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Kenny M, Pollitt AY, Patil S, Hiebner DW, Smolenski A, Lakic N, Fisher R, Alsufyani R, Lickert S, Vogel V, Schoen I. Corrigendum to Contractility defects hinder glycoprotein VI-mediated platelet activation and affect platelet functions beyond clot contraction [Research and Practice in Thrombosis and Haemostasis Volume 8, Issue 1, January 2024, 102322]. Res Pract Thromb Haemost 2024; 8:102414. [PMID: 38680968 PMCID: PMC11053318 DOI: 10.1016/j.rpth.2024.102414] [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: 05/01/2024] Open
Abstract
[This corrects the article DOI: 10.1016/j.rpth.2024.102322.].
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Affiliation(s)
- Martin Kenny
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alice Y. Pollitt
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Smita Patil
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dishon W. Hiebner
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Albert Smolenski
- School of Medicine, Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | - Natalija Lakic
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robert Fisher
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Reema Alsufyani
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sebastian Lickert
- Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | - Viola Vogel
- Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | - Ingmar Schoen
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Kenny M, Pollitt AY, Patil S, Hiebner DW, Smolenski A, Lakic N, Fisher R, Alsufyani R, Lickert S, Vogel V, Schoen I. Contractility defects hinder glycoprotein VI-mediated platelet activation and affect platelet functions beyond clot contraction. Res Pract Thromb Haemost 2024; 8:102322. [PMID: 38379711 PMCID: PMC10877441 DOI: 10.1016/j.rpth.2024.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024] Open
Abstract
Background Active and passive biomechanical properties of platelets contribute substantially to thrombus formation. Actomyosin contractility drives clot contraction required for stabilizing the hemostatic plug. Impaired contractility results in bleeding but is difficult to detect using platelet function tests. Objectives To determine how diminished myosin activity affects platelet functions, including and beyond clot contraction. Methods Using the myosin IIA-specific pharmacologic inhibitor blebbistatin, we modulated myosin activity in platelets from healthy donors and systematically characterized platelet responses at various levels of inhibition by interrogating distinct platelet functions at each stage of thrombus formation using a range of complementary assays. Results Partial myosin IIA inhibition neither affected platelet von Willebrand factor interactions under arterial shear nor platelet spreading and cytoskeletal rearrangements on fibrinogen. However, it impacted stress fiber formation and the nanoarchitecture of cell-matrix adhesions, drastically reducing and limiting traction forces. Higher blebbistatin concentrations impaired platelet adhesion under flow, altered mechanosensing at lamellipodia edges, and eliminated traction forces without affecting platelet spreading, α-granule secretion, or procoagulant platelet formation. Unexpectedly, myosin IIA inhibition reduced calcium influx, dense granule secretion, and platelet aggregation downstream of glycoprotein (GP)VI and limited the redistribution of GPVI on the cell membrane, whereas aggregation induced by adenosine diphosphate or arachidonic acid was unaffected. Conclusion Our findings highlight the importance of both active contractile and passive crosslinking roles of myosin IIA in the platelet cytoskeleton. They support the hypothesis that highly contractile platelets are needed for hemostasis and further suggest a supportive role for myosin IIA in GPVI signaling.
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Affiliation(s)
- Martin Kenny
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alice Y. Pollitt
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Smita Patil
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dishon W. Hiebner
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Albert Smolenski
- School of Medicine, Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | - Natalija Lakic
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robert Fisher
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Reema Alsufyani
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Sebastian Lickert
- Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | - Viola Vogel
- Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | - Ingmar Schoen
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Almas T, Ehtesham M, Khan AA, Ramtohul RK, Nazir M, Zaidi SMJ, Alsubai AK, Al-Ansari H, Awais M, Alsufyani R, Alsufyani M, Almesri A, Ismail H, Hadeed S, Malik J. Effect of COVID-19 on cardiac electrophysiology practice: A systematic review of literature. Ann Med Surg (Lond) 2023; 85:884-891. [PMID: 37113877 PMCID: PMC10129206 DOI: 10.1097/ms9.0000000000000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/12/2023] [Indexed: 03/31/2023] Open
Abstract
The authors conducted a systematic review on the effect of coronavirus disease 2019 on electrophysiology (EP) practice and procedure volume in various settings. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and Embase were examined with combinations of medical subject headings terms for identification of the relevant studies. After excluding duplicates, irrelevant, and ineligible studies, 23 studies were included for full qualitative analysis. The overall study-level volume reduction of EP procedures ranged from 8 to 96.7%. All studies reported an overall reduction in EP physiology procedures being carried out except one in Poland, which reported an overall increase in the total EP procedures carried out in 2020. This study still reported a decrease in EP procedure volume during the first lockdown phase. Procedural volume reduction was seen most commonly for cardiovascular implantable electronic device placement (20/23 studies, 86.9%), electrophysiology studies (11/23 studies, 47.8%), and ablations (9/23, 39.1% studies). The most common reason stated for the observed decline in EP procedures was the cancellation and postponement of nonurgent elective cases in the hospitals (15/23 studies, 65.2%). There has been an overall reduction in EP procedure volume across different centers. The impact of the decline in EP procedures will be seen only after the services resume to prepandemic levels, but an increase in-patient volume and procedure waiting time is expected. This review will provide insights into improving healthcare service delivery in times of unprecedented public health emergencies.
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Almas T, Alsufyani R, Jiffry R, Subai AKA, Almesri A, Ali SA, Baqal O, Malik J, Ahmed T, Rana MN. Estimated Glomerular Filtration Rate (eGFR) Slope Assessment as a Surrogate End-point in Cardiovascular trials: Implications, Impediments, and Future Directions. Curr Probl Cardiol 2023; 48:101508. [PMID: 36402218 DOI: 10.1016/j.cpcardiol.2022.101508] [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] [Received: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | - Riaz Jiffry
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Almas T, Haider R, Malik J, Mehmood A, Alvi A, Naz H, Satti DI, Zaidi SMJ, AlSubai AK, AlNajdi S, Alsufyani R, Ramtohul RK, Almesri A, Alsufyani M, H. Al-Bunnia A, Alghamdi HAS, Sattar Y, Alraies MC, Raina S. Nanotechnology in interventional cardiology: A state-of-the-art review. IJC Heart & Vasculature 2022; 43:101149. [DOI: 10.1016/j.ijcha.2022.101149] [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] [Received: 07/23/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
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Khan MA, Almas T, Ullah M, Alkhattab M, Shaikh F, Shaikh S, Bagwe I, Antony M, Khedro T, Nagarajan VR, Ramjohn J, Alsufyani R, Almubarak D, Al-Awaid AH, Alsufyani M, Nagarajan DR, Khan MO, Huang H, Oruk M, Samy A, Alqallaf N, Shafi A, Adeel A, Khan MK. Candida glabrata infection of a pancreatic pseudocyst in a COVID-19 patient: A case report and review of the literature. Ann Med Surg (Lond) 2022; 77:103648. [PMID: 35638027 PMCID: PMC9142617 DOI: 10.1016/j.amsu.2022.103648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Pancreatic pseudocysts remain a feared complication of acute or chronic pancreatitis and are often characterized by collections of fluids due to underlying damage to the pancreatic ducts, culminating in a walled-off region bereft of an epithelial layer but surrounded by granulation tissue. While fungal infections of pancreatic pseudocysts are rarely encountered, candida albicans remains the most frequently implicated organism. Case presentation A 55-year-old male presented with pain in the left-hypochondriac region, accompanied by non-bilious emesis and nausea. Interestingly, the patient also tested positive for a COVID-19 infection. Investigative workup divulged enhancing pancreatic walls with a radiologic impression consistent with a pancreatic pseudocyst. An ultrasound-guided external drainage was performed; the drainage was conducted unremarkably, with the resultant fluid collection revealing the presence of Candida Glabrata. The patient was commenced on antifungal therapy and continues to do well to date. Discussion Infectious ailments of pancreatic pseudocysts remain a widely known complication of acute pancreatitis. While it is rare, fungal infection is a crucial consideration for patients with pancreatic pseudocysts, especially in the context of a lack of an adequate response to antibiotics, deterioration, comorbidities, and immunocompromised states. Conclusion Rapid identification of the microbe responsible for pancreatic pseudocyst infection is vital for time-sensitive treatment and a more rapid recovery, curbing associated morbidity and mortality. Fungal infections of pancreatic pseudocysts remain a rare but well-characterized complication, culminating in significant morbidity and mortality. Telltale signs include unresponsiveness to antibiotics and worsening clinical symptoms. Rapid identification of the responsible microbe is vital for time-sensitive treatment and a more rapid recovery.
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Affiliation(s)
| | - Talal Almas
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Muneeb Ullah
- Department of Surgery, Maroof International Hospital, Islamabad, Pakistan
| | - Maha Alkhattab
- Department of Surgery, Galway University Hospital, Galway, Ireland
| | | | | | - Isha Bagwe
- Mercy University Hospital, Cork, Ireland
| | | | - Tarek Khedro
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Reema Alsufyani
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Dana Almubarak
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Majid Alsufyani
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Helen Huang
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mert Oruk
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Arjun Samy
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Nagi Alqallaf
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Adil Shafi
- Department of Surgery, Maroof International Hospital, Islamabad, Pakistan
| | - Aqsa Adeel
- Department of Surgery, Maroof International Hospital, Islamabad, Pakistan
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Almas T, Niaz MA, Sattar Y, Khedro T, Kanawati A, Yazji K, Alsufyani R, Al-Khatib Y, Akbar A, Mansoor E. Chronic inflammatory demyelinating polyneuropathy as a paraneoplastic manifestation of colorectal carcinoma: What do we know? Ann Med Surg (Lond) 2021; 68:102545. [PMID: 34434545 PMCID: PMC8376678 DOI: 10.1016/j.amsu.2021.102545] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Talal Almas
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Tarek Khedro
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Ali Kanawati
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Katia Yazji
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Reema Alsufyani
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Yousef Al-Khatib
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Emad Mansoor
- Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Almas T, Niaz MA, Zaidi SMJ, Haroon M, Khedro T, Alsufyani R, Al-Awaid AH, Tran E, Khan AW, Alaeddin H, Rifai A, Manamperi KT, Khan A, Haadi A. The Spectrum of Clinical Characteristics and Complications of Tetanus: A Retrospective Cross-Sectional Study From a Developing Nation. Cureus 2021; 13:e15484. [PMID: 34268020 PMCID: PMC8261793 DOI: 10.7759/cureus.15484] [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] [Accepted: 06/06/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction While tetanus has largely been eradicated with the advent of the tetanus vaccine, its prevalence in Pakistan remains alarmingly high due to insufficient uptake of the vaccination program. The clinical presentations that the disease elicits range from mere opisthotonos to more sinister complications, including respiratory failure and death, often posing an insurmountable challenge for hospitals. Methods A retrospective cross-sectional study was conducted and analyzed the medical charts of 43 patients with a confirmed diagnosis of tetanus infection. The charts were perused for the patients' demographics, clinical characteristics, and disease outcomes. The prevalence of various clinical symptoms and complications were reported in terms of frequencies and percentages. Results The mean age of the patients hovered at 29.53 ± 16.53 years, with a range of 12 to 65 years. Of those affected, 83.7% were males while 16.3% were females. Notably, none of the infected patients had a prior history of vaccination against tetanus. Trismus was noted to be the most prevalent clinical manifestation and was found in 90.70% of the patients while paraesthesia at the site of infection, found in 6.98%, was the least prevalent. The overall mortality was noted to hover at 46.5%. Conclusion While tetanus has largely been eradicated, its prevalence in Pakistan remains alarmingly high. The complications noted in the study have implications for the country's public health system and aims to better inform the current state of the national vaccination program.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | | | | | - Tarek Khedro
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Estelle Tran
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Abdul Wali Khan
- Internal Medicine, College of Physicians and Surgeons Pakistan, Peshawar, PAK
- Internal Medicine, Hayatabad Medical Complex, Peshawar, PAK
| | - Hasan Alaeddin
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Ali Rifai
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Abat Khan
- Cardiology, Khyber Teaching Hospital, Peshawar, PAK
| | - Abdul Haadi
- Internal Medicine, Royal College of Surgeons In Ireland, Dublin, IRL
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Almas T, Ehtesham M, Khedro T, Haadi A, Nabeel AR, Hussain S, Alsufyani R, Al-Awaid AH, Sclair S, Mansoor E. The many faces of coronavirus disease 2019: COVID-19 and the liver. Ann Med Surg (Lond) 2021; 64:102224. [PMID: 33747505 PMCID: PMC7959700 DOI: 10.1016/j.amsu.2021.102224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/10/2021] [Indexed: 02/08/2023] Open
Affiliation(s)
- Talal Almas
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Maryam Ehtesham
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tarek Khedro
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Abdul Haadi
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Salman Hussain
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Reema Alsufyani
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Seth Sclair
- Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Emad Mansoor
- Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Almas T, Ehtesham M, Khan AW, Khedro T, Hussain S, Kaneez M, Alsufyani R, Almubarak D, Alahmed F, Alaeddin H. Safety and Efficacy of Low-Dose Corticosteroids in Patients With Non-severe Coronavirus Disease 2019: A Retrospective Cohort Study. Cureus 2021; 13:e12544. [PMID: 33564538 PMCID: PMC7863064 DOI: 10.7759/cureus.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2021] [Indexed: 12/20/2022] Open
Abstract
Background To date, several pharmacological agents have been employed in the treatment and management of the coronavirus disease 2019 (COVID-19). While the utility of corticosteroids in severe COVID-19 infection is now widely touted, their efficacy in thwarting the progression of non-severe disease remains elusive. Methods A retrospective cohort study involving 25 patients with a confirmed diagnosis of non-severe COVID-19 infection was conducted. Subjects were assigned to either the steroid or the non-steroid group. A low-dose, short-course corticosteroid regimen was administered for seven days and the disease outcomes were recorded and compared among the two groups. The Kolmogorov-Smirnov test was employed to discern the data normality. Results In patients treated with low-dose, short-course steroids, the overall all-cause mortality was significantly lower compared with the non-steroid group (8.3% and 61.5%, respectively; p = 0.005). The prevalence of acute respiratory distress syndrome in the steroid group was significantly lower than that in the non-steroid group at the seven-day mark (16.7% and 84.6%, respectively; p = 0.002). Within the steroid group, the incidence of developing secondary complications was also markedly lower than that in the non-steroid group. Conclusions In patients afflicted with non-severe COVID-19, the employment of low-dose, short-course corticosteroids may confer a therapeutic advantage, significantly curtailing the mortality rate, the length of hospital stay, and the risk of developing secondary complications.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Maryam Ehtesham
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Abdul Wali Khan
- Internal Medicine, College of Physician and Surgeons Pakistan, Peshawar, PAK
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Tarek Khedro
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Salman Hussain
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Mehwish Kaneez
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dana Almubarak
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Fatimah Alahmed
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Hasan Alaeddin
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
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Syed MK, Al Faqeeh AA, Othman A, Almas T, Khedro T, Alsufyani R, Almubarak D, Al Faqeh R, Syed S, Syed SK. Management of Early Post-Operative Complications of Esophageal Atresia With Tracheoesophageal Fistula: A Retrospective Study. Cureus 2020; 12:e11904. [PMID: 33415055 PMCID: PMC7781882 DOI: 10.7759/cureus.11904] [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: 11/23/2022] Open
Abstract
Background Esophageal atresia (EA) with tracheoesophageal fistula (TEF) is a rare congenital malformation of the trachea and the esophagus. While the condition can result in a debilitating clinical picture, its outcomes have significantly ameliorated in recent times. The diminishing mortality associated with the disease can be attributed to a myriad of factors, including surgical advances, specialized anesthetic care, and categorical ventilator provision. These advances have resulted in increased survival rates even in premature infants who present with exceedingly low birth weights. Nevertheless, the mortality surrounding the condition still remains exceedingly high in some parts of the world, including the Middle East and Asia. The aim of the present study is to identify and outline the management of the postoperative complications that are intricately linked with soaring mortality rates. Methods We conducted a single-center retrospective study, three years in duration, of all the patients who were operated for esophageal atresia with tracheoesophageal fistula. The exclusion criteria included patients who died before the operation and those who were referred to other centers for management. The study evaluated several factors, including the various postoperative complications, their adept management, and the eventual outcomes. Data pertaining to the patient demographics, treatment, and radiological and laboratory findings was obtained and eventually analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA) software. Results The present study included a total of 12 cases diagnosed in our hospital during the aforementioned study period. Of these patients, two patients (16.7%) died before operation because of associated severe congenital anomalies such as cardiac pathologies. Three patients were referred to other centers for management. These patients were excluded from our analysis. The remaining seven patients were included in our analysis. In our study, gastroesophageal reflux was the most common postoperative complication and was noted in six patients. Leakage of anastomosis was noted in two patients. Lung collapse was noted in merely one patient and was thus the least common complication. The overall mortality rate hovered around 28.6%. Conclusions While most patients who are surgically managed for esophageal atresia with tracheoesophageal fistula develop postoperative complications, these complications are amenable to conservative management through the means of antibiotics, ventilator support, and total parenteral nutrition.
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Affiliation(s)
| | | | | | - Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Tarek Khedro
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dana Almubarak
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Saifullah Syed
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Sabahat K Syed
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Almas T, Saleem H, Ehtesham M, Hussain S, Khedro T, Alsufyani R, Alahmed F, Almubarak D, Zaidi SMJ, Hameed A. The Spectrum of Non-ischemic Cardiac Magnetic Resonance Imaging Findings: A Retrospective Analysis. Cureus 2020; 12:e11354. [PMID: 33304689 PMCID: PMC7720915 DOI: 10.7759/cureus.11354] [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: 11/24/2022] Open
Abstract
Introduction Since cardiac pathologies remain ubiquitous, their prompt diagnosis through the means of innovative technologies, such as cardiac magnetic resonance imaging, remains pivotal. The spectrum of these pathologies varies widely, ranging from ischemic etiologies to rare cardiac malignancies. This study evaluates the prevalence of nonischemic cardiac pathologies, such as infiltrative heart diseases, that often warrant meticulous diagnostic evaluation through the means of cardiac magnetic resonance imaging. Methods We performed a retrospective study in order to analyse the cardiac magnetic resonance imaging records of 250 patients over a period of six months with previously remarkable cardiac histories. Patients with a prior history of ischemic cardiac disease, as determined from past medical and surgical records, were excluded from the study. The prevalence of various nonischemic findings was ascertained. The demographic characteristics and comorbidities of the patients were also tabulated. Results In the present study, 250 patients were included, of which 115 were females and 135 were males, with the mean age hovering at 48.21 ± 11.49 years. The top two most prevalent cardiac magnetic resonance imaging findings were concentric moderate-to-severe left ventricular hypertrophy and patchy subendocardial late gadolinium enhancement of the left ventricle; these were observed in 62.2% and 23.7% of the patients, respectively. Cardiac magnetic resonance imaging also divulged findings typical of rarer pathologies, including cardiac sarcoidosis and primary cardiac lymphoma. Conclusion Pathologies of the heart often mandate extensive diagnostic workup through the means of radiological modalities such as cardiac magnetic resonance imaging. In patients with indications of nonischemic cardiac pathologies, cardiac magnetic resonance imaging can be employed as part of the initial radiological armamentarium. Furthermore, cardiac magnetic resonance remains the imaging modality of choice for detecting infrequent cardiac pathologies, such as cardiac sarcoidosis.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Hassan Saleem
- Radiology, Islamabad Diagnostic Center, Islamabad, PAK
| | - Maryam Ehtesham
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Salman Hussain
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Tarek Khedro
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Fatimah Alahmed
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dana Almubarak
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Aamir Hameed
- Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, IRL
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Almas T, Khedro T, Hussain S, Alsufyani R, Khan MK. Ovarian Carcinoma Uncloaked by Hydatidosis: An Intraoperative Epiphany. Cureus 2020; 12:e11276. [PMID: 33274151 PMCID: PMC7707889 DOI: 10.7759/cureus.11276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hydatidosis is an infective ailment that is caused by the parasite echinococcus granulosus. The parasitic infection typically produces cysts filled with excessive quantity of fluid and most commonly afflicts the liver. While secondary hydatidosis remains exceedingly rare, cases of hydatidosis in organs such as the ovaries and the fallopian tubes have been documented in the literature. In such instances, the patients present with a vague constellation of symptoms, including abdominal distension and vague abdominal pain. Herein, we elucidate the case of a female patient who presented with massive abdominal swelling on a background history significant for hydatid liver disease. Intraoperative findings included a left adnexal mass, which was eventually established to be an ovarian adenocarcinoma coexisting with secondary ovarian hydatidosis.
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14
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Almas T, Hussain S, Alsufyani R, Alaeddin H, Khan MK. Non-familial Juvenile Polyposis Syndrome Presenting as Rectal Prolapse: An Unusual Presentation of a Rare Disease. Cureus 2020; 12:e11222. [PMID: 33269150 PMCID: PMC7704158 DOI: 10.7759/cureus.11222] [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
Juvenile polyposis syndrome is a rare inherited disorder that afflicts the gastrointestinal system. It usually occurs as a result of gene mutations; to date, several gene mutations, including those involving the bone morphogenetic protein receptor type IA (BMPR1A) gene, have been implicated in heralding the onset of the ailment. The disease is characterized by the infiltration of the gastrointestinal system with numerous hamartomas, which are predominantly benign. However, if left untreated, the hamartomas can undergo malignant transformations. Timely diagnosis and prompt surgical intervention are, therefore, imperative in portending favorable disease outcomes. We hereby delineate the case of a patient who presented with rectal prolapse and bleeding per rectum. Further diagnostic workup revealed the presence of polyps throughout the colon and the rectum, thereby insinuating a diagnosis of non-familial juvenile polyposis syndrome. The patient was managed through open surgery and continues to do well with no indications of disease recurrence.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Salman Hussain
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Hasan Alaeddin
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Muhammad Kashif Khan
- Surgical Oncology, Federal Government Poly Clinic (Post Graduate Medical Institute), Islamabad, PAK.,Surgical Oncology, Maroof International Hospital, Islamabad, PAK
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15
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Almas T, Hussain S, Ehtesham M, Alsufyani R, Khan MK. Mucoepidermoid Carcinoma of the Parotid Gland Presenting as a Fungating Exophytic Mass: A Surgical Challenge Rooted in Extensive Nerve Encasement. Cureus 2020; 12:e10990. [PMID: 33209546 PMCID: PMC7667710 DOI: 10.7759/cureus.10990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Parotid glands, which are predominantly composed of serous acini, are the largest salivary glands in the human body. Mucoepidermoid carcinoma (MEC) of the parotid gland is the most common parotid tumour that routinely presents as a painless, fixed mass below the ears. However, its presentation as a fungating mass remains exceedingly rare. Due to the intimate anatomical relationship between the parotid gland and the facial nerve, parotid malignancies can culminate in facial nerve palsy, posing an onerous surgical challenge. In this paper, we chronicle the case of a male who presented with a fungating/exophytic mass and facial nerve weakness. A superficial parotidectomy was performed, and the eventual histopathological workup divulged an advanced mucoepidermoid parotid carcinoma entirely encasing the marginal mandibular nerve. Consequently, the marginal mandibular nerve was sacrificed, alluding to the remarkable surgical challenge encountered. Clinically, this manifested as an impairment of the motor function in the patient's left lower lip.
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16
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Syed MK, Al Faqeeh AA, Othman A, Hussein AA, Hussain S, Almas T, Alsufyani R, Alaeddin H, Syed S, Syed SK. The Spectrum of Testicular Pathologies Upon Scrotal Exploration for Acute Scrotum: A Retrospective Analysis. Cureus 2020; 12:e10984. [PMID: 33209540 PMCID: PMC7667721 DOI: 10.7759/cureus.10984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background The term acute scrotum encompasses a plethora of testicular pathologies that are detrimental to the survival and sustenance of testes. The aim of the present study is to determine the spectrum of these testicular pathologies upon scrotal exploration performed in the aftermath of acute scrotal pain in the pediatric population. Methods This multicenter retrospective cross-sectional study was conducted at the department of pediatric surgery at two hospitals. During the study period, the clinical characteristics of the 76 patients that underwent scrotal exploration for acute scrotum were assessed. These included age, duration of symptoms on presentation, and identification of the etiology underlying scrotal pain. The data obtained was eventually analyzed using the Statistical Package for the Social Sciences (SPSS) 23.0 software (IBM Corp., Armonk, NY). Results A total of 76 scrotal exploration procedures were performed. The involvement of the left side of the scrotum was more common than the right side. Most of the patients who presented were older than five years of age. A majority of the patients presented after 24 hours of the commencement of their symptoms. Of the included participants, 36 patients (47.47%) were found to have an underlying torsion of appendix testes that was appropriately managed. Testicular torsion was observed in 15 patients, out of which eight viable testes were salvaged with a subsequent orchidopexy while seven torsions required orchiectomy owing to their non-viability. Other findings included epididymo-orchitis and infected hydrocele. A total of 19 testes appeared completely normal upon scrotal exploration. Conclusion Scrotal exploration should be considered as part of the medical and surgical workup and in the management of acute scrotum, as it divulges the specific underlying testicular pathology. Prompt scrotal exploration can aid in ascertaining the underlying etiology and is, therefore, pivotal in the apt management of the underlying pathology.
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Affiliation(s)
| | | | - Alsayed Othman
- Pediatric Surgery, Al-Azhar University - Assuit Branch, Assuit, EGY
| | | | - Salman Hussain
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Reema Alsufyani
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Hasan Alaeddin
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Saifullah Syed
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Sabahat K Syed
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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