Publications by authors named "A Karim Ahmed"

7,653 Publications

Impact of COVID-19 pandemic on liver transplantation and alcohol-associated liver disease in the United States.

Hepatology 2021 Jul 26. Epub 2021 Jul 26.

Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston.

Background & Aims: The surge in unhealthy alcohol use during the COVID-19 pandemic may have detrimental effects on the rising burden of alcohol-associated liver disease (ALD) on liver transplantation (LT) in the US. We evaluated the impact of the pandemic on temporal trends for LT including ALD.

Approach & Results: Utilizing data from United Network for Organ Sharing, we analyzed waitlist outcomes in the US through March 1, 2021. In a short-period analysis, patients listed or transplanted between June 1, 2019 and February 29, 2020 were defined as the "pre-COVID" era and after April 1, 2020 were defined as the "COVID" era. Interrupted time-series analyses utilizing monthly count data from 2016-2020 were constructed to evaluate rate change for listing and LT prior to and during the COVID-19 pandemic. Rates for listings (P=0.19) and LT (P=0.14) were unchanged during the pandemic despite a significant reduction in the monthly listing rates for HCV (-21.69%, P <0.001) and NASH (-13.18%; P <0.001). There was a significant increase in ALD listing (+7.26%; P <0.001) and LT (10.67%; P <0.001) during the pandemic. In the COVID era, ALD (40.1%) accounted for more listings than those due to HCV (12.4%) and NASH (23.4%) combined. The greatest increase in ALD occurred in young adults (+33%) and patients with severe alcoholic hepatitis (+50%). ALD patients presented with a higher acuity of illness, with 30.8% of listings and 44.8% of LT having a MELD-Na ≥ 30.

Conclusions: Since the start of COVID-19 pandemic, ALD has become the most common indication for listing and the fastest increasing cause for LT. Collective efforts are urgently needed to stem the rising tide of ALD on healthcare resources.
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http://dx.doi.org/10.1002/hep.32067DOI Listing
July 2021

Case Report: Khat Chewing and Acute Myocardial Infarction in Two Young Men without Underlying Risk Factors.

Am J Trop Med Hyg 2021 Jul 26. Epub 2021 Jul 26.

Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia 1145.

Khat (Catha edulis) chewing is linked to several social, psychological, and health-related problems. Studies show that khat is associated with gastrointestinal and nervous system diseases. However, little is known about khat's effect on the cardiovascular system. This case report describes acute myocardial infarction (AMI) among two young adults who chew khat frequently, but who do not have underlying cardiovascular disease (CVD) risk factors. Case 1 is a 29-year-old apparently healthy man who presented with severe, squeezing, left-side chest pain after consumption of khat. Most of the laboratory results were within the normal range except for his serum troponin level, which was 400 times more than the normal limit. The patient was diagnosed with Killip class IV, ST-segment elevation, anteroseptal AMI. Case 2 is a 25-year-old man who is a frequent khat chewer. He presented with sudden-onset, severe, squeezing, retrosternal chest pain after khat chewing and vigorous activity. The patient was diagnosed with (Killip class III) acute ST-elevation myocardial infarction with cardiogenic pulmonary edema. These case reports describe two young adult male patients who were confirmed of having AMI with no known risk factors. Both cases had a similar history of frequent khat chewing and the onset of AMI after it, implying that khat could be an important CVD risk factor among young adults. Hence, it is essential to explore further the epidemiology and association between khat use and AMI. Both molecular and population-level studies could help to establish the causal relationship of khat and CVD.
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http://dx.doi.org/10.4269/ajtmh.21-0318DOI Listing
July 2021

Angiotensin aldosterone inhibitors improve survival and ameliorate kidney injury induced by sepsis through suppression of inflammation and apoptosis.

Fundam Clin Pharmacol 2021 Jul 26. Epub 2021 Jul 26.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, El-Minia, Egypt.

Sepsis is an extensive life-threatening illness that occurs due to an abnormal host response which extends through the initial storm of inflammation and oxidative stress and terminates at the late stage of immunosuppression. Among global intensive care units, sepsis induced acute kidney injury is reported with high mortality rate. The purpose of this study was to evaluate the protective effect of the renin angiotensin aldosterone system (RAAS) inhibition on sepsis outcomes. Cecal ligation and puncture (CLP) procedure was applied for sepsis induction. The experimental design constituted of five groups of rats; sham, CLP-non-treated and CLP-treated with ramipril (10 mg/kg, p.o.), losartan (20 mg/kg i.p.) and spironolactone (25 mg/kg p.o.). Twenty-four hours after surgery, rats were euthanized for blood and tissue samples, which were used for assessment of serum inflammatory markers, and oxidative stress parameters, as well as to kidney function parameters. The tissue samples were used for histological and caspase-3 assessment. A survival study was conducted using another set of animals. Our results showed that the different RAAS inhibitors showed protective effects evidenced by enhanced overall survival following sepsis (80% in ramipril and spironolactone-treated and 60% in losartan-treated vs. 10% in the septic group), in addition to improved renal function parameters and reduction of oxidative stress and inflammation. The timely use of RAAS inhibitors during sepsis might represent a new therapeutic approach in septic patient.
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http://dx.doi.org/10.1111/fcp.12718DOI Listing
July 2021

Disease X: A hidden but inevitable creeping danger.

Infect Control Hosp Epidemiol 2021 Jul 26:1-5. Epub 2021 Jul 26.

School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.

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http://dx.doi.org/10.1017/ice.2021.342DOI Listing
July 2021

Mantle Cell Lymphoma Presenting as Diarrhea in a Liver Transplant Recipient.

ACG Case Rep J 2021 Jul 21;8(7):e00635. Epub 2021 Jul 21.

Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI.

We present a 63-year-old man with a medical history of hepatocellular carcinoma who underwent orthotopic liver transplant 10 years prior on long-term immunosuppressive therapy. The patient presented to the clinic with diarrhea, and the workup revealed mantle cell lymphoma. Mantle cell lymphoma is an extremely rare finding in transplanted livers. It is essential to include mantle cell lymphoma, along with a broad differential, during the workup of diarrhea in post-transplant patients.
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http://dx.doi.org/10.14309/crj.0000000000000635DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297721PMC
July 2021
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