Muhammad Tariq - Academia.edu (original) (raw)
Papers by Muhammad Tariq
Sustainability
Modeling surface water quality using soft computing techniques is essential for the effective man... more Modeling surface water quality using soft computing techniques is essential for the effective management of scarce water resources and environmental protection. The development of accurate predictive models with significant input parameters and inconsistent datasets is still a challenge. Therefore, further research is needed to improve the performance of the predictive models. This study presents a methodology for dataset pre-processing and input optimization for reducing the modeling complexity. The objective of this study was achieved by employing a two-sided detection approach for outlier removal and an exhaustive search method for selecting essential modeling inputs. Thereafter, the adaptive neuro-fuzzy inference system (ANFIS) was applied for modeling electrical conductivity (EC) and total dissolved solids (TDS) in the upper Indus River. A larger dataset of a 30-year historical period, measured monthly, was utilized in the modeling process. The prediction capacity of the develo...
Crystals
Alzheimer’s disease (AD) causes dementia and continuous damage to brain cells. Cholinesterase inh... more Alzheimer’s disease (AD) causes dementia and continuous damage to brain cells. Cholinesterase inhibitors can alleviate the condition by increasing communication between the nerve cells and reducing the risk of dementia. In an effort to treat Alzheimer’s disease, we synthesized flurbiprofen-based diamines (1,2 diaminoethane and 1,3 diaminopropane) Zn(II), Cu(II) metal complexes and characterized them by single-crystal X-ray analysis, NMR, (FT)-IR, UV-Vis, magnetic susceptibility, elemental analysis and conductivities measurements. Synthesized diamine metal complexes appeared in ionic forms and have distorted octahedral geometry based on conductivity studies, magnetic susceptibility and electronic studies. Single crystal X-ray diffraction analysis confirmed (2b) Cu(H2O)2(L1)2(L2)2 complex formation. Moreover, we tested all synthesized metal complexes against the cholinesterase enzyme that showed higher inhibition potential. In general, copper metal complexes showed higher inhibitory a...
Tecnología y ciencias del agua
Drinking water quality is of vital importance for the healthy life of a community especially if c... more Drinking water quality is of vital importance for the healthy life of a community especially if consumer is a teenager. In order to compare groundwater profile of flooded area (FA) and non-flooded area (NFA) of district Sanghar, 120 water samples from public schools were collected and investigated for physico-chemical parameters, essential metals, trace elements and microbiological indicators. Analysis data revealed that 47% samples in FA were contaminated with faecal coliform bacteria as compared to only 8.3% in NFA. On the other hand, chemical indicators like TDS, Ca, Na, K, SO4, Mg and hardness were higher in FA. Comparison of trace elements content with WHO guidelines revealed that concentration of Fe, As and Zn was higher in 66.7%, 31.7% and 13.3% water samples, respectively in FA whereas content of these elements was also on higher side in 3.3%, 23.3% and 1.7% samples in NFA, respectively. Health risk assessment due to high concentration of Fe, As and Zn showed that As HRI>1, for children in 35 and 23% water samples in FA and NFA, respectively.
Zeitschrift für Kristallographie - Crystalline Materials
Synthesis of C-2 N-substituted anthranilamide derivatives was carried out in a straight forward m... more Synthesis of C-2 N-substituted anthranilamide derivatives was carried out in a straight forward manner, utilizing 2-aminobenzamide and benzyl chloride as starting materials. Their crystal structures have been established by single crystal X-ray crystallographic method. In the molecules of 2-benzylamino-benzamide (3a), intramolecular hydrogen bonding b/w O atom and proton of –NH and classical intermolecular hydrogen bonding of the type N–H · · · O forming eight membered rings in R42(8) pattern. In both molecules of 2-(dibenzylamino)benzamide (3b), unlike the molecule in 3a, each H atoms is pointed towards N atom causing intramolecular hydrogen bonding interactions, resulting in S(6) motifs. However, it is interesting to note that both molecules in 3b are lying about inversion centres and form dimers in R42(8) motifs; the two dimers are linked via non-classical intermolecular hydrogen bonds C–H · · · O resulting in clusters of four molecules in the structure. In vitro assay results re...
Clinical Genitourinary Cancer
Few data exist in the literature regarding outcomes of men with prostate cancer (CaP) who are rec... more Few data exist in the literature regarding outcomes of men with prostate cancer (CaP) who are receiving immunosuppression from prior organ transplantation. The aim of this study was to evaluate biochemical disease-free survival, distant metastasis-free survival, overall survival, and toxicity in patients with organ transplants who were later treated with definitive radiotherapy for CaP. Our institutional CaP registry was reviewed to identify patients who had undergone an organ transplantation before CaP diagnosis. Between 1999 and 2013, a total of 28 organ transplant recipients treated with definitive radiotherapy for CaP were identified. Treatment consisted of either I-125 low-dose-rate brachytherapy or external-beam radiotherapy. All patients were receiving immunosuppressive medications. The median age was 66 years. Median follow-up time was 30 months. Twenty-four patients (86%) were treated with brachytherapy, and 4 patients (14%) were treated with external-beam radiotherapy. Nine patients (32%) had low-risk CaP, 14 (50%) had intermediate-risk CaP, and 5 (18%) had high-risk CaP. At the time of last follow-up, 2 patients had died, 1 from metastatic CaP and 1 from other causes. The 3-year biochemical disease-free survival was 95.8%. The 3-year distant metastasis-free survival was 93.1%. The 3-year overall survival was 93.8%. One patient developed grade 3 late gastrointestinal toxicity. This represents one of the largest reported series of outcomes in patients with organ transplantation and CaP. Organ transplant recipients treated with prostate radiotherapy have excellent 3-year outcomes.
Molecular therapy. Nucleic acids, Jan 7, 2018
Gastric cancer is one of the most prevalent tumor types in the world. Chemotherapy is the most co... more Gastric cancer is one of the most prevalent tumor types in the world. Chemotherapy is the most common choice for cancer treatment. However, chemotherapy resistance and adverse side effects limit its clinical applications. Aberrant expression of long noncoding RNAs (lncRNAs) has been found in various stages of gastric cancer development and progression. In this study, we identified that an oncogenic lncRNA, long intergenic non-protein-coding RNA D63785 (lncR-D63785), is highly expressed in gastric cancer tissues and cells. Silencing of lncR-D63785 inhibited cell proliferation, cell migration and invasion in gastric cancer cell lines and reduced tumor volume and size in mice. We found that the expression of lncR-D63785 was inversely correlated with microRNA 422a (miR-422a) expression, which was involved in the downregulation of expression of myocyte enhancer factor-2D (MEF2D) and drug sensitivity. Knockdown of lncR-D63785 increased the expression of miR-422a and the sensitivity of gas...
Cureus, Jan 14, 2018
Waardenburg syndrome (WS) is a rare genetic disorder. It is caused by multiple mutations affectin... more Waardenburg syndrome (WS) is a rare genetic disorder. It is caused by multiple mutations affecting the melanocytes, leading to a multitude of skin, hair, and eye symptoms. It is an autosomal dominant disease with four subtypes, each presenting with varying degrees of sensorineural hearing loss along with a constellation of other symptoms. Hirschsprung disease is unique to Waardenburg-Shah syndrome subtype 4 and is not associated with any other subtype. We present a case of this subtype 4 that presented with a bilateral sensorineural hearing loss, mutism, delayed milestones, white forelock, Hirschsprung disease, and bilateral blue homochromatic irises, a finding which is not typical for this subtype. This is the first case of WS with homochromatic irises and the fourth case to be reported from Pakistan.
Cureus, Jan 16, 2018
The prolonged use of levodopa for treating Parkinson's disease is associated with motor and n... more The prolonged use of levodopa for treating Parkinson's disease is associated with motor and nonmotor complications. These include wearing-off, delayed-on, partial-on, no-on, and on-off phenomena. In the wearing-off effect, symptoms return before a patient's next scheduled dose of levodopa. Patients may present with motor, sensory, or autonomic fluctuations. In this report, we present a female patient experiencing numbness of lips and slurred speech as a symptom of wearing-off effect. The major differential for sudden numbness of lips and slurred speech includes transient ischemic attacks. Therefore, it is imperative to identify the cause of these episodes so that appropriate treatment can be initiated. Our patient underwent extensive cardiac and neurological investigations, the findings of which were unremarkable. Her symptoms were likely due to levodopa wearing-off. Her condition improved on changing her levodopa to a sustained release form with more frequent dosing along w...
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Jan 5, 2018
Investigators are using checkpoint inhibitors (CPI) to treat aggressive hematologic malignancies ... more Investigators are using checkpoint inhibitors (CPI) to treat aggressive hematologic malignancies before patients undergo allogeneic hematopoietic stem cell transplantation (allo-HSCT) and in some patients with relapsed disease after allo-HSCT. CTLA-4 inhibitors and PD-1 inhibitors are two main types of CPI, which work through activation of the immune system. On one hand CPI can achieve graft versus tumor (GVT) effect, and on the other hand there is risk of graft versus host disease (GVHD). After a comprehensive literature review we included data (n=283) from twenty-four studies (11 original manuscripts, 13 case reports or case series) and evaluated the results to assess the safety and efficacy of CPI use in conjunction with allo-HSCT. One hundred seven patients received CPI before allo-HSCT and one hundred seventy-six patients received CPI after allo-HSCT. The most common indication for CPI use was for Hodgkin lymphoma. The CPIs used in various studies included ipilimumab, nivolumab...
Current treatment options in oncology, 2018
R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximat... more R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximately 60% of patients for more than 2 decades. However, the optimal treatment of patients who are too frail to tolerate this regimen and/or are not candidates for anthracycline therapy continues to be debated. MInT and GELA trials established addition of rituximab to CHOP in DLBCL but excluded patients older than 80 years. Multiple regimens have been tried with varying success in the very elderly, including R-mini-CHOP, R-mini CEOP, R-split CHOP, pre-phase strategies, and R-GCVP. However, there has not been a randomized trial among these strategies. Although addition of novel agents including ibrutinib, brentuximab vedotin, lenalidomide, and many others on the horizon holds promise in this population, none have been tested in a randomized setting or have results awaited. There is also a lack of a validated and easy to use clinical tool in this population to predict patients who will not to...
The Journal of arthroplasty, Jan 17, 2018
The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an e... more The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an effort to advance orthopedic outcome measurements on a national scale. This study was designed to evaluate if the OME data capture system would increase the quality of data collected in the context of primary and revision total hip arthroplasty (THA) compared to conventional operative notes. This study includes data from the first 100 primary THAs and 100 revision THAs performed by 15 surgeons at a single institution from January through April 2016. Surgeons prospectively entered procedural details into OME following surgery. The OME database and operative notes were compared to evaluate completion rates and agreement. Completion rates were compared using McNemar's test (with continuity correction), while agreement was analyzed using Cohen's kappa (κ) and concordance correlation coefficient. The OME database had significantly higher completion rates for 41% (39/96) of the variable...
Acta medica academica, 2018
Continuous assessment tests influence the learning needs of medical students at particular times ... more Continuous assessment tests influence the learning needs of medical students at particular times but are also beneficial in scheduled learning, and act as motivating tool. These tests drive them to study by developing competition and optimism regarding the forthcoming result. This study has been designed to evaluate the role of these tests for medical students by learning about their motivation. This study was conducted on 150 medical students. The students selected a continuous testing system or a classical system. Those who selected the continuous system had six assessment tests each, after completion of a curriculum block, usually 45 days apart. The motivation of the students in both the groups was assessed by asking them for their expected results just before the final examination. Statistical analysis was performed using Superior Performance Statistical Software (SPSS) version 20. The students' final results showed that almost half of the students who adopted the continuous...
Atherosclerosis, 2018
Coronary heart disease (CHD) is one of the leading disorders with the highest mortality rate. Per... more Coronary heart disease (CHD) is one of the leading disorders with the highest mortality rate. Percutaneous angioplasty and stent implantation are the currently available standard methods for the treatment of obstructive coronary artery disease. However, the stent being an exogenous substance causes several complications by promoting the proliferation of vascular smooth muscle cells, immune responses and neointima formation after implantation, leading to post-stent restenosis (ISR) and late thrombosis. The prevention of these adverse vascular events is important to achieve long-term proper functioning of the heart after stent implantation. Non-coding ribonucleic acids (ncRNAs) are RNA molecules not translated into proteins, theyhave a great potential in regulating endothelial cell and vascular smooth muscle function as well as inflammatory reactions. In this review, we outline the regulatory functions of different classes of ncRNA in cardiovascular disease and propose ncRNAs as new t...
Oncotarget, Jan 10, 2018
Gastric cancer is one of the most common cancers and is the second leading cause of cancer mortal... more Gastric cancer is one of the most common cancers and is the second leading cause of cancer mortality worldwide. Therefore, it is urgent to explore new molecular biomarkers for early diagnosis, early treatment and prognosis for gastric cancer patients. Recently, increasing evidence has shown that epigenetic changes, such as aberrant DNA methylation, histone modifications, and noncoding RNAs (ncRNAs) expression, play substantial roles in the development and progression of malignancies. Among these changes, long non-coding RNAs (lncRNAs), a novel class of ncRNAs, are emerging as highly versatile actors in a variety of cellular processes by regulating gene expression at the epigenetic level as well as at the transcriptional and post-transcriptional levels. Hundreds of lncRNAs become dysregulated in the various pathological processes of gastric cancer, and multiple lncRNAs have been reported to function as tumor-suppressors or oncogenes, although the underlying mechanisms are still under...
World neurosurgery, Jan 3, 2018
Routine preoperative blood testing has become a dogma. The general practice is to order preoperat... more Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy. The hospital registry was used to identify files for review. Data was collected on a predefined proforma. A nationwide survey was performed and 30 neurosurgery centers were contacted across Pakistan to confirm the practice of preoperative workup. The survey revealed that all centers had a similar practice of preoperative workup. This included CBC, serum electrolytes and coagulation profile; including PT, aPTT and INR. A total of 1800 files we...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2018
To determine the effect of lower limb ergometric training on echocardiographic parameters of left... more To determine the effect of lower limb ergometric training on echocardiographic parameters of left ventricle in dilated cardiomyopathy (DMC) patients. Randomized control trial. Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan, from September 2016 to February 2017. Clinically stable patients with DCM (n=60), were randomly allocated into an interventional group with two-month interventional program and a non-trained control group (n=30 each). Treatment protocol for interventional group was lower limb ergometer exercise for 8 weeks, 4 days/week. Pre and post-treatment echocardiography was done in both groups at baseline and after 8 weeks. SPSS 21 was used for data analysis. The median (IQR) age of the patients was 51 (18) years in interventional group and 62 (11) years in control group. Male to female ratio was 18:9 in control group and 17:12 in Interventional group. Statistically significant results were detected within the groups regarding ejection fraction (EF), left ventricu...
Journal of cellular and molecular medicine, 2018
Necrosis is an ancient topic which gains new attraction in the research area these years. There i... more Necrosis is an ancient topic which gains new attraction in the research area these years. There is no doubt that some necrosis can be regulated by genetic manipulation other than an accidental cell death resulting from physical or chemical stimuli. Recent advances in the molecular mechanism underlying the programmed necrosis show a fine regulation network which indicates new therapy targets in human diseases. Heart diseases seriously endanger our health and have high fatality rates in the patients. Cell death of cardiac myocytes is believed to be critical in the pathogenesis of heart diseases. Although necrosis is likely to play a more important role in cardiac cell death than apoptosis, apoptosis has been paid much attention in the past 30 years because it used to be considered as the only form of programmed cell death. However, recent findings of programmed necrosis and the related signalling pathways have broadened our horizon in the field of programmed cell death and promote new...
Journal of neuro-oncology, Jan 3, 2018
Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients... more Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients with spine metastases. We created a prognostic index using recursive partitioning analysis (RPA) to allow better patient selection for spine SRS. Patients who underwent single-fraction spine SRS for spine metastases were included. Primary histologies were divided into favorable (breast/prostate), radioresistant (renal cell/sarcoma/melanoma) and other. Cox proportional hazards regression was done to identify factors associated with overall survival (OS). RPA was performed to identify factors to classify patients into distinct risk groups with respect to OS. A total of 444 patients were eligible. Median dose was 16 Gy (range 8-18) in 1 fraction and median follow-up was 11.7 months. At time of analysis, 103 (23.1%) patients were alive. Median OS was 12.9 months. RPA identified three distinct classes. Class 1 was defined as KPS > 70 with controlled systemic disease (n = 142); class 3 was...
The FEBS journal, Jan 7, 2017
Circular RNAs (circRNAs) are a newly discovered type of RNAs generated by back-splicing of precur... more Circular RNAs (circRNAs) are a newly discovered type of RNAs generated by back-splicing of precursor mRNA (pre-mRNA) and found in many species. They are, expressed in a tissue-specific manner and fulfill regulatory activities in many biological processes. Recent research revealed that circRNAs play critical roles in the development and pathologies of the cardiovascular system. Some of these circRNAs showed aberrant expression and regulatory activities during heart disease including heart failure and cardiac infarction and hypertrophy. These findings suggest that circRNAs might be a suitable target for the treatment and prevention of heart disease. In this review, we summarize the latest research on the biogenesis and functions of circRNAs with emphasis on the regulatory roles of circRNAs in the development and pathologies of the cardiovascular system. This article is protected by copyright. All rights reserved.
Frontiers in pharmacology, 2017
Sustainability
Modeling surface water quality using soft computing techniques is essential for the effective man... more Modeling surface water quality using soft computing techniques is essential for the effective management of scarce water resources and environmental protection. The development of accurate predictive models with significant input parameters and inconsistent datasets is still a challenge. Therefore, further research is needed to improve the performance of the predictive models. This study presents a methodology for dataset pre-processing and input optimization for reducing the modeling complexity. The objective of this study was achieved by employing a two-sided detection approach for outlier removal and an exhaustive search method for selecting essential modeling inputs. Thereafter, the adaptive neuro-fuzzy inference system (ANFIS) was applied for modeling electrical conductivity (EC) and total dissolved solids (TDS) in the upper Indus River. A larger dataset of a 30-year historical period, measured monthly, was utilized in the modeling process. The prediction capacity of the develo...
Crystals
Alzheimer’s disease (AD) causes dementia and continuous damage to brain cells. Cholinesterase inh... more Alzheimer’s disease (AD) causes dementia and continuous damage to brain cells. Cholinesterase inhibitors can alleviate the condition by increasing communication between the nerve cells and reducing the risk of dementia. In an effort to treat Alzheimer’s disease, we synthesized flurbiprofen-based diamines (1,2 diaminoethane and 1,3 diaminopropane) Zn(II), Cu(II) metal complexes and characterized them by single-crystal X-ray analysis, NMR, (FT)-IR, UV-Vis, magnetic susceptibility, elemental analysis and conductivities measurements. Synthesized diamine metal complexes appeared in ionic forms and have distorted octahedral geometry based on conductivity studies, magnetic susceptibility and electronic studies. Single crystal X-ray diffraction analysis confirmed (2b) Cu(H2O)2(L1)2(L2)2 complex formation. Moreover, we tested all synthesized metal complexes against the cholinesterase enzyme that showed higher inhibition potential. In general, copper metal complexes showed higher inhibitory a...
Tecnología y ciencias del agua
Drinking water quality is of vital importance for the healthy life of a community especially if c... more Drinking water quality is of vital importance for the healthy life of a community especially if consumer is a teenager. In order to compare groundwater profile of flooded area (FA) and non-flooded area (NFA) of district Sanghar, 120 water samples from public schools were collected and investigated for physico-chemical parameters, essential metals, trace elements and microbiological indicators. Analysis data revealed that 47% samples in FA were contaminated with faecal coliform bacteria as compared to only 8.3% in NFA. On the other hand, chemical indicators like TDS, Ca, Na, K, SO4, Mg and hardness were higher in FA. Comparison of trace elements content with WHO guidelines revealed that concentration of Fe, As and Zn was higher in 66.7%, 31.7% and 13.3% water samples, respectively in FA whereas content of these elements was also on higher side in 3.3%, 23.3% and 1.7% samples in NFA, respectively. Health risk assessment due to high concentration of Fe, As and Zn showed that As HRI>1, for children in 35 and 23% water samples in FA and NFA, respectively.
Zeitschrift für Kristallographie - Crystalline Materials
Synthesis of C-2 N-substituted anthranilamide derivatives was carried out in a straight forward m... more Synthesis of C-2 N-substituted anthranilamide derivatives was carried out in a straight forward manner, utilizing 2-aminobenzamide and benzyl chloride as starting materials. Their crystal structures have been established by single crystal X-ray crystallographic method. In the molecules of 2-benzylamino-benzamide (3a), intramolecular hydrogen bonding b/w O atom and proton of –NH and classical intermolecular hydrogen bonding of the type N–H · · · O forming eight membered rings in R42(8) pattern. In both molecules of 2-(dibenzylamino)benzamide (3b), unlike the molecule in 3a, each H atoms is pointed towards N atom causing intramolecular hydrogen bonding interactions, resulting in S(6) motifs. However, it is interesting to note that both molecules in 3b are lying about inversion centres and form dimers in R42(8) motifs; the two dimers are linked via non-classical intermolecular hydrogen bonds C–H · · · O resulting in clusters of four molecules in the structure. In vitro assay results re...
Clinical Genitourinary Cancer
Few data exist in the literature regarding outcomes of men with prostate cancer (CaP) who are rec... more Few data exist in the literature regarding outcomes of men with prostate cancer (CaP) who are receiving immunosuppression from prior organ transplantation. The aim of this study was to evaluate biochemical disease-free survival, distant metastasis-free survival, overall survival, and toxicity in patients with organ transplants who were later treated with definitive radiotherapy for CaP. Our institutional CaP registry was reviewed to identify patients who had undergone an organ transplantation before CaP diagnosis. Between 1999 and 2013, a total of 28 organ transplant recipients treated with definitive radiotherapy for CaP were identified. Treatment consisted of either I-125 low-dose-rate brachytherapy or external-beam radiotherapy. All patients were receiving immunosuppressive medications. The median age was 66 years. Median follow-up time was 30 months. Twenty-four patients (86%) were treated with brachytherapy, and 4 patients (14%) were treated with external-beam radiotherapy. Nine patients (32%) had low-risk CaP, 14 (50%) had intermediate-risk CaP, and 5 (18%) had high-risk CaP. At the time of last follow-up, 2 patients had died, 1 from metastatic CaP and 1 from other causes. The 3-year biochemical disease-free survival was 95.8%. The 3-year distant metastasis-free survival was 93.1%. The 3-year overall survival was 93.8%. One patient developed grade 3 late gastrointestinal toxicity. This represents one of the largest reported series of outcomes in patients with organ transplantation and CaP. Organ transplant recipients treated with prostate radiotherapy have excellent 3-year outcomes.
Molecular therapy. Nucleic acids, Jan 7, 2018
Gastric cancer is one of the most prevalent tumor types in the world. Chemotherapy is the most co... more Gastric cancer is one of the most prevalent tumor types in the world. Chemotherapy is the most common choice for cancer treatment. However, chemotherapy resistance and adverse side effects limit its clinical applications. Aberrant expression of long noncoding RNAs (lncRNAs) has been found in various stages of gastric cancer development and progression. In this study, we identified that an oncogenic lncRNA, long intergenic non-protein-coding RNA D63785 (lncR-D63785), is highly expressed in gastric cancer tissues and cells. Silencing of lncR-D63785 inhibited cell proliferation, cell migration and invasion in gastric cancer cell lines and reduced tumor volume and size in mice. We found that the expression of lncR-D63785 was inversely correlated with microRNA 422a (miR-422a) expression, which was involved in the downregulation of expression of myocyte enhancer factor-2D (MEF2D) and drug sensitivity. Knockdown of lncR-D63785 increased the expression of miR-422a and the sensitivity of gas...
Cureus, Jan 14, 2018
Waardenburg syndrome (WS) is a rare genetic disorder. It is caused by multiple mutations affectin... more Waardenburg syndrome (WS) is a rare genetic disorder. It is caused by multiple mutations affecting the melanocytes, leading to a multitude of skin, hair, and eye symptoms. It is an autosomal dominant disease with four subtypes, each presenting with varying degrees of sensorineural hearing loss along with a constellation of other symptoms. Hirschsprung disease is unique to Waardenburg-Shah syndrome subtype 4 and is not associated with any other subtype. We present a case of this subtype 4 that presented with a bilateral sensorineural hearing loss, mutism, delayed milestones, white forelock, Hirschsprung disease, and bilateral blue homochromatic irises, a finding which is not typical for this subtype. This is the first case of WS with homochromatic irises and the fourth case to be reported from Pakistan.
Cureus, Jan 16, 2018
The prolonged use of levodopa for treating Parkinson's disease is associated with motor and n... more The prolonged use of levodopa for treating Parkinson's disease is associated with motor and nonmotor complications. These include wearing-off, delayed-on, partial-on, no-on, and on-off phenomena. In the wearing-off effect, symptoms return before a patient's next scheduled dose of levodopa. Patients may present with motor, sensory, or autonomic fluctuations. In this report, we present a female patient experiencing numbness of lips and slurred speech as a symptom of wearing-off effect. The major differential for sudden numbness of lips and slurred speech includes transient ischemic attacks. Therefore, it is imperative to identify the cause of these episodes so that appropriate treatment can be initiated. Our patient underwent extensive cardiac and neurological investigations, the findings of which were unremarkable. Her symptoms were likely due to levodopa wearing-off. Her condition improved on changing her levodopa to a sustained release form with more frequent dosing along w...
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Jan 5, 2018
Investigators are using checkpoint inhibitors (CPI) to treat aggressive hematologic malignancies ... more Investigators are using checkpoint inhibitors (CPI) to treat aggressive hematologic malignancies before patients undergo allogeneic hematopoietic stem cell transplantation (allo-HSCT) and in some patients with relapsed disease after allo-HSCT. CTLA-4 inhibitors and PD-1 inhibitors are two main types of CPI, which work through activation of the immune system. On one hand CPI can achieve graft versus tumor (GVT) effect, and on the other hand there is risk of graft versus host disease (GVHD). After a comprehensive literature review we included data (n=283) from twenty-four studies (11 original manuscripts, 13 case reports or case series) and evaluated the results to assess the safety and efficacy of CPI use in conjunction with allo-HSCT. One hundred seven patients received CPI before allo-HSCT and one hundred seventy-six patients received CPI after allo-HSCT. The most common indication for CPI use was for Hodgkin lymphoma. The CPIs used in various studies included ipilimumab, nivolumab...
Current treatment options in oncology, 2018
R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximat... more R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximately 60% of patients for more than 2 decades. However, the optimal treatment of patients who are too frail to tolerate this regimen and/or are not candidates for anthracycline therapy continues to be debated. MInT and GELA trials established addition of rituximab to CHOP in DLBCL but excluded patients older than 80 years. Multiple regimens have been tried with varying success in the very elderly, including R-mini-CHOP, R-mini CEOP, R-split CHOP, pre-phase strategies, and R-GCVP. However, there has not been a randomized trial among these strategies. Although addition of novel agents including ibrutinib, brentuximab vedotin, lenalidomide, and many others on the horizon holds promise in this population, none have been tested in a randomized setting or have results awaited. There is also a lack of a validated and easy to use clinical tool in this population to predict patients who will not to...
The Journal of arthroplasty, Jan 17, 2018
The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an e... more The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an effort to advance orthopedic outcome measurements on a national scale. This study was designed to evaluate if the OME data capture system would increase the quality of data collected in the context of primary and revision total hip arthroplasty (THA) compared to conventional operative notes. This study includes data from the first 100 primary THAs and 100 revision THAs performed by 15 surgeons at a single institution from January through April 2016. Surgeons prospectively entered procedural details into OME following surgery. The OME database and operative notes were compared to evaluate completion rates and agreement. Completion rates were compared using McNemar's test (with continuity correction), while agreement was analyzed using Cohen's kappa (κ) and concordance correlation coefficient. The OME database had significantly higher completion rates for 41% (39/96) of the variable...
Acta medica academica, 2018
Continuous assessment tests influence the learning needs of medical students at particular times ... more Continuous assessment tests influence the learning needs of medical students at particular times but are also beneficial in scheduled learning, and act as motivating tool. These tests drive them to study by developing competition and optimism regarding the forthcoming result. This study has been designed to evaluate the role of these tests for medical students by learning about their motivation. This study was conducted on 150 medical students. The students selected a continuous testing system or a classical system. Those who selected the continuous system had six assessment tests each, after completion of a curriculum block, usually 45 days apart. The motivation of the students in both the groups was assessed by asking them for their expected results just before the final examination. Statistical analysis was performed using Superior Performance Statistical Software (SPSS) version 20. The students' final results showed that almost half of the students who adopted the continuous...
Atherosclerosis, 2018
Coronary heart disease (CHD) is one of the leading disorders with the highest mortality rate. Per... more Coronary heart disease (CHD) is one of the leading disorders with the highest mortality rate. Percutaneous angioplasty and stent implantation are the currently available standard methods for the treatment of obstructive coronary artery disease. However, the stent being an exogenous substance causes several complications by promoting the proliferation of vascular smooth muscle cells, immune responses and neointima formation after implantation, leading to post-stent restenosis (ISR) and late thrombosis. The prevention of these adverse vascular events is important to achieve long-term proper functioning of the heart after stent implantation. Non-coding ribonucleic acids (ncRNAs) are RNA molecules not translated into proteins, theyhave a great potential in regulating endothelial cell and vascular smooth muscle function as well as inflammatory reactions. In this review, we outline the regulatory functions of different classes of ncRNA in cardiovascular disease and propose ncRNAs as new t...
Oncotarget, Jan 10, 2018
Gastric cancer is one of the most common cancers and is the second leading cause of cancer mortal... more Gastric cancer is one of the most common cancers and is the second leading cause of cancer mortality worldwide. Therefore, it is urgent to explore new molecular biomarkers for early diagnosis, early treatment and prognosis for gastric cancer patients. Recently, increasing evidence has shown that epigenetic changes, such as aberrant DNA methylation, histone modifications, and noncoding RNAs (ncRNAs) expression, play substantial roles in the development and progression of malignancies. Among these changes, long non-coding RNAs (lncRNAs), a novel class of ncRNAs, are emerging as highly versatile actors in a variety of cellular processes by regulating gene expression at the epigenetic level as well as at the transcriptional and post-transcriptional levels. Hundreds of lncRNAs become dysregulated in the various pathological processes of gastric cancer, and multiple lncRNAs have been reported to function as tumor-suppressors or oncogenes, although the underlying mechanisms are still under...
World neurosurgery, Jan 3, 2018
Routine preoperative blood testing has become a dogma. The general practice is to order preoperat... more Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy. The hospital registry was used to identify files for review. Data was collected on a predefined proforma. A nationwide survey was performed and 30 neurosurgery centers were contacted across Pakistan to confirm the practice of preoperative workup. The survey revealed that all centers had a similar practice of preoperative workup. This included CBC, serum electrolytes and coagulation profile; including PT, aPTT and INR. A total of 1800 files we...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2018
To determine the effect of lower limb ergometric training on echocardiographic parameters of left... more To determine the effect of lower limb ergometric training on echocardiographic parameters of left ventricle in dilated cardiomyopathy (DMC) patients. Randomized control trial. Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan, from September 2016 to February 2017. Clinically stable patients with DCM (n=60), were randomly allocated into an interventional group with two-month interventional program and a non-trained control group (n=30 each). Treatment protocol for interventional group was lower limb ergometer exercise for 8 weeks, 4 days/week. Pre and post-treatment echocardiography was done in both groups at baseline and after 8 weeks. SPSS 21 was used for data analysis. The median (IQR) age of the patients was 51 (18) years in interventional group and 62 (11) years in control group. Male to female ratio was 18:9 in control group and 17:12 in Interventional group. Statistically significant results were detected within the groups regarding ejection fraction (EF), left ventricu...
Journal of cellular and molecular medicine, 2018
Necrosis is an ancient topic which gains new attraction in the research area these years. There i... more Necrosis is an ancient topic which gains new attraction in the research area these years. There is no doubt that some necrosis can be regulated by genetic manipulation other than an accidental cell death resulting from physical or chemical stimuli. Recent advances in the molecular mechanism underlying the programmed necrosis show a fine regulation network which indicates new therapy targets in human diseases. Heart diseases seriously endanger our health and have high fatality rates in the patients. Cell death of cardiac myocytes is believed to be critical in the pathogenesis of heart diseases. Although necrosis is likely to play a more important role in cardiac cell death than apoptosis, apoptosis has been paid much attention in the past 30 years because it used to be considered as the only form of programmed cell death. However, recent findings of programmed necrosis and the related signalling pathways have broadened our horizon in the field of programmed cell death and promote new...
Journal of neuro-oncology, Jan 3, 2018
Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients... more Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients with spine metastases. We created a prognostic index using recursive partitioning analysis (RPA) to allow better patient selection for spine SRS. Patients who underwent single-fraction spine SRS for spine metastases were included. Primary histologies were divided into favorable (breast/prostate), radioresistant (renal cell/sarcoma/melanoma) and other. Cox proportional hazards regression was done to identify factors associated with overall survival (OS). RPA was performed to identify factors to classify patients into distinct risk groups with respect to OS. A total of 444 patients were eligible. Median dose was 16 Gy (range 8-18) in 1 fraction and median follow-up was 11.7 months. At time of analysis, 103 (23.1%) patients were alive. Median OS was 12.9 months. RPA identified three distinct classes. Class 1 was defined as KPS > 70 with controlled systemic disease (n = 142); class 3 was...
The FEBS journal, Jan 7, 2017
Circular RNAs (circRNAs) are a newly discovered type of RNAs generated by back-splicing of precur... more Circular RNAs (circRNAs) are a newly discovered type of RNAs generated by back-splicing of precursor mRNA (pre-mRNA) and found in many species. They are, expressed in a tissue-specific manner and fulfill regulatory activities in many biological processes. Recent research revealed that circRNAs play critical roles in the development and pathologies of the cardiovascular system. Some of these circRNAs showed aberrant expression and regulatory activities during heart disease including heart failure and cardiac infarction and hypertrophy. These findings suggest that circRNAs might be a suitable target for the treatment and prevention of heart disease. In this review, we summarize the latest research on the biogenesis and functions of circRNAs with emphasis on the regulatory roles of circRNAs in the development and pathologies of the cardiovascular system. This article is protected by copyright. All rights reserved.
Frontiers in pharmacology, 2017