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Search Results: 1 - 10 of 26053 matches for " Ahmad Al-Sarraf "
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Incidence of pancreatitis, secondary causes, and treatment of patients referred to a specialty lipid clinic with severe hypertriglyceridemia: a retrospective cohort study
Supna Sandhu, Ahmad Al-Sarraf, Catalin Taraboanta, Jiri Frohlich, Gordon A Francis
Lipids in Health and Disease , 2011, DOI: 10.1186/1476-511x-10-157
Abstract: A retrospective cohort study was conducted on patients presenting non-acutely to the Healthy Heart Program Lipid Clinic at St. Paul's Hospital with a TG level > 20 mM (1772 mg/dl) between 1986 and 2007. Ninety-five patients with TG > 20 mM at the time of referral were identified, in who follow up data was available for 84. Fifteen patients (15.8%), with a mean outpatient TG level of 38.1 mM, had a history of acute pancreatitis. Among 91 additional patients with less severe HTG, none had a history of pancreatitis when TG were between 10 and 20 mM. Among patients with TG > 20 mM on presentation, 8 (8.5%), with a mean TG level of 67.8 mM, exhibited eruptive xanthomata. A diet high in carbohydrates and fats (79%) and obesity (47.6%) were the two most frequent secondary causes of HTG at initial visit. By 2009, among patients with follow up data 53% exhibited either pre-diabetes or overt Type 2 diabetes mellitus. Upon referral only 23 patients (24%) were receiving a fibrate as either monotherapy or part of combination lipid-lowering therapy. Following initial assessment by a lipid specialist this rose to 84%, and remained at 67% at the last follow up visit.These results suggest hypertriglyceridemia is unlikely to be the primary cause of acute pancreatitis unless TG levels are > 20 mM, that dysglycemia, a diet high in carbohydrates and fats, and obesity are the main secondary causes of HTG, and that fibrates are frequently overlooked as the drug of first choice for severe HTG.Hypertriglyceridemia (HTG), classically defined as fasting plasma triacylglycerols (triglycerides, TG) > 2.3 mM or 200 mg/dl, or 1.7 mM (150 mg/dl) in the definition of metabolic syndrome [1], is a common laboratory finding. Severe hypertriglyceridemia, e.g., TG > 20 mM (1772 mg/dl), is much rarer and almost always caused by a combination of inherited and secondary factors [2,3]. Genetic disorders leading to hypertriglyceridemia include familial combined hyperlipidemia, familial hypertriglyceridemia,
Endoscopic Radial Artery Harvest in Coronary Artery Bypass Surgery: Clinicopathological Evaluation  [PDF]
Amir Mohamed, Kamelia Velikova, Ahmed Nabil, Amr Algarhy, Mohamed Badawy, Adel Maher, Ashraf Abdelsalam, Jamal Al-Fadhli, Riyad Tarazi, Nael Al-Sarraf
World Journal of Cardiovascular Surgery (WJCS) , 2019, DOI: 10.4236/wjcs.2019.92002
Abstract: Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought to assess this effect both histologically and radiologically. Methods: From February 2015 to March 2016, 50 consecutive patients undergoing coronary artery bypass surgery utilizing endoscopically harvested radial artery were prospectively studied. Computerized tomography coronary angiography scan was performed randomly in 8 patients who also had their respective radial artery analyzed histologically at the time of harvest. Standard coronary angiography was also performed in 4 additional patients driven by symptoms recurrence. Results: All patients were available for follow up at 1 year following the surgery. There was no mortality during follow-up. Three patients (6%) developed transient complications in the harvest arm which resolved. All radial arteries were patent on follow-up imaging. Histological examination showed integrity of the arterial wall, intact endothelial lining, patent lumens and no significant pathological abnormalities. Conclusion: The use of endoscopic radial artery harvest was associated with few self-limiting morbidities and excellent patency rates. In addition, there was no evidence of any thermal or traumatic injuries sustained to the radial arteries when examined histologically. The use of endoscopically harvested radial arteries appears safe with excellent results.
Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report
Nael Al-Sarraf, Fahad Al-Shammari, Jamal Al-Fadhli, Emad Al-Shawaf
Journal of Medical Case Reports , 2010, DOI: 10.1186/1752-1947-4-241
Abstract: A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient.Prosthetic valve thrombosis is a rare but life threatening condition, the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient.Prosthetic valves thrombosis (PVT) is defined as any obstruction of the prosthesis by non-infective thrombotic material. The diagnosis of PVT is made by a combination of clinical data (heart failure, absence of prosthetic sounds, cardiogenic shock) and echocardiograpy. The traditional treatment for PVT is surgery with either thrombectomy or replacement of the prosthesis. In recent years, thrombolytic therapy has evolved as a substitute to surgery. Various thrombolytic treatments have been reported with variable success rates including streptokinase, urokinase and recombinant tissue plasminogen activators. However, the data on the use of tenecteplase (a synthetic tissue plasminogen activator) is limited [1].A 44-year-old Middle Eastern man was admitted for mitral valve replacement. He had history of atrial fibrillation and rheumatic heart disease affecting the mitral valve (MV) with consequent severe mitral stenosis. He was a non-smoker and did not consume alcohol. He had no family history of relevance. He weighed 60 kg and his height was 168 cm.The patient underwent an uneventful mitral valve replacement using a mechanical 29 mm St Jude prosthesis. He was commenced on oral anticoagulant (warfarin) and a beta blocker. His pre-discharge transthoracic echocardiography (TTE) showed a well-functioning prosthesis with no paravalvular leak. Six months later, the patient presented to his
Prevalence And Factors Associated With Diabetic Retinopathy, A Multi-Centric Study In Kuwait
A Al-Sarraf, S Al-Bannai, S Al-Furaih, M El-Shazly
Alexandria Journal of Medicine , 2010,
Abstract: Background: Diabetic retinopathy (DR) remains one of the major causes of vision loss and blindness in young adults despite the availability of effective treatment. Objective: To determine the prevalence of DR among adult diabetic patients attending primary health care centers in Kuwait and to identify factors that could be associated with DR. Methods: The current study is a part of a larger multi-centric one. The first phase of the study is a cross sectional one to determine the prevalence of DR among diabetic patients attending the selected primary health care centers. The second one was a nested case-control study, whereas all patients with DR (case group n = 216) were compared with all other diabetic patients without DR (control group n = 488) to determine the associated factors with cases. A pre-designed questionnaire included socio-demographic, clinical data, in addition to health care characteristics and personal practice. Basic univariate analyses were followed by multiple logistic regression analysis. Results: The prevalence of DR among adult diabetic patients attending primary health care centers was 43.6%. Of the personal factors examined, age was the only significant determinant of DR (OR = 2.2, 95% CI: 1.1 – 5.2) and (OR = 4.6, 95% CI: 2.0 – 11.0) for age groups 50 – 59 and > 60 as compared with those < 40 years respectively. Among clinical factors, patients with type 2 – insulin treated diabetes were more prone to have DR (OR = 8.0, 95% CI: 3.5 – 19.4). Duration of diabetes was a significant predictor of DR (OR = 2.6, 95% CI: 1.61 – 4.2) and (OR = 2.8, 95% CI: 1.5 – 5.5) for a duration of 10 – 19 and > 20 years as compared with < 10 years respectively. Also, poor glycemic state and uncontrolled hypertension were associated factors (OR = 2.0, 95% CI: 1.2 – 2.8) and (OR = 3.1, 95% CI: 2.0 – 4.9) respectively. Cardiovascular complications, neuropathy, nephropathy and diabetic foot were significantly associated with DR. Within patients' practice, regular follow-up was proved to be a protective factor (OR = 0.5, 95% CI: 0.3 – 0.8) Conclusion: Regular follow-up is the strongest modifiable risk factor for DR. Old patients with longer duration of diabetes particularly those having other types of long term diabetic complications and on insulin therapy are more prone and should be regularly screened for DR.
Effect of Preoperative Atrial Fibrillation on Postoperative Outcome following Cardiac Surgery
Nael Al-Sarraf,Lukman Thalib,Anne Hughes,Michael Tolan,Vincent Young,Eillish McGovern
Cardiology Research and Practice , 2012, DOI: 10.1155/2012/272384
Abstract: Atrial fibrillation remains the commonest arrhythmia encountered in cardiac surgery. Data on the effect of preoperative atrial fibrillation on postoperative outcome remain limited. We sought to assess the effects preoperative atrial fibrillation on patients' outcome following cardiac surgery. This is a retrospective review of prospectively collected departmental data of all patients who underwent cardiac surgery over 8-year period. Our cohort consisted of 3777 consecutive patients divided into atrial fibrillation ( , 11%) and sinus rhythm ( , 89%). Postoperative complications and in-hospital mortality were analysed. Univariate analysis showed significantly increased mortality and major complications in atrial fibrillation compared to sinus rhythm patients. Using multiple logistic regression analysis and after accounting for Euro SCORE as a confounding variable, we found that preoperative atrial fibrillation significantly increases the risk of mortality (OR 1.7), low cardiac output state (OR 1.3), prolonged ventilation (OR 1.4), infective complication (OR 1.5), gastrointestinal complications (OR 2.0), and intensive care unit readmission (OR 1.6). Preoperative atrial fibrillation in cardiac surgery patients increases their risk of mortality and major complications following cardiac surgery. Surgical strategies such as Cox-Maze procedure may be beneficial in these patients. 1. Introduction Atrial fibrillation (A Fib) is the most common arrhythmia seen in cardiac surgery. In addition, it has also been identified in nonsurgical patients as a marker of severe cardiac disease and a risk factor for decreased long-term survival [1]. Advancing age has been shown to have a significant association with the incidence of A Fib, a relationship that is particularly important as the number of elderly patients referred for surgical revascularization is increasing [2]. Data from the society of thoracic surgery national adults cardiac database collected during 2002 and 2003 revealed that the prevalence of A Fib was 5.3% among patients undergoing isolated coronary artery bypass graft (CABG) but it increased to 6.1% in 2005 [3]. Although previous studies have examined the effects of preoperative A Fib on mortality following cardiac surgery, the full spectrum of postoperative complications that might be encountered in such patients has not been reported. In addition, previous studies have concentrated on one type of cardiac surgery than the full spectrum of surgeries which might have impacted on the outcomes observed (e.g., CABG only, or aortic valve replacements alone or
The Code of the Symmetric Net with m = 4 and μ = 2  [PDF]
Ahmad N. Al-Kenani
Open Journal of Discrete Mathematics (OJDM) , 2012, DOI: 10.4236/ojdm.2012.21001
Abstract: In this paper, we investigated the code over GF(2) which is generated by the incidence matrix of the symmetric (2,4) - net D. By computer search, we found that this binary code of D has rank 13 and the minimum distance is 8.
Benefits and Costs of the Informal Sector: The Case of Brick Kilns in Bangladesh  [PDF]
Lelia Croitoru, Maria Sarraf
Journal of Environmental Protection (JEP) , 2012, DOI: 10.4236/jep.2012.36058
Abstract: In developing countries, the informal sector—brick kilns, leather tanning, food processing factories—is often highly polluting, causing countless deaths and illnesses. This paper presents the case of brick kilns in Dhaka, one of the most polluted cities in Asia. Five months per year, brick kilns are the city’s main source of fine particulate pollution, accounting for 38 percent of total fine particulate mass. The paper values the impacts of existing and alternative brick kiln technologies in Dhaka city. Through a Cost-Benefit Analysis, it estimates the net returns for the entrepreneur, and the social costs, such as health impacts from air pollution and damages due to carbon emissions from kilns. It shows that cleaner technologies are more attractive than traditional technologies both from the private and social perspective, and provides concrete recommendations for a cleaner brick sector in Bangladesh.
How Much Does Environmental Degradation Cost? The Case of Morocco  [PDF]
Lelia Croitoru, Maria Sarraf
Journal of Environmental Protection (JEP) , 2018, DOI: 10.4236/jep.2018.93017
Abstract: Environmental degradation is costly—to individuals, to societies and to the environment. This paper makes these costs clear in the context of Morocco, a country marked by rapid economic development and urbanization. Although Morocco has made impressive efforts to strengthen its policies and strategies to protect its environment and natural resources, environmental degradation is still an issue. Using the most updated methodology and data sources, the paper estimates that environmental degradation imposed costs on Moroccan society of about US$3.9 billion, or 3.5 percent of the country’s GDP in 2014. Water-related problems and air pollution are the most pressing challenges, followed by agricultural land degradation. Based on these findings, the paper provides guidance for an improved management of the country’s environmental priority areas.
Intercity Bus Scheduling for the Saudi Public Transport Company to Maximize Profit and Yield Additional Revenue  [PDF]
Mohamad K. Hasan, Ahmad A. Al Hammad
Journal of Service Science and Management (JSSM) , 2010, DOI: 10.4236/jssm.2010.33044
Abstract: The Saudi Public Transport Company (SAPTCO) intercity bus schedule comprises a list of 382 major trips per day to over 250 cities and villages with 338 buses. SAPTCO operates Mercedes 404 SHD and Mercedes 404 RI-IL fleet types for the intercity trip. The fleet assignment model developed by American Airlines was adapted and applied to a sample of the intercity bus schedule. The results showed a substantial saving of 29% in the total number of needed buses. This encourages the decision makers at SAPTCO to use only Mercedes 404 SHD fleet type. Hence, the fleet assignment model was modified to incorporate only one fleet type and applied to the sample example. Due to the increase in the problem size, the model was decomposed by stations. Finally, the modified decomposed model was applied to the whole schedule. The model results showed a saving of 16.5% in the total number of needed buses of Mercedes 404 SHD. A sensitivity analysis was carried out and showed that the predefined minimum connection time is critical for model efficiency. A modification to the connection time for 11 stations showed a saving of 14 more buses. Considering our recommendation of performing a field study of the trip connection time for every station, the expected saving of the total number of needed buses will be about 27.4% (90 buses). This will yield a net saving of 16.44 million Saudi Riyals (USD 4.4 million) per year for SAPTCO in addition to hiring new employees. The revenue analysis shows that these 90 surplus buses will yield about USD 20,744,000 additional revenue yearly.
A Technical Experiment on Biogas Production from Small-Scale Dairy Farm  [PDF]
Ahmad Al-Rousan, Anas Zyadin
Journal of Sustainable Bioenergy Systems (JSBS) , 2014, DOI: 10.4236/jsbs.2014.41002
Abstract:

The key objective of this study was to evaluate the economic feasibility of producing biogas from privately-owned dairy farm in the North of Jordan. This experiment did not adopt Best-Available-Technology (BAT) but rather traditional unit manufactured with minimized costs through installing locally produced materials to avoid economic burden on the farmers’ production costs. A thermophilic biodigester unit was built sub-surface with 22 m3 capacity (15 m3 manure tank plus 7 m3 biogas holder) in a relatively small scale dairy farm. The daily feed was about 500 liter of cow slurry (150 - 200 liter cow manure) and the remaining

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