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Biomedical subjects

A A Allam

Publications and source records attributed to A A Allam.

8 recordsLinked to original sources
PubMed1999

Stevens-Johnson syndrome in patients on phenytoin and cranial radiotherapy.

The use of phenytoin as a prophylactic anticonvulsant after brain surgery, particularly for brain tumors, is a common practice, regardless of whether the patient has a previous history of convulsions. This treatment policy assumes that the benefits exceed the risks. Four cases are described of adverse reactions to phenytoin during the concomitant use of cranial radiotherapy. In one patient this proved fatal. There is increasing anecdotal support in the literature for a synergistic effect between phenytoin therapy and cranial radiotherapy that can result in the life-threatening Stevens-Johnson syndrome. While the association is uncommon, four cases within 24 months in one department suggest that the routine use of postoperative phenytoin as a prophylactic anticonvulsant in the absence of a history of seizures may not be warranted, particularly if the patient is to receive cranial radiotherapy.

Adult↗
PubMed1992

Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS.

Purulent bronchitis was identified in 19 of 422 patients undergoing fiberoptic bronchoscopy during a 32-month period because of suspicion of an opportunistic lung infection complicating acquired immunodeficiency syndrome or human immunodeficiency virus infection. Five patients had Pneumocystis carinii pneumonia, but other opportunistic lung infections were excluded in the remaining 14 patients. Characteristics of these 14 patients included fever (greater than 38.3 degrees C), cough, and dyspnea in 14 of 14 patients; purulence of expectorated sputum (11/14); and widened alveolar-arterial oxygen gradient (13/14). Rapid (2 +/- 1.4 days) clinical response (defervescence and resolution of pulmonary symptoms) occurred with antibiotic therapy in 10 of 14 patients. In three patients, there was no improvement, and adult respiratory distress syndrome developed. Bacterial isolates from bronchoalveolar lavage included Streptococcus viridans (n = 12), Haemophilus influenzae (n = 7), Staphylococcus aureus (n = 3). Roentgenographic features of bronchiectasis were present in seven patients. Differential cell counts revealed greater than 50% neutrophils in the bronchial washings of all patients with purulent bronchitis. Neutrophil percentages in bronchoalveolar lavage were as follows: patient with purulent bronchitis without P carinii pneumonia (n = 14), 54.53% +/- 29.18%; patients with purulent bronchitis and concomitant P carinii pneumonia (n = 5), 62% +/- 31.9%. In a control group of 17 patients with P carinii pneumonia who did not have purulent bronchitis, the neutrophil percentage was 6.8% +/- 6.17% (p = less than 0.00001, t-test). Purulent bronchitis appears to be a distinct, treatable entity in patients with HIV infection and may accompany bacterial pneumonia, bronchiectasis, and P carinii pneumonia.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Pneumocystis carinii pneumonia in patients with AIDS: evaluation of lavage and staining techniques in diagnosis.

The diagnostic yield of unilateral vs. bilateral bronchoalveolar lavage (BAL) was prospectively evaluated in 65 consecutive patients suspected of having Pneumocystis carinii pneumonia (PCP) complicating acquired immune deficiency syndrome (AIDS). Gram-Weigert (GW), Papanicolaou (PAP), and Gomori's methenamine silver (GMS) stains were used for identification of P. carinii in all cases. Forty-eight patients had PCP that was identified by GW staining of BAL in 47/48 patients followed by PAP/GMS staining of BAL in 44/48 patients and PAP/GMS staining of bronchial washings in 40/48 patients. In patients with bilateral interstitial infiltrates, unilateral lavage was sufficient for diagnosis of PCP when GW stain was utilized. In patients with PCP complicating AIDS, the diagnostic yield of BAL may be increased by use of both GW and GMS stains.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pulmonary non-Hodgkin's lymphoma mimicking infection.

Progressive pulmonary shadows prompted investigations which provided the diagnosis of pulmonary non-Hodgkin's lymphoma in three patients (two with the acquired immunodeficiency syndrome). Rapid progression of radiographic abnormalities seen in these three patients is unusual for pulmonary non-Hodgkin's lymphoma and mimics disease evolution commonly associated with pulmonary infections.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Pregnancy hepatitis in Libya.

The death-rate from hepatitis in pregnant women in Libya is high. Of 922 hepatitis patients treated during 1975, 377 were males and 545 were females. The case fatality-rate was 0.53% for males and 7-67% for females. In 293 pregnant women it was 12-97% compared with 1-6% in 252 non-pregnant women. In pregnant women deaths occurred mainly in the last trimester. Although 18-4% of the male patients and 15-2% of the women were hepatitis B surface antigen (HBsAg) positive, no patient shown to be antigen-positive died. The frequency of hepatitis in the second half of the year fell both in pregnant women and in the general population, suggesting a warning hepatitis-A epidemic. The exact cause of the high mortality in pregnant women is not clear, but it may have a nutritional basis.

Adolescent↗
PubMed1966

The epidemiology of Schistosoma haematobium and S. mansoni infections in the Egypt-49 project area. 2. Prevalence of bilharziasis in relation to personal attributes and habits.

The over-all uncorrected prevalence rates of bilharziasis determined in this survey were-Control Division, 59.5%; Rural and Reclamation Divisions, 35.9%; Urban Division, 21.0%. There are significant differences in rates of infection between sections within a division, between adjacent villages and even between different parts of one village. Prevalence increases rapidly with age up to about the age of 14 years, declines somewhat up to the age of 40 years and then remains fairly constant at a rate of about 30%; the age-group 0-8 years should provide the most sensitive group for the assessment of control measures. S. mansoni infection is acquired more slowly than S. haematobium infection during childhood and is more persistent among adults.Except for the youngest age-group, bilharziasis rates are higher in males than in females, but more detailed analysis shows that this is true only for farmers and farm labourers and for those who swim. In respect of occupational categories, farmers and farm labourers, with prevalence rates of 50.6% and 41.6%, respectivelx, bear the brunt of the infection, since they constitute 48% of the population, although fishermen (60.4%) and boatmen (52.0%) have higher infection rates.Differences in bilharziasis rates can also be related to differences in religion, educational attainment and domestic habits (swimming, washing clothes, utensils and cattle) according to the opportunity provided for contact with polluted water. Swimming, because of the thorough exposure to possible schistosome infection that it provides, is one of the most important activities involved in the transmission of bilharziasis.

Adolescent↗
PubMed1966

The epidemiology of Schistosoma haematobium and S. mansoni infections in the Egypt-49 project area. 3. Prevalence of bilharziasis in relation to certain environmental factors.

The influence of the size and location of communities in relation to the different types of watercourse, the availability of a protected water supply, types of housing and the presence of other sanitary facilities on the prevalence of bilharziasis in the Egypt-49 project area has been studied. There is no direct relationship between the size of village and the prevalence of bilharziasis. Main drains and distributaries are potent sources of infection and, in terms of the total population exposed, distributaries play the most significant role in the transmission of infection. Of the other factors, the availability of a protected water supply seems to have the greatest effect on the prevalence. Although the presence of a latrine in the dwelling does not of itself influence the extent of schistosome infection, which is caught from polluted water, the installation of latrines assists in the cultivation of healthy habits, thereby lessening the prevalence not only of bilharziasis but also of certain other infections.

Adolescent↗