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Uddin MKM, Hossain ME, Ami JQ, Hasan R, Hasan MM, Islam A, Hasan MJ, Shaly NJ, Ahmed S, Samina P, Rahman MZ, Rahman M, Banu S. SalivaDirect: an alternative to a conventional RNA extraction protocol for molecular detection of SARS-CoV-2 in a clinical setting. Microbiol Spectr 2024; 12:e0327223. [PMID: 38014980 PMCID: PMC10783095 DOI: 10.1128/spectrum.03272-23] [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: 09/04/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE Affordable and accessible tests for COVID-19 allow for timely disease treatment and pandemic management. SalivaDirect is a faster and easier method to implement than NPS sampling. Patients can self-collect saliva samples at home or in other non-clinical settings without the help of a healthcare professional. Sample processing in SalivaDirect is less complex and more adaptable than in conventional nucleic acid extraction methods. We found that SalivaDirect has good diagnostic performance and is ideal for large-scale testing in settings where supplies may be limited or trained healthcare professionals are unavailable.
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Affiliation(s)
| | - Mohammad Enayet Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jenifar Quaiyum Ami
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashedul Hasan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md. Mahmudul Hasan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ashabul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md. Jahid Hasan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nusrat Jahan Shaly
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shahriar Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pushpita Samina
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Mohammed Ziaur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mustafizur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sayera Banu
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Wan Abdul Rahman WM, Saddki N, Mahmood Z, Hasan R, Samsudin NA. Knowledge and attitude towards children's oral health: findings from a sample of first-time mothers in Malaysia. Med J Malaysia 2024; 79:1-8. [PMID: 38287750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Women's important roles within families which include modelling appropriate oral health behaviours require them to have good knowledge and positive attitude in oral health. This study determined knowledge and attitude towards children's oral health among first-time mothers and factors associated with the attributes. MATERIALS AND METHODS A total of 154 first-time mothers in the third trimester of pregnancy who attended two health clinics in the state of Sarawak, Malaysia for antenatal care participated in this cross-sectional study. A structured selfadministered questionnaire was used to measure the variables of interest. RESULTS Most mothers could correctly identify the aetiological factors of dental caries and strategies for preventing the disease in children. However, a substantial portion could not identify certain cariogenic and noncariogenic foods or drinks. Most pregnant women have appropriate attitudes towards children's oral health although some showed unfavourable attitude about care of primary teeth. Women who were older and had attended a talk on children's oral health were more likely to have higher mean knowledge score than their respective counterparts, and higher mean knowledge score was associated with higher mean attitude score. CONCLUSION Most first-time mothers in this study had correct knowledge and favourable attitude about children's oral health, although misunderstandings and misperceptions in several issues were also common. Significant association found between experience of attending oral health talk and oral health knowledge, and between oral health knowledge and attitude, substantiate the importance of an educational intervention program to optimise the mothers' roles in caries prevention in children.
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Affiliation(s)
- W M Wan Abdul Rahman
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - N Saddki
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia.
| | - Z Mahmood
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - R Hasan
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - N A Samsudin
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia
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Ahmed MP, Khan SU, Hasan R, Sabah MN, Begum LN, Islam MS, Islam M. Phlebectomy versus Sclerotherapy in Varicose Vein Patients: A Comparative Study. Mymensingh Med J 2023; 32:743-748. [PMID: 37391968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Varicose veins are part of the spectrum of chronic venous disease and include spider telangiectasias, reticular veins, and true varicosities. It may present without advanced signs of chronic venous insufficiency. Sclerotherapy is a treatment choice for patients with varicose veins of lower extremity; it uses the intravenous injection of chemical drugs to achieve the goal of inflammatory occlusion. Phlebectomy, a minimally invasive procedure usually used for higher diameter of varicose veins at the surface of the skin. Objective of the study was to compare the outcome of Phlebectomy and Sclerotherapy in varicose vein patients. It was a quasi experimental study was conducted in the Department of Vascular Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of June 2019 to May 2020. Patients admitted with varicose vein and varicosity of the lower limbs with valves and perforator incompetence in the Department of Vascular Surgery, BSMMU, Dhaka, Bangladesh. During this period 60 patients were selected purposive randomly. Patients were divided to 30 patients were treated with Phlebectomy (Group I) 30 patients were treated with Sclerotherapy (Group II). Data were collected according to the pre-designed semi-structured data collection sheet. After editing data analysis were carried out by using the Statistical Package for Social Science (SPSS) version 22.0 Windows software. This study shows average age 40.73±15.50 years in Phlebectomy (Group I) and 38.43±11.08 years in Sclerotherapy (Group II). Males are more commonly involved than females between two groups which was 76.7% in Phlebectomy (Group I) and 70.0% in Sclerotherapy (Group II). The change CEAP improved to 93.3% in patients who underwent phlebectomy when compared to 83.3% in patients who underwent sclerotherapy. During the follow-up with duplex at treated veins showed 93.3% complete occlusion of treated veins in the phlebectomy group, while only 70.0% of the patients in the sclerotherapy group showed evidence of complete occlusion. In phlebectomy group recurrence of leg varicosities were found 6.7% of the patients, while 26.7% of the patients in the sclerotherapy group. The difference was statistically significant between two groups (p=0.038). This study shows phlebectomy to be much better option than sclerotherapy for the treatment of varicose veins and hence can be used routinely. Both phlebectomy and sclerotherapy not only revealed minimal time taken for return to normal activity but also proved to be safer with regard to complications.
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Affiliation(s)
- M P Ahmed
- Dr SM Parvez Ahmed, Assistant Professor, Department of Vascular Surgery, National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh; E-mail:
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Miah M, Hossain ME, Hasan R, Alam MS, Puspo JA, Hasan MM, Islam A, Chowdhury S, Rahman MZ. Culture-Independent Workflow for Nanopore MinION-Based Sequencing of Influenza A Virus. Microbiol Spectr 2023; 11:e0494622. [PMID: 37212605 PMCID: PMC10269883 DOI: 10.1128/spectrum.04946-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/04/2023] [Indexed: 05/23/2023] Open
Abstract
Whole-genome sequencing (WGS) of influenza A virus (IAV) is crucial for identifying diverse subtypes and newly evolved variants and for selecting vaccine strains. In developing countries, where facilities are often inadequate, WGS is challenging to perform using conventional next-generation sequencers. In this study, we established a culture-independent, high-throughput native barcode amplicon sequencing workflow that can sequence all influenza subtypes directly from a clinical specimen. All segments of IAV in 19 clinical specimens, irrespective of their subtypes, were amplified simultaneously using a two-step reverse transcriptase PCR (RT-PCR) system. First, the library was prepared using the ligation sequencing kit, barcoded individually using the native barcodes, and sequenced on the MinION MK 1C platform with real-time base-calling. Then, subsequent data analyses were performed with the appropriate tools. WGS of 19 IAV-positive clinical samples was carried out successfully with 100% coverage and 3,975-fold mean coverage for all segments. This easy-to-install and low-cost capacity-building protocol took only 24 h complete from extracting RNA to obtaining finished sequences. Overall, we developed a high-throughput portable sequencing workflow ideal for resource-limited clinical settings, aiding in real-time surveillance, outbreak investigation, and the detection of emerging viruses and genetic reassortment events. However, further evaluation is required to compare its accuracy with other high-throughput sequencing technologies to validate the widespread application of these findings, including WGS from environmental samples. IMPORTANCE The Nanopore MinION-based influenza sequencing approach we are proposing makes it possible to sequence the influenza A virus, irrespective of its diverse serotypes, directly from clinical and environmental swab samples, so that we are not limited to virus culture. This third-generation, portable, multiplexing, and real-time sequencing strategy is highly convenient for local sequencing, particularly in low- and middle-income countries like Bangladesh. Furthermore, the cost-efficient sequencing method could provide new opportunities to respond to the early phase of an influenza pandemic and enable the timely detection of the emerging subtypes in clinical samples. Here, we meticulously described the entire process that might help the researcher who will follow this methodology in the future. Our findings suggest that this proposed method is ideal for clinical and academic settings and will aid in real-time surveillance and in the detection of potential outbreak agents and newly evolved viruses.
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Affiliation(s)
- Mojnu Miah
- Infectious Diseases Division, ICDDR,B, Dhaka, Bangladesh
| | | | - Rashedul Hasan
- Infectious Diseases Division, ICDDR,B, Dhaka, Bangladesh
| | | | | | | | - Ariful Islam
- EcoHealth Alliance, New York, New York, USA
- Centre for Integrative Ecology, School of Life and Environmental Science, Deakin University, Burwood, Victoria, Australia
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Mariappan P, Johnston A, Trail M, Hamid S, Hollins G, Dreyer B, Ramsey S, Padovani L, Guerrero Enriquez J, Simpson H, Hasan R, Sharpe C, Thomas B, Bhatt J, Ahmad I, Nandwani G, Chaudhry A, Boden A, Khan R, Maresca G, Dimitropoulos K, Graham C, Hendry D. Can repeat TURBT in patients presenting with High Grade Ta Urothelial Carcinoma be more nuanced? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00752-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Schwamm LH, Kamel H, Granger CB, Piccini JP, Katz JM, Sethi PP, Sidorov EV, Kasner SE, Silverman SB, Merriam TT, Franco N, Ziegler PD, Bernstein RA, Abi-Samra F, Acosta I, Al Balushi A, Al-Awwad A, Alimohammad R, Alkahalifah M, Allred J, Alsorogi M, Arias V, Aroor S, Arora R, Asdaghi N, Asi K, Assar M, Badhwar N, Banchs J, Bansal S, Barrett C, Beaver B, Beldner S, Belt G, Bernabei M, Bernard M, Bhatt N, Black J, Bledsoe D, Bonaguidi H, Bonyak K, Boyd C, Cajavilca C, Caprio F, Carter J, Chancellor B, Chang C, Chaudhary G, Chaudhary S, Cheung P, Ching M, Chinitz L, Chiu D, Chokhawala H, Choudhuri I, Choudry S, Clayton S, Cross J, Cucchiara B, Culpepper A, Daniels J, Dash S, Del Brutto V, Deline C, Delpirou Nouh C, Deo R, Dhamoon M, Dillon G, Donsky A, Doshi A, Downey A, Dukkipati S, Epstein L, Etherton M, Fara M, Fayad PB, Felberg R, Flaster M, Frankel D, Furer S, Gadhia R, Gadient P, Garabelli P, Gibson D, Glotzer T, Goltz D, Gordon D, Graner S, Graybeal D, Grimes MR, Guerrero W, Hanna J, Hao Q, Hasabnis S, Hasan R, Heist EK, Horowitz D, Hourihane JM, Hussein H, Ishida K, Ismail H, Jadonath R, Jamal S, Jamnadas P, Jia J, Johnson M, Jung R, Kalafut M, Kalia J, Kandel A, Kasner S, Katz L, Katz J, Kaur G, Kearney M, Khatib S, Kim S, Kim C, Kipta J, Koch S, Koruth J, Kreger H, Krueger K, Kurian C, LaFranchise E, Lambrakos L, Langan MN, Lee R, Libman R, Lillemoe K, Logan W, Lord A, Lubitz S, Luciano J, Lynch J, Maccaro PC, Magadan A, Magun R, Malik M, Malik A, Manda S, Marulanda-Londono E, Matos Diaz I, Mattera B, McCall-Brown A, Mcclelland N, Meisel K, Memon Z, Mendelson S, Mendoza I, Merriam T, Messe S, Miles WM, Miller M, Mir O, Mitrani R, Morin D, Morris K, Moussavi M, Mowla A, Moye S, Mullen M, Mullins S, Neisen K, Nguyen C, Niazi I, Olson N, Olsovsky G, Ortiz G, Ostrander M, Pakala A, Parker B, Parker M, Passman R, Patel A, Patel A, Pickett RA(D, Polin G, Radoslovich G, Ramano J, Rami T, Ramirez D, Rasmussen J, Ray B, Reddy V, Reddy R, Reeves R, Regenhardt R, Rempe D, Rogers P, Rogers J, Rowe S, Rowley C, Ruff I, Sackett M, Sajjad R, Salem R, Saltzman M, Santangeli P, Saucedo S, Sawyer R, Schaller R, Seeger S, Sethi P, Shang T, Sharma J, Sharma R, Sheinart K, Shukla G, Shultz J, Sidorov E, Silverman S, Simonson J, Singh D, Skalabrin E, Sloane K, Smith M, Smith W, Soik D, Stavrakis S, Stein L, Steinberg JS, Sur N, Switzer D, Talpur N, Tansy A, Tempro K, Thavapalan V, Thomas A, Thomas K, Torres J, Torres L, Tuhrim S, Uddin P, Vidal G, Viswanathan A, Volpi J, Ward K, Weinberger J, Whang W, Wilder M, Willner J, Wright P, Yuan Q, Zhang C, Zhu D, Zide K, Zimmerman J, Zweifler R. Predictors of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: A Prespecified Secondary Analysis of the STROKE AF Randomized Clinical Trial. JAMA Neurol 2023; 80:99-103. [PMID: 36374508 PMCID: PMC9664367 DOI: 10.1001/jamaneurol.2022.4038] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Importance The Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE AF) trial found that approximately 1 in 8 patients with recent ischemic stroke attributed to large- or small-vessel disease had poststroke atrial fibrillation (AF) detected by an insertable cardiac monitor (ICM) at 12 months. Identifying predictors of AF could be useful when considering an ICM in routine poststroke clinical care. Objective To determine the association between commonly assessed risk factors and poststroke detection of new AF in the STROKE AF cohort monitored by ICM. Design, Setting, and Participants This was a prespecified analysis of a randomized (1:1) clinical trial that enrolled patients between April 1, 2016, and July 12, 2019, with primary follow-up through 2020 and mean (SD) duration of 11.0 (3.0) months. Eligible patients were selected from 33 clinical research sites in the US. Patients had an index stroke attributed to large- or small-vessel disease and were 60 years or older or aged 50 to 59 years with at least 1 additional stroke risk factor. A total of 496 patients were enrolled, and 492 were randomly assigned to study groups (3 did not meet inclusion criteria, and 1 withdrew consent). Patients in the ICM group had the index stroke within 10 days before insertion. Data were analyzed from October 8, 2021, to January 28, 2022. Interventions ICM monitoring vs site-specific usual care (short-duration external cardiac monitoring). Main Outcomes and Measures The ICM device automatically detects AF episodes 2 or more minutes in length; episodes were adjudicated by an expert committee. Cox regression multivariable modeling included all parameters identified in the univariate analysis having P values <.10. AF detection rates were calculated using Kaplan-Meier survival estimates. Results The analysis included the 242 participants randomly assigned to the ICM group in the STROKE AF study. Among 242 patients monitored with ICM, 27 developed AF (mean [SD] age, 66.6 [9.3] years; 144 men [60.0%]; 96 [40.0%] women). Two patients had missing baseline data and exited the study early. Univariate predictors of AF detection included age (per 1-year increments: hazard ratio [HR], 1.05; 95% CI, 1.01-1.09; P = .02), CHA2DS2-VASc score (per point: HR, 1.54; 95% CI, 1.15-2.06; P = .004), chronic obstructive pulmonary disease (HR, 2.49; 95% CI, 0.86-7.20; P = .09), congestive heart failure (CHF; with preserved or reduced ejection fraction: HR, 6.64; 95% CI, 2.29-19.24; P < .001), left atrial enlargement (LAE; HR, 3.63; 95% CI, 1.55-8.47; P = .003), QRS duration (HR, 1.02; 95% CI, 1.00-1.04; P = .04), and kidney dysfunction (HR, 3.58; 95% CI, 1.35-9.46; P = .01). In multivariable modeling (n = 197), only CHF (HR, 5.06; 95% CI, 1.45-17.64; P = .05) and LAE (HR, 3.32; 1.34-8.19; P = .009) remained significant predictors of AF. At 12 months, patients with CHF and/or LAE (40 of 142 patients) had an AF detection rate of 23.4% vs 5.0% for patients with neither (HR, 5.1; 95% CI, 2.0-12.8; P < .001). Conclusions and Relevance Among patients with ischemic stroke attributed to large- or small-vessel disease, CHF and LAE were associated with a significantly increased risk of poststroke AF detection. These patients may benefit most from the use of ICMs as part of a secondary stroke prevention strategy. However, the study was not powered for clinical predictors of AF, and therefore, other clinical characteristics may not have reached statistical significance. Trial Registration ClinicalTrials.gov Identifier: NCT02700945.
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Affiliation(s)
- Lee H. Schwamm
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Hooman Kamel
- Department of Neurology, Weill Cornell Medicine, New York, New York,Deputy Editor, JAMA Neurology
| | - Christopher B. Granger
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Jonathan P. Piccini
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Jeffrey M. Katz
- Department of Neurology and Radiology, North Shore University Hospital, Manhasset, New York
| | - Pramod P. Sethi
- Guilford Neurology Associates, Moses H. Cone Hospital, Greensboro, North Carolina
| | - Evgeny V. Sidorov
- Department of Neurology, The University of Oklahoma Health Sciences Center, Oklahoma City
| | - Scott E. Kasner
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | - Noreli Franco
- Clinical Department, Medtronic, Minneapolis, Minnesota
| | | | - Richard A. Bernstein
- Davee Department of Neurology, Feinberg School of Medicine of Northwestern University, Chicago, Illinois
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Sorbello A, Haque SA, Hasan R, Jermyn R, Hussein A, Vega A, Zembrzuski K, Ripple A, Ahadpour M. Artificial Intelligence-Enabled Software Prototype to Inform Opioid Pharmacovigilance From Electronic Health Records: Development and Usability Study. JMIR AI 2023; 2:e45000. [PMID: 37771410 PMCID: PMC10538589 DOI: 10.2196/45000] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Background The use of patient health and treatment information captured in structured and unstructured formats in computerized electronic health record (EHR) repositories could potentially augment the detection of safety signals for drug products regulated by the US Food and Drug Administration (FDA). Natural language processing and other artificial intelligence (AI) techniques provide novel methodologies that could be leveraged to extract clinically useful information from EHR resources. Objective Our aim is to develop a novel AI-enabled software prototype to identify adverse drug event (ADE) safety signals from free-text discharge summaries in EHRs to enhance opioid drug safety and research activities at the FDA. Methods We developed a prototype for web-based software that leverages keyword and trigger-phrase searching with rule-based algorithms and deep learning to extract candidate ADEs for specific opioid drugs from discharge summaries in the Medical Information Mart for Intensive Care III (MIMIC III) database. The prototype uses MedSpacy components to identify relevant sections of discharge summaries and a pretrained natural language processing (NLP) model, Spark NLP for Healthcare, for named entity recognition. Fifteen FDA staff members provided feedback on the prototype's features and functionalities. Results Using the prototype, we were able to identify known, labeled, opioid-related adverse drug reactions from text in EHRs. The AI-enabled model achieved accuracy, recall, precision, and F1-scores of 0.66, 0.69, 0.64, and 0.67, respectively. FDA participants assessed the prototype as highly desirable in user satisfaction, visualizations, and in the potential to support drug safety signal detection for opioid drugs from EHR data while saving time and manual effort. Actionable design recommendations included (1) enlarging the tabs and visualizations; (2) enabling more flexibility and customizations to fit end users' individual needs; (3) providing additional instructional resources; (4) adding multiple graph export functionality; and (5) adding project summaries. Conclusions The novel prototype uses innovative AI-based techniques to automate searching for, extracting, and analyzing clinically useful information captured in unstructured text in EHRs. It increases efficiency in harnessing real-world data for opioid drug safety and increases the usability of the data to support regulatory review while decreasing the manual research burden.
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Affiliation(s)
- Alfred Sorbello
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States
| | - Syed Arefinul Haque
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States
| | - Rashedul Hasan
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States
| | - Richard Jermyn
- Neuromuscular Institute, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
| | - Ahmad Hussein
- Neuromuscular Institute, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
| | - Alex Vega
- Neuromuscular Institute, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
| | - Krzysztof Zembrzuski
- Neuromuscular Institute, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States
| | - Anna Ripple
- Lister Hill National Center for Biomedical Communications, National Library of Medicine-National Institutes of Health, Rockville, MD, United States
| | - Mitra Ahadpour
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, United States
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Kennedy E, Nivins S, Thompson B, McKinlay CJD, Harding J, McKinlay C, Alsweiler J, Brown G, Gamble G, Wouldes T, Keegan P, Harris D, Chase JG, Thompson B, Turuwhenua J, Rogers J, Kennedy E, Shah R, Dai D, Nivins S, Ledger J, Macdonald S, McNeill A, Bevan C, Burakevych N, May R, Hossin S, McKnight G, Hasan R, Wilson J, Knopp J, Chakraborty A, Zhou T, Miller S. Neurodevelopmental correlates of caudate volume in children born at risk of neonatal hypoglycaemia. Pediatr Res 2022; 93:1634-1641. [PMID: 36513807 DOI: 10.1038/s41390-022-02410-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Neonatal hypoglycaemia can lead to brain damage and neurocognitive impairment. Neonatal hypoglycaemia is associated with smaller caudate volume in the mid-childhood. We investigated the relationship between neurodevelopmental outcomes and caudate volume and whether this relationship was influenced by neonatal hypoglycaemia. METHODS Children born at risk of neonatal hypoglycaemia ≥36 weeks' gestation who participated in a prospective cohort study underwent neurodevelopmental assessment (executive function, academic achievement, and emotional-behavioural regulation) and MRI at age 9-10 years. Neonatal hypoglycaemia was defined as at least one hypoglycaemic episode (blood glucose concentration <2.6 mmol/L or at least 10 min of interstitial glucose concentrations <2.6 mmol/L). Caudate volume was computed using FreeSurfer. RESULTS There were 101 children with MRI and neurodevelopmental data available, of whom 70 had experienced neonatal hypoglycaemia. Smaller caudate volume was associated with greater parent-reported emotional and behavioural difficulties, and poorer prosocial behaviour. Caudate volume was significantly associated with visual memory only in children who had not experienced neonatal hypoglycaemia (interaction p = 0.03), but there were no other significant interactions between caudate volume and neonatal hypoglycaemia. CONCLUSION Smaller caudate volume is associated with emotional behaviour difficulties in the mid-childhood. Although neonatal hypoglycaemia is associated with smaller caudate volume, this appears not to contribute to clinically relevant neurodevelopmental deficits. IMPACT At 9-10 years of age, caudate volume was inversely associated with emotional-behavioural difficulties and positively associated with prosocial behaviour but was not related to executive function or educational achievement. Previous studies have suggested that neonatal hypoglycaemia may contribute to smaller caudate volume but exposure to neonatal hypoglycaemia did not appear to influence the relationship between caudate volume and behaviour. Among children not exposed to neonatal hypoglycaemia, caudate volume was also positively associated with visual memory, but no such association was detected among those exposed to neonatal hypoglycaemia. Understanding early-life factors that affect caudate development may provide targets for improving behavioural function.
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Affiliation(s)
- Eleanor Kennedy
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Samson Nivins
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Benjamin Thompson
- Liggins Institute, University of Auckland, Auckland, New Zealand.,School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.,Centre for Eye and Vision Research, 17W Science Park, Hong Kong, Hong Kong
| | - Christopher J D McKinlay
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Jane Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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9
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Islam A, Islam S, Amin E, Hasan R, Hassan MM, Miah M, Samad MA, Shirin T, Hossain ME, Rahman MZ. Patterns and risk factors of avian influenza A(H5) and A(H9) virus infection in pigeons and quail at live bird markets in Bangladesh, 2017-2021. Front Vet Sci 2022; 9:1016970. [PMID: 36387379 PMCID: PMC9645412 DOI: 10.3389/fvets.2022.1016970] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/06/2022] [Indexed: 07/21/2023] Open
Abstract
The avian influenza virus (AIV) impacts poultry production, food security, livelihoods, and the risk of transmission to humans. Poultry, like pigeons and quail farming, is a growing sector in Bangladesh. However, the role of pigeons and quails in AIV transmission is not fully understood. Hence, we conducted this study to investigate the prevalence and risk factors of AIV subtypes in pigeons and quails at live bird markets (LBMs) in Bangladesh. We collected oropharyngeal and cloacal swab samples from 626 birds in 8 districts of Bangladesh from 2017 to 2021. We tested the swab samples for the matrix gene (M gene) followed by H5, H7, and H9 subtypes using real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). We then used exploratory analysis to investigate the seasonal and temporal patterns of AIV and a mixed effect logistic model to identify the variable that influences the presence of AIV in pigeons and quails. The overall prevalence of AIV was 25.56%. We found that the prevalence of AIV in pigeons is 17.36%, and in quail is 38.75%. The prevalence of A/H5, A/H9, and A/H5/H9 in quail is 4.17, 17.92, and 1.67%, respectively. Furthermore, the prevalence of A/H5, A/H9, and A/H5/H9 in pigeons is 2.85, 2.59, and 0.26%. We also found that the prevalence of AIV was higher in the dry season than in the wet season in both pigeons and quail. In pigeons, the prevalence of A/untyped (40%) increased considerably in 2020. In quail, however, the prevalence of A/H9 (56%) significantly increased in 2020. The mixed-effect logistic regression model showed that the vendors having waterfowl (AOR: 2.13; 95% CI: 1.04-4.33), purchasing birds from the wholesale market (AOR: 2.96; 95% CI: 1.48-5.92) instead of farms, mixing sick birds with the healthy ones (AOR: 1.60; 95% CI: 1.04-2.45) and mingling unsold birds with new birds (AOR: 3.07; 95% CI: 2.01-4.70) were significantly more likely to be positive for AIV compared with vendors that did not have these characteristics. We also found that the odds of AIV were more than twice as high in quail (AOR: 2.57; 95% CI: 1.61-4.11) as in pigeons. Furthermore, the likelihood of AIV detection was 4.19 times higher in sick and dead birds (95% CI: 2.38-7.35) than in healthy birds. Our study revealed that proper hygienic practices at the vendors in LBM are not maintained. We recommend improving biosecurity practices at the vendor level in LBM to limit the risk of AIV infection in pigeons and quail in Bangladesh.
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Affiliation(s)
- Ariful Islam
- Centre for Integrative Ecology, School of Life and Environmental Science, Deakin University, Melbourne, VA, Australia
- EcoHealth Alliance, New York, NY, United States
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Shariful Islam
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Emama Amin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Rashedul Hasan
- One Health Laboratory, International Center for Diarrheal Diseases Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Mohammad Mahmudul Hassan
- Queensland Alliance for One Health Sciences, School of Veterinary Science, University of Queensland, Brisbane, QLD, Australia
| | - Mojnu Miah
- One Health Laboratory, International Center for Diarrheal Diseases Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Mohammed Abdus Samad
- National Reference Laboratory for Avian Influenza, Bangladesh Livestock Research Institute (BLRI), Savar, Bangladesh
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Mohammad Enayet Hossain
- One Health Laboratory, International Center for Diarrheal Diseases Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- One Health Laboratory, International Center for Diarrheal Diseases Research, Bangladesh (icddr, b), Dhaka, Bangladesh
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10
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Ali MA, Keshavarzi F, Hasan R, Luckie M, Daniels M, Abulkhir A, Fraser D. The Manchester experience – a novel technique for supra-annular placement of the Edwards SAPIEN 3 Ultra TVH prosthesis in severe bicuspid aortic valve stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2104] [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
Bicuspid AV disease has been excluded from the seminal trials evaluating transcatheter heart valve (THV) placement in severe aortic stenosis. Although registry data has shown good results overall, case selection likely involves more challenging anatomical subsets being treated either surgically or medically in this very heterogenous condition. Conventional annular placement, as well as high annular placement in tapered anatomies remain the commonest deployment techniques. We reasoned that marked supra-annular placement with the mid-portion of the SAPIEN 3 Ultra (S3U) valve sealing skirt placed at the narrowest opening point at commissural level could be an alternative strategy allowing treatment of additional patient groups. This proposed technique takes advantage of elliptical expansion at commissural level with more circular expansion above and below this point to prevent embolisation, as well as sealing skirt positioning at the narrowest opening point to prevent paravalvular leak.
Aims
We examined the feasibility of marked supra-annular placement of the balloon-expandable S3U prosthesis with the mid-point of the sealing skirt placed at commissural level in patients with severe bicuspid aortic valve stenosis and relative contra-indications to annular placement.
Methods
We assessed patients with severe bicuspid aortic stenosis undergoing TAVI at our centre over a 9-month period and identified those with relative contra-indications to conventional annular placement. These included: (i) excessive annular size (ii) severe leaflet and raphe calcification with risk of rupture into the right ventricle (iii) excessive leaflet length with potential leaflet overhang. CT imaging was used to define the narrowest opening location at commissural level, typically 10–15mm supra-annular. The diameter at this level was used to select THV size. Calculations were made to approximate the mid skirt level to this supra-annular position. In most cases this involved supra-annular positioning with the lower THV border 5–8mm supra-annular. This was achieved in most cases by aligning the unexpanded border with the annulus.
Results
Out of 9 patients with biscupid AV, 4 had relative contra-indications for annular placement. In all 4 cases, excellent valvular expansion with only minimal paravaulvar leak was achieved with placement of the S3U prosthesis at 5–7mm above the annulus and with supra-annular sealing at commissural level. Annular dimensions of 35.5mm and 31.5mm were successfully treated with 29mm and 26mm valves due to significant tapering at commissural level in 2 patients. There were no procedural complications, incidences of AV blocks or valve embolisation.
Conclusion
As a proof of concept, we have demonstrated excellent outcomes with marked supra-annular TAVI placement in patients with severe bicuspid AV stenosis and anatomy unfavourable for conventional annular placement. This is the first description of this completely novel deployment technique.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Manchester Royal Infirmary
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Affiliation(s)
- M A Ali
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - F Keshavarzi
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - R Hasan
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - M Luckie
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - M Daniels
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - A Abulkhir
- Manchester Royal Infirmary , Manchester , United Kingdom
| | - D Fraser
- Manchester Royal Infirmary , Manchester , United Kingdom
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11
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Mariappan P, Johnston A, Trail M, Hamid S, Hollins G, Dreyer B, Ramsey S, Padovani L, Garau R, Guerrero Enriquez J, Simpson H, Hasan R, Sharpe C, Thomas B, Bhatt J, Ahmad I, Nandwani G, Chaudhry A, Boden A, Khan R, Maresca G, Dimitropoulos K, Graham C, Hendry D. Multicentre real world long-term outcomes in 2773 primary Non-Muscle Invasive Bladder Cancer (NMIBC) patients managed within the Scottish Bladder Cancer Quality Performance Indicator programme. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00243-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Sinkey SD, Roper D, Wylie M, Hasan R, Marcucci J, Fagan E, Fournier LE, Coffey A, Martin K, Uy J, Moats S, Rasmussen-Winkler J. Abstract NS9: Two Level Stroke Activation: Fine Tuning Stroke Criteria. Stroke 2022. [DOI: 10.1161/str.53.suppl_1.ns9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
The burden of acute stroke alerts on hospital resources and staff have grown with expanding treatment timelines. The purpose of this project is to develop a nurse activated acute stroke process to accurately capture ischemic and hemorrhage stroke amendable for acute treatment with a two level activation model for 0-4 hours (level 1) and 4-24 hours (level 2) from last known well.
Methods:
Prospective quality improvement data abstracted on patients in a five-hospital regional telestroke network from October 2020 thru June 2021 with the current single level 24-hour stroke symptom protocol. We retrospectively applied our proposed two level activation model to our data to look for accuracy in stroke diagnosis, proportion of stroke mimics, missed stroke interventions, including intracerebral hemorrhage (ICH), and telestroke provider time spent. We used standard error of mean (SEM) to measure discrepancy of process.
Results:
A total of 340 stroke activation were captured. Of those, 54% (183/340) were discharged without a stroke diagnosis, 27% (93/340) ischemic, 14% (48/340) transient ischemic attack, 4% (13/340) ICH, 1% (3/340) subarachnoid hemorrhage, and 34% (117/340) arrived in the level 2 window. We excluded 5 ICH patients due to arriving comatose necessitating emergent imaging outside of stroke alert process. Comparing single activation versus two level activation resulted in a reduction of stroke alerts (117 versus 21), telestroke provider time (2501 minutes versus 713 minutes), increase in accurate stroke diagnosis (46% versus 76%), decrease in stroke mimics (54% versus 29%), with 1 missed ICH and 1 missed thrombectomy (5%). The single activation showed a mean 11.11% and SEM of 0.023 compared to the two level activation mean 1.99% and SEM of 0.006.
Conclusion:
Two level stroke activation process was validated to reduce stroke mimics, improve accurate stroke diagnoses, maximize resources utilization, and capture 95% of all ischemic strokes with large vessel occlusions, therefore the new process will be implemented within our large telestroke system following staff education.
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13
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Mariappan P, Johnston A, Trail M, Hamid S, Hollins G, Dreyer B, Ramsey S, Padovani L, Garau R, Guerrero Enriquez J, Simpson H, Hasan R, Sharpe C, Thomas B, Bhatt J, Ahmad I, Nandwani G, Chaudhry A, Boden A, Khan R, Maresca G, Dimitropoulos K, Graham C, Hendry D, Paramananthan S, Loy G, Baker S, Grigor K, Smith G. Ceasing surveillance in low risk non-muscle invasive bladder cancer after only 12 months of being recurrence free is un-safe: A validation study from the Scottish bladder cancer Quality Performance Indicator (QPI) programme. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Mannan A, Mehedi HMH, Rob MA, Biswas SK, Sultana N, Biswas R, Hoque MM, Hossain MA, Das A, Chakma K, Salauddin A, Raza MT, Reza FH, Mahtab A, Miah M, Hasan R, Rahman M, Rahman MZ, Hossain ME. Genome Sequences of SARS-CoV-2 Sublineage B.1.617.2 Strains from 12 Children in Chattogram, Bangladesh. Microbiol Resour Announc 2021; 10:e0091221. [PMID: 34672705 PMCID: PMC8530031 DOI: 10.1128/mra.00912-21] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022] Open
Abstract
We announce the complete genome sequences of 12 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sublineage B.1.617.2 strains (Delta variant) obtained from nasopharyngeal and oropharyngeal swab samples from 12 pediatric patients in Chittagong, Bangladesh, displaying COVID-19 symptoms. Oxford Nanopore MinION sequencing technology was used to generate the genomic sequences.
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Affiliation(s)
- Adnan Mannan
- Department of Genetic Engineering & Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | | | - M. Abdur Rob
- Department of Medicine, 250 Bedded General Hospital, Chattogram, Bangladesh
| | | | - Nahid Sultana
- Chattogram Maa O Shishu Hospital, Agrabad, Chattogram, Bangladesh
| | - Rajdeep Biswas
- Anesthesia & Intensive Care Unit, 250 Bedded General Hospital, Chattogram, Bangladesh
| | - M. Minhazul Hoque
- Department of Otolaryngology, 250 Bedded General Hospital, Chattogram, Bangladesh
| | | | - Ajoy Das
- Department of Orthopaedics, 250 Bedded General Hospital, Chattogram, Bangladesh
| | - Kallyan Chakma
- Department of Genetic Engineering & Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | - Asma Salauddin
- Department of Genetic Engineering & Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
| | - M. Thosif Raza
- COVID-19 Screening Centre, Chevron Clinical Laboratory (Pte.) Ltd., Chattogram, Bangladesh
| | - Fahim Hasan Reza
- Chattogram Maa O Shishu Hospital, Agrabad, Chattogram, Bangladesh
| | - Azmain Mahtab
- Chattogram Maa O Shishu Hospital, Agrabad, Chattogram, Bangladesh
| | - Mojnu Miah
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashedul Hasan
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Enayet Hossain
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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15
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Argyriou A, Hasan R, Abunasra H, McLaughlin K, Bilal H, Sogliani F, Datta S. 1097 17 Years of Treating Deep Sternal Wound Infections at A Single Institution: Outcomes and Lessons Learned. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Deep sternal wound infections (DSWI) are a serious complication following cardiac surgery that comprise of any infection penetrating the subcutaneous tissue of the sternum. DSWI have been found to increase mortality and worsen prognostic outcomes following surgery.
Method
We conducted a retrospective cohort study using hospital e-records from 2000 to 2017 of all adult patients operated on with a median sternotomy at our institution. Univariate and multivariate analysis along with mortality and Kaplan-Meier survival curves compared the DSWI population against the remaining study population, using SPSS-25 software.
Results
Of 15521 total patients in the study, 145 (0.9%) suffered a DSWI. Variables that were associated with DSWI included age at operation (p = 0.019), gender (p = 0.007), BMI (p = 0.001), diabetes (p < 0.0001), renal disease (p = 0.008), operative urgency (p = 0.007), type of operation (p = 0.02), Euroscore (p = <0.0001), bypass-time (p = 0.038) and crossclamp-time (p = 0.008). A logistic regression encompassing significant variables revealed that gender (p = 0.031 CI 1.45-1.96), BMI (p < 0.0001 CI 1.03-1.10), diabetes (p = 0.007 CI 1.20-3.67) and type of operation (p = 0.018 CI 1.23-1.87) remained significant when covariate contribution was eliminated. DSWI subgroup mortality was insignificant at 30 days (3.4%vs2.9%, p = 0.68) but significantly worse at 90 days (8.3%vs3.7%, p = 0.004) and at 1 year (17.2%vs5.4%, p < 0.0001). Kaplan-Meier analysis depicted a significantly worse survival distribution for the DSWI population compared to rest of study (Log-Rank<0.05).
Conclusions
At our centre, DSWI are attributable to certain modifiable and set demographics and contribute heavily to medium-term mortality. A better understanding of DSWI risk factors may pinpoint those at risk and benefit the multidisciplinary team to ultimately reduce the rate of DSWI.
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Affiliation(s)
- A Argyriou
- The University of Manchester, Manchester, United Kingdom
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - R Hasan
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - H Abunasra
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - K McLaughlin
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - H Bilal
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - F Sogliani
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - S Datta
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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16
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Hasan R, Hossain ME, Miah M, Hasan MM, Rahman M, Rahman MZ. Identification of Novel Mutations in the N Gene of SARS-CoV-2 That Adversely Affect the Detection of the Virus by Reverse Transcription-Quantitative PCR. Microbiol Spectr 2021; 9:e0054521. [PMID: 34431705 PMCID: PMC8552787 DOI: 10.1128/spectrum.00545-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Accurate and timely diagnosis of SARS-CoV-2 is a critical step toward controlling the viral spread, since it facilitates the identification and isolation of infected individuals. Mutations in the primer-/probe-binding sites may lead to false-negative results.
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Affiliation(s)
- Rashedul Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Mojnu Miah
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Mahmudul Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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17
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Argyriou A, Hasan R, Abunasra H, McLaughlin K, Bilal H, Sogliani F, Datta S. 302 Is Age Just A Number in Cardiac Surgery? Evaluating Outcomes of An Octogenarian Cohort at A Single Cardiac Centre. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Cardiac surgery in octogenarians contains many age-specific perioperative risk factors and outcomes yet to be fully understood.
Method
All adults (N = 4957) undergoing cardiac surgery between 2011-2017 at our institution were retrospectively studied, encompassing 312 octogenarians. Data was evaluated with univariate and multivariate testing and mortality with Kaplan-Meier and cox-regression analyses.
Results
Compared to septuagenarians, octogenarians revealed more patients having previous surgery (p = 0.016), less diabetic patients (p = 0.034), lower BMI (0.002), and longer hospital stay (p < 0.000). Compared to rest of study, octogenarians contained more females (p = 0.012), a greater Euroscore (p < 0.000), spent longer in ITU (p = 0.001) and contained more ITU readmissions (p = 0.023). The octogenarians did not contain significant 30- and 90-day mortality but revealed significant mortality at 1-year versus septuagenarians (p = 0.039) and rest of study (p = 0.001). Variables testing significant in a multivariate regression were inserted into a cox-regression that found octogenarian group-membership to be insignificant (p = 0.051) in a 12-covariate model. Independent risk factors for mortality included emergency surgery (p = 0.04), reoperation (p < 0.000), cardiac procedure (p = 0.007), ITU time (p = 0.041) and diabetes (p = 0.023).
Conclusions
We report specific differences for octogenarians in perioperative characteristics along with promising short- and medium-term survival. Such outcomes must constantly be monitored so that cardiac surgery can be further tailored to this elderly cohort.
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Affiliation(s)
- A Argyriou
- University of Manchester, Manchester, United Kingdom
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - R Hasan
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - H Abunasra
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - K McLaughlin
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - H Bilal
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - F Sogliani
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
| | - S Datta
- Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
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18
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Abstract
Trauma & Orthopaedics (T&O) has taken a backseat during COVID-19. As the focus has shifted to care of COVID patients, other specialties have adjusted their daily working. At our local hospital, the dedicated Orthopaedic ward was absorbed into the Intensive Care department, necessitating migration to a smaller, shared working space. This project looked at ways of increasing clinical efficiency, patient safety and education within the T&O department. Members of the T&O department at The Princess Alexandra Hospital were invited to attend daily trauma meetings virtually via Microsoft Teams. In addition, the impact of moving to a larger, dedicated meeting space was assessed. Pre- and post-intervention questionnaires were delivered to assess response. Post-intervention questionnaires revealed a significant improvement in the perception of ability to see XRs (p < 0.001), quality of handover (p = 0.018), ability to discuss and formulate management plans (p = 0.002), social distancing (p < 0.001), location (p = 0.002) and trauma meetings overall (p < 0.000). The educational value of trauma meetings did not improve as anticipated, however. Virtual Trauma Meetings are a useful adjunct, allowing clinicians safely contribute to clinical care. In addition, the location of daily trauma meetings is an important factor to consider, both for the safety of patients and for the safety of clinicians.
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Affiliation(s)
- R Hasan
- Princess Alexandra Hospital, Harlow, United Kingdom
| | - R Dhir
- Princess Alexandra Hospital, Harlow, United Kingdom
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19
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Coggins BL, Anderson CE, Hasan R, Pearson AC, Ekwudo MN, Bidwell JR, Yampolsky LY. Breaking free from thermodynamic constraints: thermal acclimation and metabolic compensation in a freshwater zooplankton species. J Exp Biol 2021; 224:jeb237727. [PMID: 33328286 DOI: 10.1242/jeb.237727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/09/2020] [Indexed: 01/14/2023]
Abstract
Respiration rates of ectothermic organisms are affected by environmental temperatures, and sustainable metabolism at high temperatures sometimes limits heat tolerance. Organisms are hypothesized to exhibit acclimatory metabolic compensation effects, decelerating their metabolic processes below Arrhenius expectations based on temperature alone. We tested the hypothesis that either heritable or plastic heat tolerance differences can be explained by metabolic compensation in the eurythermal freshwater zooplankton crustacean Daphnia magna We measured respiration rates in a ramp-up experiment over a range of assay temperatures (5-37°C) in eight genotypes of D. magna representing a range of previously reported acute heat tolerances and, at a narrower range of temperatures (10-35°C), in D. magna with different acclimation history (either 10 or 25°C). We discovered no difference in temperature-specific respiration rates between heat-tolerant and heat-sensitive genotypes. In contrast, we observed acclimation-specific compensatory differences in respiration rates at both extremes of the temperature range studied. Notably, there was a deceleration of oxygen consumption at higher temperature in 25°C-acclimated D. magna relative to their 10°C-acclimated counterparts, observed in active animals, a pattern corroborated by similar changes in filtering rate and, partly, by changes in mitochondrial membrane potential. A recovery experiment indicated that the reduction of respiration was not caused by irreversible damage during exposure to a sublethal temperature. Response time necessary to acquire the respiratory adjustment to high temperature was lower than for low temperature, indicating that metabolic compensation at lower temperatures requires slower, possibly structural changes.
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Affiliation(s)
- B L Coggins
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
- Department of Biological Sciences, University of Notre Dame, Galvin Life Science Center, Notre Dame, IN 46556, USA
| | - C E Anderson
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
| | - R Hasan
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
| | - A C Pearson
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
| | - M N Ekwudo
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
| | - J R Bidwell
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
| | - L Y Yampolsky
- Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37691, USA
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20
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Gill R, Tyndall SF, Vora D, Hasan R, Megna JL, Leontieva L. Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients. Cureus 2021; 13:e12434. [PMID: 33552754 PMCID: PMC7856920 DOI: 10.7759/cureus.12434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This is the first study that explored the self-reported dietary habits of acute psychiatric inpatients. We found that 75% of the psychiatric inpatients have an unhealthy diet, which correlates with higher body mass index (BMI) and lower education level. We also found an increased sugar consumption in inpatients with schizophrenia. The link between nutrition and mental health has been explored to a limited extent owing to the cumbersome nature of conducting research that involves specific dietary intervention and follow up. Yet, there is existing literature linking poor diet with impaired mental health and poor recovery from depression, amongst other disorders. Good nutrition can be exemplified with diets like the Mediterranean diet with a focus on certain food groups that provide the nutrients linked to neurotransmitters and a fairly new concept of the gut-brain axis. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression. A randomised controlled trial published in the nutritional neuroscience journal yielded a positive outcome and improvement in the overall well-being of the patients enrolled. We explored the dietary habits of acute inpatients. After gathering a detailed diet history, their food habits were compared to a Mediterranean dietary index to assess their dietary patterns. Additionally, variables such as socio-economic characteristics, physical activity, income, BMI, and educational achievement were taken into consideration, with the intention to understand the effect of these factors on a diet consumed by acute patients and the relationship of the diet with their mental wellbeing. Ultimately, this study aims at an important aspect of preventive mental health, i.e., improved dietary habits (e.g., Mediterranean diet) may contribute to more rapid symptoms resolution and acute stabilization on a short-stay inpatient unit.
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Affiliation(s)
- Raveena Gill
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - Sean F Tyndall
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - Darshini Vora
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - Rashedul Hasan
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - James L Megna
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
| | - Luba Leontieva
- Psychiatry, State University of New York Upstate Medical University, Syracuse, USA
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Reza E, Hasan R, Hossain A, Islam M. Outcome of Management of Liver Abscess by Surgical Approach in a Tertiary Care Hospital. Mymensingh Med J 2021; 30:85-89. [PMID: 33397856] [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: 06/12/2023]
Abstract
Liver abscess is a serious, life threatening condition. A recent development in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The purpose of this study is to search for the clinical presentations and surgical outcomes of liver abscess in our country. The markers of the outcome are mortality, duration of hospital stay and complications such as wound infection, residual disease following surgery, biliary leakage, intra abdominal abscess formation. This observational cross sectional study was conducted in Mymensingh Medical College & Hospital (MMCH), Bangladesh for 12 months from 1st January 2017 to 31st December 2017. Total 25 patients presenting with the features of liver abscess were included in this study by convenient and purposive sampling according to the inclusion and exclusion criteria. Surgical principles of liver abscess management were applied and outcomes were observed. The patients were diagnosed on the basis of clinical feature, findings of abdominal ultrasound and occasionally by doing CT scan. Most of the patients (28%) were in the age group of 51-60 years. Regarding sex distribution majority of the patients (64%) was male. Most of patients presented with fever (92%), anorexia and vomiting (32%), upper abdominal pain (84%). Hepatomegaly and reactive pleural effusion are the important findings present in 9(36%) and 8(32%) patients respectively. Size of the liver abscess was more than 5cm in 72% patients. Among the patients right lobe was predominantly involved. It was found during laparotomy that 4 patients (16%) had spontaneous rupture of abscess into peritoneal cavity. One (4%) patient developed biliary leakage after surgical drainage. No intra abdominal abscess or residual diseases was observed after surgery. Among the patients 24% developed wound infection. The overall mortality rate was 12%. The median length of hospital stay was 8 days (range: 1-15 days). Outcome of surgical drainage of liver abscess in tertiary care hospital of our country shows satisfactory result. So, patients with large multiple liver abscess, septic shock, failures of percutaneous drainage should be treated by early open surgical intervention.
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Affiliation(s)
- E Reza
- Dr Ehsanur Reza, Associate Professor, Department of Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Hossain M, Haider N, Sturm-Ramirez K, Hasan R, Hossain M, Rahman M, Chowdhury S, Osmani M, Khan S, Azziz-Baumgartner E, Davis C, Zeidner N, Kennedy E. Identification of avian influenza viruses among birds in pet bird markets. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Islam A, Hossain ME, Rostal MK, Ferdous J, Islam A, Hasan R, Miah M, Rahman M, Rahman MZ, Daszak P, Epstein JH. Epidemiology and Molecular Characterization of Rotavirus A in Fruit Bats in Bangladesh. Ecohealth 2020; 17:398-405. [PMID: 32876756 PMCID: PMC7464061 DOI: 10.1007/s10393-020-01488-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 07/07/2020] [Accepted: 07/28/2020] [Indexed: 05/06/2023]
Abstract
Rotavirus A (RVA) is the primary cause of acute dehydrating diarrhea in human and numerous animal species. Animal-to-human interspecies transmission is one of the evolutionary mechanisms driving rotavirus strain diversity in humans. We screened fresh feces from 416 bats (201 Pteropus medius, 165 Rousettus leschenaultii and 50 Taphozous melanopogon) for RVA using rRT-PCR. We detected a prevalence of 7% (95% CI 3.5-10.8) and 2% (95% CI 0.4-5.2) in P. medius and R. leschenaultii, respectively. We did not detect RVA in the insectivorous bat (T. melanopogon). We identified RVA strains similar to the human strains of G1 and G8 based on sequence-based genotyping, which underscores the importance of including wildlife species in surveillance for zoonotic pathogens to understand pathogen transmission and evolution better.
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Affiliation(s)
- Ariful Islam
- EcoHealth Alliance, 460 West 34th Street, Suite 17, New York, NY, 10001, USA
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Geelong, VIC, Australia
| | - Mohammad Enayet Hossain
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Melinda K Rostal
- EcoHealth Alliance, 460 West 34th Street, Suite 17, New York, NY, 10001, USA
| | - Jinnat Ferdous
- EcoHealth Alliance, 460 West 34th Street, Suite 17, New York, NY, 10001, USA
- Institute of Epidemiology, Disease Control and Research (IEDCR), Mohakhali, Dhaka, 1212, Bangladesh
| | - Ausraful Islam
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashedul Hasan
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mojnu Miah
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Peter Daszak
- EcoHealth Alliance, 460 West 34th Street, Suite 17, New York, NY, 10001, USA
| | - Jonathan H Epstein
- EcoHealth Alliance, 460 West 34th Street, Suite 17, New York, NY, 10001, USA.
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Reza E, Bhuiyan K, Emon RI, Hossain A, Biplob MH, Kader S, Habib A, Hasan R, Chaudary AK, Rahman T, Hasan S, Nisa AA. Efficacy of Intra-peritoneal Tramadol Instillation for Postoperative Pain Management after Laparoscopic Cholecystectomy. Mymensingh Med J 2020; 29:303-310. [PMID: 32506083] [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: 06/11/2023]
Abstract
Gall stone disease is one of the most common conditions encountered in general surgical practices in adult population. The gold standard treatment for symptomatic gall stone disease is laparoscopic cholecystectomy. It results in less post-operative pain as compared to open cholecystectomy but post-operative pain may be mild, moderate or even severe in some patients. This Randomized control trail was conducted to In-patient department of Surgery, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh from April 2018 to September 2018. It was undertaken to evaluate the analgesic effect of intra-peritoneal tramadol instillation in patients undergoing laparoscopic cholecystectomy. Total 70 patients with symptomatic gallstone disease undergoing laparoscopic cholecystectomy were randomized equally in two groups. Then patients were selected in according to the inclusion and exclusion criteria. In first group (Group A), patients were received intra-peritoneal tramadol 100mg (diluted in 20.0ml distilled water). Sprayed 10.0ml diluted tramadol into the sub diaphragmatic area, 5.0ml into the area of gall bladder bed and 5.0ml into the space between the liver and kidney under direct vision just before removal of trocars. In second group (Group B) the conventional operative procedure was followed. Postoperatively, patient was extubated and shifted to recovery room. Data recorded and analyzed, such as post-operative pain score at 1, 4, 8, and 24 hour; cumulative 1, 8 and 24 hour analgesic consumption. In addition that postoperative hospital period monitoring of heart rate, blood pressure, respiratory rate, temperature at 0, 4, 8, 24 hours was also analyzed. Intensity of pain was assessed by Visual Analogue Scale (VAS) scoring system. Patients showed a VAS ≥3 or patients who requested for analgesia was administrated a supplemental dose of analgesic. In the present study the mean pain scores in Group A were found to be low at1hourpost-operative was 0.60±0.56 and there was a gradual increase in score in respect of time interval with peak of 2.07±0.91 at 24 hours. Whereas, in Group B the mean pain scores immediate post-operative period were at its peak was, 2.50±0.82 which decreased to 1.30±0.84 at 1 hour and further there was rise at 4 hours (2.10±0.71) and 24 hours (2.33±0.0.71). But at any point of time the mean VAS remained significantly low (p<0.050) in patients with Group A compared to Group B except at 1st 24 hours (p=0.210). Intra-peritoneal instillation of tramadol for postoperative pain control in laparoscopic cholecystectomy has beneficial effect in terms of postoperative pain relief following laparoscopic cholecystectomy.
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Affiliation(s)
- E Reza
- Dr Ehsanur Reza, Associate Professor, Department of Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh
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Hossain MB, Rahman MS, Watson OJ, Islam A, Rahman S, Hasan R, Kafi MAH, Osmani MG, Epstein JH, Daszak P, Haider N. Epidemiology and genotypes of group A rotaviruses in cattle and goats of Bangladesh, 2009-2010. Infect Genet Evol 2020; 79:104170. [PMID: 31904556 DOI: 10.1016/j.meegid.2020.104170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/26/2019] [Accepted: 01/01/2020] [Indexed: 10/25/2022]
Abstract
Group A rotavirus (RVA) is recognized as a major cause of severe gastroenteritis in newborn calves and goat kids. We estimated the proportion of ruminants infected with rotavirus and identified the circulating genotypes in cattle and goats in Bangladesh. Between May 2009 and August 2010, fecal samples were collected from 520 cattle and goats presenting with diarrhea at three government veterinary hospitals in three districts of Bangladesh. All samples were screened for RVA RNA using real-time, one-step, reverse transcription polymerase chain reaction (qRT-PCR). Of the 520 animals tested, 11.7% (61) were positive for RVA RNA, with 6.2% (15/241) and 16.5% (46/279) positivity in cattle and goats, respectively. RVA positive samples were further characterized by nucleotide sequence analysis of two structural protein gene fragments, VP7 (G genotype), and VP4 (P genotype). Among 17 successfully sequenced strains, G8 (17.9%) was the most prevalent G-genotype followed by G10 (8%) and G6 (1.6%). P[1] (11.3%) was the most frequently detected P-genotype followed by P[11] (3.2%) and P[15] (1.6%). The most common VP7/VP4 combinations for cattle were G10P[11], G10P[15], and G6P[11], and for goat, G8P[1], and G10P[1]. Phylogenetic analysis of the RVA strains showed clustering with bovine and caprine strains from neighboring India. The study adds to our understanding of the genetic diversity of bovine and caprine rotavirus strains in Bangladesh. Our findings highlight the importance of rotavirus surveillance in cattle and goat populations, which may serve as a potential source for genetic reassortment and zoonotic transmission.
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Affiliation(s)
| | | | - Oliver J Watson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, UK
| | - Ariful Islam
- EcoHealth Alliance, New York, USA; Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Geelong, VIC, Australia
| | - Sezanur Rahman
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Rashedul Hasan
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | | | - Mozaffar G Osmani
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | | | | | - Najmul Haider
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh; Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, UK
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Mohiuddin M, Chowdhury MN, Chowdhury MS, Islam S, Hasan R, Zakir H, Saeed A, Masum AS. Association of Estimated GFR (By MDRD) with the Carotid Intima Media Thickness (CIMT) in Different Stages of CKD among Patients with Type 2 Diabetes Mellitus. Mymensingh Med J 2020; 29:209-214. [PMID: 31915360] [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: 06/10/2023]
Abstract
Most of the mortalities among Diabetic Nephropathy patients are cardiovascular, if we identify the risk factor, measures can be taken to prevent it. Hence an objective was set to evaluate the association between carotid artery intima media thickness (CIMT) with eGFR in patients of CKD stage III, IV and V among patients with type 2 diabetes mellitus; also, correlation with age, BMI, lipid profile. This cross-sectional, observational study was performed in 70 patients in different stages of CKD in Diabetic Patients selected by Inclusion Criteria (Diabetic nephropathy patients with stages III, IV, V and exclusion Criteria (Acute kidney injury, History of carotid surgery, Patients of MI and stroke). This study was performed in Department of Nephrology, Dhaka Medical College in collaboration with the Department of Radiology and Imaging, laboratory of Department of Biochemistry and Department of Microbiology at Dhaka Medical College Hospital (By standard method in laboratory) from 1st January 2016 to 31st December 2016. eGFR was measured by MDRD formula and the CIMT was measured using an ultrasonographic examination. The mean CIMT was 0.9±0.21mm, and 62.9% of the subjects showed IMT thickening (≥1mm). The carotid IMT elevated significantly with the stage progression of CKD (Overall eGFR mean 28.8±14.5mL/min/1.73m² in CIMT<1mm with range from 6 to 54 and 9.1±9.0mL/min/1.73m² in CIMT ≥1mm with range from 3 to 32 (p=0.001). The eGFR was significantly lower in the patients with CIMT thickening than those without CIMT thickening. eGFR was also significantly associated with CKD stages (p=0.001), serum creatinine (p=0.001), BMI (r = -0.330, p=0.005), and negatively associated with age group, duration of hypertension, smoking. However, the CIMT was not significantly different among the patients at different stages of diabetic nephropathy (r = -0.172, p=156) and age group. It has been concluded that the mean CIMT was markedly high in patients with CKD compared to normal expected value. This study showed a relationship between the CIMT and the renal parameters as eGFR and the stages of diabetic nephropathy with a confirm association between the CIMT and diabetic macroangiopathy.
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Affiliation(s)
- M Mohiuddin
- Dr Md Mohiuddin, Assistant Professor, Department of Nephrology, Anwer Khan Modern Medical College (AKMMC), Dhaka, Bangladesh
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Rafihi-Ferreira R, Neto FL, Morin C, Toscanini A, Borges DS, Brasil I, Gallinaro J, Conway S, Hasan R. Acceptance and commitment therapy for insomnia: a pilot study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sarraj A, Hassan A, Savitz SI, Grotta JC, Cai C, Parsha KN, Farrell CM, Imam B, Sitton CW, Reddy ST, Kamal H, Goyal N, Elijovich L, Reishus K, Krishnan R, Sangha N, Wu A, Costa R, Malik R, Mir O, Hasan R, Snodgrass LM, Requena M, Graybeal D, Abraham M, Chen M, McCullough LD, Ribo M. Endovascular Thrombectomy for Mild Strokes: How Low Should We Go? Stroke 2019; 49:2398-2405. [PMID: 30355094 DOI: 10.1161/strokeaha.118.022114] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background and Purpose- Endovascular thrombectomy (EVT) is effective for acute ischemic stroke with large vessel occlusion and National Institutes of Health Stroke Scale (NIHSS) ≥6. However, EVT benefit for mild deficits large vessel occlusions (NIHSS, <6) is uncertain. We evaluated EVT efficacy and safety in mild strokes with large vessel occlusion. Methods- A retrospective cohort of patients with anterior circulation large vessel occlusion and NIHSS <6 presenting within 24 hours from last seen normal were pooled. Patients were divided into 2 groups: EVT or medical management. Ninety-day mRS of 0 to 1 was the primary outcome, mRS of 0 to 2 was the secondary. Symptomatic intracerebral hemorrhage was the safety outcome. Clinical outcomes were compared through a multivariable logistic regression after adjusting for age, presentation NIHSS, time last seen normal to presentation, center, IV alteplase, Alberta Stroke Program early computed tomographic score, and thrombus location. We then performed propensity score matching as a sensitivity analysis. Results were also stratified by thrombus location. Results- Two hundred fourteen patients (EVT, 124; medical management, 90) were included from 8 US and Spain centers between January 2012 and March 2017. The groups were similar in age, Alberta Stroke Program early computed tomographic score, IV alteplase rate and time last seen normal to presentation. There was no difference in mRS of 0 to 1 between EVT and medical management (55.7% versus 54.4%, respectively; adjusted odds ratio, 1.3; 95% CI, 0.64-2.64; P=0.47). Similar results were seen for mRS of 0 to 2 (63.3% EVT versus 67.8% medical management; adjusted odds ratio, 0.9; 95% CI, 0.43-1.88; P=0.77). In a propensity matching analysis, there was no treatment effect in 62 matched pairs (53.5% EVT, 48.4% medical management; odds ratio, 1.17; 95% CI, 0.54-2.52; P=0.69). There was no statistically significant difference when stratified by any thrombus location; M1 approached significance ( P=0.07). Symptomatic intracerebral hemorrhage rates were higher with thrombectomy (5.8% EVT versus 0% medical management; P=0.02). Conclusions- Our retrospective multicenter cohort study showed no improvement in excellent and independent functional outcomes in mild strokes (NIHSS, <6) receiving thrombectomy irrespective of thrombus location, with increased symptomatic intracerebral hemorrhage rates, consistent with the guidelines recommending the treatment for NIHSS ≥6. There was a signal toward benefit with EVT only in M1 occlusions; however, this needs to be further evaluated in future randomized control trials.
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Affiliation(s)
- Amrou Sarraj
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Ameer Hassan
- Department of Interventional Neurology, University of Texas-Rio Grande Valley, Harlingen (A.H.)
| | - Sean I Savitz
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - James C Grotta
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Chunyan Cai
- Department of Internal Medicine (C.C.), University of Texas Health Science Center at Houston
| | - Kaushik N Parsha
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Christine M Farrell
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Bita Imam
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Clark W Sitton
- Department of Diagnostic and Interventional Imaging (C.W.S.), University of Texas Health Science Center at Houston
| | - Sujan T Reddy
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Haris Kamal
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Nitin Goyal
- Department of Neurology and Neurosurgery (L.E., N.G.), University of Tennessee Health Sciences Center, Memphis
| | - Lucas Elijovich
- Department of Neurology and Neurosurgery (L.E., N.G.), University of Tennessee Health Sciences Center, Memphis
| | - Katelin Reishus
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Rashi Krishnan
- Department of Neurology (R.K.), University of Tennessee Health Sciences Center, Memphis
| | - Navdeep Sangha
- Department of Neurology, Kaiser Permanente Los Angeles, CA (N.S., A.W.)
| | - Abel Wu
- Department of Neurology, Kaiser Permanente Los Angeles, CA (N.S., A.W.)
| | - Renata Costa
- Department of Neurology, Rush University Medical Center, Chicago, IL (M.C., R.C., R.M.)
| | - Ruqayyah Malik
- Department of Neurology, Rush University Medical Center, Chicago, IL (M.C., R.C., R.M.)
| | - Osman Mir
- Department of Neurology, Baylor University Medical Center, Texas A&M University, Dallas (O.M., R.H., D.G.)
| | - Rashedul Hasan
- Department of Neurology, Baylor University Medical Center, Texas A&M University, Dallas (O.M., R.H., D.G.)
| | - Lindsay M Snodgrass
- Department of Neuroscience, Baylor University Medical Center, Dallas, TX (L.M.S.)
| | - Manuel Requena
- Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain (M. Ribo, M. Requena)
| | - Dion Graybeal
- Department of Neurology, Baylor University Medical Center, Texas A&M University, Dallas (O.M., R.H., D.G.)
| | - Michael Abraham
- Department of Neurology and Radiology, Kansas University Hospital, MO (M.A.)
| | - Michael Chen
- Department of Neurology, Rush University Medical Center, Chicago, IL (M.C., R.C., R.M.)
| | - Louise D McCullough
- From the Department of Neurology (A.S., S.I.S., J.C.G., K.N.P., C.M.F., B.I., S.T.R., H.K., K.R., L.D.M.), University of Texas Health Science Center at Houston
| | - Marc Ribo
- Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain (M. Ribo, M. Requena)
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Irfan S, Rao N, Irfan M, Iftikhar I, Azizullah Z, Jabeen K, Hasan R. Utility of the microcolony method for evaluation of multidrug-resistant tuberculosis patients in Karachi, Pakistan. Int J Tuberc Lung Dis 2019; 23:838-843. [PMID: 31439116 DOI: 10.5588/ijtld.18.0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To compare the microcolony method (MCM) with the reference culture method to evaluate culture conversion in multidrug-resistant tuberculosis (MDR-TB) patients.MATERIAL AND METHODS: Adult patients with Mycobacterium tuberculosis culture-positive MDR-TB undergoing second-line anti-tuberculosis treatment were recruited from two tertiary care chest clinics from January 2013 to October 2014. The MCM was performed in addition to MGIT™ and Löwenstein-Jensen medium (reference method) on sputum samples submitted on a monthly basis.RESULTS: Of 140 patients, culture conversion could be evaluated in 95 patients. The MCM showed 100% agreement with the reference M. tuberculosis culture in 83 of 95 patients who achieved culture conversion. In smear-positive and smear-negative cases, the mean time to positivity was 9.1 and 11.4 days for the MCM and 16.1 and 23.2 days for the reference M. tuberculosis culture respectively. The contamination rate for the MCM was 4.5% in comparison with 6.1% for the reference M. tuberculosis culture. The cost of MCM was estimated to be 30% that of the reference method.CONCLUSION: The MCM can be used in non-urban laboratories as a safe, rapid and cost-effective substitute for the reference M. tuberculosis culture to assess culture conversion in MDR-TB patients.Note: Abstract has been published in International Journal of Mycobacteriology 2015; 4: 159-160.
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Affiliation(s)
- S Irfan
- Aga Khan University Hospital, Karachi
| | - N Rao
- Aga Khan University Hospital, Karachi
| | - M Irfan
- Aga Khan University Hospital, Karachi
| | - I Iftikhar
- The Kidney Centre, Post Graduate Training Institute, Karachi, Pakistan
| | | | - K Jabeen
- Aga Khan University Hospital, Karachi
| | - R Hasan
- Aga Khan University Hospital, Karachi
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Hasan R, Chong C, Bukhari S, Jusoh R, Setiabudi H. Effective removal of Pb(II) by low-cost fibrous silica KCC-1 synthesized from silica-rich rice husk ash. J IND ENG CHEM 2019. [DOI: 10.1016/j.jiec.2019.03.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hasan R, Kawasaki M, Taniguchi M, Miyake H. The Damage of Root, Leaf and Chloroplast Ultrastructure on Maize Seedlings Caused by Salinity Stress. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1755-1315/197/1/012054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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Hossain MB, Khan MF, Ansary EF, Mamun AA, Talukder FA, Hasan R, Chowdhury MN, Islam MN, Gupta RD, Ahmed PI, Bhuiyan FK, Roy AS, Ahammed SU, Asadujjaman M, Rahman MA, Robbani MG, Talukder RK, Borman GC, Sarker NR, Khan SI, Roy PP. Response of Proliferative Lupus Nephritis with Pulse Cyclophosphamide Therapy during Induction Period: A Single Centre Study in Bangladesh. Mymensingh Med J 2018; 27:693-701. [PMID: 30487482] [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: 06/09/2023]
Abstract
This prospective study was conducted to assess the response of proliferative lupus nephritis with pulse cyclophosphamide therapy during induction period in the department of Nephrology of Dhaka Medical College, Dhaka, Bangladesh from December 2012 to November 2013. A total of 35 clinically diagnosed SLE patients of class III/IV lupus nephritis were included. But 3 patients were dropped out during follow-up, therefore finally 32 patients (class III = 4, class IV = 28) were studied. The patients were evaluated for response on the basis of proteinuria, serum creatinine & active sediment in urine after 6th cycle of cyclophosphamide and 62.5% patients achieved complete response, 25% patients achieved partial response & 12.5% patients achieved no response. The factors favored complete response was early clinical presentation (7 months duration), proteinuria ≤3gm/day& normal renal function during their initial presentation. And higher anti ds DNA titre was an independent predictor for partial response/no response.
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Affiliation(s)
- M B Hossain
- Dr Mohammad Bellal Hossain, Medical Officer, Department of Nephrology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh
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Kaki A, Alraies MC, Blank N, Hasan R, Hton W, Grines C, Mohamad T, Elder M, Schreiber T. P3589Outcome of women compared with men in patients undergoing complex percutaneous coronary intervention with hemodynamic support. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Kaki
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M C Alraies
- Cleveland Clinic, Department of Cardiovascular Medicine, Cleveland, United States of America
| | - N Blank
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - R Hasan
- University of Michigan Health System, Ann Arbor, United States of America
| | - W Hton
- Lenox Hill Heart and Vascular Institute, New York, United States of America
| | - C Grines
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - T Mohamad
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M Elder
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - T Schreiber
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
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Idris A, Al-Khadra Y, Kabach A, Darmoch F, Moussa Pacha H, Soud M, Hasan R, Kaki A, Alraies MC. P1834The impact of peripheral arterial disease on advanced heart failure patients undergoing left ventricular assist device surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Idris
- University of Central Florida, Internal Medicine, Gainesville, United States of America
| | - Y Al-Khadra
- Cleveland Clinic Foundation, Internal Medicine, Cleveland, United States of America
| | - A Kabach
- Creighton Cardiac Center, Cardiovascular Department, Omaha, United States of America
| | - F Darmoch
- Cleveland Clinic Foundation, Internal Medicine, Cleveland, United States of America
| | - H Moussa Pacha
- Washington Hospital Center, Internal Medicine, Washington, United States of America
| | - M Soud
- Washington Hospital Center, Internal Medicine, Washington, United States of America
| | - R Hasan
- University of Michigan, Cardiovascular Medicine, Ann Arbor, United States of America
| | - A Kaki
- Wayne State University, Cardiovascular Medicine, Detroit, United States of America
| | - M C Alraies
- Wayne State University, Cardiovascular Medicine, Detroit, United States of America
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Kaki A, Alraies MC, Blank N, Grines CL, Hasan R, Jani A, Shemesh A, Pahuja M, Kajy M, Laktineh A, Gade CG, Mohamad T, Elder M, Schreiber T. P5518Axillary artery as alternative access for mechanical circulatory support devices in patients with prohibitive peripheral arterial disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Kaki
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M C Alraies
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - N Blank
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - C L Grines
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - R Hasan
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - A Jani
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - A Shemesh
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M Pahuja
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M Kajy
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - A Laktineh
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - C G Gade
- New York University School of Medicine, New York, United States of America
| | - T Mohamad
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - M Elder
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
| | - T Schreiber
- Wayne State University, Detroit Medical Center - Interventional Cardiology, Detroit, United States of America
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Forty J, Hasan R, Cary N, White DJG, Wallwork J. Activation of the alternative pathway of complement is an important component of hyperacute rejection of rabbit hearts by human blood. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tang P, Haft J, Romano M, Assi A, Hasan R, Palardy M, Aaronson K, Pagani F. Right Ventricular Failure After LVAD Implantation Occurs in a Pro-inflammatory Environment. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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El-Dokla AM, Hasan R, Ali ST. Unilateral faciobrachial weakness: An unusual neuromuscular presentation Of West Nile Virus infection. Muscle Nerve 2018; 57:E110-E112. [DOI: 10.1002/mus.25996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/29/2017] [Accepted: 10/14/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Ahmed M El-Dokla
- Department of Neurology; SUNY Upstate Medical University; Syracuse New York USA
| | - Rashedul Hasan
- Department of Neurology; Baylor University Medical Center; Dallas Texas USA
| | - Sara T Ali
- Department of Neurology; Texas Tech University School of Medicine; Lubbock Texas USA
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Sarraj A, Hassan A, Grotta JC, Farrell CM, Goyal N, Elijovich L, Reishus K, Krishnan R, Sangha N, Wu A, Costa R, Malik R, Cai C, Parsha KN, Mir O, Hasan R, Snodgrass LM, Requena M, Graybeal D, Abraham M, Chen M, McCullough L, Savitz SI, Ribo M. Abstract 111: Endovascular Therapy for Mild Strokes: How Low Should We Go? Stroke 2018. [DOI: 10.1161/str.49.suppl_1.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Endovascular therapy (EVT) is the standard of care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) with NIHSS ≥ 6. LVO patients may present with mild (NIHSS <6) but disabling deficits and were not well represented in RCTs resulting in a NIHSS cutoff of ≥ 6 on AHA guidelines. Milder deficits may not justify EVT risk-benefit ratio. To generate practice level data, we evaluated EVT treatment effect in mild stroke.
Methods:
A retrospective cohort from 8 USA and Spain centers of AIS with LVO in the anterior circulation with NIHSS ≤ 6 presenting within 24 hrs (1/12 to 3/17) was pooled. EVT patients were compared with those only treated with medical management (MM). 90 day mRS (0-1 excellent) was chosen as the primary outcome as an appropriate goal for mild stroke. Multivariable analyses compared the treatment effects and their interactions with NIHSS, both as an ordinal and dichotomized (0-3 vs 4-5) variable. Adjustment was made for age, time LSN to EVT center arrival, IV-tPA, occlusion site and ASPECTS. Within center correlation was accounted for.
Results:
223 patients were included (EVT 105, MM 118). The two groups had similar baseline age (65.7 and 66.3 yrs, p=0.73), ASPECTS (9.4 and 9.3 p=0.53), %IV t-PA (39% and 36% p=0.65) and median (IQR) time mins to EVT center 156(66.5-301) and 212(90-387) p=0.09, EVT and MM respectively. There was no difference in outcomes (54.6% EVT vs 53.4% MM) when all patients (NIHSS 0-6) were assessed (aOR 0.94, 95% CI 0.62-1.40, p=0.94); same for NIHSS 0-5 (55.1% EVT vs 55.6% MM), (aOR 0.95, 95% CI 0.71-1.26, p=0.95). For NIHSS 0-3, MM had better outcomes (51.9% EVT vs 74.6% MM), (aOR 0.39, 95% CI 0.25-0.61, p<0.01). For NIHSS 4-5, results favored EVT (57.1% EVT vs 22.2% MM), (aOR 4.04, 95% CI 2.56-6.38, p<0.01). Fig 1, 2 show CIs of EVT and MM as related to NIHSS.
Conclusion:
Though limited by a non-randomized comparison, the data suggest a possible benefit for EVT in mild strokes with NIHSS 4-5. In NIHSS ≤3, the intervention had no additive benefit.
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Affiliation(s)
- Amrou Sarraj
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Ameer Hassan
- Neuroscience, Valley Baptist Med Cntr, Harlingen, TX
| | - James C Grotta
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | | | - Nitin Goyal
- Neurology, The Univ of Tennessee Health Science Cntr, Memphis, TN
| | - Lucas Elijovich
- Neurology, The Univ of Tennessee Health Science Cntr, Memphis, TN
| | - Katelin Reishus
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Rashi Krishnan
- Neurology, The Univ of Tennessee Health Science Cntr, Memphis, TN
| | | | - Abel Wu
- Neurology, Kaiser Permanente, Los Angeles, CA
| | | | | | - Chunyan Cai
- Internal Medicine, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Kaushik N Parsha
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Osman Mir
- Neurology, Baylor Univ Med Cntr, Dallas, TX
| | | | | | | | | | | | | | - Louise McCullough
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Sean I Savitz
- Neurology, The Univ of Texas Health Science Cntr at Houston, Houston, TX
| | - Marc Ribo
- Neurology, Univ Hosp Vall d’Hebron, Barcelona, Spain
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Abstract
In a group of 22 healthy pigs aged between 4 and 6 months, 2 pigs became ill with high fever, complete anorexia, cough and abnormal swaying movements on 22 June 2015. One of them died on June 24 and the second died on July 3. Shortly after, the remaining pigs also fell ill and died from the same illness by 10 August 2015. We investigated the aetiology, epidemiological and clinical features of the outbreak. We recorded the clinical signs and symptoms for each pig with the date of onset of illness. Veterinarians conducted post-mortem examinations on the 12 dead pigs, they collected tissue samples from the dead pigs and placed them in a tube containing 1 mL of nucleic acid extraction buffer (lysis buffer). We tested all the tissue samples by real-time reverse transcription polymerase chain reaction (rRT-PCR) to detect classical swine fever virus (CSFV) because the animals' symptoms matched those of this disease. We also conducted a phylogentic analysis of the nucleotide sequence of the E2 gene segment of CSFV detected in a lung tissue sample. The attack rate (22/22) and the case fatality were 100%. The predominant symptoms of the disease included high fever, cough, diarrhoea and swaying movements of the hind legs prior to death. Of the 12 pigs tissue samples tested, all had evidence of the presence of CSFV RNA by rRT-PCR. The phylogenetic analysis indicated that the virus belongs to genotype 2.2, which is closely related to CSFV genotype 2.2 reported in India. Our investigation suggests that CSF is circulating in pigs, posing a risk for communities in Bangladesh that rely on pigs for economic income and dietary protein. Future research could focus on estimating the disease and economic burden of CSFV in pig rearing areas to determine if interventions might be warranted or cost-effective.
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Affiliation(s)
- Shamim Sarkar
- Infectious Diseases DivisionProgramme for Emerging Infectionsicddr,bDhakaBangladesh
| | | | - Emily S Gurley
- Infectious Diseases DivisionProgramme for Emerging Infectionsicddr,bDhakaBangladesh
| | - Rashedul Hasan
- Infectious Diseases DivisionProgramme for Emerging Infectionsicddr,bDhakaBangladesh
| | - Mohammed Z Rahman
- Infectious Diseases DivisionProgramme for Emerging Infectionsicddr,bDhakaBangladesh
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Rahman M, Hossain ME, Afrad MH, Hasan R, Rahman M, Sarker MS, Azim T. Hepatitis C virus infections among clients attending an HIV testing and counseling center in Dhaka, Bangladesh. J Med Virol 2017; 90:383-387. [PMID: 28960396 DOI: 10.1002/jmv.24955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/19/2017] [Indexed: 11/08/2022]
Abstract
The prevalence of hepatitis C virus (HCV) and genotypes among 965 individuals attending an HIV testing and counseling unit in Dhaka Bangladesh during Jan-Dec 2011 was determined. Anti-HCV antibody was detected in 4.4% individuals; the highest rate 37.8% was in people who inject drugs (PWID) followed by that in the general population (1.3%) and less than 1% in other populations. HCV RNA was detected in 2.7%. The most common genotype was genotype 3 (88.5%) followed by genotype 1 (11.5%). A national wide surveillance for HCV infection reaching all key populations is required to assess the countywide burden and to develop appropriate treatment strategies.
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Affiliation(s)
- Mustafizur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammad Enayet Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mokibul Hassan Afrad
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashedul Hasan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahfuza Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Safiullah Sarker
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tasnim Azim
- Independent Public Health Specialist, Dhaka, Bangladesh
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Tee AH, Hasan R, Mclaughlin KE, Keenan DJM, Datta S. Erratum to: Is pre-operative haemoglobin A1c level a successful predictor of adverse outcome after cardiac surgery? J Cardiothorac Surg 2017; 12:21. [PMID: 28363280 PMCID: PMC5374562 DOI: 10.1186/s13019-017-0586-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ai Hooi Tee
- School of Medicine, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - R Hasan
- Department of Cardiac Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M139WL, UK
| | - K E Mclaughlin
- Department of Cardiac Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M139WL, UK
| | - D J M Keenan
- Department of Cardiac Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M139WL, UK
| | - S Datta
- Department of Cardiac Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M139WL, UK.
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Sorbello A, Ripple A, Tonning J, Munoz M, Hasan R, Ly T, Francis H, Bodenreider O. Harnessing scientific literature reports for pharmacovigilance. Prototype software analytical tool development and usability testing. Appl Clin Inform 2017; 8:291-305. [PMID: 28326432 PMCID: PMC5373771 DOI: 10.4338/aci-2016-11-ra-0188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/14/2017] [Indexed: 11/23/2022] Open
Abstract
Objectives We seek to develop a prototype software analytical tool to augment FDA regulatory reviewers’ capacity to harness scientific literature reports in PubMed/MEDLINE for pharmacovigilance and adverse drug event (ADE) safety signal detection. We also aim to gather feedback through usability testing to assess design, performance, and user satisfaction with the tool. Methods A prototype, open source, web-based, software analytical tool generated statistical disproportionality data mining signal scores and dynamic visual analytics for ADE safety signal detection and management. We leveraged Medical Subject Heading (MeSH) indexing terms assigned to published citations in PubMed/MEDLINE to generate candidate drug-adverse event pairs for quantitative data mining. Six FDA regulatory reviewers participated in usability testing by employing the tool as part of their ongoing real-life pharmacovigilance activities to provide subjective feedback on its practical impact, added value, and fitness for use. Results All usability test participants cited the tool’s ease of learning, ease of use, and generation of quantitative ADE safety signals, some of which corresponded to known established adverse drug reactions. Potential concerns included the comparability of the tool’s automated literature search relative to a manual ‘all fields’ PubMed search, missing drugs and adverse event terms, interpretation of signal scores, and integration with existing computer-based analytical tools. Conclusions Usability testing demonstrated that this novel tool can automate the detection of ADE safety signals from published literature reports. Various mitigation strategies are described to foster improvements in design, productivity, and end user satisfaction.
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Affiliation(s)
- Alfred Sorbello
- Alfred Sorbello, DO, MPH, US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Sciences, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002 USA,
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Hasan R, Gribbin C, Hutton R, Amer T, Little B, Meddings R. A successful case of a laparoscopic extraction with closure of the diverticulum for an anteriorly placed calculus in an infundibular diverticulum. Journal of Clinical Urology 2017. [DOI: 10.1177/2051415814553651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- R Hasan
- Urology department, University Hospital Ayr, South Ayrshire, UK
| | - C Gribbin
- Urology department, University Hospital Ayr, South Ayrshire, UK
| | - R Hutton
- Urology department, University Hospital Ayr, South Ayrshire, UK
| | - T Amer
- Urology department, University Hospital Ayr, South Ayrshire, UK
| | - B Little
- Urology department, University Hospital Ayr, South Ayrshire, UK
| | - R Meddings
- Urology department, University Hospital Ayr, South Ayrshire, UK
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Javaid A, Hasan R, Zafar A, Chaudry MA, Qayyum S, Qadeer E, Shaheen Z, Agha N, Rizvi N, Afridi MZ, Chima MK, Khan AR, Ghafoor A, Khan S, Awan SR, Akhtar S, Choudry K, Iqbal ZH, Ansarie M, Ahmad N. Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan. Int J Tuberc Lung Dis 2017; 21:303-308. [PMID: 28225340 DOI: 10.5588/ijtld.16.0444] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Drug resistance in general, and multidrug-resistant tuberculosis (MDR-TB) in particular, threatens global tuberculosis (TB) control efforts. Population-based estimates of drug resistance are needed to develop strategies for controlling drug-resistant TB in Pakistan. OBJECTIVE To obtain population-based data on Mycobacterium tuberculosis drug resistance in Pakistan. METHODS To obtain drug resistance data, we conducted a population-based study of TB cases in all provinces of Pakistan. We performed culture and drug susceptibility testing on M. tuberculosis isolates from patients with a prior history of anti-tuberculosis treatment (retreatment cases) from all over the country. RESULTS Of 544 isolates from previously treated cases, 289 (53.1%) were susceptible to all first-line drugs, 255 (46.9%) were resistant to at least one anti-tuberculosis drug and 132 (24.3%) were MDR-TB. Among MDR-TB isolates, 47.0% were ofloxacin (OFX) resistant. Extensively drug-resistant TB was found in two (0.4%) isolates. CONCLUSION Prevalence of drug resistance in retreatment isolates was high. The alarmingly high prevalence of OFX resistance among MDR-TB isolates may threaten the success of efforts to control and treat MDR-TB.
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Affiliation(s)
- A Javaid
- Department of Pulmonology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar
| | - R Hasan
- Department of Microbiology, Agha Khan University, Karachi
| | - A Zafar
- Department of Microbiology, Agha Khan University, Karachi
| | | | - S Qayyum
- Ojha Institute of Chest Disease, Karachi
| | - E Qadeer
- National TB Control Programme, Islamabad
| | - Z Shaheen
- Department of Pulmonology, Nishtar Medical College, Multan
| | - N Agha
- Fatima Jinnah Chest Hospital, Quetta
| | - N Rizvi
- Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi
| | | | - M K Chima
- Department of Pulmonology, Services Hospital, Lahore
| | - A R Khan
- Department of Pulmonology, Ayub Medical College, Abbottabad
| | | | - S Khan
- Department of Chest Medicine, Lahore General Hospital, Lahore
| | | | - S Akhtar
- Department of Medicine, Ziauddin University, Karachi
| | - K Choudry
- Department of Pulmonology, King Edward Medical University, Lahore
| | - Z H Iqbal
- Department of Pulmonology, Allama Iqbal Medical College, Lahore
| | - M Ansarie
- Orthopaedic and Medical Institute, Karachi, Pakistan
| | - N Ahmad
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Zafar A, Hasan R, Nizamuddin S, Mahmood N, Mukhtar S, Ali F, Morrissey I, Barker K, Torumkuney D. Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother 2016; 71 Suppl 1:i103-9. [PMID: 27048578 DOI: 10.1093/jac/dkw076] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate changes in the antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2015 in Pakistan. METHODS This is a review based on previously published studies from 2002-03, 2004-06 and 2007-09 and also new data from 2014-15. Susceptibility was determined by Etest(®) or disc diffusion according to CLSI and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS A total of 706 isolates from CA-RTIs comprising 381 S. pneumoniae, 230 H. influenzae and 95 S. pyogenes were collected between 2002 and 2015 and tested against a range of antibiotics. Antibiotic resistance in S. pneumoniae rose steeply from 2002 to 2009, with isolates non-susceptible to penicillin and macrolides increasing from 10% to 34.1% and from 13%-14% to 29.7%, respectively. Susceptibility to amoxicillin/clavulanic acid (and by inference amoxicillin) remained between 99.4% and 100% from 2002 to 2015. Over the years, the prevalence of susceptibility to cefuroxime was 98%-100% among S. pneumoniae. Resistance in S. pneumoniae to some older antibiotics between 2007 and 2009 was high (86.8% for trimethoprim/sulfamethoxazole and 57.2% for tetracycline). Between 2002 and 2015, ampicillin resistance (β-lactamase-positive strains) among H. influenzae has remained low (between 2.6% and 3.2%) and almost unchanged over the years (H. influenzae was not tested during 2004-06). For S. pyogenes isolates, macrolide resistance reached 22%; however, susceptibility to penicillin, amoxicillin/clavulanic acid and cefuroxime remained stable at 100%. CONCLUSIONS In S. pneumoniae from Pakistan, there has been a clear reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (amoxicillin) or cefuroxime. However, susceptibility in H. influenzae has remained stable. Local antibiotic susceptibility/resistance data are essential to support informed prescribing for CA-RTIs and other infections.
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Affiliation(s)
- A Zafar
- Aga Khan University Hospital, Department of Pathology and Laboratory Medicine, Section of Microbiology, Karachi, Pakistan
| | - R Hasan
- Aga Khan University Hospital, Department of Pathology and Laboratory Medicine, Section of Microbiology, Karachi, Pakistan
| | - S Nizamuddin
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan
| | - N Mahmood
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan
| | - S Mukhtar
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan
| | - F Ali
- GlaxoSmithKline Pakistan, 35 Dockyard Road, West Wharf, Karachi 74000, Pakistan
| | - I Morrissey
- IHMA Europe Sàrl, 9a route de la Corniche, Epalinges 1066, Switzerland
| | - K Barker
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
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Shakoor S, Tahseen S, Jabeen K, Fatima R, Malik F, Rizvi A, Hasan R. Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015. Int J Mycobacteriol 2016; 5:412-416. [DOI: 10.1016/j.ijmyco.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022] Open
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Padaki P, Hutton R, Amer T, Hasan R, Pugh D, Little B. A rare case of primary epithelioid angiosarcoma of the ureter. Ann R Coll Surg Engl 2016; 98:e184-e185. [PMID: 27502347 PMCID: PMC5392884 DOI: 10.1308/rcsann.2016.0230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 01/08/2023] Open
Abstract
Angiosarcoma is an extremely rare vascular malignancy with a 1-year survival rate of 50%, regardless of tumour origin. Distant metastases are common and occur in the lungs, bone, lymph nodes and soft tissues. The majority of patients with angiosarcoma present with localised disease, although 25-45% have distant metastases at presentation. There are few reported cases of angiosarcomas of the bladder and we report the second case in the literature of primary angiosarcoma of the ureter. We suggest that, in atypical manifestations of suspected urothelial malignancy, the multidisciplinary team considers the possibility of rarer, aggressive tumours early. This may influence clinical decision making towards offering radical treatments earlier, before it is too late to do so owing to aggressive oncological behaviour.
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Affiliation(s)
| | | | | | | | - D Pugh
- Inverclyde Royal Hospital , Greenock , UK
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Koch K, Abou El Ela A, Hasan R, Sarosi E, Pagani F, Haft J. Clinical Predictors of Pump Thrombosis in Explanted Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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