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Nawab R, Ali M, Haroon U, Kamal A, Akbar M, Anwar F, Ahmed J, Chaudhary HJ, Iqbal A, Hashem M, Alamri S, ALHaithloul HAS, Munis MFH. Calotropis procera (L.) mediated synthesis of AgNPs and their application to control leaf spot of Hibiscus rosa-sinensis (L.). BRAZ J BIOL 2024; 84:e261123. [DOI: 10.1590/1519-6984.261123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/23/2022] [Indexed: 11/22/2022] Open
Abstract
Abstract Nature is gifted with a wide range of ornamental plants, which beautify and clean the nature. Due to its great aesthetic value, there is a need to protect these plants from a variety of biotic and abiotic stresses. Hibiscus rosa-sinensis (L.) is an ornamental plant and it is commonly known as China rose or shoeblack plant. It is affected by several fungal and bacterial pathogens. Current study was designed to isolate leaf spot pathogen of H. rosa-sinensis and its control using silver nanoparticles (AgNPs). Based on molecular and morphological features, the isolated leaf spot pathogen was identified as Aspergillus niger. AgNPs were synthesized in the leaf extract of Calotropis procera and characterized. UV-vis spectral analysis displayed discrete plasmon resonance bands on the surface of synthesized AgNPs, depicting the presence of aromatic amino acids. Fourier transform infrared spectroscopy (FTIR) described the presence of C-O, NH, C-H, and O-H functional groups, which act as stabilizing and reducing molecules. X-ray diffraction (XRD) revealed the average size (~32.43 nm) of AgNPs and scanning electron microscopy (SEM) depicted their spherical nature. In this study, in vitro and in vivo antifungal activity of AgNPs was investigated. In vitro antifungal activity analysis revealed the highest growth inhibition of mycelia (87%) at 1.0 mg/ml concentration of AgNPs. The same concentration of AgNPs tremendously inhibited the spread of disease on infected leaves of H. rosa-sinensis. These results demonstrated significant disease control ability of AgNPs and suggested their use on different ornamental plants.
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Affiliation(s)
- R. Nawab
- Quaid-i-Azam University, Pakistan
| | - M. Ali
- Quaid-i-Azam University, Pakistan
| | | | - A. Kamal
- Quaid-i-Azam University, Pakistan
| | - M. Akbar
- Quaid-i-Azam University, Pakistan
| | - F. Anwar
- Quaid-i-Azam University, Pakistan
| | - J. Ahmed
- Quaid-i-Azam University, Pakistan
| | | | - A. Iqbal
- Quaid-i-Azam University, Pakistan
| | - M. Hashem
- King Khalid University, Saudi Arabia; Assiut University, Egypt
| | - S. Alamri
- King Khalid University, Saudi Arabia
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Mee H, Castano Leon A, Anwar F, Grieve K, Owen N, Turner C, Whiting G, Viaroli E, Timofeev I, Helmy A, Kolias A, Hutchinson P. Towards a core outcome set for cranioplasty following traumatic brain injury and stroke 'A systematic review of reported outcomes'. Brain Spine 2023; 3:101735. [PMID: 37383457 PMCID: PMC10293280 DOI: 10.1016/j.bas.2023.101735] [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] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/30/2023]
Abstract
Background There is wide-ranging published literature around cranioplasty following traumatic brain injury (TBI) and stroke, but the heterogeneity of outcomes limits the ability for meta-analysis. Consensus on appropriate outcome measures has not been reached, and given the clinical and research interest, a core outcome set (COS) would be beneficial. Objectives To collate outcomes currently reported across the cranioplasty literature which will subsequently be used in developing a cranioplasty COS. Methods This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. All full-text English studies with more than ten patients (prospective) or more than 20 patients (retrospective) published after 1990 examining outcomes in CP were eligible for inclusion. Results The review included 205 studies from which 202 verbatim outcomes were extracted, grouped into 52 domains, and categorised into one or more of the OMERACT 2.0 framework core area(s). The total numbers of studies that reported outcomes in the core areas are 192 (94%) pathophysiological manifestations/ 114 (56%) resource use/economic impact/ 94 (46%) life impact/mortality 20 (10%). In addition, there are 61 outcome measures used in the 205 studies across all domains. Conclusion This study shows considerable heterogeneity in the types of outcomes used across the cranioplasty literature, demonstrating the importance and necessity of developing a COS to help standardise reporting across the literature.
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Affiliation(s)
- H. Mee
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Rehabilitation, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - A. Castano Leon
- Neurosurgery Department, Research Institute i+12-CIBERESP, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain
| | - F. Anwar
- Department of Rehabilitation, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - K. Grieve
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - N. Owen
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - C. Turner
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - G. Whiting
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - E. Viaroli
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - I. Timofeev
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - A. Helmy
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
| | - A. Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - P. Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
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Anwar F, Waris A. Monkeypox Virus Outbreak: current situation of Pakistan. New Microbes New Infect 2022; 48:101004. [PMID: 35928519 PMCID: PMC9344352 DOI: 10.1016/j.nmni.2022.101004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- F. Anwar
- Department of Biotechnology and Genetic Engineering, Hazara University, Mansehra, 21300, KP, Pakistan
- Corresponding author. Faheem Anwar.
| | - A. Waris
- Department of Biomedical Sciences, City University of Hong Kong, SAR, Hong Kong
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Khanam R, Shahzad M, Chaudhary SG, Ali F, Shah Z, Pachika PS, Ahmed Z, Chattaraj A, Masood A, Ahmed N, Bansal R, Balusu R, Shune L, Anwar F, Hematti P, McGuirk JP, Yacoub A, Mushtaq MU. Outcomes after venetoclax with hypomethylating agents in myelodysplastic syndromes: a systematic review and meta-analysis. Leuk Lymphoma 2022; 63:2671-2678. [DOI: 10.1080/10428194.2022.2084730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Razwana Khanam
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Moazzam Shahzad
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sibgha Gull Chaudhary
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Fatima Ali
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Zunairah Shah
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Pranali S. Pachika
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Zahoor Ahmed
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Asmi Chattaraj
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Adeel Masood
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Nausheen Ahmed
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rajat Bansal
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ramesh Balusu
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Leyla Shune
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Faiz Anwar
- Division of Hematology/Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Peiman Hematti
- Division of Hematology/Oncology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Joseph P. McGuirk
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Abdulraheem Yacoub
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Muhammad Umair Mushtaq
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
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Mee H, Anwar F, Timofeev I, Owens N, Grieve K, Whiting G, Alexander K, Kendrick K, Helmy A, Hutchinson P, Kolias A. Cranioplasty: A Multidisciplinary Approach. Front Surg 2022; 9:864385. [PMID: 35656088 PMCID: PMC9152220 DOI: 10.3389/fsurg.2022.864385] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Decompressive craniectomy (DC) is an operation where a large section of the skull is removed to accommodate brain swelling. Patients who survive will usually require subsequent reconstruction of the skull using either their own bone or an artificial prosthesis, known as cranioplasty. Cranioplasty restores skull integrity but can also improve neurological function. Standard care following DC consists of the performance of cranioplasty several months later as historically, there was a concern that earlier cranioplasty may increase the risk of infection. However, recent systematic reviews have challenged this and have demonstrated that an early cranioplasty (within three months after DC) may enhance neurological recovery. However, patients are often transferred to a rehabilitation unit following their acute index admission and before their cranioplasty. A better understanding of the pathophysiological effects of cranioplasty and the relationship of timing and complications would enable more focused patient tailored rehabilitation programs, thus maximizing the benefit following cranioplasty. This may maximise recovery potential, possibly resulting in improved functional and cognitive gains, enhancement of quality of life and potentially reducing longer-term care needs. This narrative review aims to update multi-disciplinary team regarding cranioplasty, including its history, pathophysiological consequences on recovery, complications, and important clinical considerations both in the acute and rehabilitation settings.
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Affiliation(s)
- H. Mee
- Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
- Correspondence: Harry Mee
| | - F. Anwar
- Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - I. Timofeev
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - N. Owens
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - K. Grieve
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - G. Whiting
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - K. Alexander
- Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - K. Kendrick
- Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - A. Helmy
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - P. Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
| | - A. Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge & Addenbrooke’s Hospital, Cambridge, UK
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Shahzad M, Chaudhary SG, Zafar MU, Hassan MA, Hussain A, Ali F, Anwar I, Ahmed M, Ahmed N, Khurana S, Rauf MA, Anwar F, Hematti P, Callander NS, Abhyankar SH, McGuirk JP, Mushtaq MU. Impact of COVID-19 in Hematopoietic stem cell transplant recipients: A systematic review and meta-analysis. Transpl Infect Dis 2022; 24:e13792. [PMID: 35030267 DOI: 10.1111/tid.13792] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of mortality and morbidity with Coronavirus Disease 2019 (COVID-19) due to severe immune dysfunction. METHODS A literature search was performed on PubMed, Cochrane, and Clinical trials.gov from the date of inception to 12/08/2021. We identified 19 original studies reporting data on COVID-19 in HSCT recipients after screening 292 articles. Data was extracted following PRISMA guidelines. Quality evaluation was done using the NIH quality assessment tool. Inter-study variance was calculated using Der Simonian-Laird Estimator. Pooled analysis was conducted using MetaXL. A random-effects model was used to estimate the proportions with 95% confidence intervals (CI). RESULTS Of 6711 patients in 19 studies, 2031 HSCT patients with SARS-CoV-2 infection were analyzed. The median age of patients was 56.9 (range 1-81.6) years, and 63% patients were men according to 14 studies. The median time from transplant to SARS-CoV-2 infection for autologous (auto) and allogeneic (allo) HSCT patients was 23.2 (0.33- 350.5) months and 16.4 (0.2- 292.7) months respectively. The median follow-up time after COVID-19 diagnosis was 28 (0-262) days. The COVID-19 mortality rate was 19% (95% CI 0.15- 0.24, I2 = 76%, n = 373/2031). The pooled mortality rate was 17% (95% CI 0.12- 0.24, I2 = 78%, n = 147/904) in auto-HSCT patients and 21% (95% CI 0.16- 0.25, I2 = 60%, n = 231/1103) in allo-HSCT patients. CONCLUSIONS HSCT recipients have a high risk of mortality and clinical complications due to COVID-19. There is a need for ongoing vigilance, masks, and social distancing, vaccination, and aggressive management of SARS-CoV-2 infection in HSCT recipients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Moazzam Shahzad
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Sibgha Gull Chaudhary
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Muhammad U Zafar
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Maha A Hassan
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Ali Hussain
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Fatima Ali
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Iqra Anwar
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Mamoon Ahmed
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Nausheen Ahmed
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Sharad Khurana
- Division of Hematology/Oncology, University of Arizona College of Medicine, Tucson, AZ
| | - Muhammad A Rauf
- Division of Transplant Surgery, Vanderbilt University, Nashville, TN
| | - Faiz Anwar
- Division of Hematology/Oncology, Cleveland Clinic, Cleveland, OH
| | - Peiman Hematti
- Division of Hematology/Oncology, University of Wisconsin School of Medicine & Public Health, Madison, WI
| | - Natalie S Callander
- Division of Hematology/Oncology, University of Wisconsin School of Medicine & Public Health, Madison, WI
| | - Sunil H Abhyankar
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Joseph P McGuirk
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
| | - Muhammad Umair Mushtaq
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS
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Anwar F, Almohammadi M, Garni A, Jamallail S, Alsamkari W, Alsafi A. Red Blood Cell Alloimmunization in Sickle Cell Disease: Advantage of Ethnic Heritage between Donors and Patients in Jeddah, Saudi Arabia. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Red blood cell (RBC) transfusion is frequently required for patients with sickle cell disease (SCD). Development of alloantibodies in these patients complicates the blood bank process needed to identify these antibodies and to find compatible RBC units. The rate of alloimmunization has been reported as high as 47% in one study and 34.2% in another study from Eastern region of Saudi Arabia. The purpose of this study was to determine incidence and rate of RBC alloimmunization in the Saudi population in the Western region in SCD.
Methods/Case Report
A retrospective analysis of the immunohematological and transfusion history of a total of 161 SCD patients was reviewed, of which there 95 males and 66 females. All patients had erythrocytapheresis, ranging from one to 24 full red cell exchange sessions. A total of 490 red cell exchanges were performed and 4,914 units of blood were used. Extended compatibility to RhCcEe and K antigen was performed. Patient who developed alloimmunization to any of RhCcEe and K antigen were matched for Kidd, Duffy and MSN antigens for subsequent RBC requirements.
Results (if a Case Study enter NA)
The RBC alloimmunization incidence was 18% with a rate of 0.6 antibodies per 100 RBC transfusions. Alloimmunization in females was significantly higher than in the patients. Eighteen (11.2%) female patients demonstrated antibodies as compared to eleven (6.8%) male patients. Twelve patients (7.4%) had a history of at least one alloantibody and 17 (10.6%) had more than one. Antibodies found were directed against E (7.4%), K (5.6%), and D, C, c, S, M, Lea, Jk a, Chido/Rodgers, Fy a. Seven (4.3%) patients also had warm autoantibodies.
Conclusion
RBC alloimmunization incidence and rate in our study was lower to those reported in less heterogeneous population of donors and patients. Nonetheless, RBC alloimmunization still occurs in patients with SCD, often due to Rh variants or lack of consistency in the application of prophylactic antigen matching between institutions. Therefore, we believe that this rate can still be further reduced if all centers in the region establish transfusion programs to include at least RhCcEe and K phenotypic compatibility and communication mechanisms between major treating centers and transfusion centers in smaller cities to minimize the risks of exposing the patient to different RhCcEe and K phenotype and of developing RBC alloimmunization.
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Affiliation(s)
- F Anwar
- Pathology and Lab Medicine, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
| | - M Almohammadi
- Pathology and Lab Medicine, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
| | - A Garni
- Pathology and Lab Medicine, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
| | - S Jamallail
- Pathology and Lab Medicine, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
| | - W Alsamkari
- Pathology and Lab Medicine, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
| | - A Alsafi
- Adult Hematology BMT, King Abdulaziz Medical City, Jeddah, SAUDI ARABIA
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Arshad Z, majeed M, Thahir A, Anwar F, Rawal J, Hull P, Carrothers A, Chou D. 1213 Cycling-related Trauma Admissions to the Major Trauma Centre in the Cycling Capital of the United Kingdom. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
The number of cyclists travelling on roads in the United Kingdom (UK) is increasing. The government has recently introduced initiatives to promote cycling uptake and so these numbers are likely to increase. This study aims to characterise cycling related injuries presenting to a major trauma centre located within a region with the highest rates of cycling in the UK.
Method
A retrospective review of cycling related trauma admissions occurring between January 2012 and June 2020 was performed. All patients were split into three groups based on the mechanism of injury. Our institution’s electronic patient record system was used to collect data including age, gender, mechanism of injury, Glasgow coma scale score on arrival, incident date and time, injured body regions, 30-day mortality, helmet use, and length of stay.
Results
A total of 606 cycling related trauma cases were identified, with 52 being excluded due to incomplete data. The ‘cyclist v vehicle’ group was associated with a significantly higher Injury Severity score (ISS), lower GCS and longer hospital stay than the other two groups. Helmet wearers were significantly older than non-wearers and helmet use was associated with a significantly reduced risk of head injury, lower ISS and higher GCS.
Conclusions
With a likely increase in future cycling uptake, it is crucial that effective interventions are put in place to improve the safety of cyclists. A multi-faceted strategy involving driver and cyclist education, road infrastructure changes and helmet promotion campaigns targeting the younger generation could be employed.
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Affiliation(s)
- Z Arshad
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - M majeed
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - A Thahir
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - F Anwar
- Department of neurosciences, Addenbrooke's Hospital, Cambridge university NHS Foundation Trust, Cambridge, United Kingdom
| | - J Rawal
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P Hull
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Carrothers
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Chou
- Cambridge Orthopaedic Trauma Unit Addenbrooke’s Hospital Major Trauma Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Khan DZ, Placek MM, Smielewski P, Budohoski KP, Anwar F, Hutchinson PJA, Bance M, Czosnyka M, Helmy A. 817 Robotic Semi-Automated Transcranial Doppler Assessment of Cerebrovascular Autoregulation in Post Concussional Syndrome: Methodological Considerations. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Post-concussive syndrome (PCS) refers to a constellation of physical, cognitive, and emotional symptoms after traumatic brain injury (TBI). Despite its incidence, the underlying mechanisms are unclear. We hypothesised that impaired cerebral autoregulation (CA) is a contributor.
Method
A prospective, observational study was integrated into outpatient clinics at a tertiary neurosurgical centre. Data points included: demographics, symptoms (Post-Concussion Symptom Scale [PCSS]), neuropsychological assessment (Cambridge Neuropsychological Test Automated-Battery [CANTAB]) and cerebrovascular metrics (Mxa co-efficient and the transient hyperaemic-response ratio [THRR]) - via transcranial Doppler (TCD), plethysmography and bespoke software (ICM+).
Results
12 participants were recruited with 2 excluded after unsuccessful cerebrovascular TCD insonation. 10 participants (5 TBI patients, 5 healthy controls) were included in the analysis (median age 26.5, male:female 7:3). Median PCSS scores were 6/126 (TBI subgroup). Median CANTAB percentiles were 78 (healthy controls) and 25 (TBI). Mxa was calculated for 90% and THRR for 50% of participants. Median study time was 127.5 minutes and feedback (n = 6) highlighted the perceived acceptability of the study.
Conclusions
This pilot study has demonstrated a feasible and reproducible assessment of PCS and CA metrics (non-invasively) in a real-world setting. By scaling this methodology, we hope to test whether CA changes are correlated with symptomatic PCS in patients post-TBI.
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Affiliation(s)
- D Z Khan
- Division of Neurosurgery, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M M Placek
- Brain Physics Laboratory, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - P Smielewski
- Brain Physics Laboratory, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - K P Budohoski
- Division of Neurosurgery, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - F Anwar
- Department of Neurorehabilitation, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - P J A Hutchinson
- Division of Neurosurgery, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Bance
- Department of ENT, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Czosnyka
- Brain Physics Laboratory, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - A Helmy
- Division of Neurosurgery, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Gruczynska-Sekowska E, Aladedunye F, Anwar F, Koczon P, Kowalska D, Kozlowska M, Majewska E, Tarnowska K. Development of zero-trans shortenings with high thermo-oxidative stability by enzymatic transesterification. Grasas y Aceites 2020. [DOI: 10.3989/gya.0564191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Novel zero-trans frying shortenings were formed by enzymatic transesterification by exploring a palm stearin and canola oil mixture and stearic acid as substrates. Both immobilized (Novozym 435, Lipase PS “Amano” IM) and non-immobilized (Lipomod TM 34P) enzymes were applied as biocatalysts. Palmitic acid, the fatty acid which defines the proper type of crystal formation, was present at the 15% level in the reaction mixtures. The novel structured lipids had comparable physical properties and offered similar frying performance to those of commercial shortening. Needle-shaped crystals were predominant both in the transesterification products and the commercial frying shortening. Furthermore, solid fat content profiles of the zero-trans structured lipids produced by Novozym 435 and Lipase PS “Amano” IM were close to those of the commercial shortening.
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Haq I, Ullah R, Din M, Ahmad S, Anwar F, Ali M, Khan HU. Unrecognized HIV infection in asymptomatic volunteer blood donors at district Peshawar, Khyber Pakhtunkhwa, Pakistan. New Microbes New Infect 2020; 35:100685. [PMID: 32454980 PMCID: PMC7235641 DOI: 10.1016/j.nmni.2020.100685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/04/2020] [Accepted: 04/15/2020] [Indexed: 11/16/2022] Open
Abstract
Acquired immunodeficiency syndrome (AIDS) is a global epidemic that impacts the lives of many individuals each year. Human immunodeficiency virus (HIV) is a retrovirus that infects human CD4+ T helper cells and macrophages thereby causing severe immune disease. The current study aimed to examine the prevalence of HIV among the blood donors of Khyber Pakhtunkhwa at Peshawar. In this study, a total of 8634 volunteers who donated blood were carefully screened for HIV using ELISA and RT-PCR techniques. Among the volunteers (n = 8634), 63 were positive by both ELISA and RT-PCR; which shows a prevalence of 0.73%. Both diagnostic techniques exhibited similar results. All the positive individuals were informed immediately and advised to start treatment to control the progression of the infection. It was concluded that HIV is on the rise in Peshawar, and routine screening and preventive measures are immediately required to address the urgent situation of HIV infection.
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Affiliation(s)
- I Haq
- Department of Genetics, Hazara University Mansehra, Pakistan
| | - R Ullah
- Department of Biotechnology, University of Malakand, Pakistan
| | - M Din
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Pakistan
| | - S Ahmad
- Department of Biotechnology, University of Malakand, Pakistan
| | - F Anwar
- Department of Genetics, Hazara University Mansehra, Pakistan
| | - M Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Pakistan
| | - H Ullah Khan
- Khyber Medical College, Peshawar, Pakistan.,Khyber Teaching Hospital, Peshawar, Pakistan
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Lateef N, Kapoor V, Ahsan MJ, Latif A, Ahmed U, Mirza M, Anwar F, Holmberg M. Atrial fibrillation and cancer; understanding the mysterious relationship through a systematic review. J Community Hosp Intern Med Perspect 2020; 10:127-132. [PMID: 32850047 PMCID: PMC7425610 DOI: 10.1080/20009666.2020.1726571] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Atrial Fibrillation (AFib) is the most common cardiac arrhythmia, occurring in ≈1% of the general population. An increased risk of malignancy among patients with AFib would be of substantial public health importance, given the high prevalence and associated economic burden of both disorders. Objectives To evaluate the relationship between atrial fibrillation (AFib) and cancer. Methods We conducted an extensive database search on PubMed, Google Scholar, ScienceDirect, and SEER Database from their inception to September 2019 for any study that evaluated the association between AFib and cancer. Results In the first 3 months of AFib diagnosis, Ostenfeld et al. reported an absolute cancer risk of 2.5% with a standardized incidence ratio of 7.02 and 3.53 for metastatic and localized cancer, respectively. Likewise, Saliba et al. detected an increase in the odds of cancer diagnosis in first 90 days after AF diagnosis with OR of 1.85. Moreover, in another study new-onset breast and colorectal cancer was especially associated with AF in the first 90 days after diagnosis with HR of 3.4 but not thereafter (HR 1.0). Similarly, Conen et al. reported high relative risk of cancer with HR of 3.54 in the first 3 months after new-onset AFib. However, beyond the initial 90 day period, the risk of cancer in AFib is only slightly increased. Conclusion Based on our review, there appears to be an increase in risk of subsequent diagnosis of cancer in patients with AF, likely owing to the shared risk factors between the two conditions. While the results of this study raise interesting questions for future search, they are not currently strong enough to justify initiating cancer screening for an occult cancer in a patient with AF. Regardless, measures to target modification of these shared risk factors remains an important consideration.
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Affiliation(s)
- Noman Lateef
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Vikas Kapoor
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Muhammad Junaid Ahsan
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Azka Latif
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Umair Ahmed
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohsin Mirza
- Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
| | - Faiz Anwar
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Mark Holmberg
- Department of Cardiovascular Medicine, Creighton University Medical Center, Omaha, NE, USA
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Kumar V, Bhatt P, Anwar F, Verma A. 7P Selenium-enriched polysacchride green tea extract alters the early stage hepatocellular carcinoma by angiogenesis hypoxia and metastatic inhibition. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw573.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Kumar V, Bhatt P, Anwar F. 55P Development of a nanoformulation containing ganoderic acid for the prevention and treatment of the benzo[a]pyrene induced lung cancer. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Anwar F, Zreen Z, Sultana B, Jamil A. Enzyme-aided cold pressing of flaxseed ( Linum usitatissimum L.): Enhancement in yield, quality and phenolics of the oil. Grasas y Aceites 2013. [DOI: 10.3989/gya.132212] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Abbas M, Asi MR, Anwar F, Mahmood T, Khan AM, Yaqub T. RETRACTED ARTICLE: Assessment of aflatoxins in peanuts grown in the Pothohar area of Pakistan. Food Addit Contam Part B Surveill 2013; 12:X. [PMID: 31482768 DOI: 10.1080/19393210.2013.820221] [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] [Indexed: 10/26/2022]
Abstract
A survey was carried out to assess the mycotoxin (aflatoxins) contamination in locally grown peanuts. A total of 72 samples of raw, roasted and salty peanuts were collected randomly from the Pothohar Plateau of Pakistan. The samples were dried, ground and extracted by adding acetonitrile:water (84:16; v/v%). The filtered extracts were cleaned with MycoSep-226 columns and analysed by high-performance liquid chromatography with a fluorescence detector. The limit of quantification for aflatoxin B1 was 1 μg/kg with 70% recovery observed in spiked samples with a concentration range of 1-10 μg/kg. The results indicated that aflatoxins were present in almost 82% of the samples tested, with levels ranging from 14.3 to 98.8 μg/kg. This reflects that optimal conditions for fungal growth and mycotoxin contamination are frequent in peanut crop fields as well as in storehouses. Human exposure to such toxins can be controlled through appropriate measures, creating awareness and implementing regulations.
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Affiliation(s)
- M Abbas
- Department of Toxicology, Quality Operations Laboratory (QOL), University of Veterinary and Animal Sciences , Lahore , Pakistan
| | - M R Asi
- Nuclear Institute for Agriculture and Biology (NIAB) , Faisalabad , Pakistan
| | - F Anwar
- Department of Chemistry, University of Sargodha , Sargodha , Pakistan
| | - T Mahmood
- Department of Chemistry, Government Post Graduate College, Samanabad , Faisalabad , Pakistan
| | - A M Khan
- Department of Toxicology, Quality Operations Laboratory (QOL), University of Veterinary and Animal Sciences , Lahore , Pakistan
| | - T Yaqub
- Quality Operations Laboratory (QOL), University of Veterinary and Animal Sciences , Lahore , Pakistan
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Bhatti IA, Iqbal M, Anwar F, Shahid SA, Shahid M. Quality characteristics and microbiological safety evaluation of oils extracted from gamma irradiated almond ( Prunus dulcis Mill.) seeds. Grasas y Aceites 2013. [DOI: 10.3989/gya.071512] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Anwar F, Raziq S, Mahmood Z, Shahid SA, Nadeem R. Characterization of seed oils from different varieties of watermelon [ Citrullus lanatus (Thunb.)] from Pakistan. Grasas y Aceites 2012. [DOI: 10.3989/gya.022212] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Anwar F, Manzoor M, Ashraf M, Alkharfy KM. Physico-chemical characteristics of seed oils extracted from different apricot ( Prunus armeniaca L.) varieties from Pakistan. Grasas y Aceites 2012. [DOI: 10.3989/gya.095011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Nasir A, Shackelford RE, Anwar F, Yeatman TJ. Genetic risk of breast cancer. MINERVA ENDOCRINOL 2009; 34:295-309. [PMID: 20046159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Several cutting-edge strategies are being used to evaluate candidate genetic risk factors for breast cancer. These include linkage analysis for mapping out BRCA1 and BRCA2, mutational screening of candidate risk genes like CHEK2, ATM, BRIP1 and PALB2, which are associated with an intermediate level of breast cancer risk. Genome-wide association studies have revealed several low-penetrance breast cancer risk alleles. The predisposition factors are associated with different levels of breast cancer risk. Relative to control population, the risk in patients harboring high-risk BRCA1 and 2 mutations is over 10-fold, with intermediate penetrance genes 2 to 4-fold and with low penetrance alleles less than 1.5-fold. Overall, these factors account for about 25% of the genetic risk for breast cancer. In the remainder, genetic factors to contribute to the risk of breast cancer remain unknown and are a subject of current investigation. With discovery and validation of newer and clinically relevant predisposition factors, additional breast cancer risk categories may be recognized. BRCA1 and BRCA2 mutation testing allows identification of individuals at increased risk of breast cancer who are offered risk-reducing interventions. Targeted therapies are being developed that may refine management of patients with BRCA1 and BRCA2 mutations. Further genome-wide studies are required to identify clinically relevant molecular factors that will allow more accurate and widely applicable genetic risk stratification. Current efforts in discovery, validation and qualification of molecular markers of breast cancer risk offer considerable promise in the future to develop more accurate breast cancer risk assessment along with development of more effective chemopreventive and therapeutic strategies.
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Affiliation(s)
- A Nasir
- Department of Anatomic, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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22
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Inaparthy PK, Anwar F, Botchu R, Jähnich H, Katchburian MV. Compression of the deep branch of the ulnar nerve in Guyon's canal by a ganglion: two cases. Arch Orthop Trauma Surg 2008; 128:641-3. [PMID: 18509691 DOI: 10.1007/s00402-008-0636-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [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: 10/15/2006] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion compressing the nerves. MATERIALS AND METHODS We present two cases of compression of deep branch of ulnar nerve by a ganglion in the Guyon's canal. Two male patients presented with history of progressive weakness and paraesthesia in the medial 1(1/2) digits of the non-dominant hand. Interestingly, both the patients noticed sudden onset and rapid progress of the symptoms and signs. Clinical examination revealed typical symptoms of ulnar nerve (deep branch) palsy. Nerve conduction studies showed severe denervation of the deep branch of the ulnar nerves in both the patients and ultrasound confirmed the diagnosis. Surgical decompression led to complete recovery. RESULTS AND DISCUSSION Whilst compression by a ganglion in the Guyon's canal is rare but well recognized, a feature of both of our cases was the rapid progression and severe nature of the compressive symptoms and signs. This is in contrast to the more typical features of compressive neuropathy and should alert the clinician to the possible underlying cause of compression. Early decompression has the potential to promote a complete recovery.
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Affiliation(s)
- P K Inaparthy
- West Middlesex University Hospital, Isleworth, West Middlesex, UK.
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Anwar F, Latif S, Przybylski R, Sultana B, Ashraf M. Chemical Composition and Antioxidant Activity of Seeds of Different Cultivars of Mungbean. J Food Sci 2007; 72:S503-10. [DOI: 10.1111/j.1750-3841.2007.00462.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Advances in the design of the components for total ankle replacement have led to a resurgence of interest in this procedure. Between January 1999 and December 2004, 16 patients with a failed total ankle replacement were referred to our unit. In the presence of infection, a two-stage salvage procedure was planned. The first involved the removal of the components and the insertion of a cement spacer. Definitive treatment options included hindfoot fusion with a circular frame or amputation. When there was no infection, a one-stage salvage procedure was planned. Options included hindfoot fusion with an intramedullary nail or revision total ankle replacement. When there was suspicion of infection, a percutaneous biopsy was performed. The patients were followed up for a minimum of 12 months. Of the 16 patients, 14 had aseptic loosening, five of whom underwent a revision total ankle replacement and nine a hindfoot fusion. Of the two with infection, one underwent fusion and the other a below-knee amputation. There were no cases of wound breakdown, nonunion or malunion. Management of the failed total ankle replacement should be performed by experienced surgeons and ideally in units where multidisciplinary support is available. Currently, a hindfoot fusion appears to be preferable to a revision total ankle replacement.
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Affiliation(s)
- R Kotnis
- Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK.
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25
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Spivak H, Anwar F, Burton S, Guerrero C, Onn A. The Lap-Band system in the United States: One surgeon?s experience with 271 patients. Surg Endosc 2004; 18:198-202. [PMID: 14691703 DOI: 10.1007/s00464-003-8825-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [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: 07/29/2003] [Accepted: 08/21/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND The LAP-BAND system is considered an important bariatric surgery procedure in many countries and is rapidly gaining acceptance in the United States. Outcomes data emerging in the United States parallel European and Australian experience. The purpose of this study was to examine our experience with this procedure in the United States. METHODS Between November 2000 and September 2002, 271 patients (236 women) underwent LAP-BAND system placement. The mean age of patients was 40 years (18-63); preoperative mean body weight was 125 kg (93-192). Surgeries were performed using either the two-step (pars flaccida to perigastric) or the pars flaccida technique with three (1.1%) conversions to open procedures. Mean operative time was 42 min (23-86); average hospital stay was 1 day (4 h to 7 days). RESULTS The mean body mass index (BMI) decreased from a baseline of 45.3 kg/m(2) (35-68) to 41.9 ( n = 178), 39.5 ( n = 101), 38.4 (n = 81), 36.5 (n = 72), 35.9 (n = 51), and 35.1 (n = 21) kg/m(2) at 3, 6, 9, 12, 18, and 24 months, respectively, after surgery. Mean excess weight loss was 40% at 12 months and 43% at 24 months. As patients lost weight, comorbid conditions improved. No deaths occurred, no bands had to be removed, and postoperative complications were minor: 20 (7.3%) access port problems, 18 (6.6%) gastric pouch dilatations, five (1.8%) gastric slippages, and five (1.8%) stoma obstructions. All were managed conservatively or repaired laparoscopically using the original bands. Additional complications included four cases of pneumonia and one case of pulmonary embolism. One patient required reoperation because of trocar site bleeding. CONCLUSIONS The LAP-BAND system is a safe and effective bariatric procedure leading to considerable weight loss and reduction in comorbidity.
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Affiliation(s)
- H Spivak
- Department of Surgery, San Jacinto Methodist Hospital, 4301 Garth Road, Baytown, TX 77521, USA,
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26
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Abstract
CD44 is a broadly distributed family of cell surface glycoproteins. The expression of CD44H has been documented in both Hodgkin lymphoma and non-Hodgkin lymphoma. CD44V6 has been associated with more aggressive behavior in non-Hodgkin lymphoma, but such a correlation has not been established in Hodgkin lymphoma. In addition, the utility of CD44 and CD44V6 in the subclassification of Hodgkin lymphoma in paraffin-embedded tissues has not previously been evaluated. The current study included formalin- or methacarn-fixed, paraffin-embedded tissue specimens from 42 patients with Hodgkin lymphoma (25 nodular sclerosis, three interfollicular, four lymphocyte-rich classic Hodgkin, six lymphocyte predominant, and four mixed cellularity). The clinical stage of the study population at initial presentation ranged from stage IA to IVB. Evaluation of CD44H and CD44V6 (Novocastra) was performed by ABC immunoperoxidase technique after heat-induced epitope retrieval. In the six cases of lymphocyte predominant Hodgkin, the neoplastic cells lacked reactivity with CD44H reminiscent of their normal germinal center counterparts. On the other hand, classic Hodgkin lymphoma showed variable membranous and Golgi reactivity in the neoplastic cells in all cases irrespective of disease stage at presentation. In all cases, the neoplastic cells lacked reactivity with CD44V6 except for three one lymphocyte-predominant, one interfollicular, and one nodular sclerosis), all of which represented recurrent cases. In conclusion, CD44 evaluation is useful in the distinction between lymphocyte predominant and classic Hodgkin lymphoma. The presence of CD44H expression has no relation to the clinical stage of the disease at presentation or recurrence. CD44V6 is detected in a minority of cases irrespective of the histologic subtype and its presence may be associated with recurrence. There was no correlation between disease stage at presentation and the expression of CD44V6.
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Affiliation(s)
- F Anwar
- Department of Laboratory Medicine, University of Washington, Seattle 98105, USA
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27
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Abstract
Retinoblastoma (Rb) mutation in thyroid neoplasia has been identified in a few molecular studies; however, the utility of Rb immunohistochemistry in distinguishing benign and malignant thyroid lesions has not been documented in formalin-fixed, paraffin-embedded tissues. The present study investigated Rb immunohistochemistry in a series of 111 formalin-fixed, paraffin-embedded benign and malignant thyroid lesions. All of the major histologic subtypes were included to detect any heterogeneity in Rb-1 expression that might influence the diagnostic utility of this technique or further elucidate the pathogenesis of thyroid neoplasia among the categories. Altogether, 34 follicular adenomas, 9 follicular carcinomas, 7 Hürthle cell adenomas, 5 Hürthle cell carcinomas, 23 papillary carcinomas (8 of which were follicular variants), 4 insular carcinomas, 4 anaplastic carcinomas, 6 medullary carcinomas, and 19 nodular goiters were analyzed. Avidinbiotin immunohistochemistry was performed using the Dako Rb-1 clone. Pronase digestion was introduced into the epitope retrieval protocol to eliminate false-positive cytoplasmic stainig. Nuclear immunoreactivity was assessed as positive if 10% or more of thyroid epithelial nuclei stained positively, and conversely as negative. The majority of benign non-Hürthle thyroid lesions, whether hyperplastic or neoplastic, retained Rb nuclear immunopositivity in most cells (51 of 53 cases [96%]). Conversely, malignant thyroid neoplasms lacked Rb immunoreactivity in the majority (42 of 51 cases [82%]), including all papillary carcinomas (23 of 23) and almost all follicular carcinomas (8 of 9 [89%]). Virtually all Hürthle cell neoplasms were negative (11 of 12 [92%]), whether benign or malignant. In conclusion, Rb immunohistochemistry can aid in the distinction between benign and malignant thyroid lesions in conjunction with morphology. This seems to be most applicable to the often problematic differentiation between follicular adenoma and the follicular variant of papillary carcinoma (P < .0001; sensitivity and specificity, 100%) or minimally invasive follicular carcinoma (P = .0007; sensitivity, 89%; specificity, 100%).
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Affiliation(s)
- F Anwar
- Department of Pathology, University of Washington, Seattle 98195-6100, USA
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Li W, Anwar F, Jesurrun J, Erice A. Cytomegalovirus UL97 and glycoprotein B (gB) sequences in tissues from immunocompromised patients with ganciclovir-resistant virus infection. Scand J Infect Dis 2000; 31:549-53. [PMID: 10680983 DOI: 10.1080/00365549950164418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The pathogenesis of ganciclovir-resistant cytomegalovirus (CMV) was investigated by analysing UL97 and gB sequences in tissues obtained from 4 immunocompromised patients with infections caused by ganalciclovir-resistant virus. UL97 and gB sequences were obtained by automated sequencing of CMV DNA amplified from lysates prepared from deparaffinized tissue sections. Patient 1 contained wild-type UL97 and gB3 sequences. Patient 2 harboured genetically distinct viruses in his lung: one with a ganciclovir-resistance UL97 mutation and a gB3 genotype, and another without UL97 mutations and a gB1 genotype. In patient 3, a ganciclovir-resistant UL97 mutant virus with a gB1 genotype was cultured from the lung, whereas the CMV in the brain did not contain mutations and its genotype was gB2. In patient 4, ganciclovir-resistance UL97 sequences were found in oesophageal tissue prior to the isolation of a ganciclovir-resistant CMV from the blood. All viruses in this patient had a gB3 genotype. CMV containing ganciclovir-resistance UL97 mutations may cause end-organ disease in immunocompromised individuals. In these subjects, CMV circulating in the blood may have similar or different UL97 and gB genotypes than the virus causing end-organ disease.
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Affiliation(s)
- W Li
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, USA
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Francis GS, Anwar F, Bank AJ, Kubo SH, Jessurun J. Apoptosis, Bcl-2, and proliferating cell nuclear antigen in the failing human heart: observations made after implantation of left ventricular assist device. J Card Fail 1999; 5:308-15. [PMID: 10634672 DOI: 10.1016/s1071-9164(99)91335-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Heart failure is characterized by progressive left ventricular remodeling, a complex process that results from cell growth and cell death. The quantitative contribution of apoptotic cells toward left ventricular remodeling has varied widely in tissue removed from cardiomyopathic hearts. Apoptosis has been responsive to angiotensin-converting enzyme inhibition in experimental heart failure, but the dynamics and responsiveness to chronic left ventricular unloading have not been studied. METHODS AND RESULTS We studied 8 patients with severe heart failure before and after chronic left ventricular unloading with a left ventricular assist device (LVAD). Tissue from the left ventricular apex removed at the time of LVAD implantation was examined for apoptosis using the technique of terminal deoxynucleotidyl transferase deoxyuridine triphosphate-biotin nick end-labeling (TUNEL) in 10 patients. These same hearts explanted at the time of cardiac transplantation were then examined for apoptosis after patients had been on the LVAD for 99 +/- 20 (SEM) days. An additional 10 patients with equally severe heart failure who underwent heart transplantation without the use of an LVAD served as controls. Eight hearts obtained at autopsy approximately 6 hours after death from patients who died of non-cardiovascular disease causes served as non-heart failure controls. Additionally, 6 hearts were examined by immunohistochemistry for the antiapoptotic protein, Bcl-2, and for the repair and/or proliferation marker, proliferating cell nuclear antigen (PCNA), before and after LVAD. Apoptosis was not detected in the tissue sections from the hearts of 8 patients at the time of LVAD implantation. Only 1 of these patients had limited apoptosis (< 1 apoptotic cell/1,000 myocytes) after LVAD insertion. Three of 10 patients with severe heart failure who did not receive an LVAD but underwent transplantation showed limited apoptosis (< 1 apoptotic cell/1,000 myocytes). Likewise, none of the control hearts from patients who died of noncardiovascular disease manifested apoptosis. Six of 6 patients overexpressed Bcl-2 at the time of LVAD insertion. In all these patients, Bcl-2 returned to negligible levels after chronic unloading of the heart. Likewise, PCNA was abundantly expressed in 5 of 6 failing hearts at the time of LVAD implantation and was reduced in 4 of 5 hearts after chronic unloading by LVAD. CONCLUSION Apoptosis is a rare or inconsistent finding in the failing human heart. Overexpression of such indicators of cellular stress and DNA replication and/or repair as Bcl-2 and PNCA in heart failure may be altered by optimizing left ventricular loading conditions by such mechanical devices as the LVAD.
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Affiliation(s)
- G S Francis
- Department of Medicine, Fairview University Hospital Medical Center and University of Minnesota Medical School, Minneapolis, USA
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Abstract
Recent awareness of the broader spectrum of morphologic changes induced by cytomegalovirus (CMV) infection prompted us to investigate whether the concurrent introduction of effective antiviral therapy is in some way related to the appearance of atypical cytopathic features. These changes may be easily misinterpreted on histologic examination as reactive or degenerative. In addition, since resistant strain to antiviral therapy has emerged and its demonstration is a laborious process performed in highly specialized laboratories, it is important to determine if resistance to antiviral drugs can be predicted from the microscopic examination of infected tissues. The population consisted of seven immunosuppressed patients with documented CMV infection from which 18 tissue samples were obtained at autopsy or endoscopically. Antiviral susceptibility to ganciclovir was determined by plaque reduction assay and/or a DNA-DNA hybridization method. Eleven tissue specimens from patients harboring resistant strains were compared with seven specimens from patients infected with sensitive strains. Cytopathic changes were classified as typical or atypical according to previously published criteria. Of the 18 biopsy specimens, the cytopathic changes were distributed as follows: typical 1, typical and atypical 5, and atypical 12. Atypical inclusions were found in 10 of 11 and 7 of 7 sensitive and resistant cases, respectively. In conclusion, there are no specific morphologic features in CMV-infected tissues of patients with infections caused by ganciclovir resistant strains.
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Affiliation(s)
- F Anwar
- Department of Medicine, Fairview-University Medical Center, Minneapolis, MN 55455, USA
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Abstract
Carbamylated hemoglobin (carhb) is formed by the reaction of hemoglobin with cyanate, a product of in vivo urea dissociation. It is found in high levels in patients with renal failure and may be useful in their clinical evaluation. Accordingly, we measured carhb by HPLC after acid hydrolysis in 73 patients with renal failure and 11 controls. Mean carhb levels (expressed as micrograms valine hydantoin/g Hb), were highest in chronic renal failure (CRF, 146 +/- 13), intermediate in end-stage renal disease on hemodialysis (ESRD, 106 +/- 7), and lowest in acute renal failure (ARF, 80 +/- 12) when compared to normal subjects (27 +/- 2). In all patients carhb was significantly correlated with BUN but not with creatinine, bicarbonate, or phosphate. For any level of BUN above 80 mg/dl, carhb was substantially higher in CRF than in ARF. Predialysis BUN and urea reduction ratio (URR) were significant predictors of carhb in ESRD. To investigate the effect of time of exposure and BUN level on the rate of carbamylation of hemoglobin, blood from normal subjects and dialysis patients was incubated in vitro with urea equivalent to BUN levels of 50, 100, 150, and 200 mg/dl and assayed for carhb at 0, 5, 9, and 14 days. Carhb increased linearly over the first nine days of urea exposure and leveled off thereafter. The rate of carbamylation increased as BUN increased and was significantly higher in hemoglobin from dialysis patients than from normal subjects. These results show that the higher the level of carhb at baseline, the higher the rate of carbamylation upon exposure to increasing urea concentrations. We conclude that carhb formation is dependent on urea concentration and length of exposure to urea. The rate of carhb formation for a given urea concentration is greater in hemoglobin already carbamylated, and this may explain why carhb is higher in CRF than in ARF at BUN levels greater than 80 mg/dl. Carhb may thus be a useful index of the duration and degree of exposure to high blood urea levels in patients with renal failure, and may potentially serve as an index of the adequacy of dialysis.
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Affiliation(s)
- J Stim
- Department of Medicine, Cook County Hospital, University of Illinois-Chicago Medical Center, USA
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Sadaruddin A, Agha F, Anwar F, Ghafoor A. Seroepidemiology of toxoplasma gondii infection in young school children in Islamabad. J PAK MED ASSOC 1991; 41:131-4. [PMID: 1895497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sera, from 270 school children (age 13 to 20 years) residing in suburbs of Islamabad, were investigated for the presence of toxoplasma gondii, IgG antibodies using the enzyme linked immunosorbent assay (ELISA). The overall prevalence was 17.4%. There was no significant difference between the two sexes. Since a positive test result for IgG antibodies at any level does not eliminate the possibility of a current infection, the toxoplasma IgG antibody positive children were further tested for the presence of toxoplasma IgM antibodies by the same technique. An acute infection was indicated in 12.7% (6/47) IgG positive children. This study shows that toxoplasmosis is prevalent in adolescence in Islamabad. The presence of cats and the degree of soil contact appeared compatible with hypothesis of transmission by oocysts. Poor sanitary habits and conditions and water shortage in schools may cause parasitic infection through contact between the children. An improvement in general hygienic conditions is important in reducing the rate of transmission by oocysts. Further studies are needed to assess the possible age of exposure to this parasite in the paediatric group.
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Affiliation(s)
- A Sadaruddin
- Pakistan Medical Research Council, Central Research Centre, Islamabad
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Mastro TD, Ghafoor A, Nomani NK, Ishaq Z, Anwar F, Granoff DM, Spika JS, Thornsberry C, Facklam RR. Antimicrobial resistance of pneumococci in children with acute lower respiratory tract infection in Pakistan. Lancet 1991; 337:156-9. [PMID: 1670799 DOI: 10.1016/0140-6736(91)90813-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
87 strains of Streptococcus pneumoniae isolated during three winter seasons (1986-89) from the blood of children with acute lower respiratory tract infection (ALRI) in Pakistan were serotyped and tested for susceptibility to a range of antimicrobial agents. 97% of isolates were resistant to at least one antimicrobial drug. 62% had decreased susceptibility to co-trimoxazole (trimethoprim/sulphamethoxazole) (31% were fully resistant) and 39% were resistant to chloramphenicol. All isolates were susceptible to erythromycin, cefaclor, cephalothin, ceftriaxone, cefuroxime, rifampicin, vancomycin, and clindamycin. 29% of isolates were neither vaccine types nor vaccine-related types. Serotype distribution and antimicrobial susceptibility varied significantly during the three winter seasons. No single serotype was found in all three winters. The findings highlight the need for surveillance of antimicrobial resistance and serotype distribution of S pneumoniae in developing countries as a guide both to the choice of agent for treatment of pneumococcal infections, especially ALRI, and to the formulation of new pneumococcal conjugate vaccines for use in young children.
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Affiliation(s)
- T D Mastro
- Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Georgia 30333
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Ghafoor A, Nomani NK, Ishaq Z, Zaidi SZ, Anwar F, Burney MI, Qureshi AW, Ahmad SA. Diagnoses of acute lower respiratory tract infections in children in Rawalpindi and Islamabad, Pakistan. Rev Infect Dis 1990; 12 Suppl 8:S907-14. [PMID: 2270413 DOI: 10.1093/clinids/12.supplement_8.s907] [Citation(s) in RCA: 83] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A hospital-based inpatient and outpatient study of 1,492 cases of acute lower respiratory tract infection (ALRI) was conducted from November 1986 to March 1988 in two hospitals in Rawalpindi and Islamabad, Pakistan. Specimens of nasopharyngeal aspirate were processed for viral studies in all cases; blood cultures were performed in 1,331 cases; and urine was obtained for detection of bacterial antigen in 378 cases, but 227 of these samples had bacterial contamination and were discarded. Respiratory syncytial virus was identified in 33% of cases, and Haemophilus influenzae and Streptococcus pneumoniae were identified in 9.6% and 9.9% of cases, respectively. Nonencapsulated H. influenzae accounted for 32% of the Haemophilus isolates, and type b was the only encapsulated H. influenzae strain identified. Of the S. pneumoniae serotypes isolated, 31% are not included in the currently available polyvalent pneumococcal vaccine. No clinical characteristic was demonstrated to be a reliable indicator for bacterial ALRI.
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Affiliation(s)
- A Ghafoor
- Public Health Division, National Institute of Health, Islamabad, Pakistan
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35
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Weinberg GA, Ghafoor A, Ishaq Z, Nomani NK, Kabeer M, Anwar F, Burney MI, Qureshi AW, Musser JM, Selander RK. Clonal analysis of Hemophilus influenzae isolated from children from Pakistan with lower respiratory tract infections. J Infect Dis 1989; 160:634-43. [PMID: 2677160 DOI: 10.1093/infdis/160.4.634] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The clonal diversity of 105 Hemophilus isolates from the blood of children with lower respiratory tract infection in Pakistan was analyzed. Ten isolates were identified as H. parainfluenzae and 95 as H. influenzae. Of the H. influenzae isolates, 61 (64%) were serotype b and 34 (36%) were nontypable; 95% of the type b isolates were members of a single clonal group (as defined by multilocus enzyme electrophoresis, SDS-PAGE outer membrane protein profile, and biotype). This clone is rarely observed among type b strains recovered from patients with invasive type b disease in the USA or Europe. The nontypable isolates in Islamabad also were clonally restricted: 9 clonal groups were found among 34 isolates, with just 5 clonal groups accounting for most (82%) of the strains. Children infected with type b strains were hospitalized more often than those with nontypable H. influenzae disease (64% vs. 41%, P = .06), but no other clinical or demographic features distinguished children infected by type b and nontypable strains.
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Affiliation(s)
- G A Weinberg
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110
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Anwar F, Hermelin B. Movement after-effects in normal development. Psychol Res 1981; 43:307-15. [PMID: 7323245 DOI: 10.1007/bf00308454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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