1
|
Jaan A, Sarfraz Z, Farooq U, Malik S, Ur Rahman A, Okolo P. Incidence, implications and predictors of abdominal compartment syndrome in acute pancreatitis: A nationwide analysis. Pancreatology 2024; 24:370-377. [PMID: 38431446 DOI: 10.1016/j.pan.2024.02.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Acute pancreatitis (AP) often presents with varying severity, with a small fraction evolving into severe AP, and is associated with high mortality. Complications such as intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are intricately associated with AP. OBJECTIVE To assess the clinical implications and predictors of ACS in AP patients. METHODS We conducted a retrospective study using the National Inpatient Sample (NIS) database on adult AP patients, further stratified by the presence of concurrent ACS. The data extraction included demographics, underlying comorbidities, and clinical outcomes. Multivariate linear and logistic regression analyses were performed using STATA (v.14.2). RESULTS Of the 1,099,175 adult AP patients, only 1,090 (0.001%) exhibited ACS. AP patients with ACS had elevated inpatient mortality and all major complications, including septic shock, acute respiratory distress syndrome (ARDS), requirement for total parenteral nutrition (TPN), and intensive care unit (ICU) admission (P < 0.01). These patients also exhibited increased odds of requiring pancreatic drainage and necrosectomy (P < 0.01). Predictor analysis identified blood transfusion, obesity (BMI ≥30), and admission to large teaching hospitals as factors associated with the development of ACS in AP patients. Conversely, age, female gender, biliary etiology of AP, and smoking were found less frequently in patients with ACS. CONCLUSION Our study highlights the significant morbidity, mortality, and healthcare resource utilization associated with the concurrence of ACS in AP patients. We identified potential factors associated with ACS in AP patients. Significantly worse outcomes in ACS necessitate the need for early diagnosis, meticulous monitoring, and targeted therapeutic interventions for AP patients at risk of developing ACS.
Collapse
Affiliation(s)
- Ali Jaan
- Department of Internal Medicine, Rochester General Hospital, NY, USA.
| | - Zouina Sarfraz
- Department of Medicine, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Umer Farooq
- Department of Gastroenterology, Saint Louis University, MO, USA
| | - Sheza Malik
- Department of Internal Medicine, Rochester General Hospital, NY, USA
| | - Asad Ur Rahman
- Department of Gastroenterology, Cleveland Clinic Florida, FL, USA
| | - Patrick Okolo
- Department of Gastroenterology, Rochester General Hospital, NY, USA
| |
Collapse
|
2
|
Farooq U, O'Reilly NJ, Ahmed Z, Gasco P, Raghu Raj Singh T, Behl G, Fitzhenry L, McLoughlin P. Design of liposomal nanocarriers with a potential for combined dexamethasone and bevacizumab delivery to the eye. Int J Pharm 2024; 654:123958. [PMID: 38442797 DOI: 10.1016/j.ijpharm.2024.123958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
Clinicians face numerous challenges when delivering medications to the eyes topically because of physiological barriers, that can inhibit the complete dose from getting to the intended location. Due to their small size, the ability to deliver drugs of different polarities simultaneously, and their biocompatibility, liposomes hold great promise for ocular drug delivery. This study aimed to develop and characterise a dual loaded liposome formulation encapsulating Bevacizumab (BEV) and Dexamethasone (DEX) that possessed the physicochemical attributes suitable for topical ocular delivery. Liposomes were prepared by using thin film hydration followed by extrusion, and the formulations were optimised using a design of experiments approach. Physicochemical characterisation along with cytocompatibility and bioactivity of the formulations were assessed. Liposomes were successfully prepared with a particle size of 139 ± 2 nm, PDI 0.03 ± 0.01 and zeta potential -2 ± 0.7 mV for the optimised formulation. BEV and DEX were successfully encapsulated into the liposomes with an encapsulation efficiency of 97 ± 0.5 % and 26 ± 0.5 %, respectively. A sustained release of BEV was observed from the liposomes and the bioactivity of the formulation was confirmed using a wound healing assay. In summary, a potential topical eye drop drug delivery system, which can co-load DEX and BEV was developed and characterised for its potential to be used in ocular drug delivery.
Collapse
Affiliation(s)
- Umer Farooq
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, South East Technological University, Cork Road, Waterford City, Co. Waterford X91 K0EK, Ireland
| | - Niall J O'Reilly
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, South East Technological University, Cork Road, Waterford City, Co. Waterford X91 K0EK, Ireland; SSPC, The Science Foundation Ireland Research Centre for Pharmaceuticals, Ireland
| | - Zubair Ahmed
- Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Paolo Gasco
- Nanovector srl, Via Livorno, 60 Turin, Italy
| | - Thakur Raghu Raj Singh
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Gautam Behl
- Eirgen Pharma Limited, Westside Business Park, Old, Kilmeaden Road Co. Waterford X91 YV67, Ireland
| | - Laurence Fitzhenry
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, South East Technological University, Cork Road, Waterford City, Co. Waterford X91 K0EK, Ireland.
| | - Peter McLoughlin
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, South East Technological University, Cork Road, Waterford City, Co. Waterford X91 K0EK, Ireland; SSPC, The Science Foundation Ireland Research Centre for Pharmaceuticals, Ireland.
| |
Collapse
|
3
|
Ata I, Riaz N, Ata F, Farooq U, Mallhi TH. Waking up to the Naegleria threat: urgent measures needed to protect public health in Pakistan. Expert Rev Anti Infect Ther 2024; 22:129-130. [PMID: 38193480 DOI: 10.1080/14787210.2024.2304055] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/08/2024] [Indexed: 01/10/2024]
Affiliation(s)
- Ifrah Ata
- Hamdard Institute of Pharmaceutical Sciences, Hamdard University Islamabad Campus Islamabad, Pakistan
| | - Nabeel Riaz
- Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore & Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan
| | - Fariah Ata
- Department of Optometry, The University of Faisalabad, Faisalabad, Pakistan
| | - Umer Farooq
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Kingdom of Saudi Arabia
| |
Collapse
|
4
|
Sharif M, Lashari MH, Farooq U, Idris M, Afzal MA. Diagnostic efficacy of hand-held digital refractometer for determining total serum protein in indigenous sheep of Pakistan. PLoS One 2024; 19:e0295107. [PMID: 38547098 PMCID: PMC10977740 DOI: 10.1371/journal.pone.0295107] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
The study was designed to ascertain the diagnostic efficacy of hand-held digital refractometer in determining total protein (TP). The Sipli sheep (n = 128) were grouped as per gender (females = 99, males = 29) and age (G1 = up till 1 year, n = 35; G2 = from 1 to 2 years, n = 63; G3 = above 2 years, n = 30). The results regarding the overall mean (±SE) values for the TPs attained through serum chemistry analyzer (TP1) and hand-held digital refractometer (TP2) were non-significantly (P≥0.05) different (59.2±1.6g/L and 59.8±0.5g/L, respectively). However, the reference intervals (RIs) were quite different for the two TPs being 45.1-95.7g/L and 57.0-67.0g/L for TP1 and TP2, respectively. Similar results were seen for gender-wise and group-wise results. On the contrary, the results regarding correlation coefficient and logilinear regression showed a negative correlation between the two TPs (r = -0.0244) with an adjusted r-square of 0.059 (5.9% probability). Furthermore, the three tests implied to assess the level of agreement between the two methods (Cronbach alpha, Intraclass correlation coefficient, and Bland & Altman test) revealed least agreement between the two methods. In a nutshell, the results of TP through digital refractometer were not in concordance with those attained through serum chemistry analyzer. However, it can cautiously be used if these results are compared with relevant corrected RIs.
Collapse
Affiliation(s)
- Madiha Sharif
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | | | - Umer Farooq
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Musadiq Idris
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Abrar Afzal
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
5
|
Farooq U, Tarar ZI, El Alayli A, Kamal F, Niu C, Qureshi K. Analyzing the utility of renal replacement therapy to manage hepatorenal syndrome in alcoholic hepatitis without liver transplantation: a nationwide analysis. J Gastroenterol Hepatol 2024; 39:560-567. [PMID: 37953474 DOI: 10.1111/jgh.16388] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/18/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Hepatorenal syndrome (HRS) frequently complicates alcoholic hepatitis (AH) and portends poor survival in this population. Published literature indicates mixed benefits from renal replacement therapy (RRT) for HRS refractory to medical management. Therefore, we sought to assess the utilization of RRT in AH and clinical outcomes at a national level. METHODS Using the International Classification of Diseases, Tenth Revision (ICD-10) codes, we identified adult patients with AH with a coexisting diagnosis of HRS from the National Readmission Database 2016 through 2019. Mortality, morbidity, and resource utilization were compared. We compared proportions using the Fisher exact test and computed adjusted P-values based on multivariate regression analysis. Analyses were performed using Stata, version 14.2, considering a two-sided P < 0.05 as statistically significant. RESULTS A total of 73 203 patients with AH were included in the analysis (mean age 46.2 years). A total of 3620 individuals had HRS diagnosis (5%), of which 14.7% (n: 532) underwent RRT. HRS patients receiving RRT had a higher mortality rate than those who did not (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI]: 1.3-2.6, P: 0.01), along with higher resource utilization. Only those patients with HRS who underwent liver transplantation (LT) experienced a mortality reduction (24.4% for those not receiving RRTs and 36.5% for those receiving RRT). CONCLUSIONS RRT is associated with higher mortality and morbidity when offered to patients with AH and HRS, who do not undergo LT. Therefore, our results suggest careful selection of AH patients when deciding to initiate RRT for HRS.
Collapse
Affiliation(s)
- Umer Farooq
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA
| | - Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA
| | - Abdallah El Alayli
- Department of Internal Medicine, Saint Louis University, Saint Louis, Missouri, USA
| | - Faisal Kamal
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Chengu Niu
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA
| | - Kamran Qureshi
- Division of Gastroenterology and Hepatology, Saint Louis University, Saint Louis, Missouri, USA
| |
Collapse
|
6
|
Idris M, Farooq U, Rashid H, Lashari MH, Riaz U, Khan MA, Fatima I, Sajjad H, Qayyum S, Ahmad M, Awais M, Sajjad N, Perveen Z. A preliminary study on the dynamics of serum color in perspective to hemoglobin and bilirubin in indigenous sheep of Pakistan. J Exp Zool A Ecol Integr Physiol 2024; 341:123-129. [PMID: 38010902 DOI: 10.1002/jez.2765] [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] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/15/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
The present study is the first of its kind being reported for an indigenous sheep breed of Pakistan with objectives to (a) assess the diagnostic efficacy of a human-based "serum hemolysis reference palette" for sheep serum, (b) deduce normal reference intervals (RIs) for hemoglobin (Hb) and bilirubin, and (c) devise a novel serum color chart for on-field estimation of Hb and bilirubin through color matching of sheep serum. Apparently, healthy Sipli sheep (n = 130) were bled twice attaining whole blood and serum samples (n = 260). The study animals were grouped on the basis of gender, that is, males (n = 51) and females (n = 79) and age, that is, G1 (up till 1 year) (n = 41), G2 (from 1 to 2 years) (n = 46), and G3 (from 2 to 3 years) (n = 43). None of the 260 serum samples of the sheep matched the color given on the human-based "hemolysis reference palette." The G1 animals revealed marked variation in their serum color. Hence, on the basis of RIs, the serum samples (n = 178) of adult sheep (G2 and G3) showing three main color bands were used in devising a novel serum Hb and bilirubin estimation chart for adult sheep serum. In conclusion, the human-based serum hemolysis palette is not valid for sheep serum. The RIs attained in the study could provide a yardstick for assessment of health in indigenous sheep breeds whereas the serum color chart may be of value in estimating Hb and bilirubin in a quick, reliable, and cheaper way for the resource-poor settings of the world.
Collapse
Affiliation(s)
- Musadiq Idris
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Umer Farooq
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Haroon Rashid
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | | | - Umair Riaz
- Department of Theriogenology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Musarrat Abbas Khan
- Department of Animal Breeding and Genetics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Iram Fatima
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Hafsa Sajjad
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Sumama Qayyum
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Maqsood Ahmad
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Awais
- Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Nouman Sajjad
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Zobia Perveen
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
7
|
Farooq U, Szczybelski A, Ferreira FC, Faria NT, Netzer R. A Novel Biosurfactant-Based Oil Spill Response Dispersant for Efficient Application under Temperate and Arctic Conditions. ACS Omega 2024; 9:9503-9515. [PMID: 38434809 PMCID: PMC10905727 DOI: 10.1021/acsomega.3c08429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 03/05/2024]
Abstract
Synthetic oil spill dispersants have become essential in offshore oil spill response strategies. However, their use raises significant concerns regarding toxicity to phyto- and zooplankton and other marine organisms, especially in isolated and vulnerable areas such as the Arctic and shorelines. Sustainable alternatives may be developed by replacing the major active components of commercial dispersants with their natural counterparts. During this study, interfacial properties of different types of glycolipid-based biosurfactants (rhamnolipids, mannosylerythritol lipids, and trehalose lipids) were explored in a crude oil-seawater system. The best-performing biosurfactant was further mixed with different nontoxic components of Corexit 9500A, and the interfacial properties of the most promising dispersant blend were further explored with various types of crude oils, weathered oil, bunker, and diesel fuel in natural seawater. Our findings indicate that the most efficient dispersant formulation was achieved when mannosylerythritol lipids (MELs) were mixed with Tween 80 (T). The MELs-T dispersant blend significantly reduced the interfacial tension (IFT) of various crude oils in seawater with results comparable to those obtained with Corexit 9500A. Importantly, no leaching or desorption of MELs-T components from the crude oil-water interface was observed. Furthermore, for weathered and more viscous asphaltenic bunker fuel oil, IFT results with the MELs-T dispersant blend surpassed those obtained with Corexit 9500A. This dispersant blend also demonstrated effectiveness at different dosages (dispersant-to-oil ratio (DOR)) and under various temperature conditions. The efficacy of the MELs-T dispersant was further confirmed by standard baffled flask tests (BFTs) and Mackay-Nadeau-Steelman (MNS) tests. Overall, our study provides promising data for the development of effective biobased dispersants, particularly in the context of petroleum exploitation in subsea resources and transportation in the Arctic.
Collapse
Affiliation(s)
- Umer Farooq
- Department
of Petroleum, SINTEF Industry, 7465 Trondheim, Norway
| | - Ariadna Szczybelski
- Norwegian
College of Fishery Science, The Arctic University
of Norway, 9037 Tromsø, Norway
| | - Frederico Castelo Ferreira
- Institute
for Bioengineering and Biosciences and Department of Bioengineering,
Instituto Superior Técnico, Universidade
de Lisboa, 1049-001 Lisbon, Portugal
- Associate
Laboratory i4HB—Institute for Health and Bioeconomy, Instituto
Superior Técnico, Universidade de
Lisboa, 1049-001 Lisbon, Portugal
| | - Nuno Torres Faria
- Institute
for Bioengineering and Biosciences and Department of Bioengineering,
Instituto Superior Técnico, Universidade
de Lisboa, 1049-001 Lisbon, Portugal
- Associate
Laboratory i4HB—Institute for Health and Bioeconomy, Instituto
Superior Técnico, Universidade de
Lisboa, 1049-001 Lisbon, Portugal
| | - Roman Netzer
- Department
of Aquaculture, SINTEF Ocean, 7465 Trondheim, Norway
| |
Collapse
|
8
|
Tabussam T, Shehnaz H, Majeed MI, Nawaz H, Alghamdi AA, Iqbal MA, Shahid M, Shahid U, Umer R, Rehman MT, Farooq U, Hassan A, Imran M. Surface-enhanced Raman spectroscopy for studying the interaction of organometallic compound bis(1,3-dihexylimidazole-2-yl) silver(i) hexafluorophosphate (v) with the biofilm of Escherichia coli. RSC Adv 2024; 14:7112-7123. [PMID: 38419676 PMCID: PMC10899858 DOI: 10.1039/d3ra08667d] [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: 12/19/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024] Open
Abstract
Escherichia coli biofilms are a major cause of gastrointestinal tract diseases, such as esophageal, stomach and intestinal diseases. Nowadays, these are the most commonly occurring diseases caused by consuming contaminated food. In this study, we evaluated the efficacy of probiotics in controlling multidrug-resistant E. coli and reducing its ability to form biofilms. Our results substantiate the effective use of probiotics as antimicrobial alternatives and to eradicate biofilms formed by multidrug-resistant E. coli. In this research, surface enhanced Raman spectroscopy (SERS) was utilized to identify and evaluate Escherichia coli biofilms and their response to the varying concentrations of the organometallic compound bis(1,3-dihexylimidazole-2-yl) silver(i) hexafluorophosphate (v). Given the escalating challenge of antibiotic resistance in bacteria that form biofilms, understanding the impact of potential antibiotic agents is crucial for the healthcare sector. The combination of SERS with principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) enabled the detection and characterization of the biofilm, providing insights into the biochemical changes induced by the antibiotic candidate. The identified SERS spectral features served as indicators for elucidating the mode of action of the potential drug on the biofilm. Through PCA and PLS-DA, metabolic variations allowing the differentiation and classification of unexposed biofilms and biofilms exposed to different concentrations of the synthesized antibiotic were successfully identified, with 95% specificity, 96% sensitivity, and a 0.75 area under the curve (AUC). This research underscores the efficiency of surface enhanced Raman spectroscopy in differentiating the impact of potential antibiotic agents on E. coli biofilms.
Collapse
Affiliation(s)
- Tania Tabussam
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Hina Shehnaz
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Muhammad Irfan Majeed
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Haq Nawaz
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Abeer Ahmed Alghamdi
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University P.O. Box 84428 Riyadh 11671 Saudi Arabia
| | - Muhammad Adnan Iqbal
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Muhammad Shahid
- Department of Biochemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Urwa Shahid
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Rabiea Umer
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | | | - Umer Farooq
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Ahmad Hassan
- Department of Chemistry, University of Agriculture Faisalabad Faisalabad 38000 Pakistan
| | - Muhammad Imran
- Department of Chemistry, Faculty of Science, King Khalid University P.O. Box 9004 Abha 61413 Saudi Arabia
| |
Collapse
|
9
|
Jaan A, Sarfraz Z, Farooq U, Gutman J, McFarland JE, Mahmood S, Dunnigan K, Cryer B, Okolo P. Nonvariceal upper gastrointestinal bleeding in COVID-19 patients: insights from the National Inpatient Sample. Scand J Gastroenterol 2024:1-8. [PMID: 38305194 DOI: 10.1080/00365521.2024.2310161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND This retrospective study, conducted using the U.S. National Inpatient Sample (NIS), examines the outcomes and management of nonvariceal upper gastrointestinal bleeding (NVUGIB) in COVID-19 patients and identifies predictive factors to enhance patient prognosis. METHODS We analyzed the 2020 U.S. NIS data involving adult patients (≥18 years) admitted with NVUGIB and categorized them based on the presence of COVID-19. Primary and secondary outcomes, NVUGIB-related procedures, and predictive factors were evaluated. RESULTS Of 184,885 adult patients admitted with NVUGIB, 1.6% (2990) had COVID-19. Patients with NVUGIB and COVID-19 showed higher inpatient mortality, acute kidney injury, need for intensive care, and resource utilization metrics. Notably, there was a lower rate of early esophagogastroduodenoscopy (EGD). Multivariate logistic regression revealed conditions like peptic ulcer disease, mechanical ventilation, and alcohol abuse as significant positive predictors for NVUGIB in COVID-19 patients, whereas female gender and smoking were negative predictors. CONCLUSION Our findings suggest that COVID-19 significantly increases the risk of mortality and complications in NVUGIB patients. The observed decrease in early EGD interventions, potentially contributing to higher mortality rates, calls for a review of treatment strategies. Further multicenter, prospective studies are needed to validate these results and improve patient care strategies.
Collapse
Affiliation(s)
- Ali Jaan
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Zouina Sarfraz
- Department of Medicine, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Umer Farooq
- Department of Gastroenterology and Hepatology, Saint Louis University, St. Louis, MO, USA
| | - Jason Gutman
- Department of Gastroenterology and Hepatology, Rochester General Hospital, Rochester, NY, USA
| | - Joel E McFarland
- Department of Gastroenterology and Hepatology, Rochester General Hospital, Rochester, NY, USA
| | - Sultan Mahmood
- Department of Gastroenterology and Hepatology, University of Pittsburgh Medical Center Pittsburgh, PA, USA
| | - Karin Dunnigan
- Department of Gastroenterology and Hepatology, Rochester General Hospital, Rochester, NY, USA
| | - Byron Cryer
- Department of Gastroenterology and Hepatology, Baylor University Medical Center, Dallas, TX, USA
| | - Patrick Okolo
- Department of Gastroenterology and Hepatology, Rochester General Hospital, Rochester, NY, USA
| |
Collapse
|
10
|
Badar N, Ikram A, Salman M, Saeed S, Mirza HA, Ahad A, Umair M, Farooq U. Evolutionary analysis of seasonal influenza A viruses in Pakistan 2020-2023. Influenza Other Respir Viruses 2024; 18:e13262. [PMID: 38387887 PMCID: PMC10883786 DOI: 10.1111/irv.13262] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Influenza A viruses cause global health concerns due to their high amino acid substitution rates. They are linked to yearly seasonal epidemics and occasional pandemics. This study focused on sequencing influenza A virus strains in Pakistan. MATERIALS AND METHODS We analyzed the genetic characteristics of influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in Pakistan from January 2020 to January 2023. Whole genome sequences from influenza A (n = 126) virus isolates were amplified and sequenced by the Oxford Nanopore (MinION) platform. RESULTS The HA genes of influenza A(H1N1)pdm09 underwent amino acid substitutions at positions K54Q, A186T, Q189E, E224A, R259K, and K308R in sequenced samples. The HA genes of influenza A(H3N2) had amino acid substitutions at G53D, E83K, D104G, I140M, S205F, A212T, and K276R in the sequenced samples. Furthermore, the HA gene sequences of influenza A(H1N1)pdm09 in this study belonged to subclade 6B.1A.5a.2a. Similarly, the HA gene sequences of influenza A(H3N2) were classified under six subclades (3C.3a.1 and 3C.2a1b.2a [2, 2a.1, 2b, 2c, and 2a.3b]). Notably, amino acid substitutions in other gene segments of influenza A(H1N1)pdm09 and A(H3N2) were also found. CONCLUSION These findings indicate influenza A(H1N1)pdm09 and A(H3N2) viruses co-circulated during the 2020-2023 influenza season in Pakistan. Continued surveillance is crucial for real-time monitoring of possible high-virulence variation and their relevance to existing vaccine strains.
Collapse
Affiliation(s)
- Nazish Badar
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Aamer Ikram
- National Institute of HealthIslamabadPakistan
| | - Muhammad Salman
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Sidra Saeed
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Hamza Ahmed Mirza
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Abdul Ahad
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Massab Umair
- Public Health Laboratories DivisionNational Institute of HealthIslamabadPakistan
| | - Umer Farooq
- National Agricultural Research CenterIslamabadPakistan
| |
Collapse
|
11
|
Farooq U, Tarar ZI, Kamal F, Schlachterman A, Kumar A, Loren DE, Kowalski TE. Increased risk of acute pancreatitis in patients with post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis: findings from a National Cohort. HPB (Oxford) 2024; 26:313-315. [PMID: 37880009 DOI: 10.1016/j.hpb.2023.10.014] [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: 09/24/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Umer Farooq
- Department of Gastroenterology and Hepatology, Saint Louis University School of Medicine, 1201 S Grand Blvd, St. Louis, MO 63104, USA.
| | - Zahid I Tarar
- Department of Gastroenterology and Hepatology, University of Missouri, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Faisal Kamal
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, 111 S 11th St, Philadelphia, PA 19107, USA
| | - Alexander Schlachterman
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, 111 S 11th St, Philadelphia, PA 19107, USA
| | - Anand Kumar
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, 111 S 11th St, Philadelphia, PA 19107, USA
| | - David E Loren
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, 111 S 11th St, Philadelphia, PA 19107, USA
| | - Thomas E Kowalski
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, 111 S 11th St, Philadelphia, PA 19107, USA
| |
Collapse
|
12
|
Farooq U, Abbasi AF, Tarar ZI, Chaudhary AJ, Kamal F. Understanding the role of frailty in local and systemic complications and healthcare resource utilization in acute pancreatitis: Findings from a national cohort. Pancreatology 2024; 24:6-13. [PMID: 38072685 DOI: 10.1016/j.pan.2023.12.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/17/2023] [Accepted: 12/01/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Acute pancreatitis (AP) is a significant gastrointestinal cause of hospitalization with increasing incidence. Risk stratification is crucial for determining AP outcomes, but the association between frailty and AP outcomes is poorly understood. Moreover, age disparities in severity indices for AP complicate risk assessment. This study investigates frailty's impact on local and systemic complications in AP, readmission rates, and healthcare resource utilization. METHODS Using the National Readmission Database from 2016 to 2019, we identified adult AP patients and assessed frailty using the Frailty Risk Score. Our analysis included local and systemic complications, resource utilization, readmission rates, procedures performed, and hospitalization outcomes. Multivariate regression was employed, and statistical significance was set at P < 0.05 using Stata version 14.2. RESULTS Among 1,134,738 AP patients, 6.94 % (78,750) were classified as frail, with a mean age of 63.42 years and 49.71 % being female. Frail patients experienced higher rates of local complications (e.g., pseudocyst, acute pancreatic necrosis, walled-off necrosis) and systemic complications (e.g., pleural effusion, acute respiratory distress syndrome, sepsis, abdominal compartment syndrome) compared to non-frail patients. Frailty was associated with increased readmission rates and served as an independent predictor of readmission. Frail patients had higher inpatient mortality (7.11 % vs. 1.60 %), longer hospital stays, and greater hospitalization costs. CONCLUSION Frailty in AP patients is linked to elevated rates of local and systemic complications, increased mortality, and higher healthcare costs. Assessing frailty is crucial in AP management as it provides a valuable tool for risk stratification and identifying high-risk patients, thereby improving overall outcomes.
Collapse
Affiliation(s)
- Umer Farooq
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, 14621, USA.
| | - Abu Fahad Abbasi
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, 60153, USA
| | - Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO, 65211, USA
| | - Ammad J Chaudhary
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, 48202, USA
| | - Faisal Kamal
- Department of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| |
Collapse
|
13
|
Faggen AE, Kamal F, Lee-Smith W, Khan MA, Sharma S, Acharya A, Ahmed Z, Farooq U, Bayudan A, McLean R, Avila P, Dai SC, Munroe CA, Kouanda A. Correction to: Over-the-Scope Clips Versus Standard Endoscopic Treatment for First Line Therapy of Non-variceal Upper Gastrointestinal Bleeding: Systematic Review and Meta-Analysis. Dig Dis Sci 2024; 69:311-313. [PMID: 38010602 DOI: 10.1007/s10620-023-08159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Alec E Faggen
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Faisal Kamal
- Division of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10Th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
| | - Wade Lee-Smith
- Mulford Health Sciences Library, University of Toledo, Toledo, OH, USA
| | - Muhammad Ali Khan
- Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sachit Sharma
- Department of Medicine, University of Toledo, Toledo, OH, USA
- Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ashu Acharya
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Zohaib Ahmed
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Umer Farooq
- Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, IL, USA
| | - Alexis Bayudan
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Richard McLean
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Patrick Avila
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Sun-Chuan Dai
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Craig A Munroe
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Abdul Kouanda
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| |
Collapse
|
14
|
Bodla ZH, Hashmi M, Niaz F, Farooq U, Khalid F, Tariq MJ, Khalil MJ, Brown VS, Bray CL. Independent predictors of mortality and 5-year trends in mortality and resource utilization in hospitalized patients with diffuse large B cell lymphoma. Proc AMIA Symp 2023; 37:16-24. [PMID: 38174025 PMCID: PMC10761168 DOI: 10.1080/08998280.2023.2267921] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/24/2023] [Indexed: 01/05/2024] Open
Abstract
Background This retrospective study analyzed factors influencing all-cause inpatient mortality in 80,930 adult patients (2016-2020) with diffuse large B cell lymphoma using the National Inpatient Sample database. Methods Utilizing ICD-10 codes, patients were identified, and statistical analysis was conducted using STATA. Fisher's exact and Student's t tests compared proportions and variables, multivariate logistic regression examined mortality predictors, and a 5-year longitudinal analysis identified mortality and resource utilization trends. Results The inpatient mortality rate was found to be 6.56% with a mean age of 67.99 years. Several hospital- and patient-level factors including specific comorbidities such as congestive heart failure, atrial fibrillation, acute kidney injury, chronic obstructive pulmonary disease, liver failure, pancytopenia, tumor lysis syndrome, and severe protein-calorie malnutrition were independently associated with inpatient mortality. Hospitalization costs showed an increasing trend, impacting the overall population and survivors. Conclusion These insights may refine risk assessment, treatment selection, and interventions.
Collapse
Affiliation(s)
- Zubair Hassan Bodla
- University of Central Florida College of Medicine, Graduate Medical Education, Orlando, Florida, USA
- HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, Florida, USA
| | - Mariam Hashmi
- HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, Florida, USA
| | - Fatima Niaz
- King Edward Medical University, Lahore, Punjab, Pakistan
- Mayo Hospital, Lahore, Punjab, Pakistan
| | - Umer Farooq
- Rochester Regional Health, Rochester, New York, USA
| | - Farhan Khalid
- Monmouth Medical Center, Long Branch, New Jersey, USA
| | | | | | - Victoria S. Brown
- Florida Cancer Specialists and Research Institute, Gainesville, Florida, USA
| | - Christopher L. Bray
- University of Central Florida College of Medicine, Graduate Medical Education, Orlando, Florida, USA
- HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, Florida, USA
| |
Collapse
|
15
|
Zahra N, Uzair M, Zaid IU, Attia KA, Inam S, Fiaz S, Abdallah RM, Naeem MK, Farooq U, Rehman N, Ali GM, Xu J, Li Z, Khan MR. The comparative transcriptome analysis of two green super rice genotypes with varying tolerance to salt stress. Mol Biol Rep 2023; 51:22. [PMID: 38110786 DOI: 10.1007/s11033-023-08998-x] [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] [Received: 08/05/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Salinity is one of the main abiotic factors that restrict plant growth, physiology, and crop productivity is salt stress. About 33% of the total irrigated land suffers from severe salinity because of intensive underground water extraction and irrigation with brackish water. Thus, it is important to understand the genetic mechanism and identify the novel genes involved in salt tolerance for the development of climate-resilient rice cultivars. METHODS AND RESULTS In this study, two rice genotypes with varying tolerance to salt stress were used to investigate the differential expressed genes and molecular pathways to adapt under saline soil by comparative RNA sequencing at 42 days of the seedling stage. Salt-susceptible (S3) and -tolerant (S13) genotypes revealed 3982 and 3463 differentially expressed genes in S3 and S13 genotypes. The up-regulated genes in both genotypes were substantially enriched in different metabolic processes and binding activities. Biosynthesis of secondary metabolites, phenylpropanoid biosynthesis, and plant signal transduction mechanisms were highly enriched. Salt-susceptible and -tolerant genotypes shared the same salt adaptability mechanism with no significant quantitative differences at the transcriptome level. Moreover, bHLH, ERF, NAC, WRKY, and MYB transcription factors were substantially up-regulated under salt stress. 391 out of 1806 identified novel genes involved in signal transduction mechanisms. Expression profiling of six novel genes further validated the findings from RNA-seq data. CONCLUSION These findings suggest that the differentially expressed genes and molecular mechanisms involved in salt stress adaptation are conserved in both salt-susceptible and salt-tolerant rice genotypes. Further molecular characterization of novel genes will help to understand the genetic mechanism underlying salt tolerance in rice.
Collapse
Affiliation(s)
- Nageen Zahra
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Muhammad Uzair
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Imdad Ullah Zaid
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Kotb A Attia
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Safeena Inam
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Sajid Fiaz
- Department of Plant Breeding and Genetics, The University of Haripur, Haripur, 22620, Pakistan.
| | - Rizk M Abdallah
- Department of Rice, Field Crops Research Institute, ARC, Sakha, Kafrelshiekh, 33717, Egypt
| | - Muhammad Kashif Naeem
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Umer Farooq
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | - Nazia Rehman
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan
| | | | - Jianlong Xu
- Institute of Crop Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Zhikang Li
- Institute of Crop Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Muhammad Ramzan Khan
- National Institute for Genomics and Advanced Biotechnology (NIGAB), NARC, Park Road, Islamabad, 45500, Pakistan.
| |
Collapse
|
16
|
Arshad HMS, Farooq U, Cheema A, Arshad A, Masood M, Vega KJ. Disparities in esophageal cancer incidence and esophageal adenocarcinoma mortality in the United States over the last 25-40 years. World J Gastrointest Endosc 2023; 15:715-724. [PMID: 38187915 PMCID: PMC10768036 DOI: 10.4253/wjge.v15.i12.715] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 12/15/2023] Open
Abstract
BACKGROUND Esophageal carcinoma presents as 2 types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) with the frequency of both changing in the United States (US).
AIM To investigate EAC/ESCC incidence time trends among the 3 main US racial groups and investigate trends in US EAC survival by ethnicity.
METHODS Twenty-five years (1992-2016) of data from SEER 13 program was analyzed to compare incidence trends in EAC and ESCC between non-Hispanic whites (nHW), non-Hispanic Blacks (nHB) and Hispanics (Hisp) using SEERStat®. In addition, SEER 18 data, from 1975-2015, on EAC in the US was analyzed to evaluate racial disparities in incidence and survival using SEERStat® and Ederer II method.
RESULTS In the 3 major US ethnic groups, age-adjusted incidence of ESCC has declined while EAC has continued to rise from 1992-2016. Of note, in Hisp, the EAC incidence rate increased while ESCC decreased from 1992 to 2016, resulting in EAC as the predominant esophageal cancer subtype in this group since 2011, joining nHW. Furthermore, although ESCC remains the predominant tumor in nHB, the difference between ESCC and EAC has narrowed dramatically over 25 years. EAC survival probabilities were worse in all minority groups compared to nHw.
CONCLUSION Hisp have joined nHW as US ethnic groups more likely to have EAC than ESCC. Of note, EAC incidence in nHB is increasing at the highest rate nationally. Despite lower EAC incidence in all minority groups compared to nHW, these populations have decreased survival compared to nHW.
Collapse
Affiliation(s)
- Hafiz Muhammad Sharjeel Arshad
- Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
| | - Umer Farooq
- Department of Internal Medicine, Loyola Medicine/MacNeil Hospital, Berwyn, IL 60402, United States
| | - Ayesha Cheema
- Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
| | - Ayesha Arshad
- Department of Medicine, Fatima Memorial Medical College, Lahore 54000, Punjab, Pakistan
| | - Muaaz Masood
- Department of Medicine, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
| | - Kenneth J Vega
- Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
| |
Collapse
|
17
|
Shah GM, Farooq U, Shabbir Z, Guo J, Dong R, Bakhat HF, Wakeel M, Siddique A, Shahid N. Impact of Cadmium Contamination on Fertilizer Value and Associated Health Risks in Different Soil Types Following Anaerobic Digestate Application. Toxics 2023; 11:1008. [PMID: 38133410 PMCID: PMC10747593 DOI: 10.3390/toxics11121008] [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] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Cadmium (Cd) contamination in the soil potentially hampers microbial biomass and adversely affects their services such as decomposition and mineralization of organic matter. It can reduce nitrogen (N) metabolism and consequently affect plant growth and physiology. Further, Cd accumulation in plants can pose health risks through vegetable consumption. Here, we investigated consequences of Cd contamination on fertilizer value and associated health risks following the application of biogas residues (BGR) to various soil types. Our results indicate that the application of BGR to all soil types significantly increased dry matter (DM) yield and N uptake. However, the Cd contamination negatively affected DM yield and N recovery from BGR in a dose-dependent manner. Organic N mineralization from BGR also decreased in Cd-contaminated soils. The highest DM yield and N recovery were recorded in sandy soil, whereas the lowest values were observed in clay soil. Cadmium was accumulated in spinach, and health risk index (HRI) associated with its dietary intake revealed that consuming spinach grown in Cd-contaminated soil, with or without BGR, is unsafe. Among the soil types, values of daily intake of metals (DIM) and HRI were lowest in clay soil and highest in sandy soil. However, the application of BGR curtailed HRI across all soil types. Notably, the application of BGR alone resulted in HRI values < 1, which are under the safe limit. We conclude that soil contamination with Cd reduces fertilizer value and entails implications for human health. However, the application of BGR to the soil can decrease Cd effects.
Collapse
Affiliation(s)
- Ghulam Mustafa Shah
- Key Laboratory for Clean Renewable Energy Utilization Technology, Ministry of Agriculture, College of Engineering, China Agricultural University, Beijing 100083, China
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari 61100, Pakistan
| | - Umer Farooq
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari 61100, Pakistan
| | - Zunaira Shabbir
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari 61100, Pakistan
| | - Jianbin Guo
- Key Laboratory for Clean Renewable Energy Utilization Technology, Ministry of Agriculture, College of Engineering, China Agricultural University, Beijing 100083, China
| | - Renjie Dong
- Key Laboratory for Clean Renewable Energy Utilization Technology, Ministry of Agriculture, College of Engineering, China Agricultural University, Beijing 100083, China
| | - Hafiz Faiq Bakhat
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari 61100, Pakistan
| | - Muhammad Wakeel
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari 61100, Pakistan
| | - Ayesha Siddique
- Department of System-Ecotoxicology, Helmholtz Centre for Environmental Research—UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Naeem Shahid
- Department of System-Ecotoxicology, Helmholtz Centre for Environmental Research—UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Department of Evolutionary Ecology and Environmental Toxicology, Goethe University Frankfurt, 60629 Frankfurt am Main, Germany
| |
Collapse
|
18
|
Niu C, Zhang J, Bapaye J, Liu H, Zhu K, Farooq U, Zahid S, Zhang Q, Boppana H, Elkhapery A, Okolo PI. Systematic Review With Meta-Analysis: Chronic Opioid Use Is Associated With Esophageal Dysmotility in Symptomatic Patients. Am J Gastroenterol 2023; 118:2123-2132. [PMID: 37463432 DOI: 10.14309/ajg.0000000000002410] [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: 01/29/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION We aimed to conduct a systematic review and meta-analysis to assess the impact of chronic opioid exposure on esophageal motility in patients undergoing manometric evaluation. METHODS Multiple databases were searched through October 2022 for original studies comparing the manometric results of patients who have used chronic opioids (for >90 days) with those who do not. The primary outcomes were esophageal dysmotility disorders. Three high-resolution manometry parameters were conducted as secondary outcomes. A random-effects model was applied to calculate the odds ratio (OR) and means difference (MD) along with a 95% confidence interval (CI). RESULTS Nine studies were included in this meta-analysis. Opioid use was associated with higher esophageal dysmotility disorders, including distal esophageal spasm (pooled OR 4.84, 95% CI 1.60-14.63, P = 0.005, I 2 = 96%), esophagogastric junction outflow obstruction (pooled OR 5.13, 95% CI 2.11-12.43, P = 0.0003, I 2 = 93%), and type III achalasia (pooled OR 4.15, 95% CI 2.15-8.03, P < 0.0001, I 2 = 64%). No significant differences were observed for hypercontractile esophagus, type I achalasia, or type II achalasia. The basal lower esophageal sphincter pressure (MD 3.02, 95% CI 1.55-4.50, P < 0.0001, I 2 = 90%), integrated relaxation pressure (MD 2.51, 95% CI 1.56-3.46, P < 0.00001, I 2 = 99%), and distal contractile integral (MD 640.29, 95% CI 469.56-811.03, P < 0.00001, I 2 = 91%) significantly differed between the opioid use and nonopioid use group. However, opioid use was associated with a lower risk of ineffective esophageal motility (pooled OR 0.68, 95% CI 0.49-0.95, P = 0.02, I 2 = 53%). DISCUSSION Chronic opioid exposure is associated with an increased frequency esophageal dysmotility disorders. Our results revealed that opioid use is significantly associated with type III achalasia but not with type I and II achalasia. Therefore, opioid treatment should be taken into account as a potential underlying risk factor when diagnosing these major esophageal motor abnormalities.
Collapse
Affiliation(s)
- Chengu Niu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Jing Zhang
- Harbin Medical University, Harbin, China
| | - Jay Bapaye
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Hongli Liu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Kaiwen Zhu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Umer Farooq
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Salman Zahid
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Qian Zhang
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Hemanth Boppana
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Ahmed Elkhapery
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, New York, USA
| | - Patrick I Okolo
- Division of Gastroenterology, Rochester General Hospital, Rochester, New York, USA
| |
Collapse
|
19
|
Iqbal Z, Shafiq M, Sattar MN, Ali I, Khurshid M, Farooq U, Munir M. Genetic Diversity, Evolutionary Dynamics, and Ongoing Spread of Pedilanthus Leaf Curl Virus. Viruses 2023; 15:2358. [PMID: 38140599 PMCID: PMC10747432 DOI: 10.3390/v15122358] [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] [Received: 10/28/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Pedilanthus leaf curl virus (PeLCV) is a monopartite begomovirus (family Geminiviridae) discovered just a few decades ago. Since then, it has become a widely encountered virus, with reports from ca. 25 plant species across Pakistan and India, indicative of its notable evolutionary success. Viruses mutate at such a swift rate that their ecological and evolutionary behaviors are inextricably linked, and all of these behaviors are imprinted on their genomes as genetic diversity. So, all these imprints can be mapped by computational methods. This study was designed to map the sequence variation dynamics, genetic heterogeneity, regional diversity, phylogeny, and recombination events imprinted on the PeLCV genome. Phylogenetic and network analysis grouped the full-length genome sequences of 52 PeLCV isolates into 7 major clades, displaying some regional delineation but lacking host-specific demarcation. The progenitor of PeLCV was found to have originated in Multan, Pakistan, in 1977, from where it spread concurrently to India and various regions of Pakistan. A high proportion of recombination events, distributed unevenly throughout the genome and involving both inter- and intraspecies recombinants, were inferred. The findings of this study highlight that the PeLCV population is expanding under a high degree of genetic diversity (π = 0.073%), a high rate of mean nucleotide substitution (1.54 × 10-3), demographic selection, and a high rate of recombination. This sets PeLCV apart as a distinctive begomovirus among other begomoviruses. These factors could further exacerbate the PeLCV divergence and adaptation to new hosts. The insights of this study that pinpoint the emergence of PeLCV are outlined.
Collapse
Affiliation(s)
- Zafar Iqbal
- Central Laboratories, King Faisal University, Al-Ahsa P.O. Box 55110, Saudi Arabia;
| | - Muhammad Shafiq
- Department of Biotechnology, University of Management and Technology, Sialkot Campus, Sialkot P.O. Box 51340, Pakistan;
| | | | - Irfan Ali
- Centre of Agricultural Biochemistry and Biotechnology, University of Agriculture, Faisalabad P.O. Box 38000, Pakistan;
| | - Muhammad Khurshid
- School of Biochemistry and Biotechnology, University of the Punjab, Lahore P.O. Box 54590, Pakistan;
| | - Umer Farooq
- Department of Biotechnology, University of Sialkot, Sialkot P.O. Box 51340, Pakistan;
| | - Muhammad Munir
- Date Palm Research Center of Excellence, King Faisal University, Al-Ahsa P.O. Box 31982, Saudi Arabia;
| |
Collapse
|
20
|
Niu C, Bapaye J, Zhang J, Zhu K, Liu H, Farooq U, Zahid S, Elkhapery A, Okolo PI. Tip-in Versus Conventional Endoscopic Mucosal Resection for Colorectal Neoplasia: A Systematic Review and Meta-analysis. J Clin Gastroenterol 2023; 57:983-990. [PMID: 37389930 DOI: 10.1097/mcg.0000000000001880] [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] [Indexed: 07/01/2023]
Abstract
BACKGROUND Early-stage gastrointestinal neoplasms are frequently treated with conventional endoscopic mucosal resection (C-EMR). However, C-EMR frequently leads to incomplete resection of large colorectal lesions. Tip-in endoscopic mucosal resection (EMR), which was recently introduced for en bloc resection of colorectal neoplasms, minimizes slippage during the procedure. METHODS We conducted a systematic review and meta-analysis of published studies that compared Tip-in EMR with conventional EMR. We searched several electronic databases and included studies that reported on the primary outcomes of en bloc resection rate and complete resection rate, as well as secondary outcomes such as procedure time and procedure-related complications (including perforation and delayed bleeding rate). We used a random effects model to calculate odds ratios (ORs) with 95% CIs for dichotomous data and weighted mean differences with 95% CIs for continuous data. We also conducted several sensitivity analyses to assess the robustness of our findings. RESULTS A total of 11 studies involving 1244 lesions (684 in the Tip-in EMR group and 560 in C-EMR group) were included in the meta-analysis. Our meta-analysis showed that compared with conventional EMR, Tip-in EMR significantly increased the en bloc resection rate in patients with colorectal neoplasia (OR=3.61; 95% CI, 2.09-6.23; P <0.00001; I2 =0%) and had a higher complete resection rate (OR=2.49; 95% CI, 1.65-3.76; P <0.0001; I2 =0%). However, the procedure time and rates of procedure-related complications did not differ significantly between the 2 groups. CONCLUSIONS Tip-in EMR outperformed C-EMR for both the en bloc and complete resection of colorectal lesions with similar rates of procedural complications.
Collapse
Affiliation(s)
| | | | - Jing Zhang
- Harbin Medical University, Harbin, China
| | | | | | | | | | | | - Patrick I Okolo
- Division of Gastroenterology, Rochester General Hospital, Rochester, NY
| |
Collapse
|
21
|
Bano A, Hepsomali P, Rabbani F, Farooq U, Kanwal A, Saleem A, Bugti AA, Khan AA, Khalid Z, Bugti M, Mureed S, Khan S, Ujjan ID, Şahin S, Kara M, Khan A. The possible "calming effect" of subchronic supplementation of a standardised phospholipid carrier-based Melissa officinalis L. extract in healthy adults with emotional distress and poor sleep conditions: results from a prospective, randomised, double-blinded, placebo-controlled clinical trial. Front Pharmacol 2023; 14:1250560. [PMID: 37927585 PMCID: PMC10620697 DOI: 10.3389/fphar.2023.1250560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023] Open
Abstract
Background: Emotional distress conditions such as depression, anxiety, stress, and poor sleep are widespread health problems that have a significant impact on people's lives. Conventional drugs are commonly prescribed to treat emotional distress and poor sleep conditions; however, these medications have several limitations and have shown multiple side effects. Over recent years botanicals-based pharmacological agents have gained increasing research and clinical interest in the management of emotional distress and sleep disorder. Of note, Melissa officinalis L. (MO) leaf extract has demonstrated considerable neuropharmacological properties both in animal and human studies and has emerged as a promising natural "calming agent." However, research in this area is limited, and more studies are needed to validate its efficacy in amelioration of emotional distress and poor sleep conditions. Objectives: We aimed to assess the pharmacological effects of subchronic supplementation of an innovative standardised phospholipid carrier-based MO aqueous extract on emotional distress and poor sleep conditions. Design: A 3-week prospective, randomised, placebo-controlled, parallel-group, double-blinded clinical trial was conducted in 100 healthy adults complaining of a moderate degree of depression, anxiety, or stress, with scores of ≥14, ≥10, and ≥19, respectively, in the self-report Depression, Anxiety, and Stress Scale (DASS-42) or poor sleep, as indicated by the score of >5 in the Pittsburgh Sleep Quality Index (PSQI) scale. In addition, the impact of emotional distress and/or poor sleep on participants' mental wellbeing, emotional feelings, and quality of life was also assessed using the self-reported Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Positive and Negative Affect Schedule (PANAS) scale, and quality of life (WHO-QoL-BREF) scale, respectively. Results: Oral supplementation of 200 mg of phospholipid-based MO aqueous extract (Relissa™) tablets twice a day (i.e., 400 mg/day) for 3 weeks led to significant improvements in the depressive mood, anxiety, stress, positive and negative affect (emotional feelings), overall mental wellbeing, and quality-of-life scores (all p values <0.001). Supplementation of MO extract was well tolerated, and no treatment-emergent effects or serious adverse events were reported. Conclusion: According to the results of this study, the phospholipid carrier-based MO aqueous extract possesses considerable neuropharmacological properties, and its supplementation may provide a promising therapeutic option for the management of moderate emotional distress and/or poor sleep conditions. Clinical Trial Registration: clinicaltrials.gov, identifier NCT05602688.
Collapse
Affiliation(s)
- Aasiya Bano
- PEOC, Department of Health, Quetta, Balochistan, Pakistan
| | - Piril Hepsomali
- School of Psychology, University of Roehampton, London, United Kingdom
| | - Fazle Rabbani
- Department of Psychiatry, Lady Reading Hospital, Peshawar, Pakistan
| | - Umer Farooq
- Ayub Medical College and Teaching Hospital, Abbottabad, Pakistan
| | - Ayesha Kanwal
- Department of Psychiatry, Lady Reading Hospital, Peshawar, Pakistan
| | - Aisha Saleem
- Ayub Medical College and Teaching Hospital, Abbottabad, Pakistan
| | - Ali Akbar Bugti
- Department of General Surgery, Bolan Medical Complex Hospital (BMCH), Quetta, Pakistan
| | - Aftab Alam Khan
- Ayub Medical College and Teaching Hospital, Abbottabad, Pakistan
| | - Zainab Khalid
- Ayub Medical College and Teaching Hospital, Abbottabad, Pakistan
| | - Mahroo Bugti
- Department of Gynaecology and Obstetrics, BMCH, Quetta, Pakistan
| | - Shah Mureed
- Department of Paediatrics, BMCH, Quetta, Pakistan
| | - Saeed Khan
- Department of Pathology, Dow University of Health Sciences, Karachi, Pakistan
| | - Ikram Din Ujjan
- Department of Pathology, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan
| | - Sümeyye Şahin
- Department of Food Engineering, Ordu University, Ordu, Türkiye
| | - Mehtap Kara
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Istanbul University, Istanbul, Türkiye
| | - Amjad Khan
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Biochemistry, LUMHS, Jamshoro, Pakistan
| |
Collapse
|
22
|
Vukovic T, Røstad J, Farooq U, Torsæter O, van der Net A. Systematic Study of Wettability Alteration of Glass Surfaces by Dichlorooctamethyltetrasiloxane Silanization-A Guide for Contact Angle Modification. ACS Omega 2023; 8:36662-36676. [PMID: 37841121 PMCID: PMC10568999 DOI: 10.1021/acsomega.3c02448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
To investigate the effects of wettability on multiphase flow in porous media, glass bead packs or micromodels are commonly used. Their wettability can be altered by the surface treatment method-silanization. Although silanization is widely used for glass wettability modification, comparable systematic approaches over a large range of geometries, treatment conditions, and measurement systems are scarce. In this work, dichlorooctamethyltetrasiloxane (Surfasil) treatment was systematically investigated, resulting in a guide for achieving a wide range of contact angles. Initially, the influence of the Surfasil solvent, treatment time, and Surfasil-to-solvent ratio was investigated on glass plates using the sessile drop method. By varying these variables, it was possible to achieve a wide range of comparable, repeatable, and stable contact angles, from approximately 20-95° for air-water systems. Due to the linear increase of contact angle with larger Surfasil exposure, either due to the time or concentration, contact angle tuning is possible until the critical point. Beyond the critical point of exposure, a system-specific plateau value is reached, independent of the approach. After establishing a clear relationship between the parameters and contact angles, the same treatment parameters were applied to single beads, micromodels, and beadpacks with heptane as the chosen solvent. Optical image analysis was used for the microchips, and micro CT data analysis was used for the bead packs. The treatment appeared to be transferable to all geometries, resulting in similar wetting conditions within the limitations of the measurements. It is concluded that a glass plate can be used as an analogue for obtaining the contact angle alteration trends for more complex porous media with similar compositions. Data analysis methods and surface roughness could have an effect on the obtained contact angle spread.
Collapse
Affiliation(s)
- Tomislav Vukovic
- Department
of Petroleum and Geoscience, Norwegian University
of Science and Technology, Trondheim 7031, Norway
| | - Jostein Røstad
- Department
of Petroleum and Geoscience, Norwegian University
of Science and Technology, Trondheim 7031, Norway
| | - Umer Farooq
- Department
of Petroleum, SINTEF Industry, Trondheim 7465, Norway
| | - Ole Torsæter
- Department
of Petroleum and Geoscience, Norwegian University
of Science and Technology, Trondheim 7031, Norway
| | - Antje van der Net
- Department
of Petroleum and Geoscience, Norwegian University
of Science and Technology, Trondheim 7031, Norway
| |
Collapse
|
23
|
Tarar ZI, Farooq U, Zafar Y, Gandhi M, Raza S, Kamal F, Tarar MF, Ghouri YA. Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: a nationwide analysis. Ir J Med Sci 2023; 192:2159-2166. [PMID: 36593438 DOI: 10.1007/s11845-022-03258-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIM Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder that affects patients both physically and mentally. Our study aimed to investigate the burden of psychiatric disorders in IBS patients. METHODS We conducted a retrospective analysis of the National inpatient sample (NIS) from 2016 to 2019. We recruited patients admitted with a diagnosis of IBS and determined the prevalence of anxiety, depression, and suicide attempt/ideation. RESULTS We found a total of 1,256,325 hospitalizations with a diagnosis of IBS. Among them, 478,515 (38.1%) had anxiety and 344,165 (27.4%) had depression. The prevalence of psychiatric disorders including anxiety (38.1% vs. 15.1%), depression (38.1% vs. 15.1%), bipolar disorder (5.22% vs. 2.38%), suicidal attempt/Ideation (3.22% vs. 2.38%), and eating disorder (0.32% vs. 0.08%) was significantly higher in IBS patient population when compared to general adult population (p < 0.001). Patients with IBS had greater odds of anxiety (AOR 2.88, 95% CI 2.85-2.91, P < 0.001), depression (AOR 2.16, 95% CI 2.14-2.19, P < 0.001) and suicidal attempt/ideation (AOR 1.94, 95% CI 1.88-2.00, P < 0.001) in comparison to general population. IBS subtypes including diarrhea-predominant, constipation-predominant and mixed type were independently associated with increased odds of anxiety, depression, and suicide attempt/ideation. Patients with IBS and a co-diagnosis of anxiety or depression had increased mean length of hospital stay by 0.48 (95% CI 0.43-0.52, P < 0.001) and 0.52 (95% CI 0.06-0.97, P < 0.03) days, respectively. CONCLUSION The presence of IBS is associated with an increased associated prevalence of psychiatric disorders such as anxiety, depression, and suicide attempt/ideation.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA.
| | - Umer Farooq
- Rochester General Hospital, Rochester, NY, USA
| | - Yousaf Zafar
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Samina Raza
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Faisal Kamal
- Department of Gastroenterology, University of California, San Francisco, USA
| | - Moosa F Tarar
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Yezaz A Ghouri
- Division of Gastroenterology & Hepatology, School of Medicine at Columbia, University of Missouri, Columbia, MO, USA
| |
Collapse
|
24
|
Gazaille C, Bozzato E, Madadian-Bozorg N, Mellinger A, Sicot M, Farooq U, Saulnier P, Eyer J, Préat V, Bertrand N, Bastiat G. Glioblastoma-targeted, local and sustained drug delivery system based on an unconventional lipid nanocapsule hydrogel. Biomater Adv 2023; 153:213549. [PMID: 37453243 DOI: 10.1016/j.bioadv.2023.213549] [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: 05/19/2023] [Revised: 06/21/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
The objective of this work was to develop an implantable therapeutic hydrogel that will ensure continuity in treatment between surgery and radiochemotherapy for patients with glioblastoma (GBM). A hydrogel of self-associated gemcitabine-loaded lipid nanocapsules (LNC) has shown therapeutic efficacy in vivo in murine GBM resection models. To improve the targeting of GBM cells, the NFL-TBS.40-63 peptide (NFL), was associated with LNC. The LNC-based hydrogels were formulated with the NFL. The peptide was totally and instantaneously adsorbed at the LNC surface, without modifying the hydrogel mechanical properties, and remained adsorbed to the LNC surface after the hydrogel dissolution. In vitro studies on GBM cell lines showed a faster internalization of the LNC and enhanced cytotoxicity, in the presence of NFL. Finally, in vivo studies in the murine GBM resection model proved that the gemcitabine-loaded LNC with adsorbed NFL could target the non-resected GBM cells and significantly delay or even inhibit the apparition of recurrences.
Collapse
Affiliation(s)
- Claire Gazaille
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | | | | | - Adélie Mellinger
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | - Marion Sicot
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | - Umer Farooq
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | - Patrick Saulnier
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | - Joël Eyer
- Univ Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France
| | | | - Nicolas Bertrand
- Univ Laval, Faculty of Pharmacy, CHU Quebec Research Center, Québec, QC, Canada
| | | |
Collapse
|
25
|
Irshad R, Farooq U, Ullah I, Farooq A, Shah T, Gul A, Badshah A. Comparative Evaluation And Accuracy Of Ict, Clia And Nat For The Detection Of Hepatitis B, C And Hiv In The Blood Donors. J Ayub Med Coll Abbottabad 2023; 35:654-657. [PMID: 38406955 DOI: 10.55519/jamc-04-12757] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
BACKGROUND A sensitive and specific donor screening strategy is essential for the prevention of transfusion-transmitted infections (TTI). The study was conducted to ascertain the comparative efficacy of ICT, CLIA and NAT methods. METHODS This cross-sectional analytical study was conducted in Regional Blood Center Abbottabad, Pakistan from 1st April to 25 August 2022. 6233 donors were screened for Hep B, C, and HIV by testing simultaneously with ICT, CLIA and NAT. RESULTS Active Hep B, C and HIV Infection was present in 0.51%, 0.28% and 0.00048% donors respectively. The sensitivity was found to be higher for HBV and HIV with CLIA as compared to ICT but was equal for HCV with both. whereas specificity was the same with both CLIA and ICT for all three viruses. PPV was higher with ICT for HBV and HCV, but for HIV it was found higher by CLIA. NPV was higher for all three viruses by CLIA as compared to ICT. CONCLUSIONS In case rapid testing devices are used for the initial screening of blood in countries with limited resources, positive cases must be confirmed by CLIA and if possible, then by NAT because of missing cases in the window period and false positive cases.
Collapse
Affiliation(s)
| | - Umer Farooq
- Department of Community Medicine, Ayub Medical College, Abbottabad
| | - Ihsan Ullah
- Institute of Basic Medical Sciences, KMU, Peshawar
| | | | - Tahir Shah
- Regional Blood Centre, Ayub Medical College & Teaching Hospital, Abbottabad, Pakistan
| | - Adeel Gul
- Regional Blood Centre, Ayub Medical College & Teaching Hospital, Abbottabad, Pakistan
| | - Amir Badshah
- Regional Blood Centre, Ayub Medical College & Teaching Hospital, Abbottabad, Pakistan
| |
Collapse
|
26
|
Tarar ZI, Farooq U, Nawaz A, Gandhi M, Ghouri YA, Bhatt A, Cash BD. Prevalence of Fibromyalgia and Chronic Fatigue Syndrome among Individuals with Irritable Bowel Syndrome: An Analysis of United States National Inpatient Sample Database. Biomedicines 2023; 11:2594. [PMID: 37892968 PMCID: PMC10604744 DOI: 10.3390/biomedicines11102594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Background and Aim: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder associated with other somatic disorders. We studied the prevalence and predictors of fibromyalgia and chronic fatigue syndrome (CFS) in IBS patients. Methods: We used the National Inpatient Sample and included hospitalization of individuals with IBS, using ICD-10 codes, from 2016-2019. The prevalence and predictors of fibromyalgia and CFS in IBS patients were studied. Univariate and multivariate patient- and hospital-level regression models were used to calculate the adjusted odds of fibromyalgia and CFS in the IBS patient population. Results: Of 1,256,325 patients with an ICD-10 code of IBS included in the study, 10.73% (134,890) also had ICD-10 codes for fibromyalgia and 0.42% (5220) for CFS. The prevalence of fibromyalgia and CFS was significantly higher in IBS patients (adjusted odds ratio (AOR) 5.33, 95% confidence interval (CI) 5.24-5.41, p < 0.001, and AOR 5.40, 95% CI 5.04-5.78, p < 0.001, respectively) compared to the general adult population without IBS. IBS-diarrhea, IBS-constipation, and IBS-mixed types were independently associated with increased odds of fibromyalgia and CFS. Increasing age (AOR 1.02, 95% CI 1.01-1.04, p 0.003; AOR 1.02, 95% CI 1.01-1.03, p 0.001), female gender (AOR 11.2, 95% CI 11.1-11.4, p < 0.001; AOR 1.86, 95% CI 1.78-1.93, p < 0.001) and white race (AOR 2.04, 95% CI 1.95-2.12, p < 0.001; AOR 1.69, 95% CI 1.34-2.13, p < 0.001) were independent predictors of increased odds of fibromyalgia and CFS, respectively. Conclusions: It appears that IBS is associated with an increased prevalence of somatic disorders such as fibromyalgia and CFS.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Umer Farooq
- Division of Gastroenterology and Hepatology, Saint Louis University, St. Louis, MO 63103, USA;
| | - Ahmad Nawaz
- Division of Gastroenterology and Hepatology, Suny Upstate Medical University, Syracuse, NY 13210, USA
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Yezaz A. Ghouri
- Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Asmeen Bhatt
- Center for Interventional Gastroenterology at UTHealth (iGUT), Division of Elective Surgery, Department of Surgery, University of Texas Health Medical School, Houston, TX 77030, USA
| | - Brooks D. Cash
- Division of Gastroenterology & Hepatology, University of Texas Health-McGovern Medical School and UT Health Science Center at Houston, St. Houston, TX 77054, USA
| |
Collapse
|
27
|
Farooq U, Idris M, Sajjad N, Afzal MA. Assessing total erythrocyte count as a potential attribute for estimating hemoglobin in Cholistani cattle. Trop Anim Health Prod 2023; 55:306. [PMID: 37731026 DOI: 10.1007/s11250-023-03744-8] [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: 12/23/2022] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
The main objective of the study was to confirm whether a specific and constant interrelationship exists between total erythrocyte count (TEC) and hemoglobin (Hb) concentration in Cholistani cattle blood and to navigate the potential of TEC for estimating Hb level in Cholistani cattle (n = 264) grouped as per gender (males, n = 122; females, n = 142) and age (young, n = 140; adults, n = 124). The TEC and Hb (HbD) estimation was carried out through veterinary hematology analyzer. The Hb was also calculated as TEC × 3 and was termed as HbC. Linear regression was implied, and accordingly, scatterplots were drawn between TEC, HbD, HbC, and corrected Hb (CHB). The regression prediction equation hence attained was used to deduce corrected hemoglobin (CHb). A significant (P ≤ 0.05) difference was noticed between HbD and HbC. A non-significant (P ≥ 0.05) difference was noticed, however, between HbD and CHb. Tests of level of agreement indicated a higher Cronbach's alpha and intraclass correlation coefficient (0.682 for average measures) for HbD and CHb as compared to that for HbD and HbC (0.559 for average measures). A convention of Hb concentration as three times of TEC (× 3) is not valid for Cholistani cattle. A different pen-side hematological formula, i.e., Hb (g/dL) = 0.66(TEC) + 6.1, however, provides a better estimate of Hb from the TEC in cattle blood. Using hemocytometry for TEC in the field, all the stakeholders associated with veterinary research, academics, and practice may benefit from this formula in resource-poor countries.
Collapse
Affiliation(s)
- Umer Farooq
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
| | - Musadiq Idris
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Nouman Sajjad
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Abrar Afzal
- Department of Physiology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
28
|
Rehman OU, Uzair M, Farooq MS, Saleem B, Attacha S, Attia KA, Farooq U, Fiaz S, El-Kallawy WH, Kimiko I, Khan MR. Comprehensive insights into the regulatory mechanisms of lncRNA in alkaline-salt stress tolerance in rice. Mol Biol Rep 2023; 50:7381-7392. [PMID: 37450076 DOI: 10.1007/s11033-023-08648-2] [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] [Received: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Alkaline-salt is one of the abiotic stresses that slows plant growth and developmental processes and threatens crop yield. Long non-coding RNAs (lncRNAs) are endogenous RNA found in plants that engage in a variety of cellular functions and stress responses. METHOD lncRNAs act as competing endogenous RNAs (ceRNA) and constitute a new set of gene control. The precise regulatory mechanism by which lncRNAs function as ceRNAs in response to alkaline-salt stress remains unclear. We identified alkaline-salt responsive lncRNAs using transcriptome-wide analysis of two varieties including alkaline-salt tolerant [WD20342 (WD)] and alkaline-salt sensitive [Caidao (CD)] rice cultivar under control and alkaline-salt stress treated [WD20342 (WDT, and Caidao (CDT)] conditions. RESULTS Investigating the competitive relationships between mRNAs and lncRNAs, we next built a ceRNA network involving lncRNAs based on the ceRNA hypothesis. Expression profiles revealed that a total of 65, 34, and 1549 differentially expressed (DE) lncRNAs, miRNAs, and mRNAs were identified in alkaline-salt tolerant WD (Control) vs. WDT (Treated). Similarly, 75 DE-lncRNAs, 34 DE-miRNAs, and 1725 DE-mRNAs (including up-regulated and down-regulated) were identified in alkaline-salt sensitive CD (Control) vs. CDT (Treated), respectively. An alkaline-salt stress ceRNA network discovered 321 lncRNA-miRNA-mRNA triplets in CD and CDT, with 32 lncRNAs, 121 miRNAs, and 111 mRNAs. Likewise, 217 lncRNA-miRNA-mRNA triplets in WD and WDT revealed the NONOSAT000455-osa_miR5809b-LOC_Os11g01210 triplet with the highest degree as a hub node with the most significant positive correlation in alkaline-salt stress response. CONCLUSION The results of our investigation indicate that osa-miR5809b is dysregulated and plays a part in regulating the defense response of rice against alkaline-salt stress. Our study highlights the regulatory functions of lncRNAs acting as ceRNAs in the mechanisms underlying alkaline-salt resistance in rice.
Collapse
Affiliation(s)
- Obaid Ur Rehman
- Food Science and Biological Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan
| | - Muhammad Uzair
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan.
| | - Muhammad Shahbaz Farooq
- Food Science and Biological Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan
| | - Bilal Saleem
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan
| | - Safira Attacha
- Institute of Biotechnology and Genetic Engineering, The University of Agriculture, Peshawar, Pakistan
| | - Kotb A Attia
- Department of Biochemistry, Science College, King Saud University, POX, Riyadh, 2455-11451, Saudi Arabia.
| | - Umer Farooq
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan
| | - Sajid Fiaz
- Department of Plant Breeding and Genetics, The University of Haripur, Haripur, 22620, Pakistan
| | - Wael H El-Kallawy
- Agriculture Research Center, (ARC), Rice Research and Training Center, (RRTC) Sakha, Field Crop Research Institute, Sakha, Egypt
| | - Itoh Kimiko
- Institute of Science and Technology, Niigata University, Ikarashi-2, Nishi-ku, Niigata, 950-2181, Japan
| | - Muhammad Ramzan Khan
- National Institute for Genomics and Advanced Biotechnology, Park Road, Islamabad, 45500, Pakistan.
| |
Collapse
|
29
|
Niu C, Bapaye J, Zhang J, Liu H, Zhu K, Farooq U, Zahid S, Chathuranga D, Okolo PI. Systematic review and meta-analysis of cold snare polypectomy and hot snare polypectomy for colorectal polyps. J Gastroenterol Hepatol 2023; 38:1458-1467. [PMID: 37539860 DOI: 10.1111/jgh.16312] [Citation(s) in RCA: 2] [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: 02/13/2023] [Revised: 06/12/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND AIM Cold snare polypectomy (CSP) has become increasingly utilized to resect colorectal polyps, given its efficacy and safety. This study aims to compare CSP and hot snare polypectomy (HSP) for resecting small (< 10 mm) and large (10-20 mm) colorectal lesions. METHODS Relevant publications were obtained from Cochrane Library, Embase, Google Scholar, PubMed, and Web of Science databases. The publication search was limited by English-language and human studies. Pooled mean difference and odds ratios (ORs) were calculated for outcomes of interest. RESULTS Twenty-three studies were included in this meta-analysis. Pooled OR of delayed post-polypectomy bleeding (DPPB) in the CSP group versus the HSP group was 0.29 (P = 0.0001, I2 = 29%). Subgroup analysis according to lesion size showed a significant reduction in the DPPB rate in lesion sizes 10-20 mm (pooled OR 0.08, P = 0.003, I2 = 0%) and < 10 mm (pooled OR 0.35, P = 0.001, I2 = 27%). Pooled OR of major bleeding in the CSP group was 0.23 (P = 0.0004, I2 = 0%). Subgroup analysis by lesion size revealed a significant decrease in the rate of major bleeding in the CSP group for both lesion sizes 10-20 mm (pooled OR 0.11, P = 0.04) and < 10 mm (pooled OR 0.26, P = 0.003). Complete resection, en bloc resection, and recurrence rate were comparable in the two groups. CONCLUSIONS Cold snare polypectomy was associated with a lower rate of DPPB and lower risk of major bleeding compared with HSP in both small and large polyps. CSP should be considered as the polypectomy technique of choice for colorectal polyps.
Collapse
Affiliation(s)
- Chengu Niu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Jay Bapaye
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Jing Zhang
- Harbin Medical University, Harbin, China
| | - Hongli Liu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Kaiwen Zhu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Umer Farooq
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Salman Zahid
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Dileepa Chathuranga
- Division of Gastroenterology, Rochester General Hospital, Rochester, New York, USA
| | - Patrick I Okolo
- Division of Gastroenterology, Rochester General Hospital, Rochester, New York, USA
| |
Collapse
|
30
|
Tarar ZI, Farooq U, Gandhi M, Saleem S, Daglilar E. Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis. Clin Endosc 2023; 56:578-589. [PMID: 37157959 PMCID: PMC10565436 DOI: 10.5946/ce.2023.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND/AIMS The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis. METHODS We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis. RESULTS Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%-19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%-7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%-4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%-3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%-0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16-1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06-1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59-2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77-1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59-2.43; I2=0%). CONCLUSION Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Umer Farooq
- Department of Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - Saad Saleem
- Department of Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV, USA
| | - Ebubekir Daglilar
- Department of Gastroenterology and Hepatology, Charleston area Medical Center, West Virginia University School of Medicine, Charleston, WV, USA
| |
Collapse
|
31
|
Kamal F, Khan MA, Lee-Smith WM, Sharma S, Acharya A, Faggen AE, Farooq U, Tarar ZI, Aziz M, Baron T. Early versus late endoscopic treatment of pancreatic necrotic collections: A systematic review and meta-analysis. Endosc Int Open 2023; 11:E794-E799. [PMID: 37671081 PMCID: PMC10477022 DOI: 10.1055/a-2100-9076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/17/2023] [Indexed: 09/07/2023] Open
Abstract
Background and study aims Recently studies have compared early (<4 weeks) vs. late or standard (>4 weeks) endoscopic treatment of pancreatic necrotic collections (PNC) and have reported favorable results for early treatment. In this meta-analysis, we compared the efficacy and safety of early vs. late endoscopic treatment of PNC. Patients and methods We reviewed several databases from inception to September 30, 2021 to identify studies that compared early with late endoscopic treatment of PNC. Our outcomes of interest were adverse events (AEs), resolution of PNC, performance of direct endoscopic necrosectomy, need for further interventions, and mean number of endoscopic necrosectomy sessions. We calculated pooled risk ratios (RRs) with 95% confidence intervals (CIs) for categorical variables and mean differences (MDs) with 95% CIs for continuous variables. Data were analyzed by random effect model. Heterogeneity was assessed by I 2 statistic. Results We included four studies with 427 patients. We found no significant difference in rates of AEs, RR (95% CI) 1.70 (range, 0.56-5.20), resolution of necrotic or fluid collections, RR (95% CI) 0.89 (range, 0.71-1.11), need for further interventions, RR (95% CI) 1.47 (range, 0.70-3.08), direct necrosectomy, RR (95% CI) 1.39 (range, 0.22-8.80), mortality, RR (95% CI) 2.37 (range, 0.26-21.72) and mean number of endoscopic necrosectomy sessions, MD (95% CI) 1.58 (range,-0.20-3.36) between groups. Conclusions Early endoscopic treatment of PNC can be considered for indications such as infected necrosis or sterile necrosis with symptoms or complications; however, future large multicenter studies are required to further evaluate its safety.
Collapse
Affiliation(s)
- Faisal Kamal
- Gastroenterology, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, United States
| | - Muhammad Ali Khan
- Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | | | - Sachit Sharma
- Internal Medicine, University of Toledo, Toledo, United States
| | - Ashu Acharya
- Internal Medicine, University of Toledo, Toledo, United States
| | - Alec E Faggen
- Gastroenterology, University of California San Francisco, San Francisco, United States
| | - Umer Farooq
- Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, United States
| | - Zahid I Tarar
- Internal Medicine, University of Missouri School of Medicine, Columbia, United States
| | - Muhammad Aziz
- Internal Medicine, University of Toledo, Toledo, United States
| | - Todd Baron
- Gastroenterology & Hepatology, University of North Carolina, Chapel Hill, United States
| |
Collapse
|
32
|
Nadeem MD, Memon S, Qureshi K, Farooq U, Memon UA, Aparna F, Kachhadia MP, Shahzeen F, Ali S, Varrassi G, Kumar L, Kumar S, Kumar S, Khatri M. Seizing the Connection: Exploring the Interplay Between Epilepsy and Glycemic Control in Diabetes Management. Cureus 2023; 15:e45606. [PMID: 37868449 PMCID: PMC10588297 DOI: 10.7759/cureus.45606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Epilepsy, a neurological disorder characterized by recurrent seizures, and diabetes, a metabolic disorder characterized by impaired regulation of glucose levels, are two distinct conditions that may appear unrelated at first glance. Nevertheless, recent scholarly investigations have revealed these entities' intricate and ever-evolving interplay. This review initially delves into the intricate interplay between epilepsy and its potential ramifications on glycemic control. Seizures, particularly those accompanied by convulsive manifestations, have the potential to induce acute perturbations in blood glucose levels via diverse mechanisms, encompassing the liberation of stress hormones, the emergence of insulin resistance, and the dysregulation of the autonomic nervous system. Comprehending these intricate mechanisms is paramount in customizing productive strategies for managing diabetes in individuals with epilepsy. On the contrary, it is worth noting that diabetes can substantially impact the trajectory and control of epilepsy. The correlation between hyperglycemia and an elevated susceptibility to seizures, as well as the potential for exacerbating the intensity of epilepsy, has been established. This narrative review offers a concise exposition of the intricate interplay between epilepsy and glycemic control within diabetes management. The objective of exploring reciprocal influences, underlying mechanisms, and common risk factors is to augment the clinical comprehension of this intricate interconnection. In essence, this acquired knowledge possesses the potential to serve as a guiding compass for healthcare professionals, enabling them to craft bespoke therapeutic approaches that enhance the holistic welfare of individuals grappling with the coexistence of epilepsy and diabetes.
Collapse
Affiliation(s)
| | - Siraj Memon
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Kashifa Qureshi
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Umer Farooq
- Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Unaib Ahmed Memon
- Neurology and Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Fnu Aparna
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | | | - Fnu Shahzeen
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sameer Ali
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | | | - Lakshya Kumar
- General Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Sumeet Kumar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| |
Collapse
|
33
|
Ashraf MA, Hafeez A, Rasheed R, Hussain I, Farooq U, Rizwan M, Ali S. Effect of exogenous taurine on growth, oxidative defense, and nickel (Ni) uptake in canola ( Brassica napus L.) under Ni stress. Physiol Mol Biol Plants 2023; 29:1135-1152. [PMID: 37829701 PMCID: PMC10564706 DOI: 10.1007/s12298-023-01359-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/22/2023] [Accepted: 09/08/2023] [Indexed: 10/14/2023]
Abstract
Nickel (Ni) contamination and its associated hazardous effects on human health and plant growth are ironclad. However, the potential remedial effects of taurine (TAU) on Ni-induced stress in plants remain obscure. Therefore, the present study was undertaken to examine the effect of TAU seed priming (100 and 150 mg L‒1) as an alleviative strategy to circumvent the phytotoxic effects of Ni (150 mg kg‒1) on two canola cultivars (Ni-tolerant cv. Shiralee and Ni-sensitive cv. Dunkeld). Our results manifested an apparent decline in growth, biomass, photosynthetic pigments, leaf relative water content, DPPH free radical scavenging activity, total soluble proteins, nitrate reductase activity, and nutrient acquisition (N, P, K, Ca) under Ni toxicity. Further, Ni toxicity led to a substantial increase in oxidative stress reflected as higher levels of superoxide radicals (O2•‒) and hydrogen peroxide (H2O2) alongside increased relative membrane permeability, lipoxygenase (LOX) activity, and Ni accumulation in leaves and roots. However, TAU protected canola plants from Ni-induced oxidative damage through the amplification of hydrogen sulfide (H2S) production that intensified the antioxidant system to avert O2•‒, H2O2, and malondialdehyde (MDA) production. Further, TAU-mediated increase in H2S levels maintained membrane integrity that might have improved ionomics and bettered plant growth under Ni toxicity. Supplementary Information The online version contains supplementary material available at 10.1007/s12298-023-01359-9.
Collapse
Affiliation(s)
- Muhammad Arslan Ashraf
- Department of Botany, Government College University Faisalabad, Faisalabad, 38000 Pakistan
| | - Arslan Hafeez
- Department of Botany, Government College University Faisalabad, Faisalabad, 38000 Pakistan
| | - Rizwan Rasheed
- Department of Botany, Government College University Faisalabad, Faisalabad, 38000 Pakistan
| | - Iqbal Hussain
- Department of Botany, Government College University Faisalabad, Faisalabad, 38000 Pakistan
| | - Umer Farooq
- Department of Botany, Government College University Faisalabad, Faisalabad, 38000 Pakistan
| | - Muhammad Rizwan
- Department of Environmental Sciences, Government College University, Faisalabad, 38000 Pakistan
| | - Shafaqat Ali
- Department of Environmental Sciences, Government College University, Faisalabad, 38000 Pakistan
- Department of Biological Sciences and Technology, China Medical University, Taichung, 40402 Taiwan
| |
Collapse
|
34
|
Mohamad T, Jyotsna F, Farooq U, Fatima A, Kar I, Khuwaja S, Memon UA, Kumari V, Puri P, Aslam ZM, Elder Z, Varrassi G, Paladini A, Khatri M, Kumar S, Muzammil MA. Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors. Cureus 2023; 15:e43977. [PMID: 37746355 PMCID: PMC10516147 DOI: 10.7759/cureus.43977] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
The field of cardiovascular medicine is undergoing a transformative shift towards personalized medicinal therapy, particularly in the context of post stent implantation. This narrative review explores the significance, challenges, and future directions of individualized treatment strategies for patients with coronary stents. The review highlights the pivotal role of personalized approaches in optimizing treatment efficacy and minimizing adverse events. Real-world clinical studies and trials underscore the importance of tailoring antiplatelet therapy based on platelet function testing, genetic testing, and risk scoring. These studies reveal that personalized medicinal treatment improves clinical outcomes by balancing preventing thrombotic events and mitigating bleeding risks. Challenges, including cost, test availability, patient adherence, and ethical considerations, are discussed in depth, shedding light on the complexities of implementing personalized approaches. Technological advancements, including omics data integration, artificial intelligence, and big data analytics, shape the future of personalized medicinal therapy. These tools enable precise pharmacogenomic selection of medications and the development of integrated risk-scoring systems. Patient engagement and education are also central, with empowered patients and remote monitoring contributing to collaborative decision-making. In conclusion, the narrative review underscores that personalized medicinal therapy post stent implantation holds immense promise for revolutionizing cardiovascular care. By embracing a comprehensive approach that considers genetics, clinical factors, and patient preferences, healthcare providers can optimize treatment outcomes and improve patient quality of life. The evolving landscape of personalized medicine offers a glimpse into a future where tailored treatment strategies become the cornerstone of precision cardiovascular care.
Collapse
Affiliation(s)
| | - Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND
| | - Umer Farooq
- Medicine, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Aroob Fatima
- Medicine, Ejaz Sikandar Memorial Hospital, Kanganpur, PAK
| | - Indrani Kar
- Medicine, Lady Hardinge Medical College, New Delhi, IND
| | - Sundal Khuwaja
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Unaib Ahmed Memon
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Versha Kumari
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Piyush Puri
- Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | - Zaid M Aslam
- Internal Medicine, Ziauddin University, Karachi, PAK
| | - Zachary Elder
- Medical Education, American University of the Caribbean School of Medicine, Cupecoy, SXM
| | | | - Antonella Paladini
- Department of MESVA (Life, Health, and Environmental Sciences), University of L'Aquila, L'Aquila, ITA
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | | |
Collapse
|
35
|
Tarar ZI, Farooq U, Gandhi M, Zafar MU, Saleem S, Kamal F. Safety and indications for endoscopic retrograde cholangiopancreatography in liver transplant patients: an analysis of the United States' National Inpatient Sample database. Ann Gastroenterol 2023; 36:459-465. [PMID: 37396010 PMCID: PMC10304520 DOI: 10.20524/aog.2023.0801] [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: 12/15/2022] [Accepted: 02/28/2023] [Indexed: 07/04/2023] Open
Abstract
Background Endoscopic retrograde cholangiopancreatography (ERCP) is performed to treat biliary complications after a liver transplantation; however, the previously available literature on the safety of ERCP in liver transplant patients is limited. We aimed to study the safety of ERCP in liver transplant patients. Methods We used a National Inpatient Sample database from 2016-2019 to identify patients who underwent ERCP and had a history of a liver transplantation, using the international classification of diseases, 10th revision. Multivariate logistic regression analysis was conducted to determine the odds of post-ERCP complications in liver transplant recipients. Results Liver transplant patients who underwent ERCP had a higher rate of post-ERCP pancreatitis and bleeding compared to the general adult population (11.39% vs. 9.19%, 0.83% vs. 0.53%, respectively). However, the adjusted odds of post-ERCP pancreatitis (adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 0.86-1.49; P=0.36) and bleeding (aOR 1.41, 95%CI 0.58-3.46; P=0.45) were similar in both the liver transplant and no-transplant groups. There was no difference in the odds of post-ERCP cholangitis (aOR 1.26, 95%CI 0.80-2.01; P=0.32), and sepsis (aOR 0.94, 95%CI 0.66-1.34; P=0.76) between liver transplant and no transplant groups. Biliary stricture was the most common indication for ERCP in the liver transplant group, whereas choledocholithiasis was the main reason for ERCP in the general adult population. Conclusions ERCP is a safe procedure for treating biliary complications in liver transplant patients. The odds of post-ERCP complications (pancreatitis, bleeding, sepsis, cholangitis) in liver transplant patients are comparable to those in patients with no transplantation.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO (Zahid Ijaz Tarar, Mustafa Gandhi)
| | - Umer Farooq
- Department of Medicine, Rochester General Hospital, Rochester, NY (Umer Farooq)
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO (Zahid Ijaz Tarar, Mustafa Gandhi)
| | | | - Saad Saleem
- Department of Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV (Saad Saleem)
| | - Faisal Kamal
- Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, PA (Faisal Kamal), USA
| |
Collapse
|
36
|
Kamal F, Khan MA, Lee-Smith W, Sharma S, Acharya A, Farooq U, Agarwal A, Aziz M, Chuang J, Kumar A, Schlachterman A, Loren D, Kowalski T, Adler D. Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps: meta-analysis of randomized controlled trials. Gastrointest Endosc 2023; 98:7-18.e4. [PMID: 36907527 DOI: 10.1016/j.gie.2023.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/30/2022] [Revised: 02/07/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND AND AIMS The practices for resection of diminutive colon polyps vary among endoscopists, and U.S. Multi-Society Task force guidelines recommend use of cold snare polypectomy (CSP) for this purpose. In this meta-analysis, we compared CSP and cold forceps polypectomy (CFP) for resection of diminutive polyps. METHODS Several databases were reviewed to identify randomized controlled trials that compared CSP and CFP for resection of diminutive polyps. The study outcomes of interest were complete resection of all diminutive polyps, complete resection of polyps ≤3 mm in size, failure of tissue retrieval, and polypectomy time. For categorical variables, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; for continuous variables, mean differences (MDs) with 95% CIs were calculated. Data were analyzed by using a random-effects model, and heterogeneity was assessed by using the I2 statistic. RESULTS We included 9 studies with 1037 patients. Rate of complete resection of all diminutive polyps was significantly higher in the CSP group (OR, 1.68; 95% CI, 1.09-2.58). Subgroup analysis, including jumbo or large-capacity forceps, found no significant difference in complete resection between groups (OR, 1.43; 95% CI, .80-2.56). We found no significant between-groups in the rates of complete resection of polyps ≤3 mm in size (OR, .83; 95% CI, .30-2.31). Rate of failure of tissue retrieval was significantly higher in the CSP group (OR, 10.13; 95% CI, 2.29-44.74). No significant between-group difference was noted in polypectomy time. CONCLUSIONS CFP using large-capacity or jumbo biopsy forceps is noninferior to CSP for complete resection of diminutive polyps.
Collapse
Affiliation(s)
- Faisal Kamal
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Muhammad Ali Khan
- Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Sachit Sharma
- Department of Medicine; Division of Gastroenterology
| | - Ashu Acharya
- Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Umer Farooq
- Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, Illinois, USA
| | - Amit Agarwal
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Muhammad Aziz
- Division of Gastroenterology, University of Toledo, Toledo, Ohio, USA
| | | | - Anand Kumar
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Alexander Schlachterman
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - David Loren
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Thomas Kowalski
- Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Douglas Adler
- Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, Colorado, USA.
| |
Collapse
|
37
|
Tarar ZI, Farooq U, Bechtold ML, Ghouri YA. Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis. World J Meta-Anal 2023; 11:238-246. [DOI: 10.13105/wjma.v11.i5.238] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.
AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.
METHODS An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.
RESULTS Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.
CONCLUSION For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Umer Farooq
- Department of Medicine, Loyola University, Chicago, IL 60153, United States
| | - Matthew L Bechtold
- Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
| | - Yezaz A Ghouri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
| |
Collapse
|
38
|
Faggen AE, Kamal F, Lee-Smith W, Khan MA, Sharma S, Acharya A, Ahmed Z, Farooq U, Bayudan A, McLean R, Avila P, Dai SC, Munroe CA, Kouanda A. Over-the-Scope Clips Versus Standard Endoscopic Treatment for First Line Therapy of Non-variceal Upper Gastrointestinal Bleeding: Systematic Review and Meta-Analysis. Dig Dis Sci 2023; 68:2518-2530. [PMID: 36943590 DOI: 10.1007/s10620-023-07888-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 02/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND AND AIMS Over-The-Scope Clips (OTSC) use have shown promising results for first line treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). We conducted this meta-analysis to compare outcomes in patients treated with OTSC versus standard endoscopic intervention for first line endoscopic treatment of NVUGIB. METHODS We reviewed several databases from inception to December 9, 2022 to identify studies comparing OTSC and standard treatments as the first line treatment for NVUGIB. The outcomes assessed included re-bleeding, initial hemostasis, need for vascular embolization, mortality, need for repeat endoscopy, 30 day readmission rate, and need for surgery. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using random effect model. Heterogeneity was assessed by I2 statistic. RESULTS We included 11 studies with 1608 patients (494 patients in OTSC group and 1114 patients in control group). OTSC use was associated with significantly lower risk of re-bleeding (RR, 0.58; 95% CI 0.41-0.82). We found no significant difference in rates of initial hemostasis (RR, 1.05; 95% CI 0.99- 1.11), vascular embolization rates (RR, 0.93; 95% CI 0.40- 2.13), need for repeat endoscopy (RR, 0.78; 95% CI 0.40-1.49), 30 day readmission rate (RR, 0.59; 95% CI 0.17-2.01), need for surgery (RR, 0.81; 95% CI 0.29-2.28) and morality (RR, 0.69; 95% CI 0.38-1.23). CONCLUSIONS OTSC are associated with significantly lower risk of re-bleeding compared to standard endoscopic treatments when used as first line endoscopic therapy for NVUGIB.
Collapse
Affiliation(s)
- Alec E Faggen
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Faisal Kamal
- Division of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA.
| | - Wade Lee-Smith
- Mulford Health Sciences Library, University of Toledo, Toledo, OH, USA
| | - Muhammad Ali Khan
- Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sachit Sharma
- Department of Medicine, University of Toledo, Toledo, OH, USA
- Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ashu Acharya
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Zohaib Ahmed
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Umer Farooq
- Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, IL, USA
| | - Alexis Bayudan
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Richard McLean
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Patrick Avila
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Sun-Chuan Dai
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Craig A Munroe
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| | - Abdul Kouanda
- Division of Gastroenterology, University of California- San Francisco, San Francisco, CA, USA
| |
Collapse
|
39
|
Tarar ZI, Farooq U, Gandhi M, Ghous G, Saleem S, Kamal F, Imam Z, Jamil L. Effect of radiofrequency ablation in addition to biliary stent on overall survival and stent patency in malignant biliary obstruction: an updated systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2023; 35:646-653. [PMID: 37129575 DOI: 10.1097/meg.0000000000002568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Radiofrequency ablation (RFA) is used in addition to stent placement to manage extrahepatic malignant biliary obstruction. We aimed to study the effect of RFA on overall survival (OS) and stent patency in malignant biliary obstruction. METHODS A comprehensive literature search was performed from inception to May 2022 for all studies measuring the effect of RFA plus stents compared to stents placement only on OS and stent patency in patients with malignant biliary obstruction. We measured differences in OS, stent patency, and odds of adverse events. A random effect model was used to pool data for stent patency, OS, and adverse event. RESULTS A total of 17 studies (14 observational and 3 RCT) containing 1766 patients were included in the analysis. The weighted pooled mean survival difference was 58.5 days [95% confidence interval (CI): 32.6-84.4, I2 = 71%] in favor of the RFA treatment group. The weighted mean difference in stent patency was better in the RFA plus stent group by 45.3 days (95% CI: 30.1-60.5, I2 = 16.4%) compared to stent only group. The pooled odds of adverse events were the same in both groups [odds ratio (OR) 1.52, 95% CI: 0.96-2.43, I2 = 59%], and no serious adverse event was seen in either group, or no death reported secondary to RFA procedure. No difference in stent patency based on procedure type, including percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiopancreatography (P = 0.06), and an underline cause of bile duct obstruction was found (P = 0.261). CONCLUSION RFA treatment, in addition to stent placement in malignant biliary obstruction, potentially improves OS and stent patency duration.
Collapse
Affiliation(s)
- Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, Columbia, MO
| | - Umer Farooq
- Department of Medicine, Rochester General Hospital, Rochester, New York
| | - Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, Columbia, MO
| | - Ghulam Ghous
- Department of Medicine, University of Missouri School of Medicine, Columbia, Columbia, MO
| | - Saad Saleem
- Department of Medicine, Sunrise Hospital and Medical Center, Las Vegas, Nevada
| | - Faisal Kamal
- Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Zaid Imam
- Department of Gastroenterology and Hepatology, William Beaumont Medical Center, Royal Oak, Michigan, USA
| | - Laith Jamil
- Department of Gastroenterology and Hepatology, William Beaumont Medical Center, Royal Oak, Michigan, USA
| |
Collapse
|
40
|
Bodla ZH, Hashmi M, Niaz F, Farooq U, Khalid F, Abdullahi AH, Luu SW. Timing matters: An analysis of the relationship between red cell transfusion timing and hospitalization outcomes in sickle cell crisis patients using the National Inpatient Sample database. Ann Hematol 2023:10.1007/s00277-023-05275-6. [PMID: 37249608 DOI: 10.1007/s00277-023-05275-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
Vaso-occlusive pain crisis is a debilitating complication of sickle cell disease (SCD) and it is the most common cause of hospitalization among these individuals. We studied the inpatient outcomes among patients admitted with sickle cell crisis based on the timing of red blood cell transfusion. In this retrospective study, we used the United States National Inpatient Sample (NIS) data for the year 2019, to identify adult patients hospitalized with the principal diagnosis of sickle cell crisis who received simple red blood cell transfusion during their hospitalization. Patients were divided into two groups. Those who received simple red cell transfusion within 24 hours of admission were classified as early transfusion. After adjusting for confounders, the mean adjusted length of stay for patients with early transfusion was significantly lower than those who received a late blood transfusion by 3.51 days (p-value < 0.001) along with a decrease in mean adjusted hospitalization charges and cost, by 25,487 and 4,505 United States Dollar (USD) respectively. The early red cell transfusion was also associated with a decrease in inpatient mortality, demonstrated by an adjusted odds ratio (aOR) of 0.19 (p-value 0.036), and a reduction in in-hospital sepsis, with an aOR of 0.28 (p-value < 0.001), however, no statistically significant difference was found between the two groups regarding acute respiratory failure requiring intubation, vasopressors requirement, acute kidney injury requiring dialysis and intensive care unit (ICU) admission. We recommend timely triage and reassessment to identify sickle cell crisis patients requiring blood transfusion. This intervention can notably affect the inpatient length of stay, resource utilization, and hospitalization outcomes.
Collapse
Affiliation(s)
- Zubair Hassan Bodla
- University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA.
| | - Mariam Hashmi
- University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA
| | - Fatima Niaz
- King Edward Medical University, Lahore, Punjab, Pakistan
- Mayo Hospital, Lahore, Punjab, Pakistan
| | - Umer Farooq
- Rochester Regional Health, Rochester, NY, USA
| | | | - Abdullahi Hussein Abdullahi
- University of Central Florida College of Medicine, Graduate Medical Education/HCA Florida North Florida Hospital, Internal Medicine Residency Program, Gainesville, FL, USA
| | | |
Collapse
|
41
|
Gandhi M, Tarar ZI, Farooq U, Saleem S, Chela HK, Daglilar E. The COVID-19 Infection Resulted Delayed Esophagogastroduodenoscopy in Patients Admitted with Variceal Bleeding: Hospital-Based Outcomes of a National Database. Diseases 2023; 11:diseases11020075. [PMID: 37218888 DOI: 10.3390/diseases11020075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023] Open
Abstract
During the COVID-19 pandemic in 2020, most healthcare services, including inpatient and outpatient procedures, got delayed. We reviewed the effect of COVID-19 infection on the timing of esophagogastroduodenoscopy (EGD) in variceal bleeding patients and analyzed the complications of delayed EGD. Using the National Inpatient Sample (NIS) 2020, we identified patients admitted for variceal bleeding with COVID-19 infection. We performed a multivariable regression analysis and adjusted it for patient and hospital-related variables. The International Classification of Disease Tenth Revision (ICD-10) codes were used for patient selection. We measured the effect of COVID-19 on the timing of EGD and further analyzed the effect of delayed EGD on hospital-based outcomes. A total of 49,675 patients diagnosed with variceal upper gastrointestinal bleeding were analyzed, out of which 915 (1.84%) were COVID-19 positive. Variceal bleeding patients who were COVID-positive had a significantly lower rate of EGD performed within the first 24 h of admission (36.1% vs. 60.6% p = 0.001) compared to the patients who tested negative for COVID-19. The performance of EGD within 24 h of admission resulted in a decrease in all-cause mortality by 70% (adjusted odds ratio (AOR) 0.30, 95% CI 0.12-0.76, p = 0.01) compared to EGD after 24 h. A significant decrease was noted in the odds of ICU admission rate (AOR 0.37, 95% CI 0.14-0.97, p = 0.04) in patients who got EGD within the first 24 h of admission. No difference in odds of sepsis (AOR 0.44, 95% CI 0.15-1.30, p = 0.14) and vasopressor use (AOR 0.34, 95% CI 0.04-2.87, p = 0.32) was seen in COVID positive vs. COVID negative group. The hospital mean length of stay (2.14 days, 95% CI 4.35-0.06, p = 0.06), mean total charges ($51,936, 95% CI $106,688-$2816, p = 0.06), and total cost (11,489$, 95% CI 30,380$-7402$, p = 0.23) was similar in both COVID-positive and -negative groups. In our study, we found that the presence of COVID-19 infection in variceal bleeding patients resulted in a significant delay in EGD compared to COVID-negative patients. This delay in EGD resulted in increased all-cause mortality and intensive care unit admissions.
Collapse
Affiliation(s)
- Mustafa Gandhi
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65211 USA
| | - Zahid Ijaz Tarar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65211 USA
| | - Umer Farooq
- Rochester General Hospital, Rochester, NY 14621, USA
| | - Saad Saleem
- Department of Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV 89109, USA
| | - Harleen Kaur Chela
- Department of Gastroenterology and Hepatology, Charleston Area Medical Center, West Virginia University School of Medicine, Charleston, WV 25304, USA
| | - Ebubekir Daglilar
- Department of Gastroenterology and Hepatology, Charleston Area Medical Center, West Virginia University School of Medicine, Charleston, WV 25304, USA
| |
Collapse
|
42
|
Rafey A, Jahan S, Farooq U, Akhtar F, Irshad M, Nizamuddin S, Parveen A. Antibiotics Associated With Clostridium difficile Infection. Cureus 2023; 15:e39029. [PMID: 37323360 PMCID: PMC10266117 DOI: 10.7759/cureus.39029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Clostridium difficile (C. difficile) is one of the major causes of diarrhea transmitted by the fecal-oral route. C. difficile type BI/NAP1/027 is responsible for the most severe C. difficile infection (CDI). It is a major cause of antibiotic-associated diarrhea followed by Clostridium perfringens, Staphylococcus aureus,and Klebsiella oxytoca. Historically, clindamycin, cephalosporins, penicillins, and fluoroquinolones were related to CDI. We conducted this study to evaluate the antibiotics associated with CDI in recent times. Methods We conducted a retrospective, single-center study over a period of eight years. A total of 58 patients were enrolled in the study. Patients with diarrhea and positive C. difficile toxin in stool were evaluated for antibiotics given, age, presence of malignancy, previous hospital stay for more than three days in the last three months, and any comorbidities. Results Among patients who developed CDI, prior antibiotics for at least four days duration were given in 93% (54/58) of patients. The most common antibiotics associated with C. difficile infection were piperacillin/tazobactam in 77.60% (45/58), meropenem in 27.60% (16/58), vancomycin in 20.70% (12/58), ciprofloxacin in 17.20% (10/58), ceftriaxone in 16% (9/58), and levofloxacin in 14% (8/58) of patients, respectively. Seven percent (7%) of patients with CDI did not receive any prior antibiotics. Solid organ malignancy was present in 67.20% and hematological malignancy in 27.60% of CDI patients. Ninety-eight percent (98%, 57/58) of patients treated with proton pump inhibitors, 93% of patients with a previous hospital stay for more than three days, 24% of patients with neutropenia, 20.1% of patients aged more than 65 years, 14% of patients with diabetes mellitus, and 12% of patients with chronic kidney disease also developed C. difficile infection. Conclusion The antibiotics associated with C. difficile infection are piperacillin/tazobactam, meropenem, vancomycin, ciprofloxacin, ceftriaxone, and levofloxacin. Other risk factors for CDI are proton pump inhibitor use, prior hospital admission, solid organ malignancy, neutropenia, diabetes mellitus (DM), and chronic kidney disease (CKD).
Collapse
Affiliation(s)
- Abdur Rafey
- Department of Internal Medicine and Infectious Diseases, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Shah Jahan
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Umer Farooq
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Furqana Akhtar
- Department of Infectious Diseases, Bahria International Hospital, Lahore, PAK
| | - Memoona Irshad
- Department of Infectious Diseases, Aga Khan University Hospital, Karachi, PAK
| | - Summiya Nizamuddin
- Department of Microbiology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Azra Parveen
- Department of Internal Medicine and Infectious Diseases, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| |
Collapse
|
43
|
Hussain M, Khan W, Farooq U, Razzaq R. Impact of Non-Similar Modeling for Thermal Transport Analysis of Mixed Convective Flows of Nanofluids Over Vertically Permeable Surface. j nanofluids 2023. [DOI: 10.1166/jon.2023.1985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In the current article, non-similar model is developed for mixed convective boundary layer flow over a permeable vertical surface immersed in nanofluid. The flow is initiated due to the plate stretching in vertical direction and by natural means such as buoyancy. The governing dimensional
equations are converted to non-dimensional equations through characteristic dimensions. Furthermore the non-similar modeling is done by choosing ξ (X) as non-similarity variable and η(X, Y) as pseudo-similarity variable. The non-similar partial differential
system (PDS) is then solved by using local non-similarity method via bvp4c. The heat and mass transfer analysis are carried out by studying local Nusselt and Sherwood numbers in tabular form for some important parameters involved in the non-similar flow. The concentration, velocity and temperature
profiles are graphically represented for various dimensionless number such as Prandtl number (Pr), Brownian motion (Nb), Lewis number Le and thermophoresis (Nt). Reversed flow is observed for the velocity profile as non-similar variable is
varied. Enhancement in thermal profile is witnessed for Nb, Nt and reduction in temperature is observed for Pr. Concentration is reduced for different values of Pr, Le, Nb. Finally this article intends to develop an
intuitive understanding of non-similar models by emphasizing the physical arguments. The authors developed the nonsimilar transformations and tackled the dimensionless non-similar structure by employing the local non-similarity technique. To the best of authors’ observations, no such
study is yet published in literature. This study may be valuable for the researchers investigating towards industrial nanofluid applications, notably in geophysical and geothermal systems, heat exchangers, solar water heaters, biomedicine, and many other fields.
Collapse
Affiliation(s)
- Muzamil Hussain
- Department of Mathematics, COMSATS University Islamabad, Park Road Chak Shahzad Islamabad, 44000, Pakistan
| | - Wafa Khan
- Department of Mathematics, COMSATS University Islamabad, Park Road Chak Shahzad Islamabad, 44000, Pakistan
| | - Umer Farooq
- Department of Mathematics, COMSATS University Islamabad, Park Road Chak Shahzad Islamabad, 44000, Pakistan
| | - Raheela Razzaq
- Department of Mathematics, COMSATS University Islamabad, Park Road Chak Shahzad Islamabad, 44000, Pakistan
| |
Collapse
|
44
|
Ahmed Z, Iqbal U, Aziz M, Arif SF, Badal J, Farooq U, Lee-Smith W, Gangwani MK, Kamal F, Kobeissy A, Mahmood A, Nawras A, Khara HS, Confer BD, Adler DG. Outcomes and Complications of Radiological Gastrostomy vs. Percutaneous Endoscopic Gastrostomy for Enteral Feeding: An Updated Systematic Review and Meta-Analysis. Gastroenterology Res 2023; 16:79-91. [PMID: 37187550 PMCID: PMC10181338 DOI: 10.14740/gr1593] [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: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 05/17/2023] Open
Abstract
Background Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are commonly utilized to establish access to enteral nutrition. However, data comparing the outcomes of PEG vs. PRG are conflicting. Therefore, we aimed to conduct an updated systemic review and meta-analysis comparing PRG and PEG outcomes. Methods Medline, Embase, and Cochrane library databases were searched until February 24, 2023. Primary outcomes included 30-day mortality, tube leakage, tube dislodgement, perforation, and peritonitis. Secondary outcomes included bleeding, infectious complications, and aspiration pneumonia. All analyses were conducted using Comprehensive Meta-Analysis Software. Results The initial search revealed 872 studies. Of these, 43 of these studies met our inclusion criteria and were included in the final meta-analysis. Of 471,208 total patients, 194,399 received PRG and 276,809 received PEG. PRG was associated with higher odds of 30-day mortality when compared to PEG (odds ratio (OR): 1.205, 95% confidence interval (CI): 1.015 - 1.430, I2 = 55%). In addition, tube leakage and tube dislodgement were higher in the PRG group than in PEG (OR: 2.231, 95% CI: 1.184 - 4.2 and OR: 2.602, 95% CI: 1.911 - 3.541, respectively). Perforation, peritonitis, bleeding, and infectious complications were higher with PRG than PEG. Conclusion PEG is associated with lower 30-day mortality, tube leakage, and tube dislodgement rates than PRG.
Collapse
Affiliation(s)
- Zohaib Ahmed
- Department of Internal Medicine, University of Toledo, Toledo, OH, USA
- Zohaib Ahmed and Umair Iqbal contributed equally and shared the first authorship
- Corresponding Author: Zohaib Ahmed, Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA.
| | - Umair Iqbal
- Division of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA
- Zohaib Ahmed and Umair Iqbal contributed equally and shared the first authorship
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA
| | | | - Joyce Badal
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Umer Farooq
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Wade Lee-Smith
- University of Toledo Libraries, University of Toledo, Toledo, OH, USA
| | | | - Faisal Kamal
- Division of Gastroenterology, University of California San Francisco, San Francisco, CA, USA
| | - Abdallah Kobeissy
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA
| | - Asif Mahmood
- Department of Internal Medicine, University of Toledo, Toledo, OH, USA
| | - Ali Nawras
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA
| | - Harshit S. Khara
- Division of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA
| | - Bradley D. Confer
- Division of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA
| | - Douglas G. Adler
- Center for Advanced Therapeutic Endoscopy (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO, USA
| |
Collapse
|
45
|
Irshad R, Farooq U, Shah T, Gul A, Badshah A. Hepatitis B, C And Hiv Exposure On Nat And Clia Blood Examination Methods At Regional Blood Centre Abbottabad. J Ayub Med Coll Abbottabad 2023; 35:285-287. [PMID: 37422822 DOI: 10.55519/jamc-02-11600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Blood transfusion is a lifesaving method in clinical emergencies. Despite various preventive measures, the spread of Hepatitis B, C and HIV remains a big issue in Pakistan. This study was done to describe transfusion transmitted diseases using NAT and CLIA techniques, on exposure to these viruses. METHODS This study was conducted from 1st April to 25th August 2022. A descriptive study was done along with univariate analysis. The data was obtained from the regional blood centre in Abbottabad and it consists of reactive and non-reactive cases of NAT and CLIA in the sample size of 6233 donors. Data was collected from donors, and selected according to predefined criteria. RESULTS In 6233 samples, 53 were reactive for either Hepatitis B, C or HIV. Forty-seven were reactive with both CLIA and NAT. 6 were reactive with NAT only and 6107 were non-reactive. CONCLUSIONS NAT yield detected in this study is 0.096%. (1:1039 donations). It implies that NAT should be the preferred method for screening in blood banks.
Collapse
Affiliation(s)
- Romana Irshad
- Department of Pathology, Ayub Medical College, Abbottabad
| | - Umer Farooq
- Department of Community Medicine, Ayub Medical College, Abbottabad
| | - Tahir Shah
- Regional Blood Centre, Abbottabad, Pakistan
| | - Adeel Gul
- Regional Blood Centre, Abbottabad, Pakistan
| | | |
Collapse
|
46
|
Ahmed Z, Hassan M, Arif SF, Aziz M, Iqbal U, Nawaz A, Farooq U, Smith WL, Badal J, Renno A, Javaid T, Nawras A, Saab S. Comparative Efficacy of Treatment Options for the Prevention of Post-TIPS Hepatic Encephalopathy: A Systematic Review and Network Meta-analysis. J Gastrointestin Liver Dis 2023; 32:70-76. [PMID: 37004220 DOI: 10.15403/jgld-4508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/03/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND AND AIMS Transjugular intrahepatic portosystemic shunt (TIPS) is often used in patients with cirrhosis to manage portal hypertension-related complications. Unfortunately, 35-50% of patients develop overt hepatic encephalopathy (HE) after TIPS. However, data on lactulose and rifaximin to prevent post-TIPS HE is limited. Therefore, we aimed to perform a network meta-analysis to investigate the efficacy of multiple pharmacological regimens in the prevention of post-TIPS HE. METHODS A comprehensive search strategy to identify reports of studies of rifaximin use on post-TIPS hepatic encephalopathy was constructed using truncated keywords, phrases, and subject headings developed in Embase. This strategy was translated to MEDLINE, Cochrane Central Register of Controlled Trials, and the Web of Science Core Collection, with all searches performed on 10 February 2022. No publication date or language limits were used. RESULTS The initial search identified 72 studies, and 56 studies were screened after removing duplicates. Five studies, two randomized controlled trials (RCTs) and three retrospective studies, met our inclusion criteria and were included in the final analysis. A total of 840 patients were included, with 65% male. Our meta- analysis did not find a statistically significant difference between lactulose vs placebo/no prophylaxis, nor rifaximin vs placebo/no prophylaxis, nor rifaximin plus lactulose vs placebo/no prophylaxis in the reduction of post-TIPS HE. CONCLUSIONS Rifaximin alone, lactulose alone, and rifaximin plus lactulose did not significantly reduce the development of post-TIPS HE. Based on the P-scores of the three treatment groups, the combination of rifaximin plus lactulose showed the most promising trend towards preventing post-TIPS HE. More studies, especially large RCTs, are warranted.
Collapse
Affiliation(s)
- Zohaib Ahmed
- Department of Internal Medicine, University of Toledo, Toledo, Ohio, USA.
| | - Mona Hassan
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA.
| | | | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA.
| | - Umair Iqbal
- Division of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
| | - Ahmad Nawaz
- Division of Internal Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA.
| | - Umer Farooq
- Department of Internal Medicine, Loyola Medicine/MacNeal Hospital, Chicago, Illinois, USA.
| | - Wade Lee Smith
- University of Toledo Libraries, University of Toledo, Toledo, Ohio, USA.
| | - Joyce Badal
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA.
| | - Anas Renno
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA.
| | - Toseef Javaid
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA.
| | - Ali Nawras
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA.
| | - Sammy Saab
- Dept. of Medicine and Surgery at the David Geffen School of Medicine at UCLA (University of California Los Angeles), Los Angeles, California, USA.
| |
Collapse
|
47
|
Salman M, Badar N, Ikram A, Nisar N, Farooq U. Estimation of seasonal influenza disease burden using sentinel site data in Pakistan 2017–2019: A cross‐sectional study. Influenza Other Respir Viruses 2023; 17:e13125. [PMID: 36970573 PMCID: PMC10030357 DOI: 10.1111/irv.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/24/2023] Open
Abstract
Background The influenza A(H1N1)pdm09 pandemic highlighted the need for reliable disease burden estimation from low‐ and middle‐income countries like Pakistan. We designed retrospective age‐stratified estimation of influenza‐related severe acute respiratory infections (SARIs) incidence in Islamabad Pakistan 2017–2019. Materials and Methods The catchment area was mapped on SARI data from one designated influenza sentinel site and other healthcare facilities in the Islamabad region. The incidence rate was calculated as per 100,000 for each age group with 95% confidence interval. Results The catchment population for the sentinel site was 0.7 million against the total denominator of 1.015 million, and incidence rates were adjusted. During January 2017 to December 2019, among 13,905 hospitalizations, 6715 (48%) patients were enrolled; 1208 of these (18%) were positive for influenza. During 2017, influenza A/H3 dominated with 52% detections followed by A(H1N1)pdm09 (35%) and influenza B (13%). Furthermore, elderly 65+ years age group had highest hospitalizations and influenza positive. The incidence rates of all cause respiratory and influenza‐related SARI were highest among children >5 years; highest incidence was found in 0 to 11 month/year group with 424/100,000 cases and lowest in 5–15 years 56/100,000. The estimated average annual influenza‐associated hospitalization percentage was 29.3% during the study period. Conclusion Influenza accounts for a significant proportion of respiratory morbidity and hospitalization. These estimates would enable governments for evidence‐based decisions and priority allocation of health resources. It is necessary to test for other respiratory pathogens for more clear disease burden estimation.
Collapse
Affiliation(s)
- Muhammad Salman
- Public Health Laboratories Division National Institute of HealthIslamabadPakistan
| | - Nazish Badar
- Public Health Laboratories Division National Institute of HealthIslamabadPakistan
| | - Aamer Ikram
- Executive Director National Institute of HealthIslamabadPakistan
| | - Nadia Nisar
- Public Health Laboratories Division National Institute of HealthIslamabadPakistan
| | - Umer Farooq
- National Agricultural Research CenterIslamabadPakistan
| |
Collapse
|
48
|
Ahmed Z, Badal J, Nawras M, Battepati D, Farooq U, Arif SF, Lee-Smith W, Aziz M, Iqbal U, Nawaz A, Gangwani MK, Iqbal A, Kobeissy A, Addissie BD, Hassan M, Saab S. Role of rifaximin in the management of alcohol-associated hepatitis: A systematic review and meta-analysis. J Gastroenterol Hepatol 2023; 38:703-709. [PMID: 36919224 DOI: 10.1111/jgh.16179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND AND AIM Alcohol-associated hepatitis (AAH) is an acute, inflammatory liver disease with severe short-term and long-term morbidity and mortality. AAH can lead to severe complications including hepatic failure, gastrointestinal bleeding, sepsis, and the development or decompensation of cirrhosis. Rifaximin is an antibiotic that reduces bacterial overgrowth and gut translocation, and it may have a role in decreasing systemic inflammation and infection in patients with AAH. Therefore, we conducted a systematic review and meta-analysis to evaluate the role of rifaximin in the management of AAH. METHODS A comprehensive search strategy was used to identify studies that met our inclusion criteria in Embase, MEDLINE (PubMed), Cochrane Library, Web of Science Core Collection, and Google Scholar. Outcomes of interest included rates of infection, 90-day mortality, and overall mortality between the rifaximin versus non-rifaximin group. Open Meta Analyst software was used to compute the results. RESULTS Three studies with a total of 162 patients were included in the final meta-analysis. Of the three studies, two were randomized control trials (RCTs), and one was a case-control study. There was a significantly lower rate of infection in the rifaximin group versus the non-rifaximin group (RR: 0.331, 95% CI: 0.159-0.689, I2 = 0%, P = 0.003). There was no significant difference in 90-day mortality in the rifaximin versus non-rifaximin group (RR: 0.743, 95% CI: 0.298-1.850, I2 = 24%, P = 0.523), nor was there a significant difference in overall mortality (RR: 0.624, 95% 95% CI: 0.299-1.3, I2 = 7.1%, P = 0.208). CONCLUSIONS The use of rifaximin in AAH is associated with a lower rate of infection rate than the non-rifaximin group. Additional research is needed to determine whether this effect is more pronounced in patients concurrently being treated with prednisolone. Differences in 90-day or overall mortality did not reach statistical significance. Further studies, particularly large randomized controlled trials, are needed to establish the role of rifaximin in AAH, especially as an adjunct therapy with prednisolone.
Collapse
Affiliation(s)
- Zohaib Ahmed
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, USA
| | - Joyce Badal
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Mohamad Nawras
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Dhanushya Battepati
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Umer Farooq
- Department of Internal Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, Illinois, USA
| | | | | | - Muhammad Aziz
- Department of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA
| | - Umair Iqbal
- Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Ahmad Nawaz
- Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Manesh Kumar Gangwani
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, USA
| | - Amna Iqbal
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, USA
| | - Abdallah Kobeissy
- Department of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA
| | - Benyam D Addissie
- Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Mona Hassan
- Department of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, USA
| | - Sammy Saab
- Department of Medicine and Surgery, David Geffen School of Medicine at UCLA (University of California Los Angeles), Los Angeles, California, USA
| |
Collapse
|
49
|
Kamal F, Khan MA, Lee-Smith W, Sharma S, Acharya A, Farooq U, Tarar ZI, Faggen AE, Aziz M, Chandan S, Ahmed Z, Kouanda A, Dai SC, Munroe CA, Adler DG. Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction - A systematic review and meta-analysis. Endosc Ultrasound 2023; 12:228-236. [PMID: 36751758 PMCID: PMC10237615 DOI: 10.4103/eus-d-22-00077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 10/09/2022] [Indexed: 02/09/2023] Open
Abstract
Background and Objectives ERCP is the first line of treatment for benign and malignant biliary obstruction and EUS-guided biliary drainage (EUS-BD) is usually used for patients who have failed ERCP. Recently, several studies have evaluated the role of EUS-BD in the management of benign biliary obstruction. This meta-analysis evaluates the efficacy and safety of EUS-BD in the management of benign biliary obstruction. Methods We reviewed several databases from inception to July 8, 2022, to identify studies evaluating the efficacy and safety of EUS-BD in the management of benign biliary obstruction. Our outcomes of interest were technical success, clinical success, and adverse events. Pooled rates with 95% confidence intervals (CIs) for all outcomes were calculated using a random effects model. Subgroup analyses were performed including patients with normal anatomy versus surgically altered anatomy (SAA). Heterogeneity was assessed by I2 statistic. Results We included 14 studies with 329 patients. The pooled rate (95% CI) of technical success was 88% (83%, 92%). The pooled rate (95% CI) of technical success for patients with SAA and normal anatomy was 92% (85%, 96%) and 83% (75%, 89%), respectively. The pooled rates (95% CI) of clinical success and adverse events were 89% (83%, 93%) and 19% (13%, 26%), respectively. We found low heterogeneity in most of the analyses. Conclusions EUS-BD is an effective and safe option in patients with benign biliary obstruction and should be considered after a failed attempt at ERCP or when ERCP is not technically possible.
Collapse
Affiliation(s)
- Faisal Kamal
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA, USA
| | - Muhammad Ali Khan
- Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wade Lee-Smith
- Mulford Health Sciences Library, University of Toledo, Toledo, OH, USA
| | - Sachit Sharma
- Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Ashu Acharya
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Umer Farooq
- Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, IL, USA
| | - Zahid Ijaz Tarar
- Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Alec E. Faggen
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA, USA
| | - Muhammad Aziz
- Division of Gastroenterology, University of Toledo, Toledo, OH, USA
| | - Saurabh Chandan
- Division of Gastroenterology, Creighton University Medical Center, Omaha, NE, USA
| | - Zohaib Ahmed
- Department of Medicine, University of Toledo, Toledo, OH, USA
| | - Abdul Kouanda
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA, USA
| | - Sun-Chuan Dai
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA, USA
| | - Craig A. Munroe
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA, USA
| | - Douglas G. Adler
- Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, Colorado, USA
| |
Collapse
|
50
|
Arshad W, Maqbool S, Kiany JA, Raza A, Farooq U, Ali Q, Lee KY. A rare case of retropharyngeal liposarcoma: a rare location of a rare diagnosis. J Surg Case Rep 2023; 2023:rjad106. [PMID: 36896154 PMCID: PMC9991594 DOI: 10.1093/jscr/rjad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 03/09/2023] Open
Abstract
We report a case of retropharyngeal liposarcoma in a 53-year-old female, who had complaints of neck swelling accompanied with dysphagia, orthopnea and dysphonia. Clinical examination revealed huge multinodular swelling in front of neck with bilateral extension, more prominent on left side and moving with deglutition. The diagnosis of retropharyngeal liposarcoma was established following CT scan, MRI and incisional biopsy. Surgical excision of mass along with near total thyroidectomy was performed. Postoperative hospital stay was uneventful. She remained well in follow-up period of 1 year as well. In conclusion, retropharyngeal liposarcoma is a rare tumor. A review of the literature explores the reasons behind the late presentation as well as the difficulties in diagnosis and treatment of this rare tumor.
Collapse
Affiliation(s)
- Wajiha Arshad
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Shahzaib Maqbool
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Javeria A Kiany
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Ali Raza
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Umer Farooq
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Qasim Ali
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| | - Ka Y Lee
- Department of Surgical Unit II, Holy Family Hospital, Rawalpindi, Pakistan
| |
Collapse
|