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Fornari M, Claiborne MK, Breslin K, Sanchez-Jacob R, Khan MA, Thomas-Mohtat R. Utility of common bile duct measurement in the diagnosis of cholecystitis and choledocholithiasis in children. Am J Emerg Med 2024; 79:38-43. [PMID: 38341992 DOI: 10.1016/j.ajem.2024.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Ultrasound is an integral part of evaluating for acute cholecystitis and choledocholithiasis in pediatric patients. Finding the common bile duct (CBD), a structure which is normally <4 mm in children, can be very challenging. OBJECTIVE The primary objective of this study was to determine the prevalence of isolated sonographic CBD dilation in pediatric patients with acute cholecystitis and/or choledocholithiasis without laboratory abnormalities or pathologic findings on radiology based biliary ultrasound, apart from cholelithiasis. METHODS We conducted a retrospective chart review of patients ≤21-years-old, at a single free-standing tertiary care children's hospital, who received a biliary ultrasound in the radiology department (RADUS) from September 2005 to February 2020. We identified patients who had a diagnosis of acute cholecystitis and/or choledocholithiasis on RADUS. Based on prior studies, a positive ultrasound was defined as having gallbladder wall thickening (GWT), pericholecystic fluid (PCF), or sonographic Murphy's sign (SMS). The final diagnosis was confirmed using the gold standard, cholecystectomy pathology diagnosis for patients with cholecystitis and endoscopic retrograde cholangiopancreatography (ERCP) diagnosis for patients with choledocholithiasis. Ultrasound data and contemporaneous laboratory values were collected. RESULTS 180 patients met inclusion criteria. For the study population, 97 (53.9%) had a positive ultrasound, 127 patients (70.6%) had a dilated CBD, and 170 (94.4%) had at least one abnormal laboratory finding. Within the study population there were 76 patients (42.3%) with acute cholecystitis, 55 patients (30.5%) with choledocholithiasis, and 49 patients (27.2%) with acute cholecystitis and choledocholithiasis. Of the 127 patients with a dilated CBD, 80 (62.9%) had a normal ultrasound, apart from cholelithiasis. In this group of 80, 78 patients (97.5%) had at least one abnormal laboratory finding. Thus, for the entire study population, isolated CBD dilation without a positive ultrasound or laboratory abnormalities occurred in 2 patients (1.1%). Of note, these 2 patients had an ultrasound diagnosis of choledocholithiasis. CONCLUSION The prevalence of isolated sonographic CBD dilation in pediatric patients with cholecystitis and/or choledocholithiasis was 1.1%. Thus, biliary ultrasound without CBD measurement is unlikely to result in missed cholecystitis and/or choledocholithiasis if the biliary ultrasound does not demonstrate GWT, PCF, SMS, or choledocholithiasis, and the patient has normal laboratory values.
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Affiliation(s)
- Marci Fornari
- Cooper University Health Care, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Cooper Medical School of Rowan University, 1 Cooper Plaza, Camden, NJ 08103, USA.
| | - Mary Kate Claiborne
- Children's Hospital of Philadelphia, Department of Pediatrics, Division of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
| | - Kristen Breslin
- Children's National Hospital, Department of Pediatrics, Division of Emergency Medicine, George Washington School of University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA.
| | - Ramon Sanchez-Jacob
- Children's National Hospital, Department of Pediatrics, Division of Diagnostic Imaging and Radiology, George Washington School of University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA.
| | - Muhammad A Khan
- Nationwide Children's Hospital, Department of Pediatrics, Division of Gastroenterology, The Ohio State University College of Medicine, 700 Childrens Drive, Columbus, OH 43205, USA.
| | - Rosemary Thomas-Mohtat
- Children's National Hospital, Department of Pediatrics, Division of Emergency Medicine, George Washington School of University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA.
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Nazir A, Iqbal H, Mehmood A, Khan MA, Shaukat Z, Abbas Z, Kashif M. Efficacy of Glass Ionomer Cement as Pit and Fissure Sealant in Permanent First Molars. Cureus 2024; 16:e55882. [PMID: 38595900 PMCID: PMC11002968 DOI: 10.7759/cureus.55882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Background/Objectives Pit and fissure caries constitute a predominant portion, approximately 90% in permanent posterior teeth and 44% in primary teeth among children and adolescents. Among various preventive modalities, pit and fissure sealants play a pivotal role in safeguarding these vulnerable areas. Categorized by materials such as glass ionomer, composites, and polyacid-modified glass ionomers, these sealants offer effective protection. This study aims to evaluate the efficacy of glass ionomer-based pit and fissure sealants in terms of retention rate at 12-month post-procedure period in permanent first molars. Methodology This study was conducted at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Fifty-six children, aged 7 to 12 years, presenting with pit and fissure caries in permanent first molar teeth were enrolled. Glass ionomer sealant was meticulously applied to the affected pits and fissures. The efficacy was assessed after 12 months based on predefined criteria. Results The age of participants ranged from 7 to 12 years, with a mean age of 9.24 ± 1.38 years. Among the 56 patients, 23 (41.2%) were male and 33 (58.8%) were female. Sealant retention was noted in 31 (55.35%) patients, while 25 (44.65%) experienced sealant loss. In the 7 to 9-year age group, 19 demonstrated complete sealant retention, whereas in the 10 to 12-year age group, 12 exhibited complete retention. Concerning gender distribution, 17 males and 14 females exhibited complete sealant retention. Conclusion Glass ionomer-based sealants demonstrate excellent properties for pit and fissure sealing owing to their low technique sensitivity, cost-effectiveness, and favorable retention rates. Therefore, they represent an optimal choice for this preventive dental procedure.
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Affiliation(s)
- Amara Nazir
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Humara Iqbal
- Operative Dentistry, Multan Medical & Dental College, Multan, PAK
| | - Asad Mehmood
- Oral Biology, Lahore Medical and Dental College, Lahore, PAK
| | - Muhammad A Khan
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Zunaira Shaukat
- Science of Dental Materials, Multan Medical & Dental College, Multan, PAK
| | - Zaineb Abbas
- Oral Biology, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
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Saleem A, Manzoor A, Nazir A, Iqbal H, Khan MA, Ahmed Z, Sajid M, Kashif M. Examining the Efficacy of 38% Silver Diamine Fluoride in Halting Active Dental Caries Lesions Among Children: A Descriptive Study. Cureus 2024; 16:e56762. [PMID: 38650822 PMCID: PMC11033969 DOI: 10.7759/cureus.56762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND/OBJECTIVES Dental caries, a prevalent issue among children, often leads to discomfort and potential complications. Utilizing caries-arresting treatments to slow down its progression offers a practical alternative. Previous research indicates that topical fluorides can deactivate and remineralize enamel caries. This study aims to evaluate the efficacy of 38% silver diamine fluoride (SDF) in halting active dental caries lesions in children. MATERIALS AND METHODS This descriptive case series was conducted at the Operative Dentistry Department of the Nishtar Institute of Dentistry in Multan, Pakistan. We enrolled 753 patients aged three to nine years, of both genders, each with at least one cavitated lesion graded 3-6 according to the International Caries Detection and Assessment System (ICDAS). SDF was directly applied to dried and isolated teeth using a micro brush and left to absorb for up to two minutes (adjusted based on the child's cooperation), and parents were instructed to ensure the child refrained from eating or drinking for an hour post-application. Baseline examinations were performed by consultant restorative dentists, and reexaminations were conducted after two to three weeks by a consultant unaware of the study. RESULTS The study included children aged three to nine years, with a mean age of 6.02±1.35 years. The majority of patients (61.75%) were aged between three and six years. Among the 753 patients, 619 (82.20%) were male, and 134 (17.80%) were female, with a male-to-female ratio of 4.6:1. The efficacy of 38% SDF in arresting active dental caries lesions in children was observed in 720 (95.62%) patients. CONCLUSION This study demonstrates that 38% SDF is highly effective in halting active dental caries lesions in children.
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Affiliation(s)
- Ayesha Saleem
- Operative Dentistry, Nishtar Institute of Dentistry, Multan, PAK
| | - Afshan Manzoor
- Operative Dentistry, Bakhtawar Amin Dental College and Hospital, Multan, PAK
| | - Amara Nazir
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Humara Iqbal
- Operative Dentistry, Multan Medical and Dental College, Multan, PAK
| | - Muhammad A Khan
- Oral Medicine, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Zohaib Ahmed
- Periodontology, Shahida Islam Medical and Dental College, Lodhran, PAK
| | - Mustafa Sajid
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
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Tyagi IS, Tsui HYC, Chen S, Li X, Mat WK, Khan MA, Choy LB, Chan KYA, Chan TMD, Ng CPS, Ng HK, Poon WS, Xue H. Non-mitotic proliferation of malignant cancer cells revealed through live-cell imaging of primary and cell-line cultures. Cell Div 2024; 19:3. [PMID: 38341593 DOI: 10.1186/s13008-024-00109-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/15/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Anti-mitosis has been a key strategy of anti-cancer therapies, targeting at a fundamental property of cancer cells, their non-controllable proliferation due to overactive mitotic divisions. For improved anti-cancer therapies, it is important to find out whether cancer cells can proliferate independent of mitosis and become resistant to anti-mitotic agents. RESULTS In this study, live-cell imaging was applied to both primary-cultures of tumor cells, and immortalized cancer cell lines, to detect aberrant proliferations. Cells isolated from various malignant tumors, such as Grade-III hemangiopericytoma, atypical meningioma, and metastatic brain tumor exhibit distinct cellular behaviors, including amoeboid sequestration, tailing, tunneling, nucleic DNA leakage, as well as prokaryote-like division such as binary fission and budding-shedding, which are collectively referred to and reported as 'non-mitotic proliferation' in this study. In contrast, benign tumors including Grade-I hemangiopericytoma and meningioma were not obvious in such behaviors. Moreover, when cultured in medium free of any anti-cancer drugs, cells from a recurrent Grade-III hemangiopericytoma that had been subjected to pre-operation adjuvant chemotherapy gradually shifted from non-mitotic proliferation to abnormal mitosis in the form of daughter number variation (DNV) and endomitosis, and eventually regular mitosis. Similarly, when treated with the anti-cancer drugs Epirubicin or Cisplatin, the cancer cell lines HeLa and A549 showed a shift from regular mitosis to abnormal mitosis, and further to non-mitosis as the dominant mode of proliferation with increasing drug concentrations. Upon removal of the drugs, the cells reversed back to regular mitosis with only minor occurrences of abnormal mitosis, accompanied by increased expression of the stem cell markers ALDH1, Sox, Oct4 and Nanog. CONCLUSIONS The present study revealed that various types of malignant, but not benign, cancer cells exhibited cellular behaviors indicative of non-mitotic proliferation such as binary fission, which was typical of prokaryotic cell division, suggesting cell level atavism. Moreover, reversible transitions through the three modes of proliferation, i.e., mitosis, abnormal mitosis and non-mitosis, were observed when anticancer drug concentrations were grossly increased inducing non-mitosis or decreased favoring mitosis. Potential clinical significance of non-mitotic proliferation in cancer drug resistance and recurrence, and its relationship with cancer stem cells are worthy of further studies.
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Affiliation(s)
- Iram Shazia Tyagi
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Ho Yin Calvin Tsui
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Si Chen
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Xinyi Li
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Wai-Kin Mat
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Muhammad A Khan
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Lucas Brendan Choy
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China
| | - Ka-Yin Aden Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tat-Ming Danny Chan
- Division of Neurosurgery & CUHK Otto Wong Brain Tumour Centre, Department of Surgery, The Chinese University of Hong Kong (CUHK), Hong Kong, Hong Kong SAR, China
| | - Chi-Ping Stephanie Ng
- Division of Neurosurgery & CUHK Otto Wong Brain Tumour Centre, Department of Surgery, The Chinese University of Hong Kong (CUHK), Hong Kong, Hong Kong SAR, China
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Sang Poon
- Division of Neurosurgery & CUHK Otto Wong Brain Tumour Centre, Department of Surgery, The Chinese University of Hong Kong (CUHK), Hong Kong, Hong Kong SAR, China.
- Department of Neurosurgery, Neuro-Medical Centre, University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, Guangdong, China.
| | - Hong Xue
- Division of Life Science, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR, China.
- Center for Cancer Genomics, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
- Guangzhou HKUST Fok Ying Tung Research Institute, Science and Technology Building, Nansha Information Technology Park, Nansha, 511458, Guangzhou, China.
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Zaman Q, Khan J, Ahmad M, Khan H, Chaudhary HT, Rehman G, Rahman OU, Shah MM, Hussain J, Jamal Q, Khan BT, Khan MA, Sadeeda, Sahar K, Idrees M, Ahmad R, Faisal MS, Khan MI, Khisroon M, Abdulkareem AA, Lee E, Ryu SW, Bibi N, Muthaffar OY, Jelani M, Naseer MI. Unveiling genetics of non-syndromic albinism using whole exome sequencing: A comprehensive study of TYR, TYRP1, OCA2 and MC1R genes in 17 families. Gene 2024; 894:147986. [PMID: 37956964 DOI: 10.1016/j.gene.2023.147986] [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: 09/20/2023] [Revised: 10/22/2023] [Accepted: 11/10/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Oculocutaneous albinism (OCA) is a group of skin depigmentation disorders. Clinical presentation of OCA includes defects in melanocyte differentiation, melanin biosynthesis, and melanosome maturation and transport. OBJECTIVES A molecular diagnostics study of families presenting oculocutaneous albinism. METHODS In this study, 17 consanguineous OCA families consisting of 93 patients were investigated. Whole Exome Sequencing (WES) of the index patient in each family were performed. Short listed variants of WES were Sanger validated for Mendelian segregation in obligate carriers and other available family members. Variant prioritization and pathogenicity were classified as per the criteria of American College Medical Genetics and Genomics (ACMG). Comparative computational modelling was performed to predict the potential damaging effect of the altered proteins. RESULTS 15 pathogenic variations: c.132 T > A, c.346C > T, c.488C > G, c.1037G > A in TYR, c.1211C > T, c.1441G > A, c.1706_1707insT, c.2020C > G, c.2402G > C, c.2430del, in OCA2, c.1067G > A in TYRP1 and c.451C > T, c.515G > T, c.766C > T, c.917G > A in MC1R genes were identified. Three variants in OCA2 gene were characterized: c.1706_1707insT, c.2430del, and c.2402G > C, all of which were not reported before in OCA families. CONCLUSION A few studies focusing on mutation screening of OCA patients have been reported before; however, this study has uniquely presents the Pakhtun ethnic population residing on the North-Western boarder. It explains that TYR, OCA2, TYRP1, and MC1R variations lead to non-syndromic OCA phenotype The overlapping phenotypes of OCA can precisely be diagnosed for its molecular pathogenicity using WES. This study recommends WES as a first-line molecular diagnostic tool, and provides a basis for developing customized genetic tests i.e. pre-marital screening to reduce the disease burden in the future generations.
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Affiliation(s)
- Qaiser Zaman
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan; Higher Education Department, Peshawar 25120, Government of Khyber Pakhtunkhwa, Pakistan; Department of Zoology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Jamshid Khan
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Mashal Ahmad
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Hamza Khan
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan; Department of Zoology, Islamia College, Peshawar 25120, Pakistan
| | | | - Gauhar Rehman
- Department of Zoology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Obaid Ur Rahman
- Department of Biochemistry, Swat Medical College, Swat 19200, Pakistan
| | - Muhammad M Shah
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Javeria Hussain
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Qaisar Jamal
- Department of Zoology, University of Peshawar, Peshawar 25120, Pakistan
| | - Bakht Tareen Khan
- Department of Zoology, University of Peshawar, Peshawar 25120, Pakistan
| | - Muhammad A Khan
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Sadeeda
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Kalsoom Sahar
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Muhammad Idrees
- Department of Zoology, Government Postgraduate College Dargai, Malakand 23050, Pakistan
| | - Raees Ahmad
- Department of Zoology, Government Postgraduate College Timergara, Dir Lower 18300, Pakistan
| | | | | | - Muhammad Khisroon
- Department of Zoology, University of Peshawar, Peshawar 25120, Pakistan
| | - Angham Abdulrhman Abdulkareem
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia; Faculty of Science, Department of Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Nousheen Bibi
- Department of Bioinformatics, Shaheed Benazir Bhutto Women University, Peshawar 25120, Pakistan
| | - Osama Yousef Muthaffar
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Musharraf Jelani
- Rare Diseases Genetics and Genomics, Centre for Omic Sciences, Islamia College, Peshawar 25120, Pakistan.
| | - Muhammad Imran Naseer
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
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Joseph DT, Bajpai M, Yadav DK, Sharma S, Anand S, Khan MA. Plasma GDNF levels in spinal dysraphism and its relation with neurological impairment in children: A point of care study. J Pediatr Urol 2024; 20:46.e1-46.e8. [PMID: 37858511 DOI: 10.1016/j.jpurol.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/28/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
AIMS GDNF plays a crucial role in the stimulation of recovery, neuroplasticity and synaptic reorganization after spinal cord injury providing neuroprotection and neuroregeneration. Plasma GDNF levels are upregulated in cases of spina bifida owing to the intrauterine damage of the exposed spinal cord. Our aim was to compare the plasma GDNF levels in patients of spina bifida with non-spina bifida cases and assess the correlation with neurological impairment at one year of follow up. METHODS Single centre prospective analysis of cases of spina bifida from 2020 to 2022 at presentation and after one year of follow up post-surgery. Cases with hernia and hydrocele without any other disorders were recruited into the control group. Plasma GDNF levels were assessed with immunoassay kits and compared with neurological involvement. RESULTS 85 cases were included in the study. GDNF levels were elevated in cases compared to controls (mean 6.62 vs 1.76) with significant p value (<0.01). Same was observed for open and closed defects (mean 7.63 vs 4.86: p < 0.01). At follow up of 52 cases post-surgery cases with neurogenic bladder with abnormal urodynamic studies, sphincter involvement and motor impairment had significantly elevated baseline levels of GDNF compared with those who did not have this neurological impairment (p < 0.01). DISCUSSION The neurotrophic factor up-regulation can reflect an endogenous attempt at neuroprotection against the biochemical and molecular cascades triggered by the spinal cord damage. This upregulation can be represented as important biochemical markers of severe spinal cord damage and can be associated with severity of spine injury in MMC patients. Our results are in keeping with these findings, that, there were increased levels of plasma GDNF levels in cases of spinal dysraphism compared to control population. Also, the type of lesion reflecting the severity whether a closed or an open dysraphism, showed significant difference in levels between them suggesting, yet again, more damage in open defect as expected. The levels were higher with involvement of bladder, sphincter and lower limb power. CONCLUSION There is significant elevation of plasma GDNF levels in cases of spina bifida and this elevation is proportional to the degree of spinal damage and hence the neurological impairment. GDNF levels are a good predictor for assessing the severity of the lesion and thus the outcome in these cases. Additional prospective and long-term studies with a larger cohort are needed for a better understanding of neurotrophin pattern modulation in MMC.
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Affiliation(s)
- Delona Treesa Joseph
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Minu Bajpai
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - D K Yadav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sachit Anand
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - M A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
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Ragaban A, Alsharif L, Alshaikh NA, Jafar RJ, Hemeq Z, Khan MA, Gharawi RA, Aldosary T. Prevalence, Etiology, Risk Factors, and Complications of Facial Nerve Palsy at King Abdulaziz Medical City: A Multicenter Study. Cureus 2024; 16:e53403. [PMID: 38435234 PMCID: PMC10908361 DOI: 10.7759/cureus.53403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Facial nerve palsy is a condition of nerve damage that results in impaired facial movement on one or both sides of the face. OBJECTIVES This multicenter study aimed to determine the prevalence of facial nerve palsy and evaluate the association between its risk factors and complications to identify its etiology among patients admitted to King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia, between 2016 and 2023. METHODS A retrospective cross-sectional study was conducted to obtain data from medical records using the best care system for patients with facial nerve palsy. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States), Chi-square test, t-test, and ANOVA. The level of statistical significance was set at p<0.05. RESULTS The study involved 123 patients, with 0.0164% prevalence. Bell's palsy was the most common etiology, accounting for 81.8% of cases, followed by head injuries, dental trauma, otitis media, stroke, and head and neck tumors. Obesity was the most significant risk factor, followed by upper respiratory problems. Hypertension and diabetes exert similar effects. Facial asymmetry, ophthalmic complications, and eye twitching were the most common complaints followed by speech difficulties, psychological and social effects, mouth twitching, and synkinesis. CONCLUSION Facial nerve palsy is common in this region. We recommend health education sessions to increase public awareness and provide preventive strategies to reduce the complications of facial nerve damage. We recommend further research on the association between the risk factors and complications of facial nerve palsy.
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Affiliation(s)
- Ali Ragaban
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Lana Alsharif
- Department of Medical Rehabilitation Sciences/Physiotherapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, SAU
| | | | | | - Ziyad Hemeq
- Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Muhammad A Khan
- Medical Education, King Saud Bin Abdulaziz University, Jeddah, SAU
| | - Raidaa A Gharawi
- Dental Clinic, Jeddah University Medical Centre, Jeddah University, Jeddah, SAU
| | - Taghreed Aldosary
- Medical Sciences-Oral Biology, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, Jeddah, SAU
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Aggarwal P, Krishna Kumar RG, Das CJ, Kubihal V, Subudhi TK, Khan MA, Kumar R. Role of non-contrast CT component of prostate-specific membrane antigen PET/CT scan in the detection of peripheral zone prostate cancer. Br J Radiol 2024; 97:195-200. [PMID: 38263835 PMCID: PMC11027233 DOI: 10.1093/bjr/tqad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/04/2023] [Accepted: 10/19/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE The aim of this study was to look for feasibility of non-contrast CT (NCCT) in detecting peripheral zone prostate cancer (PCa). METHODS A retrospective analysis included 50 biopsy-proven PCa patients between April 2019 and March 2022 who underwent staging whole body prostate-specific membrane antigen (PSMA)/CT prior to treatment. The control subjects were 50 randomly selected adult male patients who underwent PET/CT for non-prostate malignancy during the same time period. Two readers independently calculated the Hounsfield unit (HU) of normal peripheral zone, central zone, and corresponding PSMA avid focus in cases. RESULTS No significant difference was seen in the mean HU value of normal peripheral zone between cases and controls. Significant difference in the mean HU was seen between the PSMA avid focus in cases (40.1 ± 6.2) and normal peripheral zone of cases (28.2 ± 7.0) and controls (27.7 ± 5.8). No significant difference was found between the mean HU values of high-grade PCa and non-high-grade PCa. Receiver operating characteristic (ROC) curve analysis revealed a mean HU cut-off of ≥35 for detecting PCa with a sensitivity and specificity of 86% and 90%, respectively, between cases and controls (AUC 0.88). CONCLUSION Detection of clinically significant PCa is possible on routinely performed NCCT scans. Radiologists should routinely look for and convey these findings to facilitate further work-up and early detection of PCa. ADVANCES IN KNOWLEDGE Our study adds to the knowledge that NCCT scans performed for unrelated indications can serve as a screening tool for clinically significant PCa.
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Affiliation(s)
- Piyush Aggarwal
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - R G Krishna Kumar
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Chandan J Das
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Vijay Kubihal
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - T Kishan Subudhi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - M A Khan
- Department of Bio-statistics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
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Aga SS, Milibari BB, Alqahtani ZS, Alnabihi AN, Alageely AG, Alageely OG, Al Qurashi M, Abed SS, Khawaji B, Khan MA. Assessment of mental health and various strategies among Health Professions' (HP) students: A cross sectional study in King Saud Bin Abdulaziz University for Health Sciences. J Educ Health Promot 2024; 12:457. [PMID: 38464642 PMCID: PMC10920786 DOI: 10.4103/jehp.jehp_681_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/13/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND The education environment of medical colleges is known to have a burdensome effect on the overall mental health of the students. This study aimed to investigate the immediate impact of the medical education environment on mental health and quality of life among Health Profession students and to identify various coping strategies used by students to mitigate the stress. MATERIALS AND METHODS An online survey was conducted between April 1 and May 10, 2021, using a validated questionnaire based on DASS-42, employing a snowball sampling technique. RESULTS A total of 338 students filled the questionnaire. The respondents had a high level of depression and anxiety scores, categorized as very severe which were significantly different among level of education (P < .05), for example, 88.9% of sixth year students had very severe depression compared to just 37% of first year ones. Gender-wise very severe scores varied from lowest 45.8% to 70.3% with comparable results for both males and females. Additionally, more than 30% of the students listed that the amount of material to be covered, lack of time to study the material to be tested, heavy demand to study, concern about trying to learn all the content, and competitiveness among students to be the top reason which affect their mental state of mental health. CONCLUSIONS This study identifies the need to provide the free professional and psychological services to help cope with stress to the health profession students.
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Affiliation(s)
- Syed S Aga
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Baraa B Milibari
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ziyad S Alqahtani
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ahmed N Alnabihi
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abdulaziz G Alageely
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Omar G Alageely
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mansour Al Qurashi
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Sara S Abed
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Bader Khawaji
- Department of Basic Medical Sciences, Quality Assurance Unit, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Muhammad A Khan
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Yousif P, Nahra V, Khan MA, Magrey M. Disease characteristics, pathogenesis, and treatment controversies of axial psoriatic arthritis. Joint Bone Spine 2024; 91:105625. [PMID: 37495073 DOI: 10.1016/j.jbspin.2023.105625] [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: 02/22/2023] [Revised: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
Axial psoriatic arthritis (axPsA) has considerable overlap with axial spondyloarthritis (axSpA) but has some unique features that sometimes preclude classification into axSpA. It has some clinical and radiographic differences compared to axSpA. Imaging typically shows asymmetric syndesmophytes, mainly in the cervical spine, with less frequent sacroiliitis. It more commonly presents later in life and is associated with less severe inflammatory back pain than axSpA. The interleukin (IL) IL-23/IL-17 axis is central to the pathogenesis of both diseases. However, the response to therapies targeting these cytokines has been different. IL-23 inhibitors are ineffective in axSpA but may be effective in psoriatic arthritis (PsA). Recent post hoc analyses of clinical trial data with IL-23 inhibitors in PsA have raised the possibility of their efficacy in axPsA and need evaluation in future clinical trials. Moreover, there is a need for classification criteria for axPsA and better tools to assess therapeutic response.
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Affiliation(s)
- Patrick Yousif
- Division of Rheumatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Vicky Nahra
- Division of Rheumatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Muhammad A Khan
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Marina Magrey
- Division of Rheumatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, United States.
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Nazeer A, Nazir A, Manzoor SA, Khan MA, Shaukat Z, Saleem M, Sajid M, Kashif M. Efficacy of Mineral Trioxide Aggregate (MTA) as a Reparative Material in Iatrogenic Furcal Perforations in Mandibular Molars. Cureus 2024; 16:e53206. [PMID: 38425600 PMCID: PMC10902626 DOI: 10.7759/cureus.53206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND/OBJECTIVES Mineral trioxide aggregate (MTA) is widely recognized as one of the most biocompatible materials for perforation repairs during root canal treatment (RCT). Experimental evidence has consistently demonstrated MTA's superior sealing ability and biocompatibility compared to various dental materials, including amalgam, intermediate restorative material, zinc oxide eugenol cement, and resin-modified glass ionomer cement. This study aimed to assess the efficacy of MTA as a reparative material in iatrogenic furcal perforations during RCT. MATERIALS & METHODS A descriptive cross-sectional study was conducted from May 18, 2021, to November 17, 2021, at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Seventy-six patients aged 18-60 years, of both genders, who developed iatrogenic furcal perforations during procedures were included. Patients with fractures or endo-perio lesions identified during clinical and radiographic examinations were excluded. Isolation was achieved using a rubber dam. The perforation site was cleaned and irrigated with 1% sodium hypochlorite to control hemorrhage and enhance visualization. Following the manufacturer's recommendations, the perforation site was sealed with MTA mixed with sterile saline. RESULTS The age range in this study was 18 to 60 years, with a mean age of 42.09 ± 9.69 years. Most patients (56.78%) were between 41-60 years old. Out of the 76 patients, 46 (60.53%) were male, and 30 (39.47%) were female, resulting in a male-to-female ratio of 1.5:1. The study found that MTA's efficacy as a reparative material in iatrogenic furcal perforations was observed in 61 (80.26%) patients. A 6-month follow-up revealed no periodontal ligament breakdown, demonstrating the efficacy of MTA as a reparative material in iatrogenic furcal perforations. CONCLUSION This study concludes that the efficacy of MTA as a reparative material in iatrogenic furcal perforations is remarkable and significant.
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Affiliation(s)
- Ayesha Nazeer
- Operative Dentistry, Nishtar Institute of Dentistry, Multan, PAK
| | - Amara Nazir
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Syeda A Manzoor
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Muhammad A Khan
- Oral Medicine, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | | | - Mehvish Saleem
- Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Mustafa Sajid
- Operative Dentistry, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
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Lew B, Meir A, Khan AA, Khan MA, Tarre S, Green M. Ammonia gas treatment in low cost biological reactor. Bioresour Technol 2024; 391:129949. [PMID: 37926359 DOI: 10.1016/j.biortech.2023.129949] [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: 08/09/2023] [Revised: 10/20/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
Ammonia gas contributes to a number of environmental and human health concerns. The use of chalk, a cheap alkalinity source may reduce costs for biological systems. This research studies a closed liquid flow reactor to treat ammonia gas using chalk as biomass media and alkalinity source with high value calcium nitrate fertilizer production. The proposed reactor showed complete ammonia gas removal at high rate (500 mg N/L/day) and with low cost; where chalk dissolution and ammonia gas absorption contributed to alkalinity in the water for nitrification. High calcium ion concentration (up to 10,000 mg Ca2+ as CaCO3/L) showed only minor effects on ammonia absorption and nitrification rate.
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Affiliation(s)
- B Lew
- Department of Civil Eng, Ariel University, Israel.
| | - A Meir
- Faculty of Civil and Environmental Engineering, Technion, Israel
| | - A A Khan
- Department of Civil Engineering Jamia Millia Islamia (A Central University), New Delhi, India
| | - M A Khan
- Centre for Rural Development and Technology, Indian Institute of Technology Delhi, Delhi, India
| | - S Tarre
- Faculty of Civil and Environmental Engineering, Technion, Israel
| | - M Green
- Faculty of Civil and Environmental Engineering, Technion, Israel
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13
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Raza H, Hashmi MN, Khan MA, Troncoso M, Christallone A, Alhammouri J, Hafez M, Khan MS, Hejaili F. Etiological Factors Affecting Single Versus Multiple Tunneled Hemodialysis Catheter Cuff Extrusions in the Saudi Population. Cureus 2024; 16:e52906. [PMID: 38406109 PMCID: PMC10893556 DOI: 10.7759/cureus.52906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE To identify underlying factors associated with single versus multiple expulsions of tunneled hemodialysis catheter cuffs and their associated complications. MATERIALS AND METHODS A multicenter, five-year retrospective data analysis was conducted on hemodialysis patients with tunneled catheters. Patient data included age, gender, BMI, and associated comorbidities. The type of procedure (new tunnel insertion vs. exchange), exit site infection, and catheter-related bloodstream infection (CRBSI) were also included. RESULTS The data of 122 patients was analyzed. Seventy-eight patients had diabetes mellitus, 102 patients had hypertension, and 24 had ischemic heart disease. Fifty-one patients were on antiplatelet therapy, and nine patients were on oral steroids. The access site for 98 patients was the right internal jugular; for 19 patients, it was the left internal jugular; five patients had a femoral dialysis catheter. Patients were grouped into two categories: those with single cuff extrusion episodes and those with multiple cuff-out episodes. Sixty-three patients had one cuff extrusion, and 59 had multiple cuff-out episodes during the study period. Patients who had CRBSI and hypertension and were aged between 61 and 95 had multiple episodes of cuff extrusion and reached statistical significance. Exit-site infection, diabetes mellitus, antiplatelet therapy, gender, catheter site, and BMI had no statistical significance between the two groups. CONCLUSION Tunneled catheter cuff extrusion is a frequent phenomenon. Catheter-related bloodstream infection, hypertension, and age of 61 to 95 years are high-risk factors for multiple episodes of cuff extrusion.
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Affiliation(s)
- Hammad Raza
- Nephrology, South Hemodialysis Center, National Guard Health Affairs, Riyadh, SAU
| | | | - Muhammad A Khan
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research, King Abdullah International Medical Research Center, Jeddah, SAU
- Medicine, College of Medicine, King Abdulaziz Medical City, Jeddah, SAU
| | | | | | | | - Mohamed Hafez
- Nephrology, National Guard Health Affairs, Riyadh, SAU
| | | | - Fayez Hejaili
- Nephrology, King Abdulaziz Medical City, Riyadh, SAU
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Khan MA. HLA-B*27 and Ankylosing Spondylitis: 50 Years of Insights and Discoveries. Curr Rheumatol Rep 2023; 25:327-340. [PMID: 37950822 DOI: 10.1007/s11926-023-01118-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
PURPOSE OF REVIEW To commemorate the 50th anniversary of the groundbreaking discovery of a remarkably strong association between HLA-B*27 and ankylosing spondylitis (AS). RECENT FINDINGS In addition to HLA-B*27, more than 116 other recognized genetic risk variants have been identified, while epigenetic factors largely remain unexplored in this context. Among patients with AS who carry the HLA-B*27 gene, clonally expanded CD8 + T cells can be found in their bloodstream and within inflamed tissues. Moreover, the α and β chain motifs of these T-cell receptors demonstrate a distinct affinity for certain self- and microbial-derived peptides, leading to an autoimmune response that ultimately results in the onset of the disease. These distinctive peptide-binding and presentation characteristics are a hallmark of the disease-associated HLA-B*27:05 subtype but are absent in HLA-B*27:09, a subtype not associated with the disease, differing by only a single amino acid. This discovery represents a significant advancement in unraveling the 50-year-old puzzle of how HLA-B*27 contributes to the development of AS. These findings will significantly accelerate the process of identifying peptides, both self- and microbial-derived, that instigate autoimmunity. This, in return, will pave the way for the development of more accurate and effective targeted treatments. Moreover, the discovery of improved biomarkers, in conjunction with the emerging technology of electric field molecular fingerprinting, has the potential to greatly bolster early diagnosis capabilities. A very recently published groundbreak paper underscores the remarkable effectiveness of targeting and eliminating disease-causing T cells in a HLA-B*27 patients with AS. This pivotal advancement not only signifies a paradigm shift but also bolsters the potential for preventing the disease in individuals carrying high-risk genetic variants.
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Affiliation(s)
- Muhammad A Khan
- Case Western Reserve School of Medicine, Cleveland, OH, USA.
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15
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Hashmi MN, Raza H, Khan MA, Rani S, Shaikh MN, Soomro A, Elsoul A, Abdallah AA, Ahmed E, Ismael M, Alharbi E, Hejaili F. Multicenter Study to Validate a Hospitalization Risk Assessment Tool in Hemodialysis Patients. Cureus 2023; 15:e51419. [PMID: 38299137 PMCID: PMC10828751 DOI: 10.7759/cureus.51419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction Protein-energy wasting is a prevalent condition in patients with chronic kidney disease. Our goal was to validate the risk assessment tool (Hashmi's tool) in multiple centers, developed in 2018, as it was easily applicable and cost-effective. Methods The following variables were scored as 0, 1, 2, or 3 as per severity: body mass index, HD vintage in years, functional capacity, serum albumin, serum ferritin, and the number of co-morbid conditions (diabetes mellitus, hypertension, ischemic heart disease, and cerebrovascular disease). This scoring system was applied to maintenance hemodialysis patients in six different centers. The patient's record was evaluated for two years. Patients were divided into low-risk (score <6) and high-risk (score ≥6). We compared the two groups using the chi-square test for the difference in hospitalization and mortality. Results A total of 868 patients' records were analyzed, and the maximum score was 13 with the application of Hashmi's tool. Four hundred twenty-nine patients were in the low-risk group, and 439 patients fell into the high-risk group. Four hundred sixty-seven patients were male, and 401 were females; 84% had hypertension, and 54% had diabetes mellitus. In the high-risk group, we identified more females. Patients' likelihood of being in the high-risk group was higher if they had diabetes mellitus, hypertension, or ischemic heart disease. Hospitalization due to vascular or non-vascular etiologies was more common in the high-risk group (p=0.036 and p<0.001, respectively). A total of 123 patients died during the study period, 92 from the high-risk group as compared to 31 from the low-risk group. This was three times higher and statistically significant (p<0.001). Conclusion Using a simple and cost-effective tool, we have identified malnourished patients who are at risk of hospitalization and mortality. This study has validated the previous work at a single center, which has now been reflected in six dialysis units across Saudi Arabia.
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Affiliation(s)
| | - Hammad Raza
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Muhammad A Khan
- Medical Education, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research, King Abdullah International Medical Research Center, Jeddah, SAU
- Medicine, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Shazia Rani
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | | | - Abdulsalam Soomro
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Ahmed Elsoul
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | | | - Esraa Ahmed
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Maged Ismael
- Hemodialysis, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Eman Alharbi
- Clinical Dietitian, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Fayez Hejaili
- Nephrology, King Abdulaziz Medical City, Riyadh, SAU
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Alahmadi NA, Alzahrani R, Bshnaq AG, Alkhathlan MA, Alyasi AA, Alahmadi AM, Khan MA, Zaidi SF. General Public Knowledge, Attitude, and Practice Regarding the Impact of Air Pollution and Cardiopulmonary Diseases in Jeddah, Saudi Arabia. Cureus 2023; 15:e48976. [PMID: 38024050 PMCID: PMC10657150 DOI: 10.7759/cureus.48976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Air pollution is a critical public health issue associated with various respiratory and cardiovascular diseases. The lungs and heart are the organs most affected by air pollution, and damage to these organs is strongly associated with inhaled particulate matter produced by burning fossil fuels. Household and ambient air pollution have been closely linked to lower respiratory infections, with ambient air pollution alone estimated to be responsible for millions of deaths globally each year. Therefore, this study aimed to assess the general public knowledge attitude and practice regarding air pollution and cardiopulmonary morbidity in Jeddah, Saudi Arabia. Methods The study was conducted in Saudi Arabia using a self-administered questionnaire distributed through popular social media apps. A snowball sampling technique was used, including only Saudi citizens aged 18 or older. The questionnaire consisted of 30 questions derived from a comprehensive literature review on the subject matter. Questions were validated through face validity, pilot testing, and Cronbach's alpha reliability measurement. The questionnaire included questions on demographic data, knowledge of air pollution, the relationship between air pollution and cardiopulmonary diseases, and attitudes and practices toward lowering exposure to air pollution. Results The study included 649 participants, with a mean age of 32.11 ± 13.47 years, and over half were females (54.7%). Most participants were aware of outdoor and indoor air pollution, but only a tiny percentage recognized cooking as a primary indoor source of pollution. However, the majority believed that indoor pollution could contribute to outdoor pollution. Participants associated air pollution with cardiopulmonary diseases, mainly secondhand tobacco smoke and outdoor air pollution caused by factories and industrial facilities. Knowledge and practice levels varied, with older individuals, females, and those in non-health-related occupations having higher levels of knowledge. Positive attitudes, particularly believing that moving to a less polluted area improves health, were associated with better knowledge. Females exhibited better air pollution-related practices, and there was a positive correlation between knowledge and practice scores. Conclusion The study highlighted the need for targeted public health campaigns to improve awareness and promote healthier practices, particularly among young adults, to mitigate the potential health impacts of air pollution, especially cardiopulmonary health.
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Affiliation(s)
- Nawaf A Alahmadi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Rakan Alzahrani
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdullatif G Bshnaq
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Mohammed A Alkhathlan
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Abdulrahman A Alyasi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Abeer M Alahmadi
- Family Medicine, Program of Postgraduate Studies in Family Medicine, Public Health Administration, Ministery of Health, Jeddah, SAU
| | - Muhammad A Khan
- Medical Education, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Syed Faisal Zaidi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Faculty of Eastern Medicine, Hamdard University, Islamabad, PAK
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Alharbi AF, Ali M, Alrefaey YI, Filimban HA, Alhwaity AS, Alamoudi A, Khan MA. Association Between Serum Vitamin D Levels and Body Mass Index Status: A Cross-Sectional Study at King Khalid Hospital, Jeddah, Saudi Arabia, From 2019 to 2020. Cureus 2023; 15:e46927. [PMID: 38021956 PMCID: PMC10640653 DOI: 10.7759/cureus.46927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Low vitamin D levels have been associated more with overweight and obese people in previous studies. One of the possible explanations behind this association is the lipophilic property of vitamin D that causes the vitamin to deposit in adipose tissue and reduces the serum concentration of the vitamin, which still warrants further evaluation. Objective This study estimated the association between serum vitamin D levels and body mass index (BMI) among male patients in Jeddah, Saudi Arabia. Methods This is a cross-sectional study of male patients that was carried out in King Khalid Hospital, Jeddah, Saudi Arabia. Patients were included between October 2019 and November 2020. Results We concluded that almost half of the patients, 1,132 (48.3%), had adequate vitamin D, followed by 773 (33%) with vitamin D inadequacy, and only 288 (12.3%) had vitamin D deficiency. There was a significant relationship between age and vitamin D levels; younger people had lower vitamin D levels compared to older people (p<0.001). It was found that there was no significant relationship between BMI categories and vitamin D levels (p>0.05). Conclusion According to the findings of the current study, there was no discernible relationship between serum vitamin D levels and BMI. However, there was a substantial correlation between age and vitamin D levels, with younger age groups having lower amounts than older individuals. Future studies should adopt a prospective design encompassing multiple centers and preferably include the risk factors for developing vitamin D deficiency, such as sun exposure, dietary habits, comorbidities, etc. Such studies can provide a more accurate assessment of the association between BMI and vitamin D levels.
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Affiliation(s)
- Abdulaziz F Alharbi
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Mohsin Ali
- Family Medicine, Royal College of General Practitioners, London, GBR
- Family Medicine, Royal College of Physicians, London, GBR
- Family Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Yazeid I Alrefaey
- Urology, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Hossein A Filimban
- Family Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Abdulrhman S Alhwaity
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Ahmad Alamoudi
- Pediatrics, King Abdulaziz Medical City in Jeddah, Jeddah, SAU
| | - Muhammad A Khan
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
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18
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Castrillo A, Fasci E, Furtenbacher T, D'Agostino V, Khan MA, Gravina S, Gianfrani L, Császár AG. On the 12C 2H 2 near-infrared spectrum: absolute transition frequencies and an improved spectroscopic network at the kHz accuracy level. Phys Chem Chem Phys 2023; 25:23614-23625. [PMID: 37622426 DOI: 10.1039/d3cp01835k] [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: 08/26/2023]
Abstract
Lamb dips of twenty lines in the P, Q, and R branches of the ν1 + ν3 + ν41 vibrational band of 12C2H2, in the spectral window of 7125-7230 cm-1, have been measured using an upgraded comb-calibrated frequency-stabilized cavity ring-down spectrometer, designed for extensive sub-Doppler measurements. Due to the large number of carefully executed Lamb-dip experiments, and to the extrapolation of absolute frequencies to zero pressure in each case, the combined average uncertainty of the measured line-center positions is 15 kHz (5 × 10-7 cm-1) with a 2-σ confidence level. Selection of the twenty lines was based on the theory of spectroscopic networks (SN), ensuring that a large number of transitions, measured previously by precision-spectroscopy investigations, could be connected to the para and ortho principal components of the SN of 12C2H2. The assembled SN contains 331 highly precise transitions, 119 and 121 of which are in the ortho and para principal components, respectively, while the rest remain in floating components. The para- and ortho-12C2H2 energy-level lists, determined during the present study, contain 82 and 80 entries, respectively, with an accuracy similar to that of the lines. Based on the newly assembled lists of para- and ortho-12C2H2 empirical energy levels, a line list, called TenkHz, has been generated. The TenkHz line list contains 282 entries in the spectral range of 5898.97-7258.87 cm-1; thus far, only 149 of them have been measured directly via precision spectroscopy. The TenkHz line list includes 35 intense lines that are missing in the HITRAN2020 database.
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Affiliation(s)
- Antonio Castrillo
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Eugenio Fasci
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Tibor Furtenbacher
- Laboratory of Molecular Structure and Dynamics, Institute of Chemistry, ELTE Eötvös Loránd University and MTA-ELTE Complex Chemical Systems Research Group, Pázmány Péter sétány 1/A, H-1117 Budapest, Hungary.
| | - Vittorio D'Agostino
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Muhammad A Khan
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Stefania Gravina
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Livio Gianfrani
- Department of Mathematics and Physics, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Caserta, Italy.
| | - Attila G Császár
- Laboratory of Molecular Structure and Dynamics, Institute of Chemistry, ELTE Eötvös Loránd University and MTA-ELTE Complex Chemical Systems Research Group, Pázmány Péter sétány 1/A, H-1117 Budapest, Hungary.
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Law HG, Khan MA, Zhang W, Bang H, Rood J, Most M, Lefevre M, Berglund L, Enkhmaa B. Reducing saturated fat intake lowers LDL-C but increases Lp(a) levels in African Americans: the GET-READI feeding trial. J Lipid Res 2023; 64:100420. [PMID: 37482217 PMCID: PMC10445453 DOI: 10.1016/j.jlr.2023.100420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023] Open
Abstract
Reducing dietary saturated fatty acids (SFA) intake results in a clinically significant lowering of low-density lipoprotein cholesterol (LDL-C) across ethnicities. In contrast, dietary SFA's role in modulating emerging cardiovascular risk factors in different ethnicities remains poorly understood. Elevated levels of lipoprotein(a) [Lp(a)], an independent cardiovascular risk factor, disproportionally affect individuals of African descent. Here, we assessed the responses in Lp(a) levels to dietary SFA reduction in 166 African Americans enrolled in GET-READI (The Gene-Environment Trial on Response in African Americans to Dietary Intervention), a randomized controlled feeding trial. Participants were fed two diets in random order for 5 weeks each: 1) an average American diet (AAD) (37% total fat: 16% SFA), and 2) a diet similar to the Dietary Approaches to Stop Hypertension (DASH) diet (25% total fat: 6% SFA). The participants' mean age was 35 years, 70% were women, the mean BMI was 28 kg/m2, and the mean LDL-C was 116 mg/dl. Compared to the AAD diet, LDL-C was reduced by the DASH-type diet (mean change: -12 mg/dl) as were total cholesterol (-16 mg/dl), HDL-C (-5 mg/dl), apoA-1 (-9 mg/dl) and apoB-100 (-5 mg/dl) (all P < 0.0001). In contrast, Lp(a) levels increased following the DASH-type diet compared with AAD (median: 58 vs. 44 mg/dl, P < 0.0001). In conclusion, in a large cohort of African Americans, reductions in SFA intake significantly increased Lp(a) levels while reducing LDL-C. Future studies are warranted to elucidate the mechanism(s) underlying the SFA reduction-induced increase in Lp(a) levels and its role in cardiovascular risk across populations.
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Affiliation(s)
- Hayley G Law
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Muhammad A Khan
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Wei Zhang
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Heejung Bang
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Marlene Most
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Michael Lefevre
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Nutrition, Utah State University, Logan, UT, USA
| | - Lars Berglund
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA
| | - Byambaa Enkhmaa
- Department of Internal Medicine, School of Medicine, University of California Davis, Davis, CA, USA; Center for Precision Medicine and Data Sciences, School of Medicine, University of California Davis, Davis, CA, USA.
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20
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Suhani, Kumar U, Seenu V, Sodhi J, Joshi M, Bhattacharjee HK, Khan MA, Mathur S, Kumar R, Parshad R. Evaluation of Dual Dye Technique for Sentinel Lymph Node Biopsy in Breast Cancer: Two-Arm Open-Label Parallel Design Non-Inferiority Randomized Controlled Trial. World J Surg 2023; 47:2178-2185. [PMID: 37171588 DOI: 10.1007/s00268-023-07036-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Radioisotope and blue dye are standard agents for performing sentinel lymph node (SLN) biopsy in breast cancer. The paucity of nuclear medicine facility poses logistic challenge. This study evaluated performance of radioisotope & methylene blue (MB) with indocyanine green (ICG) and MB for SLNB. PATIENTS AND METHODS This randomized controlled trial was conducted from December 2019 to July 2022 comparing SLN identification proportions of radioisotope-blue dye [Group A] with dual dye (MB + ICG; Group B]. Secondary objective included time required and cost effectiveness of performing SLNB. Sample size of 70 (35 in each arm) was calculated. Upfront operable node negative early breast cancer was included in the study. Clinico-demographic data, number & type of SLN, time taken were noted. Cost analysis was done including the equipment, manpower & consumables. Chi-square/Fisher exact test was used to compare proportion between two groups. p value of less than 0.05 was considered to represent statistical significance. RESULTS Seventy patients randomized to either group were similar in clinico-demographic and tumor characteristics. SLN identification rate (IR) was 91.43% in group A and 100% in group B. Overall IR of MB, radioisotope and ICG were 91.43%, 91.43% and 100%, respectively. Mean number of SLNs identified were 3 in group A and 4 in group B. Median time required for SLNB was 12 min and 14 min in either group, respectively. Cost of performing SLNB was higher in Group B. CONCLUSION SLNB using dual dye is non-inferior to radioisotope-blue dye in upfront operable early breast cancer. Trial registration number Clinical Trial registry India CTRI/2020/02/023503.
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Affiliation(s)
- Suhani
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India.
| | - Utkarsh Kumar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India
| | - V Seenu
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India
| | - Jitendar Sodhi
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Mohit Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India
| | - H K Bhattacharjee
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India
| | - M A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajinder Parshad
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Masjid Moth campus, Ansari Nagar East, New Delhi, India
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Marghalani YO, Kaneetah AH, Khan MA, Albakistani AA, Alzahrani SG, Kidwai A, Alansari KW, Alhamid HS, Alharbi MH, Attar A. Neurological Manifestations in Hospitalized Geriatric Patients With COVID-19 at King Abdulaziz Medical City in Jeddah, Western Region, Saudi Arabia From 2020 to 2021: A Cross-Sectional Study. Cureus 2023; 15:e45759. [PMID: 37876390 PMCID: PMC10591530 DOI: 10.7759/cureus.45759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction COVID-19 involvement in the nervous system has been reported in many cases. Viral neuroinvasion has multiple routes of entry. Neurological manifestations of COVID-19 can be divided into ones of the central nervous system (CNS), such as headache, dizziness, altered mental status, ataxia, and seizure, and of the peripheral nervous system (PNS), including ageusia, anosmia, acute illness demyelinating polyneuropathy, and neuralgia. Aim and objectives This study aims to observe and report the neurological manifestations in geriatric patients who were diagnosed with COVID-19 at KAMC-J and report the duration of admission to the in-patient and ICU wards. Methods This was a cross-sectional study conducted on admitted geriatric patients with PCR-confirmed COVID-19 from April 1, 2020 to June 30, 2021 at KAMC-J. Using Raosoft®, the sample size was estimated with a CI of 95% and a 36.4% prevalence of neurological symptoms in COVID-19 patients to be 289. Convenience sampling was used, and the data were collected from BESTCare EMRs. IBM SPSS Statistics for Windows, Version 20 (Released 2011) was used for descriptive and inferential statistical analysis. Results In this study, a total of 290 patients' data were collected, 161 (55.5%) of which were males. In addition, the median age was 71 (Q1-Q3: 65-78) years; furthermore, the median body mass index (BMI) was 30(Q1-Q3: 25-34) kg/m2. In descending order, the most prevalent comorbidities were hypertension (HTN) (70.3%), diabetes mellitus (DM) (68.6%), cardiac disease (42.1%), chronic kidney disease (26.6%), neurological disease (23.6%), cancer malignancy (13.1%), and finally chronic respiratory disease (11.4%). Regarding typical COVID-19 manifestations, 181 patients claimed to have experienced cough (62.4%), dyspnea by 164 (56.7%), fever by 154 (53.5%), fatigue by 93 (32.3%), a reading of anoxia by 68 (23.4%), abdominal pain by 58 (20.0%), diarrhea by 56 (19.4%), and finally throat pain by 19 (6.6%). Manifestations and pathologies of the CNS included headache (25.4%), dizziness (21.5%), impaired consciousness (17.2%), delirium (6.6%), ischemic stroke (4.1%), focal cranial nerve dysfunction (2.8%), seizure (2.8%), intracerebral hemorrhage (ICH) (0.3%), and ataxia (0.3%). Moreover, pathologies of the PNS manifested as taste impairment in 46 patients (15.9%), smell impairment in 33 (11.4%), nerve pain in 7 (24%), visual impairment in 5 (1.7%), Bell's palsy in 2 (0.7%), and Guillain-Barre syndrome in 1 (0.3%). Moreover, the majority of patients who developed an ischemic stroke or ICH, or required admission to the ICU had either DM or HTN. In addition, 17 (25.4%) of the 67 patients admitted to the ICU developed impaired consciousness. All-cause mortality in our study was 31 (10.71%) cases. Conclusion Neurological manifestations of COVID-19 are common and can result in serious complications if not detected and managed early, especially in the elderly. These complications are mostly seen in severely ill patients and may be the only symptoms in COVID-19 patients. In addition, patients' clinical conditions could deteriorate rapidly and result in significant morbidity and mortality. Therefore, a high index of suspicion is required among healthcare providers when dealing with such cases. Moreover, we recommend systematically collecting data on the short- and long-term neurological complications of COVID-19 globally and documenting the functional long-term outcomes after these complications.
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Affiliation(s)
- Yasir O Marghalani
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdulrahman H Kaneetah
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Unit of Postgraduate Education, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, SAU
| | - Muhammad A Khan
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Medical Education, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ammar A Albakistani
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Sultan G Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Unit of Postgraduate Education, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, SAU
| | - Abdulbari Kidwai
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Khalid W Alansari
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Hamid S Alhamid
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Muath H Alharbi
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ahmed Attar
- Department of Neuroscience, Ministry of National Guard Health Affairs, Jeddah, SAU
- Department of Medicine, Ministry of National Guard Health Affairs, Jeddah, SAU
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Department of Medicine, Hamilton Health Sciences, Hamilton, CAN
- Department of Medicine, McMaster University, Hamilton, CAN
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Sherlock D, Labchuk A, Hussain U, Khan MA, Wlodkowski P, Patel N. Late Presentation of Acute Coronary Syndrome Complicated by Ventricular Septal Rupture. Cureus 2023; 15:e43427. [PMID: 37706137 PMCID: PMC10495692 DOI: 10.7759/cureus.43427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/15/2023] Open
Abstract
Acquired ventricular septal rupture (VSR) is a rare but potentially fatal complication of late-presenting myocardial infarction (MI). In the era of revascularization and reperfusion therapy, the incidence of VSR has significantly decreased. Ruptures occur predominantly in patients with late-presenting ST elevation MI. Patients may present with a wide variety of symptoms ranging from chest pain and mild hemodynamic instability to profound cardiogenic shock. Inotropes, vasopressors, and mechanical support with intra-aortic balloon pumps and extracorporeal membrane oxygenation can be used to bridge patients to surgery. Despite treatment with ventricular septal repair, postsurgical mortality remains high. There is a wide variety of complications that can occur in the postoperative period. A multidisciplinary approach is vital in these patients who develop VSR. Improving awareness among healthcare professionals regarding the symptoms of acute coronary syndrome can hopefully help prevent delayed presentation of patients to healthcare facilities.
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Affiliation(s)
- Daniel Sherlock
- Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, USA
| | - Andrii Labchuk
- Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, USA
| | - Umar Hussain
- Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, USA
| | - Muhammad A Khan
- Cardiology, Advocate Lutheran General Hospital, Park Ridge, USA
| | | | - Nishant Patel
- Cardiology, Advocate Lutheran General Hospital, Park Ridge, USA
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Khan MA, Sartor L, Seyed-Razavi Y, Samarawickrama C. Combine and conquer: The case for an Australian and New Zealand cataract surgery registry. Clin Exp Ophthalmol 2023; 51:642-643. [PMID: 37211414 DOI: 10.1111/ceo.14239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/23/2023]
Affiliation(s)
- Muhammad A Khan
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
- Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical Research, Sydney, New South Wales, Australia
| | - Lauren Sartor
- Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical Research, Sydney, New South Wales, Australia
| | - Yashar Seyed-Razavi
- Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical Research, Sydney, New South Wales, Australia
| | - Chameen Samarawickrama
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
- Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Translational Ocular Research and Immunology Consortium (TORIC), Westmead Institute of Medical Research, Sydney, New South Wales, Australia
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Khan MA, Muhammad S, Mehdi H, Parveen A, Soomro U, Ali JF, Khan AW. Surgeon's Experience May Circumvent Operative Volume in Improving Early Outcomes After Pancreaticoduodenectomy. Cureus 2023; 15:e42927. [PMID: 37667689 PMCID: PMC10475154 DOI: 10.7759/cureus.42927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/06/2023] Open
Abstract
Introduction Pancreaticoduodenectomy (PD) is a complex procedure with a significant proportion of postoperative complications and improving but notable mortality. PD was the prototype procedure that initiated the lingering debate about the relationship of better operative outcomes when performed at higher-volume centers. This has not translated into practice. Impediments include the absence of a universally accepted definition of a high-volume center among others. Contrary evidence suggests equivalent outcomes for PD at low-volume centers when performed by experienced hepatobiliary surgeons. We reviewed our perioperative outcomes for PD from an earlier period as a low-volume center with an experienced team. Methods A longitudinal study of all PDs completed in our department between 2012 and 2017 was performed. Results A total of 28 PD were performed during this period. Pylorus-preserving PD was performed in 23 patients and classical PD in the remaining. A separate Roux-en-Y loop was used for high-risk pancreatic anastomosis in six cases. The mean patient age was 49.3±12.4 years. The male-to-female ratio was 1.3:1. Preoperative drainage procedures were carried out in 19 patients. The mean serum total bilirubin level was 3.98(±4.5) mg/dL. There was no 90-day mortality. Postoperative complications included wound infection in 10 (36.7%) and respiratory complications in 10 (36.7%) patients. Postoperative bleeding requiring intervention occurred in one patient, and two patients had an anastomotic leak (one pancreatojejunostomy (PJ) and one gastrojejunostomy (GJ)). Delayed gastric emptying (DGE) was noted in three (10.7%) patients. The mean length of hospital stay was 14±7 days. The median overall survival (OS) was 84 months. Conclusion Comparable early outcomes can be achieved at low-volume centers for patients undergoing PD with an experienced team, optimal patient selection, and the ability to rescue for complications.
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Affiliation(s)
- Muhammad A Khan
- Hepato-Pancreato-Biliary (HPB) Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
- Transplant Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
| | - Shah Muhammad
- Hepato-Pancreato-Biliary (HPB) Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
- Transplant Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
| | - Haider Mehdi
- Transplant Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
| | - Abida Parveen
- Hepato-Pancreato-Biliary (HPB) Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
| | - Uzma Soomro
- Hepato-Pancreato-Biliary (HPB) Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
| | | | - Abdaal W Khan
- Hepato-Pancreato-Biliary (HPB) Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
- General Surgery, Sindh Institute of Medical Sciences, Karachi, PAK
- Transplant Surgery, Sindh Institute of Urology and Transplantation, Karachi, PAK
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Reeves PT, James-Davis L, Khan MA. Gastrointestinal Bleeding in the Neonate: Updates on Diagnostics, Therapeutics, and Management. Neoreviews 2023; 24:e403-e413. [PMID: 37391655 DOI: 10.1542/neo.24-6-e403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Gastrointestinal bleeding (GIB) is a relatively uncommon presentation in the NICU. GIB in neonates includes a broad spectrum of disease morbidity, from minor reflux symptoms and growth failure to severe, clinically significant anemia requiring critical care resuscitation. Over the last several years, multiple diagnostic tools including fecal calprotectin and bedside ultrasonography have emerged and demonstrated utility in the early recognition of sources for GIB in neonates. Further evidence has continued to show that traditional medical therapy with intravenous proton pump inhibitors is well-tolerated, and that upper endoscopy has limited diagnostic and therapeutic value. Finally, additional research and quality improvement investigations are warranted to determine how best to prevent, recognize, and manage GIB in critical neonates.
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Affiliation(s)
- Patrick T Reeves
- Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Muhammad A Khan
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
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26
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Lamy SH, Mohammedkhalil AK, Bafaqeeh HM, Alsuwaida SA, Alhindi ASK, Maqboli SA, Khan MA. Efficacy of varicocelectomy on semen parameters and conception rates. Urol Ann 2023; 15:256-260. [PMID: 37664101 PMCID: PMC10471810 DOI: 10.4103/ua.ua_49_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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/08/2022] [Indexed: 09/05/2023] Open
Abstract
Objective Varicocele, the dilation of the pampiniform plexus of the spermatic cord. It is discovered incidentally in most patients. Symptoms vary, but its impact is especially experienced in the field of fertility and reflected in semen parameters. Varicocelectomy is a surgical approach to correct the varicocele, however, reports are conflicting regarding its success. Our aim was to evaluate the efficacy of varicocelectomy on semen parameters and conception rates in patients who underwent surgery and its association with comorbidities such as diabetes, hypertension, and obesity. Materials and Methods This cross-sectional study included the complete medical records of 86 patients. Data collection form included the patient's age, body mass index (BMI), chronic diseases, smoking, surgical history, medication usage, and the reason for performing surgery. Presurgical and postsurgical semen parameters were evaluated 3 months before surgery and an average of 6 months postoperatively. Data were analyzed with SPSS, Chi-square test, and independent and paired t-test. Results No significant difference was found between primary and secondary infertility regarding semen analysis, postoperative semen analysis indicated an improvement in semen motility at 180 min with no effect on other parameters. Using spontaneous intercourse or in vitro fertilization (IVF) after varicocelectomy was significantly associated with increasing conception rates irrespective of the type of infertility. Diabetes, hypertension, BMI, and smoking did not appear to affect semen parameters. Conclusion Patients who underwent varicocelectomy had improved sperm motility at 180 min and subsequently had a higher chance of successful conception either through spontaneous intercourse or IVF. Further studies are needed to understand the relationship between conception and sperm motility. Semen parameters were not affected if the patient had comorbidities such as diabetes and hypertension. Furthermore, smoking and BMI did not appear to affect the conception rate.
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Affiliation(s)
- Salahadin H Lamy
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah K Mohammedkhalil
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hashim M Bafaqeeh
- Department of Surgery, Urology Section, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shatha A Alsuwaida
- Department of Surgery, Urology Section, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adel S Khan Alhindi
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Sara A Maqboli
- Department of Surgery, Urology Section, College of Medicine, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Muhammad A Khan
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Alzahrani MA, Almhmd A, Khan MA, Badriq F, Salman B, Aljaziri ZY, Alotaibi N, Alkhamees M, Almutairi S, Ahmad MS, Alkhateeb S. Women as Urologists in Saudi Arabia: Career Choice and Practice Challenges: A Comparative Cross-Sectional Study. Res Rep Urol 2023; 15:273-289. [PMID: 37396016 PMCID: PMC10314780 DOI: 10.2147/rru.s412713] [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: 03/15/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
Background There is limited research on whether women choose urology as a future career. Therefore, we aimed in this study to assess the influencing and challenging factors among female physicians in Saudi Arabia. Methods We approached 552 female physicians, including 29 (5.2%) urologists and 523 (94.7%) non-urologists. A cross-sectional survey was carried out, which included five sections and 46 items to assess and compare the perspectives of (urologists and non-urologists regarding influencing factors to choose urology, challenges toward applying to urology, and challenges during and after urology residency. Statistical analysis was conducted using SPSS software. Responses were presented as frequencies and percentages, while associations were studied using the Chi-squared test/Fisher's exact test. A p-value of ≤ 0.05 was considered significant. Results Out of 552 female physicians, 466 completed the survey. The survey items compared urologists and non-urologists among female physicians. Among both cohorts, the most influencing factors in choosing urology were the diversity of practice and urological procedures (p =0.002, p<0.001). There were no social barriers or challenges when applying for urology residency (p<0.001). Overall, the majority of female urologists reported a high level of agreement that they have more time to work at the clinic (55.2%), they are satisfied as they are currently being urologists (75.8%), satisfied with their current lifestyle (72.6%). They would choose urology again as a future career (58.6%). Non-urologist female physicians 326 (74.6%) think they are more likely to have experienced gender discrimination than urologists 15 (51.7%) (p<0.001). Female urologists were less likely to face social barriers when applying for urology residency than non-urologists (p<0.001). Conclusion As urologists, we must understand women's struggles, such as gender discrimination, a lack of academic advancement, and a lack of mentorship. To foster women's careers in urology, we must understand their unique needs, provide adequate mentorship, exterminate gender discrimination bias, and improve mentorship.
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Affiliation(s)
- Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Abdalah Almhmd
- College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Muhammad A Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), Jeddah, Saudi Arabia
| | - Feras Badriq
- Division of Urology, Department of Surgery, East Jeddah General Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Budoor Salman
- Department of Urology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Zainab Y Aljaziri
- Department of Family Medicine, Al Ahsa Health Cluster, Ministry of Health, Al Ahsa, Saudi Arabia
| | - Naif Alotaibi
- King Salman Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohammad Alkhamees
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Sulaiman Almutairi
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Sultan Alkhateeb
- Department of Urology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Abu Jawdeh BG, Khan MA. A single-center experience of post-transplant atypical hemolytic uremic syndrome. Clin Nephrol 2023:CN111160. [PMID: 37288831 DOI: 10.5414/cn111160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/09/2023] Open
Abstract
PURPOSE Atypical hemolytic uremic syndrome (aHUS) is a genetic-based thrombotic microangiopathy (TMA) that is mediated by the activation of the alternative complement pathway. Heterozygous deletion in CFHR3-CFHR1 occurs in 30% of the general population and has not been classically linked to aHUS. Post-transplant aHUS has been associated with a high rate of graft loss. Herein, we report our case series of patients who developed aHUS after solid-organ transplantation. MATERIALS AND METHODS Five consecutive cases of post-transplant aHUS were identified at our center. Genetic testing was performed in all but one. RESULTS One patient had a presumed TMA diagnosis before transplant. One heart and 4 kidney (KTx) transplant recipients were diagnosed with aHUS based on the clinical picture of TMA, acute kidney injury, and normal ADAMTS13 activity. Genetic mutation testing revealed heterozygous deletion in CFHR3-CFHR1 in 2 patients and a heterozygous complement factor I (CFI) variant of uncertain clinical significance (VUCS) (Ile416Leu) in a third. Four patients were on tacrolimus, 1 had anti-HLA-A68 donor-specific antibody (DSA), and another had borderline acute cellular rejection at the time of aHUS diagnosis. Four responded to eculizumab, and 1 out of 2 patients came off renal replacement therapy. One KTx recipient died from severe bowel necrosis in the setting of early post-transplant aHUS. CONCLUSION Calcineurin inhibitors, rejection, DSA, infections, surgery, and ischemia-reperfusion injury are common triggers that could unmask aHUS in solid-organ transplant recipients. Heterozygous deletion in CFHR3-CFHR1 and CFI VUCS may be important susceptibility factors acting as the first hit for alternative complement pathway dysregulation.
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Anwar F, Warsi A, Ahmed J, Zaidi B, Turab A, Khan MA, Khan KS. The effectiveness of kangaroo mother care in lowering postpartum depression in mothers of preterm and low birth weight babies: a systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:2841-2848. [PMID: 37941566 PMCID: PMC10631594 DOI: 10.1097/ms9.0000000000000480] [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: 09/16/2022] [Accepted: 03/20/2023] [Indexed: 11/10/2023] Open
Abstract
Background Kangaroo mother care (KMC) intervention involves skin-to-skin contact between mother and infant. Some studies have shown a decrease in postpartum depression (PPD) in mothers of preterm and low birth weight (LBW) infants. However, the literature is scattered and of variable quality. Aims To conduct a systematic review of available literature and provide a comprehensive picture of the effect of KMC on PPD among mothers of preterm and LBW infants. Methods The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. After PROSPERO registration, a systematic search was conducted using PubMed, Cochrane Central Library, and Google Scholar from the inception of the databases till 14 June 2021. Of the 2944 studies assessed for titles and abstracts, nine studies with 2042 participants were included in the review. Included articles targeted mothers with LBW (<2500 g) or preterm infants (<37 weeks), used an authentic PPD tool, and had standard care or an incubator as the control group. Studies not published in English and in which mothers had a previous psychiatric illness were excluded. The risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized control trials and the Newcastle-Ottawa Scale for observational studies. All the results were converted to standard mean deviation and pooled together using a random-effects model with a 95% CI. A P-value of less than 0.05 is considered significant. Results KMC Intervention was significantly associated with a lower depression score than control groups. The reduction in depression in the intervention (KMC) group was moderate: SMD=-0.38 (-0.68 to -0.08; 95% CI; I 2=86%; P=0.013). No significant difference was found between the PPD scores of both groups using the Edinburgh Postpartum Depression Scale score. Conclusions The authors conclude that the negative effects of LBW and preterm birth experience on maternal mental health can be avoided to a moderate degree by KMC. Due to a lack of methodological uniformity, different scales for outcome measurement, and discrepancies in intervention features, significantly high heterogeneity was detected. The authors need further larger-scale studies with a uniform study design to better predict the efficacy of KMC better.
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Affiliation(s)
- Farah Anwar
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Arshia Warsi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Jawad Ahmed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Butool Zaidi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Areeba Turab
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad A. Khan
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Toru HK, Aman Z, Ali MH, Kundi W, Khan MA, Ali F, Khan S, Zahid MJ, Jan ZU. Compliance With the World Health Organization Surgical Safety Checklist at a Tertiary Care Hospital: A Closed Loop Audit Study. Cureus 2023; 15:e39808. [PMID: 37398744 PMCID: PMC10313906 DOI: 10.7759/cureus.39808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The WHO launched the "Safe Surgery Saves Lives" campaign in 2008 to improve patient safety during surgery. The campaign includes the use of the WHO Surgical Safety Checklist, which has been proven effective in reducing complications and mortality rates in several studies. This article discusses a clinical audit at a tertiary healthcare facility that assesses compliance with all three components of the checklist to minimize errors and improve safety standards. MATERIALS AND METHODS This prospective, observational, closed-loop clinical audit study was conducted at Hayatabad Medical Complex, a tertiary care public sector hospital located in Peshawar, Pakistan. The audit aimed to assess compliance with the WHO Surgical Safety Checklist. The first phase of the audit cycle commenced on October 5, 2022, and involved collecting data from 91 surgical cases in randomly selected operating rooms. Following the completion of the first phase on December 13, 2022, an educational intervention was then conducted on December 15 to underscore the significance of adhering to the checklist, and the second phase of data collection began the following day, ending on February 22, 2023. The results were analyzed using SPSS Statistics version 27.0. RESULTS The first phase of the audit showed that there was poor compliance with the latter two parts of the checklist. Certain components of the WHO Surgical Safety Checklist were well-complied with, including patient identity confirmation (95.6%), obtaining informed consent (94.5%), and counting of sponges and instruments (95.6%), while the lowest compliance rates were in recording allergies (26.3%), assessing blood loss risk (15.3%), introducing team members (62.6%), and inquiring about patient recovery concerns (64.8%, 34%, and 20.8% for surgeons, anesthetists, and nurses, respectively). In the second phase, after an educational intervention, compliance with the checklist improved significantly, particularly for those components with low compliance rates in the first phase, marking recording allergies (89.0%), introducing team members 91.2%), and inquiring about patient recovery concerns (79.1%, 73.6%, and 70.3% for surgeons, anesthetists, and nurses, respectively). CONCLUSION The study showed that education is a critical factor in improving compliance with the WHO Surgical Safety Checklist. The study suggests that overcoming the obstacles to implementing the checklist requires a collaborative environment and effective instruction. It emphasizes the importance of adhering to the checklist in all surgical settings.
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Affiliation(s)
- Hamza K Toru
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | - Zahid Aman
- General Surgery, Hayatabad Medical Complex, Peshawar, PAK
| | | | - Waqas Kundi
- General Surgery, Hayatabad Medical Complex, Peshawar, PAK
| | | | - Fawad Ali
- General Surgery, Hayatabad Medical Complex, Peshawar, PAK
| | - Shandana Khan
- General Surgery, Hayatabad Medical Complex, Peshawar, PAK
| | | | - Zaka Ullah Jan
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
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Zaidi SF, Hakami AY, Khan MA, Khalid AA, Haneef AK, Natto SS, Mastour MA, Alghamdi RF. The Awareness and Practice of Self-Medication Among the General Public in Jeddah and Makkah. Cureus 2023; 15:e39706. [PMID: 37398702 PMCID: PMC10309079 DOI: 10.7759/cureus.39706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 07/04/2023] Open
Abstract
Background Self-medication (SM) can be defined as the improper practice of obtaining and consuming a pharmaceutical drug without the consultation or prescription of a licensed physician. This includes evaluating the intensity of signs and symptoms which could lead to treating oneself with a medicine or seeking urgent medical care. Although SM can be deemed as safe for one's health, drug accessibility accounts for an irrational choice of medicines and thus exposes oneself to the adverse effects of these medicines. Several regional studies have provided sufficient evidence about how SM has commonly been practiced and held in some settings, such as pharmacies. Aim In this study, we aimed to assess the practice and awareness of SM in the general public. Thus, we utilized a questionnaire-based survey to analyze SM awareness and practice among the general population in Jeddah and Makkah. In addition, we examined the impact of demographic variables, such as educational level, economic status, age, etc. on SM practice. Methods A cross-sectional survey was distributed via social media platforms in June 2020. The study included Jeddah and Makkah's general public, all different nationalities, and both genders, and it excluded participants below the age 18-year-old and with mental and cognitive instability. After extrapolating the sample size at a 95% confidence level with an estimated 50% response distribution, a margin of error ±5%, and accounting for a 5% non-response rate, the estimated sample size was determined to be 404. Results A total of 642 participants completed the online-based survey, but only 472 responses fit the study criteria. Most of the participants (64.6%) did not consult with a physician, i.e., practiced SM, whereas (34.5%) have visited a doctor. Furthermore, people who did not visit a doctor had the commonest belief (26.1%) that they did not need a doctor to investigate their symptoms. The awareness of SM among the general public in Makkah and Jeddah was assessed by asking whether they deem this practice harmful, harmless, or beneficial. 65.9% of the participants deemed the practice of SM as harmful, and 17.6% regarded the act as harmless. Conclusion This study revealed that 64.6% of the general public of Jeddah and Makkah practice self-medication, even though 65.9% deemed this act harmful. The contradiction between the public's opinion and the actual behavior towards self-medication implies the need for more awareness of self-medication and the importance of exploring the incentives of such behavior.
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Affiliation(s)
- Syed F Zaidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Faculty of Eastern Medicine, Hamdard University Islamabad Campus, Islamabad, PAK
| | - Alqassem Y Hakami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Muhammad A Khan
- Medical Education, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Adil A Khalid
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Ahmed K Haneef
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Safwan S Natto
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Mohammed A Mastour
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Rayan F Alghamdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- Medical Research, King Abdullah International Medical Research Center, Jeddah, SAU
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Khan S, Rizwan Umer M, Ali Z, Khan MA, Raza A, Nadeem A, Hassan MR, Mumtaz H. The impact of epidural analgesia for acute pancreatitis on maternal and fetal outcome: a cohort study. Ann Med Surg (Lond) 2023; 85:1475-1479. [PMID: 37229035 PMCID: PMC10205265 DOI: 10.1097/ms9.0000000000000429] [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: 12/14/2022] [Accepted: 03/12/2023] [Indexed: 05/27/2023] Open
Abstract
It is anticipated that between 1 in 10, 000 and 1 in 30, 000 pregnancies will be affected by acute pancreatitis (AP). The authors wanted to evaluate the impact of epidural analgesia on maternal and fetal outcomes and its effectiveness in the pain treatment of obstetric patients with AP. Methodology The period for this cohort research was from January 2022 to September 2022. Fifty pregnant women with AP symptoms were enrolled in the study. Conservative medical management was done using intravenous (i.v.) analgesics, including fentanyl and tramadol. Fentanyl was infused i.v. at a rate of 1 µg/kg every hour, while tramadol was bolused i.v. at 100 mg/kg every 8 h. Boluses of 10-15 ml of 0.1% ropivacaine were injected into the L1-L2 interspace at 2-3-h intervals to provide high lumbar epidural analgesia. Results In this study, 10 patients were given an i.v. infusion of fentanyl, and 20 patients were given tramadol boluses. Epidural analgesia showed the most promising results decreasing the visual analog scale score from 9 to 2 in half of the patients. Most fetal complications were noticed in the tramadol group, including prematurity, respiratory distress, and babies requiring noninvasive ventilation. Conclusion Patients with AP during pregnancy may benefit from a new technique for simultaneous analgesia during labor and cesarean section administered via a single catheter. When AP is detected and treated during pregnancy, the mother and child benefit from pain control and recovery.
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Affiliation(s)
| | | | | | | | - Amna Raza
- KRL General Hospital, Islamabad, Pakistan
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Alzahrani BA, Alsharm FS, Salamatullah HK, Sulimany HH, Kashab MA, Khan MA. The Recurrence of Symptoms After Anterior Cervical Discectomy and Fusion. Cureus 2023; 15:e39300. [PMID: 37346208 PMCID: PMC10281543 DOI: 10.7759/cureus.39300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives This study aimed to evaluate the recurrence symptoms rate after anterior cervical discectomy and fusion (ACDF) for one year and seek the common cervical vertebral disk affected in a tertiary center in Saudi Arabia over the past five years. Methods This is a single-center, cross-sectional study conducted on patients followed in our center from January 2016 to December 2022. All patients who were older than 18 and underwent ACDF were included. Results Out of 77 patients, 43 (55.8%) have experienced a recurrence of symptoms after the ACDF operation. The highest rate of recurrent symptoms was neck pain 22 (28.6%), left upper limb numbness 20 (26%), and right upper limb numbness 16 (20.8%). It was found that shoulder pain recurred after one level of ACDF in six patients out of 10 (60%), and only one (10%) patient experienced shoulder pain after two-level ACDF. Conclusion ACDF has a high rate of recurrence of symptoms, and the most common type of ACDF was two levels. Most symptoms were neck pain and upper limb radicular pain. However, there is a lack of studies. We recommend conducting more studies on the secondary management of recurrent symptoms post-ACDF.
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Affiliation(s)
- Basil A Alzahrani
- Orthopedics, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Faisal S Alsharm
- Orthopedics, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU, Jeddah, SAU
| | - Hassan K Salamatullah
- Orthopedics, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Hani H Sulimany
- Orthopedic Surgery: Orthopedic Spine Surgery and Arthroscopy, King Abdulaziz Medical City / Ministry of National Guard - Health Affairs, Jeddah, SAU
| | - Mohammed A Kashab
- Orthopedic Surgery: Orthopedic Spine Surgery and Arthroscopy, King Abdulaziz Medical City / Ministry of National Guard - Health Affairs, Jeddah, SAU
| | - Muhammad A Khan
- Medical Education, King Saud Bin Abdulaziz University, Jeddah, SAU
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Magrey M, Walsh JA, Flierl S, Howard RA, Calheiros RC, Wei D, Khan MA. The International Map of Axial Spondyloarthritis Survey: A US Patient Perspective on Diagnosis and Burden of Disease. ACR Open Rheumatol 2023; 5:264-276. [PMID: 37095710 PMCID: PMC10184009 DOI: 10.1002/acr2.11543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that causes inflammation in the axial skeleton, resulting in structural damage and disability. We aimed to understand the effect of axSpA on work activity, day-to-day function, mental health, relationships, and quality of life and to examine barriers to early diagnosis. METHODS A 30-minute quantitative US version of the International Map of Axial Spondyloarthritis survey was administered online to US patients aged 18 years and older with a diagnosis of axSpA who were under the care of a health care provider from July 22 to November 10, 2021. This analysis describes demographics, clinical characteristics, journey to axSpA diagnosis, and disease burden. RESULTS We surveyed 228 US patients with axSpA. Patients had a mean diagnostic delay of 8.8 years, with a greater delay in women versus men (11.2 vs. 5.2 years), and 64.5% reported being misdiagnosed before receiving an axSpA diagnosis. Most patients (78.9%) had active disease (Bath Ankylosing Spondylitis Disease Activity Index score ≥4), reported psychological distress (57.0%; General Health Questionnaire 12 score ≥3), and experienced a high degree of impairment (81.6%; Assessment of Spondyloarthritis International Society Health Index score ≥6). Overall, 47% of patients had a medium or high limitation in activities of daily living, and 46% were not employed at survey completion. CONCLUSION The majority of US patients with axSpA had active disease, reported psychological distress, and reported impaired function. US patients experienced a substantial delay in time to diagnosis of axSpA that was twice as long in women versus men.
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Affiliation(s)
- Marina Magrey
- Case Western Reserve University School of Medicine and University Hospitals, Cleveland, Ohio
| | - Jessica A Walsh
- University of Utah School of Medicine and Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah
| | | | | | | | - David Wei
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Muhammad A Khan
- Case Western Reserve University School of Medicine, Cleveland, Ohio
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Waggass R, Alhindi AK, Bagabas IS, Alsaegh MH, Alsharef NK, Morya RE, Khan MA, Jastaniah W. The Prevalence of Cardiovascular Manifestations in Pediatric Sickle Cell Anemia Patients in a Large Tertiary Care Hospital in the Western Region of Saudi Arabia. Cureus 2023; 15:e35751. [PMID: 37020484 PMCID: PMC10069165 DOI: 10.7759/cureus.35751] [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] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
Background Sickle cell disease (SCD) is a common hematological disorder with a high prevalence in Saudi Arabia. Despite that, limited studies are available in our region regarding cardiovascular complications. Objectives The objective of the current study was to estimate the prevalence of cardiovascular complications among children with SCD. Design This was a cross-sectional study. Setting The study took place at a single tertiary-care center in Jeddah, Saudi Arabia. Materials and methods The study reviewed 126 electronic records of pediatric patients up to 16 years old diagnosed with SCD between January 2008 and December 2019 in King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Of these, 54 patients had a previous echocardiogram evaluation and were eligible for the study. Main outcomes measures The study identified cardiovascular complications in pediatric sickle cell patients. Sample size The study included a total of 54 pediatric sickle cell patients. Results The mean age was 11.9 (3.48) years, the male-to-female ratio was 2:1, the majority (94.4%) had the HbSS-HbSβ0 genotype, the mean baseline hemoglobin F (fetal hemoglobin) was 20.30 (9.03%), and the clinical severity score was severe in 19 (35.2%) and mild/moderate in 35 (64.8%) patients. Cardiovascular complications occurred in 32 (59.3%) patients. Increased systolic blood pressure was detected in 10 (18.5%) patients. Echocardiography showed left ventricular dilatation in nine (16.7%) patients, tricuspid valve insufficiency in six (11.1%) patients, mitral valve insufficiency in four (7.4%) patients, hyperdynamic left ventricle in one (1.9%) patient, and pulmonary hypertension in one (1.9%) patient. Long QTc interval was noticed in three (5.6%) and cardiomegaly was detected in 18 (33.3%) patients. Conclusion Cardiovascular complications occurred at a high frequency in our pediatric population despite high baseline hemoglobin F levels. Early evaluation and continuous monitoring are important for early intervention.
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Hurst AL, Pritchett D, Khan MA. Urinary tract infection caused by Lactococcus garvieae in a premature neonate: A case report. J Neonatal Perinatal Med 2023; 16:187-190. [PMID: 36872796 DOI: 10.3233/npm-221154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Lactococcus garvieae is a gram-positive cocci that has primarily been described as a pathogen in various fish species, but has increasingly been reported to cause endocarditis and other infections in humans [1]. Neonatal infection caused by Lactococcus garvieae has not been previously reported. Here we describe a premature neonate who developed a urinary tract infection with this organism and was successfully treated with vancomycin therapy.
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Affiliation(s)
- A L Hurst
- Department of Pharmacy, Sanford USD Medical Center, Sioux Falls, South Dakota, USA
| | - D Pritchett
- Department of Pharmacy, Sanford USD Medical Center, Sioux Falls, South Dakota, USA
| | - M A Khan
- Department of Pediatrics, Sanford USD Medical Center, Sioux Falls, South Dakota, USA
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Riaz S, Nasreen S, Burhan Z, Shafique S, Alvi SA, Khan MA. Microplastics assessment in Arabian Sea fishes: accumulation, characterization, and method development. BRAZ J BIOL 2023; 84:e270694. [PMID: 36790302 DOI: 10.1590/1519-6984.270694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/10/2023] [Indexed: 02/16/2023] Open
Abstract
Around the globe, plastic has been entering the aquatic system and is ingested by organisms. Identification, optimal digestion method, and characterization of the polymers to trace sources are of growing importance. Hence, the present work investigated microplastics accumulation, digestion protocol efficiency, and characterization of polymers with FTIR analysis in the guts of five fishes (Lethrinus nebulosus, Rastrelliger kanagurta, Acanthopagrus arabicus, Otolithes ruber, and Euryglossa orientalis) from the Karachi coastal area, Arabian Sea. A total of 1154 microplastics (MPs) were ingested by 29 out of 33 fish species (87%). The highest average MP/fish was recorded in Otolithes ruber (54) and the lowest in Rastrelliger kanagurta (19.42). Microfibers were the most abundant shape with the highest numbers (35.52%) as compared to the rest of the MPs identified. Transparent microfibers were recorded as the highest in numbers followed by red, black, blue, and green. In this study, KOH with different concentrations and exposure times along with oxidizing agent hydrogen peroxide was tested (Protocols 3 and 4). Results showed these bases were highly efficient in obtaining optimal digestion of the samples. FTIR analysis confirmed that the majority of the polymers found in the fish guts were polyethylene and polypropylene. This study validated for the first time the presence of these polymers of plastic in marine fish from Pakistan.
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Affiliation(s)
- S Riaz
- University of Karachi, Center of Excellence in Marine Biology, Karachi, Pakistan
| | - S Nasreen
- University of Karachi, Center of Excellence in Marine Biology, Karachi, Pakistan
| | - Z Burhan
- University of Karachi, Center of Excellence in Marine Biology, Karachi, Pakistan
| | - S Shafique
- University of Karachi, Center of Excellence in Marine Biology, Karachi, Pakistan
| | - S A Alvi
- PCSIR Laboratories Complex, Applied Chemistry Research Centre, Karachi, Pakistan
| | - M A Khan
- University of Karachi, Department of Zoology, Karachi, Pakistan
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Shoib S, Khan MA, Javed S, Das S, Chandradasa M, Soron TR, Saeed F. A possible link between air pollution and suicide? Encephale 2023; 49:94-95. [PMID: 34916076 DOI: 10.1016/j.encep.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/06/2021] [Accepted: 08/20/2021] [Indexed: 01/21/2023]
Affiliation(s)
- S Shoib
- Department of Psychiatry, Jawahar-Lal-Nehru Memorial Hospital, 190003 Srinagar, Kashmir, India.
| | - M A Khan
- Larkin community hospital, 7031 SW 62nd Avenue, 33143 South Miami, FL, USA
| | - S Javed
- Nishtar Medical University, Nishtar Road, Gillani Colony, 66000 Multan, Punjab, Pakistan
| | - S Das
- Consultant Psychiatrist Emergency Mental Health Sunshine Hospital, NWMH, 300, Grattan Street, 3050 Parkville VIC, Melbourne, Australia.
| | - M Chandradasa
- Department of Psychiatry, University of Kelaniya, Ragama, Sri Lanka
| | - T R Soron
- Telepsychiatry Research and Innovation Network, 1215 Dhaka, Bangladesh (TRS)
| | - F Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Main K, Khan MA, Nuutinen JP, Young AM, Liaqat S, Muhammad N. Evaluation of modified dental composites as an alternative to Poly(methyl methacrylate) bone cement. Polym Bull (Berl) 2023. [DOI: 10.1007/s00289-023-04677-w] [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: 01/31/2023]
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Asghar MU, Anjum AA, Rabbani M, Khan MA, Ali MA, Azeem S. A commercial monovalent canine parvovirus vaccine performs better than a commercial combination vaccine in puppies. J HELL VET MED SOC 2023. [DOI: 10.12681/jhvms.27960] [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: 01/28/2023]
Abstract
Thirty puppies were randomly divided in to 3 groups for comparative evaluation of two commercial CPV vaccines. Each group was further subdivided in to < 6 months and < 3 months -old puppies and either vaccinated with a monovalent vaccine: Primodog, a combination vaccine: Duramune or maintained as a non-vaccinated control. Humoral immune response was determined by Hemagglutination Inhibition (HAI) on 21 and 35 -days after vaccination. The geometric mean titer (GMT) induced by Duramune, 21 and 35 -days post-vaccination was GMT 73.3 and 137.2, respectively. Comparatively, Primodog demonstrated higher GMT on 21 and 35 -days after vaccination: 97.0 and 168.9, respectively. The older puppies (< 6 months old) demonstrated higher seroconversion to both vaccines.
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Khan MA, Braun WE, Kushner I, Grecek DE, Muir WA, Steinberg AG. HLA B27 in Ankylosing Spondylitis: Differences in Frequency and Relative Risk in American Blacks and Caucasians. J Rheumatol 2023; 50:39-43. [PMID: 36587954] [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: 01/03/2023]
Abstract
Twenty-eight HLA alleles of the A and B loci were determined in 23 American Blacks and 50 Caucasians with primary ankylosing spondylitis (AS). The prevalence of HLA B27 was significantly increased in American Black patients (48 per cent) vs Black controls (two per cent), but was much less than the 94 per cent found in Caucasian patients (controls eight per cent). The lower prevalence of B27 in American Black patients vs Caucasian patients was significant (p < 0.001), and indicated that susceptibility to AS is not as closely associated with B27 in Blacks as in Caucasians. No other HLA antigen was significantly associated with AS in either racial group. Among B27 positive individuals, the relative risk of developing AS was significantly lower in American Blacks than in Caucasians. These data indicate that for diagnostic purposes, the absence of B27 is less important in ruling out AS in Blacks than in Caucasians.
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Affiliation(s)
- M A Khan
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
| | - W E Braun
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
| | - I Kushner
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
| | - D E Grecek
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
| | - W Angus Muir
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
| | - A G Steinberg
- From the Department of Medicine, Cleveland Metropolitan General Hospital; the Division of Human Genetics, Case Western Reserve University; and the Department of Immunoputhology, the Cleveland Clinic, Cleveland, Ohio
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Muacevic A, Adler JR, Malaikah AA, Alghamdi AM, Al-Zahrani RM, Nahas RJ, Khan MA, Hakami AY, Babaer DA. Prevalence of Etiological Factors in Adult Patients With Epilepsy in a Tertiary Care Hospital in the Western Region of Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e33301. [PMID: 36618504 PMCID: PMC9811852 DOI: 10.7759/cureus.33301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/04/2023] Open
Abstract
Background Epilepsy is a chronic neurologic condition with different risk factors and genetic predispositions. It is characterized by the occurrence of an epileptic seizure. To our knowledge, most studies have focused on revealing epilepsy prevalence in Saudi Arabia, but the etiological prevalence is still not well-studied in the region. Thus, this research aims to raise awareness and provide more insights into the etiological prevalence of this disorder. Methodology A cross-sectional study was performed among 431 adult patients diagnosed with epilepsy in the Neurology Department at King Abdulaziz Medical City in Jeddah, Saudi Arabia. Patients' data were retrospectively collected from electronic medical files covering the period between May 2016 and April 2021. Epilepsy etiologies were classified as suggested by the International League Against Epilepsy 2017. Results The most commonly identified seizures were generalized (25.3%) and focal (8.9%). However, 66.1% of seizure types were unidentifiable. The most common etiology was structural (42.9%), followed by genetic (7.2%), with strokes (24.3%) and tumors (23.8%) being the most prevalent structural etiologies. However, 47.6% of the patients were classified under unknown etiology. Conclusions This study suggested that epilepsy diagnosed as generalized was by far the most common seizure type in our cohort. Structural etiology was evident in most patients, with stroke being the highest presented etiology.
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Muacevic A, Adler JR, Albakri LA, Alsharif RM, Alrajhi RK, Makki RM, Khan MA, Kayal H. Incidence and Risk Factors of Spinal Anesthesia-Related Complications After an Elective Cesarean Section: A Retrospective Cohort Study. Cureus 2023; 15:e34198. [PMID: 36843804 PMCID: PMC9954762 DOI: 10.7759/cureus.34198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Neuraxial anesthetic techniques are the method of choice for cesarean section (CS) deliveries, and spinal anesthesia (SA) is the preferred technique. Although the use of SA has greatly improved the outcomes of CS deliveries, SA-related complications are still a matter of concern. The study's primary aim is to measure the incidence of SA complications after a CS, specifically hypotension, bradycardia, and prolonged recovery, as well as to identify the risk factors for these complications. Method The data of patients who had elective CS using SA from January 2019 to December 2020 was collected from a tertiary hospital in Jeddah, Saudi Arabia. The study design was a retrospective cohort study. The data collected included age, BMI, gestational age, comorbidities, the SA drug and dosage used, the site of the spinal puncture, and the patient's position during the spinal block. Also, the patient's blood pressure measurements, heart rate, and oxygen saturation levels were collected at baseline and at 5, 10, 15, and 20 minutes. SPSS was used for statistical analysis. Results The incidence of mild, moderate, and severe hypotension was 31.4%, 23.9%, and 30.1%, respectively. In addition, 15.1% of the patients experienced bradycardia, with 37.4% experiencing a prolonged recovery. Two factors were associated with hypotension, including BMI and the dosage of the SA, with a p-value of 0.008 and a p-value of 0.009, respectively. The site of the SA punctures equal to or lower than L2 was the only factor associated with bradycardia (p-value = 0.043). Conclusion The present study concludes that BMI and the dose of SA were the factors associated with SA-induced hypotension during a CS, and the site of the SA puncture equal to or lower than L2 was the only risk factor associated with spinal anesthesia-induced bradycardia.
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Novikova EV, Khan MA, Turova EA. [Medical rehabilitation of children with obstructive uropathy]. Vopr Kurortol Fizioter Lech Fiz Kult 2023; 100:21-26. [PMID: 38016053 DOI: 10.17116/kurort202310005121] [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: 11/30/2023]
Abstract
Obstructive uropathy in children is predominantly urinary system malformation and one of the leading causes of chronic renal failure. Antenatal ultrasound can detect obstructive uropathy in infants. It is important to conduct diagnostics not only to identify the obstruction level in urinary system, but to assess renal function, renal blood flow and urination. Children are given conservative and surgical treatment methods to restore urodynamics, prevent infectious complications, improve renal blood flow. Currently, there are no principles, approaches and technologies for medical rehabilitation of patients with obstructive uropathy, therefore, the use of selective chromotherapy, which has an activating effect on regional circulation, and sound stimulation improving muscles tone of pelvis and ureters, is pathogenetically reasonable and promising. OBJECTIVE To develop technologies of physiotherapy application (sound stimulation, selective chromotherapy) for inclusion in comprehensive medical rehabilitation of children with megaloureter. MATERIAL AND METHODS Clinical observations and special examinations have been performed in 90 children with megaloureter aged from 1 to 10 years. The patients were divided into 2 groups: 30 children (study group) received sound stimulation combined with selective chromotherapy; 30 children (the 1st comparison group) - sound stimulation; 30 children (the 2nd comparison group) - selective chromotherapy (blue spectrum). General clinical methods, ultrasound of kidneys and bladder with Doppler monitoring of intrarenal blood flow, functional methods of bladder examination were used. RESULTS The positive effects of separate and combined application of sound stimulation and selective chromotherapy on clinical and laboratory indicators, urodynamics of urinary tract and renal blood flow in children with megaloureter after surgery have been revealed. The efficacy of selective chromotherapy use in children with megaloureter and comorbid neurologic bladder dysfunction has been proven. CONCLUSION Modern technologies for the application of physiotherapy, namely selective chromotherapy and sound stimulation, to include them in the comprehensive medical rehabilitation of children with megaloureter, have been developed for the first time and their high efficacy has been proven.
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Affiliation(s)
- E V Novikova
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Filatov Children's City Hospital, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M A Khan
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Filatov Children's City Hospital, Moscow, Russia
| | - E A Turova
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Khan MA, Lyan NA, Vakhova EL, Lvova AV, Mikhlin SB, Illarionov VE. [The high-intensity pulsed magnetic therapy in the medical rehabilitation of children. (Literature review)]. Vopr Kurortol Fizioter Lech Fiz Kult 2023; 100:99-102. [PMID: 38289311 DOI: 10.17116/kurort202310006199] [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: 02/01/2024]
Abstract
In recent decades, a promising area of physiotherapy has been intensively developed In Russia and abroad - magnetic therapy, based on the use of various types of magnetic fields for preventive, curative and rehabilitative purposes. The use of high-intensity pulsed magnetotherapy is promising. The effectiveness of the method in a number of diseases of childhood, which has an active stimulating effect on the state of the neuromuscular apparatus, has been proven.
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Affiliation(s)
- M A Khan
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Filatov Children's City Hospital, Moscow, Russia
| | - N A Lyan
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - E L Vakhova
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A V Lvova
- Moscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
| | - S B Mikhlin
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V E Illarionov
- Petrovsky National Research Centre of Surgery, Moscow, Russia
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Sayeeda S, Hayee S, Akhtar N, Begum F, Khan MA. Successful Pregnancy with SLE-associated Antiphospholipid Syndrome: A Case Report. Mymensingh Med J 2023; 32:272-276. [PMID: 36594334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Pregnancy in women with systemic lupus erythematosus (SLE) is associated with an increased risk of adverse maternal and fetal outcomes. Risk is significantly increased when SLE pregnancy is complicated by anti-phospholipid syndrome (APS). Here, we present a case of a 21 year-old multi-gravid lady with SLE- associated APS who was diagnosed as such when she presented with multisystem flare at her 16 weeks of gestation. At presentation she had fever, multiple joint pain in both upper and lower limbs, loss of hair, history of recurrent oral ulcer, skin rash over hand and feet. Physical examination and laboratory evaluation were consistent with an active SLE flare. A diagnosis of antiphospholipid syndrome (APS) was made based on her clinical presentation and laboratory findings. The reported patient had APS secondary to SLE. She had all the risk factors that would confer a remarkably high risk of pregnancy morbidity: positive anti-SSA(RO) antibody and lupus anticoagulant, history of one neonatal death due to congenital heart block and two consecutive first trimester pregnancy loss. Multidisciplinary management approach with appropriate intervention and close monitoring can bring a successful outcome.
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Affiliation(s)
- S Sayeeda
- Dr Syeda Sayeeda, Associate Professor, Department of Fetomaternal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
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Dubey H, Ranjan A, Durai J, Khan MA, Lakshmy R, Khurana S, Gupta S, Meena J, Ray MD, Tanwar P, Chopra A, Tiwari S. Evaluation of HE4 as a prognostic biomarker in uterine cervical cancer . Cancer Treat Res Commun 2023; 34:100672. [PMID: 36525756 DOI: 10.1016/j.ctarc.2022.100672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Uterine cervical cancer (UCC) is the fourth most common health problem worldwide among women. Currently available biomarkers CA125, CA199, and CEA for diagnosis or prognostic evaluation of UCC have not got widespread acceptance. METHOD Whole blood samples of 64 patients with UCC were collected along with 63 healthy females and tested for serum levels of HE4 (sHE4). A cut-off value for positive result 64.0 pmol/L was set. Statistical analysis of different clinical variables was done. RESULT Serum level of HE4 has a significant role in the diagnosis of uterine cervical cancer. Its level increases with age, higher parity (P < 0.05), stage (P < 0.16), tumor size, and parametrial invasion. Negative result was seen with vaginal invasion, lymph node involvement & cases which had recurrence. Various histological types showed variable results. So the serum level of HE4 (sHE) level may play a role in the diagnosis & therapeutic monitoring of UCC. But the prognostic evaluation needs further studies. CONCLUSION sHE4 is useful in the diagnosis of cervical cancer, but its prognostic significance is under the question marks. It may be associated with higher values in higher stages. Higher parity of the patient is associated with higher level of HE4 in UCC.
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Affiliation(s)
- Harshita Dubey
- All India Institute of Medical Sciences, New Delhi, India
| | - Amar Ranjan
- Institute Rotary Cancer Hospital, All India Institue of Medical Sciences, New Delhi, India.
| | | | - M A Khan
- All India Institute of Medical Sciences, New Delhi, India
| | - R Lakshmy
- C.N. Center, All India Institute of Medical Sciences, New Delhi, India
| | - Sachin Khurana
- Institute Rotary Cancer Hospital, All India Institue of Medical Sciences, New Delhi, India
| | - Swati Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Meena
- All India Institute of Medical Sciences, New Delhi, India
| | - M D Ray
- Institute Rotary Cancer Hospital, All India Institue of Medical Sciences, New Delhi, India
| | - Pranay Tanwar
- Institute Rotary Cancer Hospital, All India Institue of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Institute Rotary Cancer Hospital, All India Institue of Medical Sciences, New Delhi, India
| | - Sanat Tiwari
- Bionics Scientific Technologies Pvt. Ltd, New Delhi, India
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Shah SSA, Saddique U, Khan MA, Khan S. Molecular epidemiology and phylogenetic analysis of Tams I gene of Theileria annulata in Khyber Pakhtunkhwa, Pakistan. Pol J Vet Sci 2022; 25:625-629. [PMID: 36649115 DOI: 10.24425/pjvs.2022.143543] [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: 01/18/2023]
Abstract
Theileriosis is a hemoparasitic disease that affects a wide range of different animal species and is caused by various species of Theileria. This study aimed to determine the molecular epidemiology of Theileria annulata through microscopy and PCR, in crossbred cattle in some districts of Khyber Pakhtunkhwa, Pakistan. For this study, a total of 384 blood samples were collected from cattle in the Peshawar (n=120), Charsadda (n=94), Nowshera (n=84), and Swabi (n=86) districts. Microscopy and PCR were used to determine the overall prevalence of theileriosis, which was found to be 15.8 and 22.6%, respectively. Theileria annulata was detected in blood samples through PCR in the study area, and the target gene i.e., Tams 1, of positive samples was sequenced. The sequences in the current study revealed high sequence homology (ranging from 96 to 100%) with Tams 1 sequences of neighboring countries present in the NCBI database. Season, breed, age, and sex were found to be important risk factors among the several risk factors examined, whereas, among different clinical manifestations, lymphadenopathy showed a strong association with theileriosis. According to Cohen's kappa and ROC analysis, microscopy was proven to be a fair diagnostic test for detecting theileriosis in cattle, and may be used in combination with molecular techniques for screening a large number of animals.
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Affiliation(s)
- S S A Shah
- College of Veterinary Sciences, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, 25130, Khyber Pakhtunkhwa, Pakistan.,Veterinary Research Institute, Peshawar-Pakistan
| | - U Saddique
- College of Veterinary Sciences, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, 25130, Khyber Pakhtunkhwa, Pakistan
| | - M A Khan
- College of Veterinary Sciences, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, 25130, Khyber Pakhtunkhwa, Pakistan
| | - S Khan
- College of Veterinary Sciences, Faculty of Animal Husbandry and Veterinary Sciences, The University of Agriculture, Peshawar, 25130, Khyber Pakhtunkhwa, Pakistan
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Li Z, Khan MK, Villiger PM, van der Linden S, Brown MA, Khan MA. Mortality in ankylosing spondylitis according to treatment: comment on the article by Ben Shabat et al. Arthritis Care Res (Hoboken) 2022; 74:2120-2121. [PMID: 34437771 DOI: 10.1002/acr.24773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/24/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Zhixiu Li
- Queensland University of Technology and Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Muacevic A, Adler JR, Qutub M, Khan MA, Mazraani N. A 61-Year-Old Male With Chronic Appendicitis: A Case Report. Cureus 2022; 14:e32130. [PMID: 36601145 PMCID: PMC9805787 DOI: 10.7759/cureus.32130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/05/2022] Open
Abstract
The objective of this report is to present a rare case of chronic appendicitis with an atypical presentation. The patient presented with intermittent periumbilical pain without any other symptom, relieved by an anti-inflammatory, and later incidentally diagnosed on computed tomography (CT) scan. The patient was managed with an appendectomy during laparoscopic exploration. A 61-year-old male, with a history of renal calculi, managed type 2 diabetes mellitus, managed hypertension, and ischemic heart disease who underwent percutaneous coronary intervention 10 years ago, presented to the clinic for a CT scan to follow up a non-obstructing renal calculus diagnosed previously. The imaging showed incidental appendiceal findings, and the patient informed the medical team that he had been experiencing intermittent periumbilical pain once every 4-12 weeks for the past year, which was not associated with fever, nausea, or vomiting. At that time, oral non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed, following which his symptoms subsided. A few days later, he presented to the clinic with the same complaint. The patient underwent laparoscopic exploration after numerous clinic visits and was diagnosed with chronic appendicitis. Chronic appendicitis should be explored in afebrile patients with periumbilical pain lasting for several days without other symptoms or predisposing factors. It should also be suspected in patients with recurrent or intermittent vague abdominal pain that subsides with NSAIDs. A CT scan of the abdomen should be conducted, and if the results confirm or imply chronic appendicitis, appendectomy is the preferred therapy.
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