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Konark Malhotra,Niaz Ahmed,Angeliki Filippatou,Aristeidis H. Katsanos,Nitin Goyal,Konstantinos Tsioufis,Efstathios Manios,Maria Pikilidou,Peter D. Schellinger,Anne W. Alexandrov,Andrei V. Alexandrov,G 대한뇌졸중학회 2019 Journal of stroke Vol.21 No.1
Background and Purpose Although arbitrary blood pressure (BP) thresholds exist for acute ischemic stroke (AIS) patients eligible for intravenous thrombolysis (IVT), current international recommendations lack clarity on the impact of mean pre- and post-IVT BP levels on clinical outcomes. Methods Eligible studies involving IVT-treated AIS patients were identified that reported the association of mean systolic BP (SBP) or diastolic BP levels before and after IVT with the following outcomes: 3-month favorable functional outcome (modified Rankin Scale [mRS] scores of 0–1) and 3-month functional independence (mRS scores of 0–2), 3-month mortality and symptomatic intracranial hemorrhage (sICH). Unadjusted analyses of standardized mean differences and adjusted analyses of studies reporting odds ratios (ORadj) per 10 mm Hg BP increment were performed using random-effects models. Results We identified 26 studies comprising 56,513 patients. Higher pre- (P=0.02) and posttreatment (P=0.006) SBP levels were observed in patients with sICH. Patients with 3-month functional independence had lower post-treatment (P<0.001) SBP whereas trended towards lower pre-treatment (P=0.06) SBP. In adjusted analyses, elevated pre- (ORadj, 1.08; 95% confidence interval [CI], 1.01 to 1.16) and post-treatment (ORadj, 1.13; 95% CI, 1.01 to 1.25) SBP levels were associated with increased likelihood of sICH. Increasing pre- (ORadj, 0.91; 95% CI, 0.84 to 0.98) and post-treatment (ORadj, 0.70; 95% CI, 0.57 to 0.87) SBP values were also related to lower odds of 3-month functional independence. Conclusions We found that elevated BP levels adversely impact AIS outcomes in patients receiving IVT. Future randomized-controlled clinical trials will provide definitive data on the aforementioned association.
Optical Spectroscopic Analysis Techniques to Detect Elemental Profile of Human Teeth Dentine
Saifullah Jamali,Muhammad Aslam Khoso,Irfan Ali Sanjrani,Hussain Saleem,Tariq Ali Siyal,Muhammad Ashraf,Mansoor Ahmed Memon,Ghulam Murtaza,Zahid Hussain Arain,Zaheer Ahmed Ujjan,Muhammad Niaz Laghari International Journal of Computer ScienceNetwork S 2023 International journal of computer science and netw Vol.23 No.3
Numerous articles under the study and the examination of heavy metals in human teeth have been published in recent years. The heavy metal poisoning is a widespread issue emerged in toxicology area these days. It has been discovered that long-term exposure to heavy metals typically present in traces, in our everyday meals, drinking water, and in the environment as pollution causes heavy metal poisoning in human beings. Industrial effluents, Coal and Oil, as well as a variety of consumer items, such as cosmetics, can all cause this type of exposure. Teeth, which are often thought of as exoskeleton parts, store heavy metals with a high affinity and represent long-term exposure information. In this study, we have chosen and examined the sections of dentine instead, then examined the entire tooth. We have combined the work done on the examination of heavy metals in human teeth using several instrumental approaches e.g. "Optical Spectroscopic Techniques" to detect elemental profile of human teeth in the current study.
Irene Escudero-Martínez,Magnus Thorén,Peter Ringleb,Ana Paiva Nunes,Manuel Cappellari,Viiu-Marika Rand,Piotr Sobolewski,Jose Egido,Danilo Toni,Shih-Yin Chen,Nicole Tsao,Niaz Ahmed 대한뇌졸중학회 2023 Journal of stroke Vol.25 No.1
Background and Purpose Cerebral edema (CED) in ischemic stroke can worsen prognosis and about 70% of patients who develop severe CED die if treated conservatively. We aimed to describe incidence, risk factors and outcomes of CED in patients with extensive ischemia. Methods Oservational study based on Safe Implementation of Treatments in Stroke-International Stroke Treatment Registry (2003–2019). Severe hemispheric syndrome (SHS) at baseline and persistent SHS (pSHS) at 24 hours were defined as National Institutes of Health Stroke Score (NIHSS) >15. Outcomes were moderate/severe CED detected by neuroimaging, functional independence (modified Rankin Scale 0–2) and death at 90 days. Results Patients (n=8,560) presented with SHS and developed pSHS at 24 hours; 82.2% received intravenous thrombolysis (IVT), 10.5% IVT+thrombectomy, and 7.3% thrombectomy alone. Median age was 77 and NIHSS 21. Of 7,949 patients with CED data, 3,780 (47.6%) had any CED and 2,297 (28.9%) moderate/severe CED. In the multivariable analysis, age <50 years (relative risk [RR], 1.56), signs of acute infarct (RR, 1.29), hyperdense artery sign (RR, 1.39), blood glucose >128.5 mg/dL (RR, 1.21), and decreased level of consciousness (RR, 1.14) were associated with moderate/severe CED (for all P<0.05). Patients with moderate/severe CED had lower odds to achieve functional Independence (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.23 to 0.55) and higher odds of death at 90 days (aOR, 2.54; 95% CI, 2.14 to 3.02). Conclusion In patients with extensive ischemia, the most important predictors for moderate/ severe CED were age <50, high blood glucose, signs of acute infarct, hyperdense artery on baseline scans, and decreased level of consciousness. CED was associated with worse functional outcome and a higher risk of death at 3 months.
Marius Matusevicius,Charith Cooray,Viiu-Marika Rand,Ana Paiva Nunes,Tiago Moreira,Rossana Tassi,Jose Antonio Egido,Jyrki Ollikainen,Guido Bigliardi,Staffan Holmin,Niaz Ahmed 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.3
Background and Purpose The influence of stroke etiology on outcomes after endovascular thrombectomy (EVT) is not well understood. We aimed to investigate whether stroke etiology subgrouped as large artery atherosclerosis (LAA) and cardiac embolism (CE) influences outcomes in large artery occlusion (LAO) treated by EVT. Methods We included EVT treated LAO stroke patients registered in the Safe Implementation of Treatment in Stroke (SITS) thrombectomy register between January 1, 2014 and September 3, 2019. Primary outcome was successful reperfusion (modified Treatment in Cerebral Infarction 2b- 3). Secondary outcomes were symptomatic intracranial hemorrhage (SICH), 3-month functional independence (modified Ranking Scale 0–2) and death. Multivariable logistic regression models were used for comparisons. In addition, a meta-analysis of aggregate data from the current literature was conducted (PROSPERO, ID 167447). Results Of 7,543 patients, 1,903 (25.2%) had LAA, 3,214 (42.6%) CE, and 2,426 (32.2%) unknown, other, or multiple etiologies. LAA patients were younger (66 vs. 74, P<0.001) and had lower National Institutes of Health Stroke Scale score at baseline (15 vs. 16, P<0.001) than CE patients. Multivariable analyses showed that LAA patients had lower odds of successful reperfusion (odds ratio [OR], 0.70; 95% confidence interval [CI], 0.57 to 0.86) and functional independence (OR, 0.74; 95% CI, 0.63 to 0.85), higher risk of death (OR, 1.44; 95% CI, 1.21 to 1.71), but no difference in SICH (OR, 1.09; 95% CI, 0.71 to 1.66) compared to CE patients. The systematic review found 25 studies matching the criteria. The meta-analysis did not find any difference between etiologies. Conclusions From the SITS thrombectomy register, we observed a lower chance of reperfusion and worse outcomes after thrombectomy in patients with LAA compared to CE etiology, despite more favorable baseline characteristics. In contrast, the meta-analysis did not find any difference between etiologies with aggregate data.