Space Technology, National Center of GIS and Space Application - NCGSA, GIS and Space Applications in Geosciences Lab - GSAG-L, Islamabad, Pakistan
| | - J Liu
- Northwest A&F University, College of Natural Resources and Environment, Yangling, Shaanxi, China
| | - Q Liu
- Beijing Forestry University, Department of Forest Sciences, Beijing, China
| | - S Ullah
- Shaheed Benazir Bhutto University, Department of Forestry, Sheringal Dir Upper, Pakistan.,Institute of Space Technology, National Center of GIS and Space Application - NCGSA, GIS and Space Applications in Geosciences Lab - GSAG-L, Islamabad, Pakistan
| | - F Khalid
- Shaheed Benazir Bhutto University, Department of Forestry, Sheringal Dir Upper, Pakistan.,Institute of Space Technology, National Center of GIS and Space Application - NCGSA, GIS and Space Applications in Geosciences Lab - GSAG-L, Islamabad, Pakistan
| | - Taimur
- Khyber Pakhtunkhwa Forest Department, Khyber Pakhtunkhwa, Pakistan
| | - M Ismail
- Khyber Pakhtunkhwa Forest Department, Khyber Pakhtunkhwa, Pakistan
| | - A Mannan
- Karakoram International University, Department of Forestry, Gilgit, Pakistan
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23
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O’Connell LV, Hayes C, Ismail M, O’Riordain D, Hafeez A. Attitudes and access of Irish general surgery trainees to robotic surgical training. Surg Open Sci 2022; 9:24-27. [PMID: 35541566 PMCID: PMC9079091 DOI: 10.1016/j.sopen.2022.03.010] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/07/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although the use of robotic-assisted surgery is now mainstream for procedures such as robotic prostatectomy and hysterectomy, its role in general surgery is less well established. Access to training in robotics for general surgery trainees in the Republic of Ireland is variable. Further, there are no data on specific attitudes of Irish trainees toward the role of robotics. We aimed to establish attitudes of Irish general surgery trainees toward the perceived utility of robotic surgery as well as access and satisfaction with training. Methods A survey was disseminated to trainees in the Republic of Ireland enrolled in a General Surgery training scheme via email and social media. Data collected included stage of training, intended subspecialty, interest in developing robotic skills, previous exposure to robotic surgery, satisfaction with current access to robotic training, and opinion on formally incorporating training in robotics into the general surgery curriculum. Results The response rate was 53.8%. Of these, 83% reported interest in training in robotics and 66% anticipated using the technology regularly in consultant practice. Previous exposure to robotic-assisted surgery was significantly predictive of interest in developing the skillset (P = .014). More than 71% of trainees reported that they were not satisfied with access to robotic training. Of those satisfied with access, 40% felt there was a role for incorporating robotic training into the curriculum compared to 68% of those dissatisfied. Conclusion Irish general surgery trainees perceive robotic-assisted surgery to be highly relevant to their future practice. There is an unmet need to provide additional training in the skillset. Irish general surgery trainees perceive robotic surgery (RS) to be highly relevant to their future practice. Access to training in RS is limited, and the majority of trainees desire more access to RS training. Most trainees feel that there is a role for incorporating RS training into the curriculum.
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Kurban LAS, AlDhaheri S, Elkkari A, Khashkhusha R, AlEissaee S, AlZaabi A, Ismail M, Bakoush O. Predicting Severe Disease and Critical Illness on Initial Diagnosis of COVID-19: Simple Triage Tools. Front Med (Lausanne) 2022; 9:817549. [PMID: 35223916 PMCID: PMC8866724 DOI: 10.3389/fmed.2022.817549] [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: 11/18/2021] [Accepted: 01/17/2022] [Indexed: 01/08/2023] Open
Abstract
Rationale This study was conducted to develop, validate, and compare prediction models for severe disease and critical illness among symptomatic patients with confirmed COVID-19. Methods For development cohort, 433 symptomatic patients diagnosed with COVID-19 between April 15th 2020 and June 30th, 2020 presented to Tawam Public Hospital, Abu Dhabi, United Arab Emirates were included in this study. Our cohort included both severe and non-severe patients as all cases were admitted for purpose of isolation as per hospital policy. We examined 19 potential predictors of severe disease and critical illness that were recorded at the time of initial assessment. Univariate and multivariate logistic regression analyses were used to construct predictive models. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Calibration and goodness of fit of the models were assessed. A cohort of 213 patients assessed at another public hospital in the country during the same period was used to validate the models. Results One hundred and eighty-six patients were classified as severe while the remaining 247 were categorized as non-severe. For prediction of progression to severe disease, the three independent predictive factors were age, serum lactate dehydrogenase (LDH) and serum albumin (ALA model). For progression to critical illness, the four independent predictive factors were age, serum LDH, kidney function (eGFR), and serum albumin (ALKA model). The AUC for the ALA and ALKA models were 0.88 (95% CI, 0.86–0.89) and 0.85 (95% CI, 0.83–0.86), respectively. Calibration of the two models showed good fit and the validation cohort showed excellent discrimination, with an AUC of 0.91 (95% CI, 0.83–0.99) for the ALA model and 0.89 (95% CI, 0.80–0.99) for the ALKA model. A free web-based risk calculator was developed. Conclusions The ALA and ALKA predictive models were developed and validated based on simple, readily available clinical and laboratory tests assessed at presentation. These models may help frontline clinicians to triage patients for admission or discharge, as well as for early identification of patients at risk of developing critical illness.
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Affiliation(s)
| | - Sharina AlDhaheri
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Abdulbaset Elkkari
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Ramzi Khashkhusha
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Shaikha AlEissaee
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Amna AlZaabi
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Mohamed Ismail
- Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
| | - Omran Bakoush
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Jubran B, Ismail M, Stein M, Little DH, Hansen B, Gulamhusein A, Hirschfield G. A210 HEPATOLITHIASIS IS A FREQUENT AND PROGNOSTIC FINDING IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859231 DOI: 10.1093/jcag/gwab049.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aims Intrahepatic biliary stones (hepatolithiasis) are not well characterised in patients with primary sclerosing cholangitis (PSC). Methods Chart reviews were conducted on 302 patients with a histologic or radiographic diagnosis of PSC followed at the Toronto Centre for Liver Disease. Radiographic data were collected for patients between the years 2008–2018. Depending on frequency of testing, magnetic resonance imaging (MRI) and ultrasound (US) data was reviewed every 3–5 years. We assessed factors associated with hepatolithiasis based on sex, race, age and phenotype of PSC and inflammatory bowel disease (IBD). Qualitative radiographic findings on image report review, episodes of cholangitis, endoscopic retrograde cholangiopancreatography (ERCP) and occurrence of cholangiocarcinoma (CCA), death and transplant were documented. Data are reported with median and IQR and analysed using χ 2 and Mann-Whitney U tests. Results 302 patients were reviewed. The median time to follow-up, defined as from date of diagnosis to last clinic visit or to transplantation date, was 98 months (IQR = 87). The mean age at diagnosis was 38 (SD = 15.1) years; 54% of patients were male. A total of 224 patients had IBD (74%). Of the 302 patients, 80 patients (26%) had evidence of hepatolithiasis on US or MRI. Patients with hepatolithiasis were more likely to be younger (37.4 vs 39.1, p = 0.025), male (65% vs. 50%, p = 0.021), and have large duct disease (99% vs. 88%, p = 0.004). Imaging report review revealed patients with hepatolithiasis were more likely to have intrahepatic biliary thickening (76% vs. 45%, p < 0.001), extrahepatic biliary thickening (69% vs. 50%, p = 0.003), focal biliary dilation (96% vs. 78%, p < 0.001) and disease characterised by more reported strictures on qualitative imaging report review (89% vs 69%, p < 0.001). Concomitant presence of cholelithiasis was greater in the hepatolithiasis vs. the non-hepatolithiasis group (45% vs. 19%, p < 0.001). There was no significant difference in the prevalence of hepatic or portal venous thrombosis in both groups. Patients with hepatolithiasis more likely have experienced acute ascending cholangitis (50% vs. 20%, p < 0.001) and need for ERCP (50% vs. 35%, p = 0.020). CCA was numerically higher in the hepatolithiasis group (8.75% vs. 4%, p = 0.1). Patients with hepatolithiasis received transplant more frequently (26.3% vs 12.2%, p < 0.001) with no significant difference in mortality. Conclusions Hepatolithiasis is common in PSC and associated with an increased clinical and radiologic disease burden. ![]()
Funding Agencies None
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Affiliation(s)
- B Jubran
- Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada
| | - M Ismail
- Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada
| | - M Stein
- Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada
| | - D H Little
- Gastroenterology, University of Toronto, Toronto, ON, Canada
| | - B Hansen
- Gastroenterology and Hepatology, University of Toronto, Toronto, ON, Canada
| | - A Gulamhusein
- Gastroenterology, University of Toronto, Toronto, ON, Canada
| | - G Hirschfield
- Toronto Centre for Liver Disease Francis Family Liver Clinic, Toronto, ON, Canada
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Ismail M, Straubinger T, Uchida H, Graff-Guerrero A, Nakajima S, Suzuki T, Caravaggio F, Gerretsen P, Mamo D, Mulsant BH, Pollock BG, Bies R. "MAP Bayesian modeling combining striatal dopamine receptor occupancy and plasma concentrations to optimize antipsychotic dose regimens in individual patients". Br J Clin Pharmacol 2022; 88:3341-3350. [PMID: 35112390 DOI: 10.1111/bcp.15260] [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: 04/14/2021] [Revised: 10/20/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
AIM Develop a robust and user-friendly software tool for the prediction of dopamine D2 receptor occupancy (RO) in patients with schizophrenia treated with either olanzapine or risperidone, in order to facilitate clinician exploration of the impact of treatment strategies on RO using sparse plasma concentration measurements. METHODS Previously developed population pharmacokinetic (PPK) models for olanzapine and risperidone were combined with a pharmacodynamic (PD) model for D2 RO and implemented in the R programming language. Maximum a posteriori (MAP) Bayesian estimation was used to provide predictions of plasma concentration and RO based on sparse concentration sampling. These predictions were then compared to observed plasma concentration and RO. RESULTS The average (standard deviation) response times of the tools, defined as the time required for the application to predict parameter values and display the output, were 2.8 (3.1) and 5.3 (4.3) seconds for olanzapine and risperidone, respectively. The mean error (95% confidence interval) and root mean squared error (RMSE, 95% CI) of predicted versus observed concentrations were 3.73 ng/mL (-2.42 - 9.87) and 10.816 ng/mL (6.71 - 14.93) for olanzapine, and 0.46 ng/mL (-4.56 - 5.47) and 6.68 ng/mL (3.57 - 9.78) for risperidone and its active metabolite (9-OH risperidone). Mean error and RMSE of RO were -1.47% (-4.65 - 1.69) and 5.80% (3.89 - 7.72) for olanzapine and -0.91% (-7.68 - 5.85) and 8.87% (4.56 - 13.17) for risperidone. CONCLUSION Our monitoring software predicts concentration-time profiles and the corresponding D2 RO from sparsely-sampled concentration measurements in an accessible and accurate form.
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Affiliation(s)
- Mohamed Ismail
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Thomas Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ariel Graff-Guerrero
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry. University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Fernando Caravaggio
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group in Geriatrics - Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - David Mamo
- Departments of Psychiatry & Gerontology, University of Malta, Msida, Malta
| | - Benoit H Mulsant
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Bruce G Pollock
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Campbell Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert Bies
- Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Canada.,Institute for Computational and Data Sciences, University at Buffalo, Buffalo, NY, USA
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Nassar A, Younis M, Ismail M, Nassar E. Improved Wear-Resistant Performance of Epoxy Resin Composites Using Ceramic Particles. Polymers (Basel) 2022; 14:polym14020333. [PMID: 35054739 PMCID: PMC8778202 DOI: 10.3390/polym14020333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/10/2022] Open
Abstract
This work investigated the effects of using a new fabrication technique to prepare polymer composite on the wear-resistant performance of epoxy resin composites under dry friction conditions. Polymer composite samples with different weight contents of silicon carbide (SiC) particles were manufactured. This paper addresses the wear behavior of the obtained samples. With the suggested technique, the samples were prepared from epoxy/silicon carbide particles using a layer of thin kraft paper to prevent the sedimentation of the ceramic particles and to control the weight content of ceramic in the polymer. Kraft paper was used as a layer in the polymer composite. The hardness, wear resistance, and water absorption capacity of the produced epoxy composite samples prepared using the kraft paper technique were evaluated. The morphology of epoxy composite samples showed a significant improvement in the ceramic distribution and enhancement of interface bonding between ceramic and the polymer. The hardness values of the developed polymer composites were enhanced by up to 42.8%, which was obtained at 18 wt.% SiC particles. Increasing the ceramic content in the epoxy also led to the enhancement of wear resistance compared with pure epoxy. The results of the microstructure study also showed that the kraft paper layers helped in maintaining the distribution of the ceramic particles according to the previously specified content in each layer in the sample. Wear tests showed that the wear rate of the polymer composite decreased with the increase in the ceramic content. This study provides a new recycling method for using old kraft paper in polymer composite manufacturing to improve the distribution of ceramic particles in the polymer matrix.
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Affiliation(s)
- Amal Nassar
- Mechanical Engineering Department, Higher Technological Institute, Next to Small Industries Complex, Industrial Area 2, 10th of Ramadan City 11111, Egypt; (M.Y.); (E.N.)
- Correspondence:
| | - Mona Younis
- Mechanical Engineering Department, Higher Technological Institute, Next to Small Industries Complex, Industrial Area 2, 10th of Ramadan City 11111, Egypt; (M.Y.); (E.N.)
| | - Mohamed Ismail
- Mechanical Engineering Department, The British University in Egypt, Suez Desert Road, El Sherouk City 11837, Egypt;
| | - Eman Nassar
- Mechanical Engineering Department, Higher Technological Institute, Next to Small Industries Complex, Industrial Area 2, 10th of Ramadan City 11111, Egypt; (M.Y.); (E.N.)
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Nowwar A, Farghal I, Ismail M, Amin M. Biochemical Changes on Jute Mallow Plant Irrigated with Wastewater and Its Remediation. Egypt J Chem 2022. [DOI: 10.21608/ejchem.2022.109007.4972] [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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Ismail M, La S, Tavella R, Beltrame J. Relationship Between Corrected TIMI Frame Count (cTFC) and Coronary Haemodynamic Parameters in Patients With Angina and Non-Obstructive Coronary Arteries (ANOCA). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.375] [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: 10/16/2022]
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Khalaf N, Abdel-Latif E, Ismail M, Metwally H. Utilisation of bis-chloroacetamide derivative in the synthesis of new biologically active sulfide compounds. S Afr j chem 2022. [DOI: 10.17159/0379-4350/2021/v76a14] [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: 01/20/2023]
Abstract
4-Aminobenzohydrazide (1) undergoes chloroacetylation twice, at the primary amine and hydrazide-NH2 functional groups. The conforming bis-chloroacetamide derivative 3 was reacted with different sulfur reagents (namely, 2-mercaptobenzothiazole, 6-amino-2-mercaptopyrimidin-4-ol, and 2-mercapto-4,6-dimethyl-nicotinonitrile) to give new bis-sulfide compounds 5, 7 and 9, respectively. The newly synthesised bis-chloroacetamide and corresponding sulfides were screened for anti-microbial and antioxidant potential. The sulfide derivative 7 exhibited the most potent activity against Staphylococcus aureus and Pseudomonas aeruginosa. It shows inhibition activities of 83.4% and 78.8%, respectively. Moreover, the sulfide derivative 7 showed the highest antioxidant activity with an inhibition ratio of 85.9%, which is close to L-ascorbic acid.
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Ismail M, Sale M, Yu Y, Pillai N, Liu S, Pflug B, Bies R. Development of a genetic algorithm and NONMEM workbench for automating and improving population pharmacokinetic/pharmacodynamic model selection. J Pharmacokinet Pharmacodyn 2021; 49:243-256. [PMID: 34604941 DOI: 10.1007/s10928-021-09782-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
The current approach to selection of a population PK/PD model is inherently flawed as it fails to account for interactions between structural, covariate, and statistical parameters. Further, the current approach requires significant manual and redundant model modifications that heavily lend themselves to automation. Within the discipline of numerical optimization it falls into the "local search" category. Genetic algorithms are a class of algorithms inspired by the mathematics of evolution. GAs are general, powerful, robust algorithms and can be used to find global optimal solutions for difficult problems even in the presence of non-differentiable functions, as is the case in the discrete nature of including/excluding model components in search of the best performing mixed-effects PK/PD model. A genetic algorithm implemented in an R-based NONMEM workbench for identification of near optimal models is presented. In addition to the GA capabilities, the workbench supports modeling efforts by: (1) Organizing and displaying models in tabular format, allowing the user to sort, filter, edit, create, and delete models seamlessly, (2) displaying run results, parameter estimates and precisions, (3) integrating xpose4 and PsN to facilitate generation of model diagnostic plots and run PsN scripts, (4) running regression models between post-hoc parameter estimates and covariates. This approach will further facilitate the scientist to shift efforts to focus on model evaluation, hypotheses generation, and interpretation and applications of resulting models.
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Affiliation(s)
- Mohamed Ismail
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Mark Sale
- Nuventra Pharma Sciences, Durham, NC, USA
| | - Yifan Yu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Nikhil Pillai
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Sihang Liu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Beth Pflug
- Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Robert Bies
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA. .,Institute for Computational Data Science, University at Buffalo, Buffalo, NY, USA.
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Bhasker AG, Khaitan M, Bindal V, Kumar A, Rajkumar A, Kaushal A, Prasad A, Parikh C, Sethi D, Goel D, Hareendran DT, Bedi D, Jammu GS, Leo J, Kular K, Narwaria M, Chikkachanappa M, Motwani M, Bharucha M, Ismail M, Dukkipati N, Shah N, Tantia O, Patel P, Padmakumar R, Singh R, Palaniappan R, Shrivastava R, Rajput RRP, Goel R, Wadhawan R, Garg R, Aggarwal S, Patolia S, Baig SJ, Shah S, Shivaram HV, Dhorepatil S, Saggu SS, Ugale S, Perungo T, Soni V. Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients. J Minim Access Surg 2021; 17:542-547. [PMID: 34558429 PMCID: PMC8486048 DOI: 10.4103/jmas.jmas_2_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS). METHODS A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Google Form was circulated to all surgeon members through E-mail and WhatsAppTM. In the second phase, clinical details were captured from surgeons who reported positive cases. RESULTS One thousand three hundred and seven BMS were reported from 1 January 2020 to 15 July 2020. Seventy-eight per cent were performed prior to 31 March 2020 and 276 were performed after 1 April 2020. Of these, 13 (0.99%) patients were reported positive for COVID-19 in the post-operative period. All suffered from a mild disease and there was no mortality. Eighty-seven positive cases were reported from patients who underwent BMS prior to 31 December 2019. Of these, 82.7% of patients had mild disease, 13.7% of patients had moderate symptoms and four patients succumbed to COVID-19. CONCLUSION BMS may be considered as a safe treatment option for patients suffering from clinically severe obesity during the COVID-19 pandemic. Due care must be taken to protect patients and healthcare workers and all procedures must be conducted in line with the safe practice guidelines.
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Affiliation(s)
| | | | | | - Amardeep Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Chirag Parikh
- Parul Institute of Medical Science and Research, Vadodara, Gujarat, India
| | | | - Deep Goel
- BLK Super Speciality Hospital, New Delhi, India
| | | | | | | | | | - Kuldeepak Kular
- Kular College and Hospitals Private Limited, Ludhiana, Punjab, India
| | | | | | | | | | | | | | - Neha Shah
- Child Heart International, Chennai, Tamil Nadu, India
| | - Om Tantia
- ILS Hospitals, Kolkata, West Bengal, India
| | - Parag Patel
- Zydus Hospital and Healthcare Research Center, Anand, Gujarat, India
| | | | - Rahul Singh
- Ajanta Hospital, Lucknow, Uttar Pradesh, India
| | - Raj Palaniappan
- Institute of Bariatrics, Apollo Hospitals, Chennai, Tamil Nadu, India
| | | | | | - Ramen Goel
- Wockhardt Hospital, Mumbai, Maharashtra, India
| | | | - Rohit Garg
- Vardhman Mahavir Healthcare, Patiala, Punjab, India
| | - Sandeep Aggarwal
- Kular College and Hospitals Private Limited, Ludhiana, Punjab, India
| | | | | | - Shashank Shah
- Laparo-Obeso Centre, Pune, Maharashtra, India
- Lilavati Hospital Mumbai and Hinduja Healthcare Surgical, Mumbai, Maharashtra, India
| | | | - Shrihari Dhorepatil
- Shree Hospital and Diagnostic Centre Private Limited, Pune, Maharashtra, India
| | | | - Surendra Ugale
- Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India
| | - T. Perungo
- Dr. Rela Institute and Medical Centre, Chennai, Tamil Nadu, India
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Ijaz MU, Majeed SA, Asharaf A, Ali T, Al-Ghanim KA, Asad F, Zafar S, Ismail M, Samad A, Ahmed Z, Al-Misned F, Riaz MN, Mahboob S. Toxicological effects of thimerosal on rat kidney: a histological and biochemical study. BRAZ J BIOL 2021; 83:e242942. [PMID: 34468508 DOI: 10.1590/1519-6984.242942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/17/2021] [Indexed: 11/21/2022] Open
Abstract
Thimerosal is an organomercurial compound, which is used in the preparation of intramuscular immunoglobulin, antivenoms, tattoo inks, skin test antigens, nasal products, ophthalmic drops, and vaccines as a preservative. In most of animal species and humans, the kidney is one of the main sites for mercurial compounds deposition and target organs for toxicity. So, the current research was intended to assess the thimerosal induced nephrotoxicity in male rats. Twenty-four adult male albino rats were categorized into four groups. The first group was a control group. Rats of Group-II, Group-III, and Group-IV were administered with 0.5µg/kg, 10µg/kg, and 50µg/kg of thimerosal once a day, respectively. Thimerosal administration significantly decreased the activities of catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), glutathione reductase (GR), glutathione (GSH), and protein content while increased the thiobarbituric acid reactive substances (TBARS) and hydrogen peroxide (H2O2) levels dose-dependently. Blood urea nitrogen (BUN), creatinine, urobilinogen, urinary proteins, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) levels were substantially increased. In contrast, urinary albumin and creatinine clearance was reduced dose-dependently in thimerosal treated groups. The results demonstrated that thimerosal significantly increased the inflammation indicators including nuclear factor kappaB (NF-κB), tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6) levels and cyclooxygenase-2 (COX-2) activities, DNA and histopathological damages dose-dependently. So, the present findings ascertained that thimerosal exerted nephrotoxicity in male albino rats.
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Affiliation(s)
- M U Ijaz
- University of Agriculture, Department of Zoology, Wildlife and Fisheries, Faisalabad, Pakistan
| | - S A Majeed
- University of Agriculture, Department of Zoology, Wildlife and Fisheries, Faisalabad, Pakistan
| | - A Asharaf
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - T Ali
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - K A Al-Ghanim
- King Saud University, Department of Zoology, College of Science, Riyadh, Saudi Arabia
| | - F Asad
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - S Zafar
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - M Ismail
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - A Samad
- University of Agriculture, Department of Zoology, Wildlife and Fisheries, Faisalabad, Pakistan
| | - Z Ahmed
- Government College University, Department of Zoology, Faisalabad, Pakistan
| | - F Al-Misned
- King Saud University, Department of Zoology, College of Science, Riyadh, Saudi Arabia
| | - M N Riaz
- Texas A&M University, AMU, Brazos, Texas, United States of America
| | - S Mahboob
- King Saud University, Department of Zoology, College of Science, Riyadh, Saudi Arabia
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von Piekartz H, La Touche R, Paris-Alemany A, Löwen A, Ismail M, Köhl R, Benz K, Ballenberger N. Cross-Cultural Adaption and Psychometric Evaluation of the German Craniofacial Pain and Disability Inventory (CF-PDI). Pain Physician 2021; 24:E857-E866. [PMID: 34554706] [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: 06/13/2023]
Abstract
BACKGROUND The Craniofacial Pain and Disability Inventory (CF-PDI) is a cross-culturally adapted instrument designed from a biopsychosocial perspective to measure pain, disability, and function in orofacial head and neck pain with shown psychometric properties; however, the German cross-cultural adaption is lacking. OBJECTIVES To carry out a transcultural translation of CF-PDI into German and assess its psychometric properties in patients with painful temporomandibular disorders (TMD) with respect to construct and clinical validity, internal consistency and reproducibility. STUDY DESIGN Multicenter, prospective, cross-sectional design. SETTING Patients (n = 398) were recruited from dental and physical therapy clinics in middle and south Germany. METHODS Structural validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We investigated know-group validity by means of the scale's potential to discriminate between affected and unaffected subjects. Multiple linear regression analysis was used to estimate convergent validity. We tested test-retest reliability by the intraclass correlation coefficient and the Internal consistency by Cronbach's alpha, or each dimension separately, and the total score. Multiple linear regression analysis was used to estimate convergent validity. RESULTS Two hundred forty-six heterogeneous chronic craniofacial pain patients and 152 patients without complaints were recruited from the middle and south of Germany. The German version CF-PDI-G presents 21 items, 4 factors, and adequate psychometric properties. The test-retest reliability and internal consistency of the CF-PDI-G were both excellent for the entire instrument and also for all sub-scales (intraclass correlation coefficient [ICC] > 0.90) except for the comorbidities and interference with work which was acceptable (ICC = 0.69). Standard error of the measurement (SEM) and minimal detectable change values are sufficiently low. Assessment of clinical validity shows good potential of discrimination and classification into categories "no," "mild," "moderate," and "severe." The multiple linear regression model showed a strong association between neck disability index, Visual Analog Scale, and anamnestic questionnaire (supporting the scale's convergent validity). LIMITATIONS Our sample has a higher prevalence of women and the sample was not recruited consecutively, which may lead to a biased estimation of psychometric properties. CONCLUSIONS The CF-PDI-G represents valid and reliable instrument to assess pain and disability in patients with orofacial pain and headache suitable for research and clinical practice.
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Affiliation(s)
- Harry von Piekartz
- Department of Physical Therapy and Rehabilitation science, University of Applied Science Osnabruck, Germany
| | - Roy La Touche
- Physiotherapy Department, Autonomous University of Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Department of Physiotherapy, La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain; Department of Physiotherapy, Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain; Physiotherapy Department, Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain; Department of Physiotherapy, Health Research Institute of La Paz University Hospital (IdiPAZ), Madrid, Spain
| | - Alexandra Löwen
- Osnabrück University of Applied Sciences, Physical Therapy and Rehabilitation science, Osnabruck, Niedersachsen, Germany
| | - Mohamed Ismail
- Osnabrück University of Applied Sciences, Physical Therapy and Rehabilitation science, Osnabruck, Niedersachsen, Germany
| | - Roger Köhl
- Danube University Krems, Department for Health Sciences and Biomedicine at Danube University Krems, Austria
| | - Katharina Benz
- Osnabrück University of Applied Sciences, Physical Therapy and Rehabilitation science, Osnabruck, Niedersachsen, Germany
| | - Nicolaus Ballenberger
- Department of Physical Therapy and Rehabilitation science, University of Applied Science Osnabruck, Germany
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Al-Nabulsi Z, Phan YC, Abdalla O, Austin T, Tanasescu G, Osborn P, Auer A, Rowbotham C, Ismail M. Surgical and radiological predictive factors for ureteric stricture formation in patients treated with ureteroscopy for ureteric stones. Scand J Urol 2021; 55:394-398. [PMID: 34355993 DOI: 10.1080/21681805.2021.1953581] [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] [Indexed: 10/20/2022]
Abstract
BACKGROUND Ureteric stricture is a potential complication of impacted ureteric stones. This study investigates surgical and radiological factors that could predict ureteric stricture formation after ureteroscopic treatment of impacted ureteric stones. MATERIALS AND METHOD Intraoperative and radiological data for patients who underwent ureteroscopic treatment of ureteric stones impaction over a 5-year period were reviewed retrospectively. Patients who had previous ureteroscopic treatment or strictures were excluded. RESULTS Between January 2014 and May 2019, 1,340 patients presented as emergency renal colic secondary to ureteric stones. A total of 297 ureteroscopy procedures were performed for impacted calculi. The mean age was 53 years. The stricture rate was 3.3%. Analysis of radiological and surgical factors revealed that the degree of hydronephrosis, residual fragments and intraoperative ureteric injury were significant predictors for stricture formation (p = 0.018, 0.01 and 0.02, OR = 10, 47 and 1776, respectively). None of the other factors significantly predicted ureteric stricture formation. CONCLUSION Our study found the presence of severe hydronephrosis, residual stone fragments after surgery and intraoperative ureteric injury are significant predictive factors for ureteric stricture formation. The high-risk patients should be monitored with routine postoperative renal ultrasound.
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Affiliation(s)
- Zuhdi Al-Nabulsi
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK.,Inverclyde Royal Hospital, Greenock, UK
| | - Yih Chyn Phan
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK.,Royal Bournemouth Hospital, Bournemouth, UK
| | - Omer Abdalla
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK.,Wirral University Hospital, Wirral, UK
| | - Tomas Austin
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
| | - George Tanasescu
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
| | - Peter Osborn
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
| | - Andreas Auer
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
| | - Carl Rowbotham
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
| | - Mohamed Ismail
- Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trsut, Portsmouth, UK
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Phan YC, Babawale O, Karim O, Wilby D, Ismail M. A single institution experience: Robotic-assisted laparoscopic renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies. Journal of Clinical Urology 2021. [DOI: 10.1177/20514158211029813] [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: 11/16/2022]
Abstract
Introduction: The use of a robotic surgical system has transformed modern urological surgeries. There is little reported, however, on the use of robotic surgical systems in the management of benign urological diseases. We aim to report our experience in robotic-assisted surgery in renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies. Methodology: We retrospectively collected the data of patients who had robotic-assisted surgery in our institution from 1 January 2014 to 31 December 2019. Results: Over the last five years, our institution has performed over 1500 robotic-assisted urological surgeries. In this five-year period, four robotic surgeons have performed a total of 25 robotic assisted operations to treat benign urological diseases including three renal calyceal diverticulectomies, one heminephrectomy and two bladder diverticulectomies. All patients were satisfied with the outcomes of their surgery when reviewed at their follow up consultations. Conclusion: We report a very positive experience in using robotic surgical systems in managing our series of benign urological conditions in our hospital. We should not restrict the use of this tool to cancer surgery, but consider the technology in our surgical armamentarium for all aspects of our urological practice.
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Affiliation(s)
| | | | - Omer Karim
- Queen Alexandra Hospital, Portsmouth, UK
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Alenezi A, Ismail M, Eden C. Can Tumour Volume Percentage in Radical Prostatectomy Predict Cancer Biochemical Recurrence? Determining a Cut-off Point and Composite Risk Factors Approach. Res Rep Urol 2021; 13:445-455. [PMID: 34235101 PMCID: PMC8254606 DOI: 10.2147/rru.s313455] [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: 04/01/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Incidence of biochemical recurrence (BCR) after radical prostatectomy is relatively high and overall survival can be poor. Debate exists whether tumour volume predicts BCR and when treatments should be administered. In this study, we aimed to i) assess the impact of tumour volume percentage (TVP) as a predictor for BCR, ii) determine TVP cut-off point for BCR and iii) evaluate single and composite predictors of BCR. METHODS From March 2000 to December 2013, 1777 patients underwent laparoscopic radical prostatectomy for localized prostate cancer. None received neoadjuvant or adjuvant therapy. One hundred and forty-six patients experienced BCR (range 3 months-10 years). Using D'Amico classification, 146 matched controls without BCR were compared. Liu cut-point analysis was used to identify TVP with optimal sensitivity and specificity. Single and composite BCR risk predictors were analyzed using Cox hazards regression in cases and controls. RESULTS Median TVP was 10% (range 1-90%). Most of BCR peaked after 3 years of follow-up. TVP ≥8% was an independent predictor of BCR with HR 1.6 (p= 0.001, 95% CI= 1.11-2.48). TVP of 8% was associated with the highest accuracy: sensitivity 74% and specificity 53% (ROC curve= 0.7). At TVP ≥8%, pathological stage pT3 was associated with 1.7-fold higher risk of BCR compared to T2. Lymph node invasion was associated with 1.4-fold higher risk of BCR compared to no invasion. Combining TVP ≥8%, pT3 and lymph node invasion, HR jumped to 3.73 (p< 0.001, 95% CI= 2.27-6.14), whereas combining TVP ≥8%, positive surgical margin and lymph node invasion, HR was 2.68 (p= 001, 95% CI= 1.50-4.77). CONCLUSION TVP can be used as an independent predictor of BCR after radical prostatectomy for prostate cancer. TVP cut-point of ≥8% allows the best discrimination. TVP should be considered in combination with other clinico-pathological factors to improve prediction of long-term oncological outcomes and to stratify BCR risk.
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Affiliation(s)
- Ahmad Alenezi
- Department of Urology, Mubarak Hospital & Sabah Al Ahmad Urology Centre, Kuwait City, State of Kuwait
| | - Mohamed Ismail
- Department of Urology, Queen Alexandra Hospital, Portsmouth, UK
| | - Christopher Eden
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
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Mansour H, Elnaghi B, Abd-Alwahab M, Ismail M. Optimum Topology of Power Distribution Networks Using Sunflower Optimizer for Loss Reduction.(Dept.E). MEJ Mansoura Engineering Journal 2021; 46:1-10. [DOI: 10.21608/bfemu.2021.171090] [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] [Indexed: 09/02/2023]
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Akl M, Ali D, Ismail M, Hashem M. Antibacterial Activity of Eco Friendly Biologically Synthesized Copper Oxide Nanoparticles. Egypt J Chem 2021. [DOI: 10.21608/ejchem.2021.67430.3481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lamontagne F, Stegemann M, Agarwal A, Agoritsas T, Siemieniuk R, Rochwerg B, Bartoszko J, Askie L, Macdonald H, Al-Maslamani M, Amin W, Da Silva ARA, Barragan FAJ, Bausch FJ, Burhan E, Cecconi M, Chacko B, Chanda D, Dat VQ, Du B, Geduld H, Gee P, Haider M, Nerina H, Hashimi M, Jehan F, Hui D, Hunt BJ, Ismail M, Kabra S, Kanda S, Kawano-Dourado L, Kim YJ, Kissoon N, Krishna S, Kwizera A, Lisboa T, Leo YS, Mahaka I, Hela M, Migliori GB, Mino G, Nsutebu E, Pshenichnaya N, Qadir N, Ranganathan SS, Sabzwari S, Sarin R, Shankar-Hari M, Sharland M, Shen Y, Souza JP, Tshokey T, Ugarte S, Uyeki T, Venkatapuram S, Wachinou AP, Wijewickrama A, Vuyiseka D, Preller J, Brignardello-Petersen R, Kum E, Qasim A, Zeraatkar D, Owen A, Guyatt G, Lytvyn L, Jacobs M, Vandvik PO, Diaz J. A living WHO guideline on drugs to prevent covid-19. BMJ 2021; 372:n526. [PMID: 33649077 DOI: 10.1136/bmj.n526] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CLINICAL QUESTION What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. RECOMMENDATION The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). HOW THIS GUIDELINE WAS CREATED This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. UNDERSTANDING THE NEW RECOMMENDATION The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. UPDATES This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. READERS NOTE This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.
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Affiliation(s)
- François Lamontagne
- Université de Sherbrooke, Centre de recherche due CHU de Sherbrooke, Sherbrooke, Quebec, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Miriam Stegemann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory Medicine and Critical Care, Berlin, Germany
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Arnav Agarwal
- Division of General Internal Medicine, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Thomas Agoritsas
- Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Reed Siemieniuk
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Bram Rochwerg
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Jessica Bartoszko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Lisa Askie
- World Health Organization, Geneva, Switzerland
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Helen Macdonald
- The BMJ, London, UK
- Not guideline development group member; resource for methodology, systematic review, and content support
| | | | - Wagdy Amin
- Ministry of Health and Population, Cairo, Egypt
| | | | | | | | - Erlina Burhan
- Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Binila Chacko
- Division of Critical Care Medicine at Christian Medical College, Vellore, India
| | - Duncan Chanda
- Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia
| | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
| | - Bin Du
- Peking Union Medical College Hospital, Beijing, China
| | - Heike Geduld
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | | | | | | | - David Hui
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong SAR, China
| | | | | | - Sushil Kabra
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Leticia Kawano-Dourado
- Pulmonary Division, Heart Institute (InCor)- HCFMUSP, Medical School, University of Sao Paulo, São Paulo, Brazil and Research Institute, Hospital do Coração (HCor), São Paulo, Brazil
| | - Yae-Jean Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Niranjan Kissoon
- Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada
| | | | - Arthur Kwizera
- Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Yee-Sin Leo
- National Center for Infectious Diseases, Singapore
| | | | - Manai Hela
- Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia
| | | | | | | | | | - Nida Qadir
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | | | | | - Rohit Sarin
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | | | | | - Yinzhong Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | | | | | - Sebastian Ugarte
- Faculty of Medicine Andres Bello University, Indisa Clinic, Santiago, Chile
| | - Tim Uyeki
- Influenza Division, Centers for Disease Control and Prevention, USA
| | | | | | | | | | - Jacobus Preller
- World Health Organization, Geneva, Switzerland
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Elena Kum
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Anila Qasim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Andrew Owen
- University of Liverpool, Liverpool, UK
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not guideline development group member; resource for methodology, systematic review, and content support
| | - Michael Jacobs
- Royal Free London NHS Foundation Trust, London, UK
- Not guideline development group member; resource for methodology, systematic review, and content support
- co-senior author
| | - Per Olav Vandvik
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
- Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway
- Not guideline development group member; resource for methodology, systematic review, and content support
- co-senior author
| | - Janet Diaz
- World Health Organization, Geneva, Switzerland
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Not guideline development group member; resource for methodology, systematic review, and content support
- co-senior author
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Goel R, Nasta AM, Goel M, Prasad A, Jammu G, Fobi M, Ismail M, Raj P, Palaniappan R, Aggarwal S, Bindal V, Katakwar A, Vennapusa A, Bhasker AG, Peters A, Goel D, Bedi D, Palep J, Kona L, Mehrotra M, Baijal M, Bhandari M, Dukkipati N, Wadhawan R, Baig S, Pattanshetti S, Ugale S. Complications after bariatric surgery: A multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group. J Minim Access Surg 2021; 17:213-220. [PMID: 32964881 PMCID: PMC8083745 DOI: 10.4103/jmas.jmas_12_20] [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] [Indexed: 11/04/2022] Open
Abstract
Background Complications after bariatric surgery are not uncommon occurrences that influence the choice of operations both by patients and by surgeons. Complications may be classified as intra-operative, early (<30 days post-operatively) or late (beyond 30 days). The prevalence of complications is influenced by the sample size, surgeon's experience and length and percentage of follow-up. There are no multicentric reports of post-bariatric complications from India. Objectives To examine the various complications after different bariatric operations that currently performed in India. Materials and Methods A scientific committee designed a questionnaire to examine the post-bariatric surgery complications during a fixed time period in India. Data requested included demographic data, co-morbidities, type of procedure, complications, investigations and management of complications. This questionnaire was sent to all centres where bariatric surgery is performed in India. Data collected were reviewed, were analysed and are presented. Results Twenty-four centres responded with a report on 11,568 bariatric procedures. These included 4776 (41.3%) sleeve gastrectomy (SG), 3187 (27.5%) one anastomosis gastric bypass (OAGB), 2993 (25.9%) Roux-en-Y gastric bypass (RYGB) and 612 (5.3%) other procedures. Total reported complications were 363 (3.13%). Post-operative bleeding (0.75%) and nutritional deficiency (0.75%) were the two most common complications. Leaks (P = 0.009) and gastro-oesophageal reflux disease (P = 0.019) were significantly higher in SG, marginal ulcers in OAGB (P = 0.000), intestinal obstruction in RYGB (P = 0.001) and nutritional complications in other procedures (P = 0.000). Overall, the percentage of complications was higher in 'other' procedures (6.05%, P = 0.000). There were 18 (0.16%) reported mortalities. Conclusions The post-bariatric composite complication rate from the 24 participating centres in this study from India is at par with the published data. Aggressive post-bariatric follow-up is required to improve nutritional outcomes.
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Affiliation(s)
- Ramen Goel
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Amrit Manik Nasta
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Madhu Goel
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Arun Prasad
- Department of Surgery, Manipal Hospital, New Delhi, India
| | - Gurvinder Jammu
- Director and Chief Surgeon, Bariatric Surgery, Jammu Hospital, Jalandhar, Punjab, India
| | - Mathias Fobi
- Director of Clinical Affairs and Research, Mohak Bariatrics and Robotics; Clinical Professor of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
| | - Mohamed Ismail
- Bariatric Surgeon, Moulana Hospital, Perintalmanna; Bariatric Surgeon, RIMS Hospital, Kottayam, Kerala, India
| | - Praveen Raj
- Bariatric Surgeon, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India
| | - Raj Palaniappan
- Lead Consultant, Bariatric, Metabolic and Robotic Surgery, Institute of Bariatrics, Apollo Hospitals, Chennai, Tamil Nadu, India
| | | | - Vivek Bindal
- Vice-Chairman, Institute of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Abhishek Katakwar
- Associate Director, Laparoscopic/Robotic Bariatric and Metabolic Surgery, AIG Hospitals, Hyderabad, Telangana, India
| | - Amar Vennapusa
- Chief Consultant Metabolic and Bariatric Surgeon, Dr. Amar Bariatric and Metabolic Center, Hyderabad, Telangana, India
| | - Aparna Govil Bhasker
- Bariatric and Laparoscopic GI Surgeon, Gleneagles Global Hospital, Parel, Mumbai; Bariatric and Laparoscopic GI Surgeon, Apollo Hospital, Navi Mumbai, Maharashtra, India
| | - Atul Peters
- HOD and Senior Consultant, Apollo Institute of Bariatric and Metabolic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Deep Goel
- Department of Surgical Gastroenterology, Bariatric and Metabolic Surgery, BLK Super Specialty Hospital, New Delhi, India
| | | | - Jaydeep Palep
- Department of Bariatric and Minimal Access Surgery, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
| | - Lakshmi Kona
- Senior Consultant, Gleneagles Global Hospital, Hyderabad, Telangana, India
| | - Magan Mehrotra
- Director, Bariatric Surgery, Apex Hospital, Moradabad, Uttar Pradesh, India
| | - Manish Baijal
- Director, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Hospital, New Delhi, India
| | - Mohit Bhandari
- Director of Clinical Affairs and Research, Mohak Bariatrics and Robotics; Clinical Professor of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
| | | | - Randeep Wadhawan
- Department of Minimal Access, Bariatric and Gastrointestinal Surgery, Fortis Hospital, New Delhi, India
| | - Sarfaraz Baig
- Department of Minimal Access Surgery, Belle Vue Clinic, Kolkata, West Bengal, India
| | | | - Surendra Ugale
- Director, Bariatric and Metabolic Surgery, Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India
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Najah A, Teo FY, Chow MF, Huang YF, Latif SD, Abdullah S, Ismail M, El-Shafie A. Surface water quality status and prediction during movement control operation order under COVID-19 pandemic: Case studies in Malaysia. Int J Environ Sci Technol (Tehran) 2021; 18:1009-1018. [PMID: 33558809 PMCID: PMC7857098 DOI: 10.1007/s13762-021-03139-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/09/2020] [Accepted: 01/06/2021] [Indexed: 05/06/2023]
Abstract
Global concerns have been observed due to the outbreak and lockdown causal-based COVID-19, and hence, a global pandemic was announced by the World Health Organization (WHO) in January 2020. The Movement Control Order (MCO) in Malaysia acts to moderate the spread of COVID-19 through the enacted measures. Furthermore, massive industrial, agricultural activities and human encroachment were significantly reduced following the MCO guidelines. In this study, first, a reconnaissance survey was carried out on the effects of MCO on the health conditions of two urban rivers (i.e., Rivers of Klang and Penang) in Malaysia. Secondly, the effect of MCO lockdown on the water quality index (WQI) of a lake (Putrajaya Lake) in Malaysia is considered in this study. Finally, four machine learning algorithms have been investigated to predict WQI and the class in Putrajaya Lake. The main observations based on the analysis showed that noticeable enhancements of varying degrees in the WQI had occurred in the two investigated rivers. With regard to Putrajaya Lake, there is a significant increase in the WQI Class I, from 24% in February 2020 to 94% during the MCO month of March 2020. For WQI prediction, Multi-layer Perceptron (MLP) outperformed other models in predicting the changes in the index with a high level of accuracy. For sensitivity analysis results, it is shown that NH3-N and COD play vital rule and contributing significantly to predicting the class of WQI, followed by BOD, while the remaining three parameters (i.e. pH, DO, and TSS) exhibit a low level of importance.
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Affiliation(s)
- A. Najah
- Institute of Energy Infrastructure (IEI), Universiti Tenaga Nasional (UNITEN), 43000 Kajang, Selangor Darul Ehsan Malaysia
| | - F. Y. Teo
- Faculty of Science and Engineering, University of Nottingham Malaysia, 43500 Semenyih, Selangor Malaysia
| | - M. F. Chow
- Institute of Sustainable Energy (ISE), Universiti Tenaga Nasional (UNITEN), 43000 Kajang, Selangor Malaysia
| | - Y. F. Huang
- Department of Civil Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Selangor Malaysia
| | - S. D. Latif
- Department of Civil Engineering, College of Engineering, Universiti Tenaga Nasional (UNITEN), 43000 Kajang, Selangor Malaysia
| | - S. Abdullah
- Air Quality and Environment Research Group, Faculty of Ocean Engineering Technology and Informatics, Universiti Malaysia Terengganu, 21030 Kuala Nerus, Terengganu Malaysia
| | - M. Ismail
- Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030 Kuala Nerus, Terengganu Malaysia
- Institute of Tropical Biodiversity and Sustainable Development, Universiti Malaysia Terengganu, 21030 Kuala Nerus, Malaysia
| | - A. El-Shafie
- Department of Civil Engineering, Faculty of Engineering, University of Malaya (UM), 50603 Kuala Lumpur, Malaysia
- National Water and Energy Center (NWC), United Arab Emirates University, P.O. Box. 15551, Al Ain, United Arab Emirates
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Happi GM, Mouthe Kemayou GP, Stammler HG, Neumann B, Ismail M, Kouam SF, Wansi JD, Tchouankeu JC, Frese M, Lenta BN, Sewald N. Three phragmalin-type limonoids orthoesters and the structure of odoratone isolated from the bark of Entandrophragma candollei (Meliaceae). Phytochemistry 2021; 181:112537. [PMID: 33099226 DOI: 10.1016/j.phytochem.2020.112537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
The phytochemical exploration of the Entandrophragma candollei stem bark extract led to the isolation and identification of twenty compounds including three undescribed phragmalin-class limonoids named encandollens C-E (1-3), the undescribed protolimonoid 5 together with sixteen known compounds. The structures of all the isolated compounds were determined by interpretation of their spectroscopic and spectrometric data including HRMS, 1D and 2D NMR analyses. The assignment of the absolute and relative stereochemistry of the undescribed compounds was achieved using SC-XRD analyses as well as NOESY experiments. The previously reported structure of odoratone (5a) was corrected as 23 R,24 S-dihydroxy-22 S,25-epoxytirucall-7-en-3-one (5) based on its NMR and SC-XRD data. Prieurianin (4) exhibited high cytotoxic activity on KB3-1 cell lines with an IC50 of 1.47 μM compared to the reference griseofulvin (IC50 = 17-21 μM). The results of the in silico docking of compound 4 supported and delivered further insights on its cytotoxicity.
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Affiliation(s)
- Gervais Mouthé Happi
- Department of Chemistry, Higher Teacher Training College, University of Bamenda, P.O Box 39, Bambili, Cameroon; Organic and Bioorganic Chemistry, Faculty of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany; Department of Chemistry, Higher Teacher Training College, University of Yaounde I, P. O. Box 47, Yaounde, Cameroon.
| | - Guy Paulin Mouthe Kemayou
- Department of Chemistry, Higher Teacher Training College, University of Yaounde I, P. O. Box 47, Yaounde, Cameroon
| | - Hans-Georg Stammler
- Inorganic and Structural Chemistry, Department of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany
| | - Beate Neumann
- Inorganic and Structural Chemistry, Department of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany
| | - Mohamed Ismail
- Organic and Bioorganic Chemistry, Faculty of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany; Department of Microbiology, Faculty of Science, Helwan University, Ain Helwan, 11795, Cairo, Egypt
| | - Simeon Fogue Kouam
- Department of Chemistry, Higher Teacher Training College, University of Yaounde I, P. O. Box 47, Yaounde, Cameroon
| | - Jean Duplex Wansi
- Department of Chemistry, University of Douala, Faculty of Sciences, 24157, Douala, Cameroon
| | - Jean Claude Tchouankeu
- Department of Organic Chemistry, Faculty of Sciences, University of Yaounde I, 812, Yaounde, Cameroon
| | - Marcel Frese
- Organic and Bioorganic Chemistry, Faculty of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany
| | - Bruno Ndjakou Lenta
- Department of Chemistry, Higher Teacher Training College, University of Yaounde I, P. O. Box 47, Yaounde, Cameroon
| | - Norbert Sewald
- Organic and Bioorganic Chemistry, Faculty of Chemistry, Bielefeld University, D-33501, Bielefeld, Germany
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Ismail M, Nagaraj D, Rajagopal M, Ansari H, Iyyankutty K, Nair M, Hegde A, Rekha PD. Is weight regaining significant post laparoscopic Roux-en-Y gastric bypass surgery? - A 5-year follow-up study on Indian patients. J Minim Access Surg 2021; 17:159-164. [PMID: 33723179 PMCID: PMC8083740 DOI: 10.4103/jmas.jmas_108_19] [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] [Indexed: 11/04/2022] Open
Abstract
Background Laparoscopic Roux-en-Y gastric bypass (RYGB) has been proven to induce significant weight loss and remission of related co-morbidities in patients with morbid obesity. The long-term follow-up data show weight regain or failure to achieve complete remission of type 2 diabetes mellitus (T2DM) in some patients. In this study, we report weight loss patterns and remission of T2DM in patients with morbid obesity during a 5-year follow-up after RYGB. Objective The objective was to evaluate outcomes during the follow-up on excess weight loss (EWL) and remission of T2DM after laparoscopic RYGB among Indian patients. Setting The study was conducted in a tertiary care hospital, Kerala, India. Materials and Methods This is a retrospective study in patients who underwent surgery between 2007 and 2010. The patient demographics, pre- and post-operative body mass index (BMI), co-morbidities and EWL were recorded from the medical records. These data were compared between pre-operative and follow-up intervals till 5 years using statistical approaches. Results The study included 157 patients (91 males and 66 females) having a mean pre-operative BMI of 47.91 ± 7.01 kg/m2. A significant reduction in the BMI was observed at each follow-up point (P < 0.01) till 5 years after the surgery. The mean percentage of EWL increased from 34.57% ± 12.62% to 71.50% ± 15.41% from 3 months to 5 years after the surgery. Twelve per cent (n = 19) of patients achieved normal BMI (<25 mg/kg2) by 3rd year after the surgery. However, the remission of T2DM was achieved in >50% of patients within a year of surgery. During the 5th year, weight regain (1-22 kg) was observed in 36.70% (n = 58) patients, and recurrence of T2DM was observed in two patients. Conclusions The long-term durability of RYGB in the study population was satisfactory with significant weight loss and remission of T2DM.
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Affiliation(s)
- Mohamed Ismail
- Department of General, Laparoscopic and Bariatric Surgery, Moulana Hospital, Perinthalmanna, Kerala, India
| | - Dileep Nagaraj
- Department of General, Laparoscopic and Bariatric Surgery, Moulana Hospital, Perinthalmanna, Kerala, India
| | - Mahesh Rajagopal
- Department of General, Laparoscopic and Bariatric Surgery, Moulana Hospital, Perinthalmanna, Kerala, India
| | - Hafiz Ansari
- Department of General, Laparoscopic and Bariatric Surgery, Moulana Hospital, Perinthalmanna, Kerala, India
| | - Kingsly Iyyankutty
- Department of General, Laparoscopic and Bariatric Surgery, Moulana Hospital, Perinthalmanna, Kerala, India
| | - Megha Nair
- Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India
| | - Aparna Hegde
- Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India
| | - P D Rekha
- Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India
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A Mohamed A, M Hassan M, Alsanie WF, Ibrahim AM, Rizk AM, Ismail M, A Farid M. Molecular Diagnosis of <i>Mycoplasma</i> Species Infection in Camels Using Semi-nested PCR. Pak J Biol Sci 2020; 23:1506-1512. [PMID: 33274882 DOI: 10.3923/pjbs.2020.1506.1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Bacteriological isolation and identification of Mycoplasma species is difficult and time-consuming, therefore, molecular identification of Mycoplasma using PCR targeting specific genes is considered a specific and sensitive method for identification. The aim of current study was to isolate, characterize Mycoplasma infection in dromedary camels in Saudi Arabia. MATERIALS AND METHODS Nasal swabs were randomly collected from 93 camels and tested for Mycoplasma by sequencing of their 16S rRNA genes using universal primers. RESULTS The 93 samples, 24 were positive for Mycoplasma. However, no positive results were obtained using species-specific primers for Mycoplasma arginine, M. bovis or M. mycoides subsp. mycoides, thus, 16S rDNA sequencing methods and semi-nested PCR were employed. Sequences were matched to those in GenBank and phylogenetic analysis was performed. Mycoplasma edwardii (77-84% similarity with Mycoplasma edwardii ATCC 23462) and one isolate of Mycoplasma yeastsii (100% similarity with M. yeastsii GM274B) were identified. Further, some Mycoplasma species were identified as previously uncultured. The incidence of Mycoplasma infection in camels in Taif city, Saudi Arabia, was approximately 26%. CONCLUSION This study provides insights into the accuracy and efficiency of PCR and universal primers for the detection and identification of Mycoplasma, thereby circumventing conventional culturing methods that require several days to complete and exhibit low accuracy.
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47
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Ismail M, Cope A, Weng C, Mara K, Burnett T, Khan Z. The Effect of Abuse History on Preoperative and Postoperative Pain Symptoms in Women Undergoing Surgical Treatment of Endometriosis. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.126] [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: 10/23/2022]
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48
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Ismail M. Regional disparities in the distribution of Sudan's health resources. East Mediterr Health J 2020; 26:1105-1114. [PMID: 33047802 DOI: 10.26719/emhj.20.056] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/04/2019] [Indexed: 11/09/2022]
Abstract
Background Equal distribution of health resources has been a core objective of both long- and medium-term strategic plans for the health sector in Sudan. However, the targets of these plans have not yet been achieved, resulting in weak performance of the whole health system. The unequal distribution of the health resources has resulted in significant regional disparities in provision of health care services. Aims This study aims to describe and analyse the inequality in geographic distribution of public sector's physical and human health resources in Sudan. In addition, the study also aims to measure the relations between density of health resources and health outcomes. Methods State-level data on health resources and health outcomes obtained from the Sudan Health Statistical Report of 2016 were used to calculate inequality indices, drawing Lorenz curves, and calculating Spearman's correlation analysis between health resource density and health-related outcomes. Results Our findings show that the distributions of health resources, based on population size, were highly unequal among the 18 states of Sudan. Conclusion There is a crucial need to improve health status in the relatively under-resourced states, particularly in Darfur, South Kordofan and Blue Nile states. Moreover, the government needs to use health resource allocation models that take into account the population size and health outcomes variables in each state in future health strategies.
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Affiliation(s)
- Mohamed Ismail
- Institute of Public Administration, Riyadh, Saudi Arabia
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49
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Abstract
Cyclic RGD peptides are well-known ligands of integrins. The integrins αV β3 and α5 β1 are involved in angiogenesis, and integrin αV β3 is abundantly present on cancer cells, thus representing a therapeutic target. Hence, synthetic and biophysical studies continuously are being directed towards the understanding of ligand-integrin interaction. In this context, the development of versatile synthetic strategies to obtain fluorescent building blocks that can add molecular diversity and modular spectral characteristics while not compromising binding affinity or selectivity is a relevant task. An on-resin intramolecular Suzuki-Miyaura cross-coupling (SMC) between l- or d-7-bromotryptophan (7BrTrp) and a phenothiazine (Ptz) boronic acid affords fluorescent cyclic RGD pseudopeptides, c(RGD(W/w)Ptz). Ring closure by SMC establishes a phenothiazine-indole moiety with axial chirality. An array of eight novel compounds has been synthesized, among them one fluorescent compound with good affinity to integrin αV β3 . The fluorescence properties of the analogues can be efficiently tuned depending on the substituents in Ptz moiety even for fluorescence emission in the visible (red) spectral range.
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Affiliation(s)
- Elmira Ghabraie
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
| | - Isabell Kemker
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
| | - Nicolo Tonali
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
| | - Mohamed Ismail
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
| | - Veronica I. Dodero
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
| | - Norbert Sewald
- Department of ChemistryOrganic and Bioorganic ChemistryBielefeld UniversityPO Box 10013133501BielefeldGermany
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50
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Agarwal A, Hunt B, Stegemann M, Rochwerg B, Lamontagne F, Siemieniuk RA, Agoritsas T, Askie L, Lytvyn L, Leo YS, Macdonald H, Zeng L, Alhadyan A, Muna AM, Amin W, da Silva ARA, Aryal D, Barragan FAJ, Bausch FJ, Burhan E, Calfee CS, Cecconi M, Chacko B, Chanda D, Dat VQ, De Sutter A, Du B, Freedman S, Geduld H, Gee P, Haider M, Gotte M, Harley N, Hashimi M, Hui D, Ismail M, Jehan F, Kabra SK, Kanda S, Kim YJ, Kissoon N, Krishna S, Kuppalli K, Kwizera A, Lado Castro-Rial M, Lisboa T, Lodha R, Mahaka I, Manai H, Mendelson M, Migliori GB, Mino G, Nsutebu E, Peter J, Preller J, Pshenichnaya N, Qadir N, Ranganathan SS, Relan P, Rylance J, Sabzwari S, Sarin R, Shankar-Hari M, Sharland M, Shen Y, Souza JP, Swanstrom R, Tshokey T, Ugarte S, Uyeki T, Evangelina VC, Venkatapuram S, Vuyiseka D, Wijewickrama A, Tran L, Zeraatkar D, Bartoszko JJ, Ge L, Brignardello-Petersen R, Owen A, Guyatt G, Diaz J, Kawano-Dourado L, Jacobs M, Vandvik PO. A living WHO guideline on drugs for covid-19. BMJ 2020; 370:m3379. [PMID: 32887691 DOI: 10.1136/bmj.m3379] [Citation(s) in RCA: 475] [Impact Index Per Article: 118.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Updates This is the fourteenth version (thirteenth update) of the living guideline, replacing earlier versions (available as data supplements). New recommendations will be published as updates to this guideline. Clinical question What is the role of drugs in the treatment of patients with covid-19? Context The evidence base for therapeutics for covid-19 is evolving with numerous randomised controlled trials (RCTs) recently completed and underway. Emerging SARS-CoV-2 variants and subvariants are changing the role of therapeutics. What is new? The guideline development group (GDG) defined 1.5% as a new threshold for an important reduction in risk of hospitalisation in patients with non-severe covid-19. Combined with updated baseline risk estimates, this resulted in stratification into patients at low, moderate, and high risk for hospitalisation. New recommendations were added for moderate risk of hospitalisation for nirmatrelvir/ritonavir, and for moderate and low risk of hospitalisation for molnupiravir and remdesivir. New pharmacokinetic evidence was included for nirmatrelvir/ritonavir and molnupiravir, supporting existing recommendations for patients at high risk of hospitalisation. The recommendation for ivermectin in patients with non-severe illness was updated in light of additional trial evidence which reduced the high degree of uncertainty informing previous guidance. A new recommendation was made against the antiviral agent VV116 for patients with non-severe and with severe or critical illness outside of randomised clinical trials based on one RCT comparing the drug with nirmatrelvir/ritonavir. The structure of the guideline publication has also been changed; recommendations are now ordered by severity of covid-19. About this guideline This living guideline from the World Health Organization (WHO) incorporates new evidence to dynamically update recommendations for covid-19 therapeutics. The GDG typically evaluates a therapy when the WHO judges sufficient evidence is available to make a recommendation. While the GDG takes an individual patient perspective in making recommendations, it also considers resource implications, acceptability, feasibility, equity, and human rights. This guideline was developed according to standards and methods for trustworthy guidelines, making use of an innovative process to achieve efficiency in dynamic updating of recommendations. The methods are aligned with the WHO Handbook for Guideline Development and according to a pre-approved protocol (planning proposal) by the Guideline Review Committee (GRC). A box at the end of the article outlines key methodological aspects of the guideline process. MAGIC Evidence Ecosystem Foundation provides methodological support, including the coordination of living systematic reviews with network meta-analyses to inform the recommendations. The full version of the guideline is available online in MAGICapp and in PDF on the WHO website, with a summary version here in The BMJ. These formats should facilitate adaptation, which is strongly encouraged by WHO to contextualise recommendations in a healthcare system to maximise impact. Future recommendations Recommendations on anticoagulation are planned for the next update to this guideline. Updated data regarding systemic corticosteroids, azithromycin, favipiravir and umefenovir for non-severe illness, and convalescent plasma and statin therapy for severe or critical illness, are planned for review in upcoming guideline iterations.
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Affiliation(s)
- Arnav Agarwal
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Beverly Hunt
- St Thomas’ Hospital, London, UK
- ivermectin and IL-6 receptor blocker panel member
| | - Miriam Stegemann
- Charité - Universitätsmedizin Berlin, Germany
- ivermectin and IL-6 receptor blocker panel member
| | - Bram Rochwerg
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - François Lamontagne
- Université de Sherbrooke, Centre de recherche due CHU de Sherbrooke, Quebec, Canada
- Not panel member; resource for methodology, systematic review, and content support
- Corticosteroid panel member
| | - Reed Ac Siemieniuk
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
| | - Thomas Agoritsas
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
- Not panel member; resource for methodology, systematic review, and content support
- Corticosteroid panel member
| | - Lisa Askie
- World Health Organization, Geneva, Switzerland
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Yee-Sin Leo
- National Center for Infectious Diseases, Singapore
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Helen Macdonald
- The BMJ, London, UK
- Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano (MI), Italy
- Not panel member; resource for methodology, systematic review, and content support
| | - Linan Zeng
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | | | | | - Wagdy Amin
- Ministry of Health and Population, Cairo, Egypt
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | | | - Frederique Jacquerioz Bausch
- Geneva University Hospital, Switzerland
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Erlina Burhan
- Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Carolyn S Calfee
- University of California, San Francisco, USA
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano (MI), Italy
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
| | | | - Duncan Chanda
- Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - An De Sutter
- University of Gent, Belgium
- ivermectin and IL-6 receptor blocker panel member
| | - Bin Du
- Peking Union Medical College Hospital, Beijing, China
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Stephen Freedman
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | - Heike Geduld
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Patrick Gee
- USA
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Nerina Harley
- Royal Melbourne Hospital and Epworth Healthcare, Melbourne, Australia
- ivermectin and IL-6 receptor blocker panel member
| | - Madiha Hashimi
- Ziauddin University, Karachi, Pakistan
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - David Hui
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, China
| | | | | | - Sushil K Kabra
- All India Institute of Medical Sciences, New Delhi, India
- Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Seema Kanda
- McMaster University (alumnus)
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Yae-Jean Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Niranjan Kissoon
- Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Arthur Kwizera
- Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Imelda Mahaka
- Zimbabwe
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Hela Manai
- Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Marc Mendelson
- Groote Schuur Hospital, University of Cape Town, South Africa
| | | | - Greta Mino
- Alcivar Hospital in Guayaquil, Ecuador
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Emmanuel Nsutebu
- Sheikh Shakhbout Medical City, Abu Dhabi
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Natalia Pshenichnaya
- Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russia
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Nida Qadir
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Shalini Sri Ranganathan
- University of Colombo, Sri Lanka
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Saniya Sabzwari
- Aga Khan University, Karachi, Pakistan
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Rohit Sarin
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Manu Shankar-Hari
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- ivermectin and IL-6 receptor blocker panel member
| | - Michael Sharland
- St. George’s University Hospital, UK
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Yinzhong Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Joao P Souza
- University of Sao Paulo, Brazil
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | | | | | - Sebastian Ugarte
- Faculty of Medicine Andres Bello University, Indisa Clinic, Santiago, Chile)
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Timothy Uyeki
- Influenza Division, U.S. Centers for Disease Control and Prevention, United States
| | | | - Sridhar Venkatapuram
- King’s College, London, UK
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Dubula Vuyiseka
- University of Stellenbosch, South Africa
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Ananda Wijewickrama
- Ministry of Health, Sri Lanka
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Lien Tran
- Infectious Diseases Data Observatory (IDDO), Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Jessica J Bartoszko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Long Ge
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
- The BMJ, London, UK
- Not panel member; resource for methodology, systematic review, and content support
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Andrew Owen
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, England
- Not panel member; resource for methodology, systematic review, and content support
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Not panel member; resource for methodology, systematic review, and content support
| | - Janet Diaz
- World Health Organization, Geneva, Switzerland
- Not panel member; resource for methodology, systematic review, and content support
- co-senior author
| | - Leticia Kawano-Dourado
- Pulmonary Division, Heart Institute (InCor)- HCFMUSP, Medical School, University of Sao Paulo, São Paulo, Brazil and Research Institute, Hospital do Coração (HCor), São Paulo, Brazil
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- Corticosteroid panel member
- ivermectin and IL-6 receptor blocker panel member
| | - Michael Jacobs
- Royal Free London NHS Foundation Trust
- Remdesivir, hydroxychloroquine, and lopinavir-ritonavir panel member
- ivermectin and IL-6 receptor blocker panel member
- co-senior author
| | - Per Olav Vandvik
- MAGIC Evidence Ecosystem Foundation, Oslo, Norway
- Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway
- Not panel member; resource for methodology, systematic review, and content support
- co-senior author
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