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Article ; Online: Utilization of a Supraglottic Airway Device for Airway Rescue and Tamponade of an Oropharyngeal Hemorrhage After Systemic Thrombolysis for an Acute Ischemic Stroke: A Case Report.

Hashim, Salman / Patel, Nishita / Nozari, Ala / Mustafa, Wissam

A&A practice

2024 Volume 18, Issue 4, Page(s) e01782

Abstract: A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a ... ...

Abstract	A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask ventilation with an oral airway proved difficult. The team successfully placed a supraglottic airway (SGA) through which an oral endotracheal tube (ETT) was advanced over a fiberoptic bronchoscope into the trachea. The SGA remained overnight with the cuff inflated to tamponade the bleeding. The ETT was exchanged over an airway exchange catheter on postoperative day 1 without further airway complications.
MeSH term(s)	Male ; Humans ; Adult ; Tissue Plasminogen Activator/therapeutic use ; Ischemic Stroke ; Trachea ; Hemorrhage ; Thrombolytic Therapy
Chemical Substances	Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2024-04-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2575-3126
ISSN (online)	2575-3126
DOI	10.1213/XAA.0000000000001782
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Article ; Online: Possible immuno-modulatory effects of tocilizumab in patients with refractory status epilepticus.

El-Haggar, S M / Hegazy, S K / Mustafa, W / Khrieba, M O

European review for medical and pharmacological sciences

2023 Volume 27, Issue 4, Page(s) 1512–1521

Abstract: Objective: Refractory Status Epilepticus (RSE) is a neurologic emergency that carries a high risk of mortality and morbidity. Every year, there are about 200,000 cases in the United States, affecting people of all ages. This study aimed to investigate ... ...

Abstract	Objective: Refractory Status Epilepticus (RSE) is a neurologic emergency that carries a high risk of mortality and morbidity. Every year, there are about 200,000 cases in the United States, affecting people of all ages. This study aimed to investigate the possible immuno-modulatory effect of tocilizumab in RSE patients receiving conventional anti-epileptic drugs. Patients and methods: 50 outpatients who fulfilled the inclusion requirements for RSE were recruited in this randomized, controlled, and prospective study. The patients were divided into two groups randomly (n=25); the control group received standard RSE treatment, consisting of propofol, pentobarbital, and midazolam, and the tocilizumab group received standard RSE treatment plus tocilizumab. A neurologist evaluated each patient at the beginning of the therapy and after 3 months. Before and after treatment, serum nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and serum electrolytes were assessed. Results: The tocilizumab group showed a statistically significant reduction in the level of assessed parameters in comparison with the control group. Conclusions: Tocilizumab might be a novel adjuvant anti-inflammatory medication in managing RSE.
MeSH term(s)	Humans ; Prospective Studies ; Status Epilepticus ; Antibodies, Monoclonal, Humanized ; Outpatients
Chemical Substances	tocilizumab (I031V2H011) ; Antibodies, Monoclonal, Humanized
Language	English
Publishing date	2023-03-05
Publishing country	Italy
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
DOI	10.26355/eurrev_202302_31392
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Article: Evaluating the Efficacy of Methocarbamol and Nefopam in Orthopedic Surgical Pain.

Al-Nasrawi, Ahmed N / Al-Ibrahim, Mustafa W / Aljabran, Saifali J

Cureus

2024 Volume 16, Issue 5, Page(s) e59533

Abstract: Introduction Pain after orthopedic surgeries represents a special concern in patients with fractures. The use of multimodal analgesia significantly reduced the opioid need and reduced the risk of their side effects. Objectives This study compared the ... ...

Abstract	Introduction Pain after orthopedic surgeries represents a special concern in patients with fractures. The use of multimodal analgesia significantly reduced the opioid need and reduced the risk of their side effects. Objectives This study compared the effectiveness and safety of methocarbamol and nefopam in the reduction of post-operative pain for patients undergoing orthopedic surgeries. Method This prospective, double-blind, randomized controlled trial took place at Al-Sader Teaching Hospital in Basrah, Iraq, from the first of February 2022 to the end of October 2023. The study aimed to assess the post-operative pain relief efficacy and safety of intramuscular nefopam (20 mg) and intravenous methocarbamol (1 g) in 110 adults (aged 18-65) undergoing elective orthopedic surgeries. Exclusions were made for allergies to the drugs, substance abuse history, and severe hepatic or renal impairment. Participants were randomized into two groups, with pain intensity measured at one hour, six hours, and 12 hours post-operation using the visual analog scale (VAS). Side effects were also evaluated. Statistical analysis was done using SPSS 27, with a significance level set at p<0.05 and a 95% confidence interval (CI). Results In this study, we conducted a rigorous comparison between two groups, methocarbamol and nefopam, to evaluate their efficacy and safety in post-operative pain management. We started by ensuring that the groups were well-matched in terms of age, gender distribution, and body mass index (BMI). The results showed remarkable similarities in mean age, gender distribution, and BMI, supported by robust p-values, affirming the effective matching of the two groups. Moving to pain management, we observed a significant advantage in favor of methocarbamol. At all-time intervals (one hour, six hours, and 12 hours post-operation), methocarbamol consistently demonstrated lower mean VAS scores compared to nefopam. These differences were highly statistically significant, underscoring the superior pain relief efficacy of methocarbamol. Exploring side effects, we found no statistically significant disparities in the occurrence of nausea and vomiting between the two groups. However, there was a noticeable trend toward higher tachycardia incidence in the nefopam group, though it did not reach statistical significance. Conclusion The present study showed a higher efficacy of methocarbamol in post-operative pain reduction in comparison to nefopam. No serious side effects were observed with both drugs.
Language	English
Publishing date	2024-05-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.59533
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Article ; Online: Awareness During Anesthesia for Trauma: Has Anything Changed?

Lambert, Donald H / Mustafa, Wissam / Rendon, Luis F / Hartman, Ciana / Xu, Lan / Canelli, Robert

Anesthesia and analgesia

2024 Volume 138, Issue 4, Page(s) e19–e20

MeSH term(s)	Humans ; Intraoperative Awareness/diagnosis ; Intraoperative Awareness/prevention & control ; Anesthesia/adverse effects ; Anesthesiology ; Awareness ; Anesthesia, General
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006927
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Article: Evaluating the frequency of successful guidewire crossing through a complex lesion in coronary artery disease patients having chronic total occlusion.

Akhtar, Waheed / Shah, Syed Tehseen / Hasrat, Shahzad / Mustafa, Waqar

Pakistan journal of medical sciences

2022 Volume 38, Issue 5, Page(s) 1113–1117

Abstract: Objectives: To determine the frequency of successful guidewire crossing through chronic total occlusion (CTO) in patients having a J-CTO Score = 2 (difficult lesion).: Methods: A prospective, cross-sectional study was conducted at the Armed Forces ... ...

Abstract	Objectives: To determine the frequency of successful guidewire crossing through chronic total occlusion (CTO) in patients having a J-CTO Score = 2 (difficult lesion). Methods: A prospective, cross-sectional study was conducted at the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi. Patients with high calcium score on CT-angiogram were sent for elective coronary angiogram out of which patients diagnosed with chronic total occlusion (CTO) were selected and J-CTO Score was assessed. Those with a J-CTO score = 2 (difficult lesion) were enrolled for percutaneous coronary intervention (PCI). Guidewire that can cross the lesion within 30 minutes was considered successful. Results: A total of 158(95.8%) cases had successful guidewire crossing, while in 7(4.2%) patients, the procedure was unsuccessful. No significant association between the success rate of guidewire crossing and age (p = 0.21). Furthermore, there was no statistically significant relationship between guidewire crossing and LV function (p = 0.559) i.e. 32.2% and 42.9% of those with LV function between 25-35% had successful and unsuccessful guidewire crossing, respectively. While 67.7% and 57.1% patients having 36-65% LV function were observed having successful and failed PCI, respectively. Conclusions: The success rate of guidewire crossing through CTO in patients having a J-CTO Score =2 (difficult lesion) is acceptable so J-CTO score can be considered for difficulty grading of the lesion before intervention to prevent complications and success rate of PCI.
Language	English
Publishing date	2022-05-18
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	2032827-8
ISSN	1681-715X ; 1682-024X ; 1017-4699
ISSN (online)	1681-715X
ISSN	1682-024X ; 1017-4699
DOI	10.12669/pjms.38.5.4770
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Article: Relationship Between Cardiometabolic Index in Early Pregnancy and Hypertensive Disorder Complicating Pregnancy.

Khan, Zakir Ullah / Khan, Shakir Ullah / Tariq, Musaira / Mustafa, Waqar / Saleem, Humayun / Akbar, Amna / Jadoon, Sarosh Khan / Tasneem, Sabahat

Cureus

2024 Volume 16, Issue 1, Page(s) e51598

Abstract: Background This study aimed to examine the cardiometabolic index during early pregnancy in individuals with hypertension-complicating pregnancy, especially preeclampsia. Additionally, this study sought to determine the relationship between ... ...

Abstract	Background This study aimed to examine the cardiometabolic index during early pregnancy in individuals with hypertension-complicating pregnancy, especially preeclampsia. Additionally, this study sought to determine the relationship between cardiometabolic index and the incidence of varying degrees of preeclampsia. Methodology This study included 289 pregnant women diagnosed with preeclampsia who were registered and delivered at our hospital. These women were assigned to the preeclampsia group. Additionally, a group of 289 healthy pregnant women of identical gestational ages within the same time frame was included for comparison. Clinical data on pregnancy, including body mass index (BMI), blood pressure, waistline, triglyceride levels, and cardiometabolic index, were compared between the two groups. An analysis was conducted to examine the association between early pregnancy cardiometabolic index and the occurrence of preeclampsia. Results There was a significant association between the quartile of cardiometabolic index and the proportion of preeclampsia patients (p < 0.001). Furthermore, after controlling for age and BMI, the risk of preeclampsia remained significantly elevated and was associated with the cardiometabolic index. Conclusions A positive correlation was observed between cardiometabolic index during early pregnancy and the occurrence of preeclampsia.
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.51598
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Article ; Online: Association study between genetic polymorphisms in MTHFR and stroke susceptibility in Egyptian population: a case-control study.

El-Khawaga, Omali Y / Al-Azzawy, Mohammed F / El-Dawa, Aliaa N / ElSaid, Afaf M / Mustafa, Wessam / Saad, Mariam

Scientific reports

2024 Volume 14, Issue 1, Page(s) 114

Abstract: Stroke is a major global disability cause, and genetic variables for multifactorial illnesses like stroke are crucial for precision medicine. The purpose of this study is to see if genetic variants in the MTHFR gene are associated with a higher risk of ... ...

Abstract	Stroke is a major global disability cause, and genetic variables for multifactorial illnesses like stroke are crucial for precision medicine. The purpose of this study is to see if genetic variants in the MTHFR gene are associated with a higher risk of ischemic stroke among the Egyptian population. A case-control study was conducted at Mansoura University Hospital, involving 100 stroke patients and 150 healthy volunteers as the control group. Peripheral blood genomic DNA was isolated and single-nucleotide polymorphisms were genotyped using ARMS-PCR. The CT and TT genotypes of the C677T gene polymorphism exhibited substantial risks for having stroke disease [(OR 3.856; P ≤ 0.001); (OR 4.026; P ≤ 0.001), respectively]. The T allele was significantly more prevalent among patients compared to controls. (OR 2.517; (P = 0.001)). The over-dominant and dominant models demonstrated a substantial relationship between stroke groups at risk of developing stroke but not the Recessive model. An extensive connection was found between the MTHFR A1298C and stroke danger in three different inheritance models: dominant (CC + CA vs. AA), over-dominant (AA + CC vs AC), and allelic (C allele) (P < 0.001). A highly significant difference in blood pressure, total cholesterol, and triglycerides levels was found between patients and control. While there was no meaningful link discovered between genetic polymorphism with SBP, DBP, TG, LDL, VLDL among stroke group (P > 0.05 for each) except the CC genotype that was significantly associated with lower levels of TC and HDL when compared to CT + TT genotypes. The study evaluates a strong link among MTHFR mutations in genes and the probability to get stroke. The research significantly supports the use of MTHFR ((rs1801133) and (rs1801131) variations in stroke prediction.
MeSH term(s)	Humans ; Genetic Predisposition to Disease ; Case-Control Studies ; Egypt ; Genotype ; Polymorphism, Single Nucleotide ; Stroke/genetics ; Methylenetetrahydrofolate Reductase (NADPH2)/genetics ; Risk Factors
Chemical Substances	Methylenetetrahydrofolate Reductase (NADPH2) (EC 1.5.1.20) ; MTHFR protein, human (EC 1.5.1.20)
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-50277-z
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Article: Unveiling the Knowledge Gap Regarding Standard Antibiotic Prophylaxis for Infective Endocarditis Among Physicians, Dentists and Cardiologists in Pakistan: A Cross-Sectional Study.

Qadir, Mamoon / Mustafa, Waqar / Nizami, Awais Ahmed / Iqbal, Hamid / Shahzad, Maria / Ali, Anwar / Akbar, Amna

Cureus

2024 Volume 16, Issue 1, Page(s) e52938

Abstract: Introduction: Infective endocarditis is a microbial infection of the endocardial surface of the native and prosthetic valves. This study aimed to evaluate knowledge regarding the current guidelines for antibiotic prophylaxis for infective endocarditis.!# ...

Abstract	Introduction: Infective endocarditis is a microbial infection of the endocardial surface of the native and prosthetic valves. This study aimed to evaluate knowledge regarding the current guidelines for antibiotic prophylaxis for infective endocarditis. Methods: This cross-sectional study was conducted among physicians, cardiologists, and dentists in Rawalpindi and Islamabad. The questionnaire was distributed as Google Forms among the required population, and responses were collected on a Google Response Sheet. Results: The participants viewed rheumatic heart disease (83.7%) and heart transplant (96.7%) as the most vulnerable conditions that warrant the need for antibiotic prophylaxis. The other questions yielded average responses. Conclusion: The findings of this study emphasize the importance of adhering to standard guidelines and highlight the need for knowledge of the current guidelines.
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.52938
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Article ; Online: Investigation of Optimum Production Conditions and the Stability of β-Cyclodextrin-Perfluorocarbon Nanocone Clusters for Histotripsy Applications.

Mustafa, Waleed / Hall, Sarah / Huynh, Laura / Mannasse, Rachel / Luleburgaz, Serter / Vlaisavljevich, Eli / Yuksel Durmaz, Yasemin

Molecular pharmaceutics

2024 Volume 21, Issue 5, Page(s) 2383–2393

Abstract: Nanocone clusters (NCCs) have been developed as clusters with inclusion complexes of FDA-approved β-cyclodextrin (βCD) and perfluorocarbons (PFC) (i.e., perfluoropentane (PFP) and perfluorohexane (PFH)) and have shown promise in nanoparticle-mediated ... ...

Abstract	Nanocone clusters (NCCs) have been developed as clusters with inclusion complexes of FDA-approved β-cyclodextrin (βCD) and perfluorocarbons (PFC) (i.e., perfluoropentane (PFP) and perfluorohexane (PFH)) and have shown promise in nanoparticle-mediated histotripsy (NMH) applications owing to their lowered cavitation threshold, ease of production, and fluorocarbon quantification. However, there is still a lack of information on the best conditions of the synthesis of NCCs as a product that can have a maximum determinable fluorocarbon content and maintain the stability of the NCC during synthesis and when used as histotripsy agents or exposed to physiological conditions. These concerns about the stability of the clusters and the best possible formulation are investigated in the current work. The cluster formation potential was tested taking into consideration the nature of both PFCs and βCD by employing different synthesis conditions in terms of solution and environmental parameters such as concentration of solvent, stoichiometry between βCD and PFCs, temperature, pH, solvent type, etc. The best route of synthesis was then translated into various batch sizes and investigated in terms of the PFC loading and yield. These studies revealed that preparing NCCs in double-distilled water in an ice bath at the optimized solution concentration gave the highest yields and optimal PFC loading, as determined from gas chromatography. Furthermore, the stability of the clusters with different stoichiometries was scrutinized in varying concentrations, mechanical disruption times, pH levels, and temperature conditions, showing effects on each cluster's particle size in dynamic light scattering, visualized in transmission electron microscopy, and cavitation behavior in agarose gel tissue phantoms. These studies revealed stable clusters for all formulations, with PFH-containing NCCs emerging to be the most stable in terms of their cluster size and bubble formation potential in histotripsy. Finally, the shelf life of these clusters was investigated using DLS, which revealed a stable cluster. In conclusion, NCCs have shown high stability in terms of both synthesis, which can be replicated in gram-level production, and the cluster itself, which can be exposed to harsher conditions and still form stable bubbles in histotripsy.
MeSH term(s)	Fluorocarbons/chemistry ; beta-Cyclodextrins/chemistry ; Nanoparticles/chemistry ; Solvents/chemistry ; Temperature ; Hydrogen-Ion Concentration ; Pentanes
Chemical Substances	Fluorocarbons ; beta-Cyclodextrins ; perfluoropentane (678-26-2) ; Solvents ; perflexane (FX3WJ41CMX) ; betadex (JV039JZZ3A) ; Pentanes
Language	English
Publishing date	2024-03-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2138405-8
ISSN	1543-8392 ; 1543-8384
ISSN (online)	1543-8392
ISSN	1543-8384
DOI	10.1021/acs.molpharmaceut.3c01178
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Article ; Online: Do the Arabian Customers Who Belong to Similar Markets Differ in the Evaluation of Banking Service Quality?

Mustafa W. Nourallah

International Journal of Euro-Mediterranean Studies, Vol 8, Iss 1, Pp 25-

2015 Volume 41

Abstract: The main purpose of this paper is to study the customers’ evaluation from three similar markets, aiming at finding significant differences among three types of answers. Service quality was measured by using an existing scale from the literature, thus ... ...

Abstract	The main purpose of this paper is to study the customers’ evaluation from three similar markets, aiming at finding significant differences among three types of answers. Service quality was measured by using an existing scale from the literature, thus SERVPERF was selected to evaluate three types of answers. Customers of this study came from three similar markets: the Kingdom of Saudi Arabia, the United Arab Emirates and Kuwait. sps s was used to analyse the data and one-way anova was run to investigate differences among the groups. The findings showed that there were significant differences between the three groups. Also, the results indicated that except empathy, all other four dimensions showed partial differences.
Keywords	service quality ; quality of banking service ; Arab world ; culture ; Social sciences (General) ; H1-99
Language	English
Publishing date	2015-06-01T00:00:00Z
Publisher	Euro-Mediterranean University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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