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Chakrapani V, Loganathan V, Saha P, Bose DL, Khan N, Aurora T, Narayan J, Mukherjee J, Hadi SU, Dewan C. Engagement of vulnerable communities in HIV prevention research in India: a qualitative investigation. Res Involv Engagem 2024; 10:12. [PMID: 38273406 PMCID: PMC10811827 DOI: 10.1186/s40900-024-00542-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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Meaningful community engagement (CE) in HIV prevention research is crucial for successful and ethically robust study implementation. We conducted a qualitative study to understand the current CE practices in HIV prevention research and to identify expressed and implicit reasons behind translational gaps highlighted by communities and researchers. METHODS For this exploratory qualitative study, we recruited a purposive sample of participants from Indian government-recognised key populations such as men who have sex with men, transgender women, people who inject drugs and female sex workers; general population adults and adolescents/youth; and researchers. We conducted 13 virtual focus groups (n = 86) between July and October 2021. Data were explored from a critical realist perspective and framing analysis (i.e., examining how the participants framed the narratives). RESULTS Participants reported that study communities, especially those from key populations, were primarily involved in data collection, but not necessarily with optimal training. Involvement of communities before the start of the study (e.g., obtaining feedback on the study's purpose/design) or once the study is completed (e.g., sharing of findings) were highlighted as priorities for meaningful engagement. Participants suggested meaningful CE in all stages of the study: (1) before the study-to get inputs in finalising the study design, drafting comprehensible informed consent forms and culturally-appropriate data collection tools, and deciding on appropriate monetary compensation; (2) during the study-adequate training of community field research staff; and (3) after the study-sharing the draft findings to get community inputs, and involving communities in advocacy activities towards converting evidence into action, policy or programs. Timely and transparent communications with communities were explicitly stated as critical for gaining and maintaining trust. Mutual respect, reciprocity (e.g., appropriate monetary compensation) and robust community feedback mechanisms were considered critical for meaningful CE. CONCLUSIONS The findings highlighted the translational gaps and priority areas for capacity building to strengthen CE in HIV prevention research. It is not only important to engage communities at various stages of research but to understand that trust, dignity, respect, and reciprocity are fundamentally preferred ways of meaningful community engagement.
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Affiliation(s)
- Venkatesan Chakrapani
- Centre for Sexuality and Health Research and Policy (C-SHaRP), 119/2, Mathura Flats, Anna Nagar West Extension, Chennai, 600101, India.
| | - Vijayalakshmi Loganathan
- Centre for Sexuality and Health Research and Policy (C-SHaRP), 119/2, Mathura Flats, Anna Nagar West Extension, Chennai, 600101, India
| | - Paromita Saha
- IAVI, Unit No. 810, 8th Floor, Emaar Capital Tower - 1, Mehrauli Gurugram Road, Sikandarpur, Sector 26, Gurugram, Haryana, 122002, India
| | - Devi Leena Bose
- IAVI, Unit No. 810, 8th Floor, Emaar Capital Tower - 1, Mehrauli Gurugram Road, Sikandarpur, Sector 26, Gurugram, Haryana, 122002, India
| | - Nabeela Khan
- IAVI, Unit No. 810, 8th Floor, Emaar Capital Tower - 1, Mehrauli Gurugram Road, Sikandarpur, Sector 26, Gurugram, Haryana, 122002, India
| | - Tiara Aurora
- Quicksand Design Studio, 7A, Sanskriti Kendra, Anandagram, MG Road, Aya Nagar, New Delhi, 110047, India
| | - Jyoti Narayan
- Quicksand Design Studio, 7A, Sanskriti Kendra, Anandagram, MG Road, Aya Nagar, New Delhi, 110047, India
| | - Joyeeta Mukherjee
- IAVI, Unit No. 810, 8th Floor, Emaar Capital Tower - 1, Mehrauli Gurugram Road, Sikandarpur, Sector 26, Gurugram, Haryana, 122002, India
| | - Saif Ul Hadi
- IAVI, Unit No. 810, 8th Floor, Emaar Capital Tower - 1, Mehrauli Gurugram Road, Sikandarpur, Sector 26, Gurugram, Haryana, 122002, India
| | - Chitrangna Dewan
- Quicksand Design Studio, 7A, Sanskriti Kendra, Anandagram, MG Road, Aya Nagar, New Delhi, 110047, India
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Breidenstein EBM, Khan N, Duffy T, Coward C, Avis T, Abdulle O, Li CM, Mason CS. SMT-738: a novel small-molecule inhibitor of bacterial lipoprotein transport targeting Enterobacteriaceae. Antimicrob Agents Chemother 2024; 68:e0069523. [PMID: 38084954 PMCID: PMC10777851 DOI: 10.1128/aac.00695-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/10/2023] [Indexed: 01/11/2024] Open
Abstract
Carbapenem-resistant Enterobacteriaceae (CREs) are described by the Centers for Disease Control as an urgent threat, and there is a critical need for new therapeutic agents able to treat infections caused by these pathogens. Herein, we describe the microbiological profile, the mechanism f action, and the in vitro safety as well as the pharmacokinetic (PK)/PD profile of SMT-738, a small molecule belonging to a new chemical class. SMT-738 is active against Enterobacterales [including multi-drug-resistant Escherichia coli with 90% of isolates having a minimum inhibitory concentration (MIC90) of 1 µg/mL and Klebsiella pneumoniae 2 µg/mL] and inactive against a broad panel of Gram-negative and Gram-positive pathogens. SMT-738 displays rapid bactericidal activity (2-4 h) and has a low propensity for resistance development (less than ~10-9). Characterization of resistant mutants following exposure to SMT-738 identified mutations within the lipoprotein transport complex (LolCDE), a clinically unexploited and essential bacterial molecular target in Gram-negative bacteria. SMT-738 has a promising in vitro toxicology profile. Furthermore, PK studies demonstrated that when dosed intravenously, SMT-738 maintained exposure levels across infection sites (bloodstream/urinary tract/lung). Proof-of-concept studies across multiple murine in vivo infection models (bloodstream/pneumonia/urinary tract) demonstrated that SMT-738 significantly reduced the bacterial burden compared to baseline and vehicle control. SMT-738 represents a promising novel drug candidate being developed to address clinically challenging serious life-threatening infections caused by highly resistant Enterobacteriaceae including CRE.
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Affiliation(s)
| | - N. Khan
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
| | - T. Duffy
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
| | - C. Coward
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
| | - T. Avis
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
| | - O. Abdulle
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
| | - C.-M. Li
- Summit Therapeutics, Menlo Park, California, USA
| | - C. S. Mason
- Summit Therapeutics, The Works, Unity Campus, Cambridge, United Kingdom
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Garrison ZR, Hall CM, Fey RM, Clister T, Khan N, Nichols R, Kulkarni RP. Advances in Early Detection of Melanoma and the Future of At-Home Testing. Life (Basel) 2023; 13:life13040974. [PMID: 37109503 PMCID: PMC10145469 DOI: 10.3390/life13040974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/17/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
The past decade has seen numerous advancements in approaches to melanoma detection, each with the common goal to stem the growing incidence of melanoma and its mortality rate. These advancements, while well documented to increase early melanoma detection, have also garnered considerable criticism of their efficacy for improving survival rates. In this review, we discuss the current state of such early detection approaches that do not require direct dermatologist intervention. Our findings suggest that a number of at-home and non-specialist methods exist with high accuracy for detecting melanoma, albeit with a few notable concerns worth further investigation. Additionally, research continues to find new approaches using artificial intelligence which have promise for the future.
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Affiliation(s)
- Zachary R Garrison
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Connor M Hall
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rosalyn M Fey
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Terri Clister
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Nabeela Khan
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rebecca Nichols
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rajan P Kulkarni
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Cancer Early Detection Advanced Research Center (CEDAR), Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA
- Operative Care Division, U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR 97239, USA
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Rana FA, Robert HM, Ilyas M, Mahmood A, Amir M, Khan N. Significance of Hematological Parameters in Patients with Type-2 Diabetes Mellitus and Its Relationship with Disease Complications. PAFMJ 2023. [DOI: 10.51253/pafmj.v73i1.5002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Objective: To determine the association of haematological parameters with disease complications in patients with type 2 Diabetes Mellitus.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan from Feb to Aug 2019.
Methodology: In this study, 200 Patients were selected and divided into four groups, 1) Anaemia without Diabetes 2) Diabetes with Anaemia 3) Diabetes without Anaemia 4) Healthy Control Group. All the patients were assessed because of their clinical history and laboratory evidence. The patients' clinical details, type of anaemia, laboratory investigations and complications related to diabetes were recorded on a specially designed proforma.
Results: Diabetes-related complications were highest in diabetes with anaemia Group. It was recorded that diabetes with anaemia Group, 36 patients (50.0%) had microvascular complications and 32 patients (47.8%) had macrovascular complications. In the healthy control group, 8 patients (11.1%) had microvascular complications, and nine patients (13.4 %) had macrovascular complications.
Conclusion: Patients with type 2 Diabetes Mellitus should be evaluated and treated for anaemia routinely to prevent complications
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Moghaddam H, Khan N, Tan B, Khan S. Consumer attitude toward Halal food in the case of the United Kingdom: the role
of product attributes and marketing stimuli. Food Res 2022. [DOI: 10.26656/fr.2017.6(6).861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The Halal market in the United Kingdom is worth $4.5 billion and is anticipated to grow
at a rate of 5% each year. In the United Kingdom, there is a growing demand for Halal
food, which has resulted in the formation of various unregulated Halal Certification
Bodies. In the halal food market, the problem of halal authenticity has recently become a
serious concern. The purpose of the paper was to determine the effect of product attributes
and marketing stimuli on customer attitudes toward halal food among Muslim customers
in the U.K. A cross-sectional study was adopted for this study. The sample of the study
included the Muslim customers who have consumed halal food in the U.K. The authors
used a survey method to collect the quantitative data. A total of 384 responses were
received and data were analysed using SPSS. The findings of the study revealed that
product attributes such as country of origin have a significantly greater influence on the
customer attitude towards halal food compared to other product attributes. The findings
further showed that marketing stimuli such as sales’ location impact on customer attitude
however advertisement did not have any impact on customer attitude towards halal food.
The finding held perspectives from Muslim customers in the U.K and contributes to the
stimulus-organism-response theory by incorporating product attributes and marketing as
stimulus factors that affect the internal psychological state i.e., customer’s attitude in the
case of the U.K. The implication of this study was to recommend Halal enterprises import
halal food from Islamic countries for U.K customers, research the strategic location and
select the hypermarkets, that handle halal food with care.
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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [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: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abhilash Jain
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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Chambault AL, Drury NE, Poole E, Jones T, Khan N, Hudsmith L, Bowater S, Arif S, Botha P, Clift P. Adult outcomes of complex pulmonary atresia, ventricular septal defect and major aortopulmonary collaterals following repair during childhood, a single centre experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1847] [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
Complex pulmonary atresia with a ventricular septal defect and major aortopulmonary collateral arteries (PA VSD MAPCA) is a rare and complex form of congenital heart disease. Staged surgical palliation is carried out in childhood, and in expert centres, is associated with good medium term survival. Adult outcomes following transition to adult care are not known.
Purpose
To establish adult outcomes of PA VSD MAPCA following repair during childhood in our institution
Methods
Review of clinical records for outcome data including life status, NYHA class, employment status, re-intervention in adult life, arrhythmia, pregnancy, exercise capacity and mode of death, where known. We predefined our population into two groups based on their status at transition to adult care, A) complete repair with RV-PA conduit and VSD closed and B) repaired but VSD left open.
Results
188 patients from our series have transitioned to adult services. As many were tertiary referrals (nationally and internationally) the local follow up population was 53 adults (54.7% male), mean age of those alive under follow up is 27.2±6.5 years, with a mean follow up of 25.3±6.1 years. There were 43 in group A and 10 in group B. Mortality in the total population was 18.9% (10/53), group A (16.3%), group B (30.0%), mean age at death 37.5±10.3 years and 29.9±8.4 years, 6/10 deaths were sudden. 22.6% of the whole group had DiGeorge/22q11 microdeletion, with a learning deficit in 32.7% of the cohort, where this could be assessed. Reinterventions included RV-PA conduit change, coil occlusion, pacemaker implantation, ICD implantation and ablation procedures, overall 39.6% underwent reintervention in adult life. Pregnancy occurred in 33.3% of 24 female patients. 50% of individuals were found to have undertaken some form of paid work and of these 11.5% had DiGeorge.
Conclusions
Complex PA VSD MAPCA is associated with good late survival with late attrition including sudden death and heart failure. 22q11 is associated with learning deficit and consequent lack of employment. Non 22q11 have good educational outcomes and there is less observed deficit regarding employment. Successful pregnancy is possible within this population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A L Chambault
- University of Birmingham, Medical School, College of Medical and Dental Sciences , Birmingham , United Kingdom
| | - N E Drury
- University of Birmingham, Medical School, College of Medical and Dental Sciences , Birmingham , United Kingdom
| | - E Poole
- Birmingham Children's Hospital, Department of Cardiology , Birmingham , United Kingdom
| | - T Jones
- Birmingham Children's Hospital, Department of Cardiology , Birmingham , United Kingdom
| | - N Khan
- Birmingham Children's Hospital, Department of Cardiology , Birmingham , United Kingdom
| | - L Hudsmith
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - S Bowater
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - S Arif
- Queen Elizabeth Hospital , Birmingham , United Kingdom
| | - P Botha
- Birmingham Children's Hospital, Department of Cardiology , Birmingham , United Kingdom
| | - P Clift
- Queen Elizabeth Hospital , Birmingham , United Kingdom
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Gulati M, Khan N, George M, Berry C, Chieffo A, Camici PG, Crea F, Kaski JC, Marzilli M, Merz CNB. The Impact of Living with INOCA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1116] [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: 11/13/2022] Open
Abstract
Abstract
Background
There is limited literature available on the impact of myocardial ischemia but no obstructive coronary arteries (INOCA) on patients' lives.
Purpose
We sought to determine how INOCA impacts the physical, social, and mental health of persons with this diagnosis.
Methods
A survey was made available to all members of the patient support group from INOCA International over a 3-month time period. Fitness was estimated using the Duke Activity Status Index (DASI), assessing levels of activities performed prior to the onset of INOCA symptoms, and after the diagnosis of INOCA. The formula to estimate fitness in metabolic equivalents (METs) = 0.43 × DASI + 9.6 / 3.5
Results
A total of 297 patients with INOCA responded to the survey; 91.2% were women. The most common diagnosis was coronary microvascular dysfunction (64.3%) and coronary artery spasm (50.5%) (Table 1). 34.4% reported living with symptoms for ≥3 years before their diagnosis of INOCA was made. 77.8% who had been told their symptoms were not cardiac. The symptoms the respondents experienced were numerous, but 92.9% reported symptoms of chest pain, pressure, or discomfort. Fitness levels prior to the onset of INOCA symptoms were significantly higher compared to after diagnosed with INOCA (8.6±1.8 METs vs 5.6±1.8 METs; P<0.0001). Most respondents reported an adverse impact on their home life (80.5%), social life (80.1%), mental health (70.4%), outlook on life (69.7%), sex life (55.9%), and their partner/spouse relationship (53.9%). Work life was also affected once living with INOCA: approximately three-quarters had reduced their work hours or stopping work completely, 47.5% retired early, and 38.4% applied for disability. While living with INOCA, for each 1-MET decrease in fitness, there was a loss of 3.0±0.6 days/months of physical health, 1.8±0.6 days/month of mental health, and 2.9±0.7 days/months of inability to perform recreational activities (p<0.0001) (Figure 1).
Conclusions
Living with INOCA has significant impact on physical, mental and social health. Significant physical fitness declines are seen in those living with INOCA and are lower in those experiencing any adverse impact of living with INOCA. Additionally, the impact of INOCA on the ability to work has important economic consequences to both the patient and society. Increased recognition of the impact of INOCA on these aspects of health need to be recognized and further work is needed to better diagnosis and treat the symptoms of INOCA to improve the quality of life, cardiovascular outcomes, and overall health of this frequently encountered cardiovascular disorder.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Gulati
- Cedars-Sinai Smidt Heart Institute , Los Angeles , United States of America
| | - N Khan
- The Methodist Hospital, Cardiology , Houston , United States of America
| | - M George
- INOCA International , Glasgow , United Kingdom
| | - C Berry
- University of Glasgow, Cardiovascular Research Centre , Glasgow , United Kingdom
| | - A Chieffo
- San Raffaele Hospital , Milan , Italy
| | | | - F Crea
- Catholic University of the Sacred Heart , Rome , Italy
| | - J C Kaski
- St George's University of London , London , United Kingdom
| | | | - C N B Merz
- Cedars-Sinai Smidt Heart Institute , Los Angeles , United States of America
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Bhutyal D, Khan N, Sharma RK, Mahajan V, Sasan JS. Comparative efficacy of herbal methionine vis-a-vis dl-methionine on performance of broiler chicken. Journal of Livestock Science 2022. [DOI: 10.33259/jlivestsci.2022.48-57] [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: 11/11/2022]
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Ali MS, Chowdhury LH, Baten MA, Islam S, Khan N, Islam MA, Saha BK, Mamun MA, Mushtabshirah L, Mokarabin M. Comparative Study between Acacia Nilotica versus Povidone Iodine in Topical Treatment of Omphalocele Major. Mymensingh Med J 2022; 31:925-930. [PMID: 36189534] [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: 06/16/2023]
Abstract
Well established and common practice in conservative management of omphalocele major is escharotics therapy with different topical agents. Among them mercurochrome, alcohol, silver salts, povidone iodine, acacia nilotca paste are commonly used. It is a comparative study between application of acacia nilotica paste and povidone iodine solution as a primary non surgical treatment of omphalocele major regarding efficacy and safety of these two topical agents. A double blind randomized controlled study was conducted at the department of Paediatric Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2016 to June 2019. In this study 20 cases of omphalocele major and randomly divided into two equal groups. Group A and Group B treated with acacia nilotica paste and povidone iodine solution respectively. Gastroschisis, ruptured-omphalocele major or omphalocele minor excluded in this study. The size of the fascial defect in cm, time required for full oral feeding tolerance and duration of hospital stay were evaluating parameters. Patients with Group A tolerated full oral feeding earlier, shorter total hospital stay duration and low mortality rate than those from Group B. Application of acacia nilotica is a safe and effective treatment of omphalocele major regarding rapid full oral feeding tolerance, shorter hospital stay and low mortality rate.
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Affiliation(s)
- M S Ali
- Dr Mohammad Showkot Ali, Assistant Professor, Department of Paediatric Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh;
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Vyas A, Cruz-Rangel S, Khan N, Ferris R, Bruno T, Schmitt N, Kiselyov K, Duvvuri U. Hydroxychloroquine synergizes with anti-PD-1 immune checkpoint blockade in squamous carcinoma of the head and neck. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01138-8] [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: 11/28/2022]
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McMath A, Keye S, Iwinski S, Cannavale C, Khan N, Donovan S. Associations Between Dietary Patterns and Fiber Intake and Cognitive Performance in Early Childhood. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.011] [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: 11/17/2022]
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Singh S, Sharma R, Rastogi A, Khan N. Variability in the Nutritional Value of Paddy Straw (Oryza sativa) varieties. JLivestSci 2022. [DOI: 10.33259/jlivestsci.2022.213-220] [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: 11/11/2022]
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Aseem R, Khan N, Bowbrick G. 363 A Comparative Analysis of Night-Time General Surgical Training. Br J Surg 2022; 109:znac269.396. [PMCID: PMC9452090 DOI: 10.1093/bjs/znac269.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Aim The aim of surgical training is to ensure trainees acquire competencies to perform as a Day 1 Consultant. The last decade has seen the introduction of European Working Time Directive, NELA guidelines and the revised Junior Doctor Contract. All of these, as well as the COVID 19 pandemic, have caused concerns regarding training. Our aim was to examine any changes to night-time on call activity during this time. Method We retrospectively analysed prospectively collected data from 2011, 2018, and 2021, in a busy District General Hospital. The data collection period was 31 days, looking at night-time (8pm to 8am) operative experience, supervision, and non-operative activity. A regression analysis was conducted to compare outcomes. A qualitative survey was used to assess attitudes and confidence. Results On average, trainees spent 11% of their time operating independently, 2% operating supervised, 11% attending trauma-calls and 73% clerking/non-educational activities. There was a significant difference between the hours spent on operative versus non-operative activity (P 0.00046) with no differences over the years. Junior trainees did not feel confident operating at night and only 33% of all trainees found night-time training effective. Conclusions Nightshifts comprise a substantial proportion of potential training opportunities and managing the unselected emergency take is one of the Capabilities in Practice. Effective solutions must be implemented to help improve night-time surgical experience and confidence in order for this time to be effective for training of both operative and non-operative competency attainment.
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Affiliation(s)
- R Aseem
- Medway Maritime Hospital NHS Foundation Trust, Kent, United Kingdom
| | - N Khan
- Medway Maritime Hospital NHS Foundation Trust, Kent, United Kingdom
| | - G Bowbrick
- Medway Maritime Hospital NHS Foundation Trust, Kent, United Kingdom
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Khan N, Hussain N, Naz A. Awareness, Social Media, Ethnicity and Religion: are they Responsible for Vaccination Hesitancy? A Systematic Review with Annotated Bibliography. CSWHI 2022. [DOI: 10.22359/cswhi_13_4_04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Vaccination is not only a medical term rather it is framed under socio-cultural perspectives and debates as well. Human history is full of illnesses caused bacteria and viruses killing millions of people including children and adults. Technological development in the health sector enabled to combat pathogenic illnesses through different methods whereby vaccination is one of them. However, it is a dilemma that vaccination has faced many barriers including logistical but most importantly sociocultural and religious. In 2019, WHO revealed vaccine hesitancy as a leading threat to health throughout the globe even in the top 10. This study looks to analyze peer reviewed literature to explore barriers to vaccination. Methodologically, this is desk research and systematic review. Numerous databases were searched with key words and purposively studies were selected for this study. A total of 17 most relevant studies were sampled. Findings show that there are four major factors hindering vaccination. 1st cultural and ethnic background matters whereby religion and the belief system are predominant factors. 2nd awareness and educational variables are also there, for instance, it is noted that many people are not aware of vaccination process specifically in case of HPV vaccination. 3rd social media plays a pivotal role whereby misinformation internalizes negative attitudes and misperceptions about vaccines. 4th social media is a key dimension whereby disinformation and misinformation are communicated through platforms whereby some are intentionally circulated. It is suggested that culturally relativism perspective can be helpful in increasing vaccination percentages. It pertains to intervention through culturally approved methods, for example, sensitizing the ethnic backgrounds through their leadership. In addition, vaccination tracking, media campaigns, focus on school level education to include health related course can be helpful.
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Naz A, Ullah S, Khan MH, Khan N. Spreading Terrorism, Militancy, and Radicalization in Malakand Division Khyber Pakhtunkhwa Pakistan: An Analysis of the Economic Factors. CSWHI 2022. [DOI: 10.22359/cswhi_13_3_03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The current study is to analyze the causes of militancy, terrorism, and radicalization where multifarious factors are contributing towards spreading such behavior. However, the study is delimited to focus on the economic factors, including poverty, unemployment and other such factors that lead towards militancy, terrorism, and radical behavior in society. The field information was collected from 200 respondents using purposive sampling technique with stratified approach from 3 strata of the society including businessmen, teachers and clergy or religious class of age 20 and above. The data was collected through a structured interview schedule, and the analysis was made in the form of tables, discussion and the findings have been verified through chi-square test. The findings show that militancy, terrorism, and radicalization have their roots in deep rooted poverty, unemployment, and lack of other life facilities in the area. The study suggests proper planning for provision of jobs, equal distribution of resources among people and provision of life facilities to the masses.
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Iqbal MI, Robert HM, Khan N, Mahmood R, Khurshid A, Khan SA. The Detection of BRAF-V600E Mutation in Hairy Cell Leukaemia by Polymerase Chain Reaction and Study of its associated Clinicohaematological Parameters. PAFMJ 2022. [DOI: 10.51253/pafmj.v72isuppl-2.3083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To contemplate the occurrence of a rare mutation (BRAF V600E) in the patients having Hairy cell leukemia in our setting, which wouldserve asuseful analytic and diagnostic criteria.
Study Design: Analytical cross sectional study.
Place and Duration of Study: Armed Forces Institute of Pathology Rawalpindi Pakistan, from Oct 2017 to Oct 2018.
Methodology: A sample of 36 patients with a suspicion of Hairy cell leukemia were included in this investigation. Complete blood counts, bone marrow examination (trephine biopsy and aspiration), cyto-chemistry and staining of the patients suspected to have Hairy cell leukemia was performed. PCR was done for detection of BRAF V600E mutation.
Results: 29 (80.5%) cases showed a positive BRAF mutational analysis and 7 (19.4%) cases showed a negative result.
Conclusion: Almost all the cases of classic Hairy cell leukemia had BRAF V600 E mutation.Isolating this mutation can be used as a regular tool in detection of disease and monitoring disease progression and relapse.
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Iqbal MI, Robert HM, Khan N, Mahmood A, Haider A. Frequency of Cap+1 Mutation in Beta Thalassemia and its Associated Haematological Features. PAFMJ 2022. [DOI: 10.51253/pafmj.v72isuppl-2.3080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To study the frequency of Cap+1 mutation and associated hematological parameters in suspected beta thalassemia patients.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi from Aug 2017 to Aug 2018.
Methodology: 960 patients suspected to have beta thalassemia were inducted into the study. After detailed history and examination basic hematological parameters (Hemoglobin, Mean Corpuscular Volume, Mean Corpuscular Hemoglobin) were analyzed using automated analyzer (Sysmex XE-5000). Molecular genetic analysis by conventional PCR was carried out for CAP+1 mutation. Genomic DNA purification kit (Gentra system USA) was used for extracting DNA from whole blood in order to study the molecular genetics for Cap+1 mutation. Primers were designed for detection and analysis of normal and mutant DNA.
Results: The frequency of Cap+1 mutation was observed in 3.2 ± 1.7% (31/960) in all suspected cases of beta thalassemia with a normal range of Hemoglobin (12.4 ± 1.1 g/dl), Mean Corpuscular Volume (86.4 ± 2.1fl/red cell) and Mean Corpuscular Hemoglobin (29 ± 1.7pg/cell).
Conclusion: Cap+1 mutation is a silent mutation and its diagnosis remains a challenge because of its normal clinical presentation and normal to mildly deranged basic hematological parameters. Detection of CAP+1 at molecular level has revolutionized the thalassemia prevention program in Pakistan.
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Kivitz A, Wells AF, Ignacio Vargas J, Baraf HSB, Rischmueller M, Klaff J, Khan N, LI Y, Carter K, Friedman A, Durez P. POS0685 LONG-TERM SAFETY AND EFFICACY OF UPADACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS: FINAL RESULTS FROM THE BALANCE-EXTEND OPEN-LABEL EXTENSION STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundUpadacitinib (UPA) was previously evaluated in two Phase 2, randomized, controlled trials (RCTs) in patients (pts) with rheumatoid arthritis (RA) and inadequate response to tumor necrosis factor inhibitors (BALANCE-1) or methotrexate (BALANCE-2).ObjectivesTo assess the final safety and efficacy of UPA in BALANCE-EXTEND, a 312-week open-label extension (OLE) enrolling pts who completed either BALANCE-1 or BALANCE-2.MethodsAll pts initially received UPA 6 mg twice daily (BID). Increase to 12 mg BID was required for pts with <20% improvement in swollen or tender joint counts (S/TJC) at Week 6 or 12, and permitted for those not achieving Clinical Disease Activity Index (CDAI) low disease activity (LDA). Pts with <20% improvement in SJC or TJC 6 weeks after escalation, or at any two consecutive visits, discontinued. Return to 6 mg BID was permitted for safety or tolerability reasons. After January 2017, the 6 and 12 mg BID doses were replaced by 15 and 30 mg once-daily (QD) extended-release equivalents. As-observed efficacy data are shown at Week 312 for three subgroups: pts who received 6 mg BID/15 mg QD throughout (“Never titrated”), those titrated up to 12 mg BID/30 mg QD for efficacy (“Titrated up”), and those titrated up to 12 BID/30 mg QD and then back to 6 mg BID/15 mg QD due to safety concerns (“Titrated up and down”). Exposure-adjusted adverse events (EAERs) per 100 patient-years (PY) of exposure were summarized from OLE Day 1 in all pts who received UPA (Any UPA).ResultsOverall, 493 pts entered the OLE, receiving UPA for ≤6.2 years (Never titrated, n=306; Titrated up, n=149; Titrated up and down, n=38), and 270 pts (54.8%) discontinued, mostly due to withdrawal of consent (16.8%; n=83) or AEs (14.6%; n=72). Mean (standard deviation) duration of UPA exposure was 3.8 (2.4) years (range <1–6.2 years); cumulative exposure was 1863 PY. The AE profile in pts receiving UPA 15 mg was generally similar to the Any UPA population, and to that observed in the Phase 3 UPA 15 mg clinical trial population (Table 1). Efficacy was maintained to Week 312, with 84.5% and 86.6% of pts in the Never titrated group achieving DAS28-CRP ≤3.2 and CDAI LDA, respectively (Figure 1).Table 1.Summary of AEs in pts who received UPA 6 mg BID/15 mg QD in the OLE and in the UPA 15 mg Phase 3 study programBALANCE-EXTEND (UPA 6 mg BID/15 mg QD)UPA 15 mg – Phase 3 programbEvents/100 PY (95 CI)aEvents/100 PY (95% CI)aN=493, PY=1277N=3209, PY=9079Any AE138.4 (132.0, 145.0)205.5 (202.5, 208.5)Any SAE7.9 (6.4, 9.6)12.4 (11.7, 13.2)AE leading to discontinuation4.2 (3.2, 5.5)4.9 (4.4, 5.3)Death0.4 (0.1, 0.9)0.5 (0.4, 0.7)cInfection49.2 (45.5, 53.2)63.9 (62.3, 65.6) Serious infection1.4 (0.8, 2.2)2.8 (2.4, 3.1) Opportunistic infection0.2 (0.0, 0.6)0.3 (0.2, 0.4) Herpes zoster2.0 (1.3, 3.0)3.0 (2.6, 3.3)Anemia1.1 (0.6, 1.8)3.0 (2.7, 3.4)Neutropenia1.3 (0.8, 2.1)2.1 (1.8, 2.5)Lymphopenia1.7 (1.1, 2.6)1.7 (1.4, 1.9)Gastrointestinal perforation0<0.1 (0.0, 0.1)Any malignancy1.2 (0.7, 1.9)1.1 (0.9, 1.4)Non-melanoma skin cancer (NMSC)0.4 (0.1, 0.9)0.4 (0.3, 0.5) Excluding NMSC0.8 (0.4, 1.4)0.7 (0.6, 0.9)Creatinine phosphokinase elevation3.4 (2.5, 4.6)4.4 (4.0, 4.9)Hepatic disorder4.1 (3.0, 5.3)10.2 (9.5, 10.8)Venous thromboembolism0.5 (0.2, 1.0)0.4 (0.3, 0.6)Major adverse cardiovascular event0.5 (0.2, 1.0)0.4 (0.3, 0.5)aMultiple events occurring in the same pts are counted in the calculation of events/100 PY. bCut-off, June 30, 2021. cBased on 9080 PY.ConclusionIn this OLE, UPA treatment over ~312 weeks showed sustained long-term efficacy in pts with RA who had completed Phase 2 RCTs. Overall safety results showed that UPA was well tolerated over time; the types and frequencies of AEs were consistent with those in pts with similar populations of moderately to severely active RA receiving Janus kinase inhibitors.AcknowledgementsAbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. AbbVie and the authors thank all study investigators for their contributions and the patients who participated in this study. No honoraria or payments were made for authorship. Medical writing support was provided by Dan Booth, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of InterestsAlan Kivitz Shareholder of: Amgen, Gilead, GlaxoSmithKline, Novartis, Pfizer, and Sanofi (stocks or options), Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Eli Lilly, Flexion, Genzyme, Gilead, Horizon, Janssen, Merck, Novartis, Pfizer, Regeneron, Sanofi, Sanofi Aventis, SUN Pharma Advanced Research, and UCB, Grant/research support from: AbbVie (his institution received fees for his role as a Principal Investigator in the study), Alvin F. Wells Consultant of: AbbVie, Juan Ignacio Vargas Consultant of: AbbVie, Grant/research support from: AbbVie (as a Principal Investigator in the study), Herbert S.B. Baraf Consultant of: Gilead and Janssen, Grant/research support from: AbbVie, Eli Lilly, Genentech, Gilead, and Janssen, Maureen Rischmueller Consultant of: AbbVie, Bristol-Myers Squibb, CSL Behring, Eli Lilly, Gilead Sciences, Janssen Global Services, Pfizer, Sanofi US Services, and UCB Biosciences, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Janssen Global Services, Novartis, Pfizer, Sanofi Pasteur Biologics, and UCB Biosciences, Justin Klaff Shareholder of: AbbVie (may own stocks or options), Employee of: AbbVie, Nasser Khan Shareholder of: AbbVie (may own stocks or options), Employee of: AbbVie, Yihan Li Shareholder of: AbbVie (may own stocks or options), Employee of: AbbVie, Kyle Carter Shareholder of: AbbVie (may own stocks or options), Employee of: AbbVie, Alan Friedman Shareholder of: AbbVie (may own stocks or options), Employee of: AbbVie, Patrick Durez Speakers bureau: Eli Lilly and Galapagos
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Saleh K, Khan N, Ghorab A, El-Kaissi M, Mubashir A, Elarabi M, Sabbour H, Namas R. AB0652 Prevalence of Interstitial lung disease and pulmonary arterial hypertension in systemic sclerosis patients cohort at a rheumatology referral centre in the United Arab Emirates. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundScleroderma, also known as Systemic Sclerosis (SSc), is a connective tissue disease that affects multiple organ systems, including the cardiovascular and respiratory systems, namely, pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) as the leading causes of death in this patient population.ObjectivesThe purpose of this study is to determine the prevalence of PAH and ILD in a cohort of patients diagnosed with SSc.MethodsWe performed a retrospective chart review of clinical characteristics of all patients diagnosed with SSc Cleveland Clinic Abu Dhabi between April 2015 and April 2020. PAH was estimated by echocardiographic findings and diagnosed based on right heart catheterization (RHC) using 2019 World Symposium on Pulmonary Hypertension. The CT scan of the chest was read by a board-certified radiologist in chest radiology.ResultsFifty individuals were diagnosed with SSc, with 46% having diffuse cutaneous systemic sclerosis and 54% having limited cutaneous systemic sclerosis. The majority of the patients (88%) were female, with a mean age of 41 ±13 years. The average period from presentation to diagnosis was 5 ±5.4 years. The majority of the cohort (86%) were from the United Arab Emirates. The average BMI was 26.0 kg/m2. Patients’ most prevalent symptoms are fatigue (80%), gastrointestinal symptoms (72%) followed by shortness of breath (58%) and cough (50%). Twenty-six out of fifty patients (52%) underwent a CT chest scan, with 19 (38%) having ILD. Eight patients had more than 30% fibrotic alterations, four patients had 10-30% fibrotic changes, and seven patients had less than 10% fibrotic abnormalities. Patients with more than 10% fibrotic changes were more likely to have usual interstitial pneumonia, whereas those with less than 10% fibrotic changes were more likely to have none specific fibrosis. The majority of patients (92%) had echocardiogram. All except one patient had a normal ejection fraction, and five had grade 1 left ventricular diastolic dysfunction. Five patients were described as having mild, 1 moderate and 2 severe PAH. Only 4 patients underwent RHC. One patient had group II PAH based on elevated wedge pressure. One had group 1 PAH with systemic sclerosis as the only cause for her PAH and two patients had group III PAH due to having more than 30 % pulmonary fibrosis and severe restrictive defect on spirometry. Therefore, the precapillary PAH prevalence was 6% (3/50).ConclusionWhile the prevalence of pulmonary fibrosis in our SSc patients reflects what has been reported in the literature, the prevalence of PAH is significantly lower than the reported 15-20%.1 This is likely due to underdiagnosis of PAH considering the number of years of systemic sclerosis diagnosis on presentation to our clinic. A systematic approach is needed to assess for the presence and severity of PAH using tools as in Detect algorithm which has been validated and commonly used in Europe and North America to screen for PAH.2 Validation of such algorithm is likely needed in middle eastern population before it is universally adopted.References[1]Screening for pulmonary arterial hypertension in an unselected prospective systemic sclerosis cohort. Vandecasteele E, Eur Respir J. 2017;49(5) Epub 2017 May 11.[2]Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study, Coghlan et al. Ann Rheum Dis 2014;73:1340–1349. doi:10.1136/annrheumdis-2013-203301.Disclosure of InterestsNone declared
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Fleischmann RM, Combe B, Ostor A, Pacheco Tena CF, Khan N, Suboticki J, Shmagel A, Song Y, Lagunes-Galindo I, Burmester GR. POS0540 CLINICAL OUTCOMES ASSOCIATED WITH GLUCOCORTICOID DISCONTINUATION AMONG PATIENTS WITH RHEUMATOID ARTHRITIS RECEIVING UPADACITINIB OR ADALIMUMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients (pts) with rheumatoid arthritis (RA) are often administered glucocorticoids (GCs) as bridging therapy when initiating or adjusting disease-modifying antirheumatic drugs (DMARDs). Due to their systemic effects, short-term use of GCs at the lowest possible dose is recommended with rapid tapering.1ObjectivesWe describe GC discontinuation patterns and the associated clinical outcomes in pts with RA receiving upadacitinib (UPA) or adalimumab (ADA).MethodsSELECT-COMPARE is a randomized phase 3 trial of UPA vs placebo and ADA with a 48-week (wk) double-blind treatment period and a 10-year long-term extension in pts with RA receiving concomitant methotrexate (MTX) who had an inadequate response to MTX.2 Background GCs (≤10 mg/day prednisone or equivalent) were permitted and could be tapered or discontinued starting at wk 26 per physician discretion. This post hoc analysis included pts who received ≥1 dose of UPA 15 mg once daily or ADA 40 mg every other wk while on concomitant GCs at baseline. The proportion of pts with disease worsening (Clinical Disease Activity Index [CDAI] >2 and Disease Activity Score 28-joint count C-reactive protein [DAS28-CRP] >0.6) following GC discontinuation through follow-up is described. Maintenance of clinical response, including remission and low disease activity based on CDAI ≤2.8 and ≤10, respectively, as well as DAS28-CRP <2.6 and ≤3.2, were assessed among pts who discontinued GCs. Adverse events (AEs) were assessed before and after GC discontinuation through follow-up. Data were analyzed descriptively.ResultsOf 1,629 pts randomized, 978 (60%) used GCs at baseline; 128 (13%) discontinued use at/after wk 26 (UPA, n=97; ADA, n=31). Baseline demographics and clinical characteristics were broadly similar between pts who continued or discontinued GCs. Median follow-up time after GC discontinuation was 60 wks for UPA and 84 wks for ADA. At the time of GC discontinuation, a numerically higher proportion of pts treated with UPA vs ADA were in disease control (CDAI ≤2.8: 55% vs 32%; CDAI ≤10: 85% vs 68%; DAS28-CRP <2.6: 71% vs 48%; DAS28-CRP ≤3.2: 87% vs 62%) (Table 1). Few pts receiving UPA experienced disease worsening following GC discontinuation (1% CDAI increase >2; 7% DAS28-CRP increase >0.6) and none on ADA (Table 1). At 6 months follow-up after GC discontinuation, most pts treated with UPA and ADA maintained CDAI ≤2.8 (74% vs 88%) and ≤10 (92% vs 95%) and DAS28-CRP <2.6 (89% vs 85%) and ≤3.2 (91% vs 94%), respectively (Table 1). GCs were reintroduced (albeit usually temporarily) in 14% of pts on UPA and 19% on ADA (Figure 1). AEs were generally similar across treatment groups. Rates of serious infection before and after GC discontinuation were 0.8 (95% CI 0.0–4.2) and 1.5 (0.2–5.4) events per 100 patient-years (E/100 PY) for UPA and 7.7 (1.6–22.4) and 0 E/100 PY for ADA, respectively. Interpretation of results is limited by small pt numbers and different exposure times.Table 1.Clinical outcomes of pts who discontinued GCs at/after wk 26n/N (%)Pts who discontinued GCs N=128UPAn=97ADAn=31CDAI≤10 at discontinuation79/93 (85%)21/31 (68%) Maintained at 6 months post discontinuationa61/66 (92%)18/19 (95%)≤2.8 at withdrawal51/93 (55%)10/31 (32%) Maintained at 6 months post discontinuationa32/43 (74%)7/8 (88%)Increase >2 any visit after withdrawal1/93 (1%)0DAS28-CRP≤3.2 at withdrawal78/90 (87%)18/29 (62%) Maintained at 6 months post discontinuationa58/64 (91%)15/16 (94%)<2.6 at withdrawal64/90 (71%)14/29 (48%) Maintained at 6 months post discontinuationa47/53 (89%)11/13 (85%)Increase >0.6 any visit after withdrawal6/92 (7%)0aAs a proportion of pts achieving outcome at GC discontinuation and with observed data 6 months post GC discontinuation.ConclusionIn pts who achieved disease control and discontinued GCs, disease control was maintained in almost all without worsening disease activity over time following GC discontinuation.ConclusionIn pts who achieved disease control and discontinued GCs, disease control was maintained in almost all without worsening disease activity over time following GC discontinuation.References[1]Smolen JS, et al. Ann Rheum Dis. 2020;79:685–99.[2]Fleischmann R, et al. Ann Rheum Dis. 2019;78:1454–62.AcknowledgementsAbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, review, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing assistance was provided by Julia Zolotarjova, MSc, MWC of AbbVie Inc.Disclosure of InterestsRoy M. Fleischmann Consultant of: AbbVie, Amgen, BMS, Galvani, Gilead, GSK, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Astra-Zeneca, BMS, Flexion, Galvani, Gilead, GSK, Janssen, Eli Lilly, Novartis, Noven, Pfizer, Samumed, Selecta, Teva, UCB, Viela, and Vorso., Bernard Combe Speakers bureau: AbbVie, BMS, Celltrion, Eli Lilly, Gilead-Galapagos, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, and Roche-Chugai, Consultant of: AbbVie, BMS, Celltrion, Eli Lilly, Gilead-Galapagos, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, and Roche-Chugai, Grant/research support from: Pfizer and Roche-Chugai, Andrew Ostor Consultant of: AbbVie, BMS, Eli Lilly, Gilead, Janssen, Novartis, Paradigm, Pfizer, Roche, and UCB., Cesar Francisco Pacheco Tena Consultant of: AbbVie, Astra-Zeneca, Eli Lilly, Gilead, Janssen, Pfizer, Roche, R-Pharm, Sanofi Regeneron, and UCB., Grant/research support from: AbbVie, Astra-Zeneca, Eli Lilly, Gilead, Janssen, Pfizer, Roche, R-Pharm, Sanofi Regeneron, and UCB., Nasser Khan Shareholder of: May own AbbVie stock or stock options, Employee of: AbbVie, Jessica Suboticki Shareholder of: May own AbbVie stock or stock options, Employee of: AbbVie, Anna Shmagel Shareholder of: May own AbbVie stock or stock options, Employee of: AbbVie, Yanna Song Shareholder of: May own AbbVie stock or stock options, Employee of: AbbVie, Ivan Lagunes-Galindo Shareholder of: May own AbbVie stock or stock options, Employee of: AbbVie, Gerd Rüdiger Burmester Speakers bureau: AbbVie, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Pfizer, Roche, Sanofi, and UCB., Consultant of: AbbVie, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Pfizer, Roche, Sanofi, and UCB.
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Bekaii-Saab T, Khan N, Ostojic H, Jiao X, Chen G, Lin W, Bruno A. P-102 Real-world dosing of regorafenib and outcomes among patients with metastatic colorectal cancer: A retrospective analysis using US claims data. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Zaheer S, Robert HM, Mahmood A, Mahmood R, Khurshid A, Khan N. Frequency of t(4;14) in Multiple Myeloma and Its Clinicopathological Correlation. PAFMJ 2022. [DOI: 10.51253/pafmj.v72isuppl-2.3384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To determine the frequency of t(4;14) in multiple myeloma in Pakistani population and study the clinicpathological correlation of this translocation in myeloma patients.
Study Design: Cross sectional study.
Place and Duration of Study: This study was conducted at Armed Forces Institute of Pathology from Jun 2017 to May 2018 using non probability convenience sampling technique.
Methodology: A total of 53 newly diagnosed cases of multiple myeloma were included in the study. Patients were diagnosed as having multiple myeloma based on diagnostic criteria of international myeloma working group. Fish analysis was done for t (4; 14). Workup for end organ damage /myeloma defining events was done.
Results: Out of 53 patients, 16 (30%) were females and 37(70%) were males; the mean age of the patients was 59.81 ± 11.34 range from 37 to 87 years. Fish for t(4;14) was positive in eight (15%) patients while negative in forty-five (85%) patients. Patients with positive results have significantly deranged renal function tests and raised beta 2 micoglobulins levels as compare to t(4;14)negative patients.
Conclusions: Detection of t (4:14) in multiple myeloma patients not only has diagnostic value but is important in risk stratification of these patients and thus effect treatment decision.
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Hussain M, Mahmood A, Mahmood R, Khurshid A, Khan N, Sarwar N. Clinical Spectrum and Laboratory Study of Von Willebrand Disease -Experience from Tertiary Care Hospital in Pakistan. PAFMJ 2022. [DOI: 10.51253/pafmj.v72isuppl-2.3101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To determine the clinical features and laboratory parameters of patients of von Willebrand disease (vWD) in our population.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Jan to Jul 2019.
Methodology: All patients newly diagnosed von Willebrand disease patients were assessed clinically. Complete blood counts, bleeding time, coagulation profile, von Willebrand antigen levels and FVIII levels were determined.
Results: A total of 66diagnosed patients of von Willebrand disease were included in the study. Out of these 15 (22.7%) were male while 51 (77.2%) were females. The most common clinical symptom was pallor, seen in 49 (74.2%) patients, followed by epistaxis in 36 (54.5%) and gum bleeding in 28 (42.4%) patients. Consanguineous marriages were found in 40 cases (60.6%) and family history was positive in 23 (34.8%). Patients mean vWF Ag level was4.29 ± 7.7 IU/dL while mean FVIII levels was 5.18 ± 7.8 1 U/mL.
Conclusion: Von Willebr and disease is among the most common inherited bleeding disorder which presents with a classical pattern of mucocutaneous/soft tissue bleed, with pallor epistaxis and gum bleed being the most common presenting complaints.
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Hussain M, Mahmood A, Mahmood R, Iqbal H, Khurshid A, Khan N. Multiple Myeloma-Clinicopathological Features and Risk Stratification. PAFMJ 2022. [DOI: 10.51253/pafmj.v72isuppl-2.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To evaluate the clinic pathological features and to risk stratify patients of multiple myeloma in our population.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi Pakistan, from Jan to Jun 2019.
Methodology: Patients that were newly diagnosed multiple myeloma on the basis of International Myeloma Working Group (IMWG) 2014 criteria were included in the study. Blood counts, peripheral film examination, bone marrow aspirate and trephine were examined. Biochemical profile, serum protein electrophoresis and skeletal survey was assessed.
Results: A total of 65 newly diagnosed Multiple Myeloma patients were included. Of these, 43 (66.2%) were males and 22 (33.8%) females. Mean age of the patients was 58.5 years with a range of 36-76 years. The most common presenting symptom was bone pain in 33 (50.8%) patients, followed by backache in 32 (49.2%) patients. Mean percentage of plasma cell on bone marrow examination was 40.89% ± 23.2. On risk stratification based on International staging system, 20 (30.7%) patients were in stage I, 19 (29.1%) patients were on stage II while 26 (40.2%) patients were in stage III.
Conclusion: Bone pain and backache along with anemia were found the predominant complaints of patients presenting with multiple myeloma in our setup with male predominance. Risk stratification of multiple myeloma according to ISS revealed that stage III was the most predominant in our population.
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Burel JG, Hillman H, Khan N, Singhania A, Dubelko P, Casals FS, Tippalagama R, deSilva AD, Scriba TJ, Taplitz R, Seumois G, Vijayanand P, Hedrick CC, Sette A, Peters B. Profiling the myeloid compartment of PBMC in active tuberculosis reveals substantial changes in CD14+ cells and upregulation of CD16 in pro-inflammatory dendritic cells. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.161.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Tuberculosis (TB) is the second leading infectious killer after COVID-19 worldwide. Gene expression analysis of whole blood and peripheral blood mononuclear cells (PBMC) from TB infected versus uninfected donors suggests that myeloid cells contribute to the immune signature of TB infection. In this study, we carried out the largest cellular and molecular profiling of the circulating myeloid compartment in the context of Mycobacterium tuberculosis (Mtb) infection to date. Using flow cytometry and RNA sequencing, we isolated and interrogated the transcriptomic profile of myeloid cell subsets isolated from PBMC in a cohort of active TB (ATB) patients with paired sampling at diagnosis and mid-treatment, as well as from Mtb sensitized (IGRA+) and unsensitized (IGRA−) healthy individuals. We identified an increased frequency of CD14+CD16− and CD14+CD16+ myeloid cells in ATB at diagnosis with upregulated expression of interferon signaling genes that significantly overlapped with previously reported blood TB signatures. In CD14+CD16+ cells, there was an additional increased expression of MHC-II related genes, which could be traced down to a subset of pro-inflammatory dendritic cells (DCs), namely CD14+CD163+ DC3. This cell population significantly upregulated CD16 in ATB at diagnosis, thus displaying a CD14+CD16+ phenotype, similarly to intermediate monocytes. This result also suggests CD16 might play an important role in inflammatory DC function in ATB. Thus, our study demonstrates quantitative and qualitative changes in CD14+ myeloid cells that are contributing to blood TB signatures. Additionally, it reveals phenotypic overlaps between subsets of monocytes and DCs in human blood that may hold disease relevance.
Supported by a grant from NIH (U19 AI118626)
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Affiliation(s)
- Julie G Burel
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Hannah Hillman
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Nabeela Khan
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Akul Singhania
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Paige Dubelko
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | | | - Rashmi Tippalagama
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Aruna D deSilva
- 2Faculty of Medicine, General Sir John Kotelawala Def. Univ., Sri Lanka
- 3Center for Infectious Disease and Vaccine Research, General Sir John Kotelawala Def. Univ
| | - Thomas J Scriba
- 4South African Tuberculosis Vaccine Initiative, Univ. of Cape Town, South Africa
| | - Randy Taplitz
- 5Department of medicine, City of Hope Natl. Med. Ctr
| | - Gregory Seumois
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
| | - Pandurangan Vijayanand
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
- 6Department of Medicine, La Jolla Inst. for Immunology
| | | | - Alessandro Sette
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
- 6Department of Medicine, La Jolla Inst. for Immunology
| | - Bjoern Peters
- 1Center for Infectious Disease and Vaccine Research, La Jolla Inst. for Immunology
- 6Department of Medicine, La Jolla Inst. for Immunology
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Ware J, Boughton CK, Allen JM, Wilinska ME, Tauschmann M, Denvir L, Thankamony A, Campbell FM, Wadwa RP, Buckingham BA, Davis N, DiMeglio LA, Mauras N, Besser REJ, Ghatak A, Weinzimer SA, Hood KK, Fox DS, Kanapka L, Kollman C, Sibayan J, Beck RW, Hovorka R, Hovorka R, Acerini CL, Thankamony A, Allen JM, Boughton CK, Dovc K, Dunger DB, Ware J, Musolino G, Tauschmann M, Wilinska ME, Hayes JF, Hartnell S, Slegtenhorst S, Ruan Y, Haydock M, Mangat J, Denvir L, Kanthagnany SK, Law J, Randell T, Sachdev P, Saxton M, Coupe A, Stafford S, Ball A, Keeton R, Cresswell R, Crate L, Cripps H, Fazackerley H, Looby L, Navarra H, Saddington C, Smith V, Verhoeven V, Bratt S, Khan N, Moyes L, Sandhu K, West C, Wadwa RP, Alonso G, Forlenza G, Slover R, Towers L, Berget C, Coakley A, Escobar E, Jost E, Lange S, Messer L, Thivener K, Campbell FM, Yong J, Metcalfe E, Allen M, Ambler S, Waheed S, Exall J, Tulip J, Buckingham BA, Ekhlaspour L, Maahs D, Norlander L, Jacobson T, Twon M, Weir C, Leverenz B, Keller J, Davis N, Kumaran A, Trevelyan N, Dewar H, Price G, Crouch G, Ensom R, Haskell L, Lueddeke LM, Mauras N, Benson M, Bird K, Englert K, Permuy J, Ponthieux K, Marrero-Hernandez J, DiMeglio LA, Ismail H, Jolivette H, Sanchez J, Woerner S, Kirchner M, Mullen M, Tebbe M, Besser REJ, Basu S, London R, Makaya T, Ryan F, Megson C, Bowen-Morris J, Haest J, Law R, Stamford I, Ghatak A, Deakin M, Phelan K, Thornborough K, Shakeshaft J, Weinzimer SA, Cengiz E, Sherr JL, Van Name M, Weyman K, Carria L, Steffen A, Zgorski M, Sibayan J, Beck RW, Borgman S, Davis J, Rusnak J, Hellman A, Cheng P, Kanapka L, Kollman C, McCarthy C, Chalasani S, Hood KK, Hanes S, Viana J, Lanning M, Fox DS, Arreaza-Rubin G, Eggerman T, Green N, Janicek R, Gabrielson D, Belle SH, Castle J, Green J, Legault L, Willi SM, Wysham C. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial. Lancet Digit Health 2022; 4:e245-e255. [PMID: 35272971 DOI: 10.1016/s2589-7500(22)00020-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/10/2021] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Closed-loop insulin delivery systems have the potential to address suboptimal glucose control in children and adolescents with type 1 diabetes. We compared safety and efficacy of the Cambridge hybrid closed-loop algorithm with usual care over 6 months in this population. METHODS In a multicentre, multinational, parallel randomised controlled trial, participants aged 6-18 years using insulin pump therapy were recruited at seven UK and five US paediatric diabetes centres. Key inclusion criteria were diagnosis of type 1 diabetes for at least 12 months, insulin pump therapy for at least 3 months, and screening HbA1c levels between 53 and 86 mmol/mol (7·0-10·0%). Using block randomisation and central randomisation software, we randomly assigned participants to either closed-loop insulin delivery (closed-loop group) or to usual care with insulin pump therapy (control group) for 6 months. Randomisation was stratified at each centre by local baseline HbA1c. The Cambridge closed-loop algorithm running on a smartphone was used with either (1) a modified Medtronic 640G pump, Medtronic Guardian 3 sensor, and Medtronic prototype phone enclosure (FlorenceM configuration), or (2) a Sooil Dana RS pump and Dexcom G6 sensor (CamAPS FX configuration). The primary endpoint was change in HbA1c at 6 months combining data from both configurations. The primary analysis was done in all randomised patients (intention to treat). Trial registration ClinicalTrials.gov, NCT02925299. FINDINGS Of 147 people initially screened, 133 participants (mean age 13·0 years [SD 2·8]; 57% female, 43% male) were randomly assigned to either the closed-loop group (n=65) or the control group (n=68). Mean baseline HbA1c was 8·2% (SD 0·7) in the closed-loop group and 8·3% (0·7) in the control group. At 6 months, HbA1c was lower in the closed-loop group than in the control group (between-group difference -3·5 mmol/mol (95% CI -6·5 to -0·5 [-0·32 percentage points, -0·59 to -0·04]; p=0·023). Closed-loop usage was low with FlorenceM due to failing phone enclosures (median 40% [IQR 26-53]), but consistently high with CamAPS FX (93% [88-96]), impacting efficacy. A total of 155 adverse events occurred after randomisation (67 in the closed-loop group, 88 in the control group), including seven severe hypoglycaemia events (four in the closed-loop group, three in the control group), two diabetic ketoacidosis events (both in the closed-loop group), and two non-treatment-related serious adverse events. There were 23 reportable hyperglycaemia events (11 in the closed-loop group, 12 in the control group), which did not meet criteria for diabetic ketoacidosis. INTERPRETATION The Cambridge hybrid closed-loop algorithm had an acceptable safety profile, and improved glycaemic control in children and adolescents with type 1 diabetes. To ensure optimal efficacy of the closed-loop system, usage needs to be consistently high, as demonstrated with CamAPS FX. FUNDING National Institute of Diabetes and Digestive and Kidney Diseases.
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Khan N, Zeeshan M, Naz A. Linking COVID-19 with Suicide: Suggestions for Future Research. CSWHI 2022. [DOI: 10.22359/cswhi_13_1_03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
COVID-19 has impacted the world socio-economically. Unemployment, poverty, social stigma, social isolation, domestic violence and mental illnesses are the notable social issues related to COVID-19 pandemic. Framed under a review based approach, the current study searches for the link between COVID-19 pandemic and an increased vulnerability to suicide across the globe. Linking the current situation with researched determinants of suicide shows that COVID-19 pandemic is exacerbating various socio-economic and psychological causes of suicide. In near future or even during the pandemic, suicide will be a key challenge for the public health sector across the globe. Besides, future research suggestions are given in light of the discussion in order to provide an impetus to researching the impact of the COVID-19 pandemic on suicide.
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Salim M, Saeed A, Iqbal M, Khan BA, Khan N, Rabbani I, Alsenani F, Rasul A. Phytochemical screening and evaluation of antioxidant, total phenolic and flavonoid contents in various weed plants associated with wheat crops. BRAZ J BIOL 2022; 84:e256486. [PMID: 35293544 DOI: 10.1590/1519-6984.256486] [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: 09/18/2021] [Accepted: 01/10/2022] [Indexed: 11/21/2022] Open
Abstract
This study explores the antioxidant activity, phytochemical screening, total phenolic and flavonoids contents in the extracts of four locally available weeds plants namely Convolvulus arvensis, Chenopodium murale, Avena fatua and Phalaris minor with different solvents. The antioxidant activities of these extracts were determined via various in-vitro methods such as total antioxidant activity (TAA), reducing power (RP), DPPH (2,2-Diphenyl-1-Picrylhydrazyl) free radical scavenging and hydrogen peroxide scavenging assays. Phytochemical screening was performed both qualitatively as well as quantitatively. Total phenolic content (TPC) and total flavonoid content (TFC) were determined through Folin- Ciocalteu reagent and aluminium chloride methods respectively. Methanol-chloroform solvent showed the presence of a high amount of TPC in milligram of gallic acid equivalent per gram of dry weight (mg of GAE/g of DW) in the extracts of all weeds. Their descending sequence was Avena fatua (74.09) ˃ Phalaris minor (65.66) ˃ Chenopodium murale (64.04) ˃ Convolvulus arvensis (61.905), while, chloroform solvent found to be best solvent for the extraction of TFC. Methanol-chloroform solvent was also found to be best solvent for TAA (Total antioxidant activity assay) which showed values in milligram of ascorbic acid equivalent per gram of dry weight (mg of AAE /g of DW), for DPPH scavenging activity, reducing power (antioxidant activity) and hydrogen peroxide scavenging activity. Phytochemical screening indicated the presence of polyphenols, flavonoids, tannins, saponins, alkaloids and glycosides in these weeds.
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Affiliation(s)
- M Salim
- Gomal University, Department of Biological Sciences, D. I. Khan, Pakistan
| | - A Saeed
- Gomal University, Department of Biological Sciences, D. I. Khan, Pakistan
| | - M Iqbal
- Gomal University, Faculty of Pharmacy, D. I. Khan, Pakistan
| | - B A Khan
- Gomal University, Faculty of Pharmacy, D. I. Khan, Pakistan
| | - N Khan
- Gomal University, Faculty of Pharmacy, D. I. Khan, Pakistan
| | - I Rabbani
- Kohat University of Science & Technology, Department of Pharmacy, Kohat, Pakistan
| | - F Alsenani
- Umm Al Qura University, Faculty of Pharmacy, Department of Pharmacognosy, Makkah, Saudi Arabia
| | - A Rasul
- Government College University, Department of Pharmaceutics, Faisalabad, Pakistan
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30
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Khurshid A, Alam M, Mahmood A, Khan A, Khan N, Yazdani S. Red Cell Antibodies Against High Frequency Antigens, A Two Year Experience At A Regional Transfusion Institute. PAFMJ 2022. [DOI: 10.51253/pafmj.v72i1.3097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To assess the clinicohaematological presentation and outcome of patients with antibodies to high frequency antigen(HFA) in our setup.Study Design: Cross sectional study.
Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi, from Jan 2016 to Jan 2018.
Methodology: We diagnosed 29 cases of uncommon red cell antibodies including antibodies to HFA, in a span of two years (2016-2018). Information regarding patient’s age, diagnosis, transfusion history, incompatible cross match and history of pregnancy was obtained. Venous blood sample of 3ml was taken in EDTA for grouping, red cell phenotyping and Direct AntiGlobulin Test (DAT) and 5 ml venous blood was taken for Indirect Antiglobulin Test (IAT), antibody screening and identification. Tube method was used for forward and reverse blood grouping, DAT and IAT. Column Agglutination Technique (CAT) was used for antibody screening, identification and red cell phenotyping.
Results: Out of a total of 29 cases, 24 (83%) were of anti H antibody (Bombay blood group). Rest of 5 (17%) included one each of anti Rh 17, anti Rh 29 (Rh null), anti P1Pk, anti-ENA/WRB and anti P antibodies. Anti H Lectin (Ulexeuropaeus) was used for confirmation of H antigen absence, while rest of antibodies were confirmed by IBGRL Bristol, UK.
Conclusion: The sources of antigen negative blood are family members, rare donor registry, autologous donations and frozen blood banks. Finding compatible blood for patients with an antibody to HFA may be a challenge.
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Din F, Mellor F, Millard T, Pace E, Khan N, Attygalle AD, Cunningham D, Zafar S, Sharma B. Radiology of Castleman disease: the pivotal role of imaging in diagnosis, staging, and response assessment of this rare entity. Clin Radiol 2022; 77:399-408. [PMID: 35177229 DOI: 10.1016/j.crad.2022.01.045] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
Castleman Disease (CD) is a rare entity that typically presents as an enhancing nodal mass in the mediastinum or head and neck region on computed tomography (CT). It may manifest as unicentric or multicentric regions of lymph node enlargement. A key clinical issue in the context of CD is delayed diagnosis, which contributes adversely to patient outcome, given that accurate diagnosis facilitates earlier treatment of this curable disease. This article will address relevant imaging aspects, with reference to typical and atypical imaging features of CD, illustrated using examples from our specialist centre; the imaging journey for patients with CD; and will provide practical pointers to radiologists in differentiating CD from other benign and malignant causes of enhancing lymphadenopathy, including lymphoma and neoplastic adenopathy. We will also review current classification tools and staging challenges with reference to World Health Organization guidelines, International Working Group guidelines as well as the Lugano classification. Finally, we will discuss the potential role of additional imaging techniques in CD, highlighting novel imaging methods and expanded utilities from our specialist centre.
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Affiliation(s)
- F Din
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - F Mellor
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - T Millard
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - E Pace
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - N Khan
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - A D Attygalle
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - D Cunningham
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - S Zafar
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - B Sharma
- Department of Radiology, The Royal Marsden NHS Trust, London, UK.
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Manla Y, Hogan M, Bhatnagar G, Khan N, Alsindi F, Aljabery Y, Sanger S, Gobolos L. The association of preoperative dialysis with troponin trends and short term outcomes among advanced kidney disease patients undergoing coronary artery bypass grafting. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.135] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Coronary artery disease continues to be the leading cause of death in patients with stage IV-V chronic kidney disease (CKD IV-V). However, the prognosis and early outcomes for advanced CKD patients undergoing coronary artery bypass grafting (CAB) worsen as the estimated glomerular filtration rate (eGFR) deteriorates. Therefore, we compared postoperative clinical outcomes and troponin trends in patients having advanced CKD according to preoperative dialysis status in a single centre experience.
Methods
A total of 51 patients with CKD IV and V who underwent CAB between 2016-2021 were included in the study. Data on patient characteristics and postoperative outcomes were collected retrospectively, and independently for our Society of Thoracic Surgeons database. Characteristics were compared between patients having CKD IV vs. CKD V. The differences in postoperative cardiac troponin trends and outcomes were evaluated between patients who did vs. did not undergo preoperative dialysis. The statistical analysis was conducted applying appropriate parametric or non-parametric (for skewed variables) testing methods, and a p value < 0.05 was considered to be statistically significant.
Results
47% (24) of subjects had CKD IV, while the rest featured CKD V. Patients with CKD IV tended to be older (61.8 ± 9.2 vs. 56.3 ± 11.5 years, p = 0.07), more obese (BMI: 31.4 ± 6.8, 27.4 ± 4.9 kg/m2, p = 0.02) and had significantly higher preoperative GFR (23 ± 4.9 vs. 9 ± 3.3 mL/min, p < 0.001) (Table.1). When comparing patients who underwent preoperative dialysis vs. those who did not, troponin levels were the highest at 18h postoperative in both groups, however, troponin levels were comparable between both groups at all time points (Table.2). Although, there was no difference in hospital length of stay and mortality between these groups, patients who did not undergo preoperative dialysis had longer intensive care unit length of stay (ICU LOS).
Conclusion
In this single centre experience preoperative dialysis was not associated with a significant difference in trends of postoperative cardiac enzymes. Although preoperative dialysis was associated with shorter ICU LOS, complex pre-procedural surgical risk assessment remains paramount in reducing complications and mortality in this high-risk population. Abstract Figure. Abstract Figure.
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Affiliation(s)
- Y Manla
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - M Hogan
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - G Bhatnagar
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - N Khan
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - F Alsindi
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Y Aljabery
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - S Sanger
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - L Gobolos
- Cleveland Clinic, Abu Dhabi, United Arab Emirates
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KHOR S, Osman A, Hernandez Garcilazo N, Garces C, AlAttal S, Khan N. POS-129 AN ADULT CASE OF IGA VASCULITIS WITH RENAL INVOLVEMENT. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.141] [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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34
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Yoo O, Tang EKY, Salman S, Nguyen MN, Sommerfield D, Sommerfield A, Khan N, von Ungern Sternberg BS, Lim LY. A randomised controlled trial of a novel tramadol chewable tablet: pharmacokinetics and tolerability in children. Anaesthesia 2022; 77:438-448. [PMID: 35083739 DOI: 10.1111/anae.15650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
Tramadol is a bitter atypical opioid analgesic drug and is prescribed to treat postoperative pain in children. However, in many countries there is no licensed paediatric tramadol formulation available. We have formulated a novel chewable chocolate-based drug delivery system for the administration of tramadol to children. This pilot, single-centre, open-label, randomised clinical study assessed the taste tolerability and comparative population pharmacokinetics of the novel tramadol chewable tablet against a compounded tramadol hydrochloride oral liquid, at a dose of 1 mg.kg-1 . A 5-point facial hedonic scale was used by the children, parents and nurses to assess tolerability. One hundred and forty-one children aged 3-16 years were given tramadol 30 min before general anaesthesia. Blood samples were taken following the induction of anaesthesia and for up to 5 h following tramadol administration. Tramadol and its active metabolite O-desmethyltramadol were analysed using reversed-phase high-performance liquid chromatography. A population pharmacokinetic model was built using non-linear mixed effects modelling. The relative bioavailability for the tablet was 1.25 times higher (95%CI 1.16-1.35) than for tramadol hydrochloride oral liquid, while the absorption rate constant for the tablet was significantly lower (1.97 h-1 vs. 3.34 h-1 , p < 0.001). Larger inter-individual variability in absorption rates were observed with the liquid tramadol. The tramadol chewable tablet was more acceptable in taste to children when assessed by the children, parents and nurses (all p < 0.001). We conclude that the novel tramadol chewable tablet has favourable acceptability and more reliable relative bioavailability in children compared with tramadol hydrochloride oral liquid.
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Affiliation(s)
- O Yoo
- Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia
| | - E K Y Tang
- Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia
| | - S Salman
- Clinical Pharmacology and Toxicology Unit, PathWest, Perth, WA, Australia.,Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia
| | - M N Nguyen
- Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia
| | - D Sommerfield
- Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia.,Department of Anaesthesia and Pain Management, Perth's Children Hospital, Perth, WA, Australia
| | - A Sommerfield
- Department of Anaesthesia and Pain Management, Perth's Children Hospital, Perth, WA, Australia.,Peri-operative Medicine Team, Telethon Kids Institute, Perth, WA, Australia
| | - N Khan
- Department of Mathematics and Statistics, University of Western Australia, Perth, WA, Australia
| | - B S von Ungern Sternberg
- Department of Anaesthesia and Pain Management, Perth's Children Hospital, Perth, WA, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, University of Western Australia, Perth, WA, Australia
| | - L Y Lim
- Division of Pharmacy, School of Allied Health, University of Western Australia, Perth, WA, Australia
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Munir MA, Anjum KM, Javid A, Khan N, Jianming C, Naseer J, Anjum A, Usman S, Shahzad M, Hafeez S, Hussain T, Saeed A, Badeni AH, Mansoor MK, Hussain I. Sublethal toxicity of carbofuran in cattle egret (Bubulcus ibis coromandus): hematological, biochemical, and histopathological alterations. BRAZ J BIOL 2022; 84:e255055. [PMID: 35019107 DOI: 10.1590/1519-6984.255055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/22/2021] [Indexed: 11/22/2022] Open
Abstract
This study was aimed to investigate Carbofuran (CF)-induced pathological changes in cattle egret. Two hundred cattle egrets were reared and equally divided into four groups and given different CF concentrations (0.03 mg/L, 0.02 mg/L, 0.01 mg/L and 0 mg/L (control group)). Hematology, serum biochemistry, histopathology, and immunological markers were studied. Our results confirm that CF induces anemic conditions, leukocytosis, elevated liver enzymatic activity, and alterations in renal biomarkers. Moreover, specific microscopic lesions such as multifocal necrosis, pyknotic nuclei, hemorrhages, congestion, and inflammatory cell proliferation were observed in the liver, kidney, spleen, and thymus. These findings suggest that CF can induce harmful effects, so the application of this pesticide in the field must be strictly monitored to mitigate the possibility of exposure to non-target species.
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Affiliation(s)
- M A Munir
- University of Veterinary and Animal Sciences, Department of Wildlife & Ecology, Ravi Campus, Pattoki, Pakistan
| | - K M Anjum
- University of Veterinary and Animal Sciences, Department of Wildlife & Ecology, Ravi Campus, Pattoki, Pakistan
| | - A Javid
- University of Veterinary and Animal Sciences, Department of Wildlife & Ecology, Ravi Campus, Pattoki, Pakistan
| | - N Khan
- University of Veterinary and Animal Sciences, Department of Fisheries & Aquaculture, Ravi Campus, Pattoki, Pakistan
| | - C Jianming
- Minjiang University, Institute of Oceanography, Fuzhou, China
| | - J Naseer
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
| | - A Anjum
- The Islamia University of Bahawalpur, Faculty of Veterinary and Animal Sciences, Department of Pathology, Bahawalpur, Pakistan
| | - S Usman
- University of Veterinary and Animal Sciences, Faculty of Veterinary and Animal Sciences, Department of Pathology, Lahore, Pakistan
| | - M Shahzad
- The Islamia University of Bahawalpur, Faculty of Veterinary and Animal Sciences, Department of Pathology, Bahawalpur, Pakistan
| | - Shahid Hafeez
- University of Agriculture Faisalabad, Department of Forestry and Range Management, Faisalabad, Pakistan
| | - T Hussain
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
| | - A Saeed
- The Islamia University of Bahawalpur, Department of Forestry, Range and Wildlife Management, Bahawalpur, Pakistan
| | - A H Badeni
- University of Veterinary and Animal Sciences, Department of Wildlife & Ecology, Ravi Campus, Pattoki, Pakistan
| | - M K Mansoor
- The Islamia University of Bahawalpur, Faculty of Veterinary and Animal Sciences, Department of Microbiology, Bahawalpur, Pakistan
| | - I Hussain
- Bahauddin Zakariya University, Department of Pathobiology, Multan, Pakistan
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36
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Ali F, Rehman F, Hadi R, Raza G, Khan N, Ibrahim F, Aziz F, Amin M, Khalil B, Mahwish M, Bashir S, Ali A, Hussain M. Environmental sustainability assessment of wooden furniture produced in Pakistan. BRAZ J BIOL 2022; 84:e253107. [PMID: 35019094 DOI: 10.1590/1519-6984.253107] [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: 06/09/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
Abstract
Life cycle assessment was carried out for a conventional wooden furniture set produced in Mardan division of the Khyber Pakhtunkhwa province of Pakistan during 2018-19. Primary data regarding inputs and outputs were collected through questionnaire surveys from 100 conventional wooden furniture set manufacturers, 50 in district Mardan and 50 in district Swabi. In the present study, cradle-to-gate life cycle assessment approach was applied for a functional unit of one conventional wooden furniture set. Production weighted average data were modelled in the environmental impacts modelling software i.e., SimaPro v.8.5. The results showed that textile used in sofa set, wood preservative for polishing and preventing insects attack and petrol used in generator had the highest contribution to all the environmental impact categories evaluated. Total cumulative energy demand for wooden furniture set manufactured was 30,005 MJ with most of the energy acquired from non-renewable fossil fuel resources.
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Affiliation(s)
- F Ali
- University of Haripur, Department of Forestry and Wildlife Management, Khyber Pakhtunkhwa, Pakistan
| | - F Rehman
- COMSATS University Islamabad - CUI, Department of Economics, Lahore Campus, Lahore, Punjab, Pakistan
| | - R Hadi
- Jinnah University for Women, Department of Zoology, Nazimabad, Karachi, Sindh, Pakistan
| | - G Raza
- University of Baltistan, Department of Biological Sciences, Skardu, Gilgit-Baltistan, Pakistan
| | - N Khan
- Jinnah University for Women, Department of Zoology, Nazimabad, Karachi, Sindh, Pakistan
| | - F Ibrahim
- Jinnah University for Women, Department of Zoology, Nazimabad, Karachi, Sindh, Pakistan
| | - F Aziz
- Jinnah University for Women, Department of Biochemistry, Nazimabad, Karachi, Sindh, Pakistan
| | - M Amin
- Shaheed Benazir Bhutto University, Department of Environmental Sciences, Sheringal, Dir (U), KP, Pakistan
| | - B Khalil
- Jinnah University for Women, Department of Zoology, Nazimabad, Karachi, Sindh, Pakistan
| | - M Mahwish
- Jinnah University for Women, Department of Zoology, Nazimabad, Karachi, Sindh, Pakistan
| | - S Bashir
- Planning, Agriculture Research System, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - A Ali
- Department of Forestry, Range and Wildlife Management, Karakoram International University, 15100, Gilgit Baltistan, Pakistan
| | - M Hussain
- University of Haripur, Department of Forestry and Wildlife Management, Khyber Pakhtunkhwa, Pakistan
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37
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Abstract
Vitamin K acts a cofactor for the gamma-carboxylation of several proteins in the coagulation cascade. The clinical spectrum of vitamin K deficiency (VKD) can be asymptomatic to a significant bleeding. VKD is classically seen in newborns. However, this can manifest later in patients with risks such as sub-optimal nutrition, fat malabsorption, medications including antibiotics. A 17-year-old male with spinal muscular atrophy (SMA) Type 1, tracheostomy with ventilator dependent, gastrostomy tube feeding was seen by the gastroenterologist following treatment for small intestinal bacterial overgrowth (SIBO). Investigations showed coagulopathy following which he was transferred to the Pediatric ICU. Labs revealed prothrombin time (PT) 114 s [Normal 9.4-12.5 s], INR (International normalized ratio) 12.6 [Normal < 1.1] and partial thromboplastin time (PTT) 90 s [Normal 25.1-36.5 s]. Mixing studies and coagulation assays were consistent with VKD (low Factor VII and Factor IX with normal Factor V). His home blenderized feeding regimen met the caloric requirement but not the adequate intake (AI) values for vitamin K and other minerals. He received intravenous vitamin K (phytonadione) for five consecutive days with resolution of the coagulopathy (PT 13.2 s, PTT 37.1 s, INR 1.2). The patient was discharged on enteral vitamin K and additional supplements following dietary review by a nutritionist. Clinicians should be cognizant of VKD in patients on blenderized tube feeds which may not meet the adequate intake (AI) goals. In patients who are not receiving nutritionally complete formulas or receiving inadequate volumes, it is important to monitor macro and micronutrients.
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Affiliation(s)
- N Khan
- Department of Pediatrics, East Tennessee State University, Johnson City, TN, USA
| | - M Taimur
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - A Malkani
- Department of Pediatrics, East Tennessee State University, Johnson City, TN, USA
| | - R Lamsal
- Department of Pediatrics, East Tennessee State University, Johnson City, TN, USA
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Hillman H, Khan N, Singhania A, Dubelko P, Soldevila F, Tippalagama R, DeSilva AD, Gunasena B, Perera J, Scriba TJ, Ontong C, Fisher M, Luabeya A, Taplitz R, Seumois G, Vijayanand P, Hedrick CC, Peters B, Burel JG. Single-cell profiling reveals distinct subsets of CD14+ monocytes drive blood immune signatures of active tuberculosis. Front Immunol 2022; 13:1087010. [PMID: 36713384 PMCID: PMC9874319 DOI: 10.3389/fimmu.2022.1087010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Previous studies suggest that monocytes are an important contributor to tuberculosis (TB)-specific immune signatures in blood. Methods Here, we carried out comprehensive single-cell profiling of monocytes in paired blood samples of active TB (ATB) patients at diagnosis and mid-treatment, and healthy controls. Results At diagnosis, ATB patients displayed increased monocyte-to-lymphocyte ratio, increased frequency of CD14+CD16- and intermediate CD14+CD16+ monocytes, and upregulation of interferon signaling genes that significantly overlapped with previously reported blood TB signatures in both CD14+ subsets. In this cohort, we identified additional transcriptomic and functional changes in intermediate CD14+CD16+ monocytes, such as the upregulation of inflammatory and MHC-II genes, and increased capacity to activate T cells, reflecting overall increased activation in this population. Single-cell transcriptomics revealed that distinct subsets of intermediate CD14+CD16+ monocytes were responsible for each gene signature, indicating significant functional heterogeneity within this population. Finally, we observed that changes in CD14+ monocytes were transient, as they were no longer observed in the same ATB patients mid-treatment, suggesting they are associated with disease resolution. Discussion Together, our study demonstrates for the first time that both intermediate and classical monocytes individually contribute to blood immune signatures of ATB and identifies novel subsets and associated gene signatures that may hold disease relevance.
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Affiliation(s)
- Hannah Hillman
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Nabeela Khan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Akul Singhania
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Paige Dubelko
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Ferran Soldevila
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Rashmi Tippalagama
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Aruna D DeSilva
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka
| | - Bandu Gunasena
- Medical Unit, National Hospital for Respiratory Diseases, Welisara, Sri Lanka
| | - Judy Perera
- Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka
| | - Thomas J Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Cynthia Ontong
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michelle Fisher
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Angelique Luabeya
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Randy Taplitz
- Department of Medicine, City of Hope National Medical Center, Duarte, CA, United States
| | - Gregory Seumois
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Pandurangan Vijayanand
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Catherine C Hedrick
- Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Bjoern Peters
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Julie G Burel
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
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39
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Farid M, Khan N, Fatima M, Rasool F, Azmat H, Iqbal KJ, Nazir S, Bano S, Khizar A, Asghar M. Performance evaluation of the commercial aquafeeds available in the market of Pakistan on Channa marulius (Sole). BRAZ J BIOL 2021; 84:e250821. [PMID: 34755812 DOI: 10.1590/1519-6984.250821] [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: 04/08/2021] [Accepted: 07/15/2021] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to determine the effect of different levels of protein on the growth, body composition, amino acid profile and serology of Channa marulius fingerlings. The experiment was conducted in ten happas installed in earthen ponds, each stocked with 10 fishes for 90 days. Four commercial fish feeds having 25%, 30%, 32% and 40% crude protein (CP) levels were fed to fish at 3% of their wet body weight three times a day. The results of the study revealed that highest weight gain, feed conversion ratio and survival rate were observed in 30% protein feed. Meanwhile, moisture content was higher in fish fed with 30% CP feed while highest crude protein was recorded in 40% CP fed fish. Lowest fat content was observed in 32% CP feed. Amino acid profile of fish revealed better results in 30% CP feed. Total protein, glucose and globulin were also highest in fish feeding 30% CP feed, while albumin was highest in 40% CP feed. It is concluded that 30% CP feed showed better results in terms of growth, amino acid profile and serological parameters without effecting fish body composition.
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Affiliation(s)
- M Farid
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - N Khan
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M Fatima
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - F Rasool
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - H Azmat
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - K J Iqbal
- Islamia University of Bahawalpur, Department of Zoology, Bahawalpur, Pakistan
| | - S Nazir
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - S Bano
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - A Khizar
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M Asghar
- University of Veterinary and Animal Sciences, Department of Fisheries and Aquaculture, Lahore, Pakistan
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40
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Mahmud N, Weiss A, Trivedi C, Yang YX, Lewis J, Khan N. Risk of Venous Thromboembolism Among Patients With Inflammatory Bowel Disease Who Contract Severe Acute Respiratory Syndrome Coronavirus 2. Gastroenterology 2021; 161:1709-1711.e1. [PMID: 34139204 PMCID: PMC8204846 DOI: 10.1053/j.gastro.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 01/06/2023]
Affiliation(s)
| | - A Weiss
- Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - C Trivedi
- Department of Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Y-X Yang
- Department of Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania; Center of Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - J Lewis
- Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - N Khan
- Department of Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania; Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
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41
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Rana FA, Robert HM, Ilyas M, Mahmood A, Amir M, Khan N. DIAGNOSTIC UTILITY OF SERUM LACTATE DEHYDROGENASE LEVELS (LDL) IN DIFFERENTIATING MEGALOBLASTIC ANEMIA FROM MYELODYSPLASTIC SYNDROMES IN PAKISTAN. PAFMJ 2021. [DOI: 10.51253/pafmj.v71i5.5003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective: To study the diagnostic utility of lactate dehydrogenase levels in differentiating megaloblastic anemia from myelodysplastic anemia in Pakistan.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from Feb, 2019 to Aug, 2019.
Methodology: In this study, total 240 patients (18-75 years of age) males and females were selected by consecutive sampling technique and were equally divided into 3 groups; patients with megaloblastic anemia, patients with myelodysplastic syndromes and healthy control group. The clinical history and duration of anemia were recorded on special designed proforma. The laboratory investigations including lactate dehydrogenase levels were also noted. Both types of anemia were compared on basis of Lactate Dehydrogenase Levels.
Results: The lactate dehydrogenase levels in megaloblastic group were more than 3000 IU/L in 58 out of 80 patients (72.5%). On other hand, myelodysplastic group had 79 out of 80 patients with lactic acid dehydrogenase levels below 450 IU/L (98.75%). The difference in lactic acid dehydrogenase levels between both groups was found to be statistically significant.
Conclusion: Serum lactate dehydrogenase levels can be used to differentiate megaloblastic anemia from other anemia especially myelodysplastic syndromes before doing a bone marrow examination. High lactate dehydrogenase levels above 3000 IU/L in megaloblastic anemia can differentiate it from other anemia.
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42
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Wong Y, Tan B, Lau T, Khan N. Purchase intention towards dietary supplements during COVID-19 pandemic:
consumers’ perspective. Food Res 2021. [DOI: 10.26656/fr.2017.5(5).270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The consumption of dietary supplements (DSs) has been steadily increasing in the wake of
the COVID-19 outbreak in most countries. Consumer purchase intention towards DSs is
expected to be of concern to many companies in the pharmaceutical industry. This study
extends the Theory of Planned Behaviour by adding health consciousness and perceived
price in the model to investigate its effect on consumer purchase intention towards DSs
during the COVID-19 outbreak. A questionnaire-based survey was distributed via an
online survey to 207 respondents. Results from multiple regression analysis revealed that
consumer attitudes, subjective norms, perceived behavioural control, and health
consciousness contributed significantly to purchase intention towards DSs. Perceived
price did not have an impact on intention. Further investigation revealed that favourable
attitudes towards DSs were the most important contributor towards purchasing DSs during
the COVID-19 pandemic.
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43
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Parveen S, Rasool F, Akram MN, Khan N, Ullah M, Mahmood S, Rabbani G, Manzoor K. Effect of Moringa olifera leaves on growth and gut microbiota of Nile tilapia (Oreochromis niloticus). BRAZ J BIOL 2021; 84:e250916. [PMID: 34705952 DOI: 10.1590/1519-6984.250916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/05/2021] [Indexed: 11/22/2022] Open
Abstract
The study was conducted to evaluate the effect of Moringa olifera on the growth and gut health of Tilapia (Oreochromis niloticus). The feed having 30% crude protein was prepared as an experimental diet with 4%, 8% and 10% M. olifera leaf supplementation, respectively. The control diet was devoid of M. olifera leaves. The 10 weeks feeding trial was carried out on 60 fish in aquaria. Fish was fed @ 3% of body weight twice a day. Diet with the high level of inclusion of M. olifera leaves significantly increased the growth rate, Survival Rate (SR), Specific Growth Rate (SGR) and Feed Conversion Efficiency (FCE) in all treatment groups compared to the control group. Similarly, Feed Conversion Ratio (FCR) gradually decreased and found highly-significant. To check the gut health of the Tilapia, random samples were selected and dissected. Nutrient agar was used as culture media to check the growth of bacteria. Pour Plate Method was used for viable colonies count by colony counter. Through staining method, the different bacteria such as Escherichia coli, Salmonella, Shigella and Pseudomonas aeruginosa were identify abundantly in the intestine of control diet fish but less number present in treatment diets groups. These results showed that M. olifera leaves up to 10% of dietary protein can be used for Nile tilapia for significant growth and healthy gut microbiota of fish.
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Affiliation(s)
- S Parveen
- University of Agriculture, Faculty of Sciences, Department of Zoology, Wildlife & Fisheries, Faisalabad, Pakistan
| | - F Rasool
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M N Akram
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - N Khan
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - M Ullah
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - S Mahmood
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - G Rabbani
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
| | - K Manzoor
- University of Veterinary and Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries and Aquaculture, Lahore, Pakistan
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Kumar D, Yasin U, Saghir T, Akbar Sial J, Khatti S, Khan K, Khan N, Naeem Mengal M, Qamar N. Statin induced myalgia on high intensity statin in patients with Acute Coronary Syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1413] [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: 11/13/2022] Open
Abstract
Abstract
Background
High intensity statins are recommended in patients with acute coronary syndrome. Statins inhibit atherosclerotic plaque formation in the coronary arteries and reducing the burden of ischemic heart disease, therefore decreasing the morbidity and mortality. Muscle symptoms are most common adverse effect of statins. Hence, the aim of this study is to determine the statin induced myalgia by the statin myalgia clinical score.
Purpose
To monitor the Statin induced myalgia on high intensity statin in patients with Acute Coronary Syndrome
Methods
This was an prospective observational study comprised of 418 patients with acute coronary syndrome who were commenced on high intensity statins (Rosuvastatin 20–40mg & Atorvastatin 40–80). These patients were followed at 4 weeks, 8 weeks and 12 weeks subsequently and the clinical myalgia score (SAMS-CI) was calculated at each visit to determine the statin induced myalgia. SAMS-CI was categorized as unlikely (2–6), possible (7–8) and probable (9–11)
Results
From 418 patients, 327 were males and 91 were females. Mean age was 55.6±11.14. Only 19 (7.63±1.8) patients developed muscle symptoms on high intensity statins (Rosuvastatin 20 mg and Atorvastatin 40 mg) on SAMS-CI Score. 5 patients were unlikely to develop myalgia on SAMS-CI and continued with the same dosage without any new symptoms. 6 patients were possible on SAMS-CI, therefore the dosage of these patients were decreased to moderate intensity statin (Rosuvastatin 10mg, Atorvastatin 20 mg), their symptoms were resolved and continued with the moderate intensity statins. Furthermore, Statin was hold in 8 patients in the probable category for 4 weeks until the resolution of symptoms followed by moderate intensity statins.
Conclusion
Statin induced myalgia is more reported in old aged and female patients. Most of the patients can better tolerate the lower range of high intensity statins with the similar benefits and should be prescribed in every patient
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Kumar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - U Yasin
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - T Saghir
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - J Akbar Sial
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - S Khatti
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - K Khan
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - N Khan
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - M Naeem Mengal
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
| | - N Qamar
- National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
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45
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Suresh A, Goel A, Khan N, Promod P, Pabla R, Cymerman J. 1599 Review of Telephone Consultations for Suspected Head and Neck Cancer Referrals During The COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8524598 DOI: 10.1093/bjs/znab259.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Introduction Pandemic COVID-19 necessitated a transformation in the delivery of healthcare. Telephone consultations were introduced to protect and progressively manage patients with minimal delay. This is a review of the effectiveness of these remote consultations for suspected 2-week wait (2ww) head and neck cancer referrals to a north London NHS teaching hospital Oral and Maxillofacial unit during the first official UK government lockdown from March - July 2020. Method Prospective electronic records of 176 consecutive 2ww referrals between March – July 2020 was assessed. Data analysed included initial telephone consultations, subsequent face-to-face (F2F) appointments, if required, the interval from telephone to F2F appointments and histopathological diagnoses. Results 157 patients (n = 176) received an initial telephone call, of which 127 (80.9%) required a F2F consultation. The number of days between the initial telephone consultation and subsequent F2F assessment ranged from 0 to 141, with a mean of 11 and a median of 1. Notably, 31 patients (24.4%) were seen in person on the same day as their telephone consultation. Biopsies were indicated for 69 patients (54.3%) of which 9 (13.0%) were diagnosed as malignancies. Conclusions Whilst protecting patients from a pandemic is utmost, continuing care for non-pandemic conditions must be considered. It is even more important to manage 2ww referrals efficiently. These results indicate the majority of suspected cancer referrals warrant F2F assessment for a confident outcome. Despite reinstated, ongoing social restrictions, 2ww referrals are now being seen exclusively F2F, subject to patient choice. This information is useful for planning and strategizing services in a head and neck OMFS unit.
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Affiliation(s)
- A Suresh
- Royal Free London NHS Trust, London, United Kingdom
| | - A Goel
- Royal Free London NHS Trust, London, United Kingdom
| | - N Khan
- Royal Free London NHS Trust, London, United Kingdom
| | - P Promod
- Royal Free London NHS Trust, London, United Kingdom
| | - R Pabla
- Royal Free London NHS Trust, London, United Kingdom
| | - J Cymerman
- Royal Free London NHS Trust, London, United Kingdom
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Hosseini F, Franco C, Selvakumar K, Whalen B, Kaila K, Sellers S, Malhi N, Shahriari M, Lee S, Alipour S, Khan N, Gupta M, Farkouh M, Verma S, Taylor C, Leipsic J, Ramanathan K. MONOCYTE SUBSETS HETEROGENEITY AND CORONARY ATHEROSCLEROSIS IN SOUTH ASIANS COMPARED TO WHITE CAUCASIANS. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.055] [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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Ayub A, Rasool F, Khan N, Qaisrani SN, Parveen S, Anjum KM, Fatima M, Matiullah, Mahmood S, Zulfiqar T. Limiting amino acids supplementation in low crude protein diets and their impacts on growth performance and carcass composition in Labeo rohita (rohu) adult fish. BRAZ J BIOL 2021; 83:e249422. [PMID: 34495169 DOI: 10.1590/1519-6984.249422] [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: 03/04/2021] [Accepted: 04/07/2021] [Indexed: 11/21/2022] Open
Abstract
Ninety days study was conducted in hapas installed in earthen ponds. Fish of an average initial weight (220g) were evenly distributed in triplicate groups within fifteen hapas. Five experimental diets labeled as T1 (25% CP and NRC recommended amino acid level) as control diet, T2 (with 2% low protein and 5% amino acid supplementation), T3 (with 2% low protein and 10% amino acid supplementation), T4 (with 4% low protein and 10% amino acid supplementation) and T5 (with 4% low protein and 20% amino acid supplementation) were prepared. Fish were fed with @3% of their body weight twice a day at 10.00 & 16:00 hour. Significantly higher percent weight gain (420.18 ± 66.84a) and specific growth rate (13499.33±1273.54a) along with improved feed conversion ratio (1.29 ± 0.09b) and hundred percent survivals were recorded during the trial. Furthermore proximate analysis of meat showed significant improvement in the crude protein level (81.77 ± 0.19a) served with diet containing 20% limiting amino acids mixture. Therefore, limiting amino acids can be a source of cost effective feed and use safely in L. rohita diet.
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Affiliation(s)
- A Ayub
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - F Rasool
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - N Khan
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - S N Qaisrani
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan.,University of Veterinary and Animal Sciences, Faculty of Animal Production Technology, Department of Animal Nutrition, Lahore, Pakistan
| | - S Parveen
- University of Agriculture, Faculty of Sciences, Department of Zoology, Wildlife & Fisheries, Faisalabad, Pakistan
| | - K M Anjum
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - M Fatima
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - Matiullah
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - S Mahmood
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
| | - T Zulfiqar
- University of Veterinary & Animal Sciences, Faculty of Fisheries & Wildlife, Department of Fisheries & Aquaculture, Lahore, Pakistan
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Haq IU, Mehmood Z, Afzal T, Khan N, Ahmed B, Nawsherwan, Ali L, Khan A, Muhammad J, Khan EA, Khan J, Zakki SA, Xu J, Shu Y. Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan. BRAZ J BIOL 2021; 82:e249971. [PMID: 34259717 DOI: 10.1590/1519-6984.249971] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/13/2021] [Indexed: 11/22/2022] Open
Abstract
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
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Affiliation(s)
- I Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Z Mehmood
- Department of Math's, Stats & Computer Science, The University of Agriculture Peshawar, Pakistan
| | - T Afzal
- Basic Health Unit Rakhi Mounh, Tehsil Koh-e-Suleman, District Health Authority Dera Ghazi Khan, Pakistan
| | - N Khan
- Goat Production Research Station Charbagh Swat, Livestock and Dairy Development Research Department Khyber Pakhtunkhwa, Pakistan
| | - B Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Nawsherwan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, China
| | - L Ali
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - A Khan
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Muhammad
- Department of Microbiology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - E A Khan
- Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan
| | - J Khan
- Department of Agriculture, University of Swabi, Khyber Pakhtunkhwa, Pakistan
| | - S A Zakki
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - J Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Shu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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Charles-Schoeman C, Giles JT, Lane N, Choy E, Furst D, Vencovský J, Wilson AG, Burmester GR, Shaw T, Song Y, Camp H, Khan N, Yee J, Anyanwu S, Mcinnes I. OP0128 INTEGRATED LABORATORY ABNORMALITY PROFILES OF UPADACITINIB WITH UP TO 4.5 YEARS OF EXPOSURE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED IN THE SELECT PHASE 3 PROGRAM. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Upadacitinib (UPA) is an oral Janus kinase inhibitor approved for rheumatoid arthritis (RA). The safety and efficacy of UPA has been evaluated across a spectrum of patients (pts) with RA in the phase 3 SELECT clinical program.1,2Objectives:To describe long-term laboratory profiles (cutoff date: June 30, 2020) associated with exposure to UPA, adalimumab (ADA), and methotrexate (MTX) in pts with RA treated in the SELECT trials.Methods:Data were analyzed from 6 randomized controlled UPA RA trials.1,2 The proportions of pts experiencing potentially clinically significant laboratory changes at a single time point were summarized for the following groups: pooled UPA 15 mg once daily (QD; UPA15; 6 trials), pooled UPA 30 mg QD (UPA30; 4 trials), ADA 40 mg every other week (EOW; 1 trial), and MTX monotherapy (1 trial). Pts received UPA with/without background conventional synthetic disease-modifying antirheumatic drugs. Treatment-emergent adverse events are reported as exposure-adjusted event rates (events/100 pt-years [E/100 PY]). Toxicity was graded per OMERACT criteria, or NCI CTCAE for creatine phosphokinase (CPK) and creatinine.Results:4413 pts received ≥1 dose of UPA (UPA15, n=3209; UPA30, n=1204). Exposures were comparable between treatment groups (Table). Proportions of pts with Grade (Gr) 3 and 4 decreases in hemoglobin were highest with UPA30 and MTX (Table). Rates of anemia, as reported by the investigator, were comparable between UPA15, ADA, and MTX groups (Figure); the frequency of UPA-treated pts who discontinued due to anemia was low in all arms. Gr 3 and 4 decreases in neutrophils and lymphocytes with UPA were dose-dependent and higher vs ADA or MTX. Discontinuations due to neutropenia and lymphopenia were rare (<0.1%). Transaminase elevations were more frequent with UPA and MTX vs ADA; however, the proportion of pts who discontinued due to increases in alanine (ALT) or aspartate aminotransferase (AST) were comparable between UPA15 and ADA, and numerically higher with UPA30 and MTX. CPK elevations were more frequent with UPA (Figure). Most events were asymptomatic, and the 1 case of rhabdomyolysis in the UPA30 group was unrelated to study drug (attributed to influenza).Table 1.Pts with potentially clinically significant laboratory changesVariable, n (%)MTX monotherapy (n=314; 637.4 PY)ADA 40 mg EOW (n=579; 1051.8 PY)UPA 15 mg QD (n=3209; 7023.8 PY)UPA 30 mg QD (n=1204; 3091.6 PY)Mean (SD) exposure, weeks106 (67)95 (70)114 (64)134 (66)Median (range) exposure, weeks144 (1, 221)118 (2, 231)136 (0, 232)160 (0, 231)Hemoglobin, g/LGr 3 (70–<80 or decreased 21–<30)28a (9.0)24b (4.2)254d (7.9)169f (14.2)Gr 4 (<70 or decreased ≥30)16a (5.1)16b (2.8)101d (3.2)78f (6.5)Neutrophils, 109/LGr 3 (0.5–<1.0)3a (1.0)3b (0.5)40d (1.2)37g (3.1)Gr 4 (<0.5)1a (0.3)1b (0.2)10d (0.3)5g (0.4)Lymphocytes, 109/LGr 3 (0.5–<1.0)74a (23.7)53b (9.2)802d (25.1)423g (35.5)Gr 4 (<0.5)5a (1.6)3b (0.5)75d (2.3)47g (3.9)ALT, U/LGr 3 (3.0–8.0 × ULN)26a (8.3)13c (2.3)152e (4.8)71h (5.9)Gr 4 (>8.0 × ULN)5a (1.6)4c (0.7)26e (0.8)10h (0.8)AST, U/LGr 3 (3.0–8.0 × ULN)15a (4.8)9c (1.6)101e (3.2)36h (3.0)Gr 4 (>8.0 × ULN)1a (0.3)5c (0.9)18e (0.6)8h (0.7)CPK, U/LGr 3 (>5.0–10.0 × ULN)2a (0.6)3c (0.5)65e (2.0)36i (3.0)Gr 4 (>10.0 × ULN)0a (0)3c (0.5)27e (0.8)15i (1.3)Creatinine, μmol/LGr 3 (>3.0–6.0 × ULN)0a (0)1c (0.2)3e (<0.1)2j (0.2)Gr 4 (>6.0 × ULN)0a (0)4c (0.7)8e (0.3)1j (<0.1)an=312. bn=576. cn=577. dn=3201. en=3199. fn=1193. gn=1192. hn=1195. in=1196. jn=1197ULN, upper limit of normalConclusion:This long-term analysis of UPA-treated pts with RA showed dose-dependent relationships for several laboratory abnormalities. Incidences of these with UPA15 were typically higher than with ADA but similar to MTX, except for increased CPK elevations. Treatment discontinuations due to laboratory abnormalities were infrequent and similar across all treatment groups.References:[1]Tanaka Y. Mod Rheumatol 2020;30:779–87; 2. Rubbert-Roth A, et al. N Engl J Med 2020;383:1511–21.Acknowledgements:AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Russell Craddock, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of Interests:Christina Charles-Schoeman Consultant of: AbbVie, Gilead, Pfizer, and Sanofi/Regeneron, Grant/research support from: AbbVie, Bristol-Myers Squibb, and Pfizer, Jon T Giles Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Pfizer, and UCB, Grant/research support from: Pfizer, Nancy Lane Consultant of: Amgen, Mallinckrodt, Pfizer, and Roche, Ernest Choy Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Chugai, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Regeneron, Roche, Sanofi, and UCB, Consultant of: AbbVie, Amgen, Biocon, Biogen, Chugai, Eli Lilly, Gilead, Janssen, Merck Serono, Novartis, Pfizer, Regeneron, Roche, R-Pharm, and Sanofi, Grant/research support from: Bio-Cancer, Biogen, Novartis, Pfizer, Roche, Sanofi, and UCB, Daniel Furst Speakers bureau: AbbVie, Continuing Medical Education, and Novartis, Consultant of: Actelion, Amgen, Bristol-Myers Squibb, Corbus, Galapagos, Novartis, and Pfizer, Grant/research support from: Actelion, Amgen, Bristol-Myers Squibb, Corbus, Galapagos, GSK, NIH, Novartis, Pfizer, Roche/Genentech, and Sanofi, Jiří Vencovský Speakers bureau: AbbVie, Biogen, MSD, Pfizer, Roche, Sanofi, and UCB, Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly, Gilead, and Octapharma, Anthony G Wilson: None declared, Gerd Rüdiger Burmester Speakers bureau: AbbVie, Eli Lilly, Gilead, Janssen, MSD, Pfizer, Roche, and UCB, Consultant of: AbbVie, Eli Lilly, Gilead, Janssen, MSD, Pfizer, Roche, and UCB, Tim Shaw Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Heidi Camp Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Nasser Khan Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Jillian Yee Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Samuel Anyanwu Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Iain McInnes Consultant of: AbbVie, Celgene, Janssen, Novartis, and UCB, Grant/research support from: Celgene, Janssen, Novartis, Pfizer, Roche, and UCB
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Khan N, Noor S, Geller S, Khodadoust MS, Kheterpal M, Hancock H, Davey T, Ryu S, Perez L, Lares A, Ganesan N, Sohail S, Santarosa A, Galasso N, Kim E, Myskowski P, Kim YH, Horwitz S, Moskowitz A. A PHASE II TRIAL OF REDUCED DOSE BRENTUXIMAB VEDOTIN FOR CUTANEOUS T‐CELL LYMPHOMAS. Hematol Oncol 2021. [DOI: 10.1002/hon.123_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- N. Khan
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - S. Noor
- Memorial Sloan Kettering Cancer Center Dermatology, New York New York USA
| | - S. Geller
- Tel Aviv Sourasky Medical Center Dermatology Tel Aviv Israel
| | - M. S. Khodadoust
- Stanford University School of Medicine Department of Medicine Division of Oncology & Department of Dermatology Stanford California USA
| | - M. Kheterpal
- Duke University Medical Center Dermatology Durham North Carolina USA
| | - H. Hancock
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - T. Davey
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - S. Ryu
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - L. Perez
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - A. Lares
- Stanford University School of Medicine Department of Medicine Division of Oncology & Department of Dermatology Stanford California USA
| | - N. Ganesan
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - S. Sohail
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - A. Santarosa
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - N. Galasso
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - E. Kim
- Stanford University School of Medicine Department of Medicine Division of Oncology & Department of Dermatology Stanford California USA
| | - P. Myskowski
- Memorial Sloan Kettering Cancer Center Dermatology, New York New York USA
| | - Y. H. Kim
- Stanford University School of Medicine Department of Medicine Division of Oncology & Department of Dermatology Stanford California USA
| | - S. Horwitz
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
| | - A. Moskowitz
- Memorial Sloan Kettering Cancer Center Medicine, Lymphoma Service New York USA
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