Publications by authors named "N Ahmed"

2,687 Publications

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Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging.

Skeletal Radiol 2021 Sep 15. Epub 2021 Sep 15.

Antwerp University Hospital Belgium, Edegem, Belgium.

Disorders of mineral metabolism and bone disease are common complications in chronic kidney disease (CKD) patients and are associated with increased morbidity and mortality. Bone biopsies, bone scintigraphy, biochemical markers, and plain films have been used to assess bone disorders and bone turnover. Of these, functional imaging is less invasive than bone/marrow sampling, more specific than serum markers and is therefore ideally placed to assess total skeletal metabolism. F-sodium fluoride (NaF) PET/CT is an excellent bone-seeking agent superior to conventional bone scan in CKD patients due to its high bone uptake, rapid single-pass extraction, and minimal binding to serum proteins. Due to these properties, F-NaF can better assess the skeletal metabolism on primary diagnosis and following treatment in CKD patients. With the increased accessibility of PET scanners, it is likely that PET scanning with bone-specific tracers such as F-NaF will be used more regularly for clinical assessment and quantitation of bone kinetics. This article describes the pattern of scintigraphic/functional appearances secondary to musculoskeletal alterations that might occur in patients with CKD.
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http://dx.doi.org/10.1007/s00256-021-03905-6DOI Listing
September 2021

Assessment of trends in climatic extremes from observational data in the Kashmir basin, NW Himalaya.

Environ Monit Assess 2021 Sep 14;193(10):649. Epub 2021 Sep 14.

Department of Geology, School Education Department, Government of Jammu and Kashmir, Srinagar, 190002, India.

The present study aims to assess the recent changes and trends in the extreme climate indices in the Kashmir basin using the observational records from 1980 to 2016. The extreme climate indices were computed using the ClimPACT2 software and a total of 39 indices were selected for the analysis having particular utility to various sectors like agriculture, water resources, energy consumption, and human health. Besides adopting the station scale analysis, regional averages were computed for each index. In terms of the mean climatology, an increase has been observed in the annual mean temperature with a magnitude of 0.024 °C/year. Further, differential warming patterns have been observed in the mean maximum and minimum temperatures with mean maximum temperature revealing higher increases than mean minimum temperature. On the other hand, the annual precipitation shows a decrease over most of the region, and the decreases are more pronouncing in the higher altitudes. The trend analysis of the extreme indices reveals that in consonance with the rising temperature there has been an increase in the warm temperatures and decrease in the cold temperatures across the Kashmir basin. Furthermore, our analysis suggests a decrease in the extreme precipitation events. The drought indices viz., Standardised Precipitation Index (SPI), and Standardised Precipitation Evapotranspiration Index (SPEI) manifest decreasing trends with the tendency towards drier regimes implying the need for better water resource management in the region under changing climate.
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http://dx.doi.org/10.1007/s10661-021-09439-7DOI Listing
September 2021

A Rare Entity of Undifferentiated Pleomorphic Sarcoma of the Mandible - A Case Report.

Ann Maxillofac Surg 2021 Jan-Jun;11(1):156-159. Epub 2021 Jul 24.

Consultant Maxillofacial Surgeon, People Tree Hospital, Bengaluru, Karnataka, India.

The Rationale: Undifferentiated pleomorphic sarcoma originally known as malignant fibrous histiocytoma was declassified by the World Health Organization in 2002 as a formal diagnostic entity and renamed as an undifferentiated pleomorphic sarcoma. It accounts for <1% of malignant tumours of the long bone.

Patient Concerns: A 33-year-old male patient reported with swelling and pain in the lower left posterior jaw region for 3 months with a history of fall on the floor 3 months back.

Diagnosis: On examination, diffuse solitary swelling was present on the left lower third of the face and was diagnosed radiographically and histopathologically as undifferentiated pleomorphic sarcoma of the mandible.

Treatment And Outcomes: Selective neck dissection, followed by reconstruction with fibula osteomyocutaneous flap and then referred for adjuvant radiotherapy.

Take-away Lessons: Vimentin staining plays a substantial role in the diagnosis of undifferentiated pleomorphic sarcoma. A long-term follow-up after treatment is required to increase the chances of disease-free survival for the patients.
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http://dx.doi.org/10.4103/ams.ams_334_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407644PMC
July 2021

Relationship Of Prior Pulmonary Tuberculosis With The Occurrence Of Covid-19 Pneumonia: Review Of 500 Plus HRCT Chest Scans From Two Different Centres Of Sindh, Pakistan.

J Ayub Med Coll Abbottabad 2021 Jul-Sep;33(3):368-375

Department of Pulmonology, Liaquat University of Medical & Health Sciences, Hyderabad, Pakistan.

Background: COVID-19 pandemic has severely affected the entire world. However, its severity and mortality rate are lesser in developing countries, including Pakistan. This study aims to determine the association of prior pulmonary tuberculosis with COVID-19 pneumonia.

Methods: This cross-sectional study was conducted at two centres of Sindh, Pakistan. 521 HRCT chest performed from 1st May to 31st July 2020 were included and marked as "COVID-19 group". 761 HRCT chest performed during the first six months of 2019 were retrospectively evaluated to determine the prevalence of prior pulmonary tuberculosis and marked as the "pre-COVID-19 group". Previous pulmonary tuberculosis was documented as evidenced by clinical history, ATT intake and HRCT findings. Chi-square test was used to determine the association of prior pulmonary tuberculosis with COVID-19 pneumonia. A p-value of ≤0.01 was considered statistically significant.

Results: In the "COVID-19 group", 4.9% (n=26) patients had prior pulmonary tuberculosis. In the "pre-COVID-19 group", 9.8% (n=75) patients had prior pulmonary tuberculosis with a confirmed history of tuberculosis in 8.9% (n=68) and without documented history in 0.9% (n=7) cases. A significant p-value of 0.001 was obtained with a confidence interval of 99%.

Conclusions: Prior pulmonary tuberculosis might have a protective effect against COVID-19 pneumonia which could be due to developed antibodies secondary to exposure to prior tuberculosis or BCG vaccination. Our results warrant further consideration due to the potential public-health benefits that can be achieved in our fight against the novel pandemic.
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September 2021

Clinical utility of methionine restriction in adenosine kinase deficiency.

JIMD Rep 2021 Sep 27;61(1):52-59. Epub 2021 Jul 27.

Division of Genetics, Department of Specialized Medicine McGill University Health Center Montréal Quebec Canada.

Adenosine kinase (ADK) deficiency is a rare autosomal recessive inborn error of metabolism involving the methionine and purine metabolic pathways. Prior reports show that most patients present in infancy with jaundice, hypotonia, developmental delay, and mild dysmorphic features. Characteristic biochemical findings included hypoglycemic hyperinsulinism, cholestasis, elevated liver functions, methionine, S-adenosylhomocysteine, and S-adenosylmethionine, with normal or mildly elevated homocysteine level. Brain imaging demonstrated atrophy, hydrocephalus, and delayed myelination. There are 26 reported patients of ADK deficiency, of which 14 patients were placed on a methionine-restricted diet. Clinical improvement with methionine restriction was not well described.

Case Report: We report an infant who presented at birth with persistently elevated ammonia (100-163 μmol/L), hypoglycemia, cholestasis, and liver dysfunction. The initial metabolic and genetic work-up was nondiagnostic, with only a mildly increased plasma methionine level (51 [<38 μmol/L]). Iron depositions in the liver and in lip mucosa led to suspicion of gestational alloimmune liver disease. Immunoglobulin therapy and exchange transfusion treatments demonstrated transient clinical and biochemical improvements. However, subsequent episodes of acute liver failure with development of neurological abnormalities led to further evaluation. Metabolic studies showed a 25-fold increase in plasma methionine level at 8 months of life (1022 [<38 μmol/L]) with white matter abnormalities on brain MRI. Expanded molecular testing identified the disease. Urinary purines profile showed elevations of adenosine and related metabolites. Introduction of a low-methionine diet resulted in rapid clinical amelioration, improvement of brain MRI findings, and normalization of liver functions and methionine levels.
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http://dx.doi.org/10.1002/jmd2.12238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411109PMC
September 2021
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