Publications by authors named "Awan A"

Purpose: Rare diseases are individually uncommon yet collectively prevalent. They affect over 300,000 people in Ireland, with 50-70 % impacting children. This study explores the supportive care needs of parents caring for children with rare diseases in Ireland, utilising a validated Parental Needs Scale for Rare Diseases (PNS-RD).

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Dietary protein has been shown to impact long-term health outcomes differentially depending on its amount and source. It has been suggested that interactions of the gut microbiota with dietary proteins mediate some of the effects of dietary protein on health outcomes. However, it remains unclear what specific host responses drive the health effects of dietary proteins from different plant and animal sources.

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Background: Patients with complex valvular heart disease (VHD) should be evaluated by a multidisciplinary heart team (HT). In low- and middle-income countries, referral practices are more variable, permitting any physician to refer patients directly to a cardiac surgeon without prior formal evaluation by a cardiologist with expertise in VHD.

Objectives: The goal of the study was to examine the demographics of VHD patients seen in a large heart valve center in a low- and middle-income country and to assess the impact of the multidisciplinary HT in patients referred for valve surgery.

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It is critical to recognize pulmonary embolism as soon as possible in patients who have gastrointestinal problems pre- and post-surgery. Even in the absence of conventional risk factors, the Factor V Leiden mutation emphasizes the importance of a thorough thrombophilia assessment. To effectively manage and prevent thrombotic episodes, prompt anticoagulant medication and genetic screening for family members are essential.

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This review article studies the complex field of noncoding RNAs (ncRNAs) in cancer biology, focusing on their potential use as biomarkers and therapeutic targets. NcRNAs include circular RNAs (circRNAs), long noncoding RNAs (lncRNAs), and microRNAs (miRNAs). We discuss how ncRNAs affect gene expression in cancerous cells, the spread of cancer, and metastasis.

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Background: There is a lack of information on the current healthcare systems for children with kidney diseases across Europe. The aim of this study was to explore the different national approaches to the organization and delivery of pediatric nephrology services within Europe.

Methods: In 2020, the European society for Paediatric Nephrology (ESPN) conducted a cross-sectional survey to identify the existing pediatric nephrology healthcare systems in 48 European countries covering a population of more than 200 million children.

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A 72-year-old male with a history of excessive alcohol intake (35+ units of alcohol daily) presented to the emergency department with bilateral vision loss, periorbital swelling, headache, and sinus congestion with bloody nasal discharge. He was newly diagnosed with diabetes mellitus and presented with severe diabetic ketoacidosis and a hypertensive emergency (blood pressure of 240/90 mmHg). Despite initial normal brain and orbital imaging, the clinical presentation was complicated by multiple life-threatening conditions and a prior immunocompetent status, thereby delaying the early suspicion of mucormycosis.

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Although parenteral iron is widely used to treat iron deficiency anemia (IDA), some side effects have been inadequately explored. Hypophosphatemia is becoming a well-documented, yet poorly understood, side effect of parenteral iron infusion, oftentimes causing serious and/or prolonged complications. In this article, we discuss the case of a 33-year-old female with IDA who suffered debilitating physical and mental symptoms of significant recurrent hypophosphatemia following a single standard dose of parenteral iron administration.

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Article Synopsis
  • - This study compares the effectiveness of negative pressure wound therapy (NPWT) with traditional tie over dressing in securing skin grafts, focusing on wound healing and complications.
  • - Conducted at a Karachi hospital, the randomized control trial involved patients who were assigned to either NPWT or tie over dressing, assessing their wounds after a set period.
  • - Results showed NPWT significantly improved graft success and reduced complications like infection and hematoma compared to tie over dressing, with many NPWT patients experiencing no issues at all.
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Background: The purpose of the study was to compare the mean post-operative pain in patients undergoing phacoemulsification for cataract with topical anaesthesia vs. retrobulbar anaesthesia.

Methods: An interventional study was carried out in a tertiary care hospital of Islamabad.

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  • This study investigates the risk of hyponatremia (low sodium levels) associated with various antidepressants, including SSRIs, SNRIs, and NRIs, through examination of health records in the All of Us Research Program.
  • The overall incidence of hyponatremia was found to be 0.87% within the first 30 days and 10.5% over three years among participants taking these medications.
  • Among the antidepressants studied, duloxetine and escitalopram had the highest risk for hyponatremia, while bupropion and paroxetine were linked to the lowest risk, helping providers make informed treatment decisions.
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Introduction: Data on age-related differences in rejection rates, infectious episodes, and tacrolimus exposure in pediatric kidney transplant recipients (pKTRs) on a tacrolimus-based immunosuppressive regimen are scarce.

Methods: We performed a large-scale analysis of 802 pKTRs from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry from 40 centers in 14 countries. The inclusion criteria were a tacrolimus-based immunosuppressive regimen and at least 2 years of follow-up.

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  • In kidney transplant recipients, BK polyomavirus-associated nephropathy (BKPyVAN) is a significant risk for transplant loss, and reducing immunosuppression to manage BKPyV-DNAemia can also heighten the risk of graft rejection.
  • The CERTAIN study, involving 195 pediatric kidney transplant recipients, found that BKPyV-DNAemia significantly increased the risk of T cell-mediated rejection, development of donor-specific antibodies, and overall decline in graft function.
  • The findings suggest that careful monitoring and regular screening for donor-specific antibodies are essential when adjusting immunosuppressive therapy in patients with BKPyV-DNAemia to mitigate rejection risks.
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  • - The study investigates HIV-related mortality trends among young adults in the U.S. from 1999 to 2020, revealing significant demographic and regional differences in mortality rates.
  • - Findings show that while the age-adjusted mortality rates (AAMRs) declined from 1999 to 2018, there was a stabilization from 2018 to 2020, with males and non-Hispanic Blacks experiencing much higher death rates compared to females and Whites, respectively.
  • - The Southern region of the U.S. and urban areas reported notably higher mortality rates, urging the need for urgent action to address these disparities in HIV-related deaths.
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Drowsy driving among college students is a critical public health issue due to its significant impact on road safety. This cross-sectional study aimed to investigate the determinants of stopping drowsy driving behavior among college students using the multi-theory model (MTM) of health behavior change. Data for this study were collected from September to October 2023 via a 42-item psychometric valid, web-based survey disseminated via Qualtrics, involving 725 students from a large southwestern university.

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Background: Long-term renal function and survival after kidney transplantation rely on appropriate immunosuppressive treatment to prevent the risk of rejection. New biomarkers are needed to accurately assess the degree of immunosuppression in renal transplant recipients in order to avoid organ rejection and the development of opportunistic infections. Highly prevalent in humans, torque teno virus (TTV), which belongs to the family Anelloviridae, is a small, nonenveloped, single-stranded DNA virus which has not been linked with any specific human illness, but which constitutes a major component of the human virome.

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Background: This study by the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) was designed to determine the incidence, risk factors, current management strategies, and outcomes of antibody-mediated rejection (ABMR) in pediatric kidney transplant recipients (pKTR).

Methods: We performed an international, multicenter, longitudinal cohort study of data reported to the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry. Three hundred thirty-seven pKTR from 21 European centers were analyzed.

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Concerns exist regarding increased toxicities, including endocrine therapy toxicity, with concurrent radiation and endocrine therapy in early breast cancer (EBC). We present a pragmatic, randomized trial comparing concurrent versus sequential endocrine and radiotherapy in hormone-responsive EBC. In this multicenter trial, patients were randomized to receive adjuvant endocrine therapy concurrent with, or sequential to, radiotherapy.

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Mycosis fungoides (MF) is a cutaneous T-cell lymphoma (CTCL) that is characterized by atypical CD4+ T-cell aggregates in the epidermis. It is typically divided into three clinical phases, which consist of the patches, plaques, and tumor stages. There have been atypical manifestations of MF described in the literature, and it is hypothesized that the skin microbiota plays a role in the skin phenotype of MF patients.

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This study aims to formulate a mathematical framework to examine how the Lassa virus spreads in humans of opposite genders. The stability of the model is analyzed at an equilibrium point in the absence of the Lassa fever. The model's effectiveness is evaluated using real-life data, and all the parameters needed to determine the basic reproduction number are estimated.

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Purpose: While adjuvant bisphosphonate use in early breast cancer (EBC) is associated with improvements in breast cancer-specific outcomes, questions remain around optimal bisphosphonate type, dose and scheduling. We evaluated a single zoledronate infusion in a prospective randomised trial.

Methods: Postmenopausal patients with EBC were randomised to receive a single infusion of zoledronate (4 mg IV) or 6-monthly treatment for 3 years.

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(R,S)-Ketamine (ketamine) is a dissociative anesthetic that also possesses analgesic and antidepressant activity. Undesirable dissociative side effects and misuse potential limit expanded use of ketamine in several mental health disorders despite promising clinical activity and intensifying medical need. (2R,6R)-Hydroxynorketamine (RR-HNK) is a metabolite of ketamine that lacks anesthetic and dissociative activity but maintains antidepressant and analgesic activity in multiple preclinical models.

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