38 results found
Beshyah S, Hajjaji I, Ibrahim W, et al., 2018, The year in ramadan fasting research (2017): A narrative review, Ibnosina Journal of Medicine and Biomedical Sciences, Vol: 10, Pages: 39-53
<jats:p>Ramadan fasting is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslims with medical conditions still choose to fast. This may adversely affect their health if not addressed properly. Recently, there has been an increased interest in the health implications of Ramadan fasting. The authors performed a narrative, nonsystematic review of the literature including case reports, case series, and review articles indexed in PubMed and Google Scholar in a full calendar year. All records were reviewed by two coauthors at least. Studies were reviewed, summarized, and represented to provide a readily comprehensible concise account of the contributions made to research and clinical practice in 1 year (January–December 2017). The publications spanned physiological and clinical aspects and crossed conventional disciplinary lines in various languages, locations, and systems of journal access. A total of 92 and 82 were found in the PubMed and Google Scholar databases, respectively. Diabetes, hypoglycemia, insulin, and body composition were among the most relevant issues addressed this year. Discipline wise, diabetes, physiology, gastrointestinal, cardiovascular, eyes, respiratory, nephrology, neuropsychiatry, and endocrinology were most prominent. Other articles have considered professional competence, education, ethics, culture, and organization of care. Many of the research groups are based in emerging countries with Muslim-majority, but the publications are still widely distributed in internationally recognized journals. Several workers seem to have Ramadan fast at the center of their academic interest inferred from the number of publications to which they have contributed. The authors hope this review will help direct further research and should inform clinical practice guidance.</jats:p>
Shlebak A, 2017, Platelet genesis: Unraveling an incredible journey!, Ibnosina Journal of Medicine and Biomedical Sciences, Vol: 09, Pages: 101-102
Shlebak AA, Bain BJ, 2017, Training future haematologists, a privilege or a burden? "A trainer's view"., British Journal of Haematology, Vol: 178, Pages: 501-507, ISSN: 1365-2141
Recent decades have seen the emergence of new problems in haematology training, relating particularly to an expanding curriculum, less time available for training, staff shortages and the increasing separation of clinical haematology from its laboratory base. We have sought to identify the problems and propose possible solutions.
Shlebak AA, Katsarou AD, Adams G, et al., 2017, A novel mutation in exon 2 of <i>FGB</i> caused by c.221G>T <i>aEuro</i> substitution, predicting the replacement of the native Arginine at position 74 with a Leucine (p.Arg74Leu <i>aEuro</i> ) in a proband from a Kurdish family with dysfibrinogenaemia and familial venous and arterial thrombosis, JOURNAL OF THROMBOSIS AND THROMBOLYSIS, Vol: 43, Pages: 263-270, ISSN: 0929-5305
Shlebak A, Sandhu P, Ali V, et al., 2016, The impact of the DoH Commissioning for Quality and Innovation incentive on the success of venous thromboembolism risk assessment in hospitalised patients. A single institution experience in a quality outcome improvement over a 4-year cycle, JRSM Open, Vol: 7, ISSN: 2054-2704
OBJECTIVES: To i) demonstrate compliance with the Commissioning for Quality and Innovation for venous thromboembolism risk assessment ii) to undertake root cause analysis of Hospital Acquired Thrombosis and to investigate its impact on quality of care. DESIGN: Prospective monitoring of all admissions. SETTING: Imperial College Healthcare Hospitals, London. PARTICIPANTS: All Hospital Provider Spells as defined on the NHS Data Model and Dictionary. MAIN OUTCOME MEASURES: i) Percentage of patients undergoing Venous Thromboembolism Risk Assessment (VTE-RA) at and 24-hours after admission ii) root cause analysis of Hospital Acquired Thrombosis up to 90 days following discharge. RESULTS: Over a 48-month cycle 83% were overall VTE-RA assessed with 36% in the first 12 months but with significant improvement to ≥95% between April 2013 and April 2015, achieving compliance target since April 2012 involving a massive 633, 850 Spells over the 4 year period. We undertook root cause analysis of all VTE episodes from April 2013 to March 2014, to ascertain Hospital Acquired Thrombosis (HAT), we analysed 433, 174 inpatient days and found a HAT rate of 1 per 1000 with 23% and 24% for DVTs and PEs potentially avoidable respectively. We further analysed VTE risk stratification (n = 1000) and found 37.0% at high risk, 44.4% at medium risk and 18.6 % at low risk, indicating the need of thromboprophylaxis in 81.4% (high and medium) of whom 33.6% were excluded. CONCLUSIONS: We achieved 95% RA compliance which has favourably impacted on our daily practice and improved the quality of the clinical care.
Shlebak A, 2016, Antiphospholipid syndrome presenting as cerebral venous sinus thrombosis: a case series and a review, JOURNAL OF CLINICAL PATHOLOGY, Vol: 69, Pages: 337-343, ISSN: 0021-9746
Pintilie H, Raghunanan S, Shlebak A, et al., 2016, Venous sinus thrombosis in a patient with perinatally acquired HIV, a paediatric case report, HIV MEDICINE, Vol: 17, Pages: 36-36, ISSN: 1464-2662
Campbell V, Marriott K, Stanbridge R, et al., 2015, Successful aortic aneurysm repair in a woman with severe von Willebrand (Type 3) disease, Case Reports in Hematology, Vol: 2015, Pages: 1-8, ISSN: 2090-6560
von Willebrand disease type 3 (VWD3) is a rare but the most severe form of von Willebrand disease; it is due to almost complete lack of von Willebrand factor activity (VWF:RCo). It is inherited as autosomal recessive trait; whilst heterozygote carriers have mild, or no symptoms, patients with VWD3 show severe bleeding symptoms. In the laboratory, this is characterised by undetectable VWF:Ag, VWF:RCo, and reduced levels of factor VIII < 0.02 IU/dL. The bleeding is managed with von Willebrand/FVIII factor concentrate replacement therapy. In this rare but challenging case we report on the successful excision and repair of an ascending aortic aneurysm following adequate VWF/FVIII factor concentrate replacement using Haemate-P.
Shlebak A, Poles A, Manning R, et al., 2015, A Novel Homozygous c.800C>G Substitution in <i>GP1BA</i> Exon 2 in a Kuwaiti Family with Bernard-Soulier Syndrome, ACTA HAEMATOLOGICA, Vol: 134, Pages: 193-198, ISSN: 0001-5792
Banerjee S, Bentley P, Hamady M, et al., 2014, Intra-Arterial Immunoselected CD34+ Stem Cells for Acute Ischemic Stroke, Stem Cells Transl Med, Vol: pii: sctm.2013-0178. [Epub ahead of print]
Banerjee S, Bentley P, Hamady M, et al., 2014, Intra-arterial immunoselected CD34+ stem cells for acute ischemic stroke, Stem Cells Translational Medicine, Vol: 3, Pages: 1322-1331, ISSN: 2157-6564
Treatment with CD34+ hematopoietic stem/progenitor cells has been shown to improve functional recovery in nonhuman models of ischemic stroke via promotion of angiogenesis and neurogenesis. We aimed to determine the safety and feasibility of treatment with CD34+ cells delivered intraarterially in patients with acute ischemic stroke. This was the first study in human subjects. We performed a prospective, nonrandomized, open-label, phase I study of autologous, immunoselected CD34+ stem/progenitor cell therapy in patients presenting within 7 days of onset with severe anterior circulation ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score ‡8). CD34+ cells were collected from the bone marrow of the subjects before being delivered by catheter angiography into the ipsilesional middle cerebral artery. Eighty-two patients with severe anterior circulation ischemic stroke were screened, of whom five proceeded to treatment. The common reasons for exclusion were age >80 years (n = 19); medical instability (n = 17), and significant carotid stenosis (n = 13). The procedure was well tolerated in all patients, and no significant treatment-related adverse effects occurred. All patients showed improvements in clinical functional scores (Modified Rankin Score and NIHSS score) and reductions in lesion volume during a 6-month follow-up period. Autologous CD34+ selected stem/progenitor cell therapy delivered intra-arterially into the infarct territory can be achieved safely in patients with acute ischemic stroke. Future studies that address eligibility criteria, dosage, delivery site, and timing and that use surrogate imaging markers of outcome are desirable before larger scale clinical trials.
Shlebak A, 2013, Novel oral anticoagulants: A new era in anti-thrombotic therapy, Ibnosina Journal of Medicine and Biomedical Sciences, Vol: 05, Pages: 247-253
<jats:p>For over half-a-century vitamin K antagonists (VKAs) served our patients well as effective anticoagulants, several novel oral anticoagulants (NOACs) have emerged and are now available as a suitable alternative for stroke prevention, venous thromboembolism prevention and treatment and to reduce vascular events in acute coronary syndrome. Compared to VKAs, the novel agents have several advantages including an improved efficacy/safety ratio, a faster onset of action, shorter plasma half-life, few drug or food interactions, and no requirement for regular monitoring. Although very promising in many regards their proper use will require new approaches in many daily aspects with dose adjustments may be required for patients with severe renal impairment or in the setting of drug interactions. The lack of specific antidote makes reversing their effect during bleeding or for emergency surgery particularly a major challenge. This article provides a focused overview on their current status.</jats:p>
Neave EL, Schwarb H, Shlebak A, et al., 2013, Lymphodepletion chemotherapy followed by donor leukocytes for post-transplantation relapse of myelofibrosis after previous donor leukocyte infusion failure, EUROPEAN JOURNAL OF HAEMATOLOGY, Vol: 90, Pages: 76-78, ISSN: 0902-4441
Coulson S, Mohanaruban A, Shlebak A, et al., 2012, An unusual cause of bleeding in an elderly patient, CLINICAL MEDICINE, Vol: 12, Pages: 150-152, ISSN: 1470-2118
Brooks C, Burbridge J, Marks S, et al., 2011, A novel rearrangement in an atypical myeloproliferative neoplasm with subsequent development of an unrelated clone following transformation to AML, British Human Genetics Conference
Hutchinson CV, Burthem J, Bisland M, et al., 2010, British Society for Haematology, slide session, annual scientific meeting, Glasgow, 2008, INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Vol: 32, Pages: 174-183, ISSN: 1751-5521
Shlebak A, Malik I, 2009, Managing anticoagulation with heparin in patients with prosethetic cardiac valves? "Balancing the risk", Heart, Vol: Published Online First: 5 July 2009. doi:10.1136/hrt.2009.171553
Guidelines on the antithrombotic therapy in patients with prosthetic valves by the American College of Cardiology/American Heart Association (ACC/AHA) [1, 2] and by the European Society of Cardiology (ESC)  agree on most issues. Both accepting the need of anticoagulation intensity stratification according to valve position and other risk factors, and in general, concur, that many patients can be managed with lower intensity anticoagulation than previously recommended. Both concede that individual patient risk assessment is crucial, but, the ACC/AHA utilises this only to adjust anticoagulation and/or antiplatelet therapy, whereas the ESC underlines the importance of risk reduction or treatment as an integral part of overall antithrombotic strategy. The guidelines, however, disagree on many fundamental issues: 1) the antithrombotic management of bioprostheses in the first 3 months post-operatively, 2) The risk categorisation of mechanical valves, 3) The management of embolism in the presence of adequate anticoagulation, 4) the adjunct role of antiplatelets, and 5) the bridging of anticoagulation interruption for non-cardiac surgery. In this editorial the utility of heparins (unfractionated heparin (UFH) and low molecular weight heparin (LMWH)) is revisited in some special circumstances.
Purkayastha S, Shlebak A, 2009, Haematological Considerations: thrombosis in surgery, Hospital Surgery, foundations in surgical practice, Editors: Aziz, Purkayastha, Paraskeva, USA, Publisher: Cambridge Uni Press, Pages: 41-47, ISBN: 9789780521684
Purkayastha S, Shlebak A, 2009, Haematological Considerations: Bleeding, Hospital Surgery, Foundations in Surgical Practice, Editors: Aziz, Purkayastha, Paraskeva, USA, Publisher: Cambridge Uni Press, Pages: 48-56, ISBN: 9789780521684
Purkayastha S, Shlebak A, 2009, Haematological Considerations: Blood Prodcuts and Transfusion, Hospital Surgery: Foundations in Surgical Practice, Editors: Aziz, Purkayastha, Paraskeva, USA, Publisher: Cambridge Uni Press, Pages: 59-63, ISBN: 9789780521684
Purkayastha S, Uprichard J, Shlebak A, 2009, Haematological Considerations: Haemorrhage (massive-bleeding protocol), Hospital Surgery: Foundations in Surgical Practice, Editors: Aziz, Purkayastha, Paraskeva, USA, Publisher: Cambridge Uni Press, Pages: 57-58, ISBN: 9789780521684
Shlebak A, 2007, Pathophysiological Aspects of Coagulation, HAEMOSTASIS IN SURGERY, Editors: Hakim, Canelo, UK, Publisher: Imperial College Press, Pages: 1-92
Rashid ST, Thursz MR, Razvi NA, et al., 2005, Venous thromboprophylaxis in UK medical inpatients, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 98, Pages: 507-512, ISSN: 0141-0768
Harrison CN, Campbell PJ, Buck G, et al., 2005, Hydroxyurea compared with anagrelide in high-risk essential thrombocythemia, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 353, Pages: 33-45, ISSN: 0028-4793
Bose P, Black S, Kadyrov M, et al., 2004, Adverse effects of lupus anticoagulant positive blood sera on placental viability can be prevented by heparin in vitro, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol: 191, Pages: 2125-2131, ISSN: 0002-9378
Milne M, Stevenson KJ, Craig S, et al., 2003, Improving the quality of INR determination in the anticoagulantion clinic, Journal of thrombosis and Haemostasis, Vol: 1
Randle E, Bakos M, Rae R, et al., 2002, The prevalence of antibody isotopes against phosphlipids and b-2-glycoproteins in women with recurrent miscarriage
Rai R, Backos M, Elgaddal S, et al., 2002, Factor V Leiden and recurrent miscarriage - prospective outcome of untreated pregnancies, HUMAN REPRODUCTION, Vol: 17, Pages: 442-445, ISSN: 0268-1161
Rai R, Shlebak A, Cohen H, et al., 2001, Factor V Leiden and acquired activated protein C resistance among 1000 women with recurrent miscarriage, HUMAN REPRODUCTION, Vol: 16, Pages: 961-965, ISSN: 0268-1161
LENNOX A, SMOUT J, SHLEBAK A, et al., 2001, Warfarin-induced Skin Necrosis: Association with Heparin-induced Thrombocytopenia and Protein S Deficiency, EJVES Extra, Vol: 1, Pages: 25-26, ISSN: 1533-3167
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