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Diabetes among Muslims during Ramadan:A narrative review

世界临床病例杂志 2023年第26期11卷 6031-6039页

作者： rohan Kumar Ochani Asim Shaikh Simran Batra Gauri Pikale Salim Surani Internal Medicine SUNY Upstate Medical University HospitalSyracuseNY 13210United States Medicine Aga Khan UniversitySindhKarachi 74500Pakistan Internal Medicine Dow University of Health SciencesSindhKarachi 74200Pakistan Internal Medicine Chicago Medical School at Rosalind Franklin UniversityChicagoIL 60064United States Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States Medicine Aga Khan UniversityNairobi 00100Kenya

Fasting during the month of Ramadan is one of the five fundamental principles of Islam,and it is obligatory for healthy Muslim adults and *** the fasting month,Muslims usually have two meals a day,suhur(before dawn)and iftar(after dusk).However,diabetic patients may face difficulties when fasting,so it is important for medical staff to educate them on safe fasting *** strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis,but with proper knowledge,careful planning,and medication adjustment,diabetic Muslim patients can fast during *** this review,a literature search was conducted using PubMed and Google Scholar until May *** other than the English language were *** strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition,regular monitoring of blood glucose,medications,and insulin *** therapy can be continued during fasting if properly titrated to the patients’needs,and finger prick blood sugar levels should be assessed *** certain symptoms such as hypoglycemia,hyperglycemia,dehydration,or acute illness occur,or blood glucose levels become too high(>300 mg/dL)or too low(<70 mg/dL),the fast should be *** insulin formulations such as pegylated insulin and medications like tirzepatide,a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors,have shown promise in managing blood sugar levels during ***-insulin dependent medications like sodium-glucose-cotransporter-2 inhibitors,including the Food and Drug Administration-approved ertugliflozin,are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.

关键词： Ramadan Fasting Diabetes Complications Insulin therapy Newer advances Hypoglyccemia

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THE STUDY ON RISK FACTORS ASSOCIATED WITH BREAST CANCER AMONG WOMEN IN TIANJIN, CHINA AND ADELAIDE, AUSTRALIA

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Chinese Journal of Cancer Research 1989年第4期1卷 58-62页

作者：张安玉 Thomas E rohan 武光林 Department of Epidemiology Tianjin Medical College Department of Environmental and Preventive Medicine The Medical College of St. Bartholomew's Hospital University of London Department of Epidemiology Tianjin Medical Collegeo explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women the authors have compared and analysed the results of two case-control studies completed recently in Tianjin China and Adelaide Australia. Of 10 known risk factors for breast cancer 9 were significantly higher in level in Adelaide women than in Tianjin women i.e. women in Adelaide were much taller heavier more obese earlier at menarche later at first full-term pregnancy more nulliparous less parity more in history of breast cancer in first degree relatives more educated. From the 7 risk factors analysed by use of logistic regression model 5 factors i.e. earlier age at menarche later age at first full-term pregnancy less parity history of benign disease and history of breast cancer in first degree relatives were associated significantly with the increased risk for breast cancer in the Tianjin study but not in Adelaide study. These factors being not associated with breast cancer in Adelaide women were unexpected. The explanation of the indefinite findings in Adelaide study was due to the fact that the level of the risk factor is universally high relatively uniform and lack of categories. The difference in the risk factor distribution between cases and controle would not be seen in case-control studies and significance of the risk factor therefore may not be found. According to data on diet survey in these two cities the calories from fat was significantly higher in Adelaide women than in Tianjin women. The marked difference in incidence in women in the two cities resulted from the summing-up effect of a number of factors. The important role of fat intake in geographical incidence difference and in the development of breast cancer was also

To explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women, the authors have compared and analysed the results of two case-control studies completed recently in Tianjin, China and Adelaide, Australia. Of 10 known risk factors for breast cancer 9 were significantly higher in level in Adelaide women than in Tianjin women, i.e., women in Adelaide were much taller, heavier, more obese, earlier at menarche, later at first full-term pregnancy, more nulliparous, less parity, more in history of breast cancer in first degree relatives, more educated. From the 7 risk factors analysed by use of logistic regression model 5 factors, i.e., earlier age at menarche, later age at first full-term pregnancy, less parity, history of benign disease, and history of breast cancer in first degree relatives, were associated significantly with the increased risk for breast cancer in the Tianjin study, but not in Adelaide study. These factors being not associated with breast cancer in Adelaide women were unexpected. The explanation of the indefinite findings in Adelaide study was due to the fact that the level of the risk factor is universally high, relatively uniform and lack of categories. The difference in the risk factor distribution between cases and controle would not be seen in case-control studies, and significance of the risk factor therefore may not be found. According to data on diet survey in these two cities, the calories from fat was significantly higher in Adelaide women than in Tianjin women. The marked difference in incidence in women in the two cities resulted from the summing-up effect of a number of factors. The important role of fat intake in geographical incidence difference and in the development of breast cancer was also discussed.

关键词： THE STUDY ON RISK FACTORS ASSOCIATED WITH BREAST CANCER AMONG WOMEN IN TIANJIN AUSTRALIA CHINA AND ADELAIDE

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Outcomes of liver transplantation in patients with hepatorenal syndrome

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World Journal of Hepatology 2016年第24期8卷 999-1011页

作者： rohan M Modi Nishi Patel Sherif N Metwally Khalid Mumtaz Department of Internal Medicine the Ohio State University Wexner Medical Center Department of Internal Medicine Division of Gastroenterology Hepatology and Nutrition the Ohio State University Medical Center

Hepatorenal syndrome(HRS) plays an important role in patients with liver cirrhosis on the wait list for liver transplantation(LT). The 1 and 5-year probability of developing HRS in cirrhotic with ascites is 20% and 40%, respectively. In this article, we reviewed current concepts in HRS pathophysiology, guidelines for HRS diagnosis, effective treatment options presently available, and controversies surrounding liver alone vs simultaneous liver kidney transplant(SLKT) in transplant candidates. Many treatment options including albumin, vasoconstrictors, renal replacement therapy, and eventual LT have remained a mainstay in the treatment of HRS. Unfortunately, even after aggressive measures such as terlipressin use, the rate of recovery is less than 50% of patients. Moreover, current SLKT guidelines include:(1) estimation of glomerular filtration rate of 30 m L/min or less for 4-8 wk;(2) proteinuria > 2 g/d; or(3) biopsy proven interstitial fibrosis or glomerulosclerosis. Even with these updated criteria there is a lack of consistency regarding longterm benefits for SLKT vs LT alone. Finally, in regards to kidney dysfunction in the post-transplant setting, an estimation of glomerular filtration rate < 60 mL /min per 1.73 m2 may be associated with an increased risk of patients having long-term end stage renal disease. HRS is common in patients with cirrhosis and those on liver transplant waitlist. Prompt identification and therapy initiation in transplant candidates with HRS may improve post-transplantation outcomes. Future studies identifying optimal vasoconstrictor regimens, alternative therapies, and factors predictive of response to therapy are needed. The appropriate use of SLKT in patients with HRS remains controversial and requires further evidence by the transplant community.

关键词： Liver transplantation Simultaneous liver kidney transplantation Vasopressors Dialysis Posttransplant outcomes Hepatorenal syndrome

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Evaluation of fundus autofluorescence patterns in age-related macular degeneration

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International Journal of Ophthalmology(English edition) 2016年第12期9卷 1779-1784页

作者： Pradeep Venkatesh Pradeep Sagar rohan Chawla Varun Gogia Rajpal Vohra Yog Raj Sharma Department of Ophthalmology Dr. Rajendra Prasad Centre for Ophthalmic SciencesAll India Institute of Medical Sciences

AIM： To study the various morphological patterns of fundus autofluorescence （FAF） images in patients with age-related macular degeneration （AMD） in Indian ***： Totally 179 eyes of 104 patients with clinical diagnosis of AMD were recruited into the study. Autofluorescence images were captured using confocal scanning laser ophthalmoscope and the patterns of FAF were ***： Of 179 eyes, 27 （15.08%） were early AMD, 58 （32.41%） were intermediate AMD, 94 eyes （52.51%） were late AMD. Of 94 eyes with late AMD, 79 （84.04%） were neovascular AMD and 15 （15.96%） were central geographic atrophy. In eyes with early and intermediate AMD, 9 patterns of FAF were noted. Six patterns （normal, minimal change, focal increased, patchy increased, linear, reticular） were similar to that in the published classification. Two patterns （lacelike and speckled） described in the published classification were not found. Three new patterns （focal hypo-fluorescence, patchy hypo-fluorescence, mixed focal hypo-fluorescence and hyper-fluorescence） were detected. In eyes with neovascular AMD, 6 morphological patterns of FAF were noted. Two patterns （mixed hypo-fluorescence and hyper-fluorescence, central hypo-fluorescence with hyper-fluorescent rim） were similar to that in published classification. Two patterns （normal, near normal or normal background fluorescence in the centre of hypo-fluorescent area） described in the published classification were not found. Four new patterns （minimal change, hypo-fluorescent patch, central hypo-fluorescence with surrounding reticular, bull’s eye） were recognized. In eye with central geographic atrophy 5 morphological patterns were noted and these were similar to that in published ***： Phenotypic differences in the pattern of FAF exist in the study population compared to existing classification systems.

关键词： age-related macular degeneration fundus autofluorescence lipofuscin choroidal neovascularization

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Trends and outcomes of transarterial chemoembolization in hepatocellular carcinoma:a national survey

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 624-630页

作者： Khalid Mumtaz Nishi Patel rohan M Modi Vihang Patel Alice Hinton James Hanje Sylvester M Black Somashaker Krishna Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical Center Columbus OHUSA Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus OHUSA Department of Surgery The Ohio State University Wexner Medical Center Columbus OHUSA Division of Biostatistics College of Public Health The Ohio State University Columbus OH USA

BACKGROUND:Transarterial chemoembolization(TACE) is a palliative procedure frequently used in patients with advanced hepatocellular carcinoma(HCC). We examined the national inpatient trends of TACE and related outcomes in the United States over the last ***:We utilized the National Inpatient Sample(2002 to 2012) and performed trend analyses of TACE for HCC in all adult patients(age >18 years). Multivariate analyses for the outcomes of in-hospital "procedure-related complications"(PRCs) and "post-procedure complications"(PPCs) were performed. We also compared early(2002 to 2006) and late(2007 to 2012) eras by multivariate analyses to identify predictors of complications, healthcare resource utilization and ***:Overall, 19058 patients underwent TACE for HCC where PRCs and PPCs were seen in 24.2% and 17.6% of patients, respectively. The overall trends in the use of TACE(P<0.001) and associated PRCs(P=0.006) were observed to be increasing. There was less mortality [adjusted Odds ratio(a OR):0.58; 95% CI:0.41, 0.82], reduced length of hospital stay(-1.87 days; 95% CI:-2.77,-0.97) and increased hospital charges($19232; 95% CI:11013, 27451) in the late era. Additionally, there was increased mortality(a OR:4.07; 95% CI:2.96, 5.59), PRCs(a OR:3.21; 95% CI:2.56, 4.02), and PPCs(a OR:2.70; 95% CI:2.11, 3.46) among patients with ***:There is an increasing trend of TACE utilization in HCC. However, the outcomes are worse in patients with coagulopathy. Although PRCs have increased, mortality has decreased in recent years. These findings should be considered during TACE evaluation in patients with HCC.

关键词： transarterial chemoembolization hepatocellular carcinoma procedural complications mortality

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Anion order in oxysulfide perovskites:origins and implications

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npj Computational Materials 2020年第1期6卷 1062-1072页

作者： Ghanshyam Pilania Ayana Ghosh Steven T.Hartman rohan Mishra Christopher R.Stanek Blas P.Uberuaga Materials Science and Technology Division Los Alamos National LaboratoryLos AlamosNM 87545USA Materials Science&Engineering University of ConnecticutStorrsCT 06269USA Institute of Materials Science&Engineering and Department of Mechanical Engineering&Materials Science Washington University in St.LouisSt.LouisMO 63130USA

Heteroanionic oxysulfide perovskite compounds represent an emerging class of new materials allowing for a wide range of tunability in the electronic structure that could lead to a diverse spectrum of novel and improved *** cation ordered double perovskites—where the origins and design rules of various experimentally observed cation orderings are well known and understood—anion ordering in heteroanionic perovskites remains a largely uncharted territory.

关键词： perovskite anionic ordered

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Single-use flexible ureteroscopes: Comparative in vitro analysis of four scopes

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Asian Journal of Urology 2023年第1期10卷 64-69页

作者： Abhijit Patil Shashank Agrawal rohan Batra Abhishek Singh Arvind Ganpule Ravindra Sabnis Mahesh Desai Department of Urology Muljibhai Patel Urological HospitalNadiadIndia

Objective:Single-use flexible ureteroscopes(fURSs)have recently been introduced by different *** of this in-vitro study was to compare four ***:We performed in vitro analysis of Uscope 7.5 Fr and Uscope 9.5 Fr(Pusen Ltd.,Zhuhai,China),LithoVue 9.5 Fr(LithoVue,Boston Scientific,MA,USA),and Indoscope 9.5 Fr(Bioradmedisys,Pune,India).Optical characteristics(image resolution,color representation,and luminosity)were compared at various distances of 10 mm,20 mm,and 50 *** and irrigation were evaluated with and without ***:Color perception was comparable for all scopes at 10 mm(p<0.05),while Lithovue 9.5 Fr was comparable with Indoscope 9.5 Fr at the distances of 20 mm and 50 *** scopes were statistically better than both Uscopes at the distances of 20 mm and 50 *** resolution powers were comparable amongst all fURSs at the distances of 10 mm and 20 mm(3.56 line pairs per millimeter[lp/mm]).However,Indoscope(3.56 lp/mm)was superior to LithoVue and Uscope scopes(3.17 lp/mm)at the distance of 50 *** at the distance of 10 mm was comparable for LithoVue and Uscope 9.5 ***,at the distances of 20 mm and 50 mm,LithoVue had the highest luminosity while Uscope 7.5 Fr had the lowest *** had lower luminosity than other 9.5 Fr scopes at all *** empty working channel and 200 mm laser fiber,Indoscope had the maximum deflection(285).With basket,Uscope 7.5 Fr had the maximum loss of deflection(30)while Indoscope had no deflection *** empty working channel,all scopes had comparable irrigation flow rates in both deflected and undeflected ***,with 200 mm laser or basket,irrigation flow rates were comparable in all ***:Color representation was equivalent for Indoscope and LithoVue,while being better than Uscope 7.5 Fr and Uscope 9.5 *** resolution was comparable in all scopes at the distances of 10 mm and 20 *** the distance of 10 mm,luminosity of LithoV

关键词： Single-use Disposable Flexible ureteroscopes In vitro Pusen LithoVue Indoscope

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Role of CFTR mutation analysis in the diagnostic algorithm for cystic fibrosis

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World Journal of Pediatrics 2017年第2期13卷 129-135页

作者： Michelle Ratkiewicz Matthew Pastore Karen Sharrock McCoy rohan Thompson Don Hayes Jr. Shahid Ijaz Sheikh Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Section of Pulmonary Medicine Nationwide Children's HospitalColumbusOhioUSA Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Section of Human and Molecular Genetics Nationwide Children's HospitalColumbusOhioUSA Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Internal Medicine the Ohio State University College of Medicine ColumbusOhioUSA Section of Pulmonary Medicine Nationwide Children's HospitalColumbusOhioUSA

Background:The cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation identification is being used with increased frequency to aid in the diagnosis of cystic fibrosis (CF) in those suspected with *** of this study was to identify diagnostic outcomes when CFTR mutational analysis was used in CF *** mutational analysis results were also compared with sweat chloride ***:This study was done on all patients at our institution who had CFTR mutation analysis over a sevenyear period since August ***:A total of 315 patients underwent CFTR mutational ***-one (16.2%) patients had two mutations *** them 32 had positive sweat chloride levels (≥60 mmol/L),while seven had borderline sweat chloride levels (40-59 mmol/L).An additional 70 patients (22.3%) had only one mutation *** them eight had positive sweat chloride levels,and 17 had borderline sweat chloride ***-five patients (17.5%) without CFTR mutations had either borderline (n=45) or positive (n=10) sweat chloride *** patients with a CF phenotype had negative CFTR analysis but elevated sweat chloride *** eighty-three patients (26.4%) CFTR mutational analysis was done without corresponding sweat chloride ***:Although CFTR mutation analysis has improved the diagnostic capability for CF,its use either as the first step or the only test to diagnose CFTR dysfunction should be discouraged and CF diagnostic guidelines need to be followed.

关键词： CFTR cystic fibrosis sweat chloride

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First contact investigations and compliance to treatment in patients with uveitis

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International Journal of Ophthalmology(English edition) 2023年第11期16卷 1820-1826页

作者： Anuja Patil Sanjeev Gupta Pradeep Venkatesh Mousumi Banerjee Vinod Kumar rohan Chawla Shorya Vardhan Azad Atul Kumar Dr.Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical SciencesNew Delhi 110029India

AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to ***:An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June *** information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our *** with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and ***:The mean age of the study group was 35.35±14.1y and gender composition was 59.7%males and 40.3%*** uveitis was observed in 45.3%of patients,intermediate uveitis in 31.8%of patients,posterior uveitis in 14.9%of patients and panuveitis in 8.0%of *** with a systemic disease was evident in 17.9%of *** compared with standard guidelines and uveitis patterns,systemic investigations were identified to be relevant only in 38.3%of ***-compliance to treatment was documented in 22.4%of *** reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7%of patients and a busy schedule at work/school in 22.2%of ***:Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the *** a quarter of patients in this study are found to be non-compliant with the *** is more challenging to achieve in school-going children and working *** availability of comprehensive,periodically updated,evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment,respectively,in patients with uveitis.

关键词： uveitis compliance investigations first contact

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Clinical characteristics and outcome of hepatocellular carcinoma in alcohol related and cryptogenic cirrhosis: a prospective study

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Hepatobiliary & Pancreatic Diseases International 2015年第4期14卷 401-405页

作者： rohan C Siriwardana Maduni A Niriella Anuradha S Dassanayake Chandika Liyanage Bhagya Gunathilaka Subani Jayathunge Hithanadura J de Silva Department of Surgery Faculty of Medicine University of Kelaniya Department of Medicine Faculty of Medicine University of Kelaniya Department of Pharmacology Faculty of Medicine University of Kelaniya

BACKGROUND： Non-alcoholic fatty liver disease （NAFLD） is becoming a leading cause of chronic liver disease. Hepato- cellular carcinoma （HCC） is one of its complications. Although the pathophysiology is unclear, it is reasonable to expect that cryptogenic cirrhosis related HCC （cryptogenic HCC） behaves differently to other types of HCC. This study prospectively compared patients with cryptogenic HCC and those with HCC related to alcoholic cirrhosis. METHODS： A total of 150 consecutive patients with HCC （89 cryptogenic HCC and 61 alcohol related HCC） referred to our unit over a 23-month period were studied. Their demographic data, liver function, tumor characteristics and outcomes were compared. RESULTS： Alcohol related HCC was seen only in males. Com- pared with cryptogenic HCC, alcohol related HCC had signifi- cantly higher aspartate aminotransferase/alanine aminotrans- ferase （AST/ALT） ratio （1.7 vs 1.4, P=0.002）, model for end- stage liver disease score （13 vs 11, P=0.018） and Child＇s score （7 vs 6, P=0.037）. No significant difference was seen in platelet counts, serum sodium and AST to platelet ratio index. Single nodular tumors were more common in cryptogenic HCC, while diffuse type tumors and macroscopic vascular invasion were common in alcohol related HCC. In patients who could not be offered any treatment because of advanced tumors or poor liver function, alcohol related HCC had a significantly lower median survival （5.3 months） compared with crypto- genic HCC （9.3 months, P=0.034）.CONCLUSIONS： Compared wtih cryptogenic HCC, alcohol related HCC had worse liver function and aggressive tumor morphology at presentation, and a higher proportion was untreatable. In patients who could not be treated, median sur- vival was lower in patients with alcohol related HCC than in those with cryptogenic HCC.

关键词： hepatocellular carcinoma liver diseases alcoholic fatty liver

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