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Reiner J, Chung Y, Misha SH, Lehner C, Moehle C, Poulos D, Monir S, Charde KJ, Macha P, Kranz L, Thorvaldson I, Thorgrimsson B, Keith D, Hsueh YL, Rahman R, Gorman SK, Keizer JG, Simmons MY. High-fidelity initialization and control of electron and nuclear spins in a four-qubit register. Nat Nanotechnol 2024:10.1038/s41565-023-01596-9. [PMID: 38326467 DOI: 10.1038/s41565-023-01596-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024]
Abstract
Single electron spins bound to multi-phosphorus nuclear spin registers in silicon have demonstrated fast (0.8 ns) two-qubit [Formula: see text] gates and long spin relaxation times (~30 s). In these spin registers, when the donors are ionized, the nuclear spins remain weakly coupled to their environment, allowing exceptionally long coherence times. When the electron is present, the hyperfine interaction allows coupling of the spin and charge degrees of freedom for fast qubit operation and control. Here we demonstrate the use of the hyperfine interaction to enact electric dipole spin resonance to realize high-fidelity ([Formula: see text]%) initialization of all the nuclear spins within a four-qubit nuclear spin register. By controllably initializing the nuclear spins to [Formula: see text], we achieve single-electron qubit gate fidelities of F = 99.78 ± 0.07% (Clifford gate fidelities of 99.58 ± 0.14%), above the fault-tolerant threshold for the surface code with a coherence time of [Formula: see text].
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Affiliation(s)
- J Reiner
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - Y Chung
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - S H Misha
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - C Lehner
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - C Moehle
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - D Poulos
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - S Monir
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
- School of Physics, University of New South Wales, Sydney, New South Wales, Australia
| | - K J Charde
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - P Macha
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - L Kranz
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - I Thorvaldson
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - B Thorgrimsson
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - D Keith
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - Y L Hsueh
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
- School of Physics, University of New South Wales, Sydney, New South Wales, Australia
| | - R Rahman
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
- School of Physics, University of New South Wales, Sydney, New South Wales, Australia
| | - S K Gorman
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - J G Keizer
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia
| | - M Y Simmons
- Centre of Excellence for Quantum Computation and Communication Technology, School of Physics, University of New South Wales, Sydney, New South Wales, Australia.
- Silicon Quantum Computing Pty Ltd., University of New South Wales, Sydney, New South Wales, Australia.
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Ali S, Athar M, Rahman R, Rehman F. Ceftriaxone-induced Kounis syndrome: A case report and review of the literature. Rev Esp Anestesiol Reanim (Engl Ed) 2024; 71:129-133. [PMID: 37683977 DOI: 10.1016/j.redare.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/22/2023] [Indexed: 09/10/2023]
Abstract
Kounis syndrome is defined as cardiovascular symptoms that occur secondary to allergic or hypersensitivity insults, and is also called allergic angina and allergic myocardial infarction. We report a case of pre-operative ceftriaxone-induced Kounis syndrome with no evident dermatological manifestation, and describe our diagnostic dilemma. The patient was symptomatically managed and discharged in stable condition with a warning against future use of ceftriaxone.
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Affiliation(s)
- S Ali
- Department of Anaesthesiology and Critical Care, J.N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - M Athar
- Department of Anaesthesiology and Critical Care, J.N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
| | - R Rahman
- Department of Anaesthesiology and Critical Care, J.N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - F Rehman
- Department of Anaesthesiology and Critical Care, J.N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Rahman R, Siddique T, Nipa FA, Sultana S, Devi P, Islam F, Nainu F, Obaidullah AJ, Emran TB, Khatun MR. Bark extract of Chaetocarpus castanocarpus (Roxb.) exhibits potent sedative, anxiolytic, and antidepressant effects through an in vivo approach in Swiss albino mice. Eur Rev Med Pharmacol Sci 2024; 28:1202-1212. [PMID: 38375725 DOI: 10.26355/eurrev_202402_35359] [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: 02/21/2024]
Abstract
OBJECTIVE Standard phytochemical investigations were performed to identify the secondary metabolites in the methanol extract of Chaetocarpus castanocarpus bark (MECC) and investigate the neuropharmacological potential of MECC in Swiss albino mice. MATERIALS AND METHODS Swiss albino mice were used in the forced swimming test (FST) and tail suspension test (TST) to evaluate the antidepressant effect of MECC. Also, the hole board test (HBT) and elevated plus maze (EPM) were conducted to examine anxiolytic activities. In contrast, the open field test (OFT) and hole cross test (HCT) were employed to evaluate sleeping disorders. RESULTS Alkaloids, glycosides, flavonoids, terpenoids, coumarins, and tannins are only a few secondary metabolites identified in MECC by qualitative and quantitative phytochemical investigations. The oral administration of MECC considerably shortened the immobility duration during FST and TST. Encouraging dose-dependent anxiolytic effects were also observed in all relevant experiments compared to the control. Additionally, during the OFT and HCT assessment, a noteworthy decline in the locomotor activities of the experimental animals was observed. CONCLUSIONS The results of this investigation suggest that the Chaetocarpus castanocarpus bark is a possible source of therapeutic candidates for treating neurological disorders.
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Affiliation(s)
- R Rahman
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, Bangladesh.
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Rahman R, Mariam L, Su R, Malhotra C, Ozdemir S. Quality of life and its predictors among patients with metastatic cancer in Bangladesh: the APPROACH survey. BMC Palliat Care 2024; 23:2. [PMID: 38166890 PMCID: PMC10762837 DOI: 10.1186/s12904-023-01301-6] [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: 01/11/2023] [Accepted: 10/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND This study aimed to assess the health-related quality of life (HRQOL) (physical, functional, emotional, social, spiritual) and psychological (anxiety and depression) well-being and their associations with patient characteristics among patients with metastatic cancer in Bangladesh. METHODS A convenience sample of 386 Bangladeshi patients with stage IV solid cancers was recruited from a palliative care outpatient department and an inpatient palliative center. Dependent variables included the physical, functional, emotional, social, and overall scores of the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale, the anxiety, depression, and overall scores of the Hospital Anxiety and Depression (HADS) scale. Linear regressions examined the association between dependent variables and patient characteristics. RESULTS A substantial proportion of Bangladeshi patients reported anxiety (59% of outpatients and 55% of inpatients) and depression (60% of outpatients and 73% of inpatients) symptoms. Generally, greater financial difficulty and symptom burden scores were associated with worse health outcomes. Older patients reported poorer functional and spiritual well-being but better anxiety scores. Females reported worse anxiety and depressive symptoms and physical well-being but better spiritual outcomes. CONCLUSIONS Additional efforts must be directed at improving the HRQOL of patients with metastatic cancer in Bangladesh. Furthermore, assistance should be made more accessible to vulnerable groups, including women, the elderly, and those with financial difficulty.
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Affiliation(s)
- Rubayat Rahman
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Rebecca Su
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Signature Programme in Health Services and System Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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Amirah N, Rahman R. Mental Health Status during COVID-19 Pandemic and its Relationship with Economic Hardship and Financial Threat among Rural Population in Sarawak, Malaysia. Kathmandu Univ Med J (KUMJ) 2023; 21:149-155. [PMID: 38628007] [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: 04/19/2024]
Abstract
Background During the COVID-19 pandemic, job and income loss, social isolation may aggravate mental health, particularly among the most vulnerable groups. Objective To assess the current mental health situation among the rural population in Samarahan district and determine the relationship between economic hardships, financial threats, and mental health status. Method This study was a cross-sectional study conducted among the 530 households in the Samarahan district. A multistage cluster sampling technique was used to select the participants in this study. Data were collected by face-to-face interview using a structured questionnaire. The mental health status was assessed by using a validated and translated DASS-21 scale. Data analysis was done by SPSS version 27.0. A p-value of ≤ .05 was considered statistically significant. Result Analysis showed that two-thirds of the respondents (66.6%) had no mental health problem. Meanwhile, 22.4% had anxiety, 1% had depression, and 0.19% had stress. Anxiety and depression accounted for 5.8% and stress and anxiety 1.3%. However, 2.64% had stress, anxiety, and depression. In bivariate analysis, age, monthly income, type of job, economic hardship, and expenditure difference appeared to be significant predictors of mental health problems (p < .05). Conclusion Depression, anxiety, and stress pose a significant threat to the rural population's health. Therefore, public health practitioners and policymakers need to address this to minimise the pandemic's impact on mental health and provide psychological support, particularly among the most affected group.
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Affiliation(s)
- N Amirah
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia
| | - R Rahman
- Department of Community Medicine and Public Health Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia
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MAHJABIN S, Rahman R, Haque E, Islam N. WCN23-0544 CLINICAL PROFILE, IMMUNOSUPPRESSIVE MANAGMENT AND OUTCOME IN ADULT RENAL ALLOGRAFT RECIPIENTS WITH COVID-19 INFECTION: A CASE SERIES FROM SINGLE CENTRE IN BANGLADESH. Kidney Int Rep 2023. [PMCID: PMC10025673 DOI: 10.1016/j.ekir.2023.02.1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Pham A, Thomas G, Rahman R, Naghian A, Bruccoliere A, Pollina C, Rusy R, Ramon M, Mittal N, Acosta V, Iskandir M, Arvandi A, Ansari MM. CRT-300.14 Multifactorial Benefits of Transradial Access in Endovascular Interventions to Treat Peripheral Arterial Disease (PAD) – Critical Limb-Threatening Ischemia (CLTI): A Cost-Savings Analysis. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.263] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Yousuf S, Mahmood S, Rahman R, Khatun R, Tanzin F, Arzoo S, Ferdous NE. Efficacy and Safety of Repeated Use of Ulipristal Acetate in Uterine Fibroids. Mymensingh Med J 2023; 32:168-176. [PMID: 36594317] [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: 06/17/2023]
Abstract
Uterine fibroids are benign tumor of the uterus that often appear during child bearing ages. Medical treatments are considered the first-line treatment to preserve fertility, avoid or delaying surgery. This randomized control study was carried out in OPD of Obstetrics and Gynecology Department of BSMMU, Dhaka, Bangladesh from May 2018 to March 2019 to evaluate the efficacy and safety of ulipristal acetate (5mg) once daily in reproductive women with three months treatment courses. Total 52 samples with symptomatic uterine fibroids for treatment course-1, among them 36 were needed for treatment course-2 which was slow or non-responding in treatment course-1. Main outcome measures were amenorrhea, controlled bleeding, fibroid volume, anaemia, quality of life. Sixty one percent (61.0%) of patients were achieved amenorrheic during both treatment courses. Ninety percent (90.0%) patients were control of bleeding during both treatment courses. In treatment course-1, reductions from baseline in fibroid volume were 62.70%, whereas in course-2, reductions in fibroid volume were 75.33%. Five percent (5.0%) of patients were discontinuing Ulipristal acetate due to adverse effects. Renal and liver function tests were performed before and after each course of treatment. The level of creatinine, SGPT in the blood for both treatment courses had no statistically significant effects. Ulipristal acetate may be an alternative to surgical treatment, the safety profiles and prolong effects with improvement of symptoms, quality of life after cessation of drugs. Repeated use of drugs reduces the size and also improves the patient's condition.
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Affiliation(s)
- S Yousuf
- Dr Shereen Yousuf, Medical Officer, Department of Obstetrics and Gynaecology, BSMMU, Dhaka, Bangladesh; E-mail:
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Elhalawani H, Hammoudeh L, Cagney D, Qian J, Martin A, Zgrabik J, Meyers J, Pataki K, Martin K, Khouj Y, Verry C, Bi W, Arnaout O, Christ S, Alexander B, Tanguturi S, Rahman R, Haas-Kogan D, Aizer A. Leveraging Serial MRI Radiomics and Machine Learning to Predict Risk of Radiation Necrosis in Patients with Brain Metastases Managed with Stereotactic Radiation and Immunotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.954] [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: 10/31/2022]
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Ozdemir S, Lee JJ, Yang GM, Malhotra C, Teo I, Pham NT, Manalo MF, Hapuarachchi T, Mariam L, Rahman R, Finkelstein E. Awareness and Utilization of Palliative Care Among Advanced Cancer Patients in Asia. J Pain Symptom Manage 2022; 64:e195-e201. [PMID: 35705117 DOI: 10.1016/j.jpainsymman.2022.06.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/09/2022] [Accepted: 06/03/2022] [Indexed: 11/16/2022]
Abstract
CONTEXT To date, little is known about palliative care (PC) awareness and utilization in low- and middle-income countries (LMICs) in Asia. OBJECTIVES This study aimed to investigate PC awareness and its predictors, utilization of PC services, and perceived utilization barriers among advanced cancer patients from select hospitals in Asian LMICs. METHODS This cross-sectional study analyzed data of 759 advanced cancer patients at major hospitals of four LMICs in Asia (i.e., Bangladesh, Philippines, Sri Lanka, and Vietnam). The predictors of PC awareness were investigated using multivariable logistic regression. RESULTS Overall PC awareness was 30.8% (n = 234). Patients with higher education (OR = 1.0; CI = 1.0,1.1), from upper-middle or high-income households (compared to low-income) (OR = 2.0; CI = 1.2,3.3), awareness of disease severity (OR = 1.5; CI = 1.0,2.2), and higher pain severity (OR = 1.1; CI = 1.0,1.2) had higher odds of PC awareness. Compared to patients who perceived themselves as being very informed about disease trajectory, those who were unsure (OR = 0.5; CI = 0.3,0.8) or uninformed (OR = 0.5; CI = 0.3,0.9) had lower odds of PC awareness. The PC utilization rate was 35.0% (n = 82) among those with PC awareness, and 47.8% (n = 66) among patients recommended PC by a healthcare professional (n = 138). The most cited PC utilization barriers were currently receiving anti-cancer treatment (n = 43; 33.9%), and having insufficient information about PC (n = 41; 32.3%). CONCLUSION The low awareness of PC services in these major hospitals in Asian LMICs highlights that more effort may be required to promote the awareness of PC in this region. The efforts should especially focus on those from disadvantaged groups to reduce the gap in PC awareness.
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Affiliation(s)
- Semra Ozdemir
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore.
| | - Jia Jia Lee
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore
| | - Grace Meijuan Yang
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care (M.Y.), National Cancer Centre Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore
| | | | | | | | - Lubna Mariam
- Department of Radiation Oncology (L.M.), National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Rubayat Rahman
- Department of Palliative Medicine (R.R.), Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Eric Finkelstein
- Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore
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Benjanuwattra J, Abdelnabi M, Rahman R, Jenkins LA. A Massive Right Atrial Mass in Chronic Myelogenous Leukaemia: A Case Report and Literature Review. Eur J Case Rep Intern Med 2022; 9:003499. [PMID: 36093304 PMCID: PMC9451512 DOI: 10.12890/2022_003499] [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: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Right atrial masses are rare and diagnosis can be difficult unless histopathological specimens are obtained. In addition, the clinical course is not well documented, thereby making diagnosis and management challenging. The mass can be associated with haemodynamic instability with the potential to cause obstructive shock and embolism. We present the case of a young woman with untreated chronic myelogenous leukaemia with a massive haemodynamically significant right atrial mass. The usefulness of multimodality imaging and a multidisciplinary approach for diagnosing and treating this condition is highlighted.
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Affiliation(s)
- Juthipong Benjanuwattra
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Mahmoud Abdelnabi
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA; Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Dept., Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Rubayat Rahman
- Department of Cardiology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Leigh Ann Jenkins
- Department of Cardiology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Woon E, Rahman R, Ibeto L, MacLaran K, Norman-Taylor J, Nikolaou D. P-703 Developing individualized treatment strategies using detailed subgroup analysis to optimise pregnancy outcomes for women 40 and above. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What are the prognostic factors and treatment strategies for women 40 and above within different ovarian reserve subgroups?
Summary answer
Women in each ovarian reserve subgroup have different prognostic factors of pregnancy success and specific treatment strategies are needed for each subgroup.
What is known already
The number of women 40 and above seeking subfertility treatment is increasing and many are willing to undergo treatment despite extremely poor prognosis. POSEIDON criteria suggested the usage of ovarian reserve and female age as a basis for the study of the management of women in different prognostic categories. However, this classification may not be detailed enough to lead to specific recommendations for individualised management in women 40 and above, as there is rapid decline of oocyte quality and quantity. Large observational studies may lack finer detail due to challenges in recruiting women within different ovarian reserve subgroups.
Study design, size, duration
We carried out a detailed retrospective analysis of 382 IVF/ICSI cycles for 253 women from January 2019 to December 2021 in a special clinical and academic program for reproductive ageing and fertility. Inclusion criteria were all women who had IVF/ICSI cycles aged 40 and over. Analysis was done for all fresh cycles including cancelled cycles, failed fertilization, no eggs collected and embryo arrest. Cycles resulting in freezing of all embryos were excluded in analysis.
Participants/materials, setting, methods
The participants were divided into three main subroups: Group A, “normal ovarian reserve” (AMH 2.5-29.9pmol/l, n = 271 cycles); Group B, “extremely poor ovarian reserve” (AMH <2.5pmol/l, n = 85 cycles); and Group C “extremely high ovarian reserve” (PCOS or AMH ≥30.0pmol/l, n = 26 cycles). Chi-square and Mann-Whitney U tests were used to compare pregnant and non-pregnant groups for nominal and continuous data respectively. Multi-variate logistic regression was performed when indicated. All descriptive statistics are stated in median and percentages.
Main results and the role of chance
In Group A, univariate analysis showed that pregnancies were associated with lower female (41 vs 42) and male age (40 vs 43.5), administering long agonist versus antagonist protocol (73% vs 27%), the absence of androgen pretreatment (12% vs 88%), higher oestradiol level (7681pmol/l vs 6114pmol/l), higher number of oocytes retrieved (8 vs 4) and normally fertilized (4 vs 3), and embryo transfer on day 3 compared to 2 or 5 (all p < 0.05). The use of combined FSH/LH vs FSH only for ovarian stimulation given for 12 days at 300IU daily, higher endometrial thickness (11.3mm vs 10.6mm), IVF versus ICSI (65% vs 35%), and addition of subcutaneous progesterone for luteal support versus vaginal progesterone only (51% vs 43%) were trending towards but were not significant (p > 0.05). Multivariate logistic regression analysis revealed lower female and male age, less number of IVF cycles, and higher number of embryos transferred as independent factors contributing to pregnancy. In Group B, significant predictors of pregnancy included younger female age, higher gravidity, previous successful IVF and higher number of eggs fertilized (p < 0.05). In Group C, factors that contributed to positive pregnancy outcome included antagonist cycles versus agonist and usage of FSH and LH versus FSH alone (p > 0.05).
Limitations, reasons for caution
The retrospective nature of the study design limits control of potential confounding variables. Although there were clear trends, in a few sub-categories there were insufficient numbers to reach statistical significance. Continuing data collection is necessary to achieve adequate power for smaller groups especially Group B and C.
Wider implications of the findings
This detailed analysis will allow us to better understand the prognostic factors in women 40 and above, especially for women with extremes of ovarian reserve, who may benefit substantially from individualised care. We recommend standardisation of data collection and development of artificial intelligence algorithms to streamline management in the future.
Trial registration number
N/A
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Affiliation(s)
- E.V Woon
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
- Imperial College London, Department of Metabolism- Digestion and Reproduction , London, United Kingdom
| | - R Rahman
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
| | - L Ibeto
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
| | - K MacLaran
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
| | - J Norman-Taylor
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
| | - D Nikolaou
- Chelsea and Westminster Hospital NHS Foundation Trust, Assisted Conception Unit , London, United Kingdom
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Arora S, Singh GK, Das P, Rahman R, Bellad P, Shrivastav R, Bahuguna A, Sapra D, Gupta A. A study of COVID‐19 vaccine (Covishield) induced dermatological adverse effects from India. J Eur Acad Dermatol Venereol 2022; 36:e402-e404. [DOI: 10.1111/jdv.17951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/25/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022]
Affiliation(s)
- S Arora
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - G K Singh
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - P Das
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - R Rahman
- Department of Physiology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - P Bellad
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | | | - Amit Bahuguna
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - Devyani Sapra
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
| | - Akanksha Gupta
- Department of Dermatology Base Hospital Delhi Cantt & Army College of Medical Sciences New Delhi India
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14
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Teo I, Bhaskar A, Ozdemir S, Malhotra C, Hapuarachchi T, Joad AK, Manalo MF, Mariam L, Hong NX, Palat G, Rahman R, Tuong PN, Finkelstein EA. Perceived Stigma and Its Correlates Among Asian Patients with Advanced Cancer: A Multi-Country APPROACH Study. Psychooncology 2022; 31:938-949. [PMID: 35048471 DOI: 10.1002/pon.5882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/29/2021] [Accepted: 12/30/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Perceived cancer-related stigma can affect mental health and potentially treatment choices for patients with cancer. Nevertheless, perceived stigma is not very well understood in Asia. This study investigated across six developing Asian countries: 1) the prevalence of perceived stigma among advanced cancer patients, 2) its risk factors, and 3) its association with patient treatment preferences. METHODS This cross-sectional study recruited patients receiving oncology care across major hospitals in Bangladesh, China, India, Philippines, Sri Lanka and Vietnam. Participants (N = 1358) were adults diagnosed with stage IV metastatic solid cancer who completed self-reported surveys. Multi-variable logistic regression and ordered logit models examined the associations with perceived stigma and variables of interest. RESULTS Across the countries, 35%, 95% CI [32%, 38%] of patients reported experiencing at least one facet of cancer-related stigma often or always, while 60% [57%, 63%] reported it occurring occasionally. Top-endorsed facets of perceived stigma across the Asian countries suggest a distinct pattern. Having knowingly engaged in health-risk behaviours (OR = 2.03-2.24, 95% CI [1.14-1.19, 3.43-4.41]), unemployment (2.64 [1.67, 4.19]) and body image change (1.57 [1.00, 2.45]) were associated with higher odds of perceived stigma, while time mitigated perceived stigma (0.49-0.65 [0.30-0.45, 0.76-0.92]). Perceived stigma was associated with lower odds of preference for life-extending treatments, although the associations did not hold up in the adjusted model. CONCLUSIONS Perceived stigma is unique among Asian advanced cancer patients. Stigma is important to assess and address, taking into consideration the various sociodemographic, clinical and psychological factors of cancer patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
| | - Adithya Bhaskar
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | | - Anjum Khan Joad
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
| | - Maria Fidelis Manalo
- Supportive Oncology & Palliative Care, Augusto P. Sarmiento Cancer Institute, The Medical City, Philippines
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Ning Xiao Hong
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Gayatri Palat
- Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India
| | - Rubayat Rahman
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
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15
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Ozdemir S, Malhotra C, Teo I, Tan SNG, Wong WHM, Joad ASK, Hapuarachchi T, Palat G, Tuong PN, Bhatnagar S, Rahman R, Mariam L, Ning X, Finkelstein EA. Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study. MDM Policy Pract 2021; 6:23814683211061398. [PMID: 34820528 PMCID: PMC8606935 DOI: 10.1177/23814683211061398] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 07/08/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 patients with stage IV solid cancer. Multinomial logistic regressions were used to analyze associations of patient characteristics with decision-making roles. Multivariate regressions were used to analyze associations of decision-making roles with quality of life and care. Results. The most common perceived-role was no patient involvement. Most patients (73%) reported roles consistent with their preferences. Being male, nonminority, higher educated, aware of advanced cancer diagnosis, and knowledge of cancer diagnosis for ≥1 year were associated with higher levels of patient involvement in decision-making. Compared to no patient involvement, joint decision-making (together with physicians/family) was associated with higher social (β = 2.49, P < 0.01) and spiritual (β = 2.64, P < 0.01) well-being, and better quality of physician communication (β = 9.73, P < 0.01) and care coordination (β = 13.96, P < 0.01) while making decisions alone was associated with lower emotional (β = -1.43, P < 0.01), social (β = -2.39, P < 0.01), and spiritual (β = -2.98, P < 0.01) well-being. Conclusions. Findings suggest that a substantial number of advanced cancer patients were not (and preferred not to be) involved in decision-making. Despite this finding, joint decision-making together with physicians/family was associated with better quality of life and care. Implications. Physicians should explain the benefits of shared decision making to patients and encourage participation in decision-making, while ensuring that patients feel supported and do not find decision-making overwhelming.
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Affiliation(s)
- Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | | | | | - Anjum S Khan Joad
- Department of Palliative Care, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| | | | - Gayatri Palat
- Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India
| | | | - Sushma Bhatnagar
- Palliative Access Program, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India
| | - Rubayat Rahman
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Lubna Mariam
- Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Xiaohong Ning
- Department of Geriatrics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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16
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Teo I, Ozdemir S, Malhotra C, Yang GM, Ocampo RR, Bhatnagar S, Hapuarachchi T, Joad AK, Mariam L, Palat G, Rahman R, Finkelstein EA. High anxiety and depression scores and mental health service use among South Asian advanced cancer patients: A multi-country study. J Pain Symptom Manage 2021; 62:997-1007. [PMID: 33872721 DOI: 10.1016/j.jpainsymman.2021.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of anxiety and depression and mental health service use among advanced cancer patients in South Asia. OBJECTIVES To examine among South Asian advanced cancer patients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use. METHODS This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer and aware they had cancer. Participants' high anxiety and depression scores (using clinically-relevant Hospital Anxiety and Depression Scale threshold of >10), sociodemographic characteristics, patient-perceived cancer stigma and mental health service use were assessed. RESULTS In the overall sample (N = 1140), 54% met threshold for high anxiety and/or depression scores: 32% reported high anxiety scores and 47% reported high depression scores. Symptom burden (OR's [95% CI's] = 1.09-1.13 [1.05-1.09, 1.12-1.17]) and perceived stigma (1.11-1.16 [1.06-1.11, 1.16-1.22]) were statistically significantly associated with high anxiety and depression scores. Of the patients with high anxiety and/or depression scores (n = 617), 97% had not received mental health services, and 38% of them indicated they were open to a referral. CONCLUSION High, clinically-relevant anxiety and depression scores are common among South Asian advanced cancer patients. Efforts should be made to alleviate psychological morbidity, including providing greater access to supportive/palliative medicine teams or mental health services.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore.
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Grace Meijuan Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore
| | - Remee R Ocampo
- Department of Psychology, Singapore Management University, Singapore
| | - Sushma Bhatnagar
- Department of Oncology-Anaesthesiology and Palliative Medicine, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anjum Khan Joad
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
| | - Lubna Mariam
- Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh
| | - Gayatri Palat
- Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India
| | - Rubayat Rahman
- Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore
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Payne A, Alfa-Wali M, Rahman R, Bullingham R, Vamadeva S. 596 Redeployment of Surgical Trainees to Intensive Care During the COVID-19 Pandemic: Evaluation of the Impact on Training and Wellbeing. Br J Surg 2021. [PMCID: PMC8524572 DOI: 10.1093/bjs/znab259.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aim The aim of this study was to evaluate the impact of redeployment of surgical trainees to intensive care units (ICUs) during the COVID-19 pandemic in terms of transferrable technical and nontechnical skills and wellbeing. Method This was a survey study consisting of a 23-point questionnaire. The study involved senior house officer level surgical trainees that had been redeployed to the (ICU) across all hospitals in London during the COVID-19 pandemic. The survey was sent to 90 surgical trainees. Thirty-two trainees responded to the questionnaire and were included in the study results. Results All respondents spent between 4 and 8 weeks working in ICU. Prior to redeployment, 78% of participants had previous experience of ICU or an affiliated specialty, and >90% had attended at least 1 educational course with relevance to ICU. There were statistically significant increases in confidence performing central venous cannulation and peripheral arterial catheterisation (p < 0.05). With regards to clinical skills, respondents reported feeling more confident managing ventilated patients, patients on noninvasive ventilation, dialysis, and circulatory failure patients after working in ICU. Respondents (97%) felt that the experience would be beneficial to their future careers but 53% felt the redeployment had a negative impact on their mental health. Conclusions Redeployment of surgical trainees to ICU led to increased confidence in a number of technical and nontechnical skills. However, proactive interventions are needed for training surgeons with regard to their psychological wellbeing in these extraordinary circumstances and to improve workforce planning for future pandemics.
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Affiliation(s)
- A Payne
- Barts Health NHS Trust, London, United Kingdom
| | - M Alfa-Wali
- Imperial Health NHS Trust, London, United Kingdom
| | - R Rahman
- Barts Health NHS Trust, London, United Kingdom
| | | | - S Vamadeva
- Guy's and St Thomas' NHS Trust, London, United Kingdom
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18
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Ortega Franco A, Adamson-Raieste A, Rahman R, Pihlak R, Peters N, Scott JA, Aruketty S, Thomson C, Dransfield S, Henshaw A, Ward A, Cutts T, Carter L, Thistlethwaite F, Cook N, Graham D, Stevenson J, Krebs M. 44P Value of comprehensive genomic profiling in pre-screening patients for NTRK fusion in STARTRK2 trial: Single centre experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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19
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Banerjee S, Grochot R, Shinde R, Lima J, Krebs M, Rahman R, Little M, Tunariu N, Curcean A, Badham H, Mahmud M, Turner A, Parmar M, Yap C, Minchom A, Lopez J, de Bono J, Banerji U. 725MO Phase I study of the combination of the dual RAF/MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Results of efficacy in low grade serous ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1168] [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: 11/30/2022] Open
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20
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Billy Graham Mariam N, Rahman R, Mistry H, Aruketty S, Adamson-Raieste A, Church M, Scott JA, Carter L, Thistlethwaite F, Krebs M, Cook N, Graham D. 1849P Ethnicity and socioeconomic deprivation in early phase clinical trials in a UK tertiary referral centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.737] [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: 10/20/2022] Open
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21
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Browne I, Chew S, Fennelly D, Crown J, Murray H, Rahman R, McCaffrey J, Kelly C, Osman N. 57P The efficacy and safety of pembrolizumab in advanced cervical cancer: A real-world treatment study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.544] [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: 11/29/2022] Open
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Abstract
BACKGROUND Biomarkers that predict treatment response are the foundation of precision medicine in clinical decision-making and have the potential to significantly improve the efficiency of clinical trials. Such biomarkers may be identified before clinical testing but many trials enroll unselected populations. We hypothesized that time-varying treatment effects in unselected trials may result from identifiable responder subpopulations that may have associated biomarkers. MATERIALS AND METHODS We first simulated scenarios of clinical trials with biomarker populations of varying prevalence and prognostic and predictive associations to illustrate the impact of subgroup-specific effects on overall population estimates. To show a real-world example of time-dependent treatment effects resulting from a prognostic and predictive biomarker, we re-analyzed data from a published clinical trial (RTOG, Radiation Therapy Oncology Group, 9402). We then demonstrated a quantitative framework to fit survival data from clinical trials using statistical models incorporating known estimates of biomarker prevalence and prognostic value to prioritize predictive biomarker hypotheses. RESULTS Our simulation studies demonstrate how biomarker subgroups that are both predictive and prognostic can manifest as time-dependent treatment effects in overall populations. RTOG 9402 provides a representative example where 1p/19q co-deletion and IDH mutation biomarker-specific effects led to time-varying treatment effects and a considerable deviation from proportional hazards in the overall trial population. Finally, using biomarker data from The Cancer Genome Atlas, we were able to generate statistical models that correctly identified and prioritized a commonly used biomarker through retrospective analysis of published clinical trial data. CONCLUSIONS Biomarkers that are both predictive and prognostic can result in characteristic changes in survival results. Retrospectively analyzing survival data from clinical trials may highlight potential indications for which an underlying predictive biomarker may be found.
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Affiliation(s)
- R Rahman
- Department of Radiation Oncology, Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston; Department of Radiation Oncology, Harvard Medical School, Boston
| | - S Ventz
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston
| | - G Fell
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
| | - A M Vanderbeek
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - L Trippa
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston
| | - B M Alexander
- Department of Radiation Oncology, Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston; Department of Radiation Oncology, Harvard Medical School, Boston.
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Uddin MJ, Rahman AF, Rahman S, Momenuzzaman NM, Rahman A, Majumder AS, Mohibullah AM, Chowdhury AH, Malik FN, Ahsan SA, Mohsin K, Haq MM, Chowdhury AW, Sohrabuzzaman AM, Rahman M, Chakraborty B, Rahman R, Khan SR, Khan KN, Reza AM, Hussain KS, Rashid M, Choudhury AK, Karmakar KK, Ali Z, Alam N, Rahman Z, Kabir CS, Banik D, Dutta A, Badiuzzaman M, Islam AW, Sium AH, Hossain MD, Ahmed N, Jahan J, Islam MS, Arefin MM, Cader FA, Banerjee SK, Hoque H, Shofiuddin M, Selim A, Das PK, Ahmed M, Dutto B, Alam S, Paul GK, Paul SK, Azam MG. National Clinical Guidance for the Management of Cardiovascular Intervention in the COVID-19 Pandemic: From Bangladesh Society of Cardiovascular Interventions (BSCI). Mymensingh Med J 2020; 29:488-494. [PMID: 32506111] [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
Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.
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Affiliation(s)
- M J Uddin
- Professor MG Azam, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh; E-mail:
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Keihani S, Kluever V, Mandad S, Bansal V, Rahman R, Fritsch E, Gomes LC, Gärtner A, Kügler S, Urlaub H, Wren JD, Bonn S, Rizzoli SO, Fornasiero EF. The long noncoding RNA neuroLNC regulates presynaptic activity by interacting with the neurodegeneration-associated protein TDP-43. Sci Adv 2019; 5:eaay2670. [PMID: 31897430 PMCID: PMC6920028 DOI: 10.1126/sciadv.aay2670] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/23/2019] [Indexed: 05/26/2023]
Abstract
The cellular and the molecular mechanisms by which long noncoding RNAs (lncRNAs) may regulate presynaptic function and neuronal activity are largely unexplored. Here, we established an integrated screening strategy to discover lncRNAs implicated in neurotransmitter and synaptic vesicle release. With this approach, we identified neuroLNC, a neuron-specific nuclear lncRNA conserved from rodents to humans. NeuroLNC is tuned by synaptic activity and influences several other essential aspects of neuronal development including calcium influx, neuritogenesis, and neuronal migration in vivo. We defined the molecular interactors of neuroLNC in detail using chromatin isolation by RNA purification, RNA interactome analysis, and protein mass spectrometry. We found that the effects of neuroLNC on synaptic vesicle release require interaction with the RNA-binding protein TDP-43 (TAR DNA binding protein-43) and the selective stabilization of mRNAs encoding for presynaptic proteins. These results provide the first proof of an lncRNA that orchestrates neuronal excitability by influencing presynaptic function.
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Affiliation(s)
- S. Keihani
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
| | - V. Kluever
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
| | - S. Mandad
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
- Department of Clinical Chemistry, University Medical Center Göttingen, 37077 Göttingen, Germany
| | - V. Bansal
- Institute of Medical Systems Biology, Center for Molecular Neurobiology (ZMNH), UKE, 20246 Hamburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - R. Rahman
- Institute of Medical Systems Biology, Center for Molecular Neurobiology (ZMNH), UKE, 20246 Hamburg, Germany
| | - E. Fritsch
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
| | - L. Caldi Gomes
- Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), 37075 Göttingen, Germany
| | - A. Gärtner
- VIB Center for the Biology of Disease and Center for Human Genetics, KU Leuven, Leuven, Belgium
| | - S. Kügler
- Department of Neurology, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - H. Urlaub
- Department of Clinical Chemistry, University Medical Center Göttingen, 37077 Göttingen, Germany
- Bioanalytical Mass Spectrometry Group, Max Planck Institute of Biophysical Chemistry, 37077 Göttingen, Germany
| | - J. D. Wren
- Department of Genes and Human Disease, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - S. Bonn
- Institute of Medical Systems Biology, Center for Molecular Neurobiology (ZMNH), UKE, 20246 Hamburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - S. O. Rizzoli
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), 37075 Göttingen, Germany
| | - E. F. Fornasiero
- Department of Neuro- and Sensory Physiology, University Medical Center Göttingen, Excellence Cluster Multiscale Bioimaging, 37073 Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), 37075 Göttingen, Germany
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Abstract
The initial events in cardiogenic pulmonary edema involve hemodynamic pulmonary congestion with high capillary pressures. This causes increased fluid transfer out of capillaries into the interstitium and alveolar spaces. High capillary pressures can also cause barrier disruption which increases permeability and fluid transfer into the interstitium and alveoli. Fluid in alveoli alters surfactant function and increases surface tension. This can lead to more edema formation and to atelectasis with impaired gas exchange. Patients with barrier disruption have increased levels of surfactant protein B in the circulation, and these levels often remain high after the initial clinical improvement. Routine clinical assessment may not identify patients with increased extravascular fluid in the lungs; pulmonary ultrasound can easily detect pulmonary edema in patients with acute decompensation and in patients at risk for decompensation. Studies using serial pulmonary ultrasound could help characterize patients with cardiogenic pulmonary edema and help identify subgroups who need alternative management. The conventional management of cardiogenic pulmonary edema usually involves diuresis, afterload reduction and in some cases noninvasive ventilation to reduce the work of breathing and improve oxygenation. Patients with persistent symptoms, abnormal chest x-rays and diuretic resistance might benefit from alternative approaches to management. These could include beta agonists and pentoxifylline which warrant more study in patients with cardiogenic pulmonary edema.
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Affiliation(s)
- Logan Dobbe
- Department of Graduate Medical Education, Madigan Army Medical Center, Tacoma, Washington
| | - Rubayat Rahman
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Mohamed Elmassry
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Pablo Paz
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
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Smith S, Serra R, Rowlinson J, Gorelick N, Veal G, Shakesheff K, Brem H, Grundy R, Tyler B, Rahman R. P11.60 Neurosurgical delivery of the poly ADP ribose polymerase-1 inhibitor olaparib from a thermo-responsive biodegradable paste potentiates radiotherapy and prolongs survival. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
There has been considerable interest in repurposing the poly ADP ribose polymerase inhibitor and purported radiosensitiser olaparib (Lynparza), with a recent dose escalation study of olaparib plus temozolomide in recurrent GBM showing good tolerance. Due to systemic therapy-associated caveats such as dose-limiting toxicities and blood-brain-barrier penetration, here we assess localised post-surgical delivery of olaparib from our previously developed PLGA/PEG thermo-sensitive biodegradable paste.
MATERIAL AND METHODS
Metabolic and clonogenic assays were used to assess effects on proliferation and clonal growth upon in vitro glioma exposure to olaparib. Flow cytometry and Annexin V/Propidium iodide were used to determine apoptosis. The 9L high-grade glioma orthotopic allograft model was utilised to assess survival upon intra-cavity olaparib delivery.
RESULTS
Metabolic and clonogenic assays revealed impaired proliferation and clonal growth respectively, upon acute exposure of high-grade glioma cells to olaparib (3–5µM), an effect dramatically potentiated with 3Gy radiation. Flow cytometry of Annexin V+/Propidium iodide+ rodent and human high-grade glioma cells, revealed a significant cell proportion increase at late stage apoptosis when exposed to 2–3µM olaparib and 3Gy radiation (relative to untreated, olaparib alone or radiation alone). A high-grade glioma orthotopic allograft study revealed a significant overall survival benefit of locally-delivered 10% and 20% w/w (drug:polymer ratio) olaparib via PLGA/PEG paste post-surgery with adjuvant radiotherapy, compared to surgery/oral temozolomide/radiotherapy (GBM standard-of-care) and surgery/systemic olaparib (95 vs. 44 vs. 30 days respectively). A more pronounced survival benefit, as measured by number of animals surviving long-term, was observed with combined PLGA/PEG/olaparib/temozolomide/radiotherapy or PLGA/PEG/olaparib/etoposide/radiotherapy, relative to standard-of-care (95 vs. 44 days). Clinical correlation was determined using RNAseq data from 10 GBM patients, showing significantly elevated levels of apoptosis-inducing factor-1 in 5-aminolevulinic acid (5ALA)+ fluorescence-activated cell sorted populations (i.e. purified tumour cells from the invasive margin), relative to 5ALA- cells, confirming PARP-1 activity in infiltrative tumour cells.
CONCLUSION
Collectively our data supports a clinical rationale for localised olaparib delivery with adjuvant radiotherapy.
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Affiliation(s)
- S Smith
- University of Nottingham, Nottingham, United Kingdom
| | - R Serra
- Johns Hopkins University, Baltimore, MD, United States
| | - J Rowlinson
- University of Nottingham, Nottingham, United Kingdom
| | - N Gorelick
- Johns Hopkins University, Baltimore, MD, United States
| | - G Veal
- Newcastle University, Newcastle, United Kingdom
| | - K Shakesheff
- University of Nottingham, Nottingham, United Kingdom
| | - H Brem
- Johns Hopkins University, Baltimore, MD, United States
| | - R Grundy
- University of Nottingham, Nottingham, United Kingdom
| | - B Tyler
- Johns Hopkins University, Baltimore, MD, United States
| | - R Rahman
- University of Nottingham, Nottingham, United Kingdom
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Rowlinson J, McCrorie P, Smith S, Barrett D, Kim D, Grundy R, Scurr D, Rahman R. P11.62 Brain distribution models to select polymer-delivered drugs for the intra-cavity treatment of malignant glioma. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Conventional oral or intravenous chemotherapy distributes drugs to the whole body whereby systemic toxicity to healthy parts of the body (e.g. bone marrow failure) limits the maximum dose that can be achieved in the brain. This presents a particular concern for CNS tumours where the blood-brain-barrier (BBB) restricts drug influx from the circulation. The ability to deliver chemotherapy locally at the tumour site offers the opportunity to target residual cancer cells post-surgery whilst minimising systemic toxicity. We have developed a poly(lactic-co-glycolic acid)/poly(ethylene glycol) (PLGA/PEG) polymer matrix that forms a porous paste at room temperature when mixed with chemotherapy-containing saline, solidifying only at body temperature, with close apposition to the irregular surgical cavity. It is important that we can observe whether the drugs released from PLGA/PEG can penetrate brain parenchyma beyond the surgical resection margin at therapeutic doses. Currently the only way to measure the distribution of drugs in the body is to inject radioactive drugs into an animal. We aim to establish drug distribution parameters using label-free mass spectrometry imaging methods, prior to selection of drug formulations for clinically-relevant in vivo models. Drugs that penetrate the brain the furthest will be identified as good candidates for localised brain cancer drug delivery using PLGA/PEG paste.
MATERIAL AND METHODS
Diffusion rates were measured by examining the proportion of olaparib, dasatnib, carboplatin, etoposide, paclitaxel and gemcitabine at 2mg/ml concentration, which passes through 1mm slices of rat brain tissue within Franz cell chambers over a 6 hour period. The spatio-temporal distribution of label-free olaparib and dasatinib within mouse brain homogenate was quantitatively measured using innovative 3D OrbiSIMS, a hybrid time-of-flight / OrbitrapTM secondary ion mass spectrometer.
RESULTS
Within the Franz cell model, carboplatin and gemcitabine showed the highest diffusion rate diffusion at 16.4 and 6.53 µg/cm2/h respectively whereas olaparib, etoposide and paclitaxel were relatively poorly diffused at 1.87, 3.82 and 2.27 µg/cm2/h respectively. The minimum threshold of OrbiSIMS detection for label-free olaparib and dasatinib ions was 0.025 mg/ml and 0.2 mg/ml respectively throughout brain homogenate.
CONCLUSION
This study demonstrates different diffusion rates through brain tissue, between label-free chemotherapy drugs of distinct chemistries, with highest diffusion rates observed for carboplatin and gemcitabine. We also demonstrate label-free detection of olaparib and dasatinib using the innovative 3D OrbiSIMS method. These models will facilitate the rapid identification of agents most amenable for localised biomaterial-based chemotherapy delivery with high brain penetrance.
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Affiliation(s)
- J Rowlinson
- University of Nottingham, UK, Nottingham, United Kingdom
| | - P McCrorie
- University of Nottingham, UK, Nottingham, United Kingdom
| | - S Smith
- University of Nottingham, UK, Nottingham, United Kingdom
| | - D Barrett
- University of Nottingham, UK, Nottingham, United Kingdom
| | - D Kim
- University of Nottingham, UK, Nottingham, United Kingdom
| | - R Grundy
- University of Nottingham, UK, Nottingham, United Kingdom
| | - D Scurr
- University of Nottingham, UK, Nottingham, United Kingdom
| | - R Rahman
- University of Nottingham, UK, Nottingham, United Kingdom
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Rahman R, Clark MD, Collins Z, Traore F, Dioukhane EM, Thiam H, Ndiaye Y, De Jesus EL, Danfakha N, Peters KE, Komarek T, Linn AM, Linn PE, Wallner KE, Charles M, Hasnain M, Peterson CE, Dykens JA. Cervical cancer screening decentralized policy adaptation: an African rural-context-specific systematic literature review. Glob Health Action 2019; 12:1587894. [PMID: 30938248 PMCID: PMC6450494 DOI: 10.1080/16549716.2019.1587894] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 01/27/2023] Open
Abstract
Background: Worldwide, nearly 570,000 women are diagnosed with cervical cancer each year, with 85% of new cases in low- and middle-income countries. The African continent is home to 35 of 40 countries with the highest cervical cancer mortality rates. In 2014, a partnership involving a rural region of Senegal, West Africa, was facing cervical cancer screening service sustainability barriers and began adapting regional-level policy to address implementation challenges. Objective: This manuscript reports the findings of a systematic literature review describing the implementation of decentralized cervical cancer prevention services in Africa, relevant in context to the Senegal partnership. We report barriers and policy-relevant recommendations through Levesque’s Patient-Centered Access to Healthcare Framework and discuss the impact of this information on the partnership’s approach to shaping Senegal’s regional cervical cancer screening policy. Methods: The systematic review search strategy comprised two complementary sub-searches. We conducted an initial search identifying 4272 articles, then applied inclusion criteria, and ultimately 19 studies were included. Data abstraction focused on implementation barriers categorized with the Levesque framework and by policy relevance. Results: Our findings identified specific demand-side (clients and community) and supply-side (health service-level) barriers to implementation of cervical cancer screening services. We identify the most commonly reported demand- and supply-side barriers and summarize salient policy recommendations discussed within the reviewed literature. Conclusions: Overall, there is a paucity of published literature regarding barriers to and best practices in implementation of cervical cancer screening services in rural Africa. Many articles in this literature review did describe findings with notable policy implications. The Senegal partnership has consulted this literature when faced with various similar barriers and has developed two principal initiatives to address contextual challenges. Other initiatives implementing cervical cancer visual screening services in decentralized areas may find this contextual reporting of a literature review helpful as a construct for identifying evidence for the purpose of guiding ongoing health service policy adaptation.
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Affiliation(s)
- R Rahman
- a University of Toledo College of Medicine and Life Sciences , Toledo , OH , USA
| | - M D Clark
- b Library of the Health Sciences , University Library, University of Illinois at Chicago , Chicago , IL , USA.,c Department of Medical Education, College of Medicine , University of Illinois at Chicago , Chicago , IL , USA
| | - Z Collins
- d Department of Family Medicine, Institute for Health Research and Policy , University of Illinois at Chicago (UIC) , Chicago , IL , USA
| | - F Traore
- e Region medical de Kedougou , Bureau de la santé de la reproduction, prevention transmission mere enfant du VIH-SIDA , Kedougou , Senegal
| | | | - H Thiam
- g Region medical de Kedougou , Bureau régional de la formation, de la supervision et de la recherche , Kedougou , Senegal
| | - Y Ndiaye
- h Département de Recherche , Sénégal Ministère de la Santé et l'Action Sociale , Dakar , Sénégal
| | - E L De Jesus
- i School of Public Health (SPH) , University of Illinois at Chicago (UIC) , Chicago , IL , USA
| | | | - K E Peters
- k School of Public Health, Division of Community Health Sciences, Illinois Prevention Research Center, Institute for Health Research and Policy , University of Illinois at Chicago (UIC) , Chicago , IL , USA
| | - T Komarek
- l Uniformed Services University , Bethesda , MD , USA
| | - A M Linn
- m School of Public Health, Center for Communications Programs , Johns Hopkins University , Baltimore , MD , USA
| | - P E Linn
- n Logistics Management Institute , Tysons , VA , USA
| | - K E Wallner
- o Elizabeth Glaser Pediatric AIDS Foundation , Washington , DC , USA
| | - M Charles
- p Department of Internal Medicine , University of Illinois at Chicago , Chicago , IL , USA
| | - M Hasnain
- q Department of Family Medicine , University of Illinois at Chicago College of Medicine , Chicago , IL , USA
| | - C E Peterson
- r School of Public Health, Division of Epidemiology & Biostatistics, UI Cancer Center , University of Illinois at Chicago (UIC) , Chicago , IL , USA
| | - J A Dykens
- s Department of Family Medicine, Center for Global Health, Institute for Health Research and Policy, Cancer Center , University of Illinois at Chicago (UIC) , Chicago , IL , USA
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Nugent K, Dobbe L, Rahman R, Elmassry M, Paz P. Lung morphology and surfactant function in cardiogenic pulmonary edema: a narrative review. J Thorac Dis 2019; 11:4031-4038. [PMID: 31656679 DOI: 10.21037/jtd.2019.09.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The conventional analysis of acute cardiogenic pulmonary edema involves the development of high pulmonary capillary pressures resulting in hydrostatic gradients for fluid flux out of capillaries into the interstitial space and alveolar spaces. However, some patients respond poorly to diuretic management. The PubMed database was searched to identify experimental studies on pulmonary edema in animals, experimental studies on surfactant function, including patients with pulmonary edema, and clinical studies reporting barrier dysfunction and/or injury in patients with acute pulmonary edema. Studies with animal models demonstrate that high capillary pressures can cause barrier disruption in alveolar capillary units which increases permeability and the transfer of fluid and protein into lung parenchyma. Fluid in alveolar spaces alters surfactant function which increases fluid flux out of capillaries into the lung parenchyma secondary to larger transcapillary hydrostatic gradients. Patients with acute cardiogenic pulmonary edema have increased levels of surfactant protein B in their plasma which reflect barrier disruption and increased levels of tumor necrosis factor alpha which reflect acute tissue injury. Increased surfactant protein B plasma levels are associated with abnormal gas exchange in patients with chronic heart failure. Patients with exercise-induced left ventricular dysfunction have increased levels of surfactant protein B after short periods of exercise. Pathology studies in patients with chronic heart failure have found increased connective tissue in alveolar capillary units and increased numbers of type II alveolar cells, and these changes represent an adaptive response in these patients. Clinicians need to consider the possibility of barrier dysfunction and disruption in patients with both acute and chronic pulmonary edema and understand that diuresis may have a limited effect on symptoms in some patients.
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Affiliation(s)
- Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Logan Dobbe
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Rubayat Rahman
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Mohamed Elmassry
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Pablo Paz
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Tabrizi S, Rahman R, Cagney D, Aizer A, Tanguturi S, Arvold N, Reardon D, Lee E, Nayak L, Rinne M, Ligon K, Wen P, Alexander B. Impact of Delay in Initiation of Radiation Therapy in Newly Diagnosed Glioblastoma Patients after Gross Total Resection. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Rahman R, Sridharan V, Hanna G, Chau N, Lorch J, Kass J, Annino D, Goguen L, Uppaluri R, Haddad R, Tishler R, Margalit D, Schoenfeld J, Huang R. Predicting PD-L1 Expression using Radiomics in Oropharyngeal Cancer Patients Treated with Definitive Radiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1054] [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: 10/28/2022]
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Golbek A, Reafsnyder S, Rancourt D, Kelly P, Rahman R, Weiss E. Peppermint Oil Fails to Improve Exercise Performance. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.177] [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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Weiss E, Wroble K, Trott M, Schweitzer G, Rahman R, Kelly P. Low-carbohydrate, Ketogenic Diet Impairs Anaerobic Exercise Performance. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.176] [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: 11/30/2022]
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Jaaks P, Vis D, Barthorpe A, Aben N, Van der Meer D, Lightfoot H, Michaut M, Rahman R, Wessels L, Garnett M. PO-023 A multi-step framework to analyse high-throughput drug combination screens. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Perisetti A, Raghavapuram S, Sheikh AB, Yendala R, Rahman R, Shanshal M, Thein KZ, Farooq A. Mushroom Poisoning Mimicking Painless Progressive Jaundice: A Case Report with Review of the Literature. Cureus 2018; 10:e2436. [PMID: 29896444 PMCID: PMC5995584 DOI: 10.7759/cureus.2436] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Mushroom poisoning is common in the United States. The severity of mushroom poisoning may vary, depending on the geographic location, the amount of toxin delivered, and the genetic characteristics of the mushroom. Though they could have varied presentation, early identification with careful history could be helpful in triage. We present a case of a 69-year-old female of false morel mushroom poisoning leading to hepatotoxicity with painless jaundice and biochemical pancreatitis.
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Affiliation(s)
- Abhilash Perisetti
- Department of Hospital Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Saikiran Raghavapuram
- Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, USA
| | | | - Rachana Yendala
- Hematology Oncology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Rubayat Rahman
- Department of Hospital Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Mohamed Shanshal
- Hematology Oncology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Kyaw Z Thein
- Hematology Oncology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Asif Farooq
- Hospital Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
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Nasreen S, Nessa A, Islam F, Khanam A, Sultana R, Rahman R, Hossain M. Changes of Peak Expiratory Flow Rate in Adult Asthmatic Patient. Mymensingh Med J 2018; 27:245-250. [PMID: 29769485] [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: 06/08/2023]
Abstract
Asthma is a common pulmonary disorder characterizerized by airway inflammation, airway- hyper reactivity, and reversible airflow obstruction. The classic triad of symptoms is wheezing, chronic episodic dyspnea and chronic cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. The number of people with asthma in the world may be as high as 334 million. Asthma in Bangladesh appears to be a substantial public health problem: an estimated 11.6 million people including 4.1 million children suffer from asthma-related symptoms. A cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Airway resistance is always increased during the asthmatic attack. Airways obstruction, such as that caused by asthma, results in a reduced and variable Peak Expiratory Flow Rate (PEFR). PEFR is classically reduced in asthma. Recent asthma guidelines recommended the assessment of severity levels based on the most severe symptoms and peak expiratory flow rate. This descriptive type of cross-sectional study was done to find the changes of Peak expiratory flow rate in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. PEFR was estimated by Wright's Peak flow meter. For statistical analysis unpaired student's 't' test was used. Mean PEFR were significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that peak expiratory flow rate was decreased in asthmatic patient and there was a significant relation of decline lung function.
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Affiliation(s)
- S Nasreen
- Dr Shamima Nasreen, Assistant Professor, Department of Physiology, TMSS Medical College, Bogra, Bangladesh; E-mail:
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Perisetti A, Raghavapuram S, Tharian B, Warraich I, Hardwicke F, Rahman R, Onkendi E. Pure Squamous Cell Carcinoma of the Gallbladder Masquerading as a Hepatic Mass. Cureus 2018. [PMID: 29515940 PMCID: PMC5832400 DOI: 10.7759/cureus.2011] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Gallbladder (GB) carcinomas are adenocarcinomas (AC) in the majority of cases. Adenosquamous carcinoma (ASC) and pure squamous cell carcinoma (SCC) of the gallbladder are rarely encountered and comprise 1-3% of gallbladder cancer cases. Pure squamous cell carcinoma of the gallbladder is rarer with less than 1% of the incidence. Most of the published literature is based on case reports and case series. The survival rates of ASC and SCC of the gallbladder are significantly lower (mean of five months) compared to the AC of the gallbladder (mean survival of 11.4 months). Most of these lesions are advanced at presentation, rendering them unresectable and resulting in a poor prognosis. However, if the lesions are diagnosed at an early stage, they could potentially be resectable. We report one such rare case of pure SCC GB presenting as a hepatic mass. The patient subsequently underwent resection of the gallbladder and liver mass with complete recovery and is currently planned for chemotherapy and radiation treatment.
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Affiliation(s)
- Abhilash Perisetti
- Department of Hospital Medicine, Texas Tech University Health Sciences Center
| | | | - Benjamin Tharian
- Division of Gastroenterology, University of Arkansas for Medical Sciences
| | - Irfan Warraich
- Department of Pathology, Texas Tech University Health Sciences Center
| | - Fred Hardwicke
- Department of Hematology & Oncology, Texas Tech University Health Sciences Center
| | - Rubayat Rahman
- Department of Hospital Medicine, Texas Tech University Health Sciences Center
| | - Edwin Onkendi
- Department of Surgery, Texas Tech University Health Sciences Center
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Arora R, Rahman R, Joe W, Bakhshi S, Dhawan D, Radhakrishnan V, Kalra M, Chinnaswamy G, Das A, Mudaliar S, Sangareddi S, Sharma S, Seth R, Singh A, De S, Scott J, Uppuluri R, Borker A, Sankaran H, Bagai P. Families Of Children Newly Diagnosed With Cancer Incur Significant Out-Of-Pocket Expenditure For Treatment – Report Of A Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). Pediatric Hematology Oncology Journal 2018. [DOI: 10.1016/j.phoj.2018.11.038] [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: 11/29/2022] Open
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39
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Nasreen S, Nessa A, Islam F, Khanam A, Sultana R, Alam K, Naznin R, Tajkia T, Rahman R, Hossain M, Sultana MA, Kamal ST. Interaction between Hypertension and Asthma in Adult. Mymensingh Med J 2018; 27:34-40. [PMID: 29459589] [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: 06/08/2023]
Abstract
Asthma has been defined as a chronic inflammatory disorder of the airways that is associated with recruitment of inflammatory cells and the clinical development of wheezing, shortness of breath, chest tightness, and cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. Current estimates suggest that asthma affects 300 million people worldwide, with a predicted additional 100 million people affected by 2025. This cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Both asthma and hypertension are spastic disorders of smooth muscle, there is the similarities between these two diseases may predispose the individuals with one disease to the other. This descriptive type of cross-sectional study was done to find the Interaction between hypertension and asthma in adult and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and fifty (50) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Blood pressure was estimated by auscultatory method by sphygmomanometer. For statistical analysis unpaired student's 't' test was used. Mean blood pressure were significantly increased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of hypertension among asthmatic patients than non asthmatic healthy persons. From this study, it may be concluded that hypertension and asthma are closely connected.
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Affiliation(s)
- S Nasreen
- Dr Shamima Nasreen, Assistant Professor, Department of Physiology, TMSS Medical College, Bogra, Bangladesh; E-mail:
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Al-Emran M, Rahman R, Miah MI, Shahjahan M. Effects of stocking density on growth and production in monoculture of Thai sharpunti (Barbonymus gonionotus). Progress Agric 2017; 28:249-252. [DOI: 10.3329/pa.v28i3.34662] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
An experiment was carried out to study the density dependent growth of Thai sharpunti (Barbonymusgonionotus) for two months period. Three stocking densities such as 50/decimal, 100/decimal and 150/decimal representing treatment one (T1), treatment two (T2) and treatment three (T3), respectively were tested in three replications. A commercial diet (25% crude protein) was supplied twice daily throughout the study period up to satiation level. The total production of sharpunti was found 14.67 ± 2.05, 27.06 ± 3.09 and 36.87 ± 2.16 kg/decimal in T1, T2 and T3, respectively and they were significantly different (p<0.05) from each other. A higher net benefit of BDT 1079.50 was obtained from T2 where the stocking density was 100/decimal. The present study indicated that the growth and production of Thai sharpunti was density dependent in monoculture systems.Progressive Agriculture 28 (3): 249-252, 2017
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Rahman R, Cortes A, Oh K, Flaherty K, Lawrence D, Sullivan R, Shih H. The Impact of Timing of Immunotherapy with Cranial Irradiation on Early Distant Brain Progression and Overall Survival in Patients with Melanoma Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khan MH, Islam MN, Aditya GP, Islam MZ, Bhuiyan AS, Saha B, Bhowmick K, Hassan M, Paul PK, Chowdhury S, Rahman R. Correlation of Troponin-I Level with Left Ventricular Ejection Fraction and In-hospital outcomes after First Attack of Non-ST Segment Elevation Myocardial Infarction. Mymensingh Med J 2017; 26:721-731. [PMID: 29208858] [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: 06/07/2023]
Abstract
Coronary heart disease (CHD) is the most common cause of heart disease and is the single most important cause of premature death in developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has been shown to be a very sensitive and specific marker for acute myocardial infarction (AMI). Ventricular function is the best predictor of death after an acute coronary syndrome. It serves as a marker of myocardial damage, provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of elevated Troponin-I level on LV ejection fraction and in-hospital outcomes in patients with first attack of Non ST-segment Elevation Myocardial Infarction (NSTEMI). This prospective analytical study was conducted in the Department of Cardiology in Mymensingh Medical College Hospital from December 2015 to November 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group I - Patients with first attack of NSTEMI with good LV function (LVEF: ≥55%). Group II - Patients with first attack of NSTEMI with LV systolic dysfunction (LVEF: <55%). Then Troponin-I and LVEF levels were correlated using Pearson's correlation coefficient test. In this study mean Troponin-I of Group I and Group II were 5.53±7.43 and 16.46±15.79ng/ml respectively. It was statistically significant (p<0.05). Echocardiography showed that patients with high Troponin-I level had low ejection fraction (LVEF) and patients with low Troponin-I level had preserved ejection fraction (LVEF). Analysis showed that patients with severe left ventricular systolic dysfunction (LVEF <35%) had the highest level of Troponin-I with worse in-hospital outcomes and vice versa-the patients with the preserved systolic function (LVEF ≥55%) had the lowest levels of Troponin-I with better in-hospital outcomes. In our study, it also showed that the levels of Troponin-I had negative correlation with LV ejection fraction levels, with medium strength of association (r= -0.5394, p=0.001). The study enabled us to conclude that, the higher was the Troponin-I level, the lower was the LV ejection fraction level and thus worse in-hospital outcomes in first attack of NSTEMI patients.
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Affiliation(s)
- M H Khan
- Dr Mahmood Hasan Khan, MD (Thesis) Student, Department of Cardiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh
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Khan KN, Khan MH, Rahman R, Rashid MA, Haque SZ, Zakia Z. Primary Angioplasty for the Treatment of Acute ST Elevated Myocardial Infarction: Single Centre Experience. Mymensingh Med J 2017; 26:351-355. [PMID: 28588172] [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: 06/07/2023]
Abstract
Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% whereas, with thrombolytics it is only 60-70%. This retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to January 2011. Total 114 consecutive patients with acute myocardial infarction were treated with primary angioplasty included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedure were excluded from the study. Majority (89%) of the patient were male, age was minimum 30 years and maximum 90 years, 41.5% were diabetics, 58.4% were hypertensive, 43.5% were dyslipidaemic, 17% were smoker, 29.3% with positive family history. Fifty seven percent patients presented with anterior MI , 42 % with inferior MI and 1% with lateral MI. Left anterior descending (LAD) is the most common vessel involved (57%), followed by Right coronary artery (RCA) 31%, Left circumflex artery (LCX) 8 %, Ramus 1.3% and Graft vessel 2.7%. Our door to balloon time was minimum 23 min, maximum 184 min. We used drug eluting stents for most of the patients, GP IIb- IIIa receptor blockers used in 50% cases and thrombus suction device were used when indicated. We faced complications like arrhythmias in 24%, hypotension in18%, no flow or slow flow in 45%, cardiac arrest in 3% and coronary perforation in 1%. Our overall survival was 97.9%. Primary angioplasty is an emerging area in context of our country. Many of the new centers start this novel strategy which helps to save many lives Primary angioplasty is feasible and safe method of reperfusion in patient with acute myocardial infarction in our center. With the help of our initial experience we can perform PAMI with confidence to those who can afford and who need most.
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Affiliation(s)
- K N Khan
- Dr Kaisar Nasrullah Khan, Department of Cardiology, United Hospital Limited (UHL), Gulshan, Dhaka, Banglaldesh
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Rahman R, Simoes EJ, Schmaltz C, Jackson CS, Ibdah JA. Trend analysis and survival of primary gallbladder cancer in the United States: a 1973-2009 population-based study. Cancer Med 2017; 6:874-880. [PMID: 28317286 PMCID: PMC5387125 DOI: 10.1002/cam4.1044] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 12/18/2022] Open
Abstract
Primary gallbladder cancer is an aggressive and uncommon cancer with poor outcomes. Our study examines epidemiology, trend, and survival of gallbladder cancer in the United States from 1973 to 2009. We utilized the Surveillance Epidemiology and End Results database (SEER). Frequency and rate analyses on demographics, stage, and survival were compared among non-Hispanic whites, Hispanics, African American, and Asian/Pacific Islanders. A total of 18,124 cases were reported in SEER from 1973 to 2009 comprising 1.4% of all reported gastrointestinal cancers. Gallbladder cancer was more common in females than males (71 vs. 29%, respectively). The age-adjusted incidence rate was 1.4 per 100,000, significantly higher in females than males (1.7 vs. 1.0). Trend analysis showed that the incidence rate has been decreasing over the last three decades for males. However, among females, the incidence rate had decreased from 1973 to mid-90s but has remained stable since then. Trend analysis for stage at diagnosis showed that the proportion of late-stage cases has been increasing significantly since 2001 after a decreasing pattern since 1973. Survival has improved considerably over time, and survival is better in females than males and in Asian/Pacific Islanders than other racial groups. The highest survival was in patients who received both surgery and radiation. Trend analysis revealed a recent increase of the incidence of late-stage gallbladder cancer. Highest survival was associated with receiving both surgery and radiation.
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Affiliation(s)
- Rubayat Rahman
- Division of Gastroenterology and HepatologyUniversity of Missouri School of MedicineOne Hospital Drive, CE 405ColumbiaMissouri65212
| | - Eduardo J. Simoes
- Department of Health Management and InformaticsUniversity of Missouri School of MedicineOne Hospital DriveCE707 CS&E BldgColumbiaMissouri65212
| | - Chester Schmaltz
- Missouri Cancer Registry and Research CenterUniversity of Missouri at Columbia401 Clark HallColumbiaMissouri65211
| | | | - Jamal A. Ibdah
- Division of Gastroenterology and HepatologyUniversity of Missouri School of MedicineOne Hospital Drive, CE 405ColumbiaMissouri65212
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Movafagh S, Raj D, Sanaei-Ardekani M, Bhatia D, Vo K, Mahmoudieh M, Rahman R, Kim EH, Harralson AF. Hypoxia Inducible Factor 1: A Urinary Biomarker of Kidney Disease. Clin Transl Sci 2017; 10:201-207. [PMID: 28181420 PMCID: PMC5421733 DOI: 10.1111/cts.12445] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 06/24/2016] [Accepted: 01/03/2017] [Indexed: 01/22/2023] Open
Abstract
Identifying noninvasive biomarkers of kidney disease is valuable for diagnostic and therapeutic purposes. Hypoxia inducible factor 1 (HIF-1) expression is known to be elevated in the kidneys in several renal disease pathologies. We hypothesized that the urinary HIF-1a mRNA level may be a suitable biomarker for expression of this protein in chronic kidney disease (CKD). We compared HIF-1a mRNA levels from urine pellets of CKD and healthy subjects. To ensure that urinary HIF-1a mRNA is of kidney origin, we examined colocalization of HIF-1a mRNA with two kidney specific markers in urine cells. We found that HIF-1a mRNA is readily quantifiable in urine pellets and its expression was significantly higher in CKD patients compared with healthy adults. We also showed that the urinary HIF-1a mRNA comes primarily from cells of renal origin. Our data suggest that urinary HIF-1a mRNA is a potential biomarker in CKD and can be noninvasively assessed in patients.
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Affiliation(s)
- S Movafagh
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - D Raj
- Department of Nephrology, George Washington University Division of Kidney Diseases and Hypertension, Washington, DC, USA
| | | | - D Bhatia
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - K Vo
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - M Mahmoudieh
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
| | - R Rahman
- Kidney and Hypertension Specialists, Manassas, Virginia, USA
| | - E H Kim
- Kidney and Hypertension Specialists, Manassas, Virginia, USA
| | - A F Harralson
- Department of Pharmacogenomics, Bernard J. Dunn School of Pharmacy, Shenandoah University, Ashburn, Virginia, USA
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Doherty M, Khan F, Biswas FN, Khanom M, Rahman R, Islam Tanvir MM, Akter F, Sarker M, Ahmad N. Symptom Prevalence in Patients with Advanced, Incurable Illness in Bangladesh. Indian J Palliat Care 2017; 23:413-418. [PMID: 29123348 PMCID: PMC5661344 DOI: 10.4103/ijpc.ijpc_85_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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] [Indexed: 11/21/2022] Open
Abstract
Context: There is a significant need for palliative care for patients living in low- and middle-income countries. The presence and intensity of physical symptoms is a major factor influencing the suffering of patients at the end of life. Objectives: The primary aim of this study was to determine the prevalence and characteristics of common physical symptoms experienced by patients with advanced, incurable illness in a developing country. Method: This study used semi-structured interviews in patients with advanced cancer or HIV/AIDS in Bangladesh. Results: Pain was the most common symptom (70.6%) and was frequently reported to be severe (62.6%). Very few patients received strong opioids to treat their pain (13.7%). Other frequent symptoms included loss of appetite (23.5%) and fever (19.9%). The average number of physical symptoms reported was 3 (range: 0–23). The majority of patients rated their most recent symptom (excluding pain) as severe (64.3%), with 35.8% continuing to have severe symptom intensity despite treatment. Conclusions: This study reveals the significant burden of symptoms, and the associated suffering for patients living with incurable illness, in a developing country. Very few patients received strong opioids, despite frequently having severe pain. Frequently, the treatments that patients received did not alleviate their symptoms. Palliative care is vital for the relief of suffering for patients with advanced and incurable diseases, especially in low- and middle-income countries where access to curative treatments may be limited and patients often present to medical personnel when their illness is in an advanced stage or incurable.
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Affiliation(s)
- Megan Doherty
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Farzana Khan
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Fazle Noor Biswas
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Marufa Khanom
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rubayat Rahman
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Farhana Akter
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mridul Sarker
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Nezamuddin Ahmad
- Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Rayjada P, Vaghela N, Rahman R, Bhatnagar M, Ranjan M, Chauhan N, Sircar A, Manocha L, Raole P. Er 2 O 3 coating by reactive magnetron sputtering: Effect of oxygen supply and erbium pre-layer deposition. Nuclear Materials and Energy 2016. [DOI: 10.1016/j.nme.2016.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wood J, Kim D, Alqahtani S, Smith S, Barrett D, Grundy R, Rahman R. P01.04 Adult and paediatric GBM cells show differential phenotypic responses to external lipoprotein deprivation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.061] [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: 11/13/2022] Open
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Wood J, Kim D, Smith S, Lourdusamy A, Ward J, Barrett D, Grundy R, Rahman R. P08.18 LC-MS-based genome-wide profiling of glioblastoma multiforme reveals distinct metabolism within the invasive region. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.151] [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: 11/12/2022] Open
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Ayodele O, Ali I, Konenko A, Duggan L, O'Mara N, Rahman R, Ged Y, Calvert P, Horgan A, O'Connor M. Menopausal status on tumour biology in early breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.18] [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: 11/12/2022] Open
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