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Krishnan M, Dassios T, Bothamley Z, Haque S, Watson C, Davenport M, Harris C, Greenough A. Prediction of bronchopulmonary dysplasia by the chest radiographic thoracic area on day one in infants with exomphalos. J Perinat Med 2024; 52:429-432. [PMID: 38407216 DOI: 10.1515/jpm-2023-0528] [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: 12/13/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To determine if infants with exomphalos had abnormal antenatal lung growth as indicated by lower chest radiographic thoracic areas (CRTA) on day one compared to controls and whether the CRTA could predict the development of bronchopulmonary dysplasia (BPD). METHODS Infants with exomphalos cared for between January 2004 and January 2023 were included. The controls were term, newborn infants ventilated for absent respiratory drive at birth, without lung disease and had no supplemental oxygen requirement by 6 h of age. The radiographs were imported as digital image files by Sectra PACS software (Sectra AB, Linköping, Sweden). Free-hand tracing of the perimeter of the thoracic area was undertaken and the CRTA calculated by the software. RESULTS Sixty-four infants with exomphalos and 130 controls were included. Infants with exomphalos had a lower median (IQR) CRTA (1,983 [1,657-2,471] mm2) compared to controls (2,547 [2,153-2,932] mm2, p<0.001). Following multivariable regression analysis, infants with exomphalos had lower CRTAs compared to controls (p=0.001) after adjusting for differences in gestational age and male sex. In the exomphalos group, the CRTAs were lower in those who developed BPD (n=14, 1,530 [1,307-1,941] mm2) compared to those who did not (2,168 [1,865-2,672], p<0.001). Following multivariable regression analysis, the CRTA was associated with BPD development (p=0.021) after adjusting for male sex and gestational age. CONCLUSIONS Lower CRTAs on day one in the exomphalos infants compared to the controls predicted BPD development.
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Affiliation(s)
- Mirna Krishnan
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Theodore Dassios
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Zoe Bothamley
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Saira Haque
- Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Callum Watson
- Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Mark Davenport
- Department of Paediatric Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Christopher Harris
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Anne Greenough
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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De La Hoz Polo M, Hudson VE, Adu J, Chakravorty S, Haque S. The many faces of sickle cell disease in children: complications in the appendicular skeleton. Pediatr Radiol 2024:10.1007/s00247-024-05913-9. [PMID: 38740606 DOI: 10.1007/s00247-024-05913-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
Sickle cell disease (SCD) is a hereditary red cell disorder with clinical manifestations secondary to sickling or crescent-shaped distortion of the red blood cells. Musculoskeletal complications of SCD are often the main causes for acute and chronic morbidities in children with manifestations including osteomyelitis, osteoporosis and osteonecrosis. This article aims to familiarise the paediatric radiologist with appendicular skeletal complications of SCD in the paediatric population and their imaging appearance.
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Affiliation(s)
| | - Victoria E Hudson
- Radiology Department, King's College Hospital, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - John Adu
- Radiology Department, St George's University Hospital, London, UK
| | - Subarna Chakravorty
- Department of Paediatric Haematology, King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | - Saira Haque
- Radiology Department, King's College Hospital, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
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3
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Danishuddin, Malik MZ, Kashif M, Haque S, Kim JJ. Exploring chemical space, scaffold diversity, and activity landscape of spleen tyrosine kinase active inhibitors. SAR QSAR Environ Res 2024; 35:325-342. [PMID: 38690773 DOI: 10.1080/1062936x.2024.2345618] [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: 02/12/2024] [Accepted: 04/14/2024] [Indexed: 05/03/2024]
Abstract
This study aims to comprehensively characterize 576 inhibitors targeting Spleen Tyrosine Kinase (SYK), a non-receptor tyrosine kinase primarily found in haematopoietic cells, with significant relevance to B-cell receptor function. The objective is to gain insights into the structural requirements essential for potent activity, with implications for various therapeutic applications. Through chemoinformatic analyses, we focus on exploring the chemical space, scaffold diversity, and structure-activity relationships (SAR). By leveraging ECFP4 and MACCS fingerprints, we elucidate the relationship between chemical compounds and visualize the network using RDKit and NetworkX platforms. Additionally, compound clustering and visualization of the associated chemical space aid in understanding overall diversity. The outcomes include identifying consensus diversity patterns to assess global chemical space diversity. Furthermore, incorporating pairwise activity differences enhances the activity landscape visualization, revealing heterogeneous SAR patterns. The dataset analysed in this work has three activity cliff generators, CHEMBL3415598, CHEMBL4780257, and CHEMBL3265037, compounds with high affinity to SYK are very similar to compounds analogues with reasonable potency differences. Overall, this study provides a critical analysis of SYK inhibitors, uncovering potential scaffolds and chemical moieties crucial for their activity, thereby advancing the understanding of their therapeutic potential.
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Affiliation(s)
- Danishuddin
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
| | - M Z Malik
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - M Kashif
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
| | - S Haque
- Research and Scientific Studies Unit, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - J J Kim
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
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Haque S, DeStefano S, Banger A, Rutledge R, Romaire M. Telehealth Impact in Frontier Critical Access Hospitals: Mixed Methods Evaluation. JMIR Form Res 2023; 7:e49591. [PMID: 37728991 PMCID: PMC10551787 DOI: 10.2196/49591] [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: 06/02/2023] [Revised: 07/14/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Frontier areas are sparsely populated counties in states where 65% of the counties have 6 or fewer residents per square mile. Residents access primary care at critical access hospitals (CAHs) located in these rural communities but must travel great distances for specialty care. Telehealth could address access challenges; however, there are barriers to broader use, including reimbursement and the need for practical implementation support. The Centers for Medicare & Medicaid Services implemented the Frontier Community Health Integration Project (FCHIP) Demonstration to assess the impact of telehealth payment change and technical assistance to adopt and sustainably use telehealth for CAHs treating Medicare fee-for-service patients in frontier regions. OBJECTIVE We evaluated the impact of the FCHIP Demonstration telehealth payment change and technical assistance on telehealth adoption and ongoing use using a mixed methods approach. METHODS We conducted a mixed methods evaluation of the 8 CAHs in Montana, Nevada, and North Dakota that participated in the FCHIP program. Key informant interviews and FCHIP program document review were conducted and analyzed using thematic analysis to understand how CAHs implemented their telehealth programs and the facilitators of program adoption and maintenance. Medicare fee-for-service claims were analyzed from August 2013 to July 2019 relative to a group of CAHs that did not participate in the demonstration project to understand the frequency of telehealth use for Medicare fee-for-service beneficiaries receiving care at the participating CAHs before and during the Demonstration program. RESULTS CAH staff noted several key factors for establishing and sustaining a telehealth program: clinical and administrative staff champions, infrastructure changes, training on telehealth processes, and establishing strong relationships with specialists at distant facilities to deliver telehealth services to patients of CAH. There was a modest increase in telehealth services billed to Medicare during the FCHIP Demonstration that were limited to a handful of CAHs. CONCLUSIONS The frontier setting is characterized by a low population; and thus, the volumes of telehealth services provided in both the CAHs and comparison sites are low. Overall, CAHs reported that patient satisfaction was high and expressed the desire for more virtual services. Telehealth service selection was informed by perceived community needs and specialist availability. CAHs made infrastructure changes to support telehealth and expressed the desire for more virtual services. Implementation support services helped CAHs integrate telehealth into clinical and operational workflows. There was some increase in telehealth services billed to Medicare, but the volume billed was low and not enough to substantially improve hospital revenue. Future work to inform policy and practice could include standardized, formal community need assessments and assistance finding distant providers to meet those needs and further technical assistance around billing, service selection, and ongoing use to support sustainability.
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Affiliation(s)
- Saira Haque
- RTI International, Research Triangle Park, NC, United States
| | | | - Alison Banger
- RTI International, Research Triangle Park, NC, United States
| | - Regina Rutledge
- RTI International, Research Triangle Park, NC, United States
| | - Melissa Romaire
- RTI International, Research Triangle Park, NC, United States
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Tantrige P, Patel KV, Patel NK, Haque S, Leung R, Naz F, Allen P, Blake H, Yusuf GT, Sidhu PS. Ultrasound simulation training to meet the 2021 Royal College of Radiologists' curriculum for radiology trainees: South East London experience. Clin Radiol 2023; 78:671-678. [PMID: 37336673 DOI: 10.1016/j.crad.2023.05.011] [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: 01/17/2023] [Revised: 04/12/2023] [Accepted: 05/16/2023] [Indexed: 06/21/2023]
Abstract
AIM To enhance ultrasound teaching delivery to radiology trainees using a simulation course matched to the 2021 Royal College of Radiologists (RCR) curriculum. MATERIAL AND METHODS An ultrasound simulation training course was designed for specialty trainees (ST) 1 in radiology, which was based on the 2021 RCR curriculum and covered the top ultrasound training priorities. The course was piloted initially on two occasions in a 1-day format to the August 2021 and the March 2022 ST1 intake trainees. Based on the feedback, a comprehensive 4-day course was developed and delivered between October and December 2022 for the August 2022 ST1 intake, funded by Health Education England. The outcomes measured were subjective trainee feedback using numerical scores and free text. RESULTS All King's College Hospital NHS Foundation Trust radiology ST1 trainees from the August 2021 to the August 2022 intake participated in ultrasound simulation training. The training matched the RCR curriculum and increased the trainees' confidence and competency in medical ultrasound. CONCLUSIONS Ultrasound simulation training can be successfully delivered to ST1 trainees to match the 2021 RCR curriculum and enhance training in medical ultrasound for radiologists.
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Affiliation(s)
- P Tantrige
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK.
| | - K V Patel
- Department of Radiology, Croydon University Hospital, UK
| | - N K Patel
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - S Haque
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - R Leung
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - F Naz
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - P Allen
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - H Blake
- Department of Radiology, Croydon University Hospital, UK
| | - G T Yusuf
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
| | - P S Sidhu
- Department of Radiology, King's College Hospital NHS Foundation Trust, UK
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Munshi M, Slyne C, Weinger K, Sy S, Sifre K, Michals A, Davis D, Dewar R, Atakov-Castillo A, Haque S, Cummings MS, Brown SL, Toschi E. Self-care barriers and facilitators in older adults with T1D during a time of sudden isolation. Sci Rep 2023; 13:7026. [PMID: 37120574 PMCID: PMC10148576 DOI: 10.1038/s41598-023-33746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023] Open
Abstract
Older adults with type 1 diabetes (T1D) have unique challenges and needs. In this mixed-methods study, we explored the impact of isolation during a pandemic on diabetes management and overall quality of life in this population. Older adults (age ≥ 65 years) with T1D receiving care at a tertiary care diabetes center participated in semi-structured interviews during COVID-19 pandemic isolation between June and August 2020. A multi-disciplinary team coded transcripts and conducted thematic analysis. Thirty-four older adults (age 71 ± 5 years, 97% non-Hispanic white, diabetes duration of 38 ± 7 years, A1C of 7.4 ± 0.9% (57.3 ± 10.1 mmol/mol) were recruited. Three themes related to diabetes self-care emerged regarding impact of isolation on: (1) diabetes management and self-care behaviors (how isolation prompted changes in physical activity and dietary habits); (2) emotional stress and anxiety (related to isolation and lack of support system, economic concerns); and (3) concerns regarding the COVID-19 pandemic (impact on timely medical care and access to information). Our findings identify modifiable barriers and challenges faced by older adults with T1D during isolation. As this population has a higher risk of decline in physical and psychosocial support even during non-pandemic times, clinicians will benefit from understanding these issues to improve care of this population.
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Affiliation(s)
- Medha Munshi
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA.
- Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Christine Slyne
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Katie Weinger
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Sarah Sy
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Kayla Sifre
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Amy Michals
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Dai'Quann Davis
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | - Rachel Dewar
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
| | | | - Saira Haque
- RTI International, Research Triangle Park, NC, USA
| | | | | | - Elena Toschi
- Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Jilani T, Arevalo G, Haque S, Brumfield E, Spielmann S, Reyes B, Ebrahim M, Nambiar R. Cardiopulmonary implications of hypermobile ehlers-$$$danlos syndrome – a case report. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00066-6] [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: 01/28/2023]
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Pollack CC, Deverakonda A, Hassan F, Haque S, Desai AN, Majumder MS. The impact of state paid sick leave policies on weekday workplace mobility during the COVID-19 pandemic. Public Health 2023; 215:118-123. [PMID: 36689910 PMCID: PMC9464594 DOI: 10.1016/j.puhe.2022.08.019] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/12/2022] [Accepted: 08/26/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study aimed to evaluate whether the Families First Coronavirus Response Act (FFCRA) modified the association between pre-existing state paid sick leave (PSL) and weekday workplace mobility between February 15 and July 7, 2020. STUDY DESIGN This was a longitudinal, observational study. METHODS The 50 US states and Washington, D.C., were divided into exposure groups based on the presence or absence of pre-existing state PSL policies. Derived from Google COVID-19 Community Mobility Reports, the outcome was measured as the daily percent change in weekday workplace mobility. Mixed-effects, interrupted time series regression was performed to evaluate weekday workplace mobility after the implementation of the FFCRA on April 1, 2020. RESULTS States with pre-existing PSL policies exhibited a greater drop in mobility following the passage of the FFCRA (β = -8.86, 95% confidence interval: -11.6, -6.10, P < 001). This remained significant after adjusting for state-level health, economic, and sociodemographic indicators (β = -3.13, 95% confidence interval: -5.92, -0.34; P = .039). CONCLUSIONS Pre-existing PSL policies were associated with a significant decline in weekday workplace mobility after the FFCRA, which may have influenced local health outcomes. The presence of pre-existing state policies may differentially influence the impact of federal legislation enacted during emergencies.
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Affiliation(s)
- C C Pollack
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College; Lebanon, New Hampshire, USA; Department of Epidemiology, Geisel School of Medicine at Dartmouth College; Lebanon, New Hampshire, USA.
| | - A Deverakonda
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA
| | - F Hassan
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA; School of Public Health, University of Alberta; Edmonton, Alberta, Canada
| | - S Haque
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA; Network Science Institute, Northeastern University; Boston, Massachusetts, USA
| | - A N Desai
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA; Department of Internal Medicine, Division of Infectious Diseases, University of California - Davis; Sacramento, California, USA
| | - M S Majumder
- COVID-19 Dispersed Volunteer Research Network; Boston, Massachusetts, USA; Computational Health Informatics Program, Boston Children's Hospital; Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School; Boston, Massachusetts, USA
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Tajchman S, Lawler B, Spence N, Haque S, Quintana Y, Ateya M. Implementation and Use of Risk Evaluation and Mitigation Strategies Programs in Practice: A Scoping Review of the Literature. Appl Clin Inform 2022; 13:1151-1160. [PMID: 36482261 PMCID: PMC9731790 DOI: 10.1055/s-0042-1758838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Risk Evaluation and Mitigation Strategy (REMS) programs intend to improve medication safety but can add significant administrative burdens to providers and health systems. Various stakeholders have made efforts to use technology to improve REMS programs. OBJECTIVES The objective of this scoping review is to describe studies evaluating workflows, automation, or electronic data exchange related to REMS programs. METHODS A literature search of PubMed, Embase, and Web of Science was performed for articles published between January 2007 and July 2021. Studies were identified using the relevant Medical Subject Headings terms and related keywords. Articles must have described a workflow change and measured the impact of the workflow change. RESULTS Of 299 citations initially identified, 7 were included in the final review after removing duplicates and articles not meeting predefined inclusion criteria. Included studies consisted of three manuscripts and four conference abstracts. Electronic health record interventions, such as customized order sets and clinical decision support alerts, were the most common strategy reported. Other strategies included developing a portal to verify REMS enrollment, requiring prescribers to contact the dispensing pharmacy, provider education, and restrictions based on the provider specialty. One study evaluated automated data exchange for REMS program processes in a mock environment. Although only three studies reported baseline metrics for comparison, all studies noted an improvement or benefit to the implemented workflow process changes. CONCLUSION There is limited evidence describing REMS workflows, automation, and electronic data exchange. Various strategies to address REMS program requirements were reported, but no studies described the use of data exchange standards in a real-world setting despite efforts by the Food and Drug Administration and other stakeholders. Additional efforts are needed to automate REMS programs.
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Affiliation(s)
- Sharla Tajchman
- Department of Global Medical Affairs, Pfizer, Inc, New York, New York, United States,Address for correspondence Sharla Tajchman, PharmD, BCCCP, BCNSP Department of Internal Medicine, Field MedicalOutcomes and Analytics, Pfizer, Inc., 6351 East Mystic Meadow, Houston, TX 77021United States
| | - Brooke Lawler
- University of Iowa College of Pharmacy, Iowa City, Iowa, United States,Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
| | - Nathan Spence
- Department of Global Medical Affairs, Pfizer, Inc, New York, New York, United States
| | - Saira Haque
- Department of Global Medical Affairs, Pfizer, Inc, New York, New York, United States
| | - Yuri Quintana
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States,Harvard Medical School, Boston, Massachusetts, United States
| | - Mohammad Ateya
- Department of Global Medical Affairs, Pfizer, Inc, New York, New York, United States
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Toschi E, Slyne C, Weinger K, Sy S, Sifre K, Michals A, Davis D, Dewar R, Atakov-Castillo A, Haque S, Cummings S, Brown S, Munshi M. Use of Telecommunication and Diabetes-Related Technologies in Older Adults With Type 1 Diabetes During a Time of Sudden Isolation: Mixed Methods Study. JMIR Diabetes 2022; 7:e38869. [PMID: 36256804 PMCID: PMC9678329 DOI: 10.2196/38869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/31/2022] [Accepted: 10/15/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The COVID-19 lockdown imposed a sudden change in lifestyle with self-isolation and a rapid shift to the use of technology to maintain clinical care and social connections. OBJECTIVE In this mixed methods study, we explored the impact of isolation during the lockdown on the use of technology in older adults with type 1 diabetes (T1D). METHODS Older adults (aged ≥65 years) with T1D using continuous glucose monitoring (CGM) participated in semistructured interviews during the COVID-19 lockdown. A multidisciplinary team coded the interviews. In addition, CGM metrics from a subgroup of participants were collected before and during the lockdown. RESULTS We evaluated 34 participants (mean age 71, SD 5 years). Three themes related to technology use emerged from the thematic analysis regarding the impact of isolation on (1) insulin pump and CGM use to manage diabetes, including timely access to supplies, and changing Medicare eligibility regulations; (2) technology use for social interaction; and (3) telehealth use to maintain medical care. The CGM data from a subgroup (19/34, 56%; mean age 74, SD 5 years) showed an increase in time in range (mean 57%, SD 17% vs mean 63%, SD 15%; P=.001), a decrease in hyperglycemia (>180 mg/dL; mean 41%, SD 19% vs mean 35%, SD 17%; P<.001), and no change in hypoglycemia (<70 mg/dL; median 0.7%, IQR 0%-2% vs median 1.1%, IQR 0%-4%; P=.40) during the lockdown compared to before the lockdown. CONCLUSIONS These findings show that our cohort of older adults successfully used technology during isolation. Participants provided the positive and negative perceptions of technology use. Clinicians can benefit from our findings by identifying barriers to technology use during times of isolation and developing strategies to overcome these barriers.
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Affiliation(s)
- Elena Toschi
- Joslin Diabetes Center, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | | | - Sarah Sy
- Joslin Diabetes Center, Boston, MA, United States
| | - Kayla Sifre
- Joslin Diabetes Center, Boston, MA, United States
| | - Amy Michals
- Joslin Diabetes Center, Boston, MA, United States
| | | | - Rachel Dewar
- Joslin Diabetes Center, Boston, MA, United States
| | | | - Saira Haque
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Stirling Cummings
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Stephen Brown
- Research Triangle Institute International, Research Triangle Park, NC, United States
| | - Medha Munshi
- Joslin Diabetes Center, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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11
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Thomas S, Haque S, Radia T. A case report of pyogenic sacroiliitis in a 9-month-old child. Arch Clin Cases 2022; 9:108-111. [PMID: 36176492 PMCID: PMC9512130 DOI: 10.22551/2022.36.0903.10213] [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] [Indexed: 11/06/2022] Open
Abstract
A very rare condition, pyogenic sacroiliitis is responsible for 1-2% of all osteoarticular infections in children. Diagnosis is often delayed in the pediatric population due to non-specific signs and symptoms during presentation, difficulty in assessing the joint, more common differential diagnosis and low yield diagnostic findings in conventional radiography. A delayed diagnosis of this condition can lead to permanent joint damage. A 9-month-old presented to the emergency department with a history of fever, being unsettled and clingy along with refusal to weight bear over the past few days. On initial assessment, she was found to be tachycardic and afebrile with abnormal posture of her left leg held in external rotation at the hip joint. On examination, she refused to weight bear, presented with alternating tenderness of her left and right hip joints and spinal tenderness at the L5 position. Investigations done showed slightly raised inflammatory counts, normal hip and pelvic radiographs, normal hip ultrasound and blood culture growing staphylococcus aureus and Magnetic Resonance Imaging spine showing right sacroiliitis leading the diagnosis of pyogenic sacroiliitis. This case report highlights the importance of examination of the back and the importance of avoiding fixation error by history. Although rare, clinicians should consider the diagnosis of sacroiliitis in children who present with fever, being unsettled with decreased and painful movements around the pelvic region.
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Affiliation(s)
- Sarah Thomas
- Corresponding author: Sarah Thomas. King’s College Hospital NHS trust, Denmark Hill, London SE5 9RS, United Kingdom.
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12
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Dyball S, Reynolds J, Herrick A, Chinoy H, Haque S, Naz S, Bruce E, Bruce IN, Parker B. POS0756 DETERMINANTS OF HEALTH-RELATED QUALITY OF LIFE (HR-QoL) ACROSS THE SPECTRUM OF SYSTEMIC AUTOIMMUNE RHEUMATIC DISEASES: RESULTS FROM THE LEAP COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPoor health-related quality of life (HR-QoL) is recognised in patients with established connective tissue diseases (CTDs), however it is not clear how it affects patients with undifferentiated CTD (UCTD) which has traditionally been associated with a mild or more benign profile.ObjectivesTo investigate HR-QoL in patients affected with a variety of CTDs (including UCTD) using the SF-36 questionnaire; and secondly, to review demographic and clinical factors predictive of a poor HR-QoLMethodsThe Lupus Extended Autoimmune Phenotype (LEAP) cohort is a multicentre prospective study of patients with a CTD. Rheumatologist diagnosis was used to classify patients into four groups: systemic lupus erythematosus (SLE), primary Sjögren’s syndrome (pSS), UCTD, and (combined because of low numbers) those with an idiopathic inflammatory myopathy (IIM), systemic sclerosis (SSc) or overlap syndrome. The SF-36 quality of life questionnaire was completed at enrolment and includes eight domains: physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH) which range from 0 to 100, with higher scores reflecting better HR-QoL. Physical (PCS) and mental component score (MCS) were calculated for each group, with a score below 50 representing a worse HR-QoL compared to the general UK population. Predictors for poor HR-QoL was chosen a priori, then tested using linear regression adjusted for age, gender and ethnicity. All statistical analysis was performed using STATA v14, with results expressed as beta coefficients with 95% confidence intervals (95%CI).ResultsData were collected from 309 patients (280 [90.6%] women, with a mean [SD] age of 48.9 [12.9] years) from three UK rheumatology centres. The majority of patients were Caucasian (n=235, 76.1%). By rheumatologist diagnosis, 115 (37.2%) had SLE, 56 (18.1%) pSS, 72 (23.3%) UCTD and 66 (21.4%) SSc, IIM or an overlap syndrome. Patients with UCTD, pSS and SSc/IIM spectrum disorders had a shorter median disease duration (3.8, 3.7 and 6.1 years respectively) compared with patients with those with SLE (11.0 years), p<0.001. Previous steroid and immunosuppressant use was highest in patients with SLE and SSc/IIM spectrum disorders (p<0.001). The most affected domains include VT, GH and BP (Figure 1), and the PCS is more impaired compared with the MCS, with similar scores across disease groups. Agnostic of disease group, factors associated with a lower PCS include increasing age (beta -0.15 [95%CI -0.26, -0.06], p=0.008), prednisolone use (-3.1 [-6.05, -0.19], p=0.037), c-reactive protein (-0.09 [-0.62, -0.10], p=0.007), fatigue (-2.00 [-3.79, -0.22], p=0.028), and sicca syndrome (-4.70 [-7.66, -1.74] p=0.002), and these remained significant in a multivariate model.Figure 1.radar diagrams of eight SF-36 domains, and MCS and PCS boxplots. SLE; systemic lupus erythematosus; UCTD, undifferentiated CTD; pSS, primary Sjögren’s syndrome; IIM, idiopathic inflammatory myopathy; SSc, systemic sclerosis; PF, physical function; RP, role physical; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role emotional; MH, mental healthConclusionPatients with UCTD exhibit similar impairment in physical components of HR-QoL compared with other established CTDs, despite perceived differences in disease severity. This study highlights sicca syndrome, fatigue, and steroid burden as key targets for improving HR-QoL in patients across the spectrum of CTDs.Disclosure of InterestsSarah Dyball Grant/research support from: UCB and Eli Lilly, John Reynolds: None declared, Ariane Herrick Speakers bureau: Janssen, Consultant of: Arena, Boehringer-Ingelheim, Camurus, CSL-Behring, and Gesynta, Grant/research support from: Gesynta, Hector Chinoy Speakers bureau: UCB, Biogen, Consultant of: Novartis, Eli Lilly, Orphazyme, Astra Zeneca, Grant/research support from: Eli Lilly and UCB, Sahena Haque: None declared, Sophia Naz: None declared, Ellen Bruce: None declared, Ian N. Bruce Speakers bureau: AstraZeneca, GSK and UCB, Consultant of: AstraZeneca, Eli Lilly, GSK, Merck Serono, UCB and ILTOO, Grant/research support from: Genzyme/Sanofi, GSK, Roche and UCB, Ben Parker Speakers bureau: Eli Lilly and Roche, Consultant of: Fresenius-Kabi and AbbVie, Grant/research support from: Genzyme/Sanofi and GSK
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13
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Aydin MO, Kafa IM, Ozkaya G, Alper Z, Haque S. Peer-Assisted skills learning in structured undergraduate medical curriculum: An experiential perspective of tutors and tutees. Niger J Clin Pract 2022; 25:589-596. [PMID: 35593600 DOI: 10.4103/njcp.njcp_1410_21] [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: 11/04/2022]
Abstract
Background and Aims : This study aims to evaluate the implication of peer-assisted learning model adopted in students' clinical skills training from the perspective of tutees and tutors at the end of a peer-tutored clinical skills program and peer tutors themselves. Subjects and Methods This cross-sectional study was conducted in the Faculty of Medicine, Bursa Uludag in between January and March 2018. Following the clinical skills training, a questionnaire designed to assess the views of tutees and peer tutors was filled out on a voluntary basis by 159 tutees and 43 tutors. The statistical analysis of the collected and processed data was analyzed by using IBM SPSS 23.0 statistical program. The statistical significance level was maintained as α = 0.05. Results According to the Likert scale, satisfaction with the tutors and the educational environment was high in general. The 2nd term tutees provided more negative feedback compared to other terms. Among all the terms, the most positive answers were provided by the 3rd term students. Although the tutors found themselves fully skilled in communication with colleagues, there were striking differences between the tutors in the 5th and 6th terms of providing a good role model for pre-clinical terms students. Conclusion Considering peer assisted learning (PAL)'s positive responses from this study, the adoption of PAL has been started to be used as a supplementary teaching method for the clinical skills training at the Faculty of Medicine, Bursa Uludag University. PAL is considered a successful education model since it is cost-efficient for undergraduate medical training and improves the professional skills of both teacher and learner students. It can be availed of as an alternative method in medical faculties where especially the number of academic members is insufficient.
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Affiliation(s)
- M O Aydin
- Department of Medical Education, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - I M Kafa
- Department of Medical Education; Department of Anatomy Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - G Ozkaya
- Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Z Alper
- Department of Medical Education, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - S Haque
- Faculty of Medicine, Bursa Uludag University, Bursa, Turkey; College of Nursing & Allied Health Sciences, Research and Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia
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14
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Panayiotou A, De La Hoz Polo M, Tang V, Haque S. Spectrum of anatomical variants, normal findings and pathology in and around the paediatric sternum. Pediatr Radiol 2022; 52:1175-1186. [PMID: 35142891 DOI: 10.1007/s00247-021-05268-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/18/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
Abnormalities of the sternum and adjacent structures are an uncommon presentation in the paediatric population and can have a variety of benign and malignant causes, including normal and developmental variants of the chest wall. Although there is overlap with adults, many sternal abnormalities are unique to the paediatric population. Following clinical examination, radiography is usually the first type of imaging used; however, it is limited and often ultrasound and cross-sectional imaging are needed for further assessment. An understanding of the normal anatomy is important; however, this can be challenging due to the varied appearances of age-related changes of the sternum. The purpose of this article is to familiarize the general paediatric radiologist with the expected anatomy and imaging findings of the developing sternum, anatomical variants and pathology of the sternum and adjacent structures encountered in this group of patients.
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Affiliation(s)
- Andreas Panayiotou
- Department of Radiology, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK.
| | | | - Vivian Tang
- Department of Radiology, Royal Manchester Children's Hospital, Manchester, UK
| | - Saira Haque
- Department of Radiology, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK
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15
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Karim F, Akter QS, Khanom A, Haque S, Rashid MS. Estimation of Serum Fibrinogen in Males with Type 2 Diabetes. Mymensingh Med J 2022; 31:395-399. [PMID: 35383756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The patient with diabetes mellitus (DM) and its complication is increasing in our country and all over the world. Fibrinogen is a renowned factor of progressive atherosclerotic lesions and a predictor of cardiovascular events. Level of fibrinogen is increases in patients with diabetes mellitus (DM) may accelerate thromboembolic risk for cardiovascular disease (CVD). This study was carried out to assess plasma fibrinogen level in subjects with type 2 diabetes mellitus. It was a cross sectional analytic study and conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from July 2013 to June 2014. A total number of 200 adult male subjects were selected with age ranging from 40-60 years. Among them, 100 subjects with type 2 diabetes mellitus were included in the study group (Group B) and 100 healthy subjects with same age range were considered as controls (Group A) for comparison. The subjects were selected from BIRDEM hospital Dhaka and personal contact from different areas of Dhaka city on the basis of exclusion and inclusion criteria. The study parameter was plasma fibrinogen level, and was measured in the Department of Microbiology and Immunology of BIRDEM hospital, Dhaka, Bangladesh. The data were collected and recorded in pre-designed structured questionnaire by the researcher herself. For statistical analyses unpaired Student's 't' test and Pearson's correlation coefficient (r) test were performed as applicable using SPSS for windows version 19.0. In this study plasma fibrinogen level was significantly (p<0.001) higher in the study group than that of control group. From this study, it may be concluded that estimation of plasma fibrinogen level might be beneficial for prediction of future cardiovascular risk in adult diabetic male.
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Affiliation(s)
- F Karim
- Dr Fayeza Karim, Associate Professor & Head, Department of Physiology, East West Medical College, Dhaka, Bangladesh; E-mail:
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16
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Haque S. 168 Innovation Surgical Leadership: Future Directions. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Which theories, concepts and frameworks have been evidenced for surgical innovation in leadership in the United Kingdom, European Union, and the United States of America?
Method
Systematic scoping synthesis of literature will be employed where appropriate theories, concepts and frameworks will be identified. Drawing upon broader literature on leadership innovation in surgery further examples will be utilised within surgery. s and full- text articles will be used and reviewed for relevance to the research question against an inclusion and exclusion criteria.
Results
The theories of innovative leadership in surgery are broad and non-specific. It demands a professionalism, competence, teamwork, and motivation. Upon comparison of the three country/region profiles there are strong similarities but present differences. It is paramount to understand and underpin these theories in order to foster the future of innovation in surgery. Surgery is fast evolving and developments in leadership must evolve with it. Within innovation, leadership skills must be harnessed including experience and observation. It is through an interprofessional team that surgeons must collaborate in order to provide optimum results and to permit the profession to evolve.
Conclusions
Innovation and surgery are symbiotic, and the next generation of surgical leaders must foster an environment where this is possible to cultivate. Programmes across these country profiles must ensure innovative leadership is present through good mentorship, coaching, team empowerment and feedback. Future directions must be put in place in post -graduate surgical training programmes to ensure that patient care is optimised as the primary objective.
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Affiliation(s)
- S. Haque
- Maastricht University, Maastricht, Netherlands
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17
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Nair G, Haque S, Wilson M. 408 Blood Parameters as an Early Indicator of Complications Following Oesophagogastric Resection. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Oesophageal and gastric cancers are the eighth and fifth most prevalent cancers with a high degree of morbidity and mortality. Oesophagogastric resections are associated with a high degree of complications postoperatively. Complications following resection are associated with poorer hospital recovery, recurrence of cancer, readmission to hospital and increased mortality. A study was carried out to examine if there was an association between post-operative bloods and the development of complications.
Method
Data was collected from theatre logbooks, Integrated Clinical Environment (ICE) and clinical portal. Patients undergoing oesophagogastric resection for gastric and oesophageal cancer between October 2010 and November 2014 were included. Complications were organised using the Clavien Dindo classification. Data was analysed using the Student’ T test and Chi-Squared test. A P-value of 0.05 was classed as being statiscally significant.
Results
94 patients met the inclusion criteria for this study. 55 patients (58.5%) underwent Oesophagectomy, 18 (19.1%) total gastrectomy and 21 (22.3%) partial gastrectomy. A significant association was seen between development of complications and higher Day 5 White Cell count (WCC) (p = 0.048), lower Day 2–5 Albumin (Day 2 Albumin p = 0.038) and higher Day 2–5 C Reactive Protein (CRP) (Day 2 CRP p<0.001).
Conclusions
This study suggests Albumin, CRP and WCC may be used to predict postoperative complications in patients undergoing oesophagogastric resections for malignancy. Changes in the blood parameters present as early as day 2 postoperatively and can highlight patients who require closer monitoring, allowing earlier re-intervention if required.
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Affiliation(s)
- G. Nair
- Ninewells' Hospital, Dundee, United Kingdom
- Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - S. Haque
- Ninewells' Hospital, Dundee, United Kingdom
| | - M. Wilson
- Ninewells' Hospital, Dundee, United Kingdom
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Alnohair S, Syed NK, Ahmed HG, Sharaf F, Alshehri F, Haque S, Griffiths MD. COVID-19 pandemic related excessive electronic media exposure and mental health in Saudi Arabia. Eur Rev Med Pharmacol Sci 2021; 25:6941-6958. [PMID: 34859856 DOI: 10.26355/eurrev_202111_27243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Due to the continued spread of COVID-19 and the emergence of novel mutated viral variants, families all over the world are experiencing wide-ranging stressors that threaten not only their financial well-being but also their physical and mental health. The present study assessed the association between excessive electronic media exposure of pandemic-related news and mental health of the residents of Ha'il Province, Saudi Arabia. The present study also assessed the prevalence of perceived stress, fear of COVID-19, anxiety, depression, and loneliness due to COVID-19-related restrictions in the same population. MATERIALS AND METHODS A total of 490 residents of Ha'il Province participated in a cross-sectional online survey during a two-month period (March to April 2021). A validated 38-item self-report survey was used to collect the data. RESULTS Significant associations were reported between excessive electronic media exposure and the prevalence of perceived stress (χ2=140.56; p<.001), generalized anxiety (χ2=74.55; p<.001), depression (χ2=71.58; p<.001), COVID-19-related fear (χ2=24.54; p<.001), and loneliness (χ2=11.46; p<.001). It was also found that participants without depressive symptoms were 0.28 times less likely to have been exposed to excessive electronic media exposure (AOR: 0.28; C.I. 0.16-0.48; p<.001). Similarly, participants with no stress/mild stress were 0.32 times less likely to have been exposed to excessive electronic media exposure (AOR: 0.32; C.I. 0.19-0.52; p<.001). CONCLUSIONS The findings of the present study suggest an urgent need for educational resilience programs (online and in-person) for susceptible individuals (females, unemployed, urban residents, etc.). Such programs would help them to develop skills to cope with the psychological impact of the COVID-19 pandemic.
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Affiliation(s)
- S Alnohair
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, Saudi Arabia.
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19
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Gabriels S, Goru P, Haque S, Hayat M. 891 Fasting Times in Trauma List Patients. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
To reduce the risk of regurgitation and aspiration of gastric contents, patients are to fast before anaesthesia. However, prolonged periods of fasting have been found to be unnecessary and potentially harmful. Our aim was to compare pre-operative fasting times in trauma patients against the AAGBI (Association of Anaesthetists of Great Britain and Ireland) guidelines and highlight areas for improvement. The AAGBI recommends minimum fasting periods of:
Method
50 patients were audited in each cycle. Data were collected prospectively using questionnaires in the initial audit and by interviewing patients in the re-audit. Patients in ITU and those with dementia were excluded. Questions included fasting instructions given, time of the last meal and drink (including kind of drink), IV fluids administration. Anaesthetic notes were checked for time of induction of anaesthesia.
Results
Average time fasted for food was 17.09 hours and 9.32 hours for water. In the re-audit, average time fasted was 16.43 hours for food and 5.27 hours for water. All the patients received information as to when they could eat or drink until. None of them was told ‘midnight’.
Conclusions
Although there was an improvement, this was still beyond the guidelines. The results highlighted the importance of regularly reviewing the fasting status throughout the day in order to achieve the standard.
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Affiliation(s)
- S Gabriels
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - P Goru
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - S Haque
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - M Hayat
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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20
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Cuthbert R, Ferguson D, Kayani B, Haque S, Ali A, Parkar A, Bates P, Vemulapalli K. 414 Informed Consent for Neck of Femur Fracture Surgery During the Covid-19 Pandemic: An Evidence-Based Approach. Br J Surg 2021. [PMCID: PMC8524519 DOI: 10.1093/bjs/znab259.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Surgical intervention for neck of femur fractures continues to be prioritised during the Covid-19 pandemic. However, there remains a lack of clarity for clinicians during the consent process. This study quantifies additional perioperative risks for Covid-19 positive patients undergoing neck of femur fracture surgery and establishes an evidence-based framework for facilitating informed consent during the Covid-19 pandemic. Method 259 patients undergoing neck of femur fracture surgery in four hospitals at the epicentre of the United Kingdom’s first wave of Covid-19 were recruited. 51 patients were positive for Covid-19. Predefined outcomes were recorded in a 30-day postoperative period. Results Odds of intensive care admission were 4.64 times higher (95% CI 1.59-13.50, p = 0.005) and odds of 30-day mortality were 3 times higher (95% CI 1.22-7.40, p = 0.02) in Covid-19 positive patients. 74.5% of Covid-19 positive patients suffered post-operative complications. 35.3% of Covid-19 positive patients developed lower respiratory tract infection with 13.7% progressing to acute respiratory distress syndrome. 9.8% of Covid-19 positive patients experienced symptomatic thromboembolic events with a 3.9% incidence of pulmonary emboli. Conclusions The implications of Covid-19 on the informed consent process for neck of femur fracture surgery are profound. Covid-19 positive patients should be consented for increased risk of postoperative complications (including lower respiratory tract infection, acute respiratory distress syndrome and thromboembolic events), longer inpatient stay, increased frequency of intensive care admission and higher risk of mortality.
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Affiliation(s)
- R Cuthbert
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - D Ferguson
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - B Kayani
- Royal London Hospital, London, United Kingdom
| | - S Haque
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - A Ali
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - A Parkar
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - P Bates
- Royal London Hospital, London, United Kingdom
| | - K Vemulapalli
- Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
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21
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Wahid M, Jawed A, Mandal RK, Dailah HG, Janahi EM, Dhama K, Somvanshi P, Haque S. Variants of SARS-CoV-2, their effects on infection, transmission and neutralization by vaccine-induced antibodies. Eur Rev Med Pharmacol Sci 2021; 25:5857-5864. [PMID: 34604978 DOI: 10.26355/eurrev_202109_26805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE: The current study reviewed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) variants for their effects on infection, transmission and neutralization by vaccine-induced antibodies. MATERIALS AND METHODS: The research articles for the current study were searched over PubMed, Google Scholar, EMBASE and Web of Science online databases. The keywords used were: (("SARS-CoV-2" OR "COVID-19") AND ("mutation" OR "variant") AND ("death" OR "hospitalization" OR "infection" OR "transmission") AND ("antibody" OR "neutralize" OR "vaccine")). A total of 333 research articles were retrieved through online-database search. These articles were further scrutinized for their relevancy. Additionally, searches were performed to find the latest relevant information over Google search engine and relevant news browsers. Finally, around 35 germane articles were considered for scripting the current report. RESULTS: The mutations have changed amino acids at key positions in spike protein viz. S477N, E484K, Q677H, E484Q, L452R, K417T, K417N and N501Y. These mutations are relevant for different characteristics and are present in newly evolved strains of SARS-CoV-2 like E484K in B.1.526, B.1.525, P.2, B.1.1.7, P.1 and B.1.351. Mutations have increased the immune escape potential leading to 3.5-6.5-folds decrease in neutralization of antibodies (Pfizer and Moderna vaccines). The variant, B.1.617 circulating in India and many other countries (double variant) having E484Q and L452R mutations, has raised the infection rate and decreased the neutralization capacity of the vaccine-induced antibodies. Deadly K417N+E484K+N501Y triplet mutations found in B.1.351 and P.1 have increased the transmission ability of these strains by 50% leading to greater COVID-19 hospitalization, ICU admissions and deaths. CONCLUSIONS: The new SARS-CoV-2 variants have compromised the neutralization potential of the currently used vaccines, but still, they have considerable efficacy to reduce infection and mortality. Graphical Abstract https://www.europeanreview.org/wp/wp-content/uploads/Graphical_Abstract.jpg.
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Affiliation(s)
- M Wahid
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia.
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22
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Tee A, Marsland L, Gupta A, Haque S. Is it really infection? A pictorial review of chest imaging in children and adolescents. Imaging 2021. [DOI: 10.1183/13993003.congress-2021.pa3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ibbotson SH, Allan D, Dawe RS, Eadie E, Farr PM, Fassihi H, Fedele F, Ferguson J, Fityan A, Freeman P, Fullerton L, Goulden V, Haque S, Ling TC, Mackay A, McKenna K, Ralph N, Rhodes LE, Sarkany R, Turner D, Ungureanu S, Weatherhead S. Photodiagnostic services in the UK and Republic of Ireland: a British Photodermatology Group Workshop Report. J Eur Acad Dermatol Venereol 2021; 35:2448-2455. [PMID: 34459043 DOI: 10.1111/jdv.17632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Photodiagnostic investigations are essential for the accurate diagnosis of abnormal cutaneous photosensitivity and provide important information for the management of patients with photodermatoses (cutaneous photosensitivity disorders). Although photodiagnosis has been undertaken since the early 1970s, specialist services in the United Kingdom (UK) and Republic of Ireland are limited and there is no formal guidance on diagnostic approach. Indeed, there is a limited literature in this area of methodology and diagnostic practice. OBJECTIVES The primary objective was to undertake a British Photodermatology Group Workshop to review the role and activities of specialist centres in the UK and Republic of Ireland in order to ascertain whether there were consensus practices. Secondary objectives were to identify key priorities for service, training and research. METHODS An initial detailed survey review of current activities was undertaken prior to the Workshop and data from this survey were used to inform discussion at the Workshop, which was attended by key photodermatology experts from the UK and Republic of Ireland. RESULTS/CONCLUSIONS We have undertaken a detailed review of current Photodiagnostic Services in the UK and Republic of Ireland and report on our findings from the 12 centres and we have identified key areas of consensus practice. This is an important step in the process of standardising and optimising procedures and protocols and defining minimum clinical standards for photodiagnostic investigations, which are of such diagnostic importance in Dermatology.
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Affiliation(s)
- S H Ibbotson
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK.,Photobiology Unit, University of Dundee School of Medicine, Ninewells Hospital & Medical School, Dundee, UK
| | - D Allan
- Medical Physics Department, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Salford, UK
| | - R S Dawe
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - E Eadie
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - P M Farr
- Department of Dermatology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - H Fassihi
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - F Fedele
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - J Ferguson
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - A Fityan
- Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Hampshire, UK
| | - P Freeman
- Department of Medical Physics, St Thomas' Hospital, London, UK
| | - L Fullerton
- Photobiology Unit, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - V Goulden
- Department of Dermatology, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - S Haque
- Department of Dermatology, Cambridge University Hospital, Cambridge, UK
| | - T C Ling
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - A Mackay
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - K McKenna
- Department of Dermatology, Belfast City Hospital, Belfast, UK
| | - N Ralph
- Department of Dermatology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - L E Rhodes
- Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - R Sarkany
- Photodermatology Unit, St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - D Turner
- Photodermatology Unit, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK
| | - S Ungureanu
- Department of Dermatology, Solihull Hospital, Solihull, Birmingham, UK
| | - S Weatherhead
- Department of Dermatology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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Sundaram MK, Khan MA, Alalami U, Somvanshi P, Bhardwaj T, Pramodh S, Raina R, Shekfeh Z, Haque S, Hussain A. Phytochemicals induce apoptosis by modulation of nitric oxide signaling pathway in cervical cancer cells. Eur Rev Med Pharmacol Sci 2021; 24:11827-11844. [PMID: 33275255 DOI: 10.26355/eurrev_202011_23840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Nitric Oxide (NO) is produced by NO synthases (NOS) and is a key signaling molecule that regulates tumorigenesis, both aiding and alleviating it. Elevated NO levels are cytotoxic to cancer cells, making NOS an important target for cancer treatment. In the present study, the modulatory effects of the phytochemicals, quercetin, sulforaphane, genistein, and epigallocatechin-3-gallate on NO pathway and apoptosis were shown in HeLa cervical cancer cells. MATERIALS AND METHODS Fluorescent microscopy and flow cytometry were used to assess apoptosis. A Griess assay was used to quantitatively measure NO, quantitative PCR array was used to assess the expression levels of genes involved in the NO signaling pathway, and immunocytochemistry was used to determine NOS protein expression. The functional association among the modulated genes was evaluated using network biology analysis, gene set enrichment, and KEGG pathway analysis. RESULTS Treatment with the phytochemicals elevated NO levels in HeLa cells and modulated various genes involved in nitric oxide biosynthesis, superoxide metabolism, and oxidative stress, including NOS1, NOS2, NOS3, ALOX12, and SOD2, with a concomitant increase in NOS2 and NOS3 protein expression levels; also, the phytochemicals were found to induce apoptosis. CONCLUSIONS These results suggest that the phytochemical-induced cell death is partially attributed to the activation of the NO pathway and upregulation of pro-oxidant ROS generators. Further experimental studies are required to explore this mechanistic association of NO signaling pathway activation and induction of apoptosis in other types of cancer.
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Affiliation(s)
- M K Sundaram
- School of Life Sciences, Manipal Academy of Higher Education, Dubai, United Arab Emirates.
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Hussain SF, Toi T, Laurent E, Seraj SS, Haque S. 643 Near-Peer Surgical Teaching for Junior Doctors: A 16-Month Retrospective Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Surgical departments across the UK are having to mitigate service demands, budget constraints and changes to work patterns with their statutory duty to provide high-quality training and education. Securing consultant-led teaching has also become increasingly difficult leading to the rise of near-peer teaching. We evaluate the long-term effectiveness of near-peer surgical teaching for junior doctors.
Method
We developed a rolling 12-week trainee-led didactic surgical education programme for Foundation doctors and Core Surgical Trainees. Junior doctors delivered teaching to peers with registrar input; session and supervision feedback was recorded using 5-point scales and free-text responses.
Results
42 junior doctors responded to our end-of-programme feedback surveys covering December 2018 to April 2020. The overall programme (8.83±1.08/10), relevance (4.62±0.58/5), presentation quality (4.60±0.50/5) and supervisor knowledge (4.81±0.40/5) were rated highly by respondents. Attendees also reported significant improvements in subject knowledge (3.72±0.92/5 to 4.50±0.56/5, P < 0.0001), clinical confidence, presentation and teaching skills.
Conclusions
Our near-peer teaching programme addressed the educational needs of junior doctors and developed their presentation and organisational skills. Supervision and input from registrars facilitated discussion and reinforced key concepts. The success of this programme highlights the role that trainees can play in designing, developing, and leading an effective surgical teaching programme.
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Affiliation(s)
- S F Hussain
- Basildon and Thurrock University Hospital, Basildon, United Kingdom
- Buckinghamshire Healthcare NHS Trust, High Wycombe, United Kingdom
| | - T Toi
- Basildon and Thurrock University Hospital, Basildon, United Kingdom
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - E Laurent
- Basildon and Thurrock University Hospital, Basildon, United Kingdom
| | - S S Seraj
- Basildon and Thurrock University Hospital, Basildon, United Kingdom
| | - S Haque
- Basildon and Thurrock University Hospital, Basildon, United Kingdom
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Begum A, Nupur A, Sharmin S, Masud S, Luna S, Mamun A, Jesmin T, Haque S, Mainuddin G, Roy R. POS-221 Clinico-Pathological Profile of Children with Lupus Nephritis in A Tertiary Care Hospital. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Redgrave N, Bray J, Burr N, Anadkat M, Haque S, Nikkhah D. Response to: "Managing hand trauma during the COVID-19 pandemic using a one-stop clinic" https://doi.org/10.1016/j.bjps.2020.05.026. J Plast Reconstr Aesthet Surg 2020; 74:1633-1701. [PMID: 33402315 PMCID: PMC7832197 DOI: 10.1016/j.bjps.2020.12.050] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Affiliation(s)
- N Redgrave
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom.
| | - J Bray
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom
| | - N Burr
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom
| | - M Anadkat
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom
| | - S Haque
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom
| | - D Nikkhah
- Plastic Surgery Department, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, United Kingdom
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Akhter N, Ahmad S, Alzahrani FA, Dar SA, Wahid M, Haque S, Bhatia K, Sr Almalki S, Alharbi RA, Sindi AAA. Impact of COVID-19 on the cerebrovascular system and the prevention of RBC lysis. Eur Rev Med Pharmacol Sci 2020; 24:10267-10278. [PMID: 33090438 DOI: 10.26355/eurrev_202010_23251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) uses Angiotensin- converting enzyme 2 (ACE2) receptors to infect host cells which may lead to coronavirus disease (COVID-19). Given the presence of ACE2 receptors in the brain and the critical role of the renin-angiotensin system (RAS) in brain functions, special attention to brain microcirculation and neuronal inflammation is warranted during COVID-19 treatment. Neurological complications reported among COVID-19 patients range from mild dizziness, headache, hypogeusia, hyposmia to severe like encephalopathy, stroke, Guillain-Barre Syndrome (GBS), CNS demyelination, infarcts, microhemorrhages and nerve root enhancement. The pathophysiology of these complications is likely via direct viral infection of the CNS and PNS tissue or through indirect effects including post- viral autoimmune response, neurological consequences of sepsis, hyperpyrexia, hypoxia and hypercoagulability among critically ill COVID-19 patients. Further, decreased deformability of red blood cells (RBC) may be contributing to inflammatory conditions and hypoxia in COVID-19 patients. Haptoglobin, hemopexin, heme oxygenase-1 and acetaminophen may be used to maintain the integrity of the RBC membrane.
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Affiliation(s)
- N Akhter
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia. ;
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Haque S, Jawed A, Akhter N, Dar SA, Khan F, Mandal RK, Areeshi MY, Lohani M, Wahid M. Acetylsalicylic acid (Aspirin): a potent medicine for preventing COVID-19 deaths caused by thrombosis and pulmonary embolism. Eur Rev Med Pharmacol Sci 2020; 24:9244-9245. [PMID: 33015764 DOI: 10.26355/eurrev_202009_23005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S Haque
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia.
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Dar SA, Wahid M, Haque S, Almalki SS, Akhter N. Hydroxychloroquine (HCQ) use in G6PD deficient COVID-19 patients and the risk of Acute Hemeolytic Anaemia (AHA). Eur Rev Med Pharmacol Sci 2020; 24:7923-7924. [PMID: 32767316 DOI: 10.26355/eurrev_202008_22473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S A Dar
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia.
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Karim F, Akter QS, Khanom A, Haque S, Nahar S. Mean Platelet Volume in Type 2 Diabetes Male. Mymensingh Med J 2020; 29:659-663. [PMID: 32844809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The patient with diabetes mellitus and its complication is increasing in our country and all over the world. Altered platelet morphology and function have been reported in patient with DM. Mean platelet volume has been suggested as a newly emerging and independent risk marker for atherothrombosis and cardiovascular disease. The present study was carried out to assess the mean platelet volume in subjects with type 2 diabetes mellitus. The present study was a cross sectional analytic study and conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from July 2013 to June 2014. A total number of 200 adult male subjects were selected with age ranging from 40 to 60 years. Among them, 100 subjects with type 2 diabetes mellitus were included in the case (Group B) and 100 healthy subjects with same age range were considered as control (Group A) for comparison. The subjects were selected from BIRDEM hospital Dhaka and personal contact from different areas of Dhaka city on the basis of exclusion and inclusion criteria. The study parameter was mean platelet volume and was measured in the Department of Hematology of BIRDEM hospital, Dhaka. The data were collected and recorded in pre-designed structured questionnaire by the researcher herself. For statistical analyses unpaired Student's 't' test was performed as applicable using SPSS for windows version 19. In this study, mean platelet volume was significantly (p<0.001) higher in the case group than that of control group. Therefore, estimation of mean platelet volume might be beneficial for prediction of future cardiovascular risk in adult diabetic male.
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Affiliation(s)
- F Karim
- Dr Fayeza Karim, Associate Professor and Head, Department of Physiology, Aichi Medical College, Dhaka, Bangladesh; E-mail:
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Jevons G, Edginton H, Mccall G, Pillai A, Haque S. AB1345-HPR THE MULTIDISCIPLINARY FOOT CLINIC: A SERVICE EVALUATION PROJECT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with rheumatological foot disease are an overlooked population, and it was noted locally that these patients received a fragmented service; attending multiple appointments for the management of one clinical issue. This led to delays in treatment; significant inter-departmental correspondence and variations in the peri-operative management of disease modifying anti-rheumatic drug (DMARD) and biologic therapies. To remedy this a foot multidisciplinary (MDT) clinic was established, including input from rheumatology, orthopaedic surgery, specialist rheumatology podiatry and physiotherapy. The outcomes from the foot MDT clinic have been analysed in this service evaluation project.Objectives:To evaluate the outcomes of the multidisciplinary foot MDT clinic, with particular reference to concordance to the British Rheumatology Society (BSR) guidelines on peri-operative medicine guidelines.Methods:Data was collected retrospectively across all clinics from January 2017 to February 2019. Clinic letters were obtained, and data was collected using a standardised data collection sheet. Data was collected on patient demographics, rheumatological diagnoses, treatment outcomes from the foot MDT, appropriateness of peri-operative plan and post-operative complications. No data was available on these outcomes prior to the advent of the foot MDT clinic.Results:Data from 12 clinics was analysed (n=40). Patients had a median age of 66 years (IQR 27.5 years); 65% of patients were female and 35% of patients were male. The commonest rheumatological foot disease seen was rheumatoid arthritis (67%), followed by psoriatic arthritis (15%). All patients were treated with biologic or non-biologic DMARDs. Treatment outcomes were as follows: 27.5% were offered surgical treatment; 10% were offered intra-articular (IA) injections under ultrasound guidance; 10% were offered IA injections under general anaesthetic; 25% underwent specialist rheumatology podiatry, and the remaining 30% elected for a conservative approach after careful consideration of treatment options. Of those who were offered surgical treatment, 72% of patients were provided with a peri-operative plan which accorded with British Rheumatology Society (BSR) guidelines. Of those whom underwent surgery, one patient’s surgical treatment was complicated by a post-operative infection; however, the peri-operative DMARD/biologic plan was not felt to be contributing factor.Conclusion:The foot MDT clinic provides a comprehensive review of rheumatological foot conditions, with readily available access to a full range of treatment options. Co-location of all relevant professionals allows for real-time interdepartmental communication; shared decision making between clinicians and patients; avoids multiple appointments; reduces uncertainty with peri-operative planning as well as providing a cost-effective and efficacious service. Discrepancies in the peri-operative plan for medicines arose when the treating orthopaedic surgeon was not present in clinic. In these cases, the plan for surgical treatment was made outside of this clinic, without input from the treating rheumatologist. To improve concordance with BSR peri-operative medicine guidelines, it is recommended that all treatment decisions are made during the clinic, allowing input from all relevant partners. Informal feedback from patients commended the foot MDT, this shall be formalised through further qualitative data.Disclosure of Interests:None declared
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Dyball S, Reynolds J, Mccarthy E, Haque S, Herrick A, Chinoy H, Bruce E, Parker B, Bruce IN. OP0094 EULAR-ACR 2019 CLASSIFICATION CRITERIA FOR SLE: CAN WE CLASSIFY USING LABORATORY TESTS ALONE? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The EULAR-ACR 2019 (EULAR19) classification criteria for systemic lupus erythematosus (SLE) were developed to improve the sensitivity and specificity of previous criteria. Notably, both the EULAR19 and existing SLICC-SLE 2012 (SLICC12) criteria can classify patients as having SLE by the presence of immunology and haematological abnormalities in the absence of any signs or symptoms.Objectives:To validate the EULAR19 criteria, with comparison to existing criteria, in a large cohort of patients with an established systemic autoimmune rheumatic disease (SARD).Methods:We recruited 227 adult patients who were ANA positive with ≥1 clinical feature suggestive of a SARD, from three hospitals in the North West of England. Clinician diagnosis was used as gold standard; we then applied the EULAR19, SLICC12 and the ACR-SLE 1997 (ACR97) criteria.Results:Of the 227 patients recruited, by clinician diagnosis, 89 patients (36%) had SLE, 43 (17%) primary Sjögren’s (pSS), 62 (25%) undifferentiated CTD (UCTD), 25 (10%) systemic sclerosis (SSc) and 8 (3%) an inflammatory myositis. The characteristics of these patients and the breakdown of the EULAR19 criteria are outlined in figure 1.Figure 1.Baseline characteristics and classification criteria compared across five SARD diagnoses.The sensitivity and specificity of the EULAR19 is similar to ACR97 (sensitivity 84% (95% CI 75-91%) vs. 87% (95% CI 78-93%) and specificity 78% (95% CI 70-84%) vs. 76% (95% CI 68-83%) respectively). The SLICC12 criteria by contrast are more sensitive (94% (95% CI 87-98%)) and less specific (61% (95% CI 52-69%)) in this cohort.Figure 2 illustrates patients with a clinician diagnosis of SLE or UCTD who meet each of the classification criteria. Of the 89 patients with a clinician diagnosis of SLE, 39 (44%) patients would have sufficient points to meet EULAR19 criteria on blood test results alone in the absence of clinical symptoms. Four pSS patients and 4 UCTD patients would also meet EULAR19 criteria from positive blood results alone.Figure 2.Venn diagrams illustrating patients with SLE and UCTD who meet the EULAR19, ACR97 and SLICC12 classification criteria. No criteria refers to the patients not meeting any of the three SLE classification criteria.Conclusion:These results suggest that the EULAR19 criteria perform comparably to the ACR97 criteria when applied to an established cohort of SARDs. Similar to SLICC12, it is possible to classify patients as having SLE using the EULAR19 criteria by haematological and other laboratory tests. To what extent haematological abnormalities can be potentially used as the sole ‘clinical criteria’ needs consideration.SLE n=89pSS n=43UCTD n=62SSc n=25Myositis n=8Female N (%)82 (92)42 (98)53 (85)24 (96)8 (100)Age, mean (SD) /years44 (13)52 (12)47 (13)60 (9)53 (7)Disease duration, mean (SD) /years12 (10)6 (5)5 (7)9 (11)3 (3)SLE classification criteriaEULAR SLE 2019, N (%)75 (84)10 (23)20 (32)1 (4)0ACR SLE 1997, N (%)77 (87)9 (21)21 (34)2 (8)1 (13)SLICC SLE 2012, N (%)84 (94)15 (35)33 (53)4 (16)2 (25)EULAR-ACR 2019 criteriaConstitutional, N (%)10 (11)2 (5)1 (2)01 (13)Neuropsychiatric, N (%)3 (3)01 (2)1 (4)0Mucocutaneous, N (%)71 (80)13 (30)27 (44)2 (8)2 (25)Serosal, N (%)13 (15)1 (2)2 (3)00Musculoskeletal, N (%)52 (58)14 (33)22 (35)3 (12)3 (38)Renal, N (%)30 (34)001 (4)0Haematological, N (%)44 (49)12 (28)10 (16)3 (12)0Antiphospholipid antibodies, N (%)43 (48)7 (16)17 (27)4 (16)0Low complement, N (%)48 (54)10 (23)10 (16)3 (12)1 (13)Anti-Sm, N (%)19 (21)2 (5)4 (6)1 (4)0Anti-dsDNA, N (%)50 (56)8 (19)12 (19)01 (13)Disclosure of Interests:Sarah Dyball: None declared, John Reynolds: None declared, Eoghan McCarthy: None declared, Sahena Haque: None declared, Ariane Herrick: None declared, Hector Chinoy: None declared, Ellen Bruce: None declared, Ben Parker Grant/research support from: GSK and Sanofi Genzyme, Consultant of: GSK, AstraZenaca, UCV, Abbvie, Pfizer, BMS, Celltrion, Ian N. Bruce Grant/research support from: Genzyme Sanofi, GSK, and UCB, Consultant of: Eli Lilly, AstraZeneca, UCB, Iltoo, and Merck Serono, Speakers bureau: UCB
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Wallace MS, Presura R, Haque S, Pohl I, Lake P, Wu M. Cubic crystals in an x-ray polarization-splitting geometry. Rev Sci Instrum 2020; 91:023105. [PMID: 32113377 DOI: 10.1063/1.5120530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/05/2020] [Indexed: 06/10/2023]
Abstract
Hexagonal and cubic crystals contain paired sets of internal planes that reflect the linearly polarized components of certain x rays into two separate, perpendicular directions. For the cubic crystals, two distinct crystal orientations provide the same polarization-splitting geometry. One of the orientations may have advantages for plasma spectroscopy by suppressing unwanted reflections. This paper demonstrates the two orientations with a germanium crystal and K characteristic lines from copper and zirconium.
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Affiliation(s)
- M S Wallace
- Nevada National Security Site, New Mexico Operations, Sandia Office, Albuquerque, New Mexico 87123, USA
| | - R Presura
- Nevada National Security Site, New Mexico Operations, Sandia Office, Albuquerque, New Mexico 87123, USA
| | - S Haque
- Nevada National Security Site, New Mexico Operations, Sandia Office, Albuquerque, New Mexico 87123, USA
| | - I Pohl
- Nevada National Security Site, New Mexico Operations, Sandia Office, Albuquerque, New Mexico 87123, USA
| | - P Lake
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
| | - M Wu
- Sandia National Laboratories, Albuquerque, New Mexico 87123, USA
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Haque S, Islam MA, Haque N, Bari MS, Hoque MM, Haque N. Comparison of High Density Lipoprotein Cholesterol Level in Second and Third Trimester of Pregnancy in Mymensingh, Bangladesh. Mymensingh Med J 2020; 29:104-107. [PMID: 31915344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pregnancy is accompanied by changes in the maternal lipoprotein metabolism that may serve to satisfy the nutritional demands of the fetus in addition to the energy requirements of the mother. Early pregnancy is considered the anabolic phase, characterized by increased hepatic production of triglycerides and enhanced removal of triglycerides from the circulation, resulting in an increased deposition of fat in maternal adipose tissue. Late pregnancy is referred to as the catabolic phase, the release of free fatty acids from adipocytes is enhanced due to both relative insulin resistance and stimulation of hormones. Although it is known that cholesterol rises in pregnancy, at present it is not routinely measured or treated. However, a growing body of evidence from animal and human studies suggests adverse consequences of high cholesterol levels in pregnancy. High lipid profile, a major factor behind atherosclerosis may leads to unconsciousness. To avoid such problems during pregnancy this longitudinal study was carried out in the department of Biochemistry, Mymensingh Medical College in co-operation with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh from July 2011 to December 2012 to compare the changes in high density lipoprotein cholesterol level during 2nd and 3rd trimester of pregnancy. A total of one hundred subjects were participated in this study comprising of second and third trimester of pregnancy. All subjects were made to fast overnight at least for a minimum of 8 hours. Blood samples were taken and analyzed by enzymatic colorimetric kit method. Pregnancy has been found to be associated with changes in lipid profile and this differs with each trimester. The average results were analyzed with respect to each pregnancy for the whole group. The study proves that serum High Density Lipoprotein (HDL) cholesterol increases in second trimester (48.71±7.61mg/dl) than third trimester (47.01±7.45mg/dl) of Pregnancy. So, Lipid profile estimation and monitoring should be made as a part of routine investigation during antenatal period.
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Affiliation(s)
- S Haque
- Dr Shakila Haque, Associate Professor, Department of Biochemistry, Aichi Medical College, Dhaka, Bangladesh
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Wise-Draper T, Haque S, Steele A, Desai S, Harris T, Riaz M, Morris J, Takiar V, Nagasaka M, Jandarov R, Sukari A. Interim analysis of a single arm phase II study of adjuvant nivolumab after salvage resection in head and neck squamous cell carcinoma patients previously treated with definitive therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hofmanová J, Rajabi-Siahboomi A, Haque S, Mason J, Teckoe J, To D, Batchelor H. Developing methodology to evaluate the oral sensory features of pharmaceutical tablet coatings. Int J Pharm 2019; 562:212-217. [DOI: 10.1016/j.ijpharm.2019.03.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 10/27/2022]
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Haque S, Ebron S, Bailey B, Blumenfeld B. Use of Health Information Technology among Patient Navigators in Community Health Interventions. Perspect Health Inf Manag 2019; 16:1a. [PMID: 31019432 PMCID: PMC6462882] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OVERVIEW As chronic disease and comorbidities increase, so does the complexity of patient care.This complexity requires interdisciplinary care teams and multifactor interventions to ensure that patients get the most efficient care. Patient navigators-defined as individuals who help patients move through the complex care continuum-can improve access to care and patient engagement, which can translate into better outcomes. Health information technology (health IT) can support timely communication and information sharing for patient navigators and the providers with whom they interact to better coordinate care. We explored the health IT that patient navigators used, how they used it, and their health IT needs in community-based interventions. METHODS We analyzed three years of qualitative program evaluation data captured though progress reports, site visits, and telephone interviews as part of a larger evaluation of community-based demonstration projects. We used inductive analysis to identify preliminary themes to develop a codebook. Using QSR International's NVivo qualitative analysis software (version 11.0), we then used the preliminary themes in a second round of independent coding. We identified themes relevant to navigators and to barriers and facilitators for health IT. Coders achieved a final kappa of 0.8, suggesting excellent interrater reliability. RESULTS Navigators used various types of health IT (e.g., health information exchanges, electronic health records, short message service) to capture and share information with the rest of the care team. Navigators used technology to document patient information, track services, and schedule appointments for patients; however, some respondents reported challenges with systems that were not integrated. Navigators must learn to use health IT systems of varying complexity to complete their job duties. DISCUSSION Health IT can improve workflow by facilitating task organization and communication with the care team. Ultimately, integrating the health IT systems used by navigators with those used by other care team members was most beneficial. Because of the various types of health IT used, patient navigators should receive training to ensure that they have the technical skills to use these systems efficiently and reduce duplication of effort. CONCLUSION Managing the care of patients with chronic disease requires comprehensive care teams, which can include patient navigators. Integrating navigators' documentation into other health IT systems can keep providers updated on information while patients are outside of the providers' care. With the growth of health IT use in recent years, technical skills are becoming increasingly important. These findings can help leaders who are planning complex health interventions involving navigators to ensure that technology is used efficiently to support coordination and allow navigators to reach more patients.
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Affiliation(s)
- Saira Haque
- RTI International in Research Triangle Park, NC
| | | | - Bob Bailey
- RTI International in Research Triangle Park, NC
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Ahmed M, Siddiqi S, Haque S, Chau J, Amin H. Safety and efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) for depression in mild to moderate Traumatic Brain Injury (TBI): a non-controlled study. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Islam MA, Haque S, Ahmed K, Bari MS, Hoque MM, Khan MK, Haque N, Haque N, Reza-Ul-Haq KM, Kobir MS. Outcome of Surgery in Chronic Inactive Mucosal Otitis Media. Mymensingh Med J 2018; 27:617-625. [PMID: 30141454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Chronic otitis media is a common condition seen in patients attending the otorhinolaryngology Department. The discharging ear presents the otologists with the dilemma of operating on it or not. The aim of the this cross-sectional observational study was to find out the outcome of surgery in chronic inactive mucosal otitis media and was conducted on 62 patients of either sex in the age group of 15-60 years in the Department of ENT and Head Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka, Bangladesh From July 2015 to January 2016. Pre and post operative hearing assessment was done with pure tone audiometry (PTA). Post operative graft status also noted. All the information's were recorded in the fixed protocol. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using updated computerized program SPSS-19. Among 62 cases the mean age were 36.79±10.33 in chronic inactive mucosal otitis media. Majority of the study population were in age group of between 15-25 in this group of which was 16(51.6%). Male were 36(58.06) and 26(41.94) were female. All patients presented with history of otorrhoea in this group, 52(83.87%) had hearing impairment in chronic inactive mucosal otitis media, 30(48.39%) involved in right ear and 26(41.94%) involved in left ear and 06(9.68%) in both ear in chronic inactive mucosal otitis media. Majority of perforation were medium in size in this group of which was 30(48.39%). anterior perforation was 24(38.71%), posterior perforation 28(45.16%) and subtotal 10(16.13%) in chronic inactive mucosal otitis media. Sixty two (100%) cases underwent myringoplasty. Post-auricular approach used in most of operation in this group of which was 60(96.77%). Preoperative air conduction threshold 32(51.61%) were in between 31-45 dB in myringoplasty group (p<0.05) that was statistically significant. Postoperative air conduction threshold 30(48.39%) were between 16-30 dB in myringoplasty group (p<0.05) that was statistically significant. Difference between preoperative and postoperative air conduction threshold mean difference was 11.38 dB and 36.75±5.84 and 25.37±7.46 respectively (p<0.001) in myringoplasty group. Hearing gain was 42(67.74%) in myringoplasty (p>0.05) that was not statistically significant. Graft uptake in myringoplasty was 52(83.9%). Graft failure in myringoplasty was 10(16.1%). post operative complication was tinnitus in 12(19.35%) cases in myringoplasty. Success rate was more in case of posterior perforation than anterior and subtotal perforation in both chronic inactive mucosal otitis media which was 92.86%. Success rate was more in case of medium size perforation than subtotal perforation in chronic inactive mucosal otitis media which was 86.67%. Success rate was (100%) in small perforation in this group. From this study it can be concluded that myringoplasty is a valid treatment modality for chronic inactive mucosal otitis media to achieve an intact tympanic membrane and to gain hearing.
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Affiliation(s)
- M A Islam
- Dr Md Amirul Islam, Associate Professor (CC), Department of ENT&HNS, Dhaka Community Medical College & Hospital, Dhaka, Bangladesh
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Dunn LA, Fury MG, Xiao H, Baxi SS, Sherman EJ, Korte S, Pfister C, Haque S, Katabi N, Ho AL, Pfister DG. A phase II study of temsirolimus added to low-dose weekly carboplatin and paclitaxel for patients with recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2018; 29:1606. [PMID: 29300804 DOI: 10.1093/annonc/mdx801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dunn LA, Fury MG, Xiao H, Baxi SS, Sherman EJ, Korte S, Pfister C, Haque S, Katabi N, Ho AL, Pfister DG. A phase II study of temsirolimus added to low-dose weekly carboplatin and paclitaxel for patients with recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2018; 28:2533-2538. [PMID: 28961834 DOI: 10.1093/annonc/mdx346] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 12/12/2022] Open
Abstract
Background Activating events along the PI3K/mTOR pathway are common in head and neck squamous cell carcinomas (HNSCC), and preclinical studies suggest additive or synergistic effects when combining mTORC1 inhibitors with carboplatin and paclitaxel chemotherapy. Patients and methods In this single-institution phase II study, the combination of temsirolimus 25 mg, carboplatin AUC 1.5, and paclitaxel 80 mg/m2 administered on days 1 and 8 of a 21-day cycle was evaluated in 36 patients with recurrent and/or metastatic (R/M) HNSCC. The primary end point was objective response rate after two cycles of treatment. Secondary end points include the safety and tolerability profile and overall survival. Correlative studies with exome mutational analysis were performed in pre-treatment biopsy samples from 21 patients. Results Fifteen (41.7%) patients had an objective response, which were all partial responses, and 19 (52.3%) patients had stable disease as best response. The two patients who were designated as 'non-responders' were removed from study prior to two cycles of treatment, but are included in the efficacy and safety analyses. The median duration on study was 5.3 months and the median progression-free survival and overall survival were 5.9 months (95% confidence interval, 4.8-7.1) and 12.8 months (95% confidence interval, 9.8-15.8), respectively. The most common grade 3 and 4 adverse events were hematologic toxicities. Three (3.8%) patients developed neutropenic fever on study. Three of four patients with PIK3CA mutations experienced tumor regressions, and responses were also seen in patients with other genetic alterations in the PI3K/mTOR pathway. Conclusion The combination of temsirolimus with low-dose weekly carboplatin and paclitaxel appears to have meaningful clinical efficacy in the treatment of R/M HNSCC. This regimen has a relatively high response rate compared to other treatments evaluated in R/M HNSCC, and potential associations with genetic alterations in the PI3K/mTOR pathway should be further explored.
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Affiliation(s)
- L A Dunn
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine;.
| | - M G Fury
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - H Xiao
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - S S Baxi
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - E J Sherman
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - S Korte
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - C Pfister
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | | | - N Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A L Ho
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
| | - D G Pfister
- Section of Head and Neck Oncology, Division of Solid Tumor, Department of Medicine
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Wallace MS, Haque S, Neill P, Pereira NR, Presura R. Spatially resolved single crystal x-ray spectropolarimetry of wire array z-pinch plasmas. Rev Sci Instrum 2018; 89:015106. [PMID: 29390728 DOI: 10.1063/1.5006051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A recently developed single-crystal x-ray spectropolarimeter has been used to record paired sets of polarization-dependent and axially resolved x-ray spectra emitted by wire array z-pinches. In this measurement, two internal planes inside a suitable crystal diffract the x-rays into two perpendicular directions that are normal to each other, thereby separating incident x-rays into their linearly polarized components. This paper gives considerations for fielding the instrument on extended sources. Results from extended sources are difficult to interpret because generally the incident x-rays are not separated properly by the crystal. This difficulty is mitigated by using a series of collimating slits to select incident x-rays that propagate in a plane of symmetry between the polarization-splitting planes. The resulting instrument and some of the spatially resolved polarized x-ray spectra recorded for a 1-MA aluminum wire array z-pinch at the Nevada Terawatt Facility at the University of Nevada, Reno will be presented.
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Affiliation(s)
- M S Wallace
- Physics Department and Nevada Terawatt Facility, University of Nevada, Reno, Nevada 89557, USA
| | - S Haque
- Physics Department and Nevada Terawatt Facility, University of Nevada, Reno, Nevada 89557, USA
| | - P Neill
- Physics Department and Nevada Terawatt Facility, University of Nevada, Reno, Nevada 89557, USA
| | - N R Pereira
- Ecopulse, Inc., Springfield, Virginia 22152, USA
| | - R Presura
- Physics Department and Nevada Terawatt Facility, University of Nevada, Reno, Nevada 89557, USA
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Rushton A, Wiangkham T, Duda J, Haque S, Price J. Prospective cluster-randomised double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash associated disorder (WAD)II. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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K S, Das S, Pandhi D, Rai G, Ansari MA, Gupta C, Haque S, Dar SA. Challenges in culture-negative cases of Madurella mycetomatis: A case report re-accentuating PCR as an essential diagnostic tool. J Mycol Med 2017; 27:577-581. [PMID: 29102309 DOI: 10.1016/j.mycmed.2017.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 09/26/2017] [Accepted: 09/26/2017] [Indexed: 11/25/2022]
Abstract
Identification of dematiaceous fungi responsible for black-grain mycetoma has remained cumbersome and time consuming for years leading to delayed diagnosis and thereby increased agony to patients. Moreover, difficult morphology of some of these fungi demanding enough expertise for species identification in addition to culture-negativity has often led to misdiagnosis and hence inapt treatment to the patients. We report the identification of Madurella mycetomatis from culture-negative black granules discharged from foot nodular lesions of a 27 years old male using PCR followed by sequencing of the internal transcribed spacer region. The patient's lesions were successfully treated using a combination of itraconazole (200mg) and terbinafine (250mg), confirming our diagnosis. Our case study proves the clinical value of PCR as the best, rapid and accurate diagnostic method for the identification of Madurella mycetomatis and related fungi, particularly in culture-negative cases.
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Affiliation(s)
- S K
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - S Das
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - D Pandhi
- Department of Dermatology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - G Rai
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - M A Ansari
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - C Gupta
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India
| | - S Haque
- Department of Biochemistry, B.N. College of Engineering & Technology, Lucknow 226201, U.P., India; Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - S A Dar
- Department of Microbiology, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi 110095, India; Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan 45142, Saudi Arabia.
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Snodgrass C, A'Hearn MF, Aceituno F, Afanasiev V, Bagnulo S, Bauer J, Bergond G, Besse S, Biver N, Bodewits D, Boehnhardt H, Bonev BP, Borisov G, Carry B, Casanova V, Cochran A, Conn BC, Davidsson B, Davies JK, de León J, de Mooij E, de Val-Borro M, Delacruz M, DiSanti MA, Drew JE, Duffard R, Edberg NJT, Faggi S, Feaga L, Fitzsimmons A, Fujiwara H, Gibb EL, Gillon M, Green SF, Guijarro A, Guilbert-Lepoutre A, Gutiérrez PJ, Hadamcik E, Hainaut O, Haque S, Hedrosa R, Hines D, Hopp U, Hoyo F, Hutsemékers D, Hyland M, Ivanova O, Jehin E, Jones GH, Keane JV, Kelley MSP, Kiselev N, Kleyna J, Kluge M, Knight MM, Kokotanekova R, Koschny D, Kramer EA, López-Moreno JJ, Lacerda P, Lara LM, Lasue J, Lehto HJ, Levasseur-Regourd AC, Licandro J, Lin ZY, Lister T, Lowry SC, Mainzer A, Manfroid J, Marchant J, McKay AJ, McNeill A, Meech KJ, Micheli M, Mohammed I, Monguió M, Moreno F, Muñoz O, Mumma MJ, Nikolov P, Opitom C, Ortiz JL, Paganini L, Pajuelo M, Pozuelos FJ, Protopapa S, Pursimo T, Rajkumar B, Ramanjooloo Y, Ramos E, Ries C, Riffeser A, Rosenbush V, Rousselot P, Ryan EL, Santos-Sanz P, Schleicher DG, Schmidt M, Schulz R, Sen AK, Somero A, Sota A, Stinson A, Sunshine JM, Thompson A, Tozzi GP, Tubiana C, Villanueva GL, Wang X, Wooden DH, Yagi M, Yang B, Zaprudin B, Zegmott TJ. The 67P/Churyumov-Gerasimenko observation campaign in support of the Rosetta mission. Philos Trans A Math Phys Eng Sci 2017; 375:rsta.2016.0249. [PMID: 28554971 PMCID: PMC5454223 DOI: 10.1098/rsta.2016.0249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 05/15/2023]
Abstract
We present a summary of the campaign of remote observations that supported the European Space Agency's Rosetta mission. Telescopes across the globe (and in space) followed comet 67P/Churyumov-Gerasimenko from before Rosetta's arrival until nearly the end of the mission in September 2016. These provided essential data for mission planning, large-scale context information for the coma and tails beyond the spacecraft and a way to directly compare 67P with other comets. The observations revealed 67P to be a relatively 'well-behaved' comet, typical of Jupiter family comets and with activity patterns that repeat from orbit to orbit. Comparison between this large collection of telescopic observations and the in situ results from Rosetta will allow us to better understand comet coma chemistry and structure. This work is just beginning as the mission ends-in this paper, we present a summary of the ground-based observations and early results, and point to many questions that will be addressed in future studies.This article is part of the themed issue 'Cometary science after Rosetta'.
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Affiliation(s)
- C Snodgrass
- School of Physical Sciences, The Open University, Milton Keynes MK7 6AA, UK
| | - M F A'Hearn
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - F Aceituno
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - V Afanasiev
- Special Astrophysical Observatory, Russian Academy of Sciences, Nizhny Arkhyz, Russia
| | - S Bagnulo
- Armagh Observatory, College Hill, Armagh BT61 9DG, UK
| | - J Bauer
- Jet Propulsion Laboratory, M/S 183-401, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - G Bergond
- Centro Astronómico Hispano-Alemán, Calar Alto, CSIC-MPG, Sierra de los Filabres-04550 Gérgal (Almería), Spain
| | - S Besse
- ESA/ESAC, PO Box 78, 28691 Villanueva de la Cañada, Spain
| | - N Biver
- LESIA, Observatoire de Paris, CNRS, UPMC Univ. Paris 06, Univ. Paris-Diderot, 5 Place J. Janssen, 92195 Meudon Pricipal Cedex, France
| | - D Bodewits
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - H Boehnhardt
- Max-Planck-Institut für Sonnensystemforschung, Justus-von-Liebig-Weg 3, 37077 Göttingen, Germany
| | - B P Bonev
- Department of Physics, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016, USA
| | - G Borisov
- Armagh Observatory, College Hill, Armagh BT61 9DG, UK
- Institute of Astronomy and National Astronomical Observatory, 72 Tsarigradsko Chaussée Boulevard, BG-1784 Sofia, Bulgaria
| | - B Carry
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Lagrange, France
- IMCCE, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universités, UPMC Univ. Paris 06, Univ. Lille, France
| | - V Casanova
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - A Cochran
- University of Texas Austin/McDonald Observatory, 1 University Station, Austin, TX 78712, USA
| | - B C Conn
- Research School of Astronomy and Astrophysics, The Australian National University, Canberra, Australian Capital Territory, Australia
- Gemini Observatory, Recinto AURA, Colina El Pino s/n, Casilla 603, La Serena, Chile
| | - B Davidsson
- Jet Propulsion Laboratory, M/S 183-401, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - J K Davies
- The UK Astronomy Technology Centre, Royal Observatory Edinburgh, Blackford Hill, Edinburgh EH9 3HJ, UK
| | - J de León
- Instituto de Astrofísica de Canarias (IAC), C/Vía Láctea s/n, 38205 La Laguna, Spain
- Departamento de Astrofísica, Universidad de La Laguna, 38206 La Laguna, Tenerife, Spain
| | - E de Mooij
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - M de Val-Borro
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
- Department of Physics, The Catholic University of America, Washington, DC 20064, USA
| | - M Delacruz
- Institute for Astronomy, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
| | - M A DiSanti
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
| | - J E Drew
- School of Physics, Astronomy and Mathematics, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
| | - R Duffard
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - N J T Edberg
- Swedish Institute of Space Physics, Ångströmlaboratoriet, Lägerhyddsvägen 1, 751 21 Uppsala, Sweden
| | - S Faggi
- INAF, Osservatorio Astrofisico di Arcetri, Largo E. Fermi 5, 50 125 Firenze, Italy
| | - L Feaga
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - A Fitzsimmons
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - H Fujiwara
- Subaru Telescope, National Astronomical Observatory of Japan, 650 North A'ohoku Place, Hilo, HI 96720, USA
| | - E L Gibb
- Department of Physics and Astronomy, University of Missouri - St. Louis, St. Louis, MO 63121, USA
| | - M Gillon
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
| | - S F Green
- School of Physical Sciences, The Open University, Milton Keynes MK7 6AA, UK
| | - A Guijarro
- Centro Astronómico Hispano-Alemán, Calar Alto, CSIC-MPG, Sierra de los Filabres-04550 Gérgal (Almería), Spain
| | - A Guilbert-Lepoutre
- Institut UTINAM, UMR 6213 CNRS-Université de Franche Comté, Besançon, France
| | - P J Gutiérrez
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - E Hadamcik
- CNRS/INSU; UPMC (Sorbonne Univ.); UVSQ (UPSay); LATMOS-IPSL, 11 Bld d'Alembert, 78280 Guyancourt, France
| | - O Hainaut
- European Southern Observatory, Karl-Schwarzschild-Strasse 2, 85748 Garching bei München, Germany
| | - S Haque
- Department of Physics, University of the West Indies, St Augustine, Trinidad, West Indies
| | - R Hedrosa
- Centro Astronómico Hispano-Alemán, Calar Alto, CSIC-MPG, Sierra de los Filabres-04550 Gérgal (Almería), Spain
| | - D Hines
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - U Hopp
- University Observatory, Ludwig-Maximilian-University Munich, Scheiner Strasse 1, 81679 Munich, Germany
| | - F Hoyo
- Centro Astronómico Hispano-Alemán, Calar Alto, CSIC-MPG, Sierra de los Filabres-04550 Gérgal (Almería), Spain
| | - D Hutsemékers
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
| | - M Hyland
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - O Ivanova
- Astronomical Institute of the Slovak Academy of Sciences, 05960 Tatranská Lomnica, Slovak Republic
| | - E Jehin
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
| | - G H Jones
- Mullard Space Science Laboratory, University College London, Holmbury St Mary, Dorking RH5 6NT, UK
- The Centre for Planetary Sciences at UCL/Birkbeck, Gower Street, London WC1E 6BT, UK
| | - J V Keane
- Institute for Astronomy, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
| | - M S P Kelley
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - N Kiselev
- Main Astronomical Observatory of National Academy of Sciences, Kyiv, UKraine
| | - J Kleyna
- Institute for Astronomy, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
| | - M Kluge
- University Observatory, Ludwig-Maximilian-University Munich, Scheiner Strasse 1, 81679 Munich, Germany
| | - M M Knight
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - R Kokotanekova
- School of Physical Sciences, The Open University, Milton Keynes MK7 6AA, UK
- Max-Planck-Institut für Sonnensystemforschung, Justus-von-Liebig-Weg 3, 37077 Göttingen, Germany
| | - D Koschny
- Research and Scientific Support Department, European Space Agency, 2201 Noordwijk, The Netherlands
| | - E A Kramer
- Jet Propulsion Laboratory, M/S 183-401, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - J J López-Moreno
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - P Lacerda
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - L M Lara
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - J Lasue
- Université de Toulouse, UPS-OMP, IRAP-CNRS, Toulouse, France
| | - H J Lehto
- Tuorla Observatory, Department of Physics and Astronomy, University of Turku, Väisäläntie 20, 21500 Piikkiö, Finland
| | - A C Levasseur-Regourd
- UPMC (Sorbonne Univ.); UVSQ (UPSay); CNRS/INSU; LATMOS-IPSL, BC 102, 4 Place Jussieu, 75005 Paris, France
| | - J Licandro
- Instituto de Astrofísica de Canarias (IAC), C/Vía Láctea s/n, 38205 La Laguna, Spain
- Departamento de Astrofísica, Universidad de La Laguna, 38206 La Laguna, Tenerife, Spain
| | - Z Y Lin
- Graduate Institute of Astronomy, National Central University, No. 300 Zhongda Road, Zhongli District, Taoyuan City, 320 Taiwan
| | - T Lister
- Las Cumbres Observatory, 6740 Cortona Drive, Ste. 102, Goleta, CA 93117, USA
| | - S C Lowry
- Centre for Astrophysics and Planetary Science, School of Physical Sciences, The University of Kent, Canterbury CT2 7NH, UK
| | - A Mainzer
- Jet Propulsion Laboratory, M/S 183-401, 4800 Oak Grove Drive, Pasadena, CA 91109, USA
| | - J Manfroid
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
| | - J Marchant
- Astrophysics Research Institute, Liverpool John Moores University, Liverpool L3 5RF, UK
| | - A J McKay
- University of Texas Austin/McDonald Observatory, 1 University Station, Austin, TX 78712, USA
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
| | - A McNeill
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - K J Meech
- Institute for Astronomy, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
| | - M Micheli
- ESA SSA-NEO Coordination Centre, Frascati (RM), Italy
| | - I Mohammed
- Caribbean Institute of Astronomy, Trinidad, West Indies
| | - M Monguió
- School of Physics, Astronomy and Mathematics, University of Hertfordshire, College Lane, Hatfield AL10 9AB, UK
| | - F Moreno
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - O Muñoz
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - M J Mumma
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
| | - P Nikolov
- Institute of Astronomy and National Astronomical Observatory, 72 Tsarigradsko Chaussée Boulevard, BG-1784 Sofia, Bulgaria
| | - C Opitom
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
- European Southern Observatory, Alonso de Cordova 3107, Vitacura, Santiago, Chile
| | - J L Ortiz
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - L Paganini
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
| | - M Pajuelo
- IMCCE, Observatoire de Paris, PSL Research University, CNRS, Sorbonne Universités, UPMC Univ. Paris 06, Univ. Lille, France
- Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Apartado 1761, Lima, Perú
| | - F J Pozuelos
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
- Institut d'Astrophysique et de Géophysique, Université de Liège, allée du 6 Août 17, 4000 Liège, Belgium
| | - S Protopapa
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - T Pursimo
- Nordic Optical Telescope, Apartado 474, 38700 Santa Cruz de La Palma, Santa Cruz de Tenerife, Spain
| | - B Rajkumar
- Department of Physics, University of the West Indies, St Augustine, Trinidad, West Indies
| | - Y Ramanjooloo
- Institute for Astronomy, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
| | - E Ramos
- Centro Astronómico Hispano-Alemán, Calar Alto, CSIC-MPG, Sierra de los Filabres-04550 Gérgal (Almería), Spain
| | - C Ries
- University Observatory, Ludwig-Maximilian-University Munich, Scheiner Strasse 1, 81679 Munich, Germany
| | - A Riffeser
- University Observatory, Ludwig-Maximilian-University Munich, Scheiner Strasse 1, 81679 Munich, Germany
| | - V Rosenbush
- Main Astronomical Observatory of National Academy of Sciences, Kyiv, UKraine
| | - P Rousselot
- University of Franche-Comté, Observatoire des Sciences de l'Univers THETA, Institut UTINAM - UMR CNRS 6213, BP 1615, 25010 Besançon Cedex, France
| | - E L Ryan
- SETI Institute, 189 Bernardo Avenue Suite 200, Mountain View, CA 94043, USA
| | - P Santos-Sanz
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - D G Schleicher
- Lowell Observatory, 1400 W. Mars Hill Road, Flagstaff, AZ 86001, USA
| | - M Schmidt
- University Observatory, Ludwig-Maximilian-University Munich, Scheiner Strasse 1, 81679 Munich, Germany
| | - R Schulz
- Scientific Support Office, European Space Agency, 2201 AZ Noordwijk, The Netherlands
| | - A K Sen
- Department of Physics, Assam University, Silchar 788011, India
| | - A Somero
- Tuorla Observatory, Department of Physics and Astronomy, University of Turku, Väisäläntie 20, 21500 Piikkiö, Finland
| | - A Sota
- Instituto de Astrofísica de Andalucía, CSIC, Glorieta de la Astronomía s/n, 18008 Granada, Spain
| | - A Stinson
- Armagh Observatory, College Hill, Armagh BT61 9DG, UK
| | - J M Sunshine
- Department of Astronomy, University of Maryland, College Park, MD 20742-2421, USA
| | - A Thompson
- Astrophysics Research Centre, School of Mathematics and Physics, Queen's University, Belfast BT7 1NN, UK
| | - G P Tozzi
- INAF, Osservatorio Astrofisico di Arcetri, Largo E. Fermi 5, 50 125 Firenze, Italy
| | - C Tubiana
- Max-Planck-Institut für Sonnensystemforschung, Justus-von-Liebig-Weg 3, 37077 Göttingen, Germany
| | - G L Villanueva
- NASA Goddard Space Flight Center, Astrochemistry Laboratory, Code 693.0, Greenbelt, MD 20771, USA
| | - X Wang
- Yunnan Observatories, CAS, China, PO Box 110, Kunming 650011, Yunnan Province, People's Republic of China
- Key Laboratory for the Structure and Evolution of Celestial Objects, CAS, Kunming 650011, People's Republic of China
| | - D H Wooden
- NASA Ames Research Center, MS 245-3, Moffett Field, CA 94035-1000, USA
| | - M Yagi
- National Astronomical Observatory of Japan, 2-21-1, Osawa, Mitaka, Tokyo 181-8588, Japan
| | - B Yang
- European Southern Observatory, Alonso de Cordova 3107, Vitacura, Santiago, Chile
| | - B Zaprudin
- Tuorla Observatory, Department of Physics and Astronomy, University of Turku, Väisäläntie 20, 21500 Piikkiö, Finland
| | - T J Zegmott
- Centre for Astrophysics and Planetary Science, School of Physical Sciences, The University of Kent, Canterbury CT2 7NH, UK
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Jahan AB, Ahmed MU, Begum M, Hossain MM, Rahman MM, Sarwar JM, Hossain MZ, Begum F, Saha PL, Haque S, Muktadira M. Ultrasonographic Evaluation of Palpable Breast Mass and Correlation with Histopathology. Mymensingh Med J 2017; 26:223-229. [PMID: 28588154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Breast cancer is the most common malignancy in women and the second most common cause of cancer-related mortality. The distinction by physical examination of physiologic nodularity from abnormal masses can be difficult, while the clinical differentiation of a malignant mass from a benign one is difficult; the medical as well as potential legal consequences of missing a palpable carcinoma are high. There are significant number of reported cases of false-negative findings on mammography and the great desire not to miss a malignant lesion in the early stage of disease lead to aggressive biopsy, but the biopsy rate for cancer is only 10.0% to 30.0%. This means that 70.0% to 90.0% of breast biopsies are performed for benign diseases, which induce unnecessary patients discomfort and anxiety in addition to increasing costs to the patient. Clearly, there is a great need for development of additional reliable methods to complement the existing diagnostic procedures to avoid unnecessary biopsy. This cross sectional study was carried out on 43 patients having palpable breast mass, attended in the Department of Radiology and Imaging Mymensingh Medical College Hospital, Mymensingh from 1st January 2012 to 31st December 2013 for the period of two year. These patients were evaluated by USG at the Department of Radiology and Imaging and histopathological examination at the Department of Pathology of the same College to confirm the diagnosis. In diagnosis of malignant mass by USG, 9(20.9%) cases were diagnosed as malignant and 34(79.1%) cases as other than malignant. Eight out of 9 were sonographically diagnosed as malignant lesions also proved as malignant lesion by histopathology and 1 other than malignant. Out of 34 sonographically diagnosed cases of other than malignant lesions 32 were proved histopathologically and 2 did not match with sonographic findings. USG, in diagnosis of malignant lesion, sensitivity was 80.0%, specificity 96.97%, positive predictive value (PPV) (88.89%), negative predictive value 94.12% and accuracy was 93.02% and comparable to other study. In diagnosis of benign lesion by USG, sensitivity was 96.97%, specificity 80.0%, positive predictive value (PPV) (94.12%), negative predictive value 88.89% and accuracy was 93.02%. So, USG is an appropriate imaging method for diagnosis & differential diagnosis of palpable breast mass.
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Affiliation(s)
- A B Jahan
- Dr Afroza Bilkis Jahan, Radiologist, Department of Radiology & Imaging, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh
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Haque S, Pabon-Ramos W, Miller M, Sopko D, Suhocki P, Smith T, Kim C. Comparison of Celect and Denali filters: Tilt angles and tilt orientations. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ho A, Wei G, Maneval E, Esquibel V, Berger M, Haque S, Patel R, Walsh C, Hornby Z, Multani P, Li G, Drilon A. Overcoming drug resistance to Trk inhibition by rational combination of entrectinib and trametinib: from bench to bedside. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32615-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dutra EC, Koch JA, Presura R, Angermeier WA, Darling T, Haque S, Mancini RC, Covington AM. Development of a spectroscopic technique for simultaneous magnetic field, electron density, and temperature measurements in ICF-relevant plasmas. Rev Sci Instrum 2016; 87:11E558. [PMID: 27910373 DOI: 10.1063/1.4964893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Spectroscopic techniques in the visible range are often used in plasma experiments to measure B-field induced Zeeman splitting, electron densities via Stark broadening, and temperatures from Doppler broadening. However, when electron densities and temperatures are sufficiently high, the broadening of the Stark and Doppler components can dominate the emission spectra and obscure the Zeeman component. In this research, we are developing a time-resolved multi-axial technique for measuring the Zeeman, Stark, and Doppler broadened line emission of dense magnetized plasmas for Z-pinch and Dense Plasma Focus (DPF) accelerators. The line emission is used to calculate the electron densities, temperatures, and B-fields. In parallel, we are developing a line-shape modeling code that incorporates the broadening effects due to Stark, Doppler, and Zeeman effects for dense magnetized plasma. This manuscript presents the details of the experimental setup and line shape code, along with the results obtained from an Al iii doublet at the University of Nevada, Reno at Nevada Terawatt Facility. Future tests are planned to further evaluate the technique and modeling on other material wire array, gas puff, and DPF platforms.
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Affiliation(s)
- E C Dutra
- National Security Technologies, LLC, Livermore, California 94551, USA
| | - J A Koch
- National Security Technologies, LLC, Livermore, California 94551, USA
| | - R Presura
- National Security Technologies, LLC, Livermore, California 94551, USA
| | - W A Angermeier
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
| | - T Darling
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
| | - S Haque
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
| | - R C Mancini
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
| | - A M Covington
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
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