Shariq Mansoor Khan

Bio: Shariq Mansoor Khan is an academic researcher from Washington University in St. Louis. The author has contributed to research in topics: Acetylcysteine & Acetaminophen. The author has an hindex of 1, co-authored 3 publications receiving 3 citations.

Psychedelics for Brain Injury: A Mini-Review

Abstract: Objective: Brain injury due to stroke and traumatic brain injury (TBI) is one of the leading causes of disability. Even after engaging in an appropriate rehabilitation program, nearly half of patients with severe traumatic brain injury requiring hospitalization will be left with chronic severe disability. Despite decades of investigation, pharmacologic treatment of brain injury is still a field in its infancy, suffering from a lack of consistently proven drug regimens. Recent clinical trials have begun into the use of psychedelic therapeutics for treatment of brain injury. This brief review aims to summarize the current state of the science’s relevance to neurorehabilitation. Methods: Scoping review of all studies published related to psychedelic therapeutics and brain injury. Results: Recent in vitro, in vivo, and case report studies suggest psychedelic pharmacotherapies may radically alter the future of brain injury treatment through modulation of neuroinflammation, neuroplasticity, hippocampal neurogenesis, and brain complexity. Conclusions: Historical data on the safety of these substances could serve in effect as phase 0 and phase I studies. N,N-Dimethyltryptamine is currently undergoing clinical trials for treatment of stroke. Further phase II trials will illuminate how these promising drugs may treat brain injury, particularly TBI and reperfusion injury from stroke.

Adverse reactions in patients treated with the one-bag method of N-acetylcysteine for acetaminophen ingestion

Abstract: Acetaminophen (paracetamol) remains the leading pharmaceutical agent in overdoses in North America. The three-bag Prescott protocol for intravenous (IV) acetylcysteine is complex and prone to error...

Qualifications and characteristics North American dental deans seek in department chairpersons

Abstract: The aim of this study was to determine whether deans of North American dental schools perceived that one category of department chairperson skills (leadership or management) was more important than the other for their chairpersons to be successful. A secondary purpose was to determine the professional qualifications and personal characteristics these deans perceived contributed most to the success of department chairpersons and whether those differed by the research emphasis of the school. An email survey was sent in 2016 to all 75 deans of U.S. and Canadian dental schools with graduating classes. Section one of the survey was an open response section asking deans to list the five most essential characteristics of a successful department chairperson. Section two asked deans to rank the importance of eight listed professional qualifications, and the last section asked deans to rate the importance of four leadership and four management traits that could contribute to the success of their chairpersons. Questions about characteristics of the deans and the schools were also included. A response rate of 46.7% was obtained. The most frequent characteristics listed in the open response section were in the categories of vision, academic expertise, and integrity. The three most highly ranked professional qualifications were previous teaching experience, previous administrative experience, and history of external research funding. Four of the eight professional qualifications were ranked differently by deans of high compared to moderate research-intensive schools (p<0.05). Overall, the respondents rated leadership skills more highly than management skills (p=0.002) as important for departmental chairpersons.

N-acetylcysteine for acetaminophen toxicity: The one-bag regimen

Abstract: We read with interest the recent commentary by Isbister and Chiew reviewing recent developments in the use of N-acetylcysteine (NAC) for the treatment of acetaminophen (APAP) toxicity. While we appreciate the authors' clear and succinct review of this exciting field, they omitted discussion of an important alternative NAC regimen that deserves readers' attention. We have used a one-bag NAC regimen for almost two decades. Unlike the standard FDA-approved three-bag regimen and some of the alternative regimens discussed in the editorial, our regimen uses a single standardized concentration of NAC for all patients (30 g of NAC in 1 L of 5% dextrose in water). We administer an initial bolus of 150 mg/kg NAC over 1 hour from this bag. After the bolus is complete, we make a single rate change to an infusion of 12.5 mg/kg/h (from the same bag), which continues until the patient meets clinical and laboratory criteria for cessation of antidotal therapy. This regimen has several advantages. First, the use of a single standardized concentration of NAC (as opposed to patient-specific concentrations in the three-bag and two-bag approaches) standardizes, simplifies and speeds antidote preparation. This reduces dosing and preparation errors, which are common under the three-bag approach. Second, the use of a single bag eliminates the need to order and await delivery of additional bags of NAC, which can lead to significant interruptions in antidotal therapy. Third, the elimination of multiple rate changes simplifies nursing workflow and decreases the risk of administration errors. Finally, we use programmable smart pumps (BD Alaris, Benton, Dickinson & Co., Franklin Lakes, NJ, USA) set with this standard concentration. These pumps automatically change the rate from the bolus to the infusion to eliminate another potential delay or error in administration. This regimen delivers slightly more NAC than the standard threebag approach (assuming 21 hours of therapy, a total dose of 400 mg/kg as opposed to 300 mg/kg). Isbister and Chiew note in their commentary that doubling the dose of the second infusion bag in the two-bag regimen to produce a total dose of 400 mg/kg may be helpful in large APAP overdoses; our regimen essentially “builds in” this added safety factor. It also ensures that the infusion does not run out immediately after the completion of the standard 21-hour course, which is essential to prevent interruptions in therapy in cases requiring prolonged treatment with NAC. This regimen is effective and well tolerated with very infrequent interruptions in therapy and a lower error rate than the standard three-bag protocol. Repeated studies of this regimen have demonstrated safety, with a low rate of minor adverse events. It is also in use at multiple other academic medical centres in the United States and three regional poison control centres in Canada. We believe that the one-bag regimen deserves further rigorous study and widespread adoption in clinical practice. Discussion of this regimen would have enhanced Isbister and Chiew's already excellent commentary.

A review of alternative intravenous acetylcysteine regimens for acetaminophen overdose.

Abstract: Introduction Acetylcysteine is the standard treatment for preventing hepatotoxicity caused by acetaminophen overdose. Several novel approaches to the management of acetaminophen overdose have been suggested to improve patient safety by reducing adverse drug reactions and dosing errors. This article reviews these alternative treatment regimens and intends to offer a detailed assessment of the available options to assist providers in managing cases of acetaminophen overdose. Areas covered This review article covers observational and experimental studies that assessed the efficacy and safety of alternative intravenous acetylcysteine regimens for acetaminophen overdose. A literature search was conducted using PubMed, ProQuest, and Scopus to identify the studies, which included results through April 2021. The assessment of alternative regimens consists of a discussion on the limitations and benefits, barriers to implementation, and important considerations for each regimen. Expert opinion Several alternative regimens have been studied and implemented in various institutions. Many of these dosing regimens have supporting safety data but most lack robust data. A reduction in infusion-related side effects is an important outcome, but established efficacy, local poison center familiarity with the regimen, institutional resources, and patient-specific factors should be equally considered when deciding on implementing and using an alternative dosing strategy.

Nano-Neurogenesis for CNS Diseases and Disorders

Abstract: Neurogenesis encompasses the formation and development of neurons in the mammalian brain, mainly occurring in hippocampus and the olfactory system. This process is rapid, accurate, and very sensitive to the external stressors including environment, diet, age, anxiety, stress, depression, diet, and hormones. The range of stressors is big and directly impacts the generation, maturation and migration, efficacy, and myelination of the neuronal cells. The field of regenerative medicine focuses on combating the direct or indirect effects of these stressors on the process of neurogenesis, and ensures increased general and neuronal communications and functioning. Understanding the deep secrets of brain signaling and devising ways to increase drug availability is tough, considering the complexity and intricate details of the neuronal networks and signaling in the CNS. It is imperative to understand this complexity and introduce potent and efficacious ways to combat diseases. This perspective offers an insight into how neurogenesis could be aided by nanotechnology and what plausible nanomaterials are available to culminate neurogenesis-related neurological disorders. The nanomaterials are promising as they are minute, robust, and effective and help in diagnostics and therapeutics such as drug delivery, maturation and neuroprotection, neurogenesis, imaging, and neurosurgery.

Contrast-induced acute kidney injury and its contemporary prevention

Abstract: The complexity and application range of interventional and diagnostic procedures using contrast media (CM) have recently increased. This allows more patients to undergo procedures that involve CM administration. However, the intrinsic CM toxicity leads to the risk of contrast-induced acute kidney injury (CI-AKI). At present, effective therapy of CI-AKI is rather limited. Effective prevention of CI-AKI therefore becomes crucially important. This review presents an in-depth discussion of CI-AKI incidence, pathogenesis, risk prediction, current preventive strategies, and novel treatment possibilities. The review also discusses the difference between CI-AKI incidence following intraarterial and intravenous CM administration. Factors contributing to the development of CI-AKI are considered in conjunction with the mechanism of acute kidney damage. The need for ultimate risk estimation and the prediction of CI-AKI is stressed. Possibilities of CI-AKI prevention is evaluated within the spectrum of existing preventive measures aimed at reducing kidney injury. In particular, the review discusses intravenous hydration regimes and pre-treatment with statins and N-acetylcysteine. The review further focuses on emerging alternative imaging technologies, alternative intravascular diagnostic and interventional procedures, and new methods for intravenous hydration guidance; it discusses the applicability of those techniques in complex procedures and their feasibility in current practise. We put emphasis on contemporary interventional cardiology imaging methods, with a brief discussion of CI-AKI in non-vascular and non-cardiologic imaging and interventional studies.