1
|
Ranjan R, Adhikary D, Sunny SMB, Seedher A, Imtiaz N, Islam R, Adhikary AB. Impact of Socio-demographic Variables, Surgical Techniques and Risk Factors on the Outcome of Coronary Artery Bypass Graft Surgery among Bangladeshi Population. Mymensingh Med J 2024; 33:785-793. [PMID: 38944722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
This study was intended to evaluate the pathological outcome of cardiopulmonary bypass whilst considering socio-demographic variables and surgical technique on early postoperative results following coronary artery bypass graft (CABG) surgery in patients at a tertiary level hospital in Bangladesh. This observational study evaluated a total of 880 patients with ischemic heart disease in Bangabandhu Sheikh Mujib Medical University, Bangladesh from 2011 to 2019 who were undergoing an isolated CABG surgery. In this current study, the population divided into two groups- Group A: Off-pump CABG (n=440) and Group B: On-pump CABG (n=440). The mean age of the patients was 55.25±5.0 years in off-pump and 50.75±5.2 years in the on-pump group. Risk factors, including smoking, hypertension, and hyperlipidemia, were predominant in both study groups. Total operative time was notably higher in the on-pump CABG group. However, grafting time was more in the off-pump CABG procedures. Postoperative neurological deficits were higher amongst the on-pump CABG population. The mean time of mechanical ventilation, intensive care unit (ICU) stay, total hospital stay, and mortality was notably higher in the on-pump CABG group. Moreover, the number of mortalities in on-pump CABG patients was primarily due to the low output syndrome, failure of weaning from cardiopulmonary bypass (CPB) and sudden cardiac arrest. Off-pump CABG is now more acceptable due to its potentiality to avoid CPB induced complications, aortic cannulation, and cross-clamping. Cardiac arrest in on-pump CABG induces global ischemia and reperfusion injury to the cardiac muscle. Besides, the Off-pump CABG provides a conspicuous survival advantage compared to the on-pump CABG, in association with a notable reduction in postoperative morbidity and mortality.
Collapse
|
2
|
Islam R, Abbott L, Potter A, Thomas C. Bullous Amyloidosis as a cutaneous feature of Familial Lysozyme Amyloidosis. Australas J Dermatol 2024; 65:e87-e89. [PMID: 38504439 DOI: 10.1111/ajd.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 03/21/2024]
|
3
|
Stewart J, Shawon J, Ali MA, Williams B, Shahinuzzaman ADA, Rupa SA, Al-Adhami T, Jia R, Bourque C, Faddis R, Stone K, Sufian MA, Islam R, McShan AC, Rahman KM, Halim MA. Antiviral peptides inhibiting the main protease of SARS-CoV-2 investigated by computational screening and in vitro protease assay. J Pept Sci 2024; 30:e3553. [PMID: 38031661 DOI: 10.1002/psc.3553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/29/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023]
Abstract
The main protease (Mpro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays an important role in viral replication and transcription and received great attention as a vital target for drug/peptide development. Therapeutic agents such as small-molecule drugs or peptides that interact with the Cys-His present in the catalytic site of Mpro are an efficient way to inhibit the protease. Although several emergency-approved vaccines showed good efficacy and drastically dropped the infection rate, evolving variants are still infecting and killing millions of people globally. While a small-molecule drug (Paxlovid) received emergency approval, small-molecule drugs have low target specificity and higher toxicity. Besides small-molecule drugs, peptide therapeutics are thus gaining increasing popularity as they are easy to synthesize and highly selective and have limited side effects. In this study, we investigated the therapeutic value of 67 peptides targeting Mpro using molecular docking. Subsequently, molecular dynamics (MD) simulations were implemented on eight protein-peptide complexes to obtain molecular-level information on the interaction between these peptides and the Mpro active site, which revealed that temporin L, indolicidin, and lymphocytic choriomeningitis virus (LCMV) GP1 are the best candidates in terms of stability, interaction, and structural compactness. These peptides were synthesized using the solid-phase peptide synthesis protocol, purified by reversed-phase high-performance liquid chromatography (RP-HPLC), and authenticated by mass spectrometry (MS). The in vitro fluorometric Mpro activity assay was used to validate the computational results, where temporin L and indolicidin were observed to be very active against SARS-CoV-2 Mpro with IC50 values of 38.80 and 87.23 μM, respectively. A liquid chromatography-MS (LC-MS) assay was developed, and the IC50 value of temporin L was measured at 23.8 μM. The solution-state nuclear magnetic resonance (NMR) structure of temporin L was determined in the absence of sodium dodecyl sulfate (SDS) micelles and was compared to previous temporin structures. This combined investigation provides critical insights and assists us to further develop peptide inhibitors of SARS-CoV-2 Mpro through structural guided investigation.
Collapse
|
4
|
Tanzeem F, Islam R. A Systematic Review Evaluating the Efficacy, Immunogenicity and Safety of the Biosimilar FKB327 in Treating Rheumatoid Arthritis. Mymensingh Med J 2024; 33:313-319. [PMID: 38163811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Biosimilars are known to be pharmaceutical products which are very similar to a biologic drug. FKB327 is one such biosimilar of the drug Adalimumab which is prescribed in treating autoimmune diseases like Rheumatoid Arthritis. The aim of this review is to evaluate the efficacy, immunogenicity and safety of the drug FKB327 in treating patients with mild to moderate Rheumatoid Arthritis and compare the same with that of the drug Adalimumab. Two databases (PubMed and Cochrane Library) were used to screen relevant publications using pre-determined inclusion and exclusion criteria. Of the 12 studies found to be relevant, 3 were found to be eligible for the review. The data were extracted for the study characteristics, outcome measures, complications, and safety. The quality of the papers was assessed through Jadad scoring. Three (3) papers were reviewed in the study although there were limitations in reviewing efficacy as one of the papers lacked required data for efficacy. Efficacy was observed through ACR20 response and DAS28 score in the 24th week of all the three studies and immunogenicity was reviewed through the presence of Anti-drug antibody in patients after administration of both the drugs in same dosage. Safety was assessed through the development of complications after the administration of the drugs. The review concludes that there are similarities in efficacy, immunogenicity and safety between FKB327 but could not adequately prove the superiority of FKB327 over Adalimumab.
Collapse
|
5
|
Noor M, Islam MF, Islam R. How Did Mortality Rates from Covid-19 Differ between Vaccinated and Unvaccinated People in a Tertiary Level Hospital of Bangladesh? Mymensingh Med J 2023; 32:1198-1202. [PMID: 37777921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
This study aims to find out the difference in mortality rates between vaccinated & non-vaccinated Covid-19 positive patients who were admitted in a tertiary centre (Ward and Intensive care unit) of Bangladesh. Retrospective analysis of data over 6 weeks in February 2022- March 2022, 100 confirmed Covid-19 positive patients were included- 50 patients from ICU and 50 patients from ward irrespective of age, gender, vaccination status and co-morbidities. Seventy five percent (75.0%) of all confirmed Covid-19 positive patients were vaccinated. Mortality among vaccinated people was less compared to non-vaccinated population 41.3% vs. 52%. Interestingly it was found pregnancy was the most significant risk factor in childbearing age female group- 86.7% of patients (pregnant and peripartum) required Intensive care admission and mortality was 40.0% although none of them had any recorded co-morbidities. Again, mortality among vaccinated was significantly less (35.7%) compared to 100.0% mortality among unvaccinated. Mortality rate among patient admitted in intensive care was significantly high compared to patients treated in ward- 72.0% vs. 16.0%. In ICU 83.0% of patients who died were vaccinated (90.0% had 2 doses and 10.0% had 3 doses). On the other hand, 87.5% who died in ward were unvaccinated. Among the survivors from intensive care units- 93.0% were vaccinated compared to 7.0% unvaccinated. Pre-existing co-morbidities increased mortality (59.0%) compared to 40.9% mortality in patients without any previous medical conditions. We found vaccination against Covid-19 reduces the rate of death irrespective of co-morbidities or severity of disease. Recovery rate was significantly increased in vaccinated patients requiring intensive care support. Pregnancy was found to be the most important risk factor for Intensive care admission and mortality in otherwise healthy childbearing age females and mortality was significantly high (100.0% though limited data availability) in unvaccinated. These results require further revalidation on larger population.
Collapse
|
6
|
Islam M, Rabbani G, Siddiqua S, Islam S, Islam R, Hossain A, Hossen N, Saha B, Khatun N, Alif S, Karim M. 150P Sex differences in inoperable lung cancer risk and prognosis: Evidence from low-income population setting. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
7
|
Mahdi I, Yeasmin H, Hossain I, Badhan RM, Ali MA, Kaium MA, Islam R, Sufian MA, Halim MA. Potential antiviral peptides against the nucleoprotein of SARS-CoV-2. CHEMICAL PAPERS 2023; 77:813-823. [PMID: 36213321 PMCID: PMC9531640 DOI: 10.1007/s11696-022-02514-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/21/2022] [Indexed: 11/28/2022]
Abstract
Nucleoprotein is a conserved structural protein of SARS-CoV-2, which is involved in several functions, including replication, packaging, and transcription. In this research, 21 antiviral peptides that are known to have inhibitory function against nucleoprotein in several other viruses, were screened computationally against the nucleoprotein of SARS-CoV-2. The complexes of five best performing peptides (AVP1142, AVP1145, AVP1148, AVP1150, AVP1155) with nucleoprotein were selected for subsequent screening via 5 ns molecular dynamics (MD) simulation. Two peptides, namely AVP1145 and AVP1155, came out as promising candidates and hence were selected for 200 ns MD simulation for further validation, incorporating a DMPC-based membrane environment. In the long MD simulation, both AVP1155 and AVP1145 utilized multiple residues-mainly aromatic, acidic, and nonpolar residues-as interacting points to remain in contact with the nucleoprotein and formed predominantly hydrogen bonds along with hydrophobic and electrostatic interactions. However, AVP1155 proved to be superior to AVP1145 when its complex with nucleoprotein was analyzed in terms of root-mean-square deviation, root-mean-square fluctuation, radius of gyration, solvent accessible surface area and free energy landscape. In a nutshell, the findings of this research may guide future studies in the development of selective peptide inhibitors of SARS-CoV-2 nucleoprotein. Supplementary Information The online version contains supplementary material available at 10.1007/s11696-022-02514-4.
Collapse
|
8
|
Jannat T, Uddin J, Zakariah R, Talukder RI, Mortuza MG, Islam B, Islam R, Sumi SA. An Observational Study of Fixed Drug Eruption in A Tertiary Care Hospital in Bangladesh. Mymensingh Med J 2023; 32:49-53. [PMID: 36594300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Fixed drug eruption (FDE) is a distinctive pattern of cutaneous adverse drug reaction. Characteristically the eruption recurs at the same site on re exposure to the offending agent. Aim of this study was to evaluate and identification of the various offending drugs causing FDE which may help the physician to limit the associate complication regarding the drug. This observational cross sectional study was conducted from 1st June 2021 to 31st May 2022 in the department of Dermatology & Venereology of Mymensingh Medical College Hospital after taking approval from institutional ethical committee. A detailed history with clinical evaluation were done for all patients with FDE and thereby recorded in a pre designed proforma. Analysis of data was done using Microsoft Excel 2010 Spread sheet. Out of 65 cases 36(55.38%) were male and 29(44.6%) were female. Majority of cases were found in the age group of 31 to 40 years. The most common group of drug causing FDE was NSAID (52.31%) followed by antimicrobials (44.61%) and anti epileptics (3.07%). Ibuprofen (20.0%) was the most common offending drug followed by doxycycline (18.46%), diclofenac and fluconazole (13.84%), naproxen (9.23%), ciprofloxacin (7.69%), paracetamol (6.15%), metronidazole (4.61%), carbamazepine (3.07%) and aspirin (3.07%) respectively. Extremities (43.07%) were the most frequently involved site followed by trunk (29.23%) and face (10.77%). Generalized FDE found in 16.92% cases. Although FDE are very common the offending drugs show some regional variation as a result of changing trends of pharmacotherapy.
Collapse
|
9
|
Islam R, Hossain MM, Ali MA, Uddin MM, Naqib SH. Metallic boro-carbides of A 2BC (A = Ti, Zr, Hf and W): a comprehensive theoretical study for thermo-mechanical and optoelectronic applications. RSC Adv 2022; 12:32994-33007. [PMID: 36425165 PMCID: PMC9673901 DOI: 10.1039/d2ra05448e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/11/2022] [Indexed: 06/21/2024] Open
Abstract
High-hardness materials with ductile deformation behavior have recently piqued interest due to their prospective applications, particularly as hard and protective coatings. The crack formation, especially in metal and ceramic materials, is one of the biggest problems of the surface hard coatings on heavy-duty tools. In this regard, mechanical properties (Vickers hardness, fracture toughness, machinability index, index of brittleness, as well as Pugh's ratio) have been studied for the metallic boro-carbides of A2BC (A = Ti, Zr, Hf, and W) compounds using the state-of-the-art density functional theory in detail. The compounds under investigation are both thermodynamically and mechanically stable. The value of Vickers hardness (in GPa) for A2BC (A = Ti, Zr, Hf, and W) compounds are 28.20, 23.12, 12.44, and 35.70, respectively, which indicates the W2BC could be a member of the hard family (H v > 30 GPa). Pugh's ratio suggests ductile deformation for the W2BC compound, whereas the other three (Ti2BC, Zr2BC, and Hf2BC) compounds exhibit brittle deformation behavior. The W2BC compounds have the highest ductility among the other metallic boro-carbides (M2BC; M = V, Nb, Mo and Ta) and some other benchmark coating materials (TiN, TiAlN, C-BN, and Cr0.5Al0.5N). The fracture toughness (K IC) values are in the following sequence: Zr2BC < Ti2BC < Hf2BC < W2BC, which indicates that, the highest resistance (K IC = 4.96 MPam1/2) found for W2BC is suitable to prevent the crack propagation within the solid. In addition, the structural, electronic, optical, and thermal properties are also investigated for the A2BC (A = Ti, Zr, Hf, and W) compounds. The Ti2BC (W2BC) reflectivity spectra never fall below 53 (45)% in the 0 to 10.3 eV (0 to 16.70 eV) photon energy range, suggesting that these compounds have promise for usage as coating materials to reduce solar heating. Hf2BC and W2BC compounds could also be exploited as promising thermal barrier coating materials, while Ti2BC could be used as heat sink material based on the results of Debye temperature, melting temperature, thermal conductivity, and thermal expansion coefficient. The electronic properties reveal the metallic behavior of these compounds. The results obtained here are compared with those of some commercially known compounds, where available.
Collapse
|
10
|
Lilier K, Selim SA, Raihan ST, Islam R, Das J, Danquah I, Sauerborn R, Bärnighausen K. Coping strategies and barriers to coping in climate- vulnerable Bangladesh: a qualitative study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
With the mental wellbeing of billions of people at risk due to climate change, more research is required to better understand mental health and psychological implications of climate vulnerability. This research contributes to understanding how people in climate vulnerable populations psychologically cope with stress with crucial implications for adaptation efforts. We conducted n = 60 qualitative in-depth interviews with men and women in Bhola, Bangladesh to elicit the lived experiences of a climate vulnerable population. We analysed data following the tenets of Grounded Theory. Through our inductive analysis, we found coping strategies where participants highlighted what they did when encountering stress, such as ‘Resignation’ or ‘Help Seeking'. Barriers to coping were, among others, limited ‘Efficacy', ‘Time’ or ‘Stigma'. We categorized coping strategies with barriers as high-barrier coping strategies and, those without reported barriers, as low- barrier coping strategies. High-barriers restricted participants - especially women - in their coping efforts and led them to using low-barrier coping strategies. Some low-barrier coping strategies can be interpreted as maladaptive if used frequently, as they are unhealthy and draw upon resources needed to adapt for the future. Maladaptive coping strategies can thus impede long-term adaptation by reducing motivation and the ability and willingness to act. To enable adaptive coping, we recommend lifting the barriers to coping through community-led interventions where community workers create platforms for sharing problems and knowledge, such as group support meetings. Sharing and discussing could strengthen efficacy and open new opportunities for functional, adaptive coping. As the negative impacts of climate change will be felt globally with more intensity and frequency, enabling adaptive coping and removing barriers to coping in frontline communities will be essential to supporting physical and mental wellbeing.
Key messages
• Barriers to adaptive coping strategies can lead people to using maladaptive low-barrier coping strategies, which draw upon resources needed for long-term adaptation.
• Enabling adaptive coping by lifting barriers to coping in climate vulnerable populations is crucial to strengthen adaptation efforts.
Collapse
|
11
|
Islam R, Sriskanthanathan A, Maynard O, Abdalla S. P-109 A RETROSPECTIVE AUDIT OF THE DEPARTMENTAL USE OF PROPHYLACTIC ANTIBIOTICS IN ELECTIVE VENTRAL HERNIA SURGERY AS COMPARED TO NATIONAL AND INTERNATIONAL GUIDELINES. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
The routine use of prophylactic antibiotics for the prevention of surgical site infection is no longer recommended in all types of elective ventral hernia repairs, according to national and international guidelines.NICE recommends that prophylactic antibiotics are given only in clean surgeries that involve the use of a prothesis or implant. The British Hernia Society and European Hernia Society state that there is no indication for antibiotic prophylaxis in both open and laparoscopic elective groin hernia repairs with mesh in patients that are healthy and considered low risk for surgical site infection.
This is a retrospective audit of patients who underwent elective ventral hernia repairs at Ealing Hospital between June 2021 and December 2021 to assess the compliance of antibiotic prophylaxis with the current guidelines.
Forty-nine patients underwent elective ventral hernia repair, of which 44 was with the use of a mesh.Thirty-five of these cases (79.5%) received prophylactic antibiotics. All cases that underwent laparoscopic hernia repair received prophylactic antibiotics. Five cases underwent an elective open ventral hernia repair without a mesh.Three cases who were considered low risk received prophylactic antibiotics.
In conclusion, majority of patients along with those who were considered high risk received prophylactic antibiotics, which is compliant with guidelines. However, patients who did not have a mesh repair, or were not considered high risk also received prophylactic antibiotics.It would be useful to improve the awareness of the guidelines by creating clear local guidelines and improving documentation of reasons to give antibiotics against the recommendations.
Collapse
|
12
|
Da Costa K, Islam R, Peh J, Gelber E. 184 Group and Save Studies Prior to Appendicectomy. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Group and save studies prior to appendicectomy
Method
219 appendicectomy cases from Jan 2018 until Dec 2020. This was to look for whether patients had a blood transfusion post appendicectomy. Whether this was cost effective?
Results
19/219 did not have G and S studies performed. None of the patients required a blood transfusion post operatively. Price per bottle £20
Conclusions
Based on the above results we referred to the study performed by the RCS
Royal College of Surgeons did a study on ‘blood group and antibody screening prior to emergency laparoscopy’. Study included 562 cases. Concluded that routine G&S studies are not required and ‘majority of patients had a low risk of major intraoperative haemorrhage’ and thus G&S was not warranted O –ve blood can be used in cases of acute haemorrhage from major vessel injury Time taken to receive O neg blood = minutes.
Collapse
|
13
|
Da Costa K, Islam R, Khanfar A, Gelber E. 188 Quality of Documentation of Patient Notes in the Surgical Department. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Quality of documentation of patient notes
Method
Guidance for standards was taken from ‘The importance of Clinical Documentation, Ann R Coll Surg Engl(Suppl) 2014; 96:18–20’
Data of 100 patients over 2 weeks. Assessed:
Results
Availability of notes:
15/100 notes were not available on the wards at the time of data collection
Conclusions
Based on above results the significances of:
Results
Unable to provide proof of treatment if any abnormalities were found and medical negligence
Collapse
|
14
|
Islam R, Sarder M, Rabbi H, Arefin M. 263 Tuberculosis of the Bile Duct: A Rare Cause of Obstructive Jaundice. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Tuberculosis (TB) is a very rare cause of biliary stricture that is difficult to diagnose and usually requires surgical intervention in order to rule out underlying malignant etiology. A 28-years old woman with obstructive jaundice, who was originally thought to have cholangio-carcinoma. Diagnosis of tuberculosis was made on PCR testing of bile. Patient was started on antitubercular treatment, and she responded well. This case presented a rare case of common bile duct stricture due to biliary tuberculosis. This is an important condition to diagnose because early recognition with prompt treatment results in complete resolution. Even though biliary tuberculosis is a rare cause of obstructive jaundice, in endemic areas, it should be considered as a differential diagnosis and investigated, as it can be potentially curable.
Collapse
|
15
|
Islam R, Hashmi Z, Aljarad F, Madanur M, Imtiaz N, Warren R. 262 Full Cycle Audit on Definitive Management of Biliary Pancreatitis. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
To reaudit the practice of definitive management of gall stones pancreatitis in our trust for the period of 1st May-31st October and compare the result with previous one (1st June 2019–31st Dec 2019).
Method
It was a retrospective collection of data of patients admitted to our trust with biliary pancreatitis. Electronic notes, PACS for US report, Electronic discharge summary and Operative notes analysed.
Results
We identified 4 patients admitted with biliary pancreatitis during the re-audit period. US report was checked for confirmation of diagnosis of gall stones. The EDN was checked for date for Laparoscopic cholecystectomy. Unfortunately, none of them had their procedure time in 2 weeks’ time of their diagnosis. The reason behind this was because of COVID-19 pandemic, we were backlogging with our elective list. All the patients eventually underwent their procedure, but not in 2 weeks’ time as per the guidelines. All suitable patients had their cholecystectomy in a timely manner during first audit. None had it in timely manner during second audit.
Conclusions
Early Laparoscopic cholecystectomy for simple gallstone pancreatitis prevents life threatening Pancreatitis and readmissions.
The UK guidelines on management of pancreatitis issued by British society guidelines (BSG) states that all mild gall stones pancreatitis should have definitive management of lithiasis on the same admission or within 2 weeks (Recommendation B). In our practice, all our suitable patients during first audit had timely Laparoscopic cholecystectomy, however, no one had it in timely manner on the next audit for COVID-19 pandemic.
Collapse
|
16
|
Nwokedi E, Butterworth J, Lotca N, Shakir A, Islam R, Oke T. 274 Peri-Operative Communication with Next of Kin (NOK) for Patients Receiving Laparotomies: A Complete Audit Loop with an Educational intervention. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
NICE Clinical Guidelines (CG138) specify the importance of involvement of family members and carers at key patient care junctures. Furthermore, published literature and our own experience reaffirm that ‘low-quality communication causes profound distress to families that can affect the quality of dying and bereavement'. There is little evidence on NOK’s experience for surgical patients, so we sought to assess whether NOK details were available and whether they had been contacted peri-operatively for patients receiving laparotomies.
Method
We performed a closed loop audit using NELA database to identify patients admitted for laparotomies between February 1st to July 31st, 2021. The initial data was collated, analysed, and presented during educational meetings with informal reminders for a week to implement changes. Thereafter, data was collected to complete the audit cycle on communication with NOK.
Results
A total of 70 patients were included. Prior to the implementation, 86% of patients undergoing laparotomies had NOK information documented in clinical records, with only 75% of telephone numbers reachable and 33% had documented evidence of contact within 48 hours post-operation. Post-implementation, 97% of patients had their NOK information in their clinical records, with 97% telephone numbers reachable and 41% had documented evidence of contact with 48hours.
Conclusions
The importance of clerical staff and clerking doctors establishing NOK’s details, documenting these within iCare/notes and establishing whether patient are happy with NOK being contacted for updates on patient management, could reduce distress and potentially improve the experiences of hospital admission, recovery and in some cases, bereavement.
Collapse
|
17
|
Dittmar F, Heyer J, Figura M, Islam R, Hartmann K, Kliesch S, Wagenlehner F, Hedger M, Loveland B, Loveland K, Fietz D, Schuppe HC. Immune cell infiltration of testicular germ cell tumors – a clinical approach. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
18
|
Islam R, Islam S, Rahman M. Assessment of hygienic and sanitation practices among poultry butchers in selected Municipality areas of Assam (India). JOURNAL OF VETERINARY AND ANIMAL SCIENCES 2022. [DOI: 10.51966/jvas.2022.53.2.269-278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A study was conducted in Dhubri and Biswanath Chariali Municipality areas to assess the adoption of hygienic and sanitation practices being followed by poultry butchers. A total of 60 poultry butchers were selected randomly, 30 from each Municipality area so that the final sample consisted of 60 poultry butchers. Data were collected using a pre-tested structured interview schedule by personal interviews. The schedule was designed to collect information on the socioeconomic profile of the butchers, personal and meat shop hygiene, maintenance of meat shop and its equipment. The data revealed that all the poultry butchers were male among which (75%) of them had an education level only up to eight standard. The overall mean age of the poultry butchers was found to be 39.95±8.64 years of which majority (75%) of them belong to middle age group. The present study indicated that none of the poultry butchers underwent any formal training for hygienic meat handling. It was also pointed out that most (85%) of the butcheries were located at market area, while only a few (15%) were found in the residential area. Only 18.33 per cent of the poultry butchers wore clean clothes while 81.67 per cent of them did not adopt this practice during working. Majority (88.33%) of them did not wash their hands after smoking/ chewing tobacco.It was also revealed that majority (88.33%) of the butchers did not clean knives before and after cutting of meat. Majority of the butchers agreed that cleanliness of equipment (71.67%), the meat shop and its surrounding (68.33%) and personal hygiene (68.33%) were some of the important factors that were essential to ensure wholesome meat production. From the above study, it may be concluded that appropriate interventional measures by the concerned agencies such as awareness trainings for poultry butchers on crucial areas of food safety, hygienic practices relating to meat handling and personal safety are imperative. The results of the study also shed light on the need for measures to improve the infrastructural facilities in poultry meat butcheries and for appropriate interventions to strengthen the food quality control system by the government regulatory authorities.
Collapse
|
19
|
Ahmed S, Mahtarin R, Ahmed SS, Akter S, Islam MS, Mamun AA, Islam R, Hossain MN, Ali MA, Sultana MUC, Parves MDR, Ullah MO, Halim MA. Investigating the binding affinity, interaction, and structure-activity-relationship of 76 prescription antiviral drugs targeting RdRp and Mpro of SARS-CoV-2. J Biomol Struct Dyn 2021; 39:6290-6305. [PMID: 32720571 PMCID: PMC7441766 DOI: 10.1080/07391102.2020.1796804] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 12/23/2022]
Abstract
SARS-CoV-2 virus outbreak poses a major threat to humans worldwide due to its highly contagious nature. In this study, molecular docking, molecular dynamics, and structure-activity relationship are employed to assess the binding affinity and interaction of 76 prescription drugs against RNA dependent RNA polymerase (RdRp) and Main Protease (Mpro) of SARS-CoV-2. The RNA-dependent RNA polymerase is a vital enzyme of coronavirus replication/transcription complex whereas the main protease acts on the proteolysis of replicase polyproteins. Among 76 prescription antiviral drugs, four drugs (Raltegravir, Simeprevir, Cobicistat, and Daclatasvir) that are previously used for human immunodeficiency virus (HIV), hepatitis C virus (HCV), Ebola, and Marburg virus show higher binding energy and strong interaction with active sites of the receptor proteins. To explore the dynamic nature of the interaction, 100 ns molecular dynamics (MD) simulation is performed on the selected protein-drug complexes and apo-protein. Binding free energy of the selected drugs is performed by MM/PBSA. Besides docking and dynamics, partial least square (PLS) regression method is applied for the quantitative structure activity relationship to generate and predict the binding energy for drugs. PLS regression satisfactorily predicts the binding energy of the effective antiviral drugs compared to binding energy achieved from molecular docking with a precision of 85%. This study highly recommends researchers to screen these potential drugs in vitro and in vivo against SARS-CoV-2 for further validation of utility.
Collapse
|
20
|
Sakib MMH, Nishat AA, Islam MT, Raihan Uddin MA, Iqbal MS, Bin Hossen FF, Ahmed MI, Bashir MS, Hossain T, Tohura US, Saif SI, Jui NR, Alam M, Islam MA, Hasan MM, Sufian MA, Ali MA, Islam R, Hossain MA, Halim MA. Computational screening of 645 antiviral peptides against the receptor-binding domain of the spike protein in SARS-CoV-2. Comput Biol Med 2021; 136:104759. [PMID: 34403938 PMCID: PMC8352665 DOI: 10.1016/j.compbiomed.2021.104759] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/03/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022]
Abstract
The receptor-binding domain (RBD) of SARS-CoV-2 spike (S) protein plays a vital role in binding and internalization through the alpha-helix (AH) of human angiotensin-converting enzyme 2 (hACE2). Thus, it is a potential target for designing and developing antiviral agents. Inhibition of RBD activity of the S protein may be achieved by blocking RBD interaction with hACE2. In this context, inhibitors with large contact surface area are preferable as they can form a potentially stable complex with RBD of S protein and would not allow RBD to come in contact with hACE2. Peptides represent excellent features as potential anti-RBD agents due to better efficacy, safety, and tolerability in humans compared to that of small molecules. The present study has selected 645 antiviral peptides known to inhibit various viruses and computationally screened them against the RBD of SARS-CoV-2 S protein. In primary screening, 27 out of 645 peptides exhibited higher affinity for the RBD of S protein compared to that of AH of the hACE2 receptor. Subsequently, AVP1795 appeared as the most promising candidate that could inhibit hACE2 recognition by SARS-CoV 2 as was predicted by the molecular dynamics simulation. The critical residues in RBD found for protein-peptide interactions are TYR 489, GLY 485, TYR 505, and GLU 484. Peptide-protein interactions were substantially influenced by hydrogen bonding and hydrophobic interactions. This comprehensive computational screening may provide a guideline to design the most effective peptides targeting the spike protein, which could be studied further in vitro and in vivo for assessing their anti-SARS CoV-2 activity.
Collapse
|
21
|
Islam R, Parves MR, Paul AS, Uddin N, Rahman MS, Mamun AA, Hossain MN, Ali MA, Halim MA. A molecular modeling approach to identify effective antiviral phytochemicals against the main protease of SARS-CoV-2. J Biomol Struct Dyn 2021; 39:3213-3224. [PMID: 32340562 PMCID: PMC7232885 DOI: 10.1080/07391102.2020.1761883] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 12/23/2022]
Abstract
The main protease of SARS-CoV-2 is one of the important targets to design and develop antiviral drugs. In this study, we have selected 40 antiviral phytochemicals to find out the best candidates which can act as potent inhibitors against the main protease. Molecular docking is performed using AutoDock Vina and GOLD suite to determine the binding affinities and interactions between the phytochemicals and the main protease. The selected candidates strongly interact with the key Cys145 and His41 residues. To validate the docking interactions, 100 ns molecular dynamics (MD) simulations on the five top-ranked inhibitors including hypericin, cyanidin 3-glucoside, baicalin, glabridin, and α-ketoamide-11r are performed. Principal component analysis (PCA) on the MD simulation discloses that baicalin, cyanidin 3-glucoside, and α-ketoamide-11r have structural similarity with the apo-form of the main protease. These findings are also strongly supported by root-mean-square deviation (RMSD), root-mean-square fluctuation (RMSF), radius of gyration (Rg), and solvent accessible surface area (SASA) investigations. PCA is also used to find out the quantitative structure-activity relationship (QSAR) for pattern recognition of the best ligands. Multiple linear regression (MLR) of QSAR reveals the R2 value of 0.842 for the training set and 0.753 for the test set. Our proposed MLR model can predict the favorable binding energy compared with the binding energy detected from molecular docking. ADMET analysis demonstrates that these candidates appear to be safer inhibitors. Our comprehensive computational and statistical analysis show that these selected phytochemicals can be used as potential inhibitors against the SARS-CoV-2.Communicated by Ramaswamy H. Sarma.
Collapse
|
22
|
Abdalla M, Barksfield R, Islam R. 946 Introduction: Closed Loop Audit Looking at How We Are Complying with Paediatric Supracondylar Fracture (BOAST 11) Management; Results Compared With 2018 To 2019 (Full Cycle). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Supracondylar fractures. Most common childhood elbow fracture. Can be difficult to manage. Risk of significant complications
Method
Results
• NV documentation, 2018:2019, Improved (36%à45%), Inadequate (45%) in comparison to BOAST guideline.
Night ops
• Appropriate as per BOAST guideline
Surgical technique
Conclusions
Recommendations:
Collapse
|
23
|
Rabbi H, Chowdhury AQ, Sarder MM, Islam R. 743 Inflammatory Pseudotumor (IPT) Of the Liver, A Diagnostic Dilemma with Therapeutic Uncertainty in A cohort of Bangladeshi patients (Observational Cohort Study). Br J Surg 2021. [DOI: 10.1093/bjs/znab134.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
IPT a benign lesion seldom encountered in clinical practice. It’s mysterious in origin & remains ambiguous.Infection, stone,autoimmune disease,systemic inflammatory response,trauma,foreign body and neoplasm attributes to etiological factors.Advanced imaging modalities help in increased detection of focal liver lesion.
Aim
To analyze its clinical significance. 33 patients with focal liver lesions were evaluated and treated surgically as hepatic neoplasm consecutively from July 2013 to January 2020.
Method
Retrospective observational cohort study.
Results
14 male & 19 female were studied, mostly in 3rd decade of life. Clinically only 21% of them presented with fever.In 24 patients the lesions were located in left lobe of liver.The operative procedures were: wedge resection in 3 patients,limited resection in 5 patients,Left Hepatectomy 7 patients,Left lateral hepatic segmentectomy in 17 patients, right hepatectomy in 2 patients & central hepatectomy in 1 patient. 8patients required bilioenteric anastomosis as additional procedure.Histopathological study revealed Tuberculosis in 7 patients(21.21%),fungal granuloma in 3 patients, foreign body granuloma in 3 patients, Ductal calculi with abscess in 9 patients and idiopathic in 7 patients.
Conclusions
IPT of liver represents a rare entity usually mistaken as malignant lesion.Despite the low prevalence, it often creates a diagnostic dilemma resulting into therapeutic uncertainty.
Collapse
|
24
|
Hashmi Z, Ahmed R, Zafar T, Ahmed M, Yousaf N, Chaudhary K, Islam R, Aljarad F, Madanur M. 950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case.
Method
All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters.
Results
From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up.
Conclusions
Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.
Collapse
|
25
|
Hashmi Z, Ahmed R, Ahmed M, Yousaf N, Zafar T, Chaudhary K, Islam R, Aljarad F, Madanu M. 957 Comparison of Inguinodynia In Patients Undergoing Prophylactic Ilioinguinal Neurectomy vs No Neurectomy In Lichtenstein Mesh Hernioplasty. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
The objective of this study is to compare the frequency of inguinodynia in ilioinguinal neurectomy VS no neurectomy in patients undergoing Lichtenstein mesh hernioplasty.
Method
200 male patients with unilateral, primary, reducible inguinal hernia were randomly distributed in to two groups by using lottery method to undergo Lichtenstein’s hernia repair i.e., with and without ilioinguinal neurectomy. All the operation were carried out under local anesthesia. Pain score was calculated using the VAS system at 3rd month and inguinodynia was labelled if it is more than 1 on VAS scale.
Results
200 male patients with mean age of 53.25 ± 6.768 were included. 42 (21%) had Inguinodynia after surgery. When we cross tabulated both groups with inguinodynia, results came up significant (p = 0.001). In neurectomy group 10 patients had inguinodynia while in no neurectomy group, 32 patients were having Inguinodynia. There was no effect of malnutrition on outcome. Younger age group benefitted more from procedure.
Conclusions
It is concluded that there is difference in frequency of inguinodynia in ilioinguinal neurectomy versus no neurectomy in patients undergoing Lichtenstein hernia repair. Patients with ilioinguinal neurectomy had reduced incidence of inguinodynia.
Collapse
|