Asim Amjad (twc) - Academia.edu (original) (raw)
Uploads
Papers by Asim Amjad (twc)
Cureus
All modern vaccines share the risk of neurological adverse effects. Only a few cases of Parsonage... more All modern vaccines share the risk of neurological adverse effects. Only a few cases of Parsonage-Turner syndrome (PTS), an uncommon peripheral nerve condition associated with coronavirus disease 2019 (COVID-19) immunization, have been reported to date. We describe a case of COVID-19 vaccineinduced PTS and provide a brief literature review. A 78-year-old male non-smoker with a medical history of coronary artery disease presented with non-exertional, constant chest pain for one hour and new onset of bilateral hand weakness for three days. He had no neurological disease or allergies and denied any recent trauma or infection. Three weeks before the onset of the symptoms, the patient received a second dose of the BNT162b2 COVID-19 vaccine, which was administered 21 days after the first dose. Physical examination was significant for weakness in right-hand grip and wrist flexion. There were no other motor deficits, upper motor neuron signs, bulbar weakness, or sensory deficits. Diagnostic workup for the underlying diabetes mellitus, infections, or other autoimmune diseases was negative. Imaging workup revealed no demyelination, fracture deformity, traumatic subluxation, or compressive myelopathy. Nerve conduction studies, including needle electromyography, showed decreased motor unit recruitment in the bilateral first dorsal interosseous and right deltoid, biceps, and triceps muscles confirming PTS. The patient was treated with 40 mg/day of oral prednisone and occupational therapy to maintain range of motion and activities of daily living. PTS is also known as neuralgic amyotrophy, brachial plexus neuritis, brachial plexopathy, and shoulder-girdle syndrome. It is characterized by asymmetrical, chronic, resistant upper extremity neuropathic pain and neurological defects such as paralysis and paresthesia. There are two different types of PTS: non-hereditary and inherited. The etiology and pathophysiology of PTS are not fully understood. Various aspects such as genetic, environmental, and immunological predisposition may play a role in developing the syndrome. Infections, vaccines, and injuries are typical causes of non-hereditary forms. After the COVID-19 epidemic and the commencement of a global immunization effort, similar instances happened. Presently there is no available test that unequivocally confirms or excludes PTS itself. Electrodiagnostic study and imaging modalities help to rule out other differential diagnoses. Also, there is no specific treatment available; however, it may resolve independently of treatment with supportive care.
The Lancet. Infectious diseases, Jan 13, 2018
Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...
Cureus, 2021
Immune checkpoint blockade is a rapidly expanding therapeutic modality in oncology. However, its ... more Immune checkpoint blockade is a rapidly expanding therapeutic modality in oncology. However, its adverse effects extend beyond the cytotoxicity of conventional chemotherapy. Pneumotoxicity associated with immune checkpoint therapy presents a diagnostic conundrum that has been further complicated by the COVID-19 pandemic. We report a case of a patient with metastatic urothelial carcinoma who developed diffuse alveolar hemorrhage (DAH) following treatment with avelumab.
Background: To assess the existing health care waste management practices in public and private s... more Background: To assess the existing health care waste management practices in public and private sector hospitals of Bahawalpur City. Methods: In this cross sectional descriptive study all private hospitals of Bahawalpur City and 24 public sector sites from four hospitals were selected by simple random sampling for observation of practices of hospital waste management.The scoring system for the observation checklist consisted of giving a score one for step done correctly, while the step not done was given zero. Fisher’s exact test was applied to see any statistical difference in practices of public and private sector hospitals and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Out of total 48 hospitals (24 public and 24 private sector) observed for medical waste management practices in Bahawalpur city, in public sector 50% were segregating medical waste from other waste stream while in private sector it was only 16.6%. Separate area for segregation was ...
Takotsubo cardiomyopathy (TC) is a transient non-ischemic cardiomyopathy, whose frequency has inc... more Takotsubo cardiomyopathy (TC) is a transient non-ischemic cardiomyopathy, whose frequency has increased rapidly over the past few years. It is characterized by regional left ventricular wall motion abnormality, with a circumferential pattern that spreads beyond a coronary artery supply territory. It can resolve with an almost complete restoration of ventricular function within days to months. TC is more prevalent among postmenopausal women, and less prevalent in Hispanics and African-Americans. It is a heterogeneous syndrome, and several etiologies have been proposed for its pathogenesis. The central hypothesis is supported by catecholamine excess and hyperactivity of the nervous system. The clinical presentation usually overlaps with the presentation of acute coronary syndrome (ACS) which calls for an early diagnosis. In light of this, several laboratory, electrocardiographic and imaging findings have been studied in order to form the clinical diagnosis of Takotsubo Cardiomyopathy....
American Journal of Gastroenterology
American Journal of Gastroenterology
American Journal of Gastroenterology
American Journal of Gastroenterology
The Professional Medical Journal
Objective: To assess the knowledge and practice of preventive measures againstdengue fever among ... more Objective: To assess the knowledge and practice of preventive measures againstdengue fever among medical students of Quaid-e-Azasm medical college and engineeringstudents of Islamia university, Bahawalpur. Design: Cross sectional descriptive study. Period:September 2012 to December 2012. Setting: Quaid-e-Azam Medial College and Engineeringwing of Islamia University Bahawalpur. Material and method: Sample size calculated for study8 by expecting prevalence of knowledge 78% in population of 1000 in each group with 5% marginof error and at 95% confidence interval was 263; by adding 10% response error sample became290 for each population. Individuals for study were selected by simple random sampling andinterviewed by using preformed questionnaire. Obtained data was analyzed by using SPSSversion 11. For categorization of knowledge and preventive practices against dengue fever intogood, satisfactory insufficient and poor scoring was done. Results: knowledge of protectivemeasures against de...
Cureus
All modern vaccines share the risk of neurological adverse effects. Only a few cases of Parsonage... more All modern vaccines share the risk of neurological adverse effects. Only a few cases of Parsonage-Turner syndrome (PTS), an uncommon peripheral nerve condition associated with coronavirus disease 2019 (COVID-19) immunization, have been reported to date. We describe a case of COVID-19 vaccineinduced PTS and provide a brief literature review. A 78-year-old male non-smoker with a medical history of coronary artery disease presented with non-exertional, constant chest pain for one hour and new onset of bilateral hand weakness for three days. He had no neurological disease or allergies and denied any recent trauma or infection. Three weeks before the onset of the symptoms, the patient received a second dose of the BNT162b2 COVID-19 vaccine, which was administered 21 days after the first dose. Physical examination was significant for weakness in right-hand grip and wrist flexion. There were no other motor deficits, upper motor neuron signs, bulbar weakness, or sensory deficits. Diagnostic workup for the underlying diabetes mellitus, infections, or other autoimmune diseases was negative. Imaging workup revealed no demyelination, fracture deformity, traumatic subluxation, or compressive myelopathy. Nerve conduction studies, including needle electromyography, showed decreased motor unit recruitment in the bilateral first dorsal interosseous and right deltoid, biceps, and triceps muscles confirming PTS. The patient was treated with 40 mg/day of oral prednisone and occupational therapy to maintain range of motion and activities of daily living. PTS is also known as neuralgic amyotrophy, brachial plexus neuritis, brachial plexopathy, and shoulder-girdle syndrome. It is characterized by asymmetrical, chronic, resistant upper extremity neuropathic pain and neurological defects such as paralysis and paresthesia. There are two different types of PTS: non-hereditary and inherited. The etiology and pathophysiology of PTS are not fully understood. Various aspects such as genetic, environmental, and immunological predisposition may play a role in developing the syndrome. Infections, vaccines, and injuries are typical causes of non-hereditary forms. After the COVID-19 epidemic and the commencement of a global immunization effort, similar instances happened. Presently there is no available test that unequivocally confirms or excludes PTS itself. Electrodiagnostic study and imaging modalities help to rule out other differential diagnoses. Also, there is no specific treatment available; however, it may resolve independently of treatment with supportive care.
The Lancet. Infectious diseases, Jan 13, 2018
Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...
Cureus, 2021
Immune checkpoint blockade is a rapidly expanding therapeutic modality in oncology. However, its ... more Immune checkpoint blockade is a rapidly expanding therapeutic modality in oncology. However, its adverse effects extend beyond the cytotoxicity of conventional chemotherapy. Pneumotoxicity associated with immune checkpoint therapy presents a diagnostic conundrum that has been further complicated by the COVID-19 pandemic. We report a case of a patient with metastatic urothelial carcinoma who developed diffuse alveolar hemorrhage (DAH) following treatment with avelumab.
Background: To assess the existing health care waste management practices in public and private s... more Background: To assess the existing health care waste management practices in public and private sector hospitals of Bahawalpur City. Methods: In this cross sectional descriptive study all private hospitals of Bahawalpur City and 24 public sector sites from four hospitals were selected by simple random sampling for observation of practices of hospital waste management.The scoring system for the observation checklist consisted of giving a score one for step done correctly, while the step not done was given zero. Fisher’s exact test was applied to see any statistical difference in practices of public and private sector hospitals and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Out of total 48 hospitals (24 public and 24 private sector) observed for medical waste management practices in Bahawalpur city, in public sector 50% were segregating medical waste from other waste stream while in private sector it was only 16.6%. Separate area for segregation was ...
Takotsubo cardiomyopathy (TC) is a transient non-ischemic cardiomyopathy, whose frequency has inc... more Takotsubo cardiomyopathy (TC) is a transient non-ischemic cardiomyopathy, whose frequency has increased rapidly over the past few years. It is characterized by regional left ventricular wall motion abnormality, with a circumferential pattern that spreads beyond a coronary artery supply territory. It can resolve with an almost complete restoration of ventricular function within days to months. TC is more prevalent among postmenopausal women, and less prevalent in Hispanics and African-Americans. It is a heterogeneous syndrome, and several etiologies have been proposed for its pathogenesis. The central hypothesis is supported by catecholamine excess and hyperactivity of the nervous system. The clinical presentation usually overlaps with the presentation of acute coronary syndrome (ACS) which calls for an early diagnosis. In light of this, several laboratory, electrocardiographic and imaging findings have been studied in order to form the clinical diagnosis of Takotsubo Cardiomyopathy....
American Journal of Gastroenterology
American Journal of Gastroenterology
American Journal of Gastroenterology
American Journal of Gastroenterology
The Professional Medical Journal
Objective: To assess the knowledge and practice of preventive measures againstdengue fever among ... more Objective: To assess the knowledge and practice of preventive measures againstdengue fever among medical students of Quaid-e-Azasm medical college and engineeringstudents of Islamia university, Bahawalpur. Design: Cross sectional descriptive study. Period:September 2012 to December 2012. Setting: Quaid-e-Azam Medial College and Engineeringwing of Islamia University Bahawalpur. Material and method: Sample size calculated for study8 by expecting prevalence of knowledge 78% in population of 1000 in each group with 5% marginof error and at 95% confidence interval was 263; by adding 10% response error sample became290 for each population. Individuals for study were selected by simple random sampling andinterviewed by using preformed questionnaire. Obtained data was analyzed by using SPSSversion 11. For categorization of knowledge and preventive practices against dengue fever intogood, satisfactory insufficient and poor scoring was done. Results: knowledge of protectivemeasures against de...