Dilated cardiomyopathy (DCM) is a myocardial disease characterised by impaired left ventricular s... more Dilated cardiomyopathy (DCM) is a myocardial disease characterised by impaired left ventricular systolic function in conjunction with enlargement of the cardiac chambers. A number of pathogenic pathways have been implicated, including genetic mutations in cytoskeletal components or autoimmune response to acute viral myocarditis. In a significant proportion of patients, the cause remains unknown. In spite of this uncertainty, it is recognised that a common pathophysiological basis lies beyond the initial insult, involving neurohormonal dysregulation and adverse cardiac remodelling. Current treatments are focused upon these mechanisms, but there remains a conspicuous lack of upstream therapies to prevent establishment of the disease. This brief review outlines our current understanding.
Reduced systemic insulin signaling promotes endothelial dysfunction and diminished endogenous vas... more Reduced systemic insulin signaling promotes endothelial dysfunction and diminished endogenous vascular repair. We asked whether restoration of endothelial insulin receptor expression could rescue this phenotype. Insulin receptor haploinsufficient mice (IRKO) were crossed with mice expressing a human insulin receptor transgene in the endothelium (hIRECO), to produce IRKO-hIRECO progeny. No metabolic differences were noted between IRKO and IRKO-hIRECO in glucose- and insulin-tolerance tests. In contrast with control IRKO littermates, IRKO-hIRECO exhibited normal blood pressure and aortic vasodilatation in response to acetylcholine, comparable to parameters noted in wild-type littermates. These phenotypic changes were associated with enhanced basal- and insulin-stimulated nitric oxide production. IRKO-hIRECO also demonstrated normalized endothelial repair after denuding arterial injury, which was associated with rescued endothelial cell migration in vitro, but not with changes in circu...
Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80... more Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80 years. Despite multiple treatment options, it remains an independent prognostic marker of mortality due to its association with clinical sequelae, particularly cerebrovascular events. Management can be broadly divided into treatment of the arrhythmia, via rhythm or rate control, and stroke thromboprophylaxis via anticoagulation. Traditional options for pharmacotherapy include negatively chronotropic drugs such as β-blockers, and/or arrhythmia-modifying drugs such as amiodarone. More recently, catheter ablation has emerged as a suitable alternative for selected patients. Additionally, there has been extensive research to assess the role of novel oral anticoagulants as alternatives to warfarin therapy. There is mounting evidence to suggest that they provide comparable efficacy, while being associated with lower bleeding complications. While these findings are promising, recent controversi...
Aims Access site vascular complications remain a recognised complication following transcatheter ... more Aims Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs. Methods This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs. Results A total of 136 patients were included in this...
Introduction: Insulin resistance is an independent risk factor for cardiovascular disease. We hav... more Introduction: Insulin resistance is an independent risk factor for cardiovascular disease. We have previously shown that the insulin-like growth factor-1 receptor (IGF-1R) is a negative regulator o...
Journal of Ayub Medical College, Abbottabad : JAMC, 2020
BACKGROUND Early detection of sepsis in the emergency department is of prime importance and requi... more BACKGROUND Early detection of sepsis in the emergency department is of prime importance and requires tools that are time and cost-effective. The Systemic Inflammatory Response Syndrome (SIRS) has been poorly associated with sepsis. Timothy et al in a retrospective analysis of Emergency Department (ED) visit stated estimate of SIRS at 17.8% accounting to an annual yield of 16.6 million adult visits with SIRS per year, among these only 26% accounted as an infectious aetiology of SIRS, trauma being 10% and other causes being rare. Shock index is found to be independently associated with 30-day mortality in a broad population of ED patients including sepsis. With limited health resources in a low to middle income country, focused utilization is important and so is the need for markers that are non-invasive, readily available, cost effective, and easy to interpret. Shock index can serve this purpose as a surrogate marker of disease severity in patients with severe sepsis and thus resulti...
Fall armyworm is a sporadic pest and feed on almost 80 plant species. It is native to America but... more Fall armyworm is a sporadic pest and feed on almost 80 plant species. It is native to America but due to its strong flying abilities it has spread to Africa and now it has been reported in most of the Asian countries. In the present study presence of fall armyworm was observed in Faisalabad, Pakistan. At the end of Oct. and November larval collection from a maize field were examined in laboratory following dichotomous key of Passoa 1991. Larvae were also reared to adults. After examination it was identified that larvae and adults were Spodoptera frugiperda. And this is the first confirmed report that shows the presence of Spodoptera frugiperda in Faisalabad, Pakistan.
The thriving adoption of drones for delivering parcels, packages, medicines, etc., is surging wit... more The thriving adoption of drones for delivering parcels, packages, medicines, etc., is surging with time. The application of drones for delivery services results in faster delivery, fuel-saving, and less energy consumption. Giant companies like Google, Amazon, Facebook, etc., are actively working on developing, testing, and improving drone-based delivery systems. So far, a lot of work has been done for improving the design, speed, operating range, security of the delivery drones, etc. However, very limited work has been done to ensure a complete and reliable last-mile delivery from the merchant’s store to the hands of the actual customer. To ensure a complete and reliable last-mile delivery, a drone must authenticate the consumer before dropping the package. Therefore, in this work, we propose a consumer authentication (Consumer-Auth) hybrid computing framework for drone delivery as a service to make sure that the parcel is perfectly delivered to the intended customer. The proposed C...
International Journal of Communication Systems, 2021
SummaryThe handoff process in WiFi networks has a very important role to provide continuity of th... more SummaryThe handoff process in WiFi networks has a very important role to provide continuity of the service to wireless users where the access points (APs) are in numerous numbers. In traditional WiFi networks, the handoff process takes a few seconds and is initiated by the wireless devices, but these few seconds could be a reason for information loss when dealing with delay sensitive applications. In this paper, we propose a reduced detection and discovery time approach (DeRy), which generates a solution based on software defined WiFi networks (SD‐WiFi). A simple network management protocol (SNMP) manager and received signal strength indicator (RSSI) manager are employed to report the AP traffic conditions and RSSI values to the SDN controller and instead of the wireless devices, the handoff decisions are taken at the controller end. When to initiate the handoff (detection phase) and which destination AP to associate to (discovery phase) are handled by the centralized SDN controller...
BackgroundCardiac resynchronisation therapy (CRT) confers symptomatic and survival benefits in ch... more BackgroundCardiac resynchronisation therapy (CRT) confers symptomatic and survival benefits in chronic heart failure with reduced ejection fraction (HFrEF). There remains a paucity of data on long‐term performance of left ventricular (LV) leads, particularly with newer quadripolar lead designs.MethodsThis single‐centre study utilised an electronic, outpatient HFrEF database to identify CRT recipients (2008‐2014). The primary endpoint was temporal trend in LV pacing thresholds during follow‐up. Secondary outcomes were complications relating to acute or chronic lead failure and device‐related infections.ResultsTwo hundred eighty patients were included, with mean (±SD) age of 74.2 years (±9.0) and median follow‐up of 7.6 years (interquartile range 4‐9). Mean LV threshold was 1.37 V (±0.73) at implant and remained stable over the study period. No differences were observed based upon lead manufacturer. Compared to non‐quadripolar leads (n = 216), those of quadripolar designs (n = 64) had...
Dilated cardiomyopathy (DCM) is a myocardial disease characterised by impaired left ventricular s... more Dilated cardiomyopathy (DCM) is a myocardial disease characterised by impaired left ventricular systolic function in conjunction with enlargement of the cardiac chambers. A number of pathogenic pathways have been implicated, including genetic mutations in cytoskeletal components or autoimmune response to acute viral myocarditis. In a significant proportion of patients, the cause remains unknown. In spite of this uncertainty, it is recognised that a common pathophysiological basis lies beyond the initial insult, involving neurohormonal dysregulation and adverse cardiac remodelling. Current treatments are focused upon these mechanisms, but there remains a conspicuous lack of upstream therapies to prevent establishment of the disease. This brief review outlines our current understanding.
Reduced systemic insulin signaling promotes endothelial dysfunction and diminished endogenous vas... more Reduced systemic insulin signaling promotes endothelial dysfunction and diminished endogenous vascular repair. We asked whether restoration of endothelial insulin receptor expression could rescue this phenotype. Insulin receptor haploinsufficient mice (IRKO) were crossed with mice expressing a human insulin receptor transgene in the endothelium (hIRECO), to produce IRKO-hIRECO progeny. No metabolic differences were noted between IRKO and IRKO-hIRECO in glucose- and insulin-tolerance tests. In contrast with control IRKO littermates, IRKO-hIRECO exhibited normal blood pressure and aortic vasodilatation in response to acetylcholine, comparable to parameters noted in wild-type littermates. These phenotypic changes were associated with enhanced basal- and insulin-stimulated nitric oxide production. IRKO-hIRECO also demonstrated normalized endothelial repair after denuding arterial injury, which was associated with rescued endothelial cell migration in vitro, but not with changes in circu...
Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80... more Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80 years. Despite multiple treatment options, it remains an independent prognostic marker of mortality due to its association with clinical sequelae, particularly cerebrovascular events. Management can be broadly divided into treatment of the arrhythmia, via rhythm or rate control, and stroke thromboprophylaxis via anticoagulation. Traditional options for pharmacotherapy include negatively chronotropic drugs such as β-blockers, and/or arrhythmia-modifying drugs such as amiodarone. More recently, catheter ablation has emerged as a suitable alternative for selected patients. Additionally, there has been extensive research to assess the role of novel oral anticoagulants as alternatives to warfarin therapy. There is mounting evidence to suggest that they provide comparable efficacy, while being associated with lower bleeding complications. While these findings are promising, recent controversi...
Aims Access site vascular complications remain a recognised complication following transcatheter ... more Aims Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs. Methods This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs. Results A total of 136 patients were included in this...
Introduction: Insulin resistance is an independent risk factor for cardiovascular disease. We hav... more Introduction: Insulin resistance is an independent risk factor for cardiovascular disease. We have previously shown that the insulin-like growth factor-1 receptor (IGF-1R) is a negative regulator o...
Journal of Ayub Medical College, Abbottabad : JAMC, 2020
BACKGROUND Early detection of sepsis in the emergency department is of prime importance and requi... more BACKGROUND Early detection of sepsis in the emergency department is of prime importance and requires tools that are time and cost-effective. The Systemic Inflammatory Response Syndrome (SIRS) has been poorly associated with sepsis. Timothy et al in a retrospective analysis of Emergency Department (ED) visit stated estimate of SIRS at 17.8% accounting to an annual yield of 16.6 million adult visits with SIRS per year, among these only 26% accounted as an infectious aetiology of SIRS, trauma being 10% and other causes being rare. Shock index is found to be independently associated with 30-day mortality in a broad population of ED patients including sepsis. With limited health resources in a low to middle income country, focused utilization is important and so is the need for markers that are non-invasive, readily available, cost effective, and easy to interpret. Shock index can serve this purpose as a surrogate marker of disease severity in patients with severe sepsis and thus resulti...
Fall armyworm is a sporadic pest and feed on almost 80 plant species. It is native to America but... more Fall armyworm is a sporadic pest and feed on almost 80 plant species. It is native to America but due to its strong flying abilities it has spread to Africa and now it has been reported in most of the Asian countries. In the present study presence of fall armyworm was observed in Faisalabad, Pakistan. At the end of Oct. and November larval collection from a maize field were examined in laboratory following dichotomous key of Passoa 1991. Larvae were also reared to adults. After examination it was identified that larvae and adults were Spodoptera frugiperda. And this is the first confirmed report that shows the presence of Spodoptera frugiperda in Faisalabad, Pakistan.
The thriving adoption of drones for delivering parcels, packages, medicines, etc., is surging wit... more The thriving adoption of drones for delivering parcels, packages, medicines, etc., is surging with time. The application of drones for delivery services results in faster delivery, fuel-saving, and less energy consumption. Giant companies like Google, Amazon, Facebook, etc., are actively working on developing, testing, and improving drone-based delivery systems. So far, a lot of work has been done for improving the design, speed, operating range, security of the delivery drones, etc. However, very limited work has been done to ensure a complete and reliable last-mile delivery from the merchant’s store to the hands of the actual customer. To ensure a complete and reliable last-mile delivery, a drone must authenticate the consumer before dropping the package. Therefore, in this work, we propose a consumer authentication (Consumer-Auth) hybrid computing framework for drone delivery as a service to make sure that the parcel is perfectly delivered to the intended customer. The proposed C...
International Journal of Communication Systems, 2021
SummaryThe handoff process in WiFi networks has a very important role to provide continuity of th... more SummaryThe handoff process in WiFi networks has a very important role to provide continuity of the service to wireless users where the access points (APs) are in numerous numbers. In traditional WiFi networks, the handoff process takes a few seconds and is initiated by the wireless devices, but these few seconds could be a reason for information loss when dealing with delay sensitive applications. In this paper, we propose a reduced detection and discovery time approach (DeRy), which generates a solution based on software defined WiFi networks (SD‐WiFi). A simple network management protocol (SNMP) manager and received signal strength indicator (RSSI) manager are employed to report the AP traffic conditions and RSSI values to the SDN controller and instead of the wireless devices, the handoff decisions are taken at the controller end. When to initiate the handoff (detection phase) and which destination AP to associate to (discovery phase) are handled by the centralized SDN controller...
BackgroundCardiac resynchronisation therapy (CRT) confers symptomatic and survival benefits in ch... more BackgroundCardiac resynchronisation therapy (CRT) confers symptomatic and survival benefits in chronic heart failure with reduced ejection fraction (HFrEF). There remains a paucity of data on long‐term performance of left ventricular (LV) leads, particularly with newer quadripolar lead designs.MethodsThis single‐centre study utilised an electronic, outpatient HFrEF database to identify CRT recipients (2008‐2014). The primary endpoint was temporal trend in LV pacing thresholds during follow‐up. Secondary outcomes were complications relating to acute or chronic lead failure and device‐related infections.ResultsTwo hundred eighty patients were included, with mean (±SD) age of 74.2 years (±9.0) and median follow‐up of 7.6 years (interquartile range 4‐9). Mean LV threshold was 1.37 V (±0.73) at implant and remained stable over the study period. No differences were observed based upon lead manufacturer. Compared to non‐quadripolar leads (n = 216), those of quadripolar designs (n = 64) had...
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Papers by Noman Ali