Shazad Q Ashraf

Verified

Shazad verified their affiliation via an institutional email.

Learn more

Verified

Shazad verified their affiliation via an institutional email.

Learn more

• DPhil, FRCS
• Consultant colorectal surgeon at Queen Elizabeth Hospital Birmingham

The surge in medical waste has highlighted the urgent need for cost-effective and advanced management solutions. In this paper, a novel medical waste management approach, “MedBin,” is proposed for automated sorting, reusing, and recycling. A comprehensive medical waste dataset, ”MedBin-Dataset“ is established, comprising 2,119 original images spann...

Recent advancements in machine learning (ML) and deep learning (DL), particularly through the introduction of foundational models (FMs), have significantly enhanced surgical scene understanding within minimally invasive surgery (MIS). This paper surveys the integration of state-of-the-art ML and DL technologies, including Convolutional Neural Netwo...

Indexing endoscopic surgical videos is vital in surgical data science, forming the basis for systematic retrospective analysis and clinical performance evaluation. Despite its significance, current video analytics rely on manual indexing, a time-consuming process. Advances in computer vision, particularly deep learning, offer automation potential,...

Assuring the safety, fairness, robustness, and trustworthiness of Machine Learning (ML) models is essential as they become increasingly integrated into healthcare technologies. However, the black-box nature of these models makes them inherently error-prone and poses significant risks to patient health if not properly vetted. Traditional software as...

The recent release of ChatGPT has rapidly gained popularity and become one of the world’s fastest-growing applications. ChatGPT has the potential to have a significant impact on the research community and the public by revolutionising the way we perform tasks such writing articles and making decisions. ChatGPT is known for its human-like interactio...

Background Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. Methods A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colore...

Chest radiography has been a recommended procedure for patient triaging and resource management in intensive care units (ICUs) throughout the COVID-19 pandemic. The machine learning efforts to augment this workflow have been long challenged due to deficiencies in reporting, model evaluation, and failure mode analysis. To address some of those short...

Colorectal cancer is the third most common cancer, and surgery is the most common treatment. Several surgical options are available, but each is associated with a range of potential complications. The timely and efficient identification of these complications is vital for effective clinical management of these patients in order to minimise their mo...

Aim The COVID19 pandemic has accelerated the need for staff to work remotely. Our aim was to demonstrate how a next-generation digital platform could be used to create a virtual MDT ecosystem in order to manipulate holographic 2D and 3D images in real-time. Method This study involved setting up a mock virtual MDT using de-identified DICOM files fr...

Background Circular staplers perform a critical function for creation of anastomoses in colorectal surgeries. Powered stapling systems allow for reduced force required by surgeons to fire the device and may provide advantages for creating a secure anastomosis. The objective of this study was to evaluate the clinical performance of a novel circular...

Background An advanced bipolar (ABP) tissue sealer designed for division of major vessels in open procedures was evaluated in a prospective post-market study. The objective was to provide clinical data for assessment of vessel transection, hemostatic performance and ease of use of the ABP device during open colectomy, gynecologic, and thoracic oper...

Colonic diverticula are herniations of mucosa through the bowel musculature. They are seen most often in the sigmoid and descending colon, with a prevalence of up to 65% in people over the age of 80 in European populations. They are uncommon in African and Asian countries, where the prevalence is only 0.2%. A lifelong diet deficient in dietary fibr...

Background: Closure of an abdominal stoma, a common elective operation, is associated with frequent complications; one of the commonest and impactful is incisional hernia formation. We aimed to investigate whether biological mesh (collagen tissue matrix) can safely reduce the incidence of incisional hernias at the stoma closure site. Methods: In...

Objective: To identify risk factors for urethral and urologic injuries during transanal total mesorectal excision (taTME) and evaluate outcomes. Background: Urethral injury is a rare complication of abdominoperineal resection (APR) that has not been reported during abdominal proctectomy. The Low Rectal Cancer Development Program international ta...

The evolutionary events that cause colorectal adenomas (benign) to progress to carcinomas (malignant) remain largely undetermined. Using multi-region genome and exome sequencing of 24 benign and malignant colorectal tumours, we investigate the evolutionary fitness landscape occupied by these neoplasms. Unlike carcinomas, advanced adenomas frequentl...

The evolutionary events that cause colorectal adenomas (benign) to progress to carcinomas (malignant) remain largely undetermined. Using multi-region genome and exome sequencing of 24 benign and malignant colorectal tumours, we investigate the evolutionary fitness landscape occupied by these neoplasms. Unlike carcinomas, advanced adenomas frequentl...

This chapter discusses the case of a 67-year-old gentleman with a 3-month history of a change in bowel habit. On digital rectal examination, there was an easily palpable soft mass in the low rectum. A colonoscopy revealed an extensive near circumferential rectal polyp. The bulk of the lesion made assessment difficult and precluded endoscopic remova...

Aim: Extralevator abdominoperineal excision (ELAPE) has been advocated to optimize clearance of lower third rectal cancers with an involved or threatened circumferential resection margin. ELAPE could reduce positive margins and specimen perforation compared with standard APE. ELAPE can, however, be difficult particularly in identifying the anterio...

The new approach of transanal TME is technically challenging and demands a stable field of dissection with optimal view of anatomical landmarks. We aimed to describe and demonstrate a modification of both the insufflation of carbon dioxide and smoke evacuation, in order to optimize dissection. The comparison of standard insufflation to an AirSeal p...

Transanal endoscopic microsurgery (TEM) enables organ-preservation after rectal tumour surgery. Its application is being expanded using adjuvant and neo-adjuvant treatments. Our object was to evaluate the changes over time in anorectal function, urinary symptoms and quality of life (QOL) in patients who had TEM surgery for a rectal tumour. Between...

Drugs that inhibit IGF-1 receptor IGF-1R were encouraging in early trials, but predictive biomarkers were lacking and the drugs provided insufficient benefit in unselected patients. In this study, we used genetic screening and downstream validation to identify the WNT pathway element DVL3 as a mediator of resistance to IGF-1R inhibition. Sensitivit...

The use of biological therapy (biologicals) is established in the treatment of Crohn's disease. This study aimed to determine whether preoperative treatment with biologicals is associated with an increased rate of complications following surgery for Crohn's disease with intestinal anastomosis. All patients receiving biologicals and undergoing abdom...

491 Background: Nelfinavir, an inhibitor of AKT in the PI3-kinase pathway, is a radiosensitizer which increases tumor blood flow and reduces hypoxia in preclinical models. We conducted a pilot study of nelfinavir before and during hypofractionated pelvic radiotherapy (RT) in patients with rectal cancer to evaluate the safety of the combination, cha...

ECCO

Our aim was to determine the frequency and economic impact of anastomotic leakage (AL) at local and national levels in England. All patients who underwent AR in Oxford between 2007 and 2009 were evaluated for AL. Hospital Episode Statistics (HES) data were used to determine reoperation rates after elective AR (n = 23 388) in England between 2000 an...

A significant proportion of colorectal cancer (CRC) patients are resistant to anti-ERBB1 [avian erythroblastic leukemia viral (v-erb-b) oncogene homolog, receptor for EGF] monoclonal antibodies (Mabs). We evaluated both immune and nonimmune effects of cetuximab (anti-ERBB1 Mab), trastuzumab (anti-ERBB2 Mab), pertuzumab (anti-ERBB2 Mab), and lapatin...

Introduction: Effective post-operative pain management can positively influence patient outcome. Multimodal analgesic regimes are often limited by side-effects. Epidural analgesia may be resource-consuming, restrict mobility and have negative cardiovascular and gastrointestinal consequences. Consequently, there is a need for regional anaesthetic t...

Transanal endoscopic microsurgery (TEM) for early rectal cancer (ERC) gives results similar to major surgery in selected cases. Endorectal ultrasound (ERUS) is an important part of the preoperative selection process. This study reports its accuracy and impact for patients entered on the UK TEM database. The UK TEM database comprises prospectively c...

Colonic diverticula are herniations of mucosa through the bowel musculature. They are seen most often in the sigmoid and descending colon, with a prevalence of up to 65% over the age of 80 in European populations, but they are uncommon in African and Asian countries, where the prevalence is 0.2%. A lifelong diet deficient in dietary fibre is associ...

The Oxford Textbook of Medicine is the foremost international textbook of medicine. Unrivalled in its coverage of the scientific aspects and clinical practice of internal medicine and its subspecialties, it is a fixture in the offices and wards of physicians around the world.

The effect of glycoengineering a membrane specific anti-carcinoembryonic antigen (CEA) (this paper uses the original term CEA for the formally designated CEACAM5) antibody (PR1A3) on its ability to enhance killing of colorectal cancer (CRC) cell lines by human immune effector cells was assessed. In vivo efficacy of the antibody was also tested. The...

We have developed an automated, highly sensitive and specific method for identifying and enumerating circulating tumour cells (CTCs) in the blood. Blood samples from 10 prostate, 25 colorectal and 4 ovarian cancer patients were analysed. Eleven healthy donors and seven men with elevated serum prostate-specific antigen (PSA) levels but no evidence o...

The BJC is owned by Cancer Research UK, a charity dedicated to understanding the causes, prevention and treatment of cancer and to making sure that the best new treatments reach patients in the clinic as quickly as possible. The journal reflects these aims. It was founded more than fifty years ago and, from the start, its far-sighted mission was to...

The distribution of carcinoembryonic antigen (CEA) in colorectal cancer (CRC) differs from that in normal colorectal tissue, being found on all borders of the cell membrane and hence enabling access to intravenous antibody, making CEA a good target for antibody-based therapy. The distinctive anti-CEA antibody, PR1A3, binds only membrane-bound CEA....

The creation of a join between two bowel ends is an operative procedure that is of central importance in the practice of a general surgeon. Leakage from an intestinal anastomosis can be disastrous, resulting in prolonged hospital stays and increased risk of mortality. To minimize the risk of potential complications, it is important to create a tens...

There is considerable debate as to whether vascular surgery should be a subspecialty separate from general surgery. This study examines the changing relationship between general and vascular surgery in a district general surgical unit over 16 years. A detailed survey of referrals, admissions and operations to one unit was carried out over 3 months...

Laparostomy is the process by which the abdomen is left open. There are multiple indications which include gross sepsis and abdominal compartment syndrome. In these cases, closure of the abdomen would be detrimental. This is due to the cascade of events secondary to sepsis or critical pressure. The creation of laparostomy has obvious impact on hosp...

The Banff classification of renal allograft rejection grades acute tubulointerstitial rejection (AIR) by severity of tubulitis and acute vascular rejection (AVR) by severity of arteritis. The intensity of tubulitis has not, however, been demonstrated to be of prognostic value and other features such as glomerulitis and eosinophil infiltration are o...

The proinflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of acute rejection, while animal models suggest a role for interleukin-10 (IL-10) in promoting graft survival. It has also been shown that polymorphisms in the TNFA gene promoter (position -308) and in the IL-10 gene promoter (position -1082...

The association between acute cellular rejection (ACR) and the development of chronic rejection has been the subject of much debate. Studies have suggested that the two phenomena may be linked, or, conversely that there may be no association at all. In order to clarify this relationship the outcome of 284 renal allografts were examined. The transpl...