Bilal Asif - Academia.edu (original) (raw)

Papers by Bilal Asif

Atmospheric Pollution Research

Abstract With the aim to meet ever-increasing strict regulations for three major exhaust gas poll... more Abstract With the aim to meet ever-increasing strict regulations for three major exhaust gas pollutants, three-way catalytic technology has been effectively applied in automobile industries for purifying automobile exhaust gases. Here we report the efficiency of composite oxide Co3O4/TiO2 with the addition of CeO2 as a promotor. Modification of Co3O4/TiO2 (15 wt%. Co/TiO2) based composite catalyst synthesized by incipient wetness impregnation (IWI) method was followed by doping of ceria (CeO2). The series of catalysts assigned as 15% IWI, 03-CE-IWI, 06-CE-IWI, and 09-CE-IWI having cerium content from 0 to 9 wt%, respectively were prepared. The same relative Co3O4/TiO2 ratio i.e., 15 wt% was sustained in the CeO2-doped catalysts for clarifying the impact of CeO2 and its doping quantity for CO and HC oxidation along with NOx reduction. The catalysts were characterized by Scanning Electron microscopy (SEM), X-ray Diffraction (XRD), and Brunauer–Emmett–Teller (BET). The catalysts three-way catalytic converter efficiency was assessed, mounted on a motorcycle engine with an engine capacity of 70 cm3 spark ignition. It was evaluated under steady-state operational conditions. The results revealed the strong impact of doping of CeO2 on Co3O4/TiO2 composite under real engine operating conditions and the maximum doping, i.e., 09-CE-IWI can considerably enhance the surface area (41.5 m2/g). The improved performance can be credited to a higher dispersion of Co3O4/TiO2 due to CeO2 doping, possessing a higher surface area as compared to ceria undoped catalysts, and there exists a catalytic synergistic effect of Co3O4 and CeO2. The 09-CE-IWI revealed the best catalytic activity for all three constituents i.e., CO and unburned HC at 6000 rpm and NOx specifically at 2000 rpm. Maximum three-way catalytic conversion efficiencies achieved in the case of CO, HC, and NOx are 92%, 83%, and 90%, respectively.

Journal of Medical Genetics

IntroductionProphylactic total gastrectomy (PTG) can eliminate gastric cancer risk and is recomme... more IntroductionProphylactic total gastrectomy (PTG) can eliminate gastric cancer risk and is recommended in carriers of a germlineCDH1pathogenic variant. PTG has established risks and potential life-long morbidity. Decision-making regarding PTG is complex and not well-understood.MethodsIndividuals with germlineCDH1pathogenic or likely pathogenic variants who underwent surveillance endoscopy and recommended for PTG were evaluated. Factors associated with decision to pursue PTG (PTGpos) or not (PTGneg) were queried. A decision-regret survey was administered to patients who elected PTG.ResultsDecision-making was assessed in 120 patients. PTGpospatients (63%, 76/120) were younger than PTGneg(median 45 vs 58 years) and more often had a strong family history of gastric cancer (80.3% vs 34.1%). PTGpospatients reported decision-making based on family history more often and decided soon after diagnosis (8 vs 27 months) compared with PTGneg. Negative endoscopic surveillance results were more com...

Gastroenterology, 2018

Colorectal cancer (CRC) is the 3rd most common cancer among women. Though colonoscopy screening e... more Colorectal cancer (CRC) is the 3rd most common cancer among women. Though colonoscopy screening effectively prevents and detects this malignancy, women often delay CRC screening due to time committed to other highly emphasized gender specific screening, embarrassment, preference for women endoscopists, and inconvenience. We designed PINK PLUSTM, a program combining three women’s screenings in one visit; mammogram, gynecology exam (GYN) and pre-colonoscopy visit (GI). A successful pilot resulted in 75% returning for colonoscopy. The program expanded to include 3 options (mammogram/GI, GYN/GI, mammogram/GYN/GI) and showed even greater CRC screening adherence (77%) PINK PLUSTM is a flexible and convenient program demonstrating a high rate of compliance with colonoscopy, which could serve as a national template aimed at increasing adherence to all women’s cancer screenings, especially in underserved communities, by combining these life-saving screenings into one visit. Combining Women’s...

ACG Case Reports Journal, 2021

ABSTRACT Tangier disease is a rare autosomal recessive disease resulting in cholesterol depositio... more ABSTRACT Tangier disease is a rare autosomal recessive disease resulting in cholesterol deposition in different organs. We report a case of a 52-year-old white man who presented for chronic diarrhea without significant findings on noninvasive testing. Subsequent colonoscopy revealed endoscopically normal mucosa, with random biopsies remarkable for foamy macrophages in the lamina propria. Genetic testing showed adenosine triphosphate–binding cassette transporter gene mutation with low high-density lipoprotein and low low-density lipoprotein. To the best of our knowledge, this is the first report of chronic diarrhea in a patient with Tangier disease without any other clear etiology.

American Journal of Gastroenterology, 2021

Introduction: Inflammatory bowel diseases (IBD) are chronic autoimmune diseases that require ongo... more Introduction: Inflammatory bowel diseases (IBD) are chronic autoimmune diseases that require ongoing treatment and monitoring. Medical nonadherence plays a significant role in treatment failure, resulting in poor clinical outcomes including corticosteroid need, hospitalization, and surgery. Biologic therapy are administered at maintenance intervals ranging from 4 to 8 weeks. This study aims to identify risk factors for nonadherence to biologic infusion appointments in patients with IBD in the COVID-19 pandemic. Methods: This is a single-center retrospective chart review including 123 patients with IBD who received infliximab or vedolizumab at a university infusion center between January 2019 and September 2020. Beginning in March 2020, all patients with IBD receiving infusion therapy at our infusion center received a secure electronic message through the medical record portal encouraging maintenance of therapy and emphasizing the safety precautions given the pandemic. Chart review data collected for analysis included demographics, IBD disease type, socioeconomic status, employment, smoking status, poly-pharmacy, anxiety or depression diagnosis, and travel distance from home address to the infusion center. Nonadherence was classified as a categorical variable and defined as a delay from scheduled infusion by greater than 14 days. Multivariate logistic regression was performed to identify predictors of infusion nonadherence. Results: In 2019, 16 (13%) patients were noted to be nonadherent (38% female, 81% Crohn’s disease) to infusion appointments. Improvement in adherence was seen in 10 (63%) of these patients in year 2020. Multivariate analysis demonstrated higher infusion frequency as an independent variable for nonadherence (OR 1.724, 95% CI 1.063 – 2.795, p , 0.05). No significant differences were noted in age, sex, marital status, distance from infusion center, smoking status, employment, year of diagnosis, infusion medication, number of overall active medications, or diagnoses of depression or anxiety between the adherent and nonadherent cohorts. Conclusion: Prior to the COVID-19 pandemic, nonadherence to infusion appointments in our IBD center was low (13%). We observed an improvement of 63% during the COVID-19 pandemic in the previously nonadherent cohort. Higher frequency of infusion appointments was independently associated with medical nonadherence. Patient education and attention to infusion frequency should remain an integral part of all IBD clinical visits to improve medical adherence.

SSRN Electronic Journal, 2021

Case Reports in Gastroenterology, 2021

Metastases to the gastrointestinal tract (GIT) from breast carcinoma are rare, detected in approx... more Metastases to the gastrointestinal tract (GIT) from breast carcinoma are rare, detected in approximately <5% of all breast cancer patients. Invasive lobular carcinoma (ILC) is the most common histological type of breast cancer to metastasize to the GIT. We report a case of abdominal recurrence of ILC of the breast causing intra-abdominal contracture leading to extrinsic compression of the duodenum and periampullary biliary tree. Four years after the patient’s diagnosis of a left breast pT1c, pN2, cM0 invasive lobular breast cancer, she presented with liver function tests consistent with biliary obstruction, and there was concern for a periampullary malignancy. Definitive diagnosis was achieved at laparotomy. This case demonstrates the importance of considering metastatic breast cancer as a potential cause of GI symptoms and radiological abnormalities affecting any part of the GIT of women with a previous history of lobular breast cancer. This case also highlights the effectivenes...

Expert Opinion on Investigational Drugs, 2021

INTRODUCTION Chronic Hepatitis D virus (HDV) infection is a global disease leading to rapidly pro... more INTRODUCTION Chronic Hepatitis D virus (HDV) infection is a global disease leading to rapidly progressive liver disease with increased liver-related mortality and hepatocellular carcinoma. Therapies are minimally effective; however, an increased understanding of the HDV lifecycle has provided new potential drug targets. Thus, there is a growing number of investigational therapeutics under exploration for HDV with the potential for successful viral eradication. AREAS COVERED This review discusses the clinical impact of HDV infection and offers an in-depth look at the HDV life cycle. The authors examine current and new drug targets and the investigational therapies in clinical trials. The search strategy was based on PubMed database and clinicaltrials.gov which highlight the most up-to-date aspects of investigational therapies for chronic HDV infection.

Current Hepatology Reports, 2020

Purpose of Review Hepatitis B virus (HBV) infection is one of the most common viral infections wo... more Purpose of Review Hepatitis B virus (HBV) infection is one of the most common viral infections worldwide with an estimated 2 billion people exposed to HBV and 240 million with active chronic infection. Despite this, less than 1% of patients with chronic HBV infection receive treatment, and less than 3% of those achieve functional cure with traditional therapies. This review summarizes recent advances in the treatment of chronic HBV utilizing nucleic acid polymers (NAP) and entry inhibitors (EI). Recent Findings A recent phase 2 study evaluating the use of NAP following tenofovir and pegylated interferon (PEG-IFN) demonstrated increased rates of functional cure which persisted in 35% of patients after 48 weeks of follow-up. In addition, the EI Myrcludex B has demonstrated HBsAg response in up to 40% of patients when used in combination with PEG-IFN at week 72. Summary Functional cure is considered the "holy grail" of treatment, and many new therapies are under investigation for the treatment of chronic HBV. As we work towards functional cure for chronic HBV, NAPs and EIs have shown efficacy in reducing HBV DNA and HBsAg levels and have emerged as potential therapeutic agents that may lead to a functional cure for HBV.

American Journal of Gastroenterology, 2019

CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain... more CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain. An MRI of the thoracic and lumbar spine revealed multiple osseous lesions of the thoracic vertebral bodies and fractures of the L2 and L3 vertebral bodies, concerning for metastasis (Figure 1). A CT of the chest, abdomen and pelvis revealed enlarged mediastinal and hilar lymph nodes. Enlarged lymph nodes at the gastrohepatic interval and celiac level measuring up to 2 cm were noted, and multiple enlarged mesenteric and retroperitoneal lymph nodes. The patient underwent bone biopsy during kyphoplasty of the L2 and L3 vertebrae, which revealed metastatic carcinoma. Serum markers of malignancy were unrevealing, a CA19-9 of 15, CEA of 7.1, and PSA of 0.74. Urology was consulted and cystoscopy performed. No mass or filling defect was noted, and urine cytology returned negative for malignant cells. Gastroenterology was consulted and upon further history, the patient did acknowledge a history of H. Pylori, in 2016, with eradication confirmed by a negative stool antigen test. Gastroenterology recommended EGD and colonoscopy, but patient was unable to tolerate the bowel prep. The patient underwent an EGD, which revealed a 3.0 3 3.5 cm, cratered gastric ulcer without stigmata of bleeding at the incisura (Figure 2). Biopsy of this ulcer was positive for adenocarcinoma. DISCUSSION: This case demonstrates a presentation of bony metastasis of gastric cancer. This metastatic location is rare and unusual. It highlights the importance of maintaining high clinical suspicion in patients with metastatic disease. Additionally, it reinforces the relevance of a multidisciplinary approach when evaluating malignancy.

American Journal of Gastroenterology, 2019

The American Journal of Medicine, 2018

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, May 29, 2016

Although vascular occlusion has long been noted in periburn tissue, the literature is inconsisten... more Although vascular occlusion has long been noted in periburn tissue, the literature is inconsistent regarding the nature of the occlusion, with articles in the 1940s claiming that erythrocytes were the culprit and in the 1980s-90s that microthrombi were responsible. To better define the nature of vessel occlusion, we studied two porcine burn models, a hot comb horizontal injury model and a vertical injury progression model. In both cases, tissue from the first two days after burn were stained with hematoxylin and eosin, or probed for platelets or for fibrinogen/fibrin. Erythrocytes, identified as nonstained, clumped, anuclear, 5μ cells, occluded most blood vessels in both burn models. In contrast, platelet or fibrinogen/fibrin antibodies stained blood vessel occlusions minimally at early time points, and only up to 16% of deep dermal blood vessels at 48 hours in the hot model and up to 7% at 24 hours in the vertical injury progression model. Treatment of animals with a fibronectin-de...

Journal of Petroleum Science and Engineering, 2014

Eocene sediments from the Potwar Basin Pakistan have been characterized geochemically using liqui... more Eocene sediments from the Potwar Basin Pakistan have been characterized geochemically using liquid chromatography, gas chromatograph-mass spectrometry (GC-MS), GC-isotope ratio MS and metastable reaction monitoring (MRM) GC-MS. Biomarker and non-biomarker parameters have been used to evaluate the origin, paleodepositional conditions, lithology and thermal maturation of organic matter. The n-alkanes distribution profiles observed for the studied samples suggest an abundance of low molecular weight compounds in the Upper Eocene sequence, which is consistent with higher marine input. On the other hand, the bimodal n-alkanes distribution observed with depth may suggest terrigenous contribution. An enrichment of the δ 13 C of low molecular weight n-alkanes (on-C 18) reveals marine origin (algal and bacterial) while depleted 13 C values observed for n-alkanes greater than n-C 22 indicate terrigenous origin of these compounds. Despite ample biomarker parameters as to the noticeable marine origin of the organic matter, presence of oleanane and retene as well as the enrichment of the δ 13 C values of the long chain n-alkanes suggest significant terrestrial contribution in the studied organic matter. An interesting feature of the δ 13 C isotopic profiles of n-alkanes higher than C 25 is so called saw tooth profile, in which the odd carbon number compounds were more depleted in 13 C than the adjacent even numbered compounds. This feature may further support the assumption that the source of these n-alkanes lay in plant waxes. Depositional environment of these sediments were typical marine with oxic to suboxic conditions and showed variation in oxicity with depth. Our results indicate that the Upper Eocene sediments have been deposited under oxic conditions while the lower Eocene strata are more likely to be deposited under restricted suboxic reducing marine conditions. Significantly low concentration of rearranged steranes and hopanes suggested carbonate lithology for these sediments. Aliphatic and aromatic hydrocarbons geochemical data indicate level of maturity corresponding to the onset of oil generation. Therefore, it is suggested that these sediments are more likely to be considered as possible hydrocarbon source rocks within the Potwar Basin.

The American Journal of Medicine, 2019

Atmospheric Pollution Research

Abstract With the aim to meet ever-increasing strict regulations for three major exhaust gas poll... more Abstract With the aim to meet ever-increasing strict regulations for three major exhaust gas pollutants, three-way catalytic technology has been effectively applied in automobile industries for purifying automobile exhaust gases. Here we report the efficiency of composite oxide Co3O4/TiO2 with the addition of CeO2 as a promotor. Modification of Co3O4/TiO2 (15 wt%. Co/TiO2) based composite catalyst synthesized by incipient wetness impregnation (IWI) method was followed by doping of ceria (CeO2). The series of catalysts assigned as 15% IWI, 03-CE-IWI, 06-CE-IWI, and 09-CE-IWI having cerium content from 0 to 9 wt%, respectively were prepared. The same relative Co3O4/TiO2 ratio i.e., 15 wt% was sustained in the CeO2-doped catalysts for clarifying the impact of CeO2 and its doping quantity for CO and HC oxidation along with NOx reduction. The catalysts were characterized by Scanning Electron microscopy (SEM), X-ray Diffraction (XRD), and Brunauer–Emmett–Teller (BET). The catalysts three-way catalytic converter efficiency was assessed, mounted on a motorcycle engine with an engine capacity of 70 cm3 spark ignition. It was evaluated under steady-state operational conditions. The results revealed the strong impact of doping of CeO2 on Co3O4/TiO2 composite under real engine operating conditions and the maximum doping, i.e., 09-CE-IWI can considerably enhance the surface area (41.5 m2/g). The improved performance can be credited to a higher dispersion of Co3O4/TiO2 due to CeO2 doping, possessing a higher surface area as compared to ceria undoped catalysts, and there exists a catalytic synergistic effect of Co3O4 and CeO2. The 09-CE-IWI revealed the best catalytic activity for all three constituents i.e., CO and unburned HC at 6000 rpm and NOx specifically at 2000 rpm. Maximum three-way catalytic conversion efficiencies achieved in the case of CO, HC, and NOx are 92%, 83%, and 90%, respectively.

Journal of Medical Genetics

IntroductionProphylactic total gastrectomy (PTG) can eliminate gastric cancer risk and is recomme... more IntroductionProphylactic total gastrectomy (PTG) can eliminate gastric cancer risk and is recommended in carriers of a germlineCDH1pathogenic variant. PTG has established risks and potential life-long morbidity. Decision-making regarding PTG is complex and not well-understood.MethodsIndividuals with germlineCDH1pathogenic or likely pathogenic variants who underwent surveillance endoscopy and recommended for PTG were evaluated. Factors associated with decision to pursue PTG (PTGpos) or not (PTGneg) were queried. A decision-regret survey was administered to patients who elected PTG.ResultsDecision-making was assessed in 120 patients. PTGpospatients (63%, 76/120) were younger than PTGneg(median 45 vs 58 years) and more often had a strong family history of gastric cancer (80.3% vs 34.1%). PTGpospatients reported decision-making based on family history more often and decided soon after diagnosis (8 vs 27 months) compared with PTGneg. Negative endoscopic surveillance results were more com...

Gastroenterology, 2018

Colorectal cancer (CRC) is the 3rd most common cancer among women. Though colonoscopy screening e... more Colorectal cancer (CRC) is the 3rd most common cancer among women. Though colonoscopy screening effectively prevents and detects this malignancy, women often delay CRC screening due to time committed to other highly emphasized gender specific screening, embarrassment, preference for women endoscopists, and inconvenience. We designed PINK PLUSTM, a program combining three women’s screenings in one visit; mammogram, gynecology exam (GYN) and pre-colonoscopy visit (GI). A successful pilot resulted in 75% returning for colonoscopy. The program expanded to include 3 options (mammogram/GI, GYN/GI, mammogram/GYN/GI) and showed even greater CRC screening adherence (77%) PINK PLUSTM is a flexible and convenient program demonstrating a high rate of compliance with colonoscopy, which could serve as a national template aimed at increasing adherence to all women’s cancer screenings, especially in underserved communities, by combining these life-saving screenings into one visit. Combining Women’s...

ACG Case Reports Journal, 2021

ABSTRACT Tangier disease is a rare autosomal recessive disease resulting in cholesterol depositio... more ABSTRACT Tangier disease is a rare autosomal recessive disease resulting in cholesterol deposition in different organs. We report a case of a 52-year-old white man who presented for chronic diarrhea without significant findings on noninvasive testing. Subsequent colonoscopy revealed endoscopically normal mucosa, with random biopsies remarkable for foamy macrophages in the lamina propria. Genetic testing showed adenosine triphosphate–binding cassette transporter gene mutation with low high-density lipoprotein and low low-density lipoprotein. To the best of our knowledge, this is the first report of chronic diarrhea in a patient with Tangier disease without any other clear etiology.

American Journal of Gastroenterology, 2021

Introduction: Inflammatory bowel diseases (IBD) are chronic autoimmune diseases that require ongo... more Introduction: Inflammatory bowel diseases (IBD) are chronic autoimmune diseases that require ongoing treatment and monitoring. Medical nonadherence plays a significant role in treatment failure, resulting in poor clinical outcomes including corticosteroid need, hospitalization, and surgery. Biologic therapy are administered at maintenance intervals ranging from 4 to 8 weeks. This study aims to identify risk factors for nonadherence to biologic infusion appointments in patients with IBD in the COVID-19 pandemic. Methods: This is a single-center retrospective chart review including 123 patients with IBD who received infliximab or vedolizumab at a university infusion center between January 2019 and September 2020. Beginning in March 2020, all patients with IBD receiving infusion therapy at our infusion center received a secure electronic message through the medical record portal encouraging maintenance of therapy and emphasizing the safety precautions given the pandemic. Chart review data collected for analysis included demographics, IBD disease type, socioeconomic status, employment, smoking status, poly-pharmacy, anxiety or depression diagnosis, and travel distance from home address to the infusion center. Nonadherence was classified as a categorical variable and defined as a delay from scheduled infusion by greater than 14 days. Multivariate logistic regression was performed to identify predictors of infusion nonadherence. Results: In 2019, 16 (13%) patients were noted to be nonadherent (38% female, 81% Crohn’s disease) to infusion appointments. Improvement in adherence was seen in 10 (63%) of these patients in year 2020. Multivariate analysis demonstrated higher infusion frequency as an independent variable for nonadherence (OR 1.724, 95% CI 1.063 – 2.795, p , 0.05). No significant differences were noted in age, sex, marital status, distance from infusion center, smoking status, employment, year of diagnosis, infusion medication, number of overall active medications, or diagnoses of depression or anxiety between the adherent and nonadherent cohorts. Conclusion: Prior to the COVID-19 pandemic, nonadherence to infusion appointments in our IBD center was low (13%). We observed an improvement of 63% during the COVID-19 pandemic in the previously nonadherent cohort. Higher frequency of infusion appointments was independently associated with medical nonadherence. Patient education and attention to infusion frequency should remain an integral part of all IBD clinical visits to improve medical adherence.

SSRN Electronic Journal, 2021

Case Reports in Gastroenterology, 2021

Metastases to the gastrointestinal tract (GIT) from breast carcinoma are rare, detected in approx... more Metastases to the gastrointestinal tract (GIT) from breast carcinoma are rare, detected in approximately <5% of all breast cancer patients. Invasive lobular carcinoma (ILC) is the most common histological type of breast cancer to metastasize to the GIT. We report a case of abdominal recurrence of ILC of the breast causing intra-abdominal contracture leading to extrinsic compression of the duodenum and periampullary biliary tree. Four years after the patient’s diagnosis of a left breast pT1c, pN2, cM0 invasive lobular breast cancer, she presented with liver function tests consistent with biliary obstruction, and there was concern for a periampullary malignancy. Definitive diagnosis was achieved at laparotomy. This case demonstrates the importance of considering metastatic breast cancer as a potential cause of GI symptoms and radiological abnormalities affecting any part of the GIT of women with a previous history of lobular breast cancer. This case also highlights the effectivenes...

Expert Opinion on Investigational Drugs, 2021

INTRODUCTION Chronic Hepatitis D virus (HDV) infection is a global disease leading to rapidly pro... more INTRODUCTION Chronic Hepatitis D virus (HDV) infection is a global disease leading to rapidly progressive liver disease with increased liver-related mortality and hepatocellular carcinoma. Therapies are minimally effective; however, an increased understanding of the HDV lifecycle has provided new potential drug targets. Thus, there is a growing number of investigational therapeutics under exploration for HDV with the potential for successful viral eradication. AREAS COVERED This review discusses the clinical impact of HDV infection and offers an in-depth look at the HDV life cycle. The authors examine current and new drug targets and the investigational therapies in clinical trials. The search strategy was based on PubMed database and clinicaltrials.gov which highlight the most up-to-date aspects of investigational therapies for chronic HDV infection.

Current Hepatology Reports, 2020

Purpose of Review Hepatitis B virus (HBV) infection is one of the most common viral infections wo... more Purpose of Review Hepatitis B virus (HBV) infection is one of the most common viral infections worldwide with an estimated 2 billion people exposed to HBV and 240 million with active chronic infection. Despite this, less than 1% of patients with chronic HBV infection receive treatment, and less than 3% of those achieve functional cure with traditional therapies. This review summarizes recent advances in the treatment of chronic HBV utilizing nucleic acid polymers (NAP) and entry inhibitors (EI). Recent Findings A recent phase 2 study evaluating the use of NAP following tenofovir and pegylated interferon (PEG-IFN) demonstrated increased rates of functional cure which persisted in 35% of patients after 48 weeks of follow-up. In addition, the EI Myrcludex B has demonstrated HBsAg response in up to 40% of patients when used in combination with PEG-IFN at week 72. Summary Functional cure is considered the "holy grail" of treatment, and many new therapies are under investigation for the treatment of chronic HBV. As we work towards functional cure for chronic HBV, NAPs and EIs have shown efficacy in reducing HBV DNA and HBsAg levels and have emerged as potential therapeutic agents that may lead to a functional cure for HBV.

American Journal of Gastroenterology, 2019

CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain... more CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain. An MRI of the thoracic and lumbar spine revealed multiple osseous lesions of the thoracic vertebral bodies and fractures of the L2 and L3 vertebral bodies, concerning for metastasis (Figure 1). A CT of the chest, abdomen and pelvis revealed enlarged mediastinal and hilar lymph nodes. Enlarged lymph nodes at the gastrohepatic interval and celiac level measuring up to 2 cm were noted, and multiple enlarged mesenteric and retroperitoneal lymph nodes. The patient underwent bone biopsy during kyphoplasty of the L2 and L3 vertebrae, which revealed metastatic carcinoma. Serum markers of malignancy were unrevealing, a CA19-9 of 15, CEA of 7.1, and PSA of 0.74. Urology was consulted and cystoscopy performed. No mass or filling defect was noted, and urine cytology returned negative for malignant cells. Gastroenterology was consulted and upon further history, the patient did acknowledge a history of H. Pylori, in 2016, with eradication confirmed by a negative stool antigen test. Gastroenterology recommended EGD and colonoscopy, but patient was unable to tolerate the bowel prep. The patient underwent an EGD, which revealed a 3.0 3 3.5 cm, cratered gastric ulcer without stigmata of bleeding at the incisura (Figure 2). Biopsy of this ulcer was positive for adenocarcinoma. DISCUSSION: This case demonstrates a presentation of bony metastasis of gastric cancer. This metastatic location is rare and unusual. It highlights the importance of maintaining high clinical suspicion in patients with metastatic disease. Additionally, it reinforces the relevance of a multidisciplinary approach when evaluating malignancy.

American Journal of Gastroenterology, 2019

The American Journal of Medicine, 2018

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, May 29, 2016

Although vascular occlusion has long been noted in periburn tissue, the literature is inconsisten... more Although vascular occlusion has long been noted in periburn tissue, the literature is inconsistent regarding the nature of the occlusion, with articles in the 1940s claiming that erythrocytes were the culprit and in the 1980s-90s that microthrombi were responsible. To better define the nature of vessel occlusion, we studied two porcine burn models, a hot comb horizontal injury model and a vertical injury progression model. In both cases, tissue from the first two days after burn were stained with hematoxylin and eosin, or probed for platelets or for fibrinogen/fibrin. Erythrocytes, identified as nonstained, clumped, anuclear, 5μ cells, occluded most blood vessels in both burn models. In contrast, platelet or fibrinogen/fibrin antibodies stained blood vessel occlusions minimally at early time points, and only up to 16% of deep dermal blood vessels at 48 hours in the hot model and up to 7% at 24 hours in the vertical injury progression model. Treatment of animals with a fibronectin-de...

Journal of Petroleum Science and Engineering, 2014

Eocene sediments from the Potwar Basin Pakistan have been characterized geochemically using liqui... more Eocene sediments from the Potwar Basin Pakistan have been characterized geochemically using liquid chromatography, gas chromatograph-mass spectrometry (GC-MS), GC-isotope ratio MS and metastable reaction monitoring (MRM) GC-MS. Biomarker and non-biomarker parameters have been used to evaluate the origin, paleodepositional conditions, lithology and thermal maturation of organic matter. The n-alkanes distribution profiles observed for the studied samples suggest an abundance of low molecular weight compounds in the Upper Eocene sequence, which is consistent with higher marine input. On the other hand, the bimodal n-alkanes distribution observed with depth may suggest terrigenous contribution. An enrichment of the δ 13 C of low molecular weight n-alkanes (on-C 18) reveals marine origin (algal and bacterial) while depleted 13 C values observed for n-alkanes greater than n-C 22 indicate terrigenous origin of these compounds. Despite ample biomarker parameters as to the noticeable marine origin of the organic matter, presence of oleanane and retene as well as the enrichment of the δ 13 C values of the long chain n-alkanes suggest significant terrestrial contribution in the studied organic matter. An interesting feature of the δ 13 C isotopic profiles of n-alkanes higher than C 25 is so called saw tooth profile, in which the odd carbon number compounds were more depleted in 13 C than the adjacent even numbered compounds. This feature may further support the assumption that the source of these n-alkanes lay in plant waxes. Depositional environment of these sediments were typical marine with oxic to suboxic conditions and showed variation in oxicity with depth. Our results indicate that the Upper Eocene sediments have been deposited under oxic conditions while the lower Eocene strata are more likely to be deposited under restricted suboxic reducing marine conditions. Significantly low concentration of rearranged steranes and hopanes suggested carbonate lithology for these sediments. Aliphatic and aromatic hydrocarbons geochemical data indicate level of maturity corresponding to the onset of oil generation. Therefore, it is suggested that these sediments are more likely to be considered as possible hydrocarbon source rocks within the Potwar Basin.

The American Journal of Medicine, 2019