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Brar SK, Sheehan O, Martin R, Rasheed M. 160 A CLOSED-LOOP AUDIT EXAMINING THE USE OF PROPHYLACTIC ANTI-COAGULATION IN OLDER ADULTS ADMITTED TO A SPECIALIST GERIATRIC SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Guidelines recommend prescription of Prophylactic Anticoagulation (PA) to all hospitalized older adults unless a contraindication exits. In many cases this does not happen at the time of admission increasing the risk of thromboembolic events. We aimed to assess the use of PA across the medicine for the geriatric service of a level 3 hospital (average daily census of service 120) then use quality improvement to achieve our goal of 95% prescription of prophylactic anticoagulation when appropriate.
Methods
Medication kardexes and clinical notes were reviewed to collect variables including age, length of stay, creatinine clearance, weight, mobility status, use and dose of antithrombotic medications and documentation of reason if not prescribed. Following initial data collection, cause and effect analysis was performed to identify reasons for under-prescription and small tests of change were conducted across 4 PDSA cycles before data collection was repeated.
Results
Initial data collection revealed that only 80% of older adults admitted to the service were receiving prophylactic anticoagulation. Cause and effect analysis identified many reasons for failure to prescribe PA including inadequate history taking, lack of clinician education and training, poor documentation, lack of handover between clinicians, failure to complete medication reconciliation on admission and lack of pharmacy support on some wards. Each of these contributory factors were addressed in turn. After a month of QI activities prescription of PA improved to 83% and by 3 months 98.1% (104/106) of patients were receiving PA with only 2 patients for whom PA was not prescribed without clear documentation of the reason.
Conclusion
Sustained quality improvement resulted in a culture change across our service improving rates of appropriate prescription of PA and raising the quality of care delivered to older adults. This model of quality improvement is now being replicated across our department to address other gaps in service delivery.
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Affiliation(s)
- SK Brar
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - O Sheehan
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - R Martin
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
| | - M Rasheed
- Connolly Hospital Royal College of Surgeons in Ireland Hospitals Group, , Dublin, Ireland
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Gupta R, Kesavadev J, Krishnan G, Agarwal S, Saboo B, Shah M, Mittal A, Durani S, Luthra A, Singhal A, Rasheed M, Rao GVS, Tripathi V, Jha A, Ghosh A, Mohan V, Singh AK, Phatak S, Panicker J, Bhadada SK, Joshi S, Pal R, Mithal A, Vikram N, Misra A. COVID-19 associated mucormycosis: A Descriptive Multisite Study from India. Diabetes Metab Syndr 2021; 15:102322. [PMID: 34717135 PMCID: PMC8635309 DOI: 10.1016/j.dsx.2021.102322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Mucormycosis is an invasive fungal infection and carries a significant morbidity and mortality. A number of cases of mucormycosis have been reported in association with COVID-19. In this study, a consortium of clinicians from various parts of India studied clinical profile of COVID-19 associated mucormycosis (CAM) and this analysis is presented here. METHODS Investigators from multiple sites in India were involved in this study. Clinical details included the treatment and severity of COVID-19, associated morbidities, as well as the diagnosis, treatment and prognosis of mucormycosis. These data were collected using google spreadsheet at one centre. Descriptive analysis was done. RESULTS There were 115 patients with CAM. Importantly, all patients had received corticosteroids. Diabetes was present in 85.2% of patients and 13.9% of patients had newly detected diabetes. The most common site of involvement was rhino-orbital. Mortality occurred in 25 (21.7%) patients. On logistic regression analysis, CT scan-based score for severity of lung involvement was associated with mortality. CONCLUSION Universal administration of corticosteroids in our patients is notable. A large majority of patients had diabetes, while mortality was seen in ∼1/5th of patients, lower as compared to recently published data.
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Affiliation(s)
| | | | - Gopika Krishnan
- Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | | | | | | | - Atul Mittal
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Suhail Durani
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Atul Luthra
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Anuj Singhal
- Fortis Escorts Heart Institute, New Delhi, India
| | | | - G V S Rao
- Dr Rao's ENT Centre, Hyderabad, Telangana, India
| | | | - Alka Jha
- Fortis Rajan Dhall Hospital, New Delhi, India
| | | | - V Mohan
- Dr Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamilnadu, India
| | | | | | | | | | | | - Rimesh Pal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naval Vikram
- All India Institute of Medical Sciences, New Delhi, India
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Yalcin Y, Rasheed M, Muslem R, Brugts J, Constantinescu A, Manintveld O, Birim O, Bekkers J, Bogers A, Caliskan K. Outcomes over One and a Half Decade Following HeartMate II versus HeartMate 3 Left Ventricular Assist Device Therapy: The Rotterdam Experience. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1182] [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] Open
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Khan Y, Rasheed M, Adnan A, Mujtaba G, Alotaibi N, Hussain T, Alzarea A, Saifullah A. Assessment of clinical features and determinants of mortality among cancer patients with septic shock of pulmonary origin: A prospective analysis. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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El Faquir N, Vollema ME, Delgado V, Ren B, Spitzer E, Rasheed M, Rahhab Z, Geleijnse ML, Budde RPJ, de Jaegere PP, Bax JJ, Van Mieghem NM. Reclassification of aortic stenosis by fusion of echocardiography and computed tomography in low-gradient aortic stenosis. Neth Heart J 2020; 30:212-226. [PMID: 33052577 PMCID: PMC8941065 DOI: 10.1007/s12471-020-01501-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 01/05/2023] Open
Abstract
Background The integration of computed tomography (CT)-derived left ventricular outflow tract area into the echocardiography-derived continuity equation results in the reclassification of a significant proportion of patients with severe aortic stenosis (AS) into moderate AS based on aortic valve area indexed to body surface area determined by fusion imaging (fusion AVAi). The aim of this study was to evaluate AS severity by a fusion imaging technique in patients with low-gradient AS and to compare the clinical impact of reclassified moderate AS versus severe AS. Methods We included 359 consecutive patients who underwent transcatheter aortic valve implantation for low-gradient, severe AS at two academic institutions and created a joint database. The primary endpoint was a composite of all-cause mortality and rehospitalisations for heart failure at 1 year. Results Overall, 35% of the population (n = 126) were reclassified to moderate AS [median fusion AVAi 0.70 (interquartile range, IQR 0.65–0.80) cm2/m2] and severe AS was retained as the classification in 65% [median fusion AVAi 0.49 (IQR 0.43–0.54) cm2/m2]. Lower body mass index, higher logistic EuroSCORE and larger aortic dimensions characterised patients reclassified to moderate AS. Overall, 57% of patients had a left ventricular ejection fraction (LVEF) <50%. Clinical outcome was similar in patients with reclassified moderate or severe AS. Among patients reclassified to moderate AS, non-cardiac mortality was higher in those with LVEF <50% than in those with LVEF ≥50% (log-rank p = 0.029). Conclusions The integration of CT and transthoracic echocardiography to obtain fusion AVAi led to the reclassification of one third of patients with low-gradient AS to moderate AS. Reclassification did not affect clinical outcome, although patients reclassified to moderate AS with a LVEF <50% had worse outcomes owing to excess non-cardiac mortality.
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Affiliation(s)
- N El Faquir
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M E Vollema
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - V Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - B Ren
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E Spitzer
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M Rasheed
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Z Rahhab
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M L Geleijnse
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - R P J Budde
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - P P de Jaegere
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J J Bax
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - N M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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Benade V, Daripelli S, Petlu S, Subramanian R, Bhyrapuneni G, Shinde A, Rasheed M, Jayarajan P, Choudakari P, Nirogi R. 0008 SUVN-G3031, A Histamine H3 Receptor Inverse Agonist Produces Robust Wake Promoting and Anticataplectic Activity in Orexin Knockout Mice. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.007] [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] Open
Abstract
Abstract
Introduction
Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness, sleep paralysis, hallucinations, and in some cases episodes of cataplexy. Results from animal studies indicate the involvement of deficient orexin transmission in narcolepsy which can be circumvented by the activation of histaminergic neurons. SUVN-G3031 is a potent and selective histamine H3 receptor inverse agonist with hKi of 8.7 nM and shows less than 50% inhibition at 1 µM against 70 other targets. SUVN-G3031 exhibited excellent pharmacokinetic properties and brain penetration in preclinical species. Oral administration of SUVN-G3031 produces significant increase in histamine, dopamine and norepinephrine levels in the rat cortex. Long-term safety studies in animals have been successfully completed without any concern for further development of SUVN-G3031. In the present study, the effects of SUVN-G3031 were evaluated in orexin knockout mice, a reliable animal model of narcolepsy as a proof-of-concept study for the treatment of narcolepsy with and without cataplexy.
Methods
Male orexin knockout mice (10 - 15 weeks old, 25 - 35 g at the time of surgery) were implanted with telemetric device for simultaneous monitoring of electroencephalography (EEG) and electromyography. Animals were allowed surgical recovery of 3 weeks prior to EEG recording. Effects of SUVN-G3031 (3 and 10 mg/kg, p.o.) were evaluated during active period of animals.
Results
SUVN-G3031 produced significant increase in wakefulness with concomitant decrease in non-rapid eye movement sleep in orexin knockout mice. SUVN-G3031 also significantly decreased the number of cataplectic episodes in orexin knockout mice.
Conclusion
Results from the current preclinical study provide a strong basis for the utility of SUVN-G3031 for the treatment of narcolepsy with and without cataplexy. SUVN-G3031 is currently being evaluated in a Phase 2 study as monotherapy for the treatment of narcolepsy with and without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).
Support
None
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Affiliation(s)
- V Benade
- Suven Life Sciences, Hyderabad, INDIA
| | | | - S Petlu
- Suven Life Sciences, Hyderabad, INDIA
| | | | | | - A Shinde
- Suven Life Sciences, Hyderabad, INDIA
| | - M Rasheed
- Suven Life Sciences, Hyderabad, INDIA
| | | | | | - R Nirogi
- Suven Life Sciences, Hyderabad, INDIA
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Saeed D, Muslem R, Rasheed M, Caliskan K, Kalampokas N, Sipahi F, Lichtenberg A, Jawad K, Borger M, Huhn S, Cogswell R, John R, Schultz J, Shah H, Hsu S, Gilotra N, Tomashitis B, Hajj ME, Lozonschi L, Houston B, Tedford R. Less Invasive Surgical Implant Strategy is Associated with Significant Reduction in INTERMACS Defined Right Heart Failure Following LVAD Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Dkhilalli F, Megdiche Borchani S, Rasheed M, Barille R, Shihab S, Guidara K, Megdiche M. Characterizations and morphology of sodium tungstate particles. R Soc Open Sci 2018; 5:172214. [PMID: 30224991 PMCID: PMC6124057 DOI: 10.1098/rsos.172214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
A solid-state reaction technique was used to synthesize polycrystalline Na2WO4. Preliminary X-ray studies revealed that the compound has a cubic structure at room temperature. The formation of the compound has been confirmed by X-ray powder diffraction studies and Raman spectroscopy. Electrical and dielectric properties of the compound have been studied using complex impedance spectroscopy in the frequency range 209 Hz-1 MHz and temperature range 586-679 K. The impedance data were modellized by an equivalent circuit consisting of series of a combination of grains and grains boundary. We use complex electrical modulus M* at various temperatures to analyse dielectric data. The modulus plots are characterized by the presence of two relaxation peaks thermally activated. The morphologies and the average particle size of the resultant sodium tungstate sample were demonstrated by atomic force microscopy, scanning electron microscopy and transmission electron microscopy. The thicknesses and optical constants of the sample have been calculated using ellipsometric measurements in the range of 200-22 000 nm by means of new amorphous dispersion formula which is the objective of the present work. The results were obtained for Na2WO4 particles from experimental (EXP) and measured (FIT) data showed an excellent agreement. In addition, the energy gap of the Na2WO4 sample has been determined using ellipsometry and confirmed by spectrophotometry measurements.
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Affiliation(s)
- F. Dkhilalli
- Faculty of Sciences, Laboratory of Spectroscopic Characterization and Optical Materials, University of Sfax, BP 1171, 3000 Sfax, Tunisia
- MOLTECH-Anjou, University of Angers/UMR CNRS 6200, 2 Boulevard Lavoisier, 49045 Angers, France
| | - S. Megdiche Borchani
- Faculty of Sciences, Laboratory of Spectroscopic Characterization and Optical Materials, University of Sfax, BP 1171, 3000 Sfax, Tunisia
- Higher Institute of Computing and Multimedia of Sfax (ISIMS), Technological Center of Sfax, BP 242, SakietEzzit, 3021 Sfax, Tunisia
| | - M. Rasheed
- MOLTECH-Anjou, University of Angers/UMR CNRS 6200, 2 Boulevard Lavoisier, 49045 Angers, France
| | - R. Barille
- MOLTECH-Anjou, University of Angers/UMR CNRS 6200, 2 Boulevard Lavoisier, 49045 Angers, France
| | - S. Shihab
- Department of Applied Sciences, University of Technology, Baghdad, Iraq
| | - K. Guidara
- Faculty of Sciences, Laboratory of Spectroscopic Characterization and Optical Materials, University of Sfax, BP 1171, 3000 Sfax, Tunisia
| | - M. Megdiche
- Faculty of Sciences, Laboratory of Spectroscopic Characterization and Optical Materials, University of Sfax, BP 1171, 3000 Sfax, Tunisia
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ElEnen MA, Abou FM, El Abd A, Tatawy H, Tawfeek A, El Abd S, Rasheed M, Sharaby M. 195 Intraprostatic Injection of Botulinum Toxin-A in Patients with Refractory Chronic Pelvic Pain Syndrome: The Transurethral vs. Transrectal Approach. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.154] [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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Clement N, Rasheed M, Bajaj C. Uncertainty Quantified Computational Analysis of the Energetics of Virus Capsid Assembly. Proceedings (IEEE Int Conf Bioinformatics Biomed) 2016; 2016:1706-1713. [PMID: 28936368 PMCID: PMC5604467 DOI: 10.1109/bibm.2016.7822775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Most of the existing research in assembly pathway prediction/analysis of viral capsids makes the simplifying assumption that the configuration of the intermediate states can be extracted directly from the final configuration of the entire capsid. This assumption does not take into account the conformational changes of the constituent proteins as well as minor changes to the binding interfaces that continue throughout the assembly process until stabilization. This paper presents a statistical-ensemble based approach which samples the configurational space for each monomer with the relative local orientation between monomers, to capture the uncertainties in binding and conformations. Furthermore, instead of using larger capsomers (trimers, pentamers) as building blocks, we allow all possible subassemblies to bind in all possible combinations. We represent the resulting assembly graph in two different ways: First, we use the Wilcoxon signed rank measure to compare the distributions of binding free energy computed on the sampled conformations to predict likely pathways. Second, we represent chemical equilibrium aspects of the transitions as a Bayesian Factor graph where both associations and dissociations are modeled based on concentrations and the binding free energies. We applied these protocols on the feline panleukopenia virus and the Nudaurelia capensis virus. Results from these experiments showed significant departure from those one would obtain if only the static configurations of the proteins were considered. Hence, we establish the importance of an uncertainty-aware protocol for pathway analysis, and provide a statistical framework as an important first step towards assembly pathway prediction with high statistical confidence.
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Affiliation(s)
- N Clement
- Department of Computer Science, The University of Texas at Austin, Austin, TX 78712
| | - M Rasheed
- Department of Computer Science, The University of Texas at Austin, Austin, TX 78712
| | - C Bajaj
- Department of Computer Science, The University of Texas at Austin, Austin, TX 78712
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Ul-Haq N, Arain MA, Badar N, Rasheed M, Haque Z. Drinking water: a major source of lead exposure in Karachi, Pakistan. East Mediterr Health J 2012; 17:882-6. [PMID: 22276499 DOI: 10.26719/2011.17.11.882] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Excess lead in drinking water is a neglected source of lead toxicity in Pakistan. A cross-sectional survey in 2007/08 was made of water samples from drinking water sources in Karachi, a large industrial city. This study aimed to compare lead levels between untreated ground water and treated surface (tap) water in 18 different districts. Of 216 ground and surface water samples collected, 86% had lead levels higher than the World Health Organization maximum acceptable concentration of l0 ppb. Mean lead concentration in ground water [146 (SD 119) ppb] was significantly higher than in surface water [77.1 (SD 54) ppb]. None of the 18 districts had a mean lead level of ground or surface water below the WHO cut-off and ground water sources in 9 districts had a severe level of contamination (>150 ppb). Urgent action is needed to eliminate sources of contamination.
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Affiliation(s)
- N Ul-Haq
- Department of Biochemistry, Bahria Medical College, Karachi, Pakistan
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Ali AA, Aljandan B, AlHassan H, Saghah A, Rasheed M. The effectiveness of using different pulp-capping agents on the healing response of the pulp. Indian J Dent Res 2012; 23:633-7. [DOI: 10.4103/0970-9290.107381] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rasheed M, Shliozberg J, Rubinstein A. Phenotypic Variations in Patients with Profound Mannose Binding Lectin Deficiency. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Farahat Y, Elsaka A, Rasheed M. MP-06.10: Prospective randomized study for long term efficacy of percutaneous tibial nerve stimulation (PTNS) in patients with refractory overactive bladder: maintenance protocol. Urology 2010. [DOI: 10.1016/j.urology.2010.07.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rasheed M, Farahat Y, Elbahnasy A, Gaber M, Mourad S. MP-02.11: Application of small intestinal submucosa graft in repair of complicated vesico-vaginal fistula: pilot study. Urology 2010. [DOI: 10.1016/j.urology.2010.07.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Paracecal or pericecal hernia is a rare type of internal hernia that causes intestinal obstruction, and its correct preoperative diagnosis is rarely made. Its computed tomography (CT) features are sufficiently characteristic to permit an accurate diagnosis. We present the CT features of a case of paracecal hernia complicated by strangulation to facilitate its early recognition by radiologists and surgeons.
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Affiliation(s)
- N A Choh
- Department of Radiodiagnosis, SMHS Hospital, Srinagar, India.
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18
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Ward D, Rasheed M, Gillis H, Beye G, Jheengut V, Achonduh G. Simple and Efficient Preparation of Reagents for Thiopyran Introduction: Methyl Tetrahydro-4-oxo-2H-thiopyran-3-carboxylate, Tetrahydro-4H-thiopyran-4-one, and 3,6-Dihydro-4-trimethylsilyloxy-2H-thiopyran. SYNTHESIS-STUTTGART 2007. [DOI: 10.1055/s-2007-96599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ward D, Rasheed M, Gillis H, Beye G, Jheengut V, Achonduh G. Simple and Efficient Preparation of Reagents for Thiopyran Introduction: Methyl Tetrahydro-4-oxo-2H-thiopyran-3-carboxylate, Tetrahydro-4H-thiopyran-4-one, and 3,6-Dihydro-4-trimethylsilyloxy-2H-thiopyran. SYNTHESIS-STUTTGART 2007. [DOI: 10.1055/s-2007-965954] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Artlett CM, Rasheed M, Russo-Stieglitz KE, Sawaya HHB, Jimenez SA. Influence of prior pregnancies on disease course and cause of death in systemic sclerosis. Ann Rheum Dis 2002; 61:346-50. [PMID: 11874839 PMCID: PMC1754050 DOI: 10.1136/ard.61.4.346] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Microchimerism from fetal or maternal cells transferred during pregnancy has been implicated in the pathogenesis of systemic sclerosis (SSc). OBJECTIVE To determine whether a prior pregnancy influenced disease progression and cause of death in patients with SSc. PATIENTS AND METHODS The patients comprised a retrospective study cohort of 111 women with SSc: 78 patients with prior pregnancies (PP) and 33 who were never pregnant (NP), followed up at Thomas Jefferson University. Differences in age at onset, disease subset, organ involvement, cause of death, and type of antinuclear autoantibodies were evaluated statistically, including regression analysis. RESULTS The age at onset of SSc in NP patients was 32.0 years compared with 45.7 years in patients with one or two prior pregnancies (p<0.0001), 46.6 years in patients with three or four pregnancies (p<0.0001), and 51.3 years in patients with five to seven pregnancies (p<0.0005). In the 16 patients who had an elective pregnancy termination, 14/16 (87.5%) had diffuse SSc v 2/16 (12.5%) with limited SSc (p<0.0001; odds ratio (OR)=49.0). Of the NP women, 7/30 (23%) died from SSc related causes v 3/78 (4%) women who had pregnancies (p=0.0058; OR=7.6). A carbon monoxide transfer factor (TLCO) of <60% and disease duration >10 years was found in 10/13 (77%) NP patients v 10/23 (43%) patients who had pregnancies (p=0.05; OR=4.7), and a TLCO <50% and disease duration >10 years was identified in 7/13 (54%) NP patients v 6/23 (26%) of the patients who had pregnancies (p=0.09; OR=3.2). CONCLUSIONS There are differences in the age at onset, clinical course, severity of lung involvement, and cause of death in women who develop SSc before pregnancy compared with those who develop it after pregnancies. The NP patients with SSc had onset of disease at an earlier age, more severe lung involvement, and higher rate of death due to SSc.
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Affiliation(s)
- C M Artlett
- Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107-5541, USA.
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Richter C, Wunsch M, Rasheed M, Kötter I, Badran MI. Endoscopic exploration of Red Sea coral reefs reveals dense populations of cavity-dwelling sponges. Nature 2001; 413:726-30. [PMID: 11607030 DOI: 10.1038/35099547] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Framework cavities are the largest but least explored coral reef habitat. Previous dive studies of caverns, spaces below plate corals, rubble and artificial cavities suggest that cavity-dwelling (coelobite) filter-feeders are important in the trophodynamics of reefs. Quantitative community data are lacking, however, as the bulk of the narrow crevices interlacing the reef framework are inaccessible to conventional analysis methods. Here we have developed endoscopic techniques to explore Red Sea framework crevices up to 4 m into the carbonate rock, revealing a large internal surface (2.5-7.4 m2 per projected m2 reef) dominated by encrusting filter-feeders. Sponges alone provided up to 60% of coelobite cover, outweighing epi-reefal filter-feeder biomass by two orders of magnitude. Coelobite community filtration removed more than 60% of the phytoplankton in the course of its less than 5-minute passage through the crevices, corresponding to an uptake of roughly 0.9 g carbon m-2 d-1. Mineralization of the largely allochthonous organic material is a principal source of nutrients supporting coral and algal growth. The supply of new material by coelobites may provide a key to understanding the 'coral reef paradox'-a rich ecosystem thriving in nutrient-poor water.
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Affiliation(s)
- C Richter
- Zentrum für Marine Tropenökologie, Fahrenheitstr. 6, D-28359 Bremen, Germany.
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22
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Abstract
Three new triterpenoids, azadironolide [24,25,26, 27-tetranorapoeupha-7alpha-acetoxy-23xi-hydroxy-21,23-epoxy-1,14, 20(22)-trien-3,21-dione] (1), isoazadironolide [24,25,26, 27-tetranorapoeupha-7alpha-acetoxy-21xi-hydroxy-21,23-epoxy-1,14, 20(22)-trien-3,23-dione] (2), and azadiradionolide [24,25,26, 27-tetranorapoeupha-7alpha-acetoxy-21,23-epoxy-1,14,20(22)-trien-3, 16,21-trione] (3), were isolated from the fresh fruit coats of Azadirachta indica. Their structures have been elucidated through spectral analysis.
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Affiliation(s)
- BS Siddiqui
- H.E.J. Research Institute of Chemistry, University of Karachi, Karachi-75270, Pakistan
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23
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Elsharaby M, Abo-Farha O, Rasheed M, Omar A, Elgamasy A, Ghoniem G. A New Technique for Treatment of Simple Post-Prostatectomy Urinary Incontinence: Preliminary Experience. J Urol 1996. [DOI: 10.1016/s0022-5347(01)65407-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M. Elsharaby
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
| | - O. Abo-Farha
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
| | - M. Rasheed
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
| | - A. Omar
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
| | - A. Elgamasy
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
| | - G. Ghoniem
- Departments of Urology, Tanta University, Tanta, Egypt and Tulane University School of Medicine, New Orleans, Louisiana
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24
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Elsharaby M, Abo-Farha O, Rasheed M, Omar A, Elgamasy A, Ghoniem G. A new technique for treatment of simple post-prostatectomy urinary incontinence: preliminary experience. J Urol 1996; 156:1972-4. [PMID: 8911368] [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: 02/03/2023]
Abstract
PURPOSE Because of the complexity of reconstructive surgical techniques, the high failure rate and cost of the devices used, as well as the associated mechanical malfunctions there is need for an alternative operation to treat post-prostatectomy urinary incontinence. We present a new procedure along with promising results in cases of simple post-prostatectomy incontinence after transurethral resection of the prostate or open prostatectomy. MATERIALS AND METHODS The principles of our technique include lysis of the pelvic urethra with preservation of the neurovascular bundle, as well as suspension of the prostatic capsule to the anterior abdominal wall. With this technique we corrected post-prostatectomy sphincteric incompetence in 21 patients. Preoperative evaluation included physical examination, excretory urography, ascending urethrocystography and urethrocystoscopy. Urodynamic investigations included uroflowmetry, cystometrography and urethral pressure profilometry. The patients were reevaluated radiologically and urodynamically 3 months postoperatively. Mean followup was 19 months. RESULTS All patients tolerated the procedure well. Few intraoperative and postoperative complications were encountered. The success rate was 81% and these 17 patients became continent day and night. CONCLUSIONS Our procedure combines the continence enhancing features of pelvic urethral elongation, urethral suspension, angulation of the prostatomembranous junction and prostatic fixation. The preliminary success rate of this technique is encouraging. However, larger numbers of patients and long-term followup are needed to confirm our findings.
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Affiliation(s)
- M Elsharaby
- Department of Urology, Tanta University, Egypt
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25
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Abstract
The current status of onchocerciasis in Abu Hamed, Northern Province, Sudan, was studied. Of 208 persons attending out-patient clinics in villages in this region, 71 were microfilariae-positive on skin snips or had palpable nodules. Microfilariae and worms in nodules were identified as Onchocerca volvulus. No microfilariae were seen in peripheral blood. Most nodules and microfilariae were found in the pelvic region, but the intensity of infection was uniformly low (av. less than 3 mf/mg). Despite this, signs of onchocercal dermatitis were common and severe, especially over the buttocks. Papular eruptions and scarring often appeared to lead to black-grey hyperpigmentation, but no cases were seen of the unilateral, hyper-reactive 'sowda' described in Arabs in Yemen. No microfilariae were detected in the eyes of any of the patients who had positive outer canthus snips. Serum retinol concentrations were normal but mildly elevated concentrations of serum IgG, IgM and IgA were detected in many patients. Immunoglobulin E values in a sample of 20 microfilariae-positive patients were markedly higher than normal, with most in the 4,000 to 15,000 U/ml range. Eosinophil levels in differential counts of peripheral blood from the 208 villagers were markedly elevated. In skin snip surveys of over 400 villagers and school pupils, sample prevalence rates of 2 to 17.5% were recorded. Simulium biting was seasonal (November to May) and peaked in March. Over-all, the results indicate that O. volvulus infection persists in the Abu Hamed region as a serious cause of skin disease in the absence of other complicating filariases.
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