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1. Peptide conjugates for microRNA-21 inhibition in glioblastoma multiforme

Author

Chaudhry, T.

Subjects
RC0254 Neoplasms. Tumors. Oncology (including Cancer), RM Therapeutics. Pharmacology
Abstract

Glioblastoma multiforme (GBM) is the most common and lethal primary malignant brain tumour in adults (Osuka and Van Meir, 2017), following diagnosis it is estimated that less than 5% of GBM patients survive for more than 5 years (Tamimi and Juweid,2017). The current standard practise for GBM treatment includes surgery followed by a regimen daily radiotherapy and oral chemotherapy, typically Temozolomide (TMZ). However, TMZ has a poor effect on overall patient survival rates and the prognosis following GBM diagnosis remains bleak (Tamimi and Juweid, 2017). For this reason, alternative strategies have been explored for the treatment of GBM. This includes the development of miRNA-21 (miR-21) targeted GBM therapies. The function of miR-21 in relation to the development and progression of solid tumour cancers, including GBM, has been studied extensively (Volinia et al., 2006; Medina, Nolde and Slack, 2010). In relation to GBM, the oncogenic function of miR-21 in GBM was first reported by Kosik and co-workers, they demonstrated that the knockdown of miR-21 in cultured GBM cells triggered the activation of caspases, increasing apoptotic cell death. This highlighted the function of miR-21 as an antiapoptotic factor in GBM (Chan, Krichevsky and Kosik, 2005). Thus, with the view to develop miR-21 targeted cancer therapies, peptides have been reported to bind to pri-miR-21 and pre-miR-21 to inhibit the formation of mature oncogenic miR-21 (Diaz et al., 2014; Bose et al., 2015; Shortridge et al., 2017). This includes PIMP21 (peptide 49) which has been reported to bind pre-miR-21 with a binding affinity (KD) of 0.0127 µM and prevent the Dicer cleavage of pre-miR-21 (IC50 of 0.5 µM), using in-vitro studies (Bose et al., 2015). The peptide was further demonstrated to knockdown miR-21 expression at a cellular level, in MCF-7 cells, by 6-fold with respect to a scrambled control peptide (Bose et al., 2015). This highlighted the potential of peptides in the development of miR-21 targeted anti-cancer therapies. However, the use of peptides as medicine is still limited, one of the reasons for this is the limitation associated with the delivery of therapeutic peptides to their active site in cells and across difficult to penetrate barriers, like the BBB (Kadry, Noorani and Cucullo, 2020). Cell penetrating peptides (CPPs) like peptide 779 (SYPGWSW) have been highlighted to successfully deliver therapeutic cargo across the BBB and to the cytoplasm of GBM cells (Ran et al., 2017). For this reason, in this study the cell penetrating function of peptide 77 was further investigated, this led to the discovery of novel peptides 87 (S(Cha)PGWSW) and 91 (S(Nal)PGWSW) with the increased ability to penetrate GBM, relative to the parent peptide 77. It was further found that the increased cellular uptake of peptide 87 was likely associated with the increase in peptide lipophilicity, which facilitated increased hydrophobic interactions between peptide 87 and the cell membrane of GBM cells. Meanwhile, the increased cellular uptake of peptide 91 was linked to the increased proteolytic stability of the peptide (t½ = 35.54 h), when compared to parent peptide 77 (t½ = 19.25 h). Subsequently, a peptide conjugate was designed to determine the ability of the peptide 77 to deliver therapeutic cargo like the PIMP21 peptide (49) to GBM cells, to knockdown the expression of miR-21 and establish the basis for a potential miR21 targeted GBM therapy. This led to the discovery that peptide conjugate 109 (SYPGWSW-Ahx-Lys-Ahx-ALWPPNLHAWVP) was able to translocate across the BBB and penetrate GBM cells. The peptide conjugate was further demonstrated to knockdown miR-21 expression by 15-fold relative to a scrambled control peptide conjugate. Furthermore, Peptide conjugate 109 (0-100 µM) was highlighted to have no significant effect on GBM cell viability following 24 h of exposure. This was the first example of miR-21 modulation in GBM using therapeutic peptides and highlighted the therapeutic potential of peptide conjugate 109 in the development of a potential GBM targeted anti-cancer therapy.

Published
2023
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2. Exploring the experiences and use of text messages to enhance health behaviours and self-management in South Asian patients

Author

Chaudhry, T.

Abstract

This PhD thesis seeks to explore and understand the use and experiences of whether text-messaging in the South-Asian (SA) community enhances positive health behaviours, and self-management through the Florence (FLO) text messaging system. It also examines socio-cultural factors contributing to self-management, patient activation and engagement with text messaging. There is limited literature available on the use of text messaging systems in ethnic groups to support self-management to change health behaviour. In order to optimise self-management in SA ethnic minorities, understanding health behaviours, and behavioural change interventions (for example, mobile health) is becoming increasingly important. Therefore, Health behaviour and behaviour change are explored along with the contextual factors influencing the acceptance and uptake of text messaging. A mixed methodology consisting of two phases took place within Diabetes and Endocrine clinics held in the Midlands, UK. Phase one included the quantitative element in which the Patient Activation Measure (PAM) was completed to understand participants' level of skills, knowledge and confidence to self-manage their long-term condition; whilst, phase two utilised qualitative interviews to explore and understand SA participant (n=40) experiences of using a text messaging system and their self-management behaviours. Data was obtained from both users (n=20) and non-users (n=20) of the FLO system. The PAM was executed for the first time across a SA sample, and vital to provide insight to where SAs are up to with their self-management, and what healthcare providers can do to optimise their self-management. In general, users had higher patient activation levels and better self-management behaviours. Particular themes contributing to SA participant engagement with text messages and self-management included demographics (age, gender roles, ethnicity, religion, education levels and socio-economic/employment status) family support, health beliefs and cultural norms, adoption of traditional remedies over western or prescribed medications, religious and fatalistic beliefs, and language barriers. The findings also generated new knowledge by providing an underpinning on theoretical constructs that played a significant role to better understand SA health behaviour, participant contexts and acceptance to uptake such interventions. Recommendations for future practice and policy include the implementation of culturally appropriate mHealth interventions (i.e., text messaging) to better suit SA participants.

Published
2021

3. Artificial Intelligence Assisted Capsule Endoscopy Versus Conventional Endoscopy for Detection of Small Bowel Lesions – Systematic Review and Meta-analysis

Author

Dhali, A., additional, Kipkorir, V., additional, Srichawla, B. S., additional, Kumar, H., additional, Biswas, J., additional, Rathna, R. B, additional, Rugut, C., additional, Chaudhry, T., additional, Morara, G., additional, Ongidi, I., additional, Waithaka, M., additional, Ray, S., additional, and Dhali, G. K., additional

Published
2024
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4. Peptide Conjugates for MicroRNA-21 Inhibition in Glioblastoma Multiforme

Author

Chaudhry, T

Abstract

Glioblastoma multiforme (GBM) is the most common and lethal primary malignant brain tumour in adults (Osuka and Van Meir, 2017), following diagnosis it is estimated that less than 5% of GBM patients survive for more than 5 years (Tamimi and Juweid,2017). The current standard practise for GBM treatment includes surgery followed by a regimen daily radiotherapy and oral chemotherapy, typically Temozolomide (TMZ). However, TMZ has a poor effect on overall patient survival rates and the prognosis following GBM diagnosis remains bleak (Tamimi and Juweid, 2017). For this reason, alternative strategies have been explored for the treatment of GBM. This includes the development of miRNA-21 (miR-21) targeted GBM therapies. The function of miR-21 in relation to the development and progression of solid tumour cancers, including GBM, has been studied extensively (Volinia et al., 2006; Medina, Nolde and Slack, 2010). In relation to GBM, the oncogenic function of miR-21 in GBM was first reported by Kosik and co-workers, they demonstrated that the knockdown of miR-21 in cultured GBM cells triggered the activation of caspases, increasing apoptotic cell death. This highlighted the function of miR-21 as an antiapoptotic factor in GBM (Chan, Krichevsky and Kosik, 2005). Thus, with the view to develop miR-21 targeted cancer therapies, peptides have been reported to bind to pri-miR-21 and pre-miR-21 to inhibit the formation of mature oncogenic miR-21 (Diaz et al., 2014; Bose et al., 2015; Shortridge et al., 2017). This includes PIMP21 (peptide 49) which has been reported to bind pre-miR-21 with a binding affinity (KD) of 0.0127 µM and prevent the Dicer cleavage of pre-miR-21 (IC50 of 0.5 µM), using in-vitro studies (Bose et al., 2015). The peptide was further demonstrated to knockdown miR-21 expression at a cellular level, in MCF-7 cells, by 6-fold with respect to a scrambled control peptide (Bose et al., 2015). This highlighted the potential of peptides in the development of miR-21 targeted anti-cancer therapies. However, the use of peptides as medicine is still limited, one of the reasons for this is the limitation associated with the delivery of therapeutic peptides to their active site in cells and across difficult to penetrate barriers, like the BBB (Kadry, Noorani and Cucullo, 2020). Cell penetrating peptides (CPPs) like peptide 779 (SYPGWSW) have been highlighted to successfully deliver therapeutic cargo across the BBB and to the cytoplasm of GBM cells (Ran et al., 2017). For this reason, in this study the cell penetrating function of peptide 77 was further investigated, this led to the discovery of novel peptides 87 (S(Cha)PGWSW) and 91 (S(Nal)PGWSW) with the increased ability to penetrate GBM, relative to the parent peptide 77. It was further found that the increased cellular uptake of peptide 87 was likely associated with the increase in peptide lipophilicity, which facilitated increased hydrophobic interactions between peptide 87 and the cell membrane of GBM cells. Meanwhile, the increased cellular uptake of peptide 91 was linked to the increased proteolytic stability of the peptide (t½ = 35.54 h), when compared to parent peptide 77 (t½ = 19.25 h). Subsequently, a peptide conjugate was designed to determine the ability of the peptide 77 to deliver therapeutic cargo like the PIMP21 peptide (49) to GBM cells, to knockdown the expression of miR-21 and establish the basis for a potential miR21 targeted GBM therapy. This led to the discovery that peptide conjugate 109 (SYPGWSW-Ahx-Lys-Ahx-ALWPPNLHAWVP) was able to translocate across the BBB and penetrate GBM cells. The peptide conjugate was further demonstrated to knockdown miR-21 expression by 15-fold relative to a scrambled control peptide conjugate. Furthermore, Peptide conjugate 109 (0-100 µM) was highlighted to have no significant effect on GBM cell viability following 24 h of exposure. This was the first example of miR-21 modulation in GBM using therapeutic peptides and highlighted the therapeutic potential of peptide conjugate 109 in the development of a potential GBM targeted anti-cancer therapy.

Published
2024
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9. Greater Transplant-Free Survival in Patients Receiving Obeticholic Acid for Primary Biliary Cholangitis in a Clinical Trial Setting Compared to Real-World External Controls

Author

Murillo Perez, C, Fisher, H, Hiu, S, Kareithi, D, Adekunle, F, Mayne, T, Malecha, E, Ness, E, van der Meer, A, Lammers, W, Trivedi, P, Battezzati, P, Nevens, F, Kowdley, K, Bruns, T, Cazzagon, N, Floreani, A, Mason, A, Pares, A, Londono, M, Invernizzi, P, Carbone, M, Lleo, A, Mayo, M, Dalekos, G, Gatselis, N, Thorburn, D, Verhelst, X, Gulamhusein, A, Janssen, H, Smith, R, Flack, S, Mulcahy, V, Trauner, M, Bowlus, C, Lindor, K, Corpechot, C, Jones, D, Mells, G, Hirschfield, G, Wason, J, Hansen, B, Sturgess, R, Healey, C, Gunasekera, A, Kallis, Y, Wright, G, Mathialahan, T, Evans, R, Gasem, J, Ramanaden, D, Ward, E, Bhalme, M, Southern, P, Maggs, J, Yousif, M, Srivastava, B, Foxton, M, Collins, C, Prasad, Y, Porras-Perez, F, Yapp, T, Patel, M, Ede, R, Carte, M, Koss, K, Sattianayagam, P, Grimley, C, Tidbury, J, Mansour, D, Beckley, M, Hollywood, C, Ramag, J, Gordon, H, Ridpath, J, Grover, B, Abouda, G, Rees, I, Narain, M, Salam, I, Banim, P, Das, D, Matthews, H, Mohammed, F, Jones, R, Sen, S, Bird, G, Prince, M, Prasad, G, Kitchen, P, Hutchinson, J, Gupta, P, Shah, A, Saha, S, Pollock, K, Barclay, S, Mcdonald, N, Rushbrook, S, Przemioslo, R, Millar, A, Mitchell, S, Davis, A, Naqvi, A, Lee, T, Ryder, S, Collier, J, Cramp, M, Aspinal, R, Booth, J, Williams, E, Hussaini, H, Christie, J, Chaudhry, T, Mann, S, Ala, A, Maltby, J, Corbett, C, Singhal, S, Hoeroldt, B, Butterworth, J, Douglas, A, Sinha, R, Panter, S, Shearman, J, Bray, G, Roberts, M, Forton, D, Taylor, N, Jafar, W, Cowan, M, Ch'Ng, C, Rahman, M, Wesley, E, Jain, S, Mandal, A, Wright, M, Gordon, F, Unitt, E, Austin, A, Palegwala, A, Vemala, V, Higham, A, Fraser, J, Li, A, Ramakrishnan, S, King, A, Whalley, S, Gee, I, Keld, R, Fellows, H, Gotto, J, Millson, C, Murillo Perez C. F., Fisher H., Hiu S., Kareithi D., Adekunle F., Mayne T., Malecha E., Ness E., van der Meer A. J., Lammers W. J., Trivedi P. J., Battezzati P. M., Nevens F., Kowdley K. V., Bruns T., Cazzagon N., Floreani A., Mason A. L., Pares A., Londono M. -C., Invernizzi P., Carbone M., Lleo A., Mayo M. J., Dalekos G. N., Gatselis N. K., Thorburn D., Verhelst X., Gulamhusein A., Janssen H. L. A., Smith R., Flack S., Mulcahy V., Trauner M., Bowlus C. L., Lindor K. D., Corpechot C., Jones D., Mells G., Hirschfield G. M., Wason J., Hansen B. E., Sturgess R., Healey C., Gunasekera A., Kallis Y., Wright G., Mathialahan T., Evans R., Gasem J., Ramanaden D., Ward E., Bhalme M., Southern P., Maggs J., Yousif M., Srivastava B., Foxton M., Collins C., Prasad Y., Porras-Perez F., Yapp T., Patel M., Ede R., Carte M., Koss K., Sattianayagam P., Grimley C., Tidbury J., Mansour D., Beckley M., Hollywood C., Ramag J., Gordon H., Ridpath J., Grover B., Abouda G., Rees I., Narain M., Salam I., Banim P., Das D., Matthews H., Mohammed F., Jones R., Sen S., Bird G., Prince M., Prasad G., Kitchen P., Hutchinson J., Gupta P., Shah A., Saha S., Pollock K., Barclay S., McDonald N., Rushbrook S., Przemioslo R., Millar A., Mitchell S., Davis A., Naqvi A., Lee T., Ryder S., Collier J., Cramp M., Aspinal R., Booth J., Williams E., Hussaini H., Christie J., Chaudhry T., Mann S., Ala A., Maltby J., Corbett C., Singhal S., Hoeroldt B., Butterworth J., Douglas A., Sinha R., Panter S., Shearman J., Bray G., Roberts M., Forton D., Taylor N., Jafar W., Cowan M., Ch'ng C. L., Rahman M., Wesley E., Jain S., Mandal A., Wright M., Trivedi P., Gordon F., Unitt E., Austin A., Palegwala A., Vemala V., Higham A., Fraser J., Li A., Ramakrishnan S., King A., Whalley S., Gee I., Keld R., Fellows H., Gotto J., Millson C., Murillo Perez, C, Fisher, H, Hiu, S, Kareithi, D, Adekunle, F, Mayne, T, Malecha, E, Ness, E, van der Meer, A, Lammers, W, Trivedi, P, Battezzati, P, Nevens, F, Kowdley, K, Bruns, T, Cazzagon, N, Floreani, A, Mason, A, Pares, A, Londono, M, Invernizzi, P, Carbone, M, Lleo, A, Mayo, M, Dalekos, G, Gatselis, N, Thorburn, D, Verhelst, X, Gulamhusein, A, Janssen, H, Smith, R, Flack, S, Mulcahy, V, Trauner, M, Bowlus, C, Lindor, K, Corpechot, C, Jones, D, Mells, G, Hirschfield, G, Wason, J, Hansen, B, Sturgess, R, Healey, C, Gunasekera, A, Kallis, Y, Wright, G, Mathialahan, T, Evans, R, Gasem, J, Ramanaden, D, Ward, E, Bhalme, M, Southern, P, Maggs, J, Yousif, M, Srivastava, B, Foxton, M, Collins, C, Prasad, Y, Porras-Perez, F, Yapp, T, Patel, M, Ede, R, Carte, M, Koss, K, Sattianayagam, P, Grimley, C, Tidbury, J, Mansour, D, Beckley, M, Hollywood, C, Ramag, J, Gordon, H, Ridpath, J, Grover, B, Abouda, G, Rees, I, Narain, M, Salam, I, Banim, P, Das, D, Matthews, H, Mohammed, F, Jones, R, Sen, S, Bird, G, Prince, M, Prasad, G, Kitchen, P, Hutchinson, J, Gupta, P, Shah, A, Saha, S, Pollock, K, Barclay, S, Mcdonald, N, Rushbrook, S, Przemioslo, R, Millar, A, Mitchell, S, Davis, A, Naqvi, A, Lee, T, Ryder, S, Collier, J, Cramp, M, Aspinal, R, Booth, J, Williams, E, Hussaini, H, Christie, J, Chaudhry, T, Mann, S, Ala, A, Maltby, J, Corbett, C, Singhal, S, Hoeroldt, B, Butterworth, J, Douglas, A, Sinha, R, Panter, S, Shearman, J, Bray, G, Roberts, M, Forton, D, Taylor, N, Jafar, W, Cowan, M, Ch'Ng, C, Rahman, M, Wesley, E, Jain, S, Mandal, A, Wright, M, Gordon, F, Unitt, E, Austin, A, Palegwala, A, Vemala, V, Higham, A, Fraser, J, Li, A, Ramakrishnan, S, King, A, Whalley, S, Gee, I, Keld, R, Fellows, H, Gotto, J, Millson, C, Murillo Perez C. F., Fisher H., Hiu S., Kareithi D., Adekunle F., Mayne T., Malecha E., Ness E., van der Meer A. J., Lammers W. J., Trivedi P. J., Battezzati P. M., Nevens F., Kowdley K. V., Bruns T., Cazzagon N., Floreani A., Mason A. L., Pares A., Londono M. -C., Invernizzi P., Carbone M., Lleo A., Mayo M. J., Dalekos G. N., Gatselis N. K., Thorburn D., Verhelst X., Gulamhusein A., Janssen H. L. A., Smith R., Flack S., Mulcahy V., Trauner M., Bowlus C. L., Lindor K. D., Corpechot C., Jones D., Mells G., Hirschfield G. M., Wason J., Hansen B. E., Sturgess R., Healey C., Gunasekera A., Kallis Y., Wright G., Mathialahan T., Evans R., Gasem J., Ramanaden D., Ward E., Bhalme M., Southern P., Maggs J., Yousif M., Srivastava B., Foxton M., Collins C., Prasad Y., Porras-Perez F., Yapp T., Patel M., Ede R., Carte M., Koss K., Sattianayagam P., Grimley C., Tidbury J., Mansour D., Beckley M., Hollywood C., Ramag J., Gordon H., Ridpath J., Grover B., Abouda G., Rees I., Narain M., Salam I., Banim P., Das D., Matthews H., Mohammed F., Jones R., Sen S., Bird G., Prince M., Prasad G., Kitchen P., Hutchinson J., Gupta P., Shah A., Saha S., Pollock K., Barclay S., McDonald N., Rushbrook S., Przemioslo R., Millar A., Mitchell S., Davis A., Naqvi A., Lee T., Ryder S., Collier J., Cramp M., Aspinal R., Booth J., Williams E., Hussaini H., Christie J., Chaudhry T., Mann S., Ala A., Maltby J., Corbett C., Singhal S., Hoeroldt B., Butterworth J., Douglas A., Sinha R., Panter S., Shearman J., Bray G., Roberts M., Forton D., Taylor N., Jafar W., Cowan M., Ch'ng C. L., Rahman M., Wesley E., Jain S., Mandal A., Wright M., Trivedi P., Gordon F., Unitt E., Austin A., Palegwala A., Vemala V., Higham A., Fraser J., Li A., Ramakrishnan S., King A., Whalley S., Gee I., Keld R., Fellows H., Gotto J., and Millson C.

Abstract

Background & Aims: The Primary Biliary Cholangitis (PBC) Obeticholic Acid (OCA) International Study of Efficacy (POISE) randomized, double-blind, placebo-controlled trial demonstrated that OCA reduced biomarkers associated with adverse clinical outcomes (ie, alkaline phosphatase, bilirubin, aspartate aminotransferase, and alanine aminotransferase) in patients with PBC. The objective of this study was to evaluate time to first occurrence of liver transplantation or death in patients with OCA in the POISE trial and open-label extension vs comparable non-OCA–treated external controls. Methods: Propensity scores were generated for external control patients meeting POISE eligibility criteria from 2 registry studies (Global PBC and UK-PBC) using an index date selected randomly between the first and last date (inclusive) on which eligibility criteria were met. Cox proportional hazards models weighted by inverse probability of treatment assessed time to death or liver transplantation. Additional analyses (Global PBC only) added hepatic decompensation to the composite end point and assessed efficacy in patients with or without cirrhosis. Results: During the 6-year follow-up, there were 5 deaths or liver transplantations in 209 subjects in the POISE cohort (2.4%), 135 of 1381 patients in the Global PBC control (10.0%), and 281 of 2135 patients in the UK-PBC control (13.2%). The hazard ratios (HRs) for the primary outcome were 0.29 (95% CI, 0.10–0.83) for POISE vs Global PBC and 0.30 (95% CI, 0.12–0.75) for POISE vs UK-PBC. In the Global PBC study, HR was 0.20 (95% CI, 0.03–1.22) for patients with cirrhosis and 0.31 (95% CI, 0.09–1.04) for those without cirrhosis; HR was 0.42 (95% CI, 0.21–0.85) including hepatic decompensation. Conclusions: Patients treated with OCA in a trial setting had significantly greater transplant-free survival than comparable external control patients.

Published
2022

20. Safety in out-of-hours operating in trauma and orthopaedics at a district general hospital

Author

Noor S, Chaudhry T, Knebel R, Chaudhry S, Gulamhussein Ma, and Guha A

Subjects
Adult, Operating Rooms, medicine.medical_specialty, Time Factors, Adolescent, Hospitals, General, Fractures, Bone, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Out of hours, medicine, Humans, Orthopedic Procedures, General hospital, 030222 orthopedics, business.industry, General Medicine, Perioperative, Hospitals, District, Middle grades, medicine.disease, Orthopaedic Surgery, Orthopedic surgery, Clinical safety, 030211 gastroenterology & hepatology, Surgery, Patient Safety, Medical emergency, business, American society of anesthesiologists
Abstract

INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure. Furthermore, the clinical urgency and safety of cases was assessed based on whether there was any record of life or limb threatening indications at the time of admission. RESULTS Overall, 131 procedures were performed after 9pm, with 102 performed between 9pm and midnight, and 29 after midnight. Consultants performed 16 cases and the remaining 115 cases were operated on by middle grades or specialty trainees. A fifth (20%) of the cases were genuinely life or limb threatening. A total of 123 procedures were classed as having good outcomes. The complication rate was 8%. CONCLUSIONS In our study, 80% of the procedures performed after 9pm could not be categorised as life or limb threatening. Appropriate CEPOD classification would ensure that only life or limb threatening cases were listed for theatre after 9pm. Alternative methods of operating within working hours should be considered.

Published
2017
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23. Selected abstracts

Author

Corkery, P. P., Leek, B. F., Caulfield, B., Garrett, M., Gormley, J. P., OʼDonnell, P. M., Kennedy, N., Sayers, K., Stokes, E., Bresnihan, B., Fitzgerald, O., McGarvey, M. A., Tonra, M., Hooper, A. C. B., Barry, J., Maurer, B., Hussey, J., Gormley, J., Noble, J. G., Alves-Guerreiro, J., Lowe, A. S., Walsh, D. M., NicNiocaill, B., Harte, M., OʼConnor, W. T., OʼHara, A. M., Orren, A., Moran, A. P., Hardiman, D. A., Lee, T. C., Croke, D. T., Tolan, R., McBennett, S., Warmington, S., McGuire, M., Bradford, A., OʼHare, T., MacDermott, M., Lynch, F., OʼRegan, R. G., McLoughlin, P., Quinn, T., Ryan, J. P., Pickering, M., Campion, D. P., Jones, J. F. X., Ryan, S., McNicholas, W. T., Nolan, P., Doyle, F. J., Rackard, S. M., Beddy, P., Campbell, V. A., Bakhle, Y. S., Bell, C., Usher, C., Chan, L., Keenan, A. K., McQuaid, K. E., Cullen, V. C., Smith, E. M., Kelly, A., Lynch, M. A., Freir, D. B., Holscher, C., Herron, C. E., Pearson, H. A., Curran, B. P., OʼConnor, J. J., Quinn, A., McHale, J., Moriarty, D., OʼConnor, J., Glennon, J. C., Van Vliet, B. J., Long, S. K., Kruse, C., Gallagher, H. C., Bacon, C. L., Boland, B., Griffin, A. M., Preisler, J., OʼBrien, L., Regan, C. M., Hurley, S., Kearney, P. J., Slevin, J., Barry-Kinsella, C., Ryan, C. A., Kllleen, O., Glllan, J., Clarke, T., Matthews, T., Corcoran, D., Dunn, E., Geary, M., OʼHerlihy, C., Keane, D., OʼLeary, M. J., Morrison, J. J., Ryan, E., Gorman, W. A., Bourke, A., Larkin, J., Mayes, C., Jenkins, J., Ryan, M., Lalchandani, S., Sheil, O., Lynch, N., Costigan, C., Murphy, J. F., Bhatia, R., Foran, A., Donohue, V., McParland, P., LaSjaunais, P., Rodesch, G., McGinn, M., McAloon, J., OʼLeary, M., Astbury, K., Harmon, D., Sharkey, A., Gaffney, G., OʼRegan, G., McMahon, C., Murray, D., McDermott, C., Woolhead, E., Gillan, J., Cartmill, J. L., Harper, M. A., Al-Shabibi, N., Hanahoe, M., Wingfield, M., Larkin, J. A. M., Bell, A. H., McClure, B. G., Sweeney, L., Martin, D. H., OʼDonoghue, P., Davoren, A., Lucas, G. F., McKiernan, J., Gallagher, D. M. T., Dunne, K. P., Fulena, O., Sheridan, M., Griffin, E., White, M., Deasy, P., OʼRiordan, M., OʼGorman, C., Mongan, C., McCafferkey, M., Henry, G., McKenna, P., OʼMalley, A., Devaney, D., Kelleghan, P., Mooney, E. E., Gillan, J. E., Fitzpatrick, M., McQuillan, K., Heffron, C., Hodnett, P., Curtain, A., OʼConnor, T. C. F., Connell, T. G., Waldron, D., Gorman, W., Bolger, T., OʼKeefe, M., Murphy, J., Dolan, L. M., Traub, A. I., Slattery, M. M., Curley, A. E., Halliday, H. L., Tubman, T. R. J., Kileen, O., Riadha, H., Russell, J., Philips, R., Regan, C., Ali, I., Coughlan, A. C. J., Turner, M. J., Smith, A., OʼFlanagan, D., Igoe, D., Ryan, F., Forde, D., McArdle, E., Ko, D., Bedford, D., Hegarty, M., Dunlevy, B., Corcoran, R., Holohan, T., Feeney, A., McGee, H., Shannon, W., Condon, M., Hyland, C., Sayers, G., Feely, E., Crowley, D., OʼReilly, D., OʼConnell, T., Cronin, M., Johnson, H., Fitzgeraldi, M., Cafferkey, M., Breslin, A., Bonner, C. J., Foley, B., Fitzgerald, M., Wall, P. G., McNamara, E., Costigan, P., Prendergast, T., Foye, K., Cosgrove, C., Keane, A., Murphy, E., OʼDonnell, J., Quinlan, A., Thornton, L., Roch, E. A., Lyons, R. A., Maddocks, A., Barnes, P., Price, L., McCabe, M., Nash, P., Midha, A., Doyle, Y., Kilgallen, A., Wright, P., Ryan, T., De La Harpe, D., Harkins, V., Brennan, C., OʼConnell, V., Evans, D. S., Mhuircheartaigh, Ni J., OʼDonnell, J. M., Rhatigan, A., Shelley, E., Collins, C., Byrne, M., Murphy, A. W., Plunkett, P. K., Murray, A., Bury, G., Lynam, F., McMahon, G., Greally, T., Kane, D., Veale, D., Reece, R., Busteed, S., Bennett, M. W., Stone, M., Molloy, C., OʼConnell, J., Molloy, M. G., Shanahan, F., Guerin, J., Casey, E., Feighery, C., Lin, F., Jackson, J., Pendleton, A., Wright, G. D., Hughes, A. E., OʼGradaigh, D., Debham, I., Compston, J., McEvoy, A., Murphy, E. P., Salonen, D., Payne, P., Lax, M., Lapp, V., Inman, R., OʼRourke, K., Brennan, D., Harty, J., McCarthy, C., OʼByrne, J., Eustace, S., Chirayath, H., Liggett, N. W., Morgan, M. P., Fitzgerald, D. J., McCarthy, C. J., McCarthy, G. M., Lee, R. Z., Wai, K., Nevin, D., Leary, A. O., Lee, R., Casey, E. B., OʼLeary, A., Breen, D., Tuite, D., McInerney, D., Sim, R., Frederic, A. L., Smith, O., White, B., Murphy, M., Silke, C., OʼKeeffe, E., Fanning, N., Spence, L., Parfrey, N. A., McConnell, J. R., Crockard, A. D., Cairns, A. P., Bell, A. L., Kavanagh, O., Moyes, D. A., Finch, M., Rooney, M., Bell, A., Founas, I., El-Magbri, A., Mooney, S., Kennedy, M., Coughlan, R. J., Ramakrishnan, S. A., Gsel, A., Finnerty, O., Burns, M., Yateman, M., Camaco-Hubner, C., Matthews, C. F., Taggart, A., Fuller, K., Murphy, M. S., Phelan, M., Murphy, T. B., Wynne, F., Quane, K., Daly, M., OʼLeary, J., da Silva, I., Bermingham, N., Gogarty, M., Gallagher, L. P., OʼHara, R., Godson, C., Brady, H., Osman, H., El-Rafie, A., Foley-Nolan, D., Kirwan, P., Corcoran, O., Duffy, T., Drummond, F., Madigan, A., Williams, D., Gallagher, P., Hatton, C., Cunningham, S., FitzGerald, O., Minnock, P., Wylie, E., Egan, D., Mc Cormack, J., Shea, M. O., Evans, D., OʼLorcain, P., Comber, H., Evans, A., Jones, J., Garavan, C., Kelleher, K., Boland, M. C., Healy, R., OʼSullivan, M. B., Burke, M., Mc Donald, P., Smithson, R., Glass, J., Mason, C. A., Mullins, N., Nolan, D., McCormick, P., Coughlan, S., Dooley, S., Kelleher, C. C., Hope, A., Murphy, F., Barry, M., Sixsmith, J., MacFarlane, A., MacLeod, C., McElroy, G., OʼLoan, D., Kennedy, F., Kerr, R. M., Lim, J., Allwright, S. P. A., Bradley, F. L., Barry, J. M. G., Long, J., Parry, J. V., Creagh, D., Perry, I. J., Collins, A., Neilson, S., Colwell, N., OʼHalloran, D., OʼNeill, S., McErlain, S., Okasha, M., Gaffney, B., McCarron, P., Hinchion, R., Drew, C., Gavin, A., Fitzpatrick, D., Campbell, R., Wannamethee, S. G., Shaper, A., Friel, S., Kelleher, C., Kee, F., Atterson, C. C., Wilson, E. A., McConnell, J. M., Wheeler, S. M., Watson, J. D., Rahman, Norashikin N., Sheehan, J., Wall, C., Kelleher, B., OʼBroin, S. D., Mullan, R. N., McKeveney, P. J., Hodges, V. M., Winter, P. C., Maxwell, P., Simpson, D. A., Lappin, T. R. J., Maxwell, A. P., Eustace, J. A., Coresh, J., Kutchey, C., Te, P. L., Gimenez, L. F., Scheel, P. J., Walser, M., McMahon, R. A., Clarkson, M., Martin, F., Brady, H. R., Blake, C., OʼMeara, Y. M., Gupta, S., MacKenzie, H., Doyle, S., Fotheringham, T., Haslam, P., Logan, M. P., Conlon, P., Lee, M., Maderna, P., Cottell, D. C., Mitchell, S., Gulmann, C., Østerby, R., Bangstad, H. J., Rljdberg, S., Dempsey, M., Nathwani, S., Ryan, M. P., McMahon, B., Stenson, C., Murtagh, H., Brown, J. H., Doran, P., McGinty, A., Little, M. A., OʼBrien, E., Owens, P., Holian, J., Mee, F., Walshe, J. J., Omer, S. A., Power, D., Diamond, P., Watson, R. W., Shahsafei, A., Jiang, T., Brenner, B. M., Mackenzie, H. S., Neary, J., Dorman, A., Keoghan, M., Campbell, E., Walshe, J., Little, M., Nee, L., OʼCeallaigh, C., McGlynn, H., Bergin, E., Keane, T., Gormley, G., Watson, A., Atta, M. G., Perl, T. M., Song, X., Healy, E., Leonard, M., Lynch, J., Watson, A. J., Lappin, D., Lappin, D. W. P., Hannan, K., Burne, M., Daniels, F., Rabb, H., McBride, B., Kieran, N., Shortt, C., Codd, M., Murray, F., McCormack, A., Brown, C., Wong, C., Dorman, A. M., Keogan, M., Donohue, J., Farrell, J., Donohoe, J., OʼBroin, S., Balfe, A., Mellotte, G. J., Abraham, K. A., McGorrian, C., Wood, A. E., Neligan, M., Kelly, B. D., Finnegan, P., Cormican, M., Callaghan, J., Crean, J. K. G., Moffitt, T. A., Devlin, H. L., Garrett, P. J., Soosay, A., OʼNeill, D., Counihan, A., Hickey, D., Keogan, M. T., Harvey, K., OʼRiordan, E., Waldek, S., Kalra, P. A., OʼDonoghue, D. J., Foley, R. N., Kelliher, D., Mellotte, G., Giblin, L., Keogh, J. A. B., OʼConnell, M., OʼMeara, A., Breatnach, F., Gillick, J., Tazawa, H., Puri, P., Molloy, E., OʼNeill, A. J., Sheridan-Pereira, M., Fitzpatrick, J. M., Webb, D. W., Watson, R. W. G., Linnane, B., OʼDonnell, C., Clarke, T. A., Martin, C., McKay, M., McBrien, J., Glynn, F., OʼDonovan, C., Hall, W. W., Smith, J., Khair, K., Liesner, R., Hann, I. M., Smith, O. P., Gallagher, S., Mahony, M. J., Hilal, A., Cosgrove, J. F., Monaghan, C., Craig, B., Walsh, K., Duff, D., Slizlok, P. O., Halahakoon, C., McMillan, S., Dalzell, E. E., McCaughan, J., Redmond, A. O. B., DeCaluwe, D., Yoneda, A., Akl, U., Dempsey, E., Farrell, M., Webb, D., Elabbas, A., Fox, G., Gormally, S., Grant, B., Corkey, C. W. B., Nicholson, A., Murphy, A., OʼGrady, P., Barry, O., Stewart, M. C., Alderdice, F., Matthews, T. G., McDonnell, M., McGarvey, C., OʼRegan, M., Chróinín, Ní M., Tormey, P., Ennis, S., Green, A. J., Abbas, S., OʼMarcaigh, A., Conran, M., Crushell, E., Saidi, A., Curran, P., Donoghue, V., King, M. D., Elnazir, B., Leonard, J., Kavanagh, C., Brown, D., Corrigan, N., McCord, B., Quinn, M., OʼConnell, L., Mcdonagh, B., Awan, A., Gill, D., Kakkar, R., Warner, J. A., OʼConnor, C., Herzig, M., Twomey, A., White, M. J., Sweeney, B., Surana, R., Hodgson, A., Rafferty, M., Livingstone, W., Peake, D., Wassemer, E., Whitehouse, W., Abdullah, N., Al-Hassan, A., Oslizlok, P., OʼConnell, N., Balding, J., Livingstone, W. J., Healy, M., Mynett-Johnson, L., McAllister, I., Dick, A. C., Herron, B., Boston, V. E., Callaghan, C. O., Brien, D. O., Walsh, A., Philip, M., McShane, D., Hoey, M. C. V., Sharif, F., McDermott, M., Dillon, M., Drumm, B., Rowland, M., Imrie, C., Kelleher, S., Bourke, B., Iqbal, M., Ziedan, Y., OʼNeill, M., OʼRiordan, S., Basheer, S. M. B., OʼCallaghan, S., Chong, A., Kelly, M., Nicholson, A. J., Cooke, R., Sreenan, C., Fallon, M., Denham, B., Dowding, V., Cussen, G., McManus, V., Hensey, O., Monaghan, H., Basheer, S. N., Quinn, E., Hoey, H. M. C. V., Mohamed, S., Ramesh, R. R., Mayne, P., Tracy, E., Gormally, S. M., Curtis, E., McCallion, N., Watson, R., OʼMahony, O., Keegan, M., Ward, K., Barton, D., Poulton, J., Treacy, E., Honour, J., deCaluwe, D., Chróinín, Ni M., Cosgrove, J., Chaudhry, T. S., Long, N. M., Lynch, B., Lasjaunais, P., McDonald, D. G. M., McMenamin, J. B., Farrell, M. J., Roche, E. F., Menon, A., Buckley, C., Mackey, A., Ohlandieck, K., Das, A., Reilly, D., Killeen, O., Harper, J., Roche, E., Hoey, H., Caird, J., OʼBrien, D., Allcutt, D., Farrington, N., Murphy, J. F. A., Savage, J. M., Sands, A. J., Casey, F. A., Craig, B. G., Dornan, J. C., Johnston, J., Patterson, C., Lynch, C., Mulholland, H. C., Watkins, D. C., Young, I., Cran, G., Boreham, C. A. G., McCallion, W. A., Clements, N. F., Stevenson, M. R., Macpherson, C., Jenkins, L., Thompson, A. J., Shields, M. D., Taylor, R. T., Kerr, R., Hughes, J. L., Stewart, M., Jackson, P., Fitzpatrick, C., Rasheed, M., Colhoun, E., Bailie, A. G., Gray, S., Brown, S., Curley, A., Sweet, D. G., MacMahon, K. J., OʼConnor, C. M., Nichelson, A., Lynch, N. E., Finch, D., Foley, M., Scallan, E., Dillon, B., Lyons, S., OʼLoughlin, R., Ward, M., Nally, R., Harkin, A., Kelly, J. P., Leonard, B. E., Magee, P., Connor, T. J., Shen, Y., McCullough, G. R., McDonough, S. M., Niocaill, Nic B., Cramp, A. F. L., Hynes, M., Corkery, P., Carey, M., McGarrigle, D., Higgins, S., Murray, H., Moran, C. J., Dennedy, M. C., Brosnan, J., Morris, L., Sheppard, B. L., Black, A., Wilkins, B., Folan-Curran, J., Skelton, K., Owens, M., Nemeroff, C., Houlihan, D., OʼKeeffe, C., Nolan, N., McCormick, P. A., Baird, A. W., Raducan, I., Corcoran, P., Brennan, R., Molloy, P., Friel, A., Maher, M., Glennon, M., Smith, T., Nolan, A., Houghton, J. A., Carroll, O., Colleran, S., OʼCuinn, G., Snow, H. M., OʼRegan, D., Markos, H. F., Pollock, K., Cannon, D. M., McBean, G., OʼRiordan, A., Quinlan, L. R., Kane, M. T., Higglns, B. D., Moriarty, D. M., Fitzgerald, D., Katkada, A., Canny, G., MacMathuna, P., OʼDonoghue, D., OʼDonovan, M. M., Schuur, A. G., Murphy, K. J., Foley, A. G., ten Bruggencate, S. J. M., and Ireland, L.

Published
2000
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24. A-187 Is Once Enough? First Trial Performance on the Free and Cued Selective Reminding Test in a Clinical Sample of Older Adults with Neurocognitive Disorders

Author

Mary K. Colvin, Gettens K, H Duncanson, Daly M, Chaudhry T, and J Sherman

Subjects
Cued speech, Psychiatry and Mental health, Clinical Psychology, medicine.medical_specialty, Neuropsychology and Physiological Psychology, business.industry, medicine, Sample (statistics), General Medicine, Audiology, business, Neurocognitive, Test (assessment)
Abstract

Objective There is urgent need for tools that quickly identify neurocognitive disorders (NCD). The Free and Cued Selective Reminding Test (FCSRT) has high sensitivity for detecting NCD severity (Mild vs. Major) and type (amnestic vs. non-amnestic). However, full administration of three learning trials makes it relatively lengthy. We examined whether first trial performance detects NCD type and severity. Method 187 patients (Mage = 74.7 ± 6.9, Medu = 16 ± 3.1; 58% male) were clinically evaluated. Diagnoses were Mild NCD—amnestic (N = 55), Mild NCD—non-amnestic (N = 67), Major NCD -amnestic (N = 23), and Major NCD –non-amnestic (N = 42). Free recall accuracy (FRA) [number freely recalled/16 *100] and cued recall accuracy (CRA) [(number of cues provided—number recalled with cues)/16 *100] were calculated for each of 3 learning trials. Results First trial performance predicted NCD severity (2 (2) = 7.84, p Conclusions Our results suggest that first trial FCSRT performance may be enough to screen for neurocognitive disorders. Findings identify free recall accuracy as a better predictor of type and cued recall accuracy a better predictor of NCD severity.

Published
2020
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25. Assessment of Infection Prevention and Control (IPC) Implementation and Strategies Used for IPC Preparedness at Facility Level in Underdeveloped Areas of Pakistan

Author

Tahir MA, Khan MA, Ikram A, Chaudhry TH, Jabeen A, Quddous A, and Haq IU

Subjects
infection prevention and control, ipcaf, healthcare facilities, healthcare associated infections, Infectious and parasitic diseases, RC109-216
Abstract

Majid Ali Tahir,1,2 Mumtaz Ali Khan,3 Aamer Ikram,3 Tamoor Hamid Chaudhry,4 Aliya Jabeen,3 Abdul Quddous,3 Ijaz Ul Haq2 1Health Education Officer, CDC, National Institutes of Health, Islamabad, Pakistan; 2Department of Public Health & Nutrition, University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan; 3Centers for Disease Control (CDC), National Institutes of Health, Islamabad, Pakistan; 4Public Health Laboratories Division, National Institutes of Health, Islamabad, PakistanCorrespondence: Majid Ali Tahir, CDC, National Institutes of Health, Islamabad, Pakistan, Email mmtahirmughal@hotmail.com; mm.tahir@nih.org.pkBackground: During outbreaks of infectious diseases like COVID-19, the healthcare-associated infections (HCAIs) pose a burden on public health system. There are very limited data about infection prevention and control (IPC) implementation in the healthcare facilities of Pakistan. The aim of the study was to conduct assessment with the IPC Assessment Framework (IPCAF) tool in healthcare facilities of the least developed areas.Methods: A cross-sectional survey was conducted in 12 tertiary level healthcare facilities (HCF) located in the least developed provinces of Pakistan. The facilities were selected through multistage cluster random methods. A well-structured questionnaire, the “IPCAF tool”, was used for data collection. The IPCAF comprises eight sections with a 100 score of each section, thus with a maximum score of 800. The scores from 0 to 800 of the HCFs were divided into four gradual ratings through IPCAF, ie from inadequate to advanced.Results: The median score of all facilities was 405, with a range from inadequate to advanced. One facility (8.3%) fell into the “inadequate” category with a score of 172.5; 5 (41.6%) facilities achieved “basic” category, another 5 (41.6%) being “intermediate”, and only one (8.3%) hospital achieved “advanced” status. Region-wise median score of facilities of GB was 307.5, facilities in AJK scored 342.5, and a score of 520 was found for health facilities in KPK. The components of Education and Training, HCAIs Surveillance, and Multimodal Strategies achieved the lowest scores.Conclusion: Most of the facilities have developed an IPC program with key focal persons and IPC committees, but did not have relevant education and training. IPC core capacities are being implemented. Equitable attention is required on all eight components of IPC in all facilities.Keywords: infection prevention and control, IPCAF, healthcare facilities, healthcare associated infections

Published
2023

26. Estimating the health and socioeconomic effects of cousin marriage in South Asia

Author

Mobarak, A.M., Chaudhry, T., Brown, J., Zelenska, T., Khan, M.N., Chaudry, S., Wajid, R.A., Bittles, A.H., Li, S., Mobarak, A.M., Chaudhry, T., Brown, J., Zelenska, T., Khan, M.N., Chaudry, S., Wajid, R.A., Bittles, A.H., and Li, S.

Abstract

The effects of marriage between biological relatives on the incidence of childhood genetic illness and mortality are of major policy significance, as rates of consanguinity exceed 50% in various countries. Empirical research on this question is complicated by the fact that consanguinity is often correlated with poverty and other unobserved characteristics of households, which may have independent effects on mortality. This study has developed an instrumental variables empirical strategy to re-examine this question, based on the concept that the availability of unmarried cousins of the opposite gender at the time of marriage creates quasi-random variation in the propensity to marry consanguineously. Using primary data collected in Bangladesh in 2006-07 and Pakistan in 2009-10, the study found that previous estimates of the impact of consanguinity on child health were biased and falsely precise. The study also empirically investigated the social and economic causes of consanguinity (including marital quality) and concludes that marrying a cousin can have positive economic effects for one's natal family, by allowing deferral of dowry payments until after marriage.

Published
2018

27. Distribution of mcr-1 Harboring Hypervirulent Klebsiella pneumoniae in Clinical Specimens and Lytic Activity of Bacteriophage KpnM Against Isolates

Author

Aslam B, Siddique MH, Siddique AB, Shafique M, Muzammil S, Khurshid M, Rasool MH, Ahmad M, Chaudhry TH, Amir A, Salman M, Baloch Z, Alturki NA, and Alzamami A

Subjects
bacteriophages, colistin, polymyxins, mdr, virulence, Infectious and parasitic diseases, RC109-216
Abstract

Bilal Aslam,1 Muhammad Hussnain Siddique,2 Abu Baker Siddique,1 Muhammad Shafique,1 Saima Muzammil,1 Mohsin Khurshid,1 Muhammad Hidayat Rasool,1 Moeed Ahmad,1 Tamoor Hamid Chaudhry,3 Afreenish Amir,3 Muhammad Salman,3 Zulqarnain Baloch,4 Norah A Alturki,5 Ahmad Alzamami6 1Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 2Department of Bioinformatics & Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan; 3Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan; 4Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, People’s Republic of China; 5Clinical Laboratory Science Department, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia; 6Clinical Laboratory Science Department, College of Applied Medical Science, Shaqra University, AlQuwayiyah, Saudi ArabiaCorrespondence: Bilal Aslam, Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan, Email drbilalaslam@gcuf.edu.pk Ahmad Alzamami, Clinical Laboratory Science Department, College of Applied Medical Science, Shaqra University, AlQuwayiyah, Saudi Arabia, Email aalzamami@su.edu.saBackground: The World Health Organization (WHO) has declared the multi-drug resistant (MDR) Klebsiella pneumoniae as one of the critical bacterial pathogens. The dearth of new antibiotics and inadequate therapeutic options necessitate finding alternative options. Bacteriophages are known as enemies of bacteria and are well-recognized to fight MDR pathogens.Methods: A total of 150 samples were collected from different clinical specimens through a convenient sampling technique. Isolation, identification, and antibiotic susceptibility testing (AST) of K. pneumoniae were done by standard and validated microbiological procedures. Molecular identification of virulence factors and antibiotic resistance genes (ARGs) was carried out through polymerase chain reaction (PCR) by using specific primers. For bacteriophage isolation, hospital sewage samples were processed for phage enrichment, purification, and further characterization ie, transmission electron microscopy (TEM) and stability testing, etc. followed by evaluation of the lytic potential of the phage.Results: Overall, a total of 41% of isolates of K. pneumoniae were observed as hypervirulent K. pneumoniae (hvKp). Among hvKp, a total of 12 (42%) were detected as MDR hvKp. A total of 37% of all MDR isolates were found resistant to colistin, and 66% of the colistin resistance isolates were recorded as mcr-1 positive. Isolated phage KpnM had shown lytic activity against 53 (79%) K. pneumoniae isolates. Remarkably, all 8 mcr-1 harboring MDR hvKp and non-hvKp isolates were susceptible to KpnM phage.Conclusion: Significant distribution of mcr-1 harboring hypervirulent Klebsiella pneumoniae was observed in clinical specimens, which is worrisome for the health system of the country. Characterized phage KpnM exhibited encouraging results and showed the lytic activity against the mcr-1 harboring hvKp isolates, which may be used as a prospective alternative control strategy to fight this ominous bacterium.Keywords: Klebsiella pneumoniae, bacteriophages, colistin, MDR, virulence

Published
2022

30. Genetic causes of moderate to severe hearing loss point to modifiers

Author

Naz, S., primary, Imtiaz, A., additional, Mujtaba, G., additional, Maqsood, A., additional, Bashir, R., additional, Bukhari, I., additional, Khan, M.R., additional, Ramzan, M., additional, Fatima, A., additional, Rehman, A.U., additional, Iqbal, M., additional, Chaudhry, T., additional, Lund, M., additional, Brewer, C.C., additional, Morell, R.J., additional, and Friedman, T.B., additional

Published
2016
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31. Genetic causes of moderate to severe hearing loss point to modifiers.

Author

Naz, S., Imtiaz, A., Mujtaba, G., Maqsood, A., Bashir, R., Bukhari, I., Khan, M.R., Ramzan, M., Fatima, A., Rehman, A.U., Iqbal, M., Chaudhry, T., Lund, M., Brewer, C.C., Morell, R.J., and Friedman, T.B.

Subjects
HEARING disorders, HOMOZYGOSITY, USHER'S syndrome, OTOSCOPY, DNA analysis
Abstract

The genetic underpinnings of recessively inherited moderate to severe sensorineural hearing loss are not well understood, despite its higher prevalence in comparison to profound deafness. We recruited 92 consanguineous families segregating stable or progressive, recessively inherited moderate or severe hearing loss. We utilized homozygosity mapping, Sanger sequencing, targeted capture of known deafness genes with massively parallel sequencing and whole exome sequencing to identify the molecular basis of hearing loss in these families. Variants of the known deafness genes were found in 69% of the participating families with the SLC26A4, GJB2, MYO15A, TMC1, TMPRSS3, OTOF, MYO7A and CLDN14 genes together accounting for hearing loss in 54% of the families. We identified 20 reported and 21 novel variants in 21 known deafness genes; 16 of the 20 reported variants, previously associated with stable, profound deafness were associated with moderate to severe or progressive hearing loss in our families. These data point to a prominent role for genetic background, environmental factors or both as modifiers of human hearing loss severity. [ABSTRACT FROM AUTHOR]

Published
2017
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34. Emergence of blaNDM-1 Harboring Klebsiella pneumoniae ST29 and ST11 in Veterinary Settings and Waste of Pakistan

Author

Chaudhry TH, Aslam B, Arshad MI, Alvi RF, Muzammil S, Yasmeen N, Aslam MA, Khurshid M, Rasool MH, and Baloch Z

Subjects
veterinary settings, carbapenem resistance, klebsiella pneumoniae, pakistan, Infectious and parasitic diseases, RC109-216
Abstract

Tamoor Hamid Chaudhry,1,2 Bilal Aslam,1,2 Muhammad Imran Arshad,3 Roman Farooq Alvi,2 Saima Muzammil,2 Nafeesa Yasmeen,4 Muhammad Aamir Aslam,3 Mohsin Khurshid,2 Muhammad Hidayat Rasool,2 Zulqarnain Baloch1 1Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, People’s Republic of China; 2Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 3Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad, Pakistan; 4College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, People’s Republic of ChinaCorrespondence: Bilal Aslam; Zulqarnain Baloch Email drbilalaslam@gcuf.edu.pk; znbalooch@yahoo.comIntroduction: Intense livestock farming practices enforcing the farmers to use antibiotics as food supplements on a routine basis. Aberrant use of antibiotics is associated with the emergence of antibiotics resistance and resistant superbugs. Keeping in view the current scenario, the present study was designed for the first time from Pakistan with a specific aim to estimate the prevalence of the carbapenem-resistant Klebsiella pneumoniae in veterinary settings and the waste in Pakistan.Methods: A total of 138 samples from various veterinary sources were collected by employing a nonprobability sampling technique. Isolation and phenotypic identification of carbapenem-resistant K. pneumoniae were performed according to the CLSI standard. Molecular detection of various antibiotic resistance genes (ARGs) was done through PCR by using specific primers against each ARG. According to the pasture scheme, the multilocus sequence typing (MLST) was performed to characterize the K. pneumoniae sequence types (STs).Results: According to the results of the study, overall 9.4% (13/138) isolates were confirmed carbapenem-resistant K. pneumoniae. Among various carbapenem ARGs particularly, the blaNDM-1 was found in 92.3% (12/13) isolates followed by blaOXA-48 84.6% (11/13). MLST results revealed that overall 3 STs were found in the study which includes ST29, ST11, and ST258. Taking together, this is the first study to our best knowledge which demonstrated the prevalence of carbapenem-resistant K. pneumoniae and its various STs prevalent in veterinary settings and the waste of Pakistan.Conclusion: Based on the above-mentioned facts, we suggested that veterinary settings and waste are the potential source and reservoir of carbapenem-resistant K. pneumoniae, which may be disseminated to the environment and ultimately can affect the public and companion livestock health.Keywords: veterinary settings, carbapenem resistance, Klebsiella pneumoniae, Pakistan

Published
2020

36. Selected abstracts

Author

Corkery, P. P., Leek, B. F., Caulfield, B., Garrett, M., Gormley, J. P., O’Donnell, P. M., Kennedy, N., Sayers, K., Stokes, E., Bresnihan, B., Fitzgerald, O., McGarvey, M. A., Tonra, M., Hooper, A. C. B., Barry, J., Maurer, B., Hussey, J., Gormley, J., Noble, J. G., Alves-Guerreiro, J., Lowe, A. S., Walsh, D. M., NicNiocaill, B., Harte, M., O’Connor, W. T., O’Hara, A. M., Orren, A., Moran, A. P., Hardiman, D. A., Lee, T. C., Croke, D. T., Tolan, R., McBennett, S., Warmington, S., McGuire, M., Bradford, A., O’Hare, T., MacDermott, M., Lynch, F., O’Regan, R. G., McLoughlin, P., Quinn, T., Ryan, J. P., Pickering, M., Campion, D. P., Jones, J. F. X., Ryan, S., McNicholas, W. T., Nolan, P., Doyle, F. J., Rackard, S. M., Beddy, P., Campbell, V. A., Bakhle, Y. S., Bell, C., Usher, C., Chan, L., Keenan, A. K., McQuaid, K. E., Cullen, V. C., Smith, E. M., Kelly, A., Lynch, M. A., Freir, D. B., Holscher, C., Herron, C. E., Pearson, H. A., Curran, B. P., O’Connor, J. J., Quinn, A., McHale, J., Moriarty, D., O’Connor, J., Glennon, J. C., Van Vliet, B. J., Long, S. K., Kruse, C., Gallagher, H. C., Bacon, C. L., Boland, B., Griffin, A. M., Preisler, J., O’Brien, L., Regan, C. M., Hurley, S., Kearney, P. J., Slevin, J., Barry-Kinsella, C., Ryan, C. A., Kllleen, O., Glllan, J., Clarke, T., Matthews, T., Corcoran, D., Dunn, E., Geary, M., O’Herlihy, C., Keane, D., Slattery, M. M., O’Leary, M. J., Morrison, J. J., Ryan, E., Gorman, W. A., Bourke, A., Larkin, J., Mayes, C., Jenkins, J., Ryan, M., Lalchandani, S., Sheil, O., Lynch, N., Costigan, C., Murphy, J. F., Bhatia, R., Foran, A., Donohue, V., McParland, P., LaSjaunais, P., Rodesch, G., McGinn, M., McAloon, J., O’Leary, M., Astbury, K., Harmon, D., Sharkey, A., Gaffney, G., O’Regan, G., McMahon, C., Murray, D., McDermott, C., Woolhead, E., Gillan, J., Cartmill, J. L., Harper, M. A., Al-Shabibi, N., Hanahoe, M., Wingfield, M., Larkin, J. A. M., Bell, A. H., McClure, B. G., Sweeney, L., Martin, D. H., O’Donoghue, P., Davoren, A., Lucas, G. F., McKiernan, J., Gallagher, D. M. T., Dunne, K. P., Fulena, O., Sheridan, M., Griffin, E., White, M., Deasy, P., O’Riordan, M., O’Gorman, C., Mongan, C., McCafferkey, M., Henry, G., McKenna, P., O’Malley, A., Devaney, D., Kelleghan, P., Mooney, E. E., Gillan, J. E., Fitzpatrick, M., McQuillan, K., Heffron, C., Hodnett, P., Curtain, A., O’Connor, T. C. F., Connell, T. G., Waldron, D., Gorman, W., Bolger, T., O’Keefe, M., Murphy, J., Dolan, L. M., Traub, A. I., Slattery, M. M., O’Leary, M. J., Curley, A. E., Halliday, H. L., Tubman, T. R. J., Kileen, O., Riadha, H., Russell, J., Philips, R., Regan, C., Ali, I., Coughlan, A. C. J., Turner, M. J., Smith, A., O’Flanagan, D., Igoe, D., Ryan, F., Forde, D., McArdle, E., Ko, D., Bedford, D., Hegarty, M., Dunlevy, B., Corcoran, R., Holohan, T., Feeney, A., McGee, H., Shannon, W., Condon, M., Hyland, C., Sayers, G., Feely, E., Crowley, D., O’Reilly, D., O’Connell, T., Cronin, M., Johnson, H., Fitzgeraldi, M., Cafferkey, M., Breslin, A., Bonner, C. J., Foley, B., Fitzgerald, M., Wall, P. G., McNamara, E., Costigan, P., Prendergast, T., Foye, K., Cosgrove, C., Keane, A., Murphy, E., O’Donnell, J., Quinlan, A., Thornton, L., Roch, E. A., Lyons, R. A., Maddocks, A., Barnes, P., Price, L., McCabe, M., Nash, P., Midha, A., Doyle, Y., Kilgallen, A., Wright, P., Ryan, T., De La Harpe, D., Harkins, V., Brennan, C., O’Connell, V., Evans, D. S., Ni Mhuircheartaigh, J., O’Donnell, J. M., Rhatigan, A., Shelley, E., Collins, C., Byrne, M., Murphy, A. W., Plunkett, P. K., Murray, A., Bury, G., Lynam, F., McMahon, G., Greally, T., Kane, D., Veale, D., Reece, R., Busteed, S., Bennett, M. W., Stone, M., Molloy, C., O’Connell, J., Molloy, M. G., Shanahan, F., Guerin, J., Casey, E., Feighery, C., Lin, F., Jackson, J., Pendleton, A., Wright, G. D., Hughes, A. E., O’Gradaigh, D., Debham, I., Compston, J., McEvoy, A., Murphy, E. P., Salonen, D., Payne, P., Lax, M., Lapp, V., Inman, R., O’Rourke, K., Brennan, D., Harty, J., McCarthy, C., O’Byrne, J., Eustace, S., Chirayath, H., Liggett, N. W., Morgan, M. P., Fitzgerald, D. J., McCarthy, C. J., McCarthy, G. M., Lee, R. Z., Wai, K., Nevin, D., Leary, A. O., Lee, R., Leary, A. O., Casey, E. B., Leary, A. O., O’Leary, A., Breen, D., Tuite, D., McInerney, D., Sim, R., Frederic, A. L., Smith, O., White, B., Murphy, M., Silke, C., O’Keeffe, E., Fanning, N., Spence, L., Parfrey, N. A., McConnell, J. R., Crockard, A. D., Cairns, A. P., Bell, A. L., Kavanagh, O., Moyes, D. A., Finch, M., Rooney, M., Bell, A., Founas, I., El-Magbri, A., Mooney, S., Kennedy, M., Coughlan, R. J., Ramakrishnan, S. A., Gsel, A., Finnerty, O., Burns, M., Yateman, M., Camaco-Hubner, C., Matthews, C. F., Taggart, A., Fuller, K., Murphy, M. S., Phelan, M., Murphy, T. B., Wynne, F., Quane, K., Daly, M., O’Leary, J., da Silva, I., Bermingham, N., Gogarty, M., Gallagher, L. P., O’Hara, R., Godson, C., Brady, H., Osman, H., El-Rafie, A., Foley-Nolan, D., Kirwan, P., Corcoran, O., Duffy, T., Drummond, F., Madigan, A., Williams, D., Gallagher, P., Hatton, C., Cunningham, S., FitzGerald, O., Minnock, P., Wylie, E., Egan, D., Mc Cormack, J., Shea, M. O., Evans, D., O’Lorcain, P., Comber, H., Evans, A., Jones, J., Garavan, C., Kelleher, K., Boland, M. C., Healy, R., O’Sullivan, M. B., Burke, M., Mc Donald, P., Smithson, R., Glass, J., Mason, C. A., Mullins, N., Nolan, D., McCormick, P., Coughlan, S., Dooley, S., Kelleher, C. C., Hope, A., Murphy, F., Barry, M., Sixsmith, J., MacFarlane, A., MacLeod, C., McElroy, G., O’Loan, D., Kennedy, F., Kerr, R. M., Lim, J., Allwright, S. P. A., Bradley, F. L., Barry, J. M. G., Long, J., Parry, J. V., Creagh, D., Perry, I. J., Collins, A., Neilson, S., Colwell, N., O’Halloran, D., O’Neill, S., McErlain, S., Okasha, M., Gaffney, B., McCarron, P., Hinchion, R., Drew, C., Gavin, A., Fitzpatrick, D., Campbell, R., Wannamethee, S. G., Shaper, A., Friel, S., Kelleher, C., Kee, F., Atterson, C. C., Wilson, E. A., McConnell, J. M., Wheeler, S. M., Watson, J. D., Norashikin Rahman, N., Sheehan, J., Wall, C., Kelleher, B., O’Broin, S. D., Mullan, R. N., McKeveney, P. J., Hodges, V. M., Winter, P. C., Maxwell, P., Simpson, D. A., Lappin, T. R. J., Maxwell, A. P., Eustace, J. A., Coresh, J., Kutchey, C., Te, P. L., Gimenez, L. F., Scheel, P. J., Walser, M., McMahon, R. A., Clarkson, M., Martin, F., Brady, H. R., Blake, C., O’Meara, Y. M., Gupta, S., MacKenzie, H., Doyle, S., Fotheringham, T., Haslam, P., Logan, M. P., Conlon, P., Lee, M., Maderna, P., Cottell, D. C., Mitchell, S., Gulmann, C., Østerby, R., Bangstad, H. J., Rljdberg, S., Dempsey, M., Nathwani, S., Ryan, M. P., McMahon, B., Stenson, C., Murtagh, H., Brown, J. H., Doran, P., McGinty, A., Little, M. A., O’Brien, E., Owens, P., Holian, J., Mee, F., Walshe, J. J., Omer, S. A., Power, D., Diamond, P., Watson, R. W., Shahsafei, A., Jiang, T., Brenner, B. M., Mackenzie, H. S., Neary, J., Dorman, A., Keoghan, M., Campbell, E., Walshe, J., Little, M., Nee, L., O’Ceallaigh, C., McGlynn, H., Bergin, E., Garrett, P. J., Keane, T., Gormley, G., Watson, A., Atta, M. G., Perl, T. M., Song, X., Healy, E., Leonard, M., Lynch, J., Watson, A. J., Lappin, D., Lappin, D. W. P., Hannan, K., Burne, M., Daniels, F., Rabb, H., McBride, B., Kieran, N., Shortt, C., Codd, M., Murray, F., McCormack, A., Brown, C., Wong, C., Dorman, A. M., Keogan, M., Donohue, J., Farrell, J., Donohoe, J., O’Broin, S., Balfe, A., Mellotte, G. J., Abraham, K. A., McGorrian, C., Wood, A. E., Neligan, M., Kelly, B. D., Finnegan, P., Cormican, M., Callaghan, J., Crean, J. K. G., Moffitt, T. A., Devlin, H. L., Garrett, P. J., Soosay, A., O’Neill, D., Counihan, A., Hickey, D., Keogan, M. T., Harvey, K., O’Riordan, E., Waldek, S., Kalra, P. A., O’Donoghue, D. J., Foley, R. N., O’Riordan, A., Kelliher, D., Mellotte, G., Giblin, L., Keogh, J. A. B., O’Connell, M., O’Meara, A., Breatnach, F., Gillick, J., Tazawa, H., Puri, P., Molloy, E., O’Neill, A. J., Sheridan-Pereira, M., Fitzpatrick, J. M., Webb, D. W., Watson, R. W. G., Linnane, B., O’Donnell, C., Clarke, T. A., Martin, C., McKay, M., McBrien, J., Glynn, F., O’Donovan, C., Hall, W. W., Smith, J., Khair, K., Liesner, R., Hann, I. M., Smith, O. P., Gallagher, S., Mahony, M. J., Hilal, A., Cosgrove, J. F., Monaghan, C., Craig, B., Al-Hassan, A., Walsh, K., Duff, D., Slizlok, P. O., Halahakoon, C., MacPherson, C., McMillan, S., Dalzell, E. E., McCaughan, J., Redmond, A. O. B., DeCaluwe, D., Yoneda, A., Akl, U., Dempsey, E., Farrell, M., Webb, D., Elabbas, A., Fox, G., Gormally, S., Grant, B., Corkey, C. W. B., Nicholson, A., Murphy, A., O’Grady, P., Barry, O., Macpherson, C., Stewart, M. C., Alderdice, F., Matthews, T. G., McDonnell, M., McGarvey, C., O’Regan, M., Ní Chróinín, M., Tormey, P., Ennis, S., Green, A. J., Abbas, S., O’Marcaigh, A., Conran, M., Crushell, E., Saidi, A., Curran, P., Donoghue, V., King, M. D., Elnazir, B., Leonard, J., Kavanagh, C., Brown, D., Corrigan, N., McCord, B., Quinn, M., O’Connell, L., Mcdonagh, B., Awan, A., Gill, D., Kakkar, R., Sweet, D. G., Warner, J. A., O’Connor, C., Herzig, M., Twomey, A., White, M. J., Sweeney, B., Surana, R., Hodgson, A., Rafferty, M., Livingstone, W., Peake, D., Wassemer, E., Whitehouse, W., Abdullah, N., Al-Hassan, A., Oslizlok, P., O’Connell, N., Balding, J., Livingstone, W. J., Healy, M., Mynett-Johnson, L., McAllister, I., Dick, A. C., Herron, B., Boston, V. E., Callaghan, C. O., Brien, D. O., Walsh, A., Philip, M., McShane, D., Hoey, M. C. V., Sharif, F., McDermott, M., Dillon, M., Drumm, B., Rowland, M., Imrie, C., Kelleher, S., Bourke, B., Iqbal, M., Ziedan, Y., O’Neill, M., O’Riordan, S., Basheer, S. M. B., O’Callaghan, S., Chong, A., Kelly, M., Nicholson, A. J., Cooke, R., Sreenan, C., Fallon, M., Denham, B., Dowding, V., Cussen, G., McManus, V., Hensey, O., Monaghan, H., Basheer, S. N., Quinn, E., Hoey, H. M. C. V., Mohamed, S., Ramesh, R. R., Mayne, P., Tracy, E., Gormally, S. M., Curtis, E., McCallion, N., Watson, R., O’Mahony, O., Keegan, M., Ward, K., Barton, D., Poulton, J., Treacy, E., Honour, J., deCaluwe, D., Ni Chróinín, M., Cosgrove, J., Chaudhry, T. S., Long, N. M., Lynch, B., Lasjaunais, P., McDonald, D. G. M., McMenamin, J. B., Farrell, M. J., Roche, E. F., Menon, A., Buckley, C., Mackey, A., Ohlandieck, K., Das, A., Reilly, D., Killeen, O., Harper, J., Roche, E., Hoey, H., Caird, J., O’Brien, D., Allcutt, D., Farrington, N., Murphy, J. F. A., Savage, J. M., Sands, A. J., Casey, F. A., Craig, B. G., Dornan, J. C., Johnston, J., Patterson, C., Lynch, C., Mulholland, H. C., Watkins, D. C., Young, I., Cran, G., Boreham, C. A. G., McCallion, W. A., Clements, N. F., Stevenson, M. R., Macpherson, C., O’Donoghue, D., Jenkins, L., Thompson, A. J., Shields, M. D., Taylor, R. T., Kerr, R., Hughes, J. L., Stewart, M., Jackson, P., Fitzpatrick, C., Rasheed, M., Colhoun, E., Bailie, A. G., Gray, S., Brown, S., Curley, A., Sweet, D. G., MacMahon, K. J., O’Connor, C. M., Nichelson, A., Lynch, N. E., Finch, D., Foley, M., Scallan, E., Dillon, B., Lyons, S., O’Loughlin, R., Ward, M., Nally, R., Harkin, A., Kelly, J. P., Leonard, B. E., Nic Niocaill, B., Magee, P., Connor, T. J., Shen, Y., McCullough, G. R., McDonough, S. M., Nic Niocaill, B., Cramp, A. F. L., Hynes, M., Corkery, P., Carey, M., McGarrigle, D., Higgins, S., Murray, H., Moran, C. J., Dennedy, M. C., Brosnan, J., Morris, L., Sheppard, B. L., Black, A., Wilkins, B., Folan-Curran, J., Skelton, K., Owens, M., Nemeroff, C., Houlihan, D., O’Keeffe, C., Nolan, N., McCormick, P. A., Baird, A. W., Raducan, I., Corcoran, P., Brennan, R., Molloy, P., Friel, A., Maher, M., Glennon, M., Smith, T., Nolan, A., Houghton, J. A., Carroll, O., Colleran, S., O’Cuinn, G., Snow, H. M., O’Regan, D., Markos, H. F., Pollock, K., Cannon, D. M., McBean, G., O’Riordan, A., Quinlan, L. R., Kane, M. T., Higglns, B. D., Moriarty, D. M., Fitzgerald, D., Katkada, A., Canny, G., MacMathuna, P., O’Donoghue, D., O’Donovan, M. M., Schuur, A. G., Murphy, K. J., Foley, A. G., ten Bruggencate, S. J. M., and Ireland, L.

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43. Use of artificial eye and conjunctival squamous cell carcinoma.

Author

Chaudhry, T. A., Memon, M., and Ahmad, K.

Subjects
*LETTERS to the editor, *SQUAMOUS cell carcinoma
Abstract

A letter to the editor focusing on the use of artificial eye and conjunctival squamous cell carcinoma is presented.

Published
2006

44. Knowledge of patients’ visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan

Author

Tauqir Mohammad Zain, Chaudhry Tanveer Anjum, Mumtaz Sehreen, and Ahmad Khabir

Subjects
Ophthalmology, RE1-994
Abstract

Abstract Background Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. Methods This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were calculated to describe the data. Results A total of 150 ophthalmologists, residents and medical officers were invited to participate in the study. Of these, 68 (45.3%) responded. The mean age (±SD) of the participants was 42.9 (13.2) years. The proportion of participants who thought that patients could experience visual sensations during cataract surgery under regional anaesthesia was 89.7% and that under topical anaesthesia was 73.5%. The most frequently cited sensations included: light perception, changes in light brightness, movements, instruments and surgeon’s hands or fingers. The eye doctors estimated that 38.9% and 64.3% patients would see at least something during cataract surgery under regional anaesthesia and topical anaesthesia, respectively. They also believed that 24.2%-36.9% of patients may experience anxiety/fear as a result of visual sensations during such surgery. Approximately half of the eye doctors did not think that retained vision was a source of fear or anxiety for the patients. While most of them acknowledged the importance of preoperative counselling in helping to alleviate such fear/anxiety, the majority of them did not regularly counsel their patients on what to expect during the surgery. Conclusion Our study reveals that a significant proportion of eye doctors do not have adequate knowledge of the visual phenomenon and their associated anxiety or fear, that patients can experience during cataract surgery. Targeted educational interventions are needed to increase awareness of this phenomenon among eye care professionals.

Published
2012
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45. Perceptions of eye health in schools in Pakistan

Author

Qureshi Mohammad, Khan Mohammad, Ahmad Khabir, Chaudhry Tanveer, and Gilbert Clare

Subjects
Ophthalmology, RE1-994
Abstract

Abstract Background Research exploring children's and their teachers' perceptions of eye health is lacking. This paper reports for the first time on perceptions of primary schoolchildren and their teachers of healthy and diseased eyes, things that keep eyes healthy and damage them, and what actions to be taken in case of an eye injury. Methods Using draw and write technique, 160 boys and girls (9–12 years old) attending four primary schools in Abbottabad district, northern Pakistan, were invited to draw pictures in response to a set of semi-structured questions and then label them. Sixteen teachers who were currently teaching the selected students were interviewed one-on-one. Results Analysis of text accompanying 800 drawings and of the interview scripts revealed that most children and teachers perceived healthy eyes to be those which could see well, and diseased eyes to be those which have redness, watering, dirty discharge, pain, and itching; or those which have "weak eyesight" and blindness. Among things that students and teachers thought damage the eyes included sun, television, and sharp pointed objects, particularly pencils. Teachers noted that children with eye problems "have difficulty seeing the blackboard well", "screw up their eyes", and "hold their books too close". Conclusion We conclude that schoolchildren and their teachers had a good knowledge of eye health, but many of them had serious misconceptions e.g., use of kohl, medicines and eye drops keeps eyes healthy. Kohl is an important source of lead and can reduce children's intelligence even at low blood levels. Health education in schools must take into account children's existing knowledge of and misconceptions about various aspects of eye health. Such steps if taken could improve the relevance of eye health education to schoolchildren.

Published
2006
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47. Physical, chemical and biological characterisation of a steelworks waste site at Port Kembla, NSW, Australia

Author

Hill, L., Fernandez, R., Chaudhry, T. M., Gallardo, P., Hayes, W. J., Khan, A. G., and Khoo, C. S.

Subjects
SOIL pollution, SOILS, TRACE metals
Abstract

Large spoils of metal-rich filtercake from the Port Kembla BHP steelworks were characterised by certain physical, chemical and biologicalparameters. The vegetation was assessed for potential metal hyperaccumulators and the presence of arbuscular mycorrhizae in the rhizospheres. Fresh filtercake (<2 yr old) was charcoal in colour and had a fine (clay loam) texture. Its composition was distinctly different to the older filtercake (3--4 yr) which was similar to the reference soil, being lighter in colour, loamy textured, more aggregated and with higher organic matter. Variability between the two filtercake types also occurred for electrical conductivity and pH. Total trace metal concentrations (Cd, Cu, Pb and Zn) were high and although only minor proportions were in bioavailable forms, the greater percentages in the older filtercake suggested temporal changes in metal speciation. Freshfiltercake was devoid of any plant life and fungal communities. The older material, however, was able to sustain a reasonable environmentfor plant, bacterial and fungal growth. The vegetation was dominatedby Ricinus communis, along with species belonging to the families Asteraceae, Solanaceae, Malvaceae and Apiaceae. Rhizosphere of all these plants harboured mycorrhizae belonging to the Gigaspora and Glomus strains and while trace metal accumulation was observed no plant was a hyperaccumulator. The reference site was principally inhabited by certain Poaceae, Asteraceae and Verbenaceae species. All were mycorrhizal (principally Glomus strains), but no plant was represented on thecontaminated site. Here also trace metal accumulation was taking place. The absence of hyperaccumulation in the filtercake was considereda consequence of low levels of bioavailable trace metals. However, as such metal forms may increase over time, particularly for copper and lead, cultivation of known hyperaccumulators could become worthwhile after prolonged exposure (>4 yr). Among the naturally colonising plants, [ABSTRACT FROM AUTHOR]

Published
1998

48. The Taliban's grip.

Author

Jennings, John, Chaudhry, T. S., and Deva, Siddharth

Subjects
*LETTERS to the editor, *PASHTUNS
Abstract

Presents several letters to the editor on Taliban, an Islamic fundamentalist organization in Afghanistan. Impact of the Taliban government on the Pathan minority in Pakistan; Explanation for Pakistan's support to the Taliban; Agreement of India with Turkmenistan for the construction of a railway line.

Published
1996

49. Oral drug challenges in non-steroidal anti-inflammatory drug-induced urticaria, angioedema and anaphylaxis

Author

Chaudhry, T, Hissaria, P, Wiese, M, Heddle, R, Kette, F, and Smith, WB

Subjects
musculoskeletal diseases, urticaria, angioedema, anaphylaxis, challenge, skin and connective tissue diseases, allergy, digestive system, digestive system diseases, NSAID
Abstract

Background: Urticaria, angioedema and anaphylaxis are common adverse reactions to non-steroidal anti-inflammatory drugs (NSAIDs). Aim: To investigate the clinical characteristics of NSAID-induced acute hypersensitivity reactions with structured oral drug challenges. Methods: Patients with NSAID-induced urticaria, angioedema or anaphylaxis were challenged with either the homologous NSAID to confirm diagnosis or a heterologous NSAID to investigate cross-reactivity. Data were analysed retrospectively and supplemented by a telephone questionnaire. Results: Sixty-eight patients (mean age 48.3, 53 females) reported a total of 75 instances of NSAID-induced reactions of which 64% were purely cutaneous and 36% were systemic anaphylaxis. Ibuprofen was the most frequent cause of reactions (35%), however, diclofenac was the most frequent cause of anaphylaxis (48%). Seventeen out of 40 (43%) homologous NSAID challenges were positive; presentation with anaphylaxis or reaction to diclofenac predicted a positive challenge. Only 7 of 28 (25%) of heterologous NSAID challenges were positive. Structured challenges enabled us to identify 23 (34%) patients with selective reactivity to a single NSAID, 19 (28%) patients with cross-reactivity to multiple NSAIDs and 23 (34%) patients in whom NSAID hypersensitivity was not reproduced. Selective reactors presented most often with anaphylaxis and some had a background of beta-lactam antibiotic allergy. Cross-reactive patients often had a background of chronic urticaria and presented with milder reactions. Conclusion: In the absence of a reliable in vitro test, structured drug challenges allow identification of selective and cross-reactive NSAID hypersensitivity syndromes. NSAIDinduced anaphylaxis is often associated with selective hypersensitivity and patients may not need to avoid other NSAIDs. Refereed/Peer-reviewed

Published
2012

50. The Clinical Outcomes of Spinal Accessory to Suprascapular Nerve Transfer Through a Posterior Approach.

Author

Jimulia DT, Duraku LS, Parekh JN, George S, Chaudhry T, and Power DM

Subjects
Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Rotator Cuff surgery, Rotator Cuff innervation, Brachial Plexus surgery, Brachial Plexus injuries, Brachial Plexus Neuropathies surgery, Treatment Outcome, Young Adult, Nerve Transfer methods, Accessory Nerve surgery, Range of Motion, Articular physiology
Abstract

Background: Spinal accessory nerve (SAN) to suprascapular nerve (SSN) transfer can restore function to the rotator cuff following brachial plexus injuries. The traditional anterior approach using the lateral branch of the SAN causes denervation of the lateral trapezius limiting shoulder elevation. Suprascapular nerve pathology at the suprascapular notch may be missed resulting in poor reinnervation of the rotator cuff. The posterior approach uses the medial SAN and allows decompression and visualization of the SSN at the notch and nerve transfer coaptation closer to the target muscles with a shorter reinnervation distance., Methods: This is a review of 28 patients from 2014 to February 2020 who underwent SAN to SSN nerve transfer via a posterior approach. Patients were evaluated for SSN pathology, external rotation power, and range of motion. Data were evaluated for high-energy trauma (HET) and low-energy trauma/nontraumatic etiology subsets., Results: A total of 8 HET (40%) patients had pathology identified at the suprascapular notch during the posterior approach, including SSN scarring, ruptures, neuromata-in-continuity, and ossification of ligaments. British Medical Research Council grade greater than or equal to 4 shoulder external rotation was achieved in 75% patients with median range of motion 137.5°., Conclusions: Spinal accessory nerve to SSN transfer using a posterior approach allows visualization of pathology involving the SSN and coaptation of a medial SAN transfer close to the target muscles. Following HET, 8 cases (40%) had posterior pathology identified. Spinal accessory nerve to SSN transfer through a posterior approach shows improved external rotation power and range of motion., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2025
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