Publications by authors named "Ahad Qayyum"

5 Publications

  • Page 1 of 1

Overcoming barriers and building a strong peritoneal dialysis programme - Experience from three South Asian countries.

Perit Dial Int 2021 Jun 2:8968608211019986. Epub 2021 Jun 2.

Department of Nephrology, Teaching Hospital, Kandy, Sri Lanka.

The development of peritoneal dialysis (PD) programmes in lower-resource countries is challenging. This article describes the learning points of establishing PD programmes in three countries in South Asia (Nepal, Sri Lanka and Pakistan). The key barriers identified were government support (financial), maintaining stable supply of PD fluids, lack of nephrologist and nurse expertise, nephrology community bias against PD, lack of nephrology trainee awareness and exposure to this modality. To overcome these barriers, a well-trained PD lead nephrologist (PD champion) is needed, who can advocate for this modality at government, professional and community levels. Ongoing educational programmes for doctors, nurses and patients are needed to sustain the PD programmes. Support from well-established PD centres and international organisations (International Society of Peritoneal Dialysis (ISPD), International Society of Nephrology (ISN), International Pediatric Nephrology Association (IPNA) are essential.
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http://dx.doi.org/10.1177/08968608211019986DOI Listing
June 2021

Comparison of Efficacy of Dexamethasone and Methylprednisolone in Improving PaO2/FiO2 Ratio Among COVID-19 Patients.

Cureus 2020 Oct 12;12(10):e10918. Epub 2020 Oct 12.

Medical Education and Simulation, Bahria International Hospital, Lahore, PAK.

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the reason for the global pandemic that started from Wuhan, China, in December 2019, known as coronavirus diseases 2019 (COVID-19). Acute respiratory distress syndrome happened in COVID-19 not just because of uncontrolled viral replication but also because of an uncontrolled immune reaction from the host. That's why antiviral and anti-inflammatory treatments have become an increasing concern for clinicians. Methods A retrospective quasi-experimental study design was used to assess the effectiveness of methylprednisolone and dexamethasone in the improvement of PaO/FiO (P/F) ratio in COVID-19 patients. We included 60 participants for this study by using a convenient sampling technique and divided them into two groups with 30 patients in each group. Group 1 was given dexamethasone 8 mg twice daily, and group 1 given methylprednisolone 40 mg twice daily for eight days. We recorded C-reactive protein (CRP), serum ferritin level, and P/F ratio before administration of both drugs and after administration of drugs for eight days. We used the paired t-test to assess the effect of both drugs on the P/F ratio of participants. Results The initial mean CRP in group 1 was 110.34, which reduced to 19.45 after administration of dexamethasone; similarly, the CRP in group 2 was 108.65, which reduced to 43.82 after administering methylprednisolone for eight days. In P/F ratio improvement, the calculated significance value for dexamethasone (p=0.000) was less than the table value at 0.05 in all sections, p-value for methylprednisolone (p=0.009) was also less than the table value at 0.05, which shows that both dexamethasone and methylprednisolone were effective in improving P/F ratio. Calculated p-value for dexamethasone (p=0.000) was lower than the calculated p-value for methylprednisolone (p=0.009), which shows that dexamethasone is more effective as compare to methylprednisolone. Conclusions Steroid therapy is effective in controlling inflammation markers, and especially dexamethasone is significantly effective in improving the P/F ratio in COVID-19 patients.
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http://dx.doi.org/10.7759/cureus.10918DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657375PMC
October 2020

Use of Continuous Glucose Monitoring in Patients with Diabetes Mellitus on Peritoneal Dialysis: Correlation with Glycated Hemoglobin and Detection of High Incidence of Unaware Hypoglycemia.

Blood Purif 2016 20;41(1-3):18-24. Epub 2015 Oct 20.

Joint International Society of Nephrology and Kidney Research UK Fellow at the Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK.

Introduction: Glycated hemoglobin is used to assess diabetic control although its accuracy in dialysis has been questioned. How does it compare to the Continuous Glucose Monitoring System (CGMS) in peritoneal dialysis (PD) patients?

Methods: We conducted a retrospective analysis of 60 insulin-treated diabetic patients on PD. We determined the mean interstitial glucose concentration and the proportion of patients with hypoglycemia (<4 mmol/l) or hyperglycemia (>11 mmol/l).

Results: The correlation between HbA1c and glucose was 0.48, p < 0.0001. Three of 15 patients with HbA1c >75 mmol/mol experienced significant hypoglycemia (14-144 min per day). The patients with frequent episodes of hypoglycemia could not be differentiated from those with frequent hyperglycemia by demographics or PD prescription.

Conclusion: HbA1c and average glucose levels measured by the CGMS are only weakly correlated. On its own, HbA1c as an indicator of glycemic control in patients with diabetes on PD appears inadequate. We suggest that the CGMS technology should be more widely adopted.
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http://dx.doi.org/10.1159/000439242DOI Listing
December 2016

Optimizing Peritoneal Dialysis Catheter Placement by Lateral Abdomen X-Ray.

Perit Dial Int 2015 Dec;35(7):760-2

Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK

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http://dx.doi.org/10.3747/pdi.2014.00263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690634PMC
December 2015

Increasing the use of biocompatible, glucose-free peritoneal dialysis solutions.

World J Nephrol 2015 Feb;4(1):92-7

Ahad Qayyum, Klara Paudel, Stanley L Fan, Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, United Kingdom.

A major concern inhibiting some clinicians from embracing peritoneal dialysis (PD) as the preferred first modality of dialysis is the effects of PD solutions on the peritoneal membrane. These anatomical and functional changes predispose to complications like peritonitis, encapsulating peritoneal sclerosis and ultrafiltration failure. In recent years, "biocompatible" and glucose-sparing PD regimens have been developed to minimize damage to the peritoneal membrane. Can the use of these more expensive solutions be justified on current evidence? In this review of the literature, we explore how we may individualize the prescription of biocompatible PD fluid.
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http://dx.doi.org/10.5527/wjn.v4.i1.92DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317632PMC
February 2015
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