Dr Abdul haseeb Bhutta - Academia.edu (original) (raw)

Papers by Dr Abdul haseeb Bhutta

Research paper thumbnail of Urinary Incontinence Among Women After Multiple Pregnancies

The Rehabilitation Journal

Objective: The purpose of the current study was to look into the occurrence of symptoms of Stress... more Objective: The purpose of the current study was to look into the occurrence of symptoms of Stress and Urge Urinary Incontinence among women following multiple pregnancies, and the association of gravidity and age with severity of urinary incontinence. Study Design: Cross Sectional Survey. Study Setting: Al-Nafees Hospital, Islamabad. Methodology: Women aged 20-40 years of age with multiple pregnancies were included in the study, whereas females with urinary incontinence with cause other than pregnancy or delivery were excluded. Non probability convenience sampling was used. “MESA Urinary Incontinence Questionnaire: was used as an outcome measurement tool. Results: A total of 129 participants were included in the study. The mean age of participants was 30.68±5.03 years. Gravidity was 2 for 37.2% (n=48) participants and >2 for 62.8% (n=81) participants. Among participants 55.8% (n=72) women had vaginal and 44.2% (n=57) had caesarian deliveries. A non significant positive correlatio...

Research paper thumbnail of Prevalence Ratio of Urinary Incontinence and Their Association with Peridity and Gravidity

Research paper thumbnail of S0241 American College of Gastroenterology (ACG) Guidelines for Classification of Severity in Colonic Ischemia (CI) Is Useful in Predicting Mortality and Other Adverse Outcomes

The American Journal of Gastroenterology, Oct 1, 2020

Research paper thumbnail of Patients Receiving Multiple Types of Intravenous Fluids (IVFs) During Treatment (Tx) of Colonic Ischemia (CI) Have More Severe Disease, Higher Rates of Antimicrobial Usage and Worse Outcomes

The American Journal of Gastroenterology, Oct 1, 2018

Research paper thumbnail of Syphilitic hepatitis as a manifestation of secondary syphilis

Baylor University Medical Center Proceedings, Jul 6, 2021

Syphilis is a multisystem disease caused by the spirochete Treponema pallidum. Among various orga... more Syphilis is a multisystem disease caused by the spirochete Treponema pallidum. Among various organs affected, liver involvement is seen infrequently and can be missed. Here we present a case of hepatitis due to secondary syphilis that completely resolved with penicillin G therapy.

Research paper thumbnail of A Rare Case of Pancreatic Tuberculosis Diagnosed via Endoscopic Ultrasound-Guided Fine Needle Aspiration and Polymerase Chain Reaction

Cureus, Jun 24, 2020

Hoilat et al. This is an open access article distributed under the terms of the Creative Commons ... more Hoilat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Research paper thumbnail of Educational environment perception and cognitive load among physical therapy students during e-learning

The Rehabilitation Journal

Background: Understanding students' perception of the educational environment and their cogni... more Background: Understanding students' perception of the educational environment and their cognitive load in this context is crucial for optimizing the effectiveness of e-learning platforms. Objective: To compare educational environment perception and cognitive load in under-graduates Doctor of Physical Therapy (DPT) and post-graduate Master in Science of Physical Therapy (MSPT) students having online learning experiences. Methodology: In this comparative cross-sectional study, data was collected through non-probability convenient sampling from n=274 under-graduates DPT (n=225) and post-graduates MSPT(n=49) students of either gender having one-semester experience of online learning, Dundee Ready Education Environment Measure (DREEM) for measuring educational environmental perception and Rating Scale of Mental Effort (RSME) for measurement of cognitive load. Online self-structured was developed questionnaire and shared through communication media platform and data analysis was made ...

Research paper thumbnail of Prevalence Ratio of Urinary Incontinence and Their Association with Peridity and Gravidity

Journal of Women Medical and Dental College

The purpose of the current study was to find out the frequency of married females with urinary in... more The purpose of the current study was to find out the frequency of married females with urinary incontinence including stress, urge and mixed incontinence in Mansehra city and how it is affecting the daily life of females as compared to women without urinary incontinence. District Headquarter Hospital, Mansehra, Helping Hand Institute of Rehabilitation Sciences, Mansehra and Taj Health Complex, Mansehra. For the current study married women with age 18 to 65 years were selected while females with tumor, sexually transmitted diseases or female on any sedative was excluded from the study. Non- probability purposive technique was used for the sampling technique and “Questions for Urinary Incontinence Diagnosis” was used as outcome measuring tool. For the current study, 385 participants were selected. Prevalence ratio was found to be 72.5% with either type of urinary incontinence while 27.5% participants were found without any type of urinary incontinence. Mean gravidity of females with u...

Research paper thumbnail of S207 There Is No Difference in Frequency or Outcome of Colon Ischemia Based Upon the Season of Presentation

American Journal of Gastroenterology

Research paper thumbnail of Progressive Genetic Modifications with Growth Hormone Receptor Knockout Extends Cardiac Xenograft Survival to 9 Months

We report orthotopic (life-supporting) survival of genetically engineered porcine cardiac xenogra... more We report orthotopic (life-supporting) survival of genetically engineered porcine cardiac xenografts (with 3-9 progressive gene modifications) for almost 9 months in baboon recipients. This work builds on our previously reported heterotopic cardiac xenograft (3 gene modifications) survival up to 945 days with an anti-CD40 monoclonal antibody-based immunosuppression. In this current study, life-supporting xenografts containing multiple human complement regulatory, thromboregulatory, and anti-inflammatory proteins, in addition to growth hormone receptor knockout (KO) and carbohydrate antigen KOs, were transplanted. Selective "multi-gene" xenografts demonstrate survival greater than 8 months without the use of adjunctive medications and without evidence of abnormal xenograft thickness or rejection. These data demonstrate that selective “multi-gene" modifications improve cardiac xenograft survival significantly and may be foundational for paving the way to bridge transpla...

Research paper thumbnail of Su1137: OUTPATIENT VS HOSPITAL-ONSET COLON ISCHEMIA: COMPARISON OF CLINICAL FEATURES AND OUTCOMES

Research paper thumbnail of S2004 A Hard Pill to Swallow: Oropharyngeal Dysphagia Secondary to Antipsychotics

American Journal of Gastroenterology, 2020

Research paper thumbnail of S2531 A Rare Cause of Cholestasis: Secondary Sclerosing Cholangitis in a Critically Ill Patient

American Journal of Gastroenterology, 2020

Research paper thumbnail of Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation

Alimentary Pharmacology & Therapeutics, 2017

SummaryBackgroundIt has been suggested that beta‐blockers may increase mortality in patients with... more SummaryBackgroundIt has been suggested that beta‐blockers may increase mortality in patients with cirrhosis and refractory ascites but the effect of beta‐blockers discontinuation or reinitiation has not been examined.AimsTo compare, in hospitalised patients with cirrhosis and ascites, the effect of BB on survival and to examine the effect/predictors of beta‐blockers discontinuation and reinitiation.MethodsSub‐analysis of NACSELD (North American consortium for the study of end‐stage liver disease, database containing prospective data on hospitalised patients with cirrhosis) data from 7 centres enrolling >100 patients with ascites. Data on BB discontinuation and reinitiation were collected by chart review.ResultsSeven hundred and sixteen patients, 307 (43%) on beta‐blockers at admission and 366 (51%) with refractory ascites, were followed to death or hospital discharge. Beta‐blocker use was associated with a lower white blood cell count at admission. Beta‐blocker use in hospitalise...

Research paper thumbnail of Beta-Blocker Use in Hospitalized Cirrhotic Patients with Ascites is Associated with a Lower Meld, less Inflammation and an Improved Survival

Journal of Hepatology, 2016

parallel attenuation of markers of liver damage, inflammation and steatosis compared with their S... more parallel attenuation of markers of liver damage, inflammation and steatosis compared with their StARD1 floxed counterparts. Conclusions: These results suggest the role of StARD1 in the pathogenesis of alcohol liver disease, indicating that inhibition of StARD1 should be explored as a novel therapeutic strategy to ameliorate alcohol-induced liver damage.

Research paper thumbnail of Sa1645 Beta-Blocker (BB) Use in Hospitalized Cirrhotic Patients With Ascites Is Associated With a Lower MELD, Less Inflammation and an Improved Survival

Gastroenterology, 2016

BACKGROUND: Large volume paracentesis (LVP) is a common procedure performed to effectively reliev... more BACKGROUND: Large volume paracentesis (LVP) is a common procedure performed to effectively relieve symptoms of tense ascites in advanced cirrhosis. Following LVP, plasma volume expansion with albumin replacement is recommended by AASLD and other professional societies to prevent post-paracentesis circulatory disturbance, mainly expressed as impairment of renal function. However, cirrhotic patients frequently have marked coagulopathy that is often treated with fresh frozen plasma (FFP) prior to LVP in order to reduce bleeding risk (in spite of recommendations to the contrary by the guidelines). AIM:To determine if the amounts of albumin contained in FFP administered prior to LVP is clinically significant, and effective in preventing post-LVP renal dysfunction. METHODS: For each patient who received FFP prior to LVP over a 6 months period in 2015 at our university tertiary center for liver disease, we determined the following: number of FFP units received prior to LVP, volume of ascitic fluid removed, amount of albumin received after the procedure (according to 2012 AASLD guidelines), and serum creatinine before and after the LVP. Albumin content in FFP units was determined by direct assay of albumin level in FFP samples. RESULTS: 243 large volume paracentesis were performed in 107 patients between April and September 2015. FFP was administered prior to 112 LVP's (46%) to correct the INR in 40 patients (10 females, 30 males, age 57±1yrs). Causes of cirrhosis included NASH, HCV, alcohol, autoimmune, and other miscellaneous liver disorders; MELD score was 24±1 points (10-40). Mean volume of ascites removed was 6.8±0.2 liters (range: 2.0-13.1L; more than 5 liters were removed in 76% of the paracenteses). Prior to LVP, patients received 4±0.2 units of FFP (range: 1-11) per patient. After LVP, patients received 51.7±4g of intravenous albumin (range:0-200). Albumin content of FFP was 3.6±0.05 g/dL. Total amount of albumin administered was 96.9±5 g/patient, including albumin in FFP prior to LVP and albumin administered after LVP. The amount of albumin administered in excess of guidelines recommendation (i.e., 6-8 g of i.v. albumin per liter of ascites removed) was 51.9±4 g/patient. Serum creatinine increased minimally (0.07±0.4 mg/dL) after LVP. CONCLUSIONS: Almost half of cirrhotic patients receive FFP prior to large volume paracentesis. The FFP administered in preparation for paracentesis contains a significant amount of albumin (near 40 g) and leads to substantial excess albumin infusion when i.v. albumin is also given following the paracentesis (following standard of care guidelines). The excess albumin from FFP and post-LVP did not appear associated with clinical benefit or worsening of renal function following paracentesis. Our results suggest that considerably less albumin should be given after LVP when patients receive FFP prior to the procedure.

Research paper thumbnail of Turkey at the Crossroads of European Energy Politics

Energy security has assumed a pivotal role in the economic and energy security agendas of the EU ... more Energy security has assumed a pivotal role in the economic and energy security agendas of the EU and the US. The EU is dependent upon Russia for almost 33% of its energy needs. However, the 2009 European energy crisis triggered by Russia has forced the EU to reduce its dependence upon Russia and explore new sources of energy to meet its growing energy demand. Energy supplies from the Middle East through tankers have become risky due to the ongoing tussle between the US and Iran over the nuclear issue. Central Asia and the Caucasus with their proven and untapped reserves of oil and gas have attracted the attention of European and American oil and gas companies. However, the area is land locked and completely dependent upon Russia for the exploration, and transportation of its energy resources to the outside world. After the disintegration of the Soviet Union, American and the European companies rushed into the region for securing oil and gas exploration contracts. They were however, faced with the problem of transporting the discovered resources to Europe and finally decided to go overland and use pipelines. Turkey which occupies a strategic location and acts as a bridge between Europe, the Middle East and Central Asia was seen as a natural transition route for supplying oil and gas to Europe. Turkey, dependent for most of its energy needs on Russia, does not want to annoy it, but at the same time wants to take advantage of the opportunity of serving as an energy route to the EU and the US. Turkey has so far played a balanced role by keeping Russia engaged in some of the pipeline projects passing through its territory and has also offered its territory for the passage of Russian pipelines to Europe to reduce tanker traffic through the Straits of Bosporus. Russia however, does not want to lose its hold on the supply of energy to European markets. The article offers insight into how Turkey maintains a difficult balance between Russia and Europe in this new pipeline politics.

Research paper thumbnail of Biological studies on some fungi associated with sunflower in Pakistan

To know the seed mycoflora of sunflower, 196 seed samples were collected from rent sources and te... more To know the seed mycoflora of sunflower, 196 seed samples were collected from rent sources and tested using blotter paper method. Twenty fungi normally considered ogenic to oil seed crops, were recorded. Out of these, Alternaria helianthi, chslera hawaiiensis, D. longirostrata, Fusarium culmorum, F. oxyporum, pthecium hawaiiensis, D. longirostrata, Fusarium culmorum, F. oxysporum, * pthecium roridum, M. verrucaria, Phoma oleracea, Phomopsis helianthi, *phylium helianthi and Verticillium dahliae were the new record for Pakistan on lower seeds. High incidence of A. alternate and F. moniliforme, was observed * web by F. semitectum, Emericellopsis terricola, Macrophomina phaselina, S. * nthi and others. More open pollinated varieties were found infected than the * ids. To study the relationship of seed mycoflora with prevalence and incidence of lower field diseases, a systematic survey was carried out in various agro-ecological * ons of Pakistan during 1991. A total of 10 diseases were recorded. Alternaria leaf spot * charcoal rot were observed with highest incidence at maximum localities followed * ead rot, Phomosis leaf spot collar rot, Phomosis leaf spot and Phoma leaf spot / black stem rot. A higher number of lower cultivars were observed infected with charcoal rot and Alternaria leaf spot web by the head rot, collar rot and others. No new disease was observed during current survey but prevalence, incidence and * rity of already known diseases showed and upward trend. A part from charcoal rot and * rnaria leaf spot, powdery mildew and bacterial rot were found emerging pathological * lems. All the field diseases observed in current survey are known to be seed * mitted. The casusal organisms of five field diseases, namely Alternaria leaf spot, coal rot, head rot, Phoma leaf spot / black stem rot and Phomosis leaf spot were * d to be associated with seed and were analyzed for seed mycoflora. A study on the pre-treatment with mercuric chloride showed that number of seed-*e fungi remained the same but their incidence decreased. It indicated that these fungi* ternally seed-born and not surface contaminants. A study was conducted to know * ect of mycoflora on germination of sunflower seed. It was found that seed-borne caused abnormalities reaching 25%. In Pathogenicity test, 15 fungi were to be pathogenic on sunflower plants. D. hawaiiensis, D. longirostrata, D. * era. E. terricola and M. verrucaria failed to cause infection on sunflower plants in vitro conditions. For successful detection of seed-borne fungi, blotter paper * I was found most suitable, simple less time consuming and economical as red to agar plate, anchor and dry inspection methods. In the study pertaining to location of major seed-borne fungi in different seed * nents, A. alternata and M. phaselina were found in the pericarp, endosperm and *o. In transmission studies of these pathogens, the dying seedlings yielded * nata 90% from hypocotyls and cotyledons. M. phaseoline caused pre* ence death of seedlings and post emergence mortality in the form of damping off, * t and root and stem rot between fourth and eight week of growth. In a correlation from seed a field infection, it was concluded that 10% infection due to * nata and 5% of M. phaseolina in the seeds, can safely be used for sowing. The produce of sunflower kept in storage for extension of oil, were tested for * e fungi. Nineteen seed – borne fungi were detected. The highest seed recovery was of * aria, Aspergillus, Rhizopus and Fasurium spp. These fungi are known to be * ed in production of various mycotxin. Higher incidence of seed mycoflora * sed the quantity of oil and unsaturated fatty acids but increased the saturated fatty oncentration. A seed treatment study was carried out to minimize the seed – borne and subsequently field diseases. Seed treatment with Tecto, Benlate and seed * ntes viz, Azadirachta indica and Coriandrum sativum gave best control and * sed the germination of sunflower. These results indicate that seed diffusates can * I the sunflower diseases caused by seed – borne pathogens under field conditions and substitute the expensive chemicals used for the same purpose in a more healthy and * ly environment.

Research paper thumbnail of Decreased Postnatal Docosahexaenoic and Arachidonic Acid Blood Levels in Premature Infants are Associated with Neonatal Morbidities

The Journal of Pediatrics, 2011

Objective-To measure the changes in whole blood fatty acid levels in premature infants and evalua... more Objective-To measure the changes in whole blood fatty acid levels in premature infants and evaluate their association with neonatal morbidities. Study design-Retrospective cohort study of 88 infants born at < 30 weeks of gestation. Serial fatty acid profiles during the first postnatal month and infant outcomes, including chronic lung disease (CLD), retinopathy of prematurity (ROP), and late-onset sepsis, were analyzed. Regression modeling was applied to determine the association between fatty acid levels and neonatal morbidities. Results-DHA and AA levels declined rapidly in the first postnatal week with a concomitant increase in linoleic acid (LA) levels. Decreased DHA levels were associated with an increased risk of CLD (OR 2.5; 95% CI 1.3-5.0). Decreased AA levels were associated with an increased risk of late-onset sepsis (hazard ratio 1.4; 95% CI 1.1-1.7). The balance between fatty acids was also a predictor of CLD and late-onset sepsis. An increased LA:DHA ratio was associated with an increased risk of CLD (OR 8.6; 95% CI 1.4-53.1) and late-onset sepsis (hazard ratio 4.6; 95% CI 1.5-14.1). Conclusion-Altered postnatal fatty acid levels in premature infants are associated with an increased risk of CLD and late-onset sepsis.

Research paper thumbnail of M1872 Electrophysiological Studies as Therapeutic Endpoint Measures in CF

Gastroenterology, 2010

The genetic events and molecular mechanisms underlying pancreatic regeneration after acute pancre... more The genetic events and molecular mechanisms underlying pancreatic regeneration after acute pancreatitis are poorly understood. Cerulein, a cholecystokinin analog, induces acute pancreatitis in mice with pronounced acinar cell injury and acinar-ductal metaplasia within three days. Thereafter, regeneration with normal pancreatic cellular morphology and function occurs. Methods: To address what molecular factors promote injury and regeneration, we isolated RNA and performed gene expression analysis of the challenged cell population at different time points (day 0, 1, 3, and 5) by using the cerulein-induced acute pancreatitis in C57BL/6 mice and saline in age-matched wild-type littermates. Results: Unsupervised gene clustering analysis underscored that changes in gene expression are mostly limited to the early time points, specifically days 1-3, consistent with the observed morphologically changes. The experimental design of this study allowed us to identify temporally regulated genes during defined phases of injury and regeneration. On day 1 of pancreatitis 224 genes were highly significant up-or down-regulated, respectively (more than 2.5-fold, false discovery rate 0.1), compared to day 0 and matched controls. Analysis of the gene expression data by computational pathway analysis tools revealed several specific regulatory networks that are deregulated. Interestingly, besides pathways that regulate DNA replication, and repair, cell cycle, cellular assembly and organization, as well as embryonic development, the top networks are related to growth, proliferation, tumor morphology, and cancer. Conclusion: This study not only provides new insights into gene expression during regeneration but might provide evidence for overlapping and distinct gene expression signatures of development, regeneration, and cancer in the pancreas.

Research paper thumbnail of Urinary Incontinence Among Women After Multiple Pregnancies

The Rehabilitation Journal

Objective: The purpose of the current study was to look into the occurrence of symptoms of Stress... more Objective: The purpose of the current study was to look into the occurrence of symptoms of Stress and Urge Urinary Incontinence among women following multiple pregnancies, and the association of gravidity and age with severity of urinary incontinence. Study Design: Cross Sectional Survey. Study Setting: Al-Nafees Hospital, Islamabad. Methodology: Women aged 20-40 years of age with multiple pregnancies were included in the study, whereas females with urinary incontinence with cause other than pregnancy or delivery were excluded. Non probability convenience sampling was used. “MESA Urinary Incontinence Questionnaire: was used as an outcome measurement tool. Results: A total of 129 participants were included in the study. The mean age of participants was 30.68±5.03 years. Gravidity was 2 for 37.2% (n=48) participants and >2 for 62.8% (n=81) participants. Among participants 55.8% (n=72) women had vaginal and 44.2% (n=57) had caesarian deliveries. A non significant positive correlatio...

Research paper thumbnail of Prevalence Ratio of Urinary Incontinence and Their Association with Peridity and Gravidity

Research paper thumbnail of S0241 American College of Gastroenterology (ACG) Guidelines for Classification of Severity in Colonic Ischemia (CI) Is Useful in Predicting Mortality and Other Adverse Outcomes

The American Journal of Gastroenterology, Oct 1, 2020

Research paper thumbnail of Patients Receiving Multiple Types of Intravenous Fluids (IVFs) During Treatment (Tx) of Colonic Ischemia (CI) Have More Severe Disease, Higher Rates of Antimicrobial Usage and Worse Outcomes

The American Journal of Gastroenterology, Oct 1, 2018

Research paper thumbnail of Syphilitic hepatitis as a manifestation of secondary syphilis

Baylor University Medical Center Proceedings, Jul 6, 2021

Syphilis is a multisystem disease caused by the spirochete Treponema pallidum. Among various orga... more Syphilis is a multisystem disease caused by the spirochete Treponema pallidum. Among various organs affected, liver involvement is seen infrequently and can be missed. Here we present a case of hepatitis due to secondary syphilis that completely resolved with penicillin G therapy.

Research paper thumbnail of A Rare Case of Pancreatic Tuberculosis Diagnosed via Endoscopic Ultrasound-Guided Fine Needle Aspiration and Polymerase Chain Reaction

Cureus, Jun 24, 2020

Hoilat et al. This is an open access article distributed under the terms of the Creative Commons ... more Hoilat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Research paper thumbnail of Educational environment perception and cognitive load among physical therapy students during e-learning

The Rehabilitation Journal

Background: Understanding students' perception of the educational environment and their cogni... more Background: Understanding students' perception of the educational environment and their cognitive load in this context is crucial for optimizing the effectiveness of e-learning platforms. Objective: To compare educational environment perception and cognitive load in under-graduates Doctor of Physical Therapy (DPT) and post-graduate Master in Science of Physical Therapy (MSPT) students having online learning experiences. Methodology: In this comparative cross-sectional study, data was collected through non-probability convenient sampling from n=274 under-graduates DPT (n=225) and post-graduates MSPT(n=49) students of either gender having one-semester experience of online learning, Dundee Ready Education Environment Measure (DREEM) for measuring educational environmental perception and Rating Scale of Mental Effort (RSME) for measurement of cognitive load. Online self-structured was developed questionnaire and shared through communication media platform and data analysis was made ...

Research paper thumbnail of Prevalence Ratio of Urinary Incontinence and Their Association with Peridity and Gravidity

Journal of Women Medical and Dental College

The purpose of the current study was to find out the frequency of married females with urinary in... more The purpose of the current study was to find out the frequency of married females with urinary incontinence including stress, urge and mixed incontinence in Mansehra city and how it is affecting the daily life of females as compared to women without urinary incontinence. District Headquarter Hospital, Mansehra, Helping Hand Institute of Rehabilitation Sciences, Mansehra and Taj Health Complex, Mansehra. For the current study married women with age 18 to 65 years were selected while females with tumor, sexually transmitted diseases or female on any sedative was excluded from the study. Non- probability purposive technique was used for the sampling technique and “Questions for Urinary Incontinence Diagnosis” was used as outcome measuring tool. For the current study, 385 participants were selected. Prevalence ratio was found to be 72.5% with either type of urinary incontinence while 27.5% participants were found without any type of urinary incontinence. Mean gravidity of females with u...

Research paper thumbnail of S207 There Is No Difference in Frequency or Outcome of Colon Ischemia Based Upon the Season of Presentation

American Journal of Gastroenterology

Research paper thumbnail of Progressive Genetic Modifications with Growth Hormone Receptor Knockout Extends Cardiac Xenograft Survival to 9 Months

We report orthotopic (life-supporting) survival of genetically engineered porcine cardiac xenogra... more We report orthotopic (life-supporting) survival of genetically engineered porcine cardiac xenografts (with 3-9 progressive gene modifications) for almost 9 months in baboon recipients. This work builds on our previously reported heterotopic cardiac xenograft (3 gene modifications) survival up to 945 days with an anti-CD40 monoclonal antibody-based immunosuppression. In this current study, life-supporting xenografts containing multiple human complement regulatory, thromboregulatory, and anti-inflammatory proteins, in addition to growth hormone receptor knockout (KO) and carbohydrate antigen KOs, were transplanted. Selective "multi-gene" xenografts demonstrate survival greater than 8 months without the use of adjunctive medications and without evidence of abnormal xenograft thickness or rejection. These data demonstrate that selective “multi-gene" modifications improve cardiac xenograft survival significantly and may be foundational for paving the way to bridge transpla...

Research paper thumbnail of Su1137: OUTPATIENT VS HOSPITAL-ONSET COLON ISCHEMIA: COMPARISON OF CLINICAL FEATURES AND OUTCOMES

Research paper thumbnail of S2004 A Hard Pill to Swallow: Oropharyngeal Dysphagia Secondary to Antipsychotics

American Journal of Gastroenterology, 2020

Research paper thumbnail of S2531 A Rare Cause of Cholestasis: Secondary Sclerosing Cholangitis in a Critically Ill Patient

American Journal of Gastroenterology, 2020

Research paper thumbnail of Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation

Alimentary Pharmacology & Therapeutics, 2017

SummaryBackgroundIt has been suggested that beta‐blockers may increase mortality in patients with... more SummaryBackgroundIt has been suggested that beta‐blockers may increase mortality in patients with cirrhosis and refractory ascites but the effect of beta‐blockers discontinuation or reinitiation has not been examined.AimsTo compare, in hospitalised patients with cirrhosis and ascites, the effect of BB on survival and to examine the effect/predictors of beta‐blockers discontinuation and reinitiation.MethodsSub‐analysis of NACSELD (North American consortium for the study of end‐stage liver disease, database containing prospective data on hospitalised patients with cirrhosis) data from 7 centres enrolling >100 patients with ascites. Data on BB discontinuation and reinitiation were collected by chart review.ResultsSeven hundred and sixteen patients, 307 (43%) on beta‐blockers at admission and 366 (51%) with refractory ascites, were followed to death or hospital discharge. Beta‐blocker use was associated with a lower white blood cell count at admission. Beta‐blocker use in hospitalise...

Research paper thumbnail of Beta-Blocker Use in Hospitalized Cirrhotic Patients with Ascites is Associated with a Lower Meld, less Inflammation and an Improved Survival

Journal of Hepatology, 2016

parallel attenuation of markers of liver damage, inflammation and steatosis compared with their S... more parallel attenuation of markers of liver damage, inflammation and steatosis compared with their StARD1 floxed counterparts. Conclusions: These results suggest the role of StARD1 in the pathogenesis of alcohol liver disease, indicating that inhibition of StARD1 should be explored as a novel therapeutic strategy to ameliorate alcohol-induced liver damage.

Research paper thumbnail of Sa1645 Beta-Blocker (BB) Use in Hospitalized Cirrhotic Patients With Ascites Is Associated With a Lower MELD, Less Inflammation and an Improved Survival

Gastroenterology, 2016

BACKGROUND: Large volume paracentesis (LVP) is a common procedure performed to effectively reliev... more BACKGROUND: Large volume paracentesis (LVP) is a common procedure performed to effectively relieve symptoms of tense ascites in advanced cirrhosis. Following LVP, plasma volume expansion with albumin replacement is recommended by AASLD and other professional societies to prevent post-paracentesis circulatory disturbance, mainly expressed as impairment of renal function. However, cirrhotic patients frequently have marked coagulopathy that is often treated with fresh frozen plasma (FFP) prior to LVP in order to reduce bleeding risk (in spite of recommendations to the contrary by the guidelines). AIM:To determine if the amounts of albumin contained in FFP administered prior to LVP is clinically significant, and effective in preventing post-LVP renal dysfunction. METHODS: For each patient who received FFP prior to LVP over a 6 months period in 2015 at our university tertiary center for liver disease, we determined the following: number of FFP units received prior to LVP, volume of ascitic fluid removed, amount of albumin received after the procedure (according to 2012 AASLD guidelines), and serum creatinine before and after the LVP. Albumin content in FFP units was determined by direct assay of albumin level in FFP samples. RESULTS: 243 large volume paracentesis were performed in 107 patients between April and September 2015. FFP was administered prior to 112 LVP's (46%) to correct the INR in 40 patients (10 females, 30 males, age 57±1yrs). Causes of cirrhosis included NASH, HCV, alcohol, autoimmune, and other miscellaneous liver disorders; MELD score was 24±1 points (10-40). Mean volume of ascites removed was 6.8±0.2 liters (range: 2.0-13.1L; more than 5 liters were removed in 76% of the paracenteses). Prior to LVP, patients received 4±0.2 units of FFP (range: 1-11) per patient. After LVP, patients received 51.7±4g of intravenous albumin (range:0-200). Albumin content of FFP was 3.6±0.05 g/dL. Total amount of albumin administered was 96.9±5 g/patient, including albumin in FFP prior to LVP and albumin administered after LVP. The amount of albumin administered in excess of guidelines recommendation (i.e., 6-8 g of i.v. albumin per liter of ascites removed) was 51.9±4 g/patient. Serum creatinine increased minimally (0.07±0.4 mg/dL) after LVP. CONCLUSIONS: Almost half of cirrhotic patients receive FFP prior to large volume paracentesis. The FFP administered in preparation for paracentesis contains a significant amount of albumin (near 40 g) and leads to substantial excess albumin infusion when i.v. albumin is also given following the paracentesis (following standard of care guidelines). The excess albumin from FFP and post-LVP did not appear associated with clinical benefit or worsening of renal function following paracentesis. Our results suggest that considerably less albumin should be given after LVP when patients receive FFP prior to the procedure.

Research paper thumbnail of Turkey at the Crossroads of European Energy Politics

Energy security has assumed a pivotal role in the economic and energy security agendas of the EU ... more Energy security has assumed a pivotal role in the economic and energy security agendas of the EU and the US. The EU is dependent upon Russia for almost 33% of its energy needs. However, the 2009 European energy crisis triggered by Russia has forced the EU to reduce its dependence upon Russia and explore new sources of energy to meet its growing energy demand. Energy supplies from the Middle East through tankers have become risky due to the ongoing tussle between the US and Iran over the nuclear issue. Central Asia and the Caucasus with their proven and untapped reserves of oil and gas have attracted the attention of European and American oil and gas companies. However, the area is land locked and completely dependent upon Russia for the exploration, and transportation of its energy resources to the outside world. After the disintegration of the Soviet Union, American and the European companies rushed into the region for securing oil and gas exploration contracts. They were however, faced with the problem of transporting the discovered resources to Europe and finally decided to go overland and use pipelines. Turkey which occupies a strategic location and acts as a bridge between Europe, the Middle East and Central Asia was seen as a natural transition route for supplying oil and gas to Europe. Turkey, dependent for most of its energy needs on Russia, does not want to annoy it, but at the same time wants to take advantage of the opportunity of serving as an energy route to the EU and the US. Turkey has so far played a balanced role by keeping Russia engaged in some of the pipeline projects passing through its territory and has also offered its territory for the passage of Russian pipelines to Europe to reduce tanker traffic through the Straits of Bosporus. Russia however, does not want to lose its hold on the supply of energy to European markets. The article offers insight into how Turkey maintains a difficult balance between Russia and Europe in this new pipeline politics.

Research paper thumbnail of Biological studies on some fungi associated with sunflower in Pakistan

To know the seed mycoflora of sunflower, 196 seed samples were collected from rent sources and te... more To know the seed mycoflora of sunflower, 196 seed samples were collected from rent sources and tested using blotter paper method. Twenty fungi normally considered ogenic to oil seed crops, were recorded. Out of these, Alternaria helianthi, chslera hawaiiensis, D. longirostrata, Fusarium culmorum, F. oxyporum, pthecium hawaiiensis, D. longirostrata, Fusarium culmorum, F. oxysporum, * pthecium roridum, M. verrucaria, Phoma oleracea, Phomopsis helianthi, *phylium helianthi and Verticillium dahliae were the new record for Pakistan on lower seeds. High incidence of A. alternate and F. moniliforme, was observed * web by F. semitectum, Emericellopsis terricola, Macrophomina phaselina, S. * nthi and others. More open pollinated varieties were found infected than the * ids. To study the relationship of seed mycoflora with prevalence and incidence of lower field diseases, a systematic survey was carried out in various agro-ecological * ons of Pakistan during 1991. A total of 10 diseases were recorded. Alternaria leaf spot * charcoal rot were observed with highest incidence at maximum localities followed * ead rot, Phomosis leaf spot collar rot, Phomosis leaf spot and Phoma leaf spot / black stem rot. A higher number of lower cultivars were observed infected with charcoal rot and Alternaria leaf spot web by the head rot, collar rot and others. No new disease was observed during current survey but prevalence, incidence and * rity of already known diseases showed and upward trend. A part from charcoal rot and * rnaria leaf spot, powdery mildew and bacterial rot were found emerging pathological * lems. All the field diseases observed in current survey are known to be seed * mitted. The casusal organisms of five field diseases, namely Alternaria leaf spot, coal rot, head rot, Phoma leaf spot / black stem rot and Phomosis leaf spot were * d to be associated with seed and were analyzed for seed mycoflora. A study on the pre-treatment with mercuric chloride showed that number of seed-*e fungi remained the same but their incidence decreased. It indicated that these fungi* ternally seed-born and not surface contaminants. A study was conducted to know * ect of mycoflora on germination of sunflower seed. It was found that seed-borne caused abnormalities reaching 25%. In Pathogenicity test, 15 fungi were to be pathogenic on sunflower plants. D. hawaiiensis, D. longirostrata, D. * era. E. terricola and M. verrucaria failed to cause infection on sunflower plants in vitro conditions. For successful detection of seed-borne fungi, blotter paper * I was found most suitable, simple less time consuming and economical as red to agar plate, anchor and dry inspection methods. In the study pertaining to location of major seed-borne fungi in different seed * nents, A. alternata and M. phaselina were found in the pericarp, endosperm and *o. In transmission studies of these pathogens, the dying seedlings yielded * nata 90% from hypocotyls and cotyledons. M. phaseoline caused pre* ence death of seedlings and post emergence mortality in the form of damping off, * t and root and stem rot between fourth and eight week of growth. In a correlation from seed a field infection, it was concluded that 10% infection due to * nata and 5% of M. phaseolina in the seeds, can safely be used for sowing. The produce of sunflower kept in storage for extension of oil, were tested for * e fungi. Nineteen seed – borne fungi were detected. The highest seed recovery was of * aria, Aspergillus, Rhizopus and Fasurium spp. These fungi are known to be * ed in production of various mycotxin. Higher incidence of seed mycoflora * sed the quantity of oil and unsaturated fatty acids but increased the saturated fatty oncentration. A seed treatment study was carried out to minimize the seed – borne and subsequently field diseases. Seed treatment with Tecto, Benlate and seed * ntes viz, Azadirachta indica and Coriandrum sativum gave best control and * sed the germination of sunflower. These results indicate that seed diffusates can * I the sunflower diseases caused by seed – borne pathogens under field conditions and substitute the expensive chemicals used for the same purpose in a more healthy and * ly environment.

Research paper thumbnail of Decreased Postnatal Docosahexaenoic and Arachidonic Acid Blood Levels in Premature Infants are Associated with Neonatal Morbidities

The Journal of Pediatrics, 2011

Objective-To measure the changes in whole blood fatty acid levels in premature infants and evalua... more Objective-To measure the changes in whole blood fatty acid levels in premature infants and evaluate their association with neonatal morbidities. Study design-Retrospective cohort study of 88 infants born at < 30 weeks of gestation. Serial fatty acid profiles during the first postnatal month and infant outcomes, including chronic lung disease (CLD), retinopathy of prematurity (ROP), and late-onset sepsis, were analyzed. Regression modeling was applied to determine the association between fatty acid levels and neonatal morbidities. Results-DHA and AA levels declined rapidly in the first postnatal week with a concomitant increase in linoleic acid (LA) levels. Decreased DHA levels were associated with an increased risk of CLD (OR 2.5; 95% CI 1.3-5.0). Decreased AA levels were associated with an increased risk of late-onset sepsis (hazard ratio 1.4; 95% CI 1.1-1.7). The balance between fatty acids was also a predictor of CLD and late-onset sepsis. An increased LA:DHA ratio was associated with an increased risk of CLD (OR 8.6; 95% CI 1.4-53.1) and late-onset sepsis (hazard ratio 4.6; 95% CI 1.5-14.1). Conclusion-Altered postnatal fatty acid levels in premature infants are associated with an increased risk of CLD and late-onset sepsis.

Research paper thumbnail of M1872 Electrophysiological Studies as Therapeutic Endpoint Measures in CF

Gastroenterology, 2010

The genetic events and molecular mechanisms underlying pancreatic regeneration after acute pancre... more The genetic events and molecular mechanisms underlying pancreatic regeneration after acute pancreatitis are poorly understood. Cerulein, a cholecystokinin analog, induces acute pancreatitis in mice with pronounced acinar cell injury and acinar-ductal metaplasia within three days. Thereafter, regeneration with normal pancreatic cellular morphology and function occurs. Methods: To address what molecular factors promote injury and regeneration, we isolated RNA and performed gene expression analysis of the challenged cell population at different time points (day 0, 1, 3, and 5) by using the cerulein-induced acute pancreatitis in C57BL/6 mice and saline in age-matched wild-type littermates. Results: Unsupervised gene clustering analysis underscored that changes in gene expression are mostly limited to the early time points, specifically days 1-3, consistent with the observed morphologically changes. The experimental design of this study allowed us to identify temporally regulated genes during defined phases of injury and regeneration. On day 1 of pancreatitis 224 genes were highly significant up-or down-regulated, respectively (more than 2.5-fold, false discovery rate 0.1), compared to day 0 and matched controls. Analysis of the gene expression data by computational pathway analysis tools revealed several specific regulatory networks that are deregulated. Interestingly, besides pathways that regulate DNA replication, and repair, cell cycle, cellular assembly and organization, as well as embryonic development, the top networks are related to growth, proliferation, tumor morphology, and cancer. Conclusion: This study not only provides new insights into gene expression during regeneration but might provide evidence for overlapping and distinct gene expression signatures of development, regeneration, and cancer in the pancreas.