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Lin H, Lee HW, Yip TCF, Tsochatzis E, Petta S, Bugianesi E, Yoneda M, Zheng MH, Hagström H, Boursier J, Calleja JL, Goh GBB, Chan WK, Gallego-Durán R, Sanyal AJ, de Lédinghen V, Newsome PN, Fan JG, Castéra L, Lai M, Harrison SA, Fournier-Poizat C, Wong GLH, Pennisi G, Armandi A, Nakajima A, Liu WY, Shang Y, de Saint-Loup M, Llop E, Teh KKJ, Lara-Romero C, Asgharpour A, Mahgoub S, Chan MSW, Canivet CM, Romero-Gomez M, Kim SU, Wong VWS. Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease. JAMA 2024; 331:1287-1297. [PMID: 38512249 PMCID: PMC10958386 DOI: 10.1001/jama.2024.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/30/2024] [Indexed: 03/22/2024]
Abstract
Importance Metabolic dysfunction-associated steatotic liver disease (MASLD) is currently the most common chronic liver disease worldwide. It is important to develop noninvasive tests to assess the disease severity and prognosis. Objective To study the prognostic implications of baseline levels and dynamic changes of the vibration-controlled transient elastography (VCTE)-based scores developed for the diagnosis of advanced fibrosis (Agile 3+) and cirrhosis (Agile 4) in patients with MASLD. Design, Setting, and Participants This cohort study included data from a natural history cohort of patients with MASLD who underwent VCTE examination at 16 tertiary referral centers in the US, Europe, and Asia from February 2004 to January 2023, of which the data were collected prospectively at 14 centers. Eligible patients were adults aged at least 18 years with hepatic steatosis diagnosed by histologic methods (steatosis in ≥5% of hepatocytes) or imaging studies (ultrasonography, computed tomography or magnetic resonance imaging, or controlled attenuation parameter ≥248 dB/m by VCTE). Main Outcomes and Measures The primary outcome was liver-related events (LREs), defined as hepatocellular carcinoma or hepatic decompensation (ascites, variceal hemorrhage, hepatic encephalopathy, or hepatorenal syndrome), liver transplant, and liver-related deaths. The Agile scores were compared with histologic and 8 other noninvasive tests. Results A total of 16 603 patients underwent VCTE examination at baseline (mean [SD] age, 52.5 [13.7] years; 9600 [57.8%] were male). At a median follow-up of 51.7 (IQR, 25.2-85.2) months, 316 patients (1.9%) developed LREs. Both Agile 3+ and Agile 4 scores classified fewer patients between the low and high cutoffs than most fibrosis scores and achieved the highest discriminatory power in predicting LREs (integrated area under the time-dependent receiver-operating characteristic curve, 0.89). A total of 10 920 patients (65.8%) had repeated VCTE examination at a median interval of 15 (IQR, 11.3-27.7) months and were included in the serial analysis. A total of 81.9% of patients (7208 of 8810) had stable Agile 3+ scores and 92.6% of patients (8163 of 8810) had stable Agile 4 scores (same risk categories at both assessments). The incidence of LREs was 0.6 per 1000 person-years in patients with persistently low Agile 3+ scores and 30.1 per 1000 person-years in patients with persistently high Agile 3+ scores. In patients with high Agile 3+ score at baseline, a decrease in the score by more than 20% was associated with substantial reduction in the risk of LREs. A similar trend was observed for the Agile 4 score, although it missed more LREs in the low-risk group. Conclusions and Relevance Findings of this study suggest that single or serial Agile scores are highly accurate in predicting LREs in patients with MASLD, making them suitable alternatives to liver biopsy in routine clinical practice and in phase 2b and 3 clinical trials for steatohepatitis.
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Affiliation(s)
- Huapeng Lin
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Hye Won Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Terry Cheuk-Fung Yip
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Emmanuel Tsochatzis
- University College London Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, United Kingdom
| | - Salvatore Petta
- Sezione di Gastroenterologia, PROMISE, University of Palermo, Italy
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hannes Hagström
- Department of Medicine, Huddinge, Karolinska Institutet, Sweden
- Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Jérôme Boursier
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - José Luis Calleja
- Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - George Boon-Bee Goh
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Rocio Gallego-Durán
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Arun J. Sanyal
- Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, Virginia
| | - Victor de Lédinghen
- Centre d’Investigation de la Fibrose Hépatique, Haut-Lévêque Hospital, University Hospital of Bordeaux, Pessac, France
| | - Philip N. Newsome
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, United Kingdom
| | - Jian-Gao Fan
- Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Laurent Castéra
- Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d’Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France
| | - Michelle Lai
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Stephen A. Harrison
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Pinnacle Clinical Research, San Antonio, Texas
| | | | - Grace Lai-Hung Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Grazia Pennisi
- Sezione di Gastroenterologia, PROMISE, University of Palermo, Italy
| | - Angelo Armandi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Wen-Yue Liu
- Department of Endocrinology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying Shang
- Department of Medicine, Huddinge, Karolinska Institutet, Sweden
| | - Marc de Saint-Loup
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
| | - Elba Llop
- Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Kevin Kim-Jun Teh
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Carmen Lara-Romero
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Amon Asgharpour
- Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, Virginia
| | - Sara Mahgoub
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, United Kingdom
| | | | - Clemence M. Canivet
- Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory, SFR ICAT 4208, Angers University, Angers, France
| | - Manuel Romero-Gomez
- Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain
| | - Seung Up Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Vincent Wai-Sun Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
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Mahgoub S, Newsome PN. Glucagon-Like Peptide-1 Receptor Agonists in Patients With Cirrhosis: Answering the Unanswered Questions? Clin Gastroenterol Hepatol 2024:S1542-3565(24)00169-1. [PMID: 38342276 DOI: 10.1016/j.cgh.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/13/2024]
Affiliation(s)
- Sara Mahgoub
- Institute of Biomedical Research, Birmingham, United Kingdom
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Mahgoub S, Newsome PN. Efruxifermin in non-alcoholic steatohepatitis. Lancet Gastroenterol Hepatol 2023; 8:1058-1059. [PMID: 37802089 DOI: 10.1016/s2468-1253(23)00285-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Sara Mahgoub
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK; Centre for Liver and Gastrointestinal Research, Institute of Biomedical Research, Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Philip N Newsome
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK; Centre for Liver and Gastrointestinal Research, Institute of Biomedical Research, Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Khan S, Mahgoub S, Fallatah N, Lalor PF, Newsome PN. Liver Disease and Cell Therapy: Advances Made and Remaining Challenges. Stem Cells 2023; 41:739-761. [PMID: 37052348 PMCID: PMC10809282 DOI: 10.1093/stmcls/sxad029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/12/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023]
Abstract
The limited availability of organs for liver transplantation, the ultimate curative treatment for end stage liver disease, has resulted in a growing and unmet need for alternative therapies. Mesenchymal stromal cells (MSCs) with their broad ranging anti-inflammatory and immunomodulatory properties have therefore emerged as a promising therapeutic agent in treating inflammatory liver disease. Significant strides have been made in exploring their biological activity. Clinical application of MSC has shifted the paradigm from using their regenerative potential to one which harnesses their immunomodulatory properties. Reassuringly, MSCs have been extensively investigated for over 30 years with encouraging efficacy and safety data from translational and early phase clinical studies, but questions remain about their utility. Therefore, in this review, we examine the translational and clinical studies using MSCs in various liver diseases and their impact on dampening immune-mediated liver damage. Our key observations include progress made thus far with use of MSCs for clinical use, inconsistency in the literature to allow meaningful comparison between different studies and need for standardized protocols for MSC manufacture and administration. In addition, the emerging role of MSC-derived extracellular vesicles as an alternative to MSC has been reviewed. We have also highlighted some of the remaining clinical challenges that should be addressed before MSC can progress to be considered as therapy for patients with liver disease.
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Affiliation(s)
- Sheeba Khan
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, West Midlands, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, West Midlands, UK
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, West Midlands, UK
| | - Sara Mahgoub
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, West Midlands, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, West Midlands, UK
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, West Midlands, UK
| | - Nada Fallatah
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, West Midlands, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, West Midlands, UK
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Patricia F Lalor
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, West Midlands, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, West Midlands, UK
| | - Philip N Newsome
- National Institute for Health Research, Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, West Midlands, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, West Midlands, UK
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, West Midlands, UK
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Olsen K, Mahgoub S, Al-Shakhshir S, Algieder A, Atabani S, Bannaga A, Elsharkawy AM. Recent treatment advances and practical management of hepatitis D virus. Clin Med (Lond) 2023; 23:403-408. [PMID: 38614656 PMCID: PMC10541033 DOI: 10.7861/clinmed.2022-0556] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
Hepatitis D virus (HDV), also referred to as hepatitis delta virus, is the smallest virus capable of causing human disease. It is unable to replicate on its own and can only propagate in the presence of hepatitis B virus (HBV). Infection with both HBV and HDV frequently results in more severe disease than HBV alone, with higher instances of cirrhosis, liver failure and hepatocellular carcinoma (HCC). Thus, there is a need for effective treatment for HDV; however, currently approved treatment options are very limited both in terms of their efficacy and availability. This makes the management of HDV a challenge for physicians. In this review, we look at the background, diagnosis and treatment of HDV, informed by our hospital data, to set out the optimal management of HDV; we also explore novel treatment options for this disease.
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Affiliation(s)
- Kathryn Olsen
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Sara Mahgoub
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Akram Algieder
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | | | - Ayman Bannaga
- Queen Elizabeth Hospital Birmingham, Birmingham, UK.
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6
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Mahgoub S, Newsome PN. Bariatric-metabolic surgery versus lifestyle intervention in non-alcoholic steatohepatitis. Lancet 2023; 401:1747-1749. [PMID: 37088095 DOI: 10.1016/s0140-6736(23)00773-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Sara Mahgoub
- Centre for Liver and Gastrointestinal Research, Institute of Biomedical Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - Philip N Newsome
- Centre for Liver and Gastrointestinal Research, Institute of Biomedical Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK.
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Parente A, Boyd A, Mahgoub S, Morris S, Webb K, Neuberger J, Armstrong MJ, Rajoriya N. Outcomes of incoming and outgoing second opinions from a UK liver transplant centre. BMJ Open Gastroenterol 2022; 9:bmjgast-2022-000987. [PMID: 36104097 PMCID: PMC9476148 DOI: 10.1136/bmjgast-2022-000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Second transplant centre opinions (STCOs) for patients declined for liver transplantation are infrequent. We aimed to identify STCOs outcomes from a tertiary transplant centre. Design Referrals between 2012 and 2020 to Birmingham Unit were reviewed. Incoming: all referrals from out-of-region centres were collated. Outgoing: patients not listed in Birmingham were reviewed to identify referrals for STCOs to the other UK centres (A–F). Results 2535 patients were assessed for liver transplantation during the study period. Incoming: among 1751 referrals, 23 STCOs (17 unit A, 3 unit B, 1 unit C, 1 unit D and 1 unit E) were provided by Birmingham. Of the STCOs, 13/23 (57%) patients remained unsuitable for transplantation. Therefore, 10/23 (43%) underwent a second liver transplant assessment, of whom five (50%) were still deemed unsuitable, three (30%) listed (one transplanted) and two (20%) died preassessment. Outgoing: among 426 patients not listed, eight (1.8%) patients were referred for STCO (4 unit E, 2 unit B, 1 unit D, 1 unit A). Three (38%) were listed, two (25%) were assessed and declined, two (25%) were unsuitable for assessment and one (12.5%) died while waiting. Combining incoming and outgoing Birmingham STCOs (n=31), six (19%) of STCOs were listed in a second centre. Conclusion Second transplant centre opinions are rare with the majority still deemed unsuitable for liver transplantation. This highlights potential resource implications especially when undergoing a full second formal assessment. A streamlined STCO process with sharing of investigations and use of telemedicine in appropriate patients may allow for greater transparency, quicker decision making and less use of labour-intensive resources.
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Affiliation(s)
- Alessandro Parente
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK .,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Alexander Boyd
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Sara Mahgoub
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Sean Morris
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Kerry Webb
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - James Neuberger
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Matthew J Armstrong
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Neil Rajoriya
- Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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Rimmer P, Howell G, Mahgoub S, Iqbal TH. Every colon shouldn't have a silver lining: an atypical case of colitis caused by a 'commensal' organism. Frontline Gastroenterol 2022; 14:352-353. [PMID: 37409336 DOI: 10.1136/flgastro-2022-102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/08/2022] [Indexed: 08/31/2023] Open
Affiliation(s)
- Peter Rimmer
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
- Gastroenterology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - George Howell
- Gastroenterology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sara Mahgoub
- Liver Medicine Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Tariq H Iqbal
- Gastroenterology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
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Salem S, Abd El-Fattah H, Abdelbasit H, Mahgoub S. ISOLATION AND CHARACTERIZATION OF PHENOL DEGRADING BACTERIA FROM INDUSTRIAL WASTEWATER AND SEWAGE WATER. Zagazig Journal of Agricultural Research 2021; 48:443-457. [DOI: 10.21608/zjar.2021.175276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Mahgoub S, Armstrong MJ, Ferguson JW. Editorial: current challenges in predicting mortality in patients with cirrhosis and refractory ascites. Aliment Pharmacol Ther 2020; 52:885-886. [PMID: 32852822 DOI: 10.1111/apt.15982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Sara Mahgoub
- Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Matthew J Armstrong
- Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Immunology and Immunotherapy, National Institute for Health Research (NIHR) Birmingham Liver Biomedical Research Centre (BRC), University of Birmingham, Birmingham, UK
| | - James W Ferguson
- Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Immunology and Immunotherapy, National Institute for Health Research (NIHR) Birmingham Liver Biomedical Research Centre (BRC), University of Birmingham, Birmingham, UK
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11
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Khin KLS, Mahgoub S, Haldane T, Teh HP. A case report of glycogen storage disorder in an adult. Clin Med (Lond) 2020; 20:s60. [DOI: 10.7861/clinmed.20-2-s60] [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: 11/27/2022]
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12
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Lim TY, McPhail MJ, Shah A, Mahgoub S, Nayagam J, Cramp M, Bernal W, Menon K, Jassem W, Joshi D, Heneghan MA, Agarwal K, Heaton ND, Suddle A, O'Grady JG, Aluvihare VR. Sequential Cohort Analysis After Liver Transplantation Shows de Novo Extended Release Tacrolimus Is Safe, Efficacious, and Minimizes Renal Dysfunction. Transplant Direct 2020; 6:e528. [PMID: 32095514 PMCID: PMC7004634 DOI: 10.1097/txd.0000000000000970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 11/07/2019] [Indexed: 11/26/2022] Open
Abstract
The use of once-daily extended-release tacrolimus (ERT) is associated with improved long-term graft and patient survival when compared with twice-daily tacrolimus (BDT), but the underlying reasons for differential survival are unclear. The aim of the study was to compare clinical outcomes known to impact on posttransplant survival for de novo BDT and ERT in liver transplantation (LT) recipients. METHODS We conducted a single-center, prospective sequential cohort analysis of adult patients undergoing LT during a change in protocol from de novo BDT to ERT, with a 6-month post-LT follow-up. RESULTS A total of 160 transplanted patients were evaluated; 82 were in the BDT group and 78 were in the ERT group. The cohorts were matched for standard variables and a similar proportion in each group received induction interleukin-2 receptor antibody (36% and 31%). There were no significant differences in the measured outcomes of patient and graft survival, biopsy-proven acute rejection episodes, post LT diabetes, and toxicity. A significantly lower number of patients developed chronic kidney disease Stage3-4 in the ERT cohort compared with BDT cohort. In patients with pre-LT renal dysfunction who received antibody induction, estimated glomerular filtration rate decreased significantly in the BDT but not the ERT group. CONCLUSIONS We show that once-daily ERT is as safe and efficacious as BDT in de novo LT but optimally conserves renal function post-LT.
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Affiliation(s)
- Tiong Yeng Lim
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Mark J McPhail
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Amar Shah
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Sara Mahgoub
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Jeremy Nayagam
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Matthew Cramp
- Southwest Liver Unit, Derriford Hospital, Crownhill, Plymouth, Devon, United Kingdom
| | - William Bernal
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Krish Menon
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Wayel Jassem
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Deepak Joshi
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Nigel D Heaton
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Abid Suddle
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - John G O'Grady
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Varuna R Aluvihare
- Institute of Liver Studies, King's College Hospital, Denmark Hill, London, United Kingdom
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Hefny M, El-Zamek F, Abd El-Fattah H, Mahgoub S. BIOSYNTHESIS OF ZINC NANOPARTICLES USING CULTURE FILTRATES OF Aspergillus, Fusarium AND Penicillium FUNGAL SPECIES AND THEIR ANTIBACTERIAL PROPERTIES AGAINST GRAM-POSITIVE AND GRAM-NEGATIVE BACTERIA. Zagazig Journal of Agricultural Research 2019; 46:2009-2021. [DOI: 10.21608/zjar.2019.51920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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14
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Mahgoub S, Piant H, Gaudineau A, Lefebvre F, Langer B, Koch A. Risk factors for obstetric anal sphincter injuries (OASIS) and the role of episiotomy: A retrospective series of 496 cases. J Gynecol Obstet Hum Reprod 2019; 48:657-662. [PMID: 31276845 DOI: 10.1016/j.jogoh.2019.07.004] [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] [Received: 02/06/2019] [Revised: 06/20/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective of this study was to determine the prevalence and identify risk factors for obstetric anal sphincter injuries (OASIS), and to determine the prevalence of episiotomy and whether it is protective for the posterior perineum. STUDY DESIGN This is a retrospective case-control study carried out in a level 2 maternity unit and a level 3 maternity unit between 1 January 2006 and 31 December 2015. The sample population included all vaginal deliveries at term of a living singleton foetus in cephalic presentation. The case group comprised patients with an OASIS. The control group comprised patients without OASIS. Statistical analysis was subdivided into descriptive and inferential parts. RESULTS 42,626 patients were included in the study of whom 496 were cases of OASIS, i.e. a rate of 1.2%. The overall episiotomy rate was 10.0%, which reflects a restrictive practice. Episiotomy doesn't appear to be a statistically significant protective factor for OASIS (OR=0.89-95%CI [0.68-1.16]). The principal independent risk factors for OASIS were nulliparity (ORa=4.19-95%CI [3.03-5.84] - p<0.001), previous caesarean (ORa=5.59-95%CI [3.68-8.44] - p<0.001), uterine fundal height greater than 32cm (ORa=1.35-95%CI [1.03-1.77] - p=0.03), gestational or pre-pregnancy diabetes (ORa=1.76-95%CI [1.22-2.46] - p=0.002), birthweight of more than 3500g (ORa=1.48-95%CI [1.17-1.87] - p=0.001), assisted delivery (ORa=1.81-95%CI [1.18-2.86] - p=0.007), and use of a second instrument or obstetrical manoeuvre (ORa=1.93-95%CI [1.05-3.30] - p=0.02). CONCLUSION Episiotomy doesn't appear to be a statistically significant protective factor on the perineal prognosis. A deeper understanding of the factors which promote OASIS and greater awareness of them would improve the perineal prognosis of parturient women.
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Affiliation(s)
- Sara Mahgoub
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, France
| | - Hélène Piant
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, France
| | - Adrien Gaudineau
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, France
| | | | - Bruno Langer
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, France
| | - Antoine Koch
- Department of Obstetrics and Gynecology, Strasbourg Teaching Hospital, France.
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Siau K, Hodson J, Ingram R, Baxter A, Widlak MM, Sharratt C, Baker GM, Troth T, Hicken B, Tahir F, Magrabi M, Yousaf N, Grant C, Poon D, Khalil H, Lee HL, White JR, Tan H, Samani S, Hooper P, Ahmed S, Amin M, Mahgoub S, Asghar K, Leet F, Harborne MJ, Polewiczowska B, Khan S, Anjum MR, McFarlane M, Mozdiak E, O'Flynn LD, Blee IC, Molyneux RM, Kurian A, Abbas SN, Abbasi A, Karim A, Yasin A, Khattak F, White J, Ahmed R, Morgan JA, Alleyne L, Alam MA, Palaniyappan N, Rodger VJ, Sawhney P, Aslam N, Okeke T, Lawson A, Cheung D, Reid JP, Awasthi A, Anderson MR, Timothy JR, Pattni S, Ahmad S, Townson G, Shearman J, Giljaca V, Brookes MJ, Disney BR, Guha N, Thomas T, Norman A, Wurm P, Shah A, Fisher NC, Ishaq S, Major G. Time to endoscopy for acute upper gastrointestinal bleeding: Results from a prospective multicentre trainee-led audit. United European Gastroenterol J 2018; 7:199-209. [PMID: 31080604 DOI: 10.1177/2050640618811491] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/15/2018] [Indexed: 12/24/2022] Open
Abstract
Background Endoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission). Methods This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups. Results Across 348 patients from 20 centres, the median time to endoscopy was 21.2 h (IQR 12.0-35.7), comprising median admission to referral and referral to endoscopy times of 8.1 h (IQR 3.7-18.1) and 6.7 h (IQR 3.0-23.1), respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0-87.5%, p = 0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7:00 and 19:00 hours or via the emergency department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1 d; p = 0.004), but not 30-d mortality (p = 0.344). Conclusions The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.
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Affiliation(s)
- Keith Siau
- Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK.,West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - James Hodson
- Institute of Translational Medicine, University Hospital Birmingham, Birmingham, UK
| | - Richard Ingram
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Andrew Baxter
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Monika M Widlak
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Caroline Sharratt
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Graham M Baker
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Tom Troth
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ben Hicken
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Faraz Tahir
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Malik Magrabi
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Nouman Yousaf
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Claire Grant
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Dennis Poon
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Hesham Khalil
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Hui Lin Lee
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Jonathan R White
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Huey Tan
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Syazeddy Samani
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Patricia Hooper
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Saeed Ahmed
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Muhammad Amin
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Sara Mahgoub
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Khayal Asghar
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Farique Leet
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Matthew J Harborne
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Beata Polewiczowska
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Sheeba Khan
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Muhammad R Anjum
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Michael McFarlane
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ella Mozdiak
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Lauren D O'Flynn
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ilona C Blee
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Rachel M Molyneux
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ashok Kurian
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Syed N Abbas
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Abdullah Abbasi
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Aadil Karim
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Asif Yasin
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Fawad Khattak
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Josephine White
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ruhina Ahmed
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - James A Morgan
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Lance Alleyne
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Mohamed A Alam
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Naaventhan Palaniyappan
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Victoria J Rodger
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Paramvir Sawhney
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Nasar Aslam
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Theodore Okeke
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Adam Lawson
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Danny Cheung
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Jeremy P Reid
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ashish Awasthi
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Mark R Anderson
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Joe R Timothy
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Sanjeev Pattni
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Saqib Ahmad
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Gillian Townson
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Jeremy Shearman
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Vanja Giljaca
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Matthew J Brookes
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Ben R Disney
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Neil Guha
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Titus Thomas
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Anthony Norman
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Peter Wurm
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
| | - Ashit Shah
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Neil C Fisher
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Sauid Ishaq
- West Midlands Research in Gastroenterology Group (WMRIG) collaborative, West Midlands, UK
| | - Giles Major
- Gastroenterology Audit and Research Network East Midlands (GARNet) collaborative, East Midlands, UK
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Mahgoub S, Gabriele V, Faller E, Langer B, Wattiez A, Lecointre L, Akladios C. Cesarean Scar Ectopic Pregnancy: Laparoscopic Resection and Total Scar Dehiscence Repair. J Minim Invasive Gynecol 2018; 25:297-298. [DOI: 10.1016/j.jmig.2017.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 01/17/2017] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
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Omar S, Abd El-Fattah H, Abdelbasit H, Mahgoub S. CONTAMINATION OF FERMENTED FOODS IN EGYPT WITH UNDESIRABLE BACTERIA. Zagazig Journal of Agricultural Research 2018; 45:317-329. [DOI: 10.21608/zjar.2018.49860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Hamed S, Abd El-Fattah H, Abd El-Basit H, Mahgoub S. EFFICIENCY OF WASTEWATER TREATMENT PLANT AT ZAGAZIG CITY FOR REMOVING MICROBIAL AND CHEMICAL POLLUTANTS (CASE STUDY). Zagazig Journal of Agricultural Research 2016; 43:849-860. [DOI: 10.21608/zjar.2016.101018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ramsden S, Abidogun A, Stringer E, Mahgoub S, Kastrissianakis A, Baker P. A peer-led teaching initiative for foundation doctors. Clin Teach 2015; 12:236-40. [PMID: 26109008 DOI: 10.1111/tct.12297] [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: 11/28/2022]
Abstract
BACKGROUND Peer teaching has been used informally throughout the history of medical education. Formal studies within the medical student and allied health care professional communities have found it to be a popular, and highly effective, method of teaching. CONTEXT Newly qualified doctors are currently an underused resource in terms of teaching one another. INNOVATION A committee, made up of newly qualified doctors and postgraduate education staff, was established. Using only a few resources, this committee organised regular, peer-led tutorials and used educational needs assessment tools, such as questionnaires, to make improvements to early postgraduate training. IMPLICATION A realistic and well-received intervention to improve the teaching of newly qualified doctors, which is feasible in the modern, busy health care setting. Other institutions may find this method and its resources valuable. Newly qualified doctors are currently an underused resource in terms of teaching one another.
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Affiliation(s)
| | | | | | | | | | - Paul Baker
- North Western Foundation School, Health Education North West, Manchester, UK
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20
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Osman A, Mahgoub S, El-Masry R, Al-Gaby A, Sitohy M. Extending the Technological Validity of Raw Buffalo Milk at Room Temperature by Esterified Legume Proteins. J FOOD PROCESS PRES 2012. [DOI: 10.1111/j.1745-4549.2012.00768.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Osman
- Biochemistry Department; Zagazig University; Zagazig 44511 Egypt
| | - S. Mahgoub
- Microbiology Department Faculty of Agriculture; Zagazig University; Zagazig 44511 Egypt
| | - R. El-Masry
- Biochemistry Department; Zagazig University; Zagazig 44511 Egypt
| | - A. Al-Gaby
- Biochemistry Department; Zagazig University; Zagazig 44511 Egypt
| | - M. Sitohy
- Biochemistry Department; Zagazig University; Zagazig 44511 Egypt
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Mahgoub S, Hochstein L, Kopetz V, LaBombardi V, Leggiadro R, Glatt AE. Levoflaxin and Streptococcus pneumoniae. Chemotherapy 2003; 49:212; author reply 212. [PMID: 12886059 DOI: 10.1159/000071148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fahal AH, Azziz KA, Saliman SH, Galib HV, Mahgoub S. Dual infection with mycetoma and tuberculosis: report of two cases. East Afr Med J 1995; 72:749-50. [PMID: 8904072] [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: 02/02/2023]
Abstract
Dual infection with tuberculosis and mycetoma has not been reported in literature to date. This communication is a report on two patients with such infection. It indicates the serious impact of the dual infection as each of them augments the pathological effects of the other.
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Affiliation(s)
- A H Fahal
- Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan
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Abstract
An increase in incidence of regional lymphadenitis following BCG vaccination of newborns at King Abdel Aziz University Hospital, Riyadh has been observed. Eight cases are described. One case also had infraclavicular gland enlargement. The only change in routine was the introduction of a Japanese strain of BCG. It is suggested that this might be a cause for the increase in the condition. All patients were given isoniazid. Discharge and scar formation followed aspiration in five cases, whereas in the two cases subjected to surgical excision there was uncomplicated healing. It is suggested that the latter combined with antituberculous therapy may be a more satisfactory form of treatment.
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