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Articles by A Ali
Total Records ( 5 ) for A Ali
  V Hirani , K Tull , A Ali and J. Mindell
 

Background: the importance of vitamin D for bone health is well known, but emerging evidence also suggests that adequate vitamin D status may also be protective against non-communicable diseases. In the UK, government initiatives highlighting the importance of adequate vitamin D among older people have been in place since 1998.

Objectives: the aim of this analysis is to assess vitamin D status in people aged ≥65, living in private households in England, 2005 and make comparisons with the Health Survey for England (HSE) 2000 and the National Diet and Nutrition Survey (NDNS), 1994. We also examine associations of hypovitaminosis D [serum 25(OH)D <50 nmol/l] with demographic, geographic, lifestyle and health risk factors.

Design and setting: a nationally representative sample of older people living in England in 2005.

Participants: 2,070 adults aged ≥65, living in private households taking part in the HSE 2005.

Results: in the HSE 2005, mean serum 25(OH)D levels were 53 and 49 nmol/l in men and women, respectively, these levels are significantly lower than currently recommended at ≥75 nmol/l. Prevalence of vitamin D deficiency [25(OH)D <25 nmol/l] in people aged ≥65 in 2005 was 13% in women and 8% in men. Nearly two thirds (57%) of women and half of men (49%) had serum 25(OH)D <50 nmol/l. Only 16% of men and 13% of women aged ≥65 years had serum 25(OH)D levels ≥75 nmol/l. There is no improvement in vitamin D status in 2005 compared to 2000 and a significant decline in vitamin D status among men in 2005 in comparison to the 1994/1995 NDNS results. The odds of hypovitaminosis D increased by age group from those aged 75–79 to aged ≥85. Season of taking a blood sample, obesity, dark skin pigmentation, not taking vitamin supplements, cigarette smoking, poor general health and longstanding illness were all significant predictors (P < 0.05) of serum 25(OH)D status in adjusted regression models.

Conclusions: poor vitamin D status of older people continues to be a public health problem in England. Hypovitaminosis D is associated with many risk factors and poor health outcomes. There is now an urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people to prevent poor vitamin D status and its negative consequences.

  H Zayed , A Ali , O Wendler and H. Rashid
 

Objective: To assess the yield of screening for asymptomatic carotid artery disease prior to isolated heart valve surgery (IHVS).

Methods: Retrospective analysis of the preoperative carotid duplex scans performed in neurologically asymptomatic patients who underwent IHVS between 2003 and 2006 was performed. Internal carotid artery (ICA) stenosis of 70% was considered significant. Patients with concomitant coronary artery disease were excluded.

Results: A total of 177 patients underwent IHVS (one valve in 165 and 2 valves in 12 patients). No or minor ICA disease detected in 172 patients. Four patients (2.25%) had significant unilateral ICA stenosis and 1 patient (0.56%) had unilateral ICA occlusion. Three patients (1.69%) suffered postoperative stroke, while 2 patients (1.1%) suffered transient ischemic attacks. All neurologically affected patients had normal preoperative carotid duplex. The in-hospital mortality was 4.5%.

Conclusion: Prevalence of significant ICA disease is low in patients undergoing IHVS. This population does not benefit from preoperative carotid screening.

  M. R Coleman , M. H Davis , J. M Rodd , T Robson , A Ali , A. M Owen and J. D. Pickard
 

Clinical audits have highlighted the many challenges and dilemmas faced by clinicians assessing persons with disorders of consciousness (vegetative state and minimally conscious state). The diagnostic decision-making process is highly subjective, dependent upon the skills of the examiner and invariably dictated by the patients’ ability to move or speak. Whilst a considerable amount has been learnt since Jennett and Plum coined the term ‘vegetative state’, the assessment process remains largely unchanged; conducted at the bedside, using behavioural assessment tools, which are susceptible to environmental and physiological factors. This has created a situation where the rate of misdiagnosis is unacceptably high (up to 43%). In order to address these problems, various functional brain imaging paradigms, which do not rely upon the patient's ability to move or speak, have been proposed as a source of additional information to inform the diagnostic decision making process. Although accumulated evidence from brain imaging, particularly functional magnetic resonance imaging (fMRI), has been encouraging, the empirical evidence is still based on relatively small numbers of patients. It remains unclear whether brain imaging is capable of informing the diagnosis beyond the behavioural assessment and whether brain imaging has any prognostic utility. In this study, we describe the functional brain imaging findings from a group of 41 patients with disorders of consciousness, who undertook a hierarchical speech processing task. We found, contrary to the clinical impression of a specialist team using behavioural assessment tools, that two patients referred to the study with a diagnosis of vegetative state did in fact demonstrate neural correlates of speech comprehension when assessed using functional brain imaging. These fMRI findings were found to have no association with the patient's behavioural presentation at the time of investigation and thus provided additional diagnostic information beyond the traditional clinical assessment. Notably, the utility of brain imaging was further underlined by the finding that the level of auditory processing revealed by functional brain imaging, correlated strongly (rs = 0.81, P < 0.001) with the patient's subsequent behavioural recovery, 6 months after the scan, suggesting that brain imaging may also provide valuable prognostic information. Although further evidence is required before consensus statements can be made regarding the use of brain imaging in clinical decision making for disorders of consciousness, the results from this study clearly highlight the potential of imaging to inform the diagnostic decision-making process for persons with disorders of consciousness.

  A Ali , S Klasa and E. Yeung
 

Industry concentration measures calculated with Compustat data, which cover only the public firms in an industry, are poor proxies for actual industry concentration. These measures have correlations of only 13% with the corresponding U.S. Census measures, which are based on all public and private firms in an industry. Also, only when U.S. Census measures are used is there evidence consistent with theoretical predictions that more-concentrated industries, which should be more oligopolistic, are populated by larger and fewer firms with higher price-cost margins. Further, the significant relations of Compustat-based industry concentration measures with the dependent variables of several important prior studies are not obtained when U.S. Census measures are used. One of the reasons for this occurrence is that Compustat-based measures proxy for industry decline. Overall, our results indicate that product markets research that uses Compustat-based industry concentration measures may lead to incorrect conclusions.

  P Fenton , F Qureshi , A Ali and D. Potter
  Background

Distal biceps tendon ruptures are uncommon injuries. Operative treatment has been shown to improve functional outcomes. A variety of surgical repair techniques have been described for distal biceps ruptures.

Purpose

The authors present their experience with a new technique to anatomically repair distal biceps tendon ruptures through a single-incision approach that they believe is a safe and reliable method of achieving repair.

Study Design

Case series; Level of evidence, 4.

Materials and Methods

Fourteen patients with 14 biceps tendon ruptures underwent a repair with a bioabsorbable Biotenodesis screw. All 14 patients underwent clinical assessment using the Mayo Elbow Performance Score, measurement of range of motion, and flexion strength testing. Mean follow-up was 29.1 months.

Results

Three patients had a good result and 11 patients had an excellent result. The mean elbow flexion arc was 141.4° (range, 125°–155°; standard deviation, 7.19°) with no flexion contractures in the operated side compared with the unaffected elbow. All patients achieved an equal range of pronation/supination to the unaffected side. The mean flexion strength in the injured arm was 25.7 kg, compared with 26.9 kg in the uninjured side. No complications were noted about the elbow.

Conclusion

The authors believe this new technique gives a good functional outcome with reproducible results.

 
 
 
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