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Arshad T, Vainer D, Khan H, Baral A, Garg S, Ang A, Patel V, Kumaran V, Bruno D, Lee S, Sharma A, Muthiah M, Bui AT, Siddiqui MS. Development of Clinical Algorithm Utilizing Vibration-Controlled Transient Elastography to Detect Advanced Hepatic Fibrosis in Liver Transplant Recipients. Dig Dis Sci 2024; 69:1844-1851. [PMID: 38499735 PMCID: PMC11098731 DOI: 10.1007/s10620-024-08366-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/20/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Vibration-controlled transient elastography (VCTE) based liver stiffness measurement (LSM) is an excellent 'rule-out' test for advanced hepatic fibrosis in liver transplant (LT) recipients, however, its ability to 'rule-in' the disease is suboptimal. The study aimed to improve diagnostic performance of LSM in LT recipients. METHODS Adult LT recipients with a liver biopsy and VCTE were included (N = 150). Sequential covering analysis was performed to create rules to identify patients at low or high risk for advanced fibrosis (stage 3-4). RESULTS Advanced hepatic fibrosis was excluded in patients with either LSM < 7.45 kPa (n = 72) or 7.45 ≤ LSM < 12.1 kPa and time from LT < 5.6 years (n = 25). Conversely, likelihood of advanced fibrosis was 95% if patients had LSM > 14.1 and controlled attenuation parameter > 279 dB/m (n = 21). Thus, 118 (79%) were correctly identified and 32 (21%) would have required a biopsy to establish the diagnosis. Compared to previously established LSM based cutoff values of 10.5 kPa (Youden index) and 13.3 kPa (maximized specificity), the false positive rates of sequential covering analysis was 1% compared to 16.5% with LSM ≥ 10.5 kPa and 8.3% with LSM ≥ 13.3 kPa. The true positive rates were comparable at 87% for sequential covering analysis, 93% for LSM ≥ 10.5 kPa and 83% for LSM ≥ 13.3 kPa. CONCLUSION The proposed clinical sequential covering analysis allows for better risk stratification when evaluating for advanced fibrosis in LT recipients compared to LSM alone. Additional efforts are necessary to further reduce the number of patients with indeterminate results in whom a liver biopsy may be required.
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Affiliation(s)
- Tamoore Arshad
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Dylan Vainer
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Hiba Khan
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Alok Baral
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Shreya Garg
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Audrey Ang
- Department of Internal Medicine, Virginia Commonwealth University (VCU), Richmond, USA
| | - Vaishali Patel
- Division of Gastroenterology and Hepatology, VCU, MCV Campus, West Hospital, 1200 E. Broad St, PO Box 980341, Richmond, VA, 23298-0341, USA
| | | | - David Bruno
- Division of Transplant Surgery, VCU, Richmond, USA
| | - Seung Lee
- Division of Transplant Surgery, VCU, Richmond, USA
| | - Amit Sharma
- Division of Transplant Surgery, VCU, Richmond, USA
| | | | - Anh T Bui
- Department of Statistical Sciences & Operations Research, Virginia Commonwealth University (VCU), Richmond, USA
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology and Hepatology, VCU, MCV Campus, West Hospital, 1200 E. Broad St, PO Box 980341, Richmond, VA, 23298-0341, USA.
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Duffy SDX, Khan H, Gelfer Y, Monsell F. Paediatric femoral shaft fractures: an instructional review for the FRCS examination. Eur J Orthop Surg Traumatol 2024; 34:1253-1258. [PMID: 38085371 DOI: 10.1007/s00590-023-03791-9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 04/02/2024]
Abstract
This review presents the principal features of paediatric femoral shaft fractures including the contemporary management strategies and relevant supporting evidence. The article is an overview of information relevant to clinical practice, in addition to preparation for the FRCS (Orth) examination.
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Affiliation(s)
| | - Hiba Khan
- Trauma and Orthopaedic Department, Kingston Hospital, London, UK
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Tucker JS, Khan H, D'Orazio SEF. Lymph node stromal cells vary in susceptibility to infection but can support the intracellular growth of Listeria monocytogenes. J Leukoc Biol 2024:qiae040. [PMID: 38416405 DOI: 10.1093/jleuko/qiae040] [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: 11/06/2023] [Revised: 01/26/2024] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
Lymph node stromal cells (LNSC) are an often overlooked component of the immune system, but play a crucial role in maintaining tissue homeostasis and orchestrating immune responses. Our understanding of the functions these cells serve in the context of bacterial infections remains limited. We previously showed that Listeria monocytogenes, a facultative intracellular foodborne bacterial pathogen, must replicate within an as-yet-unidentified cell type in the mesenteric lymph node (MLN) to spread systemically. Here, we show that L. monocytogenes could invade, escape from the vacuole, replicate exponentially, and induce a type I IFN response in the cytosol of two LNSC populations infected in vitro, fibroblastic reticular cells (FRC) and blood endothelial cells (BEC). Infected FRC and BEC also produced a significant chemokine and pro-inflammatory cytokine response after in vitro infection. Flow cytometric analysis confirmed that GFP+ L. monocytogenes were associated with a small percentage of MLN stromal cells in vivo following foodborne infection of mice. Using fluorescent microscopy, we showed that these cell-associated bacteria were intracellular L. monocytogenes and the number of infected FRC and BEC changed over the course of a three-day infection in mice. Ex vivo culturing of these infected LNSC populations revealed viable, replicating bacteria that grew on agar plates. These results highlight the unexplored potential of FRC and BEC to serve as suitable growth niches for L. monocytogenes during foodborne infection and to contribute to the pro-inflammatory environment within the MLN that promotes clearance of listeriosis.
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Affiliation(s)
- Jamila S Tucker
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky College of Medicine, Lexington, KY
| | - Hiba Khan
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky College of Medicine, Lexington, KY
| | - Sarah E F D'Orazio
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky College of Medicine, Lexington, KY
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Khan SA, Khan H, Ahmad S, Rehman FU, Khan AA, Khan MA. GCMS characterization and biological potential of the seeds and aerial part of Galium tricorne Stokes. BRAZ J BIOL 2024; 84:e256920. [DOI: 10.1590/1519-6984.256920] [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: 10/02/2021] [Accepted: 02/12/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract Natural products have long been proven very effective against various challenging diseases including cancer and bacterial infections. Galium tricorne is one of the important source of natural products, which has not been explored till date in spite of its profound ethnomedicinal prominence. The current study has been designed to explore the biological potential of G. tricorne and to extract and isolate chemical constituents from its aerial part and seeds respectively along with identification of their chemical constituents. Phytochemical screening was performed to figure out the presence of secondary metabolite in G. tricorne. Crude Methanolic extract (Gt.Crd), which was obtained from the aerial part while the fatty acids were extracted from the seeds, which were later on analyzed by GCMS. Similarly, Well Diffusion and MTT method were used for antibacterial activity and cancer cell line assay respectively. To evaluate the cytotoxic potential, brine shrimps were used. Likewise, in Gas Chromatography-Mass Spectroscopy (GC-MS) analysis a total number of 23 compounds were identified in Gt.Crd extract out of which 7 compounds were sorted out to have some sort of toxicity profile. In the same fashion, 5 fatty acids were identified in the seeds of G. tricorne. Moreover, among the fractions, chloroform fraction (Gt.Chf) exhibited greater zone of inhibition (ZOI) 20.37 mm followed by Gt.Crd 18.40 mm against S. aureus and S. pyogenes respectively. In cytotoxicity Gt.Chf was more active followed by ethyl acetate fraction (Gt.Eta) by exhibiting 88.32±0.62% (LC50=60 µg/mL) and 73.95±2.25% (LC50=80 µg/mL) respectively at 1000 µg/mL concentration of the tested sample. Gt.Chf exhibited greater cell line inhibitory activity (IC50=61 µg/mL) against HeLa cell line. Similarly, Gt.Crd displayed IC50 values of 167.84 µg/mL and 175.46 µg/mL against HeLa and NIH/3T3 cell line respectively. Based on the literature review and screenings, it may be concluded that the aerial part and seeds of G. tricorne are the rich sources of bioactive compounds. The results of the current study also authenticate the scientific background for the ethnomedicinal uses of G. tricorne.
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Affiliation(s)
| | | | - S. Ahmad
- Sarhad University of Science & Information Technology, Pakistan
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Sharma R, Danish M, Khajenoori Y, Shaikh D, Chaudary Y, Khan H, Bhat N, Doshi A, Nalawade S, Rajput P, Shahi S, Shankar P. Codeveloping an Adolescent Health Program in India During the COVID-19 Pandemic: A Case Study of a Community-Partnered Responsive Feedback Approach. Glob Health Sci Pract 2023; 11:e2200224. [PMID: 38110201 PMCID: PMC10727469 DOI: 10.9745/ghsp-d-22-00224] [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] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/19/2023] [Indexed: 12/20/2023]
Abstract
We describe the responsive feedback (RF) approach experience of a nongovernmental organization, Girls Health Champions (now known as Adolescent Health Champions [AHC]), that undertakes peer education interventions in Mumbai, India, schools to improve gender equality and health outcomes for adolescents aged 13-19 years. AHC used the RF approach at the onset of the COVID-19 pandemic in light of uncertainties stemming from school closures and the negative impact of the lockdown on adolescents' physical and mental health. Using an RF approach, AHC was able to: (1) understand pandemic-specific challenges faced by adolescents; (2) overhaul its theory of change; (3) pilot new modes of intervention delivery; (4) design a curriculum for parents/guardians and a COVID-19 module; (5) design an AHC mobile app; (6) develop a new, more gender-inclusive name and visual identity; (7) change the overall structure, adolescent-friendly nature, and agility of the organization; (8) and help clarify future directions taken by the organization. Overall, use of the RF approach had significant positive impacts on AHC as an organization, such as changes in organizational culture, deeper stakeholder engagement, and innovation, and was instrumental in AHC's growth, development, and pandemic response. This article outlines the steps of the process, from initial informal stakeholder consultations to the eventual formalization of the RF approach into the everyday working of AHC through the creation of a youth advisory board. We discuss challenges, such as time and resource constraints encountered; strategies for dealing with such challenges; and general key findings and learnings from this experience that could be beneficial to other youth- and community-serving organizations.
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Affiliation(s)
- Ricky Sharma
- Adolescent Health Champions, San Francisco, CA, USA
| | | | | | | | | | - Hiba Khan
- Adolescent Health Champions, Mumbai, India
| | - Neha Bhat
- Adolescent Health Champions, Mumbai, India
| | | | | | | | | | - Priya Shankar
- Adolescent Health Champions, San Francisco, CA, USA.
- University of California, San Francisco, San Francisco, CA, USA
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Khan H, Panjwani V, Al Rahbi S, Eltigani A, Qureshi RN, Unissa K, Sehar N, Mittal A, Pathare AV. Correlation of Transient Elastography with Liver Iron Concentration and Serum Ferritin Levels in Patients with Transfusion-Dependent Thalassemia Major from Oman. Mediterr J Hematol Infect Dis 2023; 15:e2023048. [PMID: 37705529 PMCID: PMC10497312 DOI: 10.4084/mjhid.2023.048] [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: 05/26/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023] Open
Abstract
Aims In a longitudinal study, we aimed to assess the correlation between ultrasound transient elastography (TE), serum ferritin (SF), liver iron content (LIC) by magnetic resonance imaging (MRI) T2* along with the fibrosis-4 (FIB-4) score as a screening tool to detect significant liver fibrosis among chronically transfusion-dependent beta-thalassemia (TDT) patients. Methods The study was conducted at a tertiary health center treating TDT patients. Transient elastography was performed within 3 months of Liver MRI T2* examinations at the radiology department over a median of one-year duration. T-test for independent data or Mann-Whitney U test was used to analyze group differences. Spearman correlation with linear regression analysis was used to evaluate the correlation between TE liver stiffness measurements, Liver MRI T2* values, and SF levels. Results In this study on 91 patients, the median age (IQR) of the subjects was 33 (9) years, and the median (IQR) body mass index was 23.8 (6.1) kg/m2. Median (IQR) TE by fibroscan, MRI T2*(3T), Liver iron concentration (LIC) by MRI Liver T2*, and SF levels were 6.38 (2.6) kPa, 32.4 (18) milliseconds, 7(9) g/dry wt., and 1881 (2969) ng/mL, respectively. TE measurements correlated with LIC g/dry wt. (rS =0.39, p=0.0001) and with SF level (rS =0.43, P=0.001) but not with MRI T2* values (rS =-0.24; P=0.98). Conclusion In TDT patients, liver stiffness measured as TE decreased significantly with improved iron overload measured as LIC by MRI and SF levels. However, there was no correlation of TE with the fibrosis-4 (FIB-4) score.
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Affiliation(s)
- H Khan
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - V Panjwani
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - S Al Rahbi
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - A Eltigani
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - R N Qureshi
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - K Unissa
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - N Sehar
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - A Mittal
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | - A V Pathare
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
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Chaudry E, Singh G, Khan H, Bedi H, Hanna NG. Post-COVID-19 vaccine uveitis: A case series. J Fr Ophtalmol 2023; 46:720-725. [PMID: 37598099 DOI: 10.1016/j.jfo.2023.06.002] [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: 01/02/2023] [Revised: 05/28/2023] [Accepted: 06/19/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE With the recent emergence and worldwide distribution of COVID-19 vaccines, many side effects may be underreported and possibly unknown. Cases of vaccine-associated uveitis have been linked to almost all vaccines administered in the past; however, there is scarcity of literature providing insight into post-COVID-19 vaccine-associated uveitis. This case series documents patients presenting with uveitis after administration of the Pfizer and Moderna mRNA vaccines, in hope of advancing our current understanding of potential ocular complications of COVID-19 vaccines. METHODS Patients with ocular symptoms consistent with uveitis within 14 days after administration of the Pfizer or Moderna COVID-19 vaccines were included in this case series. RESULTS Eight patients with a mean age of 44.4 years (range, 19-83) were included. Six patients received a Pfizer, and 2 received a Moderna vaccine. Four patients presented after their first dose, 3 after their second dose, and 1 after both doses. The mean onset of ocular symptoms after the vaccine was 5.19 days (range, 1-14), and the mean BCVA was 0.678. Patients were diagnosed with bilateral anterior granulomatous uveitis (case 1), unilateral non-granulomatous anterior uveitis (case 2, 5-8), and bilateral non-granulomatous anterior uveitis (case 3-4). CONCLUSIONS The pathogenesis of vaccine-induced uveitis is not properly understood; however, the outcomes of this case series will aid in establishing a temporal association between the Pfizer and Moderna COVID-19 vaccines and the onset of uveitis. As the rate of COVID-19 vaccinations increases globally, it is imperative for physicians to be aware of the possible association and presentation of these ocular findings and diagnoses in order to treat patients effectively.
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Affiliation(s)
- E Chaudry
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - G Singh
- University of British Columbia, Vancouver, BC, Canada
| | - H Khan
- School of Medicine, Saint-George's University, West Indies, Grenada
| | - H Bedi
- Department of Ophthalmology, McMaster University, Ontario, Canada
| | - N G Hanna
- Department of Ophthalmology, McMaster University, Ontario, Canada
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Khan H, Buaki-Sogo MA, Barlow P, Vardanyan R, Zatorska A, Miller G, Arjomandi Rad A, Malawana J, Shah NM. Efficacy of pharmacological and mechanical cervical priming methods for induction of labour and their applicability for outpatient management: A systematic review of randomised controlled trials. Eur J Obstet Gynecol Reprod Biol 2023; 287:80-92. [PMID: 37300982 DOI: 10.1016/j.ejogrb.2023.05.037] [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: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND A systematic review to determine the efficacy and safety of prostaglandins (PG) and Foley catheter (FC) for cervical priming in the outpatient setting. Various methods are available to achieve cervical ripening prior to induction of labour (IOL). In this systematic review, we will report the literature to date, and investigate the efficacy and safety of using the Foley catheter balloon or prostaglandins for cervical ripening, comparing both methods with each other, and discuss the implications of these findings for midwifery led units. METHODS English peer-reviewed journals were systematically searched in the databases PubMed, MEDLINE, EMCARE, EMBASE and CINAHL, for studies investigating cervical ripening using the FC or PGs. Additional randomised controlled trials (RCTs) and non-RCTs were identified by a manual search. Search terms included: cervix dilatation effacement, cervix ripening, outpatient, ambulatory care, obstetric patients, pharmacological preparations, and Foley catheter. Only RCTs of FC versus PG or either intervention versus placebo or intervention in the in-patient Vs. outpatient setting were included. 15 RCTs were included. RESULTS The results of this review show that both FC and PG analogues are equally effective cervical ripening agents. When compared to FC, PGs lead to a reduced requirement for oxytocin augmentation and a shorter intervention to delivery interval. However, PG use is also associated with an increased risk of hyperstimulation, cardiotocographic monitoring abnormalities and negative neonatal outcomes. CONCLUSIONS FC cervical ripening is an effective method of outpatient cervical priming, which is safe, acceptable, and cost-effective and thus has a potential role in both resource-rich and resource-poor countries. With appropriate dosing, some PG analogues also appear to offer similar outcomes.
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Affiliation(s)
- Hiba Khan
- School of Medicine, University of Central Lancashire, 135A Adelphi St, Preston PR1 7BH, UK.
| | | | - Philip Barlow
- Chelsea and Westminster campus library, Imperial College London, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Robert Vardanyan
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Anna Zatorska
- Department of Internal Medicine, York NHS Trust, York, UK
| | - George Miller
- School of Medicine, University of Central Lancashire, 135A Adelphi St, Preston PR1 7BH, UK
| | | | - Johann Malawana
- School of Medicine, University of Central Lancashire, 135A Adelphi St, Preston PR1 7BH, UK
| | - Nishel M Shah
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Chelsea and Westminster Hospital, London SW10 9NH, UK
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Khan H, Siddiqui MS. Hepatic inflammation: an important target for biomarker development in nonalcoholic fatty liver disease. Hepatobiliary Surg Nutr 2023; 12:447-449. [PMID: 37351134 PMCID: PMC10282669 DOI: 10.21037/hbsn-23-196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/29/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Hiba Khan
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA
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Allega A, Anderson MR, Andringa S, Antunes J, Askins M, Auty DJ, Bacon A, Barros N, Barão F, Bayes R, Beier EW, Bezerra TS, Bialek A, Biller SD, Blucher E, Caden E, Callaghan EJ, Cheng S, Chen M, Cleveland B, Cookman D, Corning J, Cox MA, Dehghani R, Deloye J, Deluce C, Depatie MM, Dittmer J, Dixon KH, Di Lodovico F, Falk E, Fatemighomi N, Ford R, Frankiewicz K, Gaur A, González-Reina OI, Gooding D, Grant C, Grove J, Hallin AL, Hallman D, Heintzelman WJ, Helmer RL, Hu J, Hunt-Stokes R, Hussain SMA, Inácio AS, Jillings CJ, Kaluzienski S, Kaptanoglu T, Khaghani P, Khan H, Klein JR, Kormos LL, Krar B, Kraus C, Krauss CB, Kroupová T, Lam I, Land BJ, Lawson I, Lebanowski L, Lee J, Lefebvre C, Lidgard J, Lin YH, Lozza V, Luo M, Maio A, Manecki S, Maneira J, Martin RD, McCauley N, McDonald AB, Mills C, Morton-Blake I, Naugle S, Nolan LJ, O'Keeffe HM, Orebi Gann GD, Page J, Parker W, Paton J, Peeters SJM, Pickard L, Ravi P, Reichold A, Riccetto S, Richardson R, Rigan M, Rose J, Rosero R, Rumleskie J, Semenec I, Skensved P, Smiley M, Svoboda R, Tam B, Tseng J, Turner E, Valder S, Virtue CJ, Vázquez-Jáuregui E, Wang J, Ward M, Wilson JR, Wilson JD, Wright A, Yanez JP, Yang S, Yeh M, Yu S, Zhang Y, Zuber K, Zummo A. Evidence of Antineutrinos from Distant Reactors Using Pure Water at SNO. Phys Rev Lett 2023; 130:091801. [PMID: 36930908 DOI: 10.1103/physrevlett.130.091801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/14/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The SNO+ Collaboration reports the first evidence of reactor antineutrinos in a Cherenkov detector. The nearest nuclear reactors are located 240 km away in Ontario, Canada. This analysis uses events with energies lower than in any previous analysis with a large water Cherenkov detector. Two analytical methods are used to distinguish reactor antineutrinos from background events in 190 days of data and yield consistent evidence for antineutrinos with a combined significance of 3.5σ.
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Affiliation(s)
- A Allega
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M R Anderson
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Andringa
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
| | - J Antunes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Instituto Superior Técnico (IST), Departamento de Física, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal
| | - M Askins
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - D J Auty
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - A Bacon
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - N Barros
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - F Barão
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Instituto Superior Técnico (IST), Departamento de Física, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal
| | - R Bayes
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - E W Beier
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - T S Bezerra
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - A Bialek
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - S D Biller
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - E Blucher
- The Enrico Fermi Institute and Department of Physics, The University of Chicago, Chicago, Illinois 60637, USA
| | - E Caden
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - E J Callaghan
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - S Cheng
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Chen
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - B Cleveland
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - D Cookman
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - J Corning
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M A Cox
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - R Dehghani
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Deloye
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - C Deluce
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - M M Depatie
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - J Dittmer
- Technische Universität Dresden, Institut für Kern und Teilchenphysik, Zellescher Weg 19, Dresden 01069, Germany
| | - K H Dixon
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - F Di Lodovico
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - E Falk
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - N Fatemighomi
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - R Ford
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - K Frankiewicz
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - A Gaur
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - O I González-Reina
- Universidad Nacional Autónoma de México (UNAM), Instituto de Física, Apartado Postal 20-364, México D.F. 01000, México
| | - D Gooding
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - C Grant
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - J Grove
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A L Hallin
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - D Hallman
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - W J Heintzelman
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - R L Helmer
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - J Hu
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - R Hunt-Stokes
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S M A Hussain
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - A S Inácio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - C J Jillings
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - S Kaluzienski
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T Kaptanoglu
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - P Khaghani
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - H Khan
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - J R Klein
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - L L Kormos
- Physics Department, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - B Krar
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Kraus
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - C B Krauss
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - T Kroupová
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - I Lam
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - B J Land
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - I Lawson
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - L Lebanowski
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - J Lee
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Lefebvre
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Lidgard
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - Y H Lin
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - V Lozza
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - M Luo
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - A Maio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - S Manecki
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - J Maneira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - R D Martin
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - N McCauley
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - A B McDonald
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Mills
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - I Morton-Blake
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Naugle
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - L J Nolan
- School of Physics and Astronomy, Queen Mary University of London, 327 Mile End Road, London E1 4NS, United Kingdom
| | - H M O'Keeffe
- Physics Department, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - G D Orebi Gann
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - J Page
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - W Parker
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - J Paton
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S J M Peeters
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - L Pickard
- University of California, Davis, 1 Shields Avenue, Davis, California 95616, USA
| | - P Ravi
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - A Reichold
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Riccetto
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Richardson
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - M Rigan
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - J Rose
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - R Rosero
- Chemistry Department, Brookhaven National Laboratory, Building 555, P.O. Box 5000, Upton, New York 11973-500, USA
| | - J Rumleskie
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - I Semenec
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Skensved
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Smiley
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - R Svoboda
- University of California, Davis, 1 Shields Avenue, Davis, California 95616, USA
| | - B Tam
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Tseng
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - E Turner
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Valder
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - C J Virtue
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - E Vázquez-Jáuregui
- Universidad Nacional Autónoma de México (UNAM), Instituto de Física, Apartado Postal 20-364, México D.F. 01000, México
| | - J Wang
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - M Ward
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J R Wilson
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - J D Wilson
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - A Wright
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J P Yanez
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - S Yang
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - M Yeh
- Chemistry Department, Brookhaven National Laboratory, Building 555, P.O. Box 5000, Upton, New York 11973-500, USA
| | - S Yu
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - Y Zhang
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
- Research Center for Particle Science and Technology, Institute of Frontier and Interdisciplinary Science, Shandong University, Qingdao 266237, Shandong, China
- Key Laboratory of Particle Physics and Particle Irradiation of Ministry of Education, Shandong University, Qingdao 266237, Shandong, China
| | - K Zuber
- Technische Universität Dresden, Institut für Kern und Teilchenphysik, Zellescher Weg 19, Dresden 01069, Germany
- MTA Atomki, 4001 Debrecen, Hungary
| | - A Zummo
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
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11
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Khan H, Monsell F, Duffy S, Trompeter A, Bridgens A, Gelfer Y. Paediatric tibial shaft fractures: an instructional review for the FRCS exam. Eur J Orthop Surg Traumatol 2023:10.1007/s00590-023-03484-3. [PMID: 36788165 DOI: 10.1007/s00590-023-03484-3] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
This instructional review presents the literature and guidelines relevant to the classification, management and prognosis of paediatric tibial shaft fractures at a level appropriate for the FRCS exit examination in Trauma and Orthopaedic surgery.
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Affiliation(s)
- H Khan
- Trauma and Orthopaedic Department, Kingston Hospital, London, UK.
| | - F Monsell
- Bristol Royal Hospital for Children, Bristol, UK
| | - S Duffy
- Trauma and Orthopaedic Department, Bristol Royal Infirmary, Bristol, UK
| | - A Trompeter
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
- St George's University, London, UK
| | - A Bridgens
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
| | - Y Gelfer
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
- St George's University, London, UK
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12
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Langridge BJ, Jasionowska S, Khan H, Awad L, Turner BRH, Varghese J, Butler PEM. “Achieving Optimal Clinical Outcomes in Autologous Fat Grafting: A Systematic Review of Processing Techniques”. J Plast Reconstr Aesthet Surg 2023; 81:9-25. [PMID: 37075610 DOI: 10.1016/j.bjps.2023.01.003] [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] [Received: 08/16/2022] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Autologous fat grafting (AFG) is a versatile technique in reconstructive and cosmetic surgery. Graft processing is a key source of variability resulting in unreliable clinical outcomes, with no consensus on the optimal methodology. This systematic review identifies the evidence base supporting different processing paradigms. METHODS A systematic literature search was conducted using the PubMed, Scopus and The Cochrane Foundation databases. Studies comparing AFG processing methods and reporting long-term patient outcomes were identified. RESULTS Twenty-four studies (2413 patients) were identified. Processing techniques evaluated included centrifugation, decantation, washing, filtration, gauze rolling, as well as commercial devices and adipose-derived stem/stromal cell (ASC) enrichment methods. Objective volumetric and subjective patient-reported outcomes were discussed. There was a variable reporting of complications and volume retention rates. Complications were infrequent; palpable cysts (0-20%), surgical-site infections (0-8%) and fat necrosis (0-58.4%) were the most reported. No significant differences in long-term volume retention between techniques were found in AFG in the breast. In head and neck patients, greater volume retention was documented in ASC enrichment (64.8-95%) and commercial devices (41.2%) compared to centrifugation (31.8-76%). CONCLUSIONS Graft processing through washing and filtration, including when incorporated into commercial devices, results in superior long-term outcomes compared to centrifugation and decantation methods. ASC enrichment methods and commercial devices seem to have superior long-term volume retention in facial fat grafting.
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Affiliation(s)
- B J Langridge
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom; Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom; Division of Surgery & Interventional Science, University College London, London, United Kingdom.
| | - S Jasionowska
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom; Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom.
| | - H Khan
- Imperial College School of Medicine, London, United Kingdom.
| | - L Awad
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom.
| | - B R H Turner
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom; Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom.
| | - J Varghese
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom.
| | - P E M Butler
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom; Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, United Kingdom; Division of Surgery & Interventional Science, University College London, London, United Kingdom.
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13
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Khan H, Monsell F, Duffy S, Trompeter A, Bridgens A, Gelfer Y. Paediatric distal radius fractures: an instructional review for the FRCS examination. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03409-6. [PMID: 36201032 DOI: 10.1007/s00590-022-03409-6] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
An instructional review of the literature and guidelines relevant for the classification, management and prognosis of paediatric distal radius fractures. Aimed at the knowledge level required for the trauma and orthopaedic FRCS examination.
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Affiliation(s)
- H Khan
- Trauma and Orthopaedic Department, Epsom and St Helier NHS Trust, Carshalton, UK.
| | - F Monsell
- Bristol Royal Hospital for Children, Bristol, UK
| | - S Duffy
- Trauma and Orthopaedic Department, Bristol Royal Infirmary, Bristol, UK
| | - A Trompeter
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
- St George's University, London, UK
| | - A Bridgens
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
| | - Y Gelfer
- Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, UK
- St George's University, London, UK
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Gamble D, Khan H, Ross J, Cheyne L, Rudd A, Horgan G, Hannah A, Urquhart G, Masannat Y, Elsberger B, Sharma R, Dawson D. Energetic and myocellular pathways in cardiac and skeletal muscle following anthracycline chemotherapy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Anthracycline-related cardiac dysfunction is a recognised consequence of cancer therapies. Here we assess resting cardiac and skeletal muscle energic status as an early mechanistic pathway of myocyte derangement and explore molecular targets of skeletal myocyte metabolism, protein synthesis/degradation and mitochondrial biogenesis signalling.
Methods
We conducted a prospective, mechanistic, observational, longitudinal study of chemotherapy-naive breast cancer patients undergoing anthracycline-based chemotherapy, compared to a healthy control group. 31P-Magnetic Resonance spectroscopy in cardiac and skeletal muscle (phosphocreatine/gamma adenosine triphosphate (PCr/yATP) and inorganic phosphate/phosphocreatine (Pi/PCr) ratios respectively), cardiac magnetic resonance (CMR) imaging inclusive of T1 and T2 mapping, echocardiography-derived global longitudinal strain function, serum NT-pro-BNP and skeletal muscle biopsies from the right vastus lateralis were assessed before and after 3 cycles of Flurouracil, Epirubicin and Cyclophosphamide followed by 3 cycles of Docetaxel. Statistical significance was set at p<0.05.
Results
Twenty-five female breast cancer patients (median age 53 years, range 32–74 years) receiving a mean epirubicin dose 307 mg/m2) and twenty-eight controls (median age 44 years, range 23–65) were recruited. All study assessments in breast cancer patients at pre-chemotherapy stage were comparable to the matched healthy controls. However, following chemotherapy, breast cancer patients demonstrated a small but significant reduction in cardiac function (global longitudinal strain −22.9±3.9 vs −19.1±3.3%, p=0.01 and CMR-derived ejection fraction 65±5 vs 62±4%, p=0.047), a mild increase in CMR-derived indexed left ventricular volumes (end diastolic 65±10 vs 74±11 ml/m2, p=0.014 and end systolic 23±5 vs 28±5 ml/m2, p=0.01) as well as an increase in left ventricular T1 and T2-mapping (1289±29 vs 1321±31 ms, p=0.004 and 50±4 vs 55±7 ms, p=0.027, respectively) and serum NT-Pro-BNP (49±25 vs 108±84 pg/m, p=0.008). After epirubicin, there was significant reduction in cardiac PCr/yATP ratio (2.0±0.7 vs 1.2±0.6, p=0.007) and a significant increase in skeletal muscle Pi/PCr ratio (0.13±0.04 vs 0.22±0.2, p=0.008) – Figure 1.
Following chemotherapy, there was significant upregulation of skeletal myocyte protein synthesis (mammalian target of rapamycin, 0.44±0.4 vs 0.53±0.2, p<0.001) and degradation (Calcium/calmodulin dependent protein kinase II, 1.4±0.7 vs 2.7±1.1, p<0.001), metabolism (peroxisome proliferator-activated receptor gamma, 0.35±0.2 vs 0.60±0.1, p<0.001) and muscle mass regulator myostatin-2 (0.16±0.1 vs 0.24±0.1, p<0.001).
Conclusion
Contemporary doses of epirubicin for breast cancer result in significant reduction of cardiac and skeletal muscle high energy 31P-metabolism alongside skeletal myocellular alterations of protein synthesis and metabolic regulation pathways.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Tenovus ScotlandNHS Grampian Endowment fund
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Affiliation(s)
- D Gamble
- University of Aberdeen , Aberdeen , United Kingdom
| | - H Khan
- University of Aberdeen , Aberdeen , United Kingdom
| | - J Ross
- University of Aberdeen , Aberdeen , United Kingdom
| | - L Cheyne
- University of Aberdeen , Aberdeen , United Kingdom
| | - A Rudd
- University of Aberdeen , Aberdeen , United Kingdom
| | - G Horgan
- University of Aberdeen , Aberdeen , United Kingdom
| | - A Hannah
- Aberdeen Royal Infirmary, cardiology , Aberdeen , United Kingdom
| | - G Urquhart
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | - Y Masannat
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | - B Elsberger
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | - R Sharma
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | - D Dawson
- University of Aberdeen , Aberdeen , United Kingdom
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15
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Khan H, Rudd A, Gamble D, Mezincescu AM, Cheyne L, Horgan G, Dhaun N, Newby DE, Dawson DK. Renin-angiotensin and endothelin systems in patients post takotsubo syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1679] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
We investigate if renin-angiotensin and endothelin-1 response pathways follow the same pattern of recovery as left ventricular ejection fraction in patients with takotsubo syndrome.
Purpose
To provide better insight into the pathophysiology underlying this condition.
Methods
Ninety takotsubo syndrome patients [n=30 in each of “acute”, “convalescent” (3–5 months) and “recovered” (>1 year) groups] who were on minimal or no medication and were free of any significant cardiac/metabolic co-morbidities, and 30 healthy controls were studied. Serum concentrations of renin, angiotensin converting enzyme, angiotensin II, big endothelin-1, endothelin-1 were measured using commercially available ELISA, and BNP was measured using an immunoassay.
Results
Left ventricular ejection fraction was 38±1.6% in acute, 63±2.0% in convalescent and 64±2.6% in recovered takotsubo syndrome patients. As shown in Figure 1, serum renin concentrations are persistently elevated after a takotsubo episode (p=0.03 vs controls). Angiotensin converting enzyme levels are significantly depressed during the acute phase compared to convalescent (p=0.004), recovered takotsubo (p=0.02) or controls (p=0.03). Angiotensin II is increased in takotsubo patients (p<0.001 vs controls) remaining persistently elevated long-term in the recovered group (p=0.03 vs controls). B-type natriuretic peptide concentrations remain elevated after a Takotsubo episode compared to controls (p=0.003). Big endothelin-1 levels are unchanged, but endothelin-1 is significantly lower after takotsubo syndrome compared to controls (p=0.03).
Conclusions
Despite “normalisation” of the left ventricular ejection fraction, there is long-term maladaptive activation of renin-angiotensin system in takotsubo syndrome patients. This suggests therapy aimed at modulating this pathway may be beneficial in the long-term.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): British Heart Foundation
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Affiliation(s)
- H Khan
- University of Aberdeen , Aberdeen , United Kingdom
| | - A Rudd
- University of Aberdeen , Aberdeen , United Kingdom
| | - D Gamble
- University of Aberdeen , Aberdeen , United Kingdom
| | | | - L Cheyne
- University of Aberdeen , Aberdeen , United Kingdom
| | - G Horgan
- University of Aberdeen , Aberdeen , United Kingdom
| | - N Dhaun
- University of Edinburgh , Edinburgh , United Kingdom
| | - D E Newby
- University of Edinburgh , Edinburgh , United Kingdom
| | - D K Dawson
- University of Aberdeen , Aberdeen , United Kingdom
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Rudd A, Khan H, Gamble D, Stephen P, Horgan G, Dawson A, Frenneaux MP, Dawson DK. OUES from submaximal cardiopulmonary exercise. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2766] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Cardiopulmonary exercise testing (CPEX) provides valuable diagnostic and prognostic cardiopulmonary function data. However, in clinical setting a maximal test is not always achievable. The Oxygen Efficiency Uptake Slope (OUES) has been proposed as a possible submaximal measure of cardiopulmonary function as it remains relatively stable during the final quartile of the exercise test. This study explored the validity of OUES as a surrogate marker for cardiopulmonary function in the event of a submaximal test.
Methods
Four groups of subjects [128 healthy controls (73 M), 44 asymptomatic hypertensive (HT) patients (26 M), 67 adult cardiac congenital heart disease (ACHD) patients (44 M) and 35 Heart Failure with preserved Ejection Fraction (HFpEF) (10M) patients] were recruited after informed consent. All subjects underwent clinical assessment, resting ECG, blood pressure and spirometry prior to a treadmill CPEX to volitional exhaustion and a respiratory exchange ratio (RER) of at least 1.1 using the same testing protocol. Peak VO2 (ml/min) was recorded from the last 5s of the maximal test (RER=1.1) and OUES was calculated from complete (RER=1.1) and truncated (RER=0.9) gas exchange data. The linear relationships between absolute peak VO2 and OUES from complete and truncated gas exchange data were assessed using Pearson's correlation coefficient. Subsequently, the two correlations obtained in each patient group were compared. Statistical significance was set at p<0.01.
Results
Mean and 95% confidence intervals of the peak VO2 for males and females in each decile of life examined in the 4 subject groups are shown in the Figure. Peak VO2 values achieved in each of the patient groups were significantly lower when matched for age and sex compared to healthy participants (HT p=0.006, ACHD patients p<0.001 and HFpEF patients p<0.001).
In all 4 groups there was a good correlation between absolute peak VO2 and the OUES at RER 1.1 (healthy volunteers r=0.910, p<0.001, HT r=0.899, p<0.001, ACHD r=0.816, p<0.001 and HFpEF r=0.846, p<0.001). Correlations were inferior for absolute peak VO2 and OUES at RER 0.9 (healthy volunteers r=0.74, p<0.001, HT r=0.780, p<0.001, ACHD r=0.651, p<0.001 and HFpEF r=0.817, p<0.001). Correlations between absolute peak VO2 vs OUES at RER of 1.1 and 0.9 were significantly different only for healthy controls (p=0.001, Z-score = −4.649), but not for HT (p=0.05, Z-score = −1.909), ACHD (p=0.04, Z-score = −2.080) or HFpEF (p=0.7, Z-score = −0.377) patients.
Conclusion
Our data support the use of submaximal OUES at an RER of 0.9 as a surrogate marker for absolute peak VO2 obtained at an RER of 1.1, especially in patients, in whom it can often be difficult to achieve maximal exercise.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Rudd
- University of Aberdeen, Cardiovascular Research , Aberdeen , United Kingdom
| | - H Khan
- University of Aberdeen, Cardiovascular Research , Aberdeen , United Kingdom
| | - D Gamble
- University of Aberdeen, Cardiovascular Research , Aberdeen , United Kingdom
| | - P Stephen
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | - G Horgan
- University of Aberdeen, Cardiovascular Research , Aberdeen , United Kingdom
| | - A Dawson
- Aberdeen Royal Infirmary , Aberdeen , United Kingdom
| | | | - D K Dawson
- Hamad Medical Corporation , Doha , Qatar
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Qadeer M, Jaafar S, Khamis MF, Khan H, Khan T, Saeed MQ. Assessment of skeletal relationships in cleft palate with or without cleft lip: A cone-beam computed tomography study in a pakistani population. Niger J Clin Pract 2022; 25:1699-1703. [PMID: 36308242 DOI: 10.4103/njcp.njcp_177_22] [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: 06/16/2023]
Abstract
BACKGROUND Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities. AIMS The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement. MATERIALS AND METHODS Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant. RESULTS We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05). CONCLUSIONS Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.
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Affiliation(s)
- M Qadeer
- Basic and Medical Sciences Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia; Department of Oral Biology, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Punjab, Pakistan
| | - S Jaafar
- Basic and Medical Sciences Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - M F Khamis
- Basic and Medical Sciences Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - H Khan
- Department of Orthodontics, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Punjab, Pakistan
| | - T Khan
- Department of Orthodontics, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Punjab, Pakistan
| | - M Q Saeed
- Department of Orthodontics, Institute of Dentistry, CMH Lahore Medical College, National University of Medical Sciences, Lahore, Punjab, Pakistan
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18
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Khan H, Garg A, Yasmeen, Agarwal NB, Yadav DK, Ashif Khan M, Hussain S. Zolpidem use and risk of suicide: A systematic review and meta-analysis. Psychiatry Res 2022; 316:114777. [PMID: 35985088 DOI: 10.1016/j.psychres.2022.114777] [Citation(s) in RCA: 4] [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: 03/25/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Zolpidem is one of the most commonly prescribed nonbenzodiazepine hypnotic drugs for insomnia. Published epidemiological studies linked zolpidem with the risk of suicide. However, to date, no meta-analysis investigated this association. Hence, we systematically reviewed and meta-analysed the current evidence from real-world studies reporting the risk of suicide with the use of zolpidem. METHODS Medline (Ovid), Embase (Ovid), and PsycINFO databases were searched from inception till June 2021 for real-world evidence studies reporting the risk of suicide with the use of zolpidem. The quality assessment of included studies was assessed using the New-Castle Ottawa Scale (NOS). Random-effect meta-analysis was performed using a generic inverse variance method. RESULTS This meta-analysis was based on four studies with 344,753 participants, of which 42,279 were zolpidem users. The methodological quality of all the included studies was of high quality. A significantly increased risk of suicide or suicide attempt was found in zolpidem users compared to non-users, with a pooled relative risk of 1.88 (95% CI: 1.54 - 2.30). Furthermore, an increased risk of suicidal death was observed in zolpidem users compared to non-users, with a pooled relative risk of 1.82 (95% CI: 1.43 - 2.30). Dose-response analysis also revealed a significantly increased risk of suicide in patients receiving ≥ 180cDDD (cumulative defined daily doses) of zolpidem (124 times), followed by 90-179cDDD (113 times) and <90cDDD (93 times) of zolpidem compared to non-users. CONCLUSION In conclusion, zolpidem use was associated with an increased risk of suicide or suicide attempt and suicidal death. Therefore, careful prescribing practices must be followed by considering the risk-benefit profile.
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Affiliation(s)
- Hiba Khan
- Centre for Translational & Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India
| | - Aakriti Garg
- Centre for Translational & Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India
| | - Yasmeen
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Nidhi B Agarwal
- Centre for Translational & Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India
| | | | - Mohd Ashif Khan
- Centre for Translational & Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India.
| | - Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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19
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Naderi B, Krahn A, Roston T, Khan H, Sanatani S, Laksman Z, Deyell M, Davies B. DIAGNOSTIC UTILITY OF HOLTER MONITORING IN CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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20
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Pakhchanian H, Khan H, Raiker R, Ahmed S, Kavadichanda C, Abbasi M, Kardeş S, Agarwal V, Aggarwal R, Gupta L. COVID-19 outcomes in patients with Dermatomyositis: A registry-based cohort analysis. Semin Arthritis Rheum 2022; 56:152034. [PMID: 35750526 PMCID: PMC9142211 DOI: 10.1016/j.semarthrit.2022.152034] [Citation(s) in RCA: 1] [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: 10/19/2021] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patients with rheumatic diseases (RDs) like DM are known to be vulnerable towards various types of infections due to aggressive disease activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specific details on mortality is essential to navigate any precautions required in the treatment. OBJECTIVES To determine outcomes of COVID-19 in DM as compared to controls, and identify the risk association of gender, race, interstitial lung disease, neoplasms, and use of immunosuppressant. METHODS Retrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2021 was retrieved from the TriNetX database. 1:1 Propensity Score matching was used to adjust for confounders. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembolism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use. RESULTS We identified 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06]. DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25, 2.4] Subgroup analysis of 5-year neoplasm history amongst DM patients with COVID-19 was inadequate for meaningful comparison. CONCLUSION Dermatomyositis patients without comorbities have reasonable COVID-19 outcomes including mortality and hospitalisation. Black race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.
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Affiliation(s)
- Haig Pakhchanian
- George Washington School of Medicine & Health Sciences, Washington DC, USA
| | | | - Rahul Raiker
- West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Sakir Ahmed
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Bhubaneswar, India
| | - Chengappa Kavadichanda
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Sinan Kardeş
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, Uttar Pradesh, India
| | - Rohit Aggarwal
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Pittsburgh, PA, USA
| | - Latika Gupta
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, Uttar Pradesh, India,Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK,Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK.,City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK,Corresponding author at: Department of Clinical Immunology and Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
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21
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Bakouny Z, Grover P, Labaki C, Awosika J, Gulati S, Hsu CY, Bilen M, Eton O, Fecher L, Hwang C, Khan H, McKay R, Ruiz E, Weissmann L, Thompson M, Shah D, Warner J, Shyr Y, Choueiri T, Wise-Draper T. 502P Association of immunotherapy and immunosuppression with severe COVID-19 disease in patients with cancer. Ann Oncol 2022. [PMCID: PMC9472565 DOI: 10.1016/j.annonc.2022.07.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Woo JA, Zhao X, Khan H, Penn C, Wang X, Joly-Amado A, Weeber E, Morgan D, Kang DE. Correction to: Slingshot-Cofilin activation mediates mitochondrial and synaptic dysfunction via A β ligation to β1-integrin conformers. Cell Death Differ 2022; 29:2562. [DOI: 10.1038/s41418-022-01055-3] [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: 11/09/2022] Open
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23
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Jaffry M, Mostafa F, Mandava K, Rosario S, Jagarlamudi Y, Jaffry K, Kornitzer J, Jedidi K, Khan H, Souayah N. No significant increase in Guillain-Barré syndrome after COVID-19 vaccination in adults: A vaccine adverse event reporting system study. Vaccine 2022; 40:5791-5797. [PMID: 36055875 PMCID: PMC9393181 DOI: 10.1016/j.vaccine.2022.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/11/2022]
Abstract
Objective To investigate the association between Guillain-Barré syndrome (GBS) and COVID-19 vaccination. Background On July 13, 2021, the US Food and Drug Administration (FDA) released a new warning that Johnson & Johnson COVID-19 vaccine could increase the risk of developing GBS. Methods The reporting rate of adult GBS after COVID-19 vaccination, ascertained with Brighton criteria, was compared with the reporting rate after other vaccinations during the same time period, and also compared with the reporting rate during control periods. Statistical methods such as proportion tests, and Pearson’s chi-squared test were utilized to identify significant relationships. Self-controlled and case centered analyses were conducted. A machine learning model was utilized to identify the factors associated with a worse outcome defined as emergency room (ER) or doctor visits, hospitalizations, and deaths. Results The reporting rate of GBS after COVID-19 vaccination was significantly higher than after influenza and other vaccinations (49.7, 0.19, 0.16 per 10 million, p < 0.0001). However, the reporting rate was within the incidence range of GBS in the general population. Using self-controlled and case centered analyses, there was a significant difference in the reporting rate of GBS after COVID-19 vaccination between the risk period and control period (p < 0.0001). There was an estimated 0.7–1.7 per million excess reports of GBS within 6 weeks of COVID-19 vaccination. Machine learning model demonstrated that female gender and age between 18 and 44 are associated with worse outcome. No association was found between the onset interval of GBS and its prognosis. Conclusions Although the reporting rate of GBS after COVID-19 vaccination was not statistically different than that of the general population, the increased reporting of GBS within the first 6 weeks after COVID-19 vaccination, more so than with other vaccinations, suggests that some cases of GBS are temporally associated with COVID-19 vaccination. However, there is a reduction in the reporting rate of GBS after other vaccines, compared to reporting rates pre-COVID-19, highlighting limitations inherent in any passive surveillance system. These findings warrant continuous analysis of GBS after COVID-19 vaccination. Further improvement of the machine learning model is needed for clinical use.
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Affiliation(s)
- M Jaffry
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - F Mostafa
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, TX, USA
| | - K Mandava
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - S Rosario
- Department of Marketing, Columbia Business School, New York City, NY, USA
| | - Y Jagarlamudi
- Khoury College of Computer Science, Northeastern University, Boston, MA, USA
| | - K Jaffry
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Kornitzer
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA; New Jersey Pediatric Neuroscience Institute, Morristown, NJ, USA
| | - K Jedidi
- Department of Marketing, Columbia Business School, New York City, NY, USA
| | - H Khan
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - N Souayah
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA.
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24
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Omar A, Khan H. 9 Complications of Bone-Anchored Hearing Aids (BAHA) in Patients. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.186] [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: 11/07/2022]
Abstract
Abstract
Aim
BAHA implants utilise bone conduction to treat hearing loss. The aim of the study was to understand the complication rate of patients receiving the implant compared to other studies and to identify any causative factor. Recommendations would therefore be made to reduce these complications.
Methodology
A retrospective cohort study was undertaken on 134 patients who received a BAHA implant performed by a single surgeon at Salford Royal NHS Foundation Trust between 01/01/2016 to 31/12/2018. Data collected identified complications of the surgery, whether or not the abutment was still in situ and whether the patient had any comorbidities or history of smoking
Results
33.6% of the patients had no complications after surgery with the remaining 66.4% having at least one complication. BAHA connect devices had a 67.2% complication rate, attract devices had a 33% complication rate. 13.6% of BAHAs were extruded. There was no positive correlation between either smoking or diabetes and poorer complication rate.
Conclusion
Implant extrusion can be prevented with irrigation cooling of the drill site. Immobilisation of the implant, proper wound care with brushing and using an Allevyn Acticoat 7 wound dressing improves outcomes. Attract systems have fewer complications rates so must be maximised where appropriate.
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Affiliation(s)
- A Omar
- University of Manchester , Manchester , United Kingdom
| | - H Khan
- University of Manchester , Manchester , United Kingdom
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25
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Abstract
BACKGROUND An important fraction (>/~10%) of men with high-risk, localized prostate cancer and metastatic prostate cancer carry germline (heritable) pathogenic and likely pathogenic variants (also known as mutations) in DNA repair genes. These can represent known or suspected autosomal dominant cancer predisposition syndromes. Growing evidence suggests that pathogenic variants in key genes involved in homologous recombination and mismatch DNA repair are important in prostate cancer initiation and/or the development of metastases. AIMS Here we provide a comprehensive review regarding individual genes and available literature regarding risks for developing prostate cancer, and discuss current national guidelines for germline genetic testing in the prostate cancer population and treatment implications. RESULTS The association with prostate cancer risk and treatment implications is best understood for those with germline mutations of BRCA2, with emerging data supporting associations with ATM, CHEK2, BRCA1, HOXB13, MSH2, MSH6, PALB2, TP53 and NBN. Treatment implications in the metastatic castration resistant prostate cancer setting include rucaparib and olaparib, and pembrolizumab with potential clinical trial opportunities in earlier disease settings. DISCUSSION The data summarized in this review has led to the expansion of national guidelines for germline genetic testing in prostate cancer. We review these guidelines, and discuss the importance of cascade genetic testing of relatives, diverse populations with attention to inclusion, as well as prostate cancer screening updates and clinical trial opportunities for men who carry genetic risk factors for prostate cancer.
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Affiliation(s)
- Hiba Khan
- Department of Medicine, Division of Oncology, University of Washington, Seattle, WA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Heather H. Cheng
- Department of Medicine, Division of Oncology, University of Washington, Seattle, WA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, 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Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Gupta L, Pakhchanian H, Khan H, Raiker R, Abbasi M, Deyoung C, Kardes S, Ahmed S, Kavadichanda C, Sen P, Aggarwal R. POS0198 COVID-19 OUTCOMES IN PATIENTS WITH DERMATOMYOSITIS: A REGISTRY-BASED COHORT ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundDermatomyositis (DM) patients have fewer risks of COVID-19 infection compared to the general population, however, certain subgroups with DM have worse outcomes. Men. African Americans, those with interstitial lung disease, exhibited higher risks of severe COVID-19. DMARD and glucocorticoid use was associated with frequent hospitalisations and severe sepsis.ObjectivesRheumatic diseases (RDs) like DM, are previously known to be vulnerable towards various types of infections due to its aggressive activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specific details on mortality is essential to navigate any precautions required in the treatment.MethodsRetrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2020 was retrieved from the TriNetX database. A one-to-one matched COVID-19 positive control was selected using propensity score (PS) matching. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembolism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use (Figure 1).Figure 1.Overview of studyResultsWe identified 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06] (Figure 1).DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25] Subgroup analysis of neoplasms amongst DM patients with COVID-19 was inadequate for meaningful comparison (Figure 1).ConclusionDM patients are protected for certain aspects of COVID-19 disease, including severe COVID-19, hospitalization, and mortality. The African American race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.Disclosure of InterestsLatika Gupta: None declared, Haig Pakhchanian: None declared, Hiba Khan: None declared, Rahul Raiker: None declared, Maryam Abbasi: None declared, Charles DeYoung: None declared, Sinan Kardes Grant/research support from: SK has received congress travel, accommodation, and participation fee support (12th Anatolian Rheumatology Days) from Abbvie, Sakir Ahmed Speakers bureau: SA has received honorarium as speaker for Pfizer, Chengappa Kavadichanda: None declared, Parikshit Sen: None declared, Rohit Aggarwal Consultant of: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant., Grant/research support from: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant.
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Mirza A, Win Naing Z, Khonsari P, Khan H, Rezai P, Abbas AK, Nisar M. POS1421 AROMATASE INHIBITORS AND SKELETAL HEALTH – NATURAL HISTORY AND INTERVENTIONAL EPIDEMIOLOGY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBreast cancer remains the most common cancer diagnosed in women worldwide. Aromatase inhibitors (AI) are employed for hormone sensitive disease in mainly postmenopausal women. AI related bone loss (AIBL) is a known complication; although data regarding the natural history in the real-world, long-term outcomes and the role of bone active therapy in fracture prevention is sparse.ObjectivesOur aim was to determine the real-world impact of AIBL and whether bone sparing therapy utilising standard risk stratification model is sufficient for fracture prevention.MethodsWe undertook a longitudinal study of patients prescribed AI for breast cancer over a seven-year period at our university teaching hospital. All the data was recorded electronically with full access to demographics, disease parameters, investigations and drug management. DEXA scans performed prior to initiation of AI were compared with subsequent imaging over a mean follow up of 3 years. Outcome data for cancer and all fractures was collected. Statistical analysis was done to investigate significant relationships amongst the variables of interest.Results1001 women were identified during the study period. The mean age of the cohort was 64 years (range 29-93). 929 (93%) were Caucasian, 57 (6%) were Asian and 15 (1%) were Afro-Caribbean. 723 women (72%) were diagnosed with invasive ductal carcinoma and 863 women (86%) were postmenopausal. At diagnosis, 428 women (43%) had node positive disease and 35 women (4%) had metastases. 91 women (9%) had sustained fractures prior to their breast cancer diagnosis.All women had a baseline DEXA: 496 (49.6%) had osteopenia, 151 (15%) had osteoporosis and 354 (35.4%) had a normal result. 478 (48%) of women had a repeat scan available. Overall, there was a decline (from a mean of 0.888 g/cm2 to 0.858 g/cm2, p<0.0001) in left neck of femur (LNOF) bone mineral density (BMD) over time (mean of 3 years, with a range of 1-6).334 (33%) were prescribed bone active therapy with 276 women (83%) given oral bisphosphonates. This group had an improvement in BMD by 0.4% (LNOF mean BMD of 0.785 g/cm2 at baseline compared to LNOF mean BMD of 0.788 at repeat DEXA, p=0.82).Women who were not offered any treatment (n=667, 66%), showed a significant decline in bone density with the decline being -5%. (LNOF mean BMD of 0.939 g/cm2 at baseline compared to LNOF mean BMD of 0.888 g/cm2 at repeat DEXA, p< 0.0001).The rate of fractures remained the same between the treatment (19 fractures, 5.67%) and non-treatment group (38 fractures, 5.70%)ConclusionOur study provides long term data for AIBL and confirms a significant decline in BMD over seven years. It confirms that bone sparing therapy is effective in reducing the pace of decline in BMD. However standard risk stratification model such as FRAX based intervention thresholds in mainly those with WHO defined osteoporosis (T ≤-2.5) is ineffective in fracture prevention in keeping with prior literature. Since our study period overlaps with publication of newer guidelines recommending different T score-based risk model, further studies are required to confirm their utility.References[1]https://www.wcrf.org/dietandcancer/worldwide-cancer-data/. Date accessed: 26.01.2022[2]R. Coleman, J.J. Body, M. Aapro, et al., Bone health in cancer patients: ESMO clinical practice guidelines, Ann. Oncol. 25 (Suppl 3) (2014) iii124–iii137.[3]E. Amir, B. Seruga, S. Niraula, et al., Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis, J. Natl. Cancer Inst. 103 (2011) 1299–1309.Disclosure of InterestsNone declared
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Khan H, Wong RL, Darst B, Pritchard CC, Nelson P, Stanford JL, Lin DW, Cheng HH. Rates of germline genetic testing and DNA damage response mutations found through population-based recruitment of men with incident metastatic prostate cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.10501] [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: 11/20/2022] Open
Abstract
10501 Background: Approximately 10% of men with metastatic prostate cancer (mPC) have germline DNA damage response gene mutations (gDDRm), indicating candidacy for precision treatment. Consequently, national guidelines recommend germline genetic testing be offered to all men with mPC. It is currently unclear what the rates of testing are in the community, and barriers to testing are not well understood. We conducted a population-based study to better understand current rates of germline genetic testing in men with newly diagnosed mPC, and to determine whether removing major barriers of cost and access could expand uptake of germline genetic testing. Methods: This is a prospective observational study that identifies men ages 35-79y with mPC residing in a 13-county area of Washington State through the Surveillance, Epidemiology, and End Results (SEER) program (NCT04254133). Men with new diagnoses of mPC are contacted by mailed invitation and follow-up phone inquiry. Interested men are then invited to provide informed consent and complete a questionnaire about personal and family health history. A saliva collection kit for a 30-gene targeted panel of cancer predisposition genes (Color Genomics) is mailed to participants’ homes free of charge. Results are issued by phone and/or email with genetic counseling support, including discussion about cascade genetic testing if relevant. Results: As of Feb 9, 2022, 484 men with incident mPC diagnosed 1/2018-6/2021 were identified through SEER. 430 men were reached via a letter to their home address sent > 3 months after diagnosis. 175 of 430 (40.6%) men expressed interest and completed the questionnaire, the majority preferring to complete testing through mail after a phone-initiated introduction to the study. 164 of 175 men completed the consent process and were eligible. Of these 164 men, 45 (27.4%) reported prior genetic testing, and reports were requested and reviewed to ensure adequate testing. Ultimately, 121 of 164 (73.8%) participants initiated and 101/121 (83.5%) have completed genetic testing through the study. Nine percent (9/101) of participants completing testing as part of the study were found to have gDDRm. Conclusions: We used a population-based approach to understand the proportion of men with mPC undergoing germline genetic testing through clinical care, and the subsequent uptake of genetic testing when access and cost barriers are removed. The uptake of guideline-based germline genetic testing among men with mPC in the community prior to study enrollment is only 27.4%. With study interventions in the form of free testing through mail, and phone-based support, 83.5% of men in this community successfully completed testing. Further work in this study will aim to elucidate and attempt to eliminate other barriers in germline genetic testing to further improve testing rates in this community.
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Affiliation(s)
- Hiba Khan
- University of Washington, Seattle, WA
| | | | - Burcu Darst
- University of Southern California, Los Angeles, CA
| | | | - Peter Nelson
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Mirza A, Win Naing Z, Khonsari P, Khan H, Rezai P, Abbas AK, Nisar M. OP0244 AROMATASE INHIBITORS AND FRACTURE PREVENTION – DO NEW GUIDELINES WORK IN REAL WORLD? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background2,261,419 women were diagnosed with breast cancer worldwide in 2020. For postmenopausal women with hormone sensitive disease, aromatase inhibitors (AI) are recommended for their mortality benefit. However, AI bone loss (AIBL) is a recognised adverse event with resultant increase in fracture risk. In 2017, a consensus statement of 7 international bone and cancer societies was published proposing an algorithm based on clinical risk factors and different bone mineral density (BMD) threshold for bone active therapeutic intervention.ObjectivesTo determine the real-world impact of the 2017 consensus guidelines on AIBL and whether bone sparing therapy utilising proposed risk stratification model is effective in fracture prevention.MethodsOver a 7-year study period, 1001 women were prescribed AI at our university teaching hospital. The new guidelines were adopted in July 2017. We split the participants in two groups: 361 (36%) women had commenced their AI prior to the adoption of guidelines and 640 (64%) were in the post implementation group.First group were offered bone active treatment based on NOS 2009 guidelines whereas the second group followed the 2017 consensus guidelines. Women with osteoporosis were all offered treatment, however the difference in guideline is pertinent to osteopenia and we compared the results of that group.Results1001 women were included. Mean age was 64 years (range 29-93). 929 (93%) were Caucasian, 57 (6%) were Asian and 15 (1%) were Afro-Caribbean. 723 women (72%) had invasive ductal carcinoma and 863 women (86%) were postmenopausal. At diagnosis, 428 women (43%) had node positive disease and 35 women (4%) had metastases. 91 women (9%) had sustained fractures prior to their cancer diagnosis.276 women (28%) were offered oral bisphosphonates based on DEXA result, with 58 (6%) offered parenteral therapy.First group: 361 women had a baseline DEXA with a mean left neck of femur (LNOF) BMD of 0.888 g/cm2 (range 0.552-1.222). 143 (40%) women had a normal DEXA, 174 (48%) had osteopenia and 44 (12%) had osteoporosis.Of the women with osteopenia, 44 (25%) women were offered treatment and 33 women had a repeat DEXA after a mean of 4 years. In the treatment group, LNOF mean BMD remained relatively unchanged from 0.814 g/cm2 to 0.812 g/cm2 at the repeat DEXA (p= 0.94).Of the 174 women with osteopenia, 22 (13%) women had a fracture.Second group: 640 women had a baseline DEXA with a mean LNOF BMD of 0.888 g/cm2 (range 0.512-1.390). 216 (33%) women were normal, 322(50%) had osteopenia and 107 (17%) had osteoporosis.Of the women with osteopenia, 127 (39%) women were offered treatment and 56 women had a repeat DEXA after a mean of 3 years. In the treatment group, LNOF mean BMD remained relatively unchanged from 0.822 g/cm2 to 0.829 g/cm2 at the repeat DEXA (p= 0.6169).Of the 322 women with osteopenia, 8 (2.5%) women had a fracture.ConclusionOur study provides real world evidence of the success of 2017 consensus statement in lowering fracture risk. Though there has been data for positive impact on BMD decline with this approach, evidence for fracture prevention has been limited. This study showcases the success of lowering bone active therapy threshold employing alternative risk modelling strategy for women with breast cancer commenced on AI. A significant reduction in fractures pre (13%) and post guidelines change (2.5%) was demonstrated (absolute risk reduction of 10.5%) which has implications for healthcare systems worldwide as we have demonstrated this approach can reduce morbidity.References[1]https://www.wcrf.org/dietandcancer/worldwide-cancer-data/. Accessed: 26.01.2022.[2]Reid DM, Doughty J, Eastell R, et al. Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group. Cancer Treat Rev. 2008;34 Suppl 1:S3-S18.[3]Hadji P, Aapro MS, Body JJ, et al. Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG. J Bone Oncol. 2017;7:1-12.Disclosure of InterestsNone declared
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Rahman K, Khan H, Abdullah S. Mathematical calculation of COVID-19 disease in Pakistan by emergency response modeling based on complex Pythagorean fuzzy information. IFS 2022. [DOI: 10.3233/jifs-212160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The new emerged infectious disease that is known the coronavirus disease (COVID-19), which is a high contagious viral infection that started in December 2019 in China city Wuhan and spread very fast to the rest of the world. This infection caused millions of infected cases globally and still poses an alarming situation for human lives. Pakistan in Asian countries is considered the third country with higher number of cases of coronavirus with more than 649824. Recently, some mathematical models have been constructed for better understanding the coronavirus infection. Mostly, these models are based on classical integer-order derivative using real numbers which cannot capture the fading memory. So at the current position it is a challenge for the world to understand and control the spreading of COVID-19. Therefore, the aim of our paper is to develop some novel techniques, namely complex Pythagorean fuzzy weighted averaging (abbreviated as CPFWA) operator, complex Pythagorean fuzzy ordered weighted averaging (abbreviated as CPFOWA) operator, complex Pythagorean fuzzy hybrid averaging (abbreviated as CPFHA) operator, induced complex Pythagorean fuzzy ordered weighted averaging (abbreviated as I-CPFOWA) operator and induced complex Pythagorean fuzzy hybrid averaging (abbreviated as I-CPFHA) operator to analysis the spreading of COVID-19. At the end of the paper, an illustrative the emergency situation of COVID-19 is given for demonstrating the effectiveness of the suggested approach along with a sensitivity analysis, showing the feasibility and reliability of its results.
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Affiliation(s)
- K. Rahman
- Department of Mathematics, Shaheed Benazir Bhutto University Sheringal, Pakistan
| | - H. Khan
- Department of Mathematics, Shaheed Benazir Bhutto University Sheringal, Pakistan
| | - S. Abdullah
- Department of Mathematics, Abdul Wali Khan University Mardan, Pakistan
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Tekkis NP, Rafi D, Brown S, Courtney A, Kawka M, Howell AM, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Brown S, Kawka M, Mclean K, Savva N, Wilkinson P, Sam AH, Singal A, Chia C, Chia W, Ganesananthan S, Ooi SZY, Pengelly S, Wellington J, Mak S, Subbiah Ponniah H, Heyes A, Aberman I, Ahmed T, Al-Shamaa S, Appleton L, Arshad A, Awan H, Baig Q, Benedict K, Berkes S, Citeroni NL, Damani A, de Sancha A, Fisayo T, Gupta S, Haq M, Heer B, Jones A, Khan H, Kim H, Meiyalagan N, Miller G, Minta N, Mirza L, Mohamed F, Ramjan F, Read P, Soni L, Tailor V, Tas RN, Vorona M, Walker M, Winkler T, Bardon A, Acquaah J, Ball T, Bani W, Elmasry A, Hussein F, Kolluri M, Lusta H, Newman J, Nott M, Perwaiz MI, Rayner R, Shah A, Shaw I, Yu K, Cairns M, Clough R, Gaier S, Hirani D, Jeyapalan T, Li Y, Patel CR, Shabir H, Wang YA, Weatherhead A, Dhiran A, Renney O, Wells P, Ferguson S, Joyce A, Mergo A, Adebayo O, Ahmad J, Akande O, Ang G, Aniereobi E, Awasthi S, Banjoko A, Bates J, Chibada C, Clarke N, Craner I, Desai DD, Dixon K, Duffaydar HI, Kuti M, Mughal AZ, Nair D, Pham MC, Preest GG, Reid R, Sachdeva GS, Selvaratnam K, Sheikh J, Soran V, Stoney N, Wheatle M, Howarth K, Knapp-Wilson A, Lee KS, Mampitiya N, Masson C, McAlinden JJ, McGowan N, Parmar SC, Robinson B, Wahid S, Willis L, Risquet R, Adebayo A, Dhingra L, Kathiravelupillai S, Narayanan R, Soni J, Ghafourian P, Hounat A, Lennon KA, Abdi Mohamud M, Chou W, Chong L, Graham CJ, Piya S, Riad AM, Vennard S, Wang J, Kawar L, Maseland C, Myatt R, Tengku Saifudin TNS, Yong SQ, Douglas F, Ogbechie C, Sharma K, Zafar L, Bajomo MO, Byrne MHV, Obi C, Oluyomi DI, Patsalides MA, Rajananthanan A, Richardson G, Clarke A, Roxas A, Adeboye W, Argus L, McSweeney J, Rahman-Chowdhury M, Hettiarachchi DS, Masood MT, Antypas A, Thomas M, de Andres Crespo M, Zimmerman M, Dhillon A, Abraha S, Burton O, Jalal AHB, Bailey B, Casey A, Kathiravelupillai A, Missir E, Boult H, Campen D, Collins JM, Dulai S, Elhassan M, Foster Z, Horton E, Jones E, Mahapatra S, Nancarrow T, Nyamapfene T, Rimmer A, Robberstad M, Robson-Brown S, Saeed A, Sarwar Y, Taylor C, Vetere G, Whelan MK, Williams J, Zahid D, Chand C, Matthews M. The impact of the COVID-19 pandemic on UK medical education. A nationwide student survey. Med Teach 2022; 44:574-575. [PMID: 34428109 DOI: 10.1080/0142159x.2021.1962835] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
| | - Damir Rafi
- School of Medicine, Imperial College London, London, UK
| | - Sam Brown
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Alona Courtney
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Michal Kawka
- School of Medicine, Imperial College London, London, UK
| | - Ann-Marie Howell
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Kenneth McLean
- Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK
| | - Matthew Gardiner
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | | | - Peter Hutchinson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Paris Tekkis
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paul Wilkinson
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Amir H Sam
- School of Medicine, Imperial College London, London, UK
| | - Nicos Savva
- Division of Management Science and Operations, London Business School, London, UK
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- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - T Ball
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - W Bani
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Elmasry
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - F Hussein
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Kolluri
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - H Lusta
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - J Newman
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Nott
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M I Perwaiz
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - R Rayner
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Shah
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - I Shaw
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - K Yu
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | | | | | - S Gaier
- Queen Mary University of London
| | | | | | - Y Li
- Queen Mary University of London
| | | | | | | | | | - A Dhiran
- St George's Hospital Medical School
| | - O Renney
- St George's Hospital Medical School
| | - P Wells
- St George's Hospital Medical School
| | | | - A Joyce
- The Queen's University of Belfast
| | | | | | - J Ahmad
- The University of Birmingham
| | | | - G Ang
- The University of Birmingham
| | | | | | | | - J Bates
- The University of Birmingham
| | | | | | | | | | - K Dixon
- The University of Birmingham
| | | | - M Kuti
- The University of Birmingham
| | | | - D Nair
- The University of Birmingham
| | | | | | - R Reid
- The University of Birmingham
| | | | | | | | - V Soran
- The University of Birmingham
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Soni
- The University of Cambridge
| | | | | | | | | | - W Chou
- The University of East Anglia
| | | | | | - S Piya
- The University of Edinburgh
| | | | | | - J Wang
- The University of Edinburgh
| | | | | | | | | | | | | | | | | | | | | | | | - C Obi
- The University of Leicester
| | | | | | | | | | | | | | | | - L Argus
- The University of Manchester
| | | | | | | | | | | | | | | | | | | | | | | | | | - B Bailey
- University of Brighton and Sussex
| | - A Casey
- University of Brighton and Sussex
| | | | - E Missir
- University of Brighton and Sussex
| | - H Boult
- University of Exeter Medical School
| | - D Campen
- University of Exeter Medical School
| | | | - S Dulai
- University of Exeter Medical School
| | | | - Z Foster
- University of Exeter Medical School
| | - E Horton
- University of Exeter Medical School
| | - E Jones
- University of Exeter Medical School
| | | | | | | | - A Rimmer
- University of Exeter Medical School
| | | | | | - A Saeed
- University of Exeter Medical School
| | - Y Sarwar
- University of Exeter Medical School
| | - C Taylor
- University of Exeter Medical School
| | - G Vetere
- University of Exeter Medical School
| | | | | | - D Zahid
- University of Exeter Medical School
| | - C Chand
- University of Hull and the University of York
| | - M Matthews
- University of Hull and the University of York
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Abstract
INTRODUCTION Hip fractures are an important cause of morbidity and mortality. Early surgery has been shown to reduce mortality rates and surgical complications. The American Society of Anesthesiologists (ASA) grade is a widely used tool to assess preoperative health of patients. This study aims to assess is whether delay in surgical time has a greater impact on the mortality rates for high risk patients. METHOD Retrospective study using the National Hip Fracture Database (NHFD) of 4883 neck of femur fracture patients. Time of surgery, ASA grade, reason for delay and mortality at 120 days was analysed, using statistical analysis software. RESULTS There was a significant increase in mortality (p < 0.001) with increasing ASA grade. Surgical delays of more than 36 hours increased mortality by 2.9%. The impact of delaying surgery became more pronounced as the ASA grade increased. ASA 3 and above had an optimum time to surgery of between 12 and 24 hours giving the statistically significant lowest mortality rate (p = 0.004). DISCUSSION Surgical delay beyond the 36-hour target for surgery has a greater impact on mortality for patients with higher ASA grades. The effect is most profound in the high-risk ASA grade 5 patients with delayed patients showing a 37.5% increase in mortality in this group. This would imply that by prioritising this higher risk group and operating on it within a specific time frame there would be a subsequent fall in mortality associated with neck of femur fractures.
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Affiliation(s)
- Hiba Khan
- Trauma and Orthopaedics Department, Croydon University Hospital, Croydon, London, UK
| | - Al-Achraf Khoriati
- Trauma and Orthopaedics Department, Croydon University Hospital, Croydon, London, UK
| | - Stefan Lazic
- Radiology Department, St. George's Hospital, London, UK
| | - Jack Navein
- Emergency Department, St. George's Hospital, London, UK
| | - Ritesh Sharma
- Trauma and Orthopaedics Department, St Helier Hospital, Sutton, London, UK
| | - Najab Ellahee
- Trauma and Orthopaedics Department, St Helier Hospital, Sutton, London, UK
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Abstract
BACKGROUND With greater use of social media platforms for promotions of research articles, retracted articles tend to receive approximately the same attention. We systematically analyzed retracted articles from retractionwatch.com to look at the Altmetric Attention Scores (AAS) garnered over a period of time in order to highlight the role of social media and other platforms in advertising retracted articles and its effect on the spread of misinformation. METHODS Retractionwatch.com was searched for coronavirus disease 2019 related retracted papers on November 6th, 2021. Articles were excluded based on lack of digital object identifier (DOI), if they were preprint articles, absent AAS, and incomplete AAS of pre retraction, post retraction, or both scores. RESULTS A total of 196 articles were found on the Retraction Watch website of which 189 were retracted papers and 7 were expression of concern (EOC). We then identified 175 articles after excluding those that did not have a DOI and 30 preprint articles were also excluded giving 145 articles. Further exclusion of articles with absent AAS and incomplete AAS resulted in a total of 22 articles. CONCLUSION Retracted articles receive significant online attention. Twitter and Mendeley were the most popular medium for publicizing retracted articles, therefore more focus should be given by journals and their Twitter accounts to discredit all their retracted articles. Preprints should be reconsidered as a whole by journals due to the huge risk they carry in disseminating false information.
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Affiliation(s)
- Hiba Khan
- Dubai Health Authority, Dubai, United Arab Emirates
| | - Prakash Gupta
- Virgen Milagrosa University Foundation College of Medicine, San Carlos City, Pangasinan, Philippines
| | - Olena Zimba
- Department of Internal Medicine No.2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
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Khan H, Ashraf MU, Idrees M, Din HU, Nguyen CV, Amin B. Intriguing interfacial characteristics of the CS contact with MX 2 (M = Mo, W; X = S, Se, Te) and MXY ((X ≠ Y) = S, Se, Te) monolayers. RSC Adv 2022; 12:12292-12302. [PMID: 35480342 PMCID: PMC9036409 DOI: 10.1039/d2ra00668e] [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: 01/31/2022] [Accepted: 04/08/2022] [Indexed: 11/27/2022] Open
Abstract
Using (hybrid) first principles calculations, the electronic band structure, type of Schottky contact and Schottky barrier height established at the interface of the most stable stacking patterns of the CS–MX2 (M = Mo, W; X = S, Se, Te) and CS–MXY ((X ≠ Y) = S, Se, Te) MS vdWH are investigated. The electronic band structures of CS–MX2 and CS–MXY MS vdWH seem to be simple sum of CS, MX2 and MXY monolayers. The projected electronic properties of the CS, MX2 and MXY layers are well preserved in CS–MX2 and CS–MXY MS vdWH. Their smaller effective mass (higher carrier mobility) render promising prospects of CS–WS2 and CS–MoSeTe as compared to other MS vdWH in nanoelectronic and optoelectronic devices, such as a high efficiency solar cell. In addition, we found that the effective mass of holes is higher than that of electrons, suggesting that these heterostructures can be utilized for hole/electron separation. Interestingly, the MS contact led to the formation of a Schottky contact or ohmic contact, therefore we have used the Schottky Mott rule to calculate the Schottky barrier height (SBH) of CS–MX2 (M = Mo, W; X = S, Se, Te) and CS–MXY ((X ≠ Y) = S, Se, Te) MS vdWH. It was found that CS–MX2 (M = Mo, W; X = S, Se, Te) and CS–MXY ((X ≠ Y) = S, Se, Te) (in both model-I and -II) MS vdWH form p-type Schottky contacts. These p-type Schottky contacts can be considered a promising building block for high-performance photoresponsive optoelectronic devices, p-type electronics, CS-based contacts, and for high-performance electronic devices. Electronic band structure, type of Schottky contact and Schottky barrier height established at the interface of the CS–MX2 (M = Mo, W; X = S, Se, Te) and CS–MXY ((X ≠ Y) = S, Se, Te) MS vdWH.![]()
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Affiliation(s)
- H. Khan
- Department of Physics, Abbottabad University of Science & Technology, Abbottabad, 22010, Pakistan
| | - M. U. Ashraf
- Department of Physics, Abbottabad University of Science & Technology, Abbottabad, 22010, Pakistan
| | - M. Idrees
- Department of Physics, Abbottabad University of Science & Technology, Abbottabad, 22010, Pakistan
| | - H. U. Din
- Department of Physics, Bacha Khan University, Charsadda, 24420, Pakistan
| | - Chuong V. Nguyen
- Department of Materials Science and Engineering, Le Quy Don Technical University, Hanoi 100000, Vietnam
| | - B. Amin
- Department of Physics, Abbottabad University of Science & Technology, Abbottabad, 22010, Pakistan
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Riaz MMA, Ahmad U, Mohan A, Dos Santos Costa AC, Khan H, Babar MS, Hasan MM, Essar MY, Zil-E-Ali A. Global impact of vaccine nationalism during COVID-19 pandemic. Trop Med Health 2021; 49:101. [PMID: 34963494 PMCID: PMC8714455 DOI: 10.1186/s41182-021-00394-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Vaccines are the best chance to control the pandemic-unless leaders succumb to vaccine nationalism. Vaccine nationalism is a frequent recurrence, especially during a brand-new market distribution. The development of safe and effective COVID-19 vaccines in such a short space of time is a testament to modern scientific abilities. It will also test the world's political will and moral commitment to end this pandemic. As desperate as the COVID-19 pandemic, vaccine nationalism is already setting a foundation for itself and is considered socially and economically counterproductive. Vaccine equity is not just a theoretical slogan, and it protects people worldwide from new vaccine-resistant variants. Understanding and anticipating the consequences is vital, and creating a global solution approach to avoid them. This article evaluates the common issues previously faced and the plausible ones during this pandemic. A few recommendations are made to warn and accentuate the reality of this dire matter.
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Affiliation(s)
| | | | - Anmol Mohan
- Karachi Medical & Dental College, Karachi, Pakistan
| | | | - Hiba Khan
- Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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Tazyeen S, Khan H, Babar MS, Lucero-Prisno DE. Foreign workers in the Middle East during COVID-19. Int J Health Plann Manage 2021; 37:1199-1204. [PMID: 34939218 DOI: 10.1002/hpm.3403] [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: 10/24/2020] [Revised: 10/13/2021] [Accepted: 12/06/2021] [Indexed: 11/08/2022] Open
Abstract
The COVID-19 pandemic is having an unprecedented and consequential impact on global economies, businesses, and workforces. Foreign nationals account for the majority of the population in the Middle East. Throughout this article, the authors address the negative ramifications the COVID-19 pandemic has had on the migrant workforce in the Middle East. This pandemic has intensified various socio-economic and public health crises such as unemployment, income cuts, depletion of savings, repatriation difficulties, inadequate living conditions, and associated burden on healthcare facilities by the COVID-19 infection.
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Affiliation(s)
| | | | | | - Don Elisco Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.,Faculty of Management and Development Studies, University of the Philippines (Open University), Los Baños, Laguna, Philippines
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Khan H, Connolly T, Loh MY, Clark E. Duodenal volvulus: a rare cause of small bowel obstruction. Ann R Coll Surg Engl 2021; 104:e102-e104. [PMID: 34846192 DOI: 10.1308/rcsann.2021.0242] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Small bowel volvulus is a rare but life-threatening emergency. Volvulus of the duodenum is even rarer without the presence of predisposing factors. The clinical presentation is vague, including abdominal pain, nausea and vomiting, prompt diagnosis of volvulus therefore relies heavily on radiographs. The treatment options lie between conservative or surgical management, where the decision is influenced by the patient and their presentation. This case is of a 100-year-old female with an extensive surgical and medical background presenting with signs of small bowel obstruction. With the help of imaging, a rare case of duodenal volvulus was diagnosed but managed conservatively due to the patient's background, age and personal wishes.
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Affiliation(s)
- H Khan
- Stockport NHS Foundation Trust, UK
| | | | - M-Y Loh
- Stockport NHS Foundation Trust, UK
| | - E Clark
- Stockport NHS Foundation Trust, UK
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Nayab S, Alam A, A. Khan F, Khan H, Khan S, A. Khan F. Synthesis, characterization and urease inhibitory activities of Zn(II) complexes bearing C1-symmetric ligands derived from (R)-phenylethanamine. B CHEM SOC ETHIOPIA 2021. [DOI: 10.4314/bcse.v35i2.7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ABSTRACT. A series of Zn(II) complexes, supported with N-substituted phenylethanamine derivatives, [LnZnCl2] (where Ln = LA ((R)-1-phenyl-N-(thiophene-2-ylmethyl)ethanamine; LB (R)-N-(5-meyhylthiophene-2-yl)methyl-1-phenylethanamine; LC ((R)-N-(furan-2-ylmeththyl)-1-phenylethanamine and LD (R)-N-((5-methylfuran-2-yl)methyl)-1-phenylethanamine) were synthesized and characterized. The urease inhibitory activities of these complexes were determined against selected urease inhibitors where [LBZnCl2] was found to be the most prominent inhibitor of Jack bean urease (J. B. urease) (IC50 = 10.39±0.78 μM), whereas the activity of Bacillus pasteurii urease (B. P. urease) was predominantly inhibited by [LAZnCl2] (IC50 = 8.68±0.7 μM). Additionally, MOE-Dock program was used to affirm the probable binding modes of these complexes into the crystal structure of J. B. urease which certainly verified the inhibitory mechanism of these novel complexes.
KEY WORDS: Zn(II) complexes, (R)-Phenylethanamine, Urease inhibition, Molecular docking
Bull. Chem. Soc. Ethiop. 2021, 35(2), 301-314.
DOI: https://dx.doi.org/10.4314/bcse.v35i2.7
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S. Khan M, Sirajuddin M, Zubair M, Khan H, Tariq M, Mehwish S, Ullah N. Synthesis, characterization, POM analyses and biological evaluation of n-[(2-methoxy-5- nitrophenyl)]-4-oxo-4-[oxy] butenamide based zinc(II) carboxylate complexes. B CHEM SOC ETHIOPIA 2021. [DOI: 10.4314/bcse.v35i2.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ABSTRACT. The aim of medicinal chemistry is to links many scientific disciplines and allows the scientists in researching and developing new drugs with enhance and targeted properties. In this article we are exploring the preparation of four new zinc(II) carboxylate complexes based on N-[(2-methoxy-5-nitrophenyl)]-4-oxo-4-[oxy]butenamide which were characterized through FT-IR and EDX studies. The DNA binding ability and binding type of complexes were assessed by spectroscopic (UV-Visible) and viscosity measurements, exhibiting an intercalative pattern of interaction. The synthesized compounds were also assessed to know theoretically about their nature by molecular docking studies resulting also in intercalation mode. Analysis of the complexes for biological applications such as anti-microbial, anti-leishmanial, cytotoxicity and DNA damage activities showed that these complexes carries good anti-microbial, anti-leishmanial activity with no toxicity to human blood thyrocytes and DNA. The bioavailability prediction and drug likeness score has also been evaluated through Insilco studies.
KEY WORDS: Zn(II) carboxylate complex, DNA binding, Anti-leishmanial activity, Cytotoxicity, Docking study
Bull. Chem. Soc. Ethiop. 2021, 35(2), 365-380.
DOI: https://dx.doi.org/10.4314/bcse.v35i2.11
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Khan H, Tang C, Kamalakannan B, Bamford R. 57 A Closed Loop Audit of Post-Operative Driving Advice Documentation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.003] [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: 11/13/2022]
Abstract
Abstract
Aim
The Driving and Vehicle Licensing Agency state post-operatively it is between the patient and doctor to establish when would be safe to resume driving, providing recovery does not exceed three months. This audit aimed to assess and improve the documentation rate of driving advice in the discharge summaries given to patients post abdominal surgery.
Method
Retrospective data collection from electronic records over the months of August and September 2020. 132 discharge summaries were screened to assess the baseline rate of verbal/documented driving advice given on discharge. Following the 1st cycle, posters encouraging the inclusion of driving advice and demonstrating how to access driving advice to discharge summaries were developed and distributed across the surgical wards. A 2nd cycle re-audit was conducted in October 2020 to measure the effect of change, and a further 3rd cycle audit was conducted in November 2020.
Results
1st cycle included 132 patients. 62% had documented advice on their discharge summaries, while 38% had no proof of driving advice. After intervention, 2nd cycle included 30 patients. Results showed a significant increase in advice documentation (80%). A 3rd cycle was carried out with 47 patients. This showed a reduction in advice documentation (66%).
Conclusions
Driving advice on discharge in post-operative patients is crucial part of patient safety. Implementation of intervention has increased the documentation of driving advice showing enhancing patient safety. However, 3rd cycle after registrar’s changeover showed a decrease in the rate of documentation. A teaching session is planned for new doctors followed by 4th cycle.
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Affiliation(s)
- H Khan
- Musgrove Park Hospital, Taunton, United Kingdom
| | - C Tang
- Musgrove Park Hospital, Taunton, United Kingdom
| | | | - R Bamford
- Musgrove Park Hospital, Taunton, United Kingdom
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42
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Shah V, Khan H, Komor J, Vig S. 951 More Than A Checkbox: Importance of Role-Modelling and Visibility Initiatives in Improving Perceptions of Diversity in Surgical Leadership. Br J Surg 2021. [DOI: 10.1093/bjs/znab258.045] [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
The Royal College of Surgeons of England have committed themselves to championing diversity in surgery in light of recent socio-political events. Although there are now more trainees from underrepresented backgrounds entering the profession, this is not reflected in leadership roles which are key in establishing attitudes and cultures. This study evaluated whether an event showcasing surgeons from underrepresented groups holding leadership positions could improve student perceptions of diversity in surgical leadership.
Method
Participants attended an online event hosted by a student surgical society, where speakers with surgical leadership experience from a range of marginalised backgrounds highlighted topics of diversity and discrimination in surgery. Pre- and post-event questionnaires comprising Likert scales were completed to evaluate student perceptions of surgeons holding a leadership role from the following underrepresented groups: women (or gender non-conforming), BAME, LGBTQ+ and individuals with disabilities. Statistical significance was assessed using a Mann-Whitney U test with p < 0.05 denoting significance throughout.
Results
The event significantly increased attendee confidence in the idea of a surgeon being seen in a leadership role from all underrepresented groups evaluated: 9.3% for female/gender non-conforming individuals (p < 0.01), 12.3% for BAME individuals (p < 0.01), 7.5% for non-heterosexual individuals (p = 0.04) and 16.0% for individuals with a disability (p < 0.01).
Conclusions
Attendees felt significantly more confident in the belief that surgeons from underrepresented backgrounds could hold leadership positions following the event, indicating the benefit of such role-modelling initiatives. More investment is necessary in exploring factors dissuading specific underrepresented groups from pursuing surgical careers and for novel strategies to support these communities accordingly.
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Affiliation(s)
- V Shah
- Imperial College London School of Medicine, London, United Kingdom
| | - H Khan
- Imperial College London School of Medicine, London, United Kingdom
| | - J Komor
- Imperial College London School of Medicine, London, United Kingdom
| | - S Vig
- Croydon University Hospital, London, United Kingdom
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Hussain Z, Sun Y, Shah SH, Khan H, Ali S, Iqbal A, Zia MA, Ali SS. The dynamics of genome size and GC contents evolution in genus Nicotiana. BRAZ J BIOL 2021; 83:e245372. [PMID: 34669791 DOI: 10.1590/1519-6984.245372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/07/2020] [Accepted: 05/11/2021] [Indexed: 11/22/2022] Open
Abstract
Hybridization and Polyploidization are most common of the phenomenon observed in plants, especially in the genus Nicotiana leading to the duplication of genome. Although genomic changes associated with these events has been studied at various levels but the genome size and GC content variation is less understood because of absence of sufficient genomic data. In this study the flow cytometry technique was used to uncover the genome size and GC contents of 46 Nicotiana species and we compared the genomic changes associated with the hybridization events along evolutionary time scale. The genome size among Nicotiana species varied between 3.28 pg and 11.88 pg whereas GC contents varied between 37.22% and 51.25%. The tetraploid species in genus Nicotiana including section Polydiclae, Repandae, Nicotiana, Rustica and Sauveolentes revealed both up and downsizing in their genome sizes when compared to the sum of genomes of their ancestral species. The genome sizes of three homoploid hybrids were found near their ancestral species. Loss of large genome sequence was observed in the evolutionary more aged species (>10 Myr) as compared to the recently evolved one's (<0.2 Myr). The GC contents were found homogenous with a mean difference of 2.46% among the Nicotiana species. It is concluded that genome size change appeared in either direction whereas the GC contents were found more homogenous in genus Nicotiana.
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Affiliation(s)
- Z Hussain
- Chinese Academy of Agricultural Sciences, Qingdao, Shandong, China
- University of Swat, Centre for Biotechnology and Microbiology, Mingora, Swat, Khyber Pukhtunkhwa, Pakistan
| | - Y Sun
- Chinese Academy of Agricultural Sciences, Qingdao, Shandong, China
| | - S H Shah
- Allama Iqbal Open University, Faculty of Sciences, Department of Agricultural Sciences, Islamabad, Pakistan
| | - H Khan
- Quid-e-Azam University, Department of Biotechnology, Islamabad, Pakistan
| | - S Ali
- University of Swat, Centre for Biotechnology and Microbiology, Mingora, Swat, Khyber Pukhtunkhwa, Pakistan
| | - A Iqbal
- University of Swat, Centre for Biotechnology and Microbiology, Mingora, Swat, Khyber Pukhtunkhwa, Pakistan
| | - M A Zia
- National Agricultural Research Centre - NARC, National Institute for Genomics and Advanced Biotechnology - NIGAB, Islamabad, Pakistan
| | - S S Ali
- University of Swat, Centre for Biotechnology and Microbiology, Mingora, Swat, Khyber Pukhtunkhwa, Pakistan
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Mohan A, Wara UU, Amjad SW, Rackimuthu S, Hunain R, Khan H, Carla Dos Santos Costa A, Ahmad S, Essar MY. Malaria amidst COVID-19 in India: Challenges, Efforts, and Recommendations. Clin Epidemiol Glob Health 2021; 12:100867. [PMID: 34522826 PMCID: PMC8431839 DOI: 10.1016/j.cegh.2021.100867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
Since the outbreak of COVID-19 in India, the country has faced a slew of new challenges, spawning a slew of other deadly viruses and diseases while also serving as a breeding ground for them. Not only did Malaria (a vector-borne disease) emerge as a coincidental outbreak during the pandemic, but many others did as well, causing severe diseases in humans due to flaws in health-care systems that were already overburdened with identifying, preventing, and treating the recently introduced coronavirus disease. Inadequate water cleanliness, as well as the delayed and misdiagnosis of Malaria with COVID-19 due to overlapping symptoms, are major impediments in the incidence of these unique outbreaks. Appropriate steps, such as providing clean water and diagnostic facilities to control Malaria cases, should be adopted to prevent such epidemics in the country.
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Affiliation(s)
- Anmol Mohan
- Karachi Medical & Dental College, Karachi, Pakistan
| | - Um Ul Wara
- Karachi Medical & Dental College, Karachi, Pakistan
| | | | | | | | - Hiba Khan
- Dubai Medical College, Dubai, United Arab Emirates
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Khan H, Sami MB, Litvak V. The utility of Magnetoencephalography in multiple sclerosis - A systematic review. Neuroimage Clin 2021; 32:102814. [PMID: 34537682 PMCID: PMC8455859 DOI: 10.1016/j.nicl.2021.102814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 01/29/2023]
Abstract
We conducted a Systematic Review of studies, looking at 30 studies from 13 centres. MS patients had reduced power in some induced responses (motor beta, visual gamma). Increased latency and reduced connectivity were seen for somatosensory evoked fields. There was an association between upper alpha connectivity and cognitive function. MEG shows promise, although work is too preliminary to recommend current clinical use.
Introduction Magnetoencephalography (MEG), allows for a high degree temporal and spatial accuracy in recording cortical oscillatory activity and evoked fields. To date, no review has been undertaken to synthesise all MEG studies in Multiple Sclerosis (MS). We undertook a Systematic Review of the utility of MEG in MS. Methods We identified MEG studies carried out in MS using EMBASE, Medline, Cochrane, TRIP and Psychinfo databases. We included original research articles with a cohort of minimum of five multiple sclerosis patients and quantifying of at least one MEG parameter. We used a modified version of the JBI (mJBI) for case-control studies to assess for risk of bias. Results We identified 30 studies from 13 centres involving at least 433 MS patients and 347 controls. We found evidence that MEG shows perturbed activity (most commonly reduced power modulations), reduced connectivity and association with altered clinical function in Multiple Sclerosis. Specific replicated findings were decreased motor induced responses in the beta band, diminished increase of gamma power after visual stimulation, increased latency and reduced connectivity for somatosensory evoked fields. There was an association between upper alpha connectivity and cognitive measures in people with MS. Overall studies were of moderate quality (mean mJBI score 6.7). Discussion We find evidence for the utility of MEG in Multiple Sclerosis. Event-related designs are of particular value and show replicability between centres. At this stage, it is not clear whether these changes are specific to Multiple Sclerosis or are also observable in other diseases. Further studies should look to explore cognitive control in more depth using in-task designs and undertake longitudinal studies to determine whether these changes have prognostic value.
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Affiliation(s)
- H Khan
- UCL Queen's Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; Queen's Medical Centre Nottingham, Clifton Boulevard, Derby Rd, Nottingham NG7 2UH, United Kingdom.
| | - M B Sami
- Institute of Mental Health, Jubilee Campus, University of Nottingham Innovation Park, Triumph Road, Nottingham NG7 2TU, United Kingdom
| | - V Litvak
- UCL Queen's Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
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Shuaib M, Hussain F, Rauf A, Jan F, Romman M, Parvez R, Zeb A, Ali S, Abidullah S, Bahadur S, Shah AA, Azam N, Dilbar S, Begum K, Khan H, Sajjad S, Muhammad I, Shah NA. Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan. BRAZ J BIOL 2021; 83:e246803. [PMID: 34495160 DOI: 10.1590/1519-6984.246803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/20/2021] [Indexed: 11/21/2022] Open
Abstract
Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.
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Affiliation(s)
- M Shuaib
- Yunnan University, School of Ecology and Environmental Science, Kunming, PR China
| | - F Hussain
- Cholistan University of Veterinary & Animal Sciences, Department of Microbiology, Bahawalpur, Pakistan
| | - A Rauf
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan
| | - F Jan
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan
| | - M Romman
- University of Chitral, Department of Botany, Chitral, Pakistan
| | - R Parvez
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan.,Government Girls Degree College Dargai, Department of Botany, District Malakand, Pakistan
| | - A Zeb
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan
| | - S Ali
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan
| | - S Abidullah
- Abdulwali Khan University, Department of Botany, Mardan, Pakistan
| | - S Bahadur
- Hainan University, College of Forestry, Haikou, China
| | - A A Shah
- Jazan University, Department of Medical Laboratory Technology, Jazan, Saudi Arabia
| | - N Azam
- University of Peshawar, Centre of Plant Biodiversity, Peshawar, Pakistan
| | - S Dilbar
- University of Swat, Centre of Plant Biodiversity, Swat, Pakistan
| | - K Begum
- University of Hazara, Department of Genetic, Manshera, Pakistan
| | - H Khan
- University of Swat, Center of Biotechnology and Microbiology, Swat, Pakistan
| | - S Sajjad
- COMSATS University, Department of Biosciences, Park Road Islamabad, Pakistan
| | - I Muhammad
- University of Hazara, Department of Genetic, Manshera, Pakistan
| | - N A Shah
- COMSATS University, Department of Biosciences, Park Road Islamabad, Pakistan
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Yasmin F, Asghar W, Babar MS, Khan H, Ahmad S, Hameed Z, Asghar MS, Nauman H, Khattak AK, Arshad Z, Shah SMI, Siddiqui SA, Osama M, Zarak MS. Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey. Am J Trop Med Hyg 2021; 105:1230-1239. [PMID: 34525449 PMCID: PMC8592216 DOI: 10.4269/ajtmh.21-0297] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 03/11/2021] [Accepted: 08/01/2021] [Indexed: 01/02/2023] Open
Abstract
Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.
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Affiliation(s)
- Farah Yasmin
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Waleed Asghar
- 2City Gynae Hospital Toba Tek Singh, Medicine, Toba Tek Singh, Punjab, Pakistan
| | - Maryam Salma Babar
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Hiba Khan
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Shoaib Ahmad
- 4General Medicine and Surgery, Punjab Medical College, Faisalabad, Pakistan
| | - Zaid Hameed
- 5Department of Internal Medicine, Allied Hospital, Faisalabad, Pakistan
| | | | - Hamza Nauman
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Zara Arshad
- 8Department of Internal Medicine, Capital Hospital, Islamabad, Pakistan
| | | | - Sarush Ahmed Siddiqui
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Osama
- 10Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
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Ismail Z, Aborode AT, Oyeyemi AA, Khan H, Hasan MM, Saha A, Akah B. Impact of COVID-19 pandemic on viral hepatitis in Africa: Challenges and way forward. Int J Health Plann Manage 2021; 37:547-552. [PMID: 34462959 PMCID: PMC8653283 DOI: 10.1002/hpm.3317] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/22/2022] Open
Abstract
With the overwhelming COVID‐19 pandemic in Africa, many other severe epidemics have been given low priority, such as viral hepatitis. Patient mortality due to viral hepatitis has raised concern to COVID‐19 patients due to compromise with undiagnosed hepatitis in Africa. The pandemic has worsened the control of the viral hepatitis epidemic as healthcare control facilities have moved their focus towards curbing COVID‐19 infections. However, different challenges have arisen to viral hepatitis patients because of low health attention that declines the progress of already diagnosed hepatitis patients. Follow‐up plans, routine testing and treatment plans for viral hepatitis are no longer as strict with the human resources transferred towards combating the pandemic. Thus, a global effort is required to abide by renewed recommendations to eradicate viral hepatitis in Africa that also fit the current picture of the COVID‐19 pandemic. The article discusses the current challenges viral hepatitis patients faced during the COVID‐19 pandemic and important recommendations that can see through these challenges in Africa.
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Affiliation(s)
- Zainab Ismail
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Abdullahi Tunde Aborode
- Healthy Africans Platform, Research and Development, Ibadan, Nigeria.,West African Academy of Public Health, Research and Development, Abuja, Nigeria
| | | | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh.,Division of Infectious Diseases, The Red-Green Research Centre, BICCB, Dhaka, Bangladesh
| | - Anwesha Saha
- Department of Biotechnology, Heritage Institute of Technology, Kolkata, West Bengal, India
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49
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Essar MY, Khan H, Babar MS, Hasan MM, Rackimuthu S, Dos Santos Costa AC, Ahmad S, Nemat A. Mucormycosis, conflicts and COVID-19: A deadly recipe for the fragile health system of Afghanistan. Int J Health Plann Manage 2021; 37:543-546. [PMID: 34333804 PMCID: PMC8426834 DOI: 10.1002/hpm.3292] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Hiba Khan
- Dubai Medical College, Dubai, United Arab Emirates
| | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh.,Division of Infectious Diseases, The Red-Green Research Centre, BICCB, Dhaka, Bangladesh
| | | | | | | | - Arash Nemat
- Kabul University of Medical Sciences, Kabul, Afghanistan
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50
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Bhardwaj SC, Kumar S, Gangwar OP, Prasad P, Kashyap PL, Khan H, Savadi S, Singh GP, Gupta N, Thakur R. Physiologic Specialization and Genetic Differentiation of Puccinia triticina Causing Leaf Rust of Wheat on the Indian Subcontinent During 2016 to 2019. Plant Dis 2021; 105:1992-2000. [PMID: 33439038 DOI: 10.1094/pdis-06-20-1382-re] [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] [Indexed: 06/12/2023]
Abstract
Wheat is the second most cultivated cereal crop in the world and is an important crop in India. Leaf (brown) rust, caused by Puccinia triticina, was the most prevalent among the three rusts found in all the wheat-growing areas of India, Bhutan, and Nepal during 2016 to 2019. Leaf rust samples from wheat crops in these countries were pathotyped using the wheat differential genotypes and binomial Indian system of nomenclature. To facilitate international communication, each pathotype identified was also tested using the North American differentials. A total of 33 pathotypes were identified from 1,086 samples, including three new pathotypes: 61R47 (162-5 = KHTPM) and 93R49 (49 = NHKTN) from India and 93R57 (20-1 = NHKTN) from Nepal. Two pathotypes, 121R60-1 (77-9/52 = MHTKL) and 121R63-1 (77-5 = THTTM), accounted for 79.46% of the population. Virulence on Lr19 was identified in 0.27% of the samples from Nepal only. The proportion of pathotype 121R60-1 (77-9 = MHTKL) increased to 57.55% during these years. Virulence was not observed on Lr9, Lr24, Lr25, Lr28, Lr32, Lr39, Lr45, and Lr47 in the population of the Indian subcontinent. Eighteen polymorphic simple sequence repeat (SSR) primer pairs tested on the isolates amplified 48 alleles with an average of 2.66 alleles per primer pair. Based on SSR genotyping, these pathotypes could be grouped into two clades with another two subclades each. Many of the Lr genes present in Indian wheat germplasm (Lr1, Lr3a, Lr10, Lr11, Lr14a, Lr15, Lr16, Lr17, Lr20, Lr23, and Lr26) were ineffective for a majority of pathotypes. Most of these varieties possessed a high degree of leaf rust resistance. The field resistance of wheat varieties could be attributed to the interaction of genes, unknown resistance, or adult plant resistance.
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Affiliation(s)
- S C Bhardwaj
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - S Kumar
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - O P Gangwar
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - P Prasad
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - P L Kashyap
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - H Khan
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - S Savadi
- ICAR-Directorate of Cashew Research, Karnataka 574202, India
| | - G P Singh
- ICAR-Indian Institute of Wheat and Barley Research, Karnal, Haryana 132001, India
| | - N Gupta
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
| | - R Thakur
- ICAR-Indian Institute of Wheat and Barley Research, Regional Station, Flowerdale, Shimla, Himachal Pradesh 171002, India
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