26 results on '"Munzir"'
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2. Analytic and robust solar tracking solution using the linear quadratic tracking and the entropy on fuzzy logic control
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Ramli, Marwan, Ikhwan, Muhammad, Muttaqin, Mohd Iqbal, Munzir, Said, Mardlijah, Mardlijah, and Milzam, Ahmad Lutfan
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- 2024
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3. Synthesis of highly efficient asphalt-based carbon for adsorption of polycyclic aromatic hydrocarbons and diesel from emulsified aqueous phase
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Alissa, Faisal M., Mohammed, Dauda, Osman, Abdalghaffar M., Basheer, Chanbasha, Siddiqui, Mohammad Nahid, Al-Arfaj, Abdurrahman A., and Suliman, Munzir H.
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This work reports the syntheses of an inexpensive and efficient asphalt-derived mesoporous carbon (AdMC) as an adsorbent. The adsorbent was activated with potassium hydroxide to increase its surface area and then characterized by SEM–EDS, FT-IR, and BET. The adsorption properties of AdMC were evaluated for the adsorptive removal of eleven Poly Aromatic Hydrocarbons (PAHs) and diesel from water samples. The prepared AdMC showed very high surface areas and high micropore volumes equal to 2316 m2/g and 1.2 cm3/g, respectively. Various experimental conditions influencing the adsorption capacity of eleven PAHs and diesel were investigated. At high concentrations, PAHs and diesel solubility in water is very low. Hence, samples were emulsified with a surfactant, and then maximum adsorption capacity was investigated. Adsorption profile of individual PAHs was examined using gas chromatography/mass spectrometry analysis followed by liquid–liquid extraction. Total hydrocarbon removal was studied using a total organic analyzer. Asphalt-derived mesoporous sorbent showed an extreme ability to remove PAHs and diesel (average adsorption capacity of 166 mg/g for individual PAHs and diesel (maximum capacity of 1600 mg/g). The experimental results fitted the Langmuir model with a correlation efficiency of 0.9853. The results obtained for both adsorbents also matched to pseudo-second-order kinetics, suggesting that the adsorption of PAHs and diesel is chemical, monolayer, and homogeneous process.
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- 2024
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4. Ergonomics and Employee Performance: A Study on Oil Palm Plantations in Rompin District, Pahang
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Mustafa, Mazlina, Taufek, Fatini Hanim Mohamed, Ar Alhan, Asyraful Munzir, Zaidan, Muhammad Rusydi, Arazie, Nor Ismaniza Mohd, Ismail, Norizan Izwani, and Halim, Nur Atikah Abdul
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Business - Abstract
Purpose: The proceeding by the Future of Ergonomics Committee of 18th Triennial World Congress on Ergonomics, in Brazil stated that 'ergonomics or human factors have great potential to ensure that any designed artefacts, ranging from a consumer product to an organizational environment, is shaped around the capacities and aspirations of humans. Ergonomics is disregarded by many, ignored due to time, cost and considered as a complex and a battlefield for management with the recent economic conditions (Punadi, 2015). This study was conducted to determine the physical ergonomics; such as noise, lighting and furniture and the relationship towards employee performance.Design/methodology/approach: This study was quantitative in nature, using the survey method to examine the relationship between independent variables (ergonomics) and dependent variable (employee performance). Oil Palm Estates in Rompin District in Pahang were chosen as they had a substantial number of plantation employees working in various oil palm companies. 200 questionnaires had been distributed to the respondents. The response rate from the respondents was 76%.Findings: The research concluded that physical ergonomics such as furniture, noise, and lighting were considered important factors in contributing to employee's performance.Research limitations/implications: There are limited studies conducted in Malaysia on the topic of ergonomics and employee performances. Loo et al. (2012) researched on ergonomic issues in Malaysia, but not on the relationship with performance. Punadi (2015) did a research to measure the relationship between ergonomic and employee performances in private higher education institution. There is currently no research conducted in the plantation industry. In addition, it was also difficult to determine the accurate number of population as there were no statistic on the number of plantation employees in the district of Rompin.Practical implications: The study of ergonomics is valuable to organizations as most working individuals spent almost of their time in the workplace. Therefore, the design and working space should meet the right level of security to maintain the level of health; and also to increase the level of satisfaction and achieving individual comfort. This is where ergonomic principles play a role in providing welfare in the work environment. According to Leblibichi (2012), an enriched workplace environment motivates employee performance and leads to job satisfaction.Originality/value: By applying ergonomics, the plantation industry would increase their employee performances in the office. Furniture, lighting and noise are found to influencing the employee performances. Providing suitable furniture for the employees, with enough lighting in the workspace had proven it could improve the performance of employees. In fact, this research also found that noise also has a significant relationship with employee's performance. This study on ergonomics would give benefit to the organization in helping to increase the employee performances; thus increasing the productivity of the plantation industryKeywords: Ergonomics, Furniture, Noise, Lighting, Employee Performance., IntroductionBackground of the StudyAgriculture was the pioneer sector that was in operation and was important in the build-up of the national economy after the independence of Malaysia. About 11.5% of [...]
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- 2018
5. Adult appendicitis score versus Alvarado score: A comparative study in the diagnosis of acute appendicitis
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Ghali, Mohamed Said, Hasan, Samer, Al-Yahri, Omer, Mansor, Salah, Al-Tarakji, Mohannad, Obaid, Munzir, Shah, Amjad Ali, Shehata, Mona S., Singh, Rajvir, Al-Zoubi, Raed M., and Zarour, Ahmad
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Acute Appendicitis (AA) is the most common abdominal surgical emergency. It requires proper management to decrease mortality and morbidity. Clinical scoring systems for diagnosing AA aimed to decrease the use of radiological scans and the rate of negative appendectomies (NA). We aim to assess the adult appendicitis score (AAS) in the diagnosis prediction of AA.
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- 2023
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6. Electrocatalytic Investigations into a PdNi Nanostructured Alloy Supported over a Graphite Sheet toward Pt-like Hydrogen Evolution Activity
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Babar, Noor-Ul-Ain, Khan, Abuzar, Suliman, Munzir H., Marwat, Mohsin Ali, Nawaz Tahir, Muhammad, and Ehsan, Muhammad Ali
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Hydrogen desorption applications over Pd are strongly hindered due to the strong affinity of Pd metal for hydrogen, and thus, exploring Pd-centered hydrogen evolution reaction (HER) catalysts in place of Pt-based materials remains a challenge. Bimetallic alloying could modify the binding energy of metals at the alloy surface for optimum adsorption/desorption of reaction intermediates and an ultimately fast rate of the HER process. Here, a series of PdNi alloy film electrodes of varying thickness was prepared on a graphite substrate by directing the deposition time following a single-step aerosol-assisted chemical vapor deposition method. The structure and morphology of the deposited alloy films were characterized using X-ray, spectroscopic, and microscopy-based techniques. The results confirm the formation of a highly pure PdNi alloyed nanostructure. The electrocatalytic efficiency of the developed films was tested by monitoring the hydrogen evolution reaction under acidic conditions. The PdNi alloy film obtained after a 2 h deposition time demonstrated the best catalytic activity with an overpotential of only 20 mV at a current density of 10 mA cm–2and a Tafel value of 50.2 mV/dec, a small charge transfer resistance of just 1.2 Ω, and a high turnover frequency and Jexcof 0.83 s–1@0.2 V and 10.69 mA cm–2, respectively. The developed electrodes also demonstrated good chemical and mechanical stability for 22 h in a durability test operating at 100 and 200 mA cm–2. The results are comparable to the state-of-the-art Pt-based HER catalyst investigated under similar circumstances. The remarkably increased electroactive sites on the bimetallic alloy with reasonable binding energies and synergistic interactions between the nanostructured PdNi alloy and the graphite support could cumulatively enhance the electrochemical activity for HER under employed conditions.
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- 2022
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7. Retrospective case series of inverted V-shape tenotomy of gastrocnemius and recession of soleus at the musculotendinous junction for the treatment of fixed equinus deformity in children with cerebral palsy
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Odeh, Rabea and Odeh, Munzir
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- 2022
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8. Places and Causes of Mismanaged Plastic Materials in the Life Cycle of Flexible Plastic Packaging Based on Mechanical Recycling Context
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Hadengganan, Munzir and Gabriel, Djoko Sihono
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Plastic waste has become a big issue in the world for its large amount of plastic waste in the sea. Most of the plastic waste is plastic packaging which consists of flexible and rigid plastic packaging. This research discusses flexible plastic packaging. Until now, most researches on the loss of plastic materials discuss how to manage plastic waste disposal once it has been used by community: only a few discuss production cycle: while none of them discusses flexible plastic packaging area. This research aims to examine the number of mismanaged materials throughout flexible plastic packaging life cycle using a combination of Material Flow Analysis (MFA) and Life Cycle Analysis (LCA). Based on the literature review, interviews and observations conducted by the author to all stakeholders in the life cycle of flexible plastic packaging, mismanagement of plastic material occurred in each cycle, mostly caused by quality degradation of flexible plastic that could cause plastic waste was not acceptable in the mechanical recycle. The results of this study show that: (1) mismanaged material occurred in all cycles throughout the life cycles of flexible plastic packaging, (2) quality degradation is the main caused of mismanaged material in several cycles, and (3) the mismanaged materials in the life cycle of flexible plastic packaging were 98.29%.
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- 2021
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9. Capacity building of stem cell transplantation facilities in Pakistan: joint efforts of NIBD, government, and private-sector institutions
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Zaidi, Uzma, Shamsi, Tahir S., Farzana, Tasneem, Ansari, Saqib H., Borhani, Munira, Munzir, Saima, Samad, Shafaq, Parveen, Kousar, Anjum, Nasreen, Mirza, Irfan G., Safdar, Dilnasheen, Naseem, Rida, Bukhari, Nasir A., Mazari, Mansoor, Jamil, Hira, Yousuf, Rukhsana, Khan, Irfan A., Rasheed, Kamran, and Mir, Muhammad A.
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- 2019
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10. Building blocks of hematology in the last 3 decades in Pakistan
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Shamsi, Tahir S., Farzana, Tasneem, Ansari, Saqib, Hossain, Nazli, Naz, Arshi, Borhany, Munira, Taj, Mehwesh, Munzir, Saima, Zaidi, Uzma, Hassan, Jawwad, Irfan, Nida, Shakoor, Nazmeen, Mubarak, Farah, Parveen, Kouser, Anwari, Syeda, Ahmed, Nadeem, Hussain, Mansoor, Baig, Irfan Ghafoor, Safdar, Dilnasheen, and Shahab, Sadaf
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- 2019
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11. Venous thromboembolism risk in psychiatric in-patients: a multicentre cross-sectional study
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Ellis, Natalie, Grubb, Carla-Marie, Mustoe, Sophie, Watkins, Eleanor, Codling, David, Fitch, Sarah, Stirland, Lucy, Quraishy, Munzir, Jenkinson, Josie, and Harrison, Judith
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Aims and methodWe assessed venous thromboembolism (VTE) risk, barriers to prescribing VTE prophylaxis and completion of VTE risk assessment in psychiatric in-patients. This was a cross-sectional study conducted across three centres. We used the UK Department of Health VTE risk assessment tool which had been adapted for psychiatric patients.ResultsOf the 470 patients assessed, 144 (30.6%) were at increased risk of VTE. Patients on old age wards were more likely to be at increased risk than those on general adult wards (odds ratio = 2.26, 95% CI 1.51–3.37). Of those at higher risk of VTE, auditors recorded concerns about prescribing prophylaxis in 70 patients (14.9%). Only 20 (4.3%) patients had a completed risk assessment.Clinical implicationsMental health in-patients are likely to be at increased risk of VTE. VTE risk assessment is not currently embedded in psychiatric in-patient care. There is a need for guidance specific to this population.
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- 2019
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12. The impact of microstructural features of carbon supports on the electrocatalytic hydrogen evolution reactionElectronic supplementary information (ESI) available. See DOI: 10.1039/c8cy02549e
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Suliman, Munzir H., Adam, Alaaldin, Siddiqui, Mohammad N., Yamani, Zain H., and Qamar, Mohammad
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Tremendous efforts are underway to design and develop Pt-less electrocatalysts for the hydrogen evolution reaction (HER). Because of its low cost and high electrical conductivity, carbon is used as a support material for the dispersion of active sites. While carbon supports play a critical role in the HER, the impact of key microstructural attributes of carbon on the properties and the performance of electrodes is yet to be determined. Herein, an attempt is made to investigate how certain carbon features determine the properties and the performance of electrodes towards the HER. This is exemplified by dispersing iron monophosphide (FeP) on three types of carbon supports with different properties, such as morphology, specific surface area, and electrical conductivity. The change in the electrode's properties, such as specific surface area, electrochemically active surface area, intrinsic electrical conductivity, surface charge transfer resistance, turnover frequency, and Tafel slopes, before and after FeP loading is examined and correlated with the performance. The findings of this study provide fresh impetus for designing and developing Pt-free active electrodes for the HER.
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- 2019
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13. Interconnected Hollow Cobalt Phosphide Grown on Carbon Nanotubes for Hydrogen Evolution Reaction
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Adam, Alaaldin, Suliman, Munzir H., Siddiqui, Mohammad N., Yamani, Zain H., Merzougui, Belabbes, and Qamar, Mohammad
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Transition-metal phosphides are deemed as potential alternative to platinum for large-scale and sustainable electrocatalytic hydrogen production from water. In this study, facile preparation of interconnected hollow cobalt monophosphide (CoP) supported on carbon nanotubes is demonstrated and evaluated as a low-cost electrocatalyst for hydrogen evolution reaction. Hexamethylenetetramine is used as a structure-directing agent to guide the formation of interconnected cobalt oxide, which further grows into interconnected hollow CoP. Interconnected and hollow microstructural artifacts impart benign attributes, such as enhanced specific and electrochemically active surface area, low intrinsic charge transfer resistance, high interfacial charge transfer kinetics, and improved mass transport, to the electrocatalyst. As a result, the as-prepared electrode exhibits remarkable electrocatalytic performance, low onset (18 mV) and overpotential (η10= 73 mV); small Tafel slope (54.6 mV dec–1); and high turnover frequency (0.58 s–1at η = 73 mV). In addition, the electrode shows excellent electrochemical stability.
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- 2018
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14. A review of metal-organic frameworks/graphitic carbon nitride composites for solar-driven green H2production, CO2reduction, and water purification
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Usman, Muhammad, Zeb, Zonish, Ullah, Habib, Suliman, Munzir H., Humayun, Muhammad, Ullah, Latif, Shah, Syed Niaz Ali, Ahmed, Usama, and Saeed, Muhammad
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The rapid increase in population growth and economic development led to the increase in utilization of fossil fuels energy per capita. Thus, the consumption of these fossil fuel's energy resources poses serious implications for our environment. Photocatalysis plays an essential role in sustainable energy development and environmental remediation. The graphitic carbon nitride (g-C3N4) has been efficiently employed in photocatalysis due to its abundance, low price, high stability, appropriate band gap, and encouraging environmental impacts. As the photocatalytic efficiency of single component g-C3N4is still not satisfactory for efficient photocatalysis. Hence, its composites with various functional nanomaterials have been widely prepared and employed for efficient photocatalysis. Among the widely coupled functional nanomaterials, metal-organic frameworks (MOFs) have been widely explored for energy production and controlling environmental pollution due to their large surface area, tunable pore size and window, and tailored functionalities. The significance of MOF/g-C3N4composites flourished for green hydrogen (H2) production, carbon dioxide (CO2) conversion, and environmental pollution control. In this review, we comprehensively highlighted the recent advancements and challenges of g-C3N4and MOFs heterojunctions in the field of green H2production. Besides, we discussed the up-to-date applications of g-C3N4-based composites with MOFs for CO2conversion to useful fuels. Furthermore, the association between MOFs and g-C3N4composites and their performance for water purification are also discussed. Finally, we proposed the future potential of MOF/g-C3N4composites to be used for the generation of green energy in order to solve environmental issues. We suggest that this review can help to design MOF/g-C3N4composite photocatalysts for prospective applications in energy harvesting and controlling environmental pollution.
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- 2022
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15. G-XmnI Polymorphism
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Ansari, Saqib H., Shamsi, Tahir S., Munzir, Saima, Khan, Mohammed T., Erum, Sajida, Perveen, Kousar, Farzana, Tasneem, Ashraf, Mushtaq, Mehboob, Tabassum, and Moinuddin, Moinuddin
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-thalassemia is characterized by impaired -chain synthesis leading to ineffective erythropoiesis, severe anemia, and a need for blood transfusion. Presence of XmnI polymorphism (−158 C-T nucleotide change) in -globin gene is associated with a higher fetal hemoglobin and a lesser clinical severity. This prospective study attempted to find out the effect of hydroxyurea (HU) on -thalassemia patients in the presence or absence of XmnI polymorphism. A total of 143 consecutive -thalassemia patients received HU (16 mgkgd). Sixty-four (44.7) had XmnI polymorphism (either homozygous or heterozygous). Patients were evaluated at a median duration of 3 years (range, 6 mo to 9 y). Responders became transfusion independent after 6 months, partial responders had a least 50 reduction in transfusion requirement and nonresponders had no significant reduction. Of the 64 patients with XmnI polymorphism, 44 (69) showed response (P<0.01), whereas in those who lacked XmnI polymorphism (n=79), only 17 (21) were responders. This study showed that the presence of XmnI polymorphism in -thalassemia is a predictor of response to HU and highlights the possibility of managing this subset of patients without blood transfusion.
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- 2013
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16. Getting it right the first time: predicted performance guarantees from the analysis of emergent behavior in autonomous and semi-autonomous systems
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Arkin, Ronald C., Lyons, Damian, Shu, Jiang, Nirmal, Prem, and Zafar, Munzir
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A crucially important aspect for mission-critical robotic operations is ensuring as best as possible that an autonomous system be able to complete its task. In a project for the Defense Threat Reduction Agency (DTRA) we are developing methods to provide such guidance, specifically for counter-Weapons of Mass Destruction (C-WMD) missions. In this paper, we describe the scenarios under consideration, the performance measures and metrics being developed, and an outline of the mechanisms for providing performance guarantees.
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- 2012
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17. Multi-cue object detection and tracking for security in complex environments
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Ahsan, Unaiza, Sattar, Sohail Abdul, Noor, Humera, and Zafar, Munzir
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Efficient moving object tracking requires near flawless detection results to establish correct correspondences between frames. This is especially true in the defense sector where accuracy and speed are critical factors of success. However, problems such as camera motion, lighting and weather changes, texture variation and inter-object occlusions result in misdetections or false positive detections which in turn, lead to broken tracks. In this paper, we propose to use background subtraction and an optimized version of Horn & Schunk's optical flow algorithm in order to boost detection response. We use the frame differencing method, followed by morphological operations to show that it works in many scenarios and the optimized optical flow technique serves to complement the detector results. The Horn & Schunk's method yields color-coded motion vectors for each frame pixel. To segment the moving regions in the frame, we apply color thresholding to distinguish the blobs. Next, we extract appearance-based features from the detected object and establish the correspondences between objects' features, in our case, the object's centroid. We have used the Euclidean distance measure to compute the minimum distances between the centroids. The centroids are matched by using Hungarian algorithm, thus obtaining point correspondences. The Hungarian algorithm's output matrix dictates the objects' associations with each other. We have tested the algorithm to detect people in corridor, mall and field sequences and our early results with an accuracy of 86.4% indicate that this system has the ability to detect and track objects in video sequences robustly.
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- 2012
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18. Comparison between Endoloop ligature and Hem-o-lok clip (Polymer ligation) for appendiceal stump closure during laparoscopic appendicectomy
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Abounozha, Sabry, Saafan, Tamer, Obaid, Munzir, and Ibrahim, Rashid
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A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients undergoing laparoscopic appendicectomy is Hem-o-lok clip safer than Endoloop ligature for closure of appendiceal stump?
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- 2022
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19. Efficacy of intraperitoneal bupivacaine in laparoscopic bariatric surgery
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Saafan, Tamer, Abounozha, Sabry, Obaid, Munzir, and Ghali, Mohamed Said
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A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In [patients undergoing bariatric surgery], is [intraperitoneal local bupivacaine during the operation ] associated with [ lower pain score and decrease in post operative pain medications]?
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- 2022
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20. Pakistan
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Zia, Anjum and Elahi, Munzir
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- 2007
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21. Determination of Captopril in Human Blood by an Enzyme-linked Immunosorbent Assay
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Jehanli, Ahmed M T, Arafat, Towfiq, and Al-Shami, Munzir
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An immunoassay for the quantitation of the angiotensin-converting enzyme inhibitor, captopril in human plasma is described.Antisera very specific for captopril were produced by immunization with captopril conjugated to bovine serum albumin or porcine thyroglobulin via the drug's thiol group. The antibodies were used to develop an enzyme-linked immunosorbent assay (ELISA) with a detection limit of 0.3 ng mL−1and intra- and inter-assay coefficients of variation of 7 and 12%, respectively. Apart from stabilizing captopril by the addition of N-ethyl maleimide, the assay was used to detect the drug in human plasma without further extraction or purification.Our immunoassay provides a very sensitive and rapid (four hours) alternative for the study of captopril pharmacokinetics.
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- 1996
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22. Mathematical model of parking space unit for triangular parking area
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Syahrini, Intan, Sundari, Teti, Iskandar, Taufiq, Halfiani, Vera, Munzir, Said, and Ramli, Marwan
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Parking space unit (PSU) is an effective measure for the area size of a vehicle, including the free space and the width of the door opening of the vehicle (car). This article discusses a mathematical model for parking space of vehicles in triangular shape area. An optimization model for triangular parking lot is developed. Integer Linear Programming (ILP) method is used to determine the maximum number of the PSU. The triangular parking lot is in isosceles and equilateral triangles shape and implements four possible rows and five possible angles for each field. The vehicles which are considered are cars and motorcycles. The results show that the isosceles triangular parking area has 218 units of optimal PSU, which are 84 units of PSU for cars and 134 units of PSU for motorcycles. Equilateral triangular parking area has 688 units of optimal PSU, which are 175 units of PSU for cars and 513 units of PSU for motorcycles.
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- 2018
23. Optimal control for Malaria disease through vaccination
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Munzir, Said, Nasir, Muhammad, and Ramli, Marwan
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Malaria is a disease caused by an amoeba (single-celled animal) type of plasmodium where anopheles mosquito serves as the carrier. This study examines the optimal control problem of malaria disease spread based on Aron and May (1982) SIR type models and seeks the optimal solution by minimizing the prevention of the spreading of malaria by vaccine. The aim is to investigate optimal control strategies on preventing the spread of malaria by vaccination. The problem in this research is solved using analytical approach. The analytical method uses the Pontryagin Minimum Principle with the symbolic help of MATLAB software to obtain optimal control result and to analyse the spread of malaria with vaccination control.
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- 2018
24. Mathematical model of snake-type multi-directional wave generation
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Halfiani, Vera, Rusdiana, Siti, Munzir, Said, and Ramli, Marwan
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Research on extreme wave generation is one intensive research on water wave study because the fact that the occurrence of this wave in the ocean can cause serious damage to the ships and offshore structures. One method to be used to generate the wave is self-correcting. This method controls the signal on the wavemakers in a wave tank. Some studies also consider the nonlinear wave generation in a wave tank by using numerical approach. Study on wave generation is essential in the effectiveness and efficiency of offshore structure model testing before it can be operated in the ocean. Generally, there are two types of wavemakers implemented in the hydrodynamic laboratory, piston-type and flap-type. The flap-type is preferred to conduct a testing to a ship in deep water. Single flap wavemaker has been explained in many studies yet snake-type wavemaker (has more than one flap) is still a case needed to be examined. Hence, the formulation in controlling the wavemaker need to be precisely analyzed such that the given input can generate the desired wave in the space-limited wave tank. By applying the same analogy and methodhology as the previous study, this article represents multi-directional wave generation by implementing snake-type wavemakers.
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- 2018
25. Ewing’s Sarcoma of Ilium, Presenting as Right Lower Quadrant Pain
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Saleh Alshaya, Osama, Izzeldin Abbasher, Munzir, and Maqbool Wani, Mubashir
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Ewing’s sarcoma is a highly malignant tumor of bone and is more common in children in the age group of 10 to 20 years. Sometimes the classic clinical and radiological presentation of Ewing’s sarcoma may not be the norm and patient may have an atypical presentation leading to diagnostic confusion. This situation is especially true for Ewing’s sarcoma involving iliac bone. We report a case of Ewing’s sarcoma involving the right ilium in a patient presenting with right lower quadrant pain and nonspecific radiological changes. To the best of our knowledge, this scenario has not been reported in literature. We recommend early magnetic resonance imaging and computed tomography to diagnose the disease early when there is slightest suspicion of the disease.
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- 2015
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26. Genetic Modifiers Of Beta-Thalassaemia Associated With Management Without Blood Transfusion: Ten Years Experience
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Ansari, Saqib Hussain, Shamsi, Tahir S, Khan, Mohammed Tahir, Munzir, Saima, Erum, Sajida, Perveen, Kousar, Parveen, Sadia, Farzana, Tasneem, and Ashraf, Mushtaq
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Long survival with improve quality life in treatment of thalassaemia patients can be procure by blood transfusion and sedulous chelation but, it is cumbrous. Therapeutic manoeuvers designed to stabilize or increase hemoglobin without transfusion and to reduce the blood transfusion. Efforts have been undertaken to find an alternative approach to transfusion in β-thalassaemia.On the basis of our previous studies evaluating the safety & efficacy of Hydroxyurea (HU) in beta thalassemia patients which is an oral Hb-F augmentation agent, at 10-15 mg/kg/day was used on 473 patients for Mean duration of 3 years under the guidelines of Helsinki’s declaration. Response was measured by using transfusion requirement prior to 6 months period of enrollment in the study as control. Patients were finally divided into Complete Responders (CR), partial responders (PR) and non-responders(NR).Patients’ genetic profile was investigated. Chi square test was applied to check association between variables, p-value ≤0.05 considered significant.Complete responders were 176, PR were 194 while 103 were NR. Most common genetic mutations observed were IVS1-5 (46%) either homozygous or heterozygous, Fr 8-9 (14.3%), IVS1-1 (11%), Cd 30 (5.5%), Fr 41-42 (5.5%), Del-619 (5%) &Cap+1 (1.9%). Astounding results were found when association of these mutations with response of HU was observed. Response was found to be closely related with gene mutations Cd-30 (61.5 % Responders), IVS1-1 (58 % Responders), Cap+1 (44.4 % Responders), IVS1-5 (33.6 % Responders). Homozygous Xmn-I polymorphism was observed in 21% & heterozygous in 24% of the patients, while 55 % had no Xmn-I polymorphism. Xmn-I polymorphism was found to be significantly associated with Response 67 % (p-value 0.00).Hydroxyurea showed promising results in this long term follow up of large cohort of patients. We suggest screening all newly diagnosed thalassaemic children for Genetic characteristic in order to offer Hb-F Augmenting agent as an alternative to blood transfusion.No relevant conflicts of interest to declare.
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- 2013
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