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Thoracic impalement injury: A survivor with large metallic object in-situ

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Chinese Journal of Traumatology 2018年第6期21卷 369-372页

作者： randhawa muhammad afzal muhammad Armughan muhammad Waqas Javed Usman Ali Rizvi Sajida Naseem Department of Surgery. Bahawal Victoria Hospital Q_uaid-E-Azam Medical College Bahawalpur Pakistan

Impalement injuries, is a severe form of trauma, which are not common in civilian life. These injuries rarely occurs in major accidents. Abdomen, chest, limbs and perineum are often involved due to their large surface area. Thoracic impalement injury is usually a fatal injury, due to location of major vessels and heart in the thoracic cavity. These injuries are horrifying to site, but the patients who are lucky enough to make it to hospital, usually survive. Chances of survival are larger in right sided impalement injuries while central injuries are always died at the *** patient, 25 years old male, was brought to the emergency room (ER) with large impaled metallic bar (about 2.5 feet long) in situ, in right sided chest. The patient was immediately shifted to operation room (OR) and was operated, his recovery was uneventful without any *** patients should be treated and resuscitated according to advanced trauma life support (ATLS) protocols and operated without any delay for further investigations. Such operations are carried out by the most experienced surgeon team available. The impaled objects should not be processed if not necessary to avoid major hemorrhage and damage to vital structures, until the patient is in operation room. Large size and unusual position of impaled objects, makes the job difficult for surgeons/*** horrifying at scene, patients with thoracic impalement injuries are mostly young and healthy, and those who survive the pre-hospital phase are potentially manageable with proper resuscitation. Usually these patients make recovery without any further complications.

关键词： Impalement Injury Thoracic Metallic object Traffic accident Sequela

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Predicting short-term thromboembolic risk following Roux-en-Y gastric bypass using supervised machine learning

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1097-1108页

作者： Hassam Ali Faisal Inayat Vishali Moond Ahtshamullah Chaudhry Arslan afzal Zauraiz Anjum Hamza Tahir muhammad Sajeel Anwar Dushyant Singh Dahiya muhammad Sohaib afzal Gul Nawaz Amir H Sohail muhammad Aziz Department of Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Saint Peter's University Hospital and Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine UHS Wilson Medical CenterJohnsonNY 13790United States Division of Gastroenterology Hepatology and MotilityThe University of Kansas School of MedicineKansasKS 66160United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Roux-en-Y gastric bypass(RYGB)is a widely recognized bariatric procedure that is particularly beneficial for patients with class III *** aids in significant weight loss and improves obesity-related medical *** its effectiveness,postoperative care still has *** evidence shows that venous thromboembolism(VTE)is a leading cause of 30-d morbidity and mortality after ***,a clear unmet need exists for a tailored risk assessment tool for VTE in RYGB *** To develop and internally validate a scoring system determining the individualized risk of 30-d VTE in patients undergoing *** Using the 2016–2021 Metabolic and Bariatric Surgery Accreditation Quality Improvement Program,data from 6526 patients(body mass index≥40 kg/m^(2))who underwent RYGB were analyzed.A backward elimination multivariate analysis identified predictors of VTE characterized by pulmonary embolism and/or deep venous thrombosis within 30 d of *** resultant risk scores were derived from the coefficients of statistically significant *** performance of the model was evaluated using receiver operating curves through 5-fold *** Of the 26 initial variables,six predictors were *** included a history of chronic obstructive pulmonary disease with a regression coefficient(Coef)of 2.54(P7%(Coef 1.19,P<0.001),venous stasis history(Coef 1.43,P<0.001),and preoperative anticoagulation use(Coef 1.24,P<0.001).These variables were weighted according to their regression coefficients in an algorithm that was generated for the model predicting 30-d VTE risk *** risk model's area under the curve(AUC)was 0.79[95%confidence interval(CI):0.63-0.81],showing good discriminatory power,achieving a sensitivity of 0.60 and a specificity of *** training,the same model performed satisfactorily

关键词： Roux-en-Y gastric bypass Venous thromboembolism Machine learning Bariatric surgery Predictive modeling

Unraveling the complex landscape of endocrine resistance in breast cancer: Emerging role of long noncoding RNA AGPG and beyond

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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 19页

作者： Khawar muhammad Babar Yu Shiyi afzal Ali Sun Haibo Institute of Translational Medicine Medical College Yangzhou University Yangzhou Jiangsu China Jiangsu Key Laboratory of Experimental & Translational Non-Coding RNA Research Yangzhou University Yangzhou Jiangsu China Applied Molecular Biology and Biomedicine Lab Department of Zoology University of Narowal Narowal Pakistan Molecular Medicine and Cancer Therapeutics Lab Department of Zoology Faculty of Sciences Technology University of Central Punjab Lahore Pakistan

Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

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World Journal of Transplantation 2024年第2期14卷 62-75页

作者： Faisal Inayat Pratik Patel Hassam Ali Arslan afzal Hamza Tahir Ahtshamullah Chaudhry Rizwan Ishtiaq Attiq Ur Rehman Kishan Darji muhammad Sohaib afzal Gul Nawaz Alexa Giammarino Sanjaya K Satapathy Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of Gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Division of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of Internal Medicine Saint Francis Hospital and Medical CenterHartfordCT 06105United States Division of Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine Campbell University and Cape Fear Valley Medical CenterFayettevilleNC 28301United States Department of Internal Medicine North Shore University Hospital and Zucker School of Medicine at Hofstra UniversityManhassetNY 11030United States Division of Hepatology North Shore University Hospital and Zucker School of Medicine at Hofstra UniversityManhassetNY 11030United States

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has posed a major public health concern *** with comorbid conditions are at risk of adverse outcomes following *** organ transplant recipients with concurrent immunosuppression and comorbidities are more susceptible to a severe COVID-19 *** could lead to higher rates of inpatient complications and mortality in this patient ***,studies on COVID-19 outcomes in liver transplant(LT)recipients have yielded inconsistent *** To evaluate the impact of the COVID-19 pandemic on hospital-related outcomes among LT recipients in the United *** We conducted a retrospective cohort study using the 2019–2020 National Inpatient Sample *** with primary LT hospitalizations and a secondary COVID-19 diagnosis were identified using the International Classi-fication of Diseases,Tenth Revision coding *** primary outcomes included trends in LT hospitalizations before and during the COVID-19 *** outcomes included comparative trends in inpatient mortality and transplant rejection in LT *** A total of 15720 hospitalized LT recipients were *** 0.8% of patients had a secondary diagnosis of COVID-19 *** both cohorts,the median admission age was 57 *** linear trends for LT hospitalizations did not differ significantly before and during the pandemic(P=0.84).The frequency of in-hospital mortality for LT recipients increased from 1.7% to 4.4% between January 2019 and December *** to the pre-pandemic period,a higher association was noted between LT recipients and in-hospital mortality during the pandemic,with an odds ratio(OR)of 1.69[95% confidence interval(CI):1.55-1.84),P<0.001].The frequency of transplant rejections among hospitalized LT recipients increased from 0.2%to 3.6% between January 2019 and December *** hospitalizations during the COVID-19 pandemic had a higher associ

关键词： Liver transplant recipients Solid organ transplantation COVID-19 Hospitalization Transplant rejection Mortality

Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis:A propensity-matched analysis

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World Journal of Experimental Medicine 2024年第2期14卷 75-88页

作者： Hassam Ali Faisal Inayat Waqas Rasheed Arslan afzal Ahtshamullah Chaudhry Pratik Patel Attiq Ur Rehman muhammad Sajeel Anwar Gul Nawaz muhammad Sohaib afzal Amir H Sohail Subanandhini Subramanium Dushyant Singh Dahiya Deepa Budh Babu P Mohan Douglas G Adler Department of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Texas Tech University Health Sciences CenterLubbockTX 79430United States Department of Internal Medicine St.Dominic’s HospitalJacksonMS 39216United States Department of Gastroenterology Mather Hospital and Hofstra University Zucker School of MedicinePort JeffersonNY 11777United States Department of Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine UHS Wilson Medical CenterJohnson CityNY 13790United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Division of Gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 64108United States Department of Internal Medicine St.Barnabas Hospital and Albert Einstein College of MedicineBronxNY 10457United States Department of Gastroenterology and Hepatology University of Utah School of MedicineSalt Lake CityUT 84132United States Center for Advanced Therapeutic Endoscopy Porter Adventist HospitalCentura HealthDenverCO 80210United States

BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare *** peripancreatic fluid collection(APFC)may negatively impact the clinical course of *** could worsen symptoms and potentially lead to additional ***,clinical evidence regarding the specific association between APFC and early readmission in AP remains *** the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare *** To evaluate the association between APFC and 30-day readmission in patients with *** This retrospective cohort study is based on the Nationwide Readmission Database for *** with a primary diagnosis of AP were *** were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was *** primary outcome was early readmission *** outcomes included the incidence of inpatient complications and healthcare *** analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission *** A total of 673059 patients with the principal diagnosis of AP were *** these,5.1%had APFC on initial *** propensity score matching,each cohort consisted of 33914 *** with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APF

关键词： Acute pancreatitis Acute peripancreatic fluid collections Readmission predictors Inpatient complications Healthcare utilization and costs

The Influence of Depression on Different Age and Gender Groups in Bahawalpur

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Journal of Clinical and Nursing Research 2024年第7期8卷 196-207页

作者： Mehran Khan muhammad Shahbaz Tooba Waris Shoaib Yaseen Iqra afzal Emaan Khadim Sawera Usman muhammad Ismail Shah Sulaiman Aslam Zafar Iqbal Bahawalpur College of Pharmacy BMDC Complex63100PunjabPakistan

In Bahawalpur,a cross-sectional study assessed depression prevalence across age and gender groups,involving 442 participants from diverse socioeconomic backgrounds and *** the PHQ9 questionnaire,84%were found to meet depression *** findings revealed a higher incidence in females(88%)than males(79%),with the greatest disparity among young adults,particularly young women,due to factors like academic pressure and financial *** children had the lowest depression rates(68%),possibly due to better *** individuals exhibited more severe depression,likely related to aging and domestic *** study’s findings highlight a significant variation in depression severity across different demographic groups,with an overall higher incidence in *** research underscores the necessity for targeted mental health resources and interventions tailored to the specific needs of each demographic *** also points to the importance of addressing academic and socioeconomic stressors to mitigate depression,particularly among young *** the study provides valuable insights,it relies on self-reported data,which may introduce ***,future research should include clinical assessments to validate these findings and ensure a more accurate representation of depression within the community.

关键词： Influence Depression Different age Gender groups Bahawalpur

Early versus delayed necrosectomy in pancreatic necrosis:A population-based cohort study on readmission,healthcare utilization,and in-hospital mortality

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World Journal of Methodology 2024年第3期14卷 55-67页

作者： Hassam Ali Faisal Inayat Vinay Jahagirdar Fouad Jaber Arslan afzal Pratik Patel Hamza Tahir muhammad Sajeel Anwar Attiq Ur Rehman muhammad Sarfraz Ahtshamullah Chaudhry Gul Nawaz Dushyant Singh Dahiya Amir H Sohail muhammad Aziz Division of Gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Division of Gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine UHS Wilson Medical CenterJohnson CityNY 13790United States Division of Gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Division of Gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Division of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Acute necrotizing pancreatitis is a severe and life-threatening *** poses a considerable challenge for clinicians due to its complex nature and the high risk of *** minimally invasive and open necrosectomy procedures have been *** advancements in treatment modalities,the optimal timing to perform necrosectomy lacks *** To evaluate the impact of necrosectomy timing on patients with pancreatic necrosis in the United *** A national retrospective cohort study was conducted using the 2016-2019 Nationwide Readmissions *** with non-elective admissions for pancreatic necrosis were *** participants were divided into two groups based on the necrosectomy timing:The early group received intervention within 48 hours,whereas the delayed group underwent the procedure after 48 *** various intervention techniques included endoscopic,percutaneous,or surgical *** major outcomes of interest were 30-day readmission rates,healthcare utilization,and inpatient *** A total of 1309 patients with pancreatic necrosis were *** propensity score matching,349 cases treated with early necrosectomy were matched to 375 controls who received delayed *** early cohort had a 30-day readmission rate of 8.6% compared to 4.8%in the delayed cohort(P=0.040).Early necrosectomy had lower rates of mechanical ventilation(2.9%vs 10.9%,P<0.001),septic shock(8%vs 19.5%,P<0.001),and in-hospital mortality(1.1%vs 4.3%,P=0.01).Patients in the early intervention group incurred lower healthcare costs,with median total charges of $52202 compared to$147418 in the delayed *** in the early cohort also had a relatively shorter median length of stay(6 vs 16 days,P<0.001).The timing of necrosectomy did not significantly influence the risk of 30-day readmission,with a hazard ratio of 0.56(95%confidence interval:0.31-1.02,P=0.06).CONCLUSION Our findings show that

关键词： Acute necrotizing pancreatitis Pancreatic necrosis Early necrosectomy Delayed necrosectomy Readmission,Healthcare costs Mortality

Multifaceted roles of extracellular RNAs in different diseases

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Military Medical Research 2023年第3期10卷 359-368页

作者： Abdullah muhammad Sohail muhammad Babar Khawar Ali afzal Ali Hassan Sara Shahzaman Ahmed Ali Molecular Medicine and Cancer Therapeutics Lab Department of ZoologyFaculty of SciencesUniversity of Central PunjabLahorePakistan Applied Molecular Biology and Biomedicine Lab Department of ZoologyUniversity of NarowalNarowalPakistan

Extracellular RNAs(exRNAs) are novel circulating factors that can be used as biomarkers in various diseases. Their unique and diverse kinds, as well as their role as biomarkers, make them significant biomarkers. There has been immense work carried out since the discovery of exRNAs in circulation and other biological fluids to catalog and determine whether exRNAs may be utilized as indicators for health and illness. In this review, we aim to understand the current state of exRNAs in relation to various diseases and their potential as biomarkers. We will also review current issues and challenges faced in using exRNAs, with clinical and lab trials, that can be used as viable markers for different diseases.

关键词： Extracellular RNAs(exRNAs) Extracellular vehicles(EVs) Cancer Biomarkers Exosomes

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Effects of hooked-collar on the local scour around a lenticular bridge pier

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International Journal of Sediment Research 2023年第1期38卷 1-11页

作者： Rashid Farooq Amir Hossein Azimi muhammad Atiq Ur Rehman Tariq afzal Ahmed Department of Civil Engineering International Islamic University Department of Civil Engineering Lakehead University College of Engineering and Science Victoria University Department of Civil Engineering University of Engineering and Technology James Watt School of Engineering University of Glasgow

This paper presents the results of comprehensive laboratory experiments to investigate the effects of hooked-collar on the scour development around a vertical pier with a lenticular cross section. The flow around the pier was uniform, steady, and under the clear-water condition. The axial scour profiles for cases without and with a lenticular hooked-collar were measured and the effects of hooked-collar dimensions and elevation from the bed were examined. To compute the efficiency of hooked-collar for scour prevention, the results of local scour for a bridge pier without a collar and a bridge pier with a plain collar, without a hooked wall, were used as benchmark data sets. A wide range of hooked-collar geometries such as the ratio of collar width to the pier width, Wc/Wp, ranging from 1.5 to 3.5, the ratio of hooked-collar wall height to the pier width, Hc/Wp, ranging from 0.15 to 0.6, and the ratio of collar elevation to the pier width, Ec/Wp, of-0.5, 0, and 0.5 were tested. The experimental results indicated that the equilibrium scour depth decreased with the ratio of hooked-collar to the pier width when Wcis twice the pier width, Wp. For Wc/Wp> 2, the scour depth was similar to the tests with an infinitely large pier width. In addition, the scour depth consistently reduced as the hooked-collar wall height, Hc, to the pier width, Wp, approached 0.3. The highest scour reduction efficiency was achieved when the hooked-collar being placed on the bed surface. Empirical models were developed for prediction of maximum scour depth near the lenticular bridge pier with a modified collar. The results showed that the volume of scour hole around a lenticular pier increased non-linearly with the maximum scour depth and it was independent of the hooked-collar geometry.

关键词： Local scour Erosion Collar Hooked-collar Lenticular pier Scour countermeasure Steady flow