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1. Therapeutic safety and efficacy of triple-immunosuppressants versus dual-immunosuppressants in severe-to-critical COVID-19: a prospective cohort study in Bangladesh

Author: Md Jahidul Hasan, Raihan Rabbani, Ahmad Mursel Anam, and Shihan Mahmud Redwanul Huq
Subjects: COVID-19, cytokine storm, immunosuppressant, baricitinib, tocilizumab, secukinumab, Medicine
Abstract: Background Hyperinflammation-induced respiratory failure is a leading cause of mortality in COVID-19 infection. Immunosuppressants such as, Baricitinib and interleukin inhibitors are the drug-of-choice to suppress cytokine storm in COVID-19. Here, we compared the therapeutic safety and efficacy of triple-immunosuppressants with dual-immunosuppressants in patients with severe-to-critical COVID-19.Methods This study was conducted on 103 confirmed COVID-19 patients. Of 103 patients, 49 (N) and 54 (N) patients received dual-immunosuppressants (baricitinib plus two doses of secukinumab) and triple immunosuppressants (baricitinib plus single dose of tocilizumab and secukinumab) in group A and group B, respectively. Groups were compared in terms of clinical outcome, critical support-requirement, survival, re-hospitalisation, and adverse events (AEs).Results Patients in group B achieved normal blood oxygen saturation level (SpO2) earlier than the patients of group A [4 day (IQR: 3–12) vs 5 day (IQR: 5–14), p .05]. The 60-day re-hospitalisation rate was two-fold high in group A than group B (p = .024). Immunosuppressant-associated adverse events and secondary bacterial/fungal infections were relative high in patients of group B.Conclusions Triple-immunosuppressants in severe-to-critical COVID-19 infection exhibited better clinical outcome; reduced ICU and MV requirement; shorter hospital stay with deceased 60-day all cause mortality and re-hospitalisation compared to dual-immunosuppressants.
Published: 2022
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2. Impact of high dose of baricitinib in severe COVID-19 pneumonia: a prospective cohort study in Bangladesh

Author: Md. Jahidul Hasan, Raihan Rabbani, Ahmad Mursel Anam, Shihan Mahmud Redwanul Huq, Mohammad Mufizul Islam Polash, Shahzadi Sayeeda Tun Nessa, and Sitesh C. Bachar
Subjects: Baricitinib, Severe COVID-19 pneumonia, Cytokine storm, High dose, Usual dose, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Purpose Hyperinflammation in severe COVID-19 infection increases the risk of respiratory failure and one of the cogent reasons of mortality associated with COVID-19. Baricitinib, a janus kinases inhibitor, can potentially suppress inflammatory cascades in severe COVID-19 pneumonia. Methods The objective of this study was to compare the clinical outcomes of high dose of baricitinib with its usual dose in patients with severe COVID-19 pneumonia. This prospective cohort study was conducted on 238 adult patients with severe COVID-19 pneumonia. Eight milligram and 4 mg of baricitinib was given orally to 122 patients in the high dose (HD) group and 116 patients the usual dose (UD) group, respectively daily for 14 days, and clinical outcomes were compared among the groups. Results Blood oxygen saturation level was stabilized (≥94% on room air) earlier in the HD group compared to the UD group [5 (IQR: 4–5)/8 (IQR: 6–9), P 0.05; N = 116/122, respectively]. The 30-day mortality and 60-day rehospitalization rate were higher in the UD group than the HD group [6%/3.3%, P 0.05; N = 116/122, respectively]. Conclusion The daily high dose of baricitinib in severe COVID-19 results in early stabilization of the respiratory functions, declined requirements of critical care supports, reduced rehospitalization with mortality rate compared to its daily usual dose.
Published: 2021
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3. Impact of three consecutive intravenous doses of tocilizumab in severe COVID-19 pneumonia: a retrospective cohort study

Author: Raihan Rabbani, Md Jahidul Hasan, Ahmad Mursel Anam, and Shihan Mahmud Redwanul Huq
Subjects: severe COVID-19 pneumonia, tocilizumab, third dose, IL-6 inhibitor, cytokine storm, ARDS, Infectious and parasitic diseases, RC109-216
Abstract: Background. Acute respiratory distress syndrome (ARDS) in severe COVID-19 pneumonia is mostly responsible for high mortality rate. Tocilizumab, an interleukin-6 (IL-6) inhibitors, down-regulates the progression of cytokine storm leading to ARDS. Objectives. The study aimed to assess the clinical outcomes of three consecutive intravenous doses of tocilizumab in patients with severe COVID-19 pneumonia. Methods. This retrospective observational study was conducted on severe COVID-19 pneumonia patients in a single-center who were treated with three intravenous dose of tocilizumab (8 mg/Kg of body weight, max 800 mg per dose × 3) along with intravenous dexamethasone. Three doses of tocilizumab-associated changes in respiratory function, clinical outcomes and mortality rate were analyzed. Results. Seventy-four patients (N) received intravenous tocilizumab therapy. After third intravenous dose of tocilizumab (48-72 h apart from the second dose), SpO2 (blood oxygen saturation) was increased and the requirement of supplemental oxygen (RSO) was decreased more than after the second dose [Median: 96.5% (IQR: 96-98%) and Median: 0 (IQR: 0-1 L), respectively versus Median: 92% (IQR: 91-92%) and Median: 6 L (IQR: 5-7.2 L, respectively] (P
Published: 2021
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4. Intravenous -acetylcysteine in severe cutaneous drug reaction treatment: A case series

Author: Md Jahidul Hasan and Raihan Rabbani
Subjects: Medicine (General), R5-920
Abstract: Drug-induced serious adverse reaction is an unpleasant event with high rate of mortality. Stevens–Johnson Syndrome and toxic epidermal necrolysis are most common among the serious adverse drug reactions. There is no selective drug therapy for the management of serious adverse drug reactions-associated mucocutaneous blisters. The use of N -acetylcysteine in the treatment of mucocutaneous blisters has limited evidence worldwide. Three cases of toxic epidermal necrolysis or Stevens–Johnson Syndrome-associated mucocutaneous blisters are presented in this study where intravenous N -acetylcysteine (600 mg, every 8 h) was given in early hospitalization hours for the treatment of mucocutaneous fluid-filled blisters. Here, one patient with toxic epidermal necrolysis received intravenous immunoglobulin along with intravenous N -acetylcysteine and the other two patients (toxic epidermal necrolysis/Stevens–Johnson Syndrome) received only N -acetylcysteine intravenously. In response, mucocutaneous fluid-filled blisters stopped progressing within 48 h and were healed within 2 weeks of admission in the intensive care unit. Thus, intravenous N -acetylcysteine with or without having intravenous immunoglobulin in the treatment of serious adverse drug reactions-associated mucocutaneous blisters may be an effective therapeutic option for better clinical outcome.
Published: 2020
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5. High-voltage electrocution-induced pulmonary injury and cerebellar hemorrhage with fractures in atlas

Author: Lutfun Nahar Nizhu, Md Jahidul Hasan, and Raihan Rabbani
Subjects: Surgery, RD1-811
Abstract: Background: Electrocution is a common cause of mild to severe multisystem injuries leading to high rate of mortality and morbidity. Low to high-voltage injury may be clinically manifested from a simple unpleasant sensation to multiple soft tissue injury which may cause instant death. The severity of injury depends on intensity of the electrical current, voltage of the source, resistance in the victims' body and the duration of the contact. Case presentation: A 20-year-old young male experienced with an accidental high-voltage electrocution injury from a blasted electrical transformer while passing across the road. He lost his consciousness and immediately hospitalized. Bilateral pulmonary infiltrates and right cerebellar hemorrhage with fractures in anterior and posterior arch of the first cervical vertebrae (C1) were diagnosed, and there was no history of electrical burn. He stayed in hospital for three days and completely treated with initial oxygen supplementation and immobilization of his head and neck with a Philadelphia collar for 6 weeks. Electrocution is a serious public health concern and reported worldwide with few fatal ending. Accidental high-voltage electrocution injury is a serious type of unfortunate accidental injuries which in most of times, ends with immediate or delayed sequelae or even death. In this case, the victim with high-voltage-associated electrical injuries in his lungs and brain was completely recovered because of early hospitalization. Conclusions: Electrocution injury is an accidental event with high mortality and morbidity rate. Mild to severe electrical current-induced injuries including burn can be treated successfully in most of the cases, but early hospitalization is highly required. Keywords: High-voltage, Electrocution, Cerebellar hemorrhage, Pulmonary injury
Published: 2020
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6. Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Author: Md Jahidul Hasan, Lutfun Nahar Nizhu, and Raihan Rabbani
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Introduction: Alcaligenes faecalis is a species of gram-negative, rod-shaped, aerobic bacteria commonly found in the environment. A. faecalis-associated nosocomial infections are common in hospitalized patients, but serious life threatening infections are rare. Here, we report a rare case of BSI with A. faecalis resistant to all available antibiotics; successfully treated with double-dose of tigecycline. Presentation of case: A 60-year-old female presented with A. faecalis bloodstream infection, where the organism was completely resistant to all commercially available antibiotics including polymyxins and tigecycline. The physical condition of the patient was deteriorating and there were no active antibiotics available to prescribe based on sensitivities. Despite the organism’s resistance to tigecycline, double-dose of tigecycline therapy (100 mg twice daily, intravenously after a 200 mg single intravenous loading dose) was prescribed intentionally for the treatment of this infection. The organism was completely eradicated from the bloodstream of that patient within the 5 days of therapy-initiation. Discussion: Double-dose of tigecycline maintains a higher serum drug concentration rather than the standard dose, and in this case, double-dose of tigecycline completely cleared the pandrug-resistant A. faecalis from the blood where initially, that organism was resistant to tigecycline. Previously, A. faecalis isolates were found resistant to fluoroquinolones, but here it was found very rarely resistant to even reserve antibiotics, polymyxins, carbapenems and tigecycline. Conclusion: Pandrug-resistant A. faecalis-associated bloodstream infection is a very uncommon case and double-dose of tigecycline may be an effective option to treat it. Keywords: Alcaligenes faecalis, Pandrug-resistance, Bloodstream infection, Double-dose, Tigecycline
Published: 2019
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7. Aerosolized Plus Intravenous Polymyxin B Versus Colistin in the Treatment of Pandrug-Resistant Klebsiella Pneumonia-mediated Ventilator-Associated Pneumonia: A Retrospective Cohort Study in Bangladesh

Author: Md Jahidul Hasan, Chandra Datta Sumi, Shihan Mahmud Redwanul Huq, Ahmad Mursel Anam, and Raihan Rabbani
Subjects: General Medicine
Abstract: Background Pandrug-resistant Klebsiella pneumoniae ventilator associated pneumonia (VAP) is associated with high rate of mortality in intensive care unit (ICU) and has been recognized as a difficult-to-treat infection worldwide. Polymyxin B or colistin-based combination therapies are frequently used worldwide though microbial eradication rate is not promising. Aim The aim of this study is to compare the clinical outcome of intravenous with aerosolized polymyxin B versus colistin in the treatment of pandrug-resistant K. pneumoniae VAP. Methods This retrospective cohort study was conducted on 222 mechanically ventilated patients admitted from May 11, 2019 to October 19, 2020. K. pneumoniae isolates were resistant to all available antibiotics, including polymyxins in culture sensitivity tests. As treatment, polymyxin B and colistin was administered in intravenous and aerosolized form concurrently twice daily in 106 patients and 116 patients in PMB and CLN group, respectively for 14 days. Survival rate, safety, and clinical outcomes were compared among the groups. The Cox proportional-hazard model was performed to calculate hazard ratio (HR) with 95% confidence intervals (CI). Results Patients in PMB group showed more microbial eradication than the patients CLN group [68.1% (n=116)/83% (n=106), respectively; P Conclusions Concurrent administration of intravenous and aerosolized polymyxin B in patients with pandrug-resistant K. pneumoniae-associated VAP revealed better microbial eradication, reduced the length of intubation and ICU stay, and improved survival rate compared to colistin.
Published: 2023
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8. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author: Tài, Pham, Leo, Heunk, Giacomo, Bellani, Fabiana, Madotto, Irene, Aragao, Gaëtan, Beduneau, Ewan C, Goligher, Giacomo, Grasselli, Jon Henrik, Laake, Jordi, Mancebo, Oscar, Peñuela, Lise, Piquilloud, Antonio, Pesenti, Hannah, Wunsch, Frank, van Haren, Laurent, Brochard, John G, Laffey, Abrough, Fekri, P Acharya, Subhash, Amin, Pravin, Arabi, Yaseen, Aragao, Irene, Bauer, Philippe, Beduneau, Gaëtan, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Grasselli, Giacomo, Gritsan, Alexey, Mohammadreza Hashemian, Seyed, Hermans, Greet, M Heunks, Leo, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Henrik Laake, Jon, Matamis, Dimitrio, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Piquilloud, Lise, Qiu, Haibo, Abdel Razek, Assem, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Ali Zeggwagh, Amine, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Kumar Agrawal, Vijay, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, Akbas, Türkay, Akker, Mustafa, Al Sadeh, Ghamdan, Alamri, Sultan, Algaba, Angela, Ali, Muneeb, Aliberti, Anna, Manuel Allegue, Jose, Alvarez, Diana, Amador, Joaquin, H Andersen, Finn, Ansari, Sharique, Apichatbutr, Yutthana, Apostolopoulou, Olympia, Arellano, Daniel, Arica, Mestanza, Arikan, Huseyin, Arinaga, Koichi, Arnal, Jean-Michel, Asano, Kengo, Asín-Corrochano, Marta, Milagrito Avalos Cabrera, Jesu, Avila Fuentes, Silvia, Aydemir, Semih, Aygencel, Gulbin, Azevedo, Luciano, Bacakoglu, Feza, Badie, Julio, Baedorf Kassis, Elia, Bai, Gabriela, Balaraj, Govindan, Ballico, Bruno, Banner-Goodspeed, Valerie, Banwarie, Preveen, Barbieri, Rosella, Baronia, Arvind, Barrett, Jonathan, Barrot, Loïc, Emilio Barrueco-Francioni, Jesu, Barry, Jeffrey, Bawangade, Harshal, Beavis, Sarah, Beck, Eduardo, Beehre, Nina, Belenguer Muncharaz, Alberto, Bellani, Giacomo, Belliato, Mirko, Bellissima, Agrippino, Beltramelli, Rodrigo, Ben Souissi, Asma, Benitez-Cano, Adela, Benlamin, Mohamed, Benslama, Abdellatif, Bento, Lui, Benvenuti, Daniela, Bernabe, Laura, Bersten, Andrew, Berta, Giacomo, Bertini, Pietro, Bertram-Ralph, Elliot, Besbes, Mohamed, Roberto Bettini, Lisandro, Beuret, Pascal, Bewley, Jeremy, Bezzi, Marco, Bhakhtiani, Lakshay, Bhandary, Rakesh, Bhowmick, Kaushik, Bihari, Shailesh, Bissett, Bernie, Blythe, David, Bocher, Simon, Boedjawan, Narain, M Bojanowski, Christine, Boni, Elisa, Boraso, Sabrina, Borelli, Massimo, Borello, Silvina, Borislavova, Margarita, J Bosma, Karen, Bottiroli, Maurizio, Boyd, Owen, Bozbay, Suha, Briva, Arturo, Brochard, Laurent, Bruel, Cédric, Bruni, Andrea, Buehner, Ulrike, Bulpa, Pierre, Burt, Karen, Buscot, Mathieu, Buttera, Stefania, Cabrera, Jorge, Caccese, Roberta, Caironi, Pietro, Canchos Gutierrez, Ivan, Canedo, Nancy, Cani, Alma, Cappellini, Iacopo, Carazo, Jesu, Pablo Cardonnet, Lui, Carpio, David, Carriedo, Demetrio, Carrillo, Ramón, Carvalho, João, Caser, Eliana, Castelli, Antonio, Castillo Quintero, Manuel, Castro, Heloisa, Catorze, Nuno, Cengiz, Melike, Cereijo, Enrique, Ceunen, Helga, Chaintoutis, Christo, Chang, Youjin, Chaparro, Gustavogcha, Chapman, Carmel, Chau, Simon, Eugenia Chavez, Cecilia, Chelazzi, Cosimo, Chelly, Jonathan, Chemouni, Frank, Chen, Kai, Chena, Ariel, Chiarandini, Paolo, Chilton, Phil, Chiumello, Davide, Chou-Lie, Yvette, Chudeau, Nicola, Cinel, Ismail, Cinnella, Gilda, Clark, Michele, Clark, Thoma, Clementi, Stefano, Coaguila, Lui, Jaspe Codecido, Alexi, Collins, Amy, Colombo, Riccardo, Conde, Juan, Consales, Guglielmo, Cook, Tim, Coppadoro, Andrea, Cornejo, Rodrigo, Cortegiani, Andrea, Coxo, Cristina, Neville Cracchiolo, Andrea, Crespo Ramirez, Mónica, Crova, Philippe, Cruz, José, Cubattoli, Lucia, Çukurova, Zafer, Curto, Francesco, Czempik, Piotr, D'Andrea, Rocco, da Silva Ramos, Fernando, Dangers, Laurence, Danguy des Déserts, Marc, Danin, Pierre-Eric, Dantas, Fabianne, Daubin, Cédric, Dawei, Wu, de Haro, Candelaria, de Jesus Montelongo, Felipe, De Mendoza, Diego, de Pablo, Raúl, De Pascale, Gennaro, De Rosa, Silvia, Decavèle, Maxen, Declercq, Pierre-Loui, Deicas, Alberto, Del Carmen Campos Moreno, María, Dellamonica, Jean, Delmas, Benjamin, Demirkiran, Oktay, Demirkiran, Hilmi, Dendane, Tarek, di Mussi, Rossella, Diakaki, Chrysi, Diaz, Anatilde, Diaz, Willy, Dikmen, Yalim, Dimoula, Aikaterini, Doble, Patricia, Doha, Nagwa, Domingos, Guilherme, Dres, Martin, Dries, David, Duggal, Abhijit, Duke, Graeme, Dunts, Pavel, Dybwik, Knut, Dykyy, Maksym, Eckert, Philippe, Efe, Serdar, Elatrous, Souheil, Elay, Gülseren, S Elmaryul, Abubaker, Elsaadany, Mohamed, Elsayed, Hany, Elsayed, Samar, Emery, Malo, Ena, Sébastien, Eng, Kevin, A Englert, Joshua, Erdogan, Elif, Ergin Ozcan, Perihan, Eroglu, Ege, Escobar, Miguel, Esen, Figen, Esen Tekeli, Arzu, Esquivel, Alejandro, Esquivel Gallegos, Helbert, Ezzouine, Hanane, Facchini, Alberto, Faheem, Mohammad, Fanelli, Vito, Fernanda Farina, Maria, Fartoukh, Muriel, Fehrle, Lutz, Feng, Feng, Feng, Yufeng, Fernandez, Irene, Fernandez, Borja, Lorena Fernandez-Rodriguez, Maria, Ferrando, Carlo, João Ferreira da Silva, Maria, Ferreruela, Mireia, Ferrier, Janet, Jesús Flamm Zamorano, Matia, Flood, Laura, Floris, Leda, Fluckiger, Martin, Forteza, Catalina, Fortunato, Antonella, Frans, Eric, Frattari, Antonella, Fredes, Sebastian, Frenzel, Tim, Fumagalli, Roberto, Andres Furche, Mariano, Fusari, Maurizio, Fysh, Edward, Luis Galeas-Lopez, Juan, Galerneau, Louis-Marie, Garcia, Analía, Fernanda Garcia, María, Garcia, Elisabet, Garcia Olivares, Pablo, Garlicki, Jaroslaw, Garnero, Aude, Garofalo, Eugenio, Gautam, Prabha, Gazenkampf, Andrey, Gelinotte, Stéphanie, Gelormini, Domenico, Ghrenassia, Etienne, Giacomucci, Angelo, Giannoni, Robert, Gigante, Andrea, Glober, Nancy, Gnesin, Paolo, Gollo, Yari, Gomaa, Dina, Gomero Paredes, Rosita, Gomes, Rui, Alejandro Gomez, Raúl, Gomez, Oscar, Gomez, Aroa, Gondim, Louise, Gonzalez, Manuel, Gonzalez, Isabel, Gonzalez-Castro, Alejandro, Gordillo Romero, Orlando, Gordo, Federico, Gouin, Philippe, Graf Santos, Jerónimo, Grainne, Rooney, Grando, Matilde, Granov Grabovica, Sanja, Grasso, Salvatore, Grasso, Rinaldo, Grimmer, Lisa, Grissom, Colin, Gu, Qing, Guan, Xiang-Dong, Guarracino, Fabio, Guasch, Neu, Guatteri, Luca, Gueret, Renaud, Guérin, Claude, Guerot, Emmanuel, Guitard, Pierre-Gilda, Gül, Fethi, Gumus, Ayca, Gurjar, Mohan, Gutierrez, Patricia, Hachimi, Abdelhamid, Hadzibegovic, Adi, Hagan, Samantha, Hammel, Clare, Han Song, Joo, Hanlon, Gabrielle, Heines, Serge, Henriksson, Johanna, Herbrecht, Jean-Etienne, Omar Heredia Orbegoso, Gabriel, Hermon, Andrew, Hernandez, Rosana, Hernandez, Carmen, Herrera, Lui, Herrera-Gutierrez, Manuel, Heunks, Leo, Hidalgo, Juan, Hill, Dianne, Holmquist, Dagmar, Homez, Marcela, Hongtao, Xia, Hormis, Anil, Horner, Daniel, Carmen Hornos, M, Hou, Meihong, House, Stacy, Housni, Brahim, Hugill, Keith, Humphreys, Sally, Humbert, Loui, Hunter, Stephanie, Hwa Young, Lee, Iezzi, Nicola, Ilutovich, Santiago, Inal, Volkan, Innes, Richard, Ioannides, Panagioti, Antonio Iotti, Giorgio, Ippolito, Mariachiara, Irie, Hiromasa, Iriyama, Hiroki, Itagaki, Taiga, Izura, Javier, Izza, Santiago, Jabeen, Rakhshanda, Jamaati, Hamidreza, Jamadarkhana, Sunil, Jamoussi, Amira, Jankowski, Milosz, Alberto Jaramillo, Lui, Jeon, Kyeongman, Jeong Lee, Seok, Jeswani, Deepak, Jha, Simant, Jiang, Liangyan, Jing, Chen, Jochmans, Sébastien, Anders Johnstad, Bror, Jongmin, Lee, Joret, Aurélie, Junhasavasdikul, Detajin, Teresa Jurado, Maria, Kam, Elisa, Kamohara, Hidenobu, Kane, Caroline, Kara, Iskender, Karakurt, Sait, Karnjanarachata, Cherdkiat, Kataoka, Jun, Katayama, Shinshu, Kaushik, Shuchi, Kelebek Girgin, Nermin, Kerr, Kathryn, Kerslake, Ian, Khairnar, Prakash, Khalid, Abidi, Khan, Akram, K Khanna, Ashish, Khorasanee, Reza, Kienhorst, Dieneke, Kirakli, Cenk, Knafelj, Rihard, Kol Kol, Mark, Kongpolprom, Napplika, Kopitko, Csaba, Korkmaz Ekren, Pervin, Kubisz-Pudelko, Agnieszka, Kulcsar, Zoltan, Kumasawa, Junji, Kuriyama, Akira, Kutchak, Fernanda, Labarca, Eduardo, Labat, Françoise, Laborda, César, Alberto Laca Barrera, Manuel, Lagache, Laurie, Landaverde Lopez, Antonio, Lanspa, Michael, Lascari, Valeria, Le Meur, Matthieu, Hwan Lee, Su, Ju Lee, Young, Lee, Jinwoo, Lee, Won-Yeon, Lee, Jarone, Legernaes, Terje, Leiner, Tamaa, Lemiale, Virginie, Leonor, Tiago, M Lepper, Philipp, Li, Dahuan, Li, Hongbin, Li, Oleg, Raquel Lima, Ana, Lind, Dan, Litton, Edward, Liu, Ning, Liu, Ling, Liu, Jialin, Llitjos, Jean-Françoi, Llorente, Beatriz, Lopez, Rodolfo, Elizabeth Lopez, Claudia, Lopez Nava, Claudia, Lovazzano, Pablo, Lu, Min, Lucchese, Francesca, Lugano, Manuela, Lugo Goytia, Gustavo, Luo, Hua, Lynch, Ceri, Macheda, Sebastiano, Hugo Madrigal Robles, Victor, Maurizio Maggiore, Salvatore, Magret Iglesias, Mònica, Malaga, Peter, Mallapura Maheswarappa, Harish, Malpartida, Guillermo, Malyarchikov, Andrey, Mansson, Helena, Manzano, Anaid, Marey, Ismael, Marin, Nathalie, Del Carmen Marin, Maria, Markman, Eliana, Martin, Felix, Martin, Alex, Martin Dal Gesso, Cristina, Martinez, Felipe, Martínez-Fidalgo, Conchita, Martin-Loeches, Ignacio, Mas, Arantxa, Masaaki, Sakuraya, Maseda, Emilio, Massa, Eleni, Mattsson, Anna, Maugeri, Jessica, Mccredie, Victoria, Mccullough, Jame, Mcguinness, Shay, Mckown, Andrew, Medve, László, Mei, Chengqing, Mellado Artigas, Ricard, Mendes, Vitor, Khalaf Ebraheim Mervat, Mohamed, Michaux, Isabelle, Mikhaeil, Michael, Milagros, Olga, Milet, Igor, Teresa Millan, Maria, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, Gianmario, Mora Aznar, Maria, Morakul, Sunthiti, Morales, Maria, Moreno Torres, Daniel, Rolando Morocho Tutillo, Diego, Motherway, Catherine, Mouhssine, Doumiri, Mouloudi, Eleni, Muñoz, Tapia, Munoz de Cabo, Carlo, Mustafa, Mohamed, Muthuchellappan, Radhakrishnan, Muthukrishnan, Muraleekrishnan, Muttini, Stefano, Nagata, Isao, Nahar, Dick, Nakanishi, Misuzu, Nakayama, Izumi, Antonio Namendys-Silva, Silvio, Nanchal, Rahul, Nandakumar, Sivakumar, Nasi, Alessandra, Nasir, Kamal, Navalesi, Paolo, Naz Aslam, Tayyba, Nga Phan, Thuy, Nichol, Alistair, Niiyama, Shuhei, Nikolakopoulou, Sofia, Nikolic, Elena, Nitta, Kenichi, Noc, Marko, Nonas, Stephanie, Nseir, Saad, Nur Soyturk, Ayse, Obata, Yukako, Oeckler, Richard, Oguchi, Moe, Ohshimo, Shinichiro, Oikonomou, Marina, Ojados, Agueda, Teresa Oliveira, Maria, Oliveira Filho, Wilson, Oliveri, Carlo, Olmos, Aitor, Omura, Kazuya, Cristina Orlandi, Maria, Orsenigo, Francesca, Ortiz-Ruiz De Gordoa, Laura, Ota, Kei, Ovalle Olmos, Rainier, Öveges, Nándo, Oziemski, Peter, Ozkan Kuscu, Ozlem, Özyilmaz, Ezgi, Pachas Alvarado, Fernando, Pagella, Gonzalo, Palaniswamy, Vijayanand, Luis Palazon Sanchez, Eugenio, Palmese, Salvatore, Pan, Guojun, Pan, Wensen, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Parekh, Ameet, Parke, Rachael, J Parrilla, Francisco, Parrilla, Dácil, Pasha, Taha, Pasin, Laura, Patão, Lui, Patel, Mayur, Patel, Grisma, Kumar Pati, Basanta, Patil, Jayaprakash, Pattnaik, Saroj, Paul, Daniel, Pavesi, Maurizio, Alejandra Pavlotsky, Vanesa, Paz, Graciela, Paz, Enrique, Pecci, Elisabetta, Pellegrini, Carlo, Gabriela Peña Padilla, Andrea, Perchiazzi, Gaetano, Pereira, Tiago, Pereira, Vera, Perez, Manuel, Perez Calvo, Cesar, Perez Cheng, Meisy, Perez Maita, Ronald, Pérez-Araos, Rodrigo, Perez-Teran, Purificación, Perez-Torres, David, Perkins, Gavin, Persona, Paolo, Petnak, Tananchai, Petrova, Marina, Pham, Tai, Philippart, Françoi, Picetti, Edoardo, Pierucci, Elisabetta, Piervincenzi, Edoardo, Pinciroli, Riccardo, Pintado, Maria-Consuelo, Piraino, Thoma, Piras, Stephanie, Piras, Claudio, Pirompanich, Pattarin, Pisani, Luigi, Platas, Enrique, Plotnikow, Gustavo, Porras, Willy, Porta, Virginia, Portilla, Mariana, Portugal, José, Povoa, Pedro, Prat, Gwenael, Pratto, Romina, Preda, Gabriel, Prieto, Isidro, Prol-Silva, Estefania, Pugh, Richard, Qi, Yupeng, Qian, Chuanyun, Qin, Tiehe, Qu, Hongping, Quintana, Teobaldo, Quispe Sierra, Rosari, Quispe Soto, Rocio, Rabbani, Raihan, Rabee, Mohamed, Rabie, Ahmed, Augusta Rahe Pereira, Maria, Rai, Ashish, Raj Ashok, Sundar, Rajab, Mostafa, Ramdhani, Navin, Ramey, Elizabeth, Ranieri, Marco, Rathod, Darshana, Ray, Banambar, Mahmud Redwanul Huq, Shihan, Regli, Adrian, Reina, Rosa, Resano Sarmiento, Natalia, Reynaud, Faustine, Rialp, Gemma, Ricart, Pilar, Rice, Todd, Richardson, Angu, Rieder, Marcelo, Rinket, Martin, Rios, Fernando, Risso Vazquez, Alejandro, Riva, Ivano, Rivette, Monaly, Roca, Oriol, Roche-Campo, Ferran, Rodriguez, Covadonga, 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Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz 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Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica 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Tao, Yuan, Boyun, Yuangtrakul, Nadwipa, Yumoto, Tetsuya, Yun, Xie, Zakalik, Graciela, Zaki, Ahmad, Zalba-Etayo, Begoña, Zambon, Massimo, Zang, Bin, Zani, Gianluca, Zarka, Jonathan, Maria Zerbi, Simone, Zerman, Avsar, Zetterquist, Harald, Zhang, Jiuzhi, Zhang, Hongwen, Zhang, Wei, Zhang, Guoxiu, Zhang, Weixin, Zhao, Hongsheng, Zheng, Jia, Zhu, Bin, Zumaran, Ronald, Pham, Tài, Madotto, Fabiana, Goligher, Ewan C, Laake, Jon Henrik, Mancebo, Jordi, Peñuelas, Oscar, Pesenti, Antonio, Wunsch, Hannah, van Haren, Frank, Laffey, John G, Fekri Abrough, Subhash P Acharya, Pravin Amin, Yaseen Arabi, Irene Aragao, Philippe Bauer, Gaëtan Beduneau, Jeremy Beitler, Johan Berkius, Guillermo Bugedo, Luigi Camporota, Vladimir Cerny, Young-Jae Cho, Kevin Clarkson, Elisa Estenssoro, Ewan Goligher, Giacomo Grasselli, Alexey Gritsan, Seyed Mohammadreza Hashemian, Greet Hermans, Leo M Heunks, Bojan Jovanovic, Kiyoyasu Kurahashi, Jon Henrik Laake, Dimitrios Matamis, Onnen Moerer, Zsolt Molnar, Ezgi Ozyilmaz, Bernardo Panka, Alfred Papali, Óscar Peñuelas, Sébastien Perbet, Lise Piquilloud, Haibo Qiu, Assem Abdel Razek, Nuttapol Rittayamai, Rollin Roldan, Ary Serpa Neto, Konstanty Szuldrzynski, Daniel Talmor, Dana Tomescu, Frank Van Haren, Asisclo Villagomez, Amine Ali Zeggwagh, Toshikazu Abe, Abdelrhman Aboshady, Melanie Acampo-de Jong, Subhash Acharya, Jane Adderley, Nalan Adiguzel, Vijay Kumar Agrawal, Gerardo Aguilar, Gaston Aguirre, Hernan Aguirre-Bermeo, Björn Ahlström, Türkay Akbas, Mustafa Akker, Ghamdan Al Sadeh, Sultan Alamri, Angela Algaba, Muneeb Ali, Anna Aliberti, Jose Manuel Allegue, Diana Alvarez, Joaquin Amador, Finn H Andersen, Sharique Ansari, Yutthana Apichatbutr, Olympia Apostolopoulou, Daniel Arellano, Mestanza Arica, Huseyin Arikan, Koichi Arinaga, Jean-Michel Arnal, Kengo Asano, Marta Asín-Corrochano, Jesus Milagrito Avalos Cabrera, Silvia Avila Fuentes, Semih Aydemir, Gulbin Aygencel, Luciano Azevedo, Feza Bacakoglu, Julio Badie, Elias Baedorf Kassis, Gabriela Bai, Govindan Balaraj, Bruno Ballico, Valerie Banner-Goodspeed, Preveen Banwarie, Rosella Barbieri, Arvind Baronia, Jonathan Barrett, Loïc Barrot, Jesus Emilio Barrueco-Francioni, Jeffrey Barry, Harshal Bawangade, Sarah Beavis, Eduardo Beck, Nina Beehre, Alberto Belenguer Muncharaz, Giacomo Bellani, Mirko Belliato, Agrippino Bellissima, Rodrigo Beltramelli, Asma Ben Souissi, Adela Benitez-Cano, Mohamed Benlamin, Abdellatif Benslama, Luis Bento, Daniela Benvenuti, Laura Bernabe, Andrew Bersten, Giacomo Berta, Pietro Bertini, Elliot Bertram-Ralph, Mohamed Besbes, Lisandro Roberto Bettini, Pascal Beuret, Jeremy Bewley, Marco Bezzi, Lakshay Bhakhtiani, Rakesh Bhandary, Kaushik Bhowmick, Shailesh Bihari, Bernie Bissett, David Blythe, Simon Bocher, Narain Boedjawan, Christine M Bojanowski, Elisa Boni, Sabrina Boraso, Massimo Borelli, Silvina Borello, Margarita Borislavova, Karen J Bosma, Maurizio Bottiroli, Owen Boyd, Suha Bozbay, Arturo Briva, Laurent Brochard, Cédric Bruel, Andrea Bruni, Ulrike Buehner, Pierre Bulpa, Karen Burt, Mathieu Buscot, Stefania Buttera, Jorge Cabrera, Roberta Caccese, Pietro Caironi, Ivan Canchos Gutierrez, Nancy Canedo, Alma Cani, Iacopo Cappellini, Jesus Carazo, Luis Pablo Cardonnet, David Carpio, Demetrio Carriedo, Ramón Carrillo, João Carvalho, Eliana Caser, Antonio Castelli, Manuel Castillo Quintero, Heloisa Castro, Nuno Catorze, Melike Cengiz, Enrique Cereijo, Helga Ceunen, Christos Chaintoutis, Youjin Chang, Gustavogcha Chaparro, Carmel Chapman, Simon Chau, Cecilia Eugenia Chavez, Cosimo Chelazzi, Jonathan Chelly, Frank Chemouni, Kai Chen, Ariel Chena, Paolo Chiarandini, Phil Chilton, Davide Chiumello, Yvette Chou-Lie, Nicolas Chudeau, Ismail Cinel, Gilda Cinnella, Michele Clark, Thomas Clark, Stefano Clementi, Luis Coaguila, Alexis Jaspe Codecido, Amy Collins, Riccardo Colombo, Juan Conde, Guglielmo Consales, Tim Cook, Andrea Coppadoro, Rodrigo Cornejo, Andrea Cortegiani, Cristina Coxo, Andrea Neville Cracchiolo, Mónica Crespo Ramirez, Philippe Crova, José Cruz, Lucia Cubattoli, Zafer Çukurova, Francesco Curto, Piotr Czempik, Rocco D'Andrea, Fernando da Silva Ramos, Laurence Dangers, Marc Danguy des Déserts, Pierre-Eric Danin, Fabianne Dantas, Cédric Daubin, Wu Dawei, Candelaria de Haro, Felipe de Jesus Montelongo, Diego De Mendoza, Raúl de Pablo, Gennaro De Pascale, Silvia De Rosa, Maxens Decavèle, Pierre-Louis Declercq, Alberto Deicas, María Del Carmen Campos Moreno, Jean Dellamonica, Benjamin Delmas, Oktay Demirkiran, Hilmi Demirkiran, Tarek Dendane, Rossella di Mussi, Chrysi Diakaki, Anatilde Diaz, Willy Diaz, Yalim Dikmen, Aikaterini Dimoula, Patricia Doble, Nagwa Doha, Guilherme Domingos, Martin Dres, David Dries, Abhijit Duggal, Graeme Duke, Pavel Dunts, Knut Dybwik, Maksym Dykyy, Philippe Eckert, Serdar Efe, Souheil Elatrous, Gülseren Elay, Abubaker S Elmaryul, Mohamed Elsaadany, Hany Elsayed, Samar Elsayed, Malo Emery, Sébastien Ena, Kevin Eng, Joshua A Englert, Elif Erdogan, Perihan Ergin Ozcan, Ege Eroglu, Miguel Escobar, Figen Esen, Arzu Esen Tekeli, Alejandro Esquivel, Helbert Esquivel Gallegos, Hanane Ezzouine, Alberto Facchini, Mohammad Faheem, Vito Fanelli, Maria Fernanda Farina, Muriel Fartoukh, Lutz Fehrle, Feng Feng, Yufeng Feng, Irene Fernandez, Borja Fernandez, Maria Lorena Fernandez-Rodriguez, Carlos Ferrando, Maria João Ferreira da Silva, Mireia Ferreruela, Janet Ferrier, Matias Jesús Flamm Zamorano, Laura Flood, Leda Floris, Martin Fluckiger, Catalina Forteza, Antonella Fortunato, Eric Frans, Antonella Frattari, Sebastian Fredes, Tim Frenzel, Roberto Fumagalli, Mariano Andres Furche, Maurizio Fusari, Edward Fysh, Juan Luis Galeas-Lopez, Louis-Marie Galerneau, Analía Garcia, María Fernanda Garcia, Elisabet Garcia, Pablo Garcia Olivares, Jaroslaw Garlicki, Aude Garnero, Eugenio Garofalo, Prabha Gautam, Andrey Gazenkampf, Stéphanie Gelinotte, Domenico Gelormini, Etienne Ghrenassia, Angelo Giacomucci, Robert Giannoni, Andrea Gigante, Nancy Glober, Paolo Gnesin, Yari Gollo, Dina Gomaa, Rosita Gomero Paredes, Rui Gomes, Raúl Alejandro Gomez, Oscar Gomez, Aroa Gomez, Louise Gondim, Manuel Gonzalez, Isabel Gonzalez, Alejandro Gonzalez-Castro, Orlando Gordillo Romero, Federico Gordo, Philippe Gouin, Jerónimo Graf Santos, Rooney Grainne, Matilde Grando, Sanja Granov Grabovica, Salvatore Grasso, Rinaldo Grasso, Lisa Grimmer, Colin Grissom, Qing Gu, Xiang-Dong Guan, Fabio Guarracino, Neus Guasch, Luca Guatteri, Renaud Gueret, Claude Guérin, Emmanuel Guerot, Pierre-Gildas Guitard, Fethi Gül, Ayca Gumus, Mohan Gurjar, Patricia Gutierrez, Abdelhamid Hachimi, Adi Hadzibegovic, Samantha Hagan, Clare Hammel, Joo Han Song, Gabrielle Hanlon, Serge Heines, Johanna Henriksson, Jean-Etienne Herbrecht, Gabriel Omar Heredia Orbegoso, Andrew Hermon, Rosana Hernandez, Carmen Hernandez, Luis Herrera, Manuel Herrera-Gutierrez, Leo Heunks, Juan Hidalgo, Dianne Hill, Dagmar Holmquist, Marcela Homez, Xia Hongtao, Anil Hormis, Daniel Horner, M Carmen Hornos, Meihong Hou, Stacy House, Brahim Housni, Keith Hugill, Sally Humphreys, Louis Humbert, Stephanie Hunter, Lee Hwa Young, Nicolas Iezzi, Santiago Ilutovich, Volkan Inal, Richard Innes, Panagiotis Ioannides, Giorgio Antonio Iotti, Mariachiara Ippolito, Hiromasa Irie, Hiroki Iriyama, Taiga Itagaki, Javier Izura, Santiago Izza, Rakhshanda Jabeen, Hamidreza Jamaati, Sunil Jamadarkhana, Amira Jamoussi, Milosz Jankowski, Luis Alberto Jaramillo, Kyeongman Jeon, Seok Jeong Lee, Deepak Jeswani, Simant Jha, Liangyan Jiang, Chen Jing, Sébastien Jochmans, Bror Anders Johnstad, Lee Jongmin, Aurélie Joret, Detajin Junhasavasdikul, Maria Teresa Jurado, Elisa Kam, Hidenobu Kamohara, Caroline Kane, Iskender Kara, Sait Karakurt, Cherdkiat Karnjanarachata, Jun Kataoka, Shinshu Katayama, Shuchi Kaushik, Nermin Kelebek Girgin, Kathryn Kerr, Ian Kerslake, Prakash Khairnar, Abidi Khalid, Akram Khan, Ashish K Khanna, Reza Khorasanee, Dieneke Kienhorst, Cenk Kirakli, Rihard Knafelj, Mark Kol Kol, Napplika Kongpolprom, Csaba Kopitko, Pervin Korkmaz Ekren, Agnieszka Kubisz-Pudelko, Zoltan Kulcsar, Junji Kumasawa, Akira Kuriyama, Fernanda Kutchak, Eduardo Labarca, Françoise Labat, César Laborda, Manuel Alberto Laca Barrera, Laurie Lagache, Antonio Landaverde Lopez, Michael Lanspa, Valeria Lascari, Matthieu Le Meur, Su Hwan Lee, Young Ju Lee, Jinwoo Lee, Won-Yeon Lee, Jarone Lee, Terje Legernaes, Tamaas Leiner, Virginie Lemiale, Tiago Leonor, Philipp M Lepper, Dahuan Li, Hongbin Li, Oleg Li, Ana Raquel Lima, Dan Lind, Edward Litton, Ning Liu, Ling Liu, Jialin Liu, Jean-François Llitjos, Beatriz Llorente, Rodolfo Lopez, Claudia Elizabeth Lopez, Claudia Lopez Nava, Pablo Lovazzano, Min Lu, Francesca Lucchese, Manuela Lugano, Gustavo Lugo Goytia, Hua Luo, Ceri Lynch, Sebastiano Macheda, Victor Hugo Madrigal Robles, Salvatore Maurizio Maggiore, Mònica Magret Iglesias, Peter Malaga, Harish Mallapura Maheswarappa, Guillermo Malpartida, Andrey Malyarchikov, Helena Mansson, Anaid Manzano, Ismael Marey, Nathalie Marin, Maria Del Carmen Marin, Eliana Markman, Felix Martin, Alex Martin, Cristina Martin Dal Gesso, Felipe Martinez, Conchita Martínez-Fidalgo, Ignacio Martin-Loeches, Arantxa Mas, Sakuraya Masaaki, Emilio Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz Aslam, Thuy Nga Phan, Alistair Nichol, Shuhei Niiyama, Sofia Nikolakopoulou, Elena Nikolic, Kenichi Nitta, Marko Noc, Stephanie Nonas, Saad Nseir, Ayse Nur Soyturk, Yukako Obata, Richard Oeckler, Moe Oguchi, Shinichiro Ohshimo, Marina Oikonomou, Agueda Ojados, Maria Teresa Oliveira, Wilson Oliveira Filho, Carlo Oliveri, Aitor Olmos, Kazuya Omura, Maria Cristina Orlandi, Francesca Orsenigo, Laura Ortiz-Ruiz De Gordoa, Kei Ota, Rainier Ovalle Olmos, Nándo Öveges, Peter Oziemski, Ozlem Ozkan Kuscu, Ezgi Özyilmaz, Fernando Pachas Alvarado, Gonzalo Pagella, Vijayanand Palaniswamy, Eugenio Luis Palazon Sanchez, Salvatore Palmese, Guojun Pan, Wensen Pan, Metaxia Papanikolaou, Theonymfi Papavasilopoulou, Ameet Parekh, Rachael Parke, Francisco J Parrilla, Dácil Parrilla, Taha Pasha, Laura Pasin, Luis Patão, Mayur Patel, Grisma Patel, Basanta Kumar Pati, Jayaprakash Patil, Saroj Pattnaik, Daniel Paul, Maurizio Pavesi, Vanesa Alejandra Pavlotsky, Graciela Paz, Enrique Paz, Elisabetta Pecci, Carlos Pellegrini, Andrea Gabriela Peña Padilla, Gaetano Perchiazzi, Tiago Pereira, Vera Pereira, Manuel Perez, Cesar Perez Calvo, Meisy Perez Cheng, Ronald Perez Maita, Rodrigo Pérez-Araos, Purificación Perez-Teran, David Perez-Torres, Gavin Perkins, Paolo Persona, Tananchai Petnak, Marina Petrova, Tai Pham, François Philippart, Edoardo Picetti, Elisabetta Pierucci, Edoardo Piervincenzi, Riccardo Pinciroli, Maria-Consuelo Pintado, Thomas Piraino, Stephanie Piras, Claudio Piras, Pattarin Pirompanich, Luigi Pisani, Enrique Platas, Gustavo Plotnikow, Willy Porras, Virginia Porta, Mariana Portilla, José Portugal, Pedro Povoa, Gwenael Prat, Romina Pratto, Gabriel Preda, Isidro Prieto, Estefania Prol-Silva, Richard Pugh, Yupeng Qi, Chuanyun Qian, Tiehe Qin, Hongping Qu, Teobaldo Quintana, Rosari Quispe Sierra, Rocio Quispe Soto, Raihan Rabbani, Mohamed Rabee, Ahmed Rabie, Maria Augusta Rahe Pereira, Ashish Rai, Sundar Raj Ashok, Mostafa Rajab, Navin Ramdhani, Elizabeth Ramey, Marco Ranieri, Darshana Rathod, Banambar Ray, Shihan Mahmud Redwanul Huq, Adrian Regli, Rosa Reina, Natalia Resano Sarmiento, Faustine Reynaud, Gemma Rialp, Pilar Ricart, Todd Rice, Angus Richardson, Marcelo Rieder, Martin Rinket, Fernando Rios, Alejandro Risso Vazquez, Ivano Riva, Monaly Rivette, Oriol Roca, Ferran Roche-Campo, Covadonga Rodriguez, Gabriel Rodriguez, Daniel Rodriguez Gonzalez, Xandra Yanina Rodriguez Tucto, Angela Rogers, María Elena Romano, Linda Rørtveit, Alastair Rose, Damien Roux, Anahita Rouze, Paolo Nahuel Rubatto Birri, Wang Ruilan, Aldana Ruiz Robledo, Antonio Luis Ruiz-Aguilar, Tomohito Sadahiro, Ignacio Saez, Judith Sagardia, Rajnish Saha, Rohit Saha, Narongkorn Saiphoklang, Shigeki Saito, Maie Salem, Gabriele Sales, Patricia Salgado, Srinivas Samavedam, Mhamed Sami Mebazaa, Line Samuelsson, Nandyelly San Juan Roman, Patricia Sanchez, Jesus Sanchez-Ballesteros, Yazcitk Sandoval, Emanuele Sani, Martin Santos, Carla Santos, Masamitsu Sanui, Lakshmikanthcharan Saravanabavan, Sema Sari, Agnes Sarkany, Bertrand Sauneuf, Monica Savioli, Hilal Sazak, Riccardo Scano, Francis Schneider, Frédérique Schortgen, Marcus J Schultz, Gabriele Leonie Schwarz, Faruk Seçkin Yücesoy, Andrew Seely, Frederik Seiler, Yasemin Seker Tekdos, Kim Seok Chan, Luca Serano, Wojciech Serednicki, Mariano Setten, Asim Shah, Bhagyesh Shah, You Shang, Pradeep Shanmugasundaram, Konstantin Shapovalov, Eman Shebl, Takuya Shiga, Nobuaki Shime, Phil Shin, Jack Short, Chen Shuhua, Sughrat Siddiqui, Juan Ignacio Silesky Jimenez, Daniel Silva, Betania Silva Sales, Koen Simons, Brit Ågot Sjøbø, David Slessor, Jakub Smiechowicz, Nathan Smischney, Paul Smith, Tim Smith, Mark Smith, Sarah Snape, Lindi Snyman, Filiep Soetens, Kyung Sook Hong, Miguel Ángel Sosa Medellin, Giovanna Soto, Xavier Souloy, Elsa Sousa, Stefania Sovatzis, Didem Sozutek, Savino Spadaro, Marco Spagnoli, Martin Spångfors, Nick Spittle, Mike Spivey, Andrew Stapleton, Branislava Stefanovic, Lorraine Stephenson, Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica Vargas-Ordoñez, Rosanna Vaschetto, Ettore Vascotto, Maria Vatsik, Ana Vaz, Antonia Vazquez-Sanchez, Sara Ventura, Jan Wytze Vermeijden, Anxela Vidal, Jocyelle Vieira, Bruno Vilela Costa Pinto, Ana Villagra, Cristina Villegas Succar, Ole Georg Vinorum, Giovanni Vitale, Ramesh Vj, Ana Vochin, Guillaume Voiriot, Carlo Alberto Volta, Magnus von Seth, Maazouzi Wajdi, Don Walsh, Shouhong Wang, Gabriel Wardi, Nils Christian Ween-Velken, Bi-Lin Wei, Dolf Weller, Deborah Welsh, Ingeborg Welters, Michael Wert, Simon Whiteley, Elizabeth Wilby, Erin Williams, Karen Williams, Antoinette Wilson, Jadwiga Wojtas, Jin Won Huh, David Wrathall, Christopher Wright, Jian-Feng Wu, Guo Xi, Zheng-Jiang Xing, Hongyang Xu, Kotaro Yamamoto, Jie Yan, Julio Yáñez, Xiaobo Yang, Elliot Yates, Ozlem Yazicioglu Mocin, Zhenglong Ye, Fatma Yildirim, Norifumi Yoshida, Hector Higo Leon Yoshido, Bo Young Lee, Rongguo Yu, Gong Yu, Tao Yu, Boyun Yuan, Nadwipa Yuangtrakul, Tetsuya Yumoto, Xie Yun, Graciela Zakalik, Ahmad Zaki, Begoña Zalba-Etayo, Massimo Zambon, Bin Zang, Gianluca Zani, Jonathan Zarka, Simone Maria Zerbi, Avsar Zerman, Harald Zetterquist, Jiuzhi Zhang, Hongwen Zhang, Wei Zhang, Guoxiu Zhang, Weixin Zhang, Hongsheng Zhao, Jia Zheng, Bin Zhu, and Ronald Zumaran
Abstract: Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d
Published: 2023

9. Early Empirical Anidulafungin Reduces the Prevalence of Invasive Candidiasis in Critically Ill Patients: A Case-control Study

Author: Md Jahidul, Hasan, Sharmind, Neelotpol, and Raihan, Rabbani
Subjects: General Medicine
Abstract: Introduction Invasive candidiasis (IC) in critically ill patients is a serious infection with high rate of mortality. As an empirical therapy, like antibiotics, the use of antifungals is not common in intensive care units (ICUs) worldwide. The empirical use of echinocandins including anidulafungin is a recent trend. Aim of the study The objective of this study was to assess the impact of empirical anidulafungin in the development of invasive candidiasis in critically ill patients in ICU. Methods This retrospective case-control study was conducted on 149 patients with sepsis with/without septic shock and bacterial pneumonia. All the patients were divided into two groups. The ‘control group’ termed as ‘NEAT group’ received no empirical anidulafungin therapy and the ‘treated group’ termed as ‘EAT group’ received empirical anidulafungin therapy in early hospitalization hours. Results Seventy-two and 77 patients were divided into the control and the treated group, respectively. Patients in EAT group showed less incidences of IC (5.19%) than that of the NEAT group (29.17%) (p = 0.001). Here, the relative risk (RR) was 0.175 (95% CI, 0.064-0.493) and the risk difference (RD) rate was 24% (95% CI, 12.36%-35.58%). The 30-day all-cause mortality rate in NEAT group was higher (19.44%) than that of in EAT group (10.39%) (p = 0.04). Within the first 10-ICU-day, patients in the EAT group left ICU in higher rate (62.34%) than that in the NEAT group (54.17%). Conclusion Early empirical anidulafungin within 6 h of ICU admission reduced the risk of invasive candidiasis, 30-day all-cause mortality rate and increased ICU leaving rate within 10-day of ICU admission in critically ill patients.
Published: 2022
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10. Pengaruh Academic Self-Efficacy terhadap Stress Akademik Mahasiswa yang sedang Mengerjakan Skripsi

Author: Mochammad Raihan Rabbani and Hedi Wahyudi
Abstract: Stres akademik adalah tekanan yang bersumber dari aktivitas-aktivitas akademik. Skripsi menjadi kewajiban mahasiswa yang harus diselesaikan untuk menyelesaikan study sarjananya. Stress akademik dan Academic Self-Efficacy adalah dua teori yang terkait erat (Zajacova et al., 2005). Keyakinan pribadi seperti self-efficacy sangat berguna untuk menilai tekanan dari lingkungan yang akan diterjemahkan sebagai ancaman atau tantangan. Akan tetapi banyak dari penelitian sebelumnya yang membuktikan bahwa hasil dari kedua variable tersebut cukup kecil. Dari beberapa penelitian sebelumnya, terdapat kesamaan dalam populasi, dimana populasi yang diambil dalam penelitian sebelumnya terlalu luas dan tidak memiliki kriteria sampel yang spesifik. Penelitian ini meneliti tentang seberapa besar pengaruh Academic Self-Efficacy terhadap Stress akademik mahasiswa psikologi UNISBA Angkatan 2018 yang memiliki karakteristik terkena dampak pembelajaran kurang efektif dari pembelajaran jarak jauh. Metode yang dilakukan dala penelitian ini adalah metode kuantitatif. Responden penelitian ini yaitu mahasiswa fakultas Psikologi Universitas Islam Bandung yang sedang mengerjakan skripsi yang sesuai dengan kriteria berjumlah 41 mahsiswa. Teknik analisis data yang digunakan dalam penelitian ini yaitu Analisis Regresi Linear Sederhana. Hasil penelitian ini menunjukan bahwa Academic Self-Efficacy memiliki pengaruh terhadap Stress akademik dan memiliki besar pengaruh 44,4%. Kata Kunci: Mahasiswa, Efikasi Diri Akademik, Stress Akademik Abstract- Academic stress is pressure that comes from academic activities. Thesis is a student obligation that must be completed to complete their undergraduate studies. Academic stress and Academic Self-Efficacy are two closely related theories (Zajacova et al., 2005). Personal beliefs such as self-efficacy are very useful for assessing pressure from the environment which will be interpreted as a threat or a challenge. However, many previous studies have proven that the results of these two variables are quite small. From several previous studies, there were similarities in the population, where the population taken in the previous study was too broad and did not have specific sample characteristics. This research examines how much influence Academic Self-Efficacy has on the academic stress of psychology students at UNISBA Batch 2018 which has less effective learning impact characteristics than distance learning. The method used in this study is a quantitative method. The respondents of this study were 41 students from the Faculty of Psychology at the Universitas Islam Bandung who were working on a thesis that met the criteria. The data analysis technique used in this study is Simple Linear Regression Analysis. The results of this study indicate that Academic Self-Efficacy has an influence on academic stress and has a large influence of 44.4%. Keywords: Student, Academic Self-Efficacy, Academic Stress
Published: 2023
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11. Evolution of pharmacy practice and direct patient care roles for pharmacists in Bangladesh

Author: Suzanna Gim, Raihan Rabbani, Rebecca Cope, Jahidul Hasan, and Sitesh C. Bachar
Subjects: medicine.medical_specialty, business.industry, Direct patient care, Family medicine, Pharmacist, Pharmaceutical Science, Medicine, Pharmacology (medical), Pharmacy, Pharmacy practice, business
Published: 2021
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12. The Susceptibility of MDR-K. Pneumoniae to Polymyxin B Plus its Nebulised Form Versus Polymyxin B Alone in Critically Ill South Asian Patients

Author: Ahmad Mursel Anam, Md. Jahidul Hasan, Ario Santini, Shihan Mahmud Redwanul Huq, and Raihan Rabbani
Subjects: 0301 basic medicine, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, 030106 microbiology, Antibiotics, ventilator-associated pneumonia (vap), polymyxin b, multi-drug resistant k. pneumoniae (mdr-kp), law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Intensive care, Internal medicine, medicine, 030212 general & internal medicine, Mechanical ventilation, RC86-88.9, Critically ill, business.industry, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, medicine.disease, Intensive care unit, Pneumonia, Inclusion and exclusion criteria, business, Polymyxin B, medicine.drug
Abstract: Introduction Critically ill patients in intensive care units are at high risk of dying not only from the severity of their illness but also from secondary causes such as hospital-acquired infections. USA national medical record-data show that approximately 10% of patients on mechanical ventilation in an intensive care unit developed ventilator-associated pneumonia. Polymyxin B has been used intravenously in the treatment of multi-drug resistant gram-negative infections, either as a monotherapy or with other potentially effective antibiotics, and the recent international guidelines have emphasised the use of nebulised polymyxin B together with intravenous polymyxin B to gain the optimum clinical outcome in ventilator-associated pneumonia cases caused by multi-drug resistant gram-negative infections. Methods One hundred and seventy-eight patients with ventilator-associated pneumonia due to multi-drug resistant K. pneumoniae were identified during the study period. Following the inclusion and exclusion criteria, 121 patients were enrolled in the study and randomly allocated to two study groups. Group 1 patients were treated with intravenous Polymyxin B plus nebulised polymyxin B (n=64) and Group 2 patients with intravenous Polymyxin B alone (n=57). The study aimed to compare the use of Polymyxin B plus its nebulised form to polymyxin B alone, in the treatment of MDR-K. pneumoniae associated ventilator-associated pneumonia in critically ill patients. Results In Group 1, a complete clearance of K. pneumoniae was found in fifty-nine patients (92.1%; n=64) compared to forty patients (70.1%, n=57) in the Group 2 (P
Published: 2021
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13. Additional baricitinib loading dose improves clinical outcome in COVID-19

Author: Raihan Rabbani, Shihan Mahmud Redwanul Huq, Jahidul Hasan, and Ahmad Mursel Anam
Subjects: 0301 basic medicine, Baricitinib, medicine.medical_treatment, Loading dose, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, medicine, baricitinib, 030212 general & internal medicine, COVID-19 pneumonia, Mechanical ventilation, Maintenance dose, business.industry, Mortality rate, General Medicine, medicine.disease, Intensive care unit, Pneumonia, loading dose, 030104 developmental biology, Anesthesia, maintenance dose, Room air distribution, Medicine, business, Research Article
Abstract: Pneumonia associated with coronavirus disease 2019 (COVID-19) has been accounted for high mortality rate in severe COVID-19 worldwide, and additional serious scarcity of standard and effective anti-inflammatory drug in COVID-19 pneumonia management is a big challenge. Baricitinib, a Janus kinase (JAK) inhibitor, is a promising drug in COVID-19 pneumonia. This study aims to compare the clinical outcome of moderate-to-severe COVID-19 pneumonia treated with baricitinib with or without a loading dose. This prospective case-control study enrolled 37 adult patients where 17 patients (control) received baricitinib at 4 mg oral daily dose and 20 patients (case) received an additional single 8 mg oral loading dose. The median day to gain blood oxygen saturation level ≥95% (in room air) and return in normal breathing function were lower in case group than the control group. The requirement of intensive care unit and mechanical ventilation support was higher in the control group than in the case group [29.4% (N = 17)/10% (N = 20), P < 0.05; 11.8% (N = 17)/5% (N = 20), P > 0.05), respectively]. Thus, an additional loading dose of baricitinib revealed better clinical outcome of patients with COVID-19 pneumonia.
Published: 2020

14. Dengue Fever, Expanded Dengue Syndrome and Dengue Shock Syndrome: Clinical Profile, Management and Outcome of Patients at a Tertiary Hospital, Dhaka, Bangladesh

Author: Anowar Hossain, Md Robed Amin, Md Abu Bakar, Kazi Ali Hassan, Jahangir Alam, Mirza Nazim Uddin, Pratik Dewan, Raihan Rabbani, and Rozana Rouf
Subjects: medicine.medical_specialty, business.industry, Emergency medicine, medicine, General Medicine, business, Dengue shock syndrome, medicine.disease, Profile management, Dengue fever
Abstract: Background: Dengue fever is endemic in Bangladesh. Its incidence has been increasing and spreadingfrom urban Dhaka to rural areas. In 2019, over 100,000 cases reported with deaths over 250.Clinical profiles varied from classical signs and symptoms to alarming severity and complications,such as, Expanded Dengue Syndrome (EDS), Dengue Shock Syndrome (DSS) along with coinfectionsand comorbidities. No detail study on EDS & DSS carried out yet over 2019 outbreak. This reporthighlights the features, management and the outcome of EDS & DSS cases of 2018-19 admitted in aspecialized tertiary private hospital in Dhaka, Bangladesh. Methods: This cross sectional observational study was performed at Square Hospital, Dhaka,exclusively over 62 adult dengue patients with complications who fulfilled the admission criteria inICU and HDU and managed as per national guidelines and diagnosed by positive NS1 Ag, DengueRT PCR , Anti-dengue IgM, hematological and biochemical tests. Results: Of 343 cases, 62 (18.1%) patients had complications; 17 (27.4%) admitted in ICU and 45(72.6%) patients in HDU. Among 62 patients, 25 patients had EDS (40.3%) and 17 had DSS (27.4%).Of the EDS patients, majority were 40-50 years old with male predominance. Of 62 patients, 42 hadatypical presentations (67.74%), 25 (40.3%) had EDS and 17 (27.4%) had DSS, 16 (25.8%) had coinfection,45 (72.58%) had co-morbidities. Most patients presented with gastrointestinal symptoms(80%). Twenty one cases (84%) of EDS survive; 4 (16%), died after developing rhabdomyolysis, multiorgandysfunction and acute renal failure. Conclusion: Early diagnosis of complicated cases by clinical features, lab predictors and early fluidtherapy are the key to successful management with positive outcome. Death could be averted byrecognizing the stage of plasma leakage indicated by raised CRP, reduced serum Albumin, andultrasonography for detecting ascites, pleural effusion, mucosal thickening and edema of gall bladderand appropriate replacement of fluid loss and maintenance of nutrition. Bangladesh J Medicine July 2020; 31(2) :58-63
Published: 2020
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15. Professional Burn out among physicians and nurses in ICUs of Bangladesh: a multi-center study

Author: Dewan Muhammad Mahmudul Gafur, Mohammad Asaduzzaman, Abdul Hamid, Rownak Jahan Tamanna, Samira Humaira Habib, Rezaul Karim, Uzzwal Kumar Mallick, AK Qumrul Huda, Raihan Rabbani, Mohammad Omar Faruq, Mohammad Saif Uddin, Asm Areef Ahsan, and Kaniz Fatema
Subjects: business.industry, Multi center study, Burn out, Medicine, General Medicine, Medical emergency, business, medicine.disease
Abstract: Background: Burn out is a common syndrome observed among health care workers in highly stressed environment of ICU. We investigated prevalence of burn out and its associated risk factors among doctors and nurses working in ICUs of Bangladesh. Methods: We conducted a cross sectional survey on 93 physicians and 247 nurses working in 12 ICUs of Bangladesh. Maslach Burn out Inventory-Human services Survey was used to measure Burn out outcome. Univariate and multivariate random effects logistic regression analysis of predictors for burnout as outcome measure among physicians and nurses were performed. Results: 21.3 % of all study physicians and nurses suffer moderate to high burn out. 51% of all study doctors and 87 % of all study nurses suffer from low burn out. For doctors working in ICU having a religious back ground, imbalance between professional working time and time for personal life, monthly salary, hours of sleep per day, years of working experience, percentage of work time spent in ICU and number of ICU patients cared for per day, no of stay-at-home night calls or night shifts per month at work appeared significantly associated with high burn out. For nurses having a religious back ground or belief, having child more than two, higher educational qualification (bachelor degree), low monthly salary; less hours per week engaged in charity work, low level of personal control over work, imbalanced work‑life, more than 26 work days per month, more frequent shifts in work, conflicts with colleagues all were associated with high burn out. Conclusion: Among all interventions, promoting reduction of work load and improving work-life balance need to be addressed as a priority in order to reduce burn out. Bangladesh Crit Care J March 2020; 8(1): 5-16
Published: 2020
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16. Survival Benefit of High Dose Versus Usual Dose of Baricitinib in Hospitalized Patients with COVID-19: A Systematic Review

Author: Shihan Huq, Raziuddin Ahmed, Mahiuddin Ahmed, Raihan Rabbani, Jahidul Hasan, and Ahmad Anam
Abstract: Baricitinib is an oral selective Janus kinase 1 and 2 inhibitor with known anti-inflammatory and anti-viral properties. In patients hospitalized for coronavirus disease 2019 (COVID-19), baricitinib has shown to reduce the risk of death in line with dexamethasone and tocilizumab. However, the most effective and safe dose or optimal dose of baricitinib in severe COVID-19 was not addressed. We conducted this systematic review to assess whether higher than usual dose could further improve survival as primary outcome. The need of ICU (Intensive care Unit) and Invasive or non-invasive positive pressure ventilation, time to wean from oxygen, length of stay at hospital and adverse events were analyzed as secondary outcome. We included 10,032 patients in 5 studies (2 randomised control trials and 3 high quality clinical trials). Among them,5,071 patients received baricitinib at different dosage (4909 patients received 4 mg once daily and 162 patients got more than 4 mg daily) and 4961 received standard of care. Baseline characteristics including mean age, sex, co-morbidities, inflammatory marker (C-reactive protein/CRP) were similar across the intervention and standard care groups. 4 out of 5 trials showed significant survival benefit in baricitinib group usual to higher dose (4 to 8 mg daily). Use of higher dose in 3 controlled trials was associated with significant reduction in admission to ICU and requirement of invasive or non-invasive ventilation support, shortening of hospital stay and earlier stabilization of oxygen status which was not evident in two randomized control trials using usual dose (4 mg daily). There was no significant difference in any serious adverse events or opportunistic infections between higher dose versus usual dose group. Therefore, baricitinib in higher dose could be a potent, highly effective and safe immunomodulatory drug in hospitalized patients with severe COVID-19.
Published: 2022
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17. Multimodal Decision Fusion of EEG and fNIRS Signals

Author: Md. Hasin Raihan Rabbani and Sheikh Md. Rabiul Islam
Published: 2021
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18. Obstructive hydrocephalus in a patient with SLE

Author: Ahmad Mursel Anam, Shihan Mahmud Redwanul Huq, Raihan Rabbani, and Lutfun Nahar Nizhu
Subjects: Pediatrics, medicine.medical_specialty, business.industry, medicine, Obstructive hydrocephalus, General Medicine, business
Abstract: Hydrocephalous is a rare manifestation of systemic lupus erythematosus. Cerebral venous thrombosis, immune complex deposition within the arachnoid villi or direct post-inflammatory lesions of the central nervous system are possible causes of developing acute hydrochephalus. We report a case of acute non-communicating hydrocephalus secondary to stenosis of the aqueduct of Sylvius. The condition developed rapidly in a 22-year-old woman with previously diagnosed SLE. Bangladesh J Medicine Jan 2020; 31(1) : 33-36
Published: 2019
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19. Severe Hypoalbuminemia Increases the Risk of Thrombocytopenia in Critically Ill Adult Patients Receiving Teicoplanin

Author: Raihan Rabbani, Sitesh C. Bachar, and Jahidul Hasan
Subjects: medicine.medical_specialty, Adult patients, Teicoplanin, Critically ill, business.industry, Pharmaceutical Science, biochemical phenomena, metabolism, and nutrition, medicine.disease, carbohydrates (lipids), hemic and lymphatic diseases, Internal medicine, medicine, Pharmacology (medical), Hypoalbuminemia, business, medicine.drug
Abstract: Teicoplanin is a drug of choice for treating infections by gram positive microorganisms. Teicoplanininduced thrombocytopenia is an adverse drug reaction found in critically ill patients receiving teicoplanin. The aim of this observational study was to analyze the increased risk of occurring teicoplanin-induced thrombocytopenia in patients with severe hypoalbuminemia than the patients having normal blood-albumin level. A 5-month long study was conducted in an adult-ICU department on 42 critically ill adult patients. In this study, 17 (40.48%, n=42) patients developed teicoplanin-induced thrombocytopenia and among them, 14 patients (60.87%, n=23) were suffering from severe hypoalbuminemia during the initiation of teicoplanin therapy. All the events were normalized within 48 hours after discontinuing the teicoplanin. In this study, we found that teicoplanin-induced thrombocytopenia is one of the most common adverse drug reaction developed in critically ill adult patients and concurrent severe hypoalbuminemia may enormously increase the risk of this adverse drug reaction. Dhaka Univ. J. Pharm. Sci. 18(2): 153-157, 2019 (December)
Published: 2019
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20. Evaluation of the Therapeutic Effectiveness of Polymyxin B Versus Colistin in Carbapenem-resistanct Klebsiella pneumoniae-Associated Bacteremia

Author: Jahidul Hasan, Raihan Rabbani, and Sitesh C. Bachar
Subjects: Carbapenem, biology, Therapeutic effectiveness, business.industry, Klebsiella pneumoniae, Pharmaceutical Science, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Microbiology, Bacteremia, Colistin, medicine, lipids (amino acids, peptides, and proteins), Pharmacology (medical), business, Polymyxin B, medicine.drug
Abstract: Polymyxins are the last resort antibiotics for treating carbapenem-resistance Klebsiella pneumoniae (CR-Kp)-associated bacteremia. The main aim of this study was to demonstrate the therapeutic effectiveness of polymyxin B versus colistin in the treatment of CR-Kp-associated Bacteremia. This 12-month long cross-sectional study was conducted on 54 and 47 patients suffering from CR-Kp-associated Bacteremia, and residing into two separate groups, they were treated with polymyxin B and colistin, respectively. After 5 day-treatment, the microbiological eradication rate was found 96.30% (52; n=54) in polymyxin B group and 87.23% (41; n=47) in colistin group. In the 30-day mortality rate-comparison, 51.03% more death was found in colistin group (34.04 %, n= 47) than the polymyxin B group (16.67 %, n= 54). In this study, Polymyxin B showed superior therapeutic potentiality with less number of secondary infections and 30-day mortality rate in CR-Kp-associated bacteremia than colistin. Dhaka Univ. J. Pharm. Sci. 18(2): 209-215, 2019 (December)
Published: 2019
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21. Clinical Interventions of Critical Care Pharmacist in the Therapeutic Management of Critically Ill Patients: a Retrospective Study in Bangladesh

Author: Raihan Rabbani, Sitesh C. Bachar, and Jahidul Hasan
Subjects: medicine.medical_specialty, Critically ill, business.industry, Pharmacist, Psychological intervention, medicine, Pharmaceutical Science, Pharmacology (medical), Retrospective cohort study, Intensive care medicine, business
Abstract: Critically ill patients at ICU are treated with poly pharmacy and conservative drug management is necessary for ensuring drugs’ safety and accuracy. The objective of this study was to analyze the qualitative intervention of critical care pharmacists (CCP) in critically ill patients’ effective medication management. This was a 6 months long observational study. All the provided suggestions of CCP were categorized into- A (drug-drug interaction), B (addition of new drug therapies), C (rational dosing of antibiotics), D (acceleration or deceleration of the doses) and E (adverse drug reaction). Out of total CCP’s 650 suggestions, 566 (87.08%) suggestions were accepted by doctors and modified the therapies, accordingly. CCP being a part of ICU’s multi professional team contribute the professional roles in generating safe, appropriate and quality prescriptions, which finally turns into quality pharmacotherapy for critically ill patients at ICU. Dhaka Univ. J. Pharm. Sci. 18(1): 113-119, 2019 (June)
Published: 2019
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22. Impact of high dose of baricitinib in severe COVID-19 pneumonia: a prospective cohort study in Bangladesh

Author: Sitesh C. Bachar, Mohammad Mufizul Islam Polash, Raihan Rabbani, Shihan Mahmud Redwanul Huq, Ahmad Mursel Anam, Shahzadi Sayeeda Tun Nessa, and Jahidul Hasan
Subjects: Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Care, Baricitinib, High dose, Administration, Oral, Infectious and parasitic diseases, RC109-216, Comorbidity, 030204 cardiovascular system & hematology, Cytokine storm, Patient Readmission, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Respiratory system, Usual dose, Prospective cohort study, Aged, Bangladesh, Sulfonamides, business.industry, Mortality rate, Anti-Inflammatory Agents, Non-Steroidal, COVID-19, Middle Aged, medicine.disease, Severe COVID-19 pneumonia, COVID-19 Drug Treatment, Pneumonia, Infectious Diseases, Treatment Outcome, Respiratory failure, Purines, Azetidines, Pyrazoles, Female, business, Respiratory Insufficiency, Research Article
Abstract: PurposeHyperinflammation in severe COVID-19 infection increases the risk of respiratory failure and one of the cogent reasons of mortality associated with COVID-19. Baricitinib, a janus kinases inhibitor, can potentially suppress inflammatory cascades in severe COVID-19 pneumonia.MethodsThe objective of this study was to compare the clinical outcomes of high dose of baricitinib with its usual dose in patients with severe COVID-19 pneumonia. This prospective cohort study was conducted on 238 adult patients with severe COVID-19 pneumonia. Eight milligram and 4 mg of baricitinib was given orally to 122 patients in the high dose (HD) group and 116 patients the usual dose (UD) group, respectively daily for 14 days, and clinical outcomes were compared among the groups.ResultsBlood oxygen saturation level was stabilized (≥94% on room air) earlier in the HD group compared to the UD group [5 (IQR: 4–5)/8 (IQR: 6–9),P P P > 0.05;N = 116/122, respectively]. The 30-day mortality and 60-day rehospitalization rate were higher in the UD group than the HD group [6%/3.3%,P P > 0.05;N = 116/122, respectively].ConclusionThe daily high dose of baricitinib in severe COVID-19 results in early stabilization of the respiratory functions, declined requirements of critical care supports, reduced rehospitalization with mortality rate compared to its daily usual dose.
Published: 2021

23. Secukinumab in severe COVID-19 pneumonia: Does it have a clinical impact?

Author: Jahidul Hasan, Shihan Mahmud Redwanul Huq, Ahmad Mursel Anam, and Raihan Rabbani
Subjects: Microbiology (medical), Adult, Male, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Antibodies, Monoclonal, Humanized, Psoriasis, medicine, Odds Ratio, Humans, Interleukin 6, Letter to the Editor, biology, business.industry, Interleukin-6, SARS-CoV-2, COVID-19, medicine.disease, Virology, Pneumonia, Infectious Diseases, Monoclonal, biology.protein, Secukinumab, Antibody, business
Abstract: Multiple RCTs of interleukin-6 (IL-6) inhibitors in COVID-19 have been published, with conflicting conclusions. We performed a meta-analysis to assess the impact of IL-6 inhibition on mortality from COVID-19, utilising meta-regression to explore differences in study results.Systematic database searches were performed to identify RCTs comparing IL-6 inhibitors (tocilizumab and sarilumab) to placebo or standard of care in adults with COVID-19. Meta-analysis was used to estimate the relative risk of mortality at 28 days between arms, expressed as a risk ratio. Within-study mortality rates were compared, and meta-regression was used to investigate treatment effect modification.Data from nine RCTs were included. The combined mortality rate across studies was 19% (95% CI: 18, 20%), ranging from 2% to 31%. The overall risk ratio for 28-day mortality was 0.90 (95% CI: 0.81, 0.99), in favour of benefit for IL-6 inhibition over placebo or standard of care, with low treatment effect heterogeneity: IIL-6 inhibition is associated with clinically meaningful improvements in outcomes for patients admitted with COVID-19. Long-term benefits of IL-6 inhibition, its effectiveness across healthcare systems, and implications for differing standards of care are currently unknown.
Published: 2021

24. Sepsis Management in Southeast Asia: A Review and Clinical Experience

Author: Yatin Mehta, Rajib Paul, Raihan Rabbani, Subhash Prasad Acharya, and Ushira Kapilani Withanaarachchi
Subjects: General Medicine
Abstract: Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb® are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.
Published: 2022
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25. Death Drink: Methanol Poisoning and Lifesaving Treatment in ICU of a Tertiary Care Hospital in Bangladesh

Author: Shihan Mahmud Redwanul Huq, Anam, Ahmad Mursel, Raihan Rabbani, Polash, Mohammad MUFIZUL ISLAM, Shahzadi Sayeeda Tun Nessa, and Dipesh Barua
Published: 2021
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26. Critical Care Pharmacist Using Free Drug-Interaction Checker Mobile Apps Can Ensure Medication Safety in Critically Ill Patients

Author: Sitesh C. Bachar, Jahidul Hasan, and Raihan Rabbani
Subjects: Polypharmacy, business.industry, Critically ill, Pharmacist, Mobile apps, 030204 cardiovascular system & hematology, medicine.disease, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Medicine, Observational study, 030212 general & internal medicine, Medical emergency, Free drug, Medical prescription, business
Abstract: Background: Critical care pharmacists (CCPs) have a key role in ensuring medication safety by screening drug-drug interactions (DIs) in polypharmacy prescriptions, mostly in critically ill patients. The drug-interaction checker mobile apps (DICMA) are freely available for smartphones. Objectives: The current study aimed to assess the utilization of smartphone-based free mobile apps by CCPs for ensuring drug-drug interaction-free polypharmacy prescriptions in critically ill patients. Methods: This observational study was conducted in an intensive care unit. Critical care pharmacists (CCPs) checked the medications of polypharmacy prescriptions to detect DIs or potential drug-drug interactions (PDIs) using free DICMA installed on their smartphones. DIs/PDIs were sent to physicians as suggestions, and the prescriptions were modified accordingly. Results: CCPs screened 2,967 prescriptions, where 11,128 and 3,932 DIs and PDIs were identified, respectively. Prescriptions with 6 to 10 medications and prescription with more than 10 medications, on average, had 3.28 and 7.53 DIs, respectively, and 1.42 and 4.7 PDIs, respectively. Physicians accepted 95.85% (n = 3,932) of PDI suggestions from CCPs and modified prescriptions, accordingly. CCPs reported a satisfaction level of 4 (on a scale of 5) concerning the use of free DICMA. Conclusions: Drug-drug interactions-free polypharmacy prescriptions can ensure medication safety in patients. CCPs are professionally responsible for this task, but resource-limited setups do not provide them scopes to accomplish this task efficiently. In this study, CCPs ensured medication safety in the prescriptions of critically ill patients efficiently using free DICMA installed on their smartphones.
Published: 2020
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27. Comparative Evaluation of Linezolid and Teicoplanin in the Treatment of Ventilator-Associated MRSA Pneumonia: A Single-Center Experience

Author: Raihan Rabbani, Shahzadi Sayeeda Tun Nessa, and Jahidul Hasan
Subjects: 0301 basic medicine, medicine.medical_specialty, 030106 microbiology, medicine.disease_cause, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, law, Internal medicine, medicine, 030212 general & internal medicine, Teicoplanin, business.industry, Ventilator-associated pneumonia, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, Intensive care unit, Methicillin-resistant Staphylococcus aureus, Discontinuation, Pneumonia, chemistry, Linezolid, business, Adverse drug reaction, medicine.drug
Abstract: Background: Ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious infection in an intensive care unit (ICU). Ventilator-associated MRSA pneumonia (VAMP) in critically ill patients causes a high rate of mortality. Objectives: This study mainly aimed to compare the clinical outcomes and associated drug safety perspective of linezolid and teicoplanin in VAMP treatment. Methods: This retrospective study included 98 adult ICU patients with VAMP, where 42 patients (LZD group) and 56 patients (TPN group) received a standard dose of linezolid and teicoplanin, respectively, for their VAMP treatment. Adverse reactions associated with linezolid and teicoplanin were considered. Clinical outcomes and 30-day mortality rates were compared in both groups. Results: The LZD group showed a higher MRSA eradication rate (97%, n = 34) than the TPN group (94.3%, n = 53) (P = 0.034). The linezolid and teicoplanin therapy was suddenly discontinued in 19% and 5.3% of the patients in the LZD and TPN groups, respectively, before completing the full duration of antibiotic therapy due to developed adverse drug reactions (ADRs), including thrombocytopenia (LZD/TPN groups: 7/1 event), tachycardia (LZD group: 1 event), and nephrotoxicity (TPN group: 2 events). This discontinuation increased the total duration of antibiotic therapy in 19% (n = 42) and 5.3% (n = 56) of the patients (P = 0.034) in the LZD and TPN groups, respectively. Conclusions: VAMP is a life-threatening event in critically ill ICU patients worldwide. In this study, teicoplanin showed better clinical outcomes with a certain higher level of drug safety compared to linezolid in the treatment of ventilator-associated MRSA pneumonia.
Published: 2020
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28. An additional high oral loading dose of baricitinib improves clinical outcome in patients with COVID-19 pneumonia

Author: Md Jahidul Hasan, Raihan Rabbani, Ahmad Anam, and Shihan Mahmud Huq
Published: 2020
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29. The Susceptibility of MDR

Author: Md Jahidul, Hasan, Raihan, Rabbani, Ahmad Mursel, Anam, Ario, Santini, and Shihan Mahmud Redwanul, Huq
Subjects: ventilator-associated pneumonia (VAP), multi-drug resistant K. pneumoniae (MDR-KP), Research Article, Polymyxin B
Abstract: Introduction Critically ill patients in intensive care units are at high risk of dying not only from the severity of their illness but also from secondary causes such as hospital-acquired infections. USA national medical record-data show that approximately 10% of patients on mechanical ventilation in an intensive care unit developed ventilator-associated pneumonia. Polymyxin B has been used intravenously in the treatment of multi-drug resistant gram-negative infections, either as a monotherapy or with other potentially effective antibiotics, and the recent international guidelines have emphasised the use of nebulised polymyxin B together with intravenous polymyxin B to gain the optimum clinical outcome in ventilator-associated pneumonia cases caused by multi-drug resistant gram-negative infections. Methods One hundred and seventy-eight patients with ventilator-associated pneumonia due to multi-drug resistant K. pneumoniae were identified during the study period. Following the inclusion and exclusion criteria, 121 patients were enrolled in the study and randomly allocated to two study groups. Group 1 patients were treated with intravenous Polymyxin B plus nebulised polymyxin B (n=64) and Group 2 patients with intravenous Polymyxin B alone (n=57). The study aimed to compare the use of Polymyxin B plus its nebulised form to polymyxin B alone, in the treatment of MDR-K. pneumoniae associated ventilator-associated pneumonia in critically ill patients. Results In Group 1, a complete clearance of K. pneumoniae was found in fifty-nine patients (92.1%; n=64) compared to forty patients (70.1%, n=57) in the Group 2 (P
Published: 2020

30. Early Event Detection and Discontinuation of the Culprit Drug Increases the Rate of Survival in Severe Cutaneous Adverse Drug Reactions: A Multi-Center Study in Bangladesh

Author: Sitesh C. Bachar, Ruhul Hassan Joarder, Jahidul Hasan, and Raihan Rabbani
Subjects: Toxic Epidermal Necrolysis, Drug, medicine.medical_specialty, medicine.drug_class, business.industry, media_common.quotation_subject, Antibiotics, Severe Cutaneous Adverse Drug Reactions, medicine.disease, Culprit, Toxic epidermal necrolysis, Adverse Drug Event, Discontinuation, Stevens-Johnson Syndrome, Internal medicine, medicine, Drug reaction, business, Survival rate, Adverse drug reaction, media_common
Abstract: Adverse drug reactions are completely unwanted drug reactions derived from self-medications and among those unpleasant reactions, severe cutaneous adverse drug reactions like, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Acute Generalized Exanthematous Pustolosis and Drug Reaction with Eosinophilia and Systemic Symptoms, are mostly life threatening harms, globally. The main objective of this study was to find out the impact of early detection of the adverse drug events and consequently prompt withdrawn of the suspected culprit drugs in the ultimate survival rate among the patients experienced with these types of unwelcome life threatening events in Bangladesh. Here, we found that antibiotics were accounted for most adverse drug reactions (81.13%, n=53) including serious reactions. This study also showed that if the adverse drug event is possibly detected with in the first 48 hours then, 72.73% (n=11) patients were survived from severe cutaneous adverse drug reactions, where as if delayed than 48 hours, only 20% (n=5) patients were survived. Similarly, 77.77% (n=9) patients were survived after the proper treatment when suspected culprit drugs were discontinued within first 48 hours and late discontinuation resulted in only 28.57% (n=7) survival rate among these patients. So, prompt response through early event-detection and discontinuation of the culprit drug, to a serious cutaneous adverse drug reaction can tremendously save life by providing early necessary management and required treatment.Read Complete Article at ijSciences: V72018121853 AND DOI: http://dx.doi.org/10.18483/ijSci.1853
Published: 2019
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31. N-acetylcysteine in the Effective Management of TEN-associated Severe Skin Lesions

Author: Raihan Rabbani, Jamia Ahmad, Ahmad Mursel Anam, and Md. Jahidul Hasan
Subjects: medicine.medical_specialty, business.industry, Blisters, Effective management, General Medicine, medicine.disease, Gastroenterology, Intensive care unit, Toxic epidermal necrolysis, law.invention, Acetylcysteine, law, Internal medicine, medicine, medicine.symptom, Mucosal bleeding, Skin lesion, business, Adverse drug reaction, medicine.drug
Abstract: Adverse drug reaction (ADR) is a serious life-threatening event and toxic epidermal necrolysis (TEN) is a serious ADR where severe skin lesions like, blisters with oral mucosal bleeding (OMB) are most common characteristics. Both watery blisters and OMB are painful conditions in TEN and considered as common source of infections. N-acetylcysteine (NAC) has anti-inflammatory property and the objective of this study was to observe the clinical response of NAC in the TEN-associated lesions management. For this study, we considered 17 patients those were suffering from TEN and admitted in the intensive care unit. Those 17 patients were distributed into 2 groups (A and B), where patients of group-A (n=7) treated with NAC while group-B's patients (n= 10) did not get NAC therapy. As a result, in group-A, 6 (85.71%; n=7) patients were found with complete remission of blisters and OMB progression within the 72 hours with 100% 10-day complete healing rate, whereas 60% patients in group-B (n= 10) required >72 hours for complete remission with 80% 10-day complete healing rate. So, NAC can be an effective therapy for prompt healing of life-threatening TEN-associated severe skin lesions.
Published: 2019
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32. Expanded dengue syndrome: three concomitant uncommon presentations in the same patient

Author: Raihan Rabbani, Ahmad Mursel Anam, and Farzana Shumy
Subjects: Adult, Male, medicine.medical_specialty, Pediatrics, 030231 tropical medicine, Lymphohistiocytosis, Hemophagocytic, Dengue fever, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Disease process, Severe Dengue, 030212 general & internal medicine, Intensive care medicine, Acalculous Cholecystitis, business.industry, Public Health, Environmental and Occupational Health, Syndrome, medicine.disease, Pancytopenia, Infectious Diseases, Pancreatitis, Concomitant, Cholecystitis, Acute pancreatitis, business, Acute acalculous cholecystitis
Abstract: We report a case of expanded dengue syndrome, where three uncommon presentations occurred concomitantly. A patient with dengue haemorrhagic fever presented initially with acute acalculous cholecystitis along with acute pancreatitis, but later on, during resolution of pancreatitis and cholecystitis, developed pancytopenia, most likely due to haemophagocytic syndrome. Such presentations, besides being rare themselves, have not been reported to occur concomitantly, in the same patient, during the same disease process.
Published: 2017
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33. Extensive Pneumocephalus Caused by Multidrug-Resistant Klebsiella pneumoniae

Author: Md. Jahidul Hasan and Raihan Rabbani
Subjects: Mechanical ventilation, biology, business.industry, Septic shock, Klebsiella pneumoniae, medicine.medical_treatment, medicine.disease, biology.organism_classification, Intensive care unit, law.invention, Pneumonia, Pneumocephalus, Cerebrospinal fluid, law, Anesthesia, Medicine, Surgery, Neurology (clinical), business, Multidrug resistant Klebsiella pneumoniae
Abstract: Pneumocephalus is a life-threatening event associated with different infectious diseases and trauma. Klebsiella pneumoniae is a gas-forming organism that can cause pneumocephalus. A woman aged 56 years presented with a history of septic shock and community-acquired pneumonia. She was supported by mechanical ventilation in intensive care unit. Multidrug-resistant K. pneumoniae was detected in her blood and tracheal aspirate. Her level of consciousness reduced, and clinical condition was deteriorating. The computed tomography scan of the brain revealed abundant pneumocephalus entities. Multidrug-resistant K. pneumoniae was found in her cerebrospinal fluid while on appropriate antibiotic therapy. She died from acute stroke during her treatment.
Published: 2020
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34. The Relationship of Trust, Product Attractiveness, and Technology Features Towards the Technology Acceptance Model in the Case of Vending Machine

Author: Alwan Raihan Rabbani and Soebowo Musa
Subjects: Attractiveness, Retail industry, Fully automated, business.industry, media_common.quotation_subject, System integration, Technology acceptance model, Ignorance, Product (category theory), Marketing, business, Automation, media_common
Abstract: Technology has influenced businesses in various ways by providing a tool for business to develop its activities further level. In retail industry, one of the technology developments is business automation through software integration enabling retail stores to become fully automated providing convenience for their customers. The most well-known retail automation is vending machine with the application in retail for selling food and beverages that has been used in many countries. However, in Indonesia, the development of vending machine is still considered low. Scholars argue that such low development is due to people’s ignorance on how to use the system. This study makes an attempt to examine this low utilization of vending machine by looking at the external factors such as product attractiveness, technology features, and trust towards Technology Acceptance Model (TAM). The study was conducted based on total of 220 respondents JABODETABEK area. The result of this research confirms that technology features has the most significant relationship with the acceptance of vending machine in Indonesia; while trust has a positive partial relationship with TAM.
Published: 2020
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35. Therapeutic Specification of the Last Resort Polymyxins: An Intelligent Approach

Author: Raihan Rabbani, Sitesh C. Bachar, and Jahidul Hasan
Subjects: medicine.drug_class, business.industry, Polymyxin, Antibiotics, Pharmacology, Multiple drug resistance, Minimum inhibitory concentration, Antibiotic resistance, Pharmacodynamics, medicine, Colistin, lipids (amino acids, peptides, and proteins), business, Polymyxin B, medicine.drug
Abstract: Polymyxins, especially polymyxin B and colistin (polymyxin E), are the last resort antibiotics among a few reserve antibiotics still showing potentiality against Gram-negative superbugs. Globally, during the alarming situation of fast-spreading antibiotic resistance in Gram-negative bacteria, the therapeutic application of polymyxins should be rational and target-specific considering their pharmacokinetic (PK) and pharmacodynamic (PD) characteristics. Intravenous polymyxin B shows relatively higher plasma protein binding and excessive renal tubular reabsorption; it invariably exists in the plasma for longer periods, maintaining the minimum inhibitory concentration (MIC) properly, and mostly are excreted out through a nonrenal pathway. On the other hand, intravenous inactive colistimethate sodium is bio-converted in the blood and kidneys into the active colistin moiety that manifests relatively higher colistin concentration in the urinary tract for longer duration possessing the MIC statically. This study comprehensively evaluated the PK and PD data of polymyxins assuming that the therapeutic specification of polymyxin B in bloodstream infections and colistin in urinary tract infections caused by multidrug-resistant Gram-negative bacteria may be an intelligent approach during the emergence of antibiotic resistance. The therapeutic specification of polymyxins may effectively reduce the progression of polymyxin resistance and optimize its therapeutic outcomes in the treatment of life-threatening infections.
Published: 2019
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36. A young adult with post-traumatic breathlessness, unconsciousness and rash

Author: Raihan Rabbani, Mohammed Momrezul Islam, Abdul Kader Shaikh, Shihan Mahmud Redwanul Huq, Nayeema Joarder, and Ahmad Mursel Anam
Subjects: Pulmonary and Respiratory Medicine, lcsh:RC705-779, Pediatrics, medicine.medical_specialty, business.industry, fungi, Unconsciousness, food and beverages, Case Report, lcsh:Diseases of the respiratory system, respiratory system, Expert Opinion, Rash, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, medicine, 030212 general & internal medicine, medicine.symptom, Young adult, business
Abstract: A 23-year-old Bangladeshi male was referred to our hospital for gradual worsening of breathlessness over 3 h, developed following a road-accident about 14 h previously. He had a close fracture of mid-shaft of his right tibia, which was immobilised with back slab at the previous healthcare facility. During presentation at the emergency department, he was conscious and oriented (Glasgow coma scale 15/15), tachycardic (heart rate 132 per min), blood pressure 100/70 mmHg, tachypnoeic (respiratory rate 34 per min) with oxygen saturation 89% on room air, and afebrile. Chest examination revealed restricted chest movement, hyper-resonant percussion notes and reduced breath sound on the left, and diffuse crackles on both sides., Can you diagnose this young adult with post-traumatic breathlessness, unconsciousness and rash? http://bit.ly/2LlpkiV
Published: 2019

37. High-voltage electrocution-induced pulmonary injury and cerebellar hemorrhage with fractures in atlas

Author: Raihan Rabbani, Lutfun Nahar Nizhu, and Jahidul Hasan
Subjects: lcsh:Surgery, Case Report, Critical Care and Intensive Care Medicine, Electrical Injuries, 03 medical and health sciences, 0302 clinical medicine, Medicine, Orthopedics and Sports Medicine, Electrocution, 030222 orthopedics, business.industry, Mortality rate, 030208 emergency & critical care medicine, lcsh:RD1-811, High-voltage, medicine.disease, people.cause_of_death, Cerebellar hemorrhage, Electrical burn, medicine.anatomical_structure, Pulmonary injury, Anesthesia, Accidental, Soft tissue injury, Emergency Medicine, business, people, Cervical vertebrae
Abstract: Background: Electrocution is a common cause of mild to severe multisystem injuries leading to high rate of mortality and morbidity. Low to high-voltage injury may be clinically manifested from a simple unpleasant sensation to multiple soft tissue injury which may cause instant death. The severity of injury depends on intensity of the electrical current, voltage of the source, resistance in the victims' body and the duration of the contact. Case presentation: A 20-year-old young male experienced with an accidental high-voltage electrocution injury from a blasted electrical transformer while passing across the road. He lost his consciousness and immediately hospitalized. Bilateral pulmonary infiltrates and right cerebellar hemorrhage with fractures in anterior and posterior arch of the first cervical vertebrae (C1) were diagnosed, and there was no history of electrical burn. He stayed in hospital for three days and completely treated with initial oxygen supplementation and immobilization of his head and neck with a Philadelphia collar for 6 weeks. Electrocution is a serious public health concern and reported worldwide with few fatal ending. Accidental high-voltage electrocution injury is a serious type of unfortunate accidental injuries which in most of times, ends with immediate or delayed sequelae or even death. In this case, the victim with high-voltage-associated electrical injuries in his lungs and brain was completely recovered because of early hospitalization. Conclusions: Electrocution injury is an accidental event with high mortality and morbidity rate. Mild to severe electrical current-induced injuries including burn can be treated successfully in most of the cases, but early hospitalization is highly required. Keywords: High-voltage, Electrocution, Cerebellar hemorrhage, Pulmonary injury
Published: 2019

38. The Use of High Dose Eltrombopag in the Management of Sepsis-Associated Thrombocytopenia in Critically Ill Patients

Author: Md. Jahidul Hasan, Shihan Mahmud Redwanul Huq, and Raihan Rabbani
Subjects: medicine.medical_specialty, Eltrombopag, thrombocytopenia, Disease, 030204 cardiovascular system & hematology, sepsis, Sepsis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, megakaryocytes, hemic and lymphatic diseases, Internal medicine, medicine, Platelet, 030212 general & internal medicine, Adverse effect, Thrombopoietin receptor, thrombopoietin receptor, RC86-88.9, Critically ill, business.industry, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, medicine.disease, chemistry, Observational study, eltrombopag, business, Research Article
Abstract: Introduction Sepsis is a life-threatening condition, and sepsis-associated thrombocytopenia (SAT) is a common consequence of the disease where platelet count falls drastically within a very short time. Multiple key factors may cause platelet over-activation, destruction and reduction in platelet production during the sepsis. Eltrombopag is a thrombopoietin receptor agonist and is the second-line drug of choice in the treatment of chronic immune thrombocytopenia (ITP). Aim of the study The objective of this study was to observe the therapeutic outcome of high dose eltrombopag in SAT management in critically ill patients. Material and Methods This 6-month-long single group, observational study was conducted on seventeen ICU patients with SAT. Eltrombopag 100 mg/day in two divided doses was given to each patient. Platelet counts were monitored. A low platelet blood count returning to 150 K/μL or above, is taken as indicative of a successful reversal of a thrombocytopenia event. Results The mean Apache II score of patients (n= 17) was 18.71 (p-value: >0.05). No eltrombopag-induced adverse event was observed among the patients during the study period. Thrombocytopenia events were reversed successfully in 64.71% of patients (11; n= 17) within eight days of eltrombopag therapy. Conclusions The therapeutic potentiality of high dose eltrombopag regime in the management of sepsis-associated thrombocytopenia was found clinically significant in over two-thirds of critically ill adult patients enrolled in the study. These data may point to a new strategy in the management of acute type of thrombocytopenia in septic patients.
Published: 2019

39. Blood biochemical abnormalities of intensive care unit patients with SARS-CoV-2 infection, single center experience in Bangladesh

Author: Raihan Rabbani, Israt Yesmin, Bidoura Naznin, Mousumi Ghosh, and Arebia Rahman
Subjects: medicine.medical_specialty, business.industry, Secondary infection, Disease, medicine.disease, Single Center, Intensive care unit, Comorbidity, law.invention, Pneumonia, law, Internal medicine, Diabetes mellitus, Medicine, Observational study, business
Abstract: Background: Since its emergence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, and led to ever-increasing mortality. SARS-CoV-2 infection perturbs the function of the body’s vital organs, making patients of all ages susceptible to the disease. Nevertheless, individuals developing critical illness with poor outcomes were mostly the elderly and people with co-morbid conditions, who constituted the vast majority of coronavirus disease 2019 (COVID-19) fatalities. Complications of COVID-19 mostly involve the respiratory, renal and cardiovascular systems, and in severe cases secondary infections leading to pneumonia and acute respiratory distress syndrome, which may precede the death of the patient. Multi-organ failure in individuals with COVID-19 could be a consequence of their co-morbidities. It is hoped that the review will lead to more comprehensive understanding of this complex disease. The aim of the study was to evaluate biochemical abnormalities during SARS-CoV-2 infection of ICU patients. Methods: This observational study was conducted in Square Hospital Limited, Dhaka, Bangladesh, on 50 patients received ICU treatment with moderate to severe COVID-19 symptoms admitted to this hospital from 15 July to 15 September 2020. Results: Among the participants most of them were 19 (38%) belongs to 65-74 years age group male 38 (78.00%) were dominating the gender distribution. IL6, CRP, creatinine and troponin were found the most significant in biochemical blood parameters. The maximum level of comorbidity was observed due to diabetes mellitus, ischemic heart disease, and hypertension . Conclusions: Biochemical parameters may be used as an indicator of COVID-19 infections and the severity of ICU patients. For the consistency of the course of patients, the markers could be used.
Published: 2021
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40. The Pattern of Poisoning and It’s Management and Outcome in a Tertiary Care Hospital, Bangladesh: An Observational Study

Author: Rozana Rouf, Raihan Rabbani, Tahmina Rahman, Pratik Dewan, and Shihan Mahmud Redwanul Huq
Subjects: General Medicine
Published: 2021
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41. When Free 'Drug-Interaction Checker Mobile Apps' Ensure Interaction Free Medications for ICU Patients in Resource Limited Setups

Author: Md. Jahidul Hasan, Raihan Rabbani, and Sitesh C. Bachar
Subjects: Polypharmacy, medicine.medical_specialty, business.industry, Family medicine, Psychological intervention, Declaration, Mobile apps, Medicine, Retrospective cohort study, Free drug, Medical prescription, business, Limited resources
Abstract: Polypharmacy prescriptions increase the risk of drug-drug interactions (DIs) including potential drug-drug interactions (PDI) leading to alteration of drugs' therapeutic responses and occurrence of adverse drug reactions (ADRs). Critical care pharmacists (CCP) are the key responsible persons for monitoring DIs and PDIs, and drug-interaction checker mobile apps (DICMA) are the most useful tool. The main objective of this study was to evaluate the outcomes of CCP interventions in monitoring the DIs/PDIs in ICU-patients of a resource limited setup by using free DICMA. This retrospective study was conducted in a hospital in Dhaka, Bangladesh. Without having any paid DICMA, CCP of that ICU used the free DICMA: 'Medscape' and 'Epocrates' to check DIs frequently in every prescription, CCP suggested to doctors and prescriptions were modified, accordingly. Those suggestions were collected from the hospital data archive and the satisfaction level of CCP to DICMA was measured. CCP worked on 2,967 critical patients, 11,128 DIs were detected, 3,932 PDIs were identified and suggested to doctors. In every patient, 1.77 (on average) PDIs were calculated. Prescriptions containing 6 to 10 medications and above 10 medications, the number of available DIs were 3.28 and 7.53, respectively; and the number of PDIs were 1.42 and 4.7, respectively. Doctors accepted 95.85% of total PDIs suggestions (n= 3,932) and 30.41% of those PDIs suggestions yielded immediate positive responses in patients. The satisfaction level of CCP in using free DICMA was 4 (on a scale of 5). Most of the resource limited setups are unable to provide a paid DICMA to its CCP for monitoring DIs. Free DICMA can be an alternative solution for CCP to safe the critical patients from serious DIs, PDIs and ADRs through frequently screening the prescriptions, easily and cost-effectively. Funding Statement: The authors state: "No external funding source for this study." Declaration of Interests: The authors declare: "No conflicts of interest." Ethics Approval Statement: The ethical approval for this study was taken on March, 2017 from the hospital ethical committee.
Published: 2019
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42. Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Author: Jahidul Hasan, Raihan Rabbani, and Lutfun Nahar Nizhu
Subjects: 0301 basic medicine, medicine.drug_class, Aerobic bacteria, Polymyxin, 030106 microbiology, Antibiotics, Pandrug-resistance, Tigecycline, Infectious and parasitic diseases, RC109-216, Bloodstream infection, Loading dose, Article, Microbiology, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Alcaligenes faecalis, biology, Double dose, business.industry, biology.organism_classification, Infectious Diseases, Double-dose, business, medicine.drug
Abstract: Introduction: Alcaligenes faecalis is a species of gram-negative, rod-shaped, aerobic bacteria commonly found in the environment. A. faecalis-associated nosocomial infections are common in hospitalized patients, but serious life threatening infections are rare. Here, we report a rare case of BSI with A. faecalis resistant to all available antibiotics; successfully treated with double-dose of tigecycline. Presentation of case: A 60-year-old female presented with A. faecalis bloodstream infection, where the organism was completely resistant to all commercially available antibiotics including polymyxins and tigecycline. The physical condition of the patient was deteriorating and there were no active antibiotics available to prescribe based on sensitivities. Despite the organism’s resistance to tigecycline, double-dose of tigecycline therapy (100 mg twice daily, intravenously after a 200 mg single intravenous loading dose) was prescribed intentionally for the treatment of this infection. The organism was completely eradicated from the bloodstream of that patient within the 5 days of therapy-initiation. Discussion: Double-dose of tigecycline maintains a higher serum drug concentration rather than the standard dose, and in this case, double-dose of tigecycline completely cleared the pandrug-resistant A. faecalis from the blood where initially, that organism was resistant to tigecycline. Previously, A. faecalis isolates were found resistant to fluoroquinolones, but here it was found very rarely resistant to even reserve antibiotics, polymyxins, carbapenems and tigecycline. Conclusion: Pandrug-resistant A. faecalis-associated bloodstream infection is a very uncommon case and double-dose of tigecycline may be an effective option to treat it. Keywords: Alcaligenes faecalis, Pandrug-resistance, Bloodstream infection, Double-dose, Tigecycline
Published: 2019

43. Nipah Virus Encephalitis: Mri Findings

Author: Jamia Ahmad, Ahmad Mursel Anam, Raihan Rabbani, and Shihan Mahmud Redwanul Huq
Subjects: MRI findings, Bangladesh, lcsh:R5-920, medicine.diagnostic_test, business.industry, encephalitis, Nipah virus, Magnetic resonance imaging, General Medicine, medicine.disease, Virology, Education, Nipah virus encephalitis, medicine, lcsh:Medicine (General), business, Encephalitis, Mri findings
Published: 2019
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44. Microbiological Profile of Severe Lower Respiratory Tract Infection in Intensive Care Unit of a Tertiary Care Center of Dhaka, Bangladesh

Author: Raihan Rabbani, Motiul Islam, Fazle Rabbi Mohammed, M Abul Kashem, and M Abdul Mannan
Subjects: Respiratory tract infections, biology, business.industry, Antibiotic sensitivity, General Medicine, medicine.disease_cause, medicine.disease, biology.organism_classification, Methicillin-resistant Staphylococcus aureus, Intensive care unit, Microbiology, Acinetobacter baumannii, law.invention, Antibiotic resistance, law, Lower respiratory tract infection, medicine, Colistin, business, medicine.drug
Abstract: Background: Microbial resistance to antibiotics is nowadays a great threat to intensive care unit patients especially in severe pneumonia leading to high morbidity and mortality. Bacterial profile and antibiotic sensitivity pattern would help clinician in selecting more proper empirical therapy before isolation of microbes.Materials and Methods: This retrospective study was performed among 210 patients of lower respiratory tract infection in intensive care unit in Square Hospitals Ltd, a tertiary care hospital in Dhaka. Sputum, tracheal aspirates or broncho alveolar lavage were cultured, identified and antibiotic sensitivity pattern performed by standard methods.Results: Of 210 specimens, 150 (71%) were culture positive and 60 (29%) showed no growth. From 150 culture positives, 216 isolates were recovered, of which 7 specimen shows more than 2 organisms each, 52 specimen shows 2 isolates per specimen remaining 91 specimen with single isolates were recovered. The most common organisms in order of frequency were, Acinetobacter baumannii (24.0%), Staphylococcus aureus (20.6%), Klebsiella pneumoniae (19.3%), Pseudomonas aeruginisa (19.3%), Escherichia coli (14%) and Candida albicans (13%). A very high rate (83-93%) of resistance was observed among Acinetobactor baumanni to Beta lactum and clavulanate, Cephalosporin, Quinolones and Carbapenem. No resistant was observed with Colistin. Linezolid and Vancomycin are most effective against methicillin resistant Staphylococcus aureus, Coagulase negative Staphylococcus aureus and Escherichia coli, where no resistance was found.Conclusion: Farmenter and nonfermenters are the both common etiological agents of lower respiratory tract infections in this intensive care unit. There is high rate of resistance to commonly used cephalosporin and ?-lactam-?-lactamase inhibitors and quinolone group of drugs. Acinetobacter baumannii, Pseudomonas aeruginisa and Klebsiella showed most sensitivity to Colistin and actually no resistance was found.Bangladesh Crit Care J September 2014; 2 (2): 53-56
Published: 2015
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45. Dengue Fever induced Myocarditis

Author: Ahmad Mursel Anam, Raihan Rabbani, Adnan Shareef, and Zahirul Islam
Subjects: medicine.medical_specialty, Myocarditis, business.industry, Febrile illness, General Medicine, medicine.disease, Asymptomatic, Dengue fever, medicine, Fatal disease, Medical emergency, medicine.symptom, Intensive care medicine, business, Viral illness
Abstract: Dengue is an arthropod-borne viral illness, mostly asymptomatic, but may present with a wide variety of clinical manifestations, from mild febrile illness to severe and fatal disease. Cardiac involvement is a significant yet under-reported one because of lack of awareness. We report a case of myocarditis in Dengue Fever with an intention to create awareness among the physicians.Bangladesh Crit Care J September 2016; 4 (2): 125-127
Published: 2016
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46. Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital

Author: Mohammed Abdus Satter Sarker, Nahida Zafrin, Raihan Rabbani, Motlabur Rahman, Hasan Shahrear Ahmed, and Rama Biswas
Subjects: Imipenem, medicine.medical_specialty, business.industry, Antibiotic sensitivity, General Medicine, biochemical phenomena, metabolism, and nutrition, Amoxicillin, bacterial infections and mycoses, Meropenem, Microbiology, Amikacin, Nitrofurantoin, Internal medicine, medicine, Gentamicin, business, Cefixime, medicine.drug
Abstract: Background: Urinary tract infections (UTIs) remain the common infections in outpatients as well as hospitalized patients. Current knowledge on antimicrobial sensitivity pattern is essential for appropriate therapy. The aim of the study is to determine the changing pattern of antibiotic sensitivity among uropathogens causing UTI. Methods: Urinary isolates from symptomatic UTI cases attending in Square hospital were processed in the Microbiology lab. Antimicrobial susceptibility testing was performed by Kirby Bauers disc diffusion method. Extended spectrum beta lactamase (ESBL) production was determined by double disk synergy test method. Results: Of the 200 tested sample 110 samples showed growth of pathogens among which the most prevalent were E.coli (58.18%) followed by Enterococci (13.6%). The majority (68.18%) of the isolates were from female. ESBL production was observed in 46.87% o E.coli strains and 25% of Klebsiella strains. More than 98% of the isolates are sensitive to Imipenem, Meropenem , while 86.36% are sensitive to Amikacin, 73.63% to Nitrofurantoin and 74.54% to Gentamicin. Very high rate of resistance is seen against amoxicillin (88.19%), cefixime (65.46%), cotrimoxazole (68.19%) and ceftriaxone (63.63%). E. coli showed high sensitivity to meropenem, imipenem and amikacin (100%) followed by Gentamicin (94.1%). Conclusion: The study revealed that E.coli was the predominant bacterial pathogens of UTIs. An increasing trend in the production ESBLs among UTI pathogens in the community was noted. Nitrofurantoin should be used as empirical therapy for primary, uncomplicated UTIs. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19952 Bangladesh Crit Care J March 2014; 2 (1): 21-24
Published: 2014
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47. The need for adequate research data on carbapenem use and resistance in Bangladesh

Author: Jahidul Hasan and Raihan Rabbani
Subjects: medicine.medical_specialty, Carbapenem, Infectious Diseases, Resistance (ecology), business.industry, Bacteremia, medicine, MEDLINE, Intensive care medicine, medicine.disease, business, Research data, medicine.drug
Published: 2019
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48. Hyperreflexia in Guillain Barre Syndrome: A Case Report

Author: Raihan Rabbani, Mosharof Hossain, Mrinal Kanti Das, Sheikh M.K. Alam, Poly Sengupta, Kazi Deen Mohammad, and Abdul Kader Shaikh
Subjects: medicine.medical_specialty, Weakness, Guillain-Barre syndrome, medicine.diagnostic_test, business.industry, Polyradiculoneuropathy, Deep Tendon Reflex, Hyperreflexia, medicine.disease, Surgery, Methylprednisolone, Nerve conduction study, Reflex, Medicine, medicine.symptom, business, medicine.drug
Abstract: Guillain Barre Syndrome (GBS) is an immune mediated polyradiculoneuropathy classically characterized by acute ascending type of motor weakness of limbs with areflexia but in AMAN variant of GBS preserved or exaggerated reflex sometimes can occur. We report a 45 year old female patient who presented with acute flaccid quadriplegia, bilateral facial lower motor type nerve palsy and bulbar involvement, initial hyperreflexia of all four limbs and bilateral plantar extensor response 7 days following an attack of diarrhoea. Sensory and bowel bladder function was intact. She was treated with IV immunoglobulin and IV methylprednisolone. Nerve Conduction study (NCS) revealed AMAN variant of GBS. All reflexes disappeared on the 2nd day onward but returned on 21st day of illness when muscle power also improved. Follow up NCS confirmed regeneration of nerves of all four limbs. So in any patient presenting with acute quadriparesis GBS should be in the differential diagnosis even if there is preserved or exaggerated deep tendon reflexes.J Bangladesh Coll Phys Surg 2014; 32: 107-109
Published: 2015
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49. Subsequent pancreatitis and haemothorax in a patient of expanded dengue syndrome

Author: Farzana Shumy, M Mufizul Islam Polash, Raihan Rabbani, and Ahmad Mursel Anam
Subjects: Male, medicine.medical_specialty, Pediatrics, 030231 tropical medicine, Dengue fever, Diagnosis, Differential, Young Adult, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Disease process, Severe Dengue, Intensive care medicine, Hemothorax, Dengue haemorrhagic fever, business.industry, Public Health, Environmental and Occupational Health, Syndrome, medicine.disease, Infectious Diseases, Pancreatitis, Effusion, Acute pancreatitis, 030211 gastroenterology & hepatology, business
Abstract: We report a case of expanded dengue syndrome, where two different presentations occurred subsequently. A patient of dengue haemorrhagic fever initially was admitted with acute pancreatitis, complicated with left pancreatic effusion, but later on, during resolution of pancreatitis and effusion, developed spontaneous right haemothorax. Such presentations, besides being rare themselves, have not been reported to occur subsequently, in the same patient, during the same disease process.
Published: 2015
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50. Fat Embolism Syndrome: Our Experience

Author: Arm Nooruzzaman, Motiul Islam, Ahmad Mursel Anam, Mirza Nazim Uddin, Mohammad Mufizul Islam Polash, and Raihan Rabbani
Subjects: Traumatic fracture, medicine.medical_specialty, business.industry, Pulmonary insufficiency, Signs and symptoms, General Medicine, Artificial respiration, medicine.disease, Surgery, medicine.anatomical_structure, Intensive care, Fat embolism syndrome, medicine, Radiology, Fat embolism, business, Pelvis
Abstract: Fat embolism syndrome is a serious consequence of fat emboli producing a distinct pattern of clinical symptoms and signs. It is most commonly associated with fractures of long bones and the pelvis. Patients usually present with signs and symptoms of multiorgan dysfunction, particularly involving the triad of lungs, brain, and skin. A combination of clinical criteria and MRI brain will enable early and accurate diagnosis of FES. Prevention, early diagnosis, and adequate symptomatic treatment are the mainstay of management. We present a case who became drowsy, after a few hours of a traumatic fracture and developed pulmonary insufficiency, cutaneous petechiae. MRI findings were consistent with cerebral fat embolism. Treatment included intensive care, artificial respiration, and symptomatic therapy. The patient had recovered completely. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14370 Bangladesh Crit Care J March 2013; 1: 49-52
Published: 2013
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