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Tally H, Al-janabi MAH, AlDwairy H, Al-Shehabi Z, Ibrahim M. Low-grade fibromyxoid sarcoma in laryngopharynx: the first case report in the literature. J Surg Case Rep 2024; 2024:rjae141. [PMID: 38476455 PMCID: PMC10930207 DOI: 10.1093/jscr/rjae141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Low-grade fibromyxoid sarcoma is a rare mesenchymal neoplasm with distinctive histopathological features. Although it typically arises in the deep soft tissues of the trunk and extremities, its occurrence in the head and neck region is exceedingly rare. We present the first documented case of low-grade fibromyxoid sarcoma in the laryngopharynx, expanding the spectrum of this rare tumor's anatomical localization. The clinical, radiological, and histopathological features of this unique case are discussed, highlighting the diagnostic challenges and therapeutic considerations associated with this uncommon presentation.
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Affiliation(s)
- Hanan Tally
- Department of ENT, Tishreen University Hospital, Latakia 041, Syria
| | | | - Heba AlDwairy
- Department of Anesthesiology, Tishreen University Hospital, Latakia 041, Syria
| | - Zuheir Al-Shehabi
- Department of Pathology, Director of Cancer Research Center, Tishreen University Hospital, Latakia 041, Syria
| | - Mostafa Ibrahim
- Department of ENT, Tishreen University Hospital, Latakia 041, Syria
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2
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Ibrahim M. EFFECT OF RELIGIOUS FASTING ON THE SERUM LEVEL OF PRE-HAPTOGLOBIN-2 AND SOME OTHER BIOCHEMICALS. Georgian Med News 2024:104-108. [PMID: 38501630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
During the month of Ramadan, which falls on the ninth month of the Hijri Calendar, Muslims are obligated to observe religious fasting. The goal of the study was to examine the impact of fasting on various blood parameters, specifically zinc, magnesium, pre-haptoglobin-2, serum copper, total cholesterol, and HDL-cholesterol levels. In a study, a group of volunteers consisting of 20 men and 10 women agreed to partake in the fast, abstaining from food and drink for approximately 14-15 hours each day. The researchers collected two blood samples from each participant, one before the start of Ramadan fasting and another after 29 days of fasting, serum was separated and analysed for specified parameters. Serum zinc levels showed a significant (p<0.05) decrease after fasting. On the other hand, serum magnesium levels exhibited a significant (p<0.05) increase, Regarding pre-haptoglobin-2, there was a small, insignificant increase observed after 29 days of fasting. However, the study did not identify any significant changes in serum copper, total cholesterol, or HDL-cholesterol levels. Based on these findings, the study concludes that Ramadan fasting may necessitate zinc supplementation or an increase in the consumption of zinc-rich foods. Furthermore, it suggests a decrease in the intake of high-fat foods. These recommendations aim to counteract the observed decrease in serum zinc levels during fasting.
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Affiliation(s)
- M Ibrahim
- College of Pharmacy, University of Mosul, Iraq
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3
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Atta S, Mekky R, Ibrahim M, Abdallah MM, Elbaz MAH, Radwan E. Increased Expression of Neprilysin Is Associated with Inflammation in Preeclampsia. Reprod Sci 2023:10.1007/s43032-023-01410-w. [PMID: 38114865 DOI: 10.1007/s43032-023-01410-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023]
Abstract
Preeclampsia (PE) is associated with a finely tuned equilibrium between trophoblast cell invasion and fetal-maternal immunological tolerance. An imbalance between proinflammatory (IL-6) and anti-inflammatory (IL-10) cytokines is a hallmark of PE. Neprilysin (NEP), a membrane-bound metalloprotease, is vulnerable to the inflammatory environment and plays a significant role in modulating vascular tone. The aim of this study was to determine the correlation between NEP (mRNA and protein) levels and the inflammatory status in PE patients compared to healthy pregnant women and to identify the role of NEP in evaluating the severity of preeclampsia. The study group comprised 52 pregnant women with PE while the control group comprised 47 normotensive pregnant women. After a caesarean section, placental tissue samples from patients and controls were collected to measure the expression levels of IL-6, TGF-β, IL-10, and NEP mRNA. In addition, an enzyme-linked immunosorbent assay was used to assess the quantity of NEP protein in blood samples. Our results revealed a significant positive correlation between NEP (mRNA and protein) and proinflammatory markers IL-6 and TGF-β levels in patients compared to controls and a significant inverse correlation between NEP and anti-inflammatory cytokine IL-10. Moreover, this is the first study to find a strong positive correlation between NEP level and PE severity. In conclusion, in PE patients, there is a substantial relationship between NEP, the degree of inflammation, and PE severity. NEP could act as a potential biomarker for diagnosis and prognosis of PE.
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Affiliation(s)
- Sara Atta
- Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Rehab Mekky
- Institute for Drug Development and Innovation Research, Assiut University, Assiut, Egypt
| | - Mostafa Ibrahim
- Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt
| | - Mohamed M Abdallah
- Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
| | - Mona A H Elbaz
- Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eman Radwan
- Medical Biochemistry Department, Faculty of Medicine, Assiut University, Assiut, Egypt
- Biochemistry Department, Sphinx University, New Assiut, Assiut, Egypt
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4
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Abdel-Salam A, El-Sayed A, Abdel-Haseeb A, Ibrahim M. Prognostic value of arterial lactate index in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: a prospective cohort study. Future Cardiol 2023; 19:767-777. [PMID: 38127545 DOI: 10.2217/fca-2023-0065] [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] [Indexed: 12/23/2023] Open
Abstract
Aim: Limited knowledge exists on the pathophysiological cascade beyond serum lactate's association with myocardial injury. Method: Assessed the prognostic value of lactate index on periprocedural variables and its impact on 30-day major adverse cardiovascular events (MACE) in 300 prospective ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Results: Significant correlations were observed between admission lactate and Killip class, periprocedural time intervals, postprocedure thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG; p < 0.01). Lactate levels correlated with diminished ST-deviation resolution, cardiac enzymes (CK-MB, troponin; p < 0.001; 0.004), and lower ejection fraction (p < 0.001). This relationship impacted 30-day MACE (p < 0.001). Conclusion: Hyperlactatemia in STEMI patients undergoing pPCI is associated with worse Killip class, unsatisfactory TIMI flow, MBG, larger infarct size and higher 30-day MACE. Serum lactate aids risk stratification in pPCI for STEMI patients.
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Affiliation(s)
| | - Amr El-Sayed
- Cardiology department, Ain Shams University, Cairo, 7154411, Egypt
| | | | - Mostafa Ibrahim
- Cardiology department, Ain Shams University, Cairo, 7154411, Egypt
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Al-Janabi MAH, Mousto R, Abodest R, Tally H, Daoud AK, Ibrahim M. Basaloid squamous cell carcinoma of the larynx: A rare case report. Int J Surg Case Rep 2023; 111:108791. [PMID: 37690277 PMCID: PMC10507190 DOI: 10.1016/j.ijscr.2023.108791] [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: 08/17/2023] [Revised: 09/01/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive subtype of squamous cell carcinoma. BSCC in the larynx is an extremely rare occurrence, with only a few cases reported in the medical literature. This case report aims to shed light on the clinical presentation, diagnostic challenges, histopathological features, and therapeutic considerations associated with this rare entity. CASE PRESENTATION This case report describes a 65-year-old male patient who presented with hoarseness and dyspnea. Laryngoscopy revealed a 2.5 cm pedunculated lesion on the left vocal cord. The patient underwent a laryngectomy, and the histopathological examination of the excised specimen confirmed the diagnosis of BSCC. CLINICAL DISCUSSION BSCC of the larynx is a rare malignancy comprising less than 1 % of laryngeal cancers. Clinical features often overlap those of squamous cell carcinoma, such as hoarseness, progressive breathing difficulties, and swallowing issues. Treatment approaches vary, with some opting for neo-adjuvant radiotherapy before surgery, like in this case, while others favor surgical excision as the primary treatment, supplemented by adjuvant chemo- or radiotherapy in certain cases. CONCLUSION Basaloid squamous cell carcinoma is a rare variant of squamous cell carcinoma. Clinicians and pathologists should be aware of the distinctive characteristics of BSCC and its potential clinical aggressiveness. While rare, early recognition and appropriate management are essential for achieving favorable outcomes in patients with this challenging condition.
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Affiliation(s)
| | - Reham Mousto
- Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Riham Abodest
- Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Hanan Tally
- Department of ENT, Tishreen University Hospital, Lattakia, Syria
| | - Ali Kamel Daoud
- Department of Pathology, Tishreen University Hospital, Lattakia, Syria
| | - Mostafa Ibrahim
- Department of ENT, Tishreen University Hospital, Lattakia, Syria
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Yoo Y, Gibson E, Zhao G, Sandu A, Re T, Das J, Hesheng W, Kim MM, Shen C, Lee YZ, Kondziolka D, Ibrahim M, Lian J, Jain R, Zhu T, Parmar H, Comaniciu D, Balter J, Cao Y. An Automated Brain Metastasis Detection and Segmentation System from MRI with a Large Multi-Institutional Dataset. Int J Radiat Oncol Biol Phys 2023; 117:S88-S89. [PMID: 37784596 DOI: 10.1016/j.ijrobp.2023.06.414] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Developments of automated systems for brain metastasis (BM) detection and segmentation from MRI for assisting early detection and stereotactic radiosurgery (SRS) have been reported but most based upon relatively small datasets from single institutes. This work aims to develop and evaluate a system using a large multi-institutional dataset, and to improve both identification of small/subtle BMs and segmentation accuracy of large BMs. MATERIALS/METHODS A 3D U-Net system was trained and evaluated to detect and segment intraparenchymal BMs with a size > 2mm using 1856 MRI volumes from 1791 patients treated with SRS from seven institutions (1539 volumes for training, 183 for validation, and 134 for testing). All patients had 3D post-Gd T1w MRI scans pre-SRS. Gross tumor volumes (GTVs) of BMs for SRS were curated by each institute first. Then, additional efforts were spent to create GTVs for the untreated and/or uncontoured BMs, including central reviews by two radiologists, to improve accuracy of ground truth. The training dataset was augmented with synthetic BMs of 3773 MRIs using a 3D generative pipeline. Our system consists of two U-Nets with one using small 3D patches dedicated for detecting small BMs and another using large 3D patches for segmenting large BMs, and a random-forest based fusion module for combining the two network outputs. The first U-Net was trained with 3D patches containing at least one BM < 0.1 cm3. For detection performance, we measured BM-level sensitivity and case-level false-positive (FP) rate. For segmentation performance, we measured BM-level Dice similarity coefficient (DSC) and 95-percentile Hausdorff distance (HD95). We also stratified performances based upon BM sizes. RESULTS For 739 BMs in the 134 testing cases, the overall lesion-level sensitivity was 0.870 with an average case-level FP of 1.34±1.92 (95% CI: 1.02-1.67). The sensitivity was >0.969 for the BMs >0.1 cm3, but dropped to 0.755 for the BMs < 0.1 cm3 (Table 1). The average DSC and HD95 for all detected BMs were 0.786 and 1.35mm. The worse performance for BMs > 20 cm3 was caused by a case with 83 cm3 GTV and artifacts in the MRI volume. CONCLUSION We achieved excellent detection sensitivity and segmentation accuracy for BMs > 0.1 cm3, and promising performance for small BMs (<0.1cm3) with a controlled FP rate using a large multi-institutional dataset. Clinical utility for assisting early detection and SRS planning will be investigated. Table 1: Per-lesion detection and segmentation performance stratified by individual BM size. N is the number of BMs in each category.
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Affiliation(s)
- Y Yoo
- Siemens Healthineers, Princeton, NJ
| | - E Gibson
- Siemens Healthineers, Princeton, NJ
| | - G Zhao
- Siemens Healthineers, Princeton, NJ
| | - A Sandu
- Siemens Healthineers, Princeton, NJ
| | - T Re
- Siemens Healthineers, Princeton, NJ
| | - J Das
- Siemens Healthineers, Princeton, NJ
| | | | - M M Kim
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - Y Z Lee
- University of North Carolina, Chapel Hill, NC
| | - D Kondziolka
- Department of Neurosurgery, NYU Langone Health, New York, NY
| | - M Ibrahim
- University of Michigan, Ann Arbor, MI
| | - J Lian
- University of North Carolina, Chapel Hill, NC
| | - R Jain
- New York University, New York, NY
| | - T Zhu
- Washington University, St. Louis, MO
| | - H Parmar
- Department of Radiology, University of Michigan, Ann Arbor, MI
| | | | - J Balter
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - Y Cao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Ibrahim M, Wignadasan W, Haddad FS. A simple technical tip to reduce complications associated with separate pin-site incisions in robotic-assisted total knee arthroplasty. Ann R Coll Surg Engl 2023; 105:672-673. [PMID: 37489528 PMCID: PMC10471434 DOI: 10.1308/rcsann.2022.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 07/26/2023] Open
Affiliation(s)
- M Ibrahim
- University College London Hospitals NHS Foundation Trust, UK
| | - W Wignadasan
- University College London Hospitals NHS Foundation Trust, UK
| | - FS Haddad
- University College London Hospitals NHS Foundation Trust, UK
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8
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Pengel LHM, Kaisar M, Benjamens S, Ibrahim M, Ricci V, Bellini MI, Breithaupt-Faloppa AC, Falk C, Maple H, Marson L, Ortiz F, Papalois V, Paredes D, Forsberg A. Equity, Diversity and Inclusion (EDI) in Organ Transplantation: An ESOT Survey About EDI Within ESOT as an Organization and its Educational Activities, and Transplantation Research and Science. Transpl Int 2023; 36:11331. [PMID: 37680646 PMCID: PMC10481529 DOI: 10.3389/ti.2023.11331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
The European Society of Organ Transplantation (ESOT) strives to promote equity, diversity, and inclusion (EDI) across all its activities. We surveyed the transplant community's experiences and perspectives regarding EDI within ESOT as an organization and its educational activities, and research in general. A total of 299 respondents completed the questionnaire. About half agreed that ESOT's Executive Committee, Council, and Sections/Committees are diverse and inclusive (51%) and that ESOT promotes EDI in its live and digital educational activities (54%). Forty percent of respondents agreed that scientific and clinical trials in the field of transplantation are diverse and inclusive. Despite the wide distribution of the survey, most of the respondents self-identified as White and were either physician or surgeon. However, the results contribute a unique insight into the experiences and perspectives of the transplantation community regarding EDI. Whilst ESOT is committed to the principles of EDI, perceptions and the high number of proposals show the apparent need to prioritize efforts to embed EDI across ESOT and transplantation science. These data should constitute a starting point for change and provide guidance for future efforts to promote EDI within the transplantation community.
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Affiliation(s)
- L. H. M. Pengel
- Erasmus MC Transplant Institute, University Medical Center, Rotterdam, Netherlands
- Peter Morris Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - M. Kaisar
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - S. Benjamens
- Department of Surgery, Ikazia Hospital, Rotterdam, Netherlands
| | - M. Ibrahim
- Manchester Royal Infirmary, Manchester, United Kingdom
| | - V. Ricci
- European Society for Organ Transplantation, Padua, Italy
| | - M. I. Bellini
- Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - A. C. Breithaupt-Faloppa
- LIM-11, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - C. Falk
- Institut für Transplantationsimmunologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - H. Maple
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - L. Marson
- The Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - F. Ortiz
- Abdominal Center Unit, Nephrology, Helsinki University Hospital, Helsinki, Finland
| | - V. Papalois
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - D. Paredes
- Donation and Transplant Coordination Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
| | - A. Forsberg
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Thoracic Surgery, Skane University Hospital, Lund, Sweden
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9
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Bai Z, Méndez-Sánchez N, Romeiro FG, Mancuso A, Philips CA, Tacke F, Basaranoglu M, Primignani M, Ibrahim M, Wong YJ, Nery FG, Teschke R, Ferreira CN, Muñoz AE, Pinyopornpanish K, Thevenot T, Singh SP, Mohanty A, Satapathy SK, Ridola L, Maruyama H, Cholongitas E, Levi Sandri GB, Yang L, Shalimar, Yang Y, Villa E, Krag A, Wong F, Jalan R, O’Brien A, Bernardi M, Qi X. Use of albumin infusion for cirrhosis-related complications: An international position statement. JHEP Rep 2023; 5:100785. [PMID: 37456673 PMCID: PMC10339261 DOI: 10.1016/j.jhepr.2023.100785] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 02/17/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND & AIMS Numerous studies have evaluated the role of human albumin (HA) in managing various liver cirrhosis-related complications. However, their conclusions remain partially controversial, probably because HA was evaluated in different settings, including indications, patient characteristics, and dosage and duration of therapy. METHODS Thirty-three investigators from 19 countries with expertise in the management of liver cirrhosis-related complications were invited to organise an International Special Interest Group. A three-round Delphi consensus process was conducted to complete the international position statement on the use of HA for treatment of liver cirrhosis-related complications. RESULTS Twelve clinically significant position statements were proposed. Short-term infusion of HA should be recommended for the management of hepatorenal syndrome, large volume paracentesis, and spontaneous bacterial peritonitis in liver cirrhosis. Its effects on the prevention or treatment of other liver cirrhosis-related complications should be further elucidated. Long-term HA administration can be considered in specific settings. Pulmonary oedema should be closely monitored as a potential adverse effect in cirrhotic patients receiving HA infusion. CONCLUSIONS Based on the currently available evidence, the international position statement suggests the potential benefits of HA for the management of multiple liver cirrhosis-related complications and summarises its safety profile. However, its optimal timing and infusion strategy remain to be further elucidated. IMPACT AND IMPLICATIONS Thirty-three investigators from 19 countries proposed 12 position statements on the use of human albumin (HA) infusion in liver cirrhosis-related complications. Based on current evidence, short-term HA infusion should be recommended for the management of HRS, LVP, and SBP; whereas, long-term HA administration can be considered in the setting where budget and logistical issues can be resolved. However, pulmonary oedema should be closely monitored in cirrhotic patients who receive HA infusion.
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Affiliation(s)
- Zhaohui Bai
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic and Foundation, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Andrea Mancuso
- Medicina Interna 1, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Cyriac Abby Philips
- Clinical and Translational Hepatology, The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, India
| | - Frank Tacke
- Department of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Metin Basaranoglu
- Division of Gastroenterology, Department of Internal Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Massimo Primignani
- Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mostafa Ibrahim
- Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Yu Jun Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Filipe Gaio Nery
- Serviço de Cuidados Intensivos, Unidade de Cuidados Intermédios Médico-Cirúrgica, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Rolf Teschke
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Germany
| | - Carlos Noronha Ferreira
- Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria-Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Alberto E. Muñoz
- Sección Hepatología, Hospital Dr. Carlos B. Udaondo. Ciudad Autónoma de Buenos Aires, Argentina
| | - Kanokwan Pinyopornpanish
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thierry Thevenot
- Centre Hospitalier Universitaire de Besançon, Hôpital Jean Minjoz, Service d’Hépatologie et de Soins Intensifs Digestifs, Besançon, France
| | | | - Arpan Mohanty
- Section of Gastroenterology, Boston Medical Center, Boston, MA, USA
| | - Sanjaya K. Satapathy
- Department of Internal Medicine, Division of Hepatology, Sandra Atlas Bass Center for Liver Diseases & Transplantation, Donald and Barbara Zucker School of Medicine for Hofstra/Northwell Health, Manhasset, New York, USA
| | - Lorenzo Ridola
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Hitoshi Maruyama
- Department of Gastroenterology, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Li Yang
- Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, China
| | - Shalimar
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Yongping Yang
- Senior Department of Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Erica Villa
- Department of Gastroenterology, University of Modena & Reggio Emilia and Azienda Ospedaliero-Universitaria di Modena, Italy
| | - Aleksander Krag
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Florence Wong
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rajiv Jalan
- Liver Failure Group, UCL Institute for Liver and Digestive Health, The Royal Free Hospital, University College London, London, UK
| | | | - Mauro Bernardi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
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10
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Rehbar B, Bilal M, Hassan HU, Gabol K, Khan MF, Nadeem K, Ullah S, Taj M, Khan FA, Abbas M, Ibrahim M, Haq IU, Ahmad A, Ríos-Escalante PR. Morphometric analysis and roosting ecology of bat species Pteropus Medius in Mansehra, Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2023; 83:e259039. [PMID: 37466508 DOI: 10.1590/1519-6984.259039] [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: 12/18/2021] [Accepted: 03/18/2022] [Indexed: 07/20/2023] Open
Abstract
Morphometric measurement and roosting ecology of Pteropus medius were aimed to find out in Mansehra district of KP, Pakistan. Total 3149 numbers of bats were found in eight biological spots visited; Baffa Doraha, Darband, Dadar, Jallu, Hazara University, Garhi Habibullah Chattar Plain and Jabori, in total 299 numbers of different species of trees including; Morus alba, Pinus raxburghi, Eucalyptus camaldulensis, Morus nigra, Grevillea robusta, Brousonetia papyrifera, Platanus orientalis, Ailanthus altissima, Hevea brasiliensis and Populus nigra. Morphometric features were measured and found vary according to sex of the bats. The average wing span, wing`s length from tip of wing to neck, from thumb to tip of wing and the body`s length from head and claws were recorded to be 102.98 cm, 49.07cm, 28.7 cm and 22.78 cm respectively in males while 93.67 cm, 44.83cm, 24.78cm and 22.78 cm respectively in female bats. Mean circumference of the body including wings and without wing were measured as 22.78 cm and 17.29 cm in males and that of female were 20.07 cm and 16.9 cm. Average length of thumb 3.64 cm, ear`s length 3.1 cm, snout 5.62cm, eye length were 1.07 cm for both sexes and length between the feet in extended position were16.3 cm. Generally different measurement of males bodies were found to be greater than female such as mean body surface area, mass, volume and pressure were found to be 2691.79 cm2, 855.7gm,1236.4 ml and 295.77 dyne/ c m 3 for male and 2576.46 cm2, 852.71gm,1207 ml and 290.2 dyne/ c m 3 respectively for female. While weight and density for both males and females bats were same with mean of 8.59 newton and 0.701 g/m3. Findings of current reports can add valued information in literature about bats, which can be used for species identification and conservation.
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Affiliation(s)
- B Rehbar
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - M Bilal
- Government College University Lahore, Department of Zoology, Lahore, Pakistan
| | - H U Hassan
- University of Karachi, Department of Zoology, Karachi, Pakistan
- Ministry of National Food Security and Research, Fisheries Development Board, Islamabad, Pakistan
| | - K Gabol
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - M F Khan
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - K Nadeem
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - S Ullah
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - M Taj
- Degree College Gulabad Adenzai, Department of Environmental Sciences, KPK, Pakistan
| | - F A Khan
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - M Abbas
- Quaid-i- Azam University, Department of Zoology, Islamabad, Pakistan
| | - M Ibrahim
- University of Karachi, Department of Zoology, Karachi, Pakistan
| | - I U Haq
- Hazara University Mansehra, Department of Zoology, Mansehra, Pakistan
| | - A Ahmad
- Islamia College Peshawar, Department of Zoology, Peshawar, KPK, Pakistan
| | - P R Ríos-Escalante
- Universidad Católica de Temuco, Facultad de Recursos Naturales, Departamento de Ciencias Biológicas y Químicas, Temuco, Chile
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11
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Ali Y, Mousa A, Mohamed H, Ibrahim M, Naveed M, Alsamawi M. Candida pneumonia in young and immunocompetent lady: A case report and literature review. IDCases 2023; 33:e01840. [PMID: 37539094 PMCID: PMC10393732 DOI: 10.1016/j.idcr.2023.e01840] [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: 05/11/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 08/05/2023] Open
Abstract
Background Candida is a frequent respiratory tract colonizer. True candida pneumonia is rare and seen with predominance in immunosuppressed patients. Our aim is to document a previously unreported case of Candida pneumonia in a young and immunocompetent patient, highlighting, an unusual pathological manifestation of this infection in immunocompetent individuals. Case summary We report a previously healthy young lady who remained symptomatic with fever, cough and shortness of breath for three weeks duration despite treatment with extensive antibiotics regimen for community acquired pneumonia. She was eventually treated as a probable, rare case of candida pneumonia. The patient demonstrated a dramatic response to single antifungal treatment both clinically and biochemically within the first 24hrs of treatment. Candida albican was isolated on repetitive cultures form the sputum and bronchoalevolar lavage samples. The patient had negative blood cultures. Her HRCT scan revealed bilateral basal air space opacities with peri bronchovascular distribution and centrilobular nodules with branching pattern suggestive of tree in bud predominantly in lower lobes. Her endobronchial biopsies was mostly unremarkable apart from rare non-necrotizing granuloma. Conclusion Candida can rarely cause clinically significant pneumonia in immunocompetent patients and should be considered in the differential diagnosis of granulomatous lung disease.
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Affiliation(s)
- Y. Ali
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Medical education department, Hamad Medical Corporation, Doha, Qatar
| | - A. Mousa
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Medical education department, Hamad Medical Corporation, Doha, Qatar
| | - H. Mohamed
- Medical education department, Hamad Medical Corporation, Doha, Qatar
| | - M. Ibrahim
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Medical education department, Hamad Medical Corporation, Doha, Qatar
| | - M. Naveed
- Pulmonology, Internal medicine, Hamad Medical Corporation, Doha, Qatar
| | - M. Alsamawi
- Infectious disease, Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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12
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Haque N, Siddiqua SS, Hosain N, Asaduzzaman M, Jahan S, Ibrahim M, Bari MS, Khan AI, Hoque MM, Haque N, Anwar MA. Physical, Psychological and Social Impact of COVID-19 Pandemic on Healthcare Workers at a COVID Designated Bangladeshi Public Hospital. Mymensingh Med J 2023; 32:732-742. [PMID: 37391967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
The world has been devastated facing the outbreak of a novel infectious disease known as Corona virus disease (COVID-19). This has been declared as a pandemic by the World Health Organization. The frontline health care workers, who are directly involved in the diagnosis, treatment and care of patients with COVID-19, are taking significant personal risks on their own health and those of their family members. Objectives of the study include establishing the physical, psychological and social impact experience by the healthcare workers serving in public hospitals of Bangladesh. This prospective cross-sectional observational study was carried out at Kuwait Bangladesh Friendship Government Hospital, the first Covid-19 designated hospital of Bangladesh between the 1st June and the 31st August, 2020. A total of 294 doctors, nurses, ward boys and ailed healthcare workers were included in this study via purposive sampling. The study found statistically significant (p value 0.024) difference of medical co-morbidities between Covid-19 positive and Covid-19 negative groups of health care professionals. Significant association was found between duration of work and presence during aerosol generating procedure with COVID infectivity of the study subjects. 72.8% respondents experienced public fear of contracting the virus from them and 69.0% noticed negative attitude of the society towards them. Eighty five percent (85.0%) did not get any community support during this pandemic crisis. The health care professionals engaged in COVID-19 treatment have been taking significant personal risk on their life in terms of physical, psychological and social perspective. Providing safeguard to the health care workers are integral components of public health measures for addressing the COVID-19 pandemic. Special interventions to promote their physical wellbeing and arrangement of adequate psychological training need to be immediately implemented to cope up this critical situation.
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Affiliation(s)
- N Haque
- Dr Nadira Haque, Senior Consultant, Department of Obstetrics and Gynecology, Kuwait-Bangladesh Friendship Government Hospital, Dhaka, Bangladesh; E-mail:
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13
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Savard MF, Ibrahim M, Pond G, Saunders D, Vandermeer L, Fallowfield L, Ng T, Awan A, Sehdev S, Beltran-Bless A, Clemons M. P021 A pragmatic randomised, multicentre trial evaluating the dose timing (morning vs evening) of endocrine therapy for early breast cancer (REaCT-CHRONO Study). Breast 2023. [DOI: 10.1016/s0960-9776(23)00140-6] [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: 03/18/2023] Open
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14
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Blake D, Patel A, Hopkins S, Pozo AD, Marx J, Ibrahim M, Hamad E. Pseudo Cardiomyopathy in End-Stage Lung Disease With Elevated Pulmonary Vascular Resistance and/or Right Ventricular Dysfunction That Improves Following Lung Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.040] [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: 04/05/2023] Open
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15
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Ibrahim M. P246 A comparative study between round block technique and standard wide local excision in patients with breast cancer. Breast 2023. [DOI: 10.1016/s0960-9776(23)00364-8] [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: 03/16/2023] Open
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16
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Boškoski I, Pontecorvi V, Ibrahim M, Huberty V, Maselli R, Gölder SK, Kral J, Samanta J, Patai ÁV, Haidry R, Hollenbach M, Pérez-Cuadrado-Robles E, Silva M, Messmann H, Tham TC, Bisschops R. Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2023; 55:276-293. [PMID: 36696907 DOI: 10.1055/a-2003-5818] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Obesity is a chronic, relapsing, degenerative, multifactorial disease that is associated with many co-morbidities. The global increasing burden of obesity has led to calls for an urgent need for additional treatment options. Given the rapid expansion of bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This curriculum is set out in terms of the prerequisites prior to training, minimum number of procedures, the steps for training and quality of training, and how competence should be defined and evidenced before independent practice. 1: ESGE recommends that every endoscopist should have achieved competence in upper gastrointestinal endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. 2: Trainees in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery should have basic knowledge of the definition, classification, and social impact of obesity, its pathophysiology, and its related co-morbidities. The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory. 3 : ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.
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Affiliation(s)
- Ivo Boškoski
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Valerio Pontecorvi
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mostafa Ibrahim
- Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Vincent Huberty
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Roberta Maselli
- Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Stefan K Gölder
- Department of Internal Medicine, Ostalb Klinikum Aalen, Aalen, Germany
| | - Jan Kral
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jayanta Samanta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Árpád V Patai
- Division of Gastroenterology, Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Rehan Haidry
- Department of Gastroenterology, University College London Hospital, London, UK
| | - Marcus Hollenbach
- Medical Department II, Division of Gastroenterology, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Marco Silva
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Helmut Messmann
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Tony C Tham
- Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospital Leuven, TARGID, KU Leuven, Leuven, Belgium
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17
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Ibrahim M. Acute scrotal pain and COVID-19 in a busy acute hospital in the UK. Eur Urol 2023. [PMCID: PMC9912114 DOI: 10.1016/s0302-2838(23)00669-3] [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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18
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Vasey B, Novak A, Ather S, Ibrahim M, McCulloch P. DECIDE-AI: a new reporting guideline and its relevance to artificial intelligence studies in radiology. Clin Radiol 2023; 78:130-136. [PMID: 36639172 DOI: 10.1016/j.crad.2022.09.131] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/18/2022] [Accepted: 09/29/2022] [Indexed: 01/12/2023]
Abstract
DECIDE-AI is a new, stage-specific reporting guideline for the early and live clinical evaluation of decision-support systems based on artificial intelligence (AI). It answers a need for more attention to the human factors influencing clinical AI performance and more transparent reporting of clinical studies investigating AI systems. Given the rapid expansion of AI systems and the concentration of related studies in radiology, these new standards are likely to find a place in radiological literature in the near future. This review highlights some of the specificities of AI as complex intervention, why a new reporting guideline was needed for early stage, live evaluation of this technology, and how DECIDE-AI and other AI reporting guidelines can be useful to radiologists and researchers.
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Affiliation(s)
- B Vasey
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Surgery, Geneva University Hospital, Geneva, Switzerland.
| | - A Novak
- Emergency Medicine Research Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Ather
- National Consortium for Intelligent Medical Imaging, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Ibrahim
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - P McCulloch
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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19
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Wahab F, Salahuddin AZ, Ibrahim M, Sultana MZ, Sharmin S, Ahmed A, Jabbar N, Keya MT. SARS-CoV-2 Infection after Vaccination: A Comparative Profile between Dose 1 and Dose 2. Mymensingh Med J 2023; 32:96-102. [PMID: 36594308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Since the initial shipment of vaccination campaign against SARS-CoV-2 infection, it was a major concern all over the world regarding appropriate gapping between the first and second dose and also the necessity of booster dose after being vaccinated with the second dose. This cross-sectional type of comparative study was conducted at Kuwait Bangladesh Friendship Government Hospital, from the period of March 01 2021 to August 31 2021, on 148 hospitalized patients who were vaccinated with Astra Zeneca. They were divided into two groups on the background of 1st dose and 2nd dose. Collected data were entered into SPSS-26 version and after data cleaning, descriptive analysis was done with frequency distribution. To find out the significant difference between the two groups considering clinico-demographic information, disease severity, and duration of the last dose of vaccine; the Pearson Chi-square test was done with a significance level ≤0.05. The patients from both groups were mostly male and above 60 years. There were no significant age or sex variations between the two groups. SARS-CoV-2 infection was common after 38 days of dose 1 and after 63 days of dose 2. Fever, cough, running nose, shortness of breath, fatigue, nausea, vomiting, lower oxygen saturation, radiological involvement were comparatively more in patients who got only a single dose. Mild pneumonia (70.7%) was the commonest presentation in both doses of vaccinated patients and single dose vaccinated patients mostly (45.5%) presented with severe pneumonia. Elderly clinically risks group patients were mostly hospitalized with infection after 1 month of the 1st dose and on the other hand after 2 months of completing the 2nd dose. Symptomatic infection and disease severity were more in 1st dose vaccine recipients in comparison to 2nd dose.
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Affiliation(s)
- F Wahab
- Dr Farhana Wahab, Junior Consultant (Dermatology), Kuwait Bangladesh Friendship Government Hospital (KBFGH), Dhaka, Bangladesh; E-mail:
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20
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Gralnek IM, Camus Duboc M, Garcia-Pagan JC, Fuccio L, Karstensen JG, Hucl T, Jovanovic I, Awadie H, Hernandez-Gea V, Tantau M, Ebigbo A, Ibrahim M, Vlachogiannakos J, Burgmans MC, Rosasco R, Triantafyllou K. Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54:1094-1120. [PMID: 36174643 DOI: 10.1055/a-1939-4887] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
1: ESGE recommends that patients with compensated advanced chronic liver disease (ACLD; due to viruses, alcohol, and/or nonobese [BMI < 30 kg/m2] nonalcoholic steatohepatitis) and clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] > 10 mmHg and/or liver stiffness by transient elastography > 25 kPa) should receive, if no contraindications, nonselective beta blocker (NSBB) therapy (preferably carvedilol) to prevent the development of variceal bleeding.Strong recommendation, moderate quality evidence. 2: ESGE recommends that in those patients unable to receive NSBB therapy with a screening upper gastrointestinal (GI) endoscopy that demonstrates high risk esophageal varices, endoscopic band ligation (EBL) is the endoscopic prophylactic treatment of choice. EBL should be repeated every 2-4 weeks until variceal eradication is achieved. Thereafter, surveillance EGD should be performed every 3-6 months in the first year following eradication.Strong recommendation, moderate quality evidence. 3: ESGE recommends, in hemodynamically stable patients with acute upper GI hemorrhage (UGIH) and no history of cardiovascular disease, a restrictive red blood cell (RBC) transfusion strategy, with a hemoglobin threshold of ≤ 70 g/L prompting RBC transfusion. A post-transfusion target hemoglobin of 70-90 g/L is desired.Strong recommendation, moderate quality evidence. 4 : ESGE recommends that patients with ACLD presenting with suspected acute variceal bleeding be risk stratified according to the Child-Pugh score and MELD score, and by documentation of active/inactive bleeding at the time of upper GI endoscopy.Strong recommendation, high quality of evidence. 5 : ESGE recommends the vasoactive agents terlipressin, octreotide, or somatostatin be initiated at the time of presentation in patients with suspected acute variceal bleeding and be continued for a duration of up to 5 days.Strong recommendation, high quality evidence. 6 : ESGE recommends antibiotic prophylaxis using ceftriaxone 1 g/day for up to 7 days for all patients with ACLD presenting with acute variceal hemorrhage, or in accordance with local antibiotic resistance and patient allergies.Strong recommendation, high quality evidence. 7 : ESGE recommends, in the absence of contraindications, intravenous erythromycin 250 mg be given 30-120 minutes prior to upper GI endoscopy in patients with suspected acute variceal hemorrhage.Strong recommendation, high quality evidence. 8 : ESGE recommends that, in patients with suspected variceal hemorrhage, endoscopic evaluation should take place within 12 hours from the time of patient presentation provided the patient has been hemodynamically resuscitated.Strong recommendation, moderate quality evidence. 9 : ESGE recommends EBL for the treatment of acute esophageal variceal hemorrhage (EVH).Strong recommendation, high quality evidence. 10 : ESGE recommends that, in patients at high risk for recurrent esophageal variceal bleeding following successful endoscopic hemostasis (Child-Pugh C ≤ 13 or Child-Pugh B > 7 with active EVH at the time of endoscopy despite vasoactive agents, or HVPG > 20 mmHg), pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) within 72 hours (preferably within 24 hours) must be considered.Strong recommendation, high quality evidence. 11 : ESGE recommends that, for persistent esophageal variceal bleeding despite vasoactive pharmacological and endoscopic hemostasis therapy, urgent rescue TIPS should be considered (where available).Strong recommendation, moderate quality evidence. 12 : ESGE recommends endoscopic cyanoacrylate injection for acute gastric (cardiofundal) variceal (GOV2, IGV1) hemorrhage.Strong recommendation, high quality evidence. 13: ESGE recommends endoscopic cyanoacrylate injection or EBL in patients with GOV1-specific bleeding.Strong recommendations, moderate quality evidence. 14: ESGE suggests urgent rescue TIPS or balloon-occluded retrograde transvenous obliteration (BRTO) for gastric variceal bleeding when there is a failure of endoscopic hemostasis or early recurrent bleeding.Weak recommendation, low quality evidence. 15: ESGE recommends that patients who have undergone EBL for acute EVH should be scheduled for follow-up EBLs at 1- to 4-weekly intervals to eradicate esophageal varices (secondary prophylaxis).Strong recommendation, moderate quality evidence. 16: ESGE recommends the use of NSBBs (propranolol or carvedilol) in combination with endoscopic therapy for secondary prophylaxis in EVH in patients with ACLD.Strong recommendation, high quality evidence.
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Affiliation(s)
- Ian M Gralnek
- Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel.,Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel
| | - Marine Camus Duboc
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA) & Assistance Publique-Hôpitaux de Paris (AP-HP), Endoscopic Center, Saint Antoine Hospital, Paris, France
| | - Juan Carlos Garcia-Pagan
- Barcelona Hepatic Hemodynamic Laboratory, Hospital Clinic, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.,Liver Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Lorenzo Fuccio
- Gastroenterology Unit, Department of Medical and Surgical Sciences, IRCSS-S. Orsola-Malpighi, Hospital, Bologna, Italy
| | - John Gásdal Karstensen
- Gastroenterology Unit, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tomas Hucl
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ivan Jovanovic
- Euromedik Health Care System, Visegradska General Hospital, Belgrade, Serbia
| | - Halim Awadie
- Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel
| | - Virginia Hernandez-Gea
- Barcelona Hepatic Hemodynamic Laboratory, Hospital Clinic, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.,Liver Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Marcel Tantau
- University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj-Napoca, Romania
| | - Alanna Ebigbo
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | | | - Jiannis Vlachogiannakos
- Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Marc C Burgmans
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
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21
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Kitic DB, Ibrahim M, McGlynn J, O'Keane C, Donnelly T, Kemple O. 162 A REVIEW OF THE GENERAL PRACTITIONER REFERRALS TO A RAPID ACCESS FRAILTY ASSESSMENT UNIT IN A MODEL-3 HOSPITAL. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Rapid Access Frailty assessment unit (RAFAU) was set up in February 2021 and is run by a Raft (Rapid access frailty team). This is a dedicated multidisciplinary team in a model three hospital to review frail older patients to improve outcomes and admission avoidance. They review patients in the Emergency department as well as the assessment unit and on the ward for inpatient frailty reviews. The team is expanding as new roles are incorporated into the team and our service has evolved into a five day a week rapid access service.
Methods
We examined the number of GP referrals to our RAFU since May 2021 to March 2022 and the outcome of the review. Data was collected on all patients attending the RAFAU over an 11-month period. We selected all GP referrals which produced a cohort of 259 referrals to the unit.
Results
A total of 259 referrals were reviewed in RAFAU clinics. Mean age was 70-75 years old 60% were female, 40 % male. Reason for referral included: 38 % medical reasons, 32% cognitive issues, 18 % mobility ,7 % falls. Overall, 41% of referred patients had Clinical frailty scale score of 1-3, 16 % had a clinical frailty scale of 4, 8% clinical frailty scale of 5, 9% clinical frailty scale of 6, 5% clinical frailty scale of 7.The outcome of this cohort were as follows: 86 % needed further follow up, 9% were discharged and 1% admitted.
Conclusion
The RAFAU gives an alternative referral destination to GP’s for rapid review of frail older patients and thus potentially avoiding ED referral and admission. The vast majority of these referrals were for review of medical issues and cognitive assessment. The majority of patients required ongoing specialist frailty services and we hope to expand our service in the future.
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Affiliation(s)
- DB Kitic
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - M Ibrahim
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - J McGlynn
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - C O'Keane
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - T Donnelly
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - O Kemple
- Midland Regional Hospital Tullamore , Tullamore, Ireland
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22
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Kotb A, Armstrong S, Antoun I, Koev I, Mavilakandy A, Barker J, Vali Z, Panchal G, Li X, Lazdam M, Ibrahim M, Sandilands A, Chin S, Somani R, Andre Ng G. Atrial fibrillation virtual ward: reshaping the future of AF care. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) hospital admissions represent significant AF related treatment costs nationally. In the year 2019–2020 our hospital reported 1,333 admissions with a primary diagnosis of AF, with a 10% annual increase. A virtual ambulatory AF ward providing multidisciplinary care with remote hospital-level monitoring could reshape the future model of AF management.
Methods
An AF virtual ward was implemented at our UK tertiary centre, as a proof-of-concept model of care. Patients admitted with a primary diagnosis of AF satisfying the AF virtual ward (AFVW) entry criteria (i.e., haemodynamically stable, HR <140 bpm with other acute conditions excluded) were given access to a single lead ECG recording device, a Bluetooth integrated blood pressure machine and pulse oximeter with instruction to record daily ECGs, blood pressure readings, oxygen saturations and fill an online AF symptom questionnaire via a smart phone or electronic tablet. Data were uploaded to an integrated digital platform for review by the clinical team who undertook twice daily virtual ward rounds. Medication adjustment was arranged through the hospital pharmacy. Data was collected prospectively for patients admitted to the AF virtual ward between 31 January and 11 March 2022. Outcomes included length of hospital stay, admission avoidance and re-admissions. Re-admission avoidance was assessed using the index admission criteria as a parameter for re-admission likelihood. Patients' satisfaction was assessed using the NHS family and friends' test (FFT).
Results
Over the 6-week period a total of 14 patients were enrolled. One patient was unable to be onboarded because of technology related anxiety with 13 patients onboarded to the virtual ward, 30.7% (n=4) did not have smart phones and were provided with electronic tablets. The age on admission was 64±10 years (mean±SD) with the oldest at 78 years of age. All patients were in AF with a mean heart rate of 122±24 bpm, and 38.5% (n=5) were discharged from the virtual ward in sinus rhythm. One patient was onboarded directly from pacemaker clinic and hence hospital admission was completely avoided, and 5 re-admissions were avoided for 3 patients. One patient required brief readmission due to persistent tachycardia requiring acute cardioversion. The FFT yielded 100% positive responses among patients.
Conclusion
This proof-of-concept is a first real world experience of a virtual ward for hospital patients with fast AF. It demonstrates a promising new telemedicine-based care model and with clear appetite among both patients and health professionals. This model of care has the potential to reduce the financial and backlog pressures caused by AF admissions without compromising patients' care or safety. Work is ongoing to further confirm the safety and cost-effectiveness upon further progress in a larger patient cohort.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Kotb
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - S Armstrong
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - I Antoun
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - I Koev
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - A Mavilakandy
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - J Barker
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - Z Vali
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - G Panchal
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - X Li
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
| | - M Lazdam
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - M Ibrahim
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - A Sandilands
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - S Chin
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - R Somani
- University Hospitals of Leicester NHS Trust , Leicester , United Kingdom
| | - G Andre Ng
- University of Leicester, Cardiovascular sciences , Leicester , United Kingdom
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Ibrahim M, Dallash M, Jallad S. Acute scrotal pain and COVID-19 in a busy acute hospital in the UK. EUR UROL SUPPL 2022. [PMCID: PMC9581543 DOI: 10.1016/s2666-1683(22)02045-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Omran A, Awad H, Ibrahim M, El-Sharkawy S, Elfiky S, Rezk AR. Lung Ultrasound and Neutrophil Lymphocyte Ratio in Early Diagnosis and Differentiation between Viral and Bacterial Pneumonia in Young Children. Children 2022; 9:children9101457. [PMID: 36291392 PMCID: PMC9600537 DOI: 10.3390/children9101457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
Lung ultrasound (LUS) is a crucial diagnostic tool for identifying pneumonia in the pediatric age group. However, it plays a limited role in the early distinction between viral and bacterial pneumonia in children. The objectives of our study were to determine if LUS and the neutrophil-lymphocyte ratio (NLR) were useful in identifying and distinguishing between viral and bacterial pneumonia in Egyptian children under the age of two. Within the first 12 h of being admitted to our department, 52 children with clinical symptoms and signs suggestive of community-acquired pneumonia (CAP) underwent LUS and the NLR. LUS and the NLR strongly differentiated children with viral from those with bacterial pneumonia. For the early diagnosis and differentiation between viral and bacterial pneumonia in young Egyptian children, LUS was proven to be a noninvasive and reliable method. Combining the NLR with LUS increased the diagnostic accuracy when evaluating children suspected of having pneumonia.
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Affiliation(s)
- Ahmed Omran
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: ; Tel.: +20-10067-76278
| | - Heba Awad
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Mostafa Ibrahim
- Department of Radiodiagnosis, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Sonya El-Sharkawy
- Department of Pediatrics & Neonatology, Faculty of Medicine, Port Said University, Port Said 42526, Egypt
| | - Samar Elfiky
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ahmed R. Rezk
- Department of Pediatrics, Ain Shams University, Cairo 11566, Egypt
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Vanni C, Rendina E, Ciccone A, D'Andrilli A, Ibrahim M, Andreetti C, Venuta F, Maurizi G. EP05.03-002 Pulmonary Artery Reconstruction for Lung Cancer With N1 Vessel Infiltration: Is It Justified? J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vanni C, Rendina E, Ciccone A, D'Andrilli A, Ibrahim M, Andreetti C, Venuta F, Maurizi G. EP01.06-001 Lung Cancer after First Primary Breast Cancer: Risk Factors and Results of Treatment. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sannananja B, Zhu C, Colip CG, Somasundaram A, Ibrahim M, Khrisat T, Mossa-Basha M. Image-Quality Assessment of 3D Intracranial Vessel Wall MRI Using DANTE or DANTE-CAIPI for Blood Suppression and Imaging Acceleration. AJNR Am J Neuroradiol 2022; 43:837-843. [PMID: 35618420 DOI: 10.3174/ajnr.a7531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 3D intracranial vessel wall MRI techniques are time consuming and prone to artifacts, especially flow artifacts. Our aim was to compare the image quality of accelerated and flow-suppressed 3D intracranial vessel wall MR imaging techniques relative to conventional acquisitions. MATERIALS AND METHODS Consecutive patients undergoing MR imaging had conventional postcontrast 3D T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) and either postcontrast delay alternating with nutation for tailored excitation (DANTE) flow-suppressed or DANTE-controlled aliasing in parallel imaging results in higher acceleration (CAIPI) flow-suppressed and accelerated T1-SPACE sequences performed. The sequences were evaluated using 4- or 5-point Likert scales for overall image quality, SNR, extent/severity of artifacts, motion, blood suppression, sharpness, and lesion assessment. Quantitative assessment of lumen and wall-to-lumen contrast ratios was performed. RESULTS Eighty-nine patients were included. T1-DANTE-SPACE had significantly better qualitative ratings relative to T1-SPACE for image quality, SNR, artifact impact, arterial and venous suppression, and lesion assessment (P < .001 for each, respectively), with the exception of motion (P = .16). T1-DANTE-CAIPI-SPACE had significantly better image quality, lesion assessment, arterial and venous blood suppression, less artifact impact, and less motion compared with T1-SPACE (P < .001 for each, respectively). The SNR was higher with T1-SPACE compared with T1-DANTE-CAIPI-SPACE (P < .001). T1-DANTE-CAIPI-SPACE showed significantly worse lumen (P = .005) and wall-to-lumen contrast ratios (P = .001) compared with T1-SPACE, without a significant difference between T1-SPACE and T1-DANTE-SPACE. T1-DANTE-CAIPI-SPACE scan time was 5:11 minutes compared with 8:08 and 8:41 minutes for conventional T1-SPACE and T1-DANTE-SPACE, respectively. CONCLUSIONS Accelerated postcontrast T1-DANTE-CAIPI-SPACE had fewer image artifacts, less motion, improved blood suppression, and a shorter scan time, but lower qualitative and quantitative SNR ratings relative to conventional T1-SPACE intracranial vessel wall MR imaging. Postcontrast T1-DANTE-SPACE had superior SNR, blood suppression, higher image quality, and fewer image artifacts, but slightly longer scan times relative to T1-SPACE.
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Affiliation(s)
- B Sannananja
- From the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
| | - C Zhu
- Department of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
| | - C G Colip
- Kaiser Permanente Northwest (C.G.C.), Portland, OR
| | - A Somasundaram
- From the Department of Radiology (B.S., A.S.), Emory University, Atlanta, Georgia
| | - M Ibrahim
- Department of Radiology (M.I.), University of Kansas, Lawrence, Kansas
| | - T Khrisat
- Department of Surgery (T.K.), Lincoln Medical Center, New York, New York
| | - M Mossa-Basha
- Department of Radiology (C.Z., M.M.-B.), University of Washington, Seattle, Washington
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Vali Z, Ebeid A, Man S, Abuelmagd K, Dhutia H, Somani R, Ng GA, Ibrahim M. Short term outcomes of distal (ventricular) His bundle pacing: A single centre retrospective study. Europace 2022. [DOI: 10.1093/europace/euac053.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Chronic right ventricular apical pacing can lead to pacing induced cardiomyopathy in a significant proportion of patients. Conduction system pacing may restore more physiological activation of the heart, and has recently been shown to have favourable outcomes in clinical trials. However there remains concern regarding the long-term outcomes due to lead displacement and high pacing thresholds. The most widely used technique in current practice is to pace the His bundle proximal to the tricuspid valve. Distal His bundle pacing has a number of advantages over proximal His pacing, including, lower capture thresholds, a more stable lead position, less far field atrial sensing and better spacing from the AV node in case ablation of this is required for AF rate control. Despite these, outcomes of distal His bundle pacing from the ventricular aspect are less well defined.
Methods
We performed a retrospective review of patients who underwent conduction system pacing between January 2020 and October 2021 at our centre. During this period all procedures were performed employing a distal His bundle pacing approach with the lead placed on the ventricular aspect of the tricuspid annulus. Data was collected at implant, follow-up at 1 month and then every 6 months.
Results
Out of 35 patients, 33 underwent successful His bundle pacing (acute success rate of 94%), 1 patient had left bundle branch pacing and another patient had an unsuccessful procedure. Mean age was 74 years, median LVEF 45% and median pre-implant QRS was 108ms. 80% of the cohort had a history of AF. The indications for pacing were as follows: AF - for pace & ablate (60%); high grade AV block with narrow QRS and mild LVSD (17%); failed LV lead (14%); and other 9%. Mean procedure duration and fluoroscopy time were 78 minutes and 12.05 minutes, respectively. Median threshold at implant was 1.00V (IQR 0.719V). Selective His bundle pacing was achieved in 60% and non-selective in 34%. Mean follow-up duration was 150 days with median threshold at last f/up of 0.75V (IQR 0.750V). There were no acute procedural complications. 1 patient had a significant rise in threshold at follow-up and therefore required upgrade to CRT-P.
Discussion
Our data shows that distal His bundle pacing is a safe and effective technique for conduction system pacing. Thresholds appear stable at follow-up and failure rate was found to be comparable to biventricular pacing. We noted an initial learning curve for both implanter and physiologists with relatively poorer outcomes for the earlier cases. Longer term follow-up is ongoing, including functional assessment and follow-up to assess for remodelling with echocardiography. Prospective randomised trials are needed to compare conduction system pacing vs RV pacing in AF patients with HFpEF or mild LVSD undergoing AVN ablation, and vs biventricular pacing in the severe LVSD population.
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Affiliation(s)
- Z Vali
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - A Ebeid
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - S Man
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - K Abuelmagd
- Al-Azhar University, Department of Cardiology, Cairo, Egypt
| | - H Dhutia
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - R Somani
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - GA Ng
- University of Leicester, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - M Ibrahim
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain & Northern Ireland
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Man S, Vali Z, Ebeid A, Abouelmagd K, Dhutia H, Somani R, Ng GA, Ibrahim M. Short term outcome of distal (ventricular) His bundle pacing and atrioventricular node ablation in patients with symptomatic atrial fibrillation - Refining the concept. Europace 2022. [DOI: 10.1093/europace/euac053.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Many patients with atrial fibrillation (AF) do not benefit from rhythm control due to failed catheter ablation, advanced left atrial disease and comorbidities. "Pace and AV node (AVN) ablation" strategy is often adopted for rate control but with a substantial risk of pacing-induced cardiomyopathy. His bundle pacing (HBP) enables physiological biventricular activation through the His Purkinje conduction system. However, the proximity of the HBP lead to the site of AV node ablation may potentially compromise lead integrity in patients who undergo conventional HBP and AVN ablation. Therefore, we have modified HBP by placing the HBP lead distally at the ventricular side of the His bundle (D-HBP) before AVN ablation in patients with symptomatic AF. All patients had a backup RV lead.
Method
Patients who had D-HBP as part of a "Pace and AVN ablation" strategy were retrospectively analysed. Implant and device clinic follow-up data were collected and analysed.
Result
Twenty-one patients who had "pace and AVN ablation strategy" with D-HBP between 26th February 2020 and 3rd November 2021 were included. They had a mean age of 75 ± 1.4 years (mean ± SEM), NYHA class of 2.1 ± 0.2, QRS duration of 106 ± 5.3ms and 50% had at least moderately impaired LV systolic function. Seventeen patients (81%) had narrow QRS duration. D-HBP was successful in twenty of twenty-one patients (95%). At D-HBP implant, the mean acute threshold of the HBP lead was 0.96 ± 0.12V at 0.5 ± 0.05ms and the mean HBP lead impedance was 548.1 ± 29.5Ω. Selective HBP pacing was observed in thirteen of twenty patients. The mean QRS duration of HBP paced beats was 104.5 ± 4.7ms. Failure to capture the His bundle was observed in one patient. AVN ablation was performed on the same day after D-HBP in eleven patients and as a subsequent procedure in nine patients. The mean duration of procedure and fluoroscopy for D-HBP were 77.4 ± 4.6 minutes and 11.9 ± 1.4 minutes respectively. There were no acute procedural complications with no lead damage, displacement or lead perforation observed. The median follow-up period was 207 days. The mean D-HBP lead threshold following AVN ablation was 1.1 ± 0.2 V at 0.6 ± 0.07 ms and the mean lead impedance was 433.8 ± 20.7Ω, which were similar to before AVN ablation. One patient was reprogrammed with RV pacing only for elevated HBP lead threshold after AVN ablation to 4.2 V at 1ms. The mean D-HBP percentage was 92.3 ± 6.6% and the mean estimated battery longevity of the pacemaker was 7.9 ± 0.6 years at the last follow up. There was improvement in heart failure symptoms in eight patients from previously symptomatic to NYHA class I following D-HBP and AVN ablation.
Conclusion
D-HBP appear to be safe with potentially more favourable lead parameters than conventional proximal HBP in patients with symptomatic AF offered "Pace and AVN ablation" strategy.
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Affiliation(s)
- S Man
- University of Leicester, Cardiovascular Sciences, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - Z Vali
- University of Leicester, Cardiovascular Sciences, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - A Ebeid
- University Hospital of Leicester, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - K Abouelmagd
- Al-Azhar University, Department of Cardiology, Cairo, Egypt
| | - H Dhutia
- University Hospital of Leicester, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - R Somani
- University Hospital of Leicester, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - G A Ng
- University of Leicester, Cardiovascular Sciences, Leicester, United Kingdom of Great Britain & Northern Ireland
| | - M Ibrahim
- University Hospital of Leicester, Leicester, United Kingdom of Great Britain & Northern Ireland
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Eldin AB, Ibrahim M, Elsheikh A, Awad A, Elsadek A, Fekry H, Ali N. Insights into Early Pregnancy Demise following Intracytoplasmic Sperm Injection in Women with Unexplained Infertility. JBRA Assist Reprod 2022; 27:4-8. [PMID: 35575659 PMCID: PMC10065766 DOI: 10.5935/1518-0557.20220005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate the effects of some potential risk factors on early pregnancy loss -EPL - in a cohort of pregnant women treated by assisted reproductive technology - ART. METHODS This is a retrospective cohort of 195 pregnancies, defined as serum human chorionic gonadotrophins ≥ 10 IU/l on day 14 - 17 after embryo transfer, recruited from an assisted reproductive technology unit, Ain Shams & Al-Azhar Maternity hospital, Cairo, Egypt, during the period from January 1st, 2016 to December 31, 2020. Risk factors investigated were maternal age, body mass index, status, baseline hormonal profiles, treatment protocol, quality and number of embryos. RESULTS Overall early pregnancy loss among the studied 195 pregnant women was 29 cases (15%). The risk of early pregnancy loss was associated with older age and fewer number of embryos transferred. Women > 35 years were found to have two and half times of early pregnancy loss compared with younger age group < 25 years, this was not significant after adjusting for other factors. The risk in both lean (BMI < 25 kg/m2) and very obese (BMI > 35 kg/m2) women was also not significantly higher in unadjusted analysis. Transfer of two or more embryos was associated with a non-significant reduced risk of early pregnancy loss, and after adjusting for other factors, the reduction was about 70%. CONCLUSIONS Early pregnancy loss represents a considerable drawback of intracytoplasmic sperm injection treated women with old age to increase the risk of early pregnancy loss and transferring more than one embryo to reduce the risk by about 70%. Obesity and other factors appeared to play a minor role.
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Affiliation(s)
- A Bahaa Eldin
- Department of Obstetrics and Gynecology Ain Shams University Cairo Egypt Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
| | - M Ibrahim
- Department of Obstetrics and Gynecology Al-Azhar University Cairo Egypt Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
| | - A Elsheikh
- Department of Obstetrics and Gynecology Al-Azhar University Cairo Egypt Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
| | - A Awad
- Department of Obstetrics and Gynecology Al-Azhar University Cairo Egypt Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
| | - A Elsadek
- Department of Obstetrics and Gynecology Al-Azhar University Cairo Egypt Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
| | - H Fekry
- Department of Obstetrics and Gynecology Al-Azhar University Cairo Egypt Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt
| | - N Ali
- Department of Obstetrics and Gynecology Ain Shams University Cairo Egypt Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
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Ibrahim M, Roshdy N, Taleb A, Alfadda A, Al-Lehibi A, Altonbary A, Galal A, El-Fouly A, Kozlowska A, Khor C, Isayama H, Okasha H, Barthet M, Giovannini M, Pausawasdi N, Eisendrath P, Kongkam P, Ratanachu-ek T, Nakai Y. Evaluation of the ex-vivo porcine simulator on EUS-guided cystogastrostomy using lumen-apposing metal stent training. Endosc Ultrasound 2022; 11:201-207. [PMID: 35708369 PMCID: PMC9258017 DOI: 10.4103/eus-d-21-00109] [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: 04/22/2021] [Accepted: 11/30/2021] [Indexed: 11/06/2022] Open
Abstract
Bckground and Objectives EUS-guided cystogastrostomy is a well-established advanced endoscopic technique with a steep-learning curve which necessitates an ex-vivo simulator that would allow for adequate training. The aim of this study is to evaluate the feasibility of the model in allowing training for EUS-guided cystogastrostomy using lumen-apposing metal stent (LAMS). Subjects and Methods The model was created by ROEYA Training Center, Egypt, using native porcine tissue to create fluid collections simulating both cystic and solid lesions. It was designed and tested in advance while the hydrogel was added on-site. The simulator was evaluated prospectively in five training sessions involving 17 international experts. The task was to successfully deploy the LAMS to drain the created cyst. After using the simulator, the experts were asked to fill a questionnaire to assess their experience. The primary endpoint was overall satisfaction with the model as a training tool. Results All of the experts were satisfied with the model as a tool to train endoscopists for the technique. 76.5% (n = 11) of the experts thought the model to be moderately realistic. Proper visualization was reported by 94.1% of the experts. All experts believed the lesions to be either slightly like or very similar to real lesions. The model was graded "easy" in difficulty by 11 of the experts. Conclusions In all parameters assessed, the experts thought the model to be a useful tool for future training. This preliminary study suggests that the aforementioned simulator can be used to train endoscopists on using LAMS in a risk-free environment.
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Affiliation(s)
- Mostafa Ibrahim
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Brussels, Belgium
- Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Noran Roshdy
- ROEYA Gastroenterology, Hepatology and Endoscopy Center, Cairo, Egypt
| | | | - Abdulrahman Alfadda
- Department of Gastroenterology and Hepatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abed Al-Lehibi
- Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ahmed Altonbary
- Department of Gastroenterology and Hepatology, Mansoura University, Egypt
| | - Ahmed Galal
- Department of Gastroenterology, Alexandria Hospital, Egypt
| | - Amr El-Fouly
- Endemic Medicine Department, Helwan University, Egypt
| | - Anna Kozlowska
- Department of Endoscopy, Hospital of Ministry of Internal Affairs, Szczecin, Poland
| | - Christopher Khor
- Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
| | - Hiroyuki Isayama
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
| | - Hussein Okasha
- Internal Medicine Department, Kasr Al-Ainy School of Medicine, Cairo University, Egypt
| | - Marc Barthet
- Department of Gastroenterology & Hepatology, Hospital Nord, Marseille, France
| | - Marc Giovannini
- Department of Gastroenterology & Hepatology, Paoli Calmettes Institute, Marseille, France
| | - Nonthalee Pausawasdi
- Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Pierre Eisendrath
- Department of Hepato-Gastroenterology, Saint-Pierre Hospital, Brussels, Belgium
| | - Pradermchai Kongkam
- Division of Gastroenterology, Department of Medicine, Chulalongkom University, Bangkok, Thailand
| | | | - Yousuke Nakai
- Department of Endoscopy and Endoscopic Surgery, University of Tokyo, Tokyo, Japan
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Osunkwo D, Mohammed A, Kamateeka M, Nguku P, Umeokonkwo CD, Abolade OS, Ibrahim M, Ibrahim K, Nwokeukwu H, Zoakah AI. Prevalence and Predictors of Metabolic Syndrome among Adults in North-Central, Nigeria. West Afr J Med 2022; 39:375-380. [PMID: 35489039] [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: 06/14/2023]
Abstract
BACKGROUND Metabolic syndrome contributes to the burden of non-communicable diseases and is a growing public health problem in both developed and developing countries. We determined the prevalence and predictors of metabolic syndrome among adults in Benue State, North-Central, Nigeria to guide targeted interventions. METHODS We conducted a community-based cross-sectional study in Benue State, North-Central, Nigeria. Multistage sampling technique was used to recruit 823 respondents. We defined metabolic syndrome using the National Cholesterol Education Programme Adult Treatment Panel III guideline and adapted a component of the WHO Stepwise questionnaire for data collection. Prevalence of metabolic syndrome and the associated risk factors were estimated using Chi square test and logistic regression at 5% level of significance. Statistical analysis was done using SPSS version 23.0. RESULTS The mean age of the respondents was 40.1± 15.7 years. Most of the respondents were literate (86.8%) and married (67.0%). The prevalence of metabolic syndrome was 19.4%. One in every four of the respondents had pre-metabolic syndrome (25.6%) and this was more in females (28.2%) compared to males (22.9%). Thirty-four percent of the respondents had only one whereas 20.7% did not have any of the risk factors for metabolic syndrome. Age [aOR:10.3; 95%CI: 4.8-22.2], sex [aOR:2.4; 95% CI: 1.7-3.5] and education [aOR:2.9; 95%CI: 1.4-6.1] were significantly associated with metabolic syndrome among the respondents. CONCLUSION The prevalence of metabolic syndrome was high. The associated risk factors were age, gender and educational status. Therefore, interventions should be targeted at young adults to reduce the long-term impact of the disease.
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Affiliation(s)
- D Osunkwo
- National Hospital, Abuja, Nigeria
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - A Mohammed
- Federal Ministry of Health, Abuja, Nigeria
- Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - M Kamateeka
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - P Nguku
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - C D Umeokonkwo
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
- Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria
| | - O S Abolade
- National Bureau of Statistics, Abuja Nigeria
| | - M Ibrahim
- Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - K Ibrahim
- Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | | | - A I Zoakah
- Jos University Teaching Hospital, Jos, Plateau State, Nigeria
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Romero C, Dutta S, Ibrahim M, Toyoda Y, Hamad E. Survival in Orthotopic Heart Transplant Recipients: Influence of Neighborhood Income, Education, and Employment. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ibrahim M, Schneider P, Marshall D, Hoosain J, Rakita V, Mishkin A, Morewood G, Yanagida R, Toyoda Y, Rohit S S, Hamad E. Successful Robotic Sleeve Gastrectomy in a Patient with Left Ventricular Assist Device. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Background Somalia has been without an effective government since the collapse of the military regime in 1991. Years of conflict, disasters, and insecurity have all contributed to very low scores for most health indicators due to poor governance, protracted conflict, underdevelopment, economic decline, poverty, social and gender inequality, and environmental degradation. The three-decade long protracted conflict has led to widespread psychosocial trauma, social deprivation and substance abuse with devastating consequences on mental health. A WHO study showed Somalia has one of the highest rates of mental illness in the world. The main aim of this study is to assist policy makers in setting priorities for the design and delivery of interventions to promote mental health and psychosocial wellbeing in Somalia. Methods The study uses a systematic mapping technique (from January 1991 to May 2020) and data collected from public domain, to collect, collate, and present mental health data mainly from WHO’s Global Health Observatory. Since there is no primary database for Somalia’s public health research, the bibliographic databases used for mental health in this study included Medline, PubMed, CINAHL, PsycINFO, and Google Scholar. Data were extracted using techniques for web data mining for public health. Results Systematic mapping of mental health-related issues in Somalia showed that policy-related determinants and mental health services dominated (74.4%), followed by the disaster-related determinants and women’s health consequences (39.3%). The ratio of the number of beds for mental health in general hospitals (per 100,000 population) in Somalia in 2017 is 0.5 compared to the Eastern Mediterranean region (EMR) at 6.4 and globally at 24. One of the biggest casualties of the civil war was loss of essential human resources in healthcare as most either fled the country or were part of the victims of the war. Conclusions The vast scale of the mental health problems in Somalia and the priority setting guidelines for interventions to address the issues outlined in this paper, prompt a dire need that the Somali government and its national/international partners should prioritize and emphasize the need to invest in the prevention and the treatment of mental illness across the country.
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Affiliation(s)
- M Ibrahim
- School of Social Work, The University of British Columbia, 2080 Jack Bell Building, Vancouver, V6T 1Z2, Canada. .,WHO Somalia Country Office, Mogadishu, Somalia.
| | - H Rizwan
- WHO Sudan Country Office, Khartoum, Sudan
| | - M Afzal
- Health Research, Monitoring and Evaluation Consultant, Islamabad, Pakistan
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Sujan M, Bilbro N, Ross A, Earl L, Ibrahim M, Bond-Smith G, Ghaferi A, Pickup L, McCulloch P. Failure to rescue following emergency surgery: A FRAM analysis of the management of the deteriorating patient. Appl Ergon 2022; 98:103608. [PMID: 34655965 DOI: 10.1016/j.apergo.2021.103608] [Citation(s) in RCA: 4] [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: 03/28/2021] [Revised: 06/11/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Failure to rescue (FTR) denotes mortality from post-operative complications after surgery with curative intent. High-volume, low-mortality units have similar complication rates to others, but have lower FTR rates. Effective response to the deteriorating post-operative patient is therefore critical to reducing surgical mortality. Resilience Engineering might afford a useful perspective for studying how the management of deterioration usually succeeds and how resilience can be strengthened. METHODS We studied the response to the deteriorating patient following emergency abdominal surgery in a large surgical emergency unit, using the Functional Resonance Analysis Method (FRAM). FRAM focuses on the conflicts and trade-offs inherent in the process of response, and how staff adapt to them, rather than on identifying and eliminating error. 31 semi-structured interviews and two workshops were used to construct a model of the response system from which conclusions could be drawn about possible ways to strengthen system resilience. RESULTS The model identified 23 functions, grouped into five clusters, and their respective variability. The FRAM analysis highlighted trade-offs and conflicts which affected decisions over timing, as well as strategies used by staff to cope with these underlying tensions. Suggestions for improving system resilience centred on improving team communication, organisational learning and relationships, rather than identifying and fixing specific system faults. CONCLUSION FRAM can be used for analysing surgical work systems in order to identify recommendations focused on strengthening organisational resilience. Its potential value should be explored by empirical evaluation of its use in systems improvement.
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Affiliation(s)
- M Sujan
- Nuffield Department of Surgical Sciences, University of Oxford, UK; Human Factors Everywhere Ltd., UK.
| | - N Bilbro
- Nuffield Department of Surgical Sciences, University of Oxford, UK; Maimonides Medical Center, Brooklyn, NY, USA
| | - A Ross
- Dental School, University of Glasgow, UK
| | - L Earl
- Nuffield Department of Surgical Sciences, University of Oxford, UK
| | - M Ibrahim
- Nuffield Department of Surgical Sciences, University of Oxford, UK; Maimonides Medical Center, Brooklyn, NY, USA
| | - G Bond-Smith
- Nuffield Department of Surgical Sciences, University of Oxford, UK
| | - A Ghaferi
- Department of Surgery, University of Michigan, USA
| | | | - P McCulloch
- Nuffield Department of Surgical Sciences, University of Oxford, UK
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Ihsanullah M, Yousuf MJ, Ahmad N, Masood Z, Majeed S, Hassan HU, Ibrahim M, Khooharo AR, Khooharo E, Mastoi AH, Zafar N, Shaikh FM. Prevalence of cutaneous leishmaniasis in the largest populated city Karachi, Pakistan. BRAZ J BIOL 2021; 83:e247583. [PMID: 34932616 DOI: 10.1590/1519-6984.247583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022] Open
Abstract
The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p 0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.
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Affiliation(s)
- M Ihsanullah
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - M J Yousuf
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - N Ahmad
- Aquatic Diagnostic e Research Center Bahria University, Karachi-75260, Pakistan
| | - Z Masood
- Department of Zoology, Sardar Bahadur Khan Women's University Quetta Balochistan, Pakistan
| | - S Majeed
- Aquatic Diagnostic e Research Center Bahria University, Karachi-75260, Pakistan
| | - H Ul Hassan
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - M Ibrahim
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - A R Khooharo
- Centre of Excellence in Marine Biology University of Karachi, Karachi-75270, Pakistan
| | - E Khooharo
- Regional Training Institute Karachi, Population Welfare Department Government of Sindh, Pakistan
| | - A H Mastoi
- Faculty of Agriculture, Lasbela University of Agriculture, Water and Marine Science, Uthal Balochistan, Pakistan
| | - N Zafar
- Institute of Skin Diseases, Sindh, Karachi, Pakistan
| | - F M Shaikh
- Institute of Skin Diseases, Sindh, Karachi, Pakistan
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Bai Z, Wang R, Cheng G, Ma D, Ibrahim M, Chawla S, Qi X. Outcomes of early versus delayed endoscopy in cirrhotic patients with acute variceal bleeding: a systematic review with meta-analysis. Eur J Gastroenterol Hepatol 2021; 33:e868-e876. [PMID: 35048654 DOI: 10.1097/meg.0000000000002282] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Endoscopy is the mainstay treatment option for acute variceal bleeding (AVB) in liver cirrhosis. However, the optimal timing of endoscopy in such patients remains unclear. METHODS PubMed, EMBASE and Cochrane Library databases were searched. We compared the mortality, incidence of rebleeding, length of stay, endoscopic hemostasis, need for salvage and units of transfusion between cirrhotic patients with AVB who underwent early and delayed endoscopy. Meta-analyses were performed by using a random-effect model. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Subgroup analysis was performed in studies where early endoscopy was defined as <12 h. RESULTS Nine retrospective studies involving 2824 patients were included. The early endoscopy group had a significantly lower overall mortality than the delayed endoscopy group in overall analysis (OR = 0.56, 95% CI, 0.33-0.95, P = 0.03), but the difference between them was NS in subgroup analysis (OR = 0.72, 95% CI, 0.38-1.38, P = 0.33). In-hospital (OR = 0.77, 95% CI, 0.26-2.32, P = 0.65) and 6-week (OR = 0.78, 95% CI, 0.42-1.47, P = 0.45) mortality were not significantly different between them. Overall rebleeding was not significantly different between early and delayed endoscopy groups in both overall (OR = 0.88, 95% CI, 0.51-1.51, P = 0.63) and subgroup (OR = 1.04, 95% CI, 0.55-1.95, P = 0.90) analyses. In-hospital (OR = 1.41, 95% CI, 0.67-2.96, P = 0.37) and 6-week (OR = 0.93, 95% CI, 0.40-2.17, P = 0.86) rebleeding remained not significantly different between them. Additionally, the length of stay, endoscopic hemostasis, need for salvage and units of transfusion were not significantly different between them. CONCLUSIONS Early endoscopy may improve the survival of cirrhotic patients with AVB, but has no remarkable benefit on the prevention of rebleeding. These findings should be further validated by high-quality studies.
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Affiliation(s)
- Zhaohui Bai
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command & Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang
| | - Ran Wang
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command & Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang
| | - Gang Cheng
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command & Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang
| | - Dapeng Ma
- The Sixth People's Hospital of Dalian, Dalian, China
| | | | - Saurabh Chawla
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Xingshun Qi
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command & Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang
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Ibrahim M, Hashmi US, Nabeel M, Imran A, Ekin S. Embracing Complexity: Agent-Based Modeling for HetNets Design and Optimization via Concurrent Reinforcement Learning Algorithms. IEEE Trans Netw Serv Manage 2021. [DOI: 10.1109/tnsm.2021.3121282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ibrahim M, Saboe A, Kartamihardja AHA, Cool CJ. C80. Pulmonary Embolism in Congenital Heart Disease with Pulmonary Arterial Hypertension: a Case Series. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartjsupp/suab124.079] [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: 03/06/2023]
Abstract
Abstract
Background
Pulmonary arterial hypertension (PAH) is a frequent complication of congenital heart disease (CHD), notably in patients with left-to-right shunts. Patients with severe PAH due to CHD, Eisenmenger syndrome (ES), represent a high-risk group of pulmonary artery (PA) thrombosis patients. We present serial adult cases of CHD with PAH complicated by pulmonary embolism (PE).
Case Description
We found 3 cases of pulmonary embolism on adult congenital heart disease in our center. All of the patients were female, with an age range of 36 to 61 years old. The presenting symptoms were shortness of breath, WHO classification class II-III. All patients were hemodynamically stable. CHD and estimated RV systolic pressure were evaluated with echocardiography. CT-PA was performed in all patients, which findings were supporting PE. All patients were treated with anticoagulation. After three months, right heart catheterization was conducted in two patients, and one patient was refused.
Discussion
The prevalence of PE among adult patient with CHD and PAH range from 17 to 21%. PE was frequently found in older patients, women, and patients with lower oxygen saturation. To date, no uniformity regarding routine prophylaxis anticoagulation therapy in ES due to the high bleeding risk in this population despite being at risk of PA thrombosis. We conclude that risk stratification for PA thrombosis in adult CHD-PAH patients is essential, and further research is needed to prevent PE in this population.
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Affiliation(s)
- M Ibrahim
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - A Saboe
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - A H A Kartamihardja
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - C J Cool
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
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Ibrahim M, Saboe A, Kartamihardja AHA, Cool CJ. C80. Pulmonary Embolism in Congenital Heart Disease with Pulmonary Arterial Hypertension: a Case Series. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartjsupp/suab125.079] [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: 11/13/2022]
Abstract
Abstract
Background
Pulmonary arterial hypertension (PAH) is a frequent complication of congenital heart disease (CHD), notably in patients with left-to-right shunts. Patients with severe PAH due to CHD, Eisenmenger syndrome (ES), represent a high-risk group of pulmonary artery (PA) thrombosis patients. We present serial adult cases of CHD with PAH complicated by pulmonary embolism (PE).
Case Description
We found 3 cases of pulmonary embolism on adult congenital heart disease in our center. All of the patients were female, with an age range of 36 to 61 years old. The presenting symptoms were shortness of breath, WHO classification class II-III. All patients were hemodynamically stable. CHD and estimated RV systolic pressure were evaluated with echocardiography. CT-PA was performed in all patients, which findings were supporting PE. All patients were treated with anticoagulation. After three months, right heart catheterization was conducted in two patients, and one patient was refused.
Discussion
The prevalence of PE among adult patient with CHD and PAH range from 17 to 21%. PE was frequently found in older patients, women, and patients with lower oxygen saturation. To date, no uniformity regarding routine prophylaxis anticoagulation therapy in ES due to the high bleeding risk in this population despite being at risk of PA thrombosis. We conclude that risk stratification for PA thrombosis in adult CHD-PAH patients is essential, and further research is needed to prevent PE in this population.
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Affiliation(s)
- M Ibrahim
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - A Saboe
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - A H A Kartamihardja
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
| | - C J Cool
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia,Hasan Sadikin General Hospital Bandung , Indonesia
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Javed B, Farooq F, Ibrahim M, Abbas HAB, Jawwad H, Zehra SS, Ahmad HM, Sarwer A, Malik K, Nawaz K. Antibacterial and antifungal activity of methanolic extracts of Salix alba L. against various disease causing pathogens. BRAZ J BIOL 2021; 83:e243332. [PMID: 34730611 DOI: 10.1590/1519-6984.243332] [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: 09/08/2020] [Accepted: 03/30/2021] [Indexed: 11/21/2022] Open
Abstract
The present study was aimed to manifest the antibacterial and antifungal activity of methanolic extracts of Salix alba L. against seven Gram-positive and Gram-negative bacterial pathogens e.g. Streptococcus pyogenes, Staphylococcus aureus (1), S. aureus (2), Shigella sonnei, Escherichia coli (1), E. coli (2) and Neisseria gonorrhoeae and three fungal isolates from the air such as Aspergillus terreus, A. ornatus, and Rhizopus stolonifer. Two different serotypes of S. aureus and E. coli were used. The agar well-diffusion method results showed the dose-dependent response of plant extracts against bacterial and fungal strains while some organisms were found resistant e.g. E. coli (1), S. sonnei, A. terreus and R. stolonifer. The highest antibacterial activity was recorded at 17.000±1.732 mm from 100 mg/mL of leaves methanolic extracts against S. pyogenes while the activity of most of the pathogens decreased after 24 h of incubation. The highest antifungal activity was reported at 11.833±1.0 mm against A. ornatus at 50 mg/mL after 48 h of the incubation period. These experimental findings endorse the use of S. alba in ethnopharmacological formulations and suggest the use of methanolic extracts of the said plant to develop drugs to control the proliferation of resistant disease causing pathogenic microbes.
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Affiliation(s)
- B Javed
- University of Gujrat, Institute of Chemical & Biological Sciences, Department of Botany, Gujrat, Punjab, Pakistan.,Technological University Dublin, College of Sciences and Health, School of Food Science and Environmental Health, Dublin, Ireland
| | - F Farooq
- Government College University Lahore, Institute of Industrial Bio-Technology, Punjab, Pakistan
| | - M Ibrahim
- Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
| | - H A B Abbas
- Fatima Jinnah Medical University, Lahore, Punjab, Pakistan
| | - H Jawwad
- Ziauddin University, Ziauddin Medical College, Karachi, Sindh, Pakistan
| | - S S Zehra
- The Islamia University of Bahawalpur, Department of Botany, Bahawalpur, Punjab, Pakistan
| | - H M Ahmad
- PMAS-Arid Agriculture University, Department of Forestry and Range Management, Rawalpindi, Punjab, Pakistan
| | - A Sarwer
- University of Gujrat, Nawaz Sharif Medical College, Gujrat, Punjab, Pakistan
| | - K Malik
- jPMAS-Arid Agriculture University, Department of Botany, Rawalpindi, Punjab, Pakistan
| | - K Nawaz
- University of Gujrat, Institute of Chemical & Biological Sciences, Department of Botany, Gujrat, Punjab, Pakistan
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Bage T, Ibrahim M, Baden J, Filobbos G. Forklift-related lower limb injuries: a retrospective case series study with patient-reported outcome measures (PROMs). Ann R Coll Surg Engl 2021; 103:730-733. [PMID: 34719961 DOI: 10.1308/rcsann.2020.7124] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM Forklift trucks can cause serious lower limb trauma with long-lasting sequelae to patients. The aim of this study was to analyse a case series of patients with forklift-related injuries over 7 years at a level 1 major trauma centre in the UK and present their patient-reported outcome measures (PROMs) with long-term follow-up. To the best of the authors' knowledge, this is the largest case series study in the UK describing forklift injuries. METHODS Retrospective case note analysis of 19 patients over 7 years. Data including demographics, injury mechanism, pattern of injury, management, length of hospital stay, number of operations and complications were extracted from the notes. We used 'Enneking score' as a validated tool for PROMs. RESULTS Seventeen men and two women with mean age of 47 years; 20% had bilateral injuries and 34% had multi-level fractures. The mean number of theatre sessions was 5.21, while the mean length of hospital stay was 30.10 days. There was one mortality. Twelve patients (63%) required reconstruction with free tissue transfer, with one flap failure. The mean long-term Enneking percentage score was 57.33%. The mean Enneking score for patients in this study is lower than our institute's score for Gustilo 3B, highlighting the gravity of these injuries. CONCLUSION Forklifts can cause grave injuries with massive energy transfer. This study highlights the seriousness of those injuries, thus guiding patient counselling and optimising planning of management.
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Affiliation(s)
- T Bage
- Queen Elizabeth Hospital Birmingham, UK
| | - M Ibrahim
- Queen Elizabeth Hospital Birmingham, UK
| | - J Baden
- Queen Elizabeth Hospital Birmingham, UK
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Ismail R, Awad H, Allam R, Youssef O, Ibrahim M, Shehata B. Methylene blue versus vasopressin analog for refractory septic shock in the preterm neonate: A randomized controlled trial. J Neonatal Perinatal Med 2021; 15:265-273. [PMID: 34719443 DOI: 10.3233/npm-210824] [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: 11/15/2022]
Abstract
BACKGROUND Refractory septic shock in neonates is still associated with high mortality, necessitating an alternative therapy, despite all currently available treatments. This study aims to assess the vasopressor effect of methylene blue (MB) in comparison to terlipressin (TP) as adjuvant therapy for refractory septic shock in the preterm neonate. METHODS A double-blinded randomized controlled trial was conducted in the Neonatal Intensive Care Units at Ain Shams University, Egypt. Thirty preterm neonates with refractory septic shock were randomized to receive either MB or TP as an adjuvant to conventional therapy. Both MB and TP were administered as an intravenous loading dose followed by continuous intravenous infusion. The hemodynamic variables, functional echocardiographic variables, and oxidant stress marker were assessed over a 24 h period together with the side effects of MB. RESULTS MB causes significant improvement in mean arterial blood pressure with a significant decrease of the norepinephrine requirements (1.15±0.21μm/kg/min at baseline vs. 0.55±0.15μm/kg/min at 24 h). MB infusion causes an increase of the pulmonary pressure (44.73±8.53 mmHg at baseline vs. 47.27±7.91 mmHg after 24 h) without affecting the cardiac output. Serum malonaldehyde decreased from 5.45±1.30 nmol/mL at baseline to 4.40±0.90 nmol/mL at 24 h in the MB group. CONCLUSION Administration of MB to preterm infants with refractory septic shock showed rapid increases in systemic vascular resistance and arterial blood pressure with minimal side effects.
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Affiliation(s)
- R Ismail
- Associate Professor of Pediatrics, Faculty of Medicine, Ain Shams University
| | - H Awad
- Professor of Pediatrics, Faculty of Medicine, Ain Shams University
| | - R Allam
- Assistant Lecturer of Pediatrics, Faculty of Medicine, Ain Shams University
| | - O Youssef
- Professor of Pediatrics, Faculty of Medicine, Ain Shams University
| | - M Ibrahim
- Lecturer of Pediatrics, Faculty of Medicine, Ain Shams University
| | - B Shehata
- Lecturer of Pediatrics, Faculty of Medicine, Ain Shams University
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Nurlybekova A, Kudaibergen A, Dyusebaeva M, Ibrahim M, Jenis J. CHEMICAL CONSTITUENTS OF ARTEMISIA SEROTINA. Reports 2021. [DOI: 10.32014/2021.2518-1483.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Shalaby A, Ibrahim M, El Faioumy T, Elmessiry M. 90 Penetrating Abdominal Trauma: Comperative Study Between Operative and Conservative Management. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.513] [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: 11/13/2022]
Abstract
Abstract
Aim
to Assess the feasibility and safety of selective non-operative management in penetrating abdominal injuries and to identify a protocol for selection of patient’s candidates for non-operative management.
Method
In this comparative study 40 abdominal stab victims (admitted to Emergency Department of Alexandria Main University Hospital) were selected during 6 months period where 20 patients were suitable for non-operative management according to strict selection criteria whereas the other 20 patients were operated according to clinical and/or radiological indications or on basis of department protocol, the results were compared in view of final outcome.
Results
In our study, 15 patients were assigned for operative management according to selected clinical and/or radiological indications only 3 of them (20%) had non-therapeutic laparotomies, On the other hand, five patients were explored on basis of department protocol in violation of our indications for exploration; four of them (80%) were non-therapeutic. So, the rate of non-therapeutic laparotomies was significantly higher when done mandatory without selected clinical and radiological indications.
Conclusions
Assessment of vital signs together with abdominal examination are the most important and dependable tools in decision making in penetrating abdominal trauma patients. Patients with shock on admission (but responding to resuscitation), proved low grade solid organ injury (by CT), and proved intraperitoneal collection (by US or CT) could be managed conservatively regarding that they remain vitally and clinically stable. If failure of conservation occurs, it is usually during the 1st 24 hours after admission.
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Affiliation(s)
- A Shalaby
- NHS, Bridgend, United Kingdom
- Ministry of Health and Population, Alexandria, Egypt
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - M Ibrahim
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - T El Faioumy
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - M Elmessiry
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Ibrahim M, Stevens L, Ouzounian M, Hage A, Dagenais F, Peterson M, El-Hamamsy I, Boodhwani M, Bozinovski J, Moon M, Yamashita MH, Atoui R, Bittira B, Payne D, Lachapelle K, Chu M, Chung J. EVOLVING SURGICAL TECHNIQUES AND IMPROVING OUTCOMES FOR AORTIC ARCH SURGERY IN CANADA. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ibrahim M, Mohammad HF, el-Khazragy NN, El wahab ZSA. Serum Amyloid A Level in Women with Unexplained Infertility. QJM 2021; 114. [DOI: 10.1093/qjmed/hcab115.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
By various molecular and cellular research efforts it was displayed that folliculogenesis, ovulation, and corpus luteum formation is considered as an inflammatory processes that hav raised the research interest to investigate that serum amyloid A as an inflammatory mediator to reveal its possible role in infertility.
Objective
This study aims to assess the association between SAA and unexplained infertility in women.
Methods
The current research study have been conducted at Ain Shams University Maternity Hospital during the period from September 2018 to April 2019. Women approached were recruited from outpatient clinic of Ain Shams University Maternity Hospital. The recruited 90 research study subjects have been divided into two research groups
Results
Serum amyloid A was statistically significantly higher among the unexplained research group versus control group (SAA had excellent discriminative value with an area under the ROC curve (AUC) of 0.992 (95% CI = 0.945 to 1.000, Pvalue <0.0001). A best cutoff criterion is SAA of 28.7 mg/l (sensitivity = 98%, specificity = 96%, J-index = 0.93)) denoting that amyloid A as an acute phase inflammatory modulator is higher among the unexplained research group reflecting a form of chronic inflammatory process in those category of cases. Analytical research results of multivariable binary logistic regression analysis as regards the correlation between SAA and unexplained infertility after adjustment for age and BMI, it was revealed that serum amyloid A an independent predictor for unexplained infertility.
Conclusion
s: Serum amyloid A as a biomarker for could be implemented as a predictability tool for unexplained infertility since it is a reflector of an chronic inflammatory process that is ongoing that could affect the process of implantation and ovulation however the clear molecular and cellular processes linked to the pathophysiological process that reflects the fertility hindering process should be implemented in future research efforts taking in consideration to have multicentric fashion of research with larger sample sizes to verify the value of serum amyloid A as biomarker that reflects the fertility potential besides the routine infertility work up.
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Affiliation(s)
- Mostafa Ibrahim
- Obstetrics and Gynecology and Clinical pathology 2Departments, Faculty of Medicine – Ain Shams University
| | - Hayam Fathy Mohammad
- Obstetrics and Gynecology and Clinical pathology 2Departments, Faculty of Medicine – Ain Shams University
| | - Nashwa Nagy el-Khazragy
- Obstetrics and Gynecology and Clinical pathology 2Departments, Faculty of Medicine – Ain Shams University
| | - Zeinab Saad Abd El wahab
- Obstetrics and Gynecology and Clinical pathology 2Departments, Faculty of Medicine – Ain Shams University
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Kar S, Alam MR, Alam SK, Wadud MA, Ibrahim M, Rahman H, Ahammed SU, Hossain ME. Early Detection of Acute Kidney Injury by Neutrophil Gelatinase Associated Lipocalin in Patients Undergoing Coronary Artery Bypass Grafting with Cardiopulmonary Bypass. Mymensingh Med J 2021; 30:1051-1059. [PMID: 34605476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Neutrophil Gelatinase-Associated Lipocalin (NGAL) is rapidly released by renal tubules after injury, potentially allowing early identification of acute kidney injury (AKI) after cardiac surgery. However, the diagnostic performance of NGAL has varied widely in clinical studies and it remains unknown what factors modify the relationship between NGAL and AKI. The main objective of the study was to determine the efficacy of NGAL in early detection of AKI among the CABG patients undergoing cardiopulmonary bypass (CPB). This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in collaboration with the Department of Biochemistry, BSMMU among 42 patients admitted into the Department of Cardiac Surgery, Ibrahim Cardiac Hospital and Research Institute, Dhaka Bangladesh from July 2014 to June 2015. For the measurement of NGAL, urine samples were obtained before surgery and 6 hours after commencement of CPB. Serum creatinine was measured preoperatively and 6, 24 and 48 hours postoperatively. Increase in the serum creatinine level at 6, 24 and 48 hours after surgery was used to analyze the diagnostic value of urinary NGAL. In this study 42 CABG patients with no known renal insufficiency planned to have CPB were included. Receiver-operator characteristic (ROC) was constructed by using NGAL, which gave a cut off value of ≥185.90ng/ml. Eight patients were AKI positive among them 6(75.0%) patients were NGAL positive and 2(25.0%) were NGAL negative. Diagnosis of AKI was delayed by 24-48 hours by serum creatinine measurement. This study has demonstrated that level of urinary NGAL concentration at 6 hours post CPB increased before the increase of serum creatinine level and NGAL is an early predictor of AKI in adult cardiac surgical patients. The early detection of renal injury by NGAL may allow earlier intervention in patients with high risk for AKI.
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Affiliation(s)
- S Kar
- Dr Shubharthi Kar, Assistant Professor, Department of Nephrology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh; E-mail:
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50
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Peng M, Guo X, Yi F, Shao X, Wang L, Wu Y, Wang C, Zhu M, Bian O, Ibrahim M, Chawla S, Qi X. Endoscopic treatment for gastric antral vascular ectasia. Ther Adv Chronic Dis 2021; 12:20406223211039696. [PMID: 34408826 PMCID: PMC8366108 DOI: 10.1177/20406223211039696] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023] Open
Abstract
Gastric antral vascular ectasia (GAVE) is one of the uncommon causes of upper gastrointestinal bleeding. Major treatment of GAVE includes pharmacotherapy, endoscopy, and surgery. The efficacy and safety of pharmacotherapy have not been sufficiently confirmed; and surgery is just considered when conservative treatment is ineffective. By comparison, endoscopy is a common treatment option for GAVE. This paper reviews the currently used endoscopic approaches for GAVE, mainly including argon plasma coagulation (APC), radiofrequency ablation (RFA), and endoscopic band ligation (EBL). It also summarizes their efficacy and procedure-related adverse events. The endoscopic success rate of APC is 40-100%; however, APC needs several treatment sessions, with a high recurrence rate of 10-78.9%. The endoscopic success rates of RFA and EBL are 90-100% and 77.8-100%, respectively; and their recurrence rates are 21.4-33.3% and 8.3-48.1%, respectively. Hyperplastic gastric polyps and sepsis are major adverse events of APC and RFA; and Mallory-Weiss syndrome is occasionally observed after APC. Adverse events of EBL are rare and mild, such as nausea, vomiting, esophageal or abdominal pain, and hyperplastic polyps. APC is often considered as the first-line choice of endoscopic treatment for GAVE. RFA and EBL have been increasingly used as alternatives in patients with refractory GAVE. A high recurrence of GAVE after endoscopic treatment should be fully recognized and cautiously managed by follow-up endoscopy. In future, a head-to-head comparison of different endoscopic approaches for GAVE is warranted.
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Affiliation(s)
- Mengyuan Peng
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
- Postgraduate College, Jinzhou Medical University, Jinzhou, P.R. China
| | - Xiaozhong Guo
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Fangfang Yi
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Xiaodong Shao
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Le Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Yanyan Wu
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Chunmei Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Menghua Zhu
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Ou Bian
- Department of No.1 Cadre Ward, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, P.R. China
| | - Mostafa Ibrahim
- Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
| | - Saurabh Chawla
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, Liaoning Province 110840, China
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